No abstract available.

The purpose of this study was to examine professors’ and students’ perceptions of curriculum that fosters character in medical school. ‘Character’ can be defined as a desirable personality and the ability to be a good person. A total of 264 subjects (professors=131, students=133) participated in the study. Survey questions were divided into the three parts (education needs, factors of character, and curriculum management strategy). Data were analyzed by using t-test and one-way analysis of variance. Both professors and students recognized the need for character education. Professors were more aware of the need for education than students (t=4.35, p<0.01), and clinical professors were more aware of the need for education than basic medical science professors (t=3.48, p<0.01). Premedical students were more aware of the need for character-centered education than medical students in the later stages of their education (t=3.41, p<0.01). Professors and students commonly referred to ‘consideration and communication’ as the most important factor in building character. Professors considered ‘self-regulation’ more important than the students recognized, while students perceived ‘wisdom’ as more important than the professors did. There was a difference in preference for curriculum development (creating new subjects vs. revising existing subjects) between the two groups. However, both groups agreed on the teaching and evaluation methods. In conclusion, both groups acknowledged the need for character education. However, there were differences in perception on the major factors of character and preference for curriculum development. The results of this study may assist in designing character education in medical education.

Because of extensive vascular injury, reconstruction of ring avulsion injury is classically believed to be challenging for a hand surgeon. We report a case of ring avulsion injury treated by debridement of the damaged artery and interpositioning vessel graft with a healthy proper palmar digital artery, which lead to successful functional recovery.
Arteries ; Debridement ; Glycosaminoglycans ; Hand ; Transplants ; Vascular System Injuries

BACKGROUND AND OBJECTIVES: Ultrasonography is the most useful tool for detecting extrathyroidal extension, which is the deciding factor in surgical extension of papillary thyroid carcinoma. However, there are few studies on pre-operative ultrasonographic findings about extrathyroidal extension. This research thus evaluates a predictive sonographic index of extrathyroidal extension. SUBJECTS AND METHOD: 265 patients with papillary thyroid carcinoma who underwent preoperative sonography and surgery were respectively reviewed. Sonographic findings were compared with pathological results. RESULTS: There were no differences among the patents in terms of calcification and echo texture, whereas significant differences were observed in terms of mass size, lymph node metastasis, capsule contact, and degree of capsule contact. These four factors were weighted according to the degree of severity and defined the extrathyroidal index as the total of these scores. The index had high sensitivity, specificity and predictability. CONCLUSION: We suggest that the extrathyroidal extension index with sonography is helpful for drawing pre-operative sonographic diagnosis.
Diagnosis ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Sensitivity and Specificity ; Thyroid Gland* ; Thyroid Neoplasms* ; Ultrasonography*

BACKGROUND AND OBJECTIVES: This study was to done to determine the value of PROPELLER diffusion-weighted imaging in detecting cholesteatoma. SUBJECTS AND METHOD: Sixty-five patients were evaluated by preoperative magnetic resonance imaging (MRI) with PROPELLER diffusion-weighted imaging. Of 65 patients, 16 patients had chronic otitis media without cholesteatoma and 49 patients with cholesteatoma. Surgical and pathologic findings were compared with the preoperative findings by PROPELLER diffusion-weighted imaging to assess the sensitivity, specificity, positive and negative predictive values. RESULTS: In 49 patients with cholesteatoma, high signal intensity compatible with cholesteatoma was found in 46 patients, whereas in 16 patients without cholesteatoma, high signal intensity was not detected in any of them. The sensitivity, specificity, positive and negative predictive values for PROPELLER diffusion-weighted imaging were 94.1%, 100%, 100%, and 84.2%, respectively. CONCLUSION: PROPELLER diffusion-weighted imaging can be a useful tool in detecting cholesteatoma.
Cholesteatoma* ; Diffusion Magnetic Resonance Imaging ; Humans ; Magnetic Resonance Imaging ; Methods ; Otitis Media ; Sensitivity and Specificity

Increasing importance of vaccination during coronavirus disease 2019 (COVID-19) pandemic, several vaccines were developed. Messenger RNA (mRNA) vaccines including BNT162b2 (Pfizer, New York, NY, USA; BioNTech, Mainz, Germany), mRNA-1273 (Moderna, Cambridge, MA, USA) have been disclosed side effects such as thrombocytopenia, myocarditis and headache in general. In addition, adverse effects due to autoimmune responses induced by spike glycoproteins of mRNA vaccines are rarely reported such as the Guillain-Barre syndrome, autoimmune encephalitis and so on. Herein, we report a rare case of encephalitis with new-onset refractory status epilepticus after BNT162b2 mRNA COVID-19 vaccination improved with immune therapy.

OBJECTIVE: This study aimed to examine the associations between depression and both coronary artery disease (CAD) and cardiovascular risk factors (CVRs) in Korean women. Furthermore, this study sought to determine whether depression was associated with use of healthcare services in women with CAD or CVRs. METHODS: This cross-sectional study was conducted on 26,335 women who were aged 19 years or older, and who participated in the Korean National Health and Nutrition Examination Survey (2007–2014). Associations of prior diagnosis of depression with CAD and CVRs and with nonutilization of healthcare services were investigated. RESULTS: Women with depression had a higher prevalence of CAD and CVRs including obesity, hypertension, dyslipidemia, and metabolic syndrome than those without depression. In addition, depression was significantly associated with nonutilization of healthcare services in women with most CVRs. CONCLUSION: Considering the high rate of comorbid depression with CAD or CVRs and the low lvels of health service utilization in depressed patients, screening for common CVRs, such as obesity, hypertension, and dyslipidemia, should be provided for patients with depression in mental health care settings.
Coronary Artery Disease ; Cross-Sectional Studies ; Delivery of Health Care* ; Depression* ; Diagnosis ; Dyslipidemias ; Female ; Health Services ; Humans ; Hypertension ; Mass Screening ; Mental Health ; Nutrition Surveys ; Obesity ; Prevalence ; Risk Factors

Stress-induced cardiomyopathy, which is also known as takotsubo cardiomyopathy, is a cardiac syndrome of a transient, reversible left ventricular dysfunction that is caused by emotional and/or physical stress and surgery. Its clinical manifestations are similar to those of myocardial ischemia without a coronary artery lesion. Stress-induced cardiomyopathy is more common in middle-aged women, and the prognosis is favorable. We report the case of a 50-year-old female patient who underwent a total gastrectomy and developed stress-induced cardiomyopathy after surgery.
Anesthesia ; Anesthesia, General ; Cardiomyopathies ; Coronary Vessels ; Female ; Gastrectomy ; Humans ; Middle Aged ; Myocardial Ischemia ; Prognosis ; Takotsubo Cardiomyopathy ; Ventricular Dysfunction, Left

BACKGROUND AND OBJECTIVES: A considerable proportion of sinus diseases is associated with a unilateral lesion. Unilateral paranasal pathological lesions require precise preoperative diagnosis and histopathological assessment. This study aimed to analyze the changes in etiologies and clinical characteristics of operated unilateral sinus diseases between 2005 and 2015. SUBJECTS AND METHODS: Two hundred eighteen operated cases with unilateral sinus disease in 2005 and 2015 were reviewed to retrospectively analyze the etiologies and clinical characteristics. RESULTS: In 2015 compared with 2005, the proportion of unilateral sinus disease and patient age were increased. The proportions of patients with allergic rhinitis and hypertension were significantly increased in 2015. The leading cause of unilateral sinus lesions was nasal polyp, followed by fungus, tumor, mucocele, anatomical variation, odontogenic sinusitis, and foreign body. This ranking did not change between 2005 and 2015. The number of patients with fungal sinusitis was significantly increased in 2015. The direction of nasal septal deviation had no statistically significant relation with unilateral sinus disease. CONCLUSION: This comparison study of unilateral sinus disease between 2005 and 2015 showed that the proportion of fungal sinusitis, patient age, and patients with underlying disease were increased.
Diagnosis ; Foreign Bodies ; Fungi ; Humans ; Hypertension ; Mucocele ; Nasal Polyps ; Nasal Surgical Procedures ; Paranasal Sinus Diseases ; Retrospective Studies ; Rhinitis, Allergic ; Sinusitis

BACKGROUND: Exercise intolerance is a common symptom of heart failure and has a detrimental impact on the quality of life. Skeletal muscle atrophy has been considered an important contributor to exercise intolerance; however, most studies have been conducted in patients with advanced systolic heart failure. METHODS: We studied 39 ambulatory heart failure patients (age, 77.9+/-6.5; male, 17 [43.6%]) and 39 age and gender-matched, community-dwelling, elderly subjects. Clinical, laboratory, and echocardiographic evaluations were performed. Dual-energy X-ray absorptiometry was performed to assess the body composition. Exercise capacity was measured by a six-minute walk test. Comprehensive geriatric assessments were also performed to evaluate comorbidity, medication, physical function, cognitive function, and nutritional status. RESULTS: Skeletal muscle mass of heart failure patients showed no differences when compared with that of age- and gender-matched control subjects in any part of the body or in the whole body. Although diastolic heart failure patients showed lower levels of skeletal muscle mass than systolic heart failure patients, no significant difference was identified in either systolic or diastolic heart failure patients compared with respective age- and gender-matched control groups. The six-minute walk distances showed no difference between the groups (257.2+/-117.8 m in the diastolic heart failure group versus 302.7+/-109.4 m in the systolic heart failure group, p=0.226). CONCLUSION: Although skeletal muscle mass has been known to be an independent factor associated with exercise capacity in advanced heart failure patients, skeletal muscle mass was not decreased in ambulatory, elderly heart failure patients when comparing age- and gender-matched control subjects.
Absorptiometry, Photon ; Aged ; Atrophy ; Body Composition ; Comorbidity ; Geriatric Assessment ; Heart ; Heart Failure ; Heart Failure, Diastolic ; Heart Failure, Systolic ; Humans ; Male ; Muscle, Skeletal ; Quality of Life