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Current status of intragastric balloon for obesity treatment

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World Journal of Gastroenterology 2016年第24期22卷 5495-5504页

作者： Seung Han Kim Hoon Jai Chun Hyuk Soon Choi Eun Sun Kim bora keum Yoon Tae Jeen Division of Gastroenterology and Hepatology Department of Internal Medicine Institute of Gastrointestinal Medical Instrument Research Korea University College of Medicine

Endoscopic bariatric therapy may be a useful alternative to pharmacological treatment for obesity, and it provides greater efficacy with lower risks than do conventional surgical procedures. Among the various endoscopic treatments for obesity, the intragastric balloon is associated with significant efficacy in body weight reduction and relief of comorbid disease symptoms. Anatomically, this treatment is based on gastric space-occupying effects that increase the feeling of satiety and may also affect gut neuroendocrine signaling. The simplicity of the intragastric balloon procedure may account for its widespread role in obesity treatment and its applicability to various degrees of obesity. However, advances in device properties and procedural techniques are still needed in order to improve its safety and cost-effectiveness. Furthermore, verification of the physiological outcomes of intragastric balloon treatment and the clinical predictive factors for treatment responses should be considered. In this article, we discuss the types, efficacy, safety, and future directions of intragastric balloon treatment.

关键词： Intragastric balloon Obesity Bariatric Metabolic Endoscopy

Endoscopic en bloc resection of an exophytic gastrointestinal stromal tumor with suction excavation technique

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World Journal of Gastroenterology 2016年第23期22卷 5454-5458页

作者： Hyuk Soon Choi Hoon Jai Chun Kyoung-Oh Kim Eun Sun Kim bora keum Yoon-Tae Jeen Hong Sik Lee Chang Duck Kim Division of Gastroenterology and Hepatology Department of Internal MedicineInstitute of Gastrointestinal Medical Instrument ResearchKorea University College of MedicineKorea University Medical Center Department of Internal Medicine Gachon University Gil Medical CenterGachon University of Medicine and Science

Here, we report the first successful endoscopic resection of an exophytic gastrointestinal stromal tumor (GIST) using a novel perforation-free suction excavation technique. A 49-year-old woman presented for further management of a gastric subepithelial tumor on the lesser curvature of the lower body, originally detected via routine upper gastrointestinal endoscopy. Abdominal computed tomography and endoscopic ultrasound showed a 4-cm extraluminally protruding mass originating from the muscularis propria layer. The patient firmly refused surgical resection owing to potential cardiac problems, and informed consent was obtained for endoscopic removal. Careful dissection and suction of the tumor was repeated until successful extraction was achieved without serosal injury. We named this procedure the suction excavation technique. The tumor’s dimensions were 3.5 cm × 2.8 cm × 2.5 cm. The tumor was positive for C-KIT and CD34 by immunohistochemical staining. The mitotic count was 6/50 high-power fields. The patient was followed for 5 years without tumor recurrence. This case demonstrated the use of endoscopic resection of an exophytic GIST using the suction excavation technique as a potential therapy without surgical resection.

关键词： Gastrointestinal stromal tumor Endoscopic resection Submucosal tumor Subepithelial tumor En bloc resection

A novel cleansing score system for capsule endoscopy

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World Journal of Gastroenterology 2010年第7期16卷 875-880页

作者： Sung Chul Park bora keum Jong Jin Hyun Yeon Seok Seo Yong Sik Kim Yoon Tae Jeen Hoon Jai Chun Soon Ho Um Chang Duck Kim Ho Sang Ryu Division of Gastroenterology and Hepatology Department of Internal MedicineKorea University Anam HospitalInstitute of Digestive Disease and NutritionKorea University College of MedicineSeoul 136-705South Korea

AIM:To suggest a new cleansing score system for small bowel preparation and to evaluate its clinical ***:Twenty capsule endoscopy cases were reviewed and small bowel preparation was assessed with the new scoring *** the assessment,two visual parameters were used:proportion of visualized mucosa and degree of *** frames from small bowel images were serially selected and scored at 5-min *** correlation coefficient(ICC)was obtained to assess the reliability of the new scoring *** efficacy evaluation and validation,scores of our new scoring system were compared with another previously reported cleansing grading ***:Concordance with the previous system,inter-observer agreement,and intra-patient agreement were excellent with ICC values of 0.82,0.80,and 0.76,*** intra-observer agreements at four-week intervals were also *** cutoff value of adequate image quality was found to be ***:Our new scoring system is simple,efficient,and can be considered to be applicable in clinical practice and research.

关键词： Capsule endoscopy Cleansing score system

Sensitivity of the suspected blood indicator:An experimental study

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World Journal of Gastroenterology 2012年第31期18卷 4169-4174页

作者： Sung Chul Park Hoon Jai Chun Eun Sun Kim bora keum Yeon Seok Seo Yong Sik Kim Yoon Tae Jeen Hong Sik Lee Soon Ho Um Chang Duck Kim Ho Sang Ryu Division of Gastroenterology and Hepatology Department of Internal MedicineKangwon National University School of MedicineChuncheon 200-722South Korea Division of Gastroenterology and Hepatology Department of Internal MedicineKorea University College of MedicineSeoul 136-705South Korea

AIM： To investigate whether suspected blood indicator （SBI） in capsule endoscopy （CE） is affected by back- ground color and capsule passage velocity. METHODS： Experimental models of the small intestine constructed from paper in a variety of colors were used to simulate the background colors observed in CE im- ages. The background colors studied included very pale yellow, yellow, very pale magenta, light grayish pink, burnt sienna, and deep and dark brown, and red spots were attached inside them. An endoscopic capsule was manually passed through the models. The rate of detection of the red spots by the SBI was evaluated based on the colors of the models and the capsule pas- sage velocities （0.5 cm/s, 1 cm/s, and 2 cm/s）.RESULTS： The rate of detection of the red spots byground color of the model （P 〈 0.001）. Detection rates were highest for backgrounds of very pale magenta, burnt sienna, and yellow, in that order. They were lowest for backgrounds of dark brown and very pale yellow. The rate of detection of red spots by the SBI tended to decrease at rapid capsule passage velocities （1-2 cm/s） compared to slow velocities （0.5 cm/s） for backgrounds of very pale yellow （P = 0.042）, yellow （P = 0.001）, very pale magenta （P = 0.002）, and burnt sien- na （P = 0.001）. No significant differences in the rate of detection were observed according to velocity for light grayish pink （P = 0.643） or dark brown （P = 0.396）. CONCLUSION： SBI sensitivity was affected by back- ground color and capsule passage velocity in the models. These findings may facilitate the rapid detection of bleeding lesions by CE.

关键词： Capsule endoscopy Suspected blood indi-cator Sensitivity Background color Passage velocity

Comparison of sequential and 7-,10-,14-d triple therapy for Helicobacter pylori infection

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World Journal of Gastroenterology 2012年第19期18卷 2377-2382页

作者： Hyuk Soon Choi Hoon Jai Chun Sang Hoon Park bora keum Yeon Seok Seo Yong Sik Kim Yoon-Tae Jeen Soon Ho Um Hong Sik Lee Chang Duck Kim Ho Sang Ryu Division of Gastroenterology and Hepatology Department of Internal MedicineInstitute of Digestive Disease and NutritionKorea University College of MedicineSeoul 136-705South Korea

AIM:To compare the effectiveness of sequential therapy for Helicobacter pylori(***) infection with that of triple therapy of varying ***:The 460 patients enrolled in this study had ***-associated gastritis or a gastric or duodenal *** screening,***-infected patients were randomly assigned to receive either conventional triple therapy for 7,10 or 14 d,or a new 10-d sequential *** of the 4 treatment groups included 115 *** outcomes of eradication therapy were assessed 4 wk after treatment by the urea breath test and ***:The overall eradication rate was 81.0%,and eradication rates were 75.7% for 7-d conventional triple therapy,81.9% for 10-d conventional triple therapy,84.4% for 14-d conventional triple therapy,and 82.0% for 10-d sequential *** intention-to-treat analysis nor per protocol analysis showed significant differences in eradication rates using sequential therapy or the standard triple therapy(P = 0.416 and P = 0.405,respectively).CONCLUSION:There are no significant differences between 10-d sequential eradication therapy for *** and any duration of standard triple treatment in Korean patients.

关键词： He/icobacter pylori Sequential therapy Triple therapy Gastric ulcer Duodenal ulcer Gastritis

Self-expandable metal stents in patients with postoperative delayed gastric emptying after distal gastrectomy

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World Journal of Gastroenterology 2018年第40期24卷 4578-4585页

作者： Seung Han Kim bora keum Hyuk Soon Choi Eun Sun Kim Yeon Seok Seo Yoon Tae Jeen Hong Sik Lee Hoon Jai Chun Soon Ho Um Chang Duck Kim Sungsoo Park Division of Gastroenterology and Hepatology Department of Internal MedicineInstitute of Gastrointestinal Medical Instrument ResearchKorea University College of MedicineSeoul 02841South Korea Department of Surgery Korea University College of MedicineSeoul 02841South Korea

AIM To investigate the efficacy and safety of endoscopic stent insertion in patients with delayed gastric emptying after *** In this study, we prospectively collected data from patients who underwent stent placement for delayed gastric emptying(DGE) after distal gastrectomy between June 2010 and April 2017, at a tertiary referral academic center. Clinical improvement, complications, and consequences after stent insertion were *** Technical success was achieved in all patients(100%). Early symptom improvement was observed in 15 of 20 patients(75%) and clinical success was achieved in all patients. Mean follow-up period was 1178.3 ± 844.1 d and median stent maintenance period was 51 d(range 6-2114 d). During the follow-up period, inserted stents were passed spontaneously per rectum without any complications in 14 of 20 patients(70%). Symptom improvement was maintained after stent placement without the requirement of any additional intervention in 19 of 20 patients(95%).CONCLUSION Endoscopic stent placement provides prompt relief of obstructive symptoms. Thus, it can be considered an effective and safe salvage technique for post-operative DGE.

关键词： Self-expandable metal stent Delayed gastric emptying Gastrectomy Salvage technique Symptom improvement

Radiotherapy for 65 patients with advanced unresectable hepatocellular carcinoma

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World Journal of Gastroenterology 2008年第15期14卷 2394-2400页

作者： Yeon Seok Seo Jin Nam Kim bora keum Sanghoon Park Yong Dae Kwon Yong Sik Kim Yoon Tae Jeen Hoon Jai Chun Chul Yong Kim Chang Duck Kim Ho Sang Ryu Soon Ho Um Department of Internal Medicine Korea University College of Medicine Seoul 136-705 Korea Department of Radiation Oncology Korea University College of Medicine Seoul 136-705 Korea

AIM: To evaluate the efficacy of radiotherapy (RT) in patients with advanced unresectable hepatocellular carcinoma (HCC). METHODS: A total of 65 patients were treated with RT in the Korea University Medical Center. The median age of the patients was 60 years, and 86.2% were men. 18.5% and 81.5% of the patients were diagnosed as TNM stage Ⅲ and Ⅳ-A, respectively. Treatment response was assessed 4 mo after initiation of RT. Tumor regression rate 1 mo after initiation of RT (TRR1m) was also assessed. Duration of survival was calculated from the initiation of RT. RESULTS: The objective treatment response was 56.9%. The 12 mo survival rate was 34.7%. Predictive factors for survival were Child-Pugh grade, α-fetoprotein level and treatment response. An objective response was achieved more frequently in patients with TRR1m ≥ 20% than in those with TRR1m < 20% (P < 0.001). CONCLUSION: RT is effective in treating advanced HCC with a tumor response rate of 56.9%.

关键词： Hepatocellular carcinoma Radiotherapy Treatment response Survival

Prognostic value of inflammation-based markers in patients with pancreatic cancer administered gemcitabine and erlotinib

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World Journal of Gastrointestinal Oncology 2016年第7期8卷 555-562页

作者： Jae Min Lee Hong Sik Lee Jong Jin Hyun Hyuk Soon Choi Eun Sun Kim bora keum Yeon Seok Seo Yoon Tae Jeen Hoon Jai Chun Soon Ho Um Chang Duck Kim Division of Gastroenterology and Hepatology Department of Internal Medicine Korea University College of Medicine

AIM: To evaluate the value of systemic inflammationbased markers as prognostic factors for advanced pancreatic cancer(PC). METHODS: Data from 82 patients who underwent combination chemotherapy with gemcitabine and erlotinib for PC from 2011 to 2014 were collected retrospectively. Data that included the neutrophil-to-lymphocyte ratio(NLR), the platelet-to-lymphocyte ratio, and the C-reactive protein(CRP)-to-albumin(CRP/Alb) ratio were analyzed. Kaplan-Meier curves, and univariate and multivariate Cox proportional hazards regression analyses were used to identify the prognostic factors associated with progression-free survival(PFS) and overall survival(OS). RESULTS: The univariate analysis demonstrated the prognostic value of the NLR(P = 0.049) and the CRP/Alb ratio(P = 0.047) in relation to PFS, and a positiverelationship between an increase in inflammation-based markers and a poor prognosis in relation to OS. The multivariate analysis determined that an increased NLR(hazard ratio = 2.76, 95%CI: 1.33-5.75, P = 0.007) is an independent prognostic factor for poor OS. There was no association between the PLR and the patients' prognoses in those who had received chemotherapy that comprised gemcitabine and erlotinib in combination. The Kaplan-Meier method and the log-rank test determined significantly worse outcomes in relation to PFS and OS in patients with an NLR > 5 or a CRP/Alb ratio > ***: Systemic inflammation-based markers, including increases in the NLR and the CRP/Alb ratio, may be useful for predicting PC prognoses.

关键词： Pancreatic cancer Neutrophil-to-lymphocyte ratio C-reactive protein Albumin Prognostic factor

Intraductal papillary bile duct adenocarcinoma and gastrointestinal stromal tumor in a case of neurofibromatosis type 1

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World Journal of Gastroenterology 2018年第4期24卷 537-542页

作者： Jung Min Lee Jae Min Lee Jong Jin Hyun Hyuk Soon Choi Eun Sun Kim bora keum Yoon Tae Jeen Hoon Jai Chun Hong Sik Lee Chang Duck Kim Dong Sik Kim Joo Young Kim Division of Gastroenterology and Hepatology Department of Internal Medicine Institute of Gastrointestinal Medical Instrument Research Korea University College of Medicine Division of Gastroenterology and Hepatology Department of Internal Medicine Korea University Anam Hospital Division of HBP Surgery and Liver Trans- plantation Department of Surgery Korea University College of Medicine Department of Pathology Korea University College of Medicine

We report our experience with a synchronous case of gastrointestinal stromal tumor(GIST) and intraductal papillary neoplasm of the bile duct(IPNB) in anelderly woman with neurofibromatosis type 1(NF-1). A 72-year-old woman presented with a 2-mo history of right upper abdominal pain unrelated to diet and indigestion. Fourteen years earlier, she had been diagnosed with NF-1, which manifested as café au lait spots and multiple nodules on the skin. Computed tomography(CT) revealed a multilocular low-density mass with septation, and mural nodules in the right hepatic lobe, as well as a 1.7-cm-sized well-demarcated enhancing mass in the third portion of the duodenum. The patient subsequently underwent right hepatectomy and duodenal wedge resection. We present here the first report of a case involving a synchronous IPNB and GIST in a patient with NF-1. Our findings demonstrate the possibility of various tumors in NF-1 patients and the importance of diagnosis at an early

关键词： Neurofibromatosis type 1 Intraductal papillary neoplasm of the bile duct Gastrointestinal stromal tumor Synchronous