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The efficacy of treatment for hepatocellular carcinoma in elderly patients
이한아,이상헌,이해림,송정은,이동현,한소정,심주현,김보현,최종영,임현철,김도영 대한간암학회 2023 대한간암학회지 Vol.23 No.2
Background/Aim: Despite the increasing proportion of elderly patients with hepatocellular carcinoma (HCC) over time, treatment efficacy in this population is not well established. Methods: Data collected from the Korean Primary Liver Cancer Registry, a representative cohort of patients newly diagnosed with HCC in Korea between 2008 and 2017, were analyzed. Overall survival (OS) according to tumor stage and treatment modality was compared between elderly and non-elderly patients with HCC. Results: Among 15,186 study patients, 5,829 (38.4%) were elderly. A larger proportion of elderly patients did not receive any treatment for HCC than non-elderly patients (25.2% vs. 16.7%). However, OS was significantly better in elderly patients who received treatment compared to those who did not (median, 38.6 vs. 22.3 months; P<0.001). In early-stage HCC, surgery yielded significantly lower OS in elderly patients compared to non-elderly patients (median, 97.4 vs. 138.0 months; P<0.001), however, local ablation (median, 82.2 vs. 105.5 months) and transarterial therapy (median, 42.6 vs. 56.9 months) each provided comparable OS between the two groups after inverse probability of treatment weighting (IPTW) analysis (all P>0.05). After IPTW, in intermediate-stage HCC, surgery (median, 66.0 vs. 90.3 months) and transarterial therapy (median, 36.5 vs. 37.2 months), and in advanced-stage HCC, transarterial (median, 25.3 vs. 26.3 months) and systemic therapy (median, 25.3 vs. 26.3 months) yielded comparable OS between the elderly and non-elderly HCC patients (all P>0.05). Conclusions: Personalized treatments tailored to individual patients can improve the prognosis of elderly patients with HCC to a level comparable to that of non-elderly patients.
외상성 말초신경 손상으로 인한 창상 치유 지연 및 근위축이 유발된소동물에서의 미세전류 자극 효능 평가
이한아,김서현,황동현,유리,유지희,김민주,조승관,김한성 대한의용생체공학회 2018 의공학회지 Vol.39 No.1
This study was carried out to evaluate the effect of micro-current therapy on muscle atrophy and delayed wound healing process caused by traumatic peripheral nerve injury. For this, twenty-five 5-week-old Sprague Dawley rat were used and assigned to five groups including the normal group (NOR, n=5), the wound group (WD, n=5), the wounded and treated with micro-current electrical therapy group (WD+MET, n=5), the sciatic nerve denervated and wounded group (WD+DN, n=5), and the sciatic nerve denervated, wounded and treated with micro-current electrical therapy group (WD+DN+MET, n=5). In order to assess the changes in length of incisional wound for 12 days and the muscle volume for 2 weeks, the ImageJ analysis of macroscopic analysis and micro-CT data were obtained and analyzed. As a result, significant delay in the process in wound healing were observed and micro-current therapy suppress the postponement of healing process. Furthermore, there were significant changes in muscle volume between electrically treated group and non-treated group. These result shows that electrical stimulation may improve the delayed healing process and muscle atrophy at once.
경피적 귀 미주신경 자극이 자율신경계의 활동 및 식후 혈당 변화에 미치는 영향
이한아,김현,김도용,이민주,조승관,김한성 대한의용생체공학회 2023 의공학회지 Vol.44 No.1
Transcutaneous auricular vagus nerve stimulation (taVNS) is known to be effective in improving symp- toms of numerous diseases such as depression and epilepsy by increasing vagus nerve activity through electrical stimulation. The purpose of this study is to investigate the effect of vagus nerve stimulation on the activity of auto- nomic nervous system and the changes in postprandial blood glucose levels. Seven healthy adults participated in a non-invasive transcutaneous auricular vagus nerve stimulation experiment. taVNS (25 Hz, 200 µs, biphasic pulse) was applied to the cymba concha (taVNS group) or the earlobe (Sham-taVNS group) of the left ear. As autonomic nervous system signals, skin conductance level, skin temperature, and heart rate were recorded during the appli- cation of taVNS. Postprandial blood glucose changes due to food intake were recorded at 5 min intervals for 25 min- utes after taVNS or sham-taVNS. The taVNS showed a significantly lower skin conductance level than the sham- taVNS (p < 0.05). The increase rate of postprandial blood glucose was significantly lower in the taVNS than in the sham-taVNS (p < 0.05). These results showed that taVNS reduced the activity of the sympathetic nerve system and alleviated early rise in postprandial blood glucose. Although further studies in diabetic patients are needed, this study suggest that taVNS has a potential for clinical use to improve postprandial blood glucose.
보육교사의 우울이 소진에 미치는 영향: 사회적 지지의 조절효과를 중심으로
이한아,유영미 한국보육학회 2019 한국보육학회지 Vol.19 No.1
Objective: This study examined the influence of child-care teachers’ depression and social support on their burn-out and investigated whether social support had any moderating effects on the relationship between of child-care teachers’ depression and burn-out. Methods: The participants of this study were 343 child-care teachers from 131 daycare center in Seoul and Gyeon-gi province. Statistical analyses of data for this study included descriptive statistics and hierarchical regressions. The moderating effect of social support was analyzed by using the procedures proposed by Baron and Kenny (1986). Results: The results of this study indicate that the level of child-care teachers’ depression increases the level of burn-out and that the level of social support in workplace and the level of social support from out of workplace decreases the level of burn-out. In addition, social support from out of workplace only moderated the influence of child-care teachers’ depression on their burn-out. Conclusion/Implications: The influence of child-care teachers’ depression on burn-out was lower when the level of social support from out of workplace was high, compared to when it was low. 본 연구는 보육교사의 우울 및 사회적 지지가 소진에 미치는 영향을 알아보고, 보육교사의 소진에 미치는 우울에 대한 사회적 지지의 조절효과를 검증하였다. 연구 대상은 서울과 경기도 지역의 보육교사 343명이었다. 자료분석을 위해 기술통계, Pearson 적률상관계수를 산출하고 위계적 중다회귀분석을 실시하였다. 연구결과, 보육교사의 우울수준이 높을수록 소진을 더 경험하였으며, 직장 내 사회적 지지와 직장 외 사회적 지지를 많이 받을수록 소진은 감소하는 것으로 나타났다. 아울러 보육교사의 우울이 소진에 미치는 영향에 대한 직장 내와 직장 외 사회적 지지의 조절효과를 살펴본 결과, 직장 외 사회적 지지에서만 조절효과가 확인되었다. 결론적으로, 보육교사의 소진에 대한 우울의 영향은 직장 외 사회적 지지 수준이 높은 교사에서는 상대적으로 더 적은 것으로 나타나, 교사의 직장 외 사회적 지지가 우울이 소진에 미치는 영향을 완충하는 역할을 함을 보여주었다.
올레산으로 유도된 비알코올성 지방간 세포 모델에서의 미세전류 자극의 지질 대사 조절 효능 평가
이한아,이민주,김한성 대한의용생체공학회 2022 의공학회지 Vol.43 No.1
Non-alcoholic fatty liver disease(NAFLD) is excessive hepatic lipid accumulation mainly caused by obesity. This study aimed to evaluate whether micro-current stimulation(MCS) could modulate lipid metabolism regarding the Sirt1/AMPK pathway, fatty acid β-oxidation pathway, and lipolysis and lipogenesis-related factors in FL83B cells. For the NAFLD cell model, FL83B cells were treated with oleic acid for lipid accumulation. MCS were stimulated for 1 hr and used frequency 10 Hz, duty cycle 50%, and biphasic rectangular current pulse. The intensity of MCS was divided into 50, 100, 200, and 400 μA. Through the results of Oil red O staining, it was confirmed that MCSs with the intensity of 200 μA and 400 μA significantly reduced the degree of lipid droplet formation. Thus, these MCS intensities were applied to western blot analysis. Western blot analysis was performed to analyze the effects of MCS on lipid metabolism. MCS with the intensity of 400 μA showed that significantly activated the Sirt1/AMPK pathway, a key pathway for regulating lipid metabolism in hepatocytes, and fatty acid β-oxidation-related transcription factors. Moreover, it activated the lipolysis pathway and suppressed lipogenesis-related transcription factors such as SREBP- 1c, FAS, and PPARγ. In the case of MCS with the intensity of 200 μA, only PGC1α and SREBP-1c showed significant differences compared to cells treated only with oleic acid. Taken together, these results suggested that MCS with the intensity of 400 μA could alleviate hepatic lipid accumulation by modulating lipid metabolism in hepatocytes.