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Does immunohistochemical staining have a clinical impact in early gastric cancer conducted endoscopic submucosal dissection?

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World Journal of Gastroenterology 2012年第33期18卷 4578-4584页

作者： Seong Ran Jeon Joo Young Cho Gene hyun Bok Tae Hee Lee hyun gun kim Won Young Cho So Young Jin Yeon Soo kim Institute for Digestive Research Digestive Disease Center Soonchunhyang University College of Medicine Seoul 140-743 South Korea Department of Pathology Soonchunhyang University College of Medicine Seoul 140-743 South Korea Department of Internal Medicine Daejeon St. Mary's Hospital The Catholic University of Korea School of Medicine Daejeon 301-723 South Korea

AIM: To evaluate clinicopathologic parameters and the clinical significance related lymphovascular invasion (LVI) by immunohistochemical staining (IHCS) in endoscopic submucosal dissection (ESD). METHODS: Between May 2005 and May 2010, a total of 348 lesions from 321 patients (mean age 63 ± 10 years, men 74.6%) with early gastric cancer (EGC) who met indication criteria after ESD were analyzed retrospectively. The 348 lesions were divided into the absolute (n = 100, differentiated mucosal cancer without ulcer ≤ 20 mm) and expanded (n = 248) indica-tion groups after ESD. The 248 lesions were divided into four subgroups according to the expanded ESD indication. The presence of LVI was determined by factor Ⅷ-related antigen and D2-40 assessment. We compared LVI IHCS-negative group with LVI IHCSpositive in each group. RESULTS: LVI by hematoxylin-eosin staining (HES) and IHCS were all negative in the absolute group, while was observed in only the expanded groups. The positive rate of LVI by IHCS was higher than that of LVI by HES (n = 1, 0.4% vs n = 11, 4.4%, P = 0.044). LVI IHCS-positivity was observed when the cancer invaded to the mucosa 3 (M3) or submucosa 1 (SM1) levels, with a predominance of 63.6% in the subgroup that included only SM1 cancer (P < 0.01). In a univariate analysis, M3 or SM1 invasion by the tumor was significantly associated with a higher rate of LVI by IHCS, but no factor was significant in a multivariate analysis. There were no cases of tumor recurrence or metastasis during the median 26 mo follow-up. CONCLUSION: EGCs of the absolute group are immunohistochemically stable. The presence of LVI may be carefully examined by IHCS in an ESD expanded indication group with an invasion depth of M3 or greater.

关键词： Gastric cancer Endoscopic submucosal dis- section Immunohistochemical staining Lymphovascu- lar invasion Depth

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A novel device for endoscopic submucosal dissection,the Fork knife

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World Journal of Gastroenterology 2008年第43期14卷 6726-6732页

作者： hyun gun kim Joo Young Cho Gene hyun Bok Won Young Cho Wan Jung kim Bong Min Ko Jin Oh kim Joon Seong Lee Moon Sung Lee Chan Sup Shim Institute for Digestive Research Digestive Disease Research CenterSoonChunHyang University College of MedicineSeoul 140-743South Korea

AIM： To introduce and evaluate the efficacy and technical aspects of endoscopic submucosal dissection （ESD） using a novel device, the Fork knife. METHODS： From March 2004 to April 2008, ESD was performed on 265 gastric lesions using a Fork knife （Endo FS）（group A） and on 72 gastric lesions using a Flexknife （group B） at a single tertiary referral center. We retrospectively compared the endoscopic characteristics of the tumors, pathological findings, and sizes of the resected specimens. We also compared the en b/oc resection rate, complete resection rate, complications, and procedure time between the two groups. RESULTS： The mean size of the resected specimens was 4.27 ± 1.26 cm in group A and 4.29 ± 1.48 cm in group B. The en b/oc resection rate was 95.8% （254/265 lesions） in group A and 93.1% （67/72） in group B. Complete ESD without tumor cell invasion of the resected margin was obtained in 81.1% （215/265） of group A and in 73.6% （53/72） of group B. The perforation rate was 0.8% （2/265） in group A and 1.4% （1/72） in group B. The mean procedure time was 59.63 ± 56.12 min in group A and 76.65 ± 70.75 min in group B （P 〈 0.05）. CONCLUSION： The Fork knife （Endo FS） is useful for clinical practice and has the advantage of reducing the procedure time.

关键词： Fork knife Novel device Endoscopic submucosal dissection Flexknife Procedure

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Plasma levels of acylated ghrelin in patients with functional dyspepsia

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World Journal of Gastroenterology 2012年第18期18卷 2231-2237页

作者： Yeon Soo kim Joon Seong Lee Tae Hee Lee Joo Young Cho Jin Oh kim Wan Jung kim hyun gun kim Seong Ran Jeon Hoe Su Jeong Department of Internal Medicine Hallym University College of MedicineChuncheon Sacred Heart HospitalGangwon-do 200-704South Korea Department of Internal Medicine Soonchunhyang University College of MedicineSoonchunhyang University HospitalSeoul 140-743South Korea Department of Anatomy and Cell Biology Hanyang University College of Medicine222 Wangsimni-roSeongdong-guSeoul 133-792South Korea

AIM:To investigate the relationship between plasma acylated ghrelin levels and the pathophysiology of functional ***:Twenty-two female patients with functional dyspepsia and twelve healthy volunteers were recruited for the *** functional dyspepsia patients were each diagnosed based on the Rome Ⅲ *** patients completed a questionnaire concerning the severity of 10 *** acylated ghrelin levels before and after a meal were determined in the study participants using a commercial human acylated enzyme immunoassay kit;electrogastrograms were performed for 50 min before and after a standardized 10-min meal containing 265 ***:There were no significant differences in plasma acylated ghrelin levels between healthy volunteers and patients with functional ***,in patients with functional dyspepsia,there was a negative correlation between fasting plasma acylated ghrelin levels and the sum score of epigastric pain(r =-0.427,P = 0.047) and a positive correlation between the postprandial/fasting plasma acylated ghrelin ratio and the sum score of early satiety(r = 0.428,P =0.047).Additionally,there was a negative correlation between fasting acylated ghrelin plasma levels and fasting normogastria(%)(r =-0.522,P = 0.013).Interestingly,two functional dyspepsia patients showed paradoxically elevated plasma acylated ghrelin levels after the ***:Abnormal plasma acylated ghrelin levels before or after a meal may be related to several of the dyspeptic symptoms seen in patients with functional dyspepsia.

关键词： Functional dyspepsia Acylated ghrelin Electrogastrogram Rome Ⅲ criteria Dyspeptic symptoms

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A case of intussuscepted Meckel’s diverticulum

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World Journal of Gastroenterology 2009年第40期15卷 5109-5111页

作者： Tae Hee Lee Jin-Oh kim Jae Joon kim Seong Sook Hong So Young Jin hyun gun kim Joo Young Cho Joon Seong Lee Institute for Digestive Research SoonChunHyang College of Medicine Department of Surgery SoonChunHyang College of Medicine Department of Radiology SoonChunHyang College of Medicine Department of Pathology SoonChunHyang College of Medicine

We report colonoscopic features of an intussuscepted Meckel's diverticulum, presenting with hematochezia. A 35-year-old woman presented to the emergency room with acute onset, transient, sharp, severe epi-gastric pain that began 6 h earlier. Colonoscopy re-vealed a reddish, soft, fi st-sized polypoid lesion in the terminal ileum. The lesion was misinterpreted as a hematoma by an inexperienced endoscopist. The pa-tient began to complain of intermittent, severe peri-umbilical pain following the colonoscopic examination. Subsequent computed tomography showed an enteric intussusception. An exploratory laparotomy revealed an intussuscepted Meckel's diverticulum, with trans-mural infarction. Colonoscopy was of little use in as-sessing the intussusception. However, colonoscopic examination may be performed initially, especially in an intussuscepted Meckel's diverticulum present-ing with hematochezia. Endoscopists should note the endoscopic features of an intussuscepted Meckel's diverticulum.

关键词： Colonoscopy Intussusception Meckel's diverticulum

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Small sphincterotomy combined with endoscopic papillary large balloon dilation versus sphincterotomy

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World Journal of Gastroenterology 2009年第34期15卷 4298-4304页

作者： hyun gun kim Young Koog Cheon Young Deok Cho Jong Ho Moon Do hyun Park Tae Hoon Lee hyun Jong Choi Sang-Heum Park Joon Seong Lee Moon Sung Lee Institute for Digestive Research Digestive Disease Center Soonchunhyang University College of Medicine

AIM： To compare small sphincterotomy combined with endoscopic papillary large balloon dilation （SES ＋ ELBD） and endoscopic sphincterotomy （EST） for large bile duct stones. METHODS： We compared prospectively SES ＋ ELBD （group A, n = 27） with conventional EST （group B, n = 28） for the treatment of large bile duct stones （≥ 15 mm）. When the stone could not be removed with a normal basket, mechanical lithotripsy was performed. We compared the rates of complete stone removal with one session and application of mechanical lithotripsy. RESULTS： No significant differences were observed in the mean largest stone size （A： 20.8 mm, B： 21.3 mm）, bile duct diameter （A： 21.4 turn, B： 20.5 ram）, number of stones （A： 2.2, B： 2.3）, or procedure time （A： 18 min, B： 19 rain） between the two groups. The rates of complete stone removal with one session was 85% in group A and 86% in group B （P = 0.473）. Mechanical lithotripsy was required for stone removal in nine of 27 patients （33%） in group A and nine of 28 patients （32%, P = 0.527） in group ***： SES ＋ ELBD did not show significant benefits compared to conventional EST, especially for the removal of large （≥ 15 mm） bile duct stones.

关键词： Sphincterotomy Endoscopic Balloon dilatation Cholelithiasis Lithotripsy

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Trends in colorectal cancer incidence according to an increase in the number of colonoscopy cases in Korea

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World Journal of Gastrointestinal Oncology 2024年第1期16卷 51-60页

作者： Ga Hee kim Yeong Chan Lee Tae Jun kim Sung Noh Hong Dong Kyung Chang Young-Ho kim Dong-Hoon Yang Chang Mo Moon Kyunga kim hyun gun kim Eun-Ran kim Division of Gastroenterology Department of Internal MedicineAsan Medical CenterUniversity of Ulsan College of MedicineSeoul 05505South Korea Department of Digital Health Samsung Advanced Institute for Health Science and TechnologySungkyunkwan University School of MedicineSeoul 06351South Korea Division of Gastroenterology Department of Internal MedicineSamsung Medical CenterSungkyunkwan University School of MedicineSeoul 06351South Korea Division of Gastroenterology Department of Internal MedicineEwha Womans UniversitySeoul 07985South Korea Biomedical Statistics Center Samsung Medical CenterSeoul 06351South Korea Division of Gastroenterology Department of Internal MedicineSoonchunhyang University College of MedicineSeoul 04401South Korea

BACKGROUND The incidence of colorectal cancer(CRC)and preinvasive CRC(e.g.,early colon cancer and advanced adenoma)is gradually increasing in several *** To evaluate the trend in incidence of CRC and preinvasive CRC according to the increase in the number of colonoscopies performed in *** This retrospective cohort study enrolled Korean patients from 2002 to 2020 to evaluate the incidence of CRC and preinvasive CRC,and assess the numbers of diagnostic colonoscopies and colonoscopic ***-related complications by age group were also *** The incidence of CRC showed a rapid increase,then decreased after 2012 in the 50-75 year-age *** the study period,the rate of incidence of preinvasive CRC increased at a similar level in patients under 50 and 50-75 years of *** 2009,the increase has been rapid,showing a pattern similar to the increase in *** rate of colonoscopic polypectomy in patients aged under 50 was similar to the rate in patients over 75 years of age after *** rate of complications after colonoscopy and related deaths within 3 mo was high for those over 75 years of *** The diagnosis of preinvasive CRC increased with the increase in the number of colonoscopies *** the risk of colonoscopy-related hospitalization and death is high in the elderly,if early lesions at risk of developing CRC are diagnosed and treated under or at the age of 75,colonoscopy-related complications can be reduced for those aged 76 years or over.

关键词： Colorectal cancer Preinvasive colorectal cancer Colorectal polypectomy Colonoscopy

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Long-term result of endoscopic Histoacryl （N-butyl-2-cyanoacrylate）injection for treatment of gastric varices

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World Journal of Gastroenterology 2011年第11期17卷 1494-1500页

作者： Eun Jung Kang Soung Won Jeong Jae Young Jang Joo Young Cho Sae Hwan Lee hyun gun kim Sang Gyune kim Young Seok kim Young Koog Cheon Young Deok Cho Hong Soo kim Boo Sung kim Institute for Digestive Research Department of Internal MedicineSoonchunhyang University College of MedicineSeoul HospitalSeoul 140-743South Korea

AIM:To evaluate the long-term efficacy and safety of endoscopic obliteration with Histoacryl  for treatment of gastric variceal bleeding and ***:Between January 1994 and March 2010 at SoonChunHyang University Hospital,a total of 127 patients with gastric varices received Histoacryl  injections *** hundred patients underwent endoscopic Histoacryl  injections because of variceal bleeding,the other 27 patients received such injections as a prophylactic ***:According to Sarin classification,56 patients were GOV1,61 patients were GOV2 and 10 patients were *** of the varices were large(F2 or F3,111 patients).The average volume of Histoacryl  per each session was 1.7±1.3 cc and mean number of sessions was 1.3±0.6.(1 session-98 patients,2 sessions-25 patients,≥3 sessions-4 patients).Twenty-seven patients with high risk of bleeding(large or fundal or RCS+or Child C) received Histoacryl  injection as a primary prophylactic *** these patients,hepatitis B virus was the major etiology of cirrhosis,25 patients showed GOV1 or 2(92.6%)and F2 or F3 accounted for 88.9%(n=24).The rate of initial hemostasis was 98.4%and recurrent bleeding within one year occurred in 18.1%of *** hemostasis during episodes of rebleeding was achieved in 73.9%of *** survival was 50 mo (95%CI 30.5-69.5).Major complications occurred in 4 patients(3.1%).The rebleeding rate in patients with hepatocellular carcinoma or GOV2 was higher than in those with other *** of the 27 subjects who were treated prophylactically experienced treatment-related *** survival rates of the 127 patients at 6 mo,1,3,and 5 years were 92.1%,84.2%,64.2%,and 45.3%,*** 6 mo cumulative survival rate of the 27 patients treated prophylactically was 75%.CONCLUSION:Histoacryl  injection therapy is an effective treatment for gastric varices and also an effective prophylactic treatment of gastric varices which

关键词： Gastric varix Prophylaxis Histoacryl  (Nbutyl-2-cyanoacrylate) Histoacryl  injection Treatment of gastric varix

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Usefulness of magnifying endoscopy for iodine-unstained lesions in a high-risk esophageal cancer population

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World Journal of Gastroenterology 2010年第37期16卷 4709-4715页

作者： Ik Seong Choi Jae Young Jang Won Young Cho Tae Hee Lee hyun gun kim Bo Young Lee Soung Won Jeong Joo Young Cho Joon Seong Lee So Young Jin Institute for Digestive Research SoonChunHyang University College of Medicine

AIM: To investigate the usefulness of magnified observations of iodine-unstained esophageal lesions in the histological diagnosis of esophageal mucosa abnormalities, in high-risk esophageal cancer groups. METHODS: The subjects included 38 patients who had at least one of the four criteria known to be highrisk factors for esophageal cancer. Following endoscopic observation, magnified observations were performed on iodine-unstained lesions of the esophagus. The total number of lesions was 43. These lesions were classified as type A (clear papilla), type B (fused papilla), and type C (non-visible papilla) according to the findings. Tissue biopsy was then carried out. Finally the histological findings were graded in terms of histological factors, and their relationships were compared. RESULTS: Of the 43 lesions, 11 were type A, 17 were type B, and 15 were type C under magnifying endoscopy. Histological findings such as inflammatory cell infiltration and basal cell hyperplasia were significantly increased in type B and type C lesions compared with type A lesions (P < 0.05). Low-grade esophageal dysplasia was apparent in 1 (9%) of 11 type A lesions, in 3 (18%) of 17 type B lesions, and in 6 (40%) of 15 type C lesions, with the highest rate in type C. CONCLUSION: Magnified observations of the esophagus, classified by papillary aspects using magnifying endoscopy of iodine-unstained lesions in high-risk esophageal cancer groups, are considered useful in estimating dysplasia and inflammation of esophageal mucosa.

关键词： Esophageal cancer Iodine Magnifying endoscopy

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Magnifying endoscopy for the diagnosis of specialized intestinal metaplasia in short-segment Barrett's esophagus

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World Journal of Gastroenterology 2013年第41期19卷 7089-7096页

作者： Nam Seok Ham Jae Young Jang Sung Woo Ryu Ji Hye kim Eui Ju Park Woong Cheul Lee Kwang Yeun Shim Soung Won Jeong hyun gun kim Tae Hee Lee Sung Ran Jeon Jun hyung Cho Joo Young Cho So Young Jin Ji Sung Lee Institution for Digestive Research Digestive Disease CenterDepartment of Internal MedicineSoonchunhyang University HospitalSeoul 140-743South Korea Department of Pathology Soonchunhyang University HospitalSeoul 140-743South Korea Biostatistical Consulting Unit Soonchunhyang University HospitalSeoul 140-743South Korea

AIM:To determine whether magnified observation of short-segment Barrett’s esophagus(BE)is useful for the detection of specialized intestinal metaplasia(SIM).METHODS:Thirty patients with suspected short-segment BE underwent magnifying endoscopy up to×*** magnified images were analyzed with respect to their pit-patterns,which were simultaneously classified into five epithelial types[Ⅰ(small round),Ⅱ(straight),Ⅲ(long oval),Ⅳ(tubular),Ⅴ(villous)]by Endo’s ***,a 0.5%solution of methylene blue(MB)was sprayed over columnar *** patterns of the magnified image and MB staining were *** were obtained from the regions previously observed by magnifying endoscopy and MB ***:Three of five patients with a typeⅤ(villous)epithelial pattern had SIM,whereas 21 patients with a non-typeⅤepithelial patterns did not have *** sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of pit-patterns in detecting SIM were 100%,91.3%,92.3%,60%and100%,respectively(P=0.004).Three of the 12 patients with positive MB staining had SIM,whereas 14patients with negative MB staining did not have *** sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of MB staining in detecting SIM were 100%,60.9%,65.4%,25%and100%,respectively(P=0.085).The specificity and accuracy of pit-pattern evaluation were significantly superior compared with MB staining for detecting SIM by comparison with the exact McNemar’s test(P=0.0391).CONCLUSION:The magnified observation of a shortsegment BE according to the mucosal pattern and its classification can be predictive of SIM.

关键词： Short-segment Barrett’s esophagus Magnifying endoscopy Methylene blue chromoendoscopy Specialized intestinal metaplasia Dysplasia Esophageal adenocarcinoma Diagnosis

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The Characteristics of CLHS Driving for High Luminance Efficiency in AC PDP

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Plasma Science and Technology 2016年第11期18卷 1116-1122页

作者： gun-Su kim Chi-hyung AHN Seok-hyun LEE Department of Electrical and Electronic Engineering Youngsan UniversityYangsanGyeongnam 50510Korea Korea Railroad Research Institute Uiwang Gyeonggi 16105Korea School of Electrical Engineering Inha UniversityIncheon 22212Korea

This paper proposes a CLHS （Capacitor Less Half Sustain） driving method that is applied to a long gap panel to reduce the power consumption. In order to reduce the power consumption in moving images, the luminous efficiency should be improved at the low discharge load （〈25%）. The weight of reactive power consumption tends to increase as the low discharge load decreases. Thus, it is very important to improve the luminous efficiency at low discharge load. It is well known that a long gap panel improves the luminance and the luminous efficiency but it is very difficult to drive the panel due to high driving voltage. It is confirmed that the main factors which cause a long gap panel to increase the minimum driving voltages are not only a long discharge gap but also self-erasing discharge. Self-erasing discharge is generated between the address and sustain electrodes in a sustain period. The CLHS driving method can reduce the reactive power consumption in a sustain period because energy recovery capacitors were removed in the sustain circuit. The CLHS driving method can reduce the minimum driving voltage of the long gap panel because the self-erasing discharge was prevented. When the CLHS driving method was applied to the panel with an ITO gap of 100 μm, Vs and VA minimum voltages are reduced by about 9 V and 12 V compared with those of the normal driving method. The luminance and the luminous efficiency also increased by about 24.3% and 33.3% at the discharge load of 4% compared with those at the normal condition.

关键词： PDP plasma long gap CLHS

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