In order to solve the problems of traditional teaching model for medical statistics based on theoretical lecture, we developed new teaching model for medical statistics. The model was consisted of theoretical and practical lecture for 2nd grade of premedical students, Ewha Womans University. For theoretical lecture, we introduced basic concepts of medical statistics, data description and social survey method with questionnaire development. For practical lecture, we introduced the whole process from the selection for research topic to sampling, survey, data analysis, and report writing. Although students participated this class pointed out some trivial problems, they gave positive evaluation, particularly on practical lecture. We think this new model will be a good model and let medical students have ability to do medical research through basic knowledge and practical skill.
Surveys and Questionnaires ; Female ; Humans ; Linear Energy Transfer ; Schools, Medical* ; Statistics as Topic ; Students, Medical ; Students, Premedical ; Writing

Few studies have examined short term responses to the different contents of carbohydrate or fat in the meal, although long term effects of the high fat meal have been considered as compound risk factor for metabolic disorders. The aim of this study was to investigate the postprandial changes of plasma glucose, insulin and lipids upon intakes of high carbohydrate or high fat meal in young healthy women. Subjects were randomly assigned to either the high carbohydrate meal (HCM, 75% carbohydrate, n=13) or the high fat meal (HFM, 60% fat, n=12) groups. The meals were prepared as isocaloric typical Korean menu. Blood samples were obtained prior to and 30, 60, 90, 120, 180 and 240 minute after the meal. There were no significant differences on fasting blood parameters including glucose, insulin, lipids concentrations between the groups prior to the test. The HCM had higher blood glucose and insulin concentrations, reached the peak at 30 min and maintained for 240 min compared to the HFM (P<0.05). The HFM had higher plasma triglyceride (TG) and free fatty acid (FFA) concentrations, reached the peak at 120 min and maintained for 240 min compared to the HCM (P<0.05). It is concluded that macronutrients content in the meal may be an important determinant of postprandial substrate utilization in healthy women.
Blood Glucose ; Fasting ; Female ; Glucose ; Humans ; Insulin ; Kinetics ; Meals ; Plasma ; Risk Factors

Purpose: This study was to identify how a nursing management practicum was operated during the COVID-19 pandemic in Korea. Methods: This study surveyed instructors teaching the nursing management practicum with a questionnaire covering five domains and 42 items. The data were analyzed using descriptive statistics and content analysis. Results: The practicum was performed mainly by mixed methods (40.8% and 38.5%), in hospitals only (30.8% and 60.4%), online only (19.8% and 1.1%) in 2020 and 2021, respectively. The mixed methods were most frequently used for instructor teaching and conferences (43.9% and 58.3%). and the average teaching time per week was 9.40 and 8.69 hours per week, respectively. Taking charge in one to three core nursing skill items, 87.8% and 90.1% of the respondents each year performed face to face evaluation for the skills. Four to six out of 12 POs were covered by 58.2% and 54.9% of the participants, respectively, in 2020 and 2021. The greatest difficulty under the pandemic was securing students’ hospital assignments. Conclusion The nursing management practicum needs to adopt various digital technologies, and create new education models including hybrid ones combining both contact and untact methods to improve the educational effect for the post COVID-19 era.

Objective: The purpose of this study was to identify the associations of chronic physical disease between patients with severe mental illness (SMI) and the general population of South Korea. Methods: This study was conducted with National Health Insurance Corporation data from 2014 to 2019. A total of 848,058 people were diagnosed with SMI in this period, and the same number of controls were established by matching by sex and age. A descriptive analysis was conducted on the sociodemographic characteristics of patients with SMI. Conditional logistic regression analysis was performed to identify the associations between comorbid physical disease in patients with SMI and those of the general population. SAS Enterprise Guide 7.1 (SAS Inc, Cary, NC, USA) were used to perform all statistical tests. Results: The analysis revealed significant differences in medical insurance, income level, and Charlson Comorbidity Index weighted by chronic physical disease, between patients with SMI and the general population. Conditional logistic regression analysis between the two groups also revealed significant differences in eight chronic physical diseases except hypertensive disease. Conclusion This study confirmed the vulnerability of patients with SMI to chronic physical diseases and we were able to identify chronic physical disease that were highly related to patients with SMI.

PURPOSE: Mercaptopurine (MP) is one of the main chemotherapeutics for acute lymphoblastic leukemia (ALL). To improve treatment outcomes, constant MP dose titration is essential to maintain steady drug exposure, while minimizing myelosuppression. We performed two-stage analyses to identify genetic determinants of MP-related neutropenia in Korean pediatric ALL patients. MATERIALS AND METHODS: Targeted sequencing of 40 patients who exhibited definite MP intolerance was conducted using a novel panel of 211 pharmacogenetic-related genes, and subsequent analysis was performed with 185 patients. RESULTS: Using bioinformatics tools and genetic data, four functionally interesting variants were selected (ABCC4, APEX1, CYP1A1, and CYP4F2). Including four variants, 23 variants in 12 genes potentially linked to MP adverse reactions were selected as final candidates for subsequent analysis in 185 patients. Ultimately, a variant allele in APEX1 rs2307486was found to be strongly associated with MP-induced neutropenia that occurred within 28 days of initiating MP (odds ratio, 3.44; p=0.02). Moreover, the cumulative incidence of MP-related neutropenia was significantly higher in patients with APEX1 rs2307486 variants, as GG genotypes were associated with the highest cumulative incidence (p < 0.01). NUDT15 rs116855232 variants were strongly associated with a higher cumulative incidence of neutropenia (p < 0.01), and a lower median dose of tolerated MP throughout maintenance treatment (p < 0.01). CONCLUSION: We have identified that APEX1 rs2307486 variants conferred an increased risk of MP-related early onset neutropenia. APEX1 and NUDT15 both contribute to cell protection from DNA damage or misincorporation, so alleles that impair the function of either gene may affect MP sensitivities, thereby inducing MP-related neutropenia.
6-Mercaptopurine ; Alleles ; Computational Biology ; Cytochrome P-450 CYP1A1 ; Cytoprotection ; DNA Damage ; Genotype ; Humans ; Incidence ; Neutropenia* ; Pediatrics ; Precursor Cell Lymphoblastic Leukemia-Lymphoma*

Objective: To overcome the limited effectiveness of standard case management services, the Seoul Intensive Case Management program (S-ICM) for patients with serious mental illnesses was introduced in 2017. This study aimed to evaluate its effectiveness in reducing the length of hospital stay. Methods: Monitoring data from April 2019 to March 2020 were retrieved from the Seoul Mental Health Welfare Center. A total of 759 participants with serious mental illnesses were included. The average length of admission per month was compared between the pre-ICM (previous year) and during-ICM periods. For post-ICM observation subgroup, average length of admission per month was compared between pre-ICM, during-ICM, and post-ICM periods. To determine the relative contributions of risk factors for during-ICM and post-ICM admission, multivariate logistic regression analyses were performed. Results: The average admission stay for pre-ICM period was significantly longer than that for during-ICM period (1.47 vs. 0.26 days). Among the predictors for during-ICM admission, pre-ICM psychiatric admission was the most important risk factor, followed by medical aid beneficiary and suicidal behavior. In the subgroup analysis of the post-ICM observation period, the pre-ICM, during-ICM, and post-ICM average admission stays were 1.45, 0.29, and 0.57 days/month, respectively. There was a significant difference in the average length of stay between the pre-ICM and during-ICM periods and between the pre-ICM and post-ICM periods. Post-ICM admission risks included pre-ICM admission, S-ICM duration <3 months, and chronic unstable symptoms. Conclusion The results suggest that the S-ICM effectively reduces psychiatric hospitalization duration, at least over a short-term period.

Phyllodes tumor is an uncommon fibroepithelial neoplasm of the breast. And it is characterized by expanded stroma with increased cellularity and elongated epithelium-lined clefts. Mammary carcinomas within phyllodes tumors have been rarely reported. To date, however, no reports have described the invasive cribriform carcinoma arising in malignant phyllodes tumor. Here, we report a 62-year-old woman who presented with a large breast mass. Microscopically, the mass was a typical malignant phyllodes tumor showing well developed leaf-like architecture and stromal overgrowth with high cellularity and nuclear pleomorphism. In a portion of the tumor, however, the epithelial component showed a cribriform pattern of proliferation in the absence of myoepithelial cells, suggestive of the invasive cribriform carcinoma. To our knowledge, this is rare and it is difficult to make a differential diagnosis of it. Here, we report our case with a review of literatures.
Adenocarcinoma ; Breast ; Diagnosis, Differential ; Female ; Humans ; Middle Aged ; Neoplasms, Fibroepithelial ; Phyllodes Tumor

To investigate the prevalence of asthma, allergic rhinitis, and eczema, we did a cross-sectional survey of 4,003 children aged 6-7 years (students in the 1st year of elementary school) and 4,112 students aged 13-14 years (students in the 1st year of middle school), chosen from a random sample of 45 primary and 40 middle schools across the nation. The Korean-translated modified version of the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire was used in this survey. The weighted 12-month prevalence of asthma symptoms from the questionnaires was 10.3% (95% confidence interval [CI], 9.2 to 11.4) for children aged 6-7 years and 8.3% (95% CI, 7.4 to 9.2) for children aged 13-14 years. The weighted 12-month prevalence of allergic rhinoconjuctivitis symptoms was 18.9% (95% CI, 17.5 to 20.4) for children aged 6-7 years and 19.2% (95% CI, 17.9 to 20.6) for children aged 13-14 years. The weighted 12-month prevalence of eczema symptoms was 17.9% (95% CI, 16.6 to 19.3) for children aged 6-7 years and 11.2% (95% CI, 10.1 to 12.3) for children aged 13-14 years. Compared with results from a 2000 ISAAC study, the 12-month prevalence of asthma increased from 5.8% to 10.3% in children aged 6-7 years, but there was little change (from 8.7% to 8.3%) in children aged 13-14 years. The prevalence of allergic rhinoconjunctivitis and eczema has increased considerably in both age groups.
Aged ; Asthma ; Child ; Cross-Sectional Studies ; Eczema ; Humans ; Hypersensitivity ; Prevalence ; Surveys and Questionnaires ; Rhinitis ; Rhinitis, Allergic, Perennial

Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive fibrosing interstitial pneumonia, which presents with a progressive worsening dyspnea, and thus a poor outcome. The members of the Korean Academy of Tuberculosis and Respiratory Diseases as well as the participating members of the Korea Interstitial Lung Disease Study Group drafted this clinical practice guideline for IPF management. This guideline includes a wide range of topics, including the epidemiology, pathogenesis, risk factors, clinical features, diagnosis, treatment, prognosis, and acute exacerbation of IPF in Korea. Additionally, we suggested the PICO for the use of pirfenidone and nintendanib and for lung transplantation for the treatment of patients with IPF through a systemic literature review using experts' help in conducting a meta-analysis. We recommend this guideline to physicians, other health care professionals, and government personnel in Korea, to facilitate the treatment of patients with IPF.
Delivery of Health Care ; Diagnosis ; Disease Management ; Dyspnea ; Epidemiology ; Humans ; Idiopathic Pulmonary Fibrosis ; Korea ; Lung Diseases, Interstitial ; Lung Transplantation ; Prognosis ; Risk Factors ; Tuberculosis

Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive fibrosing interstitial pneumonia, which presents with a progressive worsening dyspnea, and thus a poor outcome. The members of the Korean Academy of Tuberculosis and Respiratory Diseases as well as the participating members of the Korea Interstitial Lung Disease Study Group drafted this clinical practice guideline for IPF management. This guideline includes a wide range of topics, including the epidemiology, pathogenesis, risk factors, clinical features, diagnosis, treatment, prognosis, and acute exacerbation of IPF in Korea. Additionally, we suggested the PICO for the use of pirfenidone and nintendanib and for lung transplantation for the treatment of patients with IPF through a systemic literature review using experts' help in conducting a meta-analysis. We recommend this guideline to physicians, other health care professionals, and government personnel in Korea, to facilitate the treatment of patients with IPF.