BACKGROUND Pancreatic ductal leaks complicated by endoscopic ultrasonography-guided tissue sampling(EUS-TS)can manifest as acute pancreatitis.CASE SUMMARY A 63-year-old man presented with persistent abdominal pain and...BACKGROUND Pancreatic ductal leaks complicated by endoscopic ultrasonography-guided tissue sampling(EUS-TS)can manifest as acute pancreatitis.CASE SUMMARY A 63-year-old man presented with persistent abdominal pain and weight loss.Diagnosis:Laboratory findings revealed elevated carbohydrate antigen 19-9(5920 U/mL)and carcinoembryonic antigen(23.7 ng/mL)levels.Magnetic resonance imaging of the pancreas revealed an approximately 3 cm ill-defined space-occupying lesion in the inferior aspect of the head,with severe encasement of the superior mesenteric artery.Pancreatic ductal adenocarcinoma was confirmed after pathological examination of specimens obtained by EUS-TS using the fanning method.Interventions and outcomes:The following day,the patient experienced severe abdominal pain with high amylase(265 U/L)and lipase(1173 U/L)levels.Computed tomography of the abdomen revealed edematous wall thickening of the second portion of the duodenum with adjacent fluid collections and a suspicious leak from either the distal common bile duct or the main pancreatic duct in the head.Endoscopic retrograde cholangiopancreatography revealed dye leakage in the head of the main pancreatic duct.Therefore,a 5F 7 cm linear plastic stent was deployed into the pancreatic duct to divert the pancreatic juice.The patient’s abdominal pain improved immediately after pancreatic stent insertion,and amylase and lipase levels normalized within a week.Neoadjuvant chemotherapy was then initiated.CONCLUSION Using the fanning method in EUS-TS can inadvertently cause damage to the pancreatic duct and may lead to clinically significant pancreatitis.Placing a pancreatic stent may immediately resolve acute pancreatitis and shorten the waiting time for curative therapy.When using the fanning method during EUSTS,ductal structures should be excluded to prevent pancreatic ductal leakage.展开更多
【Title】 This study explores the optimal spatial allocation of initial attack resources for firefighting in the Republic of Korea. To improve the effectiveness of Korean initial attack resources with a range of polic...【Title】 This study explores the optimal spatial allocation of initial attack resources for firefighting in the Republic of Korea. To improve the effectiveness of Korean initial attack resources with a range of policy goals, we create a scenario optimization model that minimizes the expected number of fires not receiving a predefined response. In this study, the predefined response indicates the number of firefighting resources that must arrive at a fire before the fire escapes and becomes a large fire. We use spatially explicit GIS-based information on the ecology, fire behavior, and economic characterizations important in Korea. The data include historical fire events in the Republic of Korea from 1991 to 2007, suppression costs, and spatial information on forest fire extent. Interviews with forest managers inform the range of we address in the decision model. Based on the geographic data, we conduct a sensitivity analysis by varying the parameters systematically. Information on the relative importance of the components of the settings helps us to identify “rules of thumb” for initial attack resource allocations in particular ecological and policy settings.展开更多
Carbon emissions from forest fires are considered an important factor of ecosystem carbon balance and global climate change. Carbon emissions from Japanese red pine stands （Pinus densiflora S. et Z.） burned by crown...Carbon emissions from forest fires are considered an important factor of ecosystem carbon balance and global climate change. Carbon emissions from Japanese red pine stands （Pinus densiflora S. et Z.） burned by crown fire were estimated at Mt. Palgong in Daegu Metropolitan City, and crown fuel characteristics, including crown bulk density, crown base height, and fuel moisture content of Japanese red pine, were analyzed. Total biomass combusted was calculated by subtracting the biomass of burned stands from that of unburned stands exhibiting similar stand structures and site environments. Ten trees in the unburned area and five trees in the burned area were cut by using direct harvesting techniques to estimate crown layer biomass. All biomass sampled was oven-dried and weighed. The dry weight ratios of stems, branches, and needles were 7o%, 21%, and 9%, respectively. The available fuel load susceptible to combustion during the crown fire spread was equivalent to 55% of the crown layer biomass. The crown bulk density was 0.24 kg/m3 on average. The estimated amount of CO2 was 23,454 kg CO2/ha for the crown layer. These results will be useful for calculating the amount of CO2 emitted from forest fires and for developing a forest carbon model in P. densiflora forests.展开更多
BACKGROUND One challenging scenario in the treatment of biliary stricture is that post-liver transplantation(LT)biliary strictures cannot be accessed using endoscopic retrograde cholangiopancreatography(ERCP).Here,we ...BACKGROUND One challenging scenario in the treatment of biliary stricture is that post-liver transplantation(LT)biliary strictures cannot be accessed using endoscopic retrograde cholangiopancreatography(ERCP).Here,we report such a case that was successfully treated using a novel endoscopic technique.CASE SUMMARY A 60-year-old man presented with obstructive jaundice caused by a post-LT biliary stricture.He underwent LT for compensated alcoholic liver cirrhosis and hepatocellular carcinoma.Laboratory investigations unveiled a cholestatic pattern of abnormalities in liver function and a total bilirubin level of 16 mg/dL.Magnetic resonance cholangiopancreatography revealed a stricture extending from the right intrahepatic bile duct into the common hepatic duct.Severe postoperative deformities made accessing the ampulla of Vater with a sideviewing duodenoscope impossible.Percutaneous transhepatic biliary drainage(PTBD)was performed to treat biliary obstruction.Moreover,to resolve the stricture completely,a fully covered self-expandable metal stent(FC-SEMS)with a novel proximal retrievable string was deployed into the post-LT biliary stricture through the PTBD tract.Before inserting the stent through the PTBD tract,the stent with the distal string was manually inverted to ensure that the distal part with the string became the proximal part for later endoscopic removal.After 6 mo,the FC-SEMS was successfully removed without complications,as the string was pulled out using a forward-viewing gastroscope.CONCLUSION Deployment and endoscopic removal of an FC-SEMS with a novel proximal string through the PTBD tract may be a viable option for treating post-LT biliary strictures that are inaccessible by ERCP.展开更多
In this paper, an economic model was constructed to determine the optimal wolf population and distribution across the Northern Rocky Mountains. Both ecological and economic concepts were incorporated in an implicitly ...In this paper, an economic model was constructed to determine the optimal wolf population and distribution across the Northern Rocky Mountains. Both ecological and economic concepts were incorporated in an implicitly spatial social welfare maximization problem. This interdisciplinary model relies on multiple data sources, including current wolf population and distribution information, opportunity cost to local landowners, and contingent valuation studies to determine willingness-to-pay for wolves. Economic models tend to externalize ecological concerns and ecological models often omit the complex human dimensions of conservation policy. Accordingly, this model can serve as a guide for integrating best practices from both fields. The model presented here is sufficiently general to apply to wolves in other ecosystems and to other highly interacting species such as beavers and bison. The Northern Rocky Mountain wolf was used as an example of how this economic model works, but this model can be applied far more broadly.展开更多
Background:Land use and development alter mudflat and wetland habitat availability,although mudflats and wetlands provide important stopover habitats for shorebirds during the spring and autumn migrations and support ...Background:Land use and development alter mudflat and wetland habitat availability,although mudflats and wetlands provide important stopover habitats for shorebirds during the spring and autumn migrations and support communities of ducks and geese during the winter months in the Republic of Korea.This study investigated land use changes around Sihwa Lake(Republic of Korea)and evaluated the effect of these changes on waterbird community characteristics.Methods:We conducted a land-use-change analysis at the medium-resolution level using land cover maps for 2001,2007,2009,and 2014.Also,a tidal stream survey was conducted in Sihwa Lake and the surrounding reclaimed mudflats every season for 10 years(2003-2012)to identify the seasonal and interannual variations in waterbird species composition.To determine the total annual waterbird species and population counts,species diversity index,and interspecies variations,a TRIM(trends and indices for monitoring data)analysis was used.Results:Wetland area decreased more than 10%while agricultural land,barren land,and grassland area increased more than 10%due to continuous reclamation activities around Sihwa Lake.Barren land later turned into agricultural land or other land use.Sixty-three species and 566,623 individuals were recorded.The number of species,population size,and species diversity index by year and by species showed decreasing trends that were more marked in spring and summer.Furthermore,seasonal and annual variations in waterbird species composition showed decreasing trends in dabbling ducks,herons,grebes,and shorebirds but diving ducks displayed increasing trends.In particular,shorebirds were reduced to a greater extent than other waterbird species because of the reduction and simplification of the intertidal zone,and shallow waters caused by reclamation and road construction.Conclusions:Increased development and construction around Sihwa Lake has altered migratory shorebird populations with a general decline in species diversity and population size.The greatest decline was observed in wading birds,while diving duck populations showed increasing trends.展开更多
This study explores the tradeoff relationship between the number of initial attack firefighting resources and the level of fire ignition prevention efforts mitigating the probability of human-made fires in the Republi...This study explores the tradeoff relationship between the number of initial attack firefighting resources and the level of fire ignition prevention efforts mitigating the probability of human-made fires in the Republic of Korea,where most fires are caused by human activities.To examine this tradeoff relationship,we develop a hybrid model that combines a robust optimization model with a stochastic simulation model.The robust optimization minimizes the expected number of fires not receiving a pre-defined response,such as the number of firefighting resources that must arrive at the fire within half an hour,subject to budget constraints and uncertainty about the daily number and location of fires.The simulation model produces a set of fire scenarios in which a combination of number,location,ignition time,and intensity of fires occur.Results show that fire ignition prevention is as cost-effective as initial attack firefighting resources given the current budget in the Republic of Korea for reducing the expected number of fires not covered by the predefined response.The mixed policy of fire suppression and fire prevention may produce some gains in efficiency relative to the dominant policy of strong fire suppression strategies.展开更多
文摘BACKGROUND Pancreatic ductal leaks complicated by endoscopic ultrasonography-guided tissue sampling(EUS-TS)can manifest as acute pancreatitis.CASE SUMMARY A 63-year-old man presented with persistent abdominal pain and weight loss.Diagnosis:Laboratory findings revealed elevated carbohydrate antigen 19-9(5920 U/mL)and carcinoembryonic antigen(23.7 ng/mL)levels.Magnetic resonance imaging of the pancreas revealed an approximately 3 cm ill-defined space-occupying lesion in the inferior aspect of the head,with severe encasement of the superior mesenteric artery.Pancreatic ductal adenocarcinoma was confirmed after pathological examination of specimens obtained by EUS-TS using the fanning method.Interventions and outcomes:The following day,the patient experienced severe abdominal pain with high amylase(265 U/L)and lipase(1173 U/L)levels.Computed tomography of the abdomen revealed edematous wall thickening of the second portion of the duodenum with adjacent fluid collections and a suspicious leak from either the distal common bile duct or the main pancreatic duct in the head.Endoscopic retrograde cholangiopancreatography revealed dye leakage in the head of the main pancreatic duct.Therefore,a 5F 7 cm linear plastic stent was deployed into the pancreatic duct to divert the pancreatic juice.The patient’s abdominal pain improved immediately after pancreatic stent insertion,and amylase and lipase levels normalized within a week.Neoadjuvant chemotherapy was then initiated.CONCLUSION Using the fanning method in EUS-TS can inadvertently cause damage to the pancreatic duct and may lead to clinically significant pancreatitis.Placing a pancreatic stent may immediately resolve acute pancreatitis and shorten the waiting time for curative therapy.When using the fanning method during EUSTS,ductal structures should be excluded to prevent pancreatic ductal leakage.
文摘【Title】 This study explores the optimal spatial allocation of initial attack resources for firefighting in the Republic of Korea. To improve the effectiveness of Korean initial attack resources with a range of policy goals, we create a scenario optimization model that minimizes the expected number of fires not receiving a predefined response. In this study, the predefined response indicates the number of firefighting resources that must arrive at a fire before the fire escapes and becomes a large fire. We use spatially explicit GIS-based information on the ecology, fire behavior, and economic characterizations important in Korea. The data include historical fire events in the Republic of Korea from 1991 to 2007, suppression costs, and spatial information on forest fire extent. Interviews with forest managers inform the range of we address in the decision model. Based on the geographic data, we conduct a sensitivity analysis by varying the parameters systematically. Information on the relative importance of the components of the settings helps us to identify “rules of thumb” for initial attack resource allocations in particular ecological and policy settings.
文摘Carbon emissions from forest fires are considered an important factor of ecosystem carbon balance and global climate change. Carbon emissions from Japanese red pine stands （Pinus densiflora S. et Z.） burned by crown fire were estimated at Mt. Palgong in Daegu Metropolitan City, and crown fuel characteristics, including crown bulk density, crown base height, and fuel moisture content of Japanese red pine, were analyzed. Total biomass combusted was calculated by subtracting the biomass of burned stands from that of unburned stands exhibiting similar stand structures and site environments. Ten trees in the unburned area and five trees in the burned area were cut by using direct harvesting techniques to estimate crown layer biomass. All biomass sampled was oven-dried and weighed. The dry weight ratios of stems, branches, and needles were 7o%, 21%, and 9%, respectively. The available fuel load susceptible to combustion during the crown fire spread was equivalent to 55% of the crown layer biomass. The crown bulk density was 0.24 kg/m3 on average. The estimated amount of CO2 was 23,454 kg CO2/ha for the crown layer. These results will be useful for calculating the amount of CO2 emitted from forest fires and for developing a forest carbon model in P. densiflora forests.
文摘BACKGROUND One challenging scenario in the treatment of biliary stricture is that post-liver transplantation(LT)biliary strictures cannot be accessed using endoscopic retrograde cholangiopancreatography(ERCP).Here,we report such a case that was successfully treated using a novel endoscopic technique.CASE SUMMARY A 60-year-old man presented with obstructive jaundice caused by a post-LT biliary stricture.He underwent LT for compensated alcoholic liver cirrhosis and hepatocellular carcinoma.Laboratory investigations unveiled a cholestatic pattern of abnormalities in liver function and a total bilirubin level of 16 mg/dL.Magnetic resonance cholangiopancreatography revealed a stricture extending from the right intrahepatic bile duct into the common hepatic duct.Severe postoperative deformities made accessing the ampulla of Vater with a sideviewing duodenoscope impossible.Percutaneous transhepatic biliary drainage(PTBD)was performed to treat biliary obstruction.Moreover,to resolve the stricture completely,a fully covered self-expandable metal stent(FC-SEMS)with a novel proximal retrievable string was deployed into the post-LT biliary stricture through the PTBD tract.Before inserting the stent through the PTBD tract,the stent with the distal string was manually inverted to ensure that the distal part with the string became the proximal part for later endoscopic removal.After 6 mo,the FC-SEMS was successfully removed without complications,as the string was pulled out using a forward-viewing gastroscope.CONCLUSION Deployment and endoscopic removal of an FC-SEMS with a novel proximal string through the PTBD tract may be a viable option for treating post-LT biliary strictures that are inaccessible by ERCP.
文摘In this paper, an economic model was constructed to determine the optimal wolf population and distribution across the Northern Rocky Mountains. Both ecological and economic concepts were incorporated in an implicitly spatial social welfare maximization problem. This interdisciplinary model relies on multiple data sources, including current wolf population and distribution information, opportunity cost to local landowners, and contingent valuation studies to determine willingness-to-pay for wolves. Economic models tend to externalize ecological concerns and ecological models often omit the complex human dimensions of conservation policy. Accordingly, this model can serve as a guide for integrating best practices from both fields. The model presented here is sufficiently general to apply to wolves in other ecosystems and to other highly interacting species such as beavers and bison. The Northern Rocky Mountain wolf was used as an example of how this economic model works, but this model can be applied far more broadly.
基金This was supported by 2020 Yeungnam University Research Grant.
文摘Background:Land use and development alter mudflat and wetland habitat availability,although mudflats and wetlands provide important stopover habitats for shorebirds during the spring and autumn migrations and support communities of ducks and geese during the winter months in the Republic of Korea.This study investigated land use changes around Sihwa Lake(Republic of Korea)and evaluated the effect of these changes on waterbird community characteristics.Methods:We conducted a land-use-change analysis at the medium-resolution level using land cover maps for 2001,2007,2009,and 2014.Also,a tidal stream survey was conducted in Sihwa Lake and the surrounding reclaimed mudflats every season for 10 years(2003-2012)to identify the seasonal and interannual variations in waterbird species composition.To determine the total annual waterbird species and population counts,species diversity index,and interspecies variations,a TRIM(trends and indices for monitoring data)analysis was used.Results:Wetland area decreased more than 10%while agricultural land,barren land,and grassland area increased more than 10%due to continuous reclamation activities around Sihwa Lake.Barren land later turned into agricultural land or other land use.Sixty-three species and 566,623 individuals were recorded.The number of species,population size,and species diversity index by year and by species showed decreasing trends that were more marked in spring and summer.Furthermore,seasonal and annual variations in waterbird species composition showed decreasing trends in dabbling ducks,herons,grebes,and shorebirds but diving ducks displayed increasing trends.In particular,shorebirds were reduced to a greater extent than other waterbird species because of the reduction and simplification of the intertidal zone,and shallow waters caused by reclamation and road construction.Conclusions:Increased development and construction around Sihwa Lake has altered migratory shorebird populations with a general decline in species diversity and population size.The greatest decline was observed in wading birds,while diving duck populations showed increasing trends.
基金supported by 2014 Yeungnam University Research Grant
文摘This study explores the tradeoff relationship between the number of initial attack firefighting resources and the level of fire ignition prevention efforts mitigating the probability of human-made fires in the Republic of Korea,where most fires are caused by human activities.To examine this tradeoff relationship,we develop a hybrid model that combines a robust optimization model with a stochastic simulation model.The robust optimization minimizes the expected number of fires not receiving a pre-defined response,such as the number of firefighting resources that must arrive at the fire within half an hour,subject to budget constraints and uncertainty about the daily number and location of fires.The simulation model produces a set of fire scenarios in which a combination of number,location,ignition time,and intensity of fires occur.Results show that fire ignition prevention is as cost-effective as initial attack firefighting resources given the current budget in the Republic of Korea for reducing the expected number of fires not covered by the predefined response.The mixed policy of fire suppression and fire prevention may produce some gains in efficiency relative to the dominant policy of strong fire suppression strategies.
