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Jae-Hak Lee

Publications and source records attributed to Jae-Hak Lee.

5 recordsLinked to original sources
PubMed2006

A novel method for estimating the safe margin and the adequate direction of endoscopic biliary sphincterotomy in choledocholithiasis with complications (with videos).

BACKGROUND: It is difficult to estimate the safe upper margin and the proper direction of endoscopic biliary sphincterotomy (EBS) in cases of choledocholithiasis complicated by periampullary diverticulum (PAD) or previous EBS. OBJECTIVE: This study evaluated the clinical usefulness of an inflated-balloon-pulling (IBP) technique for assessing the safe margin and the proper direction of EBS in affected patients. DESIGN: Prospective feasibility study. SETTING: Academic tertiary center. PATIENTS: From March 2003 to November 2003, the IBP technique was applied to patients with choledocholithiasis in whom EBS was difficult because of concomitant PAD or previous EBS. INTERVENTIONS AND MAIN OUTCOME MEASUREMENTS: After the endoscopically visible papillary roof of the ampulla of Vater was fully dissected, an inflated 11.5- or 15-mm retrieval balloon was inserted in the bile duct and was pulled toward the duodenal lumen, creating an artificial bulge. This bulge was considered an endoscopic landmark to indicate the residual intramural portion and the direction of the bile duct. RESULTS: A total of 19 patients (12 men, 7 women), with a mean age of 61.5 years, were consecutively enrolled. Of these patients, 7 had PAD, 7 had recurrent choledocholithiasis, and 5 had both conditions. The mean length of the IBP-induced residual intramural bile duct was 6.6 mm (range, 3-15 mm). The previous EBS was not oriented toward the bile duct in 4 of 12 patients with recurrent choledocholithiasis (33.3%). After EBS extended completely, choledocholithiases were successfully removed in all patients (1 by mechanical lithotripsy). Of the 19 patients, 2 had complications (11%; 1 mild hemorrhage, 1 mild pancreatitis), which were managed medically. There was no case of perforation. CONCLUSIONS: The IBP technique is a feasible and a reliable method for safe and effective EBS in patients with choledocholithiasis in whom EBS is difficult because of PAD or/and previous EBS. The clinical significance of the direction of previous EBS needs to be defined.

Aged↗
PubMed2005

Application of satellite infrared data for mapping of thermal plume contamination in coastal ecosystem of Korea.

The 5900 MW Younggwang nuclear power station on the west coast of Korea discharges warm water affecting coastal ecology [KORDI report (2003). Wide area observation of the impact of the operation of Younggwang nuclear power plant 5 and 6, No. BSPI 319-00-1426-3, KORDI, Seoul, Korea]. Here the spatial and temporal characteristics of the thermal plume signature of warm water are reported from a time series (1985-2003) of space-borne, thermal infrared data from Landsat and National Oceanic and Atmospheric Administration (NOAA) satellites. Sea surface temperature (SST) were characterized using advanced very high resolution radiometer data from the NOAA satellites. These data demonstrated the general pattern and extension of the thermal plume signature in the Younggwang coastal areas. In contrast, the analysis of SST from thematic mapper data using the Landsat-5 and 7 satellites provided enhanced information about the plume shape, dimension and direction of dispersion in these waters. The thermal plume signature was detected from 70 to 100 km to the south of the discharge during the summer monsoon and 50 to 70 km to the northwest during the winter monsoon. The mean detected plume temperature was 28 degrees C in summer and 12 degrees C in winter. The DeltaT varied from 2 to 4 degrees C in winter and 2 degrees C in summer. These values are lower than the re-circulating water temperature (6-9 degrees C). In addition the temperature difference between tidal flats and offshore (SSTtidal flats - SSToffsore) was found to vary from 5.4 to 8.5 degrees C during the flood tides and 3.5 degrees C during the ebb tide. The data also suggest that water heated by direct solar radiation on the tidal flats during the flood tides might have been transported offshore during the ebb tide. Based on these results we suggest that there is an urgent need to protect the health of Younggwang coastal marine ecosystem from the severe thermal impact by the large quantity of warm water discharged from the Younggwang nuclear power plant.

Ecosystem↗
PubMed2005

jPHYDIT: a JAVA-based integrated environment for molecular phylogeny of ribosomal RNA sequences.

jPHYDIT is a Java application designed to furnish a visual and integrated environment for molecular phylogeny. The program can be used to visualize intra-strand base-pairing information in secondary and tertiary structures of ribosomal RNA (rRNA) sequences. A function for the semi-automated alignment was included to facilitate handling of the database containing a large number of multiple-aligned rRNA sequences. Integration of nucleotide sequence editing, pairwise alignment, multiple alignment and phylogenetic treeing functions provide an easy and efficient way of analyzing rRNA sequences for molecular evolution, systematics, epidemiology and ecology.

Algorithms↗
PubMed2005

Pre-cut papillotomy with a new papillotome.

BACKGROUND: A new papillotome has been developed, an isolated-tip needle-knife papillotome (Iso-Tome) that has a semi-oval-shaped tip of epoxide adhesive to prevent electric leakage from the tip of the incising needle. The coated tip aids in keeping the papillotome tightly in the orifice of the ampulla of Vater and is believed to prevent unintentional deep cuts or perforations. This study was done to evaluate the clinical usefulness of the new papillotome for pre-cut papillotomy. METHODS: From June 2003 to November 2003, 115 patients underwent attempted ERCP. If biliary cannulation failed by the conventional method, pre-cut papillotomy was performed by using the Iso-Tome in the direction of the bile duct. After successful bile-duct cannulation, papillotomy was extended for therapeutic procedures, such as stone removal or stent insertion, in the majority of the cases. Post-ERCP complications were classified according to consensus guidelines. OBSERVATIONS: Pre-cut papillotomy with the Iso-Tome was done in 25 patients (21.7% of cases). Protective pancreatic stents were not used. Of these patients, 11 had common bile duct stones, 7 had pancreatitis, 5 had malignancies, one had sphincter of Oddi dysfunction, and one had bile-duct leak. After pre-cut papillotomy with the Iso-Tome, bile-duct cannulation was successfully achieved in 23 of 25 (92%) patients. Complications occurred in 7 of 25 patients (28%) and consisted of mild pancreatitis in 5 (20%), moderate bleeding in one (4%), and biliary pain in one (4%). All 7 patients with complications were managed medically, and there was no death. CONCLUSIONS: In this pilot study, the isolated-tip needle knife was found to be a clinically useful papillotome for pre-cut papillotomy. Further large comparative studies (with and without pancreatic protective stents) are needed to determine improved efficacy and safety compared with standard techniques.

Ampulla of Vater↗