• Journal of Gastric Cancer
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• 제21권4호
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• pp.379-391
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• 2021

Purpose: Promoter DNA methylation of various genes has been associated with metachronous gastric cancer (MGC). The cancer-specific methylation gene, cysteine dioxygenase type 1 (CDO1), has been implicated in the occurrence of residual gastric cancer. We evaluated whether DNA methylation of CDO1 could be a predictive biomarker of MGC using specimens of MGC developing on scars after endoscopic submucosal dissection (ESD). Materials and Methods: CDO1 methylation values (TaqMeth values) were compared between 33 patients with early gastric cancer (EGC) with no confirmed metachronous lesions at >3 years after ESD (non-MGC: nMGC group) and 11 patients with MGC developing on scars after ESD (MGCSE groups: EGC at the first ESD [MGCSE-1 group], EGC at the second ESD for treating MGC developing on scars after ESD [MGCSE-2 group]). Each EGC specimen was measured at five locations (at tumor [T] and the 4-point tumor-adjacent noncancerous mucosa [TAM]). Results: In the nMGC group, the TaqMeth values for T were significantly higher than that for TAM (P=0.0006). In the MGCSE groups, TAM (MGCSE-1) exhibited significantly higher TaqMeth values than TAM (nMGC) (P<0.0001) and TAM (MGCSE-2) (P=0.0041), suggesting that TAM (MGCSE-1) exhibited CDO1 hypermethylation similar to T (P=0.3638). The area under the curve for discriminating the highest TaqMeth value of TAM (MGCSE-1) from that of TAM (nMGC) was 0.81, and using the cut-off value of 43.4, CDO1 hypermethylation effectively enriched the MGCSE groups (P<0.0001). Conclusions: CDO1 hypermethylation has been implicated in the occurrence of MGC, suggesting its potential as a promising MGC predictor.

• 대한임상검사과학회지
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• 제54권3호
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• pp.179-191
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• 2022

본 연구는 공중보건에 위협이 되고 있는 carbapenemase 유전자형 중 bla_KPC, bla_NDM, bla_IMP, bla_VIM, bla_OXA-48-like 유전자의 표현형적 검사 및 분자진단으로 검출하고 관련 유전자 분포 양상에 대해 알아보았다. 표현형적 검사결과 MHT는 41균주 모두에서 양성을 확인하고, CIT는 meropenem+PBA는 18균주 및 meropenem+EDTA에서 8균주의 양성을 확인하였다. PCR 결과 bla_KPC 28균주, bla_NDM 25균주, bla_IMP 5균주, bla_VIM 1균주, bla_OXA-48-like 13균주에서 증폭 산물을 확인하였다. 또한 bla_KPC+bla_NDM 7균주, bla_KPC+bla_IMP 1균주, bla_NDM+bla_OXA-48-like 1균주, bla_NDM+bla_VIM 1균주, bla_KPC+bla_NDM+bla_IMP 4균주, bla_KPC+bla_NDM+bla_OXA-48-like 4균주를 확인하였다. 실시간 중합효소 연쇄반응을 이용한 융해 곡선 분석결과는 PCR 결과와 100% 일치함을 확인하였다. 결론적으로 real-time PCR을 이용한 신속하고 특이성이 높은 CRE 조기진단을 통한 유전자 확인은 제한된 치료 옵션과 높은 사망률로 공중 보건 위협을 고조하는 CRE의 감시, 진단 및 치료를 개선할 수 있으며 전염을 방지하기 위한 효과적인 항균 치료 및 시기적절한 감염 통제가 가능할 것으로 사료된다.

• Journal of Chest Surgery
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• 제56권4호
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• pp.244-251
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• 2023

Background: Extracorporeal membrane oxygenation (ECMO) has been widely used in patients with cardiorespiratory failure. The serum albumin level is an important prognostic marker in critically ill patients. We evaluated the efficacy of using pre-ECMO serum albumin levels to predict 30-day mortality in patients with cardiogenic shock (CS) who underwent venoarterial (VA) ECMO. Methods: We reviewed the medical records of 114 adult patients who underwent VA-ECMO between March 2021 and September 2022. The patients were divided into survivors and non-survivors. Clinical data before and during ECMO were compared. Results: Patients' mean age was 67.8±13.6 years, and 36 (31.6%) were female. The proportion of survival to discharge was 48.6% (n=56). Cox regression analysis showed that the pre-ECMO albumin level independently predicted 30-day mortality (hazard ratio, 0.25; 95% confidence interval [CI], 0.11-0.59; p=0.002). The area under the receiver operating characteristic curve of albumin levels (pre-ECMO) was 0.73 (standard error [SE], 0.05; 95% CI, 0.63-0.81; p<0.001; cut-off value=3.4 g/dL). Kaplan-Meier survival analysis showed that the cumulative 30-day mortality was significantly higher in patients with a pre-ECMO albumin level ≤3.4 g/dL than in those with a level >3.4 g/dL (68.9% vs. 23.8%, p<0.001). As the adjusted amount of albumin infused increased, the possibility of 30-day mortality also increased (coefficient=0.140; SE, 0.037; p<0.001). Conclusion: Hypoalbuminemia during ECMO was associated with higher mortality, even with higher amounts of albumin replacement, in patients with CS who underwent VA-ECMO. Further studies are needed to predict the timing of albumin replacement during ECMO.

• 대한토목학회논문집
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• 제30권6B호
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• pp.579-587
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• 2010

기상청에서 제공하는 강우수치예보정보를 활용하여 10일이내의 중기유량예측을 수행하였다. 기상청의 원시예보자료로는 2일예보를 위한 RDAPS와 10일예측을 위한 GDAPS예측자료를 활용하였다. 수치예보의 정확도를 제고하기 위하여 강우상세 정보를 생산할 수 있는 강수진단모형(QPM)과 QPM모의결과에 내재된 계통적 편이를 제거하기 위하여 분위사상과정 (Quantile Mapping)을 적용하였다. QPM모의결과를 유출모형의 입력정보로 활용하기 위하여 일관적인 체계를 갖춘 유역강수 정보로 변환하여, 장기연속유출모형인 SSARR모형을 이용하여 금강유역내 주요지점에서의 유량예측을 수행하여 유량예측에 대한 검증을 수행하였다. 2006년 1월 1일부터 6월 20일까지 강수예측을 수행한 결과 2일예측인 RQPM의 경우 기간 총강수량을 기준으로 실적강우대비 89.7%의 강수모의값을 보임으로서 양호한 예측성능을 확인할 수 있었다. 유량예측모의에 있어서는 2일예측의 경우 일부 강우사상에서 예측누락과 예측오류가 발생하였지만 전반적으로 유량예측이 양호한 수준이었다. 다만, 하류지점의 경우 조절유량에 의한 유출모형보정의 어려움과 수위-유량관계곡선의 신뢰도저하등의 이유로 예측성능이 떨어지는 경우도 있었다. GQPM에 대한 10일강우예측은 첨두강수와 강수총량에 있어서 다소 과소한 모의값을 보이고 있으며, 강수보정효과도 RDAPS에 비하여 저조한 수준이었다. 이 부분은 강수예측의 사후보정으로는 한계가 있는 것으로 보여지며 원시예측모형의 안정화를 통하여 개선할 수 있는 부분으로 판단된다.

• 사회복지연구
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• 제41권2호
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• pp.247-278
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• 2010

빈곤 청소년의 심리적 적응유연성, 사회적 적응유연성, 학교 적응유연성 발달궤적을 확인하고 세가지 적응유연성 영역간 종단적 상호관계 및 각 적응유연성 발달궤적에 영향을 미치는 보호요인을 규명하기 위해 한국청소년패널조사(KYPS)의 중2 패널 1차년도에서 5차년도까지의 자료와 잠재성장모형을 이용하였다. 빈곤 청소년의 심리적 적응유연성, 사회적 적응유연성, 학교 적응유연성은 4년동안 다소 증가하였다. 심리적 적응유연성 초기값이 높은 청소년의 증가속도가 상대적으로 느렸으며, 사회적 적응유연성과 학교 적응유연성은 초기값과 변화율간에 유의한 관계를 보이지 않았다. 각 적응유연성 초기값 간에는 상관관계가 높고, 변화율간에도 상관관계가 있었다. 심리적 적응유연성 초기값은 심리적 적응유연성 변화율에만 영향을 미쳤고, 사회적 적응유연성 초기값도 사회적 적응유연성 변화율에만 영향을 미쳤다. 이 두 가지 적응유연성은 타 영역의 적응유연성 변화율에는 영향을 미치지 않았으나 학교 적응유연성 초기값은 학교 적응유연성 변화율에 영향을 미치지 않고 심리적 적응유연성 변화율에만 영향을 미쳤다. 각 적응유연성에 영향을 미치는 보호요인을 분석한 결과 자아존중감, 부모감독은 심리적 적응유연성 초기값에 영향을 미쳤으며, 자아개념, 자아존중감, 부모애착 등은 사회적 적응유연성 초기값에 영향을 미쳤다. 자아개념, 자아존중감, 가족구조, 가구소득, 진학 예상 고교 유형 등은 학교 적응유연성 초기값에 영향을 미쳤으며, 학교 적응유연성 초기값은 심리적 적응유연성 변화율에 영향을 미쳤다. 연구결과를 바탕으로 빈곤 청소년의 적응유연성 향상을 위한 실천적 함의를 제시하였다.

• Animal Bioscience
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• 제37권6호
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• pp.965-981
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• 2024

Objective: Milk composition varies considerably and depends on paratypical, genetic, and epigenetic factors. MiRNAs belong to the class of small non-coding RNAs; they are one of the key tools of epigenetic control because of their ability to regulate gene expression at the post-transcriptional level. We compared the relative expression levels of miR-106b, miR-191, and miR-30d in milk to demonstrate the relationship between the content of these miRNAs with protein and fat components of milk in Holstein and Ayrshire cattle. Methods: Milk fat, protein, and casein contents were determined in the obtained samples, as well as the content of the main fatty acids (g/100 g milk), including: saturated acids, such as myristic (C14:0), palmitic (C16:0), and stearic (C18:0) acids; monounsaturated acids, including oleic (C18:1) acid; as well as long-, medium- and short-chain, polyunsaturated, and trans fatty acids. Real-time stem-loop one-tube reverse transcription polymerase chain reaction with TaqMan probes was used to measure the miRNA expression levels. Results: The miRNA expression levels in milk samples were found to be decreased in the first two months in Holstein breed, and in the first four months in Ayrshire breed. Correlation analysis did not reveal any dependence between changes in the expression level of miRNA and milk fat content, but showed a multidirectional relationship with individual milk fatty acids. Positive associations between the expression levels of miR-106b and miR-30d and protein and casein content were found in the Ayrshire breed. Receiver operating characteristic curve analysis showed that miR-106b and miR-30d expression levels can cause changes in fatty acid and protein composition of milk in Ayrshire cows, whereas miR-106b expression level determines the fatty acid composition in Holsteins. Conclusion: The data obtained in this study showed that miR-106b, miR-191, and miR-30d expression levels in milk samples have peculiarities associated with breed affiliation and the lactation period.

• 한국수자원학회논문집
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• 제57권4호
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• pp.263-276
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• 2024

지형구조가 복잡한 자연하천에서의 오염물질의 혼합과 이송 현상을 해석하기 위해 개발된 1차원 저장대 모형은 1970년대에 처음으로 제시된 이후 하천 내 오염물질의 정체 현상의 정확한 분석을 목적으로 다양한 형태로 개선되어 왔으며, 지난 수년간 지표수 및 지하수 분야에서 오염물질의 거동 및 체류시간을 예측하는 도구로써 활발히 활용되어 왔다. 그럼에도 불구하고 1차원 저장대 모형은 복잡한 자연하천의 혼합 기작을 제한된 매개변수를 통해 단순화하기 때문에 아직 해결되지 않은 숙제가 남아 있다. 본 리뷰 논문에서는 현재까지 개발된 저장대 모형의 장·단점을 설명하고, 모형의 구조적, 비구조적 불확실성에 대한 문제를 제기하고, 이를 극복하기 위해 필요한 연구의 방향성을 제시하였다. 본 연구 결과, 지속적인 정체시간분포 모델링에 대한 개선, 동수역학 해석 모형과 저장대 모형과의 결합, 그리고 추적자 실험 자료 수집 과정에서 불확도 개선을 통해 저장대 모형의 정확도를 향상시킬 수 있음을 알 수 있다. 모형의 복잡성을 증가시켜 정확도를 강화하는 방안은 지양하여야 하며, 모형 매개변수를 통한 하천의 정체특성 해석에는 수리·지형학적 근거와 추적자 실험 자료와 매개변수 추정 방식의 신뢰성이 함께 제시되어야 한다. 본 연구의 분석 결과와 제언은 저장대 모형을 통한 정밀한 하천 혼합 해석의 향후 연구에 토대가 될 것으로 기대한다.

• Korean Journal of Radiology
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• 제24권6호
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• pp.498-511
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• 2023

Objective: To evaluate the diagnostic performance of chest computed tomography (CT)-based qualitative and radiomics models for predicting residual axillary nodal metastasis after neoadjuvant chemotherapy (NAC) for patients with clinically node-positive breast cancer. Materials and Methods: This retrospective study included 226 women (mean age, 51.4 years) with clinically node-positive breast cancer treated with NAC followed by surgery between January 2015 and July 2021. Patients were randomly divided into the training and test sets (4:1 ratio). The following predictive models were built: a qualitative CT feature model using logistic regression based on qualitative imaging features of axillary nodes from the pooled data obtained using the visual interpretations of three radiologists; three radiomics models using radiomics features from three (intranodal, perinodal, and combined) different regions of interest (ROIs) delineated on pre-NAC CT and post-NAC CT using a gradient-boosting classifier; and fusion models integrating clinicopathologic factors with the qualitative CT feature model (referred to as clinical-qualitative CT feature models) or with the combined ROI radiomics model (referred to as clinical-radiomics models). The area under the curve (AUC) was used to assess and compare the model performance. Results: Clinical N stage, biological subtype, and primary tumor response indicated by imaging were associated with residual nodal metastasis during the multivariable analysis (all P < 0.05). The AUCs of the qualitative CT feature model and radiomics models (intranodal, perinodal, and combined ROI models) according to post-NAC CT were 0.642, 0.812, 0.762, and 0.832, respectively. The AUCs of the clinical-qualitative CT feature model and clinical-radiomics model according to post-NAC CT were 0.740 and 0.866, respectively. Conclusion: CT-based predictive models showed good diagnostic performance for predicting residual nodal metastasis after NAC. Quantitative radiomics analysis may provide a higher level of performance than qualitative CT features models. Larger multicenter studies should be conducted to confirm their performance.

• Korean Journal of Radiology
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• 제24권2호
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• pp.133-144
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• 2023

Objective: Cyclin-dependent kinase inhibitor (CDKN)2A/B homozygous deletion is a key molecular marker of isocitrate dehydrogenase (IDH)-mutant astrocytomas in the 2021 World Health Organization. We aimed to investigate whether qualitative and quantitative MRI parameters can predict CDKN2A/B homozygous deletion status in IDH-mutant astrocytomas. Materials and Methods: Preoperative MRI data of 88 patients (mean age ± standard deviation, 42.0 ± 11.9 years; 40 females and 48 males) with IDH-mutant astrocytomas (76 without and 12 with CDKN2A/B homozygous deletion) from two institutions were included. A qualitative imaging assessment was performed. Mean apparent diffusion coefficient (ADC), 5th percentile of ADC, mean normalized cerebral blood volume (nCBV), and 95th percentile of nCBV were assessed via automatic tumor segmentation. Logistic regression was performed to determine the factors associated with CDKN2A/B homozygous deletion in all 88 patients and a subgroup of 47 patients with histological grades 3 and 4. The discrimination performance of the logistic regression models was evaluated using the area under the receiver operating characteristic curve (AUC). Results: In multivariable analysis of all patients, infiltrative pattern (odds ratio [OR] = 4.25, p = 0.034), maximal diameter (OR = 1.07, p = 0.013), and 95th percentile of nCBV (OR = 1.34, p = 0.049) were independent predictors of CDKN2A/B homozygous deletion. The AUC, accuracy, sensitivity, and specificity of the corresponding model were 0.83 (95% confidence interval [CI], 0.72-0.91), 90.4%, 83.3%, and 75.0%, respectively. On multivariable analysis of the subgroup with histological grades 3 and 4, infiltrative pattern (OR = 10.39, p = 0.012) and 95th percentile of nCBV (OR = 1.24, p = 0.047) were independent predictors of CDKN2A/B homozygous deletion, with an AUC accuracy, sensitivity, and specificity of the corresponding model of 0.76 (95% CI, 0.60-0.88), 87.8%, 80.0%, and 58.1%, respectively. Conclusion: The presence of an infiltrative pattern, larger maximal diameter, and higher 95th percentile of the nCBV may be useful MRI biomarkers for CDKN2A/B homozygous deletion in IDH-mutant astrocytomas.

• Korean Journal of Radiology
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• 제21권12호
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• pp.1317-1325
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• 2020

Objective: The aim of this study was to prospectively evaluate whether liver stiffness (LS) assessments, obtained by two-dimensional (2D)-shear wave elastography (SWE) with a propagation map, can evaluate liver fibrosis stage using histopathology as the reference standard. Materials and Methods: We prospectively enrolled 123 patients who had undergone percutaneous liver biopsy from two tertiary referral hospitals. All patients underwent 2D-SWE examination prior to biopsy, and LS values (kilopascal [kPa]) were obtained. On histopathologic examination, fibrosis stage (F0-F4) and necroinflammatory activity grade (A0-A4) were assessed. Multivariate linear regression analysis was performed to determine the significant factors affecting the LS value. The diagnostic performance of the LS value for staging fibrosis was assessed using receiver operating characteristic (ROC) analysis, and the optimal cut-off value was determined by the Youden index. Results: Reliable measurements of LS values were obtained in 114 patients (92.7%, 114/123). LS values obtained from 2D-SWE with the propagation map positively correlated with the progression of liver fibrosis reported from histopathology (p < 0.001). According to the multivariate linear regression analysis, fibrosis stage was the only factor significantly associated with LS (p < 0.001). The area under the ROC curve of LS from 2D-SWE with the propagation map was 0.773, 0.865, 0.946, and 0.950 for detecting F ≥ 1, F ≥ 2, F ≥ 3, and F = 4, respectively. The optimal cut-off LS values were 5.4, 7.8, 9.4, and 12.2 kPa for F ≥ 1, F ≥ 2, F ≥ 3, and F = 4, respectively. The corresponding sensitivity and specificity of the LS value for detecting cirrhosis were 90.9% and 88.4%, respectively. Conclusion: The LS value obtained from 2D-SWE with a propagation map provides excellent diagnostic performance in evaluating liver fibrosis stage, determined by histopathology.