The Development of Evaluation Methods for Outcomes in Medical Humanities Curriculum of a Medical School / 계명의대학술지

This study was performed to select the proper assessing methods for learning outcomes in undergraduate education of medical humanities (MH), and to evaluate whether student assessments in MH curricula are related to the graduate outcomes (GO)and/or periodic phase outcomes (PO). We searched the reasonable assessing methods for GO and PO of MH curricula of Keimyung University School of Medicine (KUSM). The outcomes are composed of six competencies including patient care, communication, patient support, professionalism, problem solving and research, and self-development. Then, we analyzed whether student assessments carried out during formal MH curricula properly achieved their PO, furthermore their GO. Four competencies including communication, patient support, professionalism, self-development were lightened to be closely related to outcomes for MH. Only the component of problem solving was settled to be related to MH in the competency of problem solving and research. The competency of patient care was excluded from the relationship with MH. The assessing methods for the GO and three PO recommended from educational experts, and there were various available assessing methods based on medical situations and clinical contexts including direct observation of clinical skills, 360 degree feedback, peer review, self-assessment, project-based assessment, portfolio-based assessment, discussion & presentation-based assessment, log-based assessment. For the outcome-achieving from formal MH curricula, the MH programs of phase-1 (1st and 2nd grades) almost accomplished the PO of communication, patient supporting and professionalism, and considerably accomplished the PO of problem solving and self-development. The MH programs of phase-2 (3rd and 4th grades) accomplished considerably their PO as the competencies of professionalism and problem solving, and partially as communication, patient supporting and self-development. However, as only one program, public health law, was provided for MH program in phase-3 (5th and 6th grades), the extra methods to evaluate their MH outcomes are needed. Many assessing methods can be available for the most MH competencies consisting of the GO of KUSM, and the proper assessing methods for each MH competency should be selected based on programs and learning contexts in MH education. While formal MH curricula of the school variously accomplished the MH competencies of GO according to periodic phases of curricula, it is recommended to enhance the feasibility and effectiveness of evaluation for GO in MH curricula of the school.

Changes in the accreditation standards of medical schools by the Korean Institute of Medical Education and Evaluation from 2000 to 2019 / 보건의료교육평가

This review presents information on changes in the accreditation standards of medical schools in Korea by the Korean Institute of Medical Education and Evaluation (KIMEE) from 2000 to 2019. Specifically, the following aspects are explained: the development process, setting principles and directions, evaluation items, characteristics of the standards, and validity testing over the course of 4 cycles. The first cycle of accreditation (2000–2005) focused on ensuring the minimum requirements for the educational environment. The evaluation criteria emphasized the core elements of medical education, including facilities and human resources. The second cycle of accreditation (2007–2010) emphasized universities’ commitment to social accountability and the pursuit of excellence in medical education. It raised the importance of qualitative standards for judging the content and quality of education. In the post-second accreditation cycle (2012–2018) which means third accreditation cycle, accreditation criteria were developed to standardize the educational environment and programs and to be used for curriculum development in order to continually improve the quality of basic medical education. Most recently, the ASK 2019 (Accreditation Standards of KIMEE 2019) accreditation cycle focused on qualitative evaluations in accordance with the World Federation of Medical Education’s accreditation criteria to reach the international level of basic medical education, which emphasizes the need for a student-centered curriculum, communication with society, and evaluation through a comprehensive basic medical education course. The KIMEE has developed a basic medical education evaluation and accreditation system in a step-by-step manner, as outlined above. Understanding previous processes will be helpful for the future development of accreditation criteria for medical schools in Korea.

Analysis of Job Interest and Job Value in the Freshmen of a Medical School / 계명의대학술지

This study was conducted to study the job interest and job value of medical freshmen. The job interest test and job value test by the Korea Employment Information Service of the Ministry of Employment and Labor were conducted on 149 medical freshmen enrolled in a medical school at 2019 and 2020. Among six types of job interest, investigative type was most suitable for the medical freshmen, followed by realistic type, enterprising type, social type. Among 13 types of job values, job stability, body and mind space, recognition, and financial compensation were higher values than the others in order. We expect that this result will be helpful to establish the career identity of medical students, and to construct the system of curriculum or counseling programs for career developing of them.

Analysis of Job Interest and Job Value in the Freshmen of a Medical School / 계명의대학술지

This study was conducted to study the job interest and job value of medical freshmen. The job interest test and job value test by the Korea Employment Information Service of the Ministry of Employment and Labor were conducted on 149 medical freshmen enrolled in a medical school at 2019 and 2020. Among six types of job interest, investigative type was most suitable for the medical freshmen, followed by realistic type, enterprising type, social type. Among 13 types of job values, job stability, body and mind space, recognition, and financial compensation were higher values than the others in order. We expect that this result will be helpful to establish the career identity of medical students, and to construct the system of curriculum or counseling programs for career developing of them.

Application Effects of Medical Ethics for Problem Solving Ability And Grouping Methods / 계명의대학술지

This study was aimed to examinate the effectiveness of the application of a medical ethics class model at 2014 and 2016 for the improvement of students' problem solving ability (PSA) in a medical school. The PSA of medical students was relatively higher than that of regular adults and college students. There were not significant differences of PSA between male and female medical students (pre-medical ethics class: t= 0.29 p= 0.78; post-medical ethics class: t= 1.09, p= 0.29). The significant improvements of students' PSA were remarkable after the application of the medical ethics class model (at 2014: t= 3.29, p < 0.01, at 2016: t= 7.05, p < 0.01). In 2016, all five lower level competencies of PSA such as ‘clarification problem’ ‘cause analysis’, ‘developing alternatives’, ‘running the plan’ and ‘assessing performance’ were significantly improved. In 2014, however, ‘cause analysis’, ‘developing alternatives’ and ‘running the plan’ of five lower level competencies of PSA were significantly improved. There were significant improvements of PSA after the medical ethics class model in both the higher PSA group (p < 0.01) and the lower PSA group (p < 0.01) in 2016. However, there was significant improvement of PSA after the medical ethics class in the lower PSA group only in 2014 (p < 0.01). This difference is be due to the grouping ways of discussion teams. The discussion teams of 2016 were homogeneously composed of the higher PSA students only or of the lower PSA students only, comparing to the discussion teams of 2014 composed heterogeneously of combining of the higher PSA and the lower PSA students. The medical ethics class model is thought to be very helpful educational method for improving of the PSA, and the grouping into homogeneous teams with PSA members of similar PSA level seems to be helpful to improve PSA than grouping into heterogeneous teams.

Application Effects of Medical Ethics for Problem Solving Ability And Grouping Methods / 계명의대학술지

This study was aimed to examinate the effectiveness of the application of a medical ethics class model at 2014 and 2016 for the improvement of students' problem solving ability (PSA) in a medical school. The PSA of medical students was relatively higher than that of regular adults and college students. There were not significant differences of PSA between male and female medical students (pre-medical ethics class: t= 0.29 p= 0.78; post-medical ethics class: t= 1.09, p= 0.29). The significant improvements of students' PSA were remarkable after the application of the medical ethics class model (at 2014: t= 3.29, p < 0.01, at 2016: t= 7.05, p < 0.01). In 2016, all five lower level competencies of PSA such as ‘clarification problem’‘cause analysis’, ‘developing alternatives’, ‘running the plan’ and ‘assessing performance’ were significantly improved. In 2014, however, ‘cause analysis’, ‘developing alternatives’ and ‘running the plan’ of five lower level competencies of PSA were significantly improved. There were significant improvements of PSA after the medical ethics class model in both the higher PSA group (p < 0.01) and the lower PSA group (p < 0.01) in 2016. However, there was significant improvement of PSA after the medical ethics class in the lower PSA group only in 2014 (p < 0.01). This difference is be due to the grouping ways of discussion teams. The discussion teams of 2016 were homogeneously composed of the higher PSA students only or of the lower PSA students only, comparing to the discussion teams of 2014 composed heterogeneously of combining of the higher PSA and the lower PSA students. The medical ethics class model is thought to be very helpful educational method for improving of the PSA, and the grouping into homogeneous teams with PSA members of similar PSA level seems to be helpful to improve PSA than grouping into heterogeneous teams.

Application Effects of Medical Ethics for Problem Solving Ability And Grouping Methods / 계명의대학술지

This study was aimed to examinate the effectiveness of the application of a medical ethics class model at 2014 and 2016 for the improvement of students' problem solving ability (PSA) in a medical school. The PSA of medical students was relatively higher than that of regular adults and college students. There were not significant differences of PSA between male and female medical students (pre-medical ethics class: t= 0.29 p= 0.78; post-medical ethics class: t= 1.09, p= 0.29). The significant improvements of students' PSA were remarkable after the application of the medical ethics class model (at 2014: t= 3.29, p < 0.01, at 2016: t= 7.05, p < 0.01). In 2016, all five lower level competencies of PSA such as ‘clarification problem’‘cause analysis’, ‘developing alternatives’, ‘running the plan’ and ‘assessing performance’ were significantly improved. In 2014, however, ‘cause analysis’, ‘developing alternatives’ and ‘running the plan’ of five lower level competencies of PSA were significantly improved. There were significant improvements of PSA after the medical ethics class model in both the higher PSA group (p < 0.01) and the lower PSA group (p < 0.01) in 2016. However, there was significant improvement of PSA after the medical ethics class in the lower PSA group only in 2014 (p < 0.01). This difference is be due to the grouping ways of discussion teams. The discussion teams of 2016 were homogeneously composed of the higher PSA students only or of the lower PSA students only, comparing to the discussion teams of 2014 composed heterogeneously of combining of the higher PSA and the lower PSA students. The medical ethics class model is thought to be very helpful educational method for improving of the PSA, and the grouping into homogeneous teams with PSA members of similar PSA level seems to be helpful to improve PSA than grouping into heterogeneous teams.

Personality Types and Application to Medical Education in Medical Students / 계명의대학술지

Myers-Briggs Type Indicator (MBTI) is a personality type test book, which is widely used in the field of personal counseling, team organization, school education and research. This study carried out MBTI of 361 medical students in the second grade of premedical course of Keimyung University School of Medicine from 2014 to 2018, and analyzed the data to use them for the students' education. The personality type was mostly distributed to ISTJ, ISTP, ESTP and ESTJ in order among 16 types. According to preference tendency, it was found out that the introverted type was extroverted, the recognition type was intuition type, the thinking type was emotional type, and the recognition type was more distributed than the judgment type. The psychological functions were ST, SF, NF, NT. MBTI type analysis of medical students shows that it is possible to organize members in group activities to improve their ability to understand themselves and understand others in class scenes. In addition, we expect to be able to design for improvement of stress management, conflict management, and communication ability. In the career counseling scene, in addition to the MBTI data analysis, it is expected that it will be possible to recommend a major suitable for the student personality type in parallel with other psychological tests. In addition, we expect to study the preferred field of study, satisfaction with the major in the future research by continuous data accumulation and analysis.

Guidelines for Improvement of Integrated Courses in a Medical School / 계명의대학술지

To systematically develop the courses or programs of medical education, guidelines were developed for the improvement of integrated courses, modifying the existing evaluation model of school curriculum to fit the curriculum of medical school. The guidelines were divided into three parts, prior-class, mid-class, and post-class, and 18 items were developed in the areas of situation analysis, developing process, goals, contents, organization, management, performance, and evaluation.

Differences of Perceptual Importance for Graduate Outcomes among Faculties, Students and Parents in a Medical School / 계명의대학술지

To find out the different cognition of the members of medical school about the importance of graduate outcomes such as 'clinical performance, communication, supporting patients, professionalism, problem solving and research, self-development', a survey applied with self-report method was conducted with 110 faculties, 132 students (71 premedical 2nd graders and 61 medical 2nd graders), and 30 parents about graduate outcomes and sub-outcome competences. Parents usually thought highly of the importance of graduate outcomes, while medical second graders comparatively regarded them as less important. Among graduate outcomes, 'clinical performance' was definitely considered the most important and was followed by 'communication'. As for 'self-development', parents and premedical 2nd graders regarded it as important, while faculty and medical 2nd graders had lower awareness about its importance. As to the suboutcome competences, faculty generally had lower awareness about their importance compared to students and parents.

The Effect of Preventive Antihypertensive Medication with Nicardipine or Nitroglycerin during Off-pump Coronary Artery Bypass Graft / 대한마취과학회지

BACKGROUND: Tight control of blood pressure in patients with coronary artery disease is critical, especially in the setting of long-standing hypertension and left ventricular dysfunction. With off-pump coronary artery bypass graft (CABG), hypertension usually occurs after the sternotomy, along with an increase in heart rate and filling pressure. In order to minimize hypertension during this period, nitroglycerin or nicardipine was prophylactically infused. METHODS: Twenty patients scheduled to undergo an off-pump CABG from April to August, 2001, were selected and divided into two groups. Group I (n = 10) received nicardipine and Group II (n = 10) received nitroglycerin. Before the skin incision, nicardipine (0.5 - 1.0ng/kg/min) or nitroglycerin (0.5 - 1.0ng/kg/min) was continuously infused. Mean arterial pressure (MAP), heart rate (HR), mean pulmonary artery pressure (mPAP), pulmonary artery occlusion pressure (PAOP), cardiac index (CI), and the systemic vascular resistance index (SVRI) were repeatedly measured at the stages of preincision, postincision, poststernotomy, pericardium open, and 10 min after reperfusion. RESULTS: Although MAP after the sternotomy was increased compared with preincision, it remained within a normal range. Similarly, HR, mPAP, and PAOP were all within a normal range despite increases. The CI was within a normal range at all stages in both groups, and there were no significant difference between the two groups. In group I, the SVRI was significantly decreased compared with group II when pericardium was opened. CONCLUSIONS: Both nicardipine and nitroglycerin were effective in preventing or attenuating hypertension after sternotomy with the hemodynamic stability.

Changes of mRNA and Plasma Levels of Atrial Natriuretic Peptide in Subtotal Nephrectomized Rats after High Salt Intake / 대한신장학회잡지

High salt intake produces volume expansion and electrolyte imbalance in chronic renal failure and modifies the synthesis and secretion of atrial natriuretic peptide(ANP) to compensate the abnormalities in fluid and sodium handling. This study was performed to investigate the effect of high salt intake on modulation of cardiac and noncardiac ANP mRNA as well as plasma ANP levels in 5/6 subtotal nephrectomized (NPX) rats as a model of chronic renal failure. Adult male Sprague-Dawley rats were divided into sham and NPX rats. NPX rats were induced by 2/3 pole ligation and contralateral nephrectomy. Sham and NPX rats had access to normal chow with tap water for 8 weeks or normal chow with 0.45% NaCl solution(HS) for last 2 weeks. Plasma ANP levels were measured by radioimmunoassay. ANP mRNA from the right atrium, left ventricle, hypothalamus and kidney were analyzed by RT-PCR with 32P-dCTP at 8 weeks after surgical operation in both sham and NPX rats. Blood urea nitrogen(BUN) was measured to evaluate impaired renal function. Body weight, daily water intake, hemoglobin, red blood cell, hematocrit, arterial pressure and heart rate were also monitored. Arterial pressure in NPX+HS rat was significantly increased. Both percent increase of body weight and hematologic findings were decreased in NPX rats. Daily water intake was increased in NPX rats, especially in NPX+HS rat. BUN also increased in NPX rats. Plasma ANP concentration was significantly increased in sham+HS rat, but other significant increases were not shown in NPX rats. The levels of right atrial ANP mRNA represented the increasing trend like as plasma ANP. Left ventricular ANP mRNA was increased in sham+HS rat, while the level in NPX+HS rat was decreased comparing with that of sham+HS rat. Hypothalamic ANP mRNA was decreased in NPX+HS rat. In the kidney, the level of ANP mRNA in sham+HS rat was increased comparing with sham rat, but ANP synthesis in NPX+HS rat was significantly lower than in sham, sham+HS and in NPX rats. These findings represent that the high salt intake in NPX rat does not alter the plasma levels and cardiac synthesis of ANP but suppresses the renal ANP mRNA. The diminished renal ANP synthesis may attenuate the regulatory role of ANP system in the kidney and result in volume expansion and hypertension.

Hemodynamic Changes and Clinical Symptoms Resulting from Stellate Ganglion Block / 대한마취과학회지

BACKGROUND: Stellate ganglion block (SGB) is the most common nerve block procedure in pain clinics. To evaluate changes in the hemodynamics and peripheral blood flow on the affected extremity after SGB, SGB was performed unilaterally one at a time on the right and left stellate ganglions by injecting 1% mepivacaine 10 ml without epinephrine in a designated healthy man. METHODS: SGB was repeated 16 times in one subject (right side SGB: 8, left side SGB: 8) by the same clinician. The mean arterial pressure (MAP), heart rate (HR), cardiac index (CI), systemic vascular resistance index (SVRI) and peripheral blood flow were measured in the supine position before (control), and 3, 6, 9, 12, and 15 minutes after SGB using thoracic electrical bioimpedence (Bioz system A-10043, Cardiodynamics, USA), sphygomanometer, and flow meter. RESULTS: The values after SGB including MAP, HR, CI, and SVRI increased slightly compared to the control value. However, peripheral blood flow increased significantly (p < 0.05). The SGB did not affect systematic hemodynamics and the comparison between left and right SGB in hemodynamic changes were not clinically significant. Following SGB, ptosis (100%), nasal stiffness (100%), skin temperature elevation (100%), hoarseness (100%), numbness (81%), dizziness (25%), and swallowing difficulty (25%) were observed. CONCLUSIONS: We concluded that SGB showed to be a hemodynamically safe clinical technique.

Mechanism of Renal Oxidative Damage following 4-week Head-down Suspension in Rats

The purpose of this study was to observe the variation of malondialdehyde (MDA), an indirect index of oxidative damage, following 4-week of head-down suspension (HDS) at -45degreein rats as a model of simulated weightlessness. We also measured the activities of antioxidant enzymes, such as superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) and catalase for clarifying the mechanisms of renal oxidative damage. MDA was increased (p<0.05) at the 4th week of HDS rats compared to control horizontal positioned rats. Following HDS, the renal activity of SOD was also significantly increased (p<0.01) at the 4th week of HDS whereas the changes of renal GSH-Px and catalase activities were not significantly different from controls. The expression of renal SOD mRNA used by polymerase-chain reaction method showed the similar pattern with the change of renal SOD activity and was more increased (p<0.05) than control horizontal positioned rat. These results indicate that simulated weightlessness induces the augmented SOD gene expression in the kidney which results in increased SOD activity, and thus increased production of MDA due to increased production of hydrogen peroxide. And under this condition, GSH-Px and catalase do not play their protective roles against hydrogen peroxide.

Characteristics of NMDA- and Glutamate-Induced Currents in Primary Cultured Rat Hippocampal Neuron

No abstract available.

Expression of Atrial and Extra-atrial ANP mRNA in Rats with Chronic Renal Failure / 대한신장학회잡지

Chronic renal failure(CRF) may lead to fluid retention and electrolyte imbalance, and consequently increases the extracellular volume and blood pressure. These changes can trigger secretion and synthesis of atrial natriuretic peptide(ANP) as a compensatory regulator for increases in the glomerular filtration rate and excretion of water and sodium due to the reduced number of functional nephrons. ANP may exert important regulatory role on body fluid balance and blood pressure in CRF. We assessed changes in gene expression of atrial and extra-atrial ANP associated with progression of renal failure in subtotal nephrectomized rats. Adult male Sprague-Dawley rats were divided into sham and CRF rats. CRF rats were induced by 5/6 subtotal nephrectomy. We determined the plasma ANP level using by radioimmunoassay and the ANP mRNA from the right atrium, left ventricle, hypothalamus and kidney were measured by reverse transcription-polymerase chain reaction with 32P- dCTP at 8 wk in sham, and at 8 and 12 wk in CRF rats. Serum urea nitrogen(SUN) was also checked as an indicator of impaired renal function. SUN was significantly increased in CRF rats and the level was higher at CRF 12 wk rat than CRF 8 wk rat. Plasma concentration of ANP also increased in CRF rats compared with sham rat, but was not statistically significant. Altered patterns of ANP mRNA expression were different in each tissue. Right atrial and renal ANP mRNA expressions were slightly increased in CRF rats. Left ventricular ANP mRNA was significantly increased in CRF 8 wk rat compared with sham rat and maintained high at CRF 12 wk rat. However hypothalamic ANP mRNA expressions at CRF rats were decreased and the expression in CRF 12 wk was significantly lower than that at CRF 8 wk. SUN showed positive correlations with expression in left ventricular and renal ANP mRNA, but had a significant negative relationship with hypothalamic ANP mRNA. Plasma ANP concentration was positively correlated with the ANP mRNA expressions in both right atrium and kidney. The present study demonstrated that ANP mRNA in the right atrium, left ventricle, kidney and hypothalamus were differentially expressed upon CRF. This suggests that roles of the local ANP in these tissues are regulated by different mechanisms to compensate the fluid and electrolyte imbalance in rats with experimental chronic renal failure.

Effect of Intracellular ATP on Zn2+ Blockade of KATP Channels in Pancreatic Beta Cells

In the therapeutic or the nutritional aspects, Zn2+ has been used as a supplement in a variety of drugs. Most of divalent or trivalent cations affect ion channels in the cell membranes of various organs. In particular, Zn2+ has been regarded as a potassium (K+) channel blocker in the field of electrophysiology. ATP-sensitive K+ (KATP) channel, which is a kind of inward rectifier K+ channel, resides in the cell membrane of pancreatic beta cells and plays an important role in glucose-induced insulin secretion. The glucose increases intracellular ATP concentration, and this inhibits KATP channels. The inhibition of KATP channels activity depolarizes the cell, and subsequently, insulin is released by Ca2+ influx through the voltage- gated Ca2+ channels. Here, we demonstrate that KATP channels in the pancreatic beta cells are also the targets of extracellular Zn2+ blockade and its blockade is dependent on intracellular ATP concentration. This may be a compensatory mechanism preventing the oversecretion of insulin from the Pancreatic beta cells triggered by Zn2+ intake in a physiologically fasting condition.

Nitric Oxide-Mediated Cytotoxicity of Manganese in Basal Ganglia Neuronal Cells / 예방의학회지

OBJECTIVES: We have investigated to manifest whether manganese-induced neurotoxicity is mediated by nitric oxide(NO) in the rat primary neuronal cultures and assess the effect of Mn2+ on the N-methyl-D aspartate(NMDA) receptors. METHODS: We have used 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT)assay to examine the effect of cytotoxicity of MnCl2 in neuronal cells . NO production was determined by measuring nirites, a stable oxidation product of NO. The neurons in the rat that contains neuronal nitric oxide synthase(nNOS) were examined by immunofluorescence and confocal microscopy. The effects of Mn2+ on the NMDA receptors was assesed by the whole cell voltage clamp technique. RESULTS: We showed that the NO release and NOS expression were increased with 500uM MnCl2 treatment and an NOS inhibitors, NG-nitro-L-arginine , prevented neurotoxicity elicited by manganese. In the electrophysiological study, Mn2+ does not block or activate the NMDA receptors and not pass through the NMDA receptors in a neurons of basal ganglia. CONCLUSIONS: It is concluded that manganese neurotoxicity in basal ganglia was partially mediated by nitric oxide in the cell culture model.

Effect of Brain-derived Neurotrophic Factor on Excitatory Synaptic Transmission in Hippocampal Neurons

Brain-derived neurotrophic factor (BDNF) rapidly enhances synaptic transmission among the hippocampal neurons in the resting state. This mechanism may be due to the phosphorylation of NMDA receptors through its Trkb receptors on the postsynaptic neuron. In contrast, BDNF also has a suppressing effect on the synaptic transmission via non-NMDA receptors. The activities of non-NMDA receptors are known to modulate the NMDA receptors activities. This study was to investigate, using patch clamp technique, whether the BDNF increases or decreases the glutamate-induced synaptic transmission in which glutamate acts on both NMDA- and non-NMDA receptors. When a postsynaptic neuron was previously excited by a large amount of glutamate, BDNF decreased the synaptic transmission induced by subsequently-applied glutamate. However, when the signal entered into a postsynaptic neuron was blocked by the application of tetrodotoxin, BDNF increased the glutamate-induced responses. These results show that BDNF plays a role in a protection of the neurons against hazardous or uncontrolled activation of glutamate receptors and in an accentuation of the synaptic response when the signal is inevitably diminished.

BDNF mRNA Expression and Calcium Influx Pathways in Kainate-induced Neurotoxicity

Kainate is known as a neurotoxin acting on the glutamate receptors in the central nervous system (CNS). Glutamate acts an excitatory neurotransmitter at physiological concentration but has a neurotoxic effect in excess amount. BDNF (brain-derived neurotrophic factor) has been reported to have a protective effect against the cellular toxicity and to plays an important role in neuronal survival and differentiation in peripheral nervous system. However, the functional mechanism of BDNF in CNS is unclear. This study was performed to examine the protective effect of BDNF in kainate-induced neurotoxicity and to observe the relation between BDNF mRNA expression and increasing pathways of intracellular Ca2+ concentration. Cultured hippocampal neurons were prepared from 17-18 day embryonic rats and used at the 7th day after neuronal culture. The amounts of BDNF mRNA were measured by reverse transcription polymerase chain reaction after the treatment of several glutamate receptor agonists: glutamate, kainate, -amino-3-hydroxyl-4-isoxazolepropionic acid, N-methyl-D-aspartate. Kainate showed the most prominent effect in an increase of BDNF mRNA expression among the glutamate receptor agonists. The maximal increase of BDNF mRNA expression was obtained in 50 M kainate at 3 hr after the treatment. Adding BDNF to kainate containing cultured hippocampal neurons diminished the increasing level of lactic dehydrogenase according to the single treatment of kainate. In the experiment to evaluate the Ca2+ influx pathways related in BDNF mRNA expression, nifedipine (10 M), a voltage-dependent Ca2+ channel blocker, decreased the both kainate (50 M) and KCl (50 mM) induced BDNF mRNA expressions by 18.4% and 35.0%, respectively. Ryanodine (10 M), a blocker of intracellular release from Ca2+ storage, however, did not show any effect in the both kainate- and KCl-treated neurons.These results suggest that BDNF has a protecting effect against the kainate-induced neurotoxicity in cultured rat hippocampal neurons, and its expression is more related with the Ca2+ influx through the voltage-dependent Ca2+ channels than the release from intracellular Ca2+ storage.