OBJECTIVE: This study aimed to clarify the role of acute alcohol use and alcohol use disorder in individuals exhibiting suicidal behaviors, including repetition of suicide attempt. METHODS: Data pertaining to 691 suicide attempters who had visited an emergency center and had been followed-up from 2010 to 2015 were gathered. Participants were categorized into following three groups according to alcohol use pattern at the time of the suicide attempt: 1) suicide attempters with neither alcohol use disorder nor acute alcohol consumption (NAU), 2) suicide attempters who had used alcohol during the suicide attempt but did not have alcohol use disorder (AAU), and 3) suicide attempters with alcohol use disorder (AUD). Group comparisons and multivariate Cox proportional models for suicidal behavior were used for statistical analysis. RESULTS: AUD have been shown to have lower lethality of suicide attempt but higher risk of suicide reattempts in the future. Furthermore, positive relationships between suicide reattempts and AUD persisted throughout the longer period than other groups. CONCLUSION Suicide attempters with AUD should be considered a high-risk group for suicide reattempts in future, and this group should be followed-up for a longer period with specialized care program.

BACKGROUND: From May to July 2015, the Republic of Korea experienced the largest outbreak of Middle East respiratory syndrome (MERS) outside the Arabian Peninsula. A total of 186 patients, including 36 deaths, had been diagnosed with MERS-coronavirus (MERS-CoV) infection as of September 30th, 2015. MATERIALS AND METHODS: We obtained information of patients who were confirmed to have MERS-CoV infection. MERS-CoV infection was diagnosed using real-time reverse-transcriptase polymerase chain reaction assay. RESULTS: The median age of the patients was 55 years (range, 16 to 86). A total of 55.4% of the patients had one or more coexisting medical conditions. The most common symptom was fever (95.2%). At admission, leukopenia (42.6%), thrombocytopenia (46.6%), and elevation of aspartate aminotransferase (42.7%) were observed. Pneumonia was detected in 68.3% of patients at admission and developed in 80.8% during the disease course. Antiviral agents were used for 74.7% of patients. Mechanical ventilation, extracorporeal membrane oxygenation, and convalescent serum were employed for 24.5%, 7.1%, and 3.8% of patients, respectively. Older age, presence of coexisting medical conditions including diabetes or chronic lung disease, presence of dyspnea, hypotension, and leukocytosis at admission, and the use of mechanical ventilation were revealed to be independent predictors of death. CONCLUSION: The clinical features of MERS-CoV infection in the Republic of Korea were similar to those of previous outbreaks in the Middle East. However, the overall mortality rate (20.4%) was lower than that in previous reports. Enhanced surveillance and active management of patients during the outbreak may have resulted in improved outcomes.
Antiviral Agents ; Aspartate Aminotransferases ; Coronavirus Infections* ; Disease Outbreaks ; Dyspnea ; Extracorporeal Membrane Oxygenation ; Fever ; Humans ; Hypotension ; Leukocytosis ; Leukopenia ; Lung Diseases ; Middle East Respiratory Syndrome Coronavirus ; Middle East* ; Mortality ; Pneumonia ; Polymerase Chain Reaction ; Republic of Korea* ; Respiration, Artificial ; Thrombocytopenia

The purpose of this study is to examine how nutritionists, principals and parents evaluated the importance and priorities of different selection factors for food materials suppliers in an attempt to suggest how to ensure the best supplier choice, since the selection of the best supplier was mandatory for the successful TQM of school food services. This study especially aims to develop priority alternatives based on relative rather than absolute assignments on selection of suppliers for school food service materials. To apply AHP, the selection factors of a food materials suppliers were grouped into five categories, which included quality, service, reliability, hygiene and price. And the five categories involved 28 elements. As the result, quality was considered most crucial on the whole, followed by service, reliability, hygiene and price; and food labeling in the category of quality evaluated as that of first priority in the totality evaluation elements.
Dietary Sucrose ; Food Labeling ; Food Services ; Humans ; Hydroxyproline ; Hygiene ; Parents

The purpose of this research was to understand how individuals reflect on the frequency and quantity of foods that they consume. Participants selected 5 males and 15 females aged 30 years or older were first interviewed on the frequency of their food consumption. Then based on this data, they were given a cognitive interview using the method of verbal proving. The individual cognitive interviews were recorded with consent while being conducted after complete approval by the Seoul National University Institution Review Board. The recorded material was evaluated using a thematic analysis after transcribing them into text. By analyzing stages of reflection, the major barriers to make the device difficult are revealed: 1) More difficulty in remembering events over the course of a full year due to diversification in the types of food that people consume 2) difficulty calculating the average for seasonal foods 3) difficulty estimating the amount of consumption from the photos presented 4) difficulty estimating amount of consumption from the quantity presented 5) difficulty processing foods that people think are healthy and foods are unhealthy simultaneously 6) difficulty having to consider foods where target food goes in as an ingredient; 7) difficulties arising from having to increase frequency when the amount consumed is higher than the quantity that is presented 8) difficulty having to combine the frequency and quantity of each food item when numerous foods are clustered into one category. These findings show that the less participants were involved in cooking, the more diverse their eating habits were, and the more they tried to adhere to rules of filling out the questionnaire, the more it was difficult for them to come up with an answer to the question being asked. It therefore seems necessary to construct a Food Frequency questionnaire that is attentive to these problems that arise from the recall stages.
Cooking ; Eating ; Female ; Humans ; Male ; Surveys and Questionnaires* ; Seasons ; Seoul

The incidence of endobronchial tumor in the pediatric period is very rare and the symptoms are very close to those of respiratory tract infection. Diagnosis can be delayed because of low clinical suspicion and the many ways in which these tumors can present. We report the first case, in Korea, of a pulmonary carcinoid tumor that presented with recurrent pneumonia at the same location in adolescence. Treatment is surgical and geared towards complete resection while sparing healthy lung parenchyma. Long-term and careful follow up is recommended to detect local and distant metastasis.
Adolescent* ; Carcinoid Tumor* ; Diagnosis ; Follow-Up Studies ; Humans ; Incidence ; Korea ; Lung ; Neoplasm Metastasis ; Pneumonia* ; Respiratory Tract Infections

PURPOSE: We conducted a phase II study of docetaxel and ifosfamide chemotherapy for patients with platinum- resistant or refractory non-small-cell lung cancer (NSCLC) to evaluate the response and toxicity profiles as a salvage treatment. MATERIALS AND METHODS: Between July 2000 and July 2004, 40 patients who had previously received platinum- based regimen as the first-line or second-line therapy were enrolled in this study. The treatment consisted of a docetaxel 75 mg/m2 intravenous infusion on day 1 and intravenous ifosfamide 3 g/m2 with Mesna(R) uroprotectione on day 1 through 3. This regimen was repeated every 3 weeks. RESULTS: One hundred thirty cycles of treatment were given, with a median of 3 cycles (range: 2~6 cycles). All the patients were evaluable for the response rate and toxicity profile. The major toxicity was myelosuppression. Grade 3~4 neutropenia occurred in 30 patients (75%) during treatment. Febrile neutropenia occurred in 16 patients (40%). Five of 40 patients (12.5%) had a partial response (95% confidence interval, 3.3~21.7%). The median time to disease progression was 2.65 months (range: 2.02~3.20 months), and the median survival was 5.24 months (range: 2.99~7.49 months). CONCLUSION: Salvage chemotherapy with docetaxel and ifosfamide showed a low efficacy and a high proportion of severe neutropenia in patients with platinum-resistant or refractory advanced NSCLC.
Carcinoma, Non-Small-Cell Lung* ; Disease Progression ; Drug Therapy ; Febrile Neutropenia ; Humans ; Ifosfamide* ; Infusions, Intravenous ; Lung Neoplasms ; Neutropenia ; Salvage Therapy

BACKGROUND: The combination chemotherapy of gemcitabine and cisplatin has been proven effective in the treatment of advanced non-small cell lung cancer (NSCLC). However, the optimal schedule for administration of the two drugs has not yet been determined. We therefore started a phase II trial to evaluate efficacy, toxicity and dose intensity (DI) as three-week scheduled chemotherapy of gemcitabine and cisplatin. METHODS: Between October 2000 and March 2003, a total of 56 patients with stage IIIB and IV NSCLC were enrolled in this study. Treatment schedule consisted of gemcitabine 1200 mg/m2 i.v. on days 1 and 8, and cisplatin 80 mg/m2 i.v. on day 1 of each chemotherapy cycle followed by two weeks of rest. RESULTS: Forty-eight patients were evaluable in response and adverse effects in this study. The median DI was 529 mg/m2/week for gemcitabine (66%) and 22 mg/m2/week for cisplatin (83%). Partial response was observed in 23 patients. The overall response rate was 47.8% (95% confidence interval [CI], range from 33.6% to 61.9%). Anemia and thrombocytopenia were the main hematologic adverse effects, with 8.3% and 8.3% of patients experiencing grade III to IV toxicity, respectively. The median survival time was 11.78 months (95% CI, range from 8.59 to 14.97months). No significant differences in response rate were observed according to sex, age, histology and DI of gemcitabine and cisplatin. CONCLUSION: The 3-week-scheduled combination chemotherapy of gemcitabine and cisplatin has feasibility to treat advanced stage IIIB and IV NSCLC with modest adverse effects. The regimen deserves further evaluaton in a phase III prospective randomized trial.
Anemia ; Appointments and Schedules ; Carcinoma, Non-Small-Cell Lung ; Cisplatin* ; Drug Therapy ; Drug Therapy, Combination* ; Humans ; Thrombocytopenia

Systemic air embolism occurs when air enters the pulmonary venous system as a result of a positive gradient caused by low pulmonary venous pressure or increased airway pressure, or both. Systemic air embolism has been frequently reported after penetrating thoracic trauma and can induce life-threatening complications. In blunt thoracic trauma, systemic air embolism has been rarely diagnosed. Because air embolism associated with blunt trauma is more insidious, diagnosis is usually not appreciated unless special circumstances allow discovery of air in major vessels or coronary arteries, such as during emergency resuscitative thoracotomy. We report a case of systemic air embolism in an 18-month-old girl after accidental thoracic blunt trauma and review related literature.
Child* ; Coronary Vessels ; Diagnosis ; Embolism, Air* ; Emergencies ; Female ; Humans ; Infant ; Thoracotomy ; Venous Pressure

PURPOSE: Acute diarrhea in young children is a major problem in pediatric hospitals worldwide. We evaluated the clinical efficacy of orally administered Lactobacillus acidophilus in the treatment of acute diarrhea in children. METHODS: From September 2002 to July 2003 at National Police Hospital 41 children aged 3 months to 5 years with acute diarrhea were enrolled in this study. The patients were randomized to one of two groups to receive either 0.5 x 10(8) colony forming unit (CFU) of L. acidophilus or matching placebo on admission and every 8 hours during hospitalization. RESULTS: The mean duration of diarrhea in all 41 children was decreased (p=0.001) in the L. acidophilus (40.5 hours) group compared to the placebo (56.6 hours) group. Stool frequency was also reduced (p=0.01) on the 3rd day in the L. acidophilus group. Rotavirus was identified in 58% of the patients. The decrease of duration of diarrhea was more significant in rotavirus-negative patients (p=0.002) compared to the rotavirus-positive patients (p=0.027). CONCLUSION: L. acidophilus shows to be an effective therapeutic agent in acute diarrhea in children. Further studies are needed to confirm the present findings.
Child* ; Diarrhea* ; Hospitalization ; Hospitals, Pediatric ; Humans ; Lactobacillus acidophilus* ; Lactobacillus* ; Police ; Probiotics ; Rotavirus ; Stem Cells

PURPOSE: The outcomes of a surgical approach for patients with an esophageal carcinoma remain unsatisfactory despite its high complication rates. We conducted a phase II trial, using combined FP (5-fluorouracil and cisplatin) chemotherapy and concurrent radiotherapy, as a definitive therapy for patients with esophageal cancer. MATERIALS AND METHODS: Patients with histologically proven esophageal cancer were enrolled onto this study. The treatment consisted of four courses of chemotherapy and six and a half weeks of radiotherapy. The patients received chemotherapy in weeks 1, 5, 12 and 16 (5-fluorouracil 1, 000 mg/m2 on days 1 to 4 and cisplatin 75 mg/m2 on day 1). Radiotherapy was administered at a dose of 59.4 Gy, in five 1.8 Gy fractions a week. RESULTS: A total of 22 eligible patients entered the study. Of the 19 evaluable patients, a complete response occurred in 7 (37%), and a partial response in 8 (42%). After a median follow-up of 35 months, the overall survival rate was 32% at three years and the median survival was 11 months. Fourteen (64%) received planned dose of radio-therapy and 13 (59%) received more than three courses of chemotherapy. However, there was no difference in three-year survival rates between the patients that received less than three courses of chemotherapy and those that received three or more courses (31% vs. 32%). The major treatment related toxicity was mucositis, which developed in every patient, with grades III or IV in thirteen (59%) patients. During the treatment, the patients lost, on average, 3.8% of their body weight. The mean hospital stay was 23 days, with a total duration of treatment of 74 days. CONCLUSIONS: Concurrent FP chemoradiotherapy was effective as a definitive therapy for patients with esophageal cancer. The major toxicity was mucositis. Although the treatment was relatively feasible, a randomized trial of reduced courses of chemotherapy is warranted.
Body Weight ; Chemoradiotherapy* ; Cisplatin ; Drug Therapy ; Esophageal Neoplasms* ; Follow-Up Studies ; Humans ; Length of Stay ; Mucositis ; Radiotherapy ; Survival Rate