The pre-hospital analysis of patients with suicide attempts in Gangwon-do

OBJECTIVE: This study examined the characteristics of suicidal attempters, including pre-hospital patients and those who visited the emergency department. METHODS: Suicidal attempters who had been reported to the 119 call center were selected between July 2015 and June 2016. Sex, age, place, methods of suicidal attempt, season, time, and suicide success rate were reviewed in the fire center records. RESULTS: A total 961 suicide attempters were enrolled. Among them, 53.6% were males who had an approximately 2.6 times higher mortality than that of females (9.2%). The most preferred place to commit suicide was the home in both sexes (68.0% in male, 82.8% in female) and the most preferred methods was drug intoxication, particularly pesticide. The method with the highest mortality was hanging and the lowest was self-harm. The season of the highest mortality was spring. The success of suicide and the time variation were similar. Most of the un-transferred patients also selected fatal suicide attempts compared to transfer patients. CONCLUSION: Unlike previous studies, this study includes information on un-transferred patients. Overall, the probability of death was highest as more than 50 years men chose hanging as a method, which had an influence on the un-transferred patients group.

Safety and Effect of the Perigastric Devascularization with Transection of Esophagus for Treatment of Esophageal Varices

PURPOSE: There are a variety of approaches to the treatment of esophageal varix. This study evaluates the value of perigastric devascularization with transection of the esophagus, a non-shunt operation, for the management of bleeding esophageal varices. METHODS: We retrospectively analyzed the medical records of 16 patients with esophageal varix bleeding who had undergone perigastric devascularization with transection of the esophagus from 1990 through 2000. RESULTS: The mean age of the patients was 40.8 years and the most common underlying pathology was viral hepatitis. All patients had a history of previous variceal bleeding. Elective and prophylactic surgery was done in 8 and 5 patients respectively, and emergency surgery in 3 patients. One patient in Child group C and underwent emergency surgery, died after operation (mortality rate 6.3%). In the remaining 15 patients, two patients died of hepatocellular carcinoma. None of the patients demonstrated rebleeding or recurrence of the varix in the follow-up period. In 8 patients, the liver function, as measured by Child-Pugh classification, was improved following surgery as compared with measurements at the time of admission. CONCLUSION: According to this study, in spite of the small number of patients, we suggest that perigastric devascularization with transection of the esophagus is a very safe and effective treatment modality for esophageal varix bleeding, particularly if it can be done for an elective or prophylactic purpose. Furthermore, we propose that the operation should be carried out in an elective rather than in emergency manner following the improvement of liver function by non- invasive medical treatment.

Ki 67 Expression and Its Correlation with the Proliferative Index Measured by Flow Cytometry in Breast Carcinoma

PURPOSE: The aim of the present study was to evaluate the clinical utility of Ki 67 labelling index and proliferative indices measured by flow cytometry in breast carcinomas. METHODS: We conducted immunohistochemical assay for Ki 67 and analyzed the DNA content and S-phase fraction by flow cytometry in 113 cases of primary breast carcinomas. Relationship between proliferative indices measured by two method and clinical biological parameters was also analyzed. RESULTS: Ki 67 labelling index than average was increased in 53 tumors (46.9%) and demonstrated a significant correlation with S-phase fraction. Higher Ki 67 labelling index was found in 28 (59.6%) of 47 tumors with high S-phase fraction whereas it was found in only 8 tumors (30.8%) with low S-phase fraction. Concordance between Ki 67 labelling index and S-phase fraction was 63.1% (p=0.017). Tumor with high S-phase fraction had a tendency to have an aneuploid. Ki 67 labelling index correlated significantly with histologic grade (p=0.001) and nuclear grade (p=0.001). An inverse correlation was found between Ki 67 and estrogen receptor expression (p=0.004). CONCLUSION: Ki 67 labelling index significantly correlated with S-phase fraction measured by flow cytometry. Ki 67 labelling index seems to be a clinically useful method because it is rapid, practical and easily performed by immunohistchemical assay.