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Double layered self-expanding metal stents for malignant esophageal obstruction, especially across the gastroesophageal junction

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World Journal of Gastroenterology 2012年第28期18卷 3732-3737页

作者： Min Dae kim Su Bum Park Dae Hwan Kang Jae hyung Lee Cheol Woong Choi hyung wook kim Chung Uk Chung Young Il Jeong Department of Internal Medicine Bongseng Memorial Hospital Busan 601-723 South Korea Department of Internal Medicine Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology Pusan National University Yangsan Hospital Yangsan 626-770 South Korea

AIM: To evaluate the clinical outcomes of double-layered self-expanding metal stents (SEMS) for treatment of malignant esophageal obstruction according to whether SEMS crosses the gastroesophageal junction (GEJ). METHODS: Forty eight patients who underwent the SEMS insertion for malignant esophageal obstruction were enrolled. Patients were classified as GEJ group (SEMS across GEJ, 18 patients) and non-GEJ group (SEMS above GEJ, 30 patients) according to SEMS position. Double layered (outer uncovered and inner covered stent) esophageal stents were placed. RESULTS: The SEMS insertion and the clinical improvement were achieved in all patients in both groups. Stent malfunction occurred in seven patients in the GEJ group and nine patients in the non-GEJ group. Tumor overgrowth occurred in five and eight patients, respectively, food impaction occurred in one patient in each group, and stent migration occurred in one and no patient, respectively. There were no significant differences between the two groups. Reflux esophagitis occurred more frequently in the GEJ group (eight vs five patients, P = 0.036) and was controlled by proton pump inhibitor. Aspiration pneumonia occurred in zero and five patients, respectively, and tracheoesophageal fistula occurred in zero and two patients, respectively. CONCLUSION: Double-layered SEMS are a feasible and effective treatment when placed across the GEJ for malignant esophageal obstruction. Double-layered SEMS provide acceptable complications, especially migration, although reflux esophagitis is more common in the GEJ group.

关键词： Metal stent Gastroesophageal junction Malignant esophageal obstruction

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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 < 0.05). On multivariate analysis, fatty liver [P = 0.008, odds ratio (OR) = 2.219], male gender (P = 0.013, OR = 2.636), age older than 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

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Is endoscopic ultrasonography essential for endoscopic resection of small rectal neuroendocrine tumors?

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World Journal of Gastroenterology 2017年第11期23卷 2037-2043页

作者： Su Bum Park Dong Jun kim hyung wook kim Cheol Woong Choi Dae Hwan Kang Su Jin kim Hyeong Seok Nam Department of Internal Medicine Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and TechnologyPusan National University Yangsan HospitalYangsanGyeongsangnam-do 626-770South Korea

AIM To evaluate the importance of endoscopic ultrasonography(EUS) for small(≤ 10 mm) rectal neuroendocrine tumor(NET) *** Patients in whom rectal NETs were diagnosed by endoscopic resection(ER) at the Pusan National University Yangsan Hospital between 2008 and 2014 were included in this study. A total of 120 small rectal NETs in 118 patients were included in this study. Histologic features and clinical outcomes were analyzed, and the findings of endoscopy, EUS and histology were compared. RESULTS The size measured by endoscopy was not significantly different from that measured by EUS and histology(r = 0.914 and r = 0.727 respectively). Accuracy for the depth of invasion was 92.5% with EUS. No patients showed invasion of the muscularis propria or metastasis to the regional lymph nodes. All rectal NETswere classified as grade 1 and demonstrated an L-cell phenotype. Mean follow-up duration was 407.54 ± 374.16 d. No patients had local or distant metastasis during the follow-up periods. CONCLUSION EUS is not essential for ER in the patient with small rectal NETs because of the prominent morphology and benign behavior.

关键词： Neuroendocrine tumor Small Rectal Endoscopic ultrasonography Histology Endoscopy

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Somatostatin adjunctive therapy for non-variceal upper gastrointestinal rebleeding after endoscopic therapy

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World Journal of Gastroenterology 2011年第29期17卷 3441-3447页

作者： Cheol Woong Choi Dae Hwan Kang hyung wook kim Su Bum Park Kee Tae Park Gwang Ha kim Geun Am Song Mong Cho Department of Internal Medicine Pusan National University School of Medicine and Medical Research InstituteYangsan-siGyeongsangnam-do 626-770South Korea

AIM:To evaluate the effect of pantoprazole with a somatostatin adjunct in patients with acute non-variceal upper gastrointestinal bleeding(NVUGIB).METHODS:We performed a retrospective analysis of a prospective database in a tertiary care university *** October 2006 to October 2008,we enrolled 101 patients with NVUGIB that had a high-risk stigma on *** 24 h of hospital admission,all patients underwent endoscopic *** successful endoscopic hemostasis,all patients received an 80-mg bolus of pantoprazole followed by continuous intravenous infusion(8 mg/h for 72 h).The somatostatin adjunct group(n=49)also received a 250-μg bolus of somatostatin,followed by continuous infusion (250μg/h for 72 h).Early rebleeding rates,disappearance of endoscopic stigma and risk factors associated with early rebleeding were ***:Early rebleeding rates were not significantly different between treatment groups(12.2%vs 14.3%,P=0.766).Disappearance of endoscopic stigma on the second endoscopy was not significantly different between treatment groups(94.2%vs 95.9%,P=0.696).Multivariate analysis showed that the complete Rockall score was a significant risk factor for early rebleeding(P =0.044,OR:9.080,95%CI:1.062-77.595).CONCLUSION:The adjunctive use of somatostatin was not superior to pantoprazole monotherapy after successful endoscopic hemostasis in patients with NVUGIB.

关键词： Somatostatin Pantoprazole Gastrointestinal bleeding Rebleeding

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Efficacy and safety of limited endoscopic sphincterotomy before self-expandable metal stent insertion for malignant biliary obstruction

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World Journal of Gastroenterology 2017年第9期23卷 1627-1636页

作者： Hyeong Seok Nam Dae Hwan Kang hyung wook kim Cheol Woong Choi Su Bum Park Su Jin kim Dae Gon Ryu Department of Internal Medicine Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and TechnologyPusan National University Yangsan HospitalYangsan-siGyeongsangnam-do 50612South Korea

To evaluate the safety and efficacy of limited endoscopic sphincterotomy (ES) before placement of self-expandable metal stent (SEMS).METHODSThis was a retrospective analysis of 244 consecutive patients with unresectable malignant biliary obstruction, who underwent placement of SEMSs following limited ES from December 2008 to February 2015. The diagnosis of malignant biliary obstruction and assessment of patient eligibility for the study was established by a combination of clinical findings, laboratory investigations, imaging and pathological results. All patients were monitored in the hospital for at least 24 h following endoscopic retrograde cholangio pancreatography (ERCP). The incidence of immediate or early post-ERCP complications such as post-ERCP pancreatitis (PEP) and bleeding related to limited ES were considered as primary outcomes. Also, characteristics and complications according to the cancer type were *** the 244 patients included, the underlying diagnosis was cholangiocarcinoma in 118 patients, pancreatic cancer in 79, and non-pancreatic or non-biliary malignancies in the remaining 47 patients. Early post-ERCP complications occurred in 9 patients (3.7%), with PEP in 7 patients (2.9%; mild, 6; moderate, 1) and mild bleeding in 2 patients (0.8%). There was no significant association between the incidence of post-ERCP complications and the type of malignancy (cholangiocarcinoma vs pancreatic cancer vs others, P = 0.696) or the type of SEMS used (uncovered vs covered, P = 1.000). Patients who had more than one SEMS placed at the first instance were at a significantly higher risk of post-ERCP complications (one SEMS vs two SEMS, P = 0.031). No other factors were predictive of post-ERCP *** ES is feasible and safe, and effectively facilitates the placement of SEMS, without any significant risk of PEP or severe bleeding.

关键词： Endoscopic sphincterotomy Endoscopic retrograde cholangio pancreatography Complications Pancreatitis Bleeding Cholestasis Self-expandable metal stent

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Assessment of disease activity by fecal immunochemical test in ulcerative colitis

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World Journal of Gastroenterology 2016年第48期22卷 10617-10624页

作者： Dae Gon Ryu hyung wook kim Su Bum Park Dae Hwan Kang Cheol Woong Choi Su Jin kim Hyeong Seok Nam Department of Internal Medicine Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology Pusan National University Yangsan Hospital

AIM To evaluate the efficacy of quantitative fecal immunochemical test(FIT) as biomarker of disease activity in ulcerative colitis(UC).METHODS Between February 2013 and November 2014, a total of 82 FIT results, obtained in conjunction with colonoscopies, were retrospectivelyevaluated for 63 patients with UC. The efficacy of FIT for evaluation of disease activity was compared to colonoscopic findings. Quantitative fecal blood with automated equipment examined from collected feces. Endoscopic disease severity were assessed using the Mayo endoscopic subscore(MES) classification. The extent of disease were classified by proctitis(E1), left sided colitis(E2), and extensive colitis(E3). Clinical activity were subgrouped by remission or *** All of 21 patients with MES 0 had negative FIT( 134.89 ng/m L. The sensitivity, specificity, positive predictive value(PPV), negative predictive value(NPV) and accuracy of negative FIT about mucosal healing were 73.33%, 81.82%, 91.49%, 51.43% and 73.17%, respectively. The sensitivity, specificity, PPV, NPV and accuracy of predictive value of positive FIT(cutoff value > 100 ng/mL) about active disease status were 45.45%, 93.33%, 71.43%, 82.35%and 26.83%, respectively. Among patients with clinical remission, FIT was negative in 31(81.6%) of 38 cases, with a mean fecal hemoglobin concentration of 6.12 ng/mL(range, negative to 80.9 ng/mL) for this group of patients. Among patients with clinical active disease, FIT was negative in 16(36.4%) out of 44 cases, with a mean fecal hemoglobin concentration > 167.4 ng/mL for this group of patients. FIT was positively correlated with endoscopic activity(r = 0.626, P < 0.01) and clinical activity(r = 0.496, P < 0.01). But, FIT did not correlate with the extent of disease(r =-0.047, P = 0.676)CONCLUSION Quantitative FIT can be a non-invasive and effective biomarker for evaluation of clinical and endoscopic activity in UC, but not

关键词： Ulcerative colitis Fecal immunochemical test Mayo endoscopic subscore Biomarker Disease activity

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H pylori eradication:A randomized prospective study of triple therapy with or without ecabet sodium

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World Journal of Gastroenterology 2008年第6期14卷 908-912页

作者： hyung wook kim Gwang Ha kim Jong Yun Cheong Ung Suk Yang Seung Keun Park Chul Soo Song Dae Hwan Kang Geun Am Song Department of Internal Medicine Bongseng Memorial Hospital Busan Korea Department of Internal Medicine Pusan National University School of Medicine Busan 602-739 Korea Department of Internal Medicine Maryknoll Hospital Busan Korea

AIM: To investigate whether adding ecabet sodium to the standard triple therapy for H pylori infection improve eradication rate. METHODS: Two hundred and fifty-seven H pylori-infected patients were randomly assigned to standard triple therapy (group A, n = 129) or triple therapy plus ecabet sodium (group B, n = 128). Successful eradication was defined as a negative 13C-urea breath test 6-8 wk after completion of treatment. RESULTS: After completion of therapy, 194/257 patients showed negative 13C-urea breath test results. According to intention-to-treat analysis, the infection was eradicated in 93/129 (72.1%) patients in group A and 101/128 (78.9%) in group B (P = 0.204). Per-protocol analysis showed successful eradication in 93/118 (78.8%) patients from group A and 101/114 (88.6%) from group B (P = 0.044). There were no significant differences in the side effects experienced by the patients in the two treatment groups. CONCLUSION: Our results suggest that the addition of ecabet sodium improves the efficacy of the standard triple therapy for H pylori.

关键词： H pylori Eradication Triple therapy Ecabet sodium

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Pedicled abdominal flap using deep inferior epigastric artery perforators for forearm reconstruction: A case report

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World Journal of Clinical Cases 2024年第4期12卷 828-834页

作者： Jae hyung Jeon Kyung wook kim Hong Bae Jeon Department of Plastic and Reconstructive Surgery Dankook University HospitalCheonan 31116ChungnamSouth Korea Department of Orthopaedic Surgery Dankook University HospitalDankook University College of MedicineCheonan 31116ChungnamSouth Korea Department of Plastic and Reconstructive Surgery Dankook University HospitalDankook University College of MedicineCheonan 31116ChungnamSouth Korea

BACKGROUND Pedicled abdominal flaps are a widely used surgical technique for forearm reconstruction in patients with soft tissue ***,some drawbacks include restricted flap size,partial flap loss,and donor-site *** address these concerns,we present a case of a pedicled abdominal flap using the deep inferior epigastric artery perforators(DIEP)for forearm reconstruction in a patient with a large soft tissue *** SUMMARY A 46-year-old male patient was admitted to our hospital with forearm injury caused by a pressing machine.A 15 cm×10 cm soft tissue defect with complete rupture of the ulnar side structures of the forearm was *** week after orthopedic management of the neurovascular injury and fractures using the first stage of Masquelet technique,the patient was referred to the plastic and recon-structive surgery department for wound *** debridement and negative-pressure wound therapy revealed a 20 cm×15 cm soft tissue defect.A pedicle abdominal flap with the DIEP was used to cover the *** weeks later,the flap was detached from the abdomen,and the abdominal defect was directly ***,the second stage of Masquelet technique was performed at the fracture site at week ***,all donor and recipient sites healed without complications,such as flap dehiscence,infection,hematoma,or *** site osteosynthesis was achieved without *** Pedicled abdominal flap using the DIEP provides a reliable option for forearm reconstruction in patients with large soft tissue defects.

关键词： Forearm injury Open fracture reduction Perforator flap Deep inferior epigastric artery perforators Case report

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Limited endoscopic sphincterotomy plus large balloon dilation for choledocholithiasis with periampullary diverticula

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World Journal of Gastroenterology 2010年第34期16卷 4335-4340页

作者： hyung wook kim Dae Hwan Kang Cheol Woong Choi Jong Hwan Park Jin Ho Lee Min Dae kim Il Doo kim Ki Tae Yoon Mong Cho Ung Bae Jeon Suk kim Chang Won kim Jun Woo Lee Department of Internal Medicine Pusan National University School of Medicine and Medical Research Institute Pusan National University Yangsan Hospital Department of Radiology Pusan National University School of Medicine and Medical Research Institute Pusan National University Hospital

AIM: To investigate the effectiveness and safety of limited endoscopic sphincterotomy (EST) plus large balloon dilation (LBD) for removing choledocholithiasis in patients with periampullary diverticula (PAD). METHODS: A total of 139 patients with common bile duct (CBD) stones were treated with LBD (10-20 mm balloon diameter) after limited EST. Of this total, 73 patients had PAD and 66 patients did not have PAD (controls). The results of stone removal and complications were retrospectively evaluated. RESULTS: There were no significant differences between the PAD and the control groups in overall successful stone removal (94.5% vs 93.9%), stone removal in first session (69.9% vs 81.8%), mechanical lithotripsy (12.3% vs 13.6%), and complications (11.0% vs 7.6%). Clinical outcomes were also similar between the types of PAD, but the rate of stone removal in first session and the number of sessions were significantly lower and more frequent, respectively, in type B PAD (papilla located near the diverticulum) than controls [23/38 (60.5%) vs 54/66 (81.8%), P = 0.021; and 1 (1-2) vs 1 (1-3), P = 0.037, respectively] and the frequency of pancreatitis was significantly higher in type A PAD (papilla located inside or in the margin of the diverticulum) than in controls (16.1% vs 3.0%, P = 0.047). CONCLUSION: Limited EST plus LBD was an effective and safe procedure for removing choledocholithiasis in patients with PAD. However, some types of PAD should be managed with caution.

关键词： Endoscopic sphincterotomy Large balloon dilation Choledocholithiasis Periampullary diverticula

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Incorporation of Ionic Conductive Polymers into Sulfide Electrolyte-Based Solid-State Batteries to Enhance Electrochemical Stability and Cycle Life

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Energy & Environmental Materials 2024年第6期7卷 4-12页

作者： Juhyoung kim Woonghee Choi Seong-Ju Hwang Dong wook kim Advanced Materials Division Korea Research Institute of Chemical Technology(KRICT)Daejeon 34114Korea Department of Material Science and Engineering Yonsei UniversitySeoul 03722Korea Department of Material Science and Engineering Seoul National UniversitySeoul 08826Korea Advanced Materials and Chemical Engineering University of Science and Technology(UST)Daejeon 34113Korea

Sulfide-based inorganic solid electrolytes are promising materials for high-performance safe solid-state *** high ion conductivity,mechanical characteristics,and good processability of sulfide-based inorganic solid electrolytes are desirable properties for realizing high-performance safe solid-state batteries by replacing conventional liquid ***,the low chemical and electrochemical stability of sulfide-based inorganic solid electrolytes hinder the commercialization of sulfide-based safe solid-state ***,the instability of sulfide-based inorganic solid electrolytes is intensified in the cathode,comprising various *** this study,carbonate-based ionic conductive polymers are introduced to the cathode to protect cathode materials and suppress the reactivity of sulfide *** instruments,including electrochemical spectroscopy,X-ray photoelectron spectroscopy,and scanning electron microscopy,confirm the chemical and electrochemical stability of the polymer electrolytes in contact with sulfide-based inorganic solid ***-based solid-state cells show stable electrochemical performance over 100 cycles when the ionic conductive polymers were applied to the cathode.

关键词： composite cathode electrochemical stability ionic conductive polymer solid-state battery sulfide solid electrolyte

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