Yonsei University College of Medicine (YUCM) adopted a criterion-referenced assessment (CRA) system in 2014. Six cohorts have graduated over the past decade under CRA. Positive impacts on student wellness and academic achievement were observed during the system’s initial years, and this study therefore aimed to analyze the changing perceptions of graduating students who experienced CRA to reflect YUCM’s experience of CRA implementation and suggest future directions and insights. Utilizing self-reporting graduation survey data of 621 graduates from 2018 to 2023, eight items regarding perceptions of CRA were examined with analysis of variance to explore changes in perceptions among the graduates, and short answers were also reviewed to investigate keywords and main themes. The CRA grading system positively influenced students’ learning motivation, level of class participation, cooperative attitudes, and self-directed attitudes. In particular, students’ perceptions of cooperative attitudes significantly improved from 2018 (3.97) to 2023 (4.46). The system also had a positive impact on students’ interest in conducting research from 2018 (3.04) to 2023 (3.56). Students’ perceptions of validity significantly increased from 2018 (3.40) to 2023 (3.92), and the perceptions of reliability also increased from 2018 (3.38) to 2023 (3.65), although the inter-year changes were not statistically significant. This study on graduating students’ changing perceptions of the CRA at YUCM aligned with the intended goals and context of its introduction and implementation. Ongoing improvements in fairness and reliability are required to enhance students’ perceptions of the system’s credibility, necessitating ongoing education and improvement efforts. Further studies on the positive and negative factors influencing perceptions of CRA are required to derive insights for system improvement.

Yonsei University College of Medicine (YUCM) adopted a criterion-referenced assessment (CRA) system in 2014. Six cohorts have graduated over the past decade under CRA. Positive impacts on student wellness and academic achievement were observed during the system’s initial years, and this study therefore aimed to analyze the changing perceptions of graduating students who experienced CRA to reflect YUCM’s experience of CRA implementation and suggest future directions and insights. Utilizing self-reporting graduation survey data of 621 graduates from 2018 to 2023, eight items regarding perceptions of CRA were examined with analysis of variance to explore changes in perceptions among the graduates, and short answers were also reviewed to investigate keywords and main themes. The CRA grading system positively influenced students’ learning motivation, level of class participation, cooperative attitudes, and self-directed attitudes. In particular, students’ perceptions of cooperative attitudes significantly improved from 2018 (3.97) to 2023 (4.46). The system also had a positive impact on students’ interest in conducting research from 2018 (3.04) to 2023 (3.56). Students’ perceptions of validity significantly increased from 2018 (3.40) to 2023 (3.92), and the perceptions of reliability also increased from 2018 (3.38) to 2023 (3.65), although the inter-year changes were not statistically significant. This study on graduating students’ changing perceptions of the CRA at YUCM aligned with the intended goals and context of its introduction and implementation. Ongoing improvements in fairness and reliability are required to enhance students’ perceptions of the system’s credibility, necessitating ongoing education and improvement efforts. Further studies on the positive and negative factors influencing perceptions of CRA are required to derive insights for system improvement.

Yonsei University College of Medicine (YUCM) adopted a criterion-referenced assessment (CRA) system in 2014. Six cohorts have graduated over the past decade under CRA. Positive impacts on student wellness and academic achievement were observed during the system’s initial years, and this study therefore aimed to analyze the changing perceptions of graduating students who experienced CRA to reflect YUCM’s experience of CRA implementation and suggest future directions and insights. Utilizing self-reporting graduation survey data of 621 graduates from 2018 to 2023, eight items regarding perceptions of CRA were examined with analysis of variance to explore changes in perceptions among the graduates, and short answers were also reviewed to investigate keywords and main themes. The CRA grading system positively influenced students’ learning motivation, level of class participation, cooperative attitudes, and self-directed attitudes. In particular, students’ perceptions of cooperative attitudes significantly improved from 2018 (3.97) to 2023 (4.46). The system also had a positive impact on students’ interest in conducting research from 2018 (3.04) to 2023 (3.56). Students’ perceptions of validity significantly increased from 2018 (3.40) to 2023 (3.92), and the perceptions of reliability also increased from 2018 (3.38) to 2023 (3.65), although the inter-year changes were not statistically significant. This study on graduating students’ changing perceptions of the CRA at YUCM aligned with the intended goals and context of its introduction and implementation. Ongoing improvements in fairness and reliability are required to enhance students’ perceptions of the system’s credibility, necessitating ongoing education and improvement efforts. Further studies on the positive and negative factors influencing perceptions of CRA are required to derive insights for system improvement.

Yonsei University College of Medicine (YUCM) adopted a criterion-referenced assessment (CRA) system in 2014. Six cohorts have graduated over the past decade under CRA. Positive impacts on student wellness and academic achievement were observed during the system’s initial years, and this study therefore aimed to analyze the changing perceptions of graduating students who experienced CRA to reflect YUCM’s experience of CRA implementation and suggest future directions and insights. Utilizing self-reporting graduation survey data of 621 graduates from 2018 to 2023, eight items regarding perceptions of CRA were examined with analysis of variance to explore changes in perceptions among the graduates, and short answers were also reviewed to investigate keywords and main themes. The CRA grading system positively influenced students’ learning motivation, level of class participation, cooperative attitudes, and self-directed attitudes. In particular, students’ perceptions of cooperative attitudes significantly improved from 2018 (3.97) to 2023 (4.46). The system also had a positive impact on students’ interest in conducting research from 2018 (3.04) to 2023 (3.56). Students’ perceptions of validity significantly increased from 2018 (3.40) to 2023 (3.92), and the perceptions of reliability also increased from 2018 (3.38) to 2023 (3.65), although the inter-year changes were not statistically significant. This study on graduating students’ changing perceptions of the CRA at YUCM aligned with the intended goals and context of its introduction and implementation. Ongoing improvements in fairness and reliability are required to enhance students’ perceptions of the system’s credibility, necessitating ongoing education and improvement efforts. Further studies on the positive and negative factors influencing perceptions of CRA are required to derive insights for system improvement.

Yonsei University College of Medicine (YUCM) adopted a criterion-referenced assessment (CRA) system in 2014. Six cohorts have graduated over the past decade under CRA. Positive impacts on student wellness and academic achievement were observed during the system’s initial years, and this study therefore aimed to analyze the changing perceptions of graduating students who experienced CRA to reflect YUCM’s experience of CRA implementation and suggest future directions and insights. Utilizing self-reporting graduation survey data of 621 graduates from 2018 to 2023, eight items regarding perceptions of CRA were examined with analysis of variance to explore changes in perceptions among the graduates, and short answers were also reviewed to investigate keywords and main themes. The CRA grading system positively influenced students’ learning motivation, level of class participation, cooperative attitudes, and self-directed attitudes. In particular, students’ perceptions of cooperative attitudes significantly improved from 2018 (3.97) to 2023 (4.46). The system also had a positive impact on students’ interest in conducting research from 2018 (3.04) to 2023 (3.56). Students’ perceptions of validity significantly increased from 2018 (3.40) to 2023 (3.92), and the perceptions of reliability also increased from 2018 (3.38) to 2023 (3.65), although the inter-year changes were not statistically significant. This study on graduating students’ changing perceptions of the CRA at YUCM aligned with the intended goals and context of its introduction and implementation. Ongoing improvements in fairness and reliability are required to enhance students’ perceptions of the system’s credibility, necessitating ongoing education and improvement efforts. Further studies on the positive and negative factors influencing perceptions of CRA are required to derive insights for system improvement.

Objective: To compare short- and long-term dentoalveolar, skeletal, and rotational changes evaluated by Björk’s structural method of superimposition between children with Class II malocclusion treated by functional appliances and untreated matched controls. Methods: Seventy-nine prepubertal or pubertal children (mean age, 11.57 ± 1.40 years) with Class II malocclusion were included. Thirty-four children were treated using an activator with a high-pull headgear (Z-activator), while 28 were treated using an activator without a headgear (E-activator). Seventeen untreated children were included as controls. Lateral cephalograms were obtained before treatment (T1), after functional appliance treatment (T2), and after retention in the postpubertal phase (T3). Changes from T1 to T2 and T1 to T3 were compared between the treated groups and control group using multiple linear regression analysis. Results: Relative to the findings in the control group at T2, the sagittal jaw relationship (subspinalenasion- pogonion, p < 0.001), maxillary prognathism (sella-nasion-subspinale, p < 0.05), and condylar growth (p < 0.001) exhibited significant improvements in the Z- and E-activator groups, which also showed a significantly increased maxillary incisor retraction (p < 0.001) and decreased overjet (p < 0.001). Only the E-activator group exhibited significant backward rotation of the maxilla at T2 (p < 0.01). The improvements in the sagittal jaw relationship (p < 0.01) and dental relationship (p < 0.001) remained significant at T3. Condylar growth and jaw rotations were not significant at T3. Conclusions Functional appliance treatment in children with Class II malocclusion can significantly improve the sagittal jaw relationship and dental relationships in the long term.

Pancreatic acinar cell carcinoma (ACC) is a rare neoplasm accounting less than 1% of malignant pancreatic tumors. A 47-year-old male patient visited the emergency room with epigastric pain. Computed tomography or magnetic resonance imaging revealed a 4.7-cm heterogeneously enhanced solid and cystic mass with internal necrosis located in the head of the pancreas. Radiological diagnosis was borderline malignancy such as neuroendocrine tumor or solid pseudopapillary neoplasm. Two months later, the necrotic mass in the pancreas head had grown up to 11 cm, compressing the duodenum, superior mesenteric vein, and proximal transverse colon. Pylorus preserving pancreatoduodenectomy with segmental resection of transverse colon was performed. Histopathological examination revealed that the tumor was pancreatic ACC. The patient recovered without any complication and was doing well without recurrence for 12 months after surgery.

OBJECTIVE: The Ubiquitous Spaced Retrieval-based Memory Advancement and Rehabilitation Training (USMART) program was developed by transforming the spaced retrieval-based memory training which consisted of 24 face-to-face sessions into a self-administered program with an iPAD app. The objective of this study was to evaluate the feasibility and efficacy of USMART in elderly subjects with mild cognitive impairment (MCI). METHODS: Feasibility was evaluated by checking the satisfaction of the participants with a 5-point Likert scale. The efficacy of the program on cognitive functions was evaluated by the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease Neuropsychological Assessment Battery before and after USMART. RESULTS: Among the 10 participants, 7 completed both pre- and post-USMART assessments. The overall satisfaction score was 8.0+/-1.0 out of 10. The mean Word List Memory Test (WLMT) scores significantly increased after USMART training after adjusting for age, educational levels, baseline Mini-Mental Status Examination scores, and the number of training sessions (pre-USMART, 16.0+/-4.1; post-USMART, 17.9+/-4.5; p=0.014, RM-ANOVA). The magnitude of the improvements in the WLMT scores significantly correlated with the number of training sessions during 4 weeks (r=0.793; p=0.033). CONCLUSION: USMART was effective in improving memory and was well tolerated by most participants with MCI, suggesting that it may be a convenient and cost-effective alternative for the cognitive rehabilitation of elderly subjects with cognitive impairments. Further studies with large numbers of participants are necessary to examine the relationship between the number of training sessions and the improvements in memory function.
Aged ; Alzheimer Disease ; Cognitive Therapy ; Computer User Training ; Dementia ; Education* ; Humans ; Learning ; Memory* ; Mild Cognitive Impairment ; Rehabilitation*

Hemophagocytic lymphohistiocytosis (HLH), associated with acute myelocytic leukemia (AML), is a very rare disease. We here report a case of HLH occurring after induction chemotherapy for AML. AML-associated HLH can be triggered by AML itself, by chemotherapeutic agents, or by infectious complications. Our patient developed a high-grade fever of unknown cause, bilateral pulmonary infiltrates, and shock after successful treatment of AML with induction chemotherapy, and had high serum ferritin, hypertriglyceridemia, hypofibrinogenemia, hemophagocytic histiocytes in bone marrow, low natural killer cell activity, and elevated soluble interleukin-2 receptor levels. A diagnosis of HLH was made. Dexamethasone, cyclosporine, and etoposide were given and allogeneic hematopoietic stem cell transplantation was performed. Careful suspicion of HLH may be warranted if a patient experiences fever of unknown etiology, high ferritin levels, and liver dysfunction during AML treatment.
Bone Marrow ; Cyclosporine ; Dexamethasone ; Diagnosis ; Etoposide ; Ferritins ; Fever ; Hematopoietic Stem Cell Transplantation ; Histiocytes ; Humans ; Hypertriglyceridemia ; Induction Chemotherapy* ; Interleukin-2 ; Killer Cells, Natural ; Leukemia, Myeloid, Acute* ; Liver Diseases ; Lymphohistiocytosis, Hemophagocytic* ; Rare Diseases ; Shock

BACKGROUND: Postoperative nausea and vomiting (PONV) frequently occurs following bimaxillary orthognathic surgeries. Compared to opioids, Nefopam is associated with lower incidences of PONV, and does not induce gastrointestinal tract injury, coagulopathy, nephrotoxicity, or fracture healing dysfunction, which are common side effects of Nonsteroidal anti-inflammatory drugs. We compared nefopam- and fentanyl-induced incidence of PONV in patients with access to patient-controlled analgesia (PCA) following bimaxillary orthognathic surgeries. METHODS: Patients undergoing bimaxillary orthognathic surgeries were randomly divided into nefopam and fentanyl groups. Nefopam 120 mg or fentanyl 700 µg was mixed with normal saline to a final volume of 120 mL. Patients were given access to nefopam or fentanyl via PCA. Postoperative pain intensity and PONV were measured at 30 minutes and 1 hour after surgery in the recovery room and at 8, 24, 48, and 72 hours after surgery in the ward. The frequency of bolus delivery was compared at each time point. RESULTS: Eighty-nine patients were enrolled in this study, with 48 in the nefopam (N) group and 41 in the fentanyl (F) group. PONV occurred in 13 patients (27.7%) in the N group and 7 patients (17.1%) in the F group at 8 hours post-surgery (P = 0.568), and there were no significant differences between the two groups at any of the time points. VAS scores were 4.4 ± 2.0 and 3.7 ± 1.9 in the N and F groups, respectively, at 8 hours after surgery (P = 0.122), and cumulative bolus delivery was 10.7 ± 13.7 and 8.6 ± 8.5, respectively (P = 0.408). There were no significant differences in pain or bolus delivery at any of the remaining time points. CONCLUSION: Patients who underwent bimaxillary orthognathic surgery and were given nefopam via PCA did not experience a lower rate of PONV compared to those that received fentanyl via PCA. Furthermore, nefopam and fentanyl did not provide significantly different postoperative pain control.
Analgesia, Patient-Controlled ; Analgesics, Opioid ; Fentanyl ; Fracture Healing ; Gastrointestinal Tract ; Humans ; Incidence ; Nefopam ; Orthognathic Surgery ; Pain, Postoperative ; Passive Cutaneous Anaphylaxis ; Postoperative Nausea and Vomiting ; Prospective Studies ; Recovery Room