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Effect of Repetitive Transcranial Magnetic Stimulation in Drug Resistant Depressed Patients (치료 저항성 우울증 환자에서 반복적 경두개 자기자극후 국소뇌혈류 변화)

  • Chung, Yong-An;Yoo, Ie-Ryung;Kang, Bong-Joo;Chae, Jeong-Ho;Lee, Hye-Won;Moon, Hyun-Jin;Kim, Sung-Hoon;Sohn, Hyung-Sun;Chung, Soo-Kyo
    • Nuclear Medicine and Molecular Imaging
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    • v.41 no.1
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    • pp.9-15
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    • 2007
  • Purpose: Repetitive transcranial magnetic stimulation (rTMS) has recently been clinically applied in the treatment of drug resistant depressed patients. There are mixed findings about the efficacy of rTMS on depression. Furthermore, the influence of rTMS on the physiology of the brain is not clear. We prospectively evaluated changes of regional cerebral blood flow (rCBF) between pre- and post-rTMS treatment in patients with drug resistant depression. Materials and Methods: Twelve patients with drug-resistant depression (7 male, 5 female; age range: $19{\sim}52$ years; mean age: $29.3{\pm}9.3$ years) were given rTMS on right prefrontal lobe with low frequency (1 Hz) and on left prefrontal lobe with high frequency (20 Hz), with 20-minute-duration each day for 3 weeks. Tc-99m ECD brain perfusion SPECT was obtained before and after rTMS treatment. The changes of cerebral perfusion were analyzed using statistical parametric mapping (SPM; t=3.14, uncorrected p<0.01, voxel=100). Results: Following areas showed significant increase in rCBF after 3 weeks rTMS treatment: the cingulate gyrus, fusiform gyrus of right temporal lobe, precuneus, and left lateral globus pallidus. Significant decrement was noted in: the precental and middle frontal gyrus of right frontal lobe, and fusiform gyrus of left occipital lobe. Conclusion: Low-frequency rTMS on the right prefrontal cortex and high-frequency rTMS on the left prefrontal cortex for 3 weeks as an add-on regimen have increased and decreased rCBF in the specific brain regions in drug-resistant depressed patients. Further analyses correlating clinical characteristics and treatment paradigm with functional imaging data may be helpful in clarifying the pathophysiology of drug-resistant depressed patients.

Changes in Serum IGF-I and Spermatogenesis Analysed by Flow Cytometry in Growing Male Rabbit (성장 중인 수토끼에서 혈청 IGF-I 수준과 Flow Cytometry 측정에 의한 정자 형성의 변화)

  • Lee J. H.;Kim C. K.;Chang Y. M.;Ryu J. W.;Park M. Y.;Chung Y. C.;Pang M. G.
    • Reproductive and Developmental Biology
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    • v.29 no.3
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    • pp.163-168
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    • 2005
  • The aim of this study was to investigate the changes in insulin-like growth factor-I (IGF-I) and growth hormone (GH) in serum, the quantitation of spermato-genesis and the comparable relationships among these measurements during pubertal period in New Zealand White male rabbits. To investigate the age-related testicular changes in DNA contents of spermatogenic cells, the fine-needle testicular biopsies from males aged 10 to 28 wks were evaluated by flow cytometry(FCM). Body weight increased significantly between the ages of 12 and 20 wks (P<0.05) and reached 3.4 kg at 28 wks of age. The highest serum IGF-I level (451.3ng/mL) was observed at 20wks of age (P<0.05) and thereafter remained stable at low levels. Serum GH level at 18 wks of age was 183.3 pg/mL which was significantly higher compared to the other ages (P<0.05), and the rising time in serum GH tend to be somewhat earlier than that of IGF-I. The relative percentage of It-cells in testicular cell compartments was $48.2\%$ at the age of 18 wks which significantly increased than those of 16-wk-old (P<0.05) and thereafter increased with the advance of age to $68\%$. The percentage of 2C-cells in testis was $26.8\%$ at 18 wks of age which was significantly lower than $54.3\%$ at 16 wks old (P<0.05). The percentage of 4C-cells was constantly maintained $2\~6\%$ except the $9.9\%$ at 18 wks of age. In conclusion, the results suggest that the puberty onset occurred at about the 18 wks of age and that the IGF-I and GH in serum during the pubertal period showed the age/growth-specific changes and these changes might be related to the spermatogenesis. The DNA FCM combined with fine-needle testicular biopsy could offer a very sensitive method to monitor the quantitative spermatogenic events related to the puberty onset.

The Benefit of Individualized Custom Bolus in the Postmastectomy Radiation Therapy : Numerical Analysis with 3-D Treatment Planning (유방전절제술 후 방사선치료를 위한 조직보상체 개발 및 3차원 치료계획을 통한 유용성 분석)

  • Cho Jae Ho;Cho Kwang Hwan;Keum Kichang;Han Yongyih;Kim Yong Bae;Chu Sung Sil;Suh Chang Ok
    • Radiation Oncology Journal
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    • v.21 no.1
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    • pp.82-93
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    • 2003
  • Purpose : To reduce the Irradiation dose to the lungs and heart in the case of chest wail irradiation using an oppositional electron beam, we used an Individualized custom bolus, which was precisely designed to compensate for the differences In chest wall thickness. The benefits were evaluated by comparing the normal tissue complication probablilties (NTCPS) and dose statistics both with and without boluses. Materials and Methods : Boluses were made, and their effects evaluated in ten patients treated using the reverse hockey-stick technique. The electron beam energy was determined so as to administer 80% of the irradiation prescription dose to the deepest lung-chest wall border, which was usually located at the internal mammary lymph node chain. An individualized custom bolus was prepared to compensate for a chest wall thinner than the prescription depth by meticulously measuring the chest wall thickness at 1 emf intervals on the planning CT Images. A second planning CT was obtained overlying the individuailzed custom bolus for each patient's chest wall. 3-D treatment planning was peformed using ADAC-Pinnacle$^{3}$ for all patients with and without bolus. NTCPS based on 'the Lyman-Kutcher' model were analyzed and the mean, maximum, minimum doses, V$_{50}$ and V$_{95}$ for 4he heari and lungs were computed. Results .The average NTCPS in the ipsliateral lung showed a statistically significant reduction (p<0.01), from 80.2${\pm}$3.43% to 47.7${\pm}$4.61%, with the use of the individualized custom boluses. The mean lung irradiation dose to the ipsilateral iung was also significantly reduced by about 430 cGy, Trom 2757 cGy to 2,327 cGy (p<0.01). The V$_{50}$ and V$_{95}$ in the ipsilateral lung markedly decreased from the averages of 54.5 and 17.4% to 45.3 and 11.0%, respectively. The V$_{50}$ and V$_{95}$ In the heart also decreased from the averages of 16.8 and 6.1% to 9.8% and 2.2%, respectively. The NTCP In the contralateral lung and the heart were 0%, even for the cases with no bolus because of the small effective mean radiation volume values of 4.4 and 7.1%, respectively Conclusion : The use of an Individualized custom bolus in the radiotherapy of postrnastectorny chest wall reduced the NTCP of the ipsilateral lung by about 24.5 to 40.5%, which can improve the complication free cure probability of breast cancer patients.

Trends of Cancer Mortality in Gyeongsangbuk - do from 1991 to 1998 (경상북도 주민의 암사망 추이)

  • Kim, Byung-Guk;Lee, Sung-Kook;Kim, Tea-Woong;Lee, Do-Young;Lee, Kyeong-Soo
    • Journal of agricultural medicine and community health
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    • v.26 no.2
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    • pp.59-78
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    • 2001
  • Data on reported cancer mortality in the Gyeongsangbuk- do province from 1991 to 1998 were collected and analyzed using the existing mortality reporting system as well as the public health network to furnish accurate data on reported cancer death and to collect data to establish a high quality district health plan. The overall crude death rate in Gyeongsangbuk province in 1991 was 74.56 deaths per 100,000-person but this rate increased to 79.22 in 1998. Among the deaths, the overall death rate of cancer was 16.7% in 1991, which increased to 19.3% in 1998; specifically the death rate of men increased from 19.4% in 1991 to 22.3% in 1998 while that of women increased from 12.4% in 1991 to 15.5% in 1998, showing a more increase among women. The types of cancer and associated death rates in 1991 were gastric cancer(41.5%), followed by liver cancer (28.8%), and lung and bronchogenic carcinoma(8.7%) and in 1998, gastric cancer (24.7%), followed by liver cancer(22.7%), lung and bronchogenic carcinoma(19.3%), showing the same order. For men and women, gastric cancer(40.2% and 44.7%, respectively) was the most common cancer death, followed by liver cancer(33.7% and 16.7%, respectively), and lung and bronchogenic carcinoma(10.2% and 5.0%, respectively) in 1991. However, in 1998, gastric cancer(27.8%) was still the most common type among both men and women, followed by liver cancer (18.5%) and lung and bronchogenic carcinoma(12.7%), showing the most decrease in gastric cancer but most increase in lung and bronchogenic carcinoma. The age- adjusted mortality rates by gastric cancer, hepatoma, laryngeal carcinoma were decreased in both male and female, and also uterine cancer was decreased in female. The age- adjusted mortality rates by lung and bronchogenic carcinoma, pancreatic cancer, rectal cancer were increased in both male and female, and also breast cancer was increased in female. The calculated overall age-adjusted death rate based on the 1995 population was 84.25 in 1991, which decreased to 77.67 in 1998. Male death rate decreased significantly from 119.81 in 1991 to 101.82 in 1998 while the female death rate increased from 48.64 in 1991 to 53.80 in 1998. A census of cancer death rate using accurate death records is important for the establishment of proper and high-quality district health and medical plan and policy. The effort to improve the accuracy of death reports using the health facility network, as had been attempted by this study, can be continued. Furthermore, there must be a way for the Health and Welfare Department to use the death reports to improve the present reporting system. Lastly, additional studies need to be conducted to investigate how much the accuracy was improved by the supplemented death reports in this study.

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A Comparison of Anthropomery and Nutrient Intakes of Rural Middle School Students Provided with and without National School Lunch Program (경상북도 의성군 농촌지역 급식교와 비급식교 중학생의 영양소 섭취 실태와 체조성과의 상관성에 관한 연구)

  • 장현숙;이옥이
    • Journal of the East Asian Society of Dietary Life
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    • v.10 no.2
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    • pp.116-128
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    • 2000
  • The purpose of this study is to analyze the nutrient intakes and growth development of rural middle school students provided with and without the national school lunch program(NSLP). The subjects consisted of 340 rural middle school students provided with(n=177) and without(n=163) NSLP. Anthropometric measurements were taken for body weight, height, triceps skinfold thickness and percentage of body fat, and nutrient intakes were assessed by food record method. The results of this study were summarized as follows: There was no significant difference in the height, body weight girls provided with (155.8cm 47.2kg) and without (156.0cm, 49.7kg) NSLP. Total energy intakes of boys were 2123kca1 in with NSLP and 1857kca1 in without NSLP. Total energy intakes of girls were 1913kca1 in with NSLP and 1814kca1 in without NSLP. Total daily energy was provided in the ratio of 19.1%, 39.8%, 32.4% and 8.7% by breakfast, lunch, dinner and snacks in the with NSLP and 17.5%, 32.0%, 34.8% and 15.7% in without NSLP, respectively. Phosphorus, vitamin A, vitamin E, ascorbic acid, thiamin, riboflavin, niacin intakes were above the RDA in with NSLP. In without NSLP, phosphorus, vitamin E, thiamin intakes were above the RDA. however, calcium. iron, vitamin A, vitamin B$_{6}$ were less than the RDA. The study showed that total daily energy and nutrient intakes were significantly higher in students provided with than without school-lunch. Thus, the school-lunch program is recommended and necessary to improve the nutritional status of middle school students.

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Development of Practical Problem-Based Home Economics Teaching.Learning Process Plans by Blended Learning Strategy - Focusing on a Unit 'the Youth and Consumer Life' - (Blended Learning(BL) 전략을 활용한 실천적 문제 중심 가정과 교수 학습 과정안 개발 - '청소년과 소비생활' 단원을 중심으로 -)

  • Lee, Jin-Hee;Chae, Jung-Hyun
    • Journal of Korean Home Economics Education Association
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    • v.20 no.4
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    • pp.19-42
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    • 2008
  • The purpose of this study was to develop practical problem-based home economics teaching.learning process plans about a unit 'the youth and consumer life' of middle school eighth-grade Technology and Home Economics by applying blended learning(BL) strategy. According to ADDIE instructional design model, this study was conducted in the following procedure: analysis, design/development, implementation, and evaluation. In the stage of design and development, the selected unit was converted into a practical problem-based unit, and practical problem-based teaching. learning process plans were designed in detail by using BL strategy. An online study room for practical problem-based home economics instruction grounded in BL strategy was prepared by using Edunet(http://community.edunet4u.net/${\sim}$consumer2). Eight-session lesson plans were mapped out, and study aids for students and materials for teachers were prepared. In the implementation stage, the first-session teaching plans that dealt with a minor question 'what preparations should be made to become a wise consumer' were utilized when instruction was provided to 115 eighth graders who were in three different province, and the other one was in a middle school in the city of Daejeon. The experimental teaching was implemented for two weeks in the following procedure: preliminary program, pre-online learning, main instruction and post- online learning. The preliminary program was carried out in a session in the classroom, and pre-online learning was provided before the main instruction was given in a session in the classroom. After the main instruction was completed, post-online learning was offered. In the evaluation stage, a survey was conducted on all the learners and teachers to find out their opinions and suggestions.

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Risk Factor Analysis for Operative Death and Brain Injury after Surgery of Stanford Type A Aortic Dissection (스탠포드 A형 대동맥 박리증 수술 후 수술 사망과 뇌손상의 위험인자 분석)

  • Kim Jae-Hyun;Oh Sam-Sae;Lee Chang-Ha;Baek Man-Jong;Hwang Seong-Wook;Lee Cheul;Lim Hong-Gook;Na Chan-Young
    • Journal of Chest Surgery
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    • v.39 no.4 s.261
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    • pp.289-297
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    • 2006
  • Background: Surgery for Stanford type A aortic dissection shows a high operative mortality rate and frequent postoperative brain injury. This study was designed to find out the risk factors leading to operative mortality and brain injury after surgical repair in patients with type A aortic dissection. Material and Method: One hundred and eleven patients with type A aortic dissection who underwent surgical repair between February, 1995 and January 2005 were reviewed retrospectively. There were 99 acute dissections and 12 chronic dissections. Univariate and multivariate analysis were performed to identify risk factors of operative mortality and brain injury. Resuit: Hospital mortality occurred in 6 patients (5.4%). Permanent neurologic deficit occurred in 8 patients (7.2%) and transient neurologic deficit in 4 (3.6%). Overall 1, 5, 7 year survival rate was 94.4, 86.3, and 81.5%, respectively. Univariate analysis revealed 4 risk factors to be statistically significant as predictors of mortality: previous chronic type III dissection, emergency operation, intimal tear in aortic arch, and deep hypothemic circulatory arrest (DHCA) for more than 45 minutes. Multivariate analysis revealed previous chronic type III aortic dissection (odds ratio (OR) 52.2), and DHCA for more than 45 minutes (OR 12.0) as risk factors of operative mortality. Pathological obesity (OR 12.9) and total arch replacement (OR 8.5) were statistically significant risk factors of brain injury in multivariate analysis. Conclusion: The result of surgical repair for Stanford type A aortic dissection was good when we took into account the mortality rate, the incidence of neurologic injury, and the long-term survival rate. Surgery of type A aortic dissection in patients with a history of chronic type III dissection may increase the risk of operative mortality. Special care should be taken and efforts to reduce the hypothermic circulatory arrest time should alway: be kept in mind. Surgeons who are planning to operate on patients with pathological obesity, or total arch replacement should be seriously consider for there is a higher risk of brain injury.

An Exploratory study on the demand for training programs to improve Real Estate Agents job performance -Focused on Cheonan, Chungnam- (부동산중개인의 직무능력 향상을 위한 교육프로그램 욕구에 관한 탐색적 연구 -충청남도 천안지역을 중심으로-)

  • Lee, Jae-Beom
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.12 no.9
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    • pp.3856-3868
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    • 2011
  • Until recently, research trend in real estate has been focused on real estate market and the market analysis. But the studies on real estate training program development for real estate agents to improve their job performance are relatively short in numbers. Thus, this study shows empirical analysis of the needs for the training programs for real estate agents in Cheonan to improve their job performance. The results are as follows. First, in the survey of asking what educational contents they need in order to improve real estate agents' job performance, most of the respondents show their needs for the analysis of house's value, legal knowledge, real estate management, accounting, real estate marketing, and understanding of the real estate policy. This is because they are well aware that the best way of responding to the changing clients' needs comes from training programs. Secondly, asked about real estate marketing strategies, most of respondents showed their awareness of new strategies to meet the needs of clients. This is because new forms of marketing strategies including internet ads are needed in the field as the paradigm including Information Technology changes. Thirdly, asked about the need for real estate-related training programs, 92% of the respondents answered they need real estate education programs run by the continuing education centers of the universities. In addition, the survey showed their needs for retraining programs that utilize the resources in the local universities. Other than this, to have effective and efficient training programs, they demanded running a training system by utilizing the human resources of the universities under the name of the department of 'Real Estate Contract' for real estate agents' job performance. Fourthly, the survey revealed real estate management(44.2%) and real estate marketing(42.3%) is the most chosen contents they want to take in the regular course for improving real estate agents' job performance. This shows their will to understand clients' needs through the mind of real estate management and real estate marketing. The survey showed they prefer the training programs as an irregular course to those in the regular one. Despite the above results, this study chose subjects only in Cheanan and thus it needs to research more diverse areas. The needs of programs to improve real estate agents job performance should be analyzed empirically targeting the real estate agents not just in Cheonan but also cities like Pyeongchon, Ilsan and Bundang in which real estate business is booming, as well as undergraduate and graduate students whose major is real estate studies. These studies will be able to provide information to help develop the customized training programs by evaluating elements that real estate agents need in order to meet clients satisfaction and improve their job performance. Many variables of the program development learned through these studies can be incorporated in the curriculum of the real estate studies and used very practically as information for the development of the real estate studies in this fast changing era.

A Study on the Tree Surgery Problem and Protection Measures in Monumental Old Trees (천연기념물 노거수 외과수술 문제점 및 보존 관리방안에 관한 연구)

  • Jung, Jong Soo
    • Korean Journal of Heritage: History & Science
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    • v.42 no.1
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    • pp.122-142
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    • 2009
  • This study explored all domestic and international theories for maintenance and health enhancement of an old and big tree, and carried out the anatomical survey of the operation part of the tree toward he current status of domestic surgery and the perception survey of an expert group, and drew out following conclusion through the process of suggesting its reform plan. First, as a result of analyzing the correlation of the 67 subject trees with their ages, growth status. surroundings, it revealed that they were closely related to positional characteristic, damage size, whereas were little related to materials by fillers. Second, the size of the affected part was the most frequent at the bough sheared part under $0.09m^2$, and the hollow size by position(part) was the biggest at 'root + stem' starting from the behind of the main root and stem As a result of analyzing the correlation, the same result was elicited at the group with low correlation. Third, the problem was serious in charging the fillers (especially urethane) in the big hollow or exposed root produced at the behind of the root and stem part, or surface-processing it. The benefit by charging the hollow part was analyzed as not so much. Fourth, the surface-processing of fillers currently used (artificial bark) is mainly 'epoxy+woven fabric+cork', but it is not flexible, so it has brought forth problems of frequent cracks and cracked surface at the joint part with the treetextured part. Fifth, the correlation with the external status of the operated part was very high with the closeness, surface condition, formation of adhesive tissue and internal survey result. Sixth, the most influential thing on flushing by the wrong management of an old and big tree was banking, and a wrong pruning was the source of the ground part damage. In pruning a small bough can easily recover itself from its damage as its formation of adhesive tissue when it is cut by a standard method. Seventh, the parameters affecting the times of related business handling of an old and big tree are 'the need of the conscious reform of the manager and related business'. Eighth, a reform plan in an institutional aspect can include the arrangement of the law and organization of the old and big tree management and preservation at an institutional aspect. This study for preparing a reform plan through the status survey of the designated old and big tree, has a limit inducing a reform plan based on the status survey through individual research, and a weak point suggesting grounds by any statistical data. This can be complemented by subsequent studies.

Edge to Edge Model and Delay Performance Evaluation for Autonomous Driving (자율 주행을 위한 Edge to Edge 모델 및 지연 성능 평가)

  • Cho, Moon Ki;Bae, Kyoung Yul
    • Journal of Intelligence and Information Systems
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    • v.27 no.1
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    • pp.191-207
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    • 2021
  • Up to this day, mobile communications have evolved rapidly over the decades, mainly focusing on speed-up to meet the growing data demands of 2G to 5G. And with the start of the 5G era, efforts are being made to provide such various services to customers, as IoT, V2X, robots, artificial intelligence, augmented virtual reality, and smart cities, which are expected to change the environment of our lives and industries as a whole. In a bid to provide those services, on top of high speed data, reduced latency and reliability are critical for real-time services. Thus, 5G has paved the way for service delivery through maximum speed of 20Gbps, a delay of 1ms, and a connecting device of 106/㎢ In particular, in intelligent traffic control systems and services using various vehicle-based Vehicle to X (V2X), such as traffic control, in addition to high-speed data speed, reduction of delay and reliability for real-time services are very important. 5G communication uses high frequencies of 3.5Ghz and 28Ghz. These high-frequency waves can go with high-speed thanks to their straightness while their short wavelength and small diffraction angle limit their reach to distance and prevent them from penetrating walls, causing restrictions on their use indoors. Therefore, under existing networks it's difficult to overcome these constraints. The underlying centralized SDN also has a limited capability in offering delay-sensitive services because communication with many nodes creates overload in its processing. Basically, SDN, which means a structure that separates signals from the control plane from packets in the data plane, requires control of the delay-related tree structure available in the event of an emergency during autonomous driving. In these scenarios, the network architecture that handles in-vehicle information is a major variable of delay. Since SDNs in general centralized structures are difficult to meet the desired delay level, studies on the optimal size of SDNs for information processing should be conducted. Thus, SDNs need to be separated on a certain scale and construct a new type of network, which can efficiently respond to dynamically changing traffic and provide high-quality, flexible services. Moreover, the structure of these networks is closely related to ultra-low latency, high confidence, and hyper-connectivity and should be based on a new form of split SDN rather than an existing centralized SDN structure, even in the case of the worst condition. And in these SDN structural networks, where automobiles pass through small 5G cells very quickly, the information change cycle, round trip delay (RTD), and the data processing time of SDN are highly correlated with the delay. Of these, RDT is not a significant factor because it has sufficient speed and less than 1 ms of delay, but the information change cycle and data processing time of SDN are factors that greatly affect the delay. Especially, in an emergency of self-driving environment linked to an ITS(Intelligent Traffic System) that requires low latency and high reliability, information should be transmitted and processed very quickly. That is a case in point where delay plays a very sensitive role. In this paper, we study the SDN architecture in emergencies during autonomous driving and conduct analysis through simulation of the correlation with the cell layer in which the vehicle should request relevant information according to the information flow. For simulation: As the Data Rate of 5G is high enough, we can assume the information for neighbor vehicle support to the car without errors. Furthermore, we assumed 5G small cells within 50 ~ 250 m in cell radius, and the maximum speed of the vehicle was considered as a 30km ~ 200 km/hour in order to examine the network architecture to minimize the delay.