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Revision of bilateral self-expandable metallic stents placed using the stent-in-stent technique for malignant hilar biliary obstruction

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Hepatobiliary & Pancreatic Diseases International 2018年第5期17卷 437-442页

作者： Jun Hyuk Son Hee Seung Lee Sang Hyub Lee seungmin bang Jinwoo Kang Woo Hyun Paik Ji Kon Ryu Yong-Tae Kim Department of Internal Medicine and Liver Research Institute Seoul National University HospitalSeoul National University College of MedicineSeoulKorea Department of Internal Medicine Inje University Ilsan Paik HospitalGoyangKorea Department of Internal Medicine Institute of GastroenterologyYonsei University College of MedicineSeoulKorea Department of Gastroenterology and Hepatology SMG-SNU Boramae Medical CenterSeoulKorea

Background: Endoscopic biliary decompression using bilateral self-expandable metallic stent(SEMS) placed using the stent-in-stent(SIS) technique is considered favorable for unresectable malignant hilar biliary obstruction(MHBO). However, occlusion of the bilateral SIS placement is frequent and revision can be challenging. This study was performed to investigate the efficacy, the long-term patency and the appropriate approach for revision of occluded bilateral SIS placement in unresectable MHBO. Methods: From January 2011 to July 2016, thirty-eight patients with unresectable MHBO underwent revision of occluded bilateral SIS placement. Clinical data including success rates and patency of revision, were retrospectively analyzed. Results: The technical success rate of revision was 76.3%. The clinical success rate of revision was 51.7% and mean patency of revision was 49.1 days. No significant predictive factor for clinical failure of revision was observed. The cell size of SEMS was not found to have significant effects on clinical success rates or revision patency. Conclusions: Revision of occluded bilateral SIS placement for MHBO showed fair patency and clinical success rate. Revision method and cell size of SEMS were not found to influence clinical outcomes.

关键词： Malignant hilar biliary obstruction Self-expandable metallic stent Stent-in-stent Revision

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KML001, an arsenic compound, as salvage chemotherapy in refractory biliary tract cancers: A prospective study

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Hepatobiliary & Pancreatic Diseases International 2019年第1期18卷 62-66页

作者： Jung Hyun Jo Huapyong Kang Hee Seung Lee Moon Jae Chung Jeong Youp Park seungmin bang Seung Woo Park Si Young Song Division of Gastroenterology Department of Internal Medicine Severance Hospital Yonsei University College of Medicine

Background: Sodium meta-arsenite(NaAsO_2, KML001) is a potential oral anticancer agent acting on telomerase and telomere length. This prospective study evaluated its safety, tolerability, and effectiveness as salvage chemotherapy in patients with advanced biliary tract cancer(BTC) resistant to gemcitabinebased chemotherapy. Methods: Forty-four patients(21 women and 23 men) with advanced BTC and failure history of gemcitabine-based chemotherapy, performance status(PS) 0–2, normal cardiac, hepatic, and renal function were enrolled. Daily dose of KML001(7.5 mg. p.o.) was administered to eligible subjects for 24 weeks divided into six treatment cycles. Response was evaluated bimonthly using CT. Results: After an average of 1.5 months of treatment(range: 0.5–10.0), 3 patients(6.8%) obtained progression-free status, 23 patients(52.3%) had disease progression, and 18 patients(40.9%) dropped out before evaluation. One patient(2.3%) completed six treatment cycles without progression. During the treatment, morphine dosage kept the same or decreased in 20 patients(47.6%). Nine patients(20.5%) experienced grade-3 adverse events(AEs), while no patient experienced grade-4 AEs. The most common AEs were liver enzyme elevation(11/44, 25%) and anemia(10/44, 22.7%). KML001 was discontinued in six patients(13.6%) due to AEs, including liver toxicity( n = 3), QTc prolongation( n = 2), and abdominal pain( n = 1). Conclusions: KML001 did not have enough anticancer effect on patients with advanced BTC resistant to gemcitabine. However, KML001 was safe and well-tolerable in terms of AEs and pain control when used as salvage therapy. Further studies are needed to establish arsenic agents as a reliable treatment option in patients with BTC.

关键词： Biliary tract neoplasms Cholangiocarcinoma Gallbladder neoplasms KML001 Sodium meta-arsenite

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Comparison of efficacy and safety between standard-dose and modified-dose FOLFIRINOX as a first-line treatment of pancreatic cancer

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World Journal of Gastrointestinal Oncology 2018年第11期10卷 421-430页

作者： Huapyong Kang Jung Hyun Jo Hee Seung Lee Moon Jae Chung seungmin bang Seung Woo Park Si Young Song Jeong Youp Park Division of Gastroenterology Department of Internal Medicine Yonsei University College of Medicine

AIM To directly compare the efficacy and toxicity of standarddose FOLFIRINOX(sFOLFIRINOX) and modified-dose FOLFIRINOX(mFOLFIRINOX, 75% of standard-dose) for pancreatic *** One hundred and thirty pancreatic cancer patients who received sFOLFIRINOX(n = 88) or mFOLFIRINOX(n = 42) as their first-line chemotherapy from January 2013 to July 2017 were retrospectively reviewed. For efficacy analysis, the objective response rate(ORR),disease control rate(DCR), progression-free survival(PFS), and overall survival(OS) were evaluated and compared using Pearson's chi-square test, Kaplan-Meier plot and log-rank test. The adverse events(AEs) were evaluated, and severe(≥ grade 3) AEs rates of the two groups were compared for toxicity *** The mFOLFIRINOX group included more female patients(30.7% vs 57.1%; P = 0.004) and older patients [age(median), 57 vs 63.5; P = 0.018] than the sFOLFIRINOX group. In the efficacy analysis, the ORR and DCR were not significantly different between the two groups(ORR: 39.8% vs 35.7%; P = 0.656; DCR: 80.7% vs 83.3%; P = 0.716). The median PFS and OS were also not different between the groups(PFS: 8.7 mo vs 8.1 mo, P = 0.272; OS: 13.9 mo vs 13.7 mo, P = 0.476). In the safety analysis with severe AEs, the rates of neutropenia(83.0% vs 66.7%; P = 0.044), anorexia(48.9% vs 28.6%; P = 0.029) and diarrhea(13.6% vs 0.0%; P = 0.009) were markedly lower in the mFOLFIRINOX *** m FOLFIRINOX showed comparable efficacy but better safety compared to sFOLFIRINOX. If clinically necessary, initiating FOLFIRINOX with 75% of the standard-dose can alleviate toxicity concerns without compromising efficacy.

关键词： Dose modification Adverse event Pancreatic cancer Adenocarcinoma FOLFIRINOX Chemotherapy

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FOLFIRINOX vs gemcitabine/nab-paclitaxel for treatment of metastatic pancreatic cancer: Single-center cohort study

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World Journal of Gastrointestinal Oncology 2020年第2期12卷 182-194页

作者： In Rae Cho Huapyong Kang Jung Hyun Jo Hee Seung Lee Moon Jae Chung Jeong Youp Park Seung Woo Park Si Young Song Chansik An Mi-Suk Park seungmin bang Department of Internal Medicine International Saint Mary’s HospitalCatholic Kwandong University College of MedicineIncheon 22711South Korea Department of Medicine Yonsei University Graduate School50-1 Yonsei-roSeoul 03722South Korea Division of Gastroenterology Department of Internal MedicineYonsei University College of Medicine50-1 Yonsei-roSeoul 03722South Korea Department of Radiology Yonsei University College of Medicine50-1 Yonsei-roSeoul 03722South Korea

BACKGROUND FOLFIRINOX and gemcitabine plus nab-paclitaxel(Gem+nabPTX)were recently introduced for metastatic pancreatic cancer ***,studies that compared these two regimens and studies in Asian populations are *** To compare the treatment outcomes of FOLFIRINOX and Gem+nabPTX regimen for metastatic pancreatic cancer treatment in Korean *** Patients with metastatic or recurrent pancreatic cancer treated with FOLFIRINOX(n=86)or Gem+nabPTX(n=81)as the first-line since January 2015 were identified using the Severance Hospital Pancreatic Cancer Cohort *** efficacy,treatment-related adverse events and economic aspects were *** Patients in the FOLFIRINOX group were significantly younger(54 vs 65 years;P<0.001)and had better performance statuses at *** median overall survival(10.7 vs 12.1 mo;P=0.157),progression-free survival(8.0 vs 8.4 mo;P=0.134),and objective response rates(33.7%vs 46.9%;P=0.067)were not significantly different when compared with Gem+nabPTX ***≥3 neutropenia and gastrointestinal adverse events were more common in the FOLFIRINOX *** drug costs of both regimens were *** Treatment efficacy and economic burdens were comparable between the two ***,the details of adverse event were ***+nabPTX regimen might be considered preferentially in certain conditions.

关键词： Pancreatic cancer Chemotherapy FOLFIRINOX Gemcitabine Nabpaclitaxel Survival

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Multicenter phase Ⅱ trial of modified FOLFIRINOX in gemcitabine-refractory pancreatic cancer

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World Journal of Gastrointestinal Oncology 2018年第12期10卷 505-515页

作者： Moon Jae Chung Huapyong Kang Ho Gak Kim Jong Jin Hyun Jun Kyu Lee Kwang Hyuck Lee Myung Hwan Noh Dae Hwan Kang Sang Hyub Lee seungmin bang 无 Division of Gastroenterology Department of Internal Medicine Yonsei University College of Medicine Seoul 03722 South Korea Department of Internal Medicine Daegu Catholic University School of Medicine Daegu 42471 South Korea Department of Internal Medicine Korea University Ansan Hospital Korea University College of Medicine Ansan 15355 South Korea Department of Internal Medicine Dongguk University Ilsan Hospital Dongguk University College of Medicine Goyang 10326 South Korea Division of Gastroenterology Department of Internal Medicine Samsung Medical Center Sungkyunkwan University School of Medicine Seoul 06351 South Korea Department of Internal Medicine Dong-A University College of Medicine Busan 49201 South Korea Department of Internal Medicine Medical Research Institute Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology Pusan National University Yangsan Hospital Yangsan 50612 South Korea Departments of Internal Medicine and Liver Research Institute Seoul National University Hospital Seoul National University College of Medicine Seoul 03080 South Korea Pancreatobiliary Cancer Study Group of Korean Society of Gastrointestinal Cancer

AIM To evaluate the efficacy and safety of modified FOLFIRINOX as a second-line treatment for gemcitabine(GEM)-refractory unresectable pancreatic cancer(PC).METHODS This study was a prospective, multicenter, one-arm, open-label, phase Ⅱ trial. Patients with unresectable PC, who showed disease progression during GEMbased chemotherapy were enrolled. All patients were administered FOLFIRINOX with reduced irinotecan and oxaliplatin(RIO; irinotecan 120 mg/m^2 and oxaliplatin 60 mg/m^2), which was set according to the phase Ⅰ study of FOLFIRINOX. The objective response rate(ORR), disease control rate(DCR), progressionfree survival(PFS), overall survival(OS), adverse events were evaluated. Additionally, changes in quality of life(QoL) were assessed using a questionnaire on *** Between August 2015 and May 2016, a total of 48 patients were enrolled. The median follow-up time was 259 d with a median of 8.5 cycles. The ORR and DCR were 18.8% and 62.5%, respectively, including one patient who showed complete remission. The median PFS was 5.8 mo [95% confidence interval(CI): 3.7-7.9] and median OS was 9.0 mo(95%CI: 6.4-11.6). Neutropenia(64.6%) was the most common grade 3-4 adverse event, followed by febrile neutropenia(16.7%). Although 14.6% of patients experienced grade 3 fatigue, most non-hematologic AEs were under grade 2. In the QoL analysis, the global health status score before treatment was not different from the score at the last visit after treatment(45.43 ± 22.88 vs 48.66 ± 24.14, P = 0.548).CONCLUSION FOLFIRINOX with RIO showed acceptable toxicity and promising efficacy for GEM-refractory unresectable PC. However, this treatment requires careful observation of treatment-related hematologic toxicities.

关键词： Pancreatic cancer FOLFIRINOX Clinical Trial, Phase Ⅱ Chemotherapy Gemcitabine refractory

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Benefit of neoadjuvant concurrent chemoradiotherapy for locally advanced perihilar cholangiocarcinoma

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World Journal of Gastroenterology 2017年第18期23卷 3301-3308页

作者： Jang Han Jung Hyun Jik Lee Hee Seung Lee Jung Hyun Jo In Rae Cho Moon Jae Chung Jeong Youp Park Seung Woo Park Si Young Song seungmin bang Division of Gastroenterology Department of Internal Medicine Hallym University Dongtan Sacred Heart Hospital Division of Gastroenterology Department of Internal Medicine and Yonsei Institute of Gastroenterology Yonsei University College of Medicine

To clarify the role of neoadjuvant concurrent chemoradiotherapy (NACCRT) followed by surgical resection for localized or locally advanced perihilar cholangiocarcinoma (CCA).METHODSWe retrospectively reviewed 57 patients who underwent surgical resection with or without NACCRT for perihilar CCA; 12 patients received NACCRT and 45 patients did not received NACCRT. Patients with locally advanced perihilar CCA requiring NACCRT were defined as follows: (1) a mass involving unilateral branches of the portal vein or hepatic artery with insufficient volume of the anticipated remnant lobe; or (2) an infiltrating mass in the main portal vein that was too long for reconstruction, identified at preoperative *** median disease-free survival (DFS) durations of the neoadjuvant and non-neoadjuvant CCRT groups were 26.0 and 15.1 mo, respectively (P = 0.91). The median overall survival (OS) durations of the neoadjuvant and non-neoadjuvant CCRT groups were 32.9 and 27.1 mo, respectively (P = 0.26). The NACCRT group showed a downstaging tendency compared to the non-NACCRT group as compared with the tumor stage confirmed by histological examination after surgery and the tumor stage confirmed by imaging test at the time of diagnosis (P = 0.01).CONCLUSIONNACCRT does not prolong DFS and OS in localized or locally advanced perihilar CCA. However, NACCRT may allow tumor downstaging and improve tumor resectability.

关键词： Klatskin tumor Locally advanced Survival rate Neoadjuvant therapy Chemoradiotherapy

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Noncommutative analysis of Hermite expansions

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Science China Mathematics 2024年第10期67卷 2331-2356页

作者： bang Xu Department of Mathematics University of HoustonHoustonTX 77204USA Department of Mathematical Sciences Seoul National UniversitySeoul 08826Republic of Korea

This paper is devoted to the study of semi-commutative harmonic analysis associated with Hermite semigroups. In the first part, we establish the noncommutative maximal inequalities for Bochner-Riesz means associated with Hermite operators and then obtain the corresponding pointwise convergence theorems. In particular, we develop a noncommutative version of Stein's theorem of Bochner-Riesz means for Hermite operators. In the second part, we investigate two noncommutative multiplier theorems. Our approach in this part relies on a noncommutative analog of the classical Littlewood-Paley-Stein theory associated with Hermite semigroups.

关键词： noncommutative L_(p)-spaces Hermite semigroup maximal inequalities pointwise convergence multipliers

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A new centrality measure based on neighbor loop structure for network dismantling

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Digital Communications and Networks 2024年第2期10卷 472-480页

作者： Qingxia Liu bang Wang Jiming Qi Xianjun Deng School of Electronic Information and Communications Huazhong University of Science and TechnologyWuhan430074China School of Cyber Science and Engineering Huazhong University of Science and TechnologyWuhan430074China

Nearly all real-world networks are complex networks and usually are in danger of ***,it is crucial to exploit and understand the mechanisms of network attacks and provide better protection for network *** dismantling aims to find the smallest set of nodes such that after their removal the network is broken into connected components of sub-extensive *** overcome the limitations and drawbacks of existing network dismantling methods,this paper focuses on network dismantling problem and proposes a neighbor-loop structure based centrality metric,NL,which achieves a balance between computational efficiency and evaluation *** addition,we design a novel method combining NL-based nodes-removing,greedy tree-breaking and ***,we compare five baseline methods with our algorithm on ten widely used real-world networks and three types of model networks including Erd€os-Renyi random networks,Watts-Strogatz smallworld networks and Barabasi-Albert scale-free networks with different network generation *** results demonstrate that our proposed method outperforms most peer methods by obtaining a minimal set of targeted attack ***,the insights gained from this study may be of assistance to future practical research into real-world networks.

关键词： Complex networks Network dismantling Centrality measure

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Real-Time Object Detection and Face Recognition Application for the Visually Impaired

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Computers, Materials & Continua 2024年第6期79卷 3569-3583页

作者： Karshiev Sanjar Soyoun bang SookheeRyue Heechul Jung Department of Artificial Intelligence Kyungpook National UniversityDaegu41466Republic of Korea Haga Co. Ltd.Daegu38428Republic of Korea

The advancement of navigation systems for the visually impaired has significantly enhanced their mobility by mitigating the risk of encountering obstacles and guiding them along safe,navigable *** approaches primarily focus on broad applications such as wayfinding,obstacle detection,and fall ***,there is a notable discrepancy in applying these technologies to more specific scenarios,like identifying distinct food crop types or recognizing *** study proposes a real-time application designed for visually impaired individuals,aiming to bridge this research-application *** introduces a system capable of detecting 20 different food crop types and recognizing faces with impressive accuracies of 83.27%and 95.64%,*** results represent a significant contribution to the field of assistive technologies,providing visually impaired users with detailed and relevant information about their surroundings,thereby enhancing their mobility and ensuring their ***,it addresses the vital aspects of social engagements,acknowledging the challenges faced by visually impaired individuals in recognizing acquaintances without auditory or tactile signals,and highlights recent developments in prototype systems aimed at assisting with face recognition *** comprehensive approach not only promises enhanced navigational aids but also aims to enrich the social well-being and safety of visually impaired communities.

关键词： Artificial intelligence deep learning real-time object detection application

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Evaluating the role of large language models in inflammatory bowel disease patient information

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World Journal of Gastroenterology 2024年第29期30卷 3538-3540页

作者： Eun Jeong Gong Chang Seok bang Department of Internal Medicine Hallym University College of MedicineChuncheon 24253Gangwon-doSouth Korea

This letter evaluates the article by Gravina et al on ChatGPT’s potential in providing medical information for inflammatory bowel disease *** promising,it highlights the need for advanced techniques like reasoning+action and retrieval-augmented generation to improve accuracy and *** that simple question and answer testing is insufficient,it calls for more nuanced evaluation methods to truly gauge large language models’capabilities in clinical applications.

关键词： Crohn’s disease Ulcerative colitis Inflammatory bowel disease Chat generative pre-trained transformer Large language model Artificial intelligence

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