Lee, Kee-Hang;Nam, Hyun;Won, Jeong-Seob;Hwang, Ji-Yoon;Jang, Hye Won;Lee, Sun-Ho;Joo, Kyeung Min
Journal of Korean Neurosurgical Society
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제61권4호
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pp.434-440
/
2018
Objective : The purpose of this study was to find an optimal delivery route for clinical trials of intrathecal cell therapy for spinal cord injury in preclinical stage. Methods : We compared in vivo distribution of Cy5.5 fluorescent dye in the spinal cord region at various time points utilizing in vivo optical imaging techniques, which was injected into the lateral ventricle (LV) or cisterna magna (CM) of rats. Results : Although CM locates nearer to the spinal cord than the LV, significantly higher signal of Cy5.5 was detected in the thoracic and lumbar spinal cord region at all time points tested when Cy5.5 was injected into the LV. In the LV injection Cy5.5 signal in the thoracic and lumbar spinal cord was observed within 12 hours after injection, which was maintained until 72 hours after injection. In contrast, Cy5.5 signal was concentrated at the injection site in the CM injection at all time points. Conclusion : These data suggested that the LV might be suitable for preclinical injection route of therapeutics targeting the spinal cord to test their treatment efficacy and biosafety for spinal cord diseases in small animal models.
This study is a narrative review introducing global trends in patient safety education within medical schools and exploring the status of Korean education. Core competences for patient safety include patient centeredness, teamwork, evidence- and information-based practice, quality improvement, addressing medical errors, managing human factors and system complexity, and patient safety knowledge and responsibility. According to a Korean report addressing the role of doctors, patient safety was described as a subcategory of clinical care. Doctors' roles in patient safety included taking precautions, educating patients about the side effects of drugs, and implementing rapid treatment and appropriate follow-up when patient safety is compromised. The Korean Association of Medical Colleges suggested patient safety competence as one of eight essential human and society-centered learning outcomes. They included appropriate attitude and knowledge, human factors, a systematic approach, teamwork skills, engaging with patients and carers, and dealing with common errors. Four Korean medical schools reported integration of a patient safety course in their preclinical curriculum. Studies have shown that students experience difficulty in reporting medical errors because of hierarchical culture. It seems that patient safety is considered in a narrow sense and its education is limited in Korea. Patient safety is not a topic for dealing with only adverse events, but a science to prevent and detect early system failure. Patient safety emphasizes patient perspectives, so it has a different paradigm of medical ethics and professionalism, which have doctor-centered perspectives. Medical educators in Korea should understand patient safety concepts to implement patient safety curriculum. Further research should be done on communication in hierarchical culture and patient safety education during clerkship.
Students must be familiar with clinical skills before starting clinical practice to ensure patients' safety and enable efficient learning. However, performance is mainly tested in the third or fourth years of medical school, and studies using the validity framework have not been reported in Korea. We analyzed the validity of a performance test conducted among second-year students classified into content, response process, internal structure, relationships with other variables, and consequences according to Messick's framework. As results of the analysis, content validity was secured by developing cases according to a pre-determined blueprint. The quality of the response process was controlled by training and calibrating raters. The internal structure showed that (1) reliability by generalizability theory was acceptable (coefficients of 0.724 and 0.786, respectively, for day 1 and day 2), and (2) the relevant domains had proper correlations, while the clinical performance examination (CPX) and objective structured clinical examination (OSCE) showed weaker relationships. OSCE/CPX scores were correlated with other variables, especially grade point average and oral structured exam scores. The consequences of this assessment were (1) making students learn clinical skills and study themselves, while causing too much stress for students due to lack of motivation; (2) reminding educators of the need to apply practical teaching methods and to give feedback on the test results; and (3) providing an opportunity for faculty to consider developing support programs. It is necessary to develop the blueprint more precisely according to students' level and to verify the validity of the response process with statistical methods.
Standard oral and maxillofacial three-dimensional model was developed with patients' medical data while virtual reality (VR) simulator was developed in conjunction with head mount display (HMD) and Haptic device. The objective of this study was to evaluate the preclinical use of a VR training simulator in tooth preparation practice. Eighty-nine dental students were trained how to operate the simulator. The participants were then given sufficient time on the simulator to practice dental preparation. The students experience and opinion was then taken in through filling of questionnaires. On average content received 1.8 points, anatomy had 2.5 points, 2.6 points for the applicability, and 2.0 for the usability. As for the detailed items scores, queries about the possible development of the simulator and the interest of the learning process through the simulator were the highest at 3.1 and 3.0 points, respectively. Question about the benefit of the HMD and the haptic device during the practice had 1.5 and 1.6 points, respectively. The average total score was 2.2 points. VR tooth preparation simulator in the field of clinical dental education has powerful potential in regard to realistic models, environments, vision, posture, and economical efficiency.
Casticin (3', 5-dihydroxy-3, 4', 6, 7-tetramethoxyflavone) is an active compound isolated from roots, stems, leaves, fruits and seeds of a variety of plants. It is well known for its pharmacological properties and has been utilized as an anti-hyperprolactinemia, anti-tumor, anti-inflammatory, neuroprotetective, analgesic and immunomodulatory agent. Recently, the anticancer activity of casticin has been extensively investigated. The resulkts showed that it exerts protective potential by targeting apoptosis, considered important for cancer therapies. In this article, our aim was to review the pharmacological and therapeutic applications of casticin with specific emphasis on its anticancer functions and related molecular mechanisms. Chemotherapeutic effects are dependent on multiple molecular pathways, which may provide a new perspective of casticin as a candidate anti-neoplastic drug. This review suggests that additional studies and preclinical trials are required to determine specific intracellular sites of action and derivative targets in order to fully understand the mechanisms of its antitumor activity and validate this compound as a medicinal agent for the prevention and treatment of various cancers.
Since the emergence of coronavirus disease 2019 (COVID-19), medical schools have experienced a sudden, full-scale transition to online classes. As the COVID-19 pandemic continues, it is important to evaluate current educational programs and to assess their implications. This study explored perceptions of online classes and learning behavior among medical students. Twenty preclinical medical students were interviewed in focus groups for 2 months. They generally expressed positive perceptions about online classes, and in particular, positively assessed the ability to lead their individual lifestyles and study in comfortable environments with fewer time and space constraints. Students thought that the online environment provided a fair chance of facilitating positive interactions with the professor and considered communication with the professor to be an important factor only when it was related to the class content or directly helped with their grades and careers. Students also had negative views, such as feeling uncertain when they could not see their peers' learning progress and assess themselves in comparison and feeling social isolation. Learning behaviors have also changed, as students explored their learning styles and adapted to the changed learning environment. Students expanded their learning by using online functions. However, students sometimes abused the online class format by "just playing" the lecture while not paying attention and relying on other students' lecture transcripts to study. The results of this study are hoped to provide a useful foundation for future research on online class-based teaching and learning.
Neuropathic pain is a complex chronic pain state caused by the dysfunction of somatosensory nervous system, and it affects the millions of people worldwide. At present, there are very few medical treatments available for neuropathic pain management and the intolerable side effects of medications may further worsen the symptoms. Despite the presence of profound knowledge that delineates the pathophysiology and mechanisms leading to neuropathic pain, the unmet clinical needs demand more research in this field that would ultimately assist to ameliorate the pain conditions. Efforts are being made globally to explore and understand the basic molecular mechanisms responsible for somatosensory dysfunction in preclinical pain models. The present review highlights some of the novel molecular targets like D-amino acid oxidase, endoplasmic reticulum stress receptors, sigma receptors, hyperpolarization-activated cyclic nucleotide-gated cation channels, histone deacetylase, $Wnt/{\beta}-catenin$ and Wnt/Ryk, ephrins and Eph receptor tyrosine kinase, Cdh-1 and mitochondrial ATPase that are implicated in the induction of neuropathic pain. Studies conducted on the different animal models and observed results have been summarized with an aim to facilitate the efforts made in the drug discovery. The diligent analysis and exploitation of these targets may help in the identification of some promising therapies that can better manage neuropathic pain and improve the health of patients.
The main objective of pathologists is to achieve accurate lesion diagnoses, which has become increasingly challenging due to the growing number of pathological slides that need to be examined. However, using digital technology has made it easier to complete this task compared to older methods. Digital pathology is a specialized field that manages data from digitized specimen slides, utilizing image processing technology to automate and improve analysis. It aims to enhance the precision, reproducibility, and standardization of pathology-based researches, preclinical, and clinical trials through the sophisticated techniques it employs. The advent of whole slide imaging (WSI) technology is revolutionizing the pathology field by replacing glass slides as the primary method of pathology evaluation. Image processing technology that utilizes WSI is being implemented to automate and enhance analysis. Artificial intelligence (AI) algorithms are being developed to assist pathologic diagnosis and detection and segmentation of specific objects. Application of AI-based digital pathology in biomedical researches is classified into four areas: diagnosis and rapid peer review, quantification, prognosis prediction, and education. AI-based digital pathology can result in a higher accuracy rate for lesion diagnosis than using either a pathologist or AI alone. Combining AI with pathologists can enhance and standardize pathology-based investigations, reducing the time and cost required for pathologists to screen tissue slides for abnormalities. And AI-based digital pathology can identify and quantify structures in tissues. Lastly, it can help predict and monitor disease progression and response to therapy, contributing to personalized medicine.
The purpose of this study was to classify the courses of the dental-hygiene curricula into several categories by field, to incorporate the subjects in the same category into an integrated course, and to suggest how to ensure the successful phase-in application of integrative education according to Ronald M. Harden's 11-stage integrative ladder model. The findings of the study were as follows: 1. When the existing curricula were analyzed, it's found that many credits were provided to the courses in the area of basic dentistry that offered both theory and practice. In particular, the subjects tested by the national examination were offered by every college. In the field of public oral health, the largest number of credits was allocated to theory of oral prophylaxis and practice courses. In clinical area, clinical practice, in the area of dental office management, dental insurance course was given the largest credit. There were 31 to 61 major subjects in the colleges, which indicated that the major subjects were segmented in detail. 2. It seemed necessary to incorporate the subjects in the field of basic dentistry into oral biology, and theory of oral prophylaxis/practice, preventive dentistry/practice, preclinical stage, emergency treatment and introduction to dental hygiene should be integrated in to clinical dental hygiene. The courses in clinical area should be combined into clinical dentistry, and in the field of medical management, dental insurance, hospital management and medical relation law should be incorporated into management of dental clinic. 3. In the 11-stage integrative ladder, the subjects in the same field could perfectly be incorporated as the stages advanced. Each of the subjects was less emphasized, and communication and joint plans among teachers who were respectively in charge of the courses were increasingly considered important. Specifically, there should be a consensus among the teachers in regard to the outline of teaching programs, order of education. objects and objectives of programs and what and how to evaluate.
Background: 20(S)-ginsenoside-Rg3 (C42H72O13), a natural triterpenoid saponin, is extracted from red ginseng. The increasing use of 20(S)-ginsenoside Rg3 has raised product safety concerns. Methods: In acute toxicity, 20(S)-ginsenoside Rg3 was singly and orally administrated to Kunming mice and Sprague-Dawley (SD) rats at the maximum doses of 1600 mg/kg and 800 mg/kg, respectively. In the 26-week toxicity study, we used repeated oral administration of 20(S)-ginsenoside Rg3 in SD rats over 26 weeks at doses of 0, 20, 60, or 180 mg/kg. Moreover, a 4-week recovery period was scheduled to observe the persistence, delayed occurrence, and reversibility of toxic effects. Results: The result of acute toxicity shows that oral administration of 20(S)-ginsenoside Rg3 to mice and rats did not induce mortality or toxicity up to 1600 and 800 mg/kg, respectively. During a 26-week administration period and a 4-week withdrawal period (recovery period), there were no significant differences in clinical signs, body weight, food consumption, urinalysis parameters, biochemical and hematological values, or histopathological findings. Conclusion: The mean oral lethal dose (LD50) of 20(S)-ginsenoside Rg3, in acute toxicity, is above 1600 mg/kg and 800 mg/kg in mice and rats, respectively. In a repeated-dose 26-week oral toxicity study, the no-observed-adverse-effect level for female and male SD rats was 180 mg/kg.
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