Background: Late-onset hypogonadism (LOH) is associated with reduced testosterone levels and an increase in various physical, mental, and emotional changes in men with age. Several lifestyle factors, including smoking, are reported to be related to LOH; however, very few studies have sufficiently investigated the relationships between smoking and the symptoms of LOH. This study aimed to use the Androgen Deficiency in Aging Males (ADAM) questionnaire to assess the associations between smoking and LOH symptoms in Korean men. Methods: Men who underwent medical check-ups and transrectal ultrasonography at a university hospital between January 1, 2018 and March 31, 2021 (n=793) were included in this study. Multiple logistic regression was used to assess the risk of LOH symptoms among non-smokers, exsmokers, and current smokers, with adjustments for age, body mass index, alcohol consumption, and exercise and education levels. Results: There were significant correlations between LOH symptoms, as assessed using the ADAM questionnaire, and smoking status. The results of the multivariate logistic regression analysis adjusted for confounding factors indicated that the risk of LOH symptoms was higher in the ex-smokers (odds ratio, 2.446; 95% confidential interval, 1.511–3.962) and current smokers (odds ratio, 6.664; 95% confidential interval, 3.485–12.74) groups. Conclusion These results indicate a positive correlation between smoking and LOH symptoms in Korean men. Nevertheless, large-scale studies are required to further validate these findings.

Background: Late-onset hypogonadism (LOH) is associated with reduced testosterone levels and an increase in various physical, mental, and emotional changes in men with age. Several lifestyle factors, including smoking, are reported to be related to LOH; however, very few studies have sufficiently investigated the relationships between smoking and the symptoms of LOH. This study aimed to use the Androgen Deficiency in Aging Males (ADAM) questionnaire to assess the associations between smoking and LOH symptoms in Korean men. Methods: Men who underwent medical check-ups and transrectal ultrasonography at a university hospital between January 1, 2018 and March 31, 2021 (n=793) were included in this study. Multiple logistic regression was used to assess the risk of LOH symptoms among non-smokers, exsmokers, and current smokers, with adjustments for age, body mass index, alcohol consumption, and exercise and education levels. Results: There were significant correlations between LOH symptoms, as assessed using the ADAM questionnaire, and smoking status. The results of the multivariate logistic regression analysis adjusted for confounding factors indicated that the risk of LOH symptoms was higher in the ex-smokers (odds ratio, 2.446; 95% confidential interval, 1.511–3.962) and current smokers (odds ratio, 6.664; 95% confidential interval, 3.485–12.74) groups. Conclusion These results indicate a positive correlation between smoking and LOH symptoms in Korean men. Nevertheless, large-scale studies are required to further validate these findings.

Background: Late-onset hypogonadism (LOH) is associated with reduced testosterone levels and an increase in various physical, mental, and emotional changes in men with age. Several lifestyle factors, including smoking, are reported to be related to LOH; however, very few studies have sufficiently investigated the relationships between smoking and the symptoms of LOH. This study aimed to use the Androgen Deficiency in Aging Males (ADAM) questionnaire to assess the associations between smoking and LOH symptoms in Korean men. Methods: Men who underwent medical check-ups and transrectal ultrasonography at a university hospital between January 1, 2018 and March 31, 2021 (n=793) were included in this study. Multiple logistic regression was used to assess the risk of LOH symptoms among non-smokers, exsmokers, and current smokers, with adjustments for age, body mass index, alcohol consumption, and exercise and education levels. Results: There were significant correlations between LOH symptoms, as assessed using the ADAM questionnaire, and smoking status. The results of the multivariate logistic regression analysis adjusted for confounding factors indicated that the risk of LOH symptoms was higher in the ex-smokers (odds ratio, 2.446; 95% confidential interval, 1.511–3.962) and current smokers (odds ratio, 6.664; 95% confidential interval, 3.485–12.74) groups. Conclusion These results indicate a positive correlation between smoking and LOH symptoms in Korean men. Nevertheless, large-scale studies are required to further validate these findings.

Background: Late-onset hypogonadism (LOH) is associated with reduced testosterone levels and an increase in various physical, mental, and emotional changes in men with age. Several lifestyle factors, including smoking, are reported to be related to LOH; however, very few studies have sufficiently investigated the relationships between smoking and the symptoms of LOH. This study aimed to use the Androgen Deficiency in Aging Males (ADAM) questionnaire to assess the associations between smoking and LOH symptoms in Korean men. Methods: Men who underwent medical check-ups and transrectal ultrasonography at a university hospital between January 1, 2018 and March 31, 2021 (n=793) were included in this study. Multiple logistic regression was used to assess the risk of LOH symptoms among non-smokers, exsmokers, and current smokers, with adjustments for age, body mass index, alcohol consumption, and exercise and education levels. Results: There were significant correlations between LOH symptoms, as assessed using the ADAM questionnaire, and smoking status. The results of the multivariate logistic regression analysis adjusted for confounding factors indicated that the risk of LOH symptoms was higher in the ex-smokers (odds ratio, 2.446; 95% confidential interval, 1.511–3.962) and current smokers (odds ratio, 6.664; 95% confidential interval, 3.485–12.74) groups. Conclusion These results indicate a positive correlation between smoking and LOH symptoms in Korean men. Nevertheless, large-scale studies are required to further validate these findings.

Background: Primary cicatricial alopecia (PCA) is a rare disease that causes irreversible destruction of hair follicles and affects the quality of life (QOL). Objective: We aimed to investigate the disease awareness, medical use behavior, QOL, and real-world diagnosis and treatment status of patients with PCA. Methods: A self-administered questionnaire was administered to patients with PCA and their dermatologists. Patients aged between 19 and 75 years who visited one of 27 dermatology departments between September 2021 and September 2022 were included. Results: In total, 274 patients were included. The male-to-female ratio was 1:1.47, with a mean age of 45.7 years. Patients with neutrophilic and mixed PCA were predominantly male and younger than those with lymphocytic PCA. Among patients with lymphocytic PCA, lichen planopilaris was the most common type, and among those with neutrophilic PCA, folliculitis decalvans was the most common type. Among the total patients, 28.8% were previously diagnosed with PCA, 47.0% were diagnosed with PCA at least 6 months after their first hospital visit, 20.0% received early treatment within 3 months of disease onset, and 54.4% received steady treatment. More than half of the patients had a moderate to severe impairment in QOL. Topical/intralesional steroid injections were the most common treatment. Systemic immunosuppressants were frequently prescribed to patients with lymphocytic PCA, and antibiotics were mostly prescribed to patients with neutrophilic PCA. Conclusion This study provides information on the disease awareness, medical use behavior, QOL, diagnosis, and treatment status of Korean patients with PCA. This can help dermatologists educate patients with PCA to understand the necessity for early diagnosis and steady treatment.

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: To solve the difficulty in determining the appropriate treatment regimen for patients infected with extensively drug-resistant Acinetobacter baumannii (XDRAB), it is necessary to develop various strategies to increase the therapeutic effect of antimicrobial agents. The purpose of this study was to select the treatment combination showing the greatest antimicrobial effect among seven candidate antimicrobial substances. Methods: Seven strains of XDRAB were used in this study. The composition of the treatment consisted of colistin as the base and one of the seven antimicrobial substances, doripenem, minocycline, tigecycline, linezolid, fusidic acid, vancomycin, or alyteserin E4K peptide. The interaction between the drugs in each combination was evaluated by measuring the synergy rates using time-kill analysis. Results: The synergy rates of the seven combinations tested in the time-kill assay in this study were as follows, in descending order from the combination with the highest synergy rate: colistin + minocycline (57.1%), colistin + alyteserin E4K (50.0%), colistin + tigecycline (42.9%), colistin + vancomycin (28.6%), colistin + doripenem (14.3%), colistin + fusidic acid (14.3%), and colistin + linzolid (0%). None of the combinations showed antagonism. The three combinations showing bactericidal activity and the rates of their bactericidal activity were colistin + alyteserin E4K combination (33.3%), colistin + minocycline (14.3%), and colistin + vancomycin (14.3%). Conclusion The colistin + minocycline and colistin + alyteserin E4K treatment combinations, which showed high synergy rates, can be considered as promising candidates for future in vivo experiments evaluating combination therapies.

Background/Aims: This study examined the long-term outcomes of undifferentiated-type early gastric cancer (UD EGC) with positive horizontal margins (HMs) after endoscopic resection (ER) and compared them between additional surgery and nonsurgical management. Methods: From 2005 to 2015, a total of 1,124 patients with UD EGC underwent ER at 18 tertiary hospitals in Korea. Of them, 92 patients with positive HMs as the only noncurative factor (n=25) or with both positive HMs and tumor size >2 cm (n=67) were included. These patients underwent additional surgery (n=40), underwent additional endoscopic treatment (n=6), or were followed up without further treatment (n=46). Results: No lymph node (LN) metastasis was found in patients who underwent additional surgery. During a median follow-up of 57.7 months (interquartile range, 27.6 to 68.8 months), no LN or distant metastases or gastric cancer-related deaths occurred in the overall cohort. At baseline, the residual cancer rate was 57.8% (26/45) after additional surgery or ER. The 5-year local recurrence rate was 33.6% among patients who were followed up without additional treatment. The 5-year overall survival rates were 95.0% and 87.8% after additional surgery and nonsurgical management (endoscopic treatment or close follow-up), respectively (log-rank p=0.224). In the multivariate Cox regression analysis, nonsurgical management was not associated with an increased risk of mortality. Conclusions UD EGC with positive HMs after ER may have favorable long-term outcomes and a very low risk of LN metastasis. Nonsurgical management may be suggested as an alternative, particularly for patients with old age or chronic illness.

Background/Aims: This study examined the long-term outcomes of undifferentiated-type early gastric cancer (UD EGC) with positive horizontal margins (HMs) after endoscopic resection (ER) and compared them between additional surgery and nonsurgical management. Methods: From 2005 to 2015, a total of 1,124 patients with UD EGC underwent ER at 18 tertiary hospitals in Korea. Of them, 92 patients with positive HMs as the only noncurative factor (n=25) or with both positive HMs and tumor size >2 cm (n=67) were included. These patients underwent additional surgery (n=40), underwent additional endoscopic treatment (n=6), or were followed up without further treatment (n=46). Results: No lymph node (LN) metastasis was found in patients who underwent additional surgery. During a median follow-up of 57.7 months (interquartile range, 27.6 to 68.8 months), no LN or distant metastases or gastric cancer-related deaths occurred in the overall cohort. At baseline, the residual cancer rate was 57.8% (26/45) after additional surgery or ER. The 5-year local recurrence rate was 33.6% among patients who were followed up without additional treatment. The 5-year overall survival rates were 95.0% and 87.8% after additional surgery and nonsurgical management (endoscopic treatment or close follow-up), respectively (log-rank p=0.224). In the multivariate Cox regression analysis, nonsurgical management was not associated with an increased risk of mortality. Conclusions UD EGC with positive HMs after ER may have favorable long-term outcomes and a very low risk of LN metastasis. Nonsurgical management may be suggested as an alternative, particularly for patients with old age or chronic illness.

BACKGROUND: The emergence of multidrug-resistant Acinetobacter baumannii as a nosocomial pathogen is one of the major public health problems. The aim of this study was to evaluate the role of an efflux pump gene adeJ for the multidrug resistance of A. baumannii clinical isolates. METHODS: Two groups (MDRAB and SAB) of A. baumannii clinical isolates were studied. The SAB group consisted of strains that did not meet the criteria of MDRAB and were susceptible to more categories of antibiotics than MDRAB. Antimicrobial susceptibility results obtained by VITEKII system were used in data analysis and bacterial group allocation. We performed real-time reverse transcription PCR to determine relative expression of adeJ. We compared relative expression of adeJ in comparison groups by considering two viewpoints: i) MDRAB and SAB groups and ii) susceptible and non-susceptible groups for each antibiotic used in this study. RESULTS: The mean value of relative expression of adeJ of MDRAB and SAB groups was 1.4 and 0.92, respectively, and showed significant difference (P=0.002). The mean values of relative expression of adeJ of susceptible and non-susceptible groups to the antibiotics cefepime, ceftazidime, ciprofloxacin, imipenem, meropenem, tigecycline, piperacillin/tazobactam, ticarcillin/clavulanic acid, trimethoprim/sulfamethoxazole, piperacillin, and gentamicin showed statistically significant differences. CONCLUSION The overexpression of adeIJK might contribute to the multi-drug resistance in A. baumannii clinical isolates. Further, the overexpression of adeIJK might be one of the factors contributing to the resistance to numerous antibiotics.