Objective: We aimed to examined the reliability and validity of Korean version of Social Distancing Phobia scale, and whether intolerance of uncertainty mediates the association of the general population’s social distancing phobia with viral anxiety and depression. Methods: Through this anonymous online survey, we collected responses from 400 individuals in the general Korean population. Participants’ demographic information and rating scales scores, including the Social Distancing Phobia scale, Stress and Anxiety to Viral Epidemics-6 items, Patient Health Questionnaire-9, and Intolerance of Uncertainty-12 items. Results: Confirmatory factor analysis showed a good model fit, and the Korean version of Social Distancing Phobia scale showed good internal consistency. Social distancing phobia was significantly correlated with age (r=0.213, p<0.001), viral anxiety (r=0.390, p<0.001), depression (r=0.244, p<0.001), and intolerance of uncertainty (r=0.323, p<0.001). A linear regression analysis showed that age (β=0.235, p<0.001), viral anxiety (β=0.281, p<0.001), depression (β=0.121, p=0.009), and intolerance of uncertainty (β=0.200, p<0.001; adjusted R2=0.246, F=33.6, p<0.001) predicted social distancing phobia. Mediation analysis revealed that viral anxiety directly influenced social distancing phobia (z=6.48, p<0.001), and intolerance of uncertainty partially mediated this association (z=2.92, p=0.003). Conclusion Social distancing phobia may cause psychological stress but may also increase adherence to physical distancing measures and prevent the spread of viruses.

Objective: This study aimed to explore the mediating effects of cancer-related dysfunctional beliefs regarding sleep and intolerance of uncertainty on the effect of depression, insomnia, and anxiety on fear of progression (FoP). Methods: We retrospectively reviewed medical records of patients with cancer who visited the Sleep Clinic for cancer patients in Asan Medical Center for the first time between December 2021 and March 2022. Data collected included age, sex, types of cancer, staging, current treatment modalities, and history of surgical procedures. In addition, psychological symptoms were rated using the Insomnia Severity Scale (ISI), Patient Health Questionnaire–9 items (PHQ-9), State subcategory of the State and Trait of Anxiety Inventory (STAI-S), Short form of Fear of Progression Questionnaire, Cancer-related Dysfunctional Beliefs about Sleep scale (C-DBS), single item of pain and fatigue, Connor Davidson Resilience Scale 2-item (CD-RISC2), and Intolerance of Uncertainty–12 (IUS-12). The predictive variables for FoP were determined by linear regression analysis. Results: The FoP was significantly correlated with age (r=-0.289), ISI (r=0.178), PHQ-9 (r=0.703), STAI-S (r=0.377), fatigue (r=0.452), CD-RISC2 (r=-0.270), IUS-12 (r=0.585), and C-DBS (r=0.427, all p<0.01). A mediation analysis showed that intolerance of uncertainty and dysfunctional beliefs about sleep mediated the relationship of FoP with insomnia, depression, or anxiety. Conclusion Psychological support for intolerance of uncertainty and cancer-related dysfunctional beliefs about sleep in patients with cancer may be beneficial to reduce their FoP.

Objective: The discrepancy between desired time in bed and desired total sleep time (DBST index) is correlated with the severity of insomnia among the general population. This study aimed to explore whether the change in DBST index is associated with changes in insomnia severity. Methods: The study was conducted as a single source tracking online survey among the general population. The first survey (T1) was completed by all 399 participants, and the second survey (T2) was completed by 233 participants 5–6 weeks after the T1 survey with a simple instruction of reducing the DBST index. Participants’ age, sex, marital status, past psychiatric history, and sleep patterns were collected. In addition to the DBST index, the Glasgow Sleep Effort Scale (GSES), Dysfunctional Beliefs about Sleep-2 items (DBS-2), and Insomnia Severity Index (ISI) were rated. Results: The change in the ISI (T1–T2) was significantly correlated with the changes in the GSES (r=0.24, p<0.001), DBS-2 (r=0.22, p<0.001), and DBST index (r=0.15, p=0.020). The change in insomnia severity was expected with change in the GSES (β=0.23, p<0.001), DBS-2 (β=0.20, p=0.002), and DBST index (β=0.13, p=0.037). Mediation analysis showed that change in DBST index directly influenced change in insomnia severity and change in GSES or DBS-2 did not mediate the relationship. Conclusion Changing the DBST index can be a simple way to reduce insomnia severity among the general population.

The ‘32-year-old sailor’ patient was a native Korean male, infected with HIV through heterosexual contacts in the high risk areas of foreign country, mostly during. 1984 to 1986. During the following 6-months until his death, the skin nodules suggesting Kaposi's sarcoma, and penile ulcers like chancroid were gradually disappeared. Several skin diseases such as condyloma accuminatum, generalized xeiosis of the skin, acquired icthyosis, seborfheic dermatitis, diffuse hair loss and alopecia developed. His health gradually deteriorated with general symptom such as weakness, weight loss, remAtmt mild fever cough with sputum, and dyspnea with frequent pneumonia signs. The tongue became coated white and thick in which candida albicans was detected, and sore throat and dysphagia accompanied. The patients expired suddenly with acute respiratory distress syndrome, which was may be caused by a opportunistic infection of Pneumocystis carinii. In post-mortem autopsy studies, most of the lung tissue showed the findings of severe interstitial pneumonia and hyaline membrane formation, and pneumocystis cadnii and candida albicans were found in histopathological or micorbiological examination. As other infections, add fast bacilli suggesting Mycobacterium avium-intracellulare were found out in the lymph node, spleen, liver. Cytomegalovirus infection was found on the adrenal gland by histopathological examination. And various lymphoid tissue of the lymph node, spleen, thymus, respiratory tract, gastomtestinal tracts showed severe lymphoid depletion with fibrosis. The other findings had multiple glial nodules in the cerebral white matter and focal segmental glomerulosderosm There wasr t any evidence of Kaposi's sarcoma.
Adrenal Glands ; Alopecia ; Autopsy* ; Candida albicans ; Chancroid ; Cough ; Cytomegalovirus ; Cytomegalovirus Infections ; Deglutition Disorders ; Dermatitis ; Dyspnea ; Fever ; Fibrosis ; Hair ; Heterosexuality ; HIV ; Humans ; Hyalin ; Liver ; Lung ; Lung Diseases, Interstitial ; Lymph Nodes ; Lymphoid Tissue ; Male ; Membranes ; Mycobacterium avium Complex ; Opportunistic Infections ; Pharyngitis ; Pneumocystis ; Pneumocystis carinii ; Pneumonia ; Respiratory Distress Syndrome, Adult ; Respiratory System ; Sarcoma, Kaposi ; Skin ; Skin Diseases ; Spleen ; Sputum ; Thymus Gland ; Tongue ; Ulcer ; Weight Loss ; White Matter

Background: This study explores whether the intolerance of uncertainty among healthcare workers prompts viral anxiety, and whether this association is mediated by their reassuranceseeking behavior and preoccupation with the coronavirus disease 2019 (COVID-19) in Korea. Methods: An online survey was conducted among healthcare workers in Asan Medical Center, on November 29, 2021. Demographic characteristics and responses to items from rating scales were collected, including Stress and Anxiety to Viral Epidemics-9, Coronavirus Reassurance-Seeking Behaviors Scale (CRBS), Obsession with COVID-19 Scale (OCS), Patient Health Questionnaire-9, Insomnia Severity Scale, and Intolerance of Uncertainty-12 (IUS-12). Results: Among the 329 participants, viral anxiety of healthcare workers was predicted by being female (β = 0.14, P = 0.002), CRBS (β = 0.30, P < 0.001), OCS (β = 0.32, P < 0.001), and IUS-12 (β = 0.15, P = 0.002) scores (adjusted R2 = 0.43, F = 31.1, P < 0.001). Mediation analysis showed that the intolerance of uncertainty directly influenced viral anxiety, and reassuranceseeking behavior and obsession with COVID-19 partially mediated the association. Conclusion The intolerance of uncertainty among healthcare workers directly influenced their viral anxiety, and reassurance-seeking behavior and obsession with COVID-19 mediated this association in this era of “living with coronavirus” in Korea.

Background: This study aimed to explore clinical correlates of fear of progression (FoP) among patients with cancer during the coronavirus disease 2019 (COVID-19) pandemic and examine the mediation effect of cancer-related dysfunctional beliefs about sleep (C-DBS). Methods: Medical charts of patients with cancer who visited a psycho-oncology clinic between July and November 2021 were reviewed. Baseline socio-demographic and cancer-related variables were collected. Patients’ self-report questionnaires, regarding FoP, depression (Patient Health Questionnaire-9 items; PHQ-9), viral anxiety (Stress and Anxiety to Viral Epidemics-6 items; SAVE-6), C-DBS, and other distress, were investigated. Pearson’s correlation and linear regression were performed to examine the risk factors of FoP. Mediation effect analysis with the bootstrap method with 2,000 resamples was implemented. Results: A total of 231 patients were included in the analysis. Linear regression revealed that FoP was predicted by age (β = −0.14, P = 0.003), PHQ-9 (β = 0.48, P < 0.001), SAVE-6 (β = 0.34, P < 0.001), and C-DBS (β = 0.15, P = 0.005). FoP was directly influenced by SAVE-6 and mediated by C-DBS, while it was directly influenced by PHQ-9 with no mediation effect. Conclusion During the COVID-19 pandemic, the FoP of patients with cancer was associated with younger age, depression, viral anxiety, and C-DBS. Depression and viral anxiety directly influenced FoP, while C-DBS mediated the association between viral anxiety and FoP.Therefore, oncology healthcare professionals are recommended to assess C-DBS of their patients when they are highly distressed from FoP.

Objective: This study assessed the reliability and validity of the Stress and Anxiety to Viral Epidemics–9 items (SAVE-9) and Stress and Anxiety to Viral Epidemics–6 items (SAVE-6) scales for measuring viral anxiety among firefighters during the coronavirus disease-2019 pandemic. Methods: An online survey was conducted among 304 firefighters assigned in Gyeonggi-do. The SAVE-9 scale, initially developed for healthcare workers, was adapted for firefighters. We compared it with the SAVE-6 scale designed for the general population among the firefighters sample. The confirmatory factor analysis (CFA) was conducted to explore the factor structure of both scales. Internal consistency reliability was checked using Cronbach’s alpha and McDonald’s omega. Convergent validity was assessed in accordance with the Patient Health Questionnaire–9 and Generalized Anxiety Disorder–7 scales. Results: The SAVE-9 scale demonstrated a Cronbach alpha of 0.880, while the SAVE-6 scale yielded an alpha of 0.874. CFA indicated good model fits for both SAVE-9 and SAVE-6 scales among firefighters sample. The SAVE-9 and SAVE-6 comparably measures viral anxiety of firefighters. Conclusion Both of the SAVE-9 and SAVE-6 scales are reliable and valid instruments for assessing viral anxiety among firefighters during the pandemic.

Objective: This study explores whether cancer patients’ dysfunctional self-focus is a significant contributor to their fear of progression. In addition, we investigated whether their psychiatric symptoms such as depression, anxiety, and dysfunctional beliefs about sleep may mediate the relationship between these factors. Methods: We conducted a retrospective medical records review of 196 cancer patients who visited the Stress Management Clinic for the first time from March to September 2022. Their demographic information and responses to rating scales such as the Fear of Progression Questionnaire-Short Form (FoP-Q-SF), Dysfunctional Self-focus Attribution Scale (DSAS), Patient Health Questionnaire-9 Items (PHQ-9), State subcategory of the State and Trait of Anxiety Inventory (STAI-S), Insomnia Severity Index (ISI), Cancer-related Dysfunctional Beliefs about Sleep scale (C-DBS), and numeric rating scales of pain and fatigue were collected. Results: A high FoP-Q-SF score was significantly correlated with high PHQ-9 (r=0.60), STAI-S (r=0.38), ISI (r=0.34), C-DBS (r=0.47), pain (r=0.24), fatigue (r=0.37), and DSAS (r=0.58, all p<0.001). A linear regression analysis showed that the FoP-Q-SF score was significantly predicted by younger age (β=-0.13, p=0.011), PHQ-9 (β=0.36, p<0.001), STAI-S (β=0.18, p=0.001), C-DBS (β=0.22, p<0.001), and DSAS (β=0.25, p<0.001). A mediation analysis showed that dysfunctional self-focus directly influenced patients’ fear of progression. In addition, cancer patients’ depression, anxiety, and cancer-related dysfunctional beliefs about sleep mediated this relationship. Conclusion We observed that dysfunctional self-focus may influence cancer patients’ fear of progression, mediated by depression, anxiety, and cancer-related dysfunctional beliefs about sleep.

PURPOSE: Primary radiation therapy following breast-conserving surgery has been an accepted alternative to mastectomy during the past 2 decades. In this country, however, the practice of conservative therapy for early invasive breast cancer has not been generalized yet. The purpose of this report was to evaluate the results and complications of breast conservation therapy in Korean Cancer Center Hospital(KCCH) MATERIALS AND METHODS: From January 1987 to December 1989, 45 patietns with early breast cancer treated with conservative treatment in KCCH were studied retrospectively. Median follow up was 54 months(range, 4 to 82 months). All patients received partial mastectomy (biopsy, tumorectomy, or quadrantectomy) and radiation therapy. Twenty eight patients received axillary dissection. The breast was treated with two poosing tangential fields (total 50 Gy or 50.4 Gy in 5 weeks with daily target dose of 2 Gy or 1.8 Gy). Thirty patients received chemotherapy before and after radiotherapy. Eleven patients received hormonal therapy. RESULTS: Five-year survival rate, 5-year disease free survival rate and 5-year local control rate were 87.2%, 86.5% and 97.6%, respectively. Administration of systemic Therapy (chemotherapy or hormonal therapy) correlated with good prognosis but statistically not significant (0.05 < p < 0.01). The sever late complication rate was 8.9%. CONCLUSION: Primary radiation therapy following breast-conserving surgery for early breast cancer is an alternative treatment comparing to radical treatment. Long term follow-up and more patients collection is needed to evaluate the prognostic factor and cosmetic outcome.
Breast Neoplasms* ; Breast* ; Disease-Free Survival ; Drug Therapy ; Follow-Up Studies ; Humans ; Mastectomy ; Mastectomy, Segmental* ; Prognosis ; Radiotherapy* ; Retrospective Studies ; Survival Rate

OBJECTIVE: To determine whether the serum beta-human chorionic gonadotropin (hCG) profile following preimplantation genetic diagnosis (PGD) is lower than that of intracytoplasmic sperm injection (ICSI) cycles. METHODS: A total of 129 PGD cycles and 1,161 age-matched ICSI cycles, which resulted in pregnancy (serum beta-hCG> or =5 mIU/mL) on post-ovulation day (POD) 12 were included. We compared the mean serum beta-hCG levels on POD 12, 14, 21, and 28, doubling time of serum hCG, and created a cut-off value for predicting a singleton pregnancy in each group. RESULTS: The mean serum beta-hCG concentration of the PGD group was significantly lower than that of the control group on POD 12, 14, and 21. The doubling time of serum beta-hCG at each time interval showed no significant difference. The cut-off-value of serum beta-hCG for predicting a single viable pregnancy was 32.5 mIU/mL on POD 12 and 113.5 mIU/mL on POD 14 for the PGD group, which was lower than that for the control group. CONCLUSION: Blastomere biopsy may decrease the beta-hCG-producing activity of the trophoblasts, especially in early pregnancy. Setting a lower cut-off value of serum beta-hCG for predicting pregnancy outcomes in PGD may be needed.
Biopsy ; Blastomeres ; Chorionic Gonadotropin ; Female ; Humans ; Pregnancy ; Pregnancy Outcome ; Preimplantation Diagnosis ; Prostaglandins D ; Sperm Injections, Intracytoplasmic ; Trophoblasts