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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

Early rehabilitation programs after laparoscopic colorectal surgery:Evidence and criticism

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World Journal of Gastroenterology 2013年第46期19卷 8543-8551页

作者： Duck-Woo kim sung-bum Kang Soo-Young Lee Heung-Kwon Oh Myung-Hoon In Department of Surgery Seoul National University Bundang Hospital

During the past several decades,early rehabilitation programs for the care of patients with colorectal surgery have gained *** randomized controlled trials and meta-analyses have confirmed that the implementation of these evidence-based detailed perioperative care protocols is useful for early recovery of patients after colorectal *** cared for based on these protocols had a rapid recovery of bowel movement,shortened length of hospital stay,and fewer complications compared with traditional care ***,most of the previous evidence was obtained from studies of early rehabilitation programs adapted to open colonic ***,limited evidence exists on the effects of early rehabilitation after laparoscopic rectal resection,although this procedure seems to be associated with a higher morbidity than that reported with traditional *** this article,we review previous studies and guidelines on early rehabilitation programs in patients undergoing rectal *** investigated the status of early rehabilitation programs in rectal surgery and analyzed the limitations of these *** also summarized indications and detailed protocol components of current early rehabilitation programs after rectal surgery,focusing on laparoscopic resection.

关键词： Colorectal cancer Enhanced recovery after surgery Early rehabilitation Fast-track Laparoscopy Rectal

Phytogenic feed additives alleviate pathogenic Escherichia coli-induced intestinal damage through improving barrier integrity and inhibiting inflammation in weaned pigs

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Journal of Animal Science and Biotechnology 2023年第1期14卷 295-306页

作者： Se Yeon Chang Min Ho Song Ji Hwan Lee Han Jin Oh Yong Ju kim Jae Woo An Young Bin Go Dong Cheol Song Hyun AhCho Seung Yeol Cho Dong Jun kim Mi Suk kim Hyeun bum kim Jin Ho Cho Department of Animal Science Chungbuk National UniversityCheongju 28644South Korea. Division of Animal and Dairy Science Chungnam National UniversityDaejeon 34134South Korea. Eugene-Bio Suwon 16675South Korea. Department of Animal Resources Science Dankook UniversityCheonan 31116South Korea.

Background:This study was conducted to investigate the effects of each phytogenic feed additive(PFA;PFA1,bitter citrus extract;PFA2,a microencapsulated blend of thymol and carvacrol;PFA3,a mixture of bitter citrus extract,thymol,and carvacrol;PFA4,a premixture of grape seed,grape marc extract,green tea,and hops;PFA5,fenugreek seed powder)on the growth performance,nutrient digestibility,intestinal morphology,and immune response in weaned pigs infected with Escherichia coli(***).Results:A total of 634-week-old weaned pigs were placed in individual metabolic cages and assigned to seven treatment *** seven treatments were as follows:1)NC;basal diet without *** challenge,2)PC;basal diet with *** challenge,3)T1;PC+0.04%PFA1,4)T2;PC+0.01%PFA2,5)T3;PC+0.10%PFA3,6)T4;PC+0.04%PFA4,7)T5;PC+0.10%*** experiments lasted in 21 d,including 7 d before and 14 d after the first *** *** the *** challenge treatments,all pigs were orally inoculated by dividing a total of 10 mL of *** F18 for 3 consecutive *** PFA-added groups significantly increased(P<0.05)average daily gain and feed efficiency and decreased(P<0.05)the fecal score at d 0 to 14 post-inoculation(PI).Tumor necrosis factorαwas significantly lower(P<0.05)in the PFA-added groups except for T1 in d 14 PI compared to the PC *** T3 had a higher(P<0.05)immunoglobulin G and immunoglobulin A concentration compared to the PC treatment at d 7 ***,T3 showed significantly higher(P<0.05)villus height:crypt depth and claudin 1 expression in ileal mucosa,and significantly downregulated(P<0.05)the expression of calprotectin compared to the PC ***:Supplementation of PFA in weaned pigs challenged with *** alleviated the negative effects of *** and improved growth *** them,the mixed additive of bitter citrus extract,thymol,and carvacrol showed the most effective results,improving immune response,intestinal morphology,and expression of tight junction

关键词： Barrier integrity Escherichia coli Immunity Phytogenic feed additive Post-weaning diarrhea Weaned pigs

Bird-mimetic Wing System of Flapping-wing Micro Air Vehicle with Autonomous Flight Control Capability

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Journal of Bionic Engineering 2016年第3期13卷 458-467页

作者： Sriyulianti Widhiarini Ji Hwan Park bum Soo Yoon Kwang Joon Yoon ll-Hyun Paik Jong Heon kim Chan Yik Park Seung Moon Jun Changho Nam Department of Aerospace Engineering Konkuk University Gwangjin-gu Seoul South Korea Deptartment of PGM Technology Hanwha Corp. R&D Center Daejeon South Korea Agency for Defense Development Daejeon South Korea Department of Engineering Technology Arizona State University Mesa Arizona

A micro air vehicle with a bird-mimetic up-down and twisting wing drive system was developed in this study. The Flap- ping-wing Micro Air Vehicle （FMAV）, with a 50 cm wingspan and a double-crank drive system, performed successful flights of up to 23 min. The performance and capabilities of the FMAV were enhanced by adapting a number of unique features, such as a bird-mimetic wing shape with a span-wise camber and an up-down and twisting wing drive mechanism with double-crank linkages, This lift-enhancing design by mimicking the flapping mechanism of a bird＇s wing enabled the 210 g FMAV to fly autonomously in an outdoor field under wind speeds of less than 5 m.s-1. Autonomous flight was enabled by installing a flight control computer with a micro-electro-mechanical gyroscope and accelerometers, along with a micro video camera and an ultralight wireless communication system inside the fuselage. A comprehensive wind tunnel test shows that the FMAV with a high-camber wing and double-crank mechanism generates more lift and less net thrust than the FMAV with a flat wing and single-crank mechanism, which confirms the improved performance of the developed FMAV, as well as the superior slow flying or hovering capabilities of the FMAV with a high-camber wing and double-crank wing drive system.

关键词： flapping-wing MAV autonomous flight biomimetic wing double crank wing

A System for Improving the Management of the Lesion and Test Images of Patients

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Engineering（科研） 2013年第10期5卷 163-165页

作者： sung-bum Cho Kyung-Won Jin Jong-Soon kim Soo-Jin Huh Segyeong Joo Department of Biomedical Engineering Asan Medical Center Seoul Korea Department of Biomedical Engineering Asan Medical Center Seoul Korea Department of Biomedical Engineering University of Ulsan College of Medicine Seoul Korea

Nowadays, almost every hospital utilizes picture archiving and communications system (PACS) and electronic medical record (EMR) system to manage patient’s data digitally. However, patient’s pictures taken by nurses or physicians to monitor lesions or various test results are not managed well in general. Although for some disease, these pictures provide meaningful information in diagnosis and treatment. In this paper, we propose a management system for these images to improve the accessibility and storability. To manage the images efficiently, the proposed methods utilized the PACS system in the hospital. After sending the image data of each patient to a local monitoring computer, the patient’s information, such as, name, age, male, and registration number were attached on the image. This file was then converted to a DICOM (digital imaging and communications in medicine) files and transferred to the PACS Server. The proposed system promises easy and convenient access on the images of lesions and various test results of patients to support fast and appropriate treatment.

关键词： PACS Real-Time Transmission DICOM Patient Examination Wireless

Predictors for difficult cecal insertion in colonoscopy: The impact of obesity indices

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World Journal of Gastroenterology 2017年第13期23卷 2346-2354页

作者： Soo Yun Moon Byung Chang kim Dae Kyung Sohn Kyung Su Han Bun kim Chang Won Hong bum Joon Park Kum Hei Ryu Ji Hyung Nam Center for Colorectal Cancer Research Institute and HospitalNational Cancer Center Department of Surgery School of MedicineKyung Hee University Center for Cancer Prevention and Detection Research Institute and HospitalNational Cancer Center

AIM To identify the factors influencing cecal insertion time(CIT) and to evaluate the effect of obesity indices on CIT. METHODS We retrospectively reviewed the data for participants who received both colonoscopy and abdominal computed tomography(CT) from February 2008 to May 2008 as part of a comprehensive health screening program. Age, gender, obesity indices [body mass index(BMI), waist-to-hip circumference ratio(WHR), waist circumference(WC), visceral adipose tissue(VAT)volume and subcutaneous adipose tissue(SAT) volume on abdominal CT], history of prior abdominal surgery, constipation, experience of the colonoscopist, quality of bowel preparation, diverticulosis and time required to reach the cecum were analyzed. CIT was categorized as longer than 10 min(prolonged CIT) and shorter than or equal to 10 min, and then the factors that required a CIT longer than 10 min were *** A total of 1678 participants were enrolled. The mean age was 50.42 ± 9.931 years and 60.3% were men. The mean BMI, WHR, WC, VAT volume and SAT volume were 23.92 ± 2.964 kg/m2, 0.90 ± 0.076, 86.95 ± 8.030 cm, 905.29 ± 475.220 cm3 and 1707.72 ± 576.550 cm3, respectively. The number of patients who underwent abdominal surgery was 268(16.0%). Colonoscopy was performed by an attending physician alone in 61.9% of cases and with the involvement of a fellow in 38.1% of cases. The median CIT was 7 min(range 2-56 min, IQR 5-10 min), and mean CIT was 8.58 ± 5.291 min. Being female, BMI, VAT volume and involvement of fellow were significantly associated with a prolonged CIT in univariable analysis. In multivariable analysis, being female(OR = 1.29, P = 0.047), lower BMI(< 23 kg/m2)(OR = 1.62, P = 0.004) or higher BMI(≥ 25 kg/m2)(OR = 1.80, P < 0.001), low VAT volume(< 500 cm3)(OR = 1.50, P = 0.013) and fellow involvement(OR = 1.73, P < 0.001) were significant predictors of prolonged CIT. In subgroup analyses for gender, lower BMI or higher BMI and fellow involvement were predictors for prolon

关键词： Visceral obesity Difficult colonoscopy Cecal insertion time Body mass index Female

Piglet gut microbial shifts early in life:causes and effects

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Journal of Animal Science and Biotechnology 2019年第3期10卷 519-528页

作者： Robin B.Guevarra Jun Hyung Lee Sun Hee Lee Min-Jae Seok Doo Wan kim Bit Na Kang Timothy J.Johnson Richard E.Isaacson Hyeun bum kim Department of Animal Resources Science Dankook UniversityCheonan 31116South Korea National Institute of Animal Science Rural Development AdministrationCheonan 55365South Korea Abbvie Bioresearch Center AbbvieWorcesterMA 01605USA Department of Veterinary and Biomedical Sciences University of MinnesotaSt.PaulMN 55108USA

The gut microbiome has long been known to play fundamentally important roles in the animal health and the well-being of its host. As such, the establishment and maintenance of a beneficial gut microbiota early in life is crucial in pigs, since early gut colonizers are pivotal in the establishment of permanent microbial community structures affecting the health and growth performance of pigs later in life. Emphasizing this importance of early gut colonizers, it is critical to understand the factors impacting the establishment of the piglet gut microbiome at weaning. Factors include, among others, diet, in-feed antibiotics, probiotics and prebiotic administration. The impact of these factors on establishment of the gut microbiome of piglets at weaning includes effects on piglet gut microbial diversity, structure, and succession. In this review, we thoroughly reviewed the most recent findings on the piglet gut microbiome shifts as influenced by weaning, and how these microbiome changes brought about by various factors that have been shown to affect the development of microbiota in piglets. This review will provide a general overview of recent studies that can help to facilitate the design of new strategies to modulate the gut microbiome in order to enhance gastrointestinal health, growth performance and well-being of piglets.

关键词： Microbial diversity Next generation sequencing 16S rRNA Swine microbiota Weaning

A Method of Designing Nonlinear Channel Equalizer Using Conditional Fuzzy C-Means Clustering

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A Method of Designing Nonlinear Channel Equalizer Using Cond...

Endoscopic management of occluded metal biliary stents:Metal versus 10F plastic stents

2002年第6届信号处理国际会议

作者： bum-Jin Oh Keun-Chang Kwak sung-Soo kim Jeong-Woong Ryu School of Electrical Engineering Chungbuk National University Cheongju. Korea School of Electrical Engineering Chungbuk National University Cheongju. Korea School of Electrical Engineering Chungbuk National University Cheongju. Korea School of Electrical Engineering Chungbuk National University Cheongju. Korea

＜正＞ In this paper, we propose a new method of designing a nonlinear channel equalizer using an adaptive neuro-fuzzy clustering method called a conditional fuzzy c-means. The structure identification of an adaptive neuro-fuzzy system is performed by the conditional fuzzy c-means clustering method with the homogeneous properties of the given input and output data. The parameter identification is established by hybrid learning using the back-propagation algorithm and the recursive least square estimation. Experimental results demonstrate that the proposed method improves the performance of neuro-fuzzy system. Finally, we applied the proposed method to designing a nonlinear channel equalizer and obtained better results than previous methods.

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World Journal of Gastroenterology 2010年第42期16卷 5347-5352页

作者： Won Jae Yoon Ji Kon Ryu Jung Won Lee Dong-Won Ahn Yong-Tae kim Yong bum Yoon Sang Myung Woo Woo Jin Lee Division of Gastroenterology Department of Internal MedicineSeoul National University College of Medicine101 Daehang-roJongno-guSeoul110-744South Korea Center for Liver Cancer National Cancer Center323 Ilsan-roIlsandong-guGoyang-siGyeonggi-do410-769South Korea

AIM:To compare the efficacy of self-expandable metal stents(SEMSs) with 10F plastic stents(PSs) in the endoscopic management of occluded ***:We retrospectively reviewed the medical records of 56 patients who underwent SEMS insertion for palliation of unresectable malignant biliary obstruction between 2000 and 2007 and subsequent endoscopic retrograde biliary drainage(ERBD) with SEMS or PS for initial SEMS occlusion between 2000 and ***:Subsequent ERBD with SEMS was performed in 29 patients and with PS in *** median time to stent occlusion after subsequent ERBD was 186 d in the SEMS group and 101 d in the PS group(P= 0.118).Overall median stent patency was 79 d for the SEMS group and 66 d for the PS group(P = 0.379).The mean number of additional biliary drainage procedures after subsequent ERBD in patients that died(n = 50) during the study period was 2.54 ± 4.12 for the SEMS group and 1.85 ± 1.95 for the PS group(P = 0.457).The mean total cost of additional biliary drainage procedures after the occlusion of subsequent SEMS or PS was $410.04 ± 692.60 for the SEMS group and $630.16 ± 671.63 for the PS group(P = 0.260).Tumor ingrowth as the cause of initial SEMS occlusion was the only factor associated with a shorter time to subsequent stent occlusion(101 d for patients with tumor ingrowth vs 268 d for patients without tumor ingrowth,P = 0.008).CONCLUSION:Subsequent ERBD with PSs offered similar patency and number of additional biliary drainage procedures compared to SEMSs in the management of occluded SEMS.

关键词： Stents Biliary tract neoplasms Obstructive jaundice Endoscopy Endoscopic retrograde cholangiopancreatography