Blood, "a key to genome," revealed Hantaan virus infection sites

Researchers led by Prof. Jin-Won Song succeeded in building a surveilance system to identify the emergence of Hantaan viruses.

Prof. Jin-Won Song's research team in the Department of Microbiology at Korea University College of Medicine succeeded in conducting active targeted surveillance to track Hantaan virus infection sites for hemorrhagic fever with renal syndrome (HFRS) patients.

Hantaviruses were first discovered in the striped field mouse (Apodemus agrarius) and isolated by Dr. Ho Wang Lee in 1976, well known to cause HFRS. Hantaviruses are transmitted to humans via infected mice and cause renal failure, hemorrhage, thrombocytopenia and shock, posing fatal threats to life. Hantaviruses are evenly spotted around the world as well as in Korea and the domestic species include Hantaan orthohantavirus (HTNV), Seoul orthohantavirus (SEOV), Imjin thottimvirus (MJNV) and Jeju orthohantavirus(JJUV). 

The recent outbreaks of zoonotic Ebola and MERS viruses enhanced caution and needs for active surveillance system to trace new-emerging infectious agents and to identify infection sites. Prof. Jin-Won Song's research team has long been studying genetic features and pathogenicity of hantaviruses and recently succeeded in decrypting the complete genome sequence of HTNV from HFRS patients using Next-generation sequencing (NGS). The study identified the suspected sites of patient infections through epidemiological surveys with patients and phylogeographic analyses based on the geographic locations of HTNV-positive rodents. The results showed that the complete genome of HTNV, epideomiological surveys and targeted trappings enabled effective tracking and surveillance of the emergence of hantaviruses.

The study was published in the online issue of "Clinical Infectious Diseases’ in March with the title "Active Targeted Surveillance to Identify Sites of Emergence of Hantavirus." The journal "Clinical Infectious Diseases" is published by Oxford University Press and the impact factor is 9.117, within the top 3% of journals specialized in infectious diseases in the Journal Citation Reports (JCR). 

The study is also a prime example of global joint research led by researchers from Korea University College of Medicine and the US. 

Prof. Jin-Won Song said "This study will be of much help in preventing and treating viral infections as human health is threatened by zoonotic viruses around the globe. The study showed that subsequent studies and preventive measures are required to deal with zoonotic viral infections in the future. It will greatly contribute to building a prevention and surveillance system of HFRS by tracking and monitoring HTNV infection sites. I also expect that the study will lay the groundwork for targeted surveillance of other zoonotic viral infections."

Prof. Song discovered various types of new viruses including "Imjin thottimvirus" and "Jeju orthohantavirus" since he joined the Department of Microbiology in 1996. He was awarded the National Academy of Sciences of Korea Award in 2011 and the Ho Wang Lee Award in 2013 for his academic achievement. He is a renowned scholar in the field of virus research and is serving as the next President of the International Society of Hantaviruses and the Korean Society of Virology. The Department of Microbiology at Korea University College of Medicine where Prof. Jin-Won Song is affiliated has contributed to the advancement of medical sciences since 1976 when Prof. Ho Wang Lee found hantaviruses for the first time in the world, known as the cause of HFRS, and members of the Department are conducting vigorous research on diverse pathogenic viruses.

pubmed link: https://www.ncbi.nlm.nih.gov/pubmed/30891596

Clin Infect Dis. 2019 Mar 20. pii: ciz234. doi: 10.1093/cid/ciz234.

as the most renowned scholar in medical education and the founder of the OSCE. 

Korea University College of Medicine invited Prof. Ronald M. Harden at the University of Dundee, UK, the most renowned scholar in medical education, to give a lecture at the Yukwangsa Hall on April 10th.

Prof. Harden is the designer of the OSCE (Objective Structured Clinical Examination) adopted to test clinical competence of medical students or interns & residents around the world. He has played a critical role in advancing medical education through scientific studies for more than five decades. He is now serving as General Secretary of the Association for Medical Education in Europe (AMEE) and editor of Medical Teacher, a top journal in medical education.

The topic of Prof. Harden's lecture was "The medical school of the future: Imagine if the impossible isn’t" and he talked about the paradigm change in medical education to nurture doctors who can understand a future society and also about the goals for us to achieve.

First, he called for a transformative change of the paradigm in curriculum planning. He highlighted key concepts and elements of the "Authentic curriculum" such as outcome/competence-based education, just-in-time learning, assessment of competences required in practicing medicine and field-based learning.

Second, he emphasized the "adaptive learning" customizable to individual students, breaking from the traditional "one size fits all" approach. He said that a medical college is not a factory producing standard goods out of the same input materials.

Third, he stressed "collaboration" as a major competence to build in medical education. He emphasized the need to introduce interprofessional education into medical education to become a leader in medical research guiding biomedical industry and provide good care for patients, as the interorganizational and international collaborations among diverse professions are getting more important.

Fourth, he claimed that students are not just a trainee or a consumer but need to play a role as a partner in planning and managing medical curriculum for the advancement of medical education. He called for teachers to diversify their roles into a "curriculum developer" who designs a curriculum for students, a "facilitator" who facilitates learning of students, a "manager" who effectively manages a curriculum, an impartial evaluator and a professor who practices medicine and play a role model for students, not just as a clinical doctor and scholar.

Min-seo Choi, a 1^st year student in the premedical course, said "I asked Prof. Harden a question about the impact of the 4th Industrial Revolution and advances in AI technologies on doctors and about attitudes of students on what to learn. He said that the most important thing is to draw a big picture combining technological advances and occupational changes and prepare to accept technological transformations, which we should actively adopt and employ rather than exploit or be exploited by. I was impressed by the WFME and Prof. Harden’s special lecture where many participants from around the world came to exchange their ideas on medical education, and I felt proud that the event was hosted by Korea University."

Jeong-hyun Lee, a 1st year student in the premedical course, said "I have been to the WFME last Sunday. It was an excellent opportunity to learn the current status of medical education. I have been very interested in the advancement mechanism of medical education around the globe and the special lecture by Prof. Harden was helpful to partially answering my questions on the topic. I expect these experiences will help my study in medicine by providing a broader perspective on the world."

Ultrasound echo intensity index for diagnosing amyotrophic lateral sclerosis

Amyotrophic lateral sclerosis, also called Lou Gehrig's disease, is a fatal neurodegenerative disease whereby the upper motor neurons of the central nervous system and the lower motor neurons of the peripheral nervous system are selectively lost. Lou Gehrig's disease leads to muscle weakness affecting the whole body and ultimately resulting in death due to diverse complications usually within three to five years following diagnosis. In the early stages of development, the symptoms are not easy to differentiate from those of other curable diseases, therefore further markers for early detection need to be developed.

Split hand (stronger muscle atrophy on the palm and the back of the hand on the side of the thumb in comparison to that on the side of the little finger) has not yet been fully understood both anatomically and pathophysiologically and has been confirmed unique to Lou Gehrig's disease. Though an index was proposed by using compound muscle action potential to diagnose the presence of split hand at an early stage, this approach is accompanied by uncomfortable pains for patients due to electrical stimuli. Moreover, the sensitivity and specificity of the index are too low for patients whos symptoms have progressed as far as muscle atrophy is too severe to evoke compound muscle action potential.

Prof. Byung-jo Kim's research team in the Department of Neurology at Korea University College of Medicine confirmed an increase in echo intensity and a decrease in volume of denervated muscles in patients with neuropathy using muscle ultrasound. Based on these observations, researchers developed a new ultrasound echo intensity index that can identify the presence of split hand. They then compared the new echo intensity index in three separate groups which includes: patients diagnosed with Lou Gehrig's disease, patients with neuromuscular disorders having similar clinical symptoms accompanied by hand muscle atrophy and a normal healthy control group.

Compared to the existing index using compound muscle action potential, the new index applying ultrasound showed significantly higher sensitivity and specificity for diagnosing Lou Gehrig's disease. Moreover, the new index may also be applied in patients whereby severe muscular atrophy has taken place and for who the conventional index does not apply. Furthermore, no pain is experienced by patients during the new test. The new index has been patented as a diagnostic marker for Lou Gehrig's disease.

A subsequent study is underway to find a pathophysiological mechanism for split hand by combining and analyzing brain MRI data of patients with Lou Gehrig’s disease. Results of the follow-up study are expected to be employed for the development of an advanced diagnostic tool to differentiate patients with curable muscle atrophy in early stage.

pubmed link: https://www.ncbi.nlm.nih.gov/pubmed/29666207

J Neurol Neurosurg Psychiatry. 2018 Sep;89(9):943-948. doi: 10.1136/jnnp-2017-317917. Epub 2018 Apr 17.

The 2019 World Federation for Medical Education World Conference (WFME 2019) was successfully held in Seoul, Korea.

The WFME 2019 was the first and the largest international conference of medical education held in Korea, attracting 800 participants from 56 countries around the world.

The conference provided a meaningful opportunity for exchanging ideas about the future of medical education.

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The 2019 World Federation for Medical Education World Conference (WFME 2019) was successfully held in Seoul, co-hosted by Korea University College of Medicine (Dean Hong Sik Lee) and the Korean Council on Medical Education (President Hee Chul Han).

The WFME 2019 was held in the Grand Walkerhill Seoul from April 7^th to 10^th, joined by 800 experts in medical education and accreditation from 56 countries. The conference program spanned a range of topics including medical education and accreditation for quality assurance, state-run tests and refresher courses in 67 invited lectures and 300 freestyle presentations.

Notably, participants not only shared the current status of medical education in their own countries but discussed the need to establish global standards for medical education, the current records of global accreditation for medical education institutions and future advances in the field, spurred by growing exchanges of medical personnel across countries. In addition, postgraduate medical education that has been rarely touched in the discourse of medical education, i.e., the need for quality improvement and accreditation for medical residency training, was actively discussed in the conference, which was very meaningful considering the reality of residency training in Korea.

Participants also exchanged their ideas on the role of hospitals as training institutions, intensive postgraduate medical education and the improvement options. They agreed that the role of college of medicine needs to be strengthened in the postgraduate medical education as in the US and the UK. Excellent examples were introduced on how to nurture doctors who have deeper understandings of their society and empathy with their patients, drawing a lot of attention from the audience. Moreover, students expressed their own opinions on medical student exchange programs and accreditation for medical education, providing an opportunity to have a grand perspective including views of both providers and consumers of medical education.

The WFME 2019 was very meaningful because it was the first of its kind held in Asia and it provided an opportunity to discuss the goal of current medical education, the limits and issues in different countries from the perspective of followers in medical education, not from the views of advanced runners. Furthermore, the meeting showed that Korea is making efforts to advance medical education based on the global standards free from the existing leadership of advanced countries such as the US and those in Europe, playing a leading role in medical education.

President Hee Chul Han of the Korean Council on Medical Education said "It is a great honor to co-host the WFME World Conference with Korea University College of Medicine in 16 years since the previous one. It is especially meaningful that the 12 members of the Korean Council on Medical Education eagerly cooperated to organize the event including the Korean Medical Association, the Korean Hospital Association, the Korean Academy of Medical Sciences, the Korea Association of Medical Colleges and the Korean Doctors Council." He also added "I hope the government and our society pay attention to our efforts and take measures to promote normalization of medical residency training and advancement of medical education, based on the standards for medical residency training discussed in the WFME 2019."

Prof. Hong Sik Lee, Dean of Korea University College of Medicine, said "It is critical to understand the global trend to advance the medical education in Korea and the government as well as the medical community needs to discuss necessary measures in public about international exchanges of medical students and experts," and he also added "The sustained quality improvement in medical education in Korea requires our society's support and coordination." The Dean finally stated "Above all, I should say that it was a great privilege to host the WFME 2019 for the first time in Asia to discuss the current agenda in medical education with global experts. Korea University College of Medicine will play a leading role in proposing a novel paradigm and setting global standards in medical education to resolve public health issues."