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Distal migration of a partially covered duodenal stent requiring emergency surgical extraction
Luca Giovanni Campana,Rebecca Fish,Owen Thomas Dickinson,Mairéad Geraldine McNamara,Sarah Theresa O’Dwyer,Hans-Ulrich Laasch 소화기인터벤션의학회 2022 International journal of gastrointestinal interven Vol.11 No.2
Duodenal stenting is an established alternative for the palliation of malignant gastric outlet obstruction (MGOO). Despite being relatively rare, stent migration remains an issue of concern. We present a case of duodenal stent displacement in a 71-year-old female with biliary and duodenal strictures secondary to pancreatic cancer. She presented with acute abdominal pain 10 days following the insertion of a 24-mm partially covered double-layer knitted device, which migrated to the ileocaecal junction. Since the priority was to minimise hospitalisation, we performed a laparotomy with extraction through an enterotomy combined with gastrojejunostomy to bypass the duodenum. The patient resumed oral intake on postoperative day 9 and tolerated a semi-solid diet for 3 months, until death. Despite continuous advances in enteral stent design, patient surveillance remains paramount. This report illustrates the complex decision-making around MGOO, addresses the management of stent migration, and highlights the role of surgery in simultaneously treating stent complications and palliating duodenal obstruction.
Distal migration of a partially covered duodenal stent requiring emergency surgical extraction
Luca Giovanni Campana,Rebecca Fish,Owen Thomas Dickinson,Mairéad Geraldine McNamara,Sarah Theresa O’Dwyer,Hans-Ulrich Laasch 소화기인터벤션의학회 2022 Gastrointestinal Intervention Vol.11 No.2
Duodenal stenting is an established alternative for the palliation of malignant gastric outlet obstruction (MGOO). Despite being relatively rare, stent migration remains an issue of concern. We present a case of duodenal stent displacement in a 71-year-old female with biliary and duodenal strictures secondary to pancreatic cancer. She presented with acute abdominal pain 10 days following the insertion of a 24-mm partially covered double-layer knitted device, which migrated to the ileocaecal junction. Since the priority was to minimise hospitalisation, we performed a laparotomy with extraction through an enterotomy combined with gastrojejunostomy to bypass the duodenum. The patient resumed oral intake on postoperative day 9 and tolerated a semi-solid diet for 3 months, until death. Despite continuous advances in enteral stent design, patient surveillance remains paramount. This report illustrates the complex decision-making around MGOO, addresses the management of stent migration, and highlights the role of surgery in simultaneously treating stent complications and palliating duodenal obstruction.
Mairs, Steve,Johnstone, Doug,Kirk, Helen,Lane, James,Bell, Graham S.,Graves, Sarah,Herczeg, Gregory J.,Scicluna, Peter,Bower, Geoffrey C.,Chen, Huei-Ru Vivien,Hatchell, Jennifer,Aikawa, Yuri,Chen, Wen American Astronomical Society 2017 The Astrophysical journal Vol.849 No.2
<P>Investigating variability at the earliest stages of low-mass star formation is fundamental in understanding how a protostar assembles mass. While many simulations of protostellar disks predict non-steady accretion onto protostars, deeper investigation requires robust observational constraints on the frequency and amplitude of variability events characterized across the observable SED. In this study, we develop methods to robustly analyze repeated observations of an area of the sky for submillimeter variability in order to determine constraints on the magnitude and frequency of deeply embedded protostars. We compare 850 mu m JCMT Transient Survey data with archival JCMT Gould Belt Survey data to investigate variability over 2-4 year timescales. Out of 175 bright, independent emission sources identified in the overlapping fields, we find seven variable candidates, five of which we classify as Strong, and the remaining two we classify as Extended to indicate that the latter are associated with larger-scale structure. For the Strong variable candidates, we find an average fractional peak brightness change per. year of |4.0|% yr(-1), with a standard deviation of 2.7% yr(-1). In total, 7% of the protostars associated with 850 mu m emission in our sample show signs of variability. Four of the five Strong sources are associated with a known protostar. The remaining source is a good follow-up target for an object that is anticipated to contain an enshrouded, deeply embedded protostar. In addition, we estimate the 850 mu m periodicity of the submillimeter variable source, EC 53, to be 567 +/- 32 days, based on the archival Gould Belt Survey data.</P>
Temporal and spatial variability of rainfall and climate trend on Jeju Island
Alan Mair,Aly I. El-Kadi,하규철,Gi-Won Koh 한국지질과학협의회 2013 Geosciences Journal Vol.17 No.1
The temporal and spatial analyses of rainfall and temperature were conducted for understanding spatial variability and climate trend on Jeju Island. Rainfall data from 1992 to 2009 were used for the spatial analyses, and missing data were adjusted on Mt. Halla and along the northeast coast to reduce uncertainty of spatial variability. In addition, rainfall time series data of both Jeju City and Seogwipo City from 1961 to 2009 were analyzed for a long-term trend and identification of droughts. Mean annual rainfall for the period 1992–2009 shows an area of maximum rainfall centered around Mt. Halla where maximum annual rainfall reaches more than 4,300 mm and mean island rainfall is 2,082 mm. Upward trends in rainfall intensity, magnitude, and dryness conditions at the Jeju City and Seogwipo City from 1961 to 2009 suggest that rainfall has intensified with greater quantities of rainfall occurring over shorter durations, with longer dry periods between storm events. The annual cycle shows a distinct monsoon signature with peak rainfall typically occurring in August. Rainfall seasonality shows a shift in peak rainfall from June, July, and August, to July, August, and September. The most severe droughts in the period 1961–2009 were identified using a 12-month composite SPI. Three severe droughts each lasting around two years were identified over a relatively short nine-year period from 1964–1972.
Kim, Namtae,Patrick, Lorna,Mair, Stuart,Stevens, Lloyd,Ford, Gill,Birks, Vicky,Lee, Sung-Hack Informa UK Ltd. 2014 Xenobiotica Vol.44 No.6
<P>1. Gemigliptin (formerly known as LC15-0444) is a newly developed dipeptidyl peptidase 4 inhibitor for the treatment of type 2 diabetes. Following oral administration of 50 mg (5.4 MBq) [<SUP>14</SUP>C]gemigliptin to healthy male subjects, absorption, metabolism and excretion were investigated.</P><P>2. A total of 90.5% of administered dose was recovered over 192 hr postdose, with 63.4% from urine and 27.1% from feces. Based on urinary recovery of radioactivity, a minimum 63.4% absorption from gastrointestinal tract could be confirmed.</P><P>3. Twenty-three metabolites were identified in plasma, urine and feces. In plasma, gemigliptin was the most abundant component accounting for 67.2% ∼ 100% of plasma radioactivity. LC15-0636, a hydroxylated metabolite of gemigliptin, was the only human metabolite with systemic exposure more than 10% of total drug-related exposure. Unchanged gemigliptin accounted for 44.8% ∼ 67.2% of urinary radioactivity and 27.7% ∼ 51.8% of fecal radioactivity. The elimination of gemigliptin was balanced between metabolism and excretion through urine and feces. CYP3A4 was identified as the dominant CYP isozyme converting gemigliptin to LC15-0636 in recombinant CYP/FMO enzymes.</P>