There is a trial to increase as four years of the premedical course to make doctors with better humanities and variable educational backgrounds and good researchers in basic medicines. We studied the trial in the present situation of the Korean in scvcral vicwpoints There will be a confusion between doctor in a origanization and there are many problems expected with two different educational system in a countury Moreover, two years of premedical course and four years of medical course are enough to a clinician, especially a primary care doctor and there will be increased costs and late age to be a doctor if premedical course are increased as four years. It is not real reason for the lack of applicants to be good researchers in basic medicines that shot premedical course and lack of non-medical educational backgrouds. Also situation of medical school in Korea is not suffice to extend their facilities and faculties. Finally advantages from the extension of the premedical course can be gained with introductions of the limeted bachelor`s admission and or dual major system. The most important things is the single educational system to be a doctor and leaving the system to the discretion of the medical schools or universities
Education, Medical* ; Humanities ; Humans ; Korea* ; Primary Health Care ; Schools, Medical

Scopulariopsis brevicaulis is a ubiquitous soil saprophyte that commonly causes onychomycosis, accounting for 1-10% of such infections. Rarely, it may be responsible for cutaneous lesions or more severe infections, especially after traumatic or surgical injuries. We report of a 54-year-old female patient who developed facial cellulitis caused by S. brevicaulis, which occurred one year after the patient underwent cosmetic surgery of the face. The patient suffered from febrile sense, pain and a growing mass lesion on her left cheek, which were diagnosed as facial cellulitis associated with foreign material that had been implanted at the time of cosmetic surgery. Three pus cultures from the mass lesion which performed at a week interval yielded the same S. brevicaulis. Surgical removal and drainage by using liposuction procedure resulted in a favorable outcome. To our knowledge this is the first report of S. brevicaulis infection associated with cosmetic surgery in Korea.
Cellulitis ; Cheek ; Drainage ; Female ; Humans ; Intraoperative Complications ; Korea ; Lipectomy ; Middle Aged ; Onychomycosis ; Scopulariopsis* ; Soil ; Suppuration ; Surgery, Plastic*

BACKGROUND: The efficient collection of peripheral blood stem cells (PBSC) from donors who donate for allogeneic transplants as well as from patients undergoing autologous transplants is essential for a successful transplant. Recently, the Amicus cell separator and the associated MNC collection computer software program for PBSC collection were introduced in Korea. METHODS: Two apheresis machines (Amicus, Baxter Healthcare; and CS-3000 plus, Baxter Healthcare) were compared retrospectively. A total number of 144 procedures were performed on 14 donors and 28 patients. The pre- and post-apheresis complete blood cell (CBC) counts and the number of hematopoietic progenitor cells (HPC) were determined in the peripheral blood from the subjects. The CBC, HPC, CD34+ cell counts and the level of colony-forming unit-granulocyte-macrophages (CFU-GM) were measured in the PBSC product collected from both machines. RESULTS: Both machines collected a similar number of CD34+ cells from the donors and patients. On the other hand, the Amicus collected significantly more nucleated cells, MNCs, HPCs and CFU-GM in the patients with significantly less RBC contamination than those with CS-3000 plus. The decrease in the peripheral blood platelet counts in the donors and patients was more prominent after apheresis using the CS-3000 plus (117.00+/-42.75 x 10(3)/microliter, 61.22+/-43.62 x 10(3)/microliter) than Amicus (26.04+/-18.68 x 10(3)/microliter, 22.15+/-28.66 x 10(3)/microliter)(p<0.05). CONCLUSION: PBSC collection can be performed successfully using CS-3000 plus and Amicus. Amicus is superior to CS-3000 plus in avoiding apheresis-induced thrombocytopenia, and is expected to prevent unnecessary platelet transfusion.
Autografts ; Blood Cells ; Blood Component Removal ; Cell Count ; Delivery of Health Care ; Granulocyte-Macrophage Progenitor Cells ; Hand ; Hematopoietic Stem Cells ; Humans ; Korea ; Platelet Count ; Platelet Transfusion ; Retrospective Studies ; Stem Cells* ; Thrombocytopenia ; Tissue Donors

Fusarium species are representative of the emerging group of filamentous molds, which cause respiratory and disseminated infections in immunocompromised patients. To date, only five cases of respiratory or disseminated skin infections due to Fusarium spp. have been described in Korea. Here we describe a fungemia case of Fusarium oxysporum in a 3-year old boy who was neutropenics following chemotheray for leukemia. Fever, painful macules on both extremities and phlebitis on the site of venous blood sampling developed on the day 35 of admission. All four blood cultures obtained on hospital days 37, 38, 40 and 42 yielded the same F. oxysporum. The infection was cured with a high dose (1.5 mg/kg) of amphotericin B. This case shows that Fusarium is among a few filamentous fungi that cause clinically detectable fungemias in immuncompromised hosts.
Amphotericin B ; Child, Preschool ; Extremities ; Fever ; Fungemia ; Fungi ; Fusarium* ; Humans ; Immunocompromised Host ; Korea ; Leukemia ; Male ; Neutropenia ; Phlebitis ; Skin

BACKGROUND: Recently, the incidence of candidemia due to Candida species other than C. albicans have increased. In this study, we analyzed the laboratory and clinical characteristics of candidemia caused by four different Candida species (C. albicans, C. parapsilosis, C. tropicalis and C. glabrata) occurring at Chonnam National University Hospital (CNUH). METHODS: The demographic, clinical and microbiological data of 157 patients with candidemia at CNUH from 1996 to 2002 was analyzed, retrospectively. The etiologic agents for 157 cases of candidemia were C. albicans (n=48), C. parapsilosis (n=48), C. tropicalis (n=32) and C. glabrata (n= 29). The characteristics of candidemia due to each single Candida species were compared with those with all other species combined. RESULTS: Although the majority (77%) of candidemic patients were adults, candidemia due to C. albicans or C. parapsilosis occurred significantly more often in premature infants (15%, retrospectively, P=0.002), in comparison with other Candida species (0%). Candidemia due to C. glabrata was more common in patients with neutropenia (41%, P<0.001), and they also occurred frequently in the absence of central venous catheter related candidemia (86%, P<0.001). Bloodstream infections with C. parapsilosis were more frequently the cause of catheter related candidemia (56%, P=0.012), and they had a better clinical outcome (90%, P=0.004) than those with other Candida species. CONCLUSIONS: This study confirms that some characteristics of candidemia such as age, underlying conditions, relatedness of catheter, and outcome can be different according to the species of Candida.
Adult ; Candida* ; Candidemia* ; Catheters ; Central Venous Catheters ; Humans ; Incidence ; Infant, Newborn ; Infant, Premature ; Jeollanam-do ; Neutropenia ; Retrospective Studies

BACKGROUND: Pseudothrombocytopenia is a phenomenon that automated hematology analyzers calculate platelets at a spuriously low count. The most common cause of this phenomenon is platelet clumping. Several methods such as vortex mixing, changing anticoagulant to sodium citrate or heparin, and adding amikacin to ethylenediaminetetraacetic acid (EDTA) have been routinely used for managing pseudothrombocytopenia. The purposes of this study were to compare the efficacy of these four methods and to propose a cost-effective algorithm for managing pseudothrombocytopenia in clinical laboratories. METHODS: Ten patients (six males and four females) having pseudothrombocytopenia were evaluated. In these patients, platelet clumpings had been detected on more than three occasions by Coulter STKS (Beckman-Coulter, USA) and by microscopic examination on peripheral blood smear (PBS). We recollected blood samples from each patient in four tubes coated with EDTA, sodium citrate, heparin, or EDTA with amikacin. CBC of the blood samples in each tube was performed within one hour of collection; the samples in EDTA-coated tube were retested after vortex mixing. RESULTS: Platelet counts were increased in all cases (100%) by EDTA with amikacin as an anticoagulant, 80% (8/10) by vortex mixing or heparin, and in 90% (9/10) by sodium citrate. However, platelet counts were decreased in 20% (2/10) of heparin coated samples. `Clinically meaningful increase' was achieved in 60% (6/10) by heparin and EDTA with amikacin, in 50% (5/10) by sodium citrate, and in 40% (4/10) by vortex mixing. But `clinically meaningful decrease' was found in 10% (1/10) by heparin. CONCLUSIONS: When pseudothrombocytopenia due to platelet clumpings is detected, vortex mixing is recommended first. If platelet count does not increase after the vortex mixing, changing anticoagulant to sodium-citrate or adding amikacin to EDTA is recommended for managing pseudothrombocytopenia.
Amikacin ; Blood Platelets* ; Citric Acid ; Edetic Acid ; Hematology ; Heparin ; Humans ; Male ; Platelet Count ; Sodium

The Accreditation Board for Medical Education in Korea, ABMEK, is nongovernmental appraisal organization that was established at July 2, 1998. The organization is contributing to the improvement of medical education by progressing the first cycle accreditation successfully. But, the organization has various problems and subjects related to the accreditation system. The authors examined the related literature focusing on the current status and problems of accreditation system. The result of this research was as follows. First, the ABMEK needs to propel legal personality of organization and should install independent executive office. Second, the ABMEK should establish the alteration procedure of accreditation standards and develop the accreditation standards of the second cycle that take into account international flowing of medical education. Third, the ABMEK must decide forms and scope to investigate medical college present situation. Finally, to propel development tasks effectively, it needs to get the recognition of Ministry of Education and Human Development.
Accreditation* ; Education ; Education, Medical ; Human Development ; Korea* ; Schools, Medical*

BACKGROUND: Genotyping of ABO gene could be more informative and valuable than serological typing in some situations such as the resolution for ABO discrepancy between the cell typing and serum typing and determination of A and B subgroups. We developed a simple allele-specific polymerase chain reaction (AS-PCR) method without the use of any restriction enzymes to detect the A, B, O, and cis-AB alleles for Koreans. METHODS: An AS-PCR was designed with amplification refractory mutation system (ARMS) at nt (nucleotide) 261 (exon 6) and at nt 526, 803 (exon 7) of ABO gene to detect specific nucleotide sequence differences between the ABO alleles. We tested for ABO genotyping 60 DNA samples previously tested by PCR-RFLP and stored at -70degreeC. These samples had been obtained from blood donors recruited at the Gwangju-Chonnam Red Cross Blood Center between July 2002 and February 2003. RESULTS: With our new PCR method, the genotypes of the 60 samples were found to be A/O (n=10), A/A (n=5), B/O (n=10), B/B (n=5), O/O (n=10), cis-AB/A (n=5), cis-AB/B (n=5), and cis-AB/ O (n=10), which were the s ame results obtained previously with PCR-RFLP. CONCLUSIONS: Our AS-PCR is a simple and accurate method for the detection of A, B, O, and cis-AB alleles for Koreans.
Alleles ; Base Sequence ; Blood Donors ; DNA ; Genotype ; Humans ; Polymerase Chain Reaction* ; Red Cross

BACKGROUND/AIMS: Transforming growth factor beta1 (TGF-beta1) is a key cytokine in the production of extracellular matrix. A genetic polymorphism at codon 10 of the TGF-beta1 gene is associated with liver fibrosis. We investigated the effect of genetic polymorphisms at codon 10 on the development of alcoholic liver cirrhosis (ALC). METHODS: In total, 119 controls and 182 patients with ALC, were enrolled in the study. Clinical and laboratory data including total lifetime alcohol intake were collected at enrollment. The genotype at codon 10 was determined for each patient by single-strand conformation polymorphism. RESULTS: There were three types of genetic polymorphism at codon 10: homozygous proline (P/P), heterozygous proline/leucine (P/L), and homozygous leucine (L/L). Among the controls, the proportions of P/P, P/L, and L/L were 26.1%, 44.5%, and 29.4%, respectively in the ALC group, these proportions were 23.1%, 43.4%, and 33.5%, respectively. The genotype distribution did not differ between the controls and the ALC group. In the ALC group, age, total lifetime alcohol intake, and distribution of Child-Pugh class did not differ with the genotype. Of the male patients with ALC (n=164), the proportions of P/P, P/L, and L/L were 20.1%, 44.5%, and 35.4%, respectively the genotype distribution did not differ between the male controls and the male ALC patients. CONCLUSIONS: The genotype at codon 10 in TGF-beta1 does not appear to influence the development of ALC. Further study is needed to investigate other genetic factors that influence the development of ALC in patients with chronic alcohol intake.
Aged ; Alcohol Drinking ; Codon ; Female ; Genotype ; Heterozygote ; Homozygote ; Humans ; Liver Cirrhosis, Alcoholic/*genetics/pathology ; Male ; Middle Aged ; *Polymorphism, Genetic ; Transforming Growth Factor beta1/*genetics/metabolism

PURPOSE: An inflamed appendix can be removed either openly (open appendectomy [OA]) or laparoscopically (laparoscopic appendectomy [LA]). Surgical-site infection (SSI) is a representative healthcare-associated infection and can impose serious economic burdens on patients as well as affect morbidity and mortality rates. The aim of this study was to compare LA with OA in terms of SSI. METHODS: The medical records of 749 patients (420 males; mean age, 33 years) who underwent appendectomy (OA, 431; LA, 318) between September 1, 2008 and April 29, 2010 were retrospectively reviewed for demographic and pathologic characteristics, recovery of bowel movement, length of hospital stay, and postoperative complications. RESULTS: The frequency of purulent/gangrenous or perforated appendicitis was not significantly different between LA and OA groups (83% [263/318 cases] vs. 83% [359/431 cases], P = 0.183). The time to first flatus after surgery was not significantly different between the two groups (1.38 +/- 1.07 days for LA, 1.33 +/- 0.90 days for OA, P = 0.444), but the length of hospital stay was significantly shorter in LA group than in OA group (3.37 +/- 0.12 days vs. 3.83 +/- 0.12 days, P = 0.006). The frequency of overall SSI was not significantly different between the two groups (2.8% for LA, 4.6% for OA, P = 0.204), but that of superficial incisional SSI was significantly lower in LA group (0.6% vs. 3.9%, P = 0.016). CONCLUSION: The results of this study suggest that LA may lead to a shorter length of hospital stay and may have a lower risk of superficial incisional SSI than OA.
Appendectomy ; Appendicitis ; Appendix ; Flatulence ; Humans ; Length of Stay ; Medical Records ; Retrospective Studies