PURPOSE: This study aimed to investigate child abuse awareness and reporting intention among nursing and education students and correlations among the variables involved. METHODS: A cross-sectional study was conducted by administering an online questionnaire to 70 nursing college students and 70 education college students. Data were analyzed using descriptive statistics, t-test, chi-squared test, the Mann-Whitney U test, and Pearson's correlation in SPSS 21.0 (IBM, Armonk, NY). RESULTS: The mean score of child abuse awareness was 3.61±0.32 for nursing students and 3.60±0.36 for education students. The mean score of reporting intention was 5.65±0.90 for nursing students and 5.38±1.03 for education students. Females presented higher scores than males in the awareness of sexual abuse. The awareness of emotional abuse was higher in students who knew of reporting obligations or who had experienced abuse. Child abuse awareness and reporting intention were significantly positively correlated. Also, the number of times having received child abuse education was correlated with reporting intention in both mild and severe cases of abuse. CONCLUSION: Reporting intention is not only related to having received education, but also to the frequency of that education. Child abuse education is important to increase reporting intention and should be delivered repeatedly.
Child ; Child Abuse ; Child ; Cross-Sectional Studies ; Education ; Female ; Humans ; Intention ; Male ; Nursing ; Sex Offenses ; Students, Nursing

PURPOSE: Planning target volume (PTV) for tumors in abdomen or thorax includes enough margin for breathing-related movement of tumor volumes during treatment. Depending on the location of the tumor, the magnitude of PTV margin extends from 10 mm to 30 mm, which increases substantial volume of the irradiated normal tissue hence, resulting in increase of normal tissue complication probability (NTCP). We developed a simple and handy method which can reduce PTV margins in patients with liver tumors, respiratory motion reduction device (RRD). MATERIALS AND METHODS: For 10 liver cancer patients, the data of internal organ motion were obtained by examining the diaphragm motion under fluoroscope. It was tested for both supine and prone position. A RRD was made using MeV-Green and Styrofoam panels and then applied to the patients. By analyzing the diaphragm movement from patients with RRD, the magnitude of PTV margin was determined and dose volume histogram (DVH) was computed using AcQ-Plan, a treatment planning software. Dose to normal tissue between patients with RRD and without RRD was analyzed by comparing the fraction of the normal liver receiving to 50% of the isocenter dose. DVH and NTCP for normal liver and adjacent organs were also evaluated. RESULTS: When patients breathed freely, average movement of diaphragm was 12+/-1.9 mm in prone position in contrast to 16+/-1.9 mm in supine position. In prone position, difference in diaphragm movement with and without RRD was 3+/-0.9 mm and 12 mm, respectively, showing that PTV margins could be reduced to as much as 9 mm. With RRD, volume of the irradiated normal liver reduced up to 22.7% in DVH analysis. CONCLUSION: Internal organ motion due to breathing can be reduced using RRD, which is simple and easy to use in clinical setting. It can reduce the organ motion-related PTV margin, thereby decrease volume of the irradiated normal tissue.
Abdomen ; Carcinoma, Hepatocellular* ; Diaphragm ; Humans ; Liver ; Liver Neoplasms ; Prone Position ; Respiration ; Supine Position ; Thorax

OBJECTIVE: To examine the incidence of the depressive symptoms during pregnancy and the socio-demographic and obstetric factors associated with depression. METHODS: Two hundred five women who had received antenatal care at Kangnam St. Mary's Hospital from March 2008 to May 2008 completed the questionnaire related to socio-demographic characteristics and Edinburgh Postnatal Depression Scale (EPDS). Statistics were performed using chi-square test and Fisher's extract test (SPSS 12.0). Results were considered statistically significant for P-values<0.05. RESULTS: Of 205 pregnant women, the mean score of EPDS was 7.3+/-4.2.54 of 205 women (26.5%) scored more than 10 point which is the cutoff value to define depressive symptoms. The incidences of depressive symptoms were not significantly different by the trimester (25.7% vs. 29.0% vs. 25.0%, P<0.844). There were no significant socio-geographic factors associated with depressive symptoms. In cases of unexpected pregnancies, the incidence of depressive symptoms was significantly high (34.6% vs. 21.0%, P=0.036), and the women who have problems of previous pregnancies scored significantly higher EPDS (56.3% vs. 23.8%, P=0.014). CONCLUSION: This study was the first report about the depression symptoms during pregnancy. Based on this study, we have to focus on and manage depression symptoms related to pregnancy.
Depression ; Depression, Postpartum ; Female ; Humans ; Incidence ; Pregnancy ; Pregnant Women ; Surveys and Questionnaire

Although pregnancy is a medical condition that contributes to bone loss, little information is available regarding bone mineral density (BMD) in puerperal women. This cross sectional study aimed to evaluate the prevalence of low BMD in puerperal women and to identify associated risk factors. We surveyed all puerperal women who had BMD measurements taken 4–6 weeks after delivery in a tertiary university hospital, and did not have any bone loss-related comorbidities. Among the 1,561 Korean puerperal women, 566 (36.3%) had low BMD at the lumbar spine, total hip, femoral neck, and/or trochanter. Multivariate analysis revealed that underweight women had a significantly higher risk of low BMD compared with obese women at pre-pregnancy (adjusted odds ratio [aOR], 3.21; 95% confidence interval [CI], 1.83–5.63). Also, women with inadequate gestational weight gain (GWG) were 1.4 times more likely to have low BMD than women with excessive GWG (aOR, 1.42; 95% CI, 1.04–1.94). One-way ANOVA showed that BMDs at the lumbar spine and total hip were significantly different between the 4 BMI groups (both P < 0.001) and also between the 3 GWG groups (both P < 0.001). In conclusion, this study identifies a high prevalence of low BMD in puerperal women and thus suggests the need for further evaluation about the change of BMD in pregnancy and postpartum period.
Body Mass Index ; Bone Density* ; Comorbidity ; Female ; Femur ; Femur Neck ; Hip ; Humans ; Multivariate Analysis ; Odds Ratio ; Osteoporosis ; Postpartum Period ; Pregnancy ; Prevalence* ; Risk Factors* ; Spine ; Thinness ; Weight Gain

Vaccination is one of the most effective methods available to prevent infectious diseases. Mucosa, which are exposed to heavy loads of commensal and pathogenic microorganisms, are one of the first areas where infections are established, and therefore have frontline status in immunity, making mucosa ideal sites for vaccine application. Moreover, vaccination through the mucosal immune system could induce effective systemic immune responses together with mucosal immunity in contrast to parenteral vaccination, which is a poor inducer of effective immunity at mucosal surfaces. Among mucosal vaccines, oral mucosal vaccines have the advantages of ease and low cost of vaccine administration. The oral mucosal immune system, however, is generally recognized as poorly immunogenic due to the frequent induction of tolerance against orally-introduced antigens. Consequently, a prerequisite for successful mucosal vaccination is that the orally introduced antigen should be transported across the mucosal surface into the mucosa-associated lymphoid tissue (MALT). In particular, M cells are responsible for antigen uptake into MALT, and the rapid and effective transcytotic activity of M cells makes them an attractive target for mucosal vaccine delivery, although simple transport of the antigen into M cells does not guarantee the induction of specific immune responses. Consequently, development of mucosal vaccine adjuvants based on an understanding of the biology of M cells has attracted much research interest. Here, we review the characteristics of the oral mucosal immune system and delineate strategies to design effective oral mucosal vaccines with an emphasis on mucosal vaccine adjuvants.
Biology ; Communicable Diseases ; Immune System ; Immunity, Mucosal ; Lymphoid Tissue ; Mucous Membrane ; Receptor, Anaphylatoxin C5a ; Vaccination ; Vaccines

Porcine epidemic diarrhea virus (PEDV) is a contagious coronavirus infecting pigs that leads to significant economic losses in the swine industry. Given that PEDV infection occurs in gut epithelial cells mainly via the fecal-oral route, induction of PEDV-specific immune responses in the mucosal compartment is required for protective immunity against viral infection. However, an effective mucosal vaccine against the currently prevalent PEDV strain is not available. In this study, we demonstrated that the N-terminal domain (NTD) of the spike (S) protein of PEDV represents a new vaccine candidate molecule to be applied via the mucosal route. We first established an Escherichia coli expression system producing the partial NTD (NTD231–501) of the PEDV S protein. Orally administered NTD231–501 protein specifically interacted with the apical area of M cells in the follicle-associated epithelium of Peyer's patch. Additionally, the NTD protein induced antigen-specific immune responses in both the systemic and mucosal immune compartments when administered orally. Collectively, we propose the NTD of the PEDV S protein to be a candidate mucosal vaccine molecule.
Coronavirus ; Epithelial Cells ; Epithelium ; Escherichia coli ; Immunity, Mucosal ; Porcine epidemic diarrhea virus* ; Swine

BACKGROUND/AIMS: Depression and allergic diseases, including asthma, are frequently reported as comorbid conditions. However, their associations have been rarely examined in community-based elderly populations. METHODS: The analyses were performed using the baseline data set of the Korean Longitudinal Study of Health and Aging, which consists of 1,000 elderly participants (aged > 65 years) randomly recruited from an urban community. Depression was assessed using the Geriatric Depression Scale, Center for Epidemiologic Studies Depression Scale, and Hamilton Rating Scale for Depression. Major and minor depressive disorders were diagnosed by psychiatrists. Allergic conditions were assessed using structured questionnaires, lung function, and skin prick test. Quality of life and comorbidities were assessed using structured questionnaires. RESULTS: Prevalence of asthma and major depressive disorder were 5.4% and 5.3%, respectively. The rate of depression was not significantly different between the non-asthmatic and asthmatic groups. No correlation was observed between the scores obtained using the depression scales and self-reported asthma. However, chronic, frequent, and nocturnal cough were significantly associated with depression and scores obtained using the depression scales, which remained significant in multivariate logistic regression analyses (chronic cough: odds ratio [OR], 3.23; 95% confidence interval [CI], 2.57 to 12.74; p = 0.04). Rhinitis was independently associated with high Mini-Mental State Examination scores (OR, 1.11; 95% CI, 1.05 to 1.17; p < 0.001) and low 36-item short-form (OR, 0.96; 95% CI, 0.80 to 0.98; p = 0.002). CONCLUSIONS Depression may not be significantly associated with asthma and allergic diseases in elderly populations, but cough is a significant factor affecting depression.

OBJECTIVE: The dorsomedial cutaneous nerve (DMCN) to the great toe is a branch of the medial dorsal cutaneous nerve, which originates from the superficial peroneal nerve. The objective of this study is to standardize the electrodiagnostic technique, and to investigate the usefulness of dorsomedial cutaneous nerve (DMCN) conduction study in patients with peripheral neuropathy. METHOD: Sixty two legs in 31 normal adults and 56 legs in 28 patients with the clinical signs and symptoms as well as electrodiagnostic evidences of peripheral neuropathy were evaluated with the DMCN conduction study. The stimulating electrode was placed over the lateral 1/3 between medial and lateral malleoli and the active electrode was placed over 12 mm medial and 10 mm proximal to the extensor hallucis longus tendon over the 1st metatarsophalangeal joint. RESULTS: The mean values of DMCN conduction study in normal adults were 2.95+/-0.47 msec for onset latency, 3.58+/-0.43 msec for peak latency, 6.67+/-2.87microvolt in amplitude, and 12.96+/-1.17 cm for distance from active electrode to stimulation point. There were statistically significant differences between normal and patients groups in all parameters except the distance. CONCLUSION: A method for DMCN conduction study was introduced which could be used as a valuable technique for the early evaluation of peripheral neuropathy.
Adult ; Electrodes ; Humans ; Leg ; Metatarsophalangeal Joint ; Peripheral Nervous System Diseases ; Peroneal Nerve ; Tendons ; Toes*

For the management of refractory radicular pain, traditional injection techniques such as transcaudal or translumbar epidural steroid injection may be indicated. This epidural injection, done blindly, may result in improper needle placement. Fluoroscopically guided transforaminal epidural steroid injection and computerized tomography-controlled periganglionic foraminal steroid injection are selective nerve blocks. These procedures are useful for the diagnosis. The advantages of these procedures are precise anatomic location provided by fluoroscope or CT. Intraforaminal or periganglionic steroid injection is useful in the treatment of radicular pain. Thus we introduce a case of selective epidural steroid injection in a patient with refractory radicular pain.
Diagnosis ; Humans ; Injections, Epidural ; Leg* ; Needles ; Nerve Block

BACKGROUND AND OBJECTIVES: Angiogenesis is a necessary process for solid tumor to grow in human body, and thought to play an important role in metastasis. In some solid tumor such as the breast cancer and prostatic cancer, the angiogenesis is thought to be one of the most significant prognostic factors that predict the patient survival rate and metastasis. The purpose of this study is to define the significance of angiogenesis in the head and neck squamous cell carcinoma (HNSCC). SUBJECTS AND METHOD: We measured the microvascular density (MVD) using immunohistochemistry with anti-CD34 antibody in 40 HNSCC. The maximal and average MVD was compared with the clinical parameters such as stage, cervical lymph node metastasis, recurrence, and survival rate, obtained through the retrospective review of the medical records. RESULTS: 1) The maximal and average MVD correlated with overall stage, T stage and N stage statistically. The MVD were increased according to the increasement of the T and N stage. 2) The maximal and average MVD showed a significant relationship with 3 year survival rate. 3) There were no relationship between maximal and average MVD and local or regional recurrence. CONCLUSION: The maximal and average MVD may be a significant prognostic factors which can predict the survival rate of the patients with HNSCC.
Angiogenesis Inducing Agents ; Breast Neoplasms ; Carcinoma, Squamous Cell* ; Head* ; Human Body ; Humans ; Immunohistochemistry ; Lymph Nodes ; Medical Records ; Neck* ; Neoplasm Metastasis ; Prostatic Neoplasms ; Recurrence ; Retrospective Studies ; Survival Rate