PURPOSE: The smoking rates among teenagers in Korea grow gradually since 1980s despite of the numerous programs for youth smoking prevention and cessation have been developed and implemented. The purpose of this study was to explore and describe the processes of habituating to smoking among teenagers using the grounded theory methodology. METHOD: Qualitative data was collected via six focus group interviews. A total of 38 people, twelve teachers and 24 middle school students participated in this study. All focus group interviews were tape-recorded, transcribed, and analyzed according to the grounded theory methodology. RESULTS: The overriding theme of the elicited grounded theory was "stepping into a quagmire by a merest chance". The student participants began smoking by a simple chance. The contingent factors to starting smoking were "discord within the family", "family member's smoking", "schoolwork stresses", or "a rebellious spirit". The conditions of smoking included accessibility, going around in group, and the lack of discipline. "Stigmatizing", "involved in mob violence", and "making a poor academic record" coexisted as the covariance of the smoking habituation. CONCLUSION: The findings of this study illustrated the comprehensive and insightful picture of the phenomena under investigation. Nursing implications and further directions for research were discussed.
Adolescent* ; Focus Groups ; Humans ; Korea ; Nursing ; Smoke* ; Smoking* ; Tobacco Products

Acute infarction in the whole territory of the middle cerebral artery (MCA) can lead to massive cerebral edema, raised intracranial pressure and cerebral herniation which may result in come and death ultimately. There are same reports which mentioned that craniectomy or stroketomy was an effective life-saving procedure and favorable outcome would be expected after the procedure. In this study, the effect of decompressive partial temporal lobectomy was evaluated in twelve patients of extensive panhemispheric infarction of middle cerebral artery(MCA). We investigated radiologically proven patients of extensive panhemispheric infarction of MCA with impending herniation process, who were admitted to our hospital from March 1991 to June 1996, prospectively and retrospectively. Decompressive partial temporal lobectomy was performed in twelve patients and eighteen patients were treated by only conventional medical treatment(control group). Prognosis were compared between two groups to analyse the effect of the decompressive lobectomy. Fourteen out of the 18 controls(78%) and five out of 12 patients who were treated by decompressive lobectomy(41%) expired due to herniation process. The mortality between two groups was significantly different(P(0.05). Four patient had relatively good outcome(by Barthel index score) and all of them belonged to the decompressive lobectomy group. These results suggest that the decompressive lobectomy be an effective life saving procedure for malignant cerebral edema after a total MCA infarction.
Brain Edema ; Humans ; Infarction* ; Infarction, Middle Cerebral Artery ; Intracranial Pressure ; Middle Cerebral Artery* ; Mortality ; Prognosis ; Prospective Studies ; Retrospective Studies

Acute cerebellitis is a clinically isolated condition showing cerebellar signs such as ataxia, dizziness and dysarthria. Most of them are associated with viral infection, which generally occur in childhood and show benign course without sequelae. Tuberculous cerebellitis is very rare and its outcome is not well described. The aim of this study is to describe the clinical features and course in a patient with tuberculous cerebellits. We will also discuss the possible prognostic factors in acute cerebellitis.
Adult ; Ataxia ; Cerebellum ; Dizziness ; Dysarthria ; Encephalitis ; Humans ; Tuberculosis

PURPOSE: The purpose of this study was to develop a scale to measure person-centered critical care nursing and verify its reliability and validity. METHODS: A total of 38 preliminary items on person-centered critical care nursing were selected using content validity analysis of and expert opinion on 72 candidate items derived through literature review and qualitative interviews. We conducted a questionnaire survey with 477 nurses who worked in intensive care units. The collected data were analyzed using exploratory factor analysis (EFA) and confirmative factor analysis (CFA) with SPSS and AMOS 24.0 program. RESULTS: EFA was performed with principal axis factor analysis and Varimax rotation. The 15 items in 4 factors that accounted for 50.8% of the total variance were identified by deleting the items that were not meet the condition that the commonality should be .30 or more and the factor loading over .40. We named the factors as compassion, individuality, respect, and comfort, respectively. The correlation coefficient between this scale and the Caring Perception Scale was r=.57 (p < .001), which determined concurrent validity. The item-total correlation values ranged from .39 to .63, and the internal consistency for the scale was Cronbach's α=.84. CONCLUSION: The reliability and validity of the 15 item person-centered critical care nursing scale were verified. It is expected that the use of this scale would expand person-centered care in critical care nursing.
Critical Care Nursing* ; Critical Care* ; Empathy ; Expert Testimony ; Factor Analysis, Statistical ; Individuality ; Intensive Care Units ; Patient-Centered Care ; Reproducibility of Results

OBJECTIVES: We examined the effect of commercial plum beverages on dental erosion and whether the addition of calcium to these beverages would inhibit dental erosion. METHODS: We analyzed three groups as follows: Maesil 1 group (Chorok Maesil), Maesil 2 group (Sunkist plum), both of which were selected from commercially-available plum beverages, and Calcium-added maesil group (addition of 3% calcium to Chorok Maesil). For negative and positive control groups, Jeju Samdasoo and Coca Cola were selected, respectively. The characteristics of the experimental beverages were analyzed, and the specimens were immersed in the experimental beverage. The degree of erosion was measured by Vickers hardness number (VHN) and scanning electron microscope images. RESULTS: Positive control group had the lowest pH (2.50±0.03), followed by Maesil 2 (pH 2.59±0.01), Maesil 1 (pH 2.81±0.02), calcium-added maesil (pH 4.19±0.01), and negative control group (pH 7.57±0.06). Significant differences were found in surface microhardness between positive control, Maesil 1, Maesil 2 and calcium-added maesil group before immersion and at 30 minutes after immersion (P<0.05), and change in VHN (positive control group, −80.94±20.63; Maesil 1 group, −69.33±24.88; and Maesil 2 group, −78.49±18.60 in comparison with negative control group, −6.57±26.73). There was no significant difference (P<0.05) in change in VHN between calcium-added maesil (−13.02±17.33) and negative control group. CONCLUSIONS: Plum beverages can potentially induce dental erosion due to their low pH. However, adding calcium to these beverages can reduce the risk of dental erosion. Therefore, the risk of dental erosion must be considered during consumption of plum beverages, and the addition of calcium into plum beverages may be considered as a way to prevent dental erosion.
Beverages ; Calcium ; Coca ; Cola ; Hardness ; Hydrogen-Ion Concentration ; Immersion ; Prunus domestica

Background: The prognostic potential of Crohn-like lymphoid reaction (CLR) in colorectal carcinoma (CRC) has been investigated through the assessment of different criteria. Methods: The prognostic impact of CLR was investigated in 636 CRC patients to compare methods from previously published articles. These methods included CLR measured by number of lymphoid aggregates (LAs) (CLR count), LA size greater than or equal to 1 mm (CLR size), CLR density with a cutoff value of 0.38, and subjective criteria as defined by intense CLR. Results: In univariate survival analysis, CLR-positive CRC as defined by the four aforementioned methods was associated with better overall survival (OS) (hazard ratio [HR], 0.463; 95% confidence interval [CI], 0.305 to 0.702; p <.001; HR, 0.656; 95% CI, 0.411 to 1.046; p=.077; HR, 0.363; 95% CI, 0.197 to 0.669; p=.001; and HR, 0.433; 95% CI, 0.271 to 0.690; p<.001, respectively) and disease-free survival (DFS) (HR, 0.411; 95% CI, 0.304 to 0.639; p<.001; HR, 0.528; 95% CI, 0.340 to 0.821; p=.004; HR, 0.382; 95% CI, 0.226 to 0.645, p=.004; and HR, 0.501; 95% CI, 0.339 to 0.741; p<.001, respectively) than CLR-negative CRC, regardless of criteria with the exception of OS for CLR density. In multivariate analysis, two objective criteria (CLR count and CLR density) and one subjective criterion (intense CLR) for defining CLR were considered independent prognostic factors of OS and DFS in CRC patients. Conclusions CLR has similar traits regardless of criteria, but CLR-positivity should be defined by objective criteria for better reproducibility and prognostic value.

PURPOSE: This study was to develop and prove the effects of aself management compliance promotion program for primary hypertension patients who reside in rural communities. METHOD: The content of the self management compliance promotion program developed by this study was as follows: A leader trains patients as a group or individually, in walking, education and green tea therapy from the first to twelfth week. From the thirteenth to twenty fourth week, the patients should perform walking and green tea therapy by themselves. One hundred twenty subjects volunteered to participate in the study, who were among those registered as hypertension patients in the 14 community health clinics located in Chungcheongbuk-do. RESULT: Systolic blood pressure, total cholesterol, low-density lipoprotein cholesterol, triglyceride, step width, and degree of obesity decreased significantly. High-density lipoprotein cholesterol, step length, knowledge of hypertension, and self management compliance significantly increased. CONCLUSION: A self management compliance promotion program for primary hypertensive patients enhances biophysical index and knowledge on hypertension, thus ultimately suggesting a nursing intervention for promoting self management compliance.
Adult ; Aged ; Aged, 80 and over ; Female ; Health Promotion ; Humans ; Hypertension/psychology/*therapy ; Life Style ; Male ; Middle Aged ; Patient Compliance ; *Patient Education as Topic ; Rural Population ; *Self Care

PURPOSE: The probiotic effects of lactic acid bacteria have widely been researched in diverse human pathogens, but only a few effects are reported against oral pathogens. The antimicrobial effects of the Enterococcus faecium 7413 isolated from Korean infants on the 9 pathogen including 6 oral streptococci were investigated the clinical use of the antimicrobial peptide for oral microflora control. MATERIALS AND METHODS: E. faecium 7413 was identified by morphological, biochemical tests and 16S rDNA sequence analysis. Inhibitory effects of culture supernatants were determined for their ability to grow on agar plate containing pathogenic bacteria. RESULT: The culture supernatant of Enterococcus faecium 7413 showed inhibitory effects on oral pathogens, namely Streptococcus pyogenes KCTC 3556, S. pneumoniae KCTC 5080, S. mutans ATCC 25175, S. anginosus ATCC 33397, S. constellatus KCTC 3268, S. intermedius ATCC 27823 and Shigella flexneri KCTC 2008. Whereas it did not affect the multiplication of E. coli strains, KCTC 1041 and ATCC 43894. CONCLUSION: The data obtained in this study could be useful for future development of effective probiotics allowing prevention for oral pathogens.
Agar ; Bacteria ; DNA, Ribosomal ; Enterococcus ; Enterococcus faecium ; Humans ; Infant ; Lactic Acid ; Pneumonia ; Probiotics ; Sequence Analysis ; Shigella flexneri ; Streptococcus pyogenes

Several reports have described aberrant methylation in various types of human cancers. However, the interpretation of methylation frequency in various human cancers has some limitations because of the different materials and methods used for methylation analysis. To gain an insight into the role of DNA hypermethylation in human cancers and allow direct comparison of tissue specific methylation, we generated methylation profiles in 328 human cancers, including 24 breast, 48 colon, 61 stomach, 48 liver, 37 larynx, 24 lung, 40 prostate, and 46 uterine cervical cancer samples by analyzing CpG island hypermethylation of 13 genes using methylation-specific PCR. The mean numbers of methylated genes were 6.5, 4.4, 3.6, 3.4, 3.1, 3.1, 3.1, and 2.1 in gastric, liver, prostate, larynx, colon, lung, uterine cervix, and in breast cancer samples, respectively. The number of genes that were methylated at a frequency of more than 40% in each tumor type ranged from nine (stomach) to one (breast). Generally genes frequently methylated in a specific cancer type differed from those methylated in other cancer types. The findings indicate that aberrant CpG island hypermethylation is a frequent finding in human cancers of various tissue types, and each tissue type has its own distinct methylation pattern.
Quantitative Trait Loci/*genetics ; Polymerase Chain Reaction ; Neoplasms/*genetics ; Humans ; Genetic Predisposition to Disease/genetics ; Gene Frequency/genetics ; DNA, Neoplasm/*genetics ; *DNA Methylation ; CpG Islands/*genetics ; Chromosome Mapping/*methods

BACKGROUND: Tumor microenvironment has recently drawn attention in that it is related with tumor prognosis. Cancer-associated fibroblast also plays a critical role in cancer invasiveness and progression in colorectal cancers. Periostin (POSTN), originally identified to be expressed in osteoblasts and osteoblast-derived cells, is expressed in cancer-associated fibroblasts in several tissue types of cancer. Recent studies suggest an association between stromal overexpression of POSTN and poor prognosis of cancer patients. METHODS: We analyzed colorectal cancer cases for their expression status of POSTN in tumor stroma using immunohistochemistry and correlated the expression status with clinicopathological and molecular features. RESULTS: High level of POSTN expression in tumor stroma was closely associated with tumor location in proximal colon, infiltrative growth pattern, undifferentiated histology, tumor budding, luminal necrosis, and higher TNM stage. High expression status of POSTN in tumor stroma was found to be an independent prognostic parameter implicating poor 5-year cancer-specific survival and 5-year progression-free survival. CONCLUSIONS: Our findings suggest that POSTN overexpression in tumor stroma of colorectal cancers could be a possible candidate marker for predicting poor prognosis in patients with colorectal cancers.
Colon ; Colorectal Neoplasms* ; Disease-Free Survival ; Fibroblasts ; Humans ; Immunohistochemistry ; Necrosis ; Osteoblasts ; Phenobarbital ; Prognosis ; Tumor Microenvironment