1.Clinical significance and outcomes of adult living donor liver transplantation for acute liver failure: a retrospective cohort study based on 15-year single-center experience
Geun-hyeok YANG ; Young-In YOON ; Shin HWANG ; Ki-Hun KIM ; Chul-Soo AHN ; Deok-Bog MOON ; Tae-Yong HA ; Gi-Won SONG ; Dong-Hwan JUNG ; Gil-Chun PARK ; Sung-Gyu LEE
Annals of Surgical Treatment and Research 2024;107(3):167-177
		                        		
		                        			 Purpose:
		                        			This study aimed to describe adult living donor liver transplantation (LDLT) for acute liver failure and evaluate its clinical significance by comparing its surgical and survival outcomes with those of deceased donor liver transplantation (DDLT). 
		                        		
		                        			Methods:
		                        			We retrospectively reviewed the medical records of 267 consecutive patients (161 LDLT recipients and 106 DDLT recipients) aged 18 years or older who underwent liver transplantation between January 2006 and December 2020. 
		                        		
		                        			Results:
		                        			The mean periods from hepatic encephalopathy to liver transplantation were 5.85 days and 8.35 days for LDLT and DDLT, respectively (P = 0.091). Among these patients, 121 (45.3%) had grade III or IV hepatic encephalopathy (living, 34.8% vs. deceased, 61.3%; P < 0.001), and 38 (14.2%) had brain edema (living, 16.1% vs. deceased, 11.3%; P = 0.269) before liver transplantation. There were no significant differences in in-hospital mortality (living, 11.8% vs. deceased, 15.1%; P = 0.435), 10-year overall survival (living, 90.8% vs. deceased, 84.0%; P = 0.096), and graft survival (living, 83.5% vs. deceased, 71.3%;P = 0.051). However, postoperatively, the mean intensive care unit stay was shorter in the LDLT group (5.0 days vs. 9.5 days, P < 0.001). In-hospital mortality was associated with vasopressor use (odds ratio [OR], 3.40; 95% confidence interval [CI], 1.45–7.96; P = 0.005) and brain edema (OR, 2.75; 95% CI, 1.16–6.52; P = 0.022) of recipient at the time of transplantation. However, LDLT (OR, 1.26; 95% CI, 0.59–2.66; P = 0.553) was not independently associated with in-hospital mortality. 
		                        		
		                        			Conclusion
		                        			LDLT is feasible for acute liver failure when organs from deceased donors are not available. 
		                        		
		                        		
		                        		
		                        	
2.Exploration of Factors Affecting Pro-social Intention to Disclose Information in Healthcare Settings
Kyunghee CHUN ; Young-soon PARK ; Young Jun CHO ; You Jung LEE
Korean Medical Education Review 2024;26(3):198-206
		                        		
		                        			
		                        			 This study investigated the relationships of situational factors, motivational assessment–related factors, and situationally induced personal characteristics with pro-social intention to disclose patient information among health and medical students. In total, 210 students from Konyang University participated in the survey, including 116 medical students and 94 other health students. To measure the influence of variables on pro-social intention to disclose information related to health information security, a 27-item questionnaire was used. The reliability of the survey was shown by Cronbach’s α values of 0.859 to 0.917. According to students’ perceptions, higher disease severity was significantly related to higher impacts on the patient, family, and themselves (p<0.01), as well as higher situational empathy (p<0.05). Pro-social intention to disclose showed negative correlations with health information security awareness, information education experience, perceived impact on the self, responsibility to disclose, and personal norms (r=-0.136 to -0.647, p<0.05). Responsibility to disclose and situational empathy explained approximately 44% of the variance in pro-social intention to disclose. Additionally, students who received information security training perceived a significantly higher responsibility to disclose, exhibited higher health information security awareness, and had lower pro-social intention to disclose. This study confirmed the need for information security education for health and medical students, and suggested that pro-social characteristics such as empathy and responsibility need to be carefully addressed in information security education. 
		                        		
		                        		
		                        		
		                        	
3.Design and Implementation of a Cohort for Quality Management of Medical Education: A Case Study from Konyang University College of Medicine
Kyunghee CHUN ; Tae Hee LEE ; Soojin JUNG ; Young-soon PARK
Korean Medical Education Review 2023;25(2):102-108
		                        		
		                        			
		                        			 This study shares details on the operating process and results of the cohort of students and graduates that was designed and implemented at Konyang University College of Medicine in Daejeon and discusses future directions for cohort establishment and improvement. First, Konyang University College of Medicine established the necessity and defined the purpose of cohort design and implementation. A task force was formed to establish guidelines for analysis targets, procedures, reports, and data management, and cohort operation was classified as a quality control activity. Data were collected through surveys of current students and graduates, and data generated during the curriculum were collected, analyzed, and reported every 2 years. The cohort data collection and analysis methods are designed by the Department of Medical Education, and data collection is carried out by the administrative team and each committee. Data management and analysis are handled by the Center for Medical Education Support, and analysis and reporting are conducted by the Department of Medical Education. Various members of the medical school are working to collect and analyze data, report findings, provide feedback, and improve. In the future, we plan to advance database computerization and work toward more effective data analysis. Cohort operation should not be another burden for medical schools; instead, it is hoped that operating cohorts will be a meaningful activity to increase the effectiveness of medical education and help in the operation and policy decisions of medical schools. 
		                        		
		                        		
		                        		
		                        	
4.Exploring the Psychosocial Characteristics and Systematic Support of Academically Maladjusted Students
Young-Soon PARK ; Kyunghee CHUN ; Tae Hee LEE
Korean Medical Education Review 2022;24(3):215-230
		                        		
		                        			
		                        			 The purpose of this study was to explore the psychosocial characteristics of academically maladjusted students and the College's current status regarding academic maladjustment based on 4-year medical student cohort data collected from 2018 to 2021 and through interviews with 10 medical education experts using the integrated research method. This study included 223 students who consented to inclusion in the student cohort and participated in the emotional behavior test and college adaptability test of whom 65 students experienced academic maladjustment. Academically maladjusted students had significantly higher scores for social stress, anxiety, sense of inadequacy, attention, hyperactivity, and school maladjustment, and significantly lower scores for relationships with parents, interpersonal relationships, self-esteem, self-confidence, and self-strength. Academic and social integrity, emotional stability, university satisfaction, and university service satisfaction were all significantly lower in the academically maladjusted students than in the non-maladjusted group. The expert interviews indicated that academic maladjustment was mainly recognized as a personal problem, with causes such as lack of motivation and learning methods, vulnerability to stress, lack of social relationships and alienation, lack of support from the family, and insufficient resilience. Systematic support other than counseling for academically maladjusted students is required, and an early diagnosis and preventive intervention are important. 
		                        		
		                        		
		                        		
		                        	
5.Mediation effects of clinical practice stress between clinical education environment and satisfaction with clinical practice
Youngsoon PARK ; Kyunghee CHUN ; Mihye KWON
Korean Journal of Medical Education 2021;33(1):27-36
		                        		
		                        			 Purpose:
		                        			The purpose of this study was to identify the possible correlations of ‘satisfaction with clinical practice (SA)’ with ‘clinical learning environment (EN)’ and ‘clinical practice stress (ST).’ We searched for the mediating effect of ‘clinical practice stress’ on ‘satisfaction with clinical practice’ when the clinical learning environment influences ‘satisfaction with clinical practice.’ 
		                        		
		                        			Methods:
		                        			This research investigated 208 medical and nursing students attending the school of medicine and nursing in Korea. The total number of nursing students was 135 (64.9%); 73 medical students participated (35.1%). We used the Korean-Undergraduate Clinical Education Environment in 24 questions for EN, ST scale in 24 questions, and SA scale in 10 questions. We performed measurement structural equation model analysis to identify a path of the model. 
		                        		
		                        			Results:
		                        			Medical students had significantly higher levels of ST. EN had a significant negative correlation with ST and a significant positive correlation with SA. The ST had a significant negative correlation with SA. The results of the goodness of fit index have fulfilled the criteria of goodness of fit. There was a significant mediating effect of ST on SA when EN influences SA. 
		                        		
		                        			Conclusion
		                        			The clinical learning environment affected satisfaction with the clinical practice directly or indirectly mediated by clinical practice stress. Therefore, educational institutes should try to increase satisfaction with clinical practice by continuously monitoring and improving the clinical learning environment in addition to taking measures for decreasing the clinical practice stress. 
		                        		
		                        		
		                        		
		                        	
6.Validation of the Korean Version of the Undergraduate Clinical Education Environment Measure
Kyunghee CHUN ; Young Soon PARK ; Ji Won OAK
Korean Medical Education Review 2021;23(1):37-45
		                        		
		                        			
		                        			 In light of the need for a tool to evaluate the clinical practice education environment as perceived by medical and nursing students, this study is was conducted to develop and validate the Korean version of the Undergraduate Clinical Education Environment Measure (K-UCEEM) as a measurement tool for managing the clinical practice education climate and quality of education. For validation, the UCEEM consisting of 25 items developed by Pia Strand in 2013 was adapted according to standard translation procedures. The K-UCEEM questionnaire was administered to 73 medical students and 135 nursing students who participated in clinical practice at one medical institution. Exploratory factor analysis and confirmatory factor analysis were conducted to confirm the validity of the instrument’s structure. In order to determine referential validity, the relationships among stresses in clinical practice were examined, and differences in factor scores were compared by gender and college. It was confirmed that the scale of 24 items and five factors showed a moderate model fitness index. The reliability of the factors ranged from 0.786 to 0.867. In addition, all five factors were found to have negative correlations with the clinical practice stress sub-factor, and there were statistically significant differences by gender and college. Through this study, the validity and reliability of the K-UCEEM were verified. In the future, it is expected that further verification of the scale, as well as evaluation and improvement of the clinical practice education environment based on this scale, will occur. 
		                        		
		                        		
		                        		
		                        	
7.Therapeutic effect of atorvastatin on interleukin-13-induced lung pathology
Yosep MO ; Boram BAE ; Junghyun KIM ; Ruth Lee KIM ; Kyunghee SON ; Min-Jong KANG ; Chun-Gen LEE ; Sang-Heon CHO ; Hye-Ryun KANG
Allergy, Asthma & Respiratory Disease 2021;9(2):76-83
		                        		
		                        			 Purpose:
		                        			Asthma is a common chronic lung disease, in which interleukin (IL)-13 is implicated as a central regulator of IgE synthesis, mucus hypersecretion, airway hyperresponsiveness (AHR), and fibrosis. This study was designed to determine the anti-inflammatory effect of atorvastatin, a widely used lipid-lowering agent, on the IL-13-induced lung pathology through the modulation of macrophages. 
		                        		
		                        			Methods:
		                        			Atorvastatin (40 mg/kg) was given to transgenic mice overexpressing IL-13 (IL-13 TG mice) and their wild type littermates by oral gavage for 2 weeks. AHR, numbers of inflammatory cells in the airway, and cytokine levels in IL-13 TG mice were measured.Using the alveolar macrophage cell line CRL-2456, the direct effect of atorvastatin on macrophages activated by recombinant IL-13 was assessed. 
		                        		
		                        			Results:
		                        			Significant reduction in total leukocytes and alleviation of AHR were observed with administration of atorvastatin in IL-13 TG mice compared to those without atorvastatin treatment (P< 0.05). Atorvastatin administration resulted in upregulation of IL-10 in the lungs of IL-13 TG mice (P< 0.05). In addition, mRNA expression of connective tissue growth factor, fibronectin, and type III collagen as well as chord length enhanced by IL-13 overexpression were reduced by atorvastatin administration (P< 0.05). M2 macrophage markers, such as Ym-1 and CD206, were decreased, while M1 macrophage marker, inducible nitric oxide synthase, was increased upon atorvastatin treatment (P< 0.05). Administration of atorvastatin resulted in improved removal of apoptotic cells (P< 0.05). 
		                        		
		                        			Conclusion
		                        			The results of this study reveal a potential of atorvastatin as an effective antiasthmatic agent by reducing IL-13-induced lung inflammation via the modulation of macrophage polarization. 
		                        		
		                        		
		                        		
		                        	
8.Study of Work-Related Musculoskeletal Pain and Health-related Quality of Life among Hospital Workers
Giwon KIM ; Chun Sun LEE ; Kyunghee LEE
Journal of Korean Physical Therapy 2019;31(5):304-310
		                        		
		                        			
		                        			PURPOSE: This study examined the work-related musculoskeletal pain and quality of life of hospital workers.METHODS: Self-reported questionnaires were sent to 350 hospital workers at Seoul and Gyeonggi-do, of which 341 were returned. The questionnaire had four items that covered the demographic information, areas of musculoskeletal problems, pain rating scale, and quality of life. The analysis was completed using descriptive statistic, and the differences between pain and demographic variables were identified using a chi-square test. The differences between the type of occupation and quality of life were analyzed by one-way analysis of variance and a Kruskal-Wallis test.RESULTS: The 12-month prevalence of work-related musculoskeletal pain was 86.1% of physical therapists, 86.5% of occupational therapists, 77.1% of dental hygienists, and 75.8% of nurses. A significant difference in the general and work related variables was observed between the subject with a physical burden and type of occupation. The most affected pain sites of the physical therapist included low back, hand and wrist, shoulder, and neck. The occupational therapists included the hand and wrist, shoulder, neck, but the nurses and dental hygienists reported the shoulder, back, hand and wrist. A significant difference in the quality of life was noted between the subjects in physical therapists and dental hygienists and the subjects in the nurses and occupational therapists (p=0.00).CONCLUSION: These findings show that hospital workers appear to be high risk for work-related musculoskeletal pain, and the quality of life of physical therapists and nurses was higher than that of dental hygienists and occupational therapists.
		                        		
		                        		
		                        		
		                        			Dental Hygienists
		                        			;
		                        		
		                        			Gyeonggi-do
		                        			;
		                        		
		                        			Hand
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Musculoskeletal Pain
		                        			;
		                        		
		                        			Neck
		                        			;
		                        		
		                        			Occupations
		                        			;
		                        		
		                        			Physical Therapists
		                        			;
		                        		
		                        			Prevalence
		                        			;
		                        		
		                        			Quality of Life
		                        			;
		                        		
		                        			Seoul
		                        			;
		                        		
		                        			Shoulder
		                        			;
		                        		
		                        			Wrist
		                        			
		                        		
		                        	
9.Fixed prosthesis restoration in edentulous patient fully implanted without considering definitive prosthesis: A case report.
Young Hoon CHUN ; Ahran PAE ; Kung Rock KWON ; Hyeong Seob KIM
The Journal of Korean Academy of Prosthodontics 2017;55(4):427-435
		                        		
		                        			
		                        			The most important factor in the treatment of fully edentulous patients using implants is the shape of the definitive prosthesis. After the shape of the definitive prosthesis is determined, residual bone analysis and selection of the implant type, number and position should be followed. In this case, for restoration of an edentulous patient fully implanted (except the maxillary right lateral incisor) without considering definitive prosthesis, facial esthetics and possibility of fixed type prosthesis were evaluated using complete denture. It was determined that the fixed type prosthesis was possible. Implants that could not be used for the definitive prosthesis were excluded from the treatment plan and fixed type provisional restorations were fabricated. After four months of provisional restorations, the patient showed stable occlusion and esthetic satisfaction. Definitive prosthesis was made of zirconia using CAD/CAM (computer aided design and computer aided manufacturing). The results were satisfactory during the 3 months of follow-up period after termination of treatment.
		                        		
		                        		
		                        		
		                        			Denture, Complete
		                        			;
		                        		
		                        			Esthetics
		                        			;
		                        		
		                        			Follow-Up Studies
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Prostheses and Implants*
		                        			;
		                        		
		                        			Prosthesis Design
		                        			
		                        		
		                        	
10.Research trends in studies of medical students' characteristics: a scoping review.
Sung Soo JUNG ; Kwi Hwa PARK ; HyeRin ROH ; So Jung YUNE ; Geon Ho LEE ; Kyunghee CHUN
Korean Journal of Medical Education 2017;29(3):137-152
		                        		
		                        			
		                        			The purpose of this study is to investigate domestic and international research trends in studies of medical students' characteristics by using the scoping review methods. This study adopted the scoping review to assess papers on the characteristics of medical students. The procedure of research was carried out according to the five steps of the scoping review. The full texts of 100 papers are obtained and are read closely, after which suitable 88 papers are extracted by us for this research. The review is mapped by the year of the study, source, location, author, research design, research subject, objective, and key results. The frequency is analyzed by using Microsoft Excel and SPSS. We found 70 papers (79.5%) on a single medical school, 15 (17.0%) on multiple medical schools, and three (3.4%) on mixed schools, including medical and nonmedical schools. Sixty-nine (79.5%) were cross-sectional studies and 18 (20.5%) were longitudinal studies. Eighty-two papers (93.2%) adopted questionnaire surveys. We summarized research trends of studies on medical students in Korea and overseas by topic, and mapped them into physical health, mental health, psychological characteristics, cognitive characteristics, social characteristics, and career. This study provides insights into the future directions of research for the characteristics of medical students.
		                        		
		                        		
		                        		
		                        			Cross-Sectional Studies
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Korea
		                        			;
		                        		
		                        			Longitudinal Studies
		                        			;
		                        		
		                        			Mental Health
		                        			;
		                        		
		                        			Research Design
		                        			;
		                        		
		                        			Research Subjects
		                        			;
		                        		
		                        			Schools, Medical
		                        			;
		                        		
		                        			Sociological Factors
		                        			;
		                        		
		                        			Students, Medical
		                        			
		                        		
		                        	
            
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