PURPOSE: Nonverbal communication (NVC) may be a crucial factor affecting effective communication between patients and medical students during the objective structured clinical examination (OSCE), but it has not been intensively studied. We examined NVC and its correlation with patient-physician interaction (PPI) in the OSCE. METHODS: A total of 68 video recordings of routine check-up OSCEs were included. A checklist for NVC was developed that included seven nonverbal factors in a mute state (NVM) and four nonverbal factors in speech (NVS), and one point was assigned to each factor. The scores for history taking, PPI, NVM, and NVS were compared, and correlations of each score were evaluated. RESULTS: Students with adequate facial expressions, accorded speech rate and voice volume, adequately matched voice tone, and few or no moments of unnecessary silence showed better PPI scores. The PPI score was correlated with history taking and the NVS score, but not the NVM score. CONCLUSION: Our results suggest that NVS may be more influential to PPI during OSCEs than NVM. Communication teachers should help students to be better prepared to use both NVS and NVM properly.
Checklist ; Education, Medical ; Facial Expression ; Humans ; Medical History Taking ; Nonverbal Communication* ; Patient Satisfaction ; Students, Medical* ; Video Recording ; Voice

PURPOSE: Nonverbal communication (NVC) is important in the patient-physician relationship, but the effect of NVC education is not well kown. In this study, we try to identify if students' NVC abilities are improved through communication training. METHODS: First-year medical students conducted medical interviews, which were performed with standardized patients (SPs) before and after communication skill education, and recorded in video. Fifty-one students were enrolled for this study. Two researchers used the NVC checklist, which consists of 12 nonverbal behaviors, to analyze and compare the students' nonverbal expressions in the interviews recorded before and after the education. RESULTS: After the students participated in communication training, open body position and adequate facial expression were increased while unnecessary silence, un-purposive movements, and giggling were decreased. These results can be interpreted as positive effects of the education. However, hand gesture was increased as a negative effect of the education. The total NVC score of the 12 nonverbal behaviors in the NVC checklist improved significantly, rising from 8.56 to 10.03. CONCLUSION: Communication skill education using SPs can improve nonverbal behaviors of medical students, especially facial expression, un-purposive movement, body position, unnecessary silence, and giggle, but not hand gesture. Further research is needed on a variety of teaching methods to improve NVCs.
Checklist ; Education ; Education, Medical ; Facial Expression ; Gestures ; Hand ; Humans ; Nonverbal Communication ; Students, Medical* ; Teaching

Background: Appropriate nutrition is necessary for maintaining good health in the general population. During primary physician training, it is important to educate residents on the basic concepts of nutrition and methods to manage nutritional aspects according to various disease. However, little is known about the perception of nutritional education among Korean family medicine residents. This study analyzed the recognition of the importance of nutritional education, the amount received, and satisfaction with it as well as self-perceived competency in various nutrition topics among residents. Methods: Web-based questionnaires were sent via mobile messages to all the residents registered with the Korean Academy of Family Medicine (KAFM). Out of 566 residents, 68 voluntarily participated in the study. The questionnaire consisted of 41 items related to perceptions of nutrition education, self-perceived competency in nutrition topics, and demographic characteristics. Results: The response rate was 12.01%. Residents rated their satisfaction with nutrition education at 4.78 out of 10, and 83.3% considered it important. However, only 13.24% of the participants felt that it was adequate. The most common training method for nutrition education was lectures at KAFM conferences. Among the 29 nutritional topics, the residents reported highest confidence in subjects related to chronic diseases such as obesity (77.94%), diabetes (75%), cardiovascular disease (67.65%), gastrointestinal disorders (67.65%), and weight loss management (67.65%). Conversely, topics related to women (36.76%), children and adolescents (38.23%), drug-nutrient interactions (39.7%), eating disorders (42.64%), and food labels (42.64%) showed low self-perceived confidence rates. Conclusion Korean family medicine residents value nutrition education but believe that more education is necessary and they demonstrate differences in self-perceived competency in various nutrition topics.

Endometrial papillary serous carcinoma (EPSC) is a distinct variant of endometrial adenocarcinoma that histologically resembles ovarian serous papillary adenocarcinoma and has an aggressive clinical course. Usually, the tumor is diagnosed at the advanced stage. The tumor has well confused with metastatic ovarian tumor of identical histology. Dignosis of EPSC should be considered when the cervico-vaginal smear reveals numerous papillary clusters of tumor cells with macronucleoli and psammoma bodies. Recently, we have experienced two cases of EPSC diagnosed on cervico-vaginal smears, which revealed characteristic cytologic features including numerous papillary clusters of tumor cells with macronucleoli. The cytologic diagnoses were confirmed on histologic sections.
Adenocarcinoma ; Adenocarcinoma, Papillary ; Diagnosis ; Polycystic Kidney, Autosomal Recessive*

BACKGROUND: Nutrition label reading is helpful in attaining a healthy diet. Nutrition label use and its related factors have been studied in many Korean articles, but their research samples were the general population and not chronic disease patients. This study aimed to explore the use of nutrition labels and its relation to dietary intake among chronic disease patients in Korea. METHODS: A total of 3160 respondents aged> or =20 years from the 2008-2009 Fourth Korean National Health and Nutrition Examination Survey (KNHANES-IV) participated in the study. Their chronic medical conditions included hypertension, hyperlipidemia, coronary artery disease, diabetes and/or stroke and they were interviewed regarding their use of nutrition labels. Nutrition intake was also estimated by 24-hour dietary recalls. RESULTS: Overall, 10.4% of the chronic disease patients reported to using nutrition labels. The nutrients they looked at first were total calories, fat and cholesterol. Factors related to reading nutrition labels were relatively higher education, high body mass index and lower frequency of alcohol intake in males and relatively younger age and higher education in females. Nutrition label users consumed lower total calories, protein and fat in the male CAD group, lower total calories and carbohydrate in both diabetes and total groups and lower total calories and fiber in the female stroke group. CONCLUSIONS: Our study found that, in Korea, a significantly lower rate of patients with chronic disease read nutrition labels. Strategies need to be developed to improve clinical application of nutrition labels in this population.
Body Mass Index ; Cholesterol ; Chronic Disease* ; Coronary Artery Disease ; Surveys and Questionnaires ; Diet ; Education ; Female ; Food Labeling ; Humans ; Hyperlipidemias ; Hypertension ; Korea ; Male ; Nutrition Surveys* ; Stroke

Background: Interest in healthy aging has grown with the increase in the older population. Nutritional intake is crucial in frailty. Therefore, we aimed to investigate the relationship between frailty and multivitamin and mineral supplements (MVMS), which can easily provide micronutrients. Methods: The Korea National Health and Nutrition Examination Survey (KNHANES) conducted from 2018 to 2019 included 3,395 adults aged ≥65 years. Of these, 1,511 who did not consume dietary supplements (DS, non-DS group) and 415 who took MVMS (MVMS group) were included in the study. We modified Fried’s definition of frailty to fit the KNHANES data. Using multivariate logistic regression, we examined the association between MVMS use and frailty, which varied with satisfaction with total energy intake. Additional subgroup analyses were performed based on age, sex, and income. Results: MVMS reduced most micronutrient deficiencies compared to obtaining nutrients solely through food. The overall analysis revealed no association between MVMS use and frailty (odds ratio [OR], 0.75; 95% confidence interval [CI], 0.52–1.09). However, a subanalysis revealed that participants with a low income (≤25%) who took MVMS had decreased odds for frailty (OR, 0.55; 95% CI, 0.35–0.88) compared with the non-DS group. Furthermore, a significant association between using MVMS and frailty was confirmed in the group with low income and energy intake below the recommended daily allowance, with a low OR of 0.52 (95% CI, 0.30–0.90). Conclusion MVMS use was significantly associated with frailty among the low-income and low-daily energy intake groups.

Background: Interest in healthy aging has grown with the increase in the older population. Nutritional intake is crucial in frailty. Therefore, we aimed to investigate the relationship between frailty and multivitamin and mineral supplements (MVMS), which can easily provide micronutrients. Methods: The Korea National Health and Nutrition Examination Survey (KNHANES) conducted from 2018 to 2019 included 3,395 adults aged ≥65 years. Of these, 1,511 who did not consume dietary supplements (DS, non-DS group) and 415 who took MVMS (MVMS group) were included in the study. We modified Fried’s definition of frailty to fit the KNHANES data. Using multivariate logistic regression, we examined the association between MVMS use and frailty, which varied with satisfaction with total energy intake. Additional subgroup analyses were performed based on age, sex, and income. Results: MVMS reduced most micronutrient deficiencies compared to obtaining nutrients solely through food. The overall analysis revealed no association between MVMS use and frailty (odds ratio [OR], 0.75; 95% confidence interval [CI], 0.52–1.09). However, a subanalysis revealed that participants with a low income (≤25%) who took MVMS had decreased odds for frailty (OR, 0.55; 95% CI, 0.35–0.88) compared with the non-DS group. Furthermore, a significant association between using MVMS and frailty was confirmed in the group with low income and energy intake below the recommended daily allowance, with a low OR of 0.52 (95% CI, 0.30–0.90). Conclusion MVMS use was significantly associated with frailty among the low-income and low-daily energy intake groups.

Background: Interest in healthy aging has grown with the increase in the older population. Nutritional intake is crucial in frailty. Therefore, we aimed to investigate the relationship between frailty and multivitamin and mineral supplements (MVMS), which can easily provide micronutrients. Methods: The Korea National Health and Nutrition Examination Survey (KNHANES) conducted from 2018 to 2019 included 3,395 adults aged ≥65 years. Of these, 1,511 who did not consume dietary supplements (DS, non-DS group) and 415 who took MVMS (MVMS group) were included in the study. We modified Fried’s definition of frailty to fit the KNHANES data. Using multivariate logistic regression, we examined the association between MVMS use and frailty, which varied with satisfaction with total energy intake. Additional subgroup analyses were performed based on age, sex, and income. Results: MVMS reduced most micronutrient deficiencies compared to obtaining nutrients solely through food. The overall analysis revealed no association between MVMS use and frailty (odds ratio [OR], 0.75; 95% confidence interval [CI], 0.52–1.09). However, a subanalysis revealed that participants with a low income (≤25%) who took MVMS had decreased odds for frailty (OR, 0.55; 95% CI, 0.35–0.88) compared with the non-DS group. Furthermore, a significant association between using MVMS and frailty was confirmed in the group with low income and energy intake below the recommended daily allowance, with a low OR of 0.52 (95% CI, 0.30–0.90). Conclusion MVMS use was significantly associated with frailty among the low-income and low-daily energy intake groups.

Background: Interest in healthy aging has grown with the increase in the older population. Nutritional intake is crucial in frailty. Therefore, we aimed to investigate the relationship between frailty and multivitamin and mineral supplements (MVMS), which can easily provide micronutrients. Methods: The Korea National Health and Nutrition Examination Survey (KNHANES) conducted from 2018 to 2019 included 3,395 adults aged ≥65 years. Of these, 1,511 who did not consume dietary supplements (DS, non-DS group) and 415 who took MVMS (MVMS group) were included in the study. We modified Fried’s definition of frailty to fit the KNHANES data. Using multivariate logistic regression, we examined the association between MVMS use and frailty, which varied with satisfaction with total energy intake. Additional subgroup analyses were performed based on age, sex, and income. Results: MVMS reduced most micronutrient deficiencies compared to obtaining nutrients solely through food. The overall analysis revealed no association between MVMS use and frailty (odds ratio [OR], 0.75; 95% confidence interval [CI], 0.52–1.09). However, a subanalysis revealed that participants with a low income (≤25%) who took MVMS had decreased odds for frailty (OR, 0.55; 95% CI, 0.35–0.88) compared with the non-DS group. Furthermore, a significant association between using MVMS and frailty was confirmed in the group with low income and energy intake below the recommended daily allowance, with a low OR of 0.52 (95% CI, 0.30–0.90). Conclusion MVMS use was significantly associated with frailty among the low-income and low-daily energy intake groups.

PURPOSE: To analyze clinical, radiological and pathological features as well as clinical outcome after surgical treatment of patients with secondary chondrosarcoma arising from osteochondroma(tosis). MATERIALS AND METHODS: We retrospectively reviewed clinical records, radiographs, pathologic slides of 14 patients. Nine patients were male and five were female. The mean age was 34 years. The mean follow-up period was 54 months. RESULTS: All patients had a history of previous mass since childhood or puberty. Preexisted osteochondroma was single in 3 patients and multiple in 10. Remaining 1 patient had multiple osteochondromatosis with enchondromatosis. MRI clearly provided thickness of cartilage cap, which was over 2 cm except in 2 cases. Chondrosarcoma was grade 1 in all except 1 case, which was grade 2. Wide excision was performed in 10 patients, marginal excision in 3 and amputation in 1. Twelve patients were doing very well without evidence of disease. Among 3 patients with marginal excision, 1 patient had local recurrence and 1 patient died of disease. CONCLUSION: Comprehensive understanding of clinical, radiological and pathological features of secondary chondrosarcoma is warranted for accurate diagnosis. The best result can be expected with early recognition of malignant change of osteohcondroma(tosis) and wide excision.
Amputation ; Cartilage ; Chondrosarcoma ; Enchondromatosis ; Female ; Follow-Up Studies ; Humans ; Male ; Osteochondroma ; Osteochondromatosis ; Puberty ; Recurrence ; Retrospective Studies