Maternal-Fetal Medicine the Most Studied by North Korean OBGY and Pediatric  Medical Teams
- KUCM students present the results of a study analyzing North Korean medical journals
- Their findings suggest maternal health is the biggest health and medical challenge in North Korea
- This is South Korea's first research to analyze the current status of OBGY and pediatric research in North Korea

Students at Korea University College of Medicine (KUCM) analyzed North Korean medical journals and confirmed that maternal-fetal medicine is a key topic of concern in North Korea.

Ye-joo Park and Jae-woo Kim who graduated from KUCM in February joined the research team led by Professor Ki Hoon Ahn of Korea University Anam Hospital in 2021 to analyze 949 papers published in North Korea's medical journal Pediatrics, Obstetrics and Gynecology from 2015 to 2019 to sort out the disease names and disease codes according to the Korean Standard Classification of Diseases (KCD) code, their classifications and study themes.

More than half of the 949 papers were on obstetrics and gynecology (494 studies, 52%), 366 on pediatrics and 88 on breast surgery. Maternal-fetal medicine accounted for the largest proportion (257, 52%) of the obstetrics and gynecology studies, suggesting this area, which deals with maternal health, is of major topic of discussion within North Korea's healthcare circles. The largest number (26) of these papers concerned childbirth, proving that various studies are being conducted on that topic in North Korea.

The majority (58.4%) of the papers on pediatrics dealt with the sub-specialties of pediatric digestive nutrition, allergies, respiration, and pediatric cardiology. This confirmed that illnesses in children’s digestive, respiratory, and circulatory systems present a relatively high disease burden for North Korea. The most common research topics were diarrhea, congenital heart disease, pneumonia, malnutrition, and bronchitis, and the high number of papers dealing with the treatment of malnutrition showed that childhood malnutrition still remains a challenge in the country.

The research contributed to a better understanding of the current status of diseases and the burden in maternal and child health in North Korea by studying specific fields such as pediatrics and obstetrics and gynecology. The study is also significant in that it is the first paper to analyze the current status of research in North Korea's pediatric and obstetrics and gynecology sectors. The team analyzed papers published over five years and identified time-series changes.

Ye-joo Park and Jae-woo Kim, co-authors of the study, said, "We appreciate this most valuable opportunity to be engaged in such a significant research project with the support from KU student research activities, and we are delighted we are able to get the results finally published in a paper. Existing health and medical research on North Korea had limitations in that it cannot reflect the current level of disease and medical issues in the country due to its closed system. We managed to get a peek into medical problems that affect the North Korean people, as we studied the journals publishing the studies done by the scholars and doctors in that country."

Professor Ahn, who led the research team, said, "The fact that maternal-fetal medicine was studied most in North Korea's medical journals indirectly confirmed that maternal health is the biggest medical challenge that the country faces. We hope that we may work together with North Korean doctors in maternal-fetal medicine first and maintain and expand medical exchanges between the two Koreas to better understand the different health situations that we are in."

Meanwhile, the study titled "Analyzing the Status of Research on Diseases of Women and Children in North Korea: A Literature Analysis Study through Journal" was published in the April issue of the Korean Journal of Mother and Child Health.

Three Out of Ten People Have No Intention of Getting Booster Shots Against COVID-19 this Fall and Winter

A research team led by Professor Byung Chul Chun reveals findings of a survey on the attitudes of Koreans towards COVID-19 vaccine booster shots against another wave in the upcoming fall and winter season

A survey revealed that three out of ten Koreans were not willing to receive a booster shot even if the COVID-19 pandemic hits again this autumn and winter.

At an online joint forum held on September 5 and hosted by the Korean Federation of Science and Technology Societies, the National Academy of Medicine of Korea, and the Korean Academy of Science and Technology, a research team led by professor Byung Chul Chun from the Department of Preventive Medicine and the Vaccine Innovation Center at Korea University College of Medicine revealed the findings of the survey on attitudes of Koreans towards COVID-19 vaccine booster shots.

The research team analyzed people’s attitudes towards COVID-19 vaccination: whether they intend to get booster shots and related factors affecting their intention. A survey of 1,500 men and women aged 19 or over living across South Korea was conducted in order to understand people’s perception on the stability and reliability of vaccines for COVID-19 (95% confidence level, sampling error ±2.53%).

62.9% of those respondents who were vaccinated experienced adverse reactions after receiving vaccines, but only 15.2% reported of having them. This means only a limited number of those who experienced adverse events actually reported. The reporting rate was the lowest in the elderly and people with low-education and low-income, indicating that close monitoring of adverse events is needed in this population.

24.4% of respondents said they were satisfied with the actions taken after reporting adverse reactions while 47.4% said they were dissatisfied. Among them, young people, those with higher educational background or those with high-income had lower satisfaction with measures taken for adverse reactions.

In a survey on their attitudes towards COVID-19, 62.3% of the respondents said COVID-19 vaccine was important for their health, and 67.4% of the respondents agreed that it was important for the health of others in their community. On the other hand, only 51.9% respondents agreed to the statement that "COVID-19 vaccines are effective," 39.0% to "all vaccines provided by the government are beneficial," and 40.7% to "the information on the COVID-19 vaccine I receive from vaccine providers (government, pharmaceutical companies, etc.) is reliable."

45.7% of the respondents said they were willing to get a booster shot against COVID-19 in autumn or winter this year, higher than those who were not willing to do so (30.5%). In addition, not a small number of people thought that the government and pharmaceutical companies were distorting or covering up the true information on effectiveness and safety of vaccines, which proves the need for fundamental measures to be taken against the creation and spread of fake news and rumors.

Professor Chun, head of the research, said, "We have discovered that there is a large gap in people’s willingness-to-vaccinate, attitudes towards information provided by the government, and vaccine conspiracy among people in different age bands, income levels, and regions. These findings should be used as an important base on which future vaccine policies are established." He also stressed the need for a long-term vision for the success of vaccinations against new infectious diseases (such as monkey pox) as well as COVID-19 and advised, "Government officials and experts engaged in the creation of vaccine policies need to make an objective and right evaluation of the vaccine policies implemented so far and come up with the future vaccine policies from the perspective of the public."

Meanwhile, the Vaccine Innovation Center at Korea University College of Medicine was established with the aim of developing vaccines to protect the Korean public and humanity from the threat of new infectious diseases. The Center is currently engaged in the R&D project to develop vaccines, and to build a vaccine and research infrastructure in Korea to prevent and treat global infectious diseases. It aims to establish a solid vaccine platform and develop a universal vaccine in the long run.

Microfluidic Chips Developed to Identify Resistivity of Cancer Cells to Anti-Cancer Treatments

A research team led by Jason K. Sa, Professor at Korea University College of Medicine; Seok Chung, Professor at KU College of Engineering; Ph. D, Hyunho Kim at the Harvard Medical School; and Hye Won Lee, Professor of Urology at the National Cancer Center developed a microfluidic chip that can identify drug resistance of cancer cells. The study titled “Recapitulated Crosstalk between Cerebral Metastatic Lung Cancer Cells and Brain Perivascular Tumor Microenvironment in a Microfluidic Co-culture Chip” was published online on June 3 in the world-class journal Advanced Science (IF: 16.8).

For patient-tailored treatments, drugs should be selected taking into account the genetic information of the patient's cancer cells, their characteristics, and the environment of cancer tissues. However, due to the genetic diversity of tumors, it is difficult to determine a suitable target therapy only with the genetic information of the tumor, and animal experiments using mice are often found difficult to represent various cells and tumor microenvironments in humans. Overcoming these limitations requires using human cells and reproducing the characteristics of the original environment in which cancer cells grow.

The study used a microfluidic chip to allow cancer cells derived from the patient to grow under specific conditions. In particular, lung cancer that has spread to the brain was chosen as a key target since existing drugs often are not effective in lung cancer cells that have metastasized to the brain due to the specificity of the organ, the brain. This is because the specific microenvironment that exists only in the brain including the blood-brain barrier and astrocytes functions rather protect the cancer cells.

The researchers succeeded in realizing the brain microenvironment by cultivating a microenvironment consisting of cerebrovascular cells, astrocytes, and extracellular substrates in a microfluidic chip, and cultivating cancer cells derived from lung cancer patients. By comparing the drug reactions between tumor cells in the presence or absence of the microenvironment using the genomic sequencing and molecular-based profile, the change in lung cancer cells due to the microenvironment of the brain was confirmed.

Unlike conventional cell culture platforms, cell-to-cell distances are much shorter in microfluidic chips (measured in the unit of a micrometer), and the concentration of cytokines (or chemical factors) secreted by cells in the microfluidic channel is rapidly increased and maintained at high levels, ensuring highly activated signaling between cells. And this reproduces processes where cancer cells and microenvironmental cells are assimilated as they would in the real environment.

Applying anticancer drugs used in clinical trials to the chip confirmed that the reactivity of drugs was different from what was predicted in the genomic analysis, and when lung cancer cells are cultured in the brain microenvironment, the transcriptome network profile changes as the survival of cancer cells increases. It is believed that this may explain the reason why resistance to drugs is developed in the patient's body.

The researchers expressed their expectations by saying, "A preclinical research platform that can represent interactions between cancer cells and the surrounding microenvironment, which is the most important cause of failure of existing anticancer treatments, can be used to identify the molecular biological mechanism of the microenvironment ecosystem involving cancer cells and to establish a new anticancer treatment strategy targeting such mechanism."

This study was supported by National Research Foundation of Korea, Ministry of Trade, Industry and Energy's program, and the Korea Health Industry Development Institute’s research and development project.

Transfusing blood from an old mouse to a younger mouse causes aging through in trans senescence

Joint research led by Professor Ok Hee Jeon together with Professor Conboy at UC Berkeley

- A new aging process and potential interventions to prevent age-related diseases suggested: aging facilitated by pro-geronic proteins in plasma can be suppressed by removing senescent cells
- Published in Nature Metabolism, one of the top journals in the field of endocrine and metabolism

The prospect of a medical therapy that may rewind the clock on the ageing process is edging closer.

A research team led by Professor Ok Hee Jeon at the Graduate School of Korea University College of Medicine and Irina Conboy at the University of California, Berkeley, discovered the transfusion of blood from old mice to a younger mouse can induce senescence -cellular aging- through pro-aging factors secreted by senescent cells in the blood, which spread throughout the body causing propagation of these cells, a process called in trans senescence.

In response to external (e.g., stress and injury) and intrinsic (e.g., changes in DNA structure with aging), cells tend to permanently stop growing and dividing and enter a state known as cellular senescence. These senescence cells can secrete senescence-associated secretory phenotype (SASP), including pro-inflammatory proteins and other factors that induce chronic inflammation environment and accelerate aging. These cells begin to amass after a few years of life in humans as a normal process of aging. Using a heterochronic blood exchange technique that allows blood to be exchanged between young (3 months) and aged (22-24 months) mice, the researchers found that factors secreted from senescence cells in the old systemic milieu cause ‘senescence transfer’ that induces the aging of normal cells and tissues in young mice.

The research team discovered that the young mice given blood from the aged mice displayed increased expression of senescence biomarkers in the skeletal muscle, kidney, and liver tissues, accelerating the aging process exhibited by decreased muscle strength and lower physical endurance, as well as impaired or suboptimal function in the liver and the kidney. On the contrary, the elimination of senescent cells by ‘senolytic’ in aged mice could suppress the senescence transfer in young mice induced by certain pro-aging factors associated with senescence in the old blood, helping prevent symptoms of aging.

We show that senescence is not a cell-autonomous process and does not have to accumulate with the progression of time, as many people and biotech companies think; instead, it quickly manifests in young mice after a single transfer of old blood, using our recently developed process of small animal apheresis. In other words, senescence is transferred by old blood in young animals with their long telomeres, undamaged DNA, etc. youthful cells and bodies.

Professor Ok Hee Jeon, a principal investigator of the study, said, "This study is meaningful in that it suggested a new paradigm of relative aging that the aging process could be accelerated through in trans senescence that is uncoupled from the progression of chronological time. We hope this research leads to the development of senolytic drugs that can remove various pro-aging factors secreted by senescent cells in the blood and a host of age-related diseases might benefit from this approach."

This study was conducted with the support from the National Research Foundation of Korea. The study titled "Systemic Induction of Senescence in Young Mice after Single Heterochronic Blood Exchange" was published in the July 29th online edition of Nature's sister magazine, Nature Metabolism <IF=19.950>.