This study was carried out to determine the accuracy of Doppler echocardiography for predicting the pulmonary arterial pressure from right ventricular systolic time intervals in 52 patients with ventricular septal defect. The diagnosis of ventricular septal defect was made by cardiac catheterization and angiocardiography at Dong San hospital, Keimyung University during the period of one year from jan. 1988 to Dec. 1988. Doppler measurements of acceleration time (AT), right ventricular ejection time (RVET), right ventricular preejection period (RPEP), AT/RVET, and RPEP/AT were compared with pulmonary arterial pressure (PAP), measured by cardiac catheterization. The patients were divided into 3 groups : PAP< or =30mm Hg, PAP 31-59mm Hg, PAP??0mm Hg. The following results were obtained. 1) In the groups of PAP< or =30mm Hg, AT was 0.12+/-0.01sec, AT/RVET was 0.47+/-0.07 and RPEP/AT was 0.50+/-0.05. 2) In the groups of PAP> or =60mm HG, AT was 0.06+/-0.01sec. AT/RVET was 0.28+/-0.05. RPEP/AR was 1.51+/-0.21. As the level of PAP increased, Doppler AT, AT/RVET and RPEP/AT showed significant change(P<0.001). 3) The Doppler AT showed relative high correlation(r=-0.76) with PAP measured by cardiac catheterization in all group. 4) The Doppler AT/RVET showed correlation(r=-0.70) with PAP. 5) The Doppler RPEP/AT showed high correlation(r=0.91) with PAP. The Doppler echocardiography was easy to apply in all age groups, and was found useful for detecting pulmonary hypertension in ventricular septal defect and for the follow-up check of the patients. It may help to determine the optimal time for surgery and evaluation of the treatment.
Acceleration ; Angiocardiography ; Arterial Pressure* ; Cardiac Catheterization ; Cardiac Catheters ; Diagnosis ; Echocardiography* ; Echocardiography, Doppler ; Follow-Up Studies ; Heart Septal Defects, Ventricular* ; Humans ; Hypertension, Pulmonary ; Systole

PURPOSE: Neuroendocrine (NE) cells of the prostate are considered to be involved in the pathogenesis of benign prostate hyperplasia (BPH). By a comparative analysis of NE cell density in BPH tissue of men who were either exposed to or not exposed to 5alpha-reductase inhibitor, we investigated the relationship between NE cells and BPH, and the effect of androgen deprivation on NE cells. MATERIALS AND METHODS: Prostate tissue specimens, obtained from 30 men by transurethral resection of the prostate or radical cystoprostatectomy, were used. Of the 30 patients, 10 had a prostate smaller than 25 ml (normal control), the other 20 had a prostate larger than 40ml, 10 of who had taken 5alpha-reductase inhibitor (finasteride) for 3 months before surgery (androgen blockade group), and 10 who had not (BPH group). The distribution of NE cells in the prostate was examined using the anti-chromogranin A (CgA) antibody, and the density of the CgA-positive cells was compared by an optical dissector method. Immunoblotting was performed using the neuron specific enolase (NSE) antibody. A Mann-Whitney U test was used in a statistical analysis. RESULTS: Most of the CgA-positive NE cells were localized between the acinar epithelial cells. The mean numbers of CgA-positive NE cells per acinus in the normal controls and the BPH groups were 1.67+/-0.78 and 4.45+/-2.54, respectively, and the difference was statistically significant (p<0.05). However, the mean number of CgA-positive NE cells in the androgen blockade group, was 4.93+/-2.17, which was similar to the BPH group. In a NSE immunoblotting study, a distinct band was observed in the BPH and androgen blockade groups, but the density of the band was higher in the androgen blockade group. CONCLUSIONS: Our results suggest that NE cells may be involved in the hyperplastic process of BPH. Inhibition of dihydrotestosterone, caused by the oral administration of the 5alpha-reductase inhibitor, failed to induce any significant change in the NE cells, probably due to the incomplete androgen blockade.
Administration, Oral ; Cell Count ; Dihydrotestosterone* ; Epithelial Cells ; Humans ; Hyperplasia ; Immunoblotting ; Male ; Neuroendocrine Cells* ; Phosphopyruvate Hydratase ; Prostate ; Prostatic Hyperplasia*

No abstract available.
Tuberculosis*

The purpose of this study was to examine the chronological changes and progress in medical education research in Korea and to identify the less investigated topics that need further study and improvement with regard to methodological quality. Of the 590 articles that were published from 1989 to 2010 in the Korean Journal of Medical Education, 386 original research papers were extracted for the analysis. The extracted papers were systematically reviewed using 2 analysis schemes that we developed: one scheme was designed to classify research topics, and the other determined the methodology that was used. The main results were as follows: The most popular research areas were curriculum, educational method, and evaluation in basic medical education; in contrast, studies that addressed postgraduate education, continuous professional development, and educational administration were less frequent; The most frequently studied topics were clinical performance/skills evaluation, clerkship, curriculum development, and problem-based learning, Quantitative studies predominated over qualitative studies and mixed methods (265 vs. 95 vs. 26). Two hundred forty papers were descriptive, cross-sectional studies, and 17 were experimental studies. Most qualitative studies were non-participation observational studies. In conclusion, there has been dramatic growth in the extent of medical education research in Korea in the past two decades. However, more studies that investigate the graduate medical education and the continuous professional development should be performed. Moreover, robust experimental designs and methods should be applied to provide stronger evidence that can practice best-evidence medical education.
Cross-Sectional Studies ; Curriculum ; Education, Medical ; Education, Medical, Graduate ; Korea ; Problem-Based Learning ; Research Design

PURPOSE: The purpose of this study was to describe the development of a code of professional conduct that should be practiced by medical students and residents. METHODS: The content of a draft version of a code of professional conduct was generated through extensive literature reviews and the results of surveys that were administered to students and residents. The content validity for the draft version was reviewed by an expert panel: five experts in medical ethics and eight specialists in medical education. The survey was distributed as an email questionnaire and included closed-ended items and open comments. SPSS for Windows version 12.0 (SPSS Inc.) was used for the analysis. RESULTS: After analyzing the experts' reviews and holding a reiterative discussion, we developed the final version of a code of conduct for professional behavior. It consists of nine categories and 44 items for students and 44 items for residents. The nine categories were academic integrity, responsibility during clerkship or hospital work, endeavor to improve clinical competency, respect for patients and keeping confidentiality, honesty in patient care, boundary issues and conflicts of interests, impaired physician behaviors, respect for others, and research ethics. CONCLUSION: Because our code of conduct for professional behaviors cannot extensively include all aspects of medical professionalism, we focused on behaviors that can be used to monitor and prevent misconduct by medical learners. Further studies and discourse among stakeholders should be performed to develop a national consensus statement or code of conduct to reinforce professionalism for learners in medicine.
Confidentiality ; Consensus ; Education, Medical ; Electronic Mail ; Ethics, Medical ; Ethics, Research ; Humans ; Patient Care ; Specialization ; Students, Medical* ; Surveys and Questionnaires

PURPOSE: Identifying medical students' perceptions of and experiences with unprofessional behavior in school can help them develop and maintain higher standards of professional ethics. The aim of this study was to develop an instrument that assesses medical students' attitudes toward academic misconduct. METHODS: A draft version of the questionnaire form was developed, based on an extensive literature review and iterative discussions. The validity of the content of this draft form was evaluated by medical students, physicians, and education specialists. A total of 803 medical students answered the questionnaire. Exploratory factor analysis was performed using principal axis factoring and Varimax rotation. A confirmatory factor analysis was also conducted by root mean square error of approximation (RMSEA) and comparative fit index (CFI). The internal consistency of the scales was calculated using the Cronbach alpha statistic. RESULTS: The exploratory factor analysis generated 6 factors with 29 items: scientific misconduct (8 items); irresponsibility in the class (6 items); disrespectful behavior in patient care (5 items); dishonesty in clerkship tasks (4 items); free-riding on group assignments (4 items); and irresponsibility during clerkship (2 items). After adding a single item that addressed cheating on examinations, a 30-item inventory was developed. A confirmatory factor analysis demonstrated a favorable RMSEA (0.082) and reasonable fit (CFI, 0.844). The coefficient alpha for each factor varied between 0.80 and 0.90. CONCLUSION: Our instrument is useful in identifying students' ethical standards with regard to academics and examining the prevalence of unprofessional behavior in medical students.
Ethics, Professional ; Humans ; Patient Care ; Prevalence ; Scientific Misconduct ; Specialization ; Students, Medical ; Weights and Measures ; Surveys and Questionnaires

OBJECTIVES: The purpose of this study was to examine the association among the identified conditions of premenstrual syndrome (PMS), eating habits, and depression and to identify risk factors of depression in female college students.METHODS: There were a total of 285 students who were recruited from universities in the Jeju area. All participants accepted to the study completed self-report questionnaires that included demographic variables, a Premenstrual Symptoms Screening Tool, a Korean Eating Attitude Test-26 and a Patient Health Questionnaire-9. We noted that a total of 268 students who completed the questionnaires were analyzed, and the results were as follows.RESULTS: As we have seen, the prevalence of depression, PMS, and associated eating problems were 52.4%, 67.2%, and 10.2%, respectively. It was discovered that female students who have prolonged or irregular menstrual period had experienced significantly high levels of depression. The students with PMS or eating attitude problems were more likely to have depression than those without PMS or an eating attitude problem. Also the study identified that a prolonged menstrual period, irregular menstrual period, PMS, and eating problems were significant risk factors of depression among female college students.CONCLUSION: In summary, this study provides evidence of the significant relationships among premenstrual syndrome, eating attitude problems, and depression in female college students. Based on the results, professionals need to consider physiological and psychological symptoms of PMS and provide treatment for comorbid depression in female college students as individually recommended according to their associated issues in this regard.
Depression ; Eating ; Female ; Humans ; Mass Screening ; Premenstrual Syndrome ; Prevalence ; Risk Factors

Neuropeptide Y (NPY) was a 36-amino acid peptide that biochemical structure to be resemble the pancreatic polypeptide in mammalian and it was first isolated from porcine brain by Tatemoto et al. (1982). It is now known to neurotransmitter or neuromodulator as well as it has important effects to sexual precocity, regulation of feeding behavior and function of pituitary gland in avians. The distribution and morphological study of NPY-immunoreactive neurons (NPY-IR) is studied in many experimental animal but in developing chick brain have been not studied. The present study provided the distribution and morphological study of NPY-IR in developing chick brain. The developing brain of Korean native chicks embryos at E8, E10, E12, E14, E16, E18, and E20 days of incubation were used. Experimental animals were perfused with 4% paraformaldehyde through the left ventricle and aorta. The brains were removed and transferred 30% sucrose, and then cut on a cryostat into 60 mm-thick. The tissue immunostained with free-floating and avidin-biotin complex (ABC) method. The results obtained in this study are that followings. The numerous of NPY-IR first observed at E8 days in the telencephalon of neostriatum, ectostriatum, archistriatum intermedium pars ventralis, nucleus taeniae and paleostriatum agumentatum, at E12 days in telencephalon of hippocampus, at E14 days in telencephalon of hyperstriatum. In the telencephalon, NPY-IR distributed predominantly in neostriatum and ectostriatum. shape of neuron's that E8 days of incubation were oval shape neurons and increased days of chicks was sphere, oval and many multigonal shapes. Their processes were also omnidirectional. The process of neuron's that E8 days of incubation was observed a few and weak immunity and increased days of chicks was numerous and strong immunity. According to increasing the days the morphology of NPY-IR showed the tendency to increase their sizes and numbers. We suggest that the regional differences in the distribution of NPY-containing neuron types may reflect adaptations of local neuronal circuits for specialized functions.
Animals ; Aorta ; Brain ; Embryonic Structures ; Feeding Behavior ; Globus Pallidus ; Heart Ventricles ; Hippocampus ; Neostriatum ; Neurons* ; Neuropeptide Y* ; Neuropeptides* ; Neurotransmitter Agents ; Pancreatic Polypeptide ; Pituitary Gland ; Sucrose ; Taenia ; Telencephalon*

No abstract available.
Peritoneum*

OBJECTIVE: To assess the relationship between vaginal cytology and bone mineral density in postmenopausal women. METHODS: In 93 postmenopausal women, vaginal cytology smears were taken for maturation index, serum estradiol level and bone mineral density were also taken. the percentage of each cell type found By vaginal cytology was multiplied to its specific value:superficial cells, 1.0; intermediate cell, 0.6; parabasal cell, 0.2 and modified to maturation value. Bone mineral density was measured at lumbar spine using DEXA. RESULTS: The mean bone mineral density was 0.88+/-0.14g/cm2. Mean maturation value was 50.53+/-20.74 and it was related with age and bone mineral density. CONCLUSION: Maturation value of vaginal epithelial cell represents the influence of estrogen on bone mineral density.
Bone Density* ; Epithelial Cells ; Epithelium* ; Estradiol ; Estrogens ; Female ; Humans ; Spine