“Suicide CARE” (Standardized Suicide Prevention Program for Gatekeeper Intervention in Korea): An Update

Objective@#In 2011, “Suicide CARE” (Standardized Suicide Prevention Program for Gatekeeper Intervention in Korea) was originally developed for the early detection of warning signs of suicide completion, since there is a tendency to regard emotional suppression as a virtue of Korean traditional culture. A total of 1.2 million individuals completed the training program of “Suicide CARE” in Korea. @*Methods@#More sophisticated suicide prevention approaches according to age, sex, and occupation have been proposed, demanding for a more detailed revision of “Suicide CARE.” Thus, during the period from August 2019 to February 2020, “Suicide CARE” has been updated to version 2.0. The assessments on domestic gatekeeper training programs for suicide prevention, international gatekeeper training programs for suicide prevention, psychological autopsy interview reports between 2015 and 2018, and the evaluation of feedback from people who completed “Suicide CARE” version 1.6 training were performed. @*Results@#We describe the revision process of “Suicide CARE,” revealing that “Suicide CARE” version 2.0 has been developed using an evidence-based methodology. @*Conclusion@#It is expected that “Suicide CARE” version 2.0 be positioned as the basic framework for many developing gatekeeper training programs for suicide prevention in Korea in the near future.

Contents of the Standardized Suicide Prevention Program for Gatekeeper Intervention in Korea, Version 2.0

Objective@#Suicide is a huge nationwide problem that incurs a lot of socio-economic costs. Suicide also inflicts severe distress on the people left behind. The government of the Republic of Korea has been making many policy efforts to reduce suicide rate. The gatekeeper program, ‘Suicide CARE’, is one of the meaningful modalities for preventing suicide. @*Methods@#Multidisciplinary research team collaborated to update the ‘Suicide CARE’ to version 2.0. @*Results@#In the ‘Introductory part’, the authors have the time to think about the necessity and significance of the program before conducting full-scale gatekeeper training. In the ‘Careful observation’ part, trainees learn how to understand and recognize the various linguistic, behavioral, and situational signals that a person shows before committing suicide. In the ‘Active listening’ part, trainees learn how to ask suicide with a value-neutral attitude as well listening empathetically. In the ‘Risk evaluation and Expert referral’ part, trainees learn intervening strategies to identify a person’s suicidal intention, plan, and past suicide attempts, and connect the person to appropriate institutes or services. @*Conclusion@#Subsequent studies should be conducted to verify the efficacy of the gatekeeper program.

Subacute Ischemic Colitis Developed after Severe Watery Diarrhea / 대한소화기내시경학회지

Ischemic colitis represents most common form of gastrointestinal ischemia, usually developed in elderly or debilitated patient with a variety of underlying medical problems. The presumed etiologies are numerous. It usually presents as an acute abdominal illness with bloody diarrhea. Subacute ischemic colitis in healthy adults develops spontaneously in the absence of major vasculature occlusion, and the original insult precipitating the ischemic event usually cannot be established. Diagnosis is based on the clinical symptom, barium study, colonoscopic and histopathologic findings. Therapy and outcome are depen-dent on the severity of disease. It usually requires only medical management and is asso-ciated a good prognosis. We report a case of subacute ischemic colitis in healthy adults developed after severe watery diarrhea with literatures.

A Case Report of Myxoma in the Lung / 결핵

Since Virchow first introduced the term myxoma to describe a tumor that recapitulates the structure of the umbilical cord, it has been increasingly recognized that many diverse neoplasms may acquire a similar myxoid appearance. Myxoma have evolved within the pathology literature from tumors often described in practically all sites to the currently recognized subtypes restricted to the heart, skin, soft tissue, and bone. Pulmonary myxoma is extraordinary rare. We experienced pulmonary myxoma in a 63 year old man. The pulmonary radiology showed mass in right upper lung field, and percutaneous transthoracic needle lung biopsy was performed to confirm the myxoma.

A case of accessory tracheal bronchus in patient with bronchial asthma / 알레르기

Tracheal bronchus is an aberrant bronchus that arises most often from the right tracheal bronchial wall above the carina and is the result of an additional tracheal outgrowth early in embryonic life. Its incidence ranges from 0.1 to 5%. This anomaly is usually diagnosed incidentally during bronchoscopy or bronchography in patients with various respiratory problems. Tracheal bronchus may be associated with other bronchopulmonary anomalies such as tracheal stenosis, pulmonary agenesis, pulmonary sequestration, abnormal lobulation, and Down's syndrome. In patients without specific clinical symptoms, a incidentally diagnosed tracheal bronchus does not require any treatment. We report a case of 59-year-old man incidentally detected accessory tracheal bronchus associated with bronchial asthma with review of literatures.

Effect of Combination Therapy of Isoniazid, Rifampicin, Ethambutol, and Pyazinamide on Theophylline Pharmacokinetics / 결핵

BACKGROUND: Since up to 90% of a theophylline dose is biotransformed, probably by interaction with one or more the variants of the cytochrome P-450 drug metabolism system, anti-tuberculosis agents including drugs influencing microsomal enzyme systems, such as isoniazid and rifampicin, may be affect the elimination of theophylline. METHODS: The effect of combination therapy with isoniazid(INH), rifampicin(RFP), ethambutol(EMB) and pyrazinamide(PZA) on the pharmacokinetics of theophylline was evaluated by a computer program using Bayesian method. Three group were divided as follows. Group lis control, Group II is treated with INH, RFP, EMB and PZA and Group lll is treated with INH, RFP and EMB. All of them were non-smoker who were normal in liver and renal functions, and not administered drugs affecting on the clearance of theophylline with exception of anti-tuberculous agents. RESULTS: When it compared control with test groups, the clearance of theophylline in Group ll and Group lll was significantly decreased(p<0.001), and half life in Group ll and Group lll showed significant elevation(p<0.001). However there were no significant differences in clearance and half life between the Group ll and Group lll. CONCLUSION: These results suggest that theophylline dose may be need of readjustment in concurrent medica fion of anti-tuberculous agents including INH, RFP, and EMB.