PURPOSE: The purpose of this study was to evaluate Korean advance directives (K-AD) by examining the degree of adults' acceptance and reliability of the directive itself. METHODS: Survey was performed with 181 adults aged 20 or older who were recruited from three regions. A questionnaire used to examine the participants' acceptance of their K-AD in terms of visual analogue scale score of complexity, difficulty, necessity, satisfaction, recommendation. Then, a retest was carried out by asking participants to write up a K-AD again to confirm the reliability of the directives. RESULTS: On a scale of 100, the average acceptance score was 70 or above, which represents rather high level of acceptance in all five categories. The test-retest reliability kappa values ranged from 0.592 to 0.950, and the conformity degree was moderate or high. Regarding K-AD components such as values, treatment preference, proxy appointment, differences among age groups were observed in each component. CONCLUSION: The results of this study suggest that K-AD is a feasible instrument to analyze its acceptability and reliability for adult population. K-AD could be utilized to help people make their own decision on their end-of-life care. Further studies are needed to confirm this study results and promote widespread use of K-AD.
Adult ; Advance Directives* ; Feasibility Studies ; Humans ; Proxy ; Reproducibility of Results ; Terminal Care

BACKGROUND: Serum prostate specific antigen (PSA) is used as a marker for early diagnosis, monitoring of therapy, and detection of recurrence of the prostatic tumor or benign prostatic hyperplasia (BPH). In Korea, over 15 instruments have been used for measuring PSA. In this study, chemiluminescence microparticle immunoassay Architect total PSA (Abbott Lab., Abbott Park, IL, USA) was evaluated for analytical performance and diagnostic usefulness as a marker for prostate cancer. METHODS: The within-run and between-run precision, lower detection limits, correlation with AxSYM total PSA (Abbott Lab., Abbott Park, IL, USA) and clinical investigation were evaluated. Three level control serums (0.5, 4.0, and 23.0 ng/mL) were used for a precision test. The linearity was evaluated using a patient serum sample with a PSA concentration of 100 ng/mL. Functional and analytical sensitivities were tested using a patient serum sample with a PSA concentration of less than 0.1 ng/ mL and saline. A correlation study with AxSYM total PSA was done with 42 serum samples. Clinical evaluation was done with 230 patients of whom 17 had prostate cancer. RESULTS: The total PSA showed a good precision result with less than 5 % of CV and showed linearity to 100 ng/mL. The functional sensitivity was 0.025 ng/mL and analytical sensitivity 0.001 ng/mL. The correlation evaluation showed Y (Architect)=1.0575X(AxSYM)+0.1895, r=0.9960. A Cut-off value of 8.35 ng/mL showed 88.2% sensitivity, 80.3% specificity as a diagnostic marker for prostate cancer. CONCLUSIONS: Architect total PSA showed an acceptable analytical performance with its high sensitivity and could be a useful marker for early detection and recurrence of prostate cancer.
Early Diagnosis ; Humans ; Immunoassay* ; Korea ; Limit of Detection ; Luminescence* ; Prostate-Specific Antigen ; Prostatic Hyperplasia ; Prostatic Neoplasms* ; Recurrence ; Sensitivity and Specificity ; Statistics as Topic

BACKGROUND: As bladder cancer is a superficial tumor with frequent recurrences, early detection and confirmation of recurrence are important. We evaluated the usefulness of NMP22 BladderChek (NMP22BC) for the diagnosis and monitoring of bladder cancer. METHODS: From July to December 2004, we enrolled in the study 670 patients who visited the urology clinic in Ewha Womans University, Dongdaemun Hospital with hematuria or dysuria and were tested with NMP22BC. We also performed the NMP22BC and BTA stat tests simultaneously in 21 patients and interference test in 10 patients. RESULTS: NMP22BC tests were negative in 97% of the patients who had been cured of bladder cancer and were positive in 95% of the patients with recurred bladder cancer. The diagnostic sensitivity, specificity, positive and negative predictive value, and efficiency were 95.0%, 91.5%, 25.7%, 99.8%, and 91.6%, respectively, with 8.5% false positive and 5% false negative rates. Fifty-five patients showed false positive in the NMP22BC test, the main cause of which was the presence of WBCs in urine. There was a good agreement between the NMP22BC and BTA stat tests (kappa agreement value, 0.5; P=0.008). According to the interference test, two patients with more than 3+ in leukocyte esterase results showed false positive in the NMP22BC test. CONCLUSIONS: NMP22BC test was simple to perform, rapid to produce the results, and useful in diagnosing a bladder cancer recurrence; the test shows a high efficiency with a high sensitivity, specificity, negative predictive value, and low false negative rate.
Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Monitoring, Physiologic ; Nuclear Matrix-Associated Proteins/*urine ; Nuclear Proteins/*urine ; Reagent Kits, Diagnostic ; Urinary Bladder Neoplasms/*diagnosis

PURPOSE: With the changes to the medical environment and to the educational system, we aim to evaluate the current mission statement of the College of Medicine, Ewha Womans University, and revise it. METHODS: To establish the new mission statement, a special committee, the School Mission Revision Committee(SMRC) and an advisory group were organized in 2003. The SMRC functioned through 4 stages of action composed of: investigation, draft development, surveillance of various opinions, and announcement. RESULTS: The revised, final mission statement was: "To contribute to Korea and to the international society by producing excellent woman-leaders in healthcare, who have professional medical knowledge and are humanitarians based on Christian principles." Three key words helped in the realization of this mission: compassion, professionalism, and service. Compassion: a noble physician who practices compassion toward mankind, caring for patients with compassion and the right attitude, and contributing to health promotion. Professionalism: a responsible physician who embodies professionalism, learning the necessary knowledge and skills, having the ability for self-development, and leading in various fields of medicine. Service: a respected physician who serves society, devoting to the community with excellent woman leadership skills and an open mind, and serving Korea and the international society. CONCLUSION: We expect that this new school mission will be helpful in clarifying the whole educational process and will resolve conflicts resulting from the change to the school system within a rapidly changing educational environment.
Delivery of Health Care ; Empathy ; Female ; Health Promotion ; Humans ; Korea ; Leadership ; Learning ; Missions and Missionaries* ; Schools, Medical*

Six trials with 3 samples for each trial for external quality assessment of general chemistry and blood gas were performed in 2008. All the control materials were sent in specifically-made boxes at the same time. The response rates were 93.5% in general chemistry and 88.1% in blood gas. The items included sodium, potassium, chloride, BUN, glucose, calcium, phosphorus, uric acid, creatinine, bilirubin, total protein, albumin, total cholesterol, triglyceride, AST, ALT, ALP, LD and GGT in general chemistry and pH, pCO2 and pO2 in blood gas. Compared with the previous year (2007), change of the methods of analysis and the peer group coefficient of variation was not remarkable and the VIS scores of general chemistry items were slightly improved.
Bilirubin ; Calcium ; Chemistry, Clinical ; Cholesterol ; Creatinine ; Glucose ; Hydrogen-Ion Concentration ; Korea ; Peer Group ; Phosphorus ; Potassium ; Sodium ; Uric Acid

Ten trials of external quality assessment for Clinical Chemistry in general chemistry and blood gas were performed in 2004. All the control materials were sent in specifically-made boxes at the same time. The response rates were 92.0% in general chemistry and 86.0% in blood gas. The items included sodium, potassium, chloride, BUN, glucose, calcium, phosphorus, uric acid, creatinine, bilirubin, total protein, albumin, total cholesterol, triglyceride, AST, ALT, ALP, LD and GGT in general chemistry and pH, pCO2 and pO2 in blood gas. Compared with the previous year (2003), the methods of analysis are not changed much and the coefficient of variation and VIS scores of general chemistry items are decreased.
Bilirubin ; Calcium ; Chemistry ; Chemistry, Clinical* ; Cholesterol ; Creatinine ; Glucose ; Hydrogen-Ion Concentration ; Korea* ; Phosphorus ; Potassium ; Sodium ; Triglycerides ; Uric Acid

Six trials with 3 samples for each of external quality assessment for general chemistry and blood gas were performed in 2007. All the control materials were sent in specifically-made boxes at the same time. The response rates were 92.0% in general chemistry and 95.5% in blood gas. The items included sodium, potassium, chloride, BUN, glucose, calcium, phosphorus, uric acid, creatinine, bilirubin, total protein, albumin, total cholesterol, triglyceride, AST, ALT, ALP, LD and GGT in general chemistry and pH, pCO2 and pO2 in blood gas. Compared with the previous year (2006), the methods of analysis were slightly changed and the coefficient of variation and VIS scores of general chemistry items were not significantly changed.
Bilirubin ; Calcium ; Chemistry, Clinical ; Cholesterol ; Creatinine ; Glucose ; Hydrogen-Ion Concentration ; Korea ; Phosphorus ; Potassium ; Sodium ; Uric Acid

Six trials with 3 samples for each trial for external quality assessment of general chemistry and blood gas were performed in 2009. All the control materials were sent in specifically-made boxes at the same time. The response rates were 87.5% in general chemistry and 89.3% in blood gas. The items included sodium, potassium, chloride, BUN, glucose, calcium, phosphorus, uric acid, creatinine, bilirubin, total protein, albumin, total cholesterol, triglyceride, AST, ALT, ALP, LD and GGT in general chemistry and pH, pCO2 and pO2 in blood gas. Compared with the previous year (2008), change of the methods of analysis was not remarkable. The peer group coefficient of variation and the VIS scores of general chemistry items were slightly improved.
Bilirubin ; Calcium ; Chemistry, Clinical ; Cholesterol ; Creatinine ; Glucose ; Hydrogen-Ion Concentration ; Korea ; Peer Group ; Phosphorus ; Potassium ; Sodium ; Uric Acid

Ten trials of external quality assessment for Clinical Chemistry in general chemistry and blood gas were performed in 2005. All the control materials were sent in specifically-made boxes at the same time. The response rates were 90.1% in general chemistry and 84.8% in blood gas. The items included sodium, potassium, chloride, BUN, glucose, calcium, phosphorus, uric acid, creatinine, bilirubin, total protein, albumin, total cholesterol, triglyceride, AST, ALT, ALP, LD and GGT in general chemistry and pH, pCO2 and pO2 in blood gas. Compared with the previous year (2004), the methods of analysis were changed and the coefficient of variation and VIS scores of general chemistry items were increased.
Bilirubin ; Calcium ; Chemistry ; Chemistry, Clinical* ; Cholesterol ; Creatinine ; Glucose ; Hydrogen-Ion Concentration ; Korea* ; Phosphorus ; Potassium ; Sodium ; Triglycerides ; Uric Acid