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Prospective Multicenter Study of the Challenges Inherent in Using Large Cell-Type Stents for Bilateral Stent-in-Stent Placement in Patients with Inoperable Malignant Hilar Biliary Obstruction

  • Yang, Min Jae;Kim, Jin Hong;Hwang, Jae Chul;Yoo, Byung Moo;Lee, Sang Hyub;Ryu, Ji Kon;Kim, Yong-Tae;Woo, Sang Myung;Lee, Woo Jin;Jeong, Seok;Lee, Don Haeng
    • Gut and Liver
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    • v.12 no.6
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    • pp.722-727
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    • 2018
  • Background/Aims: Although endoscopic bilateral stent-instent placement is challenging, many recent studies have reported promising outcomes regarding technical success and endoscopic re-intervention. This study aimed to evaluate the technical accessibility of stent-in-stent placement using large cell-type stents in patients with inoperable malignant hilar biliary obstruction. Methods: Forty-three patients with inoperable malignant hilar biliary obstruction from four academic centers were prospectively enrolled from March 2013 to June 2015. Results: Bilateral stent-in-stent placement using two large cell-type stents was successfully performed in 88.4% of the patients (38/43). In four of the five cases with technical failure, the delivery sheath of the second stent became caught in the hook-cross-type vertex of the large cell of the first stent, and subsequent attempts to pass a guidewire and stent assembly through the mesh failed. Functional success was achieved in all cases of technical success. Stent occlusion occurred in 63.2% of the patients (24/38), with a median patient survival of 300 days. The median stent patency was 198 days. The stent patency rate was 82.9%, 63.1%, and 32.1% at 3, 6, and 12 months postoperatively, respectively. Endoscopic re-intervention was performed in 14 patients, whereas 10 underwent percutaneous drainage. Conclusions: Large cell-type stents for endoscopic bilateral stent-in-stent placement had acceptable functional success and stent patency when technically successful. However, the technical difficulty associated with the entanglement of the second stent delivery sheath in the hook-cross-type vertex of the first stent may preclude large cell-type stents from being considered as a dedicated standard tool for stent-in-stent placement.

Antioxidant and Antibacterial Activities of Glycyrrhiza uralensis Fisher (Jecheon, Korea) Extracts Obtained by various Extract Conditions (한국 제천 감초(Glycyrrhiza uralensis Fisher)의 추출 조건별 추출물의 항산화 및 항균 활성 평가)

  • Ha, Ji Hoon;Jeong, Yoon Ju;Seong, Joon Seob;Kim, Kyoung Mi;Kim, A Young;Fu, Min Min;Suh, Ji Young;Lee, Nan Hee;Park, Jino;Park, Soo Nam
    • Journal of the Society of Cosmetic Scientists of Korea
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    • v.41 no.4
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    • pp.361-373
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    • 2015
  • This study was carried out to evaluate the antioxidant and antibacterial activities of Glycyrriza uralensis Fisher (Jecheon, Korea) extracts obtained by various extraction conditions (85% ethanol, heating temperatures and times), and to establish the optimal extraction condition of G. uralensis for the application as cosmetic ingredients. The extracts obtained under different conditions were concentrated and made in the powdered (sample-1) and were the crude extract solutions without concentration (sample-2). The antioxidant effects were determined by free radical scavenging activity ($FSC_{50}$), ROS scavenging activity ($OSC_{50}$), and cellular protective effects. Antibacterial activity was determined by minimum inhibitory concentration (MIC) on human skin flora. DPPH free radical scavenging activity of sample-1 ($100{\mu}g/mL$) was 10% higher in group extracted for 6 h than 12 h, but sample-2 didn't show any significant differences. The extraction yield extracted with same temperature for 12 h was 2.6 times higher than 6 h, but total flavonoid content was 1.1 times higher. These results indicated that total flavonoid content hardly increased with increasing extraction time. Free radical scavenging activity, ROS scavenging activity and cellular protective effects were not dependent on the yield of extraction, but total flavonoid content of extraction. Antibacterial activity on three skin flora (S. aureus, B. subtilis, P. acnes)of sample-1 in different extraction conditions were evaluated on same concentration, and the group extracted at 25 and $40^{\circ}C$ showed 16 times higher than methyl paraben ($2,500{\mu}g/mL$). In conclusion, 85% ethanol extracts of G. uralensis extracted at $40^{\circ}C$ for 6 h showed the highest antioxidant and antibacterial activity. These results indicate that the extraction condition is important to be optimized by comprehensive evaluation of extraction yield with various conditions, yield of active component, and activity test with concentrations, and activity of 100% extract, for manufacturing process of products.

A Study on the pressure Rising Considered Fluid inertia in the Notch Area of Balanced Type Vane Pump (노치 영역에서 유체 관성을 고려한 압력 평형형 베인 펌프의 압력 상승에 관한 연구)

  • Jo, Myeong-Rae;Han, Dong-Cheol;Mun, Ho-Ji;Park, Min-Ho;Bae, Hong-Yong
    • Tribology and Lubricants
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    • v.13 no.1
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    • pp.14-20
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    • 1997
  • This paper reports on theoretical study of the pressure overshoot in the delivery ports and pressure rising within balanced type vane pump. Pressure overshoot occur due to the accelerated fluid through the notch, so, result in pressure ripple, flow ripple, and noise. For calculating the pressure rising and fluctuations of pressure, we have modeled mathematically used continuity equation based on compressibility and momentum equation considered fluid inertia in the notch, and analyzed simultaneously. As a results of analysis, we have found oscillation of pressure and compression chamber pressure depend on the rotational speeds, notches. Using the model, notches have been shown to be important design factor in relaxing the rapid pressure rising and reducing the amplitudes of pressure overshoot.

Accurate Delimitation of Phanerochaete chrysosporium and Phanerochaete sordida by Specific PCR Primers and Cultural Approach

  • Lim, Young-Woon;Baik, Keun-Sik;Chun, Jong-Sik;Lee, Kang-Hyun;Jung, Won-Jin;Bae, Kyung-Sook
    • Journal of Microbiology and Biotechnology
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    • v.17 no.3
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    • pp.468-473
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    • 2007
  • White rot fungi, Phanerochaete chrysosporium and Phanerochaete sordida, have been mostly studied in a variety of industrial processes like biopulping and pulp bleaching as well as in bioremediation. Whereas P. sordida is widely distributed in the North Temperate Zone, P. chrysosporium is reported in the restricted area and hundreds of reports have been described from a few strains of P. chrysosporium, which are deposited at various fungal collections in the world. The isolates of two species are not easily discriminated because of their morphological and molecular similarity. Through the ITS sequence analyses, a region containing substantial genetic variation between the two species was identified. PCR amplification using two specific primers was successfully used to differentiate P. chrysosporium from P. sordida. These results were supported by cultural studies. The growth rates at $37^{\circ}C$ on PDA, MEA, and Cza and the microscopic features of conidia on PDA and YMA were also very useful to differentiate those two species.

Employees' experiences of integrated services in Healthy Family and Multicultural Family Support Centers in Seoul (서울지역 건강가정·다문화가족지원센터 종사자의 통합서비스 운영 경험)

  • Son, Seohee;Kim, Mi Young
    • Journal of Family Resource Management and Policy Review
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    • v.23 no.4
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    • pp.1-21
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    • 2019
  • The purpose of this study was to explore employees' experiences of integrated services in Healthy Family and Multicultural Family Support Centers in Seoul. In-depth interviews were conducted with seven employees, including managers and heads of Healthy Family and Multicultural Family Support Centers. The interviews identified three themes: the direction of integrated service, the characteristics of the integration process, and the challenges of integrated service. For the direction of integrated service, the participants identified the integration center as a professional family services organization that provided customized services for different types of families. During the integration process, employees found it difficult to provide integrated services because few guidelines existed on operating an integration center that provided services to families with different characteristics and needs. However, they also explained positive aspects of integration, such as strengthening the business's capacity by expanding the organization. To improve integrated service, employees emphasized the expertise and appropriateness of the family services over the efficiency of the integration centers. They also stressed expansion as a role of a professional family services organization. These findings suggested that establishing a clear direction for integrated service as well as the roles of administrative support agencies is important for activating integrated services.

Effects of Propolis on 808 nm Laser Induced Wounds

  • Shin, Jang-In;Rhee, Chung-Ku;Lee, Seung-Wan;Ahn, Jin-Chul
    • Biomedical Science Letters
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    • v.15 no.3
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    • pp.241-247
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    • 2009
  • Wound healing is a complex and highly organized biological response to injury that results in the loss of tissue integrity. Our particular interest was propolis, traditional used as an antimicrobial and an anti-inflammatory agent. The purpose of this study was to see the effects of propolis on healing of the laser induced wounds and the level of collagen formation. 808 nm laser (20 J) was irradiated on the back of rats. Irradiated wounds were divided into gel control and 6 experimental groups (3 and 5% of different three kinds of propolis). Gel type of propolis (supplied by Seoul Propolis Co., Daejeon, Korea) in water based were applied on the laser wound once daily for 14 days. One fourth of rats were sacrificed on $3^{rd}$, $7^{th}$, $10^{th}$, and $14^{th}$ day and each wound was evaluated for degree of wound healing and the level of collagen formation. Healing of wound was evaluated by measuring and comparing the width and depth of the wounds. The levels of collagen were increased in 3 and 5% gel groups comparing to control on $3^{rd}$ day and the collagen level were increased more on $7^{th}$ day. Wounds of the experimental groups showed better healing in width comparing to the healing of the control. The results of this study demonstrated that propolis accelerated healing of wounds induced by laser irradiation and good collagen formation.

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The Relationships among Principal's Transformational and Transactional Leadership, Subjective Quality of Life of Teacher, and Organizational Commitment of Teacher in Kindergarten and Day Care Center (유아교육기관 시설장의 변혁적리더쉽과 거래적리더쉽, 교사의 주관적 삶의 질 및 조직헌신 간의 관계)

  • Gwon, Gi-Nam;Min, Ha-Yeoung
    • Korean Journal of Human Ecology
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    • v.18 no.4
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    • pp.857-867
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    • 2009
  • The purpose of this study was to examine the relationships among principal's transformational and transactional leadership, subjective quality of life of teacher, and organizational commitment of teacher in kindergarten and day care center based on the survey data from 203 teachers working in kindergarten and day care center in Kyoungbuk province. The collected data were analyzed by Simple Regression, Multiple Regression in SPSS Win program(15.0 version). The main results of this study were as follows. First, principal's transformational and transactional leadership each exerted positive effects on teacher's subjective quality of life and organizational commitment. Second, teacher's subjective quality of life had a positive influence on organizational commitment. Finally, each effect of principal's transformational and transactional leadership on teacher's organizational commitment was mediated by teacher's subjective quality of life.

Anti-Ulcer Activity of Newly Synthesized Acylquinoline Derivatives

  • Cheon, Hyae-Gyeong;Kim, Hyun-Jung;Mo, Hye-Kyoung;Shin, En-Joo;Lee, Yeon-Hee
    • Archives of Pharmacal Research
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    • v.22 no.2
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    • pp.137-142
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    • 1999
  • Anti-ulcer activity of newly synthesized acylquinoline derivatives was investigated. For the in vitro screening, the effects of compounds on gastric $H^{+}/K^{+}$ ATPase isolated from hog and rabbit were examined. Among them, AU-090, AU-091, AU-254, AU-413 and AU-466 exhibited good in vitro activity on both enzymes. To correlate the in vitro activity with in vivo action, the effects of the compounds on the basal gastric acid secretion were studied. Some derivatives showed considerable anti-secretory activities, and AU-413 was selected for further studies. AU-413 protected gastric damage induced by either ethanol or NaOH dose dependently when given orally. $ED_{50}$ values of 12 mg/kg, p.o. (ethanol) and 41 mg/kg, p.o. (NaOH) were obtained. In addition, histamine-stimulated gastric secretion was reduced upon AU-413 administration. Taken together, newly synthesized acylquinoline derivatives, especially AU-413, is worthy of further investigation to be developed as an anti-ulcer agent.

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Assessment of Applicability of Standardized Rates for Health State Comparison Among Areas: 2008 Community Health Survey (지역 간 건강수준 비교를 위한 표준화율 적용의 적절성 평가: 2008년 지역사회건강조사를 바탕으로)

  • Kwon, Geun-Yong;Lim, Do-Sang;Park, Eun-Ja;Jung, Ji-Sun;Kang, Ki-Won;Kim, Yun-A;Kim, Ho;Cho, Seong-Il
    • Journal of Preventive Medicine and Public Health
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    • v.43 no.2
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    • pp.174-184
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    • 2010
  • Objectives: This study shows the issues that should be considered when applying standardized rates using Community Health Survey(CHS) data. Methods: We analyzed 2008 CHS data. In order to obtain the reliability of standardized rates, we calculated z-score and rank correlation coefficients between direct standardized rate and indirect standardized rate for 31 major indices. Especially, we assessed the change of correlations according to population composition (age and sex), and characteristics of the index. We used Mantel-Haenszel chi-square to quantify the difference of population composition. Results: Among 31 major indices, 29 indices' z-score and rank correlation coefficients were over 0.9. However, regions with larger differences in population composition showed lower reliability. Low reliability was also observed for the indices specific to subgroups with small denominator such as 'permanent lesion from stroke', and the index with large regional variations in age-related differences such as 'obtaining health examinations'. Conclusions: Standardized rates may have low reliability, if comparison is made between areas with extremely large differences in population composition, or for indicies with large regional variations in age-related differences. Therefore, the special features of standardized rates should be considered when health state are compared among areas.

Residual stresses and viscoelastic deformation of an injection molded automotive part

  • Kim, Sung-Ho;Kim, Chae-Hwan;Oh, Hwa-Jin;Choi, Chi-Hoon;Kim, Byoung-Yoon;Youn, Jae-Ryoun
    • Korea-Australia Rheology Journal
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    • v.19 no.4
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    • pp.183-190
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    • 2007
  • Injection molding is one of the most common operations in polymer processing. Good quality products are usually obtained and major post-processing treatment is not required. However, residual stresses which exist in plastic parts affect the final shape and mechanical properties after ejection. Residual stresses are caused by polymer melt flow, pressure distribution, non-uniform temperature field, and density distribution. Residual stresses are predicted in this study by numerical methods using commercially available softwares, $Hypermesh^{TM},\;Moldflow^{TM}\;and\;ABAQUS^{TM}$. Cavity filling, packing, and cooling stages are simulated to predict residual stress field right after ejection by assuming an isotropic elastic solid. Thermo-viscoelastic stress analysis is carried out to predict deformation and residual stress distribution after annealing of the part. Residual stresses are measured by the hole drilling method because the automotive part selected in this study has a complex shape. Residual stress distribution predicted by the thermal stress analysis is compared with the measurement results obtained by the hole drilling method. The molded specimen has residual stress distribution in tension, compression, and tension from the surface to the center of the part. Viscoelastic deformation of the part is predicted during annealing and the deformed geometry is compared with that measured by a three dimensional scanner. The viscoelastic stress analysis with a thermal cycle will enable us to predict long term behavior of the injection molded polymeric parts.