Objective: This study aimed to investigate the changes in interpersonal relationships, behavioral patterns, and emotional states of children and adolescents with psychiatric disorders and their caregivers immediately after the coronavirus disease of 2019 (COVID-19) outbreak in Daegu, South Korea. Methods: A total of 147 patients and 147 caregivers participated in the Survey for Outing and Time Usage for Child, Adolescent, and Parents and the COVID-19 Visual Analog Scale for Emotion. We classified the patients and their caregivers into the internalizing disorder (ID) and externalizing disorder (ED) groups and compared the changes. Results: Parent–child relationships for adolescent patients and caregivers were interrupted, and friend relationships in all participants were disrupted, while sibling relationships improved in adolescent patients. They experienced negative emotional changes. Time spent outdoor decreased and digital screen time increased for all participants. Friend and parent–child relationships were interrupted in the ED group compared to those in the ID group. ED patients experienced negative changes in emotional states, while ID patients showed no significant changes. Conclusion Results are meaningful as a reference for predicting changes in interpersonal relationships and mental status of pediatric psychiatric patients and for determining healthcare system adaptations to allow mental health support during the COVID-19 outbreak.

Objective: This study aimed to investigate the changes in interpersonal relationships, behavioral patterns, and emotional states of children and adolescents with psychiatric disorders and their caregivers immediately after the coronavirus disease of 2019 (COVID-19) outbreak in Daegu, South Korea. Methods: A total of 147 patients and 147 caregivers participated in the Survey for Outing and Time Usage for Child, Adolescent, and Parents and the COVID-19 Visual Analog Scale for Emotion. We classified the patients and their caregivers into the internalizing disorder (ID) and externalizing disorder (ED) groups and compared the changes. Results: Parent–child relationships for adolescent patients and caregivers were interrupted, and friend relationships in all participants were disrupted, while sibling relationships improved in adolescent patients. They experienced negative emotional changes. Time spent outdoor decreased and digital screen time increased for all participants. Friend and parent–child relationships were interrupted in the ED group compared to those in the ID group. ED patients experienced negative changes in emotional states, while ID patients showed no significant changes. Conclusion Results are meaningful as a reference for predicting changes in interpersonal relationships and mental status of pediatric psychiatric patients and for determining healthcare system adaptations to allow mental health support during the COVID-19 outbreak.

PURPOSE: Recent advances in the internet have enabled us to search for large amounts of medical information. In Korea there are many websites providing medical information, but the quality and quantity of these websites relating to surgery remains to be clarified. Therefore, through the analysis of the surgical websites in Korea, the characteristics and future directions are presented. METHODS: Two hundred and thirteen websites were retrieved using three search engines: Yahoo, Lycos and Naver. We reviewed these websites, and they were classified according to their administrator, subject and content. We also recorded the presence or absence of e-mail addresses, the section on medical counseling and internet reservation. RESULTS: One hundred and sixty-eight websites (78.9%) were administrated by the local clinics. In relation to the main subjects, 94.4% of websites targeted the general public. The main contents of the websites were colorectal and anal disease (83.1%). Of the 168 websites administrated by local clinics, online medical counseling was available in 142 (84.5%) and internet reservation was possible in 39 (23.2%). Most of the local clinics' websites were located in urban area. CONCLUSION: Our study showed surgical websites were led by local clinics, which specialized in colorectal and anal disease. It is emphasized that efforts to informationalization are needed by medical schools, affiliated hospitals and medical associations, and the guidelines enabling validity of medical counseling should be put in place.
Administrative Personnel ; Counseling ; Electronic Mail ; Humans ; Internet ; Korea* ; Schools, Medical ; Search Engine

PURPOSE: Computer-aided diagnosis system was developed to improve the accuracy and the efficacy of the image interpretation. This article is to provide a possibility of computer- aided diagnosis for detection of masses in mammograms. METHODS: The craniocaudal and mediolateral images of 120 mammograms from 30 patients that were histologically proven to be malignant and 30 patients that were histologically proven to be benign were analysed using the mammography softwere. The contralateral mammograms were used as control images. Correct marks of the lesions were scored as a true positive and marks not at the location of the lesions were scored as a false negative. Any marks of the normal images were scored as a false positive and no mark of normal images were scored as a true negative. RESULTS: It took approximately 2 min to scan and 1 min to process 24 by 18-cm mammograms. There was an average of 1.4, 2.0 and 2.1 marks per image in normal, benign and malignant mammograms respectively. Mass detection rate of malignant lesion was 90.0% (27 of 30) and that of benign lesion was 63.6% (21 of 33). Mass detection rate of dense breasts was 68.8% (22 of 32) and that of fatty breasts was 83.9% (26 of 31). Mass detection rate of BI-RADS category 4, 5 and 0 was 85.7% (42 of 49) and that of category 1, 2 and 3 was 42.9% (6 of 14). The overall sensitivity was 76.2% and specificity was 28.1%. CONCLUSION: In this study, mass detection rate for malignant lesions was higher than that of benign lesions and dense breast has lower detection rate than fatty breast. According to the BI-RADS category, mass detection rate was higher in the more malignant category. Computer-aided diagnosis system for this study had limited specificity but acceptable sensitivity.
Breast* ; Diagnosis* ; Humans ; Mammography ; Sensitivity and Specificity

PURPOSE: The surgery clerkship, focusing on the clinical competency, including critical thinking, problem solving, self-directed learning, autonomy and professionalism, were revised. The purposes of this study were to evaluate the students' assessment of the revised surgery clerkship program in order to improve the quality of surgical education. METHODS: Clinical competency was classified into 6 dimensions: intelligence, skill, relationship, attitude, problem solving performance, and autonomy. Problem based learning (PBL), procedural skill training, surgical anatomy, case discussion, pre-diagnosis at outpatient clinics, quiz, clinical performance assessment (CPA) and modified essay question (MEQ) were performed. Forty-nine 3rd year medical students participated during 2002. All students were asked to rate how far they had progressed in the 6 dimensions, in order to evaluate the course, and each program, and to suggest improvements at the end of the rotation. RESULTS: The students responded extremely positively and became been more motivated. They evaluated that the new clerkship had helped them increase their abilities in clinical reasoning, self-directed learning, problem solving and clinical techology, and to develop professionalism and autonomy. Most of students revealed that the PBL, case discussion, pre-diagnosis at outpatient clinics, CPA and MEQ programs were very helpful. They felt that procedural skill training and surgical anatomy programs required further improvements. CONCLUSION: The implementation of the new surgery clerkship was successful. The PBL, case discussion, pre-diagnosis at outpatient clinics, CPA and MEQ were valuable learning tools. More tools should be developed for procedural skill training and surgical anatomy education.
Ambulatory Care Facilities ; Education ; Humans ; Intelligence ; Learning ; Problem Solving ; Problem-Based Learning ; Students, Medical ; Thinking

PURPOSE: The surgery clerkship, focusing on the clinical competency, including critical thinking, problem solving, self-directed learning, autonomy and professionalism, were revised. The purposes of this study were to evaluate the students' assessment of the revised surgery clerkship program in order to improve the quality of surgical education. METHODS: Clinical competency was classified into 6 dimensions: intelligence, skill, relationship, attitude, problem solving performance, and autonomy. Problem based learning (PBL), procedural skill training, surgical anatomy, case discussion, pre-diagnosis at outpatient clinics, quiz, clinical performance assessment (CPA) and modified essay question (MEQ) were performed. Forty-nine 3rd year medical students participated during 2002. All students were asked to rate how far they had progressed in the 6 dimensions, in order to evaluate the course, and each program, and to suggest improvements at the end of the rotation. RESULTS: The students responded extremely positively and became been more motivated. They evaluated that the new clerkship had helped them increase their abilities in clinical reasoning, self-directed learning, problem solving and clinical techology, and to develop professionalism and autonomy. Most of students revealed that the PBL, case discussion, pre-diagnosis at outpatient clinics, CPA and MEQ programs were very helpful. They felt that procedural skill training and surgical anatomy programs required further improvements. CONCLUSION: The implementation of the new surgery clerkship was successful. The PBL, case discussion, pre-diagnosis at outpatient clinics, CPA and MEQ were valuable learning tools. More tools should be developed for procedural skill training and surgical anatomy education.
Ambulatory Care Facilities ; Education ; Humans ; Intelligence ; Learning ; Problem Solving ; Problem-Based Learning ; Students, Medical ; Thinking

PURPOSE: Despite radical lymph node dissection and combined resection, the operative results of treating advanced gastric cancer remains inadequate. The aim of this study was to determine the risk factors for recurrence of gastric cancer and the pattern of recurrence after curative resection for advanced gastric cancer. METHODS: Out of 220 patients who underwent curative resection for advanced gastric cancer from 1990 to 2000, 50 whose recurrence was confirmed by clinical, radiological, endoscopic or reoperative findings were studied retrospectively. We undertook a detailed analysis of the pattern of recurrence based on the morphologic and histopathologic characteristics of the initial tumor. RESULTS: The mean time to recurrence was 19.0 months. Early recurrence was found in 38 patients (76.0%), intermediate recurrence was found in 11 patients (22.0%), and late recurrence was found in 1 patient (2.0%). The patterns of recurrence were as follows: hepatic recurrence was found in 14 cases, peritoneal recurrence in 19 cases, local recurrence in 10 cases, extraperitoneal recurrence in 6 cases. In univariate analysis, the depth of invasion, extent of lymph node metastasis, TNM stage, and combined resection were important for recurrence. In multivariate analysis, depth of invasion and lymph node metastasis were important for recurrence. CONCLUSION: The peritoneal recurrence was the most frequently encountered pattern of recurrence. The two years following surgery was the most important period for recurrence. Depth of invasion and lymph node metastasis were related to recurrence with statistical significance. Since the results of treatment remain dismal, studies of perioperative adjuvant therapy in an attempt to reduce recurrence are warranted.
Humans ; Lymph Node Excision ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis ; Recurrence* ; Retrospective Studies ; Risk Factors ; Stomach Neoplasms*

BACKGROUND: Natural moisturizing factors such as sodium pyrrolidone carboxylic acid and lactic acid may play an important role in increasing the moisture retention of isolated stratum corneum and reducing the incidence of dry and flaky skin in vivo. Although the precise mechanism of surfactant irritancy is not fully understood, it has been suggested that barrier dysfunction of stratum corneum by surfactants results in skin changes such as scaling, erythema, and even fissuring. OBJECTIVE: We evaluated the effect of sodium pyrrolidone carboxylic acid(NaPCA) and lactic acid(LA) with several non-invasive measuring methods in the irritated skin reaction induced by sodium lauryl sulphate (SLS) in normal persons and atopic dermatitis patients. METHODS: After skin irritation for 24 hours with patch test of 1% SLS on five volar sites of right forearm, we applied nothing(A), 3% LA+3% NaPCA(B), 3% LA(C), 3% NaPCA(D), and vehi cle(E) twice a day respectively. Visual score, transepidermal water loss(TEWL), water holding capa city(WHC), and erythema index were measured at 30 min, 24hr, 48hr and 72hr after patch removal. RESULTS: 1. After 72hr, the visual scores of B and C were significantly lower than that of A(control) in atopic dermatitis patients, and that of C in normal persons was significantly lower than that of A, D, and E. 2. TEWL values of B and C in both the normal (after 72hr) and atopic dermatitis group (after 48hr and 72hr) were significantly lower than that of A. 3. WHC values of B, C, D in both the normal and atopic dermatitis group were significantly higher than that of A after 48hr and 72hr. 4. After 72hr, erythema indices by Mexameter of B, C, and D in both the normal and atopic dermatitis group were significantly lower than that of A and values of C were significantly lower than that of E. In the atopic dermatitis group, values of D were also significantly lower than that of E. 5. The mean visual score was significantly correlated with TEWL value and erythema index of Mexameter (r=0.58, r=0.64) and the TEWL value was significantly correlated with erythema index of Mexameter (r=0.64). CONCLUSION: These results suggest that topical application of a moisturizing factor might improve the surfactant-induced disruption of permeability barrier with improvement of the water holding capacity of the stratum corneum.
Dermatitis, Atopic* ; Erythema ; Forearm ; Humans ; Incidence ; Lactic Acid* ; Patch Tests* ; Permeability ; Skin* ; Sodium* ; Surface-Active Agents

Interstitial lung disease (ILD) is a rare condition characterized by extensive inflammation and fibrosis mainly involving the pulmonary interstitium or alveoli. Usually, patients with ILD clinically present with chronic cough and exertional dyspnea. ILD is classified into subtypes based on clinical characteristics, detailed history obtained from patients, and radiological, and/or histopathological features. The most common type of idiopathic interstitial pneumonia is idiopathic pulmonary fibrosis (IPF). IPF is a chronic progressive fibrosing ILD and is associated with poor prognosis. An exclusive diagnosis of IPF requires no known condition causing ILD and typical radiological and/or histopathological features of lung fibrosis. Fibrosis observed in this condition is attributable to repetitive epithelial injury with consequent abnormal wound healing in genetically susceptible and elderly individuals. Currently, pirfenidone and nintedanib are useful disease-modifying agents available to treat IPF. In this article, we review the concept, diagnosis, clinical course, and treatment of ILD.
Aged ; Cough ; Diagnosis ; Dyspnea ; Fibrosis ; Humans ; Idiopathic Interstitial Pneumonias ; Idiopathic Pulmonary Fibrosis ; Inflammation ; Lung ; Lung Diseases, Interstitial ; Prognosis ; Wound Healing

Interstitial lung disease (ILD) is a rare condition characterized by extensive inflammation and fibrosis mainly involving the pulmonary interstitium or alveoli. Usually, patients with ILD clinically present with chronic cough and exertional dyspnea. ILD is classified into subtypes based on clinical characteristics, detailed history obtained from patients, and radiological, and/or histopathological features. The most common type of idiopathic interstitial pneumonia is idiopathic pulmonary fibrosis (IPF). IPF is a chronic progressive fibrosing ILD and is associated with poor prognosis. An exclusive diagnosis of IPF requires no known condition causing ILD and typical radiological and/or histopathological features of lung fibrosis. Fibrosis observed in this condition is attributable to repetitive epithelial injury with consequent abnormal wound healing in genetically susceptible and elderly individuals. Currently, pirfenidone and nintedanib are useful disease-modifying agents available to treat IPF. In this article, we review the concept, diagnosis, clinical course, and treatment of ILD.