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Rare case of hepatocellular carcinoma metastasis to urinary bladder:A case report

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World Journal of Clinical Cases 2022年第16期10卷 5470-5478页

作者： Yohan Kim young Seok Kim Jeong-ju Yoo Sang Gyune Kim Susie Chin Ahrim Moon Department of Gastroenterology Soonchunhyang University Hospital BucheonBucheon B14200202Gyeonggi-doSouth Korea Division of Gastroenterology and Hepatology Department of Internal MedicineSoonchunhyang University Bucheon HospitalBucheon B14200202Gyeonggi-doSouth Korea Department of Pathology Soonchunhyang University Bucheon HospitalBucheon B14200202Gyeonggi-doSouth Korea Department of Pathology Soonchunhyang University Bucheon HospitalSoonchunhyang University College of MedicineBucheon B14200202Gyeonggi-doSouth Korea

BACKGROUND Hepatocellular carcinoma(HCC)is a primary liver cancer with high prevalence and *** are many cases of advanced HCC at the time of *** methods and prognosis are different depends on whether metastasis is ***,it is necessary to make an accurate evaluation at the time of *** metastases of HCC usually occur through hematogenous spread or through adjacent organs such as the *** to the urinary bladder alone is ***,we report a rare case of biopsy-proven solitary metastasis of HCC to the bladder in a 60-year-old *** SUMMARY A 60-year-old female patient was found to be positive for hepatitis B surface antigen by chance after abdominal ultrasonography showed abnormal ***,liver dynamic computed tomography(CT)was *** patient visited the hospital for further *** and CT showed 3.6 cm sized arterial enhancing mass in segment 5 and an infiltrative mass in segment *** patient was diagnosed with HCC through liver dynamic magnetic resonance imaging and liver ***,she underwent two transcatheter arterial chemoembolizations within five months for *** follow-up,a newly appeared bladder tumor was found on liver dynamic *** underwent transurethral resection of the bladder tumor for diagnosis and *** tissue was confirmed as metastatic *** Although rare,metastasis to urinary bladder from HCC can occur without evidence of other distant ***,regular follow-up imaging examination and clinical attention are required.

关键词： Hepatocellular carcinoma Metastasis Urinary bladder Case report

Sutureless contact lens-type amniotic membrane for persistent epithelial defects after infectious keratitis

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International Journal of Ophthalmology(English edition) 2022年第8期15卷 1404-1406页

作者： jung Hye Shin young-Ho jung Hyun Beom Song Mee Kum Kim Chang Ho Yoon Department of Ophthalmology Seoul National University Hospital101 Daehak-roJongno-guSeoul 03080Republic of Korea Department of Ophthalmology Seoul National University College of Medicine103 Daehak-roJongno-guSeoul 03080Republic of Korea Laboratory of Ocular Regenerative Medicine and Immunology Biomedical Research InstituteSeoul National University Hospital101 Daehak-roJongno-guSeoul 03080Republic of Korea Department of Medical Science Seoul National University College of Medicine103 Daehak-roJongno-guSeoul 03080Republic of Korea

Dear Editor,We are writing to present two case reports of persistent epithelial defect after infectious keratitis successfully treated with sutureless contact lens-type amniotic membrane(AM)*** keratitis is one of the leading causes of corneal *** disrupts the normal corneal healing process and induces inflammation,limbal cell dysfunction,and corneal surface irregularity,which can lead to corneal opacities or persistent epithelial defects(PEDs)[1].Untreated PED can cause corneal thinning,resulting in corneal perforation.

关键词： keratitis healing corneal

Morbidity analysis of left hepatic trisectionectomy for hepatobiliary disease and live donor

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Hepatobiliary & Pancreatic Diseases International 2022年第4期21卷 362-369页

作者： young-In Yoon Sung-Gyu Lee Deok-Bog Moon Shin Hwang Ki-Hun Kim Hui-ju Kim Ki-Hoon Choi Division of Hepatobiliary Surgery and Liver Transplantation Department of SurgeryAsan Medical CenterUniversity of Ulsan College of Medicine388-1 Poongnap-dongSongpa-guSeoul 138-736Korea Department of Surgery Gold Coast University HospitalSouthportQLD 4215Australia

Background:Despite remarkable advances in surgical techniques and perioperative management,left hepatic trisectionectomy(LHT)remains a challenging procedure with a somewhat high postoperative morbidity rate compared with less-extensive *** study aimed to analyze the short-and long-term outcomes of LHT and identify factors associated with the postoperative morbidity of this technically demanding surgical ***:The medical records of 53 patients who underwent LHT between june 2005 and October 2019 at a single institution were retrospectively *** independent prognostic factor of postoperative morbidity was analyzed using the logistic regression ***:Hepatocellular carcinoma was the most common indication for surgery(n=21),followed by hilar cholangiocarcinoma(n=14),intrahepatic cholangiocarcinoma(n=10),and other pathologies(including colorectal liver metastasis,hepatolithiasis,gallbladder cancer,living donor,hemangioma,and multilocular biliary cyst;n=8).The rates of postoperative morbidities of Clavien-Dindo grade 3 or higher and 90-day mortality were 39.6% and 1.9%,*** 1-,3-,and 5-year overall survival rates were 81.1%,61.4%,and 44.6%,*** analysis revealed that preoperative jaundice[hazard ratio(HR)=6.15,95%confidence interval(CI):1.57-24.17,P=0.009]and operative time>420 min(HR=4.66,95%CI:1.27–17.17,P=0.021)were independent predictors of postoperative ***:The in-hospital mortality of LHT surgery can be minimalized by a reliable preoperative evaluation of liver function and selection of the dominant anatomic features of right posterior sector,active and appropriate preoperative management for obstructive cholangitis and compensatory hypertrophy of the future remnant posterior sector,and the experience of the surgeon.

关键词： Left hepatic trisectionectomy Major hepatectomy Liver neoplasms Survival rate Morbidity

Paradoxical carbon dioxide embolism during laparoscopic hepatectomy without intracardiac shunt:A case report

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World Journal of Clinical Cases 2022年第9期10卷 2908-2915页

作者： Soeun Jeon Jeong-Min Hong Hyeon Jeong Lee Yesul Kim Hyunjong Kang Boo-young Hwang Dowon Lee young-hoon jung Department of Anesthesia and Pain Medicine Pusan National UniversitySchool of MedicineBusan 49241South Korea Biomedical Research Institute Pusan National University HospitalBusan 49241South Korea

BACKGROUND Laparoscopic hepatectomy has recently become popular because it results in less bleeding than open ***,CO_(2)embolism occurs more *** CO_(2)embolisms during laparoscopic surgery are self-resolving and non-symptomatic;however,severe CO_(2)embolism may cause hypotension,cyanosis,arrhythmia,and cardiovascular *** particular,paradoxical CO_(2)embolisms are highly likely to cause neurological *** report a case of paradoxical CO_(2)embolism found on transesophageal echocardiography(TEE)during laparoscopic hepatectomy,although the patient had no intracardiac *** SUMMARY A 71-year-old man was admitted for laparoscopic left *** left hepatic vein ligation,the inferior vena cava was accidentally *** observed a sudden drop in oxygen saturation to 85%,decrease in systolic blood pressure(SBP)below 90 mm Hg,and reduction in end-tidal CO_(2)to 24 mm Hg.A“mill-wheel”murmur was auscultated over the *** fraction of inspired oxygen was increased to 100%with 5 cm H2O of positive end-expiratory pressure(PEEP)and hyperventilation was *** infusion was increased to maintain SBP above 90 mm Hg.A TEE probe was inserted,revealing gas bubbles in the right side of the heart,left atrium,left ventricle,and ascending *** surgeon reduced the pneumoperitoneum pressure from 17 to 14 mm Hg and repaired the damaged vessel ***,the patient’s hemodynamic status *** patient was transferred to the intensive care unit,recovering well without *** TEE monitoring is important to quickly determine the presence and extent of embolism in patients undergoing laparoscopic hepatectomy.

关键词： Carbon dioxide Embolism Laparoscopy Pneumoperitoneum Transesophageal echocardiography Case report

Endovascular treatment of traumatic renal artery pseudoaneurysm with a Stanford type A intramural haematoma:A case report

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World Journal of Clinical Cases 2022年第27期10卷 9760-9767页

作者： Yook Kim Jin young Lee Jin Suk Lee Jin Bong Ye Se Heon Kim young Hoon Sul Su young Yoon jung Hee Choi Hanlim Choi Department of Radiology Chungbuk National University HospitalCheongju-si 28644Chungcheongbuk-doSouth Korea Department of Trauma Surgery Chungbuk National University HospitalCheongju-si 28644Chungcheongbuk-doSouth Korea Department of Trauma Surgery College of MedicineChungbuk National UniversityCheongju-si 28644Chungcheongbuk-doSouth Korea Cardiovascular and Thoracic Surgery Chungbuk National University HospitalCheongju-si 28644Chungcheongbuk-doSouth Korea Anesthesiology and Pain Medicine Chungbuk National University HospitalCheongju-si 28644Chungcheongbuk-doSouth Korea Department of Surgery Chungbuk National University HospitalCheongju-si 28644Chungcheongbuk-doSouth Korea

BACKGROUND Aortic intramural hematoma(IMH) associated with aortic branch tear and intramurally located pseudoaneurysm after blunt trauma has not been ***,we report a case of progressive type A aortic IMH associated with a pseudoaneurysm arising from the injured proximal renal artery after blunt *** SUMMARY During logging operations,a 66-year-old man experienced blunt force trauma after being injured by a fallen *** arrived at our trauma center with a left flank pain *** tomography(CT) revealed a pseudoaneurysm arising from the proximal renal artery(localized within the aortic media) and Stanford type A IMH.A covered stent was deployed along the left main renal artery,bridging the pseudoaneurysm and covering the parent artery,successfully excluding the pseudoaneurysm as confirmed using ***,although the degree of the pseudoaneurysm decreased,follow-up CT revealed remnant pseudoaneurysm,likely caused by an ***,a covered stent was additionally installed through the previously deployed covered *** exclusion of the pseudoaneurysm was confirmed using final *** the 7-mo follow-up CT scan,the IMH and pseudoaneurysm completely disappeared with no evidence of stent-related *** Endovascular treatment such as stent-graft placement can be an effective and safe treatment for traumatic renal artery injury.

关键词： Aortic intramural hematoma Blunt trauma Intimomedial tear Renal arterial injury Stent-graft Case report

An Effective Threat Detection Framework for Advanced Persistent Cyberattacks

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Computers, Materials & Continua 2023年第5期75卷 4231-4253页

作者： So-Eun Jeon Sun-Jin Lee Eun-young Lee Yeon-Ji Lee jung-Hwa Ryu jung-Hyun Moon Sun-Min Yi Il-Gu Lee Department of Future Convergence Technology Engineering Sungshin Women’s UniversitySeoul02844Korea Department of Convergence Security Engineering Sungshin Women’s UniversitySeoul02844Korea

Recently,with the normalization of non-face-to-face online environments in response to the COVID-19 pandemic,the possibility of cyberattacks through endpoints has *** endpoint devices are managed meticulously to prevent cyberattacks and ensure timely responses to potential security *** particular,because telecommuting,telemedicine,and teleeducation are implemented in uncontrolled environments,attackers typically target vulnerable endpoints to acquire administrator rights or steal authentication information,and reports of endpoint attacks have been increasing *** persistent threats(APTs)using various novel variant malicious codes are a form of a sophisticated ***,conventional commercial antivirus and anti-malware systems that use signature-based attack detectionmethods cannot satisfactorily respond to such *** this paper,we propose a method that expands the detection coverage inAPT attack *** this model,an open-source threat detector and log collector are used synergistically to improve threat detection *** the scope of attack log collection through interworking between highly accessible open-source tools can efficiently increase the detection coverage of tactics and techniques used to deal with APT attacks,as defined by MITRE Adversarial Tactics,Techniques,and Common Knowledge(ATT&CK).We implemented an attack environment using an APT attack scenario emulator called Carbanak and analyzed the detection coverage of Google Rapid Response(GRR),an open-source threat detection tool,and Graylog,an open-source log *** proposed method expanded the detection coverage against MITRE ATT&CK by approximately 11%compared with that conventional methods.

关键词： Advanced persistent threat cybersecurity endpoint security MITRE ATT&CK open-source threat detector threat log collector

Dynamic Changes in Left and Right Cerebral Oxygen Saturation during Selective Cerebral Perfusion in young Infants

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Congenital Heart Disease 2023年第6期18卷 639-647页

作者： Hwa-young Jang Sang-jun Beon Sung-Hoon Kim In-Kyung Song Won-jung Shin Department of Anesthesiology and Pain Medicine Laboratory for Cardiovascular DynamicsAsan Medical CenterUniversity of Ulsan College of MedicineSeoul05505Korea Department of Physician Education and Training Asan Medical CenterSeoul05505Korea

Objectives:We investigated whether the selective cerebral perfusion(SCP)technique causes differences in changes in cerebral perfusion between both hemispheres in young infants,using cerebral oxygen saturation(ScO2)as an ***,we determined the association between the discrepancy in ScO2 and cerebral perfu-sion pressure during ***:The difference in ScO2 between the left and right cerebral hemispheres(ΔScO2 Rt-Lt)was calculated during clamping of the innominate artery(IA)and during ***:In 25 infants(aged 2 to 78 days),the left and right ScO2 were well maintained(median 63.2%and 60.9%during IA clamping,respectively;64.0%and 65.6%during SCP,respectively).During IA clamping,right and left ScO2 decreased(med-ian-1.4%and-1.0%,respectively).During SCP,rightΔScO2 was higher compared to leftΔScO2(median 1.5%vs.0.6%;pyoung infants;this may depend on the perfusion pressure.

关键词： Cerebral circulation congenital heart defects monitoring near-infrared spectroscopy

Clinical outcomes of endoscopic resection of superficial nonampullary duodenal epithelial tumors: A 10-year retrospective, single-center study

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World Journal of Gastrointestinal Surgery 2022年第4期14卷 329-340页

作者： Joon Hyun Cho Ki young Lim Eun jung Lee Si Hyung Lee Division of Gastroenterology and Hepatology Department of Internal MedicineYeungnam University College of MedicineDaegu 42415South Korea

BACKGROUND Although premalignant duodenal lesions such as adenomas are uncommon,the incidences of these lesions have increased in recent times,and thus,the demand for minimally invasive treatments such as endoscopic resection(ER)has also ***,ER in the duodenum is more challenging than ER in other locations of the gastrointestinal *** To evaluate the safety and efficacy of ER for superficial nonampullary duodenal epithelial tumors(SNADETs)METHODS We performed a retrospective observational study on 56 consecutive patients(58 lesions)diagnosed with SNADETs that underwent ER from January 2011 to December 2020 at Yeungnam University *** demographics,lesion characteristics,and procedural and technical data were collected,and clinical outcomes,including procedure-related complications,completeness of resection,and recurrence were *** Median patient age was 57 years[range,26–77,30(53.6%)men].Endoscopic mucosal resection(EMR)was performed on 57 lesions(98.3%)and snare polypectomy on one(1.7%).Lesions consisted of 52 adenomas with low-grade dysplasia(89.7%),3 adenomas with high-grade dysplasia(5.2%),and 3 intramucosal adenocarcinomas(5.2%).There were 16 cases of intraprocedural bleeding(27.6%)and 1 case of delayed bleeding(1.7%),and all these 17 cases were successfully managed *** perforation or procedure-related death *** lesion size was associated with an increased risk of EMR-related bleeding(P=0.033).During a median follow-up period of 23 mo(range 6–100 mo),no local recurrence occurred,despite the fact one-third of the patients(19 lesions,32.8%)underwent piecemeal resection and 3 patients(3 lesions,5.2%)that underwent en bloc resection had a pathologically determined positive lateral *** patient died from a primary duodenal *** The majority of SNADETs can be safely and curatively resected by EMR,and thus,based on consideration of the high incidence of fatal complications attribut

关键词： Duodenum Adenoma Endoscopic mucosal resection Endoscopic resection Superficial nonampullary duodenal epithelial tumor

Ankle and toe weakness caused by calcified ligamentum flavum cyst: A case report

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World Journal of Clinical Cases 2023年第35期11卷 8392-8398页

作者： Ho-young jung Geon-U Kim Yong-Won Joh jun-Seok Lee Department of Orthopedic Surgery Eunpyeong St.Mary’s HospitalCollege of MedicineThe Catholic University of KoreaSeoul 03312South Korea

BACKGROUND Ligamentum flavum cysts,which are most common in mobile junctional levels of the spine,can be a rare cause of spinal *** have been several case reports of ligamentum flavum ***,there is yet to be a documented case report of a calcified ligamentum flavum ***,we report the first case of a calcified ligamentum flavum cyst causing ankle and toe *** SUMMARY A 66-year-old male visited our hospital complaining of claudication as well as thigh and calf pain in his left leg,all beginning two weeks *** examination revealed motor weakness of the left ankle dorsiflexion and great toe *** spinal computed tomography scans showed spinal stenosis combined with a calcified mass at the left side of the L4-5 *** reso-nance imaging showed dural sac compression caused by the calcified mass at the left ligamentum flavum of the L4-5 *** performed decompressive laminectomy and excision of the calcified mass combined with posterior lumbar interbody fusion at the L4-5 ***-operatively,we found a firm and nodule like mass originating from the ventral surface of ligamentum *** examination suggested a calcified pseudocyst without a capsular *** the operation,the patient’s motor weakness in the ankle and great toe improved *** The patient’s ankle and great toe weakness were improved successfully after surgical removal of the calcified cyst.

关键词： Ligamentum flavum Calcified cyst Spinal stenosis Claudication Motor weakness Spine Case report