White matter hyperintensity (WMH), a common magnetic resonance imaging (MRI) marker ofcerebral small-vessel disease, is associated with chronic cerebral ischemia; however, themechanistic heterogeneity of WMH remains poorly defined. This review integrates multimodalMRI findings into a mechanism-oriented framework spanning four axes: WMH versus normalappearingwhite matter (NAWM), periventricular versus deep location, lesion core versus perilesionalpenumbra, and longitudinal evolution. Periventricular WMHs are associated with blood–brainbarrier dysfunction, interstitial fluid accumulation, and venous remodeling, whereas deep WMHsare more closely associated with impaired glymphatic/perivascular clearance and enlargedperivascular spaces, and demyelination/macromolecular compromise varying by context. Theperilesional penumbra emerges as a critical transition zone, showing distance-dependent gradientsof microstructural rarefaction, extracellular fluid expansion, perfusion deficits, and reducedvascular reactivity that extend beyond fluid-attenuated inversion recovery-defined borders andrelate to subsequent lesion growth. Longitudinal data further indicate that abnormalities indiffusion, perfusion, and vascular reserve within NAWM precede new WMHs, nominating imagingbiomarkers of progression risk. This framework supports risk stratification beyond total lesionburden, links therapeutic opportunities to mechanism (e.g., blood–brain barrier integrity, glymphaticclearance, and cerebrovascular reactivity), and motivates biologically interpretable readouts forpatient selection and treatment monitoring. Looking forward, standardized spatial classification(including fine-grained, distance-informed parcellations), harmonized penumbra definitions, andintegration of multimodal MRI with pathology will be essential to validate mechanism-specificsubtypes and translate them into scalable, clinically usable endpoints.

Ear cleaning using ear cleaners is recommended for the prevention of canine otitis externa. This study aimed to investigate the prevalence of bacterial contamination in home- and clinical-use ear cleaners and identify characteristics associated with such a prevalence. To obtain data regarding home-use ear cleaners, 100 bottles of commercial ear cleaners were collected from clients who visited animal clinics with their dogs and completed a survey. Data for clinic-use ear cleaners were obtained by gathering 60 bottles of ear cleaners from private animal hospitals. Bacterial culture of the applicator tips and samples of the ear cleaners was performed. In addition, to determine the relationship between ear cleaner contamination and otitis externa (OE) in dogs, ear cultures were obtained from some of the dogs that visited the clinics. Approximately 5% and 4.91% of home- and clinic-use ear cleaner applicator tips, respectively, had bacterial contamination, although no contamination of the solution within the bottles was observed. Most of the contaminated ear cleaner tips were unclean on the outside given that the bottle was placed directly into the ear canal. The contamination rate was highest among owners who used ear cleaners once a week and among veterinarians who used the product for dogs with OE. We found no ingredients that affected the incidence of ear cleaner contamination.

The efficiency of somatic cell nuclear transfer (NT) in pigs is low and requires enhancement. We identified the most efficient method for zona pellucida (ZP) removal and blastomere aggregation in pigs and investigated whether the aggregation of NT and parthenogenetic activation (PA) of blastomeres could reduce embryonic apoptosis and improve the quality of NT-derived embryos by investigating. Embryonic developmental competence after ZP removal using acid Tyrode's solution or protease (pronase E). The embryonic developmental potential of NT-derived blastomeres was also investigated using well-of-the-well or phytohemagglutinin-L. We analyzed apoptosis in aggregate-derived blastocysts. The aggregation rate of protease-treated embryos was lower than that of Tyrode’s solution-treated embryos (69.2% vs. 88.3%). No significant difference was observed between phytohemagglutinin-L and well-of-the-well (35.7%–38.5%). However, 2P1N showed a higher number of blastocysts compared to 3N (73.8% vs. 24.3%) and an increased blastocyst diameter compared to the control and 1P2N (274 μm vs. 230–234 μm). In blastomeres aggregated using phytohemagglutinin-L, the apoptotic cell ratio was significantly higher in 1P2N and 3N than in 3P (5.91%–6.46% vs. 2.94%, respectively). Our results indicate that aggregation of one NT embryo with two PA embryos improved the rate of blastocysts with increased blastocyst diameter.

Background: Ergothioneine (EGT) is a natural amino acid derivative in various animal organs and is a bioactive compound recognized as a food and medicine. Objectives: This study examined the effects of EGT supplementation during the in vitro maturation (IVM) period on porcine oocyte maturation and subsequent embryonic development competence after in vitro fertilization (IVF). Methods: Each EGT concentration (0, 10, 50, and 100 µM) was supplemented in the maturation medium during IVM. After IVM, nuclear maturation, intracellular glutathione (GSH), and reactive oxygen species (ROS) levels of oocytes were investigated. In addition, the genes related to cumulus function and antioxidant pathways in oocytes or cumulus cells were investigated. Finally, this study examined whether EGT could affect embryonic development after IVF. Results: After IVM, the EGT supplementation group showed significantly higher intracellular GSH levels and significantly lower intracellular ROS levels than the control group. Moreover, the expression levels of hyaluronan synthase 2 and Connexin 43 were significantly higher in the 10 µM EGT group than in the control group. The expression levels of nuclear factor erythroid 2-related factor 2 (Nrf2) and NAD(P)H quinone dehydrogenase 1 (NQO1) were significantly higher in the oocytes of the 10 µM EGT group than in the control group. In the assessment of subsequent embryonic development after IVF, the 10 µM EGT treatment group improved the cleavage and blastocyst rate significantly than the control group. Conclusions Supplementation of EGT improved oocyte maturation and embryonic development by reducing oxidative stress in IVM oocytes.

Atherosclerosis, which is the most common chronic disease of the coronary artery, constitutes a vascular pathology induced by inflammation and plaque accumulation within arterial vessel walls. Both DNA methylation and histone modifications are epigenetic changes relevant for atherosclerosis. Recent studies have shown that the DNA methylation and histone modification systems are closely interrelated and mechanically dependent on each other.Herein, we explore the functional linkage between these systems, with a particular emphasis on several recent findings suggesting that histone acetylation can help in targeting DNA methylation and that DNA methylation may control gene expression during atherosclerosis.

PURPOSE: The objective of this study was to evaluate the authenticity, acceptability, and feasibility of a hybrid station that combined a standardized patient encounter and a simulated Papanicolaou test. METHODS: We introduced a hybrid station in the routine clinical skills examination (CSE) for 335 third-year medical students at 4 universities in Korea from December 1 to December 3, 2014. After the tests, we conducted an anonymous survey on the authenticity, acceptability, and feasibility of the hybrid station. RESULTS: A total of 334 medical students and 17 professors completed the survey. A majority of the students (71.6%) and professors (82.4%) agreed that the hybrid station was more authentic than the standard CSE. Over 60 percent of the students and professors responded that the station was acceptable for assessing the students' competence. Most of the students (75.2%) and professors (82.4%) assessed the required tasks as being feasible after reading the instructions. CONCLUSION: Our results showed that the hybrid CSE station was a highly authentic, acceptable, and feasible way to assess medical students' performance.
Anonyms and Pseudonyms ; Clinical Competence ; Gynecology ; Humans ; Korea ; Mental Competency ; Papanicolaou Test ; Patient Simulation ; Students, Medical

PURPOSE: The objective of this study was to evaluate the authenticity, acceptability, and feasibility of a hybrid station that combined a standardized patient encounter and a simulated Papanicolaou test. METHODS: We introduced a hybrid station in the routine clinical skills examination (CSE) for 335 third-year medical students at 4 universities in Korea from December 1 to December 3, 2014. After the tests, we conducted an anonymous survey on the authenticity, acceptability, and feasibility of the hybrid station. RESULTS: A total of 334 medical students and 17 professors completed the survey. A majority of the students (71.6%) and professors (82.4%) agreed that the hybrid station was more authentic than the standard CSE. Over 60 percent of the students and professors responded that the station was acceptable for assessing the students' competence. Most of the students (75.2%) and professors (82.4%) assessed the required tasks as being feasible after reading the instructions. CONCLUSION Our results showed that the hybrid CSE station was a highly authentic, acceptable, and feasible way to assess medical students' performance.

PURPOSE: The purpose of this study was evaluation of the current status of medical students' documentation of patient medical records METHODS: We checked the completeness, appropriateness, and accuracy of 95 Subjective-Objective-Assessment-Plan (SOAP) notes documented by third-year medical students who participated in clinical skill tests on December 1, 2014. Students were required to complete the SOAP note within 15 minutes of an standard patient (SP)-encounter with a SP complaining rhinorrhea and warring about meningitis. RESULTS: Of the 95 SOAP notes reviewed, 36.8% were not signed. Only 27.4% documented the patient's symptoms under the Objective component, although all students completed the Subjective notes appropriately. A possible diagnosis was assessed by 94.7% students. Plans were described in 94.7% of the SOAP notes. Over half the students planned workups (56.7%) for diagnosis and treatment (52.6%). Accurate documentation of the symptoms, physical findings, diagnoses, and plans were provided in 78.9%, 9.5%, 62.1%, and 38.0% notes, respectively. CONCLUSION: Our results showed that third-year medical students' SOAP notes were not complete, appropriate, or accurate. The most significant problems with completeness were the omission of students' signatures, and inappropriate documentation of the physical examinations conducted. An education and assessment program for complete and accurate medical recording has to be developed.
Clinical Competence ; Diagnosis ; Education ; Humans ; Medical Records ; Meningitis ; Physical Examination ; Pilot Projects* ; Soaps* ; Students, Medical*

OBJECTIVES: This study investigated changes in hepatitis B seroprevalence from 1998 to 2013, and to identify differences in epidemiologic characteristics between hepatitis B surface antigen (HBsAg)-positive and HBsAg-negative people. METHODS: HBsAg seropositive rates were compared by year, sex, and age using the blood test data from the periods I to VI (1998-2013) of the Korea National Health and Nutrition Examination Survey. Interviews and self-administered surveys were conducted to collect data on health behavior, quality of life, comorbidities, and health care utilization. RESULTS: HBsAg seropositive rates in the Republic of Korea decreased from 4.6% in 1998 to 2.9% in 2008, and then remained the same for the next five years. While seropositive rates by age were the highest at 35 to 39 years of age in 1998, it peaked at 50 to 54 years of age in 2013. HBsAg-positive people showed high values from two liver function tests, including glutamic-oxaloacetic transaminase and glutamic-pyruvic transaminase, and the prevalence rates of liver cirrhosis and liver cancer were also significantly high. Indices for health behavior and quality of life showed no significant differences between HBsAg-positive and HBsAg-negative people. CONCLUSIONS: While HBsAg seropositive rates tended to decline after 1998, there have been no significant changes over the most recent five years. We should focus on treatment of existing hepatitis B patients along with immunization programmes to prevent new hepatitis B infections. In addition, it may be necessary to encourage HBsAg-positive people to follow healthier life-styles in order to prevent further progression of hepatitis B to liver cirrhosis and liver cancer.
Alanine Transaminase ; Aspartate Aminotransferases ; Comorbidity ; Delivery of Health Care ; Health Behavior ; Hematologic Tests ; Hepatitis B Surface Antigens* ; Hepatitis B* ; Hepatitis* ; Humans ; Immunization ; Korea ; Liver Cirrhosis ; Liver Function Tests ; Liver Neoplasms ; Nutrition Surveys ; Prevalence ; Quality of Life ; Republic of Korea* ; Seroepidemiologic Studies*

PURPOSE: Nurse educators can use film effectively to promote nursing students' motivation and indirect experiences. The purpose of this study was to develop a teaching-learning design using films based on Kolb's experiential learning model for understanding of child growth and development, and to evaluate students' satisfaction with cinenurducation according to learning type and content. METHODS: Participants were seventy-four first year nursing students in the spring semester of 2013 at a private university located in Busan. In each class, participants watched film, participated in peer-to-group discussion and an educator's lecture, and wrote a composition based on Kolb's four learning stages. After class, participants filled out a questionnaire developed by the researchers. RESULTS: Results showed a high satisfaction with cinenurducation regardless of learning type and content concerning child growth and development. Advantages of cinenurducation included it being "fun and interesting," "helpful to understand the characteristics of children," and "develop critical thinking through discussions." Disadvantages included "length of time needed," and "burdensome." CONCLUSION: Films are advantageous in that they provide indirect experience for nursing students. Selection of appropriate films and evaluation of learning goal achievements are important to maximize the effectiveness of cinenurducation.
Busan ; Child* ; Education ; Growth and Development* ; Humans ; Learning ; Motion Pictures as Topic ; Motivation ; Nursing ; Problem-Based Learning* ; Students, Nursing ; Thinking ; Surveys and Questionnaires