Adult invasive pneumococcal disease in the Republic of Korea: Risk medical conditions and mortality stratified by age group

Kim, Jong Hun,Baik, Seung Hee,Chun, Byung Chul,Song, Joon Young,Bae, In-Gyu,Kim, Hyo Youl,Kim, Dong-Min,Choi, Young Hwa,Choi, Won Suk,Jo, Yu Mi,Kwon, Hyun Hee,Jeong, Hye Won,Kim, Yeon-Sook,Kim, Jeong Elsevier 2018 INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES Vol.74 No.-

<P><B>Abstract</B></P> <P><B>Objectives</B></P> <P>This study aimed to characterize the risk factors for mortality in adult patients with invasive pneumococcal disease (IPD) stratified by age groups, after implementation of the national immunization program of 23-valent polysaccharide vaccine (PPSV23) for those aged ≥65 years in the Republic of Korea (ROK).</P> <P><B>Methods</B></P> <P>Clinical data and pneumococcal isolates from adult patients with IPD (≥18 years of age) were collected prospectively from 20 hospitals through the nationwide surveillance program from March 2013 to October 2015.</P> <P><B>Results</B></P> <P>A total of 319 patients with IPD were enrolled. Median age was 69 years. Overall in-hospital mortality was 34.2%: 17.1% in those aged 18–49 years, 23.7% in those aged 50–64 years, 33.0% in those aged 65–74 years, and 51.0% in those aged ≥75 years (<I>p<</I> 0.001). In particular, early death within 7days of hospitalization accounted for 60.6% (66/109). While old age (≥65 years), higher Pitt bacteremia score (≥4), and bacteremic pneumonia were independently associated with IPD mortality in all age groups, an additional mortality risk factor of immunocompromised status was identified for patients aged 50–64 years. PPSV23 serotypes accounted for 64.4% (122/189) of the pneumococcal isolates serotyped.</P> <P><B>Conclusions</B></P> <P>This study suggests that vaccine-type IPD continues to place a substantial burden on older adults in the ROK, necessitating an effective vaccination strategy for those at higher risk.</P> <P><B>Highlights</B></P> <P> <UL> <LI> National immunization of the elderly with the 23-valent polysaccharide vaccine (PPSV23) was implemented in Korea in 2013. </LI> <LI> Overall in-hospital mortality was 34.2% for adult invasive pneumococcal disease (IPD) and 51.0% for patients ≥75 years of age. </LI> <LI> Mortality risks were older age, higher bacteremia score, and immunocompromised status. </LI> <LI> An effective vaccination strategy for those at higher risk of IPD is needed. </LI> </UL> </P>

Suppression of peroxisome proliferator-activated receptor gamma-coactivator-1alpha normalizes the glucolipotoxicity-induced decreased BETA2/NeuroD gene transcription and improved glucose tolerance in diabetic rats.

Kim, Ji-Won,You, Young-Hye,Ham, Dong-Sik,Cho, Jae-Hyoung,Ko, Seung-Hyun,Song, Ki-Ho,Son, Ho-Young,Suh-Kim, Haeyoung,Lee, In-Kyu,Yoon, Kun-Ho Association for the Study of Internal Secretions 2009 Endocrinology Vol.150 No.9

<P>Peroxisome proliferator-activated receptor gamma-coactivator-1alpha (PGC-1alpha) is significantly elevated in the islets of animal models of diabetes. However, the molecular mechanism has not been clarified. We investigated whether the suppression of PGC-1alpha expression protects against beta-cell dysfunction in vivo and determined the mechanism of action of PGC-1alpha in beta-cells. The studies were performed in glucolipotixicity-induced primary rat islets and INS-1 cells. In vitro and in vivo approaches using adenoviruses were used to evaluate the role of PGC-1alpha in glucolipotoxicity-associated beta-cell dysfunction. The expression of PGC-1alpha in cultured beta-cells increased gradually with glucolipotoxicity. The overexpression of PGC-1alpha also suppressed the expression of the insulin and beta-cell E-box transcription factor (BETA2/NeuroD) genes, which was reversed by PGC-1alpha small interfering RNA (siRNA). BETA2/NeuroD, p300-enhanced BETA2/NeuroD, and insulin transcriptional activities were significantly suppressed by Ad-PGC-1alpha but were rescued by Ad-siPGC-1alpha. PGC-1alpha binding at the glucocorticoid receptor site on the BETA2/NeuroD promoter increased in the presence of PGC-1alpha. Ad-siPGC-1alpha injection through the celiac arteries of 90% pancreatectomized diabetic rats improved their glucose tolerance and maintained their fasting insulin levels. The suppression of PGC-1alpha expression protects the glucolipotoxicity-induced beta-cell dysfunction in vivo and in vitro. A better understanding of the functions of molecules such as PGC-1alpha, which play key roles in intracellular fuel regulation, could herald a new era of the treatment of patients with type 2 diabetes mellitus by providing protection from glucolipotoxicity, which is an important cause of the development and progression of the disease.</P>

베이커리 매장 내 구매촉진을 위한 사용자 경험 연구

김홍인(Kim, Hong In),양민혜(Yang, Min Hye),손상득(Son, Sang Deuk),김승인(Kim, Seung In) 한국디지털디자인협의회 2013 디지털디자인학연구 Vol.13 No.1

본 연구는 베이커리 매장 내 물리적 환경요소에 따른 감각 경험과 문화 체험 경험이 구매의사 및 브랜드 매력도에 미치는 영향 요인을 밝혀내어, 방문고객의 경험 만족 증진을 위한 개선점 도출 및 방향성 제시를 목적한다. 위 목적을 실현시키기 위한 문헌연구로서 구매의사에 영향을 미치는 매장 내 물리적 환경 요소와 사용자 및 브랜드 경험, 사용자 경험을 측정하는 방법론에 관한 이론적 토대를 마련하였으며, 이를 바탕으로 구매의사에 영향을 미치는 매장 내 물리적 환경소를 감각 경험 요소와 문화 체험 경험 요소로 구분 및 선정하였다. 연구의 객관적인 결과 도출을 위해 현재 업계 내 선두 브랜드인 파리바게트와 뚜레쥬르를 선정, 비교 평가를 실시하였다. 실증연구로서 물리적 환경요소를 기반으로 한 설문조사(questionnaire survey)와 포커스 그룹 인터뷰(focus group interview)를 병행하여 실시하였고, 섀도우 트랙킹(shadow tracking)을 통해 베이커리 매장 내에서의 고객 여정을 관찰하였다. 추가로 아이 트랙킹(eye tracking)을 통해 피 실험자의 실제 시선 산재도 및 집중도 등을 추적하여 인터뷰 응답내용에 따른 진위여부를 파악하는 등의 보완작업을 수행하였다. 위 실험을 통해 도출된 결론 및 제안 사항은 다음과 같다. 첫째, 고객 여정에 따른 경험요소, 즉 터치 포인트를 고려한 경험 스토리 구성이 필요하다. 둘째, 제품 자체의 매력도를 높이기 위해 물리적 환경요인이 종합적으로 고려되어야 한다. 셋째,사용자(고객) 시선에 따른 높이,각도 등이 고려된 효과적 디스플레이 진열방식이 이루어져야 한다. 넷째, 제품 정보와 관련된 시각물, 쟁반이나 집게, 의자, 테이블 등 고객의 편의성을 돕는 요소들의 사용성 관리가 중요하다. 본 연구의 궁극적 취지는 방문고객의 감각 경험에 근거한 구매요인 도출에 의의가 있으나, 매장 내 감각 경험 요소에만 주안점을 두었음에 연구의 한계점을 밝힌다. 따라서 향후 베이커리 매장의 물리적 환경 요소 중 문화 체험 경험 요소에 대한 추가적 보완연구가 이루어진다면 베이커리 업체의 충성고객을 확보하기 위한 전략 수립에 도움이 될 것이다. The objectives of this study are, to define in-store environment affects shoppers" sensory and cultural experiences can affect purchase decision making and brand preferences, and to develop to-be-direction of shoppers’ experience enhancement to increase their satisfaction in bakery industry. We divided the physical environment elements, influencing shoppers in their purchase decision making, into sensual elements and cultural experiences elements from the preliminary theory. And we validated those two category of elements by filed-validating Paris Baguette and Tous les Jour. For field research, we have tried to find shoppers insight through survey and focus group interview, observed shoppers" path in stores by shadow tracking, tracked down shoppers" eye-sight by eye tracking and validated research data by field visits. Based on implication from the research, we suggest the followings: To organize shoppers experience storyline considering touch points in shoppers’ path in stores. Physical environment should be strategically considered to increase product preference. Product display should be based on height and angle of shoppers" eye-sight. Usability maintenance of POP, plate, tongs, table and chair is also very important. However, it also shows some limits by focusing mainly in sensory experiences in stores. If it is followed by additional study of shoppers interactive and cultural experiences in stores, it will be more helpful to establish strategy of increasing loyal shoppers in bakery industry.

디자인 대학원 작품논문 표절방지를 위한 교육 체계 및 콘텐츠 개발

김지인(Kim, Ji In),박혜신(Park, Hye Sin),서인숙(Seo, Ihn Sook) 한국디지털디자인협의회 2015 디지털디자인학연구 Vol.15 No.3

연구윤리에 대한 인식이 높아지면서 연구윤리 교육이 확산추세에 있다. 그러나 현재의 연구윤리 교육은 단발성 특강형의 교육 중심으로 실행되고 있으며, 학과 특성에 적합한 교육 체계가 미비하다는 점에서 한계를 가지고 있다. 이에 본 연구는 디자인 석사학위 과정에 있는 학생의 논문 지도에 있어 표절을 미연에 방지할 수 있는 연구윤리 교육체계를 구축하되 특히 예술계에서만 존재하는 작품논문이라는 형식에 적합한 교육체계를 구축하기 위한 목적으로 이루어졌다. 연구는 디자인학부 석사학위 과정학생 10명을 대상으로 총 17개월 걸친 참여관찰을 통해 이루어졌으며 연구윤리 교육 콘텐츠의 제작, 교육 및 자료수집, 교육 결과의 피드백 및 기존 콘텐츠의 수정보완, 수정 보완 된 콘텐츠를 적용한 연구 시행, 결과 분석 총 5단계에 걸쳐 단계적으로 이루어졌다. 각각의 단계에서는 교육을 통한 콘텐츠 활용도 검증, 심층면접을 통한 연구 결과의 학계검증, 연구윤리 교육 참여자들의 논문 작성 및 표절률 검사라는 객관적 검증 장치를 두었다. 연구 과정에서 학술연구윤리 교육 콘텐츠, 디자인 연구윤리 교육 콘텐츠 두 종류의 교육 콘텐츠가 개발되었으며 논문리스트 작성노트, 디자인 연구노트, 인용연습노트 총 3개의 활용 콘텐츠가 개발되었다. 결과적으로 연구주제의 구체화 과정에서 논문리스트 작성노트를 활용한 논문 주제 독창성 검증, 논문 텍스트 작성 과정에서 인용노트 활용을 통한 인용 관련 표절여부 검증 및 디자인 연구노트 활용을 통한 작품 표절여부 검증, 최종적으로 카피검사 시스템 활용을 통한 정량적 표절률 검사의 3단계에 걸친 작품논문의 표절 예방 검증 교육체계가 구축되었다. With the growing awareness of research ethics, the education for it is being disseminated. However, it is having a limitation given that the current education of research ethics is centered on special lectures in short-term period, and department-specific educational system is lack. In respect of teaching students about thesis in graduate school, this study aims to establish an educational system to prevent plagiarism in advance, matching the environment where there is thesis portfolio for graduation only in art school. The research has been conducted with ten graduate school students in design department for 17 months in total through participatory observation, and is consisted of five stages: making educational contents of research ethics, collecting data, giving feedback of the education and evaluating or revising existing contents, conducting a research after applying the correction, and analyzing the result. We put objective verification tools at each stage such as verification of contents utilization through education, academic verification of the research result through in-depth interview, and inspection of thesis portfolio production and plagiarism rate by educational participants in research ethics. In the process of the research, educational contents of academic research and design research ethics were developed and three kinds of utilization contents, thesis list-writing note, design research note, and reference note, were made. As a result, it has become to set up three phases of plagiarism prevention measures: verifying creativity of thesis subject by utilizing thesis list-writing note in the embodiment process, verifying plagiarism relating to reference and artwork by utilizing reference note and design research note in the process of making thesis artwork, and verifying quantitatively through copy inspection system.

Probing the Issue of Informed Consent in Health Care in Korea―Concept Analysis and Guideline Development

Won-Hee Lee,In-Sook Kim,Byung-Hye Kong,Sue Kim,Sunhee Lee 한국간호과학회 2008 Asian Nursing Research Vol.2 No.2

Purpose The purpose of the study was to identify how informed consent is conceptualized by patients, family members, physicians, and nurses in Korea, and to develop guidelines for clinical practice in Korea. Methods This study employed the hybrid model to define the concept of informed consent through theoretical and fieldwork phases. For the theoretical phase, attributes of informed consent were identified through a review of the literature, and in-depth interviews were conducted for the fieldwork phase to develop attributes from the data and to verify the attributes identified from the literature review. Purposive sampling was done for 48 participants (12 patients, 12 family members, 12 physicians, 12 nurses), who were interviewed from selected units (orthopedics, cardiothoracic surgery, obstetrics/gynecology) from two university hospitals in Seoul and Kwangju, Korea. Attributes and processing issues of informed consent were extracted from both phases. Results Core attributes of informed consent include the patient’s self-directed decision-making, fulfillment of legal responsibility, focusing on forging a trusting relationship, assuming active responsibility for explanations (physicians) and granting consent (patient), factors related to sufficient explanation, and the role of family. Findings were integrated into a set of guidelines for patients and family and health care professionals. Conclusion The guidelines developed in the present study offer empirical parameters for an effective process of obtaining informed consent in Korea by seeking to decrease the gap in perceptions of informed consent among patients, family members, physicians, and nurses. The importance of advocating patients and developing a trusting relationship between health care providers and patients is especially noteworthy. [Asian Nursing Research 2008;2(2):102–112] Purpose The purpose of the study was to identify how informed consent is conceptualized by patients, family members, physicians, and nurses in Korea, and to develop guidelines for clinical practice in Korea. Methods This study employed the hybrid model to define the concept of informed consent through theoretical and fieldwork phases. For the theoretical phase, attributes of informed consent were identified through a review of the literature, and in-depth interviews were conducted for the fieldwork phase to develop attributes from the data and to verify the attributes identified from the literature review. Purposive sampling was done for 48 participants (12 patients, 12 family members, 12 physicians, 12 nurses), who were interviewed from selected units (orthopedics, cardiothoracic surgery, obstetrics/gynecology) from two university hospitals in Seoul and Kwangju, Korea. Attributes and processing issues of informed consent were extracted from both phases. Results Core attributes of informed consent include the patient’s self-directed decision-making, fulfillment of legal responsibility, focusing on forging a trusting relationship, assuming active responsibility for explanations (physicians) and granting consent (patient), factors related to sufficient explanation, and the role of family. Findings were integrated into a set of guidelines for patients and family and health care professionals. Conclusion The guidelines developed in the present study offer empirical parameters for an effective process of obtaining informed consent in Korea by seeking to decrease the gap in perceptions of informed consent among patients, family members, physicians, and nurses. The importance of advocating patients and developing a trusting relationship between health care providers and patients is especially noteworthy. [Asian Nursing Research 2008;2(2):102–112]

서울 단일 지역의 Helicobacter pylori 1차 제균율과 2차 제균율의 변화

김미연,심기남,김혜인,강현주,류민선,안소영,정혜경,정성애 Ewha Womans University School of Medicine 2014 EMJ (Ewha medical journal) Vol.37 No.1

Objectives: To investigate the rate of first-line eradication and the rate of second-line eradication of Helicobacter pylori (H. pylori) from 2001 to 2010 in a single institute in Seoul. Methods: Among the 2,717 patients who received H. pylori eradication treatment from 2001 to 2010 at Ewha Womans University Mokdong Hospital, the medical records of 1,466 patients who satisfied the condition of execution of upper gastrointestinal endoscopy, positive H. pylori eradication results at 6~8 weeks after eradication therapy were reviewed retrospectively. Then the first-line and second-line eradication rates and the eradication rates according to endoscopy findings were also compared. Results: The first-line eradication rate was 77% H. pylori eradication rate for the last 5 years was continuously increasing and no sign of decline was observed even for the whole 10 years. The rates of eradication related to endoscopic findings showed statistical significance (P<0.001) of 79.8% and 70.1% each for peptic ulcer and non-ulcerative gastric diseases, respectively. Conclusion: In this study, no decrease in tendency of first-line eradication rate could be found. In addition, the patients with the non-ulcerative gastric disease seemed to show significantly lower eradication rate. This finding suggests eradication treatment may be affected by the category of gastric diseases, and careful considerations should be taken assessing the effects and needs for the H. pylori eradication treatment.

다양한 진로모색을 위한 치위생학과 학생과 선배 치과위생사의 심층면담

경혜인 ( Hye In Kyung ),김영우 ( Young Woo Kim ),엄제현 ( Jae Hyun Eom ),이지희 ( Ji Hui Lee ),조은정 ( Eun Jung Cho ),박고은 ( Go Eun Park ),김남희 ( Nam Hee Kim ) 한국치위생과학회 2015 치위생과학회지 Vol.15 No.2

The aim of this study was to provide practical information regarding career exploration to dental hygiene students. This study interviewed 15 senior dental hygienists (graduates of Y University Dental Hygiene program) who have worked in non-clinical fields for about three months from January 14, 2014 to April 28. The most frequently mentioned pieces of information that the senior dental hygienists wanted to convey to dental hygiene students were as followed. Contrary to popular belief, clinical experience was also required in non-clinical fields as the importance of clinical experience was quite often and widely emphasized and applied in such fields. High academic excellence and clinical performance were expected of junior dental hygienists and the senior dental hygienists expressed their hope for their juniors to pioneer new fields and areas of work that a dental hygienist can do. Most of the senior dental hygienists pointed out that to develop technical tools for career exploration as early as possible, such as during undergraduate years and to think about which career path to take, whether it is clinical or academic were significantly important factors for desirable career outcomes. Based on the results of this study, undergraduate dental hygiene students should be provided with opportunities to consider and explore various career paths during their undergraduate years and to communicate with their seniors for hands-on experience-based advices. This would in turn broaden each student`s perspective beyond their knowledge or thought about the professional filed of dental hygiene. It was found that the majority of the senior dental hygienists agreed that their clinical experience was the source of their self-competence as a dental hygienist. Our study could be utilized as a valuable resource for future dental hygienists who wish to work in non-clinical fields.

전기솥과 압력솥을 이용한 기능성 강화쌀과 일반쌀의 취반 특성 연구

김혜영,김지연,이인선 한국식생활문화학회 2004 韓國食生活文化學會誌 Vol.19 No.3

The Physicochemical, sensory and cooking properties of functionally fortified rice with dietary fiber and chitosan were compared with regular rice when the rices were cooked with pressure and electric cookers. Moisture content of functional rice before cooking was 11.11%, which was lower than 13.72% in regular rice. Accordingly, moisture contents of functional rice samples cooked both with pressure and electric cookers were lower than those of regular rice. L value showing the degree of lightness of cooked rice was significantly higher in rice samples cooked with pressure cookers. The a value, the degree of redness and the b value, the degree of yellowness, were the highest in the functional rice cooked with an electric rice cookers. Textural measurement of hardness using a rheometer showed the highest value in functional rice cooked with a pressure cooker. The degree of gelatinization measured using differential scanning calorimetry (DSC) before cooking showed higher onset gelatinization temperature (T_0) and peak gelatinization temperature (T_p) in functional rice compared with those in regular rice. The gelatinization enthalpy (ΔH) of functional rice was lower than that of regular rice, showing that functional rice had lower gelatinization energy compared with regular rice. When the samples were stored in a refrigerator for one week, the DSC showed faster retrogradation degrees in samples cooked with electric rice cooker, having significantly higher enthalpies of regular and functional rice cooked with electric cookers compared to those cooked with pressure cookers. The functional rice samples cooked with pressure cooker had higher consumer acceptance test values compared to those cooked with electric cookers.

절제된 정상위벽의 자기공명영상기법에 관한 연구:조직소견과의 비교

서보경,설혜영,이남준,차인호,정규병,김정혁,박철민,이지영,Seo, Bo-Gyeong,Seol, Hye-Yeong,Lee, Nam-Jun,Cha, In-Ho,Jeong, Gyu-Byeong,Kim, Jeong-Hyeok,Park, Cheol-Min,Lee, Ji-Yeong 대한영상의학회 2001 대한영상의학회지 Vol.45 No.5

목적:급속자기공명영상기법을 이용하여 절제된 정상위벽을 관찰하고,이를 조직소견과 비교 연구하여,위벽의 관찰을 위한 최적기법을 찾고자 하였다. 대상과 방법:25명 환자의 모두 41개 절제된 정상위조직을 수술후 수지(polyethylene)통에 넣고,생리식염수로 채워 자기공명영상을 시행하였다.T1강조FLASH,지방억제T1강조FLASH, T2강조TSE와 True-FISP 등 4가지 기법으로 위조직의 영상을 얻었다.자기공명영상에서는 위벽의 층수와 각층의 신호강도를 관찰하였고,이를 조직소견과 비교하였다.자기공명영상소견을 조직소견과 비교한 후 위벽 각층의 명확성과 각층간의 구분,및 전체 영상의 질에 대하여 비교하였다.4가지 기법 중 가장 좋은 방법은 3,가장 나쁜 방법은 0으로 하여 등급을 판정하였다. 결과:자기공명영상에서 위벽의 층수는 T1강조FLASH에서 2층이 41예 중 6예(14.6%),3층 31예(75.6%),및 4층 4예(9.8%)였고,지방억제T1강조FLASH에서 2층 6예(14.6%)와 3층 35예(85.4%),T2강조TSE에서 3층 24예(58.5%),4층 11예(26.8%),및 5층 6예(14.6%)였으며,True-FISP에서 1층 2예(4.9%),2층 8예(19.5%),3층 23예(56.0%),4층은 4예(9.8%), 및 5층 4예(9.8%)이었다.위벽의 신호강도는 T1강조FLASH와 지방억제T1강조FLASH에서 2층으로 보인 예는 위내강으로부터 고-중등도,3층인 경우는 고-저-고/중등도,4층인 예는 고-저-고-중등도신호강도였다.T2강조TSE에서는 3층으로 보인 예는 등도/고-저-중등도,4 층인 경우는 중등도-저-고-중등도/저,5층인 예는 저-고-저-고-저신호강도였다.자기공명 영상소견을 조직소견과 비교하였을 때 위벽이 3층으로 보인 경우 이것은 “점막층-점막하층-근층 ”에 해당하였다.관찰한 3가지 면 모두에서 T1강조FLASH,지방억제T1강조FLASH,T2강조TSE 기법이 True-FISP보다 통계적으로 유의하게 우수하였다(p=0.001).점막층의 명확성에 있어서 가장 우수한 기법은 T1강조FLASH와 지방억제T1강조FLASH이었고(p<0.05),점막하층의 명확성과 점막하층과 근층간의 구분은 T2강조TSE가 가장 우수하였다(p<0.05).전체적인 영상의 질은 T1강조FLASH와 T2강조TSE에서 가장 우수하였다(p<0.05). 결론:자기공명영상은 위벽의 각 층을 구별할 수 있는 우수한 검사로 조직소견과 높은 연관성을 보이며,전체 영상의 질,점막하층의 명확성 및 점막하층과 근층간의 구분이 T2강조TSE에서 가장 우수한다. Purpose: To evaluate normal human gastric wall layers in vitro using magnetic resonance*(MR) imaging, to correlate the results with the histologic findings, and to determine the optimal technique for evaluation of the gastric wall. Materials and Methods: Forty-one normal resected gastric specimens obtained from 25 patients were dissected and placed in a polyethylene tube filled with normal saline. MR imaging with four MR sequences, T1-weighted FLASH*(T1FLASH), fat-saturated T1-weighted FLASH, T2-weighted TSE*(T2TSE), and True-FISP, was performed. The number of gastric wall layers and signal intensity of each layer were determined, and after correlating MR images with the histologic findings, the conspicuity of each layer*(mucosa, submucosa, and muscle), the distinction between each layer, and overall image quality were assessed. results: The gastric wall was shown by TIFLASH to have two (n=6, 14-6%), three (n=31, 75.6%) and four layers (n=4, 9.8%); by fat-saturated TIFLASH to have two (n=6, 14.6%) and three (n=35, 85.4%) ; by T2TSE to have three (n=24, 58.5%), four (n=11, 26.8%), and five (n=6, 14.6%); and by True-FISP to have one (n=2, 4.9%), two (n=8, 19.5%), three (n=23, 56%), four (n=4, 9.8%), and five (n=4, 9.8%) . The signal intensity of each layer at T1FLASH and fat-saturated T1FLASH was high-intermediate from the lumen in two-layer cases, high-low-high/intermediate in three-layer cases, and high-low-high-intermediate in four-layer cases. The signal intensity of each layer at T2TSE was intermediate/high-low-intermediate in three-layer cases, intermediatelow-high-intermediate/low in four-layer cases, and low-high-low-high-low in five-layer cases. Three-layered gastric wall corresponded mostly to mucosa, submucosa, and muscle from the inner to outer layers, respectively. T1FLASH, fat-saturated T1FLASH, and T2TSE were superior to True-FISP in evaluating the gastric wall. T1FLASH and fat-saturated T1FLASH were the best sequences for demonstrating mucosa (p<0.05), and T2TSE was the best for submucosa and the distinction between this and muscle (p<0.05). Both T1FLASH and T2TSE provided the best overall image quality (p<0.05). Conclusion: In-vitro MR imaging is an excellent technique for the evaluation of layers of normal gastric wall. T2TSE is the sequence which best demonstrates the conspicuity of submucosa, the distinction between submucosa and muscle, and overall image quality.

EGFR 돌연변이와 ROS1 전위를 동시에 가진 폐선암 환자의 Erlotinib 치료 1예

김민환,박예현,박혜정,지아영,송창호,진무년,김영주,김선욱,이중희,김인수,김혜련,김주항,조병철 Ewha Womans University School of Medicine 2014 EMJ (Ewha medical journal) Vol.37 No.1

The rearrangement of c-ros oncogene 1 (ROS1) has been recently identified as an important molecular target in non small cell lung cancer (NSCLC). ROS1 rearrangement and epidermal growth factor receptor (EGFR) mutation were mutually exclusive each other in previous studies, and the clinical implication of co-existence of the two genetic alterations has not been determined. We report a case of 46-year-old female never-smoker NSCLC patient whose tumor harbored ROS1 rearrangement and EGFR mutation concomitantly. She had undergone curative surgery for stage IIIA NSCLC, and the recurrence in left pleura and brain occurred at 2 years after the surgery. She received several lines of chemotherapy including docetaxel plus carboplatin, erlotinib, pemetrexed, and gemcitabine. Erlotinib therapy showed a favorable treatment response with progression-free survival of 9.5 months and partial response of tumor on radiologic evaluations. This case represents a successful erlotinib treatment in a NSCLC patient with concurrent ROS1 rearrangement and EGFR mutation.