• 한국동물생명공학회지
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• 제37권1호
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• pp.2-12
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• 2022

Extracellular vesicles (EVs) are nanovesicles that carry bioactive cargoes of proteins, lipids, mRNAs, and miRNAs between living cells. Their role in cellular communication has gained the attention of several research reports globally in the last decade. EVs are critically involved in sperm functions, oocyte functions, fertilization, embryonic development, and pregnancy. The review summarizes the state-of-the-art of EVs research in the diagnostic and therapeutic (theranostic) potentials of the EVs during the pregnancy that might provide a solution for gestational disturbances such as implantation failure, maternal health problems, gestational diabetes, and preeclampsia. EVs can be found in all biological fluids of the fetus and the mother and would provide a non-invasive and excellent tool for diagnostic purposes. Moreover, we provide the current efforts in manufacturing and designing targeted therapeutics using synthetic and semi-synthetic nanovesicles mimicking the natural EVs for efficient drug delivery during pregnancy.

• Nutrition Research and Practice
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• 제17권6호
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• pp.1201-1210
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• 2023

BACKGROUND/OBJECTIVES: The dietary intake of foods with fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) is known to adversely affect patients with irritable bowel syndrome (IBS). However, the effects of FODMAP have been studied predominantly among Western populations. This study aimed to identify foods high in FODMAP content which form a part of the Korean adult diet and obtain basic data for the preparation of IBS guidelines. SUBJECTS/METHODS: An online survey of 1,000 adults from the general population in the age group of 20 to 40 years was performed. Data from 787 participants (men, 386; women, 401) were analyzed. The general characteristics of the participants, health status, IBS diagnosis using the Rome III diagnostic criteria, semi-quantitative food frequency questionnaire findings, and food items causing symptoms were analyzed. RESULTS: Overall, 169 participants (21.5%) had IBS. The contribution of the FODMAP nutrients in both IBS and healthy groups was as follows: fructan > lactose > excess fructose > sorbitol > mannitol > galacto-oligosaccharides (GOS). The fructan intake was 4.6 ± 2.2 g/day and 4.3 ± 2.5 g/day in the IBS and healthy groups (P = 0.014), respectively. In the IBS group, the ratio of the intake of fructan to the total FODMAP intake was 39.5%, 29.8%, and 5.8% through onions, garlic, and bananas, respectively. CONCLUSIONS: Fructan was the FODMAP nutrient most consumed by Korean adults. Therefore, given the difference in the dietary habits of each country's population, the dietary guidelines for IBS should be country specific.

• KSII Transactions on Internet and Information Systems (TIIS)
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• 제18권1호
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• pp.105-125
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• 2024

Gliomas are the most common malignant brain tumor and cause the most deaths. Manual brain tumor segmentation is expensive, time-consuming, error-prone, and dependent on the radiologist's expertise and experience. Manual brain tumor segmentation outcomes by different radiologists for the same patient may differ. Thus, more robust, and dependable methods are needed. Medical imaging researchers produced numerous semi-automatic and fully automatic brain tumor segmentation algorithms using ML pipelines and accurate (handcrafted feature-based, etc.) or data-driven strategies. Current methods use CNN or handmade features such symmetry analysis, alignment-based features analysis, or textural qualities. CNN approaches provide unsupervised features, while manual features model domain knowledge. Cascaded algorithms may outperform feature-based or data-driven like CNN methods. A revolutionary cascaded strategy is presented that intelligently supplies CNN with past information from handmade feature-based ML algorithms. Each patient receives manual ground truth and four MRI modalities (T1, T1c, T2, and FLAIR). Handcrafted characteristics and deep learning are used to segment brain tumors in a Global Convolutional Neural Network (GCNN). The proposed GCNN architecture with two parallel CNNs, CSPathways CNN (CSPCNN) and MRI Pathways CNN (MRIPCNN), segmented BraTS brain tumors with high accuracy. The proposed model achieved a Dice score of 87% higher than the state of the art. This research could improve brain tumor segmentation, helping clinicians diagnose and treat patients.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제27권3호
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• pp.146-157
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• 2024

Purpose: Celiac disease (CD) is one of the most prevalent food-related illnesses in children, with a global prevalence of approximately 1.4%. CD can create an emotional burden, particularly on mothers, who are mainly responsible for managing challenges related to adherence to a gluten-free diet, high food costs, and food problems in schools and social areas. There is a gap in the literature, and parental experiences of raising children with CD should be explicitly examined. This qualitative study sought to provide insights into the experiences of parents raising a child with CD in the Turkish context. Methods: This study used a descriptive qualitative research methodology and conducted individual semi-structured video-based dyadic interviews with 19 parents. Results: Participants experienced both challenges and motivators through management of their children's CD. Analyses of the interview transcripts through the data uncovered three main themes focusing primarily on parental concerns: (1) parental challenges in child's disease management, (2) supportive care needs, and (3) parental expectations. Conclusion: A multidisciplinary team should approach the child and family immediately after diagnosis, and facilities should support parents with continuing education and psychological, financial, and social assistance.

• Journal of Preventive Medicine and Public Health
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• 제57권2호
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• pp.157-166
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• 2024

Objectives: Children with disabilities may exhibit a multitude of symptoms, and treatment requires a multidisciplinary approach for a satisfactory outcome. Lack of awareness among physicians, lack of referral, and lack of inter-sectoral coordination have hindered paediatric practice in Tamil Nadu, a state in India with a striking childhood disability rate that warrants a timely interdisciplinary approach. However, the perspectives of paediatricians on paediatric physiotherapy are unknown. The aim of the study was to investigate the perspectives of practicing paediatric physicians in Chennai on the role of physiotherapy in paediatrics. Methods: For an in-depth exploration, qualitative semi-structured interviews were conducted in person with 10 paediatricians. Audio from the sessions was recorded and transcribed, and data saturation was achieved through iterative analysis. Results: A grounded theory analysis of the results yielded 5 domains under which the perspectives and expectations of the physicians were described, along with the barriers experienced by patients' parents as explained by their paediatrician. The responses highlighted deficits in awareness, structural support, accessibility and direct communication between physicians and physiotherapists. Conclusions: Paediatric physicians have different opinions, and some ignorance persists concerning paediatric physiotherapy. This study warrants a proper structure of the paediatric rehabilitation unit and regular interdisciplinary meetings and focus group discussions to increase access for parents and improve patient outcomes.

• Asian-Australasian Journal of Animal Sciences
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• 제17권6호
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• pp.814-819
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• 2004

An investigation was carried out to study the effect of two housing systems on feed intake and nutrient utilization of sheep in a semi-arid region of India. Two types of housing managements were adopted. The first was a shed- 20'${\times}$10' structure with all the four sides of 6' chain link fencing with central height of 10'. The roof was covered with asbestos sheets, with mud floorings. The second was an open corral- 20'${\times}$10' open space with all the four sides covered with 6' chain link fencing. Thirty-four (32 ewes and 2 rams) sheep were grazed together on a 35 ha plot of native range. All the sheep were grazed as a flock from 08:00 to 17:00 h during the yearlong study. The flock was divided into two groups (16 ewes+1 ram) in the evening and housed according to two housing systems (Shed and Open Corral). Three digestion trials were conducted during three defined seasons of monsoon, winter and summer seasons to determine the effect of housing on nutrient intake and utilization. Blood samples were collected in three seasons for the estimation of hemoglobin and glucose. Dry and wet bulb temperatures were recorded at 06:00 A.M. and 09:00 P.M. using suitable thermometers both inside the shed and in the open corral and temperature humidity index (THI) was calculated. There was significant (p<0.05) difference in the THI between shed and open corral in all the seasons, indicating that the shed was always warmer compared to open corral. The daily dry matter intake (DMI, g/d) was 965, 615 and 982 in sheep housed under shed and 971, 625 and 1,001 in those housed in open corral during monsoon, winter and summer season, respectively. These differences were however non-significant (p>0.05). The digestibility of DM was 45.92, 45.13 and 50.30 in sheep housed under shed and 43.64, 45.02 and 55.02 in sheep housed in open corral during monsoon, winter and summer seasons, respectively. There was no significant (p>0.05) difference in the digestibility of nutrients in sheep maintained under shed and in open corral. Blood Hb concentration was 13.97, 14.13 and 13.15 in sheep housed under shed and 15.27, 13.63 and 14.82 in those kept in open corral, whereas blood glucose concentration was 59.67, 59.70 and 52.33 in sheep under shed and 61.00, 61.00 and 57.83 in open corral, during monsoon, winter and summer, respectively. There was also no significant effect of housing on the body weight changes, wool yield and survivability in ewes. Although housing had no significant effect on nutrient intake, their utilization and blood parameters, there was significant effect on the physiological responses and energy expenditure of sheep maintained under the two housing systems (Bhatta et al., 2004). It can be concluded from this study that the housing systems didn't have any significant effect on the nutrient intake and utilization of native breed like Malpura, which were well adapted to the hot semi-arid conditions of India. However, while deciding provisions for housing of different breeds of sheep (both crossbred and native) parameters like physiological responses, energy expenditure, health conditions and overall economics of the systems should be taken into consideration.

• 지역사회간호학회지
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• 제10권1호
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• pp.80-92
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• 1999

The purpose of this study was to survey appropriateness of admission and days of care for the cerebral ischemia patients as a basis to provide an effectiveness of hospitalization. The authors retrospectively reviewed the medical records of cerebral ischemia patients in two hospitals from November 1997 to February 1998. Of 194 medical records reviewed, there were 2108 medical days. I t is used a 'Appropriateness Evaluation Protocol' previously developed by Gertman and Restuccia (1981) and translated by Department of Health Management, Seoul National University and Korea Institute for Health Services Management (1993), It was found that the 'Appropriateness Evaluation Protocol' had a high inter-rater reliability(k=.92), Statistical significant was tested by using the percentage, mean, and logistic regression by SAS 6.12. The results were as follows; 1. The appropriate admissions were 87.6%, days of care 63.4%, and the average length of stay $10.9{\pm}6.7$ days. 2. The reasons of inappropriate admissions were for work-up(75.0%) and conservative care (25.0%). Major reasons of inappropriate days of care were 'cases in which the medical purpose of hospitalization has been accomplish or can be addressed in a less setting(45.0%)', and 'cases in which there is a delay in performing the work-up or treatment which required patients is hospitalized (44.4%)'. 3. Appropriate days of care were higher as ageing. Appropriate days of care were higher in patients with lower accademic back ground than those of upper college graduates, and in the patients who enter a hospital via emergency room than out-patients department. Appropriate days of care were higher in the patient with MCA infarction, and lower in the patient with cerebellar infarction than the patient with lacunar infarction. Appropriate days of care were higher in attack first than attack above second, in nomortension patients than hypertensive, and lower in groups who engaged in semi-private room and public room than private room in hospital. Appropriate days of care were higher in shorter length of stay than longer length of stay. 4. Diagnosis, admission path, and appropriate days of care explained appropriate admissions. Diagnosis, appropriate admissions, hypertension explained appropriate days of care. According to the above results, author confirms the substantial amount of inappropriate hospital bed utilization. To reduce inappropriateness, it is necessary to develop some alternative services such as home care services or nursing home with which can be replaced inpatient services and to introduce policy such as case management which includes Critical Pathway for consistent management. And, it should be followed the further study for the effectiveness.

• 한국산학기술학회논문지
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• 제21권8호
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• pp.160-169
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• 2020

이 연구는 공공 행정에서 서비스 전달 조직과 절차를 관리하고 재정을 지원하는 공공부문 사례관리 사업 중 방문건강관리 사업 실무자를 대상으로 타 사례관리 사업과의 연계협력 업무에 대한 경험을 파악하기 위해 실시하였다. 광역시와 시군 소재 보건소 방문건강관리사업 담당자 3명을 대상으로 포커스 그룹 인터뷰를 실시하였고, 자료 수집을 위해 사용한 인터뷰 질문들은 사전에 연구진간 논의를 거쳐 도출한 반구조화 질문지를 활용하였다. 연구 참여자들은 방문건강관리 업무를 수행하면서 경험한 연계협력의 성공과 실패 요인들을 심층적으로 기술하였다. 인터뷰 내용은 질적으로 분석되어 3개의 주제, 9개의 하위주제가 도출되었다. 연구결과, 공공부문 사례관리 사업 간 연계협력 업무안내서는 연계협력을 수행하는 데 있어 긍정적 성과요인이었지만, 방문건강관리 전문 인력의 불안정한 고용문제와 통합시스템의 부재는 연계협력의 장애요인이었으며, 성공적인 연계협력을 위해서는 인적 인프라 강화, 기능적 시스템 개선, 조직적 차원의 방안 마련 등 다각적인 접근이 필요한 것으로 확인되었다. 이에 명확한 연계협력 표준 및 절차 수립, 방문간호 전문인력의 처우 개선, 사례관리 통합정보시스템 개발을 제안한다. 또한, 지역 간 편차가 큰 방문건강관리 사업의 특성을 고려하여 다양한 지역을 대상으로 한 추후 연구가 필요함을 제안한다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권18호
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• pp.7533-7537
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• 2014

Background: Breast cancer (BC) is the most frequent cancer type, and the leading cause of death from cancer among women in Israel. The Bedouin-Arab (BA) population in southern Israel is characterized by a high rate of consanguinity, common hereditary disorders, and transition from a semi-nomadic, traditional society to a more sedentary and urbanized society. In this hospital-based study, the demographic and the clinicopathological characteristics of BC in BA were compared with Jewish patients. Materials and Methods: 85 BA patients treated at the Soroka Medical Center, Beer Sheba, during the years 2004-2012, were studied and compared with 180 consecutive Jewish patients treated during the year 2007. Clinicopathological features compared included age, menopausal state, number of births, a history of BC in first-degree relatives, tumor size (T), extent of lymph-node involvement (N), distant metastases (M), stage, grade, estrogen and progesterone receptor (ER/PR), and Her2 status. Types of treatment, relapse rate and site, as well as outcome were also studied. Cox's regression models were applied for studying disease-free, and overall survival. Results: Compared with Jewish patients, BA patients were younger (average age $49{\pm}12$ yrs vs $59{\pm}13$, p<0.001), had a lower rate of BC in first-degree relatives (p<0.001), and a larger number of births ($6{\pm}4.2$ vs $2.5{\pm}1.9$, p<0.001). BA patients had larger tumors (p=0.02), more extensive lymph-node involvement (p=0.002), and more advanced stage (p=0.003). Grade, ER, PR, and Her2 status were similar in the two ethnic groups. Relapse type was most commonly systemic in BA patients (p=0.05), and loco-regional in Jewish patients (p=0.02). Median survival was 63, and 35 months for Jewish and BA patients, respectively (log-rank test, p=0.02). In Cox multivariate analysis, stage and PR status (HR-0.14, p<0.0001; HR-3.11, p=0.046), but not ethnicity, influenced overall survival. Conclusions: BC presents a decade earlier, and with more advanced disease in BA compared with Jewish patients. Biologic parameters including grade, ER, PR, and Her2 status were similar in both groups. Although prognosis was worse in BA than in Jewish patients, it was affected only by stage and PR status, but not by ethnicity.

• 한국대기환경학회지
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• 제25권4호
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• pp.275-288
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• 2009

The Korean government strengthened the environmental polices to manage and enhance Metropolitan Area air quality, and also has enforced "Special Act on Seoul Metropolitan Air Quality Improvement (SASMAQI)" issued in Dec. 2004. Recently government expanded the Seoul Metropolitan Air Quality Management District (SMAQMD) to the outskirts satellite cities of Seoul area through the "Revised Law Draft of SASMAQI". The SMAQMD has been alloted the allowable emission loads to the local governments on the basis of the carrying $PM_{10}$ capacity. However, in order to establish the effective air quality control strategy for $PM_{10}$, it is necessary to understand the corresponding sources which have a potential to directly impact ambient $PM_{10}$ concentration. To deal with the situations, many receptor methodologies have been developed to identify the origins of pollutants and to determine the contributions of sources of interests. The objective of this study was to extensively identify $PM_{10}$ sources and to estimate their contributions at the metropolitan area. $PM_{10}$ samples were simultaneously collected at the 3 semi-industrialized local cities in the Seoul metropolitan area such as Hwasung-si, Paju-si, and Icheon-si sites from April 15 to May 31, 2007. The samples collected on the teflon membrane filter by one $PM_{10}$ cyclone sampler were analyzed for trace metals and soluble ions and samples on the quartz fiber filter by another sampler were analyzed for OC and EC. Source apportionment study was then performed by using a positive matrix factorization (PMF) receptor model. A total of 6 sources were identified and their contributions were estimated in each monitoring site. Contribution results on Hwasung, Paju, and Icheon sites were as follows: 33%, 27%, and 27% from soil source, 26%, 26%, and 21% from secondary aerosol source, 11%, 11%, and 12% from biomass burning, 12%, 6%, and 5% from sea salt, 7%, 15%, and 19% from industrial related source, and finally 11%, 15%, and 16% from mobile and oil complex source, respectively. This study provides information on the major sources affecting air quality in the receptor sites and thus it will help to manage the ambient air quality in the metropolitan area by establishing reasonable control strategies, especially for the anthropogenic emission sources.