Human stem cells have been isolated from embryos as well as diverse somatic tissues. Much efforts have been made to apply those stem cells for therapeutic purpose. Molecular dissection of "stemness" and differentiation process will provide us a clue to further understanding of stem cell biology. The fate of stem cell is determined in part by internal regulation mediated by transcriptional control. A set of genes related to specific functions might be expressed and suppressed upon external or internal signaling. Therefore, it is necessary to identify the complete gene expression profile that defines the stem cell. Moreover, we should verify the potential of therapeutic stem cells regarding differentiation, specific function, tumorigenecity, and toxicity rigorously before the clinical application. At present we have only limited information on "stemness" and differentiation into specific lineages. In the genome era, we can draw a molecular portrait on these functional and morphologic changes along the differentiation, trans-differentiation as well as de-differentiation using the DNA chip technology. We need to accumulate database for gene expression at various steps of stem cell differentiation, which will enhance our knowledge for research on and medical application of stem cell.
Biology ; Embryonic Structures ; Gene Expression ; Gene Expression Profiling ; Genome ; Genomics ; Humans ; Oligonucleotide Array Sequence Analysis ; Stem Cells* ; Transcriptome

No abstract available.
Breast Neoplasms* ; Breast* ; Drug Resistance, Multiple* ; Genes, MDR*

BACKGROUND: Several antibiotics can be used to treat ventilator-associated pneumonia caused by carbapenem-resistant A. baumannii (CRAB-VAP) including high-dose sulbactam. However, the effectiveness of high-dose sulbactam therapy is not well known. We report our experience with high-dose sulbactam for treatment of CRAB-VAP. METHODS: Medical records of patients with CRAB-VAP who were given high-dose sulbactam between May 2013 and June 2015 were reviewed. RESULTS: Fifty-eight patients with CRAB-VAP were treated with high-dose sulbactam. The mean age was 72.0 ± 15.2 years, and the acute physiology and chronic health evaluation II (APACHE II) score was 15.1 ± 5.10 at the time of CRAB-VAP diagnosis. Early clinical improvement was observed in 65.5% of patients, and 30-day mortality was 29.3%. Early clinical failure (odds ratio [OR]: 8.720, confidence interval [CI]: 1.346-56.484; p = 0.023) and APACHE II score ≥ 14 at CRAB-VAP diagnosis (OR: 10.934, CI: 1.047-114.148; p = 0.046) were associated with 30-day mortality. CONCLUSIONS: High-dose sulbactam therapy may be effective for the treatment of CRAB-VAP. However, early clinical failure was observed in 35% of patients and was associated with poor outcome.
Acinetobacter baumannii* ; Acinetobacter* ; Anti-Bacterial Agents ; APACHE ; Diagnosis ; Humans ; Medical Records ; Mortality ; Pneumonia, Ventilator-Associated* ; Sulbactam*

Recently, many hospitals have been adopting clinical data warehouses (CDW) as well as electronic medical records. These new hospital information systems are inevitably introducing very large amounts of clinical data that might be useful for further analysis. However, the electronic clinical data in the CDW are usually byproducts of clinical practice rather than the product of research. Therefore, they include inconsistent and sometimes erroneous information that might not have the specific context of the clinical situations. Data miners usually have various academic backgrounds such as electronics, informatics, statistics, biomedicine, and public health. If the complex situations surrounding the clinical data are not well understood, investigators performing data mining in clinical fields may have problems assessing the information they are confronted with. Here, we would like to introduce some basic concepts on the principles of data mining in clinical fields including legal and ethical considerations as well as technical concerns.
Machine Learning ; Data Mining ; Electronic Health Records ; Electronics ; Electrons ; Hospital Information Systems ; Humans ; Informatics ; Public Health ; Research Personnel

BACKGROUND: Human metapneumovirus (hMPV) is a relatively recently identified respiratory virus that induces respiratory symptoms similar to those of respiratory syncytial virus infection in children. The characteristics of hMPV-infected adults are unclear because few cases have been reported. METHODS: We conducted a retrospective review of hospitalized adult patients with a positive multiplex real-time polymerase chain reaction assay result from 2012 to 2016 at a single tertiary referral hospital in South Korea. We analyzed clinical characteristics of the enrolled patients and divided patients into an acute respiratory distress syndrome (ARDS) group and a non-ARDS group. RESULTS: In total, 110 adults were reviewed in this study. Their mean age was 61.4 years, and the majority (n = 105, 95.5%) had comorbidities or were immunocompromised. Most of the patients had pneumonia on chest X-ray (n = 88, 93.6%), 22 (20.0%) had ARDS, and 12 (10.9%) expired during hospitalization. The mortality rate for patients with ARDS was higher than that of the other patients (36.4% vs. 5.7%, P = 0.001). The risk factor for hMPV-associated ARDS was heart failure (odds ratio, 5.24; P = 0.044) and laboratory values were increased blood urea nitrogen and increased C-reactive protein. The acquisition site of infection was divided into community vs. nosocomial; 43 patients (39.1%) had a nosocomial infection. The risk factors for nosocomial infection were an immunocompromised state, malignancy and immunosuppressive treatment. CONCLUSIONS: These data suggest that hMPV is one of the important respiratory pathogens important respiratory pathogen that causes pneumonia/ARDS in elderly, immunocompromised individuals and that it may be transmitted via the nosocomial route.
Adult* ; Aged ; Blood Urea Nitrogen ; C-Reactive Protein ; Child ; Comorbidity ; Cross Infection ; Heart Failure ; Hospitalization ; Humans* ; Korea ; Metapneumovirus* ; Mortality* ; Pneumonia ; Real-Time Polymerase Chain Reaction ; Respiratory Distress Syndrome, Adult* ; Respiratory Syncytial Viruses ; Retrospective Studies* ; Risk Factors ; Tertiary Care Centers ; Thorax

Sick sinus syndrome comprises a variety of conditions involving sinus node dysfunction and commonly affects elderly persons. Though sudden cardiac death accounts for as much as 15% of all cause mortality in uremia, requiring permanent cardiac pacing in end-stage renal disease hemodialysed patients are very few. Most cases of sick sinus syndrome are idiopathic, and the cause can be multifac- torial. A-V conducton defects were attributed to extensive metastatic calcifications, involving the cardiac skeleton, conservative to severe hyperparathyroidism and inadvertent use of calcitriol and calcium carbonate as phosphate binders. If optimal hemodialysis is provided, benefits of permanent pacing are equal in uremic or non uremic patients and pacemaker implantation should be instituted. We report a case of sick sinus syndrome derived in elderly patient on hemodialysis.
Aged* ; Calcitriol ; Calcium Carbonate ; Death, Sudden, Cardiac ; Humans ; Hyperparathyroidism ; Kidney Failure, Chronic ; Mortality ; Renal Dialysis* ; Sick Sinus Syndrome* ; Skeleton ; Uremia

Intentional delay of aftercoming siblings in multiple gestation is an infrequent occurrence in obstetrics. After delivery of an immature twin, conventional treatment calls for induction and delivery of the aftercoming sibling. However, several case reports have documented the feasibility of an expectant management. And also, as in our case, an aggressive treatment consisting of cerclage, tocolysis, and broad-spectrum antibiotics has been shown to prolong pregnancy. We experienced an unavoidable delivery of a nonviable first twin after premature rupture of membranes at 16 weeks' of gestation. The placenta was left undisturbed. Twin B was confirmed to be alive within the intact second sac. Tocolysis was started and cervical cerclage was done directly after delivery of twin A. Pregnancy was successfully prolonged, which enabled the second fetus to remain in utero and grow for another 145 days. To our knowledge, this was the longest interval between deliveries in a twin pregnancy reported in the literature. A healthy 3,050 gm male was delivered by cesarean section at 37 weeks' of gestation. Below we present this case in detail and discussed with respect to the aggressive approach undertaken to prolong gestation.
Anti-Bacterial Agents ; Cerclage, Cervical ; Cesarean Section ; Female ; Fetus ; Humans ; Male ; Membranes ; Obstetrics ; Placenta ; Pregnancy* ; Pregnancy, Twin ; Rupture ; Siblings ; Tocolysis ; Twins*

No abstract available.
Genitalia* ; Humans ; Male*

This study was to evaluate the clinical usefulness of 99m Tc-MDP bone scintigraphy for assessing vascular ingrowth into the ocular implants after enucleation and evisceration. Twenty four patients(M:F=7:17, mean age:36), with a coralline hydroxyapatite after uncomplicated enucleation or evisceration surgery were studied. Uptake ratio was also calculated by measuring the implants activity(H)and contralateral orbit activity(N). Grading score and uptake ratio were compared with clinical outcome of vascularization. Additionally, we also analyzed the vascularization status as time lapse between primary surgery and scintigraphic study and surgical methods. The degree of grade and uptake ratio were inversely correlated with vascular ingrowth. Higher than grade 2 or greater than 1.56 in H/N ratio seemed to be an indicator for better prognosis. 99m Tc-MDP bone scintigraphy can be a useful method to evaluate the vascularized status of implants. Adequate time for 99m Tc-MDP bone scintigraphy after enucleation and evisceration was 11~20 weeks.
Durapatite ; Orbit ; Prognosis ; Radionuclide Imaging*

Retinal pigment epithelial cells(RPE) from a monolayer on the outer portion of sensory retina and have important physiologic functions that include solute transport, phagocytiosis and digestion of membrances shed from photoreceptor outer segments, and drug detoxication. Recently, transplantation of normal RPE has been proposed as a potential therapeutic modality in the surgical management of subretinal neovascularization in age related macular degeneration(ARMD). The viability of RPE at the time of transplantation is important for a good result after transplantation. This viability can be influenced by the period and environmental conditions of storage after harvest.In this study, the influence of these two factors on the viability was evaluated under controlling other remaining factors in vitro. And limitation of masimal time and optimal environmental conditions of storage were investigated.From November 1997 to February 1998, RPE cell sheets from six donor eyeballs for corneal transplantation in the department of ophthalmology of Severance Hospital were harvested and stored in -70degrees C, 4degrees C, or room temperature condotion. The viability of RPE cells at 0, 24 and 48 hours after havest was assessed and compared statistically.The viability was highest at 4degrees C condition. During storage, the viability was about 95% at 24 hours for and decreased abruptly to below 90% at 48 hours. Therefore, RPE cells for transplantation are to be stored at 4degrees C condition and transplantation should be performed within 24 hours after harvest.
Corneal Transplantation ; Digestion ; Epithelial Cells* ; Humans* ; Macular Degeneration ; Ophthalmology ; Retina ; Retinaldehyde* ; Tissue Donors*