• Title/Summary/Keyword: Suicide Attempted

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A Case of Moderate Paraquat Intoxication with Pulse Therapy in the Subacute Stage of Pulmonary Fibrosis (파라쿼트로 발생한 폐 섬유화증에서 pulse therapy로 호전된 환자 1례)

  • Hong, Ki-Hun;Jung, Jin-Hee;Eo, Eun-Kyung
    • Journal of The Korean Society of Clinical Toxicology
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    • v.6 no.2
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    • pp.130-133
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    • 2008
  • In South Korea, attempted suicide by paraquat (PQ) intoxication is fairly common, and is lethal by pulmonary fibrosis and hypoxemia. However, the treatment of PQ poisoning is primarily supportive management. To increase the survival rate associated with PQ intoxication, many treatments have been developed. Here, we treated a case of PQ intoxication with steroid pulse therapy. A 23-year-old man was admitted to the hospital because of PQ intoxication. He drank two mouthfuls of Gramoxon (24% commercial paraquat). His vital signs were stable, but he had a throat infection, and navy blue urine in the sodium dithionite test. Standard treatment, including gastric lavage with activated charcoal was performed, and emergent hemoperfusion with a charcoal filter was initiated 11 h after PQ ingestion. Pharmacotherapy was initiated 18 h after PQ ingestion with the administration of 5 mg dexamethasone. On day 10, chest PA showed pulmonary fibrosis. Therefore, we initiated steroid pulse therapy, with 1g methylprednisolone in 100 mL of D5W administered over 1 h repeated daily for 3 days, and 1 g cyclophosphamide in 100 mL of D5W administered over 1 h daily for 2 days. On day 15, dexamethasone therapy was initiated. On day 30, pulmonary fibrosis was improved. Thus, if pulmonary fibrosis becomes exacerbated after dexamethasone therapy during the subacute stage, pulse therapy with methylprednisolone and cyclophosphamide could be helpful.

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Interpreting Discourse Metaphors in Media: Focusing on News Coverage of Election Campaign

  • Ban, Hyun;Noh, Bokyung
    • International Journal of Advanced Culture Technology
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    • v.10 no.3
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    • pp.104-110
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    • 2022
  • This paper aims to analyze discourse metaphors by paying attention to Seoul mayoral by-election, mainly focusing on election campaign and its related news articles. The 2021 Seoul mayoral by-election was held because the former mayor died in an apparent suicide after he was accused of years of sexual harassment to a former secretary. But in the run-up to the by-election, the newly coined word 'alleged victim' from the ruling party caused a big controversy because the party attempted to deny the authenticity of the secretary's claim by calling her "an alleged victim," instead of "a victim" to defend the former mayor who is a member of the ruling party, implying that the woman's claim is just an allegation with no proof. Thus, this paper has analyzed how news stories were reported with regard to the word 'alleged victim' poser on news stories in two Korean quality newspapers, a conservative newspaper (Chosun Ilbo) and a liberal newspaper (Hankyoreh) from March 1 to April 1, 2021 and analyzed them with the framework of Lakoff and Johnson's Conceptual Metaphor Theory(1980). The findings are as follows: (i) the conservative newspaper reports this issue much more than the liberal newspaper; (ii) both quality newspapers follow the metaphor principles by Conceptual Metaphor Theory; (iii) the conservative newspaper is more likely to follow the Strick Father model (a conservative model) while the liberal newspaper is to follow the Nurturant Parent model (a liberal model), thus indicating that each newspaper's ideology is well represented by the models of Conceptual Metaphor Theory

Associations of Social Participation and Trust with Suicidal Ideation and Attempt in Communities with High Mortality (사망률이 높은 지역사회에서 사회적 참여와 신뢰의 자살 생각 및 시도와 연관성)

  • Ha, Mi-Oak;Kim, Jang-Rak;Jeong, Baekgeun;Kang, Yune-Sik;Park, Ki-Soo
    • Journal of agricultural medicine and community health
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    • v.38 no.2
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    • pp.116-129
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    • 2013
  • Objectives: This study was performed to identify the associations of social capital with suicidal thoughts and attempts in Korean communities with poor health. Methods: We used the data from community health interviews conducted at 40 administrative sections (dong, eup, or myeon) with high mortality from August to October in 2010, 2011, and 2012 as part of the Health Plus Happiness Plus Projects in Gyeongsangnam-do Province. The 8,800 study subjects composed of 220 adults systematically sampled from each administrative section were asked if they had thought about suicide or had attempted suicide within 1 year. The social participation was measured with 'participation in formal and/or informal group' and trust using responses to three questions about trust of others. Results: The prevalence of suicidal ideation and attempt within 1 year were 10.4% and 0.8%, respectively. The logistic regression analysis revealed that those who participated in only informal groups, or had highest trust level reported less suicidal ideation, or attempt after adjusting for socio-demographic factors (sex, age, marital status, occupation, and food affordability), self-rated health, and health behaviors (smoking, alcohol drinking, and exercise). Conclusions: This study suggested social capital such as social participation and trust was associated with less suicide ideation and attempt. More studies are warranted for the association of social capital with suicidal behavior.

Effect of Multidisciplinary Emergency Consultation System for Drug Intoxicated Patients (응급실을 내원한 약물중독 환자에 대한 다학제 응급협진체계의 효과 검증)

  • Kang, Jino;Kim, Hye Ri;Min, Kyungjoon;Kim, Na Ryoung;Heo, Yoon Kyung;Kim, Sun Mi
    • Korean Journal of Psychosomatic Medicine
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    • v.27 no.2
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    • pp.130-137
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    • 2019
  • Objectives : When a patient who attempts suicide visits the emergency room, it is important that the departments of emergency medicine, internal medicine, and psychiatry communicate with each other and prioritize treatment. This study was conducted to verify the effectiveness of the multidisciplinary emergency consultation system (ECS) for drug intoxicated patients. Methods : We retrospectively analyzed the data from medical records prior to the ECS, from July 2017 to May 2018, and after the ECS, from July 2018 to May 2019, to verify the effectiveness of the system. Results : After the ECS, admission to open wards was significantly higher than to the intensive care units (χ2=8.567, p=0.014). In addition, the proportion of consultations to the department of psychiatry among patients admitted to other departments tended to increase (χ2=4.202, p=0.053), and the time required for consultation response decreased (Z=-2.031, p=0.042). As a result of the consultation, the proportion of the patients who had been transferred to the department of psychiatry was increased (χ2=4.692, p=0.043), and the time spent to transfer tended to decrease (Z=-1.941, p=0.052). Conclusions : After implementing the ECS for drug intoxicated patients, unnecessary intensive care unit admissions, consultation response time, and the time spent to transfer were reduced, and the rate of consultation referrals and transfer rates increased. This means that the multidisciplinary consultation system rapidly provided essential medical services to patients at lower medical costs.

Patient's Right of Self-determination and Informed Refusal: Case Comments (환자 자기결정권과 충분한 정보에 근거한 치료거부(informed refusal): 판례 연구)

  • Bae, Hyuna
    • The Korean Society of Law and Medicine
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    • v.18 no.2
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    • pp.105-138
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    • 2017
  • This is case comments of several representative legal cases regarding self- determination right of patient. In a case in which an intoxicated patient attempted suicide refusing treatment, the Supreme Court ruled that the medical team's respect for the patient's decision was an act of malpractice, and that in particular medical situations (medical emergencies) the physician's duty to preserve life supersedes the patient's rights to autonomy. Afterwards, at the request of the patient's family, and considering the patient's condition (irrecoverable death stage, etc.) consistent with a persistent vegetative state, the Supreme Court deduced the patient's intention and decide to withdraw life-sustaining treatment. More recently, regarding patients who refuse blood transfusions or other necessary treatment due to religious beliefs, the Supreme Court established a standard of judgment that can be seen as conferring equal value to the physician's duty to respect patient autonomy and to preserve life. An empirical study of legal precedent with regard to cases in which the physician's duty to preserve life conflicts with the patient's autonomy, grounded in respect for human dignity, can reveal how the Court's perspective has reflected the role of the patient as a decision-making subject and ways of respecting autonomy in Korean society, and how the Court's stance has changed alongside changing societal beliefs. The Court has shifted from judging the right to life as the foremost value and prioritizing this over the patient's autonomy, to beginning to at least consider the patient's formally stated or deducible wishes when withholding or withdrawing treatment, and to considering exercises of self determination right based on religious belief or certain other justifications with informed refusal. This will have a substantial impact on medical community going forward, and provide implicit and explicit guidance for physicians who are practicing medicine within this environment.

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A Study on the Degree of Depression and Death Orientation of Some Students Majoring in Dental Hygiene (일부 치위생과 학생의 우울수준과 죽음의식에 관한 연구)

  • Han, Se-Young;Jung, Ui-Jung;Cheon, Seok-Yeon
    • Journal of dental hygiene science
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    • v.13 no.3
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    • pp.230-237
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    • 2013
  • In this research, the degree of depression and death orientation of the 332 female students majoring in dental hygiene at colleges located in Gyeongsangbuk-do Province were examined and analyzed through a structured self-administered questionnaire from May to July, 2012, for the purpose of improving their mental health. The results are as follows: 1. The degree of depression of the subject students majoring in dental hygiene was shown that 59.9%, 36.8%, 3.0%, and 0.3% of the students were in the normal group, mild depression group, moderate level of depression group, and severe depression group, respectively. 2. The grand mean and the standard deviation of the subjects'death orientation was $2.09{\pm}0.62$ points. 3. The degree of depression of the subjects whose family's economic level was low, whose satisfaction with their family background was low, whose satisfaction level with their major was low, whose school records was low, who frequently thought about death, and who attempted suicide was high in a meaningful way, and death orientation was meaningfully low. In addition, those in the group with the experience of feeling suicidal were proved to have a significantly high degree of depression, and those without the experience of education about death had a low level of death orientation. 4. The degree of depression and death orientation had a positive correlation. When the study results above are combined, follow-up research needs to be conducted so that differentiated programs linked with the care for mental health for the formation of proper attitudes toward depression and death will be established to help students lead a positive life.