• Journal of Korean Neurosurgical Society
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• 제54권4호
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• pp.329-335
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• 2013

Objective : Brain metastases in primary breast cancer patients are considerable sources of morbidity and mortality. Gamma knife radiosurgery (GKRS) has gained popularity as an up-front therapy in treating such metastases over traditional radiation therapy due to better neurocognitive function preservation. The aim of this study was to clarify the prognostic factors for local tumor control and survival in radiosurgery for brain metastases from primary breast cancer. Methods : From March 2001 to May 2011, 124 women with metastatic brain lesions originating from a primary breast cancer underwent GKRS at a tertiary medical center in Seoul, Korea. All patients had radiosurgery as a primary treatment or salvage therapy. We retrospectively reviewed their clinical outcomes and radiological responses. The end point of this study was the date of patient's death or the last follow-up examination. Results : In total, 106 patients (268 lesions) were available for follow-up imaging. The median follow-up time was 7.5 months. The mean treated tumor volume at the time of GKRS was 6273 $mm^3$ (range, 4.5-27745 mm3) and the median dose delivered to the tumor margin was 22 Gy (range, 20-25 Gy). Local recurrence was assessed in 86 patients (216 lesions) and found to have occurred in 36 patients (83 lesions, 38.6%) with a median time of 6 months (range, 4-16 months). A treated tumor volume >5000 $mm^3$ was significantly correlated with poor local tumor control through a multivariate analysis (hazard risk=7.091, p=0.01). Overall survival was 79.9%, 48.3%, and 15.3% at 6, 12, and 24 months, respectively. The median overall survival was 11 months after GKRS (range, 6 days-113 months). Multivariate analysis showed that the pre-GKRS Karnofsky performance status, leptomeningeal seeding prior to initial GKRS, and multiple metastatic lesions were significant prognostic factors for reduced overall survival (hazard risk=1.94, p=0.001, hazard risk=7.13, p<0.001, and hazard risk=1.46, p=0.046, respectively). Conclusion : GKRS has shown to be an effective and safe treatment modality for treating brain metastases of primary breast cancer. Most metastatic brain lesions initially respond to GKRS, though, many patients have further CNS progression in subsequent periods. Patients with poor Karnofsky performance status and multiple metastatic lesions are at risk of CNS progression and poor survival, and a more frequent and strict surveillance protocol is suggested in such high-risk groups.

• Clinical and Experimental Reproductive Medicine
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• 제40권3호
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• pp.131-134
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• 2013

Objective: To evaluate the effect of the addition of estradiol to luteal progesterone supplementation in GnRH antagonist cycles for infertile patients undergoing IVF/ICSI. Methods: One hundred and ten infertile patients, aged 28 to 39 years, were recruited for this prospective randomized study. They were randomly assigned to receive vaginal progesterone gel (Crinone) along with 4 mg estradiol valerate (group 1, n=55) or only Crinone (group 2, n=55) for luteal support. A GnRH antagonist multiple dose protocol using recombinant human FSH was used for controlled ovarian stimulation (COS) in all of the subjects. The COS results and pregnancy outcomes of the two groups were compared. Results: Group 1 and 2 were comparable with respect to the patient characteristics. The COS and IVF results were also comparable between the two groups. There were no differences in the clinical pregnancy rate (PR) and multiple PR between the two groups. However, the embryo implantation rate were significantly higher in group 1 than that in group 2 (22.2% vs. 13.3%, p=0.035). The incidence of luteal vaginal bleeding (LVB) was significantly lower in group 1 (7.4% vs. 27.8%, p=0.010). Conclusion: The addition of estradiol to luteal progesterone supplementation in GnRH antagonist cycles reduces the incidence of LVB and increases the embryo implantation rate in infertile patients undergoing IVF/ICSI.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제34권6호
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• pp.488-493
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• 2012

Hemangioma and vascular malformation are the most common benign tumors that are caused by congenitally or traumatic events. Theses tumors represent approximately 1/3~1/4 of all hemangiomas and vascular malformations in the head and neck. There are many forms of treatment for hemangioma and vascular malformation including closed observation, surgery, radiotherapy, laser therapy, steroid therapy, compression, embolization, and sclerotherapy. Ethanolamine oleate is an unsaturated fatty acid salt that has been used as a sclerosing agent because of its excellent thrombosing properties. This paper presents 1 case of intraoral multiple venous malformations treatment with 1.25% ethanolamine oleate (3.6~9.6 mg dose) intralesionally injected for 6 to 14 weeks over 2 week intervals. After the sclerotherapy, lesions almost completely disappeared without side effects. In conclusion, sclerotherapy using ethanolamine oleate is very effective against venous malformations, and sufficiently provides alternative support for surgical and other methods.

• Journal of Preventive Medicine and Public Health
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• 제34권1호
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• pp.80-88
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• 2001

Objectives : In an epidemiologic study on the health impact of Agent Orange exposure, the valid estimation of exposure level is the most important step. Based on recent studies, we examined the correlation between exposure levels categorized by personal exposure estimates and serum 2,3,7,8-tetrachlorodibenzo-p-dioxin (2,3,7,8-TCDD, Dioxin), exploring the possibility of utilizing the exposure level as a surrogate for the estimate of exposure to agent orange. Methods : During the study period (Jan 1996-Feb 1996), blood specimens of 745 subjects taken randomly among 1,329 persons and kept frozen, were analyzed for 2,3,7,8-TCDO and six other dioxin congeners. The serum dioxin and congeners were measured in 1998 by CDC, adjusted for serum lipids. We categorized the total exposure scores into five groups based on Agent Orange exposure data collected by interview and military records. Pearson and Spearman's correlation coefficients & multiple regression analysis were used to identify the relationship of the exposure level categorized with serum concentration of 2,3,7,8-TCDD, and six other dioxin congeners. Results : Dioxin and the other congeners, except 1,2,4,6,7,8-HpCDD, showed significant correlations to exposure categories (p<0.005): 2,3,7,8-TCDD and OCDD showed positive correlations, whereas the other congeners did negative. The values of 2,3,7,8-TCDD differed according to exposure category and proportionally increased from the low exposure group to the high, a dose-response relationship, even after other possible confounding variables were adjusted for. In multiple regression analysis, age$(\beta=0.033)$, dioxin$(\beta=0.433)$, 1,2,3,7,8-PeCDD$(\beta=-0.998)$, 1,2,3,4,7,8-HxCDD$(\beta=-0.773)$, 1,2,3,6,7,8-HxCDD$(\beta=0.255)$, 1,2,3,7,8,9-HxCDD$(\beta=-3.468)$, 1,2,3,4,6,7,8-HpCDD$(\beta=0.109)$ we re found to be significantly related to the total exposure score(p<0.005). Conclusion : This study demonstrated that the use of such categorizations as a surrogate measure of agent orange exposure in identifying exposure degrees in a health impact study is valid.

• 동의생리병리학회지
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• 제26권4호
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• pp.511-518
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• 2012

The mechanisms of Toll-like receptor (TLR) signaling have been the focus of extensive studies because TLRs are the target of therapeutic intervention on multiple diseases. In this study, we investigated the inhibitory potential of Vigna angularis (azuki bean) on the TLR signaling. The effect of Vigna angularis extract (JSD) on TLR activation was investigated by assessing NF-${\kappa}B$ and AP-1 inducible secreted embryonic alkaline phosphatase (SEAP) activity. JSD significantly inhibited SEAP activity induced by poly I:C (TLR3 ligand) and poly I (TLR7 ligand) in a dose-dependent manner at concentration below 100 ${\mu}g/ml$ with no sign of cytotoxicity. Pretreatment of JSD markedly suppressed mRNA expressions of pro-inflammatory cytokines and adhesive molecules such as TNF-${\alpha}$, IL-6, RANTES, MCP-1 and ICAM-1 induced by TLR ligands. It also diminished the phosphorylation of $I{\kappa}B$ kinase and $I{\kappa}B$, and followed by $I{\kappa}B$-mediated nuclear translocation of p50, p65, and phosphorylation of p38, JNK, and IRF signaling pathway. In conclusion, our results suggest that Vigna angularis has inhibitory activity on TLR-3 and -7 signaling and it can be further developed as a remedy in curing TLR-related multiple diseases.

• 대한의용생체공학회:의공학회지
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• 제18권3호
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• pp.291-299
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• 1997

As a microimaging device detecting gamma rays emitted from small lesions or tumors during operation, the intraoperative surgical probe has been proposed and is now under development. We have designed a multipurpose portable gamma prove system and evaluated the performance both for the absolute counting purpose of residual radioactivities and for the localizing capability of gamma events using the NaI(Tl) crystal and two types of photomultiplier tubes(PMTs). Counting efficiencies in the range of routine clinical use of radiation dose were measured using the assembly of single channel PMTs and 0.5 inch thick NaI(Tl) crystal of 1 inch diameter. The positioning of gamma events for imaging purpose requires the multiple channel PMTs with appropriate positioning electronics. We have designed a simple and reliable positioning circuit based on the concept of modified Anger. In preliminary experiments using the multiple channel PMT of 3 inch diameter and the dim lighth source, we were able to trace and localize the correct position with reduced positioning error by the use of two multiplier/divider chipset and simplified peripherals. The energy resolutions for the counting gamma probe measured as full width at half maximum(FWHM) for Cs-137, F-18, Tc-99m were 12%, 13%, and 36%, respectively. The spatial resolution for the imaging gamma probe measured as FWHM for green LED was 2.9 mm. The results indicate that the currently developing probe is very promising and could be very useful for many applications in nuclear medicine. Future studies will include developing collimators, improving interface hardwares, and evaluating the system with clinical data.

• 암석학회지
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• 제23권3호
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• pp.187-195
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• 2014

이 논문에서는 경주시 양남면에 분포하는 해발고도 약 45 m의 수렴단층 노두 해안단구 퇴적층의 형성시기를 추정하기 위하여, 퇴적층을 구성하고 있는 석영에 대한 단일입자 OSL(Single Grain Optically Stimulated Luminescence) 연대측정을 실시하였다. 실험에 사용된 총 1200개의 석영입자 중, 93개의 입자가 연대측정에 적합한 OSL 신호특성을 보였으며, 이들의 등가선량은 50-610 Gy까지 넓은 분포를 보인다. 이 자료를 중심연대모델(Central Age Model)과 최소연대모델(Minimum Age Model)을 이용하여 분석하면, 각각 $83{\pm}4ka$와 $60^{+3}{_{-7}}ka$의 연대가 도출되지만, 이들 연대는 MIS 5a시기로 보고된 기존의 제2해안단구의 OSL 연대와 층서적으로 불일치한다. 단일입자 OSL 분석결과들을 혼합연대모델(Finite Mixture Model)에 적용하면, 분석된 입자들 중 $6{\pm}4%$의 석영입자가 MIS 7의 퇴적시기 $194{\pm}24ka$)를 지시함을 알 수 있다. 결론적으로, 수렴단층 노두 해안단구 퇴적층이 MIS 7 시기에 형성되었을 가능성을 배제할 수 없으며, 이 퇴적층은 일반적으로 적용되는 다입자 OSL(multiple grain OSL) 연대측정법을 적용하기에 적합하지 않은 시료로 판단된다.

• 디지털융복합연구
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• 제17권7호
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• pp.215-224
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• 2019

본 연구는 졸업예정 간호 학생들의 주관적 투약수행역량 수준을 확인하고, 제 특성들이 주관적 투약수행 역량에 미치는 영향요인을 살펴보기 위함이며, 구조화된 설문지를 이용한 서술적 조사연구이다. 본 연구의 대상자는 졸업예정 간호대학생 총 128명으로, 자료수집 기간은 2018년 11월부터 2019년 1월까지이다. 본 연구의 측정변수는 약물용량계산 자기효능감, 약물계산 불안감, 주관적 투약수행역량이며, 자료분석은 SPSS 25.0 program을 이용하여 t-test, ANOVA, chi-square test, multiple regression을 시행하였다. 회귀 분석결과 본 연구의 종속변수인 주관적 투약수행 역량에 영향을 미치는 요인은 약물계산자신감(${\beta}=.463$, p<.001), 임상실습 태도(${\beta}=.168$, p=.04)이었다. 임상실습태도가 적극적이고(B=7.002), 약물계산자신감이 높을 때(B=1.648) 주관적 투약수행역량이 높았으며 이들 변수들은 주관적 투약수행역량을 29.0%를 설명하였다(F=26.93, p<.001). 적극적인 임상실습 태도와 학생들의 약물계산에 대한 자신감은 간호학생들의 투약수행 역량을 높이는데 기여할 수 있다. 본 연구 결과는 환자의 약물처방에 대한 정확성 확인, 처방된 약물용량의 재계산, 투약 후 환자반응 관찰 등 학생들의 투약수행역량을 높이기 위한 다양한 교육전략을 세우는데 활용될 수 있다.

• Clinical and Experimental Pediatrics
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• 제49권9호
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• pp.987-990
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• 2006

정맥내 면역글로블린은 급성 가와사끼병의 치료에 효과적이나 약 10-20%의 환자에서 치료 실패가 보고되고 있다. 이러한 경우 면역글로블린의 재투여 또는 스테로이드나 다른 약제의 사용 등 다양한 치료방법이 시도되고 있으나 아직 이에 대한 확립된 치료 가이드라인은 없다. $TNF-{\alpha}$는 가와사끼병의 급성기, 특히 관상동맥류를 가진 환자에서 혈중농도가 크게 증가한다. 저자들은 2번의 면역글로블린 투여와 3번의 pulse methylprednisolone 치료에 반응이 없던 10개월 된 난치성 가와사끼병 환아에게 항 $TNF-{\alpha}$인 infliximab (5 mg/kg, 1회)을 투여하여 임상 호전과 더불어 항염증지표가 정상이 되고 관상동맥류 진행이 억제됨을 경험하였다.

• Asian Journal of Atmospheric Environment
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• 제5권4호
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• pp.247-262
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• 2011

This study assessed the health risks of childhood exposure to PBDEs via different possible pathways in children's facilities and indoor playgrounds. When PBDE contamination was measured, it was determined through multiple routes, including inhalation of indoor dust, dermal contact with product surfaces and children's hands, and incidental dust ingestion. Samples were collected from various children's facilities (playrooms, daycare centers, kindergartens, and indoor playgrounds) during summer (Jul-Sep, 2007) and winter (Jan-Feb, 2008). The hazard index (HI) was estimated for non-carcinogens, and PBDEs, such as TeBDE, PeBDE, HxBDE, and DeBDE, were examined. The sensitivity to the compounds did not exceed 1.0 (HI) for any of the subjects in any facility. However, current data about toxicity does not reflect effects that were fully sensitive in children, so there is uncertainty in the dose-response data. The contribution rates of PBDEs were 71.4 to 96.1% and 3.7 to 28.2% for intake and inhalation exposure, respectively, indicating that intake of floor dust and inhalation are the primary routes.