PURPOSE: The purpose of this study was to examine differences in the prevalence of vitamin D deficiency between male and female Korean adolescents and to investigate gender-specific factors associated with vitamin D deficiency. METHODS: This cross-sectional descriptive study included 975 adolescents aged 12-18 years who participated in the fifth Korean National Health and Nutrition Examination Survey (2010~2011). Multiple logistic regression using complex sample analysis was performed to examine gender-specific factors associated with vitamin D deficiency with adjustments for covariates. RESULTS: Among the participants, 82.9% had vitamin D deficiency. The prevalence of vitamin D deficiency was higher among female adolescents (88.4%) than their male counterparts (78.4%). A rural place of residence (OR, 0.40; 95% CI, 0.19~0.87; p=.021) and daily milk intake (OR, 0.23; 95% CI, 0.07~0.75; p=.015) were significant factors significantly associated with vitamin D deficiency in males, while body mass index (OR, 8.40; 95% CI, 1.05~67.04, p=.045) and having breakfast (OR, 0.22; 95% CI, 0.10~0.49; p < .001) showed significant relationships in females. CONCLUSION: The results of this study provide preliminary evidence for developing effective strategies to prevent vitamin D deficiency in Korean adolescents. The different factors influencing vitamin D deficiency in males and females should be considered when providing interventions.
Adolescent* ; Body Mass Index ; Breakfast ; Female ; Humans ; Logistic Models ; Male ; Milk ; Nutrition Surveys* ; Prevalence ; Vitamin D Deficiency* ; Vitamin D* ; Vitamins*

OBJECTIVES: This study aimed to identify and systematically review the literature on the use of mobile technology in nursing education. The research findings could evidence the effectiveness of mobile technology in undergraduate nursing students' learning outcomes. METHODS: Computerized searches were conducted using the Ovid-MEDLINE, Ovid-EMBASE, Cochrane Library, and CINAHL databases for relevant primary studies and limited to those between 2000 and February 2018. Only randomized controlled trials (RCTs) and quasi-experimental studies published in either English or Korean were included and critically appraised using Joanna Briggs Institute tools. RESULTS: Seven RCTs and 7 quasi-experimental studies were identified. The mobile device and intervention applied varied throughout all the studies. Studies published earlier in the 2000s found that immediate access to clinical and pharmacological referencing information through the mobile device increased students' efficacy in clinical practice. Later studies, which were mostly conducted in Korea, reported that smartphone-based applications could promote nursing students' learning motivation and satisfaction but not their clinical skills and knowledge. CONCLUSIONS: We still seem to be in the beginning stage of implementing mobile technology in nursing education due to the limited implication of mobile technology and inconsistent research conclusions. In the future, rigorous primary empirical studies are needed to suggest the effective use of mobile devices in nursing education.
Clinical Competence ; Education ; Education, Nursing* ; Korea ; Learning ; Mobile Applications ; Motivation ; Non-Randomized Controlled Trials as Topic ; Nursing* ; Smartphone

PURPOSE: The study aimed to examine the effects of sleep pattern, stress, and attitude towards menstruation, and behavior that causes a reduction in exposure to endocrine disrupting chemicals (EDCs) in the course of premenstrual syndrome (PMS) in female adolescents.METHOD: In total, 200 girls attending middle school in K city were recruited via convenience sampling between December 11 and 31, 2018, and 192 subjects were selected for the analysis. Data were analyzed using descriptive statistics, an independent t-test, ANOVA, Pearson's correlation coefficient, and multiple regression.RESULTS: Overall, 9 (4.7%), 152 (79.2%), and 31 (16.1%) students had morning-, intermediate-, and evening-type sleep pattern, respectively. The mean scores for school-related stress were highest. Scores for stress regarding relationships with friends were the lowest. The mean score for attitudes toward menstruation was 72.33 out of 147. The mean score for behavior that led to a reduction in EDCs exposure was 56.57 out of 85. The mean scores for PMS severity were 25.30 and 38.39 out of 60. Analysis of factors affecting PMS revealed that severity of menstrual pain (β=.28), use of analgesics during menstruation (β=.17), family history of PMS (β=−.16), stress (β=.19), and behavior that reduces EDCs exposure (β=−.17) exerted significant effects on PMS. The explanatory power of these variables was 37%.CONCLUSION: The findings propose the necessity of a health intervention program including educational information, which can reduce PMS in adolescents, induce the behaviors which can decrease exposure to EDCs, and activities for managing the stress levels.
Adolescent ; Analgesics ; Dysmenorrhea ; Endocrine Disruptors ; Female ; Friends ; Humans ; Menstruation ; Methods ; Premenstrual Syndrome

We correct a typo in the title.

Objectives: ：This study evaluated the medical communication skills of trainee doctors and analyzed the relationship between medical communication skills, self-efficacy on clinical performance (SECP) and empathy. Methods: ：A total of 106 trainee doctors from a university hospital participated. The questionnaire comprised self-evaluated medical communication skills, modified SECP and the Korean version of the Jefferson Scale of Empathy-Health Professionals version. The mean difference in medical communication skills scores according to gender, age, division (intern, internal medicine group or surgery group) and position (intern, first-/second- and third-/fourth-year residents) were analyzed. Pearson correlation coefficients were determined between medical communication skills, modified SECP and empathy. The effects of each variable on medical communication skills were verified using the structural equation model. Results: ：There were no statistically significant mean differences in self-evaluated medical communication skills according to gender, age, division or position. Medical communication skills had a significant positive correlation with modified SECP (r=0.782, p<0.001) and empathy (r=0.210, p=0.038). Empathy had a direct effect on modified SECP (β=0.30, p<0.01) and modified SECP had a direct effect on medical communication skills (β=0.80, p<0.001). Empathy indirectly influenced medical communication skills, mediating modified SECP (β=0.26, p<0.05). Conclusions ：Medical communication skills are an important core curriculum of residency programs, as they have a direct correlation with SECP, which is needed for successful treatment. Moreover, the medical communication needs a new understanding that is out of empathy.

Stroke is one of the common causes of death and disability. Despite extensive efforts in stroke research, therapeutic options for improving the functional recovery remain limited in clinical practice. Experimental stroke models using genetically modified mice could aid in unraveling the complex pathophysiology triggered by ischemic brain injury. Here, we optimized the procedure for generating mouse stroke model using an intraluminal suture in the middle cerebral artery and verified the blockage of blood flow using indocyanine green coupled with near infra-red radiation. The first week after the ischemic injury was critical for survivability. The survival rate of 11% in mice without any treatment but increased to 60% on administering prophylactic antibiotics. During this period, mice showed severe functional impairment but recovered spontaneously starting from the second week onward. Among the various behavioral tests, the pole tests and neurological severity score tests remained reliable up to 4 weeks after ischemia, whereas the rotarod and corner tests became less sensitive for assessing the severity of ischemic injury with time. Further, loss of body weight was also observed for up 4 weeks after ischemia induction. In conclusion, we have developed an improved approach which allows us to investigate the role of the cell death-related genes in the disease progression using genetically modified mice and to evaluate the modes of action of candidate drugs.
Animals ; Anti-Bacterial Agents ; Body Weight ; Brain Injuries ; Brain Ischemia ; Cause of Death ; Disease Progression ; Indocyanine Green ; Ischemia ; Mice* ; Middle Cerebral Artery ; Stroke* ; Survival Rate ; Sutures ; Therapeutic Human Experimentation

PURPOSE: This study reports the results of the use of preoperative concurrent radiochemotherapy (CRCT) for the treatment of locoregionally advanced esophageal cancer. MATERIALS AND METHODS: From 1998 through 2005, 61 patients with intrathoracic esophageal cancer at stages II-IVB (without distant organ metastasis and presumed to be respectable) received preoperative CRCT. CRCT consisted of radiotherapy (45 Gy /25 fractions /5 weeks) and FP chemotherapy (5-FU 1 g/m2/day, days 1-4 and 29-32, Cisplatin 60 mg/m2/day, days 1 and 29). An esophagectomy was planned in 4~6 weeks after the completion of CRCT. RESULTS: There were two treatment-related deaths. Among the 61 patients, 53 patients underwent surgery and 17 patients achieved a pathological complete response (pCR). The overall survival (OS) rates of all 61 patients at 2 and 5 years were 59.0% and 38.0%, respectively. The rates of OS and disease-free survival (DFS) of the surgically resected patients at 2 and 5 years were 61.6%, 40.1% and 53.3%, 41.8%, respectively. By univariate analysis, achieviement of pCR and a clinically uninvolved distant lymph node (cM0) were favorable prognostic factors for OS and DFS. There were 27 patients that experienced a relapse-a locoregional relapse occurred in 5 patients, a distant metastasis occurred in 12 patients and combined failure occurred in 10 patients. CONCLUSION: The results of the current study are favorable. pCR and an uninvolved distant lymph node were found to be favorable prognostic factors.
Chemoradiotherapy* ; Cisplatin ; Disease-Free Survival ; Drug Therapy ; Esophageal Neoplasms* ; Esophagectomy ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Polymerase Chain Reaction ; Radiotherapy ; Recurrence ; Treatment Outcome*

PURPOSE: To evaluate the response and survival rate after three-dimensional conformal radiation therapy (3D-CRT) of patients with a solitary sternal relapse of breast cancer. MATERIALS AND METHODS: Seventeen patients between May 1996 and June 2005 were evaluated with the salvage 3D-CRT treatment of a solitary sternal relapse of breast cancer. The treatment fields included the gross tumor volume with 2 cm margins. The total radiation dose was 35.0~61.5 Gy (biologic effective dose of 43.7 ~76.9 Gy(10) using an alpha/beta ratio of 10 Gy), with a daily dose of 1.8~3.0 Gy. The tumor response was evaluated by the change in maximum tumor size via follow up CT scans 1~3 months after the completion of treatment. RESULTS: An objective tumor response was achieved in all patients, with a complete response in 5 patients and a partial response in 12 patients. The 5-year overall survival rate was 51.9% (median survival time: 27 months), and the most important factor affecting overall survival was the disease-free interval (interval from primary surgery of breast cancer to the development of sternal metastasis): The 5-year overall survival rate was 61.8% for patients with a disease-free interval > or =12 months and 0.0% for patients with disease-free interval <12 months (p=0.03). CONCLUSION: The response to 3D-CRT was good in patients with solitary sternal relapse of breast cancer. Particularly, patients with long disease-free interval from primary surgery survived significantly longer than patients with short disease-free interval from primary surgery.
Breast ; Breast Neoplasms ; Follow-Up Studies ; Humans ; Recurrence ; Survival Rate ; Tumor Burden

Therapeutic efficacy of mesenchymal stem cells (MSCs) is determined by biodistribution and engraftment in vivo.Compared to intravenous infusion, biodistribution of locally transplanted MSCs are partially understood. Here, we performed a pharmacokinetics (PK) study of MSCs after local transplantation. We grafted human MSCs into the brains of immune-compromised nude mice. Then we extracted genomic DNA from brains, lungs, and livers after transplantation over a month. Using quantitative polymerase chain reaction with human Alu-specific primers, we analyzed biodistribution of the transplanted cells. To evaluate the role of residual immune response in the brain, MSCs expressing a cytosine deaminase (MSCs/CD) were used to ablate resident immune cells at the injection site. The majority of the Alu signals mostly remained at the injection site and decreased over a week, finally becoming undetectable after one month. Negligible signals were transiently detected in the lung and liver during the first week. Suppression of Iba1-positive microglia in the vicinity of the injection site using MSCs/CD prolonged the presence of the Alu signals.After local transplantation in xenograft animal models, human MSCs remain predominantly near the injection site for limited time without disseminating to other organs. Transplantation of human MSCs can locally elicit an immune response in immune compromised animals, and suppressing resident immune cells can prolong the presence of transplanted cells. Our study provides valuable insights into the in vivo fate of locally transplanted stem cells and a local delivery is effective to achieve desired dosages for neurological diseases.

Recently, ex-vivo gene therapy has emerged as a promising approach to enhance the therapeutic potential of mesenchymal stem cells (MSCs) by introducing functional genes in vitro. Here, we explored the need of using selection markers to increase the gene delivery efficiency and evaluated the potential risks associated with their use in the manufacturing process. We used MSCs/CD that carry the cytosine deaminase gene (CD) as a therapeutic gene and a puromycin resistance gene (PuroR) as a selection marker. We evaluated the correlation between the therapeutic efficacy and the purity of therapeutic MSCs/CD by examining their anti-cancer effect on co-cultured U87/GFP cells. To simulate in vivo horizontal transfer of the PuroR gene in vivo, we generated a puromycin-resistant