The effects of torture-related stressors on long-term complex post-traumatic symptoms in South Korean torture survivors.

This study explored whether perceived distress from specific stressors during and after torture explain long-term complex post-traumatic symptoms of South Korean torture survivors. We conducted a cross-sectional survey of survivors who had been tortured by the homeland regime from the 1970s to the 2000s. Data from 206 survivors were gathered by key informants using target sampling and snowballing techniques. Project staff designed scales to encompass the specific types of stressors related to torture techniques used in Korea. Frequencies and distress ratings of exposure to torture, post-torture psychosocial stressors and physical damage related to torture were gathered. Psychological symptoms were assessed by the Impact of Event Scale-Revised-Korean version and subscales of the Symptom Checklist 90-Revised-Korean version. Perceived distress from torture stressors was mainly divided into factors representing physical, psychological and deprivation torture by adapting a principal axis factor analysis. Hierarchical regression analyses showed that distress from psychological torture explained post-traumatic stress disorder (PTSD) and that distress from deprivation explained PTSD and anxiety after controlling for demographic variables, psychological preparedness, time span since torture and distress from trauma other than torture. Among post-torture stressors, distress from physical damage related to torture and social exclusion were strong indicators of complex symptoms.

Identifying clinical correlates for suicide among epilepsy patients in South Korea: A case-control study.

OBJECTIVE: Suicide is a major cause of premature mortality in patients with epilepsy. We aimed to identify the clinical correlates of suicide in these patients. METHODS: We conducted a matched, case-control study based on a clinical case registry of epilepsy patients (n = 35,638) treated between January 1994 and December 2011 at an academic tertiary medical center in Seoul, Korea. Each epilepsy patient in the suicide group (n = 74) was matched with three epilepsy patients in the nonsuicide group (n = 222) by age, gender, and approximate time at first treatment. The clinical characteristics of the patients in both groups were then compared. RESULTS: In a univariate analysis, seizure frequency during the year before suicide, use of antiepileptic drug polytherapy, lack of aura before seizure, diagnosis of temporal lobe epilepsy, use of levetiracetam, psychiatric comorbidity, and use of antidepressants were all significantly higher in the suicide group than in the nonsuicide group. Multivariate analysis revealed that a high seizure frequency (odds ratio [OR] 3.3, 95% confidence interval [CI] 1.04-10.2), a lack of aura before seizure (OR 4.0, 95% CI 1.7-9.3), temporal lobe epilepsy (OR 3.7, 95% CI 1.6-8.6), and use of levetiracetam (OR 7.6, 95% CI 1.1-53.7) and antidepressants (OR 7.2, 95% CI 1.5-34.1) were all associated with a higher probability of suicide. SIGNIFICANCE: Patients with temporal lobe epilepsy who experience seizures weekly or more frequently, experience a lack of aura, use levetiracetam, or take antidepressants are all at a higher risk of suicide and should be monitored closely.

Social anxiety among East Asians in North America: East Asian socialization or the challenge of acculturation?

North American research has consistently reported higher social anxiety among people of Asian heritage compared to people of Western heritage. The present study used a cross-national sample of 692 university students to explore explanatory hypotheses using planned contrasts of group differences in social anxiety and related variables. The East Asian socialization hypothesis proposed social anxiety would show a linear relation corresponding to the degree of exposure to East Asian cultural norms. This hypothesis was not supported. The cultural discrepancy hypothesis examined whether bicultural East Asian participants (residing in Canada) would endorse higher social anxiety in comparison to unicultural participants (Western-heritage Canadians and native Koreans and Chinese). Compared to unicultural participants, bicultural East Asian participants reported higher social anxiety and depression, a relation that was partially mediated by bicultural participants' reports of lower self-efficacy about initiating social relationships and lower perceived social status. Overall, the results suggest higher reports of social anxiety among bicultural East Asians may be conceptualized within the context of cultural discrepancy with the mainstream culture.

Laparoscopic total mesorectal excision in a rectal cancer patient with situs inversus totalis.

Situs inversus totalis is a rare anomaly in which the abdominal and thoracic cavity structures are opposite their usual positions. A 41-yr-old woman, who had an ulcerating cancer on the rectum, was found as a case of situs inversus totalis. We present an overview of the operative technique for the first documented laparoscopic total mesorectal excision of a rectal cancer in the patient with situs inversus totalis. Careful consideration of the mirror-image anatomy permitted a safe operation using techniques not otherwise different from those used for the general population. Therefore, curative laparoscopic surgery for rectal cancer in this patient is feasible and safe.

Posttraumatic Stress Disorder (PTSD) and Disorders of Extreme Stress (DESNOS) symptoms following prostitution and childhood abuse.

With the participation of 46 prostituted women in Korea, this study investigates the relationship between prostitution experiences, a history of childhood sexual abuse (CSA), and symptoms of posttraumatic stress disorder (PTSD) and disorders of extreme stress not otherwise specified (DESNOS). Prostituted women showed higher levels of PTSD and DESNOS symptoms compared to a control group. Women who had experienced both CSA by a significant other and prostitution showed the highest levels of traumatic stress. However, posttraumatic reexperiencing and avoidance and identity, relational, and affect regulation problems were significant for prostitution experiences even when the effects of CSA were controlled.

Analyzing psychological conditions of field-workers in the construction industry.

The Korean construction industry has experienced poor labor productivity and high accident rates. Previous studies have reported that workers' mental health can cause negative impacts on work performance; thus, enhancing workers' psychological conditions would help achieve more productive and safer workplaces. This research aimed to understand the level of psychological conditions of construction field-workers using four categories: (1) stress (occupational stress and stress-coping style), (2) personal temperament, (3) emotional disturbance (depression and trait anxiety), and (4) drinking habits. This research used validated questionnaires commonly used in the field of clinical psychology, surveyed 430 respondents from road, bridge, tunnel, subway, and apartment construction sites in Korea, and analyzed the overall psychological tendency of construction workers with the collaboration of professional clinical psychologists using the Z-test, analysis of variance (ANOVA), and cross-tabulation. The research also investigated how the mental conditions differed according to different working conditions, such as demographic information, employment status, work types, work experience, and wage conditions. The results indicated that construction workers suffer from a high level of stress and showed high inclination for problem-focused coping: impulsive, cautious, and dependent on other people. Two out of five construction workers suffer from depression and experience trait anxiety. More seriously, three out of five workers show alcohol-use problems that require clinical attention. This study also revealed the particular psychological problems that occur under different working conditions. The findings can be used to promote the awareness of the importance of construction workers' mental well-being and to help in setting targets for improvement.

The fabrication of well-interconnected polycaprolactone/hydroxyapatite composite scaffolds, enhancing the exposure of hydroxyapatite using the wire-network molding technique.

In this study, the fabrication method was proposed for the well-interconnected polycaprolactone/hydroxyapatite composite scaffold with exposed hydroxyapatite using modified WNM technique. To characterize well-interconnected scaffolds in terms of hydroxyapatite exposure, several assessments were performed as follows: morphology, mechanical property, wettability, calcium ion release, and cell response assessments. The results of these assessments were compared with those of control scaffolds which were fabricated by precision extruding deposition (PED) apparatus. The control PED scaffolds have interconnected pores with nonexposed hydroxyapatite. Consequently, cell attachment of proposed WNM scaffold was improved by increased hydrophilicity and surface roughness of scaffold surface resulting from the exposure of hydroxyapatite particles and fabrication process using powders. Moreover, cell proliferation and differentiation of WNM scaffold were increased, because the exposure of hydroxyapatite particles may enhance cell adhesion and calcium ion release. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 2315-2325, 2017.

A Paleoparasitological Study on the Capital Area of the Ancient Korean Kingdom.

A paleoparasitological study was performed on soil samples obtained at archaeological sites dating to the Baekje period in ancient Korean history. The samples were obtained from Buyeo, the capital area of the Baekje Kingdom, and from others corresponding to provincial counties of the same period. We found Ascaris lumbricoides and Trichuris trichiura eggs in the Buyeo samples but not any in the samples from the provincial counties. Our results suggest that the parasite-egg contamination patterns were closely correlated with population densities, in that the provincial counties of the Kingdom, compared with the capital Buyeo, were very sparsely populated. This is the first comprehensive paleoparasitological report on soil contamination patterns in the capital of the Baekje Kingdom, one of the most highly populated areas in ancient Korean history.

Perioperative Hypertension Management during Facelift under Local Anesthesia with Intravenous Hypnotics

Perioperative hypertension is a phenomenon in which a surgical patient's blood pressure temporarily increases throughout the preoperative and postoperative periods and remains high until the patient's condition stabilizes. This phenomenon requires immediate treatment not only because it is observed in a majority of patients who are not diagnosed with high blood pressure, but also because occurs in patients with underlying essential hypertension who show a sharp increase in their blood pressure. The most common complication following facelift surgery is hematoma, and the most critical risk factor that causes hematoma is elevated systolic blood pressure. In general, a systolic blood pressure goal of 65 mm Hg are recommended. This article discusses the causes of increased blood pressure and the treatment methods for perioperative hypertension during the preoperative, intraoperative, and postoperative periods, in order to find ways to maintain normal blood pressure in patients during surgery. Further, in this paper, we review the causes of perioperative hypertension, such as anxiety, epinephrine, pain, and postoperative nausea and vomiting. The treatment methods for perioperative hypertension are analyzed according to the following 3 operative periods, with a review of the characteristics and interactions of each drug: preoperative antihypertensive medicine (atenolol, clonidine, and nifedipine), intraoperative intravenous (IV) hypnotics (propofol, midazolam, ketamine, and dexmedetomidine), and postoperative antiemetic medicine (metoclopramide and ondansetron). This article focuses on the knowledge necessary to safely apply local anesthesia with IV hypnotics during facelift surgery without the assistance of an anesthesiologist.

Down-Regulation of Survivin by Nemadipine-A Sensitizes Cancer Cells to TRAIL-Induced Apoptosis

The tumor necrosis factor (TNF)-related apoptosis-inducing ligand (TRAIL) is a member of the tumor necrosis factor family of cytokines. TRAIL selectively induces apoptotic cell death in various tumors and cancer cells, but it has little or no toxicity in normal cells. Agonism of TRAIL receptors has been considered to be a valuable cancer-therapeutic strategy. However, more than 85% of primary tumors are resistant to TRAIL, emphasizing the importance of investigating how to overcome TRAIL resistance. In this report, we have found that nemadipine-A, a cell-permeable L-type calcium channel inhibitor, sensitizes TRAIL-resistant cancer cells to this ligand. Combination treatments using TRAIL with nemadipine-A synergistically induced both the caspase cascade and apoptotic cell death, which were blocked by a pan caspase inhibitor (zVAD) but not by autophagy or a necrosis inhibitor. We further found that nemadipine-A, either alone or in combination with TRAIL, notably reduced the expression of survivin, an inhibitor of the apoptosis protein (IAP) family of proteins. Depletion of survivin by small RNA interference (siRNA) resulted in increased cell death and caspase activation by TRAIL treatment. These results suggest that nemadipine-A potentiates TRAIL-induced apoptosis by down-regulation of survivin expression in TRAIL resistant cells. Thus, combination of TRAIL with nemadipine-A may serve a new therapeutic scheme for the treatment of TRAIL resistant cancer cells, suggesting that a detailed study of this combination would be useful.

Psychiatric Diagnoses of Torture Survivors / 신경정신의학

OBJECTIVES: This study was to investigate the psychiatric diagnoses of survivors of traumatic stress, i.e. torture, as a part of a large research project of a human rights survey of torture survivors. METHODS: Participants were 24 torture survivors who consented to participate, who had experienced torture during the period of 1970 through the 2000's. Participants were recruited from human rights support groups and government agencies using the snowballing technique. Data was collected by a psychiatrist and two psychologists using the MINI-International Neuropsychiatric Interview PLUS. RESULTS: The prevalence of past psychiatric diagnoses which occurred during a post-victimization period included post-traumatic stress disorder (PTSD, 37.5%), depressive disorders (45.8%), panic disorder (16.6%), substance related disorders (24.9%), psychotic disorder (4.1%), and adjustment disorder (16.6%). The prevalence of current diagnoses at interview period included PTSD (33.3%), depressive disorders (41.6%), panic disorder (8.2%), generalized anxiety disorder (4.1%), substance related disorders (20.8%), psychotic disorder (4.1%), adjustment disorder (12.5%), and suicidal tendency of above mid-level (16.6%). The co-morbidity rate was 37.5% in the past, and 33.3% at present. CONCLUSION: It was revealed that torture survivors were suffering from high rates of chronic psychiatric disorders. Appropriate psychiatric treatment may be in need to support the sufferings of the survivors.

Reduction Malarplasty

Malar reduction procedure is one of the most frequently solicited facial bone contouring procedures, and at the same time it would appear to be the least understood among surgeons and people. There have always been debates about the surgical techniques, including approaches, osteotomies, ostectomies, fixations and the outcomes such as cheek droop, symmetry, and visible scars. Many authors have described various ways of malar bone reductions, and surgical techniques have continuously developed, but not the philosophy for the procedures. From the beginning, the most important parts have relatively been ignored. Is the malar reduction really necessary for Orientals, while Western people desire their cheek bones augmented? What are the indications and contraindications of the malar reduction procedures? What are the real benefits of these procedures? I present herein my personal concepts about the malar reduction procedures, so as to move on from the debates of detailed techniques to a new paradigm, which best explains the cons and pros of reduction malarplasty.

Comparison of C-reactive Protein between Capillary and Venous Blood in Children / 소아감염

PURPOSE: In evaluation of patients, laboratory results are crucial in determination of a treatment plan. Obtaining venous blood from infants and children is a difficult procedure. Substitution of a capillary blood sample for a venous blood sample has been suggested. However, there are few studies showing mutual correlation between C-reactive protein (CRP) results in capillary and venous blood. This study was designed to determine whether the result of the capillary sample is the same as the result of the venous blood sample. METHODS: After informed consent, a pair of venous and fingertip capillary blood samples were simultaneously collected from 100 children. The LC-178CRPTM was used for analysis of capillary blood and the Hitachi 7180 automatic hematology analyzer was used for analysis of venous blood. We compared CRP of both venous and capillary blood samples. Results were analyzed by crosstabulation analysis, simple regression analysis and the Bland Altman Plot method. RESULTS: A close correlation (90.63%) was observed between capillary and venous blood analyzed by crosstabulation analysis. CRP results were similar between the two groups and showed a high coefficient correlation (beta=1.3434, R2=0.9888, P<0.0001) when analyzed by a simple regression model. The average value in venous blood was also higher compared to capillary blood. According to Bland Altman Plot analysis, lab results were measured at a 95% confidence interval. CONCLUSION: CRP results from capillary blood showed close correlation with venous blood sampling. At present, venous blood sampling is the preferred method. However, due to difficulty in venous blood sampling, capillary sampling could be considered as an alternative technique for use with children.

A Case of Atypical Miller-Fisher Syndrome with Internal Carotid Artery Stenosis / 대한소아신경학회지

Miller-Fisher syndrome is an acute poly-neuropathy typically characterized by the triad of ophthalmoplegia, ataxia, and areflexia. Other poly-neuropathy diseases include Guillain-Barre syndrome and Bickerstaff brainstem encephalitis. However, not all cases of Miller-Fisher syndrome have the typical three symptoms. These diseases have been differentiated by clinical manifestations and anti-GQ1b IgG antibody testing. In Miller-Fisher syndrome, anti-GQ1b IgG antibody is present in over 95% of patients; however, the frequency is not so high in normal subjects or in those with other poly-neuropathy diseases. Infectious illnesses, such as respiratory diseases and gastrointestinal diseases, usually precede Miller-Fisher syndrome. In general, Miller-Fisher syndrome is a self-limiting illness; however, a few cases of Miller-Fisher syndrome progressing to respiratory failure have been reported, particularly in children. In this case, we report abnormal angiographic findings. We report a case of atypical Miller-Fisher syndrome with internal carotid artery stenosis treated with prednisolone.

Laparoscopic Total Mesorectal Excision in a Rectal Cancer Patient with Situs Inversus Totalis

Situs inversus totalis is a rare anomaly in which the abdominal and thoracic cavity structures are opposite their usual positions. A 41-yr-old woman, who had an ulcerating cancer on the rectum, was found as a case of situs inversus totalis. We present an overview of the operative technique for the first documented laparoscopic total mesorectal excision of a rectal cancer in the patient with situs inversus totalis. Careful consideration of the mirror-image anatomy permitted a safe operation using techniques not otherwise different from those used for the general population. Therefore, curative laparoscopic surgery for rectal cancer in this patient is feasible and safe.

Comparison of Blood Counts in Capillary and Venous Blood in Children

BACKGROUND: Obtaining a venous blood sample from infants and children can be a painful and traumatic procedure. It has been suggested that capillary blood samples can serve as substitutes for venous blood samples to diagnose anemia. However, few data exist about the correlation between the laboratory results obtained using capillary and venous blood samples. This study was performed to determine if the results from the LC-178CRP(TM) are the same as the results from a conventional hematology analyzer using venous blood. METHODS: After informed consent was obtained, paired venous and capillary blood sample were collected simultaneously from 104 children (M : F=50 : 54). The capillary blood was analyzed using the LC-178CRP(TM), and venous blood was analyzed using an automatic hematology analyzer. The following were compared from capillary and venous samples: CBC, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), red cell distribution width (RDW), and platelet count. The results were analyzed by Pearson's correlation and the Bland Altman Plot method. RESULTS: The hemoglobin values were similar between the two groups of samples and had a high coefficient correlation (r=0.877). White blood cells, hematocrit, MCV, and MCH also had a significant correlation between capillary and venous blood samples. Based on the Bland-Altman method, the agreement between the two methods was considered good. CONCLUSION: The hematologic results from the capillary blood had a close correlation with the conventional venous method, including white blood cell count, and hemoglobin, MCV, and MCH levels. The LC-178CRPtrade mark should be considered as an alternative for venous blood sampling for the tested parameters in children.

Detection of parasite eggs from archaeological excavations in the Republic of Korea.

Excavations at two sites dating from 2000 BC-1900 AD in southeastern areas of the Republic of Korea, revealed the remains of several structures. Examination of the contents suspected privies revealed the presence of eggs from 5 kinds of parasite: Ascaris, Trichuris, Clonorchis, and two species of unknown trematodes. Clonorchis sinensis eggs were found in a soil dating from around AD 668-935. This is the first record of C. sinensis eggs in archaeological materials in the Republic of Korea.

The Korean HapMap Project Website

Single nucleotide polymorphisms (SNPs) are the most abundant form of human genetic variation and are a resource for mapping complex genetic traits. A genome is covered by millions of these markers, and researchers are able to compare which SNPs predominate in people who have a certain disease. The International HapMap Project, launched in October, 2002, motivated us to start the Korean HapMap Project in order to support Korean HapMap infrastructure development and to accelerate the finding of genes that affect health, disease, and individual responses to medications and environmental factors. A Korean SNP and haplotype database system was developed through the Korean HapMap Project to provide Korean researchers with useful data- mining information about disease-associated biomarkers for studies on complex diseases, such as diabetes, cancer, and stroke. Also, we have developed a series of software programs for association studies as well as the comparison and analysis of Korean HapMap data with other populations, such as European, Chinese, Japanese, and African populations. The developed software includes HapMapSNPAnalyzer, SNPflank, HWE Test, FESD, D2GSNP, SNP@Domain, KMSD, KFOD, KFRG, and SNP@WEB. We developed a disease-related SNP retrieval system, in which OMIM, GeneCards, and MeSH information were integrated and analyzed for medical research scientists. The kHapMap Browser system that we developed and integrated provides haplotype retrieval and comparative study tools of human ethnicities for comprehensive disease association studies (http://www.khapmap.org). It is expected that researchers may be able to retrieve useful information from the kHapMap Browser to find useful biomarkers and genes in complex disease association studies and use these biomarkers and genes to study and develop new drugs for personalized medicine.

Development of KHapmap Browser using DAS for Korean HapMap Research

The Korean HapMap Project has been carried out for the last 5 years since it started in June, 2003. The project generated data for a sum of 1,764,000 Korean SNPs and formally registered the data to the dbSNP of NCBI (The dbSNP website. 2008). We have developed a series of software programs for association studies as well as for the comparison and analysis of Korean HapMap data with four other populations (CEPH, Yoruba, Han Chinese, and Japanese populations). The KHapmap Browser was developed and integrated to provide haplotype retrieval and comparative study tools of human ethnicities for comprehensive disease association studies (http://www.khapmap.org). On that basis, GBrowse was adopted in the KHapmap Browser for inherent Korean genetic data, and a provision of extended services was pledged with the distributed sequence annotation system (DAS). The dynamic linking service of the KHapmap Browser to other tools in our intranetwork environment provides many enhanced functions over GBrowse without DAS. KHapmap Browser is expected to be an invaluable tool for the study of Korean and international Hapmap data.

Rapid Identification of Rickettsiae using the Real-Time PCR

In this study, new real-time PCR method based on the groEL gene was developed and investigated. Four spotted fever group (SFG) strains, four typhus group (TG) strains, and four scrub typhus group (STG) strains were easily differentiated as a distinct entity. This PCR assay was applied to detect Rickettsia DNA from 100 ticks. Twelve Haemaphysalis longicornis ticks were found positive and identified as spotted fever group Rickettsia. This real-time PCR method could simultaneously perform the rapid identification of rickettsiae and the differential diagnosis of SFG, TG, and STG in a single reaction.