No abstract available.
Humans

Background: Breaking the chain of disease transmission from overseas is necessary to control new infectious diseases such as coronavirus disease 2019 effectively. In this study, we developed a mobile app called Self-Symptom Checker (SSC) to monitor the health of inbound travelers. Methods: SSC was developed for general users and administrators. The functions of SSC include non-repudiation using QR (quick response) codes, monitoring fever and respiratory symptoms, and requiring persons showing symptoms to undergo polymerase chain reaction tests at nearby screening stations following a review of reported symptoms by the Korea Disease Control and Prevention Agency, as well as making phone calls, via artificial intelligence or public health personnel, to individuals who have not entered symptoms to provide the necessary information. Results: From February 12 to March 27, 2020, 165,000 people who were subjected to the special entry procedure installed SSC. The expected number of public health officers and related resources needed per day would be 800 if only the phone was used to perform symptom monitoring during the above period. Conclusion By applying SSC, more effective symptom monitoring was possible. The daily average number of health officers decreased to 100, or 13% of the initial estimate. SSC reduces the work burden on public healthcare personnel. SSC is an electronic solution conceived in response to health questionnaires completed by inbound travelers specified in the World Health Organization International Health Regulations as a requirement in the event of a pandemic.

With the class of 2000, the College of Medicine at Korea University instituted a revised curriculum. The new revision combined the traditional, and discipline-oriented, curriculums into a newly integrated curriculum. The purpose of this study is to identify the problems of the newly introduced integrated lectures, and how to find ways to improve this curriculum. Overloaded lecture hours and content, insufficient functional integration between disciplines, unstructured handout, deficiency in reference material and lack of motivation were identified as problems for students. Most of the participants urged a more effective collaboration between the faculty members of individual disciplines. Basic and clinical disciplines must be integrated as thoroughly as possible to improve and stabilize the new curriculum. Also, overall lecture time should be diminished, thereby allowing students to actively pursue their own learning.
Cooperative Behavior ; Curriculum ; Humans ; Korea* ; Learning ; Lectures* ; Motivation

BACKGROUND: Transforming growth factor (TGF)- has a large variety of biological functions, including the modulation of inflammation and the immune system, and is presumed to play important roles in repairing wounds and reducing scarring. The objective of this study is to examine the effects of TGF-1 on healing wounds and reducing scarring. We have also analysed the ability of the hemagglutinating virus of Japan (HVJ) liposome mediated antisense oligodeoxynucleotides (ODNs) to specifically inhibit wound-induced expressions of TGF-1 proteins and mRNA in the rat skin. METHODS: Skin wounds were created on the backs of 80 anesthetized rats. The first group of wounds, as the controls, was unmanipulated. The second group of wounds, as positive controls or an excessive scarring model, was injected with TGF-1 subcutaneously. The third group of wounds was injected with anti-TGF-1 antibody subcutaneously. The fourth group of wounds was injected with HVJ liposome mediated antisense ODNs for TGF-1 subcutaneously. The wounds of all groups were bisected and analysed histologically 5, 10, 15, 30, and 50 days after the wounds were made. RESULTS: All control wounds (TGF-1 or no injection) healed with scarring, whereas the wounds treated with the antibody or antisense ODNs healed with less scar formation compared to the control group. The wounds treated with the antibody or antisense ODNs had fewer macrophages, less collagen and fibronectin contents than the other wounds. Northern blotting and in situ hybridization analysis showed that wound sites treated with HVJ liposome mediated antisense ODNs for TGF-1 exhibited decreased levels of TGF-1 mRNA after injury. CONCLUSIONS: These findings suggest an important new approach to controlling scarring in normal wound healing, complementing the practice of adding exogenous growth factors to chronic wounds in the attempt to inhibit collagen deposition.
Animals ; Blotting, Northern ; Cicatrix* ; Collagen ; Complement System Proteins ; Fibronectins ; Genetic Therapy* ; Immune System ; In Situ Hybridization ; Inflammation ; Intercellular Signaling Peptides and Proteins ; Liposomes ; Macrophages ; Oligodeoxyribonucleotides ; Oligoribonucleotides ; Rats ; RNA, Messenger ; Sendai virus ; Skin ; Transforming Growth Factor beta ; Transforming Growth Factors ; Wound Healing ; Wounds and Injuries

BACKGROUND: OSCE was conducted to measure the immediate outcome of ICM. The measurement focused on basic clinical skills. METHODS: The subject of study was 115 third year medical students who took ICM course. The examination consisted of ten 5-minute stations with nine cases that represented commonly encountered problems in primary care. OSCE stations were duplicated into two sites. Therefore, same OSCE was performed six times in each sites. We evaluated the reliability of OSCE scores and compared the mean scores according to the examination sites and time sequences. Also, we got feedback from all participants by questionnaires. RESULTS: Mean of total OSCE score was 52.1. Cronbach alpha of total station was 0.559. For blood pressure check, lung physical examination, and neck mass physical examination station, there was a significant difference in mean scores as the time sequences(p<0.05). Both students and examiners evaluated the OSCE positively, and felt that OSCE was meaningful experience to prepare clinical skills. CONCLUSION: We can confirm that OSCE is a reasonable evaluation tool for ICM. However, further trials to develop the more reliable and valid examinations will be warranted.
Blood Pressure ; Clinical Competence ; Clinical Medicine* ; Humans ; Lung ; Neck ; Physical Examination ; Primary Health Care ; Students, Medical ; Surveys and Questionnaires

BACKGROUND: Preemptive analgesia may prevent nociceptive inputs generated during surgery from sensitizing central neurons and, therefore, may reduce post-operative pain. But, preemptive analgesia has been shown to decrease postinjury pain in animals, studies in human have provided controversial results. We studied whether intravenous morphine infusion before induction could affect post-operative pain and analgesic demands, when compared with intravenous morphine infusion after the closure of the peritoneum. METHODS: Female patients scheduled for total abdominal hysterectomy were randomly assigned to one of two groups of prospectively studied in a double-blind manner. Group I (n=23) and II (n=20) received intravenous morphine (0.1 mg/kg) before induction of anesthesia and after the closure of the peritoneum, respectively. Either group had continuous infusion of morphine (1.5 mg/hr) immediately after i.v. bolus morphine. Postoperative pain relief was provided with i.v. morphine from a PCA system (Medex Walkmed). Postoperative visual analogue pain scores (VAS), analgesics requirements and side effects were examined and compared between groups for 2 postoperative days. RESULTS: VAS were significantly less in group I (3.3+/-0.4) than in group II (5.3+/-0.5) 2hrs after surgery (p<0.01). Patient-cantrolled morphine cumulative consumption in group I was significantly less than in group II for 24hours (21.9 mg vs 35.3 mg) and 48hours (37.4 mg vs 55.0 mg) after operation (p<0.01). CONCLUSIONS: Preemptive analgesia with intravenous morphine reduces postoperative pain and analgesic requirements. Lower postoperative analgesic requirements in preemptive analgesic group indicate that intravenous morphine prevents development of injury-induced peripheral or central sensitization.
Analgesia* ; Analgesics ; Anesthesia ; Animals ; Central Nervous System Sensitization ; Female ; Humans ; Hysterectomy ; Morphine ; Neurons ; Pain, Postoperative ; Passive Cutaneous Anaphylaxis ; Peritoneum ; Prospective Studies

A retrospective study was conducted to evaluate the clinical outcomes of midtrimester emergency cervical cerclage in patients with painless cervical dilatation with/without prolapsed amniotic sac, including cases of no previous history of cervical incompetence. 10 patients including 1 twin pregnancy were teviewed for study, All had received emergency cervical cerclage with Macdonald operation or Shirodka operation at 18 to 31 weeksgestation. The procedures were carried out without serious complication except for one patient who had received re-operation 3 days after Macdonald operation because of re-protrusion of amniotic sae. The mean procedure to delivery internal was 8.9+/-5.3 (range 1 to 17) weeks. The mean gestational age at delivery was 32.4+/-5.6 (range 22 to 39+6) weeks for the entire group, 36.1+/-2.6 (range 32+4 to 39+6) weeks for the 6 who achived viability, and 27.6+/-5.0 (range 22 to 29+4) weeks for the 3 who died during the neonatal period. 1 died during gestation and was delivered at 33+6 weeksgestation. The mean birthweight was 2181.6+/-971.6 (range 498 to 3500)g for the entire group, and 2712.9+/- 571.5 (range 1860 to 3500)g for the 7 infants who lived until after neonatal period. The total survival rate for 11 babies was 64%. This study demonstrates that midtrimester emergency cervical cerclage for the patients who have dilated cervix with/without prolapsed amniotic sac is valuable method to try in the cases predicted they would lost the baby with conservative treatment only.
Cerclage, Cervical* ; Cervix Uteri* ; Dilatation* ; Emergencies* ; Female ; Gestational Age ; Humans ; Infant ; Labor Stage, First ; Pregnancy ; Pregnancy Trimester, Second ; Pregnancy, Twin ; Retrospective Studies ; Survival Rate

BACKGROUND: Currently, the incidence of chronic pancreatitis is increasing due to the change of diet and high alcohol consumption in our country. Regarding more effective treatment of chronic pancreatitis, surgical intervention is favored for the control of intractable pain, various complications from the pancreatitis, suspected malignancy, and amelioration of progressively deterioratory exocrine and endocrine pancreas functions. We attempted to evaluate the various indications for an operation, various surgical treatments, and their results. METHODS: We retrospectively reviewed the clinical records of 50 patients with chronic pancreatitis who were managed surgically between July 1989 and Feb. 1998. RESULTS: The indications for operation were intractable pain in 25 cases, suspected malignancy in 12 cases, biliary obstruction in 4 cases, pancreatic pseudocyst in 7 cases, and treatment of Diabetes Mellitus in 2 cases. We performed 11 drainage procedures, 8 Peustow-Gillesby operations and 3, DuVal operations 2 combined denervations, 28 pancreatic resections 12 pancreaticoduodenectomies, duodenum-preserving resection of the pancreas head 12, distal pancreatectomies, 3 total pancreatectomies and a combined denervation, 9 bypass procedures and 2 pancreas transplantations in 2 cases. The follow-up period were from 1 month to 9 years and 7 months with a mean of 2 years and 11 months. The results were good in 23 cases (51 .1%), fair in 16 cases (35.6%) and poor (no change or aggravation) in 6 cases (13.3%). Postoperative mortality developed in 1 case due to postoperative aspiration pneumonia and sepsis after the bypass procedures. Late mortality occurred in 2 cases, one due to sepsis from uncontrolled DM and the other is rupture of the pseudoaneurysm of the anastomotic vessel after transplantation. CONCLUSIONS: Surgical procedures are the mainstays of definite treatment modality in chronic pancreatitis. Operations should be selected properly for each case. Pancreas or islet transplantation is another treatment option for the control of irreversible exocrine and endocrine pancreatic dysfunction.
Alcohol Drinking ; Aneurysm, False ; Denervation ; Diabetes Mellitus ; Diet ; Drainage ; Follow-Up Studies ; Head ; Humans ; Incidence ; Islets of Langerhans ; Islets of Langerhans Transplantation ; Mortality ; Pain, Intractable ; Pancreas ; Pancreas Transplantation ; Pancreatectomy ; Pancreatic Pseudocyst ; Pancreaticoduodenectomy ; Pancreatitis ; Pancreatitis, Chronic* ; Pneumonia, Aspiration ; Retrospective Studies ; Rupture ; Sepsis

The relationship between the level of testosterone and the incidence of coronary heart disease is still controversial in the view of the results of clinical and epidemiologic studies. This uncertainty might be partly due to relatively small number of experimental studies undertaken to investigate the cellular mechanism underlying the vascular responses to testosterone. To further investigate the cellular mechanisms of testosterone with respect to vascular response, we investigated the effect of testosterone on contractility and intracellular Ca2+ regulation in a rabbit coronary artery and evaluated the underlying mechanism of testosterone-induced changes of coronary vascular tone by using various pharmacological blockers. Testosterone was found to relax rabbit coronary arteries in a dose-dependent manner, and no significant difference was found in the relaxation response to testosterone with or without endothelium. Similar results were obtained in male and non-pregnant female rabbit coronary arteries. The relaxation response of rabbit coronary arteries to testosterone was greater for PGF2alpha-contracted rings than for KCl contracted rings, which suggest the involvement of K+ channels. Furthermore, the relaxation response to testosterone was significantly reduced by 4-aminopyridine, a sensitive blocker of voltage dependent K+ channels, but not by low doses of tetraethylammonium or iberiotoxin, a Ca2+ activated K+ channel blocker. Testosterone simultaneously reduced the intracellular Ca2+ concentration ([Ca2+]i) and tension, and 4-AP effectively antagonized the testosterone-induced change of [Ca2+]i and tension. Therefore, it may be concluded that the stimulation of voltage dependent K channels is responsible, at least in part, for the testosterone-induced relaxation of rabbit coronary arteries.
Androgens/*pharmacology ; Animals ; Arteries/drug effects ; Calcium/*metabolism ; Coronary Vessels/*drug effects ; Female ; Intracellular Membranes/*metabolism ; Male ; Osmolar Concentration ; Potassium Channels, Voltage-Gated/drug effects/*metabolism ; Rabbits ; Support, Non-U.S. Gov't ; Testosterone/*pharmacology ; *Vasodilation

PURPOSE: Since 2000, the Korea University Medical College has conducted Comprehensive Basic Medical Sciences Examination as a summative test. Summative assessment must be dependable in that it meets the highest standards of reliability and validity. The purpose of this study were to examine the validity and reliability of Comprehensive Basic Medical Sciences Examination and to improve the quality of the examination. METHODS: The subject of this study was the examination materials and scores of the test. We conducted exploratory factor analysis to testify validity. Cronbach alpha coefficient was used to examine the reliability. RESULTS: Only one factor was extracted from exploratory factor analysis. Its eigen value was 4.61 and it explained 65.93% of total variance. We could infer the extracted factor as an ability of basic medical sciences knowledge. The reliability coefficient of the test was ranged from 0.45 to 0.74. Of the total 335 item, overall acceptable items were 206(58.0%); the range of difficulty was 0.21~1.00 and discriminative indices were higher than 0.20. CONCLUSION: We confirmed the Comprehensive Basic Medical Sciences Examination in 2000 met the relative highest standards of reliability and validity. Item analysis could be of help to improve the quality of examination
Korea ; Psychometrics* ; Reproducibility of Results