Objectives: This study aimed to evaluate the effectiveness of the Jeollabuk-do Suicide Prevention Training Program for professional gatekeeper instructors, using psychological questionnaires. Methods: Eighty-three participants were recruited from mental health centers and relevant organizations in Jeollabuk-do. All the participants were randomly assigned to either an experimental group (n=41), where they took part in the suicide prevention training program developed by Jeollabuk-do for professional gatekeeper instructors, or a control group (n=42), receiving no treatment. Four participants from the control group dropped out, and the final participants for each group were 41 and 38. We analyzed the changes in the two groups, before and after the program, using the Korean Suicide Literacy Scale, Counselors’ Professional Scale for Self-injury Behaviors, Attitudes towards the Suicide Scale, and Help-Giving. Results: Participants in the experimental group exhibited a significant improvement in their knowledge of suicide prevention and their attitude toward suicide compared to those in the control group. Conclusion This study suggests that the Jeollabuk-do Suicide Prevention Training Program for professional gatekeeper instructors may serve as an effective means of improving the participant’s knowledge of suicide prevention and changing the attitude towards suicide, and may fulfill its purpose of preventing suicides.

BACKGROUND: Although medical students' clinical competence should be assessed systematically and objectively, written exams or faculty's subjective methods were used in the past. We assessed the clinical competence of the family medicine clerkship students using the OSCE and evaluated the reliability and the validity of the OSCE. The purpose of this study was to find the logistic problems and the feasibility of the OSCE to an entire clerkship evaluation. METHODS: Twenty six volunteers took part in the OSCE. Ten, 5-minute long stations, were divided into 4 areas: 3 for history taking, 3 for physical exam, 3 for technical skill, and 1 for interview skill areas. RESULTS: Eleven students were examined on first session and 15 students on second session 4 weeks later. The mean OSCE score was 65.5 5.63. The reliability of the total stations was 0.615. The total OSCE score was not different by the sessions, but there was a significant difference in the two stations where the examiners had been changed. There were statistically significant correlations between the total OSCE score and the two previous written exams (r=0.56, 0.54, P<0.01). There was no significant logistic problem and the examinees showed positive responses to the OSCE. CONCLUSION: The OSCE was a useful tool for assessing the clinical competence of family medicine clerkship students. The reliability of the OSCE was moderate and in order to extend the OSCE to an entire clerkship evaluation, we need further study to acquire a higher reliability and validity.
Clinical Competence* ; Humans ; Reproducibility of Results ; Volunteers

A hippocalcin cDNA from rat brain cDNA library was amplified by polymerase chain reation(PCR) and cloned using TA Cloning technique. For this PCR cloning, 29mer and 28mer oligonucleotide primers containing BamHl and EcoRl sites at the 5' end and 3' end, respectively were used. The nucleotide sequence of hippocalcin cDNA c1one was determined, and the complete amino acid sequence was deduced. Recombinant clone contained a cDNA insert of 610 base pairs with 582 nucleotides of open reading frame including the temination codon, 23 nucleotide of 5'-untranslated region, and 5nucleotides of 3'-nutran,slated region. The open reading frame encoded a polypepetid comprising 193 amino acids with molecular weight of 22kDa. The cDNA insert was subcloned into pVLI393 Baculovirus transfer vector. The recombinant hippocalcin was expressed in insect cell(Sf9 cell) using expression vector pVL1393. The hippocalcin expressed was purified as a single band on polyacrylamide gel electrophoresis following hydrophobic phenyl HPLC and TSKgel G3000SW gel filtration HPLC. Molecular size of rat brain hippocalcin protein expressed in this system was estimated to be 22kDa. Myristoylated hippocalcin migrated faster than nonmyristoyated form on SDS-polyacrylamide gel. Less than 10% of total hippocalcin expressed was myristoylated in this baculovirus expression system.
Amino Acid Sequence ; Amino Acids ; Animals ; Baculoviridae ; Base Pairing ; Base Sequence ; Brain* ; Chromatography, Gel ; Chromatography, High Pressure Liquid ; Clone Cells ; Cloning, Organism ; Codon ; DNA Primers ; DNA, Complementary* ; Electrophoresis, Polyacrylamide Gel ; Gene Library ; Hippocalcin* ; Insects ; Molecular Weight ; Nucleotides ; Open Reading Frames ; Polymerase Chain Reaction ; Rats*

After general anesthesia, peripheral nerve paralysis is a rare complication. The frequently damaged nerves including: branches of the brachial plexus, the ulnar, radial and common peroneal nerves, and sometimes the facial nerve. The radial nerve is the most infrequently damaged one, accounting for only 3% of nerve damage. We report a case of radial nerve paralysis due to self retractor during abdominal operation, its clinical findings, and review of the literature on peripheral nerve paralysis.
Abdomen/*surgery ; Adult ; Female ; Human ; Paralysis/*etiology ; Radial Neuropathy/*etiology ; Surgical Instruments/*adverse effects

After general anesthesia, peripheral nerve paralysis is a rare complication. The frequently damaged nerves including: branches of the brachial plexus, the ulnar, radial and common peroneal nerves, and sometimes the facial nerve. The radial nerve is the most infrequently damaged one, accounting for only 3% of nerve damage. We report a case of radial nerve paralysis due to self retractor during abdominal operation, its clinical findings, and review of the literature on peripheral nerve paralysis.
Abdomen/*surgery ; Adult ; Female ; Human ; Paralysis/*etiology ; Radial Neuropathy/*etiology ; Surgical Instruments/*adverse effects

BACKGROUND: Patients diagnosed as an advanced cancer and families need accurate information about the length of survival in order to plan for and to make the best use of the time that remains. The health care of that patient can then be redirected toward palliation and mobilizing resources to ensure a comfortable life. The purposes of this study were to evaluate the prognostic value of performance status plus some physical symptoms and some biological indices and there fore to assist in planning appropriate palliative care. METHODS: This study was performed on 161 patients, who had been diagnosed as advanced cancer in Korea University Guro Hospital from July 1999 to July 2000. : We requested Karnofsky performance status scale, mental status, jaundice, severity of pain, anorexia, voiding difficulty, dyspnea and dry mouth We assessed the biological indices by leukocyte count, plasma albumin, proteinuria. RESULTS: We could confirm 82 patients' death(54.37) of 151 patients. Univariate analysis showed that Karnofsky performance status scale, mental status, jaundice, severity of pain, anorexia, voiding difficulty, dyspnea, dry mouth, leukocyte count, albumin and proteinuria demonstrated a statistically significant predictive prognosis. Multivariate analysis using Cox's proportional hazard model showed that age, performance status, albumin, proteinuria were independent predictors of survival and severity of pain had the borderline value. CONCLUSION: Age, performance status, albumin and proteinuria were the independent prognostic factors for patients with advanced cancer.
Anorexia ; Delivery of Health Care ; Dyspnea ; Humans ; Jaundice ; Karnofsky Performance Status ; Korea ; Leukocyte Count ; Mouth ; Multivariate Analysis ; Palliative Care ; Prognosis ; Proportional Hazards Models ; Proteinuria ; Serum Albumin

Gestational trophoblastic disease is derived from the intermediate trophoblast cells which are arisied from the fetal chorion. The incidence of invasive mole in Korea was about 1.8 per 1000 delivereies. The rate of ectopic pregnancy is about 1.9% of all pregnancies. An ectopic pregnancy located in the cornual portion of uterus occurs in only 2-4% of all ectopic pregnancies. It is rare that the invasive mole is associated with cornual pregnancy. A case of metastatic invasive mole in the lung arising from a cornual pregnancy is reported, which was cured by operation and combination chemotherapy.
Chorion ; Drug Therapy, Combination ; Female ; Gestational Trophoblastic Disease ; Hydatidiform Mole, Invasive* ; Incidence ; Korea ; Lung* ; Pregnancy ; Pregnancy* ; Pregnancy, Ectopic ; Trophoblasts ; Uterus

BACKGROUNDS/AIMS: The ultimate goal of antiviral therapy using interferon/pegylated interferon combined with ribavirin in chronic C-viral hepatitis is to achieve a sustained virologic response (SVR). Several studies have shown that the reappearance rate of hepatitis C virus (HCV) RNA in serum after the achievement of an SVR is less than 1%; the durability of an SVR in Korean patients is not known. The aim of this study was to determine the durability of the virologic response in chronic hepatitis C patients with an SVR to antiviral therapy. METHODS: A total of 156 patients who were treated successfully with interferon/peginterferon and ribavirin were evaluated retrospectively. Patients received either subcutaneous conventional interferon alpha 3x10(6) units three times a week or subcutaneous pegylated interferon (alpha-2a: 180 microgram, alpha-2b: 80-100 microgram) once a week in combination with ribavirin at 600-1,200 mg daily (depending on body weight). Patients with HCV genotype 1 were treated for 48 weeks, whereas those with non-genotype 1 were treated for 24 weeks. RESULTS: Eighty-two patients underwent treatment with conventional interferon and ribavirin, whereas 74 patients were treated with pegylated interferon and ribavirin. An SVR was achieved in 73 patients (73/156, 46.8%). HCV RNA reappeared in eight patients (8/73, 11.0%; detected by qualitative PCR), including one patient with persistent viremia (1/73, 1.4%). CONCLUSIONS: Reappearance of HCV RNA after earlier achievement of an SVR might appear more frequently than previously reported. Close follow-up of these patients is recommended and the implication of temporary viremia should be determined in the future.
Adult ; Antiviral Agents/*therapeutic use ; Drug Therapy, Combination ; Female ; Genotype ; Hepatitis C, Chronic/*drug therapy ; Humans ; Interferon Alfa-2a/*therapeutic use ; Interferon-alpha/*therapeutic use ; Male ; Middle Aged ; Polyethylene Glycols/*therapeutic use ; RNA, Viral/metabolism ; Recurrence ; Retrospective Studies ; Ribavirin/*therapeutic use ; Viremia/drug therapy

The majority of cases of duodenal intramural hematoma occur in children due to blunt abdominal trauma. In adult patients, the etiology of hematoma is quite varied. A hematoma may occur due to the usage of anticoagulants, hemophilia, Henoch-Schonlein purpura, vasculitis, pancreatic disease, endoscopic coagulation of duodenal ulcer bleeding and following an endoscopic retrograde cholangiopancreatogram. A 53-year-old male patient was admitted for hematemesis. The patient was a heavy alcoholic and had a history of chronic pancreatitis, but there was no definite trauma history or other medical illness. In the duodenal second portion, a huge submucosal mass obstructed the lumen with submucosal hemorrhage. As depicted on an abdominal CT and an endoscopic ultrasonogram, chronic pancreatitis and a duodenal submucosal tumor was suspected. On the eighth hospital day, abdominal pain suddenly became worse and peritoneal-irritation signs were observed. Therefore, a surgical procedure was urgently performed. Considering the rarity of its etiology in Korea, we report a case of duodenal intramural hematoma complicated with chronic pancreatitis.
Abdominal Pain ; Adult ; Alcoholics ; Anticoagulants ; Child ; Duodenal Ulcer ; Hematemesis ; Hematoma ; Hemophilia A ; Hemorrhage ; Humans ; Korea ; Male ; Middle Aged ; Pancreatic Diseases ; Pancreatitis ; Pancreatitis, Chronic ; Purpura, Schoenlein-Henoch ; Vasculitis

Endoscopic submucosal dissection has become widely used as a minimally invasive treatment for early gastric cancer that has negligible lymph node metastasis. However, local recurrences after successful endoscopic resection including regional lymph node metastasis and metachronous, synchronous recurrence are of clinical importance, so careful follow-up is essential. We performed endoscopic submucosal dissection on a 57-year-old male with early gastric cancer in April 2006. Pathology revealed a well differentiated adenocarcinoma, 8x5 mm in size, which was confined to the muscularis mucosa, and had negative lymphovascular invasion as well as tumor free margins. So the case was diagnosed as a curative resection. The patient was followed up with regular esophagogastroduodenoscopy and abdominal CT. After 8 years, metachronous gastric cancer and peripancreatic lymph nodes enlargement was detected by endoscopy and enhanced computed tomography. Additional endoscopic submucosal dissection and excision of lymph node were carried out separately. Finally, the patient was diagnosed with metachronous early gastric cancer and follicular lymphoma.
Adenocarcinoma ; Endoscopy ; Endoscopy, Digestive System ; Humans ; Lymph Nodes ; Lymphoma, Follicular* ; Male ; Middle Aged ; Mucous Membrane ; Neoplasm Metastasis ; Neoplasm Recurrence, Local ; Neoplasms, Second Primary ; Pathology ; Recurrence ; Stomach Neoplasms* ; Tomography, X-Ray Computed