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김지예,윤동섭,박준성,이승아,김재근,정준,이희대 연세대학교의과대학 2014 Yonsei medical journal Vol.55 No.3
Purpose: Liver resection with colorectal liver metastasis widely accepted and has been considered safe and effective therapeutic option. However, the role of liver resection in breast cancer with liver metastasis is still controversial. Therefore, we reviewed the outcome of liver resection in breast cancer patients with liver metastasesin a single hospital experiences. Materials and Methods: Between January 1991 and December 2006, 2176 patients underwent breast cancer surgery in Gangnam Severance Hospital. Among these patients, 110 cases of liver metastases were observed during follow-up and 13 of these patients received liver resection with potential feasibility to achieve an R0 resection. Results: The median time intervalbetween initial breast cancer and detection of liver metastasis was 62.5 months (range, 13-121 months). The 1-year and 3-year overall survival rates of the 13 patients with liver resection were 83.1% and 49.2%, respectively. The 1-year and 3-year overall survival rates of patients without extrahepatic metastasis were 83.3% and 66.7% and those of patients with extrahepatic metastasis were 80.0% and 0.0%, respectively (p=0.001). Conclusion: Liver resection for metastatic breast cancer results in improved patient survival, particularly in patients with solitaryliver metastasis and good general condition.
코딩블록을 활용한 초등 과학영재 대상 피지컬 컴퓨팅수업의 교수·학습 과정 분석
김지예,전영석 한국정보교육학회 2018 정보교육학회논문지 Vol.22 No.6
본 연구의 목적은 초등 과학영재 학생들을 대상으로 하는, 코딩블록을 활용한 피지컬 컴퓨팅 교수·학습 과정을 분석하여 피지컬 컴퓨팅 교육에 필요한 시사점을 얻는 데 있다. 이를 위해 국제 교육성취도 평가 협회(IEA)에서 개발한 컴퓨터‧정보 소양 평가 기준으로부터 학습목표를 설정하였고, 학습목표에 따라 과학교육및 컴퓨터 교육 전문가의 협업을 통해 피지컬 컴퓨팅 교수·학습 프로그램을 개발하였다. 개발된 프로그램은 코딩블록 MODI(TM)의 활용과 연계된 것이었으며 대학부설 과학영재교육원에 재학중인 초등학교 4∼6학년 학생 중 희망자 15명을 대상으로 정규 교육과는 별도로 피지컬 컴퓨팅 수업을 32차시 실시하였다. 피지컬 컴퓨팅 수업에서의 교수 학습 과정은 수업 동영상 및 수업관찰 일지, 교사와 학생 설문지 및 면담 등의 자료를 수집하여 질적으로 분석하였다. 연구 결과를 근거로 학교교육 현장에서 코딩블록을 활용한 피지컬 컴퓨팅 교수·학습과정에 대한 시사점을 제시하였으며, 창의적인 아이디어를 구현하는 코딩 교육 활동을 통한 컴퓨팅 사고력의 확장 전략을 탐색하였다. The purpose of this study is to analyze the teaching and learning process of physical computing using coding block for elementary gifted students in science and to to obtain implications for teaching physical computing. For this purpose, we set the learning objectives from the Computer and Information Literacy Evaluation Standards developed by the International Association for the Evaluation of Educational Achievement(IEA) and developed a teaching and learning program for physical computing through collaboration between science education and computer education experts according to learning objectives. The developed program was related to the use of the coding block MODI(TM) and 32 classes of physical computing instruction were conducted for 15 students of the 4th to 6th grade who belong to an education institute for the gifted in science affiliated to the University. In the physical computing class, the teaching and learning process was analyzed by collecting data such as classroom videos, class observation logs, teacher and student questionnaires, and interviews. Based on the results of the study, the implications of the teaching and learning process of physical computing using the coded blocks in the school education field were suggested. And we also explored the strategy of expanding the computational thinking through the activities of coding instruction to realize creative ideas.
김지예,양은정,김석원,황은아 대한성형외과학회 2009 Archives of Plastic Surgery Vol.36 No.5
Purpose: In the cases of a vascular compromised condition in an injured lower extremity, soft tissue coverage with free tissue transfer presents a challenging problem to the reconstructive surgeon. For this reason, cross - leg flaps are still used in unusual circumstances. Advances in surgical technique has made the cross - leg free flap possible although it may require long operation time along with significant donor site morbidity. Therefore, a pedicled cross - leg muscle flap may be an alternative treatment modality when local flap or free flap is not possible. Methods: Twelve patients(9 males and 3 females) underwent the operation between October of 2001 and December of 2008. The patients’ age ranged from 6 to 82 years. The unusual defects included the regions such as the knee, popliteal fossa, distal third of the tibia, dorsal foot, and the heel. Indications for the cross - leg gastrocnemius flap are inadequate recipient vessels for free flap(in eight cases), extensive soft tissue injuries(in three cases) and free flap failure(in one case). The muscle flap was elevated from contralateral leg and transferred to the soft tissue defect on the lower leg while both legs were immobilized with two connected external fixator systems. Delay procedure was performed 2 weeks postoperatively, and detachment was done after the establishment of the adequate circulation. The average period from the initial flap surgery to detachment was 32 days (3 to 6 weeks). Mean follow - up period was 4 years. Results: Stable coverage was achieved in all twelve patients without any flap complications. Donor site had minimal scarring without any functional and cosmetic problems. No severe complications such as deep vein thrombosis or flap necrosis were noted although mild to moderate contracture of the knee and ankle joint developed due to external fixation requiring 3 to 4 weeks of physical treatment. All patients were able to walk without crutches 3 months postoperatively. Conclusion: Although pedicled cross - leg flaps may not substitute free flap surgery, it may be an alternative method of treatment when free flap is not feasible. Using this modification of the gastrocnemius flap we managed to close successfully soft tissue defects in twelve patients without using free tissue transfers.
김지예,박찬섭,장세경,설혜실,성민기,노우철,박인철,김현아 한국유방암학회 2022 Journal of breast cancer Vol.25 No.5
Purpose: Phosphorylated AKT1 (p-AKT1) at Ser473 is a functional isoform of AKT and a key component of the PI3K/mTOR/AKT pathway. This study aimed to evaluate the prognostic significance of p-AKT1 (Ser473) based on the molecular subtypes of breast cancer. Methods: To investigate the prognostic value of p-AKT1 (Ser473), we performed a retrospective chart review of patients with breast cancer. Data on p-AKT1 (Ser473) positivity, hormone receptor (HR) status, human epidermal growth factor receptor 2 (HER2) expression status, and other clinicopathological factors were obtained. Furthermore, the therapeutic effect of blocking p-AKT1 (Ser473) in breast cancer cells was evaluated using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, cell apoptosis assay, apoptosis protein array, and western blot analysis. Results: A total of 3,044 patients were evaluated, and the median follow-up time was 43 (range: 0–125) months. In patients with HR-positive and HER2-positive disease, the p-AKT1 (Ser473)-positive group had worse disease-free survival (DFS) than the p-AKT1 (Ser473)-negative group (hazard ratio, 1.9; 95% confidence interval, 1.1–3.5; p = 0.024). In the multivariate analysis, p-AKT1 (Ser473) remained a significantly worse prognostic factor in patients with HR-positive/HER2-positive breast cancer (p = 0.03). There was no difference in DFS according to p-AKT1 (Ser473) status among patients with other breast cancer subgroups. In vitro analysis showed that blocking p-AKT1 (Ser473) levels enhanced trastuzumab-induced cell death in HR-positive/HER2-positive and p-AKT1 (Ser473)-positive breast cancer cells. Conclusion: p-AKT1 (Ser473) is a prognostic marker for poor outcomes in patients with HR-positive/HER2-positive breast cancer and may have a potential value as a therapeutic target.
Protective Effect of Locally Injected Polydeoxyribonucleotide in Ischemic Murine Random Skin Flaps
김지예,양재문,구민희,임진혁,이지용,고윤우,최은창,심남석,김지훈 대한이비인후과학회 2023 대한이비인후과학회지 두경부외과학 Vol.66 No.2
Background and Objectives This study aimed to investigate the protective effect of poly-deoxyribonucleotide (PDRN) against skin flap necrosis in a murine skin flap model. Materials and Method Twenty mice with rectangular skin flaps on the dorsum were ran-domly divided into the PDRN (n=10) and pentobarbital sodium (PBS) (n=10) injection groups. PDRN (8 mg/kg) was subdermally injected at 12 different points immediately after the opera-tion. After 7 days, the flap perfusions were evaluated using a laser speckle contrast imaging(LSCI) system, and specimens were collected for immunohistochemistry analysis. Results The percentage of survival area relative to the total flap area was significantly higherin the PDRN group (60.87%±7.63%) than in the PBS group (45.23%±10.72%) ( p<0.05). Themean LSCI perfusion signal of the distal part of the skin flap in the PBS group was 0.57±0.12 ,and that in the PDRN group was 0.74±0.13 ( p<0.05). The PDRN group had a significantlylower interleukin 1 beta expression than the PBS group and higher vascular endothelial growthfactor α expression than the PBS group ( p<0.05). Conclusion These findings suggest that subdermally injected PDRN is more effective inenhancing flap survival during necrosis.