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A Case of Long-term Survival of Metastatic Pancreatic Cancer (전이성 췌장암 환자의 장기 생존 1예)

  • Jin Sil Pyo;Yong Woo Choi;Hoon Sup Koo;Kyung Ho Song;Yong Seok Kim;Sun Moon Kim;Tae Hee Lee;Kyu Chan Huh;Young Woo Kang
    • Journal of Digestive Cancer Research
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    • v.2 no.2
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    • pp.72-74
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    • 2014
  • Pancreatic cancer is well known to have a poor prognosis and poor responses to both of chemotherapy and radiation therapy. We report a metastatic pancreatic cancer treated successfully with chemotherapy and radiation therapy. A 71-year-old female with epigastric pain and weight loss was diagnosed as advanced pancreatic cancer with main vessels invasion and multiple mesenteric lymph node's metastasis. She was taken chemotherapy of gemcitabine single regimen and radiation therapy. Although she experienced one recurrence and concomitant primary lung cancer, she has survived for over 7 years with no symptoms. The authors report this case of long term survival in metastatic pancreatic cancer after chemoradiation therapy.

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Assessment of Combined Administration of Hypoglycemic Agents and Herbal Extracts (Pyeongwi-san or HyangsaPyongwi-san) on Blood Glucose Levels in Type 2 Diabetes Mellitus: A Retrospective Study (표준 치료를 받고 있는 제2형 당뇨병 환자에서 혈당강하제와 평위산 및 향사평위산 병용 투여가 혈당에 미치는 영향 및 안정성 연구)

  • Woo-nyoung Jung;Seung-hyun Oh;Mee-ryoung Song;Ji-won Noh;Young-min Ahn;Se-young Ahn;Byung-cheol Lee
    • The Journal of Internal Korean Medicine
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    • v.44 no.4
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    • pp.661-674
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    • 2023
  • Abstract: This retrospective study delved into the effects and safety considerations associated with the concomitant usage of hypoglycemic agents and herbal extracts, specifically Pyeongwi-san (PWS) or HyangsaPyongwi-san (HSPWS) in the context of type 2 diabetes mellitus management. Methods: The investigation involved 38 inpatients with type 2 diabetes mellitus who received PWS or HSPWS treatment at Kyung Hee University Korean Medical Hospital from January 2012 to December 2022. By investigating clinical attributes and conducting laboratory assessments, this study aimed to discern the impact of these herbal extracts on blood glucose levels, encompassing fasting blood sugar (FBS) and mean 2-hour postprandial glucose (PP2) levels. Furthermore, the safety profile of the herbal extracts was assessed by comparing liver function indicators, including aspartate aminotransferase (AST), alanine aminotransferase (ALT), and γ-glutamyl transferase (GGT), alongside kidney function markers, such as blood urea nitrogen (BUN) and creatinine (Cr). Results: Following the administration of the herbal extracts, no statistically significant alterations in FBS and mean PP2 levels emerged compared to the baseline levels. Notably, the safety evaluation revealed no significant differences in liver and kidney function parameters following herbal extract administration. Conclusion: The results of this research indicate that using PWS or HSPWS alongside hypoglycemic medications could be a beneficial additional method for addressing digestive symptoms in individuals with type 2 diabetes mellitus. Notably, this combination seems to have no negative interactions with other drugs.

A Study on Implementation of Indoor Positioning Simulator through Indoor Positioning API Development (실내측위 API개발을 통한 실내측위 시뮬레이터 구현에 관한 연구)

  • Shin, Chang Soo;Kim, Sung Su
    • KSCE Journal of Civil and Environmental Engineering Research
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    • v.43 no.6
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    • pp.873-881
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    • 2023
  • The evolution of civil engineering technology, exemplified by recent milestones like the completion of the Gangnam Global Business Center (GBC), has fostered the construction of expansive civil and architectural structures both above and below the earth's surface. This surge in construction necessitates a commensurate advancement in research and technology pertaining to safety protocols applicable to these vast edifices. Such protocols encompass a spectrum of concerns, ranging from the preemptive mitigation of accidents to the effective management of exigencies such as fires. As the trajectory of construction endeavors continues unabated, encompassing both subterranean and elevated domains, a concomitant imperative emerges to refine the methodologies underpinning precise indoor positioning. To address this need, an innovative web-based simulator has been devised to emulate indoor positioning scenarios for rigorous testing. This research further entails the development of an indoor positioning data Application Programming Interface (API) fortified by Geographic Information System (GIS) spatial operation techniques. This API is anchored in the construction of intricate test data, centered on the spatial layout of building 13 at the Electronics and Telecommunications Research Institute (ETRI). Consequently, the study renders feasible the expeditious provisioning of diverse signal-based and image-based spatial information, pivotal for enhancing the navigational acumen of mobile devices. Path delineation, cellular signal mapping, landmark identification, and ancillary navigational aids are among the manifold datasets promptly furnished by the indoor positioning data API. In summation, this study engenders a crucial leap towards the fortification of safety protocols and navigational precision within the expansive confines of modern architectural wonders.

An analysis of the educative features of mathematics teacher guidebooks for grades 3 and 4 (초등학교 3~4학년군 수학 교사용 지도서의 교육적 특징 분석)

  • Pang, JeongSuk;Oh, MinYoung;Park, Yejin
    • The Mathematical Education
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    • v.62 no.4
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    • pp.531-549
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    • 2023
  • Despite the significance of mathematics teacher guidebooks as a support for teacher learning, there are few studies that address how elementary mathematics teacher guidebooks support teacher learning. The purpose of this study was to analyze the educative features of elementary mathematics teacher guidebooks for grades 3 and 4. For this, six units from each of ten kinds of teacher guidebooks were analyzed in terms of seven dimensions of Teacher Learning Opportunities in Korean Mathematics Curriculum Materials (TLO-KMath). The results of this study showed that mathematics content knowledge for teaching was richly provided and well organized. Teacher guidebooks provided teacher knowledge to anticipate and understand student errors and misconceptions, but were not enough. Sample dialogues between a teacher and students were offered in the teacher guidebooks, making it easier for teachers to identify the overall lesson flow and key points of classroom discourse. Formative assessment was emphasized in the teacher guidebooks, including lesson-specific student responses and their concomitant feedback examples per main activity. Supplementary activities and worksheets were provided, but it lacked rationales for differentiated instruction in mathematics. Teacher knowledge of manipulative materials and technology use in mathematics was provided only in specific units and was generally insufficient. Teacher knowledge in building a mathematical community was mainly provided in terms of mathematical competency, mathematical classroom culture, and motivation. This paper finally presented implications for improving teacher guidebooks to actively support teacher learning.

CT Fractional Flow Reserve for the Diagnosis of Myocardial Bridging-Related Ischemia: A Study Using Dynamic CT Myocardial Perfusion Imaging as a Reference Standard

  • Yarong Yu;Lihua Yu;Xu Dai;Jiayin Zhang
    • Korean Journal of Radiology
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    • v.22 no.12
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    • pp.1964-1973
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    • 2021
  • Objective: To investigate the diagnostic performance of CT fractional flow reserve (CT-FFR) for myocardial bridging-related ischemia using dynamic CT myocardial perfusion imaging (CT-MPI) as a reference standard. Materials and Methods: Dynamic CT-MPI and coronary CT angiography (CCTA) data obtained from 498 symptomatic patients were retrospectively reviewed. Seventy-five patients (mean age ± standard deviation, 62.7 ± 13.2 years; 48 males) who showed myocardial bridging in the left anterior descending artery without concomitant obstructive stenosis on the imaging were included. The change in CT-FFR across myocardial bridging (ΔCT-FFR, defined as the difference in CT-FFR values between the proximal and distal ends of the myocardial bridging) in different cardiac phases, as well as other anatomical parameters, were measured to evaluate their performance for diagnosing myocardial bridging-related myocardial ischemia using dynamic CT-MPI as the reference standard (myocardial blood flow < 100 mL/100 mL/min or myocardial blood flow ratio ≤ 0.8). Results: ΔCT-FFRsystolic (ΔCT-FFR calculated in the best systolic phase) was higher in patients with vs. without myocardial bridging-related myocardial ischemia (median [interquartile range], 0.12 [0.08-0.17] vs. 0.04 [0.01-0.07], p < 0.001), while CT-FFRsystolic (CT-FFR distal to the myocardial bridging calculated in the best systolic phase) was lower (0.85 [0.81-0.89] vs. 0.91 [0.88-0.96], p = 0.043). In contrast, ΔCT-FFRdiastolic (ΔCT-FFR calculated in the best diastolic phase) and CT-FFRdiastolic (CT-FFR distal to the myocardial bridging calculated in the best diastolic phase) did not differ significantly. Receiver operating characteristic curve analysis showed that ΔCT-FFRsystolic had largest area under the curve (0.822; 95% confidence interval, 0.717-0.901) for identifying myocardial bridging-related ischemia. ΔCT-FFRsystolic had the highest sensitivity (91.7%) and negative predictive value (NPV) (97.8%). ΔCT-FFRdiastolic had the highest specificity (85.7%) for diagnosing myocardial bridging-related ischemia. The positive predictive values of all CT-related parameters were low. Conclusion: ΔCT-FFRsystolic reliably excluded myocardial bridging-related ischemia with high sensitivity and NPV. Myocardial bridging showing positive CT-FFR results requires further evaluation.

Brain-type Natriuretic Peptide Ameliorates High-fat Diet-induced Hepatic Insulin Resistance (Brain-type natriuretic peptide (BNP)의 고지방 식이 유도에 의한 인슐린 저항성 개선 효과)

  • Dae Young Jung;Jeong Bin Park;Myeong Ho Jung
    • Journal of Life Science
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    • v.34 no.1
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    • pp.1-8
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    • 2024
  • Brain-type natriuretic peptide (BNP) is a cardiac hormone that exerts cardiovascular and renal effects and regulates metabolic processes. In the current study, to determine the hepatic effects of BNP, we investigated whether it improves high-fat diet (HFD)-induced hepatic IR and characterized its possible mechanism. No significant differences in body weight, fat mass, or lean mass were observed between the saline- and BNP-treated groups of normal diet-and HFD-fed mice. During the clamp test, the BNP infusion into HFD-fed mice led to lower blood glucose levels and increased glucose infusion rates versus that into saline-treated HFD-fed mice. The BNP infusion also inhibited hepatic glucose production and decreased hepatic triglyceride levels concomitant with decreased expression of gluconeogenesis and lipogenesis-related genes, resulting in reduced levels of alanine aminotransferase and aspartate aminotransferase. BNP increased the phosphorylation of Akt and AMP-acti- vated protein kinase (AMPK) in the livers of HFD-fed mice compared to saline-fed HFD mice. The incubation of AML12 murine hepatocytes with BNP increased the basal levels of phosphorylated Akt and AMPK and recovered the phosphorylated Akt and phosphorylated AMPK levels reduced by palmitate treatment. Furthermore, BNP incubation prevented palmitate-induced increases in lipo- genesis gene expressions. Taken together, the current study's findings indicated that BNP ameliorates hepatic IR, resulting in reduced hepatic glucose production and hepatic steatosis.

Safety and Efficacy of the Percutaneous Manual Aspiration Thrombectomy Technique to Treat Thrombotic Occlusion of Native Arteriovenous Fistulas for Hemodialysis (혈액투석용 자가혈관 동정맥루의 혈전을 동반한 폐색에서 경피적 수동 흡인 혈전제거술의 안정성과 유용성)

  • Sang Eun Yoon;Sun Young Choi;Soo Buem Cho
    • Journal of the Korean Society of Radiology
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    • v.81 no.2
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    • pp.409-417
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    • 2020
  • Purpose To evaluate the safety and efficacy of the percutaneous manual aspiration thrombectomy technique to treat thrombotic occlusion of native arteriovenous fistulas. Materials and Methods A retrospective review of 20 patients who underwent percutaneous manual aspiration thrombectomy for native thrombotic arteriovenous fistula occlusion from March 2012 to December 2017 was performed. We evaluated technical and clinical success rates and complications. The primary and secondary patency rates were calculated using the Kaplan-Meier analysis. Results Percutaneous manual aspiration thrombectomy was performed in 20 patients (n = 20) with concomitant balloon angioplasty. The overall technical and clinical success rates were both 85% (n = 17). The native arteriovenous fistulas, based on their site, were the left radiocephalic (n = 13), left brachiocephalic (n = 4), and right radiocephalic (n = 3) fistulas. An underlying stenosis was detected in the juxta-anastomotic venous site (n = 16), outflow draining vein (n = 12), and central vein (n = 4). The primary and secondary patency rates at 1, 3, 6, and 12 months were 100%, 70.6%, 70.6%, and 56.5% and 100%, 94.1%, 94.1%, and 86.9%, respectively. There were no complications associated with procedure. Conclusion Percutaneous manual aspiration thrombectomy is a safe and effective method to treat thrombotic native arteriovenous fistula occlusion.

Papillary Renal Cell Carcinoma in Transplanted Kidney and Xp11.2 Translocation/Transcription Factor E3-Rearranged Renal Cell Carcinoma in the Native Kidney: A Case Report (이식신장에 생긴 유두모양 신세포암종과 고유신장에 생긴 Xp11.2전위/전사인자E3-재배열 신세포암종: 증례 보고)

  • Min Hye Kim;Kyeong Ah Kim;Jeong Woo Kim;Seok Young Lee;Jae Woong Choi
    • Journal of the Korean Society of Radiology
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    • v.85 no.2
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    • pp.437-444
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    • 2024
  • Concomitant renal cell carcinomas (RCC) of both native and allograft kidneys are extremely rare, and only a few cases have been reported in the available English literature. A particularly rare variant within the adult population is the Xp11.2 translocation/transcription factor E3 (TFE3)-rearranged RCC. Although few case reports of TFE3-rearranged RCC have been reported in children who underwent kidney transplantation (KT), no case of adults with TFE3-rearranged RCC following KT has been reported. Herein, we presented the radiological and pathological findings of a rare metachronous papillary RCC in the allograft kidney and TFE3-rearranged RCC in the native kidney. The TFE3-rearranged RCC in the native kidney exhibited slow expansion in size over five years. Radiologically, it appeared as a slightly enhanced, lobulated mass on contrast-enhanced CT. MRI revealed high signal intensity on T1-weighted images and low signal intensity on T2-weighted images.

The Influence of Simplified Surgical Procedures on the Surgical Treatment for Atrial Fibrillation with using the Cut-and-Sew Technique (절개봉합법을 이용한 심방세동 수술의 중단기 결과)

  • Choi, Jong-Bum;Kim, Jong-Hun;Lee, Mi-Kyung;Lee, Sam-Youn;Kim, Min-Ho;Kim, Kong-Su
    • Journal of Chest Surgery
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    • v.41 no.3
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    • pp.313-319
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    • 2008
  • Background: The Cox maze-III procedure is considered as the most effective surgical treatment for atrial fibrillation. Because this procedure takes a long time and it complicates the concomitant cardiac surgery, some surgeons perform a left atrial maze procedure or pulmonary vein isolation only to reduce the operation time. This study was performed to evaluate how the modified procedures, with using cut-and-sew techniques, can influence the treatment of atrial fibrillation. Material and Method: Between Feb 1999 and June 2005, 40 patients (17 males and 23 females) with organic heart disease and atrial fibrillation underwent the Cox maze-III procedure (23), the left atrial maze procedure (10) or pulmonary vein isolation (7). The cut-an-sew technique was used to ablate the atrial wall, but cryoablation was used instead of the cut-and-sew technique for the coronary sinus and the inferior wall between the pulmonary vein and the mitral annulus. Result: After a mean follow-up period of $50.0{\pm}21.6$ months, all (100%) of the 23 patients who underwent the Cox maze-III procedure had regular sinus or atrial rhythm conversion, and 7(70%) of 10 with a left atrial maze procedure and 4(57.1%) of 7 with pulmonary vein isolation had regular sinus or atrial rhythm conversion (p=0.002). Conclusion: To obtain a high conversion rate from atrial fibrillation to a regular sinus rhythm or a regular atrial rhythm, the standard Cox maze-III procedure should be performed in both atria. The limited modified procedures like the left atrial maze procedure or pulmonary vein isolation may reduce the cure rate of atrial fibrillation.

Treatment of Skin Diseases in Hyungsang Medicine (피부병의 형상의학적 치료)

  • Suk Min He;Hwang Won Duek;Jung Haeng Gyu;Lee Yong Tae
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.18 no.3
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    • pp.646-669
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    • 2004
  • By treating skin diseases with Hyungsang medicine and reviewing the clinical cases of them through classifying skin diseases into general care and into Hyungsang medical care, the writer came to the conclusion as followings. The skin is a house of Kyungnak, and it' s a place which Ki comes in and out, which human body controls conditions of his physiological function and which doctors can make a diagnosis from seeing it. The skin is subject to lung and large intestine in the point of organ, but in the point of movement, to spleen and stomach. Skin diseases come from unbalance of Ki and Hyul, mostly from fever in blood and also from Dam, Wind, Dampness and Dryness because of including fire. Generally skin diseases are treated according to classifying into distinctive symptoms, region, cause or time being occurred, and concomitant symptoms. After being divided into man and woman, age and youth, fatness and leanness, Jung Ki Shin Hyul type, visceral figures, Yukkyung shapes on Hyungsang medicine method, the remedy of skin diseases which is combined common meditation with Hyungsang medical method is efficacious. In distinguishing into man and woman, age and youth, man gets sick mainly by drinking liquor and exhausting Jung, woman is taken ill generally by indigestion and Damwha, especially by drinking liquor. Young child gets ill mostly from inherent weakness, but in many cases he is occurred by disturbed digestion, so he must be taken care of ingesting food. The aged becomes ill from weakening, so he must be treated according to reasons of diseases. To fatness and leanness, skin diseases are showed symptoms by weakened Yang, insufficient Yin or excess fever on the theory of upper and lower parts, by unbalance of Ki and Hyul on the theory of left and right, by Dryness and Dampness on the theory of front and rear and by insufficiency of vitality and combined fever on the theory of inside and outside. Therefore doctors must cure the symptoms according to the theory of upper and lower, left and right, front and rear and inside and outside. In type of Jung Ki Shin Hyul, the balances between Jung-Hyul and Shin-Ki are important points. Concretely Jung type comes to easily shortage of Jung or gathering abnormally Dampness and Dam, Ki type is easy to make a mass with Ki or to be deficient of Ki, Shin type comes to press seven emotions togather or to be insufficient of Yin and fever inside, and Hyul type is inclined to be deficient of Hyul and to become feverish or to be deficient of Ki. Therefore on the ground of the above reasons skin diseases come into existence. Inclusively in Jung-Hyul type , Ki must be moved on the base of full Jung-Hyul, so Wukmijiwhangtang or Samultang is prescribed basically. In Shin-Ki type , Jung-Hyul is saved on the base of moving Ki, so Hyangsosan or Yijintang is the proper prescription. Considering the visceral figures, doctors judge for diagnosis and remedy by putting together the elements, that is, great and small sizes of a set of features (eye, ear, mouth, nose), color and temper. The yukkyung types are classified according to many or few of Ki-Hyul, and then skin diseases appear by being inclined toward one side between Ki and hyul, or among the six atmospheric elements(wind, cold, heat, dampness, dryness, and fire). Especially because Yangmyung type is full of much Ki and Hyul, and also has much fever in stomach, he gets skin symptoms frequently. So his prescription is based on taking off fever in stomach, and also he must be careful about regimen certainly.