In the present research, first we evaluated the association between urban area size and commuting modes with physical activity among working people. Then we investigated the longitudinal effects of urban area size and commuting modes on increased physical activity due to health guidance intervention. The subjects were 401 male employees (aged 46.3±7.8) of A corporation, and were split into two groups, metropolitan area group (N=235) and local area group (N=166), based on the population density of place of work. IPAQ-E was used for evaluation of walking environments, and physical activity was assessed using pedometers. The intervention consisted of an exercise-focused health guidance over the course of one year. The cross-sectional study admitted that in comparison with the local area group the metropolitan area group had more than physical activity (p<0.01). Not only the size of urban area but commuting modes were significantly related to the level of daily physical activity (p<0.001). In longitudinal study, regarding the effects of the intervention for the physical activity, the study showed the possibility that urban area size was not directly effective but traffic safety in residential area (p<0.05) and willingness to take a walk (p<0.01) were effective. The cross-sectional study suggested that the size of the urban area and commuting modes had independently an effect on the physical activity of working people. The longitudinal study, on the other hand, suggested that the size of the urban area and commuting modes may not any direct influence on the effects of physical activity intervention.

PURPOSE: Information gathering ability had been evaluated mainly via checklists in clinical performance examinations (CPX). But, it is not proved yet if students write the information correctly in postencounter note (PN), although they asked questions or performed physical examinations (PE) about the information when they interacted with standardized patients in CPX. This study addressed the necessity of introducing PN to evaluate the ability in CPX. METHODS: After patient encounters, students were instructed to write the findings of history taking and physical examination that they considered as important information in approaching the patient's problems in PN. PNs were scored using answer keys selected from checklist items, which were considered to be recorded in PN by CPX experts. RESULTS: PNs of six CPX cases from 54 students were analyzed. Correlation coefficients between the key-checklist scores and PN scores of six cases were moderate to high (0.52 to 0.79). However, students frequently neglected some cardinal features of chief complains, pertinent findings of past/social history and PE, and pertinent negative findings of associated symptoms in PNs, which were checked as 'done' in the keys of checklists. CONCLUSION: It is necessary to introduce PN in CPX to evaluate the students' ability of synthesis and integration of patient information.
Checklist ; Clinical Competence ; Humans ; Korea ; Medical Records ; Patient Simulation ; Physical Examination*

BACKGROUND/AIMS: To introduce and review the results of the different treatment modalities of infected pancreatic necrosis and abscess that have been used during a 1-year period. As well, to assess the technique and indications of retroperitoneal drainage that is selectively performed for the management of peripancreatic necrosis because of the problem of intraperitoneal drainage. METHODS: Five patients with infected pancreatic necrosis or abscess were operated on from July 1997 to June 1998. Two undrewent surgical necrosectomy and retroperitoneal drainage and 3 had a classical procedure of multiple intraperitoneal drainage after necrosectomy. RESULTS: Two of 5 patients that had retroperitoneal drainage performed were successful of wide ranging necrosectomy of retroperitoneal necrosis or abscess through one drainage site and the left flank, resulting in a decreased rate of intraperitoneal contamination, discomfort and disability. CONCLUSION: The advantages of retroperitoneal drainage for wide ranging retroperitoneal pancreatic necrosis are made possible by draining the retroperitoneal route from the retroperitoneal cavity to the same retroperitoneal external opening. The use of retroperitoneal drainage seemed to be a significant factor for improvement by providing a reliable drainage of retropancreatic areas and by avoiding the opening of the peritoneal cavity
Abscess ; Drainage* ; Humans ; Necrosis* ; Peritoneal Cavity

Research articles were reviewed to validate the estimated energy requirements (EERs) equations developed by the Institute of Medicine of the National Academies (IOM). These equations are based on total energy expenditure (TEE) measured by the doubly labeled water (DLW) method. We subsequently aimed to provide the basis for the suitability to apply the IOM equations as EER equations for Koreans, and develop relevant equations for EER in the Dietary Reference Intake for Koreans (KDRI). Additionally, besides the EER(IOM) equations, other equations were examined for EER estimation. Research papers demonstrating the validation of the EER(IOM) equations based on TEE(DLW) were searched through PubMed (up to September 2019). Of the 637 potentially relevant articles identified, duplicates and unsuitable titles and abstracts were excluded. Furthermore, papers with irrelevant subject and inappropriate study design were also excluded. Finally, 11 papers were included in the review. Among the reviewed papers, 8 papers validated the application of the EER(IOM) equations for EER based on TEE(DLW). These included 3 studies for children (USA 1, Korea 2), 1 for adolescents (Portugal), 2 for adults (Korean), and 2 for the elderly (Korea, USA).EER(IOM) equations were found to be generally acceptable for determining EER by using the DLW method, except for Korean boys at 9–11 yrs (overestimated) and female athletes at 19–24 yrs (underestimated). Additionally, 5 papers include the validation of other EER equations, beside EER(IOM) for EER based on TEE(DLW). In Japanese dietary reference intake and recommended dietary allowance, EER equations are acceptable for determining EER based on TEE(DLW). The EER(IOM) equations is generally acceptable for determining EER using the DLW method in Koreans as well as several populations, although certain defined groups were found to be unfit for the estimation. Additionally, the concept of healthy body mass index of Koreans and physical activity levels need to be considered, thereby providing the basis for developing relevant equations of EER in KDRI.

PURPOSE: This study was designed to investigate the effects of information sharing between students on results of clinical performance examination (CPX). METHODS: 143 third-year students, who completed their core clinical clerkship, were randomly assigned to one day of a 3-day, 6 station CPX. Station checklists, scored by the SP(s), consisted of history taking, physical examination, information sharing, clinical courtesy and patient-physician interaction. We compared the CPX station scores, CPX domain scores, self assessment scores and GPA of the three groups tested on different days with ANOVA, and analyzed the differences in CPX scores, after controlling for GPA, with ANCOVA. The correlations among the CPX total and domain scores, self assessment and the GPA of the 3rd year students were calculated. Data regarding information sharing between students and self-assessment were obtained through student questionnaires. RESULTS: CPX total scores, self assessment scores and GPA of 3rd year students from day-2 were significantly higher than scores from day-1 or day-3. Checklist analysis showed that PE, CC and PPI scores were significantly higher on day-2, but Hx and IS scores were not significantly different. Results from questionnaires showed that 43% of students shared evaluation information. And CPX total scores had little correlation with self assessment scores. GPA of 3rd year students showed a similar pattern with the CPX totalscore. CONCLUSION: There is information sharing occurring between students during clinical performance examinations. Although there are significant differences in CPXscores for the treatment group, it seemed that CPX scores are not affected by information sharing between students. Reliability of information sharing from other students is low. The generalization of this study should be interpreted carefully.
Checklist ; Clinical Clerkship ; Generalization (Psychology) ; Humans ; Information Dissemination* ; Physical Examination ; Self-Assessment ; Surveys and Questionnaires

Cavernous sinus (CS) lesion is hard to access by surgical approach. With the development of endovascular technique, neurointerventional therapy is an alternative modality for CS lesions. This endovascular technique has been widely used for the past decade, avoiding the risks associated with surgical treatment. However, complications can still arise from coil embolization. Although immediate complication associate with embolic event or mass effect has been well described, but delayed (>1 year from treatment) nerve palsy after coil embolization is rare. We report two cases of delayed cranial nerve palsy after successful endovascular coil embolization in CS lesion.

Cavernous sinus (CS) lesion is hard to access by surgical approach. With the development of endovascular technique, neurointerventional therapy is an alternative modality for CS lesions. This endovascular technique has been widely used for the past decade, avoiding the risks associated with surgical treatment. However, complications can still arise from coil embolization. Although immediate complication associate with embolic event or mass effect has been well described, but delayed (>1 year from treatment) nerve palsy after coil embolization is rare. We report two cases of delayed cranial nerve palsy after successful endovascular coil embolization in CS lesion.

Extracellular vesicles (EVs) are sub-micrometer lipid vesicles secreted from parental cells with their information such as DNA, RNA, and proteins. EVs can deliver their cargo to recipient cells and regulate the signaling pathway of the recipient cells to determine their destiny. Depending on the cargo of EVs, the recipient cells can be changed into abnormal state or be relieved from diseases. Therefore, EVs has been spotlighted as emerging therapeutics in biomedical research. However, slow EV secretion rate is the major limitation for the clinical applications of EVs. EV secretion is highly environmental dependent and can be regulated by various stimulants such as chemicals, oxygen levels, pH, radiation, starvation, and culture methods. To overcome the limitation of low productivity of EVs, EV stimulation methods have been widely studied and applied to massive EV productions. Another strategy is the synthesis of artificial EVs from cells by physical methods such as nitrogen cavitation, extrusion via porous membrane, and sonication. These physical methods disrupt cellular membrane and reassemble the membrane to lipid vesicles containing proteins or drugs. In this review, we will focus on how EV generation can be enhanced and recent advances in large scale EV generation strategies.

Extracellular vesicles (EVs) are sub-micrometer lipid vesicles secreted from parental cells with their information such as DNA, RNA, and proteins. EVs can deliver their cargo to recipient cells and regulate the signaling pathway of the recipient cells to determine their destiny. Depending on the cargo of EVs, the recipient cells can be changed into abnormal state or be relieved from diseases. Therefore, EVs has been spotlighted as emerging therapeutics in biomedical research. However, slow EV secretion rate is the major limitation for the clinical applications of EVs. EV secretion is highly environmental dependent and can be regulated by various stimulants such as chemicals, oxygen levels, pH, radiation, starvation, and culture methods. To overcome the limitation of low productivity of EVs, EV stimulation methods have been widely studied and applied to massive EV productions. Another strategy is the synthesis of artificial EVs from cells by physical methods such as nitrogen cavitation, extrusion via porous membrane, and sonication. These physical methods disrupt cellular membrane and reassemble the membrane to lipid vesicles containing proteins or drugs. In this review, we will focus on how EV generation can be enhanced and recent advances in large scale EV generation strategies.

Energy requirement is defined as energy expenditure in an energy equilibrium state.The doubly labeled water (DLW) method is considered the gold standard for measuring total energy expenditure (TEE). In 2002, the Institute of Medicine (IOM) of the National Academies established dietary reference intakes (DRIs) for Americans and Canadians, and the equations for estimated energy requirement (EER) were developed by using pooled data from studies that had applied the DLW method. Since 2005, these equations have been used for establishing EER in the DRI for Koreans. These equations based on age group include the physical activity (PA) coefficient determined by the PA level (PAL; sedentary, low active, active and very active) as well as body weight and height. The PAL values of Koreans calculated using the DLW method and PA diaries were determined to fall in the low active category (1.40~1.59). Therefore, the PA coefficient corresponding to ‘low active’ was applied to the EER equations. In recent years, with increasing number of people regularly engaging in various physical activities in Korea, EER is now separately presented for people with ‘active’ and ‘very active’ PALs. In the future, like the United States and Japan, Korea needs to expand the DLW research for developing EER predictive equations for Koreans. In addition, standardized guidelines should be prepared to accurately evaluate the PAL using the physical activity diary and the new PA classification table for Koreans.