Influence of Experiences of Witnessing Tobacco Advertising and Preferences of Tobacco Companies' Social Responsibility on Current and Future Smoking Intentions in Adolescents

PURPOSE: To evaluate the influence of experiences of witnessing tobacco advertising and preferences of tobacco companies' social responsibility (CSR) on current and future smoking intentions in adolescents. METHODS: Data were collected from 700 adolescents living in Korea representing 7 metropolitan cities and 8 provinces in the method of proportional random sampling. The Gallup's data collection system was adopted using 1:1 face to face interviews. The witness of tobacco advertising was determined by 'yes', or 'no' responses to three survey items and to four survey items for preferences of tobacco CSR. For statistical analysis, chi2 test, Fisher's exact test and logistic regression were used. RESULTS: 98.4% of the adolescents had experiences of witnessing tobacco advertising. POP (OR=103.44, 95% CI: 8.22~1301.45) and magazine advertisement (OR=6.07, 95% CI: 1.34~22.58) had a significant effect on their current smoking. Also, POP (beta=.24, p<.001) and movie advertisement (beta=.42, p<.001) had a significant effect on their future smoking intentions. As for the preferences of tobacco CSR, cultural-art support activities (beta=.15, p=.025) and environmental purifying campaigns (beta=-.15, p=.034) had a significant effect on their future smoking intentions. CONCLUSION: Witness of tobacco advertising and positive responses to tobacco CSR are associated with current and future smoking intentions in adolescents.

Evaluation of efficacy and safety of fentanyl-TTS in adult patients with cancer-related pain / 대한내과학회지

The transdermal administration of narcotics is one of the alternative ways of providing adequate pain relief for the patients with chronic cancer pain. A Phase 4 trial was conducted to evaluate the efficacy and safety of Fentanyl-TTS in adult patients with cancer-related pain in Korea. METHODS: Patients with histologically confirmed malignancy, who have pain related to the cancer and/or therapy, pain necessitating the use of opoid analgesics, age of 18 yr or older, ability to communicate effectively with study personnel, and signed on informed consent were included. The patients were titrated with a short-acting narcotic to control their cancer pain before they are converted to a fentanyl-transdermal therapeutic system(TTS). Short acting parenteral morphine and MS contin were used as rescue medications. All patients were evaluated initially and were followed up with a pain visual analogue scale(VAS), quality of life(QOL)-VAS. Patients were asked to keep the daily record for 21 days about pain VAS, QOL-VAS, amount of rescue morphine used, and side effects. RESULTS: Twenth two patients were enrolled from January 1996 to October 1997. The dose of fentanyl-TTS required, ranged between 25 and 75 ug/hr (25 microgram/hr in 13, 50 microgram/hr in 4, and 75 microgram/hr in 2). The mean dose of morphine required before the use of the fentanyl-TTS was 135.3 mg (20-285 mg/day), but it was decreased after the use of the fentanyl-TTS. Pain VAS and QOL-VAS were in adquate level during the fentanyl- TTS treatment. Patients favored continuous use of fentanyl after the study was finished. Side effect of fentanyl-TTS was minimal. CONCLUSION: Transdermal fentanyl seems to be a convenient and effective analgesic for the control of cancer related pain in Korean. A controlled trial comparing fentanyl-TTS to morphine needs to be followed.

A Case of Marfan Syndrome with Subacute Bacterial Endocarditis

Marfan syndrome is a hereditary disorder of connective tissue fibers, involving skeleton, eye and cardiovascular system. The cardiovascular complications, directly related to the cause of death, are associated with about 90% of the Marfan syndrome. The cardiovascular complications are aortic and mitral insufficiency, mitral valvular prolapse, bacterial endocarditis, arrhythmia and aneurysm of interatrial septum and aorta. Among the cardiovascular complications, bacterial endocarditis is unusual. The aortic valve, though commonly abonormal in Marfan syndrome, was rarely involved by endocarditis. In contrast the mitral valve was the favoured site of infection in these patients. The low incidence of aortic valve involvement remains unexplained. There is extreme mortality in Marfan patients affected by endocarditis. A 22-year-old man was admitted to Wallace Memorial Baptist Hospital because of intermittent fever with chill, dyspnea and orthopnea. He had characteristic Marfanoid features such as a slender body with sparsity of subcutaneous fat, arachnodactly and disproprtionate long extremities, axial myopia as well as suspicious family history. Three blood cultures produced a slowly growing gamma-hemolytic streptococcus sensitive to penicillin. Chest X-ray revealed increased C-T ratio and generalized congested lung parenchyme and increased lung markings with multiple dense, horizontal lines, so called Kerley's B lines. Echocardiogram showed thickened bicuspid arotic valve with vegetation and enlarged left ventricular cavity, grade 3/4 mitral and aortic regurgitation. The authors have experienced a rare case of Marfan syndrome with subacute infective endocarditis.