Novel Methods for Clinical Risk Stratification in Patients with Colorectal Liver Metastases / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: Colorectal cancer patients with liver-confined metastases are classified as stage IV, but their prognoses can differ from metastases at other sites. In this study, we suggest a novel method for risk stratification using clinically effective factors. MATERIALS AND METHODS: Data on 566 consecutive patients with colorectal liver metastasis (CLM) between 1989 and 2010 were analyzed. This analysis was based on principal component analysis (PCA). RESULTS: The survival rate was affected by carcinoembryonic antigen (CEA) level (p < 0.001; risk ratio, 1.90), distribution of liver metastasis (p=0.014; risk ratio, 1.46), and disease-free interval (DFI; p < 0.001; risk ratio, 1.98). When patients were divided into three groups according to PCA score using significantly affected factors, they showed significantly different survival patterns (p < 0.001). CONCLUSION: The PCA scoring system based on CEA level, distribution of liver metastasis, and DFI may be useful for preoperatively determining prognoses in order to assist in clinical decisionmaking and designing future clinical trials for CLM treatment.

Focal Liver Lesion Detection in Gadoxetic Acid-enhanced Liver MRI: Effects of Scan Delay, Hepatic Function, and Magnetic Field Strength

PURPOSE: To determine the effects of scan delay, hepatic function, and magnetic field strength on the performance of gadoxetic acid enhanced magnetic resonance imaging. MATERIALS AND METHODS: Gadoxetic acid enhanced MRI conducted in 72 patients with 10 minutes and 20 minutes delay were reviewed retrospectively. For quantitative analysis, liver-to-lesion signal difference ratio (SDR) was measured and compared according to scan delay time, hepatic function and magnetic field strength. For qualitative analysis, two board-certificated radiologists reviewed 10-minute delay and 20-minute delay images. The sensitivity and specificity of each reader was compared. RESULTS: The SDR of 20-minute images in non-cirrhotic patients was significantly higher (p 0.05) to 10-min delay images. In comparisons according to the magnetic strength, there was no significant difference between 1.5-T and 3.0-T systems. Comparisons of ROC curves showed no statistically significant differences in sensitivity and specificity between 10-minute and 20-minute delay images. CONCLUSION: An increase in the liver-to-lesion signal difference ratio was dependent on the patients' hepatic function but not dependent on the magnetic strength. There was no significant difference in sensitivity or specificity between the 10-minute and 20-minute delay images.

A Validation Study of the Korean-version of Symmetry, Ordering and Arranging Questionnaire / 신경정신의학

OBJECTIVES: The Symmetry, Ordering and Arranging Questionnaire (SOAQ) has been reported as a valid tool for the assessment of symmetry, ordering and arranging compulsive behaviors of patients with obsessive compulsive disorder. It was introduced by Radomsky and Rachman in 2004. The aim of this study was to assess the reliability, validity and psychometric properties of the Korean-version of the SOAQ (K-SOAQ). METHODS: Two hundreds twenty eight under-graduate college students were enrolled in this study. They were assessed with K-SOAQ, Obsessive-Compulsive Inventory-Revised (OCI-R), Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI). Statistical analysis was done using calculation of Cronbach's alpha, Spearman Correlation Coefficient and Principal Components Analysis. RESULTS: There were no significant differences in sex, education, and total scores of BDI and BAI. The Cronbach's alpha coefficient of K-SOAQ was high, Cronbach's alpha=0.96. There was strong evidence for a one-factor solution, accounting for 60.3% of the variance. Convergent validity was examined through correlations between the SOAQ and the OCI-R (r=0.61). Divergent validity was examined through correlations between the SOAQ and two self report measures; BDI (r=0.12) and BAI (r=0.19). CONCLUSION: The K-SOAQ showed good reliability and validity for the assessment of severity of compulsive characteristics regarding symmetry, ordering and arranging. The K-SOAQ is a useful instrument for assessing compulsive symptoms related with symmetry, ordering and arranging in Korea.

Boundary of Anxiety Disorders: Obsessive-Compulsive Disorder and Schizophrenia / 신경정신의학

Although obsessive-compulsive disorder (OCD) is recognized as a major psychiatric illness, few studies have investigated obsessive-compulsive symptoms in patients with schizophrenia. Recent increases in dual diagnosis due to changes to the DSMIV diagnostic criteria, findings of obsessive-compulsive symptoms (OCS) after administration of atypical antipsychotics, increased reports of co-occurrence of schizophrenia and OCD have increased the interest in OCS in schizophrenia. The incidence of OCS in patients with schizophrenia is reported to be 3-59%; however, the rate of progression to schizophrenia from OCD is not higher than in the general population. Level of insight, which differentiates obsessions from delusions, can be confounded by the specifier 'with poor insight' in OCD. OCD with schizotypal personality disorder or poor insight differs from pure OCD in that it responds poorly to treatment, has a poor prognosis, leads to deficits in cognitive functioning similar to those observed in schizophrenia, and responds well to low-dose antipsychotics. In the past, it was believed that OCS could prevent or delay the deteriorative course of schizophrenia. However, recent studies have shown that co-occurrence of OCD and schizophrenia increases the severity of symptoms, delays the treatment response, and reduces socio-occupational functions. Schizophrenia and OCD share the same pathophysiology in that both diseases have defects in the fronto-basal functional circuitry of the brain. The use of serotonin and dopamine has been addressed in schizophrenia due to the use of atypical antipsychotics in patients with schizophrenia. The finding of drug-induced OCS suggested that the two diseases share a similar pathogenesis involving neurotransmitters. Further studies are needed to make an exact diagnosis between the two diseases and to determine the common pathophysiology between OCD and schizophrenia.

Reliability and Validity of the Korean Version of Obsessive-Compulsive Inventory-Revised in a Non-clinical Sample

PURPOSE: The reliability and validity of a Korean version of the Obsessive-Compulsive-Inventory-Revised (OCI-R) was examined in non-clinical student samples. MATERIALS AND METHODS: The Korean version of OCI-R was administered to a total of 228 Korean college students. The Maudsley Obsessive Compulsive Inventory (MOCI), Beck's Depression Inventory (BDI), and Beck's Anxiety Inventory (BAI) were administered to 228 students. RESULTS: The total and each of subscale of the Korean OCI-R demonstrated excellent internal consistency, good test-retest reliability, moderate convergent validity and good divergent validity. CONCLUSION: It was concluded that the Korean version of the OCI-R has strong psychometric properties as the original version.