PURPOSE: This study was conducted to investigate the related factors of insight, self-esteem, and coping skills and the relationships among them in patients with alcohol addiction. METHODS: The participants enrolled in this study were 106 patients from two alcohol treatment hospitals in Gyeonggi Province. Data were collected from May, 12 to 20, 2010 using self-report questionnaires. The instruments were the Hanil Alcohol Insight Scale, Rosenberg Self-esteem Scale, and the Ways of Coping Checklist. Data were analyzed using the SPSS-Win 12.0 program. RESULTS: Among the participants, 24.5% had poor insight, 45.3% fair insight, and 30.2% good insight. Insights of participants who had experienced withdrawal symptoms (t=-3.79, p<.001) and of those not living with family (t=-2.07, p=.041) were higher than those who had not experienced the symptoms and who were not living with family. Self-esteem of participants living with family (F=3.60, p<.001) and of those with better academic backgrounds (F=3.39, p=.021) were higher than those of the other groups. Also, self-esteem showed a positive relation with active coping (r=.34, p<.001). CONCLUSION: The results of the present study suggest that mental health practitioners need to focus on insight and self-esteem enhancement, coping skill development when treating patients with alcohol addiction.
Adaptation, Psychological* ; Alcoholics* ; Checklist ; Humans ; Mental Health ; Surveys and Questionnaires ; Substance Withdrawal Syndrome

BACKGROUND/OBJECTIVES: Vascular inflammation is an important feature in the atherosclerotic process. Recent studies report that leaves and branches of Carpinus turczaninowii (C. turczaninowii) have antioxidant capacity and exert anti-inflammatory effects. However, no study has reported the regulatory effect of C. turczaninowii extract on the arterial inflammatory response. This study therefore investigated modulation of the arterial inflammatory response after exposure to C. turczaninowii extract, using human aortic vascular smooth muscle cells (HAoSMCs). MATERIALS/METHODS: Scavenging activity of free radicals, total phenolic content (TPC), cell viability, mRNA expressions, and secreted levels of cytokines were measured in LPS-stimulated (10 ng/mL) HAoSMCs treated with the C. turczaninowii extract. RESULTS: C. turczaninowii extract contains high amounts of TPC (225.6 ± 21.0 mg of gallic acid equivalents/g of the extract), as well as exerts time-and dose-dependent increases in strongly scavenged free radicals (average 14.8 ± 1.97 µg/mL IC50 at 40 min). Cell viabilities after exposure to the extracts (1 and 10 µg/mL) were similar to the viability of non-treated cells. Cytokine mRNA expressions were significantly suppressed by the extracts (1 and 10 µg/mL) at 6 hours (h) after exposure. Interleukin-6 secretion was dose-dependently suppressed 2 h after incubation with the extract, at 1–10 µg/mL in non-stimulated cells, and at 5 and 10 µg/mL in LPS-stimulated cells. Similar patterns were also observed at 24 h after incubation with the extract (at 1–10 µg/mL in non-stimulated cells, and at 10 µg/mL in the LPS-stimulated cells). Soluble intracellular vascular adhesion molecules (sICAM-1) secreted from non-stimulated cells and LPS-stimulated cells were similarly suppressed in a dose-dependent manner after 24 h exposure to the extracts, but not after 2 h. In addition, sICAM-1 concentration after 24 h treatment was positively related to IL-6 levels after 2 h and 24 h exposure (r = 0.418, P = 0.003, and r = 0.524, P < 0.001, respectively). CONCLUSIONS: This study demonstrates that C. turczaninowii modulates the arterial inflammatory response, and indicates the potential to be applied as a therapeutic use for atherosclerosis.
Antioxidants ; Arteries ; Atherosclerosis ; Betulaceae ; Cell Survival ; Cytokines ; Free Radicals ; Gallic Acid ; Humans ; Inflammation ; Inhibitory Concentration 50 ; Interleukin-6 ; Muscle, Smooth, Vascular ; Phenol ; RNA, Messenger

BACKGROUND AND OBJECTIVES: Cochlear dead region (CDR) is a region in the cochlear where hearing loss has occurred due to damage to the inner hair cells and/or neurons. Recently, a subjective test involving a pure-tone test in the presence of threshold-equalizing noise (TEN) was introduced to identify CDR. However, for uncooperative patients, such a subjective method would be unsuitable and objective methods would be needed instead to detect CDR. The acoustic change complex (ACC) is an evoked potential elicited by changes in the ongoing sound. In this study, we developed an objective method of identifying CDR by combining ACC response with a TEN test, namely the TEN-ACC test, and investigated its feasibility in normal-hearing listeners. SUBJECTS AND METHOD: Ten normal-hearing subjects participated in this study. All subjects underwent both behavioral TEN test and electrophysiological TEN-ACC test. The stimuli for the TEN-ACC test consisted of TEN and embedded pure tones with different frequencies/signals to noise ratios (SNRs). To identify the thresholds, the range SNR of stimulation was varied from 0 to 20 dB, in stages of 4 dB. RESULTS: The ACC responses of all subjects who participated in this study were well elicited by stimuli developed for the TEN-ACC test. We confirm that the pure-tones embedded in TEN elicited the objective ACC response. CONCLUSION: The results of this study suggest that the novel TEN-ACC test can be applied to evoke ACC in normal-hearing listeners. Future research should incorporate hearing-impaired listeners to determine the feasibility of the TEN-ACC test as an objective method to identify CDR.
Acoustics* ; Evoked Potentials ; Hair Cells, Auditory, Inner ; Hearing Loss ; Humans ; Methods ; Neurons ; Noise

Much progress has been made during the last 15 years in the technical aspect of living donor liver transplantation (LDLT). Understanding of the detailed anatomy and performing precise donor hepatectomy have contributed to this progress. One of the most important points is to solve the problem of anterior congestion that occurs in right liver transplantation, and this can lead to graft dysfunction. This review focuses on the various types of donor right hepatectomy and venous reconstruction for drainage of the anterior section in the recipient. Technical refinement of the anterior sectional drainage in right liver transplantation is currently an issue that transplant surgeons would like to see resolved. In LDLT, donor safety overrides the benefit for the recipient. Technical innovations should be balanced with the basic principle of the transplant team, "no harm" to the live donors.
Drainage* ; Estrogens, Conjugated (USP) ; Hepatectomy ; Humans ; Liver Transplantation* ; Liver* ; Living Donors ; Tissue Donors ; Transplants

PURPOSE: Endoscopic thyroidectomy using a cervico-axillary approach (CAA) provides optimal visualization with a smaller dissection plane. Despite the excellent cosmetic results and high patient satisfaction, the surgical and oncologic safety of CAA endoscopic surgery has not been fully established. The present study evaluated the feasibility, safety, and surgical outcomes of CAA endoscopic thyroidectomy. METHODS: From October 2009 to April 2012, 100 patients with papillary thyroid cancer underwent CAA endoscopic thyroidectomy. Patient demographics, pathologic features, and surgical outcomes including complications and recurrence were collected. RESULTS: CAA endoscopic thyroidectomy was successful in all patients, and none required conversion to open thyroidectomy. All patients underwent ipsilateral thyroid lobectomy with or without central compartment neck dissection. The mean tumor size was 1.0±0.6 cm (range, 0.5~1.6), and 35.0% of tumors showed extrathyroidal extension. The mean number of harvested lymph nodes was 4.1±4.4, and metastasis was found in 12.0% of patients. The mean surgical time was 175.2±50.4 min, mean intraoperative blood loss was 42.5±69.2 ml, and the mean hospital stay was 3.3±0.6 days. There were five cases of postoperative transient hypocalcemia and eight cases of vocal cord palsy. No permanent complication or postoperative bleeding was observed. Patients continued to be seen for a median period of 63.7 months, and no recurrence of thyroid cancer was seen. CONCLUSION: CAA endoscopic thyroidectomy is a feasible and safe procedure for low-risk thyroid cancer, with excellent cosmesis. It can be recommended as an alternative option for selected patients with low-risk thyroid cancer.
Demography ; Hemorrhage ; Humans ; Hypocalcemia ; Length of Stay ; Lymph Nodes ; Neck Dissection ; Neoplasm Metastasis ; Operative Time ; Patient Satisfaction ; Recurrence ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy* ; Vocal Cord Paralysis

OBJECTIVES: The study compared the intelligence test profiles of Tourette's Disorder (TD), attention-deficit hyperactivity disorder (ADHD), and TD with ADHD (TD+ADHD) groups. METHODS: The Korean Wechsler Intelligence Scale for Children-third edition (K-WISC-III) and Korean Wechsler Intelligence Scale for Children-fourth edition (K-WISC-IV) were administered to 13 children and adolescents with TD, 17 children and adolescents with ADHD, and 15 children and adolescents with TD+ADHD. Each parameter was compared among the groups using the Kruskal-Wallis test. RESULTS: The mean scores of the freedom from distractibility/working memory index (FD/WMI) and the digit span and arithmetic subtests of the TD+ADHD group were significantly lower than those of the TD group. CONCLUSION: According to the intelligence test results, the comorbid ADHD+TD group showed a significant decrease in working memory compared to the TD group. These findings are similar to those of previous research on cognitive functions and suggest that the TD+ADHD comorbid and TD alone groups exhibit different endophenotypes. The results also imply that WISC-III and WISC-IV, the most commonly used intelligence tests clinically, are effective in evaluating cognitive functions such as attention. Further research is required to confirm these results.
Adolescent ; Child ; Cognition ; Endophenotypes ; Freedom ; Humans ; Intelligence Tests* ; Intelligence* ; Memory ; Memory, Short-Term ; Tourette Syndrome*

Purpose: This study investigated the actual incidence of acute poisoning in Korea on a nationwide scale, with the aim of laying the groundwork for future initiatives in prevention, strategic antidote distribution, and the development of effective emergency treatment for acute poisoning. Methods: The study analyzed data from 3,038 patients who presented to emergency departments with poisoning-related conditions from June 1, 2022 to December 31, 2022 at 10 sites in nine cities across the country. We extracted data on general characteristics of the poisoning cases, including demographic characteristics (age and gender), place of exposure, reason for poisoning, route of exposure, and the substance involved in the poisoning incident. Age-related patterns in reasons for poisoning, medical outcomes, frequent and primary poisoning substances, and deaths were also analyzed. Results: The population analyzed in our study was predominantly female, with women constituting 54.74% of all cases. Among infants and children, non-intentional poisoning due to general accidents was the most common cause, accounting for 71.43% of cases. Conversely, suicidal poisoning was more prevalent among teenagers and adults over 20. Fifty-two patients died during the study period, with males comprising approximately two-thirds (67.31%) of these fatalities. Pesticides were the most common poisoning substance among those who died, accounting for 55.77% of such cases. Notably, a significant majority of the victims were elderly individuals aged 60 and above. Conclusion This study holds substantial significance, since it represents the first comprehensive investigation and analysis of the symptoms, treatment, and causes of death due to poisoning in Korea on a national scale. By substantially expanding the range and types of poisonous substances examined, we were able to more precisely identify the characteristics and clinical patterns of poisoning cases nationwide.

Purpose: Suicide ranks among the top causes of death among youth in South Korea. This study aimed to identify the characteristics of suicidal individuals treated at emergency departments between 2011 and 2020. Methods: A retrospective analysis was conducted using data from January 2011 to December 2020 in the Injury Surveillance Cohort, a prospective registry. Patients’ sex, age, mortality, methods of self-harm, and previous suicide attempts were analyzed. The methods of self-harm were categorized into falls, asphyxiation, blunt injuries, penetrating injuries, poisoning, and others. Sub-groups with and without poisoning were compared. Results: The proportion of self-harm/suicide attempts increased from 2.3% (2011) to 5.0% (2020). The mortality rate decreased from 10.8% (2011) to 6.3% (2020). Poisoning was the most common method (61.7%). Mortality rates ranged from 42.0% for asphyxiation to 0.2% for blunt injuries. Individuals in their 20s showed a marked increase in suicide/self-harm attempts, especially in the last three years. A large proportion of decedents in their 70s or older (52.6%) used poisoning as a method of suicide. The percentage of individuals with two or more previous attempts rose from 7.1% (2011) to 19.7% (2020). The death rates by poisoning decreased from 7.7% (2011) to 2.5% (2020). Conclusion Our findings underscore the urgent need for targeted interventions and suicide prevention policies. Managing and reducing suicide and self-harm in emergency settings will require a focus on poisoning, the 10–29 age group, and the elderly. This paper will be valuable for future policies aiming to reduce the societal burden of suicide and self-harm.

Background and Objectives: Oropharyngeal squamous cell carcinoma (OPSCC) can be caused by human papilloma virus (HPV) infection or other factors like smoking. The 8th Edition of the AJCC Cancer Staging Manual recommends different staging and treatment approaches based on etiology. Despite criticisms of its low specificity, the current guidelines suggest using p16 immunohistochemistry (IHC) as a surrogate marker for the HPV-related OPSCC. This study assessed the reliability of p16 as a surrogate marker by correlating the survival rates of OPSCC patients with the results of p16 IHC and HPV-DNA testing.Subjects and Method A retrospective analysis was performed on patients treated for tonsil squamous cell carcinoma at a tertiary medical institution between 1994 and 2018. All patients underwent p16 immunostaining and HPV-DNA chip tests. Out of 88 patients, 17 were excluded due to insufficient data or secondary primary cancer, leaving 71 patients. Results: Among the 71 patients, 51 were p16 positive and 49 were HPV-DNA positive; both tests were associated with extended survival. However, discrepancies were noted in 18 patients: specifically, 11 patients were p16 positive but HPV-DNA negative, displaying a different survival pattern compared to HPV-associated and non-HPV-associated patients. Conclusion Both p16 immunostaining and HPV-DNA testing have their pros and cons. p16 immunostaining is cost-effective but has lower specificity. The study found discrepancies in 18 patients, suggesting that relying solely on p16 immunostaining may have limitations. It would be advisable to complement it with additional tests like the HPV-DNA chip test to predict the disease’s prognosis more accurately.

PURPOSE: We performed a comparative analysis of the plasma levels of antithrombin (AT) III, plasminogen, fibrinogen, and D-dimer among patients with and without clinically localized prostate cancer to investigate the clinical significance of the coagulation profile in prostate cancer. MATERIALS AND METHODS: A prospective study was performed in which plasma levels of AT III, plasminogen, fibrinogen, and D-dimer were assessed in patients before they underwent prostate biopsy. According to the results of the biopsy, the patients were categorized into the cancer group or the control group. Levels of the four coagulation factors were then compared between the cancer and control groups. Also, levels of the four coagulation factors were correlated with tumor stage and grade in the cancer group. RESULTS: The cancer group had significantly lower levels of AT III activity and higher plasma D-dimer levels than did the control group (p=0.007 and p=0.018, respectively). Within the cancer group, no significant differences were observed in the levels of AT III, plasminogen, fibrinogen, or D-dimer between those with a pathological Gleason score of > or =7 and otherwise. Regarding pathologic stage of prostate cancer, the subjects with organ-confined disease and those with extraprostatic extension of a tumor demonstrated no significant differences in the preoperative levels of the four coagulation factors analyzed. CONCLUSIONS: Our results suggest that plasma levels of AT III and D-dimer are altered in patients with prostate cancer. Further study is needed to elucidate the underlying mechanism and clinical significances of such a phenomenon among patients with clinically localized prostate cancer.
Antithrombin III ; Biopsy ; Blood Coagulation Factors ; Blood Coagulation Tests ; Fibrin Fibrinogen Degradation Products ; Fibrinogen ; Humans ; Neoplasm Grading ; Plasma ; Plasminogen ; Prospective Studies ; Prostate ; Prostatic Neoplasms