• 제목/요약/키워드: Internal Balance

검색결과 376건 처리시간 0.024초

Impact of Additional Preoperative Computed Tomography Imaging on Staging, Surgery, and Postsurgical Survival in Patients With Papillary Thyroid Carcinoma

  • So Yeong Jeong;Sae Rom Chung;Jung Hwan Baek;Young Jun Choi;Sehee Kim;Tae-Yon Sung;Dong Eun Song;Tae Yong Kim;Jeong Hyun Lee
    • Korean Journal of Radiology
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    • 제24권12호
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    • pp.1284-1292
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    • 2023
  • Objective: We investigated the impacts of computed tomography (CT) added to ultrasound (US) for preoperative evaluation of patients with papillary thyroid carcinoma (PTC) on staging, surgical extent, and postsurgical survival. Materials and Methods: Consecutive patients who underwent surgery for PTC between January 2015 and December 2015 were retrospectively identified. Of them, 584 had undergone preoperative additional thyroid CT imaging (CT + US group), and 859 had not (US group). Inverse probability of treatment weighting (IPTW) and propensity score matching (PSM) were used to adjust for 14 variables and balance the two groups. Changes in nodal staging and surgical extent caused by CT were recorded. The recurrence-free survival and distant metastasis-free survival after surgery were compared between the two groups. Results: In the CT + US group, discordant nodal staging results between CT and US were observed in 94 of 584 patients (16.1%). Of them, CT accurately diagnosed nodal staging in 54 patients (57.4%), while the US provided incorrect nodal staging. Ten patients (1.7%) had a change in the extent of surgery based on CT findings. Postsurgical recurrence developed in 3.6% (31 of 859) of the CT + US group and 2.9% (17 of 584) of the US group during the median follow-up of 59 months. After adjustment using IPTW (580 vs. 861 patients), the CT + US group showed significantly higher recurrence-free survival rates than the US group (hazard ratio [HR], 0.52 [95% confidence interval {CI}, 0.29-0.96]; P = 0.037). PSM analysis (535 patients in each group) showed similar HR without statistical significance (HR, 0.60 [95% CI, 0.31-1.17]; P = 0.134). For distant metastasis-free survival, HRs after IPTW and PSM were 0.75 (95% CI, 0.17-3.36; P = 0.71) and 0.87 (95% CI, 0.20-3.80; P = 0.851), respectively. Conclusion: The addition of CT imaging for preoperative evaluation changed nodal staging and surgical extent and might improve recurrence-free survival in patients with PTC.

GRIM-19 Ameliorates Multiple Sclerosis in a Mouse Model of Experimental Autoimmune Encephalomyelitis with Reciprocal Regulation of IFNγ/Th1 and IL-17A/Th17 Cells

  • Jeonghyeon Moon;Seung Hoon Lee;Seon-yeong Lee;Jaeyoon Ryu;Jooyeon Jhun;JeongWon Choi;Gyoung Nyun Kim;Sangho Roh;Sung-Hwan Park;Mi-La Cho
    • IMMUNE NETWORK
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    • 제20권5호
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    • pp.40.1-40.15
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    • 2020
  • The protein encoded by the Gene Associated with Retinoid-Interferon-Induced Mortality-19 (GRIM-19) is located in the mitochondrial inner membrane and is homologous to the NADH dehydrogenase 1-alpha subcomplex subunit 13 of the electron transport chain. Multiple sclerosis (MS) is a demyelinating disease that damages the brain and spinal cord. Although both the cause and mechanism of MS progression remain unclear, it is accepted that an immune disorder is involved. We explored whether GRIM-19 ameliorated MS by increasing the levels of inflammatory cytokines and immune cells; we used a mouse model of experimental autoimmune encephalomyelitis (EAE) to this end. Six-to-eight-week-old male C57BL/6, IFNγ-knockout (KO), and GRIM-19 transgenic mice were used; EAE was induced in all strains. A GRIM-19 overexpression vector (GRIM19 OVN) was electrophoretically injected intravenously. The levels of Th1 and Th17 cells were measured via flow cytometry, immunofluorescence, and immunohistochemical analysis. IL-17A and IFNγ expression levels were assessed via ELISA and quantitative PCR. IL-17A expression decreased and IFNγ expression increased in EAE mice that received injections of the GRIM-19 OVN. GRIM19 transgenic mice expressed more IFNγ than did wild-type mice; this inhibited EAE development. However, the effect of GRIM-19 overexpression on the EAE of IFNγ-KO mice did not differ from that of the empty vector. GRIM-19 expression was therapeutic for EAE mice, elevating the IFNγ level. GRIM-19 regulated the Th17/Treg cell balance.

데이터 기반 인천항 LNG 수요예측 모형 개발: 시계열분석 및 인공신경망 모형 비교연구 (LNG Gas Demand Forecasting in Incheon Port based on Data: Comparing Time Series Analysis and Artificial Neural Network)

  • 김범수;신광섭
    • 한국빅데이터학회지
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    • 제8권2호
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    • pp.165-175
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    • 2023
  • LNG는 인천항의 대표적인 수입화물로 인천항 전체 물동량 증감에 기여도가 상대적으로 높은 편이다. 또한, 국가적 차원에서도 LNG는 도시가스 및 전력발전에 필요한 핵심 자원으로 시장 수요의 변동 요인에 대한 분석과 적합한 수요예측모델의 구축은 LNG 기반 발전 계획 및 국가전력수급기본계획 수립 등에 매우 중요하다. 본 연구에서는 기존 연구들에서 다뤄지는 거시적 연간 자료를 통한 예측과 달리, LNG 운반선이 하역하는 주간별 물동량을 대상으로 주기성을 파악하고, 대내외 변동요인과의 상관관계를 분석한다. LNG 수요 변동요인으로는 주간 데이터의 계절성, 최대전력, 전력 공급예비력 등 전력 수급 데이터 등을 고려하였다. 또한 LNG 수요를 예측하기 위해 자료의 특성을 고려하여 주간단위별 LNG 물동량을 종속변수로 한 시계열 예측과 인공신경망 모형을 통한 예측 후 예측치에 대한 적합성을 검증 및 실적-추정치 간 오차비교를 통해 최적모형을 도출하고자 한다.

류마티스 관절염에 대한 한약의 면역학적 연구동향 (Recent Trends of Immunologic Studies of Herbal Medicine on Rheumatoid Arthritis)

  • 최도영;이재동;백용현;이송실;유명철;한정수;양형인;박상도;유미현;박은경;박동석
    • Journal of Acupuncture Research
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    • 제21권4호
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    • pp.177-196
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    • 2004
  • Objective : Rheumatoid arthritis is an autoimmune disease that pathogenesis is not fully understood and one of the most intractable musculoskeletal diseases. The concern in the immunopathogenesis of rheumatoid arthritis has been increased since 1980's and many immunotherapeutic agents including disease-modifying antirheumatic drugs (DMARDs) were developed and became the mainstay of treatment of rheumatoid arthritis. However, the cure of the disease has hardly been achieved. In oriental medicine, rheumatoid arthritis is related to Bi-Zheng(痺證), that presents pain, swelling, andlor loss of joint function as major clinical manifestations, and also known to be deeply involved in suppression of immune function related to weakness of Jung-Ki(正氣). The herbal medicine, empirically used, could be a potential resource of development of new immunotherapeutic agents for rheumatoid arthritis. Methods : We developed a search strategy using terms to include "rheumatoid arthritis and herbal medicine" combined with "Chinese medicine" and/or "Oriental medicine". The search was focused on experimental studies of herbal medicine (January 1999 to May 2004), which is known to have effects on immune function of patients with rheumatoid arthritis. Computerized search used Internet databases including KISS and RISS4U (Korea), CNKI (China), MOMJ (Main Oriental Medicine Journal, Japan), and PubMed. The articles were selected from journals of universities or major research institutes. Results : The literature search for experimental studies on effects of herbal medicine on immunity of rheumatoid arthritis retrieved a total of 21 articles (Korea; 8, China ; 12, Japan ; 1). Of 21 articles, 10 were related to single-drug formula, 2 to drug interaction, and 9 to multi-drug formula. Single-drug formula was mainly used for aqua-acupuncture and researches on active components. Studies of drug interaction emphasized harmony of Ki-Hyul(氣血) and balance of Han-Yeul(寒熱). Multi-drug regimen was mainly found among formulas for Bo-Ki-Hyul(補氣血) and Bo-Sin(補腎). Conclusion : Studies on rheumatoid arthritis were performed both in vitro and in vivo in vitro study, LPS-stimulated splenocytes and synoviocytes were treated with herbal medicine, resulting in proliferation and activation of immune cells and suppression of cytokine activities in vivo study CIA animal model demonstrated that herbal medicine decreased antibody production and improved function of immune cells. In cellular and molecular study herbal medicine showed profound effects on the level of mRNA expression of certain cytokines related to immune function. This study revealed that herbal medicine has significant immune modulatory action and could be used for recovery of immune dysfunction of rheumatoid arthritis patients.

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경험표집법(ESM)을 통해 본 음악영재의 삶의 질 (A Study for Quality of Life in Musically Talented Students Using Experience Sampling Method)

  • 이현주;최인수
    • 영재교육연구
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    • 제21권1호
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    • pp.57-81
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    • 2011
  • 본 연구의 목적은 음악영재들이 경험하는 일상을 통해 그들이 실제 인지하는 삶의 질에 대해 알아보는 것이다. 삶의 질에 대해 측정하기 위해 일상 경험을 2가지로 나누어 살펴보았다. 하나는 외적 경험으로, 주된 활동, 함께한 사람에 대한 것이며, 다른 하나는 내적 경험으로, flow, 정서에 관한 것이다. 본 연구결과를 통해 음악영재들의 삶(일상)을 정리해 보면 다음과 같다. 첫째, 일상에서 생산활동에 참여하는 시간과 혼자 보내는 시간이 많고, 그 시간에 재능 발현을 위한 준비를 하면서 긍정적인 내적 경험을 하고 있었다. 둘째, 음악영재는 일상에서 일반청소년에 비해 긍정적인 내적 경험을 보고하고 있었다. 셋째, 다른 활동을 할 때보다 자신의 재능과 관련된 음악활동을 하면서 더 깊이 flow에 빠지고, 긍정적인 정서를 느끼고 있었다. 넷째, 음악활동을 하면서 깊은 flow를 경험하고 있었지만, 상대적으로 행복하다고 생각하지는 않았다. 이는 행복감이라는 것이 flow 경험과 동시에 오지 않는 특징을 가졌기 때문으로 보인다. 본 연구는 새로운 연구방법, 즉 경험표집법(ESM)의 사용으로 일상에 대한 풍부하고 심도 깊은 자료를 제공하고, 이러한 정보들을 통해 음악영재들을 심층적으로 이해하고 상담이나 교육을 위한 기초자료를 제공해 줄 수 있을 것이다.

동력경운기의 경사지견인 및 주행특성에 관한 연구 (III)-동력경운의 경사지 견인성능- (Study on the Travel and Tractive Characteristics of the Two-Wheel Tractor on the General Slope Land(III)-Tractive Performance of Power Tiller-)

  • 송현갑;정창주
    • Journal of Biosystems Engineering
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    • 제3권2호
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    • pp.35-61
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    • 1978
  • 동력경운깅가 일반 경사지에서 견인주행하는 경우 견인주행성능과 주행특성을 구명하기 위하여 토양의 종류 및 상태는 일정하게 하고 지면의 기하학적 조건과 견인주행속도 및 견인하중을 변수로 하여 외부동력전달계의 시점인 좌우차륜과 토양간에 발생하는 차륜구동력 및 굴름정항과 Engine에서 구동륜까지 내부전달계를 통하여 전달된 동력의 이론치와 실험치와의 부합여부를 검정하고 부가적으로 동력경운기가 경사지기계화의 동력기로써의 가능성여부와 문제점을 찾으려한다.

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동력경운기의 경사지견인 및 주행특성에 관한 연구 (Ⅲ)-동력경운의 경사지 견인성능- (Study on the Travel and Tractive Characteristics of the Two-Wheel Tractor on the General Slope Land(Ⅲ)-Tractive Performance of Power Tiller-)

  • 송현갑;정창주
    • Journal of Biosystems Engineering
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    • 제3권2호
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    • pp.34-34
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    • 1978
  • 동력경운깅가 일반 경사지에서 견인주행하는 경우 견인주행성능과 주행특성을 구명하기 위하여 토양의 종류 및 상태는 일정하게 하고 지면의 기하학적 조건과 견인주행속도 및 견인하중을 변수로 하여 외부동력전달계의 시점인 좌우차륜과 토양간에 발생하는 차륜구동력 및 굴름정항과 Engine에서 구동륜까지 내부전달계를 통하여 전달된 동력의 이론치와 실험치와의 부합여부를 검정하고 부가적으로 동력경운기가 경사지기계화의 동력기로써의 가능성여부와 문제점을 찾으려한다.

인문지리학 방법론의 새로운 지평 (New horizon of geographical method)

  • 최병두
    • 대한지리학회지
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    • 제38권
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    • pp.15-36
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    • 1988
  • In this paper, I consider the development of methods in contemporary human geography in terms of a dialectical relation of action and structure, and try to draw a new horizon of method toward which geographical research and spatial theory would develop. The positivist geography which was dominent during 1960s has been faced both with serious internal reflections and strong external criticisms in the 1970s. The internal reflections that pointed out its ignorance of spatial behavior of decision-makers and its simplication of complex spatial relations have developed behavioural geography and systems-theoretical approach. Yet this kinds of alternatives have still standed on the positivist, geography, even though they have seemed to be more real and complicate than the previous one, The external criticisms that have argued against the positivist method as phenomenalism and instrumentalism suggest some alternatives: humanistic geography which emphasizes intention and action of human subject and meaning-understanding, and structuralist geography which stresses on social structure as a totality which would produce spatial phenomena, and a theoretical formulation. Human geography today can be characterized by a strain and conflict between these methods, and hence rezuires a synthetic integration between them. Philosophy and social theory in general are in the same in which theories of action and structural analysis have been complementary or conflict with each other. Human geography has fallen into a further problematic with the introduction of a method based on so-called political ecnomy. This method has been suggested not merely as analternative to the positivist geography, but also as a theoretical foundation for critical analysis of space. The political economy of space with has analyzed the capitalist space and tried to theorize its transformation may be seen either as following humanistic(or Hegelian) Marxism, such as represented in Lefebvre's work, or as following structuralist Marxism, such as developed in Castelles's or Harvey's work. The spatial theory following humanistic Marxism has argued for a dialectic relation between 'the spatial' and 'the social', and given more attention to practicing human agents than to explaining social structures. on the contray, that based on structuralist Marxism has argued for social structures producing spatial phenomena, and focused on theorising the totality of structures, Even though these two perspectives tend more recently to be convergent in a way that structuralist-Marxist. geographers relate the domain of economic and political structures with that of action in their studies of urban culture and experience under capitalism, the political ecnomy of space needs an integrated method with which one can overcome difficulties of orthhodox Marxism. Some novel works in philosophy and social theory have been developed since the end of 1970s which have oriented towards an integrated method relating a series of concepts of action and structure, and reconstructing historical materialism. They include Giddens's theory of structuration, foucault's geneological analysis of power-knowledge, and Habermas's theory of communicative action. Ther are, of course, some fundamental differences between these works. Giddens develops a theory which relates explicitly the domain of action and that of structure in terms of what he calls the 'duality of structure', and wants to bring time-space relations into the core of social theory. Foucault writes a history in which strategically intentional but nonsubjective power relations have emerged and operated by virtue of multiple forms of constrainst wihthin specific spaces, while refusing to elaborate any theory which would underlie a political rationalization. Habermas analyzes how the Western rationalization of ecnomic and political systems has colonized the lifeworld in which we communicate each other, and wants to formulate a new normative foundation for critical theory of society which highlights communicatie reason (without any consideration of spatial concepts). On the basis of the above consideration, this paper draws a new norizon of method in human geography and spatial theory, some essential ideas of which can be summarized as follows: (1) the concept of space especially in terms of its relation to sociery. Space is not an ontological entity whch is independent of society and has its own laws of constitution and transformation, but it can be produced and reproduced only by virtue of its relation to society. Yet space is not merlely a material product of society, but also a place and medium in and through which socety can be maintained or transformed.(2) the constitution of space in terms of the relation between action and structure. Spatial actors who are always knowledgeable under conditions of socio-spatial structure produce and reproduce their context of action, that is, structure; and spatial structures as results of human action enable as well as constrain it. Spatial actions can be distinguished between instrumental-strategicaction oriented to success and communicative action oriented to understanding, which (re)produce respectively two different spheres of spatial structure in different ways: the material structure of economic and political systems-space in an unknowledged and unitended way, and the symbolic structure of social and cultural life-space in an acknowledged and intended way. (3) the capitalist space in terms of its rationalization. The ideal development of space would balance the rationalizations of system space and life-space in a way that system space providers material conditions for the maintainance of the life-space, and the life-space for its further development. But the development of capitalist space in reality is paradoxical and hence crisis-ridden. The economic and poltical system-space, propelled with the steering media like money, and power, has outstriped the significance of communicative action, and colonized the life-space. That is, we no longer live in a space mediated communicative action, but one created for and by money and power. But no matter how seriously our everyday life-space has been monetalrized and bureaucratised, here lies nevertheless the practical potential which would rehabilitate the meaning of space, the meaning of our life on the Earth.

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삼출성 흉막액에서 응고 및 섬유소 용해계에 관한 연구 (Coagulation and Fibrinolysis in Exudative Pleural Effusions)

  • 류정선;이홍렬
    • Tuberculosis and Respiratory Diseases
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    • 제45권6호
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    • pp.1214-1222
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    • 1998
  • 연구배경 : Plasminogen activator inhibitor-l(PAI-1) 항원은 섬유소 용해에 관여하는 tissue type plasmingen activator(t-PA)를 억제하여 흉막액에 존재하는 섬유소가 용해되는 것을 억제하며 결국 흉막액의 응고를 촉진하게되며 패혈증 환자의 혈장에서 PAI-1 항원과 관계된 섬유소 용해능의 활성용 업종의 정도와 관계가 알려져 있슴으로 본 연구에서 흉막액내 염증 정도와 흉막액의 섬유소 용해 및 응고농 간의 상관관계를 알아보고자 하였다. 방 법 : 첫 흉막천자 후 얻어지는 검체와 검사 당일 환자의 혈액 3.8% citrate tube에 모은 후 즉시 2,000 rpm에서 30분간 원심 분리하였고 상층액을 분리하여 검사할 때까지 영하 $20^{\circ}C$에 보관하였다. 흉막액내 염증을 나타내는 지표로 흉막액의 포도당, LDH, pH, 총 단백질을, 염증세포의 침윤 정도를 나타내는 지표로 다형핵 백혈구, 림프구 및 총 백혈구를 측정하였고 혈액의 염증을 나타내는 지표로 호중구, 피브리노겐을 측정하였다. 흉막액의 섬유소 용해 및 응고능을 측정하기 위하여 D-dimer, PAI-1 항원, 트롬빈-항트롬빈 III 복합체를 측정하였으며 상관관계를 분석하였다. 결 과 : 대상환자는 30예 이었고 평균 연령은 51.4세 이었다. 흉막액의 원인 질환으로는 결핵성 흉막액 : 14예, 악성 흉막액 : 10예, 부폐렴성 흉막액 : 6예 이었다. D-dimer, PAI-1 항원, 트롬빈-항트롬빈 III 복합체는 흉막액에서 혈장치 보다 의의있게 높았으며 혈장치와 유의한 상관관계는 없었다. 혈장 PAI-1 항원과 트롬빈-항트롬빈 III 복합체는 원인질환 간에 차이를 보이지 않았다. 흉막액의 D-dimer와 트롬빈-항트롬빈 III 복합체는 원인에 따른 차이가 없었으나 흉막액 PAI-1 항원은 결핵성 흉막액에서 악성 및 부폐렴성 흉막액 보다 의의있게 높았다. 흉막액 염증의 경중에 따른 D-dimer(p=0.85), PAI-1 항원 (p=0.35) 및 트롬빈-항트롬빈 III 복합체(p=0.66)의 차이는 없었다. 흉막액 다형핵 백혈구, 림프구 및 총 백혈구수와 흉막액 트롬빈-항트롬빈 III 복합체는 부분적으로 유의한 상관관계를 보였다. 결 론 : 흉막 염증시 PAI-1 항원의 국소적 생성 가능성이 높았으며, 흉막액 염증 정도와 흉막액 D-dimer, PAI-1 항원 및 트롬빈 항트롬빈 III 복합체의 농도는 차이를 보이지 않았으며 흉막 염증시 흉막내로 유입된 염증 세포는 PAI-1 항원과는 무관하게 섬유소 용해 및 응고 과정에 관여한다고 생각된다. 흉막액 D-dimer와 흉막액 PAI-1 항원은 유의한 상관관계를 보이지 않아 이는 PAI-1 항원 이외의 다른 요인이 섬유소 용해 및 응고에 관여하고 있음을 암시하여주는 소견으로 생각된다.

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광주시(光州市) 의료시설(醫療施設)의 입지(立地)와 주민(住民)의 효율적(效率的) 이용(利用) (The Location of Medical Facilities and Its Inhabitants' Efficient Utilization in Kwangju City)

  • 전경숙
    • 한국지역지리학회지
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    • 제3권2호
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    • pp.163-193
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    • 1997
  • 복지사회를 지향하는 오늘날, 건강 중진에 직접 관계되는 의료시설의 접근성 문제는 주요 과제이다. 특히 삶의 질이라는 측면에서 질병의 치료 외에 건강진단, 예방과 회복, 요양 및 응급서비스의 비중이 커지고, 인구의 노령화 현상이 진전되면서 의료시설의 효율적인 입지가 주 관심사로 대두되고 있다. 의료시설은 주민의 생존과 직접 관계되는 기본적이고도 필수적인 중심시설로, 지역 주민은 균등한 혜택을 받을 수 있어야 한다. 이를 실현시키기 위해서는 기본적으로는 효율성과 평등성을 기반으로 1차 진료기관이 균등 분포해야 한다. 이에 본 연구에서는, 광주시를 사례지역으로 선정하여 의료시설의 입지와 그에 대한 주민의 효율적 이용에 관하여 분석하였다. 분석에 있어서는 통계자료와 기존의 연구 성과 외에 설문 및 현지조사 자료를 기반으로 시설 측면과 이용자 측면을 동시에 고찰하였다. 우선 의료 환경의 변화 및 의료시설의 변화 과정을 고찰하고, 이어서 의료시설의 유형별 입지 특성과 주민의 분포 특성을 고려한 지역별 의료수준을 분석하였다. 그리고 유형별 의료시설의 이용행태와 그 요인을 구명한 후, 마지막으로 장래 이용 유형의 예측과 문제지역의 추출, 나아가서는 시설의 합리적인 입지와 경영 방향을 제시하였다. 본 연구 결과는, 앞으로 신설될 의료시설의 적정 입지에 관한 기본 자료로서는 물론 지역 주민의 불평등성 해소라는 응용적 측면에서 의의를 지닌다.

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