PURPOSE: Recently, researchers at medical schools have shown increasing interest in developing a curriculum for medical humanities and improving 'humanity' in existing curriculums. This study introduces the process of developing the 'doctor & leadership' curriculum at K University from 2002. The results of the three-year implementation were analyzed. The effectivenessof the curriculum development is discussed. METHODS: The curriculum development followed the ADDIE model. A sixteen-week curriculum with three subjects was developed. The main methods of instruction were self-regulation learning and collaboration learning. The instruction method was a blended learning approach composed of both on-line and off-line instructions. Students were assessed through a portfolio assessment. 'Leadership self-assessment' and 'satisfaction index' of the overall curriculum were measured. RESULTS: The results on pre- and post- leadership self-assessment shows that leadership increased significantly after the learning process. Of the 4 sub-factors of the satisfaction index, the satisfaction indices on the blended learning, professor-student interaction, and instruction design had the greatest influence on the total satisfaction index (p<.001) CONCLUSION: Our outcome indicates that the 'doctor & leadership' curriculum is significantly effective. And generally, to increase the satisfaction index of courses, collaboration learning based on team projects and blended learning, as well as, professor-student interaction are helpful in encouraging the application of skills.
Cooperative Behavior ; Curriculum* ; Humanities ; Humans ; Leadership ; Learning ; Schools, Medical ; Self-Assessment

Primary tumors of the great vessels are rare. Most encountered cases are sarcomas which most commonly develop in the aorta, pulmonary artery, and inferior vena cava. We experienced an intimal sarcoma arising in the left common iliac artery in a 68-year-old male, who suffered from claudication in his left lower extremity for a year and was diagnosed as arteriosclerosis obliterans, clinically. Bypass surgery was performed on the obstructive lesion. Grossly, the vascular lumen was filled with dark hemorrhagic materials. Microscopically, the lesion showed proliferation of anaplastic spindle cells with a marked nuclear atypia, arranged haphazardly. There were numerous mitotic figures. Foci of cholesterol clefts were also found in the intima. Immunohistochemically, the tumor cells were positive for vimentin, smooth muscle actin, and cytokeratin in certain areas. Stains for CD34, desmin, myosin heavy chain, caldesmon, and S-100 protein were negative. A pathologic diagnosis was made as intimal sarcoma with myofibroblastic differentiation.
Actins ; Aged ; Aorta ; Arteriosclerosis Obliterans ; Calmodulin-Binding Proteins ; Cholesterol ; Coloring Agents ; Desmin ; Humans ; Iliac Artery ; Keratins ; Lower Extremity ; Male ; Muscle, Smooth ; Myofibroblasts ; Myosin Heavy Chains ; Pulmonary Artery ; S100 Proteins ; Sarcoma ; Vena Cava, Inferior ; Vimentin

Perineuriomas are composed of differentiated perineurial cells. Perineuriomas have been recently recognized by the immunoreactivity for epithelial membrane antigen (EMA). Microscopically, perineuriomas show proliferation of spindle cells with wavy nuclei and delicate elongated bipolar cytoplasmic processes. The tumor cells are usually negative for the S-100 protein. Ultrastructurally, perineurial cells reveal slender, nontapered processes containing pinocytic vesicles and discontinuous basal lamina. Interestingly, hybrid tumors of benign peripheral nerve sheath tumor (PNST) have been recently reported by using immunohistochemical and ultrastructural investigations. Herein, we report a case of soft tissue perineurioma arising in the skin of a 56-year-old female; another case of a hybrid tumor of perineurioma and schwannoma in the posterior mediastinum occurred in a 53-year-old male, which is the first case of the hybrid PNST tumor reported in Korea.
Basement Membrane ; Chimera ; Cytoplasm ; Humans ; Korea ; Male ; Mediastinum ; Middle Aged ; Mucin-1 ; Nerve Sheath Neoplasms ; Neurilemmoma ; Peripheral Nerves ; S100 Proteins ; Skin

BACKGROUND: It is important to differentiate between schwannomas and neurofibromas for the cases in which the histopathologic features overlap. Depending on the tumor type, surgeons can decide on a treatment method and whether to preserve or sacrifice the nerve; the possibility of malignant transformation in the case of neurofibromas also needs to be considered. METHODS: We studied 101 cases of schwannoma and 103 cases of neurofibroma. All the hematoxylin and eosin slides for these cases were reviewed, and tissue microarrays were prepared from the representative areas. Immunohistochemical analysis was performed using antibodies for S-100 protein, calretinin, CD56 and CD34. RESULTS: All the tumors except 3 neurofibromas were positive for the S-100 protein. Calretinin was found in 26.7% of the schwannomas (27/101), but it was not found in any of the neurofibromas. CD56 was positive in 77.2% of the schwannomas (78/101) and in 9.8% of the neurofibromas (10/102). CD34 was positive in 42.5% of the schwannomas (43/101) and in 80.2% of the neurofibromas (81/101). Statistically, calretinin was significantly specific for schwannomas (p<0.001) and CD56 was also sensitive for these tumors (p<0.001). On the other hand, a CD34 expression seemed highly sensitive (p<0.001) for neurofibromas. CONCLUSIONS: We concluded that combined immunohistochemical analysis for calretinin, CD56, and CD34 may be very useful for differentiating schwannomas from neurofibromas.
Antibodies ; Calcium-Binding Protein, Vitamin D-Dependent ; Diagnosis, Differential ; Eosine Yellowish-(YS) ; Hand ; Hematoxylin ; Immunohistochemistry ; Neurilemmoma ; Neurofibroma ; S100 Proteins

BACKGROUND: The prevalence of hyperuricemia has increased over the past few decades. Hyperuricemia is responsible for the increased risk of hypertension, type 2 diabetes mellitus, chronic renal disease, and cardiovascular disease. Health-related quality of life (HQoL) has been increasingly used as an outcome in clinical trials, effectiveness research, and research on quality of care. Therefore, we aimed to analyze the association between hyperuricemia and HQoL in Korean adults aged >19 years.METHODS: We included 2,376 male and 2,593 female who participated in the Korea National Health and Nutrition Examination Survey from 2016 to 2017. Hyperuricemia was defined as a serum uric acid (SUA) level of 7 mg/dL. The Euro quality of life-5 dimension (EQ-5D) questionnaire was used to measure HQoL. A multiple logistic regression analysis was performed to examine the association between hyperuricemia and HQoL.RESULTS: The EQ-5D index score of the hyperuricemia group was significantly lower than of the healthy group. After adjusting for multiple covariates, the odds ratio (95% confidence interval, [CI]) for mobility issues was 1.46 (95% CI, 1.211–1.683) in male and 1.33 (95% CI, 0.716–2.464) in female; however, the difference was not statistically significant for female.CONCLUSION: Hyperuricemia was associated with reduced quality of life. It is important to control SUA levels to improve HQoL.
Adult ; Cardiovascular Diseases ; Diabetes Mellitus, Type 2 ; Female ; Humans ; Hypertension ; Hyperuricemia ; Korea ; Logistic Models ; Male ; Nutrition Surveys ; Odds Ratio ; Prevalence ; Quality of Life ; Renal Insufficiency, Chronic ; Uric Acid

BACKGROUND: The aim of this study was to evaluate the safety and analgesic efficacy of polmacoxib 2 mg versus placebo in a superiority comparison or versus celecoxib 200 mg in a noninferiority comparison in patients with osteoarthritis (OA). METHODS: This study was a 6-week, phase III, randomized, double-blind, and parallel-group trial followed by an 18-week, single arm, open-label extension. Of the 441 patients with knee or hip OA screened, 362 were randomized; 324 completed 6 weeks of treatment and 220 completed the extension. Patients were randomized to receive oral polmacoxib 2 mg (n = 146), celecoxib 200 mg (n = 145), or placebo (n = 71) once daily for 6 weeks. During the extension, all participants received open-label polmacoxib 2 mg. The primary endpoint was the change in Western Ontario and McMaster Universities (WOMAC)-pain subscale score from baseline to week 6. Secondary endpoints included WOMAC-OA Index, OA subscales (pain, stiffness, and physical function) and Physician's and Subject's Global Assessments at weeks 3 and 6. Other outcome measures included adverse events (AEs), laboratory tests, vital signs, electrocardiograms, and physical examinations. RESULTS: After 6 weeks, the polmacoxib-placebo treatment difference was −2.5 (95% confidence interval [CI], −4.4 to −0.6; p = 0.011) and the polmacoxib-celecoxib treatment difference was 0.6 (CI, −0.9 to 2.2; p = 0.425). According to Physician's Global Assessments, more subjects were “much improved” at week 3 with polmacoxib than with celecoxib or placebo. Gastrointestinal and general disorder AEs occurred with a greater frequency with polmacoxib or celecoxib than with placebo. CONCLUSIONS: Polmacoxib 2 mg was relatively well tolerated and demonstrated efficacy superior to placebo and noninferior to celecoxib after 6 weeks of treatment in patients with OA. The results obtained during the 18-week trial extension with polmacoxib 2 mg were consistent with those observed during the 6-week treatment period, indicating that polmacoxib can be considered safe for long-term use based on this relatively small scale of study in a Korean population. More importantly, the results of this study showed that polmacoxib has the potential to be used as a pain relief drug with reduced gastrointestinal side effects compared to traditional nonsteroidal anti-inflammatory drugs for OA.
Arm ; Celecoxib* ; Electrocardiography ; Hip ; Humans ; Knee ; Ontario ; Osteoarthritis* ; Outcome Assessment (Health Care) ; Physical Examination ; Vital Signs