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Purpose@#This study investigates the characteristics of different item types to assess learning outcomes and explore the educational implications that can be obtained from the results of learning outcome assessments. @*Methods@#Forty-five second-year premedical students participated in this study. Multiple choice question (MCQ) and short essay question (SEQ) scores and pass rates for 10 learning outcomes were analyzed. Descriptive statistics and correlation analysis were used to analyze the data. @*Results@#The correlation analysis indicated that there was a significant correlation between SEQs and pass rate but there was no significant correlation between MCQs and pass rate. Some students with identical scores on the MCQs had different scores on the SEQs or on the learning outcomes. @*Conclusion@#This study showed that students’ achievement of learning outcomes can be assessed using various types of questions in outcome-based education.
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Various symptomatic complaints, including dysphagia, have been reported by patients with whiplash injury, which greatly impacts their life. There are few reports on the treatment and progression of dysphagia following whiplash injuries. This case report describes a patient who presented with delayed dysphagia after a whiplash injury. A 37-year-old female visited the Department of Rehabilitation Medicine of our institution and presented with delayed dysphagia one year after a traffic accident. At the time of the accident, the patient was diagnosed with a whiplash injury and had no symptoms of dysphagia. A videofluoroscopic swallowing study revealed decreased laryngeal elevation and impaired upper esophageal sphincter opening in the pharyngeal phase. The Penetration-Aspiration Scale score was 3 for pureed food and 7 for liquid food. Laryngeal needle electromyography showed abnormal spontaneous activity in both cricothyroid muscles. The patient underwent swallowing rehabilitation for oropharyngeal dysphagia. There were recurrences of improvement and deterioration during the treatment period. However, after five months, problems related to swallowing improved until there were no complaints. Our study indicates a differentiated treatment approach and the importance of continuous rehabilitation for dysphagia after a whiplash injury.
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Purpose@#The purpose of this study is to analyze the accreditation standards items related to the decision of accreditation of medical schools by the Korea Institute of Medical Education and Evaluation (KIMEE). @*Methods@#The subjects are medical schools in Korea that have received post-2nd cycle accreditation from the KIMEE between 2012 and 2016. Analyses were conducted for differences in accreditation decisions according to the characteristics of medical schools, sufficient ratios of basic standards items, and correlation between standards items related to accreditation decisions. @*Results@#After examining differences in accreditation decisions by the medical school’s characteristics, there were no significant correlations between accreditation standard items and accreditation decisions. Second, according to the number of schools that sufficiently or insufficiently met each standard item, from the total of 97 standard items, 20 (20.6%) were sufficiently fulfilled by all medical schools. Standard item 2-5-2 demonstrated the highest insufficiency ratio. Third, with respect to the standard item that had an effect on accreditation decisions, standard item 1-5-1 showed the highest correlation with the sufficiency rate. @*Conclusion@#The validity of accreditation standards items was assured as this study evaluated the post-2nd cycle accreditation standards items regardless of each medical school’s characteristics. The accreditation standards items were found to have a meaningful impact on the development of medical schools and qualitative improvement in medical education. The findings are expected to contribute to guaranteeing the validity and reliability of accreditation decisions and raising the quality of accreditation.
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Although hanging is the most common method of suicide in Korea, there are few reports of dysphagia following laryngeal injuries due to near-hanging. This is a case report of a patient who complained of dysphagia after a complex fracture of the neck structures caused due to attempted suicide by hanging. A 51-year-old male visited our hospital with neck injuries after a near-hanging episode. Laryngoscopy suspected dislocation of the right arytenoid cartilage. A computed tomography (CT) scan revealed fractures of the right hyoid bone and thyroid cartilage, as well as soft tissue emphysema. A closed reduction for the dislocation of the right arytenoid cartilage was performed. After surgery, oral feeding was attempted five days after surgery but stopped due to a large amount of aspiration. After two weeks, a videofluoroscopic swallowing study (VFSS) revealed a decreased laryngeal elevation and severe impairment of the upper esophageal sphincter opening. The patient was then given rehabilitation for oropharyngeal dysphagia to restore swallowing function. Four months after the injury, VFSS showed that the residue in the pyriform sinus after multiple swallowing attempts decreased compared to the previous studies. However, oral diet and enteral feeding were combined due to the patient experiencing early fatigue due to swallowing difficulties.Our observations, in this case, show that it was necessary to provide treatment through a multidisciplinary approach coupled with long-term follow-up for patients with dysphagia after complex fractures by near-hanging.
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This study evaluated the correlation between serum uric acid level and the nutrients adequacy ratio (NAR) using data from the Korea National Health and Nutrition Examination Survey (KNHANES) 2016∼2019. This is a cross-sectional study in which 6,579 Korean male adults were divided into quartiles according to their uric acid levels. All analyses were performed with adjusted age. Uric acid decreased as the age increased from the age group 19∼29 years to 30∼49 years and then to 50∼64 years. Interquartile results of serum uric acid levels showed that increases in the serum uric acid levels were associated with decreases in LDL-cholesterol (P＜0.01), triglycerides (P＜0.001), body weight (P＜0.001), waist circumference (P＜0.001), body mass index (P＜0.001), systolic blood pressure (SBP) (P＜0.001), diastolic blood pressure (DBP) (P＜0.001). However, uric acid levels decreased with an increase in HDL cholesterol (P＜0.001). The analysis of the NARs according to the quartiles of serum uric acid levels in men showed that an increase in serum uric acid levels was associated with a decrease in the NAR levels of dietary fiber (P＜0.001), calcium (P＜0.001), and folic acid (P＜0.001).
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The rotavirus vaccine is a live vaccine, and there is a possibility of infection by the virus strain used in the vaccine. We investigated the process of determining whether an infection was caused by the vaccine strain in a severe complex immunodeficiency (SCID) patient with rotavirus infection. The patient was vaccinated with RotaTeq prior to being diagnosed with SCID. The testing process was conducted in the following order: confirming rotavirus infection, determining its genotype, and confirming the vaccine strain. Rotavirus infection was confirmed through enzyme immunoassay and VP6 gene detection. G1 and P[8] were identified by multiplex polymerase chain reaction for the genotype, and G3 was further identified using a single primer. By detecting the fingerprint gene (WC3) of RotaTeq, it was confirmed that the detected virus was the vaccine strain. Genotypes G1 and P[8] were identified, and the infection was suspected of having been caused by rotavirus G1P[8]. G1P[8] is the most commonly detected genotype worldwide and is not included in the recombinant strains used in vaccines. Therefore, the infection was confirmed to have been caused by the vaccine strain by analyzing the genetic relationship between VP4 and VP7. Rotavirus infection by the vaccine strain can be identified through genotyping and fingerprint gene detection. However, genetic linkage analysis will also help to identify vaccine strains.
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The diagnostic and treatment methods of multiple myeloma (MM) have been rapidly evolving owing to advances in imaging techniques and new therapeutic agents. Imaging has begun to play an important role in the management of MM, and international guidelines are frequently updated. Since the publication of 2015 International Myeloma Working Group (IMWG) criteria for the diagnosis of MM, whole-body magnetic resonance imaging (MRI) or low-dose whole-body computed tomography (CT) and 18F-fluorodeoxyglucose positron emission tomography/CT have entered the mainstream as diagnostic and treatment response assessment tools. The 2019 IMWG guidelines also provide imaging recommendations for various clinical settings. Accordingly, radiologists have become a key component of MM management. In this review, we provide an overview of updates in the MM field with an emphasis on imaging modalities.
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Purpose@#The purpose of this study is to examine the characteristics of resistance among medical students toward e-portfolios and find the strategies for them to successfully prepare e-portfolios. @*Methods@#Participants were a group of 258 medical students. The questionnaire comprised 13 items developed based on the innovation resistance theory. The data were analyzed using descriptive analysis and Spearman’s correlation analysis using PASW SPSS version 18.0 (SPSS Inc., Chicago, USA). @*Results@#Students perceived that e-portfolios have a high degree of relative advantage, trialability, and complexity as their innovation resistance characteristics. Regarding perceived risk, they did not want others to see their information, but they had a high degree of demand for communication with their professors. @*Conclusion@#The successful use of portfolios can serve as a tool for student management and assessment that can reflect their introspection, personal development, and academic performance. This study proposed the strategies to promote the use of e-portfolios by strengthening education on the need for them, specific feedback of instructors, and students’ autonomy.
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Background@#The purpose of this study was to investigate nurses' knowledge and performance ability of Defibrillator. @*Methods@#The participants in this study were 121 nurses who have been working in a general hospital located in G region. The measuring tools of this study were developed on the basis of guidelines from American Heart Association and Korea Association of Cardiopulmonary Resuscitation. The knowledge of defibrillator was measured by self-report questionnaire, and the performance ability of defibrillator was measured by observation of the participants. The period of collected date was from May 15 to June 15 in 2016. The collected data were analyzed by using SPSS 19.0 program. @*Results@#The mean score about knowledge of defibrillator was 2.79±2.42. The mean score about performing ability of defibrillation was 6.44±3.39. The knowledge of defibrillator was a significant difference with age, working area, working carrier, experience of using defibrillator. The performance ability of defibrillator was a significant difference with age, working area, working carrier, experience of using defibrillator. There was a significant positive correlation between knowledge and performance ability of defibrillator. @*Conclusions@#The finding suggests developing the knowledge and the performance ability of defibrillator on going refresher courses and training programs, including the related nursing practice guidelines to improve the knowledge and performance ability of defibrillator.
ABSTRACT
The rotavirus vaccine is a live vaccine, and there is a possibility of infection by the virus strain used in the vaccine. We investigated the process of determining whether an infection was caused by the vaccine strain in a severe complex immunodeficiency (SCID) patient with rotavirus infection. The patient was vaccinated with RotaTeq prior to being diagnosed with SCID. The testing process was conducted in the following order: confirming rotavirus infection, determining its genotype, and confirming the vaccine strain. Rotavirus infection was confirmed through enzyme immunoassay and VP6 gene detection. G1 and P[8] were identified by multiplex polymerase chain reaction for the genotype, and G3 was further identified using a single primer. By detecting the fingerprint gene (WC3) of RotaTeq, it was confirmed that the detected virus was the vaccine strain. Genotypes G1 and P[8] were identified, and the infection was suspected of having been caused by rotavirus G1P[8]. G1P[8] is the most commonly detected genotype worldwide and is not included in the recombinant strains used in vaccines. Therefore, the infection was confirmed to have been caused by the vaccine strain by analyzing the genetic relationship between VP4 and VP7. Rotavirus infection by the vaccine strain can be identified through genotyping and fingerprint gene detection. However, genetic linkage analysis will also help to identify vaccine strains.
ABSTRACT
The diagnostic and treatment methods of multiple myeloma (MM) have been rapidly evolving owing to advances in imaging techniques and new therapeutic agents. Imaging has begun to play an important role in the management of MM, and international guidelines are frequently updated. Since the publication of 2015 International Myeloma Working Group (IMWG) criteria for the diagnosis of MM, whole-body magnetic resonance imaging (MRI) or low-dose whole-body computed tomography (CT) and 18F-fluorodeoxyglucose positron emission tomography/CT have entered the mainstream as diagnostic and treatment response assessment tools. The 2019 IMWG guidelines also provide imaging recommendations for various clinical settings. Accordingly, radiologists have become a key component of MM management. In this review, we provide an overview of updates in the MM field with an emphasis on imaging modalities.
ABSTRACT
Purpose@#The purpose of this study is to examine the characteristics of resistance among medical students toward e-portfolios and find the strategies for them to successfully prepare e-portfolios. @*Methods@#Participants were a group of 258 medical students. The questionnaire comprised 13 items developed based on the innovation resistance theory. The data were analyzed using descriptive analysis and Spearman’s correlation analysis using PASW SPSS version 18.0 (SPSS Inc., Chicago, USA). @*Results@#Students perceived that e-portfolios have a high degree of relative advantage, trialability, and complexity as their innovation resistance characteristics. Regarding perceived risk, they did not want others to see their information, but they had a high degree of demand for communication with their professors. @*Conclusion@#The successful use of portfolios can serve as a tool for student management and assessment that can reflect their introspection, personal development, and academic performance. This study proposed the strategies to promote the use of e-portfolios by strengthening education on the need for them, specific feedback of instructors, and students’ autonomy.
ABSTRACT
Background@#The purpose of this study was to investigate nurses' knowledge and performance ability of Defibrillator. @*Methods@#The participants in this study were 121 nurses who have been working in a general hospital located in G region. The measuring tools of this study were developed on the basis of guidelines from American Heart Association and Korea Association of Cardiopulmonary Resuscitation. The knowledge of defibrillator was measured by self-report questionnaire, and the performance ability of defibrillator was measured by observation of the participants. The period of collected date was from May 15 to June 15 in 2016. The collected data were analyzed by using SPSS 19.0 program. @*Results@#The mean score about knowledge of defibrillator was 2.79±2.42. The mean score about performing ability of defibrillation was 6.44±3.39. The knowledge of defibrillator was a significant difference with age, working area, working carrier, experience of using defibrillator. The performance ability of defibrillator was a significant difference with age, working area, working carrier, experience of using defibrillator. There was a significant positive correlation between knowledge and performance ability of defibrillator. @*Conclusions@#The finding suggests developing the knowledge and the performance ability of defibrillator on going refresher courses and training programs, including the related nursing practice guidelines to improve the knowledge and performance ability of defibrillator.
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Background/Aims@#Pleuroparenchymal fibroelastosis (PPFE) is a type of rare idiopathic interstitial pneumonia that is characterized by predominantly upper lobe involvement with pleural fibrosis and subjacent parenchymal fibrosis. This study aimed to determine the clinico-radiologic-pathologic features and prognosis of Korean patients with PPFE. @*Methods@#A total of 26 patients who were confirmed to have PPFE by lung biopsy, were included, and their clinico-radiologic-pathologic findings were retrospectively analyzed. @*Results@#The mean follow-up period was 23.8 months, and the mean age of the patients was 62.5 years; 61.5% were men and 50% were smokers. Cough and dyspnea were the most frequent presenting symptoms, and restrictive pattern was the most common observation in lung function. In 84.6% of the subjects, lower lobe involvement was found on chest computed tomography, and the usual interstitial pneumonia (UIP) pattern was the most common (59.1%). Among patients whose lower lobe was biopsied (n = 13), the UIP pattern was the most common (46.2%). Patients with lower lobe involvement were older and walked a shorter distance during the 6-minute walk test, compared to those without. Spontaneous pneumothorax was a common complication (26.9%), and 15.4% of the patients died mostly due to pneumonia (100%). The 1- and 3-year survival rates were 90.2% and 84.5%, respectively. @*Conclusions@#Clinical features of Korean patients with PPFE were similar to those reported previously; however, lower lobe involvement was more frequent. During follow-up, one-fourth of the patients experienced pneumothorax and one-fifth died from pneumonia.
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Purpose@#The purpose of this study was to examine the differences in the medical students’ satisfaction on online flipped learning by the learning style. @*Methods@#A total of 42 second-year medical students were participated in this study. As study tools, Felder and Soloman’s Index of Learning Styles and the Korean Educational Development Institute’s National Assessment of Student Engagement in Learning were utilized. Data analysis was conducted with the Kruskal-Wallis test, a nonparametric statistical method. @*Results@#Results showed that there were statistically significant differences within active–reflective types and sensing–intuitive types. The active–reflective type has been shown to have statistically significant differences for the three effects of learning, such as problem solving and understanding, active participation, and self-directed learning attitudes. For sensing–intuitive type, active participation showed a significant difference from other effects of learning. @*Conclusion@#The learning style is an important concept in understanding the diverse ways in which students process and absorb new information. Hence research is needed to conduct successful small group activities through online. In the future, it is necessary to find the factors that can lead to successful online classes in medical schools.
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There is a dearth of Korean studies on dehydration, one of the health risks for adult women. This study analyzed the subjects of the 2016∼2018 National Health and Nutrition Examination Survey (KNHANES) to investigate the relationship between nutrient intake ratios and sedentary time in dehydrated women. Body mass index and waist circumference in the dehydrated group (DG) were significantly higher than the normal group (NG). Intake of other liquids in the DG was significantly higher than in the NG, but total water intake in the DG was significantly lower than in the NG. Compared to the 600 sedentary minutes or more per day group, the odds ratio of dehydration was significantly higher in the less than 300 sedentary minutes per day group (1.871 [95% CI: 1.579∼2.215], P＜0.001). Compared to the drinking over 6.0 cups of water per day group, the odds ratio of dehydration was significantly higher in the 3 cups or fewer per day (OR [95% CI] is 1.198 times [1.019 to 1.408], P＜0.05), and 6.0 cups or fewer group (OR [95% CI] is 1.162 times [1.018 to 1.326], P＜0.05). The results of this study showed that the total water intake was relatively lower in the ≥600 sedentary minutes per day group compared to the 300 sedentary minutes per day group, making them more vulnerable to dehydration. The nutrient intake ratios were higher in the dehydration group than in the normal group. In conclusion, emphasis should be placed on the importance of hydration and nutrition education for adult women in the workplace.
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Objective: To investigate the antifibrotic effects of Chrysanthemum indicum ethanol extract (CIEE) against activated hepatic stellate cells (HSC) and thioacetamide (TAA)-induced hepatofibrosis in rats. Methods: Cell viability and proliferation of HSC-T6 cells were measured using MTT assay. Primary HSCs were used to study morphology. TAA (200 mg/kg) was used to induced hepatic fibrosis in rats. CIEE (100 and 500 mg/kg) and silymarin (50 mg/kg) were administered orally. Liver functions including alanine transaminase, aspartate transaminase, glutathione, and hydroxyproline levels were measured using commercial kits. Liver sections and fibrotic biomarker expression were measured using hematoxylin and eosin staining and real-Time polymerase chain reaction. Results: In vitro study revealed that CIEE (0.1, 0.25, and 0.5 mg/mL) inhibited the proliferation of activated HSCs exposed to transforming growth factor (TGF)-β and restored the activated primary HSC morphology. In in vivo studies, TAA-induced increase in liver/body weight ratio (5.46 ± 0.26) was significantly reduced (4.13 ± 0.22) by CIEE (P<0.05 at 500 mg/kg). CIEE (100 and 500 mg/kg) improved the liver functions by significantly attenuating changes in alanine transaminase, aspartate transaminase, glutathione, and hydroxyproline levels (P<0.05). Further, CIEE (100 and 500 mg/kg) ameliorated the histological changes in liver tissue and TGF-β expression significantly (P<0.05) in TAA-induced rats. Conclusions: CIEE significantly protects against TAA-induced liver damage in rats and can be used in the treatment of liver fibrosis.
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Objective: To investigate the antifibrotic effects of Chrysanthemum indicum ethanol extract (CIEE) against activated hepatic stellate cells (HSC) and thioacetamide (TAA)-induced hepatofibrosis in rats. Methods: Cell viability and proliferation of HSC-T6 cells were measured using MTT assay. Primary HSCs were used to study morphology. TAA (200 mg/kg) was used to induced hepatic fibrosis in rats. CIEE (100 and 500 mg/kg) and silymarin (50 mg/kg) were administered orally. Liver functions including alanine transaminase, aspartate transaminase, glutathione, and hydroxyproline levels were measured using commercial kits. Liver sections and fibrotic biomarker expression were measured using hematoxylin and eosin staining and real-Time polymerase chain reaction. Results: In vitro study revealed that CIEE (0.1, 0.25, and 0.5 mg/mL) inhibited the proliferation of activated HSCs exposed to transforming growth factor (TGF)-β and restored the activated primary HSC morphology. In in vivo studies, TAA-induced increase in liver/body weight ratio (5.46 ± 0.26) was significantly reduced (4.13 ± 0.22) by CIEE (P<0.05 at 500 mg/kg). CIEE (100 and 500 mg/kg) improved the liver functions by significantly attenuating changes in alanine transaminase, aspartate transaminase, glutathione, and hydroxyproline levels (P<0.05). Further, CIEE (100 and 500 mg/kg) ameliorated the histological changes in liver tissue and TGF-β expression significantly (P<0.05) in TAA-induced rats. Conclusions: CIEE significantly protects against TAA-induced liver damage in rats and can be used in the treatment of liver fibrosis.
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Background@#The timeline of infections after lung transplantation has been changed with the introduction of new immunosuppressants and prophylaxis strategies. The study aimed to investigate the epidemiological characteristics of infectious diseases after lung transplantation in the current era. @*Materials and Methods@#All patients who underwent lung or heart–lung transplantation at our institution between October 29, 2008 and April 3, 2019 were enrolled. We retrospectively reviewed the patients' medical records till April 2, 2020. @*Results@#In total, 100 consecutive lung transplant recipients were enrolled. The median follow-up period was 28 months after lung transplantation. A total of 127 post–lung transplantation bacterial infections occurred. Catheter-related bloodstream infection (25/84, 29.8%) was the most common within 6 months and pneumonia (23/43, 53.5%) was the most common after 6 months. Most episodes (35/40, 87.5%) of respiratory viral infections occurred after 6 months, mainly as upper respiratory infections. The remaining episodes (5/40, 12.5%) mostly manifested as lower respiratory tract infections. Seventy cytomegalovirus infections observed in 43 patients were divided into 23 episodes occurring before and 47 episodes occurring after discontinuing prophylaxis. Of 10 episodes of cytomegalovirus disease, four occurred during prophylaxis and six occurred after prophylaxis.Of 23 episodes of post–lung transplantation fungal infection, 7 were aspergillosis and all occurred after the discontinuation of prophylaxis. @*Conclusion@#Lung transplant recipients experienced a high burden of infection even after 6 months, especially after the end of the prophylaxis period. Therefore, these patients should be continued to be monitored long-term for infectious disease.
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We here report the first outbreak caused by rotavirus G11,P[25] in Korea in 2018, representing a case of re-assortment with pig-derived rotavirus. The genotype constellation was identical to the virus identified in Korea in 2012 as G11-P[25] -I12-R1-C1-M1-A1-N1-T1-E1-H1. The infection source was not known exactly but it must be considered infection from swine.