Novel Noncrossing Y-Stent Technique Using Tapered Proximal End of a Solitaire AB Stent for Coil Embolization of Wide-Neck Bifurcation Aneurysms

Kwon, Hyon-Jo,Lim, Jeong-Wook,Byoun, Hyoung Soo,Koh, Hyeon-Song The Korean Neurosurgical Society 2021 Journal of Korean neurosurgical society Vol.64 No.1

The crossing Y-stent method is one of the indispensable techniques to achieve sufficient neck coverage during coil embolization of bifurcation aneurysms with a wide neck and/or branch incorporation. However, the inevitable hourglass-like expansion of the second stent at the crossing point can result in insufficient vessel wall apposition, reduced aneurysm neck coverage, delayed endothelialization, and subsequent higher risks of acute or delayed thrombosis. It also interferes with engagement of the microcatheter into the aneurysm after stent installation. We expected to be able to reduce these disadvantages by installing a noncrossing type Y-stent using the Solitaire AB stent, which is fully retrievable with a tapered proximal end. Here we report the techniques and two successful cases.

A study of the beam quality correction factor in clinical proton beam conditions using Monte Carlo simulations

Kwon Yong-Cheol,Pak Sang-Il,Jo Hyon-Suk,Jeong Seonghoon,Lee Se Byeong,Kim In Jung,Yi Chul-Young,Shin Wook-Geun 한국물리학회 2022 THE JOURNAL OF THE KOREAN PHYSICAL SOCIETY Vol.81 No.11

When measuring the absorbed dose from a proton beam, the beam quality correction factor provided by IAEA TRS-398 has been used. However, that factor calculates the absorbed dose by applying the same value to clinical dosimetry without considering the initial energy of the radiation particle or the energy spectrum at the measurement position. In this study, the beam quality correction factors for the PTW 30013 farmer chamber and the PTW Advanced Markus chamber are calculated by using the TOPAS Monte Carlo simulation program to implement various clinical proton beam conditions of the National Cancer Center. In both chamber simulations, the quality correction factor measured at the Spread-Out Bragg Peak (SOBP) region shows a good agreement with the quality correction factors suggested by TRS-398. However, the quality correction factor increases at a single Bragg Peak region by 2.4% for the PTW Advanced Markus chamber and 7.1% for the PTW 30013 farmer chamber in the clinical dosimetry scenarios. The precise measurement of beam quality correction factors for mono-energy proton beams using the Monte Carlo technique is required in future studies.

Impacts of Rapid Recanalization and Collateral Circulation on Clinical Outcome after Intraarterial Thrombolysis

정혜선,Hyon-Jo Kwon,송희정,고현송,Yong Soo Kim,Ju Hun Lee,Jee Eun Shin,Suk Hoon Lee,김제 대한뇌졸중학회 2015 Journal of stroke Vol.17 No.1

Background and Purpose Rapid recanalization might improve clinical outcomes after intraarterial thrombolysis (IAT) for acute ischemic stroke patients with collateral circulation. We determined whether rapid recanalization and collateral circulation affect clinical outcomes after IAT. Methods We retrospectively evaluated the clinical and radiological data of 134 consecutive patients who underwent IAT for intracranial artery occlusion. The interval from symptom onset to recanalization after IAT (onset-to-recanalization time) as an estimate of the probability of good clinical outcome (modified Rankin scale 0-2) was calculated in patients with collateral circulation in the ischemic hemisphere, which was rated poor (0/1 American Society of Interventional and Therapeutic Neuroradiology criteria) or good (2-4). Changes in National Institute of Health Stroke Scale (NHISS) score before and after IAT and modified Rankins scale scores 3 months after discharge were compared with respect to onset-to-recanalization time. Results In patients with good collateral circulation, the estimated onset-to-recanalization time for a 0.5 probability of a good clinical outcome was 347 minutes; with poor collateral circulation, it was 172 minutes for a 0.2 probability of good clinical outcome. Outcome analyses according to onset-to-recanalization time showed patients recanalized <6 hours had lower NHISS scores (<4.5, 4.5-6, >6 hours of onset-to-recanalization time, and non-recanalization: 5.1, 6.9, 11.9, and 19.8, respectively) at discharge and higher percentages of good clinical outcome (69%, 66.7%, 21.9%, and 0%, respectively) 3 months after IAT. Conclusions The time window to expect a high probability of a good clinical outcome after IAT is highly dependent on the collateral circulation.

누가 학습조직을 주도하는가?

조창현(Chang-Hyon Jo),박문수(Mun-Su Park),정무권(Mu-Kwon Chung) 피터드러커 소사이어티 2012 창조와 혁신 Vol.5 No.2

본 연구는 최근에 글로벌 경제구조와 지식기반사회에서 다양한 문제를 해결해야 하는 중앙·지방 정부 조직을 대상으로 관료제의 단점을 해결하기 위해 학습조직의 특성 차이를 비교 분석하여, 창의적이며 혁신적인 변화를 지속적으로 주도할 수 있는 학습조직 문화를 형성하기 위한 정책적 시사점을 제시하고자 한다. 중앙정부와 지방정부(광역지자체 기초지자체)를 대상으로 DLOQ 측정도구를 사용한 설문조사를 통하여 정부조직별 특성에 따라 학습조직 확산에 차이가 있는가 그리고 개별 정부조직별 내부 특성에 따라 학습조직의 차이가 있는가를 분석하였다. 또한 공무원 중 학습조직을 주도하는 집단은 누구인지를 분석하였다. 분석결과를 종합하면, 첫째, 정부조직별로 전체적인 학습조직의 평균 차이는 존재하지 않았다. 모든 유형 정부의 학습조직은 전반적으로 상향 균등화되었으며 그에 따른 정부조직의 학습조직적 특성들이 폭넓게 확산되어 있다. 둘째, 정부조직별 두드러진 학습조직 요인은 중앙정부의 임파워먼트(권한부여)와 기초지자체의 물리적 학습기회 제공이며 타조직에 비해 통계적으로 높은 비교우위를 나타냈다. 이는 학습조직이 정부조직의 특성에 맞게 선별적으로 활용되고 있으며 그에 따른 학습조직의 특성화된 확산 때문인 것으로 판단된다. 셋째, 정부조직별 학습조직의 비교우위 차이가 나타나게 하는 주요 공무원은 남성, 대학교졸, 주무관급 집단이었다. 주로 중간급 공무원 집단에서 조직 유형에 맞게 학습조직이 실행, 확산되고 있었다. 정책적 시사점으로 첫째, 학습조직은 정부조직의 특성에 따라 학습조직의 차이가 크기 때문에 정부조직별 학습조직 활성화의 정책 대안도 특성화되어 적용되어야 한다. 특히, 상대적으로 학습조직이 특화되지 않은 조직에 대해서 조직 특성을 활성화시키기 위한 맞춤형 노력이 필요하다. 둘째, 학습조직을 조직 전반에 확산시키기 위해서 학습조직 활동에서 상대적으로 저조한 여성, 5년 근속자, 주무관미만의 하위직 공무원의 실질적 지원이 필요하다. 마지막으로, 학습조직의 전략을 담당하는 상위직 공무원이 체계적인 학습조직의 활용가능성을 위한 업무 방식의 질적 변화를 적극적으로 추진해야 한다. 또한 학습조직적 방식으로 업무의 효율성과 연계성을 가질 수 있도록 의사소통의 신뢰성, 역할 권한의 조정 등 다양한 제도를 실질적으로 지원해야 할 것이다. This study aims to analyze empirically the traits and degrees of learning organization in central and local government that resolve the various problems effectively in global economic structures and in information-basis society, and secondly to suggest policy implications for establishing a culture creative and innovative changes in governmental learning organizations. According to the results, firstly central and local organizations shows no statistic differences in the total mean in dissemination of learning organizations because the level of learning organization is generally enough upgraded and diffused into their organizational systems widely. Secondly, in some part traits of learning organizations is respectively fitting into necessities of their organizations in fact that central government has higher in the empowerment and basic local government has higher in the giving the physical opportunity of learning organization. Thirdly, the leading groups of learning organization is man, university-graduates, and grade-6 officers because of the role and the function of the organization. Several policy implications are suggested. First, for the purpose of alleviating and resolving the problems of bureaucratic organizations, the alternatives of activating learning organization is accepted discriminately according to the specialized roles and functions of works in the governmental organizations. Secondly, for the general diffusion of learning organization the leaders of organizations should give real supplement to activate the autonomous learning activity much more in the low active group which is women, short-duty public officers within 5 years, and low-class public officers. Third, top-level managers dealing with strategical leaderships have to promote qualitative change of working method actively in order to enhance systematical availability of learning organizations and to level up the efficiency, effectivity, and linkage of works through various institutions of having the trust of communications, harmonizing the role, authority and responsibility within the related works.

지속가능한 보건 서비스 지원체제 구축 방안

조창현(Chang Hyon Jo),정무권(Moo Kwon Chung) 한국공공사회학회 2017 공공사회연구 Vol.7 No.2

허혈성 심질환에서 염증지표에 관한 연구

번정득,권영주,박상호,한대희,이상철,강진환,김명구,심규혁,최병조,온영근,현민수,김성구 순천향의학연구소 2001 Journal of Soonchunhyang Medical Science Vol.7 No.2

Background : Atherosclerosis is the chief underlying cause of ischemic heart disease and there is increasing evidence that inflammation is an important determinant of the development of atherosclerosis. We assessed the levels of inflammatory markers in patients with ischemic heart disease and normal group who has normal coronary angiograms. Materials and Methods : Coronary angiography was performed in 142 patients. 107 patients of ischemic heart disease(stable angina pectoris 58, unstable angina pectoris 30, Acute myocardial infarction 19) and 38 normal control subjects. We assessed the level of inflammatory markers, such as CRP, ESR, fibrinogen and leukocyte. Results : CRP, ESR and fibrinogen values of the patients with stable angina pectoris and unstable angina pectoris were higher than that of normal control group, but there were no statistical significance. Leukocyte value of the patients with unstable angina pectoris(9003.3±701.5/mm^(3)) was significantly higher than that of the patients with stable angina pectoris(6685.5±245.8/mm^(3)) and normal control subjects(6394.3±235.1/mm^(3)). CRP, ESR and fibrinogen values of the patients with acute myocardial infarction were also higher than that of normal control subjects. CRP was 3.88±2.05 mg/dL in acute mocardial infarction group, and 0.29±0.15 mg/dL in normal control subject group(p<0.05). Fibrinogen was 541.6±45.1 mg/dL in acute myocardial infarction group, 321.4±25.6 mg/dL in normal control subject group(p<0.05). Leukocyte was 10942.1±737.6/mm^(3) in acute myocardial infarction group, 6394.3±235.1/mm^(3) in normal control subject group(p<0.05). Conclusions : This study demonstrate that CRP, fibrinogen and leukocyte values of acute myocardial infarction group were significantly higher than that of control group and stable, unstable argina pectoris group. Leucokyte values were significantly elevated in unstable angina group, but CRP values were not in unstable angina group.

Nafamostat mesilate promotes endothelium-dependent vasorelaxation via the Akt-eNOS dependent pathway

Choi, Sujeong,Kwon, Hyon-Jo,Song, Hee-Jung,Choi, Si Wan,Nagar, Harsha,Piao, Shuyu,Jung, Saet-byel,Jeon, Byeong Hwa,Kim, Dong Woon,Kim, Cuk-Seong The Korean Society of Pharmacology 2016 The Korean Journal of Physiology & Pharmacology Vol.20 No.5

Nafamostat mesilate (NM), a synthetic serine protease inhibitor, has anticoagulant and anti-inflammatory properties. The intracellular mediator and external anti-inflammatory external signal in the vascular wall have been reported to protect endothelial cells, in part due to nitric oxide (NO) production. This study was designed to examine whether NM exhibit endothelium dependent vascular relaxation through Akt/endothelial nitric oxide synthase (eNOS) activation and generation of NO. NM enhanced Akt/eNOS phosphorylation and NO production in a dose- and time-dependent manner in human umbilical vein endothelial cells (HUVECs) and aorta tissues obtained from rats treated with various concentrations of NM. NM concomitantly decreased arginase activity, which could increase the available arginine substrate for NO production. Moreover, we investigated whether NM increased NO bioavailability and decreased aortic relaxation response to an eNOS inhibitor in the aorta. These results suggest that NM increases NO generation via the Akt/eNOS signaling pathway, leading to endothelium-dependent vascular relaxation. Therefore, the vasorelaxing action of NM may contribute to the regulation of cardiovascular function.

지역공동체의 지속가능발전(SDGs)을 위한 사회자본과 거버넌스 요인에 대한 실증연구

조창현(Chang Hyon Jo),정무권(Moo Kwon Chung) 한국공공사회학회 2018 공공사회연구 Vol.8 No.3

본 연구는 SDGs를 추구하고 있는 네팔 티카풀 농촌지역에서 주민들의 인식도를 중심으로 지역 공동체의 사회자본 요인들과 거버넌스 요인들을 탐색적으로 분석하고, 이들 사회자본과 거버넌스가 네팔 티카풀 지역 공동체의 발전에 기여하는 효과를 살펴보았다. 먼저 사회자본 변수들의 요인분석에서 신뢰, 규범, 네트워크의 요인변수가 도출되었고, 거버넌스 변수들의 요인분석에서 대응성, 민주성, 효율성, 상호협력이 도출되었다. 그리고 회귀분석 결과, 지역 공동체의 지속가능발전에 대한 사회자본의 신뢰는 정(+)의 영향을 주고 거버넌스의 민주성, 효율성, 상호협력은 정의 영향을 주고 있는 반면에, 부정적인 규범(-0.110)은 부(-)의 영향을 주고 있다. 연구 결과에 의한 시사점을 살펴보면, 첫째, 사회자본인 신뢰를 높일 수 있는 사회적 환경이 마련되어야 하고, 둘째, 네팔 티카풀 지역에서 지속가능한 발전을 촉진할 수 있는 방향으로 지역 공동체 규범의 재정립이 필요하며, 셋째, 효율성을 높일 수 있는 거버넌스의 제도구축 및 지배구조가 마련되어야 한다. 넷째, 지역공동체 발전을 위한 정책 결정 프로세스에서 민주성 향상을 위한 조치가 필요하고, 다섯째, 네팔 티카풀 지역 공동체의 지속가능한 발전을 위해서 관련 이해관계자 간의 상호협력이 더욱 필요하며, 여섯째, 지역 공동체의 지역 리더의 리더십이 지역지민들의 참여와 네트워크의 강화에 중요한 역할을 한다. 특히 지역 공동체에서 다양한 지역 문제의 해결에 여성의 역할이 중요하기 때문에 사회적 규범의 변화를 위한 여성의 역할을 확대시킬 수 있는 교육 방안들이 마련되어야 한다. The purpose of this study is to analyze the social capital and good governance of community in the rural area of Nepal Tikapul pursuing SDGs and to contribute to the development of the local community. The Nepalese government also considers the promotion of the development of the local community in order to plan and promote sustainable nation-wide development at the point of view of the 17 goals of SDGs. It is very important to promote the role of social capital and the establishment of good governance for voluntary participation of local residents in the sustainable development of the local community. First, factor variables of trust, norm, and network were derived from the factor analysis of social capital variables, and also factor variables of respondence, democracy, efficiency and mutual cooperation were derived from factor analysis of good governance variables. In the regression analysis to the sustainable development of local community, trust (0.266), democracy (0.183), efficiency (0.310) and mutual cooperation (0.166) have a positive effect, while the norm (-0.110) has negative effect. The network of social capital and the respondence of governance are not significant. The implications of this study are as follows: First, an social environment should be established to increase the trust of the social capital. Second, it is necessary to redefine local community norms to promote the sustainable development in Nepal Tikal region. Third, the institutional building and authority structure of governance should be prepared to increase efficiency. Fourth, in the policy making process of the local community development the treatment to improve the democracy is necessary for the regional governance. Fifth, there is a further need for mutual cooperation among related stakeholders for the sustainable development of Tikal local community. Sixth, the leadership of local community leaders play an important role in strengthening participation and network of local people. Since the role of women in solving various regional problems in the local community is greatly contributing, education plans should be prepared to expand the role of women in the change of social norms.

관상동맥질환 환자에서 스텐트 시술 후 재협착에 관한 연구

강진환,권영주,박상호,한대희,이상철,김명구,변정득,최병조,심규혁,온영근,현민수,김성구 순천향의학연구소 2001 Journal of Soonchunhyang Medical Science Vol.7 No.2

Background and aims : In the coronary artery disease, a rate of restenosis was much decreased by placement of coronary stent than when percutaneous transluminal coronary angioplasty has been applied, but there are still important clinical problems of restenosis. There has been many progressive studies about various factors contributed to this restenosis. So, we studied a relation between restenosis after placement of coronary stent in the coronary artery disease and many clinical factors, characteristics of stenotic lesion and procedural factors, and also assessed the restenosis rate of various coronary stents. Methods : Total 58 lesions(46 cases of patients ; man 30, woman 16) were evaluated, which has been performed a follow-up coronary angiography after 6 months (mean 188 days) since coronary stent had been placed. Various stents were implanted and assessed a relation between restenosis and many factors. Results : Of 58 lesions were target stenotic studies, there were 22 of restenotic lesions(37.9%), and the restenosis rate wes statistically significant difference in the relation with diabetes mellitus(p<0.05), group of acute myocardial infarction(p<0.05) among clinical diagnosis of ischemic heart disease(stable angina, unstable angina and acute myocardial infarction) in clinical factors and with high dilation pressure of stent(p<0.05) in procedural factors. When the rate of restenosis was evaluated among implanted stents, it was lowest in the Multilink^(®) stent and highest in the Nir Royal^(®) stent(60%). Conclusion : In this study of restenosis and various factors after placement of stents in the coronary artety disease, factors such as diabetes mellitus, group of acute myocardial infarction and a dilation pressure of stent were significant related with restenosis and the restenosis rate of Multilink^(®) stent was lowest and the highest restenosis rate was of Nir Royal^(®) stent.

CoCl₂ 처리로 유도된 hypoxia상태에서 세포자살과 ER stress에 관련된 인자의 발현

Seon-Hwan Kim(김선환),Hyon-Jo Kwon(권현조),Hyeon Song Koh(고현송),Shi-Hun Song(송시헌),Kisang Kwon(권기상),O-Yu Kwon(권오유),Seung Won Choi(최승원) 한국생명과학회 2010 생명과학회지 Vol.20 No.12

PC12 세포에서 CoCl₂에 의한 hypoxia 유도는 HIF1 alpha의 상승 발현으로 확인하였다. 이때 apoptosis의 유도는 genomic DNA의 fragmentation과 apoptotic body는 Hoechst 염색으로 확인되었고, ER luminal chaperone의 발현 및 ER stress signal에 관여하는 ER membrane kinase인 IRE1, PERK, ATF6의 발현도 확인되었다. 이들이 apoptosis로 연결되는 고리 역할을 하는 IRE1-XBP1 mRNA splicing, PERK-eIF2 alpha, ATF6 protein cleavage도 반응하는 것으로 확인되었다. 위의 결과는 신경세포의 hypoxia상태는 ER stress signal pathway를 거쳐서 apoptosis가 된다는 것을 증명한 것으로 신경세포의 hypoxia치료를 위한 기초 자료가 될 것으로 생각한다. Cobalt(Ⅱ) chloride, a chemical compound with the formula CoCl₂, has been widely used in the treatment of anemia, as a chemical agent for the induction of hypoxia in cell cultures, and is known to activate hypoxic signaling. However, excessive exposure to cobalt is associated with several clinical conditions, including asthma, pneumonia, and hematological abnormalities, and can lead to tissue and cellular toxicity. It is also known to induce apoptosis. One of the questions was that of whether CoCl₂ might induce apoptosis via endoplasmic reticulum (ER) stress in neurons. To address this question, first, the level of DNA fragmentation was measured for assay of apoptotic rates using CoCl₂ with neuron PC12 cells. After confirmation of apoptosis inductions, under the same conditions, the expression levels of ER stress associated factors [ER chaperones Bip, calnexin, ERp72, ERp29, PDI, and ER membrane kinases (IRE1, ATF6, PERK)] were examined by RT-PCR and Western blotting. These results indicated that apoptosis is induced through activation of ER membrane kinases via ER stress. In conclusion, during induction of apoptosis through CoCl₂-induced hypoxia in neuron PC12 cells, ER membrane kinase of IRE1 was dominantly up-expressed, and, consecutively, TRAF2, which has been suggested to be one of the links connecting apoptosis and ER stress, was strongly up-expressed.