Background: Respiratory syncytial virus (RSV) prophylaxis using palivizumab effectively reduces RSV-associated morbidity in preterm infants. In Korea, national insurance coverage for palivizumab was implemented in October 2016 for moderate-to-late preterm (MLPT) infants born during the RSV season (October-March) who have older siblings. However, no large-scale studies have investigated the changes in the incidence and risk of severe acute lower respiratory infections (ALRIs) after insurance coverage implementation for MLPT infants. Methods: This large-scale retrospective cohort study used data from the Korean National Health Insurance Service between October 2013 and December 2019. MLPT infants (32 0/7– 35 6/7 weeks of gestation) with older siblings were stratified into pre-insurance period (PIP;October 2013–September 2016) and insurance period (IP; October 2016–March 2019) groups based on the date of birth with respect to initial insurance palivizumab implementation.Severe ALRI outcomes (hospitalization, respiratory support, and intensive care unit admission) were evaluated up to 1 year of age using multivariable logistic regression models. Results: Of the 11,722 MLPT infants included in the study, 6,716 and 5,006 infants were included in the IP and PIP groups, respectively. The incidences of ALRI-hospitalization and ALRI-respiratory support were significantly lower in the IP group than that in PIP group (24.0% vs. 26.0% and 3.1% vs. 4.0%, respectively). Additionally, ALRI-respiratory support risk was significantly lower in the IP group (adjusted odds ratio 0.771, 95% confidence interval 0.626–0.949, P = 0.014) than that in the PIP group. Among infants born during the RSV season, the risk of ALRI-hospitalization and ALRI-respiratory support were significantly lower in the IP group than that in the PIP group. However, no significant differences were observed between the IP and PIP groups for infants born during the non-RSV season. Conclusion The risks of severe ALRI outcomes decreased in Korea following the 2016 insurance implementation of palivizumab prophylaxis for MLPT infants born during the RSV season with older siblings.

Background: Respiratory syncytial virus (RSV) prophylaxis using palivizumab effectively reduces RSV-associated morbidity in preterm infants. In Korea, national insurance coverage for palivizumab was implemented in October 2016 for moderate-to-late preterm (MLPT) infants born during the RSV season (October-March) who have older siblings. However, no large-scale studies have investigated the changes in the incidence and risk of severe acute lower respiratory infections (ALRIs) after insurance coverage implementation for MLPT infants. Methods: This large-scale retrospective cohort study used data from the Korean National Health Insurance Service between October 2013 and December 2019. MLPT infants (32 0/7– 35 6/7 weeks of gestation) with older siblings were stratified into pre-insurance period (PIP;October 2013–September 2016) and insurance period (IP; October 2016–March 2019) groups based on the date of birth with respect to initial insurance palivizumab implementation.Severe ALRI outcomes (hospitalization, respiratory support, and intensive care unit admission) were evaluated up to 1 year of age using multivariable logistic regression models. Results: Of the 11,722 MLPT infants included in the study, 6,716 and 5,006 infants were included in the IP and PIP groups, respectively. The incidences of ALRI-hospitalization and ALRI-respiratory support were significantly lower in the IP group than that in PIP group (24.0% vs. 26.0% and 3.1% vs. 4.0%, respectively). Additionally, ALRI-respiratory support risk was significantly lower in the IP group (adjusted odds ratio 0.771, 95% confidence interval 0.626–0.949, P = 0.014) than that in the PIP group. Among infants born during the RSV season, the risk of ALRI-hospitalization and ALRI-respiratory support were significantly lower in the IP group than that in the PIP group. However, no significant differences were observed between the IP and PIP groups for infants born during the non-RSV season. Conclusion The risks of severe ALRI outcomes decreased in Korea following the 2016 insurance implementation of palivizumab prophylaxis for MLPT infants born during the RSV season with older siblings.

Background: Respiratory syncytial virus (RSV) prophylaxis using palivizumab effectively reduces RSV-associated morbidity in preterm infants. In Korea, national insurance coverage for palivizumab was implemented in October 2016 for moderate-to-late preterm (MLPT) infants born during the RSV season (October-March) who have older siblings. However, no large-scale studies have investigated the changes in the incidence and risk of severe acute lower respiratory infections (ALRIs) after insurance coverage implementation for MLPT infants. Methods: This large-scale retrospective cohort study used data from the Korean National Health Insurance Service between October 2013 and December 2019. MLPT infants (32 0/7– 35 6/7 weeks of gestation) with older siblings were stratified into pre-insurance period (PIP;October 2013–September 2016) and insurance period (IP; October 2016–March 2019) groups based on the date of birth with respect to initial insurance palivizumab implementation.Severe ALRI outcomes (hospitalization, respiratory support, and intensive care unit admission) were evaluated up to 1 year of age using multivariable logistic regression models. Results: Of the 11,722 MLPT infants included in the study, 6,716 and 5,006 infants were included in the IP and PIP groups, respectively. The incidences of ALRI-hospitalization and ALRI-respiratory support were significantly lower in the IP group than that in PIP group (24.0% vs. 26.0% and 3.1% vs. 4.0%, respectively). Additionally, ALRI-respiratory support risk was significantly lower in the IP group (adjusted odds ratio 0.771, 95% confidence interval 0.626–0.949, P = 0.014) than that in the PIP group. Among infants born during the RSV season, the risk of ALRI-hospitalization and ALRI-respiratory support were significantly lower in the IP group than that in the PIP group. However, no significant differences were observed between the IP and PIP groups for infants born during the non-RSV season. Conclusion The risks of severe ALRI outcomes decreased in Korea following the 2016 insurance implementation of palivizumab prophylaxis for MLPT infants born during the RSV season with older siblings.

Background: Respiratory syncytial virus (RSV) prophylaxis using palivizumab effectively reduces RSV-associated morbidity in preterm infants. In Korea, national insurance coverage for palivizumab was implemented in October 2016 for moderate-to-late preterm (MLPT) infants born during the RSV season (October-March) who have older siblings. However, no large-scale studies have investigated the changes in the incidence and risk of severe acute lower respiratory infections (ALRIs) after insurance coverage implementation for MLPT infants. Methods: This large-scale retrospective cohort study used data from the Korean National Health Insurance Service between October 2013 and December 2019. MLPT infants (32 0/7– 35 6/7 weeks of gestation) with older siblings were stratified into pre-insurance period (PIP;October 2013–September 2016) and insurance period (IP; October 2016–March 2019) groups based on the date of birth with respect to initial insurance palivizumab implementation.Severe ALRI outcomes (hospitalization, respiratory support, and intensive care unit admission) were evaluated up to 1 year of age using multivariable logistic regression models. Results: Of the 11,722 MLPT infants included in the study, 6,716 and 5,006 infants were included in the IP and PIP groups, respectively. The incidences of ALRI-hospitalization and ALRI-respiratory support were significantly lower in the IP group than that in PIP group (24.0% vs. 26.0% and 3.1% vs. 4.0%, respectively). Additionally, ALRI-respiratory support risk was significantly lower in the IP group (adjusted odds ratio 0.771, 95% confidence interval 0.626–0.949, P = 0.014) than that in the PIP group. Among infants born during the RSV season, the risk of ALRI-hospitalization and ALRI-respiratory support were significantly lower in the IP group than that in the PIP group. However, no significant differences were observed between the IP and PIP groups for infants born during the non-RSV season. Conclusion The risks of severe ALRI outcomes decreased in Korea following the 2016 insurance implementation of palivizumab prophylaxis for MLPT infants born during the RSV season with older siblings.

PURPOSE: A task force identified 4 core properties of motivation-related improvement and developed a medical volunteer program for 63 medical freshmen in 2012. Three overarching topics were examined: What were the contents of the program? Did students' motivation improve? Were the students satisfied with the course? Pretest and posttest motivation levels and program evaluation forms were analyzed. METHODS: We organized a series of committee meetings and identified 4 core factors of motivation. The program was conducted for 63 medical freshmen in March 2012. The program evaluation form was analyzed using SPSS 17.0. RESULTS: The core factors of motivation were interest in medical studies, volunteer-mindedness, medical humanities, and self-management. The program was composed of lectures, medical volunteer hours, and program evaluation and feedback sessions. Students' motivation differed significantly with regard to interest in medical studies (t=-2.40, p=0.020) and volunteer-mindedness (t=-3.45, p=0.001). Ninety percent of students were satisfied with the program, 67.8% of students were satisfied with the medical volunteer activity, and the feedback session of the program was meaningful (66.1%). CONCLUSION: The medical volunteer program, held in the first month of the medical education year, was meaningful, but the reasons for dissatisfaction with the program should be examined. We should also develop a system that has lasting beneficial effects on academic achievement and career selection.
Achievement ; Advisory Committees ; Education, Medical ; Humanities ; Humans ; Lectures ; Motivation ; Program Evaluation ; Self Care ; Students, Medical

Purpose: This study investigated the changes in gene expression in retinal ganglion cells (RGCs) following ciliary neurotrophic factor (CNTF) treatment to elucidate the underlying mechanisms contributing to its neuroprotective effects. Methods: RGCs isolated from Sprague-Dawley rat pups were treated with recombinant CNTF. Gene expression was analyzed via microarray. Differentially expressed genes (DEGs) were defined as those with a fold change greater than 2 or less than –2. The DEGs were further explored using Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses. Results: Our analysis identified 71 upregulated and 58 downregulated genes. A2m exhibited the highest increase, with a fold change of 4.97, whereas Rho displayed the most significant decrease in expression, with a fold change of –6.38. GO and KEGG pathway analyses revealed substantial involvement in sensory organ development and the phototransduction pathway. Conclusions This study provides new insights into the impact of CNTF on gene expression in RGCs, suggesting broader neuroprotective mechanisms that could inform future therapeutic strategies for retinal degenerative diseases. Our findings emphasize the importance of further investigation into the complex gene network responses to CNTF treatment.

Background: The management of distal radius fractures (DRFs) has evolved with the introduction of volar locking plate (VLP) fixation.Nevertheless, despite the low occurrence rates, reduction loss following VLP fixation has been reported in several studies. Our objective was to determine the incidence and features of reduction loss in patients despite the appropriate application of VLP fixation for DRF. Methods: This retrospective study was conducted between March 2017 and August 2023, during which a single hand surgeon performed VLP procedures for DRFs. This study included 379 patients (382 wrists) including 3 patients who underwent bilateral surgery. We identified patients who experienced reduction loss after VLP fixation (group 1) and patients without stability problems (group 2) and compared the 2 groups. Results: The mean age of the patients was 63.5 years, with a standard deviation of 13.8. There were 90 male patients (23.6%) and 289 female patients (75.7%). We identified 14 cases of DRFs, in which reduction loss occurred even after VLP fixation during the follow-up period (group 1, 3.7%). The remaining DRFs were assigned to group 2 (n=368, 96.3%). Among the 14 patients, 7 cases of screw breakage were identified as causing the loss of fracture reduction. As the joint surface collapsed and sank down to the distal row locking screw, 4 cases presented with distal locking screws penetrating into the radiocarpal joint. There were no significant differences between the 2 groups in terms of sex, weight, fracture arm direction, and Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association (AO/OTA) fracture classification. However, patients in group 1 were statistically significantly older than those in group 2 (average age, 77.5 years vs. 62 years). Among 4 patients experiencing distal screw violation of the radiocarpal joints, 3 underwent partial or complete screw removal immediately after fracture consolidation or union. Conclusions While rare, reduction loss remains a potential complication following VLP fixation, especially in elderly patients with intra-articular DRFs. However, with diligent monitoring and timely intervention, such as implant removal if necessary, acceptable outcomes can still be attained.

Purpose: This study investigated the changes in gene expression in retinal ganglion cells (RGCs) following ciliary neurotrophic factor (CNTF) treatment to elucidate the underlying mechanisms contributing to its neuroprotective effects. Methods: RGCs isolated from Sprague-Dawley rat pups were treated with recombinant CNTF. Gene expression was analyzed via microarray. Differentially expressed genes (DEGs) were defined as those with a fold change greater than 2 or less than –2. The DEGs were further explored using Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses. Results: Our analysis identified 71 upregulated and 58 downregulated genes. A2m exhibited the highest increase, with a fold change of 4.97, whereas Rho displayed the most significant decrease in expression, with a fold change of –6.38. GO and KEGG pathway analyses revealed substantial involvement in sensory organ development and the phototransduction pathway. Conclusions This study provides new insights into the impact of CNTF on gene expression in RGCs, suggesting broader neuroprotective mechanisms that could inform future therapeutic strategies for retinal degenerative diseases. Our findings emphasize the importance of further investigation into the complex gene network responses to CNTF treatment.

Purpose: This study investigated the changes in gene expression in retinal ganglion cells (RGCs) following ciliary neurotrophic factor (CNTF) treatment to elucidate the underlying mechanisms contributing to its neuroprotective effects. Methods: RGCs isolated from Sprague-Dawley rat pups were treated with recombinant CNTF. Gene expression was analyzed via microarray. Differentially expressed genes (DEGs) were defined as those with a fold change greater than 2 or less than –2. The DEGs were further explored using Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses. Results: Our analysis identified 71 upregulated and 58 downregulated genes. A2m exhibited the highest increase, with a fold change of 4.97, whereas Rho displayed the most significant decrease in expression, with a fold change of –6.38. GO and KEGG pathway analyses revealed substantial involvement in sensory organ development and the phototransduction pathway. Conclusions This study provides new insights into the impact of CNTF on gene expression in RGCs, suggesting broader neuroprotective mechanisms that could inform future therapeutic strategies for retinal degenerative diseases. Our findings emphasize the importance of further investigation into the complex gene network responses to CNTF treatment.

Background: The management of distal radius fractures (DRFs) has evolved with the introduction of volar locking plate (VLP) fixation.Nevertheless, despite the low occurrence rates, reduction loss following VLP fixation has been reported in several studies. Our objective was to determine the incidence and features of reduction loss in patients despite the appropriate application of VLP fixation for DRF. Methods: This retrospective study was conducted between March 2017 and August 2023, during which a single hand surgeon performed VLP procedures for DRFs. This study included 379 patients (382 wrists) including 3 patients who underwent bilateral surgery. We identified patients who experienced reduction loss after VLP fixation (group 1) and patients without stability problems (group 2) and compared the 2 groups. Results: The mean age of the patients was 63.5 years, with a standard deviation of 13.8. There were 90 male patients (23.6%) and 289 female patients (75.7%). We identified 14 cases of DRFs, in which reduction loss occurred even after VLP fixation during the follow-up period (group 1, 3.7%). The remaining DRFs were assigned to group 2 (n=368, 96.3%). Among the 14 patients, 7 cases of screw breakage were identified as causing the loss of fracture reduction. As the joint surface collapsed and sank down to the distal row locking screw, 4 cases presented with distal locking screws penetrating into the radiocarpal joint. There were no significant differences between the 2 groups in terms of sex, weight, fracture arm direction, and Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association (AO/OTA) fracture classification. However, patients in group 1 were statistically significantly older than those in group 2 (average age, 77.5 years vs. 62 years). Among 4 patients experiencing distal screw violation of the radiocarpal joints, 3 underwent partial or complete screw removal immediately after fracture consolidation or union. Conclusions While rare, reduction loss remains a potential complication following VLP fixation, especially in elderly patients with intra-articular DRFs. However, with diligent monitoring and timely intervention, such as implant removal if necessary, acceptable outcomes can still be attained.