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Unilateral versus bilateral Y-type stent-in-stent metal stent insertions in inoperable malignant hilar biliary strictures:A multicenter retrospective study

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Hepatobiliary & Pancreatic Diseases International 2021年第6期20卷 561-567页

作者： Ik Hyun Jo Chang-Nyol Paik dae bum kim Jaesin Lee Jong Yul Lee Jae Hyuck Chang Kyu-Hyun Paik Won-Suk Park Department of Internal Medicine College of MedicineSt.Vincent’s HospitalThe Catholic University of KoreaSeoulKorea Department of Internal Medicine College of MedicineIncheon St.Mary’s HospitalThe Catholic University of KoreaSeoulKorea Department of Internal Medicine College of MedicineBucheon St.Mary’s HospitalThe Catholic University of KoreaSeoulKorea Department of Internal Medicine College of MedicineDaejeon St.Mary’s HospitalThe Catholic University of KoreaSeoulKorea

Background:To date,there is controversy regarding unilateral versus bilateral stent placement in patients with malignant hilar biliary strictures(MHBSs).The aim of this study was to compare the clinical outcomes and complications of unilateral and bilateral(stent-in-stent method)stent placements for these ***:We conducted a multicenter retrospective analysis of patients with inoperable MHBS who underwent endoscopic self-expandable metal stent(SEMS)placement from January 2009 to December *** groups classified according to the stent procedure method were compared for demographic,procedural,and postprocedure *** analysis for patency loss and overall survival was also ***:A total of 236 subjects were included.A superior technical success rate was found in the unilateral stent group(98.8%vs.82.5%,P<0.001),whereas the clinical success rate was higher in the bilateral group(85.7%vs.70.5%,P=0.028).There was no significant difference with respect to complications or patency loss,and the bilateral group had better overall survival(P<0.01).In the Cox proportional hazard model,MHBSs from lymph node compression were associated with a higher risk of death(HR=9.803,P=0.003).In contrast,bilateral SEMS insertion showed reduced postprocedural mortality(HR=0.316,P=0.001).Conclusions:Y-type stent-in-stent bilateral SEMSs are technically difficult but demonstrated more favorable overall survival for palliative bile drainage of inoperable MHBS patients compared to unilateral insertions.

关键词： Cholestasis Extrahepatic neoplasm Cholangiopancreatography Endoscopy Self-expandable metal stents

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Two-year delay in ulcerative colitis diagnosis is associated with anti-tumor necrosis factor alpha use

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World Journal of Gastroenterology 2019年第8期25卷 989-1001页

作者： Ho Suk Kang Ja-Seol Koo Kang Moon Lee dae-bum kim Ji Min Lee Yoon Jae kim Hyuk Yoon Hyun Joo Jang Department of Internal Medicine Hallym Sacred Heart HospitalHallym University College of MedicineAnyang 14068South Korea Division of Gastroenterology and Hepatology Department of Internal MedicineKorea University Ansan HospitalDepartment of Internal MedicineKorea University College of MedicineAnsan 15355South Korea Department of Internal Medicine The Catholic University of KoreaSt.Vincent’s HospitalSuwon 16247South Korea Department of Gastroenterology Gachon Graduate School of Medicine Gil Medical CenterIncheon 21565South Korea Department of Internal Medicine Seoul National University Bundang HospitalSeongnam 13620South Korea Division of Gastroenterology Department of Internal MedicineDongtan Sacred Heart HospitalHallym University College of MedicineHwaseong 18450South Korea

BACKGROUND Ulcerative colitis(UC)is an uncommon inflammatory bowel disease(IBD).However,its incidence has recently increased in South ***,UC diagnoses are frequently delayed,and the relationship between diagnostic delay and UC prognosis has not been extensively studied in South Korean *** To identify meaningful diagnostic delay affecting UC prognosis and to evaluate risk factors associated with diagnostic delay in South Korean *** Medical records of 718 patients with UC who visited the outpatient clinic of six university hospitals in South Korea were reviewed;167 cases were excluded because the first symptom date was *** evaluated the relationship between the prognosis and a diagnostic delay of 3,6,12,18,and 24 mo by comparing the prognostic factors[anti-tumor necrosis factor(TNF)-αuse,admission history due to acute flare-ups,frequent admission due to flare-ups,surgery associated with UC,and the clinical remission state at the latest followup]at each diagnostic *** The mean diagnostic interval was 223.3±483.2 d(median,69 d;75th percentile,195 d).Among the prognostic factors,anti-TNFαuse was significantly increased after a diagnostic delay of 24 *** risk factors predictive of a 24-mo diagnostic delay were age24 mo was associated with increased anti-TNFα***<60 years at diagnosis,smoking history,and misdiagnosis of hemorrhoids were risk factors for delayed diagnosis.

关键词： Ulcerative colitis Diagnostic delay Anti-tumor necrosis factor alpha Smoking

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Clinical characteristics of Helicobacter pylori-negative drugnegative peptic ulcer bleeding

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World Journal of Gastroenterology 2015年第28期21卷 8636-8643页

作者： Woo Chul Chung Eun Jung Jeon dae bum kim Hea Jung Sung Yeon-Ji kim Eun Sun Lim Min-ah kim Jung Hwan Oh Department of Internal Medicine St. Paul’s HospitalCollege of Medicine the Catholic University of Korea

AIM:To investigate the clinical characteristics and outcomes of idiopathic Helicobacter pylori(***)-negative and drug-negative]peptic ulcer bleeding(PUB).METHODS:A consecutive series of patients who experienced PUB between 2006 and 2012 was retrospectively analyzed.A total of 232 patients were enrolled in this *** patients were divided into four groups according to the etiologies of PUB:idiopathic,***-associated,drug-induced and combined(***-associated and drug-induced)*** compared the clinical characteristics and outcomes between the *** the silver stain or rapid urease tests were ***-negative,we obtained an additional biopsy specimen by endoscopic re-examination and performed an *** antibody test 6-8 wk after the initial endoscopic *** a diagnosis of idiopathic PUB,a negative result of an *** antibody test was *** all cases,re-bleeding was confirmed by endoscopic *** the risk assessment,the Blatchford and the Rockall scores were calculated for all ***:For PUB,the frequency of *** infection was 59.5%(138/232),whereas the frequency of idiopathic cases was 8.6%(20/232).When idiopathic PUB was compared to ***-associated PUB,the idiopathic PUB group showed a higher rate of rebleeding after initial hemostasis during the hospital stay(30%vs 7.4%,P = 0.02).When idiopathic PUB was compared to drug-induced PUB,the patients in the idiopathic PUB group showed a higher rate of rebleeding after initial hemostasis upon admission(30%vs 2.7%,P < 0.01).When drug-induced PUB was compared to ***-associated PUB,the patients in the drug-induced PUB were older(68.49 ± 14.76 years vs 47.83 ± 15.15 years,P< 0.01) and showed a higher proportion of gastric ulcer(77%vs 49%,P < 0.01).However,the Blatchford and the Rockall scores were not significantly different between the two *** the patients who experienced drug-induced PUB,no significant differences were found with respect

关键词： Peptic ulcer Gastrointestinal bleeding Helicobacter pylori Non-steroidal anti-inflammatorydrug

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High mobility group box 1 in the central nervous system:regeneration hidden beneath inflammation

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Neural Regeneration Research 2025年第1期20卷 107-115页

作者： Hanki kim bum Jun kim Seungyon Koh Hyo Jin Cho Xuelian Jin Byung Gon kim Jun Young Choi Department of Brain Science Ajou University School of MedicineSuwonSouth Korea Department of Biomedical Sciences Ajou University Graduate School of MedicineSuwonSouth Korea Department of Neurology Ajou University School of MedicineSuwonSouth Korea Department of Geriatrics The Affiliated Suqian First People’s Hospital of Nanjing Medical UniversitySuqianJiangsu ProvinceChina

High-mobility group box 1 was first discovered in the calf thymus as a DNA-binding nuclear protein and has been widely studied in diverse fields,including neurology and ***-mobility group box 1 in the extracellular space functions as a pro-inflammatory damage-associated molecular pattern,which has been proven to play an important role in a wide variety of central nervous system disorders such as ischemic stroke,Alzheimer’s disease,frontotemporal dementia,Parkinson’s disease,multiple sclerosis,epilepsy,and traumatic brain *** drugs that inhibit high-mobility group box 1 as a damage-associated molecular pattern,such as glycyrrhizin,ethyl pyruvate,and neutralizing anti-high-mobility group box 1 antibodies,are commonly used to target high-mobility group box 1 activity in central nervous system *** it is commonly known for its detrimental inflammatory effect,high-mobility group box 1 has also been shown to have beneficial pro-regenerative roles in central nervous system *** this narrative review,we provide a brief summary of the history of high-mobility group box 1 research and its characterization as a damage-associated molecular pattern,its downstream receptors,and intracellular signaling pathways,how high-mobility group box 1 exerts the repair-favoring roles in general and in the central nervous system,and clues on how to differentiate the pro-regenerative from the pro-inflammatory *** targeting high-mobility group box 1 in the central nervous system may benefit from differentiating between the two functions rather than overall suppression of high-mobility group box 1.

关键词： central nervous system damage-associated molecular pattern ethyl pyruvate glycyrhizzin high mobility group box 1 inflammation neural stem cells neurodevelopment oligodendrocyte progenitor cells redox status regeneration

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Evaluation of particle growth systems for sampling and analysis of atmospheric fine particles

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Particuology 2011年第6期9卷 606-610页

作者： dae Seong kim Sang bum Hong Jung-Taek Kwon Kihong Park Department of Environmental Science and Engineering Gwangju Institute of Science and Technology Korea Polar Research Institute Laboratory of Toxicology College of Veterinary Medicine Seoul National University

Three types of water-based condensational growth systems, which can enable particles to grow in size to facilitate sampling and subsequent chemical analysis, were evaluated. The first one is a mixing type growth system where aerosols are mixed with saturated water vapor, the second one is a thermal diffusive growth system where warm flow enters cold-walled tube, and the third one is a laminar flow type where cold flow enters a warm wet-wall tube. Hygroscopic sodium chloride （NaCl）, ammonium sulfate （（NH4）2SO4） and ammonium nitrate （NH4N03）, and non-hygroscopic polystyrene latex （PSL） particles, in the size range of 50-400 nm, were used to determine their growth factors through the growth systems. Our data showed that the third-type growth system could enable particles to grow most efficiently regardless of their hygroscopic property. Collection efficiency of particles in the size range of 0.05-2.5 μm, in a continuous aerosol sampler after they passed through the third-type growth system was about 100%, suggesting that the third-type growth system would he the most useful among the tested growth systems for sampling and subsequent chemical analysis of fine and ultrafine particles.

关键词： Particle growth chamber Condensational growth Particle sampler Hygroscopic particles

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Optimal Cyber Attack Strategy Using Reinforcement Learning Based onCommon Vulnerability Scoring System

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Computer Modeling in Engineering & Sciences 2024年第11期141卷 1551-1574页

作者： bum-Sok kim Hye-Won Suk Yong-Hoon Choi dae-Sung Moon Min-Suk kim Department of Electronic Information System Engineering Sangmyung UniversityCheonan31066Republic of Korea Department of Human Intelligence&Robot Engineering Sangmyung UniversityCheonan31066Republic of Korea Intelligent Convergence Research Laboratory Electronics and Telecommunications Research InstituteDaejeon34129Republic of Korea

Currently,cybersecurity threats such as data breaches and phishing have been on the rise due to the many differentattack strategies of cyber attackers,significantly increasing risks to individuals and *** technologies such as intrusion detection have been developed to respond to these cyber ***,advanced integrated cybersecurity that incorporates Artificial Intelligence has been the *** this paper,wepropose a response strategy using a reinforcement-learning-based cyber-attack-defense simulation tool to addresscontinuously evolving cyber ***,we have implemented an effective reinforcement-learning-basedcyber-attack scenario using Cyber Battle Simulation,which is a cyber-attack-defense *** scenarioinvolves important security components such as node value,cost,firewalls,and ***,we applieda new vulnerability assessment method based on the Common Vulnerability Scoring *** approach candesign an optimal attack strategy by considering the importance of attack goals,which helps in developing moreeffective response *** attack strategies are evaluated by comparing their performance using a variety ofReinforcement Learning *** experimental results show that RL models demonstrate improved learningperformance with the proposed attack strategy compared to the original *** particular,the success rateof the Advantage Actor-Critic-based attack strategy improved by 5.04 percentage points,reaching 10.17%,whichrepresents an impressive 98.24%increase over the original ***,the proposed method canenhance security and risk management capabilities in cyber environments,improving the efficiency of securitymanagement and significantly contributing to the development of security systems.

关键词： Reinforcement learning common vulnerability scoring system cyber attack cyber battle simulation

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Assessment of disease activity by fecal immunochemical test in ulcerative colitis

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World Journal of Gastroenterology 2016年第48期22卷 10617-10624页

作者： dae Gon Ryu Hyung Wook kim Su bum Park dae Hwan Kang Cheol Woong Choi Su Jin kim Hyeong Seok Nam Department of Internal Medicine Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology Pusan National University Yangsan Hospital

AIM To evaluate the efficacy of quantitative fecal immunochemical test(FIT) as biomarker of disease activity in ulcerative colitis(UC).METHODS Between February 2013 and November 2014, a total of 82 FIT results, obtained in conjunction with colonoscopies, were retrospectivelyevaluated for 63 patients with UC. The efficacy of FIT for evaluation of disease activity was compared to colonoscopic findings. Quantitative fecal blood with automated equipment examined from collected feces. Endoscopic disease severity were assessed using the Mayo endoscopic subscore(MES) classification. The extent of disease were classified by proctitis(E1), left sided colitis(E2), and extensive colitis(E3). Clinical activity were subgrouped by remission or *** All of 21 patients with MES 0 had negative FIT( 134.89 ng/m L. The sensitivity, specificity, positive predictive value(PPV), negative predictive value(NPV) and accuracy of negative FIT about mucosal healing were 73.33%, 81.82%, 91.49%, 51.43% and 73.17%, respectively. The sensitivity, specificity, PPV, NPV and accuracy of predictive value of positive FIT(cutoff value > 100 ng/mL) about active disease status were 45.45%, 93.33%, 71.43%, 82.35%and 26.83%, respectively. Among patients with clinical remission, FIT was negative in 31(81.6%) of 38 cases, with a mean fecal hemoglobin concentration of 6.12 ng/mL(range, negative to 80.9 ng/mL) for this group of patients. Among patients with clinical active disease, FIT was negative in 16(36.4%) out of 44 cases, with a mean fecal hemoglobin concentration > 167.4 ng/mL for this group of patients. FIT was positively correlated with endoscopic activity(r = 0.626, P < 0.01) and clinical activity(r = 0.496, P < 0.01). But, FIT did not correlate with the extent of disease(r =-0.047, P = 0.676)CONCLUSION Quantitative FIT can be a non-invasive and effective biomarker for evaluation of clinical and endoscopic activity in UC, but not

关键词： Ulcerative colitis Fecal immunochemical test Mayo endoscopic subscore Biomarker Disease activity

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Efficacy and safety of limited endoscopic sphincterotomy before self-expandable metal stent insertion for malignant biliary obstruction

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World Journal of Gastroenterology 2017年第9期23卷 1627-1636页

作者： Hyeong Seok Nam dae Hwan Kang Hyung Wook kim Cheol Woong Choi Su bum Park Su Jin kim dae Gon Ryu Department of Internal Medicine Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and TechnologyPusan National University Yangsan HospitalYangsan-siGyeongsangnam-do 50612South Korea

To evaluate the safety and efficacy of limited endoscopic sphincterotomy (ES) before placement of self-expandable metal stent (SEMS).METHODSThis was a retrospective analysis of 244 consecutive patients with unresectable malignant biliary obstruction, who underwent placement of SEMSs following limited ES from December 2008 to February 2015. The diagnosis of malignant biliary obstruction and assessment of patient eligibility for the study was established by a combination of clinical findings, laboratory investigations, imaging and pathological results. All patients were monitored in the hospital for at least 24 h following endoscopic retrograde cholangio pancreatography (ERCP). The incidence of immediate or early post-ERCP complications such as post-ERCP pancreatitis (PEP) and bleeding related to limited ES were considered as primary outcomes. Also, characteristics and complications according to the cancer type were *** the 244 patients included, the underlying diagnosis was cholangiocarcinoma in 118 patients, pancreatic cancer in 79, and non-pancreatic or non-biliary malignancies in the remaining 47 patients. Early post-ERCP complications occurred in 9 patients (3.7%), with PEP in 7 patients (2.9%; mild, 6; moderate, 1) and mild bleeding in 2 patients (0.8%). There was no significant association between the incidence of post-ERCP complications and the type of malignancy (cholangiocarcinoma vs pancreatic cancer vs others, P = 0.696) or the type of SEMS used (uncovered vs covered, P = 1.000). Patients who had more than one SEMS placed at the first instance were at a significantly higher risk of post-ERCP complications (one SEMS vs two SEMS, P = 0.031). No other factors were predictive of post-ERCP *** ES is feasible and safe, and effectively facilitates the placement of SEMS, without any significant risk of PEP or severe bleeding.

关键词： Endoscopic sphincterotomy Endoscopic retrograde cholangio pancreatography Complications Pancreatitis Bleeding Cholestasis Self-expandable metal stent

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Bacteriophage cocktail supplementation improves growth performance,gut microbiome and production traits in broiler chickens

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Journal of Animal Science and Biotechnology 2021年第4期12卷 1339-1350页

作者： Santi Devi Upadhaya Je Min Ahn Jae Hyoung Cho Jin Young kim dae Kyung Kang Sung Woo kim Hyeun bum kim In Ho kim Department of Animal Resource and Science Dankook UniversityNo.29 AnseodongCheonanChoongnam 31116South Korea Department of Animal Science North Carolina State University116 Polk HallBox 7621120 W Broughton DrRaleighNC 27695USA

Background:Effective antibiotic alternatives are urgently needed in the poultry industry to control disease *** therapy mainly utilizes lytic phages to kill their respective bacterial hosts and can be an attractive solution to combating the emergence of antibiotic resistance in ***:Five hundred and four,one-day-old broilers(Ross 308)were allotted to 1 of 4 treatment groups in a completely randomized *** consisted of CON(basal diet),PC(CON+0.025%Avilamax®),BP 0.05(CON+0.05%bacteriophage),and BP 0.10(CON+0.10%bacteriophage).Results:A significant linear effect on body weight gain(BWG)was observed during days 1–7,days 22–35,and cumulatively in bacteriophage(BP)supplemented *** BWG tended to be higher(P=0.08)and the feed intake(FI)was increased(P=0.017)in the PC group over CON group.A greater(P=0.016)BWG and trends in increased FI(P=0.06)were observed in the experiment in birds fed PC than CON *** the genus level,the relative abundance of Lactobacillus was decreased in PC(65.28%),while it was similar in BP 0.05 and BP 0.10(90.65%,86.72%)compared to CON(90.19%).At the species level,the relative abundance of Lactobacillus salivarus was higher in BP 0.05(40.15%)and BP 0.10(38.58%)compared to the CON(20.04%)and PC(18.05%).A linear reduction in the weight of bursa of Fabricius(P=0.022)and spleen(P=0.052)was observed in birds fed graded level of BP and an increase(P=0.059)in the weight of gizzard was observed in birds fed PC over BP *** and quadratic responses were observed in redness of breast muscle color in birds fed graded level of ***:The inclusion of the 0.05%and 0.1%BP cocktail linearly improved broiler weight during the first 7 days,22–35 days and cumulatively,whereas 0.05%BP addition was sufficient for supporting immune organs,bursa and spleen as well as enhancing gut microbiome,indicating the efficacy of 0.05%BP as a substitute antibiotic growth promoter in broiler diets.

关键词： Bacteriophage Broiler chickens Gut microbiome Performance

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Hepatitis B virus mutations related to liver disease progression of Korean patients

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World Journal of Gastroenterology 2014年第2期20卷 460-467页

作者： bum-Joon kim Department of Biomedical Sciences Microbiology and ImmunologyLiver Research Instituteand Cancer Research InstituteCollege of MedicineSeoul National UniversitySeoul 110-799South Korea

Hepatitis B virus(HBV)infection is a global health problem and more than 350 million people worldwide are chronic carriers of the *** the recent dramatic decline in HBV chronic patients through successful programs of hepatitis B surface antigen vaccination,South Korea is still recognized as an endemic area of HBV *** infections in South Korea exhibit several distinct features in epidemiologic and clinical *** this review paper,we summarize the distinct HBV mutation patterns related to clinical severity and the molecular epidemiologic traits in Korean chronic patients based on previous ***,several lines of evidence,including our previous results,have led to the conclusion that a combination of the exclusive predominance of genotype C2,which is prone to mutations,the high prevalence of basal core promoter double mutations,and the presence of distinct immune responses against HBV proteins in the Korean population may generate the distinct HBV variants rarely or not encountered in other areas,which results in distinct clinical manifestations in Korean chronic *** may provide a novel insight into the relationships between clinical severity,HBV genotype distribution,and HBV naturally occurring variants.

关键词： Hepatitis B virus Mutation South Korea Hepatocellular carcinoma Genotype C2

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