This is a retrospective review of our experience with endoscopic extraction of 20 cases of foreign body on the upper gastrointestinal tract at sanggye paik hospital from Oct. 1989 to Nov. 1993. Among 20 cases, 3 cases were under 5years of age and 17 cases were over 27years of age. 9 cases (45%) were located in the esophagus, 8 cases (40%) were in the stomach and 3 cases (15%) were in the duodenum. All children (100%) have true foreign body, almost of all adults (82%) have food-related foreign body. Dysphagia with chest pain or vomiting was the most common symptom in the esophageal foreign body. Epigastric pain and vomiting or hematemesis were common symptoms in the stomach or duodenal foreign body, All of the esophageal foreign body (100%) were extracted within 72 hours, most of all (91%) stomach and duodenal foreign body were extracted after 72 hours.
Adult ; Chest Pain ; Child ; Deglutition Disorders ; Duodenum ; Esophagus ; Foreign Bodies* ; Hematemesis ; Humans ; Retrospective Studies ; Stomach ; Upper Gastrointestinal Tract* ; Vomiting

PURPOSE: The purpose of this study was to investigate the experience of examinees who took the first clinical skill examination in Korea. METHODS: The data were collected by written survey, telephone, and face-to-face interviews with 46 examinees who took a clinical skills examination test at Jeju National University School of Medicine. Thirty-two questionnaires were valid for analysis. RESULTS: Examinees' self-evaluation scores with regard to the level of difficulty of the CPX was 2.83 on average (1 for very easy, 5 for very difficult), and the score on the degree of adequate time for the CPX was 2.69 on average (1 for enough, 5 for very short). Examinees' self-evaluation scores on the level of difficulty of the OSCE was 2.37 on average (1 for very easy, 5 for very difficult), and the score on the degree of adequate time for the OSCE was 2.56 on average (1 for enough, 5 for very short). CONCLUSION: We hope that our study provides useful information on practical questions in the development and review of exams and will be used to develop educational content and teaching methods in medical education.
Clinical Competence ; Diagnostic Self Evaluation ; Education, Medical ; Education, Medical, Undergraduate ; Educational Measurement ; Humans ; Licensure ; Schools, Medical ; Teaching ; Telephone ; Surveys and Questionnaires

BACKGROUND: Shigellosis is one of the most important contagious diseases in Korea. Especially, Jeju island has been known as the main and large outbreak area in Korea. The purpose of this study was to investigate the epidemiologic characteristics of shigellosis in Jeju island, 2003. METHODS: Patients with shigellosis, confirmed by culture in Jeju island in 2003, were included in this study. We retrospectively reviewed epidemiologic questionnaires, medical records, and official documents. We also collected data from direct interview with the patients with shigellosis. Epidemiological analysis was performed by 3 categorized events and ages. RESULTS: Ninety-nine patients were included in this study. S. sonnei was identified in all of the patients. Shigellosis mainly occurred in preschool-aged children. However, there was no statistical difference according to sex. Although there were asymptomatic cases (15.15%), the chief complaints were loose stool (69.7%) and abdominal pain (12.12%). Initial symptoms in symptomatic patients were abdominal pain (43.43%) and fever (31.31%). The median duration of isolation in the hospital was 7 days. CONCLUSION: Large and chronic epidemic outbreaks of shigellosis have occurred in Jeju island. Throughout this survey, we could show the epidemiological characteristics and the nature of shigellosis in Jeju island.
Abdominal Pain ; Child ; Disease Outbreaks ; Dysentery, Bacillary* ; Fever ; Humans ; Korea ; Medical Records ; Retrospective Studies ; Surveys and Questionnaires

Pellagra is a disease caused by a deficiency of niacin. It is usually found among chronic alcoholics in Korea. Dermatitis, dementia and diarrhea are characteristic symptoms of pellagra. Vibrio sepsis is due to a virulent, gram-negative rod infection caused by Vibrio vulnificus. It is generally acquired in coastal areas near warm water. Underlying disease and initial clinical presentations of pellagra are very similar to that of vibrio sepsis. Herein, we report a case of pellagra that initially mimicked vibrio sepsis.
Alcoholics ; Dementia ; Dermatitis ; Diarrhea ; Humans ; Korea ; Niacin ; Pellagra ; Sepsis ; Vibrio ; Vibrio vulnificus

BACKGROUND: Shigellosis is one of the most important contagious diseases in Korea. Especially, Jeju island has been known as the main and large outbreak area in Korea. The purpose of this study was to investigate the epidemiologic characteristics of shigellosis in Jeju island, 2003. METHODS: Patients with shigellosis, confirmed by culture in Jeju island in 2003, were included in this study. We retrospectively reviewed epidemiologic questionnaires, medical records, and official documents. We also collected data from direct interview with the patients with shigellosis. Epidemiological analysis was performed by 3 categorized events and ages. RESULTS: Ninety-nine patients were included in this study. S. sonnei was identified in all of the patients. Shigellosis mainly occurred in preschool-aged children. However, there was no statistical difference according to sex. Although there were asymptomatic cases (15.15%), the chief complaints were loose stool (69.7%) and abdominal pain (12.12%). Initial symptoms in symptomatic patients were abdominal pain (43.43%) and fever (31.31%). The median duration of isolation in the hospital was 7 days. CONCLUSION: Large and chronic epidemic outbreaks of shigellosis have occurred in Jeju island. Throughout this survey, we could show the epidemiological characteristics and the nature of shigellosis in Jeju island.
Abdominal Pain ; Child ; Disease Outbreaks ; Dysentery, Bacillary* ; Fever ; Humans ; Korea ; Medical Records ; Retrospective Studies ; Surveys and Questionnaires

Pellagra is a disease caused by a deficiency of niacin. It is usually found among chronic alcoholics in Korea. Dermatitis, dementia and diarrhea are characteristic symptoms of pellagra. Vibrio sepsis is due to a virulent, gram-negative rod infection caused by Vibrio vulnificus. It is generally acquired in coastal areas near warm water. Underlying disease and initial clinical presentations of pellagra are very similar to that of vibrio sepsis. Herein, we report a case of pellagra that initially mimicked vibrio sepsis.
Alcoholics ; Dementia ; Dermatitis ; Diarrhea ; Humans ; Korea ; Niacin ; Pellagra ; Sepsis ; Vibrio ; Vibrio vulnificus

Staphylococcal scalded skin syndrome (SSSS) is an exfoliative infectious disorder caused by the exfoliative toxins of Staphylococcus aureus. The condition usually affects infants and children younger than 5 years of age. However, SSSS is rarely observed in adults. Adult SSSS is usually associated with renal failure, immunosuppression, malignancy, alcohol abuse, or HIV infection. In contrast to infant cases, adult SSSS is often accompanied with a high mortality rate, sepsis and poor prognosis. We report a rare case of SSSS in an immunocompetent 34-year-old man without renal failure.
Adult ; Alcoholism ; Child ; Exfoliatins ; HIV Infections ; Humans ; Immunosuppression ; Infant ; Prognosis ; Renal Insufficiency ; Sepsis ; Staphylococcal Scalded Skin Syndrome ; Staphylococcus aureus

BACKGROUND: The appropriate empirical antimicrobial choice in the treatment of community-acquired pneumonia (CAP) should be advocated by community-based information on the etiologic pathogens, their susceptibility to antimicrobials, clinical characteristics and outcomes. Jeju is a geographically isolated and identical region in Korea. However, there is no regional reference on adult CAP available. This study investigated the etiologic agents and clinical outcomes of adult patients diagnosed with CAP in Jeju, Korea, to help guide the empirical antimicrobial choice. METHODS: A prospective observational study for one year in a referral hospital in Jeju, Korea. Patients diagnosed with CAP were enrolled with their clinical characteristics. Microbiological evaluations to identify the etiologic agents in the adult patients with CAP were performed with blood culture, expectorated sputum smear and culture, antibody tests for mycoplasma, chlamydophila, and antigen tests for legionella and pneumococcus. The clinical outcomes of the initial empirical treatment were analyzed. RESULTS: Two hundred and three patients with mean age of 64 and 79 females were enrolled. Ten microbials from 90 cases (44.3%) were isolated and multiple isolates were confirmed in 30. Among the microbial isolates, S. pneumoniae (36.3%) was the most common, followed by M. pneumoniae (23.0%), C. pneumoniae (17.0%), S. aureus (9.6%) and P. aeruginosa (5.9%). The initial treatment failure (23.8%) was related to the isolation of polymicrobial pathogens, elevated inflammatory markers, and the presence of pleural effusion. Among the 30 isolates of S. pneumoniae, 16 (53.3%) were not susceptible to penicillin, and 19 isolates (63.3%) to erythromycin and clarithromycin. However, 29 isolates (96.7%) were susceptible to levofloxacin and ceftriaxone. CONCLUSION:S. pneumoniae, M. pneumoniae, S. aureus, and P. aeruginosa are frequent etiologic agents of adult CAP in Jeju, Korea. The clinical characteristics and antibiotic resistance should be considered when determining the initial empirical antimicrobial choice. Respiratory quinolone or ceftriaxone is recommended as an empirical antimicrobiotic in the treatment of adult CAP in Jeju, Korea.
Adult ; Ceftriaxone ; Chlamydophila ; Clarithromycin ; Community-Acquired Infections ; Drug Resistance ; Drug Resistance, Microbial ; Erythromycin ; Female ; Humans ; Korea ; Legionella ; Mycoplasma ; Ofloxacin ; Penicillins ; Pleural Effusion ; Pneumonia ; Prospective Studies ; Referral and Consultation ; Sputum ; Streptococcus pneumoniae ; Treatment Failure

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are the potentially life-threatening, acute hypersensitivity reaction to inciting drugs. These diseases have been often associated with systemic carbonic anhydrase inhibitor such as acetazolamide or methazolamide in Korean and Japanese patients. Dorzolamide is a recently developed topical carbonic anhydrase inhibitor with few significant systemic adverse effects. To the best of our knowledge, there have been only a few reports of SJS or TEN caused by topical dorzolamide in the literature. We herein present two cases of TEN and one case of SJS related with topical use of dorzolamide. It should be emphasized that although rarely, topical dorzolamide may cause serious sulfonamide hypersensitivity such as SJS or TEN in the susceptible patient through the systemic absorption.
Absorption ; Acetazolamide ; Asian Continental Ancestry Group ; Carbonic Anhydrases ; Epidermal Necrolysis, Toxic ; Humans ; Hypersensitivity ; Methazolamide ; Stevens-Johnson Syndrome ; Sulfonamides ; Thiophenes

OBJECTIVES: This retrospective cohort study aimed to estimate the mean sojourn time (MST) of preclinical gastric cancer in Korean men. METHODS: The subjects consisted of voluntary male screenees aged 40 to 69 years who underwent subsequent screening gastroscopies after testing negative at a baseline screening performed between January 2007 and December 2011. A new case was defined if gastric cancer cells were present in the biopsy specimens obtained from gastroscopy. The follow-up period was calculated as the number of person-years between the date of baseline screening gastroscopy and positive findings at a subsequent screening. The MST was calculated using transition rates of gastric cancer to determine the best screening interval. RESULTS: Of the 171 979 voluntary male screenees, 61 688 (36%) underwent subsequent screening gastroscopies between January 2007 and December 2011. A total of 91 incident cases were found during 19 598 598 person-years of follow-up. The MST of gastric cancer was 2.37 years (95% confidence intervals, 1.92 to 2.96), and those aged 40 to 49 years had a shorter MST than those 50 to 69 years did. CONCLUSIONS: These findings support the 2-year interval of screening recommended by the nationwide gastric cancer screening program in Korea. Further studies for the age-specific MST among women are needed.
Adult ; Aged ; *Algorithms ; Asian Continental Ancestry Group ; Cohort Studies ; Early Detection of Cancer ; Gastroscopy ; Humans ; Incidence ; Male ; Mass Screening ; Middle Aged ; Republic of Korea ; Retrospective Studies ; Stomach Neoplasms/*epidemiology/pathology ; Time Factors