• Journal of Korean Neurosurgical Society
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• v.61 no.3
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• pp.363-375
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• 2018

Intraoperative monitoring (IOM) utilizes electrophysiological techniques as a surrogate test and evaluation of nervous function while a patient is under general anesthesia. They are increasingly used for procedures, both surgical and endovascular, to avoid injury during an operation, examine neurological tissue to guide the surgery, or to test electrophysiological function to allow for more complete resection or corrections. The application of IOM during pediatric brain tumor resections encompasses a unique set of technical issues. First, obtaining stable and reliable responses in children of different ages requires detailed understanding of normal age-adjusted brain-spine development. Neurophysiology, anatomy, and anthropometry of children are different from those of adults. Second, monitoring of the brain may include risk to eloquent functions and cranial nerve functions that are difficult with the usual neurophysiological techniques. Third, interpretation of signal change requires unique sets of normative values specific for children of that age. Fourth, tumor resection involves multiple considerations including defining tumor type, size, location, pathophysiology that might require maximal removal of lesion or minimal intervention. IOM techniques can be divided into monitoring and mapping. Mapping involves identification of specific neural structures to avoid or minimize injury. Monitoring is continuous acquisition of neural signals to determine the integrity of the full longitudinal path of the neural system of interest. Motor evoked potentials and somatosensory evoked potentials are representative methodologies for monitoring. Free-running electromyography is also used to monitor irritation or damage to the motor nerves in the lower motor neuron level : cranial nerves, roots, and peripheral nerves. For the surgery of infratentorial tumors, in addition to free-running electromyography of the bulbar muscles, brainstem auditory evoked potentials or corticobulbar motor evoked potentials could be combined to prevent injury of the cranial nerves or nucleus. IOM for cerebral tumors can adopt direct cortical stimulation or direct subcortical stimulation to map the corticospinal pathways in the vicinity of lesion. IOM is a diagnostic as well as interventional tool for neurosurgery. To prove clinical evidence of it is not simple. Randomized controlled prospective studies may not be possible due to ethical reasons. However, prospective longitudinal studies confirming prognostic value of IOM are available. Furthermore, oncological outcome has also been shown to be superior in some brain tumors, with IOM. New methodologies of IOM are being developed and clinically applied. This review establishes a composite view of techniques used today, noting differences between adult and pediatric monitoring.

• Clinical and Experimental Reproductive Medicine
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• v.35 no.1
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• pp.61-67
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• 2008

Objective: This study was attempted to look at the effect of dexamethasone on the luteolysis of corpus luteum in rats by immunohistochemical study. Methods: Counting with an optical microscope was conducted to make a comparison on difference in luteolysis and penetration of macrophage into three groups: control group of 30 female rats at 8 weeks of age, dexamethasone 0.1 mg administered group, and dexamethasone 1mg administered group. Results: As a result of TUNEL immunostaining, the percentage of luteolysis was significantly reduced in both dexamethasone 0.1 mg administered group and 1 mg administered group, and after ED1 immunostaining, macrophage invasion was reduced in dexamethasone 1 mg administered group. As a consequence of ED1 immunostaining, the immune response of macrophage was much decreased in dexamethasone 1 mg administered group than control group. Conclusion: Dexamethasone works on luteal cell, so it can suppress apoptosis. It can suppress luteolysis by suppression macrophage invasion into corpus luteum or suppress macrophage activation in corpus luteum.

• The Journal of Korean Medicine
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• v.41 no.2
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• pp.58-79
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• 2020

Objectives: The purpose of this study is to predict the weight loss by applying machine learning using real-world clinical data from overweight and obese adults on weight loss program in 4 Korean Medicine obesity clinics. Methods: From January, 2017 to May, 2019, we collected data from overweight and obese adults (BMI≥23 kg/m2) who registered for a 3-month Gamitaeeumjowi-tang prescription program. Predictive analysis was conducted at the time of three prescriptions, and the expected reduced rate and reduced weight at the next order of prescription were predicted as binary classification (classification benchmark: highest quartile, median, lowest quartile). For the median, further analysis was conducted after using the variable selection method. The data set for each analysis was 25,988 in the first, 6,304 in the second, and 833 in the third. 5-fold cross validation was used to prevent overfitting. Results: Prediction accuracy was increased from 1^st to 2^nd and 3^rd analysis. After selecting the variables based on the median, artificial neural network showed the highest accuracy in 1^st (54.69%), 2^nd (73.52%), and 3^rd (81.88%) prediction analysis based on reduced rate. The prediction performance was additionally confirmed through AUC, Random Forest showed the highest in 1^st (0.640), 2^nd (0.816), and 3^rd (0.939) prediction analysis based on reduced weight. Conclusions: The prediction of weight loss by applying machine learning showed that the accuracy was improved by using the initial weight loss information. There is a possibility that it can be used to screen patients who need intensive intervention when expected weight loss is low.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.8
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• pp.4003-4007
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• 2016

Long interspersed elements-1s (LINE-1s) are dispersed all over the human genome. There is evidence that hypomethylation of LINE-1s and levels of sex steroids regulate gene expression leading to cancer development. Here, we compared mRNA levels of genes containing an intragenic LINE-1 in breast cancer cells treated with various sex steroids from Gene Expression Omnibus (GEO), with the gene expression database using chi-square analysis (http://www.ncbi.nlm.nih.gov/geo). We evaluated whether sex steroids influence expression of genes containing an intragenic LINE-1. Three sex steroids at various concentrations, 1 and 10 nM estradiol (E2), 10 nM progesterone (PG) and 10 nM androgen (AN), were assessed. In breast cancer cells treated with 1 or 10 nM E2, a significant percentage of genes containing an intragenic LINE-1 were down-regulated. A highly significant percentage of E2-regulated genes containing an intragenic LINE-1 was down-regulated in cells treated with 1 nM E2 for 3 hours (p<3.70E-25; OR=1.91; 95% CI=2.16-1.69). Similarly, high percentages of PG or AN-regulated genes containing an intragenic LINE-1 wwere also down-regulated in cells treated with 10 nM PG or 10 nM AN for 16 hr (p=9.53E-06; OR=1.65; 95% CI=2.06-1.32 and p=3.81E-14; OR=2.01; 95% CI=2.42-1.67). Interestingly, a significant percentage of AN-regulated genes containing an intragenic LINE-1 was up-regulated in cells treated with 10 nM AN for 16 hr (p=4.03E-02; OR=1.40; 95% CI=1.95-1.01). These findings suggest that intragenic LINE-1s may play roles in sex steroid mediated gene expression in breast cancer cells, which could have significant implications for the development and progression of sex steroid-dependent cancers.

• Progress in Medical Physics
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• v.19 no.3
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• pp.178-185
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• 2008

Living donor liver transplantation is increasingly performed as an alternative to cadaveric transplantation. Preoperative screening of the donor candidates is very important. The quality, size, and vascular and biliary anatomy of the liver are best assessed with magnetic resonance (MR) imaging or computed tomography (CT). In particular, the volume of the potential graft must be measured to ensure sufficient liver function after surgery. Preoperative liver segmentation has proved useful for measuring the graft volume before living donor liver transplantations in previous studies. In these studies, the liver segments were manually delineated on each image section. The delineated areas were multiplied by the section thickness to obtain volumes and summed to obtain the total volume of the liver segments. This process is tedious and time consuming. To compensate for this problem, automatic segmentation techniques have been proposed with multiplanar CT images. These methods involve the use of sequences of thresholding, morphologic operations (ie, mathematic operations, such as image dilation, erosion, opening, and closing, that are based on shape), and 3D region growing methods. These techniques are complex but require a few computation times. We made a phantom for volume measurement with pig and evaluated actual volume of spleen and liver of phantom. The results represent that our semiautomatic volume measurement algorithm shows a good accuracy and repeatability with actual volume of phantom and possibility for clinical use to assist physician as a measuring tool.

• The Journal of Advanced Prosthodontics
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• v.3 no.4
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• pp.216-220
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• 2011

PURPOSE. Heat of composite polymerization (HP) indicates setting efficacy and temperature increase of composite in clinical procedures. The purpose of this in vitro experimental study was to evaluate the effects of 5 temperatures on HP of two new composites. MATERIALS AND METHODS. From each material (Core Max II [CM] and King Dental [KD]), 5 groups of 5 specimens each were prepared and their total HPs (J/gr) were measured and recorded, at one of the constant temperatures $0^{\circ}C$, $15^{\circ}C$, $23^{\circ}C$, $37^{\circ}C$ and $60^{\circ}C$ ($2{\times}5{\times}5$ specimens) using a differential scanning calorimetry (DSC) analyzer. The data were analyzed using a two-way ANOVA, a Tukey's test, an independent-samples ttest, and a linear regression analysis (${\alpha}=0.05$). RESULTS. No polymerization reactions occurred at $0^{\circ}C$; then this temperature was excluded from statistical analyses. The mean HP of the remaining 20 KD specimens was $20.5{\pm}14.9$ J/gr, while it was $40.7{\pm}12.9$ J/gr for CM. The independent-samples t-test showed that there were significant differences between the HP of the two materials at the temperatures $15^{\circ}C$ (P=.0001), $23^{\circ}C$ (P=.0163), $37^{\circ}C$ (P=.0039), and $60^{\circ}C$ (P=.0106). Linear regression analysis showed statistically significant correlations between environment temperatures and HP of CM ($R^2=0.777$). CONCLUSION. Using CM is advantageous over conventional composite because of its better polymerization capacity. However due to its high HP, further studies should assess its temperature increase in vivo. Preheating KD is recommended. Refrigerating composites can negatively affect their polymerization potential.

• The Journal of Advanced Prosthodontics
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• v.6 no.5
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• pp.406-414
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• 2014

PURPOSE. The objective of this study was to investigate the biologic effects of enamel matrix derivative (EMD) with different concentrations on cell viability and the genetic expression of human gingival fibroblasts (HGF) to zirconia surfaces. MATERIALS AND METHODS. Immortalized human gingival fibroblasts (HGF) were cultured (1) without EMD, (2) with EMD $25{\mu}g/mL$, and (3) with EMD $100{\mu}g/mL$ on zirconia discs. MTT assay was performed to evaluate the cell proliferation activity and SEM was carried out to examine the cellular morphology and attachment. The mRNA expression of collagen type I, osteopontin, fibronectin, and TGF-${\beta}1$ was evaluated with the real-time polymerase chain reaction (RT-PCR). RESULTS. From MTT assay, HGF showed more proliferation in EMD $25{\mu}g/mL$ group than control and EMD $100{\mu}g/mL$ group (P<.05). HGFs showed more flattened cellular morphology on the experimental groups than on the control group after 4h culture and more cellular attachments were observed on EMD $25{\mu}g/mL$ group and EMD $100{\mu}g/mL$ group after 24h culture. After 48h of culture, cellular attachment was similar in all groups. The mRNA expression of type I collagen increased in a concentration dependent manner. The genetic expression of osteopontin, fibronectin, and TGF-${\beta}1$ was increased at EMD $100{\mu}g/mL$. However, the mRNA expression of proteins associated with cellular attachment was decreased at EMD $25{\mu}g/mL$. CONCLUSION. Through this short term culture of HGF on zirconium discs, we conclude that EMD affects the proliferation, attachment, and cell morphology of HGF cells. Also, EMD stimulates production of extracellular matrix collagen, osteopontin, and TGF-${\beta}1$ in high concentration levels. CLINICAL RELEVANCE. With the use of EMD, protective barrier between attached gingiva and transmucosal zirconia abutment may be enhanced leading to final esthetic results with implants.

• Journal of Gastric Cancer
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• v.18 no.2
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• pp.142-151
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• 2018

Purpose: The modification of the cancer classification system aimed to improve the classical anatomy-based tumor, node, metastasis (TNM) staging by considering tumor biology, which is associated with patient prognosis, because such information provides additional precision and flexibility. Materials and Methods: We previously developed an mRNA expression-based single patient classifier (SPC) algorithm that could predict the prognosis of patients with stage II/III gastric cancer. We also validated its utilization in clinical settings. The prognostic single patient classifier (pSPC) differentiates based on 3 prognostic groups (low-, intermediate-, and high-risk), and these groups were considered as independent prognostic factors along with TNM stages. We evaluated whether the modified TNM staging system based on the pSPC has a better prognostic performance than the TNM 8th edition staging system. The data of 652 patients who underwent gastrectomy with curative intent for gastric cancer between 2000 and 2004 were evaluated. Furthermore, 2 other cohorts (n=307 and 625) from a previous study were assessed. Thus, 1,584 patients were included in the analysis. To modify the TNM staging system, one-grade down-staging was applied to low-risk patients according to the pSPC in the TNM 8th edition staging system; for intermediate- and high-risk groups, the modified TNM and TNM 8th edition staging systems were identical. Results: Among the 1,584 patients, 187 (11.8%), 664 (41.9%), and 733 (46.3%) were classified into the low-, intermediate-, and high-risk groups, respectively, according to the pSPC. pSPC prognoses and survival curves of the overall population were well stratified, and the TNM stage-adjusted hazard ratios of the intermediate- and high-risk groups were 1.96 (95% confidence interval [CI], 1.41-2.72; P<0.001) and 2.54 (95% CI, 1.84-3.50; P<0.001), respectively. Using Harrell's C-index, the prognostic performance of the modified TNM system was evaluated, and the results showed that its prognostic performance was better than that of the TNM 8th edition staging system in terms of overall survival (0.635 vs. 0.620, P<0.001). Conclusions: The pSPC-modified TNM staging is an alternative staging system for stage II/III gastric cancer.

• Biomedical Science Letters
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• v.13 no.1
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• pp.25-32
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• 2007

The purpose of this study was to investigate the effect of the high voltage pulsed Current (HVPC) stimulation on the healing rate and the proliferative activity of keratinocytes and IGF-I mRNA expression of an incisional wound in rat skin. Twenty male Sprague-Dawley rats ($265{\sim}290g$) were randomly divided into HVPC (n=10) and control group (n=10). Rats received 10 mm length of full-thickness incision wound on the back under the anesthesia. The HVPC group received electrical stimulation with a Current intensity of 50 V at 100 pps for a duration of 30 minutes, while the control group was given the same treatment without electricity for a week. Polarity was negative in first three days and positive thereafter. The wound length was measured and evaluated as percentage. The mean number of nucleolar organizer regions (NORs) per nucleus and level of IGF-I mRNA expression were calculated. The mean percent of wound closure were $51.17{\pm}17.76%$ and $80.71{\pm}11.91%$, respectively, in the sham treated control and HVPC stimulated groups (t=-4.308, P<0.001). The mean NOR number per nucleus of the keratinocytes in the control and HVPC group were $1.85{\pm}0.20$ and $2.70{\pm}0.23$, respectively (t=8.638, P<0.001). The IGF-I mRNA level were $0.76{\pm}0.44$ and $1.32{\pm}0.41$, respectively, in the control and HVPC stimulated wounds (t=2.906, P<0.01). There was a positive correlation between the mean NOR number per nucleus and IGF-l mRNA level with a Pearson product moment correlation coefficient of 0.72 (P<0.05). These findings suggest that the HVPC may activate the rRNA of the basal keratinocytes and upregulate the IGF-I mRNA levels by alteration of the electrical environment, and it may increase proliferative activity of the keratinocytes in the skin wound of the rat.

• Parasites, Hosts and Diseases
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• v.54 no.4
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• pp.385-391
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• 2016

The discovery and understanding of antigenic proteins are essential for development of a vaccine against malaria. In Plasmodium falciparum, Pf92 have been characterized as a merozoite surface protein, and this protein is expressed at the late schizont stage, but no study of Pv92, the orthologue of Pf92 in P. vivax, has been reported. Thus, the protein structure of Pv92 was analyzed, and the gene sequence was aligned with that of other Plasmodium spp. using bioinformatics tools. The recombinant Pv92 protein was expressed and purified using bacterial expression system and used for immunization of mice to gain the polyclonal antibody and for evaluation of antigenicity by protein array. Also, the antibody against Pv92 was used for subcellular analysis by immunofluorescence assay. The Pv92 protein has a signal peptide and a sexual stage s48/45 domain, and the cysteine residues at the N-terminal of Pv92 were completely conserved. The N-terminal of Pv92 was successfully expressed as soluble form using a bacterial expression system. The antibody raised against Pv92 recognized the parasites and completely merged with PvMSP1-19, indicating that Pv92 was localized on the merozoite surface. Evaluation of the human humoral immune response to Pv92 indicated moderate antigenicity, with 65% sensitivity and 95% specificity by protein array. Taken together, the merozoite surface localization and antigenicity of Pv92 implicate that it might be involved in attachment and invasion of a merozoite to a new host cell or immune evasion during invasion process.