• Journal of Gastric Cancer
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• v.23 no.3
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• pp.451-461
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• 2023

Purpose: Endoscopic submucosal dissection (ESD) is an effective treatment for early gastrointestinal neoplasms. However, this is a time-consuming procedure requiring various devices. This study aimed to evaluate the efficacy and safety of the ClearCut^TM Knife H-type, which is an integrated needle-tipped and insulated-tipped (IT) knife. Materials and Methods: Between July 2020 and September 2021, 99 patients with gastric epithelial neoplasms scheduled for ESD at three tertiary care hospitals were randomly assigned to H-knife (ClearCut^TM Knife H-type) or IT-knife (conventional IT knife) groups. Procedure times, therapeutic outcomes, and adverse events were analyzed. Results: A total of 98 patients (50 in the H-knife group and 48 in the IT-knife group) were analyzed. The median total procedure time was 11.9 minutes (range, 4.4-47.2 minutes) in the H-knife group and 12.7 minutes (range, 5.2-137.7 minutes) in the IT-knife group (P=0.209). Unlike the IT-knife group, which required additional devices in all cases, no additional devices were used in the H-knife group (P<0.001). En-bloc resection was performed for all lesions in both groups. The incidence of adverse events was not significantly different between groups (4.0% in the H-knife group vs. 8.3% in the IT-knife group; P=0.431). Conclusions: The newly developed hybrid device, the ClearCut^TM Knife H-type, had comparable efficacy to the conventional IT knife for gastric ESD.

• Clinical Endoscopy
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• v.55 no.6
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• pp.775-783
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• 2022

Background/Aims: Colorectal endoscopic submucosal dissection (ESD) is burdened by its associated high risk of adverse events and long procedure time. Recently, a waterjet-assisted knife was introduced to simplify and speed up the procedure. The aim of this study was to evaluate the efficacy and safety of waterjet-assisted ESD (WESD) compared to that of the conventional ESD (CESD) technique. Methods: The charts of 254 consecutive patients who underwent colorectal ESD between January 2014 and February 2021 for colorectal neoplasms were analyzed. The primary outcome was the en-bloc resection rate. Secondary outcomes were complete and curative resection rates, the need to switch to a hybrid ESD, procedure speed, the adverse event rates, and the recurrence rates. Results: Approximately 174 neoplasias were considered, of which, 123 were removed by WESD and 51 by CESD. The en-bloc resection rate was higher in the WESD group (94.3% vs. 84.3%). Complete resection rates and curative resection rates were similar. The need to switch to a hybrid ESD was greater during CESD (39.2% vs. 13.8%). Procedure speed and adverse event rates were similar. During follow-up, one recurrence occurred after a WESD. Conclusions: WESD allows a high rate of en-bloc resections and less frequently requires a rescue switch to the hybrid ESD compared to CESD.

• 제어로봇시스템학회:학술대회논문집
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• 2005.06a
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• pp.1080-1085
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• 2005

A hybrid control scheme is proposed for the stabilization of backward movement along simple paths for a vehicle composed of a truck and six trailers. The hybrid comprises the combination of a linear quadratic regulator (LQR) and a neurocontroller (NC) that is trained by a genetic algorithm (GA). Acting singly, either the NC or the LQR are unable to perform satisfactorily over the entire range of the operation required, but the proposed hybrid is shown to be capable of providing good overall system performance. The evaluation function of the NC in the hybrid design has been modified from the conventional type to incorporate both the squared errors and the running steps errors. The reverse movement of the trailer-truck system can be modeled as an unstable nonlinear system, with the control problem focusing on the steering angle. Achieving good backward movement is difficult because of the restraints of physical angular limitations. Due to these constraints the system is impossible to globally stabilize with standard smooth control techniques, since some initial states necessarily lead to jack-knife locks. This paper demonstrates that a hybrid of neural networks and LQR can be used effectively for the control of nonlinear dynamical systems. Results from simulated trials are reported.

• Journal of Veterinary Clinics
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• v.28 no.5
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• pp.497-505
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• 2011

Natural orifice transluminal endoscopic surgery is a newly emerging technique recently, with its many potential advantages in clinical practice. Cholecystectomy by Hybrid NOTES in this work, performed with single working channel endoscope in conjunction with a laparoscopic grasping forceps in dogs, is a "bridge" between laparoscopic procedure and pure NOTES. Three different approaches for cholecystectomy were carried out; transgastric, transcolonic and transvaginal. In all three approaches, abdominal opening was made by a 5 mm trocar, followed by making pneumoperitoneum of 4 mmHg with $CO_2$ insufflator. Transgastric cholecystectomy, single working channel endoscope was advanced to the peritoneal cavity through gastric incision in antral region made by endoscopic needle knife. Endoscope was retroflexed to visualize the gall bladder. Transcolonic access, incision for endoscopic entry was done at right ventral wall of descending colon, 15 cm inside from the anus. Incision in transvaginal access was made at right-ventral region, just caudal to the caudal tubercle. With the simple traction by the laparoscopic grasping forceps, good visualization of surgical field was obtained in all three groups. Cystic duct and artery were ligated with endoclips; for complete gall bladder dissection from liver, L-knife was used. Closure of incision sites were done in transgastric and transcolonic cholecystectomy by endoclips, not in transvaginal approach.

• KOREAN JOURNAL OF CROP SCIENCE
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• v.31 no.1
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• pp.49-55
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• 1986

To obtain basic information required for improving grain yield of the two modified opaque-2 synthetics, which have been developed at College of Agr., Chungnam National Univ. in 1980 and named as Puyo No.2 and No.3, physical kernel characteristics of the two synthetics were fully investigated and results obtained are as follows: Puyo No.2 synthetics had a smaller kernel size with lighter weight than the Puyo No.3. The Puyo No.2 synthetics had higher kernel density than the Puyo No.3 with large Kernel size. The Puyo No.2 had kernels with heterogenous endosperm phenotypes. Some kernels had mottled patches on endosperm, while other kernels 1/2 and 1/2 phenotypes. All the modified opaque-2 synthetics had somewhat lighter endosperm weight than the normal check hybrid. The Puyo No.2 synthetics with smaller kernel size had more germ portion compared with large kernel, Puyo No.3. The Puyo No.2 had shown also typical endosperm texture when observed under microscope after cutting by glass knife. The lysine content of the Puyo No.2 was higher than those of other varieties studied. Breeding schemes to improve the yield capacity of the two modified opaue-2 synthetics were discussed.