• Journal of Korean Neurosurgical Society
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• v.64 no.6
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• pp.891-900
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• 2021

Objective : Vertebral artery dissecting aneurysm (VADA) is a very rare subtype of intracranial aneurysms; when ruptured, it is associated with significantly high rates of morbidity and mortality. Despite several discussions and debates, the optimal treatment for VADA has not yet been established. In the last 10 years, flow diverter devices (FDD) have emerged as a challenging and new treatment method, and various clinical and radiological results have been reported about their safety and effectiveness. The aim of our study was to evaluate the clinical and radiological results with the use of FDD in the treatment of unruptured VADA. Methods : We retrospectively evaluated the data of all patients with unruptured VADA treated with FDD between January 2018 and February 2021 at our hybrid operating room. Nine patients with unruptured VADA, deemed hemodynamically unstable, were treated with FDD. Among other parameters, the technical feasibility of the procedure, procedure-related complications, angiographic results, and clinical outcomes were evaluated. Results : Successful FDD deployment was achieved in all cases, and the immediate follow-up angiography showed intra-aneurysmal contrast stasis with parent artery preservation. A temporary episode of facial numbness and palsy was noted in one patient; however, the symptoms had completely disappeared when followed up at the outpatient clinic 2 weeks after the procedure. The 3-6 months follow-up angiography (n=9) demonstrated complete/near-complete obliteration of the aneurysm in seven patients, and partial obliteration and segmental occlusion in one patient each. In the patient who achieved only partial obliteration, there was a sac 13 mm in size, and there was no change in the 1-year follow-up angiography. In the patient with segmental occlusion, the cause could not be determined. The clinical outcome was modified Rankin Scale 0 in all patients. Conclusion : Our preliminary study using FDD to treat hemodynamically unstable unruptured VADA showed that FDD is safe and effective. Our study has limitations in that the number of cases is small, and it is not a prospective study. However, we believe that the study contributes to evidence regarding the safety and effectiveness of FDD in the treatment of unruptured VADA.

• Cross-Cultural Studies
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• v.41
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• pp.299-320
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• 2015

Lewis Carroll's Alice's Adventures in Wonderland expands scope of Children's Literature genre by introducing the discourse of pleasure as opposed to that of didactic discipline. Carroll's narrative is important, not only for children's literature, but also as a forerunner of post/modernism of James Joyce with its language play and linguistic invention. Its treatment of Alice's body change follows the motif of body transformation in myth and literature. Comparing "stasis" of Susan Sontag's character Alice (James) in her play Alice in Bed and "movement" of Carroll's Alice, this study explores the issues of woman's alienation and the dichotomy of mobility/immobility in reality and in their literary representations. Focusing on a female child's double alienation as woman and child, I argue Alice's Adventures in Wonderland is a counter-narrative of alternative bildungsroman. Alice gains her subjectivity through her adventure by power of language and story-telling. Through representation of the dream/adventure of two desiring sisters, Carroll's narrative exhibits subversion of social order and emergence of new order of "chaosmos" out of chaos. As a method of study, this study traces genealogy of "curiosity" in myth and literature as a motivating force that triggers adventure and argues "creative curiosity" is a dynamic energy propelling Alice's adventure.

• Journal of the Korean Society of Radiology
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• v.85 no.4
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• pp.746-753
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• 2024

Purpose This study aims to evaluate the incidence and management of venous ruptures after percutaneous transluminal angioplasty (PTA) for dysfunctional arteriovenous (AV) access. Materials and Methods From January 1998 to December 2015, 13506 PTA, mechanical thrombectomy, and thrombolysis procedures were performed in 6732 patients. The venous rupture rate following PTA was obtained, and access circuit primary patency (ACPP) was compared according to the etiology (PTA, thrombotic occlusion, and treatment type) of the venous rupture present. Results Venous rupture developed in 604 of the 13506 procedures. Venous ruptures were more frequent in female, AV graft cases, and in cases accompanied by thrombosis. Balloon tamponade was performed in 604 rupture cases, and stents were deployed in 119 cases where contrast extravasation and flow stasis persisted. ACPP was significantly better in the non-ruptured AV access circuits than in the ruptured group. However, AV access type and thrombosis was not associated with primary patency. In ruptured cases, ACPP is 8.4 months for prolonged balloon tamponade and 11.2 months for bare-metal stent insertion, showing statistically significant difference. Conclusion Balloon tamponade and bare-metal stent placement are effective treatment for PTA-induced venous ruptures. In particular, stent placement showed a similar ACPP to that of non-ruptured AV access circuits.

• Journal of Ginseng Research
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• v.48 no.5
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• pp.494-503
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• 2024

Background: With the prevalence of dietary supplements, the use of combinations of herbs and drugs is gradually increasing, together with the risk of drug interactions. In our clinical work, we unexpectedly found that the combination of Panax notoginseng and warfarin, which are herbs that activate blood circulation and remove blood stasis, showed antagonistic effects instead. The purpose of this study was to evaluate the drug interaction between Panax notoginseng saponins (PNS) and warfarin, the main active ingredient of Panax notoginseng, and to explore the interaction mechanism. Methods: The effects and mechanisms of PNS on the pharmacodynamics and pharmacokinetics of warfarin were explored mainly in Sprague-Dawley rats and HepG2 cells. Elisa was used to detect the concentrations of coagulation factors, HPLC-MS to detect the blood concentrations of warfarin in rats, immunoblotting was employed to examine protein levels, qRT-PCR to detect mRNA levels, cellular immunofluorescence to detect the localization of NR1I3, and dual luciferase to verify the binding of miR-214-3p and NR1I3. Results: PNS significantly accelerated warfarin metabolism and reduced its efficacy, accompanied by increased expression of NR1I3 and CYP2C9. Interference with NR1I3 rescued the accelerated metabolism of warfarin induce by PNS co-administration. In addition, we demonstrated that PNS significantly reduced miR-214-3p expression, whereas miR-214-3p overexpression reduced NR1I3 and CYP2C9 expression, resulting in a weakened antagonistic effect of PNS on warfarin. Additionally, we found that miR-214-3p bound directly to NR1I3 3'-UTR and significantly downregulated NR1I3 expression. Conclusion: Our study demonstrated that PNS accelerates warfarin metabolism and reduces its pharmacodynamics by downregulating miR-214-3p, leading to increased expression of its target gene NR1I3, these findings provide new insights for clinical drug applications to avoid adverse effects.

• Journal of Physiology & Pathology in Korean Medicine
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• v.17 no.1
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• pp.1-24
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• 2003

This study was done to compile 104 experimental theses which are related to the antitumor and immuno-activating therapies between February 1990 through February 2002. Master's and doctoral theses were dassified by schools, degrees, materials, effects, experimental methods of antitumor and immunoactivity, and results. The following results were obtained from this study : 1. Classifying the theses by the school, 34.6% were presented by Daejeon University, 29.8% by Kyung-hee University and 11.5% by Won-kwang University. Of all theses, 51.0% were aimed for the doctoral degree and 43.3% were for the master's degree. All of three universities have their own cancer centers. 2. Classifying the theses by herb materials, complex prescription accounted for 60.3%, single herb accounted for 24.8% and herbal acupuncture accounted for 14.2%. Considering the key principles of the traditional medicine, complex prescription was much more thoroughly studied than single herb prescription. The results showed that the complex prescription had both antitumor activity and immuno-activating activity, which might reflects on multi-activation mechanisms by complex components. 3. Classifying the theses by the efficacy of herbs examined, in single herb, invigorating spleen and supplementing was 35.5%, expelling toxin and cooling was 29.0%, activating blood flow and removing blood stasis was 12.9%. In herbal acupuncture, invigorating spleen and supplementing was 52.9%, expelling toxin and cooling was 29.4%. In complex prescription, pathogen-free status was 41.9%, strengthening healthy qi to eliminate pathogen was 35.5%, strengthening healthy qi was 22.6%. It is presumed that the antitumor and immunoactivating therapy based on syndrome differentiation is the best way to develop oriental oncology. 4. Classifying the theses by antitumor experiments, cytotoxic effect was 48.1 %, survival time was 48.1 % and change of tumor size was 42.3%. Survival rate was not necessarily correlated with cytotoxicity. These data reflect the characteristic, wholistic nature of the oriental medicine which is based on BRM (biological response modifier). 5. Classifying the theses by immunoactivating experiments, hemolysin titer was 51.0%, hemagglutinin titer was 46.2% and NK cell's activity was 44.2%. In the future studies, an effort to elucidate specific molecular and cellular mechanisms of cytokine production in the body would be crucial. 6. Classifying the theses according to the data in terms of antitumor activity, 50% was evaluated good, 24.0% was excellent, and 15.5% have no effect. In an evaluation of immuno-activating activity, 35.9% was excellent and 18.0% showed a little effect. The index point, as described here, may helps to use experimental data for clinical trials. Changes in index points by varying dosage implicate the importance of oriental medical theory for prescription. 7. In 167 materials, IIP (immunoactivating index point, mean : 3.12±0.07) was significantly higher than AIP(antitumor index point, mean : 2.83±0.07). These data demonstrate that the effect of herb medicine on tumor activity depends more on immunoactivating activity than antitumor activity. This further implies that the development of herbal antitumor drugs must be preceded by the mechanistic understanding of immunoactivating effect. 8. After medline-searching tumor and herb-related articles from NCBI web site, we conclude that most of the studies are primarily focused on biomolecular mechanisms and/or pathways. Henceforth, we need to define the biomolecular mechanisms and/or pathways affected by herbs or complicated prescriptions. 9. Therefore, the most important point of oriental medical oncology is to conned between experimental results and clinical trials. For the public application of herbal therapy to cancer, it is critical to present the data to mass media. 10. To develop the relationship of experimental results and clinical trials, university's cancer clinic must have a long-range plan related to the university laboratories and, at the same time, a regular consortium for this relationship is imperative. 11. After all these efforts, a new type herbal medicine for cancer therapy which is to take care of the long-term administering and safety problem must be developed. Then, it would be expected that anti-tumor herbal acupuncture can improve clinical symptoms and quality of life (QOL) for cancer patients. 12. Finally, oriental medical cancer center must be constructed in NCC (National Cancer Center) or government agency for the development of oriental medical oncology which has international competitive power.

• The Journal of Dong Guk Oriental Medicine
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• v.6 no.1
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• pp.67-89
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• 1997

The heart takes the top position as the monarch of the physiological activity in five viscera and six bowels. Activity to think and ponder, or harmony of the function of viscera and bowels and passing smoothly of qi and blood and so on, these depend on the function of heart. So it is called the center of life activity. This thesis studied bibliographically the process of formation of the system of differention of syndromes. First, in the classify of deficiency syndrome, insufficiency of the Heart is classified deficiency of the Heart-yin and insufficiency of the Heart-yang. After it classified insufficiency of the Heart-qi, insufficiency of the Heart-yang, dificiency of the 'Heart-blood and deficiency of the Heart-yin. At lately it classified more subdivide into insufficiency of the Heart-qi, insufficiency of the Heart-yang, dificiency of the Heart-blood, deficiency of the Heart-yin. Deficiency of the Heart-qi yin, deficiency of the Heart-qi blood, deficiency of the Heart-yin yang and sudden exhaustion of the Heart-yang. Second, It were the most important that the phlegm, fire and heat in the classify of excess syndrome. It classified various differentiation of syndrome. In the beginning of a period, it only classified phlegm syndrome and heat syndrome, but recently it classified not only phlegm syndrome and heat syndrome but also phlegm-fire. Also, It classified importantly gradually Heart-blood stasis caused by deficiency of the Heart-qi and the Heart-yang. Variety and subdivision of classify of differentiation of syndrome seemed resault of study to prepare various disease. And that after demanded more and more positive study.

• Cartoon and Animation Studies
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• s.33
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• pp.223-246
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• 2013

Even though cartoons and narration comics were born from different origin, they have been called by names such as 'cartoons' or 'comics'. The reason can be found in the similarity of cartoons and narration comics. The similarity of cartoons and narration comics is the genre consisting of writing and drawing. Writing can be the format of expression and it can represent the story. Such story is present as a component of 'narration'. Sub genre of comics includes cartoons and narration comics. It includes animation in a broad range. In cases of narration comics and animation, it is thought that narration is present with continuity of time. However, in case of cartoon, because one or two cuts without continuity of writing are frequently expressed, it is being asked whether narration is present. It is easy to be reminded of epic or chanson de geste whenever you hear 'narration'. Since it deals with a biography of the character, we think the concept of 'narration' with temporality. However, narration provides a certain event in a broad range. Thus, cartoons presenting one event with the image may have the existence of narration, because description of multiple scenes of narrative comics can be implicitly represented in cartoons. As such implications leave a space, the empty space can be filled by active reasoning of recipients. However, nevertheless, it is very difficult to find studies as well as mentions of narration in cartoons. Thus, in this paper, we investigate the concept and structure of narration and demonstrate the presence of narration in cartoons. First of all, we looked at the narration theory in literature before studying narration in cartoons. The reason is that we thought the approach to the literary theory was required in order to investigate the basic elements, since cartoons are a collection of writing and drawing. We were focused on the prerequisites of narration presented in "story and discourse" of s. Chatman. If the prerequisites of narration are present, we can assume that the narration is present. The prerequisites are 'narration reasoning', 'screening', 'consistency', 'process statements' and 'stasis statement'. As s. Chatman described them as prerequisites of narration, he analyzed the narration structures of films and novels. In addition, we revealed that the narrations were present in cartoons as we identified how prerequisites of narration presented by Chatman were presented and expressed through "vocabulary of comics", "Timeframe" and "life in the line" described in "understanding comics" by Scott McCloud.

• Radiation Oncology Journal
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• v.28 no.1
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• pp.16-22
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• 2010

Purpose: We analyzed the incidence and related factors of radiation dermatitis; at first, to recognize whether a decrease in radiation dermatitis is possible or not in breast cancer patients who received radiation therapy. Materials and Methods: Of 338 patients, 284 with invasive breast cancer who received breast conservation surgery with radiotherapy at Chonbuk National University Hospital from January 2007 to June 2009 were evaluated. Patients who also underwent bolus, previous contralateral breast irradiation and irradiation on both breasts were excluded. For patients who appeared to have greater than moderate radiation dermatitis, the incidence and relating factors for radiation dermatitis were analyzed retrospectively. Results: A total of 207 and 77 patients appeared to have RTOG grade 0/1 or above RTOG grade 2 radiation dermatitis, respectively. The factors found to be statistically significant for the 77 patients who appeared to have greater than moderate radiation dermatitis include the presence of lymphocele due to the stasis of lymph and lymph edema which affect the healing disturbance of radiation dermatitis (p=0.003, p=0.001). Moreover, an allergic reaction to plaster due to the immune cells of skin and the activation of cytokine and concomitant hormonal therapy were also statistically significant factors (p=0.001, p=0.025). Conclusion: Most of the breast cancer patients who received radiation therapy appeared to have a greater than mild case of radiation dermatitis. Lymphocele, lymphedema, an allergy to plaster and concomitant hormonal therapy which affect radiation dermatitis were found to be significant factors. Consequently, we should eliminate lymphocele prior to radiation treatment for patients who appear to have an allergic reaction to plaster. We should also instruct patients of methods to maintain skin moisture if they appear to have a greater than moderate case of radiation dermatitis.

• Korean Journal of Psychosomatic Medicine
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• v.9 no.1
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• pp.49-57
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• 2001

Objectives : This study was designed to investigate the relationship between gastric emptying, psychopathology(especially anxiety and depression), and various factors that can mediate stress and response, such as coping style, social support and level of perceived stress. Methods : A total 30 patients who complained of the non-ulcer dyspepsia and did not have any abnormal finding on the gastroduodenal endoscopic examination, 24 hour ambulatory esophageal manometry and conventional gastroesophageal manometry were tested with gastric emptying that would be a functional examination of stomach. The correlations between the gastric emptying and psychological vaiable such as quantity of perceived stress, Symptom Checklist-90-Revision(SCL-90-R), Beck Depression Inventory(BDI), Spielberger Stait-Trait Anxiety Inventory(STAI), Ways of Coping Checklist and Interpersonal Support Evaluation List were evaluated. Results : 1) The mean and standard deviation of the time for half of the meal to empty(T50%) was $118.50{\pm}23.64$ minute which showed no gastric stasis in terms of gastric emptying test. 2) There were significant positive correlations between T50% and the state anxiety, T50% and thedepression. 3) There was no significant correlation between T50% and the quantity of perceived stress, T50% and mediating factors(coping style and social support). Conclusion : These results suggested that psychopathology, especially emotional components such as depression and anxiety, could affect on the current physiological functional gastric activity(gastric emptying), but quantity of perceive stress and mediating factors of stress and response such as coping style and social support could not affected on the functional gastric activity. These results showed that psychological interventions should considered in management of the patients with functional dyspepia.

• Journal of Gastric Cancer
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• v.4 no.4
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• pp.242-251
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• 2004

Purpose: Recently, because of the increasing numbers of early gastric cancer patients and improvements in their survivals, greater attention has been directed towards the quality of life and nutritional status of gastric cancer patients after surgery. However, conventional reconstructions, Billroth- I, -II (B-I and B-II) or Roux-en-Y, have proven to have certain limitations, such as a small reservoir, and a malabsorption for iron, fat, calcium, and carotene. To overcome these limitations, we used a jejunal pouch interposition(JPI) after a distal gastrectomy not only to substitute for the small reservoir but also to maintain a physiologic pathway for ingested foods. Materials and Methods: A total of 196 gastric cancer patients who underwent a distal gastrectomy between March 2001 and February 2004 were divided into 3 groups: JPI group (n=100), B-I group (n=29), and B-II group (n=67). We assessed the patient's nutritional status, gastric emptying time, and gastrofiberscopic findings. Results: The percents of body weight loss at 6 months, 1 year, and 2 years postoperatively in the JPI group ($5.14\%,\;3.01\%,\;2.37\%$) were significantly less than those of the conventional B-I ($8.41\%,\;6.69\%,\;5.90\%$) and B-II groups ($7.50\%,\;7.65\%,\;5.86\%$) (P=0.011, 0.000, 0.013). The laboratory findings showed no significant differences between the 3 groups, except for a higher total protein level in the JPI group after 6 months postoperatively. Especially, stage I and II cancers in the JPI group showed much higher total protein levels after 1 year postoperatively. The gastric emptying times in the $\^{99m}$Tc- semisolid scans at 6 months, 1 year, and 2 years postoperatively were 102.5, 83.1, and 58.1 minutes in the JPI group, 95.5, 92.0, and 58.5 minutes in the B-I group, and 53.9, 69.1, and 50.2 minutes in the B-II group, respectively. Also, the symptomatic gastric stasis detected with a gastrofiberscope during the early postoperative period (6 months) was gradually improved. Conclusion: From a nutritional aspect, a jejunal pouch interposition after a distal gastrectomy could be an alternative reconstruction method, especially in stage I and II gastric cancer patients, in spite of the longer operation time and the probable delayed gastric emptying.