No abstract available.

No abstract available.
Basal Cell Nevus Syndrome* ; Carcinoma, Basal Cell

This experimental study examined differences in doctor-patient relationships according to the health communication strategies during cases of medical malpractices occurred at primary medical institution. A total of 116 subjects aged in their 20s-50s was sampled. The first medical malpractice scenario chosen was the medical malpractice case most frequently registered at the Korean Medical Association Mutual Aid and the second scenario was associated with materials and devices as the cause of malpractice. Four types of crisis communication strategy messages were utilized, consisting of denial, denial + ingratiation, apology, and apology + ingratiation. Subjects were classified into four research groups by crisis communication strategy to measure levels of trust, control mutuality, commitment, and satisfaction, before and after the occurrence of medical malpractice and application of communication strategies. The findings of this study revealed that the apology strategy, compared with the denial strategy, showed a smaller difference before and after the application of communication strategies in all variables of trust (F = 8.080, F = 5.768), control mutuality (F = 8.824, F = 9.081), commitment (F = 9.815, F = 8.301), and satisfaction (F = 8.723, F = 5.638). Further, a significant interaction effect was shown between variables. The apology strategy, compared with the denial strategy, was effective in the improvement of doctor-patient relationships in both Scenarios I and II. For Scenario I, the apology strategy without ingratiation boosted commitment and satisfaction, but for Scenario II, utilizing the apology strategy with ingratiation boosted the effectiveness of trust and commitment.
Adult ; Female ; *Health Communication ; Humans ; Male ; Malpractice ; Middle Aged ; Non-Randomized Controlled Trials as Topic ; Patient Satisfaction ; Physician-Patient Relations ; Program Evaluation ; Surveys and Questionnaires ; Trust

It is widely believed that effective communication is critical for the containment of the spread of emerging infectious diseases. Various media outlets and studies have pointed out communication failure as one of the key components that contributed to the wide and rapid spread of Middle East respiratory syndrome coronavirus in South Korea. To address these concerns, we first outline the definitions of risk and crisis communication and why they are important. We then illustrate communication models and guidelines utilized in three organizations (World Health Organization, US Centers for Disease Control and Prevention, and UK Public Health England) for health or disaster control. By analyzing the current guidelines for infectious diseases in South Korea and they were actually applied during the Middle East respiratory syndrome situation, we will assess what went wrong and what went right. Finally, we will suggest various measures that will help to ensure similar tragedies do not happen again.
Centers for Disease Control and Prevention (U.S.) ; Communicable Diseases ; Communicable Diseases, Emerging ; Containment of Biohazards ; Coronavirus ; Coronavirus Infections ; Disasters ; Korea ; Middle East ; Public Health*

Residents who are currently in the process of completing graduate medical education (GME) will eventually become independently practicing professionals; therefore, the quality of GME is of enormous importance for our society. To improve the quality of GME in Korea, we, as young doctors, suggest that the government support funding for GME; make all possible efforts to ensure reasonable and sustainable working conditions for residents; implement adequate maternity plans; prohibit all kinds of unauthorized medical practice by other healthcare providers; and prevent all kinds of workplace violence toward residents. These measures to improve the quality of GME will surely benefit patient safety and the overall quality of healthcare in the future.
Delivery of Health Care* ; Education, Medical, Graduate ; Financial Management ; Health Personnel ; Humans ; Internship and Residency ; Korea* ; Patient Safety ; Quality of Health Care ; Workplace Violence

Rhabdomyosarcoma is a malignant soft tissue tumor which shows skeletal muscle differentiation. Leptomeningeal metastasis can occur as a late complication, but currently there are no reports that have documented the cytologic features in cerebrospinal fluid (CSF). We report a case of metastatic alveolar rhabdomyosarcoma diagnosed in the CSF of a 28-year-old male who was originally diagnosed with rhabdomyosarcoma on the neck, and that went through systemic therapy. The tumor was positive for anaplastic lymphoma kinase, but progressed despite additional therapy with crizotinib. The CSF specimen revealed small round cells, large atypical cells with abundant cytoplasm and eccentric nuclei, and cells with horseshoe-shaped nuclei. These cytologic findings were in agreement with previous literature and well-correlated with histopathology. This is the first report to document the cytologic feature of rhabdomyosarcoma in CSF. In many cases it is difficult to perform ancillary tests in a CSF specimen and cytopathologists should be aware of the cytomorphologic characteristics to avoid misdiagnosis.
Adult ; Cerebrospinal Fluid ; Cytoplasm ; Diagnosis ; Diagnostic Errors ; Humans ; Lymphoma ; Male ; Muscle, Skeletal ; Neck ; Neoplasm Metastasis ; Phosphotransferases ; Rhabdomyosarcoma ; Rhabdomyosarcoma, Alveolar

Purpose: To evaluate the axillary recurrence rate and usefulness of axillary ultrasound (AUS) during supplementary whole-breast ultrasound (US) screening in women with a personal history of breast cancer (PHBC). Methods: A retrospective database search identified consecutive asymptomatic women who underwent postoperative supplemental whole-breast US screening, including that of the bilateral axillae, after negative findings on mammography between January and June 2017. Using the pathologic data or at least 1-year follow-up data as reference standards, the axillary recurrence rate, cancer detection rate (CDR), interval axillary recurrence rate per 1,000 screenings, sensitivity, specificity, and abnormal interpretation rate (AIR) were estimated. Results: From the data of 4,430 women (mean age, 55.0 ± 10.1 years) analyzed in this study, there were five axillary recurrence cases (1.1/1,000) in the median follow-up period of 57.2 months. AUS showed a CDR of 0.2 (1/4,430; 95% confidence interval [CI], 0.01–1.3) and an interval axillary recurrence rate of 0.9 (4/4,402; 95% CI, 0.2–2.3) per 1,000 examinations. The sensitivity and specificity were 20.0% (1/5; 95% CI, 0.5–71.6), and 99.4% (4,398/4,425; 95% CI, 99.1–99.6), respectively, while the AIR was 0.6% (28/4,430; 95% CI, 0.4–0.9%). Conclusion In asymptomatic women with a PHBC and negative findings on mammography, axillary recurrence after breast cancer and axillary treatment was uncommon, and the supplemental AUS screening yielded 0.2 cancers per 1,000 examinations.

BACKGROUND: Cord blood has been established as an alternative source of hematopoietic reconstituting cells for allogeneic transplantation. CHA cord blood bank, I-CORD has been followed the 'Rubinstein method', which is manual method for collecting mononuclear cells (MNCs). The problem of these manual methods are the risk of bacterial contamination and poor reliability. Recently, an automated method running on the Sepax(R) system (Biosafe S.A., Eysins, Switzerland) has been developed and we compared the results of automated system and manual technique. METHODS: For the total 40 cord blood donations to CHA cord blood bank I-CORD, we processed with manual method using Rubinstein protocol or automated method using "Sepax(R)" (Biosafe S.A.). The recovery rate of total leukocytes and mononuclear cells and hematocrit ratio were compared after processing. RESULTS: The mean ratio of hematocrit after/before processing was significantly lower in samples processed by using manual method (0.96+/-0.42) than "Sepax(R)" (1.4+/-0.4). The WBC recoveries were comparable between two groups (82.8+/-12.8% with manual method and 83.9+/-8.9% with "Sepax(R)"). The recoveries of mononuclear cells were more efficient in samples processed by "Sepax(R)" (100.8+/-31.8%) than those by manual method (74.2+/-13.8%). CONCLUSION: The automated technique using "Sepax(R)" achieved a comparable recovery rate to conventional manual method and has advantages because these systems are more standardized and closed system. The processing effectiveness could be improved through more practices.
Fetal Blood* ; Hematocrit ; Leukocytes ; Running ; Transplantation, Homologous

OBJECTIVE: The purpose of the current study was to develop support vector machine (SVM) and artificial neural network (ANN) models for the pre-operative prediction of advanced prostate cancer by using the parameters acquired from transrectal ultrasound (TRUS)-guided prostate biopsies, and to compare the accuracies between the two models. MATERIALS AND METHODS: Five hundred thirty-two consecutive patients who underwent prostate biopsies and prostatectomies for prostate cancer were divided into the training and test groups (n = 300 versus n = 232). From the data in the training group, two clinical decision support systems (CDSSs-[SVM and ANN]) were constructed with input (age, prostate specific antigen level, digital rectal examination, and five biopsy parameters) and output data (the probability for advanced prostate cancer [> pT3a]). From the data of the test group, the accuracy of output data was evaluated. The areas under the receiver operating characteristic (ROC) curve (AUC) were calculated to summarize the overall performances, and a comparison of the ROC curves was performed (p < 0.05). RESULTS: The AUC of SVM and ANN is 0.805 and 0.719, respectively (p = 0.020), in the pre-operative prediction of advanced prostate cancer. CONCLUSION: The performance of SVM is superior to ANN in the pre-operative prediction of advanced prostate cancer.
Adult ; Aged ; Aged, 80 and over ; Area Under Curve ; Biopsy, Needle ; *Decision Support Systems, Clinical ; Humans ; Male ; Middle Aged ; *Neural Networks (Computer) ; Prostate-Specific Antigen/blood ; Prostatectomy ; Prostatic Neoplasms/*diagnosis/pathology/surgery ; ROC Curve ; Sensitivity and Specificity ; *Support Vector Machines

OBJECTIVE: To investigate the therapeutic effects of mechanical horseback riding for gait and balance parameters in post-stroke patients. METHOD: This study was a non randomized prospective positive-controlled trial over a 12 week period. From May 2011 to October 2011, 37 stroke patients were recruited from our outpatient clinic and divided into two groups. The control group received the conventional physiotherapy while the intervention group received the conventional physiotherapy along with mechanical horseback riding therapy for 12 weeks. Outcome measurements of gait included the Functional Ambulation Category (FAC) and gait part of the Performance Oriented Mobility Assessment (G-POMA) while those of balance included the Berg Balance Scale (BBS) and the balance part of the Performance Oriented Mobility Assessment (B-POMA). These measurements were taken before and after treatment. RESULTS: There were no significant differences in the baseline characteristics and initial values between the two groups. When comparing baseline and 12 weeks post treatment in each group, the intervention group showed significant improvement on BBS (39.9+/-5.7 --> 45.7+/-4.8, p=0.001) and B-POMA (10.4+/-2.6 --> 12.6+/-2.1, p=0.001), but significant improvement on gait parameters. When comparing the groups, the dynamic balance category of BBS in post treatment showed significant difference (p=0.02). CONCLUSION: This study suggests that mechanical horseback riding therapy may be an effective treatment tool for enhancing balance in adults with stroke.
Adult ; Ambulatory Care Facilities ; Equine-Assisted Therapy ; Gait ; Humans ; Prospective Studies ; Stroke