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Metastasis of hepatocellular carcinoma to the small bowel manifested by intussusception

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World Journal of Gastroenterology 2006年第12期12卷 1969-1971页

作者： Hyun Soo kim Jung WooShin In Du Jeong Sung-Jo Bang do ha kim Neung Hwa Park Gyu Yeol kim Young Min kim Hee Jeong Cha Yoong Ki Jeong Division of Gastroenterology Department of Internal MedicineUniversity of Ulsan College of MedicineUlsan University HospitalUlsanKorea Department of Surgery University of Ulsan College of MedicineUlsan University HospitalUlsanKorea Department of Pathology University of Ulsan College of MedicineUlsan University HospitalUlsanKorea Department of Radiology University of Ulsan College of MedicineUlsan University HospitalUlsanKorea

Hepatocellular carcinoma （HCC） is a so highly invasive tumor that metastasizes hematogenously and lymphogenously to distant site. Frequent sites are lung, regional lymph node, bone, and adrenal gland. But metastasis to the gastrointestinal （GI） tract is rare, and most common site is stomach. Metastasis to the small intestine is extremely rare. Moreover, metastatic HCC of the small bowel causing intussusception has not been reported until now. Here, we report a case of metastasis of HCC to the small bowel manifested by intussusception.

关键词： Hepatocelluar carcinoma Small bowel metastasis Intussusception

Clinical significance of hepatitis B e antigen level measurement during long-term lamivudine therapy in chronic hepatitis B patients with e antigen positive

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World Journal of Gastroenterology 2006年第41期12卷 6693-6698页

作者： Jung Woo Shin Neung Hwa Park Seok Won Jung Byung Chul kim Sung Ho Kwon Jae Serk Park In Du Jeong Sung-Jo Bang do ha kim Division of Gastroenterology Department of Internal MedicineUniversity of Ulsan College of Medicine Ulsan University HospitalUlsanKorea

AIM： To determine the changes of quantitative hepatitis B e antigen （HBeAg） that predicts early detection of non-response or breakthrough to long-term lamivudine （LAM） therapy. METHODS： Among HBeAg positive chronic hepatitis B patients who failed to achieve HBeAg seroconversion within 12 too, we retrospectively analyzed 220 patients who had received LAM more than 24 too. RESULTS： The mean duration of LAM therapy was 36 （range, 24-72） mo. HBeAg seroconversion after the first 12 mo of LAM therapy was achieved in 53 （24.1%） patients. Viral breakthrough was observed in 105 （47.7%） patients. To find out whether the changing patterns of HBeAg levels can predict the outcome of LAM therapy, we analyzed the reduction rates of HBeAg levels during LAM therapy. Using the decrease more than 90% of pretreatment HBeAg levels, the sensitivity and specificity of response were 96.2% and 70.1%, respectively. Patients were divided into 3 groups according to the reduction patterns of the decrease of quantitative HBeAg： decrescendo, decrescendo-crescendo, no change or fluctuating groups. The optimal time to predict non-response or breakthrough was the first 9 mo of therapy. At 9 mo of therapy, 49 （92.5%） of 53 patients who had achieved HBeAg seroconversion were included in the decrescendo group. On the contrary, in the no change or fluctuating group, only four （7.5%） had achieved HBeAg seroconversion. Among patients who did not show the continuous decrease of HBeAg levels at 9 too, 95.2% （negative predictive value） failed to achieve HBeAg seroconversion. CONCLUSION： Almost all patients who failed to show a continuous decrease of HBeAg levels at 9 mo of LAM therapy were non-response or breakthrough. Therefore, monitoring changes of HBeAg levels during LAM therapy in HBeAg positive chronic hepatitis B may be valuable for identifying patients who are at high risk of non-response or breakthrough.

关键词： Hepatitis B e antigen positive chronic hepatitis B lamivudine Quantitative HBeAg levels Non- response Breakthrough

A gastrointestinal stromal tumor of the duodenum masquerading as a pancreatic head tumor

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World Journal of Gastroenterology 2007年第24期13卷 3396-3399页

作者： Sung Ho Kwon Hee Jeong Cha Seok Won Jung Byung Chul kim Jae Serk Park In Du Jeong Jong Hwa Lee Yang Won Nah Sung Jo Bang Jung Woo Shin Neung Hwa Park do ha kim Division of Gastroenterology Department of Internal Medicine University of Ulsan College of Medicine Ulsan University Hospital Ulsan Korea Department of Pathology University of Ulsan College of Medicine Ulsan University Hospital Ulsan Korea Department of Radiology University of Ulsan College of Medicine Ulsan University Hospital Ulsan Korea Department of Surgery University of Ulsan College of Medicine Ulsan University Hospital Ulsan Korea

Gastrointestinal stromal tumor (GIST) represents the most common kind of mesenchymal tumor that arises from the alimentary tract. GIST is currently defined as a gastrointestinal tract mesenchymal tumor showing CD117 (c-kit protein) positivity at immunohistochemistry. Throughout the whole length of the gastrointestinal tract, GIST arises most commonly from the stomach followed by the small intestine, the colorectum, and the esophagus. Only 3%-5% of GISTs occur in the duodenum, and especially, if GIST arises from the C loop of the duodenum, it can be difficult to differentiate from the pancreas head mass because of its anatomical proximity. Here, we report a case of duodenal GIST, which was assessed as a pancreatic head tumor preoperatively.

关键词： Gastrointestinal stromall tumor Duodenum Pancreas head tumor

Unveiling lymph node metastasis in early gastric cancer

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World Journal of Gastroenterology 2014年第18期20卷 5389-5395页

作者： Nari Shin Tae-Yong Jeon Gwang ha kim do Youn Park Department of Pathology Pusan National University Hospital and Pusan National University School of MedicineBusan 602-739South Korea Biomedical Research Institute Pusan National University HospitalBusan 602-739South Korea Departments of Surgery Pusan National University Hospital and Pusan National University School of MedicineBusan 602-739South Korea Departments of Gastroenterology Pusan National University Hospital and Pusan National University School of MedicineBusan 602-739South Korea

With respect to gastric cancer treatment,improvements in endoscopic techniques and novel therapeutic modalities[such as endoscopic mucosal resection(EMR)and endoscopic submucosal dissection(ESD)]have been ***,EMR/ESD procedures are widely accepted treatment modalities for early gastric cancer(EGC).These procedures are most widely accepted in Asia,including in Korea and *** the present era of endoscopic resection,accurate prediction of lymph node(LN)metastasis is a critical component of selecting suitable patients for EMR/***,indications for EMR/ESD are based on large Japanese datasets,which indicate that there is almost no risk of LN metastasis in the subgroup of EGC ***,there is some controversy among investigators regarding the validity of these ***,there are currently no accurate methods to predict LN metastasis in gastric cancer(for example,radiologic methods or methods based on molecular biomarkers).We recommend the use of a 2-step method for the management of early gastric cancer using endoscopic *** first step is the selection of suitable patients for endoscopic resection,based on endoscopic and histopathologic *** endoscopic resection,additional surgical intervention could be determined on the basis of a comprehensive review of the endoscopic mucosal resection/endoscopic submucosal dissection specimen,including lymphovascular tumor emboli,tumor size,histologic type,and depth of ***,evaluation of clinical application data is essential for validating this ***,gastroenterologists,surgeons,and pathologists should closely collaborate and communicate during these decisionmaking processes.

关键词： Early gastric cancer Endoscopic submucosal dissection Lymph node metastasis Biomarker Clinicopathologic features

Is it possible to differentiate gastric GISTs from gastric leiomyomas by EUS?

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World Journal of Gastroenterology 2009年第27期15卷 3376-3381页

作者： Gwang ha kim do Youn Park Suk kim Dae Hwan kim dong Heon kim Cheol Woong Choi Jeong Heo Geun Am Song Department of Internal Medicine Pusan National University School of Medicine and Medical Research Institute Pusan National University HospitalBusan 602-739 South Korea Department of Pathology Pusan National University School of MedicineBusan 602-739 South Korea Department of Radiology Pusan National University School of MedicineBusan 602-739 South Korea Department of Surgery Pusan National University School of MedicineBusan 602-739South Korea

AIM: To evaluate the ultrasonog raphy (EUS) features of gastric gastrointestinal stromal tumors (GISTs) as compared with gastric leiomyomas and then to determine the EUS features that could predict malignant ***: We evaluated the endoscopic EUS features in 53 patients with gastric mesenchymal tumors conf irmed by histopathologic diagnosis. The GISTs were classif ied into benign and malignant groups according to the histological risk classif ***: Immunohistochemical analyses demon-strated 7 leiomyomas and 46 GISTs. Inhomogenicity, hyperechogenic spots, a marginal halo and higher echogenicity as compared with the surrounding muscle layer appeared more frequently in the GISTs than in the leiomyomas (P had a sensitivity of 89.1% and a specifi city of 85.7% for predicting GISTs. Except for tumor size and irregularity of the border, most of the EUS features were not helpful for predicting the malignant potential of GISTs. On multivariate analysis, only the maximal diameter of the GISTs was an independent predictor. The optimal size for predicting malignant GISTs was 35 mm. The sensitivity and specificity using this value were 92.3% and 78.8%, ***: EUS may help to differentiate gastric GISTs from gastric leiomyomas. Once GISTs are suspected, surgery should be considered if the size is greater than 3.5 cm.

关键词： Endoscopic ultrasonography, Gastrointestinal stromal tumor Stomach

A combination strategy of functionalized polymer coating with Ta ion implantation for multifunctional and biodegradable vascular stents

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Journal of Magnesium and Alloys 2021年第6期9卷 2195-2207页

作者： Kwang-Hee Cheon Cheonil Park Min-Ho Kang Suhyung Park Jinyoung kim Seol-ha Jeong Hyoun-Ee kim Hyun-do Jung Tae-Sik Jang Department of Materials Science and Engineering Seoul National UniversitySeoul 08826Republic of Korea Department of Chemical and Biological Engineering Seoul National UniversitySeoul 08826Republic of Korea Department of Biomedical-Chemical Engineering Catholic University of KoreaBucheon-si 03083Republic of Korea Department of Biotechnology The Catholic University of KoreaBucheon-si 14662Republic of Korea Department of Materials Science and Engineering Chosun UniversityGwangju 61452Republic of Korea

Biodegradable stents made of magnesium(Mg)and its alloys have been developed to minimize persistent inflammation or in-stent restenosis,which are the main problems for permanent ***,their rapid corrosion behavior under physiological conditions leads to poor vascular compatibility and premature structural failure,which remains an important unsolved clinical ***,we demonstrate a new strategy for solving this problem by combining poly(ether imide)(PEI)coating and subsequent tantalum(Ta)ion *** PEI coating covers the whole surface of the Mg stent uniformly via a spray coating technique and provides Mg with superior corrosion resistance and stable sirolimus-carrying *** ion implantation is conducted by a sputtering-based plasma immersion ion implantation technique only onto the luminal surface of the PEI-coated Mg *** extremely short processing time(hat forms on the topmost surface of the PEI coating plays an effective role in not only preventing a rapid release of sirolimus from the surface but also improving the PEI coating’s surface *** on in vitro cellular response and blood compatibility tests,Ta ion implantation leads to the improvement of endothelial cell adhesion/proliferation and suppression of platelet adhesion/activation regardless of sirolimus *** results indicate that the combination of PEI coating and Ta ion implantation has significant innovative potential to provide excellent vascular compatibility and prevent in-stent restenosis and thrombosis.

关键词： Magnesium stent Biodegradability Tantalum Plasma immersion ion implantation Multifunctionality

Spectrum of mucin-producing neoplastic conditions of the abdomen and pelvis:Cross-sectional imaging evaluation

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World Journal of Gastroenterology 2011年第43期17卷 4757-4771页

作者： Nam Kyung Lee Suk kim Hyun Sung kim Tae Yong Jeon Gwang ha kim dong Uk kim do Youn Park Tae Un kim Dae Hwan Kang Department of Radiology Pusan National University Hospital Medical Research Institute Pusan National University School of Medicine Pusan National University Department of Surgery Pusan National University Hospital Department of Internal Medicine Pusan National University Hospital Department of Pathology Pusan National University Hospital Department of Radiology Yangsan Pusan National University Hospital Medical Research Institute Pusan National University School of Medicine Department of Internal Medicine Yangsan Pusan National University Hospital

Various mucin-producing neoplasms originate in different abdominal and pelvic *** neoplasms differ from non-mucinous neoplasms because of the differences in clinical outcome and imaging *** carcinoma,in which at least 50%of the tumor is composed of large pools of extracellular mucin and columns of malignant cells,is associated with a worse *** ring cell carcinoma is characterized by large intracytoplasmic mucin vacuoles that expand in the malignant cells with the nucleus displaced to the *** prognosis is also generally *** contrast,intraductal papillary mucinous neoplasm of the bile duct and pancreas,which is characterized by proliferation of ductal epithelium and variable mucin production,has a better prognosis than other malignancies in the pancreaticobiliary *** modalities play a critical role in differentiating mucinous from non-mucinous *** to high water content,mucin has a similar appearance to water on ultrasound(US) ,computed tomography(CT) ,and magnetic resonance imaging,except when thick and proteinaceous,and then it tends to be hypoechoic with fine internal echoes or have complex echogenicity on US,hyperdense on CT,and hyperintense on T1and hypointense on T2-weighted images,compared to ***,knowledge of characteristic mucin imaging features is helpful to diagnose various mucinproducing neoplastic conditions and to facilitate appropriate treatment.

关键词： Mucin Neoplasm Ultrasound Computed tomography Magnetic resonance Abdomen and pelvis

Associated factors for a hyperechogenic pancreas on endoscopic ultrasound

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World Journal of Gastroenterology 2010年第34期16卷 4329-4334页

作者： Cheol Woong Choi Gwang ha kim Dae Hwan Kang Hyung Wook kim dong Uk kim Jeong Heo Geun Am Song do Youn Park Suk kim Department of Internal Medicine Pusan National University School of Medicine and the Medical Research Institute Pusan National University Hospital Department of Internal Medicine Pusan National University School of Medicine and the Medical Research Institute Department of Pathology Pusan National University School of Medicine and the Medical Research Institute Department of Radiology Pusan National University School of Medicine and the Medical Research Institute

AIM: To identify the associated risk factors for hyperechogenic pancreas (HP) which may be observed on endoscopic ultrasound (EUS) and to assess the relationship between HP and obesity. METHODS: From January 2007 to December 2007, we prospectively enrolled 524 consecutive adults who were scheduled to undergo EUS. Patients with a history of pancreatic disease or with hepatobiliary or advanced gastrointestinal cancer were excluded. Finally,284 patients were included in the analyses. We further analyzed the risk of HP according to the categories of visceral adipose tissue (VAT) and subcutaneous adipose tissue in 132 patients who underwent abdominal computed tomography scans. RESULTS: On univariate analysis, age older than 60 years, obesity (body mass index > 25 kg/m 2 ), fatty liver, diabetes mellitus, hypertension and hypercholesterolemia were identified as risk factors associated with HP (P han 60 years (P = 0.001, OR = 2.874) and hypertension (P = 0.044, OR = 2.037) were significantly associated with HP. In the subgroup analysis, VAT was a statistically significant risk factor for HP (P = 0.010, OR = 5.665, lowest quartile vs highest quartile). CONCLUSION: HP observed on EUS was associated with fatty liver, male gender, age older than 60 years, hypertension and VAT.

关键词： Endoscopic Ultrasound Hyperechogenic pancreas Obesity

Etanercept-synthesizing adipose-derived stem cell secretome:A promising therapeutic option for inflammatory bowel disease

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World Journal of Gastrointestinal Surgery 2024年第3期16卷 882-892页

作者： Say-June kim Ok-Hee kim ha-Eun Hong Ji Hyeon Ju do Sang Lee Department of Surgery Seoul St.Mary’s HospitalCollege of Medicinethe Catholic University of KoreaSeoul 06591South Korea Catholic Central Laboratory of Surgery Institute of Biomedical IndustryCollege of Medicinethe Catholic University of KoreaSeoul 06591South Korea Division of Rheumatology Department of Internal MedicineSeoul St.Mary’s HospitalCollege of MedicineThe Catholic University of KoreaSeoul 06591South Korea

BACKGROUND Inflammatory bowel disease(IBD)is a chronic inflammatory condition of the gastrointestinal tract,with tumor necrosis factor(TNF)-αplaying a key role in its ***,a decoy receptor for TNF,is used to treat inflammatory *** secretome derived from adipose-derived stem cells(ASCs)has anti-inflammatory effects,making it a promising therapeutic option for *** To investigate the anti-inflammatory effects of the secretome obtained from ASCs synthesizing etanercept on colon cells and in a dextran sulfate sodium(DSS)-induced IBD mouse *** ASCs were transfected with etanercept-encoding mini-circle plasmids to create etanercept-producing *** secretory material from these cells was then tested for anti-inflammatory effects both in vitro and in a DSS-induced IBD mouse *** This study revealed promising results indicating that the group treated with the secretome derived from etanercept-synthesizing ASCs[Etanercept-Secretome(Et-Sec)group]had significantly lower expression levels of inflammatory mediators,such as interleukin-6,Monocyte Chemoattractant Protein-1,and TNF-α,when compared to the control secretome(Ct-Sec).Moreover,the Et-Sec group exhibited a marked therapeutic effect in terms of preserving the architecture of intestinal tissue compared to the *** These results suggest that the secretome derived from ASCs that synthesize etanercept has potential as a therapeutic agent for the treatment of IBD,potentially enhancing treatment efficacy by merging the anti-inflam-matory qualities of the ASC secretome with etanercept's targeted approach to better address the multifaceted pathophysiology of IBD.

关键词： Adipose-derived stem cells Etanercept Inflammatory bowel disease Secretome Tumor necrosis factor-α