New Targeted Therapy for Non-Small Cell Lung Cancer / 결핵및호흡기질환

Lung cancer ranks first in cancer mortality in Korea and cancer incidence in Korean men. More than half of Korean lung cancer patients undergo chemotherapy, including adjuvant therapy. Cytotoxic agents, targeted therapy, and immune checkpoint inhibitors are used in chemotherapy according to the biopsy and genetic test results. Among chemotherapy, the one that has developed rapidly is targeted therapy. The National Comprehensive Cancer Network (NCCN) guidelines have been updated recently for targeted therapy of multiple gene mutations, and targeted therapy is used not only for chemotherapy but also for adjuvant therapy. While previously targeted therapies have been developed for common genetic mutations, recently targeted therapies have been developed to overcome uncommon mutations or drug resistance that have occurred since previous targeted therapy. Therefore, this study describes recent, rapidly developing targeted therapies.

Comparison of Major Procedures of Korean Mental Health Law with Other Developed Countries / 신경정신의학

OBJECTIVES : The Mental Health Act is an initiative aimed at changing and shaping mental health services and protecting human rights of persons with mental disorders. Since the Mental Health Act was legislated in 1995, four amendments have been made according to the issues that arose from public concerns. However, there are still many debates about the human rights protection of the mentally ill. This study aimed to provide information regarding major aspects of the Mental Health Act by comparing them among several developed countries. METHODS : Current Mental Health Acts of the state of Michigan in the United States, Scotland in England, the state of Victoria in Australia, and Japan were reviewed. Issues regarding the Korean Mental Health Act were collected from seminar materials, news media contents, and mental health professionals. RESULTS : The definition of subjects in Korean Mental Health Act was more inclusive than other countries and was derived from a medical classification of mental illness. Family members or guardians were granted important responsibilities for deciding the involuntary admission of mentally ill patients in Korea and Japan. In Western countries, Mental Health Review Tribunals or courts have the primary responsibility for important decisions about mentally ill patients. The regulation of immediate discharge after request by voluntarily admitted patients was not enacted in all countries except Korea. The mandatory procedure for involuntary admission in Western countries includes an individual case review with personal interview by a Mental Health Review Tribunal or court. CONCLUSION : The Korean Mental Health Act appears to meet the basic standards of Guidelines from international organizations. Our traditional culture and inherent health systems seem to influence the legal regulation of mental health service and might be related to the problems of human rights protection of mentally ill patients in Korea.

Temperament Characteristics of Internet Addiction in Adults / 신경정신의학

OBJECTIVES: Since mid-90s there have been numerous studies to understand and establish the concept of internet addiction as one of diagnostic classifications in psychiatry. Among them, many studies on the personality characteristics of internet addiction have been conducted. Recently, interests are expanding to temperament characteristics of internet addictors but the subjects have been limited to adolescents. In this study, the temperament characteristics of internet addiction in adults were investigated using Tridimensional Personality Questionnaire (TPQ). METHODS: 430 participants (189 males, 241 females) answered the on-line and off-line questionnaires from January to December in 2005. Participants completed questionnaires on demography and the onset of internet use, Young's Internet Addiction Scale and Korean Contracted Version of Cloninger's Tridimensional Personality Questionnaire (TPQ). RESULTS: There were statistically significant differences in age, marital status, occupation, psychiatric history, smoking history, alcohol history and onset age of internet use among non-addiction, overuse and addiction groups by Young's scale. Of the TPQ items harm avoidance (HA) scores were significantly higher in addiction and overuse groups than non-addiction group. Reward dependence (RD) scores were significantly lower in addiction group than non-addiction group. Novelty seeking (NS) scores were significantly higher in addiction group than non-addiction group. CONCLUSION: This study suggests a significant difference of novelty seeking in temperament characteristics between adults and adolescents with internet addiction. Further studies are expected for profound understanding of internet addiction.

An Estimation of Optimal Medical Manpower in Mental Hospital / 신경정신의학

OBJECTIVES: The purpose of this study is to surmise appropriate level of medical manpower of mental hospital from the perspectives of clinical experts, psychiatrist and psychiatric nurse. METHODS: First, we wlleded data on medical manpower of domestic mental hospitals and foreign mental hospitals. Next, psychiatrists and psychiatric nurses were asked to complete a survey. We estimated the optimal level of medical manpower examining appropriate volume of medical services that should be provided for psychiatric patients, and analizying the survey carried out by direct questions. RESULTS: The number of psychiatrists of group A of private mental hospitals was 1.7 times more than that of public mental hospitals; when the number of psychiatrists in public mental hospitals was regarded as 1.0, and group B of private mental hospitals was 0.5 times, and the university hospitals 8.2 times. The number of psychiatric of group A of private hospitals was 1.5 times more than that of public mental hospitals; when the number of psychiatric nurses in public mental hospitals was regarded as 1.0, the group B of private mental hospitals was 0.6 times and university hospitals was 2.6 times. The foreign mental hospitals had more medical manpowers in all occupations than domestic mental hospitals. The number of psychiatrists estimated according to the first method was 11.1 persons and the number of psychiatric nurses was 26.3 persons per 100 beds, and the number of psychiatrists estimated according to the second method was 4.3 persons per and the number of psychiatric nurses was 20.8 persons per 100 beds. CONCLUSION: The estimated optimal number of psychiatrists for mental hospital is 4.3 persons and of psychiatric nurses was 20.8 persons per 100 beds. However, these numbers can be flexible depending on the ratio of short-term acute patients and long term chronic patients.

An Estimation of Optimal Medical Manpower in Mental Hospital / 신경정신의학

OBJECTIVES: The purpose of this study is to surmise appropriate level of medical manpower of mental hospital from the perspectives of clinical experts, psychiatrist and psychiatric nurse. METHODS: First, we wlleded data on medical manpower of domestic mental hospitals and foreign mental hospitals. Next, psychiatrists and psychiatric nurses were asked to complete a survey. We estimated the optimal level of medical manpower examining appropriate volume of medical services that should be provided for psychiatric patients, and analizying the survey carried out by direct questions. RESULTS: The number of psychiatrists of group A of private mental hospitals was 1.7 times more than that of public mental hospitals; when the number of psychiatrists in public mental hospitals was regarded as 1.0, and group B of private mental hospitals was 0.5 times, and the university hospitals 8.2 times. The number of psychiatric of group A of private hospitals was 1.5 times more than that of public mental hospitals; when the number of psychiatric nurses in public mental hospitals was regarded as 1.0, the group B of private mental hospitals was 0.6 times and university hospitals was 2.6 times. The foreign mental hospitals had more medical manpowers in all occupations than domestic mental hospitals. The number of psychiatrists estimated according to the first method was 11.1 persons and the number of psychiatric nurses was 26.3 persons per 100 beds, and the number of psychiatrists estimated according to the second method was 4.3 persons per and the number of psychiatric nurses was 20.8 persons per 100 beds. CONCLUSION: The estimated optimal number of psychiatrists for mental hospital is 4.3 persons and of psychiatric nurses was 20.8 persons per 100 beds. However, these numbers can be flexible depending on the ratio of short-term acute patients and long term chronic patients.