BACKGROUND: Team-based learning is known for its effective and satisfying education methods in the study of various medical schools. This study was prepared to confirm the satisfaction of applying this team-based learning to the training course of emergency medical technician.METHODS: A total of 165 new members of the course of second grade National Emergency medical technician at 2019 were finally enrolled in the study. Data were collected with a self-administered questionnaire. The team-based learning method was organized with eight students per group to conduct pre-learning and then proceed to open book to encourage active discussion among individuals. The questionnaire consisted of questions about the satisfaction of the discussion process, such as whether the knowledge gained from the discussion was appropriate, and whether collaboration between colleagues was successful during the discussion, and about the benefits of team-based learning, how well knowledge transfer compared to existing lectures, and the replacement of existing lectures. The questionnaire used a Likert 5 point scale, and the data obtained were analyzed using the SPSS version 22.0.RESULTS: The overall rating of team-based learning was 7.8 ± 1.5 out of 10. Many students answered positively (88.5%) for benefits, while 87.9% responded positively to whether the knowledge transfer effect was better compared to existing lectures. In addition, the satisfaction of team-based learning was generally high, with more than 90 percent of education students giving positive answers to the replacement of other lectures with team-based learning.CONCLUSION: The learners gave positive answers to the satisfaction, usefulness and learning effects of team-based learning. Team-based learning is a discussion-based study, so it is a good way to improve communication skills. Since communication and teamwork are important in first aid activities, the characteristics of team-based learning could lead to improvements in first aid services, leading to high-quality emergency medical services.
Cooperative Behavior ; Education ; Emergencies ; Emergency Medical Services ; Emergency Medical Technicians ; First Aid ; Humans ; Learning ; Lectures ; Methods ; Schools, Medical

PURPOSE: This study analyzed iodine intake by establishing an iodine database of general Korean foods eaten by Korean adults based on the data from the 1998 ~ 2014 KNHANES (Korea National Health and Nutrition Examination Survey). METHODS: Data on 56,818 subjects aged 19 years and older were obtained from health behavior interviews and a 24-hour dietary recall survey. Iodine intake of subjects was analyzed according to general characteristics, dietary lifestyle, food groups, and cooking method. RESULTS: An iodine database was established for 312 food items. The mean iodine intake of Korean adults decreased from 641.6 μg in 1998 to 236.2 μg in 2014 per day. Iodine intake of women was higher than that of men. For age distribution, those aged 30 ~ 49 years constituted more than 39 ~ 46% of subjects by survey year. Regarding iodine intake according to dietary lifestyle, the highest iodine intake was 29.4 ~ 34.4% for lunch while that of breakfast decreased. The highest iodine contribution by food group was seaweed such as kelp, sea mustard, and laver. CONCLUSION: The results of this study indicate that iodine intake of Korean adults has been decreasing, and iodine intake is associated with the prevalence of thyroid disease. This study provides basic data for the estimation of iodine intake in Korean adults.
Adult* ; Age Distribution ; Breakfast ; Cooking ; Female ; Functional Food ; Health Behavior ; Humans ; Iodine* ; Kelp ; Korea* ; Life Style ; Lunch ; Male ; Methods ; Mustard Plant ; Nutrition Surveys* ; Prevalence ; Seaweed ; Thyroid Diseases

The prevalence of obesity has been increasing worldwide, which raises concerns about the disease burden associated with obesity. Socioeconomic status (SES) has been suggested to be associated with obesity and obesity related diseases. This study aimed to evaluate the time trend in socioeconomic inequality in obesity-related mortality over the last decade in Korean population. We evaluated the influence of education level, as an indicator of SES, on obesity-related mortality using death data from the Cause of Death Statistics and the Korean Population and Housing Census databases. The rate ratio of the mortality of people at the lowest education level as compared with those at the highest education level (relative index of inequality [RII]) was estimated using Poisson regression analysis. Between 2001 and 2011, RII (95% confidence interval) for overall obesity-related disease mortality increased from 2.10 (2.02–2.19) to 6.50 (6.19–6.82) in men, and from 1.94 (1.79–2.10) to 3.25 (3.05–3.45) in women, respectively. Cause-specifically, the same trend in RII was found for cardiovascular mortality and mortality from diabetes mellitus, whereas the RII of mortality from obesity-related cancers in men did not show the similar trend. Subgroup analysis stratified by age revealed that the RII of obesity-related mortality was much higher in younger people than in older people. In conclusion, there has been persistent socioeconomic inequality in obesity-related mortality in Korea, which was more evident in younger people than in older people and has been deepened over the last decade especially for cardiovascular disease and diabetes.
Cardiovascular Diseases ; Cause of Death ; Censuses ; Diabetes Mellitus ; Education ; Educational Status ; Female ; Housing ; Humans ; Korea* ; Male ; Mortality* ; Obesity ; Prevalence ; Social Class ; Socioeconomic Factors*

Recent changes in healthcare systems have changed the epidemiologic paradigms in many infectious fields including bloodstream infection (BSI). We compared clinical characteristics of community-acquired (CA), hospital-acquired (HA), and healthcare-associated (HCA) BSI. We performed a prospective nationwide multicenter surveillance study from 9 university hospitals in Korea. Total 1,605 blood isolates were collected from 2006 to 2007, and 1,144 isolates were considered true pathogens. HA-BSI accounted for 48.8%, CA-BSI for 33.2%, and HCA-BSI for 18.0%. HA-BSI and HCA-BSI were more likely to have severe comorbidities. Escherichia coli was the most common isolate in CA-BSI (47.1%) and HCA-BSI (27.2%). In contrast, Staphylococcus aureus (15.2%), coagulase-negative Staphylococcus (15.1%) were the common isolates in HA-BSI. The rate of appropriate empiric antimicrobial therapy was the highest in CA-BSI (89.0%) followed by HCA-BSI (76.4%), and HA-BSI (75.0%). The 30-day mortality rate was the highest in HA-BSI (23.0%) followed by HCA-BSI (18.4%), and CA-BSI (10.2%). High Pitt score and inappropriate empirical antibiotic therapy were the independent risk factors for mortality by multivariate analysis. In conclusion, the present data suggest that clinical features, outcome, and microbiologic features of causative pathogens vary by origin of BSI. Especially, HCA-BSI shows unique clinical characteristics, which should be considered a distinct category for more appropriate antibiotic treatment.
Adult ; Aged ; Anti-Bacterial Agents/therapeutic use ; Bacteremia/drug therapy/*epidemiology/microbiology/mortality ; Community-Acquired Infections/drug therapy/*epidemiology/microbiology/mortality ; Cross Infection/drug therapy/*epidemiology/microbiology/mortality ; Humans ; Korea/epidemiology ; Male ; Middle Aged ; Prospective Studies ; Risk Factors ; Treatment Outcome ; Young Adult

PURPOSE: We examined the utility of biochemical markers in the diagnosis of acute cerebral infarction and the relationship between panel results and the extent and severity of the infarct. METHODS: Group-wise comparisons were made between a group (Group 1) consisting of 38 subjects who were shown through medical screening between April 2007 and March 2008 to have no past history of cerebral disorders and a group (Group 2) consisting of 55 subjects who had visited the ER (during the same period) within 24 hours after the onset of neurologic symptoms and who were diagnosed with stroke through magnetic resonance imaging. Tests were carried out using the Multimarker Index, which is based on the principle of immunofluorescence. B-type natriuretic peptide, D-dimer, matrix metalloproteinase-9, and S100beta were examined, and the Multimarker Index (MMX) was derived. The extent of the infarct lesion was assessed using a volumetry program. RESULTS: The average MMX value was 2.27 in group I and 4.14 in group II, and the difference was statistically significant (p<0.05). For group II, the MMX value had a statistically significant correlation with both the extent of infarct lesion (r=0.46, p<0.001) and its severity (r=0.39, p<0.001). CONCLUSION: We believe that biomarker tests using the MMX should provide useful data in diagnosing strokes, and be of utility in making decisions regarding additional diagnostic tests and early treatment.
Biomarkers ; Cerebral Infarction ; Diagnostic Tests, Routine ; Fibrin Fibrinogen Degradation Products ; Fluorescent Antibody Technique ; Magnetic Resonance Imaging ; Mass Screening ; Matrix Metalloproteinase 9 ; Natriuretic Peptide, Brain ; Neurologic Manifestations ; Prospective Studies ; Stroke

PURPOSE: Doxylamine succinate (DS) is frequently used to treat insomnia and it may induce rhabdomyolysis in the overdose cases. The purpose of this study is to evaluate the factors that can predict the serum creatine kinase (CK) level normalization time for patients with rhabdomyolysis due to DS ingestion. METHODS: This study was conducted on 71 patients who were admitted with rhabdomyolysis after DS ingestion during the period from January 2000 to July 2009. Rhabdomyolysis was defined as a serum CK level over 1,000 U/L. The collected data included the general characteristics, the anticholinergic symptoms, the ingested dose, the peak serum CK level, the time interval (TI) from the event to the peak CK level and the TI from the event to a CK level below 1,000 U/L. We evaluated the correlation between the patients'variables and the TI from the event to the peak CK level time and the time for a CK level below 1,000 U/L. RESULTS: The mean ingested dose per body weight (BW) was 30.86+/-18.63 mg/kg and the mean TI from the event to treatment was 4.04+/-3.67 hours. The TI from the event to the peak CK level was longer for the patients with a larger ingestion dose per BW (r=0.587, p<0.05). The CK normalization time was longer for the patients with a larger ingested dose per BW (r=0.446, p<0.05) and a higher peak CK level (r=0.634, p<0.05). CONCLUSION: The ingested dose per BW was correlated with the TI from the event to the peak CK level, and the ingested dose per BW and the peak CK level have significant correlations with the CK normalization time. These factors may be used to determine the discharge period of patients who had rhabdomyolysis following a DS overdose.
Body Weight ; Creatine ; Creatine Kinase ; Doxylamine ; Eating ; Humans ; Rhabdomyolysis ; Sleep Initiation and Maintenance Disorders ; Succinic Acid

Multiple cardiac myxomas are rare in children. However, myxomas may be lethal because of their various manifestations such as blood flow obstruction, embolization and constitutional changes. Especially, the cerebral infarction due to tumor fragmentation are more likely to be misdiagnosed of acute disseminated encephalomyelitis. We report a case of multiple cardiac myxoma complicating recurrent right hemiparesis in a 12-year-old child who at first had a wrong diagnosis of acute disseminated encephalomyelitis (ADEM). Consequently, a child who show unrepresentative symptom of ADEM, should be examined rapidly by various tools to rule out the cerebral infarction from cardiogenic cause.
Cerebral Infarction ; Child* ; Diagnosis* ; Encephalomyelitis, Acute Disseminated* ; Humans ; Myxoma* ; Paresis*

Testicular infarction is caused most commonly by acute testicular torsion, but rarely by epididymitis. We report color Doppler sonographic findings and Doppler spectrum in a 56-year-old man with epididymitis that was complicated by testicular infarction.
Epididymitis* ; Humans ; Infarction* ; Male ; Middle Aged ; Spermatic Cord Torsion ; Ultrasonography

PURPOSE: Problem-based learning (PBL) has been used in medical schools due to its educational effectiveness in terms of critical thinking, problem-solving skills, integration of theory and practice, and enculturation of the community of practice. In the digital age, however, ICT (information and communication technology)-based PBL, especially, webbased PBL seems more appropriate to meet socio-educational needs when the features of web, such as multimedia based rich information, multichannel links and navigation, connectivity (interaction and collaboration), and conservation of messages posted on the online board are considered. In this context, this case study attempted to apply 'blended learning' mode that combined both on-site and on-line classrooms, and to maximize the educational purposes of PBL. This case study examined students' perception about web-based PBL to provide basic information and data for further development and implementation of the web-based PBL METHOD: As a pilot test of the web-based PBL mode, we developed a pre-case module on the web was to provide the students with a chance to experience web-based PBL before it was fully applied to the whole class. The content of the pre-case was 'panperitonits due to gastric perforation', what a primary physician should know about. This project included two collaborative teams: 1) The development team from the graduate school of education which was in charge of the web-based PBL module development and the evaluation of the pilot test, and 2) the case development team from the Emergency Department of the school of Medicine, which dealt with the simulation (patient and doctor interaction) development, the preparation of the learning resources, and the tutor sheet. RESULTS: The participating students were mostly quite satisfied with the web-based PBL class, particularly pointing out the effectiveness of integrating theory and practice, the authentic learning tasks, and the student-directed learning environments. CONCLUSION: The highly positive responses from the students indicate that further practices using web-based PBL for classes should be more seriously considered for a more proper medical-school educational environment in the 21st Century.
Education* ; Emergencies* ; Emergency Medicine* ; Emergency Service, Hospital ; Humans ; Internet ; Learning ; Multimedia ; Pilot Projects* ; Problem-Based Learning ; Schools, Medical ; Thinking

PURPOSE: Immunosuppression is important for early success of renal transplantation. Mycofenolate mofetil (MMF) has been substituted for Azathioprine (AZA) and has been shown to have greater effect on T cell and also on B cell function than AZA. Although many side effects like infections have been investigated in patients who received AZA based therapy, they have not extensively been studied in MMF based protocol. The aim of this study is to evaluate the differences in incidence and frequency of infections during the first 6 months in the patients who received AZA or MMF based therapy. METHODS: Renal transplant recipients who received either AZA or MMF based therapy were reviewed. From January 1994 to December 2003, 112 patients were enrolled and analyzed the types and frequency of infection. RESULTS: 78 patients received AZA based therapy, and 34 patients received MMF based therapy. Infection developed in 37 (47.4%) and 12 (35.3%) patients respectively. AZA group showed higher incidence of infection than MMF group (P<0.05). In AZA group, UTI developed in 15 patients (19.2%), URI in 7 patients(9%), CMV infection in 7 patients (9%), tuberculosis in 2 patients (2.6%), and wound infection in 6 patients (7.7%). In MMF group, UTI developed in 6 patients (17.6%), URI in 2 patients (5.9%), CMV infection in 2 patients (5.9%), tuberculosis in 1 patient (2.9%), wound infection in 1 patient (2.9%). There were no significant differences in the type of various infectious episodes between two groups. CONCLUSION: AZA group showed higher incidence in total infection, but there were no differences in the type of various infectious episodes between two groups. MMF has more powerful immunosuppressive effect (18) but has similar infectious adverse effects compared with AZA.
Azathioprine ; Humans ; Immunosuppression* ; Incidence ; Kidney Transplantation ; Transplantation* ; Tuberculosis ; Wound Infection