국토계획과 환경계획체계의 연계방안 연구(A study on the linkage of spatial planning and environmental planning system toward sustainable development)

노트 : 이 연구보고서의 내용은 국토연구원의 자체 연구물로서 정부의 정책이나 견해와는 상관없습니다

실시간 이미지 편집을 위한 GAN 내 잠재의 공간차원 활용

학위논문 (석사) -- 서울대학교 대학원 : 공과대학 컴퓨터공학부, 2021. 2. 유승주.Generative adversarial networks (GANs) have been successful in synthesizing and manipulating synthetic but realistic images from latent vectors. However, it is still challenging for GANs to manipulate real images, especially in real-time. State-of-the-art GAN-based methods for editing real images suffer from time-consuming operations in projecting real images to latent vectors. Alternatively, an encoder can be trained to embed real images to the latent space instantly, but it loses details drastically. We propose StyleMapGAN, which adopts a novel representation of latent space, called stylemap, incorporating spatial dimension into embedding. Because each spatial location in the stylemap contributes to its corresponding region of the generated images, the real-time projection through the encoder becomes accurate as well as editing real images becomes spatially controllable. Experimental results demonstrate that our method significantly outperforms state-of-the-art models in various image manipulation tasks such as local editing and image interpolation. Especially, detailed comparisons show that our local editing method successfully reflects not only the color and texture but also the shape of a reference image while preserving untargeted regions.적대적 생성 신경망(GAN)은 실존하지 않지만, 실제 존재하는 것 같은 이미지들을 생성하는데 성공적으로 이용되고 있다. 또한 각 이미지를 생성하는 잠재 벡터를 이용해 가짜(실존하지 않는) 이미지들을 편집할 수 있다. 그러나 가짜 이미지가 아닌 실제 이미지를 편집하는 것은 어렵고, 특히 실시간으로는 더욱 어렵다. GAN을 이용해 실제 이미지를 편집하는 최첨단 방법들은 실제 이미지를 잠재 벡터로 투영하는 것이 선행되어야 하는데, 이 부분에 많은 시간이 소요된다. 그 대안으로 인코더를 학습해서 실제 이미지를 잠재 공간으로 즉시 임베딩할 수 있지만, 잠재 벡터를 다시 이미지로 복원 시 많은 디테일들을 잃어버린다. 우리는 새로운 형태의 잠재 공간인 stylemap을 가지는 StyleMapGAN을 제안했는데, stylemap은 기존 벡터 공간에 공간적인 차원을 추가한 잠재 공간이다. Stylemap의 각 위치는 생성된 이미지의 해당 지역에 대응되어, 인코더를 이용해 실시간이면서도 정확한 투영이 가능해질 뿐만 아니라, 실제 이미지의 공간적으로 편집이 가능해진다. 많은 실험 결과들은 우리가 제안한 방법이 다양한 이미지 편집 작업들(예를 들어, 국소적인 편집 및 이미지 보간)에서 기존 최첨단 방법들을 월등히 능가함을 보여준다. 특히 자세한 비교 실험들은 우리가 제안한 국소적인 편집 방법이 효과적임을 보여준다. 타겟하지 않는 부분의 기존 이미지는 잘 유지되고, 타겟하는 부분에서는 참조 이미지의 색과 질감뿐만 아니라 모양까지 잘 가져옴을 볼 수 있다.Abstract i Contents iii List of Tables v List of Figures vii Chapter 1 Introduction 1 Chapter 2 Related Work 3 Chapter 3 StyleMapGAN 5 3.1 Stylemap-based generator 7 3.2 Training procedure and losses 10 3.3 Local editing 10 Chapter 4 Experiments 12 4.1 Experimental Setup 12 4.2 Evaluation metrics 13 4.3 Effects of stylemap resolution 17 4.4 Real Image Projection 19 4.5 Local Editing 19 4.6 Unaligned Transplantation 20 Chapter 5 Discussion and Conclusion 24 References 25 Appendix 31 A Local editing in w+ space 31 B Additional results 33 B.1 Random generation 33 B.2 Image projection & Interpolation 34 B.3 Local editing 34 B.4 Unaligned transplantation 39 B.5 Style mixing 39 B.6 Semantic manipulation 39 B.7 Failure cases 40 C Implementation details 46 D Loss details 49 국문초록 51Maste

fabrication and analysis study

학위논문(박사) -- 서울대학교대학원 : 공과대학 기계공학부, 2022. 8. 안성훈.Azobenzene incorporated liquid crystalline elastomers (azo-LCEs) is contains azobenzene in there molecule network, and it occur photo-isomerization when PRP-LCEs irradiated UV-light. Azo-LCEs can potentially be used in diverse applications, such as soft robot, sensors, and actuators, because of their reversibility, remote-controllability, and immediateness of the response. However, real world applications of azo-LCEs are lacking because of the strains generated by irradiation of light are not so large, and the work capacity is not suitable to apply. Here, we report an azo-LCEs constructed with thiol-click Michael addition reaction. Azo LCEs shows dual stimuli shape memory cycle triggered by force/heat and light. In particular during photo deformation process, azo LCEs shows not only huge actuation (up to 26%) under the stress condition but also shows the higher work capacity than mammalian muscle (up to 77J/Kg). To better understand, we control the molecule structure system by using change of crosslinker concentration and sequential polymerization process. When azobenzene in the molecules network occur photo-isomerization, not only the isomerization effect of the azobenzene itself but also influence of tuned nematic-isotropic transition temperature of azo-LCEs molecule network contribute to make immediately huge actuation. Since the photo-isomerization of azobenzene and the external loading force applied to azo-LCEs have a complex effect on this transition temperature shifting, we constructed an in-situ experimental system to better understand this phenomenon. Our azo-LCE has not only shown that it has conditions that can be used in various applications including artificial muscles, but is also expected to be used importantly in various fields for future actuators and their mechanism studies.광반응 탄성체 소재의 분자 네트워크 내부에 가교되어 있는 아조벤젠은 특정 파장대의 빛이 조사 될 경우 광 이성질화를 일으킵니다. 이러한 광 이성질화는 아조벤젠 그 자체의 구조 및 물성변화뿐 아니라, 분자배열 전체에 변화를 야기하여 결과적으로 물성변화와 거동을 발생시킵니다. 광반응 탄성체 소재의 이러한 가역성, 원격제어 가능성 및 그 응답이 즉각적이라는 특성으로 인해 소프트로봇, 정밀 센서 및 액츄에이터와 같은 다양한 활용이 기대되고 있습니다. 그러나 광반응 탄성체의 광변형 거동 시 그 변형의 크기가 충분하지 않고 발생하는 일의 크기가 제한적이라는 특성으로 인해 실질적인 활용에는 어려움을 겪고 있습니다. 이러한 한계점들을 해결하기 위해 본 연구에서는 Michael addition thiol-click 가교반응을 사용하여 액정 단량체, 아조벤젠 단량체, thiol 작용기를 지닌 가교제로 이루어진 광반응 탄성체 소재를 합성하였습니다. 외력에 의해 일시적인 배향성을 만들고 열을 통해 지울 수 있으며, 빛에 의해서도 형상기억사이클을 발생시키는 해당 광반응 탄성체는 외력하에서 26% 이상의 광반응 대변형을 발생시키며, 포유류근육이상의 일률을 발생시킬 수 있음을 확인하였습니다. 이 후 가교제의 조성비를 제어하는 것과 촉매와 작용기를 설정해주는 방식을 이용한 순차적 중합과정을 이용한 가교과정 제어를 통해 가교율을 통제하였고, 가교율의 변화에 따른 물성의 변화를 연구하였습니다. 또한 광반응에 따른 물성변화를 실시간으로 관측할 수 있는 실험환경을 구축하여, 광반응 거동 및 물성변화의 메커니즘을 규명하였습니다. 본 연구에서 소개한 광반응 탄성체 소재는 인공근육을 비롯한 다양한 응용분야에서 사용될 수 있는 조건을 가지고 있음을 보여주었을 뿐만 아니라, 향후 액츄에이터 및 그 메커니즘 연구를 위한 다양한 분야에서 중요하게 활용될 것으로 기대됩니다.Chapter 1. Introduction 1 1.1 Multi-functional polymer-based smart actuator 1 1.2 Liquid crystalline polymer 3 1.3 Azobenzene incorporated liquid crystalline elastomers 8 1.4 Polymer alignment under the preloading force 14 1.5 Sequential polymerization 17 1.6 Scope and aim 21 1.7 Outline of dissertation 22 Chapter 2. Synthesis and characterization 24 2.1 Synthesis of bi-acrylic azobenzene monomer 24 2.2 Synthesis of unsymetric-functionalized azobenzene monomer 28 2.3 Synthesis of azobenzene incorporated liquid crystalline elastomers (Azo-LCEs) 40 2.4 Onepot method based on two-step sequential thiol-ene reaction 44 Chapter 3. Methodology and sample properties 49 3.1 Experimental method for photo-actuation test of the azo-LCEs actuator 49 3.2 Experimental method for in-situ test of the azo-LCEs actuator 53 3.3 Mechanical/ thermal properties of the azo-LCEs actuator 55 3.4 Controlled polymerization effect on properties of azo-LCEs 59 Chapter 4. Photo-triggered actuation of the azo-LCEs based actuator 64 4.1 Characteristics of the actuation 64 4.2 Effect of crosslinking density under the loading condition change 66 4.3 Effect of the sequential polymerization 73 4.4 Azo-LCEs actuator as an artificial muscle 77 Chapter 5. Actuation mechanism 79 5.1 Study of the catalyst 79 5.2 Real time in-situ test to know the thermal properties change under the photo-isomerization 94 Chapter 6. Conclusion 97 국문 요약 98 Bibliography 101박

아산화질소 및 이산화규소의 효과적인 환원을 위한 유체역학적 / 전기화학적 접근

학위논문(박사) -- 서울대학교대학원 : 공과대학 화학생물공학부, 2022. 8. 김재정.산화물을 환원시키는 효과적인 방법으로 전기화학적 환원 반응이 널리 이용되고 있다. 전기화학적 환원 반응은 상온 근처의 낮은 공정 온도에서 전극, 촉매, 전해질, 인가 조건 등의 여러 공정 변수를 조절하여 반응 속도와 반응 효율을 향상시킬 수 있어 다양한 연구 가능성을 가진 환원 방법이다. 전기화학적 환원 반응은 특히 수소 발생 반응, 산소 환원 반응, 이산화탄소 환원 방법 등의 기체 산화물 환원과 금속 도금, 고체 연료전지 등의 고체 산화물 환원 분야에 널리 활용되고 있다. 본 연구에서는 유체역학적, 전기화학적 여러 방법을 통해 전기화학적 환원 반응의 반응속도와 효율을 향상시키고자 연구를 진행하였다. 본 연구에서 다룬 기체 산화물인 아산화질소는 세계 온난화 지수가 이산화탄소에 비해 310배에 달하는 강력한 온실 기체이다. 농경 산업과 각종 산업 등에서 주로 배출되는 아산화질소는 대기중 농도가 계속해서 증가하고 있으며, 대기중에서 오랜 시간 잔류하기 때문에 분해와 저감에 대한 연구가 활발히 진행되고 있다. 아산화질소의 효과적인 전기화학적 환원을 위해 크게 두 가지의 접근 방법을 적용하였다. 첫째로, 쿠에트-테일러 유동 반응기를 전기화학적 시스템에 적용하여 유체역학적 방법을 통해 전기화학적 환원의 반응 속도와 아산화질소 환원 전환율을 증대시키고자 하였다. 전기화학적 환원을 실시하기에 앞서, 쿠에트-테일러 유동 반응기 내에서 아산화질소의 수용액으로의 용해 속도와 용해도를 측정해 테일러 유동이 아산화질소의 용해에 어떠한 영향을 미치는지 확인해 보았다. 테일러 유동의 유무에 따라 아산화질소의 용해도와 용해 속도가 확연한 차이를 보여 주었는데, 특히 테일러 유동이 일어날 때에 용해 속도 측면에서 눈에 띄는 효과를 보여주었다. 이후 아산화질소의 전기화학적 환원 반응을 쿠에트-테일러 유동 반응기 내에서 진행하여 증가된 용해 거동이 전기화학적 분해 반응에 미치는 영향을 확인하였다. 아산화질소의 전환율은 테일러 유동이 없을 때에 비해 2.7배 증가하였다. 테일러 유동에 의한 물질 전달 속도 증가에서 기인한 아산화질소의 빠른 용해 속도가 위와 같은 전환율 증가를 가져온 것으로 평가된다. 이후 아산화질소의 입구 유량에 따른 전환율 변화와 인가 전류에 따른 전환율 변화를 통해 각 전기화학적 공정변수가 전환율에 미치는 영향을 확인할 수 있었다. 아산화질소의 전기화학적 환원을 개선시키기 위한 또다른 접근법으로 전해질에 이온성 액체를 적용시켜 보았다. 본 연구에 사용된 이온성 액체는 1-butyl-3-methylimidazolium tetrafluoroborate, [BMIM][BF4] 이며, 유기 용매인 프로필렌 카보네이트와 혼합하여 전해질로 사용하였다. 이온성 액체는 수용액 내에서의 주요 부반응인 수소발생반응을 배제하기 위해 사용되었으며, 주로 전기화학적 환원 반응의 효율을 증대시키기 위해 전해질로 사용하였다. [BMIM][BF4]은 수용액에 비해 90배 이상의 높은 아산화질소 용해도를 갖고 있어 아산화질소의 전기화학적 환원에 적합한 이온성 액체로 평가되었다. 이온성 액체의 낮은 전기 전도성과 높은 점도는 전해질로서의 단점으로 작용하는데, 이는 유기용매인 프로필렌 카보네이트와의 비율 최적화를 통해 최소화할 수 있었다. 최적화된 이온성 액체 전해질 내에서의 전류 효율과 페러데이 효율은 각각 95%, 90% 이상으로 나타났고, 이는 부반응인 수소발생반응을 효과적으로 배제하고 전류의 대부분을 아산화질소 환원에 이용할 수 있었기 때문이라고 생각된다. 본 연구에서 다룬 또다른 산화물로는 고체 산화물인 이산화규소이다. 이산화규소는 일반적으로 전기가 통하지 않는 부도체이나, 전극에 직접 닿은 이산화규소에 전자를 흘려 주어 직접적인 전기화학적 환원 반응이 가능하다는 연구 내용이 발표된 바 있다. 또한 물질전달이 빠르고 이산화규소의 전기화학적 환원 반응의 부산물인 산화 이온을 잘 용해시킬 수 있는 850°C 이상의 염화칼슘 용융염을 전해질로 사용하면 이산화규소의 전기화학적 환원 반응이 가능하다. 또한 알루미늄 금속을 이용하여 알루미늄-실리콘 액체 합금 형성을 통해 전기적 접촉을 향상시키고 환원된 실리콘의 형태를 필름 형태로 만들 수 있었다. 이후 금속 도금 분야에서 활용되고 있는 펄스 도금을 응용하여 최적화를 진행하였다. 전류가 가해지지 않는 시간 동안 알루미늄-실리콘 액체 합금이 형성되는 시간과 생성된 산화 이온의 확산 시간을 확보해 줄 수 있었다. 최적화 된 시간에서 이산화규소 환원 시 오랜 환원 시간과 늘어난 환원 전하량, 두꺼워진 필름 두께를 얻을 수 있었으며, 샘플의 SEM 및 EDS 분석 결과 평평한 필름 표면과 96% 이상의 실리콘 성분을 확인할 수 있었다.Nitrous oxide, a gaseous oxide studied in this research, is a powerful greenhouse gas with a global warming potential of 310 times that of carbon dioxide. Electrochemical reduction was used as reducing method of N2O. Two approaches using electrochemical reduction were mainly applied for the effective electrochemical reduction of nitrous oxide. First, by applying a Couette-Taylor vortex reactor to an electrochemical system, it was attempted to increase the reaction rate of electrochemical reduction and the conversion rate of nitrous oxide through a hydrodynamic method. The solubility and dissolution rate of nitrous oxide showed a clear difference depending on the presence or absence of Taylor flow. Thereafter, the electrochemical reduction reaction of nitrous oxide was carried out in a Couette-Taylor vortex reactor to confirm the effect of the increased dissolution behavior on the electrochemical decomposition reaction. The conversion of nitrous oxide increased by 2.7 times compared to the absence of Taylor flow. Another approach to improve the electrochemical reduction of nitrous oxide was to apply an ionic liquid to the electrolyte. The ionic liquid used in this study was 1-butyl-3-methylimidazolium tetrafluoroborate, [BMIM][BF4] as an electrolyte. The ionic liquid was used to exclude the hydrogen evolution reaction, which is a major side reaction in the aqueous solution, and was mainly used as an electrolyte to increase the efficiency of the electrochemical reduction reaction. The low electrical conductivity and high viscosity of the ionic liquid act as disadvantages as an electrolyte, which could be minimized with the propylene carbonate. The current efficiency and the Faraday efficiency in the optimized ionic liquid electrolyte were 95% and 90%, respectively. Another oxide studied in this research is SiO2, a solid oxide. The electrochemical reduction reaction of silicon dioxide is possible by using 850°C CaCl2 molten salt as an electrolyte. In addition, it was possible to improve the electrical contact through the formation of an Al-Si liquid alloy using Al metal and to make the reduced silicon form into a film form. Afterwards, optimization was performed by applying pulse reduction, which is used in the metal plating field. When reducing SiO2 at the optimized time, a long reduction time, increased charge amount, and a thicker film were obtained. SEM and EDS analysis of the sample confirmed a flat film surface and more than 96% silicon component.Abstract i List of Figures iii List of Tables v Chapter I. Introduction 1 1.1. Electrochemical reduction of oxide 1 1.2. Electrochemical reduction of N2O with hydrodynamic approach 5 1.3. Electrochemical reduction of N2O with ionic liquid 11 1.4. Direct electrochemical reduction of SiO2 in CaCl2 molten salt 14 1.5. Purpose of this study 21 Chapter II. Experimental 25 2.1. Measurement of N2O dissolution 25 2.2. Electrochemical analysis 26 2.3. Optimization of experimental conditions and electrolyte 29 2.4. Properties and performance 31 Chapter III. Results and Discussion 38 3.1. Electrochemical reduction of N2O in CTVR 38 3.1.1. The effect of the CTVR on N2O dissolution 38 3.1.2. Conversion of N2O with CTVR system 40 3.2. Electrochemical reduction of N2O with ionic liquid 51 3.2.1. Optimization of [BMIM][BF4] / PC electrolyte 51 3.2.2. Current efficiency and Faradaic efficiency of N2O reduction 54 3.3. Direct electrochemical reduction of SiO2 in CaCl2 molten salt 60 3.3.1. Electrochemical analysis of SiO2 reduction 60 3.3.2. Properties of reduced Si with Al 63 3.3.3. On off time optimization and Si film 65 Chapter IV. Conclusion 74 References 77 국문 초록 83 List of Tables Table 1.1. Various Methods for N2O Decomposition (Ref. 12, 13) 8 Table 1.2 Solubility of N2O in Various Ionic Liquids (Ref. 46) 23 Table 3.1 The Saturation Time and Solubility of N2O at 0 rpm Batch System Condition and 1000 rpm CTVR Condition 44 Table 3.2 N2O Conversion with Various Reduction Conditions 50박

수면무호흡증 치료를 위한 변형된 양악전진술이 삶의 질 및 얼굴의 심미성 변화에 미치는 효과

학위논문(석사) -- 서울대학교대학원 : 치과대학 치의과학과, 2023. 8. 최진영.초 록 목적: 본 연구의 목적은 수면무호흡증 치료를 위한 변형된 양악전진술이 기존의 전통적 양악전진술에 비해 수술 후 환자의 삶의 질과 얼굴의 심미성 변화에 미치는 효과를 후향적으로 평가하고 비교하는 것이다. 방법: 2013년 1월 1일부터 2022년 12월 31일까지 양악 전진술을 받고 중등도에서 중증 수면무호흡증 진단을 받은 환자 (AHI가 15 이상인 환자)들의 의무기록 및 수술 후 삶의 질 개선과 심미적 안면 외모에 대한 변화에 대한 28개의 질의응답 결과를 종합하였다. 환자들의 대답에는 리커트 척도(Likert scale)와 1표본 윌콕슨 부호 순위 검정 (one sample Wilcoxon signed rank test)을 사용하여 후향적으로 조사하였고, 3은 변화가 없음, 4와 5는 삶의 질과 안면 외모에 대한 만족을, 1과 2는 감소를 의미하였다. 이에 평균 및 표준편차를 계산하였으며, 각 항목에 대한 P값이 0.05 이하일 때 통계적으로 유의미 하다고 판단하였다. 또한 전통적 양악전진술과 변형된 양악전진술이 수술 후 환자의 삶의 질과 얼굴의 심미성 변화에 미치는 효과의 차이를 비교분석하기 위해 윌콕슨 순위합 검정 (Wilcoxon rank sum test)을 사용 하였고 이에 대해서도 각 항목에 대한 P값이 0.05 이하일때 통계적으로 유의미 하다고 판단하였다. 마지막으로, 3가지 대표 사례를 선정 후 사례를 검토 하였다. 결과: 모든 환자는 골격성 II급 부정 교합이었다. 24명의 환자 중 17명이 남성이고 7명이 여성이었다. 24명 중 17명은 변형된 양악전진술을 받았으며 7명은 전통적 양악전진술을 받았다. 수술 시 평균 연령은 32.6 ± 10.9세였으며, 수술 전 평균 AHI는 51.7±21.6, 수술 후 평균 AHI는 9.5±7.78이였다. 상악 전방 전진량 평균은 전통적 양악전진술 5.00±2.12mm, 그리고 변형된 양악전진술은 2.39±1.42mm였다 (상악 중절치 절단면 기준). 전통적 양악전진술을 받은 환자들의 하악 우측 평균 전진량은 하악지 시상분할 절골술 후 7.05±2.05mm 이었고 하악 좌측은 6.65±1.90mm이었고, 변형된 양악전진술을 받은 환자들의 하악 우측 평균 전진량은 8.90±2.20mm 이었고 하악 좌측은 8.17±2.50mm 이었다 (6번 근심협측 교두 기준). 전통적 양악전진술을 받은 환자들은 수면의 질, 일상 기능, 신체 건강, 정신 건강, 교합기능, 술 후 회복 및 얼굴 심미성 (P<0.05)에 대해 개선 되었다고 응답하였고 변형된 양악전진술을 받은 환자들은 수면의 질, 일상 기능, 신체건강, 교합기능에 대해 개선(P<0.05) 되었다고 응답하였고 얼굴 심미성에 대해서도 개선 되었다고 응답하였으나 통계적 의미는 없었다 (P=0.446). 전통적 양악전진술과 변형된 전진술이 불러오는 수면 무호흡증 환자의 삶의 질과 얼굴 외모 변화의 차이를 분석한 결과, 다음 항목에서 통계적으로 유의미하였다: "숨쉬기가 더 편해졌다", "전체적으로 건강해진 느낌을 받는다", "에너지가 더 많아진 것 같다", "전반적인 기분이 좋아졌다", "발음/발성이 좋아졌다" (P<0.05). 그러나 다음 얼굴의 심미성 변화에 대한 항목에서 두 수술방법간 차이가 통계적으로 유의미하지 않았다: "수술 전 아래턱의 모습이 마음에 들지 않았다" (P=0.258), "수술 전 위턱의 모습이 마음에 들지 않았다" (P=0.067), "수술 전 외모에 자신감이 없었다" (P=0.508), "수술 후 아래턱의 변화에 만족한다" (P=0.599), "수술 후 위턱의 변화에 만족한다" (P=0.692), "외모에 대한 자신감이 상승했다" (P=0.338), "전반적인 안모/외모 변화에 만족한다" (P=0.915). 결론: 양악 전진술은 환자의 삶의 질을 향상시키는 데 도움이 되며, 안면 외모 또한 개선되거나 악화 되지는 않았다. 변형된 양악 전진술은 외모의 악화로 인해 상악을 충분히 전진 시킬 수 없는 경우 상기도의 공간을 확보하면서 상하악 복합체의 돌출을 줄이고 수술 후 삶의 질과 안면 외모 만족도를 최소한 악화시키지 않는다. 주요어: 수면무호흡증, 전통적 양악전진술, 변형된 양악 전진술, 삶의 질, 안면 외모, 심미 학번: 2019-22399Abstract Purpose/Objective: The purpose of this study is to retrospectively evaluate and compare the postoperative effects of modified Maxillo-mandibular advancement (MMA) to that of conventional MMA on quality of life and aesthetic satisfaction of patients Methods: Through chart review, medical records, 28 pre- and post-surgical follow-up responses regarding the change in quality of life and facial appearances who were 1. diagnosed with moderate to severe OSA and an AHI of 15 or higher, and 2. received conventional and modified MMA from January 1st, 2013, to December 31st, 2022, will be analyzed to investigate the improvement of quality of life and facial appearance after MMA surgery. The Likert scale with 1 sample Wilcoxon signed rank test will be used for patient responses on questions regarding the Quality of life and change in facial appearance where 3 means no change, 4 and 5 means improvement in QOL, and 1 and 2 meaning reduction in QOL. Wilcoxon rank sum test will be used to see the difference in responses between patients who have undergone conventional and modified MMA, which P value of less than 0.05 will mean the difference is statistically significant. Finally, 3 cases were selected for case review purposes. Results: Out of 24 patients, all patients were skeletal Class II. 17 patients were men, and 7 patients were women. 17 patients have received modified MMA and 7 have received conventional MMA. The mean age at surgery for conventional MMA was 30.0±8.16 years with a range of 18 - 39 years. The mean age at surgery for modified MMA was 32.6±13.8 years with a range of 4 – 59 years. The mean pre-op AHI for conventional MMA was 52.0±20.0 with a range of 28.0 – 76.6 (moderate to severe OSA). The mean pre-op AHI for conventional MMA was 52.2±21.3 with a range of 23.3 – 85.6. The mean of post operative AHI for conventional MMA was 10.4±8.10. The mean of post operative AHI for modified MMA was 8.89±4.66. The average length of advancement of the maxilla for patients who have undergone conventional MMA was 5.00±1.89mm from incisal edge position. The average length of advancement of the maxilla for patients who have undergone modified MMA was 2.39±1.42mm from incisal edge. The average length of advancement after BRSSO of the right side for conventional MMA was 7.05±2.05mm and 8.90±2.30 for modified MMA. The left side for conventional MMA was 6.65±2.05mm and 8.27±2.50 for modified MMA (from mesio-buccal cusp of first molar). Patients that received conventional MMA responded positively that their Sleep Quality, Daytime function, Physical health, Mental health, Dental function, Recovery, Facial appearance has improved (P<0.05). Patients that received modified MMA responded positively that their Sleep quality, Daytime function, Physical health, Dental function has improved (P<0.05). Although statistically insignificant, modified MMA patients have also said their facial appearance has improved (P=0.446). However, they reported their speech quality has reduced. (P=0.124) An analysis of the difference in change of quality of life and facial appearances between conventional and modified MMA has shown that the results were statistically significant in the following categories: Increased ease of daytime breathing, better overall health, greater energy, better overall mood, better in speech quality (P<0.05). In the facial aesthetics category, the difference between the two surgeries showed that they were statistically insignificant: Did not like appearance of lower jaw before surgery (P=0.258), Did not like appearance of upper jaw before surgery (P=0.067), Was not confident of looks before surgery (P=0.508), Happy with how my lower jaw has changed (P=0.599), Happy with how my upper jaw has changed (P=0.692), Gained confidence of the way I look (P=0.338), Like the overall change of the way I look (P=0.915). Conclusion: Conventional and modified MMA surgery has been shown to enhance the quality of life and improve or at least preserve facial aesthetics. Modified MMA offers the advantages of maximizing posterior airway space while reducing the degree of maxillomandibular complex advancement, thus minimizing the protrusive facial appearance that may be aesthetically undesirable for the patient. Consequently, Modified MMA not only improves postoperative quality of life but also increases satisfaction with facial appearance. Keywords: OSA, MMA, modified MMA, Quality of life, Facial appearance, Esthetics Student number: 2019-22399Table of Contents Abstract 1 Introduction 5 Materials and Methods 9 1. Inclusion criteria 2. Exclusion criteria 3. Surgery 4. Data collection 5. Demographics and medical records 6. Statistical analysis method Results 13 Statistical analysis 1. Demographics 2. Responses from conventional MMA patients vs. modified MMA patients regarding Quality of life 3. Responses from conventional MMA patients vs. modified MMA patients regarding change in facial appearance Case Review 4. Case 1. Conventional MMA and Genioglossus advancement 5. Case 2. Modified MMA and Genioglossus advancement 6. Case 3. Convetional MMA and Genioglossus advancement (Orthodontic treatment including extraction of premolars prior to considering MMA to treat OSA) Discussion 20 References 32 Tables 34 Table1. 28 questions on change in Quality of life and Facial appearance Table2. Demographics and medical records Table3. Patient responses on QOL Table4. Patient responses on facial appearance Figures 38 Figure 1. Patient responses on QOL and facial appearances (Conventional MMA) Figure 2. Patient responses on QOL and facial appearances (Modified MMA) Figure 3. Case 1. Figure 4. Case 2. Figure 5. Case 3. Abstract in Korean 42석

Sphingosine kinase 1 is a reliable prognostic factor and a novel therapeutic target for uterine cervical cancer

Sphingosine kinase 1 (SPHK1), an oncogenic kinase, has previously been found to be upregulated in various types of human malignancy and to play a crucial role in tumor development and progression. Although SPHK1 has gained increasing prominence as an important enzyme in cancer biology, its potential as a predictive biomarker and a therapeutic target in cervical cancer remains unknown. SPHK1 expression was examined in 287 formalin-fixed, paraffin-embedded cervical cancer tissues using immunohistochemistry, and its clinical implications and prognostic significance were analyzed. Cervical cancer cell lines including HeLa and SiHa were treated with the SPHK inhibitors SKI-II or FTY720, and effects on cell survival, apoptosis, angiogenesis, and invasion were examined. Moreover, the effects of FTY720 on tumor growth were evaluated using a patient-derived xenograft (PDX) model of cervical cancer. Immunohistochemical analysis revealed that expression of SPHK1 was significantly increased in cervical cancer compared with normal tissues. SPHK1 expression was significantly associated with tumor size, invasion depth, FIGO stage, lymph node metastasis, and lymphovascular invasion. Patients with high SPHK1 expression had lower overall survival and recurrence-free survival rates than those with low expression. Treatment with SPHK inhibitors significantly reduced viability and increased apoptosis in cervical cancer cells. Furthermore, FTY720 significantly decreased in vivo tumor weight in the PDX model of cervical cancer. We provide the first convincing evidence that SPHK1 is involved in tumor development and progression of cervical cancer. Our data suggest that SPHK1 might be a potential prognostic marker and therapeutic target for the treatment of cervical cancer.ope

Primary ovarian carcinoid tumor showing unusual histology and nuclear accumulation of β-catenin

Carcinoid tumor of the ovary is uncommon. We herein report a very rare case of primary ovarian carcinoid tumor with aggressive histology and an unusual immunophenotype. A 21-year-old woman presented with a palpable abdominal mass. Computed tomographic scan revealed a large, extensively necrotic solid mass in the left ovary. The patient underwent a left salpingo-oophorectomy. Grossly, the left adnexa showed a large, vaguely lobulated ovarian tumor measuring 22×15×13 cm. Histologically, the tumor had a readily identifiable neuroendocrine growth pattern, but some areas showed solid growth pattern associated with mild nuclear pleomorphism and multiple foci of punctate necrosis. Furthermore, mitotic figures were recognized in 8 per 10 high-power fields, and a few foci of large coagulative tumor necrosis were also noted. In addition, the tumor tissue exhibited uniform, strong nuclear β-catenin immunoreactivity, indicating the nuclear accumulation of β-catenin in the individual tumor cells. In summary, we described the first case of primary ovarian carcinoid tumor with loss of neuroendocrine growth pattern, increased mitotic activity and large areas of coagulative tumor necrosis. According to the WHO classification of pulmonary carcinoid tumor, this case may be classified as "atypical" carcinoid. However, currently, no primary ovarian atypical carcinoid exists in the classification system. Due to its rarity, there are no established diagnostic criteria and clinical data on patient outcomes for ovarian carcinoid tumors with aggressive histology. Additional reports are clearly necessary. We also showed for the first time the nuclear accumulation of β-catenin in carcinoid tumor cells, suggestive of a role for β-catenin in the tumorigenesis of ovarian atypical carcinoid tumor or its aggressive histology.ope

Stromal p16 expression is significantly increased in endometrial carcinoma

p16 is a negative regulator of cell proliferation and is considered a tumor suppressor protein. Alterations in p16 protein expression are associated with tumor development and progression. However, the p16 expression status in the peritumoral stroma has not been investigated in the endometrium. Therefore, we evaluated stromal p16 expression in different types of endometrial lesions using immunohistochemistry. Differences in the p16 expression status according to the degree of malignancy and histological type were analyzed. This study included 62, 26, and 36 cases of benign, precancerous, and malignant endometrial lesions, respectively. Most benign lesions showed negative or weak expression, whereas precancerous lesions showed a variable degree of staining proportion and intensity. Atypical hyperplasia/endometrial intraepithelial neoplasia (AH/EIN) and serous endometrial intraepithelial carcinoma (SEIC) had significantly higher stromal p16 expression levels than benign lesions. Endometrioid carcinoma (EC), serous carcinoma (SC), and carcinosarcoma showed significantly elevated stromal p16 expression levels compared with benign and precancerous lesions. In addition, there were significant differences in stromal p16 expression between AH/EIN and SEIC and between EC and SC. In contrast, differences in stromal p16 expression among nonpathological endometrium, atrophic endometrium, endometrial polyp, and hyperplasia without atypia were not statistically significant. Our observations suggest that stromal p16 expression is involved in the development and progression of endometrial carcinoma, and raise the possibility that p16 overexpression in the peritumoral stroma is associated with aggressive oncogenic behavior of endometrial SC.ope

Acute exposure to hypobaric hypoxia upregulates the expression of hypoxia-inducible factor-1α and vascular endothelial growth factor

Hypoxia is a stress factor frequently encountered during flight and a common cause of tissue and cell injury experienced by in-flight crew. Effects of hypoxia on the body can vary depending on the duration and severity of hypoxic exposure. As symptoms can differ among individuals, the measures taken to address hypoxia can be greatly improved by understanding its effects. It is critically important for pilots, cabin crew, and in-flight medical professionals to familiarize themselves with hypoxia and the factors that affect its presentation. In this study, we investigated the effect of hypoxia on the expression of vascular endothelial growth factor (VEGF) in mice using a hypoxic-exposure model. Experimental animals were placed in a hypobaric chamber at 8,000 ft for 1 h (n=5), 3 h (n=5), or 6 h (n=5). Immediately after hypoxic exposure, protein concentration of VEGF and mRNA levels of hypoxiainducible factor-1α (HIF-1α) and VEGF were analyzed in serum and liver tissue homogenates. Exposure to hypobaric hypoxia significantly upregulated the expression of both HIF-1α and VEGF mRNA, but not hepatic VEGF mRNA. Our data indicate that acute exposure to hypobaric hypoxia upregulates serum mRNA levels of HIF-1α and VEGF in mice, and that the liver is less likely to be the source of elevated serum VEGF mRNA. In contrast, serum VEGF protein level may be regulated by other factors. Further investigations to confirm or disprove our preliminary results are required.ope

Chemotherapy-induced endometrial pathology: mimicry of malignancy and viral endometritis.

Chemotherapy is a common type of preoperative neoadjuvant treatment and postoperative adjuvant or palliative therapy for many different types of malignancies. Certain chemotherapeutic agents can induce bizarre epithelial atypia that mimics malignancy. Unfamiliarity with these changes could potentially cause confusion with a neoplastic or infectious process. The endometrium is one of the few sites where chemotherapy-induced epithelial atypia has not been appreciated. We identified four patients with marked cytologic atypia of the endometrial glandular epithelium from the surgical pathology files of Severance Hospital. The histopathologic features, immunostaining results and medical records of these patients were reviewed. All patients underwent hysteroscopic examination with endometrial curettage for investigation of vaginal bleeding. They had previously undergone chemotherapy for uterine cervical cancer (n=1), rectal cancer (n=2) and myelodysplastic syndrome (n=1). The chemotherapy regimens included alkylating agents (busulfan, cyclophosphamide, ifosfamide, cisplatin, and oxaliplatin), pyrimidine antagonists (capecitabine, decitabine, and 5-fluorouracil), taxanes (paclitaxel), and topoisomerase inhibitors (irinotecan and etoposide). On histopathological examination, the atypical epithelial changes included marked nuclear enlargement and pleomorphism, a degenerative-looking chromatin pattern, abundant microvacuolated cytoplasm, and preservation of the nuclear/cytoplasmic ratio. This study demonstrates that certain chemotherapeutic agents may cause bizarre, reactive atypia of the endometrial glandular epithelium. These changes should not be interpreted as neoplastic or infectious in nature. An awareness of prior exposure to cytotoxic agents and a familiarity with the nature and distribution of these bizarre alterations is essential to avoid misinterpretation of the morphologic features and prevent unnecessary treatment.ope