Background: As the treatment effects for childhood and adolescent cancer continue to improve, the survivor group is gradually growing and their age is increasing. This study aimed to determine the perceptions toward childhood and adolescent cancer survivors and assess the current situation regarding their return to school, to undertake policy development to help them grow into healthy members of society. Methods: From December 2019, for about 4 months, a structured questionnaire was used to conduct one-on-one interviews with childhood and adolescent cancer survivors and their parents, as well as with parents of healthy children and adolescents. Results: The participants included 79 survivors of childhood and adolescent cancer, 186 parents of cancer survivors, and 661 general parents; their mean age was 21.8, 13.9, and 12.5 years, respectively. After completing their cancer treatment, 77.2% of the cancer survivors returned to school, with the majority returning to regular schools in the same grade as their peers. Reasons for not returning to school (20.3%) included concerns about health management (43.8%), concerns about psychological and emotional adjustment (12.5%), and poor school attendance (12.5%). Among the parents of cancer survivors, 48.9% stated that they were “satisfied” with their children’s school life; a better health status in children was associated with a higher level of satisfaction (P=0.0071). In addition, they stated that national-level support was needed in the following areas for a successful return to school: a continuous health management system (36.1%) and understanding homeroom teachers who enable flexible participation in classes and school events (29.5%). Conclusion For survivors of childhood and adolescent cancer to successfully return to school and society, nationwide awareness-raising activities should be expanded, in addition to services that are tailored to the survivors’ needs and characteristics such as management of physical and mental health and educating homeroom teachers and peers.

Educational evaluation involves data collection and the analysis of various education-related factors to make decisions that improve educational quality. Systematic educational evaluation is essential for enhancing the quality of education. This study reports a case of student-conducted process evaluation of a medical school’s student support system and the procedure for devising improvement plans. Sixteen Inje University College of Medicine students participated in the Education Evaluation Committee (IUCM-EEC) to understand the educational improvement process as learners and actively achieve improvement. The Quality Improvement Committee of the Inje University College of Medicine (IUCM-QIC) decided to reform its student support system based on a previous educational evaluation in 2019. The evaluation of the student support system was conducted for 10 months in 2021 by the student subcommittee, under the guidance of the IUCM-EEC. The CIPP (context-input-process-product) evaluation model was used for a systematic evaluation. Accordingly, the subcommittee developed evaluation criteria and indicators, and analyzed relevant data collected from surveys and the previous literature. For further recommendations and revision ideas, the student subcommittee members interviewed faculty members from six other medical schools and also conducted a focus group interview with the dean and vice deans of IUCM. Finally, the student subcommittee submitted a report to the IUCM-QIC. Communication with various stakeholders is essential for a successful evaluation process. In this case, students, as key stakeholders in education, evaluated the student support system. Their active participation helped improve their understanding of the evaluation process.

Background: Remdesivir is widely used for the treatment of coronavirus disease 2019 (COVID-19), but controversies regarding its efficacy still remain. Methods: A retrospective cohort study was conducted to evaluate the effect of remdesivir on clinical and virologic outcomes of severe COVID-19 patients from June to July 2020. Primary clinical endpoints included clinical recovery, additional mechanical ventilator (MV) support, and duration of oxygen or MV support. Viral load reduction by hospital day (HD) 15 was evaluated by calculating changes in cycle threshold (Ct) values. Results: A total of 86 severe COVID-19 patients were evaluated including 48 remdesivirtreated patients. Baseline characteristics were not significantly different between the two groups. Remdesivir was administered an average of 7.42 days from symptom onset. The proportions of clinical recovery of the remdesivir and supportive care group at HD 14 (56.3% and 39.5%) and HD 28 (87.5% and 78.9%) were not statistically different. The proportion of patients requiring MV support by HD 28 was significantly lower in the remdesivir group than in the supportive care group (22.9% vs. 44.7%, P = 0.032), and MV duration was significantly shorter in the remdesivir group (average, 1.97 vs. 5.37 days; P = 0.017). Analysis of upper respiratory tract specimens demonstrated that increases of Ct value from HD 1–5 to 11–15 were significantly greater in the remdesivir group than the supportive care group (average, 10.19 vs. 5.36; P = 0.007), and the slope of the Ct value increase was also significantly steeper in the remdesivir group (average, 5.10 vs. 2.68; P = 0.007). Conclusion The remdesivir group showed clinical and virologic benefit in terms of MV requirement and viral load reduction, supporting remdesivir treatment for severe COVID-19.

Background: Few studies have classified chest computed tomography (CT) findings of coronavirus disease 2019 (COVID-19) and analyzed their correlations with prognosis. The present study aimed to evaluate retrospectively the clinical and chest CT findings of COVID-19 and to analyze CT findings and determine their relationships with clinical severity. Methods: Chest CT and clinical features of 271 COVID-19 patients were assessed. The presence of CT findings and distribution of parenchymal abnormalities were evaluated, and CT patterns were classified as bronchopneumonia, organizing pneumonia (OP), or diffuse alveolar damage (DAD). Total extents were assessed using a visual scoring system and artificial intelligence software. Patients were allocated to two groups based on clinical outcomes, that is, to a severe group (requiring O2 therapy or mechanical ventilation, n = 55) or a mild group (not requiring O2 therapy or mechanical ventilation, n = 216). Clinical and CT features of these two groups were compared and univariate and multivariate logistic regression analyses were performed to identify independent prognostic factors. Results: Age, lymphocyte count, levels of C-reactive protein, and procalcitonin were significantly different in the two groups. Forty-five of the 271 patients had normal chest CT findings. The most common CT findings among the remaining 226 patients were groundglass opacity (98%), followed by consolidation (53%). CT findings were classified as OP (93%), DAD (4%), or bronchopneumonia (3%) and all nine patients with DAD pattern were included in the severe group. Uivariate and multivariate analyses showed an elevated procalcitonin (odds ratio [OR], 2.521; 95% confidence interval [CI], 1.001–6.303, P = 0.048), and higher visual CT scores (OR, 1.137; 95% CI, 1.042–1.236; P = 0.003) or higher total extent by AI measurement (OR, 1.048; 95% CI, 1.020–1.076; P < 0.001) were significantly associated with a severe clinical course. Conclusion CT findings of COVID-19 pneumonia can be classified into OP, DAD, or bronchopneumonia patterns and all patients with DAD pattern were included in severe group. Elevated inflammatory markers and higher CT scores were found to be significant predictors of poor prognosis in patients with COVID-19 pneumonia.

Background: Remdesivir is widely used for the treatment of coronavirus disease 2019 (COVID-19), but controversies regarding its efficacy still remain. Methods: A retrospective cohort study was conducted to evaluate the effect of remdesivir on clinical and virologic outcomes of severe COVID-19 patients from June to July 2020. Primary clinical endpoints included clinical recovery, additional mechanical ventilator (MV) support, and duration of oxygen or MV support. Viral load reduction by hospital day (HD) 15 was evaluated by calculating changes in cycle threshold (Ct) values. Results: A total of 86 severe COVID-19 patients were evaluated including 48 remdesivirtreated patients. Baseline characteristics were not significantly different between the two groups. Remdesivir was administered an average of 7.42 days from symptom onset. The proportions of clinical recovery of the remdesivir and supportive care group at HD 14 (56.3% and 39.5%) and HD 28 (87.5% and 78.9%) were not statistically different. The proportion of patients requiring MV support by HD 28 was significantly lower in the remdesivir group than in the supportive care group (22.9% vs. 44.7%, P = 0.032), and MV duration was significantly shorter in the remdesivir group (average, 1.97 vs. 5.37 days; P = 0.017). Analysis of upper respiratory tract specimens demonstrated that increases of Ct value from HD 1–5 to 11–15 were significantly greater in the remdesivir group than the supportive care group (average, 10.19 vs. 5.36; P = 0.007), and the slope of the Ct value increase was also significantly steeper in the remdesivir group (average, 5.10 vs. 2.68; P = 0.007). Conclusion The remdesivir group showed clinical and virologic benefit in terms of MV requirement and viral load reduction, supporting remdesivir treatment for severe COVID-19.

Background: Few studies have classified chest computed tomography (CT) findings of coronavirus disease 2019 (COVID-19) and analyzed their correlations with prognosis. The present study aimed to evaluate retrospectively the clinical and chest CT findings of COVID-19 and to analyze CT findings and determine their relationships with clinical severity. Methods: Chest CT and clinical features of 271 COVID-19 patients were assessed. The presence of CT findings and distribution of parenchymal abnormalities were evaluated, and CT patterns were classified as bronchopneumonia, organizing pneumonia (OP), or diffuse alveolar damage (DAD). Total extents were assessed using a visual scoring system and artificial intelligence software. Patients were allocated to two groups based on clinical outcomes, that is, to a severe group (requiring O2 therapy or mechanical ventilation, n = 55) or a mild group (not requiring O2 therapy or mechanical ventilation, n = 216). Clinical and CT features of these two groups were compared and univariate and multivariate logistic regression analyses were performed to identify independent prognostic factors. Results: Age, lymphocyte count, levels of C-reactive protein, and procalcitonin were significantly different in the two groups. Forty-five of the 271 patients had normal chest CT findings. The most common CT findings among the remaining 226 patients were groundglass opacity (98%), followed by consolidation (53%). CT findings were classified as OP (93%), DAD (4%), or bronchopneumonia (3%) and all nine patients with DAD pattern were included in the severe group. Uivariate and multivariate analyses showed an elevated procalcitonin (odds ratio [OR], 2.521; 95% confidence interval [CI], 1.001–6.303, P = 0.048), and higher visual CT scores (OR, 1.137; 95% CI, 1.042–1.236; P = 0.003) or higher total extent by AI measurement (OR, 1.048; 95% CI, 1.020–1.076; P < 0.001) were significantly associated with a severe clinical course. Conclusion CT findings of COVID-19 pneumonia can be classified into OP, DAD, or bronchopneumonia patterns and all patients with DAD pattern were included in severe group. Elevated inflammatory markers and higher CT scores were found to be significant predictors of poor prognosis in patients with COVID-19 pneumonia.

Acacetin, which is present in damiana (Turnera diffusa) and black locust (Robinia pseudoacacia), has several pharmacologic activities such as antioxidant, anti-inflammatory, and anti-proliferative effects on cancer cells. However, the effect of acacetin on head and neck cancers has not been clearly established. This study aimed to examine the effects of acacetin on cell growth and apoptosis induction in FaDu human pharyngeal carcinoma cells. These were investigated by 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide assay, Live/Dead cell assay, 4′,6-diamidino-2-phenylindole dihydrochloride staining, caspase-3 and caspase-7 activation assay, and immunoblotting in FaDu cells. Acacetin induced FaDu cell death in a dose-dependent manner, with an estimated IC50 value of 41.9 µM, without affecting the viability of L-929 mouse fibroblasts as normal cells. Acacetin treatment resulted in nuclear condensation in the FaDu cells. It promoted the proteolytic cleavage of procaspase-3, -7, -8, and -9 with increasing amounts of the cleaved caspase isoforms in FaDu cells. Acacetin-induced apoptosis in FaDu cells was mediated by the expression of Fas and activation of caspase-8, caspase-3, and poly (ADP-ribose) polymerase. Immunoblotting showed downregulation of the anti-apoptotic mitochondrial proteins Bcl-2 and Bcl-xL, but upregulation of the mitochondria-dependent pro-apoptotic proteins Bax and Badin FaDu cells after acacetin treatment. These findings indicate that acacetin inhibits cell proliferation and induces apoptotic cell death in FaDu human pharyngeal carcinoma cells via both the death receptor-mediated extrinsic apoptotic pathway and the mitochondria-mediated intrinsic apoptotic pathway.

BACKGROUND AND OBJECTIVES: This study aimed to investigate the right-left arm difference in detection of hypertension in the general Korean population. METHODS: This study analyzed data from the Cardiovascular and Metabolic Disease Etiology Research Center cohort. Study population was 2,103 people who were aged 30 to 64 years old, without history of major cardiovascular diseases, and did not use antihypertensive medication. Brachial blood pressures (BPs) were measured for both arms using an automated oscillometric device equipped with 2 cuffs for simultaneous double-arm measurements. Systolic and diastolic blood pressures (SBP and DBP) were measured 3 times, and the average value was used in the analysis. Overall hypertension was defined as elevated blood pressure (SBP/DBP ≥140/90 mmHg) at the arm with higher value, while right-arm or left-arm hypertension was defined as elevated BP at each arm. Sensitivity was calculated as the number of each-arm hypertension divided by the number of overall hypertension. RESULTS: Overall 8.6% of the population had hypertension at either arm, while 7.8% had right-arm hypertension, 7.2% had left-arm hypertension, and 6.4% had both arms hypertension. The sensitivity for the detection of hypertension was 90.6% when BP was measured only at right arm, and 83.4% when measured only at left arm. Corresponding sensitivity were 87.9% and 87.1% in men, and 95.4% and 76.9% in women. CONCLUSIONS Single-arm measurements, compared to double-arm measurements, may underestimate the prevalence of hypertension. However, if double-arm measurements are unavailable, right arm is preferred for measurement of BP, especially in women.

The Committee of Clinical Practice Guidelines of the Korean Diabetes Association revised and updated the 6th Clinical Practice Guidelines in 2019. Targets of glycemic, blood pressure, and lipid control in type 2 diabetes mellitus (T2DM) were updated. The obese and overweight population is increasing steadily in Korea, and half of the Koreans with diabetes are obese. Evidence-based recommendations for weight-loss therapy for obesity management as treatment for hyperglycemia in T2DM were provided. In addition, evidence from large clinical studies assessing cardiovascular outcomes following the use of sodium-glucose cotransporter-2 inhibitors and glucagon-like peptide 1 receptor agonists in patients with T2DM were incorporated into the recommendations.
Blood Pressure ; Diabetes Mellitus, Type 2 ; Diagnosis ; Glucagon-Like Peptide 1 ; Humans ; Hyperglycemia ; Korea ; Obesity ; Overweight

BACKGROUND AND OBJECTIVES: This study aimed to investigate the right-left arm difference in detection of hypertension in the general Korean population. METHODS: This study analyzed data from the Cardiovascular and Metabolic Disease Etiology Research Center cohort. Study population was 2,103 people who were aged 30 to 64 years old, without history of major cardiovascular diseases, and did not use antihypertensive medication. Brachial blood pressures (BPs) were measured for both arms using an automated oscillometric device equipped with 2 cuffs for simultaneous double-arm measurements. Systolic and diastolic blood pressures (SBP and DBP) were measured 3 times, and the average value was used in the analysis. Overall hypertension was defined as elevated blood pressure (SBP/DBP ≥140/90 mmHg) at the arm with higher value, while right-arm or left-arm hypertension was defined as elevated BP at each arm. Sensitivity was calculated as the number of each-arm hypertension divided by the number of overall hypertension. RESULTS: Overall 8.6% of the population had hypertension at either arm, while 7.8% had right-arm hypertension, 7.2% had left-arm hypertension, and 6.4% had both arms hypertension. The sensitivity for the detection of hypertension was 90.6% when BP was measured only at right arm, and 83.4% when measured only at left arm. Corresponding sensitivity were 87.9% and 87.1% in men, and 95.4% and 76.9% in women. CONCLUSIONS: Single-arm measurements, compared to double-arm measurements, may underestimate the prevalence of hypertension. However, if double-arm measurements are unavailable, right arm is preferred for measurement of BP, especially in women.
Arm ; Asian Continental Ancestry Group ; Blood Pressure ; Cardiovascular Diseases ; Cohort Studies ; Female ; Humans ; Hypertension ; Male ; Metabolic Diseases ; Prevalence