OBJECTIVES: The conversion of medical colleges into medical schools has been attempted by the Korean government since 2005. The aim of this study was to compare psychological characteristics of undergraduate and graduate medical students before and after changes in the medical educational system. METHODS: Four hundred-and-twenty-eight medical students participated in this study; 247 were undergraduates and 181 were graduate students. The participants completed psychological assessments including the Minnesota Multiphasic Personality Inventory (MMPI), the Symptom Checklist-90-Revision (SCL-90-R), the Beck Depression Inventory (BDI), and the Alexithymia Scale. RESULTS: Overall, undergraduate medical students demonstrated significantly higher scores than the graduate medical student on three of MMPI subscales (F, depression, and social introversion) and two of SCL-90-R subscales (somatization and obsessive-compulsive). When comparing the four groups (male undergraduate, female undergraduate, male graduate, female graduate) using analysis of covariance and controlling for age as a covariate, there were significant differences between male graduate and male undergraduate medical students in the same subscales except somatization, whereas there were no significant differences between female groups. CONCLUSION: These findings suggest that male graduate medical students may have better mental health states and less psychological problems than undergraduate medical students even after controlling for age. However, these differences were not found between female groups. Although every score of all items was within normal range regardless of group, distinctive differences between male graduate and undergraduate students were revealed for some psychological profiles such as depression, social introversion, and obsessive-compulsive traits.
Affective Symptoms ; Depression ; Female ; Humans ; Introversion (Psychology) ; Male ; Mental Health ; MMPI ; Reference Values ; Schools, Medical ; Students, Medical

BACKGROUND: Preterm labor is a leading risk factor for neonatal death and long-term impairment and linked closely with inflammation. Non-obstetric surgery is occasionally needed during pregnancy and the anesthetic drugs or surgery itself can give rise to inflammation. Here, we examined the influence of propofol pretreatment on the expression of cyclooxygenase-2 (COX-2) and prostaglandin E2 (PGE2) after lipopolysaccharide (LPS) stimulation. In addition, we evaluated the expression of pro-inflammatory cytokines and nuclear factor kappa B (NF-κB). METHODS: Human amnion-derived WISH cells were used to investigate the effect of propofol on the LPS-induced expression of inflammatory substances involved in preterm labor. For the experiment, WISH cells were pretreated with various concentrations propofol (0.01–10 µg/ml) for 1 h and then treated with LPS (1 µg/ml) for 24 h. Cytotoxicity was evaluated using MTT assay. PGE2 concentration was assessed by ELISA. Protein expressions of COX-2, PGE2 and NF-κB were analyzed by western blotting analysis. RT-PCR was used for analysis of mRNA expression of COX-2, PGE2, interlukin (IL)-1β and tumor necrosis factor (TNF)-α. RESULTS: Propofol showed no cytotoxicity on the WISH cells. LPS-induced PGE2 production and COX-2 and PGE2 expression were decreased after propofol pretreatment. Propofol also attenuated the LPS-induced mRNA expression of IL-1β and TNF-α. Moreover, the activation of NF-jB was inhibited by propofol pretreatment on LPS-stimulated WISH cells. CONCLUSION: We demonstrated that propofol suppresses the expression of inflammatory substances enhanced by LPS stimulation. Furthermore, this inhibitory effect of propofol on the inflammatory substance expression is mediated by suppression of NF-κB activation.
Amnion ; Anesthetics ; Blotting, Western ; Cyclooxygenase 2 ; Cytokines ; Dinoprostone ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Inflammation ; NF-kappa B ; Obstetric Labor, Premature ; Perinatal Death ; Pregnancy ; Propofol ; Risk Factors ; RNA, Messenger ; Tumor Necrosis Factor-alpha

OBJECTIVE: We investigated the clinical value of using preoperative differential white blood cell (WBC) count to predict the potential for malignancy of adnexal masses in laparoscopic surgery. METHODS: The electronic medical records of 1325 patients who underwent laparoscopic surgery for adnexal masses between July 2005 and December 2008 were analyzed retrospectively. RESULTS: Of 1325 patients, 30 (2.3%) had adnexal masses with malignant potential. Analysis of differential WBC count, neutrophil to lymphocyte ratio (NLR), neutrophil to monocyte ratio (NMR), serum CA 125, mass size showed that only cyst size was significantly different between patients with potentially malignant adnexal masses, those with benign disease (averages of 9.45 cm vs. 6.23 cm, p=0.001). Further analysis was performed using a combination of various markers and multiplication of cyst size and NMR yielded the highest area under the curve, at 0.711(95% confidential interval 0.619~0.806, p<0.001), with a sensitivity and specificity of 86.7% and 48.3% respectively, at a cut off value of 67.23. These values were also significantly different between patients with potentially malignant adnexal masses, and dermoid cyst or endometrioma (p=0.038 and 0.002 respectively, by analysis of variance, post hoc test). CONCLUSION: Preoperative measurement of NMR in conjunction with cyst size may be used as a simple, non invasive marker for predicting the malignant potential of adnexal masses before laparoscopic surgery.
Dermoid Cyst ; Electronic Health Records ; Endometriosis ; Female ; Humans ; Laparoscopy ; Leukocytes ; Lymphocytes ; Monocytes ; Neutrophils ; Sensitivity and Specificity

BACKGROUND: Our previous study showed that purified protein derivative (PPD)- stimulated pleural mononuclear cells (PMC) from tuberculous pleurisy (Tbp) produced significantly more IFN-gamma (10- to 70-fold) after in vitro PPD stimulation than freshly isolated pleural cells from malignant pleurisy. The present study was designed to determine whether blocking the CD40-CD40 ligand (CD40L) interaction decreases IFN-gamma production by altering IL-12 levels. METHODS: IL-12 and IFN-gamma production after neutralizing anti-CD40L antibody treatment was compared to the efficacy of anti-CD80, anti-CD86, and a combination of anti-CD80 and CD86 (CD80+86) monoclonal antibodies (mAb). These activities were measured by enzyme-linked immunosorbent assays (ELISAs) and reverse transcription-polymerase chain reaction (RT-PCR), after in vitro stimulation with PPD antigen (Ag). RESULTS: Neutralization of CD80, CD86 and CD80+86 did not decrease IFN-gamma and IL-12 production in Tbp-PMC, whereas neutralization of CD40L significantly depressed IL-12 p40 and IFN-gamma. In addition, neutralization of CD40L completely inhibited IL-12 p40 and IFN-gamma mRNA expression. CONCLUSION: The CD40-CD40L interaction might play a major role in IL-12 and IFN-gamma production in Tbp-PMC, thus contributing to protective immunity in human tuberculosis.
Antibodies, Monoclonal ; CD40 Ligand ; Enzyme-Linked Immunosorbent Assay ; Humans ; Interleukin-12* ; Pleurisy ; RNA, Messenger ; Tuberculosis ; Tuberculosis, Pleural

BACKGROUND: Our previous study showed that purified protein derivative (PPD)- stimulated pleural mononuclear cells (PMC) from tuberculous pleurisy (Tbp) produced significantly more IFN-gamma (10- to 70-fold) after in vitro PPD stimulation than freshly isolated pleural cells from malignant pleurisy. The present study was designed to determine whether blocking the CD40-CD40 ligand (CD40L) interaction decreases IFN-gamma production by altering IL-12 levels. METHODS: IL-12 and IFN-gamma production after neutralizing anti-CD40L antibody treatment was compared to the efficacy of anti-CD80, anti-CD86, and a combination of anti-CD80 and CD86 (CD80+86) monoclonal antibodies (mAb). These activities were measured by enzyme-linked immunosorbent assays (ELISAs) and reverse transcription-polymerase chain reaction (RT-PCR), after in vitro stimulation with PPD antigen (Ag). RESULTS: Neutralization of CD80, CD86 and CD80+86 did not decrease IFN-gamma and IL-12 production in Tbp-PMC, whereas neutralization of CD40L significantly depressed IL-12 p40 and IFN-gamma. In addition, neutralization of CD40L completely inhibited IL-12 p40 and IFN-gamma mRNA expression. CONCLUSION: The CD40-CD40L interaction might play a major role in IL-12 and IFN-gamma production in Tbp-PMC, thus contributing to protective immunity in human tuberculosis.
Antibodies, Monoclonal ; CD40 Ligand ; Enzyme-Linked Immunosorbent Assay ; Humans ; Interleukin-12* ; Pleurisy ; RNA, Messenger ; Tuberculosis ; Tuberculosis, Pleural