Hormone replacement therapy combined with progestogens induces changes in effect of estrogen on serum lipid levels and it has been known that the changes depend on a type and dosage of progestogen. It is also known that progestational agent induces positive ch-ange in bone mineral density. To study the effects of progestogen on lipoprotein and bone metabolism, we administ- ered conjugated equine estrogen 0.625 mg alone to 50 postmenopausal women, in combinat- ion with medroxy- progesterone acetate 5 mg to 40 postmenopausal women. The data demonstrated a beneficial effect in lipoprotein profiles in both groups. Total cholesterol in two groups decreased from the baseline values, LDL-cholesterol decreased significantly by 4.8 % in group I and 16.2 % in group II(p < 0.05), HDL-cholesterol increa- sed significantly by 11.3 % in group I and 14.7 % in group II(p < 0.05), triglyceride incre- ased slightly in both groups. Bone mineral density of femur was maintained and BMD of vertebrae increased by 1.1 % in group I and 2.0 % in group II, but it is not statistically significant. The differences of changes between two groups were not statistically significa- nt. Our results suggest that medroxyprogesterone acetate have no adverse effect on HDL -cholesterol and have no additive effect on bone mineral density in hormone replacement therapy.
Bone Density* ; Cholesterol ; Estrogens* ; Female ; Femur ; Hormone Replacement Therapy ; Humans ; Lipoproteins ; Medroxyprogesterone Acetate ; Metabolism ; Progesterone ; Progestins ; Spine ; Triglycerides

Ochrobactrum anthropi is a ubiquitous gram-negative bacillus and currently thought to be an opportunistic pathogen. We experienced a 66-year-old male patient with continuous ambulatory peritoneal dialysis (CAPD)-related peritonitis caused by O. anthropi. Susceptible antibiotic therapy including amikacin and ciprofloxacin improved the patient's clinical status. However, peritoneal effluent showed sustained leukocytosis, thus CAPD catheter was removed. After 2 weeks of temporary hemodialysis, CAPD was successfully restarted with reinsertion of catheter. This is, to our knowledge, the first case of CAPD-related peritonitis caused by O. anthropi in Korea.
Aged ; Amikacin ; Bacillus ; Catheters ; Ciprofloxacin ; Humans ; Korea ; Leukocytosis ; Male ; Ochrobactrum ; Ochrobactrum anthropi ; Peritoneal Dialysis, Continuous Ambulatory ; Peritonitis ; Renal Dialysis

PURPOSE: The purpose of this study was to explore the experience of medical teachers in the process of adapting flipped learning method through a phenomenological approach. METHODS: Semi-structured interviews with five medical teachers from two medical colleges and one medical school were conducted in December, 2017. Data analysis was done according to Colaizzi's descriptive phenomenological methodology. RESULTS: A total of 160 unique significant statements were extracted. These statements generated 17 formulated meanings that were categorized into seven theme clusters and four theme categories. Main themes were: (1) teacher with high levels of passion and motivation; (2) hurdles of flipped learning: students were still passive, struggling in preparing for flipped learning; (3) positive changes from flipped learning: changes to classroom environment and teachers' reflection through experience; and (4) challenges of flipped learning: remaining tasks for teachers, expansion of flipped learning. CONCLUSION: Through phenomenological approach, researchers were able to elucidate categories about the experience of medical teachers when attempting flipped learning. Although medical teachers did not have the exact same idea on how flipped learning was conducted and implemented, the perception of flipped learning, or difficulties in class activities, they were still wondering how they could teach students well. This study might draw more attention to flipped learning and stimulate educational and institutional supports to improve teaching and learning in medical schools.
Education, Medical ; Humans ; Learning* ; Methods ; Motivation ; Qualitative Research ; Schools, Medical ; Statistics as Topic ; Students, Medical*

PURPOSE: Medical students construct their identity as a student physician through clinical clerkship. However, there is a lack of research on the effect of clinical clerkship on professional self-concept formation. The aim of this study is to analyze and ascertain the relationship between medical students' satisfaction with clinical clerkship and professional self-concept. METHODS: This investigation studied 84 third- and fourth-year medical students enrolled in the Ajou University School of Medicine and Graduate School of Medicine. Study measures tools included satisfaction with clinical clerkship and professional self-concept measurement. For data analyses, a descriptive analysis of the research variable characteristics was applied, gender differences in variables by years of medical school were analyzed with t-tests, and correlation analysis was used to check for relationships between variables. RESULTS: We found no statistically significant differences between satisfaction with clinical clerkship with respect to medical school year and gender. While professional self-concept did not show significant differences by year of medical school, we observed statistically significant differences by gender with respect to the subscales of professional practice and communication factor. In addition, satisfaction with clinical clerkship and professional self-concept demonstrated statistically significant positive correlation. The present research was able to confirm that there exists a correlation between medical students' clinical clerkship experience and professional self-concept formation. CONCLUSION: Our study outcomes shows that provision of positive assistance as a measure to enhance satisfaction with clinical clerkship via the curriculum and environmental improvement is envisaged to lead to medical students' professional self-concept formation.
Clinical Clerkship ; Curriculum ; Humans ; Professional Practice ; Schools, Medical ; Statistics as Topic ; Students, Medical

PURPOSE: Medical students construct their identity as a student physician through clinical clerkship. However, there is a lack of research on the effect of clinical clerkship on professional self-concept formation. The aim of this study is to analyze and ascertain the relationship between medical students' satisfaction with clinical clerkship and professional self-concept. METHODS: This investigation studied 84 third- and fourth-year medical students enrolled in the Ajou University School of Medicine and Graduate School of Medicine. Study measures tools included satisfaction with clinical clerkship and professional self-concept measurement. For data analyses, a descriptive analysis of the research variable characteristics was applied, gender differences in variables by years of medical school were analyzed with t-tests, and correlation analysis was used to check for relationships between variables. RESULTS: We found no statistically significant differences between satisfaction with clinical clerkship with respect to medical school year and gender. While professional self-concept did not show significant differences by year of medical school, we observed statistically significant differences by gender with respect to the subscales of professional practice and communication factor. In addition, satisfaction with clinical clerkship and professional self-concept demonstrated statistically significant positive correlation. The present research was able to confirm that there exists a correlation between medical students' clinical clerkship experience and professional self-concept formation. CONCLUSION Our study outcomes shows that provision of positive assistance as a measure to enhance satisfaction with clinical clerkship via the curriculum and environmental improvement is envisaged to lead to medical students' professional self-concept formation.

This study was designed to investigate the apoptosis and the roles of TGF beta1 and tTG in apoptosis in fetal and postnatal rat livers using TUNEL and immunohistochemical staining. Results obtained were as follows: 1. Apoptosis began to appear in gestation day 15, reached the peak in gestation day 16 showing the highest activity of hepatic hemopoiesis, and gradually decreased after gestation day 18. But apoptosis repeatedly increased after postnatal day 1. 2. The cells showing apoptosis were mainly hemopoietic cells during gestation period, but were mainly hepatocytes after birth. In addition, apoptosis increased in sinusoidal endothelial cells after birth. 3. Apoptotic bodies rarely appeared in gestation day 16, increased in gestation day 18, and partly decreased after gestation day 20. Thereafter, the frequency of apoptotic bodies was relatively constant untill postnatal day 10. 4. TGF b1 began to be expressed from gestation day 14 when apoptosis occurred, was strongly expressed from gestation day 16, and became to be expressed weakly after gestation day 18. The expression of TGF beta1 was increased in sinusoidal endothelial cells after birth. 5. tTG began to be expressed in gestation day 16 during the highest activity of hemopoietic stage, and became to be expressed weakly in apoptotic bodies after gestation day 18. The expression of tTG increased again mainly in sinusoidal endothelial cells after birth. In summary, it is suggested that apoptosis is related to the control of hemopoiesis in prenatal period and the maintenance of the physiological balance of hepatic tissue after birth, and that TGF beta1 is related to the induction of the apoptosis during liver development and to the formation of apoptotic bodies through the control of the expression of tTG.
Animals ; Apoptosis* ; Endothelial Cells ; Hepatocytes ; In Situ Nick-End Labeling ; Liver* ; Parturition ; Pregnancy ; Rats* ; Transforming Growth Factor beta1

BACKGROUND: Lung cancer is frequently cited as an example of a disease caused solely by exposure to environmental caricinogens. However, there is a growing realization that the genetic constitution is also important in determining individual's susceptibility to lung cancer. This genetic susceptibility may result from functional polymorphims of the genes involved in carcinogen metabolism. In this study, the association between GSTM1 and CYP1A1 polymorphisms and the lung cancer risk in Korean males was investigated. MATERIALS AND METHOD: The study population consisted of 153 male lung cancer patients and 143 healthy male controls. The GSTM1 and CYP1A1 genotypes were determined by multiplex PCR and PCR-RELP analysis. RESULT: The were no significant differences in the frequency of the GSTM1 null genotype between the cases and the controls. When the cases were categorized by their histologic type, the frequency of the GSTM1 null genotype in the small cell carcinoma group was higher than those of the controls(67.2% vs 55.9%), but the difference was not statistically significant(OR=1.772 ; 95% CI=0.723-4.340). The distribution of the CYP1A1 MspI genotypes among the cases were similar to those among the controls. When the cases were grouped by their histologic type, the m1/m1, m1/m2, m2/m2 genotypes frequencies among the small cell carcinomas(23.0%, 38.5%, and 38.5%, respectively) were significantly different from those of the controls(36.4%, 46.2%, and 17.4%, respectively, p<0.05). When the m1/m1 genotype was used as a reference, the m1/m2 and m2/m2 genotypes were associated with an increased risk for small cell lung cancer(m1/m2 genotype : OR=1.337, 95% CI=0.453-3.947 ; m2/m2 genotype : OR=3.374, 95% CI=1.092-10.421). CONCLUSION: These results suggest that the GSTM1 and CYP1A1 genotypes may be a genetic determinant of the risk for lung cancer, particlulary small cell carcinoma. Further investigation is needed to confirm these results.
Carcinoma, Small Cell ; Constitution and Bylaws ; Cytochrome P-450 CYP1A1* ; Genetic Predisposition to Disease ; Genotype ; Humans ; Lung Neoplasms* ; Lung* ; Male* ; Metabolism ; Multiplex Polymerase Chain Reaction

OBJECT: Although there is extensive research. on treatment of acute unipolar depression, few studies examined the treatment of acute bipolar depression. This preliminary study was designed to suggest clinical guideline for treatment of bipolar depression through comparing the pharmacological treatment of bipolar depression with that of unipolar depression. METHOD: We studied 19 patients with bipolar depression and 38 patients with unipolar depression, who were admitted to Kyung Hee University Medical Crater from January 1990 to December 1997. The pattern of treatment and the response to treatment of bipolar depression were investigated compared with unipolar depression. RESULTS: The percentage of prescription in bipolar depression was as follows in order : combination of mood stabilizer and an antidepressant 52.6%, mood stabilizers 15.8%, ECT 15.8%, TCAs 5.3%, SSRIs 5.3%, RIMA 5.3%. In unipolar depression : TCAs 47.4%, SSRIs 28.9%, combination of mood stabilizer and an antidepressant 10.5%, others 13.2%. There was no significant difference in response to treatment in bipolar depression and unipolar depression. CONCLUSIONS: These results suggest a mood stabilizer and an antidepressant together or a mood stabilizer alone would be first line in bipolar depression. Among the antidepressants, bupropion, RIMA and SSRls is more recommended in that order rather than TCAs in consideration of the risk of switching into mania.
Antidepressive Agents ; Bipolar Disorder* ; Bupropion ; Depressive Disorder ; Drug Therapy* ; Humans ; Prescriptions

BACKGROUND: Extended-spectrum beta-lactamases(ESBL) are enzymes that confer resistance to oxyimino-beta-lactams as well as to penicillins and cephalosporins. Strains of Klebsiella pneumoniae and Escherichia coli that produce ESBL have been increasingly prevalent in many countries. The purpose of this study was to investigate the ESBL production rate of K. pneumoniae and E. coli at the in Yeungnam University Medical Center. MATERIALS AND METHODS: Thirty-one isolates of K. pneumoniae and twenty-five isolates of E. coli were examined for ESBL by double disk synergy test, using 20/10microgram ticarcillin/clavulanic acid and 30microgram oxymino-beta-lactam(ceftazidime, ceftriaxone and aztreonam) disks. RESULTS: Fifty-two percent of K. pneumoniae and sixteen percent of E. coli isolates revealed double disk synersism. Majority of ESBL-producing strains(fifty-five percent) were isolated from patients in the intensive care unit. CONCLUSION: ESBL production of K. pneumoniae and E. coli were also common at the Yeungnam Univercity Medical Center and pose a serious problem for antimicrobial therapy.
Academic Medical Centers* ; beta-Lactamases* ; Ceftriaxone ; Cephalosporins ; Escherichia coli* ; Escherichia* ; Humans ; Intensive Care Units ; Klebsiella pneumoniae* ; Klebsiella* ; Penicillins ; Pneumonia

PURPOSE: Nursing is regarded as a female-dominated profession. However, the number of Korean males entering the field of nursing is increasing. This study examines which of the following factors influence professionalism in male and female student nurses: area of nursing, gender identity, gender stereotypes, satisfaction with the field, emotional intelligence, and interpersonal relationships. METHODS: In total, 133 male and 293 female student nurses were selected from four Korean provinces between July 2013 and February 2014 to participate in this study. The data were analyzed with descriptive statistics, t-tests, chi2-tests of independence, and multiple regression analyses using SPSS/Win 20 software. RESULTS: In males, 47.4% of variance in nursing professionalism was accounted for by grades, interpersonal relationships, gender stereotypes, and satisfaction with the field. In females, 41.9% of variance in nursing professionalism was accounted for by satisfaction with the field, interpersonal relationships, area of nursing, age, emotional intelligence and grades. Common factors that influenced both genders included satisfaction with the field, interpersonal relationships and grades. CONCLUSION: Although males and females revealed no significant differences in overall mean scores of nursing professionalism, several factors influencing nursing professionalism did differ by gender. Therefore, gender-specific nursing educational and training programs may be necessary to promote professionalism among student nurses.
Education ; Emotional Intelligence ; Female ; Gender Identity ; Humans ; Male ; Nursing