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Risk prediction platform for pancreatic fistula after pancreatoduodenectomy using artificial intelligence

World Journal of Gastroenterology 2020年第30期26卷 4453-4464页

作者： In Woong Han Kyeongwon Cho Youngju Ryu Sang Hyun Shin Jin Seok Heo Dong Wook Choi Myung Jin Chung oh chul kwon Baek Hwan Cho Department of Surgery Samsung Medical CenterSungkyunkwan University School of MedicineSeoul 06351South Korea Medical Artificial Intelligence Research Center Department of Medical Device Management and ResearchSAIHSTSamsung Medical CenterSungkyunkwan University School of MedicineSeoul 06351South Korea Department of Radiology Samsung Medical CenterSungkyunkwan University School of MedicineSeoul 06351South Korea Artificial Intelligence Research Center Medical DataBase IncorporatedSeoul 06048South Korea

BACKGROUND Despite advancements in operative technique and improvements in postoperative managements,postoperative pancreatic fistula(POPF)is a life-threatening complication following pancreatoduodenectomy(PD).There are some reports to predict POPF preoperatively or intraoperatively,but the accuracy of those is questionable.Artificial intelligence(AI)technology is being actively used in the medical field,but few studies have reported applying it to outcomes after PD.AIM To develop a risk prediction platform for POPF using an AI model.METHODS Medical records were reviewed from 1769 patients at Samsung Medical Center who underwent PD from 2007 to 2016.A total of 38 variables were inserted into AI-driven algorithms.The algorithms tested to make the risk prediction platform were random forest(RF)and a neural network(NN)with or without recursive feature elimination(RFE).The median imputation method was used for missing values.The area under the curve(AUC)was calculated to examine the discriminative power of algorithm for POPF prediction.RESULTS The number of POPFs was 221(12.5%)according to the International Study Group of Pancreatic Fistula definition 2016.After median imputation,AUCs using 38 variables were 0.68±0.02 with RF and 0.71±0.02 with NN.The maximal AUC using NN with RFE was 0.74.Sixteen risk factors for POPF were identified by AI algorithm:Pancreatic duct diameter,body mass index,preoperative serum albumin,lipase level,amount of intraoperative fluid infusion,age,platelet count,extrapancreatic location of tumor,combined venous resection,co-existing pancreatitis,neoadjuvant radiotherapy,American Society of Anesthesiologists’score,sex,soft texture of the pancreas,underlying heart disease,and preoperative endoscopic biliary decompression.We developed a web-based POPF prediction platform,and this application is freely available at http://popfrisk.***.org.CONCLUSION This study is the first to predict POPF with multiple risk factors using AI.This platform is reliable(AUC 0.74),so it could be used to select pat

关键词： Postoperative pancreatic fistula Pancreatoduodenectomy Neural networks Recursive feature elimination

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Parasitic leiomyoma in the trocar site after laparoscopic myomectomy:A case report

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World Journal of Clinical Cases 2022年第9期10卷 2895-2900页

作者： chul Kyu Roh Hyuk-Jae kwon Min Jung Jung Department of Surgery National Police HospitalSeoul 05715South Korea Department of Surgery Ajou University School of MedicineSuwon 16499South Korea Department of Pathology College of MedicineThe Catholic University of KoreaSeoul 06591South Korea

BACKGROUND Laparoscopic myomectomy is increasingly used for resecting gynecological tumors.Leiomyomas require morcellation for retrieval from the peritoneal cavity.However,morcellated fragments may implant on the peritoneal cavity during retrieval.These fragments may receive a new blood supply from an adjacent structure and develop into parasitic leiomyomas.Parasitic leiomyomas can occur spontaneously or iatrogenically;however,trocar-site implantation is an iatrogenic complication of laparoscopic uterine surgery.We describe a parasitic leiomyoma in the trocar-site after laparoscopic myomectomy with power morcellation.CASE SUMMARY A 50-year-old woman presented with a palpable abdominal mass without significant medical history.The patient had no related symptoms,such as abdominal pain.Computed tomography findings revealed a well-defined contrast-enhancing mass measuring 2.2 cm,and located on the trocar site of the left abdominal wall.She had undergone laparoscopic removal of uterine fibroids with power morcellation six years ago.The differential diagnosis included endometriosis and neurogenic tumors,such as neurofibroma.The radiologic diagnosis was a desmoid tumor,and surgical excision of the mass on the abdominal wall was successfully performed.The patient recovered from the surgery without complications.Histopathological examination revealed that the specimen resected from the trocar site was a uterine leiomyoma.CONCLUSION Clinicians should consider the risks and benefits of laparoscopic vs laparotomic myomectomy for gynecological tumors.Considerable caution must be exercised for morcellation to avoid excessive tissue fragmentation.

关键词： Laparoscopic myomectomy Parasitic leiomyoma Trocar site Implantation Morcellation Case report

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Coupled CUBIC Congestion Control for MPTCP in Broadband Networks

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Computer Systems Science & Engineering 2023年第4期45卷 99-115页

作者： Jae Yong Lee Byung chul Kim Youngmi kwon Kimoon Han Department of Information and Communications Engineering Chungnam National UniversityDaejeon34134Korea Agency for Defense Development Daejeon34186Korea

Recently,multipath transmission control protocol(MPTCP)was standardized so that data can be transmitted through multiple paths to utilize all available path bandwidths.However,when high-speed long-distance networks are included in MPTCP paths,the traffic transmission performance of MPTCP is severely deteriorated,especially in case the multiple paths’characteristics are heavily asymmetric.In order to alleviate this problem,we propose a“Coupled CUBIC congestion control”that adopts TCP CUBIC on a large bandwidth-delay product(BDP)path in a linked increase manner for maintaining fairness with an ordinary TCP traversing the same bottleneck path.To verify the performance excellence of the proposed algorithm,we implemented the Coupled CUBIC Congestion Control into Linux kernels by modifying the legacy MPTCP linked-increases algorithm(LIA)congestion control source code.We constructed asymmetric heterogeneous network testbeds mixed with large and small BDP paths and compared the performances of LIA and Coupled CUBIC by experiments.Experimental results show that the proposed Coupled CUBIC utilizes almost over 80%of the bandwidth resource in the high BDP path,while the LIA utilizes only less than 20%of the bandwidth for the same path.It was confirmed that the resource utilization and traffic transmission performance have been greatly improved by using the proposed Coupled CUBIC in high-speed multipath networks,as well as maintaining MPTCP fairness with competing single-path CUBIC or Reno TCP flows.

关键词： MPTCP congestion control Coupled CUBIC high BDP network

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Free ubiquitin: a novel therapeutic target for neurodegenerative diseases

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Neural Regeneration Research 2021年第9期16卷 1781-1782页

作者： chul-Woo Park kwon-Yul Ryu Department of Life Science University of SeoulSeoulRepublic of Korea

Neurodegenerative diseases are widespread and the increasing number of patients with these diseases can no longer be ignored. Dementia is a symptom of many neurodegenerative diseases, and Alzheimer's disease(AD), which is associated with memory and learning disabilities, accounts for approximately 60 to 80% of all dementia cases(Wyss-Coray, 2016).

关键词： diseases degenerative Alzheimer

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Favorable surgical treatment outcomes for chronic constipation with features of colonic pseudo-obstruction

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World Journal of Gastroenterology 2012年第32期18卷 4441-4446页

作者： Eon chul Han Heung-kwon oh Heon-Kyun Ha Eun Kyung Choe Sang Hui Moon Seung-Bum Ryoo Kyu Joo Park Department of Surgery Seoul National University College of MedicineSeoul 110-744South Korea Seoul National University Hospital Gangnam Center Seoul 110-744South Korea

AIM:To determine long-term outcomes of surgical treatments for patients with constipation and features of colonic pseudo-obstruction.METHODS:Consecutive 42 patients who underwent surgery for chronic constipation within the last 13 years were prospectively collected.We identified a subgroup with colonic pseudo-obstruction(CPO) features,with dilatation of the colon proximal to the narrowed transitional zone,in contrast to typical slowtransit constipation(STC),without any dilated colonic segments.The outcomes of surgical treatments for chronic constipation with features of CPO were analyzed and compared with outcomes for STC.RESULTS:Of the 42 patients who underwent surgery for constipation,33 patients had CPO with dilatation of the colon proximal to the narrowed transitional zone.There were 16 males and 17 females with a mean age of 51.2 ± 16.1 years.All had symptoms of chronic intestinal obstruction,including abdominal distension,pain,nausea,or vomiting,and the mean duration of symptoms was 67 mo(range:6-252 mo).Preoperative defecation frequency was 1.5 ± 0.6 times/wk(range:1-2 times/wk).Thirty-two patients underwent total colectomy,and one patient underwent diverting transverse colostomy.There was no surgery-related mortality.Postoperative histologic examination showed hypoganglionosis or agangliosis in 23 patients and hypoganglionosis combined with visceral neuropathy or myopathy in 10 patients.In contrast,histology of STC group revealed intestinal neuronal dysplasia type B(n = 6) and visceral myopathy(n = 3).Early postoperative complications developed in six patients with CPO;wound infection(n = 3),paralytic ileus(n = 2),and intraabdominal abscess(n = 1).Defecation frequencies 3 mo after surgery improved to 4.2 ± 3.2 times/d(range:1-15 times/d).Long-term follow-up(median:39.7 mo) was available in 32 patients;all patients had improvements in constipation symptoms,but two patients needed intermittent medication for management of diarrhea.All 32 patients had distinct improvements in constipation symptoms(with a mea

关键词：手术治疗肠梗阻结肠便秘慢性假性平均年龄 CPO

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Suppression of gold nanoparticle agglomeration and its separation via nylon membranes

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Chinese Journal of Chemical Engineering 2017年第7期25卷 931-937页

作者： Ayyavoo Jayalakshmi In-chul Kim Young-Nam kwon School of Urban and Environmental Engineering Ulsan National Institute of Sdence and TechnologyUlsan 689-798Korea KIST-UNIST UIsan Center for Convergent Materials UNIST(Ulsan National Institute of Science and Technology)Korea Environment and Resources Research Center Korea Research Institute Chemical TechnologyDaejeon 305-606Korea

Use of ultraporous nylon membrane is one of the most widely employed techniques for removal of hard and soft nanoparticles in the semiconductor industry, and the accurate determination of membrane pore size is necessary in order to avoid manufacturing defects caused by contamination. The gold nanoparticle has several benefits for the evaluation of polymeric membranes; however, the nanoparticles agglomerate easily on the nylon membrane and make it difficult to evaluate the membrane precisely. The properties of 2-amino-2-hydroxymethyl-1,3-propanediol(ADP) ligand in gold nanoparticle solution were systematically investigated, and ADP was utilized for improved evaluation of the nylon membranes. Nylon membrane used in this study was prepared by phase inversion techniques. Ultrathin dense layer on top of the membrane surface and Darcy structures in the microporous membrane support were observed. The gold particle rejection was carried out at various p H values from 4 to14 and higher rejection was observed at p H 4 and 8. The suppression of gold colloid agglomeration using ADP and monodispersity of gold colloids was also analyzed by confocal laser scanning microscopy(CLSM), transmission electron microscopy(TEM), and scanning electron microscopy(SEM). van der Waals interaction energy of the particles was reduced in the addition of ADP. The presence of ADP ligand in the gold solutions prevented the agglomeration of gold nanoparticles and reduced the adsorption of the particles on the nylon membrane surface,leading to precise evaluation of membrane pore sizes.

关键词：纳米金粒子尼龙膜膜分离共聚焦激光扫描显微镜金纳米颗粒透射电子显微镜扫描电子显微镜半导体工业

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Microenvironmental regulation of stem cells injected in the area at risk of neurodegenerative diseases

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BIOCELL 2022年第10期46卷 2231-2234页

作者： JU HYUNG LEE IL-kwon KIM SANG WOO KIM SOYEON LIM SEAHYOUNG LEE KI-chul HWANG BYEONG-WOOK SONG Graduate Program of Biomedical Engineering Yonsei UniversitySeoul03722Korea Institute for Bio-Medical Convergence College of MedicineCatholic Kwandong UniversityGangwon-do25601Korea Department for Medical Science College of MedicineCatholic Kwandong UniversityGangwon-do25601Korea

The complex mechanism of degenerative diseases and the non-specific modulation of regenerative targets aretopics that need to be elucidated in order to advance the use of stem cells in improvement of neurodegenerative diseases.From pre-transplantation through post-transplantation, there are many changes in the conditions, both inside andoutside of the stem cells that have not been carefully considered. This has hindered development in the field of celltherapy and regeneration. This viewpoint highlights the potential implications of intracellular and extracellularalterations of stem cells in transplanted areas at risk of neurodegenerative disease.

关键词： Cell therapy Microenvironment Neurodegenerative disease Stem cells

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Trends in the incidence of cryptorchidism and hypospadias of registry-based data in Korea： a comparison between industrialized areas of petrochemical estates and a non-industrialized area

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Asian Journal of Andrology 2011年第5期13卷 715-718页

作者： Sae chul Kim Su Kyoung kwon Yeon Pyo Hong Department of Urology Chung-Ang University College of Medicine Seoul 156-756 Korea Department of Preventive Medicine Chung-Ang University College of Medicine Seoul 156-756 Korea

This study aimed to represent the recent trends in the nationwide incidence of cryptorchidism and hypospadias in Korea, and to determine whether there is evidence of spatial heterogeneity in the incidence. The incidence was calculated as the number of newly diagnosed patients （males） during the first 4 years after a live birth in a population, nationally and regionally （a non-industrialized area （Chuncheon） and petrochemical estates （Yeocheon and Ulsan））, between 2000 and 2005. The data （numerator） for new patients were acquired from the National Health Insurance Review Agency, and the data （denominator） for the resident registration population were from the National Statistical Office. Between 2000 and 2005, the national incidence of cryptorchidism and hypospadias had an increased tendency from 5.01 to 17.43 per 10 000 persons and from 1.40 to 3.28 per 10 000 persons, respectively. The incidence of cryptorchidism was significantly higher in Yeocheon （throughout the study period） and in Ulsan （2001, 2002, 2004 and 2005） than the national incidence, whereas the incidence in Chuncheon was significantly lower in 2001 and 2002. It was difficult to compare the rates of hypospadias yearly and regionally because of the small number of cases. In conclusion, the incidence of cryptorchidism has recently increased in Korea. The petrochemical estates, Yeocheon and Ulsan, had a significantly higher incidence of cyptorchidism than the national incidence, which suggests that further study is needed to obtain a more precise estimation of the trends in the incidence of the anomalies and to confirm the association between petrochemicals and the anomalies.

关键词： cryptorchidism hypospadias incidence petrochemical estate

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Influence of the preparation method on the catalytic activity of Mg-Al hydrotalcites as solid base catalysts

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Green Energy & Environment 2019年第3期4卷 287-292页

作者： Sungjae Park Dahye kwon Ji Yeon Kang Ji chul Jung Department of Chemical Engineering Myongji University

Mg-Al hydrotalcites were synthesized using different preparation methods(a co-precipitation method, a urea method, and a simple one) to analyze their effect on the catalytic activity of these solid base catalysts. The method strongly affected the structure of their layers(e.g., the growth and stacking of the layers, and the type of intercalated anions) and, accordingly, their catalytic activity. The Mg-Al hydrotalcite prepared by co-precipitation showed the best catalytic performance in the isomerization of glucose into fructose, due to the small crystallite size and sand rose morphology enhancing the exposure of surface active sites to reactants.

关键词： Mg-Al hydrotalcite Preparation method Base catalyst Glucose isomerization Fructose

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Is thalamocortical tract injury responsible for memory impairment in a patient with putaminal hemorrhage?

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Neural Regeneration Research 2015年第2期10卷 321-322页

作者： Hyeok Gyu kwon chul Hoon Chang Sung Ho Jang Department of Physical Medicine and Rehabilitation College of Medicine Yeungnam University Department of Neurosurgery College of Medicine Yeungnam University

Prior to development of diffusion tensor imaging （DTI）, there were many difficulties in visualization and estimation of the Papez circuit in the live human brain （Papez, 1995）. Diffusion tensor tractography （DTT）, derived from DTI, allows for identification and visualization of neural tracts in the Papez circuit （Concha et al., 2005; kwon et al., 2010; Granziera et al., 2011; Jang and Yeo, 2013; Jang et al., 2014a）. In the current study, using DTT, we report on a patient who showed injured thalamocortical tract between the anterior thalamic nuclei and the cingulate gyrus following a putaminal hemorrhage.

关键词： Is thalamocortical tract injury responsible for memory impairment in a patient with putaminal hemorrhage ROI DTT

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