The Dr. LEE Jong-wook—Seoul Project (DLSP) in the Lao People'0s Democratic Republic (PDR) is a long-term development cooperation initiative aimed at upgrading the medical education capacity at the University of Health Sciences (UHS) in the Lao PDR. Under the project, eight faculty members from UHS were trained at the Seoul National University College of Medicine for a 12-month period during 2010–2011. Using a training-of-trainers model, we estimated the effect of DLSP on the learning outcomes of students, which was measured using the standard test scores of the students. The questionnaire developed by the Medical Education Assessment Consortium in Korea was given to the students and both the percent-correct and standardized scores were examined. The evaluation strategy was to compare the learning outcomes of the students taught by the trainees with those that were not and to compare the medical topics taught by the trainees with other topics. It was found that the first group of trainees in the DLSP was associated with an increase of 1.5 in the percent-correct test scores for basic medicine. While the interpretation requires caution, it is consistent with the view that a training program for faculty members could be effective in improving the teaching capacity of medical schools in developing countries.
Developing Countries ; Education ; Education, Medical ; Educational Measurement ; Humans ; Korea ; Laos ; Learning ; Schools, Medical ; Seoul ; Students, Medical

Borderline ovarian tumors (BOTs) represent about 15% to 20% of all ovarian malignancies and differ from invasive ovarian cancers (IOCs) by many characters. Historically, standard management of BOT is peritoneal washing cytology, hysterectomy, bilateral salpingo-oophorectomy, omentectomy, complete peritoneal resection of macroscopic lesions; in case of mucinous BOTs, appendectomy should be performed. Because BOTs are often diagnosed at earlier stage, in younger age women and have better prognosis, higher survival rate than IOCs, fertility-sparing surgery is one of the option to preserve childbearing capacity. The study of such conservative surgery is being released, and still controversial. After surgery, pregnancy and ovarian induction followed by in vitro fertilization are also significant issues. In surgery, laparoscopic technique can be used by a gynecologic oncology surgeon. So far postoperative chemotherapy, radiotherapy and hormone therapy are not recommended. We will discuss controversial issues of BOTs on this review and present the outline of the management of BOTs.
Biopsy ; Chemotherapy, Adjuvant ; Female ; Humans ; Infertility, Female/prevention & control ; Intraoperative Care/methods ; Laparoscopy/methods ; Laparotomy/methods ; Neoplasm Recurrence, Local/therapy ; Neoplasm Staging ; Organ Sparing Treatments/methods ; Ovarian Neoplasms/pathology/*therapy ; Ovary/*pathology ; Precancerous Conditions/pathology/therapy

BACKGROUND: The prevalence of metabolic syndrome (MetS) has risen rapidly worldwide, including in South Korea. Factors related to lifestyle are closely associated with the development of MetS. The aim of this study was to investigate the association between MetS and a number of factors positively influencing health, namely non-smoking, low-risk drinking, sufficient sleep, regular exercise, and the habit of reading food labels, among Korean men. METHODS: This cross-sectional study included 3,869 men from the 2007–2009 Korean National Health and Nutrition Examination Survey. Information on five factors positively influencing their health was obtained using a self-reported questionnaire. We categorized subjects into four groups, depending on the number of positive factors reported (group I, 0–1 factor; group II, 2 factors; group III, 3 factors; group IV, 4–5 factors). RESULTS: Men who reported a greater number of positive health factors had better laboratory and anthropometric values than men who reported fewer positive health factors. The prevalence of MetS was 29.1, 27.2, 20.7, and 14.6% in groups I to IV, respectively. Compared to group I, odds ratios (95% confidence intervals) for MetS were 0.96 (0.78–1.19) in group II, 0.67 (0.52–0.87) in group III, and 0.52 (0.35–0.76) in group IV, after adjusting for confounding factors. Odds ratios for abdominal obesity, glucose intolerance, and hypertriglyceridemia were statistically significant. CONCLUSION: A greater number of positive lifestyle factors influencing health were associated with a lower risk of developing MetS, in a nationally representative sample of Korean men.
Alcohol Drinking ; Cross-Sectional Studies ; Drinking ; Glucose Intolerance ; Humans ; Hypertriglyceridemia ; Korea ; Life Style ; Male ; Metabolic Syndrome X ; Nutrition Surveys* ; Obesity, Abdominal ; Odds Ratio ; Prevalence ; Smoking

Anticoccidial effects of the Plantago asiatica extract (PAE) were evaluated in chickens following oral infection with Eimeria (E.) tenella. This study was conducted on the 3-day-old chickens (n=30). Those animals were divided with 3 groups; PAE 0.1% treated/infected (n=10), PAE untreated/infected (n=10) and non-infected control (n=10). Chickens were fed a standard diet supplemented with or without PAE for 1 week prior to infection with E. tenella (10,000 sporulated oocysts per chicken). The effects of PAE on E. tenella infection were assessed by two parameters; fecal oocysts shedding and body weights gain. The PAE-fed chickens produced significantly reduced fecal oocysts (P<0.05) when compared to the E. tenella-infected group fed standard diet. Also, PAE-based diet, improved body weight loss caused by E. tenella infection. Our data demonstrated that PAE had remarkable anticoccidial activities against E. tenella. This finding might have implications for the development of anticoccidial drug. This study is the first to demonstrate anticoccidial effect of PAE on Eimeria parasites.
Animals ; Body Weight ; Chickens ; Diet ; Eimeria tenella* ; Eimeria* ; Oocysts ; Parasites ; Plantago*

OBJECTIVE: To present our experience with laparoscopic tube-preserving surgery for ectopic tubal pregnancy and evaluate its feasibility and efficacy. METHODS: This was a prospective study of 57 consecutive patients with ectopic tubal pregnancies undergoing laparoscopic tube-preserving procedures including salpingotomy, salpingostomy, segmental resection and reanastomosis, and fimbrial milking. The outcome measures were treatment success rates and homolateral patency rates. RESULTS: Of the 57 surgical procedures, 55 (96.4%) were performed successfully without any additional intervention. The number of patients receiving salpingotomy, salpingostomy, segmental resection and reanastomosis, and fimbrial milking were 24 (42.1%), 25 (43.9%), 4 (7.0%), and 2 (3.5%), respectively. Two case was switched to salpingectomy because excessive bipolar coagulation was required to obtain hemostasis at the tubal bleeding bed. Over a mean β-human chorionic gonadotropin resolution time of 18.3±5.9 days, no persistent trophoblast or postoperative complications occurred. A tubal patency test using hysterosalpingography was performed in 15 cases at 3 months postoperatively. Among these, the homolateral tubal patency rate was 75% (11 of 15) and the contralateral patency rate was 80% (12 of 15). CONCLUSION: Tube-preserving surgery is a feasible and safe treatment option for ectopic tubal pregnancy. However, considering that the optimal goal of tube-preserving surgical procedures is not the treatment success, some caution is warranted in interpreting results of this study.
Chorionic Gonadotropin ; Female ; Hemorrhage ; Hemostasis ; Humans ; Hysterosalpingography ; Milk ; Outcome Assessment (Health Care) ; Postoperative Complications ; Pregnancy ; Pregnancy, Ectopic ; Pregnancy, Tubal* ; Prospective Studies ; Salpingectomy ; Salpingostomy ; Trophoblasts

OBJECTIVE: The aim of the present study was to evaluate the impact of previous abdominal surgery on surgical outcomes of single-port access (SPA) total laparoscopic hysterectomy (TLH). METHODS: We reviewed the medical records of 111 women who underwent SPA-TLH at the Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University between January 2010 and December 2010. Women were classified according to their history of previous abdominal surgery. RESULTS: Of 111 women undergoing SPA-TLH, 74 women (66.7%) without history of previous abdominal surgery and 37 women (33.3%) with history of previous abdominal surgery were classified. There was no significant difference in surgical outcomes including operative time, estimated blood loss, change in hemoglobin, uterine weight, perioperative complications, transfusion, and additional port insertion between two groups. CONCLUSION: In our experience, previous abdominal surgery has no significant impact on SPA-TLH.
Female ; Gynecology ; Hemoglobins ; Humans ; Hysterectomy ; Laparoscopy ; Medical Records ; Obstetrics ; Operative Time

OBJECTIVE: To analyze the clinical experiences of patients who treated with levonorgestrel-releasing intrauterine system (LNG-IUS) for adenomyosis associated with dysmenorrhea and/or menorrhagia. METHODS: The LNG-IUS was inserted into 103 patients who were diagnosed with adenomyosis on ultrasound examination and suffered from dysmenorrhea or menorrhagia at CHA Gangnam Medical Center between January 2009 and December 2009. Symptomatic changes of dysmenorrhea and menorrhagia, side effects, and failure rates were evaluated, retrospectively. RESULTS: During the follow-up periods, dysmenorrhea was improved in 91.4% and menorrhagia was improved in 90.4% of patients. Most common side effects were prolonged vaginal spotting in 41 (39.8%), and expulsion of LNG-IUS in 32 (31.1%) patients. Six (5.7%) patients were premature removal of LNG-IUS and 9 (8.5%) patients were underwent hysterectomy. Overall 77 (74.8%) patients continued to use of LNG-IUS. CONCLUSION: The LNG-IUS is effective treatment option for management of dysmenorrhea and menorrhagia for patients with clinical diagnosis of adenomyosis. It seemed to be an alternative treatment method before hysterectomy.
Adenomyosis ; Dysmenorrhea ; Female ; Follow-Up Studies ; Humans ; Hysterectomy ; Menorrhagia ; Metrorrhagia

OBJECTIVE: It is clear that uterine carcinosarcomas and uterine papillary serous carcinomas (UPSC) have an adverse impact on outcome, but whether carcinosarcomas are worse than UPSC is unclear. The purpose of this study is to compare the pathology, survival, and disease recurrence of patients with carcinosarcomas to patients with UPSC. METHODS: The medical records of patients diagnosed with carcinosarcomas and UPSC between 1996 and 2009 at Samsung Medical Center were retrospectively analyzed. Information from pathology reports, site of relapse, time to recurrence, and death was obtained. The survival analysis was performed using the Kaplan-Meier method. RESULTS: Thirty seven patients with carcinosarcomas and 38 patients with UPSC were identified during the study period. There was no significant difference in clinical characteristics including age, body mass index, proportion with advanced stage disease, rate of optimal debulking, and adjuvant treatment used. In addition, the pathology showed no significant difference in tumor size, myometrial involvement, lymphovascular invasion, peritoneal cytology, cervical invasion, and lymph node involvement. Patients with carcinosarcomas had similar patterns of relapse as the patients with UPSC. There was no difference in the progression-free and overall survival between the carcinosarcomas and UPSC patients (p=0.804 and p=0.651, respectively). CONCLUSION: Patients with carcinosarcomas had similar clinicopathological features compared to the patients with UPSC.
Body Mass Index ; Carcinosarcoma ; Humans ; Lymph Nodes ; Medical Records ; Recurrence ; Retrospective Studies

OBJECTIVE: The histologic types of borderline ovarian tumors (BOTs) exhibit striking differences in clinical behavior and prognosis. Yet, there is no information available on the histologic distribution of BOTs according to geographic region. The purpose of this study was to systematically review this issue worldwide. METHODS: A comprehensive search of the literature was conducted using electronic databases. Studies were eligible if BOTs were investigated and the histologic distribution of the data was shown. The studies were grouped by geographic region and totaled by country. RESULTS: Of 487 potentially relevant studies, 51 met our inclusion criteria, as follows: 8 studies from North America (2 countries); 26 studies from Europe (14 countries); 7 studies from the Middle East (3 countries); and 10 studies from East Asia (5 countries). The histologic distribution of BOTs was considerably different in different parts of the world, but follows specific patterns. In general, serous-type BOTs were the predominantly identified histology in North America, the Middle East, and Europe, while mucinous-type BOTs predominated in East Asia. CONCLUSION: Significant geographic variation is evident among BOT histology in different parts of the world. More research is needed to understand this phenomenon.
Electronics ; Electrons ; Europe ; Far East ; Middle East ; North America ; Prognosis ; Strikes, Employee

PURPOSE: This study was conducted to investigate whether a proton pump inhibitor (PPI) could enhance chemosensitivity via the inhibition of vacuolar-type H⁺ ATPase (V-ATPase) in cervical cancer. MATERIALS AND METHODS: The expression of V-ATPase was evaluated in 351 formalin-fixed, paraffin-embedded human cervical cancer tissues using immunohistochemistry and compared with clinicopathologic risk factors for disease prognosis. The influence of cell proliferation and apoptosis following V-ATPase siRNA transfection or esomeprazole pretreatment was assessed in cervical cancer cell lines using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide and enzyme-linked immunosorbent assay, respectively. RESULTS: Immunohistochemical analysis revealed that V-ATPase was expressed in about 60% of cervical cancer tissue samples (211/351), and the expression was predominantly found in adenocarcinoma histology (p=0.016). Among patients with initially bulky cervical cancer (n=89), those with V-ATPase expression had shorter disease-free survival (p=0.005) and overall survival (p=0.023). Co-treatment with V-ATPase siRNA or esomeprazole with paclitaxel significantly decreased the cell proliferation of cervical cancer cell lines, including HeLa and INT407, compared to cell lines treated with paclitaxel alone (p < 0.01). Moreover, V-ATPase siRNA or esomeprazole followed by paclitaxel significantly increased the expression of active caspase-3 in these cells compared to cells treated with paclitaxel alone (both, p < 0.05). CONCLUSION: V-ATPase was predominantly expressed in cervical adenocarcinoma, and the expression of V-ATPases was associated with poor prognosis. The inhibition of V-ATPase via siRNA or PPI (esomeprazole) might enhance the chemosensitivity of paclitaxel in cervical cancer cells.
Adenocarcinoma ; Adenosine Triphosphatases ; Antineoplastic Agents ; Apoptosis ; Caspase 3 ; Cell Line ; Cell Proliferation ; Disease-Free Survival ; Enzyme-Linked Immunosorbent Assay ; Esomeprazole ; Humans ; Immunohistochemistry ; Paclitaxel* ; Prognosis ; Proton Pump Inhibitors ; Proton Pumps* ; Protons* ; Risk Factors ; RNA, Small Interfering ; Transfection ; Uterine Cervical Neoplasms* ; Vacuolar Proton-Translocating ATPases