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.

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*

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

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.

Volume deficiency and poorly defined cupid's bow of the upper lip are frequently encountered problems in secondary cleft lip deformities. In this report, we present the method of a periumbilical dermal graft for correcting secondary cleft lip deformity. A 17-year-old male patient presented with a poorly defined notching cupid's bow and volume deficiency of the upper lip. He had undergone cleft lip surgery when he was 2 years old. We planned to perform a periumbilical dermal graft. There were sufficient amount of periumbilical subdermis and fat tissue thickness to obtain abundant volume. The periumbilical contour was similar to the natural contour of the lip. Less scarring was expected. There was no need to change the posture during operation, making it easy to harvest. Postoperative evaluations showed vermilion symmetry. Ideal cupid's bow shape and position were achieved without color mismatch. As a result, we obtained an ideal volume of the upper lip. Therefore a periumbilical dermal graft is a good option for correcting volume deficiency of the lip with good aesthetic outcomes.
Adolescent ; Cicatrix ; Cleft Lip* ; Congenital Abnormalities* ; Dermis ; Humans ; Lip ; Male ; Methods ; Posture ; Transplants* ; Umbilicus

Carcinosarcoma is a biphasic tumor composed of an intimate admixture of epithelial and mesenchymal element, both of which are malignant. Primary cutaneous cases are extremely rare. There have been reported only 18 cases of cutaneous carcinosarcoma in the world and only one case can be found in the korean pathology literature. Therefore it has been difficult to characterize the clinical course of carcinosarcoma of the skin. We present a further case of primary cutaneous carcinosarcoma in a 86-years-old woman with exophytic and hemorrhagic mass on scalp. Histologic and immunohistochemical studies revealed both squamous cell carcinoma and spindle cell sarcomatoid change intermingled in the same tumor. The clinical and histologic findings of cutanous carcinosarcoma were described.
Carcinoma, Squamous Cell ; Carcinosarcoma* ; Female ; Humans ; Pathology ; Scalp* ; Skin

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

Maxillary sinus mucocele can occur due to many medical factors such as chronic infection, allergic sinonasal disease, trauma, and previous surgery. However, it occurs mainly after Caldwell-Luc operation, usually more than 10 years after surgery. There are a few cases of maxillary sinus mucocele with ocular symptoms. Also, a case causing ocular symptoms because of invasion to the orbital floor is rare. Therefore, we report a case of a 55-year-old male patient who underwent Caldwell-Luc operation about 30 years ago. Then, symptoms such as exophthalmos, diplopia, and visual disturbance developed suddenly 3 months prior to admission. Computed tomography showed a cyst invading the orbital floor which resulted in eyeball deviation. The orbital floor defect measured approximately 2.5×3.3 cm. Maxillary sinus mucocele was removed through an endoscopic approach. After this, we reconstructed the orbital floor through a subciliary incision. Observation was carried out after three years, and ocular symptoms such as diplopia and exophthalmos did not recur.
Diplopia ; Exophthalmos ; Humans ; Male ; Maxillary Sinus* ; Middle Aged ; Mucocele* ; Orbit*

Scalp and calvarium defects are caused by trauma, burn, tumor resection, or congenital diseases. We experienced a few cases of severe electrical burn of scalp and calvarium, but fourth-degree contact burn of scalp and calvarium is a rare case. A 67 years old man was presented with a 25% total body surface area contact burn. A 20 cm×15 cm thick eschar on the patient's scalp was observed. Among various techniques for scalp reconstruction, we planned fasciocutaneous transposition flap with split thickness skin graft for coverage of large defect. Considering aesthetically satisfactory outcome, we designed a fasciocutaneous transposition flap including the hair-bearing areas. We additionally used skin graft for uncovered surrounding areas. There were no flap necrosis, graft loss, or any other surgical complications after the surgical flap and skin graft. At 6-month follow-up, the operation site was stable. The patient satisfied with functional and aesthetical outcomes, so we report this case.
Body Surface Area ; Burns* ; Follow-Up Studies ; Humans ; Necrosis ; Scalp* ; Skin ; Skull* ; Surgical Flaps ; Transplants