• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.26 no.4
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• pp.363-374
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• 2022

Backgrounds/Aims: To analyze the results of the neoadjuvant treatment of patients in our center with early pancreatic cancer. Methods: Eighty-four patients with early pancreatic cancer (I-II) were included, of which 59 were considered "bioborderline" (carbohydrate antigen [CA] 19-9 > 37 U/L), and 25 were considered "non-bioborderline" (CA19-9 < 37 U/L). The R0 resection rate, presence of negative nodes, survival, and recurrence rates were analyzed in two groups, the NEO group (neoadjuvant + surgery) and the nonNEO group (upfront surgery). Results: A 28.6% pathologic complete response was observed in the NEO group of the whole sample. The residual R0 was 85.7%, and nodes were negative in 78.6% of the patients in the NEO group of bioborderline patients. All non-bioborderline patients treated with neoadjuvant were R0, and no affected nodes were observed in any of them. The median overall survival (OS) in patients with elevated CA19-9 levels in the NEO group was 31.4 months vs. 13.1 months in the non-NEO (log-rank test p = 0.006), with a 62% relative reduction in the mortality rate (hazard ratio = 0.38, 95% confidence interval: 0.20-0.79; p= 0.008). The median OS in patients with normal CA19-9 levels in the NEO group was 65.9 months vs. 16.2 months in the non-NEO group, without statistically significant differences between the two but with a trend toward significance (log-rank test p = 0.08). Conclusions: A neoadjuvant strategy seemed to improve local control and the survival of patients with early pancreatic cancer, both those with elevated CA19-9 and normal marker levels.

• Strategy21
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• s.32
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• pp.36-70
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• 2013

Waegu(倭寇)'s invasion in the Late Goryeo(高麗) Dynasty was huge damage for Goryeo's local society. And It was shock that Goryeo government's basic foundation of rules. Invasion background of waegu for Kyeong-in-yeon(庚寅年, 1350) was Kyushyu(九州)'s political divide because of Nihon(日本) government's confusion. Waegu was huge damage for Goryeo's Jo-wun(漕運, the shipping system of grain paid as a tax) system. So, government started military response, but it was turn out a failure and had great damage. When execution of military operations failed, Goryeo government sent diplomatic delegation to request the prevent of waegu, but the invasion continued. Since waegu invasion, Goryeo was got nowhere with defence of waegu. So, some people demanded for a new understanding of the ocean defence in the government. Lee-Saek(李穡), Woo-Hyeonbo(禹玄寶), Lee-Hee(李禧) and Jung-Ji(鄭地) were representatives of a new understanding of the ocean defence. Their demands were received attention when all operations had been failed. Therefore, Goryeo government began to reorganization of the naval forces and set up a special committee of gunpowder manufacturing named Hwa-tong-do-gam(火筒都監). This administrative reform was achieved substantial results since then. In 1380, the naval battle at Jin-po(鎭浦) was a big event that first gunpowder attack the waegu. Since Jin-po, Goryeo's naval forces gain confidence. In 1389, Dae-ma-do(對馬島) was attacked by Park-Wi(朴葳). It was meant that Goryeo's naval forces had huge offense power. Goryeo's defence system was focused on a northern race before 14th century waegu's invasion. So they were neglected their ocean defence. But after military operation of waegu's invasion was failure, they focused on the ocean defence. A new understanding of the ocean defence was foundation of that. It means to us to a new understanding of the ocean defence. Now, East Asia has maritime disputes. And we have high exposure to potential threats. So, we have a new understanding of importance of the ocean defence. And we fight for 21th century's ocean threats as foundation of sense of national security.

• The Korean Journal of Pain
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• v.36 no.1
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• pp.113-127
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• 2023

Background: Resting-state functional connectivity (rs-FC) may aid in understanding the link between painmodulating brain regions and the descending pain modulatory system (DPMS) in fibromyalgia (FM). This study investigated whether the differences in rs-FC of the primary somatosensory cortex in responders and non-responders to the conditioned pain modulation test (CPM-test) are related to pain, sleep quality, central sensitization, and the impact of FM on quality of life. Methods: This cross-sectional study included 33 females with FM. rs-FC was assessed by functional magnetic resonance imaging. Change in the numerical pain scale during the CPM-test assessed the DPMS function. Subjects were classified either as non-responders (i.e., DPMS dysfunction, n = 13) or responders (n = 20) to CPM-test. A generalized linear model (GLM) and a receiver operating characteristic (ROC) curve analysis were performed to check the accuracy of the rs-FC to differentiate each group. Results: Non-responders showed a decreased rs-FC between the left somatosensory cortex (S1) and the periaqueductal gray (PAG) (P < 0.001). The GLM analysis revealed that the S1-PAG rs-FC in the left-brain hemisphere was positively correlated with a central sensitization symptom and negatively correlated with sleep quality and pain scores. ROC curve analysis showed that left S1-PAG rs-FC offers a sensitivity and specificity of 85% or higher (area under the curve, 0.78, 95% confidence interval, 0.63-0.94) to discriminate who does/does not respond to the CPM-test. Conclusions: These results support using the rs-FC patterns in the left S1-PAG as a marker for predicting CPM-test response, which may aid in treatment individualization in FM patients.

• Fire Science and Engineering
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• v.32 no.2
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• pp.57-66
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• 2018

The most urgent requirement in the event of disaster and fire in a skyscraper is to establish a system that enables people inside to evacuate safely. Hence, a practical direction needs to give evacuees confidence in the evacuation by reducing the psychological anxiety caused by the relatively large number of people inside and at the same time, the physically prolonged evacuation travel line. Evacuation tests with large numbers of people were conducted three times to solve these challenges and identify phenomena and issues that occurred during the experiment. The results revealed the factors that could cause a delay in evacuation and suggested improvements. The study results of this paper are as follows. First, a recent fire at a multipurpose high-rise resulted in a number of casualties due to a lack of experience with the disaster prevention system. To prevent such cases from occurring in advance, adaptability was achieved by conducting evacuation tests. Second, the data collected in the evacuation simulation statistics and the actual escape drills were compared and analyzed. Third, in the evacuation experiment, a large number of people could not participate in the experiment. The reasons for not participating were analyzed and their impact on the actual evacuation time was confirmed. Fourth, equipment aids were purchased to establish the optimal response measure to the causes of a delay in escape time and the standards for ensuring the safety of the evacuee were specified by developing improvements to minimize the evacuation delay time through comparative before and after analysis of the experiment. These results can be used for fire safety control of skyscrapers to improve the efficiency of evacuation.

• Journal of the Earthquake Engineering Society of Korea
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• v.6 no.4
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• pp.65-73
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• 2002

It has been recognized that the damage control must become a more explicit design consideration. In an effort to develop design methods based on performance it is clear that the evaluation of the nonlinear response is required. The methods available to the design engineer today are nonlinear time history analyses, monotonic static nonlinear analyses, or equivalent static analyses with simulated nonlinear influences. Some building codes propose the capacity spectrum method based on the nonlinear static analysis(pushover analysis) to determine the earthquake-induced demand given by the structure pushover curve. These procedures are conceptually simple but iterative and time consuming with some errors. This paper presents a nonlinear direct spectrum method(NDSM) to evaluate seismic performance of structures, without iterative computations, given by the structural initial elastic period and yield strength from the pushover analysis, especially for MDF(multi degree of freedom) systems. The purpose of this paper is to investigate the accuracy and confidence of this method from a point of view of various earthquakes and unloading stiffness degradation parameters. The conclusions of this study are as follows; 1) NDSM is considered as practical method because the peak deformations of nonlinear system of MDF by NDSM are almost equal to the results of nonlinear time history analysis(NTHA) for various ground motions. 2) When the results of NDSM are compared with those of NTHA. mean of errors is the smallest in case of post-yielding stiffness factor 0.1, static force by MAD(modal adaptive distribution) and unloading stiffness degradation factor 0.2~0.3.

• Tuberculosis and Respiratory Diseases
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• v.75 no.2
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• pp.59-66
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• 2013

Background: This study was conducted in order to elucidate the effects of docetaxel on the growth of peroxiredoxin 1 (Prx1) knockdown A549 xenograft tumors and further tested the role of Prx1 as a predictor for how a patient would respond to docetaxel treatment. Methods: Effects of docetaxel on the growth of scrambled- and shPrx1-infected A549 xenograft tumors in nude mice were measured. Moreover, immunohistochemical expression of Prx1 was evaluated in paraffin-embedded tissues from 24 non-small cell lung cancer patients who had received docetaxel-cisplatin regimens as a first-line treatment. Results: Docetaxel treatment in Prx1 knockdown xenograft tumor resulted in reduced tumors growth compared with other groups. Prx1 knockdown increased the production of cleaved caspases-8 and -9 in the control itself compared to scramble tumors. Moreover, docetaxel treatment in Prx1 knockdown tissue led to an increased protein band. Phosphorylated Akt was found in Prx1 scramble tissues. Phosphorylated FOXO1 was detected in the docetaxel treatment group. On the other hand, Prx1 knockdown completely suppressed the Akt-FOXO1 axis. The median progression-free survival (PFS) of patients with low Prx1 expression was 7 months (95% confidence interval [CI], 6.0-7.7), whereas the median progression-free survival of patients with high Prx1 expression was 4 months (95% CI, 4.0-5.0). However, high Prx1 expression was not associated with decreased PFS (p=0.114). Conclusion: Our findings suggest that elevated Prx1 provides resistance to docetaxel treatment through suppression of FOXO1-induced apoptosis in A549 xenograft tumors, but may not be related with the predictive significance for response to docetaxel treatment.

• Gut and Liver
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• v.12 no.6
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• pp.728-735
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• 2018

Background/Aims: The combination of nab-paclitaxel and gemcitabine (nab-P/Gem) is widely used for treating metastatic pancreatic cancer (MPC). We aimed to evaluate the therapeutic outcomes and prognostic role of treatment-related peripheral neuropathy in patients with MPC treated with nab-P/Gem in clinical practice. Methods: MPC patients treated with nab-P/Gem as the first-line chemotherapy were included. All 88 Korean patients underwent at least two cycles of nab-P/Gem combination chemotherapy (125 and $1,000mg/m^2$, respectively). Treatment-related adverse events were monitored through periodic follow-ups. Overall survival and progression-free survival were estimated by the Kaplan-Meier method, and the Cox proportional hazards regression linear model was applied to assess prognostic factors. To evaluate the prognostic value of treatment-related peripheral neuropathy, the landmark point analysis was used. Results: Patients underwent a mean of $6.7{\pm}4.2$ cycles during $6.3{\pm}4.4$ months. The median overall survival and progression-free survival rates were 14.2 months (95% confidence interval [CI], 11.8 to 20.3 months) and 8.4 months (95% CI, 7.1 to 13.2 months), respectively. The disease control rate was 84.1%; a partial response and stable disease were achieved in 30 (34.1%) and 44 (50.0%) patients, respectively. Treatment-related peripheral neuropathy developed in 52 patients (59.1%), and 13 (14.8%) and 16 (18.2%) patients experienced grades 2 and 3 neuropathy, respectively. In the landmark model, at 6 months, treatment-related peripheral neuropathy did not have a significant correlation with survival (p=0.089). Conclusions: Nab-P/Gem is a reasonable choice for treating MPC, as it shows a considerable disease control rate while the treatment-related peripheral neuropathy was tolerable. The prognostic role of treatment-related neuropathy was limited.

• Asian-Australasian Journal of Animal Sciences
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• v.19 no.8
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• pp.1197-1205
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• 2006

This experiment was conducted to compare the effects of feeding DL-2-hydroxy-4-(methylthio)butanoic acid (HMTBA) and DL-methionine (DLM) supplemented corn-soybean-cottonseed meal diets on growth performance, carcass composition, and muscle color of broilers. The trial was designed as a $2{\times}3{\times}2$ factorial experiment, including two methionine (Met) sources (HMTBA and DLM), three equimolar graded levels of Met supplementation (i.e., 0.08, 0.16, and 0.24% in the starter diet and 0.07, 0.14, and 0.21% in the grower and finisher diets, respectively), and two sexes (male and female). Additionally, one basal diet for each sex was formulated to be limiting in Met to test the dosage response of increasing supplemental Met levels. Four hundred and twenty 10-d-old broilers were randomly allotted to 14 treatments (seven each for males and females), with five replicate pens per treatment and six chicks per pen. There was no difference (p>0.05) between the two Met sources in growth performance and muscle deposition of broilers throughout the whole experimental period (d 10 to 49). With the increasing Met supplementation levels, average daily gain was increased (quadratic; p<0.01) during the starter, grower, and overall phases, average daily feed intake was increased (quadratic; p<0.01) during the starter phase, and feed:gain ratio was decreased (quadratic; p<0.05) during the grower and overall phases. At the end of finisher phase, Met supplementation increased breast muscle content (quadratic; p<0.01) and thigh muscle content (linear; p<0.05), and decreased abdominal fat content (quadratic; p<0.02). Compared to the broiler fed DLM, broilers fed HMTBA had superior breast and thigh muscle coloration (p<0.01). Male broilers had higher weight gain and feed intake and better feed conversion than female broilers (p<0.01). The fat content of thigh muscle in female broilers was higher than that of male broilers (p<0.03). The best fit comparison of HMTBA vs. DLM was determined by Schwarz Bayesian Criteria index, which indicated that the average relative bioefficacy of HMTBA vs. DLM was 120% with 95% confidence limit 67 to 172%. These results indicated that Met supplementation improved growth performance and carcass quality of broilers fed corn-soybean-cottonseed meal diets irrespective of Met sources. Compared to DLM, HMTBA has the same molar bioefficacy on improving the growth performance and carcass quality of broilers; however, HMTBA fed birds had superior meat color to DLM fed birds.

• Journal of The Korean Society of Clinical Toxicology
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• v.19 no.2
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• pp.72-82
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• 2021

Purpose: A high anion gap (AG) is known to be a significant risk factor for serious acid-base imbalances and death in acute poisoning cases. The strong ion difference (SID), or strong ion gap (SIG), has recently been used to predict in-hospital mortality or acute kidney injury (AKI) in patients with systemic inflammatory response syndrome. This study presents a comprehensive acid-base analysis in order to identify the predictive value of the SIG for disease severity in severe poisoning. Methods: A cross-sectional observational study was conducted on acute poisoning patients treated in the emergency intensive care unit (ICU) between December 2015 and November 2020. Initial serum electrolytes, base deficit (BD), AG, SIG, and laboratory parameters were concurrently measured upon hospital arrival and were subsequently used along with Stewart's approach to acid-base analysis to predict AKI development and in-hospital death. The area under the receiver operating characteristic curve (AUC) and logistic regression analysis were used as statistical tests. Results: Overall, 343 patients who were treated in the intensive care unit were enrolled. The initial levels of lactate, AG, and BD were significantly higher in the AKI group (n=62). Both effective SID [SIDe] (20.3 vs. 26.4 mEq/L, p<0.001) and SIG (20.2 vs. 16.5 mEq/L, p<0.001) were significantly higher in the AKI group; however, the AUC of serum SIDe was 0.842 (95% confidence interval [CI]=0.799-0.879). Serum SIDe had a higher predictive capacity for AKI than initial creatinine (AUC=0.796, 95% CI=0.749-0.837), BD (AUC=0.761, 95% CI=0.712-0.805), and AG (AUC=0.660, 95% CI=0.607-0.711). Multivariate logistic regression analyses revealed that diabetes, lactic acidosis, high SIG, and low SIDe were significant risk factors for in-hospital mortality. Conclusion: Initial SIDe and SIG were identified as useful predictors of AKI and in-hospital mortality in intoxicated patients who were critically ill. Further research is necessary to evaluate the physiological nature of the toxicant or unmeasured anions in such patients.

• Strategy21
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• s.30
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• pp.143-176
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• 2012

We are witnessing the growing maritime tension on the East Asian sea these days. Each naval powers in the region are competing each other to acquire more advanced naval capabilities. Based upon the rapid economic development, China is actively beefing up its naval capabilities and expand its boundary of naval activities all over the East Asian region. Chinese Navy already unveiled its expansive naval strategy replacing the traditional concept of 'Near-Sea Defense' with the new concept of 'Far-Sea Defense' strategy. In response to potential rival's naval build up, the U.S. is redeploying its naval forces focusing on the Asia-Pacific region. The U.S. enhances its joint naval exercises with the countries in the region, such as Japan, India, Australia and so on. In addition, Washington is devising new naval strategy under the concept of 'Air-Sea Battle' to deter Peking's so-called 'Anti-Access/ Area Denial(A2AD)' strategy. As a close ally of the U.S., Japan also disclosed its clear intention to strengthen the Maritime Self Defense Force(MSDF)'s capabilities by introducing the new concept of 'Dynamic Defense Force' in 2011. Under the new concept, JMSDF is pursuing the additional acquisition of submarines, quasi-aircraft carriers, Aegis-equipped destroyers, etc. Under the new president's strong leadership, Russia is also invigorating the naval build-up. Especially, Russia is fortifying the Pacific Fleet's naval assets by deploying new-type of naval ships such as the Mistral which was imported from France. In the midst of competitive naval build-up among the major naval powers in the region, we are observing the growing maritime conflicts on the East China Sea as well as South China Sea. Those naval conflicts can pose severe threats to our national interests. Maritime conflicts on the East or South China Sea can imperil our sea lanes which will be indispensible for national economic development. Neighboring countries' maritime conflicts also will cast an uncertainty on the path to mobilize international cooperation to resolve the North Korean issues. We should contribute to ease the maritime tension in the region by various ways. First, we should actively galvanize the bilateral maritime dialogue among the major naval powers in the region. Second, we also should take the lead to form a multilateral maritime cooperation mechanism in the region. Above all, we should set the aim to be a peaceful maritime power who can contribute to a building of stable maritime order in the region with a considerable naval power.