Psychological autopsy is a systematic methodology for comprehensive investigation of psychiatric and behavioral factors assumed to be causative or related to death of the deceased. In many countries, psychological autopsy is considered the most direct and valuable tool for determining the relationship between risk factors and suicide. The case of Finland revealed that successful psychological autopsy studies could greatly contribute to the national suicide prevention strategy, which consequently reduced the national suicide rate. Despite the strengths of psychological autopsy for identifying risk factors of suicide and consequently preventing suicide, it has not been successful in Korea. Implementation of psychological autopsy has been inconsistent and sporadic across the provinces. In addition, standardization of psychological autopsy protocol and qualification of interviewers are needed. With all of these methodological issues in mind, conduct of as many psychological autopsies as possible is important in order to build an evidence-based suicide prevention strategy. For successful implementation of psychological autopsy in Korea, it is necessary to improve attitudes toward suicide and psychiatric conditions. Legal, administrative, and institutional support are also important. Finally, multidisciplinary approach based on the financial and legal support should be employed.
Autopsy* ; Finland ; Korea ; Mental Health ; Risk Factors ; Suicide

Mental health is one of the most important issues for disaster survivors, and many studies have reported higher rates of mental health problems after disasters. Because Japan has experienced frequent earthquakes, tsunami, typhoons, and volcanoes, mental health problems have been a matter of great concern after disasters in Japan. To serve the psychiatric services after the Hanshin-Awaji (Kobe) earthquake, 'Hyogo institute for traumatic stress' was established. And when the disaster caused by the great east Japan earthquake and tsunami occurred, 'National information center of disaster mental health' and 'Disaster psychiatric assistance team' had the important role of reducing mental health problems.
Cyclonic Storms ; Disasters* ; Earthquakes ; Humans ; Information Centers ; Japan* ; Mental Health* ; Survivors ; Trauma Centers ; Tsunamis

Neuroablation should be performed cautiously because neuropathic pain can occur following denervation of a somatic nerve. A 34-year-old man presented with severe penile pain and allodynia following a selective neurectomy of the sensory nerve that innervated the glans penis for treatment of his premature ejaculation. He was treated with various nerve blocks, including continuous epidural infusion, lumbar sympathetic block and sacral selective transforaminal epidural blocks, as well as intravenous ketamine therapy. However, all of the treatments had little effect on the relief of his pain. We performed spinal cord stimulation as the next therapy. After this therapy, the patient has currently been satisfied for 3 months.
Adult ; Denervation ; Humans ; Hyperalgesia ; Ketamine ; Male ; Nerve Block ; Neuralgia ; Penis ; Premature Ejaculation ; Pudendal Nerve ; Spinal Cord ; Spinal Cord Stimulation

BACKGROUND: Asthma is a chronic inflammatory disease of the airways characterized by a marked infiltration of ecsinophils in the bronchial mucosa. Asthmatic bronchial muosa produces many factors described as king chernotaetic for inflammatory cells. IL-5, RANTES, and MCP-1 alpha are the chemotactic factors for eosinophils, but their roles are controversiaL Recently eotaxin that is a potent eosinophil chernoattracttnt cytokine was detected in a guinea-pig model of allergic airway inflammation, and human eotaxin was cloned. Eotaxin is a specific chemoattractant for eosinophils, but its role in asthma is not confirmed. We examined the in vivo expression of a,taxin in bronchi of asthmatic patients. METHODS: 11 asthmatics and 2 normal controls were enrolled. All subjects were underwent brcnchcscopy with bronchial biopsies in 2nd or 3rd carina. RNA extraction from biopsy samples was done by acid-guanidium method. Semi-quantitaive RT-PCR was done for evaluation of eotaxin mRNA expression. The extent of eosinophil infiltrartion was evaluated by counting the eosinophils in submucosa in HPF of microscope. RESULTS: Eotaxin mRNA expressed in symptomatic, uncontrolled asthma. Steroid inhibited expression of eotaxin mRNA in asthma. Expression of eotaxin mRNA correlated with eosinohil infiltration in bronchial tissues. CONCLUISON: Expression of eotaxin mRNA increases in uncontrolled asthma and eotaxin is involved in the recruitment of eosinophils.
Asthma* ; Biopsy ; Bronchi ; Chemokine CCL5 ; Chemotactic Factors ; Clone Cells ; Eosinophils ; Humans ; Inflammation ; Interleukin-5 ; Mucous Membrane* ; RNA ; RNA, Messenger*

Epignathus is an extremely rare type of congenital teratoma arising in the oral cavity. Although it is a benign tumor, it is associated with high mortality and morbidity rates because of severe airway obstruction and other malformations. We present a case of epignathus affecting one fetus in a twin pregnancy. The tumor was associated with multiple congenital malformations including cleft palate, bifid tongue, bifid uvula, congenital heart defect, and bilateral inguinal hernias. The diagnostic value of three-dimensional ultrasonography and magnetic resonance imaging was explored with respect to antenatal counseling and peripartum management.
Airway Obstruction ; Cleft Palate ; Counseling ; Fetus* ; Heart Defects, Congenital ; Hernia, Inguinal ; Magnetic Resonance Imaging* ; Mortality ; Mouth ; Peripartum Period ; Pregnancy, Twin* ; Prenatal Diagnosis* ; Teratoma ; Tongue ; Ultrasonography* ; Uvula

OBJECTIVES: The aim of this study was to analyze the environmental and familial variables associated with attention-deficit/hyperactivity disorder (ADHD) in children and adolescents. METHODS: Children and adolescents aged 6-18 with in attention, hyperactivity, or impulsivity who visited the Department of Psychiatry at Soonchunhyang University Bucheon Hospital from April 2006 to April 2012, were interviewed for diagnosis of ADHD. Diagnostic and Statistical Manual of Mental Disorders, 4th edition symptom criteria for ADHD were assessed using a semi-structured interview, the schedule for affective disorders and schizophrenia for school-age children present and lifetime version (K-SADS-PL). Environmental and familial variables were obtained using questionnaires for parents. RESULTS: In total, 262 children and adolescents with ADHD (n=139) and control subjects (n=123) were recruited. In a multivariate logistic regression model, results of this study showed that maternal psychiatric problem during pregnancy, dystoia, forceps/vacuum use during delivery, and unplanned pregnancy were risk factors for ADHD. CONCLUSION: Findings of this study showed an association of some prenatal factors (such as unplanned pregnancy or maternal psychiatric problem during pregnancy) and some perinatal factors (dystocia and forceps/vacuum use during delivery) with increased risk of ADHD. The identified risk factors are environmental, and therefore potentially preventable. Conduct of further prospective studies is needed in order to clarify the potential role of these risk factors for ADHD.
Adolescent ; Aged ; Appointments and Schedules ; Child ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Logistic Models ; Mood Disorders ; Pregnancy ; Pregnancy, Unplanned ; Surveys and Questionnaires ; Risk Factors ; Schizophrenia

As the official organization of psychiatrists in South Korea since 1945, the Korean Neuropsychiatric Association (KNPA) has played important contribution in academic and mental health development. It is time to plan long-term policy for future strategy. Thus, the authors tried to perform brainstorming in members of a special task force team and survey for internal specialists in the KNPA and external professionals. Based on the above major issues and results of the survey, the authors suggest the overall direction of the long and mid-term policy for KNPA.
Advisory Committees ; Health Policy ; Korea ; Mental Health ; Psychiatry ; Specialization

PURPOSE: The study was to determine clinical characteristics of periventricular leukomalacia (PVL) in premature infants and evaluate usefulness of brain MRI as a diagnostic tool in predicting degree of PVL to severity of neurological sequelae at 2 years of age. METHODS: The subjects included twenty premature infants admitted to NICU of Kwangju Christian Hospital from June 1993 to February 1999 whose 2 year follow up was possible. The diagnosis of PVL was made by brain MRI and severity of PVL was divided into 3 grades based on its degree of white matter volume loss. RESULTS: The infants with grade I PVL was 2 (10%), grade II was 14 (70%), grade III was 4 (20%). The mean gestational age was 32.0+/-1.7 weeks and mean birth weight was 1,770+/-370 g. The risk factors associated with PVL were mechanical ventilator care, respiratory distress syndrome, prolonged rupture of membrane, and neonatal seizures. Two patient were diagnosed with PVL later by MRI when increased periventricular echodensity noted on initial neurosonogram improved on subsequent follow up neurosonograms. Accompanied neurological sequelae included motor palsy, language delay, visual impairment, squint and epilepsy. At 2 years of age, infants with grade 1 PVL could walk without support, most (71%) of grade II could crawl and stand holding and most (75%) of grade III could sit with arm support. CONCLUSION: Brain MRI is regarded as a precise tool in diagnosing PVL. The severity of PVL on brain MRI significantly correlated with degree of the motor developmental delay.
Arm ; Birth Weight ; Brain ; Diagnosis ; Epilepsy ; Follow-Up Studies ; Gestational Age ; Gwangju ; Humans ; Infant ; Infant, Newborn ; Infant, Premature* ; Language Development Disorders ; Leukomalacia, Periventricular* ; Magnetic Resonance Imaging ; Membranes ; Paralysis ; Risk Factors ; Rupture ; Seizures ; Strabismus ; Ventilators, Mechanical ; Vision Disorders

PURPOSE: The study was to determine clinical characteristics of periventricular leukomalacia (PVL) in premature infants and evaluate usefulness of brain MRI as a diagnostic tool in predicting degree of PVL to severity of neurological sequelae at 2 years of age. METHODS: The subjects included twenty premature infants admitted to NICU of Kwangju Christian Hospital from June 1993 to February 1999 whose 2 year follow up was possible. The diagnosis of PVL was made by brain MRI and severity of PVL was divided into 3 grades based on its degree of white matter volume loss. RESULTS: The infants with grade I PVL was 2 (10%), grade II was 14 (70%), grade III was 4 (20%). The mean gestational age was 32.0+/-1.7 weeks and mean birth weight was 1,770+/-370 g. The risk factors associated with PVL were mechanical ventilator care, respiratory distress syndrome, prolonged rupture of membrane, and neonatal seizures. Two patient were diagnosed with PVL later by MRI when increased periventricular echodensity noted on initial neurosonogram improved on subsequent follow up neurosonograms. Accompanied neurological sequelae included motor palsy, language delay, visual impairment, squint and epilepsy. At 2 years of age, infants with grade 1 PVL could walk without support, most (71%) of grade II could crawl and stand holding and most (75%) of grade III could sit with arm support. CONCLUSION: Brain MRI is regarded as a precise tool in diagnosing PVL. The severity of PVL on brain MRI significantly correlated with degree of the motor developmental delay.
Arm ; Birth Weight ; Brain ; Diagnosis ; Epilepsy ; Follow-Up Studies ; Gestational Age ; Gwangju ; Humans ; Infant ; Infant, Newborn ; Infant, Premature* ; Language Development Disorders ; Leukomalacia, Periventricular* ; Magnetic Resonance Imaging ; Membranes ; Paralysis ; Risk Factors ; Rupture ; Seizures ; Strabismus ; Ventilators, Mechanical ; Vision Disorders

PURPOSE: To evaluate the relationship between F-18 FDG uptake of tumor in PET/CT scan and pathological or immunohistochemial parameters of colorectal cancer. MATERIALS AND METHODS: 147 colorectal cancer patients who underwent both pre-operative F-18 FDG PET/CT scan and surgery were included. In cases with perceptible FDG uptake in primary tumor, the maximum standardized uptake value (SUVmax) was calculated. The pathologic results such as site, size, depth of invasion (T stage), growth pattern, differentiation of primary tumor, lymph node metastasis and Dukes-Astler & Coller stage and immunohistochemical markers such as expression of EGFR, MLH1, MSH2 and Ki-67 index were reviewed. RESULTS: 146 out of 147 PET/CT scans with colorectal cancer showed perceptible focal FDG uptake. SUVmax showed mild positive linear correlation with size of primary tumor (r=0.277, p=0.001) and Ki-67 index (r=0.226, p=0.019). No significant difference in F-18 FDG uptake was found according to site, depth of invasion (T stage), growth pattern, differentiation of primary tumor, presence of lymph node metastasis, Dukes-Astler & Coller stage and expression of EGFR. CONCLUSION: The degree of F-18 FDG uptake in colorectal cancer was associated with the size and the degree of Ki-67 index of primary tumor. It could be thought that FDG uptake of primary tumor has a correlation with macroscopic and microscopic tumor growth.
Colorectal Neoplasms ; Humans ; Lymph Nodes ; Neoplasm Metastasis