Purpose: Since 2004, the Korea Institute of Medical Education and Evaluation has been responsible for the evaluation and accreditation of medical schools in Korea. The 2nd cycle of evaluations was conducted from 2007 to 2011. The present study aimed at testing the goodness of fit of the items used in the 2nd cycle of evaluation and accreditation based on the Rasch model. Methods: Dichotomous data on 40 medical schools were analyzed using Winsteps, a tool based on the Rasch model that includes goodness-of-fit testing. Results: Two of the 109 items had an outfit mean square exceeding 2.0. The other 107 items showed a goodness of fit in the acceptable range for the outfit mean square. All items were in the acceptable range in terms of the infit mean square. Furthermore, 1 school had an outfit mean square exceeding 2.0, while all schools were in the acceptable range for the infit mean square. An outfit mean square value over 2.0 means that an item is a outlier. Therefore, 2 items showed an extreme response relative to the overall response. Meanwhile, the finding of an outfit mean square over 2.0 for 1 school means that it showed extraordinary responses to specific items, despite its excellent overall competency. Conclusion The goodness of fit of the items used for evaluation and accreditation by the Korea Institute of Medical Education and Evaluation should be checked so that they can be revised appropriately. Furthermore, the outlier school should be investigated to determine why it showed such an inappropriate goodness of fit.

The aim of our study is to achieve complete periodontal tissue regeneration by the application of BMP and resorbable membrane. Three beagle dogs aged over one and half years and weighed 14 to 16 kg were used in this study. Mandibular 1st, 2nd premolars were extracted bilaterally. Horizontal furcation defects were induced around 3rd, 4th premolars bilaterally. BMP-4 were applied in the right side with resorbable membranes and only resorbable membranes were applied in the left side respectively. Each animal was sacrificed at 2, 4, and 8weeks, after regenerative surgery. Specimens were prepared with Hematoxylin-Eosin stain and Goldner's modified Masson Trichrome stain for light microscopic evaluation. The results were as follows: 1. At 2 weeks after regenerative surgery, downgrowth of junctional epithelium was observed both in the membrane-applied site and BMP-4-and-membrane-applied site. 2. At 4 weeks after regenerative surgery, resorbable membranes were completely resolved, therefore would not prevent downgrowth of junctional epithelium. New bone formation, new cementum formation and Sharpey's fiber were observed in BMP-4-and-membrane-applied site. 3. At 8 weeks after regenerative surgery, downgrowth of junctional epithelium was observed in the membrane-applied site. But, new cementum formation was observed in the same site. The extensive regeneration of new bone, new cementum and remarkable formation of Shapey's fiber were showed in BMP-4-and-membrane-applied site. 4. Resorbable membranes were resolved via the cell-mediated processes. 5. Periodontal tissue regeneration were better achieved in the BMP-4-and-membrane-applied site than in the membrane-applied site. Within the above results, BMP-4 may have the strong capability to form the new bone and resorbable membrane may be able to prevent the bony ankylosis. However, resolution rate of resorbable membrane may not be enough to protect rapid epithelial downgrowth for ideal periodontal regeneration. In conclusion, I suggest BMP-4 may have the strong possibility to be utilized in the clinical periodontal treatments.
Animals ; Ankylosis ; Bicuspid ; Dental Cementum ; Dogs ; Epithelial Attachment ; Furcation Defects ; Membranes* ; Osteogenesis ; Regeneration*

The earliest reports of the use of electrical energy to directly stimulate bone healing seem to be in 1853 from England, the techniques involved the introduction of direct current into the non-united fracture site percutaneously via metallic needles, with subsequent healing of the defect. One endpoint of the periodontal therapy is to generate structure lost by periodontal diseases. Several procedural advances may support regeneration of attachment, however, regeneration of alveolar bone does not occur consistently. Therefore, factors which stimulate bone repair are areas for research in periodontal reconstructive therapy. Effects of cytokines or growth factors on bone repair are examples of such areas. Another one is electrical current which occurs in bone naturally, so that such bone may be particularly susceptible to electrical therapy. The purposes of this study were to observe the effects of electrical stimulation on the normal periodontium, to determine whether the electricity is the useful means for periodontal regeneration or not. Forty rats weighted about 100 gram were used and divided into 4 groups, the first group, there was no electrical stimulation with the connection of electrodes only. In the second group, there was stimulated by the 10 mA during 10 minutes per a day, in the third group was stimulated by the 25 mA , and the fourth by the 50 mA. At 3, 5, 10 and 15 days post-appliance , two rats in each group were serially sacrificed. and the maxillae and the mandible processed to paraffin, and the specimens were prepared with Hematoxylin-Eosin stain for the light microscopic evaluation. The results of this study were as follows : 1. There was the distinct reversal line on the lingual alveolar crest, whereas a little changes in the labial alveolar crest to the duration and amount of currents. 2. In 50 mA group, the cells were highly concentrated at the apex of anterior teeth, and was observed the necrotic tissue. In posterior root apex, the hypercementosis was appeared, and newly formed cementum layer has been increased continuously with the time. 3. The periodontal ligament fiber and Sharpey's fiber were arranged in order, and the bone trabeculae were increased as the experiment proceeded by, relatively the bone marrows were decreased. 4. In the pulp tissue, the blood vessels were increased with blood congestion in the experimetal specimens remarkably, and the dentinal tubules were obstructed . 5. The osteoblasts in alveolar bone proper had been showed highly activity, and also observed the formation of bone trabeculea. In the conclusion, it was suggested that the electrical stimulation has influence on the periodontium and the pulp tissue. However, there might be the injurious effects.
Animals ; Blood Vessels ; Bone Marrow ; Cytokines ; Dental Cementum ; Dentin ; Electric Stimulation* ; Electricity ; Electrodes ; England ; Estrogens, Conjugated (USP) ; Hypercementosis ; Intercellular Signaling Peptides and Proteins ; Mandible ; Maxilla ; Needles ; Osteoblasts ; Osteogenesis ; Paraffin ; Periodontal Diseases ; Periodontal Ligament ; Periodontium* ; Rats ; Regeneration ; Tooth

Purpose: This study aimed to investigate the differences in the perception between professors and students regarding medical educators’ roles and discuss their desirable roles. Methods: A survey was administered to 116 professors and 379 students of the medical colleges from Dankook University and Hallym University. The subjects were given a self-created questionnaire designed to measure their perception of medical educators’ roles. Results: First, “student performance management” for professors and “teaching skill development” for students were recognized as the most essential medical educators’ role. Second, females students perceived the roles to be more important than males in eight of 10 roles. Conclusion First, “student performance management” for professors and “teaching skill development” for students were recognized as the most essential medical educators’ role. Second, females students perceived the roles to be more important than males in eight of 10 roles.

Lumbar hernia is a rare surgical entity without a standard method of repair. With advancements in laparoscopic techniques, successful lumbar herniorrhaphy can be achieved by the creation of a completely extraperitoneal working space and secure fixation of a wide posterior mesh. We present a total extraperitoneal laparoendoscopic repair of lumbar hernia, which allowed for minimal invasiveness while providing excellent anatomical identification, easy mobilization of contents and wide secure mesh fixation. A total extraperitoneal method of lumbar hernia repair by laparoscopic approach is feasible and may be an ideal option.
Hernia ; Herniorrhaphy

PURPOSE: Open cholecystectomy is preferred to a laparoscopic approach in elderly patients with gallstones, because acute inflammation is more frequent in this age group than in younger patients. However, the surgical morbidity and mortality of an open cholecystectomy are known to be higher than for a laparoscopic cholecystectomy. The aim of this study was to analyze the outcome of laparoscopic cholecystectomy in elderly patients, and to assess its safety and feasibility. METHODS: 289 laparoscopic cholecystectomy cases were enrolled with regard to their clinical parameters. There were 49 patients older and 240 younger than 70 years of age; Groups A and B, respectively. RESULTS: There were no demographic differences between the two groups. The preoperative presentation of acute cholecystitis was higher in Group A (53.1 versus 37.1%, p< 0.05). The average times interval from the initial symptoms to the operation were 36.3 and 50.2 days in Groups A and B, respectively. The rate of combined choledocholithiasis was higher in Group A (20.4 versus 9.2%, p< 0.05). The average operation time was similar in both groups (83.7+/-29.5 versus 83.0+/-29.3minute). The conversion rate from a laparoscopic to an open cholecystectomy was higher in group A (8.2% versus 2.9%, p=0.08). There were no differences in hospital stays and postoperative complications between the two groups. CONCLUSION: From this study, a laparoscopic cholecystectomy is suggested as a safe and effective treatment in elderly patients. Therefore, a laparoscopic cholecystectomy should be initially and actively performed, rather than an open cholecystectomy in elderly patients.
Aged* ; Cholecystectomy ; Cholecystectomy, Laparoscopic* ; Cholecystitis, Acute ; Choledocholithiasis ; Gallstones ; Humans ; Inflammation ; Length of Stay ; Mortality ; Postoperative Complications

PURPOSE: Since pathophysiologic evidence has been raised to suggest that obesity could facilitate an allergic reaction, obesity has been known as an independent risk factor for allergic disease such as asthma. However, the relationship between sedentary behavior and lifestyle which could lead to obesity, and those allergic diseases remains unclear. MATERIALS AND METHODS: We analyzed the relations between physical activity, including sitting time for study, sitting time for leisure and sleep time, and obesity, asthma, allergic rhinitis, and atopic dermatitis using the Korea Youth Risk Behavior Web-based Survey, which was conducted in 2013. Total 53769 adolescent participants (12 through 18 years old) were analyzed using simple and multiple logistic regression analyses with complex sampling. RESULTS: Longer sitting time for study and short sitting time for leisure were associated with allergic rhinitis. High physical activity and short sleep time were associated with asthma, allergic rhinitis, and atopic dermatitis. Underweight was negatively associated with atopic dermatitis, whereas overweight was positively correlated with allergic rhinitis and atopic dermatitis. CONCLUSION: High physical activity, and short sleep time were associated with asthma, allergic rhinitis, and atopic dermatitis.
Adolescent* ; Asthma* ; Dermatitis, Atopic* ; Humans ; Hypersensitivity ; Korea ; Leisure Activities ; Life Style ; Logistic Models ; Motor Activity* ; Obesity* ; Overweight ; Rhinitis, Allergic* ; Risk Factors ; Risk-Taking ; Sedentary Lifestyle ; Thinness

6 beagle dogs aged over one and half years and weighed 14 to 16 Kg were utilized in this study. Horizontal furcation defects were induced around 2nd, 3rd, and 4th premolars bilaterally. PDGF-BB in conjunction with EGF and PDGF-BB only were applied in the right and left premolars respectively. 2 animals were sacrificed at 4weeks, 8 weeks, and 12 weeks, after regenerative surgery respectively. Semi-thin sections using glass-knife were stained with toluidine blue for light microscopic study. The results were as follows: 1. At 4 weeks after regenerative surgery, bone formation in the PDGF-BB-applied site was thriving, but bone formation in the PDGF-BB-and-EGF-applied site was depressed. 2. Bony ankylosis was surely shown along the whole exposed root surface applied with PDGFBB, but it was shown at the root surface near the base of the bone defect where was applied with PDGF-BB in conjunction with EGF. 3. Active bone formation was made from 8 weeks after regenerative surgery in the PDGFBB-and-EGF-applied site. 4. Bone maturity as well as speed of bone formation in the PDGF-BB-applied site was superior to those in the PDGF-BB-and-EGF-applied site throughout the whole experimental period. Within the above results, PDGF-BB had the strong capability to form the new bone and EGF was not able to prevent the bony ankylosis thoroughly. However, EGF may have the possibility to prevent the bony ankylosis through the suppression of bone formation.
Animals ; Ankylosis ; Bicuspid ; Dogs ; Epidermal Growth Factor* ; Furcation Defects ; Osteogenesis ; Platelet-Derived Growth Factor* ; Regeneration* ; Tolonium Chloride

This study was performed to evaluate the effect of mixed culture of rat's calvaria cells and periodontal ligament cells on calcification. These cells have been known to do important role on the periodontal tissue regeneration, especially alveolar bone and cementum. Experimental groups were made which based on the different rate of rat's calvaria cells and periodontal ligament cells, and then these cells were cultured with Dulbecco's Modified Eagle's Medium contained with 10% fetal bovine serum, 50microgram/ml ascorbic acid, and 10mM/ ml Na-beta-glycerophosphate. Each group was characterized by examining the cell proliferation rate, amount of total protein synthesis, alkaline phosphatase activity, and the number of calcified nodules in vitro. In cell proliferation rate , the cells of control groups were cultured Dulbecco's Modified Eagle's Medium contained with 10 % fetal bovine serum. The results were as follows ; 1. The cell proliferation rate in control groups decreased stastically significantly along with the decrease of the rate of bone cells at 7 day and 20 day(P < 0.01). 2. The cell proliferation rate in experimental groups decreased stastically significantly along with decrease of the rate of bone cells at 3 day and 14 day(P < 0.01). 3. The amount of total protein synthesis was significantly decreased along with decrease of the rate of bone cells at 3 day and 6 day(P < 0.01). 4. Alkaline phosphatase activity showed reverse time dependent pattern and was significantly decreased along with decrease of the rate of bone cells during the experimental periods (P < 0.01). 5. Calcified nodules were observed in group 1 (Rat calvaria cells alone) for the first time, and the number of calcified nodule decreased stastically significantly along with the decrease of the rate of bone cells at 12 day(P < 0.01). From the above results, When bone cells and periodontal ligament cells were mixed cultured, the cell proliferation rate was mostly dependent on the actual rate of bone cells and same pattern was showed in amount of total protein synthesis, alkalinephosphatase activity, and the number of calcified nodules. And the calcified nodule forming capacity of bone cells was inhibited by periodontal ligament cells
Alkaline Phosphatase ; Animals ; Ascorbic Acid ; Cell Proliferation ; Dental Cementum ; Periodontal Ligament* ; Rats* ; Regeneration ; Skull*

Dieulafoy's lesions are often unrecognized cause of obscure, massive gastrointestinal bleeding, reported to be 0.3~1.5% of cases of major gastrointestinal bleeding. It is characterized by severe bleeding from rupture of an exposed submucosal artery. Dieulafoy's lesion is usually occured in the lesser curvature of the stomach within 6 cm of the gastroesophageal junction. Similar lesions have also been described in the esophagus, duodenum, small intestine, colon, and rectum. The diagnosis is made by endoscopy, angiography, laparoscopy, or laparotomy. Endoscopy showed protruding and eroded artery with pulsatile bleeding or adherent thrombus. Currently, various therapeutic options are available to the endoscopist for the treatment of Dieulafoy's lesions. Therapeutic endoscopy should now become first-line therapy for Dieulafoy's lesions. We experienced a rare case of bleeding from the duodenal Dieulafoy's lesion. Endoscopic hemoclipping was performed successfully. We report this case with a review of the literature.
Angiography ; Arteries ; Colon ; Cytochrome P-450 CYP1A1 ; Diagnosis ; Duodenum ; Endoscopy ; Esophagogastric Junction ; Esophagus ; Hemorrhage* ; Intestine, Small ; Laparoscopy ; Laparotomy ; Rectum ; Rupture ; Stomach ; Thrombosis