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Pancreatic fistula after pancreaticoduodenectomy:A comparison between the two pancreaticojejunostomy methods for approximating the pancreatic parenchyma to the jejunal seromuscular layer:Interrupted vs continuous stitches

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World Journal of Gastroenterology 2007年第40期13卷 5351-5356页

作者： Seung Eun Lee sung Hoon Yang Jin-Young Jang sun-whe kim Department of Surgery Seoul National University College of Medicine28 Yongon-dongChongno-guSeoul 110-744Korea

AIM： The purpose of this study is to find a better operative technique by comparing interrupted stitches with continuous stitches for the outer layer of the pancreaticojejunostomy, i.e. the stitches between the stump parenchyma of the pancreas and the jejunal seromuscular layer, and other risk factors for the incidence of pancreatic leakage.METHODS： During the period January 1997 to October 2004, 133 patients have undergone the end-to-side and duct-to-mucosa pancreaticojejunostomy reconstruction after pancreaticoduodenectomy with interrupted suture for outer layer of the pancreaticojejunostomy and 170 patients with a continuous suture at our institution by one surgeon.RESULTS： There were no significant differences between the two groups in the diagnosis, texture of the pancreas, use of octreotide and pathologic stage. Pancreatic fistula occurred in 14 patients （11%） among the interrupted suture cases and in 10 （6%） among the continuous suture cases （P = 0.102）. Major pancreatic leakage developed in three interrupted suture patients （2%） and zero continuous suture patients （P = 0.026）. In multivariate analysis, soft pancreatic consistency （odds ratio, 5.5; 95% confidence interval 2.3-13.1） and common bile duct cancer （odds ratio, 3.7; 95%CI 1.6-8.5） were＇predictive of pancreatic leakage.CONCLUSION： Pancreatic texture and pathology are the most important factors in determining the fate of pancreaticojejunal anastomosis and our continuous suture method was performed with significantly decreased occurrence of major pancreatic fistula. In conclusion, the continuous suture method is more feasible and safer in performing duct-to-mucosa pancreaticojejunostomy.

关键词： Pancreaticoduodenectomy Pancreaticojejunostomy Pancreatic fistula

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Presence of CCK-A, B receptors and effect of gastrin and cholecystokinin on growth of pancreatobiliary cancer cell lines

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World Journal of Gastroenterology 2005年第6期11卷 803-809页

作者： Jin-Young Jang sun-whe kim Ja-Lok Ku Yong-Hyun Park Jae-Gahb Park Department of Surgery

AIM: To investigate the effects of gastrin and cholecystokinin (CCK) and their specific antagonists on the growth of pancreatic and biliary tract cancer cell lines. METHODS: Five pancreatic and 6 biliary cancer cell lines with 2 conrtol cells were used in this study. Cell proliferation study was done using 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyl tetrazolium bromide (MTT) test and direct cell count method. Reverse transcription-polymerase chain reaction (RT-PCR) and slot blot hybridization were performed to examine and quantify the expression of hormonal receptors in these cell lines. RESULTS: SNU-308 showed a growth stimulating effect by gastrin-17, as did SNU-478 by both gastrin-17 and CCK-8. The trophic effect of these two hormones was completely blocked by specific antagonists (L-365, 260 for gastrin and L-364, 718 for CCK). Other cell lines did not respond to gastrin or CCK. In RT-PCR, the presence of CCK-A receptor and CCK-B/gastrin receptor mRNA was detected in all biliary and pancreatic cancer cell lines. In slot blot hybridization, compared to the cell lines which did not respond to hormones, those that responded to hormones showed high expression of receptor mRNA. CONCLUSION: Gastrin and CCK exert a trophic action on some of the biliary tract cancers.

关键词： Bile duct cancer Gallbladder cancer Pancreatic cancer Gastrin Cholecystokinin

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Intraductal papillary mucinous carcinoma with atypical manifestations:Report of two cases

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World Journal of Gastroenterology 2007年第10期13卷 1622-1625页

作者： Seung Eun Lee Jin-Young Jang sung Hoon Yang sun-whe kim Department of Surgery Seoul National University College of MedicineSeoulKorea

Intraductal papillary mucinous neoplasms （IPMNs） are a well-characterized group of rnucin-producing cystic neoplasms of the clear malignant potential type. We report here two cases of intraductal papillary mucinous carcinoma （IPMC） with atypical manifestations. In one case, we discussed a pseudomyxoma peritonei caused by a ruptured IPMC. In the other case we discussed the fistulization of IPMC into the stomach and duodenum. These two cases suggest that IPMN can either spontaneously rupture causing mucinous materials to spill into the free abdominal cavity or directly invade adjacent organs resulting in fistula development.

关键词： Intraductal papillary mucinous neoplasm Intraductal papillary mucinous carcinoma Pseudomyxoma peritonei Fistula

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Systematic review on the surgical treatment for T1 gallbladder cancer

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World Journal of Gastroenterology 2011年第2期17卷 174-180页

作者： Seung Eun Lee Jin-Young Jang Chang-Sup Lim Mee Joo Kang sun-whe kim Department of Surgery Chung-Ang University College of Medicine Department of Surgery Seoul National University College of Medicine

AIM:To evaluate the efficacy of simple and extended cholecystectomy for mucosa(T1a) or muscularis(T1b) gallbladder(GB) cancer. METHODS:Original studies on simple and extended cholecystectomy for T1a or T1b GB cancer were searched from MEDLINE(PubMed) ,Cochrane Library,EMBase,and CancerLit using the search terms of GB,cancer/carcinoma/tumor/neoplasm. RESULTS:Twenty-nine out of the 2312 potentially relevant publications met the eligibility *** the 1266 patients with GB cancer included in the publications,706(55.8%) and 560(44.2%) had T1a and T1b GB cancer,*** cholecystectomy for T1a and T1b GB cancer was performed in 590(83.6%) and 375(67.0%) patients,respectively(P<0.01) .In most series,the treatment of choice was simple cholecystectomy for T1a GB cancer patients with a 5-year survival rate of 100%.Lymph node metastasis was detected in 10.9% of the T1b GB cancer patients and in 1.8%of the T1a GB cancer patients,respectively(P<0.01) .Eight patients(1.1%) with T1a GB cancer and 52 patients(9.3%) with T1b GB cancer died of recurrent GB cancer(P<0.01) . CONCLUSION:Simple cholecystectomy represents the adequate treatment of T1a GB *** is no definite evidence that extended cholecystectomy is advantageous over simple cholecystectomy for T1b GB cancer.

关键词： Gallbladder Cancer Cholecystectomy Simple Extended

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CD24 expression predicts distant metastasis in extrahepatic bile duct cancer

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World Journal of Gastroenterology 2013年第9期19卷 1438-1443页

作者： Kyubo kim Hye Sook Min Eui Kyu Chie Jin-Young Jang sun whe kim Sae-Won Han Do-Youn Oh Seock-Ah Im Tae-You kim Yung-Jue Bang Ja-June Jang sung W Ha Department of Radiation Oncology Seoul National University College of Medicine Seoul 110-744 South Korea Department of Pathology Seoul National University College of Medicine Seoul 110-744 South Korea Institute of Radiation Medicine Medical Research Center Seoul National University Seoul 151-742 South Korea Department of Surgery Seoul National University College of Medicine Seoul 110-744 South Korea Department of Internal Medicine Seoul National University College of Medicine Seoul 110-744 South Korea

AIM: To evaluate the prognostic significance of CD24 expression in patients undergoing adjuvant chemoradiotherapy for extrahepatic bile duct (EHBD) cancer. METHODS: Eighty-four patients with EHBD cancer who underwent curative resection followed by adjuvant chemoradiotherapy were enrolled in this study. Postoperative radiotherapy was delivered to the tumor bed and regional lymph nodes up to a median of 40 Gy (range: 40-56 Gy). All patients also received fluoropyrimidine chemotherapy for radiosensitization during radiotherapy. CD24 expression was assessed with immunohistochemical staining on tissue microarray. Clinicopathologic factors as well as CD24 expression were evaluated in multivariate analysis for clinical outcomes including loco-regional recurrence, distant metastasisfree and overall survival. RESULTS: CD24 was expressed in 36 patients (42.9%). CD24 expression was associated with distant metastasis, but not with loco-regional recurrence nor with overall survival. The 5-year distant metastasis-free survival rates were 55.1% and 29.0% in patients with negative and positive expression, respectively (P=0.0100). On multivariate analysis incorporating N stage, histologic differentiation and CD24 expression, N stage was the only significant factor predicting distant metastasis-free survival (P=0.0089), while CD24 expression had borderline significance (P=0.0733). In subgroup analysis, CD24 expression was significantly associated with 5-year distant metastasis-free survival in node-positive patients (38.4% with negative expression vs 0% with positive expression, P=0.0110), but not in nodenegative patients (62.0% with negative expression vs 64.0% with positive expression,P=0.8599). CONCLUSION: CD24 expression was a significant predictor of distant metastasis for patients undergoing curative resection followed by adjuvant chemoradiotherapy especially for node-positive EHBD cancer.

关键词： CD24 Tissue microarray Extrahepatic bile duct cancer Adjuvant chemoradiotherapy Distant metastasis

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Clinical validation of scoring systems of postoperative pancreatic fistula after pancreatoduodenectomy: applicability to Eastern cohorts?

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Hepatobiliary Surgery and Nutrition 2019年第3期8卷 211-218页

作者： Jae Seung Kang Taesung Park Youngmin Han Seungyeon Lee Jae Ri kim Hongbeom kim Wooil Kwon sun-whe kim Jin Seok Heo Seong Ho Choi Dong Wook Choi Song Cheol kim Tae Ho Hong Dong Sup Yoon Joon Seong Park Sang Jae Park sung-Sik Han Sae-Byeol Choi Joo Seop kim Chang-Sup Lim Jin-Young Jang Department of Surgery and Cancer Research Institute Seoul National University College of MedicineSeoulRepublic of Korea Department of Statistics and Interdisciplinary Program in Biostatistics Seoul National UniversitySeoulRepublic of Korea Department of Mathematics and Statistics Sejung UniversitySeoulRepublic of Korea Department of Surgery Samsung Medical CenterSungkyunkwan University School of MedicineSeoulRepublic of Korea Division of Hepatobiliary and Pancreatic Surgery Department of SurgeryUlsan University College of Medicine and Asan Medical CenterSeoulRepublic of Korea Department of Surgery Seoul St.Mary’s HospitalThe Catholic University of KoreaCollege of MedicineSeoulRepublic of Korea Pancreatobiliary Cancer Clinic Department of SurgeryGangnam Severance HospitalYonsei University College of MedicineSeoulRepublic of Korea Center for Liver Cancer National Cancer CenterGyeonggidoRepublic of Korea Department of Surgery Korea University Guro HospitalKorea University College of MedicineSeoulRepublic of Korea Department of Surgery Kangdong Sacred Heart HospitalHallym University College of MedicineSeoulRepublic of Korea Department of Surgery Seoul Metropolitan Government-Seoul National University Boramae Medical CenterSeoul National University College of MedicineSeoulRepublic of Korea

Background:Although several prediction models for the occurrence of postoperative pancreatic fistula(POPF)after pancreatoduodenectomy(PD)exist,all were established using Western ***-scale external validation studies in Eastern cohorts that consider demographic variables including lower body mass index(BMI)are *** purpose of this study was to externally validate POPF prediction models using nationwide large-scale Korean ***:Nine tertiary university hospitals in the Republic of Korea ***'preoperative characteristics,intraoperative factors,and pathologic findings were *** grades were determined according to the 2016 International Study Group on Pancreatic Surgery *** POPF risk models(Callery,Roberts,and Mungroop)were selected for external ***:A total of 1,898 PD patients were enrolled.A non-pancreatic disease diagnosis[hazard ratio(HR),1.856;95%confidence interval(CI),1.223–2.817;P=0.004),higher preoperative BMI(HR,1.069;95%CI,1.019–1.121;P=0.006),and soft pancreatic texture(HR,1.859;95%CI,1.264–2.735;P=0.002)were independent risk factors for clinically relevant POPF(CR-POPF).The area under the receiver operating characteristic curve(AUC)values were 0.61,0.64,and 0.63 on the Callery,Roberts,and Mungroop models,respectively;all were lower than those published in each external validation ***:Western POPF prediction models performed less well when applied to Korean ***,a large-scale Eastern-specific and externally validated POPF prediction model is needed.

关键词： Pancreatic fistula pancreatoduodenectomy(PD) predictive score

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Mechanical properties of high-strength concrete subjected to high temperature by stressed test

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中国有色金属学会会刊：英文版 2009年第B9期19卷 128-133页

作者： Gyu-Yong kim Young-sun kim Tae-Gyu LEE Division of Architecture Engineering Chun gnam National University

Recently, the effects of high temperature on compressive strength and elastic modulus of high strength concrete were experimentally investigated. The present study is aimed to study the effect of elevated temperatures ranging from 20 ℃ to 700 ℃ on the material mechanical properties of high-strength concrete of 40, 60 and 80 MPa grade. During the strength test, the specimens are subjected to a 25% of ultimate compressive strength at room temperature and sustained during heating, and when the target temperature is reached, the specimens are loaded to failure. The tests were conducted at various temperatures (20-700 ℃) for concretes made with W/B ratios of 46%, 32% and 25%, respectively. The results show that the relative values of compressive strength and elastic modulus decrease with increasing compressive strength grade of specimen.

关键词：高强混凝土高温作用力学性能测试抗压强度温度升高弹性模量强度试验

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Oral TNF-αsiRNA delivery via milk-derived exosomes for effective treatment of inflammatory bowel disease

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Bioactive Materials 2024年第4期34卷 138-149页

作者： Geonhee Han Hyosuk kim Hochung Jang Eun sun kim sun Hwa kim Yoosoo Yang KU-KIST Graduate School of Converging Science and Technology Korea UniversitySeoul02841Republic of Korea Medicinal Materials Research Center Biomedical Research DivisionKorea Institute of Science and Technology(KIST)Seoul02792Republic of Korea Division of Bio-Medical Science and Technology KIST SchoolUniversity of Science and TechnologySeoul02792Republic of Korea Department of Internal Medicine Korea University College of MedicineSeoul02841Republic of Korea

Oral administration facilitates the direct delivery of drugs to lesions within the small intestine and colon,making it an ideal approach for treating patients with inflammatory bowel ***,multiple physical barriers impede the delivery of oral RNA drugs through the gastrointestinal ***,we developed a novel oral siRNA delivery system that protects nucleic acids in extreme environments by employing exosomes derived from milk to encapsulate tumor necrosis factor-alpha(TNF-α)siRNA *** remarkable structural stability of milk-derived exosomes(M-Exos),as opposed to those from HEK293T cells,makes them exceptional siRNA *** demonstrate that milk exosomes loaded with TNF-αsiRNA(M-Exo/siR)can effectively inhibit the expression of TNF-α-related inflammatory ***,given that milk exosomes are composed of unique lipids with high bioavailability,orally administered M-Exo/siR effectively reach colonic tissues,leading to decreased TNF-αexpression and successful alleviation of colitis symptoms in a dextran sulfate sodium-induced inflammatory bowel disease murine ***,milk-derived exosomes carrying TNF-αsiRNA can be effectively employed to treat inflammatory bowel ***,using exosomes naturally derived from milk may shift the current paradigm of oral gene delivery,including siRNA.

关键词： Milk-derived exosome Oral gene delivery siRNA Inflammatory bowel disease TNF-α

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Experimental Study on the Inlet Fogging System Using Two-Fluid Nozzles

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Journal of Thermal Science 2010年第2期19卷 132-135页

作者： Abhilash Suryan Dong sun kim Heuy Dong kim School of Mechanical Engineering Andong National University FMTRC Daejoo Machinery Co.

Large-capacity compressors in industrial plants and the compressors in gas turbine engines consume a considerable amount of power. The compression work is a strong fimction of the ambient air temperature. This increase in compression work presents a significant problem to utilities, generators and power producers when electric demands are high during the hot months. In many petrochemical process industries and gas turbine engines, the in- crease in compression work curtails plant output, demanding more electric power to drive the system. One way to counter this problem is to directly cool the inlet air. Inlet fogging is a popular means of cooling the inlet air to air compressors. In the present study, experiments have been performed to investigate the suitability of two-fluid nozzle for inlet fogging. Compressed air is used as the driving working gas for two-fluid nozzle and water at am- bient conditions is dragged into the high-speed air jet, thus enabling the entrained water to be atomized in a very short distance from the exit of the two-fluid nozzle. The air supply pressure is varied between 2.0 and 5.0 bar and the water flow rate entrained is measured. The flow visualization and temperature and relative humidity measurements are carried out to specify the fogging characteristics of the two-fluid nozzle.

关键词： Evaporative Cooling Inlet Fogging Energy Savings Two-fluid Nozzles

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Phylogenetic relationship,biogeography,and conservation genetics of endangered Fraxinus chiisanensis(Oleaceae),endemic to South Korea

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Plant Diversity 2022年第2期44卷 170-180页

作者： Changkyun kim Dong-Kap kim Hang sun Joo-Hwan kim Plant Research Division Honam National Institute of Biological ResourcesMokpo 58762Republic of Korea Forest Biodiversity Division Korea National ArboretumPocheon 11186Republic of Korea CAS Key Laboratory for Plant Biodiversity and Biogeography of East Asia Kunming Institute of BotanyChinese Academy of SciencesKunming 650204YunnanPR China Department of Life Science Gachon UniversitySeongnam 13120Republic of Korea

Endemic plants are important for understanding phylogenetic relationships,biogeographical history,and genetic variation because of their restricted distribution and their role in conserving ***,we investigated the phylogenetic relationships of the Korean endemic Fraxinus chiisanensis by reconstructing the molecular phylogeny of Fraxinus based on two nuclear DNA(nrITS and phantastica)and two chloroplast DNA(psbA-trnH and rp132-trnL)*** our fossil-calibrated phylogenetic framework,we also inferred the biogeographical history of *** provide a scientific basis for the conservation of ***,we determined the levels of genetic diversity and genetic differentiation in this *** information from nuclear and chloroplast DNA sequence data,our molecular phylogenetic analyses identified *** as a genetically distinct unit from its sister group,Fraxinus platypoda from *** molecular dating analyses using nuclear and chloroplast DNA data sets show *** diverged from its sister *** in the Early or Middle Miocene and differentiated in the Late Miocene on the Korean *** results suggest that the divergence of *** was associated with the submergence of the East China Sea land bridge and enhanced monsoons in East *** compared to ***,*** exhibits low genetic diversity within populations and high genetic differentiation among *** results help us to understand the evolutionary history of *** and to develop a conservation strategy for this species.

关键词： East China Sea land bridge Endemic species Fraxinus chiisanensis Korean Peninsula Genetic diversity Biogeography

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