Analysis of the Relationship between Students' Seating Preferences and Academic Achievement in Medical School / 한국의학교육

PURPOSE: This study aimed to explore the relationship between students' seating preferences and academic achievement in medical school. METHODS: The subjects of this study were 109 second-year students in C medical school. The pattern of seat selection of 109 students was surveyed by participant observation for 48 days, and a questionnaire was administered to determine the factors that were considered by students. Using SPSS version 12.0, we analyzed the factors that students considered with regard to seat selection and seat preference and the frequency of seat movements between areas. We performed one-way ANOVA to analyze the differences in academic achievement between students who moved seats versus those who did not. RESULTS: The most common reasons for seat selection were to focus better on the lecture (60 students), to focus better on lecture, and to feel familiar with the same seat (60 students). Students' preferred seats were in rows A4, A7, A5, and A3 (in descending order), which are primarily the central sections, and columns B15, B1, B14, B19 (in descending order), which are primarily both ends of the division. The difference in academic achievement between students who moved seats and those who did not was not significant (p>0.05). Among students who did not move seats, the difference in academic achievement between 9 seating areas was not significant in 6 subjects (p>0.05). CONCLUSION: The results of this study suggest that we should reconsider a professor's general perception regarding academic achievement according to seat location.

Clinical Analysis of Sleep Disorders in Korean Children / 대한소아신경학회지

PURPOSE: Sleep disorders are one of the most common neurologic conditions in children and adolescents. They have an important impact on quality of their life, such as physical, psychosocial and emotional problems. This study was aimed to investigate clinical and polysomnographic features of sleep disorders in Korean children and adolescents. METHODS: Thirty two patients with sleep disorders were involved in the study. Their medical records and polysomnographs(PSG) were retrospectively reviewed. RESULTS: The mean age was 10.1+/-4.2 years, and the male to female ratio was 2.6. Chief complaints included abnormal movement during sleep(n=12, 37.5%), snoring with sleep apnea(n=9, 28.1%), excessive daytime sleepiness(n=8, 25.0%). Among 12 patients who showed abnormal behaviors during the sleep, 7 patients were diagnosed as parasomnia and 4 patients as epilepsy, 1 as sleep apnea by polysomnographic findings. Eight out of nine patients with sleep apnea and snoring revealed increased apnea-hypopnea index(AHI>1). As a result, 4 patients had tonsillectomy & adenoidectomy(T&A) and 2 patients had uvulopalatopharyngoplasty (UPPP) with good results. Among 8 patients with excessive daytime sleepiness, 4 patients were diagnosed with narcolepsy by PSG and multiple sleep latency test (MSLT). They were treated with modafinil and scheduled nap. CONCLUSION: In this study, we found there are various kinds of sleep disorders in Korean children and adolescents and PSG is still a very important diagnostic tool. However, further studies are needed to elucidate sleep disorders in them.

Restoration of Reproductive Potential after Autotransplantation of Frozen Ovaries in Mice Pretreated with Cyclophosphamide / 한국유방암학회지

PURPOSE: Infertility due to ovarian failure that is caused by antineoplastic chemotherapeutic agents is one of the primary problems of female cancer atients who are in their reproductive years. It has become important to preserve the reproductive potential of female cancer patients. This study was conducted to determine whether autotransplantation of frozen ovaries can restore reproductive potential. METHODS: This study included 30 female mice that had normal reproductive potential. The mice were divided into 4 groups: the positive control, the negative control, the comparison group, and the experimental group. The positive control group received right total oophorectomy, and the negative control group received bilateral total oophorectomy. Greater than or equal to 90% of the left ovary was removed in the mice of the comparison group, and then cyclophosphamide was administered. In the experimental group, the right ovary taken out by right total oophorectomy, and this was crypreserved using the vitrification method. And then cyclophosphamide was administered. The cryopreserved ovary was autotransplanted to the left gonadal fat pad after greater than or equal to 90% of the left ovary was removed. The reproductive performance in each group was analyzed according to the pregnancy rate after mating. RESULTS: In the positive control group, all five mice became pregnant, and the number of fetuses was 4 to 5 (mean=4.60+/-0.55). In the comparison group, the pregnancy rate was 50%, and the mean number of fetuses was 1.40+/-0.55. In the experimental group, 7 of 10 (70%) mice became pregnant, and the mean number of fetuses was 4.71+/-2.56. There was no significant difference in the number of fetuses between the positive control and the experimental group (p=0.093), but there was a significant difference in the number of fetuses between the comparison group and the experimental group (p=0.019). CONCLUSION: The results of this study suggest that autotransplantation of frozen ovaries using the vitrification method may restore the impaired ovarian function induced by antineoplastic chemotherapeutic agents.

Immunohistochemical Study for MAPK Expression in Epidermal Tumors Related to Sun Exposure / 대한피부과학회지

BACKGROUND: Mitogen-activated protein kinase(MAPK) is an important molecule in transducing extracellular signal from cell surface to the nucleus. MAPK family includes ERK(extracellular signal-regulated protein kinase), JNK(stress-activated c-Jun N-terminal kinase), p38 kinases. Not only various growth factors and cytokines, but also other signals such as UV light are able to activate MAPK, resulting in various cellular responses including proliferation, differentiation and apoptosis. OBJECTIVE: The purpose of our study was to determine patterns of MAPK expression in epidermal tumors including seborrheic keratosis(SK) on sun-exposed skin and unexposed area, actinic keratosis(AK), Bowen's disease(BD), acantholytic squamous cell carcinoma(ASCC), and other squamous cell carcinoma(SCC). METHODS: Using pan ERK, JNK-2 and p-JNK, we have examined MAPK expression immunohistochemically in epidermal tumors(total 30 cases) including SK on sun-exposed skin(5 cases) and unexposed areas(5 cases), AK(5 cases), BD(5 cases), ASCC(5 cases), and SCC(5 cases). RESULTS: ERK was expressed in AK and ASCC positively but not in BD, and the staining pattern with ERK also showed positivity in microinvasive area and dysplastic cells of SCC. JNK was not expressed in all tumor cells of SK, AK, BD, and ASCC with the exception of dyskeratotic cells in BD and acantholytic cells in ASCC. CONCLUSIONS: We suggest that ERK expression may be related to sun exposure and responsible for proliferation of tumor and invasion into surrounding tissue. JNK may not be related with malignant progression of tumor and carcinogenesis cauesd by sun exposure, but with apoptosis of tumor cells.

Prospective Clinical Study of Prophylactic Antibiotic Therapy in Nonperforated Appendicitis

PURPOSE: Prophylactic antibiotics have been used in nonperforated appendicitis for preventing infection after an appendectomy. However, the duration of antibiotic administration for surgical prophylaxis in Korea has been noted to be longer than those recommended in other countries. PURPOSE: The objective of this study was to identify the appropriate duration of prophylactic antibiotic therapy in nonperforated appendicitis by comparing the wound infection rates of two different antibiotic regimens, 24 hours of cephalosporin (cefoxitin) alone and 72 hours of cephalosporin (cefoxitin) with aminoglycoside (sissomicin). METHODS: One hundred thirty-four (134) patients of nonperforated appendicitis were enrolled in this prospective, randomized, open trial and were assigned to one of two antibiotic regimens: 1) cefoxitin 1 g every 8 hours given intravenously for 24 hours and 2) cefoxitin 1 g every 8 hours given intravenously plus sissomicin 75 mg every 12 hours given intramuscularly for 72 hours. First doses were given just prior to the induction of anesthesia. RESULTS: Postoperative wound infections were detected in 3 cases (4.5%) of the 72-hour-treated group (n=66) whereas none occurred in the 24-hour-treated group (n=68). However, the difference in the rates of wound infections between the two groups was not statistically significant. Cost analysis identified a saving of 43,470 won per patient in the 24-hour-treated group. CONCLUSION: In nonperforated appendicitis cefoxitin administration alone for 24 hours is sufficient as a surgical prophylaxis.

A Case of Aneurysmal Benign Fibrous Histiocytoma / 대한피부과학회지

Aneurysmal benign fibrous histiocytoma, which is a rare variant of benign fibrous histiocytoma, usually occurs as a solitary nodule on the limbs of young to middle aged adults. The clinical diagnosis of fibrous histiocytoma is seldom considered in the differential disgnosis, which may include malignant melanoma, hemangioma, neurorfibroma, and nonspecific cyst. Histopathologically, aneurysmal benign fibrous histiocytoma is characterized by the presence of large blood-filled tissue space which is surrounded by histiocyte, fibroblast, hemosiderin pigment, and capillaries. We report a case of aneurysmal benign fibrous histiocytoma in a 15-year-old boy, who had a solitary nodular lesion on the left knee for a 2 year duration.

Case of an Intracystic (Encysted) Papillary Carcinoma of the Breast

Intracystic (encysted) papillary carcinoma of the breast (IPC) is a rare tumor with predilection for elderly postmenopausal women and has distinctive pathological features that should be distinguished from those of ductal carcinoma in situ (DCIS) of the papillary type and invasive papillary carcinoma. IPC can appear in a pure form or can be associated with DCIS or invasive carcinoma. It is usually a low-grade carcinoma with overall good prognosis, presenting low or intermediate nuclear grade, no necrosis, high positivity to estrogen receptors, and the negativity for c-erbB-2. We report here a case of IPC managed by lumpectomy with ipsilateral axillary lymph node dissection

Factors Associated with Renal Failure in Children with Primary Vesicoureteral Reflux

PURPOSE: The pathophysiologic mechanisms and risk factors of renal functional deterioration are still controversial. We analyzed the factors associated with renal failure in children with primary vesicoureteral reflux. METHODS: The medical records of 166 children who were diagnosed with primary vesicoureteral reflux from Jan. 1985 to Dec. 1996 in the Department of Pediatrics, Seoul National University Children's Hospital were reviewed retrospectively. The patients were divided into two groups according to renal function: patients with renal failure(RF group) and patients with normal renal function(NRF group). RESULTS: Eighteen(11%) were classified as RF group, and 16(89%) of them were male. Sixteen (89%) of RF group revealed decreased renal function at the time of diagnosis. There was no past history of documented urinary tract infection in 16(89%) of RF group. Patients of RF group had a higher grade of reflux as compared with those of NRF group. Proteinuria and hypertension were found in 16(89%) and 6(33%) of RF group, respectively, while no NRF patients had proteinuria or hypertension. Renal functional deterioration had progressed to end-stage renal disease in 6(33%) of RF group during a mean follow-up of 4.4+/-2.7(range 0.5-12) years. CONCLUSION: Reflux nephropathy and renal scar in children can be prevented, in some cases, by early diagnosis of vesicoureteral reflux and prophylaxis of urinary tract infection. Regular check up for proteinuria and hypertension is essential for early detection of renal dysfunction. However, in other patients, especially in male, renal dysfunction can develop independently on urinary tract infection.

The Expression of c-erbB-2 and CD44 Gene in Breast Cancer / 한국유방암학회지

There are some controversial opinions on the prognostic value of metastasis-associated tumor markers in breast cancer. Out of them, the overexpression of c-erbB-2 proto-oncogene or CD44 gene has been debated on their activities in promoting metastatic potential. To determine the relationship between expression of both genes, and, clinicopathological parameters and disease outcomes including relapse and survival, 48 archival paraffin-embedded breast-cancer tissues were stained using monoclonal antibody against each gene product by immunohistochemical staining method, and the result was analyzed. The positive expression rates of c-erbB-2 and CD44 genes were 45.8% and 18.8%, respectively. The co-expression rates of both positives and both negatives were 14.6% and 50.0%, respectively. Except the statistically significant positive correlation between CD44 and tumor size (P=0.003), the expression rates of c-erbB-2 and CD44 had no significant relationship with tumor size, stge, lymph node status, and disease recurrence (p>0.05). In the positive expression cases for CD44, disease-free survival (DFS) and overall survival (OS) in months were shorter than the negative ones (53+/-8 vs. 64+/-5 and 67+/-8 vs. 77+/-5 S.E.) And, the c-erbB-2 positive cases had longer OS than the negative ones (78+/-6 vs. 71+/-6). The OS of positive co-expression cases with the c-erbB-2 and CD44 was shorter than that of one-gene expression ones (66+/-6 vs. 75+/-7). So the OS result observed in the expression of c-erbB-2 alone was reversed in the co-expression study. Though these results had no statistically significant level (p>0.05), we suggest a question that if there is any interaction or dependency between c-erbB-2 and CD44 expression in a view of disease process including OS. Finally, further randomized controlled studies are advisable for the reproducible and significant results.

Three Cases of Papular Elastorrhexis / 대한피부과학회지

Papular elastorrhexis is a connective tissue nevus that occurs in the second decade of life as asymptomatic small white-creamy papules scattered over the chest, shoulder, abdomen, or back Histopathologically, there is a decrease in elastic fibers with focal homogenization of collagen. Recognition of this entity is important to prevent use of unnecessary diagnostic procedures and therapy. We present three cases of papular elastorrhexis. All of them occurred in children under the age 10 years.

A Case Of Dermatomyositis Associated With Uterine Cervical Cancer / 대한류마티스학회지

Dermatomyositis is a group of connective tissue disorders characterized by non-suppurative inflammation of the skeletal muscle and skin lesions. It is associated with malignancy, especially of the stomach, lung, overy and breast. we report a case of dermatomyositis with uterine cervical concer. A 78 year old female patient was admitted because of progressive proximal muscle weakness, skin rashes, and vaginal spotting. She was bedridden because of severe proximal muscle weakness and atrophy, unable to elevate her head, and suffered from dysphagia. Gottron's patches were found on the knuckles of the hands, scaly erythematous rashes on the extensor surfaces of bilateral elbows, wrists and knees. The serum concentrations of muscle enzymes were elevated, the biopsy of quadriceps muscle showed the features comparable with myositis, and the uterine cervical biopsy revealed squamous cell carcinoma, which was determined to be in stage lib by pelvic CT. Radiotherapy(total 3240 cGy) was done for the cervical cancer and prednisolone (initially 60mg/day) was given for the dermatomyositis. The muscle power improved only a little although the concentrations of serum muscle enzmes returned to normal. She deceased of aspiration pneumonia 43 days after the admission.