The Korean Prediction Model for Adolescents' Future Smoking Intentions / 예방의학회지

OBJECTIVES: The purpose of this study was to develop a prediction model for future smoking intention among Korean adolescents aged 13 to 15 in order to identify the high risk group exposed to future smoking. METHODS: The data was collected from a total of 5940 students who participated in a self-administrated questionnaire of a cross-sectional school-based survey, the 2004 Korea Global Youth Tobacco Survey. Chi-square tests and logistic regression analyses were carried out to identify the relevant determinants associated with intentions of adolescents' future smoking. Receiver Operation Characteristic (ROC) assessment was applied to evaluate the explanation level of the developed prediction model. RESULTS: 8.4% of male and 7.2% of female participants show their intentions of future smoking. Among non-smoking adolescents; who have past smoking experience [odds ratio (OR) 2.73; 95% confidence interval (CI) 1.92 - 3.88]; who have intentions of smoking when close friends offer a cigarette (OR 31.47; 95% CI = 21.50 - 46.05); and who have friends that are mostly smokers (OR 5.27; 95% CI = 2.85 - 9.74) are more likely to be smokers in the future. The prediction model developed from this study consists of five determinants; past smoking experience; parents smoking status; friends smoking status; ownership of a product with a cigarette brand logo; and intentions of smoking from close friends' cigarette offer. The area under the ROC curve was 0.8744 (95% CI=0.85 - 0.90) for current non-smokers. CONCLUSIONS: For efficiency, school-based smoking prevention programs need to be designed to target the high risk group exposed to future smoking through the prediction model developed by the study, instead of implementing the programs for all the students.

Smoking-Attributable Mortality Among Korean Adults: 1981-2003 / 한국역학회지

OBJECTIVES: Cigarette smoking has been widely recognized as a major risk factor for lung cancer and other diseases in Western countries. In Korea, male cigarette smoking prevalence is among the world's highest and smoking has also become a strong risk factor for lung cancer and cardiovascular diseases. The objectives of the study were to calculate the smoking-attributable mortality in Korea and to predict future smoking-attributable mortality based on the observed data. METHODS: Number of smoking-attributable deaths were calculated by applying the percentages of population attributable risks (PARs) to the estimated number of deaths by diseases. In this study, PARs were obtained by using relative risks from Korean Cancer Prevention Study and population smoking prevalence. RESULTS: Among adult male, the smoking-attributable mortality (40,087) represents 30.75% of total 2003 mortality, whereas the smoking-attributable mortality (6,120) for adult females was 5.70%. Smoking was supposed to be responsible for 37.29% of all male cancer and 26.73% of all male cardiovascular diseases, whereas smoking for 4.68% of all female cancer and 5.93% of all female cardiovascular diseases in Korea. CONCLUSION: Smoking actually represents a remarkable burden of avoidable deaths in Korea. Smoking-attributable mortality appears to continue increasing in the last years.

The Effect of Bundling on Neonatal Body Temperature

PURPOSE: Fever in newborn might be an indicator of serious bacterial infection. Differentiating environmental from disease-related temperature elevations in newborn is clinically important, because neonate with environment-related temperature elevation might be subjected to an unnecessary work-up to detect occult disease. But there are exists no consistent conclusions about environmental effect in previous literatures. We prospectively evaluated the effect of bundling on body temperature. METHODS: Twenty-five well, full-term newborns within 1 week old were assigned to the control group (one blanket) or to the study group (five blankets and hat). Rectal and axillary temperatures and arousal states were measured at 15-minute interval for 2 hours. RESULTS: There were 13 control and 12 study newborns. The mean axillary temperature of contol group increased by 0.21 degrees C; mean rectal temperature increased by 0.23 degrees C. The mean axillary temperature of study group increased by 0.63degrees C; mean rectal temperature increased by 0.56 degrees C. Comparing study newborns to controls, there were significant rises in both axillary temperature and rectal temperature. One newborn of the study group reached 38.3 degrees C in rectal temperature. CONCLUSION: Bundling can cause significant elevations in axillary and rectal temperature in newborn within 1 week old. Therefore, physicians treating neonates with elevated temperature should question whether to use bundling to differentiate endogenous from exogenous causes.

The Effect of Subarachnoid Block in Hyperreflexic Neurogenic Bladder / 대한마취과학회지

Spinal reflex activity that remains after insult to the spinal cord brings with it significant functional impairment. Our patient had suffered from general spasticity and hyperreflexic neurogenic bladder caused by sixth cervical cord injury. Unfortunately, the use of oral medication (baclofen) was limited by an inadequate effect. So we performed two times of subarachnoid block with 0.5% heavy bupivacaine, the patient experienced improvement in bladder and sphincter function. We concluded that subarachnoid block with 0.5% heavy bupivacaine is an effective and safe modality for spasticity control in patients who are refractory to oral medication before neurolytic block.