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Preoperative risk factors for early recurrence in patients with resectable pancreatic ductal adenocarcinoma after curative intent surgical resection

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Hepatobiliary & Pancreatic Diseases International 2018年第5期17卷 450-455页

作者： Nam Hee kim hong joo kim Division of Gastroenterology Department of Internal Medicine Kangbuk Samsung Hospital Sungkyunkwan University School of Medicine

Background: Postoperative early recurrence(ER) in patients with pancreatic ductal adenocarcinoma(PDAC) is frequently encountered after curative intent surgery. Nonetheless, clinical significance and risk factors of ER after surgery for PDAC have not been extensively investigated. The aim of this study was to determine preoperative risk predictors for ER in patients with PDAC after upfront surgery. Methods: Eighty-one consecutive patients with PDAC who underwent curative intent surgical resection at Kangbuk Samsung Hospital between January 2004 and May 2015 were enrolled. ER was defined as tumor relapse within 6 months after surgery. Results: ER occurred in 26 patients(32.1%), whereas 49 patients(60.5%) had late recurrence( ≥ 6 months after surgery), and 6 patients had no recurrence(7.4%). Univariate analysis showed that C-reactive protein(CRP) > 3.0 mg/dL, modified Glasgow prognostic score(mGPS) = 2, decrease of total lymphocyte count by > 50% of baseline value in the preoperative period, prognostic nutritional index(PNI) 3.0 mg/dL, decrease of total lymphocyte count by > 50% of baseline value, and preoperative SUVmax were significant and independent contributors of ER in patients with resectable PDAC who underwent curative intent surgery. Conclusions: Postoperative ER for resectable PDAC was frequent with poor prognosis after curative intent upfront surgery. It is reasonable to suggest that there is a subgroup of resectable PDAC patients at highrisk of ER and neoadjuvant therapy should be considered in these patients in a clinical trial setting.

关键词： Early recurrence Pancreatic ductal adenocarcinoma Preoperative risk factors C-reactive protein Maximum standardized uptake value

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Impact of nonalcoholic fatty liver disease on the risk of gallbladder polyps in lean and non-obese individuals:A cohort study

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Hepatobiliary & Pancreatic Diseases International 2024年第6期23卷 573-578页

作者： Nam Hee kim Ji Hun Kang hong joo kim Division of Gastroenterology Department of Internal MedicineKangbuk Samsung HospitalSungkyunkwan University School of MedicineSeoulKorea Department of Radiology Hanyang University Guri HospitalHanyang University College of MedicineGuriKorea

Background:The association between non-obese or lean nonalcoholic fatty liver disease(NAFLD)and gallbladder polyps(GBPs)has not yet been *** aimed to determine whether NAFLD is an independent risk factor for the development of GBPs,even in non-obese and lean ***:We analyzed a cohort of 331208 asymptomatic adults who underwent abdominal ultrasonography(US).The risk of GBP development was evaluated according to the obesity and NAFLD ***:The overall prevalence of NAFLD and GBPs≥5 mm was 28.5%and 2.9%,*** prevalence of NAFLD among 160276 lean,77676 overweight and 93256 obese participants was 8.2%,31.2%,and 61.1%,*** with NAFLD had a significantly higher incidence of GBPs with a size of≥5 mm[adjusted odds ratio(OR)=1.18;95%confidence interval(CI):1.11–1.25].A higher body mass index and its categories were also significantly associated with an increased risk of GBPs≥5 ***,risk of GBPs≥5 mm was significantly increased even in NAFLD individuals who are not obese(lean:adjusted OR=1.36,95%CI:1.19-1.54;overweight:adjusted OR=1.14,95%CI:1.03–1.26,respectively).Conclusions:Non-obese/lean NAFLD is an independent risk factor for GBP development,suggesting that NAFLD may play an important role in the pathogenesis of GBPs regardless of the obesity ***,a more thorough evaluation for GBPs may be necessary when hepatic steatosis is detected on abdominal US,even in non-obese or lean individuals.

关键词： Nonalcoholic fatty liver disease Non-obese Lean Gallbladder polyps

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Prospective comparison of prophylactic antibiotic use between intravenous moxifloxacin and ceftriaxone for high-risk patients with post-ERCP cholangitis

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Hepatobiliary & Pancreatic Diseases International 2017年第5期16卷 512-518页

作者： Nam Hee kim hong joo kim Ki Bae Bang Department of Internal Medicine Sungkyunkwan University Kangbuk Samsung Hospital Department of Internal Medicine Dankook University Hospital

BACKGROUND: The use of prophylactic antibiotics before endoscopic retrograde cholangiopancreatography(ERCP) is recommended by all major international gastroenterological societies, especially in the presence of an obstructed biliary system. This study compared the occurrence rate of post-procedural complications, including cholangitis and septicemia between prophylactic intravenous moxifloxacin and ceftriaxone in patients with bile duct obstruction scheduled for therapeutic ***: From November 2013 to July 2015, 86 consecutive patients with biliary obstruction with one or more factors predicting benefits of antibiotic prophylaxis prior to ERCP were included in the current randomized open-label non-inferiority trial(Clinical *** identifier NCT02098486). Intravenous moxifloxacin(400 mg/day) or ceftriaxone(2 g/day)were given 90 minutes before ERCP, and were administered for more than 3 days if the patient developed symptoms and signs of cholangitis or septicemia. Recalcitrant cholangitis was defined as persistence of cholangitis for more than 5 days after ERCP or recurrence of cholangitis within 30 days after ***: Recalcitrant cholangitis occurred in 1(2.3%) and 2(4.8%) patients receiving intravenous moxifloxacin and ceftriaxone group, respectively(P=0.612). Septicemia was noted in1(2.3%) and 1(2.4%) patient in intravenous moxifloxacin and ceftriaxone group, respectively(P=1.0). The mean hospital stay was also not significantly different between the moxifloxacin and ceftriaxone groups(8.8±7.2 vs 9.1±9.4 days, P=0.867). Antibiotic resistance of the isolated pathogens by in vitro activity assay was noted in 1(2.3%) and 2(4.8%) patients in the moxifloxacin and ceftriaxone group, respectively(P=0.612). CONCLUSION: Intravenous moxifloxacin is not inferior to intravenous ceftriaxone for the prophylactic treatment of post-ERCP cholangitis and cholangitis-associated morbidity.

关键词： endoscopic retrograde cholangiopancreatography cholangitis moxifloxacin ceftriaxone recalcitrant cholangitis

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Management of antiviral drug resistance in chronic hepatitis B

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World Journal of Gastroenterology 2014年第33期20卷 11641-11649页

作者： Ki Bae Bang hong joo kim Department of Internal Medicine Sungkyunkwan University Kangbuk Samsung Hospital Seoul 110-746 South Korea

Rescue antiviral treatment for patients with resistance to preexisting nucleos(t)ide analogues remains a clinical challenge. The correct choice of a first-line treatment of high potency and with a high genetic barrier to achieve sustained long-term suppression of viral replication provides the best chance of preventing treatment failure and the emergence of drug resistance. The management of treatment failure and drug resistance requires a precise and accurate clinical and virologic monitoring. Combination treatment with antiviral drugs that belong to different groups is associated with a lower chance of developing resistance to rescue drugs. To guarantee better control of viral replication in patients with drug resistance, the addition of another drug without a cross resistance profile should be given as early as possible, preferably at the time when genotypic resistance emerges. Long-term surveillance for treatment efficacy and possible emergence of drug resistance should be continued to prevent the emergence of multidrug-resistant strains.

关键词： Chronic hepatitis B Antiviral resistance Rescue treatment Multidrug resistance Cross resistance

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Influence of Tropical Cyclone Landfalls on Spatiotemporal Variations in Typhoon Season Rainfall over South China

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Advances in Atmospheric Sciences 2010年第2期27卷 443-454页

作者： Min-Hee LEE Chang-Hoi HO joo-hong kim Computational Science and Technology Seoul National University School of Earth and Environmental Sciences Seoul National University Met Office Hadley Centre

This study examined the impact of tropical cyclone (TC) landfalls on the spatiotemporal variations in the rainfall over South China for the period 1957–2005. The target region was selected to show the noteworthy contribution of TC landfalls to the total rainfall during the typhoon season (July–October). Two prevailing spatial variations in the rainfall were obtained from an EOF analysis. The first EOF mode displays singlesign variability over South China with an explained variance of 23.4%. The associated time series of this mode fluctuates on a decadal timescale and was found to be correlated with TC genesis in the South China Sea. The second EOF mode shows a seesaw pattern between Hainan Island/Guangdong Province and the remaining regions with an explained variance of 11.4%. This seesaw pattern results from an anti-correlation in seasonal TC landfalls between the two regions, which was found in previous studies. This is related to the strengthening (weakening) of the upper tropospheric jets and the corresponding development of a massive anticyclonic (cyclonic) circulation over East Asia. The EOF analysis was also conducted using just the data for rainfall caused by landfalling TCs. This revealed that the first EOF mode using just the TC-induced rainfall is nearly identical to the second mode from the total rainfall. The obvious seesaw pattern of the first mode when employing just the TC-induced rainfall in the EOF analysis implies that this pattern has larger temporal variability than the single-signed pattern (i.e., the first EOF mode using the total rainfall) in terms of TC landfalls. This study suggests that TC landfalls over South China and the accompanying rainfall significantly modulate the spatial variation of the typhoon season rainfall there.

关键词： rainfall tropical cyclone South China typhoon season

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Technical Note on a Track-pattern-based Model for Predicting Seasonal Tropical Cyclone Activity over the Western North Pacific

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Advances in Atmospheric Sciences 2013年第5期30卷 1260-1274页

作者： Chang-Hoi HO joo-hong kim Hyeong-Seog kim Woosuk CHOI Min-Hee LEE Hee-Dong YOO Tae-Ryong kim Sangwook PARK School of Earth and Environmental Sciences Seoul National University Korea Polar Research Institute Atmospheric and Oceanic Science Princeton University and NOAA/GFDL Forecast Policy Division Korea Meteorological Administration National Typhoon Center Korea Meteorological Administration

Recently, the National Typhoon Center （NTC） at the Korea Meteorological Administration launched a track-pattern-based model that predicts the horizontal distribution of tropical cyclone （TC） track density from June to October. This model is the first approach to target seasonal TC track clusters covering the entire western North Pacific （WNP） basin, and may represent a milestone for seasonal TC forecasting, using a simple statistical method that can be applied at weather operation centers. In this note, we describe the procedure of the track-pattern-based model with brief technical background to provide practical information on the use and operation of the model. The model comprises three major steps. First, long-term data of WNP TC tracks reveal seven climatological track clusters. Second, the TC counts for each cluster are predicted using a hybrid statistical-dynamical method, using the seasonal prediction of large-scale environments. Third, the final forecast map of track density is constructed by merging the spatial probabilities of the seven clusters and applying necessary bias corrections. Although the model is developed to issue the seasonal forecast in mid-May, it can be applied to alternative dates and target seasons following the procedure described in this note. Work continues on establishing an automatic system for this model at the NTC.

关键词： tropical cyclone western North Pacific seasonal forecast track-pattern-based model hybrid statistical-dynamical approach

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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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