PURPOSE: This study was planned to evaluate that a lecture employing medical drama could motivate students to have an interest in the professionalism of healthcare personnel, which has currently become a critical subject in the field of medical education. METHODS: We analyzed subject headings, learning objectives, and further plans developed by students and their responses after two drama modules, 'car crash' and 'refusal of instruction', which were selected based on the conditions made by our faculty members, were given through video or paper to our 121 second-grade medical and nursing students in year 2012. RESULTS: Meaningful subject headings and learning objectives developed by students were 58.2%~60.0% and 36.8%~38.0% and significantly more in the 'refusal of instruction' than the 'car crash' (p=0.000). According to the students' major, medical students developed significantly more than nursing students (p=0.000). In the analysis of responses, 91.7% of students reported as impressive to the educational modules and 55.3% of them described their ideas associated with healthcare professionalism. CONCLUSION: Our study results suggest a possibility that the educational module employing selected medical drama could motivate students' healthcare professionalism.
Delivery of Health Care* ; Drama* ; Humans ; Learning ; Students, Medical ; Students, Nursing ; Subject Headings

Glatiramer acetate (GA; Copaxone) has been shown to be effective in preventing and suppressing experimental autoimmune encephalomyelitis (EAE), the animal model of multiple sclerosis (MS). It has been recently shown that GA-reactive T cells migrate through the blood-brain barrier, accumulate in the central nervous system (CNS), secrete antiinflammatory cytokines and suppress production of proinflammatory cytokines of EAE and MS. Development of EAE requires coordinated expression of a number of genes involved in the activation and effector functions of inflammatory cells. Activation of inflammatory cells is regulated at the transcriptional level by several families of transcription factors. One of these is the nuclear factor kappa B (NFkappaB) family which is present in a variety of cell types and involved in the activation of immune-relative genes during inflammatory process. Since it is highly activated at site of inflammation, NFkappaB activation is also implicated in the pathogenesis of EAE. In this study, we examined whether the inhibition of NFkappaB activation induced by GA can have suppressive therapeutic effects in EAE mice. We observed the expression of NFkappaB and phospho-IkappaB proteins increased in GA-treated EAE mice compared to EAE control groups. The immunoreactivity in inflammatory cells and glial cells of NFkappaB and phospho-IkappaB significantly decreased at the GA-treated EAE mice. These results suggest that treatment of GA in EAE inhibits the activation of NFkappaB and phophorylation of IkappaB in the CNS. Subsequently, the inhibition of NFkappaB activation and IkappaB phosphorylation leads to the anti-inflammatory effects thereby to reduce the progression and severity of EAE.
Animals ; Blood-Brain Barrier ; Central Nervous System ; Cytokines ; Encephalomyelitis, Autoimmune, Experimental ; Humans ; Inflammation ; Mice ; Models, Animal ; Multiple Sclerosis ; Neuroglia ; NF-kappa B ; Peptides ; Phosphorylation ; Proteins ; T-Lymphocytes ; Transcription Factors

We report the case of a 43-year-old male with both giant left atrial appendage (LAA) aneurysm and drug-refractory atrial fibrillation (AF). The patient was treated with percutaneous electrical isolation of cardiac arrhythmogenic substrate, and has been free of AF symptom over one year. Although the surgical resection of giant LAA aneurysm is mostly used to prevent systemic thromboembolism, we have performed follow-up of the giant LAA aneurysm using cardiac magnetic resonance (CMR) imaging and transesophageal echocardiography (TEE) after the successful catheter ablation of refractory AF. At one-year follow-up CMR, the giant LAA aneurysm showed remarkable enlargement as well as decreased contractility. Additionally, one-year follow-up TEE showed spontaneous echo contrast as an indicator of blood stasis in the giant LAA aneurysm. Those findings of giant LAA aneurysm suggest that the risk of thromboembolism may be high despite termination of AF.
Adult ; Aneurysm* ; Atrial Appendage* ; Atrial Fibrillation* ; Catheter Ablation* ; Catheters* ; Echocardiography ; Echocardiography, Transesophageal ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Male ; Thromboembolism

PURPOSE: Duchenne/Becker muscular dystrophy (DMD/BMD) is an X-linked recessive disease caused by the mutation of dystrophin gene. Since the majority of mutations are deletions, recent diagnosis is made by the moleculargenetic tools. The authors summarized the clinical characteristics, and analyzed the moleculargenetic and immunohistochemical characteristics of DMD/BMD. METHODS: We reviewed the clinical and laboratory findings of 69 patients diagnosed as DMD/BMD from 1989 to 2000. Multiplex PCR using 26 primer sets was performed on 34 cases, and immunohistochemical staining using dystrophin antibody was done on 5 cases. Mutation profile and phenotype-genotype relationship were analyzed. RESULTS: 1) Mean age of onset was 3 years and 6 months. The presenting symptoms were motor weakness of the lower extremities, incidentally found elevated hepatic enzyme level, abnormal gait and motor developmental delay. Forty one percent had history of motor developmental delay, and most patients showed pseudohypertrophic calf muscles. Mean serum creatine kinase level was 11,232IU/L, and 44% revealed abnormal electrocardiogram. 2) All of the 63 cases showed typical histological findings of muscular dystrophy. Of the 5 cases with immunohistochemical staining, 2 showed complete (DYS1, 2 and 3) and 3 showed partial (DYS3) absence pattern. 3) Of the 34 cases on which multiplex PCR was performed, 14 showed deletions, and 11 of them had deletions between exon 44 and 55. CONCLUSION: Since the deletions were detected in less than 50% of the patients with multiplex PCR, tools for dystrophin protein expression must be combined for the correct diagnosis. Considering the invasiveness of muscle biopsy, we conclude immunohistochemistry should be followed in the cases with negative results in multiplex PCR, although moleculargenetic study is the primary diagnostic tool.
Age of Onset ; Biopsy ; Creatine Kinase ; Diagnosis* ; Dystrophin ; Electrocardiography ; Exons ; Gait ; Humans ; Immunohistochemistry ; Lower Extremity ; Multiplex Polymerase Chain Reaction ; Muscles ; Muscular Dystrophies* ; Polymerase Chain Reaction

We investigated the inhibitory effects of hesperidin on melanogenesis. To find melanosome transport inhibitor from natural products, we collected the structural information of natural products from Korea Food and Drug Administration (KFDA) and performed pharmacophore-based in silico screening for Rab27A and melanophilin (MLPH). Hesperidin did not inhibit melanin production in B16F10 murine melanoma cells stimulated with alpha-melanocyte stimulating hormone (alpha-MSH), and also did not affect the catalytic activity of tyrosinase. But, hesperidin inhibited melanosome transport in melanocyte and showed skin lightening effect in pigmented reconstructed epidermis model. Therefore, we suggest that hesperidin is a useful inhibitor of melanosome transport and it might be applied to whitening agent.
Biological Agents ; Computer Simulation ; Epidermis ; Hesperidin* ; Korea ; Mass Screening ; Melanins ; Melanocytes ; Melanoma ; Melanosomes* ; Monophenol Monooxygenase ; Skin ; United States Food and Drug Administration

Experimental autoimmune encephalomyelitis (EAE) is an inflammatory disease in the murine central nervous system (CNS) and has long been used as an animal model for human multiple sclerosis. Development of EAE requires coordinated expression of a number of genes that are involved in the activation and effector functions of inflammatory cells. Galectin-3 (Gal-3) is a member of the beta-galactoside-binding lectin family and plays an important role in inflammatory responses through its functions on cell activation, cell migration or inhibition of apoptosis. We investigated the functional role of Gal-3 in EAE mice following immunization with myelin oligodendrocyte glycoprotein (MOG)35-55 peptide. During the peak stage of EAE, the localization of Gal-3 in inflammatory cells markedly increased in subarachnoid membranes and perivascular regions of CNS. In contrast, Gal-3 was weakly detected in cerebrum and spinal of the recovery stage of EAE. Consistent with this finding, western blot analysis revealed that Gal-3 expression was significantly increased at the peak stage while it was slightly decreased at the recovery stage in the CNS. In addition, the population of CD11b+ macrophage expressing Gal-3 in spleen of EAE mice was markedly increased compared with control mice. In fact, most of activated macrophages isolated from spleen of EAE mice expressed Gal-3. Taken together, our results demonstrate that the over-expression of Gal-3 in activated macrophages may play a key role in promoting inflammatory cells in the CNS during EAE.
Animals ; Apoptosis ; Blotting, Western ; Cell Movement ; Central Nervous System ; Cerebrum ; Encephalomyelitis, Autoimmune, Experimental ; Galectin 3 ; Humans ; Immunization ; Macrophages ; Membranes ; Mice ; Models, Animal ; Multiple Sclerosis ; Myelin-Oligodendrocyte Glycoprotein ; Spleen

Fucoidan is a sulfated polysaccharide purified from brown algae including Fucus vesiculosus and has a variety of biological effects including mobilization of hematopoietic progenitor cells. Recently, we demonstrated that fucoidan stimulates the antigen-presenting functions of dendritic cells. In this study, we investigated the radioprotective effects of fucoidan on bone marrow cells (BMCs), which are the main cellular reservoir for the hematopoietic and immune system. To evaluate the effects of fucoidan, we assayed cell viability and immune responses. In a viability assay, fucoidan significantly increased the viability of BMCs. Based on the results of flow cytometric analysis, the increased viability of fucoidan-treated BMCs was attributed to the inhibition of radiation-induced apoptosis. Furthermore, fucoidan altered the production of immune-related cytokines from BMCs and increased the capability of BMCs to induce proliferation of allogeneic splenocytes. Taken together, our study demonstrated that fucoidan has radioprotective effects on BMCs with respect to cell viability and immunoreactivity. These results may provide valuable information, useful in the field of radiotherapy.
Animals ; Bone Marrow Cells/*drug effects/*radiation effects ; Cell Death/drug effects/radiation effects ; Cell Proliferation ; Cell Survival/drug effects ; Cells, Cultured ; Female ; Gamma Rays/*adverse effects ; Mice ; Mice, Inbred BALB C ; Mice, Inbred C57BL ; Polysaccharides/*pharmacology ; Radiation-Protective Agents/*pharmacology ; Spleen/cytology

PURPOSE: The aim of this study was to investigate the clinicopathologic features of and the prognosis for colorectal cancers (CRCs) with microsatellite instabilities (MSIs). METHODS: Between 2006 and 2009, genotyping was performed on 245 patients with stage II/III CRCs to establish the MSI status. The clinicopathologic differences and the prognostic value of MSI were analyzed. The median follow-up period was 38 months (range, 7-68 months). RESULTS: Of the total 245 patients, 20 (8.2%) had MSI-high (H) and 225 (91.8%) had MSI-low (L) or stable (S) CRCs. Adjuvant chemotherapies were performed on 101 stage II (87.8%) and 107 stage III patients (82.3%). Patients with MSI-H CRCs more frequently had a family history of colon cancer (10% vs. 2.7%, P = 0.003), more frequently had a cancer located at the proximal colon (90.0% vs. 19.1%, P < 0.0001), and more often showed a mucinous phenotype or poor differentiation (35.0% vs. 7.1%, P = 0.001). Despite less frequent lymph node metastasis (25% vs. 55.6%, P = 0.01), the number of retrieved lymph nodes was higher (26.3 +/- 13.1 vs. 20.7 +/- 1.2, P = 0.04) in the MSI-H group. The overall survival and the disease-free survival (DFS) did not differ with respect to MSI status. However, in the stage II subgroup, the DFS for patients with MSI-H CRCs was significantly worse (72.2% vs. 90.7%, P = 0.03). The multivariate analysis performed on this subgroup revealed that MSI-H was an independent poor prognostic factor (adjusted hazard ratio, 4.0; 95% confidence interval, 1.0-15.6, P = 0.046). CONCLUSION: MSI-H CRCs had distinct clinicopathologic features, and MSI-H was an independent poor prognostic factor in stage II CRCs. Considering the majority of stage II patients were administrated adjuvant chemotherapy, the efficacy of adjuvant chemotherapy for treating MSI CRCs might be different from that for treating MSI-L/S tumors.
Chemotherapy, Adjuvant ; Colon ; Colonic Neoplasms ; Colorectal Neoplasms* ; Disease-Free Survival ; Drug Therapy ; Follow-Up Studies ; Humans ; Lymph Nodes ; Microsatellite Instability* ; Microsatellite Repeats* ; Mucins ; Multivariate Analysis ; Neoplasm Metastasis ; Phenotype ; Prognosis

Fever of unknown origin (FUO) means fever that does not resolve spontaneously in the period expected for self-limited infection and whose cause cannot be ascertained despite considerable diagnostic efforts. We experienced a case of FUO associated with systemic vasculitis, which was diagnosed with clinical manifestation, radiographic findings, the presence of anti-neutrophil cytoplasmic antibody (ANCA), and renal biopsy. A 54-year-old female was admitted to our hospital with remittent fever of 3 months. A paranasal sinus (PNS) view revealed maxillary and ethmoidal sinusitis, and urine analysis showed microscopic hematuria. We performed a renal biopsy on the basis of positive ANCA and microscopic hematuria. The renal biopsy showed pauci-immune crescentic glomerulonephritis without granuloma, interstitial inflammation, and small vessel vasculitis. Under the diagnosis of ANCA-associated systemic vasculitis, she was treated with steroid and cyclophosphamide. She showed marked clinical improvement.
Antibodies, Antineutrophil Cytoplasmic ; Biopsy ; Cyclophosphamide ; Diagnosis ; Ethmoid Sinusitis ; Female ; Fever of Unknown Origin* ; Fever* ; Glomerulonephritis ; Granuloma ; Hematuria ; Humans ; Inflammation ; Malaria ; Middle Aged ; Systemic Vasculitis* ; Vasculitis

Fever of unknown origin (FUO) means fever that does not resolve spontaneously in the period expected for self-limited infection and whose cause cannot be ascertained despite considerable diagnostic efforts. We experienced a case of FUO associated with systemic vasculitis, which was diagnosed with clinical manifestation, radiographic findings, the presence of anti-neutrophil cytoplasmic antibody (ANCA), and renal biopsy. A 54-year-old female was admitted to our hospital with remittent fever of 3 months. A paranasal sinus (PNS) view revealed maxillary and ethmoidal sinusitis, and urine analysis showed microscopic hematuria. We performed a renal biopsy on the basis of positive ANCA and microscopic hematuria. The renal biopsy showed pauci-immune crescentic glomerulonephritis without granuloma, interstitial inflammation, and small vessel vasculitis. Under the diagnosis of ANCA-associated systemic vasculitis, she was treated with steroid and cyclophosphamide. She showed marked clinical improvement.
Antibodies, Antineutrophil Cytoplasmic ; Biopsy ; Cyclophosphamide ; Diagnosis ; Ethmoid Sinusitis ; Female ; Fever of Unknown Origin* ; Fever* ; Glomerulonephritis ; Granuloma ; Hematuria ; Humans ; Inflammation ; Malaria ; Middle Aged ; Systemic Vasculitis* ; Vasculitis