A clinical study was made of 14 cases of distal rectal cancer treated at the Department of Surgery, St. Mary's Hospital, Catholic University Medical College, from January 1995 to April 1996. The patients were treated in a modified Thomas Jefferson program and received high doses of preoperative radiation followed by a sphincter saving procedure. The results are as follows: 1) There were 5 male patients (35.7%) and 9 female patients(64.3%). There was also a large number of patients in their 50s and 60s. 2) The preoperative pathologic type was a moderately differentiated adenocarcinoma. 3) Rectal bleeding was the most common symptom, followed by tenesmus, constipation, anal pain, and a tarry stool. 4) At diagnosis, the Thomas Jefferson (T.J.) system was used for the clinical stage of the patients. The clinical stage of disease showed a preponderance of T.J. stage I (10 patients), T.J stage II, III, and IV occurred in 2, 1, and 1 patient, respectively. 5) The most common site was 0-3 cm above dentate line (8 patients), followed by 4-6 cm (5 patients) and > 7 cm (1 patient) above the dentate line. 6) The complications after preoperative radiation therapy were diarrhea (3 patients) and perianal dermatitis (5 patients). 7) After preoperative radiation therapy, one case showed pathologic complete remission. 8) The procedure was a Transanal Abdominal TransAnal proctosigmoidectomy and coloanal anastomosis (TATA) in 11 patients, a low anterior resection in 1 patient, an abdominal perineal resection in 1 patient, and a colostomy in 1 patient. 9) The pathologic stage showed a preponderance of Duke's B2 and B1; 5 were B2, 4 were B1, 3 were C2, 1 was D, and 1 was O. 10) The postoperative complications after colostomy repair in TATA were frequent defecation, tenesmus, anal pain at defecation, and rectovaginal fistulas which subsided 3 months after colostomy repair.
Adenocarcinoma ; Colostomy ; Constipation ; Defecation ; Dermatitis ; Diagnosis ; Diarrhea ; Female ; Hemorrhage ; Humans ; Male ; Postoperative Complications ; Rectal Neoplasms* ; Rectovaginal Fistula

The heart may be critically damaged by objects of unimpressive size or appearance. We report a case of cardiac tamponade due to penetration of the right ventricle by an acupunture needle. A 59-year-old man was admitted due to dyspnea and chest pain. He had recieved acupuncture therapy during 10 years for chronic right upper abdominal pain. He was diagnosed as cardiac tamponade due to hemopericardium caused by an broken a cupuncture needle detected on fluoroscopy, computerized tomography and trans-esophageal echocardiography, and the needle was successfully removed by cardiac surgery. The patient was discharged uneventfully and followed at the outpatient department.
Abdominal Pain ; Acupuncture Therapy ; Cardiac Tamponade* ; Chest Pain ; Dyspnea ; Echocardiography ; Fluoroscopy ; Heart ; Heart Ventricles ; Humans ; Middle Aged ; Needles* ; Outpatients ; Pericardial Effusion ; Thoracic Surgery

PURPOSE: The purpose of this study is to understand student recognition of CBT as well as its strengths and weaknesses, and to explore the improvement methodologies for the effective development and implementation of CBT. METHODS: A questionnaire survey was conducted twice (before and after implementation of CBT) with a total of 17 multiple-choice and 2 essay-type questions. The multiple-choice questions were analyzed by frequency analysis and the essay-type questions were coded by content analysis. RESULTS: The results are as follows. First, the overall satisfaction with CBT was shown to be high. Second, students listed the merits of CBT as follows: simple correction of answers (before: 89.4%; after: 80.8%), presentation of realistic materials (before: 72.9%; after: 84.7%), prompt feedback on grades (before: 60.3%; after: 71.1%), shortened exam time and effective time scheduling (before: 86.5%; after: 66.4%), accurate estimation of abilities (before: 70.2%; after: 36.6%), and assistance in academic improvement (before: 70.9%; after: 22.1%). Drawbacks of CBT were: inconvenience of review (before: 70.9%; after: 22.1%), inconvenient screen organizations (before: 0%; after: 48.1%), possibility of cheating (before: 73.9%; after: 31.8%), and equality issue of test (before: 47.3%; after: 17.3%). CONCLUSION: Assessment paradigms are currently shifting from summative evaluation to formative evaluation, from one-off assessment to continuous assessment, and from output assessment to process assessment. Therefore, CBT must be expanded to move from result-oriented summative evaluation to formative evaluation continuously monitoring the student learning process.
Education, Medical ; Humans ; Learning ; Process Assessment (Health Care) ; Surveys and Questionnaires

Background: Psoriasis is a chronic disease that can have accompanying comorbidities including arthritis, metabolic syndrome, and cardiovascular diseases. Patients with psoriasis tend to frequently visit medical institutions, and their economic burden for medical services is high. Objective: To investigate the economic burden of psoriasis in Korea. Methods: The Korean Society for Psoriasis conducted a multi-center field survey of the patients and analyzed the national insurance claim data. Also, we discussed the medical environment of psoriasis in Korea based on the results. Results: The economic burden of psoriasis patients is substantial and varied by the type of medical institute. Patients also paid the indirect and intangible medical costs. Biological agents, which is used in patients with severe psoriasis, led to an increase in the cost. Conclusion This is the first study to estimate the economic burden of psoriasis in Korea comprehensively. To improve the medical environment of psoriasis and alleviate the burden of patients, discussion on the more efficient health policy and medical insurance criteria for psoriasis would be needed.

Background: Psoriasis is a chronic disease that can have accompanying comorbidities including arthritis, metabolic syndrome, and cardiovascular diseases. Patients with psoriasis tend to frequently visit medical institutions, and their economic burden for medical services is high. Objective: To investigate the economic burden of psoriasis in Korea. Methods: The Korean Society for Psoriasis conducted a multi-center field survey of the patients and analyzed the national insurance claim data. Also, we discussed the medical environment of psoriasis in Korea based on the results. Results: The economic burden of psoriasis patients is substantial and varied by the type of medical institute. Patients also paid the indirect and intangible medical costs. Biological agents, which is used in patients with severe psoriasis, led to an increase in the cost. Conclusion This is the first study to estimate the economic burden of psoriasis in Korea comprehensively. To improve the medical environment of psoriasis and alleviate the burden of patients, discussion on the more efficient health policy and medical insurance criteria for psoriasis would be needed.

BACKGROUND: Psoriasis is an immune-mediated, chronic inflammatory disease affecting multiple aspects of patients' lives. Its epidemiology varies regionally; however, nationwide epidemiologic data on psoriasis depicting profile of Korean patients has not been available to date. OBJECTIVE: To understand nationwide epidemiologic characteristics and clinical features of adult patients with psoriasis visited university hospitals in Korea. METHODS: This multicenter, non-interventional, cross-sectional study recruited 1,278 adult patients with psoriasis across 25 centers in Korea in 2013. Various clinical data including PASI, BSA, DLQI, SF-36 and PASE were collected. RESULTS: A total of 1,260 patients completed the study (male:female=1.47:1). The mean age was 47.0 years with a distribution mostly in the 50s (24.9%). Early onset (<40 years) of psoriasis accounted for 53.9% of patients. The mean disease duration was 109.2 months; mean body mass index was 23.9 kg/m²; and 12.7% of patients had a family history of psoriasis. Plaque and guttate types of psoriasis accounted for 85.8% and 8.4%, respectively. Patients with PASI ≥10 accounted for 24.9%; patients with body surface area ≥10 were 45.9%. Patients with DLQI ≥6 accounted for 78.8%. Between PASI <10 and PASI ≥10 groups, significant difference was noted in age at diagnosis, disease duration, blood pressure, waist circumference of female, and treatment experiences with phototherapy, systemic agents, and biologics. CONCLUSION: This was the first nationwide epidemiologic study of patients with psoriasis in Korea and provides an overview of the epidemiologic characteristics and clinical profiles of this patient population.
Adult ; Biological Products ; Blood Pressure ; Body Mass Index ; Body Surface Area ; Cross-Sectional Studies* ; Diagnosis ; Epidemiologic Studies ; Epidemiology ; Female ; Hospitals, University ; Humans ; Korea* ; Phototherapy ; Psoriasis* ; Waist Circumference