Anastomotic leaks and fistulas are significant complications of gastric surgery that potentially lead to increased postoperative morbidity and mortality. Surgical intervention is reserved for cases with severe symptoms or hemodynamic instability; however, surgery carries a higher risk of complications. With advancements in endoscopic treatment options, endoscopic approaches have emerged as the primary choice for managing these complications. Endoscopic clipping is a traditional method comprising 2 main categories: through-the-scope clips and over-the-scope clips. Through-the-scope clips are user friendly and adaptable to various clinical scenarios, whereas over-the-scope clips can close larger defects. Another promising approach is endoscopic stent insertion, which has shown a high success rate for leak closure, although vigilant monitoring is required to monitor stent migration. Infection control is essential in post-surgical leakage cases, and endoscopic internal drainage provides a relatively safe and noninvasive means to manage fluids, contributing to infection control and wound healing promotion. Endoscopic suturing offers full-thickness wound closure, but requires additional training and endoscopic versatility. As a promising tool, endoscopic vacuum therapy potentially surpasses stent therapy by draining inflammatory materials and closing defects. Furthermore, the use of tissue sealants, such as fibrin glue and cyanoacrylate, has been reported to be effective in selected situations. The choice of endoscopic device should be tailored to individual cases and specific patient conditions, with careful consideration of the nature of the defect. Further extensive studies involving larger patient populations are required to provide more robust evidence on the efficacy of endoscopic approach in managing post-gastric anastomotic leaks.
Kim, Byung-Jo;Lee, Min;Lim, Eun-Jeong;Yu, Sung-Wook;Hong, Sung-Ha;Hong, Seok-Joo;Na, Heung-Sik
Annals of Clinical Neurophysiology
/
v.11
no.2
/
pp.41-47
/
2009
Background: Discogenic pain can develop into chronic low back pain that is very difficult to treat effectively, because the pathogenesis of the disease still remains controversial. To clarify the pathogenesis, numerous animal models of intervertebral disc degeneration have been proposed in the literature, each with attendant advantages and disadvantages. The aim of this study was to determine the most efficacious method and dose of complete Freund's adjuvant (CFA) injection into intervertebral disc to develop a discogenic pain in a rat. Methods: CFA was injected into the L5-L6 or L4-L5 disc of male Sprague-Dawley rats in various conditions including a dose of CFA (10, 20, or 50 uL), drilling, injection site sealing using cyanoacrylate, and injection velocity. Sham animals were subjected to the same procedure, except for the CFA injection. Mechanical and heat allodynia were serially measured at both hindpaws until 8 weeks post-operatively. Serial MRI analyses were performed to observe degenerative changes of the discs. In addition, CGRP & Substance P-immunoreactivities (ir) in the superficial dorsal horn were evaluated at 4 weeks using immunohistochemistry. Results: Each condition provoked various problems such as development of hindpaw paralysis, CFA leakage, and no pain development. Mid-sagittal T2 MRI revealed no significant degenerative changes in the CFA injected disc. The CGRP-ir of the bilateral superficial dorsal horns at the level of L5-L6 was significantly increased in the CFA group. Conclusions: A total of 10 uL CFA injection into L5-L6 disc for a period of 10 minutes using a 26-gauge needle without drilling was the most efficacious way to develop discogenic pain animal model.
Transactions of the Korean Society of Mechanical Engineers
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v.16
no.11
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pp.1999-2010
/
1992
The fixed slab analogy device which can measure stress intensity factors(S.I.F) experimentally by slab analogy theory is developed in this paper. The margin of errors resulted from the new testing apparatus are between 0.02% and 8.25%. Therefore, it is assured that this one can be effectively used for the more accurate measurement of S.I.F.( $k_{I}$, $k_{I I}$) than conventional apparatus. The pitch of master grating used in this experiment is 0.1mm It is known that the ratio of the distance from crack tip to the crack length on obtaining the accurate stress intensity factor is between 0.4 and 0.7. The optimum curvature radius of slab is about 125mm. The thickness of slab(plate) used in the fixed slab analogy device is 0.05mm(P.V.C. ; E = 64 MN/ $m^{2}$, .nu.=0.38), which is proved to be suitable for the test. The optimum material for the frame(slab`s external boundary) is a alloy tool steel(SKS 5) plate and its thickness is 1mm. In this research, the rigid cracks are directly bonded to the slab surface by cyanoacrylate adhesive for the easiness of slab making and conformity to the practical crack figure. The material of rigid crack is thin steel plate. It is expected that the developed method can be used effectively for the analysis of $k_{I}$ and $k_{I I}$ of arbitrary shaped or distributed cracks.cks.
Purpose: The aim of the present study was to evaluate the biocompatibility and barrier function of mussel adhesive protein (MAP)-loaded collagen membranes in guided bone regeneration (GBR). Methods: Eight male New Zealand white rabbits were used. Four circular defects (diameter: 8 mm) were created in the calvarium of each animal. The defects were randomly assigned to 1) a negative control group, 2) a cyanoacrylate (CA)-loaded collagen membrane group (the CA group), 3) a MAP-loaded collagen membrane group (the MAP group), and 4) a group that received a polycaprolactone block with MAP-loaded collagen membrane (the MAP-PCL group). Specimens were harvested at 2 weeks (n=4) and 8 weeks (n=4) postoperatively for observational histology and histometric analysis. Results: In the histologic analysis, MAP was completely absorbed without any byproducts. In contrast, some of the CA adhesive remained, showing an inflammatory reaction, at 8 weeks. In the MAP-PCL group, the MAP-loaded collagen membranes served as a barrier membrane despite their fast degradation in GBR. No significant difference was found in the amount of new bone between the MAP-PCL and MAP groups ($1.82{\pm}0.86mm^2$ and $2.60{\pm}0.65mm^2$, respectively). Conclusions: The MAP-loaded collagen membrane functioned efficiently in this rabbit calvarial GBR model, with excellent biocompatibility. Further research is needed to assess clinical applications in defect types that are more challenging for GBR than those used in the current model.
The transarterial embolization has been widely used to control bleeding. It has a variety of clinical utility; to reduce bleeding on the surgical field, to reduce the size of malignant tumor as a preopearative treatment, to treat arteriovenous malformation or arterial aneurysm as a curative method and to promote life quality of patient with diffuse or multiple hepatocellular carcinoma as a palliative treatment, etc. With the advance of modem technology, various embolic materials have been also developed. However, it has not been fully investigated of histopathologic changes of the embolized organs according to the embolic materials used. This study was undertaken to investigate the histopathologic changes of embolized renal artery in rabbit by various embolic materials, according to each embolic material and to time passed by after embolization. Of the 5 arteries embolized by ethylene vinyl alcohol copolymer(EVAL), one showed abscess formation in embolized kidney. The other 4 allowed to perform further pathologic study: within a week after embolization there was no any specific change in vessels, however, minimal endothelial hypertrophy was observed following 2 weeks of embolization. Of the 8 renal arteries embolized by N-buthyl-2-cyanoacrylate(Histoacryl), 4 showed total occlusion of the main renal arteries as well as renal infarction, which reflects the strong adhesiveness of Histoacryl to vascular wall. The other 4 showed fibrinoid degeneration in vascular wall within a week. However, further change was not observed thereafter. In all the 5 renal arteries embolized by polyvinyl alcohol(Ivalon), there were infiltration of inflammatory cells along the vessel walls, within one week, which represents vasculitis. They showed some fibrosis with appearance of giant cells in the vessel wall two weeks after embolization and also showed marked fibrosis of connective tissues surrounding vessels two months after embolization, respectively. The results suggest that EVAL is useful for the embolization of hypervascular lesion with limited arteriovenous fistula, Histoacryl for the curative treatment of the lesion with high blood flow or severe arteriovenous fistula, and Ivalan for palliative treatment of malignant tumor or arteriovenous malformation, respectively.
Kim, Jin-Sun;Kim, Sea-In;Yoon, Hyun-Kyoung;Choo, Min-kyu
The Journal of the Korea Contents Association
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v.22
no.10
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pp.733-741
/
2022
Among the various evidence found in maritime crimes, fingerprints and DNA are very important in that they can identify a suspect. In this study, 5 types of non-porous surfaces (plastic, stainless, glass, ceramic, FRP), which are often found as evidence in the actual marine environment, were selected, and latent and blood fingerprints were passed down and immersed at the Donghae Maritime Police Station's exclusive pier for about 7 days. After that, DNA extraction, quantification, and STR profile were analyzed after fingerprint developing CA fumming method and 4 powder methods (Swedish black powder, Concentrated black powder, Supranano red powder, Dazzle orange powder). Among the fingerprint developing methods, when Supranano red powder was applied, a relatively high amount of DNA was found. As a result of STR profile analysis, an average of 16.8 to 9 loci were secured, and all 20 were confirmed in glass and ceramic materials. As a result of the study, it was possible to secure the STR profile by extracting and quantifying DNA after applying the fingerprint developing method to virtual evidence immersed for about 7 days, and further research is needed to secure the STR profile by analyzing DNA after applying various fingerprint developing methods such as VMD and SPR.
Seok Jin Hong;Sang Min Lee;Ho Cheol Choi;Jung Ho Won;Jae Boem Na;Ji Eun Kim;Hye Young Choi
Journal of the Korean Society of Radiology
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v.82
no.1
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pp.237-243
/
2021
This is a rare case of a 73-year-old male patient who presented with hematochezia and was treated using transcatheter arterial embolization following upper gastrointestinal bleeding in the third portion of the duodenum. The cause of the bleeding was not found on gastrointestinal endoscopy and CT. On the third day of hospitalization, the hemoglobin level continued to decrease. A technetium-99m-labeled red blood cell scan revealed suspicious bleeding in the diverticulum of the third portion of the duodenum. Superior mesenteric artery angiography showed active bleeding from the posteroinferior pancreaticoduodenal artery, which was embolized with N-butyl cyanoacrylate. The patient was discharged on the seventh day after embolization without re-bleeding or complication. We report a rare case of a patient with active bleeding from a duodenal diverticulum that was difficult to diagnose using routine modalities. Herein, we report a rare case of a patient with active bleeding from a duodenal diverticulum that was difficult to diagnose using routine modalities. We also conducted a relavant literature review.
Objectives: The purpose of this study was to evaluate the polymerization shrinkage stress among conventional methacrylate-based composite resins and a silorane-based composite resin. Materials and Methods: The strain gauge method was used for the determination of polymerization shrinkage strain. Specimens were divided by 3 groups according to various composite materials. Filtek Z-250 (3M ESPE) and Filtek P-60 (3M ESPE) were used as a conventional methacrylate-based composites and Filtek P-90 (3M ESPE) was used as a silorane-based composites. Measurements were recorded at each 1 second for the total of 800 seconds including the periods of light application. The results of polymerization shrinkage stress were statistically analyzed using One way ANOVA and Tukey test (p = 0.05). Results: The polymerization shrinkage stress of a silorane-based composite resin was lower than those of conventional methacrylate-based composite resins (p < 0.05). The shrinkage stress between methacrylate-based composite resin groups did not show significant difference (p > 0.05). Conclusions: Within the limitation of this study, silorane-based composites showed lower polymerization shrinkage stress than methacrylate-based composites. We need to investigate more into polymerization shrinkage stress with regard to elastic modulus of silorane-based composites for the precise result.
Journal of the Society of Cosmetic Scientists of Korea
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v.45
no.2
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pp.131-138
/
2019
Carbonylated proteins (CPs) are synthesized by the chemical reaction of basic amino acid residues in proteins with aldehyde compounds yielded by lipid peroxidation. CPs are excited by a range of light from UVA to blue light, and resulted in the generation of superoxide anion radicals ($^{\cdot}O_2{^-}$) by photosensitizing reaction. Then, they CPs induce new protein carbonylation in stratum corneum through ROS generation. Furthermore, the superoxide anion radicals produce CPs in the stratum corneum (SC) through lipid peroxidation and finally affects skin conditions including color and moisture functions. The purpose of this study was to investigate the relationship between the production of stratum corneum carbonylated protein (SCCP) and the skin elasticity. 46 healthy female Koream at the ages of 30 ~ 50 years old were participated in this study for 8 weeks. The skin test was experiment conducted into two groups; placebo group (N = 23) used cream that did not contain active ingredients, and the other group (N = 23) used cream containing the elasticity improving ingredients. Test areas were the crow 's feet and the cheek. Various non-invasive methods were carried out to measure biophysical parameters on human skin indicating that dermis density and skin wrinkle were measured by using DUB scanner and Primos premium, respectively. Skin elasticity were measured using dermal torque meter (DTM310) and balistometer (BLS780). SCCP was assessed in a simple and non-invasive method using skin surface biopsy on the cheek of the subject. The amount of SCCP was determined using image analysis. All measurements were taken at 0, 4 and 8 8week. Results revealed that the amount of CP in SC was reduced when the skin wrinkle and skin elasticity related parameters were improved. This indicates that the correlation between the elasticity improvement and the amount of CP can be used as a anti-aging indicator and applicable to the skin clinical test for the measurement of skin aging in the future.
The celadon stools with an openwork ring design which consist of four items as one collection were excavated from Gaeseong, Gyeonggi-do Province. The celadon stools were designated and managed as treasures due to their high arthistorical value in the form of demonstrating the excellence of celadon manufacturing techniques and the fanciful lifestyles during the Goryeo Dynasty. However, one of the items, which appeared to have been repaired and restored in the past, suffered a decline in aesthetic value due to the aging of the treatment materials and the lack of skill on the part of the conservator, raising the need for re-treatment as a result of structural instability. An examination of the conservation condition prior to conservation treatment found structural vulnerabilities because physical damage had been artificially inflicted throughout the area that was rendered defective at the time of manufacturing. The bonded surfaces for the cracked areas and detached fragments did not fit, and these areas and fragments had deteriorated because the adhesive trickled down onto the celadon surface or secondary contaminants, such as dust, were on the adhesive surface. The study identified the position, scope, and conditions of the bonded areas at the cracks UV rays and microscopy in order to investigate the condition of repair and restoration. By conducting Fourier-transform infrared spectroscopy(FT-IR) and portable x-ray fluorescence spectroscopy on the materials used for the former conservation treatment, the study confirmed the use of cellulose resins and epoxy resins as adhesives. Furthermore, the analysis revealed the addition of gypsum(CaSO4·2H2O) and bone meal(Ca10 (PO4)6(OH)2) to the adhesive to increase the bonding strength of some of the bonded areas that sustained force. Based on the results of the investigation, the conservation treatment for the artifact would focus on completely dismantling the existing bonded areas and then consolidating vulnerable areas through bonding and restoration. After removing and dismantling the prior adhesive used, the celadon stool was separated into 6 large fragments including the top and bottom, the curved legs, and some of the ring design. After dismantling, the remaining adhesive and contaminants were chemically and physically removed, and a steam cleaner was used to clean the fractured surfaces to increase the bonding efficacy of the re-bonding. The bonding of the artifact involved applying the adhesive differently depending on the bonding area and size. The cyanoacrylate resin Loctite 401 was used on the bonding area that held the positions of the fragments, while the acrylic resin Paraloid B-72 20%(in xylene) was treated on cross sections for reversibility in the areas that provided structural stability before bonding the fragments using the epoxy resin Epo-tek 301-2. For areas that would sustain force, as in the top and bottom, kaolin was added to Epo-tek 301-2 in order to reinforce the bonding strength. For the missing parts of the ring design where a continuous pattern could be assumed, a frame was made using SN-sheets, and the ring design was then modeled and restored by connecting the damaged cross section with Wood epos. Other restoration areas that occurred during bonding were treated by being filled with Wood epos for aesthetic and structural stabilization. Restored and filled areas were color-matched to avoid the feeling of disharmony from differences of texture in case of exhibitions in the future. The investigation and treatment process involving a variety of scientific technology was systematically documented so as to be utilized as basic data for the conservation and maintenance.
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