산분비억제제

신철민 대한상부위장관ㆍ헬리코박터학회 2022 Korean Journal of Helicobacter Upper Gastrointesti Vol.22 No.2

Histamine H2 receptor antagonists (H2RAs) suppress gastric acid production by blocking H2 receptors in parietal cells. Studies have shown that proton pump inhibitors (PPIs) are superior to H2RAs as a treatment for acid-related disorders, such as peptic ulcer disease (PUD) and gastroesophageal reflux disease (GERD). PPIs reduce gastric acid production by irreversibly inhibiting the H+/K+ ATPase pump, and they also increase gastric emptying. Although PPIs have differing pharmacokinetic properties, each PPI is effective in managing GERD and PUDs. However, PPIs have some limitations, including short plasma half-lives, breakthrough symptoms (especially at night), meal-associated dosing, and concerns associated with long-term PPI use. Potassium-competitive acid blockers (P-CABs) provide more rapid and profound suppression of intragastric acidity than PPIs. P-CABs are non-inferior to lansoprazole in healing erosive esophagitis and peptic ulcers, and may also be effective in improving symptoms in patients with non-erosive reflux disease. Acid suppressive drugs are the most commonly used drugs in clinical practice, and it is necessary to understand the pharmacological properties and adverse effects of each drug.

임상연구 논문의 질 평가를 위한 도구들

신철민,한창수,배치운,Ashwin A Patkar 대한정신약물학회 2011 대한정신약물학회지 Vol.22 No.2

Quality of medical research reports should be evaluated before they are applied to clinical practice. Since 1990s, several guidelines on research reports were suggested. Most recently published Consolidated Standards of Reporting Trials statement 2010 consists of 25 checklists and flow diagram for reporting an randomized controlled trial. Strengthening the reporting of observational studies in epidemiology statement is a checklist of items that should be addressed in articles reporting on the observational studies in epidemiology. TREND statement for the reporting of nonrandomized designs consists of 22 checklists. The Quality of Reporting of Meta-analyses checklist proposes to provide checklist and flow diagram for reporting of meta-analyses. The Meta-analysis of Observational Studies in Epidemiology statement proposes a checklist for compensating the study errors about observational studies in epidemiology. After development of reporting guidelines, improvements in the quality of reports are continuously reported, so using guidelines in the medical research will be expected to be more generalized. 1990년대부터 임상연구 논문의 질을 평가하기 위한 도구들이 제안되기 시작하였다. 무작위대조시험에 대한 평가 도구인 CONSORT, 관찰연구의 평가 도구인 STROBE, 비무작위 설계 연구에 대한 평가 도구인 TREND, 메타분석 보고의 질을 평가하기 위한 QUOROM, 관찰연구의 메타분석에 대한 질 평가를 위한 MOOSE 등이 있다. 이들 평가도구들이 개발되어 사용된 이후 임상연구 논문의 질이 좋아지고 있다는 보고가 이어지고 있으며, 이는 추후 임상의학 발전에 보다 긍정적으로 이바지할 것이다.

위식도 역류질환의 최신지견

신철민 대한연하장애학회 2015 대한연하장애학회지 Vol.5 No.2

Gastroesophageal reflux disease (GERD) is a condition that develops when the reflux of gastric contents causes troublesome symptoms or complications. Typical symptoms are heartburn and acid regurgitation; extraesophageal manifestations include chronic cough, reflux laryngitis, asthma, non-cardiac chest pain and dental erosion. GERD can be presented as esophagitis or Barrett’s esophagus; nonerosive reflux disease (NERD) is defined as no visible esophageal erosions but objective evidence that a patient’s symptoms are caused by gastro-esophageal reflux. Transient LES relaxations (tLESRs) and hiatal hernia are the main mechanisms underlying gastroesophageal reflux, and the acid pocket relative to the diaphragm is a major determinant of the acidity of the refluxate. Especially, in patients with NERD, increased permeability due to impaired mucosal barrier may contribute to symptom generation. The mainstay of pharmacologic therapy for GERD is gastric acid suppression with proton pump inhibitors (PPIs), and PPIs are superior to histamine-2 receptor antagonist (H2RAs) for mucosal healing of erosive esophagitis and achieving symptom control. Prokinetics, cytoprotective agents and tLESR inhibitors such as baclofen also may be effective, but have only limited data. GERD could be a chronic relapsing disease, so maintenance therapy (either continuous or on-demand therapy) may be required following successful initial treatment.

식도게실

신철민 대한상부위장관ㆍ헬리코박터학회 2022 Korean Journal of Helicobacter Upper Gastrointesti Vol.22 No.3

An esophageal diverticulum is rare and is usually asymptomatic, although this condition may cause dysphagia, regurgitation, chest pain, globus, halitosis, and aspiration pneumonia. Based on its location and the characteristic pathophysiology associated with this anomaly, esophageal diverticula are classified into the following types: Zenker’s, epiphrenic, and mid-esophageal diverticula (Rokitansky diverticulum). Esophagography is useful to diagnose esophageal diverticula. Evaluation of accompanying esophageal motility disorders, including achalasia and distal esophageal spasm is essential in patients with epiphrenic diverticula. Appropriate treatment is important for management of symptomatic esophageal diverticula. Previously, diverticulectomy or diverticulopexy was the usual treatment for this condition. However, surgical resection of diverticula is challenging owing to the complex esophageal anatomy, particularly in patients with diverticula located in close proximity to the oral cavity. Technological advances have led to the introduction of minimally invasive endoscopic approaches focused on symptom improvement. Rigid diverticuloscope-assisted septotomy, flexible endoscopic septum division, Zenker peroral endoscopic myotomy (Z-POEM), and peroral endoscopic septotomy (POES) are useful for treatment of a Zenker’s diverticulum. Recent studies recommend diverticulum peroral endoscopic myotomy (D-POEM) for endoscopic management of epiphrenic diverticula. Further studies are warranted to conclusively establish the technical success rates, clinical symptom improvement, and long-term prognosis of Z-POEM, POES, and D-POEM.

장애인복지관에서 정신장애인의 복지권 강화, 문제의 진단과 대안

신철민 한국정신건강사회복지학회 2022 한국정신건강사회복지학회 학술발표논문집 Vol.2022 No.5

Prevalence and Associated Factors of Depression in General Population of Korea: Results from the Korea National Health and Nutrition Examination Survey, 2014

신철민,김윤정,박수연,윤서영,고영훈,김용구,김승현,전상원,한창수 대한의학회 2017 Journal of Korean medical science Vol.32 No.11

Depressive disorder is a common mental illness and remains a major cause of morbidity worldwide. The present study, a cross-sectional, nationwide, population-based survey assessed the prevalence of depression in the general population of Korea through a random sampling of the non-institutionalized population for the Korea National Health and Nutrition Examination Survey (KNHANES) VI. The Patient Health Questionnaire (PHQ)-9 was first introduced into the KNHANES to detect depression. The point prevalence of depression (PHQ score of 10 or higher) was 6.7% (95% confidence interval [CI], 5.7–7.6) in 4,949 subjects. Based on the analysis using the diagnostic algorithm of the PHQ-9, the prevalence of major depressive disorder was 2.7% (95% CI, 2.2–3.3). Multiple logistic regression analysis, after adjusting the sociodemographic variables, also showed that the factors associated with depression were perceived stress and health status. This study reported for the first time that the point prevalence of depression screened using the PHQ-9 in this nationwide survey of the Korean population was similar to that of the western countries. As the KNHANES to detect depression is conducted biennially, further studies on the accumulated data are expected in the future.

Effect of conditioner load on the polishing pad surface during chemical mechanical planarization process

신철민,Hongyi Qin,Seokjun Hong,Sanghyuk Jeon,Atul Kulkarni,Taesung Kim 대한기계학회 2016 JOURNAL OF MECHANICAL SCIENCE AND TECHNOLOGY Vol.30 No.12

During the Chemical mechanical planarization (CMP), the pad conditioning process can affect the pad surface characteristics. Among many CMP process parameters, the improper applied load on the conditioner arm may have adverse effects on the polyurethane pad. In this work, we evaluated the pad surface properties under the various conditioner arm applied during pad conditioning process. The conditioning pads were evaluated for surface topography, surface roughness parameters such as Rt and Rvk and Material removal rate (MRR) and within-wafer non-uniformity after wafer polishing. We observed that, the pad asperities were collapsed in the direction of conditioner rotation and blocks the pad pores applied conditioner load. The Rvk value and MRR were founded to be in relation with 4 > 1 > 7 kgF conditioner load. Hence, this study shows that, 4 kgF applied load by conditioner is most suitable for the pad conditioning during CMP.

Aberrant DNA Methylation Maker for Predicting Metachronous Recurrence After Endoscopic Resection of Gastric Neoplasms

신철민,김나영,윤혁,최윤진,박지현,박영수,이동호 대한암학회 2022 Cancer Research and Treatment Vol.54 No.4

Purpose This study aimed to investigate whether MOS methylation can be useful for the prediction of metachronous recurrence after endoscopic resection of gastric neoplasms. Materials and Methods From 2012 to 2017, 294 patients were prospectively enrolled after endoscopic resection of gastric dysplasia (n=171) or early gastric cancer (n=123). When Helicobacter pylori was positive, eradication therapy was performed. Among them, 124 patients completed the study protocol (follow-up duration > 3 years or development of metachronous recurrence during the follow-up). Methylation levels of MOS were measured at baseline using quantitative MethyLight assay from the antrum. Results Median follow-up duration was 49.9 months. MOS methylation levels at baseline were not different by age, sex, and current H. pylori infection, but they showed a weak correlation with operative link on gastritis assessment (OLGA) or operative link on gastric intestinal metaplasia assessment (OLGIM) stages (Spearman’s ρ=0.240 and 0.174, respectively; p < 0.05). During the follow-up, a total of 20 metachronous gastric neoplasms (13 adenomas and 7 adenocarcinomas) were developed. Either OLGA or OLGIM stage was not useful in predicting the risk for metachronous recurrence. In contrast, MOS methylation high group (≥ 34.82%) had a significantly increased risk for metachronous recurrence compared to MOS methylation low group (adjusted hazard ratio, 4.76; 95% confidence interval, 1.54 to 14.79; p=0.007). Conclusion MOS methylation can be a promising marker for predicting metachronous recurrence after endoscopic resection of gastric neoplasms. To confirm the usefulness of MOS methylation, validation studies are warranted in the future (ClinicalTrials No. NCT04830618). Purpose This study aimed to investigate whether <i>MOS</i> methylation can be useful for the prediction of metachronous recurrence after endoscopic resection of gastric neoplasms.Materials and Methods From 2012 to 2017, 294 patients were prospectively enrolled after endoscopic resection of gastric dysplasia (n=171) or early gastric cancer (n=123). When <i>Helicobacter pylori</i> was positive, eradication therapy was performed. Among them, 124 patients completed the study protocol (follow-up duration > 3 years or development of metachronous recurrence during the follow-up). Methylation levels of <i>MOS</i> were measured at baseline using quantitative MethyLight assay from the antrum.Results Median follow-up duration was 49.9 months. <i>MOS</i> methylation levels at baseline were not different by age, sex, and current <i>H. pylorii</i> infection, but they showed a weak correlation with operative link on gastritis assessment (OLGA) or operative link on gastric intestinal metaplasia assessment (OLGIM) stages (Spearman’s ρ=0.240 and 0.174, respectively; p < 0.05). During the follow-up, a total of 20 metachronous gastric neoplasms (13 adenomas and 7 adenocarcinomas) were developed. Either OLGA or OLGIM stage was not useful in predicting the risk for metachronous recurrence. In contrast, <i>MOS</i> methylation high group (≥ 34.82%) had a significantly increased risk for metachronous recurrence compared to <i>MOS</i> methylation low group (adjusted hazard ratio, 4.76; 95% confidence interval, 1.54 to 14.79; p=0.007).Conclusion <i>MOS</i> methylation can be a promising marker for predicting metachronous recurrence after endoscopic resection of gastric neoplasms. To confirm the usefulness of <i>MOS</i> methylation, validation studies are warranted in the future (ClinicalTrials No. NCT04830618).

MIMO-OFDM 시스템에서 Constant Modulus 신호의 SVR-MMSE 검출 성능 분석

신철민,서명석,양청해,곽경섭,Shin, Chul-Min,Seo, Myoung-Seok,Yang, Qing-Hai,Kwak, Kyung-Sup 한국통신학회 2006 韓國通信學會論文誌 Vol.31 No.12A

본 논문에서는 MIMO 시스템에서 제안된 SVR-MMSE 검출기법을 MIMO-OFDM 시스템으로 확장, 적용하고 주파수 선택적인 채널에서 성능을 분석한다. 우선 전형적인 MIMO-OFDM 시스템에 대해서 설명하고 이 시스템에서 constant modulus 신호의 검출기법에 대하여 설명을 한다. 기존의 검출 기법인 Zero Forcing, Minimum Mean Square Error 기법과 제안된 SVR-MMSE 검출의 성능을 비교해 보고, Jakes 채널 모델을 사용하여 지연확산을 가지는 다중 경로 페이딩 채널에서 도플러 주파수가 변화함에 따라 검출 기법의 성능을 알아본다. 본 논문에서 제안된 SVR-MMSE를 이용한 MIMO-OFDM 시스템에서의 검출 성능 모의실험 결과, 제안된 알고리즘이 이 시스템에서 우수한 성능을 지니고 있음을 보여주고 있다. In this paper, we extend SVR-MMSE detection scheme which is proposed in MIMO system to MIMO-OFDM system, and evaluate performance of the system in frequency selective fading channel. First of all, we explain about typical MIMO-OFDM system and detection scheme of constant modulus signals in this system. And compare proposed SVR-MMSE with Zero Forcing, Minimum Mean Square Error which is conventional detection scheme. we identify that the performance of the proposed system is shown different by varying doppler frequency in frequency selective fading channel using jakes channel model. The result of detection performance by the proposed SVR-MMSE in this simulation, it shows that proposed algorithm have a good performance in MIMO-OFDM systems.

MiMO-OFDM 시스템에서 Constant Modulus 신호의 SVR-MMSE 검출 성능 분석

신철민,서명석,양청해,곽경섭 한국통신학회 2006 韓國通信學會論文誌 Vol.31 No.12