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( Gyeol Seong ),( Dong Hyun Sinn ),( Wonseok Kang ),( Geum-youn Gwak ),( Yong-han Paik ),( Moon Seok Choi ),( Joon Hyeok Lee ),( Kwang Cheol Koh ),( Seung Woon Paik ) 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1
Aims: Hepatitis e antigen-positive patients with high serum hepatitis B virus (HBV) DNA but normal alanine aminotransferase (ALT) are presumed in immune-tolerant phase, and their risk of developing complication is still debatable. Recent guideline suggested to use ALT levels, liver biopsy, elastography or liver fibrosis biomarker (eg, FIB-4) to stratify risk of complication for patients presumed in immune-tolerant phase. Methods: We analyzed of 651 HBeAg positive patients with high serum HBV DNA levels (=7 log IU/mL) but normal or mildly elevated ALT levels (<80 U/L), age more than 18 years (male = 404) who were monitored for at least 1 year from 1998 to 2006. Normal ALT was defined as 35 U/L for men and 25 U/ L for women. The risk of developing hepatocellular carcinoma (HCC) was assessed. Results: During a median 11.2 years of follow-up (range: 1.1- 18.0 years), 42 patients (6.5%) developed HCC. Age, sex, ALT and FIB-4 levels were independent factors associated with HCC development. Those with mildly elevated ALT levels showed significantly higher risk of developing HCC than normal ALT levels (3.4% vs. 9.4% at 10 years for normal ALT vs. mildly elevated ALT, P=0.001). Among patients with normal ALT level (n = 301), FIB-4 level was independent factor associated with HCC development (hazard ratio 2.35; 95% confidence interval 1.54-3.58, P<0.001). Among 301 patients with normal ALT levels, 51 patients (16.9%) had FIB-4 = 1.453. The HCC risk at 10 years was significantly higher for those with high FIB-4 levels (1.3% vs. 13.6% for FIB-4 <1.453 vs. =1.453, P<0.001). Conclusions: Among patients presumed in immune tolerant phase, HCC risk was generally low but was not null. Among patients with normal ALT levels, some showed high FIB-4 levels, and their risk of developing HCC was high. Our data indicate that FIB-4 can be an useful non-invasive marker for stratifying HCC risk among patients presumed in immune tolerant phase, and those with high FIB-4 levels warrants close attention.
Robot-Assisted Free Flap in Head and Neck Reconstruction
Han Gyeol Song,윤인식,이원재,유대현,나동균 대한성형외과학회 2013 Archives of Plastic Surgery Vol.40 No.4
Background Robots have allowed head and neck surgeons to extirpate oropharyngeal tumors safely without the need for lip-split incision or mandibulotomy. Using robots in oropharyngeal reconstruction is new but essential for oropharyngeal defects that result from robotic tumor excision. We report our experience with robotic free-flap reconstruction of head and neck defects to exemplify the necessity for robotic reconstruction. Methods We investigated head and neck cancer patients who underwent ablation surgery and free-flap reconstruction by robot. Between July 1, 2011 and March 31, 2012, 5 cases were performed and patient demographics, location of tumor, pathologic stage, reconstruction methods, flap size, recipient vessel, necessary pedicle length, and operation time were investigated. Results Among five free-flap reconstructions, four were radial forearm free flaps and one was an anterolateral thigh free-flap. Four flaps used the superior thyroid artery and one flap used a facial artery as the recipient vessel. The average pedicle length was 8.8 cm. Flap insetting and microanastomosis were achieved using a specially manufactured robotic instrument. The total operation time was 1,041.0 minutes (range, 814 to 1,132 minutes), and complications including flap necrosis, hematoma, and wound dehiscence did not occur. Conclusions This study demonstrates the clinically applicable use of robots in oropharyngeal reconstruction, especially using a free flap. A robot can assist the operator in insetting the flap at a deep portion of the oropharynx without the need to perform a traditional mandibulotomy. Robot-assisted reconstruction may substitute for existing surgical methods and is accepted as the most up-to-date method.
Ko Gyeol,Kim Eunae,이동영,서용원 한국화학공학회 2023 Korean Journal of Chemical Engineering Vol.40 No.7
Fluorinated gases (F-gases), such as CHF3 and C2F6, which are used in the semiconductor industry and have considerable global warming potential, can be recovered after use through a gas hydrate-based separation method to prevent their release into the atmosphere. In this study, the guest distributions and dissociation enthalpy (ΔHd) of F-gas (CHF3 or C2F6)+N2 hydrates with different F-gas concentrations (CHF3: 20%, 80%, and 100% and C2F6: 20%, 60%, 80%, and 100%) were experimentally investigated using a powder X-ray diffractometer and a high-pressure micro-differential scanning calorimeter, respectively. At high N2 concentrations in the feed gas, the occupancy of N2 in the small (512) cages of the F-gas+N2 hydrates increased significantly. As a result, the F-gas+N2 hydrates exhibited reduced hydration numbers at high N2 concentration. The ΔHd values (in kJ/mol gas) of the F-gas (CHF3 or C2F6)+N2 hydrates decreased with increased N2 concentration. The overall experimental results provide useful insights into the design and operation of gas hydrate-based F-gas separation processes.
Ko Gyeol 한국화학공학회 2023 Korean Journal of Chemical Engineering Vol.40 No.7
The vast growth of the manufacturing world is producing a massive amount of wastewater from a wide range of industrial applications disposed into surface water. Undoubtedly, these effluents contain a variety of high-toxic compounds that pose a real challenge and dislocate the environment. The reverse osmosis (RO) process is recognized as a superior method due to its reliability in generating a roughly pure reuse water at a plausible cost. However, the literature has a shortage of comprehensive studies to simultaneously eliminate organic and non-organic compounds from wastewater using a predefined multi stage direct pass operation of a spiral wound module of RO process. To systematically carry out this, a mathematical model developed by the same author has been modified to critically predict the efficiency of RO process towards the simultaneous removal of multi-component from wastewater. For this system, the simulation introduces realistic operating circumstances that correspond to a high rejection of the targeted chemicals. By optimizing the design operating conditions, the accompanying treatment process’ consistency and effectiveness are also increased. As a result, there was a noticeable decline in the unintended release of the harmful substances into the recycled water within a fixed specific energy consumption.