• 한국응급구조학회지
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• 제13권3호
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• pp.71-76
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• 2009

서론(Introduction) : 의학 시뮬레이션(medical simulation)은 교육생 학습과정에서 내재된 위험이 환자에게 가해짐 없이 교육생이 실제적인 환자 상황을 경험할 수 있게 하고 여러 다양한 임상내용이 포함한 상황에 적용될 수 있다. 시뮬레이션 기술의 사용은 의학교육(medical education), 인증서(certification), 면허교부(Licensure)와 의료의 질 형성에 큰 잠재력을 가지고 있다. 복강경 수술, 내시경검사, 전문심장구조술, 응급기도관리와 외상소생을 포함한 다양한 임상시술의 수행에서 시뮬레이션이 교육생의 술기를 달성하고, 측정하고, 유지하는 유효성을 증명하였다 컴퓨터로 조절되는 시뮬레이터는 맥박, 혈압, 호흡, 대화가 가능하고, 중증질환 또는 외상환자의 치료에 필요한 같은 인명구조 시술을 수행할 수 있다. 의학 시뮬레이션은 의사, 간호사, 응급구조사와 응급 진료를 필요로 하는 환자를 치료하는 사람에게 필요하다. 최신 전문심장구조술 과정수업은 전통적인 강의와 제한된 팀 상호작용이 포함된 이틀 과정이다. 우리는 비 영어권 국제 응급구조학생의 전문심장구조술 술기능력을 알아보고, 그것을 미국 응급구조학생과 비교하고자 한다. 목적(Objective) : 이 연구의 목적은 다양한 전문심장구조술 증례 시나리오를 가진 의학 시뮬레이터를 이용하여 미국과 한국의 응급구조 학생의 능력을 비교하는 것이다. 시행 장소(Site Location) : 이 연구는 한국 제주도에 위치한 제주한라대학 스토니브룩 응급의료교육원에서 진행되었다. 학생들의 평가는 스토니브룩에 위치한 스토니브룩 대학 의료원의 한 명의 평가자(Dr. lee)에 의해 수행되었다. 방법(Methods) : 15명의 한국 응급구조학생들은 세 팀으로 무작위로 선정하였다. 5명이 한 팀이 되어 같은 증례의 시나리오를 받았다. 세 가지 시나리오는 : 첫째, 천식지속상태(Status asthmaticus), 둘째, 긴장기흉을 동반한 만성폐쇄성폐질환(COPD with tension penumothorax) 그리고 마지막으로 메가코드(megacode)를 가진 심정지 이다. 세 팀을 각각 그리고 기본인명구조술(BLS)과 전문심장구조술(ACLS)과정을 마친 미국 응급구조학생들과 비교하였다. 15명의 미국 응급구조학생들 또한 세 팀으로 무작위로 선정하였다. 이 응급구조 학생들은 플러싱병원 의료원 소속으로 그곳에서 이 연구에 참여할 뿐만 아니라 지속적인 의학교육(CME)이수를 받았다. 이들에게도 같은 세 가지 증례의 시나리오가 주어졌고 Dr lee는 총 여섯 팀을 평가하였다(한국 세 팀과 미국 세팀). 결과(Results) : 양 국가의 모든 15명의 학생이 의학시뮬레이터를 사용하여 전문심장구조술 메가코드시험을 포함한 시험에 모두 통과하였다. 비록 학생들을 무작위로 세 팀으로 나누었지만 한 팀이 이 모든 세 증례에서 다른 팀보다 뛰어났다. 제주한라대학 2번 팀은 더 나은 기도관리, 리듬인식과 임상술기를 가진 모든 중요한 활동을 얻기에서 우수했다. 그들은 핵심요구사항을 90% 이상 충족시겼다. 한국의 2번팀(G2K)은 메가코드에서 기도개방, 호흡평가, 순환징후 그리고 흉부압박수와 같은 신체검진 술기에서도 탁월했다. 게다가 다른 팀과 비교 시 리듬인식, 약물지식과 임상술기에서도 높은 점수를 받았으며 2번팀(G2K)이 6팀 중에 가장 뛰어나게 역활수행을 하였다. 결론(Conclusion) : 이 비교 연구에서 한국학생과 미국학생간에 전문심장구조술 메가코드 시험의 통과율에는 차이가 없었다. 그러나 미국학생은 세 팀 사이에 더 적은 변이로 더 일괄된 점수를 받았다. 한국학생들도 모든 세 가지 증례를 통과하였지만 이 세 팀은 미국학생 팀보다 점수에서 더 큰 변이를 보였다.

• IMMUNE NETWORK
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• 제23권2호
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• pp.17.1-17.16
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• 2023

Latent membrane protein 2A (LMP2A), a latent Ag commonly expressed in Epstein-Barr virus (EBV)-infected host cells, is a target for adoptive T cell therapy in EBV-associated malignancies. To define whether individual human leukocyte antigen (HLA) allotypes are used preferentially in EBV-specific T lymphocyte responses, LMP2A-specific CD8⁺ and CD4⁺ T cell responses in 50 healthy donors were analyzed by ELISPOT assay using artificial Ag-presenting cells expressing a single allotype. CD8⁺ T cell responses were significantly higher than CD4⁺ T cell responses. CD8⁺ T cell responses were ranked from highest to lowest in the order HLA-A, HLA-B, and HLA-C loci, and CD4⁺ T cell responses were ranked in the order HLA-DR, HLA-DP, and HLA-DQ loci. Among the 32 HLA class I and 56 HLA class II allotypes, 6 HLA-A, 7 HLA-B, 5 HLA-C, 10 HLA-DR, 2 HLA-DQ, and 2 HLA-DP allotypes showed T cell responses higher than 50 spot-forming cells (SFCs)/5×105 CD8⁺ or CD4⁺ T cells. Twenty-nine donors (58%) showed a high T cell response to at least one allotype of HLA class I or class II, and 4 donors (8%) had a high response to both HLA class I and class II allotypes. Interestingly, we observed an inverse correlation between the proportion of LMP2A-specific T cell responses and the frequency of HLA class I and II allotypes. These data demonstrate the allele dominance of LMP2A-specific T cell responses among HLA allotypes and their intra-individual dominance in response to only a few allotypes in an individual, which may provide useful information for genetic, pathogenic, and immunotherapeutic approaches to EBV-associated diseases.

• Clinical and Experimental Reproductive Medicine
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• 제36권1호
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• pp.23-34
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• 2009

목 적: 중간엽 줄기세포를 임상에 적용하기 위해서는 체외 배양을 통한 세포증식 과정이 필요하나, 오랜 기간 동안 체외 배양을 하게 되면 노화되어 특성이 변하고 분화 능력 또한 감소하게 된다. 따라서 현재까지는 초기 계대배양의 세포만이 임상에 적용되고 있는 실정이며 체외에서의 세포 배양이 세포의 특성에 미치는 영향에 대한 연구와 함께 세포의 특성 변화 없이 체외증식이 가능하도록 하는 연구들이 골수 및 지방유래 중간엽 줄기세포에서 보고되고 있다. 그러나 현재 탯줄유래 줄기세포의 체외 배양에 따른 특성 변화 분석 연구는 아직 잘 이루어지지 않고 있다. 본 연구의 목적은 탯줄유래 줄기세포의 체외 배양 시 계대배양 증가에 따른 줄기세포의 특성 변화를 분석하고자 하였다. 연구방법: 사람의 탯줄유래 줄기세포 (human umbilical cord-derived stem cells, HUC)를 분리하여 in vitro에서 계대배양하였다. 계대배양에 따른 세포의 형태와 population doubling time (PDT)을 조사하고 RT-PCR 방법을 이용하여 mRNA 분석을 하였으며 면역세포화학 염색법을 이용하여 단백질 발현을 분석하였다. 결 과: 탯줄유래 줄기세포는 평균 10번의 계대배양 후 senescence를 나타냈다. 세포의 형태는 7번째 계대배양 이후 세포질이 넓어지고 세포의 크기가 커지는 변화를 나타냈으며 PDT가 증가하기 시작하였다. 계대배양 4, 8, 10번째 시기의 세포의 mRNA 변화를 분석한 결과 Oct-4, HNF-4${\alpha}$, mRNA는 10번째 계대배양까지 지속적으로 발현하였으나 nestin, vimentin mRNA는 지속적으로 발현이 감소하였고 SCF mRNA는 지속적으로 발현이 감소하였다. 이에 반해 HLA-DR${\alpha}$, Pax-6, BMP-2 mRNA는 모든 계대배양 시기의 세포에서 발현되지 않았다. 면역세포화학 분석법을 통한 3, 6, 9번째 계대배양 세포의 단백질 발현 분석 결과 SSEA-3와 SSEA-4는 3, 6, 9번째 계대배양 세포 모두에서 발현하였으나 ICAM-1과 HLA-ABC는 계대배양이 증가함에 따라 발현이 증가되었다. Thy-1 단백질은 p9에서 발현이 증가되었으며 이와 반대로 TRA-1-60와 VCAM-1 단백질은 p6과 p9 시기에 발현이 감소되었다. HLA-DR 단백질은 모든 계대배양 시기에 발현되지 않았다. 결 론: 본 연구결과 탯줄유래 줄기세포는 체외 배양 시 줄기세포 특성이 일부 변하는 것을 관찰하였다. 앞으로 줄기세포의 특성을 유지할 수 있는 체외 배양법의 발달을 위한 연구들이 수행 되야 할 것으로 사료된다.

• 한국발생생물학회지:발생과생식
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• 제17권4호
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• pp.345-351
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• 2013

This study examines the effects on fertilization rate (FR), hatching rate (HR), and normal individual rate after artificial fertilization using frozen thawed sperm according to the cryoprotectant (DMSO) concentration and the period of cryopreserved sperm of longtooth grouper, Epinephelus bruneus. Performing artificial fertilization using frozen-thawed sperm, after freezing the sperm at different DMSO concentration of 5.0%, 7.5%, 10.0% respectively, FR were (DMSO 5.0%: $99.5{\pm}0.8%$, DMSO 7.5%: $99.5{\pm}0.7%$, and DMSO 10.0%: $99.6{\pm}0.6%$). The results are not significantly different from the control fresh sperm (100%). HR also (DMSO 5.0%: $96.2{\pm}2.3%$, DMSO 7.5%: $95.3{\pm}3.6%$, 10.0%: $96.6{\pm}1.8%$) were not significantly different in each group. The normal individual rate after hatching using with control fresh sperm ($98.4%{\pm}0.5$) and DMSO concentration level of 5.0% ($97.8{\pm}0.1%$) were not significantly different. However, with 7.5% ($97.2{\pm}0.6%$) and 10.0% DMSO concentrations ($95.9{\pm}0.2%$) are lower than the normal individual rate after hatching observed in the control and 5.0% DMSO. Performing artificial fertilization using frozen-thawed sperm at different frozen period (2 days, 2 years, and 3 years), 10% DMSO FR and HR of 3 years (FR; $66.8{\pm}1.8%$, HR: $82.0{\pm}12.9%$) and 2 years (FR; $78.5{\pm}14.8%$, HR: $79.3{\pm}0.6%$) cryopreserved sperm were lower than control (FR; 100%, HR: $91.1{\pm}3.6%$) and 2 days cryopreserved sperm (FR; $99.6{\pm}0.6%$, HR: $96.6{\pm}1.8%$). These results suggest suitable DMSO concentration ranges of cryopreservation sperm for E. bruneus is 5 to 10% and with 2 to 3 years cryopreservation period, cryopreservation sperm can be useful for seed production.

• Asian Pacific Journal of Cancer Prevention
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• 제17권4호
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• pp.1909-1915
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• 2016

Background: The purpose of this study was to determine the benefit of tertiary cytoreductive surgery (TC) for secondary recurrent epithelial ovarian cancer (EOC), focusing on whether optimal cytoreduction has an impact on disease-free survival, and whether certain patient characteristics could identify ideal candidates for TC. Materials and Methods: Retrospective analysis of secondary recurrent EOC patients undergoing TC at three Turkish tertiary institutions from May 1997 to July 2014 was performed. All patients had previously received primary cytoreduction followed by intravenous platinum-based chemotherapy and secondary cytoreduction for first recurrence. Clinical and pathological data were obtained from the patients' medical records. Survival analysis was caried out using the Kaplan Meier method. Actuarial curves were compared by the two tailed Logrank test with a statistical significance level of 0.05. Results: Median age of the patients was 49.6 years (range, 30-67) and thirty-eight (72%) had stage III-IV disease at initial diagnosis. Twenty six (49%) had optimal and 27 (51%) suboptimal cytoreduction during tertiary debulking surgery. Optimal initial cytoreduction, time to first recurrence, optimal secondary cytoreduction, time interval between secondary cytoreduction and secondary recurrence, size of recurrence, disease status at last follow-up were found to be significant risk factors to predict optimal TC. Optimal cytoreduction in initial and tertiary surgery and serum CA-125 level prior to TC were independent prognostic factors on univariate analysis. Conclusions: Our results and a literature review clearly showed that maximal surgical effort should be made in TC, since patients undergoing optimal TC have a better survival. Thus, patients with secondary recurrent EOC in whom optimal cytoreduction can be achieved should be actively selected.

• 인터넷정보학회논문지
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• 제16권6호
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• pp.57-67
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• 2015

This paper proposes an Fuzzy-based Risk Reasoning Driving Strategy on VANET. Its first reasoning phase consists of a WC_risk reasoning that reasons the risk by using limited road factors such as current weather, density, accident, and construction, a DR_risk reasoning that reasons the risk by combining the driving resistance with the weight value suitable for the environment of highways and national roads, a DS_risk reasoning that judges the collision risk by using the travel direction, speed. and distance of vehicles and pedestrians, and a Total_risk reasoning that computes a final risk by using the three above-mentioned reasoning. Its second speed reduction proposal phase decides the reduction ratio according to the result of Total_risk and the reduction ratio by comparing the regulation speed of road to current vehicle's speed. Its third risk notification phase works in case current driving speed exceeds regulation speed or in case the Total_risk is higher than AV(Average Value). The Risk Notification Phase informs rear vehicles or pedestrians around of a risk according to drivers's response. If drivers use a brake according to the proposed speed reduction, the precedent vehicles transfers Risk Notification Messages to rear vehicles. If they don't use a brake, a current driving vehicle transfers a Risk Message to pedestrians. Therefore, this paper not only prevents collision accident beforehand by reasoning the risk happening to pedestrians and vehicles but also decreases the loss of various resources by reducing traffic jam.

• Archives of Plastic Surgery
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• 제33권5호
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• pp.592-600
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• 2006

Purpose: Numerous materials, both autologous and nonautologous, have been used for augmentation of sunken areas, but they have their own limitations. The purpose of this study is to determine the histologic response and volume change of the xenogenic collagen-based scaffold($Terudermis^{(R)}$) to the transfer into a subcutaneous soft tissue location in vivo rabbit model. Methods: Eighteen New Zealand white rabbits were used. Three $1.2{\times}1.2cm$ sized subcutaneous pockets were created on the dorsal surface of each ear. $1{\times}1cm$ sized collagen matrix($Terudermis^{(R)}$) and autologous dermal graft were implanted into each pocket. Full thickness of ear was harvested in 3 days, 1, 2, 4 weeks, 3, 6 months after implantation. Results: Histological analysis of implants demonstrated progressive neovascularization, fibroblast infilteration, neocollagen bundle synthesis and organization, and few foreign body reaction. The thickness of the collagen matrix in 3 days after the operation was 87.69% of the thickness of the collagen matrix in wet state. Then it decreased to 30.17% in 6 months after the operation. The rate of decrease was similar at all points at the same time compared with autologous dermal graft. Conclusion: Our experimental study suggests that $Terudermis^{(R)}$ could be a safe material as an implant for permanent augmentation in subcutaneous tissue. However the choice of graft for augmentation should be remained to the clinical situations.

• 한국발생생물학회지:발생과생식
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• 제22권3호
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• pp.245-252
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• 2018

To improve survival rates of vitrified pig oocytes, the treatment of cytoskeletal stabilizer on an appropriate time is one of the possible approaches. However, the exact treatment timing and effect of cytoskeletal stabilizer such as cytochalasin B (CB) is not well known during oocyte vitrification procedures. Thus, the present study was conducted to determine optimal treatment timing of CB during vitrification and warming procedures. In experiment 1, the survival rates of the postwarming pig oocytes were analyzed by fluorescein diacetate (FDA) assays with 4 classifications. In results, post-warming oocytes showed significantly (p<0.05) decreased number of alive oocytes (31.8% vs. 86.4%) compared to fresh control. In detail, the significant difference (p<0.05) was found only in strong fluorescence (18.2% vs. 70.5%) not in intermediate fluorescence groups (13.6% vs. 15.9%). In experiment 2, CB was treated before (CB-Vitri) and after (Vitri-CB) vitrification. In results, group of Vitri-CB showed significantly (p<0.05) higher (91.6%) survival rates compared to group of CB-Vitri (83.7%), significantly (p<0.05) and comparable with group of Vitri Control (88.7%) by morphological inspection. In FDA assay results, group of Vitri-CB showed significantly (p<0.05) higher (44.2%) survival rates compared to groups of CB-Vitri (36.7%) and Vitri Control (35.1%). In conclusion, the increased survival rates of post-warming pig oocyte treated with Vitri-CB method are firstly described here. The main finding of present study is that the CB treatment during recovery could be helpful to refresh the post-warming pig oocyte resulting its improved survival rates.

• 한국발생생물학회지:발생과생식
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• 제24권1호
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• pp.19-30
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• 2020

The pH of water is one of the main environmental factors exerting selective pressure on marine and freshwater organisms. Here, we focus on the influence of pH on an organism's ability to maintain homeostasis and investigate the effects of acidification on immunity-related genes and osmotic pressure during early development of the olive flounder, Paralichthys olivaceus. The aim of our study was to determine the influence of various pH levels on the fertilized eggs and larvae of P. olivaceus. Gametes of P. olivaceus were artificially introduced and the resulting fertilized eggs were incubated at pH 4.0 (low), 6.0, and 8.0 (equivalent to natural sea water; control). We found that all eggs sank from the water column at pH 4.0. After 38 h, these eggs showed slow development. Hatching occurred more slowly at pH 4.0 and 6.0 and did not occur at all at pH 4.0. Result of gene expression, caspase and galectin-1 were expressed from the blastula to pre-hatch stages, with the exception of the two-cell stage. HSP 70 was also steadily expressed at all pH levels over the five days. The osmolality of fertilized eggs differed marginally at each stage and across pH levels. So, this results demonstrates that low pH level is detrimental to P. olivaceus fertilized eggs.

• 대한한의학회지
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• 제27권2호
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• pp.244-252
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• 2006

Objectives : To examine any potential relationships between the types of alopecia and the facial heat distribution in patients with alopecia. Methods : 183 patients with alopecia participated in this study to provide facial heat distribution measured by the Infrared Thermography Scanner (ITS, Nec San-ei Instruments Ltd, Japan). The thermography scan was used in a light- and heat-protected room after 20 minutes' of rest. 1.5m of distance was maintained between the patients and the scanner. Results : Specificity in the type of facial heat distribution was found as follow. 1. Types of facial heat distribution can be classified as T-type and diffused patterns. 2. There was a significant difference in the pattern of facial heat distribution among different types of alopecia (p=0.002): facial heat distribution appeared T-type in androgenic alopecia, alopecia areata, and telogen effluvium (71.3%, 85.7%, 70.4%), whereas diffused pattern was dominant in seborrheic alopecia (55.6%). 3. There was a significant difference in the pattern of facial heat distribution between men and women (p<0.001) : While the T-type and diffused type appeared equally in men (50.6% : 49.4%), T-type was dominant in women (88.0% vs. 12.0%). Conclusions : We conclude that the pattern of facial heat distribution differs depending on the types of alopecia and gender. These differences may provide useful information for diagnosis and clinical therapy for this population.