• Title/Summary/Keyword: gynecology

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Study on the Current Situation and Issues for Clinical Research in Korean Medicine worldwide - Future Clinical Research Strategy I - (한의 임상 연구에 대한 국내외 현황 및 논쟁에 관한 고찰 - 미래 임상 연구 전략 I -)

  • Jung, Ki Yong;Go, Ho Yeon;Sun, Seung Ho;Jeong, Jong Jin;Park, Jeong Su;Song, Yun Kyung;Kim, Tae Hoon;Hong, Sung In;Choi, You Kyung;Go, Seong Gyu;Lim, Eun Mee;Lee, Choong Yeol;Park, Jong Hyeong;Jeon, Chan Yong
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.28 no.2
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    • pp.137-145
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    • 2014
  • The purpose of this paper is to explore the strategy of future Korean medicine(KM) clinical research through the study on the current situation and issues for KM clinical research worldwide. In this study, the papers published in English through Pubmed were investigated mainly. And we analyzed the methodological issues from the clinical research reports in the KM fields. As a result of examining the current situation of the RCTs(Randomized Controlled Trials) studies in KM, the sample size for most studies was small and the overall methodological quality appeared to be low. And there was a discussion about whether or not to apply RCTs method to the KM clinical research. The majority of studies have argued the use of RCTs method for KM clinical research. In addition, we could find some problems through the analysis of KM clinical studies. First, the majority of RCTs in KM were of low quality. Second, RCTs method was applied to the KM clinical studies according to the Western medicine methods only. Third, the actual KM diagnosis was not used in the KM studies and inadequate outcomes measurement methods were utilized without considering the characteristics of KM practice. The methodological issues in the KM clinical research were caused by the conflict between the characteristics of KM practice and clinical research method based on the western medicine.

Evaluation of Protective Immune Response Induced by a DNA Vaccine Encoding GRA8 against Acute Toxoplasmosis in a Murine Model

  • Chu, Jia-Qi;Huang, Shuai;Ye, Wei;Fan, Xuan-Yan;Huang, Rui;Ye, Shi-Cai;Yu, Cai-Yuan;Wu, Wei-Yun;Zhou, Yu;Zhou, Wei;Lee, Young-Ha;Quan, Juan-Hua
    • Parasites, Hosts and Diseases
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    • v.56 no.4
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    • pp.325-334
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    • 2018
  • Toxoplasma gondii is an apicomplexan zoonotic protozoan parasite that infects most species of warm-blooded animals, including humans. The heavy incidence and severe or lethal damage caused by T. gondii infection clearly indicate a need for the development of an effective vaccine. T. gondii GRA8 is a member of the dense granules protein family and is used as a marker of acute infection. In the present study, we evaluated the protective immunity induced by DNA vaccination based on a recombinant eukaryotic plasmid, pDsRed2-GRA8, against acute toxoplasmosis in mice. BALB/c mice were intramuscularly immunized with the pDsRed2-GRA8 plasmid and then challenged by infection with the highly virulent GFP-RH strain of T. gondii. The specific immune responses and protective efficacy against T. gondii of this vaccine were analyzed by measuring cytokine and serum antibody titers, splenocyte proliferation assays, and the survival times of mice after challenge. Our results showed that mice immunized with pDsRed2-GRA8 demonstrated specific humoral and cellular responses, induced higher IgG antibody titers with predominant IgG2a production; increased levels of IL-10, IL-12 (p70), $IFN-{\gamma}$, $TNF-{\alpha}$, and splenocyte proliferation; and prolonged survival times compared to those of control mice. The present study showed that DNA immunization with pDsRed2-GRA8 induced humoral and cellular immune responses, and all immunized mice showed greater Th1-type immune responses and longer survival times than those of control mice. These results indicated that T. gondii GRA8 DNA immunization induces a partial protective effect against acute toxoplasmosis.

Preimplantation Genetic Diagnosis for Single Gene Disorders (단일 유전자 질환에 대한 착상전 유전진단)

  • Lee, Hyoung-Song;Kim, Min-Jee;Kang, Inn-Soo
    • Journal of Genetic Medicine
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    • v.6 no.2
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    • pp.131-145
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    • 2009
  • Preimplantation genetic diagnosis (PGD) has become an assisted reproductive technique for couples who are at risk that enables them to have unaffected baby without facing the risk of pregnancy termination after invasive prenatal diagnosis. The molecular biology and technology for single-cell genetics has reached an extremely high level of accuracy, and has enabled the possibility of performing multiple diagnoses on one cell using whole genome amplification. These technological advances have contributed to the avoidance of misdiagnosis in PGD for single gene disorders. Polymerase chain reaction (PCR)-based PGD will lead to a significant increase in the number of disorders diagnosed and will find more widespread use, benefiting many more couples who are at risk of transmitting an inherited disease to their baby. In this review, we will focus on the molecular biological techniques that are currently in use in the most advanced centers for PGD for single gene disorders, including biopsy procedure, multiplex PCR and post-PCR diagnostic methods, and multiple displacement amplification (MDA) and the problems in the single cell genetic analysis.

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Postnatal Management of Antenatally Diagnosed Patent Urachus with Bladder Prolapse

  • Choi, Hyun-Shin;Kim, Hae-Eun;Kim, Eun-Sun;Oh, Soo-Young;Chang, Yun-Sil;Seo, Jeong-Meen;Park, Won-Soon
    • Neonatal Medicine
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    • v.17 no.2
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    • pp.262-264
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    • 2010
  • A case of bladder prolapse through a patent urachus is reported in a female infant born with a large, red, tubular mass inferior to the umbilical cord. A cystic mass communicating with fetal bladder was detected by prenatal ultrasound performed at $20^{+2}$ weeks of gestation. A fetal MRI was also performed to confirm the diagnosis and to exclude associated fetal anomalies. At $40^{+4}$ weeks, the cystic mass was no longer present and a new small solid mass was noted at the fetal abdominal wall. After birth, a protruded mucosal mass inferior to the umbilical cord was noted, and catheterization confirmed communication between the protruded mass and the urinary bladder. On the second day of life, reduction of the bladder and partial resection of the urachus was performed. A voiding cystourethrogram showed good bladder capacity and no vesicoureteral reflux. The patient voided well and was discharged after 10 days. Here, we present a case of urinary bladder prolapse through a patent urachus, diagnosed by fetal sonography and this is the first case reported that was treated by simple excision without complication.

10-year Analysis of Inherited Metabolic Diseases Diagnosed with Tandem Mass Spectrometry (탠덤 매스 검사(Tandem Mass Spectrometry)를 이용한 선천성 대사이상 선별검사 10년간의 분석)

  • Lee, Bomi;Lee, Jiyun;Lee, Jeongho;Kim, Suk Young;Kim, Jong Won;Min, Won-Ki;Song, Woon Heung;Song, Jung Han;Woo, Hang Jae;Yoon, Hye Ran;Lee, Yong-Wha;Choi, Koue Young;Choi, Tae Youn;Lee, Dong Hwan
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.17 no.3
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    • pp.77-84
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    • 2017
  • Purpose: From the early 1990's, use of Tandem mass spectrometry in neonatal screening test, made early stage detection of disorders that was not detectable by the previous methods of inspection. This research aims to evaluate the frequency of positive results in national neonatal screening test by Tandem mass spectrometry and its usefulness. Methods: A designated organization for inherited metabolic disorder executed neonatal screening test on newborns using Tandem mass spectrometry from January 2006 to December 2015, followed by the investigation of these data by the Planned Population Federation of Korea (PPFK), and this research analyzed those inspected data from the PPFK. Results: Among total childbirth of 4,590,606, from January 2006 to December 2015, 3,445,238 were selected for MS/MS and conduction rate was 75.1%. 261 out of the selected 3,445,238 were confirmed patients and for last decade, detection rate of total metabolic disorder was 1/13,205. In 261 confirmed patients, 120 had an amino acid metabolic disorder and its detection rate was 1/28,710 and 110 had an organic acid metabolic disorder and detection rate was 1/31,320. Also, 31 had a fatty acid metabolic disorder and detection rate was 1/13,205. Conclusion: Inherited metabolic disorder is very rare. Until now, it was difficult to precisely grasp an understanding on the national incidence of inherited metabolic disorder, due to lack of overall data and inconsistent and incomplete long-term result analysis. However, this research attempted to comprehensively approach the domestic incidence, by analyzing previous 10 years of data.

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Comparison of Recovery Levels of Shigella sonnei ATCC 29930 Treated at Different NaCl Concentrations after Sublethal Heating (Shigella sonnei ATCC 29930의 아치사 가열 후 소금 농도에 따른 회복 정도 비교)

  • Jung, Hye-Jin;Park, Sung-Hee;Song, Eun-Seop;Park, Sung-Soo;Kim, Keun-Sung
    • Korean Journal of Food Science and Technology
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    • v.38 no.5
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    • pp.720-723
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    • 2006
  • The viability of Shigella sonnei, a significant cause of gastroenteritis in Korea, on TSA plates was determined after sublethal heating treatments and NaCl treatments. In addition, recovery levels of sublethally injured cells on TSA plates containing different concentrations of NaCl (TSAS) were investigated. The viability decreased significantly with increasing degree of sublethal heating treatments, but increases in NaCI treatment concentration from 0 to 6% had little effect on the viability. After being sublethally treated at $55^{\circ}C$ for 30 min, bacterial populations were reduced by 7.58, 7.83 and 7.93 log CFU/mL on 2, 4, and 6% TSAS, respectively. After being sublethally treated at $60^{\circ}C$ for 30 min, bacterial populations were reduced by 6.71, 6.73, and 6.73 log CFU/mL on 2, 4 and 6% TSAS, respectively. Decimal reduction times (D-values) decreased with increasing NaCl treatment concentrations after sublethal heating at 55 or $60^{\circ}C$. These data imply that the S. sonnei cells sublethally injured by insufficient heating processes had a lower recovery rate with increasing NaCl concentrations in the recovery media.

Telomeric Dynamics and Telomerase Activity in Early Bovine Embryos (소의 초기 배 발생단계별 Telomeric DNA 함량 및 Telomerase Activity 분석)

  • Jung, Yei-Hwa;Lee, Soo-Hee;Cho, Sang-Rae;Kong, Il-Keun;Cho, Jae-Dong;Sohn, Sea-Hwan
    • Clinical and Experimental Reproductive Medicine
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    • v.36 no.2
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    • pp.101-109
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    • 2009
  • Objective: This study was carried out to analyze the amount of telomeric DNA and telomerase activity in early bovine embryos. Methods: The amount of telomeric DNA in early bovine embryos at the 8 cell, morula and blastocyst stages was analyzed by Quantitative Fluorescence In Situ Hybridization (Q-FISH) technique using a bovine telomeric DNA probe. Telomerase activity was analyzed by Telomeric Repeat Amplification Protocol (TRAP assay). Results: The relative amount of telomeric DNA in early bovine embryos was gradually increased from 8 cell to blastocyst stage. It was not significantly associated with the grade of embryo quality. While telomerase activity was detected in the early bovine embryos at these stages, it significantly increased at morula stage and showed maximum activity at the blastocyst stage. Conclusion: The amount of telomeric DNA and the telomerase activity of bovine embryos increase during the progression of early embryogenesis, suggesting a positive correlation between telomeric DNA and telomerase activity. The telomerase activity seems to increase to maintain the levels of telomeric DNA through embryo development which are required for extensive cell division.

miR-4463 regulates aromatase expression and activity for 17β-estradiol synthesis in response to follicle-stimulating hormone

  • Lee, Su-Yeon;Kang, Youn-Jung;Kwon, Jinie;Nishi, Yoshihiro;Yanase, Toshihiko;Lee, Kyung-Ah;Koong, Mi Kyoung
    • Clinical and Experimental Reproductive Medicine
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    • v.47 no.3
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    • pp.194-206
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    • 2020
  • Objective: The aim of this study was to investigate microRNAs (miRNAs) related to follicle-stimulating hormone (FSH) responsiveness using miRNA microarrays and to identify their target genes to determine the molecular regulatory pathways involved in FSH signaling in KGN cells. Methods: To change the cellular responsiveness to FSH, KGN cells were treated with FSH receptor (FSHR)-specific small interfering RNA (siRNA) followed by FSH. miRNA expression profiles were determined through miRNA microarray analysis. Potential target genes of selected miRNAs were predicted using bioinformatics tools, and their regulatory function was confirmed in KGN cells. Results: We found that six miRNAs (miR-1261, miR-130a-3p, miR-329-3p, miR-185-5p, miR-144-5p and miR-4463) were differentially expressed after FSHR siRNA treatment in KGN cells. Through a bioinformatics analysis, we showed that these miRNAs were predicted to regulate a large number of genes, which we narrowed down to cytochrome P450 family 19 subfamily A member 1 (CYP19A1) and estrogen receptor alpha (ESR1) as the main targets for miR-4463. Functional analysis revealed that miR-4463 is a regulatory factor for aromatase expression and function in KGN cells. Conclusion: In this study, we identified differentially expressed miRNAs related to FSH responsiveness. In particular, upregulation of miR-4463 expression by FSHR deficiency in human granulosa cells impaired 17β-estradiol synthesis by targeting CYP19A1 and ESR1. Therefore, our data might provide novel candidates for molecular biomarkers for use in research into poor responders.

The Effect of a Clinical Training Program for Capacity Building of Medical Doctors in a Developing Country (개발도상국 의사들의 역량강화를 위한 임상연수 프로그램의 효과)

  • Yoon, Hyun Bae;Shin, Jwa-Seop;Lee, Seung-Hee;Kim, Do-Hwan;Kim, Eun Jung;Cho, Kyehyeon;Hwang, Jinyoung
    • Korean Medical Education Review
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    • v.17 no.2
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    • pp.78-87
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    • 2015
  • Mongolia is suffering from the inadequate capacity of medical doctors due to a poor education and training system. The purpose of this article is to evaluate the effect of a clinical training program for capacity building of medical doctors in Mongolia, and to suggest an effective model for continuing professional development in developing countries. Based on the results of a needs assessment, Korean and Mongolian medical experts developed a clinical training program and trained the trainers on 32 topics regarding major clinical problems in 6 specialties, including cardiology, endocrinology, pediatrics, obstetrics and gynecology, neurology, and emergency medicine. Surveillance survey and pre/post-test were used on every topic to evaluate the satisfaction and achievement, respectively, of the trainees. Six months after the clinical training program, we interviewed a sample of medical professionals to evaluate the change and impact. A total of 612 (person-year) medical doctors participated in the training, and the average score for satisfaction was 7.69 out of 8. The average score of the pre-test was 46.9 out of 100, while the post-test was 82.4. After the training, the medical doctors were applying their new knowledge and skills to their practice, and using the materials as guidelines, which improved their practice and increased patient satisfaction. They also started their own training program and adopted new equipment at their hospitals. The satisfaction and achievement of the trainees were very high, and there was significant change in the medical practice, education system, and infrastructure after the training program. This training program can be an effective model for capacity building of medical doctors in developing countries.

Human Epididymis Protein 4 Reference Intervals in a Multiethnic Asian Women Population

  • Mokhtar, N.M.;Thevarajah, M.;M.A., Noorazmi;M., Isahak
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.12
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    • pp.6391-6395
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    • 2012
  • Background: Ovarian cancer is ranked as the fifth most common cause of cancer death in women. In Malaysia, it is the fourth most common cancer in females. CA125 has been the tumor marker of choice in ovarian cancer but its diagnostic specificity in early stages is only 50%. Hence, there is a critical need to identify an alternative tumor marker that is capable of detecting detect ovarian cancer at an early stage. HE4 is a new tumor marker proposed for the early diagnosis of ovarian cancer and disease recurrence. Currently, none of the normal ranges of HE4 quoted in the literature are based on data for a multiethnic Asian population. Therefore, the aim of this study was to determine reference intervals for HE4 in an Asian population presenting in University Malaya Medical Centre, a tertiary reference hospital. Materials and Methods: 300 healthy women were recruited comprising 150 premenopausal and 150 postmenopausal women, aged from 20-76 years. All women were subjected to a pelvic ultrasonograph and were confirmed to be free from ovarian pathology on recruitment. Serum HE4 levels were determined by chemiluminescent microparticle immunoassay (CMIA, Abbott Architect). The reference intervals were determined following CLSI guidelines (C28-A2) using a non-parametric method. Results: The upper limits of the $95^{th}$ percentile reference interval (90%CI) for all the women collectively were 64.6 pmol/L, and 58.4 pmol/L for premenopausal) and 69.0 pmol/L for postmenopausal. The concentration of HE4 was noted to increase with age especially in women who were more than 50 years old. We also noted that our proposed reference limit was lower compared to the level given by manufacturer Abbott Architect HE4 kit insert (58.4 vs 70 pmol/L for premenopausal group and 69.0 vs 140 pmol/L in the postmenopausal group). The study also showed a significant difference in HE4 concentrations between ethnic groups (Malays and Indians). The levels of HE4 in Indians appeared higher than in Malays (p<0.05), while no significant differences were noted between the Malays and Chinese ethnic groups. Conclusions: More data are needed to establish a reference interval that will better represent the multiethnic Malaysian population. Probably a larger sampling size of equal representation of the Malay, Chinese, Indians as well as the other native ethnic communities will give us a greater confidence on whether genetics plays a role in reference interval determination.