PURPOSE: Communication skills are essential skills which medical students need to acquire in order to become a doctor. More attention is being given to the subject but not many studies have been done in the medical education field. As communication skills are provided to students as a subject in medical educational curriculum, the assessment of its effectiveness needs to be undertaken. METHODS: In the year 2005 and 2006, second year pre-medical students at The Catholic University College of Medicine took 'Communication Skills' course in total, 180 second year pre-medical students' survey results were used in the evaluation of the study question. The instrument used in the study was the modified and translated version of 'Beyer-Fetzer's Essential Elements of Communication Skills Assessment Sheet.' The assessment sheets were used as the pre-test and post-test to analyse the differences, which were put through the paired t-test. RESULTS: All categories of communication skills showed an improvement. For year 2005, meaningful differences were shown in 'opening the discussion (p=.005)' and 'sharing information (p=.008)', whereas in 2006, improvements were shown in all areas. CONCLUSION: From the result, it is clear that in order to create an effective communication skills program, the content should be more structured and focused on the program objectives.
Curriculum ; Education, Medical ; Humans ; Students, Medical

PURPOSE: To analyze the characteristics of the interface membrane around loose Cementless Self-Cutting Titanium(CST) acetabular components. MATERIALS AND METHOD: The authors reviewed radiographs of one hundred and thirty-four hips which underwent total hip arthroplasty using Cementless Self-Cutting Titanium(CST) acetabular components, and performed histomorphological analysis on thirteen periprosthetic membranes which were taken out at the time of revision. RESULTS: After a mean follow-up of 82 months, thirteen hips(10%) underwent revision for acetabular loosening and migration. Histologic evaluation of the periprosthetic membranes showed evidence of abundant polyethylene and metal wear particles. The interface membrane was composed of a well vascularized loose connective tissue with macrophages. Polarized microscopy revealed numerous polyethylene wear particles. Ultrastructurally, numerous, variable-sized, irregular-shaped phagosomes containing electron-dense material were seen within the cytoplasm. Tissue digestion of the periprosthetic tissue eluted numerous polyethylene and metal particles. Energy dispersive X-ray spectroscopic analysis for these wear particles revealed high concentration of titanium and carbon component suggesting that the majority of the metal particles were titanium component and polyethylene particle. CONCLUSION: This study supports the concept that wear particles in total hip arthroplasty can be a strong stimulus for a foreign body response and that this reaction causes periprosthetic osteolysis and loosening.
Acetabulum ; Arthroplasty ; Arthroplasty, Replacement, Hip* ; Carbon ; Connective Tissue ; Cytoplasm ; Digestion ; Follow-Up Studies ; Foreign Bodies ; Hip ; Macrophages ; Membranes* ; Microscopy ; Osteolysis ; Phagosomes ; Polyethylene ; Titanium*

PURPOSE: The purpose of the study is to analyse the appropriateness of using standardized patients' (SPs) assessment scores of medical students in clinical performance examination (CPX). METHODS: 110 fourth year medical students in year four were divided into two large groups (group A and group B). Each group of students performed four different cases and overall, eight cases were tested. The examination were done by professors and the SPs using the same examination paper. Test scores were analysed per station and per each test domain. The differences between the two examiners were studied using paired t-test. RESULTS: There were significant differences in the scores given out by the professors' and the SP' s in four out of the eight stations. According to the examination results of each domain, four cases showed significant differences in the history taking category, three cases in the physical examination, one case in the information sharing, four cases in clinical courtesy, and two cases in physician-patient relationship category. Cronbach' s alpha scores of all stations were over 0.6, reflecting that the test items were appropriate for the examination. CONCLUSION: From the result of this study and according to many preceding studies, using SPs' evaluation scores in CPX is appropriate. Some limitation of this study and ideas for improvement in using SPs in CPX are suggested.
Humans ; Information Dissemination ; Physical Examination ; Students, Medical

Symptoms of a peritoneal progression from ovarian cancer are nonspecific such as abdominal pain, abdominal distention and more. Many imaging studies and serum CA-125 help diagnosis. However, it is difficult to exclude the instances of the diffuse peritoneal diseases that mimic carcinomatosis. The elevated CA-125 level usually correlates with the peritoneal carcimatosis, but it is often found in other peritoneal diseases. Therefore, the pathologic confirmation is necessary because of other mimicking diseases. In our case, CA-125 levels were elevated. Abdominal computed tomography finding was suspected a peritoneal tuberculosis but the pathologic result was the peritoneal carcimatosis, eventually.
Abdominal Pain ; Carcinoma* ; Diagnosis ; Ovarian Neoplasms ; Peritoneal Diseases ; Peritonitis, Tuberculous*

Visual disturbances are common among women with pre-eclampsia. The obstetricians should have an understanding of the various conditions associated with visual impairments. We report a case of Purtscher-like retinopathy developed after pre-eclampsia combined with acute pancreatitis. A 33-year-old primigravida with twin pregnancy was admitted to the department of obstetrics and gynecology for preterm labor and pre-eclampsia at 36+4 weeks gestation. After a cesarean section, she complained of abdominal pain and visual acuity loss. She was diagnosed with Purtscher-like retinopathy combined with acute pancreatitis after ophthalmologic examination and an abdominal computed tomography scan. Purtscher-like retinopathy, most often observed after trauma, is very rare in pre-eclampsia. In addition, while visual disturbances from other conditions are transient, it can result in persistent visual impairments. Thus, when a patient with pre-eclampsia complains of visual problems for a long period of time, obstetricians should consider an ophthalmologic evaluation and treatments during the earliest stage of the disease.
Abdominal Pain ; Cesarean Section ; Female ; Gynecology ; Humans ; Obstetric Labor, Premature ; Obstetrics ; Pancreatitis ; Pre-Eclampsia ; Pregnancy ; Pregnancy, Twin ; Retinal Diseases ; Vision Disorders ; Visual Acuity

BACKGROUND: Sympathetic blocking agent, esmolol (selective beta 1 blocker) or labetalol ( alpha and beta blocker) would prevent the hypertension and tachycardia from endotracheal intubation. We have carried out the study to see the effects of esmolol or labetalol on the blood pressure, heart rate, rate pressure product and plasma catecolamines during the endotracheal intubation. METHODS: Thirty-three ASA physical status 1 or 2 adult patients were allocated into three groups; Group I:control (n=10), Group II:esmolol (n=11) and Group III: labetalol (n=12). In Group I, 2 ml of normal saline, in Group II, 1 mg/kg of esmolol, and in Group III, 0.2 mg/kg of labetalol were given 3, 2 and 4 minutes before endotracheal intubation. Blood pressure and heart rate were measured after arrival at the operating room, before endotracheal intubation and after endotracheal intubation at 15, 60, 120, 180 and 300 seconds interval under the inhalation anesthesia (enflurane-N2O-O2). Rate-pressure product was calculated from the heart rate and systolic blood pressure (RPP = heart rate x systolic blood pressure). The plasma cathecolamines, dopamine, norepinephrine and epinephrine, were measured before intubation as a baseline value and 2 minute after intubation. RESULTS: Systolic blood pressure, rate-pressure product and heart rate were significantly lower in esmolol and labetalol groups than in control group after intubation ( p<0.05). Esmolol reduced the heart rate and the rate-pressure product than labetalol, but statistically there were no significance (P > 0.05). Plasma level of dopamine, norepinephrine and epinephrine showed higher values after intubation in all three groups ( p<0.05). But there were no difference among groups (P>0.05). The side effects of esmolol and labetalol did not appear at all. CONCLUSION: 1 mg/kg of esmolol given 2 min before intubation or 0.2 mg/kg of labetalol given 4 min before intubation reduce increasing of blood pressure and heart rate, caused by adnergic response following endotracheal intubation, significantly. The reason is that esmolol and labetalol do not decrease release of catecholamines but attenuate responses of elevated catecholamines following endotracheal intubation.
Adult ; Anesthesia, Inhalation ; Blood Pressure ; Catecholamines ; Dopamine ; Epinephrine ; Heart Rate ; Hemodynamics* ; Humans ; Hypertension ; Intubation ; Intubation, Intratracheal* ; Labetalol* ; Norepinephrine ; Operating Rooms ; Plasma ; Tachycardia

We observed a slender nerve branch of the lateral root of the median nerve innervating the brachialis muscle, which is normally innervated by the musculocutaneous nerve, at the left arm of a Korean male (age, 74 years). The present nerve branch was accompanied with the communicating branch between the median and musculocutaneous nerves and supplied to the medial inferior portion of the brachialis muscle. The spinal root origins of this branch were C5 and C6. The nerve fiber number of the nerve branch innervating the brachialis muscle was 328. This variation may be very rare case and was different from previous observation.
Arm ; Humans ; Male ; Median Nerve ; Muscles ; Musculocutaneous Nerve ; Nerve Fibers ; Spinal Nerve Roots

This study aimed to confirm the presence of motor fibers in the cervical nerves distributing to the trapezius muscle. Thirteen cases were examined. Motor fibers were present in C3 in 7 of 9 cases (77.8%) and were absent in 2 of 9 cases (22.3%); the other 4 cases were damaged during dissection. C4 exhibited motor fibers in 9 of 10 cases (90.0%), whereas motor fibers were absent in 1 of 10 cases (10.0%); and 3 cases were damaged. The motor fibers in C3 were of medium size (57.1%; 4/7 cases), whereas those in C4 were large (44.4%; 4/9 cases). The average number of motor fibers in C3 and C4 were 114+/-112 and 219+/-167, respectively. These results show that C4 is more important in terms of the frequency and size of the cervical motor fibers distributing to the trapezius muscle.
Muscles

This study aimed to confirm the presence of motor fibers in the cervical nerves distributing to the trapezius muscle. Thirteen cases were examined. Motor fibers were present in C3 in 7 of 9 cases (77.8%) and were absent in 2 of 9 cases (22.3%); the other 4 cases were damaged during dissection. C4 exhibited motor fibers in 9 of 10 cases (90.0%), whereas motor fibers were absent in 1 of 10 cases (10.0%); and 3 cases were damaged. The motor fibers in C3 were of medium size (57.1%; 4/7 cases), whereas those in C4 were large (44.4%; 4/9 cases). The average number of motor fibers in C3 and C4 were 114+/-112 and 219+/-167, respectively. These results show that C4 is more important in terms of the frequency and size of the cervical motor fibers distributing to the trapezius muscle.
Muscles

OBJECTIVES: This study sought to evaluate the efficacy of collagen graft materials, as compared to other graft materials, for use in healing calvarial defects in rabbits. MATERIALS AND METHODS: Ten mm diameter calvarial defects were made in ten rabbits. The rabbits were then divided into 4 groups: control, autogenous bone graft, SureOss graft, and Teruplug graft. Bone regeneration was evaluated using histological and radiographic methods. RESULTS: Based on visual examination, no distinct healing profile was observed. At 4 weeks after treatment, histological analysis showed there was no bone regeneration in the control group; however, at 8 weeks after treatment, new bone formation was observed around the margin of the defective sites. In the autogenous bone graft group, new bone formation was observed at 4 weeks after treatment and mature bone was detected around the grafted bone after 8 weeks. In the SureOss graft group, at 4 weeks after treatment, acute inflammatory and multinuclear cells were noted around the grafted materials; at 8 weeks after treatment, a decrease in graft materials coupled with new bone formation were observed at the defective sites. In the Teruplug graft group, new bone formation was detected surrounding the bone margin and without signs of inflammation. There were statistically significant differences observed between the graft and control group in terms of bone density as evidenced by radiographic analysis using computed tomography (P<0.05), particularly for the autogenous bone graft group (P<0.001). CONCLUSION: These results suggested that autogenous bone, SureOss and Teruplug have the ability to induce bone regeneration as compared to an untreated control group. The osteogenic potential of Teruplug was observed to be lower than that of autogenous bone, but similar to that of SureOss.
Bone Density ; Bone Regeneration ; Collagen ; Durapatite ; Inflammation ; Osteogenesis ; Porifera ; Rabbits ; Transplantation, Homologous ; Transplants