• Title/Summary/Keyword: clinical stage

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Detection of genetic abnormalities in human sperm, oocytes, and preimplantation embryos using fluorescence in situ hybridization (FISH) (Fluorescence in situ hybridization(FISH) 기법을 이용한 인간 생식세포 및 착상전 배아의 유전이상 검색)

  • 방명걸
    • Proceedings of the Korean Society of Developmental Biology Conference
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    • 1998.07a
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    • pp.12-18
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    • 1998
  • Tremendous progress has been made over the past quarter-century studying the genetics of gametogenesis and the resulting gametes and embryos. Studies merging molecular techniques and conventional cytogenetics are now beginning to bridge the gap between what we have learned about the meiotic process in males and females and what we know of the mitotic chromosomes of zygotes. Numerical abnormalities in sperm, oocytes and embryo can now diagnosed by fluorescence in situ hybridization (FISH). "At risk" couples can, therefore, have only unaffected embryos replaced in the sterus and avoid the possibility of terminating a pregnancy that might only be diagnosed as affected later gestation. Single-cell genetic analysis has also provided powerful tools for studying genetic defects arising during early human development. Recent studies of sperms, oocytes and cleavage-stage human embryos have revealed an unexpectedly high incidence. These genetic abnormalities are likely to contribute to early pregnancy loss and have important implications for improving pregnancy rates in infertile couples by assisted reproduction. The widespread use of preimplantation genetic diagnosis (PGD) awaits further documentatio of safety and accuracy. Other issues also must be addressed. First, the ethical issues regarding germ cell and embryo screening must be addressed including what diseases are serious enough to warrant the procedure. Another concern is the use of this technology for non-genetic disorders such as gender selection. Finally, the experimental nature of these procedure must continually be discussed with patients, and long-term follow-up studies must be undertaken. Development of more accurate and less expensive assays coupled with improved assisted reproductive technology success rates may make PGD a more widely use clinical tool. The future awaits these development.velopment.

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Compartment syndrome due to extravasation of peripheral parenteral nutrition: extravasation injury of parenteral nutrition

  • Park, Huee Jin;Kim, Kyung Hoon;Lee, Hyuk Jin;Jeong, Eui Cheol;Kim, Kee Won;Suh, Dong In
    • Clinical and Experimental Pediatrics
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    • v.58 no.11
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    • pp.454-458
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    • 2015
  • Compartment syndrome is a rare but devastating condition that can result in permanent neuromuscular or soft tissue injuries. Extravasation injuries, among the iatrogenic causes of compartment syndrome, occur under a wide variety of circumstances in the inpatient setting. Total parenteral nutrition via a peripheral route is an effective alternative for the management of critically ill children who do not obtain adequate nutrition via the oral route. However, there is an inherent risk of extravasation, which can cause compartment syndrome, especially when detected at a later stage. Herein, we report a rare case of compartment syndrome and skin necrosis due to extravasation, requiring emergency fasciotomy and skin graft in a 7-month-old boy who was treated with peripheral parenteral nutrition via a pressurized infusion pump. Although we cannot estimate the exact time at which extravasation occurred, the extent and degree of the wound suggest that the ischemic insult was prolonged, lasting for several hours. Pediatric clinicians and medical teams should carefully examine the site of insertion of the intravenous catheter, especially in patients receiving parenteral nutrition via a peripheral intravenous catheter with a pressurized infusion pump.

Discrimination of Parkinson's Disease from Essential Tremor using Acceleration based Tremor Analysis (가속도계를 이용한 진전현상의 분석을 통한 파킨슨병과 본태성 진전의 판별)

  • Lee, Hongji;Lee, Woongwoo;Jeon, Hyoseon;Kim, Sangkyong;Kim, Hanbyul;Jeon, Beom S.;Park, Kwangsuk
    • Journal of Biomedical Engineering Research
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    • v.36 no.4
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    • pp.103-108
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    • 2015
  • Discrimination of Parkinson's disease (PD) from Essential tremor (ET) is often misdiagnosed in clinical practice. Since tremor is time-varying signal, and dominant and harmonic frequencies are shown in tremor only with moderate or severe symptom, there are some limitations to use frequency related features. Moreover, patients with PD or ET can suffer from both resting tremor and postural tremor. In this study, 28 patients with PD and 17 patients with ET were enrolled. Tremor was measured with accelerations on the more affected hand during resting and postural conditions. The ratio of root mean square (RMS) of resting tremor to RMS of postural tremor, the mean coefficients of autocorrelation function (ACF), and the mean of differences of two adjacent coefficients of ACF at resting and postural were calculated and compared between PD and ET. The performance showed 98% accuracy with support vector machine and leave-one-out cross validation. In addition, the method accurately differentiated the patients with tremor-dominant PD from patients with ET, with 100% accuracy. Therefore, the developed algorithm can assist clinicians in diagnosing and categorizing patients with tremor, especially, patients with mild symptom or the early stage of a disease, for proper treatment.

Development and Evaluation of D-Attention Unet Model Using 3D and Continuous Visual Context for Needle Detection in Continuous Ultrasound Images (연속 초음파영상에서의 바늘 검출을 위한 3D와 연속 영상문맥을 활용한 D-Attention Unet 모델 개발 및 평가)

  • Lee, So Hee;Kim, Jong Un;Lee, Su Yeol;Ryu, Jeong Won;Choi, Dong Hyuk;Tae, Ki Sik
    • Journal of Biomedical Engineering Research
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    • v.41 no.5
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    • pp.195-202
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    • 2020
  • Needle detection in ultrasound images is sometimes difficult due to obstruction of fat tissues. Accurate needle detection using continuous ultrasound (CUS) images is a vital stage of treatment planning for tissue biopsy and brachytherapy. The main goal of the study is classified into two categories. First, new detection model, i.e. D-Attention Unet, is developed by combining the context information of 3D medical data and CUS images. Second, the D-Attention Unet model was compared with other models to verify its usefulness for needle detection in continuous ultrasound images. The continuous needle images taken with ultrasonic waves were converted into still images for dataset to evaluate the performance of the D-Attention Unet. The dataset was used for training and testing. Based on the results, the proposed D-Attention Unet model showed the better performance than other 3 models (Unet, D-Unet and Attention Unet), with Dice Similarity Coefficient (DSC), Recall and Precision at 71.9%, 70.6% and 73.7%, respectively. In conclusion, the D-Attention Unet model provides accurate needle detection for US-guided biopsy or brachytherapy, facilitating the clinical workflow. Especially, this kind of research is enthusiastically being performed on how to add image processing techniques to learning techniques. Thus, the proposed method is applied in this manner, it will be more effective technique than before.

Indications, Outcomes, and Complications of Pedicled Propeller Perforator Flaps for Upper Body Defects: A Systematic Review

  • Lazzeri, Davide;Huemer, Georg M.;Nicoli, Fabio;Larcher, Lorenz;Dashti, Talal;Grassetti, Luca;Li, Qingfeng;Zhang, Yixin;Spinelli, Giuseppe;Agostini, Tommaso
    • Archives of Plastic Surgery
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    • v.40 no.1
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    • pp.44-50
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    • 2013
  • Background The aim of this investigation was to systematically review the current literature to provide the best data for indications, outcomes, survival, and complication rates of pedicled propeller perforator flaps for upper body defects. Methods A comprehensive literature review for articles published from January 1991 to December 2011 was performed using the PubMed, Medline, and Cochrane Databases. Articles without available full-text, single case reports or papers with excessive missing data were excluded. Papers reporting pedicle-perforator (propeller) flaps used for lower extremity reconstruction were excluded from meta-analysis. Results From the initial 1,736 studies our search yielded, 343 studies qualified for the second stage of selection. Of 117 full-text reports screened, 41 studies, met the definitive inclusion and exclusion criteria. Of the selected 41 articles, 26 were case series, original papers or retrospective reviews and were included, whereas 15 were case report papers and therefore were excluded. Two hundred ninety-five propeller flaps were reported to have been used in a total of 283 patients. Indications include repair of trauma-induced injuries, post-trauma revision surgery, cancer resection, chronic infection, pressure sores, and chronic ulcers with a major complication rate (3.3%) comparable to that of free flaps. No specific exclusion criteria for the procedure were presented in the studies reviewed. Conclusions Pedicled propeller flaps are a versatile and safe reconstructive option that are easy and quick to raise and that provide unlimited clinical solutions because of the theoretical possibility of harvesting them based on any perforator chosen among those classified in the body.

Sample Size Determination for Comparing Tail Probabilities (극소 비율의 비교에 대한 표본수 결정)

  • Lee, Ji-An;Song, Hae-Hiang
    • The Korean Journal of Applied Statistics
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    • v.20 no.1
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    • pp.183-194
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    • 2007
  • The problem of calculating the sample sizes for comparing two independent binomial proportions is studied, when one of two probabilities or both are smaller than 0.05. The use of Whittemore(1981)'s corrected sample size formula for small response probability, which is derived based oB multiple logistic regression, demonstrates much larger sample sizes compared to those by the asymptotic normal method, which is derived for the comparison of response probabilities belonging to the normal range. Therefore, applied statisticians need to be careful in sample size determination with small response probability to ensure intended power during a planning stage of clinical trials. The results of this study describe that the use of the sample size formula in the textbooks might sometimes be risky.

Visceral Leishmaniasis in Rural Areas of Alborz Province of Iran and Implication to Health Policy

  • Heidari, Aliehsan;Mohebali, Mehdi;Kabir, Kourosh;Barati, Hojatallah;Soultani, Yousef;Keshavarz, Hossein;Akhoundi, Behnaz;Hajjaran, Homa;Reisi, Hosein
    • Parasites, Hosts and Diseases
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    • v.53 no.4
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    • pp.379-383
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    • 2015
  • Visceral leishmaniasis (VL) or kala-azar mainly affects children in endemic areas. This study was conducted to determine the seroprevalence of VL using direct agglutination test (DAT) in children living in rural districts of Alborz Province located 30 km from Tehran capital city of Iran. Multi-stage cluster random sampling was applied. Blood samples were randomly collected from 1,007 children under 10 years of age in the clusters. A total of 37 (3.7%) of the studied population showed anti-Leishmania infantum antibodies with titers of ${\geq}1:800$. There was a significant association between positive sera and various parts of the rural areas of Alborz Province (P<0.002). Two children with anti-Leishmania infantum antibodies titers of ${\geq}1:3,200$ indicated kala-azar clinical features and treated with anti-leishmaniasis drugs in pediatric hospital. The findings of this study indicated that Leishmania infection is prevalent in rural areas of Alborz Province. Therefore, it is necessary to increase the awareness and alertness among physicians and public health managers, particularly in high-risk rural areas of the province in Iran.

Development of Measurement Scale for the Quality of Life in Hypertensive Patients (고혈압 환자의 삶의 질 측정도구 개발)

  • Kim, Keon-Yeop;Kam, Sin;Lee, Sang-Won;Park, Ki-Soo;Chae, Shung-Chull;Chun, Byung-Yeol
    • Journal of Preventive Medicine and Public Health
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    • v.38 no.1
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    • pp.61-70
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    • 2005
  • Objectives : To develop a tool for multidimensional measurement of the quality of life, which was psychometrically sound, short, and easy to administer for patients with hypertension. Methods : A sample of 1,115 hypertensive patients aged 20 or above in Cheong-Song County was studied from June 1997 to October 1998. In the development of the instrumental stage, the authors first conceptualized the quality of life. Item generation, item reduction, and questionnaire formatting were followed. Item-level (item descriptive, missing%, item internal consistency, item discriminant validity) analysis, scale-level (scale descriptive, floor and ceiling effect) analysis, and other tests(Cronbach's alpha, inter-dimension correlations, factor analysis, clinical validity) were performed to evaluate the validity and reliability of the new measurement scale. After 1 year, responsiveness and confirmatory factor analysis were performed. Results : The results of both item-level and scale-level analyses were acceptable. An acceptable degree of internal consistency was observed for each of the dimensions (Cronbach's alpha was 0.60 or higher). Inter-dimension correlations were below 0.50 and the factor analysis result was the same as the intended dimension structure. Correlation coefficients between perceived health status, stress and dimensions were proven to be acceptable. The result of comparing dimensional score means among ADL and MMSE-K groups above 60 years was statistically significant(p<0.05). The result of confirmatory factor analysis concluded that the dimensional structure model was well fitted. However, the result of responsiveness test using sensitivity and specificity was unsatisfactory. Conclusions : The newly developed measurement scale is psychometrically reliable and valid instrument for measuring quality of life in hypertensive patients.

Anti-Toxoplasmosis Effect of Citrus Unshiu Markovich against Toxoplasma Gondii (한약제 진피의 항 톡소포자충 효과 확인)

  • Kim, Hye-Kung;Jiang, Jing-Hua;Lee, Dong-Hwan;Kim, Hye-Sook;Park, Hyun
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.22 no.1
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    • pp.96-99
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    • 2008
  • Toxoplasma gondiiis a widespread apicomplexan parasite which is able to infect virtually all warm-blooded vertebrates. Twenty-two percent of the U.S. population is infected, but severe disease in adults is mainly limited to immunosuppressed patients. In patients with acquired immunodeficiency syndrome(AIDS), T. gondii causes a life-threatening opportunistic infection, with Toxoplasma encephalitis as its most severe manifestations. T. gondii is also known to cause congenital infection and is among the pathogens with the highest incidence of complications in pregnancies. Despite its clinical importance, only very few therapeutic drugs against T. gondii are available, all of which target the rapidly dividing tachyzoites, leaving the dormant encysted bradyzoite stage unaffected. We searched 15 traditional medicines that have anti-inflammatory effect from dongyibogam and Traditional Chinese medicine. In vitro studies were performed with HeLa cell cultures, with quantification of Toxoplasma growth by a cell proliferation assay. The result of experiment shows the selectivity of Citrus unshiu Markovich is 6.0. This is higher than sulfadiazine (selectivity was 1.63). For in vivo studies, mice were acutely infected intraperitoneally with $10^5$ tachyzoites of the virulent RH strain and then treated per orally for 4 days from 6 hours postinfection. Efficacy was assessed by sequential determination of parasite burdens in peritoneal cavity. In vivo, Citrus unshiu Markoviche inhibited Toxoplasma growth at a concentration of 10㎎/㎏ of body weight per day, the inhibition ratio was estimated to be 64.01%.

Distribution of ticks carrying Severe Fever with Thrombocytopenia Syndrome Virus (SFTSV) around Jiri walking trails of Jeollanam-do, Korea (지리산둘레길에서 채집한 참진드기의 분포와 참진드기에서의 중증열성혈소판감소증후군바이러스 검출)

  • Song, Byung Joon;Lim, Hyun Cheol;Ha, Tae Man;Jeon, Doo Yung;Yang, Soo In;Song, Hyeon Je
    • Korean Journal of Veterinary Service
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    • v.39 no.2
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    • pp.75-80
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    • 2016
  • Severe fever with thrombocytopenia syndrome (SFTS) is an emerging disease characterized by fever and thrombocytopenia. Haemaphysalis longicornis ticks comprise the major population of ticks in the environment and have been considered as the main vector for SFTS virus (SFTSV). Here we investigated the distribution of ticks carrying SFTSV collected from the environment using the dragging or sweeping methods during April~October 2015 in Jeollanam-do, Korea. Sampling was taken from Songjeong, Omi, Bangkwang, Sandong areas in Jiri walking trails. Among the total 3,869 ticks collected, 3,823 ticks (98.8%) were H. longicornis, 41 (1.1%) were Amblyomma testudinarium, and 5 (0.1%) were Ixodes nipponensis. Classification results by regional groups of H. longicornis indicated that 1,613 ticks were collected in Sandong, 1,190 ticks in Omi, 603 ticks in Bangkwang, and 417 ticks in Songjeong. In monthly distributional studies of H. longicornis based on the developmental stages, nymph (325 ticks) was collected from May to October, 94% of larvae from April to June, and 94% of adult from June to August. These results showed the different dominant stage of ticks according to seasons. However, no SFTSV-specific gene was detected in 3,823 ticks of H. longicornis, 41 of A. testudinarium and 5 of I. nipponensis.