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The gut visceral musculature plays essential roles in not only moving substances through the lumen but also maintaining the function and physiology of the gut. Although the development of the visceral musculature has been studied in multiple model organisms, how it degenerates is poorly understood. Here, we employ the Drosophila midgut as a model to demonstrate that the visceral musculature is disrupted by intrinsic and extrinsic factors, such as aging, feeding, chemical-induced tissue damage, and oncogenic transformation in the epithelium. Notably, we define four prominent visceral musculature disruption phenotypes, which we refer as ‘sprout’, ‘discontinuity’, ‘furcation’, and ‘crossover’ of the longitudinal muscle. Given that the occurrence of these phenotypes is increased during aging and under various stresses, we propose that these phenotypes can be used as quantitative readouts of deterioration of the visceral musculature. Intriguingly, administration of a tissue-damaging chemical dextran sulfate sodium (DSS) induced similar visceral musculature disruption phenotypes in zebrafish larvae, indicating that ingestion of a tissue-damaging chemical can disrupt the visceral musculature in a vertebrate as well. Our study provides insights into the deterioration of the gut visceral musculature and lays a groundwork for investigating the underlying mechanisms in Drosophila as well as other animals.

Atrial stretch may contribute to the mechanism of atrial fibrillation (AF) recurrence after atrial fibrillation catheter ablation (AFCA). We tested whether the left atrial (LA) wall stress (LAW-stress[measured]) could be predicted by artificial intelligence (AI) using non-invasive parameters (LAW-stress[AI]) and whether rhythm outcome after AFCA could be predicted by LAW-stress[AI] in an independent cohort. Cohort 1 included 2223 patients, and cohort 2 included 658 patients who underwent AFCA. LAW-stress[measured] was calculated using the Law of Laplace using LA diameter by echocardiography, peak LA pressure measured during procedure, and LA wall thickness measured by customized software (AMBER) using computed tomography. The highest quartile (Q4) LAW-stress[measured] was predicted and validated by AI using non-invasive clinical parameters, including non-paroxysmal type of AF, age, presence of hypertension, diabetes, vascular disease, and heart failure, left ventricular ejection fraction, and the ratio of the peak mitral flow velocity of the early rapid filling to the early diastolic velocity of the mitral annulus (E/Em). We tested the AF/atrial tachycardia recurrence 3 months after the blanking period after AFCA using the LAW-stress[measured] and LAW-stress[AI] in cohort 1 and LAW-stress[AI] in cohort 2. LAW-stress[measured] was independently associated with non-paroxysmal AF (p < 0.001), diabetes (p = 0.012), vascular disease (p = 0.002), body mass index (p < 0.001), E/Em (p < 0.001), and mean LA voltage measured by electrogram voltage mapping (p < 0.001). The best-performing AI model had acceptable prediction power for predicting Q4-LAW-stress[measured] (area under the receiver operating characteristic curve 0.734). During 26.0 (12.0–52.0) months of follow-up, AF recurrence was significantly higher in the Q4-LAW-stress[measured] group [log-rank p = 0.001, hazard ratio 2.43 (1.21–4.90), p = 0.013] and Q4-LAW-stress[AI] group (log-rank p = 0.039) in cohort 1. In cohort 2, the Q4-LAW-stress[AI] group consistently showed worse rhythm outcomes (log-rank p < 0.001). A higher LAW-stress was associated with poorer rhythm outcomes after AFCA. AI was able to predict this complex but useful prognostic parameter using non-invasive parameters with moderate accuracy.

The present study aimed to evaluate the protective effect of a methanol extract of Sargassum horneri (SHM), which contains 6-hydroxy-4,4,7a-trimethyl-5,6,7,7a-tetrahydrobenzofuran-2(4H)-one (HTT) and apo-9′-fucoxanthinone, against ultraviolet B (UVB)-induced cellular damage in human keratinocytes and its underlying mechanism. SHM significantly improved cell viability of UVB-exposed human keratinocytes by reducing the generation of intracellular reactive oxygen species (ROS). Moreover, SHM inhibited UVB exposure-induced apoptosis by reducing the formation of apoptotic bodies and the populations of the sub-G1 hypodiploid cells and the early apoptotic cells by modulating the expression of the anti- and pro-apoptotic molecules, Bcl-2 and Bax, respectively. Furthermore, SHM inhibited NF-κB p65 activation by inducing the activation of Nrf2/HO-1 signaling. The cytoprotective and antiapoptotic activities of SHM are abolished by the inhibition of HO-1 signaling. In further study, SHM restored the skin dryness and skin barrier disruption in UVB-exposed human keratinocytes. Based to these results, our study suggests that SHM protects the cells against UVB-induced cellular damages through the Nrf2/HO-1/NF-κB p65 signaling pathway and may be potentially useful for the prevention of UVB-induced skin damage.

BackgroundAlthough myocardial thickness is an important variable for therapeutic catheter ablation of cardiac arrhythmias, quantification of wall thickness has been overlooked. We developed a software (AMBER) that measures 3D-myocardial thickness using a cardiac computed tomogram (CT) image, verified its accuracy, and tested its clinical feasibility.MethodsWe generated 3D-thickness maps by calculating wall thickness (WT) from the CT images of 120 patients’ hearts and a 3D-phantom model (PhM). The initial vector field of the Laplace equation was oriented to calculate WT with the field lines derived from the 3D mesh. We demonstrate the robustness of the Laplace WT algorithm by comparing with the real thickness of 3D-PhM, echocardiographically measured left ventricular (LV) WT, and regional left atrial (LA) WT reported from previous studies. We conducted a pilot case of catheter ablation for atrial fibrillation (AF) utilizing real-time LAWT map-guided radiofrequency (RF) energy titration.ResultsAMBER 3D-WT had excellent correlations with the real thickness of the PhM (R = 0.968,p R = 0.656,p = 0.007). AMBER 3D-LAWT (n = 120) showed a relatively good match with 12 previously reported regional LAWT. We successfully conducted pilot AF ablation utilizing AMBER 3D-LAWT map-guided real-time RF energy titration.ConclusionWe developed and verified an AMBER 3D-cardiac thickness map measured by cardiac CT images for LAWT and LVWT, and tested its feasibility for RF energy titration during clinical catheter ablation.

Western medicine was first introduced to Korea by Christian missionaries and then by the Japanese in the late 19th century without its historical, philosophical, cultural, social, political, and economic values being communicated. Specifically, during the Japanese colonial era, only ideologically ‘degenerated’ medicine was taught to Koreans and the main orthodox stream of medicine was inaccessible. Hence, Korean medical education not only focuses on basic and clinical medicine, but also inherited hierarchical discrimination and structural violence. After Korea’s liberation from Japan and the Korean war, the Korean medical education system was predominantly influenced by Americans and the Western medical education system was adopted by Korea beginning in the 1980s. During this time, ethical problems arose in Korean medical society and highlighted a need for medical humanities education to address them. For Korean medical students who are notably lacking humanistic and social culture, medical humanities education should be emphasized in the curriculum. In the Fourth Industrial Revolution, human physicians may only be distinguishable from robot physicians by ethical consciousness; consequentially, the Korean government should invest more of its public funds to develop and establish a medical humanities program in medical colleges. Such an improved medical education system in Korea is expected to foster talented physicians who are also respectable people.

© Korean Medical Association This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons. org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. In order to ensure the rights of medical self-regulation, what precondition should be fulfilled by the Korean Medical Association (KMA) or any other independent medical association or organization? Regulatory authority is defined as an exercise of legal power by the State for the rights and interests of the people. Thus, if Korean physicians seek to regulate themselves, on the one hand, the KMA or any other independent medical association or organization should achieve delegation from the State, and on the other, Korean medical professionalism should fully reflect the State philosophy. This paper aims to examine the origin and precondition of medical self-regulation in French State philosophy and French medical professionalism. For this purpose, the following topics are covered: (1) Who was involved in the establishment of the French State philosophy and what was the role of French physicians? (2) By whom and how was French State philosophy introduced in American State philosophy? (3) What medical ideas and values are included in the Declaration of Human and Civic Rights of 1789? (4) How is French State philosophy emblematized by three key values–freedom, equality, and fraternity–incorporated in French medical professionalism? Dealing with these topics, this paper claims, on the basis of French history and philosophy, that the most important precondition of medical self-regulation is for medical professionalism to sufficiently reflect the State philosophy, and consequently the KMA or any other independent medical association or organization representing Korean physicians should willingly be involved in shaping the Korean State philosophy.

의 역량(competence), 복수 개념의 역량들(competencies, Medicine is the practice that occurs in the context of the society. It requires interaction with individual patients, fellow doctors and other health care professionals, health care officials, public, institution, and the society as a whole. To date, medical practice in Korea has largely been concentrated on applying biomedical knowledge and skill to a patient. We defines ‘social competency’ as ‘competency for medicine as a social institution.’ This survey aims to grasp the current situation of Korean doctors’ perception on social competency, in terms of necessity, satisfaction, learning experience, and possible intervention. Respondents generally recognized the necessity of social competencies but were not satisfied with their demonstration of those competencies. Competencies for ‘understanding on law and institution’ and ‘communication’ were perceived highly necessary. General satisfaction and each satisfaction rate on individual competencies were all below ‘neutral,’ showing their dissatisfaction. Especially, doctors assess their fellow doctors’ competencies for ‘understanding on law and institution’ and ‘understanding on human being and society’ at the lowest level. The mismatch between perceived necessity and satisfaction shows the legitimate ground for educational intervention. The proportions of respondents who have learned on each domain of social competency were all below 70%. Learning experience on self-management and leadership was the least. Among possible remedy for low social competency, respondents perceived ‘improvement on national health insurance’ and ‘improvement on resident training program’ as the most urgently needed. The data from this preliminary survey can be utilized for educational and institutional intervention in the future.

을 수행해야 한다. 의사에게 사회적 역할이 필수적인 이 Doctor’s task cannot be limited to medical practice and research. As a citizen of society, and above all as a professional, doctors should not evade their social responsibilities. This idea was systematically developed and widely diffused throughout Europe by Pierre-Jean-Georges Cabanis (1757-1808). He was not only a doctor, but also a philosopher and a politician who lived at the time of the French Revolution. His philosophy on the nature of medicine and the social role of the doctor is conceptualized in his idea of medical anthropology (science de l’homme, anthropologie). In order to understand why the social role of the doctor was particularly emphasized in and around France, Cabanis’ medical anthropology should be analyzed in depth. His medical anthropology is composed of three major domains: physiology, ethics, and analysis of ideologies. The following ideas of his medical anthropology can be identified in the current articles of the French code of medical deontology. 1) Health and disease being a social problem, a social solution should be sought (1.6, 1.7, 1.10, 2.37, 2.44, 2.50); 2) Medical practice is in principle not a commercial service for profit, but rather a public service supported by the government’s power (1.12, 1.19, 1.21, 2.55, 3.57, 3.67); 3) Doctors should maintain their professional autonomy by establishing and observing the principles of self-regulation (1.1, 1.5, 1.31, 2.50, 5.109, 5.110). Referring to the historical experience of French doctors, the Korean medical community should also enter into a broad and fundamental reflection on the nature of medicine and the social role of the doctor.