Invasive infection of the Streptococcus bovis group in a neonate is rare. In cases reported to date, the pathogen of neonatal S. bovis infections is usually Streptococcus gallolyticus subsp. pasteurianus (S. bovis biotype II/2). Streptococcus lutetiensis (S. bovis biotype II/1) was identified using 16S rRNA and tuf gene sequence analysis of the isolates from blood and cerebrospinal fluid (CSF) of a fever-presenting 28-day-old male. Blood culture analysis was performed using automatic equipment (VITEK 2) and identified Streptococcus infantarius supsp. infantarius, yet we were unable to get accurate results from the CSF culture. The fever subsided on the second day of hospitalization, and the patient was discharged without neurologic complication after 14 days of antibiotic therapy. In this case, we were able to accurately identify the pathogen using molecular genetic methods. To our knowledge, this is the first case of late onset neonatal bacteremia and meningitis caused by S. lutetiensis.
Bacteremia* ; Cerebrospinal Fluid ; Fever ; Hospitalization ; Humans ; Infant, Newborn ; Male ; Meningitis* ; Molecular Biology ; Sequence Analysis ; Streptococcus bovis ; Streptococcus*

PURPOSE: The purpose of this study was to implement a systematic career coaching program for medical students and to evaluate its effectiveness. METHODS: First-year medical students of Konyang University College of Medicine took part in the FLEX Mentoring II: Career Coaching Program from September to December in 2016 and 2017. This program included 16 weekly sessions, comprising a total of 32 hours. The students took the Career Readiness Inventory before and after the program, as a pre- and post-test of the program. Data from 100 students were used (46 students in 2016, 54 students in 2017) for the evaluation. RESULTS: Medical students' career readiness pre-test was rated as medium. In particular, many students were at a low level in terms of ‘support from colleagues and peers’ (53.0%), ‘career decision’ (48.0%), and ‘efforts for job preparation’ (60.0%). After 16 sessions of a systematic career coaching program, their career readiness level showed a significant increase except for ‘career decision’ (t=4.242, P=0.001) and ‘independence’ (t=0.731, P=0.466), a sub-factor of ‘career maturity.’ CONCLUSION The career readiness level of medical students was not sufficiently high. However, a semester of educational training in a systematic career coaching program helped the students to be better prepared for their career. In particular, the significant reduction in the ‘career decision’ variable after the program can be interpreted as indicating that the students changed their behavior to explore and approach their career more seriously and carefully, which also underscores the need for the implementation of career coaching programs in medical schools.

PURPOSE: The purpose of this study was to implement a systematic career coaching program for medical students and to evaluate its effectiveness. METHODS: First-year medical students of Konyang University College of Medicine took part in the FLEX Mentoring II: Career Coaching Program from September to December in 2016 and 2017. This program included 16 weekly sessions, comprising a total of 32 hours. The students took the Career Readiness Inventory before and after the program, as a pre- and post-test of the program. Data from 100 students were used (46 students in 2016, 54 students in 2017) for the evaluation. RESULTS: Medical students' career readiness pre-test was rated as medium. In particular, many students were at a low level in terms of ‘support from colleagues and peers’ (53.0%), ‘career decision’ (48.0%), and ‘efforts for job preparation’ (60.0%). After 16 sessions of a systematic career coaching program, their career readiness level showed a significant increase except for ‘career decision’ (t=4.242, P=0.001) and ‘independence’ (t=0.731, P=0.466), a sub-factor of ‘career maturity.’ CONCLUSION: The career readiness level of medical students was not sufficiently high. However, a semester of educational training in a systematic career coaching program helped the students to be better prepared for their career. In particular, the significant reduction in the ‘career decision’ variable after the program can be interpreted as indicating that the students changed their behavior to explore and approach their career more seriously and carefully, which also underscores the need for the implementation of career coaching programs in medical schools.
Career Choice ; Education, Medical ; Humans ; Korea ; Mentors ; Schools, Medical ; Students, Medical

PURPOSE: Erectile dysfunction (ED) remains a major complication from cavernous nerve injury during radical prostatectomy. Recently, stem cell treatment for ED has been widely reported. This study was conducted to investigate the availability, differentiation into functional cells, and potential of human muscle-derived stem cells (hMDSCs) and human adipose-derived stem cells (hADSCs) for ED treatment. MATERIALS AND METHODS: We compared the neural differentiation of hMDSCs and hADSCs. Human muscle and adipose tissues were digested with collagenase, followed by filtering and centrifugation. For neural induction, isolated hMDSCs and hADSCs were incubated in neurobasal media containing forskolin, laminin, basic-fibroblast growth factor, and epidermal growth factor for 5 days. Following neural induction, hMDSCs and hADSCs were differentiated into neural cells, including neurons and glia, in vitro. RESULTS: In neural differentiated hMDSCs (d-hMDSCs) and differentiated hADSCs (d-hADSCs), neural stem cell marker (nestin) showed a significant decrease by immunocytochemistry, and neuronal marker (beta-tubulin III) and glial marker (GFAP) showed a significant increase, compared with primary hMDSCs and hADSCs. Real-time chain reaction analysis and Western blotting demonstrated significantly elevated levels of mRNA and protein of beta-tubulin III and GFAP in d-hADSCs compared with d-hMDSCs. CONCLUSIONS: We demonstrated that hMDSCs and hADSCs can be induced to undergo phenotypic and molecular changes consistent with neurons. The neural differentiation capacity of hADSCs was better than that of hMDSCs.
Adipose Tissue ; Blotting, Western ; Caves ; Cell Differentiation ; Centrifugation ; Collagenases ; Epidermal Growth Factor ; Erectile Dysfunction ; Forskolin ; Humans ; Immunohistochemistry ; Laminin ; Male ; Muscles ; Neural Stem Cells ; Neuroglia ; Neurons ; Prostatectomy ; RNA, Messenger ; Stem Cells ; Tubulin

BACKGROUND: Statins can regulate the production of pro-inflammatory cytokines and inhibit MMP production or activation in a variety of types of cells. This study evaluated whether statins would inhibit MMP release from human lung fibroblasts, which play a major role in remodeling processes. METHODS: This study, using an in-vitro model (three-dimensional collagen gel contraction system), evaluated the effect of cytokines (tumor necrosis factor-alpha, TNF-a and interleukin-1beta, IL-1b) on the MMP release and MMP activation from human lung fibroblasts. Collagen degradation induced by cytokines and neutrophil elastase (NE) was evaluated by quantifying hydroxyproline. RESULTS: In three-dimensional collagen gel cultures (3D cultures) where cytokines (TNF-a and IL-1b) can induce the production of MMPs by fibroblasts, it was found that simvastatin inhibited MMP release. In 3D cultures, cytokines together with NE induced collagen degradation and can lead to activation of the MMP, which was inhibited by simvastatin. CONCLUSION: Simvastatin may play a role in regulating human lung fibroblast functions in repair and remodeling processes by inhibiting MMP release and the conversion from the latent to the active form of MMP.
Airway Remodeling ; Collagen ; Contracts ; Cytokines ; Fibroblasts ; Humans ; Interleukin-1beta ; Leukocyte Elastase ; Lung ; Matrix Metalloproteinases ; Necrosis ; Simvastatin

Duloxetine is a balanced serotonin and norepinephrine reuptake inhibitor available for treating peripheral neuropathic pain. The occurrence of hyponatremia as an adverse event of duloxetine treatment, but it has not yet been reported in Korea. Here, we report two cases of hyponatremia induced by duloxetine for treatment of peripheral neuropathic pain. Our findings highlight the need for special attention when using duloxetine in elderly patients taking thiazide diuretics.
Aged ; Humans ; Hyponatremia ; Korea ; Neuralgia ; Norepinephrine ; Serotonin ; Serotonin Uptake Inhibitors ; Sodium Chloride Symporter Inhibitors ; Thiophenes ; Duloxetine Hydrochloride

PURPOSE: The purpose of this study was to investigate nurses' perceptions on child abuse. METHODS: In this cross-sectional descriptive study, data were collected using a questionnaire and 217 nurses working in seven general hospitals were surveyed. The perception scale was divided into 4 subscales: physical, psychological, sexual abuse and neglect. RESULTS: Nurses who suspected child abuse accounted for 18.1% of the nurses, and 41.9% of the nurses stated that they did not to report suspected child abuse. The nurses reported receiving only a little education about the prevention of child abuse. The mean score for perception on child abuse was high (3.59±0.31). Recognition of sexual abuse ranked highest, psychological abuse ranked lowest. CONCLUSION: The findings from this research provide baseline information for understanding nurses' perceptions on child abuse, and may help in the development of appropriate education programs that will enable nurses to report child abuse.
Child ; Child Abuse* ; Child* ; Education ; Hospitals, General ; Humans ; Sex Offenses

Lateral malleolar bursitis rarely progresses to septic arthritis. In our case, the 27 year old man visited due to progressive left ankle pain, despite the antibiotics treatment of lateral malleolar bursitis. 8 years ago, modified Brostrom procedure was performed owing to chronic ankle instability. Previous surgery altered anatomical structure of lateral ankle bursa, so it may cause the infection to spread to the ankle joint. We reported rare case of secondary septic arthritis caused by lateral malleolar bursitis.
Adult ; Ankle ; Ankle Joint ; Anti-Bacterial Agents ; Arthritis, Infectious* ; Bursitis* ; Humans

PURPOSE: Currently, development of pulmonary thromboembolism (PTE) after surgery is frequently being followed by legal action in Korea, as consequences may be fatal. In the current study, we assessed possible countermeasures that medical teams can take when faced with conflicting opinions on responsibility for PTE. METHODS: A retrospective analysis of claims handled by the Supreme Court and subordinate courts, from 1999 to 2015, was performed. We analyzed the type of procedure, associated complications, and critical legal points from the recorded judgments along with any liability limitations on surgeons. RESULTS: After reviewing cases between 1999 and 2015, a total of 18 cases were analyzed. There were no cases in which the surgeon was held accountable between 1999 and 2002. From 2003, there were instances of the surgeon being held accountable, with a peak of cases in 2013. Legal standards applied in judicial decision-making related to appropriate use of preventive measures, operation characteristics, doctor's reaction towards symptom occurrence, obligation of postoperative medical care, and duty of explanation. CONCLUSION: The courts in Korea have changed their position from one of denying doctors' liability to one of enforcing responsibility for PTE. Surgeons are therefore being held responsible with greater frequency, depending on the details of the case. Lessons can be learnt from precedents that can be incorporated into medical education and training programs with the aim of reducing both major PTE complication rates and litigation costs.
Education ; Education, Medical ; Judgment ; Jurisprudence ; Korea* ; Malpractice ; Pulmonary Embolism* ; Retrospective Studies ; Surgeons

This study intended to review the precedents on plastic surgery medical malpractice lawsuits in lower-court trials, classify the reasons of 'limitation of liability' by type, and suggest a standard in the acknowledgement of limitation of liability ratio. The 30 lower-court's rulings on the cases bearing the medical negligence of the defendants acknowledged the liability ratio of the defendants between 30% and 100%. Ten cases ruled that the defendants were wholly responsible for the negligence or malpractice, while 20 cases acknowledged the limitation of liability principle. In the determination of damage compensation amount, the court considered the cause of the victim side, which contributed in the occurrence of the damage. The court also believed that it is against the idea of fairness to have the assailant pay the whole compensation, even there is no victim-side cause such as previous illness or physical constitution of the patient, and applies the legal doctrine on limitation of liability, which is an independent damage compensation adjustment system. Most of the rulings also limited the ratio of responsibility to certain extent. When considering that the legal doctrine on limitation of liability which supports concrete validity for the fair sharing of damage, the tangible classification of causes of limitation of liability suggested in this study would be a useful tool in forecasting the ruling of a plastic surgery medical malpractice lawsuit.
Humans ; *Liability, Legal ; Malpractice/*legislation & jurisprudence ; Reconstructive Surgical Procedures/adverse effects/legislation & jurisprudence ; Republic of Korea ; Surgery, Plastic/*adverse effects/*legislation & jurisprudence