• Clinical and Experimental Reproductive Medicine
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• 제30권2호
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• pp.119-126
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• 2003

Objective: This study was carried out to compare the clinical outcomes of intracytoplasmic sperm injection (ICSI) in patients with obstructive azoospermia according to sperm retrieval site and technique; microsurgical epididymal sperm aspiration (MESA), percutaneous epididymal sperm aspiration (PESA), testicular sperm extraction by open biopsy (TESE). Methods: The outcomes of ICSI and IVF-ET were evaluated and compared among 3 groups. Seventy three men suffering from infertility due to obstructive azoospermia had 107 ICSI cycles using MESA (21 cycles in 15 patients), PESA (26 cycles in 17 patients) and TESE (60 cycles in 41 patients). Results: In the clinical outcomes in patients undergoing ICSI with epididymal or testicular sperm, there were no significant differences in fertilization rate (66.1% vs. 60.5%), cleavage rate (94.9% vs. 97.6%), cumulative embryo score (CES) (51.3 vs. 58.8), implantation rate (7.9% vs. 6.1), and clinical pregnancy rate per ET (30.4% (14/46) vs. 25.4% (15/59)) between both groups. Also, in the clinical outcomes in ICSI patients using MESA, PESA, TESE, there were no significant differences in fertilization rate (61.8%, 69.4%, 60.5%), cleavage rate (92.1%, 97.3%, 97.6%), CES (38.1, 52.0, 58.8), implantation rate (9.5%, 6.6%, 6.1%), and clinical pregnancy rate per ET (35% (7/20), 26.9% (7/26), 25.4% (15/59)) among 3 groups. Conclusion: When compared with MESA or TESE, PESA, the clinical outcomes were similar in ICSI patients with obstructive azoospermia whatever the origin or the technique of sperm retrieval. However, we considered PESA is more time-saving and cost effective for ICSI in patients with obstructive azoospermia.

• Clinical and Experimental Reproductive Medicine
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• 제21권1호
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• pp.1-11
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• 1994

The occurrence and time course of capacitation, acrosomal loss, and hyperactivated motility require quantitative definition in order to characterize fertile human sperm. Recently the method has been developed to estimate the quality of spermatozoa by using kinematic parameters such as curvilinear velocity(VCL), average path velocity(VAP), linearity(LIN), straightness(STR), amplitude of lateral head displacement(ALH), and beat cross frequence(BCF) from Computer Assisted Sperm Analysis (CASA). In this study, using the Hamilton Thorn motility analyzer HTM 2030(Hamilton Thorn Research, Beverly, MA), we attempted to identify the spermatozoa with hyperactivated motility (HA) objectively and to monitor hyperactivation of human spermatozoa during incubation in capacitating media and after treatment of calcium ionophore as compared with acrosome status. And we examined whether HA are related to the result of SPA. Semen samples obtained from 16 healthy men were prepared by swim up technique and preincubated in a capacitating media(modified BWW medium) for 5 hours and treated with calcium ionophore solution. The acrosome reaction was detected with PSA-FITC labelling of the acrosome and in vitro sperm ferilizing capacity was assessed by the zona free hamster ovum penetration assay (SPA). The incidence of hyperactivated sperm was 2.6% in fresh semen, 14.3% of the swim up population, 13.7% after 5h of incubation. Significant increase of percentage of hyperactivated sperm was observed after the incubation (p<0.05) but after treatment, no significant changes of percentage of hyperactivated sperm(l1.8%) in contrast to significant rise in the percentage of acrosome reacted cells. Correlation analysis failed to show any significant relationship between the percentage of sperm with HA and SPA score. In conclusion, although no direct correlations were found between the results of SPA and HA, hyperactivation of sperm is associated with capacitation and monitoring hyperactivated sperm will be expected as a method of evaluating the functional quality of sperm such as SPA.

• 만화애니메이션 연구
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• 통권40호
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• pp.83-107
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• 2015

프로파간다의 의미는 주로 1, 2차 세계대전 기간과 이후 냉전시대의 사회주의체제 국가, 또는 독일을 통치했던 히틀러가 사용했던 정치선전, 흑색선전으로 인식되곤 한다. 따라서 이미지와 영상에 대한 프로파간다의 연구는 주로 정치선전이 활발했던 시기의 사회주의 포스터나 영화를 사례로 연구되었다. 현대사회에서 과거의 정치선전의 성격을 가진 프로파간다는 더 이상 찾아보기 힘들다. 현대의 프로파간다는 정치선전 보다는'설득'을 기본으로 하는 은유적이고 포괄적인 의미로 변하게 되었다. 따라서 과거의 직접적인 정치선전의 의미에서 탈피해, 프로파간다의 의미를 고찰해 보고, 현대적인 프로파간다를 재정의 해보는 과정이 필요해졌다. 또한 현대적인 프로파간다의 의미를 영상사회라고 할 수 있는 현대 영상에서 분석하는 과정도 필요해졌다. 이에 다양한 분야에 사용되는 애니메이션을 대상으로 프로파간다를 분석해보고자 한다. 애니메이션은 영상산업의 대표적인 상품으로 사회와 시장에 민감하게 반응한다. 또한 애니메이션은 남녀노소 모두 시청이 가능하고 모든 연령대를 아우를 수 있는 영상으로서 현대의 은유적이고 간접적인, 다양한 형식의 프로파간다를 분석하는데 적절하다. 이에 애니메이션에 대한 프로파간다 분석 연구의 초보 단계로 애니메이션 프로파간다가 전형적으로 나타났고, 체제변화에 따라 표현방법에 변화가 일어난 중국애니메이션을 사례로 애니메이션 프로파간다의 표현방법을 분석하고자 한다. 사회체제는 그대로 유지하고 경제체제만 변화한 중국의 사례는 애니메이션 프로파간다에 사회체제와 경제체제의 영향을 구분하여 살펴볼 수 있기 때문에 가장 적절한 연구대상이 된다. 중국 애니메이션을 시기별로 작품의 프로파간다의 표현방법을 분석해 체제변화와 프로파간다의 표현방법에 대한 변화를 분석해 낼 수 있고, 분석 결과를 통해 사회와 시장이 애니메이션 프로파간다에 어떤 영향을 미치는지 규정해 볼 수 있다. 중국 애니메이션의 프로파간다의 표현방법은 중국 건국이전과 이후 그리고 문화혁명 전후 분명한 차이를 보이고 있다. 중국 건국 이전 서양의 영향을 많이 받은 작품에서 중국 건국이후 자국의 문화를 이용하여 애니메이션을 제작한 민족 특색적인 애니메이션으로의 변화가 있었고, 문화혁명을 전후하여 정치선전, 선동의 프로파간다가 전형적으로 나타나다가 다시 민족적 특성과 교육적인 프로파간다로 변화하는 과정을 겪는다. 최근에는 해외로의 수출과 해외와의 합작이 늘어가면서 선전과 선동의 의미의 프로파간다는 점점 약해지고 있다.

• Journal of Chest Surgery
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• 제41권6호
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• pp.718-723
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• 2008

배경: 최근 20년간 수술적인 기법, 마취 기술, 심폐기 운용, 중환자실 관리의 발전으로 심장수술의 사망률과 합병증은 상당히 감소하였지만 심장수술이 중추신경계에 상당한 위험 요소가 되는 것은 널리 알려진 바이다. 이 연구는 두경부 MRA를 통해 심장 수술 대상자에서 불현성 뇌혈관계 질환의 유병률과 두경부 MRA 상에서 비정상적인 소견을 보인 환자의 치료 방침의 변화를 알아보고자 하였다. 대상 및 방법: 2005년 10월부터 2008년 6월까지 두경부 MRA 촬영에 동의한 107명의 심장수술 예정자(21세에서 83세까지의 연령분포를 보인 남자 71명과 여자 36명)를 대상으로 하였다. 이 환자들 중에서 신경학적인 고위험군의 비율과 그 환자들의 치료 방침의 변화를 관찰하였다. 결과: 신경학적으로 고위험군 환자의 비율은 15.7% (17예)였으며, 이중 11예는 허혈성 심질환, 6예는 판막 질환이였으며, 이 중 2예의 환자만이 이전에 신경학적인 병력이 있었다. 14명(13.1%)의 환자에서 치료 방침에 변화가 있었다. 결론: 심장수술 대상자에 있어 불현성 뇌혈관계 질환은 비교적 높은 것으로 생각되며, 이를 밝히는 데 있어 두경부 MRA가 의미 있는 것으로 생각된다.

• Radiation Oncology Journal
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• 제37권2호
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• pp.101-109
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• 2019

Purpose: The purpose of this study is to evaluate the safety and efficacy of the multimodality treatment with neoadjuvant intensity-modulated radiotherapy (IMRT) for resectable clinical T1-3N0-1M0 malignant pleural mesothelioma (MPM). Materials and Methods: A total of eleven patients who received neoadjuvant chemotherapy and radiotherapy between March 2016 and June 2018 were reviewed. Patients received 25 Gy in 5 fractions to entire ipsilateral hemithorax with helical tomotherapy. Results: All of patients were men with a median age of 56 years. Epithelioid subtype was found in 10 patients. All patients received neoadjuvant chemotherapy with pemetrexed-cisplatin regimen. Ten patients (90.9%) completed 25 Gy/5 fractions and one (9.0%) completed 20 Gy/4 fractions of radiotherapy. IMRT was well tolerated with only one acute grade 3 radiation pneumonitis. Surgery was performed 1 week (median, 8 days; range, 1 to 15 days) after completing IMRT. Extrapleural pneumonectomy was performed in 4 patients (36.3%), extended pleurectomy/decortication in 2 (18.2%) and pleurectomy/decortications in 5 (63.6%). There was no grade 3+ surgical complication except two deaths after EPP in 1 month. Based on operative findings and pathologic staging, adjuvant chemotherapy was delivered in 7 patients (63.6%), and 2 (18.2%) were decided to add adjuvant radiotherapy. After a median follow-up of 14.6 months (range, 2.8 to 30 months), there were 3 local recurrence (33.3%) and 1 distant metastasis (11.1%). Conclusion: Neoadjuvant entire pleural IMRT can be delivered with a favorable radiation complication. An optimal strategy has to be made in resectable MPM patients who would benefit from neoadjuvant radiation and surgery. Further studies are needed to look at long-term outcomes.

• Journal of Gastric Cancer
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• 제6권2호
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• pp.114-119
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• 2006

목적: pN2 이상의 조기 위암환자들은 수술 전, 중에 병기 진행의 예측이 가능하였는지 아니면 전혀 예측하지 못한 채 낮은 병기를 기대하다가 병리조직검사의 결과를 보고서야 알게 되는지를 알고자 하였다. 대상과 방법: 1990년부터 2003년까지 본 연구기관에서 위암으로 위 절제술을 받은 1,430명 중 조기위암 환자는 552명(38.6%)이었고 이들 중 pN2, pN3 환자 8명을 대상으로 수술 전의 임상적 병기 예측과 수술 중의 수술자가 예측한 병기 예측을 병리조직검사의 결과와 비교하고 환자의 경과를 알아보았다. 결과: pN2와 pN3인 조기위암 환자들은 모든 연령층에 분포하였고 남자가 7명으로 여자보다 많았다. 수술 전 전산화단층촬영의 평가에서 T1의 평가는 25% (2/8)로 대체로 과평가되었고 N2 이상 평가는 50% (4/8)이었다. cTNM병기 Ia의 예측환자는 한 명으로 나머지 환자는 진행된 병기로 예측하였다. 수술 중의 T1의 평가는 57.1%(4/7), N2 이상 평가는 66.7% (4/6)이었고 sTNM병기 Ia로 평가한 환자는 2명으로 나머지 환자들은 진행된 병기의 예측이 가능하였다. 5년 이상 장기생존 환자는 단 1명이었고 이들 8명의 중앙 생존기간은 15개월$(95%\;Cl:\;0{\sim}35.5)$이었다. 결론: pN2 이상의 조기위암 환자들은 수술 전이나 중에 진행된 병기로 예측이 어느 정도 가능하였다. 그러나 전혀 예측할 수 없었던 환자도 있어서 보다 정확히 예측할 수 있는 방법의 연구가 필요하겠다.

• Journal of Gastric Cancer
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• 제1권3호
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• pp.150-154
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• 2001

Purpose: Multiple early gastric cancers were found in $6.9\∼11.7\%$ of patients with early gastric cancer. The goal of this study was to clarify the clinicopathologic features of and to investigate treatment strategy for multiple early gastric cancer. Materials and Methods: Of 967 patients with an gastric adenocarcinoma who were treated by surgical resection during the period of $1993\∼1998$ at the Department of Surgery, Korea University College of Medicine, 267 patients had early gastric cancer. A retrospective analysis of the clinicopathologic differences between the main and the accessory lesions in multiple early gastric cancer was carried out. A comparative analysis was also conducted between solitary early gastric cancer and multiple early gastric cancer. Results: Of 267 patients with early gastric cancer, multiple early gastric cancers were found in 12 patients ($4.5\%$), including 10 men and 2 women. Eleven patients with multiple early gastric cancer had one accessory lesion and 1 patient had 2 accessory lesions. Of the 13 accessory lesions, 7 ($53.8\%$) were located in the same region as the main lesion. The most frequent combination of macroscopic types for the main lesion and the accessory lesion were depressed and depressed types (6 cases, $46.1\%$). The most frequent histologic type of main lesion was a well differentiated adenocarcinoma in 7 ($58.3\%$) of the 12 cases; the accessory lesion was also well differentiated in 4 of those 7 cases. Of the 13 accessory lesions, 4 ($30.8\%$) had been overlooked preoperatively; most of them were located in the lower third of the stomach and were IIb or IIc type and measured less than 1 cm in diameter. Lymph node metastasis was detected in 1 patient ($8.3\%$). The clinicopathologic features of multiple early gastric cancer were not different from those of solitary early gastric cancer. Conclusion: In multiple early gastric cancer, the main and the accessory lesions showed similar differentiation, and lymph node metastasis was less frequent than in solitary early gastric cancer. Therefore, limited procedures, including endoscopic mucosal resection, may be indicated if each lesion of the multiple early gastric cancer fits the criteria for treatment strategy.

• Tuberculosis and Respiratory Diseases
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• 제60권4호
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• pp.464-468
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• 2006

폐종괴로 발현하는 M. kansasii 감염은 흔하지 않으며 기관지 탄분섬유화증을 동반한 M. kansasii 폐감염에 대한 보고는 아직 없었다. 기저질환 없이 면역력이 정상인 비흡연자에서 우하엽의 폐종괴로 발현하고 기관지 탄분섬유화증을 동반한 M. kansasii 폐감염에 대하여 표준 치료로 호전되고 있는 증례를 경험하였기에 보고하는 바이다.

• Tuberculosis and Respiratory Diseases
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• 제79권1호
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• pp.31-36
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• 2016

Background: The purpose of this study was to evaluate the risk factors for mechanical ventilation in the patients with scrub typhus admitted to intensive care unit (ICU) at a university hospital. Methods: We retrospectively selected and analyzed clinical data from the medical records of 70 patients (32 men, 38 women) admitted to the ICU with scrub typhus between 2004 and 2014. The patients had a mean${\pm}$standard deviation age of $71.2{\pm}11.1years$ and were evaluated in two groups: those who had been treated with mechanical ventilation (the MV group, n=19) and those who had not (the non-MV group, n=51). Mean ages of the MV group and the non-MV group were $71.2{\pm}8.3years$ and $71.2{\pm}11.1years$, respectively. Results: Significant differences between the two groups were observed with respect to acute respiratory failure (p=0.008), Acute Physiology and Chronic Health Evaluation (APACHE) II score (p=0.015), Sequential Organ Failure Assessment (SOFA) score (p=0.013), death (p=0.014), and ICU duration (p<0.01). Multivariate analysis indicated that the following factors were significantly associated with mechanical ventilation: acute respiratory failure (p=0.011), SOFA score (p=0.005), APACHE II score (p=0.011), platelet count (p=0.009), and lactate dehydrogenase (LDH) (p=0.011). Conclusion: Thus, five factors-acute respiratory failure, SOFA score, APACHE II score, platelet count, and LDH-can be the meaningful indicators for mechanical ventilation for the patients with scrub typhus admitted to ICU.

• 대한의생명과학회지
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• 제12권4호
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• pp.375-383
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• 2006

The physiological responses following stress are different in individual or personality. We performed this study to clarify gender differences in influences of noise stress on physiological factors. 70 healthy subjects, which was divided man (n=30) and woman (n=40) groups, were exposed to 85 decibels of excavator noise for 15 minutes. Cardiac factors such as heart rate (HR), systolic and diastolic blood pressures (SBP and DBP, respectively), and heart rate-systolic pressure product (RPP) were determined. Transcranial Doppler ultrasound (TCD) was used to measure mean blood flow velocity (Vm), pulsatility index (PI), and resistance index (RI) in the middle, anterior and posterior cerebral arteries (MCA, ACA and PCA, respectively) before and during noise exposure. Cortisol level and hematological variables were also measured before (baseline) and immediately after the end of noise exposure. In the both groups HR, SBP, and RPP significantly decreased during noise exposure (P<0.05) but not significantly different between two groups (P>0.05). Vms of three cerebral arteries in man group decreased, whereas Vm of PCA in woman group fell during noise exposure (P<0.05). Vm, PI and RI in MCA and ACA during noise exposure were low in man group compared with woman group (P<0.05). Vm of PCA was low, whereas PI and RI of PCA were high in man group compared with woman group during noise exposure (P<0.05). Total leukocyte and red blood cell (RBC) counts slightly decreased during noise exposure but not significant (P>0.05). Levels in hematological variables decreased but not significant changed following noise exposure. Decreased rate of total leukocyte in man group was higher (P<0.05). Cortisol levels in the both groups decreased immediately after the end of noise exposure, while the decreased rate in man group was greater than that in woman group (p<0.05). These findings indicate that a transient exposure to experimental excavator noise may cause decreased changes in cardiac factors, cerebral hemodynamics and cortisol levels and the changes may be greater in men than in women.