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Use of a clinical pathway in laparoscopic gastrectomy for gastric cancer

World Journal of Gastroenterology 2015年第48期21卷 13507-13517页

作者： hee sung kim Sun Oak kim Byung Sik kim Department of Gastric Surgery Asan Medical CenterUlsan University School of Medicine Department of Clinical Epidemiology and Biostatistics Asan Medical CenterUlsan University School of Medicine

AIM: To evaluate the implementation of a clinical pathway and identify clinical factors affecting the clinical pathway for laparoscopic ***: A standardized clinical pathway for gastric cancer(GC) patients was developed in 2001 by the GC surgery team at the Asan Medical Center. We reviewed the collected data of 4800 consecutive patients treated using the clinical pathway following laparoscopic gastrectomy with lymph node dissection for GC involving intracorporeal and extracorporeal anastomosis. The patients were treated between August 2004 and October 2013 in a single institution. To evaluate the rate of completion and risk factors affecting dropout from the clinical pathway, we used a multivariate logistic regression ***: The overall completion rate of the clinical pathway for laparoscopic gastrectomy was 84.1%(n = 4038). In the comparison between groups of intracorporeal anastomosis and extracorporeal anastomosis patients, the completion rates were 8 3. 8 8 %(n = 1 7 4 0) a n d 8 4. 3 6 %(n = 2 0 7 1), respectively, showing no statistically significant difference. The main reasons for dropping out were postoperative complications(n = 463, 9.7%) and the need for patient observation(n = 299, 6.2%). Among the discharged patients treated using the clinical pathway, the number of patients who were readmitted within 30 d due to postoperative complications was 54(1.1%). In a multivariate analysis, the intraoperative events(OR = 2.558) were the most predictable risk factors for dropping out of the clinical pathway. Additionally, being male(OR = 1.459), advanced age(OR = 1.727), total gastrectomy(OR = 2.444), combined operation(OR = 1.731), and ASA score(OR = 1.889) were significant risk factors affecting the dropout rate from the clinical ***: Laparoscopic gastrectomy appears to be a good indication for the application of a clinical pathway. For successful application, patients with risk factors should be managed carefully.

关键词： Clinical pathway Laparoscopic gastrectomy Gastric cancer Extracorporeal anastomosis Intracorporealanastomosis

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Endoscopic salvage treatment of histoacryl after stent application on the anastomotic leak after gastrectomy: A case report

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World Journal of Clinical Cases 2021年第1期9卷 262-266页

作者： hee-sung kim Yook kim Joung-Ho Han Department of Internal Medicine Chungbuk National University HospitalChungbuk National University College of MedicineCheongju-si 28644South Korea Department of Radiology Chungbuk National University HospitalCheongju-si 28644South Korea

BACKGROUND Endoscopic approach could effectively manage postoperative anastomotic *** endoscopic methods have been developed for the treatment of anastomotic *** SUMMARY A 53-year-old woman developed anastomotic leak after laparoscopic proximal *** clip closure failed due to strong wall tension;therefore,a fully covered self-expandable esophageal metal stent(fc-SEMS)was placed to cover the leak after it was filled with a mixture of fibrin glue and ***,fluoroscopy with gastrograffin showed dye leaking out of the *** the previous fluoroscopic image for guidance,a catheter was inserted at the leakage *** radiocontrast dye was injected and was seen spreading along the sinus ***,histoacryl was *** days after the last procedure,upper gastrointestinal contrast studies showed no *** patient was subsequently discharged 9 d after histoacryl injection without any *** To seal an anastomosis leak after stent application,salvage technique using histoacryl injection at the leakage site with fluoroscopy guidance could be considered cautiously.

关键词： Anastomotic leak Stent Histoacryl Endoscopy Gastrectomy Gastric cancer Case report

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Comparison of totally laparoscopic total gastrectomy using an endoscopic linear stapler with laparoscopic-assisted total gastrectomy using a circular stapler in patients with gastric cancer: a single-center experience

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World Journal of Gastroenterology 2017年第48期23卷 8553-8561页

作者： Chung Sik Gong Byung Sik kim hee sung kim department of gastric surgery asan medical centeruniversity of ulsan college of medicine

AIM To evaluate the safety and efficacy of totally laparoscopic total gastrectomy(TLTG) with esophagojejunostomy using a linear stapler compared with laparoscopic-assisted total gastrectomy(LATG) using a circular stapler in gastric cancer *** We retrospectively reviewed 687 patients who underwent laparoscopic total gastrectomy for gastric cancer at a single institution from August 2008 to August 2014. The patients were divided into two groups according to the type of operation: 421 patients underwent TLTG and 266 underwent LATG. Clinicopathologic characteristics and surgical outcomes in the two groups were compared and *** The TLTG group had higher mean ages at the time of operation(57.78 ± 11.20 years and 55.69 ± 11.96 years,P = 0.020) and more histories of abdominal surgery(20.2% and 12.4%,P = 0.008) compared with the LATG group. Surgical outcomes such as intraoperative and postoperative transfusions,combined operations,pain scores and administration of analgesics,and complications were similar between the two groups. However,compared with the LATG group,the TLTG group required a shorter operation time(149 min vs 170 min,P < 0.001),had lower postoperative hematocrit change(3.49% vs 4.04%,P = 0.002),less intraoperative events(3.1% vs 10.2%,P < 0.001),less intraoperative anastomosis events(2.4% vs 7.1%,P = 0.003),faster postoperative recovery such as median time to first flatus(3.30 d vs 3.60 d,P < 0.001),faster median commencement of soft diet(4.30 d vs 4.60 d,P < 0.001) and shorter length of postoperative hospital stay(6.75 d vs 7.02 d,P = 0.005). CONCLUSION The intracorporeal method for reconstruction of esophagojejunostomy using a linear stapler may be considered a feasible procedure comparing with extracorporeal anastomosis using circular stapler because TLTG is simpler and more straightforward than LATG. Therefore,TLTG can be recommended as an appropriate procedure for gastric cancer.

关键词： Totally laparoscopic total gastrectomy Laparoscopic-assisted total gastrectomy Gastric cancer

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Coexisting cytomegalovirus colitis in an immunocompetent patient with Clostridioides difficile colitis:A case report

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World Journal of Clinical Cases 2023年第10期11卷 2343-2348页

作者： Jun Hyoung kim hee-sung kim Hye Won Jeong Department of Internal Medicine Chungbuk National University HospitalCheongju 28644ChungbukSouth Korea Department of Internal Medicine Chungbuk National University College of MedicineCheongju 28644ChungbukSouth Korea

BACKGROUND Clostridioides difficile(***)colitis is one of the most common infections in hospitalized patients,characterized by fever and *** usually improves after appropriate antibiotic treatment;if not,comorbidities should be ***(CMV)colitis is a possible co-existing diagnosis in patients with *** infection with poor treatment ***,compared with immunocompromised patients,CMV colitis in immunocompetent patients is not well *** SUMMARY We present an unusual case of co-existing CMV colitis in an immunocompetent patient with *** *** 80-year-old female patient was referred to the infectious disease department due to diarrhea,abdominal discomfort,and fever for 1 wk during her hospitalization for *** toxin B polymerase chain reaction on stool samples was *** *** infection was diagnosed,oral vancomycin treatment was *** symptoms including diarrhea,fever and abdominal discomfort improved for ten ***,the symptoms worsened again with bloody diarrhea and ***,a sigmoidoscopy was performed for evaluation,showing a longitudinal ulcer on the sigmoid *** biopsy confirmed CMV colitis,and the clinical symptoms improved after using *** Co-existing CMV colitis should be considered in patients with aggravated *** infection on appropriate treatment,even in immunocompetent hosts.

关键词： Cytomegalovirus Clostridioides difficile Coinfection Colitis Immunocompetent Case report

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Promoter hypermethylation and loss of CD133 gene expression in colorectal cancers

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World Journal of Gastroenterology 2010年第25期16卷 3153-3160页

作者： You-Kyung Jeon sung-hee kim Seung-Ho Choi Kyung-hee kim Byong-Chul Yoo Ja-Lok Ku Jae-Gahb Park Laboratory of Cell Biology Cancer Research Institute Seoul National University College of Medicine Seoul 110-799 South Korea Colorectal Cancer Branch Research Institute National Cancer Center Goyang 411-764 Gyeonggi South Korea

AIM: To understand CD133 promoter hypermethyl-ation and expression in 32 colorectal cancer cell lines. METHODS: Nucleic acid was isolated from 32 colorectal cancer cell lines and CD133 expression levels were measured by reverse transcription-polymerase chain reaction (RT-PCR) and real-time PCR. Promoter methylation status of the CD133 gene was analyzed with a methylation-specific PCR after sodium-bisulfi te modification and by clonal sequencing analysis. The correlation between expression and promoter methylation of CD133 gene was confirmed with treatment of 5-aza-2’-deoxycytidine. RESULTS: We measured CD133 expression levels in 32 colorectal cancer cell lines. RT-PCR analysis showed undetectable or low levels of CD133 expression in 34.4%of cell lines. To verify the relation between CD133 expression and methylation status of the CD133 gene promoter in colorectal carcinogenesis, CD133 gene promoter hypermethylation was analyzed in 32 cancer cell lines. Promoter hypermethylation was detected in 13 (40.6%) of the cell lines using methylation specificPCR and confirmed by bisulfite sequencing analysis. Treatment of 11 of the cell lines with the demethylation agent 5-aza-2’-deoxycytidine recovered CD133 expression in most of them. CONCLUSION: Transcriptional repression of CD133 is caused by promoter hypermethylation of the CD133 CpG islands in some of colorectal cancer cell lines. The study may contribute to the understanding of the role of CD133 inactivation in the progression of colorectal cancers.

关键词： CD133 Promoter Hypermethylation Colorectal cancer Sodium bisulfite modification

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Temporal manipulation of spatiotemporal optical vortices with an Airy pulse[Invited]

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Chinese Optics Letters 2023年第8期21卷 1-5页

作者： Yimin Zang Fanli Wei hee sung kim Andy Chong Department of Electro-Optics and Photonics University of DaytonDaytonOhio 45469USA Department of Physics Pusan National UniversityBusan 46241Republic of Korea

We demonstrate the temporal manipulation of spatiotemporal optical vortices(STOVs)by utilizing Airy *** combining a STOV with an Airy temporal profile,the STOV exhibits nondispersive,self-accelerating,and self-healing... 详细信息

关键词： spatiotemporal vortex Airy pulse manipulation

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Aligned Ion Conduction Pathway of Polyrotaxane‑Based Electrolyte with Dispersed Hydrophobic Chains for Solid‑State Lithium–Oxygen Batteries

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Nano-Micro Letters 2025年第2期17卷 169-186页

作者： Bitgaram kim Myeong‑Chang sung Gwang‑hee Lee Byoungjoon Hwang Sojung Seo Ji‑Hun Seo Dong‑Wan kim Department of Materials Science and Engineering Korea University145 Anam‑RoSeongbuk‑GuSeoul 02841Republic of Korea School of Civil Environmental and Architectural EngineeringKorea University145 Anam‑RoSeongbuk‑GuSeoul 02841Republic of Korea Materials Science and Chemical Engineering Center Institute for Advanced Engineering(IAE)Yongin 17180Republic of Korea

A critical challenge hindering the practical application of lithium–oxygen batteries(LOBs)is the inevitable problems associated with liquid electrolytes,such as evaporation and safety *** study addresses these problems by proposing a modified polyrotaxane(mPR)-based solid polymer electrolyte(SPE)design that simultaneously mitigates solvent-related problems and improves ***-SPE exhibits high ion conductivity(2.8×10^(−3)S cm^(−1)at 25℃)through aligned ion conduction pathways and provides electrode protection ability through hydrophobic chain *** this mPR-SPE into solid-state LOBs resulted in stable potentials over 300 *** situ Raman spectroscopy reveals the presence of an LiO_(2)intermediate alongside Li_(2)O_(2)during oxygen *** situ X-ray diffraction confirm the ability of the SPE to hinder the permeation of oxygen and moisture,as demonstrated by the air permeability *** present study suggests that maintaining a low residual solvent while achieving high ionic conductivity is crucial for restricting the sub-reactions of solid-state LOBs.

关键词： Solid polymer electrolyte Lithium-oxygen batteries Polyrotaxane ion conductivity Hydrophobic chain

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Flexible Pavement Analysis Considering Temperature Profile and Anisotropy Behavior in Hot Mix Ashalt Layer

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Open Journal of Civil Engineering 2011年第2期1卷 7-12页

作者： Joonho Choi Youngguk Seo sung-hee kim Samuel Beadles 不详

A three Dimensional finite element model (FEM) incorporating the anisotropic properties and temperature profile of hot mix asphalt (HMA) pavement was developed to predict the structural responses of HMA pavement subject to heavy loads typically encountered in the field. In this study, ABAQUS was adopted to model the stress and strain relationships within the pavement structure. The results of the model were verified using data collected from the Korean Highway Corporation Test Road (KHCTR). The results demonstrated that both the base course and surface course layers follow the anisotropic behavior and the incorporation of the temperature profile throughout the pavement has a substantial effect on the pavement response predictions that impact pavement design. The results also showed that the anisotropy level of HMA and base material can be reduced to as low as 80% and 15% as a result of repeated loading, respectively.

关键词： Anisotropic Behavior Finite Element Method Aggregate Base HMA

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Comprehensive molecular characterization to predict immunotherapy response in advanced biliary tract cancer:a phase II trial of pembrolizumab

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Oncology Research 2025年第1期33卷 57-65页

作者： RYUL kim JOO KYUNG PARK MINSUK KWON MINAE AN JUNG YONG HONG JOON OH PARK sung hee LIM SEUNG TAE kim Division of Hematology-Oncology Department of MedicineSamsung Medical CenterSungkyunkwan University School of MedicineSeoulKorea Division of Gastroenterology Department of MedicineSamsung Medical CenterSungkyunkwan University School of MedicineSeoulKorea Department of Hematology-Oncology Ajou University School of MedicineSuwon-siGyeonggi-doKorea Samsung Advanced Institute of Health Science and Technology Sungkyunkwan University School of MedicineSeoulKorea

Background:Immune checkpoint inhibitors(ICIs)are effective in a subset of patients with metastatic solid ***,the patients who would benefit most from ICIs in biliary tract cancer(BTC)are still *** and methods:We molecularly characterized tissues and blood from 32 patients with metastatic BTC treated with the ICI pembrolizumab as second-line ***:All patients had microsatellite stable(MSS)type *** of the 32 patients achieved partial response(PR),with an objective response rate(ORR)of 9.4%(95%confidence interval[CI],2.0–25.2)and nine showed stable disease(SD),exhibiting a disease control rate(DCR)of 37.5%(95%CI,21.1–56.3).For the 31 patients who had access to PD-1 ligand 1(PD-L1)combined positive score(CPS)testing(cut-off value≥1%),the ORR was not different between those who had PD-L1-positive(PD-L1+;1/11,9.1%)and PDL1-(2/20,10.0%)tumors(p=1.000).The tumor mutational burden(TMB)of PD-L1+BTC was comparable to that of PD-L1-BTC(p=0.630).TMB and any exonic somatic mutations were also not predictive of pembrolizumab *** analysis of blood and tumor samples demonstrated a relatively high natural killer(NK)cell proportion in the peripheral blood before pembrolizumab treatment in patients who achieved tumor ***,the tumors of these patients presented high enrichment scores for NK cells,antitumor cytokines,and Th1 signatures,and a low enrichment score for cancer-associated ***:This study shows the molecular characteristics associated with the efficacy of pembrolizumab in BTC of the MSS type.

关键词： Pembrolizumab Whole-exome sequencing Whole-transcriptome sequencing Biliary tract cancer

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应用内镜直线型缝合器的腹腔镜食道空肠吻合术：293例经验分析

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中国普通外科杂志 2013年第4期22卷 398-400页

作者： Byung Sik kim hee sung kim 陈泓西李新营韩国蔚山大学医学院峨山医疗中心胃外科部

1引言由于其安全性和有效性，腹腔镜胃切除术正成为一种广泛使用的手术方法用于治疗早期胃癌（EGC）。在2002年推出后，完全腹腔镜胃切除术后应用腔内重建的几种手术方法已被用于提高和改善早期腹腔镜胃切除术的手术治疗效果。

关键词：胃肿瘤胃切除术,腹腔镜食管空肠吻合术视频

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