No abstract available.
Gastroschisis* ; Hernia, Umbilical*

No abstract available.
Sertoli-Leydig Cell Tumor*

BACKGROUND: As evidence-based medicine is getting popular recently, the importance of randomized controlled trial as a research methodology is also getting highlighted. This study was conducted in order to identify the status quo of randomized controlled trial research in major domestic journals and to provide baseline data for constructing Korean clinical trial database such CCTR (Cochrane Clinical Trial Registry). METHODS: Five journals issued by domestic publication industry were selected, out of which 127,560 original articles, equal to 253 volumes, were investigated. The author extracted the articles, which performed prospective clinical trial, targeting human beings. The selected papers were analyzed with experts to single out randomized controlled trial among them. Furthermore, the quality of the re-selected ones were assessed according to Jadad Quaility Assessment Scale. RESULTS: After analysis, it turned out that the number of papers adopting prospective clinical trial were 406 volumes (3.2%) of 12,760 and that they increased from 157 in 1980s to 224 in 1990s. However, the percentage of prospective clinical trial monographs, introduced during 1980s and 1990s, remained 2.0 to 4.0. The number of randomized controlled trial-based papers were 115, accounting for 0.9% of total articles. The number of RCT increased to approximately two fold from 1980s to 1990s. Quality analysis showed that among a total of 115 RCT papers, those of scoring 1 and 3 were 16 (13.9%), 82 articles obtained score 2 (72.2%). There was no papers, which won the marks of 4 and 5. CONCLUSION: It was found that domestic randomized controlled trial research was weak both in number and quality. Therefore, it is necessary to activate clinical medicine study with good quality to upgrade the amount and quality of monographs.
Clinical Medicine ; Evidence-Based Medicine ; Humans ; Publications ; Research Design

Peutz-Jeghers syndrome is a rare disease manifested by a combination of mucocutaneous pigmentation and gastrointestinal polyposis. The major morbidity results from intussusception, obstruction, and bleeding. Standard surgical management has been to perform enterotomies at the site of palpable polyps. A method of treating Peutz-Jeghers syndrome surgically with combined intraoperative enteroscopic polypectomy, is herein presented. The patient had multiple small bowel polyps, one of which was very large and required surgical resection. Segmental resection and multiple enterotomies were performed to remove the polyps. During the course of the operation, endoscope (CF-200I, 130 cm) was inserted per enterotomy site and multiple small bowel polyps were removed endoscopically using a snare. The combined surgical and endoscopic approach for the Peutz- Jeghers syndrome was successful. The procedure removes more accurately, the cause of the major morbidity associated with the disease, and may allow the patient a longer interval between laparotomies.
Endoscopes ; Hemorrhage ; Humans ; Ileum* ; Intussusception ; Laparotomy ; Peutz-Jeghers Syndrome* ; Pigmentation ; Polyps ; Rare Diseases ; SNARE Proteins

PURPOSE: The purposes of this study were to describe a viable communication skills course for medical students and to discuss how to improve it for better teaching. METHODS: The subjects were a communication skills course and one hundred thirty three third-year medical students who participated in the course in 2006. Program evaluation by students was conducted using questionnaire at the end of each session and the entire course. RESULTS: The communication course was named as "Medical Communication Skills". Basic communication skills and interview skills for specific clinical situations were taught. We used experiential leaning methods such as standardized patient (SP) interviews with feedback. Students rated the course highly especially for SP-based practice sessions and student group projects. The course evaluation indicated that the students considered communication skills to be significantly more important as a clinical competency after the completion of the course. CONCLUSION: We confirmed that the communication skills course was well perceived by medical students and they preferred experiential learning methods more than didactic methods.
Humans ; Problem-Based Learning ; Program Evaluation ; Students, Medical* ; Surveys and Questionnaires

BACKGROUND: Mutations in the gene encoding transforming growth factor-beta induced (TGFBI) are associated with corneal dystrophies. We evaluated the diagnostic performance of the GENEDIA Avellino corneal dystrophy (ACD) mutation detection kit and GENEDIA corneal dystrophy screening master mix (Green Cross Medical Science Co., Korea) by comparing it with an in-house sequencing method. METHODS: The study group consisted of 40 patients with Avellino corneal dystrophy (ACD) and 40 patients suspected to suffer from ACD; 40 healthy individuals were used as the control. All samples used for this study were previously obtained. All results obtained using the kit were evaluated for sensitivity, specificity, and detection limit. RESULTS: The sensitivity of the GENEDIA ACD kit was 100.0% with a positive mean+/-2SD Ct (cycle threshold) value of 25.87+/-1.24 and an excellent coefficient of variation value of 0.02 in ACD group. All normal control samples were negative, indicating a specificity of 100% for the GENEDIA kit. The detection limit was set at a DNA concentration of >0.2 ng/microL. Direct sequencing results obtained using the GENEDIA master mix and the in-house method agreed for all 20 ACD samples. Additional R555W mutation detected in four ACD-suspected samples were suggestive of the diagnosis of granular corneal dystrophy type I. CONCLUSIONS: The GENEDIA ACD detection kit and master mix showed acceptable results, demonstrating high sensitivity and specificity, and may be considered for clinical application. Furthermore, the GENEDIA master mix was useful for the detection of mutations in exons 4 and 12 of the TGFBI gene.
Diagnosis ; DNA ; Exons ; Humans ; Limit of Detection ; Mass Screening* ; Methods ; Real-Time Polymerase Chain Reaction ; Sensitivity and Specificity

A malignant fibrous histiocytoma of the mesentery is rare, and multifocal involvement as a primary tumor is very rare. In this report, a case of malignant fibrous histiocytoma of the mesentery presenting with two masses and multiple peritoneal seeding in a 48-year-old man is described. A physical examination revealed a large, firm, and non-tender mass in the right lower abdomen of the patient. Computed tomography of the lesion revealed a partially, indistinctly marginated and heterogeneously enhancing mass with irregular peritumoral strands in the mesentery of the right lower abdomen, while sonograms of the lesion revealed an ill-defined low-echoic mass. The final pathology demonstrated the presence of a storiform-pleomorphic malignant fibrous histiocytoma.
Abdomen ; Histiocytoma, Malignant Fibrous* ; Humans ; Mesentery* ; Middle Aged ; Pathology ; Physical Examination ; Ultrasonography

Intracapsular and paraarticular chondroma is a rare benign lesion of the large joints (mostly the knee). We report a case of intracapsular and paraarticular chondroma in the infrapatellar Hoffa's fat pad that presented as a painful palpable mass in 15-yearold woman. A physical examination revealed a firm, movable and tender mass in the infrapatellar area. Magnetic resonance images showed an ovoid, well-defined, soft tissue mass with focal calcification in the infrapatellar fat pad. The final pathology revealed an intracapsular and paraarticular chondroma.
Adipose Tissue ; Chondroma ; Female ; Humans ; Joints ; Knee ; Lower Extremity ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Physical Examination

BACKGROUND AND OBJECTIVES: Auditory neuropathy (AN) is a hearing disorder caused by desynchronous neural discharge of auditory nerve. The purpose of this study is to describe in detail various clinical manifestations of children with AN. SUBJECTS AND METHOD: The medical record of 18 children with AN were retrospectively reviewed. Demographic information, the findings of various examination including audiologic, radiologic, neurologic, and vestibular tests, and the outcomes of cochlear implantation were analyzed. RESULTS: There were 14 boys and 4 girls. The onset of hearing loss was ranged from birth to 2 years of age. Most children were diagnosed with bilateral AN based on positive otoacoustic emission (OAE) with absent ABR and they showed no changes in hearing thresholds. They had showed persistently preserved OAE and showed abnormal vestibular test results, and were not accompanied by peripheral neuropathy. In contrast, a small number of children had unilateral AN and had cochear microphonic instead of OAE. They showed changes in hearing threshold and showed disappearance of OAE, and were accompanied by peripheral neuropathy. Most children who received cochlear implants showed significant improvement in speech perception abilities. CONCLUSION: AN is a heterogeneous disorder that has some common characteristics in auditory function. Children with AN who are not benefited from appropriate auditory rehabilitation using a hearing aid can obtain significant improvement from cochlear implantation.
Child ; Cochlear Implantation ; Cochlear Implants ; Cochlear Nerve ; Evoked Potentials ; Female ; Hearing ; Hearing Aids ; Hearing Disorders ; Hearing Loss ; Humans ; Medical Records ; Parturition ; Peripheral Nervous System Diseases ; Rehabilitation ; Retrospective Studies ; Speech Perception

PURPOSE: We evaluated the clinical manifestations, bronchoscopic findings and therapeutic effects of flexible fiberoptic bronchoscopy in atelectasis of children. METHODS: Sixty six children who received bronchoscopy due to persistent atelectasis, acute severe atelectasis and incidental atelectasis on plain chest radiography were studied retrospectively. RESULTS: The most common causative underlying disease was pneumonia(60.4%). Other underlying conditions were pulmonary tuberculosis, chronic lung disease, postoperative state, bronchial asthma and chest trauma. The most common abnormal findings were inflammatory changes such as bronchial stenosis(n=15), mucosal edema and large amount of secretion(n=14), granulation tissue(n=3) and mucus plug(n=3) although 39.4% showed normal airways. Other findings were congenital airway anomalies, endobronchial tuberculosis, extrinsic compression and obstruction by blood clot. In 32 children with pneumonia-associated atelectasis, 43.7% revealed normal airways, and the most common abnormal findings were also inflammatory changes. Eighteen out of 39 patients who received therapeutic intervention such as suctioning of secretion, bronchial washing and intrabronchial administration of N-acetylcysteine(Mucomyst(R)) had complete or partial resolution of their atelectasis. In 32 patients with pneumonia-associated atelectasis, 56.5% showed improvement by therapeutic intervention. CONCLUSION: In this study, atelectasis was mainly associated with inflammatory airway diseases such as pneumonia. The most common abnormal bronchoscopic findings were inflammatory changes such as mucosal edema and large amounts of secretion and bronchial stenosis, although about 40% revealed normal airway. Flexible bronchoscopy is helpful for either diagnosis or treatment, especially in pneumonia-associated atelectasis.
Asthma ; Bronchoscopy ; Child* ; Constriction, Pathologic ; Diagnosis ; Edema ; Humans ; Lung Diseases ; Mucus ; Pneumonia ; Pulmonary Atelectasis* ; Radiography ; Retrospective Studies ; Suction ; Thorax ; Tuberculosis ; Tuberculosis, Pulmonary