To provide the information about overall test reliability and test improvement, we analyzed the first fundamental medical sciences examination at the Kon-Kuk University College of Medicine on August 23, 1997. The results are as follows: 1. The number of the items in the test is 230. The range of the scores is from 32.5 to 61.3(average percentage score: 50.0+/-6.1). Among the 39 students, three(7.7%) passed the examination with percentage scores of higher than 60. 2. The correlation coefficients between the fundamental medical sciences examination and academic records are 0.4682(the first semester in 1st grade), 0.5933(the second semester in 1st grade), and 0.6538(the first semester of 2nd grade), respectively. 3. Among the 230 items, 47(20.4%) are too difficult or too easy. Therefore these items are recommended to be discarded. 4. Among the 230 items, 115(50%) have lower discriminative indices(lower than 0.14) and 55(23.9%) have higher discriminative indices(higher than 0.23). 5. Among the 230 items, overall acceptable items are 101; the range of difficulty is 0.15~0.84 and discriminative indices are higher than 0.15. Good acceptance is shows in pharmacology and microbiology.
Humans ; Pharmacology

Pregnant women with antiphospholipid syndrome (APS) carry a high risk of arterial or venous thrombosis. Such thrombotic conditions occur more frequently in patients with triple positivity to antiphospholipid antibodies or with high antibody titers. Hepatic infarction is a rare complication in pregnant women with APS, and it sometimes mimics HELLP syndrome. This report describes a preeclamptic pregnant woman with APS who had high titers of three antiphospholipid antibodies. She experienced severe epigastric pain with elevated liver enzymes; in addition, she had tachycardia and tachypnea. The clinical findings suggested hepatic infarction and pulmonary thromboembolism, a partial manifestation of catastrophic APS. Therefore, she underwent emergent cesarean section at 25+2 weeks of gestation. After the delivery, her laboratory test indicated HELLP-like features, and computed tomography confirmed hepatic infarction and pulmonary micro-thromboembolism. Here, we report a case of a partial manifestation of catastrophic APS in a pregnant woman with triple antibody positivity, including a brief literature review.
Antibodies, Antiphospholipid ; Antiphospholipid Syndrome* ; Cesarean Section ; Female ; HELLP Syndrome ; Humans ; Infarction* ; Liver ; Pregnancy ; Pregnant Women* ; Pulmonary Embolism ; Tachycardia ; Tachypnea ; Venous Thrombosis

PURPOSE: Despite refinements in the surgical techniques for adult-to-adult living donor liver transplantation (ALDLT), biliary complications still remain the Achilles' heel of ALDLT. Moreover, there is no consensus for the ideal technique of biliary reconstruction to reduce the rate of complications to an acceptable range. We strove to collate the available data of the current surgical techniques for biliary reconstruction in ALDLT in Korea. METHODS: A questionnaire concerning the surgical techniques for biliary reconstruction was sent to 9 surgeons who performed biliary anastomosis in the major LDLT centers of Korea (the response rate was 100%). RESULTS: MR cholangiography (n=7) and/or intra-operative cholangiography (n=5) were routinely performed to evaluate the donor biliary anatomy. All the participants (n=9) preferred duct-to-duct anastomosis to hepatico-jejunostomy. Anastomosis was usually made on the whole layer (n=7 epithelium, n=2) of recipient's common hepatic duct under loupe magnification (n=8); only one center reconstructed the anastomosis on the 2nd order hepatic duct under view of a surgical microscope. There were various techniques for biliary reconstruction as follows: suture material (absorbable: n=5, non-absorbable: n=4), suture method (continuous: n=4, interrupted: n=3, mixed: n=3) and the use of a biliary stent (routine: n=3, sometimes: n=5, rare: n=1). Ductoplasty was performed on the back table (n=7) for the cases with a very close distance (<5 mm) between the bile ducts' openings, but each duct was separately anastomosed to the recipients' bile duct (n=8) or a roux-en-Y limb (n=1) was done in cases with a distance more than 10 mm. CONCLUSION: In 9 LDLT centers of Koreas, duct-to-duct was preferred; however, there was no unique consensus, among the major centers, for the biliary reconstruction techniques that might reduce complications.
Bile ; Bile Ducts ; Cholangiography ; Consensus ; Epithelium ; Extremities ; Heel ; Hepatic Duct, Common ; Humans ; Korea ; Liver ; Liver Transplantation ; Living Donors ; Stents ; Sutures ; Tissue Donors ; Surveys and Questionnaires

Pregnant women with antiphospholipid syndrome (APS) carry a high risk of arterial or venous thrombosis. Such thrombotic conditions occur more frequently in patients with triple positivity to antiphospholipid antibodies or with high antibody titers. Hepatic infarction is a rare complication in pregnant women with APS, and it sometimes mimics HELLP syndrome. This report describes a preeclamptic pregnant woman with APS who had high titers of three antiphospholipid antibodies. She experienced severe epigastric pain with elevated liver enzymes; in addition, she had tachycardia and tachypnea. The clinical findings suggested hepatic infarction and pulmonary thromboembolism, a partial manifestation of catastrophic APS. Therefore, she underwent emergent cesarean section at 25+2 weeks of gestation. After the delivery, her laboratory test indicated HELLP-like features, and computed tomography confirmed hepatic infarction and pulmonary micro-thromboembolism. Here, we report a case of a partial manifestation of catastrophic APS in a pregnant woman with triple antibody positivity, including a brief literature review.
Antibodies, Antiphospholipid ; Antiphospholipid Syndrome* ; Cesarean Section ; Female ; HELLP Syndrome ; Humans ; Infarction* ; Liver ; Pregnancy ; Pregnant Women* ; Pulmonary Embolism ; Tachycardia ; Tachypnea ; Venous Thrombosis

PURPOSE: Cystatin C is known to predict the glomerular filtration rate (GFR) more precisely in patients with substantial muscle atrophy, such as liver cirrhosis, compared to creatinine. We evaluated the usefulness of cystatin C for prediction of renal function in liver cirrhosis patients. METHODS: From February 2007 to September 2007, we evaluated the renal function in patients with liver cirrhosis who were admitted to Soonchunhyang University Bucheon Hospital. We compared renal function with GFR as estimated by creatinine (Modification of diet in renal diseases; MDRD, the Cockroft&Gault equation; C&G, Creatinine clearance; CCr) and cystatin C (the Hoek and Larsson equations) with that of the GFR as calculated by Cr-EDTA. RESULTS: A total of 46 patients were enrolled. The mean GFR was 67.8+/-29.4, 81.6+/-29.6, 79.9+/-29.3, 62.7+/-29.8, 77.0+/-28.6, 81.0+/-35.2 mL/min/1.73m2 according to Cr-EDTA, MDRD, C&G, CCr, Hoek and Larsson equations, respectively. Cystatin C showed a correlation to MDRD (r=-0.715), C&G (r=-0.659), CCr (r=-0.536) and Cr-EDTA GFR (r=-0.617). GFR by the Hoek (r=0.657) and the Larsson (r=0.647) equation using cystatin C showed a higher correlation with Cr-EDTA GFR than GFR by MDRD (r=0.550) and C&G equation (r=0.458). CONCLUSION: Cystatin C is a more accurate predictor of renal function than creatinine in patients with liver cirrhosis.
Creatinine ; Cystatin C ; Diet ; Glomerular Filtration Rate ; Humans ; Liver ; Liver Cirrhosis ; Muscular Atrophy

Thyroid cancer is the most common malignancy in Korea; in 2012, about 44,000 new cases (19.6% of all malignancies) were registered and the estimated age-standardized incidence rate of thyroid cancer was 73.6 per 100,000 (17.3 and 88.6 per 100,000 in men and women, respectively). Despite the steep increase in its incidence, the age-standardized mortality rate of thyroid cancer has remained stable and 10-year relative survival rate is 99.2%. Increased detection using high-resolution ultrasonography may have contributed to the increased incidence of thyroid cancer if not all. However, the effectiveness of thyroid cancer screening using ultrasonography has not been fully evaluated as to whether screening and early diagnosis could decrease the morbidity or mortality of thyroid cancer. A multidisciplinary expert committee for developing a guideline for thyroid cancer screening was organized and established a recommendation for thyroid cancer screening using ultrasonography in Korea based on scientific evidence for the first time. In conclusion, the current evidence is insufficient to assess the balance of benefits and harms of the thyroid cancer screening by ultrasonography and the recommendation is that thyroid ultrasonography is not routinely recommended for healthy subjects.
Early Detection of Cancer ; Early Diagnosis ; Female ; Humans ; Incidence ; Korea ; Male ; Mass Screening* ; Mortality ; Survival Rate ; Thyroid Gland ; Thyroid Neoplasms* ; Ultrasonography

OBJECTIVE: To evaluate the prevalence of known risk factors for contrast-induced nephropathy (CIN) and their association with the actual occurrence of CIN in patients undergoing intravenous contrast-enhanced computed tomography (CECT) in Korea. MATERIALS AND METHODS: Patients who underwent CECT in 2008 were identified in the electronic medical records of 16 tertiary hospitals of Korea. Data on demographics, comorbidities, prescriptions and laboratory test results of patients were collected following a standard data extraction protocol. The baseline renal function was assessed using the estimated glomerular filtration rate (eGFR). We identified the prevalence of risk factors along the eGFR strata and evaluated their influence on the incidence of CIN, defined as a 0.5 mg/dL or 25% increase in serum creatinine after CECT. RESULTS: Of 432425 CECT examinations in 272136 patients, 140838 examinations in 101487 patients met the eligibility criteria for analysis. The mean age of the participants was 57.9 +/- 15.5 years; 25.1% of the patients were older than 70 years. The prevalence of diabetes mellitus was 11.9%, of hypertension 13.7%, of gout 0.55% and of heart failure was 1.7%. Preventive measures were used in 40238 CECT examinations (28.6%). The prevalence of risk factors and use of preventive measures increased as the renal function became worse. A CIN was occurred after 3103 (2.2%) CECT examinations, revealing a significant association with decreased eGFR, diabetes mellitus, and congestive heart failure after adjustment. CONCLUSION: Risk factors for CIN are prevalent among the patients undergoing CECT. Preventive measures were seemingly underutilized and a system is needed to improve preventive care.
Adult ; Aged ; Aged, 80 and over ; Comorbidity ; Contrast Media/*adverse effects ; Female ; Glomerular Filtration Rate ; Humans ; Incidence ; Kidney Diseases/*chemically induced/epidemiology/*radiography ; Male ; Middle Aged ; Prevalence ; Republic of Korea/epidemiology ; Risk Factors ; Tomography, X-Ray Computed/*methods

No abstract available.
Humans ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroid Nodule*

No abstract available.
Humans ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroid Nodule*

Background/Aims: While switching strategies of P2Y12 receptor inhibitors (RIs) have sometimes been used in acute myocardial infarction (AMI) patients, the current status of in-hospital P2Y12RI switching remains unknown. Methods: Overall, 8,476 AMI patients who underwent successful revascularization from Korea Acute Myocardial Infarction Registry-National Institute of Health (KAMIR-NIH) were divided according to in-hospital P2Y12RI strategies, and net adverse cardiovascular events (NACEs), defined as a composite of cardiac death, non-fatal myocardial infarction (MI), stroke, or thrombolysis in myocardial infarction (TIMI) major bleeding during hospitalization were compared. Results: Patients with in-hospital P2Y12RI switching accounted for 16.5%, of which 867 patients were switched from clopidogrel to potent P2Y12RI (C-P) and 532 patients from potent P2Y12RI to clopidogrel (P-C). There were no differences in NACEs among the unchanged clopidogrel, the unchanged potent P2Y12RIs, and the P2Y12RI switching groups. However, compared to the unchanged clopidogrel group, the C-P group had a higher incidence of non-fatal MI, and the P-C group had a higher incidence of TIMI major bleeding. In clinical events of in-hospital P2Y12RI switching, 90.9% of non-fatal MI occurred during pre-switching clopidogrel administration, 60.7% of TIMI major bleeding was related to pre-switching P2Y12RIs, and 71.4% of TIMI major bleeding was related to potent P2Y12RIs. Only 21.6% of the P2Y12RI switching group switched to P2Y12RIs after a loading dose (LD); however, there were no differences in clinical events between patients with and without LD. Conclusions In-hospital P2Y12RI switching occurred occasionally, but had relatively similar clinical outcomes compared to unchanged P2Y12RIs in Korean AMI patients. Non-fatal MI and bleeding appeared to be mainly related to pre-switching P2Y12RIs.