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( Sang Hoon Lee ),( Sang Hun Lee ),( Seung Up Kim ),( Beom Kyung Kim ),( Jun Yong Park ),( Do Young Kim ),( Sang Hoon Ahn ),( Kwang Hyub Han ) 대한간학회 2013 춘·추계 학술대회 (KASL) Vol.2013 No.1
Background/ Aims: Liver stiffness (LS) values measured using transient elastography (TE) can accurately assess the degree of liver fibrosis. The degree of liver fibrosis is significantly associated with the risk of hepatocellular carcinoma (HCC) development. Thus, this study investigated whether LS values at radiofrequency ablation (RFA) can predict HCC recurrence after RFA. Methods: Between May 2005 and April 2011, a total of 56 patients with HCC who underwent RFA and LS value measurement at the same day were analyzed in this retrospective study. All were followed up for monitoring the development of HCC recurrence until March 2013. Results: The mean age of the patients (40 men, 16 women) was 62.1 years, and the median LS value was 23.0 kPa. During the follow-up period (median 27.9 [range, 1.1-77.3] months), 33 (58.9%) patients experienced HCC recurrence and 18 (32.1%) were dead. Median time to recurrence was 17.1 (range, 2.5-67.8) months and median time to mortality was 27.9 (range, 1.1-77.3) months. Patients with recurrence showed significantly higher prevalence of liver cirrhosis, spleen size, multiple tumors, and LS values, whereas they had significantly lower platelet count than patients without recurrence (all P<0.05). On multivariate analysis, together with previous anti- HCC treatment history, patients with a higher LS value >13.0 kPa were at a significant greater risk for HCC recurrence after RFA with a hazard ratio of 6.981 (P<0.05; 95% confidence interval, 1.650-28.782) compared with those with LS value ≤13.0 kPa. However, LS values were not predictive for overall survival (P=0.237). Conclusions: Our data suggest that LS values measured using TE can be a useful predictor of HCC recurrence after RFA. Further studies with large sample size are warranted for the validation of our results.
(Sang Ah Chang),(Bong Yun Cha),(Soon Jib Yoo),(Yo Bae Ahn),(Ki Ho Song),(Je Ho Han),(Jong Min Lee),(Hyun Sik Son),(Kun Ho Yoon),(Moo Il Kang),(Kwang Woo Lee),(Ho Young Son),(Sung Ku Kang) 대한내과학회 2001 The Korean Journal of Internal Medicine Vol.16 No.2
N/A Background : It has been reported that many peripheral vasodilating drugs might improve insulin resistance. Cilostazol, a antithrombotic agent, increases peripheral blood flow in non-insulin dependent diabetic patients. The effect of cilostazol treatment on insulin resistance in streptozotocin (STZ)-induced non-insulin dependent diabetic Wistar rats was examined. Methods : About a half of two-day old neonate siblings were injected intraperitoneally with STZ and maintained for six months, at which time they were compared with age-matched control rats for intraperitoneal glucose tolerance test (IPGTT) and for glucose infusion rate (GINF) in a euglycemic hyperinsulinemic glucose-clamp study. After that, these studies were also performed after feeding rat chow containing cilostazol (100 mg/kg/day) to rats with STZ-induced non-insulin dependent diabetes mellitus for four-weeks and compared with those of age-matched control rats. Results : In the intraperitoneal glucose tolerance test studies, plasma glucose levels of STZ-induced non-insulin dependent diabetic rats were significantly higher and plasma insulin levels significantly lower than those of age-matched control rats in the age of six months. Glucose infusion rate was lower in STZ-induced non-insulin dependent diabetic rats than those of age-matched control rats. However, after a four-week cilostazol treatment, glucose infusion rate of STZ-induced non-insulin dependent diabetic rats was not significantly different from that of control rats. Conclusion : These findings suggested that cilostazol may improve insulin resistance in STZ-induced non-insulin dependent diabetic rats.
Kwang Won Seo,Gyu Rak Chon,Jong Joon Ahn,Yangjin Jega,Sang Bum Hong,Chae Man Lim,Younsuck Koh Korean Society of Critical Care Medicine 2006 Acute and Critical Care Vol.21 No.1
BACKGROUND: To evaluate effects of 5 expiratory sensitivity (ESENS) levels (5%; 15%; 25%; 35%; 45%) on lung mechanics and the effects depending on the two P(0.1) levels ( or =3 cm H2O). METHODS: Prospective, randomized, physiologic study for intubated adult patients during weaning from mechanical ventilation. Patients were randomly submitted to the 5 settings of ESENS in the Galileo ventilator (Galileo Gold, Hamilton Medical AG, Switzerland). Physiologic variables were continuously measured using a Bicore CP-100 pulmonary mechanics monitor (CP-100, Bicore, USA). RESULTS: Thirteen patients, ten men and three women, with a mean age of 65.2+/-16.1 yr were studied. Tidal volume (V(T)) decreased significantly from ESENS 5% to 45%. With increasing levels of ESENS, respiratory rates (RR) steadily increased from ESENS 5% to 35% and 45%. Shallow breath index (F/V(T)) increased significantly from ESENS 5% to 45%. Inspiratory time (T(I)) decreased gradually significantly from ESENS 5% to 45%. RR and F/V(T) increased from ESENS 5% to 15% and 45% and V(T) decreased gradually in patients with P(0.1) or =3 cm H2O. CONCLUSIONS: The proper adjustment of expiratory sensitivity (ESENS) levels improved patient-ventilator synchrony and decreased respiratory rates and shallow breath index, especially in P(0.1)
Ahn, Suk-Won,Kim, Su-Hyun,Oh, Dong-Hoon,Kim, Sung-Min,Park, Kyung Seok,Hong, Yoon-Ho,Kwon, Oh-Sang,Sung, Jung-Joon,Lee, Kwang-Woo The Korean Academy of Medical Sciences 2010 JOURNAL OF KOREAN MEDICAL SCIENCE Vol.25 No.9
<P>We investigated the availability of motor unit number estimation (MUNE) as a quantitative method to assess the severity and clinical progression of amyotrophic lateral sclerosis (ALS). The 143 ALS patients were evaluated by statistical MUNE and the revised amyotrophic lateral sclerosis functional rating scale (ALSFRS-R). By using mean values of MUNE according to disease duration, regression equation between mean MUNE and disease duration was presented as a formula. The individual MUNE ratio was calculated by dividing individual MUNE value by mean MUNE value. All patients were classified into 2 groups (MUNE ratio <1 vs. MUNE ratio ≥1) according to the MUNE ratio. Comparison between the 2 groups revealed that the patients in MUNE ratio <1 group or MUNE ratio ≥1 group were respectively assigned to rapid progression or slow progression. We recommended informative mean values of MUNE and best regression equation in ALS patients according to disease duration. These values allow us to evaluate the severity and rapidity of progression in ALS.</P>
Sung-Chan Gwark,Shin Hwang,Ki-Hun Kim,Yong-Joo Lee,Kwang-Min Park,Chul-Soo Ahn,Deok-Bog Moon,Tae-Yong Ha,Gi-Won Song,Dong-Hwan Jung,Gil-Chun Park,Sung-Gyu Lee 한국간담췌외과학회 2012 한국간담췌외과학회지 Vol.16 No.4
Backgrounds/Aims: Gallbladder carcinoma (GBCa) T2 lesions are considered to be advanced tumors showing diverse features in tumor extent. When this T2 lesion does not involve the cystic duct and there is no evidence of lymph node metastasis, we have to consider what is the most reasonable extent of resection - that is, whether to perform concurrent extra-hepatic bile duct resection (EHBD) resection or not. This study intends to evaluate the adequacy of EHBD resection in patients undergoing resection for T2N0 GBCa. Methods: From our institutional database of GBCa, 48 cases of T2N0 GBCa who underwent R0 resection during November 1995 and August 2008 were selected. Patients who underwent prior laparoscopic cholecystectomy were excluded. Their medical records were reviewed retrospectively. Results: Their mean age was 63.2±83.3 years and females were 25. The mean serum CA19-9 level was 37.3±89.3 ng/ml. The extents of liver resection were wedge resection (n=36) and segment 4a+5 resection (n=12). Concurrent EHBD resection was performed in 16 (33.3%) patients. No fatal surgical complication occurred. The majority of tumor pathology was adenocarcinoma (n=42), with additional unusual types as papillary (n=3), saromatoid (n=1), signet ring cell (n=1) and adenosquamous (n=1) cancers. The overall survival rate was 87.1% at 1 year, 69.5% at 3 years and 61.7% at 5 years. After exclusion of mortalities not related to cancer, the overall patient survival rate was 89.6% at 1 year, 72.9% at 3 years and 64.7% at 5 years, with 3-year survival rates of 72% in the EHBD resection group and 69.2% in the non-resection group (p=0.661). Conclusions: The results of this study indicate that concurrent EHBD resection did not improve patient survival when R0 resection was achieved in patients with T2N0 GBCa. Therefore, routine EHBD resection may not be indicated for T2N0 GBCa unless the tumor is close to the cystic duct. (Korean J Hepatobiliary Pancreat Surg 2012;16:142-146)