Exploring the risk factors of adolescent suicide is important for effective suicide prevention. This study explored the clustering of adolescent suicides based on six risk factors: mental disorder, broken family, depression, anxiety, previous suicide attempts, and deviant behaviors. Using 173 student suicide reports obtained from the Ministry of Education, we evaluated the associations between suicide and variables related to mental disorders; dysfunctional family life; depression and anxiety; previous suicide attempts; deviant behaviors such as drinking and smoking; and school life characteristics, including attendance and discipline, problems within the past year, and incidents prior to suicide. In addition, reports of warning signs just before suicide were included in the analysis. The two-stage cluster analysis classified the students into three clusters: the silent type (cluster 1; 48.55%), in which no risk factors were observed; environmental-risk type (cluster 2: 24.28%), which featured a high frequency of broken households, deviant behaviors such as smoking/drinking and running away from home; and depressive type (cluster 3: 27.17%), which featured a high frequency of mental health problems such as depression, anxiety, and suicide attempts. Identifying the sub-types of adolescent suicide may help to inform tailored suicide prevention and intervention strategies in school.

No abstract available.
Child* ; Heart Diseases* ; Heart* ; Humans ; Mass Screening*

Traumatic boutonniere deformity of the thumb is rare in non-rheumatoid patients. Non-rheumatoid patient develops a boutonniere deformity of the thumb following a closed injury to the dorsoradial aspect of the metacarpophalangeal joint. The patient had an extensor lag of the metacarpophalangeal joint and paradoxical hyperextension of the interphalangeal joint. The patient required surgical treatment which included advancement and reattachment of the extensor pollicis brevis insertion and imbrication of the dorsoradial capsule to restore the anatomical alignment of the extensor pollicis longus. Conservative care of the metacarpophalangeal joint may be effective, but once a boutonniere deformity is developed, surgical treatment is necessary.
Congenital Abnormalities* ; Humans ; Joints ; Metacarpophalangeal Joint ; Thumb*

BACKGROUND AND OBJECTIVES: Nasal polyps are a condition of uncertain etiology. Cytokines are thought to play a role in nasal polyps in vitro, but in vivo studies on the patterns of cytokine expression in nasal polyps have been limited. The aim of the present study is to gain a better understanding of the pathophysiology of nasal polyps by defining the patterns of expression of cytokine mRNA and p53 in the nasal mucosa of patients with nasal polyps. MATERIALS AND METHODS: This objective was supported by performing RT-PCR (reverse transcription-polymerase chain reaction) for IL-2, INF-gamma (T1 cytokine), IL-5, IL-8, IL-10, IL-13 (T2 cytokine), TNF-alpha, TGF-beta1, and p53. RESULTS: Observation of the nasal polyps indicated significant increases in mRNA for T2 cytokines and p53 over controls. The expressions of IL-10 and IL-13 mRNA in the nasal mucosa of non-allergic patients were stronger than in that of allergic patients. CONCLUSION: This result suggests that the pathogenesis of nasal polyps is associated with T2 cytokines and p53.
Cytokines* ; Humans ; Interleukin-10 ; Interleukin-13 ; Interleukin-2 ; Interleukin-5 ; Interleukin-8 ; Nasal Mucosa ; Nasal Polyps* ; Polyps ; RNA, Messenger ; Transforming Growth Factor beta1 ; Tumor Necrosis Factor-alpha

Objectives: Most developmental screening tests have been built as parent-performed questionnaires. However, they often do not guide parents on how to answer the questionnaire. This study aimed to develop easily applicable parent guidelines. Methods: We implemented the Delphi procedure with 20 panelists. The development of the initial questionnaire was based on the results of two surveys of parents and experts provided by a policy research report that investigated the item adequacy of the Korean Developmental Screening Test. Round one included 33 items comprising all possible measurements in six categories that were identified as difficult to understand or confusing. Round two merged and modified some items and included 32 items. We defined consensus as a median agreement value of one or less and convergence and stability values of 0.5 or less. The subjective usefulness of the parent guidelines was examined based on their previous test experiences. Results: Consensus was reached after the second round, reflecting the items with the highest level of accuracy in each category. Of the 167 parents who participated in the survey, 113 (67.7%) affirmed the usefulness of the guidelines, while 10 (6.0%) answered that they were not useful. Items that recommended a different scoring strategy in answering the questionnaire from their previous measurements were found to be more useful by the parents. Conclusion The parent guidelines, composed of five bullet points, drew on the consensus of the experts. Further studies are required to assess whether these guidelines improve the accuracy of screening tests in clinical settings.

Cervical chondrocutaneous branchial remnants are rare and one of several maformations resulting from abnormal development of the branchial apparatus. These lesions are usually located over or near the insertions of the sternocleidomastoid muscles in the lower neck. It is important to recognize that they may be a visible marker for other malformations and/or anomalies. Treatment is complete surgical removal as promptly as possible in order to get an exact histopathological diagnosis. In this article, we report a rare case of cervical chondrocutaneous branchial remnants and some reviews of the literature.
Diagnosis ; Muscles ; Neck

BACKGROUND: Plastic surgeons have constantly investigated methods of nasal tip plasty and nasal lengthening in rhinoplasty. The septal extension graft has been widely applied as a very useful method for East Asians who have different internal nasal structures and nasal skin from those of Caucasians. In this study, we performed nasal tip plasty with a batten-type septal extension graft using ear cartilage. METHODS: Nasal tip plasty was performed for 48 patients by batten graft with ear cartilages at the Cocoa Plastic Surgery Clinic and in the plastic surgery unit of Hanil General Hospital from January 2009 to January 2015. A batten-type septal extension graft was constructed with cymba of the concha cartilage. An average area of 2.0 cm × 1.4 cm of the cymba and 1.0 cm × 1.0 cm of the cavum from the concha cartilage was harvested. RESULTS: Of the 48 patients who underwent batten-type septal extension graft using ear cartilages, nasal tip plasty and columellar lengthening were successfully achieved in almost all of the patients. The nasal tip's height was well-maintained for the follow-up period ranging from 6 months to 5 years after surgery. CONCLUSIONS: Nasal tip plasty using a septal extension graft is a very useful method for East Asians with a low nasal tip. The septal extension graft with ear cartilage enables the creation of a desirable nasal shape because there is a sufficient amount of ear cartilage to stably support the nasal tip, thus creating a natural and smooth nose shape.
Asian Continental Ancestry Group* ; Cacao ; Cartilage ; Ear Cartilage* ; Ear* ; Follow-Up Studies ; Hospitals, General ; Humans ; Methods ; Nose ; Plastics ; Rhinoplasty ; Skin ; Surgeons ; Surgery, Plastic ; Transplants*

OBJECTIVES: The objective of this study was to identify the level of awareness regarding school-based suicide prevention programs in teachers who were in charge of the suicide prevention project, and to derive plans for future improvement. METHODS: A total of 582 teachers working in elementary, middle, and high schools across the country participated in this study. For the study, school-based suicide prevention programs were divided into four programs : curriculum-based program, staff in-service training, screening, and postvention ; the teachers' opinions regarding each program were then gathered by conduct of an online survey. RESULTS: The results indicated that participants chose the curriculum-based program as the most easily implementable program (65.6%), and postvention as the most difficult program to implement (52.9%). The curriculum-based program was implementable due to availability of procedure. Evasion of legal responsibility was significantly greater in postvention, making the program more desirable. Barriers to effective implementation include students' and parents' resistance to screening as well as time constraints in staff in-service training. CONCLUSION: These results suggest that a variety of preceding conditions must necessarily be prepared for successful implementation of each type of suicide prevention program. Policy implications and future directions are then discussed.
Humans ; Mass Screening ; Suicide*

Recently, local governments and suicide prevention centers have been trying to implement psychological autopsy. This effort has focused on adult suicide so far ; however, there are some difficulties in its application to adolescent suicide. Therefore, in this study, psychological autopsy studies of Korea were reviewed, and a methodology for adolescents\' psychological autopsy was suggested. For the effective performance of the psychological autopsy in adolescent suicide, cooperation with each area of the government and implementation of bodies is necessary. In addition, the central system, which disseminates the standardized interview to the community and manages the data nationwide, should be prepared. Also, in order to improve the accuracy of diagnosis and to obtain various types of information, a structured interview should be adopted as the psychological autopsy, as well as considering the use of social media. Investigation of specific risk factors for adolescent suicide through psychological autopsy can enable determination of the intervention point for effective suicide prevention.
Adolescent* ; Adult ; Autopsy* ; Diagnosis ; Humans ; Korea ; Risk Factors ; Social Media ; Suicide

A 26-year-old male patient presented for stump revision of an amputated right 3rd finger and neurorrhaphy for a lacerated right 2nd finger. An axillary brachial plexus block was performed using the transarterial technique. Postoperatively, the patient demonstrated signs and symptoms of brachial plexus injury. He exhibited paresthesia in the distribution of the ulnar nerve and motor weaknesses the wrist, elbow, and shoulder. On the 18th postoperative day, nerve conduction and electromyographic studies were performed, which revealed possible right radial neuropathy and axillary neuropathy, or right brachial plexopathy with posterior cord involvement. After seven months of medical and physical treatment, the pain subsided but slight paresthesia and muscle weaknesses still remained. We describe a case of postoperative neuropathy, which is believed to be caused by a direct nerve injury after an axillary brachial plexus block with persistent signs and symptoms over a considerable period.
Adult ; Brachial Plexus Neuropathies ; Brachial Plexus* ; Elbow ; Fingers ; Humans ; Male ; Muscle Weakness ; Neural Conduction ; Paresthesia ; Radial Neuropathy ; Shoulder ; Ulnar Nerve ; Wrist