PURPOSE: The purpose of this study was to identify factors associated with intermittent and light smoking among Korean high school students. METHODS: In this cross-sectional study, we employed secondary data from the 2015 Korea Youth Risk Behavior Web-Based Survey, and used the biopsychosocial model as a framework. The analysis was performed using the data of 2,851 high school students who smoked. We defined intermittent and light smoking as smoking on 1 to 29 days in a 30-day period and no more than 10 cigarettes per day. A logistic regression analysis using the complex samples procedure was conducted. RESULTS: Among all the participants, 1,231 (43.2%) were intermittent and light smokers. Factors significantly predicting intermittent and light smoking were gender and grade (biological factors); subjective stress (psychological factor); and mother's smoking, sibling's smoking and academic achievement (sociocultural factors). CONCLUSION: In smoking cessation programs, health care providers both at school and in the community should consider the unique biological, psychological, and sociocultural characteristics of intermittent and light smoking behavior among high school students.
Adolescent ; Cross-Sectional Studies ; Health Personnel ; Humans ; Korea ; Logistic Models ; Risk-Taking ; Smoke ; Smoking Cessation ; Smoking ; Tobacco Products

BACKGROUND: The purpose of this study was to identify and compare perception of importance and satisfaction regarding communication needs among patients and nurses in emergency centers.METHODS: This study used a cross sectional design and included 64 of patients and 37 of nurses in emergency centers of university hospitals located in Daejeon. Data were collected with a self-administered questionnaire between April 2017 and June in 2017. Data analysis was conducted using descriptive statistics.RESULTS: Regarding importance of communication needs, both groups of the patients and the nurses significantly recognized the importance of providing information such as performed tests and treatments and visiting time of charged physicians. Meanwhile, emotional supports and concern about social or cultural needs was recognized as less important communication needs among the patients and nurses. Regarding satisfaction of communication needs, patients were less satisfied with the needs they regarded as the most important and nurses showed moderate levels of satisfaction. This indicates that patients and nurses differ in the standards and expectations for communication performance.CONCLUSION: It is important that emergency room nurses should recognize the current situation in which the patients' desired communication needs are not being met and they should start to focus improvement effort and new directions of emergency room care systems to meet the communication needs.
Emergencies ; Emergency Service, Hospital ; Hospitals, University ; Humans ; Statistics as Topic

BACKGROUND: Several methods are performed to control the pain after a laparoscopic cholecystectomy. Recently, the transverse abdominis plane block has been proposed to compensate for the problems developed by preexisting methods. This study was designed to evaluate the effect of the ultrasound-guided transverse abdominis plane block (US-TAP block) and compare efficacy according to the concentration of local analgesics in patients undergoing laparoscopic cholecystectomy. METHODS: Fifty-four patients undergoing laparoscopic cholecystectomy were randomized into three groups. The patients in Group Control did not receive the US-TAP block. The patients in Group B(0.25) and Group B(0.5) received the US-TAP block with 0.25% and 0.5% levobupivacaine 30 ml respectively. After the general anesthesia, a bilateral US-TAP block was performed using an in-plane technique with 15 ml levobupivacaine on each side. Intraoperative use of remifentanil and postoperative demand of rescue analgesics in PACU were recorded. The postoperative verbal numerical rating scale (VNRS) was evaluated at 20, 30, and 60 min, and 6, 12, and 24 hr. Postoperative complications, including pneumoperitoneum, bleeding, infection, and sleep disturbance, were also checked. RESULTS: The intraoperative use of remifentanil, postoperative VNRS and the postoperative demand of rescue analgesics were lower in the groups receiving the US-TAP block (Group B(0.25) and Group B(0.5)) than Group Control. There were no statistically or clinically significant differences between Group B(0.25) and Group B(0.5). No complications related to the US-TAP block were observed. CONCLUSIONS: The US-TAP block with 0.25% or 0.5% levobupivacaine 30 ml (15 ml on each side) significantly reduced postoperative pain in patients undergoing laparoscopic cholecystectomy.
Analgesics ; Anesthesia, General ; Bupivacaine ; Cholecystectomy, Laparoscopic ; Hemorrhage ; Humans ; Pain, Postoperative ; Piperidines ; Pneumoperitoneum ; Postoperative Complications

BACKGROUND: It is known that bupivacaine induce cell death in several immortalized cells. However, there is no report concerning bupivacaine-induced cell death in the primary cultured cardiomyocytes. We compared the direct cytotoxicity of local anesthetics in cardiomyocytes. Furthermore, the mechanisms of cell death were evaluated. METHODS: The myocardial cells of rat pups were cultured 3 days after seeding. The methyltetrazolium (MTT) assay was employed to quantify differences in cellular viability. To confirm apoptosis, Hoechst-propidium iodide staining, DNA fragmentation by electrophoresis and western blot analysis were performed. And to examine the mechanisms of cell death, intracellular calcium and expression levels of mitogen-activated protein kinases (MAPKs) family members were evaluated. RESULTS: Among the local anesthetics under 1 mM concentration for 18 h, only bupivacaine significantly decreased the MTT activity (P < 0.001). Bupivacaine induced cell death in a dose-responsive and time dependent manner. Cell death showed apoptotic characteristics, such as DNA fragmentation, chromatin condensation, decrease of precursor caspase-3 protein level, increased cleaved PARP, and cytochrome C release into the cytoplasm. Bupivacaine phosphorylated three major MAPKs, i.e. extracellular signal-regulated kinases (ERKs), p38 kinase and c-Jun N-terminal kinases (JNKs) stress-activated protein kinases. Administration of ERK inhibitor increase cell death, whereas inhibitors of p38 kinase and JNK decreased cell death (P < 0.05). In addition, the intracellular calcium level was approximately 4 times higher after the bupivacaine treatment (P < 0.001), which was inhibited by calcium chelators (P < 0.001). Calcium chelators inhibited expression of MAPKs. CONCLUSIONS: In bupivacaine-induced apoptosis in cardiomyocytes, intracellular calcium increase and MAPKs family plays important roles.
Anesthetics, Local ; Animals ; Apoptosis* ; Blotting, Western ; Bupivacaine ; Calcium ; Caspase 3 ; Cell Death ; Chelating Agents ; Chromatin ; Cytochromes c ; Cytoplasm ; DNA Fragmentation ; Electrophoresis ; Extracellular Signal-Regulated MAP Kinases ; Humans ; Mitogen-Activated Protein Kinases ; Myocytes, Cardiac* ; p38 Mitogen-Activated Protein Kinases* ; Phosphotransferases ; Protein Kinases ; Rats

Using 3D ultrasound, bilateral chylothorax was diagnosed antenatally in the second trimester. Apparently stable, bilateral pleural effusion progressed rapidly to severe hydrops with facial edema during observation, and then we decided bilateral pleural-amniotic shunt operation. Here we present a case where drainage of pleural effusion by a double reverse pig tail stent made by ourself was achieved, although placement of the thoracoamniotic shunt resulted in near complete drainage of bilateral pleural effusion with normalization of intrathoracic anatomic relationships, subsequent resolution of fetal hydrops, but the ultimate outcome was unsuccessful due to the internalization of one catheter and unknown sudden death. We think that ongoing research is required to further evaluation about complications associated with this procedure, specifically failure of function due to obstruction, migration of the catheter,
Catheters ; Chylothorax* ; Death, Sudden ; Drainage ; Edema ; Female ; Humans ; Hydrops Fetalis ; Pleural Effusion ; Pregnancy ; Pregnancy Trimester, Second ; Stents ; Tail ; Ultrasonography

BACKGROUND AND OBJECTIVES: This study was designed to examine the effects of diamide and thioredoxin (TRX) on vascular endothelial cells in order to clarify the mechanism by which vascular damage is mediated by oxygen free radicals. MATERIALS AND METHODS: The pulmonary artery endothelial cell (PAEC) line derived from bovine serum was cultured for 8 hours in media supplemented with various concentrations of diamide and TRX. The XTT assay, MTS assay, SRB assay, LDH activity and lipid peroxidation tests were perfomed. RESULTS: In XTT and MTS assays, diamide significantly decreased the cell viability of cultured PAEC in a dose- and time-dependent manner. Diamide showed a decrease in the amount of total protein, although it showed an increase of lipid peroxidation and LDH activity in cultured PAEC. In regards to the protective effect of TRX on diamide-induced cytotoxicity, this showed an increase of total protein, however it showed a decrease of lipid peroxidation and LDH activity. CONCLUSION: Our results suggest that diamide has a vasculotoxic effect on cultured bovine PAEC and that TRX is very effective in the protection of diamide-induced cytotoxicity by duye to the increase of total protein and the decrease of lipid peroxidation and LDH activity in these cultures.
Cell Survival ; Diamide* ; Endothelial Cells* ; Endothelium, Vascular ; Free Radicals ; Lipid Peroxidation ; Oxygen ; Pulmonary Artery ; Thioredoxins*

BACKGROUND/AIMS: Sedative use is common in endoscopic examinations. The anxiety regarding sedative use may be different between doctors and nonmedical individuals. METHODS: A questionnaire survey was conducted by a research company (DOOIT Survey), and responses were collected from 649 doctors and 1,738 individuals who perform typical jobs in nonmedical fields. In this study, these ordinary workers are considered to represent nonmedical individuals. Anxiety was measured using a 5-point Likert scale. RESULTS: The nonmedical individuals exhibited more anxiety regarding the sedative use than the doctors. Age <40 years (odds ratio [OR], 2.27; p<0.001), female sex (OR, 1.62; p=0.002), experience of an adverse event (OR, 1.79; p=0.049), and insufficient explanation (OR, 2.05; p<0.001) were the significant factors that increased the anxiety of the nonmedical individuals. The doctors who experienced a sedative-related adverse event reported increased anxiety compared with the doctors who did not report this experience (OR, 1.73; p=0.031). CONCLUSIONS: Anxiety regarding sedative use during an endoscopic examination was significantly different between doctors and non-medical individuals. A younger age, female sex, an adverse event, and insufficient explanation affect the anxiety of nonmedical individuals. An adverse event also affects the anxiety of doctors.
Anxiety* ; Conscious Sedation ; Endoscopy ; Female ; Humans ; Seoul* ; Surveys and Questionnaires

A 74-year-old woman underwent posterior lumbar decompressive fusion at L4-5 for treating spondylolisthesis, with the patient under general anesthesia and she was in the prone position. Following attempts to transfuse blood using a pressurized bag, the intravenous infusion site of the left hand along with the noninvasive blood pressure cuff was changed. Swelling and several bullae on the left forearm and hand were visible. Removal of intravenous catheter, hyaluronidase injection, wet dressing were subsequently performed. In postanesthesia recovery unit, the patient did not complain of pain, and the radial pulse and oxygen saturation of the left appeared normal. Three days after the incident, the edema on the patient's forearm and hand subsided, and the patient was discharged without any complications two weeks afterwards. Impending compartment syndrome should be given close attention, and particularly when performing pressurized infusion in patients who are unable to express pain because they are under general anesthesia.
Aged ; Anesthesia, General ; Bandages ; Blister ; Blood Pressure ; Catheters ; Compartment Syndromes ; Edema ; Female ; Forearm ; Hand ; Humans ; Hyaluronoglucosaminidase ; Infusions, Intravenous ; Oxygen ; Prone Position ; Spondylolisthesis

Negative pressure pulmonary edema (NPPE) is a rare complication of acute airway obstruction which develops after endotracheal extubation. The proposed mechanism is generation of very low negative pressure during laryngospasm by inspiratory efforts, which leads to alveolar exudation and hemorrhage. The diagnosis of NPPE is confirmed by clinical findings of tachypnea, pink prothy sputum in the endotracheal tube, hypoxemia on arterial blood gas analysis, and distinctive radiologic findings. NPPE is usually self-limited within 48 hours when diagnosed early and treated appropriately. We report three patients who recovered from NPPE without complications.
Airway Extubation ; Airway Obstruction ; Anoxia ; Blood Gas Analysis ; Hemorrhage ; Humans ; Laryngismus ; Pulmonary Edema ; Sputum ; Tachypnea

PURPOSE: Currently, many operations are performed using the single-incision laparoscopic method. Although there have been recent reports on single-incision laparoscopic ileostomy, none have compared this method to conventional laparoscopic ileostomy. This study aimed to assess the safety and feasibility of single-incision laparoscopic ileostomy for anastomotic leakage following laparoscopic low anterior resections. METHODS: From April 2012 to April 2017, 38 patients underwent laparoscopic ileostomy (single-incision; 19 patients referred to as group A, conventional laparoscopy; 19 patients referred to as group B) for anastomotic leakage following laparoscopic low anterior resection. We analyzed surgical and clinical outcomes between the 2 groups. Patients in whom a protective ileostomy was carried out during the initial laparoscopic low anterior resection were excluded from this study. RESULTS: No significant differences were observed between the 2 groups in terms of patient demographics and initial operation details. Incisional surgical site infections occurred less in group A than in group B (2 of 19 vs. 9 of 19, P = 0.029). The median ileostomy operation time, amount of intraoperative bleeding, parastomal hernia ratio, hospital stay duration after ileostomy, postoperative pain score were not significantly different between the 2 groups. CONCLUSION: Single-incision laparoscopic ileostomy is safe and feasible method of fecal diversion for anastomotic leakage following laparoscopic low anterior resection.
Anastomotic Leak* ; Demography ; Hemorrhage ; Hernia ; Humans ; Ileostomy* ; Laparoscopy ; Length of Stay ; Methods* ; Minimally Invasive Surgical Procedures ; Pain, Postoperative ; Surgical Wound Infection