Clinical and Psychological Characteristics of Young Men with Military Adaptation Issues Referred for a Psychiatric Evaluation in South Korea: Latent Profile Analysis of Minnesota Multiphasic Personality Inventory-2 and Temperament and Character Inventory

Objective@#To investigate clinical and psychological characteristics of young men referred for a psychiatric evaluation due to expected unsuitability for military service and identify their heterogeneous subgroups based on the profiles of MMPI-2 and TCI. @*Methods@#We conducted a latent profile analysis of 348 men using MMPI-2 and TCI and then a comparative analysis of four latent classes in relation to sociodemographic, clinical, and IQ variables. @*Results@#We identified four classes with distinct clinical and psychological features: Class 1 (nonclinical: n=68), Class 2 (internalized: n=129), Class 3 (externalized: n=60), Class 4 (confused: n=91). Class 1 showed no significant psychiatric symptoms and relatively adaptive temperament and characteristics. Class 2 showed relatively higher harm avoidance and introverted traits indicating vulnerability to internalizing disorder. Class 3 was related to higher novelty seeking, impulsivity, and bipolarity. Class 4 showed the most severe clinical symptoms including psychotic experiences with extremely unstable temperament and immature personality. In total, 50–70% participants reported clinically significant depression, anxiety, and suicidal idea. Participants showed lower processing speed index (M=85.9, SD=16.6) than the general population. @*Conclusion@#The results suggest that clinical conceptualization and therapeutic intervention considering distinctive features of young men with adaptive problems related to military service are needed.

The Relationship between Emotional Labor and Job Stress among Hospital Workers

BACKGROUND: We divided hospital workers into two groups according to whether one was an interpersonal service worker (ISW) or was not (non-ISW). We then explored differences between these groups in job stress and emotional labor type and investigated the mediating factors influencing their relationships. METHODS: Our participants included both ISW (n = 353) and non-ISW (n = 71) hospital workers. We administered the Korean Standard Occupational Stress Scale Short Form to measure job stress and the Emotional Labor Scale to indicate both emotional labor type and characteristics. We also administered the Beck Depression Inventory-II to indicate the mediating factors of depressive symptoms, the Beck Anxiety Inventory to indicate the mediating factors of anxiety, and the State Anger Subscale of the State-Trait Anger Expression inventory to indicate the mediating factors of anger. RESULTS: The ISW group showed more severe job stress than the non-ISW group over a significantly longer duration, with greater intensity, and with higher level of surface acting. The ISW group showed a significant positive correlation between surface acting and job stress and no significant correlation between deep acting and job stress. Parallel mediation analysis showed that for ISWs surface acting was directly related to increased job stress, indirectly related to depression, and unrelated to anxiety and anger. CONCLUSION: The ISW group displayed more surface acting and job stress in its emotional labor than the non-ISW group. In the ISW group, surface acting during emotional labor was positively correlated with job stress. Depression partially mediated their relationship.

A Survey for Mental Health of Children Whose Parents Have Psychiatric Disorders: A Preliminary Study for Mental Health Screening of High Risk Children

OBJECTIVES: This study aimed to evaluate the mental health status of the children of psychiatric patients in order to plan for the resources that may be necessary to help these children achieve their full potential. METHODS: Forty-eight children (age 9–18) whose parents were registered in 5 community mental health centers located in Seoul were recruited. Tests assessing 3 psychological domains were conducted: 1) cognition: Korean version of Learning Disability Evaluation Scale, Comprehensive Attention Test, 2) parent reported emotion and behavior: Korean Child Behavior Checklist, Korean attention-deficit hyperactivity disorder Rating Scale, and 3) self-reported emotion and behavior: Korean Beck's Depression Inventory-II/Children's Depression Inventory-II, Korean Youth Self Report). We defined the children as having a high risk of developing mental health problems if their test scores were over the cut-off levels in 2 or more of the 3 domains assessed. RESULTS: Twelve (25%) children were classified as having a high risk of developing mental health issues. 20 (41.6%) children scored above the cut-off in only one of the domains. CONCLUSION: Our results suggest that the children of psychiatric patients might be vulnerable to mental illness and need early prevention or interven-tions for the sake of their mental health.

A Case of Sarcoidosis Combined with Massive Ascites

Sarcoidosis is a multi-systemic granulomatous disease of unknown cause, which most commonly involves lung, skin, eye, liver and lymph nodes. Herein, we report a case of sarcoidosis presented with massive ascites. A 47-year-old male patient visited our hospital with symptoms of general weakness and weight loss from past 4 months. Abdomen computed tomography showed multiple lymphadenopathy and hepatosplenomegaly. Lymph node biopsy demonstrated non-caseating granulomas. After biopsy, development of massive uncontrolled ascites was noted. Liver biopsy showed non-cirrhotic hepatic and portal fibrosis and omental biopsy showed submesothelial diffuse fibrosis and focal chronic inflammation, which were suggestive of hepatic and peritoneal involvement in sarcoidosis. Ascites was controlled after subsequent treatment with corticosteroids and methotrexate.

Thrombosis after a Splenectomy in a Patient with Systemic Lupus Erythematosus-related Thrombocytopenia / 대한류마티스학회지

Systemic lupus erythematosus (SLE) is a multisystemic inflammatory autoimmune disease mediated by autoantibodies and immune complexes. In SLE, a splenectomy to control the thrombocytopenia does not increase the total risk of thrombosis, but tends to increase arterial events. We experienced a patient with lupus- anticoagulant positive SLE who developed a venous thrombosis after a splenectomy for the control of thrombocytopenia, which was a very rare case.

A Case of Systemic Lupus Erythematosus Presenting with Acute Pancreatitis / 대한류마티스학회지

Systemic lupus erythematosus (SLE) is a multisystem inflammatory disorder mediated by autoantibodies and immune complexes that exhibit a range of symptoms. Although thirty-five to forty percent of patients with SLE show signs or symptoms of gastrointestinal involvement, acute pancreatitis is an uncommon complication of SLE, and SLE presenting with acute pancreatitis is extremely rare. We report a case of a 28-year-old female SLE patient who initially presented with acute abdominal pain and elevated pancreatic enzyme levels. The patient was diagnosed clinically with acute pancreatitis and then with SLE after further investigations. Her condition improved after high dose steroid therapy.

A Case of Extensive Involvement of Lupus Enteritis, from Small Bowel to Rectum / 대한류마티스학회지

Systemic lupus erythematosus (SLE) is a multisystem ic inflammatory disorder mediated by autoantibodies and immune complexes that manifests with a variety of symptoms. Lupus enteritis is a serious complication of SLE and carries a high mortality rate, however the diagnosis is not easy for there are no specific clinical manifestations and laboratory findings. Lupus enteritis usually involves the mesenteric arteries causing ischemic changes of the small and large bowels, and yet rarely involves the rectum. Here, we report a case of a 26-year-old female lupus enteritis patient who presented with atypical abdominal pain. Early diagnosis was made by abdominal pelvic computed tomography (CT) scan, which showed extensive involvement of lupus enteritis from proximal small bowel to rectum. She recovered after being treated with high dose steroid therapy.

Combined effects of job strain, shift work and life style on the prevalence of sleep problems in middle aged men

BACKGROUND: There are a few studies on the effects of job strain on the prevalence of sleep problems in the foreign countries. In Korea, it has not been studied till now. In this article, the combined effects of job strain, shift work and some life style on the prevalence of sleep proplems were studied among workers in middle aged men. METHODS: 998 cases were chosen from 1109 men who visited health screening center from October to November, 1999. Sleep problems were categorized to insomnia, sleep deprivation, daytime sleepiness and snoring on the base of result of factor analysis of 11 questions. Job strain was measured by 11 questions which developed by Karasek and Theorell. All data set were analyzed using Chi square test and multiple logistic regression analysis. RESULTS: The 4 sleep proplems were analyzed by multiple logistic regression analysis in relation to job strain, shift work, occupation, obesity, sedentary life style, smoking, drinking. Insomnia was increased significantly from highest job strain group(Odds ratio (OR:2.02)) and non exercise group(OR:2.05). In these groups, daytime sleepiness was increased significantly(OR=1.92 in the highest job strain group, OR=1.72 in non exercise group). Sleep deprivation was increased in the highest job strain group(OR=2.18), managers & clerks(OR:1.67) and non exercise group(OR:1.78). Snoring was increased from BMI(Body mass index)> OR =25(OR=1.77), BMI> OR =27(OR=2.80) and non exercise group(OR:1.87). CONCLUSION: In the highest job strain group, insomnia, sleep deprivation and daytime sleepiness was increased significantly. And sedentary life style increased all sleep problems.

CT Findings of Perihepatic Tuberculous Abscess

PURPOSE: To evaluate the CT findings of perihepatic tuberculous abscesses. MATERIALS AND METHODS: The CT scans of 11 patients (6 females and 5 males) with 14 pathologically proven perihepatic tuberculous abscess were retrospectively evaluated in terms of the morphological characteristics of the abscesses and changes in other abdominal organs and at other sites. RESULTS: A total of 14 absceses were noted in 11 patients. Six (43%) were in the right subphrenic space, three(21%) in the right perihepatic space, three (21 %) in the left subphrenic space, and two (14%) in the left perihepatic space. The right side was predominant. The abscesses ranged in size from 1 to 10 (mean, 5) cm in diameter, with a wall thickness of 2 - 7 (mean, 3) mm. Of the 14 abscesses, 13 were oval, and one spherical. CT findings were as follows: a smooth abscess margin with even wall thickness in seven of the eleven patients (64%); calcification of the wall in two (18%) ; internal septa in seven (64 %) ; localized fluid collection in nine (82%) ; lymphadenopathy in five (45 %) ; and peritoneal enhancement in seven (64%). Lesions suggesting tuberculous infection coexisted at other sites in eight patients. These included the lung in six patients (55%) , the neck in three (27 %), an axilla in two (18 %), the liver in two (18 %), the spleen in one (9 %), and the gastroin-testinal tract in one (9%). CONCLUSION: CT scanning is useful for establishing the diagnosis of perihepatic tuberculous abscesses by evaluating the morphological characteristics of the mass and by observing changes in other abdominal organs and at other sites.

Clinical and Mammographic Findings of Primary Lymphoma of the Breast

PURPOSE: To determine the clinical and mammographic characteristics of primary lymphoma of the breast. MATERIALS AND METHODS: The clinical and mammographic records of five patients (six breasts; bilateral involvement in one patient) with histologically-proven lymphoma of the breast were retrospectively reviewed. RESULTS: All patients had complained of a palpable tender mass with relatively rapid growth over a period of about 3 months. In five cases, the mass was located in the right breast and in one case in the left. Mammography revealed diffuse increased opacity of the entire breast in three cases, a homogeneous well-defined mass in one, multiple well-defined masses in one, and ill-defined lobulated opacity in one. Skin thickening and architectural distortion was seen in one case, and axillary lymphadenopathy in two. In no case was microcalcification and nipple retraction seen. CONCLUSION: In primary breast lymphoma, mammographic finding are non-specific. When a breast grows rapidly and is tender, however, and mammography shows a relatively large well defined mass and associated axillary lymphadenoapathy, the possibility of primary lymphoma should be considered.

The Role of MR Imaging in Determination of Atrial Situs in Congenital Heart Disease with Situs Ambiguus

PURPOSE: to assess the role of MR imaging in determining of the atrial situs in complicated congenital heart disease with situs ambiguus. MATERIALS AND METHODS: In order to classify the situs, the morphology of atrial appendages, on bronchial length ratio, the superior-inferior relation of the pulmonary artery (PA) and main bronchi on each side, and splenic abnormality were evaluated by MR imaging in 22 patients (12 boys and 10 girls), and the results were compared. RESULTS: In all patients, the superior-inferior relation of the PA and main bronchi tended to lateralize, and in one, bronchial length ratio was not consistent with the relation between the PA and bronchus. Bronchial and atrial situs, as determined by appendage morphology, were consistent in ten of 13 right isomerism patients, and in only three of nine of these with left isomerism. All 13 right isomerism patients, classified by the relation of the PA and main bronchi, showed asplenia, whereas eight of nine of these with left isomerism had polysplenia. CONCLUSION: In the assessment of atrial situs by MR imaging, the positional relation of a bronchus and the PA, bronchial length ratio, and splenic abnormality are constant and reliable. The accuracy of classification of situs on the basis of atrial appendage morphology is, however, limited.