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Does an extensive diagnostic workup for upfront resectable pancreatic cancer result in a delay which affects survival? Results from an international multicentre study

  • Thomas B. Russell;Peter L. Labib;Jemimah Denson;Fabio Ausania;Elizabeth Pando;Keith J. Roberts;Ambareen Kausar;Vasileios K. Mavroeidis;Gabriele Marangoni;Sarah C. Thomasset;Adam E. Frampton;Pavlos Lykoudis;Manuel Maglione;Nassir Alhaboob;Hassaan Bari;Andrew M. Smith;Duncan Spalding;Parthi Srinivasan;Brian R. Davidson;Ricky H. Bhogal;Daniel Croagh;Ashray Rajagopalan;Ismael Dominguez;Rohan Thakkar;Dhanny Gomez;Michael A. Silva;Pierfrancesco Lapolla;Andrea Mingoli;Alberto Porcu;Teresa Perra;Nehal S. Shah;Zaed Z. R. Hamady;Bilal Al-Sarrieh;Alejandro Serrablo;Somaiah Aroori
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.27 no.4
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    • pp.403-414
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    • 2023
  • Backgrounds/Aims: Pancreatoduodenectomy (PD) is recommended in fit patients with a carcinoma (PDAC) of the pancreatic head, and a delayed resection may affect survival. This study aimed to correlate the time from staging to PD with long-term survival, and study the impact of preoperative investigations (if any) on the timing of surgery. Methods: Data were extracted from the Recurrence After Whipple's (RAW) study, a multicentre retrospective study of PD outcomes. Only PDAC patients who underwent an upfront resection were included. Patients who received neoadjuvant chemo-/radiotherapy were excluded. Group A (PD within 28 days of most recent preoperative computed tomography [CT]) was compared to group B (> 28 days). Results: A total of 595 patents were included. Compared to group A (median CT-PD time: 12.5 days, interquartile range: 6-21), group B (49 days, 39-64.5) had similar one-year survival (73% vs. 75%, p = 0.6), five-year survival (23% vs. 21%, p = 0.6) and median time-to-death (17 vs. 18 months, p = 0.8). Staging laparoscopy (43 vs. 29.5 days, p = 0.009) and preoperative biliary stenting (39 vs. 20 days, p < 0.001) were associated with a delay to PD, but magnetic resonance imaging (32 vs. 32 days, p = 0.5), positron emission tomography (40 vs. 31 days, p > 0.99) and endoscopic ultrasonography (28 vs. 32 days, p > 0.99) were not. Conclusions: Although a treatment delay may give rise to patient anxiety, our findings would suggest this does not correlate with worse survival. A delay may be necessary to obtain further information and minimize the number of PD patients diagnosed with early disease recurrence.

Necessity of Developing University Radiology Curriculum for Veterinary Hospital Radiological Technologists - D University Case Focusing - (동물병원 방사선사를 위한 대학 방사선학과 교육과정 개발 필요성 - D 대학 사례 중심으로 -)

  • Won-Jeong Lee
    • Journal of the Korean Society of Radiology
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    • v.18 no.3
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    • pp.203-212
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    • 2024
  • The purpose of this study was to survey by the veterinary hospital Specialists (VHSs) and radiology students (RSs) for radiology curriculum development veterinary hospital (VH), and for veterinary hospital radiological technologists (VHRTs). VHSs were surveyed to regarding the basic information and radiological examination training, radiological examination experience, anatomy physiology, radiation safety management training, radiation biology training. RSs were surveyed to regarding the basic information and career paths, VH awareness, and VH-related department environments. The survey results were quantitatively entered into Excel and then analyzed using the SPSS ver. 26.0. The students were aged by 22.6 years old, and out of 171 students, male and female were 92 and 79 espectively. In employment career paths, 62.6% of all subjects responded that employment prospects at medical institutions were good. Employment prospects outside of medical institutions, VH had the highest number of students. Of the 83 students who responded that they wanted to work at a VH, 64 students liked animals, and 47 students the high potential for advancement. Of the 159 students who responded that there is potential for development of VH, 96.2% responded that it was due to the increase in companion animals. In the VH-related department environment, 94.7% responded that there was no related equipment, and 72.5% responded that the department needed to open animal care courses and 82.5% anatomy and physiology courses. 76.6% responded that they would be willing to take animal-related courses if they were offered. Among the 20 VHSAs, 4 had no experience in radiological examination of animals, 2 VHRTs, and 2 others. There were 7 people who had not received training in animal radiography, and 2 VHRTs had not received training in animal care and animal anatomy and physiology. This study is expected to be helpful in developing a radiology curriculum for VHRTs in the future.

Characteristic evaluation of anaerobic co-digestion using desulfurization sludge and primary sludge (탈황슬러지 및 생슬러지를 이용한 혐기성 병합소화 특성평가)

  • Seulki Koo;Woojin Chung;Soonwoong Chang;Myoungsoo Park
    • Journal of the Korea Organic Resources Recycling Association
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    • v.31 no.4
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    • pp.51-58
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    • 2023
  • In this study, anaerobic co-digestion was carried out using desulfurization sludge and sewage sludge (primary sludge) to evaluate the effects of sulfur compounds in anaerobic digestion. The experiment was carried out in the form of a batch test using 500 mL duran bottle, and the mixing ratio of the feedstock was selected based on the ratio of COD/SO4. As a result of the experiment, it was confirmed that the amount of biogas generated and the yield decreased at the mixing ratio of COD/SO4 20 or less. In particular, below COD/SO4 10, it was lower than seed (283.5 mL) which was set without feedstock to correct biogas generated by itself from seed sludge. Methane yield tended to decrease from a ratio of COD/SO4 20 or less to 0.135 m3/kg VS compared to 0.396 m3/kg VS of COD/SO4 50. In addition, compared to 0.0097 m3/kg VS of hydrogen sulfide yield from COD/SO4 50, the ratio of COD/SO4 20 increased sharply to 0.0223 m3/kg VS, and in particular, the highest result was 0.0855 m3/kg VS in COD/SO4 10. Based on these results, it is judged that the effect of sulfide in anaerobic digestion can have an adverse effect if the COD/SO4 ratio decreases to less than 20.

The Influence of K-Content Experience on National Image, Tourism Attitude and Visit to Intention: Targeting Chinese (K-콘텐츠 경험이 국가이미지와 관광태도 및 방문의도에 미치는 영향 : 중국인을 대상으로)

  • Park, Heejung
    • Journal of Service Research and Studies
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    • v.14 no.1
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    • pp.91-107
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    • 2024
  • This study attempted to empirically verify the possibility of K-content for Chinese people who have recently slowed down due to restriction of movement and political and diplomatic conflicts, although it is a very meaningful market for Korea's content industry and tourism industry. As a result of the study, each item of K-content experience, national image, tourism attitude, and visit intention was derived as one factor, and only the national image factor was derived as two factors: 'functional image' and 'cultural image'. As a result of examining the influence relationship between them established based on previous studies focusing on the derived factors, all five research hypotheses were adopted. K-content experience was found to have a significant influence on both factors of the national image. It was found that it had a greater influence on cultural image factors than functional image factors, cultural image factors were found to have a greater influence on tourism attitudes, K-content experiences had a significant effect on tourism attitudes, and tourism attitudes had a significant effect on visit intentions. Based on the results of this study, it was once again confirmed that the national image even comtually bees an important factor for linking to practical tourism behavior, and in this respect, "culture" is an important key factor that can lead to practical tourism and visits. Previous national images indicate that if the functional aspect of the country was more emphasized, it is now necessary to focus more on the importance of culture than on the functional aspect. As the K-content experience has a significant effect on tourism attitude, it can have a positive effect on the formation of a positive tourism attitude that can lead to actual tourism behavior, so various efforts will be needed to form an active tourism attitude using K-content in the future. As the content and target scope of K-content are expanded and diversified, specific strategies for each sub-market using cultural contents in various fields should be established and implemented.

Contrast Media in Abdominal Computed Tomography: Optimization of Delivery Methods

  • Joon Koo Han;Byung Ihn Choi;Ah Young Kim;Soo Jung Kim
    • Korean Journal of Radiology
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    • v.2 no.1
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    • pp.28-36
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    • 2001
  • Objective: To provide a systematic overview of the effects of various parameters on contrast enhancement within the same population, an animal experiment as well as a computer-aided simulation study was performed. Materials and Methods: In an animal experiment, single-level dynamic CT through the liver was performed at 5-second intervals just after the injection of contrast medium for 3 minutes. Combinations of three different amounts (1, 2, 3 mL/kg), concentrations (150, 200, 300 mgI/mL), and injection rates (0.5, 1, 2 mL/sec) were used. The CT number of the aorta (A), portal vein (P) and liver (L) was measured in each image, and time-attenuation curves for A, P and L were thus obtained. The degree of maximum enhancement (Imax) and time to reach peak enhancement (Tmax) of A, P and L were determined, and times to equilibrium (Teq) were analyzed. In the computed-aided simulation model, a program based on the amount, flow, and diffusion coefficient of body fluid in various compartments of the human body was designed. The input variables were the concentrations, volumes and injection rates of the contrast media used. The program generated the time-attenuation curves of A, P and L, as well as liver-to-hepatocellular carcinoma (HCC) contrast curves. On each curve, we calculated and plotted the optimal temporal window (time period above the lower threshold, which in this experiment was 10 Hounsfield units), the total area under the curve above the lower threshold, and the area within the optimal range. Results: A. Animal Experiment: At a given concentration and injection rate, an increased volume of contrast medium led to increases in Imax A, P and L. In addition, Tmax A, P, L and Teq were prolonged in parallel with increases in injection time The time-attenuation curve shifted upward and to the right. For a given volume and injection rate, an increased concentration of contrast medium increased the degree of aortic, portal and hepatic enhancement, though Tmax A, P and L remained the same. The time-attenuation curve shifted upward. For a given volume and concentration of contrast medium, changes in the injection rate had a prominent effect on aortic enhancement, and that of the portal vein and hepatic parenchyma also showed some increase, though the effect was less prominent. A increased in the rate of contrast injection led to shifting of the time enhancement curve to the left and upward. B. Computer Simulation: At a faster injection rate, there was minimal change in the degree of hepatic attenuation, though the duration of the optimal temporal window decreased. The area between 10 and 30 HU was greatest when contrast media was delivered at a rate of 2 3 mL/sec. Although the total area under the curve increased in proportion to the injection rate, most of this increase was above the upper threshould and thus the temporal window was narrow and the optimal area decreased. Conclusion: Increases in volume, concentration and injection rate all resulted in improved arterial enhancement. If cost was disregarded, increasing the injection volume was the most reliable way of obtaining good quality enhancement. The optimal way of delivering a given amount of contrast medium can be calculated using a computer-based mathematical model.

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Contactless Data Society and Reterritorialization of the Archive (비접촉 데이터 사회와 아카이브 재영토화)

  • Jo, Min-ji
    • The Korean Journal of Archival Studies
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    • no.79
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    • pp.5-32
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    • 2024
  • The Korean government ranked 3rd among 193 UN member countries in the UN's 2022 e-Government Development Index. Korea, which has consistently been evaluated as a top country, can clearly be said to be a leading country in the world of e-government. The lubricant of e-government is data. Data itself is neither information nor a record, but it is a source of information and records and a resource of knowledge. Since administrative actions through electronic systems have become widespread, the production and technology of data-based records have naturally expanded and evolved. Technology may seem value-neutral, but in fact, technology itself reflects a specific worldview. The digital order of new technologies, armed with hyper-connectivity and super-intelligence, not only has a profound influence on traditional power structures, but also has an a similar influence on existing information and knowledge transmission media. Moreover, new technologies and media, including data-based generative artificial intelligence, are by far the hot topic. It can be seen that the all-round growth and spread of digital technology has led to the augmentation of human capabilities and the outsourcing of thinking. This also involves a variety of problems, ranging from deep fakes and other fake images, auto profiling, AI lies hallucination that creates them as if they were real, and copyright infringement of machine learning data. Moreover, radical connectivity capabilities enable the instantaneous sharing of vast amounts of data and rely on the technological unconscious to generate actions without awareness. Another irony of the digital world and online network, which is based on immaterial distribution and logical existence, is that access and contact can only be made through physical tools. Digital information is a logical object, but digital resources cannot be read or utilized without some type of device to relay it. In that respect, machines in today's technological society have gone beyond the level of simple assistance, and there are points at which it is difficult to say that the entry of machines into human society is a natural change pattern due to advanced technological development. This is because perspectives on machines will change over time. Important is the social and cultural implications of changes in the way records are produced as a result of communication and actions through machines. Even in the archive field, what problems will a data-based archive society face due to technological changes toward a hyper-intelligence and hyper-connected society, and who will prove the continuous activity of records and data and what will be the main drivers of media change? It is time to research whether this will happen. This study began with the need to recognize that archives are not only records that are the result of actions, but also data as strategic assets. Through this, author considered how to expand traditional boundaries and achieves reterritorialization in a data-driven society.

Development of evaluation items for adolescents' dietary habits and nutritional practices reflecting eating behaviors and food environment (식행동, 식생활 환경을 반영한 청소년의 식생활·영양 실천 평가 항목 개발)

  • Jimin Lim;Hye Ji Seo;Jieun Oh
    • Journal of Nutrition and Health
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    • v.57 no.1
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    • pp.136-152
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    • 2024
  • Purpose: A comprehensive evaluation item was developed to assess adolescent dietary habits and nutritional practices, considering food intake, eating behaviors, and food culture, such as social support and food environment. Methods: The 59 candidate items of the evaluation checklist were obtained based on the results of the eighth Korea National Health and Nutrition Examination Survey data, Korea Dietary Reference Intakes, dietary guidelines for adolescents, Youth Risk Behavior Survey data, national nutrition policies and dietary guidelines, and literature reviews. Four hundred and three middle and high school students residing in metropolitan areas participated in a survey using the 58-item checklist, which was selected through expert evaluation and content validity ratio analysis. The construct validity of the assessment tool for the quality of adolescent diets was assessed by exploratory factor analyses to determine if the checklist items were organized properly and whether the responses to each item were distributed adequately. Results: The Bartlett sphericity test was significant for each area (p <0.001), and the eigen values were greater than one. The Kaiser-Meyer-Olkin and cumulative proportions by areas were food intake (0.765 and 56.8%, respectively), eating behaviors (0.544 and 64.8%, respectively), and food environment (0.699 and 62.4%, respectively). Twenty-two checklists were determined for the final evaluation items for the adolescents' dietary habits and nutritional practices and were categorized into three distinct factors: food intake (10 items), eating behaviors (4 items), and food environment (8 items). Conclusion: The evaluation items for adolescent dietary habits and nutritional practices is a useful checklist for easily and quickly assessing the dietary qualities and reflecting Korean adolescents and their food environmental factors related to a sustainable diet.

Communities' Perception of the Effect of Ecosystem Services on the Forest Rehabilitation of Abandoned Mine Areas: A Case Study in Taebaek-si and Jeongseon-gun (강원도 폐광산 산림복구지의 지역사회 생태계서비스 인식조사: 태백시 및 정선군을 중심으로)

  • Bohwi Lee;Dawou Joung;Jihye Kim;Gwan-in Bak;Hakjun Rhee
    • Journal of Korean Society of Forest Science
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    • v.113 no.1
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    • pp.118-130
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    • 2024
  • Rehabilitation of mining areas can reduce damage to ecosystems. However, the effects of rehabilitation on ecosystem services (ESs) and its contribution to local communities are not well known. Thus, the aims of this study were to clearly identify the ES beneficiaries affected by mining activities, to determine how the beneficiaries profit from surrounding areas in cooperation with local stakeholders, and to manage the rehabilitation areas for the ESs that the beneficiaries want. This study chose 18 ESs (4 provisioning, 7 regulating, 5 cultural, and 2 habitat services) based on The Economics of Ecosystems and Biodiversity. A semi-structured questionnaire survey using an 11-point Likert scale was conducted among 87 community residents to investigate social awareness and identify key ESs. The survey results from two local communities showed high awareness and demands mainly on cultural (mental and physical health, aesthetic appreciation, and recreation) and regulating services (local climate and air quality, and moderation of extreme events). These services were related to the daily lives of residents in local communities, provided positive benefits, and potentially improved the residents' future livelihoods. However, the average questionnaire scores were limited to 6-7 points, indicating that the benefits to local communities were meager. The residents' awareness of provisioning service was negative, even if it provided goods and profit opportunities. This indicated a disconnection between local communities and provisioning services due to forest rehabilitation that did not consider local communities that traditionally relied on specific provisioning services before the onset of mining activities. Future forest rehabilitation in abandoned mine areas must consider the welfare of local communities for sustainable use of rehabilitated forests and enhancing ESs. In this study, only a qualitative evaluation based on frequency analyses was conducted. The quantification and valuation of key ESs are warranted in the future to promote ESs from forest rehabilitation in abandoned mine areas. The study results would be useful for developing site-specific ES promotion strategies for reforesting mine areas.

Isolation and Identification of Competitive Fungi on Medium for Black Wood Ear Mushroom in Korea and In Vitro Selection of Potential Biocontrol Agents (목이버섯 배지 오염 곰팡이균의 분리, 동정 및 생물학적 방제제 선발)

  • Seoyeon Kim;Miju Jo;Sunmin An;Jiyoon Park;Jiwon Park;Sungkook Hong;Jiwoo Kim;Juhoon Cha;Yujin Roh;Da Som Kim;Mi jin Jeon;Won-Jae Chi;Sook-Young Park
    • Research in Plant Disease
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    • v.30 no.1
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    • pp.66-77
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    • 2024
  • Black wood ear mushroom (Auricularia auricula-judae) is one of the most economically important mushrooms in China, Japan, and Korea. The cultivation of wood ear mushrooms on artificial substrates is more efficient in terms of time and cost compared with their natural growth on trees. However, if the substrate cultivation is infected by fast-growing fungi, the relatively slow-growing ear mushroom will be outcompeted, leading to economic losses. In this study, we investigated the competitive fungal isolates from substrates infected with fast-growing fungi for the cultivation of ear mushrooms in Jangheung and Sunchon, Korea. We collected 54 isolates and identified them by sequencing their internal transcribed spacer region with morphological identification. Among the isolates, the dominant isolates were Trichoderma spp. (92.6%), Penicillium spp. (5.6%), and Talaromyces sp. (1.8%). To find an appropriate eco-friendly biocontrol agent, we used five Streptomyces spp. and Benomyl, as controls against Trichoderma spp. and Penicillium spp. Among the six Streptomyces spp., Streptomyces sp. JC203-3 effectively controlled the fungi Trichoderma spp. and Penicillium spp., which pose a significant problem for the substrates of black wood ear mushrooms. This result indicated that this Streptomyces sp. JC203-3 can be used as biocontrol agents to protect against Trichoderma and Penicillium spp.

A Study of Myth of King Heokgeose, the Founder of Shilla Dynasty from a Perspective of Analytical Psychology (신라 시조 혁거세왕 신화에 대한 분석심리학적 연구)

  • Sang Ick Han
    • Sim-seong Yeon-gu
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    • v.28 no.1
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    • pp.50-87
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    • 2013
  • C. G. Jung believed that universal and basic condition of human's Unconscious comes out from Märchen or mythology. We can easily experience these universality of human nature in dreams. Therefore, It is very important to interpret mythogens that appear in myths and märchen in analytical psychology to understand these 'big dreams' which could be seen in clinical practice. As I was interested in interpreting myths in analytic psychology, I tried to find universality of archetypes in Korea's traditional folk tales and took note of the birth myth of Hyeokgeose, the founder of Shilla dynasty, while examining the chater of the Unsual in history in the Heritage of the Three Kingdoms. Shilla was founded earlier than two other countries, but it was located in the very south of the Korean Peninsula, and it was behind times in politically, militarily, and culturally compare to Goguryeo and Baekje. However, Shilla achieved unifying the Three Kingdoms and it lasted 1000 years, the longest unified history in Korean history. I tried to examine archetypes in the birth myth if there are any backgrounds that are related to finding a Shilla Kingdom. It is noted that myth of the founder of Korean Peninsula's small Kingdom Shilla has complete story from before the birth to birth, birth of spouse, growth, marriage, accession, governing, death, after death, and succession. Symbols such as numbers 1, 3, 5, 6, 7, 13 and 61, various azimuthes including north, west, south, east, and central, animals like tiger, white horse, hen, dragon, phoenix, and snakes, natures like main symbol egg, rock, gourd, lightening, spring water, stream, tree, forest, mountain, iron and goddess-image like seon-do Holy Mother gradually appears in the myth. These symbols could show a meaning of human experience such as birth of Conscious, growth and development of paternal and maternal love, and story of regeneration and extinction. Moreover, It could be seen as these progress eternally continues in next generation. I have found out that a word, a sentence or stories that looks meaningless in myth revealed its true symbolical meaning. In addition, interaction between Unconscious and Conscious repeats in different forms, and expressed in layered.