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This study aims to examine the current situation of safety education of coal mining industry in Gangwon province, and suggest its problems and improvement directions. And the theoretical background was established through the literature, a survey study for general workers were conducted and its data were analyzed.

technique for guide wire placement during meniscal allograft transplantation (MAT) is usually based on the parapatellar approach that is not in the anatomical direction of meniscal horn bony insertions. Here, we present a surgical technique to achieve the correct anatomical position of the meniscal graft using the transpatellar approach.a guide wire was introduced through the patellar tendon in the direction of the meniscal insertion sites passing the lateral tibial spine. The insertion plane of the guide wire was approximately at the medial aspect of the tibial tuberosity and slightly medial to the midplane of the patellar tendon. After confirmation with C-arm, the guide wire was cut at the level just beneath the patellar tendon. The knee was then brought to the extension position which lessened the tension of the patellar tendon and retracted it to the medial aspect to expose the end of the guide wire. Drilling and insertion of bone block was performed accordingly.eleven consecutive patients with total or near-total meniscectomy of the knee underwent MAT with the described technique. The mean extrusion taken on 1-year postoperative non-weight-bearing MRI was 1.6 mm (range 0.5-2.9 mm). None of the patients presented with symptoms requiring a secondary surgery at the time of review.the described technique focuses on achieving correct positioning of the tibia tunnel through the patellar tendon and tunnel reaming in the extended knee position via the mini-open parapatellar approach during lateral MAT. This "transpatellar approach" could be an effective method for anatomical placement of meniscal graft.

Children with mental retardation (MR) obtain demonstrable benefit from cochlear implantation, and their postoperative performance was tempered by the degree of MR.The purpose of this study was to investigate the performance of children with MR after implantation, and to explore their progress according to the degree of MR.Fifteen implanted children with MR were included. Progress in speech perception, speech intelligibility, and language was measured using Categories of Auditory Performance, monosyllabic word test, Speech Intelligibility Rating, and Language Scale before and after implantation. We retrospectively examined outcomes and explored the association between the progress and the degree of MR after implantation. We compared monosyllabic word test scores using repeated-measures ANOVA.Speech perception and speech intelligibility for children with mild MR improved consistently after implantation. After implantation, monosyllabic word test scores did not differ significantly between children with mild MR and children with no additional disabilities. Although language development of children with mild MR was slow, they could communicate verbally 3 years after implantation. Children with moderate MR progressed more slowly and had limitations in speech and language development, and these children could communicate by vocalization and gesture 3 years after implantation.

Purpose The aims of this study were to explore the terms that patients preferred to be called during medical encounters and to provide a guideline about the proper use of appellations about patients in teaching medical students. Methods Patients were asked to select items from given examples to indicate how they wanted to be addressed by their doctors and how their doctors tended to address them. These terms were categorized into 3 groups; 1) terms that includes name, 2) "patient+honorific suffix, boon (hwanja- boon)", and 3) other general terms. The survey also included questions on patient's perception of the importance of terms of address in building a good doctor-patient relationship. The questionnaire was distributed to 440 out-patients of the three university affiliated hospitals in Seoul and Gyeonggi province from August to September 2007. Results Three hundred ninety-two respondents were analyzed after excluding 58 respondents who did not meet the study criteria. The ages of the respondents ranged from 18 to 80 years, and 56% of them were male. Most patients preferred to be called by the terms that includes their name (284, 72.4%) and the most preferred term was "family name (FN)+given name (GN)+honorific suffix, nim" (156, 39.8%), while doctors used the terms "patient+honorific suffix, boon" (188, 48.0%) most frequently. About 59% of respondents were addressed as they preferred. Patients in their 30s and 40s showed significantly higher perceptions of the importance of terms of address than other age groups (p= 0.0007). Conclusion Patients preferred to be called by their full name with an honorific suffix; however, patients' preferences and doctors' usage were not in agreement in many cases. The results of this study suggest that doctors should pay more attention to the proper use of appellation during medical encounters. Furthermore, these results can be used to teach undergraduate medical students and guide physicians on how to address patients in practice.

Transient receptor potential vanilloid type 1 (TRPV1) is a molecular sensor for detecting adverse stimuli, such as capsaicin, heat, and acid. TRPV1 has been localized in keratinocytes and is suggested to be a mediator of heat-induced matrix metalloproteinase-1 (MMP-1). With regard to the multimodal activation of TRPV1, we hypothesize that TRPV1 might also mediate UV-induced MMP-1 in keratinocytes. In HaCaT, a human keratinocyte cell line, we initially confirmed capsaicin-induced membrane current and Ca(2+) influx. UV irradiation induced slow and persistent calcium influx and increased membrane current, which was inhibited by TRPV1 inhibitors (capsazepine and ruthenium red). The UV-induced MMP-1 expression in HaCaT was also decreased by TRPV1 inhibitors and was facilitated by capsaicin. Knock-down of TRPV1 using siRNA transfection also decreased MMP-1 expression, as well as UV-induced Ca(2+) influx in HaCaT. UV failed to induce MMP-1 expression in HaCaT cells cultured in Ca(2+)-free media. Both the UV-induced increase in [Ca(2+)](i) and MMP-1 were suppressed by Gö6976 (a calcium-dependent PKC inhibitor), but not by rottlerin (a calcium-independent PKC inhibitor). In addition to a plausible role of TRPV1 in UV-induced MMP-1 expression, we showed that UV increased TRPV1 expression in both HaCaT cells and human skin in vivo. From these results, we suggest that UV-induced MMP-1 expression might be mediated in part by PKC-dependent activation of TRPV1 and subsequent Ca(2+)-influx in human keratinocytes. J. Cell. Physiol. 219: 766-775, 2009. (c) 2009 Wiley-Liss, Inc.

Transient receptor potential vanilloid type 1 (TRPV1) is activated by various stimuli including capsaicin, heat and acid. While TRPV1 has been localized in the epidermis, little is known about the physiological role of TRPV1 in the skin, especially in skin ageing. In this study, we investigated the effect of acute UV irradiation on TRPV1 expression in human skin and the changes in TRPV1 mRNA and protein in intrinsic ageing and photoageing using human sun-protected (upper inner arm) and sun-exposed (forearm) skin of young and elderly subjects. Western blot analysis of UV-irradiated young buttock skin revealed that the expression of TRPV1 protein was increased at 24 h (2.3-fold) and 48 h (2.4-fold) after UV irradiation. Real-time PCR analysis also showed that the mRNA level of TRPV1 was augmented by 2.4-fold at 4 h after UV irradiation. TRPV1 protein was expressed at higher levels by 2.6-fold in the sun-protected skin of the elderly subjects than in that of young people according to western blotting, real-time PCR analysis and immunohistochemical staining. In addition, the photoaged skin of elderly showed increased expression of TRPV1 mRNA and protein compared with that of the sun-protected skin of the same individuals. Also, we found increased expression of TRPV1 in nerve fibres of elderly persons using double staining of TRPV1 and nerve fibres. Based on the above results, our data suggest that the expression of TRPV1 is affected by both the intrinsic ageing and photoageing processes.

We found that Arabidopsis AtTDX, a heat-stable and plant-specific thioredoxin (Trx)-like protein, exhibits multiple functions, acting as a disulfide reductase, foldase chaperone, and holdase chaperone. The activity of AtTDX, which contains 3 tetratricopeptide repeat (TPR) domains and a Trx motif, depends on its oligomeric status. The disulfide reductase and foldase chaperone functions predominate when AtTDX occurs in the low molecular weight (LMW) form, whereas the holdase chaperone function predominates in the high molecular weight (HMW) complexes. Because deletion of the TPR domains results in a significant enhancement of AtTDX disulfide reductase activity and complete loss of the holdase chaperone function, our data suggest that the TPR domains of AtTDX block the active site of Trx and play a critical role in promoting the holdase chaperone function. The oligomerization status of AtTDX is reversibly regulated by heat shock, which causes a transition from LMW to HMW complexes with concomitant functional switching from a disulfide reductase and foldase chaperone to a holdase chaperone. Overexpression of AtTDX in Arabidopsis conferred enhanced heat shock resistance to plants, primarily via its holdase chaperone activity.

A large number of thioredoxins (Trxs), small redox proteins, have been identified from all living organisms. However, many of the physiological roles played by these proteins remain to be elucidated. We isolated a high M r (HMW) form of h-type Trx from the heat-treated cytosolic extracts of Arabidopsis (Arabidopsis thaliana) suspension cells and designated it as AtTrx-h3. Using bacterially expressed recombinant AtTrx-h3, we find that it forms various protein structures ranging from low and oligomeric protein species to HMW complexes. And the AtTrx-h3 performs dual functions, acting as a disulfide reductase and as a molecular chaperone, which are closely associated with its molecular structures. The disulfide reductase function is observed predominantly in the low M r forms, whereas the chaperone function predominates in the HMW complexes. The multimeric structures of AtTrx-h3 are regulated not only by heat shock but also by redox status. Two active cysteine residues in AtTrx-h3 are required for disulfide reductase activity, but not for chaperone function. AtTrx-h3 confers enhanced heat-shock tolerance in Arabidopsis, primarily through its chaperone function.

This study assessed the knowledge and perception of human biological materials (HBM) and biorepositories among three study groups in South Korea. The relationship between the knowledge and the perception among different groups was also examined by using factor and regression analyses. In a self-reporting survey of 440 respondents, the expert group was found more likely to be knowledgeable and positively perceived than the others. Four factors emerged: Sale and Consent, Flexible Use, Self-Confidence, and Korean Bioethics and Biosafety Action restriction perception. The results indicate that those who are well aware of the existence of biobanks were more positively inclined to receive the Sale and Consent perception. As a result of the need for high quality HBMs and the use of appropriate sampling procedures for every aspect of the collection and use process, the biorepository community should pay attention to ethical, legal, and policy issues.

Purpose: Since 2006, Korea University Medical College has offered a medical communication skills program for third-year medical students. This study examined the relationship between medical student interview performance in a medical communications skills course and students' patient-physician interaction (PPI) scores on the Clinical Performance Examination (CPX). Methods: Participants were 130 fourth-year students who took both the medical communication skills course in 2006 and the CPX in 2007. Students' scores in performance evaluation, assessed by SP interview, and their PPI scores were used for data analysis. Results: This study hypothesized that students who performed well in the medical communication skills course would have high PPI scores on the CPX. Students' PPI total and individual item scores showed statistically significant differences by the performance level of the medical communication skills course. Some of these differences were statistically significant, even after controlling for the influence of GPA. Conclusion: This study has practical implications for medical communications education, demonstrating that the knowledge and skills that are acquired in a communications skills course can be maintained.

Purpose: It has been well known that doctor-patient communication is a key to the better doctor-patient relationship. However, in Korea, there has not been much researches on the causal factors influencing the doctor-patient communication as well as on patient satisfaction and compliance. This study attempts to investigate the relationships between patient social styles and doctors' communication styles as well as patient outcomes. Methods: Patient subjects were recruited from two mid-size local hospitals. The questionnaires consist of social styles, patient-perceived doctors' communication, and patient satisfaction/compliance measures. One hundred ninety useable data were analyzed. Results: For those highly satisfied patients, patients with analytic style showed the highest percentage of viewing their doctors as highly empathic. On the other hand, for those patients with high compliance, expressive style patients showed the highest rates of regarding their doctors as highly affective. And amiable style patients are most likely to view their doctors as highly cognitive. For analytic style patients, cognitive empathy had positive effects on patient satisfaction. For amiable style patients, doctors' cognitive empathy had positive influence on patient compliance. For expressive style patients, doctors' affective empathic communication had positive effects on both patient satisfaction/compliance while cognitive had positive effects only on patient compliance. Conclusion: The results show that the different social styles of patients might influence on the fact how the patients perceive their doctors' communication as well as how much they are satisfied and compliant. Thus, when we as an medical educators need to realize the importance of this mechanism and bring this learning into classrooms.

Matrix metalloproteinase-1 (MMP-1) is considered a key initiator of collagen degradation in inflammatory responses. A heat-gated channel, transient receptor potential vanilloid type 1 (TRPV1), induces release of proinflammatory mediators. TRPV1 channels have been localized to the epidermis and we have recently suggested that they act as mediators of heat-induced MMP-1. The aim of this study was to investigate the signaling of TRPV1 in MMP-1 regulation by heat shock in human epidermal keratinocytes.Heat shock-induced MMP-1 expression was decreased by treatment with TRPV1 inhibitor. The heat-induced MMP-1 expression was suppressed by Gö6976 [calcium-dependent inhibitor] and staurosporine (ST, broad-spectrum PKC inhibitor), while rottlerin (ROT, calcium-independent PKCdelta inhibitor) had no effect. Also, transfection of PKCalpha siRNA decreased MMP-1 expression, whereas MMP-1 expression was not significantly affected in cells transfected with negative control siRNA, PKCbeta siRNA or PKCdelta siRNA.We demonstrated that heat shock failed to induce MMP-1 expression in HaCaT cells cultured in calcium-free media. The heat-induced [Ca(2+)](i) increase was inhibited by Gö6976 and ST, but not by ROT. We also found that heat-induced phosphorylation of ERK, JNK and p38 MAPK in HaCaT cells, but capsazepine and ruthenium red had no effect on this activation. In addition to the role of TRPV1 in heat-induced MMP-1 expression, we also found that heat increased TRPV1 proteins in human skin in vivo.Our results suggest that TRPV1 mediates heat shock-induced MMP-1 expression via calcium-dependent PKCalpha signaling in HaCaT cells.

Purpose: This study was designed to investigate how medical students' achievement goal orientations towards anatomy class influence perceived affect towards anatomy learning. Methods: Participants were 124 medical students. Students' self-report measures were used for the assessment of their achievement goal orientations, perceived value, interests, effort, tension, test anxiety, and negative dissection experiences. Correlation and multiple regression analyses were used for the data analyses. Results: Students with high levels of mastery-approach goals displayed high interests, values, and efforts while they showed low levels of tension, test anxiety, and negative dissection experiences. In contrast, students with high mastery- and performance-avoidance goals showed high levels of tension and/or test anxiety. Students' performance-approach goals are positively associated with both high effort and high negative dissection experiences. Conclusion: These findings offer theoretical and practical implications for anatomy teaching and learning by suggesting that students' learning experiences vary in terms of students' achievement goal orientations which may make differences in students' psychological experiences in a class.

Plant cells contain several thioredoxin isoforms that are characterized by subcellular localization and substrate specificity. Here, we describe the functional characterization of a rice (Oryza sativa) thioredoxin m isoform (Ostrxm) using a reverse genetics technique. Ostrxm showed green tissue-specific and light-responsive mRNA expression. Ostrxm was localized in chloroplasts of rice mesophyll cells, and the recombinant protein showed dithiothreitol-dependent insulin β-chain reduction activity in vitro. RNA interference (RNAi) of Ostrxm resulted in rice plants with developmental defects, including semidwarfism, pale-green leaves, abnormal chloroplast structure, and reduced carotenoid and chlorophyll content. Ostrxm RNAi plants showed remarkably decreased F v/F m values under high irradiance conditions (1,000 μmol m−2 s−1) with delayed recovery. Two-dimensional electrophoresis and matrix-assisted laser-desorption/ionization time-of-flight analysis showed that the levels of several chloroplast proteins critical for photosynthesis and biogenesis were significantly decreased in Ostrxm RNAi plants. Furthermore, 2-Cys peroxiredoxin, a known target of thioredoxin, was present in oxidized forms, and hydrogen peroxide levels were increased in Ostrxm RNAi plants. The pleiotropic effects of Ostrxm RNAi suggest that Ostrxm plays an important role in the redox regulation of chloroplast target proteins involved in diverse physiological functions.

Objective This study was conducted to assess patients’ beliefs and attitudes towards physicians taking their sexual history during routine medical visits in Korea, where Confucianism is the core societal value. Methods A survey questionnaire was administered to determine the patients’ perspectives to sexual history taking, their actual experience of being asked about sexual issues by physicians, their belief in the importance of sexual history taking, their attitudes and cooperativeness towards each component of sexual history, and the effect of the physicians’ age and gender on their comfort level during interview. Results 74.6% of respondents had never been asked about their sexual issues by physicians. Most patients showed a positive attitude and cooperativeness in general, although more than 25% had a negative attitude and were uncooperative with regards to certain components of sexual issues. Their comfort level to sexual history taking was not influenced by the physicians’ age. However, female patients felt more comfortable discussing sexual issues with female physicians. Conclusion Sexual history taking was often overlooked during routine medical visits in Korea, although patients showed a relatively positive and cooperative attitude. Women showed a greater preference for female physicians. Practice implications Sexual history taking should be more facilitated in clinical practice and requires a deliberate approach and skill.

Purpose: In spite of the rapidly expanding importance of the basic sciences, the number of professors teaching basic sciences in medicine has not changed in the last decade. Thus, the need for new methods of teaching and learning has increased. The purpose of this study was to develop and assess integrative lecturing in the basic sciences for undergraduate allied health sciences students. Methods: We developed an alternate form of lecturing in anatomy, physiology, microbiology, and pathology, focusing on the gastrointestinal system. We tested several teaching strategies including E-learning, face-to-face, and practice. Students majoring in nursing (n=43), sports science (n=26), and emergency medical technology (n=35) participated and were asked to complete an anonymous survey. Results: The majority of the students were satisfied with the new lecture style (86.6%). They preferred integrative lectures to traditional lectures. The degree of satisfaction with E-learning and practice were much higher than with face-to-face. Most of the students identified the knowledge of interdisciplinary relationship and participating in cadaveric dissections as the important effects of this lecture style. Conclusion: From this study, it can be suggested that integrative lecturing in basic sciences for public health- / medicine- related courses is effective in teaching and learning. Further studies for the development of integrative contents and system are needed.

Purpose: The objectives of this study were: 1) to analyze Clinical Performance Examination (CPX) items using item response theory (IRT) and classical test theory (CTT) and 2) to discuss how to apply and interpret these results in order to improve the quality of CPX items. In addition, we intended to explore statistical procedures in order to merge examination data from several different medical schools. Methods: The subject of the study was the 2005 CPX examination data from 10 medical schools located in Seoul and the Kyunggi province. For merging data from ten different medical schools, Levene`s test for homogeneity of variances was used. Homogeneous group selection was conducted based on ANOVA or Kruskal-Wallis` test and Tukey`s multiple comparisons appropriately. The generalized partial credit model was applied to analyze polytomous items and the 2-parameter logistic model was used to analyze dichotomous items. Results: Data from 8 medical schools were incorporated into the analysis. The result of the discrimination index by IRT was different from that of CTT in both polytomous and dichotomous items. Discrimination index from IRT tended to be lower than that of CTT. Difficulty index of dichotomous items of two models was correlated well with each other. However, for polytomous items, IRT model provided more information than CCT. Conclusion: We discovered that the CPX items were mostly easy in terms of difficulty index, and the result from IRT and CCT model did not correlated well in the discrimination index. IRT may provide more detailed information for polytomous items, but the checklist and criteria of scoring system should be cautiously reviewed.

Purpose: The purposes of this study were to describe a viable communication skills course for medical students and to discuss how to improve it for better teaching. Methods: The subjects were a communication skills course and one hundred thirty three third- year medical students who participated in the course in 2006. Program evaluation by students was conducted using questionnaire at the end of each session and the entire course. Results: The communication course was named as "Medical Communication Skills". Basic communication skills and interview skills for specific clinical situations were taught. We used experiential leaning methods such as standardized patient (SP) interviews with feedback. Students rated the course highly especially for SP-based practice sessions and student group projects. The course evaluation indicated that the students considered communication skills to be significantly more important as a clinical competency after the completion of the course. Conclusion: We confirmed that the communication skills course was well perceived by medi- cal students and they preferred experiential learning methods more than didactic methods.

An antifungal protein was isolated from Chinese cabbage (Brassica campestris L. ssp. pekinensis) by buffer-soluble extraction and two chromatographic procedures. The results of matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry revealed that the isolated Chinese cabbage protein was identical to human FK506-binding protein (FKBP). A cDNA encoding FKBP was isolated from a Chinese cabbage leaf cDNA library and named C-FKBP. The open reading frame of the gene encoded a 154-amino acid polypeptide. The amino acid sequence of C-FKBP exhibits striking degrees of identity with the corresponding mouse (61%), human (60%), and yeast (56%) proteins. Genomic Southern blot analyses using the full-length C-FKBP cDNA probe revealed a multigene family in the Chinese cabbage genome. The C-FKBP mRNA was highly expressed in vegetative tissues. We also analyzed the antifungal and peptidyl-prolyl cis-trans isomerase activity of recombinant C-FKBP protein expressed in Escherichia coli. This protein inhibited pathogenic fungal strains, including Candida albicans, Botrytis cinerea, Rhizoctonia solani, and Trichoderma viride, whereas it exhibited no activity against E. coli and Staphylococcus aureus. These results suggest that recombinant C-FKBP is an excellent candidate as a lead compound for the development of antifungal agents.

The objectives of this descriptive survey study are to understand college students‟ self-esteem, physical image, awareness of gender equality, and outlook on marriage, and to explore the measures necessary to establish healthy outlooks on marriage for the future. The subjects were 356 college students. Self-esteem was found to be significantly related to household income (F = 3.48, P = 0.020) and academic achievement (F = 3.16, P = 0.040); physical image to academic achievement (F = 6.76, P < 0.001), personality traits (t = 3.56, P < 0.001), peer relationships (F = 11.95, P < 0.000), and opposite-sex friends (t = 3.19, P < 0.000); gender equality awareness to gender (t = −3.09, P = 0.002), college year level (F = 11.14, P < 0.000), household income (t = 3.62, P = 0.010), academic achievement (F = 2.98, P = 0.050), and high school type (F = 5.41, P < 0.001); and outlook on marriage to gender (t = −4.44, P < 0.000), college year level (F = 2.58, P = 0.050), peer relationships (F = 3.35, P = 0.030), and high school type (F = 5.30, P < 0.001). Self-esteem was found to be positively correlated with gender equality awareness (r = 0.141, P = 0.008).

As clinical reasoning is a fundamental competence of physicians for good clinical practices, medical academics have endeavored to teach reasoning skills to undergraduate students. However, our current understanding of student-level clinical reasoning is limited, mainly because of the lack of evaluation tools for this internal cognitive process. This functional magnetic resonance imaging (fMRI) study aimed to examine the clinical reasoning processes of medical students in response to problem-solving questions. We recruited 24 2nd-year medical students who had completed their preclinical curriculum. They answered 40 clinical vignette-based multiple-choice questions during fMRI scanning. We compared the imaging data for 20 problem-solving questions (reasoning task) and 20 recall questions (recall task). Compared to the recall task, the reasoning task resulted in significantly greater activation in nine brain regions, including the dorsolateral prefrontal cortex and inferior parietal cortex, which are known to be associated with executive function and deductive reasoning. During the recall task, significant activation was observed in the brain regions that are related to memory and emotions, including the amygdala and ventromedial prefrontal cortex. Our results support that medical students mainly solve clinical questions with deductive reasoning involving prior knowledge structures and executive functions. The problem-solving questions induced the students to utilize higher cognitive functions compared with the recall questions. Interestingly, the results suggested that the students experienced some emotional distress while they were solving the recall questions. In addition, these results suggest that fMRI is a promising research tool for investigating students’ cognitive processes.

Purpose: This study aims to explore the perceived effectiveness, benefits, and learning experiences of interns with regard to their participation in a communication skills workshop program, which can have implications for the development and implementation of future communication skills training. Methods: One hundred twenty one interns and 12 senior residents and fellows participated in the workshop program as learners and tutors. The participating interns encountered three difficult communication situations, represented by trained standardized patients. During each encounter, each participant had an individual encounter, group discussion, and feedback on his performance. A self-assessment survey, composed of five itemized questions and seven open-ended questions, was administered after the workshop. A mixed methods approach was used to analyze the quantitative and qualitative data. Results: The participants had positive perceptions of the implementation and effects of the workshop, and they responded higher than 4.0 to all itemized questions on their perception of the effectiveness and benefits of the workshop. The analysis of open-ended questions demonstrated specific learning experiences of the participants, such as the hardship of solving ill-structured communication problems and reflection on their current knowledge, skills, attitudes, and practice as physicians. The participants reported that the workshop provided opportunities of improving diverse communication skills and problem-solving skills and identifying further learning needs. Conclusion: The results suggest that communication skills training for interns facilitates their reflection and development of communication skills, as well as their competency of situated problem solving. Consequently, communication skills development should be regarded as an important subject of continuing medical education. Several implications of this study can contribute to the design and development of communication skills-related programs.

Characteristics of Medical Students' Learning Styles and Their Relationships to GPA Mira Kim, PhD, Sowon Ahn1, PhD, Jungmo Lee2, PhD, Ducksun Ahn1, MD, Youngmee Lee1, MD Research Center of Applied Psychology, Sungkyunkwan University, Department of Psychology2, Sungkyunkwan University Department of Medical Education1, College of Medicine, Korea University Purpose: The present study examines the characteristics of medical students' learning styles and their relationships to the GPA. Methods: One hundred 2nd year medical students took the revised version of the Index of Learning Styles(ILS) by Felder-Silverman, which was computerized. The ILS classifies individual preferences for information processing into 16 categories based on four dichotomous dimension: active/reflective, sensing/intuitive, sequential/global, visual/verbal. The GPA from the previous semester was used. Results: The most frequent learning styles were reflective, sensing, sequential, and visual, covering 25% of the class. For the relationship with the GPA, we compared group means. The sensing students showed significantly higher grades than the intuitive students. Other than this result, there seemed to be no particular relationship between learning styles and GPA. This relationship should be further studied. Conclusions: In this study, medical students were categorized based on individual differences in information processing. Learning styles are expected to be helpful in designing effective learning strategies and thereby enhancing medical students' performance.

*† Summary Using the rice PEX14 cDNA as a bait in a yeast two-hybrid assay, two splice variants of the type I peroxisomal targeting signal (PTS1) receptor, OsPex5pL and OsPex5pS, were cloned from a pathogen-treated rice leaf cDNA library. The proteins were produced from a single gene by alternative splicing, which generated a full-length variant, OsPEX5L, and a variant that lacked exon 7, OsPEX5S. OsPex5pL contained 11 copies of the pentapeptide motif WXXXF/Y in its N-terminus, and seven tetratricopeptide repeats in its C-terminus. Expression of OsPEX5L and OsPEX5S predominantly occurred in leaf tissues, and was induced by various stresses, such as exposure to the pathogen Magnaporthe grisea, and treatment with fungal elicitor, methyl viologen, NaCl or hydrogen peroxide. The Arabidopsis T-DNA insertional pex5 mutant, Atpex5, which does not germinate in the absence of sucrose and was resistant to indole-3-butyric acid (IBA), was perfectly rescued by over-expression of OsPex5pL, but not by OsPex5pS. Using transient expression of OsPex5pL and OsPex5pS in the Atpex5 mutant, we show that OsPex5pL translocates both PTS1- and PTS2-containing proteins into the peroxisome by interacting with OsPex7p, whereas OsPex5pS is involved only in PTS1-dependent import in Arabidopsis.

When oxygen sensing cells are excited by hypoxia, background K+ currents are inhibited. TASK-1, which is commonly expressed in oxygen sensing cells and makes a background K+ current, is inactivated by hypoxia. Thus TASK-1 is a candidate molecule responsible for hypoxic excitation. However, TASK-1 per se cannot sense oxygen and may require a regulatory protein that can. In the present study, we propose that the NADPH oxidase NOX4 functions as an oxygen-sensing partner and that it modulates the oxygen sensitivity of TASK-1. Confocal imaging revealed the co-localization of TASK-1 and NOX4 in the plasma membrane. In HEK293 cells expressing NOX4 endogenously, the activity of expressed TASK-1 was moderately inhibited by hypoxia, and this oxygen response was significantly augmented by NOX4. Moreover, the oxygen sensitivity of TASK-1 was abolished by NOX4 siRNA and NADPH oxidase inhibitors. These results suggest a novel function for NOX4 in the oxygen-dependent regulation of TASK-1 activity.

The ubiquitously distributed peroxiredoxins (Prxs) have been shown to have diverse functions in cellular defense-signaling pathways. They have been largely classified into three Prx classes, 2-Cys Prx, atypical 2-Cys Prx and 1-Cys Prx, which can be distinguished by how many Cys residues they possess and by their catalytic mechanisms. Proteins belonging to the typical 2-Cys Prx group containing the N-terminal peroxidatic Cys residue undergo a cycle of peroxide-dependent oxidation to sulfenic acid and thiol-dependent reduction during H2O2 catalysis. However, in the presence of high concentrations of H2O2 and catalytic components, including thioredoxin (Trx), Trx reductase and NADPH, the sulfenic acid can be hyperoxidized to cysteine sulfinic acid. The overoxidized 2-Cys Prxs are slowly reduced by the action of the adenosine 5′-triphosphate-dependent enzyme, sulfiredoxin. Upon exposure of cells to strong oxidative or heat-shock stress conditions, 2-Cys Prxs change their protein structures from low-molecular weight to high-molecular weight complexes, which trigger their functional switching from peroxidases to molecular chaperones. The C-terminal region of 2-Cys Prx also plays an essential role in this structural conversion. Thus, proteins with truncated C-termini are resistant to overoxidation and cannot regulate their structures or functions. These reactions are primarily guided by the active site peroxidatic Cys residue, which serves as an ‘H2O2-sensor’ in cells. The reversible structural and functional switching of 2-Cys Prxs provides cells with a means to adapt to external stresses by presumably activating intracellular defense-signaling systems. In particular, plant 2-Cys Prxs localized in chloroplasts have dynamic protein structures that undergo major conformational changes during catalysis, forming super-complexes and reversibly attaching to thylakoid membranes in a redox-dependent manner.

The purpose of this study was to compare the proportion of therapeutic interventions that is supported by scientific evidence between hospital-based and community-based primary care clinics. The study setting is a primary care clinic in university-affiliated tertiary hospital and community-based primary care clinic in a region in Seoul. A retrospective review of patients' medical records was done according to the primary diagnosis and treatment for 890 patients in community-based clinic and 307 in hospital-based clinic. The evidence for the intervention was searched for in Medline (1966-2001) and other evidence-based databases. The evidence was then classified as one of the three categories (i) evidence from randomised controlled trials (RCTs); (ii) convincing non-experimental evidence; and (iii) interventions without substantial evidence. In the hospital-based clinics, out of 356 primary diagnosis and treatment pairs, 59.6% were supported by evidence from at least one RCTs, and 19.4% were supported by convincing non-experimental evidence. In the community-based clinics, 47.1% out of 893 pairs and 10.5% fell into each category. As a result, the proportion of interventions in community settings that were based on evidence meeting our criteria was significantly lower than that of the hospital-based settings. To facilitate evidence-based practice, supportive activity should be focused on the primary care settings based on community where medical practices are less evidence-based.

Purpose: The purpose of this study is to analyze the assessment of student performance in Problem-Based Learning, which was an elective course at Korea University College of Medicine, from 2001 to 2003, and to delineate effective strategies for Problem-Based Learning. Methods: A questionnaire was given to 126 third year Korea University medical students. The questionnaire consisted of 25 items in 2001, 37 in 2002, and 64 in 2003. These items covered self-evaluation and overall evaluation of contents, learning environments, small group activity, and tutor in PBL. The respective reliability of items in scale was .67, .75, .79, and 81. Data was analyzed using the Spsswin.11.0 Results: The results of this study are as follows. By most of all respondents, PBL was recognized as a more effective learning method, more interesting, and able to provide a more diverse spectrum of information than traditional lectures. Neutral or negative responses were given for educational settings. Competence of students was increased in the PBL setting. A large percentage of learning method was through the use of textbooks. Most respondents were satisfied with the small group activity and tutor. Conclusion: There should be sufficient educational equipments such as rooms for small group activity, textbooks, and journals for PBL. We have to consider student s characteristics carefully and to make concrete guideline and system for effective Problem based learning.

The authors introduced a "Medicine and Literature" course into the premedical curriculum to help students develop clearer expectations regarding their lives as future physicians, and also to gain insight into the humanistic and social aspects of medicine. The course was developed for the entire class of second-grade premedical students (n = 126) and consisted of one three-hour session per week over six weeks. The course was composed of two main themes: (1) medicine and film; and (2) medicine and literature. Students' responses showed that this course helped them to gain perspectives on both a physician's life and medical practice, and also enhanced their understanding of the humanistic and social aspects of medicine itself. Students reported that they also valued the advantages of collaborative learning, which holds the potential for improving their skills in presentation, discussion, communication and teamwork. In Korea, introducing arts- and humanities-related courses into the medical curriculum is a recent trend, and is still in a very early stage. Although our study has several limitations, we conclude that by studying literature and films during the premedical period, students can grasp a sense of the many different issues that physicians are faced with.

Purpose: The purpose of this study is to develop a MD-MBA joint program that will teach doctors professional hospital management and administration skills. Methods: To assess the demand for hospital management and administration skills in the medical field, information was gathered from community physicians through a questionnaire. Personal interviews were also conducted with doctors having graduated from a MD-MBA joint program and those working for hospital consulting firms. We visited institutions in developed countries offering this program and conducted literature reviews. Based on the data collected, a tentative plan for the introduction of a MD-MBA program in Korea was developed. Results: The results of this study are as follows. Community practitioners realize the need for basic management skills and feel that hospital management should be part of undergraduate or graduate medical curriculum. In the United States, there is an annual increase in the number of institutions offering MD-MBA programs and in the number of MD-MBA graduates. These programs are run very systematically. It is apparent that the introduction of this program to Korean medical students is imminent. This program can be offered in Korea at the undergraduate level with the School of Business Administration in charge of the program, with the Medical School in charge, or as a cooperative effort between these two schools. Conclusion: Most private practitioners and medical professors recognize the necessity for a MD-MBA program. Systemic and experiential research must be done. Support must be given to finances, human resources, and equipment in offering this program.

Purpose: There is a negative assumption that patients are reluctant to have medical students be involved in their care. In response, students refrain from revealing to the patients that they are students in order that they may participate in patient-care. The purpose of this study is to determine whether patients' attitudes towards medical students is negative or positive, and to explore the level acceptable by patients of students' involvement in their care. Methods: The study subjects were 90 inpatients in two university hospitals. The questionnaire consisted of 12 items covering patient's attitude toward student involvement in their care, acceptable patient-care activities in which students could be involved, and preference for being told if caregiver is a medical student. Results: Patients' attitudes towards students' participation in their care were relatively more favorable than expected. of patients reported that they would permit students to be involved up to and including simple non-invasive techniques. of patients stated that they would allow students to participate in their future in-hospital care. Most patients preferred knowing that the caregiver was a medical student. Conclusion: The results of this study are reassuring. A higher than expected percentage of patients surveyed disclosed that they would accept medical students being involved in their care. Medical educators should provide a safe environment for medical students to be able to tell the patients, 'I am a student doctor'.

PURPOSE: In this rapid changing society and medical practice, the professionalism in the management of a hospital is being required. However, most physicians do not have the opportunity for systematic training for management and business. The difficulties perceived by private practitioners in their real practices are surveyed in order to assess the need for education course on Management & Business in medical school. METHODS: From February 3rd, 2003 to February 20th, 2003, 2,381 private practitioners participated in the nation-wide internet questionnaire, of which the response rate was 7.1% (168 persons). The contents of the survey include 9 criteria, which consist of problems of hospital management, the present method of management, the demand for Management & Business course, and the need for commencement of education course. RESULTS: More than 50% of the physicians who answered this questionnaire expressed difficulties in some criteria such as accounting, taxation business, and management of hospital staffs. Many physicians(66 persons; 39.3%) suggested lack of knowledge of management & business or such skills as the reason for it. Most of them dealt with these difficulties by discussing these matters with their colleagues(96 persons; 57.1%) or by themselves according to their own experiences(44 persons; 26.2%). Eighty two percent of respondents approved of establishing the new subject, Management & Business course and its education. In this survey, patient management, marketing, and tax-related fields were chosen as the most needed fields for education. CONCLUSION: It was revealed that most private practitioners realized the importance of the ability in Management & Business and agreed with the need for experiencing systematic education during medical education. Therefore, it is necessary to perform the in - depth research about establishing Management & Business course in medical school.

Aim : The purpose of the present study was to estimate the proportion of therapeutic interventions which are supported by scientific evidence in a university based family medicine outpatient clinic. Methods : A retrospective review of patient medical records was done to assess the primary diagnosis and treatment option. A Medline review from 1966 to 2001, standard textbooks and evidence-based medicine online databases including American College of Physician journal club and Cochrane database of systematic reviews were searched to assess the evidence for the chosen intervention. The evidence was then classified as one of three categories developed by the Oxford Center for Evidence-Based Medicine: (i) evidence from randomized controlled trials (RCT); (ii) convicing non experimental evidence; (iii) and interventions without substantial evidence. Results : Of the 356 primary diagnosis and treatment pairs, 59.6% were supported by evidence from at least one RCT. A total of 19.4% were supported by convincing non experimental evidence, and 75 (21%) were classified as intervention without substantial evidence. As a result, 79.0% of interventions (281/356) met our criteria to be evidenced-based. Conclusions : Approximately 60% of the interventions in a university based family medicine outpatient practice were supported by evidence from at least one RCT. Although this result is limited to one tertiary hospital outpatient care setting, it could serve as a baseline reference for future assessments of evidence-based family practice. © 2003 Blackwell Publishing Asia and Wonca

The transient receptor potential protein homologue TRPC5 was reported as a molecular identity for the muscarinic receptor-activated nonselective cationic channel (NSCC) in the murine stomach smooth muscle. The canonical, or classical, transient receptor potential proteins, TRPC4 and TRPC5, were suggested as members of the same subfamily of TRPC channels and to be coexpressed as a heteromultimer of both TRPC as well as a homotetramer of each TRPC protein. Thus, we investigated whether the TRPC4 channel is also responsible for the NSCC activated by acetylcholine (ACh) or carbachol (CCh) using electrophysiological techniques. The TRPC channels were expressed in HEK293 cells. When murine TRPC4 channels (mTRPC4) were expressed, the current–voltage relationship of mTRPC4 was also similar to that recorded in native murine gastric myocytes or mTRPC5-expressing HEK cells. With 0.2 mM GTPγS in the pipette solution, the currents in mTRPC4-expressing cells were activated transiently like those in NSCC in the murine stomach and the expressed mTRPC5. The currents recorded in mTRPC4-expressing cells were inhibited by 1 mM La3+ and 100 μM flufenamate. The currents recorded in mTRPC4-expressing cells depended on the extracellular calcium concentration. From the above results, we suggest that mTRPC4/5 might be candidates for the NSCC activated by ACh or CCh in the murine stomach.

Purpose: This study was performed to evaluate the educational status of medical residents and to find factors that hinder resident education in Korea. Methods: A survey questionnaire on educational status of residents in internal medicine was developed, and sent to three groups: (1) specialists in internal medicine who are involved in resident training, (2) specialists in internal medicine who are not involved in resident training, and (3) residents who are under training in internal medicine. Results: The surveys revealed that the education to medical residents is mainly focused on delivery of knowledge of specialty. Insufficient or unsatisfactory items in the residents’ education are those of skills, attitude, communication skill, leadership, and practical matters concerning medical practice such as insurance. Most respondents replied that medical residents were employed doctors in hospitals rather than trainees to become qualified medical specialists. Conclusion: Residents are supposed to work in hospitals as trainees to become qualified specialists rather than as employed doctors. However, resident education in Korea is hindered by such factors as lack of teaching resources, heavy workload of educating specialists, heavy duty for residents, and lack of teaching skills of resident training staffs.

We investigated which transient receptor potential (TRP) channel is responsible for the nonselective cation channel (NSCC) activated by carbachol (CCh) in murine stomach with RT-PCR and the electrophysiological method. All seven types of TRP mRNA were detected in murine stomach with RT-PCR. When each TRP channel was expressed, the current-voltage relationship of mTRP5 was most similar to that recorded in murine gastric myocytes. mTRP5 showed a conductance order of Cs+> K+> Na+, similar to that in the murine stomach. With 0.2 mM GTPγS in the pipette solution, the current was activated transiently in both NSCC in the murine stomach and the expressed mTRP5. Both NSCC activated by CCh in murine stomach and mTRP5 were inhibited by intracellularly applied anti-Gq/11antibody, PLC inhibitor U-73122, IICR inhibitor 2-aminoethoxydiphenylborate, and nonspecific cation channel blockers La3+and flufenamate. There were two other unique properties. Both the native NSCC and mTRP5 were activated by 1-oleoyl-2-acetyl-sn-glycerol. Without the activation of NSCC by CCh, the NSCC in murine stomach was constitutively active like mTRP5. From the above results, we suggest that mTRP5 might be a candidate for the NSCC activated by ACh or CCh in murine stomach.

To successful molecular breeding, identification and functional characterization of breeding related genes and development of molecular breeding techniques using DNA markers are essential. Although the development of a useful marker is difficult in the aspect of time, cost and effort, many markers are being developed to be used in molecular breeding and developed markers have been used in many fields. Single nucleotide polymorphisms (SNPs) markers were widely used for genomic research and breeding, but has hardly been validated for screening functional genes in olive flounder. We identified single nucleotide polymorphisms (SNPs) from expressed sequence tag (EST) database in olive flounder; out of a total 4,327 ESTs, 693 contigs and 514 SNPs were detected in total EST, and these substitutions include 297 transitions and 217 transversions. As a result, 144 SNP markers were developed on the basis of 514 SNP to selection of useful gene region, and then applied to each of eight wild and culture olive flounder (total 16 samples). In our experimental result, only 32 markers had detected polymorphism in sample, also identified 21 transitions and 11 transversions, whereas indel was not detected in polymorphic SNPs. Heterozygosity of wild and cultured olive flounder using the 32 SNP markers is 0.34 and 0.29, respectively. In conclusion, we identified SNP and polymorphism in olive flounder using newly designed marker, it supports that developed markers are suitable for SNP detection and diversity analysis in olive flounder. The outcome of this study can be basic data for researches for immunity gene and characteristic with SNP.

The purpose of this study is to examine and verify the effectiveness of the materials through physiological comparison. Blood lactate concentrations and energy metabolic variables were measured from the targeted snowboarders. Five slope-style snowboarders participated in the experiment. Each subject performed three runs with each "B", "S" and "Y" deck. Blood samples were collected twice from the finger-tip at rest and immediately after each run. Portable wireless gas analyzer and Polar heart rate monitor was used in order to analyze the energy metabolic variables i.e. heart rate (HR), oxygen uptake (VO2), metabolic equivalent (MET) and total energy consumption (TEE), at rest as well as during the run. The result obtained showed increased blood lactate concentration as well as higher oxygen uptake (VO2) at the point of Lactate Threshold (LT) when performing runs by installing "B" and "Y" decks than "S".

Objective To be utilized for the development of pharmacists’ intervention service by determining factors which affect pharmacists’ prescription interventions. Setting Patients who were admitted to intensive care units (ICUs) in internal medicine departments in Korea. Methods Data including age, gender, clinical departments, length of hospital stay, status of organ dysfunction, intervention status, frequently intervened drugs, and health care providers’ questions were prospectively collected in ICUs in the department of internal medicine in a tertiary teaching hospital from January to December, 2012. Main outcome measure Primary outcome was factors which affect pharmacists’ prescription interventions. Secondary outcomes included frequencies of the intervention, intervention acceptance rates, intervention issues, and frequently intervened drugs. Results A total of 1,213 prescription interventions were made for 445 patients (33.1%) of the 1,344 patients that were analyzed. Length of hospital stay was significantly longer for the group that needed pharmacists’ interventions (p Conclusion The need for pharmacists’ prescription interventions was highest among patients with longer length of stay and patients with kidney dysfunction. Based on these findings, prescription intervention activities could be initiated with severely ill patients. The results could be utilized in countries which are planning to develop pharmacists’ intervention service.

Introduction One thousand four hundred new cases of testicular cancer are diagnosed annually in the UK, with peak incidence in men aged 25–35 years old. Seminomas account for over 40% of cases. The involvement of the gastrointestinal tract with seminoma is unusual.

Until 1970, primary sclerosing cholangitis (PSC) was considered to be a medical curiosity. With the development of endoscopic cholangiography, PSC is now recognized more frequently and is a common indication for liver transplantation. PSC is usually progressive, leading to cirrhosis, portal hypertension, and liver failure. The manifestations of disease may be clinically similar to those of other causes of bile duct obstruction and must be distinguished from gallstone disease, bile duct carcinoma, primary biliary cirrhosis, and secondary biliary cirrhosis due to bile duct stricture. Medical management of PSC must take into account the likelihood that destroyed bile ducts do not regenerate as hepatocytes do. Hence, PSC should be treated early in its course. The goal of therapy is to prevent further damage and destruction of bile ducts. In this article, we will present relevant data concerning the medical management of primary sclerosing cholangitis.