Medical big data: promise and challenges

The concept of big data, commonly characterized by volume, variety, velocity, and veracity, goes far beyond the data type and includes the aspects of data analysis, such as hypothesis-generating, rather than hypothesis-testing. Big data focuses on temporal stability of the association, rather than on causal relationship and underlying probability distribution assumptions are frequently not required. Medical big data as material to be analyzed has various features that are not only distinct from big data of other disciplines, but also distinct from traditional clinical epidemiology. Big data technology has many areas of application in healthcare, such as predictive modeling and clinical decision support, disease or safety surveillance, public health, and research. Big data analytics frequently exploits analytic methods developed in data mining, including classification, clustering, and regression. Medical big data analyses are complicated by many technical issues, such as missing values, curse of dimensionality, and bias control, and share the inherent limitations of observation study, namely the inability to test causality resulting from residual confounding and reverse causation. Recently, propensity score analysis and instrumental variable analysis have been introduced to overcome these limitations, and they have accomplished a great deal. Many challenges, such as the absence of evidence of practical benefits of big data, methodological issues including legal and ethical issues, and clinical integration and utility issues, must be overcome to realize the promise of medical big data as the fuel of a continuous learning healthcare system that will improve patient outcome and reduce waste in areas including nephrology.

Expression of Heat Shock Protein 60 kDa Is Upregulated in Cervical Cancer

PURPOSE: Cervical cancer caused by the human papilloma virus (HPV) continues to be the cause of yearly death among women. However, it is a curable disease when diagnosed at an early stage. Recently, several researches have reported that heat shock protein (HSP) 60, a chaperone protein of molecular weight of 60 kDa, is involved in carcinogenesis and apoptosis. In order to evaluate the prognostic significance of HSP60 in cervical cancer, we examined differences in the HSP60 expression between cervical cancer and normal tissues in women. MATERIALS AND METHODS: Tissue samples were collected from 20 cervical cancer patients and 20 normal controls. HSP60 expression of cervical cancer and normal tissues were verified by the 2D gel proteomics, semi-quantitative reverse transcriptase polymerase chain reaction (RT-PCR) and Western blot analyses. RESULTS: In 2D proteomic analysis, an increase of HSP60 expression was detected in cervical cancer tissues and confirmed by Western blot analysis (p < 0.05). However, messenger RNA (mRNA) levels of HSP60 did not display any significant differences between cervical cancer and normal tissues. CONCLUSION: These results suggest that HSP60 may be involved in the development of cervical cancer and have profound biological and prognostic significance.

Tong-In Club's Medical Education Movement / 의사학

During the Japanese imperialism, an attempt for colonial education in the Korean peninsula was to put into operation of a medical education movement. This plan was set up by the Tong-in club in 1907 and the foundations were laid in Pyong-yang and Tae-gu Tong-in hospitals. This report is a review acheiving the approach that was underplotted with the intention of the colonial education policy. Also, this report centralizes on the objectives of the Tong-in club establishment and the details of the medical education movement in the Korean peninslula. On June 16th, 1902, the Tong-a Don-mun club, Tong-a-mun club, Tong-mun medical club were established under the management of Mr. Irizawa Tatchkiji. The objectives of these clubs were to spread and popularize medical science into the Qing-Dynasty, Choson Dynasty and other countries. Tong-in club practiced modern medicine in the Korean peninsula. With the reason that they were responsible for cultural movement in the colonial region, the Tong-in club stayed in action until the Pacific war ended. Thus, they were playing a role similar to that of a lady-in-waiting in the aggressive war among the Imperialists. The Tong-in club was an organization with 6 main functions; 1) To provide modern medicine, prevent epidemics, maintain a sanitation level and to back up the Doctor Education Movement 2) To publish the Tong-in club's medical magazine 3) To translate and publish Chinese medical books 4) To train and provide seminars to Chinese doctors 5) To encourage communications from Chinese students studying medicine in Japan 6) To examine the standard of the hygiene in China etc. to other things To examine, the Doctor Education Movement in An-dong in the Manchurian region spread to the Chinese and Choson people in the Korean peninsula, also the Doctor Education Movement put into operation in Pyong-yang and Tae-gu. The summary of the An-dong Tong-in club's activities as follows; (1) The activities of An-dong Tong-in hospital educated 21 Koreans and 12 Chinese in 1911, but only 2 Koreans and 1 Chinese were able to graduate from the process. An-dong hospital was at the management by the principal Mr Sakazaki, and was under the pains in finance. (2) The activities of Tae-gu Tong-in hospital started on the 1st of February 1907, and continued till April 1911. Then activities they took over to the institute of medical center in Seoul attached to the Goverment-General in Choson. They educated 30 students every 1st semester and 2nd semester with the principal Mr Ikegami Shhiro as leader but all of them couldn't graduate without falling behind except 5. The contents of education mainly consisted of the Japanese language, preparatory subjects, physics, and anatomy, but they were superficial in depth. Besides that, girl students could be instructed about nursery and childbirth and delivery. And they also trained 40 students majoring in vaccination by the second term. (3) The activities of Pyong-yang Tong-in club was put into operation on December 1906. They made the medical institute attached to public Tong-in hospitals and from the days on October 1907, Mr Sato Kotcho gave his full interest in the education of the medical spheres of Korean students. The medical institute attached to Tong-in hospital had taken over the school of a private-village styled education administered by Mr Nakamura Tomitcho at the Taedong gate street on April 1905. He was the creator of medical education in that region and took a spread and hidden role in the development of medical history in Korea. 15 or 16 medical students were taught the apprentices through an interpreter at a Korean-style house in 1907. The excellent students from the public Japanese school took the role of the interpreters. At that time the Choson government gave 600 won every month to the Pyong-yang and Taegu hospitals. It seemed that the Resident-General Ito Hirobumi gazed with deep interest and anxiety on these hospital's behaviors and progress. The Pyongyang Jahye hospital taking over the former Pyongyang-hospital's duties, had 57 students including 8 seniors, 3 juniors, 6 sophomores, and 36 freshmen. There were 13 students in the nursery department including 6 Korean preparatory students and 5 Japanese and 2 Korean regular students. The first 8 students graduated form the Pyong-yang Jahye hospital in September 1910. They held a medical license without examination and entered the service of the patients at Jahye public hospitals in Won-ju, Chun-chon and Kwang-ju. I think that the projects of medical education starting from Tong-in club disappeared completely under the dictatorship of the Governor-General. It is certain that the Japanese medical education might take a great role in the development of the history in the spheres of Korean medicine. But the Japanese imperialistic government began, with deep interest and anxiety, whether it was really necessary to educate the Korean students in medical spheres. Namely, it seemed that there were many quarrelsome arguments about the necessity of medical education on the Choson colony. But it was paradoxically fortunate, the Tong-in club obtained good results to some extent by keeping the principles of the Residenty-General. It was short terms no more than 3 years but Tong-in club tried to practice the medical education projects, under the name of literally the Same Humanity and Charitly, but it managed to appease the minds of the colonized Korean people. It was the medical education projects in Tong-in club that caused a combat in outpost of the education principles of colony under 'the Same Humanity and Charity between Japan and Choson' at the just end of 3. 1 Movement by the inauguration of Saito Makkot the Governor-General. We can arrive at conclusion that the Japanese colonists tried to approach colonial education through the medical education by following the examples of western-imperialistic countries. The medical education projects of Tong-in club were the basic and continual principles since emerging Choson into Japan as colony. Namely it could be highlighted that the medical education practices of Tong-in club were planned and driven as a part of pervasion of the Japanese colonial education principles, namely 'the Same Humanity and Charity between Japan in Choson'.