OBJECTIVES: Insomnia may be one of the risk factor for suicidal ideation, but little is known about the mechanism by which sleep disturbances confer risk for suicide. The aim of this study was to investigate examine whether insomnia severity would be associated with resilience and suicidal ideation, and whether resilience would mediate the relationship between insomnia and suicidal ideation. METHODS: A total of 432 community-dwelling adults(227 male, 205 female,) completed the self-report questionnaire that covered basic socio-demographic data. To assess the psychological variables, the following instruments were applied: Insomnia Severity Index(ISI), Korean Version of the Connor-Davidson Resilience Scale(K-CD-RISC), Beck Hopelessness Scale(BHOP) and Scale for Suicidal Ideation(SSI-Beck). People with an ISI score of 8 or higher were defined as insomnia. RESULTS: Greater insomnia symptom severity was significantly associated with higher level of suicidal ideation and lower level of resilience, adjusting for hopelessness, age, sex, presence of family members living together, and household income. Additional analysis revealed that disturbance of sleep initiation and disturbance of sleep maintenance were significantly associated with suicidal ideation. Mediation analyses revealed that resilience significantly accounted for the relationship between insomnia symptom severity and suicidal ideation. CONCLUSIONS: These findings suggest that the evaluation and control of insomnia and resilience may be needed to reduce the risk of suicide.
Family Characteristics ; Humans ; Male ; Negotiating ; Risk Factors ; Sleep Initiation and Maintenance Disorders ; Suicidal Ideation ; Suicide

PURPOSE: To demonstrate the mammographic and sonographic appearances of metaplastic carcinoma of the breast. MATERIALS AND METHODS: The mammographic and sonographic findings in eight female patients (aged: 28-78 years, mean: 50.3 years) with pathologically proven metaplastic cancer were analyzed retrospectively by three radiologists. We analyzed the size, density, shape, margin, associated architectural distortion, calcification in the mass and enlarged lymph node at the axilla, on the mammograms. We also analyzed the shape, margin and echogenicity of the lesions on the sonograms. RESULTS: On mammography, irregular (n=4), lobular (n=2) or oval (n=2) shaped high density masses were found. The margins of the masses were indistinct (n=4) or obscured (n=3). There were architectural distortions in three cases and pleomorphic calcifications in two cases. On sonography, irregular (n=5) or oval (n=3) shaped masses with microlobulated margins were found. The echopatterns of the masses were complex (n=5) or hypoechoic (n=3). CONCLUSION: The mammographic and sonographic findings of metaplastic carcinoma of the breast are nonspecific and similar to those of other forms of breast cancer. However, this type of tumor should be included in the differential diagnosis for breast masses which appear as an irregular or oval shape with a microlobulated margin and a complex or hypoechoic echopattern on sonography.
Axilla ; Breast Neoplasms ; Breast* ; Diagnosis, Differential ; Female ; Humans ; Lymph Nodes ; Mammography ; Retrospective Studies ; Ultrasonography*

Alveolar soft part sarcoma (ASPS) is an extremely rare malignant soft tissue sarcoma primarily affecting young patients. It usually occurs in the lower extremities, although it can occur in soft tissue anywhere in the body. However, to our knowledge, there has been no case of primary ASPS originating from the kidney in the literature. We herein present the imaging and clinical features of an ASPS which occurred in a 16-year-old male presented as a palpable mass in the left side of the abdomen.
Adolescent ; Biopsy ; Diagnostic Imaging/methods ; Humans ; Kidney/pathology ; Kidney Neoplasms/*diagnosis/pathology ; Male ; Rare Diseases/*diagnosis/pathology ; Sarcoma, Alveolar Soft Part/*diagnosis/pathology

Objective: This study aimed to develop and validate the Korean version of the Somatic Symptom Disorder-B Criteria Scale (SSD-12) in outpatients at a psychiatric clinic and assess its diagnostic accuracy. Methods: A total of 207 patients completed SSD-12. For the diagnostic accuracy of SSD-12, the somatic symptom disorder (SSD) section of the structured clinical interview for DSM-5 disorders-research version (SCID-5-RV) was used. The SSD-12 construct and concurrent validity were assessed by examining the correlations with Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), PHQ-15, 5-level EQ-5D version (EQ-5D-5L), and World Health Organization Quality of Life Brief Version (WHOQOL-BREF). Results: The SSD-12 had excellent internal consistency (Cronbach α=0.90). Confirmatory factor analysis revealed good fit indices for a general factor model (comparative fit index [CFI]=0.92, Tucker-Lewis index [TLI]=0.88, root mean square error of approximation [RMSEA]=0.10; 95% confidence interval [CI], 0.08–0.11) and a three-factor model (CFI=0.94, TLI=0.91, RMSEA=0.08; 95% CI, 0.07–0.10). The total SSD-12 score was significantly correlated with anxiety (GAD-7: r=0.53, p<0.001), depression (PHQ-9: r=0.52, p<0.001), physical symptom burden (PHQ-15: r=0.36, p<0.001), and quality of life (EQ-5D-5L: r=-0.40, p<0.001; WHOQOL-BREF: r=-0.51, p<0.001). SSD-12 demonstrated good accuracy (area under the curve=0.75, standard error=0.04; 95% CI, 0.68–0.82) with an optimal cut-off of 29. Conclusion The Korean SSD-12 demonstrates reliability and validity for diagnosing SSD in clinical setting.