Serial Tissue Expansion at the Same Site in Pediatric Patients: Is the Subsequent Expansion Faster?

Lee, Moon Ki,Park, Seong Oh,Choi, Tae Hyun Korean Society of Plastic and Reconstructive Surge 2017 Archives of Plastic Surgery Vol.44 No.6

Background Serial tissue expansion is performed to remove giant congenital melanocytic nevi. However, there have been no studies comparing the expansion rate between the subsequent and preceding expansions. In this study, we analyzed the rate of expansion in accordance with the number of surgeries, expander location, expander size, and sex. Methods A retrospective analysis was performed in pediatric patients who underwent tissue expansion for giant congenital melanocytic nevi. We tested four factors that may influence the expansion rate: The number of surgeries, expander location, expander size, and sex. The rate of expansion was calculated by dividing the 'inflation amount' by the 'expander size'. Results The expansion rate, compared with the first-time group, was 1.25 times higher in the second-or-more group (P=0.04) and 1.84 times higher in the third-or-more group (P<0.01). The expansion rate was higher at the trunk than at other sites (P<0.01). There was a tendency of lower expansion rate for larger expanders (P=0.03). Sex did not affect the expansion rate. Conclusions There was a positive correlation between the number of surgeries and the expansion rate, a positive correlation between the expander location and the expansion rate, and a negative correlation between the expander size and the expansion rate.

Serial Tissue Expansion at the Same Site in Pediatric Patients: Is the Subsequent Expansion Faster?

이문기,박성오,최태현 대한성형외과학회 2017 Archives of Plastic Surgery Vol.44 No.6

Background Serial tissue expansion is performed to remove giant congenital melanocytic nevi. However, there have been no studies comparing the expansion rate between the subsequent and preceding expansions. In this study, we analyzed the rate of expansion in accordance with the number of surgeries, expander location, expander size, and sex. Methods A retrospective analysis was performed in pediatric patients who underwent tissue expansion for giant congenital melanocytic nevi. We tested four factors that may influence the expansion rate: The number of surgeries, expander location, expander size, and sex. The rate of expansion was calculated by dividing the ‘inflation amount’ by the ‘expander size’. Results The expansion rate, compared with the first-time group, was 1.25 times higher in the second-or-more group (P=0.04) and 1.84 times higher in the third-or-more group (P<0.01). The expansion rate was higher at the trunk than at other sites (P<0.01). There was a tendency of lower expansion rate for larger expanders (P=0.03). Sex did not affect the expansion rate. Conclusions There was a positive correlation between the number of surgeries and the expansion rate, a positive correlation between the expander location and the expansion rate, and a negative correlation between the expander size and the expansion rate.

A study on the extraction of necessary items to establish of a strategy for overseas expansion of Korean healthcare workers : Based on expert surveys

최훈화,오민재,정기택 한국보건경제정책학회 2018 보건경제와 정책연구 Vol.24 No.4

The government reported that the healthcare industry would be a repository of the creation of new government jobs and has promoted the policy for supporting expansion while visualizing Korean healthcare workers’ overseas expansion project in earnest, but still, a problem emerges, concerning medical institutions’ overseas expansion. On the other hand, as Korean medical institutions’ overseas expansion project is revitalized, the importance of the utilization of healthcare workers, the main axis of the expansion comes to the fore, but there are insufficient surveys of the opinion and recognition in the workers to be dispatched overseas about the overseas expansion project. Above all, there is no study of Korean healthcare workers’ overseas expansion projects with expects in overseas expansion. Thus, the long-term success mode of Korean medical institutions’ overseas expansion project, with experts related to overseas expansion, this study would investigate their overall opinion and awareness about healthcare workers’ overseas expansion, which may be the core of the overseas expansion strategy and draw the factors at a competitive edge for the items necessary for successful overseas expansion. This study conducted a Delphi survey with experts related to the overseas expansion of medical services a total of two times, and the first survey was conducted in the form of an in-depth open interview. As a result of a survey with experts, first, The medical institution identified the differences between the needs that are considered important on a personal level and those that are important at the government or medical institution level, when the medical personnel are released overseas. This study is the first research that conducted a survey with experts concerning Korean healthcare workers’ overseas expansion, which has a high academic contribution. Especially, this study presented opinions from various aspects of the experts. It has implications in that it provided basic data on policy decisions related to overseas advancement and human resource management strategies.

Which Emphasizing Factors Are Most Predictive of Hematoma Expansion in Spot Sign Positive Intracerebral Hemorrhage?

Kim, So Hyun,Jung, Hyun Ho,Whang, Kum,Kim, Jong Yun,Pyen, Jin Su,Oh, Ji Woong The Korean Neurosurgical Society 2014 Journal of Korean neurosurgical society Vol.56 No.2

Objective : The spot sign is related with the risk of hematoma expansion in spontaneous intracerebral hemorrhage (ICH). However, not all spot sign positive patients undergo hematoma expansion. Thus, the present study investigates the specific factors enhancing the spot sign positivity in predicting hematoma expansion. Methods : We retrospectively studied 316 consecutive patients who presented between March 2009 to March 2011 with primary ICH and whose initial computed tomography brain angiography (CTA) was performed at our Emergency Department. Of these patients, 47 primary ICH patients presented spot signs in their CTA. We classified these 47 patients into two groups based on the presence of hematoma expansion then analyzed them with the following factors : gender, age, initial systolic blood pressure, history of anti-platelet therapy, volume and location of hematoma, time interval from symptom onset to initial CTA, spot sign number, axial dimension, and Hounsfield Unit (HU) of spot signs. Results : Of the 47 spot sign positive patients, hematoma expansion occurred in 26 patients (55.3%) while the remaining 21 (44.7%) showed no expansion. The time intervals from symptom onset to initial CTA were $2.42{\pm}1.24$ hours and $3.69{\pm}2.57$ hours for expansion and no expansion, respectively (p=0.031). The HU of spot signs were $192.12{\pm}45.97$ and $151.10{\pm}25.14$ for expansion and no expansion, respectively (p=0.001). Conclusions : The conditions of shorter time from symptom onset to initial CTA and higher HU of spot signs are the emphasizing factors for predicting hematoma expansion in spot sign positive patients.

Multifactorial analysis of the surgical outcomes of giant congenital melanocytic nevi: Single versus serial tissue expansion

Kim, Min Ji,Lee, Dong Hwan,Park, Dong Ha Korean Society of Plastic and Reconstructive Surge 2020 Archives of Plastic Surgery Vol.47 No.6

Background Giant congenital melanocytic nevus (GCMN) is a rare disease, for which complete surgical resection is recommended. However, the size of the lesions presents problems for the management of the condition. The most popular approach is to use a tissue expander; however, single-stage expansion in reconstructive surgery for GCMN cannot always address the entire defect. Few reports have compared tissue expansion techniques. The present study compared single and serial expansion to analyze the risk factors for complications and the surgical outcomes of the two techniques. Methods We retrospectively reviewed the medical charts of patients who underwent tissue expander reconstruction between March 2011 and July 2019. Serial expansion was indicated in cases of anatomically obvious defects after the first expansion, limited skin expansion with two more expander insertions, or capsular contracture after removal of the first expander. Results Fifty-five patients (88 cases) were analyzed, of whom 31 underwent serial expansion. The number of expanders inserted was higher in the serial-expansion group (P<0.001). The back and lower extremities were the most common locations for single and serial expansion, respectively (P =0.043). Multivariate analysis showed that sex (odds ratio [OR], 0.257; P=0.015), expander size (OR, 1.016; P=0.015), and inflation volume (OR, 0.987; P=0.015) were risk factors for complications. Conclusions Serial expansion is a good option for GCMN management. We demonstrated that large-sized expanders and large inflation volumes can lead to complications, and therefore require risk-reducing strategies. Nonetheless, serial expansion with proper management is appropriate for certain patients and can provide aesthetically satisfactory outcomes.

개발지 확장에 따른 생태적 영향에 대한 예측 모델링 체계 구축(Ⅰ)

주용준,사공희,이후승 한국환경연구원 2021 사업보고서 Vol.2021 No.-

Ⅰ. 서 론 1. 연구의 배경 ○ 우리 주변의 환경 및 생태계에 영향을 주는 요인은 개발사업을 비롯한 다양한 인간 활동에서 비롯되고, 개발지 확장은 생태계 서식지와 기능의 훼손 등에 영향을 주며 이는 다시 감염성 질병의 확산에 따른 인간 생활환경에 영향을 주는 등 개발지 확장과 생태적 영향, 감염성 질병은 밀접한 관계가 있음 2. 연구의 목적 ○ 본 연구에서는 개발지가 확장되면서 발생하는 생태 서식지 및 생태적 기능의 훼손을 정량적으로 예측하고 거시적 패턴을 분석하기 위한 모델링 체계 구축을 목적으로 3년 동안 연구를 진행함 ○ 1차 연도에는 도시성장 관련 모델링(CA, ABM)의 이론적 고찰과 모델 적용의 국내외 사례 등을 분석하고 개발지 확장과 생태영향에 대한 모델링 방법론을 도출하고자 함 Ⅱ. 개발지 확장에 따른 생태적 영향 예측 모델의 분석 1. 도시 성장 모델의 진화 ○ 도시화는 사회적·환경적 영향을 수반하는 토지이용의 변화를 수반하기 때문에 이를 모의하는 도시성장 모델을 통하여 미래 시나리오를 예측하는 것은 정책결정에서 중요함. 공간 및 시간 차원에서 도시성장 모델은 거시적 스케일에서 미시적 스케일로 확장되고 있으며 정적 모의에서 동적 모의로 진화해 오고 있음 ○ 거시적 스케일에서 미시적 스케일로의 진화는 공간 차원에서 이질성과 국소 상호작용을 고려하는 것이 가능하며, 정적에서 동적으로의 진화는 시간에 따른 변화의 모의를 가능하게 함 ○ 도시는 인간과 자연적 상호작용이 있는 복잡한 계층적 시스템이 작동되기 때문에 복잡계 이론을 구현하는 모델로 CA 기반 모델링(cellular automatic based modeling)과 ABM(Agent-Based Modeling, 행위자기반 모델링)과 같은 도시의 토지이용 모델링이 필요함 2. CA(Cellular Automata) 모델 ○ 셀룰러 오토마타 모델, 즉 CA 모델은 2차원의 격자(grid)상에서 인접한 셀(cell) 간의 국지적 상호작용으로 공간 전체의 질서 또는 패턴이 생성되고 유지, 변화되는 과정을 확인할 수 있는 방법론임 ○ CA 모델은 셀 공간(cellular space), 상태(states), 네이버후드(neighborhood), 전이규칙(transition rule), 시간(time)으로 구성되며 2차원 그리드 셀이 기본단위임 ○ 셀 공간은 CA의 기초 단위인 동일 크기의 셀로 구성되는 물리적 공간이며 상태는 임의의 셀이 가지는 셀의 상태로서 셀의 값으로 셀의 변화를 설명함 ○ 네이버후드는 중심 셀 주위를 둘러싼 주변의 셀을 말하며 전이규칙은 CA의 가장 핵심적인 요소로서 인근 셀의 상태에 따라 해당 셀이 어떻게 변화되는지를 정의하는 일련의 규칙임 ○ CA 모델은 초기 상태, 변수(파라메타) 설정, 전이규칙 설정에 의해 각기 상이한 결과를 도출해 낼 수 있어 공간의 복합성(complex)을 모의할 수 있으며 상호작용 결과를 시각적으로 보여줄 수 있어 공간분석 시 유용함 3. ABM(Agent-Based Modelling) ○ ABM은 행위자(agent)로 불리는 다양한 객체의 행동을 모의하는 방법론의 하나이며 상호작용하는 많은 행위자로 이루어진 작은 가상세계임. ABM의 가상세계는 행위자, 행위자가 활동하고 상호작용하는 시스템 공간인 환경, 시스템에 영향을 미치는 외부 환경의 세 가지 요소로 구성됨 ○ 행위자는 특성(properties), 행동(action)을 갖고 가끔은 목표를 보유할 수도 있는 자율적인 개체 또는 객체로서 독립적으로 행동하고 외부세계와 상호작용함 ○ 환경은 행위자 공간으로 행위자들이 상호작용을 주고받으며 위치하는 공간을 의미하며, 외부 환경은 전체 시스템을 둘러싼 환경이라 할 수 있음 ○ ABM에서 행위자 간 상호작용은 매우 중요한 기작이며 행위자 간 상호작용은 크게 협조적, 조정/학습적, 인지적 상호작용으로 구분할 수 있음. 행위자 간 협조적 상호작용은 행위자들이 특정 목적을 달성하기 위해 서로 협력하는 상호작용 형태임 Ⅲ. 사례 조사 1. CA 모델 □ 세종시 비도시지역 성장관리를 위한 주택확산 모형의 개발 ○ 사례 조사 연구는 성장관리방안의 주요 규제와 관련 계획을 적용한 정책 시나리오를 설정하고, 시나리오에 따른 주택 등 개발확산 양상을 CA 모델을 이용하여 예측하고 그 영향력을 비교·측정한 것임 ○ 연구과정에서는 로지스틱 모형을 활용하여 세종시의 필지별 개발확률을 도출하고 CA 모델을 통해 정확도를 검증함. 또한 목표연도 주택입지 총면적을 상대생장모형을 통해 예측하고, CA 모델을 통해 목표연도 기준 개발확산을 예측함. 마지막으로 다양한 시나리오를 설정하고 시나리오별 개발확산을 예측함 2. ABM □ Generating Different Urban Land Configurations Based on Heterogeneous Decisions of Private Land Developers: An Agent-Based Approach in a Developing Country Context ○ 사례조사 연구는 토지 공급, 도시 개발 현실화 및 지가 설정 등에 관한 개발자의 역할 및 결정 과정을 반영한 여러 유형의 행위자들이 다양한 시나리오에서 어떻게 상호작용하고 공간적·시간적으로 구현되는지를 분석하는 것이 목적임 ○ 본 연구의 모델링 구성의 개념적 체계는 개발자가 도시 개발 프로세스의 주체가 되는 공급 측면의 관점에서 도시 공간 내에서 상호작용을 구현하도록 설계되었으며 모델에는 행위자 모듈, 환경 모듈 및 상호 작용 모듈의 세 가지 모듈이 있음 ○ ABM의 행위자 모듈은 도시 개발 과정에서 주거용 토지 개발자들을 대표하며 환경 모듈에 사용된 데이터는 토지 이용, 도시와의 근접성 등 지역의 물리적 특성과 유료 도로 등 기타 시설물을 모두 포함함 ○ 상호 작용 모듈은 개발자와 개발자가 상호작용하는 환경(즉, 셀 공간) 사이의 관계로 정의되며, 개발자들의 개발 결정은 토지 수색, 토지 평가, 토지 취득, 토지 개발 등 네 가지 단계를 순차적으로 시행하도록 설계함 3. CA 모델과 ABM 모델의 혼합 □ Development of integrated modeling framework of land use changes and ecosystem services in mountainous watersheds ○ 사례조사 연구에서는 산악 분수령에서 토지이용과 피복 변화(LUCC: Land-Use and Cover Changes)와 물 관련 생태계서비스(ES: Ecosystem Service)의 통합을 제안 하였으며 다양한 모델을 활용하여 통합모델링 체계를 개발하였음 ○ LUCC는 CA 모델을 활용하여 공간정보(강수량, 표고, 경사도, 습도, 도로 및 시골, 관공서로부터의 거리 등)와 네이버후드 정보를 토대로 10년 단위로 경험적으로 추정된 다항로직회계에 기초하여 시뮬레이션을 함 ○ 토지이용 변화로 인해 생태계 서비스가 어떻게 변화는지를 모델링하기 위해 LUCC의 공간 시뮬레이션을 위한 CA 모델과 수문학적 사이클과 관련된 ES 추정을 위한 토양 및 수질평가 방법(SWAT: Soil and Water Assessment Tool) 모델을 결합하였음 Ⅳ. 개발지 확장-생태영향 모델링 방법론 도출 1. 개발지 확장-생태영향 모델의 프레임워크 □ 사회생태 시스템적 접근 ○ 본 연구에서는 개발지 확장으로 인한 생태계 영향을 예측 분석할 수 있는 행위자 기반 모델 개발의 방법론을 도출하는 것을 목표로 하며, 사회 시스템과 생태 시스템이 서로 상호작용을 하고 결합을 하는 측면에서 하나의 사회생태 시스템의 예시가 될 수 있음 ○ 사회 시스템(social system)은 개인, 사회 집단, 사회 자본 등으로 구성되며, 각 개인들은 다른 자본, 직업, 선호 지역 등의 특성을 지니고 있고, 각자의 전략을 통해 생존함 ○ 생태 시스템(ecological system)은 다양한 생태 환경과 그 환경의 이용, 그리고 각 생태 환경 현황과 밀접한 관계가 있으며, 토지이용 및 여러 변수에 영향을 받아 시간에 따라 생태 환경 현황 또한 변화됨 ○ 사회 시스템과 생태 시스템은 각 시스템 내에서도 여러 상호작용으로 변화하지만, 상호양 방향적으로 의존하며 큰 영향을 끼치고, 하나의 피드백 루프(feedback loop)를 이루면서 예상하지 못한 결과를 만들어낼 수도 있음 □ 개발지 확장-생태영향 통합적 프레임워크 ○ 개발지 확장-생태영향 행위자 기반 모델링의 개념적 프레임워크는 사회 시스템과 생태 환경 시스템으로 구분됨. 사회 시스템은 여러 요소로 구성되어 있으며, 각 개인들은 항상 이웃들을 보고 현재 본인의 전략에 대한 효용(utility)과 이웃의 효용을 비교하게 됨 ○ 행위자로서 개인은 지역의 경사도, 표고, 식생보전등급, 지목 등에 따라 개발용이성을 평가하고 각 항목에 점수를 매겨 총점수가 가장 높은 지역으로 이동하여 개발함 ○ 생태 환경 시스템 또한 여러 요소들로 구성되며 사람들의 의사 결정 과정과 개발지 확장에 따라 LUCC가 발생하고 다양한 측면에서 생태적 영향을 야기함 2. 개발지 확장-생태영향 모델링 방법론 도출 □ 개발지 확장과 사회 시스템 모듈 ○ 본 연구에서 사회 시스템 모듈의 각 행위자들은 인간이며 공간을 구성하는 기본 단위인 패치 한 칸에 최대 한 명씩 위치하게 됨. 개인들은 다른 나이, 직업, 지역 선호도 등의 특성을 지니며 개인들은 각자 다른 효용 평가와 의사 결정을 함 ○ 의사 결정 과정은 다양한 사회학, 경제학, 심리학 등의 학문에서 정립된 기존의 이론을 바탕으로 모델링이 가능하며, 이론적 틀에 따라 사람들은 다른 이웃들과 상호작용을 하여 서로에게 영향을 미침 □ 생태환경과 생태환경 시스템 모듈 ○ 생태영향과 생태환경 시스템 모듈은 여러 생태환경 레이어로 나누어 모델링을 함. 첫번째 레이어는 거주지에서 주는 오염 영향으로 각 개안의 공간적 위치뿐만 아니라 행위자들의 오염 영역이 중첩될 경우, 두 배의 오염 효과를 보이고 인구 밀도가 높은 지역의 경우 좀 더 복잡한 공간상의 누적 오염도를 계산함 ○ 두 번째 레이어로는 하천생태 오염 레이어가 있으며 하천 변에 사는 행위자들은 각각 다른 양의 오염 물질을 하천으로 배출함. 하천은 흘러서 확산이 된다는 측면에서 평지 생태 오염과는 다른 모습을 보이기 때문에 거주자의 배출뿐만 아니라 상류에서 하류 방향으로 확산되는 오염수의 역학관계도 행위자 기반 모델링에 포함되어야 함 ○ 세 번째 레이어는 LUCC에 대한 레이어로서 각 패치는 다른 토지이용 및 피복으로 구분되고 이에 따라 생물 다양성과 생태 서비스가 다르게 나타남 ○ 행위자들의 결정에 영향을 받아 각 패치의 토지 이용 및 피복은 바뀔 수 있고, 토지 가치, 생물 및 식물 다양성, 생태 서식 환경 등의 다양한 생태환경 레이어가 가능하며, 여러 생태환경 레이어들이 합쳐져 통합적인 생태영향을 알 수 있음 □ 정책 시스템 모듈 ○ 개발지 확장과 생태영향에 부정적인 영향이 발생할 경우 정부 차원에서 상황을 분석해서 이에 대응하는 정책을 발표하여 피해를 최소화하려고 함. 개발지 확장에 따른 생태계 파괴를 방지하기 위한 여러 정책들이 행위자 기반 모델링을 통해 시험될 수 있으며 개인의 의사결정 과정에 대한 규제가 있을 수 있음 Ⅴ. 결론 및 제언 1. 결론 ○ 본 연구에서는 개발지 확장에 따른 생태적 영향 예측을 위한 방법론을 고찰하였음. 주요 내용으로는 자연 및 사회, 공학적 ABM의 이론적 고찰과 도시 확장 및 생태환경 관련 ABM의 국내외 사례를 조사·분석하였으며, ABM을 통한 개발지 확장-생태영향 모델링이 가능한지에 대한 분석과 실제 개발지 확장-생태영향 모델링 방법론을 도출하였음 ○ 기존의 개발지 확장과 관련된 모델은 변화된 토지이용에 따라 생태계 서비스가 어떻게 변화하는지를 보여준다면, 본 연구의 방법론은 ABM을 통해 시계열적으로 개발지 확장에 대한 시뮬레이션을 하고, 개발지 확장 과정에서 생태서식지 및 기능의 훼손, 연결성 단절 등에 대한 생태적 영향이 어떻게 연동되어 나타나는지를 보여줄 수 있음 2. 제언 ○ 본 연구는 도시 확장에 따른 생태적 영향을 정성적·정량적으로 평가할 수 있는 모델을 개발하기 위한 것으로, 생태학적 영향을 고려한 개발지 확장 관리를 위한 기초자료로 활용이 가능할 것임 ○ 개발지 확장에 따른 다양한 영향요인에 대한 분석과 시나리오를 설정하고 그 결과를 모델링하여 비교·분석할 경우 생태적 영향을 최소화할 수 있는 방안을 도출할 수 있을 것임. 또한 개발지 확장과 관련된 모델링은 생태적 영향뿐만 아니라 난개발 발생 우려지역의 예측 등 도시 및 환경분야에서도 활용가능성이 클 것으로 판단됨 Ⅰ. Introduction 1. Background of research ○ Factors that affect the environment and ecosystem around us stem from various human activities, including development projects. The expansion of development sites cause affects damage to ecosystem habitats and functions, which in turn affects the human living environment due to the spread of infectious diseases. As such, the expansion of development sites, ecological effects, and infectious diseases are closely related. 2. Purpose of research ○ This study was conducted for three years with the aim of establishing a modeling system to quantitatively predict damage to ecological habitats and ecological functions caused by the expansion of development sites. ○ In the first year, the theoretical review of urban growth-related modeling (CA, ABM) and domestic and foreign cases of model application were analyzed, and a modeling methodology for development site expansion and ecological impact was developed. Ⅱ. Analysis of the Ecological Impact Prediction Model According to the Expansion of Development Sites 1. Evolution of urban growth model ○ Since urbanization involves changes in land use accompanying social and environmental influences, it is important in policymaking to predict future scenarios through urban growth models that simulate this. In terms of space and time, urban growth models are expanding from macroscopic to microscopic scales and have evolved from static to dynamic simulations. ○ Evolution from macroscopic to microscopic scales enables us to consider the heterogeneity and local interaction at the spatial level, and static to dynamic evolution make possible the simulation of changes over time. ○ Complex hierarchical systems that involve interactions between humans and nature are implemented in cities, requiring land-use modeling of cities such as CA-based modeling and agent-based modeling (ABM) as models for complex systems. 2. CA(Cellular Automata) model ○ The CA model is a methodology that may confirm a process of generating, maintaining, and changing an order or pattern of an entire space due to interaction of adjacent cells on a two-dimensional grid. ○ The CA model consists of cellular space, states, neighborhood, transition rule, and time, and a two-dimensional grid cell is the default unit. ○ The cell space is a physical space composed of cells of the same size, which is a basic unit of CA, and a state is a state of any cell, and the change of the cell is explained by described as a value of the cell. ○ Neighborhood refers to the cells surrounding the central cell. The transition rule is the most important element of CA; it is a set of rules that define how the cell changes according to the state of the nearby cell. ○ The CA model can simulate space complexity and visually show interaction results by deriving different results by initial state, parameter setting, and transition rule setting. 3. ABM (Agent-Based Modeling) ○ ABM is one of the methodologies for simulating the behavior of various objects called agents and is a small virtual world of many interacting agents. The virtual world of ABM consists of three elements: the agent, environment in which the agents and the agent act and interact, and the external environment that affects the system. ○ Agents act independently and interact with the outside world as autonomous individuals or objects that have properties and actions and may sometimes have goals. ○ The environment is the agent’s space where they are located interacting with each other, and it can be said that the external environment is the environment surrounding the entire system. ○ In ABM, agent interaction is a very important mechanism, and interaction between agents can be largely divided into cooperative, coordinated/learning, and cognitive interaction. The agent's cooperative interaction is an interaction in which agents cooperate with each other to achieve a specific purpose. Ⅲ. Case Study 1. CA model □ Housing diffusion modeling for managing growth of non-urban area in Sejong City ○ The CA model case study established a policy scenario by applying the main plan of the growth management area, and predicted the development and spread of housing according to the scenario using the CA model. ○ In the research process, the probability of development by lot in Sejong City was derived using a logistic model, and the accuracy was verified through the CA model. In addition, the total area of the housing location for the target year was predicted through the relative growth model, and the development spread based on the target year was predicted through the CA model. Finally, we set up various scenarios and predicted the spread of development by scenario. 2. ABM model □ Generating Different Urban Land Configurations Based on Heterogeneous Decisions of Private Land Developers: An Agent-Based Approach in a Developing Country Context ○ A case study of the ABM model analyzed how various types of agents reflecting the role and decision process of developers in the urban development process interact and are implemented spatially and temporally. ○ The modeling system is designed to implement interactions within an urban space from the perspective of supply by developers who are the subject of urban development processes, and the model has three modules, an agent module, an environmental module, and an interaction module. ○ ABM's agent module represents residential land developers in the process of urban development, and the data used in the environmental module include both local physical characteristics such as land use and proximity to the city and other facilities such as toll roads. ○ The interaction module is defined as the relationship between the developer and the environment in which the developers interact, and the developers’ development decisions are designed to sequentially implement four steps: land search, land evaluation, land acquisition, and land development. 3. A mixture of CA and ABM models □ Development of an integrated modeling framework of land use changes and ecosystem services in mountainous watersheds ○ The case study proposed the integration of LUCC (Land Use and Cover Changes) and water-related ES (Ecosystem Service) in the mountain watershed, and developed an integrated modeling system using various models. ○ To simulate LUCC, the CA model was used based on multi-channel logic calculations empirically estimated every ten years using spatial information (precipitation, elevation, slope, humidity, road and countryside, distance from government offices, etc.). ○ To model how ecosystem services change due to land use changes, the CA model for spatial simulation of LUCC and the SWAT (Soil and Water Assessment Tool) model for estimating ecosystem services related to hydrological cycles are combined. Ⅳ. Expanding the Development Site and Seriving the Ecological Impact Modeling Methodology. 1. Model framework □ Socio-ecosystem approach ○ The goal of this study is to derive a methodology for establishing an agent-based model that can predict and analyze the impact of the ecosystem due to the expansion of development sites. A combination of social and ecological systems interacting with each other can be an example of a social ecological system. ○ The social system consists of individuals, social groups, and social capital, and each individual has different capital, jobs, preferred areas, and more, and survives through their own strategies. ○ The ecological system is closely related to various ecological environments and their use, and the status of each ecological environment, and the ecological environment status also changes over time due to land use and various variables. ○ Social systems and ecological systems change with multiple interactions within each system, but they are mutually dependent and have great influence on each other, and make feedback loops, which can lead to unexpected consequences. □ Integrated framework ○ The conceptual framework of agent-based modeling of ecological impact from expansion of development sites is divided into social system and ecological environment system. The social system consists of several elements, and each individual always looks at their neighbors and compares their utility of their current strategies and their utility. ○ Agent scores each item in consideration of the slope, elevation, vegetation preservation grade, and designation of the region, and moves to the region with the highest total score to develop it. ○ The ecological environment system is also composed of several factors, and land-use changes occur according to people's decision-making process and expansion of development sites, causing ecological effects in various aspects. 2. Developing a modeling methodology □ Expansion of development sites and social system modules ○ In this study, each agent in the social system module is human and is located up to one per patch, which is the basic unit that constitutes space. Individuals have different characteristics in terms of age, job, and preferred areas, and individuals make different utility evaluations and decisions. ○ The decision-making process can be modeled based on existing theories established in various disciplines such as sociology, economics, and psychology. According to this theoretical framework, people interact with other neighbors and influence each other. □ Ecological environment and ecological environment system module ○ Ecological impact and eco-environmental systems are modeled by classifying them into several eco-environmental layers. The first layer includes the pollution in residential areas; as well as the spatial location of each individual, it has twice the pollution effect when the contamination areas of agents overlap. ○ The second layer includes a river pollution layer, and agents living along the river discharge different amounts of pollutants into the river. It is different from the land ecological pollution in that the river flows and spreads, and the downstream is more polluted than the upstream. ○ The third layer is for LUCC (land use and cover change), and each patch is divided into different land uses and covers, and biodiversity and ecological services appear differently. ○ Influenced by the agents' decisions, the land use and covering of each patch can be changed, and various layers of ecological environment such as land value, biodiversity and plant diversity, and ecological habitat environment are possible. Various layers of ecological environment can be combined to determine the integrated ecological impact. □ Policy system module ○ In the event of a negative impact on the expansion of development sites and ecological impact, the government will analyze the situation and announce policies to respond to it to minimize damage. Several policies to prevent ecosystem destruction due to expansion of development sites can be tested through agent-based modeling, and there may be regulations on individual decision-making processes. Ⅴ. Conclusion and Suggestion 1. Conclusion ○ In this study, the methodology for predicting the ecological impact of the expansion of the development site was considered. The main content included a theoretical review of natural, social, and engineering ABMs, and domestic and foreign cases of ABMs related to urban expansion and ecological environment. In addition, a methodology for modeling ecological impacts due to expanded development sites through ABM was developed. ○ The methodology of this study can simulate the expansion of development sites in time series through ABM and show how the ecological effects such as damage to ecological habitats/functions and disconnection of connectivity jointly occur in the process of development site expansion. 2. Suggestion ○ If the ecological impact of urban expansion can be evaluated qualitatively (at a minimum level) or quantitatively based on this study, it can be used as basic data for managing the expansion of development sites taking ecological effects into account. ○ If we analyze the results of modeling scenarios on various influencing factors according to the expansion of development sites, it will be possible to derive measures to minimize ecological effects. In addition, modeling related to the expansion of development sites is expected to be highly likely to be used not only for ecological effects but also in urban and environmental fields such as prediction of areas where reckless development may take place.

Transcriptional Regulation of Lipogenesis and Adipose Expansion

장영훈 한국생명과학회 2022 생명과학회지 Vol.32 No.4

PPARγ and C/EBPα are master adipogenic transcription factors (TFs) required for adipose tissue development. They control the induction of many adipocyte genes and the early phase of adipogenesis in the embryonic development of adipose tissue. Adipose tissue continues to expand after birth, which, as a late phase of adipogenesis, requires the lipogenesis of adipocytes. In particular, the liver and adipose tissues are major sites for de novo lipogenesis (DNL), where carbohydrates are primarily converted to fatty acids. Furthermore, fatty acids are esterified with glycerol-3-phosphate to produce triglyceride, a major source of lipid droplets in adipocytes. Hepatic DNL has been actively studied, but the DNL of adipocytes in vivo remains not fully understood. Thus, an understanding of lipogenesis and adipose expansion may provide therapeutic opportunities for obesity, type 2 diabetes, and metabolic diseases. In adipocytes, DNL gene expression is transcriptionally regulated by lipogenesis coactivators, as well as by lipogenic TFs such as ChREBP and SREBP1a. Recent in vivo studies have revealed new insights into the lipogenesis gene expression and adipose expansion. Future detailed molecular mechanism studies will determine how nutrients and metabolism regulate DNL and adipose expansion. This review will summarize recent updates of DNL in adipocytes and adipose expansion in terms of transcriptional regulation. PPARγ와 C/EBPα는 adipose tissue 발생에 필요한 핵심 adipogenic TFs이다. 두 TFs는 adipose tissue의 배아 발생에 있어 초기 adipogenesis와 adipocytes 유전자 발현을 조절한다. Adipose expansion은 adipose tissue가 태어난 뒤에도 계속 팽창이 지속되는 것을 말한다. 이러한 adipose expansion은 후기 adipogenesis의 과정인 lipogenesis가 요구된다. 특히 간과 adipose tissue은 탄수화물이 기본적으로 fatty acids으로 전환되는 de novo lipogenesis (DNL)의 주요 장기이다. Fatty acids는 이어서 glycerol-3-phosphate에 에스테르화되어 adipocytes의 lipid droplets 생성을 위해 triglycerides로 전환된다. 간의 DNL이 활발하게 연구가 된 반면, in vivo에서 adipocytes의 DNL은 아직 잘 알려져 있지 않다. 그러므로, adipose expansion과 DNL에 대한 이해는 비만, 2형 당뇨 그리고 대사성 질환을 위한 치료제 개발에 도움을 줄 수 있다. Adipocytes에서 DNL 유전자 발현은 ChREBP나 SREBP1a와 같은 lipogenic TFs 뿐 아니라, lipogenesis coactivator에 의해 전사 수준에서 조절된다. 최근 in vivo 연구에 의해 lipogenesis 유전자 발현과 adipose expansion의 새로운 측면이 밝혀졌다. 향후 구체적인 분자기전 연구는 어떻게 영양분이 DNL과 adipose expansion을 조절하는 지를 규명해 줄 것이다. 본 리뷰논문은 전사조절 관점에서 adipocytes와 adipose expansion에 있어 DNL에 대한 최신 연구결과를 요약정리 할 것이다.

의사결정나무를 활용한 2030년 도시 확장 예측

김근한 ( Kim Geun-han ),최희선 ( Choi Hee-sun ),김동범 ( Kim Dong-beom ),정예림 ( Jung Yee-rim ),진대용 ( Jin Dae-yong ) 한국환경복원기술학회(구 한국환경복원녹화기술학회) 2020 한국환경복원기술학회지 Vol.23 No.6

The uncontrolled urban expansion causes various social, economic problems and natural/environmental problems. Therefore, it is necessary to forecast urban expansion by identifying various factors related to urban expansion. This study aims to forecast it using a decision tree that is widely used in various areas. The study used geographic data such as the area of use, geographical data like elevation and slope, the environmental conservation value assessment map, and population density data for 2006 and 2018. It extracted the new urban expansion areas by comparing the residential, industrial, and commercial zones of the zoning in 2006 and 2018 and derived a decision tree using the 2006 data as independent variables. It is intended to forecast urban expansion in 2030 by applying the data for 2018 to the derived decision tree. The analysis result confirmed that the distance from the green area, the elevation, the grade of the environmental conservation value assessment map, and the distance from the industrial area were important factors in forecasting the urban area expansion. The AUC of 0.95051 showed excellent explanatory power in the ROC analysis performed to verify the accuracy. However, the forecast of the urban area expansion for 2018 using the decision tree was 15,459.98㎢, which was significantly different from the actual urban area of 4,144.93㎢ for 2018. Since many regions use decision tree to forecast urban expansion, they can be useful for identifying which factors affect urban expansion, although they are not suitable for forecasting the expansion of urban region in detail. Identifying such important factors for urban expansion is expected to provide information that can be used in future land, urban, and environmental planning.

조직확장기를 이용한 급성 동맥연장의 방법에 관한 연구

박홍식,김석화,김현철 大韓成形外科學會 1995 Archives of Plastic Surgery Vol.22 No.4

Since the modern technique of tissue expansion was first introduced, it has been proved to be a safe and effective technique for obtaining extra tissue where distant flaps and grafts has been used traditionally. The vascular defects have been restored by autogenous vein graft or artificial vessel, such as Gortex. However, in the case of small vessel(diameter<1 mm) defects, no single ideal substitute has been established, although experimental trials of artificial vessel grafts have been performed. The most ideal method in restoring vascular defects is to dissect both sides of the defective vessel and obtain the primary anastomosis, if the size permits. In case the primary anastomosis is not available, autovenograft or artificial vessel grafts are tried. If the lengthening of the vessels is possible, then the additional task of obtaining a donor vessel can be avoided and will be free from the complications of the donor sites. Furthermore, it is expected that this method will help solve the problems applying artificial vessels to small vascular defects(diameter<1 mm). This study demonstrates a method which is safe and effective in the acute extraluminal expansion to elongate the arteries intraoperatively. Ten Sprague-Dawley rats were divided into 4 groups according to the difference of time in exploration for checking the patency of elongated arteries: immediately after expansion, 48 hours after expansion, I week after expansion, and 2 weeks after expansion. We compared the efficacy of CTE(Continuous Tissue Expansion) versus ISLE(Intraoperative Sustained Limited Expansion) in the arterial lengthening group with the volume of 5 cc expansion. A miniaturized tissue expander was used to stretch the left femoral artery in three consecutive cycles of over a 15-minute period, and continuous tissue expansion over a 15-minute period using infusion pump(Terumo syringe pump model STCO523) was used to stretch the right femoral artery of the same rat. There were no difficulties in the tissue expander technique in acute aterial lenghtening. We found that all the elongated arteries were patent: immediately, 48 hours, 1 week, and 2 weeks after expansion, ISLE gained about 10.08% in length, while CTE gained about 6.5%(P<0.02). In conclusion, with the maximum recommended volume of expansion in acute arterial lenghthening, ISLE and CTE are both safe with ISLE being superior to CTE in gaining elongated length.

설화에 나타난 서사 확장의 두 패턴

심우장 한국구비문학회 2022 口碑文學硏究 Vol.- No.65

When approaching a narrative from an oral culture point of view, one important passageway is patterns. This is because, in an oral culture where texts do not exist, the composition, storage, and transmission of information is done through patterns. Among folktales, there are basic narratives in a single form of disequilibrium-equilibrium, while there are many cases in which the narrative is expanded as the basic type is repeated. There are certain elaborately woven patterns in these narrative expansions. Among them, this paper pays attention to the pattern of disequilibrium-equilibrium-disequilibrium-equilibrium. In order to expand the narrative, it is necessary to newly secure the exhausted narrative drive. According to this securing method, the narrative expansion patterns are divided into two types: a context expansion pattern and a view shift pattern. In the recognition that the narrative equilibrium of the preceding story unit is incomplete, the “context expansion pattern” finds an incomplete point through context expansion to secure additional narrative drive. the “view shift pattern” finds the hidden disequilibrium through another view implied in the preceding story unit to secure a new narrative drive. These narrative expansion patterns have the effect of amplifying the subject, deepening and expanding the world perception, and strengthening the narrative closure. The narrative expansion pattern commonly found in a wide variety of works deserves attention as it reflects the process of dialectical thinking. This process of recognition from negation to unity and reconciliation through deepening and expansion of knowledge is a typical dialectical process of knowledge. In the end, the narrative expansion pattern shown in folktales can be said to be a refined process of oral cultural thinking that is wary of dogmatic recognition and aims for reflective thinking, just like dialectical thinking.