INTRODUCTION: The objective of the present study was to investigate the defense style of insomnia patients and to grasp the differences in defense style between primary insomnia patients and insomnia patients with history of major depressive disorder. METHODS: Forty three subjects with insomnia (11 subjects with primary insomnia and 32 subjects with major depressive disorder) and 138 control subjects participated in this study. To diagnose insomnia and major depressive disorder, interviews including structured clinical interview for DSM-IV (SCID-IV) were done. To assess the defense style, self-reported Korean version of Defense Style Questionnaire (K-DSQ) were completed by the participants. RESULTS: Compared to normal controls, subjects with insomnia used more acting out (t=3.25, p<0.01), consumption (t=2.66, p<0.01), fantasy (t=3.51, p<0.001), resignation (t=5.42, p<0.001), suppression (t=3.28, p<0.01), projection (t=3.92, p< 0.01), splitting (t=4.31, p<0.01), undoing (t=2.66, p<0.01), withdrawal (t=6.72, p<0.001) and isolation (t=3.80, p<0.001), and less omnipotence (t=4.08, p<0.001) and humor (t=3.20, p<0.01). Compared to normal controls, subjects with primary insomnia used more undoing and withdrawal. Compared to subjects with primary insomnia, subjects with insomnia with history of major depressive disorder used more resignation and withdrawal, and less humor. CONCLUSION: In the current study, there were differences in defenses between primary insomnia patients and insomnia patients with major depressive disorder history. To evaluate the pattern of defenses through the K-DSQ might provide important clues to differentiate these two conditions.
Acting Out ; Depressive Disorder, Major ; Diagnostic and Statistical Manual of Mental Disorders ; Fantasy ; Hand Strength ; Humans ; Surveys and Questionnaires ; Sleep Initiation and Maintenance Disorders

The study of bacteriophage began by F.W. Twort in 1915 and the lytic cycle recognized by d'Herellel in 1917. It repeated about the marine bacteriophage containing Vibrio phage by Smith, Spencer and Ju. Authors isolated 2 virulent phages for the pathogenic V. alginolyticus from marine products. These 2 phages were examined their ultrastructure & host-infection by elecron microscopy and in vivo test using skin of rats. V. alginolyticus phages(VAPs) fomed plaques about 0.5 - 0.9mm in diameter and bands 50 - 60% in sucrose density gradient. VAP had 50 - 120nm tail and 40 - 90nm head in diameter. In vivo test, using rat skin, as well as in vitro test VAP had the activity to V. alginolyticus isolated.
Animals ; Bacteriophages* ; Coriolaceae ; Head ; Microscopy ; Rats ; Skin ; Sucrose ; Tail ; Vibrio alginolyticus* ; Vibrio*

The purpose of this study is to estimate early neonatal mortality rate in relation to obstetric factors. The early neonatal mortality rate was estimated on live births with a gestational period more than 28 weeks who died during the first 7 days of life in Ewha Womans University Hospital fro-m Jan. 1974 to Dec. 1978. During this period, there were 8218 single births and 127 early neonatal deaths. 1. We had 127 deaths out of 8218 single births, and early neonatal mortality rate came to 15.5 per 1000 live births. 2. The early neonatal mortality rate was increased in cases of maternal age over 40, higher in multipara, who had delivered more than 4 times, who had frequent abortions (more than 5 times) and it was also higher in para-one than para-two. 3. The early neonatal mortality rate was 7.9 times higher in abnormal presentation of fetus than normal one. 4. There was no significant difference in early neonatal mortality rate between spontaneous vaginal delivery and Caesarian section delivery, but significant high mortality rate was noted in breech delivery. 5. In cases of anemic mother (Hemoglobin less than 10 gm%, Hematocrit less than 32%), the early neonatal mortality rate was 2.8 times higher than non-anemic group. 6. The early neonatal mortality rate of babies from mothers without antenatal care was 3 ti-mes higher than that of mothers who had. 7. Hypertensive disorders in pregnancy was present in 15.8% of all live births and early neo-natal mortality rate was 10.8. The mortality rate was 6.5 times higher in chronic hypertensive vascular disorder with toxe-mia than in preeclampsia and 3.7 times higher in eclampsia than in precclampsis. 8. The obstetric complication which increased early neonatal mortality rate were polyhydra-mnios, amnionitis, abruptio placentae etc.
Abruptio Placentae ; Amnion ; Chorioamnionitis ; Eclampsia ; Female ; Fetus ; Hematocrit ; Humans ; Infant ; Infant Mortality* ; Live Birth ; Maternal Age ; Mortality ; Mothers ; Parturition ; Pre-Eclampsia ; Pregnancy

There are various types of foreign body reactions, such as inflammation, edema, fluid collection, hematoma, infection, abscess and granulomas. There are various imaging findings according to types of foreign bodies and depending on the lapse of time. Therefore, correct diagnosis of a foreign body reaction is difficult and easily confused with soft tissue neoplasm. The MRI is ideal for the detection of foreign bodies regardless of radiolucency or acoustic impedance. It is especially very useful in the evaluation of the surrounding tissue reaction. The authors report a case of a 26-year-old female patient with both forearm swelling due to self-injection of a mixture of powdered tablets and saline. The lesion shows numerous internal T1 and T2 dark signal intensity micro-spots with surrounding fluid collection, which are diagnosed as foreign bodies with surrounding inflammatory changes during an operation.
Abscess ; Acoustics ; Edema ; Electric Impedance ; Female ; Forearm ; Foreign Bodies ; Foreign-Body Reaction ; Granuloma ; Granuloma, Foreign-Body ; Hematoma ; Humans ; Inflammation ; Injections, Intramuscular ; Soft Tissue Neoplasms ; Tablets

Inguinoscrotal bladder hernia is relatively common in obese males over 50 years old, especially patients with benign prostate hyperplasia. Various imaging modalities are used for diagnosis of inguinoscrotal bladder hernia. In particular, ultrasonography has many benefits, including non-invasiveness, and the fact that it does not require exposure to radiation; however, no domestic cases of ultrasonographic diagnosis of inguinoscrotal bladder hernia have been reported. The authors report on a case of a 67-year-old male patient with right scrotal swelling diagnosed as inguinoscrotal bladder hernia by ultrasonography, including three-dimensional imaging. Findings on ultrasonography showed a sacular lesion in the scrotum, which was connected to the urinary bladder through the inguinal canal; additional findings on CT, PET, and cystography showed that the entire lesion had a dumbbell shape.
Hernia ; Hernia, Inguinal ; Humans ; Hyperplasia ; Imaging, Three-Dimensional ; Male ; Prostate ; Scrotum ; Urinary Bladder

PURPOSE: To analyze the stress distribution of the implant and its supporting structures through 3D finite elements analysis for implants with different hexagon heights and to make the assessment of the mechanical stability and the effect of the elements. MATERIALS AND METHODS: Infinite elements modeling with CAD data was designed. The modeling was done as follows; an external connection type Phi 4.0 mm x11.5 mm Osste(R) USII (Osstem Co., Pusan, Korea) implant system was used, the implant was planted in the mandibular first molar region with appropriate prosthetic restoration, the hexagon (implant fixture's external connection) height of 0.0, 0.7, 1.2, and 1.5 mm were applied. ABAQUS 6.4 (ABAQUS, Inc., Providence, USA) was used to calculate the stress value. The force distribution via color distribution on each experimental group's implant fixture and titanium screw was studied based on the equivalent stress (von Mises stress). The maximum stress level of each element (crown, implant screw, implant fixture, cortical bone and cancellous bone) was compared. RESULTS: The hexagonal height of the implant with external connection had an influence on the stress distribution of the fixture, screw and upper prosthesis and the surrounding supporting bone. As the hexagon height increased, the stress was well distributed and there was a decrease in the maximum stress value. If the height of the hexagon reached over 1.2 mm, there was no significant influence on the stress distribution. CONCLUSION: For implants with external connections, a hexagon is vital for stress distribution. As the height of the hexagon increased, the more effective stress distribution was observed.
Dental Implants ; Molar ; Plants ; Prostheses and Implants ; Titanium

Colonic angiosarcoma is an extremely rare and aggressive malignant tumor with poor prognosis. We report a case of colonic epithelioid angiosarcoma with colonic obstruction and rapidly progressive hepatic metastasis in a 44-year-old female. Abdominal CT revealed a heterogeneously enhancing irregular mass in the ascending colon, causing proximal bowel distension. The patient underwent surgery, and histopathological examination revealed a poorly differentiated carcinoma. A follow-up liver dynamic MRI after 4 months revealed newly developed diffusely scattered numerous small nodules in both hepatic lobes with peripheral and nodular marked arterial hyperenhancement, raising the suspicion of hepatic angiosarcoma. A pathologic second opinion was obtained, and additional immunohistochemistry revealed colonic epithelioid angiosarcoma. The patient showed progressive hepatic metastasis on follow-up abdominal CT after 6 months and died 8 months after initial diagnosis. We describe an educational case of colonic angiosarcoma, a rare malignant tumor, with rapidly progressive hepatic metastasis that showed radiologic findings suggestive of angiosarcoma and enabled a re-diagnosis for proper treatment and prognosis prediction.

Purpose: To investigate the incidence, characteristics, risk factors, and treatment outcomes for infectious keratitis in patients with ocular Sjögren’s syndrome (SS). Methods: We performed a retrospective chart review of patients who had been followed up for ocular SS in Seoul National University Hospital from 2010 to 2020 and identified cases where infectious keratitis developed. The incidence, demographical and clinical characteristics, risk factors, microbiological profiles, and treatment outcome were investigated, some of which were compared with infectious keratitis cases in the non-SS group. Results: Out of 929 patients with ocular SS, infectious keratitis occurred in 18 eyes (1.94%). All 18 patients were female in the ocular SS group, while 48 out of 100 infectious keratitis patients (48%) were female in the non-SS group (p < 0.01). The mean age at diagnosis of infectious keratitis was 66.1 years in the ocular SS group, which was not different from the non-SS group (57.2 years, p = 0.12). Of risk factors analyzed, the use of therapeutic contact lens was more frequently used in the ocular SS patients, compared to the non-SS patients (67% vs. 11%, p < 0.01). Culture-positivity rate was 50% in the ocular SS group. All culture-proven cases were bacterial infection, one of which was bacterial-fungal coinfection. Infection resolved in all eyes after the mean 29 days of medical treatment, except one that additionally required penetrating keratoplasty with vitrectomy. The visual acuity improved in 15 eyes (83%) after resolution. Infectious keratitis recurred in three patients (17%) during the mean 55.7 months of follow-up. Conclusions The incidence of infectious keratitis was 1.94% in patients with ocular SS. Most were bacterial infections and resolved by medical treatment. Therapeutic and visual outcomes were favorable, but recurrence occurred in 17%.

OBJECTIVE: To evaluate the effect of peripheral vascular disease (PVD) on diabetic neuropathy with the use of Doppler ultrasound and electrodiagnostic study. METHOD: One hundred fifty one patients with diabetes mellitus underwent nerve conduction studies. PVD was diagnosed when ankle-brachial index (ABI) was 0.9 and less and also toe-brachial index (TBI) was 0.7 and less. Electrophysiologically normal group was subdivided into non- PVD group (A1) and PVD group (A2). Diabetic neuropathy group was subdivided into non-PVD group (B1) and PVD group (B2). The frequency of diabetic neuropathy and the difference of amplitude, conduction velocity, and F wave latency within A groups and B groups were investigated. RESULTS: Diabetic neuropathy was significantly correlated with PVD (p<0.05). There was no definite difference of electrophysiologic parameters between A1 and A2 groups. B1 group showed significantly reduced amplitude of sensory nerve action potential (SNAP) in sural nerve compared with B2 group (p<0.05). In all patients, the amplitude of SNAP in sural nerve was related with duration of diabetes and TBI by multiple linear regression analysis. CONCLUSION: This study supports the influence of PVD on diabetic neuropathy and suggests vascular abnormality in patients with diabetic neuropathy may result in predominantly axonal injury rather than demyelinating injury.
Action Potentials ; Ankle Brachial Index ; Axons ; Diabetes Mellitus ; Diabetic Neuropathies* ; Humans ; Linear Models ; Neural Conduction ; Peripheral Vascular Diseases* ; Sural Nerve ; Ultrasonography

Apoptosis/*drug effects/physiology ; BH3 Interacting Domain Death Agonist Protein/physiology ; Drug Design ; Genes, bcl-2 ; Humans ; Mitochondria/physiology/ultrastructure ; Mitochondrial Membranes/*metabolism/physiology ; Multigene Family ; Proto-Oncogene Proteins c-bcl-2/*antagonists & inhibitors ; Signal Transduction