Spontaneous gastric perforation in the newborn is a rare disease that requires early diagnosis and prompt surgical treatment. Between 1988 and 2001 at the Department of Pediatric Surgery, Kyungpook National University Hospital, 9 cases of spontaneous gastric perforation were treated. Seven were males and two females. The mean gestational age and birth weight were 36.7 weeks and 2,455 grespectively. All patients presented with severe abdominal distention and pneumoperitoneum on cross table lateral film of the abdomen. Perforations were located on the anterior wall along the greater curvature of the stomach in six and on the posterior wall along the greater curvature in two. One case showed two sites of perforation on the anterior and posterior wall along the greater curvature. Six patients were managed with debridement and primary closure and the others with debridement and partial gastrectomy. Peritoneal drainage was not performed. There were four deaths; two from sepsis due to leakage from the anastomotic site, one as a result of acute renal failure, and the other by associated respiratory distress syndrome. Spontaneous gastric perforation in the newborn is usually located along the greater curvature. Elevated intragastric pressure is a possible cause of the perforation. Poor prognosis is related to associated diseases and prematurity.
Abdomen ; Acute Kidney Injury ; Birth Weight ; Debridement ; Drainage ; Early Diagnosis ; Female ; Gastrectomy ; Gestational Age ; Gyeongsangbuk-do ; Humans ; Infant, Newborn* ; Male ; Pneumoperitoneum ; Prognosis ; Rare Diseases ; Sepsis ; Stomach

PURPOSE: The purpose of this study is to provide basic data for the development of a career guidance program through a demand survey. For this purpose, three study topics were examined: Is there a difference between the satisfaction and importance of a career program? Is there a difference between the satisfaction and importance of a career program by gender, grade level? and What type of mentor and the mentoring way of medical students demanded? METHODS: The subjects were 380 students at Seoul National University College of Medicine. The data were analyzed by frequency analysis, paired t-test, and Borich's formula. RESULTS: By t-test with matched samples for satisfaction-importance, We noted statistically significant differences in all domains. In particular, the difference was greater in the second year. According to the needs analysis, the most urgent program is meeting with seniors in various career areas. Also, medical students hope for mentor from clinical professors of the university and successful medical practitioners, and personal counseling. CONCLUSION: These results show that medical students need a career guidance program. The findings of the study can be used to guide the development of career education programs and curriculum for medicine students.
Counseling ; Curriculum ; Education ; Hope ; Humans ; Mentors ; Seoul ; Students, Medical

The main points of issue with the former premedical curriculum of Seoul National University College of Medicine (SNUCM) were the absence of educational objectives, decline in student motivation caused by uniform education, students' lack of a sense of belonging, and lack of humanistic education. In accordance with these issues, there were five aspects considered for the improvement of the premedical curriculum: reform based on the newly established educational objectives that corresponds with the 6-year medical school curriculum as a whole, expansion of elective courses and the development of personalized curriculum for the improvement of students' learning motives, expansion of social sciences and humanities curriculum for the development of students' capabilities as good doctors, active participation of medical professors in premedical education, and expansion of informal education and the student support program. According to the assessment done after the implementation of the reformed curriculum, premedical students were gratified with its establishment and management of multifarious liberal arts and major subjects. In preparation of the more rigorous entrance quota of the premedical school at SNUCM, there is ongoing reform of required major subjects and establishment of new subjects in the premedical curriculum in pursuit of unity with the 6-year medical curriculum. Moreover, there is ongoing development of an e-portfolio system for the association of premedical and medical education, integration of formal and informal curriculum, and reinforcement of student observation and formative evaluation. Further discussion on the assessment and betterment of premedical curriculum is needed.
Clothing ; Curriculum ; Education ; Education, Medical ; Education, Premedical ; Humanities ; Humans ; Learning ; Motivation ; Schools, Medical ; Seoul ; Social Sciences ; Students, Premedical

Purpose: In this study, we examined change in the number of cataract surgeries from 2013 to 2018, since the implementation of institutional changes in 2012, and the introduction of diagnosis-related groups (DRGs) and a gradual reduction in selective-medical expenses from 2014. Methods: Based on data from the main surgery statistical yearbook provided by the Korea National Health Insurance Service (KNHIS), we extracted the number of cataract surgeries nationwide by year from 2013 to 2018. Data were divided by sex, age, regions, and level of healthcare providers in an effort to understand changes that occurred in the number of cataract surgeries and the reasons for these changes. Statistical analysis was carried out using joint point regression. Results: The total number of cataract surgeries per 100,000 people increased by 32.9% over the six-year period, with an annual average increase of 5.9%. Females (58.0-59.2%) had more cataract surgeries than males (40.8-42.0%). Additionally, the number of cataract surgeries per 100,000 people rose over the six-year time frame for those aged under 40 years, and for those in their 40s, 50s, and 60s. In terms of regions and patients’ residence, urban areas such as Seoul, Pusan, and Daegu showed an increase in surgeries performed; most provinces, however, with the exception of Jeju Island, indicated a relative decline in cataract surgeries. There was no difference in the number of cataract surgeries performed over the six-year period in terms of the level of healthcare providers. Conclusions The number of cataract surgeries per 100,000 people rose over the six-year period between 2013 and 2018. By region, an increasing trend was observed in urban areas; however, the level of the healthcare providers did not appear to have an effect on the number of cataract surgeries performed.

Purpose: D-dimer levels are known to be associated with poor outcomes in patients with various cancers, but their significance at the end of life remains unclear. This study investigated D-dimer levels as a prognostic indicator for terminal cancer patients in the last hours of life. Methods: The retrospective study was conducted at a palliative care unit of a tertiary cancer center, using a database to analyze the records of patients treated from January 1, 2010 to December 31, 2018. In total, 67 terminal cancer patients with available data on Ddimer levels were included. Patients’ demographic data, clinical information, and laboratory values, including D-dimer levels, were collected. Survival was analyzed using the Kaplan– Meier method and the log-rank test. A Cox proportional-hazards model was used to identify prognostic factors of poor survival. Results: The most common site of cancer was the lung (32.8%) and the median survival time was 5 days. Most laboratory results, particularly D-dimer levels, deviated from the normal range. Patients with high D-dimer levels had a significantly shorter survival time than those with low D-dimer levels (4 days vs. 7 days; P=0.012). In the Cox regression analysis, only a high D-dimer level was identified as a predictor of a poor prognosis (hazard ratio, 1.83; 95% confidence interval, 1.09~3.07). Conclusion Our results suggest that at the very end of life, D-dimer levels may serve as a prognostic factor for survival in cancer patients.

BACKGROUND: The aim of this study was to compare breast and cervical cancer screening rates between female cancer survivors and a population without cancer to identify factors related to cervical and breast cancer screening in cancer survivors. METHODS: We included 17,765 adults (738 cancer survivors and 17,027 individuals without cancer) in this study, all of whom who were 30 years of age or older and participated in the Fourth and Fifth Korean National Health and Nutritional Examination Surveys from 2007–2012. Multiple logistic regression analysis was performed to identify factors related to cervical and breast cancer screening uptake in female cancer survivors. RESULTS: The screening rate for breast cancer was 56.6%, which was higher than that in the non-cancer control group (P=0.001). The screening rate for cervical cancer was 51.4%, which was not different from that of the non-cancer control group. In terms of breast cancer screening, cancer survivors showed no significant difference in the rate of screening 5 years after their cancer diagnosis. However, cervical cancer survivors were less likely to have cervical cancer screening 10 years after their cancer diagnosis. There was no significant association between cancer screening and sociodemographic factors. CONCLUSION: Breast and cervical cancer screening rates in Korean female cancer survivors are low. Secondary primary cancer screening of female cancer survivors needs to be planned in a comprehensive manner, with the consideration of influences beyond sociodemographic factors.
Adult ; Breast Neoplasms ; Breast* ; Diagnosis ; Early Detection of Cancer ; Female* ; Humans ; Korea* ; Logistic Models ; Mass Screening* ; Nutrition Surveys* ; Survivors* ; Uterine Cervical Neoplasms*

PURPOSE: Seoul National University College of Medicine (SNUMC) introduced a multiple mini-interview (MMI) to assess the noncognitive ability of applicants in 2013. This study aims to examine whether students differ with regard to their personal career values and academic achievements by admission type. METHODS: We administered a survey about career values and self-perception of competencies. We then compared the survey results and academic achievements by admission type. Finally, the correlation coefficient between MMI score and academic achievement was calculated in the MMI group. The data were analyzed by t-test and correlation analysis. RESULTS: There was no statistically significant difference in career values between groups. For self-perception of competency, only the 'interact in heterogeneous groups' domain was higher for those who entered through the MMI. The MMI group had a higher and broader level of academic achievement. Within the MMI group, there was a significant correlation between grade point average and MMI station scores. CONCLUSION: The characteristics of students who entered through the MMI were more in accordance with the goals of SNUMC and the competency of future doctors. Considering the unique feature of premedical academic achievement, this result implies that such students have superior noncognitive abilities, such as self-development and internal motivation. How these differences change subsequently remains to be seen.
Humans ; Motivation ; Schools, Medical* ; Self Concept ; Seoul ; Students, Premedical

PURPOSE: The educational purpose of a medical school is important, because it guides educational decisions in an individual organization and projects the image of the doctors that we are generating. By analyzing the educational goals of entire medical schools, this study aimed to examine the current orientation and future direction of undergraduate medical education in Korea. METHODS: Educational goals were collected from the website of each medical school and subjected to inductive content analysis. After identifying categories and themes, we examined the differences between medical school subgroups and compared the categories with competencies that have been suggested by the "Korean Doctor's Role." RESULTS: Thirteen themes were identified: medical expertise, professionalism, contribution to various levels of society, self-management and development, basic educational ideology, research ability, cooperation, leadership, dealing with future change, respect for life, creativity, problem-solving ability, and ability to educate. There was a significant difference in educational goals between medical schools when grouped by geographic location and affiliation of research-driven hospitals. Of the 16 competencies that are suggested by the Korean Doctor's Role, 12 had one or more corresponding categories. CONCLUSION: Per their current educational purposes, Korean medical schools pursue a broad variety of competencies that need cultivating during the course of undergraduate medical education. Further research is needed to determine how best to apply these educational purposes in actual institutions and ultimately lead them to become part of the competency of a graduate.
*Education, Medical, Undergraduate ; *Goals ; Humans ; *Professional Competence ; Republic of Korea ; *Schools, Medical

PURPOSE: The Lee Jong-Wook Seoul Project, which began in 2011, is a training program that aims to educate faculty members of Lao University of Health Sciences in medical knowledge and skills. The project has tremendous significance, attempting to apply the Korean health care developmental model to developing countries. Precise evaluation of the project outcome must be performed to enhance the effectiveness, improve the shortcomings, and adjust the future direction of the program. METHODS: Trainers and exchange professors were asked to fill out questionnaires in the middle and at the end of the program. Eight months after its completion, an evaluation team visited Lao and interviewed each exchange professor individually. Also, 360-degree feedback was obtained from their colleagues. We analyzed the answers to the questionnaires, based on Kirkpatrick's 4-level model. RESULTS: The trainers and exchange professors had positive reactions to the program. All participants felt that their knowledge and skills improved (in their respective fields), although the actual improvement was not extensive, according to their trainers' assessments. The 360-degree feedback demonstrated that the participants actively passed on their experience, knowledge, and skills to their colleagues on returning to work. CONCLUSION: Although a 4-level evaluation was not conducted and despite the limitations in examining academic achievement, interviewing Lao professors, and acquiring quantitative data at Lao University of Health Sciences, this project has demonstrated its value in the development of individual professors and their colleagues.
Delivery of Health Care ; Developing Countries ; Education ; Seoul* ; Surveys and Questionnaires

Arthritis of hip joints deteriorates the quality of life in ankylosing spondylitis (AS) patients. Secondary to the articular inflammatory process, the shortened hip-girdle muscles contribute to the decreased joint mobility which may lead to the functional impairment. As the limitation of range of motion (ROM) usually progress slowly, clinicians regard it as a chronic condition and prescribe long-term therapy. However, by short-term intensive multimodal treatment, a 20-year-old man diagnosed as AS with severely limited hip joint ROM who relied on crutches doubled the joint angle and could walk independently only within 2 weeks. The combination included intra-articular steroid injection, electrical twitch obtaining intramuscular stimulation, extracorporeal shock wave therapy, heat, manual therapy, and stretching exercises. The management focused on the relaxation of hip-girdle muscles as well as the direct control of intra-articular inflammation. Hereby, we emphasize the effectiveness of intensive multimodal treatment in improving the function even within a short period.
Arthritis ; Combined Modality Therapy ; Crutches ; Exercise ; Hip Joint ; Hip ; Hot Temperature ; Humans ; Inflammation ; Joints ; Muscle Relaxation ; Muscles ; Musculoskeletal Manipulations ; Quality of Life ; Range of Motion, Articular ; Relaxation ; Shock ; Spondylitis, Ankylosing ; Young Adult