Purpose: This study investigated medical educators’ readiness for online teaching by exploring their perceived ability and importance of online teaching competencies and identified the highest priority of their educational needs. Methods: In this study, 144 medical education faculty members from a university were invited to participate. The faculty online teaching readiness scale was virtually distributed at the end of the spring semester of 2020 and 38 faculty members responded for 2 weeks. The collected data were analyzed with descriptive statistics, paired t-tests, Borich Needs Assessment, and the Locus for Focus model. Results: The overall average perceived ability was 2.76, while the overall average perceived importance was 3.36. The course design and the technical competency categories showed the highest and lowest educational needs, respectively. Five competencies were given the highest priority of educational needs. Conclusion The results revealed that the medical educators are not ready for online teaching; thus, urgent educational needs for online teaching competencies exist.

During the last two decades, there has been an increasing interest in the impact of oral health on atherosclerosis and subsequent cardiovascular disease (CVD). To date, some periodontal pathogens including Porphyromonas gingivalis (P. gingivalis) have been reported to be relevant to CVD. Porphyromonas endodontalis (P. endodontalis), which shares approximately 87% sequence homology with P. gingivalis, is mostly found within infected root canals. However, recent studies reveal that this pathogen also resides in the dental plaque or periodontal pocket in patients with periodontitis. It has been shown that P. endodontalis invades human coronary artery endothelial cells (HCAEC) and coronary artery smooth muscle cells (CASMC). To evaluate whether P. endodontalis can participate in the progression of atherosclerosis and CVD, we examined the changes in transcriptional gene expression profiles of HCAEC responding to invasion by P. endodontalis in this study. The following results were obtained. 1. Porphyromonas endodontalis was invasive of HCAEC. 2. According to the microarray analysis, there were 625 genes upregulated more than two-folds, while there were 154 genes downregulated by half. 3. Upregulated genes were relevant to inflammatory cytokines, apoptosis, coagulation and immune response. Enhanced expression of MMP-1 was also noticeable. 4. The transcription profiles of the 10 selected genes examined by real-time PCR agreed well with those observed in the microarray analysis. Thus, these results show that P. endodontalis presents the potential to trigger and augment atherosclerosis leading to CVD.
Apoptosis ; Atherosclerosis ; Cardiovascular Diseases ; Coronary Vessels ; Cytokines ; Dental Plaque ; Dental Pulp Cavity ; Endothelial Cells ; Gene Expression ; Humans ; Microarray Analysis ; Myocytes, Smooth Muscle ; Oral Health ; Periodontal Pocket ; Periodontitis ; Porphyromonas ; Porphyromonas endodontalis ; Porphyromonas gingivalis ; Real-Time Polymerase Chain Reaction ; Sequence Homology ; Transcriptome

BACKGROUND: The herbicides used in Vietnam were later found to be extremely contaminated with 2,3,7, 8-tetrachlorodibenzo-rho-dioxin (TCDD). The carcinogenecity of the product was for all cancers combined. The risk of soft tissue sarcoma, lung cancer, and lymphoma, chloracne, peripheral neuropathy and other diseases were found to be increased. Although many veterans exposed to herbicides had chronic skin diseases with variable clinical features, there were few researches about herbicides-related skin diseases. The purpose of this study was to investigate the characteristics of herbicides-related skin diseases and to provide epidemiologic information. METHODS: This study has been reviewed in the clinical findings of 127 veterans with skin diseases exposed to herbicides who visited Kosin University Gospel Hospital during the 5 years from January of 1997 to December of 2001. RESULTS: The age distribution was in the range of 47~68 years. The mean age was 54.6 years old. All patients were male. In the duration, 34 patients (26.8%) developed skin diseases for 6~10 years, 21 patients (16.5%) for 16~20 years, and 21 patients (16.5%), 25 years. In the incidence, seborrheic dermatitis was the most frequently observed in 45 patients (35.4%) followed by eczematous dermatitis in 41 patients (32.3%), xerotic eczema in 23 (18.1%) and pruritic dermatoses in 21 (16.5 %). In the incidence ratio of skin diseases with systemic diseases, chronic urticaria was the most highly observed with 100% (1/1) followed by fungal infection in 70% (7/10), other diseases in 66.6% (6/9), seborrheic dermatitis in 64.4% (29/45), eczematous dermatitis in 56.1% (23/41), and xerotic eczema in 52.2% (12/23). Sixty eight patients had skin diseases with systemic disease. Hypertension and diabetes were most frequently observed with 24 and 23 patients, respectively. The order of incidence was as follows: liver disease, gastroduodenal ulcer, peripheral neuropathy, chronic gastroenteritis, and hyperlipidemia. Mycosis fungoides was found in 4 cases and monoclonal T cell gamma receptor gene rear-rangement was detected in 2 cases (50%). CONCLUSION: Skin diseases among veterans exposed to herbicides used in Vietnam was chronic and showed variable clinical features. It was difficult to confirm the relationship between skin diseases and herbicides, but further researches are required to seek guidelines for the evaluation of skin diseases.
Age Distribution ; Chloracne ; Chronic Disease ; Dermatitis, Seborrheic ; Eczema ; Gastroenteritis ; Herbicides* ; Humans ; Hyperlipidemias ; Hypertension ; Incidence ; Liver Diseases ; Lung Neoplasms ; Lymphoma ; Male ; Mycosis Fungoides ; Peptic Ulcer ; Peripheral Nervous System Diseases ; Sarcoma ; Skin Diseases* ; Skin* ; Urticaria ; Veterans* ; Vietnam*

Background: A rapid increase in bone turnover and bone loss has been observed in response to the discontinuation of denosumab. It led to an acute increase in the fracture risk, similar to that observed in the untreated patients. We aimed to investigate the effect of denosumab on osteoclast (OC) precursor cells compared to that of zoledronate. Methods: The study compared the effects of denosumab (60 mg/24-week) and zoledronate (5 mg/48-week) over 48 weeks in postmenopausal women with osteoporosis. From patients’ peripheral mononuclear cells, CD14+/CD11b+/vitronectin receptor (VNR)- and CD14+/CD11b+/VNR+ cells were isolated using fluorescent-activated cell sorting, representing early and late OC precursors, respectively. The primary endpoint was the changes in OC precursors after 48 weeks of treatment. Results: Among the 23 patients, 11 were assigned to the denosumab group and 12 to the zoledronate group (mean age, 69 years). After 48 weeks, the changes in OC precursors were similar between and within the groups. Serum C-terminal telopeptide of type I collagen levels were inversely correlated with OC precursor levels after denosumab treatment (r=-0.72, P<0.001). Lumbar spine, femur neck, and total hip bone mineral density (BMD) increased in both groups. Lumbar spine BMD increased more significantly in the denosumab group than in the zoledronate group. Conclusions Denosumab and zoledronate treatments induced similar changes in OC precursors. During denosumab treatment, old age and suppressed bone turnover were associated with increased OC precursor cell populations. Further validation studies with prospective designs are required.

BACKGROUND: Prediction of therapeutic response to radioactive iodine (RAI) in Graves disease is poorly understood. Although thyrotropin binding inhibitor immunoglobulin (TBII) level is a strong index for relapse after antithyroid drug treatment, conflicting results are described regarding its prognostic significance in Graves disease treated with RAI. This study is to evaluate possible prognostic factors including TBII wbich affect the outcome of RAI therapy in Graves disease. METHODS: Two hundred and one patients with Graves disease who were followed for over 12 months after RAI treatment were studied retrospectively. The subjects were divided into hypothyroid, euthyroid and hyperthyroid groups, based on the thyroid function evaluated at 12 months after RAI therapy. We evaluated the association of clinical parameters including patients age, goiter size, degree of hyperthyroidism and TBII index with outcome of RAI treatment. RESULTS: In Graves disease, response rate to RAI was 70.1% (hypothyroid 22.4% and euthyroid 47.7%) until 12th month. The mean age of hypothyroid group was 40+/-11 years, significantly older than that other groups (euthyroid: 33+/-12, hyperthyroid: 35+/-13, p<0.05). Initial level of thyroid function, duration of antithyroid drug treatment prior to RAI, goiter size and dosage of RAI were not significantly different between the groups. There were 61 patients who had both TBII tests before and after RAI. Twelve had negative TBII and 49 had positive TBII before RAI admini-stration. The rate of unremitted hyperthyroidism after RAI therapy was significantly lower in patients with negative TBII than in those with positive TBII prior to RAI treatment( 0% versus 46.9%, p<0.05). CONCLUSION: Graves patients with positive TBII prior to RAI therapy were associated with lower therapeutic response to RAI than those with negatve TBII. And old age was associated with the development of early hypothyroidism after RAI therapy. These results suggest these factors be also considered in the treatment of Graves disease with RAI.
Goiter ; Graves Disease* ; Humans ; Hyperthyroidism ; Hypothyroidism ; Immunoglobulins ; Iodine* ; Recurrence ; Retrospective Studies ; Thyroid Gland ; Thyrotropin

PURPOSE: The purpose of this study was to investigate the clinical course of esodeviation after exotropia surgery in older patients (older than 15 years) and to compare it with that in younger patients (15 years or younger). METHODS: The medical records of all surgeries for exodeviation from December 2004 to February 2007 were reviewed and 82 patients were found with consecutive esodeviation. The patients were divided into two groups according to their age: Group A (patients older than 15 years) and Group B (patients age 15 or younger). The clinical course of esodeviation in Group A was compared to that in Group B by means of survival analysis. RESULTS: The median survival times of the esodeviation were 2.0+/-0.1 months in Group A and 1.0+/-0.1 months in Group B (p=0.40). The prevalence of consecutive esotropia at six months was 0% in Group A and 6.1% in Group B (p=0.32). The myopic refractive error, worse sensory condition, and a larger preoperative exodeviation in Group A did not affect the clinical course of the two groups differently. CONCLUSIONS: The postoperative esodeviation of patients older than 15 years after exotropia surgery tended to persist longer during the early postoperative period than that of patients 15 years or younger, however, the difference did not persist at postoperative six months.
Adult ; Age Factors ; Child ; Esotropia/*etiology/physiopathology ; Exotropia/*surgery ; Female ; Humans ; Kaplan-Meiers Estimate ; Male ; Oculomotor Muscles/*surgery ; *Postoperative Complications ; Vision, Binocular/physiology ; Visual Acuity/physiology

We report a rare case of cauda equina syndrome due to herniated lumbar disc at L4-L5 with a large extruded fragment which was located primarily posterior (dorsal) to the thecal sac. A 44-year-old man has developed lumbago and sciatica one year prior to his visit, but recently motor weakness and voiding difficulty occurred. Lumbar computed tomography scan showed a mass compressing and surrounding the thecal sac at the L4-L5 level. Urgent decompressive lumbar laminectomy was performed. The lesion proved to be a massive extruded disc fragment dorsally located to the thecal sac. It was partially connected with intervertebral disc and removed carefully to prevent dural tear and neural injury. Although sciatica was almost relieved and motor was recovered usefully, voiding difficulty and dysthesia of the lower leg were remained at 6 months follow-up examination.
Adult ; Cauda Equina* ; Follow-Up Studies ; Humans ; Intervertebral Disc ; Laminectomy ; Leg ; Low Back Pain ; Polyradiculopathy* ; Sciatica

To evaluate the CT and MR findings of cerebral paragonimiasis (PW) and to assess the diagnostic value of the specific antibody test by enzyme-linked immunosorbent assay (ELISA) for PW, 55 CT scans and 13 MR images of 57 patients with cerebral PW were reviewed retrospectively, and correlated with the serum/CSF antibody levels. We divided the into three groups, early active(n=21), chronic(n=32), and combined stage (n=4), on the basis of CT/MR findings. In the group of early active stage the most common and characteristic findings was multiple, conglomerated, ring-like enhancing lesions in the unilateral cerebral hemisphere, which was seen in 52% on CT and 44% on MR. Other non-specific findings included a solitary ring-like or irregular enhancing lesions, ill-defined low density lesions without enhancement, localized hemorrhage with or without enhancing lesions. In the group of chronic stage there were multiple calcifications of various shapes, most commonly 1-2cm sized round shape, and associated encephalomalacia. MR was superior to CT in detecting hemorrhage and in characterizing the central contents of ring-shaped calcifications, while it was inferior to CT in identifying small calcifications. Antibody levels of serum and CSF were positive in 86% and 82% in early active group, and in 48% and 31% in chronic sgage respectively. The positive rate was significantly different between the two groups (P=0.001). CT/MR findings were characteristic in only approximately half the cases in early active cerebral PW which can be cured by traziquantel therapy. Therefore, antibody test by ELISA is recommended as a complementary tool, particularly in patients with non-specific imaging findings.
Cerebrum ; Diagnosis* ; Encephalomalacia ; Enzyme-Linked Immunosorbent Assay* ; Hemorrhage ; Humans ; Paragonimiasis* ; Praziquantel ; Retrospective Studies ; Tomography, X-Ray Computed

To evaluate the CT and MR findings of cerebral paragonimiasis (PW) and to assess the diagnostic value of the specific antibody test by enzyme-linked immunosorbent assay (ELISA) for PW, 55 CT scans and 13 MR images of 57 patients with cerebral PW were reviewed retrospectively, and correlated with the serum/CSF antibody levels. We divided the into three groups, early active(n=21), chronic(n=32), and combined stage (n=4), on the basis of CT/MR findings. In the group of early active stage the most common and characteristic findings was multiple, conglomerated, ring-like enhancing lesions in the unilateral cerebral hemisphere, which was seen in 52% on CT and 44% on MR. Other non-specific findings included a solitary ring-like or irregular enhancing lesions, ill-defined low density lesions without enhancement, localized hemorrhage with or without enhancing lesions. In the group of chronic stage there were multiple calcifications of various shapes, most commonly 1-2cm sized round shape, and associated encephalomalacia. MR was superior to CT in detecting hemorrhage and in characterizing the central contents of ring-shaped calcifications, while it was inferior to CT in identifying small calcifications. Antibody levels of serum and CSF were positive in 86% and 82% in early active group, and in 48% and 31% in chronic sgage respectively. The positive rate was significantly different between the two groups (P=0.001). CT/MR findings were characteristic in only approximately half the cases in early active cerebral PW which can be cured by traziquantel therapy. Therefore, antibody test by ELISA is recommended as a complementary tool, particularly in patients with non-specific imaging findings.
Cerebrum ; Diagnosis* ; Encephalomalacia ; Enzyme-Linked Immunosorbent Assay* ; Hemorrhage ; Humans ; Paragonimiasis* ; Praziquantel ; Retrospective Studies ; Tomography, X-Ray Computed

BACKGROUND: Surgical endarterectomy had been known to be the standard treatment modality in management of carotid stenosis. However, endarterectomy had several limitations in high-risk patients, particulary with coronary artery disease. Carotid angioplasty and stenting has been suggested to be a safer and more cost-effective alternative to carotid endarterectomy in the management of symptomatic carotid artery disease. The purpose of this study is to evaluate the feasibility and safety of elective carotid artery stent implantation in patients with carotid artery stenosis. METHOD: We treated 19 patients with symptomatic and asymptomatic stenosis of >60% in 19 carotid arteries with balloon angioplasty followed by elective stent implantation. Of all carotid stenting procedures, 18 stents were implanted in obstructing atherosclerotic plaques and in one for Takayasu's arteritis. Of all patients, 10 patients were symptomatic with a history of stroke or transient ischemic attacks which were ipsilateral to the treated carotid artery. 12 patients represented a high-risk subset with myocardial infarction, previous coronary artery bypass graft and coronary artery stenosis. 6 months follow up angiogram was done in 7 patients, a patient(Takayasu's arteritis) showed restenosis. Result: Angiographic and procedural success rate were 100%, and there were no acute or subacute stent thrombosis. Immediately after initial carotid stenting, the mean(+/-SD) stenosis was reduced from 74.9+/-13.6% to 10.2+/-8.7% and the minimal luminal diameter was increased from 1.4+/-0.8mm to 5.3+/-1.0mm corresponding to an acute gain of 3.9mm. There were no major or minor stokes during follow-up. CONCLUSION: Percutaneous carotid angioplasty with stenting is a safe and feasible procedure. It is associated with high immediate success rates and relatively low complications in the management of carotid artery stenosis. Carotid stenting seems to be a reasonable alternatives to medical management for the treatment of carotid stenosis in patients deemed to be poor candidates for standard carotid endarterectomy.
Angioplasty ; Angioplasty, Balloon ; Carotid Arteries* ; Carotid Artery Diseases ; Carotid Stenosis* ; Constriction, Pathologic ; Coronary Artery Bypass ; Coronary Artery Disease ; Coronary Stenosis ; Endarterectomy ; Endarterectomy, Carotid ; Follow-Up Studies ; Humans ; Ischemic Attack, Transient ; Myocardial Infarction ; Phenobarbital ; Plaque, Atherosclerotic ; Stents* ; Stroke ; Takayasu Arteritis ; Thrombosis ; Transplants