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Learning models for endoscopic ultrasonography in gastrointestinal endoscopy

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World Journal of Gastroenterology 2015年第17期21卷 5176-5182页

作者： Gwang ha Kim Sung Jo Bang joo ha hwang Department of Internal Medicine Pusan National University School of Medicine Biomedical Research Institute Pusan National University HospitalBusan 602-739South Korea Department of Internal Medicine Ulsan University Hospital University of Ulsan College of Medicine Ulsan 682-714South Korea Division of Gastroenterology Department of MedicineUniversity of WashingtonSeattleWA 98104United States

Endoscopic ultrasonography(EUS) has become a useful diagnostic and therapeutic modality in gastrointestinal ***,EUS requires additional training since it requires simultaneous endoscopic manipulation and ultrasonographic *** adequate EUS training can be challenging since EUS is highly operator-dependent and training on actual patients can be associated with an increased risk of complications including inaccurate ***,several models have been developed to help facilitate training of *** models currently available for EUS training include computer-based simulators,phantoms,ex vivo models,and live animal *** each model has its own merits and limitations,the value of these different models is rather complementary than ***,there is a lack of objective data regarding the efficacy of each model with recommendations on the use of various training models based on expert opinion ***,objective studies evaluating the efficacy of various EUS training models on technical and clinical outcomes are still needed.

关键词： Endoscopic ultrasonography Training Phantom Computer simulation Animal model

Gastric per-oral endoscopic myotomy: Current status and future directions

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World Journal of Gastroenterology 2019年第21期25卷 2581-2590页

作者： Alexander Podboy joo ha hwang Linda A Nguyen Patricia Garcia Thomas A Zikos Afrin Kamal George Triadafilopoulos John O Clarke Division of Gastroenterology and Hepatology Stanford University School of Medicine

Gastroparesis, or symptomatic delayed gastric emptying in the absence of mechanical obstruction, is a challenging and increasingly identified syndrome. Medical options are limited and the only medication approved by the Food and Drug Administration for treatment of gastroparesis is metoclopramide, although other agents are frequently used off label. With this caveat, first-line treatments for gastroparesis include dietary modifications, antiemetics and promotility agents, although these therapies are limited by suboptimal efficacy and significant medication side effects. Treatment of patients that fail first-line treatments represents a significant therapeutic challenge. Recent advances in endoscopic techniques have led to the development of a promising novel endoscopic therapy for gastroparesis via endoscopic pyloromyotomy, also referred to as gastric per-oral endoscopic myotomy or per-oral endoscopic pyloromyotomy. The aim of this article is to review the technical aspects of the per-oral endoscopic myotomy procedure for the treatment of gastroparesis, provide an overview of the currently published literature, and outline potential next directions for the field.

关键词： Gastroparesis Gastric per-oral endoscopic myotomy Per-oral endoscopic pyloromyotomy Myotomy Endoscopic myotomy Peroral endoscopic myotomy Gastric emptying

Magnetic resonance imaging biomarkers for pulsed focused ultrasound treatment of pancreatic ductal adenocarcinoma

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World Journal of Gastroenterology 2020年第9期26卷 904-917页

作者： Ezekiel Maloney Yak-Nam Wang Ravneet Vohra Helena Son Stella Whang Tatiana Khokhlova Joshua Park Kayla Gravelle Stephanie Totten joo ha hwang Donghoon Lee Department of Radiology University of WashingtonSeattleWA 98195United States Applied Physics Laboratory University of WashingtonSeattleWA 98195United States Division of Gastroenterology University of WashingtonSeattle 98195WAUnited States Division of Gastroenterology&Hepatology Stanford University School of MedicineRedwood CityCA 94063United States

BACKGROUND The robust fibroinflammatory stroma characteristic of pancreatic ductal adenocarcinoma(PDA)impedes effective drug *** focused ultrasound(pFUS)can disrupt this stroma and has improved survival in an early clinical ***-invasive methods to characterize pFUS treatment effects are desirable for advancement of this promising treatment modality in larger clinical *** To identify promising,non-invasive pre-clinical imaging methods to characterize acute pFUS treatment effects for in vivo models of *** We utilized quantitative magnetic resonance imaging methods at 14 tesla in three mouse models of PDA(subcutaneous,orthotopic and transgenic-KrasLSLG12D/+,Trp53LSL-R172H/+,Cre or“KPC”)to assess immediate tumor response to pFUS treatment(VIFU 2000 Alpinion Medical Systems;475 W peak electric power,1 ms pulse duration,1 Hz,duty cycle 0.1%)vs sham therapy,and correlated our results with histochemical *** pFUS treatment parameters were previously shown to enhance tumor permeability to chemotherapeutics.T1 and T2 relaxation maps,high(126,180,234,340,549)vs low(7,47,81)b-value apparent diffusion coefficient(ADC)maps,magnetization transfer ratio(MTR)maps,and chemical exchange saturation transfer(CEST)maps for the amide proton spectrum(3.5 parts per million or“ppm”)and the glycosaminoglycan spectrum(0.5-1.5 ppm)were generated and analyzed pre-treatment,and immediately post-treatment,using *** were sacrificed immediately following post-treatment *** whole-tumor was selected as the region of interest for data analysis and subsequent statistical analysis.T-tests and Pearson correlation were used for statistical *** Mean high-b value ADC measurements increased significantly with pFUS treatment for all *** glycosaminoglycan CEST and T2 measurements decreased significantly post-treatment for the KPC *** MTR and amide CEST values increased significantly for the KPC *** acid focal int

关键词： Pancreatic adenocarcinoma Multiparametric magnetic resonance imaging Focused ultrasound

Multicenter evaluation of recurrence in endoscopic submucosal dissection and endoscopic mucosal resection in the colon:A Western perspective

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World Journal of Gastrointestinal Endoscopy 2023年第6期15卷 458-468页

作者： Mike T Wei Margaret J Zhou Andrew A Li Andrew Ofosu joo ha hwang Shai Friedland Department of Gastroenterology and Hepatology Stanford University Medical CenterPalo AltoCA 94306United States Department of Gastroenterology University of Cincinnati College of MedicineCincinnatiOH 45267United States

BACKGROUND While colon endoscopic mucosal resection(EMR)is an effective technique,removal of larger polyps often requires piecemeal resection,which can increase recurrence *** submucosal dissection(ESD)in the colon offers the ability for en bloc resection and is well-described in Asia,but there are limited studies comparing ESD vs EMR in the *** To evaluate different techniques in endoscopic resection of large polyps in the colon and to identify factors for *** The study is a retrospective comparison of ESD,EMR and knife-assisted endoscopic resection performed at Stanford University Medical Center and Veterans Affairs Palo Alto Health Care System between 2016 and ***-assisted endoscopic resection was defined as use of electrosurgical knife to facilitate snare resection,such as for circumferential ***≥18 years of age undergoing colonoscopy with removal of polyp(s)≥20 mm were *** primary outcome was recurrence on *** A total of 376 patients and 428 polyps were *** polyp size was greatest in the ESD group(35.8 mm),followed by knife-assisted endoscopic resection(33.3 mm)and EMR(30.5 mm)(Phad follow-up(67.1%).On follow-up analysis,recurrence rate was lowest in knife-assisted endoscopic resection(0.0%)and ESD(1.3%)and highest in EMR(12.9%)(P=0.0017).En bloc polyp resection had significantly lower rate of recurrence(1.9%)compared to non-en bloc(12.0%,P=0.003).On multivariate analysis,ESD(in comparison to EMR)adjusted for polyp size was found to significantly reduce risk of recurrence[adjusted hazard ratio 0.06(95%CI:0.01-0.57,P=0.014)].CONCLUSION In our study,EMR had significantly higher recurrence compared to ESD and knife-assisted endoscopic *** found factors including resection by ESD,en bloc removal,and use of circumferentia

关键词： Endoscopic mucosal resection Endoscopic submucosal dissection Recurrence Colonoscopy Polypectomy

In vivo hyperthermia effect induced by high-intensity pulsed ultrasound

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Chinese Physics B 2012年第7期21卷 352-358页

作者：崔炜程屠娟 hwang joo-ha 李倩范庭波章东陈静海陈伟中 Key Laboratory of Modern Acoustics MOEand Institute of AcousticsNanjing University Center for Industrial and Medical Ultrasound Applied Physics LaboratoryUniversity of Washington Department of Cardiology of Children's Hospital Boston Harvard Medical School

Hyperthermia effects （39-44 ℃） induced by pulsed high-intensity focused ultrasound （HIFU） have been regarded as a promising therapeutic tool for boosting immune responses or enhancing drug delivery into a solid tumor. However, previous studies also reported that the cell death occurs when cells are maintained at 43 ℃ for more than 20 minutes. The aim of this study is to investigate thermal responses inside in vivo rabbit auricular veins exposed to pulsed HIFU （1.17 MHz, 5300 W/cm2, with relatively low-duty ratios （0.2%-4.3%）. The results show that：（1） with constant pulse repetition frequency （PRF）（e.g., 1 Hz）, the thermal responses inside the vessel will increase with the increasing duty ratio; （2） a temperature elevation to 43 ℃ can be identified at the duty ratio of 4.3%; （3） with constant duty ratios, the change of PRF will not significantly affect the temperature measurement in the vessel; （4） as the duty ratios lower than 4.3%, the presence of microbubbles will not significantly enhance the thermal responses in the vessel, but will facilitate HIFU-induced inertial cavitation events.

关键词： hyperthermia effects high-intensity focused ultrasound duty ratio ultrasound contrastagents

Selective catalytic NO_x reduction on Antimony promoted V_2O_5-Sb/TiO_2 catalyst

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Rare Metals 2006年第Z2期25卷 84-88页

作者： ha Heon Phil CHUNG Soon Hyo OH Young joo Metal Processing Research Center Korea Institute of Science and Technology Cheongryang Seoul 130-650 Republic of Korea

Quantum chemical calculation was carried out to choose a promoter which can reduce the poisoning of V2O5/TiO2 catalysts by SO2. Several atoms were chosen as candidates and new catalysts were synthesized by impregnation method. The NOx conversion rate was measured at temperatures between 100 and 400 ℃ and poisoning effect was investigated. The most promising candidate promoter, Se, was excluded because of its high vapor pressure. On the other hand, Sb shows best promoting properties. Sb promoted catalyst reaches the maximum NOx conversion rate at 250 ℃. It also shows considerably enhanced resistance to poisoning of V2O5/TiO2 catalysts by SO2.

关键词： De NOx selective catalytic reduction SO2 poisoning low temperature activity

Choroidal and skin metastases from colorectal cancer

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World Journal of Gastroenterology 2016年第43期22卷 9650-9653页

作者： joo Young ha Edward Hynseung Oh Moon Ki Jung Song Ee Park Ji Tak Kim In Gyu hwang Department of Internal Medicine Chung-Ang University College of Medicine Department of Internal Medicine Division of Hemato-oncology Chung-Ang University College of Medicine Department of Ophthalmology Chung-Ang University College of Medicine

Choroidal and skin metastasis of colon cancer is rare. In women, the frequency of cutaneous metastasis from colon cancer as the primary lesion in is 9% and skin metastasis occurs in 0.81% of all colorectal cancers. We report a patient with colonic adenocarcinoma who presented with visual disorder in her right eye and scalp pain as her initial symptoms. Contrast-enhance orbital magnetic resonance imaging with fat suppression revealed an infrabulbar mass, and skin biopsy of the posterior parietal scalp confirmed adenocarcinoma. These symptoms were diagnosed as being caused by choroidal and skin metastases of colonic adenocarcinoma. We started palliative chemotherapy with oral capecitabine(1000 mg/m2, twice a day, on days 1-14) every 3 wk, which was effective at shrinking the brain masses and improving the visual disorder. This is the first report that capecitabine is effective at reducing a choroidal and cutaneous metastatic lesion from rightsided colorectal cancer.

关键词： Colon cancer Choroid cancer Skin cancer Capecitabine

Surface properties of Al-doped ZnO thin film before and after CF_4/Ar plasma etching

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Plasma Science and Technology 2022年第7期24卷 194-200页

作者： Young-Hee joo Gwan-ha KIM Doo-Seung UM Chang-Il KIM School of Electrical and Electronics Engineering Chung-Ang UniversitySeoul 06974Republic of Korea Department of Semiconductor Materials and Applications Korea PolytechnicSeongnam 13122Republic of Korea Department of Electrical Engineering Sejong UniversitySeoul 05006Republic of Korea

Al-doped ZnO(AZO) is considered as an alternative to transparent conductive oxide *** and achieving a stable surface are important challenges in the development and optimization of dry etching processes, which must be overcome for the application of AZO in various devices. Therefore, in this study, the etch rate and surface properties of an AZO thin film after plasma etching using the adaptive coupled plasma system were investigated. The fastest etch rate was achieved with a CF_(4)/Ar ratio of 50:50 sccm. Regardless of the ratio of CF_(4) to Ar,the transmittance of the film in the visible region exceeded 80%. X-ray photoelectron spectroscopy analysis of the AZO thin film confirmed that metal-F bonding persists on the surface after plasma etching. It was also shown that F eliminates O vacancies. Consequently, the work function and bandgap energy increased as the ratio of CF-4 increased. This study not only provides information on the effect of plasma on AZO thin film, but identifies the cause of changes in the device characteristics during device fabrication.

关键词： Al-doped ZnO plasma etching F-based plasma surface characteristics X-ray photoelectron spectroscopy ultraviolet photoelectron spectroscopy

Cavernous mesenteric lymphangiomatosis mimicking metastasis in a patient with rectal cancer:A case report

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World Journal of Gastroenterology 2009年第31期15卷 3947-3949页

作者： Seong Su hwang Hyun joo Choi Soo Youn Park Department of Radiology St.Vincent's HospitalCollege of MedicineThe Catholic University of Korea Department of Pathology St.Vincent's HospitalCollege of MedicineThe Catholic University of Korea

Lymphangioma usually occurs in children and usually involves the skin. Mesenteric lymphangioma is extremely rare in adults. Typically, lymphangioma appears on computed tomography (CT) as a lower attenuation of a cystic mass, however, some cases appear to be a solid mass. We describe the CT and 18F-FDG positron emission tomography/CT appearance in a case of jejunal and mesenteric cavernous lymphangi-omatosis mimicking metastasis in an adult patient with rectal cancer.

关键词： Lymphangioma Lymphangiomatosis Mesentern/ Small intestine Computed tomography 18F-FDG positron emission tomography/computed tomography