Endobiliary radiofrequency ablation (RFA) is a procedure performed widely to induce locoregional tumor control by the transfer of thermal energy to the lesion and subsequent tumor necrosis. A 72-year-old male with a prior history of acute calculous cholangitis and perforated cholecystitis was admitted to the Kyungpook National University Hospital complaining of fever and nausea. He had an indwelling percutaneous transhepatic gallbladder drainage (PTGBD) catheter from the previous episode of perforated cholecystitis. An abdominal CT scan showed marked dilation of both the intrahepatic and extrahepatic bile ducts. Common bile duct cancer was confirmed histologically after an endobiliary biopsy. A surgical resection was considered to be the initial treatment option. During open surgery, multiple metastatic nodules were present in the small bowel mesentery and anterior abdominal wall. Resection of the tumor was not feasible, so endobiliary RFA was performed prior to biliary stenting. Cholecystectomy was required for the removal of the PTGBD catheter, but the surgical procedure could not be performed due to a cystic ductal invasion of the tumor. Instead, chemical ablation of the gallbladder (GB) with pure ethanol was performed to breakdown the GB mucosa. Palliative treatment for a biliary obstruction was achieved successfully using these procedures. In addition, a PTGBD catheter was removed successfully without significant side effects. As a result, an improvement in the patient's quality of life was accomplished.
Abdominal Wall ; Aged ; Bile Ducts, Extrahepatic ; Biopsy ; Catheter Ablation ; Catheters ; Cholangiocarcinoma ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis ; Cholecystectomy ; Cholecystitis ; Common Bile Duct ; Cystic Duct ; Drainage ; Ethanol ; Fever ; Gallbladder ; Gyeongsangbuk-do ; Humans ; Male ; Mesentery ; Mucous Membrane ; Nausea ; Necrosis ; Palliative Care ; Quality of Life ; Stents ; Tomography, X-Ray Computed

Gyeongsangbuk-do), mercury contents from shark meat distributed in this region have not been assessed yet. Thus, this study aims to identify the hazard by evaluating the mercury contents of the shark meat sold in the traditional market of Gyeongsangbuk-do.METHODS: The shark meat in the form of muscle meat was obtained from 15 traditional markets of Gyeongsangbuk-do in the summer and winter of 2013. Out of 105 samples in total, 49 were collected in the summer and 56 in the winter. The total mercury concentration was measured by the combustion-gold amalgamation method using an automatic mercury analyzer (Milestone DMA-80, Milestone).RESULTS: The average mercury concentration of shark meat was 2.29 ± 1.77 µg/g, ranging between 0.06–8.93 µg/g with a geometric mean of 1.44 µg/g, which is higher than those reported in many countries. The mercury concentration in 77 of 105 shark meat samples exceeded 1 µg/g. Mercury concentration ranged between 0.09–8.93 µg/g (geometric mean: 1.45) in the summer and 0.06–6.73 µg/g (geometric mean: 1.48) in the winter.CONCLUSIONS: Shark meat sold in the market contained a substantial amount of mercury. This suggests that it is difficult to reduce mercury intake by simply strengthening the standard level of mercury concentration in shark meat. Therefore, it is need to communication and awareness programs with consumers about hazardous effects of mercury inherent in shark meat.]]>
Gyeongsangbuk-do ; Korea ; Meat ; Methods ; Sharks

BACKGROUND: The role of allogeneic hematopoietic cell transplantation (allo-HCT) compared with consolidation chemotherapy alone in intermediate-risk acute myeloid leukemia (AML) patients with wild-type nucleophosmin/negative or a low level of Fms related tyrosine kinase 3 internal tandem duplication (NPM1(wt)/FLT3-ITD(neg/low)) has not yet been elucidated. METHODS: In this study, we retrospectively investigated 88 patients newly diagnosed with AML who received intensive induction chemotherapy at Kyungpook National University Hospital from March 2015 to July 2017. The selection criteria included the presence of results on genetic abnormalities including NPM1 and FLT3-ITD. RESULTS: According to the European LeukemiaNet (ELN) risk classification, 25 patients (28%) were categorized as favorable, 44 (50%) as intermediate, and 19 (22%) as adverse risk. Among the intermediate-risk patients, 40 were identified as NPM1 wt/FLT3-ITDneg/low. Among the patients with NPM1(wt)/FLT3-ITD(neg/low), complete remission (CR) was achieved in 26 patients out of 40 (65%). One-year overall survival (OS) rate was 100% in the favorable-risk group and 87.9% in the NPM1(wt)/FLT3-ITD(neg/low) group (P=0.233). Among the intermediate-risk NPM1(wt)/FLT3-ITD(neg/low) patients, there was no survival benefit with allo-HCT (N=19) compared to consolidation chemotherapy (N=21; P=0.372). In the multivariate analysis, the ELN risk group [hazard ratio (HR), 6.36; P=0.019] and the achievement of CR (HR, 2.95; P=0.017) were both identified as factors affecting OS of patients with newly diagnosed AML. CONCLUSION: Among the AML patients, intermediate-risk NPM1(wt)/FLT3-ITD(neg/low) patients and favorable-risk patients showed similar OS rates. Our results suggested that allo-HCT might have limited clinical benefit for the intermediate-risk NPM1(wt)/FLT3-ITD(neg/low) patients. Well controlled studies are needed to confirm the current results.
Cell Transplantation ; Classification ; Consolidation Chemotherapy ; Gyeongsangbuk-do ; Humans ; Induction Chemotherapy ; Leukemia, Myeloid, Acute ; Multivariate Analysis ; Patient Selection ; Protein-Tyrosine Kinases ; Retrospective Studies ; Transplants

PURPOSE: The purposes of this study were to analyze the course outcomes of integrated courses of a medical school that introduced an outcome-based curriculum and to suggest ways to improve techniques in the description of outcomes. METHODS: In order to investigate the course outcomes of 39 courses in the first and second grades at Kyungpook National University School of Medicine in Korea, verbs for the course outcome were classified according to Bloom’s taxonomy and frequency analysis was completed. The appropriateness of use of verbs in description of the outcomes was also analyzed. RESULTS: The total number of course outcomes for both grades was 497. The number of course outcomes per credit ranged from a minimum of 0.9 to a maximum of 22.0. Most of the course outcomes were classified as the comprehension domain according to Bloom’s taxonomy. The most frequently used verb was “explain,” accounting for 61.0% (n=303) of the entire course outcome verbs. Some verbs in the outcomes, however, were unmeasurable. CONCLUSION: The major findings of this study include the followings. First, the number of course outcomes varied according to courses. Second, several course outcomes included unmeasurable verbs. Finally, most of the verbs used to describe course outcome belonged to the two lower levels of Bloom’s taxonomy—knowledge and comprehension. In order to improve the description of course outcomes, this study suggests that it is necessary to adjust the number of course outcomes, applicate overt behavior verbs, and elevate the level of course outcomes from the lower memorizing level to the higher application level.
Classification ; Comprehension ; Curriculum ; Gyeongsangbuk-do ; Humans ; Korea ; Schools, Medical

PURPOSE: The purpose of this study is to determine whether there is any change in the empathy scores of third-year medical graduate students after they have taken a clerkship and have begun gaining more opportunities to meet patients through the clerkship. METHODS: The participants were 109 third-year students in 2014 and 110 fourth-year students in 2015 at Kyungpook National University, School of Medicine. The author measured empathy using a modified and expanded version of the Korean version of the Jefferson Scale of Empathy of Physician Empathy-Student version and used the Holland-III aptitude test-S to assess vocational aptitude. RESULTS: As a results, male students in their third year exhibited higher scores, but there was no significant difference in the fourth year. The empathy score increased slightly when third-year students became fourth-year students, but the difference was not statistically significant. There was no statistically significant change in the scores of both male and female students between the 2 years. The results of the vocational aptitude test showed that students who preferred person-oriented specialties had higher empathy scores when they entered their fourth academic year compared to objectively-oriented students. CONCLUSION: In this study, male students showed higher empathy scores than female students, an atypical finding that was inconsistent with the results of previous studies. However, the distribution of scores among male students was wider than that of female students, a finding consistent with previous studies. As such, individual differences need to be considered when developing curriculum in order to improve the empathy of medical students.
Aptitude Tests ; Aptitude ; Curriculum ; Empathy ; Female ; Gyeongsangbuk-do ; Humans ; Individuality ; Male ; Students, Medical

BACKGROUND: Since 2003, Korea has consistently shown the highest suicide rate among the Organization for Economic Cooperation and Development countries, and suicide remains the major cause of death. In particular, men are 2–3 times more likely to commit suicide than women, which called the ‘gender paradox of suicide.’ The areas with frequent suicide have spatially clustered patterns because suicide with a social contagion spreads around the neighborhood. The purpose of this study was twofold. The first was to estimate the hotspot areas of age-standardized male suicide mortality from 2008 to 2015. The second was to analyze the relationship between the hotspot areas and the regional characteristics for study years. METHODS: The data was collected through the Korean Statistical Information Service. The study areas were 227 si · gun · gu administrative districts in Korea. The hotspot area was used as a dependent variable. Socio-demographic variables (number of marriages per 1,000 population, number of divorces per 1,000 population, and urbanization rate), financial variables (financial independence and social security budget), and health behaviors (EuroQol-5 dimension [EQ-5D], and depression experience rate) were used as independents variables. RESULTS: The hotspot areas were commonly located in Gangwon-do, Chungcheongnam-do, Gyeongsangbuk-do, and Chungceongbuk-do. According to the results of panel logit regression, the number of divorces per 1,000 population, social security budget, and EQ-5D were statistically significant variables. CONCLUSION: The results of hotspot analysis showed the need for establishing a prevention zone of suicide using hotspot areas. Also, medical resources could be considered to be preferentially placed in the prevention zone of suicide. This study could be used as basic data for health policymakers to establish a suicide-related policy.
Budgets ; Cause of Death ; Chungcheongnam-do ; Depression ; Divorce ; Female ; Gangwon-do ; Geographic Information Systems ; Gyeongsangbuk-do ; Health Behavior ; Humans ; Information Services ; Korea ; Male ; Marriage ; Mortality ; Organisation for Economic Co-Operation and Development ; Residence Characteristics ; Social Security ; Suicide ; Urbanization

OBJECTIVES: This study aimed to assess the status of Scrub typhus, Leptospirosis and HFRS(hemorrhagic fever with renal syndrome) among farmers with febrile illness. METHODS: We involved a total of 841 farmers who had febrile illness(508 and 333 village residents were, respectively, three and four district of Gyeongju city) selected during autumn of 2014 and 2015. Data were collected by survey questionnaires and blood sample examination. RESULTS: Serum response rate for Scrub typhus and Leptospirosis was 1.5% each and 1.9% for HFRS. Serum response rate for Scrub typhus was significantly higher for tick-bite cases(38.5%), while Leptospirosis was significantly higher for those who were in fruit–planting work(23.1%). Similarly, serum response rate was significantly higher for HFRS who were working in venyl green house work(25.0%). CONCLUSIONS: Government authority should develop effective and efficient preventive strategies to create awareness of infectious diseases among farmers. Extending information, education and communication be reached to farmers that could change their perception and help early diagnosis and treatment and reduce the disease burden and its complication.
Communicable Diseases ; Early Diagnosis ; Education ; Farmers ; Fever ; Gyeongsangbuk-do ; Hemorrhagic Fever with Renal Syndrome ; Leptospirosis ; Risk Factors ; Scrub Typhus

Brucellosis is one of the zoonoses, and it is a disease that is almost eliminated in South Korea. This disease is also known as a representative disease of one health. We would like to introduce brucellosis found by one health in this study. One Health means an approach in which multiple sectors communicate and work together to achieve better public health outcomes. The Gyeongbuk Agricultural Safety and Health Center established a cooperation system between a Veterinary Service Laboratory and a Public Health Center, and found a case of human brucellosis in a farm with cattle brucellosis. Through this case, to be effective control of zoonoses as above case, epidemiological investigation for cattle and human should be concurrently conducted. And we once again recognized the need for multi-sectoral cooperation in prevention and management of zoonoses.
Agriculture ; Animals ; Brucellosis ; Cattle ; Gyeongsangbuk-do ; Humans ; Korea ; Public Health ; Zoonoses

BACKGROUND: The aim of this study was to evaluate the awareness of occupational hazards and personal protective equipment use among dental hygienists (DHs).METHODS: A total of 271 self-administered questionnaires were obtained from 280 DHs working at dental hospitals or clinics in Daegu and Gyeongsangbuk-do, Korea.RESULTS: The occupational hazards included work involving dust (94.1%), volatile substances (86.0%), noise (97.0%), and light-curing units (96.7%). The proportion of dental hygiene tasks that participants perceived as harmful were 42.4%, 51.7%, 9.2%, and 31.4% in the same order as above. The proportion of participants who used dust-proof masks during work involving dust was 1.1%. Those who wore gas-proof masks and gloves for work using volatile substances were 0.7% and 31.2%, respectively. Participants who used goggles for work involving light-curing units were 31.0%. None of the participants used ear plugs for work involving noise. A total of 22.9% of the participants recognized the Material Safety Data Sheet, while 79.7% had never been educated about harmful work environments.CONCLUSION: When compared to exposure status and perception of occupational hazards, the level of protective equipment use was very low. Extra measures to increase DHs’ use of personal protective equipment are necessary.
Daegu ; Dental Hygienists ; Dust ; Ear ; Eye Protective Devices ; Gyeongsangbuk-do ; Humans ; Korea ; Masks ; Material Safety Data Sheets ; Noise ; Occupations ; Oral Hygiene ; Personal Protective Equipment

OBJECTIVES: This study was conducted to analyze the effect that oral health literacy of adults has on perceived oral health state and to identify the factors that affect perceived oral health status. METHODS: A self-administered questionnaire survey was distributed to 554 adults who lived in the Daegu or Gyeongbuk areas and visited dental institutions located in the Daegu area. For adults who were 60 years old or older, direct interviews were conducted. Statistical analysis was performed with t-tests, analysis of variance, and multiple regression using SPSS RESULTS: Between oral health literacy and perceived oral health status, a significant positive correlation was revealed (r=0.142, P<0.01). A significant positive correlation was revealed between oral health literacy and knowledge (r=0.397, P<0.01). A significant but weakly positive correlation was revealed between oral health knowledge and perceived oral health status (r=0.086, P<0.05). To identify factors affecting perceived oral health status, multiple regression analysis was conducted, and the result showed that oral health literacy was a statistically significant factor (β=0.105, p<0.05). Among general characteristics, age was a statistically significant negatively affecting factor, as it showed a negative relationship with perceived oral health status (β=−0.140, P=0.001, adjusted R2=0.049). CONCLUSIONS: When these study results are taken into consideration, oral health literacy is a factor affecting perceived oral health status, and as such, oral health literacy of the research targets should be taken into consideration when implementing oral health education to promote oral health.
Adult ; Daegu ; Education ; Gyeongsangbuk-do ; Health Literacy ; Humans ; Literacy ; Oral Health