PURPOSE: The objective of this study was to evaluate the authenticity, acceptability, and feasibility of a hybrid station that combined a standardized patient encounter and a simulated Papanicolaou test. METHODS: We introduced a hybrid station in the routine clinical skills examination (CSE) for 335 third-year medical students at 4 universities in Korea from December 1 to December 3, 2014. After the tests, we conducted an anonymous survey on the authenticity, acceptability, and feasibility of the hybrid station. RESULTS: A total of 334 medical students and 17 professors completed the survey. A majority of the students (71.6%) and professors (82.4%) agreed that the hybrid station was more authentic than the standard CSE. Over 60 percent of the students and professors responded that the station was acceptable for assessing the students' competence. Most of the students (75.2%) and professors (82.4%) assessed the required tasks as being feasible after reading the instructions. CONCLUSION: Our results showed that the hybrid CSE station was a highly authentic, acceptable, and feasible way to assess medical students' performance.
Anonyms and Pseudonyms ; Clinical Competence ; Gynecology ; Humans ; Korea ; Mental Competency ; Papanicolaou Test ; Patient Simulation ; Students, Medical

OBJECTIVE: To investigate the anatomical correlates of the neuropsychological deficits in patients with the cerebellar stroke. METHODS: We screened patients who were admitted to the National Rehabilitation Center with the cerebellar stroke between October 2012 and November 2016. The patients with the cerebellar stroke who underwent neuropsychological testing for which the Seoul Neuropsychological Screening Battery (SNSB) or the SNSB-II were enrolled. The neuropsychological function capacities were compared in accordance with the stroke type (hemorrhagic vs. ischemic) and the location (right/left anterior, right/left posterior intermediate, right/left posterior lateral lobe, and vermis). Mean z-scores were computed to compare the patient performances with the population averages. RESULTS: Twenty-six patients (15 with ischemic stroke and 11 with hemorrhagic stroke) with a mean age of 54.8±16.6 years were assessed 8.8±9.2 months after the stroke. Differences in the neuropsychological functioning according to the stroke type were not observed. All of the numerical subtests of the stroke patients showed significantly poorer performances compared with the population averages (mean z-score < 0), and some of the subtests revealed abnormal performances in attention-, visuospatial function-, memory-, and frontal/executive function-related tasks (mean z-score <−1). The patients with the presence of a lesion in the right posterior intermediate lobe of the cerebellum showed a poorer performance in the subtests evaluating the executive function including the Korean-version Stroop Test (p=0.04), the Digit Symbol Coding Test (p=0.01), and the Korean-version Trail Making Test (p=0.02) compared with the patients without that lesion. CONCLUSION: The present study confirms that the cerebellar stroke affects the neuropsychological functioning which is associated with the anatomical site of stroke.
Cerebellum ; Clinical Coding ; Cognition ; Executive Function ; Humans ; Mass Screening ; Neuropsychological Tests ; Rehabilitation Centers ; Seoul ; Stroke* ; Stroop Test ; Trail Making Test

OBJECTIVE: To investigate the anatomical correlates of the neuropsychological deficits in patients with the cerebellar stroke. METHODS: We screened patients who were admitted to the National Rehabilitation Center with the cerebellar stroke between October 2012 and November 2016. The patients with the cerebellar stroke who underwent neuropsychological testing for which the Seoul Neuropsychological Screening Battery (SNSB) or the SNSB-II were enrolled. The neuropsychological function capacities were compared in accordance with the stroke type (hemorrhagic vs. ischemic) and the location (right/left anterior, right/left posterior intermediate, right/left posterior lateral lobe, and vermis). Mean z-scores were computed to compare the patient performances with the population averages. RESULTS: Twenty-six patients (15 with ischemic stroke and 11 with hemorrhagic stroke) with a mean age of 54.8±16.6 years were assessed 8.8±9.2 months after the stroke. Differences in the neuropsychological functioning according to the stroke type were not observed. All of the numerical subtests of the stroke patients showed significantly poorer performances compared with the population averages (mean z-score < 0), and some of the subtests revealed abnormal performances in attention-, visuospatial function-, memory-, and frontal/executive function-related tasks (mean z-score <−1). The patients with the presence of a lesion in the right posterior intermediate lobe of the cerebellum showed a poorer performance in the subtests evaluating the executive function including the Korean-version Stroop Test (p=0.04), the Digit Symbol Coding Test (p=0.01), and the Korean-version Trail Making Test (p=0.02) compared with the patients without that lesion. CONCLUSION: The present study confirms that the cerebellar stroke affects the neuropsychological functioning which is associated with the anatomical site of stroke.
Cerebellum ; Clinical Coding ; Cognition ; Executive Function ; Humans ; Mass Screening ; Neuropsychological Tests ; Rehabilitation Centers ; Seoul ; Stroke* ; Stroop Test ; Trail Making Test

BACKGROUND: The results of a particular test can be affected by the techniques used for testing. However, limited data is available on the testing techniques used in blood bank laboratories in Korea. The aim of this study was to evaluate the various testing techniques used in blood bank laboratories using the data obtained during the past six years from the Korean external quality assessment (KEQA) of blood bank laboratories. METHODS: Data was collected from all KEQA respondents via the KEQA website on the testing techniques used in blood bank laboratories from 2008 to 2013. The survey included questions on ABO grouping, D typing, crossmatching tests, direct antiglobulin tests (DAT), antibody (Ab) screening, and Ab identification (ID) tests. RESULTS: Based on the data obtained from 2008 to 2013 (ABO grouping data obtained from 2011 to 2013), the most frequently used techniques are as follows: slide agglutination (60.7% and 60.8%) for ABO cell typing; tube agglutination (78.2% and 81.2%) for ABO serum typing; slide agglutination (50% and 54.6%) for D typing; tube agglutination (91.9% and 83.8%) for crossmatching tests; tube agglutination (63.6% and 52.8%) for DAT; column agglutination technique (CAT; 74.5% and 89.4%) for Ab screen; and CAT (83.9% and 94.2%) for Ab ID. CONCLUSIONS: The findings reveal a steady increase in the use of CAT from 2008 to 2013 for crossmatching tests, DAT, Ab screen, and Ab ID and a decreasing use of the tube agglutination technique for the past six years. Since the slide agglutination technique accounted for a significant percentage of the tests conducted, further education is warranted on the improvement in the techniques used for ABO and D typing.
Agglutination ; Agglutination Tests ; Animals ; Blood Banks* ; Cats ; Clinical Laboratory Techniques ; Coombs Test ; Surveys and Questionnaires ; Education ; Korea ; Mass Screening

Clerkship has a vital role in undergraduated medical education. Despite potential benefits, clinical teaching has been much criticised for its variability due to its complex clinical environment. This article describes several problems and educational theories related to learning in clinical settings. Effective strategies were developed after these problems arised and learning theories were created, in terms of students, clinical teachers and teaching institution: first, the student should prepare medical knowledge and survival skills for self-directed learning in the clinical setting; second, the clinical teachers provide opportunities for active participation-effective feedback-reflection to students; and lastly, the teaching institution has to design a clerkship curriculum effectively. A clinical environment for students allowing them to participate actively is essential.
Clinical Clerkship ; Curriculum ; Education, Medical ; Humans ; Learning ; Test Taking Skills

Introduction: Quality control in medical laboratory includes internal quality control and external quality control is very necessary for the quality management of medical laboratory tests. However, many laboratories for different reasons have not carried out quality control, its benefits, as well as inadequately evaluated affected risks of laboratory test quality. \r\n', u'Objectives: Two objectives are set for the research. First, to evaluate the quality of blood biochemical tests in some of the provinces, districts and private laboratories in the North of Vietnam. Second, factors that affect the quality of the medical laboratory tests are also examined. \r\n', u'Subjects and method: In this study, human control serum of Biorad is sent as ordinary blood samples to the 6 provincial, 12 district and 10 private laboratories to analyze some normal blood biomedical indexes. We also collected the necessary information on staff, equipments, and chemicals\u2026of the laboratories.\r\n', u'Results: There are five main findings in the areas of (1) general information about the laboratories, (2) laboratory test results of blood biochemical indexes with true value at the normal level, (3) laboratory test results of blood biochemical indexes with true value at the pathological level (level 2), (4) the accuracy of laboratory test results based on the blood test sample level 1, (5) the accuracy of laboratory test results based on the blood test sample level 2. In general, the first results of analyzed biomedical indexes are very different by statistical calculation between laboratories. \r\n', u'Conclusion: The research results indicated that the quality of analyzed biomedical indexes in some laboratories is not ensured. It is necessary to find the reasons and the ways to resolve the problem. \r\n', u'
Quality control ; Clinical test

Pharmacologic stress testing for myocardial perfusion imaging is a widely used noninvasive method for the evaluation of known or suspected coronary artery disease. The use of exercise for cardiac stress has been practiced for over 60 years and clinicians are familiar with its using. However, there are inevitabe situations in which exercise stress is inappropriate. A large number of patients with cardiac problems are unable to exercise to their full potential due to comorbidity such as osteoarthritis, vascular disease and pulmonary disease and a standard exercise stress test for myocardial perfusion imaging is suboptimal means for assessment of coronary artery disease. This problem has led to the development of the pharmacologic stress test and to a great increase in its popularity. All of the currently used pharmacologic agents have well-documented diagnostic value. This review deals the physiological actions, clinical protocols, safety, nuclear imaging applications of currently available stress agents and future development of new vasodilating agents.
Clinical Protocols ; Comorbidity ; Coronary Artery Disease ; Exercise Test* ; Humans ; Lung Diseases ; Myocardial Perfusion Imaging ; Osteoarthritis ; Vascular Diseases

STUDY DESIGN: This case report presents a 50-year-old patient with tabetic Charcoal spinal arthropathy combined with spinal stenosis, and its management. OBJECTIVES: To present the case report and follow-up results of Charcoal arthropathy with spinal stenosis of the lumbosacral spine, which was treated by circumferential fusion with instrumentation and decompressive laminectomy. LITERATURE REVIEW: Most reports of Charcot spine mention the etiology, clinical characteristics, pathology, and management of the condition. Surgical management of Chariot spines with spinal stenosis are rare. There is no report of the two-stage procedure of circumferential fusion and decom-pression for Charcot spine with spinal stenosis. MATERIALS AND METHODS: The patient complained of back pain, radiating pain to both lower legs, and 100m neurologic claudication. Serologic testing was positive in VDRL and FTA-ABS tests. Surgical treat-nent consisted of anterior resection of the L5 body with an autogenous iliad bone graft. It was followed by a posterior wide laminectomy of L5 for spinal stenosis, and CD instrumentation with transpedicular screws was applied to L3-S1 with lateral bone graft. RESULTS: At 27 months follow-up, clinical symptoms of back pain and radiating pain were disappeared. The patient walked without claudication, and satisfied with her condition. Firm bony fusions from L3 to S1 were obtained. There was no evidence of further destruction or neural compromise in the 27 months following surgery. CONCLUSION: A case of Charcoal arthropathy of the lumbosacral spine with spinal stenosis of L3-5 and L5-S1 has been reported, and the pathology, clinical features, and management of this condition were discussed. Circumferential fusion for Charcot spine and wide decompressive laminectomy for spinal stenosis are advisable.
Back Pain ; Charcoal ; Fluorescent Treponemal Antibody-Absorption Test ; Follow-Up Studies ; Humans ; Laminectomy ; Leg ; Middle Aged ; Pathology ; Pathology, Clinical ; Serologic Tests ; Spinal Stenosis* ; Spine* ; Transplants

One hundred twenty-one patients with avascular necrosis of the femoral head in adults, who were admitted in Department of Orthopadic Surgery, Kyungpook National University Hospital between January of 1972 and June of 1986 are investigated in terms of the history, clinical data, radiographic findings and laboratory examinations. And, the following results were obtained. 1. The highest incidence was in the 5th decade and the sex ratio between male and female was 5: l. 2. 62 cases(51.2%) had the bilateral hip involvement, and higher incidence of bilateral hip involvement in steroid or alcohol induced cases. 3. Etiological factors were unknown(38 cases, 31.4%), steroid (31 cases, 25.6%), alcohol (22 cases, 18.2%), femur neck fracture (15 cases, 12.4%), trauma (13 cases, 10.7%) and caissons disease (2 cases). 4. Underlying diseases in steroid-induced avascular necrosis of the femoral head were dermopathy (8 cases), pain over other joints (7 cases), head trauma (5 cases), nephropathy (4 cases), etc. 5. The time intervals between etiological events and appearance of clinical symptoms were 1 year and 7 months in steroid-induced cases, 1 year and 9 months in femur neck fracture cases, 1 year and 1 month in trauma-induced cases, 1 year and 5 months in caissons disease. 6. The duration of morbidity was 21 months on average. 7. At first hospital visit, the Ficat stage of femoral head avascular necrosis were stage II in 12 cases (10%), transition stage in 17 cases (14%), stage III in 34 cases (29%) and stage IV in 56 cases (47%). 8. Bone scanning was performed in 59 hips of 42 cases. Cold spot was observed in 17 hips and hot spot in 36 hips. There were false negative findings in 4 hips in spite of ischemic findings of femoral head on simple x-ray. 9. Bone marrow pressure was higher than 30mmHg and was increased 10mmHg more than initial pressure by stress test. 10. On intramedullary venography, diaphyseal reflux of contrast medium and diaphyseal stasis more than 15 minutes in 7 of 9 cases over stage II.
Adult ; Bone Marrow ; Clinical Study ; Craniocerebral Trauma ; Exercise Test ; Female ; Femoral Neck Fractures ; Gyeongsangbuk-do ; Head ; Hip ; Humans ; Incidence ; Joints ; Male ; Necrosis ; Phlebography ; Sex Ratio

Evaluation and management of the anterior cruciate ligament (ACL) deficient knee pose several problems. For acute injuries, the essential factors are diagnosis of the ACL rupture and associated injuries, and selection of the appropriate method of the management. Until recently, the frequency of complete disruption of the ACL was though to be less than that of the medial collateral ligament. However, there is little doubt that the ACL is the most frequently torn ligament in the knee. Diagnosis may be made with a combination of tests: Anterior drawer, valgus or varus stress test, Lachman, and pivot shift. If the patients is unable to relax because of pain or fear, examination under the anesthesia should be performed. Treatment can be surgical or nonsurgical. Since the ACL is vital to normal knee function, surgical intervention is advisable in the majority of cases of acute disruption. Authors analyzed the records of 58 cases of acute knee ligament injuried patients treated at the department of Orthopaedic Surgery, Kang-Nam St. Marys Hospital, Catholic Medical College and Center, from November 1982 to January 1984, with follow-up range from 6 to 20 months. 1. Among 58 cases, 41(71%) had anterior cruciate ligament injury and 39(67%) had medial collateral ligament injury. 2. The causes of injury were mostly traffic accident (77%) and majority of the patients was in their twenties and thirties of age. 3. Among 41 cases of ACL Injury, 5 had isolated anterior cruciate injury, 27 cases (66%) had associated medial collateral injury, 9 (22%) had associated lateral collateral injury, and 7 (17%) had associated posterior cruciate ligament injury. 4. Meniscal injury was found only in 6 cases (15%); 4 medial and 2 lateral menisci. 5. Majority of anterior cruciate injured patients (71%) had more than 5mm joint openning than normal side in valgus or varus stress radiogram with the knee in extension. 6. In all cases of anterior cruciate ligament injured patients, the Lachman test was positive under the general anesthesia, hut anterior drawer test was positive in 80%. 7. In about 90% of the cases, the anterolateral rotatory instability (ALRI) test was positive and this finding was accentuated when the lateral collateral ligament was torn. 8. Among 41 cases, 16 (39%) had failure at the insertion site, 7 (17%) had tibial spine avulsion, and 9 patients each (22%) had tear at the ligament substance level and had grade II sprain. 9. In twenty-three, primary repair was done, in 9, primary intra-articular recopstruction was performed and 9 were treated conservatively. The result was from fair to excellent almost in all cases.
Accidents, Traffic ; Anesthesia ; Anesthesia, General ; Anterior Cruciate Ligament ; Clinical Study ; Collateral Ligaments ; Diagnosis ; Exercise Test ; Follow-Up Studies ; Humans ; Joints ; Knee ; Lateral Ligament, Ankle ; Ligaments ; Menisci, Tibial ; Methods ; Posterior Cruciate Ligament ; Rupture ; Spine ; Sprains and Strains ; Tears