Ewha Womans University launched an on-campus Coronavirus disease-19 (COVID-19) response system called Ewha Safety Campus (ESC) Project in collaboration with the Seegene Inc. RT-PCR diagnostic tests for COVID-19 were proactively provided to the participants. This study examines the effectiveness of the on-campus testing strategy in controlling the reproduction number (R_t) and identifying student groups vulnerable to infection.

The ESC project was launched on March 2, 2022, with a pilot period from Feb 22 to March 1, 2022—the peak of the Omicron variant wave. We collected daily data on the RT-PCR test results of the students of Ewha Womans University from Mar 2 to Apr 30, 2022. We daily calculated R_t and compared it with that of the general population of Korea (women, people aged 20–29 years, and Seoul residents). We also examined the students vulnerable to the infection based on the group-specific R_t and positivity rate.

A lower R_t was observed about 2 weeks after the implementation of the ESC Project than that of the general population. The lower R_t persisted during the entire study period. Dormitory residents had a higher R_t. The positivity rate was higher in students who did not comply with quarantine guidelines and did not receive the second dose of the vaccine.

The study provides scientific evidence for the effectiveness of the on-campus testing strategy and different infection vulnerabilities of students, depending on dormitory residence, compliance with the quarantine guidelines, and vaccination.

Kikuchi-Fujimoto disease (KFD) is characterized by lymphadenopathy and fever, and is usually self-limited. This study analyzed the clinical characteristics of pediatric patients with KFD.

This retrospective, observational, single-center study was conducted in South Korea from March 2008 to October 2015. KFD was diagnosed based on clinical, radiological or histological findings and excluded when there were any other causes of lymphadenopathy. Medical records were reviewed for clinical and laboratory manifestations.

A total of 35 cases were included. The mean patient age was 12.1±2.9 years (range, 5 to 17 years); the male-to-female ratio was 1:0.8. The main clinical manifestations were cervical lymphadenopathy and fever in 34 cases (97%). The mean duration of fever was 12.2±8.3 days (range, 2 to 37 days). We noted enlargement of lymph nodes in the cervical, mesenteric (n=5, 14%), axillary (n=2, 6%), and inguinal (n=1, 3%) regions. Hepatosplenomegaly, loss of appetite, and rash were observed. On laboratory examinations, elevation of ferritin, leukopenia, and positivity for anti-nuclear antibodies were frequently observed. Twelve patients underwent biopsy and 23 cases were diagnosed by radiological findings. The mean duration of hospitalization for all cases was 7.9±2.9 days (range, 3 to 13 days) and steroids were administered in 10 cases. KFD recurrence was observed in 2 cases (5.7%) with the time to relapse of 7 months and 4 years. There were no cases with systemic lupus erythematous or other autoimmune disease.

KFD should be considered in pediatric patients with lymphadenopathy and prolonged fever. Patients with KFD should be monitored for recurrence and the development of autoimmune disease.

This paper aims to describe an outcome-based curriculum development process at a medical school that has difficulty in advancement from the higher stage outcomes to the individual lesson outcomes, and to propose a way to implement it practically.

We reviewed the objectives, strategies and previous products of the school's taskforce activities and suggested the principle of bidirectional approaches of outcome based curriculum development.

The developing strategy identified such as firstly, the evaluation of present curriculum and then, the review of the outcomes developed previously with considering the nation-wide environmental change in medical education. Then, we selected one example course which was focused the resources of the school to, and finally the product of the example course was propagated to the other courses with central monitoring.

Bidirectional model of ‘Top-down’ plus ‘Bottom-up’ approaches could be an efficient way to develop the outcome-based curriculum in a medical school, which has difficulties to advance the developing process due to various reasons including limited resources.

Paroxysmal nocturnal homoglobinuria is an uncommon acquired hemolyticanemia and characterized by increased sensitivity of erythrocytes to the lytic action of comptement system, developing intravascular hemolysis. PNH is complicated by anemia, infectionand thrombosis. The more prolonged survival comparable to literature was noted and so, weperformed this study.

The previously reported twenty nine cases and six cases were collected at EwhaWontons University Hospital from Dec.1979 to Dec.1994 and were analyzed for clinical characteristics and progress.

1) The age distribution was ranged from 16 to 61 years with mean of 30 years andmale to female ratio was 1.5 : 1. The duration from the onset of symptoms to diagnosis wasranged from 3 days to 40 years and above 5 years was 22.9%. The subjective symptoms attributable to anemia were in 13 cases, to dark urine after sleep in 10 cases, to jaundice in 5 cases,to abdominal pain in 3 cases, to hemorrhage in 4 cases. The various diagnoses made beforePNH were aplastic anemia in 14 cases, hernolytic anemia in 5 cases, liver disease in 4 cases,iron deficiency anemia in 3 cases, idiopathic thrombocytopenic purpura in 1 cases, reversedcases from aplastic anemia to PNH in 2 cases.

2) Laboratory data showed ;

(1) anemia(Hg below 12g/dL) in 35 cases with mean of 7.3g/dL.

(2) leukocytopenia(below 4,000/mm³) in 5 cases, leukocytosis in 1 case with mean 4,100/mm³ except patient with chronic myelocytic leukemia.

(3) thrombocytopenia(below 150,000/mm³) in 10 cases with mean 106,000/mm³.

(4) reticulocytosis(over 2.0% ) in 20 cases with mean 4.3%.

(5) Bone marrow examination revealed hypocellular in 2 cages, normocellular in 4 cases, hypercellular in 3 cases and erythroid hyperplasia in all cases.

(6) positive Ham's test in 13 cases among 14 cases.

(7) positive sucrose hemolysis test in 10 cases anions 10 cases.

(8) decreased serum haptoglobin in 2 cases among 3 cases.

3) The treatment was consisted of blood transfusion in 26 cases among 35 cases, especiallywashed RBC in 13 cases, iron in 14 cases, folic acid in 10 cases, dextran in 5 cases, busulfanin 1 case, corticosteroid in 26 cases, androgen in 15 cases and anticoagulant in 3 cases.

4) The observed complications were infection in 3 cases, cerebral infarct in 2 cases andacute renal failure in 2 cases.

5) The nineteen patients were still alive, four patients dead, ten patients were lost duringfollow-up period. The duration of most prolonged survival case was 41 years 10 months. Theywere fo11owed from 0.3 to 115 months.

In analyzing the characteristics of PNH patients and prolonged survivals, thedata reported suggest, although the laboratory abnormalities persisted in the prolonged survival,the prognosis will be good if conservative tretment and prevention of complication is tried.

Ulcerative colitis is an waxing and waning inflammatory bowel disease characterized by rectal bleeding and diarrhea, affecting principally the mucosa of the rectum and colon. Its incidience is being higher in Europe and America and it also seems to be rising increasingly in our country because diagnostic methods are much developed and Korean life styles are westernized. So, we investigated its clinical characteristics.

We analyzed 36 cases of ulcerative colitis which had been treated in the Hospital of Ewha Womans' University from Jan. 1983 to Feb. 1993, retrospectively.

1) The most prevalent age group was 3rd decade and male to female ratio was 1:1.77.

2) The duration of symptoms was less than 6 months in 63.9%.

3) The most common clinical manifestation was hematochezia(86.1%), abdominal pain(75.0%), diarrhea(72.2%), fever(30.6%), weight loss(27.8%) in the order of frequency.

4) According to the severity, moderate type was shown in 52.8%, severe in 33.3% and mild in 13.9%.

5) According to the anatomical distribution of the lesion, pancolitis was shown in 36.1%, the involvement of the rectum and sigmoid colon in 16.6%, the left-sided colon in 13.8%, rectum only in 13.8%, transverse colon in 8.3% and backwash ileitis in 11.1%, respectively.

6) The hematologic laboratory finding was non-specific including anemia, leukocytosis, increased erythrocyte sedimentation rate, bypoalburninemia, electrolyte imbalance, increased serum transaminase and alkaline phosphatase.

7) Colonoscopy revealed ulceration(77.1%) commonly, including hyperemia(51.4%), bleeding(42.5%), mucosal friability(22.9%), pseudopolyp(22.9%), granularity(20.2%).

8) The Barium enema showed granularity commonly and loss of haustral marking(55.2%), luminal narrowing(34.5%), lead pipe rigidity(13.8%), pseudopolyp(3.4%). Also, normal finding was shown in 10.3%.

9) The most common histopathologic finding was inflammation(83.3%) and ryptitis(55.6%), ulceration(50%), goblet cell depletion(19.4%), pseudopolyp(19.4%), necrosis(13.9%), granolarity(8.3%) were also noted.

10) With the medical treatment, 76.5% of the cases showed initial improvement of the symptom, but the recurrence developed in 17.7%. The surgery was performed in 6 cases of patients(16.7%). Emergency operation was performed in 2 cases due to bowel perforation and elective operation in 4 cases.

Klebsiella ornithinolytica is a very rare type of Klebsiella species isolated from human and environment and is currently reported to be the cause of bacteremia. However, there have been no data on the clinical implication of K. ornithinolytica bacteremia.

We have analyzed 9 cases of K. ornithinolytica bacteremia diagnosed at Ewha Womans Medical Center from 2003 to 2006. All available clinical and microbial data were analyzed.

All 9 cases were community acquired. The causes of bacteremia were hepatobiliary disease(66.7%), Primary bacteremia(22.2%) and spontaneous bacterial peritonitis(11.1%). Underlying diseases were colon cancer, type 2 diabetes, hypertension and hepatobiliary disease. In 44.4% patients, there were no underlying diseases. Acute renal failure and shock occurred in 33.3% patients. All of the isolated strain were resistant to ampicillin, and only 1 case was resistant to cephalothin, piperacillin/tazobactam.

K. ornithinolytica bacteremia is commonly community acquired, especially in patients with hepatobiliary disease. Higher mortality was associated with acute renal failure and shock.