Porokeratosis may be due to an abnormal clone of cells, predisposing affected individusls to development of malignant neoplssm over involved area. A 58-year old female is prsented with basal cell epithelioma associated with PPPD, exhibiting the classical histopathologic criteria of the disease. Total excision for basal cell epithelioma and oral administration of etretinate for the treatment of porokeratosis plantaris, palmaris et disseminata and for the prevention of cancer developrnent resulted in good response.
Acitretin ; Administration, Oral ; Carcinoma, Basal Cell* ; Clone Cells ; Etretinate ; Female ; Humans ; Middle Aged ; Porokeratosis*

A 21-year-old female is presented with semicircular lipoatrophy, which had developed since birth with annular depressed strophic lesion of the left thigh. Biopsy specimen from the depressed area of left thigh showed no abnormal pathologic findings. But X-ray and CT scan of the lower extremity revealed remarkably reduced fat layer of the left thigh, compared to the right side.
Biopsy ; Female ; Humans ; Lower Extremity ; Parturition ; Thigh ; Tomography, X-Ray Computed ; Young Adult

BACKGROUND: This study was done to identify factors that influence the willingness to be vaccinated with the human papilloma virus (HPV) vaccine in female college students eligible for a catch-up vaccination program. METHODS: This cross-sectional study included 572 female students aged 18-26 years attending one selected university in the Gyeongbuk Province. From March 2 to 6, 2009, they completed a self-administered questionnaire on their HPV vaccination status. Thereafter, unvaccinated participants were educated about the vaccination program, and each participant's willingness to be vaccinated was assessed. RESULTS: Of the 572 participants, 18 (3.1%) were already vaccinated with the HPV vaccine. The number of participants advised to be vaccinated was 102 (17.8%). Of the 554 unvaccinated participants, 305 (55.1%) were willing to be vaccinated after being educated about the vaccination program. Of the remaining 249 unvaccinated participants, 116 (48.7%) refused the vaccine due to its high cost. Advice by family members was related significantly to the willingness to be vaccinated (odds ratio, 2.37; 95% confidence interval, 1.09-5.14). CONCLUSIONS: The results of this study suggest that the willingness to be vaccinated with the HPV vaccine could be increased in female college students if they are advised to do so by their family members after being educated about the vaccination program.
Aged ; Cross-Sectional Studies ; Female ; Humans ; Papilloma ; Vaccination ; Viruses ; Surveys and Questionnaires

PURPOSE: This study was planned to investigate which medical knowledge examination score-written examination on basic medicine, individual clinical medicine, and comprehensive clinical medicine-was closely related to clinical skill score in medical students. METHODS: Scores on basic medicine, clinical medicine, graduation assessment, clinical performance examination (CPX), and objective structured clinical examination (OSCE) for 106 students who graduated Dongguk University Medical School from 2010 to 2011 were included, and correlations between them were analyzed using T scores. RESULTS: All scores of basic medicine, clinical medicine, graduation assessment, CPX, and OSCE correlated significantly with each other. In connection with clinical skill, graduation assessment score showed a strong correlation (r=0.547, p<0.001) with the CPX. Regarding detailed scores on the CPX, history taking score correlated significantly with medical knowledge examination scores (r=0.435~0.406, p<0.001). By regression analysis, the score on graduation assessment was 1 point higher, and that of the CPX increased by 0.538 (p<0.001). CONCLUSION: Based on our study, comprehensive clinical knowledge is required for medical students to gain the appropriate clinical skills. Therefore, clinical skill practice and lectures that are based on the level of comprehensive clinical knowledge are recommended in the education of clinical skills in medical students.
Clinical Competence ; Clinical Medicine ; Humans ; Lectures ; Schools, Medical ; Students, Medical

BACKGROUND: Elderly patients receiving long-term care are at high risk for pressure ulcers. This study was done to identify histories of pressure ulcers and to evaluate the risk of pressure ulcers using the Braden scale. METHODS: We enrolled 103 subjects receiving nursing homecare from a university hospital in Gyeongju or admitted to nursing homes in Pohang between April 1, 2010 and June 30, 2010. Assessment tools included demographic information, level of care, activities of daily living (ADL), presence of pressure ulcer, history of pressure ulcers and the Braden scale scores. RESULTS: Twenty-six subjects (25.2%) had previous pressure ulcers. The mean Braden scale score was 15.02+/-4.23 (range, 6 to 23). And categorized into two groups based on previous pressure ulcers, the mean score was 11.92+/-3.59 for the group with previous pressure ulcers and 16.06+/-3.93 for the group without previous (p<0.001). The number of subjects with a risk for pressure ulcers according to the Braden scale was 71 (69.9%). The Braden scale had a positive correlation with level of care (p<0.001) and a negative correlation with ADL (p<0.001). Factors related to the history of pressure ulcers were homecare services (p=0.010), concurrent diabetes (p=0.023) and a low Braden scale score (p=0.028). CONCLUSION: We recommend that a pressure ulcer risk assessment be done routinely in elderly patients receiving long-term care services to minimize their occurrence.
Activities of Daily Living ; Aged ; Humans ; Long-Term Care ; Nursing Homes ; Pressure Ulcer ; Risk Assessment

PURPOSE: In this study, patients in whom two computed tomography (CT) scans had been obtained within 24 hours of injury were analyzed to determine the incidence, risk factors and clinical significance of a progressive intracerebral hematoma (PIH). METHODS: Participants were 182 patients with a traumatic intracerebral hematoma and contusion who underwent a repeat CT scan within 24 hours of injury. Univarite and multivariate statistics were used to define growth (volume increase) and to examine the relationship between the risk factors and hemorrhage expansion. RESULTS: Fifty-four percent of the patients experienced progression in the size of the lesion in the initial 24 hours postinjury. A PIH was independently associated with worsened Glasgow coma scale (GCS) score (2.99, 1.04~8.60), the presence of subarachnoid hemorrhage (6.29, 2.48~16.00), the presence of a subdural hematoma (6.18, 2.13~17.98), the presence of an epidural hematoma (5.73, 1.18~27.76), and the presence of a basal cistern effacement (10.93, 1.19~99.57). CONCLUSION: For patients undergoing scanning within 2 hours of injury, the rate of PIH approaches 61%. Early repeated CT scanning is indicated in patients with a nonsurgically-treated hemorrhage revealed on the first CT scan. Worsened GCS score, significant hematoma growth and effacement of the basal cisterns on the initial CT scan are powerful predictors of which patients will require surgery. These findings should be important factors in understanding and managing of PIH.
Contusions ; Craniocerebral Trauma ; Glasgow Coma Scale ; Head ; Hematoma ; Hematoma, Subdural ; Hemorrhage ; Humans ; Incidence ; Risk Factors ; Subarachnoid Hemorrhage

BACKGROUND: Gastroscopy is the useful method to detect the upper gastrointestinal condition, but examinee have recognized it as the procedure causing the discomfort and anxiety. This study was conducted to identify the factors related to pre-procedural anxiety for gastroscopy . METHODS: From 9th March to 12th June 2009, Data were collected from 463 examinee undergone gastroscopy at a health promotion center of a university hospital by self-administered questionnaires about general characteristics (age, sex, education state, economic state, family history of gastric cancer), gastrointestinal symptom, histroy of gastrointestinal disease, sedated gastroscopy and previous experience of gastroscopy. Before gastroscopy procedure, pre-procedural anxiety was assessed using 20-items by Korean version of Spielberger State Triat Anxiety Inventory Form-Y (STAI-Y). RESULTS: The mean score of pre-procedural state anxiety was 38.1 +/- 10.2 in all participants. The mean score was the most highest in participants who had no previous experience of gastroscopy and would perform non-sedated gastroscopy as 42.1 +/- 10.3. Factors related to pre-procedural anxiety were female (odds ratio [OR], 3.00; 95% confidence interval [CI], 1.94 to 4.64), low education state (OR, 1.68; 95% CI, 1.05 to 2.71) and the previous experience of gastroscopy (OR, 0.46; 95% CI, 0.24 to 0.88). Among participants who had the previous experienced gastroscopy, female (OR, 3.20; 95% CI, 1.97 to 5.22), low education state (OR, 1.79; 95% CI, 1.06 to 3.02) and the good tolerance at previous gastroscopy (OR, 0.35; 95% CI 0.21 to 0.59) were related to pre-procedural anxiety. CONCLUSION: In health check examinee, female, low education state and the no previous experience of gastroscopy were related to pre-procedural anxiety. Endoscopists should be provide efforts to lower pre-procedural anxiety in those subjects as to increase effectiveness of interventions.
Anxiety ; Female ; Gastrointestinal Diseases ; Gastroscopy ; Health Promotion ; Humans ; Surveys and Questionnaires

BACKGROUND: Esophagogastroduodenoscopy is a very important method to detect gastroduodenal lesions. But the investigation might be delayed due to its own discomfort and anxiety. This study was performed to evaluate the effect of relaxation music on relief of anxiety and physical discomfort during unsedated esophagogastroduodenoscopy. METHODS: From March 3 to May 14 2009, 104 clients who have undergone unsedated esophagogastroduodenoscopy more than once in the past were enrolled in this study. The subjects were randomly assigned to receive either relaxation music (music, N = 52) or no music (control, N = 52) before esophagogastroduodenoscopy. The subjects recorded their anxiety and physical discomfort about latest and today endoscopy by visual analogue scale (VAS). At pre and post music listening, systolic, diastolic blood pressure and heart rate were measured. RESULTS: There was a significant difference of anxiety VAS between music and control group (music, decrease 1.1 +/- 2.1; control, increase 0.0 +/- 1.9; P = 0.008). Throat discomfort VAS was not significant (music, decrease 0.9 +/- 1.8; control, decrease 0.5 +/- 2.7; P = 0.33). Dyspnea VAS decreased in both groups (music, 0.6 +/- 2.2; control, 0.4 +/- 2.5; P = 0.68). Nausea & vomitting VAS also decreased in both group (music, 0.9 +/- 2.2; control, 1.1 +/- 2.1, P = 0.71). There were no significant vital sign changes premusic and postmusic, In both group vital signs increased. Mean differences of systolic pressure(1.0 +/- 11.4 vs. 1.6 +/- 11.1) and diastolic pressure (0.7 +/- 7.3 vs. 1.3 +/- 5.7) were lower in music group, and mean difference of heart rate (1.8 +/- 9.5 vs. 1.5 +/- 8.0) was lower in control group. But There were no significant vital sign changes premusic and postmusic (each P = 0.8, P = 0.62, P = 0.89). CONCLUSION: Listening relaxation music before unsedated esophagogastroduodenoscopy may reduced anxiety.
Anxiety ; Blood Pressure ; Dyspnea ; Endoscopy ; Endoscopy, Digestive System ; Heart Rate ; Music ; Nausea ; Pharynx ; Relaxation ; Vital Signs

BACKGROUND: A previous Korean study recommended minimal 50 cases of Esophgogastroduodenoscopy (EGD) to achieve technical competency, based on director's opinion. Therefore, this study was conducted to evaluate the achievement of EGD's technical skills during the first 50 EGD cases. METHODS: The data were collected from the first 50 EGDs consecutively performed by six family medicine residents trained the EGD procedure in one residency program from 2004 to 2006. Technical competency of the EGD procedure was evaluated in 4 steps divided with anatomical landmarks (the gastroesophageal junction, the antrum, the fundus of the stomach, and the second portion of the duodenum). Authors measured the procedure time of EGDs performed by residents in 4 steps and calculated the rate of success cases satisfied with author's own criteria made by procedure time. RESULTS: The success rate of EGD procedure in all steps was 26.7% at 10 EGDs, but sharply increased to 80.0% at 30 EGDs, reached 88.0% at 50 EGDs. Fail to perform esophageal intubation and retroversion to the fundus of the stomach was none after 30 EGDs. However, in steps from gastroesphageal junction to the antrum of the stomach and from the antrum of the stomach to the second portion of the duodenum, the failure rate kept up less than 10% during the first 50 EGDs. A statistically significant reduction of the procedure time in success cases was observed between 20 and 30 EGDs in all steps. CONCLUSION: The technical competency of EGD was achieved approximately 90% during the first consecutive 50 EGDs.
Achievement ; Duodenum ; Esophagogastric Junction ; Gastroscopy ; Humans ; Internship and Residency ; Intubation ; Stomach

PURPOSE: Knowledge of nutritional support and attitudes of medical staff both affect patient care. We identified attitudes regarding nutritional support among medical staff as well as changes in attitudes when a nutritional support team is present. METHODS: Data were collected from 172 medical staff members who served at a university hospital located in Gyeongju by self-administered questionnaire from June 12~August 30, 2013. The questionnaire inquired about importance of nutritional support, self-confidence about nutritional support, consideration of nutritional support for patient care, consideration of nutritional support when a nutritional support team is present, and nutritional knowledge training during the past year. RESULTS: A total of 169 subjects (98.3%) thought that nutritional support is important for patient care. Only 19 subjects (11.0%) were highly self-confident about nutritional support. In total, 147 subjects (85.5%) considered nutritional support for some or all patients, whereas 169 (98.3%) considered nutritional support for patient care when a nutritional support team is present. Thirty-eight subjects (22.1%) received nutritional knowledge training during the past year. High self-confidence for nutritional support was related to nutritional knowledge training and service part. Positive changes regarding nutritional support when a nutritional support team is present were associated with nutritional knowledge training and high self-confidence for nutritional support. CONCLUSION: No differences in nutritional support attitudes for patient care were observed among the medical staff. Nutritional knowledge training and service part affected self-confidence of nutritional support and induced positive changes in attitudes for nutritional support.
Gyeongsangbuk-do ; Humans ; Inpatients ; Medical Staff* ; Nutritional Status ; Nutritional Support* ; Patient Care* ; Surveys and Questionnaires