Lack of association between the VEGFA gene polymorphisms and preterm birth in Korean women.

Preterm birth (PTB), a pregnancy-related disease, is defined as a birth before 37 weeks of gestation. It is a major cause of maternal mortality and morbidity worldwide, and its incidence rate is steadily increasing. Various genetic factors can contribute to the etiology of PTB. Vascular endothelial growth factor A (VEGFA) gene is an important angiogenic gene and its polymorphisms have been reported to be associated with PTB development. Therefore, we conducted a case-control study to evaluate the association between VEGFA rs699947, rs2010963, and rs3025039 polymorphisms and PTB in Korean women. A total of 271 subjects (116 patients with PTB and 155 women at ≥38 weeks of gestation) were analyzed in this study. The genotyping of VEGFA gene polymorphisms was performed using polymerase chain reaction- restriction fragment length polymorphism. No significant association between the patients with PTB and the control groups was confirmed. In the combination analysis, we found a significant association between PTB and VEGFA rs699947 CC-rs2010963 GG-rs3025039 CC combination (odds ratio, 3.77; 95% confidence interval, 1.091 to 13.032; p = 0.031). The VEGFA rs699947, rs2010963, and rs3025039 polymorphisms might have no genetic association with the pathogenesis of PTB in Korean women. However, the combination analysis indicates the possibility that VEGFA acts in PTB pathophysiology. Therefore, larger sample sets and replication studies are required to further elucidate our findings.

Association between genetic polymorphisms of synaptophysin (SYP) gene and attention deficit hyperactivity disorder in Korean subjects.

BACKGROUND: Attention deficit hyperactivity disorder (ADHD) is a common childhood neurodevelopmental disorder, and the prevalence of ADHD among Korean children has attained about 8.5%. Various genetic factors can contribute to the etiology of the disease. Synaptophysin (SYP) regulates neurotransmitter release and synaptic plasticity. According to previous studies, several genetic polymorphisms on SYP were risk factors for ADHD. OBJECTIVE: We investigated the effect of the SYP gene polymorphisms (rs2293945 and rs3817678) on ADHD in Korean children. METHODS: In this study, we examined the case-control study in 150 ADHD cases and 322 controls. The genotyping of SYP gene polymorphisms was performed using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). RESULTS: Significant associations in the genotype and genetic models of SYP rs2293945 polymorphism between girls with ADHD and control girls were found. The girls with ADHD having the C/T genotype were significantly associated with ADHD. In the dominant model of rs3817678, C/T + T/T genotypes were significantly associated with ADHD. The haplotype analyses showed significant associations from haplotypes of rs2293945 T-rs3817678 G and rs2293945 C-rs3817678 A. CONCLUSION: Our results imply that the SYP rs2293945 C/T polymorphism in female participants may provide a possible effect on the genetic etiology of ADHD.

Effects of Sensing Tactile Arrays, Shear Force, and Proprioception of Robot on Texture Recognition.

In robotics, tactile perception is important for fine control using robot grippers and hands. To effectively incorporate tactile perception in robots, it is essential to understand how humans use mechanoreceptors and proprioceptors to perceive texture. Thus, our study aimed to investigate the impact of tactile sensor arrays, shear force, and the positional information of the robot's end effector on its ability to recognize texture. A deep learning network was employed to classify tactile data from 24 different textures that were explored by a robot. The input values of the deep learning network were modified based on variations in the number of channels of the tactile signal, the arrangement of the tactile sensor, the presence or absence of shear force, and the positional information of the robot. By comparing the accuracy of texture recognition, our analysis revealed that tactile sensor arrays more accurately recognized the texture compared to a single tactile sensor. The utilization of shear force and positional information of the robot resulted in an improved accuracy of texture recognition when using a single tactile sensor. Furthermore, an equal number of sensors placed in a vertical arrangement led to a more accurate distinction of textures during exploration when compared to sensors placed in a horizontal arrangement. The results of this study indicate that the implementation of a tactile sensor array should be prioritized over a single sensor for enhanced accuracy in tactile sensing, and the use of integrated data should be considered for single tactile sensing.

Accreditation standards items of post-2nd cycle related to the decision of accreditation of medical schools by the Korean Institute of Medical Education and Evaluation.

PURPOSE: The purpose of this study is to analyze the accreditation standards items related to the decision of accreditation of medical schools by the Korea Institute of Medical Education and Evaluation (KIMEE). METHODS: The subjects are medical schools in Korea that have received post-2nd cycle accreditation from the KIMEE between 2012 and 2016. Analyses were conducted for differences in accreditation decisions according to the characteristics of medical schools, sufficient ratios of basic standards items, and correlation between standards items related to accreditation decisions. RESULTS: After examining differences in accreditation decisions by the medical school's characteristics, there were no significant correlations between accreditation standard items and accreditation decisions. Second, according to the number of schools that sufficiently or insufficiently met each standard item, from the total of 97 standard items, 20 (20.6%) were sufficiently fulfilled by all medical schools. Standard item 2-5-2 demonstrated the highest insufficiency ratio. Third, with respect to the standard item that had an effect on accreditation decisions, standard item 1-5-1 showed the highest correlation with the sufficiency rate. CONCLUSION: The validity of accreditation standards items was assured as this study evaluated the post-2nd cycle accreditation standards items regardless of each medical school's characteristics. The accreditation standards items were found to have a meaningful impact on the development of medical schools and qualitative improvement in medical education. The findings are expected to contribute to guaranteeing the validity and reliability of accreditation decisions and raising the quality of accreditation.

Experience of operating a medical humanities course at one medical school during the COVID-19: a retrospective study.

BACKGROUND: This study summarizes the experience of operating a 'Medical Humanities' course, which was taught remotely to maintain activities and discussions at medical schools in Daegu, Korea during the sudden and unexpected coronavirus disease 2019 (COVID-19). METHODS: The subjects of this study were 73 first- and 79 second-grade medical students who took the medical humanities (1) and (2) courses among first- and second-grade students of Yeungnam University College of Medicine in 2020. Of the 152 students who agreed to the online survey, 123 completed the survey. Self-, environmental, and program evaluations were conducted on the study subjects, and differences according to grade and gender were analyzed. RESULTS: As a result of the study, a significant difference between self-evaluation and environmental evaluation was confirmed. Self-evaluation was determined to be higher in the first grade than in the second grade. The environmental evaluation showed that male students were more satisfied than female students and students generally had difficulties in the classroom environment. Of the applications used in class, the highest satisfaction was observed with KakaoTalk (Kakao Corp.) and Zoom (Zoom Video Communications Inc.). At the end of COVID-19, the students preferred online classes. CONCLUSION: If the learning environment for online classes is well prepared and systematic provisions are made, such as class operations that are suitable for the subject, effective education and learning can be achieved by taking advantage of both face-to-face and online classes.

Impact of the COVID-19 pandemic on medical students of clinical clerkship in South Korea: A qualitative study exploring medical students' experiences.

Background and Objective: In 2020, during the coronavirus disease (COVID-19) pandemic, medical students were placed in a learning environment that exposed them to unsafe clinical settings. In this study, using a phenomenological approach, we analyze the experiences of fourth-year students in the Daegu area of South Korea, a region that experienced a high concentration of COVID-19 infections. Methods: The essays of 80 students from four medical schools who agreed to participate in the study were utilized in the final data analysis. The data were analyzed using the proposed phenomenological analysis. Results: Forty-seven condensed meaning units, twelve subthemes, and three essential themes were identified. The main theme includes the following: 1) confusion and stress due to sudden changes in the learning situation 2) learned the medical professionalism of physicians 3) reflection and internal change regarding what it means to be a physician. Conclusions: The COVID-19 pandemic had a significant impact on students who participated in clinical clerkships. This study can provide baseline data for planning educational strategies and establishing a support system for students in response to the changes that they may experience in the event of the reoccurrence of a novel infectious disease in the future.

Mesenchymal Stem Cells Decrease Oxidative Stress in the Bowels of Interleukin-10 Knockout Mice.

Background/Aims: Inflammatory bowel disease (IBD) is an autoimmune disease characterized by chronic inflammation mainly in the large intestine. The interleukin-10 knockout (IL-10 KO) mouse is a well-known animal model of IBD that develops spontaneous intestinal inflammation resembling Crohn's disease. Oxidative stress is considered to be the leading cause of cell and tissue damage. Reactive oxygen species (ROS) can cause direct cell injury and/or indirect cell injury by inducing the secretion of cytokines from damaged cells. This study evaluated the effects of mesenchymal stem cell (MSC) on the progression of IBD. Methods: In this study, human bone marrow-derived MSCs were injected into IL-10 KO mice (MSC). Oxidative stress and inflammation levels were evaluated in the large intestine and compared with those in control IL-10 KO mice (CON) and normal wild-type control mice (Wild). Results: The levels of ROS (superoxide and hydrogen peroxidase) and a secondary end-product of lipid peroxidation (malondialdehyde) were considerably higher in the CON, while superoxide dismutase and catalase levels were lower in the MSC. Inflammation-related marker (interferon-γ, tumor necrosis factor-α, IL-4, and CD8) expression and inflammatory histological changes were much less pronounced in MSC than in CON. Conclusions: MSCs affect the redox balance, leading to the suppression of IBD.

Trends in the study on medical education over the last 10 years, based on paper titles.

Medical education research subjects are incredibly diverse and have changed over time. This work in particular aims to compare and analyze research trends in medical education through the words used in the titles of these research papers. Academic Medicine (the journal of the Association of American Medical Colleges), Medical Teacher (the journal of the Association of Medical Education in Europe), the Korean Journal of Medical Education (KJME), and Korean Medical Education Review (KMER) were selected and analyzed for the purposes of this research. From 2009 to 2018, Academic Medicine and Medical Teacher published approximately 10 to 20 times more papers than the KJME and KMER. Frequently used words in these titles include "medical," "student," "education," and "learning." The words "clinical" and "learning" were used relatively often (7.80% to 13.66%) in Korean journals and Medical Teacher, but Academic Medicine used these phrases relatively less often (6.47% and 4.41%, respectively). Concern with such various topics as problem-based learning, team-based learning, program evaluations, burnout, e-learning, and digital indicates that Medical Teacher seems to primarily deal with teaching and learning methodologies, and Academic Medicine handles all aspects of medical education. The KJME and KMER did not cover all subjects, as they publish smaller papers. However, it is anticipated that research on new subjects, such as artificial intelligence in medical education, will occur in the near future.

Prevalence of feet and ankle arthritis and their impact on clinical indices in patients with rheumatoid arthritis: a cross-sectional study.

BACKGROUND: We aimed to evaluate the prevalence of foot and/or ankle arthritis (FAA) and its impact on clinical indices in patients with rheumatoid arthritis (RA). METHODS: This cross-sectional study used data from the Korean College of Rheumatology Biologics & Targeted therapy registry to observe clinical outcomes of patients undergoing biologics therapy and conventional therapy. FAA was defined as ≥1 tender or swollen joint in the ankle and/or 1st-5th metatarsophalangeal (MTP) joints. Disease Activity Score 28 (DAS28), Routine Assessment of Patient Index Data 3 (RAPID3), Simplified Disease Activity Index (SDAI), and Clinical Disease Activity Index (CDAI) were assessed. RESULTS: Among 2046 patients, 598 had FAA. The ankle joint was the most commonly involved joint in FAA (tender joint, 71.4%; swollen joint, 59.5%), followed by the third and second MTP joints. Patients with FAA showed higher DAS28, RAPID3, SDAI, and CDAI scores. FAA presence was significantly associated with non-remission as per DAS28-ESR (odds ratio, 3.4; 95% confidence interval, 2.0-5.8), DAS28-CRP (3.6, 2.4-5.3), SDAI (6.3, 2.8-14.6), CDAI (7.6, 2.4-24.3), and RAPID3 (5.6, 2.7-11.5) indices on adjusting for age, sex, disease duration, presence of rheumatoid factor, presence of anti-cyclic citrullinated peptide antibody, lung disease, use of methotrexate, and previous use of biological disease-modifying anti-rheumatic drugs. Patients with FAA were less likely to achieve remission of SDAI (n = 6, 1.0%) and CDAI (n = 3, 0.5%) than that of DAS28-ESR (n = 21, 3.5%), DAS28-CRP (n = 38, 6.4%), and RAPID3 (n = 12, 2.0%). CONCLUSIONS: FAA represents a severe disease activity and is an independent risk factor for non-remission in patients with RA.

C/EBP homologous protein deficiency inhibits statin-induced myotoxicity.

It has been well established that HMG-CoA reductase inhibitors (statins) cause adverse side effects in skeletal muscle ranging from mild to fatal myotoxicity upon dose, drug interaction, and exercise. However, the underlying mechanisms by which statins induce myotoxicity have not been fully addressed. Recent reports showed that statins induce endoplasmic reticulum (ER) stress and cell death in immune cells and myoblasts in vitro. Therefore, the goal of study is to investigate the molecular mechanism by which statins induce skeletal muscle cell death and myopathy via the regulation of ER stress. Biochemical data showed that TUDCA, an ER stress inhibitor, inhibited atorvastatin- and simvastatin-induced protein cleavages of PARP-1 and caspase-3, respectively. Actually, statin treatment activated marker proteins of unfolded protein responses (UPR) including ATF6, CHOP, and spliced XBP1 and these responses were inhibited by TUDCA. In addition, statin treatment induced mRNA levels of UPR marker genes, suggesting that statins activate ER stress in a transcriptional regulation. The physiological relevance of ER stress in statin-induced myopathy was demonstrated in a mouse model of myopathy, in which instillation of simvastatin and atorvastatin led to myopathy. Notably, the reduction of muscular endurance in response to statin instillation was significantly improved in TUDCA treating group compared to vehicle control group. Moreover, CHOP deficiency mice showed restoration of statin-induced reduction of muscular endurance, suggesting that statin induces myopathy via ER stress and in a CHOP-dependent manner. Taken together, these findings indicate that statins specifically induce myopathy in an ER stress-dependent manner, suggesting the therapeutic potential of ER stress regulation in preventing adverse effects of statin.

Complete mitochondrial genome of Lycodes tanakae (Perciformes: Zoarcidae).

The complete mitochondrial genome of Lycodes tanakae was sequenced for the first time from its muscle tissue using the next-generation sequencing method. Its mitochondrial genome was 16,594 base pairs in length, containing 13 protein-coding genes, 22 transfer RNA genes, two ribosomal RNA genes, and one control region. Its overall A, C, G, and T contents were 25.6%, 30.6%, 18.7%, and 25.2%, respectively. Its, A + T content (50.8%) was slightly higher than its G + C content (49.2%). A phylogenetic tree was built using 10 belonging to the order Perciformes and two species belonging to the order Scorpaeniformes.

Complete mitochondrial genome of Parupeneus barberinus (Perciformes, Mullidae): mitogenome characterization and phylogenetic analysis.

Parupeneus barberinus is a tropical/subtropical reef-dwelling marine fish belonging to the family Mullidae. Herein, we report the first sequencing and assembly of the complete mitochondrial genome of P. barberinus. The complete mitochondrial genome is 16,560 bp long and has the typical vertebrate mitochondrial gene arrangement, consisting of 13 protein-coding genes, 22 tRNA genes, two rRNA genes, and a control region. Phylogenetic analysis using mitochondrial genomes of 18 species showed that P. barberinus is clustered with P. multifasciatus and P. chrysopleuron and rooted with other Mullidae species. This mitochondrial genome provides potentially important resources for addressing taxonomic issues and studying molecular evolution.

CHOP deficiency inhibits methylglyoxal-induced endothelial dysfunction.

Epidemiological studies suggested that diabetic patients are susceptible to develop cardiovascular complications along with having endothelial dysfunction. It has been suggested that methylglyoxal (MGO), a glycolytic metabolite, has more detrimental effects on endothelial dysfunction rather than glucose itself. Here, we investigated the molecular mechanism by which MGO induces endothelial dysfunction via the regulation of ER stress. Biochemical data showed that 4-PBA significantly inhibited MGO-induced protein cleavages of PARP-1 and caspase-3. In addition, it was found that high glucose-induced endothelial apoptosis was enhanced in the presence of GLO1 inhibitor, suggesting the role of endogenous MGO in high glucose-induced endothelial dysfunction. MGO-induced endothelial apoptosis was significantly diminished by the depletion of CHOP with si-RNA against human CHOP, but not by SP600125, a specific inhibitor of JNK. The physiological relevance of this signaling pathway was demonstrated in CHOP deficiency mouse model, in which instillation of osmotic pump containing MGO led to aortic endothelial dysfunction. Notably, the aortic endothelial dysfunction response to MGO infusion was significantly improved in CHOP deficiency mice compared to littermate control. Taken together, these findings indicate that MGO specifically induces endothelial dysfunction in a CHOP-dependent manner, suggesting the therapeutic potential of CHOP inhibition in diabetic cardiovascular complications.

Complete mitochondrial genome of Hemilepidotus gilberti (Scorpaeniformes: Cottidae).

The complete mitochondrial genome of gilbert's irish lord (Hemilepidotus gilberti), a fish belonging to family Cottidae, was sequenced for the first time. This complete mitochondrial genome was 16,907 nucleotides in length, consisting of 38 mitochondrial genes (13 protein-coding genes, 22 tRNA genes, 2 rRNA genes, and a control region). The order of these genes was similar to that of other teleosts. The overall A, C, G, and T nucleotide contents in mitogenome were 26.8%, 30.4%, 17.0%, and 25.8%, respectively. The A + T content (52.6%) was higher than the G + C content (47.4%). NJ phylogenetic analysis was performed for 10 related species within the family of Cottidae along with, two fish species belonging to another family (Sebastidae).

[Academic burnout and selection-optimization-compensation strategy in medical students].

PURPOSE: This study was conducted to examine the relationship between academic demand, academic burnout, and the selection-optimization-compensation (SOC) strategy in medical students. METHODS: A total of 317 students at Yeungnam University, comprising 90 premedical course students, 114 medical course students, and 113 graduate course students, completed a survey that addressed the factors of academic burnout and the selection-optimization-compensation strategy. We analyzed variances of burnout and SOC strategy use by group, and stepwise multiple regression analysis was conducted. RESULTS: There were significant differences in emotional exhaustion and cynicism between groups and year in school. In the SOC strategy, there were no significant differences between groups except for elective selection. The second-year medical and graduate students experienced significantly greater exhaustion (p<0.001), and first-year premedical students experienced significantly higher cynicism (p<0.001). By multiple regression analysis, subfactors of academic burnout and emotional exhaustion were significantly affected by academic demand (p<0.001), and 46% of the variance was explained. Cynicism was significantly affected by elective selection (p<0.05), and inefficacy was significantly influenced by optimization (p<0.001). CONCLUSION: To improve adaptation, prescriptive strategies and preventive support should be implemented with regard to academic burnout in medical school. Longitudinal and qualitative studies on burnout must be conducted.

Comparison of resorbable plates and titanium plates for fixation stability of combined mandibular symphysis and angle fractures.

OBJECTIVES: We compared resorbable plates with titanium plates for treatment of combined mandibular angle and symphyseal fractures. MATERIALS AND METHODS: Patients with mandibular angle and symphysis fractures were divided into two groups. The control (T) group received titanium plates while the experimental (R) group received resorbable plates. All procedures were carried out under general anesthesia using standard surgical techniques. We compared the frequency of wound dehiscence, development of infection, malocclusion, malunion, screw breakage, and any other technical difficulties between the two groups. RESULTS: Thirteen patients were included in the R group, where 39 resorbable plates were applied. The T group consisted of 16 patients who received 48 titanium plates. The mean age in the R and T groups was 28.29 and 24.23 years, respectively. Primary healing of the fractured mandible was obtained in all patients in both groups. Postoperative complications were minor and transient. Moreover, there were no significant differences in the rates of various complications between the two groups. Breakage of 3 screws during the perioperative period was seen in the R group, while no screws or plates were broken in the T group. CONCLUSION: Resorbable plates can be used to stabilize combined mandibular angle and symphysis fractures.

Outcomes of open versus closed treatment in the management of mandibular subcondylar fractures.

OBJECTIVES: To compare the clinical and radiological outcomes after closed reduction (CR) and open reduction and internal fixation (ORIF) in the management of subcondylar fractures. MATERIALS AND METHODS: Forty-eight patients presenting with subcondylar fracture between January 2010 and March 2013 were evaluated retrospectively. Fifteen patients were treated with CR and 33 patients with ORIF. The clinical and radiologic parameters were evaluated during follow-up (mean, 7.06 months; range, 3 to 36 months). RESULTS: In the CR group, no patients had any problems with regard to the clinical parameters. The average period of maxillomandibular fixation (MMF) was 5.47 days. The preoperative average tangential angulation of the fractured fragment was 3.67°, and loss of ramus height was 2.44 mm. In the ORIF group, no clinical problems were observed, and the average period of MMF was 6.33 days. The preoperative average tangential angulation of the subcondylar fragment was 8.66°, and loss of ramus height was 3.61 mm. CONCLUSION: CR provided satisfactory clinical results, though ORIF provided more accurate reduction of the fractured fragment. So there is no distinct displacement of fractured fragment, CR should be selected than ORIF because of no need for surgery.

Fluorine geochemistry in bedrock groundwater of South Korea.

High fluoride concentrations (median=4.4 mg/L) in deep bedrock groundwater of South Korea prevent the usage of it as a drinking water source. The hydrogeochemistry of deep thermal groundwaters (N=377) in diverse bedrocks has been studied in order to evaluate the geologic and geochemical controls on fluoride concentrations in groundwater. The groundwater samples were clustered geologically, and the average and median concentrations of fluoride were compared by the Mann-Whitney U test. The order of median fluoride concentration with respect to geology is as follows: metamorphic rocks> or =granitoids > or =complex rock>>volcanic rocks> or =sedimentary rocks. This result indicates that the geological source of fluoride in groundwater is related to the mineral composition of metamorphic rocks and granitoids. With respect to groundwater chemistry, the fluoride concentration was highest in Na-HCO3 type groundwater and lowest in Ca-HCO3 type groundwater. Ionic relationships also imply that the geochemical behavior of fluoride in groundwater is related to the geochemical process releasing Na and removing Ca ions. The thermodynamic relationship between the activities of Ca and F indicates that fluoride concentration is controlled by the equilibrium of fluorite (CaF2). In other words, the upper limits of fluoride concentration are determined by the Ca ion; i.e., Ca concentrations play a crucial role in fluoride behavior in deep thermal groundwater. The result of this study suggests that the high fluoride in groundwater originates from geological sources and fluoride can be removed by fluorite precipitation when high Ca concentration is maintained. This provides a basis for a proper management plan to develop the deep thermal groundwater and for treatment of high fluoride groundwater frequently found in South Korea.

The expression of estrogen receptors in hepatocellular carcinoma in Korean patients.

Expression of estrogen receptors (ER)-alpha and -beta, as well as androgen receptor (AR), in hepatocellular carcinoma (HCC) is thought to be correlated with prognosis, survival, and male prevalence of HCC. These hypotheses are based on investigations of European patients; however the expression patterns of these receptors in Asian patients are largely unknown. In this study, we collected liver carcinoma and peritumor tissues from 32 patients (9 females and 23 males) in South Korea. The expression of ERs and ARs was studied using RT-PCR. Wild-type ER-alpha and AR were expressed in all of the samples investigated, and their expression was independent of the causal virus or patient sex. Expression of the ER-alpha variant was independent of sex (100% female vs. 91.3% male) and HCV and HBV status (91.3% vs. 100%). Wild-type ER-beta was expressed more often in HCV patients than in HBV patients (95.7% vs. 44.4%; p < 0.05). In conclusion, the stronger ER-alpha variant expression in HCC tissues implies that this variant has an important role in HCC development. However, at least in Korean patients, expression of the ER-alpha variant (vER-alpha) is not related to male HCC prevalence. In addition, the predominant expression of ER-beta in HCV patients suggests that it plays an important role in HCV-induced liver disease.

Resistant pure red cell aplasia after allogeneic bone marrow transplantation with major ABO mismatch treated by purified CD34+ cell infusion.

We report a case of pure red cell aplasia (PRCA) subsequent to an allogeneic bone marrow transplantation with a major ABO mismatch, which was resistant to the standard treatment options such as plasma exchange, erythropoietin and changes in the immunosuppressive treatment. Accordingly, two cycles of Rituximab therapy were administered without success. The patient had a chronic graft-vs.-host disease of the liver, which meant that an additional donor leukocyte infusion could not be introduced. Instead, purified CD34(+) cells were administered after fludarabine and antithymocyte globulin therapy. As a result, the PRCA was resolved and the antidonor isohemagglutinin titer became undetectable.