Association Among Self-Injury, Suicidal Tendency, and Personality and Psychological Characteristics in Korean Adolescents

Objective@#To compare mental health problems and personality characteristics between adolescents with self-injury (SI) and suicidal tendency (ST), including suicidal ideation and suicide planning. @*Methods@#The participants completed the Adolescent Personality and Mental Health Problems Screening Questionnaire, Third version (AMPQ-III), and Korean version of the Strengths and Difficulties Questionnaire (SDQ-Kr), and gave their demographic information. Based on the answered SI and ST items in AMPQ-III, the participants were divided into groups: without SI and ST, with SI and without ST, without SI and with ST, and with SI and ST. Analysis of variance (ANOVA) and post-hoc Scheffe test were used to determine group differences, stepwise multiple linear regression, and factors associated with SI and ST. @*Results@#ANOVA yielded results for all categories of mental health problems. Significant differences were observed between the four groups. Conversely, for personality characteristics, only the sense of community item between the group without SI and with ST and the group without SI and ST were significantly different; sense of community was associated with ST (β=-0.054, p=0.005). Among the mental health subscales, SI was significantly associated with conduct problems (β=0.211, p<0.001), emotional problems (β=0.173, p<0.001), peer problems (β=0.085, p<0.001), and prosocial behavior (β=0.073, p<0.001). ST was significantly associated with emotional symptoms (β=0.317, p<0.001), peer problems (β=0.130, p<0.001), conduct problems (β=0.106, p<0.001), hyperactivity (β=0.050, p=0.010), and prosocial behavior (β=0.062, p<0.001). @*Conclusion@#The findings highlight the necessity of assessing psychological strength, difficulties, and personality characteristics for the prevention and early intervention of adolescent SI.

Trends in the prevalence and management of major metabolic risk factors for chronic disease over 20 years: findings from the 1998-2018 Korea National Health and Nutrition Examination Survey / 한국역학회지

OBJECTIVES@#We aimed to explore trends in the prevalence and management of obesity, hypertension, diabetes, and hypercholesterolemia in Korean adults from 1998 to 2018 using data from the Korea National Health and Nutrition Examination Survey (KNHANES). @*METHODS@#The study participants included 79,753 individuals aged ≥ 30 years who had participated in the health examination and health interview of the first (1998) to the seventh (2016-2018) KNHANES. The prevalence and management as well as annual percent change (APC) in chronic diseases were analyzed using SAS and the Joinpoint software program. @*RESULTS@#The prevalence of obesity in men significantly increased from 26.8% in 1998 to 44.7% in 2018 (APC= 1.9, p< 0.001), whereas that in women decreased slightly from 30.5% in 1998 to 28.3% in 2018 (APC= -0.5, p< 0.001). The prevalence of hypertension in men was 33.2% in 2018, with no significant change, whereas that in women slightly decreased to 23.1% in 2018 (APC= -0.9, p< 0.001). The prevalence of diabetes in men increased slightly from 10.5% in 2005 to 12.9% in 2018 (APC= 1.6, p< 0.001), whereas that in women remained at approximately 8%, with no significant change. The prevalence of hypercholesterolemia in both men and women increased 3-fold in 2018 (20.9% in men [APC = 8.2, p < 0.001] and 21.4% in women [APC= 7.1, p< 0.001]) compared to that in 2005. The awareness rate, treatment rate, and control rate of hypertension and hypercholesterolemia increased 2-3 fold. Regarding diabetes, the treatment rate increased, but the control rate did not change. @*CONCLUSIONS@#Over the past 20 years, the prevalence of obesity (in men), diabetes, and hypercholesterolemia has increased and management indicators, such as the awareness rate, treatment rate, and control rate of chronic diseases, have improved continuously.

Trends in the prevalence and management of major metabolic risk factors for chronic disease over 20 years: findings from the 1998-2018 Korea National Health and Nutrition Examination Survey / 한국역학회지

OBJECTIVES@#We aimed to explore trends in the prevalence and management of obesity, hypertension, diabetes, and hypercholesterolemia in Korean adults from 1998 to 2018 using data from the Korea National Health and Nutrition Examination Survey (KNHANES). @*METHODS@#The study participants included 79,753 individuals aged ≥ 30 years who had participated in the health examination and health interview of the first (1998) to the seventh (2016-2018) KNHANES. The prevalence and management as well as annual percent change (APC) in chronic diseases were analyzed using SAS and the Joinpoint software program. @*RESULTS@#The prevalence of obesity in men significantly increased from 26.8% in 1998 to 44.7% in 2018 (APC= 1.9, p< 0.001), whereas that in women decreased slightly from 30.5% in 1998 to 28.3% in 2018 (APC= -0.5, p< 0.001). The prevalence of hypertension in men was 33.2% in 2018, with no significant change, whereas that in women slightly decreased to 23.1% in 2018 (APC= -0.9, p< 0.001). The prevalence of diabetes in men increased slightly from 10.5% in 2005 to 12.9% in 2018 (APC= 1.6, p< 0.001), whereas that in women remained at approximately 8%, with no significant change. The prevalence of hypercholesterolemia in both men and women increased 3-fold in 2018 (20.9% in men [APC = 8.2, p < 0.001] and 21.4% in women [APC= 7.1, p< 0.001]) compared to that in 2005. The awareness rate, treatment rate, and control rate of hypertension and hypercholesterolemia increased 2-3 fold. Regarding diabetes, the treatment rate increased, but the control rate did not change. @*CONCLUSIONS@#Over the past 20 years, the prevalence of obesity (in men), diabetes, and hypercholesterolemia has increased and management indicators, such as the awareness rate, treatment rate, and control rate of chronic diseases, have improved continuously.

Role of risk-rescue rating scale and inflammatory biomarkers in determining the disposition of suicide attempters at the emergency department

Objective@#This study aimed to identify the utility of risk-rescue rating scale (RRRS), a psychological scale, and certain biomarkers in determining the disposition of patients visiting the emergency department (ED) after their suicide attempts. @*Methods@#We retrospectively reviewed the medical records of patients who visited the ED after attempting suicide. The patients were classified into three groups for comparison: the discharged (DC) group, the general ward (GW) admission group, and the intensive care unit (ICU) admission group. @*Results@#This study included 454 patients, with 344 patients in the DC group (75.8%), 63 patients in the GW admission group (13.9%), and 47 patients in the ICU admission group (10.3%). The three groups showed statistically significant differences in age, time of visit, physical status, presumptive diagnosis, the RRRS, mental status, C-reactive protein, neutrophil-lymphocyte ratio (NLR), and systemic immune inflammation index. Multivariate logistic regression analysis showed that predictors of the GW admission included the time of visit, mental status, and the RRRS. A receiver operating characteristic curve analysis of RRRS for the decision to admit to GW and ICU showed a cut-off value of 36.5 and 44.5, respectively. However, no inflammatory biomarkers were identified as factors predicting GW and ICU admissions. @*Conclusion@#The RRRS is useful in determining the disposition of patients who visited the ED after suicide attempts.

Role of risk-rescue rating scale and inflammatory biomarkers in determining the disposition of suicide attempters at the emergency department

Objective@#This study aimed to identify the utility of risk-rescue rating scale (RRRS), a psychological scale, and certain biomarkers in determining the disposition of patients visiting the emergency department (ED) after their suicide attempts. @*Methods@#We retrospectively reviewed the medical records of patients who visited the ED after attempting suicide. The patients were classified into three groups for comparison: the discharged (DC) group, the general ward (GW) admission group, and the intensive care unit (ICU) admission group. @*Results@#This study included 454 patients, with 344 patients in the DC group (75.8%), 63 patients in the GW admission group (13.9%), and 47 patients in the ICU admission group (10.3%). The three groups showed statistically significant differences in age, time of visit, physical status, presumptive diagnosis, the RRRS, mental status, C-reactive protein, neutrophil-lymphocyte ratio (NLR), and systemic immune inflammation index. Multivariate logistic regression analysis showed that predictors of the GW admission included the time of visit, mental status, and the RRRS. A receiver operating characteristic curve analysis of RRRS for the decision to admit to GW and ICU showed a cut-off value of 36.5 and 44.5, respectively. However, no inflammatory biomarkers were identified as factors predicting GW and ICU admissions. @*Conclusion@#The RRRS is useful in determining the disposition of patients who visited the ED after suicide attempts.

Usefulness of a saline chaser to reduce contrast material dose in abdominal CT of normal dogs

Use of a saline chaser has been reported to allow reduction of contrast dose and artifacts during computed tomography (CT) examination in humans. This study assesses the extent of contrast dose by using a saline chaser in abdominal CT scans of normal dogs. Five beagles underwent abdominal CT scans. Three protocols were applied: 600 mg I/kg iohexol without saline chaser (protocol 1), 30% lower dose of iohexol (420 mg I/kg) followed by a 10 mL saline chaser (protocol 2), and 40% lower dose of iohexol (360 mg I/kg) followed by a 10 mL saline chaser (protocol 3). Attenuation values were obtained from aorta, portal vein, and liver parenchyma. The maximum enhancement values (MEVs) in protocol 2 were significantly higher than those in protocols 1 and 3 in the aorta; no difference was seen in the portal vein in all protocols. The liver parenchymal MEVs in protocols 1 and 2 were significantly higher than those obtained in protocol 3. In this study, the use of a saline chaser and a reduced dose of contrast material did not affect vessel enhancement. In conclusion, use of a saline chaser for abdominal CT of dogs is recommended because it allows a 30% reduction of contrast dose without decreasing vascular and hepatic parenchymal enhancement.

Factors associated with Behaviors that Reduce Exposure to Environmental Hormones among Nursing Students / 산업간호학회지

PURPOSE: This study aimed to examine the factors associated with behavior that reduces exposure to environmental hormones among nursing students.METHODS: Data were collected from 160 nursing students in D and B cities, using self-report questionnaires. Data were analyzed using SPSS 22.0, and the analyses included descriptive statistics, t-test, ANOVA, Pearson's correlation coefficient test, and stepwise multiple regression.RESULTS: Behavior that reduces exposure to environmental hormones differed significantly in terms of the participants' knowledge about environmental hormones. Behavior that reduces exposure to environmental hormones was negatively correlated with knowledge of environmental hormones, attitude towards pro-environmental behavior, and environmental self-efficacy; these factors were significant predictors of behavior that reduces exposure to environmental hormones, and accounted for 27.0% of the variance.CONCLUSION: Environmental self-efficacy was identified as the most significant factor affecting behavior that reduces exposure to environmental hormones in nursing students. Therefore, it is necessary to develop programs to improve pro-environmental behavior and environmental self-efficacy in nursing students.

Factors associated with Behaviors that Reduce Exposure to Environmental Hormones among Nursing Students / 한국직업건강간호학회지

PURPOSE@#This study aimed to examine the factors associated with behavior that reduces exposure to environmental hormones among nursing students.@*METHODS@#Data were collected from 160 nursing students in D and B cities, using self-report questionnaires. Data were analyzed using SPSS 22.0, and the analyses included descriptive statistics, t-test, ANOVA, Pearson's correlation coefficient test, and stepwise multiple regression.@*RESULTS@#Behavior that reduces exposure to environmental hormones differed significantly in terms of the participants' knowledge about environmental hormones. Behavior that reduces exposure to environmental hormones was negatively correlated with knowledge of environmental hormones, attitude towards pro-environmental behavior, and environmental self-efficacy; these factors were significant predictors of behavior that reduces exposure to environmental hormones, and accounted for 27.0% of the variance.@*CONCLUSION@#Environmental self-efficacy was identified as the most significant factor affecting behavior that reduces exposure to environmental hormones in nursing students. Therefore, it is necessary to develop programs to improve pro-environmental behavior and environmental self-efficacy in nursing students.

Factors Influencing on the Happiness in Community-dwelling Older Adults in Korea / 재활간호학회지

PURPOSE: The purpose of this study was to investigate the influencing factors on the happiness of community-dwelling older adults in Korea. METHODS: A convenience sample of older adults (N=191) who did not enrolled in any specific exercise programs participated in this cross-sectional correlational study. The data were collected from July to August, 2017. Participants were asked to respond to fill questionnaires including depression, physical activity, and happiness. Physical activity was classified according to physical activity scores(inactivity, minimally activity, health enhancing physical activity). Data were analyzed with descriptive statistics, independent t-test, χ² test, one-way analysis of variance (ANOVA) and hierarchical multiple regression with SPSS (ver. 24.0). RESULTS: The influencing factors on happiness were depression (β=−.64, p < .001), physical activities (minimally activity=1; β=−.15, p=.014), and religion (have=1; β=.10, p=.029). Hierarchical multiple regression analysis showed that the determinant variables accounted for 58% of the variation in the happiness (F=53.37, p < .001). CONCLUSION: These findings indicate that depression, physical activity and subjective health status influence the happiness of older adults who did not involved in any exercise program. Effective healthcare programs for managing depression and increasing the level of physical activity could increase the level of happiness among older adults.

Meal skipping habits and nutritional status among Ghanaian students living in Korea / 한국영양학회지

PURPOSE: The consistent rise in the number of foreign students in Korea demands an accurate and detailed investigation into their dietary practices and nutritional status. For these international students, assimilation into new cultures can be stressful. The influence this process may have on dietary behaviors as well as overall health cannot be overlooked. METHODS: The researchers in this study sought to investigate the nutritional status and dietary practices of Ghanaian students studying in Korea. A total of 81 Ghanaian male students with an average age of 29.4 ± 4.0 years were sampled between May and June 2016. Investigations were carried out on the general characteristics of the participants, their daily food and nutrient intakes using a 24-h dietary recall method, meal skipping practices, and the nutritional quality of their diets based on their meal skipping habits. RESULTS: The study revealed that the daily nutrient intake of subjects did not fully meet the daily recommended nutrient intake (RNI) established by Ghanaian Ministry of Health and the World Health Organization (WHO) and Food and Agriculture Organization (FAO), particularly for energy, calcium, iron, zinc, and vitamin B2 requirements. The Nutrient Adequacy Ratio (NAR) for calcium was very low, posing a deficiency risk to the participants. Meal skipping practices among participants changed significantly after arriving in Korea. The study also compared the diet quality indicators (Nutrient Adequacy Ratio and Mean Adequacy Ratio) of those who skipped meals ≥ 7 times/week with those who skipped meals < 7 times/week. Participants who skipped meals ≥ 7 times/week were shown to have lower dietary intakes of vitamins B1 and B2 than those who skipped meals < 7 times/week. CONCLUSION: Ultimately, the study found that meal skipping among Ghanaian students was common, and their daily nutrient intakes did not meet the set dietary standards. Those who skipped meals ≥ 7 times/week had lower dietary intakes of vitamins B1 and B2 than those who skipped meals < 7 times/week. Based on our study findings, we recommend that nutrition education should be organized for the Ghanaian student community in Korea using our results as a template to draw up a nutrition program that is culturally appropriate.

Thyroid Stimulating Hormone Reference Range and Prevalence of Thyroid Dysfunction in the Korean Population: Korea National Health and Nutrition Examination Survey 2013 to 2015

BACKGROUND: No nationwide epidemiological study evaluating the prevalence of subclinical and overt forms of hypothyroidism and hyperthyroidism has yet been conducted in Korea. This study aimed to evaluate the reference range of serum thyroid stimulating hormone (TSH) and the national prevalence of thyroid dysfunctions in Korea. METHODS: Nation-wide cross-sectional data were analyzed from a representative sample of the civilian, non-institutionalized Korean population (n=6,564) who underwent blood testing for thyroid function and anti-thyroid peroxidase antibody (TPOAb) as part of the Korea National Health and Nutrition Examination Survey VI (2013 to 2015). RESULTS: The reference interval of serum TSH in the Korean reference population was 0.62 to 6.68 mIU/L. Based on this reference interval, the prevalence of overt and subclinical hypothyroidism was 0.73% (males 0.40%, females 1.10%) and 3.10% (males 2.26%, females 4.04%), respectively. The prevalence of hypothyroidism increased with age until the age group between 50 to 59 years. Positive TPOAb were found in 7.30% of subjects (males 4.33%, females 10.62%). The prevalence of overt and subclinical hypothyroidism TPOAb-positive subjects was 5.16% and 10.88%, respectively. The prevalence of overt and subclinical hyperthyroidism was 0.54% (males 0.30%, females 0.81%) and 2.98% (males 2.43%, females, 3.59%), respectively. CONCLUSION: The Serum TSH reference levels in the Korean population were higher than the corresponding levels in Western countries. Differences were found in the prevalence of hypothyroidism and hyperthyroidism according to age, sex, and TPOAb positivity. This study provides important baseline information for understanding patterns of thyroid dysfunction and diseases in Korea.

Spinal Cord Compression Due to Mediastinal Extramedullary Plasmacytoma

Extramedullary plasmacytoma (EMP) is a common plasma cell tumor often involving the upper aerodigestive tract. Although extremely rare, mediastinal involvement is possible. An 81-year-old man was presented to our emergency department with chest and back pain with weakness in both legs. Chest X-ray showed a large mass in the upper right mediastinum; subsequently, computed tomography and magnetic resonance imaging evaluated the mass. He was diagnosed with mediastinal EMP, which progressed to spinal cord compression. The patient was treated with radiotherapy and chemotherapy. Spinal cord compression, due to metastatic tumor, is an emergency clinical situation that requires prompt diagnosis and treatment. Emergency medicine physicians should be aware of the clinical presentation and complications associated with EMP.

Isolated cystic duct cyst with associated stones in a 4-month-old boy

Isolated cystic duct cysts are rare entities, with few cases having been reported. We present the case of a 4-month-old male patient presenting with abdominal pain and vomiting. Ultrasonography and magnetic resonance cholangiopancreatography revealed an isolated cystic duct cyst with associated stones. The patient underwent open cholecystectomy with complete cyst excision and cystic duct transection; there were no postoperative complications. While lesions like the one described herein are extremely rare, they should be included as a separate category in classifications of choledochal cysts.

Time-course changes in the expression levels of miR-122, -155, and -21 as markers of liver cell damage, inflammation, and regeneration in acetaminophen-induced liver injury in rats

Drug-induced liver injury (DILI) is a significant threat to patient health and a major concern during drug development. Recently, multiple circulating microRNAs (miRNAs) have been reported to be potential biomarkers for DILI. To adapt and validate miRNAs for clinical use, we investigated the time-course changes in miR-122 expression levels in an acetaminophen-induced liver injury model in rats. In addition, miR-155 and miR-21 were evaluated as makers of inflammation and regeneration, respectively, to characterize liver status. Our results revealed that miR-122 is an early and sensitive biomarker of hepatocellular injury at a stage when alanine transaminase, aspartate transaminase, and total bilirubin were not detectable. However, no significant differences in the expression levels of other miRNAs (miR-155 and -21) were observed between treatment and vehicle groups. Collectively, these time-course changes in the expression levels of miRNAs may be useful as markers for clinical decision-making, in the diagnosis and treatment of DILI.

Experiences of Nursing College Students attended to Delivery Practice at Midwifery Clinic

PURPOSE: The purpose of this study was to explore the experiences of nursing college students who attended delivery practices at midwifery clinic. METHODS: This was a qualitative study using focus groups. Data were collected by group interviews with a total of 12 students who observed natural childbirth at midwifery clinic. Data were analyzed through Colaizzi's method in which meaningful statements were extracted. RESULTS: The meanings of experiences were identified five theme clusters from thirteen themes and thirty-one sub-themes. The five theme clusters were 'ultimate process of natural childbirth', 'allowed birth', 'role recognition of the midwife', 'positively changed perception', and 'barriers'. CONCLUSION: This study showed that observation of delivery at midwifery clinic was helpful for nursing students in terms of positive impression about natural childbirth with maternal and baby being centered. Nursing students expressed value and concern about delivery at midwifery clinic. Further in-depth study of natural childbirth in terms of husband and family perspective is required. For quality improvement of maternity nursing care, natural childbirth process needs to be included in nursing care at hospitals as well as students' clinical practicum.

Skin corrosion and irritation test of sunscreen nanoparticles using reconstructed 3D human skin model

OBJECTIVES: Effects of nanoparticles including zinc oxide nanoparticles, titanium oxide nanoparticles, and their mixtures on skin corrosion and irritation were investigated by using in vitro 3D human skin models (KeraSkin(TM)) and the results were compared to those of an in vivo animal test. METHODS: Skin models were incubated with nanoparticles for a definite time period and cell viability was measured by the 3-(4, 5-dimethylthiazol-2-yl)-2.5-diphenyltetrazolium bromide method. Skin corrosion and irritation were identified by the decreased viability based on the pre-determined threshold. RESULTS: Cell viability after exposure to nanomaterial was not decreased to the pre-determined threshold level, which was 15% after 60 minutes exposure in corrosion test and 50% after 45 minutes exposure in the irritation test. IL-1alpha release and histopathological findings support the results of cell viability test. In vivo test using rabbits also showed non-corrosive and non-irritant results. CONCLUSIONS: The findings provide the evidence that zinc oxide nanoparticles, titanium oxide nanoparticles and their mixture are 'non corrosive' and 'non-irritant' to the human skin by a globally harmonized classification system. In vivo test using animals can be replaced by an alternative in vitro test.

Dislodgement of Two Stents in One Patient during Percutaneous Coronary Intervention

Coronary stent loss is a rare but serious complication during interventional cardiology. This complication occurs not only in the intracoronary area but also in the extracoronary area, such as the aortic root or the left ventricle. An 83-year-old man with stable angina had a stent inserted into a heavy calcific left anterior descending artery. The stent was lost twice during the procedure. The first stent was dislodged from the left main coronary artery to the proximal left anterior descending artery, and the second stent migrated to the aortic root following separation from the balloon. We successfully redeployed the first stent at the dislodged site and retrieved the second stent using a goose-neck snare after moving the stent to the descending aorta. These steps circumvented the need for the patient to undergo emergency cardiovascular surgery.

Diagnostic imaging of malignant insulinoma in a dog / 대한수의학회지

Endocrine test data from a 13-year old intact female Maltese was indicative of the presence of an insulinoma, however ultrasonography identified a pancreatic mass only after 10 months after the first admission. Following identification of both pancreatic tumor and hepatic metastasis on computed tomography (CT), surgical excision of the mass was attempted. However, total excision failed because of tumor adhesion to adjacent large vessels. The pancreatic mass was monitored over the next 25 months via ultrasonography, CT, and positron emission tomography-computed tomography (PET-CT). Histopathological and immunohistochemical data confirmed the diagnosis of insulinoma with hepatic metastasis.

A Case of Emphysematous Pyelonephritis Associated with Emphysematous Ureteritis and Cystitis

Emphysematous pyelonephritis (EPN) is a necrotizing infection of the renal parenchyma and its surrounding tissues that results in the accumulation of gas in the renal parenchyma, collecting system or perinephric tissue. EPN is a potentially life-threatening condition, which is most commonly associated with poorly controlled diabetes. We describe a case of emphysematous pyelonephritis associated with emphysematous ureteritis and cystitis in a 68-year-old diabetic woman, who was cured with medical treatment and surgical intervention.

Exploitation of Culture Medium for Mycobacterium tuberculosis

The culture media for Mycobacterium tuberculosis (MTB) were contrived from both egg-based and agar based ingredients. In 1903, Dorset introduced the first egg-based medium. It was followed by the invention of Lowenstein-Jensen and Ogawa media that contain whole eggs as nutrient and malachite green to inhibit the growth of contaminants. These media have been used worldwide for their usefulness and inexpensiveness. However they have a fundamental disadvantage that the cultivation time for mycobacterial growth takes more than 4 weeks. In 1947, Dubos introduced the first agar medium and followed by the invention of the 7H10 by Middlebrook and Cohn. A powder base of these media contains agar, combination of seven salts, L-glutamic acid, pyridoxine, biotin, and malachite green. This requires the addition of the oleic acid, albumin, dextrose, and catalase (OADC) growth supplement. BACTEC MGIT960 has recently been introduced for rapid cultivation of MTB, which is fully automated liquid culture system with modified 7H9 broth. Agar-based medium developed by Middlebrook has a number of advantages over egg-based medium. One of them is transparency, which enables earlier detection of growing colonies. The major disadvantages of agar media are the high cost of OADC and the need for a CO2 incubator. In conclusion, there is a need for a new agar medium, which can be produced at a lower cost and earlier growth detection. In this review, we introduced the growth promoting factors which can be used as an alternative new growth supplement, cAMP and resuscitation-promoting factor (Rpf). These factors may abrogate a lag in adaption of the bacilli in culture media.