Percutaneous balloon dilation with or without placement of an external biliary drain is a nonoperative alternative method for treating benign bilioenteric anastomotic strictures. Although this procedure has a high technical success rate, outcomes are less optimal when attempting to dilate refractory tight strictures. For the stricture, cutting balloon can be an option. We present four patients with benign bilioenteric anastomotic strictures refractory to conventional balloon dilation. To the patients, a peripheral cutting balloon over-the-wire system was inflated, following subsequent conventional non-compliant balloon dilation. After the balloon dilation treatment, an external drainage catheter was placed through the stricture site and maintained for up to 30 days. Technical and end-treatment success was achieved in all four patients. In conclusion, the use of cutting balloon dilation may appear to be a safe and effective alternative method of treatment in patients with benign bilioenteric anastomotic strictures refractory to conventional balloon dilation.

Purpose: This study aimed to construct and test a hypothetical model to explain predictive factors affecting nursing students' satisfaction and self-confidence in simulation-based education based on the National League for Nursing Jeffries Simulation Theory. Methods: A cross-sectional study was conducted on 305 fourth-year nursing students with experience in simulation-based education enrolled at universities in Gangwon-do, Gyeongsangbuk-do, and Gyeonggi-do. Data were analyzed using SPSS 25.0 and AMOS 25.0. Results: The hypothetical model showed good fit with the empirical data: χ2/df 2.17, RMSEA=.01, RMR=.01, GFI=.95, AGFI=.91, NFI=.94, TLI=.95, CFI=.97, and PNFI=.68. Simulation design characteristics, teaching efficiency, and flow were found to affect satisfaction and self-confidence directly. A bootstrap test indicated that teaching efficiency and flow mediated the relationship between simulation design characteristics and satisfaction and self-confidence. Conclusion: Simulation educators should apply best practice that enhance teaching efficiency and flow through well-organized simulation designs, nursing students can attain satisfaction and self-confidence through simulation-based education.

목적: 상분리가 일어나지 않는 실리콘하이드로겔 콘택트렌즈(silicone hydrogel contact lens, SH-CL) 제조에 적합한 실리콘 모노머의 구조를 알아보고자 한다. 방법 : HEMA(2-hydroxyethyl methacrylate)와 세 종류의 실리콘 모노머, TRIM[3-(trimethoxysilyl)propyl methacrylate, Aldrich], TEMA[2-(trimethylsilyloxy)ethyl methacrylate, TCI], TMMA[(trimethylsilyl) methacrylate, Aldrich]를 활용하여 완전몰드로 SH-CL를 제조하였다. 함수율과 UV-VIS spectrophotomter 를 이용한 광투과율, TGA 분석을 통한 열적안정성 등의 물리적 특성과 FT-IR 분석을 통한 화학적 특성을 알아 보았다. 결과 : 동일한 양의 TRIM, TEMA, TMMA를 사용하여 제작한 SH-CL의 광투과율은 각각 92%, 86%, 80%로 측정되었으며, 함수율은 TRIM을 사용한 SH-CL에서 39.3%로 가장 높게 나타났다. FT-IR 분석 결과 세 종류의 SH-CL 모두 silicone monomer와 HEMA의 중합반응이 잘 이루어졌음을 확인할 수 있었고, TGA 분석을 통해 TRIM monomer의 sol-gel 반응 유무를 확인할 수 있었다. 결론 : Sol-gel 반응에 적합한 구조를 가지고 있어 상분리가 일어나지 않아 투명하고, Si에 극성 작용기인 methoxy기가 연결되어 있는 TRIM monomer가 SH-CL 제조에 적합한 구조임을 확인할 수 있었다.

In this study, we focus on the feasibility of structural topology optimization for a steel-timber composite beam design of optimally allocating glue-laminated timbers into a web with openings under the condition of given steel flanges. The motivation of this study is to topologically take maximal stiffness harmonizing both tension and compression performance of the steel-timber composite beam and become the eco-frandly timber design for buidling members. As a result of this study, the key web-openings allocation becomes triangle spaces, i.e., empty or no materials, of optimal topologies of both a pure timber plate and a steel flange-web timber plate without web-openings. Several applicable examples verify the effectiveness of topology optimization for steel-timber beams with web-openings.