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Pachter Hersch Leon,Arthurs Likolani,Sant Vivek,Underwood Hunter,Kulkarni Kopel,Parikh Manish,Agrawal Nidhi,Suh Insoo,DiMaggio Charles 대한내분비외과학회 2023 The Koreran journal of Endocrine Surgery Vol.23 No.2
Purpose: Minimally invasive adrenalectomy is the standard of care for primary lateralized aldosteronism. Controversy related to clinical cure rates, prediction scores, and the role of adrenal vein sampling (AVS) for lateralization abound. Methods: Retrospective analysis of 53 consecutive adrenalectomy patients from 2013–2021, consisting of demographics, descriptive epidemiology, statistical comparison of pre- and post-adrenalectomy blood pressure, anti-hypertensive medications, plasma aldosterone and renin activity values, comparison of predictive scores, concordance of AVS for lateralization with cross-sectional imaging. Results: Forty-seven (89%) had a beneficial outcomes—19 (36%) achieving both biochemical/clinical cure, 28 (53%) clinically improved. The Utsumi score was superior to the aldosteronoma resolution score (ARS) in discriminating likelihood of cure, particularly in patients <40 years old. Sixteen patients (30%) with pathologic proven hyperplasia, had lower rates of cure or improvement. Forty-seven patients (89%) underwent both cross-sectional imaging and AVS; of those, 45/47 (96%) had concordant lateralization. In a broader cohort of 119 patients at our institution AVS, concordance rates decreased (63%). Conclusion: Adrenalectomy for primary aldosteronism leads to clinical improvement in most, but a far lower fraction achieve full clinical cure of hypertension. Proper expectations of adrenalectomy, must incorporate the Utility of predictive scores, and the significance of any form of unilateral hyperplasia. AVS is broadly nonconcordant with cross-sectional imaging in 33%, but in carefully selected patients can be highly concordant raising the possibility of selective bypassing of AVS in in those <40 years old
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DISPLAYING "JAPAN": KUMIDAIKO AND THE EXHIBITION OF CULTURE AT WALT DISNEY WORLD
BENJAMIN PACHTER 아시아음악학회 2009 Asian Musicology Vol.14 No.-
Performing at Walt Disney World as often as six times a day, seven days a week, the kumidaiko group, Matsuriza, has the unique opportunity to expose thousands of people per day to the world of Japanese taiko performance. At the same time, the group serves as a form of ambassador for Japan, representing the country within a section of the Epcot theme park known as World Showcase. Their performance space is the Japan pavilion, part of a modern day World's Fair that seeks to introduce tourists to various cultures from around the world. Matsuriza's participation in Disney's World's Fair is not without its consequences, however. The group must grapple with issues of commoditization, authenticity, and representation that have long caught the eyes of scholars. At the same time, the group must deal with the expectations of tourists that have come to Epcot, expectations that are fueled in part by the atmosphere of the Japan pavilion created by the Walt Disney Company. In the end, kumidaiko at Walt Disney World as performed by Matsuriza is a reified art form, static and unchanging. Taiko is discussed by group members using a discourse that adheres to the sense of Japan created within the pavilion, and repertoire and performance practice are modified so as to not disrupt the atmosphere that has been created. Even as kumidaiko continues to grow and evolve outside of Epcot's borders, within the theme park it is simply another exhibit on display for the paying tourist in the museum of culture that is World Showcase.
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