• Journal of Digestive Cancer Research
• /
• v.7 no.1
• /
• pp.22-25
• /
• 2019

A 58-year-old woman presented with right flank and back pain for one month. After undergoing an abdominal computed tomography (CT), she was referred to our hospital. The abdominal CT showed a hypodense pancreatic tail mass with multiple retroperitoneal lymph node metastases. Positron emission tomography-computed tomography (PET-CT) scan showed high 18F-FDG uptake in pancreatic tumor and enlarged lymph nodes. Endoscopic ultrasound fine needle aspiration (EUS-FNA) revealed adenocarcinoma, which stained strongly in hENT1 (human equilibrative nucleoside transporter 1) on immunohistochemistry. She received gemcitabine 1,000 mg/m² + nanoparticle albumin-bound paclitaxel 125 mg/m² as a palliative chemotherapy. Follow-up abdominal CT and PET-CT after 4 cycles of chemotherapy showed that both pancreatic mass and the metastatic retroperitoneal lymph nodes were nearly disappeared. We report a case of 58-year-old female with metastatic pancreatic cancer who had a dramatic response to palliative chemotherapy (gemcitabine plus nanoparticle albumin-bound paclitaxel).

• Economic and Environmental Geology
• /
• v.32 no.4
• /
• pp.323-337
• /
• 1999

Late Cretaceous to early Tertiary volcanic rocks in the Kyongsang basin exhibit high-K calc-alkaline characteristics, and originated from the magmatism related genetically to subduction of Kula-Pacific plate. They represent HFSE depletion and LlLE enrichment characteristics as shown by magmas related to subduction. Early studies on the depth of magma generation has been estimated as 180-230 km based on K-h relation should be reevaluated, because the depth of peridotite partial melting with 0.4 wt. % water is 80-120 km at subduction zone, and subducting slab in premature arc can melted even lower than 70 km. Moreover the increase of potassium contents depends on either contamination of crustal material and fluids of subducting slab or low degree of partial melting. If the inclination of subduction zone is 30 degrees and the depth to the Benioff zone is 180-230 km, the calculated distance between the volcanic zone and trench axis would be 310-400 km. It is unlikely because the distance between the Kyongsang basin and trench during late Cretaceous to early Tertiary is closer than this value and not comparable with generally-accepted models in subduction zone magmatism. $K_{55}$ of the volcanics in the Kyongsang basin is 0.3-2.3 wt.% and the average indicate that the depth ranges between 80-170 km on the diagram of Marsh, Carmichael (1974). Fractionation from garnet lherzolite, assumed the depth of 180-230km, is not consistent with the REE patterns of the volcanoes in the Kyongsang basin. Futhermore, the range of depth suggested by many workers, who studied magmatism related to subduction, imply shallower than this depth. Crustal thickness calculated by the content of CaO and $Na_2O$ is about 30 km and about 35 km, respectively. Paleo-crustal thickness during late Cretaceous to early Tertiary times in the Kyongsang basin inferred about 30 km calculated by La/Sm versus LaJYb data, which is also supported by many previous studies.

• Journal of Chest Surgery
• /
• v.38 no.10 s.255
• /
• pp.680-684
• /
• 2005

Background: With the increasing age of the population, coronary artery bypass grafting in the elderly patients is becoming common. Off-pump coronary artery bypass grafting (OPCAB) has been proven to be less morbidity and to facilitate early recovery. The elderly patients may have benefits by avoiding the adverse effects of the cardiopulmonary bypass. The purpose of this study is to evaluate our results of OPCAB in elderly patients. Material and Method: A retrospective chart review was carried out for 12 patients aged over 80 years who underwent isolated OPCAB from January 2001 and March 2004. Data were collected risk factors for disease, extent of coronary disease, and in-hospital outcomes. Postoperative graft patiency was evaluated in 9 patients by multi-slice computed tomography. Result: Eleven patients had triple vessel disease or left main disease. Four patients were suffered from preoperative CVA, and 4 patients had chronic obstructive pulmonary disease. Two patients had myocardial infarction (MI), among them 1 patient was suffered from pulmonary edema after preoperative MI. There was no perioperative death, perioperative MI, and no ventricular arrhythmia. Also there was no perioperative stroke and renal failure. But there was one deep sternal infection who recovered by treating of muscle flap. Atrial fibrillation was newly developed in 1 patient, but was well controlled by medication. Mean intubation time was $15.9\pm4.4(8\~20hrs)$ hrs and mean ICU stay was $2.9\pm0.8(2\~4 days)$ days. Mean hospital day was $21.6\pm14.3(13\~56 days)$ days. Postoperative mean CK-MS was $11.3\pm14.1\;ng/mL$. Early postoperative graft patency rate was $100\%(24/24)$. Follow-up was completed in all patients. In this time, there was no patients with angina or death. Conclusion: The results of this study suggest that OPCAB reduces morbidity and favors hospital outcomes. Therefore, OPCAB is safe, reasonable and might be preferable operative strategy in elderly patients.

• Korea journal of population studies
• /
• v.10 no.2
• /
• pp.58-81
• /
• 1987

The purpose of this study is to examine major factors that affect patterns of living arrangements of older Korean noncitizens in the United States using the 1990 8% Public Use Microdata Sample(PUMS). In order to do so, I analyzed the effects of four factors including acculturation(English proficiency and Age at migration), economic circumstances(Personal Income and Supplemental Security Income: SSI receipt), health status(Mobility and Personal care limitation), and the ethnic community. The results show that acculturation and economic circumstances play an important role in determining the patterns of living arrangements among older Korean aliens, whereas the health status and the ethnic community do not show consistent effects. Regardless of marital status, the impact of age at migration is positively associated with solitary living of older Korean noncitizens, though, the effect of English proficiency show the opposite direction in accordance with marital status. That is, among nonmarried elders, those who cannot speak English are more likely to live alone. The case is reverse for married elders. The impact of economic feasibility is also positively associated with independent living arrangements. Those who receive SSI are much more likely to live apart from family, and elders whose annual personal income between $5,001 and $10,000 have the greatest propensity of solitary living-a large proportion of their income source is SSI. Individuals who receive SSI are also qualified to collect Medicaid, food stamps, rent subsidies, and other welfare benefits. In a sense, the economic feasibility provided by welfare benefits is the key determinant of independent living of older Korean noncitizens. Therefore, the recent welfare reform which denies legal aliens welfare benefits such as SSI and food stamps will severly affect the present living arrangements of older Korean aliens, and give economic burden to their family member The findings also show that there are significant differences within the elderly Korean Americans in terms of demographics, income, fertility, health status, and patterns of living arrangements by U.S. citizenship status. In particular, after controlling for age at migration as a proxy for acculturation, there is a statistically significant variation in living arrangements between elderly Korean noncitizens and naturalized citizens. For both theoretical and methodological reasons, future research on minority aging needs to investigate the concept of U.S. citizenship status for its impact on patterns of living arrangements among the minority elderly.

• Journal of the Korean Arthroscopy Society
• /
• v.6 no.2
• /
• pp.142-149
• /
• 2002

Purpose : The purpose of this study is to compare with result of repair and resection in displaced bucket handle medial meniscal tear. Materials and Methods : From Sep. 1998 to Dec. 2001, we experienced 46 cases, 45 patients. We classified them into repair group (group I, 23 cases) and resection group (group II, 23 cases). We analyzed the time interval between injury and operation, zone of tear, the status of reduction and quality of displaced fragment of all cases. Average follow-up period is 29, 28 months, respectively. We evaluated the final results of both groups as Lysholm knee score, radiologic changes and 2nd look arthroscopy. Results : Mean age was 25 years old in both group, respectively. Mean interval between injury and surgical treatment was 12 and 17 weeks. respectively. In group I, 6 of 7 cases were evaluated as clinical success in red-red zone, 12 of 15 cases were assessed as clinical success in red-white zonal tear, stable reduction. Another case which is evaluated as clinical failure showed red-white zonal tear, unstable reduction and poor quality meniscal fragment. 5 cases showed variant degrees of tibio-femoral compartment symptom. In group II, red-white zone (9 cases) and white-white zone (14 cases) were treated as resection and got good results. Conclusion : Considering zone of tear, reducibility and quality of meniscal fragment before treatment will improve the success rate of meniscal repair.

• Journal of the Korean Institute of Gas
• /
• v.5 no.4 s.16
• /
• pp.1-7
• /
• 2001

This paper presents a 'consequence analysis' for vapor cloud explosions caused by heavy gas leakages from commercially used storage tanks at petrochemical plants. Particularly, this paper emphasizes on evaluating the results of various vapor cloud explosion accidents from Butane storage tanks. Also this paper analyses the impact of variables on the accidents in order to acquire the optimum conditions for variables. $SuperChems^{TM}$ Professional Edition was applied to analyse the impact (If atmospheric and other variables in the situation where vapor cloud continuously disperses from the ground level. Under the assumption that practical operating conditions are selected as a standard condition, and Butane leaks from the storage tank for 15 minutes, the results show that the maximum distance of LFL (Lower Flammable Limit) was 52 meters and overpressure by the vapor cloud explosion was 1 psi at 128.2 meters. It is observed that the impact of the variables on accidental Butane storage tank leakage mainly varied upon atmospheric stability, wind velocity, pipe line size, visible length, etc., and changes in the simulation result occurred as the variables varied. The maximum distance of the LFL (Lower Flammable Limit) increased as the visible length became shorter, the size of the leak became larger, the wind velocity was decreased, and the climatic conditions became more stable. Thus, by analysing the variables that influence the simulation results of explosions of Butane storage tanks containing heavy gases, I am presenting the most appropriate method for 'consequence analysis' and the selection of standards for suitable values of variables, to obtain the most optimal conditions for the best results.

• Sleep Medicine and Psychophysiology
• /
• v.9 no.1
• /
• pp.41-47
• /
• 2002

Objectives: In a number of simulated night shift studies, timed exposure to bright light improves sleep quality and work performance. We evaluated the effect of bright light on adaptation to night shift work with a field study. Methods: Five female nurses working shifts at Korea University Hospital were recruited for participation in this study. We investigated two series of six consecutive shift rotations comprising three day and three night shifts, using wrist Actigraphy, the Stanford Sleepiness Scale, Visual-analogue scales, STIM and tympanic membrane temperature for daytime sleep quality, alertness, subjective feeling, attention performance, and temperature rhythm. The subjects were exposed to bright light (2,500 lux) from 24:00 to 04:00 a.m. on three consecutive night shifts during the second series, whereas they worked under normal lightening (650 lux) conditions during the first series. Results: Actigraphic assessment of daytime sleep showed no significant difference between the first and third night shift in both baseline and light exposure phase. The mean lowest temperature shifted earlier during baseline phase but not during the light exposure phase. Also, the score for subjective feelings of depression, anxiety, physical discomfort and sleepiness was significantly higher in the third night shift than the first during baseline phase but not during the light exposure phase. Attention and attention switching ability was significantly improved in the third night shift compared to the first night during the light exposure phase but there were no significant changes during the baseline phase. Conclusion: This result suggests that there were no significant differences between the two phases in measures of quality of daytime sleep, but subjective feelings, attention and alertness were enhanced during light exposure. Although some placebo effects and learning effects might influence this result, bright light exposure between midnight and 4:00 a.m. may improve adaptation to night shift. In future, further controlled studies with a larger sample size, including melatonin measurement, are needed for real shift workers.

• Journal of Chest Surgery
• /
• v.40 no.5 s.274
• /
• pp.341-350
• /
• 2007

Background: We present here the early and midterm surgical results for infective endocarditis and we especially focus on the effect of aggressive reconstruction or root implantation after wide debridement. Material and Method: Between January 1995 and Jun 2006, we enrolled 79 adult infective endocarditis patients who underwent surgical treatment. There were 63 and 16 native and prosthetic valve endocarditis cases, respectively. They included 27 cases of culture negative endocarditis. With performing valve replacement or repair, 28 of the patient underwent a more aggressive surgical option, for example, aortic root replacement or reconstruction, or heart base reconstruction etc. Result: There were statistical relationships between the in-hospital mortality and staphylococcal infection, urgent-based operation and operation during the active phase of endocarditis. Wide debridement and aggressive reconstruction were not related to either the post operative mortality or the early morbidity. Culture negative endocarditis was not related to the postoperative mortality and morbidity. Conclusion: Physicians must pay attention to patients' medical treatment during the preoperative period of the infective endocarditis. If surgery is considered for treating infective endocarditis, it should be performed before the downhill course of the disease so that the surgical outcome is improved. Wide debridement and more aggressive reconstruction are also warranted.

• Journal of Nutrition and Health
• /
• v.12 no.2
• /
• pp.1-13
• /
• 1979

성장발육하는 시기에 영양과 성장하는 아동들의 체위와는 밀접한 관계가 있고 또한 영양부족과 그로 말미암아 자라나는 이학적 소견과도 불가분의 관계가 있기 때문에 그동안 우리나라에서 부분적, 단편적으로 연구 발표된 문헌을 중심으로 그를 검토 고찰하여 보았다. 그 결과를 요약하면 다음과 같다. 우리나라 아동들이 출생후 6개월까지는 주로 모유에 의존하고, 약간이 인공영양에 의존하고 있는데, 이 시기에는 다른 선진제국의 어린이들의 성장발육과의 별 차이가 없었다. 그러나 이유기인 $6{\sim}30$개월 사이에는 우리나라 어머니들의 이유에 대한 지식이 빈약하고 이들 음식물을 그대로 아기들에게 적용하기 힘든 이유등으로 아이들에게 보급해서 주는 음식물이 빈약함으로 말미암아 다른 선진제국 아이들에 비해서 이 시기에 체위가 많이 떨어지고 빈혈현상을 나타내는 것을 볼 수 있다. 이때 고양군에서 농민의 아동들에 대해서 시행한 영양조사 내용을 보면, 전체 칼로리도 부족되고 특히 단백질, 철분, 칼슘, 비타민 A, B복합제가 전반적으로 부족되는 것을 알았다. 이는 어머니들의 육아와 이유식에 대한 지식의 결집도 중요한 역할을 했겠거니와 더욱더 중요한것은 우리나라 어른들의 식습관이, 민족적 전통적으로 짜고, 매웁고, 딱딱해서 이를 아기들에게 그대로 적응해서 먹이기가 힘든 것도 더 중요한 이유가 된다. 어른들을 위한 음식물에도 맵지 않고, 짜지 않으며, 아기들도 즐겨 먹을 수 있는 유동식 혹은 반유동식으로 된 영양가치가 좋은 음식물을 발전시켜 애용하도록 하는 것이 민족적인 긴급한 과제라고 하겠다. 그렇지 않으면 선진제국 모양으로 이유기에 있는 아이들을 위해서 아이들이 즐겨 먹을 수 있는 이유식을 크게 발전시켜서 이유기의 아이들에게 저렴하게 공급할 수 있는 생산공장과 제도의 마련이 긴급하다고 하겠다. 우리 민족의 체위를 향상 시키는데 영양학자와 영양사들에게 기대 하는 바가 크다. 육아하는 어머니의 교육정도와경제적인 면이 아기 체위에 주는 영향에 대한 연구에서는 교육정도가 높고, 경제적으로 좋은 위치에 있는 엄마가, 교육정도가 낮고 경제적으로 가난한 위치에 있는 어머니보다 아이들 체위에 훨씬 좋게 기를 수 있다는 것을 알았다. 특히 이유기에 들어간 6개월 이후에 체위 격차가 심한 것을 볼 때 보충해 주는 음식물의 적절한 보급이 얼마나 필요한가를 말해 주는 것이며 이에는 어머니의 교양과 열의와 경제적 뒷받침이 얼마나 필요하다는 것을 말해주는 것이다. 지역별로 서울에서 부유층 가정과 학교 아동, 농촌 지역 가정과 학교아동, 강원도 산간지역 가정과 학교 아등으로 나누어서 자라나는 아동들의 체위와 이학적 소친을 연구 조사한 바로는 서울 부유층이 제일 좋고 그 다음이 서울 빈한층, 강원도 산간지역 아동의 순으로 좋았으며 농촌지역 아종은 체위가 가장 떨어졌다. 구각증, 구내염등은 강원도 산간지역 아동에 제일 많고, 다음이 농촌지역, 서울 판자촌지역의 순으로 많으며 서울부유충지역이 가장 적어서 이는 산간일수록 또 는 빈한할수록 등물성단백질이 부족되는 것을 말해 주는 것이다. 지역별 혈색소치는 109gm/100ml 이하인 경우가 서울 빈한층가정 아동에 제일 많아서 51.7%나 되며 다음이 산간지역가정, 농촌지역가정의 순으로 많으며 서울부유층가정 아동은 2.2%에 지나지 않는다. 한국아등의 체위와 일본아동의 체위를 비교해 본 바로는 출생 후 약 12개월까지는 별차가 없지만 그후로는 점차로 그 격차가 심해져서 $12{\sim}15$세 사이에 평균체중면에서 5kg정도, 신장면에서 5cm정도의 큰 격차를 나타냈다. 그러나 그후로 성인이 되어감에 따라서 그 격차는 좁아졌다. 이는 일본국이 경제적으로 우리보다 우위에 있음에 따라서 아이들 성장에 필요한 영양분을 적기에 적당하게 공급해 주었기 때문이며 우리는 많은아이들이 가만하기 때문에 그 나이에 맞는 영양분 보급을 적당히 하지 못한 결과로 생각할 수 밖에 없다. 한국 아동의 발육표준치를 1965년초에 측정한 것과 1975년도에 측정한 것을 비교해 본 결과 1975년 치는 1965년도치에 비해 체중과 신장 면에서 상당히 증가하였다. 이는 우리라라 경제상태가 좋아지면서 굶는 아이들이 적어지거나 없어졌을 뿐만 아니라 식품 내용이 개선된 때문으로 해석된다. 따라서 민족의 체위가 개선되고 향상되려면 제일 먼저 해결되어야 할 문제는 국가의 경제력이 향상될뿐만 아니라 빈부의 격차가 적어져서 우리나라에 생을 받은 사람은 누구나 굶는 자가 없이 균형 있는 영양분을 충분히 섭취 할 수 있는기회를 갖도록 되어야 하겠다. 영양학자와 식품관리자들은 우러나라 아이들이 타고난 체위의 잠재성을 충분히 키우기 위해서 어떠한 음식물이 얼마나 필요한지 계산하여 이를 작물로 충분히 충당할 수 있도륵 계획해서 농수산물을 생산하도록 해야겠다. 영양학자들은 우리 민족의 음식물을 개선해서 아기들이 즐겨 먹을 수 있는 어른들의 음식물, 영양식을 발전시켜 이유기에 받는 우리 어린아기들의 수난을 조속히 극복하는 것이 바람직하다. 또한 영양에 대한 교육을 국민학교, 중학교 교과과정에 많이 넣어서 교육하고 영양에 대한 교육과 보급을 조직적으로, 신문, 라디오, 텔레비젼등을 통해서 성인교육을 강화해서 모든 국민들이 적은 돈을 가지고도 보다 나은 영양물을 구해서 섭취할 수 있는 지혜를 가지도록 해야겠다. 국민학교 재학중 및 졸업시기를 전후딘서 체위가 많이 떨어지며 그 영향이 일생동안 간다는 것을 감안할 때 국민학교에서 점심 한끼라도 영양식을 보급해서 우리 국민체위 향상을 위해서 나라에서 직접적으로 공헌하는 바가 있었으면 한다.

• Journal of Yeungnam Medical Science
• /
• v.25 no.1
• /
• pp.1-18
• /
• 2008

Although Lamivudine and adefovir dipivoxil are efficacious drugs for preventing hepatocellular carcinoma (HCC) in chronic hepatitis B patients, their efficacy is far from completely satisfactory. The risk of liver cirrhosis and HCC begins to increase at an HBV DNA level of $10^4$ copies/ml. Even with latent or past HBV infection, episomal covalently closed circular DNA(cccDNA) plays a key rolein the persistence, relapse and resistance of HBV in its natural course or during therapy. The annual incidence of HCC in YUMC is 1.8% and 4.7% patients/year in the antiviral treatment and control groups, respectively. The ability to achieve a high rate of sustained HBV suppression with low risk of drug resistance is the ultimate goal in the treatment of chronic HBV infection. The efficacy of universal immunization with striking reductions in the prevalence of HBV in localized countries needs to be spread worldwide. With hepatitis B immunization and effective antiviral therapy, global control of HBV infection and HBV-related complications, including HCC, are possible by the end of the first half of the $21^{st}$ century.