Dermatomyositis is an autoimmune disease characterized by chronic muscle inflammation that results in specific dermatological signs and decreased muscle strength. It is known to have a strong association with malignancy. Most neuroendocrine tumors arise from the gastrointestinal tract, with less than 1% of cases occurring at the ampulla of Vater. While cases of dermatomyositis associated with neuroendocrine tumors have been reported internationally, to date there have been no cases reported in Korea. This case report presents a 33-year-old male who had undergone pylorus-preserving pancreaticoduodenectomy for a neuroendocrine tumor located at the ampulla of Vater, and had been followed at the hospital after his procedure. Three years post-surgery, the patient developed serious muscle weakness in his upper-right and lower-left extremities, and was subsequently diagnosed with dermatomyositis. This paper presents the first domestic case of dermatomyositis developing in the context of a neuroendocrine tumor at the ampulla of Vater. A literature review on this subject follows in the discussion.
Adult ; Ampulla of Vater* ; Autoimmune Diseases ; Dermatomyositis* ; Extremities ; Gastrointestinal Tract ; Humans ; Inflammation ; Korea ; Male ; Muscle Strength ; Muscle Weakness ; Neuroendocrine Tumors* ; Pancreaticoduodenectomy

OBJECTIVES: This study was aimed to investigate the associations of childhood trauma with psychopathology and clinical characteristics in patients with schizophrenia. METHODS: This study enrolled 66 inpatients with schizophrenia. Korean Childhood Trauma Questionnaire (K-CTQ) and Life Event Questionnaire (LEQ) were administered to assess childhood trauma. Psychopatholgy and clinical characteristics were assessed with the Positive and Negative Syndrome Scale (PANSS), Beck Depression Inventory (BDI), Korean Version of Internalized Stigma of Mental Illness (K-ISMI), Perceived Stress Scale (PSS), and visual analogue scale of EuroQoL-5 Dimension Index (EQ-5D). RESULTS: Total scores on K-CTQ were positively associated with scores on the BDI, K-ISMI, PSS, and PANSS and negatively associated with the score on the EQ-5D. Among subscales of K-CTQ, emotional abuse was significantly associated with all measures for psychopathology and clinical characteristics. Patients with physical abuse (36.5%), emotional abuse (30.2%), or bullying (30.6%) according to the LEQ showed sighificanlty higher the ISMI score and lower EQ-5D score. Emotional abuse and bullying were also significantly associated with higher scores on BDI and/or PSS. CONCLUSION: Our results suggest that childhood trauma negatively influences on internalized stigma, depression, perceived stress and quality of life in patients with schizophrenia. Clinicians should carefully evalute and manage childhood traumatic experience of patients with schizophrenia.
Bullying ; Depression ; Humans ; Inpatients ; Physical Abuse ; Psychopathology* ; Quality of Life ; Schizophrenia*

OBJECTIVES: This study was aimed to investigate the associations of childhood trauma with psychopathology and clinical characteristics in patients with schizophrenia. METHODS: This study enrolled 66 inpatients with schizophrenia. Korean Childhood Trauma Questionnaire (K-CTQ) and Life Event Questionnaire (LEQ) were administered to assess childhood trauma. Psychopatholgy and clinical characteristics were assessed with the Positive and Negative Syndrome Scale (PANSS), Beck Depression Inventory (BDI), Korean Version of Internalized Stigma of Mental Illness (K-ISMI), Perceived Stress Scale (PSS), and visual analogue scale of EuroQoL-5 Dimension Index (EQ-5D). RESULTS: Total scores on K-CTQ were positively associated with scores on the BDI, K-ISMI, PSS, and PANSS and negatively associated with the score on the EQ-5D. Among subscales of K-CTQ, emotional abuse was significantly associated with all measures for psychopathology and clinical characteristics. Patients with physical abuse (36.5%), emotional abuse (30.2%), or bullying (30.6%) according to the LEQ showed sighificanlty higher the ISMI score and lower EQ-5D score. Emotional abuse and bullying were also significantly associated with higher scores on BDI and/or PSS. CONCLUSION: Our results suggest that childhood trauma negatively influences on internalized stigma, depression, perceived stress and quality of life in patients with schizophrenia. Clinicians should carefully evalute and manage childhood traumatic experience of patients with schizophrenia.
Bullying ; Depression ; Humans ; Inpatients ; Physical Abuse ; Psychopathology* ; Quality of Life ; Schizophrenia*

This study aimed to investigate the associations between various types of childhood trauma and suicidal behavior in the general population in South Korea. This mental health survey included a total of 1,490 general citizens living in a metropolitan South Korean city who completed a questionnaire that assessed respondents’ histories of childhood trauma before the age of 12 years, including bullying victimization, emotional abuse, sexual abuse, and physical abuse, as well as suicidal behavior, including current suicidal ideation and histories of suicide planning and attempts. The following psychiatric scales were administered: Hospital Anxiety and Depression Scale (HADS), Rosenberg Self-Esteem Scale (R-SES), Connor-Davidson Resilience Scale (CD-RISC), Perceived Stress Scale (PSS), and visual analogue scale of EuroQol 5D (EQ-5D). Participants who experienced any childhood trauma had significantly higher HADS and PSS scores, and significantly lower EQ-5D scores. Additionally, participants with any type of childhood trauma were significantly more likely to have current suicidal ideation and histories of planned and attempted suicide. Multivariate analyses adjusted for confounding variables indicated that bullying victimization and sexual abuse were associated significantly with all types of suicidal behavior. Physical abuse was associated significantly with histories of suicide planning and attempts. The present findings showed that any type of childhood trauma was associated with higher levels of suicidality, anxiety, depression, and perceived stress, as well as lower health-related quality of life, in the general population. In particular, associations between childhood trauma and suicidality were identified after adjustment for confounding variables.

This study aimed to investigate the associations between various types of childhood trauma and suicidal behavior in the general population in South Korea. This mental health survey included a total of 1,490 general citizens living in a metropolitan South Korean city who completed a questionnaire that assessed respondents’ histories of childhood trauma before the age of 12 years, including bullying victimization, emotional abuse, sexual abuse, and physical abuse, as well as suicidal behavior, including current suicidal ideation and histories of suicide planning and attempts. The following psychiatric scales were administered: Hospital Anxiety and Depression Scale (HADS), Rosenberg Self-Esteem Scale (R-SES), Connor-Davidson Resilience Scale (CD-RISC), Perceived Stress Scale (PSS), and visual analogue scale of EuroQol 5D (EQ-5D). Participants who experienced any childhood trauma had significantly higher HADS and PSS scores, and significantly lower EQ-5D scores. Additionally, participants with any type of childhood trauma were significantly more likely to have current suicidal ideation and histories of planned and attempted suicide. Multivariate analyses adjusted for confounding variables indicated that bullying victimization and sexual abuse were associated significantly with all types of suicidal behavior. Physical abuse was associated significantly with histories of suicide planning and attempts. The present findings showed that any type of childhood trauma was associated with higher levels of suicidality, anxiety, depression, and perceived stress, as well as lower health-related quality of life, in the general population. In particular, associations between childhood trauma and suicidality were identified after adjustment for confounding variables.

OBJECTIVE: Low self-esteem is associated with suicide risk in the general psychiatric population. The aim of this study was to examine associations between suicidality and self-esteem in patients with schizophrenia. METHODS: Subjects meeting the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) diagnostic criteria for schizophrenia were enrolled. Sociodemographic and clinical variables, including previous suicide attempt history, were assessed. Psychopathology, self-esteem, and self-perceived stigma were also measured using the Positive and Negative Syndrome Scale, the Rosenberg Self-Esteem Scale (SES), the Beck Depression Inventory (BDI), the Beck Hopelessness Scale, and the Korean version of the Internalized Stigma of Mental Illness scale (K-ISMI). RESULTS: Of the total of 87 participants, 20 (23.0%) had attempted suicide. Patients with a history of suicide attempts had significantly higher scores on the BDI (p=0.036) and K-ISMI (p=0.009), and significantly lower scores on the SES (p=0.001). Analysis of covariance revealed that the SES scores were significantly lower in patients with a history of previous suicide attempts than in those with no history, after controlling for K-ISMI and BDI scores (p=0.039). CONCLUSION: Low self-esteem appears to represent a psychological dimension that is closely related to suicide risk. Therefore, clinical attention should be paid to the evaluation and enhancement of low self-esteem in schizophrenia patients with suicidality. A longitudinal prospective study is required to ascertain whether low self-esteem leads suicide attempts.
Depression ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Prospective Studies ; Psychopathology ; Schizophrenia* ; Suicide ; Suicide, Attempted

PURPOSE: The aim of this study was to compare the clinical characteristics in emergency endotracheal intubation between patients with acute drug intoxication and medical disease. METHODS: Data for airway registry collected in two emergency departments (ED) between April 2006 and March 2010 were reviewed retrospectively. The airway registry data included patient's demographic information and variables such as Cormack-Lehane grade, 3-3-2 finger analysis, success rate, the number of attempts at intubation, complications of intubation, and clinical outcomes after intubation. RESULTS: A total of 1480 patients were enrolled; 62 patients were classified as belonging to the intubation group after the drug intoxication group. No significant differences in Cormack-Lehane grade, 3-3-2 finger analysis, success rate, the number of attempts at intubation, and complications after intubation were observed between patients with acute drug intoxication and medical disease. However, significant difference was observed for indication of emergency endotracheal intubation. While emergency endotracheal intubations were usually performed in medical patients because of failure of airway patency, they were performed in intoxicated patients with the goal of preventing serious complications. CONCLUSION: Anatomical structures related to endotracheal intubation, the process and clinical outcome of intoxicated patients are not significantly different from those for medical patients.
Emergencies* ; Emergency Service, Hospital ; Fingers ; Humans ; Intubation ; Intubation, Intratracheal* ; Poisoning ; Retrospective Studies

PURPOSE: Patients undergoing arterial puncture experience significant pain and discomfort. Cryoanalgesic pretreatment using vapocoolant spray and a cold alcohol swap stick can be easily and rapidly applied before arterial puncture. The purpose of this study was to compare the efficacy of vapocoolant spray and a cold alcohol swab stick for control of pain associated with arterial blood gas analysis. METHODS: We conducted a non-blinded, randomized controlled trial in which adult patients underwent an arterial puncture after pretreatment with different analgesics. Enrolled patients were randomized to one of three treatment groups: 1) vapocoolant spray; 2) cold alcohol swap stick; or 3) alcohol swap stick stored at room temperature (control). We assessed the patient's pain after the arterial puncture using a 100-mm visual analogue scale. The difficulty associated with the arterial puncture and the likelihood of successful puncture was assessed using time to successful sampling and the number of attempts required for successful sampling. Time to successful sampling and the number of attempts required for successful sampling were used for assessment of the difficulty associated with the arterial puncture and the likelihood of successful puncture. RESULTS: A total of 101 patients were enrolled in this study. The mean scores for pain after the arterial puncture were 41.2+/-11.7 mm for patients treated with vapocoolant spray, 35.9+/-8.6 mm for patients treated with a cold alcohol swap stick, and 66.2+/-8.5 mm for the control group (p<0.001). The time to successful sampling was less consumed and the number of attempts was significantly lower in the treatment groups, compared with the control group (p=0.002 and p=0.008, respectively). CONCLUSION: We conclude that pretreatment using a cold alcohol swap stick as well as vapocoolant spray resulted in a decrease in patients' perception of pain associated with arterial puncture and facilitated the arterial puncture.
Adult ; Analgesics ; Arteries ; Blood Gas Analysis ; Cold Temperature ; Humans ; Pain Measurement ; Punctures

OBJECTIVES: This study examined psychiatric characteristics including addictive behavior and personality traits among workers with hazardous drinking. METHODS: The cross-sectional study included 486 workers. Socio-demographic and clinical variables were collected, and employed the Alcohol Use Disorders Identification Test-Korean version (AUDIT-K), Korean translation of the Internet Addiction Test, Smartphone Addiction Scale, Hospital Anxiety and Depression Scale (HADS), Perceived Stress Scale (PSS), Korean version of Connor-Davidson Resilience Scale (K-CD-RISC), Big Five Inventory-Korean version-10 (BFI-K-10). Hazardous drinking was identified with the AUDIT-K score of 10 in men and 6 in women. Univariate and logistic regression analysis were used to identify factors associated with hazardous drinking. RESULTS: One hundred sixty-eight (34.6%) workers reported hazardous drinking. It was more common in men and workers with lower levels of education, workers that smoked and experienced smartphone addiction, and had experienced attempted suicide. Among the assessment scales, scores on the HADS and PSS were higher, and scores on the K-CD-RISC were lower for these workers. Regarding scores for the BFI-K-10, higher extraversion, lower agreeableness, and lower openness were related to hazardous drinking. Logistic regression analysis revealed that smoking, smartphone addiction, history of attemptd suicide, and higher scores on extraversion of the BFI-K-10 were significantly associated with hazardous drinking. CONCLUSION: Our findings demonstrate that hazardous drinking tends to coexist with other addictive behaviors such as smoking and smartphone addiction. Clinicians should also be aware of suicidal risk in people with hazardous drinking.
Alcohol Drinking* ; Anxiety ; Behavior, Addictive* ; Cross-Sectional Studies ; Depression ; Drinking ; Education ; Extraversion (Psychology) ; Female ; Humans ; Internet ; Logistic Models ; Male ; Smartphone ; Smoke ; Smoking ; Suicide ; Suicide, Attempted ; Weights and Measures

PURPOSE: The aim of this study is to determine the predictable factors that affect the clinical course, especially the hospital stay, the operation performed, and to determine factors that will be helpful in deciding whether in-hospital or outpatient treatment is appropriate. METHODS: We retrospectively collected medical data for patients who had been diagnosed with acute diverticulitis at Inje University Sanggye Paik Hospital between January and December 2016. In total, 117 patients were enrolled in this study. We examined clinical factors, including age, sex, body mass index, pain, body temperature, white blood cell count, C-reactive protein, nil per os (NPO) time, hospital duration, computed tomography (CT) findings, location of diverticulitis, operation performed, and presence of comorbidity (e.g., hypertension and diabetes mellitus). RESULTS: In the multivariate analysis, the statistically significant factor related with hospital duration was the presence of perforation on the CT scan (P < 0.001). Longer NPO time was related with pain score (>7) (P = 0.011). Operations were mainly performed in patients with left-sided colonic diverticulitis (P = 0.012). CONCLUSION: We suggest a perforation finding on the CT scan, a severe pain score at least above 7 on a numeric rating pain scale, and a left-sided lesion are absolute indications for in-hospital management.
Body Mass Index ; Body Temperature ; C-Reactive Protein ; Comorbidity ; Diverticulitis ; Diverticulitis, Colonic ; Humans ; Hypertension ; Length of Stay ; Leukocyte Count ; Multivariate Analysis ; Outpatients ; Retrospective Studies ; Tomography, X-Ray Computed