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Pitfalls and promises of bile duct alternatives:There is plenty of room in the regenerative surgery

World Journal of Gastroenterology 2023年第30期29卷 4701-4705页

作者： Ilya D Klabukov Denis S Baranovskii peter v shegay Andrey D Kaprin Department of Regenerative Medicine National Medical Research Radiological Center of the Ministry of Health of the Russian FederationObninsk 249036Russia Center for Innovative Radiological and Regenerative Technologies National Medical Research Radiological Center of the Ministry of Health of the Russian FederationObninsk 249036Russia

Current abdominal surgery has several approaches for biliary ***,the creation of functional and clinically applicable bile duct substitutes still represents an unmet *** the paper by Miyazawa and colleagues,approaches to the creation of bile duct alternatives were summarized,and the reasons for the lack of development in this area were *** history of bile duct surgery since the nineteenth century was also traced,leading to the conclusion that the use of bioabsorbable materials holds promise for the creation of bile duct substitutes in the *** suggest three ideas that may stimulate progress in the field of bile duct substitute ***,a systematic analysis of the causative factors leading to failure or success in the creation of bile duct substitutes may help to develop more effective ***,the regeneration of a bile duct is delicately balanced between epithelialization and subsequent submucosal maturation within limited time frames,which may be more apparent when using quantitative models to estimate ***,the utilization of the organism’s endogenous regeneration abilities may enhance the creation of bile duct *** are convinced that an interdisciplinary approach,including quantitative methods,machine learning,and deep retrospective analysis of the causes that led to success and failure in studies on the creation of bile duct substitutes,holds great ***,more attention should be directed towards the balance of epithelialization and submucosal maturation rates,as well as induced *** ideas deserve further investigation to pave the way for bile duct restoration with physiologically relevant outcomes.

关键词： Bile duct alternative Bile duct substitute Regenerative medicine Regene rative surgery Theoretical surgery Quantitative human physiology

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Evaluation of seismic residual capacity ratio for reinforced concrete structures

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Resilient Cities and Structures 2023年第1期2卷 28-45页

作者： Alex v.shegay Kota Miura Kisho Fujita Yu Tabata Masaki Maeda Matsutaro Seki Tokyo Institute of Technology 4259 NagatsutaMidori-kuYokohamaJapan Obayashi Technical Research Institute 4-640 ShimokiyotoKiyoseJapan Obayashi Corporation 2-15-2 KonanMinato-ku TokyoJapan Kume Sekkei Co.Ltd 2-1-2 ShiomiKoto-ku TokyoJapan Tohoku University 12206-6-11 Aramaki AobaAoba-kuSendaiJapan Building Research Institute Tsukuba-shiTachihara 1Japan

Use of indices that quantify the seismic residual capacity of buildings damaged in earthquakes is one way to draw judgements on the building’s safety and possibility of future *** Japanese damage assessment guidelines,several approximate calculation methods exist to evaluate the residual capacity of buildings based on visually observed damage and simplifying assumptions on the nature of the building’s response mechanism and member *** these methods provide a useful residual capacity ratio that enables a‘relative’comparison be-tween buildings,the exact relationship to a physically meaningful residual capacity is *** aim of this study is to benchmark the‘approximations’of residual *** do so,a shake-table test was conducted on a 14 scale 4-storey RC structure and a residual capacity evaluation was undertaken based on observed damage *** the help of a numerical model,a benchmark residual capacity at each of the damage states is determined and compared to the approximate residual capacity calculation results via *** was found that approx-imate methods are generally accurate prior to yield but can become overly conservative *** assumptions of equal member deformation capacity used in the residual capacity ratio calculation was found to be suitable given constraints of rapid field evaluations.

关键词： Seismic residual capacity ratio Reinforced concrete Earthquake engineering Shake-table test Damage evaluation Numerical modeling

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Endoscopic ultrasound-guided biliary drainage

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World Journal of Gastroenterology 2012年第6期18卷 491-497页

作者： Disaya Chavalitdhamrong peter v Draganov Division of Gastroenterology Hepatology and NutritionUniversity of Flori-daGainesvilleFL 32610-0214United States

Endoscopic ultrasound(EUS)-guided biliary drainage has emerged as a minimally invasive alternative to percutaneous and surgical interventions for patients with biliary obstruction who had failed endoscopic retrograde cholangiopancreatography(ERCP).EUSguided biliary drainage has become feasible due to the development of large channel curvilinear therapeutic echo-endoscopes and the use of real-time ultrasound and fluoroscopy imaging in addition to standard ERCP devices and ***-guided biliary drainage is an attractive option because of its minimally invasive,single step procedure which provides internal biliary *** investigators have reported high success and low complication ***,high quality prospective data are still *** provide detailed review of the use of EUS for biliary drainage from the perspective of practicing endoscopists with specific focus on the technical aspects of the procedure.

关键词： Bile duct, Biliary obstruction Biliary drainage Endoscopic ultrasound Endoscopic ultrasound-guidedbiliary drainage

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Paraneoplastic dermatological manifestation of gastrointestinal malignancies

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World Journal of Gastroenterology 2009年第35期15卷 4372-4379页

作者： Lyubomir A Dourmishev peter v Draganov Dermatology and venereology Medical University Department of Gastroenterology Hepatology and NutritionUniversity of Florida

Numerous dermatological disorders have been associated with underlining malignancies of the gastrointestinal (GI)*** cutaneous manifestations might have an important diagnostic value if they are the sole expressions of otherwise asymptomatic *** recognition of some typical paraneoplastic dermatologic disorders can lead to the prompt diagnosis of the underlying malignancy,timely administration of therapy,and ultimately,better *** this review we discuss the most common paraneoplastic dermatological syndromes from the perspective of the practicing gastroenterologist. We also outline a comprehensive practical approach for the evaluation for occult malignancy in patients presenting with cutaneous findings potentially associated with GI cancers.

关键词： Paraneoplastic Dermatological Gastro-intestinal Cancer Malingnancy

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Pain management in chronic pancreatitis

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World Journal of Gastroenterology 2008年第20期14卷 3137-3148页

作者： Cathia Gachago peter v Draganov University of Florida Department of Gastroenterology Hepatology and Nutrition1600 SW Archer Rd Room 602 Gainesville Florida 32610United States

Abdominal pain is a major clinical problem in patients with chronic pancreatitis. The cause of pain is usually multifactorial with a complex interplay of factors contributing to a varying degree to the pain in an individual patient and, therefore, a rigid standardized approach for pain control tends to lead to suboptimal results. Pain management usually proceeds in a stepwise approach beginning with general lifestyle recommendations. Low fat diet, alcohol and smoking cessation are encouraged. Analgesics alone are needed in almost all patients. Maneuvers aimed at suppression of pancreatic secretion are routinely tried. Patients with ongoing symptoms may be candidates for more invasive options such as endoscopic therapy, and resective or drainage surgery. The role of pain modifying agents (antidepressants, gabapentin, peregabalin), celiac plexus block, antioxidants, octreotide and total pancreatectomy with islet cell auto transplantation remains to be determined.

关键词： Chronic pancreatitis Pain Endoscopy Endoscopic ultrasound Pancreas

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Squamous cell cancer of the rectum

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World Journal of Gastroenterology 2009年第35期15卷 4380-4386页

作者： Tara Dyson peter v Draganov Department of Gastro-enterology Hepatology and NutritionUniversity of Florida 1600 SW Archer RdRoom HD 602PO Box 100214 GainesvilleFlorida 32610United States

Squamous cell carcinoma of the rectum is a rare *** appears to be associated with chronic inflammatory conditions and *** clear association seen between Human Papilloma virus and various squamous cancers has not been firmly established for the squamous cell cancer of the rectum. The presentation is nonspecific and patients tend to present with advanced stage *** relies on endoscopic examination with biopsy of the *** from squamous cell cancer of the anus can be difficult,but can be facilitated by immunohistochemical staining for *** of the cancer with endoscopic ultrasound and computed tomography provides essential information on prognosis and can guide *** present,surgery remains the main therapeutic option;however recent advances have made chemoradiation a valuable therapeutic addition. Squamous cell carcinoma of the rectum is a distinct entity and it is of crucial importance for the practicing Gastroenterologist to be thoroughly familiar with this *** to adenocarcinoma of the rectum and squamous cell cancer of the anal canal,squamous cell carcinoma of the rectum has different epidemiology, etiology,pathogenesis,and prognosis but,most importantly,requires a different therapeutic approach. This review will examine and summarize the available information regarding this disease from the perspective of the practicing gastroenterologist.

关键词： Rectal cancer Squamous cell cancer Endoscopic ultrasound Chemoradiation Surgery

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Pancreatic pseudocyst

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World Journal of Gastroenterology 2009年第1期15卷 38-47页

作者： Samir Habashi peter v Draganov Department of Gastroenterology Hepatology and Nutrition University of FloridaGainesville Florida 32610 United States

Pancreatic pseudocysts are complications of acute or chronic pancreatitis. Initial diagnosis is accomplished most often by cross-sectional imaging. Endoscopic ultrasound with fine needle aspiration has become the preferred test to help distinguish pseudocyst from other cystic lesions of the pancreas. Most pseudocysts resolve spontaneously with supportive care. The size of the pseudocyst and the length of time the cyst has been present are poor predictors for the potential of pseudocyst resolution or complications, but in general, larger cysts are more likely to be symptomatic or cause complications. The main two indications for some type of invasive drainage procedure are persistent patient symptoms or the presence of complications (infection, gastric outlet or biliary obstruction, bleeding). Three different strategies for pancreatic pseudocysts drainage are available: endoscopic (transpapillary or transmural) drainage, percutaneous catheter drainage, or open surgery. To date, no prospective controlled studies have compared directly these approaches. As a result, the management varies based on local expertise, but in general, endoscopic drainage is becoming the preferred approach because it is less invasive than surgery, avoids the need for external drain, and has a high long-term success rate. A tailored therapeutic approach taking into consideration patient preferences and involving multidisciplinary team of therapeutic endoscopist, interventional radiologist and pancreatic surgeon should be considered in all cases.

关键词： Pancreatic pseudocyst Cyst Pancreatititis Endoscopic ultrasound Therapy

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Indomethacin for post-endoscopic retrograde cholangiopancreatography pancreatitis prophylaxis:Is it the magic bullet?

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World Journal of Gastroenterology 2012年第31期18卷 4082-4085页

作者： Dennis Yang peter v Draganov Division of Gastroenterology Hepatology and NutritionDepartment of MedicineUniversity of FloridaGainesvilleFL 32610United States

Acute pancreatitis is a common complication of endoscopic retrograde cholangiopancreatography(ERCP).Pancreatic duct stent insertion after ERCP has been widely accepted as the standard of care for the prevention of this complication in high-risk ***,the placement of pancreatic stents requires higher level of endoscopic expertise and is not always feasible due to anatomic ***,effective non-invasive pharmacologic prophylaxis remains appealing,particularly if it is inexpensive,easily administered,has a low risk side effect profile and is widely *** have been multiple studies evaluating potential pharmacologic candidates for post-ERCP pancreatitis(PEP) prophylaxis,most of them yielding disappointing results.A recently published large,multicenter,randomized controlled trial reported that in high risk patients a single dose of rectal indomethacin administered immediately after the ERCP significantly decreased the incidence of PEP compare to placebo.

关键词： Non-steroidal anti-inflammatory drugs In-domethacin Post-endoscopic retrograde cholangiopan-creatography pancreatitis Acute pancreatitis

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Recent advances and remaining gaps in our knowledge of associations between gut microbiota and human health

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World Journal of Gastroenterology 2009年第1期15卷 81-85页

作者： volker Mai peter v Draganov Department of Gastroenterology Hepatology and Nutrition University of Florida1600 SW Archer Rd Room HD 602 PO Box 100214 Gainesville Florida 32610 United States

The complex gut microbial flora harbored by individuals(microbiota) has long been proposed to contribute tointestinal health as well as disease. Pre-and probioticproducts aimed at improving health by modifyingmicrobiota composition have already become widelyavailable and acceptance of these products appearsto be on the rise. However, although required forthe development of effective microbiota basedinterventions, our basic understanding of microbiotavariation on a population level and its dynamics withinindividuals is still rudimentary. Powerful new parallelsequence technologies combined with other efficientmolecular microbiota analysis methods now allow forcomprehensive analysis of microbiota composition inlarge human populations. Recent fi ndings in the fi eldstrongly suggest that microbiota contributes to thedevelopment of obesity, atopic diseases, inflammatorybowel diseases and intestinal cancers. Through theongoing National Institutes of Health Roadmap 'HumanMicrobiome Project' and similar projects in other partsof the world, a large coordinated effort is currentlyunderway to study how microbiota can impact humanhealth. Translating findings from these studies intoeffective interventions that can improve health,possibly personalized based on an individuals existingmicrobiota, will be the task for the next decade(s).

关键词： Microbiota Intestinal microbial flora Probiotic Gut Intestine

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Cystic neoplasms of the pancreas: A diagnostic challenge

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World Journal of Gastroenterology 2009年第1期15卷 48-54页

作者： Grant F Hutchins peter v Draganov Department of Gastroenterology Hepatology and Nutrition University of Florida1600 SW Archer Rd Room HD 602 PO Box 100214 Gainesville Florida 32610 United States

Cystic neoplasms of the pancreas are increasingly recognized due to the expanding use and improved sensitivity of cross-sectional abdominal imaging. Major advances in the last decade have led to an improved understanding of the various types of cystic lesions and their biologic behavior. Despite signifi cant improvements in imaging technology and the advent of endoscopic-ultrasound (EUS)-guided fineneedle aspiration, the diagnosis and management of pancreatic cystic lesions remains a significant clinical challenge. The fi rst diagnostic step is to differentiate between pancreatic pseudocyst and cystic neoplasm. If a pseudocyst has been effectively excluded, the cornerstone issue is then to determine the malignant potential of the pancreatic cystic neoplasm. In the majority of cases, the correct diagnosis and successful management is based not on a single test but on incorporating data from various sources including patient history, radiologic studies, endoscopic evaluation, and cyst fluid analysis. This review will focus on describing the various types of cystic neoplasms of the pancreas, their malignant potential, and will provide the clinician with a comprehensive diagnostic approach.

关键词： Cystic neoplasm Endoscopic ultrasound Pancreas Pancreatic cyst Pancreatitis

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