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Potential risk factors for nonalcoholic steatohepatitis related to pancreatic secretions following pancreaticoduodenectomy

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World Journal of Gastroenterology 2011年第32期17卷 3716-3723页

作者： Sun Choon Song Seong Ho Choi Dong Wook Choi jin seok heo Woo seok Kim Min Jung Kim Department of Surgery Samsung Medical Center Sungkyunkwan University School of Medicine

AIM: To identify risk factors for nonalcoholic steatohepatitis following pancreaticoduodenectomy, with a focus on factors related to pancreatic secretions. METHODS: The medical records of 228 patients who had a pancreaticoduodenectomy over a 16-mo period were reviewed retrospectively. The 193 patients who did not have fatty liver disease preoperatively were included in the final analysis. Hepatic steatosis was diagnosed using the differences between splenic and hepatic attenuation and liver-to-spleen attenuation as measured by non-enhanced computed tomography. RESULTS: Fifteen patients (7.8%) who showed postoperative hepatic fatty changes were assigned to Group A, and the remaining patients were assigned to Group B. Patient demographics, preoperative laboratory findings (including levels of C-peptide, glucagon, insulin and glucose tolerance test results), operation types, and final pathological findings did not differ significantly between the two groups; however, the frequency of pancreatic fistula (P = 0.020) and the method of pancreatic duct stenting (P = 0.005) showed significant differences between the groups. A multivari- ate analysis identified pancreatic fistula (HR = 3.332, P = 0.037) and external pancreatic duct stenting (HR = 4.530, P = 0.017) as independent risk factors for the development of postoperative steatohepatitis. CONCLUSION: Pancreatic fistula and external pancreatic duct stenting were identified as independent risk factors for the development of steatohepatitis following pancreaticoduodenectomy.

关键词： Nonalcoholic fatty liver diseases Nonalcoholic steatohepatitis Pancreatic duct stenting Pancreatic fistula Pancreatic surgery

Carcinoma of the middle bile duct:Is bile duct segmental resection appropriate?

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World Journal of Gastroenterology 2009年第47期15卷 5966-5971页

作者： Hyung Geun Lee Sang Hoon Lee Dong Do Yoo Kwang Yeol Paik jin seok heo Seong Ho Choi Dong Wook Choi Department of Surgery Samsung Medical CenterSungkyunkwan University School of MedicineSeoul 135-710South Korea

AIM:To compare survival between bile duct segmental resection(BDSR)and pancreaticoduodenectomy(PD) for treating distal bile duct cancers. METHODS:Retrospective analysis was conducted for 45 patients in a BDSR group and for 149 patients in a PD group. RESULTS:The T-stage(P<0.001),lymph node invasion (P=0.010)and tumor differentiation(P=0.005)were significant prognostic factors in the BDSR *** 3-and 5-year overall survival rates for the BDSR group and PD group were 51.7%and 36.6%,respectively and 46.0%and 38.1%,respectively(P=0.099).The BDSR group and PD group did not show any significant difference in survival when this was adjusted for the TNM *** 3-and 5-year survival rates were: stageⅠa[BDSR(100.0%and 100.0%)vs PD(76.9% and 68.4%)(P=0.226)];stageⅠb[BDSR(55.8% and 32.6%)vs PD(59.3%and 59.3%)(P=0.942)]; stageⅡb[BDSR(19.2%and 19.2%)vs PD(31.9%and 14.2%)(P=0.669)]. CONCLUSION:BDSR can be justified as an alternative radical operation for patients with middle bile duct inselected patients with no adjacent organ invasion and resection margin is negative.

关键词： Bile duct cancer Segmental resection Pancreaticoduodenectomy

Risk prediction platform for pancreatic fistula after pancreatoduodenectomy using artificial intelligence

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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 *** intelligence(AI)technology is being actively used in the medical field,but few studies have reported applying it to outcomes after *** To develop a risk prediction platform for POPF using an AI *** 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 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 *** area under the curve(AUC)was calculated to examine the discriminative power of algorithm for POPF *** The number of POPFs was 221(12.5%)according to the International Study Group of Pancreatic Fistula definition *** median imputation,AUCs using 38 variables were 0.68±0.02 with RF and 0.71±0.02 with *** maximal AUC using NN with RFE was *** 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 *** developed a web-based POPF prediction platform,and this application is freely available at http://*** This study is the first to predict POPF with multiple risk factors using *** platform is reli

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

Predictive factors associated with malignancy of intraductal papillary mucinous pancreatic neoplasms

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World Journal of Gastroenterology 2010年第42期16卷 5353-5358页

作者： jin Hee Lee Kyu Taek Lee Jongwook Park Sun Youn Bae Kwang Hyuck Lee Jong Kyun Lee Kee-Taek Jang jin seok heo Seong Ho Choi Dong Wook Choi Jong Chul Rhee Department of Medicine Samsung Medical CenterSungkyunkwan University School of MedicineSeoul 135710South Korea Department of Pathology Samsung Medical CenterSungkyunkwan University School of MedicineSeoul 135710South Korea Department of Surgery Samsung Medical CenterSungkyunkwan University School of MedicineSeoul 135710South Korea

AIM:To identify preoperative predictive factors associated with malignancy of intraductal papillary mucinous neoplasms(IPMNs) of the ***:Between April 1995 and April 2010,129 patients underwent surgical resection for IPMNs at our institute and had confirmed pathologic *** medical records were retrospectively reviewed and immunohistochemical staining for mucin(MUC) in pancreatic tissues was ***:Univariate analysis showed that the following five variables were closely associated with malignant IPMNs preoperatively:absence of extrapancreatic malignancy;symptoms;tumor size > 4 cm;main pancreaticduct(MPD) size > 7 mm;and lymph node enlargement on preoperative computed tomography(CT).Multivariate analysis revealed that the following two factors were significantly associated with malignant IPMNs preoperatively:MPD size > 7 mm [odds ratio(OR) = 2.50];and lymph node enlargement on preoperative CT(OR = 3.57).No significant differences in the expression of MUC1,MUC2 and MUC5AC were observed between benign and malignant ***:MPD size > 7 mm and preoperative lymph node enlargement on CT are useful predictive factors associated with malignancy of IPMNs.

关键词： Intraductal papillary mucinous neoplasms Malignancy Predictive factors Pancreatic neoplasms

Highly Aligned Ternary Nanofiber Matrices Loaded with MXene Expedite Regeneration of Volumetric Muscle Loss

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Nano-Micro Letters 2024年第4期16卷 269-292页

作者： Moon Sung Kang Yeuni Yu Rowoon Park Hye jin heo seok Hyun Lee Suck Won Hong Yun Hak Kim Dong‑Wook Han Department of Cogno‑Mechatronics Engineering College of Nanoscience and NanotechnologyPusan National UniversityBusan 46241Republic of Korea Medical Research Institute School of MedicinePusan National UniversityYangsan 50612Republic of Korea Department of Anatomy School of MedicinePusan National UniversityYangsan 50612Republic of Korea Engineering Research Center for Color‑Modulated Extra‑Sensory Perception Technology Pusan National UniversityBusan 46241Republic of Korea Department of Biomedical Informatics School of MedicinePusan National UniversityYangsan 50612Republic of Korea Periodontal Disease Signaling Network Research Center and Dental and Life Science Institute School of DentistryPusan National UniversityYangsan 50612Republic of Korea BIO‑IT Fusion Technology Research Institute Pusan National UniversityBusan 46241Republic of Korea Present Address:Osstem Implant Inc. Seoul 07789Republic of Korea

Current therapeutic approaches for volumetric muscle loss(VML)face challenges due to limited graft availability and insufficient *** overcome these limitations,tissue-engineered scaffolds have emerged as a promising *** this study,we developed aligned ternary nanofibrous matrices comprised of poly(lactide-co-ε-caprolactone)integrated with collagen and Ti_(3)C_(2)T_(x)MXene nanoparticles(NPs)(PCM matrices),and explored their myogenic potential for skeletal muscle tissue *** PCM matrices demonstrated favorable physicochemical properties,including structural uniformity,alignment,microporosity,and *** vitro assays revealed that the PCM matrices promoted cellular behaviors and myogenic differentiation of C2C12 ***,in vivo experiments demonstrated enhanced muscle remodeling and recovery in mice treated with PCM matrices following VML *** insights from next-generation sequencing revealed that MXene NPs facilitated protein and ion availability within PCM matrices,leading to elevated intracellular Ca^(2+)levels in myoblasts through the activation of inducible nitric oxide synthase(i NOS)and serum/glucocorticoid regulated kinase 1(SGK1),ultimately promoting myogenic differentiation via the m TOR-AKT ***,upregulated i NOS and increased NO–contributed to myoblast proliferation and fiber fusion,thereby facilitating overall myoblast *** findings underscore the potential of MXene NPs loaded within highly aligned matrices as therapeutic agents to promote skeletal muscle tissue recovery.

关键词： Ti_(3)C_(2)T_(x)MXene nanoparticle Ternary nanofibrous matrices Myogenesis Regeneration of volumetric muscle loss Next generation sequencing

Acetylacetone-TiO_(2) Promoted Large Area Compatible Cascade Electron Transport Bilayer for Efficient Perovskite Solar Cells

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Energy & Environmental Materials 2024年第2期7卷 221-228页

作者： Hyong Joon Lee jin Kyoung Park jin Hyuck heo Sang Hyuk Im Department of Chemical and Biological Engineering Korea University145 Anam-ro Seongbuk-guSeoul 17104Korea

In designing efficient perovskite solar cells(PSCs),the selection of suitable electron transport layers(ETLs)is critical to the final device performance as they determine the driving force for selective charge ***_(2)nanoparticles(NPs)based ETLs have been a popular choice for PSCs due to superior electron mobility,but their relatively deep-lying conduction band energy levels(ECB)result in substantial potential ***,TiO_(2)NPs establish favorable band alignment owing to shallower ECB,but their low intrinsic mobility and abundant surface trap sites impede the final *** this reason,constructing a cascaded bilayer ETL is highly desirable for efficient PSCs,as it can rearrange energy levels and exploit on advantages of an individual *** this study,we prepare SnO_(2)NPs and acetylacetone-modified TiO_(2)(Acac-TiO_(2))NPs and implement them as bilayer SnO_(2)/Acac-TiO_(2)(BST)ETL,to assemble cascaded energy band ***_(2)contributes to rapid charge carrier transport from high electron mobility while Acac-TiO_(2)minimizes band-offset and effectively suppresses interfacial ***,the optimized BST ETL generates synergistic influence and delivers power conversion efficiency(PCE)as high as 23.14%with open-circuit voltage(V_(oc))reaching 1.14 ***,the BST ETL is transferred to a large scale and the corresponding mini module demonstrates peak performance of 18.39%PCE from 25 cm^(2)aperture ***,the BST-based mini module exhibit excellent stability,maintaining 83.1%of its initial efficiency after 1000 h under simultaneous 1 Sun light-soaking and damp heat(85℃/RH 85%)environment.

关键词： acetylacetone large area perovskite solar cells TiO_(2)

Analysis of liver metastasis after resection for pancreatic ductal adenocarcinoma

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World Journal of Gastrointestinal Oncology 2012年第5期4卷 109-114页

作者： Kwang Yeol Paik Seong Ho Choi jin seok heo Dong Wook Choi Department of Surgery Yeouido St.Mary's HospitalCatholic UniversityCollege of Medicine# 62 Yeouido-dongYeongdeungpo-gu150-713 SeoulSouth Korea Department of Surgery Samsung Medical CenterSungkyunkwan University School of Medicine135-710 SeoulSouth Korea

AIM:To investigate the risk factors affecting the liver metastasis(LM) of pancreatic ductal adenocarcinoma(PDAC) after ***:We retrospectively analyzed 101 PDAC patients who underwent surgical resection at the Samsung Medical Center between January 2000 and December *** one patients with LM were analyzed for the time of metastasis,prognostic factors affecting LM,and ***:LM was found in 40.6%.The median time of the LM(n = 41) was 6.0 ± 4.6 mo and most LM occurred within 1 *** univariate analysis,tumor size,preoperative carbohydrate antigen 19-9,and perineural invasion were factors affecting LM after *** multivariate analysis,tumor size was the most important factor for *** univariate analysis,tumor cell differentiation was significant to LM in low-risk ***:LM after resection of PDAC occurs early and shows poor *** size is the key indicator for LM after resection.

关键词： Pancreatic ductal adenocarcinoma Liver metastasis Recurrence

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

Hepatectomy vs radiofrequency ablation for colorectal liver metastasis:A propensity score analysis

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World Journal of Gastroenterology 2015年第11期21卷 3300-3307页

作者： Huisong Lee jin seok heo Yong Beom Cho Seong Hyeon Yun Hee Cheol Kim Woo Yong Lee Seong Ho Choi Dong Wook Choi Department of Surgery Samsung Medical CenterSungkyunkwan University School of Medicine

AIM:To compare outcomes from radiofrequency ablation(RFA) and hepatectomy for treatment of colorectal liver metastasis(CRLM).METHODS:From January 2000 to December 2009,408 patients underwent curative intent treatment for *** excluded patients using the criteria:size of CRLM > 3 cm,number of CRLM ≥ 5,percutaneous RFA,follow-up period 2 cm) CRLM(P = 0.034).However,survival curves were similar for single or small(≤ 2 cm) CRLM(P = 0.714,P = 0.740).CONCLUSION:Hepatectomy is better than RFA for the treatment of ***,RFA might be suitable for selected patients with single,small(≤ 2 cm) CRLM.

关键词： Colorectal neoplasm Metastasis Catheter ablation H