• Title/Summary/Keyword: 이현주

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Evaluation of Post-Neoadjuvant Chemotherapy Pathologic Complete Response and Residual Tumor Size of Breast Cancer: Analysis on Accuracy of MRI and Affecting Factors (신보강화학요법 후 유방암의 병리학적 완전 관해 예측 및 잔류 암 평가: 유방자기공명영상의 정확도 및 영향인자 분석)

  • Hyun Soo Ahn;Yeong Yi An;Ye Won Jeon;Young Jin Suh;Hyun-Joo Choi
    • Journal of the Korean Society of Radiology
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    • v.82 no.3
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    • pp.654-669
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    • 2021
  • Purpose To evaluate the accuracy of MRI in predicting the pathological complete response (pCR) and the residual tumor size of breast cancer after neoadjucant chemotherapy (NAC), and to determine the factors affecting the accuarcy. Materials and Methods Eighty-eight breast cancer patients who underwent surgery after NAC at our center between 2010 and 2017 were included in this study. pCR was defined as the absence of invasive cancer on pathological evaluation. The maximum diameter of the residual tumor on post-NAC MRI was compared with the tumor size of the surgical specimen measured pathologically. Statistical analysis was performed to elucidate the factors affecting pCR and the residual tumor size-discrepancy between the MRI and the pathological measurements. Results The pCR rate was 10%. The diagnostic accuracy of MRI and the area under the curve for predicting pCR were 90.91% and 0.8017, respectively. The residual tumor sizes obtained using MRI and pathological measurements showed a strong correlation (r = 0.9, p < 0.001), especially in patients with a single mass lesion (p = 0.047). The size discrepancy between MRI and the pathological measurements was significantly greater in patients with the luminal type (p = 0.023) and multifocal tumors/non-mass enhancement on pre-NAC MRI (p = 0.047). Conclusion MRI is an accurate tool for evaluating pCR and residual tumor size in breast cancer patients who receive NAC. Tumor subtype and initial MRI features affect the accuracy of MRI.

A Study on Effects of the vocal psychotherapy upon Self-Consciousness (성악심리치료활동을 통한 자기의식 변화에 관한 연구)

  • Lee, Hyun Joo
    • Journal of Music and Human Behavior
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    • v.4 no.2
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    • pp.66-83
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    • 2007
  • The purpose of this study is to learn both effects of the vocal psychotherapy on the self-consciousness and the variety of the self-consciousness on the vocal psychotherapy in return. The research for this study was performed to three subjects who were students of E university, Seoul, ten times for sixty minutes. The subjects were all volunteers for the advertisement on a music-therapy program searching for them on the web site of E university. The vocal psychotherapy program consists of four steps and each of them consists of two to four short terms again. Both before and after the experiment, examinations on self-consciousness were done to recognize the change of the subjects' self-consciousness which would be caused by the vocal psychotherapy activity. After every short term, the subjects were asked to write reports to closely analyze the change of self-consciousness according to the terms and the variety of the subjects. The effect of the vocal psychotherapy activity on the changes of scores in the self-consciousness examination is the first thing to point out on this study. There appeared some personal varieties on the total scores of the examination and scores of some sub-categories. Especially, there were different scores on the private self-consciousness, the public self-consciousness, and the social anxiety between before and after performing the vocal psychotherapy program. Subject A, who had got the best score of all on the scope of the private self-consciousness, showed the steepest decrease on the very scope. On the contrary, the subject showed decrease of scores of the public self-consciousness and the social anxiety in the relatively little rate. Subject B, who had got the highest score of the three on the public self-consciousness, showed the steepest decrease on that of all scopes and showed no difference on the social anxiety scope. In the case of the last one, subject C, who had relatively low scores on the private and public self-consciousness than the others, the private self-consciousness score increased but the public self-consciousness and the social anxiety scores decreased. The changes of the scores of each questions were examined in order to see possible other changes that had not been exposed on the changes of the total and sub-categories scores. As a result of that, of all twenty-eight questions, there were changes about one to two points. Subject A showed the difference with thirteen questions, subject B with sixteen and subject C with nineteen questions. The rate of change of subject C was relatively small but more questions changed and the change of score was wider than the others. Considering all those results, It can be possibly said that the vocal psychotherapy affects the changes of the scores of sub-categories in self-consciousness examination. The next thing to point out on this study is the change of recognition that was exposed on the subjects' report after every short term of the program. As a result of the close analyzing, according to the short terms and variety of self-consciousness, recognizing the way express subjects themselves by voice and recognizing their own voices appeared to be different. How much they cared about others and why they did so were also different. According to the self reports, subject A cared much about her inner thought and emotion and tended to concentrate herself as a social object. There appeared some positive emotional experiments such as emotional abundance and art curiosities on her reports but at the same time some negative emotions such as state-trait anxiety and neuroticism also appeared. Subject B, who showed high scores on the private and public self-consciousness like subject A, had a similar tendency that concentrates on herself as a social object but she showed more social anxiety than subject A. Subject C got relatively lower points in self-consciousness examination, tended to care about herself, and had less negative emotions such as state-trait anxiety than other subjects. Also, with terms going on, she showed changes in the way of caring about her own voice and others. This study has some unique significances in helping people who have problems caused by self-estimation activated with self-consciousness, using voices closely related to one's own self, performing the vocal skills discipline to solve the technical problems. Also, this study has a potentiality that the vocal psychotherapy activity can be effectively used as a way affects the mental health and developing personality.

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A Survey on Added Sugar Intakes from Snacks and Participation Behaviors of Special Event Days Sharing Sweet Foods among Adolescents in Korea (청소년의 간식을 통한 첨가당섭취량 및 고당류식품 관련 이벤트 데이 참여행동에 대한 조사)

  • Kim, Hyun-Ju;Kim, Sun-Hyo
    • Journal of Nutrition and Health
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    • v.42 no.2
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    • pp.135-145
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    • 2009
  • This study was performed to investigate added sugar intakes from processed food-snacks and participation behaviors of special event days sharing sweet foods among adolescents in Korea. Questionnaire survey (n = 959), dietary survey (n = 71) by food record method for 3 days, and snack survey (n = 230) for 3 days were carried out, and subjects were overlapped among three surveys. As a result, middle school students (MS) preferred milks and fermented milks while high school students (HS) preferred breads and fast foods as a snack (p < 0.01). MS and HS took snacks three to six times a week, and HS took snacks more frequently than MS (p < 0.05). Most subjects participated in special event days sharing sweet foods such as friend's birthday (68.4%), Peppro's day (61.5%) and Valentine's day (42.6%). As for merits of these events, MS said ‘they could get along with their friends' and ‘relieve stress', while HS said ‘they could enjoy their own events' and ‘confess their affection to whom they like' (p < 0.01). A group of cookies, biscuits, breads and, cakes was major source of added sugars followed by beverages, sweet jellies of red bean, chocolates and candies for subjects. For MS and HS, daily total added sugar intakes from whole processed food-snacks were $30.5{\pm}23.5g/d$ (3.0-137.9 g/d) and $31.7{\pm}23.2g/d$ (1.2-126.1 g/d), and ratios of daily total energy taken from added sugars of whole processed food-snacks in proportion to daily total energy taken from diet (energy percent of added sugars from snacks) were $6.3{\pm}4.7%$ (0.6-26.1%) and $6.3{\pm}4.4%$ (0.3-23.9%), respectively. These results showed that subjects frequently participated in special event days sharing sweet foods. In addition, energy percent of added sugars from snacks was more than the UL suggested by WHO/FAO for some subjects. Therefore, it is highly critical to monitor adolescents' sugar intakes on a long-term basis and to take nutritional management on their high sugar intakes.

Genetic Counseling in Korean Health Care System (한국 의료제도와 유전상담 서비스의 구축)

  • Kim, Hyon-J.
    • Journal of Genetic Medicine
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    • v.8 no.2
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    • pp.89-99
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    • 2011
  • Over the years Korean health care system has improved in delivery of quality care to the general population for many areas of the health problems. The system is now being recognized in the world as the most cost effective one. It is covered by the uniform national health insurance policy for which most people in Korea are mandatory policy holders. Genetic counseling service, however, which is well recognized as an integral part of clinical genetics service deals with diagnosis and management of genetic condition as well as genetic information presentation and family support, is yet to be delivered in comprehensive way for the patients and families in need. Two major obstacles in providing genetic counseling service in korean health care system are identified; One is the lack of recognition for the need for genetic counseling service as necessary service by the national health insurance. Genetic counseling consumes a significant time in delivery and the current very low-fee schedule for physician service makes it very difficult to provide meaningful service. Second is the critical shortage of qualified professionals in the field of medical genetics and genetic counseling who can provide the service of genetic counseling in clinical setting. However, recognition and understanding of the fact that the scope and role of genetic counseling is expanding in post genomic era of personalized medicine for delivery of quality health care, will lead to the efforts to overcome obstacles in providing genetic counseling service in korean health care system. Only concerted efforts from health care policy makers of government on clinical genetics service and genetic counseling for establishing adequate reimbursement coverage and professional communities for developing educational program and certification process for professional genetic counselors, are necessary for the delivery of much needed clinical genetic counseling service in Korea.

Incidence of Chronic Pathologic Nephrotoxicity of Cyclosporine A in Pediatric Nephrotic Syndrome (소아 신증후군에서 Cyclosporine A에 의한 만성 조직학적 신독성의 발현빈도에 대한 연구)

  • Kim Ji-Hong;Jeong Hyun-Ju;Choi In-Jun;Kim Pyung-Kil
    • Childhood Kidney Diseases
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    • v.3 no.2
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    • pp.130-144
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    • 1999
  • Purpose : Long-term use of Cyclosporine(CsA) reduce renal blood flow by afferent arteriolar vasoconstriction and lead to chronic pathologic changes of CsA nephrotoxicity - 1) interstitial nephritis(IN); tubular atrophy (TA) and/or interstitial fibrosis(IF),2) arteriolopathy(AP). The Object of this study is to estimate the incidence of chronic pathologic CsA nephrotoxicity by duration of treatment and type of renal disease, relationship between histologic and clinical nephrotoxicity, and optimal duration of CsA therapy. Methods : 102 children with steroid resistant or dependent nephrotic syndrome confirmed by renal biopsy and treated with CsA from 1986 to 1997 were enrolled in this study(58 MCNS, 10 FSGS, 10 MGN, 15 $Henoch-Sch\"{o}nlein$ purpura nephritis with nephrotic syndrome (HSPN) and 9 IgA nephropathy with nephrotic syndrome(IgAN)). CsA was administered for 1yr, 1.5yr, 2yr in 24, 12, 22 MCNS patients and 2, 2, 6 FSGS patients respectively, 1yr, 2yr in MGN and 1yr in HSPN and IgAN. Sequential biopsies were done in all 102 patients after CsA treatment for evaluation of pathologic nephrotoxicity. Results : Complete remission rate was 92.2% (100% in MCNS and MGN, 80% in FSGS, 86.6% in HSPN and 55.5% in IgAN). Incidence of relapse during 6months after CsA treatment was significantly decreased compaed with relapsing spisodes during 6months before CsA treatment in MCNS(P<0.0001) and FSGS(P<0.0001). According to pathologic changes, 71 patients(69.6%) showed no pathological change, 24 patients(23.5%) showed IN and 7 patients(6.8%) showed AP. IN was 16.6%, 33.3%, 27.2% in 1, 1.5, 2 year of CsA treatment group in MCNS. AP was 0%, 16.6%, 9% in 1, 1.5, 2 year of CsA treatment group in MCNS. 14 out of 58 MCNS(24.1%) showed IN and 4 out of 58 MCNS(6.8%) showed AP. Incidence of pathologic change was significantly lower in CsA therapy of <1yr than >1yr(P=0.03). There were no significant difference of incidence of pathologic change in original renal disease, age and sex. Conclusion : Duration of CsA treatment was significant risk factor for nephrotoxicity and optimal duration seemed to be 1 year. Pathologic change due to nephrotoxicity did not correlate with deterioration of renal function and only detectable by renal biopsy.

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Clinical Analysis of Children with Transitory Minimal Change Nephrotic Syndrome (MCNS) to Focal Segmental Glomerulosclerosis (FSCS) (미세변화형 신증후군(MCNS)으로부터 국소성 분절성 사구체 경화증(FSGS)으로 이행된 환아의 임상양상)

  • Lee Ji Eun;Yook Jinwon;Lee Eui Seong;Kim Ji Hong;Kim Pyung-Kil;Chung Hyun Joo
    • Childhood Kidney Diseases
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    • v.4 no.1
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    • pp.17-24
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    • 2000
  • Purpose: MCNS is found in approximately $85\%$ of the idiopathic nephrotic syndrome in children and shows good prognosis with initial steroid therapy. However in FSGS, there is poor prognosis with initial therapy and shows higher rate of progression to chronic renal failure and relapse after kindney transplantation. We have experienced 8 patients who were diagnosed as MCNS on initial renal biopsy and then progressed to FSGS on follow-up biopsy. So we have investigated their clinical course and risk factors for transition of MCNS to FSGS. Methods: We conducted a retrospective study with a review of histopathologic findings and clinical manifestations of 296 cases of MCNS and FSGS that were diagnosed from January 1988 to May 1999. We classified them into 3 groups according to the histopathologic finding; MCNS, FSGS, MCNS progressed to FSGS in follow-up biopsy. Results: The number of children was 296 cases comprising 241 cases($81.4\%$) showing MCNS, 8 cases($2.7\%$) transition group, 47 cases($15.9\%$) FSGS. The mean onset age was $6.0{\pm}2.6$years in MCNS, transition group $8.3{\pm}2.3$years, FSGS $7.2{\pm4.3$years, and the gender (M:F) ratio was 3.7:1 in MCNS, 3:1 in transition group, 1.8:1 in FSGS. Comparing the presence of initial hematuria, hypertension,24 hour urine protein, serum albumin, serum creatinine, there were significant difference between the transition group and the FSGS group in the following points; 24hour urine protein $684:342mg/m^2/hr$(P<0.05), serum albumin 1.92: 2.47g/dL(P<0.05), serum cholesterol 494:343mg/dL(P<0.05). Refractoriness to steroid therapy was 13.3$\%$ in MCNS. $12.5\%$ in transition group, $29.6\%$ in FSGS; significantly higher in FSGS(P<0.05). Immunosuppressant therapy was performed in $58.5\%$ of MCNS, $100\%$ in transition group, $80.8\%$ in FSGS; transition group showed significantly higher .ate(P<0.05) comparing with MCNS. Mean number of relapse and duration from onset to first relapse showed no significance difference between these groups. Conclusion: 249 patients with MCNS have been followed and $3.2\%$ (8 patients) of them has shown change in pathologic diagnosis from MCNS to FSCS. The risk factor for transition could not be found. Our results point to the need for a follow-up biopsy to certify the possibility of transition to FSCS in some MCNS cases with refractory cases to steroid therepy, frequent relapsing cases, or in case of no remission in spite of vigorous immunosuppressant therapy.

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Effects of Y Chromosome Microdeletion on the Outcome of in vitro Fertilization (남성 불임 환자에서 Y 염색체 미세 결손이 체외 수정 결과에 미치는 영향)

  • Choi, Noh-Mi;Yang, Kwang-Moon;Kang, Inn-Soo;Seo, Ju-Tae;Song, In-Ok;Park, Chan-Woo;Lee, Hyoung-Song;Lee, Hyun-Joo;Ahn, Ka-Young;Hahn, Ho-Suap;Lee, Hee-Jung;Kim, Na-Young;Yu, Seung-Youn
    • Clinical and Experimental Reproductive Medicine
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    • v.34 no.1
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    • pp.41-48
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    • 2007
  • Objective: To determine whether the presence of Y-chromosome microdeletion affects the outcome of in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) program. Methods: Fourteen couples with microdeletion in azoospermic factor (AZF)c region who attempted IVF/ICSI or cryopreserved and thawed embryo transfer cycles were enrolled. All of the men showed severe oligoasthenoteratoazoospermia (OATS) or azoospermia. As a control, 12 couples with OATS or azoospermia and having normal Y-chromosome were included. Both groups were divided into two subgroups by sperm source used in ICSI such as those who underwent testicular sperm extraction (TESE) and those used ejaculate sperm. We retrospectively analyzed our database in respect to the IVF outcomes. The outcome measures were mean number of good quality embryos, fertilization rates, implantation rates, $\beta$-hCG positive rates, early pregnancy loss and live birth rates. Results: Mean number of good quality embryos, implantation rates, $\beta$-hCG positive rates, early pregnancy loss rates and live birth rates were not significantly different between Y-chromosome microdeletion and control groups. But, fertilization rates in the Y-chromosome microdeletion group (61.1%) was significantly lower than that of control group (79.8%, p=0.003). Also, the subgroup underwent TESE and having AZFc microdeletion showed significantly lower fertilization rates (52.9%) than the subgroup underwent TESE and having normal Y-chromosome (79.5%, p=0.008). Otherwise, in the subgroups used ejaculate sperm, fertilization rates were showed tendency toward lower in couples having Y-chromosome microdeletion than couples with normal Y-chromosome. (65.5% versus 79.9%, p=0.082). But, there was no significance statistically. Conclusions: In IVF/ICSI cycles using TESE sperm, presence of V-chromosome microdeletion may adversely affect to fertilization ability of injected sperm. But, in cases of ejaculate sperm available for ICSI, IVF outcome was not affected by presence of Y-chromosome AZFc microdeletion. However, more larger scaled prospective study was needed to support our results.

A study on the production techniques and prototype of the mother-of-pearl chrysanthemum pattern box from the Goryeo Dynasty (고려 나전국화넝쿨무늬상자의 제작기법 고찰 및 원형 연구)

  • LEE Heeseung;LEE Minhye;KIM Sunghun;LEE Hyeonju
    • Korean Journal of Heritage: History & Science
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    • v.57 no.1
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    • pp.126-144
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    • 2024
  • The chrysanthemum vine pattern box from the Goryeo Dynasty expresses in great detail the representative features of Goryeo Dynasty lacquerware with mother-of-pearl, such as engraving patterns on the surface of fine mother-of-pearl, expressing vine stems using metal wires, and twisting metal wires to form the boundaries of each patterns. While the lacquerware with mother-of-pearl that remains today from the Goryeo Dynasty has the form of a sutra box and a box with lid, the chrysanthemum vine pattern box that is the subject of this study is in the shape of a box with a separate lid and body, making it difficult to estimate the purpose of production or the stored contents. In this study, we attempted to confirm the formative characteristics of the chrysanthemum vine pattern box in order to confirm its original form, and to investigate its structure and production technique through X-ray transmission. In addition, we attempted to identify the use and production purpose of the box by classifying and comparing the previously known lacquerware with mother-ofpearl from the Goryeo Dynasty by type. As a result of the investigation, fabric was confirmed the bottom of body and inner box through X-ray images. Through this, it was confirmed that the 'Mogsimjeopichilgi'(wooden core grabbing fabric technique) of wrapping the object with fabric was used. And through wood grain, it was possible to confirm the wooden board composition of the part presumed to be the restored part and the part presumed to have had existing Jangseog. In addition, it was confirmed that the joints were connected in a Majdaeim(part to part). Based on the survey results, a total of 14 pieces, including 9 Sutra boxes, 3 boxes, and 2 small boxes, that remain from the Goryeo Dynasty were classified by type and examined for similarity. Among them, there is a "Chrysanthemum Vine Pattern Sutra Box" from a private collection in Japan, a "Black Lacquered Chrysanthemum Arabesque Bun Sutra Box" from the Tokugawa Art Museum, a "Sutra Holder" from the British Museum, and a "Small Box with a Mother-of-Pearl Chrysanthemum Vine Pattern" from a private collection in Korea. The pattern composition of five points was most similar to the subject of this study. As a result of comparing the damage pattern, formative characteristics, and structural features of each part, it is presumed that the sutra holder in the British Museum was transformed into its current form from the original the chrysanthemum vine patterned box. Lastly, in order to confirm the purpose of production, that is, the use of this box, we investigated examples of Tripitaka Koreana printed version produced at a time similar to the social atmosphere of Goryeo at the time. Following the Mongol(元) invasion after the Goryeo military regime at the time, sutras appeared to pray for the stability of the nation and the soul of an individual, and with the development of domestic printing and paper in the 13th century, it gradually coincided with the transition from a scroll to a folded form, and the form of a box changed from a box. It is believed that the storage method also changed.

Effect of Chungkukjang supplementation on oxidative stress and antioxidant nutrients of diabetic rats induced by streptozotocin (청국장 식이 보충이 당뇨 쥐의 산화적 스트레스와 항산화 영양소 함량에 미치는 영향)

  • Park, Heyun-Sook;Kong, Hyun-Joo;Lee, Eon-Hee;Choi, Eun-Mi;Jang, Joung-Hyeon;Lee, Myoung-Hee;Hong, Ju-Yeon;Hwang, Su-Jung;Jung, Hyeon-A;Yang, Kyung-Mi
    • Food Science and Preservation
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    • v.22 no.2
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    • pp.281-289
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    • 2015
  • This study was conducted to examine the effects of a supplemented Chungkukjang diet on oxidative stress and antioxidant nutrients in Streptozotocin (STZ, 45 mg/kg of BW, IP injection)-induced diabetic rats. Diets that contained soybean Chungkukjang powder (SC), Yakkong Chungkukjang powder (YC), and Yakkong Chungkukjang powder with black food added (YCB) were administered to the STZ-induced diabetic rats for seven weeks. The increased lipid peroxide contents of their serum and liver were slightly controlled by providing them three types of Chungkukjang. The retinol level in the serum was 7.5 times higher in the STZ-induced diabetic group after the provision of YC. The total antioxidant capacity (TAC) level in the serum was higher in the STZ-induced diabetic group after the provision of YCB. Also, the retinol and tocopherol levels in the liver of the STZ-induced diabetic rats increased after they were provided YCB, and the decreased reduced glutathione (GSH) /oxidized glutathione (GSSG) level in their liver improved after they were fed a diet that contained YC. Moreover, the decreased anthocyanin level in the liver of the STZ-induced diabetic group improved after the provision of three types of Chungkukjang powder. These findings suggest that the Chungkukjang diet is a valuable food for the management of the health of diabetic patients and for the prevention of diabetic complications.

Clinical course and prognosis of hemodynamically significant congenital heart defects in very low birth weight infants (혈역학적으로 의미있는 선천성 심기형을 가진 극소 저체중 출생아의 임상경과 및 예후)

  • Yoo, Hye Soo;Kim, Ji Eun;Park, Soo Kyoung;Seo, Hyun Ju;Jeong, Yoo Jin;Chio, Seo Heui;Jeong, Soo In;Kim, Sung Hoon;Yang, Ji Hyuk;Huh, June;Chang, Yun Sil;Jun, Tae Gook;Kang, I Seok;Park, Won Soon;Park, Pyo Won;Lee, Heung Jae
    • Clinical and Experimental Pediatrics
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    • v.52 no.4
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    • pp.481-487
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    • 2009
  • Purpose : This study investigated the clinical course and prognostic factor of very low birth weight infants (VLBWI) with hemodynamically significant congenital heart defects (CHDs). Methods : Medical records of 1,098 VLBWI with birth weight <1,500 g who had been admitted to the neonatal intensive care unit of Samsung Medical Center from October 1994 to December 2007 were reviewed retrospectively. The data for these patients with hemodynamically significant CHD (n=33) were compared with those without CHD (n=1,065). Results : The incidence of CHD was 3.0% (33 patients) 7 patients (21%) had CHD combined with the congenital abnormalities or chromosomal disorders. The most common CHD was a ventricular septal defect. The incidence of intrauterine growth retardation was higher in patients with CHD than in patients without CHD (34% vs. 20%), but there were no significant differences in gestational age, birth weight, respiratory distress syndrome, bronchopulmonary dysplasia, necrotizing enterocolitis, severe intraventricular hemorrhage (${\geq}$Gr III), and periventricular leukomalacia. Cardiac surgery was performed on 13 patients (39%). Nine patients received staged operations, and 10 patients received early intervention. The overall mortality in patients who had CHD was higher than in the patients who did not have CHD (27% vs. 16%). In patients with CHD, congenital abnormalities or chromosomal disorders were more important factors for increased mortality (86% vs. 11%) than the degree of complexity of CHD (19% vs. 42%). Conclusion : The most important prognostic factors of VLBWI with CHD are the associated congenital abnormalities or chromosomal disorders.