“Comfort women” are survivors of sexual slavery by the Imperial Japanese Army during World War II, who endured extensive trauma including massive rape and physical torture. While previous studies have been focused on the trauma of the survivors themselves, the effects of the trauma on the offspring has never been evaluated before. In this article, we reviewed the first study on the offspring of former “comfort women” and aimed to detect the evidence of transgenerational transmission of trauma. In-depth psychiatric interviews and the Structured Clinical Interview for DSM-5 Axis I Disorders were conducted with six offspring of former “comfort women.” Among the six participants, five suffered from at least one psychiatric disorder including major depressive disorder, panic disorder, posttraumatic stress disorder, adjustment disorder, insomnia disorder, somatic symptom disorder, and alcohol use disorder. Participants showed similar shame and hyperarousal symptoms as their mothers regarding stimuli related to the “comfort woman” issue. Increased irritability, problems with aggression control, negative worldview, and low self-esteem were evident in the children of mothers with posttraumatic stress disorder. Finding evidence of transgenerational transmission of trauma in offspring of “comfort women” is important. Future studies should include more samples and adopt a more objective method.
Adjustment Disorders ; Aggression ; Asian Continental Ancestry Group ; Child ; Depressive Disorder, Major ; Humans ; Methods ; Military Personnel ; Mothers ; Panic Disorder ; Rape ; Shame ; Slavery ; Sleep Initiation and Maintenance Disorders ; Stress Disorders, Post-Traumatic ; Survivors ; Torture ; World War II

“Comfort women” refers to young women and girls who were forced into sexual slavery by the Imperial Japanese military during World War II. They were abducted from their homes in countries under Imperial Japanese rule, mostly from Korea, and the rest from China, Philippines, Malaysia, Taiwan, Indonesia, the Netherlands, etc. “Comfort women” endured extreme trauma involving rape, sexual torture, physical abuse, starvation, threats of death, and witnessed many others being tortured and killed. This article reviews all the studies that have investigated the psychiatric or psychosocial sequelae of the survivors of the Japanese military sexual slavery. Most importantly, a recent study which conducted a psychiatric evaluation on the former “comfort women” currently alive in South Korea is introduced. The participants’ unmarried rate was relatively high and their total fertility rate was relatively low. Majority of the participants reported having no education and being the low economic status. They showed high current and lifetime prevalence of posttraumatic disorder, major depressive disorder, somatic symptom disorder, social anxiety disorder, panic disorder, and alcohol use disorder. Participants showed high suicidality and majority of the participants still reported being ashamed of being former “comfort women” after all these years. This article high-lights the fact that the trauma has affected the mental health and social functioning of former “comfort women” throughout their lives, and even to the present day.
Anxiety Disorders ; Asian Continental Ancestry Group* ; Birth Rate ; China ; Depressive Disorder, Major ; Education ; Female ; Humans ; Indonesia ; Korea ; Malaysia ; Mental Health ; Military Personnel* ; Netherlands ; Panic Disorder ; Philippines ; Physical Abuse ; Prevalence ; Rape ; Single Person ; Slavery* ; Starvation ; Stress Disorders, Post-Traumatic ; Survivors* ; Taiwan ; Torture ; World War II*

BACKGROUND AND OBJECTIVES: Unilateral sinus lesions can be caused by many diseases and exact preoperative diagnosis is often difficult to make. The aims of this study were to evaluate the recent trends for prevalence of unilateral sinus lesions and find useful factors in differential diagnosis. MATERIALS AND METHOD: Preoperative clinical diagnosis including computed tomography (CT) images, endoscopic findings and postoperative diagnosis based on pathology were assessed retrospectively in 384 consecutive patients who underwent unilateral sinus surgery from 2004 to 2013. RESULTS: Chronic bacterial rhinosinusitis (40%) was the most common cause of unilateral sinus lesions, followed by fungal sinusitis (21%), benign and malignant tumors (14%), and odontogenic sinusitis (11%). The incidence of odontogenic sinusitis has recently increased and mismatches of pre- and post-operative diagnosis were commonly found among patients with chronic bacterial rhinosinusitis, fungal sinusitis, or odontogenic sinusitis. Microcalcification in fungal sinusitis and dental lesions in odontogenic sinusitis were confirmed as critical factors by logistic regression analysis. CONCLUSION: The incidence of odontogenic sinusitis has been increasing steadily over the last 10 years. The findings of microcalcification and dental lesions on CT could provide crucial information to make a precise preoperative diagnosis among chronic bacterial rhinosinusitis, fungal sinusitis and odontogenic sinusitis.
Diagnosis ; Diagnosis, Differential* ; Humans ; Incidence ; Logistic Models ; Methods ; Pathology ; Prevalence* ; Retrospective Studies ; Sinusitis*

We evaluated the performance of a recently developed immunoassay, Elecsys vitamin D total II assay (Roche Diagnostics GmbH, Germany). Precision, linearity, and comparison studies were performed according to the Clinical and Laboratory Standards Institute guidelines. Control materials, linearity materials, and patient samples were used for the evaluation. For the correlation study, liquid chromatography-tandem mass spectrometry was used as the comparative method. Total coefficients of variations of the analyte were between 5.1% and 9.6%. The results of linearity evaluation were also acceptable for the range tested. Correlations with comparative methods were good; however, the mean values of the Elecsys vitamin D assay were higher than those of liquid chromatography-tandem mass spectrometry. The overall analytical performance of the Elecsys vitamin D total II assay is acceptable for the immunology analyzer. Therefore, the Elecsys vitamin D total II assay is expected to be widely used.
Allergy and Immunology ; Humans ; Immunoassay ; Mass Spectrometry ; Methods ; Statistics as Topic ; Vitamin D* ; Vitamins*

Acute rhinosinusitis can usually be managed by appropriate medical therapy, but it may also extend to the periorbital area in some complicated cases. Periorbital necrotizing fasciitis is uncommon among orbital complications, but can be fatal if it leads to soft tissue infection characterized by extensive necrosis and gas formation in the fascia and subcutaneous tissue. Immunocompromised states such as old ages, diabetes mellitus, alcoholics, and chronic renal failure have been reported to be predisposing factors, but the disease has also been detected in healthy patients. If proper treatment is not performed at the right time, necrotizing fasciitis can lead to systemic toxicity, multisystem organ failure, and eventual death. Therefore, early diagnosis and treatment are important. We report a case of periorbital necrotizing fasciitis that occurred in a healthy 30-year-old male patient with acute rhinosinusitis, which was treated with a combination of intravenous antibiotics and debridement of necrotic tissue and local wound management.
Adult ; Alcoholics ; Anti-Bacterial Agents ; Causality ; Debridement ; Diabetes Mellitus ; Early Diagnosis ; Fascia ; Fasciitis, Necrotizing* ; Humans ; Kidney Failure, Chronic ; Male ; Necrosis ; Orbit ; Sinusitis ; Soft Tissue Infections ; Subcutaneous Tissue ; Wounds and Injuries

Ectopic thyroid gland is usually located along the development path of thyroid in the anterior midline of the neck. However, its occurrence within the mediastinum is very rare. Mediastinal ectopic thyroid cyst is usually benign and asymptomatic, but we experienced a case of the mediastinal ectopic thyroid cyst inducing a severe airway obstruction in a 45-year-old male. The mass had no connection to the cervical thyroid gland and histological examination revealed a mediastinal cyst of an ectopic thyroid. We present the case with a review of the related literatures.
Airway Obstruction ; Humans ; Male ; Mediastinal Cyst ; Mediastinum ; Middle Aged ; Neck ; Thyroid Dysgenesis* ; Thyroid Gland

BACKGROUND AND OBJECTIVES: The aim of this study was to compare between preoperative and postoperative voices by subjective auditory perceptual evaluation and objective acoustic analysis. The study also analyzed the acoustic parameters that best reflected the auditory perceptual characteristics in laryngeal microsurgery. SUBJECTS AND METHOD: The records of 49 patients who had been diagnosed as benign vocal fold mucosal diseases and had undergone laryngeal microsurgery were retrospectively analyzed. Preoperative and postoperative voices were assessed by auditory perceptual evaluation using the GRBAS Scale and acoustic analysis using Multi-Dimensional Voice Program (MDVP) and Analysis of Dysphonia in Speech and Voice (ADSV). Correlation between auditory perceptual characteristics and acoustic parameters was analyzed. RESULTS: Auditory perceptual evaluation showed that the patients' voices were improved after the operation. Several acoustic parameters of MDVP related to short-term and long-term variability showed significant improvement. Also, there were significant differences in several cepstral/spectral parameters of ADSV after operation. In the correlation analysis, the overall grade (G) of the GRBAS Scale showed highest correlation with the cepstral spectral index of dysphonia (CSID) (r=-0.700). The roughness (R) of GRBAS Scale was correlated with the smoothed amplitude perturbation quotient of long-term variability of MDVP (r=0.468), breathiness (B) with cepstral peak prominence (r=-0.703) and strain (S) with CSID (r=0.650) (p<0.01). CONCLUSION: Our results showed that the acoustic parameters were related to the long-term variability of MDVP, and the parameters of cepstrum/spectrum were useful for the objective assessment of voice quality in patients who received laryngeal microsurgery. These parameters were also useful for the quantification of voice quality and abnormality of phonation.
Acoustics* ; Dysphonia ; Humans ; Methods ; Microsurgery ; Phonation ; Retrospective Studies ; Vocal Cords* ; Voice Quality* ; Voice*

BACKGROUND/AIMS: As bacterial resistance to antimicrobial agents has grown due to the increasing use of antimicrobial agents, we sought to evaluate the suitability of ceftriaxone usage (representative of third generation cephalosporins) at 10 university hospitals in Korea. METHODS: We prospectively evaluated the appropriateness of antibiotic usage in 400 adult patients who received ceftriaxone between February 1, 2006 and June 30, 2006. Drug utilization evaluation (DUE) methods were based on standards set forth by the American Society of Hospital Pharmacists. The DUE criteria used in this study were modified to be more suitable in our hospital setting: justification of drug use, critical and process indications, complications, and outcome measures. RESULTS: The average patient age was 64.4 years. The utilization of ceftriaxone was appropriate in 262 cases (65.5%) for the justification of use, while inappropriate use was observed in 138 cases (34.5%). Common reasons for inappropriate use of ceftriaxone included continued empiric use for presumed infections, prophylactic perioperative injection, and empiric therapy for fever. Most of the critical indications showed a high rate of suitability (66.5-98.5%). Complications occurred in 37 cases (9.3%). With respect to outcome measures, clinical responses were observed in 60.7% of cases, while only 15.7% of cases showed evidence of infection eradication via negative cultures. CONCLUSIONS: Appropriate use (65.5%) of ceftriaxone was higher than inappropriate use (34.5%) at university hospitals in Korea. Inappropriate utilization, however, including continued empiric use for presumed infections and prophylactic perioperative injection remained high. Intensification of educational programs and antibiotic control systems for ceftriaxone is needed to improve the suitability of antimicrobial use.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Anti-Bacterial Agents/*therapeutic use ; Ceftriaxone/adverse effects/*therapeutic use ; Child ; Child, Preschool ; *Drug Utilization Review ; Female ; Humans ; Male ; Middle Aged ; Prospective Studies ; Treatment Outcome

Although the etiology of Behcet's Disease (BD; MIM 109650) remains to be clearly elucidated, levels of tumor necrosis factor alpha (TNF-alpha) have been reported to be significantly elevated in BD patients, and TNF-alpha blockers have been demonstrated to exhibit some degree of therapeutic efficacy for a certain subset of BD sufferers. In this study, we have conducted an analysis of the TNFA haplotypes in the promoter response element that affect the binding affinity of specific transcription factors, in order to characterize their association with the clinical features of BD. Six polymorphisms in the promoter region of TNFA were genotyped in 254 BD patients and 344 control subjects, via the PCR-RFLP technique. TNFA -1031*C, -863*A and -308*G alleles were associated with an increased risk of BD (p=0.030, OR=1.4; p=0.008, OR=1.5; p=0.010, OR=1.8, respectively). The sole TNFA haplotype -1031C-863A-857C-376G-308G-238G, was associated with a 1.6 fold increase in the risk of BD, whereas the TNFA haplotype -1031T-863C-857C-376G-308A-238G was associated with a 0.6 decreased risk of BD. The TNFA -1031*C, -863*A, -857*C and -308*G alleles were significantly associated with BD. The findings of this study, collectively, indicate that TNFA haplotypes in the promoter response elements may exert significant influence on susceptibility to BD.
Tumor Necrosis Factor-alpha/*genetics ; Promoter Regions (Genetics)/*genetics ; Polymorphism, Single Nucleotide/genetics ; Odds Ratio ; Middle Aged ; Male ; Linkage Disequilibrium ; Humans ; Haplotypes/*genetics ; Genotype ; Genetic Predisposition to Disease/genetics ; Gene Frequency ; Female ; Behcet Syndrome/*genetics/pathology ; Aged ; Adult ; Adolescent

Dermatophytes have been demonstrated infrequently in the dermis, subcutis, lymph nodes, bones and other tissues. A few cases of deep granulomatous cutaneous infections due to dermatophytes have been reported, but Trichophyton mentagrophytes are extremely rare. We report two cases of T. mentagrophytes infection showing unusual granulomatous manifestations. A 63-year-old woman presented with multiple erythematous patches and nodules on both arms and lower extremities for 3 months. The second patient was a 69-year-old man who had erythematous annular plaques on the dorsum of the left hand for 4 months. Histopathologic examinations of the skin lesions of both patients showed chronic granulomatous inflammation with fungal elements. The biopsy specimens yielded T. mentagrophytes on culture. The skin lesions were cured after administration of itraconazole.
Aged ; Arm ; Arthrodermataceae ; Biopsy ; Dermis ; Female ; Granuloma* ; Hand ; Humans ; Inflammation ; Itraconazole ; Lower Extremity ; Lymph Nodes ; Middle Aged ; Skin ; Trichophyton*