Purpose: This study aims to design that using formative assessment as an instructional strategy in real-time online classes, and to explore the application of Bloom’s taxonomy in the development of formative assessment items. Methods: We designed the instruction using formative assessment in real-time online classes, developed the items of formative assessment, analyzed the items statistically, and investigated students' perceptions of formative assessment through a survey. Results: It is designed to consist of 2–3 learning outcomes per hour of class and to conduct the formative assessment with 1–2 items after the lecture for each learning outcome. Formative assessment was 31 times in the physiology classes (total 48 hours) of three basic medicine integrated. There were nine “knowledge” items, 40 “comprehension” items, and 55 “application” items. There were 33 items (31.7%) with a correct rate of 80% or higher, which the instructor thought was appropriate. As a result of the survey on students’ perceptions of formative assessment, they answered that it was able to concentrate on the class and that it was helpful in achieving learning outcomes. Conclusion The students focused during class because they had to take formative assessment immediately after the learning outcome lecture. “Integration of lesson and assessments” was maximized by solving the assessment items as well as through the instructor’s immediate explanation of answers. Through formative assessment, the students were able to utilize metacognition by learning what content they understood or did not understand. Items that consider Bloom’s taxonomy allow students to remember, understand, and apply to clinical contexts.

Purpose: This study aims to design that using formative assessment as an instructional strategy in real-time online classes, and to explore the application of Bloom’s taxonomy in the development of formative assessment items. Methods: We designed the instruction using formative assessment in real-time online classes, developed the items of formative assessment, analyzed the items statistically, and investigated students' perceptions of formative assessment through a survey. Results: It is designed to consist of 2–3 learning outcomes per hour of class and to conduct the formative assessment with 1–2 items after the lecture for each learning outcome. Formative assessment was 31 times in the physiology classes (total 48 hours) of three basic medicine integrated. There were nine “knowledge” items, 40 “comprehension” items, and 55 “application” items. There were 33 items (31.7%) with a correct rate of 80% or higher, which the instructor thought was appropriate. As a result of the survey on students’ perceptions of formative assessment, they answered that it was able to concentrate on the class and that it was helpful in achieving learning outcomes. Conclusion The students focused during class because they had to take formative assessment immediately after the learning outcome lecture. “Integration of lesson and assessments” was maximized by solving the assessment items as well as through the instructor’s immediate explanation of answers. Through formative assessment, the students were able to utilize metacognition by learning what content they understood or did not understand. Items that consider Bloom’s taxonomy allow students to remember, understand, and apply to clinical contexts.

Purpose: This study aims to investigate how medical schools in Korea managed their academic affairs and student support in response to the coronavirus disease 2019 (COVID-19) pandemic and their plans for the post-COVID-19 era. Methods: An online survey was conducted, and a link to a questionnaire was distributed to all the administrators of the 40 medical schools in Korea. The final analysis data involved responses from 33 medical schools and 1,342 students. Frequency analysis, cross-tabulation analysis, Fisher’s exact test, and one-way analysis of variance were applied for statistical analysis. Results: Regarding instruction methods, most medical schools in Korea transitioned from in-person learning to video-on-demand learning (51.5%) and real-time online learning (42.4%). Among the school leaders, 36.4% planned to continue offering online classes combined with in-person classes beyond the end of the pandemic. Among the students, the online class concentration and participation score was 3.0 points or lower, but the class understanding score was 3.6 points, above a moderate level. Conclusion Students cited the shorter times needed to attend school and being able to take classes repeatedly as advantages of online classes, and over one-third of medical schools intended to continue with a hybrid of in-person and online learning even after the COVID-19 pandemic restrictions end.

Aggressive angiomyxomas (AAMs) are rare, benign, but locally aggressive, hypocellular soft tissue neoplasms found in the vulvovaginal region. AAMs are most commonly found in women in their reproductive years. Only about 150 cases of this rare, soft tissue tumor have been reported thus far, most of which are reported from the gynecologic, obstetric, urologic, and pathologic fields. AAMs are considered to be a slow-growing mesenchymal tumor with a locally infiltrative growth pattern. There are only two reports of metastasic disease. We have managed a case of AAM which occurred during adolescence and was pathologically-confirmed.
Adolescent ; Female ; Humans ; Myxoma ; Soft Tissue Neoplasms ; Vulva

Aggressive angiomyxomas (AAMs) are rare, benign, but locally aggressive, hypocellular soft tissue neoplasms found in the vulvovaginal region. AAMs are most commonly found in women in their reproductive years. Only about 150 cases of this rare, soft tissue tumor have been reported thus far, most of which are reported from the gynecologic, obstetric, urologic, and pathologic fields. AAMs are considered to be a slow-growing mesenchymal tumor with a locally infiltrative growth pattern. There are only two reports of metastasic disease. We have managed a case of AAM which occurred during adolescence and was pathologically-confirmed.
Adolescent ; Female ; Humans ; Myxoma ; Soft Tissue Neoplasms ; Vulva

BACKGROUND: Bacterial infections in diabetic patients are an important cause of increased morbidity and mortality. It has been reported that bacterial infections in diabetics showed more impaired PMN functions such as reduced PMN respiratory burst and decreased microbicidal activity in inflammed tissues. Also, apoptosis(programmed cell death) is postulated to be a key mechanism for neutrophil elimination. It is very important that PMN apoptosis keeps the balance from an area of inflammation. Actuallly, as little was known about PMN apoptosis and respiratory burst in diabetes, we investigated PMN apoptosis and hydrogen peroxide production after endotoxin exposure. METHODS: Peripheral venous blood samples were collected by routine venipuncture from healthy volunteers and diabetics to harvest neutrophils. We respectively measured the PMN apoptosis, the production of hydrogen peroxide, and the cell viability. RESULTS: Normal neutrophils showed a tendency to decreased apoptosis after endotoxin treatment. In patients with diabetes, PMN apoptosis was significantly decreased compared with healthy controls. In addition, the LPS-induced neutrophils in diabetics demonstrated more decreased apoptosis. However, the production of hydrogen peroxide was not different between groups. CONCLUSION: These observations suggest that the decreased PMN apoptosis in diabetics with endotoxin exposure may also affect the increased susceptibility and severity of infections.
Apoptosis* ; Bacterial Infections ; Cell Survival ; Healthy Volunteers ; Humans ; Hydrogen Peroxide ; Inflammation ; Mortality ; Neutrophils* ; Phlebotomy ; Respiratory Burst

The prediction of functional outcome in patients with acute cerebral infarction depends on many factors. Various techniques have been applied to predict severity and outcome after cerebral infarction. Neuron-specific enolase (NSE) is a component of a specific brain enzyme and a useful marker of brain injury. We evaluated the relation between initial serum NSE level and short- and long-term clinical outcome in 59 patients with acute cerebral infarction and in 38 age-matched healthy controls. Serum NSE levels were determined in patients with carotid artery (CA) territory cerebral infarction within 24 hours of onset. Brain MRI was performed four to seven days after stroke. Patients were divided into two groups: large CA territory infarction with a lesion extending cortex (cortex group), and small subcortical CA territory infarction (subcortical group) with a lesion confined to the subcortical white matter. We compared the initial serum NSE levels of the two groups. National Institute of Health Stroke Scale (NIHSS) was determined at admission and seven days after onset and the modified Rankin's scale was used at the 3 months follow-up after onset. Serum NSE levels were significantly elevated in patients with acute cerebral infarction compared with the normal controls (13.88 +/- 5.47 ng/dl vs. 8.15 +/- 1.53 ng/dl, p < 0.05). The initial ( < 24 h) serum NSE level was higher in the cortical group than in the subcortical group (16.68 +/- 5.70 ng/dl vs. 10.98 +/- 3.34 ng/dl, p < 0.05). NIHSS on admission and on the 7th day correlated with the initial serum NSE level (p < 0.05), as were more severe functional outcomes, as determined 3 months after onset (p < 0.05). This study shows that initial serum NSE level may be a useful marker for severity in acute ischemic stroke, and that it may be well correlated with short-term and long-term functional outcomes.
Acute Disease ; Aged ; Carotid Artery Diseases/*physiopathology ; Cerebral Infarction/*physiopathology ; Female ; Human ; Male ; Middle Age ; Phosphopyruvate Hydratase/*blood ; Severity of Illness Index

PURPOSE: This study was performed to determine the natural history of histologically confirmed IgA nephropathy in pediatric patients who presented with hematuria and proteinuria. PATIENTS AND METHODS: We reviewed the clinical course of 57 patients diagnosed with IgA nephropathy at the age of 15 years or younger from 1981 to 2000. All patients presented with hematuria or minimal proteinuria(<40 mg/m2/day) and had normal renal function and blood pressure at the time of renal biopsy. Based on the clinical and pathological findings at the time of diagnosis, we sought for complications of IgA nephropathy such as heavy proteinuria(> or =40 mg/m2/day), hypertension, and chronic renal failure. RESULTS: The mean age at presentation was 9.5+/-2.8 years(4 to 15 years) and 42(74%) were male. Isolated gross hematuria was observed in 20 patients(35%), microscopic hematuria in 3(5%), minimal proteinuria in 4(7%), both gross hematuria and minimal proteinuria in 15(26 %), and both microscopic hematuria and minimal proteinuria in 15(26%). During a median follow-up of 7.0+/-3.5 years, 38(67%) had complete resolution of hematuria and proteinuria, 12(21%) had persistently abnormal urinalysis without development of adverse events. Only 7(12%) developed adverse events:4(7%) developed severe proteinuria, 1(2%) became hypertensive, and 2(3%) developed impaired renal function. By univariate analysis using the chi-square test, the age at presentation(>10 years)(P<0.01) and poor histological classes of the Lee or Haas classification at onset(P<0.05) were significantly correlated with adverse events, whereas sex and clinical signs at onset were less concordant. CONCLUSION: We can conclude that the prognosis of IgA nephropathy diagnosed in early childhood is better and a good correlation exists between the clinical manifestations of this disease and the histological classes.
Biopsy ; Blood Pressure ; Child* ; Classification ; Diagnosis ; Follow-Up Studies ; Glomerulonephritis, IGA* ; Hematuria ; Humans ; Hypertension ; Immunoglobulin A* ; Kidney Failure, Chronic ; Male ; Natural History ; Prognosis* ; Proteinuria ; Urinalysis

BACKGROUND: Dystrophin deficient muscular dystrophies (dystrophinopathies) are the most common form of muscular dystrophy with variable clinical phenotypes from the severe Duchenne to the milder Becker forms (DMD/BMD). Dystrophinopathies are X-linked recessive diseases caused by the mutation of the dystrophin gene. Western blot and immunohistochemical staining for dystrophin, and exon deletion analysis by multiplex polymerase chain reaction (PCR) are important diagnostic tools. We investigated the relationship between the clinical characteristics, immunohistochemistry for dystrophin, and the pattern of exon deletions in patients with dystrophinopathy. METHODS: We reviewed the clinical and laboratory findings of 35 male patients diagnosed as DMD/BMD. Genomic DNA of the 35 patient was analyzed by multiplex PCR using 19 primer sets of dystrophin gene. Immunohistochemistry for dystrophin of muscle biopsy tissue was performed in all cases. RESULTS: The mean age of symptom onset in 35 patients was 4.6 +/- 2.7 years [range, 2-15 years]. Twenty-four of 35 (68.6%) patients showed complete loss (C-, Rod-, N terminal), and 11 of 35 (31.4%) patient showed incomplete loss of dystrophin in immunohistochemistry. Of the 35 patients, 20 had deletions (57%) by multiplex PCR analysis. Sixteen of 20 patients (80%) had exon deletions between exon 45 and 52. CONCLUSIONS: Immunohistochemistry of biopsied muscle specimen is an important diagnostic method for expression and localization of dystrophin. The exon deletion analysis by multiplex PCR using peripheral blood is also a simple and useful test for the diagnosis of dystrophinopathies, although it has limited sensitivity.
Biopsy ; Blotting, Western ; Diagnosis ; DNA ; Dystrophin ; Exons ; Humans ; Immunohistochemistry ; Male ; Multiplex Polymerase Chain Reaction ; Muscular Dystrophies ; Phenotype

BACKGROUND: Due to the anatomical nature of the radial nerve, dissection and attainment of an adequate operative field in mid to distal humerus fracture is dangerous and limited. We devised a combined anterolateral and lateral approach that ensures protection of the radial nerve. This is achieved by performing bimodal dissection of the proximal humerus anteriorly and the distal humerus laterally. METHODS: Thirty-five consecutive patients were treated using a combined anterolateral and lateral approach for a minimum follow-up period of 24 months. We analyzed time to bony union, time to return to daily work, range of motion, elbow joint function as assessed by the Mayo elbow performance index and complications. RESULTS: Radiologic bony union was observed at 11.2 weeks (range, 8 to 20 weeks) on average. Four cases of incomplete radial nerve palsy before surgery all recovered. Time to return to work was 10.2 weeks (range, 2 to 32 weeks) on average. The average range of motion of the elbow was 3.3degrees (range, 0degrees to 10degrees) of extension and 135.9degrees (range, 125degrees to 145degrees) of flexion. There were 21 cases of excellent and 13 cases of good or better recovery, comprising over 97.1% on the Mayo elbow performance index. There were no complications of radial nerve palsy, non-union, mal-union, or infection. CONCLUSIONS: Our a modified combined anterolateral and lateral approach is a clinically effective surgical method of achieving protection of the radial nerve and securing easy and firm internal fixation.
Adolescent ; Adult ; Aged ; Female ; Humans ; Humeral Fractures/radiography/*surgery ; Male ; Middle Aged ; Orthopedic Fixation Devices ; Orthopedic Procedures/adverse effects/instrumentation/*methods ; Pain, Postoperative ; Prospective Studies ; Range of Motion, Articular ; Return to Work ; Treatment Outcome