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Intraoperative radiofrequency ablation with or without tumorectomy for hepatocellular carcinoma in locations difficult for a percutaneous approach

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Hepatobiliary & Pancreatic Diseases International 2009年第6期8卷 591-596页

作者： Hyung Ook kim Seung Kwon kim byung Ho Son Chang Hak Yoo Hyun Pyo Hong Yong Kyun Cho byung ik kim Departments of Surgery Kangbuk Samsung Hospital Sungkyunkwan University School of Medicine Radiology Kangbuk Samsung Hospital Sungkyunkwan University School of Medicine Division of Interventional Radiology Mallinckrodt Institute of RadiologyWashington University School of Medicine Internal Medicine Kangbuk Samsung Hospital Sungkyunkwan University School of Medicine

BACKGROUND:Although hepatic resection is widely accepted as a proper modality for treating hepatocellular carcinoma(HCC),a majority of patients are unable to undergo surgical resection due to various tumor and patient *** ablation(RFA)has mostly been used as a therapeutic alternative to resection for treating *** objective of this study was to evaluate the results of intraoperative RFA for HCCs in locations difficult for a percutaneous ***:Eight patients(male,seven;age,49-67 years) with 8 HCCs in difficult locations were treated by intraoperative *** of the patients had local tumor progression after initial transarterial chemoembolization or ultrasound(US)guided percutaneous *** locations of the tumors were hepatic dome in six patients,posterior subcapsule in one,and caudate lobe in *** tumor size was 2.0 to 6.4 cm(mean,3.9 cm).Intraoperative RFA was performed at the tumor itself and an anticipated resection line under US guidance with 3 cm monopolar single or clustered internally cooled *** resection was performed in six *** month later,treatment response was assessed by contrast material-enhanced computed tomography(CT).CT studies were performed every 2 or 3 months after ***:RFA was technically successful in all tumors,and the contrast-enhanced CT images acquired one month later showed complete disappearance of tumor *** pneumothorax *** a median follow-up of 18 months(range,6-30 months),no tumors showed local *** the follow-up period,four new recurrent tumors were observed in three *** patients were alive at the time of this report and the other four died of hepatorenal syndrome,liver failure,and progression of new recurrent ***:Intraoperative RFA with tumor resection can be an alterative treatment option for HCC in locations difficult for a percutaneous approach.

关键词： hepatocellular carcinoma radiofrequency ablation intraoperative

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Metabolic syndrome is associated with erosive esophagitis

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World Journal of Gastroenterology 2008年第35期14卷 5442-5447页

作者： Jung Ho Park Dong IL Park Hong Joo kim Yong Kyun Cho Chong IL Sohn Woo Kyu Jeon byung ik kim Department of Medicine Kangbuk Samsung HospitalSungkyunkwan University School of MedicineSeoulSouth Korea

AIM： To clarify whether insulin resistance and metabolic syndrome are risk factors for erosive esophagitis.METHODS： A case-control study was performed using the database of the Kangbuk Samsung Hospital Medical Screening Center.RESULTS： A total of 1679 cases of erosive esophagitis and 3358 randomly selected controls were included. Metabolic syndrome was diagnosed in 21% of the cases and 12% of the controls （P 〈 0.001）. Multiple logistic regressions confirmed the association between erosive esophagitis and metabolic syndrome （Odds ratio, 1.25; 95% CI, 1.04-1.49）. Among the components of metabolic syndrome, increased waist circumference, elevated serum triglyceride levels and hypertension were significant risk factors for erosive esophagitis （all P 〈 0.01）. Furthermore, increased insulin resistance （Odds ratio, 0.91; 95% CI, 0.85-0.98） and fatty liver, as diagnosed by ultrasonography （odds ratio, 1.39; 95% CI, 1.20-1.60）, were also related to erosive esophagitis even afl：er adjustment for a series of confounding factors.CONCLUSION： Metabolic syndrome and increased insulin resistance are associated with an increased risk of developing erosive esophagitis.

关键词： Metabolic syndrome Erosive esophagitis Insulin resistance Fatty liver

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Comparison of brush and basket cytology in differential diagnosis of bile duct stricture at endoscopic retrograde cholangiopancreatography

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Hepatobiliary & Pancreatic Diseases International 2014年第6期13卷 622-627页

作者： Ki Bae Bang Hong Joo kim Jung Ho Park Dong Il Park Yong Kyun Cho Chong Il Sohn Woo Kyu Jeon byung ik kim Department of Internal Medicine Sungkyunkwan University Kangbuk Samsung Hospital 108 Pyung-Dong Jongro-Ku Seoul 110-746 Korea

BACKGROUND： A previous report has identified a significantly higher sensitivity of cancer detection for dedicated grasping basket than brushing at endoscopic retrograde cholangiopancreato- graphy （ERCP）. This study aimed to compare the diagnostic accuracy of Geenen brush and Dormia basket cytology in the differential diagnosis of bile duct stricture. METHOD： The current study enrolled one hundred and fourteen patients who underwent ERCP with both Geenen brush and Dormia basket cytology for the differential diagnosis of bile duct stricture at our institution between January 2008 and December 2012. RESULTS： We adopted sequential performances of cytologic samplings by using initial Geenen brush and subsequent Dormia basket cytology in 59 patients and initial Dormia basket and subsequent Geenen brush cytology in 55 patients. Presampling balloon dilatations and biliary stentings for the stricture were performed in 17 （14.9%） and 107 patients （93.9%）, respectively. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of Geenen brush cytology for the diagnosis of malignant bile duct stricture were 75.0%, 100.0%, 100.0%, 66.7% and 83.3%, respectively, and those of Dormia basket cytology were 64.5%, 100.0%, 100.0%, 58.5% and 76.3%, respectively （P=0.347 and 0.827 for sensitivity and accuracy, respectively）. The good and excellent cellular yields （≥grade 2） were obtained by Geenen brush and Dormia basket cytology in 88 （77.2%） and 79 （69.3%） patients, ***： The sensitivity, specificity and accuracy of biliary sampling with a Dormia basket are comparable to those with conventional Geenen brush cytology in the detection of malignant bile duct stricture.

关键词： bile duct stricture cholangiocarcinoma brush cytology basket cytology

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Epidermal growth factor upregulates Skp2/Cks1 and p27^(kip1) in human extrahepatic cholangiocarcinoma cells

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World Journal of Gastroenterology 2014年第3期20卷 755-773页

作者： Ja-yeon kim Hong Joo kim Jung Ho Park Dong Il Park Yong Kyun Cho Chong Il Sohn Woo Kyu Jeon byung ik kim Dong Hoon kim Seoung Wan Chae Jin Hee Sohn Kangbuk Samsung Medical Research Institute Sungkyunkwan University Kangbuk Samsung Hospital Department of Internal Medicine Sungkyunkwan University Kangbuk Samsung Hospital Department of Pathology Sungkyunkwan University Kangbuk Samsung Hospital

AIM:To evaluate the expression status of S-phase kinase-associated protein 2(Skp2)/cyclin-dependent kinases regulatory subunit 1(Cks1)and p27kip1,and assess the prognostic significance of Skp2/Cks1 expression with p27kip1in patients with extrahepatic ***:Seventy-six patients who underwent curative resection for histologically confirmed extrahepatic cholangiocarcinoma at our institution from December1994 to March 2008 were *** staining for Skp2,Cks1,p27kip1,and Ki67,along with other relevant molecular biologic experiments,were ***:By Cox regression analyses,advanced age(>65 years),advanced AJCC tumor stage,poorly differentiated histology,and higher immunostaining intensity of Skp2 were identified as independent prognostic factors in patients with extrahepatic *** epidermal growth factor(EGF,especially 0.1-10 ng/mL)significantly increased the proliferation indices by MTT assay and the mRNA levels of Skp2/Cks1 and p27kip1in SNU-1196,SNU-1079,and SNU-245 *** protein levels of Skp2/Cks1(from nuclear lysates)and p27kip1(from cytosolic lysate)were also significantly increased in these *** were significant reductions in the protein levels of Skp2/Cks1and p27kip1(from nuclear lysate)after the treatment of *** chromatin immunoprecipitation assay,we found that E2F1 transcription factor directly binds to the promoter site of ***:Higher immunostaining intensity of Skp2/Cks1 was an independent prognostic factor for patients with extrahepatic *** upregulates the mRNA and protein levels of Skp2/Cks1and p27kip1via the PI3K/Akt pathway and direct binding of E2F1 transcription factor with the Skp2 promoter.

关键词： S-phase kinase-associated protein 2 Cyclindependent kinases regulatory subunit 1 P27kip1 Cholangiocarcinoma E2F1 PI3K/Akt

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Different risk factors for advanced colorectal neoplasm in young adults

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World Journal of Gastroenterology 2016年第13期22卷 3611-3620页

作者： Ji Yeon kim Yoon Suk Jung Jung Ho Park Hong Joo kim Yong Kyun Cho Chong Il Sohn Woo Kyu Jeon byung ik kim Kyu Yong Choi Dong Il Park Comprehensive Health Care Center Korea Cancer Center Hospital Korea Institute of Radiological and Medical Sciences Department of Internal Medicine Kangbuk Samsung Hospital Sungkyunkwan University School of Medicine

AIM: To compare the risk of developing advanced colorectal neoplasm(ACRN) according to age in ***: A total of 70428 Koreans from an occupational cohort who underwent a colonoscopy between 2003 and 2012 at Kangbuk Samsung Hospital were retrospectively selected. We evaluated and compared odds ratios(OR) for ACRN between the young-adults(YA < 50 years) and in the older-adults(OA ≥ 50 years). ACRN was defined as an adenoma ≥ 10 mm in diameter, adenoma with any component of villous histology, high-grade dysplasia, or invasive ***: In the YA group, age(OR = 1.08, 95%CI: 1.06-1.09), male sex(OR = 1.26, 95%CI: 1.02-1.55), current smoking(OR = 1.37, 95%CI: 1.15-1.63), family history of colorectal cancer(OR = 1.46, 95%CI: 1.01-2.10), diabetes mellitus related factors(OR = 1.27, 95%CI: 1.06-1.54), obesity(OR = 1.23, 95%CI: 1.03-1.47), CEA(OR = 1.04, 95%CI: 1.01-1.09) and low-density lipoprotein-cholesterol(OR = 1.01, 95%CI: 1.01-1.02) were related with an increased risk of ACRN. However, age(OR = 1.08, 95%CI: 1.06-1.09), male sex(OR = 2.12, 95%CI: 1.68-2.68), current smoking(OR = 1.38, 95%CI: 1.12-1.71), obesity(OR = 1.34, 95%CI: 1.09-1.65) and CEA(OR = 1.05, 95%CI: 1.01-1.09) also increased the risk of ACRN in the OA ***: The risks of ACRN differed based on age group. Different colonoscopic screening strategies are appropriate for particular subjects with risk factors for ACRN, even in subjects younger than 50 years.

关键词： Young-adult Advanced colorectal neoplasm Risk factors Age Metabolic abnormality

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Pre-operative predictive factors for gallbladder cholesterol polyps using conventional diagnostic imaging

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World Journal of Gastroenterology 2008年第44期14卷 6831-6834页

作者： Ji-Hoon Choi Jung-Won Yun Yong-Sung kim Eun-A Lee Sang-Tae Hwang Yong-Kyun Cho Hong-Joo kim Jung-Ho Park Dong-Il Park Chong-Il Sohn Woo-Kyu Jeon byung-ik kim Hyoung-Ook kim Jun-Ho Shin Department of Internal Medicine Kangbuk Samsung HospitalSungkyunkwan University School of MedicineSeoul 110-746South Korea Department of Surgery Kangbuk Samsung HospitalSungkyunkwan University School of MedicineSeoul 110-746South Korea

AIM： To determine the clinical data that might be useful for differentiating benign from malignant gallbladder （GB） polyps by comparing radiological methods, including abdominal ultrasonography （US） and computed tomography （CT） scanning, with postoperative pathology findings. METHODS： Fifty-nine patients underwent laparoscopic cholecystectomy for a GB polyp of around 10 ram. They were divided into two groups, one with cholesterol polyps and the other with non-cholesterol polyps. Clinical features such as gender, age, symptoms, size and number of polyps, the presence of a GB stone, the radiologically measured maximum diameter of the polyp by US and CT scanning, and the measurements of diameter from postoperative pathology were recorded for comparative analysis. RESULTS： Fifteen of the 41 cases with cholesterol polyps （36.6%） were detected with US but not CT scanning, whereas all 18 non-cholesterol polyps were observed using both methods. In the cholesterol polyp group, the maximum measured diameter of the polyp was smaller by CT scan than by ***, the discrepancy between those two scanning measurements was greater than for the non- cholesterol polyp group. CONCLUSION： The clinical signs indicative of a cholesterol polyp include：（1） a polyp observed by US but not observable by CT scanning, （2） a smaller diameter on the CT scan compared to US, and （3） a discrepancy in its maximum diameter between US and CT measurements. In addition, US and the CT scan had low accuracy in predicting the polyp diameter compared to that determined by postoperative pathology.

关键词： Cholesterol Polyps Gallbladder Computed tomography Ultrasonography

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Technical issues and new devices of ESD of early gastric cancer

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World Journal of Gastroenterology 2011年第31期17卷 3585-3590页

作者： Wan Sik Lee Jin Woong Cho Young Dae kim Kyu Jong kim byung ik Jang Division of Gastroenterology Department of Internal MedicineChonnam University Medical School Division of Gastroenterology and Hepatology Department of Internal MedicinePresbyterian Medical Center Division of Gastroenterology and Hepatology Department of Internal MedicineSchool of MedicineChosun University Division of Gastroenterology Department of Internal MedicineKosin University College of Medicine Division of Gastroenterology Department of Internal MedicineYeungnam University College of Medicine

Endoscopic submucosal dissection(ESD) is a highly refined technique compared to conventional endoscopic mucosal *** enables complete resection of early gastric cancer(EGC) which has no possibility of lymph node *** for ESD of EGC generally entails early gastric cancer confined to the mucosa with well differentiated histology,though there are clinically suitable expanded *** ESD requires specific skill and expertise,endoscopists need to be familiarized with basic methods and the use of special *** essence of the technique is to dissect the submucosal layer with direct vision and maintain thecutting plane above the underlying proper muscle *** there are some differences in the detailed technical aspect,the cardinal method of ESD is now well established and ***,research and development of new ESD devices that render more efficient,safe ESD are still in progress to improve the overall result of ESD on early gastric cancer.

关键词： Endoscopic submucosal dissection Technique Device Early gastric cancer

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Clinical significance of tumor-infiltrating lymphocytes for gastric cancer in the era of immunology

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World Journal of Gastrointestinal Oncology 2017年第7期9卷 293-299页

作者： byung Woog Kang Jong Gwang kim In Hee Lee Han ik Bae An Na Seo Department of Hematology/Oncology Kyungpook National University Hospital Kyungpook National University School of Medicine Department of Pathology Kyungpook National University Hospital Kyungpook National University School of Medicine

Immunotherapy has begun to revolutionize cancer treatment, by introducing therapies that target the host immune system instead of the tumor, therapies that possess unique adverse event profiles, and therapies that may cure certain types of cancer. The immune microenvironment of tumors is emerging as the most important means of understanding the relationship between a patient' immune system and their cancer, informing prognosis, and guiding immunotherapy, such as an antibody blockade of immune checkpoints. For some solid tumors, simple quantitation of lymphocyte infiltration would seem to have prognostic significance, suggesting that lymphocyte infiltration is not passive but may actively promote or inhibit tumor growth. For gastric cancers, several studies have provided strong evidence that immune cells contribute to determining prognosis. However, the exact role of immune cells in gastric cancer remains unclear. Therefore, this review focuses on the clinical significance of immune cells, especially tumor-infiltrating lymphocytes, in gastric cancer.

关键词： Gastric cancer Tumor-infiltrating lymphocytes Immunotherapy

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Efficacy of 0.5-L vs 1-L polyethylene glycol containing ascorbic acid as additional colon cleansing methods for inadequate bowel preparation as expected by last stool examination before colonoscopy

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World Journal of Clinical Cases 2019年第1期7卷 39-48页

作者： Joon Hyun Cho Eun Joo Goo Kyeong Ok kim Si Hyung Lee byung ik Jang Tae Nyeun kim Division of Gastroenterology and Hepatology Department of Internal Medicine Yeungnam University College of Medicine

BACKGROUND No consensus has been reached in patients suspected of having inadequate bowel preparation regarding optimal salvage methods, which negatively affects the efficacy and quality of colonoscopy. The most ideal and reasonable rescue option involves early suspicion and identification of patients with inadequate preparation before sedation, additional oral ingestion of a suitable preparation formulation, and same-day *** To compare 0.5-L and 1-L polyethylene glycol containing ascorbic acid(PEG +Asc) as additional bowel cleansing methods after a 2-L split-dose PEG + Asc regimen in patients with expected inadequate bowel preparation before *** Individuals with expected inadequate bowel preparation based on last stool form, such as turbid liquid, particulate liquid, or liquid with small amounts of feces, were randomized to either a 0.5-L PEG + Asc group or a 1-L PEG + Asc group. The primary endpoint was bowel preparation as assessed using the Aronchick bowel preparation scale(ABPS) and Boston bowel preparation scale(BBPS) scores. The secondary endpoints were cecal intubation time, withdrawal time, polyp detection rate(PDR), adenoma detection rate(ADR), individual compliance with additional PEG + Asc, and patient *** Initially, 98 patients were included, but 8 were later excluded due to withdrawal of consent to participate in the study. Adequate bowel preparation(as assessed by ABPS) was observed in 80.9%(38/47) of subjects in the 0.5-L group and in88.4%(38/43) of subjects in the 1-L group(P = 0.617). Mean total BBPS was 6.7 points in the 0.5-L group and 7.0 points in the 1-L group(P = 0.458). ADRs and PDRs were similar in the two groups, and cecal intubation and withdrawal times were not significantly different. However, mean patient satisfaction score was significantly higher in the 0.5-L group(P = 0.041).CONCLUSION The bowel cleaning efficacy of additional 0.5-L PEG + Asc was not inferior to that of 1-L PEG + Asc. Add

关键词： Inadequate bowel preparation Additional colon cleansing Colonoscopy Polyethylene glycol

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Profile of Blow-up Solution to Hyperbolic System with Nonlocal Term

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Acta Mathematica Sinica,English Series 2007年第6期23卷 1083-1094页

作者： Zhi Wen DUAN Kwang ik kim Department of Mathematics Huazhong University of Science and Technology Wuhan 430074 P. R. China Department of Mathematics Pohang University of Science and Technology Pohang 790-784 Republic of Korea

This paper is concerned with a nonlocal hyperbolic system as follows utt = △u ＋（∫Ωvdx ）^p for x∈R^N,t〉0 ,utt = △u ＋（∫Ωvdx ）^q for x∈R^N,t〉0 ,u（x,0）=u0（x）,ut（x,0）=u01（x） for x∈R^N,u（x,0）=u0（x）,ut（x,0）=u01（x） for x∈R^N, where 1≤ N ≤3, p ≥1, q ≥ 1 and pq 〉 1. Here the initial values are compactly supported and Ω belong to R^N is a bounded open region. The blow-up curve, blow-up rate and profile of the solution are discussed.

关键词： hyperbolic system nonlocal term blow-up profile

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