Anticoagulation after pancreatic surgery with venous resection (TIGRESS): What should we do? Results from an international survey

Thomas B. Russell,Debora Ciprani,Somaiah Aroori 한국간담췌외과학회 2023 Annals of hepato-biliary-pancreatic surgery Vol.27 No.4

Backgrounds/Aims: Patients who undergo pancreatic surgery with venous resection have high rates of morbidity/mortality. Also, they are high-risk for postoperative venous thromboembolism. Whether this group should be routinely anticoagulated is unknown. This study aimed to establish current anticoagulation practices. Methods: A survey (https://form.jotform.com/220242489107048) was sent out to pancreatic surgeons. Questions covered center volume, venous resection/reconstruction techniques and anticoagulation policies. Results: Sixty-five centers from 17 countries responded. Following a “side-bite” venous resection with a patch repair, 40% used an autologous vein patch, 27% used peritoneum, and 27% used a bovine patch. After formally resecting a segment of vein, 17% of centers used an interposition graft (IG). Left renal vein (41%) and polytetrafluoroethylene (73%) grafts were the most commonly used autologous and prosthetic IGs, respectively. Following a prosthetic IG, an autologous IG, and a “side-bite” resection, 59%, 28%, and 19% of centers provided therapeutic anticoagulation, respectively (66% used low molecular-weight heparin). The duration of therapy provided varied from inpatient stay only (14%) to six months (32%). Conclusions: Our global survey indicates that anticoagulation practices are highly variable. Centers do not agree on when to anticoagulate, how to anticoagulate, or the duration of therapy. A robust trial is required to provide clarity.

Does an extensive diagnostic workup for upfront resectable pancreatic cancer result in a delay which affects survival? Results from an international multicentre study

Thomas B. Russell,Peter L. Labib,Jemimah Denson,Fabio Ausania,Elizabeth Pando,Keith J. Roberts,Ambareen Kausar,Vasileios K. Mavroeidis,Gabriele Marangoni,Sarah C. Thomasset,Adam E. Frampton,Pavlos Lyk 한국간담췌외과학회 2023 Annals of hepato-biliary-pancreatic surgery Vol.27 No.4

Backgrounds/Aims: Pancreatoduodenectomy (PD) is recommended in fit patients with a carcinoma (PDAC) of the pancreatic head, and a delayed resection may affect survival. This study aimed to correlate the time from staging to PD with long-term survival, and study the impact of preoperative investigations (if any) on the timing of surgery. Methods: Data were extracted from the Recurrence After Whipple’s (RAW) study, a multicentre retrospective study of PD outcomes. Only PDAC patients who underwent an upfront resection were included. Patients who received neoadjuvant chemo-/radiotherapy were excluded. Group A (PD within 28 days of most recent preoperative computed tomography [CT]) was compared to group B (> 28 days). Results: A total of 595 patents were included. Compared to group A (median CT-PD time: 12.5 days, interquartile range: 6–21), group B (49 days, 39–64.5) had similar one-year survival (73% vs. 75%, p = 0.6), five-year survival (23% vs. 21%, p = 0.6) and median time-todeath (17 vs. 18 months, p = 0.8). Staging laparoscopy (43 vs. 29.5 days, p = 0.009) and preoperative biliary stenting (39 vs. 20 days, p < 0.001) were associated with a delay to PD, but magnetic resonance imaging (32 vs. 32 days, p = 0.5), positron emission tomography (40 vs. 31 days, p > 0.99) and endoscopic ultrasonography (28 vs. 32 days, p > 0.99) were not. Conclusions: Although a treatment delay may give rise to patient anxiety, our findings would suggest this does not correlate with worse survival. A delay may be necessary to obtain further information and minimize the number of PD patients diagnosed with early disease recurrence.

Five-year follow-up after pancreatoduodenectomy performed for malignancy: A single-centre study

Thomas Brendon Russell,Peter Lawrence Zaki Labib,Somaiah Aroori 한국간담췌외과학회 2023 Annals of hepato-biliary-pancreatic surgery Vol.27 No.1

Backgrounds/Aims: The aim of this study was to describe short- and long-term outcomes of patients who underwent pancreatoduodenectomy (PD) at a typical United Kingdom hepatopancreatobiliary unit. Methods: A retrospective analysis of all PD patients with histologically-confirmed pancreatic ductal adenocarcinoma (PDAC), ampullary adenocarcinoma (AA), or distal cholangiocarcinoma (CC) from September 1st, 2006 to May 31st, 2015 was carried out. The following information was obtained: demographics, comorbidities, preoperative investigations, neoadjuvant treatment, operative details, postoperative management, complications, adjuvant treatment, five-year recurrence, and five-year survival. Effects of selected preoperative variables on short- and long-term outcomes were investigated. Results: Of 271 included patients, 57.9% had PDAC, 25.8% had AA, and 16.2% had CC. In total, 67.9% experienced morbidity and 17.3% developed a Clavien-Dindo grade ≥ III complication. The 90-day mortality was 3.3%. Clinically-relevant postoperative pancreatic fistula, bile leak, gastrojejunal leak, postpancreatectomy haemorrhage and delayed gastric emptying affected 8.1%, 4.1%, 0.0%, 9.2%, and 19.9% of patients, respectively. American Society of Anesthesiologists grade III–VI correlated with overall morbidity (p = 0.002) and major morbidity (p = 0.009), but not 90-day mortality or five-year survival. The same pattern was observed in patients with a preoperative serum bilirubin > 29 μmol/L and/or a neutrophil/lymphocyte ratio > 3.1. Five-year cancer recurrence and five-year survival were 68.3% and 22.5%, respectively. PDAC patients had higher five-year recurrence but lower five-year survival rates (both p = 0.001). Conclusions: In our series, the majority of patients experienced a complication. However, few patients experienced major morbidity. Surgical risk factors did not affect five-year survival.

Aspects of Electrohydrodynamic Instabilities at Polymer Interfaces

Russell, Thomas P.,Lin, Zhiqum,Schaffer, Erik,Steiner, Ullrich The Korean Fiber Society 2003 Fibers and polymers Vol.4 No.1

Electrospinning is emerging as a simple means of producing fibers with diameters ranging from 0.02 $\mu\textrm{m}$ to many microns. Electrospinning, however, relies on the force generated by an electric field on the surface of a polymer solution to either enhance instabilities in a thinning jet or to rapidly elongate a jet of polymer solution form a nozzle. In this article the fundamental physics and fluid dynamics on the subject matter are described, and tome of the relevant parameters in electrodynamic instabilities at polymer interfaces are discussed in some detail.

University of Massachusetts, Amherst

Thomas P. Russell 한국고분자학회 2006 고분자 과학과 기술 Vol.17 No.5

Do some patients receive unnecessary parenteral nutrition after pancreatoduodenectomy? Results from an international multicentre study

Thomas B. Russell,Peter L. Labib,Paula Murphy,Fabio Ausania,Elizabeth Pando,Keith J. Roberts,Ambareen Kausar,Vasileios K. Mavroeidis,Gabriele Marangoni,Sarah C. Thomasset,Adam E. Frampton,Pavlos Lykou 한국간담췌외과학회 2024 Annals of hepato-biliary-pancreatic surgery Vol.28 No.1

Backgrounds/Aims: After pancreatoduodenectomy (PD), an early oral diet is recommended; however, the postoperative nutritional management of PD patients is known to be highly variable, with some centers still routinely providing parenteral nutrition (PN). Some patients who receive PN experience clinically significant complications, underscoring its judicious use. Using a large cohort, this study aimed to determine the proportion of PD patients who received postoperative nutritional support (NS), describe the nature of this support, and investigate whether receiving PN correlated with adverse perioperative outcomes. Methods: Data were extracted from the Recurrence After Whipple’s study, a retrospective multicenter study of PD outcomes. Results: In total, 1,323 patients (89%) had data on their postoperative NS status available. Of these, 45% received postoperative NS, which was “enteral only,” “parenteral only,” and “enteral and parenteral” in 44%, 35%, and 21% of cases, respectively. Body mass index < 18.5 kg/m2 (p = 0.03), absence of preoperative biliary stenting (p = 0.009), and serum albumin < 36 g/L (p = 0.009) all correlated with receiving postoperative NS. Among those who did not develop a serious postoperative complication, i.e., those who had a relatively uneventful recovery, 20% received PN. Conclusions: A considerable number of patients who had an uneventful recovery received PN. PN is not without risk, and should be reserved for those who are unable to take an oral diet. PD patients should undergo pre- and postoperative assessment by nutrition professionals to ensure they are managed appropriately, and to optimize perioperative outcomes.

Kimchi and Spaghetti

Thomas Russell(토마스 러셀) 동국대학교 영상미디어센터 2012 씨네포럼 Vol.0 No.14

웨스턴영화의 종말은 지금까지 여러 번 반복되어 언급되었지만, 계속해서 이 장르의 회기를 도모하기도 한다. 토마스 샤츠는 그의 저서 『할리우드 장르: 형식, 제작, 스튜디오』에서 “웨스턴영화는 문화적 자료와 내러티브와 주제적 모티프의 근원으로 존재한다”라고 지적하고 있다. 김지운 감독의 〈좋은 놈, 나쁜 놈, 이상한 놈〉(2008)의 경우를 예로 들면, 이 영화는 미국 재건시대의 탄광, 마을, 사막이라는 배경을 1930년대 만주로 부활시켰다. 이 영화는 최근 한국영화에서 첫 웨스턴이라는 의미를 갖고 있는데 “K-오터(한국형 웨스턴)”라는 타이틀도 얻게 되었다. 그리고 이 영화는 웨스턴과 하위 장르로서 “스파게티 웨스턴”의 장르적 요소를 잘 그리고 있다. 특히 세르지오 레오네의 〈석양의 무법자〉(1966)와 스타일적으로 많은 유사점이 존재한다. 장르로서 웨스턴은 즉각적으로 알아볼 수 있는 아이콘과 주제적 요소를 가지고 있다. 예를 들면, 총 싸움, 막판대결, 술집, 총, 개척자, 마을, 기차, 사냥꾼, 악당, 신비한 독불장군 등이 반복적으로 등장한다. 샤츠에 따르면 웨스턴은 미국 정체성을 보여주는 가장 기본적인 요소로서 중요한 마스터 키로 여겨질 수 있다. 특히, 웨스턴의 장르적 개념으로 기억된 개척자 정신의 신화는 미국의 국가 정체성과 특성의 핵심적인 부분으로 생각할 수 있다. 그리고 웨스턴은 미국의 국내외 정치를 비판하는데 종종 사용되기도 한다. 이 장르는 스파게티 웨스턴의 형식과 관련해서 질문을 받기도 한다. 스파게티 웨스턴은 웨스턴의 논쟁적인 부분을 점하고 있는데, 스파게티 웨스턴은 시각적이고 음악적인 스타일과 리얼리즘적이라는 부분에서 할리우드 웨스턴의 열등적 모방이라고 표현되기도 한다. 프레일링에 따르면, 스파게티 웨스턴은 미국과 유럽 문화의 특이하고 잠재적인 교차수정으로 여겨진다. 이러한 교차수정 시각을 스파게티 웨스턴과 김치 웨스턴에서 찾을 수 있다. 본 연구는 비교문화적 리메이크와 장르적 작용을 알아보기 위해서 김지운의 〈좋은 놈, 나쁜 놈, 이상한 놈〉과 세르지오 레오네의 〈석양의 무법자〉에 대한 비교연구라고 할 수 있다. 레오네 영화의 내러티브와 주제적 모티프를 조사함으로써 김지운의 영화가 어떻게 한국의 역사적, 문화적, 국가적 정체성을 리메이크를 통해서 제시했는지를 살펴볼 것이다. The western’s obituary has been written time and time again yet somehow it always manages to rise from the dead in one form or another. In his influential book Hollywood Genres : Formulas, Filmmaking, and the Studio System, Thomas Schatz points out “…the Western lives on both as point of cultural reference and as a source of narrative and thematic motifs…” (Schatz 74). In the case of Kim Jee Woon’s The Good, the Bad and the Weird (Kim 2008), the Western has been resurrected and transported from the mining camps, boomtowns and deserts of Reconstruction era America to 1930s Manchuria. The film is South Korea’s first entry in the Western genre and is credited with launching a new genre, the “K-oater” (Elley 35). The film draws heavily on generic elements of the Western and the sub-genre the “Spaghetti Western”, especially the works of Sergio Leone, particularly Leone’s The Good, The Bad, and The Ugly. As a genre, the Western has been especially noted for its immediately recognizable iconic and thematic elements: gunfights and showdowns, saloons and sixguns, the frontier and the town, trains, bounty hunters, bandits and mysterious loners who drift into town and ride off into the sunset. The Western has been considered a “master key to unlocking and understanding the most basic elements of American identity” (Schatz 54). In particular, the myth of the frontier, encoded within the generic tropes of the Western has been “assigned a central, even defining, place in the foundation of American national identity and national character” (Schatz 55). The Western has also been used to comment on or criticize American domestic and foreign policy, and to interrogate concepts of social and gender identity. The genre has itself been interrogated in the form of the Spaghetti Western. The Spaghetti Western occupies a controversial place within the genre. It has been described as “an inferior imitation of the American Western, a revitalization of the same in terms of visuals and music, or in terms of added realism” (Fridlund 3). For Frayling, it “represented an extraordinary and potent cross-fertilization of American and European cultures” (Frayling vi). It is this idea of cross-fertilization that I wish to examine in regards to the latest incarnation of the “Spaghetti Western”, the so-called “Kimchi Western”. My essay will undertake a close examination of Kim’s The Good, The Bad, and The Weird and Leone’s The Good, The Bad and The Ugly in order to expose the operations of genre and culture in cross-cultural remakes. By examining the “narrative and thematic motifs” that dovetail with and differentiate the film from Leone’s film, I will show how Kim uses the remake to investigate Korean historical, cultural and national identity.

Economic and environmental effects of precursor variation in a continuous carbon fibre manufacturing process

Thomas Groetsch,Maxime Maghe,Claudia Creighton,Russell J. Varley 한국공업화학회 2023 Journal of Industrial and Engineering Chemistry Vol.127 No.-

Commercial carbon fibre manufacture is a proprietary process which has resulted in limited informationbeing publicly available in regard to the processing of different materials and their impact on material,environmental and economic characteristics. This study investigates the relationship between differentprecursor materials and these parameters through an in-depth analysis of process structures, materialproperties, incurred emissions, energy demand and cost composition. This study compares three importantprecursor types for carbon fibre manufacture including ecological and economical aspects. Two ofthe precursors are polyacrylonitrile based, a special carbon fibre and textile grade, while the third is a sustainablyderived lignin-cellulose blend. The lower cost textile precursor has significantly higher processingcost than the specialized material while also incurring a higher amount of emissions. Indeed, up to270% more compared to the special grade precursor. The analysis of the lignin-cellulose blend precursorillustrates its shortcomings, especially with respect to processability and properties, despite its lowerenvironmental impact and up to 25% cost advantage. This study suggests pathways for the industrial processingof alternative precursors outlining their economic and ecological benefits and highlighting areasof necessary improvement such as material properties and energy demand.

Electrohydrodynamic Instabilities of Polymer/Nanoparticle Thin Films

배준원,Thomas P Russell 한국고분자학회 2008 한국고분자학회 학술대회 연구논문 초록집 Vol.33 No.1

NANOSCALE PATTERNING IN BLOCK COPOLYMER THIN FILMS

박수진,THOMAS P. RUSSELL 성균관대학교(자연과학캠퍼스) 성균나노과학기술원 2010 NANO Vol.5 No.1

Nanoscale patterning in block copolymer (BCP) thin films is one of the key issues in nanoscience and nanotechnology. To make useful nanoscale patterns in applications such as magnetic media, wire-grid polarizer, and opto-electronics, the control of orientation and lateral ordering of BCP microdomains is required. The generation of highly ordered and oriented cylindrical microdomains in BCP thin films will be discussed. This is followed by a review of applications of nanoscale patterns like fabrication of nanoporous templates, metallic nanowires, and the preparation of nanostructured inorganic materials.