Metabolic syndrome induced by anticancer treatment in childhood cancer survivors

최희원,유재호 대한소아내분비학회 2017 Annals of Pediatirc Endocrinology & Metabolism Vol.22 No.2

The number of childhood cancer survivors is increasing as survival rates improve. However, complications after treatment have not received much attention, particularly metabolic syndrome. Metabolic syndrome comprises central obesity, dyslipidemia, hypertension, and insulin resistance, and cancer survivors have higher risks of cardiovascular events compared with the general population. The mechanism by which cancer treatment induces metabolic syndrome is unclear. However, its pathophysiology can be categorized based on the cancer treatment type administered. Brain surgery or radiotherapy may induce metabolic syndrome by damaging the hypothalamic-pituitary axis, which may induce pituitary hormone deficiencies. Local therapy administered to particular endocrine organs directly damages the organs and causes hormone deficiencies, which induce obesity and dyslipidemia leading to metabolic syndrome. Chemotherapeutic agents interfere with cell generation and growth, damage the vascular endothelial cells, and increase the cardiovascular risk. Moreover, chemotherapeutic agents induce oxidative stress, which also induces metabolic syndrome. Physical inactivity caused by cancer treatment or the cancer itself, dietary restrictions, and the frequent use of antibiotics may also be risk factors for metabolic syndrome. Since childhood cancer survivors with metabolic syndrome have higher risks of cardiovascular events at an earlier age, early interventions should be considered. The optimal timing of interventions and drug use has not been established, but lifestyle modifications and exercise interventions that begin during cancer treatment might be beneficial and tailored education and interventions that account for individual patients’ circumstances are needed. This review evaluates the recent literature that describes metabolic syndrome in cancer survivors, with a focus on its pathophysiology.

장애유아 통원시설에서의 행동장면 현장조사 및 분석연구: 일본 동경에 위치한 KA 시설 아동 데이서비스 사례를 중심으로

최희원 한국청소년시설환경학회 2022 청소년시설환경 Vol.20 No.3

This study analyzes child care activities and children’s behavioral characteristics in ‘Children’s Day Service’, outpatient facilities for disabled children in Japan, in order to understand the characteristics of those facilities and also present foundational data to plan the facilities and child care environment for disabled children afterwards. The method of the study is described as follows. First of all, through literature review, this author considered behavior setting and the concept of ‘Children’s Day Service’ in Japan. Moreover, this researcher visited the KA facility in Tokyo and then analyzed ‘behavior setting’ through behavior observation and investigation to present the implications. The results and implications are summed up as follows: 1) Through the analysis of ‘behavior setting’, relations between the time, place, and space could be grasped about each of the child care activities. 2) It is necessary to plan the space for storing play tools that are essentially needed to take care of disabled children efficiently. 3) It is needed to establish safety measures in consideration of the characteristics of disabilities. Since it is crucial to understand the characteristics of disabled infants to create an environment that can support their growth and development, it will be necessary to accumulate follow-up studies dealing with their behavioral patterns.

CNN 기반 전이학습을 이용한 음성 감정 인식

최희원,박승민,심귀보 한국지능시스템학회 2019 한국지능시스템학회논문지 Vol.29 No.5

Interaction between human and robot is important because robots exist for the convenience of people. Robot grasping human emotions is one of many interactions. The field of SER (speech emotion recognition) has been improved by combining deep learning. The lack of data makes it difficult to expect high accuracy without using deep neural networks or applying additional learning techniques. In this paper, we confirm the effect of applying the transfer learning, which is one of the learning methods used when there is insufficient data, to SER. For deep learning, CNN (convolutional neural networks) architecture is used. By using general sound data instead of speech emotion data for the transfer learning, the limit on the number of data is eliminated. The results are verified by dividing transfer learning into two case, using as a feature extractor and fine-tuning. As a result, convergence time was reduced by about 20% when fine-tuning, and about 20% to 70% when used as a feature extractor. Accuracy of the feature extractor is rather reduced when it is used as a feature extractor and increased by about 3% when it is increased. On the average, the accuracy was improved by about 7% when fine-tuning. 로봇은 사람의 편의를 위해 존재하므로 사람과 로봇의 상호작용은 중요하다. 로봇이 사람의 감정을 파악하는 것은 여러상호작용 중 하나이다. 최근 사람의 음성으로 감정을 인식하는 음성 감정 인식(speech emotion recognition; SER)분야는딥러닝 (deep learning)의 접목으로 그 성능이 향상되고 있다. 하지만, 데이터의 부족으로 깊은 신경망을 사용하거나추가적인 학습 기법을 적용하지 않고서는 높은 정확도를 기대하기 힘들다. 본 논문에서는 데이터가 부족할 때 사용하는 학습기법 중의 하나인 전이학습 (transfer learning)을 SER에 적용한 효과를 확인한다. 딥러닝을 적용하기 위해 합성곱 신경망(convolutional neural networks; CNN) 구조를 사용한다. 전이학습에 음성 감정 데이터가 아닌 일반 소리 데이터를 사용하여데이터 개수에 대한 한계를 없앤다. 전이학습 중 특징 추출기 (feature extractor)로써 사용한 경우와 미세조정 (fine tuning)을한 경우로 나누어 결과를 확인한다. 그 결과, 미세조정한 경우 수렴 시간이 약 20% 줄었고, 특징 추출기로써 사용한 경우 약20%에서 70% 줄었다. 정확도는 특징 추출기로써 사용한 경우 오히려 정확도가 감소하는 경우가 발생하였고 증가한 경우 약3% 증가했다. 미세조정을 한 경우 정확도가 평균적으로 약 7% 향상되었다

하악전돌증 환자의 하악지시상분할골절단술 후 고정방법에 따른 안정성과 회귀율에 대한 분석

최희원,김경원,이은영,Choi, Hee-Won,Kim, Kyoung-Won,Lee, Eun-Young 대한악안면성형재건외과학회 2005 Maxillofacial Plastic Reconstructive Surgery Vol.27 No.4

The purpose of this study was to compare the postoperative stability and relapse according to 2 different fixation methods after bilateral sagittal split ramus osteotomies in mandibular prognathic patients. Tweenty one patients with Class III dental and skeletal malocclusion who were treated with bilateral sagittal split ramus osteotomy were selected for this retrospective study. We classfied the patients into two groups according to the fixation methods of bony segments after osteotomies. Group W (n = 10) had the bone segments fixed with nonrigid wire and Group S (n = 11) had bicortical screws inserted in the gonial area through a transcutaneous approach. Cephalometric radiographs were taken preoperatively, immediate postoperatively and more than six months postoperatively in each patient. After tracing the cephalometric radiographs, various parameters were measured. Before surgery, both groups were balanced with respect to linear and angular measurements of craniofacial morphology. Mean posterior sagittal setback amounts of the mandibular symphysis was 8.6 mm in the wire group and 6.79 mm in the rigid group, Six months postoperatively, the wire group had 33.1% relapse of the mandibular symphysis and 22.8% in the rigid group relapse. Both groups experienced changes in the orientation and configuration of the mandible. It is thought that Rigid screw fixation is a more stable method than nonrigid wire fixation for maintaining mandibular setback after sagittal split ramus osteotomy.

기업의 사회적 책임(CSR)활동과 CEO의 역할에 대한 고찰

최희원,이종호,장인성,김대영,문철우 한국인사조직학회 2010 한국인사ㆍ조직학회 발표논문집 Vol.2010 No.2

최근 우리나라에서는 기업의 사회적 책임(Corporate Social Responsibility, CSR)에 관한 논의가 지속적으로 이루어지고 있으며, CSR의 범위에 기업윤리, 지배구조, 회계 및 거래투명성, 노사관계, 환경·안전·위생, 사회공헌, 협력업체와의 관계 등이 포함되고 있고, 지속가능경영을 포함하는 개념으로 확대되고 있다. CSR이 기업의 전략적 선택으로 활용되는 경향이 있으며, 이러한 의사결정에 영향을 미치는 CEO의 리더십 특질(카리스마적 성향과 지적자극활동) 중 지적자극이 CSR 활동에 긍정적인 영향을 미친다는 외국의 선행연구의 결론을 바탕으로 우리나라 기업에 동일한 가설을 적용하여 연구를 수행하였다. 연구결과 CEO의 리더십 특질 중 카리스마적 성향은 CSR 활동과 정(+)의 상관관계가 있다는 가설은 지지되었으나, 지적자극은 유의한 상관관계를 보이지 않았다. 외국의 선행연구와는 다소 상이한 결과가 도출 되었고, 이는 국내기업의 CSR 활동이 CEO의 지적자극에 의한 종업원들의 행동변화에 의한 것이 아니라, 최고경영진이 CSR에 관심을 가지고 상발하향식(top-down)으로 추진되고 있는 현실을 반영한 것으로 추론 된다. 향후 대상기업을 확대·연구하여 외국의 선행연구 결과와 본 연구 결과 간의 차이가 유의한 것인지에 대해 추가적으로 고찰할 필요성이 제기 되었다.

Genetic Analysis and Clinical Characteristics of Hereditary Pheochromocytoma and Paraganglioma Syndrome in Korean Population

최희원,김경진,홍남기,신새암,최종락,강상욱,이승태,이유미 대한내분비학회 2020 Endocrinology and metabolism Vol.35 No.4

Background: Pheochromocytoma and paragangliomas (PPGL) are hereditary in approximately 30% to 40% cases. With the advancement of genetic analysis techniques, including next-generation sequencing (NGS), there were attempts to classify PPGL into molecular clusters. With NGS being applied to clinical settings recently, we aimed to review the results of genetic analysis, including NGS, and investigate the association with clinical characteristics in Korean PPGL patients. Methods: We reviewed the medical records of PPGL patients who visited Severance hospital from 2006 to 2019. We documented the clinical phenotype of those who underwent targeted NGS or had known germline mutations of related genes. Results: Among 57 PPGL patients, we found 28 pathogenic germline mutations of susceptibility genes. Before the targeted NGS was implemented, only obvious syndromic feature lead to the Sanger sequencing for the specific genes. Therefore, for the exact prevalence, only patients after the year 2017, when targeted NGS was added, were included (n=43). The positive germline mutations were found in 14 patients; thus, the incidence rate is 32.6%. Patients with germline mutations had a higher likelihood of family history. There were significant differences in the type of PPGLs, percentage of family history, metastasis rate, presence of other tumors, and biochemical profile among three molecular clusters: pseudohypoxic tricarboxylic acid cycle-related, pseudohypoxic von Hippel-Lindau (VHL)/endothelial PAS domain-containing protein 1-related, and kinase-signaling group. Germline mutations were identified in seven PPGL-related genes (SDHB, RET, VHL, NF1, MAX, SDHA, and SDHD). Conclusion: We report the expected prevalence of germline mutations in Korean PPGL patients. NGS is a useful and accessible tool for genetic analysis in patients with PPGLs, and further research on molecular classification is needed for precise management.

위암등록자료에 대한 프레일티 모형 적합

최희원,하일도,노맹석,김창훈 한국데이터정보과학회 2018 한국데이터정보과학회지 Vol.29 No.4

Gastric cancer was the most common carcinoma in Korea, even though incidence has recently decreased and relative survival rate has increased. In particular, the death rate of gastric cancer in Busan was higher than that of the whole country or Seoul during 10 years from 2006 to 2016. In this paper, the survival analysis for the survival time, i.e. time to death from initial diagnosis of gastric cancer, was performed using the Busan cancer registry data. For this, we compared survival rates according to sex and age by Kaplan-Meier survival curves. Especially, because survival rate of gastric cancer may be different according to region, we fitted the frailty models considering Eup-Myon-Dong regional unit as a random effect. Various visualizations and disease mapping of Busan area were presented for the fitting result. In addition, the two inference results were also compared when deprivation index variable was included in the model. As a result, the deprivation index variable decreased the significance for death of gastric cancer among Dongs. 위암은 최근 발생률이 감소하고 상대생존율이 증가하는 추세를 보이지만 여전히 국내에서 가장 많이 발생하는 암종이다. 특히, 2006년부터 2016년까지 10년동안 부산광역시의 위암 사망률이 전국이나 다른 대도시보다 더 높은 것으로 나타났다. 본 연구에서는 부산광역시 소지역별 위암 사망률의 차이를 알아보고자 암등록자료에 대한 위암 환자들의 초진부터 사망까지를 생존시간으로 정의하여 생존분석을 실시하였다. 이를 위해, 성별 및 연령에 따른 병기별 생존률을 카플란-마이어 생존곡선을 통해 비교하였으며, 특히 지역에 따라 위암 생존률이 다를 수 있으므로 읍면동 지역단위를 변량효과로 고려하여 프레일티 생존모형을 적합하였다. 이러한 적합 결과에 대하여 다양한 시각화 및 부산지역 질병지도를 제시하였으며, 추가적으로 모형에 박탈지수 변수를 포함하였을 때 두 추론결과를 또한 비교하였다. 결과적으로, 박탈지수 변수가 위암 사망에 대한 동 간 유의성을 감소시키는 것으로 나타났다.

Korean clinical practice guidelines for the diagnosis of hereditary hemolytic anemia

최희원,Sang Mee Hwang,Ye Jee Shim,Jae Min Lee,Hee Sue Park,Joon Hee Lee,Youngwon Nam,김남희,Hye Lim Jung,Hyoung Soo Choi,on behalf of Korean RBC Disorder Working Party 대한혈액학회 2022 Blood Research Vol.57 No.2

Although the prevalence of hereditary hemolytic anemia (HHA) is relatively low in Korea, it has been gradually increasing in recent decades due to increment in the proportions of hemoglobinopathies from immigrants of South East Asia, raising awareness of the disease among clinicians, and advances in diagnostic technology. As such, the red blood cell (RBC) Disorder Working Party (WP), previously called HHA WP, of the Korean Society of Hematology (KSH) developed the Korean Standard Operating Procedures (SOPs) for the diagnosis of HHA in 2007. These SOPs have been continuously revised and updated following advances in diagnostic technology [e.g., flow cytometric osmotic fragility test (FOFT) and eosin-5-maleimide (EMA) binding test], current methods for membrane protein or enzyme analysis [e.g., liquid chromatography-tandem mass spectrometry (LC-MS/MS), ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS), high-performance liquid chromatography (HPLC)], and molecular genetic tests using next-generation sequencing (NGS). However, the diagnosis and treatment of HHA remain challenging as they require considerable experience and understanding of the disease. Therefore, in this new Korean Clinical Practice Guidelines for the Diagnosis of HHA, on behalf of the RBC Disorder WP of KSH, updated guidelines to approach patients suspected of HHA are summarized. NGS is proposed to perform prior to membrane protein or enzyme analysis by LC-MS/MS, UPLC-MS/MS or HPLC techniques due to the availability of gene testing in more laboratories in Korea. We hope that this guideline will be helpful for clinicians in making diagnostic decisions for patients with HHA in Korea.

제 IV 형 근관에서 System B Plugger tip의 깊이에 따른 근관 충전 효과

최희원,김수미,황호길,Choi, Hee-Won,Kim, Soo-Mee,Hwang, Ho-Keel 대한치과보존학회 2008 Restorative Dentistry & Endodontics Vol.33 No.6

본 연구의 목적은 제 IV형 근관에서 Continuous Wave 가압법을 이용하여 충전할 때 System B Plugger tip의 깊이에 따른 근단부 밀폐효과를 평가하기 위함이다. 50개의 J형 만곡을 갖는 레진 블록에 부러진 F3 ProTaper 파일을 이용해 근관장에서 3mm 지점에 ledge를 형성한 후, F1 ProTaper Ni-Ti file을 이용해 레진 블록을 천공시켜 제 IV형 근관을 형성하고 System B Plugger tip의 깊이에 따라 3개의 실험군과 1개의 대조군으로 분류하였다. 제 IV형 근관의 거터퍼쳐와 실러의 길이는 확대경하에서 캘리퍼를 이용해 측정하였고 다음과 같은 결과를 얻었다. 1. 대조군의 설측 근관에서 거터퍼쳐와 실러 모두 관찰되지 않았다. 2. 3 mm군에서는 5 mm 또는 7 mm군에 비해 유의하게 많은 거터퍼쳐의 충전이 관찰되었다 (p<0.05). 3. 7 mm군에서는 유의하게 많은 빈 공간이 관찰되었다 (p<0.05). The purpose of this study was to evaluate the effect of the apical sealing according to the depth of the System B Plugger tip when root canal was filled with gutta-percha and sealer by Continuous Wave of Condensation technique in the Type IV canal. 50 simulated resin blocks with J-shaped curvature canals were instrumented by ProTaper (Dentsply Maillefer, Ballagiues, Switzerland) Ni-Ti files using the crown-down technique. Type IV canals were made using a broken ProTaper F3 Ni-Ti file for making a ledge at 3mm short from the working length. And ProTaper F1 Ni-Ti file was used for perforating resin block. The prepared Type IV canals were randomly divided into three experimental groups of 15 each according to the depth of System B Plugger tip. All of experimental groups were obturated with Continuous Wave of Condensation technique. The length of gutta-percha and sealer in lingual of the Type IV canals was measured with a measuring digital calliper under magnifying glass (${\times}2.3$). The results are as follows : 1. In control group, there was no gutta-percha and sealer in lingual canal. 2. 3 mm group showed relatively more gutta-percha than 5mm or 7 mm group (p<0.05). 3. 7 mm group did not showed gutta-percha and relatively more void were observed than 3mm or 5 mm group. (p<0.05) In conclusion, within the limits of the results of this experiment, the 3 mm depth of System B Plugger tip was acceptable for obturating the Type IV canal.

일본 육아지원 공동주택 인증사례의 계획요소 특성에 관한 연구 - 일본 요코하마(橫浜)시의 사례를 중심으로 -

최희원,Choi, Hee-Won 한국주거학회 2014 한국주거학회 논문집 Vol.25 No.4

The purpose of this study is to analyze the contents and assessment items in the certification criteria for Child Care Support Apartment program in Japan that is implemented mainly by local authorities with a view to provide information that could be used as reference in enhancement of the residential environment. For this purpose, the architectural planning elements for individual residence units and the public spaces of the Child Care Support Apartment Certification programs in effect in Yokohama city were identified and analyzed. In spite of the recent trends in Korea, in which the residential services are more diversified and segmented in consideration of the needs of the residents and the increased interest in child care in general, the literatures that addressed the direct relationship between childbirth and residences are scarce, and it is anticipated that the result of this study would be of contribution to provide a hint in direction for improvement of residential environment with child support programs.