• Title/Summary/Keyword: 형성적 연구방법론

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Analysis of Childhood Rapidly Progressive Glomerulonephritis (소아 급속 진행성 사구체신염의 임상적 고찰)

  • Uhm Ji Hyun;Kim Mi Jin;Lee Young-Mock;Kim Ji Hong;Lee Jae Seung;Kim Pyung-Kil;Hong Soon Won;Jeung Hyeun Joo
    • Childhood Kidney Diseases
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    • v.5 no.2
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    • pp.78-86
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    • 2001
  • Purpose: Rapidly progressive glomerulonephritis (RPGN) is characterized by the rapid increase in serum creatitnin and crescents formation involving more than $50\%$ of glomeruli. 10 patients who had been treated for RPGN were studied retrospectively for thier underlying diseases and clinical features Method: Cilinical review was performed on 10 children who were diagnosed with RPGN by clinical features and renal biopsy and followed up at department of pediatrics during tile last 10 years, from May 1990 to May 2000. Result: There were 6 males and 4 females between the ages of 2.1 and 14.3 years (mean $10.9{\pm}3.8$). 3 had Henoch-$Sch{\ddot{o}}nlein$ purpura nephritis; 2, idiopathic rapidly progressive glomerulonephritis; 2, lupus nephritis; 1, hemolytic uremic syndrome; 1, membranous glomerulonephritis and 1, microscopic polyangiitis. The most common chief complaints were gross hematuria and oliguria. Initial clinical features included proteinuria, edema, hypertension, nausea and arthralgia. Mean serum BUN was $74.2{\pm}39.1\;mg/dL$ mean serum creatinin, $3.2{\pm}1.8\;mg/dL$ and mean creatinin clearance, $26.5{\pm}13.2\;mL/min/1.73m^2$. Antineutrophil cytoplasmic antibody was positive only in microscopic polyangiitis. ANA and Anti-DNA antibody were positive in two lupus nephritis patients. Serum complements were decreased in 4 patients. All patients except Hemolytic uremic syndrome received steroid pulse therapy and immunosupressive agents. 3 patients were performed acute peritoneal dialysis and 2 patients were given plasmapheresis. At the last follow up, 1 patient was dead, 4 patients had elevated serum creatinin, 2 of these 4 patients were on chronic ambulatory peritoneal dialysis and 6 patients had normal renal function. Conclusion: Rapidly progressive glomerulonephritis is a medical emergency that requires very rapid diagnosis, classification, and therapy. Appropriate therapy selected on the basis of underlying disease mechanism can substantially improve renal survival. (J. Korean Soc Pediatr Nephrol 2001 ; 5 : 78-86)

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Analysis of the Range Verification of Proton using PET-CT (Off-line PET-CT를 이용한 양성자치료에서의 Range 검증)

  • Jang, Joon Young;Hong, Gun Chul;Park, Sey Joon;Park, Yong Chul;Choi, Byung Ki
    • The Journal of Korean Society for Radiation Therapy
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    • v.29 no.2
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    • pp.101-108
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    • 2017
  • Purpose: The proton used in proton therapy has a characteristic of giving a small dose to the normal tissue in front of the tumor site while forming a Bragg peak at the cancer tissue site and giving up the maximum dose and disappearing immediately. It is very important to verify the proton arrival position. In this study, we used the off-line PET CT method to measure the distribution of positron emitted from nucleons such as 11C (half-life = 20 min), 150 (half-life = 2 min) and 13N The range and distal falloff point of the proton were verified by measurement. Materials and Methods: In the IEC 2001 Body Phantom, 37 mm, 28 mm, and 22 mm spheres were inserted. The phantom was filled with water to obtain a CT image for each sphere size. To verify the proton range and distal falloff points, As a treatment planning system, SOBP were set at 46 mm on 37 mm sphere, 37 mm on 28 mm, and 33 mm on 22 mm sphere for each sphere size. The proton was scanned in the same center with a single beam of Gantry 0 degree by the scanning method. The phantom was scanned using PET-CT equipment. In the PET-CT image acquisition method, 50 images were acquired per minute, four ROIs including the spheres in the phantom were set, and 10 images were reconstructed. The activity profile according to the depth was compared to the dose profile according to the sphere size established in the treatment plan Results: The PET-CT activity profile decreased rapidly at the distal falloff position in the 37 mm, 28 mm, and 22 mm spheres as well as the dose profile. However, in the SOBP section, which is a range for evaluating the range, the results in the proximal part of the activity profile are different from those of the dose profile, and the distal falloff position is compared with the proton therapy plan and PET-CT As a result, the maximum difference of 1.4 mm at the 50 % point of the Max dose, 1.1 mm at the 45 % point at the 28 mm sphere, and the difference at the 22 mm sphere at the maximum point of 1.2 mm were all less than 1.5 mm in the 37 mm sphere. Conclusion: To maximize the advantages of proton therapy, it is very important to verify the range of the proton beam. In this study, the proton range was confirmed by the SOBP and the distal falloff position of the proton beam using PET-CT. As a result, the difference of the distally falloff position between the activity distribution measured by PET-CT and the proton therapy plan was 1.4 mm, respectively. This may be used as a reference for the dose margin applied in the proton therapy plan.

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Assessment of Nutritional Status in Hospitalized Pediatric Patients (입원 환아의 영양상태 평가)

  • Lee, Dong-Gon;Rho, Young-Ill;Moon, Kyung-Rye
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.4 no.1
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    • pp.83-91
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    • 2001
  • Purpose: The aim of this study was to investigate the current prevalence of protein-energy malnutrition (PEM) and the nutritional status of hospitalized pediatric patients. Methods: We evaluated the nutritional status of the 200 patients from February to July 1994 and the 233 patients from February to July 1999 admitted to Pediatric Department of Chosun University Hospital. Nutritional status was assessed by anthropometric and laboratory data. The nutritional status was classified according to based on the Waterlow criteria and using the laboratory data obtained between 3 days to 5 days after admission. Results: 1) The prevalence of acute PEM (weight for height) was as follows: severe, 0.5%; moderate, 7%; mild, 18%; and none, 74.5% in 1994 and severe, 2.24%; moderate, 3.59%; mild, 19.73%; and none, 74.4% in 1999. 2) The prevalence of chronic PEM (height for age) was as follows: severe, 5%; moderate, 5.5%; mild, 25.5%; and none, 64% in 1994 and severe, 2.24%; moderate, 4.04%; mild, 22.87%; and none, 70.85% in 1999. There was not a statistically significant difference between 1994 and 1999. 3) The prevalence of PEM according to age group, all age group had in general higher prevalence of mild PEM. 4) Values for hemoglobin and albumin were below than total lymphocyte values in PEM. Conclusion: The prevalence of acute or chronic PEM was common in hospitalized children. Therefore, the assessment of nutritional status may an important role to establish effective nutritional support and to improve their subsequent hospital course in hospitalized pediatric patient.

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Pulmonary Mycoses in Immunocompromised Hosts (면역기능저하 환자에서 폐진균증에 대한 임상적 고찰)

  • Suh, Gee-Young;Park, Sang-Joon;Kang, Kyeong-Woo;Koh, Young-Min;Kim, Tae-Sung;Chung, Man-Pyo;Kim, Ho-Joong;Han, Jong-Ho;Choi, Dong-Chull;Song, Jae-Hoon;Kwon, O-Jung;Rhee, Chong-H.
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.6
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    • pp.1199-1213
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    • 1998
  • Background : The number of immunocompromised hosts has been increasing steadily and a new pulmonary infiltrate in these patients is a potentially lethal condition which needs rapid diagnosis and treatment. In this study we sought to examine the clinical manifestations, radiologic findings, and therapeutic outcomes of pulmonary mycoses presenting as a new pulmonary infiltrate in immunocompromised hosts. Method : All cases presenting as a new pulmonary infiltrate in immunocompromised hosts and confirmed to be pulmonary mycoses by pathologic examination or by positive culture from a sterile site between October of 1996 and April of 1998 were included in the study and their chart and radiologic findings were retrospectively reviewed. Results : In all, 14 cases of pulmonary mycoses from 13 patients(male : female ratio = 8 : 5, median age 47 yr) were found. Twelve cases were diagnosed as aspergillosis while two were diagnosed as mucormycosis. Major risk factors for fungal infections were chemotherapy for hematologic malignancy(10 cases) and organ transplant recipients(4 cases). Three cases were receiving empirical amphotericin B at the time of appearance of new lung infiltrates. Cases in the hematologic malignancy group had more prominent symptoms : fever(9/10), cough(6/10), sputum(5/10), dyspnea(4/10), chest pain(5/10). Patients in the organ transplant group had minimal symptoms(p<0.05). On simple chest films, all of the cases presented as single or multiple nodules(6/14) or consolidations(8/14). High resolution computed tomograph showed peri-lesional ground glass opacities(14/14), pleural effusions(5/14), and cavitary changes(7/14). Definitive diagnostic methods were as follows : 10 cases underwent minithoracotomy, 2 underwent video-assisted thoracoscopic surgery, 1 underwent percutaneous needle aspiration and 1 case was diagnosed by culture of abscess fluid. All cases received treatment with amphotericin B with 1 case each being treated with liposomal amphotericin B and itraconazole due to renal toxicity. Lung lesion improved in 12 of 14 patient but 4 patients died before completing therapy. Conclusion : When a new lung infiltrate develops presenting either as a nodule or consolidation in a neutropenic patient with hematologic malignancy or in a transplant recipient, you should always consider pulmonary mycoses as one of the differential diagnosis. By performing aggressive work up and early treatment, we may improve prognosis of these patients.

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The Lymphocyte Dependent Bactericidal Assay of Human Monocyte and Alveolar Macrophage for Mycobacteria (마이코박테리아에 대한 인체 말초혈액 단핵구와 폐포대식세포의 림프구 의존적 살해능에 관한 연구)

  • Cheon, Seon-Hee;Lee, You-Hyun;Lee, Jong-Soo;Bae, Ki-Sun;Shin, Sue-Yeon
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.1
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    • pp.5-16
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    • 2002
  • Background : Though mononuclear phagocytes serve as the final effectors in killing intracellular Mycobacterium tuberculosis, the bacilli readily survive in the intracellular environment of resting cells. The mechanisms through which cellular activation results in the intracellular killing is unclear. In this study, we sought to explore an in vitro model of a low-level infection of human mononuclear phagocytes with MAC and $H_{37}Ra$ and determine the extent of the lymphocyte dependent cytotoxicity of human monocytes and alveolar macrophages. Materials and Methods : The peripheral monocytes were prepared using the Ficoll gradient method from PPD positive healthy people and tuberculosis patients. The alveolar macrophages were prepared from PPD positive healthy people via a bronchoalveolar lavage. The human mononuclear phagocytes were infected at a low infection rate (bacilli:phagocyte 1:10) with MAC(Mycobacterium avium) and Mycobacterium tuberculosis $H_{37}Ra$. Non-adherent cells(lymphocyte) were added at a 10:1 ratio. After 1,4, and 7 days culture in $37^{\circ}C$, 5% CO2 incubator, the cells were harvested and inoculated in a 7H10/OADC agar plate for the CFU assay. The bacilli were calculated with the CFU/$1{\times}10^6$ of the cells and the cytotoxicity was expressed as the log killing ratio. Results : The intracellular killing of MAC and $H_{37}Ra$ within the monocyte was greater in patients with tuberculosis compared to the PPD positive controls (p<0.05). Intracellular killing of MAC and $H_{37}Ra$ within the alveolar macrophage appeared to be greater than that within the monocytes of the PPD positive controls. There was significant lymphocyte dependent inhibition of intracellular growth of the mycobacteria within the monocytes in both the controls and tuberculosis patients and within the macrophages in the controls(p<0.05). There was no specific difference in the virulence between the MAC and the $H_{37}Ra$. Conclusion : This study is an in vitro model of a low-level infection with MAC and $H_{37}Ra$ of human mononuclear phagocytes. The intracellular cytotoxicity of the mycobacteria within the phagocytic cells was significantly lymphocyte dependent. During the 7 days culture after the intracellular phagocytosis, the actual confinement of the mycobacteria was observed within the monocytes of tuberculosis patients and the alveolar macrophages of the controls as in the case of adding lymphocytes.

TNF-α stimulated IL-8 and IL-10 expression in monocytes from patients with chronic granulomatous disease (만성육아종질환 환자 단핵구에서 TNF-α 자극에 의한 IL-8과 IL-10의 발현 양상)

  • Shin, Kyung-Sue
    • Clinical and Experimental Pediatrics
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    • v.51 no.10
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    • pp.1096-1101
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    • 2008
  • Purpose : Patients with chronic granulomatous disease (CGD) have genetic mutations in a component of the NADPH oxidase enzyme that is necessary for the generation of the superoxide anion. The profound defect in innate immunity is reflected by the patients susceptibility to catalase-positive bacteria and fungi. In addition, CGD patients display signs of persistent inflammation, which is not associated only with deficient superoxide anion production. The aim of this study was to elucidate the cytokine responses in CGD patients after $TNF-{\alpha}$ stimulation. Methods : Heparinized blood samples were collected from 8 CGD patients and 10 healthy volunteers. Monocytes ($1{\times}10^6cell/well$) isolated by the magnet cell isolation system were incubated with a constant amount of $TNF-{\alpha}$ (10 ng/mL) at $37^{\circ}C$ for 6 h. Incubated cells were harvested at 60-min intervals for IL-8 and IL-10 mRNA analysis, and the supernatant was collected at the same intervals to determine IL-8 and IL-10 expression. Monocytes from healthy volunteers were also incubated with antioxidants followed by $TNF-{\alpha}$ stimulation for IL-8 and IL-10 expression. Results : In CGD patients, a high expression of IL-8 together with a significantly higher IL-10 expression than in the healthy controls was seen after $TNF-{\alpha}$ stimulation. Moreover, normal monocytes treated with antioxidants exhibited increased IL-8 responses. Conclusion : The absence of phagocyte-derived reactive oxidants in CGD might be associated with a dysregulated production of pro- and antiinflammatory cytokines. Additional research related to reactive oxidants is needed to clarify the role of cytokines in CGD patients.

IMRT and IMRS Checking the Dose Distribution in the Small Field Evaluation of Measurement by Changes in SAD (IMRT 및 IMRS에서 Small Field의 선량분포 확인시 SAD 변화에 따른 측정의 유용성 평가)

  • Ko, Seung-Young;Kim, Sung-Joon;Park, Gir-Yong;Son, Mi-Suk;Lee, Nam-Ki;Kim, Jin-Soo
    • The Journal of Korean Society for Radiation Therapy
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    • v.22 no.1
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    • pp.33-39
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    • 2010
  • Purpose: It is very important to confirm conformance of dose distribution that is formed with treatment planning from IMRS or IMRT. It has been a problem dropped accuracy and conformance when the field size is getting smaller because of character of the 2D ion chamber. Verification of MatriXX Phantom dose distribution with a change in the SAD. Dose distribution measurement and analysis to improve the accuracy and should be useful to evaluate the award. Materials and Methods: A use of Novalis linear accelerator 6 MV photon beams. In general, IMRS were 25 patients with small field size. The selected patients were divided into three groups on the basis of the field size. SAD was changed from 80 to 130 cm and field size to determine the dose distribution to the change, each dose was measured using MatriXX Phantom. Analysis of measured values obtained from the program for each patient through the treatment planning system comparison and analysis of the dose distribution and gamma values were expressed. Result: SAD 80, 100, and 120 cm in size in the gamma value to the investigation of patients less than $3\;cm^2$ average 0.939, 0.969, and 0.979, respectively. Patients with more than $5\;cm^2$ 0.962, 0.983, and 0.988, respectively. $5\;cm^2$ or more patients 0.982, 0.990, and 0.992, respectively. Conclusion: The error rate of less than $3\;cm^2$ field size is increased rapidly. If the field size is increased, resolution is increased by 2D ion chambers. It has been approved that it can be credible if it is around $3\;cm^2$ when measuring dose distribution using MatriXX. Adjusting geometric field size by changing SAD is likely to be very useful when you measure dose distribution using MatriXX.

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An Expert System for the Estimation of the Growth Curve Parameters of New Markets (신규시장 성장모형의 모수 추정을 위한 전문가 시스템)

  • Lee, Dongwon;Jung, Yeojin;Jung, Jaekwon;Park, Dohyung
    • Journal of Intelligence and Information Systems
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    • v.21 no.4
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    • pp.17-35
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    • 2015
  • Demand forecasting is the activity of estimating the quantity of a product or service that consumers will purchase for a certain period of time. Developing precise forecasting models are considered important since corporates can make strategic decisions on new markets based on future demand estimated by the models. Many studies have developed market growth curve models, such as Bass, Logistic, Gompertz models, which estimate future demand when a market is in its early stage. Among the models, Bass model, which explains the demand from two types of adopters, innovators and imitators, has been widely used in forecasting. Such models require sufficient demand observations to ensure qualified results. In the beginning of a new market, however, observations are not sufficient for the models to precisely estimate the market's future demand. For this reason, as an alternative, demands guessed from those of most adjacent markets are often used as references in such cases. Reference markets can be those whose products are developed with the same categorical technologies. A market's demand may be expected to have the similar pattern with that of a reference market in case the adoption pattern of a product in the market is determined mainly by the technology related to the product. However, such processes may not always ensure pleasing results because the similarity between markets depends on intuition and/or experience. There are two major drawbacks that human experts cannot effectively handle in this approach. One is the abundance of candidate reference markets to consider, and the other is the difficulty in calculating the similarity between markets. First, there can be too many markets to consider in selecting reference markets. Mostly, markets in the same category in an industrial hierarchy can be reference markets because they are usually based on the similar technologies. However, markets can be classified into different categories even if they are based on the same generic technologies. Therefore, markets in other categories also need to be considered as potential candidates. Next, even domain experts cannot consistently calculate the similarity between markets with their own qualitative standards. The inconsistency implies missing adjacent reference markets, which may lead to the imprecise estimation of future demand. Even though there are no missing reference markets, the new market's parameters can be hardly estimated from the reference markets without quantitative standards. For this reason, this study proposes a case-based expert system that helps experts overcome the drawbacks in discovering referential markets. First, this study proposes the use of Euclidean distance measure to calculate the similarity between markets. Based on their similarities, markets are grouped into clusters. Then, missing markets with the characteristics of the cluster are searched for. Potential candidate reference markets are extracted and recommended to users. After the iteration of these steps, definite reference markets are determined according to the user's selection among those candidates. Then, finally, the new market's parameters are estimated from the reference markets. For this procedure, two techniques are used in the model. One is clustering data mining technique, and the other content-based filtering of recommender systems. The proposed system implemented with those techniques can determine the most adjacent markets based on whether a user accepts candidate markets. Experiments were conducted to validate the usefulness of the system with five ICT experts involved. In the experiments, the experts were given the list of 16 ICT markets whose parameters to be estimated. For each of the markets, the experts estimated its parameters of growth curve models with intuition at first, and then with the system. The comparison of the experiments results show that the estimated parameters are closer when they use the system in comparison with the results when they guessed them without the system.

Jingfang's yaobian theory seen from Dasan Jeong Yagyong's view on the Book of Change. (다산역의 관점에서 본 경방의 효변설)

  • Bang, In
    • Journal of Korean Philosophical Society
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    • v.131
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    • pp.199-222
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    • 2014
  • This essay aims at clarifying Dasan Jeong Yagyong's view on Jingfang's yaobian theory. As is well known, Jingfang was a scholar of the Earlier Han period who exerted a profound influence on the theoretical development of Xiangshu School by creating the various techniques for interpreting the Zhouyi. Jingfang is also important in relation with Dasan's commentary of the Zhouyi, because some part of Dasan's interpreting techniques are thought to have their origin in Jinfang. For example, Dasan used the bigua theory of which the origin could be traced back into Jingfang. However, in this article, I did not deal with the bigua theory because I am going to write another article about it. In stead, my focus will be put on analyzing how Dasan evaluated Jingfang's yaobian theory. The main issues of my argument can be summarized as following. Firstly, in terms of yaobian, Jeong Yagyong called attention to Jingfang's annotation on the Zhouyi in which Jingfang utilized the yaobian method in three occasions, i.e., the first nine of the Qian(乾初九), the sixth nine of the Guan(觀上九), and the sixth nine of the Bo(剝上九). It seems that Jeong Yagyong set forth enough evidence about Jingfang's use of yaobian at least in relation to two cases of the first nine of the Qian and the sixth nine of the Bo, while the other evidence of the sixth nine of the Guan was not so persuasive. However, even if it is evident that Jingfang made use of the yaobain in two cases, there is no reason to equate it with that of Dasan. If one takes a close look, it becomes clear that Jingfang's way of yaobain is very different from Dasan's. Secondly, Jeong Yagyong mentioned Jiayi(賈誼) who lived about one hundred years before Jingfang, as the person who utilized the yaobian in his book of Xinshu(新書). If it is certain that Jiayi was aware of the yaobian, we can assume that the yaobian technique had been handed down from Jiayi to Jingfang. The manuscript excavated from the Mawangdui tomb also increases the possibility that Jiayi could have had the knowledge on the yaobian. In the chapter of Muhe(繆和) of the Mawangdui Zhouyi, there appears the phrase, i.e., "the first six of the qian, qian goes to mingyi," which shows exactly the same form of the yaobian in the Mr Zuo's Spring and Autumn Annals(春秋左氏傳). The burial period of Mawangdui tomb is estimated at the same year of B.C.168 in which Jiayi died. Therefore, judging from that fact, it becomes evident that the yaobain method was widely diffused around B.C.168. Subsequently, it is possible to infer that the yaobian method had been handed down from the period of Jiayi to Jingfang. If we could present the persuasive evidence to support that inference, it would also have the effect of consolidating Dasan's argument about the yaobian.

Profiles of microRNAs in Mice Follicles According to Gonadotropins during in vitro Culture (생쥐 난포의 체외배양 중 생식샘자극호르몬에 따른 미세리보핵산 발현 양상)

  • Kim, Yong-Jin;Ku, Seung-Yup;Kim, Yoon-Young;Oh, Sun-Kyung;Kim, Seok-Hyun;Choi, Young-Min;Moon, Shin-Yong
    • Clinical and Experimental Reproductive Medicine
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    • v.36 no.4
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    • pp.265-274
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    • 2009
  • Objective: MicroRNAs (miR) are known to repress target genes at post-transcriptional level and play important roles in development and maturation of cell. However, the expression profiles of miR during ovarian follicle maturation have not been fully elucidated. Here, we designed this study to investigate the expression profiles of miR in oocytes and granulose cells (G-cells) after in vitro culture according to gonadotropins and adding hCG. Methods: Ovaries from 12-day-old mice (C57BL6) were removed and preantral follicles were isolated and cultured in $20\;{\mu}L$-drop of culture media with supplementation of either rFSH, rLH, or rFSH+rLH. After their full maturation, follicles were incubated with rhCG and rEGF. RNA was isolated from oocytes and G-cells, and real-time PCR were performed with primers of miR known to be expressed in the mouse ovary (mmu-miR-16, -miR-27a, -miR-126, -miR-721). Results: FSH+LH group showed the highest ovulation and MII rates among gonadotropin groups. The profiles of miRs in oocytes and G-cells differed according to gonadotropin groups and adding hCG. The profiles of miRs showed divergent changes between oocytes and G-cells. Conclusion: miR expression profiles are altered by gonadotropins and supplementation of hCG during in vitro maturation of murine follicles. Target gene study must be necessary to validate these findings.