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Retrospective Evaluation of Discrepancies between Radiological and Pathological Size of Hepatocellular Carcinoma Masses

  • Tian, Fei;Wu, Jian-Xiong;Rong, Wei-Qi;Wang, Li-Ming;Wu, Fan;Yu, Wei-Bo;An, Song-Lin;Liu, Fa-Qiang;Feng, Li;Liu, Yun-He
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권21호
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    • pp.9487-9494
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    • 2014
  • Background: The size of a hepatic neoplasm is critical for staging, prognosis and selection of appropriate treatment. Our study aimed to compare the radiological size of solid hepatocellular carcinoma (HCC) masses on magnetic resonance imaging (MRI) with the pathological size in a Chinese population, and to elucidate discrepancies. Materials and Methods: A total of 178 consecutive patients diagnosed with HCC who underwent curative hepatic resection after enhanced MRI between July 2010 and October 2013 were retrospectively identified and analyzed. Pathological data of the whole removed tumors wereassessed and differences between radiological and pathological tumor size were identified. All patients were restaged using a modified Tumor-Node-Metastasis (TNM) staging system postoperatively according to the maximum diameter alteration. The lesions were classified as hypo-staged, iso-staged or hyper-staged for qualitative assessment. In the quantitative analysis, the relative pre and postoperative tumor size contrast ratio ($%{\Delta}size$) was also computed according to size intervals. In addition, the relationship between radiological and pathological tumor diameter variation and histologic grade was analyzed. Results: Pathological examination showed 85 (47.8%) patients were overestimated, 82 (46.1%) patients underestimated, while accurate measurement by MRI was found in 11 (6.2%) patients. Among the total subjects, 14 (7.9%) patients were hypo-staged and 15 (8.4%) were hyper-staged post-operatively. Accuracy of MRI for calculation and characterized staging was related to the lesion size, ranging from 83.1% to 87.4% (<2cm to ${\geq}5cm$, p=0.328) and from 62.5% to 89.1% (cT1 to cT4, p=0.006), respectively. Overall, MRI misjudged pathological size by 6.0 mm (p=0.588 ), and the greatest difference was observed in tumors <2cm (3.6 mm, $%{\Delta}size=16.9%$, p=0.028). No statistically significant difference was observed for moderately differentiated HCC (5.5mm, p=0.781). However, for well differentiated and poorly differentiated cases, radiographic tumor maximum diameter was significantly larger than the pathological maximum diameter by 3.15 mm and underestimated by 4.51 mm, respectively (p=0.034 and 0.020). Conclusions: A preoperative HCC tumor size measurement using MRI can provide relatively acceptable accuracy but may give rise to discrepancy in tumors in a certain size range or histologic grade. In pathological well differentiated subjects, the pathological tumor size was significantly overestimated, but underestimated in poorly differentiated HCC. The difference between radiological and pathological tumor size was greatest for tumors <2 cm. For some HCC patients, the size difference may have implications for the decision of resection, transplantation, ablation, or arterially directed therapy, and should be considered in staging or selecting the appropriate treatment tactics.

초임계유체 $CO_2$ 및 Co-solvent 첨가에 따른 금은화(Lonicera fles)의 Flavonoid류 추출특성 (Extraction Characteristics of Flavonoids from Lonicera flos by Supercritical Fluid Carbon Dioxide ($SF-CO_2$) with Co-solvent)

  • 서상철;조성길;홍주헌;최용희
    • 한국식품과학회지
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    • 제37권2호
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    • pp.183-188
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    • 2005
  • 순수 methanol을 cd-solvent로 첨가하였을 때 소량의 수율을 얻을 수 있었던 반면 methanol에 물을 첨가하여 수용액을 조제한 후 각각 첨가하였을 때 co-solvent의 극성도 증가에 비례하여 수율이 현저하게 증가하였다. 60% methanol을 첨가하였을 때 수율이 가장 높았으며 순수 methanol 첨가구와 비교하여 luteolin이 5.9배, quercetin이 4.1배, apigenin이 7.8배 가량 증가하였다. Co-solvent에 citric acid를 농도별로 첨가한 결과 첨가량 1%까지는 추출수율이 농도 비례적으로 증가하는 경향을 나타내어 대조구에 비해 대략 luteolin이 14.64mg/100g, quercetin이 10.17mg/100g, apigenin이 2.4mg/100g의 유의적인 증가율을 보였으나 그 이상의 농도에서는 소량 감소하는 경향을 보였다. 한편 산을 첨가한 모든 조건에서 대조구보다 높은 수율을 얻을 수 있었다. 추출수율이 가장 우수하였던 citric acid가 1% 첨가된 60% aqueous methanol을 co-solvent로 초임계상태에 첨가하였을 때 공정압력이 100bar에서 200ber로 증가함에 따라 추출수율이 비례적으로 증가하였으나 250bar 이상에서는 감소하는 경향을 나타내었다. 온도에 따라서는 $40^{\circ}C$에서 $50^{\circ}C$까지는 증가하는 경향을 보이다 이상의 온도에서는 오히려 감소하였다. 추출 시간의 증가와 더불어 추출 수율은 유의적으로 증가하다가 60분일 때 최대값을 보였으며 90분 이상의 추출시간에서는 추출수율이 거의 일정해졌다. $CO_{2}$ 대비 cosolvent를 15(0.3mL/min)% 첨가하였을 때 최대 추출수율을 보였으며 25% 이상의 첨가구에서는 첨가량은 증가하였으나 수율은 감소하는 경향을 보였다. 것으로 나타났다. 그러므로 감마선 조사 및 저온저장($10^{\circ}C$)은 김밥재료 뿐만 아니라 김밥의 미생물 제어에 효과적인 것으로 확인되었다.와 비례하는 경향을 나타내었다. 또한 FA-swelling mica의 중금속 이온의 선택성은 Pb>Cu>Cd$\geq$Zn 순으로 나타났다.지 않았다.l years and a new type of transfer crane has been developed. Design concepts and control methods of a new crane will be introduced in this paper.and momentum balance was applied to the fluid field of bundle. while the movement of′ individual material was taken into account. The constitutive model relating the surface force and the deformation of bundle was introduced by considering a representative prodedure that stands for the bundle movement. Then a fundamental equations system could be simplified considering a steady state of the process. On the basis of the simplified model, the simulation was performed and the results could be confirmed by the experiments under various conditions.뢰, 결속 등 다차원의 개념에 대한 심도 깊은 연구와 최근 제기되고 있는 이론의 확대도 필요하다. 마지막으로 신뢰와 결속에 영향을

p-Coumaric acid에 의해 유도되는 인체 Jurkat T 세포의 에폽토시스 기전 (Activation of Pro-Apoptotic Multidomain Bcl-2 Family Member Bak and Mitochondria-Dependent Caspase Cascade are Involved in p-Coumaric Acid-Induced Apoptosis in Human Jurkat T Cells)

  • 이제원;김영호
    • 생명과학회지
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    • 제21권12호
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    • pp.1678-1688
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    • 2011
  • 다양한 식용식물에 함유되어 있는 것으로 알려진 phenolic acids의 일종인 p-coumaric acid의 항암활성을 규명하고자, 인체 급성백혈병 T 세포주인 Jurkat T 세포에 대한 p-coumaric acid의 에폽토시스 유도기전을 조사하였다. Jurkat T 세포를 p-coumaric acid (50-$150{\mu}M$)로 처리한 결과, 세포독성, 에폽토시스-관련 DNA fragmentation, 및 pro-apoptotic multidomain Bcl-2 family member인 Bak의 활성화, ${\Delta}{\psi}m$ loss, caspase-9, -3, -7, 및 -8의 활성화, 그리고 PARP 분해 등의 여러 에폽토시스-관련 생화학적 현상들이 농도의존적으로 나타났다. 그러나 이러한 에폽토시스-관련 생화학적 현상들은 Jurkat T 세포에 anti-apoptotic Bcl-2 단백질을 과발현할 경우에는 나타나지 않았다. 또한 p-coumaric acid처리에 의해 유도되는 Jurkat T 세포의 에폽토시스에는 necrosis가 수반되지 않는 것으로 확인되었다. Jurkat T 세포를 pan-caspase inhibitor인 z-VAD-fmk를 전처리할 경우, p-coumaric acid 처리에 의해 유도되는 apoptotic sub-$G_1$ peak는 차단되어 나타나지 않았으나 ${\Delta}{\psi}m$ loss는 여전히 나타났는데, 이는 p-coumaric acid처리에 의한 에폽토시스의 유도에 caspase cascade 활성화가 필수적이며 ${\Delta}{\psi}m$ loss의 downstream 현상임을 나타낸다. 한편, FADD 및 caspase-8을 함께 발현하는 Jurkat T 세포주 A3, FADD-결손 Jurkat T 세포주 I2.1, 그리고 caspase-8-결손 Jurkat T 세포주 I9.2의 p-coumaric acid의 세포독성에 대한 감수성은 서로 유사하게 나타났는데, 이는 p-coumaric acid처리에 의한 에폽토시스의 유도가 Fas와 FasL간의 상호작용에 의해 개시되지 않음을 시사한다. p-Coumaric acid의 세포독성은 Jurkat T 세포에 비해 인체 정상 말초혈액 T 세포에서 훨씬 낮게 나타났다. 이러한 결과들은 p-coumaric acid 처리에 의해 유도되는 Jurkat T 세포의 에폽토시스가 Bak 활성화, ${\Delta}{\psi}m$ loss, caspase-9, -3, -7, 및 -8로 이루어진 caspase cascade의 활성화, 그리고 PARP 분해에 의해 유도되며, 또한 anti-apoptotic 단백질인 Bcl-2의 과발현에 의해서 음성적으로 조절됨을 나타낸다.

여조겸(呂祖謙) 심론(心論) 연구(硏究) : 여조겸과 주희의 사상적 대립과 절충 (A Study on the theory of Mind in LüZuqian(呂祖謙) philosophy)

  • 연재흠
    • 한국철학논집
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    • 제38호
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    • pp.63-96
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    • 2013
  • 주희 장식과 더불어 동남삼현(東南三賢)이라 일컬어지는 여조겸(呂祖謙)은 남송시대 대표적인 철학자 가운데 한 사람이다. 여조겸은 심후한 가학(家學)을 바탕으로 당시의 학자들과 폭넓게 교류하며 자신의 학문체계를 건립하였다. 여조겸의 심론(心論)은 기본적으로 맹자의 양심(良心) 본심(本心)에 관한 이론에 기초하고 있다. 여조겸은 초심(初心) 내심(內心)을 통해 이러한 양심의 의미를 설명하였다. 여조겸에 따르면 양심이 외부사물과 접촉했을 때 바로 생기는 마음이 초심(初心)이며, 초심(初心)은 외부사물에 대해 옳은 판단을 내릴 수 있다. 내심(內心)은 도덕적 자각능력을 회복한 양심 본심을 의미한다. 여조겸의 심론(心論)의 중요한 특징은 심외무도(心外無道) 심외무천(心外無天)에 있다. 여조겸은 이를 통해 마음과 천(天) 도(道) 리(理)가 하나임을 강조하였다. 여조겸은 아호사(鵝湖寺)의 모임을 주선하며, 주희와 육구연의 학문적 절충을 위해 노력하였다. 그러나 발명본심(發明本心)을 주장했던 육구연과는 달리 양심의 자각과 더불어 도문학(道問學) 역시 중시하였다. 한편 여조겸은 주희와 마찬가지로 경(敬)을 중시하였다. 그러나 여조겸에게 있어 경(敬)이란 순일불잡(純一不雜)한 도덕심(道德心)의 무간단(無間斷)을 의미하며, 성(誠)과 동일한 함의를 지니고 있다. 여조겸은 독서와 강학을 중시하였지만, 마음의 자각과 반성, 간단(間斷) 없는 지속을 통해 리(理)를 이해하고 실현할 수 있다고 주장하였다. 이와 같이 주희와의 절충과 대립을 통해 드러나는 여조겸의 심학적(心學的) 학풍(學風)은 남송 시대 사상계에서 중요한 의미를 지닌다고 할 수 있다.

주자학과 대순사상의 수양론 비교 연구 (The Comparative Research on the Theory of Self-cultivation in Neo-Confucianism and Daesoon Thought)

  • 이광주
    • 대순사상논총
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    • 제24_2집
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    • pp.231-270
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    • 2015
  • This thesis examined Chu Hsi's self-cultivation theory as the representative theory of cultivation in Confucianism, while juxtaposing it to self-cultivation theory in Daesoon thought, concentrating on its similarity and difference. Neo-Confucianism is a scholarship which has wielded a tremendous influence upon East Asia, while functioning as an official scholarship for long period up to Yuan, Ming, and Ching period, after achieving its synthesis by Chu Hsi. After 13th century, Neo-Confucianism has been a representative academic system in Confucianism, and self-cultivation theory was in its center. It suggested various virtues that classical scholars have to equip to fulfill the sainthood and the politics of royal road. The self-cultivation theory of Chu Hsi was developed upon the basis of the theory 'Li-Qi' and the theory of mind. Here, the practice of Geokyung(morally awakened state with a reverent spirit in every moment) and Gyeokmul-tsiji(reaching into the utmost knowledge through investigation of things) formed a nucleus of Chu Hsi's self-cultivation theory. While Geokyung was to reveal one's true nature through cultivation of mind, Gyeokmul-tsiji was to demonstrate the complete use of mind's essence and function. Chu Hsi's self-cultivation theory attempted to realize the unity of heaven and man, and through cultivating self and governing people, it also tried to achieve its ideal of the society of Great Union(Daedong). Daesoon Thought is originated from Sangjenim who has descended to this world as a human being called Jeungsan. He went on his circuit to rectify the disorder of heaven and earth for 9 years to rectify the Three worlds of heaven, earth and human being which were faced with total annihilation due to its rule of mutual conflict, while creating an earthly paradise. Respecting the will of Sangjenim, Dojunim established the foundation of Do through launching 'Meukeukdo' and setting tenet, creed and object so that the cultivators (Doins) could believe and respect the truth of Sangje's great itineration (Daesoon). Among those, the two components of creed, which are four fundamental principles and the three fundamental attitudes are of great account as precept and cardinal point. Through this means, the cultivators of Daesoonjinrihoe aspire to guard against self-deception through transforming the human spirit, to realize earthly immortality through renewing human beings, and to create an earthly paradise through transforming the world. This thesis attempted to compare and analyze the theory of self-cultivation in Neo-Confucianism and Daesoon Thought in the aspect of ground, method, and object of cultivation. First, as for the ground of cultivation, the doctrines of Chu-tzu and Daesoon thought place the essence of cultivation on 'heaven'. Yet, whereas the former postulates Taekeuk (the Great Ultimate) as a principle as well as the heaven of a natural order, Daesoon thought postulates Sangenim as the heaven of superintendence as well as the heaven of a natural order, signified as its equation of Daesoon with circle, along with the unity of Meukeuk (Endlessness) and Taegeuk (the Great Ultimate). Further, the doctrine of Chu-zhu and Daesoon thought is identical in the point that both thoughts see mind as the subject of cultivation, while trying to restore a pure essence. Nevertheless, whereas Neo-Confucianism intends to give scope to ability of the complete use of mind's essence and function, Daesoon Thought sees mind as the essence which is used by spiritual beings and as an organ that heaven, earth and human being rely upon as the center of the universe. In the aspect of method of cultivation, the doctrine of Chuzhu lays emphasis on the rational factor in that it brightens its 'myung-deoki'(bright inner virtue),' while trying to correspond to the law of heaven on the basis of 'Geokyung' and 'Gyeokmul-tsiji.' On the contrary, Daesoon thought lays much emphasis on faith factor in that it aspires for human perfection based on the restoration of conscience by cultivating Daesoonjinri with sincerity, reverence and faith along with 'quieting the heart-mind', 'quieting the body', 'respecting the God of the Ninth Heaven', and 'observing ritual practice on the basis of the faith in Sangjenim. Yet, both thoughts have similarities in that cultivation of body forms the basis and that they attempt to realize their ideals through cultivation in daily life while taking 'Guarding against self-deception' as the key method of self-cultivation.' However, the principle of Chu-zhu can be said to be a voluntary and autonomous practice based on scripture of the saint as well as self-reflection. On the other hand, Daesoon thought reveals certain difference in that it combines faith factor with one's self-effort by concentrating on cultivation under the presence of Sangjenim as the object of belief and the spirits of heaven and earth. In the aspect of object of cultivation, both thoughts share similarities in that the saint and the perfected gentleman with a moral virtue as an ideal image of men in both thoughts attempt to realize each of their 'myung-deok' in human nature as a heavenly mandate while respecting morality. Further, they also share similarity in the point that the desirable characters in both thoughts want to participate in harmonious creation and nurturance. Yet, the perfected gentleman with a moral virtue is also characterized by its aim for a new heaven and earth where there is no mutual conflict but mutual beneficence, by promoting the moral influence and virtue of Sangjenim over one's own virtue, while practising the mutual beneficence of all life through harmonious union of divine beings and human beings.