Objectives: This study developed a battery test that allows a comprehensive evaluation of depressive symptoms and related protective-vulnerable factors to screen for depression and mental health and examined the reliability and validity of the test. Methods: PROtective and Vulnerable factors battEry test (PROVE) consisting of five sub-sections was developed: depressive symptomatology (PROVE-DS), suicide risk (PROVE-SR), and three protective-vulnerable factors, which were adult attachment type (PROVE-ATT), adverse childhood experience (PROVE-ACE), and mentalization capacity (PROVE-MC). Two hundred and thirteen subjects completed the PROVE test and other comparative scales, and the analysis was carried out based on the data. Results: The PROVE test showed good convergent, discriminant, and concurrent validity as well as adequate internal consistency. In addition, five sub-sections of the PROVE test showed significant relevance to each other. Conclusion The results of this study indicate that the PROVE test is a reliable and valid test, which will be useful for the prevention, evaluation, and treatment of depression in various clinical settings.

Objectives: This study developed a battery test that allows a comprehensive evaluation of depressive symptoms and related protective-vulnerable factors to screen for depression and mental health and examined the reliability and validity of the test. Methods: PROtective and Vulnerable factors battEry test (PROVE) consisting of five sub-sections was developed: depressive symptomatology (PROVE-DS), suicide risk (PROVE-SR), and three protective-vulnerable factors, which were adult attachment type (PROVE-ATT), adverse childhood experience (PROVE-ACE), and mentalization capacity (PROVE-MC). Two hundred and thirteen subjects completed the PROVE test and other comparative scales, and the analysis was carried out based on the data. Results: The PROVE test showed good convergent, discriminant, and concurrent validity as well as adequate internal consistency. In addition, five sub-sections of the PROVE test showed significant relevance to each other. Conclusion The results of this study indicate that the PROVE test is a reliable and valid test, which will be useful for the prevention, evaluation, and treatment of depression in various clinical settings.

Waldenstrom's macroglobulinemia is a rare disease of plasmacytoid lymphocyte proliferation usually presented without bone lesion which is the common presenting symptom in multiple myeloma. We report a 50-year-old female with Waldenstrom's macroglobulinemia presented as a bony lesion without many other features common in this diesease. She was admitted with the chief complaint of low back pain and low extremity paresthesia for two months. Bone marrow biopsy and aspiration, protein and immune electrophoresis showed findings consistent with Waldenstr m's macroglobulinemia. Magnetic resonance imaging of thoracic spine showed pathologic compression fracture in T6 and T7 with posterior epidural mass at T6 to T7 level. We report this unusual case of Waldenstrom's macroglobulinemia presented as compression fracture of thoracic spine with a review of literatures.
Biopsy ; Bone Marrow ; Electrophoresis ; Extremities ; Female ; Fractures, Compression* ; Humans ; Low Back Pain ; Lymphocytes ; Magnetic Resonance Imaging ; Middle Aged ; Multiple Myeloma ; Paresthesia ; Rare Diseases ; Spine* ; Waldenstrom Macroglobulinemia*

BACKGROUND: About 60~80% of previously untreated patients with acute myelogenous leukemia (AML) achieve complete remission (CR) when treated with cytarabine and anthracycline. Anthracycline is one of the most important chemotherapeutic agents in AML. It has been claimed that idarubicin showed superior complete remission rate than daunorubicin, which is not completely established. We evaluated idarubicin in combination with cytarabine (AI) as an induction chemotherapy in patient with AML. METHODS: Thirty one patients with newly diagnosed acute myelogenous leukemia were enrolled. Remission induction emotherapy was consisted of cytarabine (100mg/m2 IV over 24 hours on day 1~7) and idarubicin (12mg/m2 IV over 30 minutes on day 1~3). After achievement of CR, patients underwent consolidation therapy with high- dose cytarabine and/or bone marrow transplantation. RESULTS: Median age of the patients was 43 years (range; 17~62) and M2 was the most common subtype. The CR rate was 71% (22/ 31). The median overall and disease-free survival were 67 weeks (95% confidence interval, CI; 43~91) and 65 weeks (95% CI; 26~104), respectively with a median follow-up of 48 weeks. Major toxicities were fever and infection during the neutropenic period. There were three treatment-related mortalities. Causes of death were refractory AML in 1 patient and infection in 2 patients. CONCLUSION: AI induction chemotherapy seems to be effective and safe regimen as an induction chemotherapy in AML.
Bone Marrow Transplantation ; Cause of Death ; Cytarabine* ; Daunorubicin ; Disease-Free Survival ; Fever ; Follow-Up Studies ; Humans ; Idarubicin* ; Induction Chemotherapy* ; Leukemia, Myeloid, Acute* ; Mortality ; Remission Induction

The reactive airway dysfunction syndrome (RADS), a subset of irritant-induced asthma, has been described following exposure to various irritant gas. We describe a case of RADS occuring following a single exposure to high levels of chlorine gas in the workplace. No documented pre-existing respiratory illness and atopy was identified. Cough, dyspnea, and wheezing were developed with the single accidental exposure to chlorine gas and methacholine provocation test was positive. He was completely recovered with the treatment of corticosteroid and oxygen therapy.
Angioedema ; Asthma ; Cellulitis ; Chlorine* ; Cough ; Dyspnea ; Eosinophilia ; Hypereosinophilic Syndrome ; Methacholine Chloride ; Oxygen ; Respiratory Sounds

Background: Outcomes of traditional treatment for osteonecrosis of the femoral head (ONFH) are not always satisfactory. Hence, cell-supplementation therapy has been attempted to facilitate necrotic-tissue regeneration. Adipose-derived mesenchymal stem cell (ADMSC) transplantation is potentially advantageous over bone marrow-derived MSC implantation, but its outcomes for ONFH remain unclear. The aim of this study was to determine 2-year radiological and clinical outcomes of culture-expanded autologous ADMSC implantation for ONFH. Methods: Eighteen hips with necrotic lesions involving ≥ 30% of the femoral head were included. ADMSCs were harvested by liposuction and culture expanded for 3 passages over 3 weeks. With a 6-mm single drilling, ADMSCs were implanted into the necrotic zone. All patients underwent magnetic resonance imaging (MRI), single-photon emission computed tomography/computed tomography (SPECT/CT) at screening and 6 months, 12 months, and 24 months postoperatively. The primary outcome was the change in the size of necrotic area on MRI. Secondary outcomes were changes in clinical scores and radioisotope uptake on SPECT/CT. Conversion total hip arthroplasty (THA) was defined as the endpoint. Results: Preoperatively, the necrotic lesion extent was 63.0% (38.4%–96.7%) of the femoral head. The mean Harris hip score was 89.2, the University of California at Los Angeles (UCLA) score was 5.6, and Western Ontario and McMaster Universities Arthritis index (WOMAC) was 79.4. Three patients underwent THA and 1 patient died in an accident. Finally, 11 patients (14 hips) were available for ≥ 2-year follow-up. At the last follow-up, no surgery-related complications occurred, and 14 of 17 hips (82%) were able to perform daily activities without THA requirement. There was no significant decrease in lesion size between any 2 intervals on MRI.However, widening of high signal intensity bands on T2-weighted images inside the necrotic lesion was observed in 9 of 14 hips (64%); 11 of 14 hips (79%) showed increased vascularity on SPECT/CT at 2 years postoperatively. No significant differences were observed between preoperative and 24-month mean Harris hip score (89.2 vs. 88.6), WOMAC (79.4 vs. 75.7), and UCLA score (5.6 vs. 6.2). Conclusions Our outcomes suggest that culture-expanded ADMSC implantation is a viable option for ONFH treatment without adverse events.

PURPOSE: This study aims to compare the efficacy and safety of propiverine hydrochloride (propiverine) 40mg for the treatment of overactive bladder (OAB). MATERIAL AND METHODS: Total of 284 patients (male:86, female:198) with OAB were included in this study. The patients were treated with propiverine 20mg twice daily or 40mg once daily for 8 weeks. The initial evaluation included with history taking, physical examination, International Prostatic Symptom Score (IPSS), IPSS QoL and consecutive voiding diaries for 3 days. After a 8-week treatment, IPSS, IPSS QoL, patients perception of treatment benefit, global assessment of efficacy by physicain and safety were evaluated. RESULTS: Two hundred eighteen patients were treated with propiverine 20mg twice daily and 66 patients treated with 40mg once daily. The 59 patients had been treated previously with anticholinergics. After a 8-week treatment, IPSS score (total, voiding and storage subscore) and IPSS QoL were improved in all patients (p<0.05). After a 8-week with propiverine 40mg once daily, improvement of IPSS score was noted in the patients non-responsive to anticholinergics previously (p<0.05). The patients treated with propiverine 40mg once daily showed much more symptomatic improvements assessed by physicians than 20mg twice daily (p<0.05). The overall side effect was noted in the 13.4% patients and the most common side effect was dry mouth. CONCLUSION: Propiverine 40mg once daily is considered to reduce the symptom of OAB effectively and can be used safely in the patients with OAB. Treatment with propiverine 40mg is seemed to show more improvement in the unsatisfactory patients with previous anticholinergics.
Cholinergic Antagonists ; Humans ; Mouth ; Observational Study* ; Physical Examination ; Prospective Studies* ; Treatment Outcome ; Urinary Bladder, Overactive*

Objective: This study evaluated the clinical effectiveness of Minds.NAVI, a depression screening kit combining psychometric measures and stress hormone biomarkers, in a prospective clinical trial. The objective was to assess its potential as a depression screening tool and investigate the associations between psychological assessments, salivary hormone staging, and depression severity. Methods: Thirty-five participants with major depressive disorder and 12 healthy controls (HCs) were included. The Minds.NAVI software, utilizing the PROtective and Vulnerable factors battEry Test (PROVE) and salivary cortisol/dehydroepiandrosterone (DHEA) analysis, was employed. The PROVE test is a comprehensive self-report questionnaire that assesses depressive symptoms, suicide risk, attachment style, adverse childhood experiences, mentalization capacity, and resilience. In addition, salivary cortisol and DHEA levels were measured to evaluate the functional stage of the hypothalamic–pituitary–adrenal (HPA) axis. Results: Minds.NAVI exhibited 100% sensitivity, 91.7% specificity, and 97.9% accuracy in distinguishing depression from HCs within an exploratory small group. Salivary stress hormone phases showed changes with depression stage (p=0.030), and the proportion of patients with “adrenal exhaustion stage” was higher in the moderate/severe depression group (p=0.038). Protective/vulnerable factors differed significantly between controls and depressed groups (p<0.001). Cortisol awakening response inversely correlated with depressive symptom severity (r=-0.31, p=0.034). Conclusion This study suggested possible clinical effectiveness of Minds.NAVI, a depression screening tool that integrates psychometric measures and stress hormone biomarkers. The findings support the potential association between depression, chronic stress, and HPA axis hyporesponsiveness.

BACKGROUND: Korean Nosocomial Infections Surveillance System (KONIS) operating since July 2006 is the first nationwide monitoring system for nosocomial infections in the in the intensive care unit (lCU) with a standard protocol and web-based prompt response network in Korea. This report describes the characteristics of the KONIS hospitals compared with those of all Korean hospitals with 400 beds and over. METHODS: A survey was conducted for the 44 hospitals participating in KONIS 2006, and the data were rechecked by the KONIS hospitals through KONIS web-network. The survey form included questions about the size of the hospital, infection control personnel, nursing personnel, and the status of microbiologic laboratory. RESULTS: Compared to all Korean hospitals with 400 beds and over, the KONIS hospitals were larger in term of average number of beds (857 vs 654); the number of hospitals with 700 beds and over was over-represented in Seoul (P=0.01) and under-represented in the central/south area (P<0.001) The majority of the KONIS hospitals were major teaching university-affiliated (88,6%) and private (72.7%), but in the central/south area, public hospitals comprised up to 60%. The number of infection control professionals (ICP) averaged 1.6, hospital beds per ICP 531, and infectious disease physicians 1.3. Medical and medical combined ICUs were the major component (67,1%) of the KONIS ICUs, The lCU bed per nurse was 0.63. CONCLUSION: The KONIS 2006 hospitals were over-represented in the overall indicators in Seoul. Because no objective indicators were available regarding the patient quality, KONIS data must be interpreted in consideration of all indicators.
Communicable Diseases ; Cross Infection* ; Hospitals, Public ; Humans ; Infection Control ; Intensive Care Units ; Korea ; Nursing ; Seoul

We report here on a case of non-Hodgkin's lymphoma in which liver involvement was the predominant clinical manifestation. A healthy 44-year-old man presented with upper abdominal pain, hepatosplenomegaly, thrombocytopenia, elevated AST, ALT and bilirubin, and marked elevation of lactate dehydrogenase and alkaline phosphatase. The abdominal CT scan showed only diffuse hepatosplenomegaly and uneven contrast enhancement of the spleen without any definite mass of the liver and spleen. US-guided aspiration biopsy of liver and the histologic examination confirmed a diagnosis of non-Hodgkin's lymphoma, the diffuse large B cell type. Bone marrow biopsy showed the infiltration of malignant lymphoma cells. PET-CT showed an increased FDG uptake of the liver, spleen and long bones. The patient was treated with combination regimen of cyclophosphamide, doxorubicin, vincristine and prednisone chemotherapy. Even in the absence of a mass lesion or lymphadenopathy, primary hepatic or hepatosplenic lymphoma should be considered in differential diagnosis of hepatitis or liver cirrhosis, especially for patients with diffuse hepatosplenomegaly and markedly elevated LDH.
Adult ; Diagnosis, Differential ; English Abstract ; Hepatitis/*diagnosis ; Humans ; Liver Neoplasms/*diagnosis/pathology ; Lymphoma, B-Cell/*diagnosis/pathology ; Male