C.V.JOINT DRIVE SHAFT

홍남기 한국자동차공학회 1979 한국자동차공학회 학술강연초록집 Vol.- No.-

선천성 좌심방 류 -1례 보고-

홍남기,정태은,이정철,한승세,이동협 대한흉부심장혈관외과학회 2000 Journal of Chest Surgery (J Chest Surg) Vol.33 No.9

Isolated congenital aneurysm of the left atrium with intact pericardium is a rate anomaly, which usually presents with arrhythmia, cerebral embolism or abnormalities on routine chest X-ray. Surgery is indicated in most cases to eliminate a potential source of systemic emboli and arrhythmias. A 42-year-old woman having cervical cancer, she was suspected of having a left atrial aneurysm on review of chest X-ray and confirmed by echocardiography and cardiac catheterization. Surgical resection of Left atrial aneurysm was achieved without complication using median sternotomy with cardiopulmonary bypass. The postoperative course was uneventful.

Long QT 증후군 환자에게 시행한 좌측 흉부 교감신경절 절제술 -1례 보고-

홍남기,정태은,이정철,한승세,이동협 대한흉부심장혈관외과학회 2000 Journal of Chest Surgery (J Chest Surg) Vol.33 No.9

The long QT syndromes have been classified into acquired or inheritary forms, both of which are associated with a characteristic type of life-threatening polymorphic ventricular tachycardia called torsade de points. Beta-adrenergic blocker is the first cholic treatment, but in those whom cardiac events are not prevented by $\beta$-blockade, left thoracic sympathetic ganglionectomy may be useful in selected cases. A 50-year-old woman had an recurrent syncopal attack in which she was unconscious for 1-2 min and 1-2 times a month for 10 years. The EKG revealed that QT & QTc intervals were 744 and 632 msec respectively. Treatment with Beta-adrenergic blocker and calcium channel blocker was ineffective in preventing recurrence of syncopal spell. Therefore, she underwent left thoracic sympathetic ganglionectomy with thoracoscope. During the 9 months after operation, she was free of syncopal episodes and is doing well.

S-396 Adjuvant endocrine therapy and incidence of fatty liver in postmenopausal women with breast cancer

홍남기,윤한결,서다혜,박세호,김승일,손주혁,이유미 대한내과학회 2016 대한내과학회 추계학술대회 Vol.2016 No.1

Objective: Nonalcoholic fatty liver disease is associated with lipid disorders, insulin resistance, and increased cardiovascular risk. Tamoxifen (TMX) and aromatase inhibitors (AI), well-established adjuvant therapies for hormone receptor-positive breast cancer, are known to be associated with fatty liver. However, there are few data regarding comparison of its effect on long-term incidence of fatty liver. Methods: A total of 5250 patients with breast cancer on adjuvant TMX or AI (anastrozole or letrozole), from July 2005 to January 2015, were enrolled in this retrospective cohort. After excluding those who received both agents, those with fatty liver at baseline, metastatic breast cancer, previous liver disease, and current alcohol intake, TMX and AI group were 1:1 matched using propensity-score. The primary outcome was newly-developed fatty liver diagnosed by annually-performed ultrasonography. Results: Among 316 patients (N=158 for each group, mean age 53.5), 101 newly-developed fatty liver cases were detected in 948.9 person-years. Compared to AI, the incidence rate of fatty liver was significantly higher in TMX (128.2 vs. 90.2 per 1000 person-years, p=0.039) with higher prevalence of moderate to severe grade fatty liver (22/52, 42.3% vs. 2/49, 4.1%; p<0.001). In multivariate Cox model, TMX was associated with greater risk of incident fatty liver compared to AI (HR 1.62, 95% CI 1.06-2.48, p=0.025) independent of body mass index, diabetes, serum triglyceride, and HOMA-IR. Follow-up ultrasonography in subjects with newly developed fatty liver at median 2 years after the first detection showed persistent or worsened grade in about half of cases (45.9% in AI and 58.1% in TMX). During follow-up, decrease in serum total cholesterol was observed in both groups whereas triglyceride level remained high in TMX group compared to AI. Conclusions: TMX had more adverse long-term effect on incidence and progression of fatty liver compared to AI in postmenopausal women with breast cancer.

Comparison of the Effects of Ezetimibe-Statin Combination Therapy on Major Adverse Cardiovascular Events in Patients with and without Diabetes: A Meta-Analysis

홍남기,이용호,Kenichi Tsujita,Jorge A. Gonzalez,Christopher M. Kramer,Tomas Kovarnik,George N. Kouvelos,Hiromichi Suzuki,한경도,이찬주,박성하,이병완,차봉수,강은석 대한내분비학회 2018 Endocrinology and metabolism Vol.33 No.2

Background: Ezetimibe-statin combination therapy has been found to reduce low density lipoprotein cholesterol levels and the risk of major adverse cardiovascular events (MACEs) in large trials. We sought to examine the differential effect of ezetimibe on MACEs when added to statins according to the presence of diabetes. Methods: Randomized clinical trials with a sample size of at least 50 participants and at least 24 weeks of follow-up that compared ezetimibe-statin combination therapy with a statin- or placebo-controlled arm and reported at least one MACE, stratified by diabetes status, were included in the meta-analysis and meta-regression. Results: A total of seven trials with 28,191 enrolled patients (mean age, 63.6 years; 75.1% men; 7,298 with diabetes [25.9%]; mean follow-up, 5 years) were analysed. MACEs stratified by diabetes were obtained from the published data (two trials) or through direct contact (five trials). No significant heterogeneity was observed among studies (I2=14.7%, P=0.293). Ezetimibe was associated with a greater reduction of MACE risk in subjects with diabetes than in those without diabetes (pooled relative risk, 0.84 vs. 0.93; Pheterogeneity=0.012). In the meta-regression analysis, the presence of diabetes was associated with a greater reduction of MACE risk when ezetimibe was added to statins (β=0.87, P=0.038). Conclusion: Ezetimibe-statin combination therapy was associated with greater cardiovascular benefits in patients with diabetes than in those without diabetes. Our findings suggest that ezetimibe-statin combination therapy might be a useful strategy in patients with diabetes at a residual risk of MACEs.

Machine Learning Applications in Endocrinology and Metabolism Research: An Overview

홍남기,박해정,이유미 대한내분비학회 2020 Endocrinology and metabolism Vol.35 No.1

Machine learning (ML) applications have received extensive attention in endocrinology research during the last decade. This reviewsummarizes the basic concepts of ML and certain research topics in endocrinology and metabolism where ML principles have beenactively deployed. Relevant studies are discussed to provide an overview of the methodology, main findings, and limitations of ML,with the goal of stimulating insights into future research directions. Clear, testable study hypotheses stem from unmet clinical needs,and the management of data quality (beyond a focus on quantity alone), open collaboration between clinical experts and ML engineers, the development of interpretable high-performance ML models beyond the black-box nature of some algorithms, and a creative environment are the core prerequisites for the foreseeable changes expected to be brought about by ML and artificial intelligence in the field of endocrinology and metabolism, with actual improvements in clinical practice beyond hype. Of note, endocrinologists will continue to play a central role in these developments as domain experts who can properly generate, refine, analyze, andinterpret data with a combination of clinical expertise and scientific rigor.

체외순환에 따른 혈중 Interleukin-10의 변화

홍남기,이동협,정태은,이정철,한승세 대한흉부심장혈관외과학회 2000 Journal of Chest Surgery (J Chest Surg) Vol.33 No.8

Background: Cardiopulmonary bypass during open heart surgery causes systemic inflammatory respose. IL-10 is an anti-inflammatory cytokine that inhibits inflammatory process and protects organ function by down regulation of pro-inflammatory cytokine release and maintenance of blood level balance with pro-inflammatory cytokines. Mateial and Method: Plasma IL-10 levels were measured and analyzed in 22 patients who underwent open heart surgery (11 cases of coronary artery bypass graft, 11 cases of valve replacement) under cardiopulmonary bypass since 1988 January to July at Department of Thoracic and Czardiovascular surgery, Yeungnam University Hospital. 1g of methylprednisolone was administrated to thirteen patients randomly. Blood samp.es were taken and collected at the time of induction of anesthesia, 10 min before cardiopulmonary bypass, 10 min after starting of CPB, 10 min aftr aortic cross clamping, 10 min after ACC release, and 10 min, 2 hours, and `5 hours after CPB respectively. The plasma levels of IL-10 were determined by enzyme-linked immunosorbent assays(ELISA). Wilcoxon-Raule Sum test was used for statistical analysis. Result: In all 22 patients, cardiopulmonary bypass time was used for statistical analysis. Result: In all 22 patients, cardiopulmonary bypass time was 171$\pm$41.4 min and aortic cross clamp time was 118$\pm$36.5 min. Peak IL-10 level was achieved at 10 min after ACC(361.0$\pm$52.81pg/ml) and was decreased sharply at 2 hours after CPB. Peak IL-10 level was correlated positively with aortic cross clamp time(p=0.011); however, it did not correlated with bypass time(p=0.181). In valve replacement group, mean IL-10 level at peak point was 567.89$\pm$107.69 pg/ml and was significantly higher than that of coronary artery bypass group(205.67$\pm$192.70 pg/ml)(p<0.001). ACC time in valve replacement group was significantly longer than that of coronary artery bypass group(p<0.01), however, bypass time was not(p=0.212). Thirteen patients with steroid pretreatment before starting of CPB showed relatively higher plasma IL-10 level than in control group, however, no statistical significance was noted(p=0.19). Conclusion: plasma level of IL-10 was increased in association with cardiopulmonary bypass and revealed peak at 10 min after ACC release. IL-10 level was correlated positively with ACC time. Therefore, systemic inflammatory respeonse in association with cardiopulmonary bypass could be decreased by reducing ACC time during cardiac surgery.

듀이의 “사회적 지성” 개념의 교육적 함의

홍남기 ( Nam Ki Hong ) 한국교육철학학회(구 교육철학회) 2013 교육철학연구 Vol.35 No.1

현대 교육학 이론에서는 지적인 능력을 각 개인이 개별적으로 형성, 소유한 것으로 묘사하는 경우가 많다. 반면에 듀이에 의하면 지성은 각 개인에게 귀속되는 것이 아니라 상호주관적으로 형성, 공유되는 것이다. 그리고 이러한 지성이 활성화될 때 각 개인이 지적, 도덕적으로 성장하게 된다. 듀이가 말하는 ‘사회적 지성’은 집단적 의사소통을 통해 상호주관적으로 공유되는 지성이라는 점에서 볼 때, 최근에 회자되는 집단 지성과 유사하다. 하지만 민주적 공동체라는 맥락에서 사회적 지성은 도구적 합리성에 머무르지 않고 의사소통적 합리성을 지향하는 집단 지성이 된다. 이는 교육적 차원에서 각 개인의 지성을 고립시켜 경쟁하는 교육 목표가 아닌 공동의 지성을 협동적으로 구성하면서 상호 간의 이해를 추구하는 교육 목표로 구현될 수 있다. 또한 듀이는 사회적 지성을 증진하는 방안으로서 공감적 의사소통의 활성화와 공적인 관심사에 대한 반성적 탐구의 강화를 제시한다. 이는 교육적 차원에서 논증적 의사소통뿐만 아니라 공감적 의사소통을 활성화해 보다 확장적이고 창의적인 사회적 지성을 형성하는 방안으로, 그리고 공적인 관심사에 대한 즉각적이고 지속적이며 체계적인 탐구를 강화해 학습자가 공동의 이해관심을 매개로 성장하게 하는 방안으로 구체화될 수 있다. Modern education theories often describe intellectual faculty as the one that each individual has formed and possessed for himself. But John Dewey argued that intelligence does not belong to each individual but has been formed and shared inter-subjectively. And individuals can attain to intellectual and moral growth as far as this intelligence is activated. Dewey`s ``social intelligence`` is similar to the concept of collective intelligence which is popular recently in that social intelligence is shared inter-subjectively through collective communication. But Dewey`s intelligence is accompanied by communicative rationality as well as instrumental rationality. In pedagogical dimension, social intelligence is embodied in educational objectives which reconstruct common intelligence cooperatively, not objectives which make each person`s intelligence isolated and competed each other. Moreover, according to Dewey the activation of empathetic communication and the reinforcement of reflective inquiry into public interests are the best ways which improve social intelligence. In pedagogical dimension, this argument can be embodied into the practice which activates empathetic communication as well as argumentative communication to form more expansive and creative social intelligence, and the practice which intensifies the immediate, continuous, systematic inquiry into public interests in order that learners should grow intellectually, morally by the medium of common interests.

교과 지식을 활용한 가치재구성 모형 탐구 사례의 개발 -개정 고등학교 교과 지식을 중심으로-

홍남기 ( Nam Ki Hong ) 한국사회과교육학회 2014 시민교육연구 Vol.46 No.4

본 연구의 목적은 기존 가치 탐구 모형의 한계를 보완하는 대안으로서 ‘가치재구성’ 모형을 제안하고 가치재구성 모형을 적용하기 위한 일련의 가치 탐구 사례들을 개발하는데 있다. 인성 교육이 시대적 과제로 부각되면서 우리나라 청소년의 지나친 이기주의, 물질주의 가치관이 문제로 제기되는 상황이다. 인지적 차원에서 볼 때, 이러한 가치관 문제에 대처할수 있는 대표적인 가치 탐구 방안으로는 가치명료화, 가치분석, 가치추론 모형이 있지만 각각의 모형은 대처 방안으로서 한계가 있다. 가치명료화 및 가치분석 모형은 학습자의 욕망이나 가치관을 명료화해 합리적으로 재구성하려고 하지만 기본적으로 학습자가 정립한 가치를 지속적이고 확장적으로 재구성하려 하지 않는다. 그래서 학습자들이 부적절한 욕망이나 가치관을 정립하더라도 이를 고착화, 정당화할 위험이 있다. 그리고 가치추론 모형은 학습자가 자신의 욕망을 진정으로 원하는 방향으로 재구성하기보다는 도덕적으로 정당화되는 가치를 추론하는 것에 중점을 둔다. 이로 인해 학습자는 자기 내면의 욕망이나 가치관에 근거하지 않은 도덕적 가치를 제시할 가능성이 크다. 반면에 듀이의 교육 이론에서는 학습자의 욕망과 가치관을 수용, 존중하면서 이를 지속적이고 확장적으로 재구성하려 한다. 그래서 학습자가 보다 진정성 있고 사려 깊은 욕망과 가치관을 형성해나가도록 돕는다. 본 논문에서는 이러한 듀이 이론의 취지를 충분히 살린 가치 탐구 모형으로서 ‘가치재구성’ 방안을 제시한다. ‘가치재구성’ 모형을 구현하기 위해서는 우선적으로 학습자의 편협한 가치관을 집중적, 지속적, 확장적으로 재검토하게 하는 일련의 가치 탐구 사례들이 필요하다. 그리고 그러한 사례들을 교과 내용과 분리시키지 않고 연계하는 방안은 사회과의 교과 지식을 학습자 자신의 가치관과 직결되는 가치 딜레마 사례들로 가공해 제시하는 것이 될 것이다. 이러한 일련의 가치 딜레마 사례들은 다양한 교과 지식에 근거할 수 있지만 학습자의 특정한 가치관을 공통적 주제로 하며 이를 집중적, 확장적으로 재검토하게 하는 요소를 담고 있다. 물론 가치재구성으로서의 가치 탐구를 반복하더라도 학습자는 기존의 편협한 욕망이나 가치관을 고수할수도 있다. 그러나 최소한 인지적 차원에서는 예전보다 다각도로 검토된 욕망, 나아가 더 진정성 있고 사려 깊은 욕망을 발견하게 될 것이다. This Study is aimed to explain that existing value inquiry models such as value clarification, value analysis, value reasoning(or development approach) do not enough to cope with the personality problem of korean juveniles, and search for the alternative value inquiry model based on Dewey``s inquiry theories, and develop value inquiry cases. Basically, value inquiry approaches help learners to examine their own values reflectively and search for desirable values. Especially in korea, value inquiry is necessary for the cultivation of juveniles`` desirable values because they have formed narrow views and their citizen consciousness has been weakened. But value clarification and value analysis models do not ask learners to improve their established values constantly although those models help learners to reconstruct their values consistently and clearly. In comparison, value reasoning model help learners to examine their inappropriate desires critically on the basis of universal justice principle. But this model do not ask learners to transform their desires into more rationally deliberated desires although Dewey`` theories demand the rational transformation of desires. According to Dewey``s theory which forms the foundation of those models, Learners develop their values not based on universal moral standard but based on their own desires, and reconstruct these desires and values continuously. And they form more thoughtful and more authentic desires through continuous value reconstruction. For the purpose of ‘value reconstruction’ model, it is necessary that value inquiry cases which enable learners’ narrow values to be reexamined intensively, continuously, expansively are developed in advance. And it will be effective that those cases are connected to controversial knowledges of social studies as well as are composed of the value dilemmas related to learners’ view of life.

듀이의 반성적 탐구와 가치재구성으로서의 가치 탐구

홍남기 ( Nam Ki Hong ) 한국사회과교육학회 2013 시민교육연구 Vol.45 No.1

본 연구의 목적은 가치명료화, 가치분석, 가치추론(또는 발달 단계) 등의 기존 가치 탐구모형이 듀이의 반성적 탐구의 취지를 충분히 살리지 못한다는 점을 밝히고 듀이의 탐구 및 성장 이론에 근거한 대안적 가치 탐구 방안을 모색하는데 있다. 가치 탐구 방안은 기본적으로 학습자가 자신의 가치를 반성적으로 검토하면서 바람직한 가치를 탐색하도록 돕는다. 특히, 청소년들의 가치 편향이나 시민의식 약화가 문제가 되는 우리나라 현실에서 가치 탐구는 청소년들의 바람직한 가치관 형성을 위해 필요하다. 하지만 기존의 가치탐구 모형은 듀이의 반성적 탐구 이론에 근거함에도 불구하고 이러한 이론의 취지를 충분히 살리지 못하는 한계가 있다. 듀이의 탐구 및 성장 이론에 따르면 학습자는 “경험을 끊임없이 재구성”하는 반성적 탐구 과정을 통해 자신의 가치를 끊임없이 재구성하게 된다. 하지만 가치명료화나 가치분석 모형은 학습자 자신의 가치를 명료하고 통합적으로 재구성하도록 돕지만, 정립된 가치를 끊임없이 개선할 것을 요구하지 않는다. 이에 비해 가치추론 모형은 학습자가 보편적인 정의 원리에 따라 자신의 부적절한 가치관을 비판적으로 검토하도록 돕지만, 듀이의 이론에서 제시되듯이 학습자 자신의 욕망을 보다 이성적으로 숙고된 형태로 만들어갈 것을 요구하지 않는다. 듀이의 탐구 이론에 따르면 학습자는 보편적 도덕기준이 아니라 자신의 욕망에 기초해 가치관을 형성하고 이러한 욕망과 가치관을 끊임없이 재구성해나가게 된다. 이러한 점에서 듀이의 반성적 탐구의 취지를 살린 가치 탐구는 ‘가치재구성으로서의 가치 탐구’라고 말할 수 있다. 이 탐구 방안은 기본적으로 가치명료화나 가치분석 방안과 유사하지만 가치 재구성의 기회를 지속적으로 제공한다는 점에서 차이가 있다. This Study is aimed to explain that existing value inquiry models such as value clarification, value analysis, value reasoning(or development approach) do not enough to succeed to the import of Dewey`s reflective inquiry, and search for the alternative value inquiry based on Dewey`s inquiry and growth theories. Basically, value inquiry approaches help learners to examine their own values reflectively and search for desirable values. Especially in korea, value inquiry is necessary for the cultivation of juveniles` desirable values because they have narrow views and their citizen consciousness is weakened. But existing value inquiry models do not inherit the core of Dewey`s inquiry and growth theories although they are based on Dewey`s theories. According to Dewey`s theories, learners reconstruct their own values continuously through the reflective inquiry process in which their experiences are reconstructed continuously. But value clarification and value analysis models do not ask learners to improve their established values constantly although those models help learners to reconstruct their values consistently and clearly. In comparison, value reasoning model help learners to examine their inappropriate desires critically on the basis of universal justice principle. But this model do not ask learners to transform their desires into more rationally deliberated desires although Dewey` theories demand the rational transformation of desires. According to Dewey`s theory, Learners form their values not based on universal moral standard but based on their own desires, and reconstruct these desires and values continuously. In this regard, ``value inquiry as value reconstruction`` deserves to be called as the value inquiry succeeding to Dewey`s inquiry and growth theories. This inquiry is similar with value clarification or value analysis but is different in that this inquiry continuously offers opportunities which develop more authentic value.