• Korean Journal of Bronchoesophagology
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• v.13 no.1
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• pp.55-58
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• 2007

Caustic bums of the upper aerodigestive tract continue to be a significant clinical problem. Wide -field pharyngoesophagectomy is commonly performed as treatment for malignancies of the hypopharynx. A total laryngectomy is often necessary at the time of this procedure because of the anatomical proximity of the cancer or because of the likely compromise of swallowing postoperatively. When preservation of the larynx is attempted, aspirations after surgery frequently require a second-stage laryngectomy. And various flaps are using for reconstruction of esophageal defect. The choice of reconstruction is depended to the patient's status. A 54-year-old women whose symptom was severe dysphagia and X-ray revealed laryngopharyngeal stricuture. She had attempted suicide by swallowing lye liquids 32 years ago. She has entire laryngopharyngeal and esophageal stricutures. Total laryngectomy was performed and reconstruction of theesophagus was carried out with unusual reversed-gastric tube formation. Hence, we report this case with the review of literaturefor proper management in the future.

• Journal of The Korean Society of Clinical Toxicology
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• v.13 no.1
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• pp.40-42
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• 2015

Benzoylureas are chemical compounds best known for their use as insecticides. Diflubenzuron is one of the more commonly used benzoylurea pesticides. Others include chlorfluazuron, flufenoxuron, hexaflumuron, and triflumuron. They act as insect growth regulators by inhibiting synthesis of chitin in the body of the insect. They have low toxicity in mammals because mammals have no chitin. Chlorfluazuron insecticides, which are mixed with solvent naphatha, are commonly used. Thus we assume that in the presented case mental change outcome of poisoning was connected with toxic effects of solvent naphtha rather than with chlorfluazuron action. Components of solvent naphtha, particularly trimethylbenzenes, exert strong irritant action on the gastric mucosa and are very well absorbed from the gastrointestinal tract. We report on a 67-year-old man with stuporous mentality after intentional ingestion of approximately 200 ml of liquid chlorfluazuron in a suicide attempt. He was discharged after conservative treatments including gastric irrigation, charcoal, mechanical ventilation, hydration, and antibiotics for aspiration pneumonia without complications.

• Journal of The Korean Society of Clinical Toxicology
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• v.11 no.1
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• pp.31-35
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• 2013

Acute organophosphate intoxication is important because of its high morbidity and mortality. The mortality is still high despite the use of atropine as specific antidotal therapy and oximes for reactivation of acetylcholinesterase. Inhibition of acetylcholinesterase by organophosphate can cause acute parasympathetic system dysfunction, muscle weakness, seizure, coma, and respiratory failure. Acute alteration in conscious state or a coma, which may occur following organophosphate intoxication, is an indication of severe intoxication and poorer prognosis. This acute decline in conscious state often reverses when the cholinergic crisis settles; however, it may be prolonged in some patients. We report on a case of a 60-year-old male who showed prolonged decline in conscious state due to of Central Nervous System (CNS) toxicity after a suicide attempt with organophosphate.

• Journal of The Korean Society of Clinical Toxicology
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• v.19 no.1
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• pp.59-63
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• 2021

Copper sulfate is widely used as a fungicide and pesticide. Acute copper sulfate poisoning is rare but potentially lethal in severe cases. Copper sulfate can lead to cellular damage of red blood cells, hepatocytes, and myocytes. Toxic effects include intravascular hemolysis, acute tubular necrosis and, rhabdomyolysis. A 76-year-old man presented with vomiting and epigastric pain. He had ingested a copper-containing fungicide (about 13.5 g of copper sulfate) while attempting suicide 2 hours prior to presentation. From day 3 at the hospital, laboratory findings suggesting intravascular hemolysis were noted with increased serum creatinine level. He was treated with a chelating agent, dimercaptosuccinic acid (succimer). His anemia and acute kidney injury gradually resolved with a 19-day regimen of succimer. Our case suggests that succimer can be used for copper sulfate poisoning when other chelating agents are not available.

• Anxiety and mood
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• v.19 no.2
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• pp.56-60
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• 2023

Progressive supranuclear palsy (PSP) is rare atypical Parkinsonism accompanied by various psycho-behavioural problems. In this case report, we describe the diagnostic and treatment progress of a 65-year-old PSP patient who visited the psychiatric clinic with a depressed mood and lumbar pain resulting in a suicide attempt. Over the course of 30 months of treatment, typical characteristics of PSP, such as postural instability, dyskinesia, cognitive dysfunction and supranuclear gaze palsy, became prominent, and magnetic resonance imaging and the F-18 FP-CIT positron emission tomography revealed midbrain atrophy and reduced dopamine uptake in the basal ganglia. When treating elderly patients with depression, parkinsonism symptoms such as gait disturbances, frequent falls, tremors, and rigidity should be closely examined.

• Korean Journal of Psychosomatic Medicine
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• v.25 no.2
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• pp.193-199
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• 2017

Objectives : Insomnia may be one of the risk factor for suicidal ideation, but little is known about the mechanism by which sleep disturbances confer risk for suicide. The aim of this study was to investigate examine whether insomnia severity would be associated with resilience and suicidal ideation, and whether resilience would mediate the relationship between insomnia and suicidal ideation. Methods : A total of 432 community-dwelling adults(227 male, 205 female,) completed the self-report questionnaire that covered basic socio-demographic data. To assess the psychological variables, the following instruments were applied: Insomnia Severity Index(ISI), Korean Version of the Connor-Davidson Resilience Scale(K-CD-RISC), Beck Hopelessness Scale(BHOP) and Scale for Suicidal Ideation(SSI-Beck). People with an ISI score of 8 or higher were defined as insomnia. Results : Greater insomnia symptom severity was significantly associated with higher level of suicidal ideation and lower level of resilience, adjusting for hopelessness, age, sex, presence of family members living together, and household income. Additional analysis revealed that disturbance of sleep initiation and disturbance of sleep maintenance were significantly associated with suicidal ideation. Mediation analyses revealed that resilience significantly accounted for the relationship between insomnia symptom severity and suicidal ideation. Conclusions : These findings suggest that the evaluation and control of insomnia and resilience may be needed to reduce the risk of suicide.

• Korean Journal of Social Welfare Studies
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• v.42 no.2
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• pp.467-491
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• 2011

The purpose of this study is to examine relationship between social strains such as status strains and relational strains and adolescent suicidality by gender. As method, a self-report survey was completed by students (n = 819) from 3 middle schools in Seodaemun area, Seoul, Korea. Logistic regression analyses were conducted to identify factors associated with adolescent suicidality, t-test analyses were used to verify gender difference. Results show that male adolescents are more likely to experience abuse from their father, and school violence related to relational strains than female. Differences were found in strains for males and females contributing to suicidality; male are responsive to economic status, a dimension of status strain, whereas female are reactive to non-physical abuse from father, a type of relational strains. Non-physical school violence was appeared to be a significant factor influencing suicidality for both genders. Based on these findings, research draws implications for social work interventions. First, different approaches by gender are needed to prevent adolescent suicide in consideration of the tendency that men are status-oriented and women are relationship-oriented. Second, it is suggested to hire full-time school social worker to provide consistent social service for students. Third, intensive effort is necessary to reduce non-physical school violence.

• Korean Journal of Culture and Social Issue
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• v.24 no.3
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• pp.411-428
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• 2018

This study has attempted to identify whether or not the effects of perceived burdensomeness and thwarted belongingness of the elderly on a suicidal ideation is mediated by the meaning in life and, during this process, examined if social participation known as a protective factor against elderly suicide has a moderating effect. For this, a total of 403 elderly men and women residing in Honam area have been selected as the subjects of the study, among whom self-report surveys have been conducted as to perceived burdensomeness, thwarted belongingness, meaning in life (presence of meaning/search for meaning) and social participation. The mediating analysis with the use of the process macro has identified the path where the perceived burdensomeness encourages a suicidal ideation through the presence of the meaning in life. On the other hand, the thwarted belongingness has turned out to be significant only in a direct path to a suicidal ideation. The analysis results of moderated mediating effects, including social participation have found that social participation does mediate the path to a suicidal ideation caused by the perceived burdensomeness through the presence of the meaning in life, verifying its moderated mediating effects.

• Archives of Reconstructive Microsurgery
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• v.21 no.1
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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.

• Korean Journal of Biological Psychiatry
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• v.6 no.2
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• pp.253-258
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• 1999

The fluoxetine is one of the most frequently prescribed drugs for the treatment of depression and obsessive-compulsive disorder(OCD). This has been known as one of the most safest medication. But since the advent of this drug, there have been several reports of side effects-the mania and suicidal ideation-encountered during coadministration of fluoxetine with or without other psychotropic drugs. We experienced a case of 20 years old male OCD patient who developed into abrupt manic state and also was preoccupied with intense suicidal ideation following fluoxetine use. He was a only child in his family and his father had a history of alcoholism about 15years ago. Our patient's obsessive-compulsive symptoms have been occured since puberty. His OCD symptoms and anxiety were aggravated since joining the army. Beside these facts, we could not find any other psychiatric history such as depressive disoder and bipolar disorder. We used the fluoxetine starting dosage of 20mg and increased to 40mg at second week. About 3 weeks after the treatment, he developed sudden manic symptom and more aggravated suicidal ideation without any OCD symptoms. He felt vitalized and energetic without having enough sleep and food. These symptoms were ceased over two weeks by stopping medication. Up to this point, the reason why fluoxetine induces mania and suicidal preoccupation is unclear. But somehow the fluoxetine has effects on serotonin receptor and serotonin-dopamine regulations, thus we could make an assumption that fluoxetine can induce mania, extrapyramidal symptoms(EPS) and suicidal ideation in some part of the serotonin unbalanced patients. We think this would be the first report to remark on fluoxetine's suicidal and manic side effects in Korea. So here we present the case with the summary of reviewed articles.