Correlation between serum 25-hydroxyvitamin D levels and severity of atopic dermatitis in children

PURPOSE: Vitamin D deficiency has been suggested to play a role in the pathogenesis of atopic dermatitis. In addition, inverse correlationship between serum 25-hydroxyvitamin D concentration and severity of atopic dermatitis has been suggested. METHODS: Clinical and laboratory parameters including serum 25-hydroxyvitamin D level and serum total IgE of 251 patients with atopic dermatitis who were 13 months to 18 years were measured. Severity of atopic dermatitis was assessed with SCORing Atopic Dermatitis (SCORAD) index. Statistical analysis was performed using Pearson correlation coefficient, one-way analysis of variance test and chi-square test. RESULTS: Among 251 patients, vitamin D deficiency (25-hydroxyvitamin D or =30 ng/mL, group 3) was present in 74 (29.5%). There was a statistically significant inverse correlation between serum concentration of 25-hydroxyvitamin D and values of SCORAD index (R=-0.24, P<0.000). Serum concentration of 25-hydroxyvitamin D were inversely correlated with total IgE (R=-0.29, P<0.000), and age (R=-0.49, P<0.000). CONCLUSION: The results from this study indicate that serum concentration of 25-hydroxyvitamin D is inversely correlated with clinical severity of atopic dermatitis in children.

Comparing Attitudes toward Disclosing Medical Errors between Medical Students and Interns / 한국의학교육

PURPOSE: The purpose of this study was to compare attitudes toward disclosing medical errors between medical students and interns. METHODS: The questionnaires were administrated to 164 medical students and interns. The questionnaires consist of 3 major concepts: knowledge, attitudes toward disclosure of medical error, barriers to the disclosure of medical error. RESULTS: Interns (56.1%) took medical errors less seriously than medical students (74.8%). Medical students (75.6%) believed that patients would want to be informed of any kind of medical errors while Interns (46.3%) thought so. Medical students (83.1%) considered that serious medical errors should be disclosed to patients. On the contrary, only 46.3% of interns believed so. Medical students (16.3%) and interns (19.5%) believed disclosing medical error would increase patients trust in doctors. Both medical students and interns pointed out worries about malpractice suits as the biggest barrier to disclosing medical error. CONCLUSION: The attitudes toward disclosing medical error between medical students and interns were significantly different in many aspects. Interns show more negative attitudes about disclosing medical errors than medical students. And they also take medical errors less seriously than medical students. In particular, the attitudes of the subjects in this study were greatly different from the results of a previous patients' attitudes study. These perspectives differences could work against achieving patient-centered care which is the upmost priority in the current trends in health care. The efforts to bridge these perspective gaps between patients and doctors should start from medical school by teaching medical students the importance of the disclosing medical errors.

Juvenile Nasopharyngeal Angiofibroma with Skull Base Invasion: Intratumoral Direct Puncture Embolization

PURPOSE: To demonstrate the utility and efficacy of percutaneous direct glue embolization for juvenilenasopharyngeal angiofibromas with skull base invasion MATERIALS AND METHODS: In nine cases of juvenilenasopharyngeal angiofibromas with invasion of the skull base, embolization under general anethesia was performed.Using an 18G spinal needle, direct puncture were made via the transnasal or mandibular sciatic notch. Aglue-lipiodol mixture (1:1-1:3) was injected slowely for 15 to 30 seconds under fluoroscopic control; the numberof injections depended on the size of the tumoral compartment. The results were evaluated by post-embolizationangiography and the distribution of embolic materials was assessed on CT within 1-3 days. The mass was surgicallyremoved 3 to 7 days after embolization. RESULTS: Postembolization angiography revealed total devascularization insix cases, and devascularization greater than 90% of the initial volume in the remaining three. The cast of thetumor was clearly demonstrated by the embolization material with increased density. Surgical removal was safelyperformed without significant bleeding. And no neurologic complications were observed. CONCLUSION: Direct glueembolization of juvenile angiofibroma with skull base invasion appears to be a simple and safe procedure. Thetechnique could be used for other hypervascular lesions in the base fo the skull or parapharyngeal space.