Performance Evaluation of Biozentech Malaria Scanner in Plasmodium knowlesi and P. falciparum as a New Diagnostic Tool

The computer vision diagnostic approach currently generates several malaria diagnostic tools. It enhances the accessible and straightforward diagnostics that necessary for clinics and health centers in malaria-endemic areas. A new computer malaria diagnostics tool called the malaria scanner was used to investigate living malaria parasites with easy sample preparation, fast and user-friendly. The cultured Plasmodium parasites were used to confirm the sensitivity of this technique then compared to fluorescence-activated cell sorting (FACS) analysis and light microscopic examination. The measured percentage of parasitemia by the malaria scanner revealed higher precision than microscopy and was similar to FACS. The coefficients of variation of this technique were 1.2-6.7% for Plasmodium knowlesi and 0.3-4.8% for P. falciparum. It allowed determining parasitemia levels of 0.1% or higher, with coefficient of variation smaller than 10%. In terms of the precision range of parasitemia, both high and low ranges showed similar precision results. Pearson’s correlation test was used to evaluate the correlation data coming from all methods. A strong correlation of measured parasitemia (r2=0.99, P<0.05) was observed between each method. The parasitemia analysis using this new diagnostic tool needs technical improvement, particularly in the differentiation of malaria species.

Performance Evaluation of Biozentech Malaria Scanner in Plasmodium knowlesi and P. falciparum as a New Diagnostic Tool

The computer vision diagnostic approach currently generates several malaria diagnostic tools. It enhances the accessible and straightforward diagnostics that necessary for clinics and health centers in malaria-endemic areas. A new computer malaria diagnostics tool called the malaria scanner was used to investigate living malaria parasites with easy sample preparation, fast and user-friendly. The cultured Plasmodium parasites were used to confirm the sensitivity of this technique then compared to fluorescence-activated cell sorting (FACS) analysis and light microscopic examination. The measured percentage of parasitemia by the malaria scanner revealed higher precision than microscopy and was similar to FACS. The coefficients of variation of this technique were 1.2-6.7% for Plasmodium knowlesi and 0.3-4.8% for P. falciparum. It allowed determining parasitemia levels of 0.1% or higher, with coefficient of variation smaller than 10%. In terms of the precision range of parasitemia, both high and low ranges showed similar precision results. Pearson’s correlation test was used to evaluate the correlation data coming from all methods. A strong correlation of measured parasitemia (r2=0.99, P<0.05) was observed between each method. The parasitemia analysis using this new diagnostic tool needs technical improvement, particularly in the differentiation of malaria species.

Practice patterns in the management of threatened preterm labor in Korea: A multicenter retrospective study

OBJECTIVE: This study aimed to examine clinical practice patterns in the management of pregnant women admitted with threatened preterm labor (TPL) in Korea. METHODS: Data from women admitted with a diagnosis of TPL were collected from 22 hospitals. TPL was defined as regular uterine contractions with or without other symptoms such as pelvic pressure, backache, increased vaginal discharge, menstrual-like cramps, bleeding/show and cervical changes. Data on general patient information, clinical characteristics at admission, use of tocolytics, antibiotics, and corticosteroids, and pregnancy outcomes were collected using an online data collections system. RESULTS: A total of 947 women with TPL were enrolled. First-line tocolysis was administered to 822 (86.8%) patients. As a first-line tocolysis, beta-agonists were used most frequently (510/822, 62.0%), followed by magnesium sulfate (183/822, 22.3%), calcium channel blockers (91/822, 11.1%), and atosiban (38/822, 4.6%). Of the 822 women with first-line tocolysis, second-line tocolysis were required in 364 (44.3%). Of 364 with second-line, 199 had third-line tocolysis (37.4%). Antibiotics were administered to 29.9% of patients (284/947) with single (215, 22.7%), dual (26, 2.7%), and triple combinations (43, 4.5%). Corticosteroids were administered to 420 (44.4%) patients. Betamethasone was administered to 298 patients (71.0%), and dexamethasone was administered to 122 patients (29.0%). CONCLUSION: Practice patterns in the management of TPL in Korea were quite various. It is needed to develop standardized practice guidelines for TPL management.

Generation accumulation of murine ovarian genes in offspring exposed to microwave in uterus / 대한산부인과학회지

OBJECTIVE: The aim of this study was to evaluate generational accumulation of murine fetal ovarian genes following prenatal exposure to 1.765-GHz microwave radiation. METHODS: A 1.765-GHz microwave generator was used. Twenty pregnant ICR mice were divided into two groups: the microwave-exposed experimental (irradiated) group, and the sham-exposed (sham) group. On the fifth day post-mating, dam mice were exposed to microwave irradiation in the insulated cage for 8 hours each day. The remaining mice were treated in the same way. Second generation mice were raised for 8 weeks then classified into four groups for examination. We removed the neonatal ovaries on the seventh day after the third delivery. We investigated the expression of six genes in the ovaries: Tnfaip 8, TNFsf 12, Cfd, CCL 11, Zfp 74, and Brd 3. Real time reverse transcription-polymerase chain reaction was performed using total RNA extracted from the removed ovaries. RESULTS: In the third-generation offspring, we detected some differences in ovarian gene expression between the first group and the fourth. Expression of CCL 11, and TNFsf 12 was decreased in the first group compared to the fourth group. Expression of Tnfaip 8, brd 3, Cfd, and Zfp 74 was higher in the first group than in the fourth group. We found differing results when we compared ovarian gene expression in mice of the second generation with those of the third. CONCLUSION: The results suggest that there is no generational accumulation of murine ovarian genes in offspring exposed to 1.765-GHz microwaves in the uterus.

Clinical characteristics and perinatal outcomes of fetal omphalocele / 대한산부인과학회지

OBJECTIVE: The purpose of this study is to describe the clinical characteristics and perinatal outcomes of fetuses with omphalocele. METHODS: The study enrolled all fetuses diagnosed prenatally with omphalocele at a single institution, from August 1996 to April 2008. Data were collected retrospectively by reviewing the maternal and neonatal medical records. RESULTS: The study population consisted of 54 cases with prenatally diagnosed omphalocele. In all, 15 fetuses were live-born, 29 were terminated, four died in utero, and six were lost to follow-up. Associated anomalies were found in 72.9% (35/48). Abnormal karyotype was found in 33.3% (16/48). In the live births, associated major anomalies were present in 46.7% (7/15) and were associated with increased neonatal morbidity. The rate of severe neonatal morbidity was 53.3% (8/15). In one case, death followed prolonged hospitalization with complications related to associated anomalies. The neonatal mortality rate was 6.7% (1/15) with no postoperative deaths. CONCLUSION: In this study, the neonatal mortality rates were low in the absence of associated anomalies or genetic defects. The results emphasize the importance of identifying both those fetuses with a potentially positive prognosis and favorable outcome and those which are likely to have a fatal outcome.

The clinical outcomes on fetal gastroschisis / 대한산부인과학회지

OBJECTIVE: The aim of this study is to analyze the perinatal courses, fetal treatment and postnatal outcomes of fetal gastroschisis. METHODS: A retrospective review of the medical records of 35 cases with a prenatal diagnosis of gastroschisis was conducted between March 1997 and April 2007. RESULTS: Twenty-eight fetuses were followed up and 17 fetuses of them were born alive. Chromosomal study was performed in 22 fetuses and no abnormality was detected in them. Associated anomalies except for gastrointestinal anomalies were found in 12 (34.2%) cases: amniotic band syndrome (n=8), scoliosis (n=6), cleft lip (n=1), hydrops (n=1), hydrocephalus (n=1), acrania (n=1). In 4 fetuses, amnioinfusion and amnioexchange were performed simultaneously for treatment. Four cases (23.5%) were delivered by cesarean section. All neonates received corrected operation immediately after birth and 8 (47.1%) of them had postoperative complications. Three of them were died and the overall survival rate was 82.4%. The average length of hospital stays for the survivors was 36 days (2~210days). CONCLUSION: Fetal gastroschisis diagnosed prenatally has a good prognosis and high survival rates. The result of this study was not different from that of preexisting studies and will be a useful guide in counseling parents with a prenatal diagnosis of gastroschisis.

Microarray analysis of gene expression in mice ovaries exposed to a 1.765 GHz microwave in utero / 대한산부인과학회지

OBJECTIVE: The aim of this study was to evaluate the effects on murine fetal ovarian gene expression of prenatal exposure to 1.765 GHz of microwave irradiation. METHODS:Ten pregnant ICR mice were divided into two groups. At 5th days after mating, dam mice were exposed to microwave (SAR: 0.38~1.71 W/kg) in the insulated cage for 8 hours each day. The remaining mice were treated in the same way. Neonatal ovaries were removed for study 7 days after delivery. Microarray analysis was performed using total RNA extracted from the removed ovaries. We investigated the differences in ovarian gene expression between the groups. SPSS 12.0 was used for statistical analysis. P<0.05 was considered to be statistically significant. RESULTS: The mean birth weight of the offspring in the irradiated group was significantly lower than that in the sham group (1.54+/-.22 g vs. 1.60+/-.21 g, P=0.012). The mean number of offspring per pregnancy in the irradiated group was significantly higher than in the sham group (13.60+/-.70 vs. 11.40+/-.17, P=0.009). We detected that in the irradiated ovaries, 14 genes were expressed at levels 2-fold higher than in the sham ovaries and 74 genes were expressed at levels 2-fold lower than in the sham ovaries. CONCLUSION: We found differences in fetal ovarian gene expression between the irradiated and sham groups. In the irradiated group, the Tnfaip8, TNFsf 12, Cfd, CCL 11, and Zfp74 genes were down-regulated and the Brd 3 gene was up-regulated.

Microarray analysis of gene expression in mice ovaries exposed to a 1.765 GHz microwave in utero / 대한산부인과학회지

OBJECTIVE: The aim of this study was to evaluate the effects on murine fetal ovarian gene expression of prenatal exposure to 1.765 GHz of microwave irradiation. METHODS:Ten pregnant ICR mice were divided into two groups. At 5th days after mating, dam mice were exposed to microwave (SAR: 0.38~1.71 W/kg) in the insulated cage for 8 hours each day. The remaining mice were treated in the same way. Neonatal ovaries were removed for study 7 days after delivery. Microarray analysis was performed using total RNA extracted from the removed ovaries. We investigated the differences in ovarian gene expression between the groups. SPSS 12.0 was used for statistical analysis. P<0.05 was considered to be statistically significant. RESULTS: The mean birth weight of the offspring in the irradiated group was significantly lower than that in the sham group (1.54+/-.22 g vs. 1.60+/-.21 g, P=0.012). The mean number of offspring per pregnancy in the irradiated group was significantly higher than in the sham group (13.60+/-.70 vs. 11.40+/-.17, P=0.009). We detected that in the irradiated ovaries, 14 genes were expressed at levels 2-fold higher than in the sham ovaries and 74 genes were expressed at levels 2-fold lower than in the sham ovaries. CONCLUSION: We found differences in fetal ovarian gene expression between the irradiated and sham groups. In the irradiated group, the Tnfaip8, TNFsf 12, Cfd, CCL 11, and Zfp74 genes were down-regulated and the Brd 3 gene was up-regulated.

Clinical efficiency of the measurement of fetal nuchal translucency and Doppler examination of ductus venosus as a screening tool for chromosomal abnormalities / 대한산부인과학회지

OBJECTIVE: To evaluate the efficiency of the measurement of fetal nuchal translucency (FNT) and ductus venosus Doppler examination (DV Doppler) as a screening tool for chromosomal abnormalities. METHODS: FNT measurement and DV Doppler wereperformed in 950 pregnancies between 11(+0)~13(+6) weeks' gestation. Chromosomal analysis was done when FNT was more than 3 mm and DV Doppler showed absent flow or reversed flow. The numbers of cases with increased FNT and abnormal DV Doppler were counted in the groups of abnormal and normal karyotype. RESULTS: Data were available in 912 pregnancies. 11 pregnancies showed abnormal karyotype (1.2%). In the 11 cases with abnormal karyotype,increased FNT was found in 8 cases with 72.7% sensitivity and abnormal DV Doppler was found in 5 cases with 45.4% sensitivity. In the 901 cases withnormal karyotype, increased FNT was found in 33 cases with 96.3% specificity and abnormal DV Doppler was found in 12 cases with 98.7% specificity. Positive predictive value was 19.5% in cases of increased FNT, 29.4% in cases of abnormal DV Doppler, and 44.4% in cases of increased FNT and abnormal DV Doppler both. CONCLUSION: There is no improvement in general screening for chromosomal abnormalities when FNT measurement and DV Doppler were performed together. But better specificity and positive predictive value for chromosomal abnormalities were found.

Randomized comparison of vaginal prostaglandin E2 pessary with vaginal prostaglandin E2 tablet for the induction of labor / 대한산부인과학회지

OBJECTIVE: To compare the efficacy and the safety of two standardized preparations of vaginal prostaglandin E2 pessary (PGE2 pessary) and vaginal prostaglandin E2 tablet (PGE2 tablet) for the induction of labor. METHODS: Pregnant women who were hospitalized for the induction of labor from December 2002 to June 2004 at the Asan Medical Center were included for the prospective randomized study. Subjects were randomly assigned to receive PGE2 pessary or PGE2 tablet as a cervical ripening agent. A successful outcome was defined as a change in Bishop score of >or=3, Bishop score of >or=6 at 12 hours, or vaginal delivery after the insert placement. RESULTS: One hundred ninety-seven women (PGE2 pessary, 99 women; PGE2 tablet, 98 women) completed the protocol. There were no statistically significant differences between the two groups in terms of a successful outcome (85.9% vs 84.7%; p=0.952) and the following mean times: (1) time to active labor (851 vs 751 minutes; p=0.207), (2) time to vaginal delivery (1024 vs 873 minutes; p=0.091). However, in parous women the labor time interval was shorter in PGE2 tablet group. In addition, no differences were observed in the incidences of cesarean delivery, hyperstimulation syndrome, abnormal fetal heart rate patterns, and adverse neonatal outcomes. CONCLUSION: Both PGE2 preparations were equally effective in achieving cervical ripening, initiating labor, and achieving a successful vaginal delivery. However, the vaginal PGE2 pessary may offer the advantage of prompt removal when it is required.

Extraovarian endodermal sinus tumor arising from myometrium: A case report / 대한산부인과학회잡지

Endodermal sinus tumor (EST) is not so common germ cell neoplasm which arises most commonly in the ovary. The extraovarian sites such as the upper female genital tract are rare sites of origin. The 26-year-old female patient was found to have hemoperitoneum. Emergency laparotomy at local clinic, revealed a 8 cm sized mass, which arose from the anterior myometrium. Because both of the ovaries appeared to be normal, the tumor was thought to be originated from the myometrium. The excision of tumor mass was performed and the permanent biopsy confirmed the mass as EST histologically. The patient was transferred to AMC and staging operation including hystrectomy, left salpingooophorectomy, omentectomy, retroperitoneal lymph node (LN) and paraaortic LN dissection, appendectomy was performed and no metastasis was found. She received 6 cycles of combination chemotherapy (bleomycin, etoposide, and cisplatinum). Her serum alpha-fetoprotein (AFP) level dropped to normal from the initial level of 19,300 ng/ml. In the author's knowledge, the myometrium has not been reported as a site of EST origin. So we report this case with brief review of the literatures.