• Clinical Endoscopy
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• v.56 no.6
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• pp.761-768
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• 2023

Background/Aims: Self-expandable metallic stents (SEMSs) are widely adopted for the palliation of dysphagia in patients with malignant esophageal strictures. An important adverse event is the development of SEMS-induced esophagorespiratory fistulas (SEMS-ERFs). This study aimed to assess the risk factors related to the development of SEMS-ERF after SEMS placement in patients with esophageal cancer. Methods: This retrospective study was performed at the Instituto do Cancer do Estado de São Paulo. All patients with malignant esophageal strictures who underwent esophageal SEMS placement between 2009 and 2019 were included in the study. Results: Of the 335 patients, 37 (11.0%) developed SEMS-ERF, with a median time of 129 days after SEMS placement. Stent flare of 28 mm (hazard ratio [HR], 2.05; 95% confidence interval [CI], 1.15-5.51; p=0.02) and post-stent chemotherapy (HR, 2.0; 95% CI, 1.01-4.00; p=0.05) were associated with an increased risk of developing SEMS-ERF, while lower-third tumors were a protective factor (HR, 0.5; 95% CI, 0.26-0.85; p=0.01). No difference was observed in overall survival. Conclusions: The incidence of SEMS-ERFs was 11%, with a median time of 129 days after SEMS placement. Post-stent chemotherapy and a 28 mm stent flare were associated with a higher risk of SEMS-ERF.

• Journal of Advanced Marine Engineering and Technology
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• v.38 no.2
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• pp.202-207
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• 2014

Recently, the study of energy saving technology of ships begins in earnest, as energy saving policies are performed all around the world. SEMS (Ship Energy Management System) is one of the techniques to increase energy efficiency by applying to a independent system like a ship and offshore. SEMS is composed of Cooling Pump Control System (CPCS), Renewable Energy Emergency Power Control System (REEPCS), Load Control System (LCS), and Heating, Ventilation, and Air Conditioning System (HVACS). SEMS is enable to increase energy efficiency and achieve integrated management through the interlocking of each system. Especially, it is possible to improve the flexibility of the selection of the generator capacity in conjunction with a rechargeable battery and renewable energy. In this paper, SEMS applied rechargeable battery is proposed and simulated. By applying the rechargeable battery, it was confirmed that SEMS applied rechargeable battery can be operated at optimum efficiency of the generator.

• Journal of Digestive Cancer Research
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• v.10 no.2
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• pp.92-98
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• 2022

Self-expandable metal stent (SEMS) is effective for biliary drainage, especially in pancreaticobiliary cancer. The mechanical properties, material, and design of SEMS are important in preventing recurrent biliary obstruction and complication. Radial and chronic expansion forces play roles in preventing stent migration and collapse. Complications, such as stent impaction, cholecystitis, and pancreatitis, were related to the axial force. The nickel-titanium alloy shows more flexibility, conformability, and optimal axial force compared to previously used stainless steel. Additionally, the stent structure affected the mechanical properties of SEMS. Therefore, understanding the mechanical properties, material, and design of SEMS will provide the best outcome for biliary drainage, as well as better SEMS development.

• Tuberculosis and Respiratory Diseases
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• v.78 no.1
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• pp.31-35
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• 2015

An 18-year-old woman was evaluated for a chronic productive cough and dyspnea. She was subsequently diagnosed with mediastinal non-Hodgkin lymphoma (NHL). A covered self-expandable metallic stent (SEMS) was implanted to relieve narrowing in for both main bronchi. The NHL went into complete remission after six chemotherapy cycles, but atelectasis developed in the left lower lobe 18 months after SEMS insertion. The left main bronchus was completely occluded by granulation tissue. However, the right main bronchus and intermedius bronchus were patent. Granulation tissue was observed adjacent to the SEMS. The granulation tissue and the SEMS were excised, and a silicone stent was successfully implanted using a rigid bronchoscope. SEMS is advantageous owing to its easy implantation, but there are considerable potential complications such as severe reactive granulation, stent rupture, and ventilation failure in serious cases. Therefore, SEMS should be avoided whenever possible in patients with benign airway disease. This case highlights that SEMS implantation should be avoided even in malignant airway obstruction cases if the underlying malignancy is curable.

• Clinical Endoscopy
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• v.56 no.6
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• pp.802-811
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• 2023

Background/Aims: Covered self-expandable metallic stents (cSEMS) have become popular for endoscopic ultrasound-guided hepaticogastrostomy with transmural stenting (EUS-HGS). We compared the time to recurrent biliary obstruction (TRBO), complications, and reintervention rates between EUS-HGS using plastic stent (PS) and cSEMS in patients with unresectable malignancies at multicenter institutions in Japan. Methods: Patients with unresectable malignant biliary obstruction who underwent EUS-HGS between April 2015 and July 2020 at any of the six participating facilities were enrolled. Primary endpoint: TRBO; secondary endpoints: rate of complications other than recurrent biliary obstruction and technical success rate of reintervention were evaluated. Results: PS and cSEMS were used for EUS-HGS in 109 and 43 patients, respectively. The TRBO was significantly longer in the cSEMS group than in the PS group (646 vs. 202 days). Multivariate analysis identified two independent factors associated with a favorable TRBO: combined EUS-guided antegrade stenting with EUS-HGS and the use of cSEMS. No significant difference was observed in the rate of complications other than recurrent biliary obstruction between the two groups. The technical success rate of reintervention was 85.7% for PS and 100% for cSEMS (p=0.309). Conclusions: cSEMS might be a better option for EUS-HGS in patients with unresectable malignancies, given the longer TRBO.

• Journal of the Korean Society of Systems Engineering
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• v.8 no.2
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• pp.11-17
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• 2012

Suppliers in light rail transit project makes a systems engineering management plan(SEMP) as a top level plan which has a SEMS and SEDS as an control and monitoring means. In this paper, we analyze the international standards and some related documents, and present the directions to make the SEMS and SEDS which have WBS, accomplishments, schedule, events, person in charge. And then customize the project management tool and make SEMS and SEDS of LRT project as an example. The research results can be applied in LRT project after tailoring based on the project.

• Proceedings of the KSR Conference
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• 2005.05a
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• pp.163-168
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• 2005

In case of rolling stock, SEMS is generally applied in the advanced countries, but is start stage in our country. SEMS is defined the system engineering management system in order to achieve the optimized train performance among the several client requirements aspect of technical engineering management during the design life cycle. And the fire engineering activities in hong kong EMU project are introduced aspect of SEMS in this paper. The fire engineering at rolling stock in view of SEMS controls to apply the satisfied interior material by the fire safety standards (regulation of the commute urban subway safety guideline by the MOCT, BS 6853, NFPA 130, NF F 16-101) and to minimize the fire load in order that passengers egress safe from the fired rolling stock. The rolling stock in the advanced countries is designed to stand for 15-20 minutes in considering the rolling stock to be fired in tunnel. For passenger fire safety, the passenger evacuation provision and progress is set up.

• Clinical Endoscopy
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• v.56 no.2
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• pp.135-142
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• 2023

Endoscopic biliary drainage strategies for managing unresectable malignant hilar biliary obstruction differ in terms of stent type, drainage area, and deployment method. However, the optimal endoscopic drainage strategy remains unclear. Uncovered self-expandable metal stents (SEMS) are the preferred type because of their higher functional success rate, longer time to recurrent biliary obstruction (RBO), and fewer cases of reintervention than plastic stents (PS). Other PS subtypes and covered SEMS, which feature a longer time to RBO than PS, can be removed during reintervention for RBO. Bilateral SEMS placement is associated with a longer time to RBO and a longer survival time than unilateral SEMS placement. Unilateral drainage is acceptable if a drainage volume of greater than 50% of the total liver volume can be achieved. In terms of deployment method, no differences were observed in clinical outcomes between side-by-side (SBS) and stent-in-stent deployment. Simultaneous SBS boasts a shorter procedure time and higher technical success rate than sequential SBS. This review of previous studies aimed to clarify the optimal endoscopic biliary drainage strategy for unresectable malignant hilar biliary obstruction.

• Journal of Chest Surgery
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• v.28 no.5
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• pp.499-503
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• 1995

Since the insertion of self expandable metalic stent[SEMS has became popular method for hollow organ stenosis, many attempts for further apply the stent to airway stenosis as an simple procedure has been made, but intrabronchial migration of stent or occurrence of inflammatory granuloma around stent develop occasionally and sometimes it worsen bronchial stenosis further more. This report describes 2 case of surgically treated bronchial restenosis in whom intrabronchial stent were applied for release of bronchial stenosis. Our surgical option was pneumonectomy and bronchoplasty with sleeve right middle and upper lobectomy respectively. During the operation we found the SEMSs were tightly impacted in restenotic bronchial lumen with overgrowth of granulation tissues. The bronchial obstructions occupied more than 90% of lumens in both cases, and needed much complicated procedure to be relieved. Therefore, even though the insertion of SEMS remains as a prcedure determined by the physician`s preference, it has to be considered prudently that the use of SEMS can cause severe restenosis and the surgeon has more difficulties in performing segmental resection of restenotic bronchus in patient with SEMS previously inserted. Throughout these experiences we can conclude that the insertion of SEMS must be performed only in very selected cases of bronchial stenosis.

• Journal of Nuclear Fuel Cycle and Waste Technology(JNFCWT)
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• v.2 no.4
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• pp.263-269
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• 2004

During the last two years, Site Information and Total Environmental database management System (SITES) ver. 1.0 has been developed for the systematic SITES Database Module (SDM), which includes site information, facility information and environmental information. The SITES includes the module for site environmental monitoring system and safety assessment (M&A) system for the nuclear facility. SITES is expected to be an effective system for the radioactive waste disposal management facility. Currently, SITES ver.2.0 is under development after the SITES ver.1.0 that is focused on the M&A system. The main purpose of this paper is to introduce and try to account for the major development in the concept of SEMS sub-module of the M&A module. The SEMS is purposed of development of the program for real time environmental monitoring, prediction, and automatic alarm system using SITES Database and related information.