There are many controversies concerning therapeutic guidelines for the treatment of Kienbock's disease. We experienced 17 cases of stage II or III Kienbock's disease(Lichtman's classification), which were treated with triscaphe fusion from March 1983 to March 1992. The mean Follow-up peri- od was 25 months. The purpose of this study is to evaluate the clinical and radiological result of triscaphe fusion of 17 cases of Kienbock's disease. 1. The pain was relieved in all cases, but range of motion was not improved after operation. 2. The postoperative results of triscaphe fusion were evaluated by Licthman's method. 9 cases (53%) were rated as satisfactory and 8 cases as unsatisfactory. 75%(3 cases of 4) were rated sat isfactory in IIIA a group and 22%(2 casaes of 9) were rated satisfactory in IIIB group. 3. The psudoarthrosis was noted in 2 cases of 17.
Follow-Up Studies ; Methods ; Osteonecrosis ; Range of Motion, Articular

Purpose: This study aims to analyze pre-clerkship medical students’ learning strategies and perceptions in online classes during the coronavirus disease 2019 pandemic. Methods: To develop the survey items, 20 pre-clerkship students were interviewed about their learning experiences in the first semester of 2020. A total of 425 pre-clerkship students have participated in the survey, which comprised four parts (general experience, learning strategies, important features, and overall satisfaction). Results: Before classes began, students generally had “neutral expectations” about online classes (2.90 out of 5). At the end of the semester, overall satisfaction with the curriculum was moderate (3.04 out of 5). Premedical students reported lower scores in “daily study hours” and “regular lifestyle” and higher scores in “experience of playing recorded lectures solely for an attendance check” (p<0.001). In addition, first-year premedical students not only showed significantly lower utilization of learning strategies compared to other grades (p<0.001). Conclusion Although pre-clerkship students mostly shared similar perceptions and behaviors in their learning regardless of grade level, some characteristics were either more prominent in premedical students on the whole or limited to first-year premedical students.

Purpose: This study aims to analyze pre-clerkship medical students’ learning strategies and perceptions in online classes during the coronavirus disease 2019 pandemic. Methods: To develop the survey items, 20 pre-clerkship students were interviewed about their learning experiences in the first semester of 2020. A total of 425 pre-clerkship students have participated in the survey, which comprised four parts (general experience, learning strategies, important features, and overall satisfaction). Results: Before classes began, students generally had “neutral expectations” about online classes (2.90 out of 5). At the end of the semester, overall satisfaction with the curriculum was moderate (3.04 out of 5). Premedical students reported lower scores in “daily study hours” and “regular lifestyle” and higher scores in “experience of playing recorded lectures solely for an attendance check” (p<0.001). In addition, first-year premedical students not only showed significantly lower utilization of learning strategies compared to other grades (p<0.001). Conclusion Although pre-clerkship students mostly shared similar perceptions and behaviors in their learning regardless of grade level, some characteristics were either more prominent in premedical students on the whole or limited to first-year premedical students.

Solid pseudopapillary tumors of the pancreas (SPTPs) are rare tumors with limited malignant potential; they are mainly diagnosed in young women. Complete surgical resection of the tumor is usually possible and patients have an excellent prognosis. However, local invasion and distant metastases have been reported in about 10-20% of patients with SPTPs; these patients require supplementary management for long-term survival. Here, we report a pediatric patient with inoperable SPTP unresponsive to neoadjuvant chemotherapy using cisplatin, ifosfamide, and etoposide which had spread to other organs. Subtotal resection of the primary tumor, radiofrequency ablation, radiotherapy, and adjuvant chemotherapy using gemcitabine were done to control this progressive SPTP.
Chemotherapy, Adjuvant ; Cisplatin ; Deoxycytidine ; Etoposide ; Female ; Humans ; Ifosfamide ; Neoplasm Metastasis ; Pancreas ; Prognosis

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.

Purpose: This study examined how students’ academic performance changed after undergoing a transition to online learning during the coronavirus disease 2019 (COVID-19) pandemic, based on the test results of 16 integrated courses conducted in 3 semesters at Hanyang University College of Medicine in Korea. Methods: For the 16 required courses that formed an integrated system-based curriculum running for 3 semesters, the major examinations’ raw scores were collected for each student. Percent-correct scores were used in the subsequent analysis. We used the t-test to compare grades between 2019 and 2020, and the Cohen D was calculated as a measure of effect size. The correlation of scores between courses was calculated using Pearson correlation coefficients. Results: There was a significant decrease in scores in 2020 for 10 courses (62.5%). While most of the integrated system-based curriculum test scores showed strong correlations, with coefficients of 0.6 or higher in both 2019 and 2020, the correlation coefficients were generally higher in 2020. When students were divided into low, middle, and high achievement groups, low-achieving students consistently showed declining test scores in all 3 semesters. Conclusion Our findings suggest that the transition to online classes due to COVID-19 has led to an overall decline in academic performance. This overall decline, which may occur when the curriculum is centered on recorded lectures, needs to be addressed. Further, medical schools need to consider establishing a support system for the academic development of low-achieving students.

Purpose: Team-based learning in medical education facilitates the formation of interpersonal relationships, enhances academic achievement, and establishes future clinical connections. Despite medical schools’ distinct educational environments and curricula, research investigating students’ learning and behavioral characteristics within this context remains limited. This study aimed to investigate the specific characteristics of interpersonal relationship formation among freshmen medical students in team-based learning activities. Methods: Focus group interviews were conducted with 11 students who participated in a team-based class held during the first semester of the premedical year. Results: Medical students passively expressed their thoughts and feelings, such as active sympathy for the team’s opinions and self-censorship of SNS (social networking service) conversations. When performing team activities, students were excessively conscious of others and focused on evenly dividing their work, minimizing their opinions, and fulfilling their share to prevent potential interpersonal conflicts. Interpersonal activities were only superficial, as students intentionally maintained a certain distance from team members or used team activities as an opportunity to accumulate relational capital. Conclusion The results of this study are expected to provide a useful basis for designing and conducting team activity classes to enhance interpersonal relationship formation.

Purpose: This study assessed the alignment between Korean medical schools’ mission statements (MSs) and Korean Doctor’s Role (KDR) domains, considering school characteristics. Methods: We analyzed the South Korean medical school’s MS characteristics using a mixed-methods approach. Quantitative analysis preprocessed MS text data to identify concept words, while qualitative content analysis categorized information into predefined KDR domains and extracted themes from other parts. Results: At the KDR domain level, “social accountability” was the most frequent, followed by “education and research” and “patient care,” while “professionalism” had the least frequency. At the competency level, the most frequent domains were “involvement in public and global health initiatives,” while “self-regulation based on professional leadership” and “professionalism and self-management” were not present. Conclusion The study found that the majority of MSs had a homogeneous pattern and included traditional themes. Medical schools should evaluate and incorporate missing elements in their MSs to reflect the institution’s own purpose and current societal needs.

BACKGROUND: This study aimed to describe the acceptability and feasibility of the “HAPPY ME”, a smartphone application (app) for guiding healthy eating habits and physical activities to prevent childhood obesity, through in-depth interviews of 5th and 6th grade students of an elementary school. METHODS: A total of 25 students were recruited from grades 5 and 6 of an elementary school in Gimpo. They were asked to participate in in-depth interviews about expectations regarding the “HAPPY ME”, smartphone usage behaviors, perceptions and attitudes towards health, and satisfaction with the “HAPPY ME”, before and after the 4-week trial of the “HAPPY ME”. RESULTS: Study participants reported a high level of satisfaction regarding gamification elements such as awarding points as rewards for completing missions and using closed social networking services with friends. They also reported that their eating habits had improved after the 4-week trial. However, some students felt that the app was complicated to use and recommended that it should have prompts as notifications. CONCLUSIONS: This study showed that the “HAPPY ME” is acceptable and feasible for use with children. However, the app needs to be modified based on the results of this study.
Awards and Prizes ; Child ; Child Nutrition Sciences ; Eating ; Friends ; Gyeonggi-do ; Humans ; Mobile Applications ; Motor Activity ; Obesity ; Pediatric Obesity* ; Religious Missions ; Reward ; Smartphone*

Purpose: This study evaluated thyroid cancer risk in a lung cancer screening population according to the presence of an incidental thyroid nodule (ITN) detected on low-dose chest computed tomography (LDCT). Methods: Of 47,837 subjects who underwent LDCT, a lung cancer screening population according to the National Lung Screening Trial results was retrospectively enrolled. The prevalence of ITN on LDCT was calculated, and the ultrasonography (US)/fine-needle aspiration (FNA)–based risk of thyroid cancer according to the presence of ITN on LDCT was compared using the Fisher exact or Student t-test as appropriate. Results: Of the 2,329 subjects (female:male=44:2,285; mean age, 60.9±4.9 years), the prevalence of ITN on LDCT was 4.8% (111/2,329). The incidence of thyroid cancer was 0.8% (18/2,329, papillary thyroid microcarcinomas [PTMCs]) and was higher in the ITN-positive group than in the ITN-negative group (3.6% [4/111] vs. 0.6% [14/2,218], P=0.009). Among the 2,011 subjects who underwent both LDCT and thyroid US, all risks were higher (P<0.001) in the ITNpositive group than in the ITN-negative group: presence of thyroid nodule on US, 94.1% (95/101) vs. 48.6% (928/1,910); recommendation of FNA according to the American Thyroid Association guideline and Korean Thyroid Imaging Reporting and Data System guideline, 41.2% (42/101) vs. 2.4% (46/1,910) and 39.6% (40/101) vs. 1.9% (37/1,910), respectively. Conclusion Despite a higher risk of thyroid cancer in the LDCT ITN-positive group than in the ITN-negative group in a lung cancer screening population, all cancers were PTMCs. A heavy smoking history may not necessitate thorough screening US for thyroid incidentalomas.