• Title/Summary/Keyword: P4 medicine

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A case of partial trisomy 3p syndrome with rare clinical manifestations

  • Han, Dong-Hoon;Chang, Ji-Young;Lee, Woo-In;Bae, Chong-Woo
    • Clinical and Experimental Pediatrics
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    • v.55 no.3
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    • pp.107-110
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    • 2012
  • Partial trisomy 3p results from either unbalanced translocation or $de$ $novo$ duplication. Common clinical features consist of dysmorphic facial features, congenital heart defects, psychomotor and mental retardation, abnormal muscle tone, and hypoplastic genitalia. In this paper, we report a case of partial trisomy 3p with rare clinical manifestations. A full-term, female newborn was transferred to our clinic. She had cleft lip-plate, dysgenesis of the corpus callosum, patent ductus arteriosus, pulmonary hypertension, and severe right-sided hydronephrosis, associated with ureteropelvic junction obstruction. Cytogenetic investigation revealed partial trisomy 3p; 46,XX,der(4)t(3;4)(p21.1;p16). The karyotype of her father showed a balanced translocation, t(3;4)(p21.1;p16). Therefore, the size of duplication can be an important factor.

Systems Biology and Emerging Technologies Will Catalyze the Transition from Reactive Medicine to Predictive, Personalized, Preventive and Participatory (P4) Medicine

  • Galas, David J.;Hood, Leroy
    • Interdisciplinary Bio Central
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    • v.1 no.2
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    • pp.6.1-6.4
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    • 2009
  • We stand at the brink of a fundamental change in how medicine will be practiced. Over the next 5-20 years medicine will move from being largely reactive to being predictive, personalized, preventive and participatory (P4). Technology and new scientific strategies have always been the drivers of revolutions and this is certainly the case for P4 medicine, where a systems approach to disease, new and emerging technologies and powerful computational tools will open new windows for the investigation of disease. Systems approaches are driving the emergence of fascinating new technologies that will permit billions of measurements on each individual patient. The challenge for health information technology will be how to reduce this enormous amount of data to simple hypotheses about health and disease. We predict that emerging technologies, together with the systems approaches to diagnosis, therapy and prevention will lead to a down turn in the escalating costs of healthcare. In time we will be able to export P4 medicine to the developing world and it will become the foundation of global medicine. The "democratization" of healthcare will come from P4 medicine. Its first real emergence will require the unprecedented integration of biology, medicine, technology and computation. as well as societal issues of major importance: ethical, regulatory, public policy, economic, and others. In order to effectively move the P4 scientific agenda forward new strategic partnerships are now being created with the large-scale integration of complementary skills, technologies, computational tools, patient records and samples and analysis of societal issues. It is evident that the business plans of every sector of the healthcare industry will need to be entirely transformed over the next 10 years.and the extent to which this will be done by existing companies as opposed to newly created companies is a fascinating question.

Serum Pepsinogen Levels as a Screening Test of Gastric Cancer and Adenoma in Korea (혈청 펩시노겐치를 이용한 위암 및 위선종의 집단검진)

  • Kim, Jang-Rak;Choi, Jin-Hak;Kim, Young-Chai;Lee, Ok-Jae;Cho, Kyu-Il;Lee, Han-Woo;Hong, Dae-Yong
    • Journal of Preventive Medicine and Public Health
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    • v.27 no.4 s.48
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    • pp.677-691
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    • 1994
  • To evaluate the validity of serum pepsinogen levels as a screening tool for gastric cancer and adenoma, immunoradiometric assays of serum pepsinogen I level (PG I), II level (PG II) and esphagogastroduodenal endoscopies were done in 757 health examinees. Serum PG I level was higher in subjects with active duodenal ulcer (n=45, $75.2{\pm}34.3{\mu}g/l(mean{\pm}standard\;deviation)$, p<0.01) and gastroduodenal ulcers (n=8, $75.6{\pm}19.8{\mu}g/l$, p<0.05), and was lower in those with gastric adenoma(n=4, $37.7{\pm}37.2{\mu}g/l$, p<0.2) than those with normal, mild gastritis findings or ulcer scars (n=378, $56.6{\pm}24.9{\mu}g/l$. Serum PG II level was higher in subjects with active duodenal ulcer($17.2{\pm}13.8{\mu}g/l$, p<0.2), active gastro-duodenal ulcers ($18.3{\pm}7.4{\mu}g/l$, p<0.2) and gastric carcinoma (n=3, $23.8{\pm}10.9{\mu}g/l$, p<0.05) than those with normal, mild gastritis findings or ulcer scars $(14.5{\pm}7.9{\mu}g/l)$. Serum PG I/PG II ratio was higher in subjects with active duodenal ulcer($5.1{\pm}1.6$, p<0.05) and was lower in those with chronic gastritis(n=107, $4.1{\pm}1.7$, p<0.05), gastric polyp(n=19, $3.9{\pm}1.4$, p<0.2), gastric adenoma(n=4, $2.1{\pm}1.9$, p<0.01) and gastric carcinoma(n=3, $2.7{\pm}1.2$, p<0.1) than those with normal, mild gastritis findings or ulcer scars ($4.5{\pm}1.7$). Serum PG II level increased with age until 6th decade, whereas serum PG I/PG II ratio decreased with age in 378 subjects with normal, mild gastritis findings or ulcer scars. The screening criteria of serum PG I<$70{\mu}g/l$ and PG I/PG II ratio<3.0 for detecting gastric cancer and adenoma gave a positive rate of 15.7%, sensitivity of 57.1% and specificity of 84.7%.

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Differences in youngest-old, middle-old, and oldest-old patients who visit the emergency department

  • Lee, Sang Bum;Oh, Jae Hun;Park, Jeong Ho;Choi, Seung Pill;Wee, Jung Hee
    • Clinical and Experimental Emergency Medicine
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    • v.5 no.4
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    • pp.249-255
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    • 2018
  • Objective As aging progresses, clinical characteristics of elderly patients in the emergency department (ED) vary by age. We aimed to study differences among elderly patients in the ED by age group. Methods For 2 years, patients aged 65 and older were enrolled in the study and classified into three groups: youngest-old, ages 65 to 74 years; middle-old, 75 to 84 years; and oldest-old, ${\geq}85years$. Participants' sex, reason for ED visit, transfer from another hospital, results of treatment, type of admission, admission department and length of stay were recorded. Results During the study period, a total 64,287 patients visited the ED; 11,236 (17.5%) were aged 65 and older, of whom 14.4% were 85 and older. With increased age, the female ratio (51.5% vs. 54.9% vs. 69.1%, P<0.001), medical causes (79.5% vs. 81.3% vs. 81.7%, P=0.045), and admission rate (35.3% vs. 42.8% vs. 48.5%, P<0.001) increased. Admissions to internal medicine (57.5% vs. 59.3% vs. 64.7%, P<0.001) and orthopedic surgery (8.5% vs. 11.6% vs. 13.8%, P<0.001) also increased. The ratio of admission to intensive care unit showed no statistical significance (P=0.545). Patients over age 85 years had longer stays in the ED (330.9 vs. 378.9 vs. 407.2 minutes, P<0.001), were discharged home less (84.4% vs. 78.9% vs. 71.5%, P<0.001), and died more frequently (6.3% vs. 10.4% vs. 13.0%, P<0.001). Conclusion With increased age, the proportion of female patients and medical causes increased. Rates of admission and death increased with age and older patients had longer ED and hospital stays.

Assessment of Thyroid Status by T4, TSH and Thyroglobulin Autoantibody in Dogs (개에서 T4, TSH, 갑상샘글로불린 자가항체 값에 의한 갑상샘의 상태 평가)

  • Choi Eun-Wha;Bae Bo-Kyoung;Shin Il-Seob;Bhang Dong-Ha;Hwang Cheol-Yong;Lee Chang-Woo;Youn Hwa-Young
    • Journal of Veterinary Clinics
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    • v.23 no.2
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    • pp.149-152
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    • 2006
  • The canine thyroglobulin autoantibody assay is to be used for the diagnosis of autoimmune thyroid disease in dogs. Antithyroglobulin antibodies are present in about 50 percent of hypothyroid dogs. In this report, the sera of the five canine patients ($P1{\sim}P5$) referred to the Veterinary Medical Teaching Hospital in Seoul National University were assessed by T4, TSH and thyroglobulin autoantibody (TgAA). P1 was diagnosed as severe hypothyroidism since he showed very high TSH levels with low T4 values. P2 and P3 born with a genetic predisposition were assessed as normal in thyroid function. P4 was normal, but needed follow-up examination for TgAA assay. P5 showed the positive result in TgAA assay, so it was diagnosed as autoimmune thyroiditis. As the cases above show, not only T4 and TSH, but also TgAA assay to be considered for more accurate assessment of the status of the thyroid.

High Cytoplasmic CXCR4 Expression Predicts Prolonged Survival in Triple-Negative Breast Cancer Patients Treated with Adjuvant Chemotherapy

  • Shim, Bobae;Jin, Min-Sun;Moon, Ji Hye;Park, In Ae;Ryu, Han Suk
    • Journal of Pathology and Translational Medicine
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    • v.52 no.6
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    • pp.369-377
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    • 2018
  • Background: Chemokine receptor CXC chemokine receptor type 4 (CXCR4) and its ligand CXC motif chemokine 12 (CXCL12; stromal cell-derived factor-1) are implicated in tumor growth, metastasis, and tumor cell-microenvironment interaction. A number of studies have reported that increased CXCR4 expression is associated with worse prognosis in triple-negative breast cancer (TNBC), but its prognostic significance has not been studied in TNBC patients treated with adjuvant chemotherapy. Methods: Two hundred eighty-three TNBC patients who received adjuvant chemotherapy were retrospectively analyzed. Tissue microarray was constructed from formalin-fixed, paraffin-embedded tumor tissue and immunohistochemistry for CXCR4 and CXCL12 was performed. Expression of each marker was compared with clinicopathologic characteristics and outcome. Results: High cytoplasmic CXCR4 expression was associated with younger age (p=.008), higher histologic grade (p=.007) and lower pathologic stage (p=.045), while high CXCL12 expression was related to larger tumor size (p=.045), positive lymph node metastasis (p=.005), and higher pathologic stage (p=.017). The patients with high cytoplasmic CXCR4 experienced lower distant recurrence (p=.006) and better recurrence-free survival (RFS) (log-rank p=.020) after adjuvant chemotherapy. Cytoplasmic CXCR4 expression remained an independent factor of distant recurrence (p=.019) and RFS (p=.038) after multivariate analysis. Conclusions: High cytoplasmic CXCR4 expression was associated with lower distant recurrence and better RFS in TNBC patients treated with adjuvant chemotherapy. This is the first study to correlate high CXCR4 expression to better TNBC prognosis, and the underlying mechanism needs to be elucidated in further studies.

Nicotine Dependence and Stress Susceptibility in E-Cigarette Smokers: The Korea National Health and Nutrition Examination Survey 2013-2017

  • Kim, Jae Yeol;Kang, Hye Seon;Jung, Jae-Woo;Jung, Sun Young;Park, Hye Jung;Park, Jong Sook;Park, Joo Hun;Lee, Sang Haak;Chun, Eun Mi;Park, Dong Il;Park, Jisook;Choi, Hye Sook;Korean Smoking Cessation Study Group
    • Tuberculosis and Respiratory Diseases
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    • v.84 no.2
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    • pp.159-166
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    • 2021
  • Background: E-cigarettes are steadily gaining popularity in Korea. However, the characteristics of e-cigarette smokers, especially nicotine dependence and stress susceptibility, have not been evaluated in comparison to those of nonsmokers or combustible cigarette smokers in Korea. Methods: In this study, 28,059 participants from the Korea National Health and Nutrition Examination Survey (2013-2017) were classified into the following three groups: non-smokers, smokers (current smokers and ex-smokers of combustible cigarettes only), and e-smokers (current smokers and ex-smokers of e-cigarettes regardless of combustible cigarette use). Results: Among the participants, 16,980 (60.5%), 9,247 (33.0%), and 1,832 (6.4%) subjects were non-smokers, smokers, and e-smokers, respectively. E-smokers were younger, more educated, and had a higher household income than non-smokers or smokers. The number of e-smokers who smoked within 5 minutes of waking up (31.5% vs. 19.8%, p<0.001) and who planned to quit smoking within 6 months (39.1% vs. 35.7%, p<0.05) was greater than that of smokers. E-smokers perceived stress as "very much" (7.0% vs. 4.4%, p<0.001) and "a lot" (29.1% vs. 20.5%, p<0.001) compared to non-smokers. Suicidal ideation (6.5% vs. 4.7%, p<0.001), plans (2.4% vs. 1.3%, p<0.001), and attempts (1.1% vs. 0.5%, p<0.001) were higher in e-smokers than in non-smokers. Depressive episodes in 1 year (14.2% vs. 11.4%, p<0.05) and suicidal plans (2.4% vs. 1.8%, p<0.05) were more frequent among e-smokers than among smokers. Conclusion: E-smokers were younger, more educated, and had a higher income, but they were more dependent on nicotine and susceptible to stress than non-smokers and smokers. Smoking cessation counseling should be tailored according to the characteristics of e-smokers.

Association between Gastric pH and Helicobacter pylori Infection in Children

  • Seo, Ji-Hyun;Park, Heung Keun;Park, Ji Sook;Yeom, Jung Sook;Lim, Jae-Young;Park, Chan-Hoo;Woo, Hyang-Ok;Youn, Hee-Shang;Jun, Jin-Su;Ko, Gyung-Hyuck;Baik, Seung-Chul;Lee, Woo-Kon;Cho, Myung-Je;Rhee, Kwang-Ho
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.18 no.4
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    • pp.246-252
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    • 2015
  • Purpose: To assess gastric pH and its relationship with urease-test positivity and histological findings in children with Helicobacter pylori infection. Methods: Fasting gastric juices and endoscopic antral biopsy specimens were collected from 562 children and subjected to the urease test and histopathological examination. The subjects were divided into 3 age groups: 0-4, 5-9, and 10-15 years. The histopathological grade was assessed using the Updated Sydney System, while the gastric juice pH was determined using a pH meter. Results: The median gastric juice pH did not differ significantly among the age groups (p=0.655). The proportion of individuals with gastric pH >4.0 was 1.3% in the 0-4 years group, 6.1% in the 5-9 years group, and 8.2% in 10-15 years (p=0.101). The proportions of moderate and severe chronic gastritis, active gastritis, and H. pylori infiltration increased with age (p<0.005). Urease-test positivity was higher in children with hypochlorhydria (77.8%) than in those with normal gastric pH (31.7%) (p<0.001). Chronic and active gastritis were more severe in the former than the latter (p<0.001), but the degree of H. pylori infiltration did not differ (20.9% vs. 38.9%; p=0.186). Conclusion: Gastric pH while fasting is normal in most children regardless of age. Urease-test positivity may be related to hypochlorhydria in children, and hypochlorhydria is in turn related to H. pylori infection.

Interactions between Hyaluronic Acid, Lysozyme, Peroxidase, and Glucose Oxidase in Enzymatic Activities at Low pH

  • Kim, Bum-Soo;Kim, Yoon-Young;Chang, Ji-Youn;Kho, Hong-Seop
    • Journal of Oral Medicine and Pain
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    • v.39 no.4
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    • pp.127-132
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    • 2014
  • Purpose: Many substances in saliva or oral health care products interact with each other. The aim of this study was to investigate interactions between hyaluronic acid (HA), lysozyme, peroxidase, and glucose oxidase (GO) in enzymatic activities at low pH levels. Methods: HA (0.5 mg/mL), hen egg-white lysozyme (HEWL, $30{\mu}g/mL$), bovine lactoperoxidase (bLPO, $25{\mu}g/mL$), and GO ($50{\mu}g/mL$) were used. The influences of HA, bLPO, and GO on HEWL activity were determined by measuring the turbidity of a Micrococcus lysodeikticus suspension. The influences of HA and HEWL on bLPO activity were determined by the NbsSCN assay, measuring the rate of oxidation of 5-thio-2-nitrobenzoic acid (Nbs) to 5,5'-dithiobis(2-nitrobenzoic acid) $(Nbs)_2$. The influences of HA and HEWL on GO activity were determined by measuring oxidized o-dianisidine production. All experiments were performed at pH 4, 5, and 6. Results: HA and GO did not affect the enzymatic activity of HEWL at pH 4, 5, and 6. bLPO enhanced the enzymatic activity of HEWL at pH 5 (p<0.05) and pH 6 (p<0.05) significantly. The enzymatic activity of bLPO was not affected by HA and HEWL at pH 4, 5, and 6. HA and HEWL did not affect the enzymatic activity of the GO at pH 4, 5, and 6. Conclusions: Peroxidase enhances lysozyme activity at low pH, otherwise there were no significant interactions in enzymatic activities between HA, lysozyme, peroxidase, and GO at low pH levels.

Effect of Donor Cell Types and Passages on Preimplantation Development and Apoptosis in Porcine Cloned Embryos

  • Lee, Youn-Su;Ock, Sun-A;Cho, Seong-Keun;Jeon, Byeong-Gyun;Kang, Tae-Young;Balasubramanian, S.;Choe, Sang-Yong;Rho, Gyu-Jin
    • Asian-Australasian Journal of Animal Sciences
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    • v.20 no.5
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    • pp.711-717
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    • 2007
  • In this study, two cell types from porcine females, namely fetal fibroblasts (pFFs) and adult ear fibroblasts (pAEFs) and two passages (3-4 and 7-8) were investigated by evaluating the development rate, blastocyst cell number and the incidence of apoptosis. No significant differences were observed in the cleavage rates of cloned and IVF embryos. The blastocyst rates between the embryos cloned with pFFs ($15.1{\pm}3.2$) and pAEFs ($10.4{\pm}2.6$) did not differ significantly but was significantly (p<0.05) lower in pAEFs than that in IVF ($22.5{\pm}4.5$) embryos. Total cell number in pFFs ($28.4{\pm}4.3$) and pAEFs cloned blastocysts ($24.2{\pm}5.1$) was significantly (p<0.05) lesser than IVF control ($35.4{\pm}3.2$). Apoptosis rates between cloned blastocysts differed significantly (p<0.05) and were significantly (p<0.05) higher than IVF embryos. The blastocyst rates between the cloned embryos cloned with different cell passages did not differ significantly but in embryos cloned with 7-8 cell passage was significantly (p<0.05) lower than the IVF control. Apoptosis signals were detected in IVF and cloned embryos as early as day 3 and the rates of apoptosis increased concurrently with the embryo development. In conclusion, high apoptosis during in vitro preimplantation development resulted in low development rate and total cell number of cloned embryos. Moreover, based on the apoptotic incidence in cloned blastocysts, fetal fibroblasts are more suitable for production of cloned embryos in porcine.