BACKGROUND: Patients with locally advanced non-small cell lung cancer are often treated with radiation alone or in combination with chemotherapy. Both modalities have a potentially damaging effect on pulmonary function. In order to examine changes in the cardiopulmonary exercise function of patients with locally advanced non-small cell lung cancer before and after conventional radiotherapy, we conducted a prospective study involving patients with such cancer, that had received radiation therapy. METHODS: Resting pulmonary function test, thoracic radiographic finding and cardiopulmonary exercise test(CPET) were assessed prior to and 4 weeks following radiation therapy in 11 male patients with locally advanced non-small cell lung cancer. Patient with endobronchial mass were excluded. RESULTS: The forces vital capacity(FVC), forced expiratory volume in 1 second(FEV1)and maximal voluntary ventilation(MVV) did not decreased between before and 4 weeks after radiation but the diffusing capacity(DLCO) had decreased by 11% 4 weeks after radiation, which was not statistically significant. No changes in maximal oxygen consumption(VO2max), carbon dioxide production(VCO2), exercise time and work load were attributed to radiation therapy. Follow up cardiopulmonary exercise testing revealed unchanged cardiovascular function, ventilatory function and gas exchange. No difference in cardiopulmonary exercise test performance was observed between pre- and post-radiation. CONCLUSION: Cardiopulmonary exercise function did not decrease within the short-term after the radiation of patients with locally advanced non-small cell lung cancer.
Carbon Dioxide ; Carcinoma, Non-Small-Cell Lung* ; Drug Therapy ; Exercise Test ; Follow-Up Studies ; Forced Expiratory Volume ; Humans ; Lung Neoplasms ; Male ; Oxygen ; Prospective Studies ; Radiotherapy ; Respiratory Function Tests

OBJECTIVES: In this study, we examined the relationship between attachment style, alexithymia, marital satisfaction, and depressive symptoms in married couples. METHODS: We administered the Korean version of Experiences in Close Relationships questionnaire-Revised (K-ECR-R), Korean version of the 20-item Toronto Alexithymia Scale (TAS-20K), Revised-Dyadic Adjustment Scale (R-DAS), Korean version of the Beck Depression Inventory (K-BDI), and to 105 men and 115 women in the community. The data was analyzed with correlation analysis between related variables, and the regression analysis method of Baron and Kenny (1986) was used. RESULTS: The current study assumes that alexithymia mediates between attachment style and marital satisfaction, and these factors influence depressive symptoms. The results were as follows : 1) alexithymia mediated perfectly between attachment anxiety style and marital satisfaction and 2) alexithymia, and marital satisfaction had significant influences on depressive symptoms. Attachment avoidance style was excluded for dissatisfaction with the assumption of the regression analysis method of Baron and Kenny (1986). CONCLUSION: These results suggest that attachment style, alexithymia, and marital satisfaction seem to be important factors in depressive symptoms among married people. These results suggest that different interventions according to attachment style may helpful for the enhancement of marital satisfaction and the reduction of the depressive symptoms of married couples.
Affective Symptoms ; Anxiety ; Depression ; Family Characteristics ; Female ; Humans ; Male

OBJECTIVES: Adult attachment is a relatively stable disposition, rooted in internal working models of self and relationship patterns. However, findings reported from recent research have suggested that levels of attachment anxiety, avoidance, and security are also affected by situational factors. The State Adult Attachment Measure (SAAM) was developed for the purpose of capturing temporary fluctuations in the sense of attachment security and insecurity. In this study, we examined the reliability and validity of the Korean version of the State Adult Attachment Measure (K-SAAM). METHODS: K-SAAM, Experiences in Close Relationships Questionnaire-Revised (ECR-R), Relationship Questionnaire (RQ), Korean version of Positive Affective and Negative Affect Schedule (K-PANAS), Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), Revised Dyadic Adjustment Scale (R-DAS), and Toronto Alexithymia Scale 20-K (TAS 20-K) were administered to 180 subjects in the community. Exploratory factor analyses and correlation analyses among related variables were conducted. RESULTS: Scores on the K-SAAM demonstrated high internal consistency, with corrected item-total correlations from .56 to .87. Results of exploratory factor analysis yielded three reliable subscales measuring state levels of attachment-related anxiety, avoidance, and security. Results of additional analyses demonstrated both convergent validity and discriminant validity of the K-SAAM. CONCLUSION: The results reported here are highly supportive of the reliability, validity, and utility of the K-SAAM as a state measure of attachment. This new measure will allow clinicians to assess various temporary changes in attachment levels and to examine the efficacy of attachment-based psychotherapy. The K-SAAM has the potential to advance the field in understanding of the dynamics of adult attachment.
Adult ; Affective Symptoms ; Anxiety ; Appointments and Schedules ; Depression ; Humans ; Psychotherapy ; Surveys and Questionnaires ; Reproducibility of Results

OBJECTIVES: This study investigated the effects of Emotionally Focused Therapy (EFT) on distressed married couples. METHODS: We conducted 5 to 19 EFT sessions once a week with 10 couples from Yongin Mental Hospital who were experiencing marital conflict. We assessed participants before and after EFT, using the Beck Depression Inventory (BDI), Symptom Checklist 90-R (SCL-90R), and Korean Marital Satisfaction Inventory (K-MSI). The EFT consisted of 3 stages comprising 9 steps. Every couple followed this EFT structure. RESULTS: After completing the EFT sessions, the inventories showed the couples experiencing significant improvements in various psychological symptoms and marital satisfactions. CONCLUSION: These results indicate that EFT could be applied to distressed couples in a clinical setting and could effectively reduce psychological symptoms and improve marital satisfaction. Further study of the generalizability of these results and of the process variables are needed.
Checklist ; Depression ; Equipment and Supplies ; Family Characteristics ; Family Conflict ; Hospitals, Psychiatric ; Pilot Projects

BACKGROUND: Pulmonary complications including pneumonia and pulmonary edema frequently develop in critically ill surgical patients. Lung ultrasound (LUS) is increasingly used as a powerful diagnostic tool for pulmonary complications. The purpose of this study was to report how LUS is used in a surgical intensive care unit (ICU). METHODS: This study retrospectively reviewed the medical records of 67 patients who underwent LUS in surgical ICU between May 2016 and December 2016. RESULTS: The indication for LUS included hypoxemia (n = 44, 65.7%), abnormal chest radiographs without hypoxemia (n = 17, 25.4%), fever without both hypoxemia and abnormal chest radiographs (n = 4, 6.0%), and difficult weaning (n = 2, 3.0%). Among 67 patients, 55 patients were diagnosed with pulmonary edema (n = 27, 41.8%), pneumonia (n = 20, 29.9%), diffuse interstitial pattern with anterior consolidation (n = 6, 10.9%), pneumothorax with effusion (n = 1, 1.5%), and diaphragm dysfunction (n = 1, 1.5%), respectively, via LUS. LUS results did not indicate lung complications for 12 patients. Based on the location of space opacification on the chest radiographs, among 45 patients with bilateral abnormality and normal findings, three (6.7%) and two (4.4%) patients were finally diagnosed with pneumonia and atelectasis, respectively. Furthermore, among 34 patients with unilateral abnormality and normal findings, two patients (5.9%) were finally diagnosed with pulmonary edema. There were 27 patients who were initially diagnosed with pulmonary edema via LUS. This diagnosis was later confirmed by other tests. There were 20 patients who were initially diagnosed with pneumonia via LUS. Among them, 16 and 4 patients were finally diagnosed with pneumonia and atelectasis, respectively. CONCLUSIONS: LUS is useful to detect pulmonary complications including pulmonary edema and pneumonia in surgically ill patients.
Anoxia ; Critical Care* ; Critical Illness ; Diagnosis ; Diaphragm ; Fever ; Humans ; Lung* ; Medical Records ; Pneumonia ; Pneumothorax ; Pulmonary Atelectasis ; Pulmonary Edema ; Radiography, Thoracic ; Retrospective Studies ; Ultrasonography* ; Weaning

PURPOSE: We studied to compare computed tomographic(CT) findings of liver injury with management methods in adults and, moreover, to present the CT basis for the management. MATERIALS AND METHODS: We retrospectively reviewed CT scans of 43 adults diagnosed as liver injury during a 66-month period. Thirty-eight patients were hemodynamically stable. Thirty-two of them were managed conservatively, whereas six managed operatively. Five unstable patients underwent emergency operation. We classified CT findings according to the severity of liver injuries(ie, hematoma, laceration, and periportal tracking) and hemperitoneum, ranging from grade 1 to 5 and from 0 to 3+, respectively. Thus, we compared the CT classificafions with their management(ie, operation rate), especially hemodynamically stable patients. RESULTS: Operation rates of all patients and hemodynamically stable patients were 26% and 16%, respectively. Operation rate at each grade of liver injury was low, especially in hemodynamically stable, despite relatively high operation rate in grade 4. Operation rate of 3+ hemoperitoneum was 100%, including hemodynamically stable patients, in contrast to otherwise low operation rate of others. CONCLUSION: Most liver injury in adults, including grade 4, were managed conservatively, especially hemodynamically stable. Though large amount of hemoperitoneum(ie, 3+) required operation, most hemoperitoeum were managed conservatively. Thus, CT findings of liver injury is helpful in the decision for the management method.
Adult* ; Classification* ; Emergencies ; Hematoma ; Hemoperitoneum ; Humans ; Lacerations ; Liver* ; Retrospective Studies ; Tomography, X-Ray Computed

Hair graying is an obvious sign of human aging. Although graying has been investigated extensively, the mechanism remains unclear. Here, we reviewed previous studies on the mechanism of graying and seek to offer some new insights. The traditional view is that hair graying is caused by exhaustion of the pigmentary potential of the melanocytes of hair bulbs. Melanocyte dysfunction may be attributable to the effects of toxic reactive oxygen species on melanocyte nuclei and mitochondria. A recent study suggests that bulge melanocyte stem cells (MSCs) are the key cells in play. Graying may be caused by defective MSC self-maintenance, not by any deficiency in bulbar melanocytes. Our previous study suggested that graying may be principally attributable to active hair growth. Active hair growth may produce oxidative or genotoxic stress in hair bulge. These internal stress may cause eventually depletion of MSC in the hair follicles. Taken together, hair graying may be caused by MSC depletion by genotoxic stress in the hair bulge. Hair graying may also be sometimes caused by dysfunction of the melanocytes by oxidative stress in the hair bulb. In addition, hair graying may be attributable to MSC depletion by active hair growth.
Aging ; DNA Damage ; Hair Follicle ; Hair* ; Humans ; Melanocytes ; Mitochondria ; Oxidative Stress ; Reactive Oxygen Species ; Rivers* ; Stem Cells

The clinical utility of thallium-201 SPECT combined dwith pharmacologic vasodilation induced by oral dipyridamole as an alternatiove to intravenous dipyridamole was incestigated in 21 patients who had concomitant coronary arteriography. Tomographic images were assessed visually. Sensitivity & specificity for overall detection of coronary artery disease were 93.7% and 80% respectively. Sensitivity & specificity for identification of indevidual diseased vessels were 84.6% and 87.5% for the left anterior descending artery, 75% and 84.6% for the right coronary artery, 60% and 100% for the left circumflex artery, respecitively. Of the 26 patients unergoing thallium scintigraphy 11 patients(42.3%) had some adverse effects between 20 and 50 minutes after oral dipyrdamole ingestion, including headache(26.9%), chest pain(26.9%), electrocardiographic changes(19.2%), and nausea(11.5%). Intravenous aminophylline was used to resolve these adverse effects in 8 patients & most of the adverse effects were subsided within 10 minutes. There was no ventricular arrhythmias, myocardial infarctions or deaths. In conclusion, oral dipyridamole thallium-201 SPECT is safe and accurate test for the overall detection of coranary artery disease and identification of disease in individual arteries. Furthermore it is useful for determining the necessities of coronary reperfusion and prognstically stratiofying the patients with coronary artery disease.
Aminophylline ; Angiography ; Arrhythmias, Cardiac ; Arteries ; Coronary Artery Disease* ; Coronary Vessels* ; Dipyridamole* ; Eating ; Electrocardiography ; Humans ; Myocardial Infarction ; Myocardial Perfusion Imaging* ; Myocardial Reperfusion ; Radionuclide Imaging ; Sensitivity and Specificity ; Thallium ; Thorax ; Tomography, Emission-Computed, Single-Photon* ; Vasodilation

PURPOSE: Sometimes chronic subdural hematoma can be developed following posttraumatic subdural hygroma. The purpose of this study is to investigate its incidence, the duration required for their conversion, and characteristic CT and MR findings of subdural hygroma and chronic subdural hamatoma. MATERIALS AND METHODS: We studied 8 patients with persistent posttraumatic subdural hygroma which consquently developed chronic subdural hamatoma. The patients were examined with CT initially and foilowed-up with CT in 3 and MR in 5. We analyzed the location of the lesion, the change of the density or signal intensity, the change of the size, and the degree of enhancement and mass effect. RESULTS: The duration required for the formation of hematoma was 48-166 days (mean, 76 days). The characteristic CT findings of subdural hygroma were a crescentric lesion with CSF density along the inner table without contrast enhancement. The mass effect was minimal. The CT findings of chronic subdural hematoma were higher density than that of hygroma in all cases, increase in thickness and size in 3 cases, and contrast enhancement along the inner membrane of the hematoma in 5 cases. The signal intensities of the subdural hygroma were identical to those of CSF on both T1 and T2 weighted images, whereas, those of chronic subdural hematoma were higher. CONCLUSION: The increased signal intensity on T1 weighted MR images and increased attenuation or contrast enhancement of the lesion on CT may suggest the conversion of subdural hygroma into chronic subdural hematoma.
Hematoma ; Hematoma, Subdural, Chronic* ; Humans ; Incidence ; Lymphangioma, Cystic ; Membranes ; Subdural Effusion*

BACKGROUND: Pulmonary Kaposi's sarcoma (PKS) directly affects the life expectancy of those infected and yet the clinical and radiographic features of Kaposi's sarcoma (KS) with pulmonary involvement are nonspecific, which makes diagnosis difficult. In Uganda, pulmonary tuberculosis, which has clinical features that closely resemble those of PKS, also occurs commonly and thus confusion is bound to arise. Bronchoscopy is a recognized diagnostic investigatory modality for PKS. The aim of present study was to identify unique or useful points for the differential diagnosis of PKS and other opportunistic infections. METHODS: The clinical, radiologic, and bronchoscopic findings in thirty-five Ugandan patients (age 20-50, median 32) with PKS were analyzed. RESULTS: Cough and weight loss were most common and occurred in 97.1%, whereas fever occurred in 62.9%, and breathlessness in 57.1%. Thirty-four patients (97.1%) showed mucocutaneous KS, and palatal KS was most frequent and was observed in 74.3%. In addition, 25 patients (71.4%) showed the characteristic endobronchial plaques of KS. The most frequently observed radiographic abnormality was bilateral reticulonodular density. Histological examinations of bronchoscopic biopsies revealed KS in 7 (36.6%) cases. Five PFS patients (25%) also had co-existent tuberculosis. CONCLUSIONS: The majority of patients with PKS showed no specific findings on physical examination, apart from mucocutaneous KS. Our findings indicate that palatal KS may be a strong predictor of PKS. In Uganda, pulmonary tuberculosis may be the most common concomitant pulmonary infection in PKS patients.
Uganda ; Tuberculosis, Pulmonary/diagnosis ; Sarcoma, Kaposi/*diagnosis ; Middle Aged ; Male ; Lung Neoplasms/*diagnosis ; Humans ; Female ; Diagnosis, Differential ; *Bronchoscopy ; Adult