No abstract available.
Suicide*

OBJECTIVE: This study aims to provide alternative care plans for mental health of North Korean refugees who are in protective facilities in China. METHODS: Personality Assessment Inventory (PAI) was utilized to measure the presence/absence of post traumatic stress disorder (PTSD) among 65 North Korean refugees. RESULTS: The gender differences in PAI t-scores showed that women exhibited meaningfully higher scores largely in anxiety (m=61.85), depression (m=65.23), and schizophrenia (m=60.98). In different age groups, schizophrenia in the 30 age bracket (m=65.23) was meaningfully higher than the teens (m=48.11). Aggression among the treatment features was the highest in the 20 age group (m=59.19) showing higher t-scores than the teens (m=39.67). Duration in the facility affected mental health in that the 3-5 years group (m=63.91) reported the highest in paranoia. Groups of under 1 year and less than 1-3 years showed meaningfully higher scores in nonsupport. The PTSD (including partial PTSD) rate of the group recorded 9.2%. Correlation between the PTSD and PAI scores showed that the full-PTSD group demonstrated higher average scores in negative impression, somatic complaints, anxiety, anxiety-related disorder, depression, paranoia, schizophrenia, antisocial features, suicide ideation, and treatment rejection than the non-PTSD group. CONCLUSION: Mental health of North Korean refugees in China was worse in women, the thirties, and less than 3-5 years in the facility, and it deteriorated as the duration prolonged. To promote better psychological health of North Korean refugees in China, the attention and aid from the protection facilities and domestic and international interests are required.
Adolescent ; Aggression ; Anxiety ; China* ; Depression ; Female ; Humans ; Mental Health* ; Paranoid Disorders ; Personality Assessment ; Refugees* ; Schizophrenia ; Stress Disorders, Post-Traumatic ; Stress Disorders, Traumatic ; Suicide

PURPOSE: It remains controversial whether to use a tube graft or a bifurcated graft during open abdominal aortic aneurysm (AAA) repair, due to the potential for progression or development of a common iliac artery (CIA) aneurysm. This study evaluated the fate of CIA after tubular AAA repair. METHODS: On a retrospective basis, we reviewed 61 patients who underwent open AAA repair with a tube graft, between March 2000 and December 2009. Fifty-seven patients were included in this study; we excluded 4 cases in which the patients died in-hospital. Of those enrolled, 24 patients underwent follow-up computed tomography at least 1-year after surgery. CIAs were categorized into 3 groups: normal (< or =12 mm), ectasia (range, 13 to 18 mm), and aneurysm (range, 19 to 25 mm). The incidence of CIA aneurysm rupture was investigated, and the expansion rate of CIA was calculated. RESULTS: Mean patient age was 64 years and 73% of patients were male. Preoperatively, 8 patients had 2 normal CIAs, 14 patients had one CIA aneurysm at least, 27 patients had one CIA ectasia, and 8 patients were unknown. There was a mean follow-up of 51 months; no deaths were caused by rupture of CIA aneurysm, and no patient underwent invasive treatment for a CIA aneurysm. The mean follow-up for 24 patients with 48 CIAs was 45 months. The mean expansion rate of CIA was 0.5 mm/y. CONCLUSION: AAA repair using a tube graft was a safe and durable procedure. However, a bifurcated graft should be considered when patients are young and there is the expectation of a long life expectancy is anticipated allowing for a CIA expansion rate of 0.5 mm/y.
Aneurysm ; Aortic Aneurysm, Abdominal ; Dilatation, Pathologic ; Follow-Up Studies ; Humans ; Iliac Artery ; Incidence ; Life Expectancy ; Male ; Retrospective Studies ; Rupture ; Transplants

Aniridia or iridremis is a Clinical term denoting absence of the iris in whole or in part. Actually, total absence has not been reported, as there has been rudimentary iris tissue in all cases reported in the literature. Because of its extra ordinary propensities as a dominant characteristic, occasionally an irregular dominant, and because of its stricking appearance which facilitates investigation, it has received extensive study by geneticists. Indeed, so interesting are its hereditary and pathologic aspects that these have received for more attention that have therapeutic measures for aniridic cases. I have experienced a case of aniridic family, a 40 years old women and her two sons, without other disturbances during their life saving, except poor vision, which was not significant of in correction for visual acuity.
Adult ; Aniridia* ; Female ; Humans ; Iris ; Mothers* ; Visual Acuity

OBJECTIVE: This study was conducted at Hanawon-a government sponsored educational facility for the settlement of North Korean refugees during their initial phase in South Korea-in 2004 to explore their mental health status and traumatic experiences in North Korea and during their escape period. METHODS: A survey was conducted in November 2004 with 62 North Korean refugees at Hanawon, and the Trauma Checklist was used to measure their traumatic experiences. To measure their psychological-mental health status, the Personality Assessment Inventory was administered. RESULTS: In comparison with the traumatic experiences of the North Korean refugees found in the study conducted in 2001 at Hanawon using the same methods, the current study showed a relatively lower frequency of traumatic experiences among the participants. The Personality Assessment Inventory results revealed that the study participants scored higher than average South Koreans in all clinical scales. Particularly, their mania (62.51) and schizophrenia (61.75) scores were above 60, a clinically meaningful score. In the gender comparison, the males exhibited meaningfully higher levels of alcohol problem, non-support, and warmth scale scores. CONCLUSION: Compared to the 2001 study, the overall traumatic experiences among North Korean refugees participated in this study. But continous support is necessary for their successful adaptation to South Korean Society have declined. The North Korean refugees at Hanawon experienced difficulties maintaining their mental health and the men in particular requested more intensive care and support for this purpose.
Bipolar Disorder ; Checklist ; Democratic People's Republic of Korea ; Humans ; Critical Care ; Korea ; Male ; Mental Health* ; Personality Assessment ; Refugees* ; Schizophrenia ; United Nations ; Weights and Measures

Acute disseminated encephalomyelitis (ADEM) is an inflammatory demyelinating disease of the central nervous system that typically follows an infection or vaccination and has a favorable long-term prognosis. We describe the first reported case of ADEM after vaccination against novel influenza A (H1N1). A previously healthy 34-month-old boy who developed ADEM presented with a seizure and left-sided weakness 5 days after vaccination against novel influenza A (H1N1). Cerebrospinal fluid examination revealed elevated cell counts. T2-weighted images and fluid-attenuated inversion recovery images revealed multiple patchy hyperintense lesions in the frontal and parietal subcortical white matter and the left thalamus. After the administration of intravenous corticosteroid, the patient's clinical symptoms improved and he recovered completely without neurologic sequelae.
Cell Count ; Central Nervous System ; Child ; Demyelinating Diseases ; Drug Toxicity ; Encephalomyelitis, Acute Disseminated ; European Continental Ancestry Group ; Humans ; Influenza, Human ; Preschool Child ; Prognosis ; Seizures ; Thalamus ; Vaccination

A POEMS syndrome(polyneuropathy, organomegaly, endocrinopathy, monoclonal M protein, and skin lesion) is a rare multisystem disease of unknown cause with varying clinical manifestations. POEMS- associated renal disease is also a rare condition. We experienced a 42-year-old male who had been suffered from generalized edema, low extremity weakness and pain. He also had a significant hematuria, proteinuria, azotemia, hepatospenomegaly, intraperitoneal lymph node enlargement, hypothyroidism, IgA lamda type monoclonal gammopathy, specific skin change and ascites. In renal biopsy, membranoproliferative features with enlarged glomeruli, mesangial proliferation, capillary wall thickening and paucity of immune deposit was noted. We suppose that renal insufficiency could come from POEMS syndrome. His symptoms such as low extremity pain, azotemia and generalized edema were improved by hemodialysis and use of prednisolone. At present, he is under the treatment of prednisolone and melphalan.
Adult ; Ascites ; Azotemia ; Biopsy ; Capillaries ; Edema ; Extremities ; Glomerulonephritis* ; Glomerulonephritis, Membranoproliferative ; Hematuria ; Humans ; Hypothyroidism ; Immunoglobulin A ; Lymph Nodes ; Male ; Melphalan ; Paraproteinemias ; POEMS Syndrome* ; Prednisolone ; Proteinuria ; Renal Dialysis ; Renal Insufficiency ; Skin

PURPOSE: To evaluate of the role in carcinogenesis of p53 over-expression and bcl-2 inhibition in early gastric and advanced gastric cancers, we investigated the immunohistochemical tissue status of 31 primary early gastric-cancer patients and 31 primary advanced gastric-cancer patients. METHODS: DO7, the monoclonal antiserum to the P53 protein, and clone 124, the monoclonal antibody to the bcl-2 protein, were used for the immunohistochemical analysis of the 31 surgically resected primary early gastric cancer specimens and the 31 surgically resected advanced gastric-cancer specimens. The expressions were scored and divided into negative, positive, low expression, and overexpression. RESULTS: The clinicopathologic parameter; tumor depth of invasion, histologic type, and differentiation, were not related with the expression status of p53 or bcl-2. Of the 31 primary early gastric-cancer patients, 14 exhibited p53 overexpression and 16 showed negative the bcl-2 expression; 5 cases had both p53 overexpression and negative bcl-2 expression. Of the 31 advanced gastric cancer patients, 19 showed the p53 overexpression, and negative bcl-2 expression, 15 exhibited both p53 overexpression and negative bcl-2 expression. CONCLUSION: These results suggest that cell cycle alteration and apoptosis control by p53 and bcl-2 may play roles in the carcinogenesis of gastric cancer. However, there are many other mediators that may facilitate carcinogenesis. This study proved that bcl-2 is a valuable prognostic factor.
Apoptosis ; Carcinogenesis ; Cell Cycle ; Clone Cells ; Humans ; Stomach Neoplasms*

PURPOSE: Rectovaginal fistula (RVF) after low anterior resection for rectal cancer is a type of anastomotic leakage. The aim of this study was to find out the difference of leakage, according to RVF presence or absence and to identify the optimal strategy for RVF. METHODS: All female patients who underwent low anterior resection with colorectal anastomosis or coloanal anastomosis (n = 950) were retrospectively analyzed. Patients' demographics and perioperative outcomes were analyzed between the RVF group and leakage without the RVF (nRVF) group. We performed 4 types of procedures—primary repair, diverting stoma, redo coloanal anastomosis (RCA), and conservative procedure—to treat RVF, and calculated the success rates of each type of procedure. RESULTS: The leakage occurred in 47 patients (4.9%). Among them, 18 patients (1.9%) underwent an RVF and 29 (3.0%) underwent nRVF. The RVF group received more perioperative radiotherapy (27.8% vs. 3.4%, P < 0.015) and occurred late onset after surgery (181.3 ± 176.4 days vs. 23.2 ± 53.6 days, P < 0.001) more than did the nRVF group. In multivariate analysis for the risk factor of the RVF group, the RVF group was statistically associated with less than 5 cm of anastomosis more than was the no-leakage group. A total of 35 procedures were performed in 18 patients with RVF for treatment. RCA showed satisfactory success rates (85.7%, n = 6) and, primary repair (transanal or transvaginal) showed acceptable success rate (33.3%, n = 8). CONCLUSION: After low anterior resection for rectal cancer, RVF was strongly correlated with a lower level of primary tumor location. Among the patients who underwent leakages, receipt of perioperative radiotherapy was significantly high in the RVF group than that of the nRVF group. Additionally, this study suggests that RCA might be considered another successful treatment strategy for RVF.
Anastomotic Leak ; Colectomy ; Demography ; Female ; Humans ; Multivariate Analysis ; Radiotherapy ; Rectal Neoplasms ; Rectovaginal Fistula ; Retrospective Studies ; Risk Factors

BACKGROUND/AIMS: The aim was to compare the insulin sensitivity and secretion index of pregnant Korean women with normal glucose tolerance (NGT), gestational impaired glucose tolerance (GIGT; only one abnormal value according to the Carpenter and Coustan criteria), and gestational diabetes mellitus (GDM). METHODS: A cross-sectional study was performed with 1,163 pregnant women with positive (1-hour plasma glucose > or = 7.2 mmol/L) in a 50-g oral glucose challenge test (OGCT). The 100-g oral glucose tolerance test (OGTT) was used to stratify the participants into three groups: NGT (n = 588), GIGT (n = 294), and GDM (n = 281). RESULTS: The GDM group had higher homeostasis model assessment of insulin resistance and lower insulin sensitivity index (ISOGTT), quantitative insulin sensitivity check index, homeostasis model assessment for estimation of index beta-cell secretion (HOMA-B), first and second phase insulin secretion, and insulin secretion-sensitivity index (ISSI) than the NGT group (p < or = 0.001 for all). Moreover, the GIGT group had lower ISOGTT, HOMA-B, first and second phase insulin secretion, and ISSI than the NGT group (p < 0.001 for all). Among the GIGT subjects, the 1-hour plasma glucose abnormal levels group showed significantly greater weight gain during pregnancy and higher values in the 50-g OGCT than the other two groups. Moreover, the 1-hour and 2-hour abnormal levels groups had poorer insulin secretion status than the 3-hour abnormal levels group. CONCLUSIONS: Korean women with GDM show impairments of both insulin secretion and insulin sensitivity. In addition, GIGT is associated with both beta-cell dysfunction and insulin resistance.
Adult ; Cross-Sectional Studies ; Diabetes, Gestational/*metabolism ; Female ; Glucose Tolerance Test ; Humans ; Insulin/*secretion ; *Insulin Resistance ; Pregnancy