OBJECTIVES: Paranoia is a complex phenomenon, affected by a number of factors such as depression, trait anxiety, and attributional bias in schizophrenia. The aim of this study was to explore whether paranoia within continuum of clinical and subclinical states is associated with emotional dysregulation, attributional bias and neurocognitive impairment in whole individuals of normal controls, ultra-high risk (UHR) for psychosis and schizophrenia. METHODS: 101 normal controls, 50 participants at UHR for psychosis, and 49 schizophrenia patients were recruited. All subjects were asked to complete self-reported paranoia scale and emotional dysregulation scales including Rosenberg's self-esteem, Spielberg's state-trait anxiety inventory and Beck depression inventory. The attributional style was assessed by Ambiguous Intentions Hostility Questionnaire (AIHQ). Participants were also requested to complete the comprehensive neurocognitive battery. RESULTS: Multiple linear regression analysis showed that paranoia were found to be associated with emotional dysregulation (state anxiety, trait anxiety and depression), composite blaming bias in ambiguous situation, impairment of attention and working memory in whole participants [F (9, 190)=34.85, p<0.001, adjusted R2=0.61]. CONCLUSION: The main findings suggest that paranoia is a complex affective and cognitive structure that may be associated with emotional dysregulation, blaming bias and attention and working memory impairment in clinical and non-clinical paranoia.
Anxiety ; Bias (Epidemiology)* ; Depression ; Hostility ; Humans ; Intention ; Linear Models ; Memory, Short-Term ; Paranoid Disorders* ; Psychotic Disorders* ; Surveys and Questionnaires ; Schizophrenia* ; Weights and Measures

PURPOSE: This study analyzed the correlation between grade point average (GPA) of medical school and the score of Korean Medical Licensing Examination (KMLE). METHODS: This study based on the results of 67th KMLE applicants who graduated from a college of medicine in 2003. We also gathered data of these applicants from the college of medicine: gender, age, type of entrance, GPA of basic medicine, clinical medicine, clinical clerkships and final test scores. We analyzed whether there was discrimination between achievement of KMLE passed and that of KMLE failed, which of variables affected the results of KMLE. RESULTS: 173 applicants passed KMLE among 189. There were significant correlations between basic medicine, clinical medicine, final test score and the score of KMLE (respective p-value; < 0.0001). There were also significant differences of GPA between KMLE passed applicants and failed. Final test scores were the most correlated with those of KMLE. If the GPA of 2nd grade was below 2.5 and the GPA of 3rd year grade was below 2.3, they was a high-risk group for failing KMLE (sensitivity 100%, specificity 90%). CONCLUSION: There were significant correlations between the GPA of medical school and the score of KMLE, and significant differences between KMLE passed applicants and failed. A high-risk group of failing KMLE was the students that the GPA of 2nd grade was below 2.5 and the GPA of 3rd grade was below 2.3.
Clinical Medicine ; Discrimination (Psychology) ; Humans ; Licensure* ; Schools, Medical* ; Sensitivity and Specificity

Intra-abdominal desmoplastic small round cell tumor (DSRCT) is a highly malignant tumor of uncertain histogenesis. Here we report a case of DSRCT involving the stomach, initially misdiagnosed as gastric cancer. A 12-year-old boy presented with upper abdominal pain developed 1 month prior. On gastroscopy, a 7-cm mass was noted involving the esophago-gastric junction to the fundus, and positron emission tomography showed multiple hot uptakes suggesting distant metastasis. Gastroscopic biopsy showed poorly differentiated malignant cells. We diagnosed as stage IV gastric cancer and treated with 6 cycles of chemotherapy. Laparotomy revealed a huge gastric mass along with peritoneal disseminations. Palliative proximal gastrectomy was performed. Pathological examination revealed transmural involvement of DSRCT, and t(11;22)(p12;q12) was demonstrated on fluorescence in situ hybridization test. The chemotherapeutic regimen was changed and the patient underwent 8 additional cycles of post-operative chemotherapy. The patient is now alive and the residual tumor shows no significant changes after chemotherapy.
Abdominal Pain ; Biopsy ; Child ; Desmoplastic Small Round Cell Tumor ; Fluorescence ; Gastrectomy ; Gastroscopy ; Humans ; In Situ Hybridization ; Laparotomy ; Neoplasm Metastasis ; Neoplasm, Residual ; Positron-Emission Tomography ; Stomach ; Stomach Neoplasms

BACKGROUND: Bronchoscopy has been widely used for a histologic diagnosis through a transbronchial lung biopsy or for staging of patients with peripheral lung cancer. However a transthoracic needle aspiration (TTNA) has been used more widely for a histologic diagnosis in patient with a small size nodule or a nodule located in the outer portion of the lung because of the low diagnostic yield of bronchoscopy in these cases. The role of bronchoscopy for staging is not well established in patients with peripheral lung cancer diagnosed by a TTNA or patients who are undergoing surgery without a histologic diagnosis. METHOD: To evaluate the role of bronchoscopy for the staging in patients with peripheral lung cancer, who were diagnosed by TTNA, the medical records of 86 patients with peripheral lung cancer who underwent bronchoscopy at Kyungpook National University Hospital between January 1995 and May 1997 were reviewed. RESULTS: While 53 cases had normal bronchoscopic findings, 33 cases had abnormal bronchoscopic findings comprising 9 cases of tumor, 10 cases of infiltration and 14 cases of compression of which there were 25 cases of T1 and 8 T2 endoscopically. The bronchoscopic staging did not influence the changes of the clinical stage of lung cancer. The frequencies of bronchial involvement tended to increase as the sizes of the nodule increased. Among the 42 patients who underwent surgery, 9 patient staged higher after operation because of lymph node involvement in 8 patients and the involvement of the pulmonary artery in 1 patient. No case staged above after operation due to a bronchial invasion. CONCLUSION: These findings suggests that bronchoscopy is not useful for staging in patients with peripheral lung cancer diagnosed by a TTNA.
Biopsy ; Bronchoscopy* ; Diagnosis ; Gyeongsangbuk-do ; Humans ; Lung Neoplasms* ; Lung* ; Lymph Nodes ; Medical Records ; Needles ; Pulmonary Artery

Background: Biogenetic causal explanations of mental disorders are commonly used for public education and campaigns. However, the influence of biogenetic explanations on the ideas about and attitudes toward mental illness is unclear. We examined the influence of biogenetic explanations on attitudes toward mental disorders using a meta-analytic method accompanied by subgroup analyses. Methods: The protocol for this meta-analysis was registered in PROSPERO (CRD42020158656) in March 2020. Experimental and correlational studies were analyzed separately. Five outcome measures related to attitudes toward mental disorders were included: ‘attitude toward helpseeking,’ ‘blame,’ ‘perceived dangerousness,’ ‘prognostic pessimism,’ and ‘social distance.’ Subgroup analyses were performed for the type of mental disorder, population, and geographic region for which a biogenetic explanation was provided. Results: A total of 44 studies were included, of which 24 were experimental and 20 were correlational. A positive attitude toward help-seeking was associated with having a biogenetic concept (d = 0.43; 95% confidence interval [CI], 0.18 to 0.67; P < 0.001) in general population and in Eastern countries in particular. Although a biogenetic explanation was associated with a decreased level of blame (d = −0.20; 95% CI, −0.38 to −0.02; P = 0.029) in the general population, it was also associated with significantly higher levels of perceived dangerousness (d = 0.13; 95% CI, 0.03 to 0.23; P = 0.008). A tendency toward a higher level of prognostic pessimism and social distance was associated with a biogenetic concept of mental disorders although there was no statistical significance. Conclusion Having a biogenetic concept of the cause of mental disorders was related with a positive attitude toward help-seeking, particularly in the general population and individuals living in Eastern countries. Providing a biogenetic explanation decreased blame toward individuals with mental illness but was associated with increased perceived dangerousness and prognostic pessimism. Therefore, although a biogenetic explanation use of mental health services, it should be carefully applied to avoid an increase in negative thoughts, such as that mental illness is biologically irreversible and untreatable.promotes public

BACKGROUND: The aim of study is to identify the dependence of right ventricular (RV) free wall longitudinal deformation on ventricular loading through segmental approach in relatively large number of patients with atrial septal defect (ASD). METHODS: Patients with ASD (n = 114) and age matched healthy children (n = 60) were echocardiographically examined the day before percutaneous device closure and within 24 hours afterwards. RV free wall deformation parameters, strain (small je, Ukrainian) and strain rate (SR), were analyzed in the apical (small je, Ukrainian(A), SR(A)) and basal (small je, Ukrainian(B), SR(B)) segments. Measured deformation parameters were adjusted for RV size (small je, Ukrainian(AL), SR(AL), small je, Ukrainian(BL), SR(BL)) by multiplying by body surface area indexed RV longitudinal dimension. Regression analyses determined the relationships of these deformation parameters with RV loading parameters that were measured by catheterization. RESULTS: small je, Ukrainian(BL) and SR(BL) were not different between pre-closure patients and controls (p = 0.245, p = 0.866), and were decreased post-closure (p = 0.001, p = 0.018). Post-closure small je, Ukrainian(BL) was lower than in controls (p = 0.001). Pre-closure small je, Ukrainian(AL) and SR(AL) were higher than in controls (p = 0.001, p < 0.001), but decreased after closure (all p < 0.001). The pulmonary to systemic flow ratio was related to procedural differences of small je, Ukrainian(BL) (p = 0.017) and of SR(BL) (p = 0.019). RV end diastolic pressure was negatively related to post-closure small je, Ukrainian(BL) (p = 0.020) and post-closure SR(BL) (p = 0.012), and the procedural SR(BL) difference (p = 0.027). CONCLUSION: The longitudinal deformation of the RV basal segment is dependent and its remodeling is also dependent on volume loading in children with ASD.
Blood Pressure ; Body Surface Area ; Catheterization ; Catheters ; Child* ; Heart Septal Defects, Atrial* ; Humans ; Ventricular Function, Right

OBJECTIVE: This study was designed to analyze outcome of removal of non-palpable Implanon(TM) by ultrasound guidance. METHODS: This is retrospective study of patients who were referred from local clinic where removal of non-palpable Implanon(TM) had been failed. The cases were 32 patients who visited to Yonsei University Gangnam Severance Hospital between March 2004 through March 2009. RESULTS: Implanons(TM) were localized on ultrasound in all 32 cases. 18 cases were located in subcutaneous layer, 10 cased were located in fascial layer, 4 cases were located in muscle layer. All cases were successfully removed. The average length of time required for removal was 19.3 minutes. There was no complication except one patient, who had mild median nerve injury. CONCLUSION: Ultrasound guidance removal was safe and effective procedure to remove non palpable Implanon(TM).
Humans ; Median Nerve ; Muscles ; Retrospective Studies

Since the first descriptions of Brugada as a new clinical entity defined by sudden cardiac death in patients with typical electrocardiogram (ECG) patterns, Brugada syndrome (BS) has been increasingly diagnosed. This syndrome is known as a disease that is inherited via an autosomal dominant trait, and the SCN5A mutation has been found in 20-25% of BS patients. Because BS primarily manifests in adulthood, little information is available on BS during childhood. Although there have been several reports on adult BS in Korea, pediatric BS has not been reported. Herein, we report on childhood BS in two families. One infantile BS patient and his family had a novel SCN5A mutation (c.4035G>T, p.W1345C, heterozygote) in domain III of the sodium channel.
Adult ; Brugada Syndrome ; Death, Sudden, Cardiac ; Electrocardiography ; Humans ; Korea ; Sodium Channels ; Tachycardia, Ventricular

PURPOSE: In 2004, the American Heart Association (AHA) had published an algorithm for the diagnosis of incomplete Kawasaki disease (KD). The aim of the present study was to investigate characteristics of supplemental laboratory criteria in this algorithm. METHODS: We retrospectively examined the medical records of 355 patients with KD who were treated with intravenous immunoglobulin (IVIG) during the acute phase of the disease. Laboratory data were obtained before the initial IVIG administration and up to 10 days after fever onset. In 106 patients, laboratory testing was performed more than twice. RESULTS: The AHA supplemental laboratory criteria were fulfilled in 90 patients (25.4%), and the frequency of laboratory examination (odds ratio [OR], 1.981; 95% confidence interval [CI], 1.391-2.821; P<0.001) was a significant predictor of it. The fulfillment of AHA supplemental laboratory criteria was significantly associated with refractoriness to the initial IVIG administration (OR, 2.388; 95% CI, 1.182-4.826; P=0.013) and dilatation of coronary arteries (OR, 2.776; 95% CI, 1.519-5.074; P=0.001). CONCLUSION: Repeated laboratory testing increased the rate of fulfillment of the AHA supplemental laboratory criteria in children with KD.
American Heart Association ; Child* ; Coronary Vessels ; Diagnosis ; Dilatation ; Fever ; Humans ; Immunoglobulins ; Immunoglobulins, Intravenous ; Medical Records ; Mucocutaneous Lymph Node Syndrome* ; Retrospective Studies

PURPOSE: In this study, we evaluated the effects of training for survival prediction of terminally ill patients in terms of medical professionals' confidence, accuracy and knowledge of survival prediction. METHODS: Twenty-nine participants completed a self-administered questionnaire where they scored their confidence, accuracy and knowledge of survival prediction before and after the training session. The training was provided in July 2009 at a university hospital located in Gyeonggi province, Republic of Korea. The participants were instructed by a professor of family medicine specialized in hospice palliative medicine to predict survival of a case using the palliative prognostic score and objective prognostic score. The training was provided in the form of a PowerPoint presentation for 40 minutes. RESULTS: Participants' confidence in survival prediction significantly increased from 4.00+/-1.73 (mean+/-SD) (0~10, visual analogue scale) to 5.83+/-1.71 after the training (P<0.001). Before training, participant's level of confidence significantly correlated with their age (P=0.04). The training significantly improved the correlation between the confidence level and the number of terminal cancer patients whom they have experienced (P=0.005 before training, P=0.017 after training). Participant's accuracy in survival prediction also significantly improved from 14 of 29 (48%) to 27 of 29 (93.1%) (P<0.001). The change in knowledge of survival prediction was too small to be statistically analyzed. CONCLUSION: After training, the confidence and accuracy scores significantly improved. Further study with a greater number of participants is needed to generalize this finding.
Hospices ; Humans ; Palliative Care ; Prognosis ; Republic of Korea ; Terminally Ill ; Surveys and Questionnaires