Purpose: This study aimed to identify the effect of self-esteem and spouse support on prenatal depression. Methods: The subjects were 131 pregnant women who visited two women clinics located in Changwon City. Data were collected from September 25 to November 20, 2019, and the self-report questionnaire included spouse support, self-esteem, and prenatal depression. The collected data were analyzed by IBM SPSS Statistics ver. 23.0 using descriptive statistics, independent t-test, one-way analysis of variance, Pearson correlation coefficients, and multiple regression analysis. Results: Prenatal depression had a significant negative correlation with self-esteem (r=-0.39, p=0.001) and spouse support (r=-0.36, p<0.001). The factors affecting prenatal depression were religion (β=-0.16, p=0.035), monthly family income (β=-0.15, p=0.040), self-esteem (β=-0.25, p=0.002), and spouse support (β=-0.19, p=0.017); these variables explained 28.4% of the variance in prenatal depression. Conclusion To prevent depression in pregnant women, professional counseling and support systems such as spouses, religious and social environments should be applied to pregnant women, especially those with low self-esteem. Additionally, more financial support should be provided for low-income pregnant women. Further, there is a need to screen and manage the risk of depression in pregnancy.

Human carboxylesterase 1 (CES1) is a serine esterase that hydrolyzes various exogenous compounds. Single nucleotide polymorphisms (SNPs) of CES1 may lead to inter-individual metabolic variability of its substrates. The allele and haplotype frequencies of known SNPs have been demonstrated to vary among ethnic groups. We analyzed genetic variations of CES1 in a Korean population. Direct sequencing of all exons and flanking regions of the CES1 gene was performed on samples obtained from 200 Koreans. We identified 41 SNPs. The most frequent SNPs was -914G>C (frequency: 99.5%), followed by 4256G>A (frequency: 65.8%), -75T>G (frequency: 59.3%). Haplotype analysis using the identified SNPs revealed fifteen haplotypes (> or =1% haplotype frequency) in our samples. The most frequent haplotype was Hap1 (frequency: 15.4%). Among the identified 41 SNPs, nine of which are novel variants and 14 SNPs were nonsynonymous variants. Using the functional predictive software PolyPhen-2, the G19V, E221G, and A270S variants were predicted to be most likely damaging to the function and structure of CES1. In-vitro analyses for two of these variants have been previously performed; however, functional evaluation of E221G (11657A>G, rs200707504) still needs to be conducted. Therefore, further studies are warranted to characterize the functional impact of E221G on CES1 activity.
Alleles ; Asian Continental Ancestry Group ; Carboxylesterase* ; Ethnic Groups ; Exons ; Genetic Variation ; Haplotypes ; Humans ; Polymorphism, Genetic* ; Polymorphism, Single Nucleotide ; Serine

OBJECTIVES: We aimed to evaluate the efficacy of biofeedback-assisted autogenic training for chronic tension-type headache, and to determine the relationship among the changes in electromyography (EMG) activity, headache activity, and mood states according to the psychophysiological treatment. METHODS: Chronic tension-type headache patients aged from 20 to 40 years (n=35) were randomized to the treatment group receiving biofeedback-assisted autogenic training (8 sessions) or the monitoring-only control group. EMG activities, headache index, and various psychological variables were examined. RESULTS: We found greater treatment response rate (> or =50% reduction in headache index) in patients with biofeedbackassisted autogenic training than in the monitoring group (61% vs. 18%; chi-square=6.882, df=1, p=0.01). There were no significant changes in the mean values of the pretreatment EMG activities across the sessions in either group (all p's>0.1). Mood states including anxiety and depression improved over time in the both groups, with the improvements being more prominent in the treatment group. Moreover, the reduction in depression level predicted treatment outcome in terms of headache index (95% confidence interval: 0.272-0.966, p=0.039). CONCLUSION: These results show that biofeedback-assisted autogenic training is effective for the treatment of chronic tension-type headache in a Korean population. Changes in mood states may be closely associated with the clinical outcome in the treatment of chronic tension-type headache using biofeedback-assisted autogenic training.
Aged ; Anxiety ; Autogenic Training ; Biofeedback, Psychology ; Depression ; Electromyography ; Headache ; Humans ; Tension-Type Headache ; Treatment Outcome

Primary esophageal melanoma is a rare disease with a poor prognosis. To date, 18 cases have been reported in Korea. Four patients visited the Chonnam National University Hwasun Hospital with dysphagia, followed by epigastric pain and discomfort, odynophagia, and weight loss. Esophagogastroduodenoscopy revealed a black pigmented polypoid mass, protruding mass, or black-pigmented flat lesions. Two patients had distant metastases and lymphadenopathies in imaging studies. Two patients underwent esophagectomy and intrathoracic esophagogastrostomy. One patient was treated with chemotherapy and interferon-alpha. The other patient declined further treatment. The routine histology using H&E revealed brown-colored atypical melanocytes. Immunohistochemical staining exhibited strong reactivity for Melan-A, S-100, and HMB-45 proteins. The biopsy specimens were interpreted to be malignant melanoma.One patient had multiple distant metastases 13 months after surgery. The other patient had no recurrence for 33 months after surgery. The patient treated with chemotherapy and interferon-alpha showed disease progression in the follow-up examination. Primary esophageal melanoma in Korea is a rare disease characterized by aggressive behavior, early metastasis, and poor prognosis.

Despite the coronavirus disease 2019 (COVID-19) vaccination roll-out, variant-related outbreaks have occurred repeatedly in Korea. Although public hospitals played a major role in COVID-19 patients’ care, difficulty incorporating evolving COVID-19 treatment guidelines called for a clinical pathway (CP). Eighteen public hospitals volunteered, and a professional review board was created. CPs were formulated containing inclusion/exclusion criteria, application flow charts, and standardized order sets. After CP roll-out, key parameters improved, such as increased patient/staff five-point satisfaction scores (0.41/0.57) and decreased hospital stays (1.78 days)/medical expenses (17.5%). The CPs were updated consistently after roll-out as new therapeutics drugs were introduced and quarantine policies changed.

Encapsulating peritoneal sclerosis (EPS) is a rare complication of peritoneal dialysis associated with a high mortality rate. Bacterial peritonitis (BP), a complication of EPS treatment, is uncommon, and treatments for BP are not well known. We report two patients who had undergone steroid treatment who developed BP after hemodialysis transfer. In the first case, we treated the BP with antibiotics and performed several surgical drainage procedures; however, the fluid became too thick to drain. This patient died of malnutrition and sepsis. In the second case, antibiotics and surgical enterolysis with peritonectomy were used to treat the BP. Solid food was accepted on day 7 postoperatively, and the patient was stable after 20 months. Thus, surgical enterolysis with peritonectomy may be a good treatment modality for patients with EPS and BP.
Anti-Bacterial Agents ; Drainage ; Humans ; Malnutrition ; Mortality ; Peritoneal Dialysis ; Peritoneal Fibrosis* ; Peritonitis* ; Renal Dialysis ; Sepsis

We report unusual MRI findings (including those from diffusion-weighted imaging (DWI)) in a patient with recurrent Wernicke's encephalopathy with a remarkable cerebellar lesion. DWI showed high signal intensities in the superior portion of the cerebellar hemisphere and vermis area. After thiamine administration, clinical symptoms improved and the lesions with high signal intensities disappeared on follow-up DWI.
Cerebellum ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging* ; Thiamine ; Wernicke Encephalopathy*

The solitary fibrous tumor, of rare mesodermal origins, primarily affects the pleura and occasionally occursin the peritoneum and at nonserosal sites. Although this is a pathologically well established entity, it isfrequently confused radiologically and pathologically with other tumors of mesenchymal origin. We report one case of a solitary fibrous tumor in the retroperitoneum. The 15X10X7cm mass, lacated in the left perirenal space just above the left kidney, had relatively homogeneous consistency and was well-delineated from surrounding organs inCT and MR images. It showed intense, gradual, centripetal enhancement during dynamic scans, and partially unenhanced areas which matched the high signal intensity portions in T2 weighted MR images, pathologically correlated to myxoid degeneration. Although not specific, when a large, well-delineated mass of strong contrast enhancement with lack of massive necrosis is encountered, solitary fibrous tumor must be included in the differential diagnosis of a refroperitoneal soft tissue mass.
Diagnosis, Differential ; Fibroma ; Kidney ; Mesoderm ; Necrosis ; Peritoneum ; Pleura ; Solitary Fibrous Tumors*

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

The purpose of this study was to investigate the changes in nutritional status of gastrectomy patients. The anthropometric and biochemical data were measured at pre-operation, at discharge, 1 month after discharge, and 3 months after discharge. Nutrient intake levels, nutrients adequacy ratio (NAR), mean adequacy ratio (MAR), and the proportion of patients with intake levels inferior to those of dietary reference intakes (DRIs) were analyzed at discharge, 1 month after discharge, and 3 months after discharge. Finally, the data on 23 patients (15 male and 8 female) were collected and used for statistical analysis. Fifteen patients underwent subtotal gastrectomy, and 8 patients underwent total gastrectomy. Compared to pre-operation, body weight and body mass index of subjects significantly decreased at discharge, 1 month after discharge, and 3 months after discharge (P<0.001). Serum albumin (P<0.001), total lympocyte count (P<0.001), total cholesterol (P<0.001), hemoglobin (P<0.001), hematocrit (P<0.001), and mean corpuscular hemoglobin concentration (P<0.05) were significantly different between pre-operation, at discharge, 1 month after discharge, and 3 months after discharge. The proportions of patients with lower nutrient intake levels than DRIs were substantial. MAR at discharge, 1 month after discharge, and 3 months after discharge were 0.70, 0.80 and 0.91, respectively. Especially, the NARs of folate, niacin, vitamin B2, vitamin C, and zinc were all low. Considering the various nutritional problems of gastrectomy patients, systematic medical nutrition therapy is needed after gastrectomy.
Ascorbic Acid ; Body Mass Index ; Body Weight ; Cholesterol ; Erythrocyte Indices ; Folic Acid ; Gastrectomy ; Hematocrit ; Hemoglobins ; Humans ; Male ; Niacin ; Nutrition Therapy ; Nutritional Status ; Riboflavin ; Serum Albumin ; Zinc