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Survival improvement and prognostic factors in recent management of extrahepatic cholangiocarcinoma:A single-center study

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Hepatobiliary & Pancreatic Diseases International 2020年第2期19卷 153-156页

作者： Jung Wan Choe Hyo Jung kim jae seon kim Division of Gastroenterology Department of Internal MedicineKorea University Ansan HospitalKorea University College of Medicine516 Gojan-dongDanwon-guAnsan-siGyeonggi-do15355Korea Division of Gastroenterology Department of Internal MedicineKorea University Guro HospitalKorea University College of Medicine148 Gurodong-roGuro-guSeoul 08308Korea

Background:Cholangiocarcinoma was considered as a dismal disease with very poor prognosis until *** is increasingly found due to increased life *** surgical and medical management were advanced recently,data on the prognosis,especially extrahepatic cholangio-carcinoma(ECC),were *** study aimed to identify clinicopathologic features and prognosis of patients with ***:Patients followed up and diagnosed with ECC between January 2014 and December 2016 at a tertiary hospital were included,whereas those with intrahepatic cholangiocarcinoma,gallbladder cancer,and ampullary cancer were ***:A total of 83 patients were followed after the treatment(49 men and 34 women;median age 73.3 years).Cancer location was classified as distal common bile duct(25 patients),proximal com-mon bile duct(24 patients),common hepatic duct(20 patients),and hilar(14 patients).About 14.5%of patients had history of another malignant neoplasm,and 24.1%patients had chronic ***-cal resection was performed in 54 patients(65%)and dysplasia was combined in 63%(34/54).Adjuvant chemotherapy was performed in 54%(29/54),but only 7 underwent palliative chemotherapy in 29 non-surgical *** median overall survival in all patients was 30.9 *** analyzing the treatment modality,median survival of adjuvant chemotherapy,surgery only,palliative chemotherapy,and support-ive care groups were 42.9,30.9,12.0,and 8.9 months,respectively(P<0.05).In the Cox regression analy-sis of survival,age,surgical resection,chemotherapy,and comorbidity were significant prognostic factors,and the comorbidity was the only significant prognostic factor in the multivariable analysis(hazard ratio[HR]=2.80;95%CI:1.32–5.95;P=0.007).In a subgroup analysis of surgical patients,the presence of dysplasia was a favorable prognostic factor in the multivariable analysis(HR=0.29;95%CI:0.09–0.91;P=0.033).Conclusions:The overall survival of patients with ECC wa

关键词： Cholangiocarcinoma Survival Prognosis

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Significance of dysplasia in bile duct resection margin in patients with extrahepatic cholangiocarcinoma:A retrospective analysis

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World Journal of Clinical Cases 2022年第10期10卷 3078-3087页

作者： Jung Wan Choe Hyo Jung kim jae seon kim Department of Internal Medicine Korea University Ansan HospitalKorea University College of MedicineAnsan 15355South Korea Department ofInternal Medicine Korea University Guro HospitalKorea University College of MedicineSeoul 08308South Korea Department ofInternal Medicine Korea University Guro Hospital2

BACKGROUND Radical resection is the only indicator associated with survival in extrahepatic cholangiocarcinoma(EHCC).However,limited data are available regarding the implications of dysplasia at the resection margin following *** To evaluate the prognostic significance of dysplasia-positive margins in patients diagnosed with *** We reviewed the records of patients who had undergone surgery for EHCC with curative intent between January 2013 and July *** retrospectively analyzed the clinicopathological data of 116 patients followed for longer than 3 *** status of resection margin was used to classify patients into negative low-grade dysplasia(LGD)and high-grade dysplasia(HGD)/carcinoma in situ(CIS)*** Based on postoperative status,72 patients underwent resection with negative margins,19 had LGD-positive margins,and 25 showed HGD/CIS-positive *** mean survival rates of the patients with negative margins,LGD margins,and HGD/CIS margins were 49.1±4.5,47.3±6.0,and 20.8±4.4 mo,respectively(P70 years and HGD/CIS-positive margins were significant independent factors for survival(hazard ratio=1.90 and 2.47,respectively).CONCLUSION HGD/CIS margin in resected EHCC is associated with a poor ***,the LGDpositive resection margin is not a significant indicator of survival in patients with EHCC.

关键词： Dysplasia Cholangiocarcinoma Survival Extrahepatic cholangiocarcinoma Low-grade dysplasia High-grade dysplasia

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Usefulness of CA 19–9 for pancreatic cancer screening in patients with new-onset diabetes

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Hepatobiliary & Pancreatic Diseases International 2018年第3期17卷 263-268页

作者： Jung Wan Choe Hyo Jung kim jae seon kim jaehyung Cha Moon Kyung Joo Beom jae Lee Jong-jae Park Young-Tae Bak Department of Internal Medicine Korea University College of MedicineSeoul 08308Korea Department of Biostatistics Korea University Medical CenterSeoul 08308Korea

Background： Generally, carbohydrate antigen 19–9 （CA 19–9） is not useful for screening pancreatic cancerin the asymptomatic general population. This study aimed to evaluate the utility of CA 19–9 level as a scre... 详细信息

关键词： Diabetes mellitus Pancreatic neoplasms Early detection of cancer Carbohydrate antigen 19-9 Bilirubin

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Ileal polypoid lymphangiectasia bleeding diagnosed and treated by double balloon enteroscopy

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World Journal of Gastroenterology 2013年第45期19卷 8440-8444页

作者： Min seon Park Beom jae Lee Dae Hoe Gu Jeung-Hui Pyo Kyeong Jin kim Yun Ho Lee Moon Kyung Joo Jong-jae Park jae seon kim Young-Tae Bak Division of Gastroenterology Department of Internal Medicine Korea University Guro Hospitial Seoul 152-703 South Korea

Intestinal lymphangiectasia is a rare disease characterized by focal or diffuse dilated enteric lymphatics with impaired lymph *** causes protein-losing enteropathy and may lead to gastrointestinal ***,lymphangiectasia presents as whitish spots or *** our knowledge,small bowel bleeding resulting from polypoid intestinal lymphangiectasia has not been ***,we report a rare case of active bleeding from the small bowel caused by polypoid lymphangiectasia with a review of the relevant *** 80-year-old woman was hospitalized for *** could not identify the source of *** colonoscopy showed fresh bloody material gushing from the small *** abdominal-pelvic contrast-enhanced computed tomography scan did not reveal any abnormal *** capsule endoscopy showed evidence of active and recent bleeding in the *** localize the bleeding site,we performed double balloon enteroscopy by the anal approach.A small,bleeding,polypoid lesion was found in the distal ileum and was successfully removed using endoscopic snare electrocautery.

关键词： Intestinal lymphangiectasia Small bowel bleeding Double balloon endoscopy Solitary ileal polypoid lesion Endoscopic polypectomy

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Clinical outcomes of endoscopic papillectomy of ampullary adenoma: A multi-center study

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World Journal of Gastroenterology 2022年第17期28卷 1845-1859页

作者： seong Ji Choi Hong Sik Lee Jiyeong kim Jung Wan Choe jae Min Lee Jong Jin Hyun Jai Hoon Yoon Hyo Jung kim jae seon kim Ho Soon Choi Department of Internal Medicine Hanyang University College of MedicineSeoul 04763South Korea Division of Gastroenterology and Hepatology Department of Internal MedicineKorea University College of MedicineSeoul 02841South Korea Lab of Biostatistical Consulting and Research Medical Research Collaborating CenterIndustry-University Cooperation FoundationHanyang UniversitySeoul 04763South Korea

BACKGROUND Ampullary adenoma is a rare premalignant lesion,but its incidence is *** papillectomy has become the first treatment of choice for ampullary adenomas due to its safety and effectiveness,thereby replacing surgical ***,recurrence rates and adverse events after endoscopic papillectomy were reported in up to 30%of *** To review the long-term outcomes of endoscopic papillectomy and investigate the factors that affect these *** We retrospectively analyzed the data of patients who underwent endoscopic papillectomy for ampullary adenoma at five tertiary hospitals between 2013 and *** evaluated clinical outcomes and their risk *** definitions of outcomes were as follow:(1)curative resection:complete endoscopic resection without recurrence;(2)endoscopic success:treatment of ampullary adenoma with endoscopy without surgical intervention;(3)early recurrence:reconfirmed adenoma at the first endoscopic surveillance;and(4)late recurrence:reconfirmed adenoma after the first endoscopic *** A total of 106 patients were included for *** the included patients,81(76.4%)underwent curative resection,99(93.4%)had endoscopic success,showing that most patients with noncurative resection were successfully managed with *** patients(15.1%)had piecemeal resection,22 patients(20.8%)had shown positive/uncertain resection margin,11 patients(16.1%)had an early recurrence,13 patients(10.4%)had a late recurrence,and 6 patients(5.7%)had a *** multivariate analysis,a positive/uncertain margin[Odds ratio(OR)=4.023,P=0.048]and piecemeal resection(OR=6.610,P=0.005)were significant risk factors for early and late recurrence,*** resection was also a significant risk factor for non-curative resection(OR=5.424,P=0.007).Twenty-six patients experienced adverse events(24.5%).CONCLUSION Endoscopic papillectomy is a safe and effective treatment for ampullary ***

关键词： Endoscopic papillectomy Ampullary adenoma Clinical outcome Recurrence Adverse event

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Butein effects in colitis and interleukin-6/signal transducer and activator of transcription 3 expression

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World Journal of Gastroenterology 2015年第2期21卷 465-474页

作者： Sehe Dong Lee Jung Wan Choe Beom jae Lee Myoung Hee Kang Moon Kyung Joo Ji Hoon kim Jong Eun Yeon Jong-jae Park jae seon kim Young-Tae Bak Division of Gastroenterology Department of Internal MedicineKorea University Medical CenterSeoul 152-703South Korea

AIM: To evaluate the effects of butein on inflammatory cytokines, matrix metalloproteinase-9(MMP-9), andcolitis in interleukin(IL)-10-/- ***: To synchronize colitis, 8- to 10-wk-old IL-10-/- mice were fed pellet-chow containing piroxicam for 2 wk. Subsequently, phosphate-buffered saline or butein(1 mg/kg per day, ip) was injected for 4 wk. Histologic scores, inflammatory cytokines, MMP-9 and phosphorylated signal transducer and activator of transcription 3(p STAT3) expressions were analyzed in IL-10-/- mice and in Colo 205 ***: Butein reduced the colonic inflammatory score by > 50%. Expression levels of IL-6, IL-1β, interferon(IFN)-γ and MMP-9 were decreased in the colons of mice exposed to butein, whereas other inflammatory cytokines(IL-17 A, IL-21 and IL-22) were unchanged. Immunohistochemical staining for p STAT3 and MMP-9 was significantly decreased in the buteintreated groups compared with the controls. Butein inhibited IL-6-induced activation of STAT3 in Colo 205 ***: Butein ameliorated colitis in IL-10-/-mice by regulating IL-6/STAT3 and MMP-9 activation.

关键词： Butein Interleukin-6/signal transducer and activat

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Upper gastrointestinal bleeding from duodenal vascular ectasia in a patient with cirrhosis

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World Journal of Gastroenterology 2007年第38期13卷 5154-5157页

作者： Beom jae Lee Jong-jae Park Yeon Seok Seo Ji Hoon kim Aeree kim Jong Eun Yeon jae seon kim Kwan Soo Byun Young-Tae Bak Division of Gastroenterology Department of Internal Medicine Korea University College of Medicine Seoul Korea

We report a cirrhotic patient with duodenal vascular ectasia and spontaneous bleeding. The bleeding was successfully controlled with argon plasma coagulation. Duodenal vascular ectasia may be a cause of upper gastrointestinal bleeding in patients with cirrhosis, and argon plasma coagulation may be effective and safe to achieve hemostasis of this lesion.

关键词： Vascular ectasia Duodenum Cirrhosis Gastrointestinal hemorrhage Hemostasis

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Removal of press-through-packs impacted in the upper esophagus using an overtube

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World Journal of Gastroenterology 2006年第36期12卷 5909-5912页

作者： Yeon Seok Seo Jong-jae Park Ji Hoon kim Jin Yong kim Jong Eun Yeon jae seon kim Kwan Soo Byun Young-Tae Bak Department of Internal Medicine Korea University Medical Center Guro Hospital Seoul Korea Department of Internal Medicine Sungkyunkwan University School of Medicine Seoul Korea

Foreign bodies in the upper esophagus should be re-moved as soon as possible to avoid serious complica-tions. However, removals of foreign bodies in the upper esophagus are very difficult, especially if they have sharp edges, such as press-through-packs (PTPs). We expe-rienced four cases of the impacted PTPs in the upper esophagus which was successfully extracted endoscopi-cally with the overtube. Because two edges of PTPs were so firmly impacted in the esophageal wall in all cases, the PTPs were not movable in the upper esophagus. However, after insertion of the overtube, PTPs became movable and were successfully extracted and no serious complications occurred after extraction of PTPs. In one case, insertion of the overtube rapidly expanded the up-per esophagus and PTP progressed to the gastric cavity and it could be extracted with the endoscopic protector hood. The endoscopic removal with the overtube was a simple, safe and effective technique for the removal of the impacted PTPs in upper esophagus.

关键词： Esophagus Foreign body Endoscopy

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Inverted cystic tubulovillous adenoma involving Brunner’s glands of duodenum

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World Journal of Gastroenterology 2007年第23期13卷 3262-3264页

作者： Ji Hoon kim Jung Woo Choi Yeon Seok Seo Beom jae Lee Jong Eun Yeon jae seon kim Kwan Soo Byun Young-Tae Bak Insun kim Jong- jae Park Division of Gastroenterology Department of Internal Medicine Korea University College of Medicine Seoul South Korea Department of Pathology Korea University College of Medicine Seoul South Korea

Benign neoplasia of the duodenum are very rare. Moreover, duodenal tubulovillous adenomas are more uncommon lesions. The microscopic structure of tubulovillous adenoma has frond-like projection of mucosa with branching papillary structure and generally upward growth into the lumen. We describe a 72-year-old man who showed aduodenal tubulovillous adenoma with unusual inverted cystic growth pattern. Interestingly, this tubulovillous adenomatous lesion was interrupted by gastric metaplasia in the deep portion of the cyst and was closely surrounded by Brunner’s glands. Although histogenesis of gastric metaplasia of duodenum is not fully understood, Brunner’s glands has been suggested as a precursor for gastric metaplasia. Therefore, these findings argued that this adenoma arises from Brunner’s glands through gastric metaplasia. This is the first case of inverted cystic tubulovillous adenoma involving Brunner’s glands of duodenum with gastric metaplasia.

关键词： Brunner's glands Duodenum Gastric metaplasia Tubulovillous adenoma

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Antiviral efficacy of adefovir dipivoxil versus lamivudine in patients with chronic hepatitis B sequentially treated with lamivudine and adefovir due to lamivudine resistance

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World Journal of Gastroenterology 2007年第30期13卷 4072-4079页

作者： Yeon Seok Seo Ji Hoon kim Jong Eun Yeon Jong-jae Park jae seon kim Kwan Soo Byun Young-Tae Bak Chang Hong Lee Division of Gastroenterology and Hepatology Department of Internal Medicine Korea University College of Medicine Seoul Korea Division of Gastroenterology and Hepatology Department of Internal Medicine Konkuk University College of Medicine Seoul Korea

AIM： To compare the antiviral efficacy of adefovir （ADV） in lamivudine （LMV）-resistant patients with LMV treatment in nucleoside-naive patients, using serum samples collected sequentially during the course of treatment progressing from LMV to ADV.METHODS： Forty-four patients with chronic hepatitis B （CHB） were included. The patients were initially treated with LMV and then switched to ADV when LMV resistance developed. Antiviral efficacy was assessed by measuring the following： reduction in serum HBV DNA from baseline, HBV DNA negative conversion （defined as HBV DNA being undectable by the hybridization assay）, and HBV DNA response （either HBV DNA level ≤ 10^s copies/mL or a ≥ 2 log10 reduction from baseline HBV DNA level）.RESULTS： After two and six months of treatment, HBV DNA reduction was greater with LMV compared to ADV treatment （P = 0.021）. HBV DNA negative conversion rates were 64% and 27% after one month of LMV and ADV treatment respectively （P = 0.001）. Similarly, HBV DNA response rates were 74% and 51% after two months of LMV and ADV treatment respectively （P = 0.026）. The time taken to HBV DNA negative conversion and to HBV DNA response were both delayed in ADV treatment compared with LMV.CONCLUSION： The antiviral efficacy of ADV in LMV-resistant patients is slower and less potent than that with LMV in nucleoside-naive patients during the early course of treatment.

关键词： Chronic hepatitis B Lamivudine Adefovir Treatment efficacy

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