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Tracking glymphatic dysfunction in isolated rapid eye movement sleep behavior disorder: a longitudinal neuroimaging study
No full textPURPOSE: This study aimed to investigate baseline diffusion tensor imaging along the perivascular space (DTI-ALPS) index differences between patients with isolated REM sleep behavior disorder (iRBD) who progressed to a neurodegenerative disease (iRBD-C) and those who did not (iRBD-NC), and to assess the longitudinal changes in the DTI-ALPS index. METHODS: We prospectively studied a cohort of 48 iRBD patients (minimum three-year follow-up) and 20 age- and sex-matched Healthy controls. All participants underwent magnetic resonance imaging. The DTI-ALPS index was then calculated and its values were compared among the iRBD-C, iRBD-NC, and control groups. Twenty-nine iRBD patients and 5 controls were rescanned after a mean of 41 months, and during the total follow-up period (mean = 4.5 years), 14 patients converted. RESULTS: The iRBD-C group showed significantly lower DTI-ALPS indices at baseline compared to the control group (left: p = 0.009; right: p = 0.019). However, there was no significant difference between the iRBD-NC group and the control group. Furthermore, the iRBD-C group showed a lower DTI-ALPS index in the right hemisphere than the iRBD-NC group (p = 0.013). The longitudinal analysis showed a reduction in the ALPS index in patients with iRBD bilaterally. The baseline DTI-ALPS index was associated with baseline and longitudinal changes in cognitive function scores. CONCLUSION: The baseline DTI-ALPS index may be a promising biomarker for predicting iRBD patients at risk for conversion to alpha-synucleinopathy. The decrease in the ALPS index observed over time may reflect progressive neurodegenerative processes
Association between lean mass and the risk of metabolic syndrome in Korean children and adolescents: data from the Korea National Health and Nutrition Examination survey
No full textSkeletal muscle is considered an endocrine and paracrine organ that has metabolic effects, and several studies have shown a positive association between muscle mass and insulin sensitivity. However, results on the relationship between muscle mass and metabolic syndrome in children and adolescents remain inconsistent. Body composition consists primarily of lean and fat mass, with lean mass being closely associated with body size. Since muscle constitutes a part of lean mass, the contribution of muscularity can be evaluated more accurately by assessing lean mass relative to fat mass, which is inversely associated with body size. This study utilized nationally representative data to assess the association between lean mass (measured via dual-energy X-ray absorptiometry) and the risk of metabolic syndrome. Model 1 was adjusted for age, sex, physical activity, alcohol consumption, smoking status, household income, and rural residence. Model 2 was based on Model 1 and the fat mass index. The odds ratio of lean mass was 1.6 (95% CI 1.4-1.8) and 2.0 (95% CI 1.8-2.3) in Model 2 and Model 1, respectively. However, the lean-to-fat mass ratio showed a strong inverse association with metabolic syndrome (adjusted odds ratio 0.2 [95% CI 0.1-0.3]), suggesting a protective effect of a greater proportion of lean mass relative to fat mass. These findings suggest that the balance of body composition plays an important role in metabolic risk. Both lean mass and fat mass need to be considered when evaluating metabolic risk in children and adolescents
Real-world treatment outcomes in South Korean patients with epidermal growth factor receptor-mutant non-small cell lung cancer
No full textBACKGROUND/AIMS: This study aimed to assess the real-world treatment outcomes in South Korean patients with epidermal growth factor receptor (EGFR)-mutant non-small cell lung cancer (NSCLC) receiving first-line (1L) EGFR tyrosine kinase inhibitors (TKIs). METHODS: We used the Health Insurance Review and Assessment Service database, which includes the data of a large proportion of the Korean population. Patients with EGFR-positive NSCLC who received gefitinib, erlotinib, or afatinib as the 1L treatment between 2012 and 2018 were included. Survival outcomes, subsequent therapies, and treatment patterns were analyzed. RESULTS: Among the 9,478 patients included, gefitinib (56.68%) was the most commonly prescribed 1L EGFR-TKI, followed by afatinib (25.30%) and erlotinib (18.02%). The median time to next treatment was 16.4 to 18.8 months. Overall survival (OS) was significantly different among the three treatment groups; the median OS was 28.8, 25.3, and 23.9 months for patients who were treated with afatinib, gefitinib, and erlotinib, respectively (p < 0.001). For the patients who received second-line (2L) therapy (n = 4,904, 51.74%), pemetrexed monotherapy was most commonly used (47.70%), followed by osimertinib (21.59%). Patients who received osimertinib as the 2L treatment had longer OS compared to those receiving pemetrexed (median OS: not reached vs. 25.3 to 28.8 months). CONCLUSION: Our real-world study demonstrated survival outcomes that were comparable to those observed in clinical trials for patients with EGFR-mutant NSCLC treated with EGFR-TKIs. Detection of the acquired T790M mutation and subsequent osimertinib treatment had significant prognostic value
Comparison of clinical outcomes for single- and double-balloon enteroscope-assisted endoscopic retrograde cholangiopancreatography in patients with surgically altered anatomy
No full textBACKGROUND: Balloon-assisted enteroscopy with a specialized overtube has improved the success of endoscopic retrograde cholangiopancreatography (ERCP) in patients with surgically altered anatomy (SAA). However, direct comparative data between double-balloon enteroscopy (DBE) and single-balloon enteroscopy (SBE) remain limited. AIM: To compare the ERCP-related outcomes between DBE and SBE in patients with SAA. METHODS: We retrospectively reviewed the medical records of 1042 patients with SAA who underwent ERCP. After propensity score matching for age and sex, 494 patients were included, with 247 patients in each of the SBE and DBE groups. RESULTS: The success rates of intubation, cannulation, completion of intended ERCP, and adverse events were similar between the DBE and SBE groups (94.3% vs 96.4%, P = 0.393; 89.5% vs 93.5%, P = 0.147; 88.3% vs 92.7%, P = 0.125; 10.5% vs 14.6%, P = 0.222, respectively). However, the SBE group had significantly longer intubation and procedure times than the DBE group (23.5 +/- 22.3 minutes vs 14.1 +/- 13.5 minutes, P < 0.001; 65.2 +/- 37.9 minutes vs 31.0 +/- 18.5 minutes, P < 0.001). Preserved gastric anatomy and Roux-en-Y reconstruction were independently associated with intubation failure (odds ratio = 3.18, 95% confidence interval: 1.30-8.31; odds ratio = 8.65, 95% confidence interval: 1.71-157.60, respectively). CONCLUSION: DBE and SBE showed comparable clinical success and safety profiles in ERCP for patients with SAA, although SBE required significantly longer procedure times. DBE could provide procedural efficiency benefits in cases where an extended procedure duration is expected. Furthermore, a preserved gastric anatomy and Roux-en-Y reconstruction were identified as independent risk factors for intubation failure
상급초보 간호사의 직무착근도 영향요인
No full textMasterⅠ. 서론 1
A. 연구의 필요성 1
B. 연구목적 4
C. 용어정의 5
Ⅱ. 문헌고찰 7
A. 상급초보 간호사 7
B. 임상 간호사의 직무착근도 9
C. 임상 간호사의 직무착근도 영향요인 11
Ⅲ. 연구방법 18
A. 연구설계 18
B. 연구대상 18
C. 연구도구 19
D. 자료수집방법 22
E. 자료분석방법 23
F. 윤리적 고려 24
Ⅳ. 연구결과 25
A. 대상자의 일반적 특성 25
B. 대상자의 직무착근도, 긍정심리자본, 간호근무환경 정도 27
C. 대상자의 일반적 특성에 따른 직무착근도의 차이 29
D. 대상자의 긍정심리자본, 간호근무환경, 직무착근도 간의 상관관계 31
E. 대상자의 직무착근도 영향요인 32
V. 논의 34
A. 상급초보 간호사의 직무착근도, 긍정심리자본, 간호근무환경 정도 34
B. 상급초보 간호사의 직무착근도 영향요인 37
VI. 결론 및 제언 41
참고문헌 43
부 록 5
희소돌기교세포와 허혈성 백질 손상의 실험적 모델
No full textDoctorⅠ. INTRODUCTION 1
1. Oligodendrocytes and the oligodendrocyte lineage 1
2. Experimental models of oligodendrocytes and related diseases 3
3. Development of experimental models for research on oligodendrocytes and ischemic white matter injury 4
Ⅱ. MATERIALS & METHODS 6
1. Animals 6
2. The E3 method for primary OL culture 6
3. Primary OL culture (shaking method) 10
4. Cryopreservation of primary OPCs (E3 method) 10
5. EdU proliferation assay 11
6. WST-8 cell viability and proliferation assay 11
7. Genetic manipulation 12
8. One-step myelinating OL/neuron co-culture 13
9. Oxygen-glucose deprivation (OGD) 13
10. Cell death assays 14
11. In vivo hypoxia 14
12. Spectral Confocal Reflectance (SCoRe) microscopy 15
13. Immunofluorescence 15
14. Immunoblotting 16
15. Image analyses 16
16. Statistical analysis 18
Ⅲ. RESULTS 19
Part I: Development of the E3(Easy, Efficient, Effective) method for primary oligodendrocyte culture from neonatal rodent brains. 19
1. The necessity for the de novo development of a primary OL culture method 19
2. Trials with density gradient centrifugation and the discovery of a two-step differential centrifugation to isolate OPCs 27
3. Optimization of OPC proliferation media formulae 31
4. Cell death during OL differentiation and the need for the passaging of crowded OPC colonies 36
5. Optimization of OL differentiation media formulae 46
6. Applicability of the E3 method to C57BL/6 mice 51
7. In vitro myelination of OLs cultured through the E3 method 53
Part II: Cryopreservation of primary OLs, and spatial/morphological analyses to evaluate in vitro OL function. 56
1. Cryopreservation of primary OLs cultured through the E3 method 56
2. In vitro functional validity of cryopreserved OLs 60
3. Poisson point process-based evaluation of the spatial distribution of OPCs 65
4. Sholl analysis and fractal dimensionality analysis to assess the morphological complexity of mature OLs 68
Part III: Adjunctive experimental methods for in vitro primary OLs. 71
1. Genetic manipulation of primary rat OPCs 71
2. Modification of the E3 method for adult rodent brains 75
3. One-step neuron-OL myelinating co-culture 77
4. The role of osmolarity in OPC proliferation and OL differentiation 81
Part IV: In vitro and in vivo experimental models of ischemic white matter injury. 83
1. In vitro oxygen-glucose deprivation (OGD) 83
2. Cell death and damage assays to evaluate OL injury after OGD 88
3. In vivo rodent model of neonatal hypoxic-ischemic encephalopathy (HIE) 91
4. Label-free detection of myelin and myelin damage 93
Ⅳ. DISCUSSION 95
Ⅴ. REFERENCES 10
Rosmarinic acid의 퇴행성 관절염 치료 효과 및 염증성 연골 손상 억제 메커니즘 분석
No full textMasterI. Introduction 1
II. Material and Methods 8
1. Regents and Treatments 8
2. Primary mouse articular chondrocyte culture 8
3. Cytotoxicity analysis 8
4. RNA Extraction and Amplification of Gene Transcripts by RT-PCR and qPCR 9
5. Western blotting 11
6. Culture of cartilage explants and Alcian blue staining 12
7. Induction of experimental osteoarthritis and intra-articular injection (i.a) 12
8. Cartilage tissue histology and immunohistochemistry 13
9. Immunoprecipitation (IP) 14
10. Statistical analysis 14
III. Results 16
1. RosA does not exhibit cytotoxicity in chondrocytes and suppresses IL-1β-induced catabolic factor 16
2. RosA reduces IL-1β-mediated cartilage matrix loss in cartilage explants 19
3. RosA alleviates cartilage degradation in a mouse model of DMM-induced OA 22
4. Inhibitory effects of RosA on NF-κB-mediated signaling in osteoarthritic conditions 25
5. RosA promotes cartilage matrix synthesis via upregulation of Sox9 and ECM-associated genes 28
IV. Discussion 34
V. Reference 37
국문 초록 4
탈회 골 기질 기반 삼중구역 반월판 지지체 제작
No full textMaster제1장 서론 1
제1절 연구 배경 및 목적 1
제2장 연구방법 9
제1절 연구 재료 및 방법 9
가. 화학 물질, 시약 및 조직 9
나. 탈회골 기질 (Demineralized bone matrix: DBM) 지지체 제작 9
다. 탈세포화된 반월상 연골 세포외기질(Decellularized Meniscus Extracellular Matrix: DMECM) 하이드로겔 제조 10
라. 구획특이적 DBM+DMECM 지지체 제작 12
제2절 실험 방법 13
가. 물리화학적 특성 분석 13
나. 생화학적 특성 분석 16
다. 생체 적합성 평가 21
라. 체외 섬유연골 분화 유도능 평가 25
마. 누드 마우스 피하 이식 모델에서의 섬유연골 분화 유도능 평가 26
바. 통계 분석 30
제3장 연구 결과 31
제1절 탈회골 기질 지지체의 물리화학적 특성 분석 31
제2절 반월상 연골 유래 탈세포외기질 하이드로겔의 생화학적 특성 분석 33
제3절 구획특이적 반월상 연골 인공 지지체의 제작 36
가. 반월상 연골 유래 탈세포외기질 하이드로겔의 농도 최적화 36
나. 탈회골 기질 내 하이드로겔의 코팅 횟수 최적화 39
다. 구역 특이적 반월상 연골 유래 탈세포외기질 하이드로겔이 코팅된 탈회골 기질 지지체의 제작 43
제4절 체외 생체적합성 평가 및 섬유연골 분화 유도능 평가 46
제5절 체외 누드 마우스 피하 이식 후 생화학적 및 기계적 평가 50
제6절 누드 마우스 피하 이식 후 섬유연골 조직 형성능 평가 53
제4장 고찰 57
제5장 결론 68
Reference 69
Abstract 8
젊은 남성에서의 혈청 요산 대 크레아티닌 비와 대사증후군의 연관성
No full textMasterⅠ. 서론 1
1. 연구의 배경 및 필요성 1
2. 연구의 목적 5
Ⅱ. 연구방법 6
1. 연구대상 6
2. 연구설계 8
3. 연구변수 9
4. 분석방법 13
Ⅲ. 연구결과 14
1. 인구사회학적 특성 16
2. 건강행태 및 만성질환 이환, 대사증후군 특성 18
3. 인구사회학적 특성에 따른 혈청 요산 대 크레아티닌 비(SUA/Cr) 분포 20
4. 건강행태 및 만성질환 이환 특성에 따른 혈청 요산 대 크레아티닌 비(SUA/Cr) 분포 22
5. 인구사회학적 특성에 따른 대사증후군 여부 24
6. 혈청 요산 대 크레아티닌 비(SUA/Cr) 삼분위에 따른 대사증후군 여부 26
7. 건강행태 및 만성질환 이환 특성에 따른 대사증후군 여부 27
8. 혈청 요산 대 크레아티닌 비(SUA/Cr)와 대사증후군의 연관성 29
9. 혈청 요산 대 크레아티닌 비(SUA/Cr)의 대사증후군 예측력 비교 (ROC 곡선) 30
Ⅳ. 고찰 31
Ⅴ. 결론 37
참고문헌 38
부록 43
ABSTRACT 5
노인의 건강노화 수준의 지역 간 차이 및 관련 요인
No full textDoctor제1장 서론 1
제1절 연구의 필요성 1
제2절 연구 목적과 연구 문제 3
제2장 이론적 고찰 4
제1절 건강노화 4
1. 건강노화의 개념 4
2. 건강노화의 중요성 7
3. 건강노화의 영역 8
제2절 건강노화지수 11
제3절 건강노화와 지역사회 14
1. 지역의 개념화 14
2. 건강노화와 지역사회 환경 15
3. 지역 수준 요인 16
제3장 연구 방법 24
제1절 연구 설계 24
제2절 연구 대상 및 분석 변수 25
1. 연구 대상 및 분석 자료 25
2. 종속변수 26
3. 독립변수 29
제3절 분석 방법 35
1. 기초통계분석 35
2. 다층모형분석 36
제4장 분석 결과 37
제1절 기초통계분석 37
1. 건강노화지수 분포 37
2. 건강노화지수 상위 25%와 하위 25% 지역의 건강노화 수준 비교 42
3. 건강노화 관련 요인 45
제2절 다층모형분석 49
제5장 고찰 53
제1절 건강노화지수 53
제2절 건강노화 수준 55
제3절 건강노화 관련 요인 57
1. 개인 수준 요인 57
2. 지역 수준 요인 59
3. 개인 및 지역 수준 요인 62
제6장 결론 및 제언 65
제1절 결론 65
제2절 제언 67
참고문헌 68
부록 87
Abstract 9