1.A Study of Comparison between Moral Sensitivity and Reasoning in Medical Students.
Ji Hye LEE ; Yong Lin MOON ; Ji Young KIM ; Hee Jung SON ; Kyung Pyo HONG
Korean Journal of Medical Education 2006;18(1):41-54
PURPOSE: The purpose of this study is to investigate the trends and traits of moral sensitivity and reasoning over six years of medical school. METHODS: The participants in this study consisted of 217 first to sixth-year medical students of Sungkyunkwan University School of Medicine in Korea. Essay type questionnaire was used for evaluating moral sensitivity and the Korean-Defining Issues Test (KDIT) was used for evaluating moral reasoning. RESULTS: It was found that the medical students' sensitivity of 'public welfare', 'prospective result' and 'role-taking as a doctor' was significantly higher than that of the pre-medical students'. Moral sensitivity increased in the 3rd and the 4th years but decreased in the 5th and the 6th years. Moral reasoning decreased in the 3rd and the 4th years but increased in the 5th and the 6th years. No correlation was observed between moral sensitivity and reasoning(r=0.033). Developmental trends of moral sensitivity and reasoning showed a significant difference in terms of year of medical school. CONCLUSION: The results suggest that medical school curriculum tends to impct students' moral sensitivity. This school has implemented the problem-based learning curriculum into the 3rd and the 4th years. It is necessary to consider the developmental state of the student's morality when developing an effective medical ethics program.
Curriculum
;
Ethics, Medical
;
Humans
;
Korea
;
Morals
;
Problem-Based Learning
;
Schools, Medical
;
Students, Medical*
;
Surveys and Questionnaires
2.Differences in Bacterial Species and Their Resistance Rates based on Sputum Cultures between Tertiary Hospitals and Smaller Medical Institutions.
Tae Hyung KIM ; Kyung Pyo CHO ; Jae Sung LEE ; Yong Moon WOO ; Ji Seok SEONG ; Chang Suk NOH
The Ewha Medical Journal 2013;36(2):126-131
OBJECTIVES: Since the 1990s, drug-resistant bacteria have become common pathogens of hospital-acquired infections. In recent years, healthcare-associated infections have come to the fore, and it is reported that distribution rates of these bacteria are comparable to those of hospital-acquired infections. However, there have been few studies on differences in resistant bacteria depending on the size of hospitals. Thus, the authors studied differences in drug-resistant bacteria between a tertiary hospital and smaller medical institutions. METHODS: We retrospectively analyzed the clinical findings and sputum culture results of patients transferred from tertiary hospitals (group A, n=74) and those transferred from smaller medical institutions (group B, n=65). RESULTS: The number of patients with malignancy was higher in group A than in group B. The length of intensive care unit stay was longer in group A than in group B. Antibiotic therapy and mechanical ventilation were more frequently used in group A than in group B. There were no significant differences between the 2 groups in bacterial species (Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa) and their resistance rates to carbapenem, while there were significant differences between the 2 groups in the bacterial species (Acinetobacter baumannii) and its resistance rate to carbapenem. CONCLUSION: In this study, there were significant differences between the 2 groups in the bacterial species and resistance rates to carbapenem for A. baumannii infection unlike other bacterial infections. Further studies on risk factors and patient classification are needed to confirm our results.
Acinetobacter baumannii
;
Bacteria
;
Bacterial Infections
;
Drug Resistance, Bacterial*
;
Escherichia coli
;
Humans
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Intensive Care Units
;
Klebsiella pneumoniae
;
Pseudomonas
;
Respiration, Artificial
;
Retrospective Studies
;
Risk Factors
;
Tertiary Care Centers*
3.Operative Treatments in Syringomyelia Caused by Trauma or Arachnoiditis.
Hyeon Dong JANG ; Kwan Ho PARK ; Moon Pyo JI ; Jae Oh KIM ; Jung Chul KIM
Journal of Korean Neurosurgical Society 2003;33(3):264-270
OBJECTIVE: Most cases of syringomyelia with arachnoid scarring were related to spinal trauma or inflammatory reaction. The aim of this study is to analyze the influence of arachnoid scarring on the altered dynamics of cerebrospinal fluid(CSF) and determine the proper treatment. METHODS: Between Jan 1991 and Dec 2001, We have operated on 15 patients with progressive neurological deficits associated with syringomyelia. We analyze the clinical presentations, radiographic and magnetic resonance images. RESULTS: As to cause of syringomyelia, 11 patients were related with trauma and 4 patients were tuberculous meningitis. Shunting procedures underwent in 11 patients and 5 showed clinical improvement. Subarachnoid adhesiolysis and expansile duraplasty were performed in 4 patients and 3 experienced clinical improvement. The 6 patients with shunting procedures were neurologically deteriorated and 4 were reoperated. CONCLUSION: The arachnoid scarring interferes with CSF flow and causes syringomyelia. Successful long-term outcome in the surgical treatment of syringomyelia caused by focal arachnoid scar appeared to require microsurgical dissection of scar and expansile duroplasty. For extensive arachnoid scarring over multiple spinal levels or after previous surgery, shunting procedure may be indicated only.
Arachnoid*
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Arachnoiditis*
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Cerebrospinal Fluid
;
Cicatrix
;
Humans
;
Syringomyelia*
;
Tuberculosis, Meningeal
4.Postoperative Results of Canal Wall Up Mastoidectomy Only Performing Anterior Tympanotomy.
Jae Yong BYUN ; Chang Il CHA ; Seok Min HONG ; Ji Ho MOON ; In Young LEE ; Nam Pyo HONG
Korean Journal of Otolaryngology - Head and Neck Surgery 2004;47(11):1085-1089
BACKGROUND AND OBJECTIVES: Retrospective reflect of canal wall up (CWU) mastoidectomy with posterior tympanotomy revealed some problems such as ineffectiveness against the recurrence of cholesteatoma, reclosure of ventilation route and that a posterior tympanotomy might be harmful to inner ear. Objectives of this study is to evaluate the effect of mastoidectomy with anterior tympanotomy on postoperative hearing results and complications. SUBJECTS AND METHOD: From January 1998 through July 2001, 29 cases of CWU mastoidectomy with anterior tympanotomy were reviewed retrospectively. All of the cases were difficult to perform posterior tympanotomy due to anatomical variations and had lesions restricted to anterior epitympanum. The hearing results were assessed by postoperative 1-year pure tone average and postoperative 1-year air-bone gap (ABG), and we checked complications. RESULTS: Of the 29 cases, 21 cases (72.4%) had ABG <20 dB in the postoperative 1-year, with the postoperative 1-year ABG of 14.9+/-9.2 dB. The postoperative hearing gain was 10.1+/-10.6 dB. There were 3 cases of chorda tympani nerve cutting, 1 case of accidental malleoincudal joint dislocation and 1 case of recurrence. CONCLUSION: Anterior tympanotomy could be a good approach for ventilation in selected CWU mastoidectomy approach, and further long term follow-up is needed to study about recurrence.
Cholesteatoma
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Chorda Tympani Nerve
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Dislocations
;
Ear, Inner
;
Follow-Up Studies
;
Hearing
;
Joints
;
Mastoid
;
Otitis Media
;
Recurrence
;
Retrospective Studies
;
Ventilation
5.Phenotypes of Granular Corneal Dystrophy Type 2 among Koreans in Their Twenties
Ji Hyung SUH ; Ik Hee RYU ; Jin Pyo HONG ; Ja Yoon MOON ; Jin Seok CHOI ; Ikhyun JUN ; Tae-Im KIM ; Eung Kweon KIM
Journal of the Korean Ophthalmological Society 2022;63(12):965-972
Purpose:
Granular corneal dystrophy type 2 (GCD2) is a hereditary disease that features granular and lattice stromal deposits in the cornea. There are homozygotes and heterozygotes and the opacities are exacerbated by corneal trauma or surgery, such as laser in situ keratomileusis (LASIK). As there is individual variability in GCD2 phenotypes, we investigated various corneal features of GCD2 patients in their twenties, the main age group for refractive surgery.
Methods:
From genetically confirmed GCD2 patients who had an R124H mutation of the transforming growth factor β induced (TGFBI) gene at age 20 to 29 years, we chose representative patients: one homozygote; one compound heterozygote; one simple heterozygote with a severe phenotype with many granular deposits; one common heterozygote; and four heterozygotes with normal corneas. The corneas of all patients were subject to slit-lamp examination and photographed.
Results:
The homozygote had confluent granular deposits covering the cornea. The compound heterozygote had granular and lattice deposits covering the center of the cornea. The patient with a severe phenotype had more than 30 granular deposits in one eye, but was a simple GCD2 heterozygote, verified by full-sequencing of the TGFBI gene. In the four patients with normal corneas, a single small lesion was subsequently detected during follow-up in two, at 3 weeks and 6 months, respectively. Both corneas were judged clear at chance examinations.
Conclusions
Among Koreans in their twenties, GCD2 patients have various phenotypes, from clear corneas to severe confluent opacities. There are GCD2 heterozygotes with nearly clear corneas, so caution must be taken when choosing patients for refractive surgery.
6.Treatment Result in Advanced T3 and T4 Glottic Carcinoma: YUMC Experience.
Hyun Soo SHIN ; Hyung Sik LEE ; Eun Ji CHUNG ; Gwi Eon KIM ; Juhn Kyu LOH ; Chang Ok SUH ; Kwang Moon KIM ; Won Pyo HONG
Journal of the Korean Society for Therapeutic Radiology 1991;9(1):73-80
Between January 1980 and September 1988, 68 patients with advanced T3 & T4 glottic carcinoma were treated with RT and surgery/RT in the Department of Radiation Oncology, Yonsei Cancer Center and ENT, Yonsei University College of Medicine. The mean age was 60 years old (range 33 to 79 year old). The 34 patients were treated with irradiation alone, and the remaining 34 patients with surgery and irradiation. Initial nodal presentation was 37% (25/68); 31% (11/34) in RT alone group and 41% (14/34) in combined treatment group. The minimum follow-up was 2 years. The local control rate after treatment was 47% in RT alone group and 65% in combined treatment group; 57% for node negative and 27% for node positive patients treated with RT alone; 65% for node negative and 64% for node positive patients treated with combined treatment. The treatment failure was observed in 30 patients; 14 patients for primary local failure, 6 patients for regional nodal failure, 6 patients for local and regional failure, 26 patients for primary failure and/or distant metastasis, and 2 patient for regional failure and/or distant metasasis. The overall 5-year survival rate was 57%; 37% in RT alone group and 76% in combined treatment group; 55% for node negative and 20% for node positive patients treated with RT alone; 73% for node negative and 77% for node positive patients treated with combined treatment. In conclusion, the combined treatment groups in the treatment of advanced T3 and T4 glottic cancer showed the better results in local control rates and 5-year actuarial survival rates than RT alone group. We suggest that total laryngectomy and postoperative RT in the most patients of advanced glottic cancer were performed. However, in cases of node negative patients, RT alone is prefer as a treatment modality over combined surgery and RT since the treatment results were comparable and furthermore functional preservation could be achieved.
Follow-Up Studies
;
Humans
;
Laryngectomy
;
Middle Aged
;
Neoplasm Metastasis
;
Radiation Oncology
;
Survival Rate
;
Treatment Failure
7.Development and Assessment of Clinical Pathway for Simple Congenital Heart Surgery.
Ju Ryoung MOON ; June HUH ; I Seok KANG ; Ji Hyuk YANG ; Tae Gook JUN ; Pyo Won PARK ; Heung Jae LEE
Journal of the Korean Pediatric Cardiology Society 2006;10(1):22-36
PURPOSE: To standardize hospital management of patients with simple congenital heart disease (CHD), we developed a protocol called the 'clinical pathway (CP)'and evaluated quality improvement in patient outcomes. METHODS: The study included a group of 60 patients with simple CHD who had surgery between June 1 and October 31, 1998. The control group included 48 patients who had surgery for the same disease during the corresponding time in 1997. Two CPs were developed according to state and place of residence of patients. Information on patients was reviewed including: education, physical examination, hospital stay, type of care and date of discharge from the hospital. The effect of each protocol on standard procedures was reviewed. After patient discharge additional performance information was assessed including: procedures used, duration of hospital stay, medical cost, treatment outcome, complications and parent satisfaction. RESULTS: The duration of hospital stay prior to surgery (1.8 days vs. 3.0 days), the ICU stay (1.3 days vs. 3.6 days), number of ward days after surgery (5.3 days vs. 7.9 days) and total number of hospital days (8.5 days vs. 14.7 days) were significantly shortened in the study group compared to the control group. The intubation time (P=0.000) and the frequency of laboratory studies (P=0.000) during the hospitalization decreased in the study group compared to the control group. The average medical costs of cases was also significantly lower in the study group (P=0.001). There were no deaths, readmissions or serious complications in the study group. A questionnaire survey of patient family members showed that they were satisfied with care; with more than 85 percent response rate to questionnaire items. CONCLUSION: Application of our new CP protocol shortens hospital stay and reduces medical costs while improving the quality of care for patients and their families. This CP protocol should now be considered for more complex CHD.
Critical Pathways*
;
Health Care Costs
;
Heart Defects, Congenital
;
Heart*
;
Hospitalization
;
Humans
;
Intubation
;
Length of Stay
;
Parents
;
Patient Discharge
;
Physical Education and Training
;
Quality Improvement
;
Surveys and Questionnaires
;
Thoracic Surgery*
8.A Case of Crescentic Glomerulonephritis and Marginal Zone B-cell Lymphoma.
Yongjin YI ; Hyunjin RYU ; Ji In PARK ; Jung Pyo LEE ; Chun Soo LIM ; Kyung Chul MOON ; Yun Kyu OH
Korean Journal of Medicine 2014;87(5):609-614
Secondary rapidly progressive glomerulonephritis (RPGN) can be caused by many diseases and conditions, including vasculitis, systemic rheumatic diseases, infections, drugs and malignancies. Among the secondary RPGNs, malignancy-associated RPGN is extremely rare and causes renal function deterioration within several weeks to months. Thus, timely immunosuppressant therapy can improve renal outcome. Herein, we describe a case of RPGN detected simultaneously with marginal zone B-cell lymphoma. An 82-year-old male patient, who presented generalized edema and oliguria, was diagnosed with crescentic glomerulonephritis and marginal B-cell lymphoma. After the patient was given methylprednisolone pulse therapy, renal function was restored and hemodialysis was successfully discontinued without complications.
Aged, 80 and over
;
Edema
;
Glomerulonephritis*
;
Humans
;
Lymphoma, B-Cell
;
Lymphoma, B-Cell, Marginal Zone*
;
Male
;
Methylprednisolone
;
Oliguria
;
Renal Dialysis
;
Rheumatic Diseases
;
Systemic Vasculitis
9.A Case of Crescentic Glomerulonephritis and Marginal Zone B-cell Lymphoma.
Yongjin YI ; Hyunjin RYU ; Ji In PARK ; Jung Pyo LEE ; Chun Soo LIM ; Kyung Chul MOON ; Yun Kyu OH
Korean Journal of Medicine 2014;87(5):609-614
Secondary rapidly progressive glomerulonephritis (RPGN) can be caused by many diseases and conditions, including vasculitis, systemic rheumatic diseases, infections, drugs and malignancies. Among the secondary RPGNs, malignancy-associated RPGN is extremely rare and causes renal function deterioration within several weeks to months. Thus, timely immunosuppressant therapy can improve renal outcome. Herein, we describe a case of RPGN detected simultaneously with marginal zone B-cell lymphoma. An 82-year-old male patient, who presented generalized edema and oliguria, was diagnosed with crescentic glomerulonephritis and marginal B-cell lymphoma. After the patient was given methylprednisolone pulse therapy, renal function was restored and hemodialysis was successfully discontinued without complications.
Aged, 80 and over
;
Edema
;
Glomerulonephritis*
;
Humans
;
Lymphoma, B-Cell
;
Lymphoma, B-Cell, Marginal Zone*
;
Male
;
Methylprednisolone
;
Oliguria
;
Renal Dialysis
;
Rheumatic Diseases
;
Systemic Vasculitis
10.Three Cases of FDG-FET Scan Application in Patients with Metastatic Gestational Trophoblastic Tumor.
Sung Min KIM ; June Hee LIM ; Ji Young LEE ; Moon Hong KIM ; Ju Won ROH ; Jae Won KIM ; Noh Hyun PARK ; Yong Sang SONG ; Soon Beom KANG ; Hyo Pyo LEE
Korean Journal of Gynecologic Oncology and Colposcopy 2000;11(3):328-335
Positron emission tomography(PET) is an imaging technique that produces images reflective of tissue biochemistry rather anatomy. The great versatility of PET and its potential of direct noninvasive study of tumor function will make it a very important clinical and research tool in oncology. Recently, whole body PET techniques have been developed which permit imaging of the entire body during a single scanning session promising both in determining the nature of a localized lesion and in defining the systemic extent of malignant disease. FDG-PET scan seems valuable in evaluating patients with GTT resistant to chemotherapy with persistent elevation of beta-hCG levels and localizing the site of a viable tumor. We present three cases of FDG-PET scan in patients with metastatic gestational trophoblastic tumor with a brief review of literatures.
Biochemistry
;
Drug Therapy
;
Electrons
;
Humans
;
Neoplasm Metastasis
;
Trophoblastic Neoplasms*
;
Trophoblasts*