• Title/Summary/Keyword: 임상에서의 문제점

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Possibility of Cancer Treatment by Cellular Differentiation into Adipocytes (지방세포로의 분화를 통한 악성 종양의 치료 가능성)

  • Byeong-Gyun Jeon;Sung-Ho Lee
    • Journal of Life Science
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    • v.33 no.6
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    • pp.512-522
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    • 2023
  • Cancer with unlimited cell growth is a leading cause of death globally. Various cancer treatments, including surgery, chemotherapy, radiation therapy, immunotherapy, and targeted therapy, can be applied alone or in combination depending on the cancer type and stage. New treatments with fewer side effects than previous cancer treatments are continually under development and in demand. Undifferentiated stem cells with unlimited cell growth are gradually changed via cellular differentiation to arrest cell growth. In this study, we reviewed the possibility of treating cancer by using cellular differentiation into the adipocytes in cancer cells. In previous in vitro studies, oral antidiabetic drugs of the thiazolidinedione (TDZ) class, such as rosiglitazone and pioglitazone, were induced into the adipocytes in various cancer cell lines via increased peroxisome proliferator-activated receptor-γ (PPAR γ) expression and glucose uptake, which is the key regulator of adipogenesis and the energy metabolism pathway. The differentiated adipogenic cancer cells treated with TDZ inhibited cell growth and had a less cellulotoxic effect. This adipogenic differentiation treatment suggests a possible chemotherapy option in cancer cells with high and abnormal glucose metabolism levels. However, the effects of the in vivo adipogenic differentiation treatment need to be thoroughly investigated in different types of stem and normal cells with other side effects.

A Study on the High Content Ceramide Stabilization Formulation with Cyclodextrin (사이클로덱스트린을 함유한 고함량 세라마이드 안정화 제형 연구)

  • Ye Ji Kim;Sang Woo Han;So Min Lee;Byungsun Cha;Hyojin Heo;Sofia Brito;Lei Lei;Sang Hun Lee;You-Yeon Chun;Ha Hyeon Jo;Hyung Mook Kim;Byeong-Mun Kwak;Bum-Ho Bin
    • Journal of the Society of Cosmetic Scientists of Korea
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    • v.49 no.2
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    • pp.97-106
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    • 2023
  • In this study, we would like to study the stabilization of the high content of ceramide formulation by containing cyclodextrin. Ceramide, which constitutes the intercellular lipid, a human skin barrier, is a very important ingredient in moisturizing maintenance by protecting moisture in the skin and strengthening the skin barrier. However, since ceramide is poorly soluble, even if it is included in the cosmetic formulation, it has a problem that it is slowly gelled or crystallized and deposited over time, making it difficult to containing a high amount of ceramide. Cyclodextrin is a cyclic oligosaccharide connected with glucose molecules and has a cylindrical structure with hydrophilic outer surface and hydrophobic inner surface, which is known to improve the physicochemical properties of drugs such as improving solubility and absorption of poorly soluble drugs. We demonstrated the stability of the formulation containing high amount of ceramide by measuring hardness and observing emulsion drops with polarized microscope. This study also demonstrated that the high-content ceramide formulation containing cyclodextrin has the effect of preventing gelation or crystallization of ceramide, thus having excellent environmental conditions stability and skin moisturization.

An Anatomical Study of the Posterior Tympanum (한국인 중이강후벽에 관한 형태해부학적 고찰)

  • 양오규;윤강묵;심상열;김영명
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1982.05a
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    • pp.17.2-19
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    • 1982
  • The sinus tympani is subject to great variability in the size, shape and posterior extent. A heavy compact bony zone, especially in the posterior portion and the narrow space between the facial nerve and posterior semicircular canal are the limitation of surgical approach. The facial recess should be opened, creating a wide connection between the mesotympanum and mastoid in the Intact canal wall tympanoplasty with mastoidectomy. The surgically created limits of the facial recess are the facial nerve medially, the chorda tympani laterally and the bone adjacent to the incus superiorly. Using adult Korean's thirty-five temporal bones, the authors measured the osteologic reslationship in the posterior tympanum, especially sinus tympani and facial recess. The result was as followed. 1. The average distance from the anterior end of the pyramidal eminence. 1) to the edge of the sinus tympani directly posterior was 2.54(1.05-5.40)mm. 2) to the maximum posterior extent was 3.22(1.25-7.45)mm. 3) to the maximum cephaled extent was 0.67 (0.40-1.75)mm. 2. The boundary of the sinus tympani was 82.9% from the lower margin oval window to the upper margin round window niche. 3. The deepest part of the sinus tympani was 62.9% in the mid portion, between the ponticulus and subiculum. 4. The oblique dimension from the fossa incudis above to the hypotympanum below was 8.13(7.90-9.55)mm. 5. The transverse dimensions midway between the oval window above and round window below was 3.00(2.85-3.45)mm. 6. The transverse dimension at the level of the fossa incudis was 1.81(1.40-2.15)mm. 7. The facial nerve dehiscence was 14.3%. 8. Anterior-posterior diameter of the footplate was 2.98(2.85-3.05) mm. 9. The average distance from the footplate. 1) to the cochleariform process was 1.42(1.35-1.55) mm. 2) to the round window niche was 1.85(1.45-2.10) mm.

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INHIBITORY EFFECT OF DENTAL LASERS ON THE GROWTH AND THE FUNCTION OF STREPTOCOCCUS MUTANS (각종 치과레이저의 Streptococcus mutans에 대한 증식 및 기능억제 효과)

  • Han, Kang-Seog;Kook, Joong-Ki;You, So-Young;Kim, Hwa-Sook;Park, Jong-Whi;Park, Heon-Dong;Lee, Sang-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.30 no.3
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    • pp.439-447
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    • 2003
  • This was performed to evaluate the inhibitory effect of laser on the growth of S. mutans. The bacterial pallets containing S. mutans KCTC 3065 were irradiated with Er:YAG laser and Nd :YAG laser by non-contact method at an intensity of 50mJ for 5 sec with the pulse repetition rates of 10Hz and 30Hz, respectively. The following results were obtained on colony count, acid producing ability, and the amount of insoluble extracellular polysaccharide synthesis. 1. The irradiation of Nd:YAG laser after photosensitization with Chinese ink inhibited the proliferation of S. mutans the most, and the irradiation of Er:YAG also inhibited the proliferation. However, the irradiation of Nd:YAG laser alone could not inhibited the proliferation of S. mutans. The pulse repetition rate did not affect significantly on the proliferation of bacteria in overall. 2. The irradiation of Nd:YAG laser after the photosensitization with Chinese ink inhibited the acid production of S. mutans the most for a certain period of time. Er:YAG laser also inhibited acid production. When Nd:YAG laser was used alone, the acid production of S. mutans was not been inhibited. The irradiation of Nd:YAG laser after photosensitization with Chinese ink inhibited the acid production ability of bacteria the most as the pulse repetition rate increased. 3. Laser irradiation did not inhibited the synthesis of insoluble extracellular polysaccharide of S. mutans. From these results, we conclude that the irradiation of Er:YAG laser and Nd:YAG laser after photosensitization with Chinese ink would inhibit the proliferation and acid production by S. mutans, which may prevent dental caries. However, this effect does not last long time so that the laser irradiation should be repeated frequently in order to obtain clinical effect; thus, this laser irradiation would not have a clinical usefulness in preventing dental caries when used solely.

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The Clinical Utility of Polymerase Chain Reaction in the Bronchoalveolar Lavage Fluid for the Detection of Mycobacteria (객담 도말 음성인 환자에서 기관지폐포 세척액 결핵균 중합 효소 연쇄반응 검사의 유용성)

  • Mo, Eun-Kyung;Kyung, Tae-Young;Kim, Dong-Gyu;Park, Myung-Jae;Lee, Myung-Goo;Hyun, In-Gyu;Jung, Ki-Suck;Lee, Kyung-Wha
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.3
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    • pp.519-528
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    • 1998
  • Background: Diagnosis of pulmonary tuberculosis is not easy when the sputum smear for Mycobacterium tuberculosis(M. Tb) is negative. We evaluated the clinical utility of polymerase chain reaction(PCR) for detecting M. Tb in bronchoalveolar lavage(BAL) samples. Methods: We recruited 84 patients whose sputum smear for M. Tb were negative or not available due to no production of sputum. We performed bronchoalveolar lavage for acid-fast stain, culture of mycobacteria, and PCR assay of BAL fluid. We analyzed the results of microbiologic examination. Results: The sensitivity of BAL fluid smear, culture, and PCR were 20%, 38%, and 40%, respectively. The specificity of BAL fluid PCR was 95%. The positive predictive value of PCR was 89%. The smear of BAL fluid was positive in 17%. The PCR of BAL fluid was the only diagnostic test in 17%. Therefore, the BAL fluid analysis including smear and PCR was diagnostic in 34 % within 24 hours. The BAL fluid analysis including smear, PCR, and culture was diagnostic in 55% within 2 month. Conclusion: The BAL fluid PCR was valuable method in the diagnosis of pulmonary tuberculosis in patients whose sputa were not available or reveal negative smear.

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Design and Implementation of Game Server using the Efficient Load Balancing Technology based on CPU Utilization (게임서버의 CPU 사용율 기반 효율적인 부하균등화 기술의 설계 및 구현)

  • Myung, Won-Shig;Han, Jun-Tak
    • Journal of Korea Game Society
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    • v.4 no.4
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    • pp.11-18
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    • 2004
  • The on-line games in the past were played by only two persons exchanging data based on one-to-one connections, whereas recent ones (e.g. MMORPG: Massively Multi-player Online Role-playings Game) enable tens of thousands of people to be connected simultaneously. Specifically, Korea has established an excellent network infrastructure that can't be found anywhere in the world. Almost every household has a high-speed Internet access. What made this possible was, in part, high density of population that has accelerated the formation of good Internet infrastructure. However, this rapid increase in the use of on-line games may lead to surging traffics exceeding the limited Internet communication capacity so that the connection to the games is unstable or the server fails. expanding the servers though this measure is very costly could solve this problem. To deal with this problem, the present study proposes the load distribution technology that connects in the form of local clustering the game servers divided by their contents used in each on-line game reduces the loads of specific servers using the load balancer, and enhances performance of sewer for their efficient operation. In this paper, a cluster system is proposed where each Game server in the system has different contents service and loads are distributed efficiently using the game server resource information such as CPU utilization. Game sewers having different contents are mutually connected and managed with a network file system to maintain information consistency required to support resource information updates, deletions, and additions. Simulation studies show that our method performs better than other traditional methods. In terms of response time, our method shows shorter latency than RR (Round Robin) and LC (Least Connection) by about 12%, 10% respectively.

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Clinical Experience of Long-term Home Oxygen Therapy (재택산소요법을 받고 있는 환자들에 대한 임상 관찰)

  • Lee, Young-Suk;Cha, Seung-Ick;Han, Chun-Duk;Kim, Chang-Ho;Kim, Yeun-Jae;Park, Jae-Yong;Jung, Tae-Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.3
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    • pp.283-291
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    • 1993
  • Background: Long-term low flow oxygen therapy not only increases survival, but also improves the quality of life in patients with chronic obstructive pulmonary disease (COPD) with chronic hypoxemia. For the assessment and improvement of the status of home oxygen therapy, we analyzed clinical experience of 26 patients who have been administered low flow oxygen at home. Method: Twenty-six patients (18 men and 8 women) who have been received long-term oxygen therapy (LTOT) at home were examined. We reviewed physical characteristics, clinical history, pulmonary function test, ECG, arterial blood gas analysis, hemoglobin and hematocrit, types of oxygen devices, inhalation time per day, concentration of administered $O_2$, duration of $O_2$ therapy, and problems in the home oxygen therapy. Results: The underlying diseases of patients were COPD 14 cases, far advanced old pulmonary tuberculosis 9 cases, bronchiectasis 2 cases, and idiopathic pulmonary fibrosis 1 case. The reasons for LTOT at home were noted for cor pulmonale 21 cases, for dyspnea on exertion and severe ventilatory impairment 4 cases, and for oxygen desaturation during sleep 1 case. The mean values of aterial blood gas analysis before home oxygen therapy were $PaO_2$ 57.7 mmHg, $PaCO_2$ 48.2 mmHg, and $SaO_2$ 87.7%. And the mean values of each parameters in the pulmonary function test were VC 2.05 L, $FEV_1$ 0.92 L, and $FEV_1$/FVC% 51.9%. Nineteen patients have used oxygen tanks as oxygen devices, 1 patient oxygen concentrator, 2 patients oxygen tank and liquid oxygen, and other 4 patients oxygen tank together with portable oxygen. The duration of oxygen therapy was below 1 year in 3 cases, 1~2 years in 15 cases, 3~5 years in 6 cases, 9 years in 1 case, and 10 years in 1 case. All patients have inhalated oxygen with flow rate less than 2.5 L/min. And only 10 patients have inhalated oxygen more than 15 hours per day, but most of them short time per day. Conclusion: For the effective oxygen administration, it is necessary that education for long-term low flow oxygen therapy to patients, their family and neighbor should be done, and also the institutional backup for getting convenient oxygen devices is required.

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Immunization Practices in Children with Renal Disease : A Survey of the Members of Korean Society of Pediatric Nephrology (신질환 소아의 예방접종 현황 : 대한소아신장학회 회원들의 접종 방식에 대한 조사)

  • Park Seong-Shik;Ahn Sung-Ryou;Lee Ju-Suk;Kim Su-Yung
    • Childhood Kidney Diseases
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    • v.6 no.2
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    • pp.198-208
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    • 2002
  • Purpose : There is no scientific basis for an immunization policy for children with renal disease who have increased risk of infection in Korea. As an initial step in approaching this problem, this survey of pediatric nephrologists was undertaken to determine the current recommendations of practicing pediatric nephrologists Methods : Questionnaires were sent to the members of Korean Society of Pediatric Nephrology via mail and E-mail. The questionnaire was designed to obtain information about the immunization practice of basic vaccination schedule for nephrotic syndrome, the side effects after vaccination and the immunization practice about recommended vaccines for children with renal disease. Results : Questionnaires were sent to 56 pediatric nephrologists. 35 replies were received (response rate: 62.5%). Almost of the respondents (82.8%) reported practicing at university hospital. All respondents reported modified vaccination schedule. 65.7% of the respondents immunized nephrotic children with live vaccines some time later after discontinuation of corticosteroids treatment and 57.1% of respondents immunized them with killed vaccines during medication of low doses of corticosteroids. Respondents experienced relapse of nephrotic syndrome after vaccination are nine, lack of vaccine efficacy are three and infection by organisms of live vaccines are two. 71.4% of respondents reported vaccinating children with renal disease for hepatitis B, pneumococcus and influenza during medication of low doses of corticosteroids. But There is few difference of the rates of respondents vaccinating them for Hemophilus influenzae type b between during medication of low doses of corticosteroids and after discontinuation of corticosteroids treatment (45.7% us 42.9%). Almost of respondents reported vaccinating renal failure children without immunosuppression for hepatitis B, pneumococcus, influenza and H. influenzae type b ($54.3{\sim}77.1%$). Conclusion : Pediatric nephrologists practiced modifying vaccination schedules for children with renal disease in Korea and there was variation according to the progression of disease and the doses of corticosteroids. It is necessary to establish the immunization guideline for children with renal disease through the prospective studies.

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Palliative Irradiation Using Helical Tomotherapy in Recurrent Pelvic Tumors with Prior Radiotherapy (방사선치료 후 재발한 골반암에서 토모테라피를 이용한 고식적 재치료)

  • Kay, Chul-Seung;Yoo, Eun-Jung;Kim, Ji-Hoon;Ro, Duck-Young;Kim, Ki-Jun
    • Radiation Oncology Journal
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    • v.28 no.3
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    • pp.133-140
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    • 2010
  • Purpose: We retrospectively investigated the effect of irradiation using helical tomotherapy in recurrent pelvic tumors that underwent prior irradiation. Materials and Methods: Fourteen patients with recurrent pelvic tumors consisting of rectal cancer (57.1%), cervical cancer (35.7%) and cancer with an unknown origin (7.1%) were treated with tomotherapy. At the time of irradiation, median tumor size was 3.5 cm and 7 patients complained of pain originating from a recurrent tumor. The median radiation dose delivered to the gross tumor volume, clinical target volume, and planning target volume was 50 Gy, 47.8 Gy and 45 Gy, respectively and delivered at 5 fractions per week over the course of 4 to 5 weeks. Treatment response and duration of local disease control were evaluated using the Response Evaluation Criteria in Solid Tumors (ver. 1.0) and the Kaplan-Meyer method. Treatment-related toxicities were assessed through Common Terminology Criteria for Adverse Events (ver. 3.0). Results: The median follow-up time was 17.3 months, while the response rate was 64.3%. Symptomatic improvement appeared in 6 patients (85.7%). The median duration time of local disease control was 25.8 months. The rates of local failure, distant failure, and synchronous local and distant failure were 57.1%, 21.4%, and 7.1%, respectively. Acute toxicities were limited in grade I or II toxicities, except for one patient. No treatment related death or late toxicity was observed. Conclusion: Helical tomotherapy could be suggested as a feasible palliative option in recurrent pelvic tumors with prior radiotherapy. However, to increase treatment effect and overcome the limitation of this outcome, a large clinical study should be performed.

Surgical Treatment of Primary Lung Cancer (원발성 폐암의 외과적 치료)

  • 김성완;구본원;이응배;전상훈;장봉현;이종태;김규태;강덕식
    • Journal of Chest Surgery
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    • v.31 no.2
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    • pp.134-141
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    • 1998
  • Primary lung cancer has recently increased progressively in its incidence in Korea. It is clearly evident that surgical resection offers the best offortunity for cure of non-small cell carcinoma. This study was designed to analyse the clinical data of 100 primary non-small cell carcinoma patients who underwent lung resection surgery from January 1992 to July 1995 at the department of Thoracic and Cardiovascular Sugery, Kyungpook National University Hospital. There were 86 males and 14 females(6:1). In the age distribution, the peak incidence was recorded in the seventh decade(43%). The methods of tissue diagnosis were bronchoscopic biopsy in 53 patients(50.5%), percutaneous needle aspiration in 17 patients(16.2%), transbronchial lung biopsy in 11 patients(10.5%), mediastinoscopic biopsy in 2 patients (1.9%), sputum cytology in 2 patients(1.9%), and thoracotomy in 20 patients(19.0%). Fifty-five lobectomies, 22 pneumonectomies, 15 bilobectomies, 2 segmentectomies, 4 sleeve lobectomies, a sleeve pneumonectomy, and a wedge pneumonectomy were performed. Operative mortality occured in 4 cases(sepsis in 2 cases, respiratory failure in 1 case, and acute myocardiac infarction in 1 case). The histologic types of tumor were 67 squamous cell carcinomas, 26 adenocarcinomas, 6 large cell carcinomas, and an adenosquamous cell carcinoma. Eighteen patients with N2 mediastinal lymph node metastases had 8 squamous cell carcinomas(11.9%), 9 adenocarcinomas(34.6%), and a large cell carcinoma(16.7%). The primary tumors in these patients were in the right upper lobe in 4 patients, the right middle and lower lobe in 9 patients, the left upper lobe in 3 patients, and the left lower lobe in 2 patients. With regard to pathologic stages, 45 patients had stage I disease; 13 patients, stage II; 36 patients, stage IIIa; 5 patients, stage IIIb; and 1 patient, stage IV. The overall actuarial survival rate was 77.5% at 12 months, 56.1% at 24 months and 43.7% at 43 months. The actuarial survival rates at 43 months were 81.3% in Stage I, 20.8% in Stage II, 27.9% in Stage IIIa, 25.0% in Stage IIIb and 33.3% in Stage IV. These facts suggest that early detection and surgical resection are recommended for favorable postoperative survival in non-small cell lung cancer.

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