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Lee A, Kim SY, Kang S, Kang SH, Kim DW, Choe JW, Hyun JJ, Jung SW, Jung YK, Koo JS, Yim HJ, Kim S. Effect of Probiotics in Stress-Associated Constipation Model in Zebrafish ( Danio rerio) Larvae. Int J Mol Sci 2024; 25:3669. [PMID: 38612481 PMCID: PMC11012156 DOI: 10.3390/ijms25073669] [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: 02/21/2024] [Revised: 03/18/2024] [Accepted: 03/22/2024] [Indexed: 04/14/2024] Open
Abstract
The pathophysiology of functional bowel disorders is complex, involving disruptions in gut motility, visceral hypersensitivity, gut-brain-microbiota interactions, and psychosocial factors. Light pollution, as an environmental stressor, has been associated with disruptions in circadian rhythms and the aggravation of stress-related conditions. In this study, we investigated the effects of environmental stress, particularly continuous light exposure, on intestinal motility and inflammation using zebrafish larvae as a model system. We also evaluated the efficacy of probiotics, specifically Bifidobacterium longum (B. longum), at alleviating stress-induced constipation. Our results showed that continuous light exposure in zebrafish larvae increased the cortisol levels and reduced the intestinal motility, establishing a stress-induced-constipation model. We observed increased inflammatory markers and decreased intestinal neural activity in response to stress. Furthermore, the expressions of aquaporins and vasoactive intestinal peptide, crucial for regulating water transport and intestinal motility, were altered in the light-induced constipation model. Administration of probiotics, specifically B. longum, ameliorated the stress-induced constipation by reducing the cortisol levels, modulating the intestinal inflammation, and restoring the intestinal motility and neural activity. These findings highlight the potential of probiotics to modulate the gut-brain axis and alleviate stress-induced constipation. Therefore, this study provides a valuable understanding of the complex interplay among environmental stressors, gut function, and potential therapeutic strategies.
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Affiliation(s)
- Ayoung Lee
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, College of Medicine, Korea University, Ansan 15355, Republic of Korea; (A.L.); (S.Y.K.); (S.H.K.); (D.W.K.); (J.W.C.); (J.J.H.); (S.W.J.); (Y.K.J.); (J.S.K.); (H.J.Y.)
| | - Seung Young Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, College of Medicine, Korea University, Ansan 15355, Republic of Korea; (A.L.); (S.Y.K.); (S.H.K.); (D.W.K.); (J.W.C.); (J.J.H.); (S.W.J.); (Y.K.J.); (J.S.K.); (H.J.Y.)
- Zebrafish Translational Medical Research Center, Korea University, Ansan 15355, Republic of Korea;
| | - Seyoung Kang
- Zebrafish Translational Medical Research Center, Korea University, Ansan 15355, Republic of Korea;
| | - Seong Hee Kang
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, College of Medicine, Korea University, Ansan 15355, Republic of Korea; (A.L.); (S.Y.K.); (S.H.K.); (D.W.K.); (J.W.C.); (J.J.H.); (S.W.J.); (Y.K.J.); (J.S.K.); (H.J.Y.)
| | - Dong Woo Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, College of Medicine, Korea University, Ansan 15355, Republic of Korea; (A.L.); (S.Y.K.); (S.H.K.); (D.W.K.); (J.W.C.); (J.J.H.); (S.W.J.); (Y.K.J.); (J.S.K.); (H.J.Y.)
| | - Jung Wan Choe
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, College of Medicine, Korea University, Ansan 15355, Republic of Korea; (A.L.); (S.Y.K.); (S.H.K.); (D.W.K.); (J.W.C.); (J.J.H.); (S.W.J.); (Y.K.J.); (J.S.K.); (H.J.Y.)
| | - Jong Jin Hyun
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, College of Medicine, Korea University, Ansan 15355, Republic of Korea; (A.L.); (S.Y.K.); (S.H.K.); (D.W.K.); (J.W.C.); (J.J.H.); (S.W.J.); (Y.K.J.); (J.S.K.); (H.J.Y.)
| | - Sung Woo Jung
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, College of Medicine, Korea University, Ansan 15355, Republic of Korea; (A.L.); (S.Y.K.); (S.H.K.); (D.W.K.); (J.W.C.); (J.J.H.); (S.W.J.); (Y.K.J.); (J.S.K.); (H.J.Y.)
| | - Young Kul Jung
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, College of Medicine, Korea University, Ansan 15355, Republic of Korea; (A.L.); (S.Y.K.); (S.H.K.); (D.W.K.); (J.W.C.); (J.J.H.); (S.W.J.); (Y.K.J.); (J.S.K.); (H.J.Y.)
| | - Ja Seol Koo
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, College of Medicine, Korea University, Ansan 15355, Republic of Korea; (A.L.); (S.Y.K.); (S.H.K.); (D.W.K.); (J.W.C.); (J.J.H.); (S.W.J.); (Y.K.J.); (J.S.K.); (H.J.Y.)
| | - Hyung Joon Yim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, College of Medicine, Korea University, Ansan 15355, Republic of Korea; (A.L.); (S.Y.K.); (S.H.K.); (D.W.K.); (J.W.C.); (J.J.H.); (S.W.J.); (Y.K.J.); (J.S.K.); (H.J.Y.)
| | - Suhyun Kim
- Zebrafish Translational Medical Research Center, Korea University, Ansan 15355, Republic of Korea;
- Department of Biomedical Sciences, College of Medicine, Korea University, Seoul 04763, Republic of Korea
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Ferlini Agne G, Kapusniak AE, Wooldridge AA, Jung SW. Clinical effect of torsemide in a horse with congestive heart failure and atrial fibrillation. J Equine Vet Sci 2024; 133:105001. [PMID: 38190865 DOI: 10.1016/j.jevs.2024.105001] [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] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 01/03/2024] [Accepted: 01/04/2024] [Indexed: 01/10/2024]
Abstract
In this case report, a high dose of torsemide (6mg/kg, every 12 hours for 3 days followed by 12mg/kg, every 12 hours for 4 days) was administered orally to a horse with congestive heart failure (CHF) and atrial fibrillation. Blood samples for measurement of plasma torsemide concentrations were obtained one hour after each drug administration. Pharmacodynamic effects of oral torsemide were evaluated by daily physical examination, electrocardiography, and serum biochemistry. The horse tolerated administration of torsemide. A decrease in ventral oedema and venous congestion was subjectively noted at day 7. Torsemide plasma concentration markedly increased at day 5 (peak concentration of 15.41 µg/mL). Evidence of an increase in renal markers was observed throughout the study period. Electrolyte measurements revealed mild hyponatremia and hypochloremia, and moderate hypokalaemia. No electrocardiographic changes related to torsemide administration were observed. After seven days of treatment, the horse was euthanised due to his disease stage and poor prognosis. Results indicate that torsemide was absorbed after oral administration and was well tolerated in this horse. Furthermore, clinical improvement in this single case indicates that torsemide might be utilized as an oral alternative to furosemide in the management of equine patients in CHF. The high doses of torsemide used in this case report should be reserved for cases without clinical response to lower doses and with close monitoring of electrolytes and renal function parameters. Further investigation of torsemide clinical efficacy and safety in horses with CHF with a larger cohort and prolonged administration is warranted.
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Affiliation(s)
- G Ferlini Agne
- School of Animal and Veterinary Sciences, The University of Adelaide, 1454 Mudla Wirra Road, Roseworthy, 5371, South Australia, Australia.
| | - A E Kapusniak
- School of Animal and Veterinary Sciences, The University of Adelaide, 1454 Mudla Wirra Road, Roseworthy, 5371, South Australia, Australia
| | - A A Wooldridge
- Department of Clinical Sciences, Auburn University, 1130 Wire Rd., Auburn 36849, Alabama, United States
| | - S W Jung
- Department of Clinical Sciences, Auburn University, 1130 Wire Rd., Auburn 36849, Alabama, United States
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Cho YK, Kim JH, Kim HS, Kim TO, Oh JH, Choi SC, Moon JS, Lee SK, Jung SW, Kim SS, Jung HK, Lee SP, Cheon GJ, Park MI, Jung HY, Ko KH, Sung IK, Lee SH, Lee JY, Lee ST, Rhee PL, Kim N, Hong SJ, Kim HJ, Kim GH, Lee KJ, Kim SK, Shin WG, Lee OY. Randomised clinical trial: comparison of tegoprazan and lansoprazole as maintenance therapy for healed mild erosive oesophagitis. Aliment Pharmacol Ther 2023; 57:72-80. [PMID: 36314172 PMCID: PMC10092320 DOI: 10.1111/apt.17255] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [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] [Received: 08/03/2022] [Revised: 08/08/2022] [Accepted: 10/06/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Tegoprazan is a novel potassium-competitive acid blocker used to treat acid-related disorders. AIM To compare tegoprazan 25 mg with lansoprazole 15 mg as maintenance therapy in healed erosive oesophagitis (EE) METHODS: In this phase 3, double-blind, multi-centre study, patients with endoscopically confirmed healed EE were randomised 1:1 to receive tegoprazan 25 mg or lansoprazole 15 mg once daily for up to 24 weeks. The primary efficacy endpoint was the endoscopic remission rate after 24 weeks. The secondary efficacy endpoint was the endoscopic remission rate after 12 weeks. Safety endpoints included adverse events, clinical laboratory results and serum gastrin and pepsinogen I/II levels. RESULTS We randomised patients to tegoprazan 25 mg (n = 174) or lansoprazole 15 mg (n = 177). Most had mild EE (Los Angeles (LA) grade A: 57.3%, LA grade B: 37.3%). The endoscopic remission rate after 24 weeks was 90.6% with tegoprazan and 89.5% with lansoprazole. Tegoprazan was not inferior to lansoprazole for maintaining endoscopic remission at 24 weeks and 12 weeks. In subgroup analysis, tegoprazan 25 mg showed no significant difference in maintenance rate according to LA grade (p = 0.47). The maintenance effect of tegoprazan was consistent in CYP2C19 extensive metabolisers (p = 0.76). Increases in serum gastrin were not higher in tegoprazan-treated than lansoprazole-treated patients. CONCLUSIONS Tegoprazan 25 mg was non-inferior to lansoprazole 15 mg in maintenance of healing of mild EE. In this study, tegoprazan had a similar safety profile to lansoprazole.
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Affiliation(s)
- Yu Kyung Cho
- Catholic Photomedicine Research Institute, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Jae Hak Kim
- Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, South Korea
| | - Hyun-Soo Kim
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju Christian Hospital, Wonju, South Korea
| | - Tae-Oh Kim
- Department of Internal Medicine, Inje University Haeundae Paik Hospital, Busan, South Korea
| | - Jung-Hwan Oh
- Department of Internal Medicine, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Suck Chei Choi
- Department of Internal Medicine, Wonkwang University Hospital, Iksan, South Korea
| | - Jeong Seop Moon
- Department of Internal Medicine, Inje University, Seoul Paik Hospital, Seoul, South Korea
| | - Sang Kil Lee
- Department of Internal Medicine, Yonsei University College of Medicine, Severance Hospital, Seoul, South Korea
| | - Sung Woo Jung
- Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Sung Soo Kim
- Department of Internal Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, South Korea
| | - Hye-Kyung Jung
- Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, South Korea
| | - Sang Pyo Lee
- Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, South Korea
| | - Gab-Jin Cheon
- Department of Internal Medicine, GangNeung Asan Hospital, College of Medicine, Ulsan University, Gangneung, South Korea
| | - Moo In Park
- Department of Internal Medicine, Kosin University College of Medicine, Busan, South Korea
| | - Hwoon-Yong Jung
- Department of Gastroenterology, Asan Medical Center, University of Ulsan, Seoul, South Korea
| | - Kwang Hyun Ko
- Digestive Disease Center, CHA Bundang Medical Center, CHA University, Seongnam, South Korea
| | - In Kyung Sung
- Department of Internal Medicine, Konkuk University Medical Center, Seoul, South Korea
| | - Si Hyung Lee
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, South Korea
| | - Ju Yup Lee
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu, South Korea
| | - Soo Teik Lee
- Department of Internal Medicine, Jeonbuk National University Hospital, Jeonju, South Korea
| | - Poong-Lyul Rhee
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University, Seoul, South Korea
| | - Nayoung Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam and Seoul National University College of Medicine, Seoul, South Korea
| | - Su Jin Hong
- Department of Internal Medicine, Soonchunhyang University College of Medicine, Bucheon, South Korea
| | - Hyun Jin Kim
- Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Changwon, South Korea
| | - Gwang Ha Kim
- Department of Internal Medicine, Pusan National University College of Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Kwang Jae Lee
- Department of Gastroenterology, Ajou University Hospital, Ajou University School of Medicine, Suwon, South Korea
| | - Sung Kook Kim
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, South Korea
| | - Woon Geon Shin
- Department of Internal Medicine, Hallym University College of Medicine/Institute for Liver and Digestive Diseases, Chuncheon, South Korea
| | - Oh Young Lee
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, South Korea
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Kim D, Koun S, Kim SY, Ha YR, Choe JW, Jung SW, Hyun JJ, Jung YK, Koo JS, Yim HJ, Lee SW. Prokinetic effects of diatrizoate meglumine (Gastrografin®) in a zebrafish for opioid-induced constipation model. Anim Cells Syst (Seoul) 2021; 25:264-271. [PMID: 34745433 PMCID: PMC8567942 DOI: 10.1080/19768354.2021.1991472] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Constipation is a common disease that reduces life quality. Drugs of various mechanisms are being developed to resolve this affliction. Intestinal motility can be easily monitored in zebrafish, and so we selected this organism to develop a constipation model to measure drug-induced prokinetic effects. In this study, intestinal motility was monitored in zebrafish by tracking intestinal transit using fluorescence, after which an opioid-induced constipation model was established using loperamide. We then evaluated the prokinetic effect of diatrizoate meglumine (Gastrografin®), which has been empirically used to treat post-operative ileus or adhesive small bowel obstructions. Diatrizoate meglumine was effective in promoting bowel movements in an opioid-induced zebrafish constipation model and its prokinetic effect was associated with an increased expression of interstitial cells of Cajal (ICC) markers. Therefore, the loperamide-induced zebrafish constipation model developed herein is a promising tool to evaluate novel constipation therapies.
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Affiliation(s)
- Dongwoo Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Soonil Koun
- Biochemical Research Center, Korea University Ansan Hospital, Ansan, Republic of Korea.,Korea University Zebrafish Translational Medical Research Center, Ansan, Republic of Korea
| | - Seung Young Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Seoul, Republic of Korea.,Korea University Zebrafish Translational Medical Research Center, Ansan, Republic of Korea
| | - Young Ran Ha
- Biochemical Research Center, Korea University Ansan Hospital, Ansan, Republic of Korea
| | - Jung Wan Choe
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Sung Woo Jung
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Jong Jin Hyun
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Young Kul Jung
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Ja Seol Koo
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Hyung Joon Yim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Sang Woo Lee
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Seoul, Republic of Korea
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Cha S, Kim DW, Choe JW, Kim TH, Kim SY, Hyun JJ, Jung SW, Koo JS, Jung YK, Yim HJ. A case report of a patient presented with skin ulcer after treatment of lenvatinib. J Liver Cancer 2021; 21:194-198. [PMID: 37383088 PMCID: PMC10035686 DOI: 10.17998/jlc.2021.09.20] [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] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 09/18/2021] [Accepted: 09/20/2021] [Indexed: 06/30/2023]
Abstract
A 60-year-old man diagnosed with unresectable hepatocellular carcinoma (HCC) presented to the hospital with pain in the perineal region. He had been taking lenvatinib every day for 2 months after he was diagnosed with HCC with metastases to the lymph node, small bowel mesentery, and retroperitoneal space. Enhanced abdominal computed tomography revealed mild elevation in intensity in the perineal subcutaneous tissue with subcutaneous emphysema. The patient was diagnosed with Common Terminology Criteria for Adverse Events grade 3, skin ulceration of stage IV with full-thickness skin loss and tissue necrosis in the muscular layer. The patient was taken off the medication with prescription of antibiotics, and after 3 weeks, the skin has fully recovered. This is the first report of an HCC patient who presented with a skin ulceration of stage IV after lenvatinib treatment. We recommend stopping the medication immediately and changing to alternative treatments with appropriate supportive care.
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Affiliation(s)
- Serin Cha
- Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Dong Woo Kim
- Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Jung Wan Choe
- Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Tae Hyung Kim
- Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Seung Young Kim
- Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Jong Jin Hyun
- Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Sung Woo Jung
- Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Ja Seol Koo
- Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Young Kul Jung
- Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Hyung Joon Yim
- Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
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Cho E, Jung SW, Park IJ, Jang JK, Park SH, Hong SM, Lee JL, Kim CW, Yoon YS, Lim SB, Yu CS, Kim JC. Improvement in the Assessment of Response to Preoperative Chemoradiotherapy for Rectal Cancer Using Magnetic Resonance Imaging and a Multigene Biomarker. Cancers (Basel) 2021; 13:cancers13143480. [PMID: 34298695 PMCID: PMC8305437 DOI: 10.3390/cancers13143480] [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] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 07/09/2021] [Accepted: 07/09/2021] [Indexed: 11/16/2022] Open
Abstract
The response to preoperative chemoradiotherapy (PCRT) is correlated with oncologic outcomes in patients with locally advanced rectal cancer. Accurate prediction of PCRT response before surgery can provide crucial information to aid clinicians in further treatment planning. This study aimed to develop an evaluation tool incorporating a genetic biomarker and magnetic resonance imaging (MRI) to improve the assessment of response in post-CRT patients with locally advanced rectal cancer. A total of 198 patients who underwent PCRT followed by surgical resection for locally advanced rectal cancer between 2010 and 2016 were included in this study. Each patient's response prediction index (RPI) score, a multigene biomarker developed in our previous study, and magnetic resonance tumor regression grade (mrTRG) score were added to create a new predictive value for pathologic response after PCRT, called the combined radiation prediction value (cRPV). Based on the new value, 121 and 77 patients were predicted to be good and poor responders, respectively, showing significantly different cRPV values (p = 0.001). With an overall predictive accuracy of 84.8%, cRPV was superior to mrTRG and RPI for the prediction of pathologic chemoradiotherapy response (mrTRG, 69.2%; RPI, 77.3%). In multivariate analysis, cRPV was found to be the sole predictor of tumor response (odds ratio, 32.211; 95% confidence interval, 14.408-72.011; p = 0.001). With its good predictive value for final pathologic regression, cRPV may be a valuable tool for assessing the response to PCRT before surgery.
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Affiliation(s)
- Eunhae Cho
- Asan Medical Center, Department of Colon and Rectal Surgery, University of Ulsan College of Medicine, Seoul 05505, Korea; (E.C.); (J.L.L.); (C.W.K.); (Y.S.Y.); (S.-B.L.); (C.S.Y.); (J.C.K.)
| | - Sung Woo Jung
- Department of General Surgery, Good Morning Hospital, Pyeongtaek-si 17874, Korea;
| | - In Ja Park
- Asan Medical Center, Department of Colon and Rectal Surgery, University of Ulsan College of Medicine, Seoul 05505, Korea; (E.C.); (J.L.L.); (C.W.K.); (Y.S.Y.); (S.-B.L.); (C.S.Y.); (J.C.K.)
- Correspondence: ; Tel.: +82-2-3010-3937
| | - Jong Keon Jang
- Asan Medical Center, Department of Radiology, University of Ulsan College of Medicine, Seoul 05505, Korea; (J.K.J.); (S.H.P.)
| | - Seong Ho Park
- Asan Medical Center, Department of Radiology, University of Ulsan College of Medicine, Seoul 05505, Korea; (J.K.J.); (S.H.P.)
| | - Seung-Mo Hong
- Asan Medical Center, Department of Pathology, University of Ulsan College of Medicine, Seoul 05505, Korea;
| | - Jong Lyul Lee
- Asan Medical Center, Department of Colon and Rectal Surgery, University of Ulsan College of Medicine, Seoul 05505, Korea; (E.C.); (J.L.L.); (C.W.K.); (Y.S.Y.); (S.-B.L.); (C.S.Y.); (J.C.K.)
| | - Chan Wook Kim
- Asan Medical Center, Department of Colon and Rectal Surgery, University of Ulsan College of Medicine, Seoul 05505, Korea; (E.C.); (J.L.L.); (C.W.K.); (Y.S.Y.); (S.-B.L.); (C.S.Y.); (J.C.K.)
| | - Yong Sik Yoon
- Asan Medical Center, Department of Colon and Rectal Surgery, University of Ulsan College of Medicine, Seoul 05505, Korea; (E.C.); (J.L.L.); (C.W.K.); (Y.S.Y.); (S.-B.L.); (C.S.Y.); (J.C.K.)
| | - Seok-Byung Lim
- Asan Medical Center, Department of Colon and Rectal Surgery, University of Ulsan College of Medicine, Seoul 05505, Korea; (E.C.); (J.L.L.); (C.W.K.); (Y.S.Y.); (S.-B.L.); (C.S.Y.); (J.C.K.)
| | - Chang Sik Yu
- Asan Medical Center, Department of Colon and Rectal Surgery, University of Ulsan College of Medicine, Seoul 05505, Korea; (E.C.); (J.L.L.); (C.W.K.); (Y.S.Y.); (S.-B.L.); (C.S.Y.); (J.C.K.)
| | - Jin Cheon Kim
- Asan Medical Center, Department of Colon and Rectal Surgery, University of Ulsan College of Medicine, Seoul 05505, Korea; (E.C.); (J.L.L.); (C.W.K.); (Y.S.Y.); (S.-B.L.); (C.S.Y.); (J.C.K.)
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7
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Kim GH, Lee HL, Joo MK, Park HJ, Jung SW, Lee OJ, Kim H, Chun HJ, Lee ST, Kim JW, Jeon HH, Chung IK, Kim HS, Lee DH, Kim KO, Lim YJ, Park SJ, Cho SJ, Kim BW, Ko KH, Jeon SW, Kim JG, Sung IK, Kim TN, Sung JK, Park JJ. Efficacy and Safety of Rebamipide versus Its New Formulation, AD-203, in Patients with Erosive Gastritis: A Randomized, Double- Blind, Active Control, Noninferiority, Multicenter, Phase 3 Study. Gut Liver 2021; 15:841-850. [PMID: 33827990 PMCID: PMC8593495 DOI: 10.5009/gnl20338] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 12/10/2020] [Accepted: 12/28/2020] [Indexed: 11/22/2022] Open
Abstract
Background/Aims The mucoprotective drug rebamipide is used to treat gastritis and peptic ulcers. We compared the efficacy of MucostaⓇ (rebamipide 100 mg) and its new formulation, AD-203 (rebamipide 150 mg), in treating erosive gastritis. Methods This double-blind, active control, noninferiority, multicenter, phase 3 clinical trial randomly assigned 475 patients with endoscopically proven erosive gastritis to two groups AD-203 twice daily or MucostaⓇ thrice daily for 2 weeks. The intention-to-treat (ITT) analysis included 454 patients (AD-203, n=229; MucostaⓇ, n=225), and the per-protocol (PP) analysis included 439 patients (AD-203, n=224; MucostaⓇ, n=215). The posttreatment assessments included the primary (erosion improvement rate) and secondary endpoints (erosion and edema cure rates; improvement rates of redness, hemorrhage, and gastrointestinal symptoms). Drug-related adverse events were evaluated. Results According to the ITT analysis, the erosion improvement rates (posttreatment) in AD-203-treated and MucostaⓇ-treated patients were 39.7% and 43.8%, respectively. According to the PP analysis, the erosion improvement rates (posttreatment) in AD-203-treated and MucostaⓇ-treated patients were 39.3% and 43.7%, respectively. The one-sided 97.5% lower limit for the improvement rate difference between the study groups was −4.01% (95% confidence interval [CI], –13.09% to 5.06%) in the ITT analysis and −4.44% (95% CI, –13.65% to 4.78%) in the PP analysis. The groups did not significantly differ in the secondary endpoints in either analysis. Twenty-four AD-203-treated and 20 MucostaⓇ-treated patients reported adverse events but no serious adverse drug reactions; both groups presented similar adverse event rates. Conclusions The new formulation of rebamipide 150 mg (AD-203) twice daily was not inferior to rebamipide 100 mg (MucostaⓇ) thrice daily. Both formulations showed a similar efficacy in treating erosive gastritis.
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Affiliation(s)
- Gwang Ha Kim
- Department of Internal Medicine, Pusan National University College of Medicine, and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Hang Lak Lee
- Department of Internal Medicine, Hanyang University Hospital, Seoul, Korea
| | - Moon Kyung Joo
- Division of Gastroenterology, Department of Internal Medicine, Korea University Guro Hospital, Seoul, Korea
| | - Hong Jun Park
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Sung Woo Jung
- Division of Gastroenterology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Ok-Jae Lee
- Department of Internal Medicine, Gyeongsang National University College of Medicine, Jinju, Korea
| | - Hyungkil Kim
- Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea
| | - Hoon Jai Chun
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Institute of Gastrointestinal Medical Instrument Research, Korea University College of Medicine, Seoul, Korea
| | - Soo Teik Lee
- Department of Internal Medicine, Jeonbuk National University Hospital, Jeonju, Korea
| | - Ji Won Kim
- Department of Internal Medicine, SMG-SNU Boramae Medical Center, Seoul National University of College of Medicine, Seoul, Korea
| | - Han Ho Jeon
- Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Il-Kwun Chung
- Department of Internal Medicine, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Hyun-Soo Kim
- Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Korea
| | - Dong Ho Lee
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Kyoung-Oh Kim
- Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - Yun Jeong Lim
- Department of Internal Medicine, Dongguk University College of Medicine, Seoul, Korea
| | - Seun-Ja Park
- Department of Internal Medicine, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Korea
| | - Soo-Jeong Cho
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Byung-Wook Kim
- Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kwang Hyun Ko
- Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Seong Woo Jeon
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Jae Gyu Kim
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - In-Kyung Sung
- Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Tae Nyeun Kim
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Jae Kyu Sung
- Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Korea
| | - Jong-Jae Park
- Division of Gastroenterology, Department of Internal Medicine, Korea University Guro Hospital, Seoul, Korea
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Jung SW. Endoscopic Treatment of Gastric and Duodenal Neuroendocrine Tumors: Present and Future. Korean J Helicobacter Up Gastrointest Res 2021. [DOI: 10.7704/kjhugr.2020.0055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Gastric and duodenal neuroendocrine tumors (NETs) are not common; however, there is an increase in the incidence due to increased use of endoscopy. Endoscopic treatment has been applied to treat small NET G1 in the stomach and duodenum. For the endoscopic treatment of NETs, it is necessary to evaluate tumor size, depth of invasion, and lymphatic and distant metastasis. This article will review the current knowledge concerning the endoscopic treatment of gastric and duodenal neuroendocrine tumors.
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9
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Choe JW, Kim SY, Lee DW, Hyun JJ, Ahn KR, Yoon I, Jung SW, Jung YK, Koo JS, Yim HJ, Lee SW. Incidence and risk factors for postoperative common bile duct stones in patients undergoing endoscopic extraction and subsequent cholecystectomy. Gastrointest Endosc 2021; 93:608-615. [PMID: 32598960 DOI: 10.1016/j.gie.2020.06.060] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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] [Received: 03/31/2020] [Accepted: 06/15/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIMS In patients who undergo cholecystectomy after endoscopic common bile duct (CBD) stone extraction, CBD stones found postoperatively could be problematic. This study aimed to investigate the incidence and risk factors of postoperative CBD stones after cholecystectomy. METHODS A total of 278 patients (mean age, 59.2 years; 71 men [51.1%]) who underwent endoscopic removal of CBD stones followed by cholecystectomy from January 2013 to December 2017 were included. An endoscopic nasobiliary drainage (ENBD) tube was placed immediately after endoscopic clearance of the CBD stones in all patients until cholecystectomy. An ENBD tubogram was obtained in all patients to determine the presence of postoperative CBD stones. RESULTS Postoperative CBD stones were detected in 20.1% (56/278). An ENBD tubogram was obtained after an average of 2.42 days postoperatively. Based on univariate analysis, the statistically significant risk factors for postoperative CBD stone were CBD stones >2, CBD stone size >10 mm, cholesterol stone, maximum diameter of CBD >15 mm, treatment with endoscopic sphincterotomy alone, and use of endoscopic mechanical lithotripsy (EML). In multivariate analysis, cholesterol stone, CBD stones >2, CBD stone size >10 mm, and EML were related to postoperative CBD stones after cholecystectomy. CONCLUSIONS Based on the relatively high rate of postoperative CBD stones after cholecystectomy, careful follow-up should be considered in patients with high-risk factors to detect CBD stones early.
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Affiliation(s)
- Jung Wan Choe
- Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Seung Young Kim
- Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Dong-Won Lee
- Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Jong Jin Hyun
- Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Ke Ryun Ahn
- Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Ik Yoon
- Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Sung Woo Jung
- Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Young Kul Jung
- Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Ja Seol Koo
- Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Hyung Joon Yim
- Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Sang Woo Lee
- Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
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Park JH, Kim D, Choe JW, Kim SY, Jung SW, Hyun JJ, Jung YK, Koo JS, Yim HJ, Lee SW. First-line Helicobacter pylori Eradication Rate of the 10-day Hybrid Therapy. Korean J Helicobacter Up Gastrointest Res 2020. [DOI: 10.7704/kjhugr.2020.0019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background/Aims: To improve the eradication rate of a first-line therapy for Helicobacter pylori infection, alternate regimens such as sequential, concomitant, and hybrid therapies have been tried. The aim of this study was to evaluate the eradication rate of the 10-day hybrid therapy as a first-line therapy.Materials and Methods: This retrospective study enrolled 124 patients from the Korea University Ansan Hospital between April 2016 and December 2019. The 10-day hybrid therapy comprised 5 days of dual therapy (proton pump inhibitor [PPI] standard dose and amoxicillin 1 g, twice daily) followed by 5 days of quadruple therapy (PPI, amoxicillin 1 g, clarithromycin 500 mg, and metronidazole 500 mg, twice daily). We compared the 10-day hybrid therapy with the 10-day concomitant therapy comprising PPI, amoxicillin 1 g, clarithromycin 500 mg, and metronidazole 500 mg, twice daily. Eradication was assessed by a <sup>13</sup>C-urea breath test or gastroscopic biopsy at least 4 weeks after treatment completion.Results: The eradication rates of the 10-day hybrid and concomitant therapies were 74.2% (46/62) and 67.7% (42/62), respectively, in the intention-to-treat (ITT) analysis and 88.5% (46/52) and 82.4% (42/51), respectively, in the per-protocol (PP) analysis. There was no significant difference in the eradication rates between the two groups in the ITT (P=0.429) and PP analysis (P=0.380). Adverse events developed in 75.0% and 70.6% of patients in the hybrid and concomitant groups, respectively, but there was no significant difference (P=0.615).Conclusions: The 10-day hybrid therapy can be an option for a first-line therapy of Helicobacter pylori infection.
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Brannagan TH, Wang AK, Coelho T, Waddington Cruz M, Polydefkis MJ, Dyck PJ, Plante-Bordeneuve V, Berk JL, Barroso F, Merlini G, Conceição I, Hughes SG, Kwoh J, Jung SW, Guthrie S, Pollock M, Benson MD, Gertz M. Early data on long-term efficacy and safety of inotersen in patients with hereditary transthyretin amyloidosis: a 2-year update from the open-label extension of the NEURO-TTR trial. Eur J Neurol 2020; 27:1374-1381. [PMID: 32343462 PMCID: PMC7496583 DOI: 10.1111/ene.14285] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 03/26/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND AND PURPOSE Hereditary transthyretin (hATTR) amyloidosis causes progressive polyneuropathy resulting from transthyretin (TTR) amyloid deposition throughout the body, including the peripheral nerves. The efficacy and safety of inotersen, an antisense oligonucleotide inhibitor of TTR protein production, were demonstrated in the pivotal NEURO-TTR study in patients with hATTR polyneuropathy. Here, the long-term efficacy and safety of inotersen are assessed in an ongoing open-label extension (OLE) study. METHODS Patients who completed NEURO-TTR were eligible to enroll in the OLE (NCT02175004). Efficacy assessments included the modified Neuropathy Impairment Score plus seven neurophysiological tests composite score (mNIS + 7), the Norfolk Quality of Life - Diabetic Neuropathy (Norfolk QOL-DN) questionnaire total score and the Short-Form 36 Health Survey (SF-36) Physical Component Summary (PCS) score. Safety and tolerability were also assessed. RESULTS Overall, 97% (135/139) of patients who completed NEURO-TTR enrolled in the OLE. Patients who received inotersen for 39 cumulative months in NEURO-TTR and the OLE continued to show benefit; patients who switched from placebo to inotersen in the OLE demonstrated improvement or stabilization of neurological disease progression by mNIS + 7, Norfolk QOL-DN and SF-36 PCS. No new safety concerns were identified. There was no evidence of increased risk for grade 4 thrombocytopenia or severe renal events with increased duration of inotersen exposure. CONCLUSION Inotersen slowed disease progression and reduced deterioration of quality of life in patients with hATTR polyneuropathy. Early treatment with inotersen resulted in greater long-term disease stabilization than delayed initiation. Routine platelet and renal safety monitoring were effective; no new safety signals were observed.
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Affiliation(s)
- T H Brannagan
- Columbia University Medical Center, New York, NY, USA
| | - A K Wang
- University of California, Irvine, Orange, CA, USA
| | - T Coelho
- Centro Hospitalar do Porto, Porto, Portugal
| | - M Waddington Cruz
- CEPARM, Amyloidosis Referral Center, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | | | | | - J L Berk
- Boston University, Boston, MA, USA
| | | | - G Merlini
- Amyloidosis Center, IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - I Conceição
- CHULN, Hospital Santa Maria and Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - S G Hughes
- Ionis Pharmaceuticals, Inc., Carlsbad, CA, USA
| | - J Kwoh
- Ionis Pharmaceuticals, Inc., Carlsbad, CA, USA
| | - S W Jung
- Ionis Pharmaceuticals, Inc., Carlsbad, CA, USA
| | | | - M Pollock
- Akcea Therapeutics, Inc., Boston, MA, USA
| | - M D Benson
- Indiana University School of Medicine, Indianapolis, IN, USA
| | - M Gertz
- Mayo Clinic, Rochester, MN, USA
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12
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Yu CS, Jung SW, Lee JL, Lim SB, Park IJ, Yoon YS, Kim CW, Yang SK, Ye BD, Park SH, Han M, Kim JC. The Influence of Preoperative Medications on Postoperative Complications in Patients After Intestinal Surgery for Crohn's Disease. Inflamm Bowel Dis 2019; 25:1559-1568. [PMID: 30753560 DOI: 10.1093/ibd/izz010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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: 08/01/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Many patients with Crohn's disease (CD) are treated with medications, including steroids, immunomodulators, and anti-tumor necrosis factor alpha (anti-TNF-α) agents, at the time of surgery. This study evaluated the effects of these medications on postoperative complications in CD patients. METHODS This retrospective study analyzed patients who underwent bowel resection for CD between January 2006 and December 2015. Postoperative complications were defined as a Clavien-Dindo classification of grade 2A or higher within the first 30 days after surgery. RESULTS Of the 817 patients enrolled, 687 patients received bowel resection and anastomosis without stoma formation. Of 687 patients, 381 (55.5%) were being treated with preoperative medications at the time of surgery (medication group) and 306 (44.5%) were not (nonmedication group). The overall rate of postoperative complications was not different between the medication and nonmedication groups (23.4% vs 21.9%, P = 0.36). Preoperative treatments with immunomodulators plus anti-TNF-α agents (relative risk [RR], 2.314; 95% confidence interval [CI], 1.126-4.753; P = 0.022) and treatment with immunomodulators plus steroids (RR, 2.536; 95% CI, 1.124-5.725; P = 0.025) were risk factors for infectious complications. Preoperative treatments with immunomodulators plus anti-TNF-α agents (RR, 2.731; 95% CI, 1.102-6.769; P = 0.03) and treatment with immunomodulators plus steroids (RR, 3.118; 95% CI, 1.169-8.320; P = 0.023) were significantly associated with increased risk of intra-abdominal sepsis. CONCLUSIONS Preoperative treatments with immunomodulators plus anti-TNF-α agents or steroids were risk factors for infectious complications, especially intra-abdominal sepsis in patients who underwent bowel resection and anastomosis.
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Affiliation(s)
- Chang Sik Yu
- Departments of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Sung Woo Jung
- Departments of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Jong Lyul Lee
- Departments of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Seok-Byung Lim
- Departments of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - In Ja Park
- Departments of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Yong Sik Yoon
- Departments of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Chan Wook Kim
- Departments of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Suk-Kyun Yang
- Departments of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Byong Duk Ye
- Departments of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Sang Hyoung Park
- Departments of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Minkyu Han
- Departments of Clinical Epidemiology and Biostatistics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Jin Cheon Kim
- Departments of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
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Seo MW, Lee JM, Jung HC, Jung SW, Song JK. Effects of Various Work-to-rest Ratios during High-intensity Interval Training on Athletic Performance in Adolescents. Int J Sports Med 2019; 40:503-510. [PMID: 31288289 DOI: 10.1055/a-0927-6884] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
To examine the effect of high-intensity interval training (HIIT) with different work-to-rest ratios on athletic performance in athletes. Forty-seven male Taekwondo athletes (aged 15-18 yrs) were randomly assigned into 3 HIIT groups and a control group. Each group performed 6 and 8 bouts of HIIT: 1) 1:2 (30:60 s), 2) 1:4 (30:120 s), and 3) 1:8 (30:240 s) groups while the control group performed only Taekwondo training program. All HIIT groups completed 10 sessions over 4 weeks. Athletic performance tests including VO2max test, Wingate anaerobic test, vertical jump, and agility T-test were measured at both pre- and post-tests. Two-way repeated measures ANOVA were applied to examine the performance changes between protocols. VO2max improved significantly in all HIIT groups (p<0.01), and the post-hoc test indicated that the only 1:4 group showed significant improvement compared to the control group. The HIIT with 1:4 ratio showed the effective protocol for enhancing anaerobic capacity including relative peak and mean power compared to control (p<0.01). Ten sessions of HIIT involving the 1:4 group, lasting over a brief 4-week period revealed the effective protocol for enhancing both aerobic and anaerobic capacity. Our findings provide practical implications to develop a performance-enhancing program specialized for adolescent Taekwondo athletes.
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Affiliation(s)
- Myong-Won Seo
- Department of Taekwondo, Kyung Hee University (Global Campus), Yong-In, Korea (the Republic of)
| | - Jung-Min Lee
- Department of Physical Education, Kyung Hee University (Global Campus), Yong-In, Korea (the Republic of)
| | - Hyun Chul Jung
- Department of Kinesiology, College of Communication and Education, California State University-Chico, USA
| | - Sung Woo Jung
- Department of Taekwondo, Kyung Hee University (Global Campus), Yong-In, Korea (the Republic of)
| | - Jong Kook Song
- Department of Taekwondo, Kyung Hee University (Global Campus), Yong-In, Korea (the Republic of)
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14
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Lee DW, Yim HJ, Seo YS, Na SK, Kim SY, Suh SJ, Hyun JJ, Jung SW, Jung YK, Koo JS, Kim JH, Yeon JE, Lee SW, Byun KS, Um SH. Prognostic assessment using a new substaging system for Barcelona clinic liver cancer stage C hepatocellular carcinoma: A nationwide study. Liver Int 2019; 39:1109-1119. [PMID: 30972935 DOI: 10.1111/liv.14117] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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: 04/30/2018] [Revised: 03/10/2019] [Accepted: 03/13/2019] [Indexed: 12/12/2022]
Abstract
AIM & BACKGROUND Advanced hepatocellular carcinoma (HCC) (Barcelona clinic liver cancer [BCLC] stage C) needs subclassification to more accurately predict survival. This study aims to establish a substaging system of BCLC stage C HCC patients for accurate prognosis. METHODS Data from 564 patients with newly diagnosed BCLC stage C HCC from three tertiary-care hospitals affiliated with the Korea University (training set) were assessed retrospectively. Variables affecting overall survival (OS) were analysed, and patients were substaged according to the number of prognostic factors they fulfilled. The substaging system was validated using a nationwide database from the Korean Liver Cancer Association (validation set; n = 742). RESULTS In the training set, tumour factors such as tumour burden ≥10 cm, major portal vein invasion and distant metastasis, as well as underlying liver function, were independently associated with OS. BCLC stage C was classified into four substages (C1-4) according to the number of prognostic factors. Substages C1, C2, C3 and C4 showed a median OS of 17.50 months (95% confidence interval [CI], 8.57-26.43), 10.13 months (95% CI, 8.17-12.09), 4.20 months (95% CI, 3.42-4.98), and 2.90 months (95% CI, 2.34-3.46) respectively (P < 0.05). This substaging system also had good discriminative ability in predicting survival in the validation set. In addition, it was considered that the BCLC substaging is better than Hong Kong liver cancer substaging in predicting the OS for patients with advanced HCC. CONCLUSION Our substaging for BCLC stage C might help predict patients' prognosis better.
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Affiliation(s)
- Dong-Won Lee
- Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Hyung Joon Yim
- Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Yeon Seok Seo
- Department of Internal Medicine, Korea University Anam Hospital, Seoul, Korea
| | - Seong Kyun Na
- Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Seung Young Kim
- Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Sang Jun Suh
- Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Jong Jin Hyun
- Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Sung Woo Jung
- Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Young Kul Jung
- Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Ja Seol Koo
- Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Ji Hoon Kim
- Department of Internal Medicine, Korea University Guro Hospital, Seoul, Korea
| | - Jong Eun Yeon
- Department of Internal Medicine, Korea University Guro Hospital, Seoul, Korea
| | - Sang Woo Lee
- Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Kwan Soo Byun
- Department of Internal Medicine, Korea University Guro Hospital, Seoul, Korea
| | - Soon Ho Um
- Department of Internal Medicine, Korea University Anam Hospital, Seoul, Korea
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15
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Kim D, Lee SW, Hwang SH, Kim SY, Hyun JJ, Jung SW, Koo JS. Characteristics and epidemiology of gastric cancer in Korea: Disparity in sex and age according to histologic classification. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.4_suppl.21] [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] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
21 Background: Gastric cancer (GC) is one of the most common cancers worldwide. The overall incidence of gastric cancer is higher in males, but signet ring cell carcinoma (SRC) is more common in younger females. However, the sex disparity according to the histological classification of GC in Korea has not studied much. The aim of this study is to analyze the difference of clinical manifestation between sex groups and to assess sex disparity to gastric cancer. Methods: We retrospectively analyzed 1488 patients (459 females (30.8%) and 2017 males (69.0%)) who diagnosed with gastric cancer at Korea University Ansan Hospital from 2009 to 2017. The patients were divided into three groups according to Lauren’s classification: Intestinal type GC (IGC), diffuse type GC (DGC), mixed type. The difference of clinicopathologic characteristics between these groups and sex groups were compared. Results: The age-group-specific annual incidence rates for intestinal and diffuse type GC were analyzed. The incidence of IGC increased from 40s in males. In females, the incidence of DGC was higher in young age and the proportion of IGC was increased rapidly after age 60 in females. Most of IGC appeared after age 60. (19.3% in below 60 vs. 80.7% in above 60 in females, 35.1% vs. 64.9% in males, p < 0.001) IGC seemed to appear 10-20 years earlier in male than female. Female patients were associated with poorly differentiated adenocarcinoma, SRC and DGC. Diffuse and mixed type GC was more frequent with younger, female patients and associated with advanced GC and TNM stage. Kaplan-Meier analysis revealed that the patients with IGC had a higher cumulative survival rate than those with DGC (5-year survival rate 88.2% vs. 80.5%, p < 0.001). Conclusions: Female patients with IGC were older than male patient and appeared about 10-20 years later. But this difference did not observed in DGC. Therefore, unlike DGC, sex hormones such as estrogen may act in development of IGC. This is supported by an increase of IGC in females after menopause. Further studies on role of estrogen in the development of gastric cancer are needed.
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Affiliation(s)
- Dongwoo Kim
- Division of Gastroenterology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea, Republic of (South)
| | - Sang Woo Lee
- Division of Gastroenterology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea, Republic of (South)
| | - Su Hyun Hwang
- Division of Gastroenterology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea, Republic of (South)
| | - Seung Young Kim
- Division of Gastroenterology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea, Republic of (South)
| | - Jong Jin Hyun
- Division of Gastroenterology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea, Republic of (South)
| | - Sung Woo Jung
- Division of Gastroenterology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea, Republic of (South)
| | - Ja Seol Koo
- Division of Gastroenterology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea, Republic of (South)
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Kang KH, Hwang SH, Kim D, Kim DH, Kim SY, Hyun JJ, Jung SW, Koo JS, Jung YK, Yim HJ, Lee SW. [The Effect of Helicobacter pylori Infection on Recurrence of Gastric Hyperplastic Polyp after Endoscopic Removal]. Korean J Gastroenterol 2018; 71:213-218. [PMID: 29684970 DOI: 10.4166/kjg.2018.71.4.213] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Background/Aims Several previous studies suggest that eradication of Helicobacter pylori (H. pylori) leads to the disappearance of gastric hyperplastic polyps. However, little is known about the effect of H. pylori status and eradication on the recurrence of gastric polyps after endoscopic removal. Here, we investigated the recurrence of gastric polyps according to the final H. pylori status in patients who underwent endoscopic removal of gastric hyperplastic polyps. Methods Between January 2011 and December 2016, patients who underwent endoscopic removal of gastric hyperplastic polyps and were followed-up for more than two months were enrolled. The success of H. pylori eradication was assessed by histology and rapid urease test or urea breath test, at least 4 weeks after the completion of eradication treatment. At follow-up, the recurrence of gastric polyp was evaluated via esophagogastroduodenoscopy. Results Seventy-nine patients were enrolled. During the mean follow-up period of 16.4 months, the recurrence rate of gastric polyp was 25.3%. Among those who received H. pylori eradication therapy, the H. pylori persistent group showed a higher recurrence of polyp than the H. pylori eradicated group; but there was no statistical significance (42.9% vs. 21.7%, p=0.269). Regarding the final H. pylori infection status, the recurrence rate of gastric polyps was significantly higher in the H. pylori positive group than in the H. pylori negative group (42.9% vs. 18.9%, p=0.031). In multivariate analysis, the final H. pylori infection status was a significant risk factor for gastric polyp recurrence after endoscopic removal. Conclusions The final positive H. pylori infection status is significantly associated with higher recurrence of gastric hyperplastic polyps after endoscopic removal.
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Affiliation(s)
- Kyu Ho Kang
- Division of Gastroenterology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Su Hyun Hwang
- Division of Gastroenterology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Dongwoo Kim
- Division of Gastroenterology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Dae Ha Kim
- Division of Gastroenterology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Seung Young Kim
- Division of Gastroenterology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Jong Jin Hyun
- Division of Gastroenterology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Sung Woo Jung
- Division of Gastroenterology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Ja Seol Koo
- Division of Gastroenterology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Young Kul Jung
- Division of Gastroenterology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Hyung Joon Yim
- Division of Gastroenterology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Sang Woo Lee
- Division of Gastroenterology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
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Choe JW, Kim SY, Hyun JJ, Jung SW, Jung YK, Koo JS, Yim HJ, Lee SW. Is the AIMS 65 Score Useful in Prepdicting Clinical Outcomes in Korean Patients with Variceal and Nonvariceal Upper Gastrointestinal Bleeding? Gut Liver 2018; 11:813-820. [PMID: 28798285 PMCID: PMC5669597 DOI: 10.5009/gnl16607] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [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: 12/20/2016] [Revised: 03/11/2017] [Accepted: 03/19/2017] [Indexed: 12/23/2022] Open
Abstract
Background/Aims Various clinical scoring systems, including the Glasgow-Blatchford score (GBS), Rockall risk score (RS), and AIMS65 score (AIMS65), have been validated to predict the clinical outcomes in patients with upper gastrointestinal bleeding (UGIB). We compared the performance of these three scoring systems in predicting clinical outcomes in patients with UGIB in Korea. Methods We retrospectively evaluated 286 patients with UGIB who visited emergency department. The primary outcome was the need for clinical intervention (endoscopic, radiologic, or surgical) and blood transfusion. Results The causes of UGIB were esophageal/gastric varices in 64 patients, peptic ulcer in 168, Mallory-Weiss tear in 32, malignancy of UGI tract in eight, and unknown in 14. One hundred seventy-four (61%) patients required blood transfusion, 166 (58%) required endoscopic intervention, and 10 (3.5%) required surgical intervention. The GBS outperformed the RS and AIMS65 in predicting the need for endoscopic intervention. Conclusions The GBS and RS were more accurate than AIMS65 in predicting the need for clinical interventions and transfusion patients with UGIB, regardless of variceal or nonvariceal bleeding. The AIMS65 may not be optimal for predicting clinical outcomes of UGIB in Korea.
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Affiliation(s)
- Jung Wan Choe
- Department of Internal Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Seung Young Kim
- Department of Internal Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Jong Jin Hyun
- Department of Internal Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Sung Woo Jung
- Department of Internal Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Young Kul Jung
- Department of Internal Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Ja Seol Koo
- Department of Internal Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Hyung Joon Yim
- Department of Internal Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Sang Woo Lee
- Department of Internal Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
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Yeom SS, Kim CW, Jung SW, Oh SH, Lee JL, Yoon YS, Park IJ, Lim SB, Yu CS, Kim JC. Trephine Transverse Colostomy Is Effective for Patients Who Have Previously Undergone Rectal Surgery. Ann Coloproctol 2018; 34:72-77. [PMID: 29742862 PMCID: PMC5951093 DOI: 10.3393/ac.2017.09.29] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 04/20/2017] [Accepted: 09/29/2017] [Indexed: 12/22/2022] Open
Abstract
Purpose Colostomy creation is an essential procedure for colorectal surgeons, but the preferred method of colostomy varies by surgeon. We compared the outcomes of trephine colostomy creation with open those for the (laparotomy) and laparoscopic methods and evaluated appropriate indications for a trephine colostomy and the advantages of the technique. Methods We retrospectively evaluated 263 patients who had undergone colostomy creation by trephine, open and laparoscopic approaches between April 2006 and March 2016. We compared the clinical features and the operative and postoperative outcomes according to the approach used for stoma creation. Results One hundred sixty-three patients (62%) underwent colostomy surgery for obstructive causes and 100 (38%) for fistulous problems. The mean operative time was significantly shorter with the trephine approach (trephine, 46.0 ± 1.9 minutes; open, 78.7 ± 3.9 minutes; laparoscopic, 63.5 ± 5.0 minutes; P < 0.001), as was the time to flatus (1.8 ± 0.1 days, 2.1 ± 0.1 days, 2.2 ± 0.3 days, P = 0.025). Postoperative complications (<30 days) were not different among the 3 approaches (trephine, 4.3%; open, 1.2%; laparoscopic, 0%; P = 0.828). In patients who underwent rectal surgery, a trephine colostomy was feasible for a diversion colostomy (P < 0.001). Conclusion The trephine colostomy is safe and can be implemented quickly in various situations, and compared to other colostomy procedures, the patient’s recovery is faster. Previous laparotomy history was not a contraindication for a trephine colostomy, and a trephine transverse colostomy is feasible for patients who have undergone previous rectal surgery.
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Affiliation(s)
- Seung-Seop Yeom
- Departments of Colon and Rectal Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Chan Wook Kim
- Departments of Colon and Rectal Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sung Woo Jung
- Departments of Colon and Rectal Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Se Heon Oh
- Departments of Colon and Rectal Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jong Lyul Lee
- Departments of Colon and Rectal Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yong Sik Yoon
- Departments of Colon and Rectal Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - In Ja Park
- Departments of Colon and Rectal Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seok-Byung Lim
- Departments of Colon and Rectal Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Chang Sik Yu
- Departments of Colon and Rectal Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jin Cheon Kim
- Departments of Colon and Rectal Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Kim SY, Choung RS, Lee SK, Choe JW, Jung SW, Hyun JJ, Koo JS, Lee SW, Shin C. Self-reported Sleep Impairment in Functional Dyspepsia and Irritable Bowel Syndrome. J Neurogastroenterol Motil 2018; 24:280-288. [PMID: 29605983 PMCID: PMC5885727 DOI: 10.5056/jnm17098;] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 11/18/2017] [Accepted: 12/12/2017] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND/AIMS Sleep impairment is a common complaint among patients with irritable bowel syndrome (IBS) and functional dyspepsia (FD). This study aimed to evaluate the prevalence of sleep impairment in FD or IBS patients, and to determine whether IBS-FD overlap induced more sleep disturbance than FD or IBS alone. METHODS A population-based cohort in South Korea including 2251 subjects was asked about gastrointestinal symptoms including IBS and dyspepsia-related symptoms. In addition, sleep disturbance was measured using the Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale questionnaires. One-way ANOVA and logistic regression were used to assess differences among the 4 groups (healthy subjects, IBS alone, FD alone, and IBS-FD overlap). RESULTS Of 2251 subjects who were surveyed by questionnaire, 2031 responded (92.5% response rate) and were analyzed. The prevalence of IBS, FD, and IBS-FD overlap was 8.0% (95% confidence interval [CI], 6.8-9.2%), 4.8% (95% CI, 3.9-5.8%), and 1.8% (95% CI, 1.2-2.4%), respectively. FD alone, but not IBS alone, was significantly associated with a poorer sleep quality index (OR, 2.68; 95% CI, 1.43-5.01) and more daytime sleepiness (OR, 2.21; 95% CI, 1.14-4.30), compared to healthy subjects. IBS-FD overlap had the greatest likelihood of a poorer sleep quality index (OR, 3.88; 95% CI, 1.83-8.19), daytime sleepiness (OR, 2.47; 95% CI, 1.01-5.67), and insomnia (OR, 2.84; 95% CI, 1.39-5.82), compared to healthy subjects. CONCLUSION A correlation between functional gastrointestinal disorders and sleep disturbance was demonstrated, which was significantly pronounced in the context of IBS-FD overlap.
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Affiliation(s)
- Seung Young Kim
- Division of Gastoenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan,
Korea
| | - Rok Seon Choung
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota,
USA
| | - Seung Ku Lee
- Institute of Human Genomic Study, Korea University Ansan Hospital, Ansan,
Korea
| | - Jung Wan Choe
- Division of Gastoenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan,
Korea
| | - Sung Woo Jung
- Division of Gastoenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan,
Korea
| | - Jong Jin Hyun
- Division of Gastoenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan,
Korea
| | - Ja Seol Koo
- Division of Gastoenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan,
Korea
| | - Sang Woo Lee
- Division of Gastoenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan,
Korea
| | - Chol Shin
- Institute of Human Genomic Study, Korea University Ansan Hospital, Ansan,
Korea
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20
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Kim SY, Choung RS, Lee SK, Choe JW, Jung SW, Hyun JJ, Koo JS, Lee SW, Shin C. Self-reported Sleep Impairment in Functional Dyspepsia and Irritable Bowel Syndrome. J Neurogastroenterol Motil 2018; 24:280-288. [PMID: 29605983 PMCID: PMC5885727 DOI: 10.5056/jnm17098] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 11/18/2017] [Accepted: 12/12/2017] [Indexed: 12/13/2022] Open
Abstract
Background/Aims Sleep impairment is a common complaint among patients with irritable bowel syndrome (IBS) and functional dyspepsia (FD). This study aimed to evaluate the prevalence of sleep impairment in FD or IBS patients, and to determine whether IBS-FD overlap induced more sleep disturbance than FD or IBS alone. Methods A population-based cohort in South Korea including 2251 subjects was asked about gastrointestinal symptoms including IBS and dyspepsia-related symptoms. In addition, sleep disturbance was measured using the Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale questionnaires. One-way ANOVA and logistic regression were used to assess differences among the 4 groups (healthy subjects, IBS alone, FD alone, and IBS-FD overlap). Results Of 2251 subjects who were surveyed by questionnaire, 2031 responded (92.5% response rate) and were analyzed. The prevalence of IBS, FD, and IBS-FD overlap was 8.0% (95% confidence interval [CI], 6.8–9.2%), 4.8% (95% CI, 3.9–5.8%), and 1.8% (95% CI, 1.2–2.4%), respectively. FD alone, but not IBS alone, was significantly associated with a poorer sleep quality index (OR, 2.68; 95% CI, 1.43–5.01) and more daytime sleepiness (OR, 2.21; 95% CI, 1.14–4.30), compared to healthy subjects. IBS-FD overlap had the greatest likelihood of a poorer sleep quality index (OR, 3.88; 95% CI, 1.83–8.19), daytime sleepiness (OR, 2.47; 95% CI, 1.01–5.67), and insomnia (OR, 2.84; 95% CI, 1.39–5.82), compared to healthy subjects. Conclusion A correlation between functional gastrointestinal disorders and sleep disturbance was demonstrated, which was significantly pronounced in the context of IBS-FD overlap.
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Affiliation(s)
- Seung Young Kim
- Division of Gastoenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Rok Seon Choung
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA
| | - Seung Ku Lee
- Institute of Human Genomic Study, Korea University Ansan Hospital, Ansan, Korea
| | - Jung Wan Choe
- Division of Gastoenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Sung Woo Jung
- Division of Gastoenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Jong Jin Hyun
- Division of Gastoenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Ja Seol Koo
- Division of Gastoenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Sang Woo Lee
- Division of Gastoenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Chol Shin
- Institute of Human Genomic Study, Korea University Ansan Hospital, Ansan, Korea
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Choe JW, Jung SW, Kim SY, Hyun JJ, Jung YK, Koo JS, Yim HJ, Lee SW. Comparative study of Helicobacter pylori eradication rates of concomitant therapy vs modified quadruple therapy comprising proton-pump inhibitor, bismuth, amoxicillin, and metronidazole in Korea. Helicobacter 2018; 23:e12466. [PMID: 29369454 DOI: 10.1111/hel.12466] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [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] [Indexed: 12/12/2022]
Abstract
BACKGROUND The standard triple Helicobacter pylori regimen now shows unacceptably low treatment success in Korea. Administration of the concomitant therapy for 10 days, which has a high cure rate, is recommended as an alternative first-line treatment in areas of high clarithromycin resistance including Korea. Recently, modified bismuth-containing quadruple therapy with amoxicillin (PAM-B therapy) showed excellent results, regardless of dual clarithromycin and metronidazole resistance. This study compared the concomitant therapy with PAM-B therapy as a first-line treatment for H. pylori infection. METHOD Subjects infected with H. pylori and naïve to treatment were performed a head-to-head comparison between 10-day concomitant therapy [rabeprazole 20 mg, amoxicillin 1 g, clarithromycin 500 mg, and metronidazole 500 mg twice daily] and 14-day PAM-B therapy [rabeprazole 20 mg, amoxicillin 1 g, metronidazole 750 mg, and tripotassium dicitrato bismuthate 600 mg (elemental bismuth 240 mg) twice daily]. Six weeks after treatment, H. pylori eradication was assessed. RESULTS Two hundred and seventy subjects were randomized. Both regimens achieved high cure rates: 83.0% (112/135) and 88.1% (119/135) by the intention-to-treat analysis and 95.5% (106/111) and 96.6% (114/118) by the per-protocol analysis, respectively. The intention-to-treat and per-protocol analyses revealed no statistically significant difference in the eradication rate (P = .299 and P = .743, respectively). Rates of adverse events were similar between groups (25.2% vs 23.0%, P -value: .776) Adverse events, which resulted in poor compliance, occurred in six patients of each group, but there were no serious complications. CONCLUSIONS PAM-B therapy is as effective as concomitant therapy for eradicating H. pylori with comparative safety. PAM-B therapy is regarded as a promising alternative to standard triple therapy for a first-line eradication in Korea.
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Affiliation(s)
- Jung Wan Choe
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Sung Woo Jung
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Seung Young Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Jong Jin Hyun
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Young Kul Jung
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Ja Seol Koo
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Hyung Joon Yim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Sang Woo Lee
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
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22
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Abstract
BACKGROUND The efficacy of the standard triple therapy for Helicobacter pylori eradication has decreased to an unacceptable level. We aimed to compare the efficacy of sequential and concomitant therapies as for the first-line treatments for H. pylori eradication and analyzed the effect of clarithromycin resistance on the eradication rates. MATERIALS AND METHODS Four hundred and seventy-eight patients with H. pylori infection were randomly assigned to either concomitant therapy (amoxicillin 1000 mg with clarithromycin 500 mg, metronidazole 500 mg, and pantoprazole 40 mg twice daily for 10 days) or sequential therapy (amoxicillin 1000 mg with pantoprazole 40 mg twice daily for 5 days, followed by clarithromycin 500 mg with metronidazole 500 mg and pantoprazole 40 mg twice daily for 5 days). The success of the eradication was evaluated 4-5 weeks after treatment completion. To evaluate the efficacy of the two regimens according to clarithromycin sensitivity, dual-priming oligonucleotide-based multiplex-polymerase chain reaction was also performed in the final third of the enrolled study populations. RESULTS The eradication rates with concomitant or sequential therapy were 81.9% and 76.6% (P = .153) in intention-to-treat analysis, and 93.4% and 84.8% (P = .004) in per-protocol analysis, respectively. Among the 156 patients for whom dual-priming oligonucleotide-based multiplex-polymerase chain reaction was performed, 17.9% were clarithromycin resistant, and the efficacy of concomitant therapy was better than sequential therapy in the clarithromycin-resistant strains (100% vs 58.3%, P = .010). CONCLUSION Concomitant therapy was superior to sequential therapy as the first-line treatment for H. pylori eradication, especially in clarithromycin-resistant strains in Korea.
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Affiliation(s)
- Seung Young Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Sang Woo Lee
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Jung Wan Choe
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Sung Woo Jung
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Jong Jin Hyun
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Young Kul Jung
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Ja Seol Koo
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Hyung Joon Yim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
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Lee JJ, Hyun JJ, Choe JW, Lee DW, Kim SY, Jung SW, Jung YK, Koo JS, Yim HJ, Lee SW. Endoscopic biliary stent insertion through specialized duodenal stent for combined malignant biliary and duodenal obstruction facilitated by stent or PTBD guidance. Scand J Gastroenterol 2017; 52:1258-1262. [PMID: 28685637 DOI: 10.1080/00365521.2017.1349833] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [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] [Indexed: 02/04/2023]
Abstract
OBJECTIVES Endoscopic stenting for combined malignant biliary and duodenal obstruction is technically demanding. However, this procedure can be facilitated when there is guidance from previously inserted stent or PTBD tube. This study aimed to evaluate the feasibility and clinical success rate of endoscopic placement of biliary self-expandable metal stent (SEMS) through duodenal SEMS in patients with combined biliary and duodenal obstruction due to inoperable or metastatic periampullary malignancy. MATERIALS AND METHODS A total of 12 patients with combined malignant biliary and duodenal stricture underwent insertion of biliary SEMS through the mesh of specialized duodenal SEMS from July 2012 to October 2016. Technical and clinical success rate, adverse events and survival after completion of SEMS insertion were evaluated. RESULTS The duodenal strictures were located in the first portion of the duodenum in four patients (Type I), in the second portion in three patients (Type II), and in the third portion in five patients (Type III). Technical success rate of combined metallic stenting was 91.7%. Insertion of biliary SEMS was guided by previously inserted biliary SEMS in nine patients, plastic stent in one patient, and PTBD in two patients. Clinical success rate was 90.9%. There were no early adverse events after the procedure. Mean survival period after combined metallic stenting was 91.9 days (range: 15-245 days). CONCLUSIONS Endoscopic placement of biliary SEMS through duodenal SEMS is feasible with high success rates and relatively easy when there is guidance. This method can be a good alternative for palliation in patients with combined biliary and duodenal obstruction.
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Affiliation(s)
- Jong Jin Lee
- a Department of Internal Medicine, Division of Gastroenterology and Hepatology , Korea University, Ansan Hospital , Ansan-si , Korea
| | - Jong Jin Hyun
- a Department of Internal Medicine, Division of Gastroenterology and Hepatology , Korea University, Ansan Hospital , Ansan-si , Korea
| | - Jung Wan Choe
- a Department of Internal Medicine, Division of Gastroenterology and Hepatology , Korea University, Ansan Hospital , Ansan-si , Korea
| | - Dong-Won Lee
- a Department of Internal Medicine, Division of Gastroenterology and Hepatology , Korea University, Ansan Hospital , Ansan-si , Korea
| | - Seung Young Kim
- a Department of Internal Medicine, Division of Gastroenterology and Hepatology , Korea University, Ansan Hospital , Ansan-si , Korea
| | - Sung Woo Jung
- a Department of Internal Medicine, Division of Gastroenterology and Hepatology , Korea University, Ansan Hospital , Ansan-si , Korea
| | - Young Kul Jung
- a Department of Internal Medicine, Division of Gastroenterology and Hepatology , Korea University, Ansan Hospital , Ansan-si , Korea
| | - Ja Seol Koo
- a Department of Internal Medicine, Division of Gastroenterology and Hepatology , Korea University, Ansan Hospital , Ansan-si , Korea
| | - Hyung Joon Yim
- a Department of Internal Medicine, Division of Gastroenterology and Hepatology , Korea University, Ansan Hospital , Ansan-si , Korea
| | - Sang Woo Lee
- a Department of Internal Medicine, Division of Gastroenterology and Hepatology , Korea University, Ansan Hospital , Ansan-si , Korea
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Ahn KR, Koo JS, Kim HI, Kim JH, Lee JH, Kim SY, Jung SW, Lee SW. Endoscopic Treatment of Jejunal Heterotopic Gastric Mucosa that Caused Recurrent Intussusception. Clin Endosc 2017; 50:605-608. [PMID: 29050458 PMCID: PMC5719913 DOI: 10.5946/ce.2017.026] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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: 01/31/2017] [Revised: 08/08/2017] [Accepted: 08/21/2017] [Indexed: 11/14/2022] Open
Abstract
Heterotopic gastric mucosa (HGM) is a rare anomaly in the small bowel and may be the cause of intussusception when it gets a lead point in the jejunum. All cases of intussusception due to intestinal HGM have been treated with surgical resection. A 5-year-old girl presented with chief complaints of vomiting and abdominal pain for 2 weeks. A computed tomography scan of the abdomen showed intussusception at the proximal jejunal loops. Three air reductions and one saline reduction were attempted without success. She continued to be symptomatic, and endoscopic evaluation was performed. Enteroscopy revealed some variable-sized polypoid mucosal lesions with erosions on the proximal jejunum. Endoscopic mucosal resection was performed using a snare. The resected tissues histologically showed a hyperplastic polyp arising from the HGM. Her symptoms did not recur within 1 year after the treatment. Our case showed that enteroscopy could be useful for the diagnosis and management of jejunal intussusception caused by HGM.
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Affiliation(s)
- Ke Ryun Ahn
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Ja Seol Koo
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Hwan Il Kim
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Ji Hye Kim
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Jee Hyun Lee
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
| | - Seung Young Kim
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Sung Woo Jung
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Sang Woo Lee
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
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Yeom SS, Park IJ, Jung SW, Oh SH, Lee JL, Yoon YS, Kim CW, Lim SB, Kim N, Yu CS, Kim JC. Outcomes of patients with abdominoperineal resection (APR) and low anterior resection (LAR) who had very low rectal cancer. Medicine (Baltimore) 2017; 96:e8249. [PMID: 29068989 PMCID: PMC5671822 DOI: 10.1097/md.0000000000008249] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [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: 01/27/2023] Open
Abstract
We compared the oncological outcomes of sphincter-saving resection (SSR) and abdominoperineal resection (APR) in 409 consecutive patients with very low rectal cancer (i.e., tumors within 3 cm from the anal verge); 335 (81.9%) patients underwent APR and 74 (18.1%) underwent SSR. The APR group comprised higher proportions of men (67.5% vs 55.4%, P = .049) and advanced-stage patients (P < .001). Preoperative chemoradiotherapy (PCRT) was more frequently administered in the SSR group (83.8% vs 52.8%, P < .001). Overall, the systemic and local recurrence rates were 29.1% and 6.1%, respectively. On stratification according to PCRT and pathologic stage, the mode of surgery did not affect the recurrence type. Moreover, recurrence-free survival (RFS) did not differ according to the mode of surgery in different cancer stages. RFS was associated with ypT and ypN stages in patients who received PCRT, while pN stage, lymphovascular invasion (LVI), and circumferential resection margin (CRM) involvement were risk factors for RFS in those who did not receive PCRT. Notably, SSR was not found to be a risk factor for RFS in either subgroup. Patients who were stratified according to cancer stage and PCRT also showed no differences in RFS according to the mode of surgery. Our results demonstrate that, regardless of PCRT administration, SSR is an effective treatment for very low rectal cancer, while CRM is an important prognostic factor for patients who did not receive PCRT.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Nayoung Kim
- Department of Clinical Epidemiology and Biostatistics, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea
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Lee DW, Koo JS, Choe JW, Suh SJ, Kim SY, Hyun JJ, Jung SW, Jung YK, Yim HJ, Lee SW. Diagnostic delay in inflammatory bowel disease increases the risk of intestinal surgery. World J Gastroenterol 2017; 23:6474-6481. [PMID: 29085197 PMCID: PMC5643273 DOI: 10.3748/wjg.v23.i35.6474] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 07/28/2017] [Accepted: 08/15/2017] [Indexed: 02/07/2023] Open
Abstract
AIM To investigate the factors affecting diagnostic delay and outcomes of diagnostic delay in inflammatory bowel disease (IBD)
METHODS We retrospectively studied 165 patients with Crohn’s disease (CD) and 130 patients with ulcerative colitis (UC) who were diagnosed and had follow up durations > 6 mo at Korea University Ansan Hospital from January 2000 to December 2015. A diagnostic delay was defined as the time interval between the first symptom onset and IBD diagnosis in which the 76th to 100th percentiles of patients were diagnosed.
RESULTS The median diagnostic time interval was 6.2 and 2.4 mo in the patients with CD and UC, respectively. Among the initial symptoms, perianal discomfort before di-agnosis (OR = 10.2, 95%CI: 1.93-54.3, P = 0.006) was associated with diagnostic delays in patients with CD; however, no clinical factor was associated with diagnostic delays in patients with UC. Diagnostic delays, stricturing type, and penetrating type were associated with increased intestinal surgery risks in CD (OR = 2.54, 95%CI: 1.06-6.09; OR = 4.44, 95%CI: 1.67-11.8; OR = 3.79, 95%CI: 1.14-12.6, respectively). In UC, a diagnostic delay was the only factor associated increased intestinal surgery risks (OR = 6.81, 95%CI: 1.12-41.4).
CONCLUSION A diagnostic delay was associated with poor outcomes, such as increased intestinal surgery risks in patients with CD and UC.
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Affiliation(s)
- Dong-won Lee
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan-si, Gyeonggi-do 15355, South Korea
| | - Ja Seol Koo
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan-si, Gyeonggi-do 15355, South Korea
| | - Jung Wan Choe
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan-si, Gyeonggi-do 15355, South Korea
| | - Sang Jun Suh
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan-si, Gyeonggi-do 15355, South Korea
| | - Seung Young Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan-si, Gyeonggi-do 15355, South Korea
| | - Jong Jin Hyun
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan-si, Gyeonggi-do 15355, South Korea
| | - Sung Woo Jung
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan-si, Gyeonggi-do 15355, South Korea
| | - Young Kul Jung
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan-si, Gyeonggi-do 15355, South Korea
| | - Hyung Joon Yim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan-si, Gyeonggi-do 15355, South Korea
| | - Sang Woo Lee
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan-si, Gyeonggi-do 15355, South Korea
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Choi HB, Hong JS, Jin SS, Jung SW, Jang JC, Jeong JH, Kim YY. Effect of rapeseed meal supplementation to gestation diet on reproductive performance, blood profiles and milk composition of sows. Asian-Australas J Anim Sci 2017; 31:386-394. [PMID: 28728405 PMCID: PMC5838344 DOI: 10.5713/ajas.17.0015] [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] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 02/25/2017] [Accepted: 07/04/2017] [Indexed: 11/28/2022]
Abstract
Objective This experiment evaluated the effect of dietary supplementation levels of rapeseed meal (RSM) in gestation diets on reproductive performance, blood profiles, milk composition of sows, and growth of their progeny. Methods A total of 55 mixed-parity sows (Yorkshire×Landrace; average parity = 3.82) with an initial body weight (BW) of 193.0 kg were used in this experiment. Sows were allotted to one of 5 treatments at breeding based on BW and backfat thickness in a completely randomized design. Treatments consisted of dietary RSM supplementation levels (0%, 3%, 6%, 9%, and 12%) in gestation diets. During lactation all sows were fed a common lactation diet with no RSM supplementation. Results Body weight, backfat thickness, litter size, lactation feed intake, and milk composition of sows, and growth of their progeny were not different among dietary treatments. In blood profiles, a quadratic increase (Quadratic, p<0.05) in serum triiodothyronine (T3) concentration and a linear increase (Linear, p<0.01) in serum thyroxine (T4) concentration were observed at d 110 of gestation as dietary RSM supplementation levels increased. However, serum T3 and T4 concentrations in lactating sows and their piglets were not affected by RSM supplementation of gestation diets. Concentrations of serum total cholesterol and low density lipoprotein cholesterol in sows were not influenced by dietary treatments, whereas serum glucose level in sows decreased linearly at d 110 of gestation (Linear, p<0.05) by increasing dietary RSM supplementation in gestation diets. Conclusion The RSM could be supplemented to gestation diets up to 12% with no detrimental effects on reproductive performance and growth of their progeny. However, increasing supplementation levels of RSM in gestation diets may increase serum T3 and T4 concentrations and decrease serum glucose concentration of sows in late gestation.
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Affiliation(s)
- H B Choi
- Department of Agricultural Biotechnology, College of Agricultural Life Science, Seoul National University, Seoul 08826, Korea.,CJ Cheiljedang, CJ blossom park, Suwon 16495, Korea
| | - J S Hong
- Department of Agricultural Biotechnology, College of Agricultural Life Science, Seoul National University, Seoul 08826, Korea
| | - S S Jin
- Department of Agricultural Biotechnology, College of Agricultural Life Science, Seoul National University, Seoul 08826, Korea
| | - S W Jung
- Department of Agricultural Biotechnology, College of Agricultural Life Science, Seoul National University, Seoul 08826, Korea
| | - J C Jang
- Department of Agricultural Biotechnology, College of Agricultural Life Science, Seoul National University, Seoul 08826, Korea
| | - J H Jeong
- Department of Agricultural Biotechnology, College of Agricultural Life Science, Seoul National University, Seoul 08826, Korea
| | - Y Y Kim
- Department of Agricultural Biotechnology, College of Agricultural Life Science, Seoul National University, Seoul 08826, Korea
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Abstract
The effectiveness of colonoscopy is highly dependent on the quality of bowel preparation. Although many studies have previously evaluated the role of cleansing methods and dosing regimens, few have examined the association between bowel habits and subsequent bowel preparation. Here, we aimed to evaluate the impact of bowel habits on the quality of bowel preparation.A total of 404 patients who underwent a total colonoscopy and completed a personal bowel habit questionnaire at Korea University Hospital between December 2012 and December 2013 were enrolled. The usual stool form of patients was classified into 7 categories according to the Bristol Stool Scale (BSS). The quality of bowel preparation was determined during colonoscopy according to the Ottawa Bowel Preparation Scale (OBPS). Segment scores of ≥3 or total OBPS scores of >7 were defined as poor bowel preparation.Poor bowel preparation was reported in 9.4% of observed colonoscopies. The odds ratio (OR) of poor bowel preparation being associated with infrequent bowel movements (<3/week) was 5.00 (95% confidence interval [CI], 1.91-13.1, P = .001). BSS types 1 and 2 tended to have an association with poor bowel preparation, but the association was statistically insignificant (OR: 2.38; 95% CI, 0.90-6.33, P = .082). After adjusting for age, sex, drinking, presence of diabetes mellitus, and bowel preparation regimen, infrequent bowel movement (<3/week) was still significantly associated with poor bowel preparation. When subdividing by colonic segment, it was significantly associated with poor bowel preparation in all segments.Infrequent bowel movement (<3/week) was significantly associated with poor bowel preparation.
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Jung SW, Kim SY, Choe JW, Hyun JJ, Jung YK, Koo JS, Yim HJ, Lee SW. Standard and double-dose intravenous proton pump inhibitor injections for prevention of bleeding after endoscopic resection. J Gastroenterol Hepatol 2017; 32:778-781. [PMID: 27637734 DOI: 10.1111/jgh.13597] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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] [Accepted: 09/08/2016] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND AIM Endoscopic resection is commonly used to remove gastric neoplasms. However, effective dosing or scheduling of proton pump inhibitors for the prevention of delayed bleeding after endoscopic resection remains unclear. METHODS One hundred sixty-six patients with gastric adenoma or early gastric cancer were enrolled. After an endoscopic procedure, each subject was randomly assigned to 40 mg every 24 h (standard dose group) or 40 mg every 12 h (double-dose group) of intravenous pantoprazole for 48 h. Second-look endoscopy was performed on day 2 after endoscopic resection to compare signs of rebleeding and ulcer status between the two groups. RESULT Eighty-one patients of the standard dose group and 81 of the double-dose group were analyzed. There were no significant differences in the incidence of delayed bleeding events (1.3% vs 6.2%, P = 0.21) and bleeding ulcer at the second-look endoscopy (6.2% vs 3.9%, P = 0.69) between standard and double-dose groups. There were no other significant variables associated with delayed bleeding or bleeding ulcer on second-look endoscopy. CONCLUSIONS Intravenous pantoprazole 40 mg every 24 h or 12 h for 2 days after endoscopic resection was equally effective for the prevention of delayed bleeding.
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Affiliation(s)
- Sung Woo Jung
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Seung Young Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Jung Wan Choe
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Jong Jin Hyun
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Young Kul Jung
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Ja Seol Koo
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Hyung Joon Yim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Sang Woo Lee
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
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Jung SW, Park IJ, Oh SH, Yeom SS, Lee JL, Yoon YS, Kim CW, Lim SB, Lee JB, Yu CS, Kim JC. Association of immunologic markers from complete blood counts with the response to preoperative chemoradiotherapy and prognosis in locally advanced rectal cancer. Oncotarget 2017; 8:59757-59765. [PMID: 28938679 PMCID: PMC5601775 DOI: 10.18632/oncotarget.15760] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [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: 01/13/2017] [Accepted: 02/20/2017] [Indexed: 02/06/2023] Open
Abstract
We investigated retrospectively whether immunologic markers from a complete blood count (CBC) are associated with the responsiveness to preoperative chemoradiotherapy (PCRT) and oncologic outcomes in 984 patients with locally advanced rectal cancer (LARC) who also underwent radical surgery from 2005 to 2013. CBC parameters including the neutrophil to lymphocyte ratio (NLR), lymphocyte to monocyte ratio (LMR), and platelet to lymphocyte ratio (PLR) were recorded. Pathologic responses to PCRT were evaluated in the resected specimens using the tumor regression grade system. The cut-off values of the immunologic markers were calculated to analyze their association with recurrence-free survival (RFS). One hundred ninety-five patients achieved total regression of their primary tumor. By receiver operating characteristic analysis, NLR, PLR, and LMR could not distinguish total regression from residual disease after PCRT. The NLR, LMR and PLR cut-off values were 1.7, 6.8 and 92.88, respectively. By univariate analysis, low NLR (≤1.7), high LMR (>6.8) and high PLR (>92.88) were indicators of a favorable RFS outcome. By multivariate analysis, high PLR was associated with an improved RFS (HR, 0.649; 95% CI, 0.473-0.89; P=0.007). High NLR (>1.7) was an independent negative prognostic factor for RFS in stage II (HR, 1.868; 95% CI, 1.08-3.109; P=0.025) and high PLR was a positive prognostic factor in stage III (HR, 0.675; 95% CI, 0.421-0.957; P=0.03). Immunologic markers derived from CBCs are independently associated with the RFS outcome in LARC patients treated with PCRT followed by radical resection. However, these markers are not predictive of total primary tumor regression after PCRT.
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Affiliation(s)
- Sung Woo Jung
- Department of Colon and Rectal Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea
| | - In Ja Park
- Department of Colon and Rectal Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea
| | - Se Heon Oh
- Department of Colon and Rectal Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea
| | - Seung-Seop Yeom
- Department of Colon and Rectal Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea
| | - Jong Lyul Lee
- Department of Colon and Rectal Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea
| | - Yong Sik Yoon
- Department of Colon and Rectal Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea
| | - Chan Wook Kim
- Department of Colon and Rectal Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea
| | - Seok-Byung Lim
- Department of Colon and Rectal Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea
| | - Jung Bok Lee
- Department of Clinical Epidemiology and Biostatistics, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea
| | - Chang Sik Yu
- Department of Colon and Rectal Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea
| | - Jin Cheon Kim
- Department of Colon and Rectal Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea
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Newhard DK, Jung SW, Winter RL, Kuca T, Bayne J, Passler T. Double-outlet right ventricle with an intact interventricular septum and concurrent hypoplastic left ventricle in a calf. J Vet Cardiol 2017; 19:205-210. [PMID: 28111139 DOI: 10.1016/j.jvc.2016.11.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 04/20/2016] [Revised: 11/18/2016] [Accepted: 11/29/2016] [Indexed: 10/20/2022]
Abstract
A 3-day-old Hereford heifer calf presented for evaluation of lethargy and dyspnea, with persistent hypoxia despite supplemental oxygen therapy. A grade III/VI right apical systolic murmur was noted during cardiac auscultation. Echocardiography revealed a double-outlet right ventricle with an intact interventricular septum and concurrent hypoplastic left ventricle and tricuspid valve dysplasia. Post-mortem examination revealed additional congenital anomalies of ductus arteriosus, patent foramen ovale, and persistent left cranial vena cava. This report illustrates the use of echocardiographic images to diagnose a double-outlet right ventricle with an intact interventricular septum and a hypoplastic left ventricle in a calf.
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Affiliation(s)
- D K Newhard
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL, USA
| | - S W Jung
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL, USA.
| | - R L Winter
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL, USA
| | - T Kuca
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL, USA
| | - J Bayne
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL, USA
| | - T Passler
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL, USA
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Sim JS, Kim SY, Lee YJ, Seo JH, Kim DJ, Choe JW, Lee D, Jung SW, Lee SW. Indication and Clinical Outcomes of Percutaneous Endoscopic Gastrostomy: A Single-center Retrospective Analysis. Korean J Helicobacter Up Gastrointest Res 2017. [DOI: 10.7704/kjhugr.2017.17.3.138] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Ju Sung Sim
- Division of Gastroenterology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Seoung Young Kim
- Division of Gastroenterology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Ye Jin Lee
- Division of Gastroenterology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Ji Hye Seo
- Division of Gastroenterology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Dong Ju Kim
- Division of Gastroenterology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Jung Wan Choe
- Division of Gastroenterology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Dongwon Lee
- Division of Gastroenterology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Sung Woo Jung
- Division of Gastroenterology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Sang Woo Lee
- Division of Gastroenterology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
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Kim SY, Jung SW, Choe JW, Hyun JJ, Jung YK, Koo JS, Yim HJ, Lee SW. Predictive Factors for Pain After Endoscopic Resection of Gastric Tumors. Dig Dis Sci 2016; 61:3560-3564. [PMID: 27696098 DOI: 10.1007/s10620-016-4325-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 02/23/2016] [Accepted: 09/21/2016] [Indexed: 01/27/2023]
Abstract
BACKGROUND Abdominal pain is a common complaint following endoscopic resection (ER). AIMS To investigate the predictive factors for abdominal pain after ER. METHODS Patients who were scheduled to undergo endoscopic mucosal resection or endoscopic submucosal dissection for the treatment of gastric adenoma or cancer were prospectively enrolled. Pain scores were checked every 6 h after ER and whenever patients complained of pain by using a 0-10 pain scale. If the pain score exceeded 5, 25 mg of intravenous (IV) pethidine was administered. RESULTS Among 156 patients who underwent ER, 66 (42.3 %) received IV pethidine due to moderate/severe abdominal pain. Both the number of patients complaining of abdominal pain and the pain scores decreased with time following the procedure, with only a few patients complaining of mild abdominal pain 2 days after ER. Multivariate analysis showed that female sex [odds ratio (OR) 2.88; confidence interval (CI) 1.31-6.33], tumor location in the lower third of the stomach (OR 5.46; CI 2.31-12.92), and procedures time more than 60 min (OR 2.96; CI 1.26-6.98) were significant predictive factors for developing pain after ER. CONCLUSIONS Female sex, tumor location in the lower third of the stomach, and longer procedure time were significantly associated with pain after ER. Close monitoring and active management of pain is recommended for patients who have these risk factors. With these efforts, the majority of patients could experience pain relief within 2 days after the procedure.
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Affiliation(s)
- Seung Young Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Sung Woo Jung
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea. .,Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Korea University College of Medicine, 123 Jukgumro, Danwon-gu, Ansan, Gyeonggi-do, 425-707, Korea.
| | - Jung Wan Choe
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Jong Jin Hyun
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Young Kul Jung
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Ja Seol Koo
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Hyung Joon Yim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Sang Woo Lee
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
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Hong JS, Jin SS, Jung SW, Fang LH, Kim YY. Evaluation of dry feeding and liquid feeding to lactating sows under high temperature environment. J Anim Sci Technol 2016; 58:36. [PMID: 27795834 PMCID: PMC5075156 DOI: 10.1186/s40781-016-0118-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 10/08/2016] [Indexed: 11/14/2022]
Abstract
Background Liquid feeding system has been introduced to domestic swine farms, but negative cognition about liquid feeding system has been remained for feed waste decay related with poor management and microbial contamination. For these reasons, this study was conducted to evaluate the effects of feeding method in lactating sows. Methods A total of 30 mixed-parity (average 4.13) lactating sows (Yorkshire × Landrace) with an initial BW of 218.8 ± 19.5kg was used in a 3 week trial. Sows were allotted to 1 of 2 treatments in a completely randomized design by their body weight, backfat thickness, parity and alive litter weight. One of treatments was dry feeding and the other was liquid feeding (water to feed ratio, 1:1). Experimental diets contained 3265 kcal ME/kg, 12.6 % CP, 5.76 % EE, 1.09 % total lysine, 0.25 % total methionine, as fed basis. Results Dry feeding treatment had high body weight loss rather than liquid feeding treatment (P = 0.04). Dry feeding treatment had tendency to increase litter weight at 21d of lactation (P = 0.06) and litter weight gain (P = 0.04) during lactation period (0–3 week). Sows fed dry feeding method made milk containing high content of casein and total solid rather than sows fed liquid feeding method (P = 0.04). In addition, dry feeding treatment had tendency to higher content of milk fat, protein and solid not fat on 21d of lactation (P = 0.07). Sows fed dry feeding type also showed higher milk energy content in milk of 21d lactation (P = 0.05). Furthermore, liquid feeding treatment showed high occurrence in feed waste during lactation period (P < 0.01). Conclusion Dry feeding method was more suitable feeding method to lactating sows under high temperature environment like lactating barn.
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Affiliation(s)
- J S Hong
- School of Agricultural Biotechnology, Seoul National University, Seoul, Korea
| | - S S Jin
- School of Agricultural Biotechnology, Seoul National University, Seoul, Korea
| | - S W Jung
- School of Agricultural Biotechnology, Seoul National University, Seoul, Korea
| | - L H Fang
- School of Agricultural Biotechnology, Seoul National University, Seoul, Korea
| | - Y Y Kim
- School of Agricultural Biotechnology, Seoul National University, Seoul, Korea
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Kang BH, Yoon KC, Jung SW, Lee GR, Lee HS. Feasibility of single-incision laparoscopic appendectomy in a small hospital. Ann Surg Treat Res 2016; 91:74-9. [PMID: 27478812 PMCID: PMC4961889 DOI: 10.4174/astr.2016.91.2.74] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 06/09/2016] [Accepted: 06/09/2016] [Indexed: 11/30/2022] Open
Abstract
PURPOSE This study aimed to compare clinical outcomes for single-incision laparoscopic appendectomy (SILA) and conventional laparoscopic appendectomy (CLA) for the treatment of acute appendicitis and to assess the feasibility of performing SILA in a small hospital with limited surgical instruments and staff experience. METHODS Retrospective record review identified 133 patients who underwent laparoscopic appendectomy from December 2013 to April 2015. Patients were categorized according to the type of appendectomy performed (SILA or CLA). Patient characteristics and surgical outcomes were compared between the 2 groups. Postoperative complication rates were compared using the Clavien-Dindo classification. Postoperative pain was assessed using a visual analog scale immediately postsurgery; at 12, 24, 36, and 48 hours postoperatively, and at 7 days postoperatively. RESULTS Record review identified 38 patients who had undergone SILA and 95 patients who had undergone CLA. No significant differences in clinical characteristics were found between the 2 groups. There were no significant differences in operation time, time to flatus, or length of hospital stay. Overall complication rates were not significantly different between the 2 groups. No complications worse than grade IIIa occurred in the SILA group. Postoperative pain scores were not significantly different between the 2 groups at any time point. CONCLUSION We found comparable surgical outcomes for SILA compared to CLA. Even in a small hospital with limited surgical instruments and staff experience, SILA may be a feasible and safe technique.
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Affiliation(s)
- Byung Hee Kang
- Department of Surgery, Armed Forces Ildong Hospital, Pocheon, Korea
| | - Kyung Chul Yoon
- Department of Surgery, Armed Forces Ildong Hospital, Pocheon, Korea
| | - Sung Woo Jung
- Department of Surgery, Armed Forces Ildong Hospital, Pocheon, Korea
| | - Gyeo Ra Lee
- Department of Surgery, Armed Forces Ildong Hospital, Pocheon, Korea
| | - Hyung Soon Lee
- Department of Surgery, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea
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Jin SS, Jung SW, Jang JC, Chung WL, Jeong JH, Kim YY. Effects of Dietary Energy Levels on the Physiological Parameters and Reproductive Performance of Gestating Gilts. Asian-Australas J Anim Sci 2016; 29:1004-12. [PMID: 27282975 PMCID: PMC4932577 DOI: 10.5713/ajas.16.0269] [Citation(s) in RCA: 2] [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] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 04/27/2016] [Accepted: 05/25/2016] [Indexed: 11/27/2022]
Abstract
This experiment was conducted to investigate the effects of dietary energy levels on the physiological parameters and reproductive performance of gestating first parity sows. A total of 52 F1 gilts (Yorkshire×Landrace) were allocated to 4 dietary treatments using a completely randomized design. Each treatment contained diets with 3,100, 3,200, 3,300, or 3,400 kcal of metabolizable energy (ME)/kg, and the daily energy intake of the gestating gilts in each treatment were 6,200, 6,400, 6,600, and 6,800 kcal of ME, respectively. During gestation, the body weight (p = 0.04) and weight gain (p = 0.01) of gilts linearly increased with increasing dietary energy levels. Backfat thickness was not affected at d110 of gestation by dietary treatments, but increased linearly (p = 0.05) from breeding to d 110 of gestation. There were no significant differences on the litter size or litter birth weight. During lactation, the voluntary feed intake of sows tended to decrease when the dietary energy levels increased (p = 0.08). No difference was observed in backfat thickness of the sows within treatments; increasing energy levels linearly decreased the body weight of sows (p<0.05) at d 21 of lactation and body weight gain during lactation (p<0.01). No significant differences were observed in the chemical compositions of colostrum and milk. Therefore, these results indicated that high-energy diets influenced the bodyweight and backfat thickness of sows during gestation and lactation. NRC (2012) suggested that the energy requirement of the gestation gilt should be between 6,678 and 7,932 kcal of ME/d. Similarly, our results suggested that 3,100 kcal of ME/kg is not enough to maintain the reproductive performance for gilts during gestation with 2 kg feed daily. Gilts in the treatment 3,400 kcal of ME/kg have a higher weaning number of piglets, but bodyweight and backfat loss were higher than other treatments during lactation. But bodyweight and backfat loss were higher than other treatments during lactation. Consequently, an adequate energy requirement of gestating gilts is 6,400 kcal of ME/d.
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Affiliation(s)
- S S Jin
- School of Agricultural Biotechnology, and Research Institute for Agriculture and Life Science, Seoul National University, Seoul 151-921, Korea
| | - S W Jung
- School of Agricultural Biotechnology, and Research Institute for Agriculture and Life Science, Seoul National University, Seoul 151-921, Korea
| | - J C Jang
- School of Agricultural Biotechnology, and Research Institute for Agriculture and Life Science, Seoul National University, Seoul 151-921, Korea
| | - W L Chung
- School of Agricultural Biotechnology, and Research Institute for Agriculture and Life Science, Seoul National University, Seoul 151-921, Korea
| | - J H Jeong
- School of Agricultural Biotechnology, and Research Institute for Agriculture and Life Science, Seoul National University, Seoul 151-921, Korea
| | - Y Y Kim
- School of Agricultural Biotechnology, and Research Institute for Agriculture and Life Science, Seoul National University, Seoul 151-921, Korea
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Kang SH, Yim HJ, Kim SY, Suh SJ, Hyun JJ, Jung SW, Jung YK, Koo JS, Lee SW. Proton Pump Inhibitor Therapy Is Associated With Reduction of Early Bleeding Risk After Prophylactic Endoscopic Variceal Band Ligation: A Retrospective Cohort Study. Medicine (Baltimore) 2016; 95:e2903. [PMID: 26937932 PMCID: PMC4779029 DOI: 10.1097/md.0000000000002903] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Endoscopic variceal band ligation (EVL) is an effective procedure to control and prevent variceal bleeding in patients with liver cirrhosis, but it can be complicated by bleeding from post-EVL ulcers. Several studies have reported that proton pump inhibitors (PPIs) decrease the size of post-EVL ulcers. However, evidence are limited as to whether PPIs actually reduce the risk of bleeding after EVL. This study aimed to analyze the factors associated with bleeding after prophylactic EVL and to assess the effect of PPI therapy.Five hundred and five cirrhotic patients with high risk esophageal varices who received primary prophylactic EVL were included for this retrospective cohort study. Post-EVL bleeding was defined as bleeding after prophylactic EVL within 8 weeks evidenced by the occurrence of melena or hematemesis, or by a decrease of hemoglobin by >2.0 g/dL. If evidence of bleeding from ulceration of the EVL sites was confirmed by endoscopy, we defined it as post-EVL ulcer bleeding.Fourteen patients developed bleeding after prophylactic EVL. Factors associated with post-EVL bleeding included alcohol as etiology, low albumin, high total bilirubin, high Child-Pugh score, high MELD score, coexistence of gastric varices, and not administrating PPI medication by univariate analysis. In multivariate logistic analysis, Co-existing gastric varix (odds ratio [OR] 5.680, P = 0.005] and not administrating PPIs (OR 8.217, P = 0.002) were associated with bleeding after prophylactic EVL. In the subgroup analysis excluding patients whose gastric varices were treated, not administering PPI medication (OR 8.827, P = 0.008) was the sole factor associated with post-EVL bleeding.We suggest that PPI therapy needs to be considered in patients receiving prophylactic EVL to reduce the risk of bleeding after prophylactic EVL.
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Affiliation(s)
- Seong Hee Kang
- From the Department of Internal Medicine, Division of Gastroenterology and Hepatology, Korea University Ansan Hospital, Ansan-Si, Gyeonggi-Do, Republic of Korea
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Choe JW, Kim SY, Hyun JJ, Jung SW, Koo JS, Park JJ, Chun HJ, Lee SW. Prevalence of colorectal adenoma in patients with multiple gastric adenoma or cancers. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.4_suppl.517] [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] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
517 Background: It has been reported that patients with single gastric cancer or adenoma are at increased risk of colorectal cancer or adenoma. However, the incidence of colorectal adenoma in patients with multiple gastric neoplasms has not been discussed yet. Methods: We retrospectively analyzed the esophagogastroduodenoscopic and colonoscopic findings as well as the clinicopathologic features between October 2012 and July 2014. The aim of this study was to investigate whether the incidence of colorectal adenoma is higher or not in patients with multiple gastric neoplasms than those with a single gastric neoplasm. Results: A total of 164 patients with gastric neoplasm were divided into two groups whether the number of lesions was single or multiple. Among the 138 patients with single gastric neoplasm, 51 patients performed colonoscopy for surveillance study and 9 patients underwent colonoscopy among the 26 patients with multiple gastric neoplasms. Colorectal adenoma were detected in 58.8% (30/51) of the single gastric neoplasm group, and in 88.8% (8/9) of the multiple gastric neoplasms group (p < 0.001). The mean number of colorectal adenomas was significantly higher in the multiple gastric neoplasm group than in the single group. (4.78 vs. 1.94, p = 0.013). The age, sex, BMI, presence of underlying diseases and the degree of gastric dysplasia were not significantly different between the two groups. Conclusions: The prevalence and the number of colorectal adenoma were significantly higher in patients with multiple gastric neoplasms than in those with single gastric neoplasm. Clinical trial information: KUGH14308-001.
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Affiliation(s)
- Jung Wan Choe
- Division of Gastroenterology, Department of Internal Medicine, Korea University Ansan Hospital, Seoul, South Korea
| | - Seung Young Kim
- Korea University Medical Center, Korea University, Seoul, South Korea
| | - Jong Jin Hyun
- Division of Gastroenterology, Department of Internal Medicine, Korea University Ansan Hospital, Seoul, South Korea
| | - Sung Woo Jung
- Korea University Medical Center, Korea University, Seoul, South Korea
| | - Ja Seol Koo
- Korea University Medical Center, Korea University, Seoul, South Korea
| | - Jong-Jae Park
- Division of Gastroenterology, Department of Internal Medicine, Korea University Guro Hospital, Seoul, South Korea
| | - Hoon Jai Chun
- Division of Gastroenterology, Department of Internal Medicine, Korea University Anam Hospital, Seoul, South Korea
| | - Sang Woo Lee
- Division of Gastroenterology, Department of Internal Medicine, Korea University Ansan Hospital, Seoul, South Korea
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Choe JW, Jung SW, Song JK, Shim E, Choo JY, Kim SY, Hyun JJ, Koo JS, Yim HJ, Lee SW. Predictive Factors of Atelectasis Following Endoscopic Resection. Dig Dis Sci 2016; 61:181-8. [PMID: 26289260 DOI: 10.1007/s10620-015-3844-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 06/01/2015] [Accepted: 08/02/2015] [Indexed: 12/09/2022]
Abstract
BACKGROUND AND AIM Atelectasis is one of the pulmonary complications associated with anesthesia. Little is known about atelectasis following endoscopic procedures under deep sedation. This study evaluated the frequency, risk factors, and clinical course of atelectasis after endoscopic resection. METHODS A total of 349 patients who underwent endoscopic resection of the upper gastrointestinal tract at a single academic tertiary referral center from March 2010 to October 2013 were enrolled. Baseline characteristics and clinical data were retrospectively reviewed from medical records. To identify atelectasis, we compared the chest radiography taken before and after the endoscopic procedure. RESULTS Among the 349 patients, 68 (19.5 %) had newly developed atelectasis following endoscopic resection. In univariate logistic regression analysis, atelectasis correlated significantly with high body mass index, smoking, diabetes mellitus, procedure duration, size of lesion, and total amount of propofol. In multiple logistic regression analysis, body mass index, procedure duration, and total propofol amount were risk factors for atelectasis following endoscopic procedures. Of the 68 patients with atelectasis, nine patients developed fever, and six patients displayed pneumonic infiltration. The others had no symptoms related to atelectasis. CONCLUSIONS The incidence of radiographic atelectasis following endoscopic resection was nearly 20 %. Obesity, procedural time, and amount of propofol were the significant risk factors for atelectasis following endoscopic procedure. Most cases of the atelectasis resolved spontaneously with no sequelae.
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Affiliation(s)
- Jung Wan Choe
- Department of Internal Medicine, Korea University College of Medicine, Ansan, Korea
| | - Sung Woo Jung
- Department of Internal Medicine, Korea University College of Medicine, Ansan, Korea. .,Korea University Ansan Hospital, 123, Jeokgeum-ro, Danwon-gu, Ansan, Gyeonggi-do, 425-707, Korea.
| | - Jong Kyu Song
- Department of Internal Medicine, Korea University College of Medicine, Ansan, Korea
| | - Euddeum Shim
- Department of Radiology, Korea University College of Medicine, Ansan, Korea
| | - Ji Yung Choo
- Department of Radiology, Korea University College of Medicine, Ansan, Korea
| | - Seung Young Kim
- Department of Internal Medicine, Korea University College of Medicine, Ansan, Korea
| | - Jong Jin Hyun
- Department of Internal Medicine, Korea University College of Medicine, Ansan, Korea
| | - Ja Seol Koo
- Department of Internal Medicine, Korea University College of Medicine, Ansan, Korea
| | - Hyung Joon Yim
- Department of Internal Medicine, Korea University College of Medicine, Ansan, Korea
| | - Sang Woo Lee
- Department of Internal Medicine, Korea University College of Medicine, Ansan, Korea
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Abstract
Eradication of Helicobacter pylori is recommended for the management of various gastric diseases, including peptic ulcers and mucosa-associated lymphoid tissue lymphoma. Because of the increasing prevalence of antibiotic resistance, the eradication rates of antibiotic-based therapies have decreased. Therefore, alternative treatments should be considered. The antibacterial properties of fatty acids (FAs) have been investigated in various organisms, including H. pylori. Some FAs, particularly polyunsaturated FAs, have been shown to have bactericidal activity against H. pylori in vitro; however, their antibacterial effects in vivo remain controversial. Poor solubility and delivery of FAs may be important reasons for this discrepancy. Recently, a series of studies demonstrated the antibacterial effects of a liposomal formulation of linolenic acid against H. pylori, both in vitro and in vivo. Further research is needed to improve the bioavailability of FAs and apply them in clinical use.
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Affiliation(s)
- Sung Woo Jung
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Sang Woo Lee
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
- Correspondence to Sang Woo Lee, M.D. Department of Internal Medicine, Institute of Digestive Disease and Nutrition, Korea University Ansan Hospital, 123 Jeokgeum-ro, Danwon-gu, Ansan 15355, Korea Tel: +82-31-412-5580 Fax: +82-31-8099-6373 E-mail:
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Jung SW, Sun W, Griffiths LG, Kittleson MD. Atrial Fibrillation as a Prognostic Indicator in Medium to Large-Sized Dogs with Myxomatous Mitral Valvular Degeneration and Congestive Heart Failure. J Vet Intern Med 2015; 30:51-7. [PMID: 26681398 PMCID: PMC4913664 DOI: 10.1111/jvim.13800] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [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: 10/06/2014] [Revised: 09/18/2015] [Accepted: 11/04/2015] [Indexed: 12/04/2022] Open
Abstract
Background The prevalence and prognostic importance of atrial fibrillation (AF) on survival in nonsmall breed dogs with myxomatous mitral valvular disease (MMVD) and congestive heart failure (CHF) remain unknown. Aim To identify the prevalence of AF in nonsmall breed dogs with CHF because of MMVD and to characterize the impact of AF on survival outcome. Animal Sixty‐four client‐owned dogs (>15 kg) with MMVD and CHF. Methods Retrospective review of medical records for dogs weighing >15 kg with MMVD treated for CHF. Results Thirty‐three dogs presented with AF or developed AF during follow‐up examinations, and 31 dogs were free of AF until cardiac‐related death. For dogs with AF, median survival time (MST) was 142 days (range: 9–478) while dogs without AF lived 234 days (range: 13–879 days). AF increased risk of cardiac‐related death (HR = 2.544; 95% CI = 1.41–4.59; P = .0019) when compared to dogs without AF. MST was significantly prolonged for dogs with AF whose rates were adequately controlled (<160 bpm; 171 days; n = 13) when compared to dogs that failed to respond to negative chronotropic agents (61 days; n = 20; P = .032). The administration of combination treatment (diltiazem and digoxin) significantly decreased median HR to 144 bpm (range: 84–218 bpm) in dogs with AF and significantly prolonged MST (diltiazem+digoxin: 130 days versus diltiazem: 35 days, P = .0241) when compared to diltiazem alone. Conclusions and Clinical Importance Inadequately controlled AF is associated with a higher rate of mortality. Optimization of therapeutic strategies for the rate control of AF remains determined.
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Affiliation(s)
- S W Jung
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL
| | - W Sun
- Department of Mathematics and Statistics, Auburn University, Auburn, AL
| | - L G Griffiths
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California-Davis, Davis, CA
| | - M D Kittleson
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California-Davis, Davis, CA
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Lee JM, Hyun JJ, Choi IY, Yeom SK, Kim SY, Jung SW, Jung YK, Koo JS, Yim HJ, Lee HS, Lee SW, Kim CD. Comparison on Response and Dissolution Rates Between Ursodeoxycholic Acid Alone or in Combination With Chenodeoxycholic Acid for Gallstone Dissolution According to Stone Density on CT Scan: Strobe Compliant Observation Study. Medicine (Baltimore) 2015; 94:e2037. [PMID: 26683912 PMCID: PMC5058884 DOI: 10.1097/md.0000000000002037] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Medical dissolution of gallstone is usually performed on radiolucent gallstones in a functioning gallbladder. However, absence of visible gallstone on plain abdominal x-ray does not always preclude calcification. This study aims to compare the response and dissolution rates between ursodeoxycholic acid (UDCA) alone or in combination with chenodeoxycholic acid (CDCA) according to stone density on computed tomography (CT) scan. A total of 126 patients underwent dissolution therapy with either UDCA alone or combination of CDCA and UDCA (CNU) from December 2010 to March 2014 at Korea University Ansan Hospital. In the end, 81 patients (CNU group = 44, UDCA group = 37) completed dissolution therapy for 6 months. Dissolution rate (percentage reduction in the gallstone volume) and response to therapy (complete dissolution or partial dissolution defined as reduction in stone volume of >50%) were compared between the 2 groups. Dissolution and response rates of sludge was also compared between the 2 groups. The overall response rate was 50.6% (CNU group 43.2% vs UDCA group 59.5%, P = 0.14), and the overall dissolution rate was 48.34% (CNU group 41.5% vs UDCA group 56.5%, P = 0.13). When analyzed according to stone density, response rate was 33.3%, 87.1%, 30.0%, and 6.2% for hypodense, isodense, hyperdense, and calcified stones, respectively. Response rate (85.7% vs 88.2%, P = 0.83) and dissolution rate (81.01% vs 85.38%, P = 0.17) of isodense stones were similar between CNU and UDCA group. When only sludge was considered, the overall response rate was 87.5% (CNU group 71.4% vs UDCA group 94.1%, P = 0.19), and the overall dissolution rate was 85.42% (CNU group 67.9% vs UDCA group 92.7%, P = 0.23). Patients with isodense gallstones and sludge showed much better response to dissolution therapy with CNU and UDCA showing comparable efficacy. Therefore, CT scan should be performed before medication therapy if stone dissolution is intended.
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Affiliation(s)
- Jae Min Lee
- From the Department of Internal Medicine (JML, JJH, SYK, SWJ, YKJ, JSK, HJY, HSL, SWL, CDK); and Department of Radiology (IYC, SKY), Korea University College of Medicine, Seoul, Korea
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Kim JH, Jung SW, Song JG, Choe JW, Kim SY, Hyun JJ, Jung YK, Koo JS, Yim HJ, Lee SW. [Esophageal Hemangioma Treated by Endoscopic Mucosal Resection: A Case Report and Review of the Literature]. Korean J Gastroenterol 2015; 66:277-81. [PMID: 26586351 DOI: 10.4166/kjg.2015.66.5.277] [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] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Hemangioma of the esophagus is a rare form of benign esophageal tumor. It usually presents as a single lesion located in the lower third of the esophagus and is mostly asymptomatic. However, it may occasionally cause hematemesis and/or obstruction. Surgical resection is the conventional treatment modality for managing esophageal hemangioma, but less invasive approaches such as endoscopic therapy are recently becoming more widely employed. Herein, we report a case of a 54-year-old man who presented with an esophageal hemangioma that was successfully treated by endoscopic mucosal resection without any complications.
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Affiliation(s)
- Ji Hye Kim
- Division of Gastroenterology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Sung Woo Jung
- Division of Gastroenterology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Jong Gyu Song
- Division of Gastroenterology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Jung Wan Choe
- Division of Gastroenterology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Seoung Young Kim
- Division of Gastroenterology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Jong Jin Hyun
- Division of Gastroenterology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Young Kul Jung
- Division of Gastroenterology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Ja Seol Koo
- Division of Gastroenterology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Hyung Joon Yim
- Division of Gastroenterology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Sang Woo Lee
- Division of Gastroenterology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
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Affiliation(s)
- Jung Wan Choe
- Division of Gastroenterology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Sung Woo Jung
- Division of Gastroenterology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Sang Woo Lee
- Division of Gastroenterology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
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Jang JC, Jung SW, Jin SS, Ohh SJ, Kim JE, Kim YY. The Effects of Gilts Housed Either in Group with the Electronic Sow Feeding System or Conventional Stall. Asian-Australas J Anim Sci 2015; 28:1512-8. [PMID: 26323407 PMCID: PMC4554859 DOI: 10.5713/ajas.14.0819] [Citation(s) in RCA: 7] [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] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Revised: 12/15/2014] [Accepted: 04/30/2015] [Indexed: 11/27/2022]
Abstract
This experiment was conducted to assess the welfare and productivity of gestating gilts in groups with the electronic sow feeding (ESF) system compared to conventional stalls. A total of 83 gilts (Yorkshire×Landrace) were housed into individual stalls to be artificially inseminated. Gilts confirmed pregnant were introduced to their treatment, conventional stalls (ST) or groups with the ESF system. All gilts were taken to the farrowing crates one week prior to their expected farrowing date. In the gestation period, there were no significant differences between gilts allocated to ST and ESF on growth performance. However, backfat thickness gain (p = 0.08) and body condition score (BCS) at 110 days of gestation (p = 0.10) tended to be higher in ESF gilts than ST. Likewise, gilts housed in group showed significantly higher estimated body muscle contents at 110 days of gestation (p = 0.02) and body muscle change during gestation (p = 0.01). There was a trend for a shorter parturition time in ESF gilts (p = 0.07). In the lactation period, group housed gilts showed a tendency to increased BCS changes (p = 0.06). Reproductive performance did not differ with the exception of piglet mortality (ST = 0.2 no. of piglets vs ESF = 0.4 no. of piglets; p = 0.01). In blood profiles, ST gilts showed a higher cortisol level at 110 days of gestation (p = 0.01). Weaning to estrus interval was shorter in gilts housed in ESF than ST (p = 0.01). In locomotory behaviors, ESF gilts recorded a tendency to elevate locomotion score at 36, 70, and 110 days of gestation (p = 0.07, p = 0.06, and p = 0.06, respectively). Similarly, ESF gilts showed significantly higher incidence of scratches at 36, 70, and 110 days of gestation (p = 0.01). Moreover, farrowing rates were higher in stall treatment (97.6%) compare to group housing treatment (95.2%). In conclusion, while group housed gilts with ESF system positively affected welfare status in combination with less physiologically stressful environments and activity, it negatively effects piglet mortality, farrowing rates and injuries of gilts.
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Affiliation(s)
- J C Jang
- College of Animal Life Science, Kangwon National University, Chuncheon 200-701, Korea
| | - S W Jung
- College of Animal Life Science, Kangwon National University, Chuncheon 200-701, Korea
| | - S S Jin
- College of Animal Life Science, Kangwon National University, Chuncheon 200-701, Korea
| | - S J Ohh
- College of Animal Life Science, Kangwon National University, Chuncheon 200-701, Korea
| | - J E Kim
- National Institute of Animal Science, Rural Development Administration, Cheonan 331-801, Korea
| | - Y Y Kim
- College of Animal Life Science, Kangwon National University, Chuncheon 200-701, Korea
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Na YJ, Hyun JJ, Kim SY, Jung SW, Koo JS, Yim HJ, Lee SW. Presumed pancreatic cyst proven to be venous malformation due to intestinal malrotation. Endoscopy 2015; 46 Suppl 1 UCTN:E399-400. [PMID: 25254598 DOI: 10.1055/s-0034-1377399] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- Young Ju Na
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Jong Jin Hyun
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Seung Young Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Sung Woo Jung
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Ja Seol Koo
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Hyung Joon Yim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Sang Woo Lee
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
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Song JG, Koo JS, Kang HS, Park JY, Kim SY, Hyun JJ, Jung SW, Lee SW. [A case of necrotizing colitis presenting with hepatic portal venous gas and pneumatosis intestinalis]. Korean J Gastroenterol 2015; 65:177-81. [PMID: 25797382 DOI: 10.4166/kjg.2015.65.3.177] [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] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Hepatic portal venous gas is a very rare radiologic sign which is characterized by gas accumulation in the portal venous circulation. Pneumatosis intestinalis is also very rare and is characterized by multiple air cysts in the serosal or submucosal layers of the gastrointestinal tract walls. These two findings are caused by various pathological conditions and can develop individually or simultaneously. The latter is clinically more significant because it is frequently related to bowel ischemia or necrosis, and represents a poor prognosis. However, prognosis is more influenced by the severity of underlying disease rather than hepatic portal venous gas or pneumatosis intestinalis itself. If bowel ischemia or necrosis is the primary cause, emergency operation is very important to improve patient's prognosis. Herein, we report a case of necrotizing colitis presenting as hepatic portal venous gas and pneumatosis intestinalis which was successfully managed by early surgery.
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Affiliation(s)
- Jong Gyu Song
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Ja Seol Koo
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Hyo Sung Kang
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Jin Yong Park
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Seoung Young Kim
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Jong Jin Hyun
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Sung Woo Jung
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Sang Woo Lee
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
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Lee SW, Choi IK, Lee CM, Kim SY, Hyun JJ, Jung SW, Jung YK, Koo JS, Kim JH, Park SH, Kim SJ, Kim JS. The prognostic factors and the cause of death in patients with advanced or recurrent gastric cancer. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.3_suppl.215] [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] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
215 Background: The purpose of this study is to evaluate significant prognostic factor and compare the cause of death in patients with advanced or recurrent gastric cancer. Methods: We reviewed the medical records of 170 patients who had been diagnosed as advanced or recurrent gastric cancer between January 2006 and September 2013. The patients were divided into two groups. One group (advanced gastric cancer: AC) included 104 patients had undergone chemotherapy for advanced gastric cancer, and the other group (recurrent gastric cancer: RC) 66 for recurrence after surgical treatment. The causes of death and overall survival were compared between two groups, and the significant prognostic factors were investigated by multivariate analysis. Also, subgroup analysis was performed for 18 patients with gastrectomy for curative intent, and they were proved to have unresectable gastric cancer after surgery (non-palliative surgery for advanced gastric cancer: NS). Results: In the comparison for the causes of death, two groups showed no statistical difference, but AC group had more tendency to die because of bleeding ( p = 0.054) and infection ( p = 0.075). Overall survival of AC group did not differ from that of RC ( p = 0.901). In multivariate analysis, bone metastasis ( p = 0.013, HR = 1.923), peritoneal seeding ( p = 0.001, HR = 2.182) and the frequency of chemotherapy ( p < 0.001, HR = 0.887) were significantly associated with the overall survival. In a subgroup analysis, the overall survival of NS was significantly higher than AC ( p = 0.032). Conclusions: In the patients with advanced or recurrent gastric cancer, AC might have more possibility to die because of bleeding and infection than RC. Additionally, the prognosis of patients with advanced or recurrent gastric cancer was affected by the presence of bone metastasis, peritoneal seeding and frequency of chemotherapy. Non-palliative surgery for gastric cancer might show the better prognosis than AC in the specific conditions.
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Affiliation(s)
- Sang Woo Lee
- Korea University Medical Center, Korea University, Seoul, South Korea
| | - In Keun Choi
- Korea University Medical Center, Korea University, Seoul, South Korea
| | - Chang Min Lee
- Korea University Medical Center, Korea University, Seoul, South Korea
| | - Seung Young Kim
- Korea University Medical Center, Korea University, Seoul, South Korea
| | - Jong Jin Hyun
- Korea University Medical Center, Korea University, Seoul, South Korea
| | - Sung Woo Jung
- Korea University Medical Center, Korea University, Seoul, South Korea
| | - Young Kul Jung
- Korea University Medical Center, Korea University, Seoul, South Korea
| | - Ja Seol Koo
- Korea University Medical Center, Korea University, Seoul, South Korea
| | - Jong-Han Kim
- Korea University Medical Center, Korea University, Seoul, South Korea
| | - Seong-Heum Park
- Korea University Medical Center, Korea University, Seoul, South Korea
| | - Seung-Joo Kim
- Korea University Medical Center, Korea University, Seoul, South Korea
| | - Jun Suk Kim
- Korea University Guro Hospital, Seoul, South Korea
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Suh KH, Koo JS, Hyun JJ, Choi J, Han JS, Kim SY, Jung SW, Jeen YT, Lee SW, Choi JH. Risk of adenomas with high-risk characteristics based on two previous colonoscopy. J Gastroenterol Hepatol 2014; 29:1985-90. [PMID: 24909388 DOI: 10.1111/jgh.12650] [Citation(s) in RCA: 5] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/20/2014] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND AIM The recommended intervals between surveillance colonoscopies are based on the most recent examination findings. However, whether the two previous colonoscopies affect second surveillance colonoscopic findings is not established. The aim of this study is to estimate the risk of obtaining high-risk findings (HRF) on the next surveillance colonoscopy using the results of two previous colonoscopies, and to estimate the appropriate time interval for the next surveillance colonoscopy. METHODS Among subjects who underwent screening colonoscopy during January 2002-December 2009, patients who underwent second surveillance colonoscopy before June 2012 were enrolled. "No adenoma" was defined as a hyperplastic polyp or no polyp, "low-risk findings (LRF)" as one or two small (< 1 cm) tubular adenomas, and "HRF" as advanced adenoma, cancer, or any sized multiple (≥ 3) adenomas. RESULTS Among enrolled 852 subjects, 65 (7.6%) had HRF at second surveillance colonoscopy. Multivariate analysis showed that HRF on second surveillance colonoscopy were associated with male and HRF on screening colonoscopy (all, P < 0.01). In subjects with LRF on first surveillance colonoscopy, HRF on the screening colonoscopy significantly affected the detection of HRF on second surveillance colonoscopy (P < 0.01). Patients with HRF on screening colonoscopy and LRF on the first surveillance colonoscopy had no different risk of HRF on second surveillance colonoscopy from those with HRF on first surveillance colonoscopy (P > 0.05). CONCLUSIONS The HRF on second surveillance are significantly associated with previous two colonoscopic results. In patients with LRF on first surveillance, screening colonoscopic findings should be considered to determine the optimal surveillance interval.
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Affiliation(s)
- Kang-Heum Suh
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
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Kang HS, Hyun JJ, Kim SY, Jung SW, Koo JS, Yim HJ, Lee SW. Bezoar formation and obstruction caused by a surgical nylon thread after gastric bypass surgery. Endoscopy 2014; 45 Suppl 2 UCTN:E412. [PMID: 24285076 DOI: 10.1055/s-0033-1344991] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- Hyo Sung Kang
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea
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