Purpose: This study aimed to investigate the levels of adolescence parentification and identify its influence on adulthood depression in children of women with breast cancer. Methods: This study used a cross-sectional online survey. Data were collected from an online community comprising Korean women with breast cancer and their families. A total of 217 adult children of women with breast cancer completed the online questionnaire. Measurements included the Korean version of the Filial Responsibility ScaleAdult (FRS-A), Korean version of Rosenberg’s Self-Esteem Inventory, Korean version of the Resilience Scale (RS14), and the Korean version of Center for Epidemiologic Studies-Depression Scale. Results: The mean score for FRS-A was 2.27 out of 4 points. Adolescence parentification was significantly negatively correlated with adulthood self-esteem (r=-.74, p<.001) and resilience (r=-.72, p<.001), and significantly positively correlated with adulthood depression (r=.76, p<.001). Multiple regression analysis revealed that adolescence parentification was a significant factor associated with adulthood depression after adjusting for general characteristics, self-esteem, and resilience. Conclusion Our finding suggests that parentification can be stressful for adolescents living with a parent with cancer. Hence, a greater awareness regarding parentification is needed to prevent adolescents from developing depression in their adulthood.

Ectopic breast tissue and male breast cancer are both very rare diseases with only a few reports in the literature. Here, we present the first case of ectopic male breast cancer in the perineum. The patient was a 70-year-old man with a palpable mass in the perineum. A wide local excision and inguinal lymph node dissection revealed invasive breast carcinoma of no special type involving the skin and subcutis, and inguinal lymph node metastases. Immunohistochemical staining showed that the tumor cells were strongly positive for estrogen and progesterone receptors and negative for human epidermal growth factor receptor 2. Moreover, no p53 overexpression was observed. Herein, the clinical and pathologic features, as well as a review of ectopic male breast cancer are discussed.
Aged ; Breast ; Breast Neoplasms ; Breast Neoplasms, Male* ; Estrogens ; Humans ; Lymph Node Excision ; Lymph Nodes ; Male ; Male* ; Mammary Glands, Human ; Neoplasm Metastasis ; Perineum* ; Rare Diseases ; Receptor, Epidermal Growth Factor ; Receptors, Progesterone ; Skin

PURPOSE: We evaluated the identification and antimicrobial susceptibility patterns of nosocomial and community-acquired pathogens in children of the medium-sized hospital. METHODS: The 357 bacterial strains isolated from Pediatric department of Dongsan Sacred Heart Hospital were examined the species identification and antimicrobial susceptibility test during the period of March to October 1996. RESULTS: Fifty three strains (15%) of 357 strains were nosocomial pathogens. A half of Enterococcus faecium is nosocomial pathogens. As a rule, Antimicrobial resistance of nosocomial pathogens were higher than those of community-acquired pathogens. Enterococcus sp. isolated from nosocomial infection were significantly less susceptible than those from community-acquired infection to imipemem (P<0.05). Escherichia coli isolated from nosocomial infection were significantly less susceptible than those from community-acquired infection to amoxicillin/clavulanate, cefuroxime, cefoxitin, ceftazidime, and aztreonam (P<0.05). Klebsiella pneumoniae isolated from nosocomial infection were significantly less susceptible than those from community-acquired infection to cephalothin, cefuroxime, cefotaxime, aztreonam, tobramycin, gentamicin, and co-trimoxazole (P<0.05). CONCLUSIONS: In medium-sized hospital, the rate of antimicrobial resistance to nosocomial pathogens was higher than community-acquired pathogens. The regular reports of the susceptibility patterns of nosocomial and community-acquired pathogens would be useful to improve the effects of empirical antimicrobial therapy.
Aztreonam ; Cefotaxime ; Cefoxitin ; Ceftazidime ; Cefuroxime ; Cephalothin ; Child* ; Community-Acquired Infections ; Cross Infection ; Enterococcus ; Enterococcus faecium ; Escherichia coli ; Gentamicins ; Heart ; Humans ; Klebsiella pneumoniae ; Tobramycin ; Trimethoprim, Sulfamethoxazole Drug Combination

Elevated peak inspiratory airway pressure (PIP) can occur during general anesthesia and is usually easily rectified. In rare circumstances it can lead to potentially fatal conditions such as tension pneumothorax. We report on a 77-year-old male patient admitted for a cervical laminoplasty. The preoperative chest radiograph showed normal findings and there was no medical history of allergy or underlying airway inflammation. Anesthesia induction and maintenance progressed uneventfully. However, 5 minutes after prophylactic antibiotic administration, PIP suddenly increased and blood pressure dropped. The operation was abandoned and the patient was moved to a supine position to perform chest radiography. Cardiac arrest occurred, and cardiopulmonary resuscitation was performed. The radiograph showed bilateral tension pneumothorax. Needle aspiration was immediately performed, and chest tubes were inserted. Ventilation rapidly improved and the vital signs normalized. The patient was discharged without sequelae on postoperative day 36.
Aged ; Anaphylaxis ; Anesthesia ; Anesthesia, General ; Blood Pressure ; Cardiopulmonary Resuscitation ; Chest Tubes ; Heart Arrest ; Humans ; Hypersensitivity ; Inflammation ; Male ; Needles ; Pneumothorax ; Spine ; Supine Position ; Thorax ; Ventilation ; Vital Signs

PURPOSE: Methylphenidate (MPH) is an effective medication for the treatment of attention deficit hyperactivity disorder (ADHD). However, about 30% of patients do not respond to or are unable to tolerate MPH. Based on previous findings, we hypothesized that great variability in response time (RT) among Korean children with ADHD on a computerized continuous performance attention test would be related to poor MPH treatment response. MATERIALS AND METHODS: Children (ages 6-18 years) with ADHD were recruited for a prospective 12-week, open-labeled, multicenter study to examine optimal dosage of OROS methylphenidate. Of the 144 subjects selected, 28 dropped out due to adverse events, medication noncompliance, or follow-up loss, and an additional 26 subjects with comorbid disorders were excluded from statistical analyses. We defined 'responders' as subjects who received a score of less than 18 on the attention deficit hyperactivity disorder rating scale (ARS; Korean version, K-ARS) and a score of 1 or 2 on the Clinical Global Impression-Improvement scale (CGI-I). RT variability was assessed with the ADHD diagnostic system (ADS). RESULTS: Fifty-nine (67%) subjects responded to MPH treatment. The non-responders showed greater RT variability at baseline (Mann Whitney U = 577.0, p < 0.01). Baseline RT variability was a significant predictor of MPH response (Nagelkerke R2 = 0.136, p < 0.01). It predicted 94.9% of responder, 17.2% of non-responder and 69.3% of overall group. CONCLUSION: High RT variability may predict poor response to MPH treatment in children with ADHD.
Adolescent ; Attention Deficit Disorder with Hyperactivity/*drug therapy ; Child ; Female ; Humans ; Korea ; Male ; Methylphenidate/*therapeutic use ; *Reaction Time ; Treatment Outcome

Pancreatic neuroendocrine tumors (NETs) frequently accompany metastatic lesions, and hepatic metastases are the most common of all NETs. However, another disease may also be present, potentially leading to misdiagnosis and metastasis of a NET. Clinicians should consider an active diagnostic evaluation for metastatic lesions, including liver biopsy, particularly when the hepatic lesion has distinct characteristics from the primary tumor. In our case, the patient had both a pancreatic NET and a primary hepatic lymphoma. She underwent laparoscopic distal pancreatectomy with splenectomy, and progress of the primary hepatic lymphoma was observed in the outpatient clinic.
Ambulatory Care Facilities ; Biopsy ; Diagnostic Errors ; Humans ; Liver ; Lymphoma ; Lymphoma, B-Cell ; Lymphoma, Non-Hodgkin ; Neoplasm Metastasis ; Neuroendocrine Tumors ; Pancreas ; Pancreatectomy ; Splenectomy

Pancreatic neuroendocrine tumors (NETs) frequently accompany metastatic lesions, and hepatic metastases are the most common of all NETs. However, another disease may also be present, potentially leading to misdiagnosis and metastasis of a NET. Clinicians should consider an active diagnostic evaluation for metastatic lesions, including liver biopsy, particularly when the hepatic lesion has distinct characteristics from the primary tumor. In our case, the patient had both a pancreatic NET and a primary hepatic lymphoma. She underwent laparoscopic distal pancreatectomy with splenectomy, and progress of the primary hepatic lymphoma was observed in the outpatient clinic.

OBJECTIVES: This study researched the clinical effects of hippotherapy and medication in attention deficit hyperactivity disorder (ADHD) children. METHODS: The study employed an open label randomized controlled trial. Participants were 10 children of ages between 6 and 12 years. These subjects were placed in 2 groups : the hippotherapy group and the medication group. Evaluation tools used in this study include Affective Disorders and Schizophrenia-Present and Lifetime Version- Korean Version, the Wechsler Intelligence Scale for Children-IV, Korean Child Behavior Check List (K-CBCL), ADHD rating scale (ARS), Clinical Global Impression (CGI), and Quantitative electroencephalography (QEEG). RESULTS: Grossly scores of investigator-administered ADHD rating scale (ARS-I), K-CBCL, and CGI-Severity of Illness scale were improved in both the hippotherapy and the medication group. The ARS-I scores of the Hippotherapy group were not significantly different from baseline after 12 weeks. In the QEEG, theta/beta ratio of Pz area in the hippotherapy group was significantly different from baseline. Children treated with medication showed significant difference from baseline in ARS-I, K-CBCL subscales, and QEEG. CONCLUSION: The use of hippotherapy could be a viable treatment strategy as a part of a multimodal therapy for children with ADHD. This pilot study provides good prospects for future studies to document these positive trends on larger samples.
Attention Deficit Disorder with Hyperactivity* ; Child Behavior ; Child* ; Electroencephalography ; Equine-Assisted Therapy* ; Humans ; Intelligence ; Mood Disorders ; Pilot Projects*

OBJECTIVES: There is evidence that Hypothalamic-Pituitary-Adrenocortical (HPA) system dysregulation plays a role in the pathophysiology of depression. However which psychiatric symptoms are related to HPA system dysregulation has not been studied well. The primary aim of this study was to investigate which symptom components of the Hamilton Depression Rating Scale (HAM-D) are related to HPA system dysregulation in Korean psychiatric outpatients. The secondary aim was to find other variables that have association with HAM-D components. METHODS: This study was a retrospective review of the charts of outpatients who first visited Samsung Medical Center Depression Clinic between July 2012 and October 2013. Among them those who checked the plasma cortisol level and HAM-D within one week of their first visit were selected. Fifty nine patients were selected. The HAM-D was divided into four components, including depression, anxiety, insomnia, and somatic components. Multiple regression of cortisol level was used for four subscales. RESULTS: Significant positive correlations were observed between the plasma cortisol level and depression component of HAM-D (beta=0.251, p=0.049). Age also showed negative correlation with the depression component of HAM-D (beta=-0.427, p=0.002). However anxiety, insomnia and somatic components of HAM-D did not show correlation with plasma cortisol level. CONCLUSION: Our study suggests that in Korean depression clinic outpatients, the depression component of HAM-D is related to plasma cortisol level.
Anxiety ; Depression* ; Humans ; Hydrocortisone* ; Outpatients* ; Plasma* ; Retrospective Studies ; Sleep Initiation and Maintenance Disorders

OBJECTIVE: This study was aimed to determine effectiveness and tolerability of Osmotic-controlled Release Oral delivery (OROS) methylphenidate (MPH) and its optimal dose administered openly over a period of up to 12 weeks in drug naive Korean children with ADHD. METHODS: Subjects (n=143), ages 6 to 18-years, with a clinical diagnosis of any subtype of ADHD were recruited from 7 medical centers in Korea. An individualized dose of OROS-MPH was determined for each subject depending on the response criteria. The subjects were assessed with several symptom rating scales in week 1, 3, 6, 9 and 12. RESULTS: 77 of 116 subjects (66.4%) achieved the criteria for response and the average of optimal daily dose for response was to 30.05+/-12.52 mg per day (0.90+/-0.31 mg/kg/d) at the end of the study. Optimal dose was not significantly different between ADHD subtypes, whereas, significant higher dose was needed in older aged groups than younger groups. The average of optimal daily dose for response for the subjects aged above 12 years old was 46.38+/-15.52 per day (0.81+/-0.28 mg/kg/d) compared to younger groups (p<0.01). No serious adverse effects were reported and the dose did not have a significant effect on adverse effects. CONCLUSION: Optimal mean dose of OROS-MPH was significantly different by age groups. Higher dose was needed in older aged groups than younger groups. Effectiveness and tolerability of OROS-MPH in symptoms of ADHD is sustained for up to 12 weeks.
Aged ; Child ; Humans ; Korea ; Methylphenidate ; Weights and Measures