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Cho, Iksung,ó,Hartaigh, Brí,ain,Gransar, Heidi,Valenti, Valentina,Lin, Fay Y.,Achenbach, Stephan,Berman, Daniel S.,Budoff, Matthew J.,Callister, Tracy Q.,Al-Mallah, Mouaz H.,Cademartiri, F Elsevier 2017 Atherosclerosis Vol.262 No.-
<P><B>Abstract</B></P> <P><B>Background and aims</B></P> <P>Coronary artery calcium (CAC) scoring is a predictor of future adverse clinical events, and a surrogate measure of overall coronary artery plaque burden. Coronary computed tomographic angiography (CCTA) is a contrast-enhanced method that allows for visualization of plaque as well as whether that plaque causes luminal narrowing. To date, the prognosis of individuals with CAC but without stenosis has not been reported. We explored the prevalence of CAC>0 and its prognostic utility for future mortality for patients without luminal narrowing by CCTA.</P> <P><B>Methods</B></P> <P>From 17 sites in 9 countries, we identified patients without known coronary artery disease, who underwent CAC scoring and CCTA, and were followed for >3 years. CCTA was graded for % stenosis according to a modified American Heart Association 16-segment model. We calculated hazard ratios (HR) with 95% confidence intervals (95% CI) for incident mortality and compared risk of death for patients as a function of presence or absence of CAC and presence or absence of luminal narrowing by CCTA.</P> <P><B>Results</B></P> <P>Among 6656 patients who underwent CCTA and CAC scoring, 399 patients (6.0%) had no coronary luminal narrowing but CAC>0. During a median follow-up of 5.1 years (IQR: 3.9–5.9 years), 456 deaths occurred. Compared to individuals without luminal narrowing or CAC, individuals without luminal narrowing but CAC>0 were older, more likely to be male and had higher rates of diabetes, hypertension, and dyslipidemia. Individuals without luminal narrowing but CAC experienced a 2-fold increased risk of mortality, with increasing risk of mortality with higher CAC score. Following adjustment, incident death persisted (HR, 1.8; 95% CI, 1.1–2.9, <I>p</I> = 0.02) among patients without luminal narrowing but with CAC>0 compared with patients whose CACS = 0. Individuals without luminal narrowing but CAC ≥100 had mortality risks similar to individuals with non-obstructive CAD (0 < stenosis<50%) by CCTA [HR 2.5 (95% CI 1.3–4.9) and 2.2 (95% CI 1.6–3.0), respectively].</P> <P><B>Conclusions</B></P> <P>Patients without luminal narrowing but with CAC experience greater risk of 5-year mortality. Patients with CAC score ≥100 and no coronary luminal narrowing experience death rates similar to those with non-obstructive CAD.</P> <P><B>Highlights</B></P> <P> <UL> <LI> The prevalence of individuals without coronary stenosis but with evident coronary calcium was identified in this large international coronary CT angiography registry. </LI> <LI> Coronary plaques with positive remodeling reflect a potential mechanism for the presence of coronary calcium without luminal narrowing. </LI> <LI> The current study observed a worsened prognosis among those without luminal narrowing but with coronary artery calcium. </LI> </UL> </P>
Cho, Iksung,Chang, Hyuk-Jae,Ó,Hartaigh, Brí,ain,Shin, Sanghoon,Sung, Ji Min,Lin, Fay Y.,Achenbach, Stephan,Heo, Ran,Berman, Daniel S.,Budoff, Matthew J.,Callister, Tracy Q.,Al-Mallah, Moua The European Society of Cardiology 2015 European heart journal Vol.36 No.8
<P><B>Aim</B></P><P>Prior evidence observed no predictive utility of coronary CT angiography (CCTA) over the coronary artery calcium score (CACS) and the Framingham risk score (FRS), among asymptomatic individuals. Whether the prognostic value of CCTA differs for asymptomatic patients, when stratified by CACS severity, remains unknown.</P><P><B>Methods and results</B></P><P>From a 12-centre, 6-country observational registry, 3217 asymptomatic individuals without known coronary artery disease (CAD) underwent CACS and CCTA. Individuals were categorized by CACS as: 0–10, 11–100, 101–400, 401–1000, >1000. For CCTA analysis, the number of obstructive vessels—as defined by the per-patient presence of a ≥50% luminal stenosis—was used to grade the extent and severity of CAD. The incremental prognostic value of CCTA over and above FRS was measured by the likelihood ratio (LR) <I>χ</I><SUP>2</SUP>, <I>C</I>-statistic, and continuous net reclassification improvement (NRI) for prediction, discrimination, and reclassification of all-cause mortality and non-fatal myocardial infarction. During a median follow-up of 24 months (25th–75th percentile, 17–30 months), there were 58 composite end-points. The incremental value of CCTA over FRS was demonstrated in individuals with CACS >100 (LR<I>χ</I><SUP>2</SUP>, 25.34; increment in <I>C</I>-statistic, 0.24; NRI, 0.62, all <I>P</I> < 0.001), but not among those with CACS ≤100 (all <I>P</I> > 0.05). For subgroups with CACS >100, the utility of CCTA for predicting the study end-point was evident among individuals whose CACS ranged from 101 to 400; the observed predictive benefit attenuated with increasing CACS.</P><P><B>Conclusion</B></P><P>Coronary CT angiography provides incremental prognostic utility for prediction of mortality and non-fatal myocardial infarction for asymptomatic individuals with moderately high CACS, but not for lower or higher CACS.</P>
‘사유의 본질’에서 존재와 ‘시선’에 대하여 - 「과학의 형이상학」에 덧붙이는 글
임익성(IkSung Lim) 사회와철학연구회 2021 사회와 철학 Vol.- No.42
이 글은 ‘사유의 본질’에 관한 이야기이다. 형이상학적 사유로부터 벗어나 ‘사유의 본질’을 탐색하기 위해 우리는 ‘존재의 시선’으로 눈을 돌린다. 존재의 시선이란 실제로 존재하는 시선이 아님에도 불구하고 우리에게 필요한 이유가 있다. 왜냐하면 모든 존재자를 대상으로 표상하는 ‘인간의 시선’으로는 전체 존재자들이 갖는 자신의 고유함을 있는 그대로 바라보지 못하기 때문이다. 존재를 사유하지 못함은 곧 ‘인간의 본질 역사’를 회복하지 못함을 의미한다. ‘다른 세상’을 기다리며 ‘다른 시원’으로 도약함은, 사물에 대한 주관성의 시선으로부터 해방됨이다. 그러한 해방(Gelassenheit)이 곧 ‘사물에 이르는 초연한 내맡김’이다. ‘사유의 본질’로 향함이란, 학문을 위한 표상적 사유로부터 한 걸음 물러섬이다. 그러한 현존재의 결단과 기다림이, 곧 ‘전회’의 사유이다. 기다림은 사물로 하여금 스스로 자신의 ‘사물존재’ 속에 고요히 머무르도록 놓아둠이다. 고요함으로 머무르게 함은 자기로부터 운동을 배제하는 것이 아니라 자기 안에 운동을 포함한다. 마치 폭풍전야와 같이, 또는 빅뱅의 순간처럼 고요함은 세상의 모든 에너지를 끌어모아 거대한 움직임을 준비한다. 모든 운동은 ‘고요함’과 ‘기다림’을 필요로 한다. 이러한 ‘고요함’과 ‘기다림’이 곧 ‘사유의 본질’이다. This article is about the essence of thinking(Wesen des Denkens). In order to escape from metaphysical thinking and explore the essence of thinking, we turn to the view of Being. However, the view of Being is not the gaze that actually exists. Nevertheless, the reason why we need the view of Being is that the human gaze, which represents all beings as an object(Gegenstand), does not allow us to see their own(Eigenes) of all beings as they are. And the inability to think about Being means that the history of man’s essence(Wesensgeschichte des Menschen) cannot be recovered. Waiting for another world and jumping into another beginning (anderen Anfang) is liberation from the gaze of subjectivity on things. Such liberation is the Releasement toward Things(Gelassenheit zu den Dingen). Toward the essence of thinking is a step back from representational thinking for the sake of science. Such resoluteness(Entschlossenheit) and waiting (Warten) for Dasein is thinking of the reversal(Denken der Kehre). Waiting is allowing the thing in its thing-being(Dingsein), to rest in itself. To rest does not exclude movement from oneself, but includes movement within oneself. Like the eve of a storm, or the moment of the Big Bang, the rest (Ruhe) gathers all the energy of the world and prepares it for a great movement. All movements require ‘rest(Ruhe)’ and ‘wait(Warten)’. These ‘rest(Ruhe)’ and ‘wait(Warten)’ are the essence of thinking(Wesen des Denkens).
선박용 고속 디젤엔진에서 연료의 황 함유량이 입자상과 가스상 배기배출물에 미치는 영향
이익성(Iksung Lee),문건필(Gunfeel Moon),임동국(Dongguk Im),남연우(Younwoo Nam),천강우(Kangwoo Chun) 대한기계학회 2015 대한기계학회 춘추학술대회 Vol.2015 No.11
The effort of reducing sulfur oxides and particulate emission lead to limits on sulfur content in marine fuels. Additionally, regulation of particulate emission is discussed at International Maritime Organization, which means conversion from indirect to direct control. In this respect, an experimental study was conducted on a high speed diesel engine fuelled with ultra low sulfur diesel (ULSD) and relatively higher sulfur diesel fuel (HSD) to investigate engine-out emission characteristics (especially particulate emission). The results represented the particulate mass for HSD increased by a maximum of 1.9 times compared to ULSD, which can be explained by higher sulfur contents within HSD. This shows reasonable consistency with the results of analysis on particulate component.