Visuo-Haptic-Based Multimodal Feedback Virtual Reality Solution to Improve Anxiety Symptoms: A Proof-of-Concept Study

With proper guidance, virtual reality (VR) can provide psychiatric therapeutic strategies within a simulated environment. The visuo-haptic-based multimodal feedback VR solution has been developed to improve anxiety symptoms through immersive experience and feedback. A proof-of-concept study was performed to investigate this VR solution. Nine subjects recently diagnosed with panic disorder were recruited, and seven of them eventually completed the trial. Two VR sessions were provided to each subject. Depression, anxiety, and VR sickness were evaluated before and after each session. Although there was no significant effect of the VR sessions on psychiatric symptoms, we could observe a trend of improvement in depression, anxiety, and VR sickness. The VR solution was effective in relieving subjective anxiety, especially in panic disorder without comorbidity. VR sickness decreased over time. This study is a new proof-of-concept trial to evaluate the therapeutic effect of VR solutions on anxiety symptoms using visuo-haptic-based multimodal feedback simultaneously.

Detection of an Ala601Thr Mutation of Plasminogen Gene in 3 out of 36 Korean Patients with Deep Vein Thrombosis

Plasminogen is a key proenzyme in the fibrinolytic and thrombolytic systems. Congenital deficiency of plasminogen and molecular abnormality of plasminogen (dysplasminogenemia) have been reported in association with the thrombotic tendency in human. In dysplasminogenemia, the level of immunoreactive plasminogen is normal, although the functional activity is reduced. Human plasminogen gene spans about 52.5 kb of DNA and consists of 19 exons. Three types of mutations (Ala601Thr, Val355Phe, and Asp676Asn) have been described in dysplasminogenemia. In this study, we measured the plasminogen activity in patients with deep vein thrombosis and analyzed the DNA sequence to detect three point mutations (Ala601Thr, Val355Phe and Asp676Asn) in patients with hypo/dysplasminogenemia. Dysplasminogenemia was identified in 3 (8.3%) of unrelated 36 patients with deep vein thrombosis and the Ala601Thr mutation was detected in all three patients with dysplasminogenemia. In conclusion, dysplasminogenemia is not rare in deep vein thrombosis, which suggests a risk factor for the thrombosis in Korean population.

Management of Clinical Laboratory Staffs in Korea (II) / 임상검사와정도관리

BACKGROUND: For the efficient management of clinical pathology laboratory, not only the economic side but also the quality of test should be considered. Therefore, the authors investigated the status of laboratory in the management point including the status of technical personnel by survey and tried to find out the fundamental status of work environment, laboratory automation, computerization, and to evaluate the efficiency of management of clinical pathology laboratories in Korea. METHOD: The questionnaires included those for investigating laboratory management status, qualities of laboratory personnels, workloads, test items and numbers of tests performed annually. It contained 22 items with 32 detailed sub-questionnaires for laboratory personnel survey, and 9 items with 106 detailed sub-questionnaires for facilities. We sent those three times to 400 laboratories that were participating in the National External Quality Assessment Scheme in Korea and analysed the answers by descriptive statistics, ANOVA, t-test and correlation analysis. RESULTS: The replies were from 96 laboratories and 326 technical personnels. Among the 96 laboratories, there were 71 full time employed clinical pathologists. The annually performed number of tests were increased with the increased the size of laboratory, that was classified by number of personnels. As the laboratory size was increased, part time personnels, cases of test per technical personnel, automation and computerization, satisfaction for their work (58,2%) were increased but decreased satisfaction of salaries. CONCLUSIONS: We surveyed the present employee status of laboratory personnels and status of laboratory and offered fundamental data of clinical laboratory management in Korea.

A Review of Prenatal Cytogenetic Analysis in 2942 Midtrimester Amniocentesis / 대한산부인과학회잡지

OBJECTIVES: To analyze 2942 cases of prenatal genetic amniocentesis with their cytogenetic results. METHODS: This study reviewed 2942 genetic amniocentesis results which were perfomed at Ilsin Christian Hospital from 1993 to 1999, as prenatal genetic diagnosis for the possibility of chromosomal abnormality of fetus. Age distribution, gestational weeks, indications of amniocentesis and cytogenetic results were the key factors for the analysis. RESULTS: Maternal ages were ranged from 20 to 45, mostly 25-39. Of indications of prenatal genetic amniocentesis, abnormal maternal serum marker was the most common(57.9%) and followed by advanced maternal age(29.3%). The frequency of abnormal karyotypes was 3.1%(90/2942). Down syndrome(trisomy 21) and inversion of chromosome were found at 0.8%(24/2942) and 1.0%(30/2942). The incidence of abnormal karyotype according to indication had statistical significance in family history and abnormal ultrasonographic findings.(p<0.001) CONCLUSIONS: Midtrimester genetic amniocentesis is an important diagnostic tool in prenatal genetic diagnosis. In addition to the maternal serum markers and maternal ages, complete family history takings and ultrasonograms should be considered in prenatal genetic counseling.

Evaluation of the Collection Efficiency of the Granulocyte in Leukapheresis Using 10% Pentastarch / 대한임상병리학회지

BACKGROUND: To collect high concentration of granulocytes for transfusion to neutropenic cancer patients with infections, we investigated the effect of G-CSF or dexamethasone as granulocyte mobilizers and 10% pentastarch (PS) as the sedimentation agent in granulocyte collection by leukapheresis. Subsequently, the therapeutic effect of the granulocyte transfusions was assessed. METHODS: Forty five leukapheresis were performed with CS-3000Plus (Baxter, Deerfield, IL, USA) using 10% pentastarch. The donors were classified into three groups according to their premedication drugs and the interface detector offset; group 1 used dexamethasone with offset 15 (n=16), group 2 used dexamethasone with offset 33 (n=16), and group 3 used G-CSF with offset 33 (n=10). We compared total collected granulocyte counts and granulocyte collection efficiency (GCE). RESULTS: The mean counts of total granulocytes collected and GCE were as follows; 0.9 0.5 x 1010 and 31.6 14.3% in group 1, 1.3 0.6 x 1010 and 39.0 14.2% in group 2, and 1.6 0.9 x 1010 and 63.9 32.2% in group 3, respectively. The counts of granulocytes collected in group 3 was significantly higher than that in group 1 (P<0.05). The GCE of group 3 was significantly higher than that of group 1 and group 2 (P<0.05). Sixteen granulocyte transfusions were performed to 11 patients. We observed successful therapeutic effects in 10 out of 16 transfusions (63%). CONCLUSIONS: G-CSF indicates greater potency than dexamethasone although its high cost is limitation of routine use as mobilizing agents and PS was an excellent red cell sedimenting agent in granulocyte collection. Large volume granulocyte transfusions allow high therapeutic effects in neutropenic patients with marrows of sufficient regenerating capacity.

Flow Cytometric Analysis of BRCA1 Protein in Sporadic Breast Cancer / 대한암학회지

PURPOSE: To study the subcellular localization with flow-cytometry and to evaluate their prognostic values. MATERIALS AND METHODS: The breast tissues were obtained from 28 patients with breast cancer and 6 patients with benign mass. The expression of BRCA1 protein was analyzed with the flow cytometry(Coulter Epics-XL, Coulter Corps, FL, USA) using the monoclonal antibody(BRCA1(Ab-1), Calbiochem, MA, USA) before and after nuclear and cytoplasmic permeabilization in association with DNA ploidy analysis. Several BRCA1 protein indices were derived including 95 percentile channel fluorescence(95% CF) and mean channel fluorescence(MCF) and percentage of BRCA 1 positive cell population arbitarily defined as those above 0.12 channel fluorescence. RESULTS: Cytoplasmic 95% CF were higher in breast cancer(n=28, 0.65+/-0.26) than in benign mass(n=6, 0.40+/-0.13, p=0.0211). Cytoplasmic BRCAl positive cell percentages were significantly higher in malignant tissues(24.0+/-10.3) than in benign mass(43.4+/-15.2, p=0.0059). Cytoplasmic BRCA1 positive cell percentages were significantly different according to the stages(stage I vs II, 32.6+/-9.8 vs 48.3+/-18.8, p=0.048, stage I vs stage III, 32.6+/-9.8 vs 47.0+/-10.9, p=0.010). The BRCA1 protein indices were not significantly correlated with histologic grades and DNA indices(aneuploidy, S phase and proliferation fractions). CONCLUSIONS: Flowcytometric assay offers an alternative approach to evaluating BRCA1 protein status of breast cancer tissue and detection of cytoplasmic BRCA1 protein by this method may help to understand the role of BRCA1 in breast cancer cell biology. The further study on cytoplasmic or nuclear BRCA1 protein in association with clinical therapeutic response or prognosis seems to be warranted.

Iron related indices in iron deficiency anemia of geriatric Korean patients

The purpose of this study was to compare iron related indices in patients with iron deficiency anemia and chronic causative diseases between geriatric older than 65 years and adult, nongeriatric younger than 65 years groups. Iron deficiency anemia (IDA) cases with chronic disorders from Youngdong Severance hospital from June, 1991 to April, 1994, older than 65 years (17 cases), and younger than 65 years (29 cases) were analysed with iron related indices. Mean hemoglobin was 7.8 +/- 2.2 g/dl in geriatric IDA and 8.0 +/- 1.8 g/dl in adult IDA without significant difference. RDW value was 19.5 +/- 2.6 in geriatric IDA and 18.4 +/- 3.2 in adult IDA with no significant difference. Serum iron and transferrin saturation between geriatric IDA were 22.7 +/- 12.3 ug/dl, 6.7 +/- 4.1% and 28.6 +/- 16.6 ug/dl, 7.1 +/- 4.4% in adult IDA with no significant difference, but TIBC was significantly lower (P = 0.011) in geriatric IDA than in adult IDA patients (357.2 +/- 83.2, 413.6 +/- 54.0 ug/dl). In normal elderly people, serum ferritin was 152.5 +/- 95.4 ng/ml in male and 111.1 +/- 54.1 ng/ml in female with range 19.8 approximately 367.7 ng/ml in male and 11.7 approximately 238.7 ng/ml in female and was higher than that of normal adult in both sexes (147.0 +/- 108.0, 35.3 +/- 20.5 ng/ml) (P = 0.045). Serum ferritin in geriatric IDA was 13.8 +/- 11.8 ng/ml and 5.7 +/- 4.0 ng/ml in adult IDA with significant difference(P = 0.001). The Upper margin for geriatric IDA was 37 ng/ml with 95% confidence interval. In the diagnosis of geriatric IDA with causative diseases, we should consider that TIBC does not increase and the upper margin for serum ferritin is suggested to increases up to 37 ng/ml.