OBJECTIVE: The Revised Obsessive Intrusion Inventory (ROII) is a 52-item scale that evaluates obsessional intrusive thoughts. The aim of the present study was to validate a short, 20-item Korean version of the ROII (ROII-20). METHODS: Of the 1125 participants who completed the ROII-20, 895 participants completed the scale to examine the factor structure of the scale. A subgroup of these participants (n=53) completed the scale twice to determine test-retest reliability. To establish external validity, 230 participants completed the scale and other questionnaires. RESULTS: Exploratory factor analyses suggested a hierarchical model comprising two higher order factors of autogenous obsessions (resulting from aggressive thoughts and sexual thoughts) and reactive obsessions (resulting from thoughts about contamination, thoughts about accidents, and thoughts about dirt). Confirmatory factor analyses supported this model. The results indicated good internal consistency and test-retest reliability. External validity was supported by relationships with obsessive-compulsive symptoms and general distress. CONCLUSION: The ROII-20 presents good psychometric properties and may be considered as a promising instrument for measuring obsessional intrusions.
Obsessive Behavior ; Psychometrics* ; Surveys and Questionnaires

BACKGROUND: As measurement of Ki-67 proliferation index is an important part of breast cancer diagnostics, we conducted a multicenter study to examine the degree of concordance in Ki-67 counting and to find factors that lead to its variability. METHODS: Thirty observers from thirty different institutions reviewed Ki-67-stained slides of 20 different breast cancers on whole sections and tissue microarray (TMA) by online system. Ten of the 20 breast cancers had hot spots of Ki-67 expression. Each observer scored Ki-67 in two different ways: direct counting (average vs. hot spot method) and categorical estimation. Intraclass correlation coefficient (ICC) of Ki-67 index was calculated for comparative analysis. RESULTS: For direct counting, ICC of TMA was slightly higher than that of whole sections using average method (0.895 vs 0.858). The ICC of tumors with hot spots was lower than that of tumors without (0.736 vs 0.874). In tumors with hot spots, observers took an additional counting from the hot spot; the ICC of whole sections using hot spot method was still lower than that of TMA (0.737 vs 0.895). In categorical estimation, Ki-67 index showed a wide distribution in some cases. Nevertheless, in tumors with hot spots, the range of distribution in Ki-67 categories was decreased with hot spot method and in TMA platform. CONCLUSIONS: Interobserver variability of Ki-67 index for direct counting and categorical estimation was relatively high. Tumors with hot spots showed greater interobserver variability as opposed to those without, and restricting the measurement area yielded lower interobserver variability.
Breast Neoplasms* ; Breast* ; Observer Variation* ; Online Systems

Few recent reports have indicated that Mycobacterium massiliense causes various infections including respiratory infection. However, there is scarce information on the clinical significance, natural history of the infection, and therapeutic strategy. This report describes a case of an immunocompetent old man infected by M. massiliense that causes acute respiratory failure. In light of the general courses of non-tuberculous mycobacterium infections, rapid progression and fatality are very rare and odd. In addition, we discuss the biological and pathological properties of M. massiliense with the review of cases reported previously including our fatal one.
Light ; Mycobacterium ; Mycobacterium Infections ; Mycobacterium Infections, Nontuberculous ; Natural History ; Respiratory Insufficiency

Codonopsis lanceolata, which is predominantly found in Korea and East Asia, has attracted considerable scientific attention due to its long-standing use in traditional medicine. However, despite both its roots and stems being utilized as functional food and medicinal resources, there has been limited phytochemical investigation into its aerial parts. Therefore, the aim of this study is to isolate compounds present in the aerial parts of C. lanceolata. Through repeated chromatography, two alkaloids (1 and 2), seven flavones (3-9), and three isoflavones (10-12) and one type of phenylpropanoid (13) and polyacetylene (14) were isolated from a 70% ethanol extract of C. lanceolata. The structure of each compound was determined through the analysis of spectroscopic data ( 1 H and 13 C NMR), and by comparing them with previous research results. Among the isolates, the presence of methyl 2-formyl-5-(methoxymethyl)-1H-pyrrole-1-butanoate (1), chrysoeriol 5-O-β-D-glucopyranoside (3), apigenin-5-O-β-D-glucopyranoside (5), and 3′-O-methylorobol 7-O-β-D-glucopyranoside (12) were reported for the first time in plants belonging to the Campanula family in this study. In addition, the current study marked the isolation of luteolin 4′-O-β-D-glucopyranoside (4) from C. lanceolata for the first time.

Background: Malaria elimination strategies in the Republic of Korea (ROK) have decreased malaria incidence but face challenges due to delayed case detection and response. To improve this, machine learning models for predicting malaria, focusing on high-risk areas, have been developed. Methods: The study targeted the northern region of ROK, near the demilitarized zone, using a 1-km grid to identify areas for prediction. Grid cells without residential buildings were excluded, leaving 8,425 cells. The prediction was based on whether at least one malaria case was reported in each grid cell per month, using spatial data of patient locations. Four algorithms were used: gradient boosted (GBM), generalized linear (GLM), extreme gradient boosted (XGB), and ensemble models, incorporating environmental, sociodemographic, and meteorological data as predictors. The models were trained with data from May to October (2019–2021) and tested with data from May to October 2022. Model performance was evaluated using the area under the receiver operating characteristic curve (AUROC). Results: The AUROC of the prediction models performed excellently (GBM = 0.9243, GLM = 0.9060, XGB = 0.9180, and ensemble model = 0.9301). Previous malaria risk, population size, and meteorological factors influenced the model most in GBM and XGB. Conclusion Machine-learning models with properly preprocessed malaria case data can provide reliable predictions. Additional predictors, such as mosquito density, should be included in future studies to improve the performance of models.

Transfusion-related acute lung injury (TRALI) is a serious adverse reaction of transfusion, and presents as hypoxemia and non-cardiogenic pulmonary edema within 6 hours of transfusion. A 14-year-old primigravida woman at 34 weeks of gestation presented with upper abdominal pain without dyspnea. Because she showed the syndrome of HELLP (hemolysis, elevated liver enzymes, and low platelet count), an emergency cesarean section delivery was performed, and blood was transfused. In the case of such patients, clinicians should closely observe the patient's condition at least during the 6 hours while the patient receives blood transfusion, and should suspect TRALI if the patient complains of respiratory symptoms such as dyspnea. Furthermore, echocardiography should be performed to distinguish between the different types of transfusion-related adverse reactions.
Abdominal Pain ; Acute Lung Injury* ; Adolescent ; Anoxia ; Blood Platelets ; Blood Transfusion ; Cesarean Section* ; Dyspnea ; Echocardiography ; Emergencies ; Female ; HELLP Syndrome* ; Humans ; Liver ; Pregnancy ; Pulmonary Edema

We report a case of agranulocytosis caused by ethambutol in a 79-year-old man with pulmonary tuberculosis. He was referred for fever and skin rash developed on 21th day after antituberculosis drugs (isoniazid, rifampicin, ethambutol, and pyrazinamide) intake. Complete blood count at the time of diagnosis of pulmonary tuberculosis was normal. On the seventh admission day, agranulocytosis was developed with absolute neutrophil count of 70/microL. We discontinued all antituberculosis drugs, and then treated with granulocyte colony-stimulating factor. Three days later, the number of white blood cell returned to normal. We administered isoniazid, pyrazinamide, and ethambutol in order with an interval. However, fever and skin rash developed again when adding ethambutol, so we discontinued ethambutol. After these symptoms disappeared, we added rifampicin and ethambutol in order with an interval. However after administering ethambutol, neutropenia developed, so we discontinued ethambutol again. He was cured with isoniazid, rifampicin, and pyrazinamide for 9 months.
Aged ; Agranulocytosis* ; Blood Cell Count ; Diagnosis ; Ethambutol* ; Exanthema ; Fever ; Granulocyte Colony-Stimulating Factor ; Humans ; Isoniazid ; Leukocytes ; Neutropenia ; Neutrophils ; Pyrazinamide ; Rifampin ; Tuberculosis, Pulmonary*

Since IgG4-related pancreatitis was first reported in 2001, IgG4-related disease has been identified in other organs such as salivary gland, gallbladder, thyroid, retroperitoneum and kidney; but lung invasion is rare. A 63-year-old man presented with hemoptysis at the pulmonary clinic and chest computed tomography revealed about 4.1 cm irregular shaped mass with spiculated margin at the left upper lobe. Despite no elevation of serum IgG4 level, he was finally diagnosed as IgG4-related lung disease by transthoracic needle biopsy. After treatment with oral glucocorticoids, hemoptysis disappeared and the size of lung mass was decreased.
Biopsy, Needle ; Gallbladder ; Glucocorticoids ; Hemoptysis ; Humans ; Immunoglobulin G* ; Immunoglobulins ; Kidney ; Lung Diseases* ; Lung* ; Middle Aged ; Pancreatitis ; Salivary Glands ; Thorax ; Thyroid Gland

OBJECTIVE: To investigate what factors are associated with a failed arterial embolization for postpartum hemorrhage (PPH) and to attempt to estimate efficacy of arterial embolization. METHODS: Between 2004 and 2008, 60 patients at Korea University Medical Cencter underwent arterial embolization to control obstetrical hemorrhage. In all cases, arterial embolization was performed because of intractable hemorrhage unresponsive to conservative management. Medical records and angiographic results were reviewed. Arterial embolization failure was defined as the requirement for subsequent surgical procedure to control PPH with the procedure, and its results. RESULTS: Arterial embolization was attempted in 60 of deliveries. Failures occurred in 7 of 60 cases (11.7%) and in 4 of 7 cases (57.1%) of abnormal placentation (placenta previa totalis with or without placenta accrete or increta). Comparison of the failed and successful arterial embolization groups showed no differences in maternal characteristics, clinical status, and angiographic finding. Amount of total transfusion in failed arterial embolization group were larger than successful group although hemoglobin before embolization was not different. CONCLUSION: The only factor significantly associated with failed arterial embolization was an abnormal placentation. Arterial embolization is a safe and highly effective method to control PPH.
Hemoglobins ; Hemorrhage ; Humans ; Korea ; Medical Records ; Placenta ; Placentation ; Postpartum Hemorrhage ; Postpartum Period

Although pulmonary tuberculosis is known to be the most common type in tuberculosis, it actually can affect any organ system. However, abdominal type is very rare among the extra-pulmonary types, and obstructive jaundice caused by lymphadenopathies due to tuberculosis is especially uncommon manifestation even in endemic areas. Tuberculous lymphadenopathies can mimic lymphadenopathies by other metastatic tumors or lymphoma, thus early correct diagnosis is very important for avoiding unnecessary surgical interventions. Here, we reported two cases of obstructive jaundice caused by tuberculous lymphadenopathies. Both were treated with anti-tuberculosis medications and endoscopic retrograde biliary drainage without surgery.
Diagnosis ; Drainage ; Jaundice ; Jaundice, Obstructive* ; Lymphatic Diseases ; Lymphoma ; Tuberculosis ; Tuberculosis, Pulmonary