PURPOSE: The purpose of this study was to identify symptom clusters in patients with breast cancer and to investigate the associations among them with functional status and quality of life (QOL). METHODS: A convenient sample of 303 patients was recruited from an oncology-specialized hospital. RESULTS: Two distinct clusters were identified: A gastrointestinal-fatigue cluster and a pain cluster. Each cluster significantly influenced functional status and QOL. Based on these two clusters, we identified subgroups of symptom clusters using K-means cluster analysis. Three relatively distinct patient subgroups were identified in each cluster: mild, moderate, and severe group. Disease-related factors (i.e., stage, metastasis, type of surgery, current chemotherapy, and anti-hormone therapy) were associated with these subgroups of symptom clusters. There were significant differences in functional status and QOL among the three subgroups. The subgroup of patients who reported high levels of symptom clusters reported poorer functional status and QOL. CONCLUSION: Clinicians can anticipate that breast cancer patients with advanced stage, metastasis, and who receive mastectomy, and chemotherapy will have more intense gastrointestinal-fatigue or pain symptoms. In order to enhance functional status and QOL for patients with breast cancer, collective management for symptoms in a cluster may be beneficial.
Breast ; Breast Neoplasms ; Humans ; Mastectomy ; Neoplasm Metastasis ; Quality of Life

Equivalent dipole source localization is a well-established approach to localizing the electrical activity in electroencephalogram (EEG). So far, source localization has been used primarily in localizing the epileptic source in human epileptic patients. Currently, source localization techniques have been applied to account for localizing epileptic source among the epileptic patients. Here, we present the first application of source localization in the field of sleep spindle in mouse brain. The spatial distribution of cortical potential was obtained by high density EEG and then the anterior and posterior sleep spindles were classified based on the K-mean clustering algorithm. To solve the forward problem, a realistic geometry brain model was produced based on boundary element method (BEM) using mouse MRI. Then, we applied four different source estimation algorithms (minimum norm, eLORETA, sLORETA, and LORETA) to estimate the spatial location of equivalent dipole source of sleep spindles. The estimated sources of anterior and posterior spindles were plotted in a cine-mode that revealed different topographic patterns of spindle propagation. The characterization of sleep spindles may be better be distinguished by our novel visualization method.
Animals ; Brain ; Electroencephalography* ; Humans ; Insulator Elements ; Magnetic Resonance Imaging ; Methods* ; Mice

Human studies of brain stimulation have demonstrated modulatory effects on the perception of pain. However, whether the primary somatosensory cortical activity is associated with antinociceptive responses remains unknown. Therefore, we examined the antinociceptive effects of neuronal activity evoked by optogenetic stimulation of primary somatosensory cortex. Optogenetic transgenic mice were subjected to continuous or pulse-train optogenetic stimulation of the primary somatosensory cortex at frequencies of 15, 30, and 40 Hz, during a tail clip test. Reaction time was measured using a digital high-speed video camera. Pulse-train optogenetic stimulation of primary somatosensory cortex showed a delayed pain response with respect to a tail clip, whereas no significant change in reaction time was observed with continuous stimulation. In response to the pulse-train stimulation, video monitoring and local field potential recording revealed associated paw movement and sensorimotor rhythms, respectively. Our results show that optogenetic stimulation of primary somatosensory cortex at beta and gamma frequencies blocks transmission of pain signals in tail clip test.
Animals ; Brain ; Humans ; Mice ; Mice, Transgenic ; Neurons ; Optogenetics ; Pain Perception* ; Reaction Time ; Somatosensory Cortex* ; Tail*

Dopamine is a catecholamine used in the treatment of circulatory shock of various etiologies. The usual dose range used is from 1 to 25 ug/kg/min. When used at higher doses, the prominent effect of dopamine on the vasculature is vasoconstriction induced by stimulation of alpha-adrenergic receptors. We report a case of dopamine gangrene. The gangrene developed on the injection site in the right dorsum of foot in a 43-year-old man during infusion of dopamine for treatment of septic shock. The gangrenous lesion healded after change of injection site to subclavian vein. The dosage of dopamine was not higher, we think that the gangrene developed due to the local vasoconstriction caused by dopamine leakage from the vessels.
Adult ; Dopamine* ; Foot ; Gangrene* ; Humans ; Receptors, Adrenergic, alpha ; Shock ; Shock, Septic ; Subclavian Vein ; Vasoconstriction

Objective: Two years after the 2017 Pohang earthquake, some people sought follow-up mental health support. The demographic and clinical characteristics of this unique group of people were investigated to identify some insights on the predisposing factors of the longterm need for psychiatric help after a severe earthquake disaster. Methods: De-identified data from those seeking mental health support 2 years after the 2017 Pohang earthquake were used. The descriptive statistics of demographic and clinical characteristics of the study group was identified and paired with general population data obtained from open and public governmental websites. Sex, age distribution, destruction of house, and psychiatric disorder were compared between the follow-up sample and general population. Results: The proportion of women in the group seeking support was two times higher than that in the general population, and people ages between 50 and 70 years commonly sought support. The severity of home destruction was higher among people who sought and needed follow-up mental health support programs than in the general population. There was a higher proportion of people with psychiatric disorders in the group seeking support than in the general population. Conclusion The need for long-term mental health support 2 years after an earthquake was higher in women than in men and those aged between 50 and 70 years, and those with a previous psychiatric history and with a higher severity of home destruction, which lead to necessitating leaving the home. Future earthquake response should include screening and psychiatric treatment referral and residential support in vulnerable people.

Serotonin syndrome is an unexpected fatal adverse event related to serotonergic medication. This case report is the first report describing the possible treatment effect of famotidine on serotonin syndrome. Furthermore, this is the first case report of serotonin syndrome induced by meperidine alone in a patient with no previous history suggesting a susceptibility to serotonin syndrome. A 70-year-old male with no recent history of serotonergic drug use presented with severe serotonin syndrome following ureteroscopy, possibly due to postoperative meperidine administration. The patient's symptoms included hypertension, tachycardia, tachypnea, hyperthermia, myoclonus, diaphoresis, retching, nausea, agitation, and semicoma mentality with no pupillary light reflex. Symptoms began to subside immediately after the administration of intravenous famotidine for prevention of aspiration pneumonia, with mental and neurological symptoms showing improvement initially, followed by autonomic symptoms. This case report suggests that the histamine type 2 receptor antagonist famotidine may be an effective emergency treatment for serotonin syndrome.
Aged ; Dihydroergotamine ; Emergency Treatment ; Famotidine ; Fever ; Histamine ; Histamine H2 Antagonists ; Humans ; Hypertension ; Male ; Meperidine ; Myoclonus ; Nausea ; Pneumonia, Aspiration ; Reflex ; Serotonin Syndrome* ; Serotonin* ; Tachycardia ; Tachypnea ; Ureteroscopy

Serotonin syndrome is an unexpected fatal adverse event related to serotonergic medication. This case report is the first report describing the possible treatment effect of famotidine on serotonin syndrome. Furthermore, this is the first case report of serotonin syndrome induced by meperidine alone in a patient with no previous history suggesting a susceptibility to serotonin syndrome. A 70-year-old male with no recent history of serotonergic drug use presented with severe serotonin syndrome following ureteroscopy, possibly due to postoperative meperidine administration. The patient's symptoms included hypertension, tachycardia, tachypnea, hyperthermia, myoclonus, diaphoresis, retching, nausea, agitation, and semicoma mentality with no pupillary light reflex. Symptoms began to subside immediately after the administration of intravenous famotidine for prevention of aspiration pneumonia, with mental and neurological symptoms showing improvement initially, followed by autonomic symptoms. This case report suggests that the histamine type 2 receptor antagonist famotidine may be an effective emergency treatment for serotonin syndrome.
Aged ; Dihydroergotamine ; Emergency Treatment ; Famotidine ; Fever ; Histamine ; Histamine H2 Antagonists ; Humans ; Hypertension ; Male ; Meperidine ; Myoclonus ; Nausea ; Pneumonia, Aspiration ; Reflex ; Serotonin Syndrome* ; Serotonin* ; Tachycardia ; Tachypnea ; Ureteroscopy

OBJECTIVES: There have been no consistent reliable and valid tool for examining the psychosocial problems for the patients with mental disorders in Korea. The purpose of the present study is to develop a scale that examine the psychosocial problems for the patients with mental disorders and to test its reliability and validity. METHODS: To identify the psychosocial problems for 1,100 patients with mental disorders were selected in university hospitals and professional training institutes. And the items of the psychosocial problems were taken from them and divided them into individual and environmental categories. The representative items were established among these items of psychosocial problems and a questionnaire for a pilot study was made based on the representative items. The pilot study was done for 306 patients with mental disorders using the questionnaire to investigate reliability of the questionnaire. After the pilot study items and format of the questionnaire were revised and complemented. The revised questionnaire was given to 600 patients with mental disorders to test its validity and reliability and new scale for psychosocial problems was developed. RESULTS: At the pilot study, which was performed with 1,100 patients, 3,200 items of psychosocial problems of 205 types were selected. Among these items 78 representative psychosocial problems items were withdrawn. Fifty-eight psychosocial problem items were finally set for the questionnaire after discussing them with the expert groups and examining its content reliability. Forty-seven psychosocial problems items were finally selected and given to 306 subjects at the pilot study. At the main study in which 600 subjects were tested inner-reliability. Correlation between items and scale was relevant and correlation coefficient between test and retest was high. The finally developed psychosocial problems testing scales were consisted of 46 testing items into 9 areas. CONCLUSION: The Psychosocial Problems Assessment Scale, which were developed at this study is proved to be valid and reliable and it will be able to be used to examine overall psychosocial problems for the patients with mental disorders in Korea.
Academies and Institutes ; Complement System Proteins ; Hospitals, University ; Humans ; Korea ; Mental Disorders ; Pilot Projects ; Surveys and Questionnaires ; Reproducibility of Results ; Weights and Measures

PURPOSE: The purpose of this study was to identify relationships of periodontal disease and health related quality of life (HRQoL) in pregnant women. METHODS: The participants in this study were 129 pregnant women. Data were collected using questionnaires of characteristics of the participants and subjective perception of periodontal disease and a dentist's assessment of periodontal disease. Data were analyzed using descriptive statistics, correlation, and hierarchical multiple regression. RESULTS: The physical QoL showed significant negative correlation with subjective perception of periodontal disease (r=-.21, p=.013). Mental QoL had significant negative correlations with subjective perception of periodontal disease (r=-.32, p<.001) and objective periodontal disease (r=-.34, p<.001). Hierarchical multiple regression analyses revealed that pregnant women who had a history of abortion and had higher subjective perception of periodontal disease tended to report lower levels of physical QoL. Pregnant women whose age are between 30-34 years and higher subjective perception and objective periodontal disease tended to report lower mental QoL. CONCLUSION: To improve HRQoL of pregnant women, nurses should pay attention on the status of periodontal disease. Careful assessment of oral healthy behaviors and proper intervention for oral health of pregnant women are needed to enhance HRQoL of pregnant women.
Female ; Humans ; Oral Health ; Periodontal Diseases* ; Pregnant Women* ; Quality of Life*

PURPOSE: This study was designed to investigate how medical students' achievement goal orientations towards anatomy class influence perceived affect towards anatomy learning. METHODS: Participants were 124 medical students. Students' self-report measures were used for the assessment of their achievement goal orientations, perceived value, interests, effort, tension, test anxiety, and negative dissection experiences. Correlation and multiple regression analyses were used for the data analyses. RESULTS: Students with high levels of mastery-approach goals displayed high interests, values, and efforts while they showed low levels of tension, test anxiety, and negative dissection experiences. In contrast, students with high mastery- and performance-avoidance goals showed high levels of tension and/or test anxiety. Students' performance-approach goals are positively associated with both high effort and high negative dissection experiences. CONCLUSION: These findings offer theoretical and practical implications for anatomy teaching and learning by suggesting that students' learning experiences vary in terms of students' achievement goal orientations which may make differences in students' psychological experiences in a class.
Achievement ; Anxiety ; Humans ; Learning ; Orientation ; Statistics as Topic ; Students, Medical