대동맥에 대한 조작이 없는 무심폐기하 관상동맥 우회술에서 기존의 위험성 예측 시스템의 임상적 유용성 평가에 대한 연구

학위논문 (박사) -- 서울대학교 대학원 : 의과대학 임상의과학과, 2020. 8. 김기봉.Background: Risk prediction scoring systems are used to measure perioperative risk and identify high-risk patients. Currently, the Society of Thoracic Surgeons (STS) risk model and European System for Cardiac Operative Risk Evaluation II (EuroSCORE II) are widely used for cardiac surgery. Additionally, the Synergy between PCI with Taxus and Cardiac Surgery (SYNTAX) score II predicts 4-year mortality after coronary artery bypass grafting (CABG). This study aimed to evaluate the performance of preexisting preoperative risk evaluation systems, such as the STS risk model, EuroSCORE II, and SYNTAX score II, for patients undergoing an-aortic off-pump coronary bypass grafting (OPCAB). Methods: Of 1,140 patients had planned to undergo isolated OPCAB preoperatively between January 2010 and June 2017, 1048 patients (isolated anaortic OPCAB: 1043, on-pump conversion: 5) were enrolled in this study. The STS risk score, EuroSCORE II, and SYNTAX score were retrospectively or prospectively calculated with dedicated online software. Calibration of the STS risk model and EuroSCORE II were performed by the risk-adjusted event ratio that was defined as observed events divided by expected events (O/E ratio) and the Hosmer-Lemeshow test. The discrimination powers of the STS risk model and EuroSCORE II were evaluated by the area under the receiver operating characteristic curve (AUC). Students t-test was used to compare SYNTAX score I and II between patients with and without mortality or morbidity. Results: Operative mortality occurred in 10 patients (0.95%). The predicted mortality rates calculated by the EuroSCORE II and STS risk model were 2.58 ± 4.15% and 1.72 ± 2.92%, respectively. The O/E ratio of the EuroSCORE II was 0.370 (confidence interval(CI): 0.177 – 0.681), and the EuroSCORE II significantly overpredicted the operative mortality for patients (P = 0.003). EuroSCORE II showed good discrimination power with an AUC of 0.784. The O/E ratio of mortality in the STS risk model was 0.556 (CI: 0.266 – 1.023), and the STS risk model overpredicted the operative mortality with marginal significance (P = 0.052). However, in the subgroup analysis, the STS risk model significantly overpredicted mortality (O/E ratio: 0.481, CI: 0.193-0.992). Permanent stroke occurred in 6 patients (0.53%). The predicted permanent stroke occurrence rate calculated by the STS risk model was 1.73 ± 1.48%. The O/E ratio was 0.332 (CI: 0.121 – 0.722), and the STS risk model significantly overpredicted the permanent stroke occurrence rate (P = 0.011). In terms of discrimination power for the STS risk model, the AUC for operative mortality and permanent stroke were 0.876 and 0.740, respectively. There was no significant difference in SYNTAX score I value between patients who did and did not experience mortality or morbidity. However, patients with mortality or morbidity showed a significantly higher SYNTAX score II than those without mortality or morbidity. Conclusions: The preexisting risk prediction scoring systems for CABG, the STS risk model and EuroSCORE II, overpredicted the risk of mortality and stroke rate for anaortic OPCAB. These findings suggest the possibility that anaortic OPCAB can lower the operative mortality and occurrence of postoperative stroke than conventional CABG. In addition, these results show that the characteristics of the surgical method, especially whether anaortic OPCAB is performed, should be considered to predict the operative risk for CABG.서론: 수술 후 위험도를 점수로 예측하는 시스템은 환자의 수술 위험도를 측정하고, 고위험군 환자를 확인하는데 이용된다. 현재 STS 위험도 예측 모델과 EuroSCORE II는 심장 수술 환자에서 널리 이용되고 있으며, SYNTAX score II 는 관상동맥 우회술 후 4년 사망률을 예측한다. 이 연구에서는 현재 존재하고 있는 위험도 예측 시스템인 STS 위험도 예측 모델, EuroSCORE II, SYNTAX score II가 대동맥 조작이 없는 무심폐기하 관상동맥 우회술 환자에서 임상적 유의성을 보이는지 평가해 보도록 하겠다. 방법: 2010년 1월부터 2017년 6월까지, 수술 전 무심폐기하 관상동맥 우회술을 계획한 1,140명의 환자 중, 대동맥 조작이 없는 무심폐기하 관상동맥 우회술을 시행한 1043명의 환자와 수술 중 심폐기를 가동하게 된 5명의 환자를 포함하여 총 1048명의 환자를 대상으로 하였다. STS score, EuroSCORE II, SYNTAX score II는 인터넷 프로그램을 이용하여 후향적 또는 전향적으로 계산되었다. STS 위험도 모델과 EuroSCORE II의 calibration은 실제 발생한 사건 수를 예측 발생 사건 수로 나눈 risk-adjusted event ratio (O/E ratio) 와 Hosmer-Lemeshow 검사를 이용하여 평가하였고, 분별력은 ROC curve의 면적 (AUC)을 통하여 평가하였다. Students t-test는 수술 후 사망 또는 합병증이 발생한 환자와 그렇지 않은 환자에서 SYNTAX score I 과 II를 비교하는데 이용되었다. 결과: 수술 후 사망은 10명(0.95%)에서 발생했다. EuroSCORE II와 STS 위험도 모델로 계산한 예측 사망률은 각각 2.58 ± 4.15%, 1.72 ± 2.92% 이였다. EuroSCORE II는 사망률을 통계적으로 의미있게 높게 평가 했으며 (P = 0.003), O/E ratio는 0.370 (신뢰구간: 0.177-0.681) 이었다. EuroSCORE II는 AUC가 0.784로 좋은 분별력을 보여주었다. STS 위험도 모델의 사망률에 대한 O/E ratio는 0.556 (신뢰구간: 0.266 – 1.023) 였으며, 예측 사망률은 실제 발생에 비하여 높게 계산되었으며, 통계적으로 경계성 유의성을 보였다 (P = 0.052). 그러나 하위집단 분석에서 STS 위험도 모델은 사망률을 통계적으로 의미있게 높게 예측하였다. (O/E ratio: 0.481, 신뢰구간: 0.193-0.992). 수술 후 영구적 뇌졸중은 6명(0.53%)에서 발생했으며, STS 위험도 모델로 예측한 영구적 뇌졸중 발생률은 1.73 ± 1.48%이었다. O/E ratio는 0.332 (신뢰구간: 0.121 – 0.722) 였고, STS 위험도 모델은 영구적인 뇌졸중 발생을 통계적으로 의미있게 높게 예측하였다 (P = 0.011). STS 위험도 모델의 사망률과 영구적 뇌졸중 발생률에 대한 분별력은 AUC가 각각 0.876, 0.740이었다. 수술 후 사망 또는 합병증이 발생한 환자와 그렇지 않은 환자의 SYNTAX score를 비교하였을 때, 두 그룹에서 SYNTAX score I은 차이를 보이지 않았으며 (P =0.469), SYNTAX score II는 수술 후 사망 또는 합병증이 발생한 환자에서 유의하게 높게 나타났다 (P <0.001). 결론: 관상동맥 우회술에 대한 기존의 위험도 예측 시스템인 STS 위험도 모델과 EuroSCORE II는 대동맥 조작이 없는 무심폐기하 관상동맥 우회술에서 사망률과 뇌졸중 발생률을 실제보다 높게 예측했다. 이러한 결과는 무심폐기하 관상동맥 우회술이 기존의 관상동맥 우회술보다 사망률과 뇌졸중 발생을 낮출 수 있다는 가능성을 시사한다. 또한, 이러한 결과는 관상동맥 우회술의 수술 위험도를 예측할 때 대동맥 조작이 없는 무심폐기하 관상동맥 우회술 같은 수술의 방법적 특성이 반드시 고려되어야 함을 보여준다.1. Introduction 1 2. Patients and methods 3 2.1 Patient characteristics and surgical procedure 3 2.2 Calculation of the risk prediction scores 4 2.3 Statistical analysis 7 3. Results 8 3.1 Performance of the EuroSCORE II 8 3.2 Performance of the STS risk model 9 3.3 Performance of SYNTAX score I and II 12 3.4 Subgroup analyses for high-risk patients 12 4. Discussion 12 4.1 Limitations 18 5. Conclusions 18 6. Acknowledgment 19 7. References 20 8. Figures and tables 26 9. 국문 초록 46Docto

Experimental Study on Tow Deformation during Impregnation in LCM

학위논문 (석사)-- 서울대학교 대학원 : 기계항공공학부, 2012. 8. 이우일.액상주입성형공정(LCM)은 제조공정 상의 이점과 경제적 이점으로 인해 복합재료 제조 산업에서 각광을 받고 있고, 기존의 공정을 대체해 나가고 있다. 하지만 수지 주입 공정에 있어 유량과 투과성에 관한 연구가 더 수행될 필요가 있다. 투과성계수는 수지 주입 공정과 충진 시간을 이해하는 중요한 파라미터이기 때문이다. Darcys law에 따르면 투과성계수는 유량과 유량의 변화에 따른 섬유 다발의 형상 변화에 따라 변화가 일어나게 된다. 따라서 본 연구에서는 섬유 다발의 형태와 수지 주입 압력의 변화에 따른 유량이 투과성에 영향을 미칠 것이라 예상하며 실험을 수행하였다. 실제LCM 공정과 유사한 조건의 실험기구를 제작하여 공정 진행 중 측면에서 섬유다발의 변화를 관찰하였으며, 유량이 증가함에 따라 섬유다발의 형상이 변화하였고 결과적으로 투과성계수가 증가함을 확인할 수 있었다.Liquid Composites Molding(LCM) is one of the most effective manufacturing method in terms of cost and processes so it has been substituting existing processes such as autoclave, pultrusion, filament winding. However, we need to study for the relation between volume flow rate and permeability during impregnation further because the permeability is a key parameter to figure out the impregnation process of resin and the impregnation time. According to Darcys law, permeability is proportional to volume flow rate and volume flow rate influences on fiber-tow geometry. Therefore this study has been conducted on the assumption that fiber-tow geometry and volume flow rate influenced by injection pressure would affect permeability. Experimental apparatus similar to an actual LCM process was made and the cross section pictures of the process during impregnation were taken. As volume flow rate increases, fiber-tow geometry is changed. As a result, that permeability is increased is confirmed.ABSTRACT I CONTENTS III LIST OF TABLES AND FIGURES IV LIST OF NOMENCLATURE VI CHAPTER 1 1 1. 1. 복합재료(COMPOSITE MATERIALS) 1 1.2. 액상주입성형(LIQUID COMPOSITE MOLDING, LCM) 2 1.3. 연구 목적 2 CHAPTER 2 4 2.1 재료 4 2.1.1 엔진오일 4 2.1.2 유리섬유 4 2.2 실험 기기 5 2.2.1 LCM 공정 기기 5 2.2.2 촬영 기기 6 2.2.3 수지 주입 기기 6 2.2.4 압력 측정 기기 6 2.3 실험 수행 7 2.3.1 실험 기구 설치 7 2.3.2 실험 수행 8 CHAPTER 3 9 3.1 유량의 변화에 따른 섬유다발의 변형 9 3.1.1 섬유다발의 변형 및 영향 10 CHAPTER 4 13 REFERENCES 14 초 록 26Maste

돼지에 이식한 포괄적인 항석회화 처리를 시행한 새로운 소 심낭 패치의 조기 성적

학위논문 (석사)-- 서울대학교 대학원 : 의학과 흉부외과학 전공, 2016. 2. 임청.Introduction: Bovine pericardial patches have been widely used for various cardiovascular surgeries. However, calcification still remains an important drawback. We evaluated the short term safety and effectiveness of our comprehensive anti-calcification procedure in a comparative study of the novel and commercially available bovine pericardial patch in a swine implantation model. Material and Methods: Our comprehensive anti-calcification procedure consisted of 4 steps, including decellularization with sodium dodecyl sulfate and tritonX-100, space filler treatment with polyethylene glycol, glutaraldehyde cross-linking with organic solvent, and detoxification with glycine. We simultaneously implanted both the commercially available bovine pericardial patch (Supple Peri-Guard®) and novel bovine pericardial patch processed by the comprehensive anti-calcification procedure into the main pulmonary artery in 7 pigs. Every pig underwent a cardiac angiography and was humanely sacrificed on the 28th postoperative day. The extracted patches were stained with hematoxylin and eosin. Results: All pigs survived for 4 weeks without any complication. Cardiac angiography showed the absence of leakage and structural problem. Neointimas were formed evenly without intimal hyperplasia. There were no significant differences in the degree of inflammation, necrosis, and calcification between the novel and commercially available patch (p = 0.450, p = 0.317, p = 0.999). Conclusions: Novel bovine pericardial patch using comprehensive anti-calcification procedure was similar to existing cardiovascular patch in early surgical results in a swine model. The comprehensive anti-calcification procedure could facilitate appropriate bioprosthetic properties of the bovine pericardium.1. Introduction 1 2. Material and methods 3 2.1 Material 3 2.1.1 Bovine pericardial patches 3 2.2 Methods 4 2.2.1 Comprehensive anti-calcification procedure 4 2.2.2 Operation 7 2.2.3 Postoperative care 8 2.2.4 Cardiac angiography and histology 9 2.3 Statistical analysis 9 3. Results 11 3.1 Blood sample test 11 3.2 Cardiac angiography and gross findings 11 3.3 Histologic findings 12 4. Discussion 15 5. Conclusions 23 6. References 24 7. Figures and table 31 8. 국문초록 40Maste

충돌 회피를 위한 긴급 주행 보조 알고리즘

학위논문 (박사)-- 서울대학교 대학원 : 기계항공공학부, 2014. 2. 이경수.In recent years, automakers have been trying to help drivers to avoid or mitigate collision with active safety system. Practical applications have become possible due to recent advances in exterior sensors and electronically controllable actuators. These advances have opened up many possibilities for active safety systems like lane keeping assistance system (LKAS), advanced emergency braking system (AEBS) and blind spot detection (BSD). The further enhancement of these technologies will lead to an automated driving system that requires a collision avoidance function using by automatic braking and even automatic throttle and steering. This dissertation focuses on automated collision avoidance using automated steering control and control of motor-driven power steering (MDPS) torque overlay and differential braking for emergency driving support (EDS). A robust Model Predictive Control (MPC) method is used in order to guarantee safety constraints despite of disturbances and model uncertainty. A minimum Robust Positively Invariant (RPI) set of vehicle state error is calculated and the robust MPC calculates the appropriate collision avoidance steering. The performance of the proposed algorithm has been investigated via computer simulations. The simulation studies show that the controlled vehicle can achieve safe collision avoidance maneuver using small lateral acceleration in a long distance preceding vehicle avoidance scenario, and it can achieve safe collision avoidance maneuver using high lateral acceleration in a sudden appeared vehicle avoidance scenario. Electrically controllable actuators, MDPS and differential brake system are used as actuators instead of automated steering and a radar and camera are used as a sensor system for the EDS algorithm. Using environment and vehicle information obtained from the sensor system, a risk of collision and drivers intention are determined. A trapezoidal acceleration profile (TAP) is generated incorporating the drivers intention and based on the TAP, the MDPS overlay torque is determined in order to assist the drivers speed of response. The differential braking is determined to maximize the minimum vehicle-to-vehicle distance to avoid collision. From the non-linear optimal control problem, the rule-based control algorithm is designed for real-time application. The performance of the proposed algorithm has been investigated via computer simulations and real-time human-in-the-loop simulations. The simulation studies show that the controlled vehicle can secure additional vehicle-to-vehicle distance in severe lane change maneuvering for collision avoidance. The success rate of collision avoidance has been investigated for 8 test drivers using the human-in-the-loop simulations. It has been shown that the most of the test drivers can benefit from the proposed support system.Abstract i List of Tables vi List of Figures vii Chapter 1 Introduction 1 1.1 Backgraound and Motivation 1 1.2 Previous Researches 5 1.3 Thesis Objectives 8 1.4 Thesis Outline 10 Chapter 2 Automated Collision Avoidance using Robust Model Predictive Control 11 2.1 Model Predictive Control Problem 12 2.1.1 Vehicle model 13 2.1.2 Constraint design 17 2.1.3 Model predictive control formulation 21 2.2 Robustness Analysis 24 2.2.1 Disturbance analysis 24 2.2.1.1 Tire force disturbance 24 2.2.1.2 Vehicle parameter uncertainties 29 2.2.2 Linear state feedback 30 2.2.3 Robust Positively Invariant set computation 31 2.3 Simulation 33 Chapter 3 Emergency Driving Support 41 3.1 Overview of Emergency Driving Support 43 3.1.1 Danger area estimation 43 3.1.2 Index module 46 3.1.2.1 Lane change intention index 46 3.1.2.2 Collision risk index 48 3.1.2 State manager 50 3.2 Motor Driven Power Steering Overlay Torque Control 52 3.2.1 Trapezoidal Acceleration Profile 53 3.2.2 Motor Driven Power Steering overlay torque control 58 3.2.2.1 Linear model analysis 59 3.2.2.2 Non-linear vehicle simulation 63 3.2.2.3 Map-based overlay torque control 65 3.3 Differential Braking Control 66 3.3.1 Optimal control problem 67 3.3.2 Rule-based differential braking control 71 3.3.3 Non-linear vehicle simulation 77 3.4 Evaluation 80 3.4.1 Simulation 80 3.4.2 Best case scenario evaluation 82 3.4.2 Evaluation on a Virtual Test Track 84 Chapter 4 Conclusions and Future Works 89 Bibliography 92 국문초록 100Docto

Clinical effect of sarcopenia and subcutaneous adipose tissue on mortality and prognosis of liver cirrhosis

Increasing evidence suggests that decreased skeletal muscle mass (sarcopenia) or adipose tissue assessed predicts negative outcomes in patients with cancer. In liver cirrhosis, while there is consensus that sarcopenia has been associated with higher mortality, the prognostic value of adipose tissue is not clear. We investigated the independent prognostic significance of visceral and subcutaneous adiposity in predicting mortality in liver cirrhosis. and further more we devided group by gender, MELD score to find out ther diffence. The cross-sectional areas (cm2) of skeletal muscles (SM) and subcutaneous and visceral adipose tissues were measured on CT imaging at the level of the third lumbar (L3) vertebra. Adipose tissue markers, including the visceral adipose tissue index (VATI, cm2/m2) and subcutaneous adipose tissue index (SATI, cm2/m2), were estimated for 550 patients diagnosed with cirrhosis. Sarcopenia was defined using established cut-offs in patients with cirrhosis as SM index (SMI) <39 cm2/m2 in females and 50< cm2/m2 in males. The cutoff values for low subcutaneous or visceral adipose tissue were adopted if SATI or VATI were lower than the mean for men and women. Among the patients, most were male (79.2%) with a mean age of 53.8 ± 10 years and model for end-stage liver disease (MELD) score of 10.4 ± 3. Body composition differed according to sex, with male having greater SMI (mean, 53.2 ± 8.6 vs. 47.3 ± 10.5) and VATI (37.76 ± 19.30 vs. 35.95 ± 20.62) whereas SATI (35.98 ± 17.20 vs. 68.01 ± 33.20) was higher in females. In a total of 550 patients, the 5-year overall survival in patients with higher SATI was 76.1%, while it was 65.0% in those with lower SATI (p=0.019). The 5-year overall survival in patients with lower VATI was 67.6%, while it was 60.5% in those with higher VATI (p=0.657). A low VATI was not associated with overall survival in both females and males. The 5-year overall survival in patients with sarcopenia was 44.5%, while it was 74.5% in those without sarcopenia (p<0.001). In gender stratified multivariate analyses, higher SATI was significantly associated with overall survival (adjusted HR [aHR]=0.292, p=0.027) in females whereas sarcopenia independently associated with mortality risk (aHR=1.469, p=0.043) in males after adjusting for MELD score and albumin. Also, in MELD score stratified multivariate analyses, higher SATI was significantly associated with overall survival in female high MELD score group, where as male group had different result in low and high MELD score group. In male low MELD score group, higher SATI was associated with overall survival whereas sarcopenia was associated with mortality in male High MELD score group. Moreover, patients with lower SATI were at a significantly higher risk of variceal bleeding than those with higher SATI (HR=0.421, p<0.001). Lower SATI group showed a trend toward a higher risk of developing of ascites than higher SATI group, but the difference was not statistically significant (HR, 0.715; P=0.070). Subcutaneous adipose tissues, but not visceral adipose tissues, appear to be associated with a reduction in mortality risk, demonstrating the prognostic importance of fat distribution in female patients with cirrhosis. Meanwhile, SMI predicts mortality in male patients with cirrhosis. Moreover, the effect of sarcopenia on survival was more pronounced in male patients with low muscle mass. 암 환자에 있어서 골격근의 저하 또는 피하지방조직의 변화가 불량한 예후와 관련 있다는 것은 잘 알려져 있다. 간경변증에 있어서도 현재 이에 대하여 관한 연구 또한 활발이 진행되고 있으며 골격근의 감소의 경우 간경변증 환자의 사망률을 높인다는 결과가 보고되고 있으나1 피하지방 조직과 간경화환자의 예후에 대한 연구는 부족한 실정이다. 본 연구에서는 이러한 기존 연구들을 바탕으로 간경화 환자에서 피하지방조직, 내장지방조직 및 골격근을 측정하여 사망률과의 연관성을 알아보고자 하였으며, 성별 및 간경변증의 진행 정도에 따른 사망률의 차이 및 비만지표들에 따른 식도정맥류 및 복수 같은 간경화 합병증의 발생의 차이점 또한 알아보고자 하였다. 총 550명의 환자에서 피하지방조직과 내장지방조직 및 골격근의 단위 면적을 요추 3번(L3) 위치에서 컴퓨터 단층촬영을 통하여 측정하였고, 측정된 단위면적을 키로 나누어 내장지방조직지수(visceral adipose tissue index, VATI, cm2/m2)와 피하지방조직지수(subcutaneous adipose tissue index, SATI, cm2/m2), 골격근지수(skeletal muscle index, SMI, cm2/m2)를 계산하였다. 근감소증은 상용화된 cut-off value를 사용하여 분류 하였으며, 이에 따라 분류하였을 때 여성의 경우 SMI <39 cm2/m2, 남성의 경우 <50 cm2/m2 로 정의하였다.2 지방조직지수의 cut-off value는 본 연구의 SATI 및 VATI의 평균값을 기준으로 분류하였다. 환자들 중 대부분은 남성 이었으며(n=436, 79.2%) 평균 연령은 53.8 ± 10.0 세였고 model for end-stage liver disease (MELD) score 의 평균은 10.4 ± 3.0 였다. 인체 구성은 성별에 따라 다르게 나타났는데, 남성에서 SMI가 높게 나타났으며(p=0.001), SATI는 여성에서 높게 나타났다(p=0.001). 총 550명의 환자 중, 높은 SATI를 가진 환자들의 5년 생존율은 76.1%였으며, 낮은 SATI 환자들의 5년 생존율 65%에 비하여 유의하게 높은 것으로 나타났다(log-rank P =0.019). 낮은 VATI 환자들의 5년 생존율은 67.6%로 측정되었고, 높은 VATI 환자에서의 60.5%와 비교 하였을 때 통계적으로 유의한 차이는 없었다(log-rank P =0.657). 근감소증이 있는 환자의 경우 생존율이 44.5%로 나타났으나, 근감소증이 없는 경우 74.5%로 유의한 차이를 보였다(log-rank P <0.026). 성별에 따른 세부 분석을 시행하였을 경우 여성 간경변증 환자 중 높은 SATI level을 가진 환자군에서 사망률이 유의하게 낮은 것으로 나타났으며(adjusted HR= 0.292, 95% CI: 0.098-0.869 p=0.027) 남성 간경화 환자에서는 근감소증이 있을 경우 사망률이 유의하게 증가하는 것으로 보였다(adjusted HR= 1.469, 95% CI: 1.013-2.131 p=0.043). 또한 MELD score에 따른 다중회귀분석을 진행하였고 여성 간경변증 환자 중 MELD score 10 이상 환자군에서 높은 SATI level과 생존율이 연관을 보였으며, 남성 환자의 경우 MELD score 10미만 환자군에서는 높은 SATI level과 생존율이, MELD score 10 이상 환자군에서는 근감소증과 사망률이 연관성을 보였다. 추가적으로 높은 SATI를 갖은 환자 군의 경우 낮은 SATI 환자군보다 명확하게 적은 식도정맥류 출혈이 나타났다(HR=0.421, p<0.001). 복수의 경우 높은 SATI 환자 군에서 낮은 SATI 환자 군보다 더 적은 경향을 보이긴 하였으나 통계적으로 유의한 차이를 보이지 않았다(HR, 0.715; P=0.070). 본 연구 결과 여성에서 내장지방조직지수가 아닌 피하지방조직지수의 증가가 환자의 생존율과 연관 있다는 것을 알 수 있었으며 근감소증은 남성 간경화 환자의 사망률을 증가시켰다. 본 연구는 간경변증 환자에서 골격근 외 피하지방조직, 내장지방조직을 측정하는 것이 환자의 예후 및 사망률을 예측하는 매개변수로 충분히 활용될 수 있으며, 여성 간경변증 환자에서 지방조직의 분포가 예후에 중요함을 보여준다.open석

Characterization of P2Y Purinergic Receptors in Dopaminergic SN4741 cells

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