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( Andrew Huynh ),( Scott Baker ),( Andrew Stewardson ),( Douglas Johnson ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: Denosumab, a humanised monoclonal antibody against receptor activator of nuclear factor kappa beta ligand (RANKL), reduces bone turnover via inhibition of osteoclasts and osteoclastogenesis and is used in the management of osteoporosis and metastatic bone disease. While hypocalcaemia complicating denosumab treatment has been reported, the real world incidence, clinical and biochemical risk factors are not fully elucidated. This study aims to investigate the incidence of denosumab-associated hypocalcaemia (DAH) and identify relevant clinical and investigation features. Methods: We performed a retrospective observational audit of patients administered denosumab (60mg/120mg) over a 12 month period at a tertiary hospital in Australia. Data collected: denosumab dosage and indication, 25-hydroxyvitamin D concentration, parathyroid hormone, estimated glomerular filtration rate (eGFR), nadir and duration of hypocalcaemia (albumin adjusted serum calcium concentration <2.15 mmol/L or ionised calcium <1.13 mmol/L upto 6 months post denosumab administration), calcium and colecalciferol pre- and post-administration of denosumab. The primary outcome was the incidence proportion of DAH. Results: Of 161 patients administered denosumab (106 osteoporosis, 55 bone metastases), 20 patients (12.4%, mean age 78.5 years, 11 male, 11 osteoporosis, 9 bone metastases) developed hypocalcaemia. Median calcium nadir was 2.06 mmol/L (interquartile range (IQR) 1.81-2.11), with the median time to diagnosis 24.50 days (IQR 9.25-41.25). One patient required intravenous calcium gluconate treatment. 75% of affected patients had a 25-hydroxyvitamin D concentration >50nmol/L and 90% of affected patients were on calcium or colecalciferol supplementation. DAH was associated with sex (27% males versus 8% females, p=0.004), but not age (8% under 60 years versus 13% aged 60 or more, p=0.74) or indication (16% with bone metastases versus 10% with osteoporosis, p=0.32). Conclusions: Denosumab-associated hypocalcaemia occurred in over 12% of patients in this population, despite wide use of appropriate calcium and colecalciferol supplementation.
Short-Term Study on the Effects of Rosemary on Cognitive Function in an Elderly Population
Andrew Pengelly,James Snow,Simon Y. Mills,Andrew Scholey,Keith Wesnes,Leah Reeves Butler 한국식품영양과학회 2012 Journal of medicinal food Vol.15 No.1
Rosemary (Rosmarinus officinalis L.) has traditional reputations that justify investigation for a potential role in reducing widespread cognitive decline in the elderly. A randomized, placebo-controlled, double-blinded, repeated-measures crossover study was conducted to investigate possible acute effects of dried rosemary leaf powder on cognitive performance. Twenty-eight older adults (mean age, 75 years) were tested using the Cognitive Drug Research computerized assessment system 1, 2.5, 4, and 6hours following a placebo and four different doses of rosemary. Doses were counterbalanced, and there was a 7-day washout between visits. There was a biphasic dose-dependent effect in measures of speed of memory: the lowest dose (750mg) of rosemary had a statistically significant beneficial effect compared with placebo (P= .01), whereas the highest dose (6,000mg) had a significant impairing effect (P< .01). There were significant deleterious effects on other measures of cognitive performance, although these were less consistent. Speed of memory is a potentially useful predictor of cognitive function during aging. The positive effect of the dose nearest normal culinary consumption points to the value of further work on effects of low doses over the longer term.
The Korean Speech Act of Refusals:Sociopragmatic Analysis
Andrew Sangpil Byon 한국사회언어학회 2003 사회언어학 Vol.11 No.1
Byon, Andrew Sangpil. 2003. The Korean Speech Act of Refusals: Sociopragmatic Analysis. 사회언어학, 11(1). 외국어 습득에서의 화용론의 역할에 관한 관심이 높아지면서 중간 언어 화용론(jnterlanguage pragmatics)에 관한 연구가 최근 들어 많이 이루어지고 있다. 그러나 영어를 모국어로 하는 KFL 학습자를 대상으로 한 중간 언어 화용론 연구는 매우 미흡한 실정이다. 이에 본고에서는 보다 활발한 한국어 중간 언어 화용론 연구를 위해 먼저 기존의 중간 언어적 화용론 자료 수집 방법론(data-gathering methodology)에 대해 논의하고 한국어를 이용한 written discourse completion task(DCT)를 Brown and Levinson(1987)의 두개의 사회적 변수인 power와 distance에 근거해서 개발하였다. 그 DCT를 이요해서 30명의 한국 대학생과 30명의 영어를 모국어로 하는 한국어 학습자의 한국어 거부 발화 행위를 비교 조사 분석 해 보았다. 그리고 모국어 전의 영향(L1 transfer effect)을 분석하기 위해 30명의 미국 대학생의 영어 거부 발화 행위를 조사하여 한국어 학습자의 결과와도 비교했다. 분석 결과로는, 먼저 12 종류의 거부의 주된 행위 전략(refusal head acts)과, 5종류의 거부 지지 행위 전략(refusal supportive move)을 사용하고 있음을 알아냈으며, 학습자의 한국어 거부 발호 행위에서 나타난 모국어 전이의 영향에 대해 논의했다. 그리고, 사회적 변수가 발호 행위에 미치는 영향을 Sohn(1986)의 수직론(hierarchicalism)과 간접론(indirectness)에 근거해서 한국 대학생과 학습자의 발화 행위를 설명했다. 본고의 결론에서는 이런 연구 결과들을 실제로 한국어 중간 언어 화용론 연구와 외국어로의 한국어 교육에 어떤 식으로 반영시켜야 할 지를 논의했다.
Lasers and Robots: Recent Developments in Transoral Laser and Transoral Robotic Surgery
Andrew Reyes Padalhin 대한의학레이저학회 2020 MEDICAL LASERS Vol.9 No.2
Transoral microsurgery has come a long way as a go-to surgical intervention technique for head and neck cancers. This minimally invasive procedure had gained acceptance through comparative clinical studies against radical neck surgical procedures, radiotherapy, and chemotherapy. Laser technology has vastly improved the oncological outcomes of this procedure and brought about an appreciation of transoral laser surgery (TLM) as a mainstay for re-sectioning malignant tumors along the throat. As an established procedure, TLM has undergone several upgrades regarding the different energy devices used for cutting, ablation, and hemostasis. Continued advances in automation have eventually led to surgical robotics, resulting in the emergence of transoral robotic surgery (TORS) as a viable advanced alternative for TLM. Similarly, expansions and enhancements (image-based guidance, fluorescence spectroscopy, and advanced robotic system) have also been investigated as potential upgrades for TORS. This paper reviews a selection of publications on the significant technological advancements to TLM and TORS over the past five years.