• 대한골관절종양학회지
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• 제13권2호
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• pp.195-200
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• 2007

역분화성 방골성 골육종은 골육종의 드문 변이로서, 국소 재발 및 원격 전이와 관련하여 불량한 예후와 연관된 것으로 알려져 있다. 그러므로 종양의 역분화성을 진단하는 것은 치료 방침을 결정하는데 있어서 매우 중요하다고 할 수 있다. 29세 여자 환자로 2년 전부터 발생한 좌측 대퇴 근위부의 종창 및 불편감으로 내원하여 시행한 검사상 방골성 골육종으로 진단되어, 종괴 절제 및 재건술 시행하였다. 환자 병력상 수술 2주 전부터 대퇴부 통증이 심해졌고, 종괴 크기의 증가가 있었으며, 이에 수술직전 시행한 자기공명영상(MRI) 상 종괴의 크기 증가 및 인접 근육으로의 침범 소견 관찰되었고, 술 후 시행한 절제 표본의 조직검사 상 미분화성 방골성 골육종으로 진단되어 결국 환자는 수술적인 절제 후 불량한 병의 경과로 사망하게 되었다. 술전 조직 검사상 방골성 골육종으로 진단된 경우라도 급격한 통증의 증가나 종괴 크기의 증가 등의 임상양상의 변화가 있을 때는 종양의 역분화 가능성을 고려해야 한다.

• Journal of Gastric Cancer
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• 제1권2호
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• pp.106-112
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• 2001

Purpose: Even with excellent surgical outcome, recurrence of early gastric cancer (EGC) after a curative resection is not declining because the incidence of EGC is increasing. The aim of this study was to propose an appropriate treatment strategy by assessing the risk factors for recurrence of curatively resected early gastric cancer. Materials and Methods: Of 3662 patients who had undergone gastric resections for gastric cancer from 1987 to 1996, the cases of 1050 curatively resected EGC patients were reviewed retrospectively. Among those 1050 patients, 50 patients ($4.8\%$) were diagnosed as having recurrent cancer, which was confirmed by clinico-radiological examination or re-operation. The risk factors that determined the recurrence patterns were investigated by using univariate and multivariate analyses. Results: The mean time to recurrence was 30.9 months, and hematogenous recurrence was the most frequent type ($32.0\%$). Among the 50 recurred patients, peritoneal recurrence showed the shortest mean time to recurrence ($18.5\pm17.7$months). Between the recurred and the non-recurred patients, there was no statistically significant difference with respect to age, sex, operation type, tumor size, tumor location, gross appearance, or histological differentiation. However, depth of invasion (submucosal invasion) and nodal involvement were significantly different (P<0.001) between the two groups. Using logistic regression analyses, nodal involvement was the only significant risk factor for recurrence in early gastric cancer (P<0.001). The median survival after the recurrence had been diagnosed was 4 months. Conclusion: Although the prognosis for EGC patients is excellent and recurrence of EGC after a curative resection is rare, the time to recurrence and the patterns of recurrence in EGC patients were diverse and unpredictable, and the result after recurrence is dismal. Considering the impact of lymph node metastasis on recurrence of EGC, a systematic lymphadenectomy, rather than limited surgery, should be performed if lymph node involvement is confirmed pre- or intraoperatively. Also if the postoperative pathologic findings reveal lymph node involvement, adjuvant chemotherapy is recommended.

• Tuberculosis and Respiratory Diseases
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• 제78권4호
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• pp.321-325
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• 2015

Background: The adverse effects of the phosphodiesterase-4 inhibitor roflumilast, appear to be more frequent in clinical practice than what was observed in chronic obstructive pulmonary disease (COPD) clinical trials. Thus, we designed this study to determine whether adverse effects could be reduced by starting roflumilast at half the dose, and then increasing a few weeks later to $500{\mu}g$ daily. Methods: We retrospectively investigated 85 patients with COPD who had taken either $500{\mu}g$ roflumilast, or a starting dose of $250{\mu}g$ and then increased to $500{\mu}g$. We analyzed all adverse events and assessed differences between patients who continued taking the drug after dose escalation and those who had stopped. Results: Adverse events were reported by 22 of the 85 patients (25.9%). The most common adverse event was diarrhea (10.6%). Of the 52 patients who had increased from a starting dose of $250{\mu}g$ roflumilast to $500{\mu}g$, 43 (82.7%) successfully maintained the $500{\mu}g$ roflumilast dose. No difference in factors likely to affect the risk of adverse effects, was detected between the dose-escalated and the discontinued groups. Of the 26 patients who started with the $500{\mu}g$ roflumilast regimen, seven (26.9%) discontinued because of adverse effects. There was no statistically significant difference in discontinuation rate between the dose-escalated and the control groups (p=0.22). Conclusion: Escalating the roflumilast dose may reduce treatment-related adverse effects and improve tolerance to the full dose. This study suggests that the dose-escalated regimen reduced the rate of discontinuation. However, longer-term and larger-scale studies are needed to support the full benefit of a dose escalation strategy.

• 대한영양사협회학술지
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• 제15권4호
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• pp.335-342
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• 2009

Forty-two percent of the patients with renal failure that requires continuous renal replacement therapy (CRRT) have been reported to have severe malnutrition, and preexisting malnutrition is a statistically significant and independent predictor of negative hospital outcomes. We performed this study to evaluate the appropriateness of the calorie and protein provided for the critically ill patients who require CRRT. One hundred forty-nine patients who received CRRT were enrolled. The demographic data, the length of the ICU stay and the mortality were recorded. The calorie/protein intake and the blood urea nitrogen (BUN), albumin and creatinine levels were used as nutritional parameters. The mean daily calorie intake during CRRT was 16.1${\pm}$7.4 kcal/kg, which was 64% of the recommended intake. Only 10% of the patients received the recommended caloric intake and the ratio of the enteral and parenteral calories was 26%/74%. The mean protein intake was 0.58${\pm}$0.34 g/kg, which was 38% of the recommended intake. The calorie and protein intakes at the termination of CRRT were significantly increased compared to the initial day of treatment, but they stayed under the recommended intake. The BUN, creatinine and albumin levels were significantly increased in the survival group (odds ratio for albumin: 2.73; creatinine: 2.43). A strategy to increase the nutrition provision is needed to improve the nutritional statuses and clinical outcomes of the critically ill patients who require CRRT.

• BMB Reports
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• 제41권7호
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• pp.537-541
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• 2008

Epilepsy is characterized by the presence of spontaneous episodes of abnormal neuronal discharges and its pathogenic mechanisms remain poorly understood. Recently, we found that the expression of creatine kinase (CK) was markedly decreased in an epilepsy animal model using proteomic analysis. A human CK gene was fused with a HIV-1 Tat peptide to generate an in-frame Tat-CK fusion protein. The purified Tat-CK fusion protein was efficiently transduced into PC12 cells in a time- and dose-dependent manner when added exogenously to culture media. Once inside the cells, the transduced Tat-CK fusion protein was stable for 48 h. Moreover, the Tat-CK fusion protein markedly increased endogenous CK activity levels within the cells. These results suggest that Tat-CK provides a strategy for the therapeutic delivery of proteins in various human diseases including the delivery of CK for potential epilepsy treatment.

• Journal of Acupuncture Research
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• 제22권2호
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• pp.71-81
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• 2005

Objective : Dear antler (Cervus korean TEMMINCK var. mantchuricus Swinhoe) used for traditional immunosuppressive and immuno-activating action. The effect of deer antler herbal-acupuncture(DAH) solution, prepared by water extract method, on cathepsin activities in bone tissues (cartilage and synovial) cells from mouse rheumatoid arthritis (RA) model was studied. The cysteine endoprotease cathepsin mediates degradation of the MHC class II invariant chain (Ii) in human and mouse antigen-presenting cells. The studies described here examine the functional significance of cathepsin inhibition on autoantigen presentation and organ-specific autoimmune diseases in a murine model for RA. Methods : An animal model for RA in BALB/c mice thymectomized 3 days after birth (3d-Tx) was constructed All 3d-Tx BALB/c mice developed autoimmune lesions in the bone tissue cells, starting at 3 weeks of age, and the disease mediated by CD4+ T cells was chronic and progressive. Significant inhibitory effects of DAH solution on cathepsin S and L were observed in each organ in a dose-dependent manner. Moreover, we confirmed that cathepsin S and L activity in each organ were clearly inhibited by DAB solution. When we examined the inhibitory effects of DAH solution against autoantigen-specific T cell responses in vitro, in regional lymph node cells, but not in spleens, from model mice, a significant inhibitory effect of DAB solution was observed in a dose-dependent manner. DAH solution do not block T cell proliferation to Con A, indicated that the dose of DAB solution 10 to $20\;{\mu}g/m{\ell}$ was sufficient to inactivate the autoantigen-specific T cell responses in vitro. In vivo therapeutic effects of DAB solution were examined in a murine model for RA, autoantigen-specific (C-II-specific) T cell response were significantly inhibited in LNCs from DAH solution-treated mice. Results : Iinhibition of cathepsin S and L in vivo alters autoantigen presentation and development of organ-specific autoimmunity in RA model. Conclusion : These data identify selective inhibition of cysteine protease cathepsin S and L as a potential therapeutic strategy for autoimmune disease process such RA. Thus, DAH solution will served as a potent anti-inflammatory and anti-arthritic agents for treatment of human RA.

• 농촌의학ㆍ지역보건
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• 제31권2호
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• pp.157-164
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• 2006

본 연구는 말라리아 고위험지역인 강화군 주민을 대상으로 신속진단킷트 시행으로 인한 진단소요일의 변화와 신속진단킷트 검사의 민감도와 특이도를 평가하고자 하였다. 이를 위하여 1998년 1월부터 2005년 12월까지 인천광역시 강화군에서 발열증상으로 말라리아가 의심되어 보건소, 보건지소, 진료소, 병의원 등 보건의료기관을 내원한 검사자 중 질병관리본부의 최종 검사결과 말라리아가 확진된 검사자 942명을 대상으로 최초 발열일부터 검사일까지의 기간으로 진단 소요일을 추정하였으며, 2004년 1월부터 2005년 12월까지 보건의료기관에서 신속진단킷트 검사와 혈액도말검사를 동시에 실시한 검사자 434명을 대상으로 질병관리본부의 최종 검사결과와 비교하여 진단소요일에 따른 민감도와 특이도를 측정하였다. 연구결과, 2003년 신속진단킷트 시행으로 인하여 진단소요일은 2002년 4.68일에서 2004년 3.14일과 2005년 3.31일로 감소한 것으로 나타났다. 또한 신속진단킷트의 민감도와 특이도는 98.2%와 98.5%인 것으로 나타나 혈액도말검사의 97.5%, 100%와 비교하여 큰 차이가 없었다. 이상의 결과를 종합할 때, 말라리아 신속진단킷트 검사는 진단소요일을 단축하면서도 민감도와 특이도를 유지하는 장점이 있는 것으로 판단되었다. 말초혈액도말검사를 실시할 역량을 갖추지 못한 보건의료기관에서는 신속하고 정확한 말라리아 진단을 위하여 신속진단킷트 검사를 적극적으로 고려할 필요가 있다.

• 대한심미치과학회지
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• 제25권1호
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• pp.15-24
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• 2016

전치부에서는 비록 임플란트가 기능적으로 문제가 없다고 하더라도 심미적인 문제가 있다면 실패로 간주한다. 2003년 Kan은 임플란트의 골 레벨은 인접치아의 골 레벨에 의해 결정된다고 보고하였다. 그 후로 많은 학자들이 인접치아의 골 소실이 있는 증례에서 어떻게 심미적 결과를 얻을 수 있는지에 대하여 연구해왔다. 2012년 Takino가 지금까지 여러 저널을 정리 및 분류하여 Class 1부터 4로 발표하였다. Class 1과 2는 인접치의 골소실이 없는 경우, Class 3,4는 인접치의 골소실이 있는 경우로 나누어서 각 분류마다 최적의 심미를 얻을 수 있는 방법에 대하여 설명하였다. 인접치의 골소실이 없는 경우에는 쉽게 심미적 결과를 얻을 수 있으나 인접치까지 골소실이 있는 경우는 수술이 복잡해지고 심미적 결과를 장담하기 힘들다. 따라서 장기적인 안정적 결과를 유지하기 위해서는 인접치에 대한 골재생술이 필요하다. 하지만 그 과정이나 치료법이 너무 복잡하여 이 저널에서는 기존의 수술법을 단순화하여 쉽게 비슷한 결과를 얻을 수 방법을 보고하고자 한다.

• Journal of Periodontal and Implant Science
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• 제35권2호
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• pp.511-524
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• 2005

The regeneration of lost periodontal tissue is a major goal of therapy. Periodontal ligament cell(PDL) is a specialized connective tissue that connects cementum and alveolar bone to maintain and support teeth in situ and preserve tissue homoeostasis. Bone morphogenetic proteins(BMPs) have shown much potential in the reconstruction of the periodontum by stimulate new bone and new cementum formation. Limitiations of BMP administration to periodontal lesions is high dose delivery, BMP transient biological activity, and low bioavailability of factors at the wound site. Gene delivery method can be alternative treatment strategy to deliver BMPs to periodontal tissue. The purpose of this study is to investigate efficiency of BMP-2 gene delivery with cell-based therapy using PDL cells. PDL cell were transduced with adenoviruses encoding either BMP-2 or Lac-Z gene. To evaluate osteogenic activity of expressed BMP-2 on PDL cells, we investigated secreted BMP-2, cellular activity, ALPase, produced mineralized nodules. To evaluate collagen scaffold as carrier for transduced cell delivery, we examined morphology and secreted BMP-2 of transducd PDL cells on it. BMP-2 transducd PDL cells produced higher levels of BMP-2, ALPase, mineralized nodules than non transduced cells. Cellular activity of transduced cells was showed similar activity to non transduced cells. Transduce cells attached on collagen scaffold secreted BMP-2 at 7day and was showed similar morphology to non transduced cells. These results demonstrated that transduced PDL cells produced biologically active BMP-2 and collagen scaffold could be carrier of transducd cells.

• 한국과학교육학회지
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• 제32권10호
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• pp.1551-1566
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• 2012

이 연구에서는 중학교 과학 수업에 협동학습 전략을 적용하여 학생들의 집단주의 성향을 고려한 소집단 구성이 학업 성취도, 과학 학습 동기, 과학 수업 환경에 대한 인식에 미치는 효과를 조사하였다. 또한, 협동학습에 대한 인식도 설문과 면담을 통하여 조사하였다. 188명의 학생들을 통제 집단과 이질 및 동질집단으로 무선 배치하고, 12차시 동안 수업을 실시하였다. 분석 결과, 학업 성취도, 과학 학습 동기, 관련성에서 수업 처치와 집단주의 성향 수준 사이의 상호작용 효과가 나타났으며, 자신감, 과학 수업 환경에 대한 인식, 친화성, 규칙의 명확성 영역에서 수업 처치의 주 효과가 나타났다. 집단주의 성향 하위 학생들의 학업 성취도는 이질 집단에서보다 동질 집단에서 더 높았다. 집단주의 성향 상위 학생들은 이질 및 동질 집단에서 과학 학습 동기와 관련성이 높게 나타났다. 또한, 동질 집단과 이질 집단의 자신감과 친화성 검사 점수가 통제 집단에 비하여 유의미하게 높았다. 동질 집단의 과학 수업 환경에 대한 인식과 규칙의 명확성 검사 점수가 통제 집단에 비하여 유의미하게 높았다. 집단주의 성향 수준에 따라 학생들이 가진 협동학습에 대한 인식의 차이가 있었다.