Though SP programs have been used in Korean medical education for half a decade, few of those SP programs have demonstrated psychometric characteristics. In order to be a more useful educational tool, and in to more accurately evaluate Korean Medical students, the standardized patient program needs to be more thoroughly researched and developed. In the near future, if Korean medical educators lend their support and standardize the program in Korea, SPs will be widely adopted across the curriculum because of their potential advantages: from medical interviewing and physical diagnosis courses to clinical clerkships and residency training. This study demonstrates why Korean SP programs need early, systematic collaboration and cooperation among Korean medical colleges through a regional consortium in order to form an agenda for the implementation of SP programs, and realize the implications of this agenda throughout medical education.
Clinical Clerkship ; Cooperative Behavior ; Curriculum ; Diagnosis ; Education, Medical ; Humans ; Internship and Residency ; Korea* ; Psychometrics ; Students, Medical

For parthenogenetic activation as a model system of nuclear transfer, microinjection and electroporation as activation treatments in bovine metaphase II oocytes were administered to each of three groups as follows: control group (treatments with Ca2+, Mg2+ -free PBS+100 micro M EGTA), IP3 group (control+25 micro M IP3) and IP3+ ryanodine group (control+25 micro M IP3+10 mM ryanodine). In experiments using microinjection, no significant differences were observed between any of the developmental stages of the electroporation experiment. For electroporation, cleavage rates were significantly higher in the IP3+ryanodine group than in the IP3 or control group (85.6% vs 73.7% or 67.6%, respectively). In the subsequent stages of embryonic development, such as morula and blastocyst formation, the IP3 and ryanodine group exhibited significantly higher rates of morula fomation than the IP3 or control groups (40.6% vs 24.2% or 16.7%, respectively). Similarly, the rate of blastocyst formation in the IP3+ryanodine group was significantly higher than the control group (16.3% vs 6.9%) but did not differ significantly from the IP3 group (16.3% vs 9.5%). In nuclear transfer, activation was performed at 30 hpm by microinjection and elecroporation with 25 micro M IP3+ 10 mM ryanodine followed by 6-DMAP treatment. No significant differences were observed at any stage of embryonic development and none of the embryos activated by electroporation reached either the morula or blastocyst stage. However, 3.8% and 1.9% of embryos activated by microinjection sucessfully developed to the morula and blastocyst stages, respectively. In conclusion, activation treatments using IP3 and ryanodine are able to support the development of bovine parthenogenetic and reconstructed embryos.
Adenine/administration & dosage/*analogs & derivatives/pharmacology ; Animals ; Cattle/*embryology/physiology ; Cell Fusion ; Electroporation/veterinary ; Embryonic and Fetal Development/*drug effects ; Enzyme Inhibitors/administration & dosage/pharmacology ; Female ; Inositol 1,4,5-Trisphosphate/administration & dosage/*pharmacology ; Microinjections/veterinary ; Nuclear Transfer Techniques ; Oocytes/drug effects/growth & development ; Parthenogenesis/*drug effects ; Protein Kinase Inhibitors ; Ryanodine/administration & dosage/*pharmacology ; Skin/cytology

As a criterion of competence, performance-based assessment methods have been used in the health professions for centuries, and dozens of studies of their psychometric characteristics have been reported over the last several decades. Performance-based assessment methods, commonly used in medical education, include written clinical simulations (PMPs), computer-based clinical simulations, role-playing oral examinations, and standardized patient (SP) simulations. The underlying rationale for utilizing performance-based assessments is that they are tools with which one can appropriately evaluate medical students and reinforce what they have learned throughout their undergraduate studies. SPs are being widely used across the curriculum because of their potential advantages: from medical interviewing and physical diagnosis courses to clinical clerkships to residency training. The primary objective for SP encounters is to assist in the formation of fundamental medical interviewing and to improve clinical skills. However, as the program matures, SPs could be used at more advanced levels of medical training and be used to evaluate examinees, as well as obtain feedback on how well the educational program is working, at all levels including residency, continuing medical education for physicians, and even as a way to assess the abilities of foreign medical school graduates. Implementing an SP program will permit Korean medical educators to prospectively identify critical skills for their students to learn and establish explicit performance criteria for clinical competence. This study demonstrates why Korean SP programs should be implemented in the early stages in the medical education program, how to train SPs, and how to apply an SP program in an innovative curriculum, how to study about it, and how to disseminate SP programs throughout the Korean medical educational system.
Checklist ; Clinical Clerkship ; Clinical Competence ; Curriculum ; Diagnosis ; Diagnosis, Oral ; Education, Medical* ; Education, Medical, Continuing ; Health Occupations ; Humans ; Internship and Residency ; Mental Competency ; Prospective Studies ; Psychometrics ; Schools, Medical ; Students, Medical

The authors tried to evaluate the effect of the growth factors on cell proliferation in the human retina astrocyte culture. Each growth factor, EGF, bFGF, GGF, IGF-1 or PDGF, together with BrdU was added to astrocytes-enriched cultures in the serum-free media. The proliferating effect of each growth factor was evaluated by a double immunofluo- rescenece labelling for GFAP and BrdU. By and addition of each growth factor, the number of retinal astrocytes at the synthetic stage significantly increased than those of control group (p<0.01). In comparision, PDGF was more potent than IGF-1 (p<0.01). Above data extended the concept of astrocytic proliferation caused by several growth factors in human retinal injury.
Astrocytes ; Bromodeoxyuridine ; Cell Proliferation ; Culture Media, Serum-Free ; Epidermal Growth Factor ; Humans ; Insulin-Like Growth Factor I ; Intercellular Signaling Peptides and Proteins* ; Neuroglia* ; Retina ; Retinaldehyde*

PURPOSE: The diagnosis of Mycoplasma pneumoniae (M. pneumoniae) infection is usually based on serology using complement fixation assay (CFA), particle agglutination test (PA), enzyme immunoassay (EIA) and polymerase chain reaction (PCR). The objective of this study is to compare the performance of EIA and PCR in diagnosis of M. pneumoniae infection. We also evaluated the usefulness of EIA which were checked on short-term follow-up (3-5 days). METHODS: We included 234 pneumonia children. We used serum specimens for EIA test, which were obtained on admission and 3-5 days after admission. We collected throat swabs or sputums for PCR test, which were obtained on admission or next morning after admission. RESULTS: Of 234 patients, 124 (53.0%) met the diagnostic criteria. The median age was 6 years (from 10 months to 12 years). On admission, the sensitivity and specificity of EIA-specific IgM were 46.1% and 72.8%, respectively. The rate of agreement between PCR and EIA was 64.1%.(kappa=0.187, P=0.004) On 3-5 days after admission, the sensitivity and specificity rates of EIA specific IgM were 85.5%, 69.6%, respectively. The rate of agreement between PCR and EIA was 74.8%.(kappa=0.490, P=0.000) Days after onset had no relation with sensitivity of EIA.(P>0.05) The sensitivity and specificity rates of PCR were 57.5% and 90.0%, respectively. CONCLUSION: This study suggests that PCR and EIA may be the useful diagnostic methods for detecting early phase of M. pneumoniae infection. And EIAs which checked on short-term follow up is also useful. PCR has shown a higher specificity but lower sensitivity. Therefore, PCR must be performed with serologic tests.
Agglutination Tests ; Child ; Complement System Proteins ; Follow-Up Studies ; Humans ; Immunoenzyme Techniques ; Immunoglobulin M ; Mycoplasma ; Mycoplasma pneumoniae ; Pharynx ; Pneumonia ; Pneumonia, Mycoplasma ; Polymerase Chain Reaction ; Sensitivity and Specificity ; Serologic Tests ; Sputum

The aim of the study was to evaluate the association between genetic polymorphisms of CYP2D6 and outcomes in breast cancer patients with tamoxifen treatment. We evaluated the CYP2D6 genetic polymorphisms in 766 breast cancer patients. Among them, 110 patients whose samples were prospectively collected before surgery and treated with tamoxifen were included to evaluate the association between CYP2D6 and outcomes. The genotypes of CYP2D6 were categorized as extensive metabolizer (EM), intermediate metabolizer (IM), and poor metabolizer (PM) according to the activity score. The clinicopathologic features of 110 patients were not significantly different among the three groups except for the T-stage and nodal status. The high T-stage and axillary metastasis were more frequent in the PM group. While recurrence-free and overall survival in the PM group was poorer than the other groups, there was no significant difference between the EM and the IM group. The difference between the PM and the other groups on univariate analysis disappeared on multivariate analysis. These conflicting results suggest that the clinical value of CYP2D6 polymorphisms is still unclear and more large-sized and comprehensively designed trials are necessary.
Adult ; Aged ; Aged, 80 and over ; Antineoplastic Agents, Hormonal/*therapeutic use ; Breast Neoplasms/drug therapy/*genetics/mortality ; Cytochrome P-450 CYP2D6/*genetics ; Female ; Genotype ; Humans ; Kaplan-Meier Estimate ; Middle Aged ; Neoplasm Staging ; *Polymorphism, Single Nucleotide ; Tamoxifen/*therapeutic use

OBJECTIVE: This study was aimed to characterize the clinical features and course of acute hepatitis A in Korean adults. METHODS: One-hundred and thirteen cases of acute hepatitis A, diagnosed between Jan. 1995 to July 1998 at 6 medical centers in Korea, were reviewed retrospectively. The clinical course of 94 cases with follow-up duration longer than 3 months were analyzed. RESULTS: The median age was 26 (16-65) years and 97.3% of the patients were under 40 years. The presumed sources of infection were identifed in 62 cases (54.9%). Among those, the leading source was ingestion of raw food. All patients showed normalization of bilirubin level within 8 weeks. The ALT levels normalized within 8 weeks in all patients except three patients (3.2%). Three patients with prolonged elevation of ALT showed second rise of ALT, suggesting a possibility of relapsing hepatitis. Prolonged fever (>38 degree C) more than 10 days was observed in 3 patients (3.2%). One case showed prolonged elevation of alkaline phosphatase (> x3 upper normal limit). No case of fulminant hepatic failure or death was observed. CONCLUSION: The majority of cases with acute hepatitis A in Korean adults showed self-limited course with full recovery.
Adult* ; Alkaline Phosphatase ; Bilirubin ; Eating ; Fever ; Follow-Up Studies ; Hepatitis A* ; Hepatitis* ; Humans ; Korea ; Liver Failure, Acute ; Retrospective Studies

BACKGROUND: To estimate bowel patterns in the Korean, we surveyed routine check-up subjects about their bowel habits, using self-reported questionnaire. METHODS: We analyzed 2939 subjects (male 1430, female 1509; age range 25 - 65 years) who had visited health promotion center for routine check-up. Subjects were given a validated self-report questionnaire, which measured the defecation frequency; stool consistency; self-report of constipation; straining to defecate; and levels of laxative use. RESULTS: Of the whole subjects 96.4% had defecation frequency between three per week and three per day. The prevalence of two or less bowel movements per week (4.1% compared to 0.6%), straining to defecate (20.8% compared to 13.0%) and hard stool (18.0% compared to 9.3%) was higher in women than men (p<0.01). The prevalence of self-reported constipation was higher in women than men (9.0% compared to 2.9%, p<0.01). Women were more likely to use laxatives than men (5.5% compared to 0.6%, p<0.01). CONCLUSIONS: Defecation frequency in most of routine check-up subjects is between three per week to three per day. Bowel dysfunction is a greater problem in women.
Constipation ; Defecation ; Epidemiology ; Female ; Health Promotion ; Humans ; Laxatives ; Male ; Prevalence ; Surveys and Questionnaires