Objectives: This study examined the factors associated with suicide risk among out-of-school youths (OSY) by analyzing their medical records retrospectively. Methods: The medical records of 280 OSYs who were admitted to the National Medical Center from January 2015 to December 2018 were examined. The demographic and clinical records, including behavioral problems, post-traumatic symptoms, harmful alcohol consumption, family functioning, and quality of life, were analyzed. Results: Among the 280 subjects, 80 (28.6%) were considered a high-risk suicidal group. The number of post-traumatic symptoms was found to be positively correlated, and the family functioning scores were negatively correlated with the increasing risk of suicide in the OSY based on the multiple regression analysis of the medical records. Conclusion The result of this study provides inputs for suicide prevention programs targeted at OSYs by identifying the risk and protective factors associated with suicide among the group.

Determining blood loss [100% – RBV (%)] is challenging in the management of haemorrhagic shock. We derived an equation estimating RBV (%) via serial haematocrits (Hct1 , Hct2 ) by fixing infused crystalloid fluid volume (N) as [0.015 × body weight (g)]. Then, we validated it in vivo. Mathematically, the following estimation equation was derived: RBV (%) = 24k / [(Hct1 / Hct2 ) – 1]. For validation, nonongoing haemorrhagic shock was induced in Sprague–Dawley rats by withdrawing 20.0%–60.0% of their total blood volume (TBV) in 5.0% intervals (n = 9). Hct1 was checked after 10 min and normal saline N cc was infused over 10 min. Hct 2 was checked five minutes later. We applied a linear equation to explain RBV (%) with 1 / [(Hct1 / Hct2 ) – 1]. Seven rats losing 30.0%–60.0% of their TBV suffered shock persistently. For them, RBV (%) was updated as 5.67 / [(Hct1 / Hct2 ) – 1] + 32.8 (95% confidence interval [CI] of the slope: 3.14–8.21, p = 0.002, R2 = 0.87). On a Bland-Altman plot, the difference between the estimated and actual RBV was 0.00 ± 4.03%; the 95% CIs of the limits of agreements were included within the pre-determined criterion of validation (< 20%). For rats suffering from persistent, non-ongoing haemorrhagic shock, we derived and validated a simple equation estimating RBV (%). This enables the calculation of blood loss via information on serial haematocrits under a fixed N.Clinical validation is required before utilisation for emergency care of haemorrhagic shock.

PURPOSE: The purpose of this study was to identify the levels of bone mineral density (BMD) and to explain the factors influencing BMD among female college students in Korea. METHODS: A cross-sectional study was conducted with 144 college women. Lifestyle factors were determined by self-report questionnaire. Body composition was measured by body composition analyzer and bone mineral density was measured by ultrasound bone densitometry. Data were analyzed using SPSS for windows, version 19.0. RESULTS: The mean BMD at calcaneus site was 0.56 g/cm2 (mean T-score=-0.22). The incidence of osteopenia was 21.5%. Factors predicting BMD were menarche age (r=-.22, p=.009) and height (r=-.18, p=.030) with 7% of explained variance. CONCLUSION: These results suggest that health care professionals need to provide young women with program that is intended to affect their intention toward osteoporosis preventive behavior change.
Body Composition ; Bone Density ; Bone Diseases, Metabolic ; Calcaneus ; Cross-Sectional Studies ; Delivery of Health Care ; Densitometry ; Female ; Humans ; Incidence ; Intention ; Life Style ; Menarche ; Osteoporosis ; Surveys and Questionnaires

Retrograde jejunogastric intussusception is a rare complication following Billroth ll gastric surgery. It is a segmental invagination of a jejunal loop into the stomach through stoma. Clinical manifestations are epigastric pain, vomiting with bile or blood, and a palpable mass in the epigastrium. Gastroscopy and a upper GI (UGI) series are very helpful in the diagnosis of this disease. Although the management of this disease is usually surgical, when endoscopic reduction has failed, surgery should be immediately done because of the high mortality. We present here a case of jejunogastric intussusception that was diagnosed by gastroscopy in a patient with a history of Billroth ll surgery that had been done 6 years prior due to gastric cancer.
Bile ; Gastrectomy ; Gastroscopy ; Humans ; Intussusception ; Stomach ; Stomach Neoplasms ; Vomiting

This report describes a patient with hepatic congestion due to right heart failure mimicking liver tumor. The patient had a history of breast cancer and left total mastectomy 30 years ago, tricuspid valve regurgitation and tricuspid valve replacement 4 years ago. Three years ago, abdominal contrast-enhanced computed tomography (CT) was performed to evaluate inguinal hernia, which revealed multiple small hepatic nodules. After 1 year, the number and size of liver nodules were increased in CT scan. The patient underwent gun biopsy and histopathology revealed sinusoid enlargement. The patient recently had jaundice, abdominal distension, and peripheral edema. Liver dynamic CT scan was done to evaluate the palpable liver. The number and size of liver nodules were more increased in CT than 2 years ago. In magnetic resonance imaging (MRI), numerous variable sized ill-defined nodules replacing entire liver with progressing centripetal enhancement, which were suggestive of malignancy such as angiosarcoma, were noted. MRI finding suspects malignancy or hemangiosarcoma. Finally, the patient received repeated gun biopsy, and histopathology revealed findings compatible with hepatic congestion.
Biopsy, Needle ; Female ; Heart Failure/*complications ; Humans ; Liver Diseases/*diagnosis/etiology/pathology ; Liver Neoplasms/diagnosis ; Magnetic Resonance Imaging ; Middle Aged ; Tomography, X-Ray Computed

BACKGROUND/AIMS: Interferon beta (IFN-beta) has been shown to have antiviral activity, and thus could be useful in treating viral infections. Therefore, we compared the efficacy and safety of recombinant IFN-beta(IFN-beta-1a) plus oral ribavirin versus interferon alpha (IFN-alpha) plus ribavirin therapy for the treatment of chronic hepatitis C (HCV). METHODS: Twenty treatment-naive patients were randomized into two equal-sized treatment groups. Both IFN-beta-1a (44microgram) and IFN-alpha (3 MIU) were given subcutaneously three times a week, while ribavirin was given orally at 1,000-1,200 mg/day. Patients were treated for 24 weeks and followed for an additional 24 weeks. RESULTS: After 24 weeks of treatment, six (60%) and four patients (40%) in the IFN-beta-1a group and IFN-alpha groups, respectively, achieved viral clearance. The sustained virological response (SVR) at the end of the observation period was similar in both groups (40%). However, the baseline viral load was significantly higher (p=0.034) in the IFN-beta-1a group than in the IFN-alpha group, and there were more HCV genotype 1 patients in the IFN-beta-1a group (eight versus seven). The IFN-beta-1a group was associated with similar adverse events in terms of frequency and severity. CONCLUSIONS: The SVR rate and safety profile were similar for the combination of IFN-beta-1a and ribavirin and that of IFN-alpha and ribavirin.
Genotype ; Hepatitis C ; Hepatitis C, Chronic ; Humans ; Interferon-alpha ; Interferon-beta ; Interferons ; Pilot Projects ; Prospective Studies ; Ribavirin ; Treatment Outcome ; Viral Load

BACKGROUND: Transient elastography (FibroScan(R)) is a rapid and non-invasive method to measure liver stiffness and this allow the assessment of liver fibrosis. The aim of this study was to assess the diagnostic accuracy of measuring the liver stiffness in addition to measuring the other biochemical markers such as the aspartate transaminase to platelet ratio index [APRI] and the AST/ALT ratio. METHODS: We enrolled 228 HBsAg positive patients whose liver stiffness was measured by FibroScan(R) between March 2005 and September 2005. Liver biopsy examinations were performed in 34 patients. The fibrosis (F) was staged on a 0-4 scale according to the Ludwig classification. RESULTS: According to the clinical diagnosis, the median values of liver stiffness were 7.0+/-2.7 kPa for inactive carriers (n=29), 8.3+/-5.3 kPa for chronic hepatitis patients (n=106), 15.9+/-8.3 kPa for compensated cirrhosis patients (n=63), 31.8+/-20.3 kPa for decompensated cirrhosis patients (n=26), and 45.1+/-34.5 kPa for HCC patients (n=4). The degree of liver stiffness was significantly different between the different disease groups (p<0.001). Liver stiffness was well correlated with the fibrosis stages (r=0.726; p<0.001). The AUROC of FibroScan(R), the APRI and the AST/ALT ratio values were of the same order; 0.72, 0.61 and 0.58, respectively, for F> or =2; 0.92, 0.73, and 0.56, respectively, for F> or =3; and 0.97, 0.79, and 0.55, respectively, for F=4. FibroScan(R) offered the best diagnostic performance both for significant fibrosis (F> or =2) and severe fibrosis-cirrhosis (F3-F4). CONCLUSIONS: FibroScan(R) is a reliable, rapid non-invasive method to diagnose the severity of chronic liver disease and to predict fibrosis in patients with chronic hepatitis B, in addition to using the APRI and AST/ALT ratio.
Aspartate Aminotransferases ; Biomarkers* ; Biopsy ; Blood Platelets ; Classification ; Diagnosis ; Elasticity Imaging Techniques ; Fibrosis ; Hepatitis B ; Hepatitis B Surface Antigens ; Hepatitis B, Chronic* ; Hepatitis, Chronic* ; Humans ; Liver Cirrhosis* ; Liver Diseases ; Liver*

BACKGROUND/AIMS: Hepatocellular carcinoma (HCC) with an extension to the inferior vena cava (IVC) or right atrium is uncommon, and its prognosis remains unclear due to the few case reports. In order to elucidate the natural history and treatment outcome, this study investigated advanced HCC patients with an IVC invasion or atrial tumor thrombus. METHODS: Between November 1987 and June 2004, a total of 41 patients were diagnosed as having HCC with IVC or right atrial involvement using the new imaging techniques including a two-dimensional echocardiography. Those patients were stratified into the untreated 'control group' (n=17) and 'treated group' (n=24). The clinical features, treatment outcome and prognosis including patient survival were analyzed. RESULTS: The mean age of the total patients was 55 years (male:female, 33:8). The most common cause of HCC was a hepatitis B virus infection (85.4%), followed by a hepatitis C virus infection (7.4%). According to the Child-Pugh classification, 24 patients were Child-Pugh class A (58.5%), 15 were Child-Pugh class B (36.6%), and 2 were Child-Pugh class C (4.9%). Lung metastases were identified in 10 patients (24.5%). The treatment modalities of the treated group included 11 systemic chemotherapy regimens (5-FU and cisplatin), 10 transarterial chemotherapy regimens, 2 chemoradiation procedures and 1 hepatic resection. The overall survival was 3.0 months (range, 1-29 months). The 6 month survival rate was 23.5% (4/17) in the control group and 29.2% (7/24) in the treated group. The 12 months survival rate was 0% (0/17) and 25.0% (6/24), respectively. Independent prognostic factor affecting the survival was whether or not any treatment had been carried out. CONCLUSIONS: Although the prognosis of advanced HCC with IVC invasion or a right atrial tumor thrombi is poor, treatment might improve the survival rate.
Adolescent ; Adult ; Aged ; Carcinoma, Hepatocellular/mortality/*pathology/*therapy ; Combined Modality Therapy ; Female ; *Heart Atria/pathology ; Heart Diseases/*etiology ; Humans ; Liver Neoplasms/mortality/*pathology/*therapy ; Male ; Middle Aged ; Neoplasm Invasiveness ; Neoplasm Staging ; Prognosis ; Retrospective Studies ; Severity of Illness Index ; Survival Analysis ; Thrombosis/*etiology ; Treatment Outcome ; *Vena Cava, Inferior/pathology

BACKGROUND/AIMS: The long-term virologic and biochemical changes in patients with HBeAg negative HBV infection, especially in Asia, remain unclear. To address this issue, we conducted a 3 year- retrospective, cohort study. METHODS: A total of 157 patients with HBeAg negative HBV infection who were monitored without treatment were reviewed between January 1999 and March 2004. Those patients were followed up every 3 months with liver function tests and serologic tests. All patients were stratified into 3 groups; inactive carrier (IC), viremic carrier (VC) and chronic hepatitis (CH). Serum HBV DNA was measured by a hybridization assay (sensitivity: 1.4 x 10(5) genomes/mL, Digene Diagnostics, Silver Spring, USA). RESULTS: The median age of enrolled patients was 42.7 years (M:F=2.3:1). By single time-point observations, the 3 year-cohort prevalence of HBeAg negative CH varied from 12.7 to 35.8% (median 20.7%) HBeAg negative CH was accumulated over time (P=0.002) and transition rates among three groups after 3 years of follow-up are as follows: IC to CH, 6.0%; IC to VC, 4.1%; VC to CH, 23.2%. VC seems to be a disease state in the middle of transition from IC to CH. CONCLUSIONS: We demonstrated the dynamic changing patterns of HBeAg negative CH with time, of which the change from IC or VC to CH was dominant.
Middle Aged ; Male ; Humans ; Hepatitis B, Chronic/*immunology/virology ; Hepatitis B e Antigens/*blood ; Female ; Carrier State/immunology ; Adult

BACKGROUND: Transcatheter hepatic arterial chemoembolization (TACE) is used for curative or palliative treatment of hepatocellular carcinoma (HCC). However, it is neither well known how much TACE induces tumor necrosis histologically, nor whether preoperative TACE has benefit for resectable HCC. The purpose of this study is to measure the degree of tumor necrosis induced by one session of TACE and to evaluate the effect of preoperative TACE for resectable HCC. METHODS: Between January 1999 and January 2004, 20 HCC patients with one session of preoperative TACE (TACE group) and 36 HCC patients with only preoperative hepatic angiography, without TACE (angiography group) were enrolled. RESULTS: In TACE group, 12 patients had tumor necrosis of 100%, 5 patients having between 80% and 99%, and 3 patients less than 50%. The mean tumor necrosis rate of HCC less than 5 cm in diameter were 84.7%, while 90.5% in larger size (>5 cm in diameter) of HCC (p>0.05). The mean tumor necrosis rate of the recurred patients in TACE group and in angiography group was 98.75 and 17.5% (p=0.02), respectively. Disease free survival time of the recurred patients in TACE and in angiography group was 16.75 and 20.25 months, respectively (p=0.77). CONCLUSIONS: The tumor size was not related with the degree of tumor necrosis and no relevant factors could be found. Although the mean tumor necrosis was greater in TACE group than in angiography group, the disease free survival time was not different between the two groups.
Angiography ; Carcinoma, Hepatocellular* ; Disease-Free Survival ; Humans ; Necrosis ; Palliative Care