Stereotactic vacuum-assisted breast biopsy (VAB) has been used to evaluate microcalcifications or non-palpable breast lesions on mammography. Although stereotactic VAB is usually performed in a prone or upright position, an expensive prone table is necessary and vasovagal reactions often occur during the procedure. For these reasons, the lateral decubitus position can be applied for stereotactic VAB, and true lateral mammography can be used to detect the lesion. We report on 15 cases of lateral decubitus positioning for stereotactic VAB with true lateral mammography for non-palpable breast lesions or microcalcifications. The mean procedure time was approximately 30.1 minutes, and no complications occurred during the procedures. Fourteen cases had benign breast lesions and one case had a ductal carcinoma in situ. The lateral decubitus stereotactic VAB with true lateral mammography can be applied for microcalcifications or non-palpable breast lesions and helps to minimize anxiety and vasovagal reactions in patients.
Anxiety ; Biopsy ; Breast ; Carcinoma, Intraductal, Noninfiltrating ; Humans ; Mammography ; Stereotaxic Techniques

OBJECTIVES: Paranoia is a complex phenomenon, affected by a number of factors such as depression, trait anxiety, and attributional bias in schizophrenia. The aim of this study was to explore whether paranoia within continuum of clinical and subclinical states is associated with emotional dysregulation, attributional bias and neurocognitive impairment in whole individuals of normal controls, ultra-high risk (UHR) for psychosis and schizophrenia. METHODS: 101 normal controls, 50 participants at UHR for psychosis, and 49 schizophrenia patients were recruited. All subjects were asked to complete self-reported paranoia scale and emotional dysregulation scales including Rosenberg's self-esteem, Spielberg's state-trait anxiety inventory and Beck depression inventory. The attributional style was assessed by Ambiguous Intentions Hostility Questionnaire (AIHQ). Participants were also requested to complete the comprehensive neurocognitive battery. RESULTS: Multiple linear regression analysis showed that paranoia were found to be associated with emotional dysregulation (state anxiety, trait anxiety and depression), composite blaming bias in ambiguous situation, impairment of attention and working memory in whole participants [F (9, 190)=34.85, p<0.001, adjusted R2=0.61]. CONCLUSION: The main findings suggest that paranoia is a complex affective and cognitive structure that may be associated with emotional dysregulation, blaming bias and attention and working memory impairment in clinical and non-clinical paranoia.
Anxiety ; Bias (Epidemiology)* ; Depression ; Hostility ; Humans ; Intention ; Linear Models ; Memory, Short-Term ; Paranoid Disorders* ; Psychotic Disorders* ; Surveys and Questionnaires ; Schizophrenia* ; Weights and Measures

Objective: We conducted this study to address the incidence and prevalence of schizophrenia and similar psychosis in South Korea with Health Insurance Review and Assessment (HIRA) database. Methods: We used HIRA database, which includes diagnostic information of nearly all Korean nationals to collect number of cases with diagnosis of schizophrenia and schizophrenia-similar disorders (SSP), including schizophreniform, acute/transient psychotic disorders, schizoaffective disorders, and other/unspecific nonorganic psychosis (ICD-10 codes F20/23/25/28/29) between 2010 and 2015. The annual prevalence and incidence were calculated using the population data from the Korean Statistical Office. Results: The 12-month prevalence of SSP of Korea between 2010 and 2015 were 0.48–0.66%. The 12-month prevalence of schizophrenia were 0.40–0.52%; The annual incidence rates (IR) of SSP between 2010 and 2015 were 118.8–148.7 per 100,000 person-year (PY). For schizophrenia, IR per 100,000 PY were 77.6–88.5 between 2010 and 2015. Conclusion The 12-month prevalence found in the present study was higher than that reported in community-based epidemiologic studies in South Korea but similar to those from other countries. The annual incidence of SSP and schizophrenia was found to steadily increase and was higher than that of other countries. The high incidence rate observed in the current study needs to be studied further.

Objective: To overcome the limited effectiveness of standard case management services, the Seoul Intensive Case Management program (S-ICM) for patients with serious mental illnesses was introduced in 2017. This study aimed to evaluate its effectiveness in reducing the length of hospital stay. Methods: Monitoring data from April 2019 to March 2020 were retrieved from the Seoul Mental Health Welfare Center. A total of 759 participants with serious mental illnesses were included. The average length of admission per month was compared between the pre-ICM (previous year) and during-ICM periods. For post-ICM observation subgroup, average length of admission per month was compared between pre-ICM, during-ICM, and post-ICM periods. To determine the relative contributions of risk factors for during-ICM and post-ICM admission, multivariate logistic regression analyses were performed. Results: The average admission stay for pre-ICM period was significantly longer than that for during-ICM period (1.47 vs. 0.26 days). Among the predictors for during-ICM admission, pre-ICM psychiatric admission was the most important risk factor, followed by medical aid beneficiary and suicidal behavior. In the subgroup analysis of the post-ICM observation period, the pre-ICM, during-ICM, and post-ICM average admission stays were 1.45, 0.29, and 0.57 days/month, respectively. There was a significant difference in the average length of stay between the pre-ICM and during-ICM periods and between the pre-ICM and post-ICM periods. Post-ICM admission risks included pre-ICM admission, S-ICM duration <3 months, and chronic unstable symptoms. Conclusion The results suggest that the S-ICM effectively reduces psychiatric hospitalization duration, at least over a short-term period.

Objective: To establish and to promote the qualitative development of a housing service model in South Korea. Methods: The questionnaire was collected through the housing needs survey and the focus group interview on the mental health professions. We enrolled 365 subjects from 63 places (community conversion facilities, cohabitation, cohabitation families, hospitals, psychiatric nursing homes) to answer the questionnaires. Results: The survey result confirms the needs of people with a mental illness to be self-reliant, but it shows that the economic vulnerability is a hindrance. In addition, the most necessary factor for self-reliant living is to provide services that support daily living. Therefore, the study points out that a system that guarantees self-reliance must be added in order for the housing services to be distributed throughout local communities for the people with mental illness. Conclusion The study proposes the Seoul-type housing services model to replace the housing services that functions in a fragmented manner with the provision of an integrated services through a unified channel by establishing a housing support center (tentative name). This will ultimately help people with a mental illness to live a healthy life that meets their needs as community members.

PURPOSE: Major chest wall reconstruction following radical excision of advanced breast cancer is remained a challenging treatment of oncoplastic surgeons. The aims of this study are to introduce a method of external oblique myocutaneous flap (EOMCF) and evaluate the effect of large chest wall reconstruction using external oblique myocutaneous flap. METHODS: A retrospective review of 17 patients who underwent chest wall reconstruction with external oblique myocutaneous flap from January of 2007 through May of 2008 was performed. The upper edge of external oblique myocutaneous flap was lower margin of defect. The medial edge was mid-line of abdomen by umbilicus, vertically along the linea alba. The lower edge was a lateral transverse line at the level of umbilicus. The flap was rotated clockwise in the left side chest wall defects and counterclockwise in the right. RESULTS: The mean chest wall defect was 360.8+/-137.8 cm2 and the mean flap size was 591.1+/-136.2 cm2. The mean reconstruction time was 41.5+/-7.9 min and patients were discharged on 8.8+/-1.2 postoperative day (mean). Three patients had superficial skin loss (<5%) and this lesions are healed with conservative therapy. CONCLUSION: We propose that the external oblique myocutaneous flap may be a safe and feasible method for reconstruction of large chest wall defects after radical mastectomy including all breast skin.
Abdomen ; Breast ; Breast Neoplasms ; Humans ; Mastectomy, Radical ; Retrospective Studies ; Skin ; Thoracic Wall ; Umbilicus

PURPOSE: Stage-related treatment has been recommended for gallbladder cancer (GBC). When patients with T2 tumors undergo an extended cholecystectomy, the 5-year survival rates have been reported to be 64~100%. But when patients with T2 tumors undergo simple cholecystectomy, the 5-year survival rates have been reported to be only 20~40%. The question may rise as to which patients benefit from simple cholecystectomy among patients with T2 GBC. We investigated the survivals and the facts leading to death or recurrence after simple cholecystectomy for T2 GBC. METHODS: Between Mar. 2001 and Dec. 2007, 13 patients had refused second radical operation for T2 GBC incidentally discovered after simple cholecystectomy. Survival analyses were evaluated by clinopathological factors. RESULTS: The 1-, 3- and 4-year overall survival rates were 84.6%, 76.2% and 38.1% and 1- and 3-year disease-free survival rates were 69.2%, 51.3%. The factors affected survival rates were low serum albumin titer and R1 resection (Lymph node metastasis or cystic duct involvement in microscopic finding) (P<0.05). CONCLUSION: Simple cholecystectomy is not a curative method of T2 GBC, because it reveals lower 5-year survival rates compared to those of extended cholecystectomy or radical surgery. But in the case when the patient refuses reoperation or it is difficult to undergo reoperation because of severe underlying disease, simple cholecystectomy with normal albumin titer or the absence of lymph node metastasis and absence of cystic duct involvement in microscopic findings may help the long-term survivals after simple cholecystectomy.
Cholecystectomy ; Cystic Duct ; Disease-Free Survival ; Gallbladder ; Gallbladder Neoplasms ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Recurrence ; Reoperation ; Serum Albumin ; Survival Rate

Pancreatic lipomas are commonly diagnosed based on radiologic images, although the prevalence of lipomas has not been established. Histologic confirmation of pancreatic lipomas is extremely rare because surgical treatment is unnecessary in most cases. Endoscopic ultrasound-guided fine-needle aspiration cytology has been suggested to avoid unnecessary surgery to distinguish between a lipoma and a well-differentiated liposarcoma; however, surgery would be needed when the tumor is associated with symptoms or difficult to distinguish from a liposarcoma. We present a case of a pancreatic lipoma in a 54-year-old male patient that was histologically-confirmed by subtotal pancreatectomy.
Biopsy, Fine-Needle ; Humans ; Lipoma ; Liposarcoma ; Male ; Middle Aged ; Pancreas ; Pancreatectomy ; Prevalence ; Unnecessary Procedures

BACKGROUND AND OBJECTIVES: There are a few reports about the function of submandibular gland obstructed by stone. The purpose of this study was to evaluate the histopathologic change of submandibular gland for sialolithiasis and its correlation to histopathologic grades and clinical findings. MATERIALS AND METHODS: Retrospectively, we reviewed the clinical history of 23 patients who underwent submandibular gland excision for sialolithiasis. Histopathologic grades of submandibular gland were estabilished by the degrees of inflammation, atrophy, and fibrosis. We evaluated the relation between histopathologic grades and clinical findings including age, sex, duration of symptoms, number of infectious episodes, time between the last infectious episode and surgery, use of antibiotics. RESULTS: Normal to mild histopathologic grades showed 22% (5/23), the moderate grade showed 35% (8/23), the severe grade showed 43% (10/23). There is no significant relationship between histopathologic grades and clinical findings. CONCLUSION: The results of this study suggest that, if possible, the conservative therapy should be preferred rather than performing the excision of submandibular gland for sialolithiasis.
Anti-Bacterial Agents ; Atrophy ; Fibrosis ; Humans ; Inflammation ; Retrospective Studies ; Salivary Gland Calculi* ; Submandibular Gland

Background: Biogenetic causal explanations of mental disorders are commonly used for public education and campaigns. However, the influence of biogenetic explanations on the ideas about and attitudes toward mental illness is unclear. We examined the influence of biogenetic explanations on attitudes toward mental disorders using a meta-analytic method accompanied by subgroup analyses. Methods: The protocol for this meta-analysis was registered in PROSPERO (CRD42020158656) in March 2020. Experimental and correlational studies were analyzed separately. Five outcome measures related to attitudes toward mental disorders were included: ‘attitude toward helpseeking,’ ‘blame,’ ‘perceived dangerousness,’ ‘prognostic pessimism,’ and ‘social distance.’ Subgroup analyses were performed for the type of mental disorder, population, and geographic region for which a biogenetic explanation was provided. Results: A total of 44 studies were included, of which 24 were experimental and 20 were correlational. A positive attitude toward help-seeking was associated with having a biogenetic concept (d = 0.43; 95% confidence interval [CI], 0.18 to 0.67; P < 0.001) in general population and in Eastern countries in particular. Although a biogenetic explanation was associated with a decreased level of blame (d = −0.20; 95% CI, −0.38 to −0.02; P = 0.029) in the general population, it was also associated with significantly higher levels of perceived dangerousness (d = 0.13; 95% CI, 0.03 to 0.23; P = 0.008). A tendency toward a higher level of prognostic pessimism and social distance was associated with a biogenetic concept of mental disorders although there was no statistical significance. Conclusion Having a biogenetic concept of the cause of mental disorders was related with a positive attitude toward help-seeking, particularly in the general population and individuals living in Eastern countries. Providing a biogenetic explanation decreased blame toward individuals with mental illness but was associated with increased perceived dangerousness and prognostic pessimism. Therefore, although a biogenetic explanation use of mental health services, it should be carefully applied to avoid an increase in negative thoughts, such as that mental illness is biologically irreversible and untreatable.promotes public