Background : The incidence of anemia in the female athlete is high, and anemia causes not only a decrease in performance, but also various subjective symptoms. It is said that the cause of hemolysis -a type of anemia- is a decrease in antioxidants and an increase in the reactive oxygen species caused by exercise. Purpose : This study investigated the effect of acute exercise on hemolysis and oxidative stress in female athletes. Methods : On the basis of basal body temperature (BBT) data and urinary ovulation tests of the subjects (age 20.5±1.0 yr ), they were divided into two groups : eumenorrheic athletes (Eu, n=12) group, and irregular menstrual athletes (Am, n=9). The subjects performed an acute period of exhausting exercise on a bicycle ergometer. Lactate, hemoglobin, hematocrit, RBC, serum estradiol, haptoglobin, thiobarbituric acid reactive substances (TBARS) were determined in blood samples collected at rest and after exercise. Results : Lactate increased and hemoglobin, hematocrit, RBC, haptoglobin decreased after exercise in both the Eu and Am groups (p<0.05). However, serum TBARS did not show a significant change after exercise in both the Eu and Am groups. Conclusion : These results suggest that hemolysis may have developed, because haptoglobin decreased as a result of acute exercise. However, it is thought that the effect of oxidative stress is small because TBARS were not changed by acute exercise in both Eu and Am groups. In addition, there was no significant correlation between hemolysis and estrogen.

We compared the effects on clinical clerkships of an electronic medical record (EMR) system and a standard medical record system. Using an EMR system, students described medical records with a problem-oriented medical record system/subject objective assessment, and plan that was much better than the standard medical record system. In the EMR system, students cannot see physicians' medical records, including laboratory data and X-ray films. Instead, students themselves must obtain the patient history and request examinations as physicians do. This system helps supervisors give suitable comments and provide data that students have requested. Directors can also evaluate supervisors by reviewing their comments. Therefore, an EMR system has the advantage of problem-oriented medical record system-based learning for students and is also useful for clinical clerkships.

[Objective] The aim of this investigation was to evaluate bone metabolism responses to acute resistance exercise during the menstrual cycle. [Methods] Subjects were young healthy sedentary women (n=7) with regular menstrual cycles. The subjects performed acute resistance exercise in each phase (follicular and luteal) of the menstrual cycle. Bone metabolism markers (bone formation marker BAP and bone resorption marker ICTP), bone metabolism related hormones (parathyroid hormone, calcitonin, calcium and inorganic phosphorus) and lactate were determined. Blood samples were collected before (Pre) and immediately following the exercise (Post), 1 hour (P1h) and 24 hours (P24h) after the exercise. [Results] BAP significantly increased at Post compared with Pre both in the follicular and luteal phases (p<0.05), but significantly decreased at P1h and P24h in the luteal phase. ICTP significantly increased at Post in the follicular phase (p<0.05) and significantly decreased at P1h and P24h in the luteal phase. The bone metabolism responses in the luteal phase moved to low-bone turnover at P1h and P24h. [Conclusion] The bone metabolism response to acute resistance exercise was different between menstrual phases. These results suggest that bone metabolism is influenced by the menstrual cycle.

Behcet's disease is recognized as a systemic inflammatory disease of unknown etiology. The disease has a chronic course with periodic exacerbations and progressive deterioration. Previous reports have shown at least three major pathophysiologic changes in Behcet's disease; excessive functions of neutrophils, vasculitis with endothelial injuries, and autoimmune responses. Many reports suggested that immunological abnormalities and neutrophil hyperfunction may be involved in the etiology and the pathophysiology of this disease. HLA-B51 molecules by themselves may be responsible, in part, for neutrophil hyperfunction in Behcet's disease. T cells in this disease proliferated vigorously in response to a specific peptide of human heat shock protein (hsp) 60 in an antigen-specific fashion. T cells reactive with self-peptides produced Th1-like proinflammatory and/or inflammatory cytokines. This leads to tissue injury, possibly via delayed-type hypersensitivity reaction, macrophage activation, and activation and/or recruitment of neutrophils. These data shed new light on the autoimmune nature of Behcet's disease; molecular mimicry mechanisms may induce and/or exacerbate Behcet's disease by bacterial antigens that have activated T cells which are reactive with self-peptide(s) of hsp. This would lead to positive selection of autoreactive T cells in this disease.
Behcet's Syndrome/pathology ; Behcet's Syndrome/immunology* ; Behcet's Syndrome/etiology ; Chaperonin 60/immunology ; Eye/pathology ; Human ; Neutrophils/physiology ; Skin/pathology ; T-Lymphocytes/physiology

Problem-based learning (PBL) tutorials were introduced at our university in April 2001. Because a complete PBLbased curriculum could not be adopted, a transitional curriculum incorporating 3-hour PBL tutorial sessions into the traditional curriculum was introduced. More than 80% of students agreed that PBL is an effective way of learning problem solving at the bedside. Twenty percent to 40% of teachers felt that students who took PBL were more motivated for bedside learning and self-directed learning and had better at presentation than were students who did not take PBL. Because of 80% of the curriculum comprised didactic lectures, most students considered PBL tutorials a type of lecture. For this reason, motivating students to learn additional material originating from PBL tutorials was difficult. Although the combination of a traditional curriculum and PBL tutorials may appear to be a new curriculum, this type of PBL has limited value as a method for studying problem solving.

A prospective case–control study was conducted in urban districts in Hanoi, northern Vietnam to evaluate the effect of migration on the risk of hospitalisation for dengue in a Vietnamese urban population. We enrolled laboratory-confirmed dengue patients aged >18 years who were hospitalised in local hospitals in November and December 2010. Four neighbourhood-matched controls for each case were recruited within a week of hospitalisation. Sociodemographic data were collected by interviews, and the number of immature and adult mosquitoes within household premises was counted by entomological survey. Matched-pair analyses were conducted using conditional logistic regression models. Among 43 cases and 168 controls, 84% and 83% were migrants from rural areas, respectively. Although statistical significance was marginal, recent migration (residing in study area for <5 years) independently increased the risk of hospitalisation for dengue compared with inhabitants after controlling for potential confounders (adjusted odds ratio [aOR] = 3.78; 95% confidence interval [CI] = 0.99–14.27), whereas longer-term migration (residing in study area for >6 years) did not change the risk (aOR = 1.1; 95% CI = 0.30–4.05). Younger age (18–34 years) (aOR = 7.26; 95% CI = 2.39–22.06) and higher adult Aedes aegypti infestation level within household premises (aOR = 9.25; 95% CI = 1.68–51.09) were also independently associated with hospitalisation for dengue. Recent migration from rural areas seems to increase the risk of hospitalisation for dengue in urban populations in endemic areas. Further research including cohort study should be done to confirm the impact of migration on the risk of dengue in urban areas.

BACKGROUND: Synovial chondromatosis occurs rarely in the shoulder, and its details remain unclear. The purpose of this study was to clarify the clinical results of surgical resection and the histopathological findings of synovial chondromatosis in the shoulder. METHODS: Ten shoulders with synovial chondromatosis that had been operatively resected were reviewed retrospectively. Osteochondral lesions were present in the glenohumeral joint in six shoulders and in the subacromial space in four shoulders. Two patients had a history of trauma with glenohumeral dislocation without recurrent instability, and the other seven patients (eight shoulders) did not have any traumatic episodes or past illness involving the ipsilateral shoulder girdle. The occurrences of osteochondral lesions, inferior humeral osteophytes, and acromial spurs were assessed on radiographs before resection, just after resection, and at final follow-up. The Constant scores were compared before resection and at final follow-up with Wilcoxon signed-rank tests. Resected lesions were histopathologically differentiated between primary and secondary synovial chondromatosis. RESULTS: Inferior humeral osteophytes were found in five shoulders with synovial chondromatosis in the glenohumeral joint, and all four shoulders with synovial chondromatosis in the subacromial space had acromial spur formation. Osteochondral lesions appeared to have been successfully removed in all shoulders on postoperative radiographs. At the final follow-up, however, one shoulder with secondary synovial chondromatosis in the subacromial space showed recurrence of osteochondral lesions and acromial spur formation. The mean Constant score improved significantly from 53.0 points before resection to 76.0 points at a mean follow-up of 6.0 years (p = 0.002). On histopathological evaluation, one shoulder was diagnosed as having primary synovial chondromatosis, while nine shoulders had secondary synovial chondromatosis. CONCLUSIONS The present study showed that resection of shoulder osteochondral lesions successfully relieved the clinical symptoms and that primary synovial chondromatosis is less common than secondary synovial chondromatosis in the shoulder. Although most of the present osteochondral lesions were clinically determined to be primary chondromatosis, only one case was histopathologically categorized as primary synovial chondromatosis. These results suggest that histopathological identification is needed to differentiate between primary and secondary synovial chondromatosis.