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라병소,신경자,신준식,서동엽 한국수학교육학회 2002 수학교육 Vol.41 No.3
We investigated on the primary school children's abilities of formal reasoning. Seventy students in grade 5 participated in the study. They responsed their best reactions on the problems constituted of three parts requiring the informal or formal reasoning and generalization. Their reactions are classified by some criteria depending the level of reasoning. About 10 students showed that they constructed a kind of scheme for solving the problems, similar to formal reasoning and beyond naive informal reasoning. And about 30 students did so partially. We concluded that the teaching and learning of reasoning by the progressive increasing the degree of rigor from grade 5 is possible.
Shin, Dong Hoon,Kang, Min-Ju,Kim, Jin Wook,Shin, Dong-Jin,Park, Hyeon-Mi,Sung, Young Hee,Kim, Eung Yeop S. Karger AG 2017 Cerebrovascular diseases Vol.44 No.5
<P><B><I>Background:</I></B> An accurate measurement of patient weight is important in determining the dosage for intravenous alteplase thrombolysis. In most emergency rooms, however, weight is not measured. We investigated the difference between stated and measured weight and its effect on hemorrhagic transformation and clinical outcomes. <B><I>Methods:</I></B> We enrolled 128 consecutive patients who had hyperacute stroke and were treated by alteplase. Alteplase dose was calculated using the weight provided by patient or guardian/caregiver, and the actual weight was measured after administration. Patients were classified into 2 groups: overused group (stated weight >measured weight) and underused group (measured weight ≥stated weight). The prevalence of hemorrhagic transformation on follow-up, determined by gradient-recalled echo MRI or non-enhanced CT, was compared between the 2 groups. The predictors for hemorrhage with progression, defined as an increase in the National Institutes of Health Stroke Scale (NIHSS) by a value of 4 or more accompanied by hemorrhage, were determined using multivariable logistic regression analysis and included the overused or underused alteplase and baseline clinical and laboratory findings. <B><I>Results:</I></B> Sixty-six (51.6%) of 128 patients were in the underused group and 62 patients (48.4%) in the overused group. The median difference between the stated and measured weights was 1.5 (interquartile range 0.56-3.81) kg, with the largest difference being 25.6 kg. Although there were no significant difference in baseline clinical and laboratory findings between the 2 groups, the overused group showed a significantly higher prevalence of hemorrhagic transformation (<I>p</I> = 0.012) and hemorrhage with progression (<I>p</I> = 0.025). The multivariable logistic regression analysis demonstrated that overused alteplase (OR 7.26; 95% CI 1.24-42.45; <I>p</I> = 0.028), baseline glucose (>144 mg/dL; OR 5.03; 95% CI 1.00-25.26; <I>p</I> = 0.050), and initial NIHSS (OR 1.13 per 1-point NIHSS increase; 95% CI 1.00-1.27; <I>p</I> = 0.047) in model 1 that use alteplase overdose as a categorical variable and overused alteplase (OR 1.67 1-mg increase; 95% CI 1.05-2.66; <I>p</I> = 0.027) in model 2 that use an overused alteplase dose as numerical variable were significant predictors for hemorrhage with progression. <B><I>Conclusion:</I></B> More alteplase usage than actual weight led to higher hemorrhagic transformation. As one of the predictors for clinical deterioration, it is important to administrate alteplase based on an accurately measured weight.</P>
Dong-Yeop Shin,Yun-Gyoo Lee,이현정,Seyoun Choi,Jin Joo Park,김동완 대한혈액학회 2010 Blood Research Vol.45 No.4
Primary cardiac lymphoma (PCL) is a rare disease entity with only a few reported cases in Korea. In this paper, we report a case of PCL in a 59-year-old man presenting with chest pain. Diffuse large B-cell lymphoma was diagnosed through a cardiac catheterization-assisted percutaneous endomyocardial biopsy, and there was no evidence of extracardiac involvement of the lymphoma.The patient had a complete clinical response after systemic chemotherapy with a rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP) regimen and additional post-chemotherapeutic radiation therapy. The patient experienced a long-term disease-free survival of over 4 years. However, he received coronary artery bypass graft surgery due to an acute myocardial infarction that occurred 3 years after the completion of the radiation therapy. Although the addition of radiation therapy to the treatment is thought to decrease the risk of relapse in patients with PCL, a careful and thorough consideration of the potential complications of radiation therapy, particularly with respect to cardiac complications, should be considered.
Shin, Dong-Yeop,Byun, Byung Hyun,Kim, Kyeong Min,Kang, Joo Hyun,Lim, Ilhan,Kim, Byung Il,Lee, Seung-Sook,Choi, Chang Woon,Kang, Hye Jin,Lim, Sang Moo Springer-Verlag 2016 Cancer chemotherapy and pharmacology Vol.78 No.4
<P>Purpose The aim of this study was to assess the clinical activity and toxicity of I-131-rituximab as consolidation therapy for patients with diffuse large B-cell lymphoma (DLBCL) who were treated with R-CHOP (rituximab, cyclophosphamide, vincristine, doxorubicin, and prednisolone). Methods Patients who had been diagnosed with advanced stage (Ann Arbor III or IV) or bulky stage II DLBCL and achieved complete or partial response after six to eight cycles of R-CHOP were enrolled. Results A total of 16 patients were enrolled and treated with a single dose of I-131-rituximab as consolidation therapy after the completion of six or eight cycles of R-CHOP between December 2005 and June 2011. This trial was terminated before the scheduled enrollment owing to low recruitment. Among the 16 patients who were treated with consolidative I-131-rituximab, 6 achieved complete response (CR) after three cycles of R-CHOP, and another 9 patients further achieved CR after the completion of six or eight cycles of R-CHOP. During the median follow-up period of 73 months, only four patients (25 %) experienced relapse. Two-year relapse-free survival was 88 %, and 5-year relapse-free survival was 81 %. Grade 3 or 4 treatment-related toxicity occurred in four patients and included neutropenia and thrombocytopenia. Conclusions I-131-rituximab showed promising efficacy as consolidation treatment for patients with DLBCL. A future randomized phase III study to confirm our results is warranted.</P>
( Dong Yeop Chang ),( Hyun Woong Lee ),( Won Seok Kang ),( Young Jun Koh ),( Jino Lee ),( So Youn Shin ),( Soo Seong You ),( Yoon Seok Choi ),( Ji Hye Kim ),( In Soo Oh ),( Dong Ho Lee ),( Kyung Suk S 대한간학회 2012 춘·추계 학술대회 (KASL) Vol.2012 No.1
Background/Aims: During viral infection, tissue damage is caused not only by direct cytopathic effects of virus but also by host immune responses. We investigated activation status and functions of CD8+ T cells and the mechanism of CD8+ T cell-mediated host injury in acute hepatitis A (AHA), which is caused by hepatitis A virus (HAV) infection and manifested by severe liver injury in adults. Methods: The study population was AHA-diagnosed 56 patients, hospitalized in Chung-Ang University Hospital. All patients were seropositive for anti-HAV IgM and had clinical and laboratory features of acute hepatitis. The whole blood and serum were obtained, and peripheral blood mononuclear cells were isolated by Ficoll density-gradient centrifugation and cryopreserved. Direct ex vivo IFN-γ ELISpot assay of peripheral blood lymphocytes was performed by stimulating them with overlapping peptides for HAV VP2 and 3C proteins in order to assess comprehensively HAV-specific IFN-γ response. Results: Total IFN-γ response against VP2 and 3C did not show positive correlation to serum ALT level, corroborating that the liver injury of AHA is not associated with HAV-specific T cell response. Activation of unrelated virus-specific CD8+ T cells significantly correlated with the percentage of CD38+HLA-DR+ cells in total CD8+ T cells, which was a correlate of the liver injury. In a prospective analysis, the percentage of CD38+ HLA-DR+ cells in total CD8+ T cells or that in unrelated virusspecific CD8+ T cells decreased along with the decrease in serum ALT level at the time of discharge, but that in HAVspecific CD8+ T cell population did not. Conclusions: We demonstrate that unrelated virus-specific CD8+ T cells, which are not specific to HAV, are activated and proliferating in AHA, the severity of liver injury correlates with the activation of non-HAV-specific CD8+ T cells, not to that of HAV-specific T cells.