Review of Computer-Aided Sinus Surgery / 한양의대학술지

Sinus is a cavity within a bone. Most are commonly found in the bones of the face. Specially, paranasal sinuses are air cavities in the cranial bones, especially those near the nose. They include the frontal sinuses, the ethmoid sinuses, the sphenoid sinuses and the maxillary sinuses. There are many types of sinus disease. They are classified as acute (quick onset) and chronic (over a long period of time). Besides, there are several other types of sinus diseases due to fungus and polyps. Sinus tumors also happen although it is relatively uncommon. Navigation software for general sinus surgery has been developed and are being used in the operation room. However, there are still many blind regions in the sinus area by using conventional straight type endoscope and devices. To cope with such a problem, flexible endoscope and devices are being developed along with advanced navigation algorithms. In this review, many research activities associated with computer-aided sinus surgery are discussed.

Review of Computer-Aided Sinus Surgery / 한양의대학술지

Sinus is a cavity within a bone. Most are commonly found in the bones of the face. Specially, paranasal sinuses are air cavities in the cranial bones, especially those near the nose. They include the frontal sinuses, the ethmoid sinuses, the sphenoid sinuses and the maxillary sinuses. There are many types of sinus disease. They are classified as acute (quick onset) and chronic (over a long period of time). Besides, there are several other types of sinus diseases due to fungus and polyps. Sinus tumors also happen although it is relatively uncommon. Navigation software for general sinus surgery has been developed and are being used in the operation room. However, there are still many blind regions in the sinus area by using conventional straight type endoscope and devices. To cope with such a problem, flexible endoscope and devices are being developed along with advanced navigation algorithms. In this review, many research activities associated with computer-aided sinus surgery are discussed.

Efficacy and Safety of Autologous Bone Marrow-derived Mesenchymal Stem Cell Treatment in Patients With Amyotrophic Lateral Sclerosis

BACKGROUND: This study was performed to investigate the efficacy and safety of intrathecal autologous bone marrowderived mesenchymal stem cells (MSCs) treatment for patients with ALS. METHODS: After a lead-in period for 3 months, 22 patients were treated with MSCs twice at an interval of 1 month. After initial MSCs injection, all patients were followed up for 3 months and their disease course, clinical characteristics were assessed. Disease status of patients were analyzed with ALS functional rating scale-revised (ALSFRS-R) for primary outcome measure, and additional clinical findings after treatment were all collected for secondary outcome measure and safety. Age and disease-duration matched patients with ALS were selected as a control group. RESULTS: During the follow-up period, MSCs treatment yielded a significant lesser change of ALSFRS-R score, compared to control group (1.54 vs 3.56, p<0.01). Moreover, the slop of decline of ALSFRS-R was significantly lower during the follow-up period, compared to the lead-in period in MSCs treatment group (2.68 vs 1.54, p=0.04), whereas the slopes during the two periods were not different in the control group (3.15 vs 3.56, p=0.37). MSCs treatment was well tolerated except for occurrences of transient headache, low back pain, and myalgia. CONCLUSIONS: Our results show that intrathecal MSCs injection can slow disease progression and might be used as a disease modifying modality as an alternative treatment choice in patients with ALS.

A Case of Apical Hypertrophic Cardiomyopathy Combined Acute Myocardial Infarction with Multiple Coronary Thrombosis

We report a case of apical hypertrophic cardiomyopathy combined with acute myocardial infarction and multiple coronary thrombosis. The patient presented with signs and symptoms of acute myocardial infarction, showing ST elevation in the lateral leads and ST depression in anterior chest leads on initial electrocardiogram. The coronary angiogram on admission, multiple thrombosis of distal left anterior descending artery, left circumflex, diagonal and obtuse marginal arteries were found. The present case shows that apical hypertrophic cardiomyopathy can be combined with acute myocardial infarction and multiple coronary thrombosis.

Efficient culture system for human embryonic stem cells using autologous human embryonic stem cell-derived feeder cells

Human embryonic stem cells (hESCs) need feeder cells for their maintenance in an undifferentiated state. In conventional culture systems, mouse embryonic fibroblasts (MEFs) serve as feeder cells to maintain hESCs. However, the use of MEFs elevates the risk of transmitting mouse pathogens and thus limits the potential of hESCs in cell replacement therapy. Consequently, the use of human feeder cells would be an important step forward in this in vitro technology. To address this issue, we used fibroblast-like cells differentiated from the Miz-hES6 hESC line (Diff (Miz-hES6)) as feeder cells to support the in vitro growth of three hESC lines. Immunofluorescence microscopy and reverse transcription-PCR assessing the expression of undifferentiated hESC markers revealed all three hESC lines were maintained in an undifferentiated state. In vitro proliferation proceeded as efficiently as when the hESCs were cultured on MEFS. Moreover, karyotype analysis revealed the chromosomal normality of the hESC lines and the Diff (Miz-hES6) feeders themselves after even 50 passages. Furthermore, the hESC lines maintained their pluripotency since they remained capable of forming embryoid bodies (EBs) in vitro. Thus, hESC-derived fibroblast-like cells successfully support in vitro hESC propagation.

The effect of LH Receptor in the Pregnancy of Poor Responders / 대한불임학회지

OBJECTIVES: To investigate the effect of LH receptor in folliculogenesis, we confirm the expression level of LH receptor (LH-R) mRNA in human granulosa cells (GCs) and its expression levels were analyzed by comparison to embryo developmental rate and pregnancy rate. MATERIALS AND METHODS: GCs were obtained at the time of oocyte retrieval from the patients undergoing IVF-ET program. The patients were divided into two groups: Group I (n=20) is poor responder (retrieved oocyte(s)3ea). After the extraction of total RNA, semiquantitative RT-PCR was performed and the expression level of LH-R mRNA was normalized by beta-actin. Statistical analysis was performed by using Chi(2) test, Student's t-test and Pearson correlation. RESULTS: In Group II, the relative values of LH-R mRNA (0.680 vs. 0.463, p<0.005) and pregnancy rate (54.7% vs. 23.1%, p<0.05) were significantly higher than in Group I. Number of retrieved oocyte(s) was gradually increased when the expression of LH-R mRNA was increased (p<0.05). But the quality of retrieved oocyte and transferred embryo were not related with the expression of LH-R mRNA. When the pregnancy rate was compared with FSH only group and FSH combined with hMG group in the ovarian stimulation protocol, FSH combined with hMG group was significantly higher than FSH only group in Group I (37.5% vs. 0%), and the expression of LH-R mRNA was significantly higher in hMG combined group than FSH only group (p<0.05). CONCLUSION: Expression level of LH-R mRNA has important role in ovarian function related with the response to gonadotrophin in human folliculogenesis. Furthermore these data might provide the evidence that additional use of hMG is helpful to poor responders.

Recent Advances in Human Embryonic Stem Cell Research

The 21st century is considered as the era of Biotechnology (BT). Recently, the regenerative medicine using stem cells has been recognized as the future medicine, especially for the devastating diseases such as neurodegenerative diseases, heart disease, diabetes, infertility and liver diseases. Human embryonic stem cells (hESCs) are at the center of the stem cell research due to its ability to proliferate unlimitedly without differentiation (self-renewal) and to differentiate into the derivatives of all three germ layers including germ cells with appropriate treatments (pluripotency). A total of 173 hESC lines have been derived since the first derivation by Thomson et al. in 1998, and 70 hESC lines are currently available for distribution including hESC line (Miz-hES1) established at the MizMedi Hospital. The major goal of hESC research is to provide basic and clinical clues for cell replacement therapy, whose targets are aforementioned incurable diseases. One of the landmarks in hESC research is the derivation of a hESC line from a cloned human blastocyst, which has recently been done by Korean scientists. This made it possible to overcome the issue of immune-mediated rejection following cell replacement therapy using hESCs. Guided differentiation of hESCs into specific cell types by treating growth factors and drugs or by genetic manipulation by using overexpression or an RNAi knockdown system is one of the most active research areas. Combined efforts towards the guided differentiation of hESC into specific cell types and the cloning of hESC from a cloned human blastocyst will overcome a list of diseases hitherto considered to be incurable.

Induced Differentiation of Embryonic Stem Cells to Insulin Secreting Cells / 대한불임학회지

OBJECTIVE: Embryonic stem (ES) cells could be differentiated into the specific cell types by alternation of culture condition and modification of gene expression. This study was performed to evaluate the differentiation protocol for mouse and human ES cells to insulin secreting cells. METHODS: Undifferentiated mouse (JH-1) and human (Miz-hES1) ES cells were cultured on STO feeder layer, and embryoid bodies (EBs) were formed by suspension culture. For the differentiation, EBs were cultured by sequential system with three stage protocol. The differentiating ES cells were collected and marker gene expressions were analyzed by semi-quantitative RT-PCR in each stage. Amount of secreted insulin levels in culture media of human ES cells were measured by human insulin specific RIA kit. RESULTS: During the differentiation process of human ES cells, GATA-4, alpha-fetoprotein, glucose transporter-2 and Ngn-3 expression were increased whereas Oct-4 was decreased progressively. Insulin and albumin mRNAs were expressed from stage II in mouse ES cells and from stage III in human ES cells. We detected 3.0~7.9 microU/ml secretion of insulin from differentiated human ES cells by in vitro culture for 36 days. CONCLUSION: The sequential culture system could induce the differentiation of mouse and human ES cells into insulin secreting cells. This is the first report of differentiation of human ES cells into insulin secreting cells by in vitro culture with serum and insulin free medium.

Isolation and Culture of Human Embryonic Stem-like Cells from Abnormal Blastocysts / 대한불임학회지

No abstract available.

Microdeletions of Y Chromosome in Infertile Korean Men and Correlation with Pathologic Presentation / 대한남성과학회지

PURPOSE: Microdeletions on the Y chromosome have been associated with infertile in men. The deletions cluster in three regions, named azoospermia factor (AZF): AZFa, AZFb and AZFc. It has been suggested that deletions in AZFa result in Type I Sertoli cell-only (SCO) infertility (no spermatogonia present), deletions in AZFb in spermatogenic arrest, and deletions in AZFc Type II SCO (some spermatogonia present with limited spermatogenesis). The purpose of this study was to determine the prevalence of Y chromosome microdeletions and to correlate of the pathologic presentation with specific deletions in infertile Korean men. MATERIALS AND METHODS: We analyzed 115 non-obstructive azoospermic (NOA), 30 obstructive azoospermic (OA), 30 severe oligospermic (sperm concentration <5 x 10(6)/ml) patients and 50 fathered men. We tested leukocyte DNA by PCR for the presence of STS markers, AZFa (sY84, 85, 86), AZFb (sY129, 134, 135, 143, RBM1) and AZFc (DAZ, sY242). The PCR results were confirmed by Southern hybridization and were investigated by SSCP analysis for DAZ gene muations. RESULTS: None of 30 OA and 50 fertile men had microdeletions, but 15 (13.0%) of the 115 NOA and 4 (13.3%) severely oligospermic patients had one or more microdeletions. Deletions involving only the AZFc region were found in 9 men (3 severe oligospermia, 4 spermatogenic arrest, 1 Type I SCO and 1 Type II SCO). Deletions involving only the AZFb were found in 4 (1 severe oligospermia and 3 spermatogenic arrest), and deletions involving only AZFa were found in 1 (Type I SCO). Also, deletions involving the AZFb and AZFc were found in 5 (2 severe oligospermia and 3 Type I SCO). CONCLUSIONS: The prevalence of Y chromosome microdeletion was 13.0% and 13.3% in NOA and severely oligo spermia patients. The earlier reported association with particular types of infertility was not confirmed. The region of the deletions does not correlate with severity of spermatogenic failure or the presence of visible sperm. Deletions involving more proximal regions of the Y chromosome (AZFa) seemed to be rare.

A Case of Bilateral Pleural Effusion due to Ovarian Hyperstimulation Syndrome / 결핵

Ovarin hyperstimulation syndrome (OHSS), an iatrogenic complication of ovarian stimulation, shows varying degrees of clinical manifestations. The pathogenesis of OHSS is an increase of vascular permeability resulting in hypovolemia, thromboembolism, ARDS, and death in sometimes. Pleural effusion is also a result of an increase of vascular permedability in the pleura. Thoracentesis is sometimes required to relieve dyspnea. We report a case of OHSS with bilateral exudative pleural effusfion is a 23 year-old female with resting dyspnea. She was received clomi;hen, FSH, and LH for the treatment of irregular menstruation twenty days previously. The ultrasonogram showed severe ascites and bilaterally huge ovary, and chest radiography showed bilateral effusion. Therapeutic thoracentesis and paracentesis were done for relief of the dyspnea. Two weeks later the bilateral effusion and symptoms disappeared spontaneously.

Regulation of LIF Gene Expression by Interleukin-1 in the Mouse Peri-implantation Embryos and Uterine Endometiral Cells / 대한불임학회지

No abstract available.

Diagnosis and Treatment of Azoospermia

No abstract available.

Biochemical Assisted Hatching of Embryos in Human IVF-ET Program / 대한산부인과학회잡지

Human assisted reproductive technology programs have been being developed marvelously during this decade. However, implantation rates following embryo replacement remain low, regardless of increased fertilization rates by ICSI. One proposed possibility limiting the successful implantation is an impaired hatching caused by suboptimal culture conditions. As to improve the hatching potential of blastocysts, assisted hatching by an artificial alteration of zona pellucida(ZP) have been done in many laboratories using the various methods. We tried to investigate whether the supplementation of proteases into culture media has any effect on development, zona structure, and/or hatching of mouse embryos. Supplementation of either pronase E(PE) or proteinase K(PK) in culture media did not affect development up to blastocyst but significantly increased hatching rate. And we observed the alteration of ultrastructure and casein binding properties of ZP in mouse embryos. Also we investigated the effects of protease on development of human embryos and pregnancy rates in human ART program. From July 1994 to December 1996, 792 cycles(for study I) and 1095 cycles(for study II) undergoing the IVF-ET program in MizMedi Hospital were randomly selected for BAH. The concentrations of proteases used in this study were 1microgram/ml PE, 0.1microgram/ml PK and 1microgram/mlPE+0.1microgram/ml PK in HTF with 0.5% human serum albumin(HSA), and in vitro fertilized embryos were cultured for 24 hours. We analyzed the efficiency and stability of biochemical assisted hatching(BAH) according to the clinical profiles of patients and fertilization methods. After cultured in HTF with proteases for 24 hours of human embryos, the thinning in zona pellucida of embryos was observed but its development was not disturbed. Also, clinical pregnancy rates were higher in the PE, PK and PE+PK groups than the control group without proteases(36.0%(32/89), 35.3%(36/102), 35.1%(39/111) vs. 25.5%(125/490), p<0.05). The live birth rate in the PE, PK and PE+PK groups were increased than control, and the abortion rate were not different. They were showed a effect and safety of proteases treatment in human embryos. We selected PE as BAH for study II because of slightly better embryonic morphology and pregnancy rate. In patients over 35 years old, clinical pregnancy rates of the BAH group was higher than that of the control group(31.4%(58/185) vs. 22.2%(51/230); p<0.05). And in the cases with few oocytes retrieval, or less than 3 cycles of IVF-ET, clinical pregnancy rates of the BAH group was significantly higher than that of the control group(36.8%(86/234) vs. 27.2%(93/342), p<0.05; 36.8%(148/402) vs. 29.9%(168/562), p<0.05). In BAH groups, the clinical pregnancy rate was similar between conventional IVF and ICSI group. From above results, it is suggested that improved hatching by protease treatment is due to physiological alteration of ZP structure, giving rise to the similar hatching process to that in vivo. We suggest that BAH using protease is a simple, safe and economic technique compared to the other known assisted hatching techniques in human ART program.

A Case of Cardiac Tamponade due to Primary Hypothyroidism

Pericardial effusions occur in approximately 30% of patients with untreated hypothyroidism. The effusions are more common in patients with longstanding, severe disease. But, cardiac tamponade is a very rare complication, because of the elasticity of pericardium and slow progression. We experienced a 61 year old female patient with cardiac tamponade due to primary hypothyroidism. She was treated with pericardiocentensis and thyroid hormone replacement, confirmed by echocardiography,thyroid function test and TRH stimulation test.

Effects of sperm extracts on sperm-egg binding in mouse / 대한불임학회지

No abstract available.

Localization and activity of alkaline phosphatase and adenosine triphosphatase of ovarian follicles in pig / 대한불임학회지

No abstract available.