• Biomolecules & Therapeutics
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• 제19권4호
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• pp.431-437
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• 2011

Aberrant activation of microglia has been reported to cause neuronal damages by releasing a variety of pro-inflammatory cytokines. Besides where microglia become active, damages have been also observed in remote places, which is considered due to the migration of activated microglia. Therefore, an agent that could suppress abnormal activation of microglia and their subsequent migration might be valuable in activated microglia-related brain pathologies. The objective of the present study was to evaluate anti-inflammatory effects of betulinic acid on lipopolysaccharide (LPS)-stimulated BV2 microglial cells. Pretreatment of betulinic acid significantly attenuated LPS-induced NO production and protein expression of iNOS. Betulinic acid also significantly suppressed LPS-induced release and expression of cytokines such as TNF-${\alpha}$ and IL-$1{\beta}$. Furthermore, betulinic acid significantly uppressed LPS-induced MMP-9 expression, which has been suggested to play an important role in the migration of activated microglia. In order to understand the possible mechanism by which betulinic acid suppresses LPS-induced cytokine production and migration of microglia, the role of NF-kB, a major pro-inflammatory transcription factor, was examined. Betulinic acid significantly suppressed LPS-induced degradation of IKB, which retains NF-kB in the cytoplasm. Therefore, nuclear translocation of NF-kB upon LPS stimulation was significantly suppressed with betulinic acid. Taken together, the present study for the first time demonstrates that betulinic acid possesses anti-inflammatory activity through the suppression of nuclear translocation of NF-kB in BV2 microglial cells.

• 의료법학
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• 제22권1호
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• pp.3-23
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• 2021

원격의료는 원격지에서 영상, 통화 등 기기를 사용하여 환자를 진단, 치료하는 의료의 한 분야이다. 환자를 대면하여 진단, 치료, 처방하는 전통적인 방식에서 벗어나, 원격에 있는 환자에게 의료를 제공하기 때문에, 의료 소외 지역, 거동이 불편한 환자에 도움이 될 것이고, 의사들은 공간적 제약을 벗어나 환자를 볼 수 있다는 장점이 있다. 하지만 의사가 환자를 대면 진료하는 것에 비하면, 진료의 질이 떨어지는 문제가 나타날 수 있어서, 허용 여부와 한계를 정하는 것도 필요하다. 원격의료 유형 중에서 의사가 환자를 원격에서 진료하고 처방전을 발행하는 것을 원격진료라고 정의할 수 있는데, 현행 의료법상 허용되는지에 대하여 법 해석이 일관되지 못하고 있다. 의료법 처방전 조항은 의사의 '진찰' 또는 '직접 진찰' 규정에 의하여 처방전을 발급한다고 규정하고 있는데, 이것을 대면 진료를 요구하는 규정이라고 해석하는 헌법재판소 결정과 일정한 제한 하에서 전화 처방을 인정할 수 있다는 대법원 판결이 대립하고 있다. 또한 의료법상 원격의료 규정에 의하여 명백하게 법상 허용되는 원격의료자문 외에 의사 환자 간 원격진료는 불법이라는 대법원 판결이 있다. 본 논문에서는 의료법 개정 연혁, 개정 이유 및 관련 의료법 조항과의 관련성을 통하여 원격진료에 대한 대법원 판례를 해석하고자 한다. 결론적으로 의료법상 처방전 규정에 의한, 의사의 직접 진찰 후, 처방전 발급 조항은 환자를 진찰한 의사가 처방전을 발급해야 한다는 처방전 발급 명의에 관한 의무 조항으로 해석하며, 의료법 원격의료 규정에 의하여 의사-환자 간 원격진료는 허용되지 않은 것으로 판단한다.

• 동의생리병리학회지
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• 제25권5호
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• pp.765-772
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• 2011

Knowledge which is represented by formal logic are widely used in many domains such like artificial intelligence, information retrieval, e-commerce and so on. And for medical field, medical documentary records retrieval, information systems in hospitals, medical data sharing, remote treatment and expert systems need knowledge representation technology. To retrieve information intellectually and provide advanced information services, systematically controlled mechanism is needed to represent and share knowledge. Importantly, medical expert's knowledge should be represented in a form that is understandable to computers and also to humans to be applied to the medical information system supporting decision making. And it should have a suitable and efficient structure for its own purposes including reasoning, extendability of knowledge, management of data, accuracy of expressions, diversity, and so on. we call it ontology which can be processed with machines. We can use the ontology to represent traditional medicine knowledge in structured and systematic way with visualization, then also it can also be used education materials. Hence, the authors developed an Shanghanlun ontology by way of showing an example, so that we suggested a methodology for ontology development and also a model to structure the traditional medical knowledge. And this result can be used for student to learn Shanghanlun by graphical representation of it's knowledge. We analyzed the text of Shanghanlun to construct relational database including it's original text, symptoms and herb formulars. And then we classified the terms following some criterion, confirmed the structure of the ontology to describe semantic relations between the terms, especially we developed the ontology considering visual representation. The ontology developed in this study provides database showing fomulas, herbs, symptoms, the name of diseases and the text written in Shanghanlun. It's easy to retrieve contents by their semantic relations so that it is convenient to search knowledge of Shanghanlun and to learn it. It can display the related concepts by searching terms and provides expanded information with a simple click. It has some limitations such as standardization problems, short coverage of pattern(證), and error in chinese characters input. But we believe this research can be used for basic foundation to make traditional medicine more structural and systematic, to develop application softwares, and also to applied it in Shanghanlun educations.

• 대한예방한의학회지
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• 제4권1호
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• pp.1-16
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• 2000

From 1998, Oriental Medical Physicians(OMP) is distributed in Public Health Sector. but long term plan for Oriental Medicine in Public Health is not existed. So, this study is designed for the activation of OMP Subjects in this study were comprised 3 groups of oriental medicine related persons, the group of which are Students of 11 Oriental Medical Schools, Oriental Medical Physicians in Public Health Sector, Specialist Croup of Oriental medicine Policy(total 1,458 persons). Data were collected from July 1st to November 30, 1999. Direct interview with key persons, systematic interview by using of interview protocol, e-mail and facsimile have been conducted. The results of survey were coded by Excel 5.0, and analysed with SAS 6.12 statistical package. Inter-group difference determined by T-test, and descriptive statistics have been examined. Major findings can be epitomized as follows. 1) OMP disposition to multifarious organizations and institutes such as Public Health Centers, Public Health Sub-centers, Public Hospitals, Private Hospitals in Remote-Vulnerable Area, Community Social Welfare Centers, Institutes for Heath Policy Research, etc, will promise an effective use of Oriental Medical Physician. 2) Average number of patients treated by OMP was 22.8, average budget for oriental medical department, in which OMP were affiliated, was 39.6 million Won per year. Direct cost per every patient visit was 7,210.9 Won, which is considered expensive for public health service. Therefore, development and transformation for Oriental Medical Service in Public Health Sector is desirable in economic and political aspects. 3) It is recommended that ${\ulcorner}Advisory\;Committee{\lrcorner},{\ulcorner}Planning\;Commission\;for\; Public\;Health\;in\;Oriental\;Medicine{\lrcorner}$ should be established for the activation and for the support of Oriental Medical Physician in Public Health Sector, 4) Most effective programmes for oriental public health doctor are health service programmes for the elderly, Home health visit, chronic degenerative disease control services(p<0.001). 5) Standard guideline for facilities and equipments of Oriental Medicine Department in Public Health Center is needed for optimal supply of resources and activation of public health activity.

• Genomics & Informatics
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• 제6권1호
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• pp.18-28
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• 2008

Single nucleotide polymorphisms (SNPs) are the most abundant forms of human genetic variations and resources for mapping complex genetic traits and disease association studies. We have constructed a linkage disequilibrium (LD) map of chromosome 22 in Korean samples and compared it with those of other populations, including Yorubans in Ibadan, Nigeria (YRI), Centre d'Etude du Polymorphisme Humain (CEPH) reference families (CEU), Japanese in Tokyo (JPT) and Han Chinese in Beijing (CHB) in the HapMap database. We genotyped 4681 of 111,448 publicly available SNPs in 90 unrelated Koreans. Among genotyped SNPs, 4167 were polymorphic. Three hundred and five LD blocks were constructed to make up 18.6% (6.4 of 34.5 Mb) of chromosome 22 with 757 tagSNPs and 815 haplotypes (frequency $\geq$ 5.0%). Of 3430 common SNPs genotyped in all five populations, 514 were monomorphic in Koreans. The CHB + JPT samples have more than a 72% overlap with the monomorphic SNPs in Koreans, while the CEU + YRI samples have less than a 38% overlap. The patterns of hot spots and LD blocks were dispersed throughout chromosome 22, with some common blocks among populations, highly concordant between the three Asian samples. Analysis of the distribution of chimpanzee-derived allele frequency (DAF), a measure of genetic differentiation, Fst levels, and allele frequency difference (AFD) among Koreans and the HapMap samples showed a strong correlation between the Asians, while the CEU and YRI samples showed a very weak correlation with Korean samples. Relative distance as a quantitative measurement based upon DAF, Fst, and AFD indicated that all three Asian samples are very proximate, while CEU and YRI are significantly remote from the Asian samples. Comparative genome-wide LD studies provide useful information on the association studies of complex diseases.

• The Korean Journal of Physiology
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• 제1권2호
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• pp.157-168
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• 1967

The entry of antipyrine and urea from the peritoneal cavity of rabbit into organ tissue and blood plasma was studied. Two hundred mg of antipyrine plus 300 mg of urea in 10 ml Ringer's solution was injected into the peritoneal cavity of anesthetized rabbit. The injection was made from above of a rabbit kept tying right side down and it enabled part of the abdominal organs (liver, intestine, kidney) was immersed in the injected solution and kept high concentration gradient throughout the experimental period. The remaining part of the organs was revered only by a thin film of the test solution. Subsequently, in this part of the organs the concentration gradient of the diffusible substances during entry was presumed to decrease as time elapsed. Four pieces of the liver tissue were taken namely, the right superficial, right deep, left superficial and left deep portions. Two were taken from the small intestine, one from the portion which was immersed in. the fluid and the other from that above the fluid mass. Both kidneys were separately analyzed. As a remote organ the gastrocnemius muscle was taken from the right leg of the animal. The intervals which were the time periods elapsed after injections were 5,7,10,15 or 30 minutes. At each point 5 animals were sacrificed and the concentrations of the test substances in the tissue water were measured. The results obtained were as follows. 1. In the liver the right portion which was immersed in the fluid showed higher concentration if the test substances than the left portion and the superficial region exceeded the deep region. The concentrations diminished as the time elapsed after infusion, particulary in the case of antipyrine, suggesting circulatory removal of the substances. In urea such decreasing tendency of the concentration was not obvious, and suggested slower removal rate of it as compared with that of antipyrine. 2. In the small intestine there was no regional difference in the concentration of the test substances. Because of the intestinal motility different portions of the intestine were seemed to have bathed in the fluid of the same concentration. In general the concentrations in the intestinal wall exceeded those of the liver, suggesting a slower removal rate than in the latter. 3. In the kidney the accumulation of the endogenous urea was predominant, and the accumulating mechanism in the renal tissue went on during the period of the experiment. Therefore it revealed increasing tendencies as the time elapsed. The penetration of the test substances in this organ from the peritoneal cavity seemed to be slower than in other abdominal organs, namely liver or small intestine. Part of the test substances in the kidney were obviously brought by the blood stream. 4. Rapid exponential decay of the concentration of antipyrine and of the osmolality of the peritoneal fluid was attributed to the extensive removal through the whole dimension of the peritoneal surface, and the remote organ such as the gastrocnemius muscle attained a fairly close value to that of the abdominal organs in less than 30 minutes. The factors which related to the absorption rate were discussed. They were the concentration gradient, permeability and the regional perfusion rate.

• 의료법학
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• 제21권2호
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• pp.3-33
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• 2020

원격의료가 이미 허용되어 상당히 진행된 국가도 있는 반면, 원격의료가 법률해석상 금지되는 국가들도 있다. 최근까지 한국과 독일은 모두 후자에 속하였다. 독일에서 원격의료가 금지되는 가장 주요한 근거는 독일연방의사협회가 마련한 표준의사직업규정 제7조 제4항이 "상담을 전적으로 인쇄 및 통신매체를 통해 수행해서는 안 된다. 원격의료절차에서도, 의사가 환자를 직접 진료하는 것이 보장되어야 한다."고 규정하고 있었고 각 주(州)의 의사직업규정이 이를 그대로 수용하였기 때문이다. 그렇지만 독일 내에서도 전적인 원격의료가 허용되어야 한다는 논의 및 전자의료(E-Health) 활성화를 위한 인프라와 그를 규제하는 법을 마련해야 한다는 논의가 상당히 오래 전부터 있어 왔다. 2018년 표준의사직업규정이 변경되었고 대부분의 주(州)의사협회가 의사직업규정을 개정하였으므로 이제 독일에서는 원격의료가 대부분 허용된다고 할 수 있다. 아직 우리나라는 원격의료를 허용하지는 않으나, 우리와 같은 입장이었던 독일이 어떤 준비 하에 원격의료 허용 쪽으로 선회하였는지 살펴보는 것은 우리법이 개정될 경우를 대비하여 여전히 중요한 작업이라 할 것이다.

• 대한치과보철학회지
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• 제58권4호
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• pp.349-355
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• 2020

외상, 구강암, 선천적 요인 등에 의한 구강 결손시 음식물의 섭취, 흡입성 폐렴 방지, 안모 지지를 위하여 치과용 obturator가 제작된다. 그러나 기존의 전통적인 인상 채득 방법을 이용한 obturator제작 시, 제작 과정에서 술자와 환자, 기공사 모두 번거로운 과정을 거쳐야 하며, 환자는 악안면 보철 치료가 가능한 치과 보철 전문의가 있는 병원을 찾아 방문해야 하는 어려움이 있다. 그러나, 3D printing을 포함한 CAD-CAM 기술을 이용하면 비교적 간단하게 hollow obturator를 제작할 수 있고, 보철 전문의가 없는 지역에서도, 지역 치과의사와 멀리 떨어져 있는 보철 전문의 간의 협진을 통해 수월한 치료가 가능할 수 있다. 본 연구에서는 한국의 상악 구개 결손 환자들의 치료를 위해, 일본에서 obturator를 디자인하고 한국에서 3D printing하여 성공적으로 obturator를 제작하였고, 더불어 원격 치료의 가능성을 확인하였기에 보고하는 바이다.

• 대한의용생체공학회:학술대회논문집
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• 대한의용생체공학회 1997년도 추계학술대회
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• pp.201-205
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• 1997

With the recent advance of Web and its associated technologies, information sharing on distribute computing environments has gained a great amount of attention from many researchers in many application areas, such as medicine, engineering, and business. One basic requirement of distributed medical consultation systems is that geographically dispersed, disparate participants are allowed to exchange information readily with each other. Such software also needs to be supported on a broad range of computer platforms to increase the software's accessibility. In this paper, the development of world-wide-web based medical consultation system or radiology imaging is addressed to provide the platform independence and great accessibility. The system supports sharing of 3-dimensional objects. We use VRML (Virtual Reality Modeling Language), which is the de-facto standard in 3-D modeling on the Web. 3-D objects are reconstructed from CT or MRI volume data using a VRML format, which can be viewed and manipulated easily in Web-browsers with a VRML plug-in. A Marching cubes method is used in the transformation of scanned volume data set to polygonal surfaces of VRML. A decimation algorithm is adopted to reduce the number of meshes in the resulting VRML file. 3-D volume data are often very large-sized, and hence loading the data on PC level computers requires a significant reduction of the size of the data, while minimizing the loss of the original shape information. This is also important to decrease network delays. A prototype system has been implemented (http://netopia.snu.ac.kr/-cyber/). and several sessions of experiments are carried out.

• Archives of Reconstructive Microsurgery
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• 제8권2호
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• pp.130-138
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• 1999

The lower extremity injuries are extremely increasing with the development of industrial & transportational technology. For the lower extremity injuries that result from high-energy forces, particularly those in which soft tissue and large segments of bone have been destroyed and there is some degree of vascular compromise, the problems in reconstruction are major and more complex. In such cases local muscle coverage is probably unsuccessful, because adjacent muscles are destroyed much more than one can initially expect. Reconstruction of the lower extremity has been planned by dividing the lower leg into three parts traditionally The flaps available in each of the three parts are gastrocnemius flap for proximal one third, soleus flap for middle one third and free flap transfer for lower one third. Microvascular surgery can provide the necessary soft tissue coverage from the remote donnor area by free flap transfer into the defect. Correct selection of the appropriate recipient vessels is difficult and remains the most important factor in successful free flap transfer. Vascular anastomosis to recipient vessels distal to the zone of injury has been advocated and retrograde flow flaps are well established in island flaps. Retrograde flow anastomosis could not interrupt the major blood vessels which were essential for survival of the distal limb, the compromise of fracture or wound healing might be prevented. During 5 years, from March 1993 to Feb. 1998, we have done 68 free flap transfers in 61 patients to reconstruct the lower extremity. From analysis of the cases, we concluded that for the reconstruction of the lower extremity, free flap transfer yields a more esthetic and functional results.