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      • KCI등재

        합리적 열정에 대한 탐색 - 스피노자의 관점 -

        박준식 ( Park¸ Jun-sik ) 한국초등도덕교육학회 2021 초등도덕교육 Vol.- No.74

        본 연구의 목적은 피터즈가 도덕적 동기로 지칭한 ‘합리적 열정’의 성격을 스피노자의 정서에 관한 이론에 비추어 밝히는 데에 있다. 스피노자는, 피터즈가 이성적 사고에 붙박혀 있는 것으로 보았으나 자세히 설명하지 않고 있는 합리적 열정이 어떻게 그러한 방식으로 존재하는지를 보여준다. 스피노자에 의하면, 인간은 인식의 발달로 그에 부합하는 정서를 느끼게 되는데, 합리적 열정은 스피노자가 말한 2종의 이성적 인식과 불가분의 관계에 있는 능동적 정서 이외에 다른 것일 수 없다. 합리적 열정을 포함하여 모든 정서는 신적인 역량인 코나투스를 원천으로 하며, 그러한 정서를 존재 방식으로 하는 인간은 본래의 자신에게로 되돌아가려 한다. 인간의 자기에게로의 복귀는 신적 인식으로 성취되며, 합리적 열정은 인간을 그러한 인식으로 이끄는 내적 힘이다. The purpose of this study is to reveal the nature of ‘rational passion’, which Peters referred to as a moral motive, in the light of Spinoza’s theory of affect. Peters considers rational passion as embedded in rational thinking, but does not explain the reason. According to Spinoza, the inseparable relationship between cognition and affect arises from the fact that they have the same origin. cognition and emotion arise through ideas of the affections of the body, and the initial recognition through it is inadequate and involves passion, which is a passive affect. Both passions and rational passions come from conatus. A Human being whose essence is conatus, which is a divine potentia, is trying to return to himself as a mode of God. Human being’s return to Self can be accomplished by divine thought, and rational passion is the power that makes it possible.

      • KCI등재

        Diagnostic significance of diaphragmatic height index in traumatic diaphragmatic rupture

        Junsik Kwon,John Cook-Jong Lee,Jonghwan Moon 대한외과학회 2019 Annals of Surgical Treatment and Research(ASRT) Vol.97 No.1

        Purpose: Traumatic diaphragmatic rupture resulting from blunt trauma is usually severe. However, it is often overlooked during initial evaluation because there are no characteristic signs and symptoms. Thus, this study aimed to determine the clinical characteristics of diaphragmatic rupture caused by blunt trauma and investigate the diagnostic usefulness of diaphragmatic height index (DHI) measured using chest radiographs. Methods: The cohort comprised patients who were admitted due to diaphragmatic rupture from blunt trauma. Patients were divided into 2 groups; the control group comprised patients with blunt trauma who were matched for age, sex, and Injury Severity Score, while the DHI group comprised patients with diaphragmatic rupture from blunt trauma. Receiver operating characteristic curve was used to determine the cutoff value of DHI for diaphragmatic injury. The sensitivity, specificity, predictability, accuracy, and likelihood ratio of the cutoff were then determined. Results: A total of 60 patients were confirmed to have diaphragmatic rupture. The mean DHI in patients with diaphragmatic rupture on the right and left side were both significantly different compared to that in the control group. A DHI cutoff value of >1.31 showed 71% sensitivity and 87% specificity for diagnosing right diaphragmatic rupture, while a cutoff value of <0.43 showed 87% sensitivity and 76% specificity for diagnosing left diaphragmatic rupture. Conclusion: DHI can be useful in the diagnosis of diaphragmatic rupture. DHI as determined using chest radiographs in patients with blunt abdominal trauma, particularly in those ineligible for diagnostic work-up, may help in the diagnosis of diaphragmatic rupture.

      • KCI등재

        Overexpression of p53, Mutation of hMLH1 and Microsatellite Instability in Gastric Carcinomas

        Junsik Kwon,Ju-Hee Lee,Ye Seob Jee,Do-Jung Park,Hyung-Ho Kim,Hyuk-Joon Lee,Han-Kwang Yang,Kuhn Uk Lee,Hye Seung Lee 대한외과학회 2010 Annals of Surgical Treatment and Research(ASRT) Vol.79 No.2

        Purpose: Mutated p53 is a tumor suppressor gene, hMLH1 is a mismatch repair gene, and hypermethylation of hMLH1 follows microsatellite instability (MSI). This research’s aim is to investigate mutated p53, inactivated hMLH1 and MSI in gastric cancer and their clinicopathologic implications. Methods: Between 2003 and 2007, 618 patients underwent curative radical gastrectomy for gastric cancer at Seoul National University Bundang Hospital in Korea. We reviewed their medical charts and the pathologic reports with immunohistochemistry for p53, hMLH1 and polymerase chain reaction for MSI in 509, 499, and 561 cases, respectively. These genetic markers were statistically compared with clinicopathologic features and postoperative survival. Results: The expression ratios of mutated p53, inactivated hMLH1, and MSI were 32.8%, 8.4%, and 8.7%, respectively. Mutation of p53 occurred more frequently in aged group (over 40), differentiated group (against the non-differentiated group), intestinal type, infiltrative type and positive lymph node metastasis group. Inactivated hMLH1 occurred more frequently in aged group, differentiated group, intestinal type and expanding growth type group. MSI was found more frequently in aged group, intestinal type and expanding growth type group. All three genetic markers had no significant associations with the 5-year survival. Conclusion: We identified significant relationships between mutated p53, inactivated hMLH1, and MSI with some clinicopathologic features of gastric cancer. However, there were no apparent relationships between p53, hMLH1, and MSI and prognosis.

      • IMMUNE CHARACTERISTICS OF TUMOR-INFILTRATING T CELLS IN OVARIAN CLEAR CELL CARCINOMA RELATIVE TO OVARIAN HIGH-GRADE SEROUS CARCINOMA

        ( Junsik Park ),( Jung Chul Kim ),( Miran Lee ),( Joohyang Lee ),( Sunghoon Kim ),( Sang Wun Kim ),( Jung-yun Lee ),( Yu Sang Lee ) 대한산부인과학회 2022 대한산부인과학회 학술대회 Vol.108 No.-

        Objective: A recent series of clinical trials have demonstrated the potential efficacy of immune checkpoint inhibitors (ICIs) for ovarian clear cell carcinoma (OCCC). However, little is known about the immune characteristics of OCCC. In this study, we investigated the immunologic properties of tumor-infiltrating lymphocytes (TILs) in patients with OCCC to elucidate therapeutic responses to ICIs. Methods: We analyzed peripheral blood mononuclear cells (PBMCs) and TILs from patients with ovarian cancer. CD8 and regulatory T (Treg) cells of OCCC (n=25) and high-grade serous carcinoma (HGSC) patients (n=33) were compared using flow cytometry. Results: First, we explored the immune characteristics of OCCC-infiltrating T cells. The % of CD8 and Treg cells were higher in TILs than in PBMCs. CD8 TILs exhibited higher expression of PD-1, CD39, CD103, granzyme B, Ki-67 and TCF-1, compared with peripheral CD8 T cells. Tumor-infiltrating Treg cells were enriched with effector Treg cells and showed higher expression of PD-1, CTLA-4, 4-1BB, OX-40, CD39, and CCR8, compared with peripheral Treg cells. Second, we compared TILs from advanced/recurrent patients with OCCC (n=9) and HGSC (n=33). The expression of PD-1 on CD8 TILs was significantly lower in OCCC than in HGSC. Furthermore, the expression of TCF-1 was significantly higher in OCCC. Meanwhile, the % of tumor-infiltrating Treg cells, especially effector Treg cells was significantly lower in OCCC than in HGSC. Conclusion: Overall, CD8 TILs in OCCC were exhausted similar to those in HGSC. However, CD8 TIL in OCCC showed less exhausted than those in HGSC. Further research is needed to investigate whether the immune properties of TILs in OCCC are actually correlated with the favored responses of ICIs.

      • PD-1 blockade improves treatment responses to PARP inhibitor by targeting PD-1+regulatory T cells in patients with epithelial ovarian cancer

        ( Junsik Park ),( Jung Chul Kim ),( Miran Lee ),( Joohyang Lee ),( Yoo-na Kim ),( Yong Jae Lee ),( Jung-yun Lee ) 대한산부인과학회 2022 대한산부인과학회 학술대회 Vol.108 No.-

        Objective: Poly (adenosine diphosphate [ADP]-ribose) polymerase inhibitors (PARPi) are becoming the standard of care options for epithelial ovarian cancer (EOC). In the current study, we investigated the immunologic effects of PAPRi on circulating Treg cells during PARPi maintenance therapy. Furthermore, we explored ways in which the addition of PD-1 blockade to PAPRi maintenance therapy enhances survival outcomes in recurrent EOC. Methods: We collected serial peripheral blood mononuclear cells (PBMCs) from EOC patients who responded to their most recent platinum-based chemotherapy (n=27). Peripheral blood was collected before treatment and at 1, 3, and 6 months after treatment initiation. Olaparib or niraparib was used as maintenance therapy. We also collected serial PBMCs from patients treated with PAPRi+anti-PD-1 (n=26, NCT04361370). The peripheral Treg cells were analyzed according to treatment responses using multi-color flow cytometry. PARPi responses were defined according to BRCA status and duration of PARPi treatment. Results: The expression of CTLA-4 and CCR8 on Treg cells significantly decreased after 6 months of PAPRi mono-treatment. PAPRi decreased the expression of FoxP3, CTLA-4, TIGIT, CD39, and CCR8 on Treg cells in vitro, but did not change PD-1 expression. Patients with high percentages of PD-1+Treg cells before PAPRi therapy showed significantly poorer progression-free survival (PFS). In a cohort of individuals treated with PAPRi+anti-PD-1 treatment, the expression of PD-1 on Treg cells was significantly decreased after the addition of anti-PD-1. Among patients with high percentages of PD-1+Treg cells between the two cohorts, those in the PAPRi+anti-PD-1 cohort had significantly longer PFS than those in the PAPRi monotherapy cohort. Conclusion: Peripheral PD-1+Treg cell amounts before PAPRi treatment could predict clinical responses, and targeting PD-1+Treg cells with additional PD-1 blockade during PAPRi treatment could potentially improve survival outcomes.

      • KCI등재

        Immune checkpoint inhibitors for cancer treatment

        Junsik Park,권민석,Eui-Cheol Shin 대한약학회 2016 Archives of Pharmacal Research Vol.39 No.11

        During immune responses antigen-specific Tcells are regulated by several mechanisms, includingthrough inhibitory receptors and regulatory T cells, toavoid excessive or persistent immune responses. Theseregulatory mechanisms, which are called ‘immune check-points’, suppress T cell responses, particularly in patientswith chronic viral infections and cancer where viral anti-gens or tumor antigens persist for a long time and con-tribute to T cell exhaustion. Among these regulatorymechanisms, cytotoxic T lymphocyte associated protein-4(CTLA-4) and programmed cell death 1 (PD-1) are themost well-known receptors and both have been targeted fordrug development. As a result, anti-CTLA-4 and anti-PD-1(or anti-PD-L1) antibodies were recently developed asimmune checkpoint inhibitors for use in cancer treatments. In this review we describe several receptors that function asimmunological checkpoints as well as the pharmaceuticalsthat target them.

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