Recently, there is a growing concern for loss of iron among repeat blood donors. We evaluated the effects of blood donation to iron deficiency in several studies and propose following measures to prevent iron depletion among repeat blood donors. We reviewed and analyzed comprehensively results of several domestic and foreign studies and cited Korean blood donor's statistics data. There is a high prevalence of iron depletion in repeat blood donors. Predictors of iron depletion (serum ferritin <12~15 ng/mL) included a high frequency of blood donation, short donation interval, and female gender regardless of blood donation type. Taking iron supplements reduced the risk of iron depletion for repeat blood donors. We would like to propose the following preventive measures for repeat blood donors. 1) Test for serum ferritin for repeat donors who donate at least three times per year. If the donors show low serum ferritin level which is below 15 ng/mL, 2) Increase the donation interval or limit of blood donation frequency and 3) Recommend iron supplement for a certain period.
Anemia, Iron-Deficiency ; Blood Donors ; Female ; Ferritins ; Humans ; Iron ; Prevalence ; Tissue Donors

PURPOSE: To evaluate outcome and morbidity in patients with vulvar cancer treated with radiotherapy, concurrent chemoradiotherapy or postoperative radiotherapy. MATERIALS AND METHODS: The records of 24 patients treated with radiotherapy for vulvar cancer between July 1993 and September 2009 were retrospectively reviewed. All patients received once daily 1.8-4 Gy fractions external beam radiotherapy to median 51.2 Gy (range, 19.8 to 81.6 Gy) on pelvis and inguinal nodes. Seven patients were treated with primary concurrent chemoradiotherapy, one patient was treated with primary radiotherapy alone, four patients received palliative radiotherapy, and twelve patients were treated with postoperative radiotherapy. RESULTS: Twenty patients were eligible for response evaluation. Response rate was 55% (11/20). The 5-year disease free survival was 42.2% and 5-year overall survival was 46.2%, respectively. Fifty percent (12/24) experienced with acute skin complications of grade III or more during radiotherapy. Late complications were found in 8 patients. 50% (6/12) of patients treated with lymph node dissection experienced severe late complications. One patient died of sepsis from lymphedema. However, only 16.6% (2/12) of patients treated with primary radiotherapy developed late complications. CONCLUSION: Outcome of patients with vulvar cancer treated with radiotherapy showed relatively good local control and low recurrence. Severe late toxicities remained higher in patients treated with both node dissection and radiotherapy.
Carcinoma, Squamous Cell ; Chemoradiotherapy ; Disease-Free Survival ; Humans ; Lymph Node Excision ; Lymphedema ; Pelvis ; Recurrence ; Retrospective Studies ; Sepsis ; Skin ; Treatment Outcome ; Vulvar Neoplasms

Amnesic patients who have damage in the hippocampus and in associated areas in the medial temporal lobe suffer from remembering specific events that may or may not share similar objects and locations. Computational models, behavioral studies, and physiological findings all suggest that neural circuits in the hippocampus are suitable for representing seemingly similar events as distinctively different individual event memories. This article offers a selective review on this particular function of the hippocampus and its associates areas such as the perirhinal cortex, mostly centering upon lesion studies and physiological studies using animals. We also present recent experimental results showing that the dentate gyrus subfield of the hippocampus and perirhinal cortex are particularly important for discriminating similar paired associates between same objects and different locations, or vice versa.
Animals ; Brain ; Dentate Gyrus ; Hippocampus ; Humans ; Temporal Lobe

BACKGROUND: Resistance to epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs), such as gefitinib, is a limited factor in the treatment of non-small-cell lung cancer (NSCLC) patients. Therefore, ongoing studies are trying to identify EGFR-TKIs-resistant mechanisms and to discover novel therapeutic strategies and targets for NSCLC treatment.METHODS: In the present study, the possibility of overcoming intrinsic gefitinib-resistance was examined by regulating the expression of AXL. A natural product-derived antitumor agent, yuanhuadine (YD) was employed to modulate the expression of AXL in the cells.RESULTS: Treatment with YD effectively downregulated AXL expression in AXL-overexpressed gefitinib-resistant H1299 cells. The combination of gefitinib and YD exhibited a synergistic grwoth-inhibitory activity in H1299 cells by downregulation of AXL expression.CONCLUSIONS: Based on these findings, AXL was found to be a promising therapeutic target to overcome the intrinsic resistance to gefitinib in NSCLC. Furthermore, YD is able to effectively regulate the expression of AXL and thus it may be applicable as a potential lead compound for the treatment of gefitinib-resistant NSCLC.
Carcinoma, Non-Small-Cell Lung ; Down-Regulation ; Drug Resistance ; Humans ; Lung Neoplasms ; Protein-Tyrosine Kinases ; Receptor, Epidermal Growth Factor

Objective: To analyze the effects of lymphovenous anastomosis (LVA) surgery after 1 year using the elastic index (EI) and volume. Methods: This study was a retrospective study of 41 patients, with lymphedema, who underwent LVA surgery between July 2018 and June 2020. Limb circumference, used to determine the volume of the limb with lymphedema, and EI, which reflects tissue stiffness and measured using ultrasonography were measured for each patient before and 1 year after LVA surgery. To examine the effect of LVA, differences in the preoperative and 1-year postoperative volumes and EIs were analyzed using the Wilcoxon signed-rank test. Results: The mean volume and EI of the dominant site in upper-extremity lymphedema were 2,309.4 cm3 and 1.4, respectively, preoperatively and 2,237.1 cm3 and 0.9, respectively, at 1 year postoperatively. The mean volume and EI difference of the dominant site 1 year after surgery was -16.6 cm3 (p=0.22) and -0.5 (p<0.001). The mean volume and EI of dominant site in lower-extremity lymphedema were 6,137.0 cm3 and 1.2, respectively, preoperatively, and 5,832.6 cm3 and 1.1, respectively, at 1 year postoperatively. The mean volume and EI difference of the dominant site 1 year postoperatively were -320.9 cm3 (p=0.04) and -0.2 (p=0.09), respectively. Conclusion LVA surgery is more effective in reducing pressure than in reducing volume, which may be helpful in preventing the progression of lymphedema.

Purpose: The aim of this study was to evaluate the feasibility and satisfaction of an online global health education course for medical students in comparison with an in-person of the course and to assess students’ preferences regarding online methods of delivery. Methods: Second-year medical students enrolled in this course in 2019 (in-person) and 2020 (online). The attendance rate, satisfaction in the course evaluation survey, and academic achievement on the written final examination were utilized to compare the two different methods of course delivery. The medical students who took the online course were also asked about their preferences regarding the method of course delivery and the advantages and drawbacks of each method of online lectures. Results: There was no significant difference in the attendance rate and overall satisfaction between the two groups. The mean score on the written examination of the online course (84.1±19.6) showed comparable effects to the in-person course (78.0±18.3). The percentages of students who achieved high performance (55.5%) and the achieved minimum requirement (95.9%) were also maintained compared to the in-person course (14.6% and 93.6%, respectively). Medical students preferred the online course to the in-person course; in particular, they preferred prerecorded videos over live streaming online lectures. Conclusion The participation, satisfaction, and the academic achievement of the online course were comparable to those of the in-person course. However, the greatest drawback of the online course was the lack of interaction between peer learners. Therefore, diverse methods for online education should be considered to increase students’ sense of belonging to a learning community.

Purpose: The aim of this study was to evaluate the feasibility and satisfaction of an online global health education course for medical students in comparison with an in-person of the course and to assess students’ preferences regarding online methods of delivery. Methods: Second-year medical students enrolled in this course in 2019 (in-person) and 2020 (online). The attendance rate, satisfaction in the course evaluation survey, and academic achievement on the written final examination were utilized to compare the two different methods of course delivery. The medical students who took the online course were also asked about their preferences regarding the method of course delivery and the advantages and drawbacks of each method of online lectures. Results: There was no significant difference in the attendance rate and overall satisfaction between the two groups. The mean score on the written examination of the online course (84.1±19.6) showed comparable effects to the in-person course (78.0±18.3). The percentages of students who achieved high performance (55.5%) and the achieved minimum requirement (95.9%) were also maintained compared to the in-person course (14.6% and 93.6%, respectively). Medical students preferred the online course to the in-person course; in particular, they preferred prerecorded videos over live streaming online lectures. Conclusion The participation, satisfaction, and the academic achievement of the online course were comparable to those of the in-person course. However, the greatest drawback of the online course was the lack of interaction between peer learners. Therefore, diverse methods for online education should be considered to increase students’ sense of belonging to a learning community.

Primary liver tumor, especially hepatocellular carcinoma (HCC), is a common cause of cancer death worldwide. The incidence is generally higher in Asian countries than in western countries. Carcinogenesis of HCC is often associated with hepatitis viral infections. Current standard treatment of HCC is surgical resection or transplantation in patients with early stage disease. However, the patient with advanced stage disease, surgical resection is often limited. Sorafenib or other treatment modalities are not so effective as well. We report a case of unusual radiation super-sensitivity in advanced stage HCC, and review the literature.
Asian Continental Ancestry Group ; Carcinogenesis ; Carcinoma, Hepatocellular ; Hepatitis ; Humans ; Incidence ; Liver ; Radiotherapy

BACKGROUND: We analyzed the prevalence of anti-tuberculosis drug resistance in Mycobacterium tuberculosis isolates from respiratory specimens of patients with newly diagnosed and previously treated tuberculosis. METHODS: From February 2010 to July 2010, a total of 542 M. tuberculosis clinical isolates were collected from pulmonary tuberculosis patients in six university hospitals distributed throughout Korea. We analyzed the results of anti-tuberculosis drug resistance tests according to treatment history and geographic location. RESULTS: Among the 542 isolates, 473 (87.3%) were from newly diagnosed cases and 69 (12.7%) were from previously treated cases. The rates of multi-drug resistance (MDR), fluoroquinolone (ofloxacin, levofloxacin, and moxifloxacin) resistance, and extensive drug resistance (XDR) were 3.8%, 1.1-1.5%, and 0%, respectively, in new cases, and 21.7%, 13.0-17.4%, and 4.3%, respectively, in previously treated cases. In the previously treated cases, the proportions of XDR-TB in MDR-TB were 20% (3/15). The resistance rates were variable according to geographic location. CONCLUSION: As the anti-tuberculosis drug resistance rates are much higher in newly diagnosed cases than in previously treated patients, efforts should be made to ensure that tuberculosis treatment is successful. In addition, before the selection of an anti-tuberculosis drug treatment for previously treated patients, the susceptibility test results, including to fluoroquinolone, should be verified.
Dietary Sucrose ; Drug Resistance ; Drug Resistance, Multiple ; Extensively Drug-Resistant Tuberculosis ; Hospitals, University ; Humans ; Korea ; Mycobacterium ; Mycobacterium tuberculosis ; Ofloxacin ; Prevalence ; Tuberculosis ; Tuberculosis, Pulmonary

BACKGROUND: We evaluated the performance of the AdvanSure MDR-TB GenoBlot Assay kit (AdvanSure MDR-TB, LG Life Science, Korea) to detect mutations related to rifampin (RFP)- and isoniazid (INH)-resistant Mycobacterium tuberculosis complex in respiratory specimens. METHODS: From February 2010 to June 2010, a total of 542 M. tuberculosis clinical isolates were collected from pulmonary tuberculosis patients in six university hospitals across Korea. We analyzed the conventional drug susceptibility testing (DST) and compared the results with those of the AdvanSure MDR-TB. RESULTS: Compared with the conventional DST, the overall agreement rates, sensitivity, and specificity were 98.2% (532/542), 84.6% (33/39), and 99.2% (499/503), respectively, for RFP resistance and 96.1% (521/542), 79.7% (59/74), 98.7% (462/468), respectively, for INH resistance. The three common rpoB mutations were rpoB S531L (53.8%), rpoB D516V (15.4%) and rpoB H526R (7.7%) in RFP-resistant strains. For INH resistance, the katG S315T mutation (58.1%) was the most common, followed by inhA C-15T (23.0%) and katG S315N (4.1%). CONCLUSION: The AdvanSure MDR-TB showed high concordance with the conventional DST and would be helpful for early detection of RFP and INH resistance, although it requires improved sensitivity.
Biological Science Disciplines ; Hospitals, University ; Humans ; Isoniazid ; Korea ; Mycobacterium ; Mycobacterium tuberculosis ; Rifampin ; Sensitivity and Specificity ; Tuberculosis ; Tuberculosis, Pulmonary