As most infections by the helminth parasite elicit the recruitment of CD4+CD25+Foxp3+ T (T(reg)) cells, many scientists have suggested that these cells could be used for the treatment of immune-mediated inflammation and associated diseases. In order to investigate the distribution and alteration of activated T(reg) cells, we compared the expression levels of T(reg) cell activation markers in the ileum and gastrocnemius tissues 1, 2, and 4 weeks after infection. The number of T(reg) cells was monitored using GFP-coded Foxp3 transgenic mice. In mice at 1 week after Trichinella spiralis infection, the number of activated T(reg) cells was higher than in the control group. In mice at 2 weeks after infection, there was a significant increase in the number of cells expressing Foxp3 and CTLA-4 when compared to the control group and mice at 1 week after infection. At 4 weeks after infection, T. spiralis was easily identifiable in nurse cells in mouse muscles. In the intestine, the expression of Gzmb and Klrg1 decreased over time and that of Capg remained unchanged for the first and second week, then decreased in the 4th week. However, in the muscles, the expression of most chemokine genes was increased due to T. spiralis infection, in particular the expression levels of Gzmb, OX40, and CTLA-4 increased until week 4. In addition, increased gene expression of all chemokine receptors in muscle, CXCR3, CCR4, CCR5, CCR9, and CCR10, was observed up until the 4th week. In conclusion, various chemokine receptors showed increased expressions combined with recruitment of T(reg) cells in the muscle tissue.
Animals ; Gene Expression ; Helminths ; Ileum ; Inflammation ; Intestines ; Mice* ; Mice, Transgenic ; Muscles ; Parasites ; Receptors, Chemokine ; T-Lymphocytes, Regulatory* ; Trichinella spiralis ; Trichinella*

PURPOSE: The promotion of educators is challenged by the lack of accepted standards to evaluate the quality and impact of educational activities. Traditionally, promotion is related to research productivity. This study developed an evaluation tool for educational performance of medical school faculty using educator portfolios (EPs). METHODS: Design principles and quantitative items for EPs were developed in a consensus workshop. These principles were tested in a simulation and revised based on feedback. The changes of total educational activities following introduction of the system were analyzed. RESULTS: A total of 71% faculty members answered the simulation of the system and the score distributed widely (mean±standard deviation, 65.43±68.64). The introduction of new system significantly increased the total educational activities, especially in assistant professors. CONCLUSION: The authors offer comprehensive and practical tool for enhancing educational participation of faculty members. Further research for development of qualitative evaluation systems is needed.
Consensus Development Conferences as Topic ; Education ; Education, Medical ; Efficiency ; Evaluation Studies as Topic ; Schools, Medical*

OBJECTIVES: Ambivalence of self-image is considered to be important in patients with schizophrenia since impairment of self-referential processing and increment in ambivalence are illness-related symptoms. This study aimed to evaluate quantitative and qualitative properties of ambivalence of self-image in patients with schizophrenia. METHODS: Twenty patients with schizophrenia and 20 normal controls performed a set of 'self-image reflection task' and then the level of ambivalence towards actual and ideal self-image were numerically scored. Ambivalence scores were compared between groups and correlation analyses with psychometric scales were done in each group. RESULTS: Patients with schizophrenia had higher level of ambivalence towards both actual and ideal self-image (p<0.001). Normal controls showed significant correlations with the scales representing level of self-concept clarity (r=-0.480, p=0.033), depression (r=0.479, p=0.033), and self-esteem (r=-0.555, p=0.011 ; R=-0.600, p=0.005) while the patients did not. CONCLUSION: Ambivalence towards one's self-image is more intense in patients with schizophrenia. This symptom may be considered to exist as an independent symptom in schizophrenia.
Depression ; Humans ; Psychometrics ; Schizophrenia* ; Weights and Measures

PURPOSE: We aimed to describe the differences in clinical characteristics that affect readmission between late and moderate preterm or full-term infants. METHODS: Medical records were reviewed for 881 patients with gestational ages of ≥31⁺⁰ weeks who were born at Inje University Sanggye Paik Hospital between1 January 2013 and 20 September 2015. The patients were categorized into three subgroups as follows moderate preterm infants: those born at 31-33 weeks' gestation (n=73), late preterm infants: those born at 34–36 weeks' gestation (n=169),and full-term infants: those born at ≥37 weeks' gestation (n=639). We compared the late and moderate preterm or full-term infants in terms of clinical characteristics that affect readmission. RESULTS: The readmission rate was 18.9% in the late preterm infants, 21.9% in the moderate preterm infants, and 16.7% in the full-term infants. The independent risk factors of readmission were gestational age in the late preterm infants, positive pressure ventilation at birth in the moderate preterm infants, and air-leak syndrome in the full-term infants. In addition, antenatal care at the first trimester of pregnancy was an independent protective factor against readmission in the full-term infants. CONCLUSION: Our results suggest that gestational age may affect the readmission rate of late preterm infants.
Female ; Gestational Age ; Humans ; Infant* ; Infant, Newborn ; Infant, Premature* ; Medical Records ; Parturition ; Patient Readmission ; Positive-Pressure Respiration ; Pregnancy ; Pregnancy Trimester, First ; Protective Factors ; Risk Factors

Objective: Little has been explored about a reflection towards self-image in schizophrenia, though it can be related to heterogeneous symptoms of the illness. We identified the neural basis of ambivalence towards ideal self-image in patients with schizophrenia. Methods: 20 patients with schizophrenia and 20 healthy controls underwent functional MRI while the self-image reflection tasks of determining whether to agree with sentences describing their actual or ideal self-image that contained one of the adjective pairs with opposite valence. The interaction between the group and ideal ambivalence score was examined, and group differences in functional connectivity related to ambivalence towards ideal self-image were further studied. Results: The interaction of group-by-ideal ambivalence score was shown in the dorsal anterior cingulate cortex and dorsolateral prefrontal cortex, where activities were positively correlated with the level of ideal self-image ambivalence in patients, but not in controls. Task-related decrease in functional connectivity was shown between the orbitofrontal cortex and cerebellum in patients. Conclusion The process of reflecting on ambivalent ideal self-image in schizophrenia may be related to aberrant prefrontal activity and connectivity. Abnormality in the prefrontal regions that take part in cognitive conflict monitoring and value judgment may underlie the pathophysiology of increased ambivalence towards ideal self-image.

Middle East respiratory syndrome (MERS) is an acute infectious disease of the respiratory system caused by the new betacoronavirus (MERS coronavirus, MERS-CoV), which shows high mortality rates. The typical symptoms of MERS are fever, cough, and shortness of breath, and it is often accompanied by pneumonia. The MERS-CoV was introduced to Republic of Korea in May 2015 by a patient returning from Saudi Arabia. The disease spread mostly through hospital infections, and by the time the epidemic ended in August, the total number of confirmed diagnoses was 186, among which 36 patients died. Reflecting the latest evidence for antiviral drugs in the treatment of MERS-CoV infection and the experiences of treating MERS patients in Republic of Korea, these guidelines focus on antiviral drugs to achieve effective treatment of MERS-CoV infections.
Antiviral Agents ; Communicable Diseases ; Coronavirus ; Cough ; Cross Infection ; Diagnosis ; Dyspnea ; Fever ; Humans ; Middle East* ; Mortality ; Pneumonia ; Republic of Korea ; Respiratory System ; Saudi Arabia

Due to the increasing use of the internet, various social problems have been emerging, and one of them is internet gaming disorder (IGD). The purpose of this study was to investigate whether low internal motivation was present in IGD and basic psychological needs affected internal motivation. Twenty-one individuals with IGD and 21 healthy controls performed a ‘motivation task’ in which the avatar in virtual reality asked whether they would accept an activity in two conditions stimulating intrinsic or extrinsic motivation. The task performance was compared between the two groups, and was correlated with the Basic Psychological Needs Scale scores. Patients had a significantly lower acceptance rate of the proposal in the intrinsic motivation condition than controls, and this intrinsic motivated tendency was correlated with the satisfaction in their basic psychological needs. As with other substance use disorders, IGD was associated with a lower level of internal motivation, which was related to the dissatisfaction of basic psychological needs such as autonomy, competence, and relationship.
Humans ; Immunoglobulin D ; Internet* ; Mental Competency ; Motivation* ; Social Problems ; Substance-Related Disorders ; Task Performance and Analysis

OBJECTIVES: Disturbance in self-experience has been considered to be a core feature of schizophrenia. Evidence from mirror face-recognition tasks supports the connection between self-face recognition and self-awareness which is a part of self-experience. The aim of this study was to investigate the self-other boundary recognition using morphed face pictures in patients with schizophrenia. METHODS: Twenty-one patients with schizophrenia and twenty-three healthy controls completed the self-face recognition task that consisted of various morphed pictures. Participant's own picture was morphed with each of three different, unknown, gender-matched facial identities in steps of 10% ; each pair producing 11 images with graded blending of facial features. Thirty-three images in total were randomly presented as stimuli in a run, which was repeated three times. Participants were instructed to choose whether the stimulus was self-face or not. RESULTS: Self-face proportion was significantly lower in the schizophrenia group at both recognition start point I and II (33.33% vs. 53.04%, p<0.001 ; 61.43% vs. 70.87%, p=0.01, respectively). Using the mean value of each recognition start point in the control group, we calculated the difference in self-face proportion for each individual with schizophrenia. There was a significant correlation between the degree of this difference and total Scale for the Assessment of Negative Symptoms (SANS) score at recognition start point I (r=0.507, p=0.019). CONCLUSION: The difference in self-other boundary recognition in this study may account for self-disturbance of schizophrenia. Its correlation with SANS total score may reflect the shared nature of persistent disturbance between the disturbance in self-experience and the negative symptom.
Humans ; Schizophrenia*

PURPOSE: Charcot-Marie-Tooth disease (CMT) is a peripheral neuropathy mainly divided into CMT type 1 (CMT1) and CMT2 according to the phenotype and genotype. Although molecular pathologies for each genetic causative have not been revealed in CMT2, the correlation between cell death and accumulation of misfolded proteins in the endoplasmic reticulum (ER) of Schwann cells is well documented in CMT1. Establishment of in vitro models of ER stress-mediated Schwann cell death might be useful in developing drug-screening systems for the treatment of CMT1. MATERIALS AND METHODS: To develop high-throughput screening (HTS) systems for CMT1, we generated cell models using transient expression of mutant proteins and chemical induction. RESULTS: Overexpression of wild type and mutant peripheral myelin protein 22 (PMP22) induced ER stress. Similar results were obtained from mutant myelin protein zero (MPZ) proteins. Protein localization revealed that expressed mutant PMP22 and MPZ proteins accumulated in the ER of Schwann cells. Overexpression of wild type and L16P mutant PMP22 also reduced cell viability, implying protein accumulation-mediated ER stress causes cell death. To develop more stable screening systems, we mimicked the ER stress-mediated cell death in Schwann cells using ER stress inducing chemicals. Thapsigargin treatment caused cell death via ER stress in a dose dependent manner, which was measured by expression of ER stress markers. CONCLUSION: We have developed genetically and chemically induced ER stress models using Schwann cells. Application of these models to HTS systems might facilitate the elucidation of molecular pathology and development of therapeutic options for CMT1.
Cell Death ; Cell Survival ; Charcot-Marie-Tooth Disease* ; Endoplasmic Reticulum ; Endoplasmic Reticulum Stress ; Genotype ; Mass Screening* ; Mutant Proteins ; Myelin P0 Protein ; Myelin Sheath ; Pathology, Molecular ; Peripheral Nervous System Diseases ; Phenotype ; Schwann Cells ; Thapsigargin

BACKGROUND: Unlike the right internal jugular vein (RIJV), there is a paucity of data regarding the effect of the Trendelenburg position on the left internal jugular vein (LIJV). The purpose of this study is to investigate the cross-sectional area (CSA) of the LIJV and RIJV and their response to the Trendelenburg position using two-dimensional ultrasound in adult subjects. METHODS: This study enrolled fifty-eight patients with American Society of Anesthesiologists physical status class I-II who were undergoing general anesthesia. CSAs of both the RIJV and LIJV were measured with a two-dimensional ultrasound in the supine position and then in a 10degrees Trendelenburg position. RESULTS: In the supine position, the transverse diameter, anteroposterior diameter, and CSA of the RIJV were significantly larger than those of the LIJV (P < 0.001). Of 58 patients, the RIJV CSA was larger than the LIJV CSA in 43 patients (74.1%), and the LIJV CSA was larger than the RIJV CSA in 15 patients (25.9%). In the Trendelenburg position, CSAs of the RIJV and LIJV increased 39.4 and 25.5%, respectively, compared with the supine position. However, RIJV changed at a rate that was significantly greater than that of the LIJV (P < 0.05). Of 58 patients, the RIJV CSA was larger than the LIJV CSA in 48 patients (82.8%), and the LIJV CSA was larger than the RIJV CSA in 10 patients (17.2%). CONCLUSIONS: In supine position, the RIJV CSA was larger than the LIJV CSA. The increased CSA in the Trendelenburg position was greater in the RIJV than the LIJV.
Adult ; Anesthesia, General ; Central Venous Catheters ; Head-Down Tilt* ; Humans ; Jugular Veins* ; Supine Position ; Ultrasonography