As the coronavirus disease 2019 (COVID-19) has rapidly spread worldwide, there are growing concerns about patients' mental health. We investigated psychological problems in COVID-19 patients assessed with self-reported questionnaires including the Patient Health Questionnaire-9, Generalized Anxiety Disorder-7 scale, and Impact of Event ScaleRevised Korean version. Ten patients who recovered from COVID-19 pneumonia without complications underwent self-reported questionnaires about 1 month after discharge. Of them, 10% reported depression and posttraumatic stress disorder (PTSD) while 50% had depression during the treatment. Perceived stigma and history of psychiatric treatment affected PTSD symptom severity, consistent with previous emerging infectious diseases. Survivors also reported that they were concerned about infecting others and being discriminated and that they chose to avoid others after discharge. Further support and strategy to minimize their psychosocial difficulties after discharge should be considered.

Common variable immunodeficiency (CVID) is a heterogeneous group of primary immune deficiencies in adults characterized by hypogammaglobulinemia, recurrent bacterial infections, and a higher incidence of autoimmune diseases. More than 25% of CVID patients also have autoimmune diseases such as autoimmune hemolytic anemia, immune thrombocytopenic purpura, rheumatoid arthritis, and systemic lupus erythematosus. However, the pathogenesis of autoimmunity in CVID remains obscure. We report a 56-year-old woman with CVID and Sjogren's syndrome. In addition to a long history of recurrent upper respiratory infections, acute gastroenteritis, and cellulitis, she has also suffered from persistent xerostomia and xerophthalmia for the past 10 years. Serologic studies revealed hypogammaglobulinemia (low levels of IgG, IgA, and IgM in serum) and the presence of anti-Ro antibodies, and salivary scintigraphy indicated salivary gland involvement. These findings led to a diagnosis of CVID and Sjogren's syndrome, which was treated by monthly intravenous immunoglobulin therapy.
Adult ; Agammaglobulinemia ; Anemia, Hemolytic, Autoimmune ; Antibodies ; Arthritis, Rheumatoid ; Autoimmune Diseases ; Autoimmunity ; Bacterial Infections ; Cellulitis ; Common Variable Immunodeficiency* ; Diagnosis ; Female ; Gastroenteritis ; Humans ; Immunization, Passive ; Immunoglobulin A ; Immunoglobulin G ; Immunoglobulin M ; Incidence ; Lupus Erythematosus, Systemic ; Middle Aged ; Purpura, Thrombocytopenic, Idiopathic ; Radionuclide Imaging ; Respiratory Tract Infections ; Salivary Glands ; Sjogren's Syndrome* ; Xerophthalmia ; Xerostomia

Metastatic tumors to the heart are far more frequent than primary tumors of the heart. Cardiac metastasis may be detected up to 30 percent of patients with fatal lung cancers. Metastatic cancer to the heart is difficult to suspect. Where cardiac metastasis is diagnosed ante-mortem, signs and symptoms of the primary cancer are usually the presenting features and the presence of cardiac involvement is often incidentally detected. We experienced a case of 35-year-old woman with metastatic lung cancer invading the left atrium via pulmonary vein, which was not proved pathologically. She presented with hemoptysis and chest pain. Transthoracic echocardiography demonstrated massive cardiac infiltration with tumor and decreased cardiac wall motion, correlating with the chest CT findings, which were also remarkable for the presence of intracardiac mass and direct invasion to adherent pericardium, pulmonary vein and left atrium. We suggest that careful examination of 2D echocardiography can be noninvasive and valuable tool for diagnosis of metastatic cancer to the heart.
Adult ; Carcinoma, Large Cell* ; Chest Pain ; Diagnosis ; Echocardiography ; Female ; Heart ; Heart Atria* ; Hemoptysis ; Humans ; Lung Neoplasms ; Lung* ; Neoplasm Metastasis* ; Pericardium ; Pulmonary Veins ; Tomography, X-Ray Computed

Although diseases of the parotid gland are relatively uncommon in children, a variety of benign and malignant lesions may occur and the use of imaging is essential for accurate diagnosis and treatment. Ultrasonography (US) is the initial imaging modality utilized for suspected parotid lesions, and its use may suggest a correct diagnosis in an adequate clinical setting. The use of computed tomography (CT) and magnetic resonance imaging (MRI) are useful for the assessment of large and atypical lesions. These modalities also allow the ability to image the deep parotid lobe and to better define the nature of a lesion. CT is the preferred imaging modality for inflammatory processes, including suspected sialolithiasis, abscesses and salivary duct obstructions, whereas MRI is usually used to evaluate tumors due to excellent anatomic resolution and a lack of ionizing radiation exposure, especially in children. This report describes the imaging findings of various parotid gland lesions in children. Familiarity with these findings will aid in lesion characterization and should facilitate optimal clinical management.
Abscess ; Child ; Humans ; Magnetic Resonance Imaging ; Parotid Gland ; Radiation, Ionizing ; Recognition (Psychology) ; Salivary Ducts ; Salivary Gland Calculi ; Tomography, X-Ray

Although gastrointestinal stromal tumor (GIST) is the most common mesenchymal tumor of the gastrointestinal tract, it also occurs in the non-gastrointestinal tract, and is referred to as extragastrointestinal stromal tumor (EGIST). In this report, we describe a 48-year-old female patient who presented with hematuria, and who was finally diagnosed with a primary extragastrointestinal stromal tumor of the pelvic cavity involving the bladder, vagina and left ureter. Tumor cells were positive for immunohistochemical staining for CD117 antigen (proto-oncogene protein c-kit), CD34, and vimentin, whereas they were negative for desmin, smooth muscle actin, and S-100 protein. These findings provide histopathological and immunohistochemical evidence for diagnosing this tumor as EGIST.
Actins ; Desmin ; Female ; Gastrointestinal Stromal Tumors ; Gastrointestinal Tract ; Hematuria ; Humans ; Middle Aged ; Muscle, Smooth ; Proto-Oncogene Proteins c-kit ; S100 Proteins ; Ureter ; Urinary Bladder ; Vagina ; Vimentin

OBJECTIVE: The aim of this study is to assess the relationships between maternal plasma and umbilical cord leptin concentrations and their effects on newborn birth weights, maternal body mass indices and fetal sex in term normotensive (NT) and preeclampsia (PE) women. METHODS: Blood samples were obtained at delivery from 20 NT group and another 20 from PE group of at least 36 weeks of gestation. And the umbilical cord samples were also taken from their newborns at birth. Plasma leptin levels were determined in both groups using a human recombinant leptin 125-I radioimmunoassay. RESULTS: Mean maternal plasma and umbilical cord leptin concentrations were 16.16+/-2.05 ng/ml and 7.11+/-1.01 ng/ml in NT group, 17.09+/-1.67 ng/ml and 8.55+/-6.63 ng/ml in PE group, and there was no statistical significances among them. The differences of leptin concentrations in maternal plasma and umbilical cord according to baby sex were not significant in both NT and PE groups. Plasma leptin concentrations were related with maternal weight gain and BMI in NT group and with body weight in PE group. The BMI and birth weights of the neonates have significant effects on the umbilical cord leptin concentrations in both NT and PE groups. CONCLUSION: In this study, no correlation was found between maternal plasma and umbilical cord leptin concentrations in both NT and PE groups. But maternal plasma leptin concentrations had positive correlations with maternal body weight, BMI, and body weight changes during pregnancy in both NT and PE groups. There were also positive correlations among umbilical cord leptin concentrations, BMI and birth weights of the neonates of NT and PE groups term. Therefore umbilical cord leptin is considered to be the index of fetal birth weight.
Birth Weight ; Body Weight ; Body Weight Changes ; Female ; Fetal Blood* ; Fetal Weight* ; Humans ; Infant, Newborn ; Leptin* ; Parturition ; Plasma* ; Pre-Eclampsia* ; Pregnancy ; Radioimmunoassay ; Umbilical Cord ; Weight Gain

OBJECTIVE: The aim of this study is to assess the relationships between maternal plasma and umbilical cord leptin concentrations and their effects on newborn birth weights, maternal body mass indices and fetal sex in term normotensive (NT) and preeclampsia (PE) women. METHODS: Blood samples were obtained at delivery from 20 NT group and another 20 from PE group of at least 36 weeks of gestation. And the umbilical cord samples were also taken from their newborns at birth. Plasma leptin levels were determined in both groups using a human recombinant leptin 125-I radioimmunoassay. RESULTS: Mean maternal plasma and umbilical cord leptin concentrations were 16.16+/-2.05 ng/ml and 7.11+/-1.01 ng/ml in NT group, 17.09+/-1.67 ng/ml and 8.55+/-6.63 ng/ml in PE group, and there was no statistical significances among them. The differences of leptin concentrations in maternal plasma and umbilical cord according to baby sex were not significant in both NT and PE groups. Plasma leptin concentrations were related with maternal weight gain and BMI in NT group and with body weight in PE group. The BMI and birth weights of the neonates have significant effects on the umbilical cord leptin concentrations in both NT and PE groups. CONCLUSION: In this study, no correlation was found between maternal plasma and umbilical cord leptin concentrations in both NT and PE groups. But maternal plasma leptin concentrations had positive correlations with maternal body weight, BMI, and body weight changes during pregnancy in both NT and PE groups. There were also positive correlations among umbilical cord leptin concentrations, BMI and birth weights of the neonates of NT and PE groups term. Therefore umbilical cord leptin is considered to be the index of fetal birth weight.
Birth Weight ; Body Weight ; Body Weight Changes ; Female ; Fetal Blood* ; Fetal Weight* ; Humans ; Infant, Newborn ; Leptin* ; Parturition ; Plasma* ; Pre-Eclampsia* ; Pregnancy ; Radioimmunoassay ; Umbilical Cord ; Weight Gain

OBJECTIVES: OThis study aimed to explore the difference in emotional recognition of musical auditory stimulation and art-related visual stimulation between subjects with and without schizophrenia. METHODS: Twenty songs and 20 paintings that evoke sad or cheerful emotions were presented to 123 patients with schizophrenia and 224 non-schizophrenic people (control group). All subjects were asked to describe the emotions they felt during each auditory stimulation and each visual stimulation. To measure the emotional responses, the Emotional Empathy Scale was used. For members of the patient group, the levels of psychopathology and thought-related disorder were evaluated by using the Positive and Negative Syndrome Scale and the Formal Thought Disorder Rating Scale, respectively. RESULTS: The rate of correct answers to musical auditory stimulation in the schizophrenia patient group was significantly lower than that in the control group. In addition, the rate of correct answers to the art visual stimulation in the patient group was significantly lower than that in the control group. Moreover, the patient group showed lower emotional empathic ability than that shown by the control group. In the patient group, the correct answer rates to the musical and art stimulations were negatively correlated with the Formal Thought Disorder Rating Scale. CONCLUSION: Patients with schizophrenia have difficulty in achieving accurate emotional recognition of auditory and visual stimulations. This difficulty is associated with the lowered empathic ability and altered thinking disorder of patients with schizophrenia.
Acoustic Stimulation ; Empathy ; Humans ; Music ; Paint ; Paintings ; Photic Stimulation ; Psychopathology ; Schizophrenia* ; Thinking

OBJECTIVE: This study was designed to evaluate the effect of epidural analgesia on the course of labor and delivery mode. METHOD: Three hundred eighteen term pregnant women with singleton fetus in vertex presentation were admitted for vaginal delivery at the Department of Obstetrics and Gynecology, medical center Chung-ju hospital from January 1, 1998 to December 31, 1998. They were divided into two groups: epidural analgesia group and non-epidural analgesia group. Epidural analgesia group was 106 women (79 primiparas and 27 multiparas). Non-epidural analgesia group was 212 women (138 primiparas and 74 multiparas). Course of labor and delivery mode were compared between the two groups. RESULTS: 1. The duration of the first stage of labor was not significantly different between two groups (primiparas: 672+/-110 min vs 625+/-134 min, multiparas: 458+/-152 min vs 422+/-184 min), and that of the second stage of labor in the primiparas was significantly longer in epidural analgesia group than non-epidural analgesia group (62+/-25 min vs 42+/-20 min, p=0.03), but did not differ significantly in the multiparas groups (36+/-12 min vs 31+/-20 min).2. Cesarean delivery rates were not significantly different between two groups (19.8% vs 15.1%).3. Cesarean delivery rates due to failure to progress were not significantly different between two groups (85.7% vs 78.1%).4. Oxytocin augmentation rates were significantly higher in epidural analgesia group than in non-epidural analgesia group (primiparas: 42.3% vs 20.1%, p=0.008, multiparas: 38.5% vs 19.7%, p=0.01).5. The newborn birthweight, Apgar score and the incidence of meconium-stained amnionic fluid were not significantly different between two groups.6. The complication of the epidural analgesia were back pain (10.4%), shivering (7.5%), nausea and vomiting (1.3%), hypotension (0.9%), and voiding difficulty (0.9%). CONCLUSION: Though epidural analgesia prolonged second stage of labor in the primiparas and increased oxytocin augmentation rates but did not increased the cesarean delivery rates. So intrapartum epidural analgesia provided safe and effective pain control without undesirable effects on labor outcomes.
Amnion ; Analgesia ; Analgesia, Epidural* ; Apgar Score ; Back Pain ; Cesarean Section ; Chungcheongbuk-do ; Female ; Fetus ; Gynecology ; Humans ; Hypotension ; Incidence ; Infant, Newborn ; Nausea ; Obstetrics ; Oxytocin ; Pregnancy ; Pregnant Women ; Shivering ; Vomiting

The purpose of this study was to explore the difference of defense mechanisms between medicine and surgery groups, and between residents and specialists who were professors of a medical school. The author evaluated the defense mechanisms by using Ewha Defense Mechanisms Test. The author compared the defense mechanisms of medicine and surgery specialist groups who are employed by Soonchunhyang university hospital as professors in 2000, and of medicine and surgery resident groups in 1999. First, there were significant differences in mean scores of the defense mechanisms ratings. In surgery specialist group, the rate of using projection and show-off were significantly higher than those of medicine group. In resident group, show-off, passive-aggression, dissociation, somatization, acting-out and regression were significantly higher than those of specialist group. In medicine group, residents were higher than specialists in show-off, passive-aggression, acting-out and regression. But for the specialist group, the score on anticipation was higher than in the resident group. In surgery group, residents were higher than specialists in identification, rationalization and regression. In the interaction, analysis by hierarchy and field anticipation and altruism have a significant interaction effect. Second, in comparison of maturity level between the field of speciality and level of hierarchies, surgery group used more neurotic and narcissistic defense than medicine group significantly. For the level of hierarchies, residents used more immature and neurotic defense than specialists. In medicine group, residents used immature defense more than specialists, but more mature defenses were used in specialists than residents significantly. In surgery group, residents used more immature and neurotic defenses than specialists. Mature defenses have more interaction effect. This results may reflect the fact that discipline in surgery have characteristic apprentices system and more dramatical therapeutic approach. The results seem to be useful in understanding the optimal character for each speciality. In the process of selecting spescialities evaluating one's defenses and matching with the characteristics and coping mechanisms of each specialty group can be helpful.
Altruism ; Defense Mechanisms ; Rationalization ; Schools, Medical ; Specialization