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.

Hepatocellular carcinoma (HCC) is the 2nd most common cause of cancer related death in Korea and well-known malignancy with poor prognosis. Sorafenib is the first-line molecular targeted agent in patients with extra-hepatic spread of HCC. However, complete response is extremely rare in patients treated with sorafenib and the disease control rate is only 43%. We report a 53-year-old man with advanced HCC with pulmonary metastasis who showed complete response by cytotoxic chemotherapy with doxorubicin and cisplatin with relatively tolerable adverse effects after failure of treatment with sorafenib.
Carcinoma, Hepatocellular* ; Cisplatin ; Doxorubicin ; Drug Therapy* ; Humans ; Korea ; Middle Aged ; Neoplasm Metastasis* ; Prognosis

Hydrogen peroxide is commonly used as a disinfectant that has been reported to cause chemical colitis. We report a case of 49 year-old man who presented with chemical colitis caused by self-inflicted hydrogen peroxide enema. In the sigmoidoscopic examination, diffuse erythematous and edematous mucosal change with multiple ulcerations and easy touch bleeding was noted from the rectum to the proximal sigmoid colon. Abdominal computed tomography showed diffuse wall thickening of the rectum and the sigmoid colon with inflammatory and reactive change at surrounding. The patient was treated with NPO, intravenous fluid, and antibiotic therapy. On 5th hospital day, abdominal pain and bloody stool disappeared, and the patient started oral feeding. He discharged on 6th hospital day with fully recovered state.
Abdominal Pain/etiology ; Colitis/*chemically induced/therapy ; Enema/*adverse effects ; Gastrointestinal Hemorrhage/etiology ; Humans ; Hydrogen Peroxide/*adverse effects ; Male ; Middle Aged ; Sigmoidoscopy ; Tomography, X-Ray Computed

PURPOSE : Evidence exists that deregulation of apoptosis is involved in the mechanisms of cancer development, and the somatic mutations of apoptosisrelated genes have been reported in human cancers. Bcl- XL/Bcl-2-associated death promoter (BAD), a pro-apoptotic member of Bcl-2 family, plays an important role in the intrinsic apoptosis pathway. MATERIALS AND METHODS : To explore the possibility that the genetic alterations of BAD might be involved in the development of human cancers, we analyzed the entire coding region and all splice sites of human BAD gene in 100 human non-small cell lung cancers (NSCLC) by polymerase chain reaction (PCR)-based single-strand conformation polymorphism (SSCP). RESULTS : The PCR-SSCP analysis detected no mutation in the entire coding regions and all splice sites of human BAD gene in the 100 NSCLCs. CONCLUSION : The data presented here suggested that BAD gene mutation may not contribute to the pathogenesis of human NSCLCs
Apoptosis ; Carcinoma, Non-Small-Cell Lung* ; Clinical Coding ; Humans ; Lung Neoplasms ; Polymerase Chain Reaction

PURPOSE: Several lines of evidence have indicated that the deregulation of apoptosis is involved in the mechanisms of cancer development, and somatic mutations of the apoptosis-related genes have been reported in human cancers. In addition to its role in oxidative phosphorylation, release of cytochrome c from the mitochondrial intermembrane space results in nuclear apoptosis. The aim of this study was to explore whether alteration of cytochrome c gene mutation is a characteristic of human non-small cell lung cancers (NSCLC). MATERIALS AND METHODS: In the current study, to detect the somatic mutations in the DNA sequences encoding cytochrome c in 48 NSCLCs, we used polymerase chain reaction (PCR), single-strand conformation polymorphism (SSCP), and DNA sequencing. RESULTS: The SSCP analysis revealed no mutation in the entire coding regions and all splice sites of human cytochrome c gene in the 48 NSCLCs. CONCLUSION: The data presented here indicate that the pro-apoptotic cytochrome c may not be somatically mutated in human NSCLCs, and suggest that NSCLCs may not utilize mutational events of cytochrome c gene in the mechanisms for evading apoptosis.
Apoptosis ; Base Sequence ; Carcinoma, Non-Small-Cell Lung ; Clinical Coding ; Cytochromes c* ; Cytochromes* ; Humans ; Lung Neoplasms* ; Lung* ; Oxidative Phosphorylation ; Polymerase Chain Reaction ; Polymorphism, Single-Stranded Conformational ; Sequence Analysis, DNA

OBJECTIVE: This study was performed to examine the relationship between community-based social support and psychosocial distress in workers. METHODS: The study subjects were 596 workers recruited from 11 companies in Chungju city. A structured questionnaire was used to assess sociodemographics, health-related behaviors, job characteristics, job stress, work-based social support, community-based social support and level of psychosocial distress. RESULTS: Hierarchical multiple regression analysis showed that workers with no chronic disease, exercise and sufficient sleep had a higher score of psychosocial distress than those with chronic disease, no exercise, and not enough sleep. Coworker's work-based social support and community-based social support were negatively associated with psychosocial distress. The R square value of total independent variables on psychosocial distress was 0.409, and that of community-based social support on psychosocial distress was 0.052. CONCLUSION: This study showed that community-based social support served as a protective factor against psychosocial distress in some workers. We recommend the establishment of a worksite stress reduction program in occupational level as well as community-based social support.
Chronic Disease ; Chungcheongbuk-do ; Questionnaires ; Workplace

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

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

PUPOSE: Most gastrointestinal stromal tumors (GISTs) have gain-of-function mutations of the KIT or the platelet-derived growth factor receptor alpha (PDGFRA) genes, but approximately 10% of the GISTs are wild types for both the KIT and the PDGFRA genes. The purpose of this study was to investigate the possibility that epidermal growth factor receptor (EGFR) gene mutation might be responsible for the pathogenesis of GIST. MATERIALS AND METHODS: We analyzed the EGFR gene in 60 GISTs for the detection of somatic mutations by using the polymerase chain reaction (PCR), the single strand conformation polymorphism (SSCP), and DNA sequencing in exon 18, 19, and 21 encoding the kinase domain. RESULTS: The SSCP analysis revealed no evidence of EGFR mutations in exon 18, 19, and 21 in GISTs. CONCLUSION: The data indicate that the EGFR gene may not be mutated in human GIST and suggest that therapies targeting the mutated EGFR gene products might not be useful in the treatment of GISTs.
Epidermal Growth Factor* ; Exons ; Gastrointestinal Stromal Tumors* ; Genes, erbB-1 ; Humans ; Phosphotransferases ; Polymerase Chain Reaction ; Polymorphism, Single-Stranded Conformational ; Receptor, Epidermal Growth Factor* ; Receptors, Platelet-Derived Growth Factor ; Sequence Analysis, DNA

PURPOSE: Evidence exists that dysregulation of Bcl-2 family members is involved in the pathogenesis of cancer development. The aim of this study was to explore whether the somatic mutation of proapoptotic Bcl-2 member genes, one of the mechanisms that prolong the survival of cancer cells, is involved in gastric carcinogenesis. MATERIALS AND METHODS: In the current study, to detect somatic mutations of the DNA sequences encoding the Bcl-2 homology 3 (BH3) domain of the human BAD, BIM, BIK, and Bcl-G genes in 60 advanced gastric adenocarcinomas, we used the polymerase chain reaction (PCR), single strand conformation polymorphism (SSCP), and DNA sequencing. RESULTS: The SSCP analysis revealed no mutations in the coding regions of the BH3 domain in the cancers. CONCLUSION: The data presented here indicate that proapoptotic Bcl-2 member genes, BAD, BIM, BIK, and Bcl-G, may not be mutated in human gastric carcinomas and suggest that these genes might be altered by mechanisms other mechanisms somatic mutation.
Adenocarcinoma ; Apoptosis ; Base Sequence ; Carcinogenesis ; Clinical Coding ; Humans ; Polymerase Chain Reaction ; Polymorphism, Single-Stranded Conformational ; Sequence Analysis, DNA