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Difference of Somatic Symptoms between Anxiety Disorder and Major Depressive Disorder and Their Domainal Association with Suicidal Idealization, Plan and Attempts (불안 장애와 주요우울장애에서 나타나는 신체 증상과 증상군에 따른 자살 사고, 계획, 행동과의 관계 고찰)

  • Ahn, Jun Seok;Kim, Eun young;Cho, Maeng Je;Hong, Jin Pyo;Hahm, Bong-Jin;Chung, In-Won;Ahn, Joon-Ho;Jeon, Hong Jin;Seong, Su Jeong;Lee, Dong-Woo
    • Korean Journal of Psychosomatic Medicine
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    • v.24 no.2
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    • pp.174-183
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    • 2016
  • Objectives : The aim of this study is to evaluate difference of somatic symptoms of anxiety disorder and major depressive disorder and domainal association with suicidal idealization, plan, and attempts. Methods : A total of 359 adults diagnosed with major depressive disorder and anxiety disorder of last one year participated. Participants interviewed with certain sections of Korean version of Composite International Diagnostic interview of CIDI. Sections of interests includes questionnaires regarding somatic symptoms and suicidal idea, plan and attempts of last one year. Results : Chest pain shows more prevalence in major depressive disorder. Symptoms of Headache and loose stool are more prevalent in anxiety disorder. Difficulty in equilibrium and fainting spells are more common somatic complaints of co-diagnosis states of anxiety disorder and major depressive disorder. Comparing 3 domains of pain symptoms, gastrointestinal symptoms and pseudo-neurological symptoms, pain symptom domains, gastrointestinal symptoms domain shows significant statistic difference between diagnosis. Average somatic symptom numbers of each symptom domains increase through suicidal idealization, plan and attempt, accordingly. Conclusions : Our finding shows some of somatic symptoms are more prevalent at certain diagnosis. Since increasing numbers of somatic complaints of each symptom domains goes with the suicidal idealization to suicidal attempts, proper psychiatric evaluation and consultations are crucial for patients with numerous somatic complaints in non-psychiatric clinical settings.

Prognostic Analysis of Drug-Eluting Balloon Catheter and Drug-Eluting Stent for In-Stent Restenosis of Drug-Eluting Stent (스텐트 재협착 병변에서 약물코팅 풍선카테터과 약물용출 스텐트의 예후 분석)

  • Lee, Doo Hwan;Song, Jong Nam;Park, Sin eui;Choi, Nam Gil;Han, Jae Bok;Kim, In Soo
    • Journal of the Korean Society of Radiology
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    • v.13 no.3
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    • pp.381-389
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    • 2019
  • Although the development of Drug-eluting stent (DES) improved the ISR significantly more than the Bare metal stent (BMS), the coronary stent restenosis (ISR) treatment still has a high recurrence rate. This study is compared the efficacy of DEB with that of DES implantation in patients with ISR. Among 4,316 patients who underwent coronary stent implantation at the Chonnam National University Hospital between November 2012 and December 2016, 187 patients developed ISR on follow-up coronary angiography ($66.3{\pm}11.0years$, 123 males) were enrolled and divided into two groups according to revascularization method as group I (DEB group; n=127) and group II (DES group; n=60). Primary end point was defined as major adverse cardiac events (MACEs), composite of cardiac death (CD), myocardial infaction (MI), target lesion revascularization (TLR) and stent thrombosis (ST) during two-year follow-up between the two groups. There were no differences in the baseline characteristics and angiographic findings except that prevalence of device length was shorter ($21.1{\pm}5.3$ vs. $25.3{\pm}9.6 mm$, p<0.002) in group I.Two-year MACE were not different in the two groups (8.7%vs.10.0%, p=0.789). The incidences of cardiac death (0%vs.0%, p=1.000), MI (1.6%vs.6.7%, p=0.085), TLR(8.7% vs. 10.0%, p=0.789) and ST (0% vs. 0%, p=1000). DEB demonstrated comparable risk reduction for MACEs compared with DES in patients with ISR during two-year follow-up. DEB might be good alternative for the treatment of ISR in patients with ISR.

Application of Automated Microscopy Equipment for Rock Analog Material Experiments: Static Grain Growth and Simple Shear Deformation Experiments Using Norcamphor (유사물질 실험을 위한 자동화 현미경 실험 기기의 적용과 노캠퍼를 이용한 입자 성장 및 단순 전단 변형 실험의 예)

  • Ha, Changsu;Kim, Sungshil
    • Economic and Environmental Geology
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    • v.54 no.2
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    • pp.233-245
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    • 2021
  • Many studies on the microstructures in rocks have been conducted using experimental methods with various equipment as well as natural rock studies to see the development of microstructures and understand their mechanisms. Grain boundary migration of mineral aggregates in rocks could cause grain growth or grain size changes during metamorphism or deformation as one of the main recrystallization mechanisms. This study suggests improved ways regarding the analog material experiments with reformed equipment to see sequential observations of these grain boundary migration. It can be more efficient than the existing techniques and carry out an appropriate microstructure analysis. This reformed equipment was implemented to enable optical manipulation by mounting polarizing plates capable of rotating operation on a stereoscopic microscope and a deformation rig capable of experimenting with analog materials. The equipment can automatically control the temperature and strain rate of the deformation rig by microcontrollers and programming and can take digital photomicrographs with constant time intervals during the experiment to observe any microstructure changes. The composite images synthesized using images by rotated polarizing plates enable us to see more accurate grain boundaries. As a rock analog material, norcamphor(C7H10O) was used, which has similar birefringence to quartz. Static grain growth and simple shear deformation experiments were performed using the norcamphor to verify the effectiveness of the equipment. The static grain growth experiments showed the characteristics of typical grain growth behavior. The number of grains decreases and the average grain size increases over time. These case experiments also showed a clear difference between the growth curves with three temperature conditions. The result of the simple shear deformation experiment under the medium temperature-low strain rate showed no significant change in the average grain size but presented the increased elongation of grain shapes in the direction of about 53° regarding the direction perpendicular to the shearing direction as the shear strain increases over time. These microstructures are interpreted as both the plastic deformation and the internal recovery process in grains are balanced by the deformation under the given experimental conditions. These experiments using the reformed equipment represent the ability to sequentially observe changing the microstructure during experiments as desired in the tests with the analog material during the entire process.

Text Mining of Successful Casebook of Agricultural Settlement in Graduates of Korea National College of Agriculture and Fisheries - Frequency Analysis and Word Cloud of Key Words - (한국농수산대학 졸업생 영농정착 성공 사례집의 Text Mining - 주요단어의 빈도 분석 및 word cloud -)

  • Joo, J.S.;Kim, J.S.;Park, S.Y.;Song, C.Y.
    • Journal of Practical Agriculture & Fisheries Research
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    • v.20 no.2
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    • pp.57-72
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    • 2018
  • In order to extract meaningful information from the excellent farming settlement cases of young farmers published by KNCAF, we studied the key words with text mining and created a word cloud for visualization. First, in the text mining results for the entire sample, the words 'CEO', 'corporate executive', 'think', 'self', 'start', 'mind', and 'effort' are the words with high frequency among the top 50 core words. Their ability to think, judge and push ahead with themselves is a result of showing that they have ability of to be managers or managers. And it is a expression of how they manages to achieve their dream without giving up their dream. The high frequency of words such as "father" and "parent" is due to the high ratio of parents' cooperation and succession. Also 'KNCAF', 'university', 'graduation' and 'study' are the results of their high educational awareness, and 'organic farming' and 'eco-friendly' are the result of the interest in eco-friendly agriculture. In addition, words related to the 6th industry such as 'sales' and 'experience' represent their efforts to revitalize farming and fishing villages. Meanwhile, 'internet', 'blog', 'online', 'SNS', 'ICT', 'composite' and 'smart' were not included in the top 50. However, the fact that these words were extracted without omission shows that young farmers are increasingly interested in the scientificization and high-tech of agriculture and fisheries Next, as a result of grouping the top 50 key words by crop, the words 'facilities' in livestock, vegetables and aquatic crops, the words 'equipment' and 'machine' in food crops were extracted as main words. 'Eco-friendly' and 'organic' appeared in vegetable crops and food crops, and 'organic' appeared in fruit crops. The 'worm' of eco-friendly farming method appeared in the food crops, and the 'certification', which means excellent agricultural and marine products, appeared only in the fishery crops. 'Production', which is related to '6th industry', appeared in all crops, 'processing' and 'distribution' appeared in the fruit crops, and 'experience' appeared in the vegetable crops, food crops and fruit crops. To visualize the extracted words by text mining, we created a word cloud with the entire samples and each crop sample. As a result, we were able to judge the meaning of excellent practices, which are unstructured text, by character size.

A Study on Differences of Opinions on Home Health Care Program among Physicians, Nurses, Non-medical personnel, and Patients. (가정간호 사업에 대한 의사, 간호사, 진료관련부서 직원 및 환자의 인식 비교)

  • Kim, Y.S.;Lim, Y.S.;Chun, C.Y.;Lee, J.J.;Park, J.W.
    • The Korean Nurse
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    • v.29 no.2
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    • pp.48-65
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    • 1990
  • The government has adopted a policy to introduce Home Health Care Program, and has established a three stage plan to implement it. The three stage plan is : First, to amend Article 54 (Nurses for Different Types of Services) of the Regulations for Implementing the Law of Medical Services; Second, to tryout the new system through pilot projects established in public hospitals and clinics; and third, to implement at all hospitals and equivalent medical institutions. In accordance with the plan, the Regulation has been amend and it was promulgated on January 9,1990, thus establishing a legal ground for implementing the policy. Subsequently, however, the Medical Association raised its objection to the policy, causing a delay in moving into the second stage of the plan. Under these circumstances, a study was conducted by collecting and evaluating the opinions of physicians, nurses, non-medical personnel and patients on the need and expected result from the home health care for the purpose of help facilitating the implementation of the new system. As a result of this study, it was revealed that: 1. Except the physicians, absolute majority of all other three groups - nurses, non-medical personnel and patients -gave positive answers to all 11 items related to the need for establishing a program for Home Health Care. Among the physicians, the opinions on the need for the new services were different depending on their field of specialty, and those who have been treating long term patients were more positive in supporting the new system. 2. The respondents in all four groups held very positive view for the effectiveness and the expected result of the program. The composite total of scores for all of 17 items, however, re-veals that the physicians were least positive for the- effectiveness of the new system. The people in all four groups held high expectation on the system on the ground that: it will help continued medical care after the discharge from hospitals; that it will alleviate physical and economic burden of patient's family; that it will offer nursing services at home for the patients who are suffering from chronic disease, for those early discharge from hospital, or those who are without family members to look after the patients at home. 3. Opinions were different between patients( who will receive services) and nurses (who will provide services) on the types of services home visiting nurses should offer. The patients wanted "education on how to take care patients at home", "making arrangement to be admitted into hospital when need arises", "IV injection", "checking blood pressure", and "administering medications." On the other hand, nurses believed that they can offer all 16 types of services except "Controlling pain of patients", 4. For the question of "what types of patients are suitable for Home Health Care Program; " the physicians, the nurses and non-medical personnel all gave high score on the cases of "patients of chronic disease", "patients of old age", "terminal cases", and the "patients who require long-term stay in hospital". 5. On the question of who should control Home Health Care Program, only physicians proposed that it should be done through hospitals, while remaining three groups recommended that it should be done through public institutions such as public health center. 6. On the question of home health care fee, the respondents in all four groups believed that the most desireable way is to charge a fixed amount of visiting fee plus treatment service fee and cost of material. 7. In the case when the Home Health Care Program is to be operated through hospitals, it is recommended that a new section be created in the out-patient department for an exclusive handling of the services, instead of assigning it to an existing section. 8. For the qualification of the nurses for-home visiting, the majority of respondents recommended that they should be "registered nurses who have had clinical experiences and who have attended training courses for home health care". 9. On the question of if the program should be implemented; 74.0% of physicians, 87.5% of non-medical personnel, and 93.0% of nurses surveyed expressed positive support. 10. Among the respondents, 74.5% of -physicians, 81.3% of non-medical personnel and 90.9% of nurses said that they would refer patients' to home health care. 11. To the question addressed to patients if they would take advantage of home health care; 82.7% said they would if the fee is applicable to the Health Insurance, and 86.9% said they would follow advises of physicians in case they were decided for early discharge from hospitals. 12. While 93.5% of nurses surveyed had heard about the Home Health Care Program, only 38.6% of physicians surveyed, 50.9% of non-medical personnel, and 35.7% of patients surveyed had heard about the program. In view of above findings, the following measures are deemed prerequisite for an effective implementation of Home Health Care Program. 1. The fee for home health care to be included in the public health insurance. 2. Clearly define the types and scope of services to be offered in the Home Health Care Program. 3. Develop special programs for training nurses who will be assigned to the Home Health Care Program. 4. Train those nurses by consigning them at hospitals and educational institutions. 5. Government conducts publicity campaign toward the public and the hospitals so that the hospitals support the program and patients take advantage of them. 6. Systematic and effective publicity and educational programs for home heath care must be developed and exercises for the people of medical professions in hospitals as well as patients and their families. 7. Establish and operate pilot projects for home health care, to evaluate and refine their programs.

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Ensemble Learning with Support Vector Machines for Bond Rating (회사채 신용등급 예측을 위한 SVM 앙상블학습)

  • Kim, Myoung-Jong
    • Journal of Intelligence and Information Systems
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    • v.18 no.2
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    • pp.29-45
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    • 2012
  • Bond rating is regarded as an important event for measuring financial risk of companies and for determining the investment returns of investors. As a result, it has been a popular research topic for researchers to predict companies' credit ratings by applying statistical and machine learning techniques. The statistical techniques, including multiple regression, multiple discriminant analysis (MDA), logistic models (LOGIT), and probit analysis, have been traditionally used in bond rating. However, one major drawback is that it should be based on strict assumptions. Such strict assumptions include linearity, normality, independence among predictor variables and pre-existing functional forms relating the criterion variablesand the predictor variables. Those strict assumptions of traditional statistics have limited their application to the real world. Machine learning techniques also used in bond rating prediction models include decision trees (DT), neural networks (NN), and Support Vector Machine (SVM). Especially, SVM is recognized as a new and promising classification and regression analysis method. SVM learns a separating hyperplane that can maximize the margin between two categories. SVM is simple enough to be analyzed mathematical, and leads to high performance in practical applications. SVM implements the structuralrisk minimization principle and searches to minimize an upper bound of the generalization error. In addition, the solution of SVM may be a global optimum and thus, overfitting is unlikely to occur with SVM. In addition, SVM does not require too many data sample for training since it builds prediction models by only using some representative sample near the boundaries called support vectors. A number of experimental researches have indicated that SVM has been successfully applied in a variety of pattern recognition fields. However, there are three major drawbacks that can be potential causes for degrading SVM's performance. First, SVM is originally proposed for solving binary-class classification problems. Methods for combining SVMs for multi-class classification such as One-Against-One, One-Against-All have been proposed, but they do not improve the performance in multi-class classification problem as much as SVM for binary-class classification. Second, approximation algorithms (e.g. decomposition methods, sequential minimal optimization algorithm) could be used for effective multi-class computation to reduce computation time, but it could deteriorate classification performance. Third, the difficulty in multi-class prediction problems is in data imbalance problem that can occur when the number of instances in one class greatly outnumbers the number of instances in the other class. Such data sets often cause a default classifier to be built due to skewed boundary and thus the reduction in the classification accuracy of such a classifier. SVM ensemble learning is one of machine learning methods to cope with the above drawbacks. Ensemble learning is a method for improving the performance of classification and prediction algorithms. AdaBoost is one of the widely used ensemble learning techniques. It constructs a composite classifier by sequentially training classifiers while increasing weight on the misclassified observations through iterations. The observations that are incorrectly predicted by previous classifiers are chosen more often than examples that are correctly predicted. Thus Boosting attempts to produce new classifiers that are better able to predict examples for which the current ensemble's performance is poor. In this way, it can reinforce the training of the misclassified observations of the minority class. This paper proposes a multiclass Geometric Mean-based Boosting (MGM-Boost) to resolve multiclass prediction problem. Since MGM-Boost introduces the notion of geometric mean into AdaBoost, it can perform learning process considering the geometric mean-based accuracy and errors of multiclass. This study applies MGM-Boost to the real-world bond rating case for Korean companies to examine the feasibility of MGM-Boost. 10-fold cross validations for threetimes with different random seeds are performed in order to ensure that the comparison among three different classifiers does not happen by chance. For each of 10-fold cross validation, the entire data set is first partitioned into tenequal-sized sets, and then each set is in turn used as the test set while the classifier trains on the other nine sets. That is, cross-validated folds have been tested independently of each algorithm. Through these steps, we have obtained the results for classifiers on each of the 30 experiments. In the comparison of arithmetic mean-based prediction accuracy between individual classifiers, MGM-Boost (52.95%) shows higher prediction accuracy than both AdaBoost (51.69%) and SVM (49.47%). MGM-Boost (28.12%) also shows the higher prediction accuracy than AdaBoost (24.65%) and SVM (15.42%)in terms of geometric mean-based prediction accuracy. T-test is used to examine whether the performance of each classifiers for 30 folds is significantly different. The results indicate that performance of MGM-Boost is significantly different from AdaBoost and SVM classifiers at 1% level. These results mean that MGM-Boost can provide robust and stable solutions to multi-classproblems such as bond rating.

The Spatial Disparity of Opportunity Potentials in Korea (한국 도시의 경제 $\cdot$ 문화 $\cdot$ 사회 복지적 기회 잠재력의 지역적 격차)

  • Choi, Yoon-Jeong;Lee, Keumsook
    • Journal of the Economic Geographical Society of Korea
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    • v.8 no.1
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    • pp.91-105
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    • 2005
  • The assessment (or the evaluation) of spatial disparity is the main concern for the study of spatial disparities or spatial inequalities. In order to evaluate the spatial disparity, the regional differences have to be counted quantitatively. Several measurements have been introduced for evaluating the development potentials of each region. Most of them are the composite indices of the socio-economic variables rather than the real potentials of the region. This study attempts to investigate the spatial disparity in Korea. For the purpose, the levels of opportunity potentials of the cities have been calculated by the Potential Model redefined by Lee(1995). The opportunity potentials have been calculated for the educational, cultural, medical service, environmental sectors, income, and consumption sectors, and the spatial patterns of various opportunity potentials have been analyzed. The spatial patterns of opportunity potentials show the severe concentration on the Metropolitan Seoul area through all sectors. The next level concentration appears at the other end of the Keuyng-Bu axis. And the cities relatively high opportunity potential values are distributed along the Keuyng-Bu axis. Remain parts of the country show quietly low opportunity potential values. In particular, the southern-west and the northern-east parts show relatively very low values. This pattern appears for all sectors except for the opportunity potential of the environmental sector. It means that the spatial disparity in Korea have been promoted and enhanced by the national development policies concentrated the investment on the large cities along the Keuyng-Bu axis during the last 40 years.

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Effect of Heat-Moisture Treatment of Domestic Rice Flours Containing Different Amylose Contents on Rice Noodle Quality (아밀로오스 함량이 다른 국내산 쌀가루의 수분-열처리가 쌀국수 품질에 미치는 영향)

  • Seo, Hye-In;Ryu, Bog-Mi;Kim, Chang-Soon
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.40 no.11
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    • pp.1597-1603
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    • 2011
  • The influence of heat-moisture treatment (HMT) and substitution of rice flour containing different amylose contents on the quality characteristics of rice noodles was investigated. HMT was applied to rice flours with 21% moisture content at 100 and 105$^{\circ}C$ for 30 min. Three rice cultivars were used, including high amylose of Goami (GM) and intermediate amylose of Choochung (CC) as domestic rice flours and imported rice of Taeguk (TG) as a control. HMT and substitution of rice flour with different amylose contents affected the cooking and texture quality of rice noodles. When rice noodles were made of intermediate amylose rice flour with HMT, cooking properties improved with decreased cooking loss and cooking water turbidity and thus were closer to those of control. Especially, the hardness, adhesiveness, tensile strength, and darkness of rice noodles notably increased when HMT rice flour was used. Based on the results of quantitative descriptive analysis for selected rice noodles, the noodles made of HMT CC at 105$^{\circ}C$ (CC105) had high scores for resilience and adhesiveness and low scores for hardness compared with imported commercial rice noodles and other experimental noodles such as TG, HMT GM100, TG+CC, and TG+CC105. In conclusion, rice noodles were made of composite flours containing high amylose and intermediate amylose contents or HMT intermediate amylose content rice flour.

Assessment of Metabolic Impairment in Alzheimer's Disease with [$^{18}F$]FDG PET: Validity and Role of Simplified Tissue Radioactivity Ratio Analysis (알쯔하이머병에서 양전자방출단층촬영을 이용한 국소뇌포도당대사의 변화에 관한 연구)

  • Kim, Sang-Eun;Na Duk-Lyul;Lee, Jeong-Rim;Choi, Yong;Lee, Kyung-Han;Choe Yearn-Seong;Kim, Doh-Kwan;Kim, Byung-Tae;Lee, Kwang-Ho;Kim, Seung-Tai P.
    • The Korean Journal of Nuclear Medicine
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    • v.30 no.3
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    • pp.299-314
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    • 1996
  • The purpose of the present study was to validate the use of tissue radioactivity ratios instead of regional metabolic rates for the assessment of regional metabolic changes in Alzheimer's disease(AD) with [$^{18}F$]FDG PET and to examine the correlation of ratio indices with the severity of cognitive impairment in AD. Thirty-seven AD Patients(age $68{\pm}9 yrs$, $mean{\pm}s.d.$; 36 probable and 1 definite AD), 28 patients with dementia of non-Alzheimer type(age $66{\pm}7 yrs$), and 17 healthy controls(age $66{\pm}4 yrs$) underwent [$^{18}F$]FDG PET imaging. Two simplified radioactivity ratio indices were calculated from 37-66 min image: region-to-cerebellar radioactivity ratio(RCR) and a composite radioactivity ratio(a ratio of radioactivity in the most typically affected regions over the least typically affected regions: CRR). Local cerebral metabolic rate for glucose(LCMRglu) was also measured using a three-compartment, five-parameter tracer kinetic model. The ratio indices were significantly lower in AD patients than in controls(RCR in temporoparietal cortex, $0.949{\pm}0.136$ vs. $1.238{\pm}0.129$, p=0.0004; RCR in frontal cortex, $1.027{\pm}0.128$ vs. $1.361{\pm}0.151$, p<0.0001; CRR, $0.886{\pm}0.096$ vs. $1.032{\pm}0.042$. p=0.0024). On the RCR analysis, 86% of AD patients showed a pattern of bilateral temporoparietal hypometabolism with or without frontal involvement; hypometabolism was unilateral in 11% of the patients. When bilateral temporoparietal hypometabolism was considered to be suggestive of AD, the sensitivity and specificity of the RCR analysis for the differential diagnosis of AD were 86% and 73%, respectively. The RCR was correlated significantly with the macroparameter K [$K_1k_3/(k_2+k_3)$] (r=0.775, p<0.0001) and LCMRglu(r=0.633, p=0.0002) measured using the kinetic model. In patients with AD, both average RCR of cortical association areas and CRR were correlated with Mini-Mental Status Examination(r=0.565, p=0.0145; r=0.642, p=0.0031, respectively), Clinical Dementia Rating(r=-0.576, p=0.0124; r=-0.591, p=0.0077), and total score of Mattis Dementia Rating Scale (r=0.574, p=0.0648; r=0.737, p=0.0096). There were also significant correlations between memory and language impairments and corresponding regional RCRs. The results suggest that the [$^{18}F$]FDG PET ratio indices, RCR and CRR, reflect global and regional metabolic rates and correlate with the severity of cognitive impairment in AD. The simplified ratio analysis may be clinically useful for the differential diagnosis and serial monitoring of the disease.

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Effect of Cardiotonic Pills$^{(R)}$ on Chest Pain and Discomfort: A Multi-center Double-blind Randomized Controlled Trial. (심적환$^{(R)}$이 흉통 흉민에 대하여 미치는 영향에 대한 다기관 무작위배정 이중맹검 임상연구)

  • Jang Insoo;Ko Changnam;Lee In;Park Jung-mi;Kim Sehyun;Kim Sangwoo
    • The Journal of Korean Medicine
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    • v.26 no.2 s.62
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    • pp.95-104
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    • 2005
  • Objectives: This was a double blinded, randomized, placebo-controlled clinical study for evaluation of safety and effective dose finding of Cardiotonic Pills$^{(R)}$ in patients with chest pain and discomfort. Cardiotonic Pills$^{(R)}$ are composed of Salviae Miltiorrhizae Radix (丹蔘), Notoginseng Radix (三七根) and Borneolum (龍腦). Major effects of Salviae Miltiorrhizae Radix and Notoginseng Radix are vasodilatation, sedation and analgesic action. Borneolum has an antibacterial effect, and can stimulate the central nervous system. All of these substances are oriental herbs that have been used for a long time in east Asia. Cardiotonic Pills fi received Investigational New Drug (IND) approval from the Food and Drug Administration (FDA) in the USA and 40 million people in the world take this pill. We performed a phase IV clinical study to confirm its efficacy and safety in patients who have probable cardiogenic or psychogenic chest pain or chest stifling. Methods: This study was planned for a multi-center clinical trial including four university hospitals of oriental medicine in Korea. This was the first time to evaluate the 'planning treatment according to diagnosis (辨證施治)' of chest pain or chest discomfort according to oriental medical guidelines. The patients who were included in this trial were adult volunteers from 20 to 70 years old who had chest pain or chest discomfort more than twice during a recent month, and we received written consent to participate in this study from all of them. After administration of Cardiotonic Pills$^{(R)}$ for 8 weeks, number of occurrences, duration, appearance and degree of chest pain or chest discomfort was observed and degree of symptoms (severity of illness, global improvement) were measured using a patient's global assessment composite scale. Results: In the patient's global assessment scale, the severity of illness of the Cardiotonic Pills$^{(R)}$ group (n=25) was 14/25=0.56 but of the placebo group (n=25) was 7/25=0.28 (p-value=0.0449). This result indicates Cardiotonic Pills$^{(R)}$have a positive effect on the symptoms of chest pain and discomfort. However, the global improvement of the Cardiotonic Pills$^{(R)}$group was 23/25=0.92, and of the placebo group was 22/25=0.88 (p-value=0.6374). The total symptom score of the Cardiotonic Pills$^{(R)}$ group was $1.68\pm20.06$, and of the placebo group was $16.76\pm72.l4$(p-value=0.2285). The number of symptom events of the Cardiotonic Pills$^{(R)}$ group was $72\pm29.78$, and of the placebo group (n=25) was $10.80\pm38.42$ (p­value=0.3660). We could not find any effects on the other factors examined besides the severity of illness, beyond the difference of standard deviations. Conclusions: Cardiotonic Pills$^{(R)}$ significantly reduced chest pain and chest discomfort in patients. Therefore, we expect that Cardiotonic Pills$^{(R)}$ will be helpful for patients with chest pain and chest discomfort not only caused by heart disease but also by other diseases.

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