Hollow carbon materials are considered promising sulfur reservoirs for lithium–sulfur batteries owing to their internal void space and porous conductive shell, providing high loading and utilization ...of sulfur. Since the pores in carbon materials play a critical role in the infusion of sulfur, access of the electrolyte, and the passage of lithium polysulfides (LPSs), the creation and tuning of hierarchical pore structures is strongly required to improve the electrochemical properties of sulfur/porous carbon composites, but remains a major challenge. Herein, a “brain‐coral‐like” mesoporous hollow carbon nanostructure consisting of an in situ‐grown N‐doped graphitic carbon nanoshell (NGCNs) matrix and embedded CoS2 nanoparticles as an efficient sulfur host is presented. The rational synthetic design based on metal–organic framework chemistry furnishes unusual multiple porosity in a carbon scaffold with a macrohollow in the core and microhollows and mesopores in the shell, without the use of any surfactant or template. The CoS2@NGCNs/S composite electrode facilitates high sulfur loading (75 wt%), strong adsorption of LPSs, efficient reaction kinetics, and stable cycle performance (903 mAh g−1 at 0.1 C after 100 cycles), derived from the synergetic effects of the dual hollow features, chemically active CoS2, and the conductive and mesoporous N‐doped carbon matrix.
A rationally designed dual hollow scaffold, where microhollows consisting of CoS2 nanoparticles wrapped in N‐doped graphitic carbon nanoshells creates a macrohollow, is developed as an efficient sulfur host via in situ and template‐free formation based on metal–organic framework chemistry. The unusual multiple porosity in a carbon scaffold with CoS2 allows high‐sulfur loading and superior lithium storage performances.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
Although lithium–sulfur batteries exhibit a fivefold higher energy density than commercial lithium‐ion batteries, their volume expansion and insulating nature, and intrinsic polysulfide shuttle have ...hindered their practical application. An alternative sulfur host is necessary to realize porous, conductive, and polar functions; however, there is a tradeoff among these three critical factors in material design. Here, the authors report a layered porous carbon (LPC) with VO2/V3S4 heterostructures using one‐step carbonization–sulfidation of metal–organic framework templates as a sulfur host that meets all the criteria. In situ conversion of V–O ions into V3S4 nuclei in the confined 2D space generated by dynamic formation of the LPC matrix creates {200}‐facet‐exposed V3S4 nanosheets decorated with tiny VO2 nanoparticles. The VO2/V3S4 @ LPC composite facilitates high sulfur loading (70 wt%), superior energy density (1022 mA h g−1 at 0.2 C, 100 cycles), and long‐term cyclability (665 mA h g−1 at 1 C, 1000 cycles). The enhanced Li–S chemistry is attributed to the synergistic heterocatalytic behavior of polar VO2 and conductive V3S4 in the soft porous LPC scaffold, which accelerates polysulfide adsorption, conversion, and charge‐transfer ability simultaneously.
A new “all‐in‐one” cathodic sulfur host, VO2–V3S4 heterocatalyst embedded layered porous carbon is developed for cathodic S host of Li–S batteries. The unusual heterocatalyst with carbon nanostructures offer highly efficient adsorption and conversion ability for lithium polysulfide, which originates from the in situ formation of metal–organic‐framework chemistry.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
The goal of the study was to determine whether endoscopic ultrasound (EUS)-guided biliary drainage (EUS-BD) is comparable to conventional transpapillary stenting with endoscopic retrograde ...cholangiopancreatography (ERCP) in palliation of malignant distal biliary obstruction. Although ERCP for the palliation of malignant biliary obstruction is the standard of care, post-procedure pancreatitis and stent dysfunctions are not uncommon. While EUS-BD has garnered interest as a viable alternative when ERCP is impossible, its role as a primary palliation of malignant distal biliary obstruction is yet to be proven.
We performed random allocation to EUS-BD or ERCP in 125 patients with unresectable malignant distal biliary obstruction at four tertiary academic referral centers in South Korea.
Technical success rates were 93.8% (60/64) for EUS-BD and 90.2% (55/61) for ERCP (difference 3.6%, 95% 1-sided confidence interval lower limit -4.4%, P = 0.003 for noninferiority margin of 10%). Clinical success rates were 90.0% (54/60) in EUS-BD and 94.5% (52/55) in ERCP (P = 0.49). Lower rates of overall adverse events (6.3% vs 19.7%, P = 0.03) including post-procedure pancreatitis (0 vs 14.8%), reintervention (15.6% vs 42.6%), and higher rate of stent patency (85.1% vs 48.9%) were observed with EUS-BD. EUS-BD was also associated with more preserved quality of life (QOL) than transpapillary stenting after 12 weeks of the procedure.
This study demonstrated comparable technical and clinical success rates between EUS-BD and ERCP in relief malignant distal biliary obstruction. Substantially longer duration of patency coupled with lower rates of adverse events and reintervention, and more preserved QOL were observed with EUS-BD (cris.nih.go.kr, Identifier: KCT0001396, https://cris.nih.go.kr/cris/search/search_result_st01_en.jsp?seq=9716<ype=&rtype= ).
Real‐time guidance of needle advancement has transformed endoscopic ultrasound (EUS) from a diagnostic to an interventional procedure. EUS‐guided fine‐needle puncture has application in various ...interventional procedures (drainage of pseudocyst, biliary intervention, and injection of drugs). Celiac plexus or ganglion neurolysis for pain control is the major current EUS‐guided fine‐needle injection procedure. Feasibility and safety to accurately position needle devices and/or inject under real‐time EUS imaging with precise delivery of interventional agent have expanded the use of EUS to ablate tumors. These include radiofrequency ablation, or delivery of fiducial markers, potential antitumor agents, or radioactive seeds, in the cancer mass. Minimally invasive EUS‐guided antitumor therapy is primarily used for pancreatic cancer because of better anatomic access (vs other imaging modality) and the dismal prognosis (despite improvements in surgery and chemoradiation). Also, the response to parenteral chemotherapy in pancreatic cancer is poor because of suboptimal drug delivery resulting from hypovascularity and abundant desmoplasia. Other targets for EUS‐guided tumor ablation are pancreatic neuroendocrine tumor and pancreatic cyst lesion, which are less aggressive and curable by resection. However, patients non‐eligible for surgery may benefit from local EUS‐guided ablation.
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DOBA, FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, UILJ, UKNU, UL, UM, UPUK
Abstract
The mobility of molecular shuttles inside a mechanically interlocked polymer (MIP) can improve the ionic conductivity and electron transport capacity of a solid polymer electrolyte (SPE) and ...maintain a mechanically tough structure. The polyrotaxane‐based MIP electrolyte with a necklace‐like molecular structure exhibits high ionic conductivity (σ = 5.93 × 10
−3
S cm
−1
at 25 °C and 1.44 × 10
−2
S cm
−1
at 60 °C), a high Li
+
ion transference number (
t
+
= 0.71), and high electrochemical oxidation stability (≈4.7 V vs Li
+
/Li). When SPEs are used in Li‐based batteries, a high Coulombic efficiency (≥98.5%), an excellent rate capability, and fast charging (≥2C) can be achieved using a “built‐in molecular shuttle” design.
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FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
Background & Aims Endoscopic ultrasound-guided transmural gallbladder drainage (EUS-GBD) is an alternative to percutaneous transhepatic gallbladder drainage (PTGBD) for patients with acute, ...high-risk, or advanced-stage cholecystitis who do not respond to initial medical treatment and cannot undergo emergency cholecystectomy. However, the technical feasibility, efficacy, and safety of EUS-GBD and PTGBD have not been compared. Methods Fifty-nine patients with acute cholecystitis, who did not respond to initial medical treatment and were unsuitable for an emergency cholecystectomy, were chosen randomly to undergo EUS-GBD (n = 30) or PTGBD (n = 29). The technical feasibility, efficacy, and safety of EUS-GBD and PTGBD were compared. Results EUS-GBD and PTGBD showed similar technical (97% 29 of 30 vs 97% 28 of 29; 95% 1-sided confidence interval lower limit, −7%; P = .001 for noninferiority margin of 15%) and clinical (100% 29 of 29 vs 96% 27 of 28; 95% 1-sided confidence interval lower limit, −2%; P = .0001 for noninferiority margin of 15%) success rates, and similar rates of complications (7% 2 of 30 vs 3% 1 of 29; P = .492 in the Fisher exact test) and conversions to open cholecystectomy (9% 2 of 23 vs 12% 3 of 26; P = .999 in the Fisher exact test). The median post-procedure pain score was significantly lower after EUS-GBD than after PTGBD (1 vs 5; P < .001 in the Mann–Whitney U test). Conclusions EUS-GBD is comparable with PTGBD in terms of the technical feasibility and efficacy; there were no statistical differences in the safety. EUS-GBD is a good alternative for high-risk patients with acute cholecystitis who cannot undergo an emergency cholecystectomy.
Background and Aim
Endoscopic ultrasound (EUS)‐guided biliary drainage is being increasingly performed as an alternative to percutaneous transhepatic biliary drainage (PTBD) to treat malignant hilar ...obstruction (MHO) after failed endoscopic retrograde cholangiopancreatography (ERCP). However, no study has compared EUS‐guided hepaticoduodenostomy (EUS‐HDS) with PTBD for right intrahepatic duct (IHD) obstruction after failed ERCP in patients with unresectable MHO.
Methods
We retrospectively reviewed the data of consecutive patients with right IHD obstruction developed by unresectable MHO who underwent EUS‐HDS or PTBD after a previous placement of a stent in the left and/or right IHD between March 2018 and October 2021. Technical success, clinical success, stent or tube‐related adverse events, frequency of reintervention, and stent patency were evaluated.
Results
A total of 42 patients (18 EUS‐HDS, 24 PTBD) were analyzed. Both groups did not show significant differences in technical success (EUS‐HDS, 94% vs PTBD, 100%; P = 0.429), clinical success (83% vs 83%; P = 0.999), early adverse events (24% vs 46%; P = 0.144), and stent or tube‐related late adverse events (29% vs 54%; P = 0.116). During follow‐up, the EUS‐HDS group had a longer median duration of patency (131 days vs 58.5 days; P = 0.041), and lower mean frequency of reinterventions per patient (0.35 vs 1.92; P = 0.030) than the PTBD group.
Conclusions
EUS‐HDS showed comparable efficacy and safety to PTBD for drainage of the right biliary system and produced longer duration of patency and lower frequency of reinterventions in patients with unresectable MHO.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
Background and Aims
A fully covered self‐expandable metal stent (FCSEMS) has recently been applied in the management of chronic pancreatitis patients with pancreatic strictures. However, related ...long‐term effects remain unclear. This study aimed to evaluate the long‐term outcomes of FCSEMS placement in chronic pancreatitis patients with refractory strictures.
Method
We retrospectively reviewed our database for patients undergoing FCSEMS placement for refractory pancreatic strictures between September 2008 and December 2010. The main outcomes were technical, radiological, and clinical success, as well as recurrence and adverse events.
Results
A total of 35 patients were included. Technical success was achieved in all patients. The median FCSEMS indwelling time was 3.2 months (interquartile range IQR, 3.0–4.9 months). Radiological success was achieved in all patients (complete, n = 2; partial, n = 33). Clinical success was achieved in 29 patients (82.9%; complete analgesic cessation, n = 19; analgesic reduction >50%, n = 11). During the median follow‐up of 136 months, (IQR, 85.8–145.5 months), eight patients (22.9%) experienced recurrence. The median interval from stent removal to recurrence was 24.9 months (IQR, 11.3–30.3 months). Biliary obstruction, an early adverse event, occurred in two patients (5.7%); the late adverse event stent‐induced de novo stricture was observed in 17 patients (48.6%).
Conclusions
Our findings suggest that an FCSEMS is effective for relieving refractory strictures in chronic pancreatitis. However, FCSEMSs were associated with stent‐induced de novo strictures in nearly half of the patients. Prospective studies are required to further evaluate the long‐term efficacy and safety of FCSEMSs in chronic pancreatitis.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
Background EUS-guided biliary drainage (EUS-BD) has been proposed as an effective alternative for percutaneous transhepatic biliary drainage (PTBD) after failed ERCP. To date, the risk factors for ...adverse events and long-term outcomes of EUS-BD with transluminal stenting (EUS-BDS) have not been fully explored. Objective To evaluate risk factors for adverse events and long-term outcomes of EUS-BDS. Design Prospective follow-up study. Setting Tertiary-care academic center. Patients This study involved 57 consecutive patients with malignant or benign biliary obstruction undergoing EUS-BDS after failed ERCP. Intervention EUS-guided hepaticogastrostomy (EUS-HGS) and EUS-guided choledochoduodenostomy with transluminal stenting (EUS-CDS). Main Outcome Measurements Risk factors for postprocedure and late adverse events and clinical outcomes of EUS-BDS. Results The overall technical and functional success rates, respectively, in the EUS-BDS group were 96.5% (intention-to-treat, n = 55/57) and 89% (per-protocol, n = 49/55). Postprocedure adverse events developed after EUS-BDS in 11 patients (20%, n = 11/55). This included bile peritonitis (n = 2), mild bleeding (n = 2), and self-limited pneumoperitoneum (n = 7). In multivariate analysis, needle-knife use was the single risk factor for postprocedure adverse events after EUS-BDS (odds ratio 12.4; P = .01). A late adverse event in EUS-BDS was distal stent migration (7%, n = 4/55). The mean stent patencies with EUS-HGS and EUS-CDS were 132 days and 152 days, respectively. Limitations Single-operator performed, nonrandomized study. Conclusion EUS-HGS and EUS-CDS may be relatively safe and can be used as an alternative to PTBD after failed ERCP. Both techniques offer durable and comparable stent patency. The use of a needle-knife for fistula dilation in EUS-BDS should be avoided if possible.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Background
Type 1 autoimmune pancreatitis (AIP), as a pancreatic manifestation of IgG4-related disease, shows a favorable prognosis in the short term. However, disease relapse is common in long-term ...follow-up, despite a successful initial treatment response. This study aimed to identify the predictors of relapse and long-term outcomes in patients with type 1 AIP.
Methods
Patients with more than 2 years of follow-up who met the International Consensus Diagnostic Criteria for type 1 AIP were included. Patients who had undergone pancreatic operations associated with AIP or who lacked sufficient clinical data were excluded.
Results
All 138 patients achieved clinical remission with initial steroid therapy, and 66 (47.8%) experienced relapse during a median 60 (range 24–197) months follow-up. Among the relapsed patients, about 74% (49/66) relapsed within 3 years. About 60% (82/138) had other organ involvement (OOI), most commonly in the proximal bile duct (26.8%). At first diagnosis, OOI, and especially OOI of the proximal bile duct, was a significant independent predictor of relapse (hazard ratio 2.65; 95% confidence interval 1.44–4.89;
p
= 0.002), according to multivariate analysis. During the follow-up period, 16 (11.6%) patients experienced endocrine/exocrine dysfunction and 32 (23.2%) patients developed de novo pancreatic calcifications/stones. No pancreatic cancer occurred in any patients.
Conclusions
Type 1 AIP has common relapses, and patients with OOI, especially OOI of the proximal bile duct, appear to be at increased risk for relapse. Long-term sequelae, including pancreatic insufficiency and pancreatic calcifications/stones, are common in patients with relapse. To reduce the relapse, longer maintenance treatment may be needed especially for patients at high risk for relapse.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OBVAL, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
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