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Unilateral versus bilateral Y-type stent-in-stent metal stent insertions in inoperable malignant hilar biliary strictures:A multicenter retrospective study

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Hepatobiliary & Pancreatic Diseases International 2021年第6期20卷 561-567页

作者： Ik Hyun Jo chang-Nyol Paik Dae Bum Kim jaesin Lee Jong Yul Lee jae hyuck chang Kyu-Hyun Paik Won-Suk Park Department of Internal Medicine College of MedicineSt.Vincent’s HospitalThe Catholic University of KoreaSeoulKorea Department of Internal Medicine College of MedicineIncheon St.Mary’s HospitalThe Catholic University of KoreaSeoulKorea Department of Internal Medicine College of MedicineBucheon St.Mary’s HospitalThe Catholic University of KoreaSeoulKorea Department of Internal Medicine College of MedicineDaejeon St.Mary’s HospitalThe Catholic University of KoreaSeoulKorea

Background:To date,there is controversy regarding unilateral versus bilateral stent placement in patients with malignant hilar biliary strictures(MHBSs).The aim of this study was to compare the clinical outcomes and complications of unilateral and bilateral(stent-in-stent method)stent placements for these ***:We conducted a multicenter retrospective analysis of patients with inoperable MHBS who underwent endoscopic self-expandable metal stent(SEMS)placement from January 2009 to December *** groups classified according to the stent procedure method were compared for demographic,procedural,and postprocedure *** analysis for patency loss and overall survival was also ***:A total of 236 subjects were included.A superior technical success rate was found in the unilateral stent group(98.8%vs.82.5%,P<0.001),whereas the clinical success rate was higher in the bilateral group(85.7%vs.70.5%,P=0.028).There was no significant difference with respect to complications or patency loss,and the bilateral group had better overall survival(P<0.01).In the Cox proportional hazard model,MHBSs from lymph node compression were associated with a higher risk of death(HR=9.803,P=0.003).In contrast,bilateral SEMS insertion showed reduced postprocedural mortality(HR=0.316,P=0.001).Conclusions:Y-type stent-in-stent bilateral SEMSs are technically difficult but demonstrated more favorable overall survival for palliative bile drainage of inoperable MHBS patients compared to unilateral insertions.

关键词： Cholestasis Extrahepatic neoplasm Cholangiopancreatography Endoscopy Self-expandable metal stents

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Clinical outcomes of self-expandable metal stents in palliation of malignant anastomotic strictures caused by recurrent gastric cancer

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World Journal of Gastroenterology 2009年第28期15卷 3523-3527页

作者： Yu Kyung Cho Sang Woo Kim Kwan Woo Nam jae hyuck chang jae Myung Park Jeong-Jo Jeong In Seok Lee Myung-Gyu Choi In-Sik Chung Department of Internal Medicine The Catholic University of Korea

AIM:To examine the technical feasibility and clinical outcomes of the endoscopic insertion of a self-expandable metal stent(SEMS) for the palliation of a malignant anastomotic stricture caused by recurrent gastric ***:The medical records of patients, who had obstructive symptoms caused by a malignant anastomotic stricture after gastric surgery and underwent endoscopic insertion of a SEMS from January 2001 to December 2007 at Kangnam St Mary's Hospital, were reviewed ***:Twenty patients(15 male, mean age 63 years) were *** operations were a total gastrectomy with esophagojejunostomy(n = 12), subtotal gastrectomy with Billroth-—migration occurred with a covered stent in 3 patients who underwent a subtotal gastrectomy with *** cases of partial stent migration were easily treated with a second stent or stent *** median stent patency was 56 d(range, 5-439 d).The median survival was 83 d(range, 12-439 d).CONCLUSION:Endoscopic insertion of a SEMS provides safe and effective palliation of a recurrent anastomotic stricture caused by gastric cancer.A meticulous evaluation of the presence of other strictures before inserting the stent is essential for symptom improvement.

关键词：金属支架膨胀恶性狭窄复发胃癌临床

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Newly developed autoimmune cholangitis without relapse of autoimmune pancreatitis after discontinuing prednisolone

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World Journal of Gastroenterology 2012年第41期18卷 5990-5993页

作者： Ji Hun Kim jae hyuck chang Sung Min Nam Mi Jeong Lee Il Ho Maeng Jin Young Park Yun Sun Im Tae Ho Kim chang Whan Kim Sok Won Han Department of Internal Medicine College of MedicineThe Catholic University of KoreaSeoul 137-701South Korea

A 57-year-old man presented with a 2-wk history of painless jaundice and weight *** had a large illdefined enhancing mass-like lesion in the uncinate process of the pancreas with stricture of the distal common bile *** cytology of the pancreatic mass demonstrated inflammatory cells without evidence of *** serum immunoglobulin G level was slightly elevated,but IgG4 level was *** the 2-wk 40 mg prednisolone trial,the patient's symptoms and bilirubin level improved significantly.A follow-up computed tomography(CT) scan showed a dramatic resolution of the pancreatic lesion.A low dose steroid was *** six months he self-discontinued prednisolone for 3 wk,and was presented with jaundice again.A CT scan showed newly developed intrahepatic biliary dilatation and marked concentric wall thickening of the common hepatic duct and the proximal common bile duct without pancreatic *** patient' s IgG4 level was elevated to 2.51 g/*** was started again,after which his serum bilirubin level became normal and the thickening of the bile duct was *** case suggests that autoimmune pancreatitis can progress to other organs that are not involved at the initial diagnosis,even with sustained pancreatic remission.

关键词：自身免疫性泼尼松龙胰腺炎胆管开发计算机断层扫描复发免疫球蛋白G

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Comparative study of rendezvous techniques in post-liver transplant biliary stricture

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World Journal of Gastroenterology 2012年第41期18卷 5957-5964页

作者： jae hyuck chang In Seok Lee Ho Jong Chun Jong Young Choi Seung Kyoo Yoon Dong Goo Kim Young Kyoung You Myung-Gyu Choi Sok Won Han Department of Internal Medicine College of MedicineThe Catholic University of KoreaSeoul 137-701South Korea Department of Radiology College of MedicineThe Catholic University of KoreaSeoul 137-701South Korea Department of Surgery College of MedicineThe Catholic University of KoreaSeoul 137-701South Korea

AIM:To investigate the usefulness of a new rendezvous technique for placing stents using the Kumpe(KMP) catheter in angulated or twisted biliary ***:The rendezvous technique was performed in patients with a biliary stricture after living donor liver transplantation(LDLT) who required the exchange of percutaneous transhepatic biliary drainage catheters for inside *** rendezvous technique was performed using a guidewire in 19 patients(guidewire group) and using a KMP catheter in another 19(KMP catheter group).We compared the two groups ***:The baseline characteristics did not differ between the *** success rate for placing inside stents was 100% in both groups.A KMP catheter was easier to manipulate than a *** mean procedure time in the KMP catheter group(1012 s,range:301-2006 s) was shorter than that in the guidewire group(2037 s,range:251-6758 s,P = 0.022).The cumulative probabilities corresponding to the procedure time of the two groups were significantly different(P = 0.008).The factors related to procedure time were the rendezvous technique method,the number of inside stents,the operator,and balloon dilation of the stricture(P < 0.05).In a multivariate analysis,the rendezvous technique method was the only significant factor related to procedure time(P = 0.010).The procedural complications observed included one case of mild acute pancreatitis and one case of acute cholangitis in the guidewire group,and two cases of mild acute pancreatitis in the KMP catheter ***:The rendezvous technique involving use of the KMP catheter was a fast and safe method for placing inside stents in patients with LDLT biliary stricture that represents a viable alternative to the guidewire rendezvous technique.

关键词：肝移植技术狭窄胆道急性胰腺炎 KMP 多变量分析导管

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Duodenal obstruction following acute pancreatitis caused by a large duodenal diverticular bezoar

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World Journal of Gastroenterology 2012年第38期18卷 5485-5488页

作者： Ji Hun Kim jae hyuck chang Sung Min Nam Mi Jeong Lee Il Ho Maeng Jin Young Park Yun Sun Im Tae Ho Kim Il Young Park Sok Won Han Department of Internal Medicine College of Medicine The Catholic University of Korea Seoul 137-701 South Korea Department of Surgery College of Medicine The Catholic University of Korea Seoul 137-701 South Korea

Bezoars are concretions of indigestible materials in the gastrointestinal tract. It generally develops in patients with previous gastric surgery or patients with delayed gastric emptying. Cases of periampullary duodenal divericular bezoar are rare. Clinical manifestations by a bezoar vary from no symptom to acute abdominal syndrome depending on the location of the bezoar. Biliary obstruction or acute pancreatitis caused by a bezoar has been rarely reported. Small bowel obstruction by a bezoar is also rare, but it is a complication that requires surgery. This is a case of acute pancreatitis and subsequent duodenal obstruction caused by a large duodenal bezoar migrating from a periampullary diverticulum to the duodenal lumen, which mimicked pancreatic abscess or microperforation on abdominal computerized tomography. The patient underwent surgical removal of the bezoar and recovered completely.

关键词：急性胰腺炎十二指肠肠梗阻牛黄手术治疗临床表现断层扫描手术切除

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Long-term outcome of stem cell transplantation with and without anti-tumor necrotic factor therapy in perianal fistula with Crohn’s disease

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World Journal of Stem Cells 2024年第3期16卷 257-266页

作者： Min Young Park Yong Sik Yoon jae Ha Park Jong Lyul Lee chang Sik Yu Division of Colon and Rectal Surgery Department of SurgeryYonsei University College of MedicineSeoul 03722South Korea Division of Colon and Rectal Surgery Department of SurgeryUniversity of Ulsan College of MedicineAsan Medical CenterSeoul 05505South Korea

BACKGROUND Stem cell transplantation is a promising therapeutic option for curing perianal fistula in Crohn’s disease(CD).Anti-tumor necrotic factor(TNF)therapy combined with drainage procedure is effective as ***,previous studies are limited to proving whether the combination treatment of biologics and stem cell transplantation improves the effect of fistula *** This study aimed to evaluate the long-term outcomes of stem cell transplantation and compare Crohn’s perianal fistula(CPF)closure rates after stem cell transplantation with and without anti-TNF therapy,and to identify the factors affecting CPF closure and *** The patients with CD who underwent stem cell transplantation for treating perianal fistula in our institution between Jun 2014 and December 2022 were *** data were compared according to anti-TNF therapy and CPF *** A total of 65 patients were *** median age of females was 26 years(range:21-31)and that of males was 29(44.6%).The mean follow-up duration was 65.88±32.65 months,and complete closure was observed in 50(76.9%)*** closure rates were similar after stem cell transplantation with and without anti-TNF therapy(66.7%vs 81.6%at 3 year,P=0.098).The patients with fistula closure had short fistulous tract and infrequent proctitis and anorectal stricture(P=0.027,0.002,and 0.008,respectively).Clinical factors such as complexity,number of fistulas,presence of concurrent abscess,and medication were not significant for *** cumulative 1-,2-,and 3-year closure rates were 66.2%,73.8%,and 75.4%,*** Anti-TNF therapy does not increase CPF closure rates in patients with stem cell ***,both refractory and non-refractory CPF have similar closure rates after additional anti-TNF *** tract length,proctitis,and anal stricture are risk factors for non-closure in patients with CPF after stem cell transplantation.

关键词： Crohn’s disease Anus Fistula Stem cell transplantation Tumor necrosis factor-alpha inhibitors Infliximab

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Short- and long-term outcomes of surgical treatment in patients with intestinal Behcet’s disease

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World Journal of Gastrointestinal Surgery 2024年第2期16卷 429-437页

BACKGROUND Behcet’s disease(BD),a chronic vasculitic disorder affecting multiple organs,is characterized by recurrent oral and genital ulcers,arthritis,vasculitis,and intes-tinal *** intestinal involvement of BD is common in East Asia,the efficacy and long-term outcomes of surgical treatment of intestinal BD still remain to be *** To evaluate the postoperative clinical course of intestinal BD and determine factors associated with its *** Data from patients who underwent surgical treatment for intestinal BD between January 2010 and August 2021 were retrospectively ***’demo-graphics,clinical features,postoperative course,complications,and follow-up data were *** We analyzed 39 surgeries in 31 *** mean patient age was 45.1 years,and the mean interval between the diagnosis of intestinal BD and surgical treatment was 4.9 years(range 1.0-8.0 years).The most common indication for surgery was medical intractability(n=16,41.0%),followed by fistula or abscess(n=11,28.2%).Laparoscopic approaches were used in 19 patients(48.7%),and 5 patients(12.8%)underwent emergency *** most common surgical procedure was ileocecal resection(n=18,46.2%),followed by right colectomy(n=11,28.2%).A diverting stoma was created in only one patient(2.6%).During a mean follow-up period of 45(range 8-72)months,eight cases(20.5%)of recurrence in five patients required *** interval between operations was 12.1 months(range 6.3-17.8 mo).Four patients(10.3%)experienced recurrence within 1 year postoperatively,and all eight recurrences occurred within 2 years of the initial *** reoperation rates at 1 and 3 years were 10.3%and 20.5%,respectively.A redo ileocolic anastomosis was performed in all recurrent *** multivariate Cox regression analysis,emergency surgery[hazard ratio(HR)9.357,95%confidence interval(CI):1.608-54.453,P=0.013]and elevated C-reactive protein(CRP)levels(HR 1.154,95%CI:1.002–1.328,

关键词： Behcet syndrome Intestinal General surgery Recurrence Risk factors

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Current diagnosis and treatment of benign biliary stricturesafter living donor liver transplantation

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World Journal of Gastroenterology 2016年第4期22卷 1593-1606页

作者： jae hyuck chang Inseok Lee Myung-Gyu Choi Sok Won Han Division of Gastroenterology Department of Internal MedicineCollege of MedicineThe Catholic University of KoreaSeoul 137-701South Korea

Despite advances in surgical techniques, benign biliary strictures after living donor liver transplantation(LDLT) remain a significant biliary complication and play an important role in graft and patient survival. Benign biliary strictures after transplantation are classified into anastomotic or non-anastomotic strictures. These two types differ in presentation, outcome, and response to therapy. The leading causes of biliary strictures include impaired blood supply, technical errors during surgery, and biliary anomalies. Because patients usually have non-specific symptoms, a high index of suspicion should be maintained. Magnetic resonance cholangiography has gained widespread acceptance as a reliable noninvasive tool for detecting biliary complications. Endoscopy has played an increasingly prominent role in the diagnosis and treatment of biliary strictures after LDLT. Endoscopic management in LDLT recipients may be more challenging than in deceased donor liver transplantation patients because of the complex nature of the duct-to-duct reconstruction. Repeated aggressive endoscopic treatment with dilation and the placement of multiple plastic stents is considered the first-line treatment for biliary strictures. Percutaneous and surgical treatments are now reserved for patients for whom endoscopic management fails and for those with multiple, inaccessible intrahepatic strictures or Roux-en-Y anastomoses. Recent advances in enteroscopy enable treatment, even in these latter cases. Direct cholangioscopy, another advanced form of endoscopy, allows direct visualization of the inner wall of the biliary tree and is expected to facilitate stenting or stone extraction. Rendezvous techniques can be a good option when the endoscopic approach to the biliary stricture is unfeasible. These developments have resulted in almost all patients being managed by the endoscopic approach.

关键词： Biliary strictures Living donor liver transplantation Endoscopic retrograde cholangiography Percutaneous transhepatic cholangiography Biliarycomplication

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Stable immobilization of lithium polysulfides using three-dimensional ordered mesoporous Mn2O3 as the host material in lithium-sulfur batteries

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Carbon Energy 2024年第6期6卷 99-112页

作者： Sung Joon Park Yun Jeong Choi Hyun-seung Kim Min Joo Hong Hongjun chang Janghyuk Moon Young-Jun Kim Junyoung Mun Ki jae Kim Department of Energy Science Sungkyunkwan UniversitySuwonGyeonggi-doRepublic of Korea Department of Energy Engineering Konkuk UniversitySeoulRepublic of Korea Advanced Batteries Research Center Korea Electronic Technology InstituteSeongnamRepublic of Korea Department of Future Energy Engineering Sungkyunkwan UniversitySuwonRepublic of Korea Department of Energy Systems Engineering Chung-Ang UniversitySeoulRepublic of Korea SKKU Advanced Institute of Nanotechnology Sungkyunkwan UniversitySuwonGyeonggi-doRepublic of Korea SKKU Institute of Energy Science and Technology(SIEST) Sungkyunkwan UniversitySuwonRepublic of Korea School of Advanced Materials Science and Engineering Sungkyunkwan UniversitySuwonRepublic of Korea

Lithium-sulfur batteries(LSBs)have drawn significant attention owing to their high theoretical discharge capacity and energy ***,the dissolution of long-chain polysulfides into the electrolyte during the charge and discharge process(“shuttle effect”)results in fast capacity fading and inferior electrochemical *** this study,Mn_(2)O_(3)with an ordered mesoporous structure(OM-Mn_(2)O_(3))was designed as a cathode host for LSBs via KIT-6 hard templating,to effectively inhibit the polysulfide shuttle ***-Mn_(2)O_(3)offers numerous pores to confine sulfur and tightly anchor the dissolved polysulfides through the combined effects of strong polar-polar interactions,polysulfides,and sulfur chain *** OM-Mn_(2)O_(3)/S composite electrode delivered a discharge capacity of 561 mAh g-1 after 250 cycles at 0.5 C owing to the excellent performance of OM-Mn_(2)O_(3).Furthermore,it retained a discharge capacity of 628mA h g-1 even at a rate of 2 C,which was significantly higher than that of a pristine sulfur electrode(206mA h g-1).These findings provide a prospective strategy for designing cathode materials for high-performance LSBs.

关键词： host material lithium-sulfur battery ordered mesoporous structure shuttle effect transition-metal oxides

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电沉积Mo和Mo-Co合金纳米线用于互联电阻的电阻率改性

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Engineering 2024年第1期32卷 127-137页

作者： Jun Hwan Moon Taesoon Kim Youngmin Lee Seunghyun Kim Yanghee Kim jae-Pyoung Ahn Jungwoo Choi hyuck Mo Lee Young Keun Kim Department of Materials Science and Engineering Korea UniversitySeoul 02841Republic of Korea Department of Materials Science and Engineering Korea Advanced Institute of Science and EngineeringDaejeon 34141Republic of Korea Advanced Analysis Center Korea Institute of Science and TechnologySeoul 02792Republic of Korea Research Resources Division Korea Institute of Science and TechnologySeoul 02792Republic of Korea

Achieving historically anticipated improvement in the performance of integrated circuits is challenging,due to the increasing cost and complexity of the required technologies with each new *** overcome this limitation,the exploration and development of novel interconnect materials and processes are highly desirable in the microelectronics ***(Mo)is attracting attention as an advanced interconnect material due to its small resistivity size effect and high cohesive energy;however,effective processing methods for such materials have not been widely ***,we investigate the electrochemical behavior of ions in the confined nanopores that affect the electrical properties and microstructures of nanoscale Mo and Mo-Co alloys prepared via template-assisted *** in an electrolyte allow the deposition of extremely pure metal materials,due to their interac-tion with metal ions and *** this study,boric acid and tetrabutylammonium bisulfate(TBA)were added to an acetate bath to inhibit the hydrogen evolution *** accelerated the reduction of Mo at the surface by inducing surface conduction on the *** Mo nanowires with a 130 nm diameter synthesized through high-aspect-ratio nanopore engineering exhibited a resistivity of(63.0±17.9)μΩ*** also evaluated the resistivities of Mo-Co alloy nanowires at various compo-sitions toward replacing irreducible conventional barrier/liner *** intermetallic compound formed at a Mo composition of 28.6 at%,the resistivity of the Mo-Co nanowire was(58.0±10.6)μΩcm,indicat-ing its superior electrical and adhesive properties in comparison with those of conventional barriers such as TaN and ***,density functional theory and non-equilibrium Green's function calcula-tions confirmed that the vertical resistance of the via structure constructed from Mo-based materials was 21%lower than that of a conventional Cu/Ta/TaN structure.

关键词： Molybdenum Molybdenum-cobalt Interconnect Microstructure Electrodeposition Density functional theory

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