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Yeo MK, Kang SH, Lee HS, Eun HS, Moon HS, Lee ES, Kim SH, Sung JK, Lee BS, Jeong HY. Risk Factors for a Narrow Safety Margin after Endoscopic Submucosal Dissection for Early Gastric Cancer. Dig Dis 2024; 42:137-144. [PMID: 38171344 DOI: 10.1159/000536053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 12/19/2023] [Indexed: 01/05/2024]
Abstract
INTRODUCTION A narrow safety margin (NSM) after endoscopic submucosal dissection (ESD) is a well-recognized risk factor for local recurrence in early gastric cancer (EGC). However, only a few studies have investigated the risk factors for the development of NSM. METHODS The medical records and pathologic specimens of patients with EGC who underwent ESD from January 2020 to December 2020 at a single tertiary hospital (Daejeon, South Korea) were reviewed. RESULTS A total of 218 patients were enrolled and 29 had NSM (<3 mm). When comparing the NSM and the control groups, the size of the lesion, the depth of invasion, and the operating endoscopist were found to be risk factors for the development of NSM. The increased length of the subepithelial spread of the lesion was associated with a narrower safety margin. Logistic regression analysis revealed that lesion size was a risk factor for NSM, and a marginally significant difference between endoscopists was found. CONCLUSIONS Multiple factors may need to be considered during ESD, including lesion size, invasion depth, operating endoscopist, and subepithelial spread.
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Affiliation(s)
- Min Kyung Yeo
- Department of Pathology, Chungnam National University College of Medicine, Deajeon, Republic of Korea
| | - Sun Hyung Kang
- Department of Internal Medicine, Chungnam National University College of Medicine, Deajeon, Republic of Korea
| | - Hyun Seok Lee
- Department of Internal Medicine, Chungnam National University College of Medicine, Deajeon, Republic of Korea
| | - Hyuk Soo Eun
- Department of Internal Medicine, Chungnam National University College of Medicine, Deajeon, Republic of Korea
| | - Hee Seok Moon
- Department of Internal Medicine, Chungnam National University College of Medicine, Deajeon, Republic of Korea
| | - Eaum Seok Lee
- Department of Internal Medicine, Chungnam National University College of Medicine, Deajeon, Republic of Korea
| | - Seok Hyun Kim
- Department of Internal Medicine, Chungnam National University College of Medicine, Deajeon, Republic of Korea
| | - Jae Kyu Sung
- Department of Internal Medicine, Chungnam National University College of Medicine, Deajeon, Republic of Korea
| | - Byung Seok Lee
- Department of Internal Medicine, Chungnam National University College of Medicine, Deajeon, Republic of Korea
| | - Hyun Yong Jeong
- Department of Internal Medicine, Chungnam National University College of Medicine, Deajeon, Republic of Korea
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Park JH, Kang SH, Kim JS, Moon HS, Sung JK, Jeong HY. Contribution of sex and gender roles to the incidence of post-infectious irritable bowel syndrome in a prospective study. Sci Rep 2023; 13:19467. [PMID: 37945663 PMCID: PMC10636197 DOI: 10.1038/s41598-023-45300-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 10/18/2023] [Indexed: 11/12/2023] Open
Abstract
Post-infectious irritable bowel syndrome (PI-IBS) occurs in about 10% of cases following gastroenteritis. The incidence of IBS is higher in females. However, it is not clear whether this is due to biological or psychosocial factors. We aimed to investigate the influence of gender roles on the incidence of PI-IBS, alongside traditional risk factors. Our study included 231 patients diagnosed with gastroenteritis who were hospitalized and treated with antibiotics between 2018 and 2021. The Korean Sex Role Inventory-Short Form (KSRI-SF), based on the Bem Sex Role Inventory (BSRI) was used to categorize patients (androgynous, masculine, feminine, and undifferentiated types). Six months after treatment, we conducted a telephone survey to confirm the presence of PI-IBS using the ROME IV criteria. Among the patients, 43.3% were female, and the mean age was 43.67 ± 16.09 years. After 6 months, 34 patients developed PI-IBS. Univariate analysis revealed that younger age, female sex, KSRI-SF undifferentiated type, and longer duration of antibiotic use independently influenced the occurrence of PI-IBS. Multivariate analysis showed that PI-IBS was associated with the KSRI-SF undifferentiated type and higher C-reactive protein (CRP) levels. Our study showed that the KSRI-SF undifferentiated type and high CRP levels at initial infection were associated with PI-IBS.
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Affiliation(s)
- Jae Ho Park
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Sejong Hospital, Sejong, South Korea
- Chungnam National University School of Medicine, Daejeon, South Korea
| | - Sun Hyung Kang
- Chungnam National University School of Medicine, Daejeon, South Korea.
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, South Korea.
| | - Ju Seok Kim
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Sejong Hospital, Sejong, South Korea
- Chungnam National University School of Medicine, Daejeon, South Korea
| | - Hee Seok Moon
- Chungnam National University School of Medicine, Daejeon, South Korea
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, South Korea
| | - Jae Kyu Sung
- Chungnam National University School of Medicine, Daejeon, South Korea
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, South Korea
| | - Hyun Yong Jeong
- Chungnam National University School of Medicine, Daejeon, South Korea
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, South Korea
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Yuan XT, Kang SH, Wang Q, Bai YS, Che HL. [The implementation and management of disease risk reduction claims in the European Union and the United States]. Zhonghua Yu Fang Yi Xue Za Zhi 2023; 57:1674-1681. [PMID: 37859388 DOI: 10.3760/cma.j.cn112150-20230616-00476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 10/21/2023]
Abstract
The improvement of food labeling can improve consumers' health awareness, reduce the burden of chronic diseases on the health and economy, and promote the development of the healthy food industry. Disease Risk Reduction Claim has been developed in European Union and the U.S. for over 20 years, with mature management methods and experience, but it is still lacking in China. Learning and drawing on the international management experience of food disease risk reduction claims can assist China to establish food disease risk reduction claims and improve the food health claims and labeling system.
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Affiliation(s)
- X T Yuan
- College of Food Science and Nutritional Engineering, China Agricultural University, Beijing 100083, China
| | - S H Kang
- College of Engineering, China Agricultural University, Beijing 100083, China
| | - Q Wang
- College of Food Science and Nutritional Engineering, China Agricultural University, Beijing 100083, China
| | - Y S Bai
- Beijing Huairou Space Biology Active Health Research Institute, Beijing 101499, China
| | - H L Che
- College of Food Science and Nutritional Engineering, China Agricultural University, Beijing 100083, China
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Kim SH, Moon HS, Choi SW, Kang SH, Sung JK, Jeong HY. Comparison and validation of the Japanese score and other scoring systems in patients with peptic ulcer bleeding: A retrospective study. Medicine (Baltimore) 2023; 102:e34986. [PMID: 37653832 PMCID: PMC10470669 DOI: 10.1097/md.0000000000034986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 08/05/2023] [Accepted: 08/07/2023] [Indexed: 09/02/2023] Open
Abstract
Acute upper gastrointestinal bleeding (UGIB) is one of the most urgent medical conditions, with peptic ulcer bleeding (PUB) accounting for most gastrointestinal bleeding cases. The Japanese scoring system was developed to predict the probability of intervention in patients with UGIB, and it is more effective than other scoring systems, according to several studies. This study aimed to verify whether the Japanese scoring system is better than other scoring systems in predicting the probability of intervention when limited to PUB in patients with UGIB. We enrolled patients who presented with symptoms of UGIB and were diagnosed with peptic ulcers using endoscopy. The performances of the scoring systems in predicting patient outcomes were validated and compared using the receiver-operating characteristic curve analysis. Additionally, we used the chi-square test, Fisher exact test, and the t test to analyze the association between the patients characteristics and clinical outcomes. Of the 1228 patients diagnosed with peptic ulcers, 90.6% underwent endoscopy. rebleeding occurred in 12.5% of the patients, and 2.5% of the patients died within 30 days. The Japanese score was the most effective in predicting the need for endoscopic intervention for PUB. Sex, systolic blood pressure, hematemesis, syncope, blood urea nitrogen level, and the American Society of Anesthesiologists score were predictive factors for the probability of endoscopic intervention in patients with PUB. The Japanese score is an effective predictor of the probability of endoscopic intervention in patients with PUB.
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Affiliation(s)
- Seong Hoon Kim
- Division of Gastroenterology, Department of Internal Medicine, Daejeon Veteran Hospital, Daejeon, South Korea
| | - Hee Seok Moon
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, South Korea
| | - Seong Woo Choi
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, South Korea
| | - Sun Hyung Kang
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, South Korea
| | - Jae Kyu Sung
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, South Korea
| | - Hyun Yong Jeong
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, South Korea
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Shin HD, Bang KB, Kang SH, Moon HS, Sung JK, Jeong HY, Lee DK, Kim KB, Kim SM, Lee SW, Lee DS, Cho YS, Chung IK, Kim JS. Clinical Outcome of Endoscopic Submucosal Dissection for Papillary Type Early Gastric Cancer: A Multicenter Study. Gut Liver 2023:gnl230132. [PMID: 37574957 DOI: 10.5009/gnl230132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 06/01/2023] [Accepted: 06/05/2023] [Indexed: 08/15/2023] Open
Abstract
Background/Aims Papillary adenocarcinoma is classified to differentiated-type gastric cancer and is indicated for endoscopic submucosal dissection. However, due to its rare nature, there are limited studies on it. The purpose of this study was to determine the outcome of endoscopic submucosal dissection in patients with papillary-type early gastric cancer and to find the risk factors of lymph node metastasis. Methods Patients diagnosed with papillary-type early gastric cancer at eight medical centers, who underwent endoscopic submucosal dissection or surgical treatment, were retrospectively reviewed. The clinical results and long-term outcomes of post-endoscopic submucosal dissection were evaluated, and the risk factors of lymph node metastasis in the surgery group were analyzed. Results One-hundred and seventy-six patients with papillary-type early gastric cancer were enrolled: 44.9% (n=79) in the surgery group and 55.1% (n=97) in the endoscopic submucosal dissection group. As a result of endoscopic submucosal dissection, the en bloc resection and curative resection rates were 91.8% and 86.6%, respectively. The procedure-related complication rate was 4.1%, and local recurrence occurred in 3.1% of patients. Submucosal invasion (odds ratio, 3.735; 95% confidence interval, 1.026 to 12.177; p=0.047) and lymphovascular invasion (odds ratio, 7.636; 95% confidence interval, 1.730 to 22.857; p=0.004) were the risk factors of lymph node metastasis in papillary-type early gastric cancer patients. Conclusions The clinical results of endoscopic submucosal dissection in papillary-type early gastric cancer were relatively favorable, and endoscopic submucosal dissection is considered safe if appropriate indications are confirmed by considering the risk of lymph node metastasis.
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Affiliation(s)
- Hyun-Deok Shin
- Department of Internal Medicine, Dankook University Hospital, Dankook University College of Medicine, Cheonan, Korea
| | - Ki Bae Bang
- Department of Internal Medicine, Dankook University Hospital, Dankook University College of Medicine, Cheonan, Korea
| | - Sun Hyung Kang
- Department of Internal Medicine, Chungnam National University College of Medicine, Cheongju, Korea
| | - Hee Seok Moon
- Department of Internal Medicine, Chungnam National University College of Medicine, Cheongju, Korea
| | - Jae Kyu Sung
- Department of Internal Medicine, Chungnam National University College of Medicine, Cheongju, Korea
| | - Hyun Yong Jeong
- Department of Internal Medicine, Chungnam National University College of Medicine, Cheongju, Korea
| | - Dong Kyu Lee
- Department of Internal Medicine, Daejeon Eulji Medical Center, Eulji University School of Medicine, Cheongju, Korea
| | - Ki Bae Kim
- Department of Internal Medicine, Chungbuk National University School of Medicine, Cheongju, Korea
| | - Sun Moon Kim
- Department of Internal Medicine, Konyang University College of Medicine, Daejeon, Korea
| | - Seung Woo Lee
- Division of Gastroenterology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Dong Soo Lee
- Division of Gastroenterology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Young Sin Cho
- Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
| | - Il-Kwun Chung
- Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
| | - Ju Seok Kim
- Department of Internal Medicine, Chungnam National University College of Medicine, Cheongju, Korea
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Rou WS, Eun HS, Choung S, Jeon HJ, Joo JS, Kang SH, Lee ES, Kim SH, Kwon IS, Ku BJ, Lee BS. Prognostic Value of Erythroblastic Leukemia Viral Oncogene Homolog 2 and Neuregulin 4 in Hepatocellular Carcinoma. Cancers (Basel) 2023; 15:cancers15092634. [PMID: 37174100 PMCID: PMC10177431 DOI: 10.3390/cancers15092634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 05/03/2023] [Accepted: 05/05/2023] [Indexed: 05/15/2023] Open
Abstract
Although the roles of erythroblastic leukemia viral oncogene homolog 2 (ERBB2), neuregulin 4 (NRG4), and mitogen-inducible gene 6 (MIG6) in epidermal growth factor receptor signaling in hepatocellular carcinoma (HCC) and other malignancies have been previously investigated, the prognostic value of their serum levels in HCC remains undetermined. In the present study, correlations between serum levels and tumor characteristics, overall survival, and tumor recurrence were analyzed. Furthermore, the prognostic potential of the serum levels of these biomarkers was evaluated relative to that of alpha-fetoprotein. Both ERBB2 and NRG4 correlated with the Barcelona Clinic Liver Cancer stage, ERBB2 correlated with the tumor-maximal diameter, and NRG4 correlated with a tumor number. Cox proportional hazards regression analysis revealed that ERBB2 (hazard ratio [HR], 2.719; p = 0.007) was an independent prognostic factor for overall survival. Furthermore, ERBB2 (HR, 2.338; p = 0.002) and NRG4 (HR, 431.763; p = 0.001) were independent prognostic factors for tumor recurrence. The products of ERBB2 and NRG4 had a better area under the curve than alpha-fetoprotein for predicting 6-month, 1-year, 3-year, and 5-year mortality. Therefore, these factors could be used to evaluate prognosis and monitor treatment response in patients with HCC.
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Affiliation(s)
- Woo Sun Rou
- Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon 35015, Republic of Korea
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chungnam National University Sejong Hospital, Sejong 30099, Republic of Korea
| | - Hyuk Soo Eun
- Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon 35015, Republic of Korea
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chungnam National University Hospital, Daejeon 35015, Republic of Korea
| | - Sorim Choung
- Department of Medical Science, Chungnam National University College of Medicine, Daejeon 35015, Republic of Korea
| | - Hong Jae Jeon
- Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon 35015, Republic of Korea
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chungnam National University Sejong Hospital, Sejong 30099, Republic of Korea
| | - Jong Seok Joo
- Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon 35015, Republic of Korea
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chungnam National University Sejong Hospital, Sejong 30099, Republic of Korea
| | - Sun Hyung Kang
- Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon 35015, Republic of Korea
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chungnam National University Hospital, Daejeon 35015, Republic of Korea
| | - Eaum Seok Lee
- Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon 35015, Republic of Korea
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chungnam National University Hospital, Daejeon 35015, Republic of Korea
| | - Seok Hyun Kim
- Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon 35015, Republic of Korea
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chungnam National University Hospital, Daejeon 35015, Republic of Korea
| | - In Sun Kwon
- Clinical Trial Center, Statistics Office, Biomedical Research Institute, Chungnam National University Hospital, Daejeon 35015, Republic of Korea
| | - Bon Jeong Ku
- Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon 35015, Republic of Korea
- Division of Endocrinology, Department of Internal Medicine, Chungnam National University Hospital, Daejeon 35015, Republic of Korea
| | - Byung Seok Lee
- Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon 35015, Republic of Korea
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chungnam National University Hospital, Daejeon 35015, Republic of Korea
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Jeon HJ, Eun HS, Kwon IS, Lee BS, Lee ES, Rou WS, Sung JK, Moon HS, Kang SH, Lee HS, Kim SH, Chun K, Kim SH. Outcomes of laparoscopic radiofrequency ablation versus percutaneous radiofrequency ablation for hepatocellular carcinoma. Surg Endosc 2023:10.1007/s00464-023-09956-1. [PMID: 36947227 DOI: 10.1007/s00464-023-09956-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 02/12/2023] [Indexed: 03/23/2023]
Abstract
BACKGROUND Few studies have compared the therapeutic outcomes in patients with HCC who underwent laparoscopic radiofrequency ablation (LRFA) versus percutaneous radiofrequency ablation (PRFA) for hepatocellular carcinoma (HCC). Therefore, this study compared the recurrence and survival outcomes of the two RFA methods in patients with HCC. METHODS Recurrence and overall survival outcomes were evaluated in 307 patients who underwent LRFA (n = 151) or PRFA (n = 156) as a treatment method for de novo HCC. Inverse probability of treatment weighting (IPTW) analysis was performed to reduce the impact of treatment selection bias. RESULTS There were no significant differences in major baseline characteristics between the LRFA and PRFA groups. However, the proportion of cirrhotic patients was higher in the LRFA group, whereas the LRFA group had more tumors and a more advanced tumor-node-metastasis stage. Moreover, the mean tumor size was significantly larger in the LRFA group than in the PRFA group. In a multivariate analysis, serum albumin level, more than three tumors, and the RFA method were identified as significant predictors of recurrence-free survival. Moreover, for the overall survival of HCC patients, serum albumin levels, days of hospital stay during RFA, and the RFA method were independent predictors. In the IPTW-adjusted analysis, the LRFA group showed significantly higher recurrence-free survival and overall survival. CONCLUSIONS Our study revealed that compared with PRFA, LRFA was associated with longer recurrence-free survival and favorable overall survival in patients with HCC. Therefore, LRFA should be considered the primary therapy in patients with HCC eligible for RFA.
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Affiliation(s)
- Hong Jae Jeon
- Department of Gastroenterology, Chungnam National University Sejong Hospital, 20, Bodeum 7-ro, Sejong-si, 30099, Republic of Korea
- Department of Internal Medicine, School of Medicine, Chungnam National University, 266, Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea
| | - Hyuk Soo Eun
- Department of Internal Medicine, School of Medicine, Chungnam National University, 266, Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea
- Department of Gastroenterology, Chungnam National University Hospital, 282, Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea
| | - In Sun Kwon
- Clinical Trials Center, Chungnam National University Hospital, 282, Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea
| | - Byung Seok Lee
- Department of Internal Medicine, School of Medicine, Chungnam National University, 266, Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea
- Department of Gastroenterology, Chungnam National University Hospital, 282, Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea
| | - Eaum Seok Lee
- Department of Internal Medicine, School of Medicine, Chungnam National University, 266, Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea
- Department of Gastroenterology, Chungnam National University Hospital, 282, Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea
| | - Woo Sun Rou
- Department of Gastroenterology, Chungnam National University Sejong Hospital, 20, Bodeum 7-ro, Sejong-si, 30099, Republic of Korea
- Department of Internal Medicine, School of Medicine, Chungnam National University, 266, Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea
| | - Jae Kyu Sung
- Department of Internal Medicine, School of Medicine, Chungnam National University, 266, Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea
- Department of Gastroenterology, Chungnam National University Hospital, 282, Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea
| | - Hee Seok Moon
- Department of Internal Medicine, School of Medicine, Chungnam National University, 266, Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea
- Department of Gastroenterology, Chungnam National University Hospital, 282, Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea
| | - Sun Hyung Kang
- Department of Internal Medicine, School of Medicine, Chungnam National University, 266, Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea
- Department of Gastroenterology, Chungnam National University Hospital, 282, Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea
| | - Hyun Seok Lee
- Department of Internal Medicine, School of Medicine, Chungnam National University, 266, Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea
- Department of Gastroenterology, Chungnam National University Hospital, 282, Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea
| | - Seok-Hwan Kim
- Department of Surgery, Chungnam National University Hospital, 282, Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea
- Department of Surgery, School of Medicine, Chungnam National University, 266, Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea
| | - Kwangsik Chun
- Department of Surgery, Chungnam National University Hospital, 282, Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea.
- Department of Surgery, School of Medicine, Chungnam National University, 266, Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea.
| | - Seok Hyun Kim
- Department of Internal Medicine, School of Medicine, Chungnam National University, 266, Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea.
- Department of Gastroenterology, Chungnam National University Hospital, 282, Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea.
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Yeo MK, Park JH, Kang SH, Moon HS, Sung JK, Jeong HY, Kim JS. What are the risk factors for extraintestinal manifestations in inflammatory bowel diseases? Medicine (Baltimore) 2023; 102:e33031. [PMID: 36862909 PMCID: PMC9981435 DOI: 10.1097/md.0000000000033031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/04/2023] Open
Abstract
Extraintestinal manifestations (EIMs) are common in patients with inflammatory bowel disease (IBD); however, studies surrounding EIMs are lacking, particularly in Asia. This study aimed to identify risk factors by analyzing the characteristics of patients with EIMs. From January 2010 to December 2020, the medical records of 531 patients diagnosed with IBD (133 with Crohn disease [CD] and 398 with ulcerative colitis [UC]) were reviewed. The patients' baseline characteristics and risk factors were analyzed by dividing them into 2 groups according to EIMs presence. The prevalence of EIMs in all patients with IBD was 12.4% (n = 66), of which CD and UC prevalences were 19.5% (n = 26) and 10.1% (n = 40), respectively. The articular (7.9%, n = 42), cutaneous (3.6%, n = 19), ocular (1.5%, n = 8), and hepatobiliary types (0.8%, n = 4) of EIMs were observed. Two or more EIMs occurred in only 1.2% of all IBD patients (n = 6). Multivariate analysis revealed that the risk factors for the occurrence of EIMs were a follow-up period ≥ 10 years (odds ratio, 2.106; 95% confidence interval, 1.187-3.973; P = .021) and treatment with biologics (odds ratio, 1.963; 95% confidence interval, 1.070-3.272; P = .037). The EIMs prevalence in patients with IBD was 12.4%, and the particular type was the most common, with EIMs occurring more frequently in patients with CD than in those with UC. Patients who have been treated for IBD for more than 10 years or who are using biologics should be carefully monitored as they are at high risk for EIMs.
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Affiliation(s)
- Min-Kyung Yeo
- Department of Pathology, Chungnam National University School of Medicine, Daejeon, Korea
| | - Jae Ho Park
- Departments of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea
| | - Sun Hyung Kang
- Departments of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea
| | - Hee Seok Moon
- Departments of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea
| | - Jae Kyu Sung
- Departments of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea
| | - Hyun Yong Jeong
- Departments of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea
| | - Ju Seok Kim
- Departments of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea
- * Correspondence: Ju Seok Kim, Department of Internal Medicine, Chungnam National University School of Medicine, 282 Munhwa-ro, Jung-gu, Daejeon 35015, Korea (e-mail: )
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Yeon SH, Moon HS, Choi SW, Kang SH, Sung JK, Jeong HY. A comparative study of scoring systems that accurately predict the prognosis of lower gastrointestinal bleeding. Int J Colorectal Dis 2023; 38:51. [PMID: 36806639 DOI: 10.1007/s00384-023-04348-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/13/2023] [Indexed: 02/23/2023]
Abstract
PURPOSE Lower gastrointestinal (GI) bleeding can be fatal; therefore, several scoring systems have been developed to predict its prognosis. We compared the mortality predictions and evaluated the usefulness of various scoring systems. METHODS The medical records of 3794 patients who visited the emergency department with hematochezia between January 2016 and December 2021 were retrospectively reviewed. We calculated the areas under the receiver operating characteristic curves for 30-day mortality and prolonged hospital stay (≥ 10 days) based on the age, blood tests, and comorbidities (ABC); AIMS65; Glasgow-Blatchford; Oakland; Rockall (pre-endoscopy); and SHA2PE scores and compared the predictive accuracy of each score. RESULTS Data for 963 patients (median age, 69 years; males, 54.5%; median hospital stay, 6 days) with colonoscopy-confirmed lower GI bleeding were analyzed. The 30-day mortality rate was 3.5%; the most common causes of lower GI bleeding were ischemic colitis and diverticulum bleeding in 19.3% and 19.2% of the cases, respectively. The AIMS65 and ABC scores were superior in predicting 30-day mortality (p < 0.001). The SHA2PE score was the most accurate predictor of prolonged hospital stay (p < 0.001). Through multivariate regression analysis, 30-day mortality was correlated with albumin level ≤ 3.0 g/dL, international normalized ratio > 1.5, blood urea nitrogen level ≥ 30 mg/dL, and systolic blood pressure (SBP) < 100 mmHg. A prolonged hospital stay was correlated with liver cirrhosis, hemoglobin ≤ 10 g/dL, albumin level ≤ 3.0 g/dL, and SBP < 100 mmHg. CONCLUSION The recently developed scoring systems accurately predict lower GI bleeding prognosis, and their usefulness in clinical decision-making was confirmed.
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Affiliation(s)
- Sang Hoon Yeon
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, South Korea
| | - Hee Seok Moon
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, South Korea.
| | - Seong Woo Choi
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, South Korea
| | - Sun Hyung Kang
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, South Korea
| | - Jae Kyu Sung
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, South Korea
| | - Hyun Yong Jeong
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, South Korea
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10
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Kim JS, Seo SI, Kang SH, Lee SK, Kim AR, Park HW, Kim BT, Song GS. Effects of Tegoprazan Versus Esomeprazole on Nighttime Heartburn and Sleep Quality in Gastroesophageal Reflux Disease: A Multicenter Double-blind Randomized Controlled Trial. J Neurogastroenterol Motil 2023; 29:58-64. [PMID: 36581325 PMCID: PMC9837551 DOI: 10.5056/jnm22104] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 07/27/2022] [Accepted: 08/31/2022] [Indexed: 12/31/2022] Open
Abstract
Background/Aims Patients with gastroesophageal reflux disease (GERD) frequently experience nighttime heartburn and sleep disturbance. Tegoprazan is a new potassium-competitive acid blocker that can rapidly block acid secretion. This study aims to evaluate the efficacy of tegoprazan compared with esomeprazole in relieving nighttime heartburn and sleep disturbances. Methods Patients with erosive esophagitis, nighttime heartburn, and sleep disturbances were randomized to receive tegoprazan 50 mg or esomeprazole 40 mg for 2 weeks. The primary endpoint was time to first nighttime heartburn-free interval. The percentage of nighttime heartburn-free days was also compared between the 2 groups. Results A total of 46 patients were enrolled in this study. Time to the first nighttime heartburn-free interval was shorter with tegoprazan than with esomeprazole but the difference was not statistically significant (1.5 days vs 3 days, P = 0.151). The percentage of nighttime heartburn-free days was higher in the tegoprazan group but the difference was insignificant (57.8% vs 43.1%, P = 0.107). Adverse events occurred in 2 patients. They were mild in severity. Conclusions Tegoprazan may induce faster relief of nighttime heartburn symptoms and may improve sleep disorders associated with nighttime heartburn. Further large-scale studies are required to validate our findings.
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Affiliation(s)
- Joon Sung Kim
- Division of Gastroenterology, Department of Internal Medicine, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Seung In Seo
- Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Sun Hyung Kang
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea
| | - Sang Kil Lee
- Department of Internal Medicine, Yonsei Institute of Gastroenterology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea,Correspondence: Sang Kil Lee, MD, PhD, Department of Internal Medicine, Yonsei Institute of Gastroenterology, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seoul 03722, Korea, Tel: +82-2-2228-1996, Fax: +82-2-393-6884, E-mail:
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11
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Choi SW, Moon HS, Kwon IS, Sakong H, Kang SH, Sung JK, Jeong HY. Validation and Comparison of the Japanese Score and Other Scores in Patients with Nonvariceal Upper Gastrointestinal Bleeding: A Retrospective Study. Dig Dis 2023; 41:66-73. [PMID: 35901784 DOI: 10.1159/000526136] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 07/15/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Various scoring systems have been developed to predict endoscopic intervention, mortality, and rebleeding in patients with nonvariceal upper gastrointestinal bleeding (NVUGIB); however, they have not been sufficiently validated in Korea. Therefore, this study aimed to evaluate the usefulness of several scoring systems in Korea by validating and comparing the Japanese score and other scores in Korean people with NVUGIB. METHODS The medical records of 1,368 patients with NVUGIB were reviewed to collect statistical, clinical, laboratory, and endoscopic data. The Japanese score, ABC score, Glasgow-Blatchford Bleeding Score (GBS), and MAP score were calculated retrospectively at a single research institution. These scores for predicting the need for endoscopic intervention, mortality, and rebleeding were calculated and evaluated using the area under the receiver operating characteristic curve. RESULTS Of 1,368 patients, 88.5% required endoscopic intervention, 4.1% died within 30 days, and 12.6% experienced rebleeding. The Japanese score was effective for predicting endoscopic intervention, and the ABC score was best for predicting 30-day mortality. Sex, age, hematemesis, blood urea nitrogen, and American Society of Anesthesiologists score were found to be predictors of the need for endoscopic intervention. CONCLUSION The Japanese score did not prove useful in Koreans with upper gastrointestinal bleeding. Additional research is needed due to the limitations of a retrospective study conducted in a single research institute.
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Affiliation(s)
- Seong Woo Choi
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Hee Seok Moon
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - In Sun Kwon
- Clinical Trials Center, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Heon Sakong
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Sun Hyung Kang
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Jae Kyu Sung
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Hyun Yong Jeong
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Republic of Korea
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12
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Sakong H, Moon HS, Choi SW, Kang SH, Sung JK, Jeong HY. ABC score is an effective predictor of outcomes in peptic ulcer bleeding. Medicine (Baltimore) 2022; 101:e31541. [PMID: 36626500 PMCID: PMC9750577 DOI: 10.1097/md.0000000000031541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Risk stratification is recommended for patients with gastrointestinal (GI) bleeding. The ABC score is a new scoring tool with high accuracy for upper and lower GI bleeding. We aimed to evaluate the effectiveness of the ABC score in predicting the outcomes of patients with peptic ulcer bleeding. METHODS This single-center retrospective study included 809 patients, each with symptoms of upper GI bleeding, and who were diagnosed with ulcerative lesions between October 2011 and March 2021. The association between the ABC score's variables and the patients' outcome was analyzed. The score's performance in predicting the patients' outcome was validated using receiver-operating characteristic curve analysis and compared with that of other scores. RESULTS The study analyzed 772 patients with peptic ulcer bleeding. The primary outcome measure was all-cause 30-day mortality. Secondary outcome measures included rebleeding within 30 days and the need for radiologic/surgical intervention. Age (P = .013), serum albumin levels (P < .001), serum creatinine levels (P = .004), mental status (P < .001), and American Society of Anesthesiologists score (P < .001) were associated with the primary outcome. The ABC score predicted the 30-day mortality (area under the receiver-operating characteristic curve [AUROC] 0.927; 95% confidence interval [CI] 0.899-0.956) better than other scores. However, it was less accurate in predicting rebleeding (AUROC 0.630; 95% CI 0.563-0.697) and need for radiologic/surgical intervention (AUROC 0.641; 95% CI 0.550-0.732). CONCLUSIONS The ABC score accurately predicts the 30-day mortality in patients with peptic ulcer bleeding. However, it may not be suitable for predicting rebleeding or the need for radiologic/surgical interventions.
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Affiliation(s)
- Heon Sakong
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, South Korea
| | - Hee Seok Moon
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, South Korea
- *Correspondence: Hee Seok Moon, MD, PhD, Division of Gastroenterology, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea (e-mail: )
| | - Seong Woo Choi
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, South Korea
| | - Sun Hyung Kang
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, South Korea
| | - Jae Kyu Sung
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, South Korea
| | - Hyun Yong Jeong
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, South Korea
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13
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Cho D, Ha MC, Jo HR, Kang SH. Regional inequality of socioeconomic status and the prevalence of hypertension between rural and urban areas. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Lower socioeconomic status (SES) is associated with greater burdens of cardiovascular disease in a community. The regional disparity of SES may result in an uneven distribution of hypertension (HTN) by a region. This study aims to analyze the regional disparity in the SES and HTN burden between rural and urban areas of the Korea.
Methods
We used data from the Korea National Health and Nutrition Examination Survey (KNHANES) V (2010–2012), VI (2013–2015), and VII (201–2018). We analyzed 11,206 and 1739 subjects from Seoul metropolitan and rural area (Gangwon province), respectively. We compared socioeconomic characteristics, the distribution of HTN between two regions. Finally, we performed a multivariate logistic regression adjusting for traditional CV risk factors and SES status to examine differences in the prevalence of HTN.
Results
Subjects in Gangwon province were older than Seoul (54.6±0.4 vs 49.4±0.2 years old, p<0.001). The proportions of subjects with low economic status and low education level were significantly higher in Gangwon province compared to Seoul (low economic status; 25.6 vs 14.4%, p<0.001, low education level; 35.3 vs 16.5%, p<0.001). Mean systolic blood pressure (SBP) was higher in Gangwon compared to Seoul (121.6±0.4 vs 118.1±0.2 mmHg, p<0.001). In the longitudinal trend from KNHANES V to VII, the difference of SBP between the two regions increased (Figure). The age-matched prevalence of HTN was significantly higher in Gangwon compared to Seoul (23.8 vs 21.6%, p<0.05), and the difference of prevalence of HTN by regions longitudinally increased (Figure). In the univariate analysis, the residency in Gangwon was associated with the presence of HTN (reference: Seoul, OR=1.63; 95% CI: 1.45–1.83). In the multivariate logistic regression model, the residency in Gangwon was not associated, however, low economic status and low education level were significantly associated with the presence of HTN (economic status, OR=1.39; 95% CI: 1.17–1.67, education level, OR=1.88; 95% CI: 1.57–2.24).
Conclusion
The SES status was lower and the prevalence of HTN was higher in Gangwon compared to Seoul. The burden of HTN longitudinally increased in Gangwon, but not in Seoul. The poor SES was significantly associated with HTN. It suggests that the inequalities of SES in Gangwon may contribute to the increasing prevalence of HTN. The regional and individual disparity of SES should be considered in the establishment of public health strategies for HTN.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- D Cho
- Wonju Severance Christian Hospital , Wonju , Korea (Republic of)
| | - M C Ha
- Wonju Severance Christian Hospital , Wonju , Korea (Republic of)
| | - H R Jo
- Wonju Severance Christian Hospital , Wonju , Korea (Republic of)
| | - S H Kang
- Inje University Sanggye Paik Hospital , Seoul , Korea (Republic of)
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14
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Lee W, Kang SH, Kim SH, Chae IH. Impact of dementia and drug compliance on patients with acute myocardial infarction. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
There has been a worrying rise in the number of people with dementia, especially with many of them also suffering from acute myocardial infarction (AMI), a disease with a high mortality rate.
Purpose
We evaluated the impact of dementia on the mortality of patients with AMI and how drug compliance affects this relationship.
Methods
The data were derived from National Health Insurance Service-Senior. The total number of patients diagnosed with AMI for the first time between 2007 and 2013 was 16,835, among whom 2,021 had dementia. Medication possession ratio (MPR) was used to assess medication adherence.
Results
AMI patients with dementia had unfavorable baseline characteristics; they had significantly higher risk of all-cause mortality (Hazard ratio [HR]: 2.49; 95% confidence interval (CI): 2.34–2.66; P<0.001) and lower MPR (aspirin: 21.9% vs. 42.8%; P<0.001). AMI patients were stratified by presence of dementia and medication adherence, and the survival rate was the highest among those with no dementia and good adherence. followed by those with no dementia and poor adherence, those with dementia and good adherence, and those with dementia and poor adherence. The multivariable analysis revealed that dementia (HR: 1.64; 95% CI: 1.53–1.75; P<0.001) and poor adherence to medication (HR: 1.60; 95% CI: 1.49–1.71; P<0.001) had a significant association with all-cause mortality in AMI patients.
Conclusions
AMI patients with dementia have a higher mortality rate. Patients with dementia have poorer medication adherence than those without, negatively affecting their prognosis.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- W Lee
- Seoul National University Bundang Hospital , Seongnam , Korea (Republic of)
| | - S H Kang
- Seoul National University Bundang Hospital , Seongnam , Korea (Republic of)
| | - S H Kim
- Seoul National University Bundang Hospital , Seongnam , Korea (Republic of)
| | - I H Chae
- Seoul National University Bundang Hospital , Seongnam , Korea (Republic of)
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15
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Jeon HJ, Lee JS, Lee BS, Kim SH, Lee ES, Sung JK, Moon HS, Kang SH, Lee HS, Choi S, Sa-Kong H, Cheon S, Eun HS. Correction to: Typhoid fever presenting with gastric ulcer bleeding. BMC Gastroenterol 2022; 22:230. [PMID: 35538404 PMCID: PMC9092868 DOI: 10.1186/s12876-022-02261-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- Hong Jae Jeon
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Sejong Hospital, 20, Bodeum 7-ro, Sejong, 30099, Republic of Korea.,Department of Internal Medicine, School of Medicine, Chungnam National University, 266, Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea
| | - Jong Seo Lee
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, 282, Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea.,Department of Internal Medicine, School of Medicine, Chungnam National University, 266, Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea
| | - Byung Seok Lee
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, 282, Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea.,Department of Internal Medicine, School of Medicine, Chungnam National University, 266, Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea
| | - Seok Hyun Kim
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, 282, Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea.,Department of Internal Medicine, School of Medicine, Chungnam National University, 266, Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea
| | - Eaum Seok Lee
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, 282, Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea.,Department of Internal Medicine, School of Medicine, Chungnam National University, 266, Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea
| | - Jae Kyu Sung
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, 282, Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea.,Department of Internal Medicine, School of Medicine, Chungnam National University, 266, Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea
| | - Hee Seok Moon
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, 282, Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea.,Department of Internal Medicine, School of Medicine, Chungnam National University, 266, Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea
| | - Sun Hyung Kang
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, 282, Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea.,Department of Internal Medicine, School of Medicine, Chungnam National University, 266, Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea
| | - Hyun Seok Lee
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, 282, Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea.,Department of Internal Medicine, School of Medicine, Chungnam National University, 266, Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea
| | - Seongwoo Choi
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, 282, Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea.,Department of Internal Medicine, School of Medicine, Chungnam National University, 266, Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea
| | - Heon Sa-Kong
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, 282, Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea.,Department of Internal Medicine, School of Medicine, Chungnam National University, 266, Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea
| | - Shinhye Cheon
- Division of Infectious Disease, Department of Internal Medicine, Chungnam National University Hospital, 282, Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea. .,Department of Internal Medicine, School of Medicine, Chungnam National University, 266, Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea.
| | - Hyuk Soo Eun
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, 282, Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea. .,Department of Internal Medicine, School of Medicine, Chungnam National University, 266, Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea.
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16
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Gong EJ, Park CH, Jung DH, Kang SH, Lee JY, Lim H, Kim DH. Efficacy of Endoscopic and Surgical Treatments for Gastroesophageal Reflux Disease: A Systematic Review and Network Meta-Analysis. J Pers Med 2022; 12:jpm12040621. [PMID: 35455737 PMCID: PMC9031147 DOI: 10.3390/jpm12040621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 04/06/2022] [Accepted: 04/08/2022] [Indexed: 02/04/2023] Open
Abstract
Although various endoscopic and surgical procedures are available for the treatment of gastroesophageal reflux disease (GERD), the comparative efficacy of these treatments has not been fully elucidated. This study aimed to comprehensively evaluate the efficacy of various endoscopic and surgical treatments for GERD. All relevant randomized controlled trials published through August 2021 that compared the efficacy of endoscopic and surgical GERD treatments, including radiofrequency energy delivery, endoscopic plication, reinforcement of the lower esophageal sphincter (LES), and surgical fundoplication, were searched. A network meta-analysis was performed to analyze treatment outcomes, including the requirement of proton pump inhibitor (PPI) continuation and GERD-health-related quality of life questionnaire score (GERD-HRQL). As such, 25 studies with 2854 patients were included in the analysis. Endoscopic plication, reinforcement of the LES, and surgical fundoplication were effective in reducing the requirement of PPI continuation compared to PPI therapy (pooled risk ratio (RR) (95% confidence interval [CI]): endoscopic plication, 0.34 (0.21–0.56); reinforcement of LES, 0.32 (0.16–0.63), and surgical fundoplication, 0.16 (0.06–0.42)). Radiofrequency energy delivery tended to reduce the requirement of PPI continuation compared to PPI therapy (RR (95% CI): 0.55 (0.25–1.18)). In terms of GERD-HRQL, all endoscopic and surgical treatments were superior to PPI therapy. In conclusion, all endoscopic or surgical treatments, except radiofrequency energy delivery, were effective for discontinuation of PPI medication, especially surgical fundoplication. Quality of life, measured by GERD-HRQL, also improved in patients who underwent endoscopic or surgical treatment compared to those who received PPI therapy.
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Affiliation(s)
- Eun Jeong Gong
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon 24253, Korea;
| | - Chan Hyuk Park
- Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri 11923, Korea;
| | - Da Hyun Jung
- Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea;
| | - Sun Hyung Kang
- Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon 35015, Korea;
| | - Ju Yup Lee
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu 42601, Korea;
| | - Hyun Lim
- Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Korea;
| | - Do Hoon Kim
- Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea
- Correspondence: ; Tel.: +82-2-3010-3193
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17
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Kang SH. Can Helicobacter pylori Eradication Therapy Reduce the Incidence of Nonalcoholic Fatty Liver Disease? Korean J Helicobacter Up Gastrointest Res 2022. [DOI: 10.7704/kjhugr.2022.0067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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18
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Jung SO, Moon HS, Kim TH, Park JH, Kim JS, Kang SH, Sung JK, Jeong HY. Nutritional Impact of Percutaneous Endoscopic Gastrostomy: A Retrospective Single-center Study. Korean J Gastroenterol 2022; 79:12-21. [PMID: 35086968 DOI: 10.4166/kjg.2021.086] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 09/02/2021] [Accepted: 11/01/2021] [Indexed: 11/03/2022]
Abstract
Background/Aims Several conditions may cause difficulties with oral feeding. Percutaneous endoscopic gastrostomy (PEG) is commonly performed on patients who require enteral feeding for >2-3 weeks. This study examined the nutritional state of patients who required enteral feeding and underwent PEG to quantify the benefits of the procedure. Methods This retrospective study included patients who underwent PEG at the Chungnam National University Hospital between January 2013 and December 2018. A gastroenterologist performed all PEG procedures using the pull technique, and all patients were followed up for >3 weeks postoperatively. The BMI and lymphocyte count, along with the levels of hemoglobin, total protein, albumin, total cholesterol, BUN, and creatinine pre-PEG and between 3 weeks and 6 months post-PEG were evaluated. Results Overall, 151 patients (116 males; mean age 64.92 years) were evaluated. Of these patients, 112 (74.2%), 34 (22.5%), and five (3.3%) underwent PEG tube insertion because of neurological diseases, malignancy, and other conditions, respectively. The BMI and the hemoglobin, total protein, albumin, and total cholesterol levels were significantly higher post-PEG than pre-PEG. Conclusions These findings highlight the usefulness of PEG in the management of nutritionally poor patients with difficulties in feeding orally.
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Affiliation(s)
- Sang Ok Jung
- Division of Gastroenterology, Department of Internal Medicine, Daejeon Veterans Hospital, Daejeon, Korea
| | - Hee Seok Moon
- Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea.,Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Daejeon, Korea
| | - Tae Hyung Kim
- Division of Disaster Statistics, Department of Fire and Disaster Prevention, Daejeon University, Daejeon, Korea
| | - Jae Ho Park
- Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea.,Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Sejong Hospital, Sejong, Korea
| | - Ju Seok Kim
- Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea.,Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Sejong Hospital, Sejong, Korea
| | - Sun Hyung Kang
- Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea.,Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Daejeon, Korea
| | - Jae Kyu Sung
- Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea.,Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Daejeon, Korea
| | - Hyun Yong Jeong
- Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea.,Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Daejeon, Korea
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Yeo MK, Kang SH, Jeong KB, Lee HS, Jeon HJ, Eun HS, Lee ES, Moon HS, Kim SH, Sung JK, Lee BS, Jeong HY. Comparison of Gene Expression Profiles of Signet Ring Cell Carcinoma and Poorly Cohesive Carcinoma in Early Gastric Cancer. Clin Med Insights Oncol 2022; 16:11795549221097941. [PMID: 35603092 PMCID: PMC9121514 DOI: 10.1177/11795549221097941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 04/14/2022] [Indexed: 11/15/2022] Open
Abstract
Introduction: Although signet ring cell carcinoma (SRC) is a subtype of poorly cohesive carcinoma (PC), the differences in the biological behavior between the 2 morphologically similar carcinomas have not been fully studied. Therefore, we performed transcriptome analysis to evaluate the differences of genetic expressions between SRC and PC. Methods: The study group consisted of patients with SRC or PC pathology from patients with early gastric cancer (EGC) whose depth of invasion was localized in the mucosal layer. A total of 18 patients were enrolled. The patients were divided into 3 groups based on their histologic type and lymph node (LN) status. Group 1 consisted of patients with PC and positive LN metastasis, Group 2 consisted of patients with PC without LN metastasis, and Group 3 consisted of patients with SRC without LN metastasis. Transcriptome analysis was performed using the nCounter PanCancer Progression Panel Kit. Results: The expression of 77 genes in Group 1 was altered compared to that in normal tissues. The expression of 49 and 13 genes in Groups 2 and 3, respectively, was altered when compared to that in normal tissues. Groups 1 and 2 showed similar genetic expressions. However, Group 3 showed numerous differences in gene expression including Roundabout4 (Robo4) compared to the other groups, especially Group 1. Conclusion: Our data suggest that gene expression patterns were different between SRC and PC and expression of ROBO4 may play an important role in the prognosis of SRC and PC type of EGC.
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Affiliation(s)
- Min Kyung Yeo
- Department of Pathology, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Sun Hyung Kang
- Division of gastroenterology and Hepatology, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Ku Bean Jeong
- Division of gastroenterology and Hepatology, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Hyun Seok Lee
- Division of gastroenterology and Hepatology, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Hong Jae Jeon
- Division of gastroenterology and Hepatology, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Hyuk Soo Eun
- Division of gastroenterology and Hepatology, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Eaum Seok Lee
- Division of gastroenterology and Hepatology, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Hee Seok Moon
- Division of gastroenterology and Hepatology, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Seok Hyun Kim
- Division of gastroenterology and Hepatology, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Jae Kyu Sung
- Division of gastroenterology and Hepatology, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Byung Seok Lee
- Division of gastroenterology and Hepatology, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Hyun Yong Jeong
- Division of gastroenterology and Hepatology, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Republic of Korea
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20
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Lee HS, Moon HS, Kwon IS, Jeong HY, Lee BS, Kim SH, Lee ES, Sung JK, Kang SH. Validation and modification of existing mortality prediction models for lower gastrointestinal bleeding: a retrospective study. BMC Gastroenterol 2021; 21:450. [PMID: 34844565 PMCID: PMC8628414 DOI: 10.1186/s12876-021-02037-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 11/18/2021] [Indexed: 11/10/2022] Open
Abstract
Background Lower gastrointestinal bleeding (LGIB) often subsides without medical intervention; however, in some cases, the bleeding does not stop and the patient’s condition worsens. Therefore, predicting severe LGIB in advance can aid treatment. This study aimed to evaluate variables related to mortality from LGIB and propose a scoring system. Methods In this retrospective study, we reviewed the medical records of patients who visited the emergency room with hematochezia between January 2016 and December 2020. Through regression analysis of comorbidities, medications, vital signs, laboratory investigations, and duration of hospital stay, variables related to LGIB-related mortality were evaluated. A scoring system was developed and the appropriateness with an area under the receiver operating characteristics curve (AUROC) was evaluated and compared with other existing models. Results A total of 932 patients were hospitalized for LGIB. Variables associated with LGIB-related mortality were the presence of cancer, heart rate > 100 beats/min, blood urea nitrogen level ≥ 30 mg/dL, an international normalized ratio > 1.50, and albumin level ≤ 3.0 g/dL. The AUROCs of the models CNUH-4 and CNUH-5 were 0.890 (p < 0.001; cutoff, 2.5; 95% confidence interval, 0.0851–0.929) and 0.901 (p < 0.001; cutoff, 3.5; 95% confidence interval, 0.869–0.933), respectively. Conclusions The model developed for predicting the risk of LGIB-related mortality is simple and easy to apply clinically. The AUROC of the model was better than that of the existing models.
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Affiliation(s)
- Hyun Seok Lee
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, 282, Munhwa-ro, Juong-gu, Daejeon, 35015, Republic of Korea
| | - Hee Seok Moon
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, 282, Munhwa-ro, Juong-gu, Daejeon, 35015, Republic of Korea.
| | - In Sun Kwon
- Clinical Trials Center, Chungnam National University, 282, Munhwa-ro, Juong-gu, Daejeon, 35015, Republic of Korea
| | - Hyun Yong Jeong
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, 282, Munhwa-ro, Juong-gu, Daejeon, 35015, Republic of Korea
| | - Byung Seok Lee
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, 282, Munhwa-ro, Juong-gu, Daejeon, 35015, Republic of Korea
| | - Seok Hyun Kim
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, 282, Munhwa-ro, Juong-gu, Daejeon, 35015, Republic of Korea
| | - Eaum-Seok Lee
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, 282, Munhwa-ro, Juong-gu, Daejeon, 35015, Republic of Korea
| | - Jae Kyu Sung
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, 282, Munhwa-ro, Juong-gu, Daejeon, 35015, Republic of Korea
| | - Sun Hyung Kang
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, 282, Munhwa-ro, Juong-gu, Daejeon, 35015, Republic of Korea
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21
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Joo JS, Park JH, Kim JS, Kang SH, Moon HS, Sung JK, Jeong HY. Risk factors for the histologic discrepancy of gastric adenomatous lesions and long-term outcome. Medicine (Baltimore) 2021; 100:e27827. [PMID: 34766597 PMCID: PMC8589245 DOI: 10.1097/md.0000000000027827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 10/29/2021] [Indexed: 01/05/2023] Open
Abstract
Although endoscopic forceps biopsies (EFB) have a significant role in diagnosing gastric adenoma, there are still discrepancies between EFBs and finalized pathology results.Therefore, the objective of this study was to find the risk factors that cause this discrepancy and to analyze the effects of this discrepancy on the long-term outcome.In this study patients that had received endoscopic resection due to low-grade gastric adenoma diagnosis from EFB between January of 2011 and January of 2018 at the Chungnam National University Hospital were retrospectively analyzed. According to whether there was histological discrepancy the cumulative incidence of the metachronous lesions were analyzed.A total of 745 lesions diagnosed as low-grade gastric adenoma at EFB were enrolled, and the final pathology results were confirmed to be non-neoplastic (n = 19), low-grade adenoma (n = 614), High-grade adenoma (n = 63), and carcinoma (n = 49), and with the exception of non-neoplastic lesion, the results confirmed 84.6% (n = 614) for the concordant group and 15.4% (n = 112) for the discordant. The results of the multivariate analysis confirmed that depressed lesion (odds ratio [OR]: 2.056; 95% confidence interval [CI]: 1.130-3.451; P = .011), erythema (OR: 2.546; 95% CI: 1.604-4.030; P = .004), and a size >1.5 cm (OR: 1.903; 95% CI: 1.102-3.172; P = .018) were risk factors for discrepancy. The results also confirmed that for the average observation period of (SD) 39.12 (12.31) months, the cumulative incidence of metachronous neoplasm had a higher significance (P = 0.001) in the discordant group when compared to that of the concordant group.The factors related to the histologic discrepancy of low-grade gastric adenoma were depressed lesion, erythema and size >1.5 cm. In the groups with histological discrepancy, the cumulative incidence of the metachronous neoplasm was significantly higher and therefore closer observation of such patients after performing endoscopic resection is necessary.
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Park JH, Kang SH, Joo JS, Rou WS, Kim JS, Eun HS, Moon HS, Lee ES, Kim SH, Sung JK, Lee BS, Jeong HY. Effect of Diminutive Adenoma with High-Grade Dysplasia on Surveillance Colonoscopy Interval. Dig Dis 2021; 40:545-552. [PMID: 34763334 DOI: 10.1159/000520829] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 11/08/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Colonoscopy surveillance guidelines set the surveillance schedule based on polyp characteristics. Polyps with high-grade dysplasia (HGD) require 3 years of follow-up regardless of size. However, it is unclear whether patients with diminutive polyps (≤5 mm) with HGD have a higher risk. We evaluated the effect of diminutive adenoma with HGD on adenoma occurrence. METHODS From January 2015 to December 2017, patients who underwent index and surveillance colonoscopy were retrospectively screened. The patients were grouped into no adenoma group, low-risk (patients with ≤2 low-grade dysplasia [LGD]), diminutive HGD, and high-risk (HGD >5 mm, ≥3 adenomas) groups according to the index colonoscopy results. Each group was analyzed using logistic analysis. RESULTS The mean follow-up period was 22.47 months. Altogether, 610 (50.45%) patients had LGD and 152 (12.5%) had HGD. Among them, 61 (5.0%) patients had a diminutive polyp with HGD. Analysis of the risks of developing advanced adenoma in the surveillance colonoscopy showed that compared to the no adenoma group, the diminutive HGD group did not show a significant risk (odds ratio [OR] = 1.503 [0.449-5.027], p = 0.509), while the high-risk group showed a significant risk (OR = 2.044 [1.015-4.114], p = 0.045). CONCLUSIONS Diminutive adenoma with HGD increased the risk of adenoma on surveillance colonoscopy, and in the case of advanced adenoma, the risk was increased, but it was not statistically significant.
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Affiliation(s)
- Jae Ho Park
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Sejong Hospital, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Sun Hyung Kang
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Jong Seok Joo
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Sejong Hospital, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Woo Sun Rou
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Sejong Hospital, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Ju Seok Kim
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Sejong Hospital, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Hyuk Soo Eun
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Hee Seok Moon
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Eaum Seok Lee
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Seok Hyun Kim
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Jae Kyu Sung
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Byung Seok Lee
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Hyun Yong Jeong
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Republic of Korea
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Kim JS, Park JC, Lee JY, Ahn JY, Kang SH, Yang HJ, Kim SJ, Joo MK, Park JM. Long-Term Clinical Outcomes of Gastric MALT Lymphoma: A Nationwide Multicenter Study in Korea. Front Oncol 2021; 11:681689. [PMID: 34722238 PMCID: PMC8551628 DOI: 10.3389/fonc.2021.681689] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 09/28/2021] [Indexed: 12/14/2022] Open
Abstract
Background Treatment recommendations for gastric mucosa-associated lymphoid tissue (MALT) lymphoma are based on case series and expert opinions. Only a few previous studies have focused on the long-term outcomes of gastric MALT lymphoma, especially according to stage. Methods Patients diagnosed with gastric MALT lymphoma from January 2000 to December 2018 at nine university hospitals in Korea were included. Clinical data of medical history, endoscopic features, histological diagnosis, results of Helicobacter pylori (H. pylori) testing, stage, treatment conditions, and outcomes were collected. Results A total of 1,163 patients was enrolled, and 97.6% (n=1,038) of patients were diagnosed as stage IE. 10-year overall survival (OS) for the entire population was 99.1% and was better for patients in stage IE compared with patients in stage III/IV (p=0.002). The 10-year OS for H. pylori-positive patients was better than that of H. pylori-negative patients (p=0.022). Multivariate analyses revealed initial stage III/IV as a prognostic factor associated with over-all survival. Conclusion The majority of gastric MALT lymphoma patients are diagnosed at an early localized stage in Korea. The overall survival rate of gastric MALT lymphoma is excellent and is associated with the initial stage of the disease.
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Affiliation(s)
- Joon Sung Kim
- Division of Gastroenterology, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Jun Chul Park
- Division of Gastroenterology, Yonsei University College of Medicine, Severance Hospital, Seoul, South Korea
| | - Jong Yeul Lee
- Center for Gastric Cancer, National Cancer Center, Goyang, South Korea
| | - Ji Yong Ahn
- Division of Gastroenterology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Sun Hyung Kang
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University School of Medicine, Dajeon, South Korea
| | - Hyo-Joon Yang
- Division of Gastroenterology, Department of Internal Medicine and Gastrointestinal Cancer Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Su Jin Kim
- Division of Gastroenterology, Department of Internal Medicine, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Moon Kyung Joo
- Division of Gastroenterology, Department of Internal Medicine, Korea University Guro Hospital, Korea University, College of Medicine, Seoul, South Korea
| | - Jae Myung Park
- Division of Gastroenterology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
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Shin MY, Moon HS, Kwon IS, Park JH, Kim JS, Kang SH, Lee ES, Kim SH, Sung JK, Lee BS, Jeong HY. Development and Validation of a Risk Scoring Model for Early Prediction of Severe Colon Ischemia. Dig Dis Sci 2021; 66:3993-4000. [PMID: 33242157 DOI: 10.1007/s10620-020-06717-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Accepted: 11/10/2020] [Indexed: 12/09/2022]
Abstract
BACKGROUND Colon ischemia (CI) is injury to the intestines secondary to insufficient blood flow. Its clinical severity can range from mild to life-threatening. AIMS To investigate predictive risk factors for CI and propose a scoring model for severe outcomes. METHODS We retrospectively analyzed the medical records of patients admitted to Chungnam National University Hospital from January 2010 to December 2018. CI was defined as severe when patients required surgery immediately or after initial conservative management, death occurred after hospitalization, or symptoms persisted after 2 weeks. By controlling for possible confounders from the logistic regression analysis, we obtained a new risk scoring model for the early prediction of severe CI. Furthermore, using the area under the receiver operating characteristics curve (AUROC), we assessed the accuracy of the model. RESULTS A total of 274 patients endoscopically diagnosed with CI were included, of whom 181 had severe CI. In the multivariate analysis, tachycardia, elevated C-reactive protein, Favier endoscopic classification stage ≥ 2, and history of hypertension were independently and significantly associated with severe CI. The AUROC of the model was 0.749. CONCLUSIONS This risk scoring model based on the presence of tachycardia, elevated C-reactive protein level, unfavorable endoscopic findings by Favier's classification, and the history of hypertension could be used to predict severe CI outcomes at an early stage.
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Affiliation(s)
- Min Young Shin
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University College of Medicine, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, South Korea
| | - Hee Seok Moon
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University College of Medicine, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, South Korea.
| | - In Sun Kwon
- Clinical Trials Center, Chungnam National University Hospital, Daejeon, South Korea
| | - Jae Ho Park
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University College of Medicine, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, South Korea
| | - Ju Seok Kim
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University College of Medicine, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, South Korea
| | - Sun Hyung Kang
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University College of Medicine, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, South Korea
| | - Eaum Seok Lee
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University College of Medicine, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, South Korea
| | - Seok Hyun Kim
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University College of Medicine, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, South Korea
| | - Jae Kyu Sung
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University College of Medicine, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, South Korea
| | - Byung Seok Lee
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University College of Medicine, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, South Korea
| | - Hyun Yong Jeong
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University College of Medicine, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, South Korea
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25
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Jung HK, Tae CH, Song KH, Kang SJ, Park JK, Gong EJ, Shin JE, Lim HC, Lee SK, Jung DH, Choi YJ, Seo SI, Kim JS, Lee JM, Kim BJ, Kang SH, Park CH, Choi SC, Kwon JG, Park KS, Park MI, Lee TH, Kim SY, Cho YS, Lee HH, Jung KW, Kim DH, Moon HS, Miwa H, Chen CL, Gonlachanvit S, Ghoshal UC, Wu JCY, Siah KTH, Hou X, Oshima T, Choi MY, Lee KJ. 2020 Seoul Consensus on the Diagnosis and Management of Gastroesophageal Reflux Disease. J Neurogastroenterol Motil 2021; 27:453-481. [PMID: 34642267 PMCID: PMC8521465 DOI: 10.5056/jnm21077] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 07/02/2021] [Indexed: 02/06/2023] Open
Abstract
Gastroesophageal reflux disease (GERD) is a condition in which gastric contents regurgitate into the esophagus or beyond, resulting in either troublesome symptoms or complications. GERD is heterogeneous in terms of varied manifestations, test findings, and treatment responsiveness. GERD diagnosis can be established with symptomatology, pathology, or physiology. Recently the Lyon consensus defined the “proven GERD” with concrete evidence for reflux, including advanced grade erosive esophagitis (Los Angeles classification grades C and or D esophagitis), long-segment Barrett’s mucosa or peptic strictures on endoscopy or distal esophageal acid exposure time > 6% on 24-hour ambulatory pH-impedance monitoring. However, some Asian researchers have different opinions on whether the same standards should be applied to the Asian population. The prevalence of GERD is increasing in Asia. The present evidence-based guidelines were developed using a systematic review and meta-analysis approach. In GERD with typical symptoms, a proton pump inhibitor test can be recommended as a sensitive, cost-effective, and practical test for GERD diagnosis. Based on a meta-analysis of 19 estimated acid-exposure time values in Asians, the reference range upper limit for esophageal acid exposure time was 3.2% (95% confidence interval, 2.7-3.9%) in the Asian countries. Esophageal manometry and novel impedance measurements, including mucosal impedance and a post-reflux swallow-induced peristaltic wave, are promising in discrimination of GERD among different reflux phenotypes, thus increasing its diagnostic yield. We also propose a long-term strategy of evidence-based GERD treatment with proton pump inhibitors and other drugs.
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Affiliation(s)
- Hye-Kyung Jung
- Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea
| | - Chung Hyun Tae
- Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea
| | - Kyung Ho Song
- Division of Gastroenterology, Department of Internal Medicine, CHA Ilsan Medical Center, CHA University School of Medicine, Ilsan, Jeollabuk-do, Korea
| | - Seung Joo Kang
- Department of Internal Medicine, Seoul National University Hospital Gangnam Center, Seoul, Korea
| | - Jong Kyu Park
- Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Gangwon-do, Korea
| | - Eun Jeong Gong
- Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Gangwon-do, Korea
| | - Jeong Eun Shin
- Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Chungcheongnam-do, Korea
| | - Hyun Chul Lim
- Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Gyeonggi-do, Korea
| | - Sang Kil Lee
- Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Da Hyun Jung
- Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Yoon Jin Choi
- Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Seung In Seo
- Division of Gastroenterology, Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Joon Sung Kim
- Division of Gastroenterology, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
| | - Jung Min Lee
- Digestive Disease Center, CHA Gangnam Medical Center, CHA University, Seoul, Korea
| | - Beom Jin Kim
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Sun Hyung Kang
- Department of Gastroenterology, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Korea
| | - Chan Hyuk Park
- Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Gyeonggi-do, Korea
| | - Suck Chei Choi
- Department of Internal Medicine and Digestive Disease Research Institute, Wonkwang University School of Medicine, Iksan, Jeollabuk-do, Korea
| | - Joong Goo Kwon
- Department of Internal Medicine, Daegu Catholic University School of Medicine, Daegu, Korea
| | - Kyung Sik Park
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea
| | - Moo In Park
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Tae Hee Lee
- Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Seung Young Kim
- Department of Internal Medicine, College of Medicine, Korea University, Seoul, Korea
| | - Young Sin Cho
- Division of Gastroenterology, Department of Internal Medicine, Soonchunhyang University Cheonan, Hospital, Cheonan, Chungcheongnamdo, Korea
| | - Han Hong Lee
- Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kee Wook Jung
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Do Hoon Kim
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hee Seok Moon
- Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea
| | - Hirota Miwa
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
| | - Chien-Lin Chen
- Institute of Medical Sciences, Tzu Chi University, and Department of Public Health, College of Medicine, Tzu Chi University, Hualien City, Taiwan
| | - Sutep Gonlachanvit
- Center of Excellence on Neurogastroenterology and Motility, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Uday C Ghoshal
- Departments of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Science, Lucknow, India
| | - Justin C Y Wu
- Institute of Digestive Disease, Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, China
| | - Kewin T H Siah
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Division of Gastroenterology and Hepatology, University Medicine Cluster, National University Hospital, Singapore
| | - Xiaohua Hou
- Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Tadayuki Oshima
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan
| | - Mi-Young Choi
- Division of Healthcare Technology Assessment Research, National Evidence-based Healthcare Collaborating Agency, Seoul, Korea
| | - Kwang Jae Lee
- Department of Gastroenterology, Ajou University School of Medicine, Suwon, Gyeonggi-do, Korea
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Jeon HJ, Moon HS, Kwon IS, Kang SH, Sung JK, Jeong HY. Which scoring system should be used for non-variceal upper gastrointestinal bleeding? Old or new? J Gastroenterol Hepatol 2021; 36:2819-2827. [PMID: 34031928 DOI: 10.1111/jgh.15555] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 05/01/2021] [Accepted: 05/19/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND AIM Several scoring systems for predicting outcomes in patients with non-variceal upper gastrointestinal bleeding (NVUGIB) have recently been devised, but not sufficiently validated. We compared the predictive accuracy of several scoring systems and assessed the usefulness of new scoring systems. METHODS The medical records of 1048 patients with NVUGIB were reviewed to collect demographic, clinical, laboratory, and endoscopic data. The areas under the receiver operating characteristic curve (AUROCs) were calculated for the ABC, new Japanese scoring system, Progetto Nazionale Emorrhagia Digestiva (PNED), and other scores to compare their predictive accuracy for 30-day mortality, therapeutic intervention, rebleeding, and prolonged hospital stay (≥ 10 days). Outcome predictors were identified by multivariate analysis. RESULTS The ABC, new Japanese scoring system, and PNED scores best predicted 30-day mortality (AUROC 0.907), need for therapeutic intervention (AUROC 0.707), and rebleeding (AUROC 0.874), respectively (all P < 0.001). The ABC and PNED scores were similarly better at predicting prolonged hospital stay (ABC AUROC: 0.765; PNED AUROC: 0.790; both P < 0.001). Thirty-day mortality was related to sex, systolic blood pressure (SBP), syncope, estimated glomerular filtration rate (eGFR), albumin, heart failure, disseminated malignancy, chronic obstructive pulmonary disease (COPD), and liver cirrhosis. Sex, age, SBP, hematemesis, blood urea nitrogen, and eGFR independently predicted the need for therapeutic intervention. Sex, SBP, pulse, albumin level, heart failure, disseminated malignancy, and COPD predicted rebleeding. CONCLUSION The outcomes of patients with NVUGIB were better predicted by newly developed than by old scoring systems.
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Affiliation(s)
- Hong Jae Jeon
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, South Korea
| | - Hee Seok Moon
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, South Korea
| | - In Sun Kwon
- Clinical Trials Center, Chungnam National University Hospital, Daejeon, South Korea
| | - Sun Hyung Kang
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, South Korea
| | - Jae Kyu Sung
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, South Korea
| | - Hyun Yong Jeong
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, South Korea
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Kim KJ, Kim IS, Oh SH, Lee SM, Lee HJ, Kang SH, Lee JB, Ryu YL, Chang CL. Evaluation of an automated specimen processing system for staining and culture for acid-fast bacilli. Int J Tuberc Lung Dis 2021; 25:677-679. [PMID: 34330357 DOI: 10.5588/ijtld.21.0206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- K J Kim
- Department of Laboratory Medicine, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - I-S Kim
- Department of Laboratory Medicine, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - S-H Oh
- Department of Laboratory Medicine, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - S M Lee
- Department of Laboratory Medicine, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - H-J Lee
- Department of Laboratory Medicine, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - S H Kang
- Department of Laboratory Medicine, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - J B Lee
- Department of Laboratory Medicine, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Y L Ryu
- Department of Laboratory Medicine, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - C L Chang
- Department of Laboratory Medicine, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
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Kim JS, Jung E, Kang SH, Ji JS, Cho YK, Lee BI, Cho YS, Kim BW, Choi H, Jeong HY, Choi MG, Park JM. Safety of Endoscopy in Peritoneal Dialysis Patients. Clin Transl Gastroenterol 2021; 12:e00379. [PMID: 34193802 PMCID: PMC8345910 DOI: 10.14309/ctg.0000000000000379] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 05/28/2021] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Endoscopic procedures can provoke peritonitis in patients receiving peritoneal dialysis (PD). The aim of this study was to assess the development of peritonitis after endoscopic procedures in PD patients. METHODS We retrospectively reviewed the data from PD patients who underwent endoscopies in 3 tertiary hospitals between 2008 and 2018. The patients were grouped into nonprophylactic, prophylactic, and prior antibiotic therapy groups. The incidence of peritonitis within 7 days of endoscopy was assessed. We also examined the factors associated with peritonitis. RESULTS There were 1,316 endoscopies performed in 570 PD patients. The peritonitis rate after endoscopy was 3.0%. Specifically, the peritonitis rate was 1.8% for esophagogastroduodenoscopies, 4.2% for the colonoscopy group, and 5.3% for the sigmoidoscopy group. The prior antibiotic therapy group showed a significantly higher risk of peritonitis (odds ratio = 4.6; 95% confidence interval: 2.2-9.6; P < 0.01). Prophylactic antibiotics were not associated with reducing peritonitis. Therapeutic colonoscopies such as polypectomy were associated with an increased risk of developing peritonitis (odds ratio = 6.5; 95% confidence interval: 1.6-25.9). However, biopsies were not associated with an increased risk of peritonitis. DISCUSSION Prophylactic antibiotics did not reduce the risk of peritonitis after endoscopy in PD patients. Therapeutic colonoscopies such as polypectomy and prior antibiotic therapy before endoscopy were associated with an increased risk of peritonitis.
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Affiliation(s)
- Joon Sung Kim
- Division of Gastroenterology, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Eunha Jung
- Division of Gastroenterology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sun Hyung Kang
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea
| | - Jeong-Seon Ji
- Division of Gastroenterology, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yu Kyung Cho
- Division of Gastroenterology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Bo-In Lee
- Division of Gastroenterology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Young-Seok Cho
- Division of Gastroenterology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Byung-Wook Kim
- Division of Gastroenterology, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hwang Choi
- Division of Gastroenterology, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyun Yong Jeong
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea
| | - Myung-Gyu Choi
- Division of Gastroenterology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jae Myung Park
- Division of Gastroenterology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Yeo MK, Kang SH, Eun HS, Lee ES, Moon HS, Kim SH, Sung JK, Lee BS, Jeong HY, Bae GE. Subepithelial spread of early gastric cancer is common and extends more than expected. Gastric Cancer 2021; 24:888-896. [PMID: 33620603 DOI: 10.1007/s10120-021-01171-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 02/12/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUNDS The clinical significance of subepithelial (SE) spread from early gastric cancer (EGC) is poorly understood. Thus, we evaluated the proportion and extent of SE spread from EGC, as well as related risk factors. METHODS We reviewed medical records and pathological specimens from patients with EGC who underwent surgery or endoscopic resection between January 2016 and December 2016 at Chungnam National University Hospital. RESULTS A total of 404 patients were reviewed and SE spread was identified for 142 patients (35.1%). The presence of SE spread was associated with gender, histological type, location, endoscopic appearance, color change, presence of lymphovascular invasion, and invasion depth. Multivariable analysis revealed that SE spread was only independently associated with histological type. The distance of SE spread was significantly different between histological types, and the maximum distance was 17 mm. CONCLUSION More than 30% of our patients with EGC had SE spread, which could reach up to 17 mm. Given the proportion of SE spread in these cases, a wider resection margin may be safe during endoscopic resection or surgery.
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Affiliation(s)
- Min Kyung Yeo
- Department of Pathology, School of Medicine, Chungnam National University, Daejeon, Republic of Korea
| | - Sun Hyung Kang
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Chungnam National University, 282 Munhwa-ro Jung-Gu, Daejeon, 35015, Republic of Korea.
| | - Hyuk Soo Eun
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Chungnam National University, 282 Munhwa-ro Jung-Gu, Daejeon, 35015, Republic of Korea
| | - Eaum Seok Lee
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Chungnam National University, 282 Munhwa-ro Jung-Gu, Daejeon, 35015, Republic of Korea
| | - Hee Seok Moon
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Chungnam National University, 282 Munhwa-ro Jung-Gu, Daejeon, 35015, Republic of Korea
| | - Seok Hyun Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Chungnam National University, 282 Munhwa-ro Jung-Gu, Daejeon, 35015, Republic of Korea
| | - Jae Kyu Sung
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Chungnam National University, 282 Munhwa-ro Jung-Gu, Daejeon, 35015, Republic of Korea
| | - Byung Seok Lee
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Chungnam National University, 282 Munhwa-ro Jung-Gu, Daejeon, 35015, Republic of Korea
| | - Hyun Yong Jeong
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Chungnam National University, 282 Munhwa-ro Jung-Gu, Daejeon, 35015, Republic of Korea
| | - Go Eun Bae
- Department of Pathology, School of Medicine, Chungnam National University, Daejeon, Republic of Korea
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Yeo MK, Sun P, Chung C, Park JH, Kang SH, Moon HS, Sung JK, Jeong HY, Kim JS. Clinical Significance of Composition Changes in T-cell Subpopulations After Chemotherapy in Patients With Gastric Cancer. In Vivo 2021; 35:2417-2424. [PMID: 34182525 DOI: 10.21873/invivo.12519] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 04/01/2021] [Accepted: 04/13/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND/AIM New therapeutic agents and prognostic biomarkers for gastric cancer are needed. We analyzed the composition of peripheral blood T-cell subpopulations in response to chemotherapy in patients with gastric cancer. PATIENTS AND METHODS Peripheral blood samples were collected from patients diagnosed with gastric cancer before and after chemotherapy (FOLFOX; oxaliplatin, 5-fluorouracil, and leucovorin). Peripheral blood mononuclear cells were isolated. Patients were divided into responder (n=5) and non-responder groups (n=2) based on their chemotherapy outcomes. RESULTS Non-responders showed lower numbers of CD4+/total cells and CD8+/total cells after chemotherapy compared to the responder group, but the difference was not significant (p=0.905, p=0.095). Naïve T, central memory T, effector memory T and effector T-cell counts differed in both groups after chemotherapy. CONCLUSION Changes in peripheral T-cell subpopulations after chemotherapy were confirmed in patients with gastric cancer, which may be a prognostic predictor and development of therapeutic agents.
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Affiliation(s)
- Min-Kyung Yeo
- Department of Pathology, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Pureum Sun
- Research Institute for Medical Sciences, College of Medicine, Chungnam National University, Daejeon, Republic of Korea
| | - Chaeuk Chung
- Division of Pulmonology, Department of Internal Medicine, College of Medicine, Chungnam National University, Daejeon, Republic of Korea
| | - Jae Ho Park
- Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Sun Hyung Kang
- Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Hee Seok Moon
- Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Jae Kyu Sung
- Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Hyun Yong Jeong
- Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Ju Seok Kim
- Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Republic of Korea
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Kang SH, Park SJ, Park JW, Kim WS, Seo SJ. Paradoxical darkening following picosecond laser and successful treatment. Clin Exp Dermatol 2021; 46:1128-1129. [PMID: 33774841 DOI: 10.1111/ced.14661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2021] [Indexed: 11/28/2022]
Affiliation(s)
- S H Kang
- Departments of Plastic Surgery, Chung-Ang University College of Medicine, Seoul, Korea
| | - S J Park
- Dermatology, Chung-Ang University College of Medicine, Seoul, Korea
| | - J W Park
- Dermatology, Chung-Ang University College of Medicine, Seoul, Korea
| | - W S Kim
- Departments of Plastic Surgery, Chung-Ang University College of Medicine, Seoul, Korea
| | - S J Seo
- Dermatology, Chung-Ang University College of Medicine, Seoul, Korea
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Park J, Hwang Y, Nam JH, Oh DJ, Kim KB, Song HJ, Kim SH, Kang SH, Jung MK, Jeong Lim Y. Artificial intelligence that determines the clinical significance of capsule endoscopy images can increase the efficiency of reading. PLoS One 2020; 15:e0241474. [PMID: 33119718 PMCID: PMC7595411 DOI: 10.1371/journal.pone.0241474] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 10/14/2020] [Indexed: 02/07/2023] Open
Abstract
Artificial intelligence (AI), which has demonstrated outstanding achievements in image recognition, can be useful for the tedious capsule endoscopy (CE) reading. We aimed to develop a practical AI-based method that can identify various types of lesions and tried to evaluate the effectiveness of the method under clinical settings. A total of 203,244 CE images were collected from multiple centers selected considering the regional distribution. The AI based on the Inception-Resnet-V2 model was trained with images that were classified into two categories according to their clinical significance. The performance of AI was evaluated with a comparative test involving two groups of reviewers with different experiences. The AI summarized 67,008 (31.89%) images with a probability of more than 0.8 for containing lesions in 210,100 frames of 20 selected CE videos. Using the AI-assisted reading model, reviewers in both the groups exhibited increased lesion detection rates compared to those achieved using the conventional reading model (experts; 34.3%–73.0%; p = 0.029, trainees; 24.7%–53.1%; p = 0.029). The improved result for trainees was comparable to that for the experts (p = 0.057). Further, the AI-assisted reading model significantly shortened the reading time for trainees (1621.0–746.8 min; p = 0.029). Thus, we have developed an AI-assisted reading model that can detect various lesions and can successfully summarize CE images according to clinical significance. The assistance rendered by AI can increase the lesion detection rates of reviewers. Especially, trainees could improve their efficiency of reading as a result of reduced reading time using the AI-assisted model.
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Affiliation(s)
- Junseok Park
- Department of Internal Medicine, Digestive Disease Center, Institute for Digestive Research, Soonchunhyang University College of Medicine, Seoul, Republic of Korea
| | - Youngbae Hwang
- Department of Electronics Engineering, Chungbuk National University, Cheongju, Republic of Korea
| | - Ji Hyung Nam
- Division of Gastroenterology, Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Republic of Korea
| | - Dong Jun Oh
- Division of Gastroenterology, Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Republic of Korea
| | - Ki Bae Kim
- Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Republic of Korea
| | - Hyun Joo Song
- Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Republic of Korea
| | - Su Hwan Kim
- Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Sun Hyung Kang
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Min Kyu Jung
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Yun Jeong Lim
- Division of Gastroenterology, Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Republic of Korea
- * E-mail:
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Lee HS, Moon HS, Kwon IS, Park JH, Kim JS, Kang SH, Lee ES, Kim SH, Sung JK, Lee BS, Jeong HY. Comparison of conventional and modified endoscopic mucosal resection methods for the treatment of rectal neuroendocrine tumors. Surg Endosc 2020; 35:6055-6065. [PMID: 33094828 DOI: 10.1007/s00464-020-08097-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 10/13/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND/AIM Small rectal neuroendocrine tumors (NETs) confined to the submucosa are endoscopically resectable. Because most rectal NETs are submucosal tumors, conventional endoscopic mucosal resection (cEMR) may not result in a complete resection. This study investigated whether modified EMRs, namely endoscopic submucosal resection with ligation (ESMR-L), EMR with precutting (EMR-P), and strip biopsy are superior to cEMR for achieving histologically complete resection (HCR) of rectal NETs. METHODS Medical records of 215 patients who were treated with endoscopic resections for rectal NETs between January 2011 and July 2019 were retrospectively enrolled. Of the patients, 110, 33, 29, and 43 underwent cEMR, ESMR-L, EMR-P, and strip biopsy, respectively. For each method, HCR and en bloc resection rates, procedure times, and complication rates were measured. RESULTS HCR was achieved with cEMR, EMR-P, ESMR-L, and strip biopsies for 74.5%, 90.9%, 93.1%, and 90.7% of cases, respectively. The HCR rate for cEMR was inferior to those of the modified EMRs (p = 0.045 for cEMR vs. EMR-P; p = 0.031 for cEMR vs. ESMR-L; p = 0.027 for cEMR vs. strip biopsy). Among the three modified EMRs, there was no significant difference in achieving HCR (p = 1.000). En bloc resection (p = 0.096) and complication rates (p = 0.071) were not significantly different among the four EMR methods, although EMR-P required the longest procedure time (p = 0.000). CONCLUSIONS All three modified EMRs are superior to cEMR and are equally effective for achieving HCR of rectal NETs.
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Affiliation(s)
- Hee Sung Lee
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University College of Medicine, Chungnam National University Hospital, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, South Korea
| | - Hee Seok Moon
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University College of Medicine, Chungnam National University Hospital, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, South Korea.
| | - In Sun Kwon
- Clinical Trials Center, Chungnam National University Hospital, Daejeon, 35015, South Korea
| | - Jae Ho Park
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University College of Medicine, Chungnam National University Hospital, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, South Korea
| | - Ju Seok Kim
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University College of Medicine, Chungnam National University Hospital, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, South Korea
| | - Sun Hyung Kang
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University College of Medicine, Chungnam National University Hospital, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, South Korea
| | - Eaum Seok Lee
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University College of Medicine, Chungnam National University Hospital, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, South Korea
| | - Seok Hyun Kim
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University College of Medicine, Chungnam National University Hospital, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, South Korea
| | - Jae Kyu Sung
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University College of Medicine, Chungnam National University Hospital, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, South Korea
| | - Byung Seok Lee
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University College of Medicine, Chungnam National University Hospital, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, South Korea
| | - Hyun Yong Jeong
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University College of Medicine, Chungnam National University Hospital, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, South Korea
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Park CH, Seo SI, Kim JS, Kang SH, Kim BJ, Choi YJ, Byun HJ, Yoon JH, Lee SK. Treatment of non-erosive reflux disease and dynamics of the esophageal microbiome: a prospective multicenter study. Sci Rep 2020; 10:15154. [PMID: 32938975 PMCID: PMC7494862 DOI: 10.1038/s41598-020-72082-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 08/18/2020] [Indexed: 02/06/2023] Open
Abstract
Non-erosive reflux disease (NERD) pathogenesis has not been thoroughly evaluated. Here, we assessed the response of patients with NERD to proton pump inhibitor (PPI) therapy; changes in the microbiome and biologic marker expression in the esophageal mucosa were also evaluated. Patients with NERD (n = 55) received esomeprazole (20 mg) for eight weeks. The treatment response was evaluated at baseline, week four, and week eight. Esophageal mucosal markers and oropharyngeal and esophageal microbiomes were analyzed in patients who underwent upper gastrointestinal endoscopy at screening (n = 18). Complete and partial response rates at week eight were 60.0% and 32.7% for heartburn, and 61.8% and 29.1% for regurgitation, respectively. The expressions of several inflammatory cytokines, including IL-6, IL-8, and NF-κB, were decreased at week eight. Streptococcus, Haemophilus, Prevotella, Veillonella, Neisseria, and Granulicatella were prevalent regardless of the time-point (baseline vs. week eight) and organ (oropharynx vs. esophagus). The overall composition of oropharyngeal and esophageal microbiomes showed significant difference (P = 0.004), which disappeared after PPI therapy. In conclusion, half-dose PPI therapy for eight weeks could effectively control NERD symptoms. The expression of several inflammatory cytokines was reduced in the esophagus, and oropharyngeal and esophageal microbiomes in patients with NERD showed significant difference. However, the microbial compositions in the oropharynx and esophagus were not affected by PPI therapy in this study. Impact of PPI on the microbiome in patients with NERD should be more investigated in future studies.
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Affiliation(s)
- Chan Hyuk Park
- Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Republic of Korea
| | - Seung In Seo
- Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea
| | - Joon Sung Kim
- Division of Gastroenterology, Department of Internal Medicine, College of Medicine, Incheon St Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sun Hyung Kang
- Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Beom Jin Kim
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Yoon Jin Choi
- Department of Internal Medicine, Korea University Guro Hospital, Seoul, Republic of Korea.,Department of Internal Medicine, Yonsei Institute of Gastroenterology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hyo Joo Byun
- Department of Internal Medicine, Yonsei Institute of Gastroenterology, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seoul, 03722, Republic of Korea.,Brain Korea 21 PLUS Project for Medical Science, Yonsei University, Seoul, Republic of Korea
| | - Jung-Ho Yoon
- Department of Internal Medicine, Yonsei Institute of Gastroenterology, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seoul, 03722, Republic of Korea.,Brain Korea 21 PLUS Project for Medical Science, Yonsei University, Seoul, Republic of Korea
| | - Sang Kil Lee
- Department of Internal Medicine, Yonsei Institute of Gastroenterology, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seoul, 03722, Republic of Korea. .,Brain Korea 21 PLUS Project for Medical Science, Yonsei University, Seoul, Republic of Korea.
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Cho MJ, Moon HS, Lee HS, Park JH, Kim JS, Kang SH, Lee ES, Kim SH, Sung JK, Lee BS, Jeong HY. Immunoglobulin G4-related disease in the stomach presenting as a gastric subepithelial tumor: Case report. Medicine (Baltimore) 2020; 99:e22078. [PMID: 32899079 PMCID: PMC7478664 DOI: 10.1097/md.0000000000022078] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION Immunoglobulin G4-related disease (IgG4-RD) is an immune-mediated fibroinflammatory disorder characterized by specific pathologic findings and often, but not in all cases, elevated serum IgG4 concentration. Although it can virtually involve every organ system, cases involving the gastrointestinal tract and especially gastric mass lesions have rarely been reported. PATIENT CONCERNS A 45-year-old man, who was incidentally discovered asymptomatic subepithelial tumor (SET), by endoscopy, on the greater curvature of the upper gastric body, was referred to our hospital for further evaluation. DIAGNOSIS The patient was postoperatively diagnosed with IgG4-RD by histopathologic results. INTERVENTIONS The patient underwent laparoscopic wedge resection. OUTCOMES The patient is presently followed up annually in our clinic and had no problems and showed no signs of recurrence in examination. CONCLUSION We reported a rare case of IgG4-RD presenting as a gastric SET. The first line treatment of IgG4-RD is glucocorticoid administration. However, because pathologic examination is challenging owing to the lesion location, preoperative diagnosis is difficult and may lead to unnecessary gastric resection. Thus, using alternative preoperative diagnostic methods such as endoscopic ultrasound-guided fine-needle biopsy or the biopsy unroofing technique could spare the patient from unnecessary surgical treatment.
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Kim DY, Moon HS, Kwon IS, Park JH, Kim JS, Kang SH, Lee ES, Kim SH, Lee BS, Sung JK, Jeong HY. Self-expandable metal stent of esophagogastric junction versus pyloric area obstruction in advanced gastric cancer patients: Retrospective, comparative, single-center study. Medicine (Baltimore) 2020; 99:e21621. [PMID: 32872019 PMCID: PMC7437803 DOI: 10.1097/md.0000000000021621] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Upper gastrointestinal stenting is a palliative treatment for relieving symptoms such as nausea, vomiting, and dietary intake in patients with obstruction due to inoperable advanced stomach cancer. Self-expandable metal stent (SEMS) implantation for malignant obstruction has recently become more effective, safer, and less expensive than operative modality. It also has better short-term outcomes, particularly a shorter hospital stay and a more rapid return to oral intake, than surgical treatment. However, there is no comparative analysis regarding the efficacy, side effects, and survival rate of stenting between the esophagogastric junction (EGJ) and pyloric obstructions.To compare the prognoses and complications after SEMS implantation between EGJ and pyloric obstructions in advanced gastric cancer.Among advanced gastric cancer patients with gastrointestinal obstruction diagnosed from January 2008 to December 2017 at the Gastroenterology Department of Chungnam National University Hospital, 42 and 76 patients presented with EGJ (EGJ obstruction group) and gastric pyloric obstructions (pyloric obstruction group), respectively. We retrospectively reviewed the survival period, changes in food intake, and complications of these patients before and after SEMS placement.The prevalences of aspiration pneumonia were 11.9% (5/42) and 2.6% (2/76) in the EGJ and pyloric obstruction groups, respectively, before SEMS placement (P value: .041). Other symptoms associated with gastric malignant obstruction were not statistically different between the groups. Success rate and adverse events did not significantly differ between the EGJ and pyloric obstruction groups. There was no difference in frequency of stent reinsertion procedures performed owing to reobstruction, but the reprocedure average period was statistically significantly longer in the EGJ obstruction group [EGJ obstruction: 158.3 days (±42.4); pyloric obstruction: 86.0 days (±29.1)] (P value: .022). As an index of improved dietary status, the Gastric Outlet Obstruction Scoring System score was not significantly different between the groups before and after SEMS placement.The EGJ and pyloric obstruction groups did not significantly differ in prognosis or complication rates. However, EGJ stent was more stable than pyloric stent when reobstruction was considered.
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Affiliation(s)
- Deok Yeong Kim
- Division of Gastroenterology, Department of Internal Medicine, Daejeon Veterans Hospital
| | - Hee Seok Moon
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital
| | - In Sun Kwon
- Clinical Trials Center, Chungnam National University Hospital, Daejeon, South Korea
| | - Jae Ho Park
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital
| | - Ju Seok Kim
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital
| | - Sun Hyung Kang
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital
| | - Eaum Seok Lee
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital
| | - Seok Hyun Kim
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital
| | - Byung Seok Lee
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital
| | - Jae Kyu Sung
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital
| | - Hyun Yong Jeong
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital
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Lee J, Kim JH, Kang SH, Yoo HM. Improvement of digital PCR conditions for direct detection of KRAS mutations. J Clin Lab Anal 2020; 34:e23344. [PMID: 32329932 PMCID: PMC7439326 DOI: 10.1002/jcla.23344] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Revised: 03/05/2020] [Accepted: 03/31/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND In standard analytical conditions, an isolation step is essential for circulating tumor DNA (ctDNA) analysis. The necessity of this step becomes unclear with the development of highly sensitive detection methods. The aim of this study was to evaluate ctDNA mimetic nDNA detection as reference materials (RMs) using dPCR technologies either directly from serum or without serum. METHODS To determine an absolute count of both mutation and wild-type bearing DNA molecules, genomic DNA (gDNA) and nucleosomal DNA (nDNA), which are similar in size to cell-free DNA, were evaluated. We tested 3 KRAS mutations in colorectal cancer cell lines. RESULTS We describe the recent progress in RMs. The short DNA fragments, such as sDNA and nDNA, exhibited higher quantitative values of dPCR compared to gDNA. The efficiency between Atlantis dsDNase (AD) and Micrococcal Nuclease (MN) affects DNA quantification. Moreover, there was a significant difference in dPCR output when spiking gDNA or nDNA containing KRAS mutations into FBS compared to the dPCR output under non-FBS conditions. CONCLUSION The matrix effect crucially affects the accuracy of gDNA and nDNA level estimation in the direct detection of mimic of patient samples. The form of reference material we proposed should be optimized for various conditions to develop reference materials that can accurately measure copy number and verify the detection of KRAS mutations in the matrix.
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Affiliation(s)
- Jina Lee
- Center for BioanalysisKorea Research Institute of Standards and Science (KRISS)DaejeonKorea
- College of PharmacyChungnam National UniversityDaejeonKorea
| | - Ji Hyun Kim
- Center for BioanalysisKorea Research Institute of Standards and Science (KRISS)DaejeonKorea
| | - Sun Hyung Kang
- Division of Gastroenterology and HepatologyDepartment of Internal MedicineChungnam National University School of MedicineDaejeonKorea
| | - Hee Min Yoo
- Center for BioanalysisKorea Research Institute of Standards and Science (KRISS)DaejeonKorea
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Kanase RS, Karade VC, Kollu P, Sahoo SC, Patil PS, Kang SH, Kim JH, Nimbalkar MS, Patil PB. Evolution of structural and magnetic properties in iron oxide nanoparticles synthesized using Azadirachta indica leaf extract. Nano Ex 2020. [DOI: 10.1088/2632-959x/aba682] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
The novel superparamagnetic nature of magnetic nanoparticles (MNPs) has received significant attention in the wide variety of fields. However, the prerequisites to use these MNPs, particularly in biomedical applications are biocompatibility and high saturation magnetization (Ms). Thus, the development of a sustainable approach for the synthesis of biocompatible MNPs, which utilizes the redox properties of natural compounds from plant extracts, is highly desired. Herein, we have examined the growth of phase selective MNPs synthesized using Azadirachta indica (Neem) extract as a reducing and capping agent. The physical and biological properties of MNPs synthesized with the modified green hydrothermal method at different reaction times and temperatures were investigated. It was observed that the reaction time and temperature strongly modulated the magnetic and structural characteristics of MNPs. At lower reaction time and temperature of 200 °C for 2 h, primarily iron oxalate hydrate (Fe(C2O4).2(H2O)) was formed. Further, with increasing reaction temperature, the phase transformation from iron oxalate hydrate to pure magnetite (Fe3O4) phase was observed. The MNPs prepared with optimum conditions of 220 °C for 4 h show superparamagnetic nature with improved Ms value of 58 emu g−1. The antibacterial study of MNPs against gram-positive bacteria Staphylococcus aureus showed that the MNPs inhibits the growth of bacteria with the least inhibitory MNPs concentration of 6 μl. Thus, the MNPs obtained by this modified biogenic approach will widen the scope and their applicability in future biomedical applications.
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Kang SH, Moon HS, Park JH, Kim JS, Kang SH, Lee ES, Kim SH, Lee BS, Sung JK, Jeong HY, Lee KH. Intestinal Perforation as a Paradoxical Reaction to Antitubercular Therapy: A Case Report. Ann Coloproctol 2020; 37:S18-S23. [PMID: 32674552 PMCID: PMC8359699 DOI: 10.3393/ac.2020.03.16.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 03/16/2020] [Indexed: 11/10/2022] Open
Abstract
Paradoxical reactions to tuberculosis (TB) treatment are characterized by an initial improvement of the clinical symptoms followed by clinical or radiological deterioration of existing tuberculous lesions, or by development of new lesions. Intestinal perforation in gastrointestinal TB can occur as a paradoxical reaction to antitubercular therapy. A 55-year-old man visited the outpatient department with lower abdominal pain and weight loss. He was diagnosed with intestinal TB and started antitubercular therapy. After 3 months of antitubercular therapy, a colonoscopy revealed improvement of the disease. Three days after the colonoscopy, the patient visited the emergency room complaining of abdominal pain. Abdominal computed tomography revealed extraluminal air-filled spaces in the pelvic cavity. We diagnosed a small bowel perforation and performed an emergency laparotomy and a right hemicolectomy with small bowel resection. This report describes the case of intestinal perforation presenting as a paradoxical reaction to antitubercular and provides a brief literature review.
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Affiliation(s)
- Sung Hoon Kang
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Korea
| | - Hee Seok Moon
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Korea
| | - Jae Ho Park
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Korea
| | - Ju Seok Kim
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Korea
| | - Sun Hyung Kang
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Korea
| | - Eaum Seok Lee
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Korea
| | - Seok Hyun Kim
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Korea
| | - Byung Seok Lee
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Korea
| | - Jae Kyu Sung
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Korea
| | - Hyun Yong Jeong
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Korea
| | - Kyung Ha Lee
- Department of Surgery, Chungnam National University College of Medicine, Daejeon, Korea
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Kim MH, Moon HS, Kwon IS, Kim JS, Kang SH, Sung JK, Lee ES, Kim SH, Lee BS, Jeong HY. The incidence and risk factors of sessile serrated adenomas in left side colon cancer patients after curative surgery. Medicine (Baltimore) 2020; 99:e20799. [PMID: 32702823 PMCID: PMC7373563 DOI: 10.1097/md.0000000000020799] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Sessile serrated adenomas (SSAs) are precursors of colorectal cancer (CRC). However, there are limited data on detection rates of this premalignant lesion during colonoscopy surveillance in patients with a history of left side colonic resection for cancer. We aimed to identify the incidence and risk factors of SSAs in post-left side colectomy patients.We retrospectively reviewed the medical records of patients who had undergone left side colectomy for colon and rectal cancer between September 2009 and September 2016 and had at least 1 follow-up colonoscopy. Patient baseline characteristics, SSA diagnoses and characteristics, and colonoscopy information were collected.In total, 539 patients were enrolled. At the first follow-up (mean duration 11.5 months), 98 SSAs were identified (22.2%). At the second follow-up (mean duration 25.8 months), 51 SSAs were identified in 212 patients (24.0%). Multivariate analysis showed that alcohol intake (hazard ratio [HR] 1.524; 95% confidence interval [CI] .963-2.411, P = .041), excellent bowel preparation (HR 2.081; 95% CI 1.214-3.567, P = .049), and use of a transparent cap (HR 1.702; 95% CI 1.060-2.735, P = .013) were associated with higher SSA incidence in the first surveillance colonoscopy, while body mass index (BMI) ≥ 25.0 (HR 1.602; 95% CI 1.060-2.836) was associated with a significantly increased risk of SSAs in the second surveillance.Considering the endoscopic appearance of SSAs, adequate bowel preparation and use of transparent caps during postoperative surveillance colonoscopy can increase the diagnosis rate. Modification of alcohol intake and BMI may reduce the incidence of SSAs in left side colon cancer patients.
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Affiliation(s)
- Myung Hee Kim
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University School of Medicine
| | - Hee Seok Moon
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University School of Medicine
| | - In Sun Kwon
- Clinical Trials Center, Chungnam National University Hospital, Daejeon, South Korea
| | - Ju Seok Kim
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University School of Medicine
| | - Sun Hyung Kang
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University School of Medicine
| | - Jae Kyu Sung
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University School of Medicine
| | - Eaum Seok Lee
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University School of Medicine
| | - Seok Hyun Kim
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University School of Medicine
| | - Byung Seok Lee
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University School of Medicine
| | - Hyun Yong Jeong
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University School of Medicine
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Park JH, Moon HS, Kwon IS, Kim JS, Kang SH, Lee ES, Kim SH, Sung JK, Lee BS, Jeong HY. Quality of Preoperative Colonoscopy Affects Missed Postoperative Adenoma Detection in Colorectal Cancer Patients. Dig Dis Sci 2020; 65:2063-2070. [PMID: 31667695 DOI: 10.1007/s10620-019-05912-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 10/18/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND Despite thorough preoperative screening, 19-30% of synchronous polyps or adenomas are detected after colon cancer surgery. Remnant synchronous lesions require additional colonoscopy procedures or surgery. AIM To investigate factors of preoperative colonoscopy potentially affecting the detection of missed lesions in patients subjected to colorectal cancer surgery. METHODS Of 1147 colorectal cancer patients subjected to curative open or laparoscopic colectomy and colonoscopy at the Chungnam National University Hospital from January 2012 to December 2016, 518 patients underwent pre- and postoperative colonoscopy. The index colonoscopy was defined as the last preoperative endoscopy performed. We analyzed pre- and postoperative medical charts for colonoscopy and pathological data. The effects of patient, procedure, and tumor factors on the postoperative adenoma detection rate, advanced adenoma detection rate, and adenoma miss rate (AMR) were analyzed. RESULTS The overall AMR was 25.7% (95% confidence interval, 22.2-29.8%). Comparing optimal and non-optimal bowel preparation groups, the latter had greater postoperative polyp missed rate (PMR), AMR (p < 0.01), and AAMR (p = 0.272). The optimal preparation group allowed identification of more synchronous adenomas than in the fair (OR 5.72) and poor (OR 11.39) preparation groups. On univariate analysis, patient age and left-sided colectomy (p < 0.01) influenced AMR. Multivariate analysis showed that age, preoperative bowel preparation, and left colon resection influenced postoperative AMR. CONCLUSION A better quality of index colonoscopy had a positive effect on lowering the detection rate of postoperative adenoma. Older age and suboptimal bowel preparation at the index colonoscopy and left-sided colectomy had negative effects on lowering the postoperative AMR.
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Affiliation(s)
- Jae Ho Park
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University College of Medicine, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, South Korea
| | - Hee Seok Moon
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University College of Medicine, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, South Korea.
| | - In Sun Kwon
- Clinical Trials Center, Chungnam National University Hospital, Daejeon, South Korea
| | - Ju Seok Kim
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University College of Medicine, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, South Korea
| | - Sun Hyung Kang
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University College of Medicine, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, South Korea
| | - Eaum Seok Lee
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University College of Medicine, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, South Korea
| | - Seok Hyun Kim
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University College of Medicine, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, South Korea
| | - Jae Kyu Sung
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University College of Medicine, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, South Korea
| | - Byung Seok Lee
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University College of Medicine, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, South Korea
| | - Hyun Yong Jeong
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University College of Medicine, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, South Korea
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Kang SH, Joo JH, Jang SI, Park EC. Association of exposure to secondhand smoke at home with early age at menarche in South Korea. Public Health 2020; 185:144-149. [PMID: 32622222 DOI: 10.1016/j.puhe.2020.04.041] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 02/13/2020] [Accepted: 04/30/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The secular trend in age at menarche (AAM) has declined both worldwide and in Korea. Early AAM is associated with the risk of several diseases, reproductive capacity, and psychological problems. We aimed to investigate the relationship between secondhand smoke (SHS) exposure at home and early puberty onset using AAM in Korean adolescents. STUDY DESIGN This is a retrospective cross-sectional study. METHODS This study used data from the Korea Youth Risk Behavior Web-based Survey 2014-2015. We used the mean AAM (12.2 years) as a determinant of early AAM. After the exclusion of girls without menarche or who did not respond, the total population comprised 63,618 participants. We categorized AAM as 'early' and 'average or late.' Adolescents with SHS exposure were assigned to the 'never exposed,' 'light exposure,' and 'heavy exposure' groups. Multiple logistic regression analyses were performed. RESULTS We observed a positive association, approximately 1.12 times, between early AAM and high SHS exposure (odds ratio [OR], 1.12; 95% confidence interval [CI], 1.05-1.19). Girls who started smoking before the age of 12 years (OR, 1.68; 95% CI, 1.41-1.99) showed a stronger association with early AAM than non-smokers. Active smoking showed a stronger association with early AAM. Never smokers with high SHS exposure at home were 1.13 times likelier to have an early AAM (OR, 1.13; 95% CI, 1.05-1.22) than those without SHS exposure. CONCLUSIONS In addition to active smoking, SHS may also be a risk factor for early AAM. Education aimed at active and secondhand smoking prevention is needed to protect children against early AAM.
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Affiliation(s)
- S H Kang
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea; Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - J H Joo
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea; Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - S I Jang
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea; Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - E C Park
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea; Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
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Kim MS, Moon HS, Kwon IS, Park JH, Kim JS, Kang SH, Sung JK, Lee ES, Kim SH, Lee BS, Jeong HY. Validation of a new risk score system for non-variceal upper gastrointestinal bleeding. BMC Gastroenterol 2020; 20:193. [PMID: 32552662 PMCID: PMC7301517 DOI: 10.1186/s12876-020-01346-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Accepted: 06/12/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Recently, a new international bleeding score was developed to predict 30-day hospital mortality in patients with upper gastrointestinal bleeding (UGIB). However, the efficacy of this newly developed scoring system has not been extensively investigated. We aimed to validate a new scoring system for predicting 30-day mortality in patients with non-variceal UGIB and determine whether a higher score is associated with re-bleeding, length of hospital stay, and endoscopic failure. METHODS A retrospective study was performed on 905 patients with acute non-variceal UGIB who were examined in our hospital between January 2013 and December 2017. Baseline characteristics, endoscopic findings, re-bleeding, admission, and mortality were reviewed. The 30-day mortality rate of the new international bleeding risk score was calculated using the receiver operating characteristic curves and compared to the pre-endoscopy Rockall score, AIMS65, Glasgow Blatchford score, and Progetto Nazionale Emorragia Digestiva score. To verify the variable for the 30-day mortality of the new scoring system, we performed multivariate logistic regression using our data and further analyzed the score items. RESULTS The new international bleeding scoring system showed higher receiver operating characteristic (ROC) curve values in predicting mortality (area under ROC curve 0.958; [95% confidence interval (CI)]), compared with such as AIMS65 (AUROC, 0.832; 95%CI, 0.806-0.856; P < 0.001), PNED (AUROC, 0.865; 95%CI, 0.841-0.886; P < 0.001), Pre-RS (AUROC, 0.802; 95%CI, 0.774-0.827; P < 0.001), and GBS (AUROC, 0.765; 95%CI, 0.736-0.793; P < 0.001). Multivariate analysis was performed using our data and showed that the 30-day mortality rate was related to multiple comorbidities, blood urea nitrogen, creatinine, albumin, syncope at first visit, and endoscopic failure within 24 h during the first admission. In addition, in the high-score group, relatively long hospital stay, re-bleeding, and endoscopic failure were observed. CONCLUSION This is a preliminary report of a new bleeding score which may predict 30-day mortality better than the other scoring systems. High-risk patients could be screened using this new scoring system to predict 30-day mortality. The use of this scoring system seemed to improve the outcomes of non-variceal UGIB patients in this study, through proper management and intervention.
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Affiliation(s)
- Min Seong Kim
- Division of Gastroenterology, Departmentof Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea
| | - Hee Seok Moon
- Division of Gastroenterology, Departmentof Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea.
| | - In Sun Kwon
- Clinical Trials Center, Chungnam National University Hospital, Daejeon, 34952, South Korea
| | - Jae Ho Park
- Division of Gastroenterology, Departmentof Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea
| | - Ju Seok Kim
- Division of Gastroenterology, Departmentof Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea
| | - Sun Hyung Kang
- Division of Gastroenterology, Departmentof Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea
| | - Jae Kyu Sung
- Division of Gastroenterology, Departmentof Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea
| | - Eaum Seok Lee
- Division of Gastroenterology, Departmentof Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea
| | - Seok Hyun Kim
- Division of Gastroenterology, Departmentof Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea
| | - Byung Seok Lee
- Division of Gastroenterology, Departmentof Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea
| | - Hyun Yong Jeong
- Division of Gastroenterology, Departmentof Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea
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Lee HS, Kang SH, Rou WS, Eun HS, Joo JS, Kim JS, Lee ES, Moon HS, Kim SH, Sung JK, Lee BS, Jeong HY. Computed tomography versus lower endoscopy as initial diagnostic method for evaluating patients with hematochezia at emergency room. Medicine (Baltimore) 2020; 99:e20311. [PMID: 32481401 DOI: 10.1097/md.0000000000020311] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
For acute lower gastrointestinal bleeding (LGIB), lower gastrointestinal endoscopy is the preferred initial diagnostic test. However, it is difficult to perform urgently. Computed tomography (CT) is a convenient alternative.This study aimed to determine the diagnostic performance of CT compared to lower endoscopy as an initial test for evaluating acute LGIB.The medical records of 382 patients who visited our emergency department with hematochezia between January 2012 and January 2017 were retrospectively analyzed. Of them, 112 underwent CT, 65 underwent colonoscopy, and 205 underwent sigmoidoscopy as an initial test. For each method, sensitivity, specificity, positive predictive value, and negative predictive value were calculated upon active bleeding site detection and LGIB etiology diagnosis.The sensitivity, specificity, positive predictive value, and negative predictive value of CT for active bleeding site detection were 85.7%, 100%, 100%, and 96.9%, respectively, while those for identifying the etiology of LGIB were 87.4%, 40.0%, 83.5, and 47.6%, respectively.CT was not inferior to lower endoscopy for active bleeding site detection. Early localization and the exclusion of active bleeding were possible with CT. Etiology was diagnosed with high sensitivity and PPV by CT. Thus, CT can be an alternative initial diagnostic tool for evaluating acute LGIB.
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Affiliation(s)
- Hee Sung Lee
- Division of Gastroenterology, Department of Internal medicine, Chungnam National University School of Medicine, Daejeon, Korea
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Kim JS, Kang SH, Moon HS, Lee ES, Kim SH, Sung JK, Lee BS, Jeong HY. Accuracy of endoscopic size measurements of early gastric signet ring cell carcinoma. Surg Endosc 2020; 35:2324-2331. [PMID: 32430526 DOI: 10.1007/s00464-020-07646-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 05/13/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIMS Indications for endoscopic submucosal dissection (ESD) of early gastric cancer (EGC) are expanding, but signet ring cell carcinoma (SRC) is still unclear because of its unclear boundaries. The purpose of this study was to compare pathologic size and endoscopic size in SRC-type EGC and to find risk factors associated with tumor size underestimation. METHODS Medical records of 137 patients diagnosed with SRC-type EGC between January 2009 and December 2016 at our tertiary hospital were reviewed. According to pathologic and endoscopic tumor sizes, they were classified into correct estimation, underestimation, and overestimation groups, and risk factors related to underestimation were analyzed. RESULTS Among 137 patients with SRC-type EGC, 77 patients (56.2%) had undergone correct estimation, 43 patients (31.4%) had undergone underestimation, and 17 patients (12.4%) had undergone overestimation. Mean pathologic size (SD) was 20.1 (13.8) mm and mean endoscopic size (SD) was 17.9 (10.1) mm, the correlation coefficients were 0.919 (p < 0.001) , and there was no significant difference between the two groups. Multivariate analysis showed that tumor size more than 20 mm (OR 3.419; 95% CI 1.271-9.194; p = 0.015) and atrophy (OR 6.011; 95% CI 2.311-15.633; p = 0.001) were risk factors for tumor size underestimation. CONCLUSION There was no significant difference in pathologic and endoscopic size in SRC-type EGC. Therefore, ESD may be considered as a therapeutic option if the size of the tumor is less than 20 mm and atrophy is not present in the surrounding mucosa.
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Affiliation(s)
- Ju Seok Kim
- Department of Internal Medicine, Chungnam National University School of Medicine, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, Korea
| | - Sun Hyung Kang
- Department of Internal Medicine, Chungnam National University School of Medicine, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, Korea.
| | - Hee Seok Moon
- Department of Internal Medicine, Chungnam National University School of Medicine, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, Korea
| | - Eaum Seok Lee
- Department of Internal Medicine, Chungnam National University School of Medicine, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, Korea
| | - Seok Hyun Kim
- Department of Internal Medicine, Chungnam National University School of Medicine, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, Korea
| | - Jae Kyu Sung
- Department of Internal Medicine, Chungnam National University School of Medicine, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, Korea
| | - Byung Seok Lee
- Department of Internal Medicine, Chungnam National University School of Medicine, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, Korea
| | - Hyun Yong Jeong
- Department of Internal Medicine, Chungnam National University School of Medicine, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, Korea
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Back MK, Moon HS, Kwon IS, Park JH, Kim JS, Kang SH, Sung JK, Lee ES, Kim SH, Lee BS, Jeong HY. Analysis of factors associated with local recurrence after endoscopic resection of gastric epithelial dysplasia: a retrospective study. BMC Gastroenterol 2020; 20:148. [PMID: 32397967 PMCID: PMC7216613 DOI: 10.1186/s12876-020-01293-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 05/05/2020] [Indexed: 02/06/2023] Open
Abstract
Background Endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) are widely used techniques for the treatment of gastric epithelial dysplasia. Previous studies have compared the clinical outcome of endoscopic resection for early gastric cancer, but few studies have focused on gastric dysplasia alone. This study aimed to evaluate the long-term prognosis following endoscopic procedures for gastric epithelial dysplasia, investigate differences in local recurrence rates according to the treatment modality, and identify risk factors associated with local recurrence. Methods In this retrospective study, local recurrence rates and risk factors associated with local recurrence were compared between 599 patients who underwent EMR and 306 who underwent ESD for gastric epithelial dysplasia from January 2011 to December 2015. Results The en bloc resection rate (32.2% vs. 100%, p < 0.001) and complete resection rate (94.8% vs. 99.0%, p = 0.003) were significantly lower in the EMR group than in the ESD group. The local recurrence rate was significantly lower in the ESD group (1.3%) than in the EMR group (4.2%; p = 0.026). There was a significantly increased risk of local recurrence, regardless of lesion location or histologic grade, in patients with lesions > 2 cm (p = 0.002) or red in color (p = 0.03). The ESD group had a significantly lower local recurrence rate, with a higher complete resection rate, than that in the EMR group (p < 0.05). In the case of recurrence after endoscopic resection, most of the recurred lesions were removed through additional endoscopic procedures; there was no difference between the two groups (p = 0.153). Conclusions The complete resection rate was significantly higher, and the local recurrence rate was significantly lower, in patients with gastric epithelial dysplasia treated with ESD. Therefore, ESD should be considered the preferred treatment in patients with lesions > 2 cm or showing redness due to an increased risk of local recurrence and EMR may be possible for low-grade dysplasia that is less than 2 cm without surface changes such as redness, depression and nodularity.
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Affiliation(s)
- Min Kyung Back
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, Korea
| | - Hee Seok Moon
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, Korea. .,Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea.
| | - In Sun Kwon
- Clinical Trials Center, Chungnam National University Hospital, Daejeon, 34952, Korea
| | - Jae Ho Park
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, Korea
| | - Ju Seok Kim
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, Korea
| | - Sun Hyung Kang
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, Korea
| | - Jae Kyu Sung
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, Korea
| | - Eaum Seok Lee
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, Korea
| | - Seok Hyun Kim
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, Korea
| | - Byung Seok Lee
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, Korea
| | - Hyun Yong Jeong
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, Korea
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Joo JS, Cho SY, Rou WS, Kim JS, Kang SH, Lee ES, Moon HS, Kim SH, Sung JK, Kwon IS, Eun HS, Lee BS. TEAD2 as a novel prognostic factor for hepatocellular carcinoma. Oncol Rep 2020; 43:1785-1796. [PMID: 32323824 PMCID: PMC7160555 DOI: 10.3892/or.2020.7578] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 02/14/2020] [Indexed: 12/26/2022] Open
Abstract
TEA Domain Transcription Factors (TEADs) are important in development and serve essential roles in tumorigenesis; however, the role of TEAD2 expression in hepatocellular carcinoma (HCC) has not been widely examined. The present study was conducted to investigate the expression status of TEAD2 in HCC and to evaluate whether the expression of TEAD2 is associated with the prognosis of patients with HCC. mRNA expression data was retrieved for Hippo pathway genes of 50 normal control and 377 HCC samples from The Cancer Genome Atlas data portal. Gene set enrichment, GeneNeighbors, ClassNeighbors and survival analyses were then performed based on the gene expression levels. The mRNA expression of TEAD2 and VGLL4 was significantly higher in HCC compared with the normal control samples, and the mRNA expression of TEAD2 was higher in advanced stages than in early stages. Specifically, survival analysis revealed that higher mRNA expression of TEAD2 was significantly associated with a less favorable overall survival rate (P=0.0067) and there was a trend towards significance between higher mRNA expression of VGLL4 and poor overall survival rate (P=0.051). According to the gene set enrichment analysis, patients with higher mRNA expression of TEAD2 and VGLL4 had strongly enhanced epithelial-mesenchymal transition and angiogenesis, which are associated with tumor progression. In conclusion, increased mRNA expression of TEAD2 is associated with a poor prognosis in patients with HCC. TEAD2 may serve as a prognostic factor for HCC and a novel therapeutic target.
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Affiliation(s)
- Jong Seok Joo
- Department of Internal Medicine, Chungnam National University School of Medicine, Jung‑gu, Daejeon 35015, Republic of Korea
| | - Sang Yeon Cho
- Department of Internal Medicine, Chungnam National University School of Medicine, Jung‑gu, Daejeon 35015, Republic of Korea
| | - Woo Sun Rou
- Department of Internal Medicine, Chungnam National University School of Medicine, Jung‑gu, Daejeon 35015, Republic of Korea
| | - Ju Seok Kim
- Department of Internal Medicine, Chungnam National University School of Medicine, Jung‑gu, Daejeon 35015, Republic of Korea
| | - Sun Hyung Kang
- Department of Internal Medicine, Chungnam National University School of Medicine, Jung‑gu, Daejeon 35015, Republic of Korea
| | - Eaum Seok Lee
- Department of Internal Medicine, Chungnam National University School of Medicine, Jung‑gu, Daejeon 35015, Republic of Korea
| | - Hee Seok Moon
- Department of Internal Medicine, Chungnam National University School of Medicine, Jung‑gu, Daejeon 35015, Republic of Korea
| | - Seok Hyun Kim
- Department of Internal Medicine, Chungnam National University School of Medicine, Jung‑gu, Daejeon 35015, Republic of Korea
| | - Jae Kyu Sung
- Department of Internal Medicine, Chungnam National University School of Medicine, Jung‑gu, Daejeon 35015, Republic of Korea
| | - In Sun Kwon
- Clinical Trial Center, Chungnam National University Hospital, Jung‑gu, Daejeon 35015, Republic of Korea
| | - Hyuk Soo Eun
- Department of Internal Medicine, Chungnam National University School of Medicine, Jung‑gu, Daejeon 35015, Republic of Korea
| | - Byung Seok Lee
- Department of Internal Medicine, Chungnam National University School of Medicine, Jung‑gu, Daejeon 35015, Republic of Korea
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Lee YM, Kang SH, Kim JS, Eun HS, Joo JS, Rou WS, Park JH, Moon HS, Lee ES, Kim SH, Sung JK, Lee BS, Jeong HY, Yeo MK, Song KS, Yoo HM. Subepithelial Spread of Early Gastric Signet Ring Cell Carcinoma: How Far They Can Reach? Dig Dis 2020; 38:442-448. [PMID: 32187603 DOI: 10.1159/000507322] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 03/17/2020] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Although signet ring cell carcinoma (SRC) is a poorly differentiated cancer subtype, recent studies suggest that endoscopic resection can be applied in small, mucosal early gastric SRC. However, other studies report frequent positive lines at the lateral resection margin after endoscopic treatment. Subepithelial spread beneath normal mucosa can exist in SRC, and such lesions may be the cause of positive margins after endoscopic resection. Thus, we conducted a retrospective study in order to evaluate the significance of subepithelial spread in early gastric SRC. METHOD Medical records of early gastric SRC patients who underwent surgery or endoscopic resection from January 2011 to December 2016 at a single tertiary hospital (Daejeon, South Korea) were reviewed to examine subepithelial spread and clinical datum. Two expert pathologists reviewed all pathologic specimens, and only patients showing a pure SRC component were included. RESULTS Eighty-six patients were initially enrolled, and subepithelial spread existed in 62 patients (72.1%). The mean distance of subepithelial spread was 1,132.1 µm, and the maximal distance was 6,000 μm. Only discoloration was significantly associated with the presence of a subepithelial spread (p < 0.05, χ2 test, and logistic regression test). Distance of subepithelial spread did not correlate with total lesion size. CONCLUSION Subepithelial spread of early gastric SRC occurs frequently and can reach up to 6 mm. Lesion discoloration may be associated with the presence of subepithelial spread. Our results suggest that careful decision of the margin is needed when performing endoscopic resection of early gastric SRC.
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Affiliation(s)
- Yong Moon Lee
- Department of Pathology, Dankook University School of Medicine, Cheonan, Republic of Korea
| | - Sun Hyung Kang
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Republic of Korea,
| | - Ju Seok Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Hyuk Soo Eun
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Jong Seok Joo
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Woo Sun Rou
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Jae Ho Park
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Hee Seok Moon
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Eaum Seok Lee
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Seok Hyun Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Jae Kyu Sung
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Byung Seok Lee
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Hyun Yong Jeong
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Min Kyung Yeo
- Department of Pathology, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Kyu Sang Song
- Department of Pathology, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Hee Min Yoo
- Center for Bioanalysis, Korea Research Institute of Standards and Science, Daejeon, Republic of Korea
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Abstract
OBJECTIVE Many people experience orthopaedic problems (OPPs), such as knee joint pain, hip joint pain, low back pain, and knee stiffness in their lifetimes. OPPs can impair lower extremity function, cause depression, and worsen quality of life. The aim of this study was to investigate the association between sedentary time (SDT) and OPPs. DESIGN Retrospective cross-sectional study. SETTING This study used data from the 2014-2015 Korea National Health and Nutrition Examination Survey. Survey participants with previous or current osteoarthritis or rheumatoid arthritis, as diagnosed by a doctor, were excluded. OPPs were defined as knee joint pain, hip joint pain, low back pain, and knee stiffness. The cut-off value for SDT was 7.5 hours/day. The study population comprised 3,671 people (1,856 men and 1,815 women), all of whom were ≥50 years-old. Multiple logistic regression analyses were performed. RESULTS A total of 328 men (17.7%) and 519 women (28.6%) had OPPs. Men with SDTs ≥7.5 hours had a greater risk of OPPs than did men with SDTs <7.5 hours (odds ratio [OR], 1.45; 95% confidence interval [CI], 1.08-1.93). A pink-collar job, physical inactivity during leisure time, and passive (e.g. riding in a car or train) versus active (e.g. walking or riding a bicycle) transportation predicted OPPs in men with SDTs ≥7.5 hours. SDT was a risk factor for knee joint pain in men (OR, 1.80; 95% CI, 1.11-2.92) and hip joint pain in women (OR, 2.05; 95% CI, 1.35-3.11). CONCLUSIONS In men, prolonged SDT is a risk factor for OPPs. More physical activity programmes should be launched at the community level for people ≥50 years-old to reduce the occurrence of OPPs.
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Affiliation(s)
- S H Kang
- Sung-In Jang, MD, Department of preventive Medicine and Institute of Health Services Research, Yonsei University College of Medicine, 50 Yonsei-to, Seodaemun-gu, Seoul 03722, Republic of Korea, Tel: +82-2-2228-1863; E-mail: ; Fax: +82-2-392-8133
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Kim DK, Kang SH, Kim JS, Rou WS, Joo JS, Kim MH, Eun HS, Moon HS, Lee ES, Kim SH, Sung JK, Lee BS, Jeong HY. Feasibility of using two-dimensional axial computed tomography in pretreatment decision making for patients with early gastric cancer. Medicine (Baltimore) 2020; 99:e18928. [PMID: 31977908 PMCID: PMC7004674 DOI: 10.1097/md.0000000000018928] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Computed tomography (CT) is widely used in the pretreatment period of early gastric cancer (EGC). Only few studies have reported low accuracy of CT imaging for T and N staging in patients with EGC. However, owing to the limited number of studies, the value of CT imaging for EGC staging is not well known. Thus, we conducted a retrospective cross-sectional study regarding the associations among submucosal invasion, lymph node metastasis, and CT findings.The medical records of patients with EGC who had surgery or endoscopic resection were reviewed in a single center from January 2011 to December 2016. We evaluated the histological type, invasion depth, and lymph node (LN) metastasis on the basis of two-dimensional CT findings.We enrolled 1544 patients. Submucosal (SM) invasion was related to tumor size, histological type, and wall thickening or enhancement on CT images. Deep SM invasion (>500 μm) was also related to tumor size, poorly differentiated type, and abnormal CT findings (wall thickening, enhancement, and central depression). Among the patients with LN reactive positivity (0.5-1 cm), those who were female and had a tumor invasion of >1000 μm showed a higher prevalence of LN metastasis. The false-negative LN group had a higher prevalence of large tumors (>3 cm), poor differentiation, and SM invasion than the true-negative group.Wall thickening, enhancement, and central depression on CT images might be related to SM invasion. Patients with any positive CT findings needs more attention when performing ESD.
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