OBJECTIVE: To examine gender differences in the characteristics of suicidal behavior in South Korea. METHODS: Between August 2003 and December 2006, 344 suicide attempters (116 men, 228 women) participated in this study. The attempters were interviewed using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), and the lethality of the attempt was measured using the Lethality Suicide Attempt Rating Scale-II (LSARS-II) and Risk-Rescue Rating Scale (RRRS). RESULTS: Significantly more women than men were admitted to emergency rooms due to attempted suicide during the study period. The male attempters were older and had a higher rate of employment than the females. Depression was the most common psychiatric disorder in both genders. The lesion/toxicity scores of the RRRS indicated that the male suicide attempters used higher doses or more toxic agents than the female attempters. The most common methods of suicide were ingestion and cutting in both sexes. Although there were significant gender differences in the RRRS risk score and RRRS total scores, there was no gender difference in the LSARS-II scores, which suggests that patients of both sexes share a similar ambivalence regarding suicide completion or death. CONCLUSION: Our study should be understood within the context of the specific cultural background of South Korea. We found that males and females use similar methods when attempting suicide and share a similar ambivalence regarding the outcome of the attempt; however, there was a difference in severity of the attempt between the two groups. Our findings may aid in the identification of more effective methods of intervention to prevent suicide.
Axis, Cervical Vertebra ; Depression ; Diagnostic and Statistical Manual of Mental Disorders ; Eating ; Emergency Service, Hospital ; Employment ; Female ; Humans ; Korea ; Male ; Risk Factors ; Suicide ; Suicide, Attempted

No abstract available.
Chorionic Gonadotropin* ; Female ; Humans* ; Pregnancy ; Pregnancy, Ectopic* ; Ultrasonography*

A solid pseudopapillary tumor is a rare pancreatic tumor with a low malignant potential that occurs commonly in young females. We report a case of 12-year-old girl with a solid pseudopapillary tumor of the pancreas associated with symptoms of anemia. She was suspected to have a 7x4.5 cm mass growing from the head of the pancreas based on an esophagogastroduodenoscopy, a radiological imaging study, and an immunohistochemical stain examination. She was finally diagnosed with a solid pseudopapillary tumor after a pancreaticoduodenectomy as the definitive treatment.
Anemia ; Child ; Endoscopy, Digestive System ; Female ; Head ; Hemorrhage ; Humans ; Pancreas ; Pancreaticoduodenectomy

No abstract available.
Hematoma, Subdural ; Hemophilia A ; Hemophilia B ; Humans ; Infant

PURPOSE: During sedated esophagogastroduodenoscopy (EGD), patients may not be able to perform inspiration, which is necessary to examine the esophagogastric junction. Therefore sedation may affect diagnosis of gastroesophageal reflux-related findings. The aim of our study was to investigate the effect of sedation on diagnosis of gastroesophageal reflux-related findings during EGD. MATERIALS AND METHODS: This retrospective study evaluated 28914 patients older than 20 years who underwent EGD at our institution between January 2011 and December 2011. Ultimately, 1546 patients indicated for EGD for health check-up and symptom evaluation were included. RESULTS: There were 18546 patients who had diagnostic EGD: 10471 patients (56%) by non-sedated EGD and 8075 patients (43%) by sedated EGD. After statistical adjustment for age, sex, and body mass index, minimal change esophagitis, and hiatal hernia were significantly less frequently observed in the sedated EGD group [odds ratio (OR), 0.651; 95% confidence interval (CI), 0.586 to 0.722 and OR, 0.699; 95% CI, 0.564 to 0.866]. Nevertheless, there was no significant difference in other findings at the gastroesophageal junction, such as reflux esophagitis with Los Angeles classification A, B, C, and D or Barrett's esophagus, between the two groups. Similarly, there were no differences in early gastric cancer, advanced gastric cancer, and gastric ulcer occurrence. CONCLUSION: Sedation can impede the detection of minimal change esophagitis and hiatal hernia, but does not influence detection of reflux esophagitis of definite severity and Barrett's esophagus.
Adult ; Aged ; Barrett Esophagus ; Body Mass Index ; Endoscopy, Digestive System/instrumentation/*methods ; Esophagitis, Peptic/*diagnosis ; Esophagogastric Junction/*pathology ; Female ; Gastroesophageal Reflux/*diagnosis ; Hernia, Hiatal/*diagnosis ; Humans ; Male ; Middle Aged ; Retrospective Studies

PURPOSE: Mycoplasmal pneumonia is one of the most common respiratory diseases in childhood, and is increasing in frequency. We reviewed several aspects of Mycoplasmal pneumonia for applying treatment. METHODS: We reviewed clinical and radiological features of 79 cases of serologically proven Mycoplasmal pneumonia in admitted children between January and December 2003. RESULTS: The mean age was 4 years 2 months and the sex ratio was 1: 1.25 in the male to female ratio. The peak incidence of monthly distribution was September. On the chest x-ray examination, bronchopneumonia was the most common type and the right lower lobe (RLL) was the most common unilateral involvement in lobar consolidation. Leukocytosis, positive CRP and positive ESR were common findings in Mycoplasma pneumonia. CONCLUSION: In this study, peak incidence of monthly distribution did not conflict with previous reports but peak incidence of age in Mycoplasmal pneumonia was lower than in those reports. More studies are needed to prove changes of previous manifestations in Mycoplasmal pneumonia.
Bronchopneumonia ; Child* ; Female ; Humans ; Incidence ; Leukocytosis ; Male ; Pneumonia* ; Pneumonia, Mycoplasma ; Sex Ratio ; Thorax

Purpose: : This study aims to investigate the status of delirium intervention in adult intensive care unit (ICU) patients and the perception of this delirium by medical staff. Methods: : This retrospective study involves 185 patients, whereas, a descriptive survey is conducted with 197 medical staff members. Results: : The delirium group includes 100 patients (54.1%). The incidence of delirium is 64.9% in the medical ICU, 65.9% in the surgical ICU, 42.4% in the neuro ICU, and 46.5% in the cardiac ICU. The percentages of delirium prevention intervention differs between the two groups: 65.0% in the delirium group and 95.3% in the non-delirium group. The medical staff recognize that delirium is a common problem in the ICU (100.0%) and requires active medical intervention (98.5%). Conclusion : The length of stay at the ICU is longer in the delirium group than in the non-delirium group. It is necessary to standardize delirium prevention and treatment protocols to be equally applicable to all ICU patients.

Biliary-enteric fistula is a rare disease, and the common causes of biliary-enteric fistula are gallstone, peptic ulcer, malignancy and trauma. It is known that the most common type of biliary-enteric fistula is the cholecysto-duodenal fistula, yet the combination of choledocho-duodeno-colonic fistula is a rare finding. A 78-year-old woman was admitted because she had suffered with right upper quadrant pain, a febrile sense and chills for 2 days. We confirmed the choledocho-duodeno-colonic fistula by performing gastroduodenoscopy, abdominal CT and an upper GI series. So, we report here on an usual case of choledocho-duodeno-colonic fistula, along with a review of the relevant literatures.
Aged ; Biliary Fistula ; Chills ; Female ; Fistula* ; Gallstones ; Humans ; Peptic Ulcer ; Rare Diseases ; Tomography, X-Ray Computed

Mediastinal emphysema (pneumomediastinum) may result from lung disease, trauma, surgery, diagnostic or therapeutic procedure, but spontaneous occurrence is rare. Patients presenting with chest pain, radiating pain to neck and back, cough, dyspnea, dysphagia and demonstrate air-shadow line on left cardiac border by chest radiography. The authors' case is presented of pneumomediastinum, with subcutaneous emphysema occurring three days postoperatively, in a 12-year-old male patient who underwent bilateral vesico-urethral reimplantation under general anesthesia. The patient was treated conservatively with oxygen and had an uneventful recovery. The authors discuss the possible causes and its management with a review of the relevant literature.
Anesthesia, General* ; Chest Pain ; Child ; Cough ; Deglutition Disorders ; Dyspnea ; Humans ; Lung Diseases ; Male ; Mediastinal Emphysema* ; Neck ; Oxygen ; Radiography ; Replantation* ; Subcutaneous Emphysema* ; Thorax

Neuroleptic malignant syndrome (NMS) is a rare, but potentially fatal idiosyncratic reaction to neuroleptics characterized by muscle rigidity, fever, altered consciousness, autonomic instability, leukocytosis and elevated creatinine phosphokinase level suggesting muscle injury. The incidence of NMS is estimated to be between 0.07 and 2.2% among patients receiving neuroleptics, with a motality of 11%. Although the pathophysiology of NMS is not completely understood, reduced dopaminergic activity secondary to antipsychotic induced dopamine receptor blockage is considered to be the best explanation to date. We experienced NMS in a 22-year-old male with antipsychotic drug intoxication who underwent primary closure of dual, self-inflicted wrist laceration. We recognized as NMS about 30 minutes after induction of general anesthesia. All anesthetics were stopped, and supportive care was performed with management of hyperthermia and fluid. Also, Dantrolene sodium and bromocriptine were administered. The patient recovered without any complication.
Anesthesia, General ; Anesthetics ; Antipsychotic Agents ; Bromocriptine ; Consciousness ; Creatinine ; Dantrolene ; Fever ; Humans ; Incidence ; Lacerations ; Leukocytosis ; Male ; Muscle Rigidity ; Neuroleptic Malignant Syndrome* ; Receptors, Dopamine ; Risperidone* ; Wrist ; Young Adult