• 한국간담췌외과학회지
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• 제28권1호
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• pp.59-69
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• 2024

Backgrounds/Aims: Pancreaticoduodenectomy (PD) is the only radical treatment for periampullary malignancies. Superior mesenteric artery (SMA) first approach combined with total meso-pancreas (MP) excision was conducted to improve the oncological results. There has not been any previous research of a technique that combines the SMA first approach and total MP excision with a detailed description of the MP macroscopical shape. Methods: We prospectively assessed 77 patients with periampullary malignancies between October 2020 and March 2022 (18 months). All patients had undergone PD with SMA first approach combined total MP excision. The perioperative indications, clinical data, intra-operative index, R0 resection rate of postoperative pathological specimens (especially mesopancreatic margin), postoperative complications, and follow-up results were evaluated. Results: The median operative time was 289.6 min (178-540 min), the median intraoperative blood loss was 209 mL (30-1,600 mL). Microscopically, there were 19 (24.7%) cases with metastatic MP, and five cases (6.5%) with R1-resection of the MP. The number of lymph nodes (LNs) harvested and metastatic LNs were 27.2 (maximum was 74) and 1.8 (maximum was 16), respectively. Some (46.8%) patients had pancreatic fistula, but mostly in grade A, with 7 patients (9.1%) who required re-operations. Some 18.2% of cases developed postoperative refractory diarrhea. The rate of in-hospital mortality was 1.3%. Conclusions: The PD with SMA first approach combined TMpE for periampullary malignancies was effective in achieving superior oncological statistics (rate of MP R0-resection and number of total resected LNs) with non-inferior short-term outcomes. It is necessary to evaluate survival outcomes with long-term follow-up.

• 대한임상독성학회지
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• 제18권2호
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• pp.57-65
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• 2020

Purpose: Since 2012, acetaminophen can be accessed easily not only at pharmacies but also at convenience stores. The relationship between the easy access of acetaminophen and the risk of poisoning has been controversial. Several studies also reported different results regarding the risk of acetaminophen poisoning after access to acetaminophen was relaxed. This study examined the long-term effects on the risk of acetaminophen poisoning after easy access to acetaminophen was implemented. Methods: This was a retrospective analysis of an emergency department (ED)-based in-depth Injury Surveillance Cohort by the Korea Center for Disease Control and prevention from 2011 to 2018. Poisoning cases were selected from the Cohort, and the incidence of acetaminophen poisoning and the characteristics of the cases of acetaminophen poisoning were analyzed. The purchase path and the amount of ingestion in acetaminophen poisoning were sub-analyzed from data of six EDs. Results: Of 57,326 poisoning cases, 4.0% (2,272 cases) were acetaminophen poisoning. Of 2,272 cases of acetaminophen poisoning, 42.8% (974 cases) required in-patient care after ED management. Two hundred and sixty-four of these 964 cases required intensive care. The rates of cases that required in-patient treatment and the rates of cases that required intensive care increased from 29.4% in 2011 to 48.1% in 2018, and from 3.1% in 2011 to 15.2% in 2018, respectively (p<0.001, p<0.001). In the poisoning group with in-depth toxic surveillance (n=15,908), the incidence and proportion of acetaminophen (AAP) poisoning increased from 55 cases per year to 187 cases per year and 4.9% to 6.1%, respectively (p=0.009, p<0.001, respectively). The most common age group of acetaminophen poisoning was teenagers, which is different from the most common age group of other pharmaceutical agents: the middle age group of 40-49 years (p<0.001). Of 15,908 in-depth toxic surveillance patients, 693 patients had AAP poisoning, of whom 377 cases (54.2%) purchased acetaminophen from a non-pharmacy. The proportions of the purchase path from non-pharmacy were 41.4% at 2011-12 and 56.4% (2013-18) (p=0.004). The amount of acetaminophen ingestion was 13.5±14.3 g at 2011-12 and 13.9±15.1 g at 2013-18 (p=0.794). Conclusion: Although the incidence of acetaminophen poisoning did not increase remarkably in the short term after the implementation of the new regulation, the incidence of acetaminophen poisoning has increased slightly during the study period of 2017-18. In addition, the proportion of the purchase path from non-pharmacies has increased since the emergence of new regulations for the easy access of acetaminophen in 2012. The incidence of acetaminophen poisoning might have been affected after the increasing accessibility of acetaminophen in convenience stores. Continuous control of acetaminophen poisoning is required. Furthermore, the prevention of acetaminophen poisoning should be focused on teenagers with specialized school education programs.

• 한국식품영양과학회지
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• 제40권9호
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• pp.1208-1214
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• 2011

주간졸음증은 업무수행 능력을 감소시키고 사고의 위험을 증가시키는 것으로 보고되어 있으며, 특히 교통사고의 주요 원인이 된다. 카페인은 전 세계적으로 가장 널리 이용되는 커피, 녹차, 콜라 등의 음료에 함유되어 있는 물질로써 정신적 스트레스를 완화시키고, 자살충동 및 우울증의 감소 등 특정 효과가 있는 것으로 보고된바 있으며 졸음을 억제하기 위한 수단으로 주로 이용된다. 그러나 산소 소모의 증가, 체내 에너지 손실 및 대사율 증가뿐 아니라 비장의 DNA 합성 감소, 체내 지질 산화 등의 많은 부작용을 가진다. 따라서 본 연구에서는 국화, 민들레, 두릅, 냉이, 석창포, 과라나 등의 자생식물들을 이용하여 행동학적 분석을 통한 각성 효과뿐만 아니라 인체의 생리활성에 안전한 물질을 탐색하고자 하였다. Open field test의 결과, 단회 투여 시 대조군에 비해 카페인 투여군에서 활동적인 행동 양상을 나타내었으며 NP군에서 카페인 투여군과 같은 수준의 활동 정도를 나타내었다. 또한 3주간 NP의 투여는 카페인의 투여에 비해 증가한 활동성의 결과를 보였다. 총콜레스테롤과 중성지방, LDL-콜레스테롤 농도의 경우 각 군 간의 유의적 차이가 나타나지 않았으며 HDL-콜레스테롤 농도의 경우 대조군에 비해 카페인군과 NP군에서 유의적 차이는 없었으나 카페인 투여군에 비해 NP 투여군에서 유의적으로 높은 수준을 보였다. 혈중 지질과산화 농도는 대조군(5.6 mM)에 비해 카페인군(11.7 mM)에서 유의적으로 높은 농도를 나타낸데 반해 NP군(6.4 mM)은 대조군과 같은 수준을 나타내었다. 간세포의 DNA 손상정도에서는 대조군($18.4{\pm}2.1$)에 비해 카페인 투여군($23.8{\pm}3.1$) 에서 유의적으로 손상이 증가한데 반해 NP군($15.9{\pm}1.7$)은 대조군에 비해 유의적 차이를 보이지 않음으로써 NP의 장기 투여는 DNA 손상에 아무런 영향을 주지 않았다. 본 연구의 결과, 국화, 민들레, 두릅, 냉이, 석창포, 과라나 등의 자생식물 혼합추출물이 카페인과 비슷한 각성효과를 보이면서도 장기복용 시 안전한 것으로 나타나 각성효능이 있는 기능성식품으로서의 가능성이 충분하다고 사료된다.