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Duty hour regulations (DHRs) were enforced in 2017 in Korea to prevent the detrimental effects of excessively prolonged working hours among medical residents. We investigated the adoption of and implications of the new DHRs among medical residents and faculty members. Semi-structured interviews were conducted with 15 medical residents and 9 faculty members across general surgery, internal medicine, obstetrics-gynecology, and pediatrics departments at Chonnam National University Hospital. Based on the constructivist grounded theory, we developed themes from the data by concurrent coding and analysis with theoretical sampling until data saturation. In addition, respondent validation was used to ensure accuracy, and all authors remained reflexive throughout the study to improve validity. The methods of DHRs adoption among residents and faculty members included the following 4 themes: DHRs improved work schedule, residents have more time to learn on their own, clinical departments have come to distribute work, organization members have strived to improve patient safety. Residents have undertaken initial steps towards creating a balance between personal life and work. Teamwork and shift within the same team are the transitions that minimize discontinuity of patient care considering patient safety. Teaching hospitals, including faculty members, should ensure that residents' work and education are balanced with appropriate clinical experience and competency-based training.
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Internado y Residencia , Carga de Trabajo , Niño , Humanos , Admisión y Programación de Personal , Docentes Médicos , República de CoreaRESUMEN
We implemented flipped learning for a gross anatomy dissection course and compared its effects on students' motivation and academic achievement with those of traditional dissection methods. We invited 142 first-year medical students at Chonnam National University Medical School to participate in this study. All participants engaged in traditional dissection methods in the first part of the study and flipped learning in the latter part. Medical students' motivation to learn anatomy by cadaveric dissection was measured using the ARCS (Attention, Relevance, Confidence, and Satisfaction) model. Thereafter, all students completed a written examination consisting of 96 multiple-choice questions. The students' mean motivational score regarding attention was significantly higher in association with flipped learning than with traditional learning. However, the students' mean motivational scores regarding relevance, confidence, and satisfaction were not significantly different between the methods. Additionally, the mean anatomy practice test score was significantly higher in association with flipped learning than with traditional learning. The students' motivational scores and anatomy practice test scores associated with flipped learning positively correlated with the extent of learning material completion. The students' responses indicated that flipped learning helped enhance the learning process, improve time management, reduce confusion during practice, and promote independent practice. The application of flipped learning to a cadaveric dissection course increased individual learning motivation, which improved learning activities both in and out of class, as well as academic achievement.
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Anatomía , Estudiantes de Medicina , Humanos , Evaluación Educacional , Aprendizaje , Disección , Curriculum , Cadáver , Aprendizaje Basado en Problemas/métodos , Anatomía/educaciónRESUMEN
Longitudinal research has provided systematic empirical data on the short- and long-term outcomes of admissions policies, curricular innovations, and complex decisions on students' academic progress. This study aimed to investigate the academic performance of medical students and related factors using cohort database collected from a medical school. The study participants included 134 medical students who graduated from Chonnam National University Medical School in 2022. The medical school's cohort database was used to collect data on demographics, admission, academic performance, extracurricular activities, and performance on the National Korean Medical Licensing Examination (KMLE). Participating in club activities had a significant association with medical students' academic advancement delay or leave of absence during the entire course of medical school (P = 0.007). Logistic regression analysis indicated that the nationwide clinical knowledge mock examination during the fourth year of medical school was significantly associated with passing the KMLE (adjusted odds ratio 1.12, 95% confidence interval 1.02-1.22; P = 0.014). Extracurricular school activities (a non-cognitive student attribute) and a wide range of cognitive student attributes captured from the cohort database were associated with medical students' academic performance. In conclusion, this study can reinforce a strong emphasis on the inclusion of cognitive and non-cognitive information in medical school curricula and assessments in order to improve medical education programs and future postgraduate performance.
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Rendimiento Académico , Estudiantes de Medicina , Humanos , Estudios Retrospectivos , Estudiantes de Medicina/psicología , Facultades de Medicina , UniversidadesRESUMEN
BACKGROUND: This study explored the relationship between integrase strand transfer inhibitor (INSTI)-based anti-retroviral agents and weight gain over time, and the risk factors for weight gain in Korean people living with human immunodeficiency virus (PLWH). MATERIALS AND METHODS: The study was conducted retrospectively in PLWHs 18 years of age or older who took one of three INSTI-based single-tablet regimens (STRs) (tenofovir disoproxil fumarate/emtricitabine/elvitegravir/cobicistat [TDF/F/EVG/c], tenofovir alafenamide/emtricitabine/elvitegravir/cobicistat [TAF/F/EVG/c], and abacavir/lamivudine/dolutegravir [ABC/3TC/DTG]) for more than 2 years at three university-affiliated hospitals in South Korea from May 2014 to December 2020. Analysis was performed in the treatment-naïve and treatment-experienced groups, respectively. RESULTS: Individual INSTI-based STRs were associated with weight gain at the 24-month follow up in both treatment-naïve (n = 179) and treatment-experienced (n = 290) groups. Body mass index (BMI) categories changed over time for TAF/F/EVG/c and ABC/3TC/DTG, with significant increases in the rates of overweight and obesity in treatment-naïve patients, whereas there was no change for TDF/F/EVG/c. TAF/F/EVG/c significantly increased total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and triglyceride (TG) compared to other regimens over 24 months. In the treatment-naïve group, a baseline CD4+ T cell count <100 cells/mm3, human immunodeficiency virus (HIV) viral load (VL) ≥100,000 copies/mL, no physical exercise, and TAF/F/EVG/c (vs. TDF/F/EVF/c) were risk factors for ≥10% weight gain. In the treatment-experienced group, age <45 years, BMI <25 kg/m², and no physical exercise were risk factors for ≥5% weight gain. CONCLUSION: INSTI-based STR continued to increase body weight at the 24-month follow up in treated and untreated Korean PLWH. Exercise, together with demographic-, HIV-, and anti-retroviral therapy-related factors, influenced weight gain. Therefore, when prescribing an INSTI-based STR, weight gain and metabolic changes should be closely monitored in PLWH with these risk factors.
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PURPOSE: The purpose of this study was to investigate the effect of motivational regulation strategies (MRSs) on cognitive learning and academic performance. METHODS: The participants were a total of 510 pre-medical and medical students. Survey instruments assessed the use of MRSs and cognitive learning strategies. Students' grade point averages were used for academic performance. Structural equation modeling was used to analyze data, using Mplus ver. 7.4 (Muthén & Muthén, Los Angeles, USA). RESULTS: Confirming the measurement model validity, the results of structural model indicated the followings: (1) MRSs had a significant impact on cognitive learning, while these strategies negatively affected academic performance; (2) cognitive learning significantly influenced academic performance and mediated the effect of MRSs on academic performance; and (3) only academic levels had a significant effect on cognitive learning. CONCLUSION: The findings from this study confirmed that MRSs were highly influential to predicting students' cognitive learning which affects their better learning performance. Thus, instructional design and practice to support learning motivation is needed to promote cognitive learning and training programs to practice the effective methods of using MRSs in learning need to be provided.
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Rendimiento Académico , Educación a Distancia , Estudiantes de Medicina , Cognición , Humanos , MotivaciónRESUMEN
BACKGROUND: Achievement of target blood concentrations of cyclosporine (CsA) early after transplantation is known to be highly effective for reducing the incidence of acute graft versus host disease (aGVHD). However, no research has been conducted for predicting aGVHD occurrence with low CsA concentrations at different time periods. The objective of this study was to investigate the risk of aGVHD according to low CsA concentrations at lag days in children with allogenic hematopoietic stem cell transplantation (HSCT). METHODS: The records of 61 consecutive children who underwent allogeneic HSCT and received CsA as prophylaxis against aGVHD between May 2012 and March 2015 were retrospectively evaluated. The main outcome was any association between low CsA concentrations at lag days and aGVHD occurrence, which was examined for the first month after transplantation. Mean CsA concentrations at three lag periods were calculated: lag days 0-6, 7-13, and 14-20 before aGVHD occurrence. RESULTS: Patients whose mean CsA concentrations at lag days 0-6 did not reach the initial target concentration had 11.0-fold (95% confidence interval [CI]: 2.3-51.9) greater incidence of aGVHD. In addition, the AORs of low CsA concentrations at lag days 7-13 and 14-20 for developing aGVHD were 108.2 (95% CI: 7.7-1515.5) and 12.1 (95% CI: 1.1-138.1), respectively. CONCLUSIONS: After low CsA concentrations are detected, careful attention needs to be paid to prevent aGVHD.
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Enfermedad Injerto contra Huésped , Trasplante de Células Madre Hematopoyéticas , Enfermedad Aguda , Niño , Ciclosporina/efectos adversos , Enfermedad Injerto contra Huésped/prevención & control , Trasplante de Células Madre Hematopoyéticas/efectos adversos , Humanos , Estudios RetrospectivosRESUMEN
PURPOSE: This study investigated the perceptions of medical residents and faculty members before the implementation of the duty hour regulation in December 2017. METHODS: A survey was administered to 263 residents and 358 faculty members in the Chonnam National University Hospital. The subjects were given a self-administered structured questionnaire designed to measure their perspectives on duty hour regulation. They were also asked to answer an open-ended question regarding their expectations or concerns regarding duty hour regulation. The response rates were 50.2% for residents and 24.0% for faculty members. RESULTS: Residents and faculty members regarded the improvement of junior residents' well-being favorably, but had conflicting views regarding senior residents. Residents expressed difficulty in completing unchanged workloads within the limited time, while faculty members were more concerned about worsening patient safety due to the discontinuity of care and insufficient resident education. CONCLUSION: Medical residents and faculty members had differing concerns regarding duty hour regulation. Further studies and the development of future policies should be considered to improve resident education and patient safety within the limited duty hour regulation.
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Actitud del Personal de Salud , Educación de Postgrado en Medicina/organización & administración , Docentes Médicos/psicología , Internado y Residencia/organización & administración , Estudiantes de Medicina/psicología , Carga de Trabajo , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Seguridad del Paciente , República de Corea , Encuestas y CuestionariosRESUMEN
PURPOSE: This study investigated medical students' attitudes toward academic misconduct that occurs in the learning environment during the pre-clinical and clinical periods. METHODS: Third-year medical students from seven medical schools were invited to participate in this study. A total of 337 of the 557 (60.5%) students completed an inventory assessing their attitudes toward academic misconduct. The inventory covered seven factors: scientific misconduct (eight items), irresponsibility in class (six items), disrespectful behavior in patient care (five items), dishonesty in clerkship tasks (four items), free riding on group assignments (four items), irresponsibility during clerkship (two items), and cheating on examinations (one item). RESULTS: Medical students showed a strict attitude toward academic misconduct such as cheating on examinations and disrespectful behavior in patient care, but they showed a less rigorous attitude toward dishonesty in clerkship tasks and irresponsibility in class. There was no difference in students' attitudes toward unprofessional behaviors by gender. The graduate medical school students showed a stricter attitude toward some factors of academic misconduct than the medical college students. This difference was significant for irresponsibility in class, disrespectful behavior in patient care, and free riding on group assignments. CONCLUSION: This study indicates a critical vulnerability in medical students' professionalism toward academic integrity and responsibility. Further study evidence is needed to confirm whether this professionalism lapse is confined only to this population or is pervasive in other medical schools as well.
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Actitud del Personal de Salud , Mala Conducta Profesional/psicología , Mala Conducta Científica/psicología , Estudiantes de Medicina/psicología , Estudios Transversales , Evaluación Educacional , Femenino , Humanos , Masculino , República de Corea , Estudiantes de Medicina/estadística & datos numéricosRESUMEN
Using multilocus sequence typing (MLST), Candida albicans can be subdivided into 18 different clades. Farnesol, a quorum-sensing molecule secreted by C. albicans, is thought to play an important role in the development of C. albicans biofilms and is also a virulence factor. This study evaluated whether C. albicans bloodstream infection (BSI) strains belonging to different MLST clades secrete different levels of E,E-farnesol (FOH) and whether they have different clinical characteristics. In total, 149 C. albicans BSI isolates from ten Korean hospitals belonging to clades 18 (n = 28), 4 (n = 23), 1 (n = 22), 12 (n = 17), and other clades (n = 59) were assessed. For each isolate, the FOH level in 24-hour biofilms was determined in filtered (0.45 µm) culture supernatant using high-performance liquid chromatography. Marked differences in FOH secretion from biofilms (0.10-6.99 µM) were observed among the 149 BSI isolates. Clade 18 isolates secreted significantly more FOH than did non-clade 18 isolates (mean ± SEM; 2.66 ± 0.22 vs. 1.69 ± 0.10 µM; P < 0.001). Patients with isolates belonging to clade 18 had a lower mean severity of illness than other patients, as measured using the "acute physiology and chronic health evaluation" (APACHE) III score (14.4 ± 1.1 vs. 18.0 ± 0.7; P < 0.05). This study provides evidence that C. albicans BSI isolates belonging to the most prevalent MLST clade (clade 18) in Korea are characterized by increased levels of FOH secretion and less severe illness.
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Candida albicans/genética , Candida albicans/metabolismo , Candidemia/microbiología , Farnesol/metabolismo , Tipificación de Secuencias Multilocus , Adulto , Anciano , Biopelículas/crecimiento & desarrollo , Candida albicans/clasificación , Candidemia/diagnóstico , Candidemia/tratamiento farmacológico , Candidemia/etiología , Candidemia/mortalidad , Femenino , Genotipo , Humanos , Masculino , Persona de Mediana EdadRESUMEN
PURPOSE: This study was to explore the relationship between clinical performance examination (CPX) achievement and epistemological beliefs to investigate the potentials of epistemological beliefs in ill-structured medical problem solving tasks. METHODS: We administered the epistemological beliefs questionnaire (EBQ) to fourth-year medical students and correlated the results with their CPX scores. The EBQ comprised 61 items reflecting five belief systems: certainty of knowledge, source of knowledge, rigidity of learning, ability to learn, and speed of knowledge acquisition. The CPX included scores for history taking, physical examination, and patient-physician interaction. RESULTS: The higher epistemological beliefs group obtained significantly higher scores on the CPX with regard to history taking and patient-physician interaction. The epistemological beliefs scores on certainty of knowledge and source of knowledge were significantly positively correlated with patient-physician interaction. The epistemological beliefs scores for ability to learn were significantly positively correlated with those for history taking, physical examination, and patient-physician interaction. CONCLUSION: Students with more sophisticated and advanced epistemological beliefs stances used more comprehensive and varied approaches in the patient-physician interaction. Therefore, educational efforts that encourage discussions pertaining to epistemological views should be considered to improve clinical reasoning and problem-solving competence in the clinic setting.
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Logro , Actitud , Competencia Clínica , Cultura , Educación de Pregrado en Medicina , Conocimiento , Estudiantes de Medicina , Adulto , Evaluación Educacional , Femenino , Humanos , Masculino , Anamnesis , Examen Físico , Relaciones Médico-Paciente , Aprendizaje Basado en Problemas , República de Corea , Facultades de Medicina , Encuestas y Cuestionarios , Pensamiento , Adulto JovenRESUMEN
INTRODUCTION: This study examines the relationship between the clinical performance of medical students and their performance as doctors during their internships. METHODS: This retrospective study involved 63 applicants to a residency programme conducted at the Chonnam National University Hospital, South Korea, in November 2012. We compared the performance of the applicants during their internship with the clinical performance of the applicants during their fourth year of medical school. The performance of the applicants as interns was periodically evaluated by the faculty of each department, while the clinical performance of the applicants as fourth year medical students was assessed using the Clinical Performance Examination (CPX) and the Objective Structured Clinical Examination (OSCE). RESULTS: The performance of the applicants as interns was positively correlated with their clinical performance as fourth year medical students, as measured by CPX and OSCE. The performance of the applicants as interns was moderately correlated with the patient-physician interactions items addressing communication and interpersonal skills in the CPX. CONCLUSION: The clinical performance of medical students during their fourth year in medical school was related to their performance as medical interns. Medical students should be trained to develop good clinical skills, through actual encounters with patients or simulated encounters using manikins, so that they are able to become competent doctors.
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Competencia Clínica , Educación de Postgrado en Medicina/métodos , Evaluación Educacional/métodos , Internado y Residencia , Facultades de Medicina , Estudiantes de Medicina/psicología , Femenino , Humanos , Masculino , República de Corea , Estudios RetrospectivosRESUMEN
Peer-assisted learning encourages students to participate more actively in the dissection process and promotes thoughtful dissection. We implemented peer-assisted dissection in 2012 and compared its effects on students' self-assessments of learning and their academic achievement with those of faculty-led dissection. All subjects performed dissections after a lecture about upper-limb gross anatomy. Experimental group (n = 134) dissected a cadaver while guided by peer tutors who had prepared for the dissection in advance, and control group (n = 71) dissected a cadaver after the introduction by a faculty via prosection. Self-assessment scores regarding the learning objectives related to upper limbs were significantly higher in experimental group than in control group. Additionally, experimental group received significantly higher academic scores than did control group. The students in peer-assisted learning perceived themselves as having a better understanding of course content and achieved better academic results compared with those who participated in faculty-led dissection. Peer-assisted dissection contributed to self-perception and to the ability to retain and explain anatomical knowledge.
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Anatomía/educación , Disección/métodos , Educación de Pregrado en Medicina/métodos , Grupo Paritario , Adulto , Cadáver , Comprensión , Evaluación Educacional , Femenino , Humanos , Aprendizaje , Masculino , Modelos Estadísticos , Percepción , Estudiantes de Medicina , Encuestas y Cuestionarios , Adulto JovenRESUMEN
PURPOSE: To explore the relationship between problem-based learning (PBL) evaluations and clinical performance. METHODS: The study included 117 third-year medical students at Chonnam National University Medical School. The students' first-, second-, and third-year PBL evaluations were compared with their clinical performance examination (CPX) scores in third year. The PBL evaluations were composed of three subscales: tutors' evaluation (students' professional behavior, contribution to group process, and contribution to group content), a report, and a written examination. The CPX assessed four performance categories: history taking, physical examination, information sharing, and patient-physician interaction. RESULTS: No significant correlation was found between the first-year PBL evaluations and CPX scores; however, the second-year PBL evaluations were significantly correlated with history taking (r=0.186, p=0.044) and patient-physician interaction (r=0.213, p=0.021) of CPX. The third-year PBL evaluations were significantly correlated with physical examination (r=0.248, p=0.007), and patient-physician interaction (r=0.283, p=0.002) of CPX. Several significant correlations between the PBL evaluations subscales and CPX scores were revealed. The PBL tutors' evaluation (r=0.343, p=0.000) and report scores (r=0.210, p=0.023) were significantly correlated with patient-physician interaction of CPX. The contribution to group process of tutors' evaluation was significantly correlated with patient-physician interaction (r=0.186, p=0.045), and the contribution to group content of tutors' evaluation was significantly correlated with physical examination (r=0.187, p=0.044). CONCLUSION: We found a significant association between PBL evaluations and CPX scores.
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Competencia Clínica , Educación de Pregrado en Medicina , Evaluación Educacional , Aprendizaje Basado en Problemas , Estudiantes de Medicina , Procesos de Grupo , Humanos , República de Corea , Facultades de Medicina , UniversidadesRESUMEN
A survey was conducted to evaluate the multi-exposure level and correlation among toxic metal biomarkers (Cd, Pb, and Hg). A total of 592 individuals who participated in the survey were residents near an industrial complex in Gwangyang and Yeosu (exposed group) and of Hadong and Namhae (control group) in southern Korea from May 2007 to November 2010. The Gwangyang and Yeosu area exposed groups had slightly higher blood Pb (2.21 and 1.90 µg/dL), urinary Cd observed values (2.20 and 1.46 µg/L), urinary Cd with a urinary creatinine correction (1.43 and 1.25 µg/g Cr), and urinary Hg observed values (2.26 and 0.98 µg/L) in women participants than those in the Hadong and Namhae area (control group). Blood Pb (3.18 and 2.55 µg/dL), urinary Hg observed values (1.14 and 0.92 µg/L), and urinary Hg with a urinary creatinine correction (1.06 and 0.96 µg/L) for male participants were also slightly higher than those in the Hadong and Namhae area (control group). The correlation among urinary Cd, Hg and Pb concentrations in the blood was significant. We suggest that the exposed group of residents were simultaneously exposed to Pb, Cd, and Hg from contaminated ambient air originating from the iron manufacturing industrial complex.
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Exposición a Riesgos Ambientales/análisis , Contaminantes Ambientales/metabolismo , Industrias , Metales Pesados/metabolismo , Adulto , Anciano , Biomarcadores/metabolismo , Estudios de Cohortes , Exposición a Riesgos Ambientales/estadística & datos numéricos , Monitoreo del Ambiente , Femenino , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , República de CoreaRESUMEN
OBJECTIVES: We hypothesized that medical students exposed to a case-based curriculum in years 1 and 2 and clinical cases in the year 3 clerkship would demonstrate a longitudinal increase in the deep approach to learning and a decrease in the surface apathetic approach. METHODS: A cohort of first-year medical students completed the Approaches and Study Skills Inventory for Students at the beginning of their first term and again at the beginning of their fourth year. Approaches and Study Skills Inventory for Students scores were aggregated into three main learning approach scales: deep, strategic, and surface apathetic. RESULTS: On average, deep and strategic scores did not significantly change between years 1 and 4, but the surface apathetic mean score decreased as a result of lower syllabus boundness and fear of failure subscale scores. Effect sizes were small (d = 0.30, 0.34, respectively). CONCLUSIONS: The deep approach to learning is a complex process and did not change in our students after 3 years of medical school, even though a case-based curriculum was believed to foster deeper learning. By the end of year 3, our students were, on average, less bound to syllabi and feared failure less.
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Educación de Pregrado en Medicina/métodos , Aprendizaje , Estudiantes de Medicina/psicología , Enseñanza/métodos , Adulto , Evaluación Educacional/métodos , Femenino , Humanos , Estudios Longitudinales , Masculino , Aprendizaje Basado en Problemas/métodos , Estudios Prospectivos , Encuestas y Cuestionarios , Adulto JovenRESUMEN
Amomum tsao-ko Crevost et Lemarié (Zingiberaceae) has traditionally been used to treat inflammatory and infectious diseases, such as throat infections, malaria, abdominal pain and diarrhoea. This study was designed to assess the anti-inflammatory effects and the molecular mechanisms of the methanol extract of A. tsao-ko (AOM) in lipopolysaccharide (LPS)-induced RAW 264.7 macrophages and in a murine model of sepsis. In LPS-induced RAW 264.7 macrophages, AOM reduced the production of nitric oxide (NO) by inhibiting inducible nitric oxide synthase (iNOS) expression, and increased heme oxygenase-1 (HO-1) expression at the protein and mRNA levels. Pretreatment with SnPP (a selective inhibitor of HO-1) and silencing HO-1 using siRNA prevented the AOM-mediated inhibition of NO production and iNOS expression. Furthermore, AOM increased the expression and nuclear accumulation of NF-E2-related factor 2 (Nrf2), which enhanced Nrf2 binding to antioxidant response element (ARE). In addition, AOM induced the phosphorylation of extracellular regulated kinase (ERK) and c-Jun N-terminal kinase (JNK) and generated reactive oxygen species (ROS). Furthermore, pretreatment with N-acetyl-l-cysteine (NAC; a ROS scavenger) diminished the AOM-induced phosphorylation of ERK and JNK and AOM-induced HO-1 expression, suggesting that ERK and JNK are downstream mediators of ROS during the AOM-induced signalling of HO-1 expression. In LPS-induced endotoxaemic mice, pretreatment with AOM reduced NO serum levels and liver iNOS expression and increased HO-1 expression and survival rates. These results indicate that AOM strongly inhibits LPS-induced NO production by activating the ROS/MAPKs/Nrf2-mediated HO-1 signalling pathway, and supports its pharmacological effects on inflammatory diseases.
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Amomum , Antiinflamatorios/farmacología , Hemo-Oxigenasa 1/biosíntesis , Lipopolisacáridos , Macrófagos/efectos de los fármacos , Proteínas de la Membrana/biosíntesis , Óxido Nítrico Sintasa de Tipo II/biosíntesis , Extractos Vegetales/farmacología , Sepsis/tratamiento farmacológico , Amomum/química , Animales , Antiinflamatorios/aislamiento & purificación , Modelos Animales de Enfermedad , Relación Dosis-Respuesta a Droga , Inducción Enzimática , Inhibidores Enzimáticos/farmacología , Quinasas MAP Reguladas por Señal Extracelular/antagonistas & inhibidores , Quinasas MAP Reguladas por Señal Extracelular/metabolismo , Frutas , Hemo-Oxigenasa 1/antagonistas & inhibidores , Hemo-Oxigenasa 1/genética , Proteínas Quinasas JNK Activadas por Mitógenos/antagonistas & inhibidores , Proteínas Quinasas JNK Activadas por Mitógenos/metabolismo , Macrófagos/enzimología , Masculino , Proteínas de la Membrana/antagonistas & inhibidores , Proteínas de la Membrana/genética , Ratones , Ratones Endogámicos C57BL , Factor 2 Relacionado con NF-E2/metabolismo , Óxido Nítrico Sintasa de Tipo II/genética , Fitoterapia , Extractos Vegetales/aislamiento & purificación , Plantas Medicinales , Células RAW 264.7 , Interferencia de ARN , ARN Mensajero/biosíntesis , Especies Reactivas de Oxígeno/metabolismo , Sepsis/inducido químicamente , Sepsis/enzimología , Sepsis/genética , Transducción de Señal/efectos de los fármacos , Factores de Tiempo , TransfecciónRESUMEN
BACKGROUND: Few clinical data are available on the relationship between genospecies and outcome of Acinetobacter bacteremia, and the results are inconsistent. We performed this study to evaluate the relationship between genospecies and the outcome of Acinetobacter bacteremia. METHODS: Clinical data from 180 patients who had Acinetobacter bacteremia from 2003 to 2010 were reviewed retrospectively. The genospecies were identified by rpoB gene sequence analysis. The clinical features and outcomes of 90 patients with A. baumannii bacteremia were compared to those of 90 patients with non-baumannii Acinetobacter bacteremia (60 with A. nosocomialis, 17 with Acinetobacter species "close to 13 TU", 11 with A. pittii, and two with A. calcoaceticus). RESULTS: A. baumannii bacteremia was associated with intensive care unit-onset, mechanical ventilation, pneumonia, carbapenem resistance, and higher APACHE II scores, compared to non-baumannii Acinetobacter bacteremia (P<0.05). In univariate analyses, age, pneumonia, multidrug resistance, carbapenem resistance, inappropriate empirical antibiotics, higher APACHE II scores, and A. baumannii genospecies were risk factors for mortality (P<0.05). Multivariate analysis revealed A. baumannii genospecies (OR, 3.60; 95% CI, 1.56-8.33), age, pneumonia, and higher APACHE II scores to be independent risk factors for mortality (P<0.05). CONCLUSION: A. baumannii genospecies was an independent risk factor for mortality in patients with Acinetobacter bacteremia. Our results emphasize the importance of correct species identification of Acinetobacter blood isolates.
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Infecciones por Acinetobacter/tratamiento farmacológico , Acinetobacter/genética , Bacteriemia/tratamiento farmacológico , Carbapenémicos/uso terapéutico , Farmacorresistencia Bacteriana , Acinetobacter/efectos de los fármacos , Infecciones por Acinetobacter/microbiología , Infecciones por Acinetobacter/mortalidad , Adulto , Bacteriemia/microbiología , Bacteriemia/mortalidad , Carbapenémicos/farmacología , Farmacorresistencia Bacteriana/efectos de los fármacos , Femenino , Genotipo , Humanos , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Factores de Riesgo , Resultado del TratamientoRESUMEN
BACKGROUND: Scaffolds are one of the three most important elements constituting the basic concept of regenerative medicine, and are included in the core technology of regenerative medicine along with stem cells and tissue engineering. Stem cells are very important technology because they are directly responsible for the regenerative treatment of the disease and the damaged tissue, but with regards to the technology and the products that use stem cells exclusively, there is a technical limitation of limited survival rate and the engraftment rate of the transplanted cell, and rather than recovering the damaged tissue fundamentally, there is a limit that the concept is more of just another medicine treatment using cells. A scaffold is a natural or synthetic biocompatible material transplanted into a human body to be used as the exclusive treatment or as an assisted method of another treatment of a disease and for the recovery of damaged tissue. Therefore, according to the characteristics of the tissue to be applied, scaffolds must have the characteristics such as the excellent biocompatibility, biodegradability, minimum immunity and inflammation, proper mechanical strength and interaction between the material and the cells. RESULTS: The world stem cell market was approximately 2.715 billion dollars in 2010, and with a growth rate of 16.8% annually, a market of 6.877 billion dollars will be formed in 2016. From 2017, the expected annual growth rate is 10.6%, which would expand the market to 11.38 billion dollars by 2021. Meanwhile, the world scaffold element technology market was approximately 4.57 million dollars in 2013, and by increasing 13.4% annually, it is estimated to expand to 10.63 million dollars by 2020. The Korean scaffold element technology market was about 22 million dollars in 2013, and with a steady growth of approximately 13.4% every year, it is prospected to be about 52 million dollars by 2020. CONCLUSIONS: In comparison to the medical material and medicine sales growth rate, the future scaffold element technology market is judged to be higher in growth possibility.
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INTRODUCTION: Effective mentoring helps interns in the early stages of their medical career to reach personal and professional goals. This study investigated the mentoring experience of Korean interns during medical internship and evaluated mentoring effects to facilitate the development of future mentoring programmes. METHODS: Participants were interns being trained at Chonnam National University Hospital, South Korea, in 2011. Interns were asked to complete a questionnaire about their mentoring experiences and job satisfaction. RESULTS: A total of 61 medical interns participated in the study, giving a response rate of 70.1%. Among these interns, 26 (42.6%) had mentoring experiences, with an average of 2.3 ± 1.9 mentors per mentee. Mentees usually discussed career planning and concerns regarding their personal and social lives with their mentors. Perceived quality of the mentor was significantly more important for male mentees than for female mentees. Female interns without a mentor made significantly less effort to seek a mentor than their male counterparts. Having and not having a mentor resulted in significant differences in the interns' job satisfaction. CONCLUSION: Fewer than half of the medical interns had mentoring experiences. Results suggest that the mentoring relationship may be less satisfying and more challenging for female interns. Effective mentoring may not only help interns plan their medical career, but also increase job satisfaction. Mentoring programmes during medical internship should be expanded and supported, as it is the initial step in a medical career.