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In reproduction, mitochondria produce bioenergy, help to synthesize biomolecules, and support the ovaries, oogenesis, and preimplantation embryos, thereby facilitating healthy live births. However, the regulatory mechanism of mitochondria in oocytes and embryos during oogenesis and embryo development has not been clearly elucidated. The functional activity of mitochondria is crucial for determining the quality of oocytes and embryos; therefore, the underlying mechanism must be better understood. In this review, we summarize the specific role of mitochondria in reproduction in oocytes and embryos. We also briefly discuss the recovery of mitochondrial function in gametes and zygotes. First, we introduce the general characteristics of mitochondria in cells, including their roles in adenosine triphosphate and reactive oxygen species production, calcium homeostasis, and programmed cell death. Second, we present the unique characteristics of mitochondria in female reproduction, covering the bottleneck theory, mitochondrial shape, and mitochondrial metabolic pathways during oogenesis and preimplantation embryo development. Mitochondrial dysfunction is associated with ovarian aging, a diminished ovarian reserve, a poor ovarian response, and several reproduction problems in gametes and zygotes, such as aneuploidy and genetic disorders. Finally, we briefly describe which factors are involved in mitochondrial dysfunction and how mitochondrial function can be recovered in reproduction. We hope to provide a new viewpoint regarding factors that can overcome mitochondrial dysfunction in the field of reproductive medicine.
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no abstract available.
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Background@#Polo-like kinase 4 (PLK4) is a serine/threonine protein kinase located in the centriole of the chromosome during the cell cycle. PLK4 overexpression has been described in a variety of many common human epithelial tumors. Conversely, PLK4 acts as a haploinsufficient tumor suppressor in some situations, highlighting the importance of strict regulation of PLK4 expression, activity, and function. Meanwhile, the importance of chemoradiation resistance in rectal cancer is being emphasized more than ever. We aimed to analyze PLK4 expression and the tumor regression grade (TRG) in patients with rectal cancer, treated with chemoradiotherapy (CRT). @*Methods@#A retrospective study was conducted on 102 patients with rectal cancer who received preoperative CRT. Immunohistochemistry for PLK4 in paraffin-embedded tissue was performed from the biopsy and surgical specimens. @*Results@#We found significant association between high expression of PLK4 and poor response to neoadjuvant CRT (according to both Mandard and The Korean Society of Pathologists TRG systems) in the pre-CRT specimens. Other clinicopathologic parameters did not reveal any correlation with PLK4 expression. @*Conclusions@#This study revealed an association between high expression of PLK4 in the pre-CRT specimens and TRG. Our results indicated that PLK4 could potentially be a new predictor for CRT effect in patients with rectal cancer.
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Diarylpropionitrile (DPN), a selective agonist for estrogen receptor β(ERβ), has been reported to regulate various hormonal responses through activation of ERβ in tissues including the mammary gland and brain. However, the effect of DPN on melanogenesis independent of ERβ has not been studied. The aim of this study is to examine the possibility of anti-melanogenic effect of DPN and its underlying mechanism. Melanin contents and cellular tyrosinase activity assay indicated that DPN inhibited melanin biosynthesis in alpha-melanocyte stimulating hormonestimulated B16F10 melanoma cell line. However, DPN had no direct influence on in vitro tyrosinase catalytic activity. On the other hand, 17β-estradiol had no effect on inhibition of melanogenesis, suggesting that the DPN-mediated suppression of melanin production was not related with estrogen signaling pathway. Immunoblotting analysis showed that DPN down-regulated the expression of microphthalmiaassociated transcription factor (MITF), a central transcription factor of melanogenesis and its down-stream genes including tyrosinase, tyrosinase-related protein (TRP)-1, and TRP-2. Also, DPN attenuated the phosphorylation of protein kinase A (PKA) and cAMP-response element-binding protein (CREB). Additionally, DPN suppressed the melanin synthesis in UVB-irradiated HaCaT conditioned media culture system suggesting that DPN has potential as an anti-melanogenic activity in physiological conditions. Collectively, our data show that DPN inhibits melanogenesis via downregulation of PKA/CREB/MITF signaling pathway.
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Background/Aims@#Pirfenidone slows the progression of idiopathic pulmonary fibrosis (IPF). We investigated its efficacy and safety in terms of dose and disease severity in real-world patients with IPF. @*Methods@#This multicenter retrospective cohort study investigated 338 patients treated with pirfenidone between July 2012 and March 2018. Demographics, pulmonary function, mortality, and pirfenidone-related adverse events were also investigated. Efficacy was analyzed according to pirfenidone dose and disease severity using linear mixed-effects models to assess the annual decline rate of forced vital capacity (FVC) and diffusing capacity of the lungs for carbon monoxide (DLCO). @*Results@#The mean %FVCpredicted and %DLCOpredicted values were 72.6% ± 13.1% and 61.4% ± 17.9%, respectively. The mean duration of pirfenidone treatment was 16.1 ± 9.0 months. In the standard dose (1,800 mg/day) group, the mean %FVCpredicted was −6.56% (95% confidence interval [CI], −9.26 to −3.87) per year before, but −4.43% (95% CI, −5.87 to −3.00) per year after treatment with pirfenidone. In the non-standard lower dose group, the mean %FVCpredicted was −4.96% (95% CI, −6.82 to −3.09) per year before, but −1.79% (95% CI, −2.75 to −0.83) per year after treatment with pirfenidone. The FVC decline rate was significantly reduced, regardless of the Gender-Age-Physiology (GAP) stage. Adverse events and mortality were similar across dose groups; however, they were more frequent in GAP stages II–III than in the stage I group. @*Conclusions@#The effect of pirfenidone on reducing disease progression of IPF persisted even with a consistently lower dose of pirfenidone.
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Background@#Fever and skin eruption are common manifestations in patients; however, assessing them can be challenging because of the wide range of differential diagnosis. @*Objective@#We aimed to obtain tips that could assist in differential diagnoses in patients with fever and skin eruption through the analysis of clinical features. @*Methods@#Medical records of hospitalized patients who had fever and skin eruption were examined from January 2010 to December 2019. @*Results@#The patients of the adverse drug reaction group were older (p=0.024), and they had underlying diseases (p<0.001), whole body skin eruption (p=0.018), elevated alanine aminotransferase (p=0.027). The autoimmune disease group was associated with longer total fever and skin eruption duration (p=0.049, 0.037), leukocytosis (p=0.015), and neutrophilia (p=0.006). Infectious erythema group was associated with targetoid lesions (p=0.003). @*Conclusion@#Clinicians should examine patients with fever and skin eruption, considering that there may be various causes. This can be assisted by delicate skin exam and laboratory tests.
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Glioblastoma multiforme (GBM) is the most lethal type of brain tumor and its prognosis was extremely poor. Here, we studied the clinical and prognostic value of telomerase reverse transcriptase (TERT) and GA Binding Protein Transcription Factor Subunit Beta 1 longer (GABPB1L) mRNA expression in GBM by using open big data. In total 152 GBM patients, gene expressions were downloaded from the Cancer Genome Atlas (TCGA) data and its values were statistically analyzed. TCGA data showed that GABPB1L mRNA expression levels did not correlate with those of TERT mRNA (r = -0.027, p = 0.744). GABPB1L and TERT expressions in GBM were associated with subtype by gene expression. GABPB1L (562.7 ± 76.8 days vs. 479.1 ± 5.8 days, p = 0.401) and TERT (468.1 ± 43.6 days vs. 565.3 ± 75.8 days, p = 0.403) expression was not associated with GBM prognosis. However, disease-free survival was tended to be different in GBM patients according to TERT and GABPB1L expressions though it did not get statistical significance (2122.6 ± 160.2 days vs. 1381.1 ± 244.0 days, p = 0.072). These genes may contribute to the GBM pathogenesis and its further study should be performed in GBM patients and cell lines.
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The educational development in Korean Medical School has shown remarkable results in about 20 years. These institutes has an excellent evaluation base and educational independence. And the curriculum, the method, and the evaluation in medical education have been innovated over recent 20 years. Those revolutionary outcome of the innovation of medical education affirms possibilities and potentialities of innovation and reformation in the future. In response, this article attempted to reflect on the deficiencies of medical education through the analysis of the educational status of medical humanities in 40 medical schools for better future medical humanities education under such a strong environment. Therefore, the purpose of this article is to present the direction in which medical humanities literature based on value education. In this process, in order to find the essence of medical education through educational philosophy discourse, the blue print of evidence based medicine is presented, and the role and direction of medical humanities are suggested through reflection on strengthening medical education capabilities.
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A genetic etiology of male infertility is identified in fewer than 25% of infertile men, while 30% of infertile men lack a clear etiology, resulting in a diagnosis of idiopathic male infertility. Advances in reproductive genetics have provided insights into the mechanisms of male infertility, and a characterization of the genetic basis of male infertility may have broad implications for understanding the causes of infertility and determining the prognosis, optimal treatment, and management of couples. In a substantial proportion of patients with azoospermia, known genetic factors contribute to male infertility. Additionally, the number of identified genetic anomalies in other etiologies of male infertility is growing through advances in whole-genome amplification and next-generation sequencing. In this review, we present an up-to-date overview of the indications for appropriate genetic tests, summarize the characteristics of chromosomal and genetic diseases, and discuss the treatment of couples with genetic infertility by microdissection-testicular sperm extraction, personalized hormone therapy, and in vitro fertilization with pre-implantation genetic testing.
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Background@#Bacterial skin soft-tissue infection is a common clinical manifestation in dermatology. The treatment of bacterial skin infections is often challenging due to antibiotic resistance, including methicillin resistance. @*Objective@#The aim of this study was to investigate the isolation rate of bacteria, antibiotic susceptibility, clinical features, and factors associated with treatment response in bacterial skin infections. @*Methods@#We retrospectively reviewed the medical records of patients who underwent ordinary bacterial skin cultures of the site of superficial skin infections between 2010 and 2019. @*Results@#A total of 1,298 patients were included in the study. The most commonly isolated bacteria were Staphylococcus aureus (31.3%), followed by coagulase-negative staphylococci (22.0%) and Pseudomonas species (4.2%). The methicillin-resistance rate of S. aureus was 22.7%. Crusted lesions (p=0.025), treatment with steroids (p=0.035), duration over 7 days (p=0.009), and isolation of Pseudomonas (p<0.001) or other uncommon species (non-Staphylococcus, Streptococcus, and Pseudomonas species, p<0.001) were significantly associated with treatment response. @*Conclusion@#The methicillin-resistance rate of S. aureus was similar to that of the past 5 years, but the mupirocin-resistance rate significantly increased. Lesions with crust or those that were treated with steroids showed good treatment responses, but longer disease durations of over 7 days and skin infections caused by Pseudomonas or other uncommon species were poor prognostic factors that should receive more attention.
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Atypical fibroxanthoma (AFX) is a rare fibrohistiocytic tumor usually observed on ultraviolet light-exposed areas of the body, such as the face or scalp in elderly individuals. Despite its clinically benign course, AFX presents with malignant features on histopathological evaluation. A 12-year-old male adolescent presented with a 3-month history of an asymptomatic, skin-colored, oval-shaped nodule on his right thigh. Histopathological examination showed a dermal tumor adjacent to the epidermis, without epidermal invasion. The tumor was composed of numerous pleomorphic spindle cells and large atypical histiocytes with abundant vacuolated cytoplasm and pleomorphic nuclei. Immunohistochemical analysis revealed tumor cells, which were immunopositive for vimentin, CD68, CD10 and immunonegative for desmin, pan-cytokeratin antibody (AE1/AE3), and S-100. Therefore, the patient was diagnosed with AFX. We report a rare case of AFX that occurred on the thigh (an unusual site) in an adolescent (an uncommon age group). Immunohistochemical analysis is important in patients with suspected AFX, regardless of the patient’s age and site of lesion, for accurate diagnosis to differentiate this condition from other diseases with a similar presentation.
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In the modern era, the standards and expectations for the shape and beauty of the face are increasing. Therefore, we measured the facial structure and its proportions in Koreans, and to find out the correlation between these results and beauty satisfaction. A questionnaire survey and facial structure measurement were conducted on 85 college students about their beauty satisfaction. The vertical height of the face was 206.0 ± 35.5 mm, and the vertical ratio was 1:1:1. The width of the face was 168.1 ± 30.4 mm, and when it was divided into 5 parts, the middle part was the widest. Dimples and dark circles were found in 22 (25.9%) and 51 (60.0%), respectively, and eye length and nose height nose were 12.6 ± 2.7 mm and 22.8 ± 9.5 mm, respectively. Beauty satisfaction was on average 28.7 ± 5.9 out of a total of 50 points, inversely proportional to the length of the face (r = -0.235), and was proportional to the width of the nose (r = 0.298). And beauty satisfaction was related to skin condition, but it was not statistically significant. It can be used in various ways as basic data on the shape and proportion of Korean faces obtained through this study, and by comparing this with beauty satisfaction, it is thought that false recognition and stress according to the individual's aesthetic standards can be reduced.
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Purpose@#This study aimed to investigate the optimal threshold value in Hounsfield units (HU) on CT to detect the solid components of pulmonary subsolid nodules using pathologic invasive foci as reference. @*Materials and Methods@#Thin-section non-enhanced chest CT scans of 25 patients with pathologically confirmed minimally invasive adenocarcinoma were retrospectively reviewed. On CT images, the solid portion was defined as the area with higher attenuation than various HU thresholds ranging from -600 to -100 HU in 50-HU intervals. The solid portion was measured as the largest diameter on axial images and as the maximum diameter on multiplanar reconstruction images. A linear mixed model was used to evaluate bias in each threshold by using the pathological size of invasive foci as reference. @*Results@#At a threshold of -400 HU, the biases were lowest between the largest/maximum diameter of the solid portion of subsolid nodule and the size of invasive foci of the pathological specimen, with 0.388 and -0.0176, respectively. They showed insignificant difference (p = 0.2682, p = 0.963, respectively) at a threshold of -400 HU. @*Conclusion@#For quantitative analysis, -400 HU may be the optimal threshold to define the solid portion of subsolid nodules as a surrogate marker of invasive foci.
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Objectives@#This review article examines international examples of personal health records (PHRs) in advanced countries and discusses the implications of these examples for the establishment and utilization of PHRs in South Korea. @*Methods@#This article synthesized PHR case reports of Organization for Economic Co-operation and Development (OECD) member countries, the Global Digital Health Partnership website on PHRs, and patient portals of individual countries to review the status of PHR services. The concept and significance of PHRs were also discussed with respect to PHR utilization status in European Union and OECD countries. @*Results@#A review of international PHR services showed that the countries shared common points regarding the establishment of Electronic Health Records and national health information infrastructure. In addition, the countries provided services centered on primary healthcare institutions and public hospitals. However, promoting more positive participation and increasing the PHR acceptance rate requires workflow integration, including Electronic Medical Records, the provision of incentives, and the preparation of a supportive legal framework. @*Conclusions@#South Korea is also conducting a national-level PHR project. Since the scope of PHRs is extensive and a wide range of PHR services must be connected, an extensive trial-and-error process will be necessary. A long-term strategy should be prepared, and necessary resources should be secured to establish national-level PHRs.
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Background@#Bacterial skin soft-tissue infection is a common clinical manifestation in dermatology. The treatment of bacterial skin infections is often challenging due to antibiotic resistance, including methicillin resistance. @*Objective@#The aim of this study was to investigate the isolation rate of bacteria, antibiotic susceptibility, clinical features, and factors associated with treatment response in bacterial skin infections. @*Methods@#We retrospectively reviewed the medical records of patients who underwent ordinary bacterial skin cultures of the site of superficial skin infections between 2010 and 2019. @*Results@#A total of 1,298 patients were included in the study. The most commonly isolated bacteria were Staphylococcus aureus (31.3%), followed by coagulase-negative staphylococci (22.0%) and Pseudomonas species (4.2%). The methicillin-resistance rate of S. aureus was 22.7%. Crusted lesions (p=0.025), treatment with steroids (p=0.035), duration over 7 days (p=0.009), and isolation of Pseudomonas (p<0.001) or other uncommon species (non-Staphylococcus, Streptococcus, and Pseudomonas species, p<0.001) were significantly associated with treatment response. @*Conclusion@#The methicillin-resistance rate of S. aureus was similar to that of the past 5 years, but the mupirocin-resistance rate significantly increased. Lesions with crust or those that were treated with steroids showed good treatment responses, but longer disease durations of over 7 days and skin infections caused by Pseudomonas or other uncommon species were poor prognostic factors that should receive more attention.
ABSTRACT
Atypical fibroxanthoma (AFX) is a rare fibrohistiocytic tumor usually observed on ultraviolet light-exposed areas of the body, such as the face or scalp in elderly individuals. Despite its clinically benign course, AFX presents with malignant features on histopathological evaluation. A 12-year-old male adolescent presented with a 3-month history of an asymptomatic, skin-colored, oval-shaped nodule on his right thigh. Histopathological examination showed a dermal tumor adjacent to the epidermis, without epidermal invasion. The tumor was composed of numerous pleomorphic spindle cells and large atypical histiocytes with abundant vacuolated cytoplasm and pleomorphic nuclei. Immunohistochemical analysis revealed tumor cells, which were immunopositive for vimentin, CD68, CD10 and immunonegative for desmin, pan-cytokeratin antibody (AE1/AE3), and S-100. Therefore, the patient was diagnosed with AFX. We report a rare case of AFX that occurred on the thigh (an unusual site) in an adolescent (an uncommon age group). Immunohistochemical analysis is important in patients with suspected AFX, regardless of the patient’s age and site of lesion, for accurate diagnosis to differentiate this condition from other diseases with a similar presentation.
ABSTRACT
In the modern era, the standards and expectations for the shape and beauty of the face are increasing. Therefore, we measured the facial structure and its proportions in Koreans, and to find out the correlation between these results and beauty satisfaction. A questionnaire survey and facial structure measurement were conducted on 85 college students about their beauty satisfaction. The vertical height of the face was 206.0 ± 35.5 mm, and the vertical ratio was 1:1:1. The width of the face was 168.1 ± 30.4 mm, and when it was divided into 5 parts, the middle part was the widest. Dimples and dark circles were found in 22 (25.9%) and 51 (60.0%), respectively, and eye length and nose height nose were 12.6 ± 2.7 mm and 22.8 ± 9.5 mm, respectively. Beauty satisfaction was on average 28.7 ± 5.9 out of a total of 50 points, inversely proportional to the length of the face (r = -0.235), and was proportional to the width of the nose (r = 0.298). And beauty satisfaction was related to skin condition, but it was not statistically significant. It can be used in various ways as basic data on the shape and proportion of Korean faces obtained through this study, and by comparing this with beauty satisfaction, it is thought that false recognition and stress according to the individual's aesthetic standards can be reduced.
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Purpose@#This study aimed to investigate the optimal threshold value in Hounsfield units (HU) on CT to detect the solid components of pulmonary subsolid nodules using pathologic invasive foci as reference. @*Materials and Methods@#Thin-section non-enhanced chest CT scans of 25 patients with pathologically confirmed minimally invasive adenocarcinoma were retrospectively reviewed. On CT images, the solid portion was defined as the area with higher attenuation than various HU thresholds ranging from -600 to -100 HU in 50-HU intervals. The solid portion was measured as the largest diameter on axial images and as the maximum diameter on multiplanar reconstruction images. A linear mixed model was used to evaluate bias in each threshold by using the pathological size of invasive foci as reference. @*Results@#At a threshold of -400 HU, the biases were lowest between the largest/maximum diameter of the solid portion of subsolid nodule and the size of invasive foci of the pathological specimen, with 0.388 and -0.0176, respectively. They showed insignificant difference (p = 0.2682, p = 0.963, respectively) at a threshold of -400 HU. @*Conclusion@#For quantitative analysis, -400 HU may be the optimal threshold to define the solid portion of subsolid nodules as a surrogate marker of invasive foci.
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Objectives@#This review article examines international examples of personal health records (PHRs) in advanced countries and discusses the implications of these examples for the establishment and utilization of PHRs in South Korea. @*Methods@#This article synthesized PHR case reports of Organization for Economic Co-operation and Development (OECD) member countries, the Global Digital Health Partnership website on PHRs, and patient portals of individual countries to review the status of PHR services. The concept and significance of PHRs were also discussed with respect to PHR utilization status in European Union and OECD countries. @*Results@#A review of international PHR services showed that the countries shared common points regarding the establishment of Electronic Health Records and national health information infrastructure. In addition, the countries provided services centered on primary healthcare institutions and public hospitals. However, promoting more positive participation and increasing the PHR acceptance rate requires workflow integration, including Electronic Medical Records, the provision of incentives, and the preparation of a supportive legal framework. @*Conclusions@#South Korea is also conducting a national-level PHR project. Since the scope of PHRs is extensive and a wide range of PHR services must be connected, an extensive trial-and-error process will be necessary. A long-term strategy should be prepared, and necessary resources should be secured to establish national-level PHRs.
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Background@#The oral administration of polystyrene-microplastics (PS-MPs) causes chronic constipation of ICR mice, but there are no reports on their effects on the inflammatory response in the colon. To determine if the oral administration of MPs causes inflammation in the colon, the changes in the apoptosis-associated speck like protein containing a caspase recruitment domain (ASC)-inflammasome pathway, nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) signaling pathway, and inflammatory cytokine expression were evaluated in the mid colon of ICR mice treated with 0.5 μm size PS-MPs for two weeks. @*Results@#The thicknesses of the mucosa, muscle, flat luminal surface, and crypt layer were decreased significantly (p < 0.01) in the mid colon of the MPs treated group compared to the Vehicle treated group. On the other hand, a remarkable increase in the expression levels of NOD-like receptor pyrin domain-containing protein (NLRP) 3, ASC, and Cleaved Caspase (Cas)-1 protein was observed in the MPs treated group. In addition, similar increasing pattern in the levels of p-NF-κB and phospho-inhibitory subunit of NF-κB (p-IkB) α protein was detected. Four inflammatory cytokines, including NF-κB, interleukin (IL)-6, tumor necrosis factor (TNF)-α, and IL-1β, showed an increased expression level after the MPs treatment. @*Conclusions@#Therefore, the present study suggests that PS-MPs can be a novel cause of an inflammatory response in the mid colon of ICR mice.