BACKGROUND: Primary hyperparathyroidism is a relatively frequent disease in western countries. The rate of occurrence in Korea is increasing due to increased concern of people and the development of imaging techniques. METHODS: The purpose of this study is to evaluate the clinical characteristics of patients with primary hyperparathyroidism by a retrospective analysis of their medical records. RESULTS: 19 patients with symptomatic hyperparathyroidism underwent a parathyroidectomy from Dec. 1987 to Aug. 1997 at the Department of Surgery, Korea University Hospital. The mean age of the patients was 44.6 years old, and the male-to-female ratio is 7:12. The major symptoms were generalized weakness (47.4%), polydipsia (36.8%), neck mass (36.8%), and arthralgia (15.8%) in order of frequency. Associated conditions during admission were urinary tract stones (21.1%), thyroid nodules (15.8%), degenerative osteoarthritis (10.5%), and pathologic fracture (10.5%). The mean duration of the major symptom of hyperparathyroidism was 20.6 months. The level of preoperative serum calcium was 13.2+/-2.1 mg, and that of the ionized calcium was 5.8+/-0.7 mg/dl. The level of serum parathormone was greatly higher than the standard value of hospital laboratory (687.2 pg/ml, reference value: 9~55 pg/ml). The true positive rates of imaging study were 78.9% of the hand and skull plain films, 71.4% of the neck CT scans, 40.0% of the neck sonograms, 80.0% of the Tl-c subtraction scans and 100% of the Sestamibi scans. One enlarged parathyroid gland was removed in each of 18 cases and two glands were removed in 1 case. The pathologic types of the enlarged glands were adenomas (16 cases), carcinomas (2 cases), and hyperplasia (1 case). The mean size of the parathyroid tumors was 2.2 cm X 1.7 cm X 1.2 cm, and the mean weight was 7.7 gram. Postoperative hypocalcemia developed in 15 patients and was the most severe on postoperative 3rd day. CONCLUSION: There was 20.6 months interval from the onset of patients' symtoms to the time of parathyroidectomy. Endocrine surgeons should pursue detecting the operable parathyroid tumors and remind medical endocrinologists that the best way of localizing parathyroid tumors is through an operation.
Adenoma ; Arthralgia ; Calcium ; Fractures, Spontaneous ; Hand ; Humans ; Hyperparathyroidism ; Hyperparathyroidism, Primary* ; Hyperplasia ; Hypocalcemia ; Korea ; Laboratories, Hospital ; Medical Records ; Neck ; Osteoarthritis ; Parathyroid Glands ; Parathyroid Hormone ; Parathyroidectomy ; Polydipsia ; Reference Values ; Retrospective Studies ; Skull ; Thyroid Nodule ; Tomography, X-Ray Computed ; Urinary Calculi

OBJECTIVES: The objective of this study was to revise the target pattern in food guidance system for adolescents' balanced menu planning. METHODS: The food groups in the target pattern were divided into detailed food items, and intake number were assigned to each food items based on the revised standard food composition table. The validity of revised target pattern was examined. Menu planning according to the revised target pattern was made available to 305 male and female middle school students and the nutritional assessment of the menu plan were carried out using SPSS WIN 12.0. RESULTS: The energy contents, energy contribution ratios of carbohydrate, fat, and protein, and 4 minerals' and 6 vitamins' contents of the revised target pattern were adequate. The average energy contents of the menu planned according to revised target pattern were 400~500 kcal higher than that of the revised target pattern when the revised standard food composition was applied. The energy contribution ratios of fat were 28.9%, close to maximum of acceptable macronutrient distribution range (AMDR) (30%), and that of carbohydrate were 54.5%, lower than minimum of AMDR (55%). The nutrient adequacy ratios (NARs) of calcium and vitamin C were less than 1.0. According to index of nutritional quality (INQ) of food items, kimchi, milkdairy products, and soybean curd were energy efficient source for calcium, kimchi, fruit, vegetable and seaweed were energy efficient source for vitamin C, with INQ of food items were higher or close to 2.0. Kimchi was the best energy efficient source of calcium and vitamin C. CONCLUSIONS: Revised target pattern based on the adolescent's foods intake was not good enough for balanced menu planning by adolescents, because what they ate and what they wanted to eat were very much different. Detailed guidance for food selection is necessary in each food items.
Adolescent ; Ascorbic Acid ; Calcium ; Female ; Food Preferences ; Fruit ; Humans ; Male ; Menu Planning ; Nutrition Assessment ; Nutritive Value ; Seaweed ; Soybeans ; Vegetables

Purpose: This study aimed to investigate the overall operational status of medical school admission interview evaluations in South Korea and explore the operational experience of universities conducting interview evaluations. Methods: This study used a mixed-methods approach, combining quantitative and qualitative methods. Through a nationwide survey and data collection from 39 medical schools, the quantitative analysis explored interview evaluations procedures, the purpose of the interview evaluations, and the competencies expected of medical school freshmen. Concurrently, qualitative data were obtained through focus group discussions with 12 professors from 10 medical schools, providing in-depth insights into the operational experiences and challenges faced during interview evaluations. Results: In the quantitative data, interview evaluations were most prevalent in the “comprehensive school records screening” for rolling admissions (85.5%), but less common in regular admissions (18.6%). Private schools (64.2%) showed a statistically significant higher proportion of interview admissions than public schools (11.1%) in the “high school grades focused admission” (p<0.01). Metropolitan areas (50.0%) conducted interview evaluations more frequently than non-metropolitan areas (11.1%) in the “College Scholastic Ability Test-focused admissions” (p<0.05). In the qualitative data, professors recognize the dominant role of “negative selection” in filtering out unsuitable candidates. Challenges in maintaining a consistent evaluator pool and team-based question development were acknowledged. Strategies, such as seeking student feedback for question improvement and conducting study meetings for interviewer preparation are essential. Conclusion This study illuminates the operation of admissions interview evaluations in South Korea, revealing variations across regions and admissions types. These findings offer insights for enhancing medical school admission processes, guiding future research and policy.

BACKGROUND: Endovascular aortic aneurysm repair (EVAR) has come into use and been widely extended because of the low complication rate and less-invasiveness. This article aimed to describe our experience in the treatment of abdominal aortic aneurysm with EVAR. MATERIALS AND METHODS: A retrospective review was conducted for the 22 patients who underwent EVAR in a single hospital December 2001 to June 2009. RESULTS: The mean age of the patients was 68.5+/-7.6 years. There were several risk factors and comorbidities in 20 patients (90.9%). The mean diameter of the aortic aneurysms was 61.2+/-12.9 mm. The mean length, diameter, and angle of the aneurysmal neck were 30.5+/-15.5 mm, 24.0+/-4.5 mm, and 43.9+/-16.0degrees, respectively. The mean follow-up period of the patients was 28.8+/-29.5 months. The 30-day postoperative mortality was none. Seven patients (31.8%) had endoleaks during the hospital stay and three patients (13.6%) had endoleaks during the follow-up period. One patient (4.5%) died due to a ruptured aortic aneurysm. The cumulative patient survival rates were 88.2%, 88.2%, and 70.6% at 1, 3, and 5 years of follow-up, respectively. CONCLUSION: EVAR is currently a safe, feasible procedure for high risk patients with abdominal aortic aneurysm because of low postoperative complication and mortality if patients are selected properly and followed up carefully.
Aneurysm ; Aorta, Abdominal ; Aortic Aneurysm ; Aortic Aneurysm, Abdominal ; Aortic Rupture ; Comorbidity ; Endoleak ; Follow-Up Studies ; Humans ; Length of Stay ; Neck ; Postoperative Complications ; Retrospective Studies ; Risk Factors ; Survival Rate

Intermetatarsal coalition (IC) is very rare; although few cases have been reported in foreign orthopedic journals, these have not originated in our country. We report the case of a 20-year-old man who complained of pain in the left forefoot only during long distance running (3 km). On examination, his foot shape, skin appearance, and gait were normal, with no plantar keratosis; however, the radiograph revealed coalition between the fourth and fifth metatarsals. Surgical excision was performed. In the histopathologic study, fibrous coalition was confirmed. This paper reports an uncommon case involving surgical excision of IC in the military service, involving active sport activity.
Foot ; Gait ; Humans ; Keratosis ; Metatarsal Bones ; Military Personnel ; Orthopedics ; Running ; Skin ; Sports ; Synostosis ; Young Adult

Purpose: This study aimed to identify challenges and potential improvements in Korea's medical education accreditation process according to the Accreditation Standards of the Korean Institute of Medical Education and Evaluation 2019 (ASK2019). Meta-evaluation was conducted to survey the experiences and perceptions of stakeholders, including self-assessment committee members, site visit committee members, administrative staff, and medical school professors. Methods: A cross-sectional study was conducted using surveys sent to 40 medical schools. The 332 participants included self-assessment committee members, site visit team members, administrative staff, and medical school professors. The t-test, one-way analysis of variance and the chi-square test were used to analyze and compare opinions on medical education accreditation between the categories of participants. Results: Site visit committee members placed greater importance on the necessity of accreditation than faculty members. A shared positive view on accreditation’s role in improving educational quality was seen among self-evaluation committee members and professors. Administrative staff highly regarded the Korean Institute of Medical Education and Evaluation’s reliability and objectivity, unlike the self-evaluation committee members. Site visit committee members positively perceived the clarity of accreditation standards, differing from self-assessment committee members. Administrative staff were most optimistic about implementing standards. However, the accreditation process encountered challenges, especially in duplicating content and preparing self-evaluation reports. Finally, perceptions regarding the accuracy of final site visit reports varied significantly between the self-evaluation committee members and the site visit committee members. Conclusion This study revealed diverse views on medical education accreditation, highlighting the need for improved communication, expectation alignment, and stakeholder collaboration to refine the accreditation process and quality.

A preliminary study into the protective mechanisms of adaptive immunity against porcine reproductive and respiratory syndrome virus (PRRSV) in piglets (n = 9) born to a gilt challenged intranasally with a type-2 PRRSV. Immune parameters (neutralizing antibodies, CD3⁺CD4⁺, CD3⁺CD8⁺, CD3⁺CD4⁺CD8⁺ T-lymphocytes, and PRRSV-specific interferon (IFN)-γ secreting T-lymphocytes) were compared with infection parameters (macro- and microscopic lung lesion, and PRRSV-infected porcine alveolar macrophages (CD172α⁺PRRSV-N⁺ PAM) as well as with plasma and lymphoid tissue viral loads. Percentages of three T-lymphocyte phenotypes in 14-days post-birth (dpb) peripheral blood mononuclear cell (PBMC) had significant negative correlations with percentages of CD172α⁺PRRSV-N⁺ PAM (p < 0.05) as well as with macroscopic lung lesion (p < 0.01). Plasma and tissue viral loads had significant (p < 0.05) negative correlations with CD3⁺CD4⁺CD8⁺ T-lymphocyte percentage in PBMC. Frequencies of CD3⁺CD8⁺ and CD3⁺CD4⁺ T-lymphocytes in 14-dpb PBMC had significant negative correlations with of lymph node (p = 0.04) and lung (p = 0.002) viral loads. IFN-γ-secreting T-lymphocytes frequency had a significant negative correlation with gross lung lesion severity (p = 0.002). However, neutralizing antibody titers had no significant negative correlation (p > 0.1) with infection parameters. The results indicate that T-lymphocytes contribute to controlling PRRSV replication in young piglets born after in-utero infection.

A preliminary study into the protective mechanisms of adaptive immunity against porcine reproductive and respiratory syndrome virus (PRRSV) in piglets (n = 9) born to a gilt challenged intranasally with a type-2 PRRSV. Immune parameters (neutralizing antibodies, CD3⁺CD4⁺, CD3⁺CD8⁺, CD3⁺CD4⁺CD8⁺ T-lymphocytes, and PRRSV-specific interferon (IFN)-γ secreting T-lymphocytes) were compared with infection parameters (macro- and microscopic lung lesion, and PRRSV-infected porcine alveolar macrophages (CD172α⁺PRRSV-N⁺ PAM) as well as with plasma and lymphoid tissue viral loads. Percentages of three T-lymphocyte phenotypes in 14-days post-birth (dpb) peripheral blood mononuclear cell (PBMC) had significant negative correlations with percentages of CD172α⁺PRRSV-N⁺ PAM (p < 0.05) as well as with macroscopic lung lesion (p < 0.01). Plasma and tissue viral loads had significant (p < 0.05) negative correlations with CD3⁺CD4⁺CD8⁺ T-lymphocyte percentage in PBMC. Frequencies of CD3⁺CD8⁺ and CD3⁺CD4⁺ T-lymphocytes in 14-dpb PBMC had significant negative correlations with of lymph node (p = 0.04) and lung (p = 0.002) viral loads. IFN-γ-secreting T-lymphocytes frequency had a significant negative correlation with gross lung lesion severity (p = 0.002). However, neutralizing antibody titers had no significant negative correlation (p > 0.1) with infection parameters. The results indicate that T-lymphocytes contribute to controlling PRRSV replication in young piglets born after in-utero infection.
Adaptive Immunity ; Antibodies ; Antibodies, Neutralizing ; Interferons ; Lung ; Lymph Nodes ; Lymphoid Tissue ; Macrophages, Alveolar ; Phenotype ; Plasma ; Porcine Reproductive and Respiratory Syndrome ; Porcine respiratory and reproductive syndrome virus ; T-Lymphocytes ; Viral Load

BACKGROUND/OBJECTIVE: Orostachys japonicus A. Berger (Crassulaceae) has been used in traditional herbal medicines in Korea and other Asian countries to treat various diseases, including liver disorders. In the present study, the anti-fibrotic effects of O. japonicus extract (OJE) in cellular and experimental hepatofibrotic rat models were investigated. MATERIALS/METHODS: An in vitro hepatic stellate cells (HSCs) system was used to estimate cell viability, cell cycle and apoptosis by MTT assay, flow cytometry, and Annexin V-FITC/PI staining techniques, respectively. In addition, thioacetamide (TAA)-induced liver fibrosis was established in Sprague Dawley rats. Briefly, animals were divided into five groups (n = 8): Control, TAA, OJE 10 (TAA with OJE 10 mg/kg), OJE 100 (TAA with OJE 100 mg/kg) and silymarin (TAA with Silymarin 50 mg/kg). Fibrosis was induced by treatment with TAA (200 mg/kg, i.p.) twice per week for 13 weeks, while OJE and silymarin were administered orally two times per week from week 7 to 13. The fibrotic related gene expression serum biomarkers glutathione and hydroxyproline were estimated by RT-PCR and spectrophotometry, respectively, using commercial kits. RESULTS: OJE (0.5 and 0.1 mg/mL) and silymarin (0.05 mg/mL) treatment significantly (P < 0.01 and P < 0.001) induced apoptosis (16.95% and 27.48% for OJE and 25.87% for silymarin, respectively) in HSC-T6 cells when compared with the control group (9.09%). Further, rat primary HSCs showed changes in morphology in response to OJE 0.1 mg/mL treatment. In in vivo studies, OJE (10 and 100 mg/kg) treatment significantly ameliorated TAA-induced alterations in levels of serum biomarkers, fibrotic related gene expression, glutathione, and hydroxyproline (P < 0.05-P < 0.001) and rescued the histopathological changes. CONCLUSIONS: OJE can be developed as a potential agent for the treatment of hepatofibrosis.
Animals ; Apoptosis ; Asian Continental Ancestry Group ; Biomarkers ; Cell Cycle ; Cell Survival ; Fibrosis* ; Flow Cytometry ; Gene Expression ; Glutathione ; Hepatic Stellate Cells* ; Humans ; Hydroxyproline ; In Vitro Techniques ; Korea ; Liver ; Liver Cirrhosis ; Models, Animal ; Rats* ; Rats, Sprague-Dawley ; Silymarin ; Spectrophotometry ; Thioacetamide

Quetiapine is an atypical or second-generation antipsychotic agent and has been a subject of a series of case report and suggested to have the potential for misuse or abuse. However, it is not a controlled substance and is not generally considered addictive. In this study, we examined quetiapine's dependence potential and abuse liability through animal behavioral tests using rodents to study the mechanism of quetiapine. Molecular biology techniques were also used to find out the action mechanisms of the drug. In the animal behavioral tests, quetiapine did not show any positive effect on the experimental animals in the climbing, jumping, and conditioned place preference tests. However, in the head twitch and self-administration tests, the experimental animals showed significant positive responses. In addition, the action mechanism of quetiapine was found being related to dopamine and serotonin release. These results demonstrate that quetiapine affects the neurological systems related to abuse liability and has the potential to lead psychological dependence, as well.
Animals ; Behavior, Animal ; Dopamine ; Head ; Molecular Biology ; Pharmacology* ; Rodentia* ; Serotonin ; Substance-Related Disorders ; Quetiapine Fumarate