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Best Palliative Management for the Patient with Unresectable Recurrent Biliary Cancer
Seungmin Bang 한국간담췌외과학회 2014 한국간담췌외과학회 학술대회지 Vol.2014 No.4
Cholangiocarcinoma can be divided into intrahepatic, hilar and extrahepatic cholangiocarcinoma according to the site of primary tumor. Although clinical manifestations can be different according the primary site of tumor, surgery can be the sole therapy to make the patient be free from the disease. However, only 10% of all patients can be the optimal candidates for curative surgery at the initial diagnosis. And the 5-year survival of the patient who received curative surgery is less than 40% at best. This dismal prognosis of cholangiocarcinoma suggests the palliative treatment has a more important role in real management of the patients. Especially, obstructive jaundice and its related symptoms including cholangitis and biliary pain are the most frequent condition of unresectable and/or recurred cholangiocarcinoma. Endoscopic management had been positioned as the standard palliation for such condition. In the review, we will discuss the recent advances in endoscopic palliation for obstructive jaundice with introduction of EUS guided biliary drainage.
방승민 ( Seungmin Bang ) 대한췌담도학회 2016 대한췌담도학회지 Vol.21 No.4
췌장암은 비약적인 현대 의학의 발전에도 불구하고 5년 생존율이 여전히 5% 미만인 인류 최악의 악성 종양이다. 특히효과적인 조기 진단검사와 백신을 이용한 일차 예방을 통해위암, 대장암 및 간암의 생존율이 눈부시게 향상되고 있음에 비해 췌장암은 여전히 조기 진단을 위한 생물학적 표지자나 영상학적 검사가 없는 실정이다. 이러한 임상적 한계는 췌장암의 80% 이상이 근치적 절제수술이 어려운 진행성 상태로 진단되어 그 예후를 더욱 불량하게 만들고 있다. 또한 췌장암은 발생 초기부터 전신 질환으로의 특성을 보이는 것으로 간주되고 있다. 이는 근치적 수술이 가능한 췌장암의 경우 수술후 간을 포함한 전이가 매우 빈번하다는 점과 췌장암 발생 초기에 이미 전신 전이가 진행된다는 실험적 연구 결과들을 통해 추정 가능하다. 즉, 대부분의 췌장암 환자는 전신 항암 치료가 필요함에도 불구하고 1990년대부터 표준적 전신 항암치료제로 사용되고 있는 gemcitabine이 여전히 표준 치료제라는 사실은 췌장암의 치료가 얼마나 어려운지를 시사하는 바가 크다 하겠다. 최근 FOLFIRINOX 및 albumin bounded paclitaxel/gemcitabine 병용요법이 전신상태가 상대적으로 양호한 진행성 췌장암 환자에서 괄목할 만한 효과를 보이고있어, 진행성 췌장암의 치료에 새로운 희망을 불러오고 있다. 이와 더불어 immune check point inhibitor, CAR-T cell 등을 기반으로 하는 면역 치료, 암세포 특이 표적을 이용한 새로운 표적 치료제 및 췌장암 조직의 특징을 이용한 새로운 치료법들이 시도되고 있다. 이에 본고에서는 최근 진행성 췌장암의 항암 치료의 연구 동향에 대해 알아보고자 한다. Pancreatic cancer is still one of the most devastating cancers with less than 5% of 5-year survival even though the advances in modern medicine. Considering effective screening strategies and vaccinations has been improving clinical outcomes in other gastrointestinal malignancies, there is not yet effective tools for pancreatic cancer in earlier stage. Thus, about 80% of patients of pancreatic cancer are diagnosed as unsuitable for curative resection. Furthermore, recent experimental data suggest metastasis of pancreatic cancer can be developed in remarkably earlier stage during carcinogenesis. Based on these findings, systemic chemotherapy is the main therapeutic option for treating pancreatic cancer. However, the outcome of systemic chemotherapy is still disappointing even though recent data with FOLFIRINOX and nab-paclitaxel showed relatively promising. With advances in molecular technologies including next generation sequencing, the therapeutic paradigm for handling malignancies has been rapidly changing. The new wave of tailored or precision medicine leads to develop several novel therapeutic options like immune check point inhibitor or novel adoptive cell therapy. Herein, we will discuss the current status and perspectives of targeted therapy for pancreatic cancer.
친환경 고전압 전력기기 개발을 위한 GN₂의 절연특성 분석
방승민(Seungmin Bang),이온유(Onyou Lee),김준일(Junil Kim),강종오(Jong O Kang),이홍석(Hongseok Lee),고태국(Taekuk Ko),강형구(Hyoungku Kang) 대한전기학회 2014 전기학회논문지 P Vol.63 No.4
The environmental pollution caused by green-house gases such as GN₂ has been becoming the main issue of industrial society. As a part of these efforts, 180 countries signed the Kyoto Protocol in 1997 to cut back on their green-house gas emissions [1]. Therefore, a study on the dielectric characteristics of the GN₂ is important for designing a eco-friendly high voltage apparatuses. In this paper, to develop an electrically reliable, stable, and eco-friendly high voltage apparatus, the breakdown voltage and partial discharge inception voltage characteristics in GN₂ considering utilization factors are studied for the establishment of insulation design criteria of an high voltage apparatus. Dielectric experiments are performed by using several kinds of sphere-plane electrode systems made of stainless steel. Also, the dielectric characteristics of the GN₂ are analyzed by using a Finite Elements Method ( FEM ) according to various field utilization factors. The results are expected to be applicable to designing the high voltage apparatuses using GN₂ as an insulation gas.