OBJECTIVE: The Center for Epidemiological Studies Depression Scale (CES-D) is designed to measure the current level of depressive symptomatology in the general population. However, no review has examined whether the scale is reliable and valid among children and adolescents in Korea. The purpose of this study was to test whether the Korean form of the CES-D is valid in adolescents. METHODS: Data were obtained from 1,884 adolescents attending grades 1–3 in Korean middle schools. Reliability was evaluated by internal consistency (Cronbach’s alpha). Concurrent validity was evaluated by a correlation analysis between the CES-D and other scales. Construct validity was evaluated by exploratory factor and confirmatory factor analyses. RESULTS: The internal consistency coefficient for the entire group was 0.88. The CES-D was positively correlated with scales that measure negative psychological constructs, such as the State Anxiety Inventory for Children, the Korean Social Anxiety Scale for Children and Adolescents, and the Reynold Suicidal Ideation Questionnaire, but it was negatively correlated with scales that measure positive psychological constructs, such as the Korean version of the Rosenberg Self-Esteem Scale and the Connor-Davidson Resilience Scale-2. The CES-D was examined by three-dimensional exploratory factor analysis, and the three-factor structure of the scale explained 53.165% of the total variance. The variance explained by factor I was 24.836%, that explained by factor II was 15.988%, and that explained by factor III was 12.341%. The construct validity of the CES-D was tested by confirmatory factor analysis, and we applied the entire group’s data using a three-factor hierarchical model. The fit index showed a level similar to those of other countries’ adolescent samples. CONCLUSION: The CES-D has high internal consistency and addresses psychological constructs similar to those addressed by other scales. The CES-D showed a three-factor structure in an exploratory factor analysis. The present findings suggest that the CES-D is a useful and reliable tool for measuring depression in Korean adolescents.
Adolescent Psychiatry ; Adolescent ; Anxiety ; Child ; Depression ; Epidemiologic Studies ; Fibrinogen ; Humans ; Korea ; Prothrombin ; Psychometrics ; Suicidal Ideation ; Thromboplastin ; Weights and Measures

Laryngeal leukoplakia is seen in a number of pathologic settings such as keratosis without atypia(KWOA), keratosis with atypia(KWA), squamous cell carcinoma in situ(CIS) and invasive squamous cell carcinoma, and it continues to be a confusing and controversial topic for both otolaryngologist and pathologist. This is largely due to the use of ambiguous and inconsistent terminology, the lack of unanimous agreement on the definition of these terms, failure of the clinician to obtain a representative biopsy, and the subjectivity of the pathologist interpreting the biopsy. To evaluate the applicability of the expression pattern of p53 and PCNA in borderline cases of histopathologic classification, we performed a histopathologic analysis of leukoplakia to includ clinical follow-up, correlation of disease progression and degree of atypia, and expression of p53 and PCNA according to the degree of atypia. Histologically, laryngeal leukoplakia included seven cases of KWOA, fourteen cases of KWA (mild-2, moderate-8, severe-4), three cases of CIS, and one case of invasive squamous cell carcinoma. Keratosis with atypia, a moderate degree or more, showed a strong tendency to progress to invasive carcinoma(p<0.05). The degree of p53 and PCNA expression correlated with the degree of atypia(p<0.05). p53-positive cases at the initial biopsy clearly tended to recur and develop into invasive carcinoma(p<0.01).
Biopsy

BACKGROUND: The aim of this study was to identify causative factors for cerebral white matter changes on MRI and relationship between cerebral white matter changes and cognitive function. METHODS: The patients who were admitted to the Department of Neurology ward or visited to outpatient clinic at the Chungnam National University Hospital from September 1999 to July 2000 were selected. All patients underwent brain MRI with 1.5 T for determination of degree and distribution of cerebral white matter changes. The patients were evaluated their cognitive function with the Mini Mental State Examination (MMSE) and the Modified Mini-Mental State Examination (3MS), which has more extensive and detailed tool for fluency and memory domains of cognition compared with the MMSE. Statistical analyses were performed to identify whether there was difference in causative factors and cognitive status between patients with white matter change and patients without white matter changes. RESULTS: White matter changes were significantly more common in patients with hypertension and women. On correlation analyses, hypertension and aging were significantly related with cerebral white matter changes. General cognitive status in patients with white matter changes were worse than those of patients without white matter changes and of control group. Frontal lobe functions like fluency, attention, and visuo-constructive function were especially affected by white matter changes on the 3MS. CONCLUSIONS: Hypertension, female sex and aging may contribute to the development of cerebral white matter changes. Cerebral white matter changes may be responsible for the general cognitive decline. (J Korean Neurol Assoc 19(5):471~477, 2001)
Aging ; Ambulatory Care Facilities ; Brain ; Chungcheongnam-do ; Cognition ; Female ; Frontal Lobe ; Humans ; Hypertension ; Magnetic Resonance Imaging ; Memory ; Neurology

PURPOSE: A variety of postnatal therapies have been and will be evaluated for prevention or treatment of neonatal chronic lung disease. A simple method for early selection of the highest risk infants would optimize intervention trials. The purpose of this study was to develop an scoring system to predict the bronchopulmonary dysplasia (BPD) in preterm infants. METHODS: A retrospective analysis of clinical, respiratory and radiographic variables of a 2.5-year experience was done with data of preterm infants less than 34 weeks of gestation admitted to Ewha Womans University Hospital from January 1998 to July 2000. RESULTS: Multiple regression analysis identified four independent predictors of BPD; longer duration of assisted ventilation, lower Apgar score at 5 minute, higher PaCO2 at birth, presence of patent ductus arteriosus after 7 days. A clinical predictive scoring system (CPSS) was developed with these four predictors. CONCLUSION: We have come up with a CPSS for early identification of preterm infants with high risk of BPD. A prospective study is on going to evaluate the predictivity of this scoring system.
Apgar Score ; Bronchopulmonary Dysplasia* ; Ductus Arteriosus, Patent ; Female ; Gestational Age* ; Humans ; Infant ; Infant, Newborn ; Infant, Premature* ; Lung Diseases ; Parturition ; Pregnancy ; Retrospective Studies ; Ventilation

PURPOSE: A variety of postnatal therapies have been and will be evaluated for prevention or treatment of neonatal chronic lung disease. A simple method for early selection of the highest risk infants would optimize intervention trials. The purpose of this study was to develop an scoring system to predict the bronchopulmonary dysplasia (BPD) in preterm infants. METHODS: A retrospective analysis of clinical, respiratory and radiographic variables of a 2.5-year experience was done with data of preterm infants less than 34 weeks of gestation admitted to Ewha Womans University Hospital from January 1998 to July 2000. RESULTS: Multiple regression analysis identified four independent predictors of BPD; longer duration of assisted ventilation, lower Apgar score at 5 minute, higher PaCO2 at birth, presence of patent ductus arteriosus after 7 days. A clinical predictive scoring system (CPSS) was developed with these four predictors. CONCLUSION: We have come up with a CPSS for early identification of preterm infants with high risk of BPD. A prospective study is on going to evaluate the predictivity of this scoring system.
Apgar Score ; Bronchopulmonary Dysplasia* ; Ductus Arteriosus, Patent ; Female ; Gestational Age* ; Humans ; Infant ; Infant, Newborn ; Infant, Premature* ; Lung Diseases ; Parturition ; Pregnancy ; Retrospective Studies ; Ventilation

No abstract available in English.
Adenocarcinoma, Bronchiolo-Alveolar* ; Pathology*

Prader-Willi syndrome (PWS), which is considered the most common genetic form of obesity, results from the absence of imprinted genes in the paternally derived PWS critical region located on chromosome 15q11.2−13. Infants with PWS exhibit poor sucking, neonatal hypotonia, and delayed motor milestones. These patients begin to experience hyperphagia and obesity from 2 to 3 years of age. PWS is a multisystemic disorder, and its clinical manifestations include developmental delay/ intellectual disability, behavioral problems, dysmorphic facial features, short stature, scoliosis, and endocrine abnormalities such as hypogonadism, growth hormone deficiency, hypothyroidism, and central adrenal insufficiency. Although the underlying mechanism of hyperphagia is not completely understood, hypothalamic and endocrine dysregulation is believed to be responsible for the lack of satiety and abnormal food-seeking behaviors that lead to severe obesity. The management of PWS requires a multidisciplinary team approach. Early diagnosis and comprehensive early intervention are essential to prevent the development of obesity-related morbidities, including metabolic syndrome, diabetes mellitus, obstructive sleep apnea, respiratory failure, pulmonary hypertension, and cardiovascular complications. Although several clinical trials have been conducted on the pharmacologic treatment of obesity in PWS, no drugs have demonstrated a consistently beneficial effect to date. Nevertheless, ongoing research efforts should be directed toward understanding the mechanism of the unique obesity phenotype of PWS and developing pharmacological therapies.

PURPOSE:Transient desaturation in fullterms related to feeding may be ignored. But those who are presenting significant cyanosis during feeding without any underlying disease, esophagogastric or laryngopharyngeal reflux must be regarded. The goal of this study was to investigate the incidence of reflux diseases in those newborns using esophagography. METHODS:157 newborn infants showing cyanosis during feeding were collected among 705 neonates born after 37 weeks of festation from July 2003 to June 2005. Excluding infants with other underlying diseases, 40 newborns were studied for reflux diseases by esophagography. RESULTS:117 (74.5%) infants had underlying diseases among 157 presenting cyanosis. The other 40 (25.5%) cases had decrease in oxygen saturation during and after feeding, which were spontaneously restored after ceasation of feeding. The mean gestational age and weight of the 40 newborns (composed of 21 boys and 19 girls) were 38.9+/-1.42 wks and 3.3+/-0.59 kg. Imaging study was done at 9.5th day of life in average. The level of desaturation was 79.4+/-9.1%. From 31 (77.5%) patient who showed reflux in esophagograhy, 21 patients had laryngopharyngeal reflux, 16 cases showed major degree GERD, 8 of which had GERD minor degree. Omeprazole was prescribed to the patients with major degree of GERD and the others were educated only (feeding position & feeding skills) which lead to improvement of symptom. CONCLUSION:We concluded that the esophagography is a valuable tool in evaluation of full tern infants with desaturation during feeding.
Animals ; Charadriiformes ; Cyanosis ; Gastroesophageal Reflux ; Gestational Age ; Humans ; Incidence ; Infant* ; Infant, Newborn ; Laryngopharyngeal Reflux ; Omeprazole ; Oxygen*

We reviewed 93 cases of fine needle aspiration of skin\subcutaneous and soft tissue lesions with histologic confirmation. On the basis of the most prominent cytologic features, morphologic classification of the aspirates was done. Neoplastic lesions of soft tissue were categorized as ; round cell, spindle cell, polygonal cell, well-differentiated and myxoid tumor. This classification is convenient to recognize and categorize most soft tissue tumors.
Biopsy, Fine-Needle ; Classification ; Skin

PURPOSE: This study aimed to identify factors affecting cognitive function in stomach cancer patients. METHODS: This was a cross-sectional study designed to obtain data from stomach cancer patients. The Global Assessment of Recent Stress, Hospital Anxiety-Depression Scale, Distress Thermometer, Korean version of the Montreal Cognitive Assessment, and electronic medical records were used to assess stress, anxiety, depression, psychological distress, and cognitive function, respectively. RESULTS: Among 182 total participants, there were statistically significant differences in sex between the group of patients who received chemotherapy and those who did not (χ2=5.32, p=.029). There were statistically significant differences in stress and cognitive function between the two groups. The factors affecting cognitive function in stomach cancer patients included distress, stress, anxiety, and depression. CONCLUSION: Cognitive function should be examined with consideration of the psychological distress, stress, anxiety, and depression in patients with stomach cancer. Moreover, an improved program to manage cognitive function is needed, which includes mediation between psychological and physiological factors including stress, anxiety, and cognitive level.
Anxiety ; Cognition* ; Cross-Sectional Studies ; Depression ; Drug Therapy ; Electronic Health Records ; Humans ; Negotiating ; Stomach Neoplasms* ; Stomach* ; Stress, Psychological ; Thermometers