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림프질 전이가 있는 하인두암과 하부식도암의 진단에 활용된 내시경초음파 유도하 Trucut 생검 1예
광명옥,이정환,문정섭,김유선,류수형,총배천,김형훈,김현태 仁濟大學校 白病院 2010 仁濟醫學 Vol.31 No.-
The incidence of double primary cancer is about 10% in all kinds of cancers. Double primary cancer is usually accompanied by gastrointestinal cancer. Esophageal cancer is supposed to be frequently accompanied by squamous cell carcinoma of the head and neck or the upper respiratory tract, because of such common carcinogens as smoking and alcohol ingestion. Esophageal cancer and hypopharyngeal cancer are usually diagnosed by esophagogastric endoscopy with biopsy. We performed endoscopic ultrasound-guided Trucut biopsy(EUS-TCB) to diagnose a mediastinal mass in a 49 year-old patient, who visited our hospital because of voice change. During procedure, we accidently found enlarged celiac lymph node, and obtained tissue from the mediastinal lymph node and the celiac lymph node. We confirmed double primary cancer of squamous cell carcinoma in the esophagus and the hypopharynx via esophagogastric endoscopy.
( Pei Chuan Tsung ),( Soo Hyung Ryu ),( In Hye Cha ),( Hee Won Cho ),( Jin Nam Kim ),( You Sun Kim ),( Jeong Seop Moon ) 대한간학회 2013 Clinical and Molecular Hepatology(대한간학회지) Vol.19 No.2
Background/Aims: Spontaneous bacterial peritonitis (SBP) has been known to greatly influence the survival rate of patients with liver cirrhosis. However, the factors that affect the survival rate in patients with SBP need to be clarified. Methods: This study enrolled 95 liver cirrhosis patients diagnosed with SBP. The laboratory findings of their serum and ascetic fluid were examined and the characteristics of the isolated microorganisms in their peritoneal fluid were analyzed. Results: The proportion of patients with culture-positive SBP was 41.1%, and 47 microorganisms were isolated from the ascetic fluid. The proportions of cultured bacteria that were Gram negative and Gram positive were 57.4% and 40.4%, respectively. The proportions of Escherichia coli, Klebsiella species, and Streptococcus species were 25.5%, 19.1%, and 19.1%, respectively. Enterococcus species represented 12.8% of the microorganisms cultured. The overall survival rates at 6, 12, and 24 months were 44.5%, 37.4%, and 32.2%, respectively. There was no relationship between the bacterial factors and the survival rate in SBP. Multivariate analysis revealed that the presence of hepatocellular carcinoma (HCC; P=0.001), higher serum bilirubin levels (≥3 mg/dL, P=0.002), a prolonged serum prothrombin time (I.e., international normalized ratio>2.3, p<0.001), renal dysfunction (creatinine >1.3 mg/dL, P<0.001), and lower glucose levels in the ascetic fluid (<50 mg/dL, p<0.001) were independent predictive factors of overall survival rate. Conclusions: HCC, higher serum bilirubin levels, a prolonged serum prothrombin time, renal dysfunction, and lower ascetic glucose levels are associated with higher mortality rates in cirrhotic patients with SBP.
A case of giant left atrial myxoma presenting with severe mitral valve obstructive symptoms
Chuan, Tsung-Pei,Sir, Jung-Ju,Park, Il-Kwon,Park, Young-Il,Kim, Hyun-Tae,Park, Kyung-Jun,Min, Seon-Kyung,Kim, Yong-In,Cho, Wook-Hyun,Choi, Suk-Koo 인제대학교 2008 仁濟醫學 Vol.29 No.-
심장 내 점액종은 매우 드문 질환이다. 본 증례는 지속적으로 악화되는 양상의 호흡 곤란을 주소로 내원한 35세 남자에서 심장 초음파 검사 상 좌심방 내 거대 심장내 종괴가 발견되어 입원 후 개흉 수술로 종괴를 제거하였으며 조직 검사상 점액종으로 확진된 증례이다. 심장 초음파 소견 상 종괴는 매우 유동적으로 심실 이완기에 승모판막 입구를 폐쇄하여 유입 혈류를 제한하는 양상이었다. 수술 후 환자는 증상이 호전되어 퇴원하였다.
( Pei Chuan Tsung ),( Jong Hyeok Park ),( You Sun Kim ),( Sun Young Kim ),( Won Wo Park ),( Hyun Tae Kim ),( Jin Nam Kim ),( Yun Kyung Kang ),( Jeong Seop Moon ) 대한간학회 2013 Gut and Liver Vol.7 No.2
Background/Aims: Mini-probe endoscopic ultrasonography (mEUS) is a useful diagnostic tool for accurate assessment of tumor invasion. The aim of this study was to estimate the accuracy of mEUS in patients with early colorectal cancer (ECC). Methods: Ninety lesions of ECC underwent mEUS for pre-treatment staging. We divided the lesions into either the mucosal group or the submucosal group according to the mEUS findings. The histological results of the specimens were compared with the mEUS findings. Results: The overall accuracy for assessing the depth of tumor invasion (T stage) was 84.4% (76/90). The accuracy of mEUS was significantly lower for submucosal lesions compared to mucosal lesions (p=0.003) and it was lower for large tumors (≥2 cm) (p=0.034). The odds ratios of large tumors and submucosal tumors affecting the accuracy of T staging were 3.46 (95% confidence interval [CI], 1.05 to 11.39) and 6.25 (95% CI, 1.85 to 25.14), respectively. When submucosal tumors were combined with large size, the odds ratio was 14.67 (95% CI, 1.46 to 146.96). Conclusions: The overall accuracy of T stage determination with mEUS was considerably high in patients with ECC; however, the accuracy decreased when tumor size was >2 cm or the tumor had invaded the submucosal layer. (Gut Liver 2013;7:163-168)
Cell Surface Sialylation Mediates the Binding of Enterovirus 71 to Host Cells
Pei-Yi Su,Yueh-Tung Liu,Chuan-Fa Chang 한국당과학회 2012 한국당과학회 학술대회 Vol.2012 No.1
Enterovirus 71 (EV71) is a major causative agent of hand-foot-and-mouth disease (HFMD). The clinical severity of EV71central nerve system (CNS) infection is mostly in children less than 5 years-old. Recently, the twoglycosylated membrane proteins SCARB2 and PSGL-1 have been identifiedas the cellular and functional receptors of EV71.But the role of glycosylation in EV71 infection remainsunclear. In this study, we demonstrated thatthe attachment of EV71 to two susceptible cell lines werediminished after the removal of cell surface sialic acids. Pre-incubatecells with sialic acid specific lectins, MAA and SNA,reducedthe binding of EV71. Additionally, we found that SCARB2 was a sialylated glycoprotein,andthe interaction of SCARB2and EV71was decreased after desialylation. Based on these results, we concluded that the attachment of EV71 to cell surface was assisted bysialic acids.Cell surface sialylation should be a key regulator that facilitates the binding and infection of EV71.
Pei-Chun Chao,Chuan-Chia Chang,Hsin-An Chang 대한신경정신의학회 2018 PSYCHIATRY INVESTIGATION Vol.15 No.9
Transcranial direct current stimulation (tDCS), a non-invasive neuromodulation technique, has been increasingly used to treat bipolar depression. Researchers recently noticed the risk of tDCS-emergent mania/hypomania in depressed patients and started to evaluate this risk by launching a meta-analysis. Here we present a female with bipolar II depression who rapidly developed hypomanic switching during bifrontal tDCS.
Yi-Chuan Hsieh,Su-Fen Cheng,Pei-Kwei Tsay,Wen-Jen Su,Yen-Hua Cho,Chi-Wen Chen 한국간호과학회 2017 Asian Nursing Research Vol.11 No.4
Purpose: This study aimed to evaluate the effects of cognitive-behavioral program on pain and medical fear in hospitalized school-aged children receiving intravenous (IV) placement. Methods: This study used an quasi-experimental design. Thirty-five participants were assigned to the experimental group and 33 to the control group in the acute internal medicine ward of a children's hospital. The cognitive-behavioral program entailed having the patients read an educational photo book about IV placement before the procedure and having them watch their favorite music video during the procedure. The outcome measures were numeric rating scales for pain intensity and fear during the procedure. Results: After applying the cognitive-behavioral program, the mean scores on pain and fear decreased in the experimental group. However, the difference in pain intensity between these two groups was nonsignificant. The intensity of fear in the experimental group was significantly lower than that in the control group. Conclusion: In this study, the cognitive-behavioral program used with school-aged hospitalized children promoted less fear during IV placement. The results of this study can serve as a reference for empirical nursing care and as care guidance for clinical IV injections involving children.
Investors’ Herd Behavior: Rational or Irrational?
Shih-Chuan Tsai,William T. Lin,Pei-Yau Lung 한국증권학회 2013 Asia-Pacific Journal of Financial Studies Vol.42 No.5
This study examines the relationships between the herding of various investor groups and trading noise in the Taiwan stock market to determine whether any of the investor groups tend to herd rationally. The study uses a unique and comprehensive data set on intraday transactions and limit order books of the Taiwan Stock Exchange (TWSE). We calculate the high-frequency herding measures and trading noise in a call auction market. We find that institutional investors are likely to be informed traders and herd rationally based on superior information. Institutional investors’ herding has a negative impact on trading noise. Their buy (sell) herding predicts positive (negative) future market returns. By contrast, the herding of individual investors tends to contain limited information, as it increases trading noise; the buy (sell) herding of individuals is negatively correlated with future market returns. These findings are more significant for stocks with higher turnover.
Pathogenesis and treatment of non-alcoholic steatohepatitis and its fibrosis
Kuei-Chuan Lee,Pei-Shan Wu,Han-Chieh Lin 대한간학회 2023 Clinical and Molecular Hepatology(대한간학회지) Vol.29 No.1
The initial presentation of non-alcoholic steatohepatitis (NASH) is hepatic steatosis. The dysfunction of lipid metabolism within hepatocytes caused by genetic factors, diet, and insulin resistance causes lipid accumulation. Lipotoxicity, oxidative stress, mitochondrial dysfunction, and endoplasmic reticulum stress would further contribute to hepatocyte injury and death, leading to inflammation and immune dysfunction in the liver. During the healing process, the accumulation of an excessive amount of fibrosis might occur while healing. During the development of NASH and liver fibrosis, the gut-liver axis, adipose-liver axis, and renin-angiotensin system (RAS) may be dysregulated and impaired. Translocation of bacteria or its end-products entering the liver could activate hepatocytes, Kupffer cells, and hepatic stellate cells, exacerbating hepatic steatosis, inflammation, and fibrosis. Bile acids regulate glucose and lipid metabolism through Farnesoid X receptors in the liver and intestine. Increased adipose tissue-derived non-esterified fatty acids would aggravate hepatic steatosis. Increased leptin also plays a role in hepatic fibrogenesis, and decreased adiponectin may contribute to hepatic insulin resistance. Moreover, dysregulation of peroxisome proliferator-activated receptors in the liver, adipose, and muscle tissues may impair lipid metabolism. In addition, the RAS may contribute to hepatic fatty acid metabolism, inflammation, and fibrosis. The treatment includes lifestyle modification, pharmacological therapy, and non-pharmacological therapy. Currently, weight reduction by lifestyle modification or surgery is the most effective therapy. However, vitamin E, pioglitazone, and obeticholic acid have also been suggested. In this review, we will introduce some new clinical trials and experimental therapies for the treatment of NASH and related fibrosis.