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Purpose@#Reduced port surgery (RPS) for gastric cancer has been frequently reported in distal gastrectomies but rarely in total gastrectomies. This study aimed to determine the feasibility of 3-port totally laparoscopic total gastrectomy (TLTG) with overlapping esophagojejunal (EJ) anastomosis. @*Materials and Methods@#A total of 81 patients who underwent curative TLTG for gastric cancer (36 and 45 patients with 3-port and 5-port TLTG, respectively) were evaluated. All 3-port TLTG procedures were performed with the same method as 5-port TLTG, including EJ anastomosis with the intracorporeal overlap method using a linear stapler, except for the number of ports and assistants. Short-term outcomes, including the number of lymph nodes (LNs) harvested by station and postoperative complications, were analyzed retrospectively. @*Results@#Clinical characteristics were not significantly different among the groups, except that the 3-port TLTG group was younger and had a lower rate of pulmonary comorbidity.There were no cases of open conversion or additional port placement. All operative details and the number of harvested LNs did not differ between the groups, but the rate of suprapancreatic LN harvest was higher in the 3-port TLTG group. No significant differences were observed in the overall complication rates between the 2 groups. @*Conclusions@#Three-port TLTG with overlapping EJ anastomoses using a linear stapler is a feasible RPS procedure for total gastrectomy to treat gastric cancer.
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Background@#This study aimed to empirically derive and validate subtypes of nonsuicidal selfinjury (NSSI) based on the forms of self-harm behavior. @*Methods@#Sixty young adults who exhibited repetitive NSSI completed a clinical interview and baseline measures, followed by a two-week ecological momentary assessment (EMA).A latent class analysis was administered to identify NSSI subtypes based on the forms of self-harm behavior. The subtypes were then compared to baseline clinical and EMA variables, including emotions and urges to self-harm. @*Results@#The best-fitting model supported two subtypes: 1) substance abuse and suicide attempt subtype and 2) cutting and scratching subtype. The substance abuse and suicide attempt subtype reported a higher rate of engaging in lifetime suicide plans and suicide attempts and a higher number of lifetime suicide attempts. They also showed significantly higher severity of self-harm behavior, borderline personality traits, anger, posttraumatic symptoms, and difficulties in emotion regulation when compared to the cutting and scratching subtype. However, there was no inter-subtype difference in self-esteem. In the EMA data, anger toward others, feeling of rejection, loneliness, and helplessness were significantly high in the substance abuse and suicide attempt subtype. The variability of anger toward others was also higher in this subtype compared to the cutting and scratching subtype. Finally, in the two-week research period, the substance abuse and suicide attempt group showed a higher rate of reported urges to self-harm with or without suicidal intent. @*Conclusion@#Findings support the validity of the subtypes based on the forms of self-harm behavior, suggesting the clinical utility of addressing heterogeneity within individuals exhibiting self-harm for assessment and treatment.
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Objective@#The Emotion Regulation Questionnaire (ERQ) is one of the widely used instruments to assess emotion regulation skills in many countries, including Korea. However, its psychometric properties have not been validated within this population. Also, the ERQ has increasingly been used in studies with psychiatric patients despite a general lack of validation in clinical settings. Therefore, the present study aimed to investigate the psychometric properties of the Korean version of the ERQ (K-ERQ) using a clinical sample in Korea. @*Methods@#One hundred and ninety-three psychiatric patients completed a packet of self-report measures, including K-ERQ, K-BDI-II, K-ASI-3, PCL-5-K, AUDIT-K. Confirmatory factor analysis (CFA) was administered to investigate the factor structure of the K-ERQ, and internal reliability and validity were examined. @*Results@#Results of the CFA supported the two-factor structure, but only after the removal of one item. The K-ERQ showed good internal consistency reliability, and its concurrent validity was also confirmed. Cognitive reappraisal was negatively correlated with depression and alcohol use disorder-related symptoms, and expressive suppression was positively correlated with depression, anxiety sensitivity, posttraumatic stress disorder (PTSD)-related symptoms and alcohol use disorder-related symptoms. Significant group differences were found in the use of emotion regulation strategies; patients with PTSD reported the higher level of cognitive reappraisal than patients with depressive disorders, bipolar disorders, and attention-deficit hyperactivity disorder. @*Conclusion@#The 9-itemed K-ERQ is a reliable and valid tool to assess the emotion regulation strategies in a Korean clinical sample. Our study also adds preliminary evidence on the usefulness of the ERQ in clinical settings.
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Objective@#Limited data exist on non-suicidal self-injury (NSSI) and suicide attempts among psychiatric patients in Korea. In this study,we investigated the clinical characteristics of patients who engaged in NSSI and/or suicide attempts. @*Methods@#We performed a retrospective medical chart review of patients with NSSI and/or suicide attempts at the psychiatric departmentof a university medical center in Seoul between 2017 and 2019. According to their history, patients were allocated to one of threegroups: NSSI only, suicide attempts only and NSSI and suicide attempts group. Groups were compared based on sociodemographic characteristicsand psychological assessments. @*Results@#Overall, 80 patients with NSSI and/or suicide attempts were evaluated. Patients with NSSI and suicide attempts were more likelyto be female than the other two groups. Patients with NSSI and suicide attempts were more likely to suffer from Cluster B personality disorderthan the other groups. And patients with NSSI and suicide attempts scored significantly higher on novelty-seeking in TCI and RC8,RC9 in MMPI-2. @*Conclusion@#Patients with NSSI and/or suicide attempts were more likely to be female, younger, and showed higher levels of psychologicaldisturbances. These findings highlight the importance of early detection and intervention for patients with NSSI.Psychiatry Investig 2020;17(4):320-330
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BACKGROUND: Telomerase, a ribonucleoprotein enzyme capable of synthesizing telomeric repeats, attracts attention for its possible role in determining the replicative capacity of normal somatic cells, transformed cells, and cells of the germline lineage. Differently from normal somatic cells with no telomerase activity, normal lymphocytes has been reported to have telomerase activity comparable to that found in transformed cells during development and activation, which substantiate a role in supporting the capacity of lymphocytes for extensive clonal expansion. METHODS: Here, in order to define the telomerase regulation in murine T lymphocytes, telomerase activity in cloned murine CD8+ T cells and naive CD8+ T cells isolated from C57BL/6 mice was examined. Next, the regulatory mechanism of telomerase activity at transcriptional and post- translational levels was investigated by determining the expression level of the TERT protein, a key component for telomerase activity. RESULTS: It was demonstrated that telomerase activity was expressed in an inactivated state as well as in an activated state in the murine CD8+ T lymphocytes by using TRAP assay. The increase of telomerase activity was partially dependent on the net increase of TERT expression. Also, telomerase activity was decreased after treatment with protein kinase inhibitors, indicating that telomerase activation was prevented by inhibition of phosphorylation. CONCLUSION: Therefore, these results suggest that telomerase activity is constitutively expressed in the murine resting T lymphocytes and controlled by both transcriptional regulation and post-translational modifications.