PURPOSE: The purpose of this study is to analyze the smoking behaviors and to identify the impacts of depression, temperament, and characteristic on smoking experience in the female adolescents. METHODS: This study surveyed 691 highschool girls in the Gangwon area using self-administered questionnaires. Data were analyzed by SPSS 12.0. using Pearson correlation coefficient and multiple regression. RESULTS: The smoking rate of the highschool girls was lower than that of the national average. Depression was observed to be seriously in the highschool girls. There were a positive correlations among smoking experience, the school records and novelty seeking and a negative correlation between smoking and cooperativeness. The significant predictors of smoking experience were the type of school, the satisfaction with school, the school records, novelty seeking, reward dependence and cooperativeness. CONCLUSION: These results suggest that femalel adolescents who have the factors identified in this study are considered to have the potential for smoking. These results provide the basis for developing smoking prevention and cessation programs.
Adolescent* ; Depression* ; Female ; Gangwon-do ; Humans ; Reward ; Smoke* ; Smoking* ; Temperament* ; Surveys and Questionnaires

Merkel cell carcinoma (MCC) is an aggressive neuroendocrine carcinoma with a high rate of metastasis. MCC is rarely suspected during clinical examination, thus requiring biopsy to establish a pathologic diagnosis. In addition, MCC sometimes occurs in double primary cancers. Although there have been reviews on double primary cancers, only a few cases involving MCC have been described. Herein, we report a case of a 54-year-old female patient who presented to our clinic with a diagnosis of earlobe MCC following an excisional biopsy performed by another clinic. Further evaluation, including chest imaging, revealed a mass in the lung. The patient underwent a wide excision of the right earlobe, and video-assisted thoracic surgery on the lung. Pathology confirmed MCC in the right earlobe and adenocarcinoma in the lung. The patient underwent postoperative adjuvant chemotherapy followed by radiotherapy. Up to this point, 3 years after the surgery, there has been no evidence of recurrence.

The purpose of the study was to examine the adolescents' awareness and practice of Dietary Action Guide for Adolescence, which was developed by the Ministry of Health & Welfare. Subjects were middle and high school students, selected one class each from all of the 16 provinces in Korea, which were 32 schools and 998 students all together. The subjects were asked to self-evaluate the degree of awareness and practice of Dietary Action Guide using the 5 point-Likert scale from July to September, 2010. On average, 55.1% of the students responded that they were aware of the Dietary Action Guide and 49.4% answered that they put Guidelines into practice. The average score of awareness and practice were 3.54 +/- 0.24 and 3.42 +/- 0.33, respectively. The awareness score was higher than those of practice score in all the questions in the 6 categories. Awareness score of female students was higher than those of male students but there was no difference by residence area. Awareness and practice of the nutrition education-experienced were higher than those of the inexperienced. Practice score was higher among middle school-students compared to high school students, which reflected the opportunity of taking nutrition related classes. This finding shows that nutrition education for adolescents is important to change their dietary behaviors regardless of gender, residence area and school level.
Adolescent ; Female ; Humans ; Korea ; Male

To select the method to cover the soft tissue defect, we should take into account of many factors, such as the location of the defect, the depth and length of the defect, the presence of the osteomyelitis, the exposure of nerve, blood vessel and bone, and so on. As a first choice, primary closure or skin graft can be done. However, with the exposure of tendon, bone, blood vessle and nerve, we should consider local flap, muscle flap, fasciocutaneous flap, musculocutaneous flap and free flap to cover the defect. To make matters worse, it can be happened in some cases that these procedures are even impossible due to debilitating general condition, accompanying other diseases or previous operative scar in neighboring tissue. The authors reconstructed the soft tissue defect elevating the neighboring dermal flap or fasciodermal flap in the fashion of -over flap after deepethelialization in 7 cases of total 6 patients. They had soft tissue defect with varying etiologies and skin graft was done both on the recipient and donor sites of turnover flap in all cases except case 4. With the average 1Z.7 months of follow up period, turn-over flap brought satisfactory results in functional and aesthetic aspects without notable complications in donor and recipient sites, though it has a tendency to leave the recipient site somewhat hypertrophied comparing with neighboring no 1 tissue. In conclusion, turnover flap is an useful one-staged operative procedure and it is simple in design and easy in technique. Furthermore, the operative procedure can be done with the advantage of providing safe and thick skin to the area with a remarkable scar in neighboring tissue after multiple operative procedures or to the case in which it is difficult to do the skin graft, local flap or distant flap due to the technical problems.
Blood Vessels ; Cicatrix ; Follow-Up Studies ; Free Tissue Flaps ; Humans ; Myocutaneous Flap ; Osteomyelitis ; Skin ; Surgical Procedures, Operative ; Tendons ; Tissue Donors ; Transplants

Anterior diastemas are common esthetic problems. One of the challenges in clinical esthetic dentistry is closing anterior diastemas without creating “black triangles” between the teeth. The success of a restorative treatment in anterior teeth depends on the esthetic integration between soft tissues and hard tissues. This report describes the successfully accomplished diastema closure case by producing the emergence profile with natural contours at the gingival-tooth interface and then generating of gingival recontouring process.
Dentistry ; Diastema* ; Tooth

Operating Room nurses are required to have special skills and knowledge to do their job. However, because there is no systematic education program, which considers special circumstances in the OR, novice nurses have a great deal of difficulty adapting themselves to the work environment. The purpose of this study is to develope a multimedia education program, which provides the systematic learning environment, so novice nurses can adapt to the OR environment more effectively. This study has been implemented according to Computer Assisted Instruction Design Model(Il-Joo Na and In-Sung Jung, 1990), which goes through the following steps; 1). Education program analysis 2). Development, evaluation 3). CompletionLearning goals, objectives, motive strategy, and analysis of the education program are analyzed by the concepts based on basic education materials for novice surgery nurses of 6 Medical Centers in Seoul and 'Development of the job training program for newly employed nurses in operating rooms. 'written by Ji-Young Yoon(2000). We divided 9 areas of the contents in surgery education; 1. Basic orientation 2. OR nurses' roles and responsibilities 3. Asceptic technique 4. Disinfection and sterilization 5. OR safety 6. OR nursing care 7. Surgical positioning 8. OR Material management 9. Anesthetic care. We selected asceptic technique, which is the most fundamental concept in OR nursing care. The program screens consist of cover screen, screen for guide, mini menu screen, and test screen. We distributed questionnaires to fifteen experts and investigated their opinions to analyze learning contents and effects of the Courseware. The education program was modified based on respones provided by experts. This study offers an educational program, which allows the individuals to choose the areas they want to learn. The program is easy to use, which encourages the individuals to search for additional information more than one area.
Computer-Assisted Instruction ; Disinfection ; Education* ; Learning ; Multimedia* ; Nursing Care ; Operating Rooms* ; Surveys and Questionnaires ; Seoul ; Sterilization

No abstract available.
Apoptosis* ; Placenta Previa* ; Placenta*

A 31-year-old woman admitted because of fever, chilling and sore throat for 4 days. The symptom was developed after receiving methimazole 20mg per day and carteolol 10mg per day due to Graves disease during last 4 weeks. Physical examination revealed hyperemic enlarged tonsils with whitish plaque. The peripheral blood total neutrophil count was 1,400/mm3 (absolute neutrophil count, ANC 36) and a peripheral blood smear revealed rare neutrophil with lymphocytosis. On the first day of hospitalization, the patient was severely ill with ANC 0, it was decided to administer G-CSF 2ug/kg daily. On the fifth day of hospitalization, ANC in peripheral blood count was persistently zero and bone marrow aspiration and biopsy were performed, which revealed hypocellularity and myeloid hypoplasia. G-CSF given daily for 7days, it was discontinued when the ANC reached 1,539/mm3. The availability of G-CSF may help to shorten the course of agranulocytosis and to reduce its mortality rate.
Adult ; Agranulocytosis* ; Biopsy ; Bone Marrow ; Carteolol ; Colony-Stimulating Factors* ; Female ; Fever ; Granulocyte Colony-Stimulating Factor* ; Granulocytes* ; Graves Disease ; Hospitalization ; Humans ; Lymphocytosis ; Methimazole* ; Mortality ; Neutrophils ; Palatine Tonsil ; Pharyngitis ; Physical Examination

BACKGROUND: For effective blood usage and reduction of unnecessary workload at blood banks, we established the maximum surgical blood order schedule (MSBOS) for major elective surgeries and evaluated indicators, including the rate of returned red blood cells (RBCs). METHODS: During August 2016 and May 2017, MSBOS for neurosurgery, thoracic surgery, orthopedic surgery, and general surgery was established using two formulas: the mean units of transfusion per procedure (MSBOS 1) and the mean units of transfusion in transfused patients per procedure (MSBOS 2). The crossmatch to transfusion (C/T) ratio, transfusion probability, and rate of returned RBCs were calculated and analyzed. RESULTS: Based on MSBOS 1, type and screen can be applied to all elective surgeries of the general surgery department. MSBOS 2 was higher than MSBOS 1 in most surgeries ranging from 1 to 3 units. The C/T ratio and transfusion probability of surgery exhibited similar tendencies, and the general surgery department was over-prescribed compared to the actual transfusion requirement. The rate of returned RBCs was the highest in thoracic surgery (32/101, 32%), and the total number of returned RBC unit was the highest in orthopedic surgery (276 of 1131 units). CONCLUSION: MSBOS 1 was the formula corresponding to the purpose of the maximum blood application protocol. Application of an appropriate MSBOS protocol and concurrent utilization of C/T ratio, probability of transfusion, and rate and number of returned units of RBCs will further aid the efficiency of blood bank resources.
Appointments and Schedules* ; Blood Banks ; Erythrocytes ; Humans ; Neurosurgery ; Orthopedics ; Thoracic Surgery

BACKGROUND: Hematopoietic stem cell transplantation (HSCT) patients need parenteral nutrition because of nausea, vomiting, and mucositis caused by conditioning regimens. The demand for glutamine increases during the HSCT period. We evaluated the effects of glutamine-containing parenteral nutrition on the clinical outcomes of HSCT patients. METHODS: In this retrospective analysis, we reviewed HSCT patients from Seoul National University from August 2013 to July 2017. Depending on their glutamine supplementation status, 91 patients were divided into 2 groups: glutamine group (N=44) and non-glutamine group (N=47). We analyzed the rate of weight change, infection (clinically/microbiologically documented), complications (duration of mucositis and neutropenia, acute graft versus host disease), and 100-days mortality in each group. RESULTS: Regarding the clinical characteristics of the patients, there were no significant differences between the 2 groups except that there was a larger proportion of myeloablative conditioning regimen in the glutamine group (P=0.005). In the glutamine group, the average number of days of glutamine use, parenteral nutrition, and mucositis was 7.6±1.4, 14.6±9.9, and 13.3±9.5, respectively. Furthermore, multivariate analysis revealed odds ratios of 0.37 (95% CI, 0.14–0.96; P=0.042) and 0.08 (95% CI, 0.01–0.98; P=0.048) for clinically documented infection and 100-days mortality, respectively, in the glutamine group. CONCLUSION: Results showed that the glutamine group had less clinically documented infection and 100-days mortality than the non-glutamine group, but the other outcomes did not show significant differences. The extended duration of glutamine supplementation according to the period of total parenteral nutrition and mucositis should be considered.
Adult ; Glutamine ; Hematopoietic Stem Cell Transplantation ; Hematopoietic Stem Cells ; Humans ; Mortality ; Mucositis ; Multivariate Analysis ; Nausea ; Neutropenia ; Odds Ratio ; Parenteral Nutrition ; Parenteral Nutrition, Total ; Retrospective Studies ; Seoul ; Transplants ; Vomiting