Objectives: This study analyzed the current state of community mental health programs in Korea to develop evidence-based criteria for these programs. Methods: Seventy community mental health facilities nationwide were surveyed about the scope of their operated mental health programs. Details, including program structure, staff expertise, standardization, and quality management, of the 511 programs submitted by the facilities as their representative programs were also analyzed to evaluate their efforts for evidence-based practice. Results: The average number of programs operated by community mental health welfare centers was 15.9. The most common programs were those related to serious mental illness (SMI), followed by child/adolescent mental health programs, early psychosis programs, and non-SMI adult mental health programs. In the case of community addiction management centers, there were 7.2 different addiction-related programs per center. Among the psychiatric rehabilitation facilities for SMI, the average number of programs for SMI was 13.1, with some programs for early psychosis. Of the 511 programs submitted as representative programs in their facilities, only 12.3% were judged to be good evidence-based programs. Conclusion More efforts by mental health professionals and governments are needed to implement evidence-based programs in Korea.

Objective: As of 2019, suicide is serious problem in Korea, with the highest suicide rate among OECD countries. To reduce suicide rates Emergency Department Based Post-Suicide Attempt Case Management carried out with government funding in South Korea, but it is insufficient to address the issue. Aim of this study is to prevent suicide attempts through continuous provision of mental health services even after discharge from acute care. Methods: We selected 15 mental health specialists who are multidisciplinary experts in Suicide Prevention. Two-round Delphi survey was conducted on them to reach an agreement for hospital-based case management. Results: The first Delphi survey consisted of 8 areas and 39 questions. Among them, 30 questions draw agreement above the reference value. The second Delphi survey, consisted of 37 questions, resulted in 32 above-standard questions. Conclusion Consensus was reached in most category of the Hospital Based Case Management for Suicide High-Risk Group. Core of the developed plan was to provide services to patients who visited the hospital, pursue the stability and universalization of services through a medical insurance fee system. In the future, hospital-based case management service will be implemented as a new model contributing to the reduction of suicide rates in Korea.

BACKGROUND/AIMS: To evaluate the diagnostic value of contrast (SonoVue(R)) enhancement ultrasonography (CEUS) and to compare this method with computed tomography (CT) and magnetic resonance imaging (MRI) in evaluating liver masses. METHODS: CEUS (n=50), CT (n=47), and MRI (n=43) were performed on 50 liver masses in 48 patients for baseline mass characterization. The most likely impression for each modality and the final diagnosis, based on the combined biopsy results (n=14), angiography findings (n=36), and clinical course, were determined. The diagnostic value of CEUS was compared to those of CT and MRI. RESULTS: The final diagnosis of the masses was hepatocellular carcinoma (n=43), hemangioma (n=3), benign adenoma (n=2), eosinophilic abscess (n=1), and liver metastasis (n=1). The overall diagnostic agreement with the final diagnosis was substantial for CEUS, CT, and MRI, with kappa values of 0.621, 0.763, and 0.784, respectively. The sensitivity, specificity, and accuracy were 83.3%, 87.5%, and 84.0%, respectively, for CEUS; 95.0%, 87.5%, and 93.8%, respectively, for CT; and 94.6%, 83.3%, and 93.0%, respectively for MRI. After excluding the lesions with poor acoustic sonographic windows, the sensitivity, specificity, and accuracy for CEUS were 94.6%, 87.5%, and 93.3%, respectively, with a kappa value of 0.765. CONCLUSIONS: If an appropriate acoustic window is available, CEUS is comparable to CT and MRI for the diagnosis of liver masses.
Adult ; Aged ; Contrast Media/diagnostic use ; Female ; Humans ; Liver Diseases/pathology/radiography/*ultrasonography ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Sensitivity and Specificity ; Tomography, X-Ray Computed

PURPOSE: Although violence occurs frequently in Korean television dramas, its description or definition is unusual. Many studies have shown that TV dramas have a powerful effect on society and the violence shown in medical dramas helps in comprehension of hospital violence occurring in real life. Therefore, this study will cover the types and levels of violence. METHODS: We selected five recent Korean medical dramas. These five dramas, which consisted of 94 episodes and were broadcast from 2007 to 2011, are analyzed. Violence is limited to the occurrence inside the hospital; violence that occurs outside of the hospital is excluded. Media violence is analyzed within PAT (perpetrator-action-target). In addition, the violence levels and violence relationships are analyzed. RESULTS: Among the types of violence, 88.5% is verbal abuse, 3.5% is physical threat, and 8.0% is physical violence. In comparison of the violence relationship, violence between a doctor and a doctor forms the highest rate of 72.6%. In the level of violence, 0 level of violence caused by verbal abuse is the highest (88.5%); however, 5 level of violence level, which is death, is not observed. There are 1475 minutes of violence scenes from 6243 minutes, which is 23.6% of total time. CONCLUSION: Frequency of violence in Korean medical dramas is higher than that of normal dramas. Considering the powerful influence of the mass media, the violence of medical dramas should be controlled. To resolve the problem, the role of advisory doctors seems important.
Comprehension ; Drama ; Korea ; Mass Media ; Television ; Violence

Capillary hemangioma of the tracheobronchial tree is an extremely rare benign tumor in adults, especially those located in the bronchus. Characteristics and treatment of capillary hemangiomas of adult tracheobronchial trees have not been well known. We present a 61-year-old man with hemoptysis, which was caused by a small tiny nodule in the left lingular segmental bronchus. The nodule was removed by a forcep biopsy, via flexible bronchoscopy, and it was revealed to be capillary hemangioma. A small isolated endobronchial capillary hemangioma can be treated with excisional forcep biopsy, but a risk of massive bleeding should not be overlooked.
Adult ; Biopsy ; Bronchi ; Bronchoscopy ; Capillaries ; Hemangioma, Capillary ; Hemoptysis ; Hemorrhage ; Humans ; Surgical Instruments

OBJECTIVES: The purpose of this study was to evaluate community mental health professionals and hospital workers attitude and awareness towards suicide. METHODS: This study investigated 264 community mental health professionals and 228 hospital workers. SOQs (Suicidal Opinion Questionnaires) were used from July 2007 to September 2007. After a factor analysis for the attitude towards suicide, the items on ethics, mental illness, religion, risk, and motivation were included in the subsequent analysis. RESULTS: There were significant differences in the attitude towards suicide according to religion, age, educational background, the marriage status, the economic position, and different professional licenses. Hospital workers' view was different from the community workers'. The hospital workers judged that suicide was due to mental illness, and suicide was high for the people in a special environment and who lacked motivation, which caused them to fall in a dangerous situation. For the lower educational group, they thought that suicide was attributable to mental illness. The awareness for suicide was significantly higher in the group with a postgraduate education, unmarried people, mental health professionals and the persons who had concern and experience with suicide. The factors that had an influence on the awareness of suicide were the items of mental illness, religion, risk and motivational factors. CONCLUSIONS: This study suggested that the factors to increase the awareness and attitude for suicide were the experience of increased education and case management of suicide. Therefore, education dealing with suicide and reinforcement of crisis management programs should be developed.
Adult ; *Attitude of Health Personnel ; *Awareness ; *Community Mental Health Services ; Female ; Health Personnel/*psychology ; Humans ; Korea ; Male ; Personnel, Hospital/*psychology ; Questionnaires ; *Suicide ; Young Adult

PURPOSE: We evaluated the clinical and radiological outcomes related to use of the Targon(R) proximal femoral nail for repairing femoral intertrochanteric fractures. MATERIALS AND METHODS: Between April 2004 and November 2005, the records of 56 patients with intertrochanteric fractures treated with the proximal femoral nail, were analyzed. The mean patient age was 75.2 years. The mean duration of follow-up was 32 months. There were 26 stable fractures and 30 unstable fractures. Clinical assessment included parameters of operating time, transfusion rate, pain analysis by visual analogue scale (VAS), timing of maximum tolerable weight-bearing, functional evaluation by modified Koval index, and complications. Radiological assessment was directed toward adequacy of reduction, union time, and changes observed between immediate postoperative and final follow-up roentgenograms in various parameters. RESULTS: The mean operating time was 37 minutes. Visual analogue scale at final follow-up was 2.8 on average, and 38 of 43 preoperative ambulators (88%) were able to bear weight as much as tolerable within 6 weeks postoperatively. Postoperative mobility recovered to pre-injury levels in 40 cases (71%). Radiologic evaluation showed adequate reduction in all cases. Mean union time was 8.9+/-2.5 weeks. The neck-shaft angle changed at final follow-up an average of 3.6+/-1.9(R). The femoral shaft displaced medially an average of 2.8+/-0.9 mm, and the lag screw slid an average of 4.7+/-0.6 mm. Complications such as cutting through, Z-effect, and femoral shaft fracture were not observed in any cases. CONCLUSION: The Targon(R) proximal femoral nail showed excellent results in terms of early ambulation, clinical recovery, and radiologic parameters and may be a useful implant for treating femoral intertrochanteric fractures.
Early Ambulation ; Femoral Fractures ; Follow-Up Studies ; Hip Fractures ; Humans ; Nails ; Ursidae ; Weight-Bearing

BACKGROUND: Several lines of evidence have indicated that the deregulation of apoptosis is involved in the mechanisms of cancer development, and somatic mutations of the apoptosisrelated genes have been reported in human cancers. Members of the bcl-2 family proteins regulate the intrinsic apoptosis pathway mainly in the mitochondria. The aim of this study was to explore whether the somatic mutation of the proapoptotic bcl-2 family genes, one of the mechanisms that prolong the survival of cancer cells, occurred in colorectal carcinomas. METHODS: In the current study, to detect the somatic mutations in the DNA sequences encoding the bcl-2 homology 3 (BH3) domain of the human bak, bid, bik, bim, PUMA, bcl-rambo, bcl-G, and bmf genes in 98 colon adenocarcinomas, we used polymerase chain reaction (PCR), single strand conformation polymorphism (SSCP), and DNA sequencing. RESULTS: The SSCP analysis detected no evidence of somatic mutations of the genes in the coding regions of the BH3 domain in the cancers. CONCLUSIONS: The data presented here indicate that the proapoptotic bcl-2 family genes, bak, bid, bik, bim, PUMA, bcl-rambo, bcl-G and bmf may not be somatically mutated in human colorectal carcinomas, and suggest that the colorectal cancers may not utilize mutational events of these proapoptotic bcl-2 family genes in the mechanisms for evading apoptosis.
Adenocarcinoma ; Apoptosis ; Base Sequence ; Clinical Coding ; Colon* ; Colonic Neoplasms ; Colorectal Neoplasms ; Humans ; Mitochondria ; Polymerase Chain Reaction ; Polymorphism, Single-Stranded Conformational ; Puma ; Sequence Analysis, DNA

PURPOSE : Several lines of evidence have indicated that deregulation of apoptosis is involved in the mechanism of cancer development. Caspase-8 activation plays a central role in the initiation phase of apoptosis, while caspase-7 is one of the main execution phase caspases of apoptosis. The aim of this study was to explore the possibility that genetic alterations of the caspase-8 and caspase-7 genes are involved in the development of human non-small cell lung cancer (NSCLC). MATERIALS AND METHODS : We have analyzed the entire coding region of both the caspase-7 and caspase-8 genes to detect the somatic mutations in 100 NSCLCs by using polymerase chain reaction (PCR)- single strand conformation polymorphism (SSCP). RESULTS : The PCR-SSCP analysis detected no mutations in the entire coding regions of both the caspase-7 and caspase-8 genes in the NSCLCs. CONCLUSION : The data presented here suggests that both the caspase-7 and caspase-8 genes may not be somatically mutated in human NSCLCs
Apoptosis ; Carcinoma, Non-Small-Cell Lung* ; Caspase 7* ; Caspase 8 ; Caspases ; Clinical Coding ; Humans ; Polymerase Chain Reaction

PURPOSE: To evaluate the cause and treatment results of nonunion of humerus shaft fractures. MATERIALS AND METHODS: 39 cases were treated for humerus shaft nonunion between February 1990 and May 2002. The presence of open wounds, initial treatment modality after injury, treatment method for the nonunion and time to union were studied using medical records. The fracture type and appropriateness and problems of the initial surgical treatment were reviewed. Also, Pain and functional recovery in daily living were evaluated in the outpatient clinic, after surgery for nonunion. RESULTS: Amongst the 30 cases, transverse fracture was the most common with 19cases. Most of 29 cases, initially surgically treated, revealed incorrect selection of the internal fixator or technical errors. For surgical treatment of nonunion, open reduction and internal fixation with cancellous bone graft was performed, most commonly, in 36 cases (92.3%). All cases showed clinical and radiographic union at an average of 13.3 weeks. More than 90% of the patients replied minimal pain and excellent functional recovery of daily living at final follow-up. CONCLUSION: If treated with surgery by correct selection of internal fixation methods and accurate technical skills, nonunion incidence can be reduced.
Ambulatory Care Facilities ; Follow-Up Studies ; Humans ; Humerus* ; Incidence ; Internal Fixators ; Medical Records ; Transplants ; Wounds and Injuries