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김하경,유홍석,표홍렬,노재명,주상규,이우진,박병석,김진만,강노을,신선혜,박혜윤 대한결핵 및 호흡기학회 2018 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.126 No.-
Background: IBM Watson for Oncology (WFO) is a cognitive computing system which helps physicians quickly identify key information in a patient’s medical record, surface relevant evidence and explore treatment options. We evaluated the level of agreement between WFO and multidisciplinary tumor board (MDT) for lung cancer. Methods: From January to April 2018, newly diagnosed lung cancer cases in Chonnam National University Hwasun Hospital were retrospectively examined using WFO version 18.4 according to four treatment categories [surgery, radiotherapy, concurrent chemoradiotherapy (CCRT), and palliative setting]. Concordance between MDT and WFO was analyzed by Cohen's kappa value. Results: Total 132 cases were enrolled in this study. The concordance rate occurred in 92.4% (k=0.881, p<0.001) for the all cases. The strength of agreement was very good in stage 1 (92.4%, k=0.855), stage 4 NSCLC (100%, k=1.000) and extensive disease SCLC (100%, k=1.000). In stage 3 NSCLC, the strength of agreement was good (80.8%, k=0.622). And the concordance was moderate in stage 2 NSCLC (83.3%, k=0.556) and limited disease SCLC (84.6%, k=0.435). There were discordant cases in surgery (4/29, 13.8%) and CCRT (5/33, 15.2%), but discordance was not occurred in radiotherapy and palliative care. Conclusion: Treatment recommendations made by WFO and MDT were highly concordant for lung cancer cases especially in stage 1 NSCLC and metastatic stage. However, WFO was just an assisting tool in stage 2-3 NSCLC and limited disease SCLC, so shared decision making may be more important in this stage.
Ouabain이 摘出병아리 網膜의 網膜電位圖 C-파에 미치는 效果
金夏卿,佐藤匡,米山高仁,田澤豊,具本術 중앙대학교 의과대학 의과학연구소 1988 中央醫大誌 Vol.13 No.1
Noradrenaline, a stimulant of the adenylate cyclase, augmented c-wave as much as ouabain and this effect was largest at 10^-9M. After augmentation of the c-wave by 10^-9 noradrenaline, there was no additional augmenting effect of 10^-7M ouabain. This fact suggests that the ouabain-induced augmentation of the c-wave may be due to the stimulation of adencylate cyclase. In the presence of 10^-7M ouabain, the light sensitivity of retina was elevated to 0.5 log unit and it was increased about 30% over the maximum response. This may be one of the signs of visual complications caused by ouabain, such as metachromatopsia. The effect of ouabain on the ERC c-wave was investigated in the isolated chick retina. Although the c-wave was abolished by a high dose of ouabain (10^-4M), it increased in amplitude in the presence of ouabain at a low concentration of 10^-7M, which was within the therapeutic range of clinical use for cardiac glycoside. The standing potential of the retina did not change appreciably until 10^-6M order and then decreased gradually at higher concentrations. In the presence of 10^-4M ouabain, the level having a complete blocking effect of Na-K ATPase, both the c-wave and the standing potential were almost abolished. These effects of ouabain were more conspicuous when the drug was applied to the vitreous side than to the choroidal side.