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Understanding the Legal Structure of German Human Gene Testing Act (GenDG) (독일 유전자검사법의 규율 구조 이해 - 의료 목적 유전자검사의 문제를 중심으로 -)

  • Kim, Na-Kyoung
    • The Korean Society of Law and Medicine
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    • v.17 no.2
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    • pp.85-124
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    • 2016
  • The Human gene testing act (GenDG) in Germany starts from the characteristic features of gene testing, i.e. dualisting structure consisted of anlaysis on the one side and the interpretation on the other side. The linguistic distincion of 'testing', 'anlaysis' and 'judgment' in the act is a fine example. Another important basis of the regulation is the ideological purpose of the law, that is information autonomy. The normative texts as such and the founding principle are the basis of the classification of testing types. Especially in the case of gene testing for medical purpose is classified into testing for diagnostic purpose and predictive purpose. However, those two types are not always clearly differentiated because the predictive value of testing is common in both types. In the legal regulation of gene testing it is therefore important to manage the uncertainty and subjectivity which are inherent in the gene-analysis and the judgment. In GenDG the system ensuring the quality of analysis is set up and GEKO(Commity for gene tisting) based on the section 23 of GenDG concretes the criterium of validity through guidelines. It is also very important in the case of gene testing for medical purpose to set up the system for ensurement of procedural rationality of the interpretation. The interpretation of the results of analysis has a wide spectrum because of the consistent development of technology on the one side and different understandings of different subjects who performs gene testings. Therefore the process should include the communication process for patients in oder that he or she could understand the meaning of gene testing and make plans of life. In GenDG the process of genetic counselling and GEKO concretes the regulation very precisely. The regulation as such in GenDG seems to be very suggestive to Korean legal polic concerning the gene testing.

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Sentiment analysis on movie review through building modified sentiment dictionary by movie genre (영역별 맞춤형 감성사전 구축을 통한 영화리뷰 감성분석)

  • Lee, Sang Hoon;Cui, Jing;Kim, Jong Woo
    • Journal of Intelligence and Information Systems
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    • v.22 no.2
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    • pp.97-113
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    • 2016
  • Due to the growth of internet data and the rapid development of internet technology, "big data" analysis is actively conducted to analyze enormous data for various purposes. Especially in recent years, a number of studies have been performed on the applications of text mining techniques in order to overcome the limitations of existing structured data analysis. Various studies on sentiment analysis, the part of text mining techniques, are actively studied to score opinions based on the distribution of polarity of words in documents. Usually, the sentiment analysis uses sentiment dictionary contains positivity and negativity of vocabularies. As a part of such studies, this study tries to construct sentiment dictionary which is customized to specific data domain. Using a common sentiment dictionary for sentiment analysis without considering data domain characteristic cannot reflect contextual expression only used in the specific data domain. So, we can expect using a modified sentiment dictionary customized to data domain can lead the improvement of sentiment analysis efficiency. Therefore, this study aims to suggest a way to construct customized dictionary to reflect characteristics of data domain. Especially, in this study, movie review data are divided by genre and construct genre-customized dictionaries. The performance of customized dictionary in sentiment analysis is compared with a common sentiment dictionary. In this study, IMDb data are chosen as the subject of analysis, and movie reviews are categorized by genre. Six genres in IMDb, 'action', 'animation', 'comedy', 'drama', 'horror', and 'sci-fi' are selected. Five highest ranking movies and five lowest ranking movies per genre are selected as training data set and two years' movie data from 2012 September 2012 to June 2014 are collected as test data set. Using SO-PMI (Semantic Orientation from Point-wise Mutual Information) technique, we build customized sentiment dictionary per genre and compare prediction accuracy on review rating. As a result of the analysis, the prediction using customized dictionaries improves prediction accuracy. The performance improvement is 2.82% in overall and is statistical significant. Especially, the customized dictionary on 'sci-fi' leads the highest accuracy improvement among six genres. Even though this study shows the usefulness of customized dictionaries in sentiment analysis, further studies are required to generalize the results. In this study, we only consider adjectives as additional terms in customized sentiment dictionary. Other part of text such as verb and adverb can be considered to improve sentiment analysis performance. Also, we need to apply customized sentiment dictionary to other domain such as product reviews.

The Structure of the Theory of Three Natures from the Hermeneutic Perspective of "the Three Turns of the Dharma Cakra" ('3전법륜설'의 해석학적 지평으로 본 삼성설의 구조)

  • Kim, Jae-gweon
    • Journal of Korean Philosophical Society
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    • v.117
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    • pp.35-55
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    • 2011
  • This article purports to clarify the doctrinal characteristics of the $Yog{\bar{a}}c{\bar{a}}ra$ school's hermeneutic interpretations of the "theory of the three turns of the Dharma Cakra" in the Saṃdbinirmocana-sūtra through early Indian $Yog{\bar{a}}c{\bar{a}}ra$ treatises such as the $Yog{\bar{a}}c{\bar{a}}rabb{\bar{u}}mi-vy{\bar{a}}kby{\bar{a}}$ and the. $Vy{\bar{a}}khy{\bar{a}}yukti$. It will probe how these interpretations apply co the theory of two truths or that of three natures($trisvabh{\bar{a}}va$) among the main doctrines of the $Yog{\bar{a}}c{\bar{a}}ra$ school. Especially, the peculiar characteristic of the "theory of the three turns of the Dharma Cakra" is such chat the thought of ${\acute{s}}{\bar{u}}nyat{\bar{a}}$ in the lineage of $Praj{\bar{n}}{\bar{a}}p{\bar{a}}ramita-s{\bar{u}}tras$ is regarded as incomplete, as the early school of Madhyamaka represented by $N{\bar{a}}g{\bar{a}}rjuna$ is conceived of as belonging to the second period of turn. Speaking of the further details of the "theory of the three turns of the Dharma Cakra", the $Yog{\bar{a}}c{\bar{a}}ra$ school subdivides the realm of saṃvṛti satya in $N{\bar{a}}g{\bar{a}}rjuna^{\prime}s$ theory of two truths; that is, it divides the saṃvṛti into merely linguistic existence and actual existence, and the thus-created structure of the theory of three natures on the basis of ocher-dependent nature(paratantra-$svabh{\bar{a}}va$) makes it possible to establish the doctrinal system of the thought of ${\acute{s}}{\bar{u}}nyat{\bar{a}}$ that is not subject to "nihilism or ${\acute{s}}{\bar{u}}nyat{\bar{a}}$ attached to evil." In effect, the above hermeneutic interpretation of the "theory of the three turns of the Dharma Cakra" is inherited into the structure of the $abh{\bar{u}}taparikalpa$ in the $Madhy{\bar{a}}nta-vibh{\bar{a}}ga$ so that, as seen in the commentary of Sthiramati, it is ascertained to apply to later doctrines through its secure establishment. To summarize its characteristics succinctly, firstly the $abh{\bar{u}}taparikalpa$ newly established as a saṃvṛti-satya is set up as the other-dependent nature, which is seen to have been set up particularly in order to sublate both the $Sarv{\bar{a}}stiv{\bar{a}}da^{\prime}s$ realist "view of being" and the Madhyamaka's "view of ${\acute{s}}{\bar{u}}nyat{\bar{a}}$" that impairs the ocher-dependent nature as a samvṛti-satya. In other words, according to the five kinds of views suggested in Sthiramati's commentary, the three natures are seen to be presented as the fundamental truth in order to unify all the doctrinal systems available ever since the beginning of Buddhism. Then, the theory of three natures is established principally on the basis of the $abh{\bar{u}}taparikalpa$, while the two truths of the $Yog{\bar{a}}c{\bar{a}}ra$ school are clearly ascertained to have been embedded in the structure of the $abh{\bar{u}}taparikalpa$. In fact, this might be understood to reflect the unique ontological view of reality or truth in the $Yog{\bar{a}}c{\bar{a}}ra$ School.

The Narrative Structure of Terayama Shūji's Sekkyōbushi Misemono Opera Shintokumaru (데라야마 슈지(寺山修司)의 '셋교부시(說敎節)에 의한 미세모노(見せ物)오페라' <신토쿠마루(身毒丸)>의 서사 구조)

  • Kang, Choon-ae
    • (The) Research of the performance art and culture
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    • no.32
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    • pp.489-524
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    • 2016
  • This study examines the birth of a genre, the $Sekky{\bar{o}}bushi$ Misemono Opera, focusing on how it accepted and modernized Katarimono $Sekky{\bar{o}}bushi$. Unlike earlier studies, it argues that Terayama was clearly different from other first-generation Angura artists, in that he rebirthed the medieval story $Sekky{\bar{o}}bushi$ as a modern Misemono Opera. Shintokumaru (1978) was directed by Terayama $Sh{\bar{u}}ji$, a member of the first generation of Japan's 1960s Angura Theatre Movement. It takes as its subject the Katarimono $Sekky{\bar{o}}bushi$ Shintokumaru, a story set to music that can be considered an example of the modern heritage of East Asian storytelling. $Sekky{\bar{o}}$ Shintokumaru is set in Tennoji, Japan. The title character Shintoku develops leprosy as a result of his stepmother's curse and is saved through his fiancee Otohime's devoted love and the spiritual power of the Bodhisattva Avalokitesvara. In this work, Terayama combined the narrative style of $Sekky{\bar{o}}bushi$ with J.A. Caesar's shamanistic rock music and gave it the subtitle 'Misemono Opera by $Sekky{\bar{o}}bushi$'. He transforms its underlying theme, the principle of goddesses and their offspring in a medieval religious world and the modori (return) instinct, into a world of mother-son-incest. Also, the pedestrian revenge scene from $Sekky{\bar{o}}bushi$ is altered to represent Shintokumaru as a drag queen, wearing his stepmother's clothes and mask, and he unites sexually with Sensaku, his stepbrother, and ends up killing him. The play follows the cause and effect structure of $Sekky{\bar{o}}bushi$. The appearance of katarite, a storyteller, propelling the narrative throughout and Dr. Yanagida Kunio is significant as an example of the modern use of self-introduction as a narrative device and chorus. Terayama $Sh{\bar{u}}ji^{\prime}s$ memories of desperate childhood, especially the absence of his father and the Aomori air raids, are depicted and deepened in structure. However, seventeen years after Terayama's death, the version of the play directed by Ninagawa Yukio-based on a revised edition by Kishida Rio, who had been Terayama's writing partner since the play's premier-is the today the better-known version. All the theatrical elements implied by Terayama's subtitle were removed, and as a result, the Rio production misses the essence of the diverse experimental theatre of Terayama's theatre company, $Tenj{\bar{o}}$ Sajiki. Shintokumaru has the narrative structure characteristic of aphorism. That is, each part of the story can stand alone, but it is possible to combine all the parts organically.

Characteristic of Personnel Organization and Facility of Gyeonggi Kamyoung during Late Joseon (조선후기 경기감영의 인원 구성과 시설 특징)

  • YI, SUN HUI
    • (The)Study of the Eastern Classic
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    • no.73
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    • pp.185-217
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    • 2018
  • This research is a part of basic research on Gyeonggi Kamyoung focused on reconstruct personnel organization and facility of Gyeonggi Kamyoung, the only Kamyoung without a Kamyoung Record, which should have been recorded on it. Excluding Gyeonggi Kamyoung, other 7 Kamyoung each have its Kamyoung Record that shows their detailed history and set up. Due to lack of information about Gyeonggi Kamyoung, this research set objective on reconstructing Kamyoung Record of it with fragments of information on multiple historical records. By doing this, this research will also be a background for general research on distinguishing administrative unity from regional uniqueness of all 8 provinces Kamyoung. Kamyoung's personnel organization is sorted into government official from central government and Yeongli and staff. The information about the government official on this research is based on "Ki-Yung-Jang-Gae- Deung-Rok"'s personal assessment. According to it, Dosa Junggun Geomlyul had the same task and position as others in different provinces did. The difference Gyeonggi Kamyoung had was an absence of Sim Yak since 1700 while others still had it. The information about Yeongli and staff's organization was based on "Ki-Yeong-Sin-Jeong-Sa-Le". In Gyeonggi Kamyoung, along 6-Bang, there were 208 Yeongli and staff categorized into 50 different official duties. Also, compared to other Kamyoungs, Youngli's scale was smaller. Kamyoung's facility inside Pojeongmun and wall is distinguished from other Kamyoung related facilities in this research. Organization of facilities inside Pojeongmun and wall is based on "Gyeonggi-Kamyoung-Do". Like other Kamyoungs in different provinces, Seonhwadang, which is the main building, is located in the center and had a similar organization. Significant point was that Gyeonggi Kamyoung had both Youngli-Cheong and Hyeongli-Cheong at the same time. In the dense and developed area outside of Seodaemun, Gyeonggi Kamyoung had its related facility around it in small scale.

Major Class Recommendation System based on Deep learning using Network Analysis (네트워크 분석을 활용한 딥러닝 기반 전공과목 추천 시스템)

  • Lee, Jae Kyu;Park, Heesung;Kim, Wooju
    • Journal of Intelligence and Information Systems
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    • v.27 no.3
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    • pp.95-112
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    • 2021
  • In university education, the choice of major class plays an important role in students' careers. However, in line with the changes in the industry, the fields of major subjects by department are diversifying and increasing in number in university education. As a result, students have difficulty to choose and take classes according to their career paths. In general, students choose classes based on experiences such as choices of peers or advice from seniors. This has the advantage of being able to take into account the general situation, but it does not reflect individual tendencies and considerations of existing courses, and has a problem that leads to information inequality that is shared only among specific students. In addition, as non-face-to-face classes have recently been conducted and exchanges between students have decreased, even experience-based decisions have not been made as well. Therefore, this study proposes a recommendation system model that can recommend college major classes suitable for individual characteristics based on data rather than experience. The recommendation system recommends information and content (music, movies, books, images, etc.) that a specific user may be interested in. It is already widely used in services where it is important to consider individual tendencies such as YouTube and Facebook, and you can experience it familiarly in providing personalized services in content services such as over-the-top media services (OTT). Classes are also a kind of content consumption in terms of selecting classes suitable for individuals from a set content list. However, unlike other content consumption, it is characterized by a large influence of selection results. For example, in the case of music and movies, it is usually consumed once and the time required to consume content is short. Therefore, the importance of each item is relatively low, and there is no deep concern in selecting. Major classes usually have a long consumption time because they have to be taken for one semester, and each item has a high importance and requires greater caution in choice because it affects many things such as career and graduation requirements depending on the composition of the selected classes. Depending on the unique characteristics of these major classes, the recommendation system in the education field supports decision-making that reflects individual characteristics that are meaningful and cannot be reflected in experience-based decision-making, even though it has a relatively small number of item ranges. This study aims to realize personalized education and enhance students' educational satisfaction by presenting a recommendation model for university major class. In the model study, class history data of undergraduate students at University from 2015 to 2017 were used, and students and their major names were used as metadata. The class history data is implicit feedback data that only indicates whether content is consumed, not reflecting preferences for classes. Therefore, when we derive embedding vectors that characterize students and classes, their expressive power is low. With these issues in mind, this study proposes a Net-NeuMF model that generates vectors of students, classes through network analysis and utilizes them as input values of the model. The model was based on the structure of NeuMF using one-hot vectors, a representative model using data with implicit feedback. The input vectors of the model are generated to represent the characteristic of students and classes through network analysis. To generate a vector representing a student, each student is set to a node and the edge is designed to connect with a weight if the two students take the same class. Similarly, to generate a vector representing the class, each class was set as a node, and the edge connected if any students had taken the classes in common. Thus, we utilize Node2Vec, a representation learning methodology that quantifies the characteristics of each node. For the evaluation of the model, we used four indicators that are mainly utilized by recommendation systems, and experiments were conducted on three different dimensions to analyze the impact of embedding dimensions on the model. The results show better performance on evaluation metrics regardless of dimension than when using one-hot vectors in existing NeuMF structures. Thus, this work contributes to a network of students (users) and classes (items) to increase expressiveness over existing one-hot embeddings, to match the characteristics of each structure that constitutes the model, and to show better performance on various kinds of evaluation metrics compared to existing methodologies.

Analysis of the Range Verification of Proton using PET-CT (Off-line PET-CT를 이용한 양성자치료에서의 Range 검증)

  • Jang, Joon Young;Hong, Gun Chul;Park, Sey Joon;Park, Yong Chul;Choi, Byung Ki
    • The Journal of Korean Society for Radiation Therapy
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    • v.29 no.2
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    • pp.101-108
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    • 2017
  • Purpose: The proton used in proton therapy has a characteristic of giving a small dose to the normal tissue in front of the tumor site while forming a Bragg peak at the cancer tissue site and giving up the maximum dose and disappearing immediately. It is very important to verify the proton arrival position. In this study, we used the off-line PET CT method to measure the distribution of positron emitted from nucleons such as 11C (half-life = 20 min), 150 (half-life = 2 min) and 13N The range and distal falloff point of the proton were verified by measurement. Materials and Methods: In the IEC 2001 Body Phantom, 37 mm, 28 mm, and 22 mm spheres were inserted. The phantom was filled with water to obtain a CT image for each sphere size. To verify the proton range and distal falloff points, As a treatment planning system, SOBP were set at 46 mm on 37 mm sphere, 37 mm on 28 mm, and 33 mm on 22 mm sphere for each sphere size. The proton was scanned in the same center with a single beam of Gantry 0 degree by the scanning method. The phantom was scanned using PET-CT equipment. In the PET-CT image acquisition method, 50 images were acquired per minute, four ROIs including the spheres in the phantom were set, and 10 images were reconstructed. The activity profile according to the depth was compared to the dose profile according to the sphere size established in the treatment plan Results: The PET-CT activity profile decreased rapidly at the distal falloff position in the 37 mm, 28 mm, and 22 mm spheres as well as the dose profile. However, in the SOBP section, which is a range for evaluating the range, the results in the proximal part of the activity profile are different from those of the dose profile, and the distal falloff position is compared with the proton therapy plan and PET-CT As a result, the maximum difference of 1.4 mm at the 50 % point of the Max dose, 1.1 mm at the 45 % point at the 28 mm sphere, and the difference at the 22 mm sphere at the maximum point of 1.2 mm were all less than 1.5 mm in the 37 mm sphere. Conclusion: To maximize the advantages of proton therapy, it is very important to verify the range of the proton beam. In this study, the proton range was confirmed by the SOBP and the distal falloff position of the proton beam using PET-CT. As a result, the difference of the distally falloff position between the activity distribution measured by PET-CT and the proton therapy plan was 1.4 mm, respectively. This may be used as a reference for the dose margin applied in the proton therapy plan.

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A Basic Study on the Establishment of Preservation and Management for Natural Monument(No.374) Pyeongdae-ri Torreya nucifera forest of Jeju (천연기념물 제374호 제주 평대리 비자나무 숲의 보존·관리방향 설정을 위한 기초연구)

  • Lee, Won-Ho;Kim, Dong-Hyun;Kim, Jae-Ung;Oh, Hae-Sung;Choi, Byung-Ki;Lee, Jong-Sung
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.32 no.1
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    • pp.93-106
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    • 2014
  • In this study, Analyze environment of location, investigation into vegetation resources, survey management status and establish to classify the management area for Natural monument No.374 Pyengdae-ri Torreya nucifera forest. The results were as follows: First, Torreya nucifera forest is concerned about influence of development caused by utilization of land changes to agricultural region. Thus, establish to preservation management plan for preservation of prototypical and should be excluded development activity to cause the change of terrain that Gotjawal in the Torreya nucifera forest is factor of base for generating species diversity. Secondly, Torreya nucifera forest summarized as 402 taxa composed 91 familly 263 genus, 353 species, 41 varieties and 8 forms. The distribution of plants for the first grade & second grade appear of endangered plant to Ministry of Environment specify. But, critically endangered in forest by changes in habitat, diseases and illegal overcatching. Therefore, when establishing forest management plan should be considered for put priority on protection. Thirdly, Torreya nucifera representing the upper layer of the vegetation structure. But, old tree oriented management and conservation strategy result in poor age structure. Furthermore, desiccation of forest on artificial management and decline in Torreya nucifera habitat on ecological succession can indicate a problem in forest. Therefore, establish plan such as regulation of population density and sapling tree proliferation for sustainable characteristics of the Torreya nucifera forest. Fourth, Appear to damaged of trails caused by use. Especially, Scoria way occurs a lot of damaged and higher than the share ratio of each section. Therefore, share ratio reduction Plan should be considered through the additional development of tourism routes rather than the replacement of Scoria. Fifth, Representing high preference of the Torreya nucifera forest tourist factor confirmed the plant elements. It is sensitive to usage pressure. And requires continuous monitoring by characteristic of Non-permanent. In addition, need an additional plan such as additional development of tourism elements and active utilizing an element of high preference. Sixth, Strength of protected should be differently accordance with importance. First grade area have to maintenance of plant population and natural habitats. Set the direction of the management. Second grade areas focus on annual regeneration of the forest. Third grade area should be utilized demonstration forest or set to the area for proliferate sapling. Fourth grade areas require the introduced of partial rest system that disturbance are often found in proper vegetation. Fifth grade area appropriate to the service area for promoting tourism by utilizing natural resources in Torreya nucifera forest. Furthermore, installation of a buffer zone in relatively low ratings area and periodic monitoring to the improvement of edge effect that adjacent areas of different class.

Development of Information Extraction System from Multi Source Unstructured Documents for Knowledge Base Expansion (지식베이스 확장을 위한 멀티소스 비정형 문서에서의 정보 추출 시스템의 개발)

  • Choi, Hyunseung;Kim, Mintae;Kim, Wooju;Shin, Dongwook;Lee, Yong Hun
    • Journal of Intelligence and Information Systems
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    • v.24 no.4
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    • pp.111-136
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    • 2018
  • In this paper, we propose a methodology to extract answer information about queries from various types of unstructured documents collected from multi-sources existing on web in order to expand knowledge base. The proposed methodology is divided into the following steps. 1) Collect relevant documents from Wikipedia, Naver encyclopedia, and Naver news sources for "subject-predicate" separated queries and classify the proper documents. 2) Determine whether the sentence is suitable for extracting information and derive the confidence. 3) Based on the predicate feature, extract the information in the proper sentence and derive the overall confidence of the information extraction result. In order to evaluate the performance of the information extraction system, we selected 400 queries from the artificial intelligence speaker of SK-Telecom. Compared with the baseline model, it is confirmed that it shows higher performance index than the existing model. The contribution of this study is that we develop a sequence tagging model based on bi-directional LSTM-CRF using the predicate feature of the query, with this we developed a robust model that can maintain high recall performance even in various types of unstructured documents collected from multiple sources. The problem of information extraction for knowledge base extension should take into account heterogeneous characteristics of source-specific document types. The proposed methodology proved to extract information effectively from various types of unstructured documents compared to the baseline model. There is a limitation in previous research that the performance is poor when extracting information about the document type that is different from the training data. In addition, this study can prevent unnecessary information extraction attempts from the documents that do not include the answer information through the process for predicting the suitability of information extraction of documents and sentences before the information extraction step. It is meaningful that we provided a method that precision performance can be maintained even in actual web environment. The information extraction problem for the knowledge base expansion has the characteristic that it can not guarantee whether the document includes the correct answer because it is aimed at the unstructured document existing in the real web. When the question answering is performed on a real web, previous machine reading comprehension studies has a limitation that it shows a low level of precision because it frequently attempts to extract an answer even in a document in which there is no correct answer. The policy that predicts the suitability of document and sentence information extraction is meaningful in that it contributes to maintaining the performance of information extraction even in real web environment. The limitations of this study and future research directions are as follows. First, it is a problem related to data preprocessing. In this study, the unit of knowledge extraction is classified through the morphological analysis based on the open source Konlpy python package, and the information extraction result can be improperly performed because morphological analysis is not performed properly. To enhance the performance of information extraction results, it is necessary to develop an advanced morpheme analyzer. Second, it is a problem of entity ambiguity. The information extraction system of this study can not distinguish the same name that has different intention. If several people with the same name appear in the news, the system may not extract information about the intended query. In future research, it is necessary to take measures to identify the person with the same name. Third, it is a problem of evaluation query data. In this study, we selected 400 of user queries collected from SK Telecom 's interactive artificial intelligent speaker to evaluate the performance of the information extraction system. n this study, we developed evaluation data set using 800 documents (400 questions * 7 articles per question (1 Wikipedia, 3 Naver encyclopedia, 3 Naver news) by judging whether a correct answer is included or not. To ensure the external validity of the study, it is desirable to use more queries to determine the performance of the system. This is a costly activity that must be done manually. Future research needs to evaluate the system for more queries. It is also necessary to develop a Korean benchmark data set of information extraction system for queries from multi-source web documents to build an environment that can evaluate the results more objectively.

The Prognostic Role of B-type Natriuretic Peptide in Acute Exacerbation of Chronic Obstructive Pulmonary Disease (만성폐쇄성폐질환의 급성 악화시 예후 인자로서의 혈중 B-type Natriuretic Peptide의 역할)

  • Lee, Ji Hyun;Oh, So Yeon;Hwang, Iljun;Kim, Okjun;Kim, Hyun Kuk;Kim, Eun Kyung;Lee, Ji-Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.6
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    • pp.600-610
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    • 2004
  • Background : The plasma B-type natriuretic peptide(BNP) concentration increases with the degree of pulmonary hypertension in patients with chronic respiratory disease. The aim of this study was to examine the prognostic role of BNP in the acute exacerbation of chronic obstructive lung disease (COPD). Method : We selected 67 patients who were admitted our hospital because of an acute exacerbation of COPD. Their BNP levels were checked on admission at the Emergency Department. Their medical records were analyzed retrospectively. The patients were divided into two groups according to their in-hospital mortality. The patients' medical history, comobidity, exacerbation type, blood gas analysis, pulmonary function, APACHE II severity score and plasma BNP level were compared. Results : Multiple logistic regression analysis identified three independent predictors of mortality: $FEV_1$, APACHE II score and plasma BNP level. The decedents group showed a lower $FEV_1$($28{\pm}7$ vs. $37{\pm}15%$, p=0.005), a higher APACHE II score($22.4{\pm}6.1$ vs. $15.8{\pm}4.7$, p=0.000) and a higher BNP level ($201{\pm}116$ vs. $77{\pm}80pg/mL$, p=0.000) than the sSurvivors group. When the BNP cut-off level was set to 88pg/mL using the receiver operating characteristic curve, the sensitivity was 90% and the specificity was 75% in differentiating between the survivors and decedents. On Fisher's exact test, the odds ratio for mortality was 21.2 (95% CI 2.49 to 180.4) in the patients with a BNP level > 88pg/mL. Conclusion : The plasma BNP level might be a predictor of mortality in an acute exacerbation of COPD as well as the $FEV_1$ and APACHE II score.