Even though suicide ranks as the fourth cause of death and is causing a significant loss in Korea, it seems that the conventional notion regarding suicide as a feasible way of solving a troublesome life situation hinders early recognition and proper management of suicide. This article reviews suicide prevention strategies recommended based on robust experience and scientific understanding of the characteristics of the suicide problem. In the UK, a suicide prevention strategy was formed at the national level suggesting significant goals to reduce the rate of suicide. In the US, the Institute of Medicine study committee examined the state of the science base, gaps in knowledge, strategies for prevention, and research designs for the study of suicide. This recommendation includes more science-based, coherent and well-coordinated multidisciplinary approaches, and thus suggests important practical recommendations for a suicide prevention strategy of Korea. The author concludes that suicide should be defined as a treatable and even preventable medical condition. Constructing a national network of suicide research, data surveillance, developing tools for suicide prevention including early detection and safety planning, and comprehensive insurance coverage are recommended.
Cause of Death ; Depression ; Institute of Medicine (U.S.) ; Insurance Coverage ; Korea ; Research Design ; Suicide

This is a case report of miliary tuberculosis in adult with normal simple chest X-ray finding in early state of FUO. Miliary tuberculosis is fatal, which have nonspecific presenting symptoms. Then, a high index of suspicion and diagnostic persistence, are required for early treatment and cure.
Adult ; Humans ; Thorax* ; Tomography, X-Ray Computed ; Tuberculosis, Miliary*

OBJECTIVES: Medical complications are common and often serious in patients with eating disorders, however, little is known about complications in patients with bulimia nervosa. METHODS: We conducted a retrospectively investigation of clinical characteristics and hematologic, biochemical, hormonal, and bone density evaluations in 90 Korean women with bulimia nervosa together with 100 healthy Korean women of comparable ages. RESULTS: In patients with bulimia nervosa, 20% were anemic, 3.3% were hypokalemic, 14.4% had increased alanine aminotransferase, 24.4% were lower in serum protein, 8.8% were hypercholesterolemia, and 77.8% were hyperamylasemia. Osteopenia at any one site was identified in 26.7% of patients and the lowest-ever body mass index was the main determinant of bone mineral density in patients with bulimia nervosa. CONCLUSION: In this study, many features of medical findings reported in anorexia nervosa were found in bulimia nervosa, however, the findings in bulimia nervosa were milder form than in anorexia nervosa. Management of any physical abnormalities in bulimia nervosa should focus on correction of the eating disorder.
Alanine Transaminase ; Anorexia Nervosa ; Body Mass Index ; Bone Density ; Bone Diseases, Metabolic ; Bulimia Nervosa* ; Bulimia* ; Feeding and Eating Disorders ; Female ; Humans ; Hyperamylasemia ; Hypercholesterolemia ; Retrospective Studies

OBJECTIVES: QT interval prolongation and dispersion known as indicators of an increased risk for ventricular arrhythmias and sudden death have been reported to be prolonged in patients with anorexia nervosa. The aims of this study were to compare conduction abnormalities in Korean patients with anorexia nervosa and bulimia nervosa, and to examine its relation with clinical and laboratory factors. METHODS: We retrospectively examined 45 women with anorexia nervosa and 75 women with bulimia nervosa who were assessed by 12-lead electrocardiogram at baseline. QT interval and corrected QT interval, QT dispersion of the difference between the longest and shortest QT intervals, and abnormal U wave were measured for conduction abnormalities. RESULTS: QT interval was significantly longer in patients with anorexia nervosa compared with those with bulimia nervosa. There were no differences in QTc (Corrected QT), QTd (QT dispersion) and abnormal U wave between patients with anorexia nervosa and those with bulimia nervosa. QTd was significantly correlated with the lowest ever lifetime body mass index (kg/m2) as well as the serum amylase level in patients with anorexia nervosa. CONCLUSIONS: These results suggest some conduction abnormalities reported in patients with anorexia nervosa are also found in patients with bulimia nervosa. It appears that severity of weight loss and purging behavior could affect the cardiac arrhythmia in patients with eating disorders. Appropriate attention should be paid to cardiac involvement in patients with eating disorders.
Amylases ; Anorexia ; Anorexia Nervosa ; Arrhythmias, Cardiac ; Body Mass Index ; Bulimia Nervosa ; Death, Sudden ; Eating ; Feeding and Eating Disorders ; Electrocardiography ; Female ; Humans ; Retrospective Studies ; Weight Loss

PURPOSE: We assessed the clinical outcome of contralateral arthroscopic meniscectomy performed with unilateral total knee arthroplasty (TKA). MATERIALS AND METHODS: From May 1999 to June 2006, 23 patients underwent unilateral total knee arthroplasty and contralateral arthroscopic meniscectomy at the same time. All patients were women and followed for at least 36 months, except 2 patients who died. For clinical assessment, range of motion of the knee joint, Hospital for Special Surgery (HSS) knee score and the Lysholm knee score were evaluated preoperatively and at the last follow-up. At arthroscopy, meniscal pathology and cartilage changes were recorded and classified according to the Outerbridge scale. Progression of osteoarthritis in the contralateral knee to subsequent TKA was also assessed. RESULTS: The mean age of the 21 patients was 67.1 years and the mean follow-up period was 5.7 years. All of the patients were diagnosed with osteoarthritis and had Outerbridge grade 3 or 4 cartilage changes. Eight of the 21 patients had subsequent TKA at an average of 3.1 years after the index operation. The other 13 patients had no further surgery and clinical results including the HSS knee score and the Lysholm score were improved from 74.5 and 60.6 preoperatively to 90.8 and 82.4 postoperatively, respectively (p<0.001). CONCLUSIONS: Contralateral arthroscopic meniscectomy performed simultaneously with unilateral TKA produces relatively good results regardless of the presence of cartilage degeneration.
Arthroplasty ; Arthroscopy ; Cartilage ; Female ; Follow-Up Studies ; Humans ; Knee Joint ; Knee ; Osteoarthritis ; Pathology ; Range of Motion, Articular

OBJECTIVE: To investigate the current status and the basic information of cumulative traumatic disorder among workers. METHOD: The subjects were 198 workers, consisted of 100 shipspublisher workers, 155 telephone operators and 43 light workers. Workers were surveyed with a standardized self- administered questionnaire and examed by the occupational medicine doctors and physiatrists for the cumulative traumatic disorders. Laboratory tests, nerve conduction studies and X-rays of the C-spine and shoulders were performed in all subjects. RESULT AND CONCLUSION: Myofascial pain syndrome was the most frequent problem in the shipspublisher and telephone operators. As a result of the multiple logistic regression analysis, cycle time, palm pinch, lumbar and neck flexion were the significant variables accounting for the musculoskeletal symptoms.
Logistic Models ; Myofascial Pain Syndromes ; Neck ; Neural Conduction ; Occupational Medicine ; Prevalence* ; Surveys and Questionnaires ; Shoulder ; Telephone

Cumulative trauma disorders were surveyed in a cross-sectional study of 100 male ship yard workers and 43 male office workers. And baseline checklist for risk assessment of cumulative trauma disorders was applicated in a ship making process. Cases of cumulative trauma disorders were defined using physical examinations and electronic diagnostic methods. Data on demographics, individual factors (medical condition), work organization and psychosocial aspects of work were obtained by questionnaire. Association between the above factors and cumulative trauma disorders were assessed by multiple logistic regression models. 29(29 %) participants of male shipyard workers and 4(9.2 %) study subjects of male office workers met our case definitions for cumulative trauma disorders. The myofascial pain syndrome of neck muscles(12 % of participants) and carpal tunnel syndrome(5 % of participants) were the major two medical conditions in shipyard workers. The odds of male shipyard workers for cumulative trauma disorders to male office workers was 3.15 after adjustment of age(95 % C.I. :2.25-5.44). And the variables such as duration of present job, HIVD condition, and surges in workload were associated at least one of the cumulative trauma disorders in the final models (p<0.05) . This study indicates that work related upper extremity musculoskeletal disorders are relatively common among shipyard workers, and shows that the psychosocial factors is not likely to be related to the occur rences of these disorders in heavy workers. Also we developed baseline checklist for risk assessment of cumulative trauma disorders. The checklist was unique in that its expected users were industrial hygienists and occupational healthing nurses who did not have much ergonomic background and in that it was targeted to Korean workers in various types. As the first application of the checklist, shipyard workers were evaluated.
Checklist* ; Cross-Sectional Studies ; Cumulative Trauma Disorders* ; Demography ; Humans ; Logistic Models ; Male ; Myofascial Pain Syndromes ; Neck ; Occupational Health ; Physical Examination ; Psychology ; Questionnaires ; Risk Assessment* ; Ships ; Upper Extremity

Cumulative trauma disorders were surveyed in a cross-sectional study of 100 male ship yard workers and 43 male office workers. And baseline checklist for risk assessment of cumulative trauma disorders was applicated in a ship making process. Cases of cumulative trauma disorders were defined using physical examinations and electronic diagnostic methods. Data on demographics, individual factors (medical condition), work organization and psychosocial aspects of work were obtained by questionnaire. Association between the above factors and cumulative trauma disorders were assessed by multiple logistic regression models. 29(29 %) participants of male shipyard workers and 4(9.2 %) study subjects of male office workers met our case definitions for cumulative trauma disorders. The myofascial pain syndrome of neck muscles(12 % of participants) and carpal tunnel syndrome(5 % of participants) were the major two medical conditions in shipyard workers. The odds of male shipyard workers for cumulative trauma disorders to male office workers was 3.15 after adjustment of age(95 % C.I. :2.25-5.44). And the variables such as duration of present job, HIVD condition, and surges in workload were associated at least one of the cumulative trauma disorders in the final models (p<0.05) . This study indicates that work related upper extremity musculoskeletal disorders are relatively common among shipyard workers, and shows that the psychosocial factors is not likely to be related to the occur rences of these disorders in heavy workers. Also we developed baseline checklist for risk assessment of cumulative trauma disorders. The checklist was unique in that its expected users were industrial hygienists and occupational healthing nurses who did not have much ergonomic background and in that it was targeted to Korean workers in various types. As the first application of the checklist, shipyard workers were evaluated.
Checklist* ; Cross-Sectional Studies ; Cumulative Trauma Disorders* ; Demography ; Humans ; Logistic Models ; Male ; Myofascial Pain Syndromes ; Neck ; Occupational Health ; Physical Examination ; Psychology ; Questionnaires ; Risk Assessment* ; Ships ; Upper Extremity

OBJECTIVE: The authors investigated the current practice of intensive psychotherapy by residents in the department of psychiatry. METHODS: We mailed a questionnaire to 126 fourth-year psychiatry residents in order to obtain data on their clients' sociodemographic characteristics, the settings in which psychotherapy is being conducted, the effects of psychotherapy, the difficulties associated with psychotherapy, the state of supervision and the level of clients' satisfaction. RESULTS: Approximately 51.5% of the residents completed the questionnaires. The average number of clients was 4.9+/-3.8, the average number of psychotherapy sessions was 26.2+/-20.1, and 69.4% of the residents had performed insight-oriented psychotherapy. Approximately 69.8% of the fourth-year residents had received some form of supervision, and 58.7% agreed to increase the frequency of supervision. Approximately 74.2% of the cases were supervised. The average number of supervisions per case was 9.2+/-10.5. CONCLUSION: The setting in which psychotherapy is conducted, number of clients, and type of supervision varied greatly among the training institutes surveyed. Based on these findings, we expect to create better psychotherapy training programs for psychiatric residents.
Academies and Institutes ; Education ; Internship and Residency* ; Organization and Administration ; Postal Service ; Psychotherapy* ; Surveys and Questionnaires

OBJECTIVES: According to the recent Korean National Police Agency report, rape victims were 17.1%, but sexual molestation victims were more than the rape victims by 78.0%. Despite many international reports about the occurrence of severe psychiatric symptoms in sexual molestation victims, there is no domestic research. Therefore in this study, we investigated psychiatric symptoms of sexual molestation victims, and we also compared it with psychiatric symptoms in rape victims. METHODS: 58 women who visited Busan Smile Center within 3months after sexual violence were the study subjects. Questionnaire about sociodemographic and sexual violence related characteristics were retrospectively investigated. Of the psychiatric symptoms, Beck Depression Inventory(BDI), Beck Anxiety Inventory(BAI) for severity of depression and anxiety, and Impact of Event Scale-Revised(IES-R) to check the presence of posttraumatic stress disorder(PTSD) symptoms were used. RESULTS: Of 58 sexual violence victims, sexual molestation victims were 36(62.1%) and rape victims were 22(37.9%). In sexual molestation victims, 80.6% had more than moderate severity of depression, 83.3% had more than moderate severity of anxiety, and 94.4% had significant scores at PTSD screening test. Compared with rape victims' psychiatric symptoms(each 95.5%, 95.5%, 95.5%) there were no significant difference. CONCLUSIONS: The majority of sexual molestation victims were also accompanied by depression, anxiety and PTSD symptoms as rape victims. There results suggest that appropriate assessment and early treatment for psychiatric symptom must be made in the early stage of injury in sexual molestation victims.
Adult* ; Anxiety ; Busan ; Depression ; Female* ; Humans ; Mass Screening ; Police ; Rape* ; Retrospective Studies ; Sex Offenses ; Stress Disorders, Post-Traumatic