OBJECTIVES: Breast cancer has been the most prevalent female cancer in South Korea since 2001. Early detection of this disease is the most effective strategy for reducing mortality. The objective of this study was to identify factors which could predict advanced stage at diagnosis of breast cancer. METHODS: Participants who were initially diagnosed with breast cancer and referred to the Stress Clinic of the Breast Cancer Center at Kyungpook National University Hospital were included. Through a semi-structured interview, the authors investigated psychosocial variables such as the extent of marital and family functioning and emotional-economic family burden as well as sociodemographic and health behavior-, health characteristic- and cancer-related variables. RESULTS: Data were collected from 219 participants. One hundred and twenty(54.8%) subjects were diagnosed with advanced-stage breast cancer. Variables that were significantly different between the advanced-stage and early-stage groups included : monthly breast self examination(p<0.000), annual mammographic screening(p< 0.000), mode of tumor detection(p<0.000), nature of the first symptoms(p<0.000), time to treatment after di-agnosis(p<0.000), overloaded economic and family burden(p=0.018), marital functioning(p<0.000) and family functioning(p<0.00). Logistic regression analysis indicated that irregular annual mammography screening(OR=7.431 ; 95% CI 2.407-22.944) or a lack of screening(OR=25.299 ; 95% CI 7.855-81.482) and a dysfunctional marital relationship(OR=4.772 ; 95% CI 2.244-10.145) were significantly associated with advanced stage at diagnosis of breast cancer. CONCLUSIONS: We reconfirmed screening behavior to be a risk factor for delayed diagnosis of breast cancer. Our findings also emphasized the importance of psychosocial factors such as marital functioning in early detection of breast cancer. Psychiatric consultation in the area of martial functioning could be beneficial for increasing early detection in breast cancer.
Breast ; Breast Neoplasms* ; Delayed Diagnosis* ; Diagnosis ; Female ; Gyeongsangbuk-do ; Humans ; Korea ; Logistic Models ; Mammography ; Marriage* ; Mass Screening ; Mortality ; Psychology* ; Risk Factors ; Time-to-Treatment

OBJECTIVES: The purpose of this study is to analyze a changing picture of the delusional types and contents in Korean adolescent psychotic patients during the last three decades. METHODS: The subjects were Korean adolescent psychotic patients with definite delusion who had been admitted to Kyungpook University Hospital and classified into three groups:the first group consisting of 39 patients from January 1, 1977 to December 12, 1978;the second group consisting of 41 patients from January 1, 1987 to December 12, 1988;the third group consisting of 44 patients from January 1, 1997 to December 12, 1998. RESULTS: 1) There was no significant difference in sex, age, religion, and parent distributions in three groups. The ratio of college or university graduates was increased in third group. As to birth order, the ratio of the eldest in third group was higher than that in the first two groups. 2) With respect to delusional type, persecutory delusion was the most common in the three groups. With regard to delusional content, delusion with friend theme was the most common and the frequency of it had been increasing. 3) In case of males, frequencies of reference delusion and delusion with friend theme had been increasing, whereas frequency of delusion with superpower theme decreasing. In case of females, frequencies of grandiose delusion and delusion with superpower theme had been increasing. 4) In case of 18-21 agers, frequencies of persecutory delusion and delusion with friend theme had been increasing. The type and content of delusion became diverse as age increased in the three groups. CONCLUSIONS: The results suggest that recent shifts in adolescent culture in Korea have had influence on the content of delusion in adolescent psychotic patients.
Adolescent* ; Birth Order ; Delusions* ; Female ; Friends ; Gyeongsangbuk-do ; Humans ; Korea ; Male ; Parents

PURPOSE: Premature ejaculation is the most common male sexual disorder, affecting perhaps as many as 75% of men, but its cause has not been well established. The objective of this study is to evaluate whether alcohol injection on the dorsal aspect of the penis can induce a desensitization of penile sensory nerve fiber in rats. MATERIALS AND METHODS: Forty-four male Sprague-Dawley rats were divided into 4 groups. Group I of 4 rats, the control group, did not undergo any procedure. Group II of 8 rats, received only an alcohol injection without electrical stimulation. In group III of 4 rats, only electrical stimulation was performed without alcohol injection. In group IV of 28 rats, all rats received an alcohol injection on the dorsal aspect of the penis, and groups of four rats were sacrificed after electrical stimulation on the glans penis at 1, 2, 4, 7, 10, 14, and 21 days after alcohol injection. Spinal cords were sectioned and processed for immunohistochemical staining for c-Fos protein. RESULTS: No c-Fos protein was detected in the normal control group, and either none or few c-Fos protein positive neurons were seen in the alcohol injection only group. The number of c-Fos protein positive neurons in the electrical stimulation only group was 30.25+/-3.53 cells/section. Four days after alcohol injection, the level of c-Fos protein positive neurons was reduced significantly compared with the control group (p<0.05), and was very close to the control group at 10 days after alcohol injection. CONCLUSIONS: Our study demonstrates that alcohol injection in the dorsal aspect of the penis reduces c-Fos protein positive neurons in the spinal cord segment through desensitization of penile sensory nerve fibers.
Animals ; Electric Stimulation ; Humans ; Male ; Nerve Fibers ; Neural Conduction* ; Neurons ; Penis ; Premature Ejaculation ; Rats* ; Rats, Sprague-Dawley ; Spinal Cord

BACKGROUND: It is expected that the number of families who provide caregiving for hospice patients will be increased in this society. Family caregiver will have fi nancial, psychological, social burden and stress related to this responsibility. Hospice patients, facing death, need not only biomedical therapy, but also systematic and continuous treatments such as mental or psycho-social intervention. The purpose of this study was to investigate the family caregiver's depression level and the associated factors. METHODS: The survey was conducted with 62 family caregivers of the hospice patients who had been hospitalized at the Gwangju Veterans Hospital from December 2005 to May 2006. The questionnaire consisted of the general characteristics of the subjects, Beck's depression inventory (BDI) evaluating the depression level and family APGAR score evaluating the family function. RESULTS: The mean age of the subjects was 58.2 years. The relationship with patients as 'spouse' accounted for 42 individuals (67.7%). The mean (+/- SD) BDI score was 25.3 (+/- 10.1) points and 58 percent of the subjects were suggested to have depression tendency (> or = 21 point). There was no relationship between the caregiver's depression level and their gender, religion, household income and Family APGAR score. However, the depression level was signifi cant related to the total caregiving duration (P = 0.001), visiting frequency of visitors (P = 0.004) and caregiving hours per day (P = 0.005). CONCLUSION: More than half of the family caregivers were suggested to have depression tendency. The depression level was infl uenced by the burden of caregiving and the visiting frequency of visitors. There is a need to activate social resources to share the burden of caregiving and to develop continuous and comprehensive care for hospice patients and their families.
Apgar Score ; Caregivers ; Depression ; Family Characteristics ; Hospices ; Hospitals, Veterans ; Humans

OBJECTIVES: The aim of this study was to develop the Reciprocal Attachment Questionnaire-Korean version (RAQ-K). METHODS: The authors tested the reliability of dimensional and pattern scales of RAQ-K with Crohnbach's alpha, test-retest reliability and interscale correlation, and construct validity with factor analysis. The subjects were Korean undergraduate students: 234 males and 249 females in the medical and nursing schools of Kyungpook National University. RESULTS: The dimensional scale of RAQ-K proved to be reliable in terms of Crohnbach's alpha coefficient except Availability and Use subscales, test-retest reliability and interscale correlation. The pattern scales of RAQ-K were reliable. Both dimensional and pattern scales were valid with two factor orthogonal rotation. CONCLUSION: The authors found RAQ-K retained available psychometric properties. But further study with some consideration to develop RAQ-K is expected. This research should assess samples of various age groups or various kinds of patients after considering two subscales. The authors stress that it is very important to consider the cultural difference between the East and the West and characteristics of Korean culture in developing a Korean version of foreign scales.
Female ; Gyeongsangbuk-do ; Humans ; Male ; Psychometrics ; Surveys and Questionnaires* ; Reproducibility of Results* ; Schools, Nursing ; Weights and Measures

Primary aldosteronism is characterized by hypokalemic metabolic alkalosis, low plasma renin activity, elevated plasma aldosterone level and can be suspected in the patients with hypertension and unexplained hypokalemia. Small adrenal cortical adenomas are responsible for this syndrome in most cases. The incidence of thyrotoxic periodic paralysis ranges from 1.9 to 6.2 % in Japan. Thyrotoxic periodic paralysis usually subsides following treatment of hyperthyroidism and has good prognosis. A 56 year-old man presented with hyperthyroidism, hypertension and recurrent hypokalemia. During the treatment of hyperthyroidism, he repeatedly experienced weakness of both lower extremities. Hormonal evaluation was performed and he was found to have a 2*2*1.5 cm sized right adrenal tumor by abdominal computerized topography(CT). After right adrenalectomy, hypokalemic periodic paralysis was improved. Both thyroid and adrenal function should be comprehensively investigated in periodic paralysis. In conclusion, physicians must be aware of the possibility of primary aldosteronism in hyperthyroid patients with hypokalemic periodic paralysis. We report a case of aldosteronoma complicated with hyperthyroidism and literatures are reviewed.
Adrenalectomy ; Adrenocortical Adenoma ; Aldosterone ; Alkalosis ; Humans ; Hyperaldosteronism ; Hypertension ; Hyperthyroidism* ; Hypokalemia ; Hypokalemic Periodic Paralysis ; Incidence ; Japan ; Lower Extremity ; Middle Aged ; Paralysis ; Plasma ; Prognosis ; Renin ; Thyroid Gland

OBJECTIVE: Alexithymic characteristics may represent cognitive and affective mediators between stressors and stress responses among those with depressive disorders. This study evaluated how alexithymic characteristics, as measured by the Korean version of the Toronto Alexithymia Scale-20 (TAS-20K), could be related to stress response patterns, as measured by the Stress Response Inventory (SRI), within a sample composed of individuals diagnosed with depressive disorders. METHODS: Participants comprised a cross section of patients diagnosed with depressive disorders (n=98). Data on demographic and psychosocial factors (i.e., sex, age, and level of education), clinical profiles {i.e., primary and comorbid psychiatric conditions meeting the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) criteria at the time of the evaluation}, duration of illness, medications, and Clinical Global Impression (CGI) scores, and the results of psychological assessments (TAS-20K, SRI) were analyzed. RESULTS: Patients having depressive disorders with alexithymia obtained significantly higher scores in terms of all seven subscales of the SRI, as compared to those without alexithymia, a logistic regression model was used to assess possible predictors for the presence of alexithymia in patients with depressive disorders, including the seven subscales of the SRI, gender, age, and duration of illness. We found that aggressive and somatizing responses to stress were significantly associated with the presence of alexithymia among patients with depression. CONCLUSION: These findings suggest that patients having depression with alexithymia were more susceptible to stress than those without alexithymia. Clinicians might improve their treatment of depression by identifying the clinical predictors for alexithymia and by helping those individuals demonstrating such symptoms in coping with emotionally stressful situations.
Affective Symptoms ; Depression ; Depressive Disorder ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Korea ; Logistic Models

Human rhinoviruses (HRV) mostly cause mild and self-limiting upper respiratory tract infections. We report 2 infants with acute respiratory failure requiring mechanical ventilation, 1 of whom deteriorated to death. The causal pathogen was HRV group A confirmed by multiplex-PCR. In Korea, this is the first report of severe respiratory failure caused by HRV group A during the same season.
Humans ; Infant ; Korea ; Respiration, Artificial ; Respiratory Insufficiency ; Respiratory System ; Respiratory Tract Infections ; Rhinovirus ; Seasons

The motor evoked potentials (MEPs) have been advocated as a method of monitoring the integrity of spinal efferent pathways in various injury models of the central nervous system. However, there were many disputes about origin sites of MEPs generated by transcranial electrical stimulation. The purpose of present study was to investigate the effect of major extrapyramidal motor nuclei such as lateral vestibular nucleus (VN) and medullary reticular nucleus (mRTN) on any components of the MEPs in adult Sprague-Dawley rats. MEPs were evoked by electrical stimulation of the right sensorimotor cortex through a stainless steel screw with 0.5mm in diameter, and recorded epidurally at T9 - T10 spinal cord levels by using a pair of teflon-coated stainless steel wire electrodes with 1mm exposed tip. In order to inject lidocaine and make a lesion, insulated long dental needle with noninsulated tips were placed stereotaxically in VN and mRTN. Lidocaine of 2~3 mul was injected into either VN or mRTN. The normal MEPs were composed of typical four reproducible waves; P1, P2, P3, P4. The first wave (P1) was shown at a mean latency of 1.2 ms, corresponding to a conduction velocity of 67.5 m/sec. The latencies of MEP were shortened and the amplitudes were increased as stimulus intensity was increased. The amplitudes of P1 and P2 were more decreased among 4 waves of MEPs after lidocaine microinjection into mRTN. Especially, the amplitude of P1 was decreased by 50% after lidocaine microinjection into bilateral mRTN. On the other hand, lidocaine microinjection into VN reduced the amplitudes of P3 and P4 than other MEP waves. However, the latencies of MEPs were not changed by lidocaine microinjection into either VN or mRTN. These results suggest that the vestibular and reticular nuclei contribute to partially different role in generation of MEPs elicited by transcranial electrical stimulation.
Adult ; Animals ; Central Nervous System ; Dissent and Disputes ; Efferent Pathways ; Electric Stimulation ; Electrodes ; Evoked Potentials, Motor* ; Hand ; Humans ; Lidocaine ; Microinjections ; Needles ; Rats* ; Rats, Sprague-Dawley ; Spinal Cord ; Stainless Steel ; Vestibular Nucleus, Lateral

Following the development of human immunodeficiency virus (HIV) treatments, the mean lifespan of patients with an HIV infection has increased to a level comparable to the general population. Patients receiving HIV treatment can achieve viral suppression and perform routine activities without the risk of infection transmission. Recently, the quality of life (QoL) and mental health of patients are becoming the primary outcomes in HIV treatment. The objective of this review was to investigate psychiatric disorders in patients with an HIV infection and available treatment programs. A search for clinical studies and scientific publications was performed. Patients with an HIV infection had a higher prevalence of psychiatric disorders than the general population. The psychopathological factors in HIV infection included neurobiological changes of infection, side-effects of medications, negative social perception, and unresolved intrapsychic conflicts. Severe and unmanaged psychiatric disorders with HIV infection negatively impacted HIV infection transmission and treatment adherence. However, psychiatric treatment programs and referrals to a psychiatric professional were found to be insufficient in most countries. This review revealed a need for psychiatric interventions in clinical practice to improve patients’ mental health and HIV treatment adherence. Psychiatric interventions integrated with conventional HIV treatment can be efficacious to achieve this goal. In addition, clinicians need to investigate and recognize HIV-related stigma as the relationship between patients and clinicians has a significant role in the patient’s treatment adherence.