• Archives of Reconstructive Microsurgery
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• 제21권1호
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• pp.41-49
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• 2012

Purpose: To report clinical appearances and the outcomes of patients treated for wrist laceration with suicidal intent. Materials and Methods: Between March 2005 and February 2008, patients with wrist laceration were treated at our center. Among them, 14 patients with suicidal intent were reviewed retrospectively. They were 8 females and 6 males with a mean age of 33 years at the time of treatment. The side of injured wrist, injured structures, suicidal instrument, the time of injury, a suicidal motive, drug or alcohol abuse or not, indication of combined psychiatric disease, the duration of postoperative treatment, and the results of treatment were analyzed. Results: The injured wrist was the left one in 13 cases (93%), and knife wounds in 11 cases (79%) was the most frequent mechanism of injury. An average of 4.6 structures were injured including 3.5 tendons, 0.57 nerves and 0.5 arteries. The most frequently injured structures were the palmaris longus (71%), FCU (50%), FCR (43%), FDS 3 (36%), FDS 2, median nerve, and ulnar artery (each 29%). Simultaneous injury of both median and ulnar nerves occurred in 3 cases (21%), and simultaneous injury of both radial and ulnar artery occurred in 1 case (7%). The injury time was the night in 12 cases (86%), and the most frequent suicidal motive was human relations such as lover or spouse in 12 cases (86%). In 9 cases (64%), the injured were in a drunken state, 3 cases (21%) had been treated for a psychiatric disease at the time of the injury. The durations of postoperative treatment were an average of 5 days of admission and 1 day follow up. Only 1 case results could be evaluated. Conclusions: Patient's poor compliance in wrist laceration with suicidal intent should be expected and these characteristics may affect the management plan.

• 대한예방한의학회지
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• 제2권1호
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• pp.31-43
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• 1998

The ultimate goal of national health promotion services is the improvement of quality of life and health longevity through the implementation of health promotion services. The approach strategy for national health promotion summariged as follows: 1) A model for health promotion should be developed by the level of government. 2) Roles and functions between central government and autonomous local governments should be defined to carry out the health promotion services effectively. 3) New manpower for health promotion such as health educator should be trained and activated at hospitals, health centers, industries, school, and related community agencies. 4) School health education should be strengthened in order to teach: various health subject(smoking & alcohol, drug abuse, accident and safe, nutrition, environmental pollution and preservation, population & family planning, personnel hygiene, physical growth, stress, sex education, communicable disease, physical exercise etc) students through appointing health teachers at school base. 5) Health promotion services in industries should be activated using manpower such as health educator, exercise instructor, dietist and counsellor, 6) Health promotion services for the elderly should be activated. 7) Health screening services in the medical insurance and his/her family should be activated for health promotion services. 8) Health education material development center for health promotion should be established and the materials should be made to distribute to related groups, agencies and institutions (health conte.5, hospitals, schools, pharmacies, industries etc). 9) The pilot health promotion center in each automous local governments(large cities, provinces, Guns and Gu level) should be established and operated for community people. 10) The mass media such as TV, radio, newspapers and magazines should be used effectively. 11) Periodic evaluation of health promotion services should be carried out in order to help effective and successful planning for community health promotion in the future.

• 여성건강간호학회지
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• 제5권2호
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• pp.278-287
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• 1999

Women's health is directly related to economic and developmental level of their nations, and it is very much effected by socio-cultural factors which are related to gender discrimination. women's health needs have been oppressed and neglected in male-dominated society. For maintenance and promotion in women's health and improve of quality of life, the common idea of gender discrimination in our society and preference of having son rather than daughter from its certain from must be banished. Though the common idea of gender discrimination was a basic ideology in liberation of women, recently the aspect of difference rather than discrimination is an important matter and unique characteristics of women are strongly pointed and additionally harmonic living with men is getting to be a man idea in women's health. The social idea in gender discrimination was from christian culture in the western society and confucianism related the social norms of "Namzonyobe" (means men are honorable and women are low), "Samzongzido" (means women ought to obey certain three rules for the family), "Chilgeziak" (means seven wickedness of housewife) in this country, korea. Those ideas deprived women's ability in health management and in the decision making process for their health. Because of those cultural influences, still many pregnant women are experiencing artificial abortion when they know the fetus is a girl through ultrasound and amniocentesis. Nowadays there are many health problems of women in korea. The reasons are that Korea culture has complicatedly mixing with confucianism and western culture. Under the these cultural influences, change in value of beauty and trend of liberation in sexuality have brought out health problems, alcohol, smoking, and drug abuse in young women. In order to solve the women's health problem, first of all women have to come out of the passive manner of dependency on man. Also they should have the insight and the management and/or intervention ability of caring their health. It can be obtained through the family-society-nation wide approach as well as the approach for women themselves.

• Journal of Korean Neurosurgical Society
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• 제43권3호
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• pp.143-148
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• 2008

Objective: Postoperative delirium (POD) is characterized by an acute change in cognitive function and can result in longer hospital stays, higher morbidity rates, and more frequent discharges to long-term care facilities. In this study, we investigated the incidence and risk factors of POD in 224 patients older than 70 years of age, who had undergone a neurosurgical operation in the last two years. Methods: Data related to preoperative factors (male gender, >70 years, previous dementia or delirium, alcohol abuse, serum levels of sodium, potassium and glucose, and co-morbidities), perioperative factors (type of surgery and anesthesia, and duration of surgery) and postoperative data (length of stay in recovery room, severity of pain and use of opioid analgesics) were retrospectively collected and statistically analyzed. Results: POD appeared in 48 patients (21.4%) by postoperative day 3. When we excluded 26 patients with previous dementia or delirium, 17 spontaneously recovered by postoperative day 14, while 5 patients recovered by postoperative 2 months with medication, among 22 patients with newly developed POD. The univariate risk factors for POD included previously dementic or delirious patients, abnormal preoperative serum glucose level, pre-existent diabetes, the use of local anesthesia for the operation, longer operation time (>3.2 hr) or recovery room stay (>90 mini, and severe pain (VAS>6.8) requiring opioid treatment (p<0.05). Backward regression analysis revealed that previously dementic patients with diabetes, the operation being performed under local anesthesia, and severe postoperative pain treated with opioids were independent risk factors for POD. Conclusion: Our study shows that control of blood glucose levels and management of pain during local anesthesia and in the immediate postoperative period can reduce unexpected POD and help preventing unexpected medicolegal problems and economic burdens.

• 한국콘텐츠학회논문지
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• 제17권1호
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• pp.692-700
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• 2017

본 연구는 학교에서 발생한 성범죄 사건들을 대상으로, 동일한 피해자를 대상으로 장기적으로 지속된 성범죄의 특성을 살펴보았다. 이를 위해 국내에서 발생한 총 218건의 학교 성범죄 사건을 대상으로, 상습 반복적으로 발생한 사건과 단순 1회에 그친 사건들을 큰 축으로 하여 가해자, 피해자의 배경 특성과 범행 특성을 비교분석하였다. 그 결과, 가해자의 나이와 직업, 거주지 특성, 피해자의 연령 등에서 차이점이 발견되었다. 또한, 범행 계획성과 피해자 유인 방법, 성적 행위 유형 및 피해자 저항 여부 등에서도 차이가 드러났다. 더불어, 학교에서 발생한 성범죄의 지속성에 영향을 미치는 요인들을 살펴본 결과, 가해자의 직업 및 학교 내 범죄 발생 장소, 성적 행위 유형 등 다양한 예측 변인이 나타났다. 본 연구 결과를 통하여 학교에서 지속적으로 발생하는 성범죄 예방 대책 및 발생 장기화 방지를 위한 방안에 대해 논의하였다.

• 대한두개안면성형외과학회지
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• 제17권4호
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• pp.229-232
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• 2016

None of the reports of delayed infection mentioned a latent period exceeding 13 months. we report an infection that developed 18 months after implantation of an absorbable plate. A 16-year-old adolescent girl had undergone reduction and fixation with an absorbable plate for Lefort I and zygomaticomaxillary complex fractures 18 months prior at our hospital. In her most recent hospital visit as an outpatient, abscess was observed in periocular area. Computed tomography revealed sinusitis with an abscess above the infraorbital rim. Wound culture yielded methicillin-resistant Staphylococcus aureus. Despite conservative treatments, wound state did not improve. Therefore, our department decided to perform surgery. Absorbable plate had been mostly absorbed but remained a bit. Bony depression of infraorbital rim and mucosal exposure of maxillary sinus anterior wall were observed. After the surgery, the patient recovered. We believe that the reason the wound infection and sinusitis manifested at the same time is because of several factor such as alcohol abuse, smoking, and mucosal exposure of maxillary sinus anterior wall. Absorbable plate takes 9 months to 3 years to be completely absorbed, thus we suggest studies with a follow-up of at least 3 years be undertaken to determine the outcomes of patients with many risk factors.

• Journal of Preventive Medicine and Public Health
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• 제41권1호
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• pp.51-60
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• 2008

Objectives : We examined the effect of sociodemographic factors, cancer, and psychiatric disorders on suicide by gender and age-specific patterns in South Korea. Methods : The study is a case-control study. Claim data was obtained from the national health insurance database and national death registration database. The number of people who committed suicide was 11,523, which was matched with a control group consisting of ten times as many people at 115,230 selected from the national health insurance and medical aids beneficiaries. The medical utilization of the case group was one year before death and that of the control group was from July 1,2003 to June 30, 2004. Four variables-address, economic status, presence of a psychiatric disease, and cancer-were used in multiple logistic regression analyses. Results : Living in cities or in rural areas showed a greater risk for suicide than living in a metropolitan city. Low economic status, the presence of a psychiatric disorder, and cancer were also statistically meaningful risk factors for suicide. The three major psychiatric diseases, schizophrenia, alcohol abuse, and bipolar disorder, were meaningful in all age groups, but the scale of the odds ratio differed by the age group. Only the psychiatric disorder variable was meaningful in the adolescent group, whereas a psychiatric disorder and economic status were meaningful for the young adult group, and all variables were meaningful for the middle-aged group. A psychiatric disorder and cancer were meaningful in the elderly group, economic status was meaningful for male subjects, and address was meaningful for female subjects. Conclusions : Factors such as living in city or rural areas, low economic status, the presence of a psychiatric disorder, and cancer were statistically meaningful risk factors in suicide. These factors also differed by age group. Therefore, policymakers should establish policies for suicide prevention that are relevant for each age group.

• 생물정신의학
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• 제9권2호
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• pp.103-111
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• 2002

Neurocognitive research focusing on cognitive deficits in Depression has resulted in several important but yet potentially contradictory findings. Much literature documents the presence of significant neurocognitive impairments in depressive patients. Studies have shown that dysthymic disorder patients demonstrate a diffuse pattern of cognitive impairment which is frequently indistinguishable from that of focal braindamaged patients. Some reports have suggested that there is a focal pattern of deficit, such as anterior cingulate dysfunction, frontal lobe impairment, or dysfunction of the temporal-limbic cortex. The aim of this study is to evaluate the neurocognitive functions in dysthymic disorder patients, and to compare the functions with those of major depressive disorder patients. The subjects are 17 dysthymic disorder patients. And their neurocognitive functions are compared with those of 23 major depressive episode patients. Patients with a history of neurologic disease, alcohol dependence, substance abuse and mental retardation are excluded. They are assessed with a part of Vienna Test System which is computerized neurocognitive function tests and can evaluate attention, eductive ability, reproductive ability, visuoperceptual analysis, vigilance, visual immediate memory, the speed of information-processing, judgement, and fine motor coordinations. There are no other specific difference between two groups, except the result of cognitrone test. This study provides information about the neurocognitive functions and some difference between major depressive disorder patients and carefully diagnosed dysthymic disorder patients.

• 대한수의학회지
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• 제46권4호
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• pp.315-322
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• 2006

Ethanol abuse is associated with liver injury, neurotoxicity, modulation of immune responses, and increased risk for cancer, whereas moderate ethanol consumption exerts protective effects against liver injury. However, the underlying signal transduction mechanisms of insulin-like growth factors (IGFs) which play an important regulatory role in various metabolism mechanisms are not well understood. We investigated the effects of ethanol-induced p42/44 activity on IGF-I secretion, IGF-I receptor and IGFBP-1 secretion using radioimmunoassay and western blotting in primary cultured rat hepatocytes. The p42/44 activity, IGF-I secretion and IGF-I receptor activity significantly accelerated compared to control at 10 and 30 min after 200 mM ethanol treatment, but then it became suppressed at 180 min. In contrast, IGFBP-1 secretion was inhibited compared to control at 30 min after 200 mM ethanol treatment, but increased at 180 min. The IGF-I secretion, IGF-I receptor and p42/44 activity at 30 min after 200 mM ethanol treatment accelerated with increasing ethanol concentration but IGFBP-1 secretion inhibited (p<0.05). The increased IGF-I secretion, inhibited IGFBP-1 secretion and IGF-IR activity by ethanol-induced temporal p42/44 activity at 30 min after ethanol treatment was blocked by treatment with PD98059. Alcohol dehydrogenase (ADH) inhibitor, 4-methylpyramazole blocked the changes of IGF-I secretion, IGFBP-1 secretion, and IGF-IR activity by ethanol-induced p42/44 activity at 30 and 180 min. Taken together, these results suggest that ethanol is involved in the modulation of IGF-I and IGFBP-1 secretion and IGF-IR activity by p42/44 activity in primary cultured rat hepatocytes. In addition, changing of p42/44 activity by ethanol was caused with ADH.

• Archives of Plastic Surgery
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• 제41권5호
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• pp.571-575
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• 2014

Background Disulfiram implantation is a widely used treatment alternative for alcohol abuse, yet reports on the surgical aspect of disulfiram implantation with respect to patient and drug-related treatment efficacy and wound complications are very limited. We present our clinical experiences with disulfiram implantation and discuss the surgical outcomes obtained with different anatomical planes for implantation. Methods Medical records of all patients referred to our clinic from the psychiatry department between 2007 and 2013 for disulfiram implantation were retrospectively analyzed. Implantation was carried out using 10 sterile Disulfiram tablets (WZF Polfa S.A.), each tablet containing 100 mg of disulfiram. The procedure was carried out by implanting the tablets randomly in either a subcutaneous or an intramuscular plane. The location and the plane of implantation and the complications were recorded for each patient and compared to determine the differences in the outcomes. Results A total of 32 implantation procedures were evaluated for this study. Twenty-five implants were placed in the intramuscular plane (78.2%), while seven implants were placed subcutaneously (21.8%). Exposure was encountered in three of the seven subcutaneous implants (42.9%), while no exposure was seen with the intramuscular implants. Incomplete absorption of the tablets was encountered in one patient with a previous subcutaneous implant who presented 1 year later for re-implantation as part of the continuation of therapy. Conclusions To overcome the issue of treatment continuation in the case of disulfiram therapy, which may be ceased due to frequently encountered wound complications, we believe that implantation in the subscapular intramuscular plane allows both uneventful healing and an out-of-reach implant location.