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Reconstructive Surgeries of Cholangiocarcinoma
( Valeriy Boyko ),( Yuriy Avdosyev ),( Anastasiia Sochnieva ) 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1
Aims: A great number of post-operative complications and high mortality accompanies reconstructive surgeries of cholangiocarcinomas. The development of irreversible hepatic decompensation in the post-operative period becomes the main cause of unsatisfactory treatment outcomes. Methods: Treatment outcomes for 22 patients with cholangiocarcinomas were analyzed. All patients underwent reconstructive surgeries. The amount and type of operative treatment depended on the extent, localization of the tumor, and the Bismuth-Corlette classification. Results: Pre-operative preparation in the form of biliary decompression was performed through percutaneous transhepatic biliary drainage (PTBD) in 11 (50%) patients (target group) and other 11 (50%) (reference group) patients were operated without biliary decompression. Isolated resections of bile ducts were performed in type I and II tumors in 10 (45.5%) patients, right-side and left-side hemihepatectomy with total caudal lobectomy in 3 (13.6%) and 2 (9.1%) cases in patients with type IIIA and IIIB tumors in both groups. Biliodigestive junction performed in 6 (27.3%). Postoperative complications were observed in 2 (18.2%) patients of target group and 3 (27.3%) of reference group: hepatic failure in 1 (9,1%) patients of target group and 2 (18.2%) of reference group, septic cholangitis in 1 (9.1%) patient of reference group, hepaticojejunostomic leakage in 1 (9.1%) patients of target group. Mortality in target group was 9.1% (1 case), in reference group was 18.2% (2 cases). Conclusions: Pre-operative PTBD reduces the number of complications after reconstructive surgeries from 27.3% to 18.2%, and the mortality rate from 18.2% to 9.1% as compared to patients who previously underwent operations without biliary decompression.
( Nadiya Boyko ),( Andras Kulja ),( Judit Szabo ),( Victor Petrov ),( Istvan Kalapos ),( Halyna Koval ) 대한소화기학회 2007 SIDDS Vol.9 No.-
Background/Aims: Some probiotic candidated have proven to be effective in increasing human resistance to nosocomial pathogens. The aim of this study was to determine the possible cellular and humoral mechanisms of bacteriological protection and therapy against opportunistic agents. Methods: Opportunistic pathogens isolated form patients of gastrointestinal clinical division were identified by biochemical properties. The resistance to antibiotics was the marker of their congeniality. Antibacterial properties of the representatives Lactobacilli, Escherichia, Bacillus and Morganella genera against opportunistic pathogens were tested in vitro and in vivo. Moncassociated and co-colonized genetically different mouse models were used for studying the role of various subsets of innate and adaptive immune cells in the generation of specific immune responses to bacterial antigens and pathogenic agents at the mucosal surface. RIA, FACS qRT-PCR assays were performed. Results: The nosocomial agents were represented by Enterobacer cloaceae, Klebsiella pneumoniae, K. oxytoca, Pseudomonas aeruginosa, Bacteroides spp. and Staphylococcus aureus (MRSA) strains. Schaedler E.coli and M.morganii demonstrated the highest inhibition activity against both Klebsiella species in vitro and in vivo. All MRSA strains were completely inhibited by Bacillus subtilis under their in vitro co-cultivation. Lactobacilli strain shows rather moderate effectiveness against investigated clinical isolates. Specific stimulation of B1 cells, IFN-gamma production by IEL-NK cells, increasing of IgAs, IgG2a, IgG2b level in gut compartments and Reg III-beta and gamma secretion by colonic epithelial cells are main regulatory mechanisms providing the first line defense stimulated by commensal representatives against opportunistic enteric pathogens. Conclusions: Commensal flora could specifically protect the host against some dangerous opportunistic pathogenic agents.
EBG Metamaterial Ground Plane for Mitigation of Multipath Signals in GNSS Antenna
Sergey N. Boyko,Alexander S. Kukharenko,Yury S. Yaskin 한국전자파학회JEES 2015 Journal of Electromagnetic Engineering and Science Vol.15 No.4
An electromagnetic band gap (EBG) metamaterial construction is presented. A construction of a multipath mitigating ground plane, based on the EBG metamaterial is described. A method of the ground plane application and installation, which provides the multipath mitigating without spoiling antenna element phase center stability, is suggested and explained. A designed construction of GNSS antenna module, which contains the multipath mitigating ground plane, made from the presented EBG metamaterial and installed in the described way is shown and parameters of the antenna module are provided.
( Valeriy Vladimirovich Boyko ),( Yuriy Vladimirovich Avdosyev ),( Anastasiia Lvovna Sochnieva ) 대한간학회 2020 춘·추계 학술대회 (KASL) Vol.2020 No.1
Aims: The aim of the study is evaluation of the efficacy of percutaneous transhepatic cholangiography (PTCG) in the diagnosis of the common bile duct diseases complicated by mechanical jaundice. Methods: In the period 2011-2017, 88 patients with the common bile duct diseases were hospitalized: “endoscopically complex forms” of choledocholithiasis - 6 (6,8%), strictures of the common bile duct - 2 (2,3%), strictures of biliodigestive anastomosis - 7 (8%) and cholangiocarcinomas - 73 (82.9%) of different localization according to the Bismuth-Corlette classification. PTCG were performed on the angiograph “Integris Allura 12” (“Philips”, The Netherlands). Results: PTCG was performed in 82 (93.1%) patients. Re PTCG made 20 (22.7%) patients. The diameters of segmental and lobular hepatic ducts ranged from 4 to 12 mm and from 6 to 14 mm, respectively (on average 7.8 mm and 9.6 mm, respectively), and the common bile duct - from 8 to 21 mm (average 13.8 mm). Contrasting with only one part of the liver was noted in 11 (13.4%) patients. The nature and level of obstruction set in 80 (97.5%). The proximal biliary block was detected in 59 (71.9%) patients, distal in 23 (28%). Partial passage of contrast agent in the duodenum was observed in 59 (71.9%) patients, complete occlusion - 23 (28%). Partial passage of contrast medium through the stricture zone was detected in 8 (9.75%) patients. Full biliary block detected in 15 (18.3%) patients, partial - in 67 (81.7%). The sensitivity, specificity and accuracy of PTCG for the common bile duct diseases were calculated: for choledocholithiasis - 80%, 98.5%, 86.5%; for strictures of the common bile duct - 66,6%, 95,7%, 84,1%; for strictures of biliodigestive anastomosis - 71,4%, 95,7%, 87,8%; for cholangiocarcinomas - 98.5%, 92.8%, 97.5% respectively. The wrong diagnosis was made in 2 (2.5%) patients. False-positive conclusions made in 8 (9.8%) and false-negative in 5 (6.1%). Conclusions: PTCG in diseases of the common bile duct complicated by mechanical jaundice in 97.5% of cases makes it possible to contrast all parts of the bile ducts, as well as to assess the level and completeness of the biliary block.
The Evidence for an Obesity Paradox in Type 2 Diabetes Mellitus
한승진,Edward J. Boyko 대한당뇨병학회 2018 Diabetes and Metabolism Journal Vol.42 No.3
Although overweight/obesity is a major risk factor for the development of type 2 diabetes mellitus, there is increasing evidence that overweight or obese patients with type 2 diabetes mellitus experience lower mortality compared with patients of normal weight. This paradoxical finding, known as the “obesity paradox,” occurs in other chronic diseases, and in type 2 diabetes mellitus is particularly perplexing given that lifestyle intervention with one goal being weight reduction is an important feature of the management of this condition. We summarize in this review the findings from clinical and epidemiologic studies that have investigated the association between overweight and obesity (usually assessed using body mass index [BMI]) and mortality in type 2 diabetes mellitus and discuss potential causes of the obesity paradox. We conclude that most studies show evidence of an obesity paradox, but important conflicting findings still exist. We also evaluate if potential bias might explain the obesity paradox in diabetes, including, for example, the presence of confounding factors, measurement error due to use of BMI as an index of obesity, and reverse causation.