Purpose: Early nutritional support (ENS) for critically ill patients is promoted by many studies. However, there is a lack of data evaluating its necessity in general wards. This study aims to determine the impact of ENS on patients in general wards. Methods: Patients aged 18 and above, admitted to the Jeonbuk National University Hospital in Jeonju from January 2020 to December 2020, who were eligible for nutritional support and hospitalized for at least 7 days were included in the study. We divided the patients into two groups: the ENS group, who received nutritional support within 48 hours of admission, and the control group, who received it after 48 hours. Results: Among 1,077 patients, 146 met the inclusion criteria. The ENS group (n=38) and the control group (n=108) were compared retrospectively. There was a significant age difference between the two groups (P=0.028). The admission ratio to the intensive care unit (ICU) in the ENS group was significantly lower than that in the control group (10.2% vs.26.3%, P=0.019). The calorie support rate (%) and protein support rate (%) in the ENS group were significantly higher than in the control group (50.12%±23.30% vs. 38.56%±18.02%, P=0.006; 44.61%±25.07% vs. 32.07%±22.76%, P=0.002, respectively). After propensity score matching, the ENS was significantly associated with ICU low admissions (odds ratio 0.08, 95% confidence interval 0.01–0.69, P=0.022). Conclusion A future multi-center study considering underlying diseases is needed to provide additional scientific evidence to support the effects of ENS.

The purpose of this study was to evaluate clinical characteristics and treatment outcome of patients with head and neck squamous cell carcinoma of unknown primary (HNSCCUP), treated according to the method of our hospital. Six patients with histopathologically and radiologically confirmed HNSCCUP January 2010-December 2016 were enrolled in this study. All patients underwent radical neck dissection involving level I-V, bilateral tonsillectomy, and diagnostic esophagoscopy and postoperative radiotherapy (RT), with or without concurrent chemotherapy. There were no major complications resulting from surgical intervention. Duration of follow-up was 56.3±20.2 months (range, 28-82 months). There was no recurrence or late detection of primary site of HNSCCUP. All patients with HNSCCUP except one were alive, at the time of the last follow-up. The other patient had no recurrence of HNSCCUP, but died of colon cancer at 58 months postoperatively. We have successfully treated patients with HNSCCUP by performing radical neck dissection, bilateral tonsillectomy, and diagnostic esophagoscopy and postoperative RT with concurrent chemotherapy, and recommend using this method as the main treatment method.

Purpose: This cross-sectional study aimed to identify factors affecting coronavirus disease 2019 (COVID-19) vaccination intention. Methods: For an anonymous online survey, recruitment notices were posted on an anonymous community by each university, and an online survey was conducted through online form from June to July 2021. COVID-19 knowledge and health-protective behavior were measured using a questionnaire based on previous literature and reflecting the Korea Centers for Disease Control and Prevention’s COVID-19 Response Guidelines. The psychological antecedents of vaccination were measured by 5C scale. Results: Two-hundred and ninety-four college students (women 67.3%) answered the survey; 179 (60.9%) reported that they would accept a COVID-19 vaccine. The mean scores for COVID-19 knowledge and health-protective behavior were 22.97 ± 5.33 (out of 35) and 9.92 ± 2.22 (out of 12), respectively. For the psychological antecedents of vaccination, the mean scores for confidence, collective responsibility, calculation, complacency, and constraints were 4.45 ( ± 1.24), 5.61 ( ± 1.09), 5.09 ( ± 1.18), 2.42 ( ± 1.11), and 2.37 ( ± 1.19) out of 5 points, respectively. The confidence, calculation, and collective responsibility were associated with vaccination intention. Additionally, the top reason for those who were less prone to accept vaccination against COVID-19 was concern about vaccine safety. Conclusion The higher the confidence in the vaccine and the higher the collective responsibility, the higher the vaccination intention. As it is a factor related to an individual’s perception of COVID-19 information, it is necessary to increase confidence in the vaccines through obtaining accurate information on the safety, effectiveness, and side effects of the COVID-19 vaccines and vaccination.

BACKGROUND AND OBJECTIVES: This study compared two types of skin graft reconstruction for the defect of the radial forearm free flap. SUBJECTS AND METHOD: Ten cases of split-thickness skin graft (STSG) harvested from the thigh were analyzed. Also, ten cases of full-thickness skin graft (FTSG) harvest from the inguinal area applied with vacuum-assisted closure (VAC) system were analyzed. RESULTS: The defect size of the radial forearm was increased more in the STSG group than in the FTSG group (p<0.05). Skin grafts were recovered completely sooner in the FTSG group than in the STSG group although it was not statistically significant (p=0.082). Five complications (pruritus, hypertrophic scar) were found in the donor site in the STSG group (p<0.05). FTSG gave better scores according to the Vancouver Scar Scale in terms of pigmentation, pliability, and height (p<0.05). CONCLUSION: FTSG harvested from the inguinal area with the application of VAC system has many advantages for the defect of the radial forearm free flap although it is usually used for smaller size defects than for STSGs.
Cicatrix ; Forearm ; Free Tissue Flaps ; Humans ; Methods ; Negative-Pressure Wound Therapy ; Pigmentation ; Pliability ; Reconstructive Surgical Procedures ; Skin Transplantation ; Skin ; Thigh ; Tissue Donors ; Transplants

BACKGROUND AND OBJECTIVES: This study compared two types of skin graft reconstruction for the defect of the radial forearm free flap. SUBJECTS AND METHOD: Ten cases of split-thickness skin graft (STSG) harvested from the thigh were analyzed. Also, ten cases of full-thickness skin graft (FTSG) harvest from the inguinal area applied with vacuum-assisted closure (VAC) system were analyzed. RESULTS: The defect size of the radial forearm was increased more in the STSG group than in the FTSG group (p<0.05). Skin grafts were recovered completely sooner in the FTSG group than in the STSG group although it was not statistically significant (p=0.082). Five complications (pruritus, hypertrophic scar) were found in the donor site in the STSG group (p<0.05). FTSG gave better scores according to the Vancouver Scar Scale in terms of pigmentation, pliability, and height (p<0.05). CONCLUSION FTSG harvested from the inguinal area with the application of VAC system has many advantages for the defect of the radial forearm free flap although it is usually used for smaller size defects than for STSGs.

OBJECTIVES: To verify the clusters of oral health-related behaviors by gender for adolescents in Gangneung, and to assess the influences of psychosocial factors (family socioeconomic status factors, individual economic factors, and psychological factors) on these clusters. METHODS: A survey was conducted of 3,611 adolescents (6th grade students in primary school, 2nd grade students in middle school, and 2nd grade students in high school) in Gangneung. The response rate was 96.6% (1,846 boys; 1,765 girls). The data were collected via self-administered structured questionnaires assessing participants 'smoking experience,' 'tooth brushing,' 'consumption of crackers or soft drinks,' and 'consumption of fruits or vegetables.' K-means cluster analysis was used to cluster the oral health-related behaviors by gender. A chi-square test was used to assess the difference between the clusters for oral health-related behaviors by gender and psychosocial factors. RESULTS: Clusters of oral health related-behaviors were classified into the unhealthy group (group 1; bad oral health-related behaviors), healthy group (group 2; good behaviors), and complex group (group 3; low smoking experiences and complex other behaviors). The clusters were different by gender. In the unhealthy group, boys represented 19.9% while, in the healthy group, girls represented 47.3%, which are both higher than the theoretical rates. Psychosocial factors in the unhealthy group were significantly lower than the healthy group (P<0.05). CONCLUSIONS: Meaningful clusters of oral health-related behaviors by gender were identified. Furthermore, the clusters were different by psychosocial factors. This finding suggests that one of the best ways to enhance oral health for adolescents is to develop oral health promotion programs for each oral health-related behavior cluster.
Adolescent* ; Female ; Fruit ; Gangweon-do* ; Humans ; Oral Health ; Psychology* ; Surveys and Questionnaires ; Smoke ; Smoking ; Social Class

No abstract available.
Extracorporeal Membrane Oxygenation ; Stents

OBJECTIVES: The principle purpose of this study was to investigate the differences of oral health-related behaviors by a type of school among high school students in Gangneung city. The secondary purpose was to assess the influences of other factors (father's education status, mother's education status, subjective economic status, FAS, experienced part-time job, pocket money and perceived stress) on these differences. METHODS: A cross-sectional survey of 1,282 high school students was conducted in Gangneung city. The response rate was 93.4%; general high school students were 773 and vocational high school students were 509. The data were collected by self-administered structured questionnaires. The differences of oral health-related behaviors of high school students by school type were assessed by a chisquare test. Logistic regression models were used to analyze the influences of other factors on these differences. RESULTS: Oral health-related behaviors were markedly better in students attending general high school, rather than vocational high school (P<0.001). The differences of oral health-related behaviors by school type were persisted after adjusting for gender (Model 1), socio-economic factors (Model 2), part-time job and pocket money (Model 3), psychological variables (Model 4) and all variables (Model 5), except for visiting a dental clinic. CONCLUSIONS: We found a marked influence of school type in oral health-related behaviors. This finding suggests that school type is a risk factor of oral health-related behaviors in high school students. Therefore, one of the best ways to enhance oral health for high school students is to develop oral health promotion programs for vocational high school students.
Cross-Sectional Studies ; Humans ; Logistic Models ; Oral Health ; Surveys and Questionnaires ; Risk Factors

The rat hepatocytes were immortalized using a temperature-sensitive mutant of SV40 large T antigen (tsT) to develop as a possible substitute for primary hepatocytes. Four rat hepatocyte lines that have been developed and maintained more than passage 50, were characterized for their cellular morphology, T antigen and p53 expression, chromosomes, liver-specific differentiation, telomerase activity and anchorage independent growth. All of four cell lines showed a typical epithelial cell morphology, but the population-doubling time became short with passage: 18 to 60%. T antigen expression was increased with passage about 3 to 65 times at permissive temperature but decreased significantly at non-permissive temperature. The expression level of p53 unchanged during passages was also decreased at non-permissive temperature. The distribution of chromosome number changed somewhat with passage. The production levels of albumin and urea in four cell lines were 2.4 to 13.0% and 7.5 to 19.9% of those produced in primary hepatocytes, respectively and were decreased to an undetectable level with passage. Telomerase activity was increased 10 fold following immortalization of cells, but anchorage independent growth of cells did not develop. These results indicate that conditionally immortalized hepatocytes become dedifferentiated with in vitro passage, which may be caused by marked chromosomal damages that occur with compulsive and continuous replications by the increment of T antigen content with passage and its sequential inhibition of p53 function.
Animal ; Antigens, Polyomavirus Transforming/biosynthesis ; Cell Adhesion ; Cell Differentiation ; Cell Division ; Cell Line, Transformed ; Cell Transformation, Viral* ; Chromosome Aberrations ; Liver/cytology* ; Protein p53/metabolism ; Rats ; Telomerase/metabolism ; Time Factors

BACKGROUND: Human cells are almost never spontaneously immortalized in vitro. We tried to immortalize human fetal hepatocytes (h-FH) and evaluate the differentiational status and its change. METHODS: Hepatocytes were isolated from a liver fragment of 20 week old fetus and infected with amphotropic recombinant retrovirus containing a temperature- sensitive mutant of SV40 large T antigen and neomycin phosphotransferase gene. G418 resistant colonies were cloned and expanded. The cells which were able to divide more than 30 times were used to analyze various functions. RESULTS: The immortalization rate was 3.3 x 10-8 and two cell lines (C11, D21) were established. C11-60, C11-80, D21-30 and D21-60 (suffix number means the cell division counts) were evaluated. D21-30 was thougt to be imcompletely immortalized because a considerable portion of cells died during culture. The morphology was similar to that of epithelial cells except for D21-30 which looked like fibroblast. The cells grew rapidly at 33oC but stopped growing at 39oC. T antigen and p53 was expressed at 33oC but disappeared at 39oC, which suggest that T antigen binds to p53. Chromosomal changes were so marked that it was impossible to discriminate exact number. Albumin was secreted as about 1/10 as that of h-FH, but alpha-fetoprotein secretion stopped after immortalization. Telomerase was activated in both cell lines except for the incompletely immortalized cells D21-30. Telomere was elongated in competely immortalized cell lines, but it was rather shortened in D21-30 compared to that of h-FH. Macroscopic colonies did not develop in soft agar assay. CONCLUSIONS: We successfully immortalized human fetal hepatocytes. Although the cells are not likely to have oncogenicity, the functions are not so good, possibly due to marked chromosomal changes which are thought to occur before telomerase is activated during immortalization step.
Agar ; alpha-Fetoproteins ; Antigens, Viral, Tumor* ; Cell Division ; Cell Line ; Clone Cells ; Epithelial Cells ; Fetus ; Fibroblasts ; Hepatocytes* ; Humans* ; Kanamycin Kinase ; Liver ; Retroviridae* ; Telomerase ; Telomere