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  • 1
    In: Journal of Hepato-Biliary-Pancreatic Sciences, Wiley, Vol. 30, No. 1 ( 2023-01), p. 133-143
    Abstract: Although we previously proposed a nomogram to predict malignancy in intraductal papillary mucinous neoplasms (IPMN) and validated it in an external cohort, its application is challenging without data on tumor markers. Moreover, existing nomograms have not been compared. This study aimed to develop a nomogram based on radiologic findings and to compare its performance with previously proposed American and Korean/Japanese nomograms. Methods We recruited 3708 patients who underwent surgical resection at 31 tertiary institutions in eight countries, and patients with main pancreatic duct  〉 10 mm were excluded. To construct the nomogram, 2606 patients were randomly allocated 1:1 into training and internal validation sets, and area under the receiver operating characteristics curve (AUC) was calculated using 10‐fold cross validation by exhaustive search. This nomogram was then validated and compared to the American and Korean/Japanese nomograms using 1102 patients. Results Among the 2606 patients, 90 had main‐duct type, 900 had branch‐duct type, and 1616 had mixed‐type IPMN. Pathologic results revealed 1628 low‐grade dysplasia, 476 high‐grade dysplasia, and 502 invasive carcinoma. Location, cyst size, duct dilatation, and mural nodule were selected to construct the nomogram. AUC of this nomogram was higher than the American nomogram (0.691 vs 0.664, P  = .014) and comparable with the Korean/Japanese nomogram (0.659 vs 0.653, P  = .255). Conclusions A novel nomogram based on radiologic findings of IPMN is competitive for predicting risk of malignancy. This nomogram would be clinically helpful in circumstances where tumor markers are not available. The nomogram is freely available at http://statgen.snu.ac.kr/software/nomogramIPMN .
    Type of Medium: Online Resource
    ISSN: 1868-6974 , 1868-6982
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2536390-6
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  • 2
    In: Journal of Hepato-Biliary-Pancreatic Sciences, Wiley, Vol. 25, No. 12 ( 2018-12), p. 533-543
    Abstract: There is no consensus on the optimal treatment of T1b gallbladder cancer (GBC) due to the lack of evidence and the difficulty of anatomy and pathological standardization. Methods A total of 272 patients with T1b GBC who underwent surgical resection at 14 centers with specialized hepatobiliary‐pancreatic surgeons and pathologists in Korea, Japan, Chile, and the United States were studied. Clinical outcomes including disease‐specific survival (DSS) rates according to the types of surgery were analyzed. Results After excluding patients, the 237 qualifying patients consisted of 90 men and 147 women. Simple cholecystectomy (SC) was performed in 116 patients (48.9%) and extended cholecystectomy (EC) in 121 patients (51.1%). The overall 5‐year DSS was 94.6%, and it was similar between SC and EC patients (93.7% vs. 95.5%, P  = 0.496). The 5‐year DSS was similar between SC and EC patients in America (82.3% vs. 100.0%, P  = 0.249) as well as in Asia (98.6% vs. 95.2%, P  = 0.690). The 5‐year DSS also did not differ according to lymph node metastasis ( P  = 0.688) or tumor location ( P  = 0.474). Conclusions SC showed similar clinical outcomes (including recurrence) and survival outcomes as EC; therefore, EC is not needed for the treatment of T1b GBC.
    Type of Medium: Online Resource
    ISSN: 1868-6974 , 1868-6982
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2018
    detail.hit.zdb_id: 2536390-6
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  • 3
    In: The International Journal of Medical Robotics and Computer Assisted Surgery, Wiley, Vol. 18, No. 1 ( 2022-02)
    Abstract: Single‐incision robotic cholecystectomy (SIRC) is widely performed with both the da Vinci Xi system (Xi) and the da Vinci SP system (SP). But there are limited numbers of studies comparing these platforms. Methods Patients who underwent SIRC between 2019 and 2020 were enrolled. Patient demographics, intraoperative factors, postoperative complications, postoperative pain were compared using a one‐to‐one propensity score matching (PSM). Results Overall, 258 patients underwent SIRC with Xi and 72 with SP. After PSM, there were significant differences between the Xi and SP in operation time at console and numeric rating scale for postoperative pain, but no difference in total operation time and postoperative complications. The SP group showed more estimated blood loss. Conclusions Despite the statistical difference, clinical benefit was not significant. Both platforms can be safe and feasible to perform SIRC, but further investigation including the surgeon's workload and ergonomics is needed as a prospective study.
    Type of Medium: Online Resource
    ISSN: 1478-5951 , 1478-596X
    URL: Issue
    RVK:
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2156187-4
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  • 4
    In: Clinical and Translational Science, Wiley, Vol. 14, No. 4 ( 2021-07), p. 1280-1291
    Abstract: This study aimed to demonstrate pharmacokinetic (PK) equivalence of a single dose of the proposed adalimumab biosimilar CT‐P17 to United States‐licensed adalimumab (US‐adalimumab) and European Union‐approved adalimumab (EU‐adalimumab). This double‐blind, parallel‐group, phase I trial (clinicaltrials.gov NCT03970824) was conducted at 10 hospitals (Republic of Korea), in which healthy subjects (1:1:1) were randomized to receive a single 40 mg (100 mg/ml) subcutaneous injection of CT‐P17, US‐adalimumab, or EU‐adalimumab. Primary end points were PK equivalence in terms of: area under the concentration–time curve from time zero to infinity (AUC 0–inf ); AUC from time zero to the last quantifiable concentration (AUC 0–last ); and maximum serum concentration (C max ). PK equivalence was concluded if 90% confidence intervals (CIs) for percent ratios of geometric least squares means (GLSMs) for pairwise comparisons were within the equivalence margin of 80–125%. Additional PK end points, safety, and immunogenicity were evaluated. Of the 312 subjects who were randomized (103 CT‐P17; 103 US‐adalimumab; 106 EU‐adalimumab), 308 subjects received study drug. AUC 0–inf , AUC 0–last , and C max were equivalent among CT‐P17, US‐adalimumab, and EU‐adalimumab, because 90% CIs for the ratios of GLSMs were within the 80–125% equivalence margin for each pairwise comparison. Secondary PK end points, safety, and immunogenicity were similar between treatment groups. In conclusion, PK equivalence for single‐dose administration of CT‐P17, EU‐adalimumab, and US‐adalimumab was demonstrated in healthy adults. Safety and immunogenicity profiles were comparable between treatment groups and consistent with previous reports for adalimumab biosimilars.
    Type of Medium: Online Resource
    ISSN: 1752-8054 , 1752-8062
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 2433157-0
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  • 5
    In: Clinical Pharmacology in Drug Development, Wiley, Vol. 12, No. 1 ( 2023-01), p. 21-29
    Abstract: This study evaluated the pharmacokinetics and pharmacodynamics of the antiplatelet agent prasugrel, and explored its optimal dose regimens via modeling and simulation using NONMEM. We measured platelet aggregation and the serial plasma concentrations of the inactive (R‐95913) and active metabolites (R‐138727) of prasugrel after a single oral dose of 10–60 mg in 20 healthy adult male volunteers. A pharmacokinetic model for R‐95913 and R‐138727, and a pharmacodynamic model between the concentration of R‐138727 and maximal platelet aggregation measured by light transmittance were constructed. The predictability of the model for platelet aggregation was evaluated by comparing the model prediction values with the observed ones not used in the construction of the model. Pharmacokinetic data were best described by a 3‐compartment models for R‐95913, a 1‐compartment model for R‐138727 with transit compartment model for absorption delay, and first‐pass metabolic conversion of R‐95913 into R‐138727 during absorption. The association–dissociation model between R‐138727 and its receptor in platelets was applied for the inhibitory effect of prasugrel on platelet aggregation. Prasugrel rapidly inhibited platelet aggregation after oral administration, with a prolonged duration of action; however, the concentration of the active metabolite decreased rapidly, which may have been due to the slow dissociation rate of R‐138727 from its target receptor in platelets. The external validation suggests that our model could be used to individualize prasugrel treatment in various clinical situations. Simulation showed rapid onset of inhibitory effect with great magnitude and consistent inhibition after therapeutic dose of prasugrel.
    Type of Medium: Online Resource
    ISSN: 2160-763X , 2160-7648
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2649010-9
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  • 6
    In: Journal of Hepato-Biliary-Pancreatic Sciences, Wiley, Vol. 25, No. 2 ( 2018-02), p. 142-149
    Abstract: Robot surgery is a new method that maintains advantages and overcomes disadvantages of conventional methods, even in pancreatic surgery. This study aimed to evaluate safety and benefits of robot‐assisted minimally invasive pancreaticoduodenectomy (robot PD ). Methods This study included 237 patients who underwent PD between 2015 and 2017. Demographics and surgical outcomes were evaluated. Results Fifty‐one patients underwent robot PD and 186 underwent open PD . Robot PD group had younger age (60.7 vs. 65.4 years, P = 0.006) and lower body mass index (22.7 vs. 24.0, P = 0.007). Robot PD group had lower proportion of patients with firm or hard pancreatic texture (15.7% vs. 38.2%, P = 0.004) and smaller pancreatic duct size (2.3 vs. 3.3 mm, P = 0.002). Two groups had similar operation time (robot vs. open: 335.6 vs. 330.1 min) and complications (15.7% vs. 21.0%), including postoperative pancreatic fistula rate (6.0% vs. 12.0%). Robot PD group had lower postoperative pain score (3.7 vs. 4.1 points, P = 0.008), and shorter postoperative stay (10.6 vs. 15.3 days, P = 0.001). Conclusion Robot PD is comparable to open PD in early outcomes. Robot PD is safe and feasible and enables early recovery; indication for robot PD is expected to expand in the near future.
    Type of Medium: Online Resource
    ISSN: 1868-6974 , 1868-6982
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2018
    detail.hit.zdb_id: 2536390-6
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  • 7
    In: The Journal of Clinical Pharmacology, Wiley, Vol. 58, No. 7 ( 2018-07), p. 905-912
    Abstract: Udenafil is a phosphodiesterase‐5 inhibitor used to treat erectile dysfunction. Although udenafil is not predominantly eliminated by the kidney, renal impairment can alter its secretion/transport pathways. Drug pharmacokinetics and safety must therefore be assessed in subjects with a renal impairment. We investigated the effects of impaired renal function on the pharmacokinetics and safety of a single 100‐mg oral dose of udenafil in a single‐dose, open‐label, parallel‐group study of 31 subjects. Cockcroft‐Gault creatinine clearance was used to stratify these subjects into healthy controls ( 〉 80 mL·min −1 ) and individuals with mild (50 to ≤80 mL·min −1 ), moderate (30 to ≤50 mL·min −1 ), and severe ( 〈 30 mL·min −1 ) renal impairment. Pharmacokinetic measurements and safety assessments indicated that the geometric mean of the area under the concentration‐time curve to the last measurement in mildly, moderately, and severely renally impaired subjects was 1.30‐ (90% CI 1.05‐1.60), 1.62‐ (90% CI 1.28‐2.06), and 1.60‐ (90% CI 1.28‐2.01) fold higher, respectively, than the healthy controls. The geometric mean of the maximum observed concentration was 1.41‐ (90% CI 1.05‐1.88), 2.02‐ (90% CI 1.47‐2.79), and 1.65‐ (90% CI: 1.21‐2.24) fold higher, respectively. Significant correlations were observed among the creatinine clearance, oral clearance, and maximum concentration of udenafil ( P 〈 .01). All adverse events were mild, and no subject discontinued the study. Udenafil administration was well tolerated in all groups. In view of the clinical relevance of drug exposure, our findings indicate that a dose adjustment of udenafil is warranted in subjects with moderate or severe renal impairment.
    Type of Medium: Online Resource
    ISSN: 0091-2700 , 1552-4604
    URL: Issue
    RVK:
    Language: English
    Publisher: Wiley
    Publication Date: 2018
    detail.hit.zdb_id: 2010253-7
    SSG: 15,3
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  • 8
    In: Journal of Hepato-Biliary-Pancreatic Sciences, Wiley, Vol. 28, No. 2 ( 2021-02), p. 131-142
    Abstract: With the increase in detection of intraductal papillary mucinous neoplasms (IPMN), a tailored approach is needed. This study was aimed at exploring the natural history of IPMN and suggest optimal treatment based on malignancy risk using a nomogram and Markov decision model. Methods Patients with IPMN who underwent surveillance or surgery were included. Changes in worrisome features/high‐risk stigmata and malignancy conversion rate were assessed. Life expectancy and quality‐adjusted life year (QALY) were compared using a nomogram predicting malignancy. Results Overall, 2006 patients with histologically confirmed or radiologically typical IPMN were enrolled. Of these, 1773 (88.4%), 81 (4.0%), and 152 (7.6%), respectively, had branch duct (BD)‐, main duct‐, and mixed‐type IPMN at initial diagnosis. The cumulative risk of developing worrisome feature or high‐risk stigmata was 19.0% and 35.0% at 5‐ and 10‐year follow‐up, respectively. The progression of malignancy rate at 10‐year follow‐up was 79.9% for main and mixed IPMNs and 5.9% for BD‐IPMN. Nomogram‐based malignancy risk prediction is well correlated with natural history based on pathologic biopsy and shows good stratification of survival. The decision model recommends surgery to maximize survival and QALY especially in those with 〉 35% malignancy risk. Conclusions Compared with main duct‐ and mixed‐type IPMN, which have a high risk of malignancy (79.9%), BD‐IPMN is very indolent (5.9%). The nomogram‐based decision model suggests surgery rather than surveillance for patients with a high malignancy risk. The optimal treatment strategy between surgery and surveillance should consider patients' health status, malignancy risk, and centers' experience.
    Type of Medium: Online Resource
    ISSN: 1868-6974 , 1868-6982
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 2536390-6
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  • 9
    Online Resource
    Online Resource
    Wiley ; 2022
    In:  Journal of Hepato-Biliary-Pancreatic Sciences Vol. 29, No. 6 ( 2022-06), p. 659-669
    In: Journal of Hepato-Biliary-Pancreatic Sciences, Wiley, Vol. 29, No. 6 ( 2022-06), p. 659-669
    Abstract: A history of familial pancreatic cancer (FPC) increases the incidence of pancreatic cancer (PC) among first‐degree relatives. We aimed to determine the incidence of FPC and analyze its clinical characteristics. Methods Between 2010 and 2014, 1159 patients with PC were included in the study. We evaluated the incidence of FPC, clinicopathological features, and survival prognosis between FPC and non‐FPC patients. We further analyzed the clinical outcomes of 389 patients with PC who underwent curative‐intent surgery. Results Familial pancreatic cancer incidence was 3.1% (n = 36) among all patients with PC (n = 1159). FPC was diagnosed at an advanced clinical stage compared to non‐FPC ( P  = .041). The tested variables and 5‐year survival rate (5YSR) between FPC and non‐FPC after propensity score matching had no differences (5YSR: 4.6% vs 2.6%, P  = .834). Among PC patients who underwent curative‐intent surgery (n = 389), FPC incidence was 1.8% (n = 7). FPC patients were older than non‐FPC patients (75.3 ± 4.7 years vs 64.0 ± 9.9 years, P   〈  .001). 5YSR tended to differ between FPC and non‐FPC (14.3% vs 22.5%, P  = .07) groups. Conclusion Familial pancreatic cancer is diagnosed at an advanced stage, and FPC that has undergone resection is associated with older age or worse prognosis. A prospective nationwide pedigree registration system was required.
    Type of Medium: Online Resource
    ISSN: 1868-6974 , 1868-6982
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2536390-6
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  • 10
    In: Advanced Optical Materials, Wiley, Vol. 6, No. 21 ( 2018-11)
    Abstract: The convergence of nano‐optics with an aqueous environment is promising for future chemical or biological applications. While the rapid development in nanofabrication has led to the realization of sub‐10 nm nanogaps of various structures, coupling water into high aspect ratio metallic nanogaps with a well‐defined area is not yet demonstrated. Here, arrays of 10 nm wide metallic trenches are reported filled with dielectric, air, liquid water, and various molecules in optical hotspots. Due to the high height‐to‐width aspect ratio of 20:1 and strong gap plasmon coupling in the 10 nm width, the trenches show distinct spectral changes at terahertz frequencies under changing gap materials, from which the full etching and water filling of the 10 nm gap can be unambiguously confirmed. A 75% transmitted amplitude decrease is observed through 200 nm deep trenches upon water filling, which converts to an effective 1100‐fold increase in the water absorption coefficient. The gap‐filling scheme can be applied to distinguish different liquids with 400 attoliters of volume or to detect rhodamine 6G molecules inside the gap with surface‐enhanced Raman scattering. Accordingly, the scheme can also be applied to a general class of polar organic molecules suitable for various biological or chemical applications.
    Type of Medium: Online Resource
    ISSN: 2195-1071 , 2195-1071
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2018
    detail.hit.zdb_id: 2708158-8
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