• Title/Summary/Keyword: 연세대학교

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A Study of Relationship Between PPC (Probability of Primary Clearance: a multivariate modelling system predicting tumor clearance proposed by RTOG) and Survival in the Patients with Carcinoma of the Nasopharynx following Radiation Therapy (비인강암의 방사선치료 : RTOG에서 제시한 PPC와 생존율에 대한 고찰)

  • Cho Kwan Ho;Park Kyung Ran;Oh Won Yong;Chun Mison;Suh Chang Ok;Kim Gwi Eon;Loh John J.K.
    • Radiation Oncology Journal
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    • v.4 no.1
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    • pp.45-50
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    • 1986
  • RTOG proposed a multivariate modelling system predicting the response of head and neck cancers to radiation therapy in 1984. The aim of this study was to veri(y whether PPC (Probaility of primary clearance calculated by a multivariate modelling system) had any correlation with the survival in the patients with carcinoma of the nasopharynx following radiation therapy Analysing 81 patients with carcinoma of the nasopharynx treated with radiotherapy between January 1, 1971 and December 31, 1983 at Yonsei University College of Medicine, Yonsei Cancer Center the actuarial 5 year survival rate was $36\%$ and median survival was 39 months. The survivals for Group 1 (27 who had more than $80\%$ of PPC), Group 2 (20 who had between 71 and $80\%$ of PPC), and Group 3 (29 who had less than $71\%$ of PPC) were $66\%$ (median survival months : more than 72), $27\%$ (31), and $4\%$ (12) respectively. There was a definite correlation between PPC and survival among the three groups.

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Characteristics of the Oropharyngeal Swallowing Impairment in Stroke Patient using the Modified Barium Swallowing Impairment Profile (MBSImP에 따른 뇌졸중 환자의 삼킴 장애 양상 분석)

  • Im, Ikjae
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.7
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    • pp.36-44
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    • 2019
  • Swallowing impairment is a frequent complication following stroke. The characteristics of swallowing impairment with stork patient can facilitate identification of individuals at risk of dysphagia would be of great helpful. The present study examined oropharyngeal swallowing impairment with subacute stroke patients using the Modified Barium Swallowing Impairment Profile(MBSImP). The 49 consecutive patients with the supratentorial stroke met inclusion criteria for the present study. A retrospective review was performed of patients who underwent the videofluoroscopic swallowing study(VFSS). Of Stroke patients, 95.9% exhibited abnormal function of lip closure. 98% and 57.1 % shown abnormal tongue function and lingual motion, respectively. Oral residue was present in 51% and delayed pharyngeal response was present in 89.9%. In addition, abnormal laryngeal and hyoid excursion was seen in 42.9% and 87.8%, respectively. Abnormal function of soft palate elevation was present in 18.4% and abnormal epiglottic movement was seen in 4.1%. 30.6% of 30.6% of these patients exhibited abnormal laryngeal closure. All of the stroke patients(100%) in this study exhibited abnormal pharyngeal stripping wave and pharyngoesophageal segment opening. Abnormal tongue base retraction and oral reside were present 91.8%, respectively. The results suggest that stroke patient is more likely to exhibit reduced swallowing functions including lip closure, tongue control, initiation of pharyngeal swallow, anterior hyoid motion, tongue base retraction, pharyngeal residue and pharyngoesophageal contraction. Therefore, these data could provide valid and precise information regarding physiological evidence to delineate symptoms of dysphagia in this stroke cohort. Future studies should explore the bolus effect in the swallowing impairment.

Maintaining Professional Dignity in the Age of Social Media (소셜미디어 시대에서 의료전문직으로서의 품위 유지)

  • KIM, Claire Junga;BHAN, Yoo Wha
    • Korean Journal of Medical Ethics
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    • v.21 no.4
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    • pp.316-329
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    • 2018
  • Although the use of social media by doctors raises important issues concerning medical professionalism, the relevant professional bodies in South Korea have failed to issue clear guidelines on social media usage. The Korean Medical Association's newly revised ethics guidelines do require members to maintain dignity while using social media, but the idea of "maintaining dignity" is far from clear, and its premodern connotation prevents it from being reliably used in professional codes of conduct. The authors of this article examine the concept of maintaining dignity and conclude that once it is clarified and redefined it can and should be used as a viable ethical standard in a variety of contexts, including the use of social media. Social media's unpredictability and uncontrollability, and the blurred distinction between professional/public and personal/private can be a threat to medical professionalism. In order to deal with this threat, the concept of dignity is important. We present three examples in which the dignity of medical professionals is undermined and explain why these jeopardize public trust. We conclude that in order to maintain public trust the Korean Medical Association should provide more detailed guidelines on the use of social media by its members.

Hemodynamic, Autonomic, and Vascular Function Changes after Sleep Deprivation for 24, 28, and 32 Hours in Healthy Men

  • Slomko, Joanna;Zawadka-Kunikowska, Monika;Kozakiewicz, Mariusz;Klawe, Jacek J.;Tafil-Klawe, Malgorzata;Newton, Julia L.;Zalewski, Pawel
    • Yonsei Medical Journal
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    • v.59 no.9
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    • pp.1138-1142
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    • 2018
  • This study aimed to analyze the impact of sleep deprivation (SD) on cardiac, hemodynamic, and endothelial parameters and to determine whether these are sustained with increased periods of SD. The study included 60 healthy men (mean: age $31.2{\pm}6.3years$; body mass index $24.6{\pm}2.6kg/m^2$). Hemodynamic parameters, parameters of myocardial contractility, spectral analysis of heart rate (HR) and blood pressure (BP) variability, and the sensitivity of arterial baroreflex function were evaluated. Biochemical tests were performed to assess L-arginine (L-Arg) and asymmetric dimethylarginine (ADMA) levels in reflection of endothelial nitric oxide synthase ability. Measurements of cardiovascular system parameters were obtained at 9 a.m. (baseline) on the first day of the study and 9 a.m. (24-h SD), 1 p.m. (28-h SD), and 5 p.m. (32-h SD) on the second day. Blood samples for evaluating biochemical parameters were obtained at baseline and after 24-h SD. ANOVA Friedman's test revealed a significant effect for time in relation to HR (${\chi}^2=26.04$, df=5, p=0.000), systolic BP (${\chi}^2=35.98$, df=5, p=0.000), diastolic BP (${\chi}^2=18.01$, df=5, p=0.003), and mean BP (${\chi}^2=28.32$, df=5, p=0.000). L-Arg and ADMA levels changed from $78.2{\pm}12.9$ and $0.3{\pm}0.1$ at baseline to $68.8{\pm}10.2$ and $0.4{\pm}0.1$ after 24-hr SD, respectively (p=0.001, p=0.004). SD in healthy men is associated with increases in BP, which appear to occur after 24 hours of SD and are maintained over increasing periods of SD. The observed hemodynamic changes may have resulted due to disordered vascular endothelial function, as reflected in alterations in L-Arg and ADMA levels.

Seroepidemiology of Hepatitis Viruses and Hepatitis B Genotypes of Female Marriage Immigrants in Korea

  • Kwon, Jae-Cheol;Chang, Hye Young;Kwon, Oh Young;Park, Ji Hoon;Oh, In Soo;Kim, Hyung Joon;Lee, Jun Hyung;Roh, Ha-Jung;Lee, Hyun Woong
    • Yonsei Medical Journal
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    • v.59 no.9
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    • pp.1072-1078
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    • 2018
  • Purpose: The Korean society has moved rapidly toward becoming a multicultural society. This study aimed to estimate the seroprevalence of hepatitis viruses and investigate hepatitis B virus (HBV) genotypic diversity in female marriage immigrants. Materials and Methods: Screening program was conducted at support centers for multicultural families in 21 administrative districts in Korea between July 2011 and January 2017. A total of 963 female marriage immigrants were included in this study. Blood samples were tested for hepatitis viral markers and HBV genotype. Results: Subjects' median age was 33 years (20-40 years), and they originated from nine countries including Vietnam (n=422, 43.8%), China (n=311, 32.3%), the Philippines (n=85, 8.8%), Cambodia (n=58, 6.0%), and Japan (n=39, 4.0%). About 30% (n=288) of subjects required hepatitis A vaccination. HBsAg positive rate was 5.4% (n=52). Positive HBsAg results were the highest in subjects from Southeast Asia (6.6%, n=38). Anti-HBs positive rate was 60.4% (n=582). About 34% (n=329) of subjects who were negative for anti-HBs and HBsAg required HBV vaccinations. Genotypes B and C were found in 54.6% (n=12) and 45.4% (n=10) of the 22 subjects with HBV, in whom genotypes were tested. Eight (0.8%) subjects were positive for anti-HCV. Positive anti-HCV results were the highest in subjects from Central Asia (7.9%, n=3). Conclusion: Testing for hepatitis viral marker (hepatitis A virus IgG and HBsAg/anti-HBs) is needed for female marriage immigrants. Especially, HBV genotype B is different from genotype C of Koreans. Therefore, interest and attention to vaccination programs for female marriage immigrants are necessary for both clinicians and public health institutes.

Socioeconomic Inequalities in Cervical and Breast Cancer Screening among Women in Korea, 2005-2015

  • Choi, Eunji;Lee, Yoon Young;Suh, Mina;Lee, Eun Young;Mai, Tran Thi Xuan;Ki, Moran;Oh, Jin-Kyoung;Cho, Hyunsoon;Park, Boyoung;Jun, Jae Kwan;Kim, Yeol;Choi, Kui Son
    • Yonsei Medical Journal
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    • v.59 no.9
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    • pp.1026-1033
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    • 2018
  • Purpose: Consistent evidence indicates that cervical and breast cancer screening rates are low among socioeconomically deprived women. This study aimed to assess trends in cervical and breast cancer screening rates and to analyze socioeconomic inequalities among Korean women from 2005 to 2015. Materials and Methods: Data from the Korean National Cancer Screening Survey, an annual nationwide cross-sectional survey, were utilized. A total of 19910 women were finally included for analysis. Inequalities in education and household income status were estimated by slope index of inequality (SII) and relative index of inequality (RII), along with calculation of annual percent changes (APCs), to show trends in cancer screening rates. Results: Cervical and breast cancer screening rates increased from 54.8% in 2005 to 65.6% in 2015 and from 37.6% in 2005 to 61.2% in 2015, respectively. APCs in breast cancer screening rates were significant among women with higher levels of household income and education status. Inequalities by household income in cervical cancer screening uptake were observed with a pooled SII estimate of 10.6% (95% CI: 8.1 to 13.2) and RII of 1.4 (95% CI: 1.3 to 1.6). Income inequalities in breast cancer screening were shown to gradually increase over time with a pooled SII of 5.9% (95% CI: 2.9 to 9.0) and RII of 1.2 (95% CI: 0.9 to 1.3). Educational inequalities appeared to diminish over the study period for both cervical and breast cancer screening. Conclusion: Our study identified significant inequalities among socioeconomically deprived women in cervical and breast cancer screening in Korea. Especially, income-related inequalities were greater than education-related inequalities, and these were constant from 2005 to 2015 for both cervical and breast cancer screening.

Factors Associated with Lung Function Recovery at the First Year after Lung Transplantation

  • Yoon, Bo Ra;Park, Ji Eun;Kim, Chi Young;Park, Moo Suk;Kim, Young Sam;Chung, Kyung Soo;Song, Joo Han;Paik, Hyo-Chae;Lee, Jin Gu;Kim, Song Yee
    • Yonsei Medical Journal
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    • v.59 no.9
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    • pp.1088-1095
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    • 2018
  • Purpose: Post-operative pulmonary function is an important prognostic factor for lung transplantation. The purpose of this study was to identify factors affecting recovery of forced expiratory volume in 1 second (FEV1) at the first year after lung transplantation. Materials and Methods: We retrospectively reviewed the medical records of lung transplantation patients between October 2012 and June 2016. Patients who survived for longer than one year and who underwent pulmonary function test at the first year of lung transplantation were enrolled. Patients were divided into two groups according to whether they recovered to a normal range of FEV1 (FEV1 ${\geq}80%$ of predicted value vs. <80%). We compared the two groups and analyzed factors associated with lung function recovery. Results: Fifty-eight patients were enrolled in this study: 28 patients (48%) recovered to a FEV1 ${\geq}80%$ of the predicted value, whereas 30 patients (52%) did not. Younger recipients [odds ratio (OR), 0.92; 95% confidence interval (CI), 0.87-0.98; p=0.010], longer duration of mechanical ventilator use after surgery (OR, 1.14; 95% CI, 1.03-1.26; p=0.015), and high-grade primary graft dysfunction (OR, 8.08; 95% CI, 1.67-39.18; p=0.009) were identified as independent risk factors associated with a lack of full recovery of lung function at 1 year after lung transplantation. Conclusion: Immediate postoperative status may be associated with recovery of lung function after lung transplantation.

Inhibition of miR-128 Abates Aβ-Mediated Cytotoxicity by Targeting PPAR-γ via NF-κB Inactivation in Primary Mouse Cortical Neurons and Neuro2a Cells

  • Geng, Lijiao;Zhang, Tao;Liu, Wei;Chen, Yong
    • Yonsei Medical Journal
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    • v.59 no.9
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    • pp.1096-1106
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    • 2018
  • Purpose: Alzheimer's disease (AD) is the sixth most common cause of death in the United States. MicroRNAs have been identified as vital players in neurodegenerative diseases, including AD. microRNA-128 (miR-128) has been shown to be dysregulated in AD. This study aimed to explore the roles and molecular mechanisms of miR-128 in AD progression. Materials and Methods: Expression patterns of miR-128 and peroxisome proliferator-activated receptor gamma ($PPAR-{\gamma}$) messenger RNA in clinical samples and cells were measured using RT-qPCR assay. $PPAR-{\gamma}$ protein levels were determined by Western blot assay. Cell viability was determined by MTT assay. Cell apoptotic rate was detected by flow cytometry via double-staining of Annexin V-FITC/PI. Caspase 3 and $NF-{\kappa}B$ activity was determined by a Caspase 3 Activity Assay Kit or $NF-{\kappa}B$ p65 Transcription Factor Assay Kit, respectively. Bioinformatics prediction and luciferase reporter assay were used to investigate interactions between miR-128 and $PPAR-{\gamma}$ 3'UTR. Results: MiR-128 expression was upregulated and $PPAR-{\gamma}$ expression was downregulated in plasma from AD patients and $amyloid-{\beta}$ $(A{\beta})-treated$ primary mouse cortical neurons (MCN) and Neuro2a (N2a) cells. Inhibition of miR-128 decreased $A{\beta}-mediated$ cytotoxicity through inactivation of $NF-{\kappa}B$ in MCN and N2a cells. Moreover, $PPAR-{\gamma}$ was a target of miR-128. $PPAR-{\gamma}$ upregulation attenuated $A{\beta}-mediated$ cytotoxicity by inactivating $NF-{\kappa}B$ in MCN and N2a cells. Furthermore, $PPAR-{\gamma}$ downregulation was able to abolish the effect of anti-miR-128 on cytotoxicity and $NF-{\kappa}B$ activity in MCN and N2a cells. Conclusion: MiR-128 inhibitor decreased $A{\beta}-mediated$ cytotoxicity by upregulating $PPAR-{\gamma}$ via inactivation of $NF-{\kappa}B$ in MCN and N2a cells, providing a new potential target in AD treatment.

An Age of Essays: Memoirs, Philosophical essays and Essays of the 1960s (수필의 시대: 1960년대 수기, 수상, 에세이 -김형석, 안병욱, 김태길의 수필을 중심으로)

  • Park, Suk-Ja
    • Journal of Popular Narrative
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    • v.26 no.3
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    • pp.9-44
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    • 2020
  • This article aimed to looked back at the 1960s, which were assessed to be 'the age of essays', to survey denotations of essays, amplified by the discourse antagonism surrounding 'essays' and the writings of philosophers. Kim Hyeong Suk, Ahn Byeong Uk, and Kim Te Gil were philosophy professors of Yonsei University, Soongshil University, and Seoul National University and writers of numerous essay collections of the 1960s. However, there have been very few studies conducted on them. This is because of old prejudices within literary history that primarily undervalue essays and practices that try to limit them as 'Literariness'. Essays of the 1960s became the flavor of the times based on democratic demands that attempted to objectify individual experiences and grounds that passed through the war and the April 19 Revolution. The language of philosophers was expropriated through the various senses of first person writing to readers of the times, which lacked civil culture and national morality. Deficits in public spheres of the 1950s and 1960s were filled by Kim Hyeong Suk's narrations of comfort and conquest based on historic experiences, Ahn Byeong Uk's logic of self-discipline and knowledge based on democracy, and Kim Te Gil's humor and introspection that objectified the lives of the petit bourgeois. However, as the essays of philosophers failed to connect with the public discourse of the age, they were unable to go as far as sparking or serving as a medium for civil culture in the 1970s. Regardless, as essays rose historically in the 1960s, thought was given to the characteristics of the 'essay' genre and in connection, to the merits and demerits of cultural history that possesses the language of philosophers.

The Effect of Amount of Use on the Affected and Unaffected Side Using an Accelerometer in Stroke Patients on the Upper Limb Function Assessment for Improving Life Care (가속도계를 활용한 뇌졸중 환자의 환측과 건측의 사용량이 라이프 케어 증진을 위한 상지 기능 평가에 미치는 영향)

  • Kwak, Ho-Soung;Kim, Sun-Ho
    • Journal of Korea Entertainment Industry Association
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    • v.14 no.7
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    • pp.511-518
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    • 2020
  • The purpose of this study was to provide useful data for clinical occupational therapy by examining the correlation between the use of affected and unaffected sides measured using an accelerometer and upper limb function in chronic stroke patients. In this study, accelerometer, Fugle-Meyer Assessment(FMA), Motor Activity Log(MAL), and Yonsei-Bilateral Activity Test(Y-BAT) was measured on 40 stroke patients who were hospitalized in Won-ju city Y hospital between May 2, 2019 and July 18, 2020. As a result of the study, there was a significant negative correlation between amount of use on the unaffected side and FMA and MAL's Amount of Use(AOU), Quality of Movement(QOM), the quality and satisfaction of performing both hands through Y-BAT. The amount of use on the affected side showed a significant positive correlation with FMA and MAL's AOU, QOM, satisfaction of performing both hands. This study is meaningful in that it suggested the possibility that the actual amount of use on the affected and unaffected side measured using an accelerometer could be used as an evaluation item for upper limb function in stroke patients.