Validation of Group B Borderline Resectable Pancreatic Cancer: Retrospective Analysis

( Tak Geun Oh ),( Moon Jae Chung ),( Seungmin Bang ),( Seung Woo Park ),( Jae Bok Chung ),( Si Young Song ),( Jinsil Seong ),( Chang Moo Kang ),( Woo Jung Lee ),( Jeong Youp Park ) 대한소화기학회 2014 Gut and Liver Vol.8 No.5

Background/Aims: Among borderline resectable pancreatic cancer (BRPC), group B BRPC patients have findings that are suggestive but not diagnostic of metastasis. In this study, we attempted to validate whether group B could truly be categorized as a borderline resectable group. Methods: We placed the BRPC patients into group A or group B. The survival outcomes were compared between the groups. Results: A total of 53 patients with pancreatic adenocarcinoma was classified as either group A or B borderline resectable. In group A, 23 (60.5%) of 38 patients underwent pancreatectomy after concurrent chemoradiotherapy or chemotherapy, but in group B, only five (33.3%) of 15 patients underwent pancreatectomy, mainly because of the progression of suspected distant metastasis. There was a significant difference in overall survival (OS) between group A and B patients (median OS, 21.2 months vs 10.2 months, respectively; p=0.007). Of the patients who underwent pancreatectomy, group B had a higher recurrence rate compared to group A (recurrence rate: 11 of 23 patients [47.8%] vs five of five patients [100%], respectively; p=0.033). Conclusions: This report is the first to validate the definition of BPRC. Group B had much worse outcomes, and whether group B BRPC can be categorized as BRPC together with group A is questionable. (Gut Liver 2014;8:557-562)

다낭성 난소증후군 치험 1례

오탁근 ( Tak Geun Oh ),김송백 ( Song Baeg Kim ),이수정 ( Su Jeong Lee ),유성원 ( Sung Won Ryu ),김지양 ( Ji Ryang Kim ),강정아 ( Jung Ah Kang ) 대한한방부인과학회 2008 大韓韓方婦人科學會誌 Vol.21 No.2

특집-급성 췌장염의 최신 지견 : 급성 췌장염의 병태생리

오탁근 ( Tak Geun Oh ),방승민 ( Seungmin Bang ) 대한내과학회 2013 대한내과학회지 Vol.85 No.2

여러 가지 원인이 급성 췌장염을 일으키나 각각의 요인들이 어떤 메커니즘으로 급성 췌장염을 유발하는지에 대한 이해는 급성 췌장염의 원인을 정확히 파악하고 치료하는 데 도움이 될 수 있다. 대표적인 원인 인자로는 만성 알코올 남용과 담석을 꼽을 수 있으며 그 밖에 CFTR mutation과 연관된 가족성 췌장염을 생각해 볼 수 있다. 심한 형태인 괴사성 췌장염에 관해서는 췌장효소의 활성화, 췌장 미세혈관의 손상, 염증인자의 분비가 췌장의 손상과 괴사를 악화시키며 심한 췌장 손상을 받은 일부 환자에서는 전신성 염증반응 증후군까지 진행될 수 있는데 이는 염증소견을 보이는 췌장에서 분비된 활성화된 췌장효소와 사이토카인이 전신으로 순환하면서 발생한다고 볼 수 있다. 일반적으로는 보상화된 항염증 반응이 전신성 염증반응과 균형을 이루면서 회복이 되지만 이와 같은 균형이 깨지면 심한 장기 부전으로 인해 사망으로까지 이를 수 있다. 또한, 급성 췌장염의 경과 중 장내 세균의 전좌(translocation)로 인하여 심한 급성 췌장염 환자의 30%에서 췌장과 췌장주위에 세균감염이 발생할 수 있는데, 이 경우 다발성 장기부전으로 이어질 수 있다. 췌장염의 초기 과정에서는 선방 세포 내의 trypsinogen의 활성화가 중요한 역할을 하나 사망에까지 이르게 하는 전신적 염증 반응의 경우는 독립적인 인자들이 작용하므로 이에 대한 메커니즘 연구 및 그에 맞는 치료법에 대한 연구가 필요한 실정이다. 이와 같이 급성 췌장염은 사망에까지 이르게 할 수 있는 질환으로서 정확한 진단과 치료의 기반이 될 수 있는 급성 췌장염의 병태생리에 대한 이해와 연구가 중요하다. Acute pancreatitis is an inflammatory disease that is caused by various etiologies including gallstone, alcohol or hypertriglyceridemia. Although most cases of acute pancreatitis show self-limiting course, severe cases are still associated with significant morbidity and mortality. The pathogenic mechanisms of acute pancreatitis are not fully understood. However, it is a central dogma that premature intracellular activation of trypsinogen is the earliest pathologic event. Even though it remains unknown how intracellular trypsinogen activation can be caused by such diverse etiologies, this initial insult in pancreatic acinar cells lead to local inflammatory complications and a systemic response or death. Pathophysiologic mechanisms related to the progression of acute pancreatitis include microcirculatory injury, chemoattraction of inflammatory cells, release of pro-inflammatory cytokines, and bacterial translocation to pancreas and systemic circulation. Recently, several interesting transgenic mice model experiments shed a light in trypsin independent mechanism of local and systemic inflammation for progression of acute pancreatitis.(Korean J Med 2013;85:111-115)

당뇨병 백서에서 혈관평활 근 세포를 이용한 인슐린 유전자 요법

오태근,이미자,김영규,김승택 대한당뇨병학회 2002 Diabetes and Metabolism Journal Vol.26 No.1

연구배경:인슐린의존형 당뇨병은 췌장 베타세포의 파괴로 인한 인슐린 결핍에 기인한다. 본 연구의 목표는 retroviral 벡터를 이용하여 인슐린 유전자를 이입시킨 혈관평활근 세포를 이식하여 줌으로써 당뇨병 유발 쥐에서 혈당 조절의 가능성을 검정하는 것이다. 방법:모든 세포에 존재하는 endopeptidase인 furin에 의해 프로 인슐린의 C­peptide 부분을 절단하는 변이된 프로인슐린 cDNA를 사용하여 먼저 재조합 retroviral 벡터 (LhInABCSN)를 제작하고, packaging 세포주인 PA317 세포에 이입시켜 PA317/LhInABCSN 을 제작하였다. 배양된 혈관평활근 세포(SMC, in bred F344 rat)에 PA317 /LhInABCSN 세포의 상충액을 넣어 인슐린을 생산하는 혈관평활근 세포(SMC/LhInABCSN)를 제작하였다. 동물실험으로 F344(in bred)쥐의 경동맥을 절개하여 풍선 카테터로 내피세포를 제거한 후 제작된 SMC/LhInABCSN를 이식하였다. 대조군으로는 SMC/LNFZ를 이식하였다. 수술 2주후 복강내로 스트렙토조토신(50㎎/㎏)을 주사하여 당뇨병을 유발시킨후 치료군과 대조군의 혈당 및 인슐린 농도, 체중변화 및 생존율을 비교하였다. 결과:인슐린 유전자가 이입된 혈관평활근 세포(SMC/LhInABCSN)의 상층액에서 인슐린 농도를 측정한 결과 24시간에 160.2μIU/mL, 48시간에 243.6μIU/mL, 72시간에서 350.2μIU/mL로 나왔고, 프로인슐린 농도는 24시간, 48시간 및 72시간 모두에서 1.0pmol/L 이하로 나와 SMC/LhInABCSN에서 생산되는 것이 프로인슐린이 아닌 인슐린임을 확인할 수 있었다. 스트렙토조토신 주사후 치료군과 대조군의 1일째(397±36㎎/dL vs. 392±49㎎/dL)와 3일째(338±37㎎/dL vs. 392±49㎎/dL)의 혈당차이가 없었으나 7일째에는 대조군중 생존한 3마리 모두에서 500㎎/dL 이상의 고혈당을 보인 반면, 치료군에서 생존한 10마리중 500㎎/dL 이상의 고혈당을 보인 쥐는 한 마리도 없었으며 14일째에도 대조군중 생존한 3마리의 혈당은 계속 500㎎/dL 이상의 고혈당을 보인 반면 치료군중 생존한 8마리중 500㎎/dL 이상의 고혈당을 보인 쥐는 한 마리도 없었다. STZ 투여후의 양군의 체중변화를 비교하였을 때 통계학적 차이는 없었으나 치료군이 대조군에 비해 체중감소량이 적은 경향을 보였다. 혈중 인슐린 농도는 STZ 투여 3일째 치료군에서 2.7±1.5μIU/mL, 대조군이 1.6±1.1μIU/mL로 두 군간에 통계학적 차이는 없었으나 치료군에서 약간 높은 경향을 보였다(p=0.077). 양 군의 평균 생존률을 비교해 보았을 때, 치료군의 median survival은 29일(9∼104일)로 대조군의 6일(3∼49일)에 비해 현저한 증가를 보였다(p<0.05). 결론:이상의 결과로 경동맥 혈관평활근세포를 이용한 인슐린 유전자요법은 정상 혈당의 회복은 가져오지 못했으나, 치료군이 대조군에 비해 현저한 생존율의 증가를 보이는바 혈관 평활근세포를 이용한 인슐린 유전자 요법이 당뇨병 치료의 한가지 방법이 될 수 있다고 생각한다. Background:Type 1 diabetes mellitus is caused by a lack of insulin. The purpose of this study was to test whether blood glucose control in severe diabetic animals can be achieved by transplanting of rat vascular smooth muscle cells which are transduced with the insulin gene using a retroviral vector system. Method:After cloning the recombinant retroviral plasmid including human mutated proinsulin cDNA which contains furin endopeptidase cleavage site, the resulting plasmid, LlnABCSN, was transfected into the retroviral packaging cell line(PA317/LhlnABSN). The resulting retrovirus in the supernatant of PA317/LhlnABCSN infected the F344 rat vascular smooth muscle cell(SMC)and produced the SMC/LhlnABCSN cells. After transplanting SMC/LhlnABCSN cells into the internal carotid artery of the rat, diabetes was induced by an intraperitoneal streptozotocin(STZ)injention(50㎎/㎏)2 week later. The blood glucose and insulin levels, percent weight change and the survival rates between the control group(SMC/LNFZ)and the treatment group(SMC/LhlnABCSN)were compared. Results:The insulin concentrations in the supernatant of the SMC/LhlnABCSN mice were 160.2μlu/mL in 24 hours, 243.6μlu/mL in 48 hours and 350.2μlu/mL in 72hours, but the proinsulin concentrations in 24,48 and 72 hours were all lower than 1 pmol/L. After 1 day and 3 days of the STZ injection, there were no differences in glucose concentrations between treatment group(n=10)and control group(n=10). There were no statistical differences in the percent weight change between the control and treatment group but the treated rats showed bad a lower weight loss than control rats. After 3 days of the STZ injection, serum insulin concentration of treatment group showed slightly higher levels than the control group(2.7±1.5μlu/mL vs. 1.6±1.1μlu/mL, p=0.077). The survival showed a significant increase in treatment group(median survival:29days, 9∼104 days)compared to the control group(median survival:6 days, 3∼49 days, p<0.05). Conclusion:Although this study did not show a normal glucose concentration in treated rats, it did show significantly higher survival smooth muscle cells which transduced the insulin gene may be a new insulin delivery method(J Kor Diabetes Asso 26:31∼45, 2002).

Delta Neutrophil Index is a Predictor of Disease Severity in Patients with Acute Pyelonephritis

( Geun Woo Ryu ),( Hyung Woo Kim ),( Seohyun Park ),( Sul A Lee ),( Jonghyun Jhee ),( Su-young Jung ),( Hyung Jung Oh ),( Jung Tak Park ),( Seung Hyeok Han ),( Shin-wook Kang ),( Tae-hyun Yoo ) 대한내과학회 2015 대한내과학회 추계학술대회 Vol.2015 No.1

Background: Delta neutrophil index (DNI) is the fraction of immature granulocytes provided by a complete blood count analyzer. Previous studies demonstrated that DNI is a novel marker to predict outcomes in sepsis patients. Therefore, this study aimed to evaluate DNI as a predictor of disease severity in patients with acute pyelonephritis (APN). Methods: Patients diagnosed with APN at Severance Hospital from December 2009 to July 2012 were retrospectively investigated. DNI levels were measured at the time of admission. The patients were classified into two groups according to the median value of DNI at baseline. Severe APN was diagnosed with one or more of these conditions including bacteremia, acute kidney injury, hypotension requiring use of vasopressors and admission of intensive care unit. Independent risk factors for severe APN were determined by multiple logistic regression analysis. Receiver operating characteristic (ROC) curves were plotted for DNI, white blood cell (WBC) count and C-reactive protein (CRP). Results: A total of 258 patients were included in this study. The median age was 61.0 (19.0-87.0), 237 patients (91.9%) were female, and the median DNI level was 2.5%. Severe APN was significantly more prevalent in high DNI group. Multivariate analysis showed that DNI, WBC count and CRP level independently predicted severe APN. DNIwas a better predictive marker of severe APN than WBC count, as reflectd by area under the ROC curve analysis (0.697 [95% CI, 0.637-0.753] vs. 0.562 [95% CI, 0.499-0.624], p=0.0013). DNI was not inferior to CRP levels to predict severe APN (0.697 [95% CI, 0.637-0.753] vs. 0.633 [95% CI, 0.571-0.692], p=0.1185). Conclusions: DNI level at admission is a valuable predictor of disease severity in patients with APN.

A 10-Bit 40-MS/s Pipelined ADC With a Wide Range Operating Temperature for WAVE Applications

Ghil-Geun Oh,Chang-Kyo Lee,Seung-Tak Ryu IEEE 2014 IEEE transactions on circuits and systems. a publi Vol.61 No.1

<P>A 10-bit 40-MS/s analog-to-digital converter (ADC) that is suitable for wireless access in vehicular environment applications is introduced. In order to satisfy the severe requirement of a wide range operating temperature under the given constraints, the ADC was simplified by eliminating nonessential building blocks such as reference drivers, a sample-and-hold amplifier (SHA), and level shifters. The proposed internal signal amplification method extends the effective signal range in both multiplying digital-to-analog converter and flash ADC, as well as the error correction range. A new clock generation circuit for a SHA-less pipelined ADC removes the need for a higher frequency external clock. The prototype ADC was fabricated in a 180-nm CMOS process. The ADC core consumes 23.4 mW at 3.3-V/1.8-V supplies. The measured worst differential nonlinearity and integral nonlinearity were -0.52/+0.7 LSB and -0.86/ +0.9 LSB, respectively, at a temperature of -40 <SUP>°</SUP> C. The signal-to-noise-and-distortion ratio stayed above 55 dB in the Nyquist condition in a temperature range of -40 <SUP>°</SUP>C-125 <SUP>°</SUP>C, which is about a 0.5 effective-number-of-bits drop from the room-temperature result.</P>

우리나라 식물원·수목원의 이용자 만족도 분석

현정오(Jung-Oh Hyun),김용식(Yong-Shik Kim),신현탁(Hyun-Tak Shin),강신구(Shin Koo Kang),김종익(Jong-Ik Kim),김종근(Jong-Geun Kim),윤정원(Jung-Won Yoon),이명훈(Myung-Hoon Yi) 한국산림휴양학회 2012 한국산림휴양학회지 Vol.16 No.1

우리나라 수목원의 나아가야할 방향을 제시하고자 공립수목원 3개소, 사립수목원 3개소 탐방객을 대상으로 설문을 통해 이용자 만족도를 분석하였다. 탐방객들이 인식하는 수목원의 기능 변수에서는 보전 기능만 유의하였다. 방문동기를 살펴보면 공립수목원의 경우 접근성 및 저비용으로 인해 방문 기회가 용이한 반면, 수목원을 공원으로 인식하는 경향이 우려된다. 또한 탐방객은 수목원 이용 후 자연의 아름다움, 자연에서 느낀 혼자만의 시간, 접근성 및 저비용 측면에서 만족감을 나타내었다. 마지막으로 시설물 이용 만족도 평가 결과 주차장, 화장실, 식물, 경관의 4항목에 서 주차장의 위치, 수용능력, 관리상태, 화장실의 위치, 청결상태, 미관, 관리상태, 식물다양성, 경관의 식물 특이성 변수에서 유의한 것으로 나타났다. 식물 다양성 및 식물 특이성 변수로 볼 때 공립수목원 보다는 사립수목원에서 보다 다양한 식물의 수집 및 교환이 이루어지고 있어 보다 다양한 식물을 접하는 것으로 나타났다. 전반적으로 공립수목원은 종 수집, 전시, 보전적 측면에의 노력을 통해 수목원 본연의 기능을 강화해야할 것으로 판단된다. In order to present domestic arboreta's path to go, a questionnaire was conducted regarding user's satisfaction on visitors to three public and three private arboreta. Among functional variables recognized by the visitors, only conservation function was significant. As for their motives for visiting arboreta, accessibility and low costs enabled ready visits to public arboreta. However, they tended to recognize arboreta as parks, which is worrisome. They also expressed satisfaction with the beauty of nature, time spent alone within nature, accessibility, and low costs. The result of evaluation of their satisfaction with facilities?parking lots, rest rooms, plants, and landscape?showed that variables such as the locations of parking lots, their capacity, cleanliness, fine views, management conditions, plant diversity, and plant specificity in landscape were significant. In terms of plant diversity and specificity, private arboreta collected and exchanged more diverse plants than public arboreta and therefore visitors could experience more various plants in private arboreta. Overall, it is judged that public arboreta should strengthen their original functions by making efforts in collection of species, exhibition, and conservation.

위암의 분자생물학적 치료의 이해

오탁근,이상길,Tak Geun Oh,Sang Kil Lee 대한소화기암연구학회 2013 Journal of digestive cancer reports Vol.1 No.1

The five-year survival for patients with gastric cancer improved only modestly over the last 50 years. So, several studies about molecular target chemotherapy were investigated. We reviewed about molecular target chemotherapy for advanced unresectable and metastatic gastric cancer, which has developed recently. EGFR (Epidermal growth factor receptor), HER (Human epidermal growth factor receptor), VEGF (Vascular endothelial growth factor receptor) can be the target of therapy for gastric cancer. Patients with advanced gastric adenocarcinoma who are potential candidates for trastuzumab should have their tumors assayed for the presence of HER2 overexpression utilizing tumor-specific criteria and/or gene amplification. We suggest the addition of trastuzumab to chemotherapy in patients with HER2-positive tumors (as defined by 3+ immunohistochemical staining or FISH positivity), as long as they do not have a contraindication to trastuzumab. Except for trastuzumab, we summarized several studies for molecular target agents which were not validated yet.

반사판과 CW 레이더를 이용한 딥러닝 기반의 좌우 제스처 인식

라승탁(Seung-Tak Ra),도태용(Tae-Yong Doh),이희열(Hee-Yeol Lee),이영지(Young-Ji Lee),김정윤(Jeong-Yoon Kim),김홍직(Hong-Jik Kim),오승진(Seung-Jin Oh),김기범(Gi-Beom Kim),박혜지(Hye-Ji Park),이동근(Dong-Geun Lee),유하영(Ha-Young Yoo),이 대한전자공학회 2022 대한전자공학회 학술대회 Vol.2022 No.6

S-8 : Comparison of Efficacy Between Full-dose GEM CCRT and 5FU CCRT in Locally Advanced Pancreatic Cancer

( Huapyong Kang ),( Tak Geun Oh ),( Moon Jae Chung ),( Jeong Youp Park ),( Seung Woo Park ),( Si Young Song ),( Jae Bok Chung ),( Seung Min Bang ) 대한내과학회 2013 대한내과학회 추계학술대회 Vol.2013 No.1

Background: Concurrent chemoradiotherapy (CCRT) is a standard therapeutic option for managing locally advanced pancreatic cancer (LAPC). Although 5-Fluorouracil (5-FU) or gemcitabine are recommended as the reference chemotherapeutic agent for CCRT, the optimal dosage for CCRT is still controversial. Aim: To compare the therapeutic efficacy and tolerability of full-dose gemcitabine based CCRT (FG-CCRT) and low dose 5-FU based CCRT (5FU-CCRT) for LAPC. Methods & Materials: From January 2006 to March 2013, 110 patients with LAPC who received FG-CCRT (n=90) or 5FU-CCRT (n=20) were included for retrospective analysis. FG-CCRT included full-dose weekly gemcitabine monotherapy (1000 mg/m2) or combination therapy with cisplatin (70 mg/m2). 5FU-CCRT treated with radiosensitizing low dose of bolus 5-FU (500mg/m2, weekly) plus leucovorin (20mg/m2). Concurrent radiotherapy targeted the primary tumor with 5 to 10 mm margin without regional lymph node irradiation. One month after completion of CCRT, response evaluation was conducted by computed tomography scan. Results: FG-CCRT had more advanced T-stage at the time of diagnosis (T4-86.7% versus 60.0%; p=0.005). Objective response rate (ORR) and disease control rate (DCR) was significantly higher for FG-CCRT than 5FU-CCRT (ORR-32.6% versus 5%; p=0.013; DCR-79.8% versus 50.0%; p=0.006). Both groups showed similar loco-regional control rate (92.2% versus 85.0%; p=0.362) but distant metastasis rate was higher in 5FU-CCRT (17.8% versus 45.0%; p=0.017). Grade 3 or higher neutropenia (34.4% versus 10%; p=0.031) and thrombocytopenia (21.1% versus 0%; p=0.021) was more frequent in FG-CCRT. The subgroup of FG-CCRT patients who received gemcitabine monotherapy showed no significant differences in toxicity rate compared with 5FU-CCRT (all p>0.05). Conclusion: Full-dose gemcitabine based CCRT seems more effective on initial local and distant control of LAPC than bolus 5-FU based CCRT. With cautious monitoring on hematologic toxicities, FG-CCRT can be tolerably conducted. Considering that distant metastasis is one of treatment failure pattern in CCRT of LAPC, full-dose gemcitabine CCRT should be considered as the first line treatment.