OBJECTIVES: We investigated the prevalence and functional impairment of premenstrual dysphoric disorder (PMDD) and premenstrual syndrome(PMS) in young women. METHODS: A total of 1063 female college students were recruited from two urban areas(Seoul and Suwon) of Korea. Questionnaires for sociodemographic data and risk factors of PMDD, attitude about menstruation, and the Premenstrual Symptoms Screening Tool(PSST) were applied. RESULTS: The prevalence of severe moderate to severe PMS and PMDD were 16.9% and 11.7%, respectively. There were differences in the alcohol and coffee consumption, severity of menstrual cramp, and family history of PMS among the moderate to severe PMS, PMDD, and no/mild PMS groups. Although some participants did not fulfill diagnostic criteria for PMDD, they showed significant functional impairment. Participants with negative attitude about menstruation reported premenstrual symptoms more frequently than those with positive or ambivalent attitude about menstruation. CONCLUSION: These results suggest that PMS and PMDD were prevalent and associated with functional impairment in young females. Some participants reported significant functional impairments although they did not meet the full DSM-IV diagnostic criteria for PMDD. Negative attitude about menstruation was associated with more premenstrual symptoms experiences.
Coffee ; Diagnostic and Statistical Manual of Mental Disorders ; Female ; Humans ; Korea ; Mass Screening ; Menstruation ; Muscle Cramp ; Premenstrual Syndrome ; Prevalence ; Questionnaires ; Risk Factors

PURPOSE: Papillary thyroid microcarcinoma (PTMC) is defined as a papillary thyroid carcinoma <10 mm in greatest dimension without palpation. In general, prognosis of PTMC is very favorable. PTMC can present with advanced features like papillary thyroid carcinoma >10 mm. Indication of FNAC based only on tumor size is still in debate. Some favor the criteria of a size <5 mm without FNAC and some argue for more study of the indication of FNAC according to tumor size. We analyzed the relationship of prognostic factors and number of FNACs prior to surgery for PTMC according to 5 mm size criterion. METHODS: Three hundred seven patients diagnosed with PTMC after surgery were enrolled. Based on tumor size, patients were divided into group 1 (≤5 mm, n=151) and group 2 (>5 mm, n=156) and the prognostic factors and number of pre-surgical FNAC procedures were compared. RESULTS: There were no significant differences in gender, age, site, accompanying benign disease, multifocality and bilaterality. Group 2 patients displayed more advanced features than group 1 patients concerning capsular invasion, lymph node metastasis and tumor stage. The number of FNAC procedures prior to the decision of surgery was not different in the two groups. CONCLUSION: PTMC exceeding 5 mm in size showed advanced features than smaller tumors. Further study about the use of FNAC according only to the size of thyroid nodules is warranted.
Biopsy, Fine-Needle* ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Palpation ; Prognosis ; Thyroid Gland* ; Thyroid Neoplasms ; Thyroid Nodule

PURPOSE: This study evaluated the risk factors for hypothyroidism after lobectomy for low risk papillary thyroid carcinoma according to existence of thyroiditis, especially on preoperative thyroid stimulating hormone (TSH) level and remnant thyroid volume. METHODS: The clinical records of 169 patients who underwent thyroid lobectomy due to papillary thyroid carcinoma were reviewed. We maintain the TSH level between 0.10~0.50 mU/L with thyroid hormone until 6 to 12 months after lobectomy. Then we stopped medication and check TSH level at intervals of 2~6 months. The patients were divided into 2 groups; hypothyroid (n=63) and euthyroid (n=106) state after lobectomy. Euthyroid state was defined as an TSH level between 0.50~5.0 mU/L, hypothyroid state as an elevated TSH level above 10 mU/L and need thyroid hormone. RESULTS: Factor for age, sex, type of operation, result of biopsy were not significant to postoperative hypothyroidism. Presence of thyroid autoantibody was significantly different (P<0.01) in the patients with thyroiditis compared with the patients without thyroiditis. When patient had thyroiditis, there was high possibility of postoperative hypothyroidism regardless of preoperative TSH level and remnant thyroid volume (P>0.05). When patient didn't have thyroiditis, there was high possibility of postoperative hypothyroidism when preoperative TSH is in high normal level and remnant thyroid volume ratio is below 50% (P<0.01). CONCLUSION: One can check the presence of thyroiditis with thyroid autoantibody and can predict the possibility of postoperative hypothyroidism after lobectomy in patients with low risk papillary thyroid carcinoma with preoperative TSH level and remnant thyroid volume.
Biopsy ; Humans ; Hypothyroidism* ; Risk Factors* ; Thyroid Gland* ; Thyroid Neoplasms ; Thyroidectomy ; Thyroiditis* ; Thyrotropin

PURPOSE: Although numerous etiological models of premenstrual syndrome(PMS) such as the biochemical, hormonal, psychosocial models have been proposed, there is no consistent conclusion. Especially, in psychosocial model, state-dependent changes in the perception of stressors according to menstrual cycle phases was suggested for PMS. In this study, we investigated relationship between menstrual cycle and daily minor stressors in young women, and vulnerability to minor stressors in young women with PMS. METHODS: 46 female college students completed modified daily rating form(DRF) of premenstrual symptoms which based on DSM-IV criteria for PMDD, and daily stress inventory(DSI) during at least one menstrual cycle. If the mean score of at least one DRF item during premenstrual phase were more than 3 on 6 point scale and 30% increase in symptom severity during premenstrual phase compared with during postmenstrual phase, they were referred as PMS group(N=20), and the others as non-PMS group(N=26). The event, impact, and impact/event ratio scores of DSI were compared in two groups. Data were analyzed by analysis of variance with repeated measure ANOVA. And post hoc simple; repeated contrast test were performed when indicated by significant repeated measure ANOVA. RESULTS: In all subjects, the event and the impact scores in premenstrual and menstrual phases were significantly higher than in postmenstrual phase. Among the DSI categories, the impact scores of interpersonal problem and cognitive stressors in premenstrual and menstrual phases were significantly higher than in postmenstrual phase. In PMS group, there was a significant difference between premenstrual and postmenstrual phase in the impact score but not in the event score, and the event and the impact scores were significantly increased in menstrual phase than postmenstrual phase. In non-PMS group, the event and the impact scores in premenstrual and menstrual phases were significantly higher than in postmenstrual phase. There was no significant difference in the impact/event ratio scores in both groups. Between the PMS and non-PMS group, there was significant difference in the impact/event ratio scores in premenstrual phase, but not in the event score and the impact scores at any phase. CONCLUSION: Young women may experience more daily minor stressors and may be impacted more severely in premenstrual and menstrual phases than in postmenstrual phase. In premenstrual phase, the young women with PMS are likely to have more vulnerability to daily minor stressors than controls. Further studies using larger sample size with varied age are required.
Diagnostic and Statistical Manual of Mental Disorders ; Female ; Humans ; Life Change Events* ; Menstrual Cycle ; Premenstrual Syndrome* ; Sample Size

OBJECTIVES: Within the normal reproductive cycles of women, dramatic fluctuations of sexual hormones occur in the premenstrual and menopausal periods. In both periods, women are vulnerable to mood disturbances and show several somatic complaints. Based on these common clinical profiles and physiological changes, a relationship between vasomotor symptoms and the premenstrual syndrome has been suggested. However, attempts to establish such a link have yielded inconclusive results. The purpose of this study was to investigate the association between histories of premenstrual syndrome and menopausal vasomotor symptoms within different menopausal stages. METHODS: This cross-sectional study recruited Korean women aged 45-64 years who were perimenopausal and postmenopausal from 16 branch offices of the Korean Association of Health Promotion. All subjects completed self-report questionnaires that asked about a history of premenstrual syndromes, vasomotor symptoms, and several other variables. RESULTS: A total of 1054 participants(361 perimenopausal women and 693 postmenopausal women) completed the study. Severity of premenstrual symptoms significantly correlated with postmenopausal vasomotor symptoms, only in late perimenopausal(r=0.213, p=0.010) and early postmenopausal women(r=0.246, p<0.001). After adjusting for several factors related to vasomotor symptoms, a history of premenstrual syndrome was a significant predictor of moderate to very severe vasomotor symptoms in late perimenopausal(OR=5.197, p=0.005) and early postmenopausal women(OR=3.017, p=0.010). CONCLUSIONS: This study suggests that a history of premenstrual syndrome/premenstrual dysphoric disorder is differentially associated with vasomotor symptoms in the menopausal stage. Prospective studies with larger population are needed to confirm these findings.
Cross-Sectional Studies ; Female ; Health Promotion ; Humans ; Menopause ; Premenstrual Syndrome ; Questionnaires

We have relatively limited knowledge of symptomatic aspects of the postmenopause, rather than perimenopause. We tried to determine the factors associated with experiencing menopausal symptoms by Korean postmenopausal women. A total of 657 Korean women who underwent a natural menopause completed multiple questionnaires, which included questions regarding their attitudes to menopause, depressive symptoms, state anxiety, self-esteem, dyadic relationships, sociodemographic variables, and 11-item Menopause Rating Scale (MRS). Multiple regression analyses were performed to collectively examine the relative impact of each independent variable on the quality of life, as determined by the MRS. Decreased severity of menopausal symptoms was associated with more time spent in education, an employed status, a history of pregnancy, longer postmenopausal duration, positive attitudes to menopause, higher state anxiety, heightened self-esteem, and higher dyadic consensus. Increased severity of menopausal symptoms was also associated with absence of a partner, alcohol consumption, a history of hormone replacement therapy, a history of probable premenstrual dysphoric disorder, and increased severity of depressive symptoms. Sociodemographic characteristics, lifestyle factors, premenstrual dysphoric disorder, attitudes to menopause, a dyadic relationship with a partner, and the inner psychological status can be associated with the severity of menopause symptoms specifically in Korean postmenopausal women.
Adult ; Age Distribution ; Anxiety/*epidemiology/*psychology ; Comorbidity ; Depression/*epidemiology/*psychology ; Educational Status ; Employment ; Female ; Humans ; Incidence ; Korea/epidemiology ; Marital Status ; Middle Aged ; Postmenopause/*psychology ; Risk Assessment ; Risk Factors

PURPOSE: To compare CT features of gastrointestinal stromal tumors (GIST) with those of lymphomas in the small intestine. MATERIALS AND METHODS: CT findings of 11 pathologically confirmed GIST patients and 10 lymphoma patients were retrospectively reviewed. CT findings were analyzed with regard to location, size, margin, growth patterns, internal character, enhancement, invasion, vascular encasement, lymphadenopathy, intestinal obstruction and ascites. RESULTS:An extraluminal mass was present in 82% (9/11) of the GIST patients versus 30% (3/10) of the lymphoma patients. Circumferential wall thickening was observed in 80% (8/10) of the lymphoma patients (p<.05). Internal necrosis or gas was present in 73% (8/11) of the GIST patients versus 10% (1/10) of the lymphoma patients (p<.05). Inhomogeneous enhancement was observed in 63% (7/11) of the GIST patients compared to homogeneous enhancement in 90% (9/10) of the lymphoma patients (p<.05). Lymphadenopathy was only observed in 80% (8/10) of the lymphoma patients (p<.05). In other findings such as fatty infiltration, ascites and intestinal obstruction there were no statistically significant differences (p>.05). CONCLUSION: Features revealed by CT scans are highly useful in differentiating GIST from lymphoma of the small intestine. Extraluminal growth and internal necrosis or gas are more common in patients with GIST compared with lymphoma. CT features of circumferential wall thickening and associated lymphadenopathy are more common in patients with lymphoma.
Ascites ; Gastrointestinal Stromal Tumors* ; Humans ; Intestinal Obstruction ; Intestine, Small* ; Lymphatic Diseases ; Lymphoma* ; Necrosis ; Retrospective Studies ; Tomography, X-Ray Computed

PURPOSE: We wanted to evaluate the usefulness of a new type of a complex expandable nitinol stent that was designed to reduce the stent's propensity to migration during the treatment of malignant gastroduodenal obstructions. MATERIALS AND METHODS: Two types of expandable nitinol stent were constructed by weaving a single thread of 0.2 mm nitinol wire in a tubular configuration: an uncovered stent 18mm in diameter and a covered stent 16mm in diameter. Both ends of the covered stent were fabricated by coaxially inserting the covered stent into the tubular uncovered stent and then attaching the two stents together with using nylon monofilament. Under fluoroscopic guidance, the stent was placed in 29 consecutive patients (20 men and 9 women, mean age: 65 years) who were suffering with malignant gastric outlet obstruction (n=20), duodenal obstruction (n=6) or combined obstruction (n=3). Clinical improvement was assessed by comparing the food intake capacity before and after the procedure. The complications were investigated during the follow up period. RESULTS: Stent placement was successful in all the patients. After stent placement, the symptoms improved in all but one patient. During the follow up, stent migration occurred in one patient (3%) at 34 days after the procedure. Despite the stent migration, the patient was able to resume a soft diet. Six patients developed recurrent symptoms of obstruction with tumor overgrowth at a mean of 145 days after the procedure; all the patients underwent coaxial placement of an additional stent with good results. One patient showed recurrence of obstruction due to tumor in-growth, and this was treated by placement of a second stent. Two patients with stent placement in the duodenum suffered from jaundice 26 days and 65 days, respectively, after their procedures. CONCLUSION: Placement of the newly designed complex expandable nitinol stent seems to be effective for the palliative treatment of malignant gastroduodenal obstructions. The new stent also seems to help overcome the disadvantage of the increased migration observed for the covered stent.
Diet ; Duodenal Obstruction ; Duodenum ; Eating ; Female ; Follow-Up Studies ; Gastric Outlet Obstruction ; Humans ; Jaundice ; Male ; Nylons ; Palliative Care ; Recurrence ; Stents*

PURPOSE: We evaluated the accuracy of 18FFDG PET/CT for the detection of recurrence or metastasis after treatment in patients with primary head and neck cancer, and compared the results with those of CT/MRI. MATERIALS AND METHODS: We studied 34 patients with the diagnosis of head and neck cancer, who underwent treatment and follow up with 18FFDG PET/CT and CT/MRI. The patients were divided into two subgroups based on the difference in follow-up time interval and the type of treatment. Accuracy was evaluated by follow-up information and histopathology findings. The results of the 18FFDG PET/CT and CT/MRI were compared by statistical analysis. RESULTS: For the 18FFDG PET/CT results, 19 FDG uptake lesions were detected in 17 patients. Among these lesions, 18 were confirmed as recurrent or metastatic lesions and one as an inflammatory reaction from radiation therapy. Four lesions that had high FDG uptake were not detected by the CT/MRI. The sensitivity and specificity were 100% and 94.4% for the 18FFDG PET/CT and 77.8% and 94.4% for the CT/MRI (p<0.05). For the subgroup that received radiation therapy, 18FFDG PET/CT was more sensitive than CT/MRI (sensitivity = 100% vs. 63.6%, p<0.05). CONCLUSION: The results of this study showed that 18FFDG PET/CT was a useful screening modality for detecting recurrent or metastatic disease after treatment of patients with head and neck cancer, especially post-radiation.
Diagnosis* ; Follow-Up Studies ; Head and Neck Neoplasms* ; Head* ; Humans ; Mass Screening ; Neoplasm Metastasis ; Positron-Emission Tomography and Computed Tomography* ; Recurrence ; Sensitivity and Specificity

The calcium sensing receptor (CaSR) plays an important role for sensing local changes in the extracellular calcium concentration ([Ca2+]o) in bone remodeling. Although the function of CaSR is known, the regulatory mechanism of CaSR remains controversial. We report here the regulatory effect of caveolin on CaSR function as a process of CaSR regulation by using the human osteosarcoma cell line (Saos-2). The intracellular calcium concentration ([Ca2+]i) was increased by an increment of [Ca2+]o. This [Ca2+]i increment was inhibited by the pretreatment with NPS 2390, an antagonist of CaSR. RT-PCR and Western blot analysis of Saos-2 cells revealed the presence of CaSR, caveolin (Cav)-1 and -2 in both mRNA and protein expressions, but there was no expression of Cav-3 mRNA and protein in the cells. In the isolated caveolae-rich membrane fraction from Saos-2 cells, the CaSR, Cav-1 and Cav-2 proteins were localized in same fractions (fraction number 4 and 5). The immuno-precipitation experiment using the respective antibodies showed complex formation between the CaSR and Cav-1, but no complex formation of CaSR and Cav-2. Confocal microscopy also supported the co-localization of CaSR and Cav-1 at the plasma membrane. Functionally, the [Ca2+]o- induced [Ca2+]i increment was attenuated by the introduction of Cav-1 antisense oligodeoxynucleotide (ODN). From these results, in Saos-2 cells, the function of CaSR might be regulated by binding with Cav-1. Considering the decrement of CaSR activity by antisense ODN, Cav-1 up-regulates the function of CaSR under normal physiological conditions, and it may play an important role in the diverse pathophysiological processes of bone remodeling or in the CaSR- related disorders in the body.
Bone Neoplasms ; Calcium/*metabolism ; Caveolins/*metabolism ; Cell Fractionation ; Cell Line, Tumor ; Cell Membrane/*metabolism ; Humans ; Microscopy, Confocal ; Oligoribonucleotides, Antisense/pharmacology ; Osteosarcoma ; Receptors, Calcium-Sensing/antagonists & inhibitors/*metabolism ; Research Support, Non-U.S. Gov't ; Up-Regulation