OBJECTIVES: The definition of a hidden youth is a young person who has completely withdrawn from society and shut himself or herself away for more than 3 months. Those pathologically-withdrawn youths have become a burden not only to society but also to the family. However, screening of these hidden youths cannot be done easily. This study focused on developing a primary effective screening tool for these hidden youths. METHODS: The 42 participants of this study were parents of hidden youths that are between 8 to 25 years old. They were selected from from mental health centers and psychiatric clinics around Seoul and Gyeonggi Province. We also recruited 239 parents of middle and high school students in the Seoul metropolitan area for a control group. In order to decide the concurrent validity of this questionnaire, we used the Symptom Checklist-90-Revision, Children's Depression Inventory, Beck Depression Inven-tory, Social Anxiety Scale for Children-Revised, Social Anxiety and Distress Scale, Avoidant Personality Disorder Scale, and State-Trait Anxiety Inventory for Children. SPSS version 12.0 was used for statistical analysis. RESULTS: Cronbach's alpha values, the reliability coefficient to represent internal consistency, were between 0.396 and 0.935, which showed relatively high internal consistency for this questionnaire. The test-retest coefficient was between 0.68 and 0.78, which was a statistically significant result. In a factor analysis, 4 factors such as avoidance, withdrawal, isolation, and apathy were extracted. In a concurrent validity test with SCL-90-R, the isolation factor showed a statistically-significant relationship with a phobic-anxiety sub-scale, and avoidance and withdrawal sub-scales were remarkably correlated with the interpersonal sensitivity sub-scale. CONCLUSION: Since the questionnaire for socially withdrawn youths has achieved statistically-satisfactory reliability and validity, it will be a useful method to screen for hidden youths in educational, community, and clinical settings.
Adolescent ; Anxiety ; Apathy ; Child ; Depression ; Humans ; Mass Screening ; Mental Health ; Parents ; Personality Disorders ; Reproducibility of Results ; Surveys and Questionnaires

OBJECTIVES: The definition of a hidden youth is a young person who has completely withdrawn from society and shut himself or herself away for more than 3 months. Those pathologically-withdrawn youths have become a burden not only to society but also to the family. However, screening of these hidden youths cannot be done easily. This study focused on developing a primary effective screening tool for these hidden youths. METHODS: The 42 participants of this study were parents of hidden youths that are between 8 to 25 years old. They were selected from from mental health centers and psychiatric clinics around Seoul and Gyeonggi Province. We also recruited 239 parents of middle and high school students in the Seoul metropolitan area for a control group. In order to decide the concurrent validity of this questionnaire, we used the Symptom Checklist-90-Revision, Children's Depression Inventory, Beck Depression Inven-tory, Social Anxiety Scale for Children-Revised, Social Anxiety and Distress Scale, Avoidant Personality Disorder Scale, and State-Trait Anxiety Inventory for Children. SPSS version 12.0 was used for statistical analysis. RESULTS: Cronbach's alpha values, the reliability coefficient to represent internal consistency, were between 0.396 and 0.935, which showed relatively high internal consistency for this questionnaire. The test-retest coefficient was between 0.68 and 0.78, which was a statistically significant result. In a factor analysis, 4 factors such as avoidance, withdrawal, isolation, and apathy were extracted. In a concurrent validity test with SCL-90-R, the isolation factor showed a statistically-significant relationship with a phobic-anxiety sub-scale, and avoidance and withdrawal sub-scales were remarkably correlated with the interpersonal sensitivity sub-scale. CONCLUSION: Since the questionnaire for socially withdrawn youths has achieved statistically-satisfactory reliability and validity, it will be a useful method to screen for hidden youths in educational, community, and clinical settings.
Adolescent ; Anxiety ; Apathy ; Child ; Depression ; Humans ; Mass Screening ; Mental Health ; Parents ; Personality Disorders ; Reproducibility of Results ; Surveys and Questionnaires

BACKGROUND: Environmental pollutants are thought to be one of major triggers of atopic dermatitis (AD). OBJECTIVE: We attempted to evaluate the clinical effects of environment with low indoor pollutant levels on AD management. METHODS: Fifty-one children (mean age 1.7 years) with moderate to severe AD who failed to show improvement with conventional management were recruited. Disease severity was assessed by SCORAD (Scoring of AD) indices. They were admitted in a low pollutant oom for 3-4 days (mean 3.3 days) which was designed to keep low levels of dust, house dust mites, micro-organisms, and indoor air pollutants such as total volatile organic compounds (TVOCs), particulate matter (PM), and so on. Air pollutant levels in the low pollutant room were lower than primary standards defined by the Korean Ministry of Environment. we compared disease severity on admission and after discharge, and the pollutant levels of each patient's home and low pollutant room. RESULTS: The SCORAD was significantly reduced from 42.0 ± 11 .5 to 29.8 ± 8.9 (p < 0.001) by management in a low pollutant room. PM₂.₅, PM₁₀, formaldehyde, TVOCs, carbon dioxide, bacterial suspensions, and indoor molds were significantly higher in the patient's home than low pollutant room. Out of 29 patients who deteriorated after discharge to their home, 8 patients were admitted again, and their SCORAD was rapidly decreased from 53.1 ± 16.2 to 39.2 ± 9.8 (p = 0.036). CONCLUSION: Indoor air pollutants are likely to affect AD in susceptible individuals. Environmental control to lower indoor air pollutant levels might be necessary for better management of AD in some patients.
Air Pollutants ; Air Pollution ; Carbon Dioxide ; Child ; Dermatitis, Atopic ; Dust ; Environmental Pollutants ; Formaldehyde ; Fungi ; Hospitalization ; Humans ; Mites ; Particulate Matter ; Suspensions ; Volatile Organic Compounds

PURPOSE: Breast cancers frequently undergo distant metastasis during the early phase, on which the survival of patients is greatly dependent. It has been suggested that the occurrence of micrometastasis relates with other prognostic features of breast cancer, such as lymph node metastasis and the presence of vascular invasion. The aim of this study was to examine the presence of keratin-19 and mammaglobin mRNA in bone marrow aspirates obtained from breast cancer patients, and their possible correlation with tumor staging and disease free survival. METHODS: Bone marrow samples were obtained from 254 breast cancer patients at the time of surgery. We separated the mononuclear fraction from the samples and carried out nested reverse transcriptase polymerase chain reaction for the detection of keratin-19 and mammaglobin mRNA using two different pairs of primers. We also studied the possible correlations between the tumor size, nodal involvement, stage, and distant metastasis. RESULTS: Seventy-five of the 254 samples were studied for cytokeratin 19 and the others for cytokeratin and mammaglobin. The median follow-up time was 21.1 months. Sixty-five (26%) of the 254 samples were cytokeratin 19 positive and 25 (14.3%) of the 175 were mammaglobin positive. Eight cases (12.3%) in the cytokeratin positive group showed a recurrent disease in distant organs. Whereas, six (3.2%) out of 185 cytokeratin negative patients had distant recurrences. Mammaglobin positivity was not correlated with distant metastasis. The stage, nodal status, and estrogen receptor were independent of bone marrow micrometastasis. CONCLUSION: Bone marrow micrometastasis, detected by nested RT-PCR for cytokeratin 19, could be a useful predictive marker for the distant metastasis of breast cancer.
Bone Marrow* ; Breast Neoplasms* ; Breast* ; Disease-Free Survival ; Estrogens ; Follow-Up Studies ; Humans ; Keratin-19* ; Keratins* ; Lymph Nodes ; Neoplasm Metastasis ; Neoplasm Micrometastasis* ; Neoplasm Staging ; Recurrence ; Reverse Transcriptase Polymerase Chain Reaction ; RNA, Messenger

The authors encountered a case of gliosarcoma with hemorrhage arising in the left frontotemporal lobe of a 34-year old woman who five months previously had undergone surgery for an ICH in the same lobe. On CT brain scan, we could a slight hyperdense tumor with irregular enhancement could be detected, and perilesional edema and obvious mass effect were also noted. The tumor was firm and surgically,its margine was somewhat poor. On pathologic and histochemical study, the presence of a gliosarcoma was confirmed.
Adult ; Brain ; Brain Neoplasms ; Edema ; Female ; Gliosarcoma* ; Hemorrhage* ; Humans

The authors encountered two cases of Langerhans' cell histiocytosis. One, a three-year-old male, had persistent epiphora and showed exophthalmos of the left eye. A mass was detected in the left orbit and was removed subtotally; pathologic examination revealed Langerhans cell histiocytosis. The other case, a 24-year-old male, presented with a gradually growing palpable mass in the parietal area; the skull defect was punched out in shape. The mass, which was tightly attached to the outer layer of the dura mater, was completely removed. On the basis of pathologic findings, Langerhans' cell histiocytosis was diagnosed, and the patient subsequently underwent radiotherapy.
Dura Mater ; Exophthalmos ; Histiocytosis* ; Histiocytosis, Langerhans-Cell ; Humans ; Lacrimal Apparatus Diseases ; Male ; Orbit ; Rabeprazole ; Radiotherapy ; Skull ; Young Adult

The authors have experienced a case of an arachnoid cyst within the cervical canal. The patient suffered from right upper extremity pain and numbness for 1 month. On cervical MRI, intradural extramedullary mass was detected. A total laminectomy of C5, C6 and C7 was performed. We could diagnose by radiological and pathological findings.
Arachnoid* ; Humans ; Hypesthesia ; Laminectomy ; Magnetic Resonance Imaging ; Spinal Canal* ; Upper Extremity

The authors have experienced a case of an arachnoid cyst within the cervical canal. The patient suffered from right upper extremity pain and numbness for 1 month. On cervical MRI, intradural extramedullary mass was detected. A total laminectomy of C5, C6 and C7 was performed. We could diagnose by radiological and pathological findings.
Arachnoid* ; Humans ; Hypesthesia ; Laminectomy ; Magnetic Resonance Imaging ; Spinal Canal* ; Upper Extremity

The authors reviewed the radiographs and medical records of 134 consecutive patients who underwent chemonucleolysis and automated percutaneous lumbar discectomy(APLD) between March 1990 and December 1994 at our institute. Among the 34 consecutive patients, 90 patients underwent chemonucleolysis and the other remaining patients underwent APLD using a nucleotome. The results are summarized as follows: 1) In both groups, predominent patients were of young age and males. 2) The most common lesion was in L4-5 interspace in both groups 3) The posteior lateral type showed high incidence in APLD group. 4) The results were better in the younger age group and when spinal CT demonstrated posterior lateral type in both groups. 5) The results showed relatively good success rate of 84.4% in chemonucleolysis group and 88.6% in APLD group. 6) Better results can be anticipated when patients are carefully selected and operated on with a higher skillful technique.
Diskectomy* ; Humans ; Incidence ; Intervertebral Disc Chemolysis ; Male ; Medical Records ; Spine*

Recently we experienced a soft tissue sarcoma originated in the spinal epidural space at upper sacral area and extending into intrapelvic area in a young male patient. It was diagnosed primary Ewing's sarcoma histologically. Ewing's sarcoma is usually found in long bones. But rarely discovered in an extraosseous area. So, spinal epidural Ewing's sarcoma is rare to be found. Only 6 cases were reported in the English literature until 1986. We present the case with review of literatures.
Epidural Space ; Humans ; Male ; Sarcoma ; Sarcoma, Ewing*