Purpose: This study aimed to propose a revision of the evaluation objectives of the Korean Dentist Clinical Skill Test by analyzing the opinions of those involved in the examination after a review of those objectives. Methods: The clinical skill test objectives were reviewed based on the national-level dental practitioner competencies, dental school educational competencies, and the third dental practitioner job analysis. Current and former examinees were surveyed about their perceptions of the evaluation objectives. The validity of 22 evaluation objectives and overlapping perceptions based on area of specialty were surveyed on a 5-point Likert scale by professors who participated in the clinical skill test and dental school faculty members. Additionally, focus group interviews were conducted with experts on the examination. Results: It was necessary to consider including competency assessments for “emergency rescue skills” and “planning and performing prosthetic treatment.” There were no significant differences between current and former examinees in their perceptions of the clinical skill test’s objectives. The professors who participated in the examination and dental school faculty members recognized that most of the objectives were valid. However, some responses stated that “oromaxillofacial cranial nerve examination,” “temporomandibular disorder palpation test,” and “space management for primary and mixed dentition” were unfeasible evaluation objectives and overlapped with dental specialty areas. Conclusion When revising the Korean Dentist Clinical Skill Test’s objectives, it is advisable to consider incorporating competency assessments related to “emergency rescue skills” and “planning and performing prosthetic treatment.”

Background: Coronavirus disease 2019 (COVID-19) is generally asymptomatic or mild in otherwise healthy children, however, severe cases may occur. In this study, we report the clinical characteristics of children classified as critical COVID-19 in Korea to provide further insights into risk factors and management in children. Methods: This study was a retrospective case series of children < 18 years of age classified as critical COVID-19. Cases were identified by the Korea Disease Control and Prevention Agency surveillance system and medical records were reviewed. Critical COVID-19 was defined as cases with severe illness requiring noninvasive (high flow nasal cannula, continuous positive airway pressure, or bilevel positive airway pressure) or invasive mechanical ventilation, extracorporeal membrane oxygenation (ECMO) or continuous renal replacement therapy (CRRT), between January 20, 2020 and October 7, 2021. Results: Among 39,146 cases diagnosed with COVID-19 in subjects < 18 years of age, eight cases (0.02%) were identified as critical COVID-19. The median age was 13 years (range 10 month–17 years) and male-to-female ratio was 1:1. Three children had underlying diseases; one child has asthma and major depressive disorder, one child had LennoxGastaut syndrome and one child had mental retardation and was newly diagnosed with type 2 diabetes mellitus with the diagnosis of COVID-19. Among the eight children, seven were obese (body mass index range [BMI] median 29.3, range 25.9–38.2, weight-for-length > 97% for infant) and one was overweight (BMI 21.3). All patients had fever, six patients had dyspnea or cough and other accompanied symptoms included sore throat, headache, lethargy and myalgia. Radiologic findings showed pneumonia within 1–8 days after symptom onset. Pneumonia progressed in these children for 2–6 days and was improved within 5–32 days after diagnosis. Among the eight critical cases, remdesivir was administered in six cases.Steroids were provided for all cases. Inotropics were administered in one case. Six cases were treated with noninvasive mechanical ventilator and three required mechanical ventilator. One case required ECMO due to acute respiratory distress syndrome. All cases were admitted to the intensive care unit and admission period ranged from 9–39 days. Among all critical COVID-19 cases < 18 years of age, there were no fatal cases. Conclusion To develop appropriate policies for children in the COVID-19 pandemic, it is important to monitor and assess the clinical burden in this population.

The global obesity epidemic and associated metabolic diseases require alternative biological targets for new therapeutic strategies. In this study, we show that a phytochemical sulfuretin suppressed adipocyte differentiation of preadipocytes and administration of sulfuretin to high fat diet-fed obese mice prevented obesity and increased insulin sensitivity. These effects were associated with a suppressed expression of inflammatory markers, induced expression of adiponectin, and increased levels of phosphorylated ERK and AKT. To elucidate the molecular mechanism of sulfuretin in adipocytes, we performed microarray analysis and identified activating transcription factor 3 (Atf3) as a sulfuretin-responsive gene. Sulfuretin elevated Atf3 mRNA and protein levels in white adipose tissue and adipocytes. Consistently, deficiency of Atf3 promoted lipid accumulation and the expression of adipocyte markers. Sulfuretin’s but not resveratrol’s anti-adipogenic effects were diminished in Atf3 deficient cells, indicating that Atf3 is an essential factor in the effects of sulfuretin. These results highlight the usefulness of sulfuretin as a new anti-obesity intervention for the prevention of obesity and its associated metabolic diseases.
Activating Transcription Factor 3 ; Adipocytes ; Adiponectin ; Adipose Tissue, White ; Animals ; Diet* ; Insulin Resistance ; Metabolic Diseases* ; Mice ; Mice, Obese* ; Microarray Analysis ; Obesity* ; RNA, Messenger

BACKGROUND: The Korean Computerized Neurobehavioral Test (KCNT) is a psychological assessment tool used as part of Workers’ Special Health Examinations in Korea. Due to the spread of mobile technology, this study aimed to compare results of the KCNT administered on a tablet PC versus a desktop computer, and, therefore, assess the clinical applicability of mobile devices. METHODS: A total of 72 participants enrolled in this study. Their age, sex, and years of formal education were collected during an interview, as well as their typing speed. The test battery comprised five subtests: Simple Reaction Time test, Choice Reaction Time test, Digit Addition test, Symbol-Digit Substitution test, and Finger Tapping Speed test. Participants repeated the KCNT test battery in a randomly assigned order using four different testing systems: a desktop computer equipped with a conventional 106-key keyboard (System 1), a desktop computer equipped with a simplified keyboard (System 2), a tablet PC with a simplified 17-key on-screen keyboard (System 3), and a tablet PC equipped with a simplified keyboard (System 4). RESULTS: Results of the Digit Addition test did not differ significantly for different testing systems. In contrast, results of the Simple Reaction Time test, Choice Reaction Time test, Symbol-Digit Substitution test, and Finger Tapping test were lower for the tablet PC (Systems 3 and 4) compared to the desktop computer (Systems 1 and 2). Systems 1 and 2 did not show significantly different results. Performance on System 3 was inferior to that on System 4, only for the Choice Reaction Time test and Finger Tapping Speed test. There were also significant differences in performance by computer familiarity when adjusted for age and education; however, the performance of each group on the test systems showed similar patterns. CONCLUSIONS: It is not recommended to use a tablet PC to administer the KCNT to evaluate neurobehavioral performance for the Simple Reaction Time test and Choice Reaction Time test; however, tablet PCs with an on-screen keyboard may be used to perform the Digit Addition test, and the Symbol-Digit Substitution test and Finger Tapping Speed test to a limited degree.
Education ; Fingers ; Korea ; Reaction Time ; Recognition (Psychology)

OBJECTIVE: Mind-body training (MBT) may control reactions to stress and regulate the nervous and immune systems. The present study was designed to assess the effects of MBT on plasma cytokines and their interactions with catecholamines. METHODS: The study group consisted of 80 subjects who practice MBT and a control group of 62 healthy subjects. Plasma catecholamine (norepinephrine, NE; epinephrine, E; and dopamine, DA) and cytokine (TNF-alpha, IL-6, IFN-gamma, and IL-10) levels were measured, and the differences between the MBT and control groups and the interactions of cytokines with catecholamines were investigated. RESULTS: A significant increase in IL-10+IFN-gamma was found in females of the MBT group compared with controls. Also, a significant increase of IL-10 (anti-inflammatory cytokine) in the MBT group was shown in a specific condition in which TNF-alpha and IL-6 (pro-inflammatory cytokines) are almost absent (≤1 ng/L) compared with controls. In the MBT group, significant positive correlations were found between IL-10 and the NE/E ratio and between IL-10 and the DA/E ratio, whereas the control group did not show any such correlations. CONCLUSION: MBT may increase IL-10, under specific conditions such as a decrease of pro-inflammatory cytokines or E, which may regulate the stress response and possibly contribute to effective and beneficial interactions between the nervous and immune systems.
Catecholamines* ; Cytokines* ; Dopamine ; Epinephrine ; Female ; Healthy Volunteers ; Humans ; Immune System ; Interleukin-10 ; Interleukin-6 ; Plasma ; Tumor Necrosis Factor-alpha

Malignant rhabdoid tumor was first discovered in the kidney, and rhabdoid tumor of the lung was first reported in 1995. These were included as the variants of large-cell carcinoma, according to the 1999 World Health Organization classification of lung tumors. The rhabdoid tumor of the lung exhibits aggressive biological behavior and has a poor prognosis, and only a few reports of this tumor exist. We report a case of lung carcinoma with a rhabdoid phenotype, initially misdiagnosed as an aspergilloma, in a 48-year-old man who presented with recurrent hemoptysis. The chest computed tomography scans showed a huge consolidative lesion with an air crescent sign in the left upper lung and no contrast-enhancing lesion. An aspergilloma was diagnosed by the radiologist. However, after surgical excision and pathological examination, rhabdoid carcinoma was diagnosed. A surgical resection helps to make it possible to pathologically distinguish a malignancy from an aspergilloma.
Aspergillosis ; Classification ; Hemoptysis* ; Humans ; Kidney ; Lung* ; Middle Aged ; Phenotype* ; Prognosis ; Rhabdoid Tumor ; Thorax ; World Health Organization

Malignant rhabdoid tumor was first discovered in the kidney, and rhabdoid tumor of the lung was first reported in 1995. These were included as the variants of large-cell carcinoma, according to the 1999 World Health Organization classification of lung tumors. The rhabdoid tumor of the lung exhibits aggressive biological behavior and has a poor prognosis, and only a few reports of this tumor exist. We report a case of lung carcinoma with a rhabdoid phenotype, initially misdiagnosed as an aspergilloma, in a 48-year-old man who presented with recurrent hemoptysis. The chest computed tomography scans showed a huge consolidative lesion with an air crescent sign in the left upper lung and no contrast-enhancing lesion. An aspergilloma was diagnosed by the radiologist. However, after surgical excision and pathological examination, rhabdoid carcinoma was diagnosed. A surgical resection helps to make it possible to pathologically distinguish a malignancy from an aspergilloma.
Aspergillosis ; Classification ; Hemoptysis* ; Humans ; Kidney ; Lung* ; Middle Aged ; Phenotype* ; Prognosis ; Rhabdoid Tumor ; Thorax ; World Health Organization

PURPOSE: In colorectal cancer, the role of detecting free malignant cells from peritoneal lavage is currently unclear. In this study, we investigated the positive rate of free malignant cells in peritoneal lavage fluid and their predictive value for prognosis and peritoneal recurrence after a curative resection. METHODS: From October 2009 to December 2011, in a prospective manner, we performed cytologic examinations of peritoneal lavage fluid obtained just after the abdominal incision from 145 patients who underwent curative surgery for colorectal cancer. We used proportional hazard regression models to analyze the predictive role of positive cytology for peritoneal recurrence and survival. RESULTS: Among total 145 patients, six patients (4.1%) showed positive cytology. During the median follow-up of 32 months (range, 8-49 months), 27 patients (18.6%) developed recurrence. Among them, 5 patients (3.4%) showed peritoneal carcinomatosis. In the multivariate analysis, positive cytology was an independent predictive factor for peritoneal recurrence (hazard ratio [HR], 136.5; 95% confidence interval [CI], 12.2-1,531.9; P < 0.0001) and an independent poor prognostic factor for overall survival (HR, 11.4; 95% CI, 1.8-72.0; P = 0.009) and for disease-free survival (HR, 11.1; 95% CI, 3.4-35.8; P < 0.0001). CONCLUSION: Positive cytology of peritoneal fluid was significantly associated with peritoneal recurrence and worse survival in patients undergoing curative surgery for colorectal cancer. Peritoneal cytology might be a useful tool for selecting patients who need intraperitoneal or systemic chemotherapy.
Ascitic Fluid ; Carcinoma ; Colorectal Neoplasms* ; Disease-Free Survival ; Drug Therapy ; Follow-Up Studies ; Humans ; Multivariate Analysis ; Peritoneal Lavage* ; Prognosis* ; Prospective Studies ; Recurrence*

PURPOSE: We conducted the immunoassay of pertussis according to ages, in order to evaluate protective immunity against pertussis in Korean populations. METHODS: Healthy subjects were enrolled at four university hospitals in Korea. The subjects were grouped as seven age groups (every 10 years). Antibodies against pertussis toxin (PT) in sera were measured by enzyme linked immunosorbent assay (ELISA) kits. Geometric mean concentrations (GMC) of antibodies and the ratios of the subjects with seroprotective antibody levels were determined. The subjects with antibody titers > or =24.0 EU/mL were considered to seroprotective as the manufacturer's protocol. RESULTS: Total 1,605 subjects (age: 2 months-65 years) participated in this study, and their GMC was 56.16+/-50.54 EU/mL. Among seven age groups, age group <11 year showed the highest GMC (64.78+/-53.24 EU/mL) (P<0.001). In the analysis of the ratios of the subjects with seroprotective antibody titers, 68.2% of the subjects were proven to seroprotective, and age group <11 year also showed the highest ratio (76.5%) (P<0.001). CONCLUSIONS: We found that adolescences or adults (age group > or =11 year) showed lower levels of antibody against pertussis and lower ratio of the subjects with seroprotective antibody titers than children (age group <11 year).
Adult ; Antibodies ; Child ; Enzyme-Linked Immunosorbent Assay ; Hospitals, University ; Humans ; Immunization ; Immunoassay ; Korea ; Pertussis Toxin ; Whooping Cough

Diphtheria-tetanus-acellular pertussis (DTaP) vaccination must currently be administered three times starting at 2 months of age, at intervals of two months, with the first and second boosters administered at 15 to 8 months and 4 to 6 years of age. A high rate of vaccination is maintained, but studies of the efficiency and safety of booster vaccination are lacking. This study evaluated the immunogenicity and safety of the DTaP booster vaccine. Seventy-two infants who had been vaccinated with the first booster and 78 children who had been vaccinated with the second booster were enrolled in this study. Local and systemic adverse reactions after vaccination were recorded. Sera obtained before and 1 month after booster vaccination were analyzed for antibodies to diphtheria and tetanus toxoid, and anti-pertussis toxin. Diphtheria: The GMT was increased. Tetanus: The geometric mean antibody titer (GMT) was increased. Pertussis: The GMT was increased by 13.72 times and 14.37 times after the first and the second additional vaccination, respectively. Although the seroconversion rate was low prior to the first booster, the average amount of anti-pertussis toxin antibodies before the first additional vaccination was 143.37 EU/mL, which rose to 261.88 EU/mL after the vaccination. The seroconversion rate also increased to 100%. Adverse reactions showed spontaneous resolution within a few days after vaccination. After the second additional vaccination, there was a statistically significant increase in the manifestation of myalgia compared to after the first additional vaccination. In conclusion, DTaP booster vaccination was effective in Korean children, demonstrating that modifications to the current regimen would be unnecessary.
Antibodies ; Child ; Diphtheria ; Diphtheria-Tetanus-acellular Pertussis Vaccines ; Humans ; Immunization, Secondary ; Infant ; Tetanus Toxoid ; Vaccination ; Whooping Cough