Slide Session : OS-IFD-07 ; Infectious Disease : In Vitro Antiviral Activity of Ribavirin Against Severe Fever with Thrombocytopenia Syndrome Virus

( Myung Jin Lee ),( Kye Hyung Kim ),( Jong Youn Yi ),( Su Jin Choi ),( Chung Jong Kim ),( Nak Hyun Kim ),( Kyoung Ho Song ),( Pyoeng Gyun Choi ),( Ji Hwan Bang ),( Wan Beom Park ),( Eu Suk Kim ),( San 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

In Vitro Antiviral Activity of Ribavirin Against Severe Fever with Thrombocytopenia Syndrome Virus Myung Jin LEE1, Kye-Hyung KIM1, Jongyoun YI2, SuJin CHOI1, Chung-Jong KIM1, Nak- Hyun KIM1, Kyoung-Ho SONG1, Pyoeng Gyun CHOI1, Ji-Hwan BANG1, Wan Beom PARK1, Eu Suk KIM1, Sang-Won PARK1, Hong Bin KIM1, Nam Joong KIM1, Myoung- Don OH1 Seoul National University College of Medicine, Korea1, Pusan National University School of Medicine, Korea2 Background: Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease caused by a novel Bunyavirus, severe fever with thrombocytopenia syndrome virus (SFTSV). No effective antiviral therapy is proven yet, but clinical use of ribavirin (RBV) has been tried. We investigated the antiviral effect of RBV against SFTSV in vitro. Methods: To test for cytotoxicity of RBV, Vero cells were treated with different concentrations of RBV (3.90 to 500 μg/mL, two-fold dilution) and analyzed by cell viability MTS assay 48h post-infection. To determine antiviral activity of RBV against SFTSV, Vero cells were infected with SFTSV strain Gangwon/Korea/2012 at 100 TCID50 (50% tissue culture infective dose) per well in a 96-well plate, and RBV was added at the concentrations showing no or minimal cytotoxicity. Viral RNAs were extracted from the culture supernatants and quantifi ed using one-step real-time reverse transcription- PCR to amplify the partial large segment of SFTSV. Statistical analysis was done by one-way ANOVA with Tukey`s post hoc test. Results: Cytotoxicity due to RBV was not observed at RBV concentration =31.3 μg/ mL. Viral RNAs at 24h post-RBV treatment were reduced with increasing RBV concentrations (1-32 μg/mL), compared with those of mock-treated cells (P <0.01, Figure). Half maximal inhibitory concentration (IC50) of RBV was 3.69 μg/mL at 24h post-RBV treatment. Conclusions: Our study shows that RBV has antiviral effect against SFTSV in a dose-dependent manner. Further studies are required to evaluate the effi cacy of RBV in SFTS.

임상 술기 교육을 위한 동료 지원 학습 및 비디오 평가를 사용한 완전학습 모형 개발과 적용

이형석(Hyung Suk Yi),김민정(Min Jeong Kim) 학습자중심교과교육학회 2022 학습자중심교과교육연구 Vol.22 No.1

목적 환자 안전에 대한 인식이 강화되면서 의과대학 졸업생들에게 숙련되고 정확하게 임상 수기를 수행하는 것이 요구되고 있다. 학생들이 안전하고 숙련된 술기 수행 목표에 도달하기 위해서는 반복적인 술기 학습과 피드백이 필요하다. 그러나 여전히 의과대학 교육에서 임상 수기 교육을 위한 시간, 장소와 인적 자원의 제약으로 인해, 학생들이 완전한 수행 역량을 갖출 수 있도록 교육과정을 운영하는 것이 어려운 것이 현실이다. 이 연구는 임상수기 교육과정에서 동료지원학습과 동영상 평가를 활용함으로써 학생들이 완전한 술기 수행 역량을 성취할 수 있는지 확인하고, 대안적 교수-학습 방법으로써의 적용가능성을 살펴보고자 하였다. 방법 일개 의과대학에서 처음으로 임상수기교육을 시작하는 의학과 1학년 임상수기입문교육과정에 Benjamin Bloom의 완전학습모형을 적용하여 학습 목표설정, 성취 수준 설정, 학습 활동, 형성평가, 반복 교육과 심화학습단계로 수업을 설계하고 적용하였다. 반복학습 단계에서는 동료지원학습을 활용하였으며, 모든 평가와 피드백은 학생들이 개인별로 술기 수행을 촬영하여 제출한 동영상으로 하였다. 수업이 종료된 후 학생들의 성취 정도와 과정에 대한 학생과 교수의 인식을 조사하였다. 결과 반복 학습 횟수의 차이는 있었으나 모든 학생이 의도한 성과에 도달하였다. 학생들은 동료들과의 직간접적인 학습 경험이 술기 수행에 도움이 됨을 보고하였으며 동영상을 통한 평가와 피드백도 대부분의 학생이 만족함을 알 수 있었다. 결론 제한적인 교육 환경 아래서 동료지원학습과 동영상을 활용한 평가와 피드백은 임상수기 완전학습을 구현할 수 있는 학습 방법으로 활용 가능하며, 향후 지속적으로 학습 효과를 유지하기 위한 학습전략을 탐색하고 그것을 반영한 완전학습 프로그램을 개발이 필요할 것이다. Objectives With the growing awareness of patient safety, medical school graduates are required to perform skillfully and accurately clinical skills. Repeated skill learning and feedback are necessary for students to reach their goals for safe and skilled skill performance. However, the reality is that it is difficult to operate the curriculum so that students can have full performance competency due to the constraints of time, place and human resources for clinical skill education in medical school education. The purpose of this study is to confirm whether students can achieve complete skill performance competency by using peer-assisted learning and video evaluation in the clinical skill curriculum, and to examine their applicability as an alternative teaching and learning method. Methods In the clinical skill introductory curriculum, the class was designed and applied in the steps of learning goal setting, achievement level setting, learning activity, formative evaluation, repeated education, and in-depth learning, by applying Benjamin Bloom s mastery learning model. In the repetitive learning stage, peer-assisted learning was used, and all evaluations were made with videos submitted by students filming individual skill performances. After the class was over, the students achievement level and the students and professors perceptions of the process were investigated. Results All students achieved the intended performance although there was a difference in the number of repetitions. Students reported that direct and indirect learning experiences with peers were helpful in skill performance, and it was found that most students were satisfied with the evaluation and feedback through videos. Conclusions Under a limited educational environment, peer-assisted learning and evaluation and feedback using videos can be used as a learning method to implement complete clinical skill learning. It will be necessary to explore a learning strategy to maintain the learning effect continuously and develop a mastery learning that reflects it.

Pure laparoscopic versus open right hepatectomy in live liver donors: a propensity score matched analysis

Suk Kyun HONG,Kyung-Suk SUH,Jae-Hyung CHO,Jeong-Moo LEE,Nam-Joon YI,Kwang-Woong LEE 대한외과학회 2019 대한외과학회 학술대회 초록집 Vol.2019 No.10

Pure Laparoscopic Donor Right Hepatectomy: Perspectives in Manipulating a Flexible Scope

Suk Kyun Hong,Eunhye Shin,Kwang-Woong Lee,Kyung Chul Yoon,Jeong-Moo Lee,Jae-Hyung Cho,Nam-Joon Yi,Kyung-Suk Suh 대한외과학회 2018 대한외과학회 학술대회 초록집 Vol.2018 No.11

Impact of Body Mass Index ≥30 on Pure Laparoscopic Donor Right Hepatectomy

Suk Kyun Hong,Kyung-Suk Suh,Jae-Hyung Cho,Jeong-Moo Lee,Nam-Joon Yi,Kwang-Woong Lee 대한외과학회 2018 대한외과학회 학술대회 초록집 Vol.2018 No.11

The Learning Curve in Pure Laparoscopic Donor Right Hepatectomy: Cumulative Sum Analysis

( Suk Kyun Hong ),( Kyung-suk Suh ),( Kyung Chul Yoon ),( Jeong- Moo Lee ),( Jae-hyung Cho ),( Nam-joon Yi ),( Kwang-woong Lee ) 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1

Aims: Due to increased experience and knowledge in laparoscopic surgery in the era of minimally invasive surgery, laparoscopic donor hepatectomy is also being performed at some experienced centers. However, more evidence of feasibility, safety, and especially the learning curve is needed for wide introduction of this technique. Therefore, in the current study, we aimed to determine the learning curve for this procedure with single surgeon experience of 100 consecutive cases using Cumulative Sum (CUSUM) method. Methods: Between November 2015 and October 2017, 150 donors underwent pure laparoscopic hepatectomy at our cen-ter. Of these, 100 donors underwent right or extended right hepatectomy by a single surgeon. Results: According to the CUSUM analysis, the graph showed steep decrease in the curve and the learning curve was accomplished after about 60 cases of pure laparoscopic donor right hepatectomy. When we performed the risk-adjusted CUSUM to take into account the expected risk of surgical failure associated with each specific case, 65-70 cases were the learning curve. Conclusions: Our experience indicates that, when performed by an experienced adult living donor liver transplant surgeon, performance of about 65-70 PLDRHs is needed to standardize the procedure.

Evaluation of the learning curve for pure laparoscopic donor right hepatectomy by analyzing 115 consecutive cases in an experienced adult living donor liver transplant center

Suk Kyun HONG,Kwang-Woong LEE,Kyung Chul YOON,Jeong-Moo LEE,Jae-Hyung CHO,Nam-Joon YI,Kyung-Suk SUH 대한외과학회 2017 대한외과학회 학술대회 초록집 Vol.2017 No.11

경추부에 발생한 골막성 연골종의 증례 보고 : Case Report

이형중,김영수,이형석,이승로,함창곡,고용,오성훈,오석전,김남규,김광명 대한신경외과학회 1995 Journal of Korean neurosurgical society Vol.24 No.5

The authors experienced a case of cervical periosteal chondroma presenting with symptom of spinal cord compression in 26-year-old woman. The diagnosis was based on the characteristic features of computed tomographic scan and magnetic resonance imaging scan. Total surgical removal in two-staged operation was followed by full neurological recovery. column was observed and rarely reported in this literature.

A Phase 3 Study of Tenofovir Alafenamide Compared with Tenofovir Disoproxil Fumarate in Patients with HBeAg-positive Chronic Hepatitis B

( Hyung Joon Kim ),( Young-Suk Lim ),( Ki Tae Yoon ),( Won Young Tak ),( Sang Hoon Ahn ),( Jae-Seok Hwang ),( Henry LY Chan ),( Scott Fung ),( Wai Kay Seto ),( Wan-Long Chuang ),( Chi-Yi Chen ),( Aric 대한간학회 2016 춘·추계 학술대회 (KASL) Vol.2016 No.1

Aims: Tenofovir alafenamide (TAF), a novel prodrug of tenofovir (TFV),is more stable in plasma and enhances delivery of TFV into hepatocyteswhile lowering circulating levels of TFV by approximately 90% comparedto tenofovir disoproxil fumarate (TDF).Methods: In this Phase 3 study, patients with HBeAg-positive chronichepatitis B (CHB) were randomized 2:1 to TAF 25 mg QD or TDF300 mg QD and treated for 96 weeks. After Week 96, patients receiveopen label TAF for 48 weeks. The primary efficacy analysis was thepercent of patients with HBV DNA <29 IU/mL at Week 48. Key secondarysafety endpoints were assessed sequentially: changes in hip andspine bone mineral density (BMD), changes in serum creatinine (sCr),and dipstick proteinuria. Markers of bone formation and resorption,and renal tubular function were also assessed.Results: 873 patients were randomized and treated at 164 sites in19 countries. Baseline characteristics included: mean age 38 years,83% males, 82% Asians; 47% had HBV DNA ≥ 8 log10 IU/mL, and26% were treated previously with nucleos(t)ides. At Week 48, TAFwas non-inferior in efficacy to TDF with virologic response rates of63.9% with TAF and 66.8% with TDF. A greater percentage of patientstreated with TAF achieved normalization of serum ALT values.Patients on TAF experienced significantly less declines in hip and spineBMD, and a smaller increase in sCr than TDF; eGFRCG, and renaltubular markers also changed less with TAF. No viral resistance wasobserved in 22/581 (3.8%) and 11/292 (3.8%) of TAF and TDF patients,respectively, who qualified for testing.Conclusions: Compared to TDF 300 mg, the efficacy of TAF 25 mgin patients with HBeAg-positive CHB was noninferior. Safety wasalso improved, with less change in bone and renal parameters.

요양보호사의 직무 스트레스, 공감 능력, 사회적 지지가 공감피로에 미치는 영향

이수정(Yi, Su-Jeong),장형숙(Jang, Hyung-Suk) 한국웰니스학회 2018 한국웰니스학회지 Vol.13 No.3

본 연구는 장기요양기관에 근무하는 요양보호사의 공감 피로, 공감 능력, 직무 스트레스 및 사회적 지지 정도를 파악하고 공감피로에 미치는 영향요인을 분석하고자 실시하였다. 연구대상자는 요양보호사 자격증을 취득하고 노인 장기 요양기관에 근무하는 요양보호사 110명을 대상으로 하였다. 연구 도구는 이은희(2004)의 직무 스트레스 도구, 박성희(1997)가 번안한 한글판 IRI, 박복식 (2013)의 사회적 지지 도구, ProQOLS : Compassion satisfaction/fatigue subscale version 5 (Korean)를 사용하였으며 수집된 자료는 SPSS 20.0 통계 프로그램을 이용해 기술통계, t-test, ANOVA, Pearson Correlation Coefficient, 다중 회귀 분석을 하였다. 연구결과 나이, 종교, 근무 경력, 고용 형태에 따라 공감 피로에 유의한 차이가 있었으며 상관관계 분석 시 직무 스트레스 (r=45, p<.001)와 공감(r=.50, p<.001)이 공감 피로와 유의한 상관성을 보였다. 공감 피로에 영향을 미치는 요인을 파악하고자 다중회귀분석을 실시한 결과 직무 스트레스, 공감, 근무형태가 통계적으로 유의한 영향요인으로 나타났으며 공감 피로를 55% (F=23.37, p<.001) 설명하였다. 따라서 요양보호사의 인적자원관리 시 공감피로 및 공감피로와 상관성이 높은 변수들을 고려하여야 할 것이다. This study was conducted to understand job stress, empathy and social support of care helpers working at longterm care facilities and analyze how they affect to compassion fatigue. The study participants were 110 care helpers who has care helper certificate working at longterm care facilities. Lee Eun-Hee (2004)`s job stress tool, Korean version IRI, which was translated by Park Sung-Hee(1997), Park Bok-Sik(2013)`s social support tool, and the ProQOLS : Compassion satisfaction/fatigue subscale version 5 (Korean) were used as the survey instruments and analysis included descriptive statistics, t-test, ANOVA, Pearson Correlation Coefficient, multiple regression using SPSS 20.0. As a result of the study, there were significant differences in compassion fatigue according to age, religion, length of career, type of employment. Job stress (r=45, p<.001) and empathy (r=50, p<.001) showed a significant correlation with compassion fatigue. As a result of multiple regression analysis to identify factors influencing compassion fatigue, job stress, empathy and type of employment were shown as significant predictors (55%) of compassion fatigue (F=23.37, p<.001). Therefore, variables highly correlated with compassion fatigue should be considered when managing care helper human resources.