• 제목/요약/키워드: human cases

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Vitamin D Sufficiency: How should it be defined and what are its functional indicators?

  • Hollis Bruce W.
    • 한국영양학회:학술대회논문집
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    • 한국영양학회 2004년도 추계학술대회
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    • pp.22-33
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    • 2004
  • It has been more than three decades since the first assay assessing circulating 25(OH)D in human subjects was performed. That publication as well as several that followed it defined 'normal' nutritional vitamin D status in human populations. Recently, the wisdom by which 'normal' circulating 25(OH)D levels in human subjects were assigned in the past has come under question. It appears that sampling human subjects, who appear to be free from disease, and assessing 'normal' circulating 25(OH)D levels by plotting a Gaussian distribution is grossly inaccurate. There are many reasons why this method is inaccurate, including race, lifestyle habits, sunscreen usage, age, latitude, and inappropriately low dietary recommendations for vitamin D. For instance, a 400IU/day. AI for vitamin D is insignificant when one considers that a 10-15 minute whole body exposure to peak summer sun will generate and release up to 20,000 IU vitamin $D_3$ into the circulation. Recent studies, which orally administered up to 10,000 IU/day vitamin $D_3$ to human subjects for several months, have successfully elevated circulating 25(OH)D levels to those observed in individuals from sun-rich environments. Further, we are now able to accurately assess sufficient circulating 25(OH)D levels utilizing specific biomarkers instead of guessing what an adequate level is. These biomarkers include intact parathyroid hormone (PTH), calcium absorption, bone mineral density (BMD), insulin resistance and pancreatic beta cell function. Using the data from these biomarkers, vitamin D deficiency should be defined as circulating levels of $25(OH)D{\leq}30ng/mL$. In certain cases, such as pregnancy and lactation, significantly higher circulating 25(OH)D levels would almost certainly be beneficial to both the mother and recipient fetus/infant.

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발뒤꿈치의 재건 시에 사용할 수 있는 다양한 피판술 (Various Modalities of Flap Surgery in Heel Pad Reconstruction)

  • 정연익;이동원;윤인식;나동균;이원재
    • Archives of Plastic Surgery
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    • 제38권4호
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    • pp.415-420
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    • 2011
  • Purpose: The reconstruction of a soft tissue defect of the heel pad can be challenging. One vital issue is the restoration of the ability of the heel to bear the load of the body weight. Many surgeons prefer to use local flaps or free tissue transfer rather than a skin graft. In this study, we evaluated the criteria for choosing a proper flap for heel pad reconstruction. Methods: In this study, 23 cases of heel pad reconstruction were performed by using the flap technique. The etiologies of the heel defects included pressure sores, trauma, or wide excision of a malignant tumor. During the operation, the location, size and depth of the heel pad defect determined which flap was chosen. When the defect size was relatively small and the defect depth was limited to the subcutaneous layer, a local flap was used. A free flap was selected when the defect was so large and deep that almost entire heel pad had to be replaced. Results: There was only one complication of poor graft acceptance, involving partial flap necrosis. This patient experienced complete recovery after debridement of the necrotic tissue and a split thickness skin graft. None of the other transferred tissues had complications. During the follow-up period, the patients were reported satisfactory with both aesthetic and functional results. Conclusion: The heel pad reconstructive method is determined by the size and soft-tissue requirements of the defect. The proper choice of the donor flap allows to achieve satisfactory surgical outcomes in aesthetic and functional viewpoints with fewer complications.

국내 민간 무인항공기 사고조사 HFACS 적용중점 (Applicable Focal Points of HFACS to Investigate Domestic Civil Unmanned Aerial Vehicle Accidents)

  • 이건희;김현덕
    • 한국항행학회논문지
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    • 제25권3호
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    • pp.256-266
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    • 2021
  • 국내외 연구들은 무인항공기 사고의 주원인으로 인적요인을 지목하고 있고, 이러한 인적요인을 효과적으로 분석하는 기법으로 HFACS를 소개하고 있다. 현재까지는 HFACS를 이용해 무인항공기 사고의 인적요인을 분석했던 국내외 사례는 주로 군용 무인항공기가 대상이었는데, 항공사고를 유발하는 인적요인 정보를 분석하여 객관적 원인 규명과 유사 사고 예방 도구로 사용할 수 있는 HFACS가 국내 민간 무인항공기 분야에서도 활용이 필요한 시점이다. 특히, 국내 민간 무인항공기의 성능과 운용 여건을 고려한 HFACS 적용중점을 식별한다면 사고 발생 시 원인 규명과 재발 방지에 큰 도움이 될 것으로 예상된다. 본 연구는 HFACS version 7.0을 근간으로 우리나라 항공철도사고조사위원회가 수행했던 사고조사 결과보고서 자료를 분석하여 국내 민간 무인항공기 사고조사에 활용할 수 있는 HFACS 적용중점을 식별하였다.

Toxicity of the recombinant human hyaluronidase ALT-BC4 on embryonic development

  • Lee, Ji Hye;Yoo, Miyoun;Lee, Sang Mee;Park, Soon-Jae;Kil, Tae Young;Kim, Min Kyu
    • Journal of Animal Science and Technology
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    • 제63권2호
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    • pp.272-280
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    • 2021
  • Cumulus-oocyte complexes (COCs), which contain immature oocytes, are matured in vitro for in vitro embryo production. Oocyte and cumulus cells are then separated using hyaluronidase. To date, there have only been a few reported cases of the toxic effects of hyaluronidase on porcine oocytes. The aim of this study was to compare the effects of bovine testis-derived hyaluronidase and recombinant human hyaluronidase on oocyte denudation and quality. Porcine COCs were matured for 44 h and denuded using different hyaluronidase concentrations and exposure times. Then, oocytes were activated by electrical parthenogenesis. In experiment 1, COCs were denuded using bovine-derived, ovine-derived (Hirax), and human recombinant (ALT-BC4) hyaluronidases for 10 and 20 min. In experiment 2, bovine-derived and human recombinant (ALT-BC4 and ICSI Cumulase®) hyaluronidases were used to denude the COCs for 2 and 20 min. In both experiments the oocytes were all completely denuded, and there was no degeneration. Rate of embryo development was significantly increased in group treated ALT-BC4 for 2 min and not significantly different in other treatment groups. In general it slightly decreased with longer exposure times. These results have confirmed that different sources of hyaluronidase do not have detrimental effects on the quality of porcine oocytes and suggest that the human recombinant hyaluronidase ALT-BC4 is suitable for oocyte denudation with an increased blastocyst rate.

한의학 기초이론 연구와 한의학 이론, 용어의 은유적 이해 (Searching for a New Path to Research on Basic Theory of Korean Medicine: Metaphorical Understanding of Korean Medicine Theories and Terminologies)

  • 이충열
    • 동의생리병리학회지
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    • 제35권5호
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    • pp.139-150
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    • 2021
  • This paper examines whether the conceptual metaphor theory, which has been recently treated as important research topic in the field of cognitive linguistics, can be a new method that can promote the modernization of basic Korean medicine (KM) theory. In addition, the significance and potential of this study are reviewed by looking at Chinese research cases that applied this theory to Traditional Chinese Medicine theories and terminologies. The results are summarized as follows. From the viewpoint of metaphoric cognition, KM is a medicine that attempts to understand the human body (microcosm) through nature (great universe) by metaphorically projecting human experiences of nature on the human body based on the thought of correspondence between nature and human (天人相應). The language system of KM is based on a metaphor that extends our experience of nature to the human body, and an abundance of metaphors can be seen throughout the language of KM. Understanding and interpreting KM theories and terminologies from a metaphorical point of view allow us to understand the nature of KM theoretical key terms more deeply than now. And this understanding can help define and describe KM theoretical key terms and promote the modernization of KM theory research. In addition, various image schema that plays an important role in the metaphorical expansion of physical experience can be used for modeling KM theory. Research of KM theories and terminologies from a metaphorical point of view can serve as a bridge between traditional KM theory and modernization research, opening a new path to the modernization of basic KM theory in difficult situations.

글로벌 콘텐츠가 재현하는 AI 윤리와 인간 정체성의 과제: 넷플릭스 다큐 <소셜딜레마>의 서사 분석을 중심으로 (The Challenges of AI Ethics and Human Identity Reproduced by Global Content: Focusing on Narrative Analysis of Netflix Documentary )

  • 최종환;이현주
    • 한국콘텐츠학회논문지
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    • 제22권7호
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    • pp.548-562
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    • 2022
  • 본 연구는 글로벌 콘텐츠에 나타난 AI 윤리의 문제적 상황을 진단하고, 인간의 정체성을 강화하기 위한 담론이 무엇인지를 파악하고자 했다. 연구 진행을 위해 넷플릭스(Netflix) 오리지널 콘텐츠 <소셜딜레마>(The Social Dilemma)를 분석대상으로 선정했다. 연구방법은 서사분석을 채택했다. 분석결과 <소셜딜레마>는 전통적인 시사 다큐멘터리 구조를 보였으며, 이야기 전개를 위해 주로 전문가와 통계자료를 활용한 것으로 확인되었다. 미얀마 학살 사건, 가짜뉴스 전파 등 국내외 사례를 열거하며 콘텐츠 핵심 주장을 강화하기도 했다. 인물의 관계에서는 개발자와 미디어 기업, 이용자와 광고주 사이의 이항대립이 명확하게 드러났다. 해결책으로는 기업에 대한 강력한 규제와 소셜미디어의 이용 중단을 주장했다. 하지만, <소셜딜레마>는 AI 기술의 오남용을 지적하는 수준에 머무르며, 인간 고유의 정체성과 사회적 관계를 외면하는 서사를 구성했다. 이러한 결과는 AI 시대를 맞아 인간의 사회성과 관계성, 학습 능력의 중요성을 강조하는 콘텐츠의 필요성을 제기한다.

Factors Associated With Failure of Health System Reform: A Systematic Review and Meta-synthesis

  • Mahboubeh Bayat;Tahereh Kashkalani;Mahmoud Khodadost;Azad Shokri;Hamed Fattahi;Faeze Ghasemi Seproo;Fatemeh Younesi;Roghayeh Khalilnezhad
    • Journal of Preventive Medicine and Public Health
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    • 제56권2호
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    • pp.128-144
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    • 2023
  • Objectives: The health system reform process is highly political and controversial, and in most cases, it fails to realize its intended goals. This study was conducted to synthesize factors underlying the failure of health system reforms. Methods: In this systematic review and meta-synthesis, we searched 9 international and regional databases to identify qualitative and mixed-methods studies published up to December 2019. Using thematic synthesis, we analyzed the data. We utilized the Standards for Reporting Qualitative Research checklist for quality assessment. Results: After application of the inclusion and exclusion criteria, 40 of 1837 articles were included in the content analysis. The identified factors were organized into 7 main themes and 32 sub-themes. The main themes included: (1) reforms initiators' attitudes and knowledge; (2) weakness of political support; (3) lack of interest group support; (4) insufficient comprehensiveness of the reform; (5) problems related to the implementation of the reform; (6) harmful consequences of reform implementation; and (7) the political, economic, cultural, and social conditions of the society in which the reform takes place. Conclusions: Health system reform is a deep and extensive process, and shortcomings and weaknesses in each step have overcome health reform attempts in many countries. Awareness of these failure factors and appropriate responses to these issues can help policymakers properly plan and implement future reform programs and achieve the ultimate goals of reform: to improve the quantity and quality of health services and the health of society.

비강 및 부비동의 반전성 유두종에서 인유두종바이러스검출과 p53및 c-erbB-2의 발현 (Detection of Human Papillomavirus and Expression of p53, c-erbB-2 Protein in Inverted Papilloma of the Nasal Cavity and Paranasal Sinuses)

  • 조재식;백준;임상철;조연;윤제환;서덕중;박창수
    • 대한두경부종양학회지
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    • 제17권2호
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    • pp.162-168
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    • 2001
  • Background: Inverted papilloma(IP) of the nasal cavity and paranasal sinuses is a benign neoplastic condition that can be associated with squamous cell carcinoma (SCC). Several studies have indicated an etiologic role for viruses in the development of inverted papilloma. And it is necessary to find out the significance of a biologic markers such as p53, c-erbB-2 to predict the malignant potential. The purposes of this study are to detect HPV in inverted papilloma of the nasal cavity and paranasal sinus, to examine role of HPV as an etiological agent, to examine the relationship between HPV subtype and malignant transformation of inverted papilloma, and to investigate the relation between expression rate of p53, c-erbB-2 and HPV in recurrent or malignant transformation cases. Material and Methods: Thirty two cases of inverted papilloma(IP) in the nasal cavity and paranasal sinuses were reviewed and classified into 3 groups; simple IP, IP with dysplasia group, IP with squamous cell carcinoma group. Paraffin embedded achival tissue was used in this study. The HPV was detected by in situ hybridzation (ISH) using HPV type 6/11, 16/18, 31/33/35 DNA probes. Expression of p53 and c-erbB-2 was examined by immunohistochemical staining. Results: 1) The HPV was detected in 6(19%) out of 32 cases. 2) The HPV 6/11 was dectected in 4 out of 21 cases of simple IP, HPV 16/18 in 1, HPV 31/33/35 in lout of 8 cases of IP with dysplasia respectively. 3) The positive expression of p53 was 13 cases out of 32 cases; 2 out of 21 cases of simple IP, all of 8 cases of IP with dysplasia and 3 cases of IP with squamous cell carcinoma 4) The positive expression of c-erbB-2 was in 24 out of 32 cases; 16 out of 21 cases of simple IP, 6 out of 8 cases of IP with dysplasia, 2 out of 3 cases of IP with squamous cell ca. 5) The recurrence of IP occurred in lout of 6 cases of positive for HPV, in 4 out of 26 cases negative for HPV. 6) The recurrence of IP occurred only in positive cases for p53. 7) The recurrence of IP occurred in 4(17%) out of 24 cases positive for c-erbB-2, in 1(13%) out of 8 cases negative for c-erbB-2. Conclusion: The p53 expression was associated with Inverted papillomas exhibiting evidence of malignant transformation. Also, there was a correlation between the p53 expression and recurrence.

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Significance of HPV Infection and Genic Mutation of APC and K-ras in Patients with Rectal Cancer

  • Sun, Zhen-Qiang;Wang, Hai-Jiang;Zhao, Ze-Liang;Wang, Qi-San;Fan, Chuan-Wen;Kureshi, Kureshi;Fang, Fa
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권1호
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    • pp.121-126
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    • 2013
  • Background: Significance of HPV infection and genic mutation of APC and K-ras in rectal cancer has been investigated but not clarified. The objective of our study was to investigate these parameters in patients with rectal cancer to analyze correlations with biological behaviour, to determine relationships among the three, and also to demonstrate survival prognosis effects. Methods: From December 2007 to September 2008, 75 rectal cancer cases confirmed by histopathology in the Tumor Hospital of Xinjiang Medical University were enrolled. The control group consisted of normal rectal mucous membrane taken simultaneously, a least 10 cm distant from the carcinoma fringe. HPV DNA, the MCR of APC and exon-1 of K-ras were detected by PCR and PCR-SSCP. All results were analyzed in relation to clinical pathological material, using chi-square and correlation analysis via SPSS.13 and Fisher's Exact Probability via STATA. 9.0. All 75 patients were followed up for survival analysis using Kaplan-Meier and Log-rank tests. Results: 55 out of 75 cases demonstrated gene HPV L1 while it was notdetected in normal rectal mucosa tissue. HPV infection was correlated with age and lymphatic metastasis (P<0.05) but not other characteristics, such as ethnicity, tumor size, histological type, tumor type, Duke's stage and infiltration depth. Some 43 cases exhibited APC genic mutation (57.3%) and 34 K-ras genic mutation (45.3%). APC genic mutation was correlated with gender(P<0.05), but not age, histological type, infiltration depth, lymphatic metastasis and Duke's stage. In 55 cases of rectal cancer with HPV infection, there were 31 cases with genic mutation of APC (56.4%) and 24 with genic mutation of K-ras (43.6%). For the 20 cases of rectal cancer with non-HPV infection, the figures were 12 cases (60%) and 10 (50.0%), respectively, with no significant relation. Survival analysis showed no statistical significance for K-ras genic mutation, APC genic mutation or HPV infection (P>0.05). However, the survival time of the patients with HPV infection was a little shorter than in cases without HPV infection. Conclusions: Our results suggest that HPV infection might be an important factor to bring about malignant phenotype of rectal cancer and influence prognosis. Genic mutation of APC and K-ras might be common early molecular events of rectal cancer, but without prognostic effects on medium-term or early stage patients with rectal cancer.

인유두종 바이러스의 감염 또는 감염되지 않은 자궁 경부 이형성증에서 p53 및 Ki-67의 발현 (Expression of p53 and Ki-67 in Cervical Dysplasia with Human Papilloma Virus Infection or Non-infection)

  • 최숙경;김태전;홍승복;이훈택
    • 대한임상검사과학회지
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    • 제36권2호
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    • pp.178-184
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    • 2004
  • This research focuses on the overall evaluation of tumor protein (p53) and cell growth marker (Ki-67) in their functions as carcinogenic factors in both a HPV-infected group and in a HPV-noninfected group with the precancerous dysplasia of uterine cervix. Histological grades were determined by the H&E staining and the expression level of p53 and Ki-67 were tested by the immunohistochemistry method. The results were as follows. Among the total of 66 cases, p53 (+) was observed in 19 cases (29.0%) from the mild grade group, 22 cases (33.0%) from the moderate grade group, and 19 cases (29.0%) from the severe grade group. The values correlate with the increase of dysplasia intensity in HPV-noninfected group and showed significant correlation (p<0.05), but there were no significant difference from the HPV-infected group. Among a total of 66 cases, the mitotic index of Ki-67 (+) were observed in 19 cases (29.0%) from the mild grade group, 22 cases (33.0%) from the moderate grade group, and 19 cases (29.0%) from the severe grade group. The values were significantly different against dysplasia intensity (p<0.05), but showed no significant difference from HPV infection. After cross comparing the statistical parameters of p53 and ki-67 in their significance, p53 was shown to be statistically significant with Ki-67 while there was no statistically significant difference with Ki-67 (p<0.05). Taken together, tumor protein (p53) and an index of Ki-67 observed in cervical dysplasia and in HPV related dysplasia of cervix uterine did not have any notable significance with HPV infection. The incidence rate of p53, however, had some significant correlation with dysplasia while Ki-67 had no particular statistical significance. As a result, p53 and Ki-67 can be considered as effective diagnostic markers in predicting the disease progression of dysplasia to cervical cancer.

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