Induced pluripotent stem cells (iPSC) are specially manipulated cells from somatic cells by the introduction of four factors that are reprogrammed. The properties of iPSC are similar to embryonic stem cells (ESC) characteristic of self-renewal and pluripotency. The technology of reprogramming somatic cells to iPSC enables the generation of patient-specific cells that can be used as powerful tools for drug screening, in vitro models for human disease and autologous transplantation. The iPSC technology provides a priceless resource for regenerative medicine but there are still changing obstacles over the safety of iPSC in avoiding induction of tumorigenicity and maintaining high purity of re-differentiated cells from iPSC to produce more functional cells for cell therapy. A variety of methods to overcome the limitation of iPSC application applied in the clinical setting have been developed. In this review, we summarize the recent progress in iPSC generation and differentiation techniques to facilitate clinical application of iPSC with future potential in regenerative medicine.
Autografts ; Cell- and Tissue-Based Therapy ; Drug Evaluation, Preclinical ; Embryonic Stem Cells ; Humans ; Induced Pluripotent Stem Cells* ; Regenerative Medicine ; Stem Cells* ; Transplantation, Autologous

Objective: Research on neural correlates in the prefrontal cortex (PFC) associated with self-injurious behavior has mainly been performed in adults. However, studies on adolescents are scarce. We aimed to investigate the activation and connectivity of the PFC between adolescents with self-injurious behavior (ASI) and psychiatric controls (PC) using functional near-infrared spectroscopy (fNIRS). Methods: We used an emotion recognition task during fNIRS to assess 37 adolescents (23 with self-injurious behavior and 14 PC) between June 2020 and October 2021 and compared connectivity and activation between the two groups. We also measured adverse childhood events (ACE, Adverse Childhood Experiences) and performed a correlation analysis of channel activation according to ACE total scores. Results: The difference in activation between the groups was not statistically significant. The connectivity of channel 6 was statistically significant. The interaction between channel 6 and the ACE total score showed statistical significance between the two groups(t[33] -2.61; p=0.014). The ASI group showed a negative correlation with the total ACE score. Conclusion This is the first study to investigate PFC connectivity using fNIRS in ASI. It has the implication of a novel attempt with a practically useful tool to uncover neurobiological differences among Korean adolescents.

Bortezomib (Velcade(R)) came into the spotlight as a target therapy for multiple myeloma. It acts through reversible inhibition of intracellular proteasomes, which triggers apoptosis, with relative selectivity for malignant cells. It has been hypothesized that the accumulation of damaged proteins in myocytes impairs cardiac function. Cardiotoxicity is a rare side effect of bortezomib treatment. We report a case of reversible systolic heart failure that probably occurred after bortezomib treatment in a patient with multiple myeloma. Patients being treated with bortezomib who have previously had cardiac comorbidities should undergo routine cardiac monitoring.
Apoptosis ; Comorbidity ; Heart Failure* ; Heart Failure, Systolic ; Humans ; Multiple Myeloma* ; Muscle Cells ; Bortezomib

PURPOSE: There are many known risk factors for a retinopathy of prematurity (ROP). We analyzed the most important risk factors and predictors of ROP among them. METHODS: We retrospectively reviewed the medical records of all premature infants admitted to the neonatal intensive care unit (NICU), between January 2010 and December 2012 at Gangnam CHA Medical Center, Seoul. . All infants (n=185) were hospitalized for more than 28 days, received eye examination for ROP and showed one of the following criteria: birth weight (BW) below 1,500 g, gestational age (GA) below 32 weeks, or oxygen treatment (> or =40% oxygen for more than 3 days). We divided the infants into the Non-ROP group (n=162) and the ROP group (n=23, more than stage 1) and analyzed group comparisons, risk factors and the importance of each factor of ROP by SPSS 13.0. RESULTS: Risk factors were duration of oxygen uses [Odds ratio (OR): 1.064, 95% confidence interval (CI): 1.007-1.125, P=0.028] and intravenous (IV) steroid (OR: 1.234, 95% CI: 1.000-1.523, P=0.049) by multi-factor adjustment. The most important factor was oxygenation duration. The following factors were time to full enteral feedings, and IV steroid duration. CONCLUSION: The incidence of ROP will be decreased if we can reduce the length of oxygen uses, IV steroid use and advance the full feeding achievement.
Birth Weight ; Enteral Nutrition ; Gestational Age ; Humans ; Incidence ; Infant ; Infant, Newborn ; Infant, Premature* ; Intensive Care, Neonatal ; Medical Records ; Oxygen ; Retinopathy of Prematurity* ; Retrospective Studies ; Risk Factors ; Seoul

BACKGROUND: Decreased left atrial (LA) reservoir function is reported to be associated with elevated left ventricular (LV) end diastolic pressure and LV diastolic dysfunction. Echocardiographic parameters that reflect LA reservoir function include LA total emptying fraction [(maximum LA volume - minimum LA volume) / maximum LA volume], peak LA longitudinal strain (PLALS) at systole, and LA stiffness index (E/E´/PLALS). We aimed to investigate the long-term outcomes of LV diastolic function in children with a history of Kawasaki disease (KD) (KDHx group) by assessing LA reservoir function. METHODS: Retrospectively, echocardiograms performed at a mean follow-up period of 5 years after the acute phase of KD in 24 children in the KDHx group were compared to those from 20 normal control subjects. LA total emptying fraction, PLALS, LA stiffness index, LV peak longitudinal systolic strain (ε), and strain rate (SR) were evaluated with conventional echocardiographic parameters. RESULTS: The mean age at long term follow-up echocardiography in children in the KDHx group was 6.8 years. Five children (20.8%) had coronary artery lesions (CALs) in the acute stage of KD. No children showed CALs at a mean follow-up period of 5 years after the acute phase of KD. There were no significant differences in the conventional echocardiographic parameters and in LA total emptying fraction, PLALS, LA stiffness index, LV peak longitudinal systolic ε, and SR, between the children in the KDHx and control group. CONCLUSION: LV diastolic function assessed by LA reservoir function parameters at long-term follow-up in children in the KDHx group appears to be favorable.
Atrial Function ; Blood Pressure ; Child* ; Coronary Vessels ; Echocardiography ; Follow-Up Studies ; Humans ; Mucocutaneous Lymph Node Syndrome* ; Prognosis ; Retrospective Studies ; Systole

Fetomaternal hemorrhage (FMH) is due to the entry of fetal blood into the maternal circulation. Although very rare, FMH complicates pregnancies, presents with severe symptoms, and leads to fetal death. Majority of FMH cases are idiopathic and difficult to diagnose. The known used diagnostic tests are Kleihauer-Betke Test (KBT) and flow cytometry, which can detect fetal hemoglobin in the maternal blood. However, such methods have limited use because of low sensitivity, labor-intensive and error-susceptible procedures, poor reproducibility, and tendency to overestimate the FMH volume. Other tests include high performance liquid chromatography (HPLC) and alpha-fetoprotein (AFP) tests, which can be as favorable to confirm FMH as KBT. However, in case of acute FMH, the diagnostic results of KBT, flow cytometry, and HPLC may be false negative. AFP test is a noninvasive, fast, easily assessable, adjuvant, and confirmatory diagnostic test. Published Korean articles show confirmed FMH by KBT or HPLC in singleton late-preterm and term neonates. Herein, we report a case of monochorionic diamniotic twin neonates (birth weight <1,500 g) who presented borderline fetal hemoglobin level because of acute FMH and were diagnosed with FMH by maternal AFP. Our experience of diagnosing FMH rapidly by AFP test will be very helpful to clinicians for the prevention and treatment of FMH during pregnancy.

Purpose: We aimed to analyze the correlations between the Bayley Scales of Infant Development (BSID)-III and Korean Developmental Screening Test (K-DST) in very-low-birth-weight (VLBW; birth weight <1,500 g) preterm infants. Methods: We enrolled 53 VLBW infants (mean gestational age, 28.9±2.11 weeks; mean birth weight, 1,158.5±241.1 g) and assessed them using the BSID-III and K-DST at a corrected age of 18 to 24 months. We analyzed the correlations between the BSID-III and K-DST subdomains and evaluated whether the estimated developmental levels were consistent with the corrected ages. Results: In the BSID-III, the composite scores for cognition, motor, and language were 105.9±13.1 (median, 105; 66th percentile; 95% confidence interval [CI], 98 to 113), 100.9±12.4 (100; 50th percentile; 95% CI, 92 to 108), and 94.9±16.8 (97.5; 34th percentile; 95% CI, 87 to 102), respectively. The scaled scores for receptive/expressive language and gross/fine motor were 9.9±2.9 (10.5)/8.2±2.7 (8) and 9.6±2.4 (9)/10.6 ±2.3 (10), respectively. In the K-DST, the mean scores of cognition (17.8±4.7 [18.5]), language (16.6±7.2 [20]), fine motor (19.4±3.4 [20]), gross motor (19.9±3.8 [21]), sociality (18.6±4.7 [20]), and self-control (17.3±5.1 [18]) were within the range of normal developmental status. Among the overlapping subdomains, cognition (r=0.58, P= 0.003) and language (r=0.86, P<0.001), but not fine and gross motor status (r=0.05, P= 0.79; r=0.16, P=0.44, respectively), showed significant correlation between the BSID-III and K-DST. Conclusion The language and cognition domains of the K-DST were significantly correlated with the BSID-III in preterm VLBW infants. Clinicians should consider these discrepancies and correlations when evaluating the developmental status of preterm VLBW infants.

Fetomaternal hemorrhage (FMH) is due to the entry of fetal blood into the maternal circulation. Although very rare, FMH complicates pregnancies, presents with severe symptoms, and leads to fetal death. Majority of FMH cases are idiopathic and difficult to diagnose. The known used diagnostic tests are Kleihauer-Betke Test (KBT) and flow cytometry, which can detect fetal hemoglobin in the maternal blood. However, such methods have limited use because of low sensitivity, labor-intensive and error-susceptible procedures, poor reproducibility, and tendency to overestimate the FMH volume. Other tests include high performance liquid chromatography (HPLC) and alpha-fetoprotein (AFP) tests, which can be as favorable to confirm FMH as KBT. However, in case of acute FMH, the diagnostic results of KBT, flow cytometry, and HPLC may be false negative. AFP test is a noninvasive, fast, easily assessable, adjuvant, and confirmatory diagnostic test. Published Korean articles show confirmed FMH by KBT or HPLC in singleton late-preterm and term neonates. Herein, we report a case of monochorionic diamniotic twin neonates (birth weight <1,500 g) who presented borderline fetal hemoglobin level because of acute FMH and were diagnosed with FMH by maternal AFP. Our experience of diagnosing FMH rapidly by AFP test will be very helpful to clinicians for the prevention and treatment of FMH during pregnancy.

Purpose: We aimed to analyze the correlations between the Bayley Scales of Infant Development (BSID)-III and Korean Developmental Screening Test (K-DST) in very-low-birth-weight (VLBW; birth weight <1,500 g) preterm infants. Methods: We enrolled 53 VLBW infants (mean gestational age, 28.9±2.11 weeks; mean birth weight, 1,158.5±241.1 g) and assessed them using the BSID-III and K-DST at a corrected age of 18 to 24 months. We analyzed the correlations between the BSID-III and K-DST subdomains and evaluated whether the estimated developmental levels were consistent with the corrected ages. Results: In the BSID-III, the composite scores for cognition, motor, and language were 105.9±13.1 (median, 105; 66th percentile; 95% confidence interval [CI], 98 to 113), 100.9±12.4 (100; 50th percentile; 95% CI, 92 to 108), and 94.9±16.8 (97.5; 34th percentile; 95% CI, 87 to 102), respectively. The scaled scores for receptive/expressive language and gross/fine motor were 9.9±2.9 (10.5)/8.2±2.7 (8) and 9.6±2.4 (9)/10.6 ±2.3 (10), respectively. In the K-DST, the mean scores of cognition (17.8±4.7 [18.5]), language (16.6±7.2 [20]), fine motor (19.4±3.4 [20]), gross motor (19.9±3.8 [21]), sociality (18.6±4.7 [20]), and self-control (17.3±5.1 [18]) were within the range of normal developmental status. Among the overlapping subdomains, cognition (r=0.58, P= 0.003) and language (r=0.86, P<0.001), but not fine and gross motor status (r=0.05, P= 0.79; r=0.16, P=0.44, respectively), showed significant correlation between the BSID-III and K-DST. Conclusion The language and cognition domains of the K-DST were significantly correlated with the BSID-III in preterm VLBW infants. Clinicians should consider these discrepancies and correlations when evaluating the developmental status of preterm VLBW infants.