OBJECTIVES: This study aimed to identify psychopathologies of sexually abused children and intervening variables of symptom severity. METHODS: Eighty-four school-aged children were identified for sexual abuse from a center for child sexual abuse by psychiatrists, clinical psychologists, and social workers. We analyzed correlations among symptom severity, types of sexual abuse, gender, age, relationship with the abuser, family system, and current and past psychopathologies. RESULTS: The percentage of victims with particular psychiatric disorders (current) were 79.8%. Children without identifiable disorders were 20.2%, but these children had significantly increased scores on self report scales of anxiety (RCMAS), depression (CDI), and withdrawal scores on parental reports of child behavior checklist (K-CBCL). Sixty nine percent of abused children had primary diagnosis related to sexual abuse in DSM-IV diagnositic system. PTSD was 41.7%, depressive disorder was 38.1%, and anxiety disorder was 21.4%. Psychopathologies were more severe if perpetrators were of acquaintance or if victims had previous psychopathologies or parent-child relational problems. Types of primary caregiver and older age were also related to the severity of psychopathologies. CONCLUSION: Present study suggests that most victims of childhood sexual abuse suffer from significant psychological distress. Intervening variables are relationship with the perpetrator, previous mental health status, age of the child, type of the primary care taker, and the quality of parent-child relationship.
Anxiety ; Anxiety Disorders ; Caregivers ; Checklist ; Child Abuse, Sexual ; Child Behavior ; Child* ; Depression ; Depressive Disorder ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Korea* ; Mental Health ; Parent-Child Relations ; Parents ; Primary Health Care ; Psychiatry ; Psychology ; Psychopathology* ; Self Report ; Sex Offenses ; Social Workers ; Stress Disorders, Post-Traumatic ; Weights and Measures

Schwannoma arising from cervical sympathetic chain is relatively uncommon and can be occasionally misdiagnosed as carotid body tumor. On MR images, schwannoma shows generally hypointense features on the T1-weighted images and hyperintense features on the T2-weighted images. Occasionally, however, contrast administration, which lets schwannoma show marked enhancement, may make it difficult to differentiate schwannoma from carotid body tumor. A 41-year-old woman presented a neck mass on the left. MR images of the neck and carotid angiography revealed a well-enhancing ovoid tumor, which separated the internal carptod arteries from the external carotid arteries at the level of carotid bifurcation. Complete tumor resection was performed and histopathology findings confirmed a schwannoma originating from the sympathetic chain. Postoperatively, miosis and facial anhydrosis of the left side were noted without ptosis, enophthalmos or other neurologic deficits. We report this case with a review of the literatures.
Adult ; Angiography ; Arteries ; Carotid Artery, External ; Carotid Body Tumor* ; Enophthalmos ; Female ; Humans ; Linear Energy Transfer ; Miosis ; Neck ; Neurilemmoma* ; Neurologic Manifestations

Pulmonary aspergillosis may present with three different features, according to the immune status of the host. These forms are invasive aspergillosis, allergic bronchopulmonary aspergillosis (ABPA) or aspergilloma. Bronchial involvement is an uncommon type of invasive pulmonary aspergillosis. We encountered an unusual case of an endobronchial aspergillosis that completely obstructed the left upper lobe, which was initially thought to be lung cancer. We report this case along with a review of the relevant literature.
Aspergillosis* ; Aspergillosis, Allergic Bronchopulmonary ; Bronchi* ; Invasive Pulmonary Aspergillosis ; Lung Neoplasms ; Pulmonary Aspergillosis

BACKGROUND: To know whether the laryngeal mask airway (LMA) triggers a pharyngo-esophago- gastric reflex during general anesthesia, we compared the esophageal motility of patients with an LMA or endotracheal tube (ETT) in place. METHODS: Fifty patients (ASA I or II) scheduled for elective orthopedic surgery with general anesthesia were randomly allocated into LMA (n = 30) or ETT (n = 20) groups. The esophageal manometric inputs were recorded continuously using an ambulatory esophageal manometric recorder and divided into five perioperative phases (preanaesthesia, induction, operation, LMA or ETT rejection, and arousal phase). RESULTS: The peristaltic percent and number of contractions per minute were significantly decreased during induction, operation, LMA or ETT rejection and arousal phases compared with preanesthetic phases in both the LMA and ETT groups. However, there were no significant group differences in any corresponding perioperative phases. CONCLUSIONS: We suggest that during general anesthesia the use of a LMA does not provoke significantly different esophageal peristalsis compared with an ETT. Thus, the LMA is unlikely to potentiate gastric regurgitation and reflux during general anesthesia by stimulating the pharyngo-esophago-gastric reflex.
Anesthesia, General* ; Arousal ; Humans ; Laryngeal Masks* ; Laryngopharyngeal Reflux ; Orthopedics ; Peristalsis ; Reflex

BACKGROUND: Although many studies regarding several neurotransmitters and receptors have been conducted to define the mechanism involved in the development of dependence on opioids, definitive evidence has still not been presented. This study was designed to investigate the effect of morphine on glutamate-induced cytotoxicity of rat C6 glial cells. METHODS: The 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-tetrazolium bromide (MTT) assay was used for cell viability. Morphology of nuclei was observed by fluorescent microscopy. Reduced glutathione (GSH) contents were measured in acid-soluble cell fractions. Generation of hydrogen peroxide (H2O2) was measured from the cultured supernatant of C6 glial cells using the scopoletin-horseradish peroxidase (HRP) assay. RESULTS: Glutamate induced the death of C6 glial cells in a time- and dose-dependent manner. Glutamate-induced cytotoxicity was protected by morphine and antioxidants, such as GSH and N-acetyl-L-cysteine (NAC). However, morphine antagonist, naloxone did not inhibit the protective effect of morphine on glutamate-induced cytotoxicity. In addition, the specific agonists, [D-Ala2, N-Me-Phe4, Gly5-ol]-Enkephalin acetate salt (DAMGO), [D-Pen2,5]-Enkephalin (DPDPE) and U69593 did not protect C6 glial cells from glutamate-induced cytotoxicity. Furthermore, morphine recovered the depletion of GSH by glutamate and inhibited the generation of H2O2 by glutamate in C6 glial cells. CONCLUSIONS: We suggest that morphine protects C6 glial cells from glutamate-induced cytotoxicity via the inhibition of GSH depletion and the generation of H2O2 by glutamate.
Acetylcysteine ; Analgesics, Opioid ; Animals ; Antioxidants ; Cell Survival ; Glutamic Acid ; Glutathione ; Hydrogen Peroxide ; Microscopy ; Morphine* ; Naloxone ; Neuroglia* ; Neurotransmitter Agents ; Peroxidase ; Rats

BACKGROUND: Stem cell transplantation with high dose chemoradiotherapy has made it possible to cure a significant proportion of patients with hematopoietic malignancies. RBC purging is an essential step prior to transplantation in ABO mismatched setting. The purpose of this study is to develop a new simple method for RBC depletion from harvested stem cells. METHODS: Ten cord bloods were collected during deliveries at Kyungpook National University Hospital, Taegu, Korea at August, 1998. All nucleated cells were collected after the compression of bags with 6% hydroxyethyl starch and cord blood for 4 hours. The cell viability of mononucleated cell (MNC) was calculated after 24~72 hours. RESLUTS: The collected mean volume of cord blood was 37.1 +/- 6.7 ml. The WBC count was 10,852 +/- 1,137/microL. The 3.90 +/- 0.62x108 TNC and 1.82 +/- 0.36x108 MNC were obtained per collection. TNC efficiency was 83.8 +/- 7.01% and MNC efficiency was 90.9 +/- 9.23% by compression method with 6% hydroxyethyl starch. RBC contamination was negligible. The cell viabilities of mononuclear cell were kept in a range of 99~100% after 24~72 hours. CONCLUSION: Because compression method with 6% hydroxyethyl starch progresses in closed system is simple & easy, has high erythrocyte depletion efficacy, and can maintain high viability of stem cells, it can be used for RBC purging in ABO mismatched stem cell transplantation.
Cell Survival ; Chemoradiotherapy ; Daegu ; Erythrocytes* ; Fetal Blood* ; Gyeongsangbuk-do ; Hematologic Neoplasms ; Humans* ; Korea ; Starch* ; Stem Cell Transplantation ; Stem Cells ; Umbilical Cord*

Purpose: In patients with locally advanced breast cancer, neoadjuvant chemotherapy is widely used. It has a distinct advantage in the downstaging of the primary tumor and provides important information about treatment response. With its increasing usage, concerns over the appropriate management of the axilla have emerged. In this study, we compared oncological outcomes of conventional axillary lymph node dissection (ALND) over axillary sampling (AS) with radiotherapy (RT) in patients who received neoadjuvant chemotherapy. Methods: In this retrospective study, we included female patients with triple negative breast cancer (TNBC) and HER2 type breast cancer who underwent breast and axillary surgery after neoadjuvant chemotherapy between May 2011 to December 2016. A total of 89 patients’ medical records were eligible for analysis. We defined AS as removal of at least four axillary lymph nodes located near the sentinel lymph nodes without full exposure of the axillary vein, long thoracic nerve, and thoracodorsal nerve. Results: The median follow-up period was 47.00 months. The disease-free survival was 69.66 months in the AS with RT group and 69.02 months in the ALND group (p=0.280). The invasive disease-free survival was 75.16 months in the AS with RT group and 78.44 months in the ALND group (p=0.218). Conclusion AS with radiotherapy might be a feasible surgical option in patients with TNBC and HER2 type breast cancer after neoadjuvant chemotherapy.

BACKGROUND: Granulocyte-colony stimulating factor (G-CSF) has been used in normal heathy donors to mobilize hematopoietic progenitors. Recently, it was reported that an addition of granulocyte-macrophage-CSF (GM-CSF) mobilized more primitive CD34+ subsets than did G- CSF alone. We investigated the result of the allogeneic peripheral blood stem cell transplantation (PBSCT) with stem cells mobilized with GM-CSF alone or a combination of GM-CSF and G-CSF from normal healthy donors in hematological malignancies. METHODS: Twenty-nine patients with hematologic malignancies had allogeneic PBSCT from normal sibling donors. Nine healthy donors were mobilized with GM-CSF (Leucogen (R)) alone and 20 with a combination of GM-CSF and G-CSF (Leucostim (R)). After 5~8 days of cytokine treatment, PBSCs were collected by large volume leukapheresis and analyzed. RESULTS: Stem cells were collected from the HLA matched normal healthy sibling donors. The mean harvested cell content was 8.74+/-3.22X10(8) MNCs/kg, 15.65+/-16.02X10(6) CD34+ cells/kg of the patients. There were significant differences in the harvested MNC count between mobilization group with GM-CSF alone and group with a bination of GM-CSF and G-CSF. Observed side effects of cytokine mobilization were myalgia (76%), headache (41%), febrile sense (24%) and skin rash (10%). These complications disappeared within 48 hours after discontinuation of cytokines. The median interval to achieve a WBC count>500/uL was 15.00+/-4.23 days, and 14.00+/-33.01 days to a platelet count>20,000/uL. The actual incidence of acute GVHD was 36.4%, 22.7%, and 4.5% for skin, GIT, and liver, respectively. Immunosuppressant responsive chronic GVHD developed in 63.1% (12/19) of assessable patients including 6 cases who had donor lymphocyte infusions. CONCLUSION: In this study, GM-CSF based cytokine mobilization was able to collect sufficient numbers of stem cells and allow rapid engraftment in the allogeneic PBSCT. Mobilization protocol with a combination of GM-CSF and G-CSF seemed to be superior to GM-CSF alone. Acute GVHD in patients with allogeneic PBSCT didn't appear to be more severe than in patients undergoing allogeneic BMT.
Blood Platelets ; Cytokines ; Exanthema ; Granulocyte Colony-Stimulating Factor* ; Granulocyte-Macrophage Colony-Stimulating Factor* ; Headache ; Hematologic Neoplasms* ; Hematopoietic Stem Cell Mobilization* ; Humans ; Incidence ; Leukapheresis ; Liver ; Lymphocytes ; Myalgia ; Peripheral Blood Stem Cell Transplantation* ; Siblings ; Skin ; Stem Cells* ; Tissue Donors*

PURPOSE: To determine the necessity of postmastectomy radiotherapy (PMRT) and which regions would be at risk for recurrence, we evaluated local and regional recurrence in breast cancer patients with 1–3 positive nodes and a tumor size of <5 cm. MATERIALS AND METHODS: We retrospectively analyzed data of 133 female breast cancer patients with 1–3 positive nodes, and a tumor size of <5 cm who were treated with mastectomy followed by adjuvant systemic therapy between 2007 and 2016. The median follow-up period was 57 months (range, 12 to 115 months). Most patients (82.7%) were treated with axillary lymph node dissection. Adjuvant chemotherapy, endocrine therapy, and trastuzumab therapy were administered to 124 patients (93.2%), 112 (84.2%), and 33 (24.8%), respectively. The most common chemotherapy regimen was anthracycline and cyclophosphamide followed by taxane (71.4%). RESULTS: Three patients (2.3%), 8 (6.0%), and 12 (9.0%) experienced local, regional, and distant failures, respectively. The 5-year cumulative risk of local recurrence, regional recurrence, distant metastasis, and disease-free survival was 3.1%, 8.0%, 11.7%, and 83.4%, respectively. There were no statistically significant clinicopathologic factors associated with local recurrence. Lymphovascular invasion (univariate p = 0.015 and multivariate p = 0.054) was associated with an increased risk of regional recurrence. CONCLUSION: Our study showed a very low local recurrence in patients with 1–3 positive nodes and tumor size of <5 cm who were treated with mastectomy and modern adjuvant systemic treatment. The PMRT volume need to be tailored for each patient’s given risk for local and regional recurrence, and possible radiation-related toxicities.
Breast Neoplasms ; Breast ; Chemotherapy, Adjuvant ; Cyclophosphamide ; Disease-Free Survival ; Drug Therapy ; Female ; Follow-Up Studies ; Humans ; Lymph Node Excision ; Mastectomy ; Neoplasm Metastasis ; Radiotherapy ; Recurrence ; Retrospective Studies ; Trastuzumab

PURPOSE: Advanced breast cancer traditionally has been perceived as a contraindication to immediate breast reconstruction, because of concerns regarding adjuvant treatment delays and the cosmetic effects of radiotherapy to breast reconstruction, so delayed reconstruction is usually preferred in advanced breast cancer patients undergoing mastectomy. However, with the improved outcome using multimodality therapy, consisting of perioperative chemotherapy and radiotherapy, immediate breast reconstruction is now being performed as surgical option for selected advanced breast cancer patients. Additionally, advanced breast cancer patients may be needed soft tissue coverage of an extensive skin and soft tussue defect after mastectomy. Current authors have experienced several types of immediate breast and chest wall reconstruction for advanced breast cancer. METHODS: From December of 2007 to June of 2009, 14 women performed for immediate breast and chest wall reconstruction for advanced breast cancer. They had been treated with neoadjuvant chemotherapy or chemoradiotherapy followed by modified radical mastectomy or radical mastectomy. Four different techniques were used immediate breast and chest wall reconstruction, which are pedicled TRAM flap(4 cases), extended LD flap with STSG(3 cases), thoracoabdominal flap(4 cases) and thoracoepigastric flap(3 cases). RESULTS: The mean age was 53 years and mean follow up period was 9 months. Patients' oncologic status ranged stage IIIa to stage IV. Two patients had major complications: partial flap necrosis of TRAM flap and one distal necrosis of thoracoabdominal flap. Three patients with stage IV disease died from metastases. CONCLUSION: The result of this study suggests that immediate breast and chest wall reconstruction can be considered as surgical option for advanced breast cancer. But we need long term follow up and large prospective studies for recurrence and survival.
Breast ; Breast Neoplasms ; Chemoradiotherapy ; Cosmetics ; Female ; Follow-Up Studies ; Humans ; Mammaplasty ; Mastectomy ; Mastectomy, Modified Radical ; Mastectomy, Radical ; Necrosis ; Recurrence ; Skin ; Thoracic Wall ; Thorax