Objective: This study analyzed the characteristics of people who attempted suicide that resulted in deaths as compared to that of the suicide survivors. Methods: This study included 799 suicide attempts that occurred from March 1, 2015, to March 31, 2019 at the emergency department of the university hospital in a city of around 300,000 people. Suicide attempts were classified into the survivor and death groups, and the characteristics of each group were compared. The suicide deaths due to re-attempts were also analyzed. Results: There were more males than females in the death groups. There was a high proportion of people aged 50 or older in the death groups. Hanging, carbon monoxide poisoning, and jumping from great heights were the most commonly used methods of suicide in the death groups. In the selected death group, psychiatric symptom, physical illness, and economic problem among the suicidal causes and depressive disorder among the psychiatric diagnoses were factors that increase the risk of suicide death. Sixty-three point four percent of the survival groups and 52.5% of the selected deaths had not received psychiatric care. On the analysis of suicide deaths due to re-attempts, the average number of suicide attempts was 2.45±0.9. The time from the first suicide attempt to the last suicide attempt was 13.8±10.4 months. Conclusion If it is necessary to make a treatment decision for a suicide attempt in a limited time, such as the case of treating a suicide attempter who visits an emergency department, it is necessary to consider the characteristic factors of the death attempts of suicidal people.

The achievements of genome-wide association studies have suggested ways to predict diseases, such as type 2 diabetes (T2D), using single-nucleotide polymorphisms (SNPs). Most T2D risk prediction models have used SNPs in combination with demographic variables. However, it is difficult to evaluate the pure additive contribution of genetic variants to classically used demographic models. Since prediction models include some heritable traits, such as body mass index, the contribution of SNPs using unmatched case-control samples may be underestimated. In this article, we propose a method that uses propensity score matching to avoid underestimation by matching case and control samples, thereby determining the pure additive contribution of SNPs. To illustrate the proposed propensity score matching method, we used SNP data from the Korea Association Resources project and reported SNPs from the genome-wide association study catalog. We selected various SNP sets via stepwise logistic regression (SLR), least absolute shrinkage and selection operator (LASSO), and the elastic-net (EN) algorithm. Using these SNP sets, we made predictions using SLR, LASSO, and EN as logistic regression modeling techniques. The accuracy of the predictions was compared in terms of area under the receiver operating characteristic curve (AUC). The contribution of SNPs to T2D was evaluated by the difference in the AUC between models using only demographic variables and models that included the SNPs. The largest difference among our models showed that the AUC of the model using genetic variants with demographic variables could be 0.107 higher than that of the corresponding model using only demographic variables.
Area Under Curve ; Body Mass Index ; Case-Control Studies ; Genome-Wide Association Study ; Korea ; Logistic Models ; Methods ; Polymorphism, Single Nucleotide ; Propensity Score ; ROC Curve

The achievements of genome-wide association studies have suggested ways to predict diseases, such as type 2 diabetes (T2D), using single-nucleotide polymorphisms (SNPs). Most T2D risk prediction models have used SNPs in combination with demographic variables. However, it is difficult to evaluate the pure additive contribution of genetic variants to classically used demographic models. Since prediction models include some heritable traits, such as body mass index, the contribution of SNPs using unmatched case-control samples may be underestimated. In this article, we propose a method that uses propensity score matching to avoid underestimation by matching case and control samples, thereby determining the pure additive contribution of SNPs. To illustrate the proposed propensity score matching method, we used SNP data from the Korea Association Resources project and reported SNPs from the genome-wide association study catalog. We selected various SNP sets via stepwise logistic regression (SLR), least absolute shrinkage and selection operator (LASSO), and the elastic-net (EN) algorithm. Using these SNP sets, we made predictions using SLR, LASSO, and EN as logistic regression modeling techniques. The accuracy of the predictions was compared in terms of area under the receiver operating characteristic curve (AUC). The contribution of SNPs to T2D was evaluated by the difference in the AUC between models using only demographic variables and models that included the SNPs. The largest difference among our models showed that the AUC of the model using genetic variants with demographic variables could be 0.107 higher than that of the corresponding model using only demographic variables.

Cerebrospinal fluid (CSF) leakage is a potential complication of cranial and spinal surgery. Postoperative CSF leakage can induce delayed healing, wound infection and meningitis. DuraSeal(R) (Covidien, Waltham, MA, USA) is a synthetic product which has been increasingly used to facilitate watertight repair of dural defects after cranial and spinal surgery. Despite some advantages of Duraseal(R), the authors report a patient who developed cord compression following the use of DuraSeal(R) in cervical spine surgery in which the expansion of the DuraSeal(R) was believed to be the causative factor.
Humans ; Hydrogel ; Meningitis ; Spine ; Wound Healing

OBJECTIVES: The purpose of this study is to find the influential clinical and physical characteristics which affect apnea-hypopnea index (AHI) in suspected obstructive sleep apnea (OSA) patients. METHODS: We evaluated the comprehensive factors including sleep related symptoms, clinical scales, medical history, substance use, and anthropometric data of the 119 participants who complained of the symptoms of OSA. All the participants underwent attended-full night laboratory polysomnography. The correlation and multiple regression analysis were conducted to find the influential and predictive factors of AHI. RESULTS: A multiple linear regression model 1 showed that higher AHI was associated with higher body mass index (BMI)(p < 0.001) and higher frequency of observed apnea (p = 0.002). In multiple linear regression model 2, AHI was associated with higher BMI (p < 0.001) and loudness of snoring (p = 0.018). CONCLUSIONS: The present preliminary results suggest that BMI and observed apnea are most influential factors that affect AHI in suspected OSA patients. In the future study we will design the prediction formula for the OSA and AHI, which is useful in the clinical medical field.
Apnea ; Body Mass Index ; Humans ; Linear Models ; Polysomnography ; Sleep Apnea, Obstructive ; Snoring ; Weights and Measures

PURPOSE: The bicoronal incision, traditional procedure to correct the frontal sinus fracture, could remain a long scar, alopecia etc. Hence, the authors introduce the procedure to fix the outer table fracture of the frontal sinus through the upper eyelid incision as a concealed scar. MATERIAL & METHODS: From November, 2007 to December, 2010, five patients who suffered from outer table fracture of frontal sinus fracture underwent operation to correct the depressed contour of forehead. Instead of the reduction of depressed outer wall, autogenous bone was grafted trough the upper eyelid incision. The result of operation was evaluated with VAS score system(score arrange 0 to 5). VAS score was taken from patients as well as 4 plastic surgeons. RESULTS: Both patients and surgeons were satisfied about result of operation. The overall average score from plastic surgeon was 4.2. Especially to the scar of upper eyelid incision, the score was 4.7. Average score from the patients was 4.1. And there were no other complications as follow-up periods. CONCLUSION: This technique could be one of good options to correct the depression after the outer table fracture of the frontal sinus. And this technique has some benefits to overcome the disadvantage of previous introduced methods.
Alopecia ; Bone Transplantation ; Cicatrix ; Depression ; Eyelids ; Follow-Up Studies ; Forehead ; Fractures, Closed ; Frontal Sinus ; Humans ; Transplants

PURPOSE: Cellulose is a natural substance from plants or bacteria. It is known that bacterial synthesized cellulose has an effect of wound healing. The aim of this study is to show the effect of bacterial synthesized cellulose from citrus on wound healing. METHODS: Three full-thickness skin defects were made on the back of Sprague-Dawley rats. Three wounds were treated by vaseline gauze(Group V), Algisite M(R)(Group A) and bacterial synthesized cellulose from citrus(Group C) was used for dressing on skin defect on rats. We analyzed the gross, histological and biochemistry finding. RESULTS: Group C showed more decrease of wound size compared to Group V(33% versus 7.2#) after 14 days. The histologic findings revealed Group C and Group A preceed the process of wound healing rather than Group V(More rapid collagen deposition and neovascularization and reduced inflammation). Also, the expressions of vascular endothelial growth factor(VEGF) and transforming growth factor(TGF)-beta1 were increased in the Group C and Group A compared with the Group V in 7 days. VEGF and TGF-beta1 expression were decreased in the Group C and Group A in 14 days, however Group V was not decreased at 14 day because of delayed wound healing process. CONCLUSION: Bacterial synthesized cellulose from citrus affects wound healing by reducing the inflammatory stage. And stimulates wound contracture by the deposition of extracellular matrix, thus preventing the formation of chronic wounds.
Animals ; Bacteria ; Bandages ; Biochemistry ; Cellulose ; Citrus ; Collagen ; Contracture ; Extracellular Matrix ; Petrolatum ; Rats ; Rats, Sprague-Dawley ; Skin ; Transforming Growth Factor beta1 ; Vascular Endothelial Growth Factor A ; Wound Healing

PURPOSE: Superior orbital fissure syndrome is a rare neurological complex. Superior orbital fissure syndrome may result from a variety of inflammatory, infectious, neoplastic, iatrogenic, traumatic, vascular cause. The author report a patient who suffered from superior orbital fissure syndrome after inferior orbital wall reduction. METHODS: A 26-year-old female suffered from inferior orbital wall fracture with inferior gaze limitation and orbital soft tissue herniation. On posttrauma 10 day, inferior orbital wall was reduced using endoscope and porous polyethylene(Medpor(R)) was inserted. On immediate postoperation, she reported that extraocular movement was limited in almost any directions. She underwent exploration surgery to release the presence of extraocular muscle impingement. But, there was no observation of extraocular muscle impingement. On postoperative one day, high- dose steroid therapy was started to release superior orbital fissure syndrome which was defined in postoperative computed tomography. RESULTS: After one month of high-dose steroid therapy, extraocular movement limitations improved progressively in all directions. In four months, extraocular movement recovered completely. CONCLUSION: Superior orbital fissure syndrome may occur after surgical procedure of orbital wall reduction. Prompt diagnosis and treatment with mega-dose corticosteroid is an effective option for avoiding disaster from compressive syndrome.
Adult ; Disasters ; Endoscopes ; Female ; Humans ; Muscles ; Orbit

PURPOSE: A cranioremodeling helmet for correcting plagiocephaly was recently developed. However, no discrete objective methods to evaluate how the deformity is being corrected have been developed. We have established an easy and cost-effective method that can be used not only to show the correction process, but can also be used by physicians to assess the degree of plagiocephaly two-dimensionally. METHODS: For two-dimensional evaluation, a length of malleable memory wire (2 mm in diameter) resembling "Sun-Wukong's headband" was placed on the patient's head. The wire around the patient's head was positioned on a plane including points 1 cm above the eyebrow and 1 cm above the auricle. The wire was placed on a sheet of paper and the outline was marked using pens of various colors during each visit. The degree of plagiocephaly correction could then be shown to the patient's parents at every consultation. RESULTS: The method established by the present study easily shows the horizontal cross-section transformation of the head, illustrates plagiocephaly correction by the helmet, and shows the degree of correction in a two-dimensional manner. CONCLUSION: A soft-shell helmet is widely used for correcting plagiocephaly. However, evaluating the effectiveness of the helmet has been determined in a subjective manner, and a more objective method is now in demanded. Our study found that a "Sun-Wukong's headband" wire can accurately measure two-dimensional changes. Future studies will be required to identify landmarks needed for assessing plagiocephaly correction.
Congenital Abnormalities ; Eyebrows ; Head ; Head Protective Devices ; Humans ; Memory ; Parents ; Plagiocephaly ; Plagiocephaly, Nonsynostotic

The traditional treatment of nasal bone fracture is closed manual reduction. Disadvantage of the method arises from frequent recurrence and inaccurate correction because open method is nonused in anatomical result. In addition, since the interest about cosmetic problems rapidly rises, people who want aesthetic correction during reduction surgery are increasing. From June 2007 to June 2009, This study includes 121 patients who had been performed by correction of nasal bone fracture in our center. 98 out of 121 patients, were undergone with nasal tip plasty, septoplasty was done in 51 patients. Cartilage graft for augmentation rhinoplasty was performed in 36 patients. Average period of follow-up was 6 months and existence of complications such as nasal deviation, nasal obstruction, infection and etc were investigated. Reoperation was done in one patient who showed nasal obstruction, and patients who complained about other complications, such as nasal deviation, were observed. There is the need of more accurate reduction method than traditional non-invasive reduction maneuver, in order to reduce the occurrence of secondary deformation after nasal bone fracture. Hence the authors operated precise reduction by extended endonasal approach without columellar scar, and aesthetic correction rather than anatomical correction was done with variable cartilage if needed.
Cartilage ; Cicatrix ; Cosmetics ; Follow-Up Studies ; Humans ; Morinda ; Nasal Bone ; Nasal Obstruction ; Recurrence ; Reoperation ; Rhinoplasty ; Transplants