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Pancreas-preserving limited duodenal resection: Minimizing morbidity without compromising oncological adequacy

  • Ajay Sharma;Anand Nagar;Peeyush Varshney;Maunil Tomar;Shashwat Sarin;Rajendra Prasad Choubey;V. K. Kapoor
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.26 no.2
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    • pp.149-158
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    • 2022
  • Backgrounds/Aims: Pancreaticoduodenectomy is the most common procedure for the management of duodenal pathologies. However, it is associated with substantial morbidity and a low risk of mortality. Pancreas-preserving limited duodenal resection (PPLDR) can be performed under specific scenarios. We share our experience with PPLDR and its outcome. Methods: We retrospectively analyzed a prospectively maintained database of patients undergoing limited duodenal resection in the form of wedge (sleeve) resection or segmental resection of one or more duodenal segments from March 2016 to March 2021 at a tertiary care center in North India. Results: During the study period, 10 patients (including 9 males) underwent PPLDR. Five of these 10 patients showed primary duodenal or proximal jejunal pathology, while the remaining five had duodenal pathology involving an adjacent organ tumor. Four patients underwent wedge (sleeve) resection, while the remaining six underwent segmental duodenal resection of one or more duodenal segments. Mean hospital stay was 6 days (range, 3-11 days) without 30-day mortality. Morbidity occurred in 4 patients (Grade I-II, n = 3; Grade III, n = 1). All patients were alive and disease-free at the time of last follow-up. The mean follow-up duration was 23 months (range, 2-48 months). Conclusions: PPLDR is a safe and effective alternative for pancreaticoduodenectomy when selected carefully for specific tumor types and location.

Development of 'NewChinese' women's clothing design on based on the design preferences of Chinese women in their 20s ('신중국풍'(New Chinese) 여성복 디자인 개발 -중국 20대 여성의 디자인 선호도를 기반으로-)

  • Gao Li;Chahyun Kim
    • Journal of Fashion Business
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    • v.28 no.4
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    • pp.21-44
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    • 2024
  • The purpose of this study was to research modern reinterpretation of traditional Chinese culture and design development of fashion items in the context of globalization and technological advancements, reflecting fashion demands of young female consumers in their 20s in China. To achieve this, this study investigated fashion preferences of young women in major Chinese cities, focusing on design elements such as form, details, patterns, and colors in 'New Chinese Style' fashion. Results indicated a high preference for overlapping collars, Mandarin collars, oblique front pieces, and slit sleeves. Additionally, there was a strong preference for natural and eco-friendly materials such as plant dyes and embossed velvet. Based on survey results and analysis of the popular brand 'TUYUE,' this study proposed two design themes. The first theme, 'natural symbiosis,' focused on casual wear with a soft and free image with a simple design. The second theme, 'chivalrous guest,' targeted work attire with minimal designs emphasizing power and confidence. Both themes aimed to meet aesthetic and practical needs of modern women by incorporating overlapping collars, asymmetrical front pieces, slit sleeves, and preferred colors and patterns. In conclusion, although this study was limited to design preferences of young Chinese women in their 20s, results offer valuable direction for future design innovation, contributing to sustainable development of the fashion industry and the preservation and innovation of traditional culture.

Autometallography for Zinc Detection in the Central Nervous System (중추신경계통내 분포하는 Zinc의 조직화학적 동정)

  • Jo, Seung-Mook;Gorm, Danscher;Kim, Sung-Jun;Park, Seung-Kook;Kang, Tae-Cheon;Won, Moo-Ho
    • Applied Microscopy
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    • v.30 no.4
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    • pp.347-355
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    • 2000
  • Zinc is one of the most abundant oligoelements in the living cell. It appears tightly bound to some metalloproteins and nucleic acids, loosely bound to some metallothioneins or even as free ion. Small amounts of zinc ions (in the nanomolar range) regulate a plentitude of enzymatic proteins, receptors and transcription factors, thus rolls need accurate homeostasis of zinc ions. Zinc is an essential catalytic or structural element of many proteins, and a signaling messenger that is released by neural activity at many central excitatory synapses. Growing evidences suggest that zinc may also be a key mediator and modulator of the neuronal death associated with transient global ischemia and sustained seizures, as well as perhaps other neurological disease stoles. Some neurons have developed mechanisms to accumulate zinc in specific membrane compartment ('vesicular zinc') which can be evidenced using histochemical techniques. Substances giving a bright colour or emitting fluorescence when in contact with divalent metal ions are currently used to detect them inside cells; their use leads to the so called 'direct' methods. The fixation and precipitation of metal ions as insoluble salt precipitates, their maintenance along the histological process and, finally, their demonstration after autometallographic development are essential steps for other methods, the so called 'indirect methods'. This study is a short report on the autometallograhical approaches for zinc detection in the central nervous system (CNS) by means of a modified selenium method.

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Flora in Woopo Wetland and Topyeong Stream (우포늪과 토평천의 식물상)

  • Oh, Kyung hwan;Kim, Cheol Soo;Lee, Pal Hong;Son, Sung Gon
    • Journal of Wetlands Research
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    • v.6 no.3
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    • pp.107-118
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    • 2004
  • The flora of the vascular hydrophytes and hygrophytes and the change of flora according to the fluctuation of the water level before and after flooding were investigated from September 2002 to October 2003 in Woopo Wetland and Topyeong Stream, Changnyeong-gun, Gyeongsangnam-do, Korea. The flora of the Woopo, Mokpo, Sajipo, Jokjibyeol, Topyeongcheon Upstream, and Topyeongcheon Downstream were composed of 256, 242, 265, 177, 201, and 180 taxa, respectively. The flora of total study area was 86 families, 232 genera, 302 species, 42 varieties, 6 form, or total 350 taxa. Among them, hydrophytes, hygrophytes, and others were 36, 96, and 218 taxa, respectively. The life form of the vascular hydrophytes was classified as 19 taxa of emergent plants, 6 taxa of floating-leaved plants, 4 taxa of free-floating plants, and 7 taxa of submersed plants. The specified wild plants designated by the Korean Association for Conservation of Nature, Ministry of Forest, and Ministry of Environment were Euryale ferox, Hydrocharis dubia, Persicaria amphibia, Acorus calamus var. angustatus. And Aristolochia contorta was distributed in the study area. The floras of the naturalized plants of the Woopo, Mokpo, Sajipo, Jokjibyeol, Topyeongcheon Upstream, and Topyeongcheon Downstream were composed of 27, 25, 35, 21, 26 and 24 taxa, respectively. The flora of the naturalized plants of total study area was 43 taxa, this equalled 12.3% of total vascular plants in the study area. And 165~244 taxa were surveyed in the each study area before flooding, total 299 taxa, and 86~212 taxa after flooding, total 299 taxa. Among them, hydrophytes, hygrophytes, and others were 33 and 29, 93 and 83, 183 and 187 taxa before and after flooding, respectively. Before and after flooding, the species number of emergent plants, floating-leaved plants, free-floating plants, and submersed plants was nearly the same. It was guessed that vascular hydrophytes and hygrophytes adapted to fluctuation of the water level in the study area.

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Can high serum anti-M${\ddot{u}}$llerian hormone levels predict the phenotypes of polycystic ovary syndrome (PCOS) and metabolic disturbances in PCOS patients?

  • Hwang, Yu Im;Sung, Na Young;Koo, Hwa Seon;Cha, Sun Hwa;Park, Chan Woo;Kim, Jin Yeong;Yang, Kwang Moon;Song, In Ok;Koong, Mi Kyoung;Kang, Inn Soo;Kim, Hye Ok
    • Clinical and Experimental Reproductive Medicine
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    • v.40 no.3
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    • pp.135-140
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    • 2013
  • Objective: To evaluate correlations between serum anti-M${\ddot{u}}$llerian hormone (AMH) levels, phenotypes of polycystic ovary syndrome (PCOS), obesity, and metabolic parameters in patients with PCOS. Methods: A total of 175 patients with PCOS were diagnosed according to the Rotterdam Consensus were included. Exclusion criteria were age over 40, FSH>25 mIU/mL, and 17a-OHP>1.5 ng/mL. The Phenotypes of PCOS were divided into a severe form (oligo-anovulation, ANOV/hyperandrogenism/polycystic ovary morphology [PCOM]; n=59) and a mild form without HA (ANOV/PCOM, n=105). The serum AMH levels were classified into 3 groups (<5 vs. 5-10 vs. >10 ng/mL). Obesity was defined as body mass index (BMI) ${\geq}25kg/m^2$ (n=34). Results: The mean age was $25.9{\pm}5.7$ year and mean AMH level was $10.1{\pm}5.4$ ng/mL. The BMI ($kg/m^2$) was higher in group 1 ($24.2{\pm}6.3$) than in group 2 ($21.9{\pm}4.3$, p=0.046) or group 3 ($21.6{\pm}3.3$, p=0.019). There was no difference among the three groups in age, menstrual interval, antral follicle counts, androgens, or other metabolic parameters. The obesity group showed significantly lower AMH ($7.7{\pm}3.9$ ng/mL vs. $10.7{\pm}5.6$ ng/mL), p=0.004) and low-density lipoprotein levels ($93.1{\pm}21.2$ mg/dL vs. $107.5{\pm}39.3$ mg/dL, p=0.031), and showed higher total T ($0.74{\pm}0.59$ L vs. $0.47{\pm}0.36$ ng/mL, p=0.001), free T ($2.01{\pm}1.9$ vs. $1.04{\pm}0.8$ pg/mL, p=0.0001), and free androgen index ($6.2{\pm}7.9$ vs. $3.5{\pm}3.0$, p=0.003). After controlling for age factors and BMI, the serum AMH levles did not show any significant correlations with other hormonal or metabolic parmeters. Conclusion: For PCOS patients under the age 40, serum AMH is not negatively correlated with age. High serum AMH levels can not predict the phenotype of PCOS and metabolic disturbances in PCOS patients in the non-obese group. Further study might be needed to define the relation more clearly.

Role of Oxygen Free Radical in the Expression of Interleukin-8 and Interleukin-$1{\beta}$ Gene in Mononuclear Phagocytic Cells (내독소에 의한 말초혈액 단핵구의 IL-8 및 IL-$1{\beta}$ 유전자 발현에서 산소기 역할에 관한 연구)

  • Kang, Min-Jong;Kim, Jae-Yeol;Park, Jae-Seok;Lee, Seung-Joon;Yoo, Chul-Gyu;Kim, Young-Whan;Han, Sung-Koo;Shim, Young-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.6
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    • pp.862-870
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    • 1995
  • Background: Oxygen free radicals have generally been considered as cytotoxic agents. On the other hand, recent results suggest that small nontoxic amounts of these radicals may act a role in intracellular signal transduction pathway and many efforts to reveal the role of these radicals as secondary messengers have been made. It is evident that the oxygen radicals are released by various cell types in response to extracellular stimuli including LPS, TNF, IL-1 and phorbol esters, all of which translocate the transcription factor $NF{\kappa}B$ from cytoplasm to nucleus by releasing an inhibitory protein subunit, $I{\kappa}B$. Activation of $NF{\kappa}B$ is mimicked by exposure to mild oxidant stress, and inhibited by agents that remove oxygen radicals. It means the cytoplasmic form of the inducible tanscription factor $NF{\kappa}B$ might provide a physiologically important target for oxygen radicals. At the same time, it is well known that LPS induces the release of oxygen radicals in neutrophil with the activation of $NF{\kappa}B$. From above facts, we can assume the expression of IL-8 and IL-$1{\beta}$ gene by LPS stimulation may occur through the activation of $NF{\kappa}B$, which is mediated through the release of $I{\kappa}B$ by increasing amounts of oxygen radicals. But definitive evidence is lacking about the role of oxygen free radicals in the expression of IL-8 and IL-$1{\beta}$ gene in mononuclear phagocytic cells. We conducted a study to determine whether oxygen radicals act a role in the expression of IL-8 and IL-$1{\beta}$ gene in mononuclear phagocytic cells. Method: Human peripheral blood monocytes were isolated from healthy volunteers. Time and dose relationship of $H_2O_2$-induced IL-8 and IL-$1{\beta}$ mRNA expression was observed by Northern blot analysis. To evaluate the role of oxygen radicals in the expression of IL-8 and IL-$1{\beta}$ mRNA by LPS stimulation, pretreatment of various antioxiants including PDTC, TMTU, NAC, ME, Desferrioxamine were done and Northern blot analysis for IL-8 and IL-$1{\beta}$ mRNA was performed. Results: In PBMC, dose and time dependent expression of IL-8 and IL-$1{\beta}$ mRNA by exogenous $H_2O_2$ was not observed. But various antioxidants suppressed the expression of LPS-induced IL-8 and IL-$1{\beta}$ mRNA expression of PBMC and the suppressive activity was most prominant when the pretreatment was done with TMTU. Conclusion: Oxygen free radical may have some role in the expression of IL-8 and IL-$1{\beta}$ mRNA of PBMC but that radical might not be $H_2O_2$.

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Recovery of Lipids from Chlorella sp. KR-1 via Pyrolysis and Characteristics of the Pyrolysis Oil (Chlorella sp. KR-1 열분해에 의한 지질 회수 및 열분해 오일 특성 분석)

  • Lee, Ho Se;Jeon, Sang Goo;Oh, You-Kwan;Kim, Kwang Ho;Chung, Soo Hyun;Na, Jeong-Geol;Yeo, Sang-Do
    • Korean Chemical Engineering Research
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    • v.50 no.4
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    • pp.672-677
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    • 2012
  • Lipids in microalgal biomass were recovered by using pyrolysis method. The pyrolysis experiments of two Chlorella sp. KR-1 samples, which have triglyceride contents of 10.8% and 36.5%, respectively were carried out at $600^{\circ}C$ to investigate the effects of lipid contents in the cells on the reaction characteristics. The conversion and liquid yield of the lipid-rich sample were higher than those of the lipid-lean sample since its carbon to hydrogen ratio was low. There were low molecular weight organic acids, ketones, aldehydes and alcohols in the liquid products from both KR-1 samples, but the pyrolysis oil of the lipid-rich sample was abundant in free fatty acids, particularly palmitic acid, oleic acid and stearic acid while the content of nitrogen containing organic compounds was low. The microalgal pyrolysis oil had two layers composed of the light hydrophobic fraction and the heavy hydrophilic fraction. The light fraction might be originated from triglycerides and the heavy fraction might be from carbohydrates and proteins. In the light fraction of the liquid products, there were considerable linear alkanes such as pentadecane and heptadecane as well as free fatty acids, implying that deoxygenation reaction including decarboxylation was occurred during the pyrolysis. The yield of the liquid products from the pyrolysis of the KR-1 sample having triglyceride content of 36.5% was 56.9% and the light fraction in the liquid products was 68.2%. Also more than 80% of the light fraction was free fatty acids and pure hydrocarbons, thus showing that most triglycerides could be extracted in the form of suitable raw materials for biofuels.

'Open Skies' Agreements and Access to the 'Single' European Sky;Legal and Economic Problems with the European Court of Justice's Judgment in 'Commission v. Germany'(2002) Striking Down the 'Nationality Clause' in the U.S.-German Agreement (항공(航空) 자유화(自由化)와 '단일(單一)' 유럽항공시장(航空市場) 접근(接近);유럽사법재판소(司法裁判所)의 미(美) ${\cdot}$ 독(獨) 항공운수협정(航空運輸協定)상 '국적요건(國籍要件)' 조항(條項)의 공동체법(共同體法)상 '내국민대우(內國民待遇)' 규정 위반(違反) 관련 '집행위원회(執行委員會) 대(對) 독일연방(獨逸聯邦)' 사건 판결(判決)(2002)의 문제점을 중심으로)

  • Park, Hyun-Jin
    • Journal of the Korean Society for Aviation and Aeronautics
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    • v.15 no.1
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    • pp.38-53
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    • 2007
  • In a seminal judgment of November 2002 (Case C-476/98) relating to the compatibility with Community laws of the 'nationality clause' in the 1996 amending protocol to the 1955 U.S.-German Air Services Agreement, the European Court of Justice(ECJ) decided that the provision constituted a measure of an intrinsically discriminatory nature and was thus contrary to the principle of national treatment established under Art. 52 of the EC Treaty. The Court, rejecting bluntly the German government' submissions relying on public policy grounds(Art. 56, EC Treaty), seemed content to declare and rule that the protocol provision requiring a contracting state party to ensure substantial ownership and effective control by its nationals of its designated airlines had violated the requirement of national treatment reserved for other Community Members under the salient Treaty provision. The German counterclaims against the Commission, although tantalizing not only from the perusal of the judgment but from the perspective of international air law, were nonetheless invariably correct and to the point. For such a clause has been justified to defend the 'fundamental interests of society from a serious threat' that may result from granting operating licenses or necessary technical authorizations to an airline company of a third country. Indeed, the nationality clause has been inserted in most of the liberal bilaterals to allow the parties to enforce their own national laws and regulations governing aviation safety and security. Such a clause is not targeted as a device for discriminating against the nationals of any third State. It simply acts as the minimum legal safeguards against aviation risk empowering a party to take legal control of the designated airlines. Unfortunately, the German call for the review of such a foremost objective and rationale underlying the nationality clause landed on the deaf ears of the Court which appeared quite happy not to take stock of the potential implications and consequences in its absence and of the legality under international law of the 'national treatment' requirement of Community laws. Again, while US law limits foreign shareholders to 24.9% of its airlines, the European Community limits non-EC ownership to 49%, precluding any ownership and effective control by foreign nationals of EC airlines, let alone any foreign takeover and merger. Given this, it appears inconsistent and unreasonable for the EC to demand, $vis-{\grave{a}}-vis$ a non-EC third State, national treatment for all of its Member States. The ECJ's decision was also wrongly premised on the precedence of Community laws over international law, and in particular, international air law. It simply is another form of asserting and enforcing de facto extraterritorial application of Community laws to a non-EC third country. Again, the ruling runs counter to an established rule of international law that a treaty does not, as a matter of principle, create either obligations or rights for a third State. Aside from the legal problems, the 'national treatment' may not be economically justified either, in light of the free-rider problem and resulting externalities or inefficiency. On the strength of international law and economics, therefore, airlines of Community Members other than the designated German and U.S. air carriers are neither eligible for traffic rights, nor entitled to operate between or 'free-ride' on the U.S. and German points. All in all and in all fairness, the European Court's ruling was nothing short of an outright condemnation of established rules and principles of international law and international air law. Nor is the national treatment requirement justified by the economic logic of deregulation or liberalization of aviation markets. Nor has the requirement much to do with fair competition and increased efficiency.

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THE STUDY ABOUT THE CHANGES OF MASTICATORY SYSTEM SUBSEQUENT TO RANDOMLY INCREASING THE VERTICAL DIMENSION (교합고경의 인위적인 증가에 따른 저작계의 반응에 관한 연구)

  • Kim, Nam-Jung;Lee, Sung-Bok;Choi, Dae-Gyun;Park, Nam-Soo
    • The Journal of Korean Academy of Prosthodontics
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    • v.33 no.4
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    • pp.731-752
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    • 1995
  • This study was performed to research the changes of masticatory system subsequent to randomly increasing the vertical dimension. The subjects were twenty seven persons, twenty two men and five women, with a mean age of 24.3(age ranged from 22 to 26). The subjects had a complete or almost complete set of natural teeth and reported no subjected symptoms of pain or dysfunction in the masticatory system. The occlusal splint increased vertical dimension was made on semiadjustable articulator. The subjects were randomly divided to three groups according to the vertical dimension, at which the occlusal splint was made. Group I occlusal splints were made at 2mm form the occlusal vertical dimension, group II occlusal splints at 5mm, group III occlusal splints at 8mm. The occlusal splints were almost weared for 2 weeks except meal-time. Clinical examination, muscle activity, changes of free-way space, movement of mandible and articular condyle were recorded and analyzed by means of biopak system(Bioresearch Inc, Millwakee Wisconsin.) and radiograph. 1. In clinical examination, various symptoms were reported by all subjects immediately after the placement of occlusal splint. At the end of experiment, symptoms were lasted by 1 subject in Group I, 2 subjects in Group II, 6 subjects in Group III. At the other subjects, the most of symptoms were disappered within 2-4 days after the placement of occlusal splints. 2. The average free-way space before the startof experiment was 1.77mm in all twenty seven subjects. Immediately after the placement of occlusal splints, 0.67mm at Group I, 0.49mm at Group II, 0.41mm at Group III, At 2 weeks after the placement of occlusal splint 0.93mm, 0.79mm, 0.78mm each other, 1.94mm, 1.77mm, 2.3 mm at immediately after the removal of occlual splint. At 1 week after the removal of occlusal splint, free-way space was recovered to the pre-experimental state 3. In cephalometric radiograph, following either the placement or the removal of the occlusal splints, the movements of mandible in an antero-posterior direction were not statistically significant(p>0.05). 4. In transcranial radiograghs of TMJ, 1 week after the placement of occlusal splint the movement of most superior position on condyle in all group shoed antero-inferior position than before the experiment(p<0.001) and also showed antero-inferior position in mandibular postural rest position than in certric occlusion(p<0.001). Following either the placement or the removal of the splints, the amount of movement of most superior position on condyle was group III. group II and group I in order(p<0.001). 5. In anterior temporal and superficial masseter muscle, muscle activity at postural rest position decreased at 2 weeks after the placement of occlusal splint in group I and group II (p>0.05), but significantly increased in group III(p<0.001). At 1 week after the removal of the occdusal splint, muscle activity at postural rest position was recovered preconditional state 6. In anterior temporal and superficail masseter muscle, muscle activity at clenching in all group was significantly decreased after placement of the occlusal splint, slightly increased during experimental period and recovered to the original state at 1 week after removal of the occlusal splint. But was not statistically significat(p>0.05)s.

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A Convergence Study for the Academic Systematization of Cartoon-animation (만화영상학의 학문적 체계화를 위한 융합적 연구)

  • Lim, Jae-Hwan
    • Cartoon and Animation Studies
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    • s.43
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    • pp.285-320
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    • 2016
  • Cartoons and Animation are convergent arts created with a composite application of language arts described in the form of literary texts and sounds, plastic arts visualized in the form of artistic paintings, and film arts produced in the form of moving pictures. An academic university major in cartoons and animation studies established in late 20th century however, did not satisfactorily meet the needs in academic research and development and the free expression of artistic creation was limited. In order to systematize the major in cartoons and animation studies, an convergent approach to establish and clarify following are in demand : the terms and definitions, the historical developments, the research areas and methods, the major education and related jobs and start-ups. New culture and arts industries including cartoons, animation, moving images, and games contents are not yet listed in the industries listing service jointly provided online by the portal site Naver.com and Hyung-Seol publishing company. Above all, cartoons and animation are inseparably related to each other that even if one uses the term separately and independently, the meaning may not be complete. So a new combined term "Animatoon" can be established for the major in cartoons and animation studies and also used for its degree with concentrations of cartoons, animation, moving images, games, and etc. In the Introduction, a new combined term Animatoon is defined and explained the use of this term as the name of the major and degree in cartoons and animation studies. In the body, first, the Historical Developments classified Animatoon in the ancient times, the medieval times, and the modern times and they are analyzed with the help of esthetics and arts using examples of mural frescos, animal painting, religion cartoons, caricatures, cartoons, satire cartoons, comics, animation, 2 or 3 dimensional webtoons, and K-toons. Second, the Research Areas of Animatoon reviewed the theories, genres, artworks, and artists and the Research Methods of Animatoon presented the curriculum that integrated the courses in humanities, science technologies, culture and arts, and etc. Third, the Major Education considered Animatoon education in children, young adults, students of the major and the Related Jobs and Start-Ups explored various jobs relating to personal creation of artwork and collective production of business-oriented artwork. In the Conclusion, the current challenges of Animatoon considered personalization of the artists, specialization of the contents, diversification of the types, and liberalization of the art creation. And the direction of improvement advocated Animatoon to be an academic field of study, to be an art, to be a culture, and to be an industry. The importance of cartoons and animation along with videos and games rose in the 21st century. In order for cartoons and animation to take a leading role, make efforts in studying Animatoon academically and also in developing Animatoon as good contents in the cultural industries.