Background: Post-dural puncture headache (PDPH) is one of the well-known complication of spinal anesthesia. Epidural blood patch is the treatment of choice for PDPH but is rarely used for the prevention of PDPH after spinal anesthesia. The purpose of this study is to observe the effectiveness of epidural blood patch for prevention of PDPH and to evaluate the complications after epidural blood injection. Methods: Three hundred patients (ASA I or II) receiving spinal anesthesia were studied. They were randomly devided into two groups. Patients in Group I, the control group, were maintained in a supine position for 24 hour after spinal anesthesia. Patients in Group II, the study group, received 3 ml of autologous blood in the epidural space after spinal anesthesia. PDPH was evaluated for 5 days. The incidence, location, onset, and duration of headache in the patients presenting with PDPH were measured for 5 days, and the complications following epidural blood patch in Group II were observed for 2 weeks. Results: The incidence of PDPH in group I was 11%, but 0% in group II. There were no specific complications following epidural blood patch in Group II. Conclusions: This study suggest that the 3 ml epidural autologous blood patch is an useful method for the prevention of PDPH in patients with spinal anesthesia.
Anesthesia, Spinal* ; Blood Patch, Epidural ; Epidural Space ; Headache ; Humans ; Incidence ; Post-Dural Puncture Headache ; Punctures* ; Supine Position

OBJECTIVES: To study the distributions of pH and gas values in umbilical arterial(UA) blood of normal newborns following uncomplicated pregnancies and vaginal births. Methods: In 457 consecutive normal term infants who were born between March 1995 and June 1998, we examined the UA pH and blood gas values obtained immediately following delivery. Maternal inclusion criteria were defined as an uncomplicated singleton pregnancy and a normal full term spontaneous vaginal delivery. And also neonatal inclusion criteria were defined as a normal intrauterine growth appropriate for gestational age without any malformations and Apgar score of 7 or more at both one and five minutes after birth. Umbilical artery blood samples were collected at each birth and were evaluated for pH, carbon dioxide pressure (PaCO2), oxygen pressure (PaO2) and actual bicarbonate. RESULTS: Histogram of UA pH value resemble normal distribution curve. The lowest UA pH was 7.04 and the 10th percentile value was 7.23. The median UA pH was 7.31 and 5% was below 7.20. The lowest UA PaO2 was 4.6mmHg and the 10th percentile value was 11.5mmHg. The highest UA PaCO2 was 67.2mmHg and the 90th percentile value was 56.5mmHg. The lowest bicarbonate value was 13.2mmol/L and the 10th percentile value was 18.4mmol/L. CONCLUSION: The distributions of the UA pH and gas values of the collective of normal newborns were illustrated. None of the UA pH was below 7.0.
Apgar Score ; Blood Gas Analysis* ; Carbon Dioxide ; Gestational Age ; Humans ; Hydrogen-Ion Concentration ; Infant ; Infant, Newborn* ; Oxygen ; Parturition ; Pregnancy ; Umbilical Arteries*

Background: This study was aimed to identify the level of awareness and compliance on the nosocomial infection control among clinical nurses. Methods: Data was collected from Sept. 15 to Oct. 10, 2001 and obtained from the nurses working at six general hospitals in Daegu city and Kyungpook province. Five hundred sixteen nurses were answered to the 36 item questionnaire which was composed of the hand washing(5 items), the management of sterile article(7 items), the management of contaminated article(8 Items), the administration of medication(8 items) and the environment management(8 items). Results: The mean score of the awareness about the infection control was 3.59/4. In sub-sections, the mean score of the administration of medication was 3.66, the hand washing was 3.65, the environmental management was 3.60, the sterile article management was 3.57, and the contaminated article management was 3.48. The mean score of the compliance about the infection control was 0.78/1. In sub-sections, the mean score of the administration of medication was 0.88, the sterile article management was 0.80, the hand washing was 0.76 and theenvironment management was 0.76. There was positive correlation between the level of the awareness and the compliance on the nosocomial infection control. Conclusion: Therefore, it should be required that the development of the educational programs and the supportive policy of the hospital about infection control for the nurses.
Compliance* ; Cross Infection* ; Daegu ; Gyeongsangbuk-do ; Hand ; Hand Disinfection ; Hospitals, General ; Infection Control ; Surveys and Questionnaires

Background: This study was aimed to identify the level of awareness and compliance on the nosocomial infection control among clinical nurses. Methods: Data was collected from Sept. 15 to Oct. 10, 2001 and obtained from the nurses working at six general hospitals in Daegu city and Kyungpook province. Five hundred sixteen nurses were answered to the 36 item questionnaire which was composed of the hand washing(5 items), the management of sterile article(7 items), the management of contaminated article(8 Items), the administration of medication(8 items) and the environment management(8 items). Results: The mean score of the awareness about the infection control was 3.59/4. In sub-sections, the mean score of the administration of medication was 3.66, the hand washing was 3.65, the environmental management was 3.60, the sterile article management was 3.57, and the contaminated article management was 3.48. The mean score of the compliance about the infection control was 0.78/1. In sub-sections, the mean score of the administration of medication was 0.88, the sterile article management was 0.80, the hand washing was 0.76 and theenvironment management was 0.76. There was positive correlation between the level of the awareness and the compliance on the nosocomial infection control. Conclusion: Therefore, it should be required that the development of the educational programs and the supportive policy of the hospital about infection control for the nurses.
Compliance* ; Cross Infection* ; Daegu ; Gyeongsangbuk-do ; Hand ; Hand Disinfection ; Hospitals, General ; Infection Control ; Surveys and Questionnaires

Variables affecting bone heath of growing children were analyzed among forty nine 10-12 year old elementary students in three rural regions of north west Chungnam area. Information on age of the parents, duration of breast feeding and birth weight were collected from the guardians of the participants and nutrient intake and diet quality were assessed by average of three-day food records of participants with the help of dietitians. Bone health status was measured by calceneal broadband ultrasound attenuation (BUA) using quantitative ultrasound (QUS). Results showed that anthropometic indexes and nutrient intake levels were not different between boys and girls. However, iron intake was significantly lower in girls than in boys. Girls after menarche showed lower intake levels for thiamin, riboflavin, pyridoxine and niacin than girls before menarche. z-scores of BMI were lower than -1 and higher than +1 showed shorter breast feeding period than others but the difference was statistically non-significant. Overall, the subjects did not consume enough s of calcium, vitamin C and folic acid. Zinc intake and BMI were the most significant factors affecting BUA by the results of backward elimination in multiple regression models. Phosphorous and beta-carotene intakes showed significant negative relation with BUA. This study showed that children living in the rural area of Chungnam need extra care to keep their health and nutrient intakes especially for the nutrients known to affect growth. Tailored nutrition education needs to be more focused on the improvement of bone health status of children.
Ascorbic Acid ; beta Carotene ; Birth Weight ; Breast Feeding ; Calcium ; Child ; Diet ; Female ; Folic Acid ; Humans ; Iron ; Menarche ; Niacin ; Nutritional Status ; Parents ; Pyridoxine ; Riboflavin ; Zinc

PURPOSE: Fungi, rhinoviruses (RVs), and eosinophils are associated with upper respiratory diseases. We evaluated the effects of fungal stimulation and eosinophil co-culture on the expression of mucin genes in RV-infected nasal polyp epithelial cells. METHODS: Nasal polyp epithelial cells were obtained from chronic rhinosinusitis patients. Cultured epithelial cells were stimulated with Alternaria and Aspergillus with or without RV-16 infection. The epithelial cells were co-cultured with eosinophils for 16 h. MUC4, MUC5AC, MUC5B, and MUC8 mRNA expressions in the epithelial cells were quantified using real-time RT-PCR. To determine the underlying mechanism, nuclear factor-kappaB (NF-kappaB), activator protein-1 (AP-1), and mitogen-activated protein kinase (MAPK) inhibitors were used to inhibit mucin gene expression. RESULTS: Fungi and RV-16 induced mucin gene expression in nasal polyp epithelial cells. However, there was no synergistic increase in mucin gene expression, with the exception of MUC4 mRNA expression stimulated by 25 microg/mL Aspergillus. When RV-16-infected epithelial cells were stimulated with fungi and then co-cultured with eosinophils, MUC4, MUC5B, and MUC8 mRNA expressions increased. Mucin gene expression was inhibited by NF-kappaB inhibitors. CONCLUSIONS: RV-16, airborne fungi, and eosinophils may exacerbate the inflammatory process in nasal mucosal diseases by enhancing mucin gene expression.
Alternaria ; Aspergillus ; Coculture Techniques ; Eosinophils* ; Epithelial Cells* ; Fungi* ; Gene Expression* ; Humans ; Methods ; Mucins* ; Nasal Polyps ; NF-kappa B ; Protein Kinases ; Rhinovirus ; RNA, Messenger ; Transcription Factor AP-1

Purpose: This study examined how students’ academic performance changed after undergoing a transition to online learning during the coronavirus disease 2019 (COVID-19) pandemic, based on the test results of 16 integrated courses conducted in 3 semesters at Hanyang University College of Medicine in Korea. Methods: For the 16 required courses that formed an integrated system-based curriculum running for 3 semesters, the major examinations’ raw scores were collected for each student. Percent-correct scores were used in the subsequent analysis. We used the t-test to compare grades between 2019 and 2020, and the Cohen D was calculated as a measure of effect size. The correlation of scores between courses was calculated using Pearson correlation coefficients. Results: There was a significant decrease in scores in 2020 for 10 courses (62.5%). While most of the integrated system-based curriculum test scores showed strong correlations, with coefficients of 0.6 or higher in both 2019 and 2020, the correlation coefficients were generally higher in 2020. When students were divided into low, middle, and high achievement groups, low-achieving students consistently showed declining test scores in all 3 semesters. Conclusion Our findings suggest that the transition to online classes due to COVID-19 has led to an overall decline in academic performance. This overall decline, which may occur when the curriculum is centered on recorded lectures, needs to be addressed. Further, medical schools need to consider establishing a support system for the academic development of low-achieving students.

Purpose: Team-based learning in medical education facilitates the formation of interpersonal relationships, enhances academic achievement, and establishes future clinical connections. Despite medical schools’ distinct educational environments and curricula, research investigating students’ learning and behavioral characteristics within this context remains limited. This study aimed to investigate the specific characteristics of interpersonal relationship formation among freshmen medical students in team-based learning activities. Methods: Focus group interviews were conducted with 11 students who participated in a team-based class held during the first semester of the premedical year. Results: Medical students passively expressed their thoughts and feelings, such as active sympathy for the team’s opinions and self-censorship of SNS (social networking service) conversations. When performing team activities, students were excessively conscious of others and focused on evenly dividing their work, minimizing their opinions, and fulfilling their share to prevent potential interpersonal conflicts. Interpersonal activities were only superficial, as students intentionally maintained a certain distance from team members or used team activities as an opportunity to accumulate relational capital. Conclusion The results of this study are expected to provide a useful basis for designing and conducting team activity classes to enhance interpersonal relationship formation.

Purpose: This study assessed the alignment between Korean medical schools’ mission statements (MSs) and Korean Doctor’s Role (KDR) domains, considering school characteristics. Methods: We analyzed the South Korean medical school’s MS characteristics using a mixed-methods approach. Quantitative analysis preprocessed MS text data to identify concept words, while qualitative content analysis categorized information into predefined KDR domains and extracted themes from other parts. Results: At the KDR domain level, “social accountability” was the most frequent, followed by “education and research” and “patient care,” while “professionalism” had the least frequency. At the competency level, the most frequent domains were “involvement in public and global health initiatives,” while “self-regulation based on professional leadership” and “professionalism and self-management” were not present. Conclusion The study found that the majority of MSs had a homogeneous pattern and included traditional themes. Medical schools should evaluate and incorporate missing elements in their MSs to reflect the institution’s own purpose and current societal needs.

Leber's Hereditary Optic Neuropathy(LHON) is a maternally inherited disorders that occurs primarily in young males and is characterized by subacute, sequential, bilateral central visual loss, ultimately, optic atrophy. We report 2 cases of molecularly confirmed LHON which reveal 11778 and 14484 mitochondral DNA mutation, respectively but there is no family history of visual loss. So the diagnosis of LHON deserves to be considered in all crypotogenic cases of acute or subacute optic or chiasmal neuropathy. Late or early age at onset, female gender, and a negative family history should not be dissuasive.
Diagnosis ; DNA ; Female ; Humans ; Male ; Molecular Biology* ; Optic Atrophy ; Optic Nerve Diseases*