• Title/Summary/Keyword: SEMs

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A Study on the Design of SUS Module for SITES Development (부지환경종합관리시스뎀 개발용 SEMS모듈 설계에 관한 연구)

  • Ko Do-Young;Park Se-Moon;Kim Chang-Lak
    • 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.

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Self-expandable Metal Stents for Malignant Colorectal Obstruction (악성 대장 폐색에서의 자가팽창형 스텐트 삽입술)

  • Jae Jun Park
    • Journal of Digestive Cancer Research
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    • v.12 no.1
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    • pp.15-22
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    • 2024
  • Malignant colorectal obstructions urgently require decompression therapy to prevent the severe risks of intestinal ischemia and bowel perforation. In managing malignant colonic strictures endoscopically, the use of self-expandable metal stents (SEMS) is the predominant approach. Colonic SEMs are primarily used in preoperative decompression therapy before curative surgery and palliative treatment in patients with advanced disease stages. Furthermore, the stenting process, which requires rigorous clinical supervision, can lead to complications. This review endeavors to concisely review the clinical considerations associated with the SEMS procedure, with a focus on its indications, technical aspects, and potential complications that may arise during the procedure.

Advances in self-expandable metal stents for endoscopic ultrasound-guided interventions

  • Dong Kee Jang;Dong Wook Lee;Seong-Hun Kim;Kwang Bum Cho;Sundeep Lakhtakia
    • Clinical Endoscopy
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    • v.57 no.5
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    • pp.588-594
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    • 2024
  • Endoscopic ultrasound (EUS)-guided interventions have evolved rapidly in recent years, with dedicated metal stents playing a crucial role in this process. Specifically, the invention of biflanged short metal-covered stents, including lumen-apposing metal stents (LAMS), and modifications in a variety of tubular self-expandable metal stents (SEMS), have led to innovations in EUS-guided interventions. LAMS or non-LAMS stents are commonly used in the EUS-guided drainage of pancreatic fluid collections, especially in cases of walled-off necrosis. Additionally, LAMS is commonly considered for drainage of the EUS-guided gallbladder or dilated common bile duct and EUS-guided gastroenterostomy. Fully or partially covered tubular SEMS with several new designs are being considered for EUS-guided biliary drainage. This review focuses on advances in SEMS for EUS-guided interventions and discusses related research results.

A STUDY ON DEVELOPMENT OF MONITORING & ASSESSMENT MODULE FOR SITES

  • Park, Se-Moon;Yoon, Bong-Yo;Kim, Dae-Jung;Park, Joo-Wan;Kim, Chang-Lak
    • Nuclear Engineering and Technology
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    • v.38 no.6
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    • pp.575-584
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    • 2006
  • As the development of total management systems for sites along with site environmental information is becoming standard, the system known as the Site Information and Total Environmental database management System (SITES) has been developed over the last two years. The first result was a database management system for storing data obtained from facilities, and a site characterization in addition to an environmental assessment of a site. The SITES database is designed to be effective and practical for use with facility management and safety assessment in relation to Geographic Information Systems. SITES is a total management program, which includes its database, its data analysis system required for site characterization, a safety assessment modeling system and an environment monitoring system. It can contribute to the institutional management of the facility and to its safety reassessment. SITES is composed of two main modules: the SITES Database module (SDM) and the Monitoring & Assessment (M&A) module [1]. The M&A module is subdivided into two sub-modules: the Safety Assessment System (SAS) and the Site Environmental Monitoring System (SEMS). SAS controls the data (input and output) from the SITES DB for the site safety assessment, whereas SEMS controls the data obtained from the records of the measuring sensors and facilities. The on-line site and environmental monitoring data is managed in SEMS. The present paper introduces the procedure and function of the M&A modules.

Application of Structural Equation Models to Genome-wide Association Analysis

  • Kim, Ji-Young;Namkung, Jung-Hyun;Lee, Seung-Mook;Park, Tae-Sung
    • Genomics & Informatics
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    • v.8 no.3
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    • pp.150-158
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    • 2010
  • Genome-wise association studies (GWASs) have become popular approaches to identify genetic variants associated with human biological traits. In this study, we applied Structural Equation Models (SEMs) in order to model complex relationships between genetic networks and traits as risk factors. SEMs allow us to achieve a better understanding of biological mechanisms through identifying greater numbers of genes and pathways that are associated with a set of traits and the relationship among them. For efficient SEM analysis for GWASs, we developed a procedure, comprised of four stages. In the first stage, we conducted single-SNP analysis using regression models, where age, sex, and recruited area were included as adjusting covariates. In the second stage, Fisher's combination test was conducted for each gene to detect significant genes using p-values obtained from the single-SNP analysis. In the third stage, Fisher's exact test was adopted to determine which biological pathways were enriched with significant SNPs. Finally, based on a pathway that was associated with the four traits in common, a SEM was fit to model a causal relationship among the genetic factors and traits. We applied our SEM model to GWAS data with four central obesity related traits: suprailiac and subscapular measures for upper body fat, BMI, and hypertension. Study subjects were collected from two Korean cohort regions. After quality control, 327,872 SNPs for 8842 individuals were included in the analysis. After comparing two SEMs, we concluded that suprailiac and subscapular measures may indirectly affect hypertension susceptibility by influencing BMI. In conclusion, our analysis demonstrates that SEMs provide a better understanding of biological mechanisms by identifying greater numbers of genes and pathways.

A novel fully covered metal stent for unresectable malignant distal biliary obstruction: results of a multicenter prospective study

  • Arata Sakai;Atsuhiro Masuda;Takaaki Eguchi;Keisuke Furumatsu;Takao Iemoto;Shiei Yoshida;Yoshihiro Okabe;Kodai Yamanaka;Ikuya Miki;Saori Kakuyama;Yosuke Yagi;Daisuke Shirasaka;Shinya Kohashi;Takashi Kobayashi;Hideyuki Shiomi;Yuzo Kodama
    • Clinical Endoscopy
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    • v.57 no.3
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    • pp.375-383
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    • 2024
  • Background/Aims: Endoscopic self-expandable metal stent (SEMS) placement is currently the standard technique for treating unresectable malignant distal biliary obstructions (MDBO). Therefore, covered SEMS with longer stent patency and fewer migrations are required. This study aimed to assess the clinical performance of a novel, fully covered SEMS for unresectable MDBO. Methods: This was a multicenter single-arm prospective study. The primary outcome was a non-obstruction rate at 6 months. The secondary outcomes were overall survival (OS), recurrent biliary obstruction (RBO), time to RBO (TRBO), technical and clinical success, and adverse events. Results: A total of 73 patients were enrolled in this study. The non-obstruction rate at 6 months was 61%. The median OS and TRBO were 233 and 216 days, respectively. The technical and clinical success rates were 100% and 97%, respectively. Furthermore, the rate of occurrence of RBO and adverse events was 49% and 21%, respectively. The length of bile duct stenosis (<2.2 cm) was the only significant risk factor for stent migration. Conclusions: The non-obstruction rate of a novel fully covered SEMS for MDBO is comparable to that reported earlier but shorter than expected. Short bile duct stenosis is a significant risk factor for stent migration.

Postoperative Clinical Outcomes of Colonic Stent Placement as Bridge-to-surgery vs. Emergency Surgery in Left-sided Malignant Colonic Obstruction

  • Choe, Eun Ju;Lee, Yong Kang;Jeon, Han Ho;Choi, Jong Won;Park, Byung Kyu;Won, Sun Young;Seo, Jeong Hun;Lee, Chun Kyon;Cho, Yong Suk
    • Journal of Digestive Cancer Research
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    • v.9 no.2
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    • pp.43-49
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    • 2021
  • Background/Aims: Colonic stenting as a bridge to elective surgery is an alternative for emergency surgery in patients with acute malignant colonic obstruction. However, since its benefits are uncertain, we aimed to establish whether it has better clinical outcomes. Methods: The patients with acute malignant left-sided colon obstruction enrolled from January 2009 to December 2018 in National Health Insurance Service Ilsan Hospital. The patients were enrolled to undergo colonic stenting as a bridge to elective surgery or emergency surgery. The following oncological outcomes were assessed: incidence of complete remission, disease progression, local recurrence, and systemic recurrence. Results: Out of 40 patients, 33 received self-expanding metallic stent (SEMS) as a bridge-to-surgery, and 7 underwent emergency surgery. More stoma was made in case of emergency surgery with statistical significance (p < 0.001). There were no significant differences in complete remission rate in curable left-sided malignant colonic obstruction between SEMS as a bridge-to-surgery and emergency surgery. Complete remission was achieved for 3 patients (42.9%) in the non-stent group and 27 patients (81.8%) in the stent group. There was no statistically significant difference in oncologic outcomes between the two groups (p = 0.069). According to multi-variate analysis, advanced TNM stage, Adjuvant chemotherapy, and SEMS bridge-to-surgery were significantly associated with disease-free survival. Disease-free survival rate differed significantly between the two groups (p = 0.024). Conclusions: SEMS as a bridge-to-surgery might be an effective strategy and reduce stoma formation in acute malignant left-sided colon obstruction.

Prophylactic endoscopic transpapillary gallbladder stenting to prevent acute cholecystitis induced after metallic stent placement for malignant biliary strictures: a retrospective study in Japan

  • Fumisato Kozakai;Yoshihide Kanno;Shinsuke Koshita;Takahisa Ogawa;Hiroaki Kusunose;Toshitaka Sakai;Keisuke Yonamine;Kazuaki Miyamoto;Haruka Okano;Yuto Matsuoka;Kento Hosokawa;Hidehito Sumiya;Kei Ito
    • Clinical Endoscopy
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    • v.57 no.5
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    • pp.647-655
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    • 2024
  • Background/Aims: Endoscopic biliary drainage using self-expandable metallic stents (SEMSs) for malignant biliary strictures occasionally induces acute cholecystitis (AC). This study evaluated the efficacy of prophylactic gallbladder stents (GBS) during SEMS placement. Methods: Among 158 patients who underwent SEMS placement for malignant biliary strictures between January 2018 and March 2023, 30 patients who attempted to undergo prophylactic GBS placement before SEMS placement were included. Results: Technical success was achieved in 21 cases (70.0%). The mean diameter of the cystic duct was more significant in the successful cases (6.5 mm vs. 3.7 mm, p<0.05). Adverse events occurred for 7 patients (23.3%: acute pancreatitis in 7; non-obstructive cholangitis in 1; perforation of the cystic duct in 1 with an overlap), all of which improved with conservative treatment. No patients developed AC when the GBS placement was successful, whereas 25 of the 128 patients (19.5%) without a prophylactic GBS developed AC during the median follow-up period of 357 days (p=0.043). In the multivariable analysis, GBS placement was a significant factor in preventing AC (hazard ratio, 0.61; 95% confidence interval, 0.37-0.99; p=0.045). Conclusions: GBS may contribute to the prevention of AC after SEMS placement for malignant biliary strictures.

Colon stenting as a bridge to surgery in obstructive colorectal cancer management

  • Dong Hyun Kim;Han Hee Lee
    • Clinical Endoscopy
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    • v.57 no.4
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    • pp.424-433
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    • 2024
  • Colonic stent placement is a commonly used bridging strategy for surgery in patients with obstructive colorectal cancer. The procedure involves the placement of a self-expandable metallic stent (SEMS) across the obstructive lesion to restore intestinal patency and alleviate the symptoms of obstruction. By allowing patients to receive surgery in a planned and staged manner with time for preoperative optimization and bowel preparation, stent placement may reduce the need for emergency surgery, which is associated with higher complication rates and poorer outcomes. This review focuses on the role of colon stenting as a bridge to surgery in the management of obstructive colorectal cancer. SEMS as a bridge to surgery for left-sided colon cancer has been demonstrated to be particularly useful; however, further research is needed for its application in cases of right-sided colon cancer. Colon stent placement also has limitations and potential complications including stent migration, re-obstruction, and perforation. However, the timing of curative surgery after SEMS placement remains inconclusive. Considering the literature to date, performing surgery at an interval of approximately 2 weeks is considered appropriate. Therefore, colonic stent placement may be an effective strategy as a bridge to surgery in patients with obstructive colorectal cancer.