The present study was carried out in order to investigate the relationship between immune function and the activity of hypothalamic-pituitary-adrenal(HPA) axis in patients with major depression. The subjects were 16 female major depressives and 16 female healthy controls. We measured mitogen-induced production of IL-1 beta, IL-2, IL-6 and serum level of IL-1 beta, IL-2, IL-6 and basal plasma cortisol levels at 8 00 a.m. We measured post-DST(dexamethasone suppression test) cortisol levels in 16 major depressives. The result were as follows : 1) Basal cortisol level was significantly higher in the patients with major depression than in the healthy controls(14.4+/-4.6 microgram/dl, 10.1+/-5.2microgram /dl, respectively, p<0.05). 2) IL-2 production was significantly lower in the patients with major depression than in the healthy controls(1747.3+/-387.9 pg/ml, 2520.2+/-884.1 pg/ml, respectively, p<0.05). There were no significant differences in IL-1 beta and IL-6 production between the patients with major depression and the healthy controls. 3) Serum level of IL-2 was detectable in 12 of 16 patients with major depression and in 10 of 16 healthy controls. There was no significant difference in serum level of IL-2 between two groups. Serum level of IL-1 beta was detectable in 3 of 16 patients with major depression and of 16 healthy controls. We could not detect serum level of IL-6 in both groups. 4) There was significant negative correlation between IL-2 production and post-DST cortisol level(r= -0.89) in the 16 patients with major depression. There was significant negative correlation between serum level of IL-2 and post-DST cortisol level(r= -0.97) in the 12 patients with major depression. There was significant negative correlation between serum level of IL-2 and basal cortisol level(r= -0.65) in the 12 patients with major depression. But there was no significant correlation between IL-2 production and basal cortisol level in the 16 patients with major depression. These findings suggest that immune function is decreased in major depression and the decreased immune function is highly related to the hyperactivity of the HPA axis.
Axis, Cervical Vertebra* ; Depression* ; Female ; Humans ; Hydrocortisone ; Interleukin-1* ; Interleukin-1beta* ; Interleukin-2 ; Interleukin-6 ; Interleukins ; Plasma

No abstract available.
Adult* ; Humans ; Seoul*

PURPOSE: To quantify the cardiac dose reduction during breathing adapted radiotherapy using Real-time Position Management (RPM) system in the treatment of left-sided breast cancer. MATERIALS AND METHODS: Twenty-two patients with left-sided breast cancer underwent CT scans during breathing maneuvers including free breathing (FB), deep inspiration breath-hold (DIBH), and end inspiration breath-hold (EIBH). The RPM system was used to monitor respiratory motion, and the in-house self respiration monitoring (SRM) system was used for visual feedback. For each scan, treatment plans were generated and dosimetric parameters from DIBH and EIBH plans were compared to those of FB plans. RESULTS: All patients completed CT scans with different breathing maneuvers. When compared with FB plans, DIBH plans demonstrated significant reductions in irradiated heart volume and the heart V25, with the relative reduction of 71% and 70%, respectively (p < 0.001). EIBH plans also resulted in significantly smaller irradiated heart volume and lower heart V25 than FB plans, with the relative reduction of 39% and 37%, respectively (p = 0.002). Despite of significant expansion of lung volume using inspiration breath-hold, there were no significant differences in left lung V25 among the three plans. CONCLUSION: In comparison with FB, both DIBH and EIBH plans demonstrated a significant reduction of radiation dose to the heart. In the training course, SRM system was useful and effective in terms of positional reproducibility and patient compliance.
Breast Neoplasms* ; Cardiac Volume ; Feedback, Sensory ; Heart ; Humans ; Lung ; Patient Compliance ; Radiotherapy* ; Respiration* ; Tomography, X-Ray Computed

No abstract available.
Extracorporeal Membrane Oxygenation* ; Thrombosis*

Nine typical cases of ossifying fibroma in the tibia or fibula were retrospectively reviewed for clinical and histopathological aspects of this disease. Along with the case analysis, light and polarized microscopic examinations were performed in each case. Differential points with monostotic fibrous dysplasia were as follows; 1) ossifying fibroma begins in the significantly younger age, which is in most cases below 10 years of age, 2) it is confined to diaphysis of tibia or fibula, 3) radiologically, multilocular osteolytic destructive change in eccentric pattern is usually combined with anterior or anterolateral bowing deformity, 4) microscopically, characteristic findings are presence of osteoblastic rimming, peripheral maturation, and zonal phenomenon. In the treatment of ossifying fibroma, definitive surgical treatment should be delayed until skeletal maturity, when segmental resection in wide margin including periosteum might be preferred.
Congenital Abnormalities ; Diagnosis ; Diaphyses ; Fibroma, Ossifying ; Fibrous Dysplasia, Monostotic ; Fibula ; Fluconazole ; Osteoblasts ; Periosteum ; Retrospective Studies ; Tibia

An association of low total cholesterol in blood with psychiatric diseases and suicidal behavior has been suggested. As part of an attempt to further explore this relationship, we examine first, whether serum cholesterol levels in psychiatric patients with suicidal attempt would be lower than in non-suicidal psychiatric inpatients or normal controls, second, whether such significant difference of cholesterol levels would be present when the diagnostic groups are analyzed separately, third whether low cholesterol level would be associated with a history of serious suicidal attempts, and finally, whether low cholesterol level in suicide attempters is as state or a trait marker. We determined the serum cholesterol levels in 231 patients admitted to an emergency room following an suicidal attempt, in the same numbers of age-, sex- and diagnosis-matched non-suicidal psychiatric controls, and in the same numbers of age-, sex matched normal controls. The seriousness of an attempt was divided into 5 grades according to the degree of the resulting medical injury. Total cholesterol levels in suicide attempters were significantly lower compared with both psychiatric and normal controls, when sex, age, and nutritional status(i.e., body mass index) were controlled for. This significant relationship was observed in major depressive disorders and personality disorders, but not in schizophrenia and bipolar type I disorders. The severity of suicide by a lowering of blood cholesterol was related to the magnitude of the cholesterol reduction. After treatment of their psychiatric ailments, the cholesterol levels in suicide attempters were significantly increased. This result suggests that low cholesterol level in psychiatric patients might be a potential biological marker of suicide risk. It is hypothesized that low cholesterol levels is associated with the suicide by modifying the serotonin metabolism, the production of interleukin-2 and melatonin metabolism in psychiatric patients.
Biomarkers ; Cholesterol* ; Depression ; Depressive Disorder, Major ; Emergency Service, Hospital ; Humans ; Inpatients ; Interleukin-2 ; Melatonin ; Metabolism ; Personality Disorders ; Schizophrenia ; Serotonin ; Suicide*

Objectives: This study aimed to develop an accurate pediatric bone age prediction model by utilizing deep learning models and contrast conversion techniques, in order to improve growth assessment and clinical decision-making in clinical practice. Methods: The study employed a variety of deep learning models and contrast conversion techniques to predict bone age. The training dataset consisted of pediatric left-hand X-ray images, each annotated with bone age and sex information. Deep learning models, including a convolutional neural network , Residual Network 50 , Visual Geometry Group 19, Inception V3, and Xception were trained and assessed using the mean absolute error (MAE). For the test data, contrast conversion techniques including fuzzy contrast enhancement, contrast limited adaptive histogram equalization (HE) , and HE were implemented. The quality of the images was evaluated using peak signal-to-noise ratio (SNR), mean squared error, SNR, coefficient of variation, and contrast-to-noise ratio metrics. The bone age prediction results using the test data were evaluated based on the MAE and root mean square error, and the t-test was performed. Results: The Xception model showed the best performance (MAE=41.12). HE exhibited superior image quality, with higher SNR and coefficient of variation values than other methods. Additionally, HE demonstrated the highest contrast among the techniques assessed, with a contrast-to-noise ratio value of 1.29. Improvements in bone age prediction resulted in a decline in MAE from 2.11 to 0.24, along with a decrease in root mean square error from 0.21 to 0.02. Conclusion This study demonstrates that preprocessing the data before model training does not significantly affect the performance of bone age prediction when comparing contrast-converted images with original images.

OBJECTIVE: To compare clinical features and surgical outcomes of laparoscopic-assisted vaginal hysterectomy (LAVH) by the number of ports in the treatment of uterine myoma and adenomyosis. METHODS: Between 1st January 2009 and 31th March 2010, 50 patients underwent 5 mm-2 port LAVH and 10 mm-3 port LAVH respectively by same surgeon at Chosun university hospital. We compared clinical features and surgical outcomes. RESULTS: There was no difference in weight of uterus between the 5 mm-2 port LAVH group and the 10 mm-3 port LAVH group (465.2+/-206.9 g vs. 470.8+/-148.5 g) (Mean+/-S.D.), and in amounts of blood loss during procedure between the two groups (115.0+/-179.3 mL vs. 125.0+/-211.7 mL). The duration of procedure showed a difference between the two groups(55.1+/-12.0 minutes vs. 60.4+/-19.5 minutes) (p=0.03). In the 5 mm-2 port LAVH group, 2 of 50 (4%) converted to laparotomy, and 1 of 50 (2%) in the 10 mm-3 port LAVH group. There was no difference in length of postoperative hospital day between the two groups (5.8+/-1.0 days vs. 6.3+/-1.6 days). In the comparison of postoperative complications, 1 of 50 (2%) required readmission and reoperation for both of the two groups. CONCLUSION: We conclude that 5 mm-2 port LAVH could be a available method in the treatment of uterine myoma and adenomyosis.
Adenomyosis ; Female ; Humans ; Hysterectomy, Vaginal ; Laparotomy ; Myoma ; Postoperative Complications ; Reoperation ; Uterus

BACKGROUND: The purpose of this study was to examine the prevalence of and the sociodemographic risk factors for depressive symptoms among inpatients with chronic diseases who completed the Patient Health Questionnaire-9 (PHQ-9) conducted by a social work department at university medical centers. METHODS: In 2015, PHQ-9 data were collected from six medical centers affiliated with Hallym University Medical Center. The sample comprised 517 inpatients aged 18 years or over with chronic diseases. Descriptive statistics, chi-square test, simple logistic regression, and multiple logistic regression were used for data analyses. RESULTS: The prevalence of depressive symptoms among inpatients with chronic diseases was 31.7 percent. The results of the simple and multiple logistic regressions showed that the single/widowed/divorced/separated group was at higher risk for depressive symptoms than married inpatients. Having a religion or being unemployed also increased the risk of depressive symptoms among the respondents. CONCLUSIONS: Findings of this study emphasize the importance of systematic depressive symptom management for inpatients with chronic diseases.
Academic Medical Centers ; Chronic Disease ; Depression ; Humans ; Inpatients ; Logistic Models ; Prevalence ; Risk Factors ; Social Work ; Statistics as Topic ; Surveys and Questionnaires

BACKGROUND: The purpose of this study was to examine the prevalence of and the sociodemographic risk factors for depressive symptoms among inpatients with chronic diseases who completed the Patient Health Questionnaire-9 (PHQ-9) conducted by a social work department at university medical centers. METHODS: In 2015, PHQ-9 data were collected from six medical centers affiliated with Hallym University Medical Center. The sample comprised 517 inpatients aged 18 years or over with chronic diseases. Descriptive statistics, chi-square test, simple logistic regression, and multiple logistic regression were used for data analyses. RESULTS: The prevalence of depressive symptoms among inpatients with chronic diseases was 31.7 percent. The results of the simple and multiple logistic regressions showed that the single/widowed/divorced/separated group was at higher risk for depressive symptoms than married inpatients. Having a religion or being unemployed also increased the risk of depressive symptoms among the respondents. CONCLUSIONS Findings of this study emphasize the importance of systematic depressive symptom management for inpatients with chronic diseases.