Student Evaluation of Clerkship Experience at Dermatology Department Through Questionnaire / 대한피부과학회지

BACKGROUND: As part of medicine's shift in emphasis toward primary patient care, clinical curriculum is very important in the education of medical students. There are excellent opportunities for general learning of clinical skills especially in dermatological clinical clerkship course. OBJECTIVE: The purpose of this study is to evaluate the dermatological clerkship with questionnaire by students. We would like to find out and look into the way how to improve the clerkship course. METHODS: 103 students filled in well-structured questionnaires after they had finished a 2 week-clinical clerkship course of Department of Dermatology. The questionnaire consisted of overall evaluation of clinical clerkship, of subtypes of clinical clerkship course, and the way how to evaluate students. After finishing the clinical clerkship course, 10 students were interviewed with the results of the questionnaire. RESULTS: Most students were generally pleased with the didactic quality of clerkship. The course of observation of outpatient clinic among various subtypes of clinical clerkship were favored most by the students. The newly developed educational contents revealed not to be properly used. Faculty activity was also scored to be better than average. The test for clinical clerkship was regarded a little difficult to the students. CONCLUSION: The evaluation of didactic quality of clinical clerkship seems very important in the improvement of medical education. The development of the more valid and reliable questionnaire is needed. The overall evaluation of clerkship by various perspectives such as students, faculties, patients and institutions will provide more improvement of quality of clerkship at Dermatology department.

Severe and Atypical Manifestation of Molluscum Contagiosum in AIDS Patients / 대한피부과학회지

Molluscum contagiosum is caused by a DNA virus from the poxvirus family. With the advent of new populations of immunocompromised individuals-especially those infected with HIV-molluscum contagiosum has emerged as an important cause of morbidity and disfigurement. Molluscum contagiosum in AIDS, although not life-threatening, is often a marker of late-stage disease and may lead to atypical clinical features and a progressive course that is recalcitrant to treatment. We report two cases of AIDS-related molluscum contagiosum in a 45 year-old male and a 30 year-old male. They were diagnosed as HIV-positive 3 years ago and 1 year ago, respectively. Physical examination revealed asymptomatic numerous skin-colored papules, nodules and tumorous masses on the face and neck. The histopathological finding showed characteristic features of molluscum contagiosum. We think that this is the first report of severe AIDS-related molluscum contagiosum in Korean literature.

Hypoxic - ischemic Encephalopathy in Term Infants: Correlation of Neurosonographic Findings in Basal Ganglia and Thalamus with Prognosis

PURPOSE: To evaluate abnormal neurosonographic (NSG) findings of thalami and basal ganglia in full term babies with hypoxic-ischemic encephalopathy and to correlate the findings with follow-up studies and prognosis. METHODS: We evaluated 13 full term babies with abnormal NSG findings of thalarni and basal ganglia. NSG was performed within 7 days after clinical abnormalities. Follow-up NSG was done in 11 cases; CT scan in 4 and MRI in 7. We classified NSG findings as diffuse, unilateral, and focal types according to increased echogenicity and evaluated prognosis based on follow-up studies and neurological sequelae. RESULTS: Nine cases of diffuse type had diffuse echogenic changes of bilateral thalami and basal ganglia, slit-like lateral ventricles suggesting cerebral edema, and increased parenchymal echogenicity. In diffuse type, follow-up studies showed more prominent echogencities and ventricular dilatations and cerebromalacia. One case of unilateral type caused by thromboembolism had unilateral echogenicity of right thalamus and basal ganglia with increased echogenicity of the ipsilateral cerebral hemisphere and compression of the lateral ventricle, suggesting cerebral infarction. Follow-up study showed unilateral cystic cerebromalacia. Three cases of focal type had a localized echogenic area in thalamus with lacunar infarction, which decreased in size during follow-up. Among nine cases of diffuse type, one died within 2 days, two were discharged against medical advice, and six had severe neurologic sequelae. One case of unilateral type had a moderate degree of neurologic sequelae. All 3 cases of focal type had normal development. CONCLUSION: Pattems of abnormal echogenicity in thalami and basal ganglia in fullterm infants with hypoxic-ischemic encephalopathy are correlated with the outcome and may be helpful for treatment planning.

Review of the Patch Test Results in patients with the Cosmetic Contact Dermatitis / 대한피부과학회지

BACKGROUND: Contact dermatitis is frequently caused by cosmetics. Detection of causative allergens is important in prevention and treatment of cosmetic contact dermatitis. Patch test has been accepted as the only reliable diagnostic method to detect allergens. OBJECTIVE: The objectives of this study were to clarify evoluting trends of positive patch tests and to compare the positive frequencies of various allergens between different time sequences. MATERIALS AND METHODS: We reviewed patch test results of the 806 cosmetic contact dermatitis patients, who had visited our clinic from 1982 to 1997. We divided the patients into three groups as follows: I group:1982-1987, II group:1988-1992, III group:1993-1997 and compared the test results. The patch tests were performed with standard batteries, cosmetic-related allergens and the patients's own cosmetics. RESULTS: The results of the studies were summarized as follows; 1. Trends of increasing positivity in cosmetic-induced dermatitis was noted in a chronologic point of view. Among the patients, an increased proportion of males was notable. 2. In age distribution, a decreasing proportion of patients at the third & the fourth decades was observed. Contrary to this, the proportion of patients over the fifth decades was increased. 3. Among standard allergens, nickel sulphate showed the highest positive rate in all defined triple periods, whereas positive rates of neomycin sulphate & balsam of Peru were diminishing sequentially. Among fragrance allergens, cinnamic alcohol & cinnamic aldehyde revealed the highest positive rates. 4. In as is test, skin care products showed the highest positive rate, followed by toiletries and makeup products. Increasing positive rates of the toiletry products were observed in order of time. In fragrance products, positive rates reached their peak in the second period and declined in the third period. CONCLUSION: This study showed that perfume components were the most frequent allergens in cosmetics followed by preservative agents. Our study showed that comestic allergies in men seems to have increased.

Evaluation of Skin Surface Hydration in Diabetic Patients Using a Hydrometer and Corneometer / 대한피부과학회지

BACKGROUND: Diabetes mellitus is a common condition, and the majority of patients have one or more cutaneous complications. Among them, xerosis is well known to be closely related to diabetics. The xerosis is inversely reflected upon skin surface hydration, the state of which can be exactly assessed with various investigating instruments, such as a hydrometer and corneometer. OBJECTIVE: Our purpose was to compare the hydration state of diabetics with normal persons by the use of a corneometer and hydrometer. METHODS: A total of 267 diabetics were asked whether they felt xerosis or pruritus. In a subgroup of 31 patients, the water content was evaluated and compared by the parameters of diabetic severity. Forty-one non-diabetics were selected for the normal control.

A Case of Congenital Tuberculosis

Perinatal tuberculosis can be divided into congenital tuberculosis due to intrauterine infection and neonatal tuberculosis due to infection irnmediately following birth. It is a rare disease entity with only 300 cases reported worldwide. In Korea, only a few cases have been reported and only 1 case has been confirmed by autopsy at neonatal period. Although the majority of the mothers are found to have advanced tuberculosis and the children themselves are usually of premature birth, early diagnosis is difficult and despite antituberculous medication, the mortality rate is high. We report a premature baby with respiratory difficulty admitted to our hospital, whose mother was found to have miliary tuberculosis during the course of management. The baby died and autopsy was performed to confirm congenital tuberculosis.