BACKGROUND: Psychogenic and physical aspects of health is interesting issue in the field of family medicine. We intended to study the relationship between physical illness and symptoms with self esteem, and hoped to understand disease in general behavioral context. METHODS: We selected 124 persons who visited family medicine OPD in Paik Hospital from August 3 to August 20, 1995, and answered questionnaire frankly. The qestionnaire consisted of Rosenberg self esteem scale as paremeter of self esteem and Hopkins symptom check list as parameter of physical health. The third author analyzed the medical record and rated the severity of disease as grade I-VII, for another parameter of physical health. The other factors-age, sex, marriage, education level, family, income-were analyzed by self esteem. RESULTS: We divided the study population into two groups, low self esteem group and high self esteem group. In low self esteem group, the persons complain more symptoms in Hopkins symptom check list significantly(P=0.009). Those who were highly educated had significantly higher self esteem(P=0.047). The severity of disease, sex, age, marriage, type of family, income showed no significant relationship with self esteem. CONCLUSIONS: The education level was the factor that influence self esteem. The person of low self esteem complains more symptoms. So we should consider self esteem in medical practice.
Education ; Hope ; Humans ; Marriage ; Medical Records ; Self Concept* ; Surveys and Questionnaires

BACKGROUND: Psychogenic and physical aspects of health is interesting issue in the field of family medicine. We intended to study the relationship between physical illness and symptoms with self esteem, and hoped to understand disease in general behavioral context. METHODS: We selected 124 persons who visited family medicine OPD in Paik Hospital from August 3 to August 20, 1995, and answered questionnaire frankly. The qestionnaire consisted of Rosenberg self esteem scale as paremeter of self esteem and Hopkins symptom check list as parameter of physical health. The third author analyzed the medical record and rated the severity of disease as grade I-VII, for another parameter of physical health. The other factors-age, sex, marriage, education level, family, income-were analyzed by self esteem. RESULTS: We divided the study population into two groups, low self esteem group and high self esteem group. In low self esteem group, the persons complain more symptoms in Hopkins symptom check list significantly(P=0.009). Those who were highly educated had significantly higher self esteem(P=0.047). The severity of disease, sex, age, marriage, type of family, income showed no significant relationship with self esteem. CONCLUSIONS: The education level was the factor that influence self esteem. The person of low self esteem complains more symptoms. So we should consider self esteem in medical practice.
Education ; Hope ; Humans ; Marriage ; Medical Records ; Self Concept* ; Surveys and Questionnaires

We present a case of meningeal and brain metastasis of multiple myeloma. A 60-year-old woman who had been diagnosed as multiple myeloma two years ago, was referred to neurosurgery department because of headache and nausea. The magnetic resonance image of the brain showed a large epidural mass and the parenchymal enhancement. The patient received an operation of tumor removal and cranioplasty. A histological diagnosis of metastatic multiple myeloma was made.
Brain ; Diagnosis ; Female ; Headache ; Humans ; Immunoglobulin G* ; Middle Aged ; Multiple Myeloma* ; Nausea ; Neoplasm Metastasis ; Neurosurgery ; Plasmacytoma*

No abstract available.
Dermatomyositis*

Subretinal neovascular membrane is the direct cause of visual impairment in various macular lesions. The aim of this study is to understand the pathophysiology of subretinal neovascular membrane by ultrastructural study. Six cases of surgically excised idopathic subretinal neovascular membrane were examined ultrastructurally. The vascular channels, which were lined by endothelial cells and surrounded by pericyte or retinal pigment epithelium, were the main feature of subretinal neovascular membrane. Other cellular components were retinal pigment epithelium, myofibroblast containing melanosome, chronic inflammatory cells including macrophages, histiocytes, plasma cells and lymphocytes, fibrocytes and outer segments of photoreceptor cells. Considereing that the development of subretianl neovascular membrane is similar to the wound healing process, it is suggested that pathophysiology of subretinal neovascular membrane may be a process of abnormal wound healing.
Endothelial Cells ; Histiocytes ; Lymphocytes ; Macrophages ; Melanosomes ; Membranes* ; Myofibroblasts ; Pericytes ; Photoreceptor Cells ; Plasma Cells ; Retinal Pigment Epithelium ; Vision Disorders ; Wound Healing

PURPOSE: To evaluate the relationship between endoscopic change in esophagogastric varices and post transjugular intrahepatic portosystemic shunt (TIPS) portal pressure reduction, and to study any difference in post-TIPS endoscopic change between esophageal and gastric varices. MATERIALS AND METHODS: Sixty four patients who had undergone pre- and post- TIPS endoscopic examination were analysed. They were divided into two groups, Group 1 (n = 40) and Group 2 (n = 24), according to whether they had not or had, respectively, undergone post-TIPS residual variceal embolization. The varices were classified as either esophageal (n = 54) or gastric (n = 60). Post TIPS endoscopic change was evaluated as Grade 1 (complete disappearance), Grade 2 (partial disappearance), or Grade 3 (no change). Mean pressure reduction between the pre and post TIPS portosystemic pressure gradient was checked, and statistical correlation between mean portal pressure reduction and endoscopic change in Group 1 and Group 2 was evaluated using the ANOVA test. By means of the x2 test, post-TIPS endoscopic change between esophageal and gastric varices was also evaluated. RESULTS: In Group I, a significant statistical relationship was found between endoscopic change and mean portal pressure reduction (p<0.001), but in Group 2, no such relationship was found (p>0.05). No significant statistical difference was found between endoscopic change in esophageal and in gastric varices (p> 0 . 0 5 ). CONCLUSION: In patients who had not undergone post-TIPS residual variceal embolization, endoscopicf change in gastroesophageal varices correlated significantly with post-TIPS portal pressure reduction. With regard to post-TIPS endoscopic change, these was no significant difference between esophageal and gastric varices.
Endoscopy* ; Esophageal and Gastric Varices ; Humans ; Portal Pressure ; Portasystemic Shunt, Surgical ; Stomach ; Varicose Veins

Multiple endocrine neoplasia type 1 (MEN1) syndrome is a relatively rare disease, characterized by the occurrence of multiple endocrine tumors in the parathyroid and pituitary glands as well as the pancreas. Here, we report a case of MEN1 with neuroendocrine tumors (NETs) in the stomach, duodenum, and pancreas. A 53-year-old man visited our hospital to manage gastric NET. Five years prior to his visit, he had undergone surgery for incidental meningioma. His brother had pancreatic nodules and a history of surgery for adrenal adenoma. His brother's daughter also had pancreatic nodules, but had not undergone surgery. The lesion was treated by endoscopic submucosal dissection and diagnosed as a grade 1 NET. Another small NET was detected in the second duodenal portion, resected by endoscopic submucosal dissection, which was also diagnosed as a grade 1 NET. During evaluation, three nodules were detected in the pancreas, and no evidence of pituitary, parathyroid tumors, or metastasis was observed. After surgery, the pancreatic lesions were diagnosed as NETs, with the same immunohistochemical patterns as those of the stomach and duodenum. Genetic testing was performed, and a heterozygous mutation was detected in the MEN1 gene, which is located on 11q13.
Adenoma ; Duodenum* ; Endoscopy ; Genetic Testing ; Germ-Line Mutation ; Humans ; INDEL Mutation ; Meningioma ; Middle Aged ; Multiple Endocrine Neoplasia Type 1* ; Neoplasm Metastasis ; Neuroendocrine Tumors* ; Nuclear Family ; Pancreas* ; Pituitary Gland ; Rare Diseases ; Siblings ; Stomach*

OBJECTIVES: Childhood is a critical period involving various developmental tasks that need to be accomplished. Childhood depression has overall negative implications for certain areas of development, including cognition, emotion, social skills, academic achievement, and ability to cope with stress. Yet, because depression can be "masked" by accompanying behavioral problems, early detection and diagnosis of childhood depression is somewhat challenging. In this study, using the Korean version of the Child Behavior Checklist (K-CBCL), we evaluated the association between children's self reports on depression and parents' assessment of children's behaviors. METHODS: Subjects were recruited from the S city, a cohort comprising a non-random convenience sample of 226, 10-year-old ethnic Koreans in their fourth year of elementary school and their parents. All participants underwent several tests, including Children's Depression Inventory (CDI) and K-CBCL. RESULTS: A total of 226 children, including 166 boys (73.5%) and 60 girls (26.5%), participated in the study. The average CDI for the participants was 14.57 (SD=7.54). Two items on the K-CBCL, total scale of adjustment scale and social withdrawal problems, showed a close association with the CDI. CONCLUSION: Although much remains to be elucidated, after controlling for covariates, the results of this study suggested that behavioral problems observed in children may be closely associated with depression.
Achievement ; Checklist ; Child ; Child Behavior ; Cognition ; Cohort Studies ; Critical Period (Psychology) ; Depression ; Humans ; Parents ; Phosphatidylethanolamines ; Self Report

BACKGROUND: Growth factors play important roles in wound healing. However, the evidence for the effects of growth factors on post-thyroidectomy scars is limited. OBJECTIVE: We performed a prospective study to assess the preventive and therapeutic effect of a multi-growth factor (MGF)-containing cream on post-thyroidectomy scars. METHODS: Twenty-one patients with thyroidectomy scars applied MGF cream twice a day. We assessed the changes in erythema, pigmentation, skin elasticity, and skin hydration status using the erythema index, melanin index, cutometer, and corneometer, respectively. In addition, Vancouver scar scale (VSS) and patient satisfaction were assessed at 10 days after surgery (baseline), 2 weeks, 6 weeks, and 12 weeks after baseline. RESULTS: The mean total VSS scores were significantly lower at 6 weeks (3.24±1.51 vs. 1.91±1.38) and 12 weeks (3.24±1.51 vs. 1.71±1.59) compared to the baseline. The degree of pigmentation was significantly lower at 12 weeks compared to the baseline, and the skin elasticity, and the skin hydration status were significantly higher at 12 weeks compared to the baseline. Over 85% of the patients were satisfied with the use of MGF cream without any adverse effect. CONCLUSION: MGF cream might have additive or supportive effect for scar formation after thyroidectomy.
Cicatrix* ; Elasticity ; Erythema ; Humans ; Intercellular Signaling Peptides and Proteins ; Melanins ; Patient Satisfaction ; Pigmentation ; Prospective Studies ; Skin ; Skin Pigmentation ; Thyroidectomy ; Wound Healing

PURPOSE: We applied low-dose-rate brachytherapy for low- and intermediate-risk groups of prostate cancer patients. Our initial experiences were analyzed to assess the result of low-dose-rate brachytherapy for low- and intermediate-risk groups of patients with localized prostate cancer. MATERIALS AND METHODS: A total of 50 consecutive patients have been treated with brachytherapy for 1 year since April 2007. Among them, a total of 24 patients in the low- or intermediate-risk groups were enrolled: 10 of the 24 patients were in the low-risk group (clinical T1a-T2b, Gleason score [GS] of 2-6, PSA<10 ng/ml), and 14 patients were in the intermediate-risk group (clinical T2b-T2c, Gleason score of 7, or PSA 10-20 ng/ml). Implantations were performed by practicing a real-time ultrasound-guided placement including prostatic capsular placement in the intermediate-risk group. All 24 patients were treated with 1 to 3 months of androgen-deprivation therapy. RESULTS: In the low- and intermediate-risk groups, the median patients' ages were 64 and 70 years, respectively. The numbers of patients in the low-risk group according to clinical T stage were 4 cases of T1c and 6 cases of T2a. The intermediate-risk group included 4 patients of stage T2a, 3 patients of stage T2b, and 7 patients of T2c. Five patients with a GS< or =6 and 9 patients with a GS of 7 were classified as being in the intermediate-risk group. Serum PSA levels in the intermediate-risk group were less than 10 ng/ml in 11 patients and 10-20 ng/ml in 3 patients. The median radiation doses delivered to 90% of the prostate in the low-risk and intermediate-risk groups were 257.5 Gy (range, 142.5-357.5 Gy) and 260.0 Gy (range, 147.5-357.5 Gy), respectively. Biochemical failure was not revealed in any case during follow-up. No patients experienced major complications. CONCLUSIONS: We can expect outstanding local control effect with low-dose-rate brachytherapy in low- and intermediate-risk prostate cancer. Our technique of modifying the insertion field in the intermediate-risk group is feasible and tolerable. However, long-term follow-up data are needed for this strategy.
Brachytherapy ; Follow-Up Studies ; Humans ; Neoplasm Grading ; Prostate ; Prostatic Neoplasms