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World Journal of Gastroenterology 2022年第46期28卷 6564-6572页

作者： ji young park Tae Joo Jeon Department of Internal Medicine Inje University College of MedicineSanggye Paik HospitalSeoul 01757South Korea Department of Internal Medicine Yonsei University College of MedicineSeoul 03722South Korea

BACKGROUND Endoscopic ultrasonography(EUS)has become a reliable method for predicting the invasion depth of early gastric cancer(EGC).However,diagnostic accuracy of EUS is affected by several factors.In particular,it is difficult to differentiate between T1a and T1b EGC through EUS.AIM To confirm whether submucosal saline injection(SSI)could improve the accuracy of EUS in distinguishing T1a and T1b lesions in EGC.METHODS Twenty-four patients with EGC were examined by EUS and subsequently by SSI combined EUS to compare the degree of tumor invasion.Then,they underwent endoscopic or surgical resection within 7 d.The diagnostic accuracy of EUS and SSI combined EUS was evaluated based on the final pathological findings postoperatively.Saline injected into the submucosa acted as an echoic contrast enhancing agent and had the effect of distinguishing the mucosal and submucosal layers clearly.RESULTS Of total 24 patients,23 were diagnosed with EGC(T1 cancer:13 as T1a,and 10 as T1b).Standard EUS identified 6 of 13 T1a cancer patients and 3 of 10 T1b cancer patients.Whereas,EUS-SSI identified 12 of 13 T1a cancer patients and 6 of 10 T1b cancer patients.In this study,SSI combined EUS was more accurate than EUS alone in diagnosing T1a and T1b lesions of EGC(75.0%and 37.5%,respectively).CONCLUSION SSI improved the diagnostic accuracy of EUS in distinguishing between the T1a and T1b stages in EGC.

关键词： Endoscopic ultrasonography Gastric cancer Endoscopy Surgery

Clinical significance of the neutrophil-lymphocyte ratio as an early predictive marker for adverse outcomes in patients with acute pancreatitis

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World Journal of Gastroenterology 2017年第21期23卷 3883-3889页

作者： Tae Joo Jeon ji young park Division of Gastroenterology Department of Internal Medicine Inje University College of Medicine Sanggye Paik Hospital

AIM To investigated the prognostic value of the neutrophillymphocyte ratio(NLR) in patients with acute pancreatitis and determined an optimal cut-off value for the prediction of adverse outcomes in these patients.METHODS We retrospectively analyzed 490 patients with acute pancreatitis diagnosed between March 2007 and December 2012. NLRs were calculated at admission and 24, 48, and 72 h after admission. Patients were grouped according to acute pancreatitis severity and organ failure occurrence, and a comparative analysis was performed to compare the NLR between groups. RESULTS Among the 490 patients, 70 had severe acute pancreatitis with 31 experiencing organ failure. The severe acute pancreatitis group had a significantly higher NLR than the mild acute pancreatitis group on all 4 d(median, 6.14, 6.71, 5.70, and 4.00 vs 4.74, 4.47, 3.20, and 3.30, respectively, P < 0.05). The organ failure group had a significantly higher NLR than the group without organ failure on all 4 d(median, 7.09, 6.72, 6.27, and 6.24 vs 4.85, 4.49, 3.35, and 2.34, respectively, P < 0.05). The optimal cut-off value for baseline NLR was 4.76 in predicting severity and 4.88in predicting organ failure in acute pancreatitis. CONCLUSION Elevated baseline NLR correlates with severe acute pancreatitis and organ failure.

关键词：尖锐胰腺炎嗜中性淋巴细胞的比率机关失败严重尖锐胰腺炎

Usefulness of magnifying endoscopy in post-endoscopic resection scar for early gastric neoplasm:A prospective short-term follow-up endoscopy study

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World Journal of Gastroenterology 2009年第3期15卷 349-355页

作者： Tae Hoon Lee Il-Kwun Chung ji-young park Chang Kyun Lee Suck-Ho Lee Hong Soo Kim Sang-Heum park Sun-Joo Kim Hyun-Deuk Cho young Hwangbo Division of Gastroenterology Department of Internal MedicineSoonchunhyang University College of MedicineCheonan Hospital23-20 Bongmyung-dongCheonan330-721South Korea Department of Pathology Soonchunhyang University College of MedicineCheonan Hospital23-20 Bongmyung-dongCheonan330-721South Korea Department of Preventive Medicine Soonchunhyang University College of MedicineCheonan Hospital23-20 Bongmyung-dongCheonan330-721South Korea

AIM:To investigate the relationship between post-endoscopic resection(ER) scars on magnifying endoscopy(ME) and the pathological diagnosis in order to validate the clinical significance of ME.METHODS:From January,2007 to June,2008,124 patients with 129 post-ER scar lesions were enrolled.Mucosal pit patterns on ME were compared with conventional endoscopy(CE) findings and histological results obtained from targeted biopsies.RESULTS:CE fi ndings showed nodular scars(53/129),erythematous scars(85/129),and ulcerative scars(4/129).The post-ER scars were classified into four pit patterns of sulci and ridges on ME:47 round;54 short rod or tubular;19 branched or gyrus-like;and9 destroyed pits.Sensitivity and specificity were 88.9% and 62.5%,respectively,by the presence of nodularity on CE.Erythematous lesions were high sensitivity(100%),but specificity was as low as 36.7%.The range of the positive predictive value (PPV) on CE was as low as 10.6%-25%.Nine type  pit patterns were diagnosed as tumor lesions,and 120 cases of type pit patterns revealed non-neoplastic lesions.Thus,the sensitivity,specificity,and the PPV of ME were 100%.CONCLUSION:ME findings can detect the presence of tumor in post-ER scar lesions,and make evident the biopsy target site in short-term follow-up.Further large-scale and long-term studies are needed to determine whether ME can replace endoscopic biopsy.

关键词：内窥镜检查黏膜切除术黏膜下层解剖伤痕

Clinical implications of fatty pancreas:Correlations between fatty pancreas and metabolic syndrome

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World Journal of Gastroenterology 2009年第15期15卷 1869-1875页

作者： Jun Seok Lee Sang Heum Kim Dae Won Jun Jee Hye Han Eun Chul Jang ji young park Byung Kwan Son Seong Hwan Kim Yoon Ju Jo young Sook park Yong Soo Kim Department of Internal Medicine Eulji University School of Medicine Department of Radiology Eulji University School of Medicine Department of Family Medicine Eulji University School of Medicine Department of Occupational and Environmental Medicine College of MedicineSoonchunhyang University Department of Radiology Hanyang University School of Medicine

AIM:To investigate the clinical implications of lipid deposition in the pancreas(fatty pancreas). METHODS:The subjects of this study were 293 patients who had undergone abdominal computed tomography(CT)and sonography.Fatty pancreas was diagnosed by sonographic findings and subdivided into mild,moderate,and severe fatty pancreas groups comparing to the retroperitoneal fat echogenicity. RESULTS:Fatty pancreas was associated with higher levels for visceral fat,waist circumference,aspartate aminotransferase(AST),alanine aminotransferase (ALT),total cholesterol,triglyceride,high density lipoprotein,free fatty acid,γ-GTP,insulin,and the homeostasis model assessment of insulin resistance (HOMA-IR)than the control group(P<0.05).HOMAIR,visceral fat,triglyceride,and ALT also tended to increase with the degree of fat deposition in the pancreas on sonography.In a multivariate logistic regression analysis,HOMA-IR,visceral fat,and ALT level were independently related to fatty pancreas after adjustment for age,body mass index,and lipid profile.The incidence of metabolic syndrome in the fatty pancreas group was significantly higher than in the control group,and the numbers of metabolic syndrome parameters were significantly higher in the fatty pancreas group(P<0.05).CONCLUSION:Sonographic fatty pancrease showed higher insulin resistance,visceral fat area,triglyceride, and ALT levels than normal pancreases.Fatty pancreas also showed a strong correlation with metabolic syndrome.

关键词：代谢综合征内脏脂肪正常胰腺临床意义胰岛素抵抗 ALT水平 logistic 谷草转氨酶

Chemical ablation of the gallbladder using alcohol in cholecystitis after palliative biliary stenting

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World Journal of Gastroenterology 2009年第16期15卷 2041-2043页

作者： Tae Hoon Lee Sang-Heum park Sang Pil Kim ji-young park Chang Kyun Lee Il-Kwun Chung Hong Soo Kim Sun-Joo Kim Division of Gastroenterology Department of Internal MedicineSoonchunhyang University College of MedicineCheonan Hospital

Chemical ablation of the gallbladder is effective in patients at high risk of complications after surgery. Percutaneous gallbladder drainage is an effective treatment for cholecystitis; however, when the drain tube cannot be removed because of recurrent symptoms, retaining it can cause problems. An 82-year-old woman presented with cholecystitis and cholangitis caused by biliary stent occlusion and suspected tumor invasion of the cystic duct. We present successful chemical ablation of the gallbladder using pure alcohol, through a percutaneous gallbladder drainage tube, in a patient who developed intractable cholecystitis with obstruction of the cystic duct after receiving a biliary stent. Our results suggest that chemical ablation therapy is an effective alternative to surgical therapy for intractable cholecystitis.

关键词：化学消融治疗胆道内支架置入术胆囊炎纯酒精姑息胆道支架胆囊引流术高危患者

Calcium channel blocker monotherapy versus combination with reninangiotensin system inhibitors on the development of new-onset diabetes mellitus in hypertensive Korean patients

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Journal of Geriatric Cardiology 2019年第6期16卷 439-447页

作者： Yong Hoon Kim Ae-young Her Seung-Woon Rha Byoung Geol Choi Se Yeon Choi Jae Kyeong Byun Yoonjee park Dong Oh Kang Won young Jang Woohyeun Kim Woong Gil Choi Tae Soo Kang jihun Ahn Sang-Ho park ji young park Min-Ho Lee Cheol Ung Choi Chang Gyu park Hong Seog Seo Division of Cardiology Department of Internal Medicine Kangwon National University School of Medicine Chuncheon South Korea Cardiovascular Center Korea University Guro Hospital Seoul South Korea Department of Medicine Korea University Graduate School Seoul South Korea Cardiology Department Konkuk University Chungju Hospital Chungju South Korea Department of Internal Medicine Cardiovascular Division Dankook University Hospital Cheonan South Korea Department of Cardiology Soonchunhyang University Gumi Hospital Gumi South Korea Cardiology Department Soonchunhyang University Cheonan Hospital Cheonan South Korea Division of Cardiology Department of Internal Medicine Cardiovascular Center Nowon Eulji Medical Center Eulji University Seoul South Korea Department of Cardiology Soonchunhyang University College of Medicine Seoul South Korea

Background In real practice, two or more antihypertensive drugs are needed to achieve target blood pressure. We investigated the comparative beneficial actions of combination therapy of renin-angiotensin system inhibitors (RASI), with calcium channel blockers (CCB) over CCB monotherapy on the development of new-onset diabetes mellitus (NODM) in Korean patients during four-year follow-up periods. Methods A total of 3208 consecutive hypertensive patients without a history of diabetes mellitus who had been prescribed CCB were retrospectively enrolled from January 2004 to December 2012. These patients were divided into the two groups according to the additional use of RASI (the RASI group, n = 1221 and the no RASI group, n = 1987). Primary endpoint was NODM, defined as a fasting blood glucose ≥ 126 mg/dL or hemoglobin A1c ≥ 6.5%. Secondary endpoint was major adverse cardiac events (MACE) defined as total death, myocardial infarction (MI) and percutaneous coronary intervention (PCI). Results After propensity score-matched (PSM) analysis, two propensity- matched groups (939 pairs, n = 1878, C-statistic = 0.743) were generated. The incidences of NODM (HR = 1.009, 95% CI: 0.700–1.452, P = 0.962), MACE (HR = 0.877, 95% CI: 0.544–1.413, P = 0.589), total death, MI, PCI were similar between the two groups after PSM during four years. Conclusions The use of RASI in addition to CCB showed comparable incidences of NODM and MACE compared to CCB monotherapy in non-diabetic hypertensive Korean patients during four-year follow-up period. However, large-scaled randomized controlled clinical trials will be required for a more definitive conclusion.

关键词： Calcium channel blocker Diabetes mellitus Renin-angiotensin system inhibitors

Five-year clinical outcomes of first-generation versus second-generation drug-eluting stents following coronary chronic total occlusion intervention

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Journal of Geriatric Cardiology 2019年第8期16卷 639-647页

作者： Yong Hoon Kim Ae-young Her Seung-Woon Rha Byoung Geol Choi Se Yeon Choi Jae Kyeong Byun Yoonjee park Dong Oh Kang Won young Jang Woohyeun Kim Ju Yeol Baek Woong Gil Choi Tae Soo Kang jihun Ahn Sang-Ho park ji young park Min-Ho Lee Cheol Ung Choi Chang Gyu park Hong Seog Seo Division of Cardiology Department of Internal MedicineKangwon National University School of MedicineChuncheonSouth Korea Department of Cardiology Soonchunhyang University College of MedicineSeoulSouth Korea Cardiovascular Center Korea University Guro HospitalSeoulSouth Korea Department of Medicine Korea University Graduate SchoolSeoulSouth Korea Cardiovascular Center Seoul St. Mary’s Hospitalthe Catholic University of KoreaSeoulSouth Korea Cardiology Department Konkuk University Chungju HospitalChungjuSouth Korea Department of Internal Medicine Cardiovascular DivisionDankook University HospitalCheonanSouth Korea Department of Cardiology Soonchunhyang University Gumi HospitalGumiSouth Korea Cardiology Department Soonchunhyang University Cheonan HospitalCheonanSouth Korea Division of Cardiology Department of Internal MedicineCardiovascular CenterNowon Eulji Medical CenterEulji UniversitySeoulSouth Korea

Background There are limited data comparing long-term clinical outcomes between first-generation (1G) and second-generation (2G) drug-eluting stents (DESs) in patients who underwent successful percutaneous coronary intervention (PCI) for coronary chronic total occlusion (CTO) lesion. Methods A total of 840 consecutive patients who underwent PCI with DESs for CTO lesion from January 2004 to November 2015 were enrolled. Finally, a total of 324 eligible CTO patients received 1G-DES (Paclitaxel-eluting stent or Sirolimus-eluting stent, n = 157) or 2G-DES (Zotarolimus-eluting stent or Everolimus-eluting stent, n = 167) were enrolled. The clinical endpoint was the occurrence of major adverse cardiac events (MACE) defined as all-cause death, recurrent myocardial infarction (re-MI), total repeat revascularization [target lesion revascularization (TLR), target vessel revascularization (TVR), and non-TVR]. We investigated the 5-year major clinical outcomes between 1G-DES and 2G-DES in patient who underwent successful CTO PCI. Results After propensity score matched (PSM) analysis, two well-balanced groups (111 pairs, n = 222, C-statistic = 0.718) were generated. Up to the 5-year follow-up period, the cumulative incidence of all-cause death, re-MI, TLR, TVR and non-TVR were not significantly different between the two groups. Finally, MACE was also similar between the two groups (HR = 1.557, 95% CI: 0.820–2.959, P = 0.176) after PSM. Conclusions In this study, 2G-DES was not associated with reduced long-term MACE compared with 1G-DES following successful CTO revascularization up to five years.

关键词： Chronic total occlusion Drug-eluting stent Outcomes

Bedside index for severity in acute pancreatitis:comparison with other scoring systems in predicting severity and organ failure

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Hepatobiliary & Pancreatic Diseases International 2013年第6期12卷 645-650页

作者： ji young park Tae Joo Jeon Tae Hwan Ha jin Tae Hwang Dong Hyun Sinn Tae-Hoon Oh Won Chang Shin Won-Choong Division of Gastroenterology Department of Internal MedicineInje University Sanggye Paik Hospital

BACKGROUND:The early identification of severe acute pancreatitis is important for the management and for improving outcomes.The bedside index for severity in acute pancreatitis(BISAP)has been considered as an accurate method for risk stratification in patients with acute pancreatitis.This study aimed to evaluate the comparative usefulness of the BISAP.METHODS:We retrospectively analyzed 303 patients with acute pancreatitis diagnosed at our hospital from March 2007to December 2010.BISAP,APACHE-II,Ranson criteria,and CT severity index(CTSI)of all patients were calculated.We stratified the number of patiants with severe pancreatitis,pancreatic necrosis,and organ failure as well as the number of deaths by BISAP score.We used the area under the receiveroperating curve(AUC)to compare BISAP with other scoring systems,C-reactive protein(CRP),hematocrit,and body mass index(BMI)with regard to prediction of severe acute pancreatitis,necrosis,organ failure,and death.RESULTS:Of the 303 patiants,31(10.2%)were classified as having severe acute pancreatitis.Organ failure occurred in 23(7.6%)patients,pancreatic necrosis in 40(13.2%),and death in6(2.0%).A BISAP score of 2 was a statistically significant cutoff value for the diagnosis of severe acute pancreatitis,organ failure,and mortality.AUCs for BISAP predicting severe pancreatitis and death were 0.80 and 0.86,respectively,which were similar to those for APACHE-II(0.80,0.87)and Ranson criteria(0.74,0.74)and greater than AUCs for CTSI(0.67,0.42).The AUC for organ failure predicted by BISAP,APACHE-II,Ranson criteria,and CTSI was 0.93,0.95,0.84 and 0.57,respectively.AUCs for BISAP predicting severity,organ failure,and death were greater than those for CRP(0.69,0.80,0.72),hematocrit(0.45,0.35,0.14),and BMI(0.41,0.47,0.17).CONCLUSION:The BISAP predicts severity,death,and especially organ failure in acute pancreatitis as well as APACHE-II does and better than Ranson criteria,CTSI,CRP,hematocrit,and BMI.

关键词： acute pancreatitis scoring system pancreatic necrosis organ failure

Clinical Response to Treatment of Central Nervous System Tuberculosis in Non-Human Immunodeficiency Virus-Infected Adolescents and Adults

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Journal of Tuberculosis Research 2016年第4期4卷 173-182页

作者： jin young Lee Su jin Lee ji young park Min Jeong Kim Department of Internal Medicine Kosin Medical College Busan Korea Department of Internal Medicine Pusan National University Busan Korea Department of Neurology Kosin Medical College Busan Korea

Introduction: More than half of patients with central nervous system tuberculosis (CNS TB) die or are left with severe neurological deficits despite receiving anti-TB treatment. Aims of the study: This study examined risk factors associated with poor response to initial treatment with four anti-TB drug regimens or three drug regimens with steroids as adjuvant therapy. Methods: This study analyzed medical records from two tertiary hospitals in Busan, Korea, between January 2009 and March 2012. The subjects were non-human immunodeficiency virus (HIV)-infected patients aged ≥16 years with clinical CNS TB. The subjects were divided into two groups according to response to treatment. Results: In totally, 52 patients with CNS TB were included. Of these, 14 (26%) and 38 (73%) showed poor and good responses, respectively. Of the patients with poor response, nine had stage III disease (64.3%) according to the British Medical Research Council (BMRC) staging system. A significantly higher proportion was seen in the good response group (p < 0.05). Patients with positive cerebrospinal fluid (CSF) acid-fast bacillus (AFB) culture, positive sputum AFB culture, positive CSF TB polymerase chain reaction (PCR) results, and brain tuberculoma had poorer responses (p < 0.05). Multivariate analysis to determine risk factors associated with poor response to anti-TB therapy revealed that a poor response was associated with stage III clinical signs upon diagnosis (odds ratio [OR] 32.122;95% confidence interval [CI] 2.221 - 464.605), positive sputum AFB culture (OR 13.624;95% CI 1.066 - 174.149), and tuberculoma on brain images (OR 45.714;95% CI 1.893 - 1104.018). Conclusions: The results demonstrate the importance of identifying the severity of CNS TB and promptly administering anti-TB drugs. It is necessary to perform drug susceptibility testing for anti-TB drugs. Further studies are needed to confirm the correlations between risk factors associated with poor response and anti-TB drug resistance and the other risk factors.

关键词： Central Nervous System Tuberculosis Poor Response Severity of Symptoms Anti-Tuberculosis Drug Resistance

Aortoduodenal fistula and aortic aneurysm secondary to biliary stent-induced retroperitoneal perforation

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World Journal of Gastroenterology 2008年第19期14卷 3095-3097页

作者： Tae Hoon Lee Do Hyun park ji-young park Suck-Ho Lee Il-Kwun Chung Hong Soo Kim Sang-Heum park Sun-Joo Kim Division of Gastroenterology Department of Internal MedicineSoonchunhyang University College of Medicine Division of Gastroenterology Department of Internal MedicineUniversity of Ulsan College of Medicine

Duodenal perforations caused by biliary prostheses are not uncommon, and they are potentially life threatening and require immediate treatment. We describe an unusual case of aortic aneurysm and rupture which occurred after retroperitoneal aortoduodenal fistula formation as a rare complication caused by biliary metallic stent-related duodenal perforation. To our knowledge, this is the first report describing a lethal complication of a bleeding, aortoduodenal fistula and caused by biliary metallic stent-induced perforation.

关键词：大动脉瘤腹膜穿孔瘘管症状