• Journal of Chest Surgery
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• 제18권4호
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• pp.872-880
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• 1985

Myasthenia gravis is a neuromuscular transmission disorder characterized by fatigue and weakness of voluntary muscles. Although the pathogenesis is known as reduction of available acetylcholine receptors at neuromuscular junctions by autoimmune attack, the thymic role in myasthenia gravis is still unclear and under investigation. But thymectomy in the management of myasthenia gravis has become increasingly important since the first successful operation with remission of symptoms in 1939 by Blalock. From January 1983 to June 1985, authors performed 17 thymectomies for patients with myasthenia gravis. Among them, 12 patients were free from thymoma [Croup A] and 5 were coupled with thymoma [Group B]. The results were as follows: 1] Sex distribution was 11 females and 6 males. Mean age of the patients was 32.2 year old. Sex and age distribution by the Group A and B are shown Table 1. 2] Clinical manifestations of ocular symptoms were seen in 5 patients [88.2%], extremity weakness in 13 patients, bulbar weakness in 12 patients and dyspnea in 6 patients. According to the Osserman`s classification, 5 patients were in group IIA, 6 in IIB and 6 in IIC. 3] Pre-operatively, all patients were positive response to the anti-cholinesterase test and 12 patients [92.3%] revealed positive findings in electromyography [EMC] which was done in 13 patients. 4] The postoperative complications were respiratory distress in 3 patients, myasthenic crisis in 2 patients and wound disruption in one patients. 5] Pathologic examination of the thymus showed hyperplasia in 10 patients [90%] and thymoma in 5 patients, of which 4 were mixed type with invasion to the adjacent tissues and one lymphocytic type without invasion. Normal thymus was noticed in only 2 patients. 6] In postoperative evaluations, among the 12 patients c free from thymoma [Group A], complete remission of symptoms was noticed in 3 patients and improvement in 7 patients. But among the 5 patients coupled with thymoma [Group B], only one patients showed improvement [Table 8]. Therefore, remission and clinical improvement were noticed in 11 patients [64.7%] of the all and complete remission was noticed in 3 patients [17.6%].

• 대한예방한의학회지
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• 제23권1호
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• pp.61-72
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• 2019

Introduction : The aim of this study was to investigate menstrual pattern according to Mibyeong Index(MBI) and compare Mibyeong symptom score according to severity of menstrual pain. Mibyeong Index was designed to measure inconvenience and resilience of subject's complains including four physical symptoms(fatigue, pain, low sleep quality, indigestion) and mental distress including anxiety, anger, depression. Method : We used the clinical data of Korean medicine Date Center(KDC) for subjects who participated in the study of 'Clinical research for collecting of clinical cases based on the personal type of Mibyeng' conducted in Seoul, from June 26, 2015 to June 26, 2017. A total of 566 fertile women aged 30 to 50 who completed the questionnaires were included in this study. In this study, we used items of Mibyeong Index and the menstrual pattern by self-report questionnaires. The date were analyzed through Kruskal Wallis test, Pearson's chi-square test, and one-way ANOVA using SPSS statistics 19.0. Results : Mibyeong status was significantly associated with severity of menstrual pain(p<0.001), worst day of menstrual pain(p<0.05), and type of menstrual pain(low back pain, nausea, depression, and none (respectively, p<0.05)). In addition, The 7-subtype score (fatigue (p<0.001), pain(p<0.001), low sleep quality(p<0.001), indigestion(p<0.001), anxiety(p<0.05), anger(p<0.05) and depression(p<0.05)) of Mibyeong index and total score of Mibyeong Index (p<0.001) showed significant difference for severity of menstrual pain. Conclusion : This result indicates that a close relationship between Mibyeong status and severity of menstrual pain. Further studies are needed but, we hope that this results will be used as the basic data to improve mibyeong status through health care to alleviate dysmenorrhea.

• BMB Reports
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• 제56권5호
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• pp.314-319
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• 2023

Sepsis is a life-threatening multi-organ dysfunction with high mortality caused by the body's improper response to microbial infection. No new effective therapy has emerged that can adequately treat patients with sepsis. We previously demonstrated that interferon-β (IFN-β) protects against sepsis via sirtuin 1-(SIRT1)-mediated immunosuppression. Another study also reported its significant protective effect against acute respiratory distress syndrome, a complication of severe sepsis, in human patients. However, the IFN-β effect cannot solely be explained by SIRT1-mediated immunosuppression, since sepsis induces immunosuppression in patients. Here, we show that IFN-β, in combination with nicotinamide riboside (NR), alleviates sepsis by blocking endothelial damage via SIRT1 activation. IFN-β plus NR protected against cecal ligation puncture-(CLP)-induced sepsis in wild-type mice, but not in endothelial cell-specific Sirt1 knockout (EC-Sirt1 KO) mice. IFN-β upregulated SIRT1 protein expression in endothelial cells in a protein synthesis-independent manner. IFN-β plus NR reduced the CLP-induced increase in in vivo endothelial permeability in wild-type, but not EC-Sirt1 KO mice. IFN-β plus NR suppressed lipopolysaccharide-induced up-regulation of heparinase 1, but the effect was abolished by Sirt1 knockdown in endothelial cells. Our results suggest that IFN-β plus NR protects against endothelial damage during sepsis via activation of the SIRT1/heparinase 1 pathway.

• 대한불안의학회지
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• 제18권2호
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• pp.109-115
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• 2022

Objective : The purpose of this study was to examine the influence of subscales of emotional intelligence on empathy in first-year medical students. Methods : A total of 215 first-year medical students were eligible for this study. Demographic factors (age, sex, and medical school entrance type) and measures for emotional intelligence and empathy, such as the Wong and Law Emotional Intelligence Scale and the Interpersonal Reactivity Index, were included in the survey. The relationship between emotional intelligence and empathy was analyzed by multiple linear regression, adjusting for age, sex, and entrance type. Results : The female students' level of emotional intelligence was higher than the male students for the self-emotional appraisal (p=0.029) and others' emotional appraisal (p=0.006) subscales. Meanwhile, the graduate-entry students scored higher for the use of emotion (p<0.001) and regulation of emotion (p=0.010) subscales than the direct-entry students. For empathy, the female students revealed a higher score in empathic concern (p=0.009) than the male students, and graduate-entry students scored higher than the direct-entry students in perspective taking (p=0.004) and empathic concern (p<0.001). The multiple linear regression analysis has identified significant influences of subscales of emotional intelligence on empathy: others' emotional appraisal on perspective taking (p<0.001), self-emotional appraisal (p=0.035) and regulation of emotion (p=0.023) on fantasy, others' emotional appraisal (p<0.001) and use of emotion (p=0.020) on empathic concern, and self-emotional appraisal (p=0.033) and regulation of emotion (p<0.001) on personal distress. Conclusion : This study's findings suggest that emotional intelligence may affect empathy in medical students, which can have implications for developing educational strategies to enhance empathetic attitudes in medical students.

• The Korean Journal of Physiology and Pharmacology
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• 제2권5호
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• pp.617-628
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• 1998

In order to understand the pathogenetic mechanism of adult respiratory distress syndrome (ARDS), the role of phospholipase A2 (PLA2) in association with oxidative stress was investigated in rats. $Interleukin-1{\alpha}\;(IL-1,\;50\;{\mu}g/rat)$ was used to induce acute lung injury by neutrophilic respiratory burst. Five hours after IL-1 insufflation into trachea, microvascular integrity was disrupted, and protein leakage into the alveolar lumen was followed. An infiltration of neutrophils was clearly observed after IL-1 treatment. It was the origin of the generation of oxygen radicals causing oxidative stress in the lung. IL-1 increased tumor necrosis factor (TNF) and cytokine-induced neutrophil chemoattractant (CINC) in the bronchoalveolar lavage fluid, but mepacrine, a PLA2 inhibitor, did not change the levels of these cytokines. Although IL-1 increased PLA2 activity time-dependently, mepacrine inhibited the activity almost completely. Activation of PLA2 elevated leukotriene C4 and B4 (LTC4 and LTB4), and 6-keto-prostaglandin $F2{\alpha}\;(6-keto-PGF2{\alpha})$ was consumed completely by respiratory burst induced by IL-1. Mepacrine did not alter these changes in the contents of lipid mediators. To estimate the functional changes of alveolar barrier during the oxidative stress, quantitative changes of pulmonary surfactant, activity of gamma glutamyltransferase (GGT), and ultrastructural changes were examined. IL-1 increased the level of phospholipid in the bronchoalveolar lavage (BAL) fluid, which seemed to be caused by abnormal, pathological release of lamellar bodies into the alveolar lumen. Mepacrine recovered the amount of surfactant up to control level. IL-1 decreased GGT activity, while mepacrine restored it. In ultrastructural study, when treated with IL-1, marked necroses of endothelial cells and type II pneumocytes were observed, while mepacrine inhibited these pathological changes. In histochemical electron microscopy, increased generation of oxidants was identified around neutrophils and in the cytoplasm of type II pneumocytes. Mepacrine reduced the generation of oxidants in the tissue produced by neutrophilic respiratory burst. In immunoelectron microscopic study, PLA2 was identified in the cytoplasm of the type II pneumocytes after IL-1 treatment, but mepacrine diminished PLA2 particles in the cytoplasm of the type II pneumocyte. Based on these experimental results, it is suggested that PLA2 plays a pivotal role in inducing acute lung injury mediated by IL-1 through the oxidative stress by neutrophils. By causing endothelial damage, functional changes of pulmonary surfactant and alveolar type I pneumocyte, oxidative stress disrupts microvascular integrity and alveolar barrier.

• Journal of Yeungnam Medical Science
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• 제1권1호
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• pp.59-66
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• 1984

일측폐장을 절제한 뒤 대상성증식기의 폐장을 태아폐장증식의 모델로 삼고 이때 steroid가 대상성증식중의 폐장내 제II형폐포세포의 폐포표면활성물질의 분비에 미치는 영향을 알아보기 위한 본 실험의 결과를 요약하면 다음과 같다. 1. 잔류폐장의 무게 및 체중에 대한 폐장무게의 비는 폐절제후 betamethasone을 투여한 군에서 폐절제군에 비해 감소하는 경향을 보였다. 2. 폐세척액내의 인지질인의 함량은 폐절제후 betamethasone을 투여한 군에 있어서는 무처치대조군에 비해서는 유의한(p<0.01) 증가를 보였고 폐절제군에 비해서는 증가하는 경향을 보였다. 3. TLC(thin layer chromatography)를 통해 폐세척액내의 인지질의 조성을 조사한 결과, 폐절제후 betamethasone을 투여한 군은 무처치대조군 및 폐절제군과는 다른 양상을 보였다. 이상의 실험결과로 미루어 steroid는 태아폐장의 대상성증식기에 폐포표면활성물질의 분비를 증가시키며 동시에 제II형폐포세포에서 분비되는 폐포표면활성물질의 주성분인 인지질의 조성에도 변화를 일으켜 폐장의 융압률을 증가시킨다고 사료된다.

• 한국도로학회논문집
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• 제3권4호
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• pp.127-136
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• 2001

콘크리트 암거와 같은 지중구조물의 뒷채움시에 부등침하를 줄이기 위해서는 양질의 뒷채움 재료사용과 대형진동 다짐장비를 이용한 정밀한 다짐을 실시하는 것이 중요하다. 또한 효과적인 정밀 다짐은 진동 롤러의 강한 진동을 함께 구조물부에 근접하여 다지는 것이 필요하다. 그러나, 이와 같은 다짐방법은 과도한 충격하중 발생으로 구조물의 벽체균열 발생을 유발할 수 있다. 본 논문에서는 콘크리트 암거의 뒷채움 시공을 위하여 충격완화재의 종류와 다짐방법을 변화하여 다짐시의 구조물에 발생하는 다짐토압을 현장계측을 통하여 분석하였다. 타이어칩과 발포 폴리 스틸렌을 사용한 패널들을 뒷채움 다짐시공전 암거 벽면에 부착하였다. 충격완화재 Type A(Rubber)와 Type B(EPS)의 성능 비교를 위한 실내시험 결과 Type A는 Type B보다 작은 탄성계수와 큰 재료감쇠를 가지고 있어 보다 큰 충격완화효과를 기대할 수 있는 것으로 나타났다. 다짐장비는 대부분 큰 다짐에너지를 위하여 고주파수인 30Hz를 적용하였다. 현장계측 결과로부터 다짐하중에 의한 동적 수평토압의 크기는 다짐장비의 가진여부, 측정깊이, 다짐장비 이격거리 및 다짐방향에 의존하고 있었다. 암거의 동적 수평토압 측정결과로부터 롤러 다짐장비를 콘크리트 구조물에 직각방향으로 다짐작업을 실시하는 것이 수평방향으로 다짐하는 것 보다 다짐효과를 증가하는 것으로 나타났다.

• Pediatric Infection and Vaccine
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• 제29권2호
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• pp.70-76
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• 2022

코로나바이러스감염증-19 (COVID-19)의 임상 양상은 무증상부터 급성 호흡곤란 증후군에 이르기까지 다양하다. 점액 다당류증(mucopolysaccharidosis) 2형은글라이코스아미노글라이칸(glycosaminoglycan)의 일종인 헤파란 황산염(heparan sulfate)과 더마탄 황산염(dermatan sulfate)의 분해를 촉매하는 효소 결핍에 의해 상기 물질이 리소좀(lysosome)에 축적되는 질환으로 전신 침범, 특히 호흡기침범을 특징으로 한다. 따라서 박테리아나 바이러스에 의한 호흡기 감염은 예후에 치명적일 수 있다. 현재 점액 다당류증 환자에서 제 2형 중증급성호흡기증후군 코로나 바이러스(SARS-CoV-2) 감염 후의 임상 양상에 대한 보고는 매우 드물고, 이에 점액 다당류증 2형으로 효소대체요법을 받고 있던 환자에서 상기 바이러스 감염 후의 임상 양상에 대해 보고하고 관련 문헌에 대해 고찰하고자 한다. 16세 남아로 가족간 전파로 코로나바이러스감염증이 발생하였다. 콧물, 기침, 가래 등 호흡기 증상이 관찰되었다. 발열이나 산소요구도 증가는 없었으며 심박수, 호흡수, 산소 포화도는 정상 범위였고 혈액검사결과에서 백혈구 감소증이 관찰되었다. 흉부 방사선 사진에서 폐렴 소견은 보이지 않았다. 보존적 치료와 격리만으로 증상이 호전되었다. 경미한 임상 양상의 원인으로 전구 물질의 축적으로 인해 바이러스에게 불리한 숙주의 세포 환경, 바이러스와의 상호작용에 관여하는 단백질을 암호화하는 유전자 발현의 특정방향으로의 변화가 제시되고 있다. 또한 점액 다당류증 환자에서 증가된 혈청 헤파란 황산염이 SARS-CoV-2 스파이크 단백질과 숙주 세포의 상호작용에 필수적인 세포 표면의 헤파란 황산염과 경쟁하여 SARS-CoV-2의 세포 내 침투로부터 보호한다는 가설도 있다. 향후 더 많은 사례를 통해 점액 다당류증 등의 리소좀 축적질환에서 코로나바이러스감염증의 발현 양상에 대한 연구가 필요하다.

• 대한한방내과학회지
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• 제44권4호
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• pp.645-660
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• 2023

Objectives: This study analyzed the clinical characteristics of patients with functional dyspepsia (FD) who received Korean medicine treatment. Methods: A retrospective chart review was conducted to investigate sociodemographic characteristics, clinical characteristics, and prescribed treatments. The clinical records of 192 patients who visited Kyung Hee University Korean Medicine Hospital for FD from May 1, 2022, to May 31, 2023, were analyzed. In addition, the distribution of pattern identification and symptom type according to body mass index (BMI), as well as prescription history, were analyzed. Results: As the degree of obesity increased, the proportion of Spleen-Qi deficiency pattern patients decreased (p=0.012), and the proportion of damp-phlegm pattern patients increased (p=0.000). Additionally, as the degree of obesity increased, the proportion of patients with excess differentiation increased (p=0.002). The PDS (Postprandial distress syndrome) symptom type was significantly more frequent in the underweight and normal groups than in the overweight and obese groups, and the EPS (Epigastric pain syndrome) symptom type was more frequent in the overweight and obese groups. Regardless of the type of pattern identification, the most frequently used prescriptions were Naesowhajung-tang, Hanshin Naeso-san, and Sojeokgunbi-hwan granule. Conclusion: This study analyzed the medical records of patients with FD to elucidate the use of Korean medicine treatments. Our study is meaningful in that we found that the distribution of pattern identification and symptom patterns are linked to the degree of obesity in FD patients and identified the tendency for herbal medicine treatments to be prescribed in clinical practice.

• 지능정보연구
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• 제27권1호
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• pp.83-102
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• 2021

2020년 8월 정부는 한국판 뉴딜을 뒷받침하기 위한 공공기관의 역할 강화방안으로서 각 공공기관별 역량을 바탕으로 5대 분야에 걸쳐 총 20가지 과제를 선정하였다. 빅데이터(Big Data), 인공지능 등을 활용하여 대국민 서비스를 제고하고 공공기관이 보유한 양질의 데이터를 개방하는 등의 다양한 정책을 통해 한국판 뉴딜(New Deal)의 성과를 조기에 창출하고 이를 극대화하기 위한 다양한 노력을 기울이고 있다. 그중에서 한국무역보험공사(KSURE)는 정책금융 공공기관으로 국내 수출기업들을 지원하기 위해 여러 제도를 운영하고 있는데 아직까지는 본 기관이 가지고 있는 빅데이터를 적극적으로 활용하지 못하고 있는 실정이다. 본 연구는 한국무역보험공사의 수출신용보증 사고 발생을 사전에 예측하고자 공사가 보유한 내부 데이터에 기계학습 모형을 적용하였고 해당 모형 간에 예측성과를 비교하였다. 예측 모형으로는 로지스틱(Logit) 회귀모형, 랜덤 포레스트(Random Forest), XGBoost, LightGBM, 심층신경망을 사용하였고, 평가 기준으로는 전체 표본의 예측 정확도 이외에도 표본별 사고 확률을 구간으로 나누어 높은 확률로 예측된 표본과 낮은 확률로 예측된 경우의 정확도를 서로 비교하였다. 각 모형별 전체 표본의 예측 정확도는 70% 내외로 나타났고 개별 표본을 사고 확률 구간별로 세부 분석한 결과 양 극단의 확률구간(0~20%, 80~100%)에서 90~100%의 예측 정확도를 보여 모형의 현실적 활용 가능성을 보여주었다. 제2종 오류의 중요성 및 전체적 예측 정확도를 종합적으로 고려할 경우, XGBoost와 심층신경망이 가장 우수한 모형으로 평가되었다. 랜덤포레스트와 LightGBM은 그 다음으로 우수하며, 로지스틱 회귀모형은 가장 낮은 성과를 보였다. 본 연구는 한국무역보험공사의 빅데이터를 기계학습모형으로 분석해 업무의 효율성을 높이는 사례로서 향후 기계학습 등을 활용하여 실무 현장에서 빅데이터 분석 및 활용이 활발해지기를 기대한다.