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Infections and inflammatory conditions of immature musculoskeletal systems in pediatric patients also affect the adjacent muscles, connective tissues, and joints. Rapid diagnosis leading to appropriate treatment can significantly impact the occurrence of complications and mortality rates due to these conditions. When a radiologist becomes familiar with the imaging findings of pediatric musculoskeletal infections and inflammatory diseases, rapid differential diagnoses and more timely and appropirate treatment could be possible. In this paper, we introduce the imaging findings of infectious and inflammatory diseases affecting the immature musculoskeletal system, such as osteomyelitis, pyogenic arthritis, juvenile idiopathic arthritis, and hemophilic arthritis, based on the anatomical and pathophysiological characteristics of the immature musculoskeletal system in children. [ABSTRACT FROM AUTHOR]

This issue of Volume 34, Issue 1 contains 5 papers, 3 original articles, 2 review articles, and 0 case report. By subject, there were 0 papers on Aerospace Medicine, 5 on Aviation Human Factors, and 0 on Aviation Nursing. The first paper investigated the effect of self-management competence on social anxiety among students in an aviation program at a college, based on a survey of 90 students. Conducted with careful consideration of student anonymity, this study found that higher self-management competence are associated with lower social anxiety. The second paper explored the introduction of a pre-safety assessment and consulting system in the aviation industry, gathering and analyzing opinions from professionals through an online survey. The third study analyzed air traffic control threats and their impact, using data collected from Line Operations Safety Audits, and presented statistically significant findings. The fourth paper focused on fatigue management strategies for shift workers in air traffic control, reviewing related domestic and international laws and regulations and emphasizing the need for effective fatigue management. Lastly, the fifth paper discussed the characteristics of low-cost carriers and their ripple effects on the air transport market, examining both positive and negative aspects. [ABSTRACT FROM AUTHOR]

Air travel market has changed significantly by the emergence of a lowcost carrier (LCC). The LCCs offer lower fares and fewer frills than the traditional full service carriers (FSCs). The key competitive advantage of the LCCs is their ability to offer significantly lower fares, or at least to create the image of offering lower fares, while being able to generate profits by having low unit costs. LCCs have reshaped the competitive environment within air travel markets and have made significant impacts in the domestic passenger markets, which had previously been largely controlled by FSCs. The new demand for air travel experience through the low fares of low-cost airlines increases the likelihood of choosing not only low-cost airlines but also existing large airlines when choosing air travel. This generally equates to the intention of customers to move to more advanced products as their experience with new products increases. Therefore, the purpose of this study is to theoretically discuss the operating characteristics and market ripple effects of low-cost airlines, and to explore the theoretical implications of existing papers. [ABSTRACT FROM AUTHOR]

Statistical analysis is an essential component of the medical writing process for research-related articles. Although the importance of statistical testing is emphasized, statistical mistakes continue to appear in journal articles. Major statistical mistakes can occur in any of the three different stages of medical writing, including in the design stage, analysis stage, and interpretation stage. In the design stage, mistakes occur if there is a lack of specificity regarding the research hypothesis or data collection and analysis plans. Discrepancies in the analysis stage occur if the purpose of the study and characteristics of the data are not sufficiently considered, or when an inappropriate analytic procedure is followed. After performing the analysis, the results are interpreted, and an article is written. Statistical analysis mistakes can occur if the underlying methods are incorrectly written or if the results are misinterpreted. In this paper, we describe the statistical mistakes that commonly occur in medical research-related articles and provide advice with the aim to help readers reduce, resolve, and avoid these mistakes in the future. [ABSTRACT FROM AUTHOR]

This issue of Volume 33, Issue 4 contains 4 papers, 2 review articles, 1 letter, 1 case report focusing on aerospace medicine and human factors. The first paper discusses the implementation of lightning warning systems in domestic airports, emphasizing safety enhancements and efficient communication. The second uses Analytic Hierarchy Process to assess community acceptance and human factors in Urban Air Mobility, highlighting the importance of medical transport, speed, and flight safety. The third letter-style paper examines the increase in panic attacks during air travel, suggesting better crew training and passenger screening. The fourth investigates the risk of recurrent stroke among passengers with ischemic stroke history, concluding that further research is needed for clearer results. This issue addresses vital topics in aerospace medicine and human factors, with no reported conflicts of interest. [ABSTRACT FROM AUTHOR]

This issue of Volume 33, Issue 3 contains 6 papers, 4 original and 2 review articles. The first paper analyzes communication errors between domestic air traffic controllers and pilots and highlights the importance of adhering to the International Civil Aviation Organization standard language. The second paper analyzes trends in bacterial dysentery outbreaks in South Korea and Japan from 2016 to 2020, highlighting the need for robust information systems. The third paper analyzes human papillomavirus vaccination trends and shows a gradual recovery in vaccination rates after the COVID-19 pandemic. The fourth paper analyzes 24 years of trends in aviation medical examinations, highlighting the impact of the COVID-19 pandemic and the increase in the proportion of female pilots. The fifth paper explores the potential applications of blockchain technology in the aviation industry, presenting several use cases. The final paper analyzes medical error cases using the SHELL model and highlights the systemic problems of medical institutions in Korea. The journal covers a wide range of topics related to aerospace and human factors, and each paper presents important issues and suggestions for improvement in the field. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to study the epidemiologic series of Tsutsugamushi disease (TD), also known as scrub typhus in the Republic of Korea (Korea) and Japan. Methods: We investigated raw data of TD outbreaks from the National Notifiable Disease Surveillance System of the Korea Diseases Control and Prevention Agency in Korea, and the National Institute of Infectious Diseases in Japan, 2016 to 2020. Results: There were 36,785 cases of TD with a cumulative infectious rate (CIR) of 14.3 per 100,000 populations in Korea from 2016 to 2020. During the same period in Japan, there were 2,350 cases with a CIR of 0.4. When compared, Korea was much higher than that in Japan (P<0.01). In Korea, more females (60.2% of total cases) were infected than males (39.8%), while there was a significant difference between males (58.8%) and females (41.2%) in Japan, respectively (P<0.01). Conclusion: These differences in TD risk factors reflect differences of vectors/hosts, climate, and geographical and cultural characteristics between the two countries. The surveillance of TD, primarily a zoonotic disease, should be continued in order to obtain a better understanding of its current status. Moreover, guidelines for the prevention of TD, and its control measures should be more established. [ABSTRACT FROM AUTHOR]

Iron has a vital role in the human body, including the central nervous system. Increased deposition of iron in the brain has been reported in aging and important neurodegenerative diseases. Owing to the unique magnetic resonance properties of iron, MRI has great potential for in vivo assessment of iron deposition, distribution, and non-invasive quantification. In this paper, we will review the MRI methods for iron assessment and their changes in aging and neurodegenerative diseases, focusing on Alzheimer’s disease. In addition, we will summarize the limitations of current approaches and introduce new areas and MRI methods for iron imaging that are expected in the future. [ABSTRACT FROM AUTHOR]

As the number of passengers using aircraft increases around the world, there may be more medical measures needed within the aircraft. These medical measures may also include measures against serious situations such as cardiopulmonary resuscitation (CPR). However, since the environment is different from the hospital in the aircraft, it may be difficult to cope with such a situation. Moreover, such in-flight CPR may become more difficult at a time when the proportion of out-ofhospital CPR is decreasing due to the recent COVID-19 pandemic. In this paper, I would like to summarize how in-flight CPR is performed and review the main discussions on CPR in the COVID-19 pandemic, and finally suggest how to perform a safe CPR in the COVID-19 situation. [ABSTRACT FROM AUTHOR]

Small cell carcinoma (SmCC) is a type of neuroendocrine tumor commonly originating in the lung, with only about 2-4% of cases arising at extrapulmonary sites. Extrapulmonary SmCC of the head and neck has a poor prognosis and a high rate of distant metastasis. The paranasal sinus is a rare location for extrapulmonary SmCC and only a few related papers have been published to date. We report a rare case of SmCC originating from the sphenoid sinus in a patient with a recurrent pituitary tumor with a literature review. [ABSTRACT FROM AUTHOR]

The coronavirus disease-19 (COVID-19) vaccine is expected to play an important role in stopping the pandemic. Studies show that COVID-19 vaccines are effective at keeping you from getting COVID-19. Getting a COVID-19 vaccine will also help keep you from getting seriously ill even if you do get COVID-19. Efforts to find an effective vaccine against severe acute respiratory syndrome coronavirus 2 have progressed unprecedentedly through active support from public research grants and private-public partnership programs. Clinical studies have been actively conducted, and some vaccines are being vaccinated with approval for urgent use. The WHO has approved and supplied the Pfizer-BioNTech COVID-19 vaccine and the Oxford-AstraZeneca COVID-19 vaccine. In Korea, the Oxford-AstraZeneca vaccine was approved for urgent use, and vaccination began on February 26, 2021. In this paper, the efficacy and side effects of each vaccines and the effect on pilots and air traffic controllers related to COVID-19 vaccination were investigated in terms of aviation medicine. [ABSTRACT FROM AUTHOR]

Aircraft accidents caused by dizziness of aviation workers are so common that they account for 5% to 10% of the total, and in most cases, have fatal consequences. Therefore, it is essential to diagnose and treat the dizziness of aviation workers properly. Common diseases caused by abnormal vestibular function include benign paroxysmal positional vertigo, Meniere's disease, and vestibular neuritis. In this paper, we first proposed an overview of these diseases' pathophysiology, diagnosis, and treatment. Also, we evaluated the importance of these diseases in aerospace medicine and presented aerospace medical dispositions for aviation medical examiners. [ABSTRACT FROM AUTHOR]

Launched in 1964, the Journal of the Korean Society of Radiology (JKSR) has served as the official journal of the Korean Society of Radiology (KSR). However, with establishment of the Korean Journal of Radiology (KJR), an entirely English journal, in 2000 and listing of the KJR in the SCI(E), KJR has become the representative academic journal of the KSR. Therefore, the identity of JKSR needs to be restructured, and a questionnaire survey was conducted to investigate the status and the future direction of the JKSR. The survey was conducted in September 2018 with 10 questions through on-line and mobile, and 553 members gave responses. According to the survey results, about 75% of the respondents read more than one JKSR article a year, mostly through on-line. All types of papers, including original article, case report, and review article were being read. The most common reason for contributing articles to the JKSR was submission for the radiology board examination, and the most common reason for not contributing articles to the JKSR was non-recognition of the publication in JKSR as achievement in universities because JKSR is not indexed in SCI(E). Many respondents were hoping for dealing with continuous medical education and health policies in radiology as the future role of JKSR. Based on these surveys, we plan to reorganize JKSR in 2019, which we would like to introduce in this paper. [ABSTRACT FROM AUTHOR]

Coronavirus disease 2019 (COVID-19) has had a significant impact on our society as a whole. The COVID-19 pandemic is not only a health crisis, it is also an economic, social and humanitarian crisis. Considering the dramatic global economic and social impact that the crisis has engendered, the aviation system is standing on the doorstep of rapid transformation. In particular, the impact on the aviation and travel industries is enormous. Air travel to most countries has been suspended and blocked. Looking at Korea's current situation, COVID-19 has wholly changed the aviation industry. As COVID-19 spreads around the world, countries have come up with aviation safety measures. Infectious disease safety measures were established to protect passengers and crew members, and countries with collapsed medical systems extended the validity period for aviation medical examinations. In Korea, on August 11, the Ministry of Land, Infrastructure and Transport provided guidance on medical measures related to COVID-19 through an official letter of "Notification of cautions for pilots and air traffic control officers (ATCO) when COVID-19 is confirmed". Overseas countries such as the United States and the United Kingdom have announced regulations for aviation medical examination regulations in relation to COVID-19, and have set standards for returning to aviation after COVID-19 is confirmed. In this paper, we would like to investigate the regulations for aviation medical examination related to COVID-19. [ABSTRACT FROM AUTHOR]

Internet of Things (IoT) is a technology that communicates data between devices, which are things, using an embedded sensor connected through network backbone such as the internet. Here, data communication technology, sensor technology, and actuator (interface) technology are fused into IoT and it turns devices into smart things. As a result, vast sized data are being generated and that data is being processed into useful actions that can control the things that are devices to make our lives much fruitful. Nowadays, the IoT, early defined as Machine-to-Machine (M2M) connection, becomes a key technology powered by growing innovation of wireless communication trends in the internet connectivity through mobile networking. This paper gives an overview of Internet of Things and brief information about major technologies and its applications in various fields focusing aviation. [ABSTRACT FROM AUTHOR]

The coronavirus infectious disease-19 (COVID-19) pandemic has had a profound impact on the aviation industry. In order to overcome this crisis, airlines have made their efforts in various fields. Therefore, we tried to summarize these efforts of airlines. It is also essential to keep aircraft that have been in landing for a long time in optimal condition. In this paper, we tried to find out about efforts to maintain landing aircraft and maintenance of personnel. Through such constant care, airlines will be able to quickly respond to increasing aviation demand when the infectious disease situation is stabilized in the future. Finally, airlines and passengers must make several efforts to ensure that passengers are free from COVID-19 while traveling by air. These include general precautions to prevent infection, separation of airline personnel and passengers, changes in seat assignments and in-flight services, periodic aircraft disinfection, and prevention of in-flight infections. [ABSTRACT FROM AUTHOR]

In Vol. 31, No. 3, our journal prepared three review articles, an original paper, and two case reports. First, as COVID-19 continues for a long time, aviation workers, including pilots, are also experiencing mental problems such as depression. Therefore, we have compiled the basic principles for improving the mental health of pilots. Next, it is difficult to properly perform cardio-pulmonary resuscitation (CPR) when a cardiac arrest situation occurs in an aircraft. Moreover, in the context of the COVID-19 pandemic, CPR is more difficult because medical staff and other passengers may also be exposed to infections. Therefore, we have summarized the principles of CPR on board and ways to perform CPR while keeping the safety of medical staff and other passengers in the COVID-19 situation. The sudden change of gravity caused by space travel has various effects on the human body, and among them, the effect on the immune system is profound. Therefore, we reviewed the research methods to study the effect of gravity on the immune system and the results. In addition, we analyzed the demographic characteristics and health status of immigrant visa applicants who intended to immigrate to the United States over the past five years. Next, through two case reports, we reported cases of determining physical fitness for aviation service in patients who recovered after receiving appropriate treatment for chronic myeloid leukemia or renal cell carcinoma. [ABSTRACT FROM AUTHOR]

Since allergic rhinitis is a disease with a very high prevalence, it is common to find patients with allergic rhinitis among aviation workers. However, they are so afraid that the report of rhinitis will have a negative effect on the evaluation of one's work suitability. Therefore, aviation medical examiners (AMEs) must be able to accurately understand the nature of allergic rhinitis, and confidently explain that appropriate treatment of rhinitis has a positive effect on their performance. In the treatment of allergic rhinitis, there are some medications that may cause drowsiness, which may impair the accuracy and safety of the aviation service. Therefore, AMEs should accurately know safe drugs that do not cause drowsiness and prescribe them to patients. In addition, it is necessary to know exactly whether air workers may receive the latest treatments for allergic rhinitis, such as surgical treatment and immunotherapy, and be able to recommend these treatments appropriately. Therefore, in this paper, we first briefly describe the pathophysiology, genetics, causative antigen, symptoms, diagnosis, and treatment of allergic rhinitis. We also aimed to discuss safe medication and other treatment modalities for allergic rhinitis. [ABSTRACT FROM AUTHOR]

Acute abdomen is a condition with sudden abdominal pain that may require immediate surgical treatment. The causes of acute abdomen in pediatric patients are diverse, and can be categorized in broad range from diseases requiring surgery to diseases requiring medication or clinical observation only. The role of the imaging study in children with acute abdomen is to distinguish between patients who need medication and patients who need surgery by identifying diseases that cause abdominal pain, if possible. Since intussusception and appendicitis are the leading causes of acute abdomen requiring surgical treatment in children, it is important to exclude intussusception in young infants complaining of acute abdominal pain and exclude acute appendicitis in older children with acute abdomen. In this paper, we introduce intussusception, acute appendicitis, midgut volvulus, Meckel’s diverticulum and duplication cyst, which has characteristic imaging finding of the disease that can cause acute abdomen in pediatric patients [ABSTRACT FROM AUTHOR]

The Republic of Korea is rapidly entering an aging society. With the aging of society, the overseas travel of the elderly is increasing rapidly. According to the Korea Tourism Organization, the number of overseas tourists aged 61 or older last year exceeded 2.5 million, of which over 80 were over 200,000. Age is no longer a limiting factor for traveling abroad, but traveling to unfamiliar places is certainly a challenge. Old people may experience a variety of problems, so special care should be taken. In particular, the aircraft cabin environment is different from the ground, so elderly travelers with respiratory or heart disease require special attention. In this paper, we want to know the precautions and how to prepare for the safe air travel for the elderly. [ABSTRACT FROM AUTHOR]

Lung cancer is the leading cause of death from cancer worldwide. The most effective way to reduce lung cancer mortality is early detection and treatment. Two large randomized controlled trials (RCTs), the National Lung Screening Trial and the Dutch-Belgian Randomized Lung Cancer Screening Trial, showed that low-dose CT (LDCT) can reduce the chances of lung cancer death. This paper reviews the two aforementioned RCTs and the current situations of implementing LDCT screening in several counties. Although nationwide programs of lung cancer screening are rare, they would increase in the near future. Using the two aforementioned RCTs and accumulating data from many counties, including the East Asian countries, a more effective way of LDCT screening in Korea can be devised and implemented. [ABSTRACT FROM AUTHOR]

Urinary tract injuries occur in up to 10% of patients with abdominal trauma, and the kidney is the most commonly injured structure of the urinary system. The kidney is the third most common abdominal organ to be injured by trauma, following the spleen and liver, in that order. The American Association for the Surgery of Trauma kidney injury scale is the most commonly used classification system for blunt renal injuries, which grades renal injury based on the size of laceration and its proximity to the renal hilum on CT. CT aids in delineating the most important features of urological injury that affect the diagnosis and management, including interventions. The major renal injuries are usually surgical emergencies. The current trend toward a more conservative management of renal trauma and advances in interventional radiology in the field of trauma may increase the use of interventional procedures for patients with renal injury. Urethral injuries can be anterior or posterior depending on the injury site, and interventional urethral realignment plays an important role in the treatment of urethral injury and surgical repair or endoscopic urethral realignment. Therefore, in this paper, we provide a literature review and discuss the efficacy and clinical significance of intervention for urologic trauma. [ABSTRACT FROM AUTHOR]

In Vol. 31, No. 1, our journal prepared four review articles and two original papers. First, in commemoration of the 30th anniversary of our journal, the first review article described the history, development, and recent efforts for the qualitative improvement of the journal. For aviation workers, dizziness is an important disease that can interfere with their work. So, in the second review, we introduced guidelines that aviation medical examiners should be aware of in evaluating aviation workers who complain of dizziness. In the era of coronavirus disease 19 (COVID-19) pandemic, it is very important for aviation workers to get the vaccination safely and return to their work. So, Kwon introduced the latest updated guidelines for vaccination for aviation workers. In addition, Kim described the relationship between COVID-19 infection and respiratory allergic disease, and appropriate treatment guidelines. Lim investigated the recent trend of human papillomavirus vaccination for foreigners during the COVID-19 period, and investigated its implications. Finally, Ra developed various programs to strengthen students' global competencies and analyzed their satisfaction. [ABSTRACT FROM AUTHOR]

Due to rapid developments in the deep learning model, artificial intelligence (AI) models are expected to enhance clinical diagnostic ability and work efficiency by assisting physicians. Therefore, many hospitals and private companies are competing to develop AI-based automatic diagnostic systems using medical images. In the near future, many deep learning-based automatic diagnostic systems would be used clinically. However, the possibility of adversarial attacks exploiting certain vulnerabilities of the deep learning algorithm is a major obstacle to deploying deep learning-based systems in clinical practice. In this paper, we will examine in detail the kinds of principles and methods of adversarial attacks that can be made to deep learning models dealing with medical images, the problems that can arise, and the preventive measures that can be taken against them. [ABSTRACT FROM AUTHOR]

Automated breast ultrasonography (ABUS) is a recently introduced technology. Similar to handheld ultrasound (HHUS), it is a supplementary screening test for breast cancer to be used along with mammography. It is particularly useful for detecting invasive breast cancers that may be overlooked by mammography in denser breast tissue. The use of ABUS is becoming more common because of the advantages of low operator dependency during image acquisition, high reproducibility, a wide field-of-view, and unavailability of better coronal imaging with HHUS. Consequently, there have been suggestions to extend ABUS use to diagnostic screening. Therefore, in this paper, we provide a review of the literature and discuss the usefulness and value of ABUS in breast cancer screening. [ABSTRACT FROM AUTHOR]

In commemoration of Vol. 30, Issue 3, our journal prepared five review articles and one original paper. The global outbreak of COVID-19 in 2020 has impacted our society, and especially the aviation and travel industries have been severely damaged. Kwon presented the aviation medical examination regulations related to COVID-19 announced by the Ministry of Land, Infrastructure, and Transport of the Republic of Korea. Lim summarized various efforts of airlines to overcome the crisis in the aviation industry. He also discussed the management of these aircraft as the number of airplanes landing for long periods increased. Finally, he suggested various quarantine guidelines at airports and onboard aircraft. COVID-19 has had a profound impact on mental health as well as physical effects. Kim investigated the impact of COVID-19 on mental health and suggested ways to manage the stress caused by it. The Internet of Things (IoT) refers to a technology in which devices communicate with each other through wired or wireless communication. Hyun explained the current state of the technology of the IoT and how it could be used, especially in the aviation field. In the area of airline service, various situations arise between passengers and crew. Therefore, role-playing is useful in performing education to prepare and respond to passengers' different needs appropriately. Ra introduced the conceptual background and general concepts of role-playing and presented the actual role-play's preparation process, implementation, evaluation, and feedback process. For a fighter to fly for a long time and perform a rapid air attack, air refueling is essential, which serves refueling from the air rather than from the aircraft base. Koo developed a questionnaire based on the HFACS (Human Factors Analysis and Classification System) model and used it to conduct a fighter pilot survey and analyze the results. [ABSTRACT FROM AUTHOR]

Purpose: This aim of this study is to examine trends in medical education research in the Korean Journal of Medical Education (KJME) and suggest improvements for medical education research. Methods: The main variables were keywords from research papers that were published in KJME. Abstracts of papers (n=499) that were published from 1991 through 2015 were analyzed by social network analysis (NetMiner 4.0) a common research method for trends in academic subjects. Results: The most central keywords were ”medical education,” ”clinical competence,” ”medical student,” and ”curriculum.” After introduction into graduate medical school, newly appearing keywords were ”professional behavior,” ”medical humanities,” ”communication,” and ”physician-patient relation.” Based on these results, we generated a schematic of the network, in which the five groups before introduction to graduate medical school expanded to nine groups after introduction. Conclusion: Medical education research has been improving qualitatively and quantitatively, and research subjects have been expanded, subdivided, and specific. While KJME has encompassed medical education studies comprehensively, studies on medical students have risen in number. Thus, the studies that are published in KJME were consistent with the direction of journal and a new study on the changes in medical education is being conducted. [ABSTRACT FROM AUTHOR]

In commemoration of Vol. 30, Issue 2, our journal prepared three review articles, two original papers, and a case report. The first review analyzed aircraft accidents caused by pilots' fatigue and presented a protocol to measure their fatigue, such as primary background survey, subjective drowsiness/arousal evaluation, sleep and activity log, sleep data, and performance measurement. The second review analyzed shift work patterns and work characteristics that may affect the fatigue of aviation mechanics. Also, desirable work principles for aviation mechanics (restrictions on working hours, appropriate rest hours, and night shift restrictions) were presented. The third review discussed the effects that allergic rhinitis can have on pilots (drowsiness and decreased arousal) and introduced a safe treatment method that can prevent these adverse effects. In the first original article, the ratio of 'incompatible (non-fit)' result in aerospace medical examination among Korean aircraft pilots for the past five years was investigated by age group and the common causes of nonconformity were analyzed. In the second original article, the prevalence, mortality, prevalence according to age groups, and regional characteristics of severe febrile thrombocytopenia syndrome were compared and analyzed in Korea and Japan for the past five years. Finally, in the case report, the cases of a patient diagnosed as gastrointestinal stromal tumors who received surgical treatment and chemotherapy were discussed, and the results of the judgment were presented. [ABSTRACT FROM AUTHOR]

Background and Objectives: Positional therapy is a therapeutic method for obstructive sleep apnea (OSA). However, little is known about the effectiveness of positional OSA treatment based on meta-analysis. Therefore, we undertook a review and meta-analysis of studies to assess the effect of positional therapy on OSA. Subjects and Method: We searched PubMed (Medline), OVID Medline, EMBASE, Cochrane Library, SCOPUS, KoreaMed, MedRIC, and KSI KISS using the key words "obstructive sleep apnea" and "positional therapy". To estimate the effect of positional OSA therapy, we analyzed the ratio of means (ROM) for pre- and post-treatment polysomnographic data including apnea-hypopnea index (AHI), lowest oxygen saturation, arousal index, and sleep efficiency. Results: Finally, twenty two studies from 21 papers were included in the meta-analysis. Positional therapy significantly decreased AHI by 54.1% [ROM, 0.459; 95% confidence interval (CI), 0.394 to 0.534] and increased lowest oxygen saturation by 3.3% (ROM, 1.033; 95% CI, 1.020 to 1.046). However, positional therapy did not significantly change arousal index (ROM, 0.846; 95% CI, 0.662 to 1.081) or sleep efficiency (ROM, 1.008; 95% CI, 0.990 to 1.027). Conclusion: Positional therapy significantly improves respiratory parameters including AHI and lowest oxygen saturation in patients with OSA. [ABSTRACT FROM AUTHOR]

Random allocation is commonly used in medical researches, and has become an essential part of designing clinical trials. It produces comparable groups with regard to known or unknown prognostic factors, and prevents the selection bias which occurs due to the arbitrary assignment of subjects to groups. It also provides the background for statistical testing. Depending on the change in allocation probability, random allocation is divided into two categories: fixed allocation randomization and dynamic allocation randomization. In this paper, the author briefly introduces both the theory and practice of randomization. The definition, necessity, principal, significance, and classification of randomization are also explained. Advantages and disadvantages of each randomization technique are further discussed. Dynamic allocation randomization (Adaptive randomization), which is as yet unfamiliar with the anesthesiologist, is also introduced. Lastly, the methods and procedures for random sequence generation using Microsoft Excel is provided. [ABSTRACT FROM AUTHOR]

Background and Objectives: Endoscopic sinus surgery (ESS) was introduced to Korea in the 1980s and has since developed rapidly. There have been many changes in ESS over this period. Thus, in this paper, we explore trends in the clinical characteristics of ESS. Subjects and Method: We retrospectively reviewed patients who underwent the ESS at 000 Hospital performed by a single surgeon at a 10-year interval. By comparing 106 patients who underwent ESS in 2003 and 108 patients who underwent ESS in 2013, we investigated changes in ESS in terms of the target group of surgical indications, CT scores, range of operation and complications. Results: With regard to surgical indications, the proportion of patients who underwent surgery due to nasal polyps in 2013 (32.4%) was lower than in 2003 (59.4%), while the proportion of patients undergoing fungal sinusitis surgery in 2013 (13.9%) was higher than in 2003 (0.0%). In terms of preoperative CT evaluation, Lund-Mackay scores for the maxillary sinus, ethmoid sinus, and ostiomeatal unit were lower in 2013 than in 2003. The proportion of ESS performed only in the maxillary sinus in 2013 (20.0%) was higher than in 2003 (10.0%). Conclusion: According to this study, the range and extent of sinusitis was favorable in 2013 compared to in 2003. The group of patients requiring treatment for only maxillary sinus disease accounted for a larger proportion of patients in 2013 than in 2003. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the chronological changes and progress in medical education research in Korea and to identify the less investigated topics that need further study and improvement with regard to methodological quality. Of the 590 articles that were published from 1989 to 2010 in the Korean Journal of Medical Education, 386 original research papers were extracted for the analysis. The extracted papers were systematically reviewed using 2 analysis schemes that we developed: one scheme was designed to classify research topics, and the other determined the methodology that was used. The main results were as follows: The most popular research areas were curriculum, educational method, and evaluation in basic medical education; in contrast, studies that addressed postgraduate education, continuous professional development, and educational administration were less frequent; The most frequently studied topics were clinical performance/skills evaluation, clerkship, curriculum development, and problem-based learning, Quantitative studies predominated over qualitative studies and mixed methods (265 vs. 95 vs. 26). Two hundred forty papers were descriptive, cross-sectional studies, and 17 were experimental studies. Most qualitative studies were non-participation observational studies. In conclusion, there has been dramatic growth in the extent of medical education research in Korea in the past two decades. However, more studies that investigate the graduate medical education and the continuous professional development should be performed. Moreover, robust experimental designs and methods should be applied to provide stronger evidence that can practice best-evidence medical education. [ABSTRACT FROM AUTHOR]

Crohn's disease and ulcerative colitis represent two distinct forms of inflammatory bowel diseases (IBD). In this paper, we discuss how immunological mechanisms contribute to the pathogenesis of IBD. Intestinal homeostasis is sustained by various kinds of cells, such as epithelial cells, lymphocytes, antigen presenting cells, and other innate immune cells. We pay special attention to intestinal CD14+ macrophages. Intestinal macrophages play a central role in the regulation of immune responses against commensal bacteria. In the physiological condition, intestinal macrophages lack the expression of innate-immune receptor CD14 and do not produce proinflammatory cytokines. We identified a unique macrophage subset of IBD in the human intestine, which expressed both macrophage (CD14, CD33, CD68) and dendritic cell (DC) markers (CD205, CD209) and produced larger amounts of proinflammatory cytokines, such as interleukin (IL)-23 and tumor necrosis factor (TNF)-α. In addition, the CD14+ macrophages contributed to interferon (IFN)-γ production rather than IL-17 production by lamina propria mononuclear cells dependent on IL-23. We discuss herein this IL-23/IFN-γ-positive feedback loop in IBD patients. We also discuss IFN-γ and IL-17 production from mucosal T cells and natural killer (NK) cells. Here, we show our recent findings about the plasticity of T helper cells in colitis. Th17 cells express T-bet, and finally lose the expression of retinoic acid-related orphan receptor (ROR) γt, the master regulator of Th17 cells, and are differentiated 'alternative Th1 cells.' In addition to Th1 cells, mucosal NK cells are also important sources of IFN-γ. Some of our ideas may be provocative, but we hope this review paper will provide new and firm understanding of the pathogenesis of IBD. [ABSTRACT FROM AUTHOR]

Propensity score matching method (PSM) is widely used in observational study to reduce selection bias. Observational study lacks randomization, hence, statistical inferences without bias adjustments usually include observed or unobserved effects of covariates. If a subject with specific characteristics has a higher chance to be selected for a specific treatment, the characteristics have a possible effect on statistical results. PSM is the method for controlling covariate imbalance that produces the selection bias. In this paper, we introduce the basic concepts of PSM and simplified methods of PSM process. However, PSM is a rapidly developing statistical area with many limitations and some disadvantages. These points are described in the concluding section to emphasize the importance of considering the various features of PSM in the study design. [ABSTRACT FROM AUTHOR]

In Vol. 31, No. 2, our journal prepared a review article, two original papers, and three case reports. First, autonomous systems are increasingly being introduced in aircraft systems. Therefore, it is crucial that flight crews are trained to adapt and handle these autonomous systems better. Consequently, we discussed crew resource management for handling autonomous systems. The fatigue of aviation workers is one of the biggest threats to aviation safety. Therefore, we analyzed the degree of fatigue in commercial aircraft pilots and evaluated the relationship between fatigue and their workload and the effect of fatigue on sleep. Since obesity has a significant impact on the health of aviation workers, we also comparatively analyzed the prevalence of obesity in Korea and Japan based on the data from the National Health and Nutrition Examination Survey. We defined cases that are difficult for aviation medical examiners to evaluate. This issue included cases of peripheral dizziness and tinnitus, cases of atopic dermatitis treated with biological agents, and cases of malignant tumors. [ABSTRACT FROM AUTHOR]

Purpose: We performed a two-and-a-half year follow-up study of strategy factors in successful learning to predict academic achievements in medical education. Methods: Strategy factors in successful learning were identified using a content analysis of open-ended responses from 30 medical students who were ranked in the top 10 of their class. Core words were selected among their responses in each category and the frequency of the words were counted. Then, a factors survey was conducted among year 2 students, before the second semester. Finally, we performed an analysis to assess the association between the factors score and academic achievement for the same students 2.5 years later. Results: The core words were "planning and execution," "daily reviews" in the study schedule category; "focusing in class" and "taking notes" among class-related category; and "lecture notes," "previous exams or papers," and "textbooks" in the primary self-learning resources category. There were associations between the factors scores for study planning and execution, focusing in class, and taking notes and academic achievement, representing the second year second semester credit score, third year written exam scores and fourth year written and skill exam scores. Study planning was only one independent variable to predict fourth year summative written exam scores. Conclusion: In a two-and-a-half year follow-up study, associations were founded between academic achievement and the factors scores for study planning and execution, focusing in class, and taking notes. Study planning as only one independent variable is useful for predicting fourth year summative written exam score. [ABSTRACT FROM AUTHOR]

Purpose: Empathy is an important trait of a physician and a key element in the physician-patient relationship. This study evaluated the ability to express empathy in medical students. Methods: Medical student empathy was measured by the modified Pencil-and-Paper Empathy Rating Test of Winefield and Chur-Hansen. The subjects comprised 110 medical students. The data were analyzed by descriptive analysis and t-test using SPSS version 21.0 (IBM Corp.). Results: Empathy rating test scores were low-level in medical students (mean, 12.59). There were no differences in the level of ability to express empathy between genders (t=-1.714, p=0.089). Conclusion: Our results suggest that practical training in expressing empathy should be included in medical education and that an empathy training program must be focused on changes in behavior. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to examine the relationship between ego-states and communication skills in medical students. Methods: A total of 109 medical school students participated in this study, which used the communication skills self-test papers and the Egogram checklist. The data were analyzed by frequency analysis, and Pearson correlation analysis. Results: Ego-state was related to communication skills. In particular, adapted child ego-state was negatively associated with each sphere of communication skills. Conclusion: Our results suggested that ego-state types should be considered in developing a communication skills education program for medical students. [ABSTRACT FROM AUTHOR]

Purpose: This study was planned to evaluate that a lecture employing medical drama could motivate students to have an interest in the professionalism of healthcare personnel, which has currently become a critical subject in the field of medical education. Methods: We analyzed subject headings, learning objectives, and further plans developed by students and their responses after two drama modules, 'car crash' and 'refusal of instruction', which were selected based on the conditions made by our faculty members, were given through video or paper to our 121 second-grade medical and nursing students in year 2012. Results: Meaningful subject headings and learning objectives developed by students were 58.2%∼60.0% and 36.8%∼38.0% and significantly more in the 'refusal of instruction' than the 'car crash' (p=0.000). According to the students' major, medical students developed significantly more than nursing students (p=0.000). In the analysis of responses, 91.7% of students reported as impressive to the educational modules and 55.3% of them described their ideas associated with healthcare professionalism. Conclusion: Our study results suggest a possibility that the educational module employing selected medical drama could motivate students' healthcare professionalism. [ABSTRACT FROM AUTHOR]

Open surgical repair has long been considered a mainstream treatment for abdominal aortic aneurysm (AAA). Although endovascular aneurysm repair is minimally invasive and yields satisfying short-term results, there has been concerns about it's the long-term durability. Recent studies showed that laparoscopic AAA repair is a feasible technique and that the benefits of laparoscopy can be consistent with open repair. In particular, total laparoscopic AAA repair has the advantage of reducing postoperative problems in abdominal wall and intestine, and increasing the patient's respiratory recovery and general comfort. In this paper, we report a successful case of total laparoscopic AAA repair. To our knowledge, this is the first report of total laparoscopic AAA repair in Korea. [ABSTRACT FROM AUTHOR]

Understanding of the pathophysiology of inflammatory bowel disease (IBD) is constantly evolving and, recently, a number of biologic agents that selectively target specific molecules or pathways to correct the imbalance of the gut immune system have been developed. Among them, an antibody to tumor necrosis factor (anti-TNF) is the first developed drug which has dramatically improved the management of patients with IBD. However, more than one-third of IBD patients do not respond to medications, and there is the problem of antibody formation. Therefore, enormous efforts have been made into the development of novel anti-cytokines and stem cell injection as an alternative to has been made. However, the efficacy and safety of stem cell treatment are under investigation. Some studies have reported very promising data; however, others have shown conflicting results. In addition, most trials involved a very small number of subjects and did not compare stem cell treatment with anti- TNF. The present paper reviews the function and therapeutic mechanism of stem cells for the treatment of IBD. [ABSTRACT FROM AUTHOR]

There has been a recent tendency to attach special importance to writing education. Books on 'writing to heal' are being written in or translated into Korean. According to these texts, writing is a valuable tool for internal healing, depending on the mode of application. Writing can have positive effects and give hope to an individual or group, but it can also be a source of frustration and despair. Based on the distinct effects of writing, we cannot overemphasize the significance of writing education. Writing is generally taught during a premedical course that targets students who will eventually practice medicine. Many reports have examined immorality in medical students and health care providers, which is a reason that writing education is important for medical systems. 'Writing for Healing' is open to freshmen at Yonsei University Wonju College of Medicine. The aim of this subject is to help students identify and acknowledge internal diseases to lead a healthier life and eventually become positive and responsible health care providers. However, in addition to the vague definition of what 'healing' is, the concept of 'writing for healing' has not been defined. This paper attempts to define the concept of 'writing for healing' and considers what influences it can have on a humanities curriculum in medical colleges [ABSTRACT FROM AUTHOR]

Purpose: Medical schools and graduate medical schools should understand the personality and psychological qualities of graduate medical students, medical students, and premedical students and link them with the curriculum. Methods: In this study, through June 2010 we analyzed medical papers that were published in Korea. The search terms were psychological terminology, including emotion, cognition, intelligence, social ability, stress, motivation, judgment, and learning style. Results: In the cognitive and learning aspects, preliminary doctors were under the influence of prior knowledge; cumulative learning; self-efficacy; and visual, logical, non-self-led learning types and had external learning motivation. In the emotional adaptive aspects, they appeared to be the ISTJ (introversion, sensing, thinking, judging) personality type with regard to the Myers-Briggs indicators and perfectionists, suffering from severe academic stress. Their motivation on matriculation was associated with their interests and aptitudes, and through community service, they adapted to the learning and living environment of medicine. In the social and moral aspects, they did not have high moral judgment, felt devaluated about their job than before, and tended to have an open and flexible doctor-patient relationship. Conclusion: Medical graduate students, medical students, and premedical students have greater likelihood to cultivate their character and capacity for adaptation [ABSTRACT FROM AUTHOR]

In commemoration of Vol. 30, Issue 1, our journal prepares four review articles and two original papers. The first review article provides guidelines for medical treatment for emergencies in an aircraft furing flight. This guideline addresses the resources and medical equipment available to physicians on board, common medical conditions, how to deal with them, including legal issues. The second review article covers historically meaningful animals that have contributed to aerospace research and the role of a veterinarian. The third one describes cardiovascular, musculoskeletal, and vestibular physiological effects of microgravity on the human body. As we are about to enter an aging society, the fourth review article introduces guidelines for safe overseas travel for senior passengers. The role of the aviation medical examiner is to maintain aircrew's health and to help them work long and healthy. In this regard, Choi et al. analyzed the physical examination data and sick leave data of an airline. Han et al. investigated the aerospace medical examination data of the Republic of Korea and suggested a solution to some common health problems of the crew. [ABSTRACT FROM AUTHOR]