OBJECTIVES: Sleep problems has been consistently reported as a suicidal risk factor in adults and, recently, also in adolescents. In this study, dividing study subjects by the previous suicidal behaviors (suicidal vs non-suicidal), we compared the group differences of suicidal risk factors, and examined the possibility of sleep as a suicidal risk factor. METHODS: Study subjects were 561 (271 boys and 290 girls) from a community sample of high school students. Suicidal Risk Behavior Checklist, Center for Epidemiological Study-Depression (CES-D), Symptom Checklist-90-Revision (SCL-90-R) Anxiety and Aggression subscale, Pittsburg Sleep Quality Index (PSQI) were done. RESULTS: Forty six students (8.1%) reported previous actual self-harm behavior as a suicidal attempt, 181 students (32.4%) reported having suicidal thought only. Three hundred thirty four students (59.5%) reported no previous suicidal behavior (thought and attempt, both). Suicidal behavior group showed higher score on risk behaviors such as school violence, substance use and internet addiction. CES-D, SCL-90-R, PSQI showed significant group difference. Logistic regression analysis showed suicidal risk were significantly associated with depression, stress in suicidal risk factors and sleep latency, daytime dysfunction in PSQI. Analysis of variance (ANOVA) shows the most prolonged sleep latency and increased index of all PSQI components except sleep efficiency in suicidal attempt group. CONCLUSIONS: Sleep Problems had a strong association with the suicidal risk behavior in adolescents. Sleep problems, especially, prolonged sleep latency, daytime dysfunction might be important markers for suicidal behavior. Screening for sleep problems in adolescents are encouraged for the parents, school teachers, and related medical physicians.
Adolescent ; Adult ; Aggression ; Anxiety ; Checklist ; Depression ; Humans ; Internet ; Logistic Models ; Mass Screening ; Parents ; Risk Factors ; Risk-Taking ; Suicide ; Violence

PURPOSE: The purposes of this study were to develope and evaluate a constipation intervention program for inpatients. METHOD: To develope this program, Six phases were processed including the organization of team, the analysis of medical chart, the development of tentative constipation intervention program, the test of content validity, the test of clinical validity and the determination of final constipation intervention program. To evaluate the clinical validity of this program, 10 subjects who were in the C University Hospital were selected from March, 2001 to October, 2001. RESULT: The clinical validity was supplied by the pilot test, showing the potential effect of the program. Based on the validity results the final algorithm and the form of nursing record for this program which consist of the 3-step assessments and the intervention protocol were presented in this study. CONCLUSION: The advantage of this program is being able to assess and manage constipation simultaneously and is especially effective to patients who are at risk for developing constipation during their admission. Further study needs are also necessary to evaluate the effect of this program on the self-symptom of constipation.
Constipation* ; Humans ; Inpatients* ; Nursing Records ; Program Development

This research has been done in order to improve quality of nursing and medical service. In order to improve those qualities the study has been done to know inpatient perception of kindness and meaning of kindness which patients receive from nurse and also what effect inpatient have when they experience kindness from nurse. The subjects were 454 people who admitted in K Hospital. Time period was from October to December 1995. This survey has been done by personal interview with a written questionnaire. Analysis of data has been done by X2-test and percentage. The results of the research may be summarized as follows. 1. The inpatients perception of kindness on nurse were explanation(26.8%), tolerance(16.3%), warm-heartedness(12.8%), interest(9.5%), ability(8.4%), confidence(6.4%), respect(4.0%), support(2.65%). 2. In order to find out general meaning of kindness, study classified by age, sex, education, job, experience of hospitalization, inpatient ward. As a result of X2-test, no special meaning of kindness was presented in inpatient perception of kindness. 3. Contents kindness which inpatient experienced were, warm-heartedness(23%), understanding(18.1%), interest(17.8%), ability(12.8%), tolerance(5.7%), confidence(2.6%). 4. Over half of subjects(59.1%) answered stability to effect on kindness of Nurse. Next are self-confidence(7.9%), respect(5.3%), confidence(4.6%), warm-heartedness(3.5%), understanding(2.6%). According to above results inpatient feels that meaning of kindness were explanation, tolerance, warm-heartedness. This meaning has no distinctive difference other than consistent meaning. Likewise, inpatient experience about contents of kindness is similar to meaning of kindness. As a result of this research, which show that kindness of nurse gives patient stability, respect and confidence, we would kindness is important for recovery of inpatient. Therefore, this research outcome could be able to help to improve quality of nursing and medical service.
Education ; Hospitalization ; Humans ; Inpatients* ; Nursing ; Surveys and Questionnaires

Next-generation sequencing, such as whole-genome sequencing, whole-exome sequencing, and targeted panel sequencing have been applied for diagnosis of many genetic diseases, and are in the process of replacing the traditional methods of genetic analysis. Clinical exome sequencing (CES), which provides not only sequence variation data but also clinical interpretation, aids in reaching a final conclusion with regards to genetic diagnosis. Sequencing of genes with clinical relevance rather than whole exome sequencing might be more suitable for the diagnosis of known hereditary disease with genetic heterogeneity. Here, we present the clinical usefulness of CES for the diagnosis of hereditary spastic paraplegia (HSP). We report a case of patient who was strongly suspected of having HSP based on her clinical manifestations. HSP is one of the diseases with high genetic heterogeneity, the 72 different loci and 59 discovered genes identified so far. Therefore, traditional approach for diagnosis of HSP with genetic analysis is very challenging and time-consuming. CES with TruSight One Sequencing Panel, which enriches about 4,800 genes with clinical relevance, revealed compound heterozygous mutations in SPG11. One workflow and one procedure can provide the results of genetic analysis, and CES with enrichment of clinically relevant genes is a cost-effective and time-saving diagnostic tool for diseases with genetic heterogeneity, including HSP.
Diagnosis ; Exome* ; Genetic Diseases, Inborn ; Genetic Heterogeneity ; Humans ; Spastic Paraplegia, Hereditary*

We examined the alteration and expression of c-myc protooncogene in 11 human intracranial meningiomas using Southern blot, Northern blot and immunohistochemical techniques. Southern blot showed neither amplification nor rearrangement but Northern blot and immunohistochemical study revealed enhanced expression of the c-myc gene. Immunohistochemically, c-myc product was found in all of the 11 cases and seven of these cases showed an above moderate degree of immunoreaction in semiquantitative analysis. Loss of heterozygosity at IGLC2 locus on chromosome 22 was detected in four of the 8 informative cases. But extent and intensity of immunoreactivity did not correlated with loss of heterozygosity on chromosome 22. These genetic changes may play important roles in the pathogenesis of human intracranial meningioma.
Adult ; Blotting, Southern ; Female ; *Gene Expression Regulation, Neoplastic ; *Genes, myc ; Humans ; Immunohistochemistry ; Male ; Meningeal Neoplasms/*genetics ; Meningioma/*genetics ; Middle Aged

Two cases of giant cell tumor of bone diagnosed by fine needle aspiration cytology are decribed. Case 1 was a 28-year -old male who had pain sense for one year at the right distal thigh. His radiologic finding revealed a destructive cortical lesion with soft tissue extension at medial side of epiphysis of the distal femur. Case 2 was a 21-year-old female complaining pain at left distal forearm for eight months and showed a well-demarcated expansile osteolytic lesion with multisepatation, and cortical destruction at epiphysis and metaphysis of the left distal radius on the X-ray. Fine needle aspiration of each lesion was performed. The aspirate of the case 1 reveated moderate cellularity, which was composed of scattered giant cells of osteoclastic type and small round to oval monotonous stromal cells in large areas. Giant cells were evenly distributed in single or small groups and had irregular but abundant cytoplasms with 10 to 20 nuclei in the center. The nuclei showed ovoid shape, fine granular chromatin, and a small but conspicuous nucleolus, Stromal cells were dispersed in isolated pattern or sometimes aggregated in clusters and showed the same nuclei as those of giant cells and scanty cytoplasms, Comparing to case 1, case 2 had a more translucent abundant cytoplasm in the giant cells and more spindled stromal cells, All two cases revealed neither nuclear atypism nor increased abnormal mitoses in both giant and stromal cells, suggesting no evidence of malignancy. Therafter the lesions were treated with excision and curettage and histologically confirmed as giant cell tumors of the bone.
Biopsy, Fine-Needle* ; Chromatin ; Curettage ; Cytoplasm ; Epiphyses ; Female ; Femur ; Forearm ; Giant Cell Tumor of Bone ; Giant Cell Tumors* ; Giant Cells* ; Humans ; Male ; Mitosis ; Osteoclasts ; Radius ; Stromal Cells ; Thigh ; Young Adult

BACKGROUND: Typhoid fever, caused by Salmonella enterica serotype Typhi, remams an important public health problem in Korea, and asymptomatic chronic carriers play a role in the endemicity. However, the molecular studies of S. typhi isolates are very limited. We characterized clinical isolates of S. typhi by molecular and phage typing tools for the extent of genetic diversity and relatedness among the isolates. METHODS: A total of 49 S. typhi isolates from sporadic cases of typhoid fever were collected in 3 university hospitals in Seoul during 1992 to 1998 and examined for in vitro susceptibility to 14 antimicrobials by disk diffusion method, ribotyping using PstI restriction enzyme, and pulsed-field gel electrophoresis (PFGE) using XbaI and Vi phage typing. The distribution of the epidemiological types and genomic DNA relatedness were analyzed. RESULTS: Forty-five out of 49 isolates were susceptible to all drugs tested. Thirty-two out of 47 were typable by phage typing and 56.3% possessed the phage type El or Ml. Forty-nine isolates divided into 6 different ribotypes (A to F) and 19 different PFGE types (AO through A17, BO) by ribotyping and PFGE analysis, respectively. Based on the 3 typing systems, 32 isolates divided into 17 different epidemiological types. The E1-A-A12 (phage type-ribotype-PFGE type) was most prevalent (18.8Fo) and isolated only in 1998, but distributed in various areas of isolation. The next prevalent M1-A-A1 (15.6%) was isolated from 1992 through 1998. The genetic relatedness based on PFGE analysis revealed that F (coefficient of similarity) values are 0.64 to 1.0 and 0.52 for A subtypes and BO type, respectively. CONCLUSIONS: We conclude that the circulating S. typhi strains in Seoul city show considerable genetic diversity, whereas most of them seems to be clonally related.
Bacteriophage Typing ; Bacteriophages ; Diffusion ; DNA ; Electrophoresis, Gel, Pulsed-Field ; Genetic Variation ; Hospitals, University ; Korea ; Public Health ; Ribotyping ; Salmonella enterica* ; Salmonella typhi ; Salmonella* ; Seoul* ; Typhoid Fever

The Purposes of this study were to understand the types of appellations used by nurses and doctors for patients in a hospital and to analyze satisfaction and reason about appellation for patient. This would enable us to provide basic data on culturally suitable appellations for admitted patients. 454 Patients at K University hospital in Seoul were subjects for this study. Subjects were interviewed individually using a questionnaire and frequency X2-test. Results are as follows. 1. The most frequently used type of appellations in hospitals was '-ssi ; -sir' used by 88.1% of the nurses and 83.9% of the doctors. About 3 quaters of the medical staff used '-ssi' while none used job position. 2. 93.2% of the patients were satisfied with the appellations used by nurses and 93.0% of the patients were satisfied with the appellations used by the doctors 43.7% didn't think appellations were important and 44.3% thought it natural to use the appellation. The most satisfactory form of appellation used by nurses was '-ssi' to 93.3% of patients. All were satisfied with '-nim ; -sir', '-teacher' and there was no statistically significance. On the other hand, the level of satisfaction and the appellation used by doctors showed a relationship(X2=19.72, p=.000). Every patient was satisfied with '-nim' and '-teacher' but 19.9% were dissatisfied with the others of appellations. 3. Most patients preferred to be called '-ssi' by nurses(77.3%) and doctors(78.7%) respectively. The dominant reason being accuracy(45.8%), naturalness(33.9%) for nurses and 43.8% and 45.4% respectively for doctors. 4. The relationship between the type of appellations requested of nurses and general characteristics showed that age(X2=83.91% p=.000), level of education(X2=33.35 p=.000), and occupation(X2=38.22 p=.033) were related to the type of appellation. The type of appellation requested of doctors was related to the age(X2=72.56 p=.000), level of education(X2=30.01 p=.000), and occupation(X2=42.90 p=.010). Generally, '-ssi' was requested of doctors and nurses, but lower age group or higher age group(over 61), those in elementary schools or elementary school graduates and students preferred being called by their first names or grandfather, grandmother. From the results above, we can see that the most general type of appellation used for patients by the medical staff is '-ssi' and most patients were satisfied with the appellation but, the reason being that such appellations were accepted without concern. This shows that most are not adequately satisfied with the appellation. Only a small number of people use '-nim' and '-teacher' but is the preferred and frequently used types of appellation. Therefore, a continuous research of appellations used for patients with patients using '-nim' and an investigation with nurses' opinions of appellations for patients as the subject are required.
Hand ; Humans ; Medical Staff ; Surveys and Questionnaires ; Seoul

Congenital hypothyroidism (CH) is the most common endocrine disorder in neonates and infants with an incidence of one in 2,000 to one in 4,000 newborns. Primary CH can be caused by thyroid dysgenesis and thyroid dyshormonogenesis. CH due to a TG gene mutation is one cause of thyroid dyshormonogenesis and can be characterized by goitrous CH with absent or low levels of serum thyroglobulin (Tg). In the present case, a 15-day-old neonate was referred to us with elevated thyroid stimulating hormone detected during a neonatal screening test. At the age of 34 months, extensive genetic testing was performed, including targeted exome sequencing for hypothyroidism, and revealed compound heterozygous mutations in the TG gene. Sanger sequencing of both parents’ DNA samples revealed a c.3790T> C (p.Cys1264Arg) mutation located at exon 17 inherited from the mother, and a c.4057C> T (p.Gln1353*) mutation located at exon 19 was inherited from the father. The c.4057C> T (p.Gln1353*) mutation located at exon 19 has never been reported and, therefore, is a new discovery. We report a case of primary permanent CH with compound heterozygous mutations of the TG gene, including a novel mutation.
Congenital Hypothyroidism ; DNA ; Exome ; Exons ; Fathers ; Genetic Testing ; Humans ; Hypothyroidism ; Incidence ; Infant ; Infant, Newborn ; Mothers ; Neonatal Screening ; Thyroglobulin ; Thyroid Dysgenesis ; Thyroid Gland ; Thyrotropin

Smith-Kingsmore syndrome (SKS; OMIM 616638), also known as macrocephaly-intellectual disability-neurodevelopmental disorder-small thorax syndrome (MINDS; ORPHA 457485), is a rare autosomal dominant disorder, the prevalence of which is not known. It is caused by a heterozygous germline mutation in MTOR (OMIM 601231). Ten different MTOR germline mutations in 27 individuals have been reported in the medical literature to date. These were all gain-of-function missense variants, and about half of the 27 individuals had c.5395G>A p.(Glu1799Lys) in MTOR. Here, I report for the first time a Korean patient with the heterozygous germline mutation c.5395G>A p.(Glu1799Lys) in MTOR. It was found to be a de novo mutation, which was identified by whole-exome sequencing and confirmed by Sanger sequencing. The patient showed typical clinical features of SKS, including macrocephaly/megalencephaly; moderate intellectual disability; seizures; behavioral problems; and facial dysmorphic features of curly hair, frontal bossing, midface hypoplasia, and hypertelorism.
Databases, Genetic ; Germ-Line Mutation ; Hair ; Humans ; Hypertelorism ; Intellectual Disability ; Megalencephaly ; Prevalence ; Problem Behavior ; Seizures ; Thorax