• Title/Summary/Keyword: self-limiting

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The Results of Curative Radiation Therapy for 49 Patients of the Uterine Cervical Carcinomas (자궁 경부암의 근치적 방사선 치료 효과 -49예의 분석 -)

  • Ryu Mi Ryeong;Kim Yeon Sil;Choi Byung Ock;Yoon Sei Chul;Shinn Kyung Sub;Namkoong Sung Eun;Kim Seung Jo
    • Radiation Oncology Journal
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    • v.10 no.2
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    • pp.219-225
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    • 1992
  • Fifty patients with carcinoma of the uterine cervix received curative radiotherapy by external irradiation of the whole pelvis and intracavitary radiation at the Department of Therapeutic Radiology, Kangnam St. Mary's Hospital from September, 1983 to October, 1986. External beam whole pelvic irradiation was done first up to 4500-5940 cGy in 5 weeks to 6.5 weeks, followed by an intracavitary radiation. Total dose of radiation to point A varied from 6500 cGy to 11344 cGy (average 6764 cGy). Of the 50 patients, one patient was lost to follow up and follow up period of the remaining 49 patients ranged from 3 months to 93 months (median 32 months). According to FIGO classification, 6 ($12.2\%$) were in stage Ib, 6 ($12.2\%$) in stage IIa, 25 ($51\%$) in stage IIb, 7 ($14\%$) in stage III, and 5 ($10.2\%$) in stage IV. Age of the patients ranged from 33 to 76 years (median 60 years). Pathologically, fourty six ($94\%$) patients had squamous cell carcinoma, 2 ($4\%$) had adenocarcinoma, and 1 ($2\%$) had adenosquamous cell carcinoma. Overall response rate was $84\%$. 5-year survival rate was $49\%$ for entire group ($75\%$ for stage Ib, $83\%$ for Stage IIa, $42.5\%$ for stage IIb, $25\%$ for stage III, $40\%$ for stage IV). Complications were observed in 11 ($22.4\%$) patients, who revealed rectal complications with most common frequency. Others were self limiting trifle ones such as wet desquamation, fatigue, mild leukopenia, etc. The correlation of the survival rate with various factors (age, dose, Hb level, pelvic lymph node status, performance status, local recurrence) was evaluated but showed no statistical significance except the age and local recurrence in this series; survival of patients less than 50 years of age was worse than that of the older, and the presence of local recurrence had worse prognosis (p<0.05).

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Decreased Neutrophil Apoptosis in Patients with Sepsis is Related to the Activation of NF-κB (패혈증 환자에서 NF-κB 활성화에 의한 호중구 아포프토시스의 억제)

  • Kwon, Sung Youn;Lee, Choon-Taek;Kim, Young Whan;Han, Sung Koo;Shim, Young-Soo;Yoo, Chul-Gyu
    • Tuberculosis and Respiratory Diseases
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    • v.54 no.5
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    • pp.495-509
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    • 2003
  • Background : Neutrophil-mediated inflammation is usually self-limiting, because neutrophils have a remarkably short life span. Prolonged neutrophil survival, which is caused by decreased spontaneous apoptosis, leads to persistent inflammation in sepsis. Because many inflammatory cytokines, which generate signals that delay apoptosis, are regulated by nuclear factor-${\kappa}B$ transcription factor, we hypothesized that nuclear factor-${\kappa}B$ might be related to the reduced neutrophil apoptosis observed in sepsis. Methods : Neutrophils of healthy volunteers and sepsis patients were freshly isolated from venous blood. Neutrophil apoptosis was assayed with two approaches : by counting apoptotic cells under a microscope and by flow cytometry using Annexin V. The activity of nuclear factor-${\kappa}B$ was assessed by immunofluorescent staining or electrophoretic mobility shift assay. Expression of X-linked inhibitor of apoptosis was measured by western blot assay. Results : We confirmed reduced spontaneous neutrophil apoptosis in patients with sepsis. The number of apoptotic neutrophils in patients with sepsis increased to the level of that in healthy controls after cycloheximide treatment, suggesting that decreased spontaneous neutrophil apoptosis is dependent on de novo protein synthesis. In patients with sepsis, basal neutrophil nuclear factor-${\kappa}B$ was activated compared to the level in healthy controls. Moreover, a blockade of nuclear factor-${\kappa}B$ activity reversed the decreased spontaneous neutrophil apoptosis in sepsis patients. Meanwhile, X-linked inhibition of apoptosis expression, which is regulated by nuclear factor-${\kappa}B$, decreased 24 hours after incubation in healthy persons, but persisted for 24 hours in patients with sepsis. Conclusion : These observations suggest that the reduced spontaneous neutrophil apoptosis observed in patients with sepsis may be related to the induction of survival protein by nuclear factor-${\kappa}B$.

Awareness and Practice of Sugar Reduction in School Foodservice and the Practice of Nutrition Education in Daegu (대구시 영양(교)사의 학교급식 당류 저감화 인식도와 실천도 및 영양교육 실태)

  • Jang, Suhyang;Kim, Kilye;Lee, Yeon-Kyung
    • Korean Journal of Community Nutrition
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    • v.26 no.3
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    • pp.167-176
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    • 2021
  • Objectives: This study was conducted to identify the awareness and practice of reducing sugar in school meals and the status of nutrition education regarding sugar reduction. Methods: An online survey was conducted on 101 nutrition teachers (dietitians) working at elementary, middle, and high schools in Daegu. Results: School nutrition teachers in Daegu recognized the need for efforts to reduce the sugar intake in the Korean diet, and it was found that elementary nutrition teachers were more aware of the implementation of the sugar reduction policy at the national level than middle and high school nutrition teachers (P = 0.002). Among the policies to reduce sugar intake at the national level, there was a high need for the promotion of self-control and limiting the sales of food with high sugar content in schools and their vicinity. The degree of practice for reducing sugar in school meals was found to be higher in the preparation, purchase, and cooking stage compared to the serving stage (P < 0.05). There was a high need for changing the preferences of the subjects for a sweet taste as a means of reducing the sugar in school meals. Thirty-six percent of nutrition teachers conducted sugar reduction education, and sending out school newsletters was the highest type of nutrition education at 80.6%. Conclusions: To effectively promote reduced sugar intake in school meals, it is necessary to change the preference of the subjects for sweetness and to conduct continuous education that can improve the awareness of people for reducing their sugar intake. For this, it is necessary to set aside time for nutrition education and to prepare an institutional framework for providing this education.

A Study on the Caligraphy as a modern concept of art (근대적 예술 개념으로서의 서예에 관한 연구)

  • Kim, Hee Jeong
    • (The)Study of the Eastern Classic
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    • no.50
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    • pp.295-318
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    • 2013
  • The purpose of this study was to define the 'caligraphy as a modern concept of art. For this purpose, it was necessary to exclude the elements betraying 'the caligraphy as a pure art' in reference to 'autonomy' as an indicator of modernity in order to reflect on the current topology of the caligraphy in our age. Checking the current conditions facing the caligraphy from the pre-modern, modern and post-modern perspectives will clarify the current topology of the caligraphy and further exploring 'the caligraphy as a post-modern art concept. To this end, this study defines the caligraphy 'as a pure formative art' and thereby discusses it in terms of nature and form. In terms of nature, the caligraphy should be subsumed into a spacial art, but it has a nature of a temporal art created and appreciated over time. Hence, among the spacial arts, the painting is most similar to the caligraphy, while among the temporal arts, the caligraphy is most similar to such rhythmic (of high mobility) or performing arts as music and dance. Merely, the painting does not reveal the flow of time on the canvas, while music and dance leave no residual in terms of audibility and visuality. All in all, the caligraphy is sort of 'temporal-spacial art' like dance in that the visible letters express the artist's sense of life on the plane over time like music. In terms of form, this study compares the caligraphy with engraving, wood print and character design to define the caligraphy as a pure art concept. The caligraphy as a modern art concept, namely, the autonomy of the caligraphy is associated with legibility and meaning in addition to the question whether it is an applied or a pure art. The legibility and meaning of the characters are not only the essential elements of the caligraphy but also are the factors limiting its autonomy, which must be a paradox. All in all, the legibility and meaning of the characters must be the key criteria for determining the caligraphy as a practical art or literary art or as a pure figurative art. In this context, this study discusses the caligraphy as a pure art by comparing it with the spatial art 'painting' and the temporal art 'music.' It might be impossible to define the caligraphy or a genre of art as an autonomous art of self-perfection and categorical identity. Moreover, any attempt to define the caligraphy would fail to interpret the caligraphy appropriately. Merely, we are obliged to position the caligraphy in the process of localizing 'their modernity' and thereby, discuss how to respond to their scheme.

The Fiduciary Duties of Doctor in Clinical Trials (임상시험에서 의사의 선량한 관리자의 주의의무)

  • Lee, Jiyoun
    • The Korean Society of Law and Medicine
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    • v.21 no.2
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    • pp.163-207
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    • 2020
  • Korea has been positioned as the leading country in the industry of clinical trials as the clinical trail of Korea has developed for the recent 10 years. Clinical trial has plays a significant role in the development of medicine and the increase of curability. However, it has inevitable risk as the purpose of the clinical trial is to prove the safety and effectiveness of new drugs. Therefore, the clinical trial should be controlled properly to protect the health of the subjects of clinical trial and to ensure that they exercise a right of self-determination. In this context, the fiduciary duties of doctors who conduct clinical trials is especially important. The Pharmaceutical Affairs Act and the relevant regulations define several duties of doctors who conduct clinical trials. In particular, the duty to protection of subjects and the duty to provide information constitute the main fiduciary duties to the subjects. Those are essentially similar to the fiduciary duties of doctors in usual treatment from the perspective of the values promoted by the law and the content of the law. Nonetheless, clinical trials put more emphasis on the duties to provide explanation than in usual treatment. Further research and study are required to establish the concrete standard for the duty of care. However, if the blind pursuit of higher standards for the duty of care or to pass the burden of proof to doctors may result in disrupting the development of clinical trials, limiting the accessibility of patients to new treatment and even violating the principle of sharing damage equally and properly. In addition to these duties, the laws of clinical trials define several duties of doctors. Any decision on whether the violation of the law constitutes the violation of the fiduciary duty and justifies the demand for compensation of damages should be based on whether relevant law aims to protect the safety and benefit of subjects, even if in an incidental way, the degree to which such violation breaches the values promoted by the law and the concrete of violation of benefit of law, the detailed acts of such violation. The legal interests of the subjects can be protected effectively by guaranteeing compliance with those duties and establishing judicial and administrative controls to ensure that the benefit of subjects are protected properly in individual cases.

6-Month Short-Course Chemotherapy for Tuberculous Pleural Effusion (결핵성 흉막염에서의 6개월 단기 치료)

  • Kim, Tae-Hyung;Kim, Kyoung-A;Lim, Chae-Man;Lee, Sang-Do;Koh, Youn-Suck;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.3
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    • pp.509-518
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    • 1998
  • Background: Short-course chemotherapy for 6 months is well established for pulmonary tuberculosis. However, little is known about the efficacy of the short-course chemotherapy for tuberculous pleural effusion. Tuberculous pleural effusion itself may be self-limiting without any treatment, but about two thirds of the patients with tuberculous pleural effusion may subsequently develop pulmonary tuberculosis within 5 years. After completing treatment for tuberculous pleural effusion. prolonged follow-up is necessary for evaluating the efficacy of the treatment There is still no report on the efficacy of 6-month regimens for tuberculous pleural effusion in Korea, where the incidence of tuberculous disease and drug resistance is high. We studied the efficacy of 6 month short-course chemotherapy comparing with 9 month chemotherapy. Method : Retrospective study was done through medical record review in 238 patients with tuberculous pleural effusion who admitted to Asan Medical Center during May 1989-May 1993. The diagnosis of tuberculous pleural effusion was made by bacteriologic or histopathologic study. Results: Among 238 patients, 38 patients were dropped out during follow-up period. In 2 patients, second line drugs were prescribed according to known drug resistance results. And, in 23 patients, treatment longer than 9 months was done due to accompanying extrapulmonary tuberculosis or durg resistance. In 8 patients, treatment regimen was changed due to hepatotoxicity. Remaining 167 cases (70.2%) completed the treatment as scheduled ; 6 month chemotherapy in 88 cases and 9 month chemotherapy in 79 cases. In 60 patients (35.9%) with pleural effusion only in chest X-ray finding, sputum smear or culture for M.tuberculosis was positive in 6 cases (10.0%), and in 63 patients (37.7%) with radiologically inactive pulmonary tuberculosis, sputum smear or culture was positive in 18 cases (28.6%). In 44 patients (26.3%) with radiologically active pulmonary tuberculosis, the sputum smear or culture was positive in 24 cases (54.5%). In 6-month chemotherapy group (n=88), during mean 23 months (range; 1~61months) follow-up period, pulmonary tuberculosis developed in 1 case (1.4%). In 9-month chemotherapy group(n=79), during mean 23 months (range; 3~70months) follow-up period, pulmonary tuberculosis developed in 2 cases (2.5%). All the cases who developed pulmonary tuberculosis also showed active pulmonary tuberculosis on initial chest X-ray before treatment Conclusion: In patients with tuberculous pleural effusion, the incidence of pulmonary tuberculosis after 6 month chemotherapy showed no difference from that after 9 month chemotherapy. Thus, 6 month short-course chemotherapy seems to be an effective treatment for tuberculous pleural effusion.

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A Study on the Impact of Artificial Intelligence on Decision Making : Focusing on Human-AI Collaboration and Decision-Maker's Personality Trait (인공지능이 의사결정에 미치는 영향에 관한 연구 : 인간과 인공지능의 협업 및 의사결정자의 성격 특성을 중심으로)

  • Lee, JeongSeon;Suh, Bomil;Kwon, YoungOk
    • Journal of Intelligence and Information Systems
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    • v.27 no.3
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    • pp.231-252
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    • 2021
  • Artificial intelligence (AI) is a key technology that will change the future the most. It affects the industry as a whole and daily life in various ways. As data availability increases, artificial intelligence finds an optimal solution and infers/predicts through self-learning. Research and investment related to automation that discovers and solves problems on its own are ongoing continuously. Automation of artificial intelligence has benefits such as cost reduction, minimization of human intervention and the difference of human capability. However, there are side effects, such as limiting the artificial intelligence's autonomy and erroneous results due to algorithmic bias. In the labor market, it raises the fear of job replacement. Prior studies on the utilization of artificial intelligence have shown that individuals do not necessarily use the information (or advice) it provides. Algorithm error is more sensitive than human error; so, people avoid algorithms after seeing errors, which is called "algorithm aversion." Recently, artificial intelligence has begun to be understood from the perspective of the augmentation of human intelligence. We have started to be interested in Human-AI collaboration rather than AI alone without human. A study of 1500 companies in various industries found that human-AI collaboration outperformed AI alone. In the medicine area, pathologist-deep learning collaboration dropped the pathologist cancer diagnosis error rate by 85%. Leading AI companies, such as IBM and Microsoft, are starting to adopt the direction of AI as augmented intelligence. Human-AI collaboration is emphasized in the decision-making process, because artificial intelligence is superior in analysis ability based on information. Intuition is a unique human capability so that human-AI collaboration can make optimal decisions. In an environment where change is getting faster and uncertainty increases, the need for artificial intelligence in decision-making will increase. In addition, active discussions are expected on approaches that utilize artificial intelligence for rational decision-making. This study investigates the impact of artificial intelligence on decision-making focuses on human-AI collaboration and the interaction between the decision maker personal traits and advisor type. The advisors were classified into three types: human, artificial intelligence, and human-AI collaboration. We investigated perceived usefulness of advice and the utilization of advice in decision making and whether the decision-maker's personal traits are influencing factors. Three hundred and eleven adult male and female experimenters conducted a task that predicts the age of faces in photos and the results showed that the advisor type does not directly affect the utilization of advice. The decision-maker utilizes it only when they believed advice can improve prediction performance. In the case of human-AI collaboration, decision-makers higher evaluated the perceived usefulness of advice, regardless of the decision maker's personal traits and the advice was more actively utilized. If the type of advisor was artificial intelligence alone, decision-makers who scored high in conscientiousness, high in extroversion, or low in neuroticism, high evaluated the perceived usefulness of the advice so they utilized advice actively. This study has academic significance in that it focuses on human-AI collaboration that the recent growing interest in artificial intelligence roles. It has expanded the relevant research area by considering the role of artificial intelligence as an advisor of decision-making and judgment research, and in aspects of practical significance, suggested views that companies should consider in order to enhance AI capability. To improve the effectiveness of AI-based systems, companies not only must introduce high-performance systems, but also need employees who properly understand digital information presented by AI, and can add non-digital information to make decisions. Moreover, to increase utilization in AI-based systems, task-oriented competencies, such as analytical skills and information technology capabilities, are important. in addition, it is expected that greater performance will be achieved if employee's personal traits are considered.