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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

Folfirinox chemotherapy prolongs stent patency in patients with malignant biliary obstruction due to unresectable pancreatic cancer

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Hepatobiliary & Pancreatic Diseases International 2020年第6期19卷 590-595页

作者： Jinwoo Kang Sang Hyub Lee Jin Ho Choi Woo hyun Paik Dong-Won Ahn Ji Bong Jeong 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 SMG-SNU Boramae Medical CenterSeoulKorea

Background:Stent insertion for biliary decompression to relieve jaundice and subsequent biliary infection is necessary for patients with biliary obstruction caused by pancreatic cancer,and it is important to keep the stent patent as long as ***,few studies have compared stent patency in terms of chemotherapy in patients with pancreatic *** study aimed to evaluate the differences in stent patency in terms of recently evolving ***:Between January 2015 and May 2017,161 patients with pancreatic cancer who had undergone biliary stent insertion with a metal stent were retrospectively *** relationship between chemotherapy and stent patency was ***,overall survival according to the treatment,risk factors for stent patency,and long-term adverse events were ***:Median stent patency was 42 days for patients with the best supportive care and 217 days for patients with chemotherapy(conventional gemcitabine-based chemotherapy and folfirinox)(P<0.001).Furthermore,the folfirinox group showed the longest median stent patency and overall survival,with 283 days and 466 days,respectively(P<0.001)despite higher adverse events *** who underwent folfirinox chemotherapy after stent insertion had better stent patency in multivariate analysis(HR=0.26;95%CI:0.12–0.60;P=0.001).Conclusions:Compared with patients who received best supportive care only,patients who underwent chemotherapy after stent insertion had better stent *** prolonged stent patency can be expected for patients with folfirinox than conventional gemcitabine-based chemotherapy.

关键词： Stent patency Malignant distal biliary obstruction Pancreatic cancer Folfirinox Chemotherapy

Acetylsalicylic acid for metal stent in malignant distal common bile duct obstruction:A randomized controlled trial

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Hepatobiliary & Pancreatic Diseases International 2022年第5期21卷 493-499页

作者： Jin Ho Choi Kyong Joo Lee Woo hyun Paik Namyoung Park Jung Won Chun Sang Hyub Lee Ji Kon ryu Yong-tae Kim Department of Internal Medicine Liver Research InstituteSeoul National University College of MedicineSeoulKorea Department of Internal Medicine Yonsei University Wonju College of MedicineWonjuKorea

Background:Endoscopic biliary drainage is the treatment of choice for patients with malignant distal common bile duct ***-expandable metal stents have clinical advantages including an increased duration of patency that may be prolonged by acetylsalicylic acid(ASA)*** aim of this study was to investigate whether ASA had a positive effect on the patency of self-expandable metal stents compared with ***:This prospective,multicenter,double-blinded,and randomized placebo-controlled trial was conducted from October 2017 to May 2020 in *** who underwent palliative endoscopic biliary drainage with self-expandable metal stents for malignant distal bile duct obstruction were enrolled,and allocated to ASA treatment or *** study outcomes were the rate of stent dysfunction at 6 months,duration of stent patency,risk factors for stent dysfunction,and any adverse ***:Interim analysis included 24 and 28 patients in the ASA and placebo groups,*** was no significant difference between the ASA and placebo groups in stent dysfunction(25.0%vs.20.7%,P=0.761)or the duration of stent patency(150.97±10.55 vs.158.07±8.70 days,P=0.497).Six patients experienced suspected ASA-related adverse events,and there was one lethal ***:ASA did not prolong stent *** study was terminated early because of the possibility of serious adverse events related to ASA treatment of these patients receiving palliative care.

关键词： Endoscopic retrograde cholangiopancreatography Self expandable metallic stents Randomized controlled trial Acetylsalicylic acid

Transcriptomic Responses of Garlic(Allium sativum L.)to Heat and Drought Stresses

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Phyton-International Journal of Experimental Botany 2023年第11期92卷 3077-3090页

作者： Seung Hee Eom tae Kyung hyun Department of Industrial Plant Science and Technology Chungbuk National UniversityCheongju28644Korea

Heat and drought are prominent abiotic stressors that limit crop productivity and yield,particularly concerning climate change;therefore,understanding the molecular mechanisms underlying plant stress responses is crucial for stress-tolerant crop *** study conducted a transcriptomic analysis to elucidate how garlic(Allium sativum L.)responds to drought and heat stress *** libraries were generated to identify differentially expressed genes(DEGs)induced by drought and heat *** classification and clustering analysis of DEGs revealed stress-specific gene expression ***,cell wall-related genes were implicated in the drought response,whereas heat stress was associated with heat stress transcription factors and heat shock *** results provide essential information for future studies on stress tolerances in garlic.

关键词： Differentially expressed gene drought heat garlic transcriptome

Endoscopic papillary large balloon dilation in patients with periampullary diverticula

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World Journal of Gastroenterology 2013年第41期19卷 7168-7176页

作者： Kook hyun Kim tae Nyeun Kim Division of Gastroenterology and Hepatology Department of Internal medicineYeungnam University College of MedicineDaegu 705-717South Korea

AIM:To evaluate the safety and effectiveness of endoscopic papillary large balloon dilation(EPLBD)for bile duct stone extraction in patients with periampullary ***:The records of 223 patients with large common bile duct stones(≥10 mm)who underwent EPLBD(12-20 mm balloon diameter)with or without limited endoscopic sphincterotomy(ES)from July 2006to April 2011 were retrospectively *** these patients,93(41.7%)had periampullary diverticula(PAD),which was categorized into three *** clinical variables of EPLBD with limited ES(EPLBD+ES)and EPLBD alone were analyzed according to the presence of ***:Patients with PAD were significantly older than those without(75.2±8.8 years vs 69.7±10.9years,P=0.000).The rates of overall stone removal and complete stone removal in the first session were not significantly different between the PAD and nonPAD groups,however,there was significantly less need for mechanical lithotripsy in the PAD group(3.2%vs 11.5%,P=0.026).Overall stone removal rates,complete stone removal rates in the first session and the use of mechanical lithotripsy were not significantly different between EPLBD+ES and EPLBD alone in patients with PAD(96.6%vs 97.1%;72.9%vs 88.2%;and 5.1%vs 0%,respectively).No significant differences with respect to the rates of pancreatitis,perforation,and bleeding were observed between EPLBD+ES and EPLBD alone in the PAD group(3.4%vs 14.7%,P=0.095;0%vs 0%;and 3.4%vs 8.8%,P=0.351,respectively).CONCLUSION:EPLBD with limited ES and EPLBD alone are safe and effective modalities for common bile duct stone removal in patients with PAD,regardless of PAD subtypes.

关键词： Endoscopic papillary large balloon dilation Endoscopic sphincterotomy Periampullary diverticula

Endoscopic prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis

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World Journal of Gastroenterology 2014年第44期20卷 16582-16595页

作者： tae Hoon Lee Do hyun Park Division of Gastroenterology Department of Internal Medicine Soonchunhyang University School of Medicine Cheonan Hospital Division of Gastroenterology Department of Internal Medicine University of Ulsan College of Medicine Asa Medical Center

Post-endoscopic retrograde cholangiopancreatography(ERCP) pancreatitis(PEP) is not an uncommon adverse event but may be an avoidable complication. Although pancreatitis of severe grade is reported in 0.1%-0.5% of ERCP patients, a serious clinical course may be lethal. For prevention of severe PEP, patient risk stratification, appropriate selection of patients using noninvasive diagnostic imaging methods such as magnetic resonance cholangiopancreatography or endoscopic ultrasonography(EUS), and avoidance of unnecessary invasive procedures, are important measures to be taken before any procedure. Pharmacological prevention is also commonly attempted but is usually ineffective. No ideal agent has not yet been found and the available data conflict. Currently, rectal non-steroidal anti-inflammatory drugs are used to prevent PEP in high-risk patients, but additional studies using larger numbers of subjects are necessary to confirm any prophylactic effect. In this review, we focus on endoscopic procedures seeking to prevent or decrease the severity of PEP. Among various cannulation methods, wire-guided cannulation,precut fistulotomy,and transpancreatic septostomy are *** pancreatic stent placement,which is the best-known prophylactic method,is reviewed with reference to the ideal stent type,adequate duration of stent placement,and stentrelated ***,we comment on other treatment alternatives,and make the point that further advances in EUS-guided techniques may afford useful PEP prophylaxis.

关键词： Endoscopic retrograde cholangiopancreatography Prevention Pancreatitis Pancreas stent Cannulation Fistulotomy

Relationship between early structural changes at cornea incision sites and surgical outcomes after phacoemulsification

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International Journal of Ophthalmology(English edition) 2019年第7期12卷 1139-1145页

作者： Kyung hyun Jin tae Gi Kim Department of Ophthalmology Kyung Hee University Medical Center Kyung Hee University Seoul 02447 Korea Department of Ophthalmology Kyung Hee University Hospital at Gangdong Kyung Hee University Seoul 05278 Korea

AIM: To assess the early structural changes at clear corneal cataract incision sites and surgical outcomes using anterior segment optical coherence tomography(AS-OCT).METHODS: We evaluated 80 eyes of 59 patients who underwent phacoemulsification with a clear corneal incision. All incisions were evaluated 1 wk, 1, and 3 mo postoperatively using AS-OCT and analyzed regarding angle, length of the incision, maximal corneal thickness at the incision, and if present, corneal endothelial gap length and incision gap area. The patients were divided into two groups according to whether or not an endothelial gap was present at 1 wk postoperatively(endothelial gap, group 1;no endothelial gap, group 2). We analyzed the difference in patient and surgical factors between the two groups, and compared the surgical outcome and the refractive ***: An endothelial gap was observed in 56(70.0%) of 80 eyes at 1 wk postoperatively but not at 3 mo postoperatively. The mean patient age was significantly higher in group 1 than in group 2. The longer the length of the corneal incision and the steeper the incision angle, the greater the length and area of the endothelial gap. In group 1, the mean change in mean keratometry of the anterior cornea was significantly greater than in group 2, and the spherical equivalent(SE) and mean numerical error indicated significant myopic changes at 1 wk postoperatively. CONCLUSION: The risk of an endothelial gap increases with patient age and a long corneal incision and steep incision angle. The presence of an endothelial gap aftersurgery may affect the early postoperative corneal curvature and SE.

关键词： corneal incision structure phacoemulsification corneal curvature corneal endothelial gap anterior segment optical coherence tomography

Clinical and pathological differences between serum immunoglobulin G4-positive and -negative type 1 autoimmune pancreatitis

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World Journal of Gastroenterology 2013年第25期19卷 4031-4038页

作者： Woo hyun Paik Ji Kon ryu Jin Myung Park Byeong Jun Song Joo Kyung Park Yong-tae Kim Kyoungbun Lee Department of Internal Medicine Liver Research Institute Division of Gastroenterology Department of Internal Medicine Seoul National University College of Medicine Department of Pathology Seoul National University College of Medicine

AIM: To identify clinical and pathological differences between serum immunoglobulin G4 (IgG4)-positive (SIP) and IgG4-negative (SIN) type 1 autoimmune pancreatitis (AIP) in South Korea. METHODS: AIP was diagnosed by the international consensus diagnostic criteria. The medical records and pathology were retrospectively reviewed and IgG4-positive cells were counted in a high power field (HPF). Type I AIP was defined as a high serum level of IgG4or histological finding. SIN type 1 AIP was defined as a histological evidence of type 1 AIP and a normal serum IgG4 level. The clinical and pathological findings were compared between the two groups. The analysis was performed using Student's t test, Fischer's exact test and Mann-Whitney's U test. A P value of < 0.05 was considered statistically significant. As repeated com- parison was made, P values of less than 5% (P < 0.05) were considered significant. RESULTS: Twenty five patients with definite type 1 AIP (19 histologically and six serologically diagnosed cases) were enrolled. The mean tissue IgG4 concentrations were significantly higher in SIP than SIN group (40 cells per HPF vs 18 cells per HPF, P = 0.02). Among eight SIN patients, the tissue IgG4 concentrations were less than 15 cells per HPF in most of cases, except one. The sensitivity of serum IgG4 was 68% (17 SIP and eight SIN AIP). Other organ involvement was more frequent- ly associated with SIP than SIN AIP (59% vs 26%, P = 0.016). However, the relapse rate and diffuse swelling of the pancreas were not associated with serum IgG4 level. The concentrations of IgG4-positive cells per HPF were higher in SIP than SIN AIP (40 vs 18, P = 0.02). CONCLUSION: The sensitivity of serum IgG4 was 68% in type 1 AIP. High serum IgG4 level was associated with other organ involvement and tissue IgG4 concentration but did not affect the relapse rate in type 1 AIP.

关键词： Autoimmunity Chronic pancreatitis Immunoglobulin G4-related systemic disease Lymphoplas-macytic sclerosing pancreatitis Immunoglobulin G4

Polymer-based membranes for solvent-resistant nanofiltration:A review

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Chinese Journal of Chemical Engineering 2017年第11期25卷 1653-1675页

作者： Slow Kee Lira Kunli Goh tae-hyun Bae Rong Wang Singapore Membrane Technology Center Nanyang Environment and WaterResearch InstituteNanyang Technological UniversityI Cleantech Loop637141 SingaporeSingapore Nanyang Environment and Water Research Institute Interdisciplinary Graduate SchoolNanyang Technological University637141 SingaporeSingapore School of Chemical and Biomedical Engineenng Nanyang Technological University62 Nanyang Drive637459 SingaporeSingapore School of Civil and Environmental Engineering Nanyang Technological University50 NanyangAvenue639798 SingaporeSingapore

Separation of organic mixture is an inevitable process in most modern industrial processes. In the quest for a more sustainable and efficient separation, solvent-resistant nanofiltration(SRNF) has emerged as a promising answer. This is because SRNF is a membrane-based process which offers the key advantages of high efficacy and low energy intensity separation. In particular, polymer-based membranes can offer compelling opportunities for SRNF with unprecedented cost-effectiveness. As a result, intensive research efforts have been devoted into developing novel polymer-based membranes with solvent-resistant capacities as well as exploring potential applications in different types of industries. In this review, we aim to give an overview of the recent progress in the development of the state-of-the-art polymer-based membranes for SRNF in the first section. Emerging nanomaterials for mixed matrix and thin film nanocomposite membranes are also covered in this section. This is followed by a discussion on the current status of membrane engineering and SRNF membrane commercialization. In the third section, we highlight recent efforts in adopting SRNF for relevant industrial applications such as food, bio-refinery, petrochemical, fine chemical and pharmaceutical industries followed by separations of enantiomers in stereochemistry, homogeneous catalysis and ionic liquids. Finally, we offer a perspective and provide deeper insights to help shape future research direction in this very important field of SRNF.

关键词： Nanofiltration Solvent-resistant Polymeric membranes Nanomaterials Crosslinking Industrial applications