PURPOSE: The objective of this study was to investigate the predictors of depression and coping and the correlation between depression and use of coping among breast cancer patients in Korea. METHODS: Of 1,250 eligible breast cancer patients attending Yonsei University Severance Hospital, 1,160 completed our surveys. Depression and coping were assessed using the Beck Depression Inventory and Korean Cancer Coping Questionnaire. Socio-demographic characteristics were included in the survey and medical factors were compiled by reviewing each patient's medical chart. RESULTS: Education, economic status, the level of daily activities, menopause and the type of surgery significantly predicted depression. Age, education, economic status, time since surgery, the level of daily activities, and menopause were significant predictors for personal coping; marriage, education, economic status, time since surgery, the surgical method and radiotherapy significantly predicted interpersonal coping. Personal coping and interpersonal coping had significant negative correlations with depression. CONCLUSION: Many factors are significant predictors but education and economic status are the most significant and consistent predictors for both depression and coping in breast cancer patients. Psychosocial intervention should be planned according to different characteristics of breast cancer patients, in order to reduce depression and enhance effective coping.
Adaptation, Psychological ; Breast ; Breast Neoplasms ; Depression ; Female ; Humans ; Korea ; Marriage ; Menopause

No abstract available.
Herpesvirus 3, Human* ; Korea* ; Polymorphism, Restriction Fragment Length*

PURPOSE: The present study aims to evaluate the prevalence of unmet needs among breast cancer survivors, to assess the relationships between unmet needs and depression and quality of life, and to explore the extent to which unmet needs of breast cancer patients relate to the time elapsed since surgery. MATERIALS AND METHODS: Among 1,250 eligible patients who participated in the study, 1,084 cases (86.7%) were used for analysis. Clinicopathological and social parameters were reviewed and the Supportive Care Needs Survey, Functional Assessment of Cancer Therapy-Breast cancer instrument, and Beck Depression Inventory were administered. The frequency of unmet needs, the association between unmet needs and depression and/or quality of life (QOL) and the impact of the time elapsed since surgery on the patients' unmet needs were analyzed. RESULTS: The highest levels of unmet needs were found to be in the health system and information domain. Patients with a survival duration of less than 1 year since surgery showed significantly higher unmet needs in all need domains except the sexuality domain (p<0.001) than participants in the other groups. Patients with a survival duration of 1-3 years also experienced significantly higher psychological and information needs than long-term survivors (>5 years). In addition, unmet needs were significantly associated with depression (p<0.001) and QOL (p<0.001). CONCLUSION: The present study demonstrated that long-term breast cancer survivors had a significantly lower level of unmet needs than patients with survival duration of less than 3 years after surgery and patients with survival duration of less than 1 year since surgery suffered the greatest unmet needs. QOL might be enhanced if interventions are made for specific unmet needs of each patient group.
Adult ; Breast Neoplasms/*mortality/*psychology/surgery ; Cross-Sectional Studies ; Depression/diagnosis/mortality ; Female ; Health Services Accessibility/*statistics & numerical data ; Humans ; Middle Aged ; Needs Assessment/*statistics & numerical data ; Prevalence ; *Quality of Life ; Republic of Korea/epidemiology ; *Social Support

OBJECTIVES : The primary purpose of this study was to investigate the effects of computerized cognitive rehabilitation training on inpatients with schizophrenia in the rehabilitation unit. METHODS : Thirty-eight patients with schizophrenia from the Yongin Mental Hospital Rehabilitation Ward were randomly assigned either to a computerized cognitive rehabilitation group or to a control group. The rehabilitation group received 12 sessions of computerized cognitive rehabilitation training (Cog-Trainer) over 3 months. This training program consisted of ten units, each of which consisted of 3 levels, practice, application, and advanced. Neurocognitive functions were assessed at the beginning and end of the training period. Cognitive measures included Span of Apprehension (SPAN), Continuous Performance Test (CPT), Digit Span, Trail Making Test, and the Stroop Test. RESULTS : Compared to controls, subjects receiving computerized cognitive rehabilitation training experienced a significant improvement in attention, concentration, and working memory. CONCLUSION : These results indicate that computerized cognitive rehabilitation training can contribute to improvement in cognitive function of patients with schizophrenia. Further study to generalize these results is required.
Hospitals, Psychiatric ; Humans ; Inpatients ; Memory, Short-Term ; Pilot Projects ; Schizophrenia ; Trail Making Test

PURPOSE: The objective of this study was to assess the supportive needs of breast cancer patients and determine the socio-demographic and clinicopathological predictors of those unmet needs. METHODS: Of 302 eligible breast cancer patients, attending Yonsei University Severance Hospital, 250 completed the surveys. The supportive care needs were assessed by administering a Supportive Care Needs Survey. RESULTS: Of the ten highest perceived needs items, 7 items were related to the health system and information domain and 2 to the psychological domain. The univariate analysis in each domain showed education (P=0.083) and chemotherapy (P=0.042) were significant predictors in the psychological domain; education (0=0.000), time since surgery (P=0.009), node metastasis (0.022), chemotherapy (P=0.001) and radiation therapy (P=0.003) in the physical and daily living domain; age (P=0, 009) and duration of marriage (P= 0.004) for sexuality; node metastasis (P=0.048), TNM stage (P=0.036), and recurrence (P=0.010) in the health system and information domain and religion (P=0.016) in the care and support domain. A multivariate analysis showed age (P=0.0253) and chemotherapy (P=0.0517) as significant independent predictors in the sexuality domain; education (P=0.0010), chemotherapy (P=0.0011), radiation therapy (P= 0.0133) and time since surgery (P=0.036) in the physical and daily living domain; recurrence (P=0.0324) in the health system and information; domain and education (P=0.0134) and chemotherapy (P=0.0207) in psychological domain. CONCLUSION: Breast cancer patients experience high levels of unmet supportive needs across each domain, but especially in the health systems and information domain. Also, the types of needs varied according to the patient subgroups. This study suggests considerable improvements be made in terms of supportive care of breast cancer patients.
Breast Neoplasms* ; Breast* ; Drug Therapy ; Education ; Humans ; Marriage ; Multivariate Analysis ; Neoplasm Metastasis ; Recurrence ; Sexuality

OBJECTIVES: Compared with the general population, individuals with schizophrenia are known to have lower self-esteem, in part because of internalized self-stigma. The aim of this study was to assess the efficacy of a Self-stigma Overcome Program (SOP), named self-esteem enhancement program for inpatients with schizophrenia. METHODS: The 46 patients with schizophrenia from Yongin Mental Hospital Rehabilitation Ward were randomly assigned to a SOP group or to a control group. The SOP groups received 15 sessions of SOP treatment over four months. SOP combined existing structured modules for the purpose of increasing self-esteem and empowerment with cognitive behavior therapy (CBT) techniques. The program module was divided into three building blocks: sense of security, sense of purpose, and sense of competence. All the subjects were assessed before and after the treatment period on measures of psychosocial functioning, diagnostic variables, and symptomatology. RESULTS: Compared with patients in the control condition, SOP group patients showed significant improvements on measures of empowerment and internalized stigma. The SOP groups subjectively also reported more improved self-respect, self-understanding, and positive self-regard. However, there were no significant improvements on measures of self-esteem and quality of life. CONCLUSION: These results indicate that individuals with schizophrenia appear to be benefit from a self-esteem enhancement module, particularly when they are involved in a rehabilitation program. These findings encourage a reconsideration of patients' empowerment and competence in order to ensure lasting effects on overall functional outcome of chronic schizophrenics.
Cognitive Therapy ; Dietary Sucrose ; Hospitals, Psychiatric ; Humans ; Inpatients ; Mental Competency ; Power (Psychology) ; Schizophrenia

No Abstract Available.
Allografts* ; Posterior Cruciate Ligament*

Accurate anatomical reduction of the displaced acetabular fractures has a great clinical importance because acetabulum is related to weight-bearing and their fractures can lead to serious major sequelae. There are controversies and a lot of problems with regard to the management of the displaced acetabular fractures. The purpose of our study is to analyze the clinical results of operative treatment of the displaced acetabular fractures and to establish guidelines for treatment of their fractures. A clinical analysis was performed on 19 patients with displaced unstable acetabular fractures who had been operated on and followed for minimum 1 year period at Asan Medical Center from September 1989 to August 1992. The results were as follows: 1. The most common type was posterior wall fracture according to Letournel's classification. 2. Excellent or good results were obtained in 84% according to Goodwin's assessment method. All of the elementary fracture.s presented excellent or good results, while fair or poor results were observed in some T-shaped fractures or transverse and posterior wall fracture. 3. Complications were observed in 5 cases, including ectopic ossification(2 cases), traumatic arthritis(1 case), avascular necrosis of femoral head(1 case) and deep wound infection(1 case). Those seemed to be related with severe acetabular injury and extensive approach. 4. Kocher-Langenbeck approach was satisfactory for reduction and fixation of posterior column in transverse fracture, while extended iliofemoral approach was necessary for fixation of both column in T-shaped fracture. 5. Reduction of fracture of ilium was prerequisite for reduction of acetabular articular surface. 6. In displaced unstable acetabular fractures, early surgical intervention shich includes accurate anatomical reduction, and rigid internal fixation should be undertaken, and early joint motion should be followed to restore the joint function and to decrease the complication rate.
Acetabulum ; Chungcheongnam-do ; Classification ; Humans ; Ilium ; Joints ; Methods ; Necrosis ; Weight-Bearing ; Wounds and Injuries

Various cancer types have been associated with cancer-related cerebral infarction. In this study, we describe the first case of cancer-related cerebral infarction in which the underlying disease was primary bone marrow lymphoma (PBML). A 79-year-old man presented with abruptly developed bilateral lower extremity weakness and confusion. Diffusion-weighted imaging on admission showed multiple cortical and subcortical embolic infarction lesions in multiple vascular territories. Diagnostic evaluations to determine the embolic source revealed no abnormalities. Laboratory testing demonstrated elevated D-dimer (2.59 μg/mL) but no other prothrombotic abnormalities. In suspicion of cancer-related stroke, we performed chest CT, abdomen CT, and FDG-PET to detect the hidden malignancy. Findings revealed no evidence of cancer; however, they did reveal signs of anemia (hemoglobin 9.0 g/dL). Bone marrow aspiration biopsy showed large atypical B cell involvement suggestive of high-grade B cell lymphoma. The patient was diagnosed with primary bone marrow diffuse large B-cell lymphoma initially presenting with ischemic stroke. Our case suggests that primary bone marrow cancer may be a candidate for the differential diagnosis of hidden malignancy in patients with suspected cancer-related stroke. Bone marrow biopsy may be essential for establishing an appropriate differential diagnosis in patients with abnormal hematologic findings.

Magnetic resonance (MR) imaging of thirteen patients with tuberous sclerosis were reviewed. Seven patients underwent computed tomography (CT). The characteristic MR finding of tuberous sclerosis was those of subependymal nodules which were best seen on short repetition time (TR) spin-echo images. Hypointensities within the nodules consistent with calcification were most evident on long TR images. Contrast enhancing lesions, indicative subependymal giant cell astrocytoma, occurred in four cases. Cortical tubers (n=11) and white matter lesions(n=8) exhibited long T1 and T2 relaxation characteristics although reversed pattern was noted in one newborn patients. Cortical tubers and white matter lesions had more irregular shapes in early childhood patients. MR imaging is the sensitive method in detection of gyral tubers and white matter lesions and also valuable in detecting giant all astrocytoma.
Astrocytoma ; Humans ; Infant, Newborn ; Magnetic Resonance Imaging ; Methods ; Relaxation ; Tuberous Sclerosis* ; White Matter