• Experimental and Molecular Medicine
• /
• v.50 no.12
• /
• pp.12.1-12.14
• /
• 2018

Osteoporosis develops with high prevalence in both postmenopausal women and hypogonadal men. Osteoporosis results in significant morbidity, but no cure has been established. Mesenchymal stem cells (MSCs) critically contribute to bone homeostasis and possess potent immunomodulatory/anti-inflammatory capability. Here, we investigated the therapeutic efficacy of using an infusion of MSCs to treat sex hormone-deficient bone loss and its underlying mechanisms. In particular, we compared the impacts of MSC cytotherapy in the two genders with the aim of examining potential gender differences. Using the gonadectomy (GNX) model, we confirmed that the osteoporotic phenotypes were substantially consistent between female and male mice. Importantly, systemic MSC transplantation (MSCT) not only rescued trabecular bone loss in GNX mice but also restored cortical bone mass and bone quality. Unexpectedly, no differences were detected between the genders. Furthermore, MSCT demonstrated an equal efficiency in rectifying the bone remodeling balance in both genders of GNX animals, as proven by the comparable recovery of bone formation and parallel normalization of bone resorption. Mechanistically, using green fluorescent protein (GFP)-based cell-tracing, we demonstrated rapid engraftment but poor inhabitation of donor MSCs in the GNX recipient bone marrow of each gender. Alternatively, MSCT uniformly reduced the $CD3^+T$-cell population and suppressed the serum levels of inflammatory cytokines in reversing female and male GNX osteoporosis, which was attributed to the ability of the MSC to induce T-cell apoptosis. Immunosuppression in the microenvironment eventually led to functional recovery of endogenous MSCs, which resulted in restored osteogenesis and normalized behavior to modulate osteoclastogenesis. Collectively, these data revealed recipient sexually monomorphic responses to MSC therapy in gonadal steroid deficiency-induced osteoporosis via immunosuppression/anti-inflammation and resident stem cell recovery.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
• /
• v.28 no.2
• /
• pp.54-65
• /
• 2015

Objective : This Study was conducted in order to develop the Learning Satisfaction (LS)and Learning Flow Scale(LFS) for Korean Medical Ophthalmology & Otolaryngology & Dermatology and to investigate the reliability and validity. Methods : LF and LFS were administered to 44 students and 20 resident physicians . We examined the test-retest reliability, internal consistency and perfomed factor analysis. Result : 1. Test-retest reliability were reliable on LS and LFS for Korean Medical Ophathalmology & Otolaryngology.2. Test-retest reliability were unreliable comparatively on LS and LFS for Korean Medical Dermatology.3. internal consistency were all reliable in LS and LFS Korean Medical Ophthalmology & Otolaryngology & Dermatology.4. factor analysis were reliable only LS of Korean Medical Dermatology. Conclusions : LS and LFS has reliability to measure learning satisfaction and learning flow of Korean Medical students. But there is no evidence about validity of LS and LFS for Korean Medical Ophthalmology & Otolaryngology & Dermatology.

• Korean Medical Education Review
• /
• v.22 no.1
• /
• pp.9-15
• /
• 2020

Currently, accreditation within medical education is a priority on the agenda for many countries worldwide. The World Federation for Medical Education's (WFME) launch of its first trilogy of standards in 2003 was a seminal event in promoting accreditation within basic medical education (BME) globally. Parallel to that, WFME also actively spearheaded a project to recognize the accrediting agencies within individual countries. The introduction of competency-based medical education (CBME) with the two key concepts of "entrusted professional activity" and milestones has enabled researchers to identify the relationship between patient outcomes and medical education. Recent data driven by CBME has been used for the continuous quality improvement of trainees and training programmes as well. The goal of accreditation has shifted from the single purpose of quality assurance to balancing quality assurance and quality improvement. Even though there are a plethora of types of postgraduate medical education (PGME), it may be possible to accredit resident programmes on a global scale by adopting the concept of CBME. In addition, the alignment of the accreditation for BME and PGME, which center on competency, will be achievable. This argument may extend the possibility of measuring the outcomes of the accreditation itself against patient outcomes as well. Therefore, evidence of the advantages of costly and labor-consuming accreditation processes will be available in the near future and quality improvement will be the driving force of the accreditation process.

• Journal of agricultural medicine and community health
• /
• v.30 no.3
• /
• pp.293-303
• /
• 2005

Objectives: Yearly, annual report of cancer patients in Korea is released by National Cancer Center. But, this report is focused in all of the patients in nation. So, there is needed to modify and analyze this report to be used properly for local resident. In Ulleung island, local county and Ulleung medical center don't have cancer occurrence data of local resident until now. The aim of this analysis is to know characteristics and data of cancer patients occurrence in Ulleung island for 10 years. Methods: We are offered data of cancer patients occurrence in Ulleung island for 10 years from National Cancer Center. This data was composed of sex, address (only town level), diagnosed date, diagnosis. So, we analyze this data and compare to Korea data for same duration. Results: There were 268 patients for 10 years (1993-2002). Man were 175 about 65% and women were 93 about 35%. There were 163 in Ulleungeup about 60%, 39 in Seomyun about 14.5% and 48 in Bukmyun about 18%. There were 19 patients in unknown residence. After 1998, above 30 patients were occurred, but before 1998, below 27 patients were occurred. Diagnosed date was concentrated in June, 33 patients were occurred about 12%, but least occurred month was December. Most occurred age were from 60 to 69, there were 80 patients about 30%. Most occurred cancer was gastric cancer, there were 54 patients about 20%. Hepatic cancer was second and third was lung cancer. In man, most occurred cancers were gastric cancer and hepatic cancer, both was 38 patients. In woman, gastric cancer and uterine cervix cancer were occurred mostly. After 2001, in Korea most occurred female cancer was breast, but in Ulleung island, most occurred cancer was stomach. Conclusions: Researcher should demand and analyze cancer data from National Cancer Center that cancer management project in local county and public health education of cancer could focus on local resident because annually released cancer data from National Cancer Center focus on a nation. In Ulleung island, cancer incidence was more than incidence in Korea and breast cancer was occurred less than in Korea. So, more study should be needed to confirm why more cancer were occurred than Korea and breast cancer was less occurred.

• Journal of Preventive Medicine and Public Health
• /
• v.30 no.4 s.59
• /
• pp.708-718
• /
• 1997

The author surveyed overall obesity indicies and factors concerned with obesity such as dietary intake, physical activity, stress and life style with the subject of doctors. The number of subjects was total 508 with 396 men and 112 women. They were subgrouped into surgical part, medical part and service and basic part by speciality. And also subgrouped into intern and resident, pay doctor, and practitioner by working type. The results were as follows. 1) Obesity indices: BMI of total doctor was $23.1{\pm}2.8$, and WHR was $0.87{\pm}0.08$ and overweight prevalence(BMI>25.0) was 23.6%. It was within normal limit but slightly over the Korean standard. The degree of obesity indices of subgroups by speciality was 'surgical part > medical part > service and basic part', and by working type was 'practitioner > pay doctor > intern and resident'. 2) Dietary intake and Physical activity: Average dietary intake was $2148{\pm}451kcal/day$. The degree of dietary intake by speciality was 'surgical part > medical part > service and basic part'. By working type it was 'practitioner > pay doctor > intern and resident'. Average physical activity was $29{\pm}5$ METs/day. The degree of physical activity also showed similiar pattern. But there was no significant difference among each groups. 3) Comparision between over-weight and non-over-weight group: The items that showed significant difference between two groups were dietary intake, skip breakfast, regular exercise, smoking, heavy drinking, chronic disease etc.

• Journal of Preventive Medicine and Public Health
• /
• v.30 no.2 s.57
• /
• pp.428-436
• /
• 1997

Objectives : The purpose of this paper is to estimate the completeness of the Korean Medical Insurance Data in childhood asthma. Methods : Capture-recapture method was used to estimate the prevalence of childhood asthma and case ascertainment rate(completeness) of Korean Medical Insurance Data using two source model, 'Korean Medical Insurance Committee Data (KMICD)' and 'Nationwide Study of Asthma and Allergies in Korean Children'. The asthma cases were restricted to those who were born from 1981 to 1989 and were identified by their Resident Register Number. Asthma cases in Korean Medical Insurance Data were defined as cases coded by ICD-9 493 and ICD-10 J45. In 'Nationwide Study of Asthma and Allergies in Korean Children', asthma cases were defined as the children who had been diagnosed asthma and had experienced symptoms of asthma during the past 12 months. The defined cases in two data sources were matched by 13 digits Resident Register Number. The numbers of matched patients in two data sources were 245 of 32,825 eligible total subjects. Chapman and Wittes' nearly unbiased estimation was used for capture-recapture analysis of two data sources. Results : Observed prevalence rate of childhood asthma was 5.3% and estimated prevalence rate by capture-recapture analysis was 11.6%. The highest prevalence rate was observed in 6-7 age group and the older the rate decreased. The completeness (the proportion of cases ascertained by KMICD to the total observed cases by two data sources) was 20.6%, and ranged form 10.8% to 28.8% by area. Conclusions : Invalid diagnosis of cases might overestimate the prevalence of child-hood asthma and might underestimate the completeness of Korean Medical Insurance Committee Data in this study.

• Korean Medical Education Review
• /
• v.19 no.2
• /
• pp.70-75
• /
• 2017

In order to adapt to the rapidly changing medical environment, it is important to advance not only the basic medical education in medical schools but also that of residents. The quality of the training environment and educational goals for residency must also be improved for specialists. Although each institute including internal medicine, general surgery, family medicine, etc., strives to standardize, sets educational goals, and develops content to train capable specialists, the education programs focus on special techniques and competency of medical care for patients. The training environment of each residency program is different in each trainee hospital, and hospitals are making an effort to set education goals for the residents and improve their education programs. In Korea, there is no common core education program for residents, while in the United States, the Accreditation Council for Graduate Medical Education is responsible for the development and evaluation of a standardized curriculum for residents, and in Canada, CanMEDs presents a basic curriculum to help residents develop competency. Fully capable specialists have more than just clinical competency; they also need a wide range of abilities including professionalism, leadership, communication, cooperation, in addition to taking part in continuous professional development/continuing medical education activities. We need to provide a core curriculum for residency to demonstrate attention to and knowledge about health problems of the community.

• Journal of Korean Academy of Nursing
• /
• v.39 no.3
• /
• pp.366-375
• /
• 2009

Purpose: To evaluate the effects of case management using Resident Assessment Instrument-Home Care(RAI-HC) in home health service for older people. Methods: All elders were assessed at baseline and 3 months later using RAI-HC. The change of function in the intervention group was compared with that of a conventional intervention group. Function was measured with Activities of Daily Living(ADL), Instrumental Activities of Daily Living(IADL), Cognitive Performance Scale(CPS), Depression Rating Scale(DRS), Pain and the number of Clinical Assessment Protocols(CAP). Results: Among ninety two elders participated in the program, 59 were allocated to the case management group and 33 to the conventional group. The intervention, home health service by a nurse over a 3 month period, consisted of comprehensive assessment, case conference for care plan, direct care, education and referral, and outcome evaluation. The percent of elders whose function improved in the intervention group was greater than the conventional group for depression(odds ratio [OR]: 10.941, confidence interval [CI]: 2.338-51.206), IADL(OR: 4.423, CI: 1.151-16.999) and the number of CAP(OR: 11.443, CI: 3.805-34.410). Conclusion: Case management was effective for older people in the community. The effect might have resulted from individual, systematic intervention, however, standards of service including eligibility criteria for case management and collaboration of multi-disciplines is required for more effective home health service programs.

• Journal of Korean Neurosurgical Society
• /
• v.52 no.3
• /
• pp.200-203
• /
• 2012

Objective : The sub-axial injury classification (SLIC) and severity scale was developed to decide whether to operate the cervical injured patient or not, but the reliability of SLIC and severity scale among the different physicians was not well known. Therefore, we evaluated the reliability of SLIC among a spine surgeon, a resident of neurosurgery and a neuro-radiologist. Methods : In retrograde review in single hospital from 2002 to 2009 years, 75 cases of sub-axial spine injured patients underwent operation. Each case was blindly reviewed for the SLIC and severity scale by 3 different observers by two times with 4 weeks interval with randomly allocated. The compared axis was the injury morphology score, the disco-ligamentous complex score, the neurological status score and total SLIC score; the neurological status score was derived from the review of medical record. The kappa value was used for the statistical analysis. Results : Interobserver agreement of SLIC and severity scale was substantial agreement in the score of injury morphology [intraclass correlation (ICC)=0.603] and total SLIC and severity sacle (ICC value=0.775), but was fair agreement in the disco-ligamentous complex score (ICC value= 0.304). Intraobserver agreements were almost perfect agreement in whole scales with ICC of 0.974 in a spine surgeon, 0.948 in a resident of neurosurgery, and 0.963 in a neuro-radiologist. Conclusion : The SLIC and severity scale is comprehensive and easily applicable tool in spine injured patient. Moreover, it is very useful tool to communicate among spine surgeons, residents of neurosurgery and neuro-radiologists with sufficient reproducibility.

• Journal of Preventive Medicine and Public Health
• /
• v.29 no.3 s.54
• /
• pp.429-437
• /
• 1996

The geographical distribution of active physicians who graduated from medical schools before 1985 were studied. Those who had emigrated, hold non-medical jobs, are in the military service, or work as public health physicians and resident staff were excluded from the study. A total of 27,728 physicians were analyzed. Our studies have shown a relationship between the location of the medical schools from the which the physicians have graduated and the geographical regions in which they practice. A statistically significant number of physicians are working near the medical colleges from which they have graduated. That is, those who had graduated from medical schools located in the southern area of the country are presently working in the same region. This relationship was shown to be especially significant for older physicians and female doctors, who work around the area of the medical colleges from which they graduated.