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T his study was done to analyze students’ learning and its lasting effect by teaching strategy involving questioning. This study was performed with 68 students who were enrolled in a physiology class of the Yonsei University College of Medicine in Seoul, Korea, in 2003. The students were randomly divided into 2 groups. One group was taught in a way where students asked questions and the instructor answered the questions. For the other group of students, the instructor asked questions, and the students answered the questions. We performed a pre-test before the study begins and post-tests immediately, 3 weeks, and 6 weeks after the study. The results were analyzed by using analysis of covariance and repeated measures analysis of variance. A higher learning effect was observed in a group where questions were asked by students compared with the other group. The post-test results showed no significant difference in the lasting effect of learning according to the teaching strategy. Students’ learning significantly improved when students asked questions and the instructor answered the questions compared with the strategy of the instructor asking questions and students answering to the questions

We evaluated the prognostic significance of excision repair cross-complementation group 1 protein (ERCC1) and thymidylate synthase (TS) in patients with nasopharyngeal cancer (NPC) treated with concurrent chemoradiotherapy (CCRT). Pre-treatment tumor biopsy specimens from 41 patients with locally advanced NPC (stage I: 1, II: 10, III: 9, IV: 21 patients) were analyzed for ERCC1 and TS expression by immunohistochemistry. All patients were treated with one cycle of induction chemotherapy (5-fluorouracil 1000 mg/m(2)/day and cisplatin 20mg/m(2)/day, days 1-4) followed by CCRT starting on day 22. CCRT consisted of radiotherapy (70 Gy/35 fractions for 7 weeks) with cisplatin 20mg/m(2)/day for 4 days on weeks 1, 4, and 7 of radiotherapy. High expression of ERCC1 and TS was observed in 25 (60%) and 21 (51%) patients, respectively. High expression of ERCC1 was associated with WHO type 1 or 2 histology (p=0.045). With a median follow-up duration of 106 months (32-152 months) in survivors, the 5-year overall survival (OS) of all patients was 53%. In univariate analysis, 5-year OS (73% versus 39%, p=0.005) was significantly inferior in patients with high expression of ERCC1, while high expression of TS was not correlated with patient outcome. In multivariate analysis, high expression of ERCC1 was a significant independent prognostic factor for poor OS (p=0.029) along with WHO type 1 or 2 histology. High expression of ERCC1 protein may be a useful prognostic factor for poor outcome in patients with locally advanced NPC treated with CCRT.

Changes in cyclic nucleotide production and atrial dynamics have been known to modulate atrial natriuretic peptide (ANP) release. Although cardiac atrium expresses histamine receptors and contains histamine, the role of histamine in the regulation of ANP release has to be defined. The purpose of the present study was to define the effect of histamine on the regulation of ANP release in perfused beating rabbit atria. Histamine decreased ANP release concomitantly with increases in cAMP efflux and atrial dynamics in a concentration-dependent manner. Histamine-induced decrease in ANP release was a function of an increase in cAMP production. Blockade of histamine H2receptor with cimetidine but not of H1receptor with triprolidine abolished the responses of histamine. Cell-permeable cAMP analog, 8-Br-cAMP, mimicked the effects of histamine, and the responses were dose-dependent and blocked by a protein kinase A (PKA)-selective inhibitor, KT5720. Nifedipine failed to modulate histamine-induced decrease in ANP release. Protein kinase nonselective inhibitor staurosporine blocked histamine-induced changes in a concentration-dependent manner. KT5720 and RP-adenosine 3′,5′-cyclic monophosphorothioate, another PKA-selective inhibitor, attenuated histamine-induced changes. These results suggest that histamine decreases atrial ANP release by H2receptor-cAMP signaling via PKA-dependent and -independent pathways.

6085 Background: We evaluated the prognostic significance of thymidylate synthase (TS), and Excision Repair Cross-Complementation Group 1 protein (ERCC1) in patients (pts) with nasopharyngeal cancer (NPC) treated with concurrent chemoradiotherapy (CCRT). Methods: Pretreatment tumor biopsy specimens from 41 pts with locally advanced NPC were analyzed for TS and ERCC1 expression by immunohistochemistry. All patients were treated with 1 cycle of induction chemotherapy (5-fluorouracil 1,000 mg/m2/day and cisplatin 20 mg/m2/day, days 1–4) followed by CCRT starting on day 22. CCRT consisted of radiotherapy (70Gy/35 fractions for 7 weeks) with cisplatin 20mg/m2/day for 4 days on weeks 1, 4, 7 of radiotherapy. Results: Complete response and partial response were achieved in 34 pts (83%) and 6 pts (15%), respectively. Within median follow up duration of 101 months (26–147months) in survivors, 5-years overall survival (OS) of all pts was 50%. High expression of TS and ERCC1 was observed in 21 (51%) and 25 (60%) pts, respectively. High expression of ERCC1 was associated with WHO type 1 or 2 histology (p = 0.045). In univariate analysis, high expression of ERCC1 was associated with poor OS (5-year: 73% versus 35%; p = 0.005), while high expression of TS was not correlated with pts outcome (p = 0.867). In multivariate analysis, high expression of ERCC1 was a significant independent predictor of poor OS (p = 0.041) along with WHO type 1 or 2 histology (p = 0.004). Conclusions: High expression of ERCC1 protein may be useful for prediction of poor outcome in pts with NPC treated with CCRT. No significant financial relationships to disclose.

Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a rare, but serious, side effect of bisphosphonate therapy that produces significant morbidity in affected patients. It is characterized by poor wound healing and spontaneous intra-oral soft tissue breakdown, which lead to exposure of necrotic maxillary and mandibular bone. We report a case of BRONJ in 56-year-old man who visited Ajou University Hospital Dental Clinic in March 2007. He had been diagnosed with Waldenstrom's macroglobulinemia in 2005 and had been treated with chemotherapeutic agents, along with concomitant pamidronate injections (45 mg monthly). The patient had clinical features of bisphosphonate-related osteonecrosis of the mandible precipitated by tooth extraction. The patient had multiple systemic risk factors, including extended duration of intravenous pamidronate therapy, chemotherapy, and glucocorticoid therapy for his malignancy. In the 6 months prior to presentation, curettage and debridement were performed repeatedly, but there was no improvement in the mandibular lesion. The patient was referred to the Endocrinology Clinic and was diagnosed with BRONJ. We discontinued pamidronate and started conservative care. BRONJ should be considered in the differential diagnosis when patients complain of poor oral wound healing or have recurrent exposure of necrotic maxillary and mandibular bone. (J Korean Endocr Soc 23:210~214, 2008)