• Title/Summary/Keyword: 위험 평가

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축산식품중(畜産食品中)의 Cholestrerol에 관(關)한 고찰(考察)

  • Han, Seok-Hyeon
    • Proceedings of the Korean Society for Food Science of Animal Resources Conference
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    • 1995.11a
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    • pp.1-48
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    • 1995
  • 식생활은 인간 생활의 주체이고 먹는다는 것은 그 수단이다. 그중 중요한 하나의 명제는 인간이 놓여진 여러 환경에서 어떻게 건강을 유지하고 그 개체가 소유하고 있는 능력을 최대치까지 생리적으로 성장 발전시킴과 동시에 최대한 수명을 연장시키기 위한 식물 섭취방법을 마이크로 레벨까지 해명하는데 있다. 인간은 일생동안 엄청난 양의 음식물을 먹는다(70세 수명일 경우 200만 파운드 즉 체중의 1,400배). 그러나 먹기는 먹되 자신의 건강과 장수를 위하여 어떤 음식을 어떻게 선택하여 어떻게 먹어야 하는 문제가 매우 중요하다. 최근 우리나라도 국민 소득이 늘면서 식생활은 서구화 경향으로 기우는 듯하다. 공해를 비롯한 수입식품 등 여러 가지 문제점이 제기됨에 따라 자연식과 건강식을 주장하는 소리가 높이 일고 있다. 그중에는 축산 식품이 콜레스테롤 함량이 다른 식품에 비하여 높게 함유하고 있다는 것으로 심혈관질환의 주범인양 무차별 강조하는 나머지 육식공포 내지는 계란 등의 혐오감 마저 불러 일으키는 경향까지 있는 듯하다. 따라서 본논고에서는 축산식품중의 콜레스테롤 함량수준이 과연 성인병의 주범인지 아니면 다른 지방산과 관련해서 올바르게 평가하고 그 문제점과 대책을 개관해 보고 요약하면 다음과 같다. 1. 사람은 유사이래 본능적으로 주변의 식물이나 동물의 고기를 먹고 성장하여 자손을 증식시키고 어느 사이에 늙으면 죽음을 맞이 하는 싸이클을 반복하면서 기나긴 세월동안 진화를 하여 오늘날의 인간으로서의 자태를 이루었다. 유인원과 같은 인류의 선조들은 수렵을 통해 육식을 많이 하였을 것이므로 인간은 원래 육식동물이 아닐까? 구석기시대의 유물을 보면 많은 뼈가 출토되고 “얄타미라”나 “라스코” 동굴벽화가 선명하게 묘사되고 있다. 2. 우리나라 선조 승구족의 일파가 백두산을 비롯한 만주 송화강 유역에 유입되면서 수렵과 목축을 주요 식품획득의 수단으로 식품문화권을 형성하면서 남하하여 한반도 민족의 조상인 맥족(貊族)으로 맥적(貊炙)이라고 하는 요리(오늘날의 불고기)를 먹었다는 기록이 있다. 3. 인간의 수명을 1900년대로 거슬러 올라가서 뉴질랜드가 세계최장수국(호주는 2위)로서 평균수명은 남자 58세, 여자 69세인 반면 일본과 한국은 당시 남자 36세, 여자 37세이던 것이 일본은 1989년에 이르러 세계 최장수국으로 등장했으나 1990년 당시 뉴질랜드${\cdot}$호주 등은 목축 및 밀(小麥) 생산국가였기 때문이라는 것과 일본은 오늘날 합리적인 식생활 국가라는 것을 간과해서는 안된다. 4. 우리나라 10대 사망원인중 (1994년도) 뇌혈관질환이 1위, 교통사고 2위, 암이 3위 순위로서 연령별로는 10~30대의 불의의 사고(교통사고), 40~60대는 암, 70대 이상은 뇌혈관질환이 가장 많다. 구미${\cdot}$일 7개국 정상국가들은 심질환 사망이 가장 높다. 5. 식생활의 변화에 있어서 우리나라는 주식으로 섭취해 왔던 곡류는 70년 대비 94년에는 0.7배 감소된 반면 육류 5배, 계란 2.4배, 우유는 무려 29.3배 증가되었다. 식생활 패턴이 서구화 경향으로 바뀌는 것 같다. 6. 71년도 우리나라의 지질섭취량은 국민 1인당 1일 평균 13.1g에 섭취에너지의 5.7%수준이었으나 92년도에는 34.5g으로서 총에너지 섭취량의 16.6%에 달하고 총섭취 지방질중 동물성 섭취 비율은 47%를 차지 한다. 국민 평균 혈청콜레스테롤 농도는 80년에 비해 88년에는 11%가 증가되었고 80년에 210mg/dl 이상 되는 콜레스테롤 혈증인 사람의 비율이 5%에서 88년에는 23%로 크게 증가했다. 7. 세계 정상국가들의 단백질 즉 축산식품의 섭취는 우리나라보다 적게는 2배, 많게는 6~7배 더 섭취하고 90년도 우리나라의 지질섭취량은 일본의 1/3수준에 불과하다. 8. 콜레스테롤은 인체를 비롯한 모든 동물체에 필수적으로 분포하고 있는 것으로 체내 존재하고 있는 총량은 90~150g, 이중 혈청콜레스테롤은 4%(6g)를 차지하고 있음에도 불구하고 이 아주 적은 콜레스테롤에 일희일비(一喜一悲) 논쟁은 60~70년 끄러오고 있다. 9. 콜레스테롤의 생체내 기능으로서는 (1) 세포벽의 지지물질 (2) 신경세포 보호막물질 (3) 담즙산의 합성 (4) 비타민 D의 합성 (5) 임신시에 반듯이 필요한 분자 (6) 기타 여러 가지 기능을 수행하는 것으로 필수적인 물질이다. 10. 우리가 식이를 통해서 섭취 콜레스테롤을 550mg정도를 섭취한다고 하더라도 이 정도의 양은 배설 소모되는 양과 거의 맞먹는 양이다. 피부와 땀샘에서 소실되는 양만도 100~300mg에 달하기 때문에 미국농무성에서 섭취량을 300mg로 제한하는 것은 무의미하다. 11. 콜레스테롤 운반체로서의 지단백질은 그 밀도가 낮은 것으로부터 킬로미크론(chylomicron), 초저밀도 지단백질(VLDL), 저밀도 지단백질(LDL) 및 고밀도 지단백질(HDL)으로 나누는데 LDL은 혈청콜레스테롤 중 약 70%, HDL은 약20%를 함유한다. 12. 혈중 콜레스테롤 수준에 영향을 미치는 요인을 열거하여 보면 다음과 같다. 1) 음식을 통해서 섭취되는 콜레스테롤 중 단지 10~40%정도가 흡수되고, 체내에서 합성되는 콜레스테롤이 증가할수록 식이콜레스테롤은 실제 혈청콜레스테롤 수준에 거의 영향을 미치지 않으므로 식이중함량에 대하여 공포를 느끼고 기피할 필요가 없다. 2) 고도불포화지방산, 단가불포화지방산, 포화지방산의 비 즉 P/M/S의 비가 균형되도록 권장한다. 3) 동맥경화를 비롯한 성인병의 원인이 되는 혈전증에는 EPA의 양을 높여줌으로서 성인병을 예방할 수 있다. 4) 오메가6지방산 아라키도닉산과 오메가3지방산인 EPA로 유도되는 에이코사에노이드 또는 프로스타노이드는 오메가6와 3지방산을 전구체로 하여 생합성되는 중요한 생리활성 물질이다. 5) 사람은 일반적으로 20세에서 60세까지 나이를 먹어감에 따라 혈중 콜레스테롤 수준이 증가하고 60세 이후부터는 일정한 수준을 유지하며 심장보호성 HDL-콜레스테롤은 감소하는 반면에 죽상경화성 LDL콜레스테롤은 증가한다. 6) 높은 HDL콜레스테롤 수준이 심장병 발생 위험요인을 감소시키는 기능을 갖고 있기 때문에 좋은 HDL이라 부르고, LDL은 나쁜 콜레스테롤이라 부르기도 하는데, 이것은 유전적 요인보다도 환경적 요인이 보다 큰 영향을 미친다. 7) 이것은 생활 형태와 영양섭취상태를 포함해서 개인적 생활패턴에 영향을 받는다. 8) 많은 실험에서 혈중 콜레스테롤 상승은 노년의 가령(加齡)에 적응하기 위한 자연적 또는 생리적인 세포의 생화학적이고 대사적인 기능을 위해 필수적일 수 있다는 것을 간과해서는 안될 것이다. 이 점으로 미루어 노년의 여성들을 위한 콜레스테롤 농도를 200mg/dl이 가장 알맞은 양이 아닌 듯하다. 9) 스트레스는 두가지 모양으로 유발되는데 해로은 스트레스(negative), 이로운 스트레스(positive)로서 긴장완화는 혈중 콜레스테롤 농도를 10% 떨어진다. 10) 자주 운동을 하는 사람들은 혈중 HDL콜레스테롤치가 운동을 하지 않는 사람보다 높다. 육체적인 운동의 정도와 혈중 HDL콜레스테롤 농도와는 정비례한다. 11) 흡연은 지방을 흡착시키므로 혈전증의 원이이 되며 혈관속의 HDL농도를 감소시킨다. 12) 에너지의 과잉섭취에 의한 체중 증가느 일반적으로 지단백질대사에 영향을 미치고, 간에서는 콜레스테롤 과잉 생산과 더불어 VLDL콜레스테롤의 LDL콜레스테롤 혈증을 나타냄으로 운동과 더불어 비만이 되지 않도록 하여야 한다. 13. 콜레스테롤 함량에 대한 조절기술 1) 식품의 우열을 평가할 때 단순히 동물성 또는 식물성 식품으로 분류해서 총괄적으로 논한다는 것은 지양되어야 한다. 이것은 그 식품에 함유하고 있는 지방산의 종류에 따라서 다르기 때문이다. 2) 인체의 원할한 기능 유지를 위해서는 P /M /S비율 뿐만 아니라 섭취 지방질의 오메가6 /오메가3계 지방산의 비율이 모두 적절한 범위에 있어야 하며 한두가지 지방산만이 과량일 때는 또 다른 불균형을 일으킬 수 있다는 점을 알아야 한다. 3) 닭고기는 오메가6지방산 함량을 높이기 위하여 사료중에 등푸른 생선이나 어분이나 어유를 첨가하여 닭고기는 첨가수준에 따라 증가됨을 알 수 있다. 4) 오늘날 계란내의 지방산 조성을 변화시켜 난황내의 오메가 3계열 지방산 함량을 증가시킨 계란의 개발이 활발해졌다. 14. 계란 콜레스테롤에 대한 소비자들의 부정적 인식을 불식시키고자 계란의 클레스테롤 함량을 낮추는 과제가 등장하면서 그 기술개발이 여러모로 시도되고 있으나 아직 실용 단계에 이르지 못했다. 15. 계란의 콜레스테롤 문제에 대한 대책으로서 난황의 크기를 감소시키는 방법에 대한 연구도 필요하다. 16. 계란 중 콜레스테롤 함량 분석치는 표현 방식에 따라서 소비자들을 혼란시킬 가능성이 있다. 또한 과거에는 비색법으로 분석했으나 오늘날은 효소법으로 분석하면 분석치에 상당한 차이가 있다. 17. 소비자의 요구를 만족시키고 버터 소비를 촉진시키기 위해 콜레스테롤을 감소시키는 물리적${\cdot}$생물학적 방식이 제안되어 있으나 현장적용이 가능한 것은 아직 없다. 18. 우리나라에서 이미 시판되고 있는 DHA우유가 선보였고 무콜레스테롤 버터의 경우 트란스(trans)형 지방산에 관해서는 논란의 여지가 많을 것이다. 끝으로 국가 목표의 하나는 복지사회 건설에 있고 복지국가 실현에는 국민 기본 욕망의 하나인 식생활 합리화가 선행되어야 한다. 소득이 늘고 국가가 발전해감에 따라 영양식${\cdot}$건강식 및 기호식을 추구하게 됨을 매우 당연한 추세라 하겠다. 우리의 식생활이 날로 향상되어 지난날의 당질 위주에서 점차 축산물쪽으로 질적 개선이 이루어진다는 것은 고무적임에 틀림없다. 이 축산물을 통한 풍요로운 식의 문화를 창출하면서 건강과 장수 그리고 후손에 이르기까지 번영하고 국가 경쟁력 강화에 심혈을 기우려야 할 때이다.

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Feasibility of Deep Learning Algorithms for Binary Classification Problems (이진 분류문제에서의 딥러닝 알고리즘의 활용 가능성 평가)

  • Kim, Kitae;Lee, Bomi;Kim, Jong Woo
    • Journal of Intelligence and Information Systems
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    • v.23 no.1
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    • pp.95-108
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    • 2017
  • Recently, AlphaGo which is Bakuk (Go) artificial intelligence program by Google DeepMind, had a huge victory against Lee Sedol. Many people thought that machines would not be able to win a man in Go games because the number of paths to make a one move is more than the number of atoms in the universe unlike chess, but the result was the opposite to what people predicted. After the match, artificial intelligence technology was focused as a core technology of the fourth industrial revolution and attracted attentions from various application domains. Especially, deep learning technique have been attracted as a core artificial intelligence technology used in the AlphaGo algorithm. The deep learning technique is already being applied to many problems. Especially, it shows good performance in image recognition field. In addition, it shows good performance in high dimensional data area such as voice, image and natural language, which was difficult to get good performance using existing machine learning techniques. However, in contrast, it is difficult to find deep leaning researches on traditional business data and structured data analysis. In this study, we tried to find out whether the deep learning techniques have been studied so far can be used not only for the recognition of high dimensional data but also for the binary classification problem of traditional business data analysis such as customer churn analysis, marketing response prediction, and default prediction. And we compare the performance of the deep learning techniques with that of traditional artificial neural network models. The experimental data in the paper is the telemarketing response data of a bank in Portugal. It has input variables such as age, occupation, loan status, and the number of previous telemarketing and has a binary target variable that records whether the customer intends to open an account or not. In this study, to evaluate the possibility of utilization of deep learning algorithms and techniques in binary classification problem, we compared the performance of various models using CNN, LSTM algorithm and dropout, which are widely used algorithms and techniques in deep learning, with that of MLP models which is a traditional artificial neural network model. However, since all the network design alternatives can not be tested due to the nature of the artificial neural network, the experiment was conducted based on restricted settings on the number of hidden layers, the number of neurons in the hidden layer, the number of output data (filters), and the application conditions of the dropout technique. The F1 Score was used to evaluate the performance of models to show how well the models work to classify the interesting class instead of the overall accuracy. The detail methods for applying each deep learning technique in the experiment is as follows. The CNN algorithm is a method that reads adjacent values from a specific value and recognizes the features, but it does not matter how close the distance of each business data field is because each field is usually independent. In this experiment, we set the filter size of the CNN algorithm as the number of fields to learn the whole characteristics of the data at once, and added a hidden layer to make decision based on the additional features. For the model having two LSTM layers, the input direction of the second layer is put in reversed position with first layer in order to reduce the influence from the position of each field. In the case of the dropout technique, we set the neurons to disappear with a probability of 0.5 for each hidden layer. The experimental results show that the predicted model with the highest F1 score was the CNN model using the dropout technique, and the next best model was the MLP model with two hidden layers using the dropout technique. In this study, we were able to get some findings as the experiment had proceeded. First, models using dropout techniques have a slightly more conservative prediction than those without dropout techniques, and it generally shows better performance in classification. Second, CNN models show better classification performance than MLP models. This is interesting because it has shown good performance in binary classification problems which it rarely have been applied to, as well as in the fields where it's effectiveness has been proven. Third, the LSTM algorithm seems to be unsuitable for binary classification problems because the training time is too long compared to the performance improvement. From these results, we can confirm that some of the deep learning algorithms can be applied to solve business binary classification problems.

Multivessel Coronary Revascularization with Composite LITA-RA Y Graft (좌내흉동맥-요골동맥 복합이식편을 이용한 다중혈관 관상동맥우회술)

  • Lee Sub;Ko Mgo-Sung;Park Ki-Sung;Ryu Jae-Kean;Jang Jae-Suk;Kwon Oh-Choon
    • Journal of Chest Surgery
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    • v.39 no.5 s.262
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    • pp.359-365
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    • 2006
  • Background: Arterial grafts have been used to achieve better long-term results for coronary revascularization. Bilateral internal thoracic artery (ITA) grafts have a better results, but it may be not used in some situations such as diabetes and chronic obstructive pulmonary disease (COPD). We evaluated the clinical and angiographic results of composite left internal thoracic artery-radial artery (LITA-RA) Y graft. Material and Method: Between April 2002 and September 2004, 119 patients were enrolled in composite Y graft for coronary bypass surgery. The mean age was $62.6{\pm}8.8$ years old and female was 34.5%. Preoperative cardiac risk factors were as follows: hypertension 43.7%, diabetes 33.6%, smoker 41.2%, and hyperlipidemia 22.7%, There were emergency operation (14), cardiogenic shock (6), left ventricle ejection fraction (LVEF) less than 40% (17), and 17 cases of left main disease. Coronary angiography was done in 35 patients before the hospital discharge. Result: The number of distal anastomoses was $3.1{\pm}0.91$ and three patients (2.52%) died during hospital stay. The off-pump coronary artery bypass (OPCAB) was applied to 79 patients (66.4%). The LITA was anastomosed to left anterior descending system except three cases which was to lateral wall. The radial Y grafts were anastomosed to diagonal branches (4), ramus intermedius (21), obtuse marginal branches (109), posterolateral branches (12), and posterior descending coronary artery (8). Postoperative coronary angiography in 35 patients showed excellent patency rates (LITA 100%, and RA 88.5%; 3 RA grafts which anastomosed to coronary arteries <70% stenosed showed string sign with competitive flow). Conclusion: The LITA-RA Y composite graft provided good early clinical and angiographic results in multivessel coronary revascularization. But it should be cautiously used in selected patients.

The Evaluation of Radiation Dose to Embryo/Fetus and the Design of Shielding in the Treatment of Brain Tumors (임산부의 전뇌 방사선 치료에 있어서의 태아의 방사선량 측정 및 차폐 구조의 설계)

  • Cho, Woong;Huh, Soon-Nyung;Chie, Eui-Kyu;Ha, Sung-Whan;Park, Yang-Gyun;Park, Jong-Min;Park, Suk-Won
    • Journal of Radiation Protection and Research
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    • v.31 no.4
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    • pp.203-210
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    • 2006
  • Purpose : To estimate the dose to the embryo/fetus of a pregnant patient with brain tumors, and to design an shielding device to keep the embryo/fetus dose under acceptable levels Materials and Methods : A shielding wall with the dimension of 1.55 m height, 0.9 m width, and 30 m thickness is fabricated with 4 trolleys under the wall. It is placed between a Patient and the treatment head of a linear accelerator to attenuate the leakage radiation effectively from the treatment head, and is placed 1 cm below the lower margin of the treatment field in order to minimize the dose to a patient from the treatment head. An anti-patient scattering neck supporters with 2 cm thick Cerrobend metal is designed to minimize the scattered radiation from the treatment fields, and it is divided into 2 section. They are installed around the patient neck by attach from right and left sides. A shielding bridge for anti-room scattered radiation is utilized to place 2 sheets of 3 mm lead plates above the abdomen to setup three detectors under the lead sheets. Humanoid phantom is irradiated with the same treatment parameters, and with and without shielding devices using TLD, and ionization chambers with and without a build-up cap. Results : The dose to the embryo/fetus without shielding was 3.20, 3.21, 1.44, 0.90 cGy at off-field distances of 30, 40, 50, and 60 cm. With shielding, the dose to embryo/fetus was reduced to 0.88, 0.60, 0.35, 0.25 cGy, and the ratio of the shielding effect varied from 70% to 80%. TLD results were 1.8, 1.2, 0.8, 1.2, and 0.8 cGy. The dose measured by the survey meter was 10.9 mR/h at the patient's surface of abdomen. The dose to the embryo/fetus was estimated to be about 1 cGy during the entire treatment. Conclusion : According to the AAPM Report No 50 regarding the dose limit of the embryo/fetus during the pregnancy, the dose to the embryo/fetus with little risk is less than 5 cGy. Our measurements satisfy the recommended values. Our shielding technique was proven to be acceptable.

Usefulness of Tuberculin Skin Test by Tuberculin PPD RT23 2 TU (Tuberculin PPD RT23 2 TU를 이용한 투베르쿨린 피부반응 검사의 의의)

  • Yang, Jong-Wuk;Jeon, Man-Jo;Kim, Sung-Jung;Lee, Hyang-Lim;Lee, Seung-Jun;Lee, Myoung-Goo;Kim, Dong-Gyu;Park, Myoung-Jae;Kang, Min-Jong;Hyoen, In-Gyu;Jung, Ki-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.4
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    • pp.401-408
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    • 2002
  • Background : Tuberculin skin test is a method to examine M. tuberculosis infection and has been used all over the world. But various factors make it difficult to understand testing results. In 2000, the American Thoracic Society recommended that skin test results should be decided by considering risk factors of the tested. In Korea, high tuberculosis infection rate and BCG vaccination rate make it difficult to differentiate current infection, past infection, and no infection by the skin test. This study was attempted to examine a negative predictive value of the skin test to understand how the skin test acts on deciding administration of anti-tuberculosis drug. Methods : From Mar. 1 to Jul. 31 in 2001, the test was performed for patients hospitalized in Department of Internal Medicine, Hallym University College of Medicine, Chunchon, Korea by administering Tuberculin PPD RT23 2 TU (0.1 ml)to them that has been currently used in Korea based on Mantoux method. They were decided to be infected with tuberculosis bacilli by following diagnostic standard: 1) tuberculosis bacilli was cultured in sputum by microbiological diagnostic standard or Acid-fast bacilli was proven on a microscopic examination or 2) tuberculosis bacilli was not proven in the aforesaid microbiological test by clinical diagnostic standard, while there was opinion or symptom suitable for tuberculosis by radiographic or histological standard so the doctor decided to apply the tuberculosis treatment. Results : In this study, total 210 patients except 20 patients (8.7%) among 230 hospitalized patients were evaluated. Their average age was 60±16.8 years, and male-female rate was 1.28 : 1 (male: 118, female: 92). Number of patient, who was diagnosed and decided as tuberculosis, was 53(25.2%). Pulmonary tuberculosis was found in 45 patients (84.9%); 22 patients were decided to be positive in the Acid-fast bacilli smear test by microbiological examination (culture positive: 13, culture negative: 9), and 23 patients were decided to be tuberculosis patients by clinical diagnosis standard. Tuberculosis pleuritis was found in 8 patients (15.1%); 4 patients were diagnosed and decided by histological standard, and 4 patients were decided and treated by clinical standard. In differentiating patients into 'Negative' and 'Positive' by the skin test standard of the American Thoracic Society, negative predictive value 92.3%, positive predictive value 47.3%, sensitivity and specificity were 83%, 68.8%, respectively. Conclusion : In hospitalized respiratory patients, there was high negative predictive vlaue 92.3% by tuberculin skin test, therefore skin test would be a important factor for deciding administration of anti-tuberculosis drug on negative skin test patient.

Lung Uptake of $^{99m}Tc-sestamibi$ during Routine Gated Exercise SPECT Imaging : Comparison with Left Ventricular Ejection Fraction and Severity of Perfusion Defect (일상적인 운동 부하 게이트 심근 관류 SPECT에서 $^{99m}Tc-sestamibi$ 폐섭취 : 좌심실 구혈률과 관류 결손 정도와의 비교)

  • Jeong, Shin-Young;Lee, Jae-Tae;Bae, Jin-Ho;Ahn, Byeong-Cheol;Lee, Kyu-Bo
    • The Korean Journal of Nuclear Medicine
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    • v.37 no.2
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    • pp.83-93
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    • 2003
  • Background: Lung-to-heart uptake ratio (LHR) in $^{201}Tl-chloride$ myocardial perfusion scan is believed to be a reliable marker for left ventricular (LV) dysfunction, but the clinical value of LHR is controversial for $^{99m}Tc-MIBI$ imaging. Furthermore, most of results suggesting lung uptake of $^{99m}Tc-MIBI$ as a potential marker for LV dysfunction used immediate post-stress images, instead of routine images acquired 1 hour after tracer injection. The goal of our study was to investigate whether LHR evaluated with routine gated $^{99m}Tc-MIBI$ imaging can reflect the degree of perfusion defect or left ventricular performance. Subjects and Methods: 241 patients underwent exercise $^{99m}Tc-MIBI$ myocardial SPECT were classified into normal myocardial perfusion (NP, n=135) and abnormal myocardial perfusion (AP, n=106) group according to the presence of perfusion defect. LHR was calculated from anterior projection image taken at 1-hour after injection. Two legions of interest (ROIs) were placed on left lung above LV and on myocardium showing the highest radioactivity. Subjects were classified by left ventricular ejection fraction (LVEF), as Gr-I: >50%, Gr-II: 36-50%, Gr-III: <36% and by summed stress score (SSS), as Gr-A: <4, Gr-B: 4-8, Gr-C: 9-13, Gr-D: >13, LHR was compared among these groups. Results: In NP group(n=135), LHR, were higher in men than women ($men:\;0.311{\pm}0.03,\;women:\;0.296{\pm}0.03,\;p<0.05$). Significant difference, in LHR were found between NP and AP groups both for men and women ($men:\;0.311{\pm}0.03\;vs\;.\;0.331{\pm}0.06,\;women:\;0.296{\pm}0.03\;vs.\;0.321{\pm}0.07.\;p<0.05$). There were weak negative correlation between LHR and LVEF (r=-0.342, p<0.05) and weak positive correlation between LHR and SSS (r=0.478, p<0.05) in men, but not in women (LVEF: r=-0.279, p=0.100, SSS: r=0.276, p=0.103). Increased LHR was defined when for more than mean + 2SD value ($men{\geq}0.38,\;women{\geq}0.37$) of the LHR of the subject with normal perfusion. Increased LHR were observed more frequently in subjects with lower LVEF (Gr-I: 11.1%, Gr-II: 27.0%, Gr-III: 35.4%, p<0.05) and higher SSS(Gr-A: 14.0%, Gr-B: 5.7%, Gr-C: 18.2%, Gr-D: 40.7%, p<0.05). Conclusions: LHRs obtained from routine $^{99m}Tc-MIBI$ gated SPECT images were weakly correlated with LVEF and perfusion defect. Although significant overlaps were observed between normal and abnormal perfusion group, LHRs could be used as an indirect marker of severe perfusion defect or reduced left ventricular function.

The Expression of Vascular Endothelial Growth Factor (VEGF) is a Highly Significant Prognostic Factor in Stage IB Carcinoma of the Cervix (병기 IB 자궁경부암에서 혈관내피세포성장인자(VEGF)의 발현이 예후에 미치는 영향)

  • Lee Ik Jae;Park Kyung Ran;Lee Jong Young;Lee Kang Kyoo;Song Ji Sun;Lee Kwang Gil;Cha Dong Soo;Choi Hyun Il
    • Radiation Oncology Journal
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    • v.19 no.4
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    • pp.335-344
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    • 2001
  • Purpose : The aim of this study was to clarify the role of VEGF expression as an independent prognostic factor and to identify the patients at high risk for poor prognosis in stage IB cervical cancer. Materials and methods : A total of 118 patients with stage IB cervical cancer who had radical hysterectomy and pelvic lymph node dissection were included in the study. All known high risk factors of the patients were pathologically confirmed from the surgical specimen. Of the 118 patients, n patients were treated with postoperative radiotherapy and/or chemotherapy. VEGF expression was examined using immunohistochemistry in formalin-fixed, paraffin-embedded specimens of post-hysterectomy surgical materials. A semiquantitative analysis was made using a scoring system of 0, +, ++, and +++ for increasing intensity of stain. We classified the patients with scores from 0 to ++ as low VEGF expression and the patients with a score of +++ as high VEGF expression. Results : Of the 118 patients, 35 patients $(29.7\%)$ showed high VEGF expression. Strong correlations were found between the high VEGF expression and both deep stromal invasion (p=0.01) and the positive pelvic node (p=0.03). The 5-year overall and disease-free survival rates for all 118 patients were $95.5\%\;and\;93.8\%$. The 5-year overall (p=0.03) and disease-free survival (p<0.001) rates were $98.5\%\;and\;100%$ for low VEGF expression (0, +, and ++) and $85.5\%\;and\;79.7\%$ for high VEGF expression, respectively. Pelvic and distant failures for low versus high VEGF expression were $1.2\%$ versus $17.1\%$, (p=0.001) and $0\%$ versus $14.3\%$ (p<0.001), respectively. In a Cox multivariate analysis of survival, the high VEGF expression (p=0.02) and the bulky mass (p=0.02) were significant prognostic factors for overall survival. The high VEGF expression (p=0.002), and bulky mass (p=0.01) demonstrated as significant prognostic indicators for disease free survival. Conclusion : These results showed that VEGF expression was a highly significant predictor for pelvic and distant failure and the most significant prognostic factor of overall and disease free survival for the patients with stage IB cervix cancer treated with radical surgery. We strongly suggest that the immune-histochemistry for VEGF expression be performed in a routine clinical setting in order to identify the patients at high risk for poor prognosis in early stage cervical cancer. Furthermore, postoperative and/or chemotherapy did not reduce the pelvic failure and distant metastasis. To improve the cure rate for the patients with high VEGF expression in stage IB cervical cancer, antiangiogenic therapy including anti-VEGF Ab may be new treatment option.

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Effect of Exercise on Antioxidant Enzyme Activities of Skeletal Muscle and Liver in STZ-diabetic Rats (STZ-당뇨쥐에서 운동부하가 골격근 및 간의 항산화효소 활성도에 미치는 영향)

  • Seok, Kwang-Ho;Lee, Suck-Kang
    • Journal of Yeungnam Medical Science
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    • v.17 no.1
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    • pp.21-30
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    • 2000
  • Background: The purpose of the present study was to investigate the effect of exercise on the activities of antioxidant enzymes, super oxide dismutase(SOD), glutathione peroxidase(GPX) and catalase(CAT) of skeletal muscle(gastrocnemius) and liver in streptozotocin(STZ) induced diabetic rats. The malondialdehyde(MDA) concentration was also measured as an index of lipid poroxidation of tho tissues by exercise-induced oxidative stresses in diabetic rats. Material and Methods: Male Sprague-Dawley rats were randomly divided into control and STZ-induced diabetic rats. The STZ in citrate buffer solution was injected twice at S days intervals intraperitoneally(50, 70 mg/kg respectively). On the 28th day after the first STZ injection, the diabetic animals were randomly divided into pre- and post-exercise groups, The exercise was introduced to the rats of post-exercise group by treadmill running until exhaution with moderate intensity ($V_{O2max}$: 50-70%) of exercise. The duration of average running time was 2 hours and 19 minutes. Results: The blood glucose concentration was increased(p<0.001) and plasma insulin concentration was decreased(p<0.001) in the diabetic rats. The glycogen concentration in the muscle and liver was decreased by exhaustive exercise in the diabetic rats(p<0.001), In the skeletal muscle, the activities of GPX was increased(p<0.05) and the activities of SOD and CAT were not changed in the diabetic rats compare to those of the control rats. The activities of GPX was not changed by exercise but the activities of SOD(p<0.01) and CAT(p<0.01) were decreased by exercise in the diabetic rats, The concentration of MDA was not changed by exercise in diabetic rats, and the values of pre-exercise and post-exercise diabetic rats were not different from the value those of control rats, In the liver, the activities of SOD was decreased(p<0.01), and the activities of GPX and CAT were not changed in diabetic rats compared to the values of control rats, The activities of SOD, GPX and CAT were not changed by exercise in diabetic rats but the activity of SOD seemed to decrease slightly, The MDA concentration was increased in the diabetic rats compared to the values of control rats(p<0.001), but there was no change of MDA concentration by exercise in diabetic rats, Conclusions: In summary, exhaustive physical exercise did not seem to impose oxidative stress on the skeletal muscle because of due to oxygen free radicals, regardless of the decrease in SOD and CAT in the diabetic rats, In liver tissue, the tissue damage by oxidative stress was observed in diabetic rats but the additional tissue damage by exhaustive physical exercise was not observed.

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A New Exploratory Research on Franchisor's Provision of Exclusive Territories (가맹본부의 배타적 영업지역보호에 대한 탐색적 연구)

  • Lim, Young-Kyun;Lee, Su-Dong;Kim, Ju-Young
    • Journal of Distribution Research
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    • v.17 no.1
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    • pp.37-63
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    • 2012
  • In franchise business, exclusive sales territory (sometimes EST in table) protection is a very important issue from an economic, social and political point of view. It affects the growth and survival of both franchisor and franchisee and often raises issues of social and political conflicts. When franchisee is not familiar with related laws and regulations, franchisor has high chance to utilize it. Exclusive sales territory protection by the manufacturer and distributors (wholesalers or retailers) means sales area restriction by which only certain distributors have right to sell products or services. The distributor, who has been granted exclusive sales territories, can protect its own territory, whereas he may be prohibited from entering in other regions. Even though exclusive sales territory is a quite critical problem in franchise business, there is not much rigorous research about the reason, results, evaluation, and future direction based on empirical data. This paper tries to address this problem not only from logical and nomological validity, but from empirical validation. While we purse an empirical analysis, we take into account the difficulties of real data collection and statistical analysis techniques. We use a set of disclosure document data collected by Korea Fair Trade Commission, instead of conventional survey method which is usually criticized for its measurement error. Existing theories about exclusive sales territory can be summarized into two groups as shown in the table below. The first one is about the effectiveness of exclusive sales territory from both franchisor and franchisee point of view. In fact, output of exclusive sales territory can be positive for franchisors but negative for franchisees. Also, it can be positive in terms of sales but negative in terms of profit. Therefore, variables and viewpoints should be set properly. The other one is about the motive or reason why exclusive sales territory is protected. The reasons can be classified into four groups - industry characteristics, franchise systems characteristics, capability to maintain exclusive sales territory, and strategic decision. Within four groups of reasons, there are more specific variables and theories as below. Based on these theories, we develop nine hypotheses which are briefly shown in the last table below with the results. In order to validate the hypothesis, data is collected from government (FTC) homepage which is open source. The sample consists of 1,896 franchisors and it contains about three year operation data, from 2006 to 2008. Within the samples, 627 have exclusive sales territory protection policy and the one with exclusive sales territory policy is not evenly distributed over 19 representative industries. Additional data are also collected from another government agency homepage, like Statistics Korea. Also, we combine data from various secondary sources to create meaningful variables as shown in the table below. All variables are dichotomized by mean or median split if they are not inherently dichotomized by its definition, since each hypothesis is composed by multiple variables and there is no solid statistical technique to incorporate all these conditions to test the hypotheses. This paper uses a simple chi-square test because hypotheses and theories are built upon quite specific conditions such as industry type, economic condition, company history and various strategic purposes. It is almost impossible to find all those samples to satisfy them and it can't be manipulated in experimental settings. However, more advanced statistical techniques are very good on clean data without exogenous variables, but not good with real complex data. The chi-square test is applied in a way that samples are grouped into four with two criteria, whether they use exclusive sales territory protection or not, and whether they satisfy conditions of each hypothesis. So the proportion of sample franchisors which satisfy conditions and protect exclusive sales territory, does significantly exceed the proportion of samples that satisfy condition and do not protect. In fact, chi-square test is equivalent with the Poisson regression which allows more flexible application. As results, only three hypotheses are accepted. When attitude toward the risk is high so loyalty fee is determined according to sales performance, EST protection makes poor results as expected. And when franchisor protects EST in order to recruit franchisee easily, EST protection makes better results. Also, when EST protection is to improve the efficiency of franchise system as a whole, it shows better performances. High efficiency is achieved as EST prohibits the free riding of franchisee who exploits other's marketing efforts, and it encourages proper investments and distributes franchisee into multiple regions evenly. Other hypotheses are not supported in the results of significance testing. Exclusive sales territory should be protected from proper motives and administered for mutual benefits. Legal restrictions driven by the government agency like FTC could be misused and cause mis-understandings. So there need more careful monitoring on real practices and more rigorous studies by both academicians and practitioners.

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A survey on daily physical activity level, energy expenditure and dietary energy intake by university students in Chungnam Province in Korea (충남지역 대학생의 신체활동수준, 에너지소비량 및 에너지섭취량 조사)

  • Kim, Sun Hyo
    • Journal of Nutrition and Health
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    • v.46 no.4
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    • pp.346-356
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    • 2013
  • This study investigated the daily physical activity level, energy expenditure, energy balance, and body composition and their relationship with university students. The participants were 130 male students ($19.5{\pm}0.5$ yrs) and 139 female students ($19.5{\pm}0.3$ yrs) at a university in Chungnam province. Physical activity level was evaluated by an equation based on 24 hr-activity record and dietary nutrient intake was evaluated using the food record method during a three-day period consisting of two week days and one weekend. Body composition was measured using Inbody 430 (Biospace Co., Cheonan, Korea). As a result, mean body mass index (BMI) of subjects indicated that they had normal weight, however mean body fat ratio was $19.1{\pm}5.4%$ for males and $28.4{\pm}5.0%$ for females, indicating that they had higher than normal weight. Daily mean physical activity level was 1.55 for males and 1.47 for females, which was regarded as 'low active', respectively. Females had more light activity than males (p<0.01). Daily mean energy expenditure was $2,803.5{\pm}788.9$ kcal/d for males and $1,915.4{\pm}510.2$ kcal/d for females (p<0.001). Daily mean dietary energy intake was $2,327.0{\pm}562.5$ kcal/d for males and $1,802.1{\pm}523.6/d$ for females (p<0.001), and daily mean energy balance was $-476.5{\pm}955.9$ kcal/d for males and $-113.3{\pm}728.1$ kcal/d for females (p<0.01). Daily mean dietary intake of protein, vitamins, and minerals, except Ca, satisfied recommended nutrient intake. Daily energy expenditure was positively related to body weight (p<0.01), BMI (p<0.01), and fat free mass ratio (p<0.05), but was negatively related to body fat ratio (p<0.01). In conclusion, subjects had a negative energy balance and low physical activity. They had a normal weight by BMI but had a more fat than normal weight by body fat ratio. This appears to be related to their low physical activity. Thus, nutrition education should be provided for university students in order to increase their physical activity for maintenance of normal weight by body composition and health promotion.