Crossed pulmonary arteries is an uncommon anomaly in which the ostium of the left pulmonary artery originates superiorly and to the right of the right pulmonary artery. The pulmonary arteries then cross each other and supply their respective lungs. The recognition of this rare anomaly is important because of its association with significant cardiac and extracardiac congenital abnormalities. These congenital conotruncal malformations have long been considered part of the clinical spectrum of DiGeorge syndrome, velocardiofacial(Shprintzen) syndrome, and conotruncal face syndrome. More recent reports have shown that a high percentage of patients with these syndromes have microscopic deletions of chromosomal region 22q11. We experienced a case of crossed branch pulmonary arteries in Dandy-Walker malformation. The diagnosis of crossed branch pulmonary arteries was made by echocardiography and this case had no evidence of 22q11 deletion in high resolution chromosome study and fluorescence in situ hybridization. This case of both conotruncal malformation and Dandy-Walker malformaltion was due to an abnormal developmental process involving the neural crest. We report this case with related literature.
Congenital Abnormalities ; Dandy-Walker Syndrome* ; Diagnosis ; DiGeorge Syndrome ; Echocardiography ; Fluorescence ; Humans ; In Situ Hybridization ; Lung ; Neural Crest ; Pulmonary Artery*

PURPOSE: This research aimed to investigate the effects of a cognitive rehearsal program (CRP) on workplace bullying among nurses. METHODS: A randomized controlled trial was performed. Participants were 40 nurses working in different university hospitals in B city, South Korea. The experimental group was provided with a 20-hour CRP comprising scenarios on bullying situations, standard communication, and role-playing. To evaluate effects of the CRP, we measured interpersonal relationships, workplace bullying, symptom experience, and turnover intention at preand post-intervention. Follow-up effect was measured in the experimental group only at 4 weeks after the intervention. RESULTS: After the intervention, there were significant differences in interpersonal relationships (F=6.21, p=.022) and turnover intention (F=5.55, p=.024) between experimental and wait-list groups. However, there was no significant difference in workplace bullying or symptom experience between the 2 groups. The beneficial effects on interpersonal relationships and turnover intention lasted at least up to 4 weeks after CRP. CONCLUSION: The CRP for workplace bullying improves interpersonal relationships and decreases turnover intention. So it can be utilized as one of the personal coping strategies to reduce the the turnover among nurses. Further studies on the effects of unit- or hospital-based CRP and on the long-term effects of CRP are necessary.
Bullying* ; Cognitive Therapy ; Follow-Up Studies ; Hospitals, University ; Humans ; Intention* ; Korea ; Role Playing

OBJECTIVE: Rumination is a negative coping strategy defined as repetitive and passive focusing on negative feelings such as depression. The Ruminative Response Scale (RRS) is a widely-used instrument to measure rumination, but there is continuing argument about the construct validity of the RRS, because of probable overlap between the measurement of depression and that of rumination. The RRS-Revised (RRS-R), which removed 12 items of the RRS, is suggested as a more valid instrument for measuring rumination. Therefore, we translated RRS-R into Korean and explored the reliability, validity and factor structure in patients with major depressive disorders. METHODS: Seventy-nine patients with major depressive disorder took the Korean version of RRS, RRS-R, State Trait Anxiety Inventory, Beck Depression Inventory and Penn State Worry Questionnaire. We performed exploratory factor analysis of RRS-R, and tested construct validity, internal reliability and test-retest reliability. RESULTS: The internal and test-retest reliability of RRS-R was high. Factor analysis revealed that RRS-R is composed of two factors. 'Brooding' factor explained 56.6% and 'Reflection' factor explained 12.5%. RRS-R, especially 'Brooding factor', was highly correlated with other clinical symptoms such as depression, anxiety and worry. CONCLUSION: In this study, we find out the RRS-R is more reliable and valid than the original RRS in Korean patients with depression because the RRS-R is free from the debate about the overlap of item with BDI. We also revealed that 'Brooding' is highly correlated with depressive symptoms. RRS-R may be a useful instrument to explore the implication of 'Brooding' in depression.
Anxiety ; Depression ; Depressive Disorder, Major ; Humans ; Surveys and Questionnaires

Objective: PD-1 inhibitors have demonstrated improved health outcomes in cancer patients. PD-1 inhibitors are well-tolerated and associated with immune-related adverse events. The objectives of this study are to analyze use patterns of PD-1 inhibitors in patients with cancer and to investigate the incidence of thyroid-related adverse reactions in patients treated with PD-1 inhibitors. Methods: The study included patients who had been administered PD-1 inhibitors (either nivolumab or pembrolizumab) at the Samsung Medical Center between October 1, 2016 and June 30, 2017. Data was collected from electronic medical records and tested using Mann-Whitney tests and Chi-Square tests for statistical significance. Associations between PD-1 inhibitors and incidence of adverse events were tested using Cox regression for age, gender, BMI, ECOG PS and medication. Results: Two hundred fifteen patients were identified as eligible for analyses. Thyroid-related adverse events occurred in 20% of patients (n=43). Thyroid function tests (TFTs) was performed in 109 patients (50.7%). Positive results of PD-L1 testing were found in 53.2% of the 94 patients who had the test. Approved doses of nivolumab (3 m/kg) and pembrolizumab (200 mg) were administered in 70.4% and 53% of patients, respectively. The analysis of risk factor of thyroid-related adverse reaction did not show statistically significant differences (Cox regression). Conclusion Thyroid-related adverse events are common in patients treated with PD-1 inhibitors and hypothyroidism is the most frequent adverse reaction. Routine TFTs monitoring is strongly recommended to evaluate thyroid function in real-world clinical practice.

Objective: PD-1 inhibitors have demonstrated improved health outcomes in cancer patients. PD-1 inhibitors are well-tolerated and associated with immune-related adverse events. The objectives of this study are to analyze use patterns of PD-1 inhibitors in patients with cancer and to investigate the incidence of thyroid-related adverse reactions in patients treated with PD-1 inhibitors. Methods: The study included patients who had been administered PD-1 inhibitors (either nivolumab or pembrolizumab) at the Samsung Medical Center between October 1, 2016 and June 30, 2017. Data was collected from electronic medical records and tested using Mann-Whitney tests and Chi-Square tests for statistical significance. Associations between PD-1 inhibitors and incidence of adverse events were tested using Cox regression for age, gender, BMI, ECOG PS and medication. Results: Two hundred fifteen patients were identified as eligible for analyses. Thyroid-related adverse events occurred in 20% of patients (n=43). Thyroid function tests (TFTs) was performed in 109 patients (50.7%). Positive results of PD-L1 testing were found in 53.2% of the 94 patients who had the test. Approved doses of nivolumab (3 m/kg) and pembrolizumab (200 mg) were administered in 70.4% and 53% of patients, respectively. The analysis of risk factor of thyroid-related adverse reaction did not show statistically significant differences (Cox regression). Conclusion Thyroid-related adverse events are common in patients treated with PD-1 inhibitors and hypothyroidism is the most frequent adverse reaction. Routine TFTs monitoring is strongly recommended to evaluate thyroid function in real-world clinical practice.

Objective: This study aims to validate the Korean version of Geriatric Suicide Ideation Scale-Screen (K-GSIS-Screen) and evaluate its clinical utility for screening suicidal ideation and risk among older adults across clinical and community settings. Methods: GSIS-Screen was translated into Korean and administered to 50 community-residing older adults and 49 elderly patients attending a depression clinic in the psychiatric department of a hospital. Reliability and validity were assessed by Cron-bach’s α and exploratory factor analysis. Then, clinical utility was further examined through receiver operating characteristic(ROC) curve analysis. Results: Exploratory factor analysis confirmed a single-factor structure. Overall findings demonstrated moderate to strong in-ternal consistency, convergent validity, and discriminant validity across community and clinical settings. Additionally, K-GSISScreen differentiated between older adults with and without suicidal ideation, with those in the former group scoring higher.ROC analysis confirmed an area under curve of 0.81. Conclusion The K-GSIS-Screen appears to be a useful primary screening tool for detecting suicidal ideation among older adults. It has the potential to facilitate rapid identification of suicidal ideation in clinical and community settings, thereby sup-porting early and appropriate interventions.

Objective: This study aims to validate the Korean version of Geriatric Suicide Ideation Scale-Screen (K-GSIS-Screen) and evaluate its clinical utility for screening suicidal ideation and risk among older adults across clinical and community settings. Methods: GSIS-Screen was translated into Korean and administered to 50 community-residing older adults and 49 elderly patients attending a depression clinic in the psychiatric department of a hospital. Reliability and validity were assessed by Cron-bach’s α and exploratory factor analysis. Then, clinical utility was further examined through receiver operating characteristic(ROC) curve analysis. Results: Exploratory factor analysis confirmed a single-factor structure. Overall findings demonstrated moderate to strong in-ternal consistency, convergent validity, and discriminant validity across community and clinical settings. Additionally, K-GSISScreen differentiated between older adults with and without suicidal ideation, with those in the former group scoring higher.ROC analysis confirmed an area under curve of 0.81. Conclusion The K-GSIS-Screen appears to be a useful primary screening tool for detecting suicidal ideation among older adults. It has the potential to facilitate rapid identification of suicidal ideation in clinical and community settings, thereby sup-porting early and appropriate interventions.

Objective: This study aims to validate the Korean version of Geriatric Suicide Ideation Scale-Screen (K-GSIS-Screen) and evaluate its clinical utility for screening suicidal ideation and risk among older adults across clinical and community settings. Methods: GSIS-Screen was translated into Korean and administered to 50 community-residing older adults and 49 elderly patients attending a depression clinic in the psychiatric department of a hospital. Reliability and validity were assessed by Cron-bach’s α and exploratory factor analysis. Then, clinical utility was further examined through receiver operating characteristic(ROC) curve analysis. Results: Exploratory factor analysis confirmed a single-factor structure. Overall findings demonstrated moderate to strong in-ternal consistency, convergent validity, and discriminant validity across community and clinical settings. Additionally, K-GSISScreen differentiated between older adults with and without suicidal ideation, with those in the former group scoring higher.ROC analysis confirmed an area under curve of 0.81. Conclusion The K-GSIS-Screen appears to be a useful primary screening tool for detecting suicidal ideation among older adults. It has the potential to facilitate rapid identification of suicidal ideation in clinical and community settings, thereby sup-porting early and appropriate interventions.

Objective: This study aims to validate the Korean version of Geriatric Suicide Ideation Scale-Screen (K-GSIS-Screen) and evaluate its clinical utility for screening suicidal ideation and risk among older adults across clinical and community settings. Methods: GSIS-Screen was translated into Korean and administered to 50 community-residing older adults and 49 elderly patients attending a depression clinic in the psychiatric department of a hospital. Reliability and validity were assessed by Cron-bach’s α and exploratory factor analysis. Then, clinical utility was further examined through receiver operating characteristic(ROC) curve analysis. Results: Exploratory factor analysis confirmed a single-factor structure. Overall findings demonstrated moderate to strong in-ternal consistency, convergent validity, and discriminant validity across community and clinical settings. Additionally, K-GSISScreen differentiated between older adults with and without suicidal ideation, with those in the former group scoring higher.ROC analysis confirmed an area under curve of 0.81. Conclusion The K-GSIS-Screen appears to be a useful primary screening tool for detecting suicidal ideation among older adults. It has the potential to facilitate rapid identification of suicidal ideation in clinical and community settings, thereby sup-porting early and appropriate interventions.

BACKGROUND: Tumor-infiltrating lymphocytes, which form a part of the host immune system, affect the development and progression of cancer. This study investigated whether subsets of lymphocytes reflecting host-tumor immunologic interactions are related to the prognosis of patients with acute myeloid leukemia (AML). METHODS: Lymphocyte subsets in the peripheral blood of 88 patients who were newly diagnosed with AML were analyzed by quantitative flow cytometry. The relationships of lymphocyte subsets with AML subtypes, genetic risk, and clinical courses were analyzed. RESULTS: The percentages of T and NK cells differed between patients with acute promyelocytic leukemia (APL) and those with AML with myelodysplasia-related changes. In non-APL, a high proportion of NK cells (>16.6%) was associated with a higher rate of death before remission (P=0.0438), whereas a low proportion of NK cells (≤9.4%) was associated with higher rates of adverse genetic abnormalities (P=0.0244) and relapse (P=0.0567). A multivariate analysis showed that the lymphocyte subsets were not independent predictors of survival. CONCLUSION: Lymphocyte subsets at diagnosis differ between patients with different specific subtypes of AML. A low proportion of NK cells is associated with adverse genetic abnormalities, whereas a high proportion is related to death before remission. However, the proportion of NK cells may not show independent correlations with survival.
Diagnosis ; Flow Cytometry ; Humans ; Immune System ; Killer Cells, Natural ; Leukemia, Myeloid, Acute* ; Leukemia, Promyelocytic, Acute ; Lymphocyte Subsets* ; Lymphocytes* ; Lymphocytes, Tumor-Infiltrating ; Multivariate Analysis ; Prognosis ; Recurrence