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Adolescents' Experiences of Non-Suicidal Self-Injury: An Interpretative Phenomenological Analysis Study (청소년의 비자살적 자해 경험: 해석 현상학적 분석)

  • Ko, Jung A;Kim, Ji Young
    • Journal of Korean Academy of Nursing
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    • v.53 no.5
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    • pp.538-555
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    • 2023
  • Purpose: This qualitative study used interpretative phenomenological analysis and photovoice methods to explore the meaning of non-suicidal self-injury experienced by adolescents. Methods: Participants were adolescents enrolled in middle and high schools in Gyeonggi-do and Jeollabuk-do who were selected through snowball sampling. Six participants had repeatedly engaged in self-injurious behavior for over a year. Data were collected through in-depth interviews and the photovoice method between November 2020 and July 2021. The collected data were analyzed using six steps of interpretative phenomenological analysis. Results: The results yielded 5 main themes and 18 subthemes. The main themes were 'a silent cry to an indifferent world', 'a heartache that one endures with scars', 'an inescapable cycle', 'filling the space in one's heart', and 'healing the wounds'. The study findings revealed that the self-injurious behavior of adolescents began as a consequence of feeling lost and struggling with conflicts at home and school, which helped them relieve tension and pain. Nonetheless, inflicting self-injury only left signs of regret and remorse, which became a trace that the participants wanted to hide. However, the wounds healed after receiving attention and support from others. They were determined to stop engaging in repeated self-injurious behaviors and made efforts to do so. Conclusion: This study can be used as a basis for the development of educational programs to prevent non-suicidal self-injury in adolescents. Additionally, it can inform nursing interventions that focus on building support systems to help adolescents who attempt self-injury.

Changes in Urinary Nitric Oxide in Pediatric Renal Diseases (소아 신장질환에서 소변 내 산화질소의 변화)

  • Kim, Jong-Hwa;Jung, Ji-In;Yim, Hyung-Eun;Hong, Young-Sook;Lee, Joo-Won;Yoo, Kee-Hwan
    • Childhood Kidney Diseases
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    • v.11 no.1
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    • pp.24-31
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    • 2007
  • Purpose : Nitric oxide(NO) is a very potent vasodilator synthesized from L-arginine by endothelial cells. We investigated whether urinary NO excretion was altered in various renal diseases in children and whether urinary NO excretion could be used in predicting pathologic causes and fibrosis in renal diseases in children. Methods : We recruited 48 patients(32 minimal change nephrotic syndrome[MCNS] and 16 vesicoureteral reflux[VUR] patients from the pediatric renal clinic in Korea University Guro Hospital. We measured the concentration of nitrite$(NO_2)$ and nitrate$(NO_3)$ by Griess reaction and that of creatinine(Cr) by Jaffe method in randomized spot urines. We then analyzed the urinary$(NO_2+NO_3)/Cr$ ratios and compared the values between each patient group. Urinary $(NO_2+NO_3)/Cr$ ratios were also evaluated according to the recurrence and the degree of proteinuria at sampling in the MCNS group and compared according to the presence of renal scarring and the grade of reflux in the VUR group. Results : The ratios of urinary$(NO_2+NO_3)/Cr$ were significantly increased in the VUR and MCNS groups, as compared to the control group. In the MCNS group, a higher level of urine $(NO_2+NO_3)/Cr$ was observed In frequent relapse patients(relapse over four times within one year after first diagnosis) and the patients with severe proteinuria at sampling, respectively. The VUR group with renal scars also showed a higher level of urinary$(NO_2+NO_3)/Cr$ compared to that without scars. Conclusions : In summary, VUR may play a role in the pathogenesis of VUR and MCNS. NO also seems to affect proteinuria and renal scar formation. (J Korean Soc Pediatr Nephrol 2007;11:24-31)

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Seasonal Occurrence of Yellow Tea Thrips, Scirtothrips dorsalis Hood (Thysanoptera: Thripidae) in Citrus Orchards and Its Damage Symptoms on Citrus Fruits (노지재배 감귤에서의 볼록총채벌레 발생 양상과 피해 증상)

  • Hyun, Jae-Wook;Hwang, Rok-Yeon;Lee, Kwan-Seok;Song, Jeong-Heub;Yi, Pyoung-Ho;Kwon, Hyeog-Mo;Hyun, Dong-Hee;Kim, Kwang-Sik
    • Korean journal of applied entomology
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    • v.51 no.1
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    • pp.1-7
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    • 2012
  • Silver-grey or dark brown scaring, or dark brown discolored damages caused by the yellow tea thrip, $Scirtothrips$ $dorsalis$ Hood (Thysanoptera: Thripidae) have occurred on citrus fruits cultivated in the open field in east-south area orchards of Jeju Island since 2007. The weekly population of yellow tea thrips adults caught with a yellow sticky trap increased gradually from early May and peaked in late August, 2009. In 2010 and 2011, the most population was in early October. The yellow tea thrips of some species usually dominated from July in open citrus fields, and seven generations, at least, had occurred from May to late October 2009 by a yellow sticky trap survey. In 2009, $S.$ $dorsalis$ larva were observed from July and with peaks from late August to mid September and early October on citrus fruits. The damage symptoms appeared in the mid September. In 2011, the population peaks were in early July and late September, and the symptoms increased continually from mid July to late October. The symptoms were silver-scars or initial dark discolorations and then gradually changed to dark-brown discolorations or dark-brown scars. The percent of damaged fruits were 0.9%, 0.4%, 0.8% and 2.7% in 2008, 2009, 2010 and 2011, respectively, by survey in 64 typical orchards in Jeju Island. We are the first to report symptoms of the yellow tea thrip ($Scirtothrips$ $dotsalis$) on citrus fruits.

Transilluminated Powered Phlebectomy Using Arthroscopic Equipment in Varicose Vein of Lower Extremities (하지정맥류에서 관절경 장비를 이용한 광투시 전동형 정맥적출술)

  • 박형주;이철세;이길노;이석열
    • Journal of Chest Surgery
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    • v.36 no.6
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    • pp.391-396
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    • 2003
  • Background: Recently transilluminated powered phlebectomy was introduced and used as a method of surgical treatment for varicose vein in lower extremities. The advantage of transilluminated powered phlebectomy are minimal scar and good cosmetic effect. However, the disadvantages of transilluminated powered phlebectomy is that a high priced Trivex system must be used which increases the patient's expenses. Therefore, we performed a transilluminated powered phlebectomy using an existing arthroscopic equipment instead of Trivex system and observed the effect of treatment and efficiency of the treatment. Material and Method: From March, 2000 to February, 2003, 78 patients (113 limbs) underwent transilluminated powered phlebectomy with an arthroscopic equipment. Patient's disease history, the number of operative scars and complications were reviewed. Result: The operation was performed in 133 limbs of the 78 patients (34 men, 44 women) and the age of patients were ranged from 16 to 72 years with mean age of 41.8 years. Operative time ranged from 20 to 65 minutes (average 48.7 minutes) per limb. The number of operative scar per limb from 2 to 7 (average 4.9). Postoperative complications are transient ecchymosis (78 cases) that desappeared spontaneously, edema persisting longer than 3 weeks (6 cases), remnant varicose vein (4 cases), skin perforation during operative procedure (2 cases), and contact dermatitis due to compression stocking (4 cases) The mean hospitalization day was 3.09 days. Subjective mean satisfaction degree of operation by the patients using a visual analogue scale was 92.6%. Conclusion: Our findings demonstrated that transilluminated powered phleectomy using arthroscopic equipment was possible and had good cosmetic results with acceptable complications.

Kirschner Wire Fixation for the Treatment of Comminuted Zygomatic Fractures

  • Kang, Dai-Hun;Jung, Dong-Woo;Kim, Yong-Ha;Kim, Tae-Gon;Lee, JunHo;Chung, Kyu Jin
    • Archives of Craniofacial Surgery
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    • v.16 no.3
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    • pp.119-124
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    • 2015
  • Background: The Kirschner wire (K-wire) technique allows stable fixation of bone fragments without periosteal dissection, which often lead to bone segment scattering and loss. The authors used the K-wire fixation to simplify the treatment of laborious comminuted zygomatic bone fracture and report outcomes following the operation. Methods: A single-institution retrospective review was performed for all patients with comminuted zygomatic bone fractures between January 2010 and December 2013. In each patient, the zygoma was reduced and fixed with K-wire, which was drilled from the cheek bone and into the contralateral nasal cavity. For severely displaced fractures, the zygomaticofrontal suture was first fixated with a microplate and the K-wire was used to increase the stability of fixation. Each wire was removed approximately 4 weeks after surgery. Surgical outcomes were evaluated for malar eminence, cheek symmetry, K-wire site scar, and complications (based on a 4-point scale from 0 to 3, where 0 point is 'poor' and 3 points is 'excellent'). Results: The review identified 25 patients meeting inclusion criteria (21 men and 4 women). The mean age was 52 years (range, 15-73 years). The mean follow up duration was 6.2 months. The mean operation time was 21 minutes for K-wire alone (n=7) and 52 minutes for K-wire and plate fixation (n=18). Patients who had received K-wire only fixation had severe underlying diseases or accompanying injuries. The mean postoperative evaluation scores were 2.8 for malar contour and 2.7 for K-wire site scars. The mean patient satisfaction was 2.7. There was one case of inflammation due to the K-wire. Conclusion: The use of K-wire technique was associated with high patient satisfaction in our review. K-wire fixation technique is useful in patient who require reduction of zygomatic bone fractures in a short operating time.

Subbrow Approach as a Minimally Invasive Reduction Technique in the Management of Frontal Sinus Fractures

  • Lee, Yewon;Choi, Hyun Gon;Shin, Dong Hyeok;Uhm, Ki Il;Kim, Soon Heum;Kim, Cheol Keun;Jo, Dong In
    • Archives of Plastic Surgery
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    • v.41 no.6
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    • pp.679-685
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    • 2014
  • Background Frontal sinus fractures, particularly anterior sinus fractures, are relatively common facial fractures. Many agree on the general principles of frontal fracture management; however, the optimal methods of reduction are still controversial. In this article, we suggest a simple reduction method using a subbrow incision as a treatment for isolated anterior sinus fractures. Methods Between March 2011 and March 2014, 13 patients with isolated frontal sinus fractures were treated by open reduction and internal fixation through a subbrow incision. The subbrow incision line was designed to be precisely at the lower margin of the brow in order to obtain an inconspicuous scar. A periosteal incision was made at 3 mm above the superior orbital rim. The fracture site of the frontal bone was reduced, and bone fixation was performed using an absorbable plate and screws. Results Contour deformities were completely restored in all patients, and all patients were satisfied with the results. Scars were barely visible in the long-term follow-up. No complications related to the procedure, such as infection, uncontrolled sinus bleeding, hematoma, paresthesia, mucocele, or posterior wall and brain injury were observed. Conclusions The subbrow approach allowed for an accurate reduction and internal fixation of the fractures in the anterior table of the frontal sinus by providing a direct visualization of the fracture. Considering the surgical success of the reduction and the rigid fixation, patient satisfaction, and aesthetic problems, this transcutaneous approach through a subbrow incision is concluded to be superior to the other reduction techniques used in the case of an anterior table frontal sinus fracture.

Applicability and Safety of in Vitro Skin Expansion Using a Skin Bioreactor: A Clinical Trial

  • Jeong, Cheol;Chung, Ho Yun;Lim, Hyun Ju;Lee, Jeong Woo;Choi, Kang Young;Yang, Jung Dug;Cho, Byung Chae;Lim, Jeong Ok;Yoo, James J.;Lee, Sang Jin;Atala, Anthony J.
    • Archives of Plastic Surgery
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    • v.41 no.6
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    • pp.661-667
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    • 2014
  • Background Tissue expansion is an effective and valuable technique for the reconstruction of large skin lesions and scars. This study aimed to evaluate the applicability and safety of a newly designed skin expanding bioreactor system for maximizing the graft area and minimizing the donor site area. Methods A computer-controlled biaxial skin bioreactor system was used to expand skin in two directions while the culture media was changed daily. The aim was to achieve an expansion speed that enabled the skin to reach twice its original area in two weeks or less. Skin expansion and subsequent grafting were performed for 10 patients, and each patient was followed for 6 months postoperatively for clinical evaluation. Scar evaluation was performed through visual assessment and by using photos. Results The average skin expansion rate was $10.54%{\pm}6.25%$; take rate, $88.89%{\pm}11.39%$; and contraction rate, $4.2%{\pm}2.28%$ after 6 months. Evaluation of the donor and recipient sites by medical specialists resulted in an average score of 3.5 (out of a potential maximum of 5) at 3 months, and 3.9 at 6 months. The average score for patient satisfaction of the donor site was 6.2 (out of a potential maximum of 10), and an average score of 5.2 was noted for the recipient site. Histological examination performed before and after the skin expansion revealed an increase in porosity of the dermal layer. Conclusions This study confirmed the safety and applicability of the in vitro skin bioreactor, and further studies are needed to develop methods for increasing the skin expansion rate.

Fretting Wear Test of Inconel 690 Tubes Employing Piezoelectric Actuator (압전 구동기를 이용한 인코넬 690 튜브의 프레팅 마멸시험)

  • Chung, Il-Sup;Lee, Myung-Ho;Park, Ki-Hong;Lee, Jung-Hoon;Kwon, Jae-Do
    • Journal of the Korean Society for Precision Engineering
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    • v.26 no.2
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    • pp.101-108
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    • 2009
  • A fretting wear test rig for dry ambient condition, which employs a piezoelectric actuator, has been developed. It is driven and loaded in a very simple manner with acceptable experimental accuracy. By using the rig, Inconel 690 tube has been tested under the normal load of 10 and 15N with sliding amplitude of less than $100{\mu}m$ during $10^6$cycles. The wear resistance of the material has been characterized in terms of the wear coefficient based on the work rate model. SEM micrographs show the complex structures of the scars, which consist of risen peaks, plate-type thin layers and locally exposed bare surfaces. The cracks spread over the layers give clue to the fretting wear mechanism of the material.

Interpretation of geological structures and stratigraphy around the Kita-Yamato Bank in the East Sea (동해 키타-야마토 뱅크 주변 해역의 지질구조 및 퇴적층서 해석)

  • Huh Sik;Yoo Hai Soo;Park Chan Hong;Han Sang Joon;Jou Hyeong Tae
    • The Korean Journal of Petroleum Geology
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    • v.9 no.1_2 s.10
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    • pp.16-23
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    • 2001
  • The study area in the East Sea is located on the northeastern margins of the Ulleung Basin near the Kita-Yamato Bank. The research area provides the important clue to the development of Miocene basins which are characterized by the normal faults and volcanic activities related to rifting in the continental crust. Kita-Yamato Bank is a small sediment-filled graben which was formed by failed rifting in the Early Miocene. The basins rapidly vary the bathymetry, depth of acoustic basement and thickness of sedimentary layer. The tension in the study area caused the extensional lithospheric deformation before/during the Early Miocene. In consequence, tectonic forces resulted in the depression or subsidence of basement from continental rifting in the Kita-Yamato Bank followed by the opening of the Ulleung Basin, and caused the onset of graben or half-graben structure bounded by large blocked syn-rift faults. Afterward no significant tectonic deformation exists, with the consequence that post-rift normal faults with small heave were formed and reactivated by the resultant forces such as tectonic subsidence, sediment loading and volcanic activity. The Cenozoic sediment layer has a maximum thickness of 1.0 s along the center of the graben or half-graben, which overlies the consolidated acoustic basement. Seismic units V and IV supposed to be syn-rift sedimentary rocks are deformed by both the volcanic activities and numerous basement-involved normal faults induced from extension. In the uppermost layer, slump scars resulted from the slope failure are recognized.

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The Usability of Various Flaps for Hindfoot Reconstruction (다양한 피판술을 이용한 후족부 연부조직의 결손)

  • Lee, Jung-Hwan;Lee, Jong-Wook;Koh, Jang-Hyu;Seo, Dong-Kook;Choi, Jai-Koo;Oh, Suk-Jun;Jang, Young-Chul
    • Archives of Plastic Surgery
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    • v.37 no.2
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    • pp.129-136
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    • 2010
  • Purpose: Anatomically, the foot is provided with insufficient blood supply and is relatively vulnerable to venous congestion compared to other parts of the body. Soft tissue defects are more difficult to manage and palliative treatments can cause hyperkeratosis or ulcer formation, which subsequently requires repeated surgeries. For weight bearing area such as the heel, not only is it important to provide wound coverage but also to restore the protective senses. In these cases, application of flaps for hind foot reconstruction is widely recognized as an effective treatment. In this study, we report the cases of soft tissue reconstruction for which various types of flaps were used to produce good results in both functional and cosmetic aspects. Methods: Data from 37 cases of hind foot operation utilizing flaps performed between from June 2000 to June 2008 were analyzed. Results: Burn related factors were the most common cause of defects, accounting for 19 cases. In addition, chronic ulceration was responsible for 8 cases and so forth. Types of flaps used for the operations, listed in descending order are radial forearm free flap (18), medial plantar island flap (6), rotation flap (5), sural island flap (3), anterolateral thigh free flap (2), lattisimus dorsi muscular flap (2), and contra lateral medial plantar free flap (1). 37 cases were successful, but 8 cases required skin graft due to partial necrosis in small areas. Conclusion : Hind foot reconstruction surgeries that utilize flaps are advantageous in protecting the internal structure, restoring functions, and achieving proper contour aesthetically. Generally, medial plantar skin is preferred because of the anatomical characteristics of the foot (e.g. fibrous septa, soft tissue for cushion). However alternative methods must be applied for defects larger than medial plantar skin and cases in which injuries exist in the flap donor / recipient site (scars in the vicinity of the wound, combined vascular injury). We used various types of flaps including radial forearm neurosensory free flap in order to reconstruct hind foot defects, and report good results in both functional and cosmetic aspects.