The stigma of mental illness is a problem that should be addressed urgently as such stigma has a negative effect on the lives of individuals with mental disorders, which may result in social and economic losses. Moreover, mental health stigma acts as a barrier to mental health service utilization. Thus, the need to reduce the mental health stigma has been highlighted. In Korea, stigma associated with individuals with mental disorders has been studied; however, few of those studies investigated mental health literacy, which might influence an individual's attitudes toward and beliefs about people with mental disorders. Furthermore, there are fewer evidence-based anti-stigma campaigns and programs in Korea than in other countries. On that basis, a review of previous studies focusing on mental disorder stigma was undertaken, and the effects of such stigma on individuals with mental disorders and on society were assessed. In addition, research into mental health literacy, rarely undertaken in South Korea, was discussed. Finally, anti-stigma campaigns that are reportedly effective in reducing mental illness stigma were reviewed. With regard to future research on mental health stigma in South Korea, it is suggested that researchers study mental health literacy to assess accurately the public's misperceptions about mental disorders. In addition, a variety of evidence-based anti-stigma campaigns should be implemented to increase public knowledge of mental disorders. Lastly, cooperation between public and private sectors should be encouraged to develop strategies for reducing the stigma and negative beliefs associated with mental disorders.
Korea* ; Literacy ; Mental Disorders ; Mental Health ; Mental Health Services ; Private Sector

OBJECTIVE: The aim of the study was to develop the Korean Psychological Autopsy Checklist for Adolescent (K-PAC-A) and conduct a pilot study. METHODS: A number of steps were undertaken in the development of the K-PAC-A including literature reviews, consultations, and a pilot study. The Korean psychology autopsy checklist 2.0 (K-PAC 2.0) was carefully reviewed to adopt some domains and questions which can be applied to adolescents. RESULTS: In addition to the adoption of some domains and questions from the K-PAC 2.0, some items were developed by considering the risk factors shown in the previous studies and cultural factors including family-based and school-based problems. A pilot study was conducted in collaboration with Eulji hospital, and Suicide and School Mental Health Institute of Hallym University and 5 cases of adolescent suicide victims were recruited. A final version of the K-PAC-A consists of three domains; a bereaved family (informants), a decedent, and psychological assessments. CONCLUSION: An adolescent psychological autopsy study using the K-PAC-A is expected to provide useful evidence for suicide prevention policies and intervention plans for Korean youths in the future.
Adolescent* ; Autopsy* ; Checklist* ; Child ; Cooperative Behavior ; Humans ; Mental Health ; Pilot Projects ; Psychology ; Referral and Consultation ; Risk Factors ; Suicide

Ataxia-telangiectasia (AT) is characterized by cerebellar ataxia, progressive immunodeficiency, radiation sensitivity, telangiectasia, and predisposition to malignancy. AT patients have a 100-fold increased risk for the development of lymphoid malignancies. It is important to consider AT in a child with pre-existing ataxia, or lymphoid malignancy that was diagnosed at a younger age than expected. This consideration avoids the confusion between ataxia development and toxicity from chemotherapy. Hodgkin's lymphoma (HL) is usually treated with chemotherapy and/or radiotherapy. Unfortunately, when treated with conventional doses of radiotherapy, AT patients invariably experience devastating necrosis of their normal tissues. Therefore, a new treatment protocol for patients with HL in AT must be established. In this paper, we report the case of an 8-year-old female patient with HL in AT who was treated with chemotherapy. This patient was also treated with brentuximab (which targets CD30) for salvage therapy after the disease progressed.
Ataxia ; Ataxia Telangiectasia ; Cerebellar Ataxia ; Child ; Clinical Protocols ; Drug Therapy ; Female ; Hodgkin Disease ; Humans ; Necrosis ; Radiation Tolerance ; Radiotherapy ; Salvage Therapy ; Telangiectasis

OBJECTIVES: This study was conducted to examine the effect of blood mercury on neurobehavioral performance in Korean elementary school students. METHODS: We measured the blood mercury concentration in 1,077 elementary school students from Seoul, Busan, Daegu and Gwangju, then the students underwent computerized neurobehavioral test. RESULTS: The mean concentration of blood mercury of study subjects was 2.10 microg/L. An increased blood mercury was associated with an increased reaction time in digit addition and symbol digit. CONCLUSIONS: The blood mercury concentration of study subjects was very high compared to findings in a foreign country. We found several associations between blood mercury level and neurobehavioral performance.
Humans ; Reaction Time

PURPOSE: To report the results of dosimetric comparison between intensity-modulated radiotherapy (IMRT) using Tomotherapy and four-box field conformal radiotherapy (CRT) for pelvic irradiation of locally advanced rectal cancer. MATERIALS AND METHODS: Twelve patients with locally advanced rectal cancer who received a short course preoperative chemoradiotherapy (25 Gy in 5 fractions) on the pelvis using Tomotherapy, between July 2010 and December 2010, were selected. Using their simulation computed tomography scans, Tomotherapy and four-box field CRT plans with the same dose schedule were evaluated, and dosimetric parameters of the two plans were compared. For the comparison of target coverage, we analyzed the mean dose, V(n Gy), D(min), D(max), radical dose homogeneity index (rDHI), and radiation conformity index (RCI). For the comparison of organs at risk (OAR), we analyzed the mean dose. RESULTS: Tomotherapy showed a significantly higher mean target dose than four-box field CRT (p = 0.001). But, V(26.25 Gy) and V(27.5 Gy) were not significantly different between the two modalities. Tomotherapy showed higher D(max) and lower D(min). The Tomotherapy plan had a lower rDHI than four-box field CRT (p = 0.000). Tomotherapy showed better RCI than four-box field CRT (p = 0.007). For OAR, the mean irradiated dose was significantly lower in Tomotherapy than four-box field CRT. CONCLUSION: In locally advanced rectal cancer, Tomotherapy delivers a higher conformal radiation dose to the target and reduces the irradiated dose to OAR than four-box field CRT.
Appointments and Schedules ; Chemoradiotherapy ; Humans ; Organs at Risk ; Pelvis ; Preoperative Care ; Radiometry ; Radiotherapy, Conformal* ; Radiotherapy, Intensity-Modulated ; Rectal Neoplasms*

Several theories emphasize that aging is closely related to oxidative stress and disease. The formation of excess ROS can lead to DNA damage and the acceleration of aging. Vigna angularis is one of the important medicinal plants in Korea. We isolated vitexin from V. angularis and elucidated the lifespan-extending effect of vitexin using the Caenorhabditis elegans model system. Vitexin showed potent lifespan extensive activity and it elevated the survival rates of nematodes against the stressful environments including heat and oxidative conditions. In addition, our results showed that vitexin was able to elevate antioxidant enzyme activities of worms and reduce intracellular ROS accumulation in a dose-dependent manner. These studies demonstrated that the increased stress tolerance of vitexin-mediated nematode could be attributed to increased expressions of stress resistance proteins such as superoxide dismutase (SOD-3) and heat shock protein (HSP-16.2). In this work, we also studied whether vitexin-mediated longevity activity was associated with aging-related factors such as progeny, food intake, growth and movement. The data revealed that these factors were not affected by vitexin treatment except movement. Vitexin treatment improved the body movement of aged nematode, suggesting vitexin affects healthspan as well as lifespan of nematode. These results suggest that vitexin might be a probable candidate which could extend the human lifespan.
Acceleration ; Aging ; Caenorhabditis elegans* ; Caenorhabditis* ; DNA Damage ; Eating ; Heat-Shock Proteins ; Hot Temperature ; Humans ; Korea ; Longevity ; Oxidative Stress ; Plants, Medicinal ; Superoxide Dismutase ; Survival Rate

OBJECTIVES: Recent studies have raised the possibility that nerve growth factor(NGF) is abnormally regulated in the central nervous system(CNS) of animal models with alcohol dependence. The possible alteration of NGF by prolonged alcohol intake may play an important role in alcohol-induced neurotoxicity. Carbohydrate-deficient transferrin(CDT) is regarded as a reliable biological marker of alcohol dependence. The goal of this study was to estimate the changes of %CDT and serum NGF level according to the duration of alcohol abstinence, and to identify whether %CDT level is associated with the serum NGF level in the patients with alcohol dependence. METHODS: The subjects were 24 patients with alcohol dependence. We used the Axis-Shield ASA to measure the %CDT level and the enzyme-linked immunosorbent assay(ELISA) to measure the serum NGF level. %CDT and NGF levels were measured immediately after the admission and at 2 weeks after the admission. RESULTS: Decreased %CDT were observed during the period of 2 weeks after the admission. NGF level was not significantly different after 2 weeks. The NGF levels were not correlated with %CDT. The possibility of %CDT as a predictor of alcohol-induced neurotoxicity was not confirmed. CONCLUSION: Serum NGF levels is not a reliable indicator of abstinence state in the patients with alcohol dependence. Further studies are needed to evaluate the relation between two indicators in regard to hematological and neurological changes in alcohol dependence.
Alcohol Abstinence ; Alcoholism* ; Biomarkers ; Humans ; Models, Animal ; Nerve Growth Factor* ; Transferrin*

Background: Prostate-specific antigen-based routine screening is not recommended for the general population due to conflicting results with mortality reduction. We aimed to develop a web-based decision aid (DA) for informed decision making for prostate cancer screening. Methods: Using the International Patient Decision Aid Standards (IPDAS) development process model, we developed our DA based on patient and clinician interviews and multidisciplinary expert discussions. The prototype consisted of predicting individual prostate cancer risk and informed decision-making, including knowledge, risk and benefit, cost, personal value, and decision making. We conducted a pilot study on 101 healthy men, evaluating the effectiveness of DA by measuring knowledge, attitude, and intention to screen before and after using the DA, as well as decisional conflict and usefulness after using the DA. Results: Of the 101 participants (median age 60 [50–69] years), 84% had not undergone screening for prostate cancer in the past two years. After using the DA, knowledge on prostate cancer screening increased (mean score [of 10] before versus after: 6.85 ± 1.03 versus 7.57 ± 1.25; P < 0.001), and intention to not screen increased from 27.7% to 51.5% (P < 0.001), but attitude toward screening did not change (P = 0.564). After use of the DA, 79 participants reported no decisional conflict, and the usefulness score was high (mean score [of 100] 77.35 ± 7.69), with 85% of participants reporting that the DA helped with decision making. Conclusion Our web-based DA yielded increased knowledge, decreased screening intention, and high perceived usefulness. These findings indicate potential clinical relevance, especially among younger individuals.

Mitochondrial dysfunction and endoplasmic reticulum (ER) stress are considered the key determinants of insulin resistance. Impaired mitochondrial function in obese animals was shown to induce the ER stress response, resulting in reduced adiponectin synthesis in adipocytes. The expression of inducible nitric oxide synthase (iNOS) is increased in adipose tissues in genetic and dietary models of obesity. In this study, we examined whether activation of iNOS is responsible for palmitate-induced mitochondrial dysfunction, ER stress, and decreased adiponectin synthesis in 3T3L1 adipocytes. As expected, palmitate increased the expression levels of iNOS and ER stress response markers, and decreased mitochondrial contents. Treatment with iNOS inhibitor increased adiponectin synthesis and reversed the palmitate-induced ER stress response. However, the iNOS inhibitor did not affect the palmitate-induced decrease in mitochondrial contents. Chemicals that inhibit mitochondrial function increased iNOS expression and the ER stress response, whereas measures that increase mitochondrial biogenesis (rosiglitazone and adenoviral overexpression of nuclear respiratory factor-1) reversed them. Inhibition of mitochondrial biogenesis prevented the rosiglitazone-induced decrease in iNOS expression and increase in adiponectin synthesis. These results suggest that palmitate-induced mitochondrial dysfunction is the primary event that leads to iNOS induction, ER stress, and decreased adiponectin synthesis in cultured adipocytes.
3T3-L1 Cells ; *Adipocytes/drug effects/metabolism ; Adiponectin/biosynthesis ; Adipose Tissue/metabolism ; Animals ; Endoplasmic Reticulum Stress/drug effects ; Insulin Resistance/genetics ; Mice ; Mitochondria/drug effects/*metabolism/pathology ; Mitochondrial Turnover/drug effects/genetics ; *Nitric Oxide Synthase Type II/genetics/metabolism ; Nuclear Respiratory Factor 1 ; Obesity/genetics/metabolism ; Palmitic Acid/pharmacology ; Thiazolidinediones/pharmacology

Background: Cholecystitis is an important risk factor for gallbladder cancer, but the bile microbiome and its association with gallbladder disease has not been investigated fully.We aimed to analyze the bile microbiome in normal conditions, chronic cholecystitis, and gallbladder cancer, and to identify candidate bacteria that play an important role in gallbladder carcinogenesis. Methods: We performed metagenome sequencing on bile samples of 10 healthy individuals, 10 patients with chronic cholecystitis, and 5 patients with gallbladder cancer, and compared the clinical, radiological, and pathological characteristics of the participants. Results: No significant bacterial signal was identified in the normal bile. The predominant dysbiotic bacteria in both chronic cholecystitis and gallbladder cancer were those belonging to the Enterobacteriaceae family. Klebsiella increased significantly in the order of normal, chronic cholecystitis, and gallbladder cancer. Patients with chronic cholecystitis and dysbiotic microbiome patterns had larger gallstones and showed marked epithelial atypia, which are considered as precancerous conditions. Conclusion We investigated the bile microbiome in normal, chronic cholecystitis, and gallbladder cancer. We suggest possible roles of Enterobacteriaceae, including Klebsiella, in gallbladder carcinogenesis. Our findings reveal a possible link between a dysbiotic bile microbiome and the development of chronic calculous cholecystitis and gallbladder cancer.