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Evaluation of early-age strains and stresses in roller-compacted concrete pavement

Journal of Traffic and Transportation Engineering(English Edition) 2022年第1期9卷 93-105页

作者： Tetsya Sok young kyu kim Jun young Park Seung Woo Lee Public Infrastructure Department Ministry of Public Works and TransportPhnom Penh 12100Cambodia Institute for Disaster Prevention Gangneung-Wonju National UniversityGangneung-si 25457South Korea Korea Expressway Research Institute Korea Expressway CorporationHwaseong-si 18489South Korea Civil Engineering Department Gangneung-Wonju National UniversityGangneung-si 25457South Korea

In the structural design of a roller-compacted concrete pavement(RCCP), it is crucial to estimate strain and stress developments in the RCCP slab realistically. Since the RCCP mix uses less cement and lower amount of water, shrinkage strain and concrete temperature during the hardening stage are expected to be reduced as compared to those of conventional concrete mixture, resulting in a reduction of the concrete early-age deformation and stress developments in the RCCP slab. In this paper, early-age concrete strain and stress developments in RCCP slab subjected to environmental loads were evaluated. A full-scale test section of RCCP under real climatic conditions was monitored. The early-age total strains,stress-independent strains, shrinkage strains, and coefficient of thermal expansion(CTE) of the RCCP were measured and analyzed. Using the results of measured strains, in-situ CTE and shrinkage strain, and temperature, the early-age concrete stress development is computed by incorporating a viscoelastic property of the early-age concrete. The results revealed that the shrinkage strain of the RCCP is quite low as compared to that of conventional concrete. The early-age stress developments in the RCCP slab are strongly governed by the thermal-induced stresses. Shrinkage-induced stresses were quite small and might be negligible in a preliminary estimation of early-age stress developments in the RCCP slab.

关键词： Road engineering Roller-compacted concrete pavement Concrete strain Concrete stress Shrinkage strain Environmental loads

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Conversion of twice-daily to once-daily tacrolimus is safe in stable adult living donor liver transplant recipients

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Hepatobiliary & Pancreatic Diseases International 2015年第4期14卷 374-379页

作者： Seong Hoon kim Seung Duk Lee young kyu kim Sang-Jae Park Center for Liver Cancer National Cancer Center 111 Jungbalsan-ro Ilsandong-gu Goyang-si Gyeonggi-do 410-769 Korea

Once-daily extended-release tacrolimus （Tac-OD） has been introduced as a useful therapeutic option to increase patient adherence to immunosuppressive therapy. This study aimed to evaluate the safety, efficacy and immunosuppressant adherence of conversion from twice-daily tacrolimus （Tac-BID） to Tac-OD in stable adult living donor liver transplant （LDLT） recipients in a single institution. METHODS： Between February and May 2013, Tac-BID was converted to Tac-OD in recipients followed up for at least 12 months after transplantation and without previous rejection episodes. The switching policy was based on a dose ratio of 1：1 with dose adjustment target trough levels at 3-5 ng/mL. Tacro- limus trough levels, laboratory parameters, metabolic disor- ders, and adverse events were assessed. RESULTS： A total of 229 patients were enrolled in the study. The median age at conversion was 53 years （range 31-73）. The median transplant duration was 35.3 months （range 12.0-95.4）. During a median follow-up of 13.5 months after conversion, 9 patients returned to Tac-BID because of adverse events. No acute rejection episodes were observed. Of 214 patients still on Tac-OD at 12 months, 12 （5.6%） received a reduced dose and 95 （44.4%） required an increased dose over baseline. Overall adherence was 82.2% at the end of follow-up. CONCLUSION： The conversion from Tac-BID to Tac-OD with similar target trough levels after conversion is safe and effec- tive for long-term stable LDLT patients.

关键词： liver transplantation living donor immunosuppressive agents tacrolimus

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Right hepatectomy in living donors with previous abdominal surgery

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Hepatobiliary & Pancreatic Diseases International 2017年第1期16卷 33-38页

作者： Seong Hoon kim Seung Duk Lee young kyu kim Sang-Jae Park Center for Liver Cancer National Cancer Center 111 Jungbalsan-ro Ilsandong-gu Goyang-si Gyeonggi-do 410-769 Korea

BACKGROUND： Few studies have evaluated the impact of previous abdominal surgery （PAS） on living donor right hepatectomy （LDRH）. The aim of this study was to investigate the outcomes of liver transplantation using right lobe grafts of living donors with PAS. METHODS： Data were reviewed from LDRH patients at the authors＇ institution between March 2008 and November 2014. LDRH patients with PAS were divided into two groups according to upper PAS （group 1） or lower PAS （group 2）, and they were compared to those without PAS （group 3） who were matched 1：1 based on age, gender, and body mass index. Periop- erative data, complications by the Clavien classification, and the outcomes with more than 14 months follow-up were compared. RESULTS： Twenty-three （4.9%） of a total of 471 LDRH donors had PAS. Eleven donors were assigned to group 1, 12 to group 2, and 23 to group 3. Intraperitoneal adhesions were found in 20 （87.0%） of 23 donors with PAS, of whom 5 （21.7%） had adhesiolysis-related injuries that happened more commonly in group 1 than in group 2 （P=0.025）. LDRH was successfully completed under upper midline laparotomy in all donors. No donors received perioperative blood transfusion. The peak postoperative AST, ALT, INR, and total bilirubin levels made no difference between the three groups. Compared with group 3, groups 1 and 2 had a longer operative time （P=0.012） and a higher grade I complication rate （P=0.047）. All donors recovered fully to their routine activities. The 23 recipients of grafts from donors with PAS showed good liver function with 1-year graft and patient survivals of 100%. CONCLUSION： A history of PAS is not a contraindication to LDRH in the current era of advanced surgical techniques.

关键词： living donor liver transplantation liver surgery liver function

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Pushing the frontiers of living donor right hepatectomy

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World Journal of Gastroenterology 2014年第48期20卷 18061-18069页

作者： Seong Hoon kim Seung Duk Lee young kyu kim Sang-Jae Park Center for Liver Cancer National Cancer Center 111 Jungbalsan-ro Ilsandong-gu Goyang-si Gyeonggi-do 410-769 South Korea

Living donor right hepatectomy (LDRH) is currently the most common donor surgery in adult-to-adult living donor liver transplantation although the morbidity and mortality reported in living donors still contradicts the Hippocratic tenet of “do no harm”. Achieving low complication rates in LDRH remains a matter of major concern. Living donor surgery is performed worldwide as an established solution to the donor shortage. The aim of this study was to assess the current status of LDRH and comment on the future of the procedure; assessment was made from the standpoint of optimizing the donor selection criteria and reducing morbidity based on both the authors’ 8-year institutional experience and a literature review. New possibilities have been explored regarding selection criteria. The safety of living donors with unfavorable conditions, such as low remnant liver volume, fatty change, or old age, should also be considered. Abdominal incisions have become shorter, even without laparoscopic assistance; upper midline laparotomy is the primary incision used in more than 400 consecutive LDRHs in the authors’ institution. Various surgical techniques based on preoperative imaging technology of vascular and biliary anomalies have decreased the anatomical barriers in LDRH. Operative time has been reduced, with low blood loss. Laparoscopic or robotic LDRH has been tried in only a few selected donors. The LDRH-specific, long-term outcomes remain to be addressed. The follow-up duration of these studies should be long enough to address possible late complications. Donor safety, which is the highest priority, is ensured by three factors: preoperative selection, intraoperative surgical technique, and postoperative management. These three focus areas should be continuously refined, with the ultimate goal of zero morbidity.

关键词： Living donor Right hepatectomy Liver transplantation Donor morbidity Donor selection

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Graft-to-recipient weight ratio lower to 0.7% is safe without portal pressure modulation in right-lobe living donor liver transplantation with favorable conditions

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Hepatobiliary & Pancreatic Diseases International 2014年第1期13卷 18-24页

作者： Seung Duk Lee Seong Hoon kim young-kyu kim Soon-Ae Lee Sang-Jae Park Center for Liver Cancer National Cancer Center

BACKGROUND: The low graft-to-recipient weight ratio(GRWR) in adult-to-adult living donor liver transplantation(LDLT) is one of the major risk factors affecting graft survival. The goal of this study was to evaluate whether the lower limit of the GRWR can be safely reduced without portal pressure modulation in right-lobe LDLT. METHODS: From 2005 to 2011, 317 consecutive patients from a single institute underwent LDLT with right-lobe grafts without portal pressure modulation. Of these, 23 had a GRWR of less than 0.7%(group A), 27 had a GRWR of ≥0.7%, <0.8%(group B), and 267 had a GRWR of more than and equal to 0.8%(group C). Medical records, including recipient, donor, operation factors, laboratory findings and complications were reviewed retrospectively. RESULTS: The baseline demographics showed low model for end-stage liver disease score(mean 16.3±8.9) and high percentage of hepatocellular carcinoma(231 patients, 72.9%). Three groups by GRWR demonstrated similar characteristics except recipient body mass index and donor gender. For smallforsize syndrome, there were 3(13.0%) in group A, 1(3.7%) in group B, and 2 patients(0.7%) in group C(P<0.001). Hepatic artery thrombosis was more frequently observed in group A than in groups B and C(8.7% vs 3.7% vs 1.9%, P=0.047). However, among the three groups, graft survival rates at 1 year(100% vs 96.3% vs 93.6%) and 3 years(91.7% vs 73.2% vs 88.1%) were not different(P=0.539). In laboratory measurements,there was no group difference in total bilirubin and albumin. However, prothrombin time was longer in group A within postoperative 1 week and platelet count was lower in groups A and B within postoperative 1 month. CONCLUSION: A GRWR lower to 0.7% is safe and does not need to modulate portal pressure in adult-to-adult LDLT using the right-lobe in favorable conditions including low model for end-stage liver disease score.

关键词： graft-to-recipient weight ratio living donor liver transplantation small-for-size graft small-for-size syndrome

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Pretransplant absolute monocyte count in peripheral blood predicts posttransplant tumor prognosis in patients undergoing liver transplantation for hepatocellular carcinoma

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Hepatobiliary & Pancreatic Diseases International 2014年第3期13卷 250-258页

作者： young-kyu kim Seong Hoon kim Seung-Duk Lee Soon-ae Lee Sang-Jae Park Center for Liver Cancer National Cancer Center323 Ilsan-ro Ilsandong-gu Goyang-si Gyeonggi-do Republic of Korea Department of Surgery College of Medicine Kangwon National University 1 Kangwondaehak-gilChuncheon-si Gangwon-do 200-701 Republic of Korea

BACKGROUND: Preoperative absolute monocyte count in peripheral blood(AMCPB) is closely associated with prognoses in not only various malignancies but also hepatocellular carcinoma(HCC). The purpose of this study was to evaluate whether pretransplant AMCPB predicts posttransplant outcomes in patients with HCC undergoing liver transplantation(LT).METHOD: We retrospectively analyzed relationships between clinicopathologic factors involving pretransplant AMCPB and tumor recurrence or survival in 256 patients who had undergone LT for HCC between January 2005 and April ***: ROC curve analysis showed that AMCPB >200/mm3was a risk factor for tumor recurrence; 43 patients showed higher AMCPB(>200/mm3), whereas 213 showed lower AMCPB(≤200/mm3) at the time of LT. On multivariate analysis,pretransplant high AMCPB, positive findings in pretransplant18F-FDG PET/CT, pathological maximal tumor size >5 cm,intrahepatic metastasis, moderately or poorly differentiated tumor and microvascular invasion were independent factors affecting recurrence-free survival. When we performed subgroup analysis based on the Milan criteria, high AMCPB was an independent factor for predicting HCC recurrence in patients with tumor beyond the Milan criteria(P=0.004), and not for patients within the ***: This study demonstrated that pretransplant AMCPB could predict tumor recurrence after LT for HCC,especially in patients with tumor beyond the Milan criteria.

关键词： liver transplantation hepatocellular carcinoma recurrence survival monocyte count

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Clinicopathological features and prognosis of combined hepatocellular carcinoma and cholangiocarcinoma after surgery

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Hepatobiliary & Pancreatic Diseases International 2014年第6期13卷 594-601页

作者： Seung Duk Lee Sang-Jae Park Sung-Sik Han Seong Hoon kim young-kyu kim Soon-Ae Lee young Hwan Ko Eun kyung Hong Center for Liver Cancer Research Institute and Hospital National Cancer Center Goyang-si Gyeonggi-do Republic of Korea

BACKGROUND： Combined hepatocellular carcinoma and cholangiocarcinoma （cHCC-CC） is a rare subtype of primary liver cancer consisting of both hepatocellular carcinoma （HCC） and cholangiocarcinoma （CC）. Because of the rarity of this tumor, its feature is poorly understood. The present study aimed to evaluate the clinicopathological features and long-term prognosis of patients with cHCC-CC after surgery and to compare with those of the patients with stage-matched HCC and CC. METHODS： The dinicopathological features of the patients who underwent surgery for cHCC-CC at our center during the period of 2001-2010 were retrospectively analyzed and compared with those of stage-matched HCC and CC patients. Cancer staging was performed according to the AJCC Cancer Staging Manual （6th ed.）. Overall survival and disease-free survival were compared among the groups and prognostic factors of cHCC-CC were evaluated. RESULTS： Significant differences were observed in clinico- pathological features among 42 patients with cHCC-CC, 90 patients with HCC and 45 patients with CC. Similar to HCC patients, cHCC-CC patients had frequent hepatitis B virus antigen positivity, microscopic vessel invasion, cirrhosis and high level of serum alpha-fetoprotein. Similar to CC patients, cHCC-CC patients showed increased bile duct invasion and decreased capsule. The 1-, 3-, and 5-year overall survival and disease- free survival of patients with cHCC-CC were not significantly different from those with stage-matched patients with CC;but significantly poorer than those with HCC. In subanalysis of patients with stage Ⅱ, the overall survival in patients with cHCC-CC or CC was significantly poorer than that in patients with HCC. We did not find the difference in patients with other stages. Univariate analysis of overall and disease-free survival of patients with cHCC-CC showed that the vascular invasion and intrahepatic metastasis were the significant predictive factors. CONCLUSION： Patients with cHCC-CC showe

关键词： hepatocellular carcinoma cholangiocarcinoma stage prognosis

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A Case of co-existing pituitary adenoma and low grade glioma

A Case of co-existing pituitary adenoma and low grade glioma

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中国抗癌协会神经肿瘤专业委员会第八届学术会议

作者： Yang Won Sim young kyu kim Dong Ho kim Department of Neurosurgery College of MedicineChungbuk National university

The co-occurrence of two or more brain tumors with different histotological features is *** describe a case of low grade astrocytoma associated with a pituitary adenoma.A 42-year old woman presented with features of thyrotoxicosis such as palpitation and weight *** TSH and T3 levels were normal range,but,free T4 level was *** MRI showed the presence of a diffuse infiltrative lesion involving right temporal lobe and a heterogeneously enhancing sella and suprasellar mass.A right pterional craniotomy with right partial temporal lobectomy and removal of the pituitary tumor were *** diagnosis revealed that pituitary mass was pituitary adenoma and temporal lobe lesion was low grade ***,the features of thyrotoxicosis were diappeared,and serum T4 levels were *** are 13 earlier reports of gliomas with pituitary *** them,there are only one previous report of a thyrotropin secreting pituitary adenoma and an associated low grade *** our knowledge,this is the second report of thyrotropin secreting pituitary adenoma and an associated low grade astrocytoma

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Proposal of new expanded selection criteria using total tumor size and ^(18)F-fluorodeoxyglucose- positron emission tomography/computed tomography for living donor liver transplantation in patients with hepatocellular carcinoma:The National Cancer Center K

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World Journal of Transplantation 2016年第2期6卷 411-422页

作者： Seung Duk Lee Bora Lee Seong Hoon kim Jungnam Joo Seok-Ki kim young-kyu kim Sang-Jae Park Center for Liver Cancer Research Institute and HospitalNational Cancer Center Biometric Research Branch Research Institute and HospitalNational Cancer Center Department of Nuclear Medicine Research Institute and HospitalNational Cancer Center Department of Surgery College of MedicineJeju National University

AIM: To expand the living donor liver transplantation(LT) pool of eligible patients with hepatocellular carcinoma(HCC) using new morphological and biological ***: Patients with HCC who underwent living donor LT(LDLT) from March 2005 to May 2013 at the National Cancer Center Korea(NCCK) were enrolled. We performed the 18F-fluorodeoxyglucose positron emission tomography/computed tomography(PET/CT)before LDLT. Overall and disease-free survival analysis was done in patients to evaluate the usefulness of new NCCK criteria using PET/CT and total tumor size(10 cm).RESULTS: We enrolled a total of 280 patients who pathologically confirmed to have HCC and performed the PET/CT before transplantation. Among them, 164(58.6%) patients fulfilled the NCCK criteria and 132 patients(47.1%) met the Milan criteria. Five-year overall and disease-free survival rates for patients who fulfilled the NCCK criteria showed 85.2% and 84.0%, respectively, and were significantly higher than those beyond the NCCK criteria(60.2% and 44.4%, respectively; P < 0.001). The correlation analysis between preoperative imaging tests and pathologic reports using Cohen's Kappa demonstrated the better results in the NCCK criteria than those in the Milan criteria(0.850 vs 0.583). The comparison of diseasefree analysis among the NCCK, Milan, and University of California, San Francisco(UCSF) criteria using the receiver operating characteristics curves revealed the similar area under the curve value criteria(NCCK vs Milan, P = 0.484; NCCK vs UCSF, P = 0.189 at 5-years).CONCLUSION: The NCCK criteria using hybrid concept of both morphological and biological parameters showed an excellent agreement between preoperative imaging and pathological results, and favorable survival outcomes. These new criteria might select the optimal patients with HCC waiting LDLT and expand the selection pool.

关键词： Hepatocellular carcinoma Living donor Liver transplantation Selection criteria

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Surgical outcome of pancreatic cancer using radical antegrade modular pancreatosplenectomy procedure

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World Journal of Gastroenterology 2012年第39期18卷 5595-5600页

作者： Ye Rim Chang Sung-Sik Han Sang-Jae Park Seung Duk Lee Tae Suk Yoo young-kyu kim Tae Hyun kim Sang Myung Woo Woo Jin Lee Eun kyung Hong Department of Surgery Seoul National University HospitalSeoul 110-744South Korea Center for Liver Cancer National Cancer CenterGyeonggido 411-764South Korea

AIM:To evaluate the surgical outcomes following radical antegrade modular pancreatosplenectomy (RAMPS) for pancreatic cancer. METHODS:Twenty-four patients underwent RAMPS with curative intent between January 2005 and June 2009 at the National Cancer Center, South Korea. Clinicopathologic data, including age, sex, operative findings, pathologic results, adjuvant therapy, postop-erative clinical course and follow-up data were retro-spectively collected and analyzed for this study. RESULTS:Twenty-one patients (87.5%) underwent distal pancreatectomy and 3 patients (12.5%) underwent total pancreatectomy using RAMPS. Nine patients (37.5%) underwent combined vessel resection, including 8 superior mesenteric-portal vein resections and 1 celiac axis resection. Two patients (8.3%) underwent combined resection of other organs, including the colon, stomach or duodenum. Negative tangential margins were achieved in 22 patients (91.7%). The mean tumor diameter for all patients was 4.09 ± 2.15 cm. The 2 patients with positive margins had a mean diameter of 7.25 cm. The mean number of retrieved lymph nodes was 20.92 ± 11.24 and the node positivity rate was 70.8%. The median survival of the 24 patients was 18.23 ± 6.02 mo. Patients with negative margins had a median survival of 21.80 ± 5.30 mo and those with positive margins had a median survival of 6.47 mo (P = 0.021). Nine patients (37.5%) had postoperative complications, but there were no postoperative mortalities. Pancreatic fistula occurred in 4 patients (16.7%):2 patients had a grade A fistula and 2 had a grade B fistula. On univariate analysis, histologic grade, positive tangential margin, pancreatic fistula and adjuvant therapy were significant prognostic factors for survival. CONCLUSION:RAMPS is a feasible procedure for achieving negative tangential margins in patients with carcinoma of the body and tail of the pancreas.

关键词： Carcinoma Pancreas Surgical resection Sur-vival Radical antegrade modular pancreatosplenectomy

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