Mirtazapine-a newly developed drug with reduce adverse effects and toxicity of original antidepre-ssants-has been known to have antidepressant effect by enhancing the transmission of norepinephrine and serotonin via blockade of alpha2-noradrenergic autoreceptor and heteroreceptor and to have common side effects such as sedation, weight gain, and dizziness. We report a case of 50 years old female depressive patient who developed mirtazapine-associated hyperglycemia during treatment with mirtazapine and returned to normal glucose level after stopping the usage of mirtazapine. In patients who receive drugs with the risk of hyperglycemia and diabetes mellitus, we should consider the evaluation for diabetes mellitus and follow it up carefully in the future.
Autoreceptors ; Diabetes Mellitus ; Dizziness ; Female ; Glucose ; Humans ; Hyperglycemia* ; Middle Aged ; Norepinephrine ; Serotonin ; Weight Gain

BACKGROUND: Several antibiotics can be used to treat ventilator-associated pneumonia caused by carbapenem-resistant A. baumannii (CRAB-VAP) including high-dose sulbactam. However, the effectiveness of high-dose sulbactam therapy is not well known. We report our experience with high-dose sulbactam for treatment of CRAB-VAP. METHODS: Medical records of patients with CRAB-VAP who were given high-dose sulbactam between May 2013 and June 2015 were reviewed. RESULTS: Fifty-eight patients with CRAB-VAP were treated with high-dose sulbactam. The mean age was 72.0 ± 15.2 years, and the acute physiology and chronic health evaluation II (APACHE II) score was 15.1 ± 5.10 at the time of CRAB-VAP diagnosis. Early clinical improvement was observed in 65.5% of patients, and 30-day mortality was 29.3%. Early clinical failure (odds ratio [OR]: 8.720, confidence interval [CI]: 1.346-56.484; p = 0.023) and APACHE II score ≥ 14 at CRAB-VAP diagnosis (OR: 10.934, CI: 1.047-114.148; p = 0.046) were associated with 30-day mortality. CONCLUSIONS: High-dose sulbactam therapy may be effective for the treatment of CRAB-VAP. However, early clinical failure was observed in 35% of patients and was associated with poor outcome.
Acinetobacter baumannii* ; Acinetobacter* ; Anti-Bacterial Agents ; APACHE ; Diagnosis ; Humans ; Medical Records ; Mortality ; Pneumonia, Ventilator-Associated* ; Sulbactam*

PURPOSE: The population of metabolic syndrome is increasing in Korea. The prevalence is related to lifestyle, such as lack of physical activity and irregular diet. Most patients with metabolic syndrome know that lifestyle intervention is important to managing the condition. However, they do not always follow the intervention for various reasons, including lack of knowledge on how to change their lifestyle and lack of accessibility to that knowledge. The purpose of this study was to test the web-based health promotion program we developed. METHODS: Fifty-six adult workers from eight areas of business were recruited. They all had a confirmed metabolic syndrome diagnosis after being registered at a university hospital for annual health checkups. Twenty-nine workers were assigned to the experimental group, and the others were assigned to the control group. The web-based program was applied to the experimental group as an intervention for 8 weeks.Waist circumference, fasting blood glucose, triglyceride, high-density lipoprotein cholesterol, and blood pressure were measured before and after the program. Data were analyzed using chi-square test, Fisher's exact test, and t test. RESULTS: There were statistically significant differences between the two groups in waist circumference and high-density lipoprotein cholesterol (t = -4.43, p < .001; t = 2.22, p = .031, respectively). Of the 29 participants, 13 (44.83%) in the intervention group had less than two indices for metabolic syndrome. CONCLUSIONS: This study suggests that a web-based program is useful for patients with metabolic syndrome to improve physiologic parameters related to metabolic syndrome. The web-based program may be easily applicable to community as well as clinical setting.
Adult ; Blood Glucose/metabolism ; Case-Control Studies ; Female ; *Health Behavior ; Health Promotion/*methods/standards ; Humans ; *Internet ; *Life Style ; Lipoproteins, HDL/blood ; Male ; Metabolic Syndrome X/*rehabilitation ; Middle Aged ; Triglycerides/blood ; Waist Circumference ; Young Adult

Purpose: Team-based learning in medical education facilitates the formation of interpersonal relationships, enhances academic achievement, and establishes future clinical connections. Despite medical schools’ distinct educational environments and curricula, research investigating students’ learning and behavioral characteristics within this context remains limited. This study aimed to investigate the specific characteristics of interpersonal relationship formation among freshmen medical students in team-based learning activities. Methods: Focus group interviews were conducted with 11 students who participated in a team-based class held during the first semester of the premedical year. Results: Medical students passively expressed their thoughts and feelings, such as active sympathy for the team’s opinions and self-censorship of SNS (social networking service) conversations. When performing team activities, students were excessively conscious of others and focused on evenly dividing their work, minimizing their opinions, and fulfilling their share to prevent potential interpersonal conflicts. Interpersonal activities were only superficial, as students intentionally maintained a certain distance from team members or used team activities as an opportunity to accumulate relational capital. Conclusion The results of this study are expected to provide a useful basis for designing and conducting team activity classes to enhance interpersonal relationship formation.

Background and Objectives: This study aims to investigate the indications of external approach septoplasty and improvement in subjective symptoms and objective parameters in patients who underwent external approach septoplasty to correct septal deviation with various types of deformities. Subjects and Methods: Thirty-one patients who underwent external approach septoplasty from October 2014 to January 2019 were classified by direction, location, and degree of nasal septal deviation, septal shape and surgical techniques. Through acoustic rhinometry, the minimum cross-sectional area and nasal volume were measured before and after surgery. To evaluate the improvement in symptoms, the Nasal Obstruction Symptom Evaluation (NOSE) survey and nasal congestion visual analogue scale (VAS) were also measured. Results: We found significant correlations between: the direction and degree of nasal septal deviation; the location and degree of nasal septal deviation; septal shape and location of the nasal septal deviation; septal shape and surgical techniques; and the degree of nasal septal deviation and presence of spreader grafts. The NOSE scale following external approach septoplasty improved from 14.7±4.4 to 3.1±3.2 (p<0.001), while the VAS score improved from 7.2±2.3 to 1.2±1.4 (p<0.001). Also, acoustic rhinometry showed that the minimum cross-sectional area and nasal volume at the convex side of nasal cavity significantly increased after surgery. Conclusion The external approach septoplasty is a surgical technique that is effective not only in improving subjective symptoms, but also in improving objective parameters. External approach septoplasty could be used in case of caudal and/or dorsal nasal septal deviation.

Purpose: This study examined how students’ academic performance changed after undergoing a transition to online learning during the coronavirus disease 2019 (COVID-19) pandemic, based on the test results of 16 integrated courses conducted in 3 semesters at Hanyang University College of Medicine in Korea. Methods: For the 16 required courses that formed an integrated system-based curriculum running for 3 semesters, the major examinations’ raw scores were collected for each student. Percent-correct scores were used in the subsequent analysis. We used the t-test to compare grades between 2019 and 2020, and the Cohen D was calculated as a measure of effect size. The correlation of scores between courses was calculated using Pearson correlation coefficients. Results: There was a significant decrease in scores in 2020 for 10 courses (62.5%). While most of the integrated system-based curriculum test scores showed strong correlations, with coefficients of 0.6 or higher in both 2019 and 2020, the correlation coefficients were generally higher in 2020. When students were divided into low, middle, and high achievement groups, low-achieving students consistently showed declining test scores in all 3 semesters. Conclusion Our findings suggest that the transition to online classes due to COVID-19 has led to an overall decline in academic performance. This overall decline, which may occur when the curriculum is centered on recorded lectures, needs to be addressed. Further, medical schools need to consider establishing a support system for the academic development of low-achieving students.

Neuromyelitis optica (NMO) is an inflammatory demyelinating disease of the central nervous system, characterized by repeatedly invading the brain, optic nerve, or spinal cord. In 2004, when a disease-specific antibody (aquaporin-4-immunoglobulin G) was discovered in the serum of an optic neuromyelitis patient, it was thought to be a separated disease from multiple sclerosis. Since 2004, however, the concept of the disease has been expanded to include NMO spectrum disorder (NMOSD). We experienced a rare case of NMOSD in a patient who presented with left visual disturbance and underwent endoscopic sinus surgery because of acute fungal sinusitis. We report this case with a review of the literature.

Purpose: This study assessed the alignment between Korean medical schools’ mission statements (MSs) and Korean Doctor’s Role (KDR) domains, considering school characteristics. Methods: We analyzed the South Korean medical school’s MS characteristics using a mixed-methods approach. Quantitative analysis preprocessed MS text data to identify concept words, while qualitative content analysis categorized information into predefined KDR domains and extracted themes from other parts. Results: At the KDR domain level, “social accountability” was the most frequent, followed by “education and research” and “patient care,” while “professionalism” had the least frequency. At the competency level, the most frequent domains were “involvement in public and global health initiatives,” while “self-regulation based on professional leadership” and “professionalism and self-management” were not present. Conclusion The study found that the majority of MSs had a homogeneous pattern and included traditional themes. Medical schools should evaluate and incorporate missing elements in their MSs to reflect the institution’s own purpose and current societal needs.

PURPOSE: The purpose of this study was to compare the cutting method and the lamination method to investigate whether the CAD data of the proposed inlay shape are machined correctly. MATERIALS AND METHODS: The Mesial-Occlusal shape of the inlay was modeled by changing the stereolithography (STL). Each group used SLS (metal powder) or SLA (photocurable resin) in the additive method, and wax or zirconia in the subtractive method (n=10 per group, total n=40). Three-dimensional (3D) analysis program (Geomagic Control X inspection software; 3D systems) was used for the alignment and analysis. The root mean square (RMS) in the 2D plane state was measured within 50 µm radius of eight comparison measuring points (CMP). Differences were analyzed using one-way analysis of variance and post-hoc Tukey's test were used (α=.05). RESULTS: There was a significant difference in RMS only in SLA and SLS of 2D section (P < .05). In CMP mean, CMP 4 (−5.3±46.7 µm) had a value closest to 0, while CMP 6 (20.1±42.4 µm) and CMP 1 (−89.2±61.4 µm) had the greatest positive value and the greatest negative value, respectively. CONCLUSION: Since the errors obtained from the study do not exceed the clinically acceptable values, the lamination method and the cutting method can be used clinically.
Inlays ; Methods ; Radius

The objective of this study was to investigate the effect of different cooling rates and subsequent post-firing heat treatment on the final hardness of a metal-ceramic alloy. For this, Specimens of Pd-Ag-In-Sn alloy underwent simulated firing at two different cooling rates, followed by post-firing heat treatment. Hardness measurement, microstructure observation, and crystal structure analysis were conducted on the firing simulated and post-firing heat-treated specimens to analyze the causes of hardness variations. The experimental results showed that the difference in cooling rates during simulated firing had an impact on the final hardness of the alloy, and the specimens cooled at the slowest rate (Stage 3) exhibited higher hardness at all firing Stages compared to the specimens cooled at the highest rate (Stage 0). Regardless of the difference in cooling rates during the firing process, the hardness of the alloy significantly increased by the post-firing heat treatment. The increase in hardness by the post-firing heat treatment was attributed to the formation of fine precipitates in the matrix, and the precipitation reaction occurred as a result of the decrease in solubility of (Pd, Ag, Au) 3 (In, Sn, Zn) phase in the Pd-Ag-rich matrix. The clinical significance of this study is that performing the post-firing heat treatment demonstrates effectiveness in increasing the reduced hardness after porcelain firing in metal-ceramic alloys.