OBJECTIVES: Patients with schizophrenia often have a concrete thinking or an impairment in abstract thinking, but there has been a limitation in quantitatively measuring this cognitive function. The aim of the current study was to investigate a deficit in abstract thinking in patients with schizophrenia using the theme identification task. METHODS: Twenty subjects with schizophrenia and 20 healthy volunteers participated in the behavioral study for theme identification. The visual stimuli were composed of a series of pictures, which contained positive or negative emotional situations. Three words, indicating a main theme of the picture, a theme-related item and a theme-unrelated item, respectively, were presented in the bottom of the pictures, and participants had to select a theme. RESULTS: The patient group selected theme words at significantly lower rate in both emotional conditions than the control group (positive, p=0.002 ; negative, p=0.001). Especially, in the negative condition, the patient group more selected theme-unrelated items than the control group (p=0.001). The rates of theme identification were inversely correlated with scores of the Social Anhedonia Scale (positive, r=-0.440, p=0.007 ; negative, r=-0.366, p=0.028). CONCLUSION: Patients with schizophrenia exhibited an impairment in abstract thinking, and it was remarkable in the negative condition. The ability to think abstractly was associated with the severity of social anhedonia. The impairment of abstract thinking may become one of the reasons for poor social functioning in socially anhedonic patients.
Anhedonia ; Humans ; Schizophrenia ; Thinking

Cutaneous angiosarcomas are uncommon malignancies which account about 1% of sarcomas. They are found most commonly in the head and neck regions, frequently on the scalp. Although preferred treatment has been combined surgery and postoperative radiation therapy, the extensiveness and multiplicity of the lesions set limits to such an approach and the patient is often referred for radiotherapy without surgery. As the entire scalp usually needs to be treated, radiation therapy is a challenging problem to radiation oncology staffs. We report a case of angiosarcoma of the scalp, which was treated successfully by radiation therapy with a simple and repeatable method using mixed photon and electron beam technique. Using a bolus to increase the surface dose of the scalp and to minimize dose to the normal tissues of the brain desirable but difficult technically to be well conformed o the three dimensional curved surface such as vertex of the head. A helmet made of thermoplastics filled with paraffin was elaborated and used for the treatment, resulting of the relatively uniform surface doses along the several points measured on the scalp, the difference among the points not exceeding 7% of the prescribed dose by TLD readings.
Brain ; Head ; Head Protective Devices ; Hemangiosarcoma* ; Humans ; Neck ; Paraffin ; Radiation Oncology ; Radiotherapy* ; Reading ; Sarcoma ; Scalp*

No abstract available.

Xeroderma pigmentosum is a group of dermatoses characterized by autosomal recessive inheritance, photosensitivity, photophobia, early onset freckles, and subsequent cutaneous neoplastic changes on sun-exposed areas. It is due to enzymatic defects that render the cells unable to repair UV-induced DNA damages resulting in various clinical phenotypes. A 66-year-old female patient who has been diagnosed as xeroderma pigmentosum twenty years ago developed a recurrent basal cell carcinoma on the right nasal side-wall, resulting in a large defect that comprises multiple aesthetic units, after a Mohs micrographic surgery. A combination of dorsal nasal and cheek advancement flaps with full thickness skin graft was a useful method for the reconstruction of the large nasal defect.
Aged ; Carcinoma, Basal Cell ; Cheek ; DNA Damage ; Female ; Humans ; Melanosis ; Mohs Surgery* ; Phenotype ; Photophobia ; Skin ; Skin Diseases ; Transplants ; Wills ; Xeroderma Pigmentosum

Xeroderma pigmentosum is a group of dermatoses characterized by autosomal recessive inheritance, photosensitivity, photophobia, early onset freckles, and subsequent cutaneous neoplastic changes on sun-exposed areas. It is due to enzymatic defects that render the cells unable to repair UV-induced DNA damages resulting in various clinical phenotypes. A 66-year-old female patient who has been diagnosed as xeroderma pigmentosum twenty years ago developed a recurrent basal cell carcinoma on the right nasal side-wall, resulting in a large defect that comprises multiple aesthetic units, after a Mohs micrographic surgery. A combination of dorsal nasal and cheek advancement flaps with full thickness skin graft was a useful method for the reconstruction of the large nasal defect.
Aged ; Carcinoma, Basal Cell ; Cheek ; DNA Damage ; Female ; Humans ; Melanosis ; Mohs Surgery* ; Phenotype ; Photophobia ; Skin ; Skin Diseases ; Transplants ; Wills ; Xeroderma Pigmentosum

Objectives: ：Somatic symptom disorder (SSD) is characterized by the manifestation of a variety of physical symptoms, but little is known about differences in autonomic nervous system activity according to symptom severity, especially within patient groups. In this study, we examined differences in heart rate variability (HRV) across symptom severity in a group of SSD patients to analyze a representative marker of autonomic nervous system changes by symptoms severity. Methods: ：Medical records were retrospectively reviewed for patients who were diagnosed with SSD based on DSM-5 from September 18, 2020 to October 29, 2021. We applied inverse probability of treatment weighting (IPTW) methods to generate more homogeneous comparisons in HRV parameters by correcting for selection biases due to sociodemographic and clinical characteristic differences between groups. Results: ：There were statistically significant correlations between the somatic symptom severity and LF (nu), HF (nu), LF/HF, as well as SD1/SD2 and Alpha1/Alpha2. After IPTW estimation, the mild to moderate group was corrected to 27 (53.0%) and the severe group to 24 (47.0%), and homogeneity was achieved as the differences in demographic and clinical characteristics were not significant. The analysis of inverse probability weighted regression adjustment model showed that the severe group was associated with significantly lower RMSSD (β=-0.70, p=0.003) and pNN20 (β=-1.04, p=0.019) in the time domain and higher LF (nu) (β=0.29, p<0.001), lower HF (nu) (β=-0.29, p<0.001), higher LF/HF (β=1.41, p=0.001), and in the nonlinear domain, significant differences were tested for SampEn15 (β=-0.35, p=0.014), SD1/SD2 (β=-0.68, p<0.001), and Alpha1/Alpha2 (ß=0.43,p=0.001). Conclusions ：These results suggest that differences in HRV parameters by SSD severity were showed in the time, frequency and nonlinear domains, specific parameters demonstrating significantly higher sympathetic nerve activity and reduced ability of the parasympathetic nervous system in SSD patients with severe symptoms.

Cutaneous metastasis from lung cancer is less common than metastasis from other organs. However, lung cancer is the most common origin of cutaneous metastasis in men and the second most common in women. Recognition of cutaneous metastatic cancer is important because it can be the first sign of visceral cancer. Although skin metastasis can appear on any cutaneous surface, the most common site is the chest wall. The prognosis for patients having lung cancer with cutaneous metastasis is very poor because the disease is advanced, with the involvement of other sites such as the brain, liver, bone, and adrenal gland. Herein, we report a case of an 87-year-old male with an undifferentiated metastatic carcinoma of the scrotum originating from lung cancer which was found later than the cutaneous metastatic cancer.
Adrenal Glands ; Aged, 80 and over ; Brain ; Female ; Humans ; Liver ; Lung Neoplasms* ; Lung* ; Male ; Neoplasm Metastasis ; Prognosis ; Scrotum ; Skin ; Thoracic Wall

BACKGROUND: Red blood cell (RBC) transfusion is one of the major treatments for correcting anemia, but its use should be carefully considered because of adverse transfusion reactions and inappropriate usage. Therefore, individual health care facilities have self evaluated their use of transfusion in an attempt to decrease unnecessary procedures. In this study, we evaluated the differences in the minimum hemoglobin (Hb) trigger for RBC transfusion among clinical departments in Severance Hospital. METHODS: We analyzed the electronic medical records of RBC transfusion episodes that were conducted at a Hb level above 8 g/dL from July 2014 to September 2015. We classified these data by clinical department, and considered the overall medical conditions of the patients. The minimum Hb trigger level in this study was defined as the lowest Hb level within 24 hours prior to RBC transfusion. RESULTS: A total of 4,953 RBC transfusion episodes that were conducted at Hb levels above 8 g/dL were analyzed over that period. In general, the minimum Hb trigger level was higher in the operation group than the hemorrhage group. When compared among clinical departments, the department of orthopedic surgery, neurosurgery, rehabilitation medicine, and anesthesiology showed high levels of minimum Hb trigger equal to or greater than 10 g/dL. CONCLUSION: The minimum Hb trigger level differed among clinical departments, with the operation group showing a much higher level of minimum Hb trigger. We hope that these data will be practically applied to establish plans and strategies for managing the appropriateness of RBC transfusions in Korea. In addition, continuous evaluation and transfusion education for clinical departments should be performed.
Anemia ; Anesthesiology ; Delivery of Health Care ; Education ; Electronic Health Records ; Erythrocyte Transfusion* ; Erythrocytes* ; Hemorrhage ; Hope ; Humans ; Korea ; Neurosurgery ; Orthopedics ; Rehabilitation ; Transfusion Reaction ; Unnecessary Procedures

Purpose: This study developed a protocol for nursing care after death for adult patients in hospitals. Methods: This was a methodological study to develop a care after death protocol. The preliminary protocol was developed based on a literature review, guidelines, and practice recommendations from groups of experts and clinical nurses. Content validity was evaluated by a group of experts (n=6) and nurses (n=30) in two hospitals. Results: The preliminary protocol recommendations were modified by validation and the open-question analysis results. The final protocol comprised three general recommendations and 43 recommendations in five steps that are verification and notification of a death, personal care of the body, viewing the patient, patient transfer, and documentation and self-care. Conclusion This study result provides nurses with a consensus information on patient care after death and family support in a hospital setting. This nursing protocol is expected to improve the quality of care after death for adult patients and their families, and can be used for developing educational and emotional support for nurses to accomplish their important role.

OBJECTIVES: Patients with schizophrenia often present the idea of reference in social situations ; however, the number of research studies examining the nature of the idea of reference and the visual searching pattern in social situations is limited. The aim of this study was to investigate behavioral and visual searching characteristics of patients with schizophrenia in social situations in which the idea of reference can be provoked. METHODS: Eighteen subjects with schizophrenia (eight males) and 18 healthy volunteers (seven males) performed the idea-of-reference-provoking task, which was composed of movie clips with scenes of two women sitting on a bench 1 m away. The participants' reactions were rated using questionnaires for self-reference, malevolent intentions, and anxiety. Visual scan path was monitored during performance of the task. RESULTS: There were significant group differences in the reactions on self-reference, malevolent intentions, and anxiety. The visual searching pattern in patients with schizophrenia was to avoid looking at the women's body area in every movie clip. However, there was no significant difference in the face area in both groups. CONCLUSION: A distinct visual strategy in schizophrenia may affect the self-referential bias and paranoid response. The absence of difference in attention to a core information region (face) may suggest the possibility of inferential errors as well as the cause of self-referential bias and paranoid responses.
Anxiety ; Bias (Epidemiology) ; Female ; Healthy Volunteers ; Humans ; Intention ; Surveys and Questionnaires ; Schizophrenia*