No abstract available.
Primary Myelofibrosis*

Invasive infection of the Streptococcus bovis group in a neonate is rare. In cases reported to date, the pathogen of neonatal S. bovis infections is usually Streptococcus gallolyticus subsp. pasteurianus (S. bovis biotype II/2). Streptococcus lutetiensis (S. bovis biotype II/1) was identified using 16S rRNA and tuf gene sequence analysis of the isolates from blood and cerebrospinal fluid (CSF) of a fever-presenting 28-day-old male. Blood culture analysis was performed using automatic equipment (VITEK 2) and identified Streptococcus infantarius supsp. infantarius, yet we were unable to get accurate results from the CSF culture. The fever subsided on the second day of hospitalization, and the patient was discharged without neurologic complication after 14 days of antibiotic therapy. In this case, we were able to accurately identify the pathogen using molecular genetic methods. To our knowledge, this is the first case of late onset neonatal bacteremia and meningitis caused by S. lutetiensis.
Bacteremia* ; Cerebrospinal Fluid ; Fever ; Hospitalization ; Humans ; Infant, Newborn ; Male ; Meningitis* ; Molecular Biology ; Sequence Analysis ; Streptococcus bovis ; Streptococcus*

PURPOSE: This study examined Korean clinical nurses' intentions to care for SARS patients and identify determinants of the intentions. Theory of planned behavior was the framework to explain the intentions of Korean nurses for SARS patients care. METHODS: A convenient sample of six hundreds and seventy nine clinical nurses from four university-affiliated hospitals located in Seoul and in Kyung-gi province was used. Self-administered (83-items) questionnaire was used to collect data. Intentions, attitude, subjective norm, perceive behavioral control, behavioral beliefs, normative beliefs, and control beliefs were the study variables. All items were measured using 7-point Likert scale (-3 to +3). Data were analyzed using descriptive statistics, Pearson correlation method, and stepwise multiple regression methods. RESULTS: Intentions and attitudes toward SARS patient care among Korean clinical nurses were moderate, but their subjective norm and perceive behavioral control of SARS patients care were negative. Stepwise multiple regression analysis indicated that attitude toward SARS patient care, perceived behavioral control, subjective norm were the determinants of the intentions for SARS patients care as theory proposed. Among the behavioral beliefs, "SARS-patient caring would be a new experience", "during SARS-patient caring, I should be apart from my family", "after completing SARS-patient caring, I would be proud of myself being able to cope with a stressful event" and "with my SARS-patient caring, patients could recover from SARS" were the significant determinants. Among the normative beliefs, colleague approval, spouse approval, and physician approval were significant determinants of the intentions. Among the control beliefs, "SARS-patient caring would be a challenge" "SARS-patient caring is a professional responsibility", "tension during the care of SARS patients" and "support from team members" were the significant determinants of the intentions. CONCLUSIONS: Korean clinical nurses in this study were not willing to care for SARS patients and showed negative attitude toward the care. They believed their friends and family were not approved their care for SARS patients. Nurses were in conflicts between professional responsibilities to care for SARS patients and personal safety. This study was the first to understand stress and burden of Korean clinical nurses who are in front line to care for newly developed communicable disease such as SARS. Under the circumstance where several fatal communicable diseases are predictable, conflicts between professional responsibility and their personal risks should be taken into considerations by nurses themselves and by nursing administrators in order to improve quality of care.
Adult ; *Attitude of Health Personnel ; Female ; Humans ; *Intention ; Korea ; Middle Aged ; Multivariate Analysis ; Nursing Staff, Hospital/*psychology ; Psychological Theory ; Regression Analysis ; Severe Acute Respiratory Syndrome/*nursing

This study examined effect of preceptorship on clinical education of senior nursing students of Y. University in Seoul. Quasi-experimental study design was used. Sixty students of pre-test and 80 of post-test participated in this study. Competency scores of the students before the clinical education(pre-competency scores) were compared with the competency scores after the clinical education(post-competency scores), and teacher evaluation scores between preceptors and clinical the data from students with preceptors(experimental group, N=22) and with clinical instructors(comparative group, N=58) were also examined. Study results indicated that the total post-competency scores were higher compared to the total pre-competency scores, and the difference was statistically significant. Among 7 sub-domains, differences were all statistically significant in 6 sub-domains except "self-esteem" domain. Competency scores of the students who had clinical education with had clinical education from clinical instructors. But the difference between those scores was not statistically significant. However, students gave higher evaluation scores to preceptors than clinical instructors. This study concluded that preceptorship did not influence much on clinical education at this time yet. However it is expected that when preceptors adjust their new roles and function them in expert education. This study recommended that for the preceptors to increase their motivation to teach students and to accept their roles, systemic rewards are needed.
Education* ; Humans ; Motivation ; Nursing* ; Preceptorship* ; Reward ; Seoul ; Students, Nursing*

OBJECTIVES: Autism is a complex neurodevelopmental spectrum disorder with a strong genetic component. Previous neurochemical and genetic studies have suggested the possible involvement of the serotonin system in autism. Tryptophan 2,3-dioxygenase(TDO2) is the rate-limiting enzyme in the catabolism of tryptophan, which is the precursor of serotonin synthesis. The aim of this study was to investigate the association between the TDO2 gene and autism spectrum disorders(ASD) in a Korean population. METHODS: The patients were diagnosed with ASD on the basis of the DSM-IV diagnostic classification outlined in the Korean version of the Autism Diagnostic Interview-Revised and Autism Diagnostic Observation Schedule. The present study included the detection of four single nucleotide polymorphisms(SNPs) in the TDO2 gene(rs2292536, rs6856558, rs6830072, rs6830800) and the family-based association analysis of the single nucleotide polymorphisms in Korean ASD trios using a transmission disequilibrium test(TDT) and haplotype analysis. The family trios of 136 probands were included in analysis. 87.5% were male and 86.0% were diagnosed with autism. The mean age of the probands was 78.5+/-35.8 months(range: 26-264 months). RESULTS: Two SNPs showed no polymorphism, and there was no significant difference in transmission in the other two SNPs. We also could not find any significant transmission in the haplotype analysis(p>.05). CONCLUSION: We could not find any significant statistical association between the transmission of SNPs in the TDO2 gene and ASD in a Korean population. This result may not support the possible involvement of the TDO2 gene in the development of ASD, and further exploration might be needed to investigate other plausible SNP sites.
Appointments and Schedules ; Autistic Disorder* ; Child ; Autism Spectrum Disorder* ; Classification ; Diagnostic and Statistical Manual of Mental Disorders ; Haplotypes ; Humans ; Male ; Metabolism ; Polymorphism, Single Nucleotide ; Serotonin ; Tryptophan

The neurobiological basis of emotional recognition, processing and regulation has been extensively studied over the past years. Especially, posttraumatic stress disorder (PTSD) can be conceptualized as a dysfunction of fear circuit, thus, many studies focused on neural substrate of fear using functional neuroimaging. Neuroimaging studies of PTSD have suggested that the amygdala is hyperresponsive to fearful stimuli, which may be related to hyperarousal or reexperience symptoms of PTSD. The medial prefrontal cortex is hyporesponsive and fails to inhibit the amygdala. Researches also have acknowledged that abnormal activities in ventromedial prefrontal cortex and hippocampus might be associated with impairment of extinction of traumatic memory. Recent researches using facial emotional stimuli have suggested that PTSD involved not only dysfunction of fear circuit but also dysregulation of basic emotional processing. Despite the progress, many points are left which are yet to be clarified. Fear conditioning, contextualization, habituation and extinction should be investigated using novel paradigms that can explain the complexity of PTSD.
Amygdala ; Facial Expression ; Functional Neuroimaging ; Hippocampus ; Memory ; Neuroimaging ; Prefrontal Cortex ; Stress Disorders, Post-Traumatic

Mood disorder is unlikely to be a disease of a single brain region or a neurotransmitter system. Rather, it is now generally viewed as a multidimensional disorder that affects many neural pathways. Growing neuroimaging evidence suggests the anterior cingulate-pallidostriatal-thalamic-amygdala circuit as a putative cortico-limbic mood regulating circuit that may be dysfunctional in mood disorders. Brain-imaging techniques have shown increased activation of mood-generating limbic areas and decreased activation of cortical areas in major depressive disorder(MDD). Furthermore, the combination of functional abnormalities in limbic subcortical neural regions implicated in emotion processing together with functional abnormalities of prefrontal cortical neural regions probably result in the emotional lability and impaired ability to regulate emotion in bipolar disorder. Here we review the biological correlates of MDD and bipolar disorder as evidenced by neuroimaging paradigms, and interpret these data from the perspective of endophenotype. Despite possible limitations, we believe that the integration of neuroimaging research findings will significantly advance our understanding of affective neuroscience and provide novel insights into mood disorders.
Bipolar Disorder ; Brain ; Depression ; Endophenotypes ; Mood Disorders ; Neural Pathways ; Neuroimaging ; Neurosciences ; Neurotransmitter Agents

Purpose: This study was conducted to examine the results of designing and implementing a teaching program for medical education as the elective course for 4th-year students of medical course. Methods: In order to design the teaching program for medical education as an elective course, we conducted literature review, five medical education experts were interviewed, and the literature required in the design process was reviewed. A developing teaching program was implemented as an elective course in a medical school of Korea, and 4th-year students of medical course participated in the program. Results: In the elective course, the medical education program process competencies were derived into three categories: theoretical educational knowledge, teaching competency, and research competency for education. Moreover, instructional materials were developed to help students achieve these competencies. And project-based learning strategy was selected and implemented for 4th-year students in medical course, and positive satisfaction was confirmed. Conclusion As a study designed and implemented in a medical education program in a medical school in Korea, it is expected to be helpful when introducing medical education to undergraduate students or developing a medical education program to strengthen the teaching capacity of residents.

Purpose: Overweight (OW)/obese girls tend to have an earlier pubertal onset than girls with normal weight. However, only a few studies have reported the progression of puberty in these girls. This study aimed to identify risk factors for rapid pubertal progression in OW/obese girls presenting with precocious breast development. Methods: This retrospective cohort study reviewed the medical records of 110 OW (body mass index [BMI] ≥85th percentile for age and sex) and 213 nonoverweight (NW, BMI <85th percentile for age and sex) girls who presented with breast budding before 8 years of age. OW girls were divided into 2 subgroups: girls with central puberty progression before 9 years of age (OW-RP) and those without (OW-SP). Results: Progression to central puberty before the age of 9 was more common in NW girls than in OW girls (83.8 % vs. 65.2 % in NW vs. OW group, p<0.001), and progression-free survival for 1, 2, and 3 years was higher in the OW group (p<0.001). In a subgroup analysis of OW girls, the OW-RP subgroup had more advanced bone age (BA) at the first visit (p=0.047) and higher initial luteinizing hormone (LH, p=0.010) levels than the OW-SP subgroup. Being NW (p=0.001) and having more advanced BA (p=0.023) at the initial workup were the risk factors for pubertal progression before age 9. Conclusion Pubertal progression seems to be slower in OW girls than in NW girls presenting with precocious breast development. However, it can progress rapidly in OW girls with particularly pronounced BA advancement and high LH levels at the initial workup.

Purpose: We have developed and operated a portfolio-based course aimed at strengthening pre-medical students’ capabilities for self-management and self-improvement. In order to determine the effectiveness of the course and to establish future operational strategies, we evaluated the course and the students’ learning experience. Methods: The subjects of this study were 97 students of a pre-medical course “Self-development and portfolio I” in 2019. Their learning experience was evaluated through the professor’s assessment of portfolios they had submitted, and the program was evaluated based on the responses of 68 students who completed a survey. The survey questionnaire included 32 items. Descriptive statistics were reported for quantitative data, including the mean and standard deviation. Opinions collected from the open-ended question were grouped into categories. Results: The evaluation of students’ portfolios showed that only 6.2% of the students’ portfolios were well-organized, with specific goals, strategies, processes, and self-reflections, while most lacked the basic components of a portfolio (46.4%) or contained insufficient content (47.4%). Students’ responses to the survey showed that regular portfolio personality assessments (72.1%), team (64.7%), and individual (60.3%) activities were felt to be more appropriate as educational methods for this course, rather than lectures. Turning to the portfolio creation experience, the forms and components of the portfolios (68.2%) and the materials provided (62.2%) were felt to be appropriate. However, students felt that individual autonomy needed to be reflected more (66.7%) and that this course interfered with other studies (42.5%). Conclusion The findings of this study suggest that standardized samples, guidelines, and sufficient time for autonomous portfolio creation should be provided. In addition, education on portfolio utilization should be conducted in small groups in the future.