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Percutaneous Biliary Metallic Stent Insertion in Patients with Malignant Duodenobiliary Obstruction: Outcomes and Factors Influencing Biliary Stent Patency

  • Ji Hye Kwon;Dong Il Gwon;Jong Woo Kim;Hee Ho Chu;Jin Hyoung Kim;Gi-Young Ko;Hyun-Ki Yoon;Kyu-Bo Sung
    • Korean Journal of Radiology
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    • v.21 no.6
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    • pp.695-706
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    • 2020
  • Objective: To investigate the technical and clinical efficacy of the percutaneous insertion of a biliary metallic stent, and to identify the factors associated with biliary stent dysfunction in patients with malignant duodenobiliary obstruction. Materials and Methods: The medical records of 70 patients (39 men and 31 women; mean age, 63 years; range, 38-90 years) who were treated for malignant duodenobiliary obstruction at our institution between April 2007 and December 2018, were retrospectively reviewed. Variables found significant by univariate log-rank analysis (p < 0.2) were considered as suitable candidates for a multiple Cox's proportional hazard model. Results: The biliary stents were successfully placed in all 70 study patients. Biliary stent insertion with subsequent duodenal stent insertion was performed in 33 patients and duodenal stent insertion with subsequent biliary stent insertion was performed in the other 37 study subjects. The median patient survival and stent patency time were 107 days (95% confidence interval [CI], 78-135 days) and 270 days (95% CI, 95-444 days), respectively. Biliary stent dysfunction was observed in 24 (34.3%) cases. Multiple Cox's proportional hazard analysis revealed that the location of the distal biliary stent was the only independent factor affecting biliary stent patency (hazard ratio, 3.771; 95% CI, 1.157-12.283). The median biliary stent patency was significantly longer in patients in whom the distal end of the biliary stent was beyond the distal end of the duodenal stent (median, 327 days; 95% CI, 249-450 days), rather than within the duodenal stent (median, 170 days; 95% CI, 115-225 days). Conclusion: The percutaneous insertion of the biliary metallic stent appears to be a technically feasible, safe, and effective method of treating malignant duodenobiliary obstruction. In addition, a biliary stent system with a distal end located beyond the distal end of the duodenal stent will contribute towards longer stent patency in these patients.

Time-Lapse Live-Cell Imaging Reveals Dual Function of Oseg4, Drosophila WDR35, in Ciliary Protein Trafficking

  • Lee, Nayoung;Park, Jina;Bae, Yong Chul;Lee, Jung Ho;Kim, Chul Hoon;Moon, Seok Jun
    • Molecules and Cells
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    • v.41 no.7
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    • pp.676-683
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    • 2018
  • Cilia are highly specialized antennae-like organelles that extend from the cell surface and act as cell signaling hubs. Intraflagellar transport (IFT) is a specialized form of intracellular protein trafficking that is required for the assembly and maintenance of cilia. Because cilia are so important, mutations in several IFT components lead to human disease. Thus, clarifying the molecular functions of the IFT proteins is a high priority in cilia biology. Live imaging in various species and cellular preparations has proven to be an important technique in both the discovery of IFT and the mechanisms by which it functions. Live imaging of Drosophila cilia, however, has not yet been reported. Here, we have visualized the movement of IFT in Drosophila cilia using time-lapse live imaging for the first time. We found that NOMPB-GFP (IFT88) moves according to distinct parameters depending on the ciliary segment. NOMPB-GFP moves at a similar speed in proximal and distal cilia toward the tip (${\sim}0.45{\mu}m/s$). As it returns to the ciliary base, however, NOMPB-GFP moves at ${\sim}0.12{\mu}m/s$ in distal cilia, accelerating to ${\sim}0.70{\mu}m/s$ in proximal cilia. Furthermore, while live imaging NOMPB-GFP, we observed one of the IFT proteins required for retrograde movement, Oseg4 (WDR35), is also required for anterograde movement in distal cilia. We anticipate our time-lapse live imaging analysis technique in Drosophila cilia will be a good starting point for a more sophisticated analysis of IFT and its molecular mechanisms.

Chronologically Change and Importance of Acupuncture Points Used in Bell's Palsy in Classical Literature (고전문헌 중 안면신경마비에 사용된 혈위의 시대적 변화와 중요도 분석)

  • Jung Eun Jang;Si-Hyun Park;Kyung Ho Kim;Seung Deok Lee
    • The Journal of Korean Medicine
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    • v.44 no.3
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    • pp.87-101
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    • 2023
  • Objectives: Many acupuncture points have been suggested for the treatment of Bell's palsy, but information on which acupuncture points are more important in treatment is not provided. This study was conducted to investigate the importance of acupuncture points currently used clinically in Bell's palsy. Methods: By reviewing the full text of 11 books that recorded acupuncture prescriptions from the Qin Dynasty to the Qing Dynasty, the frequency of use of acupuncture points, their meridians, and their location were investigated. Results: The average number of acupuncture points used for local, adjacent and distal points selection was 10.5, 2, 4 respectively. The number of acupuncture points increased from the Qin Dynasty to the Ming Dynasty 《Bojaebang》 and then decreased, but the proportion of local points has been still high. From the Ming Dynasty, ST4, ST6, GV26, and GV24 were mainly have been used as the local points. Except for the GB12, the use of the rest of the acupuncture points gradually decreased in the adjacent points. In the distal acupuncture points, it was summarized to point of lung and large intestine channel until the Ming Dynasty, and LI4 was mainly used in the Qing Dynasty. Yangming meridian has been most often used at the local and distal area except for the adjacent area. Conclusions: In the treatment of facial paralysis, the lower part of the face had the highest proportion among local acupuncture points, and the Yangming had the highest proportion by meridian.

A THREE-DIMENSIONAL FINITE ELEMENT ANALYSIS ON THE LOCATION OF CENTER OF RESISTANCE DURING INTRUSION OF UPPER ANTERIOR TEETH (상악 전치 intrusion시 저항중심의 위치에 관한 3차원 유한요소법적 연구)

  • Park, Chun-Keun;Yang, Won-Sik
    • The korean journal of orthodontics
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    • v.27 no.2
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    • pp.259-272
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    • 1997
  • This study was performed to locate the anteroposterior position of the center of resistance of upper anterior teeth when intrusive forces are acted on them by applying segmented arch mechanics. Three-dimensional finite element model of upper six anterior teeth, periodontal ligament and alveolar bone was constructed The locations of the center of resistance were compared according to the three variables, which are number of teeth contained in anterior segment, axial inclination of anterior teeth, and degree of alveolar bone loss. The following conclusions were drawn from this study; 1. When the axial inclination and alveolar bone height were normal, the locations of center of resistance of anterior segment according to the number of teeth contained were as follows; 1). In 2 teeth segment, the center of resistance was located in the distal area of lateral incisor bracket 2) In 4 teeth segment, the center of resistance was located in the distal 2/3 of the distance between the brackets of lateral incisor and canine. 3) In 6 teeth segment, the center of resistance was located in 3mm distal of canine bracket, which is interproxirnal area. between canine and 1st premolar. 4) As the number of teeth contained in anterior segment increased, the center of resistance shifted to the distal side. 2. As the labial inclination of incisors increased, the center of resistance shifted to the distal side. 3. As the alveolar bone loss increased, the center of resistance shifted to the distal side.

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Non-extraction treatment in Class III malocclusion by using improved superelastic NiTi wire (III급 부정교합 환자에서 초탄성 Ni-Ti alloy wire를 이용한 비발치 치료)

  • Min, Sam;Chung, Chu-Ryung;Hwang, Chung-Ju;Cha, Jung-Yul
    • The korean journal of orthodontics
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    • v.41 no.4
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    • pp.297-306
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    • 2011
  • Nonextraction camouflage treatment in mild Class III malocclusion is achieved by backward movement of the lower dentition and forward movement of the upper dentition. Many camouflage treatment modalities have been used for distal tipping and distal movement of mandibular posterior teeth. The amount of distal movement of mandibular dentition can be improved in cases of severe crowding, even without the patient's cooperation, by using miniscrews for anchorage. However, miniscrew insertion may be unsuccessful, and it may contact the adjacent root because of the distal movement of dentition. Distal tipping of mandibular dentition can be achieved using multiloop edgewise archwires and intermaxillary elastics. However, the complexity of this wire design causes discomfort to patients. Recently, a new treatment using improved superelastic NiTi wires (ISWs) and intermaxillary elastics has been introduced. ISWs can deliver orthodontic force more effectively, and their use with molar tip-back treatment has several advantages-this approach is effective, simple, and easy to use and reduces patient discomfort. The aim of this study was to report a case of camouflage treatment using ISW with tip-back and intermaxillary elastics for distal tipping of mandibular posterior dentition and to evaluate the effectiveness of this treatment in a clinical setting.

Comparison between Intramedullary Nailing and Percutaneous K-Wire Fixation for Fractures in the Distal Third of the Metacarpal Bone

  • Moon, Sung Jun;Yang, Jae-Won;Roh, Si Young;Lee, Dong Chul;Kim, Jin Soo
    • Archives of Plastic Surgery
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    • v.41 no.6
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    • pp.768-772
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    • 2014
  • Background To compare clinical and radiographic outcomes between intramedullary nail fixation and percutaneous K-wire fixation for fractures in the distal third portion of the metacarpal bone. Methods A single-institutional retrospective review identified 41 consecutive cases of metacarpal fractures between September 2009 and August 2013. Each of the cases met the inclusion criteria for closed, extra-articular fractures of the distal third of the metacarpal bone. The patients were divided by the method of fixation (intramedullary nailing or K-wire). Outcomes were compared for mean and median total active motion of the digit, radiographic parameters, and period until return to work. Complications and symptoms were determined by a questionnaire. Results During the period under review, 41 patients met the inclusion criteria, and the fractures were managed with either intramedullary nailing (n=19) or percutaneous K-wire fixation (n=22). The mean and median total active range of motion and radiographic healing showed no statistically significant difference between the two groups. No union failures were observed in either group. The mean operation time was shorter by an average of 14 minutes for the percutaneous K-wire fixation group. However, the intramedullary nailing group returned to work earlier by an average of 2.3 weeks. Complications were reported only in the K-wire fixation group. Conclusions Intramedullary nailing fixation is advisable for fractures in the distal third of the metacarpal bone. It provides early recovery of the range of motion, an earlier return to work, and lower complication rates, despite potentially requiring a wire removal procedure at the patient's request.