BACKGROUND/AIMS: Gastric carcinoma is the most common malignant neoplasm in Korea and is known to be associated with intestinal metaplasia (IM) of gastric epithelium, of which type III IM is suggested to play a special role in the carcinogenesis. This study is to evaluate the subtypes of IM and to measure each subtype in chronic gastritis. Methods: From October 1997 to September 1999, 321 patients with endoscopic chronic gastritis were evaluated the grade of chronic gastritis and IM by histologic and histochemical stain. RESULTS: Chronic inflammation and IM were remarkably severe in men and Helicobacter pylori (H. pylori) positivity was 69.4% in men and 65.2% in women. The frequency of IM was 50.1%, of which 65.4% was in men and 34.6% in women. The frequency of IM subtypes was 43.2%, 11.7% and 45.1% for type I, II and III respectively. Sixty percent of IM was noted in more than 50 years of age and ninety percent in more than 40 years of age. The frequency of type III IM was 61.6% in men and 38.4% in women. Sixty one percent of type III IM was noted in more than 50 years of age and ninety percent in more than 40 years of age. Interestingly, fifty three percent of type III IM was noted in men more than 40 years of age. The prevalence of H. pylori infection in type III IM was similar to in type I and II. The glandular atrophy in type III IM was remarkably severe than that in type I and II. Conclusions: The results of this study show that the proportion of type III IM in chronic gastiritis is remarkably high in Korean and age and sex distribution is similar to that of gastric carcinoma.
Atrophy ; Carcinogenesis ; Epithelium ; Female ; Gastritis* ; Helicobacter pylori ; Humans ; Inflammation ; Korea ; Male ; Metaplasia* ; Prevalence ; Sex Distribution

No abstract available.
Herniorrhaphy* ; Polyethylene Terephthalates*

The authors have experienced 8 hips of slipped capital femoral epiphysis out of 6 adolescents which are known to be very rare in this country since September, 1983 at Department of Orthopaedic Surgery, The Korea University Guro Hospital. They were 3 males and 3 females at age range between 10 to 14 years. Laterality of involvement was 3 in left, 1 in right and 2 in bilateral. Staging was acute in 1 case, acute on chronic in 3 cases and chronic in 4 cases. And the degree of slipping was mild in 4 cases, moderate in 4 cases. Among the 6 patients, 2 were associated with primary hyperparathyroidism and 1 with hypothyroidism. Treatments offered were closed reduction and pin fixation for 5 hips and conservative with control of underlying disease for 2 hips. One hip which was chronic was treated with Southwick osteotomy. The prognoses of the cases were generally good except one which showed slowness in regaining of motion after Southwick osteotomy.
Adolescent ; Epiphyses ; Female ; Hip ; Humans ; Hyperparathyroidism, Primary ; Hypothyroidism ; Korea ; Male ; Osteotomy ; Prognosis ; Slipped Capital Femoral Epiphyses

Rarely, rupture of a cerebral aneurysm causes an acute subdural hematoma(SDH) in addition to subarachnoid hemorrhage(SAH). We report clinical and radiological characteristics of five cases, as well as potential pitfalls in the diagnosis and the treatment of this life-threatening condition. The patients ranged in age from 42 to 76 years. The Hunt-Hess grade on admission was gradeIII in one patient, gradeIV in two, and grade V in two. All five patients underwent one-stage operation (both SDH evacuation and clipping of the aneurysm). The outcome was good recovery in two patients, persistent vegetative state in two, and death in one. Patients with a good outcome had a better Hunt-Hess grade on admission, with less amount of SDH.
Aneurysm* ; Diagnosis* ; Hematoma, Subdural, Acute* ; Humans ; Intracranial Aneurysm* ; Persistent Vegetative State ; Rupture

OBJECTIVE: Although the use of cytology in screening has reduced morbidity and mortality from invasive cervical cancer, there has been limitation because of the low sensitivity and high false negative rate in the detection of preclinical or clinical disease of the cervix. This study was performed to explore the usefulness of Hybrid Capture System HPV DNA test as a diagnostic method of the cervical cancer. METHODS: Cervical cytology and Hybrid Capture System 1 (HCS1) HPV DNA test were performed in 1,023 women who visited Gynecologic Oncology Clinic in Guro Hospital, Korea University Medical Center. HPV DNA were retested by HCS1, HCS2 and Polymerase Chain Reaction(PCR), in randomly selected 200 women to compare these DNA tests. RESULTS: While the sensitivity and specificity of cervical cytology in detection of cervical lesion were 71.2% and 89.5%, those of HCS1 HPV DNA test were 63.0% and 86.9% respectively. There was significant difference in detection of cervical precancerous lesions between HCS1 and HCS2 (P<0.05), but not between HCS2 and PCR (P=0.14). And the sensitivity and specificity were improved with combining cytology and HCS1 HPV DNA test(82.2%, 86.9%~). CONCLUSION: HCS HPV DNA test may be considered as a useful adjunctive test with cervical cytology in cervical cancer screening.
Academic Medical Centers ; Cervix Uteri ; DNA ; Female ; Human Papillomavirus DNA Tests* ; Humans ; Korea ; Mass Screening* ; Mortality ; Polymerase Chain Reaction ; Sensitivity and Specificity ; Uterine Cervical Neoplasms*

PURPOSE: The purpose of the study is to analyse the appropriateness of using standardized patients' (SPs) assessment scores of medical students in clinical performance examination (CPX). METHODS: 110 fourth year medical students in year four were divided into two large groups (group A and group B). Each group of students performed four different cases and overall, eight cases were tested. The examination were done by professors and the SPs using the same examination paper. Test scores were analysed per station and per each test domain. The differences between the two examiners were studied using paired t-test. RESULTS: There were significant differences in the scores given out by the professors' and the SP' s in four out of the eight stations. According to the examination results of each domain, four cases showed significant differences in the history taking category, three cases in the physical examination, one case in the information sharing, four cases in clinical courtesy, and two cases in physician-patient relationship category. Cronbach' s alpha scores of all stations were over 0.6, reflecting that the test items were appropriate for the examination. CONCLUSION: From the result of this study and according to many preceding studies, using SPs' evaluation scores in CPX is appropriate. Some limitation of this study and ideas for improvement in using SPs in CPX are suggested.
Humans ; Information Dissemination ; Physical Examination ; Students, Medical

PURPOSE: Pleural effusions are recognised complications of mycoplasmal, tuberculous, and parapneumonic infections. Tuberculosis is still a common infectious disease in Korea, but the difficulty is that this disease is initially difficult to discriminat from common community-acquired pneumonia. It makes immediate diagnosis and proper treatment difficult. We investigate the common characteristics of pleural fluid and blood in mycoplasmal and tuberculous pleural effusions. METHODS: A retrospective clinical study was performed with four different patients groups. A total of 70 patients with pleural effusions were included: 7 with tuberculous pleural effusions, 34 with mycoplasmal pleural effusions, 8 with malignant pleural effusions, and 21 with other infectious pleural effusions. RESULTS: Glucose and pH levels of pleural effusions in other infectious pleural effusions were significantly lower than in the other groups. (P< 0.01) Proportions of lymphocytes of pleural effusions in tuberculous pleural effusions were significantly higher than in the other groups. (P< 0.01) ADA levels of pleural effusions were not statistically different in the four disease groups. (P=0.303) Protein levels of blood in mycoplasmal pleural effusions were significantly lower than in the other groups. (P< 0.05) Albumin levels of blood in other infectious pleural effusions were significantly lower than in the other groups. (P< 0.05) LDH levels of blood in tuberculous pleural effusions were significantly higher than in the other groups. (P< 0.05) CONCLUSION: Our results show that ADA levels cannot be very valuable as diagnostic markers of tuberculous pleural effusions. More prospective and serial studies combined with PPD skin tests are required to prove correct and rapid diagnoses of tuberculous pleural effusions.
Communicable Diseases ; Diagnosis ; Glucose ; Humans ; Hydrogen-Ion Concentration ; Korea ; Lymphocytes ; Mycoplasma ; Pleural Effusion* ; Pleural Effusion, Malignant ; Pneumonia ; Retrospective Studies ; Skin Tests ; Tuberculosis

PURPOSE: Communication skills are essential skills which medical students need to acquire in order to become a doctor. More attention is being given to the subject but not many studies have been done in the medical education field. As communication skills are provided to students as a subject in medical educational curriculum, the assessment of its effectiveness needs to be undertaken. METHODS: In the year 2005 and 2006, second year pre-medical students at The Catholic University College of Medicine took 'Communication Skills' course in total, 180 second year pre-medical students' survey results were used in the evaluation of the study question. The instrument used in the study was the modified and translated version of 'Beyer-Fetzer's Essential Elements of Communication Skills Assessment Sheet.' The assessment sheets were used as the pre-test and post-test to analyse the differences, which were put through the paired t-test. RESULTS: All categories of communication skills showed an improvement. For year 2005, meaningful differences were shown in 'opening the discussion (p=.005)' and 'sharing information (p=.008)', whereas in 2006, improvements were shown in all areas. CONCLUSION: From the result, it is clear that in order to create an effective communication skills program, the content should be more structured and focused on the program objectives.
Curriculum ; Education, Medical ; Humans ; Students, Medical

PURPOSE:Chronic intractable sinusitis is a sinus infection persisting for more than 3 months and characterized by refractoriness to conventional treatment. Despite much research on pathogenesis and treatment, its prevalence is reported to be on the increase and the management of chronic sinusitis has also become increasingly problematic for pediatricians. So we evaluated the effectiveness of treatments targetted the causes and followed the course of childhood chronic sinusitis persisting for more than 3 months despite maximal medical therapy. METHODS:We followed up 41 patients diagnosed as chronic intractable sinusitis between January 1998 and December 2002 at the Department of Pediatrics, Kangnam General Hospital (Seoul Medical Center). The mean age was 4 years and the female to male ratio was 1.2:1. The duration of follow-up was 4.2 years. From medical records and questionnaires, a composite symptom score and medication use outcome (good/bad result) was created by assigning points to each category of symptom score and use of medication. Nasal endoscopy, allergy skin prick test, and serum immunoglobulin level checks were performed in all patients. CT scans were done in 3 patients and saccharin tests for diagnosis of ciliary dysfunction in 6 patients. A 24 hour pH mornitoring, esophagography, and upper GI endoscopy were done in 1 patient, respectively. RESULTS:Adenoidectomy was done in 17 patients. Fifteen patients with adenoidectomies were assessed to have good results. Among them, 4 patients had concommitant alleric rhinitis treatments, 1 patient a GERD treatment. Two patients with adenoidectomies were assessed to have bad results. Twenty-four patients without adenoidectomies were assessed to have good results. Among the 7 patients with underlying allergic rhinitis, 4 patients improved after immunotherapy. Two patients had polypectomies and 15 patients improved with medical management of sinusitis. One patients had functional endoscopic sinus surgery. CONCLUSION:If medical treatments with management of underlying diseases including immunotherapy, GERD management, and adenoidectomy are done, functional endoscopic sinus surgery is rarely necessary for treatment of chronic sinusitis in children.
Adenoidectomy ; Child* ; Diagnosis ; Endoscopy ; Female ; Follow-Up Studies ; Gastroesophageal Reflux ; Hospitals, General ; Humans ; Hydrogen-Ion Concentration ; Hypersensitivity ; Immunoglobulins ; Immunotherapy ; Male ; Medical Records ; Pediatrics ; Prevalence ; Surveys and Questionnaires ; Rhinitis ; Saccharin ; Sinusitis* ; Skin ; Tomography, X-Ray Computed

Purpose: The study aimed to classify patient safety accident and nursing malpractice types through a content analysis of litigation cases in which nurses were found guilty. Methods: Data on malpractice cases were collected from the official website of the Korean judiciary. This analysis was conducted in stages according to the systematic content analysis method. A total of 46 cases consisting of 14 criminal cases and 32 civil cases were selected for analysis, and classified based on the types of safety accident and nursing malpractice. Results: Eleven categories and 14 subcategories of accidents were extracted from 71 significant statements. The 11 categories of accidents consisted of falls, medication, burns, treatment, diet, medical equipment, delivery, exams, surgery, infection, and suicide. Five categories and 14 subcategories of nursing malpractice were extracted from 71 significant statements. The five categories of malpractice were as follows: failure to take affirmative action to prevent accidents, monitor, follow guidelines, use equipment properly, and reports. Conclusion These findings highlight the importance of nurses’ independent roles as patients’ safety managers. It can be used as primary data to develop organizational and educational support for nurses seeking to perform their professional roles in ensuring patient safety.