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Increased incidence of indeterminate pancreatic cysts and changes of management pattern: Evidence from nationwide data

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Hepatobiliary & Pancreatic Diseases International 2023年第3期22卷 294-301页

作者： Jaewoo Park jinkyeong Park Yoon Suk Lee Kwangrok Jung In Ho Jung Jong-Chan Lee jin-hyeok hwang Jaihwan Kim Department of Internal Medicine Seoul National University Bundang HospitalSeoul National University College of MedicineSeongnamKorea Department of Internal Medicine Kyung Hee University Hospital at GangdongSeoulKorea Department of Internal Medicine Inje University College of MedicineIlsan Paik HospitalGoyangKorea

Background:Pancreatic cysts are ***,most studies are based on data collected from individual *** present study aimed to evaluate the changes of management patterns for pancreatic cystic lesions(PCLs)by analyzing large epidemiologic ***:Between January 2007 and December 2018,information regarding pancreatic cystic lesions was acquired from the nationwide Health Insurance Review and Assessment Service database in ***:The final number of patients with pancreatic cysts was 165277 among the total claims for reimbursement of 855983 associated with PCLs over 12 *** total number of claims were increased from 19453 in 2007 to 155842 in 2018 and the prevalence increased from 0.04%to 0.23%.For 12 years,2874(1.7%)had pancreatic cancer and 8212(5.0%)underwent surgery,and 36 had surgery for twice(total 8248 pancreatectomy).After ruling out claims from the first 3 years of washout period,the incidence increased from 9891 to 24651 and the crude incidence rate of PCLs expanded from 19.96 per 100000 to 47.77 per *** to specific neoplasm codes(D136 or D377),the use of pancreatic cyst code(K862)has been remarkably increased and the most common since *** annual number of pancreatectomies increased from 518 to 861 between 2007 and 2012,and decreased to 596 until *** percentage of pancreatic cancer in patients who received pancreatectomy increased from 5.6%in 2007 to 11.7%in ***:The incidence of PCLs is rapidly *** PCLs,indeterminate cyst is increasing outstandingly.A trend of decreasing in the number of resections and increasing cancer rates among resected cysts may be attributed to the updated international guidelines.

关键词： Pancreatic cyst Incidence Prevalence Pancreatectomy Big data

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It is necessary to exam bottom and top slide smears of EUS-FNA for pancreatic cancer

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Hepatobiliary & Pancreatic Diseases International 2018年第6期17卷 553-558页

作者： Jong-chanb Lee Haeryoung Kim Hyoung Woo Kim Jongchan Lee Kyu-hyun Paik jingu Kang jin-hyeok hwang Jaihwan Kim Department of Internal Medicine Seoul National University College of Medicine Seoul National University Bundang Hospital Department of Pathology Seoul National University College of Medicine Seoul National University Hospital Department of Internal Medicine Chungbuk National University College of Medicine Chungbuk National University Hospital Department of Internal Medicine The Catholic University of Korea Daejeon St. Mary’s Hospital Department of Internal Medicine Kangdong Sacred Heart Hospital of Hallym University Medical Center

Background: Despite many reports on the diagnostic yield of cytology from endoscopic ultrasound-guided fine-needle aspiration(EUS-FNA), inter-slide differences are unknown. This prospective study aimed to compare diagnostic yield and cellular characteristics of bottom slides(BS) and top slides(TS) from EUSFNA cytology performed without an on-site cytopathologist. Methods: In patients with suspected pancreatic cancer on previous imaging explorations, a single endoscopist performed EUS-FNA and obtained 2 sets of cytology slide(8 BS and 8 TS), 1 cellblock slide, and 1 biopsy slide. Both slide sets were randomly assigned. A cytopathologist with more than 10 years of expertise in pancreatic cytopathology blindly inspected and compared two slide sets. Results: In total, 73 specimens [42 head(57.5%), 16 body(21.9%), and 15 tail(20.5%)] were acquired for final analysis. Seventy-one cases were finally diagnosed with pancreatic cancer. The sensitivity and specificity of BS were 80.3% and 100.0%; and of TS 78.9% and 100.0%, respectively. In analyzing inter-slide difference, 66 cases(90.4%) showed consistent results between BS and TS. However, seven(9.6%) were positive only in one slide sets(4 BS and 3 TS). The proportions of specimens more than moderate and high cellularity were 75.3% and 60.3% in both slide sets( P > 0.99), and the proportion of artifact-free sets were 50.7%, and 52.1% for the BS and TS, respectively( P = 0.869). Conclusions: Although BS and TS exhibited highly consistent diagnostic yields in cytologic smears from EUS-FNA, the proportion of inter-slide discordance is clinically considerable. Both slide sets need to be examined if there is no on-site cytopathologist.

关键词： Endoscopic ultrasound-guided fine-needle aspiration Pancreatic neoplasm Cytology

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Optimal initiation of Helicobacter pylori eradication in patients with peptic ulcer bleeding

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World Journal of Gastroenterology 2015年第8期21卷 2497-2503页

作者： Hyuk Yoon Dong Ho Lee Eun Sun Jang Jaihwan Kim Cheol Min Shin Young Soo Park jin-hyeok hwang jin-Wook Kim Sook-Hayng Jeong Nayoung Kim Departments of Internal Medicine Seoul National University Bundang Hospital

AIM:To evaluate when Helicobacter pylori(***)eradication therapy(ET)should be started in patients with peptic ulcer bleeding(PUB).METHODS:Clinical data concerning adults hospitalizedwith PUB were retrospectively collected and ***,sex,type and stage of peptic ulcer,whether endoscopic therapy was performed or not,methods of *** detection,duration of hospitalization,and specialty of the attending physician were *** influencing the confirmation of *** infection prior to discharge were determined using multiple logistic regression *** *** eradication rates of patients who received ET during hospitalization and those who commenced ET as outpatients were ***:A total of 232 patients with PUB were evaluated for *** infection by histology and/or rapid urease *** these patients,53.7%(127/232)had confirmed results of *** infection prior to *** multivariate analysis,duration of hospitalization and ulcer stage were factors independently influencing whether *** infection was confirmed before or after *** the patients discharged before confirmation of *** infection,13.3%(14/105)were lost to *** the patients found to be ***-positive after discharge,41.4%(12/29)did not receive *** was no significant difference in the *** eradication rate between patients who received ET during hospitalization a n d t h o s e w h o c o m m e n c e d E T a s o u t p a t i e n t s[intention-to-treat:68.8%(53/77)vs 60%(12/20),P=0.594;per-protocol:82.8%(53/64)vs 80%(12/15),P=0.723].CONCLUSION:Because many patients with PUB who were discharged before *** infection status was confirmed lost an opportunity to receive ET,we should confirm *** infection and start ET prior to discharge.

关键词： Helicobacter pylori Peptic ulcer hemorrhage Diseas

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Biliary drainage for obstructive jaundice caused by unresectable hepatocellular carcinoma: the endoscopic versus percutaneous approach

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Hepatobiliary & Pancreatic Diseases International 2012年第6期11卷 636-642页

作者： Jongkyoung Choi Ji Kon Ryu Sang Hyub Lee Dong-Won Ahn jin-hyeok hwang Yong-Tae Kim Yong Bum Yoon Joon Koo Han Department of Internal Medicine and Liver Research Institute Seoul National University College of Medicine Seoul Korea Department of Internal Medicine National Medical Center Seoul Korea Department of Internal Medicine Seoul National University Bundang Hospital Seongnam Gyeonggi-do Korea Department of Internal Medicine Seoul National University Boramae Medical Center Seoul Korea Department of Radiology Seoul National University College of Medicine Seoul Korea

BACKGROUND: For palliative treatment of the obstructive jaundice associated with unresectable hepatocellular carcinoma (HCC), percutaneous transhepatic biliary drainage (PTBD) or endoscopic retrograde biliary drainage (ERBD) has been performed. PTBD is preferred as an initial procedure. Little is known about the better option for patients with obstructive jaundice caused by unresectable HCC. METHODS: Sixty patients who had received ERBD or PTBD for the palliative treatment of obstructive jaundice caused by unresectable HCC between January 2006 and May 2010 were included in this retrospective study. Successful drainage, drainage patency, and the overall survival of patients were evaluated. RESULTS: Univariate analysis revealed that the overall frequency of successful drainage was higher in the ERBD group (22/29, 75.9%) than in the PTBD group (15/31, 48.4%) (P=0.029); but multivariate analysis showed marginal significance (P=0.057). The duration of drainage patency was longer in the ERBD group than in the PTBD group (82 vs 37 days, respectively, P=0.020). Regardless of what procedure was performed, the median survival time of patients who had a successful drainage was much longer than that of the patients who did not have a successful drainage (143 vs 38 days, respectively, P<0.001).CONCLUSION: Besides PTBD, ERBD may be used as the initial treatment option to improve obstructive jaundice in patients with unresectable HCC if there is a longer duration of drainage patency after a successful drainage.

关键词： hepatocellular carcinoma obstructive jaundice endoscopic retrograde biliary drainage percutaneous transhepatic biliary drainage

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Non-surgical treatment of post-surgical bile duct injury: Clinical implications and outcomes

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World Journal of Gastroenterology 2014年第22期20卷 6924-6931页

作者： Young Ook Eum Joo Kyung Park Jaeyoung Chun Sang-Hyub Lee Ji Kon Ryu Yong-Tae Kim Yong-Bum Yoon Chang jin Yoon Ho-Seong Han jin-hyeok hwang Department of Internal medicine Cheongju St. Mary's HospitalChungcheongbuk-do 360-568South Korea Department of Internal Medicine Seoul National University Hospital Seoul National University College of Medicine Seoul 110-744South Korea Department of Internal Medicine Seoul National University College of Medicine Seoul National University Bundang Hospital Gyeonggi-do 463-707South Korea Department of Radiology Seoul National University Bundang HospitalGyeonggi-do 463-707South Korea Department of Surgery Seoul National University Bundang HospitalGyeonggi-do 463-707South Korea

AIM: To investigate the prognostic factors determining the success rate of non-surgical treatment in the management of post-operative bile duct injuries (BDIs).

关键词： Endoscopic retrograde cholangiography Percutaneous transhepatic cholangiography Percutaneous transhepatic biliary drainage Bile duct Biliary stricture.

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Preoperative biliary drainage in hilar cholangiocarcinoma: When and how?

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World Journal of Gastrointestinal Endoscopy 2014年第3期6卷 68-73页

作者： Woo Hyun Paik Nerenthran Loganathan jin-hyeok hwang Division of Gastroenterology Department of Internal Medicine University of Ulsan College of Medicine Asan Medical Center Department of Internal Medicine Seoul National University College of Medicine Seoul National University Bundang Hospital

Hilar cholangiocarcinoma is a tumor of the extrahepatic bile duct involving the left main hepatic duct, the right main hepatic duct, or their confluence. Biliary drainage in hilar cholangiocarcinoma is sometimes clinically challenging because of complexities associated with the level of biliary obstruction. This may result in some adverse events, especially acute cholangitis. Hence the decision on the indication and methods of biliary drainage in patients with hilar cholangiocarcinoma should be carefully evaluated. This review focuses on the optimal method and duration of preoperative biliary drainage(PBD) in resectable hilar cholangiocarcinoma. Under certain special indications such as right lobectomy for Bismuth type ⅢA or Ⅳ hilar cholangiocarcinoma, or preoperative portal vein embolization with chemoradiation therapy, PBD should be strongly recommended. Generally, selective biliary drainage is enough before surgery, however, in the cases of development of cholangitis after unilateral drainage or slow resolving hyperbilirubinemia, total biliary drainage may be considered. Although the optimal preoperative bilirubin level is still a matter of debate, the shortest possible duration of PBD is recommended. Endoscopic nasobiliary drainage seems to be the most appropriate method of PBD in terms of minimizing the risks of tract seeding and inflammatory reactions.

关键词： Klatskin’s tumor Management Jaundice Endoscopic biliary drainage Percutaneous biliary drainage Preoperative biliary drainage

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Pre-operative factors that can predict neoplastic polypoid lesions of the gallbladder

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World Journal of Gastroenterology 2011年第17期17卷 2216-2222页

作者： Byung Hyo Cha jin-hyeok hwang Sang Hyub Lee Jang Eon Kim Jai Young Cho Haeryoung Kim So Yeon Kim Department of Internal Medicine Cheju Halla General HospitalCheju-siCheju-do 690-766South Korea Departments of Internal Medicine Seoul National University College of Medicine Seoul National University Bundang Hospital Seongnam-siGeonggi-do 463-707South Korea Department of Surgery Seoul National University College of Medicine Department of Pathology Seoul National University College of Medicine Department of Radiology Seoul National University College of Medicine

AIM:To investigate the preoperative factors that can predict neoplastic polypoid lesions of the gallbladder(PLGs) as well as malignant ***:A retrospective analysis was conducted on the 210 consecutively enrolled patients who underwent cholecystectomy due to a PLG larger than 10 mm,as was determined by preoperative trans-abdominal ultrasonography or endoscopic *** ana-lyzed the medical,laboratory,radiologic data and the pathologic ***:In 210 cases,146 had non-neoplastic polyps(69.5%) and 64 cases were neoplastic polyps(30.5%).An older age(≥ 65 years),the presence of diabetes mellitus(DM) and the size of polyp(≥ 15 mm) were revealed to be independent predictive variables for neoplastic polyps with odd ratios(OR) of 2.27(P = 0.044),2.64(P = 0.021) and 4.94(P < 0.01),*** the neoplastic PLGs,an older age(≥ 65 years),the presence of DM and polyp size(≥ 15 mm) were associated with malignancy with ORs of 4.97(P = 0.005),6.13(P = 0.001) and 20.55(P < 0.001),***:Among patients with PLGs larger than 10 mm in size,higher risk groups such as elderly patients more than 65 years old,those with DM or a large polyp size(≥ 15 mm) should be managed by cholecystectomy.

关键词： Gallbladder Polyp Neoplastic Cholecystectomy Diabetes Pre-operative factors

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Histologic characteristics of gastric polyps in Korea: Emphasis on discrepancy between endoscopic forceps biopsy and endoscopic mucosal resection specimen

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World Journal of Gastroenterology 2006年第25期12卷 4029-4032页

作者： Won Jae Yoon Dong Ho Lee Yong jin Jung Ji Bong Jeong Ji Won Kim Byeong Gwan Kim Kook Lae Lee Kwang Hyuck Lee Young Soo Park jin-hyeok hwang jin-Wook Kim Nayoung Kim Jun Kyu Lee Hyun Chae Jung Yong Bum Yoon In Sung Song Department of Internal Medicine Seoul National University College of Medicine SeoulKorea

AIM： To investigate histological characteristics of gastric polyps in the Korean population. METHODS： We reviewed endoscopic photographs and medical records of patients with gastric polyps who underwent endoscopic mucosal resection from April 1996 through February 2003. RESULTS： A total of 85 gastric polyps from 74 patients were reviewed, Male-to-female ratio was 1：1,96, Mean age was 59.9 =1：10,8 years. Multiple polyps were observed in 10,8%, Gastric polyps occurred most frequently in the antrum （58.8%）, Pathological results on resected specimens were as follows： tubular adenoma 45.9%, hyperplastic polyp 31.8%, inflammatory polyp 9.4%, hamartoma 3.5%, fundic gland polyp 2.4%, tubulovillous adenoma 2.4%, adenocarcinoma 2.4%, dysplasia 1.1%, and mucosal pseudolipomatosis 1.1%. Discrepancy rate between endoscopic biopsy and pathology of resected specimens was 27.1%. There was no relationship between the size of the polyp and concordance rate. CONCLUSION： There is considerable discrepancy in histologic findings between endoscopic forceps biopsy and resected specimens. Approaches to review of the histology of an entire polyp should be performed, especially when an adenoma is suspected.

关键词： Polyp Gastric Histology

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Apolipoprotein A-I binding protein-mediated neuroprotection in glaucomatous neuroinflammation and neurodegeneration

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Neural Regeneration Research 2025年第5期20卷 1414-1415页

作者： Sinwoo hwang Seunghwan Choi Soo-Ho Choi Keun-Young Kim Yury I.Miller Won-Kyu Ju Hamilton Glaucoma Center and Shiley Eye Institute The Viterbi Family Department of OphthalmologyUniversity of California San DiegoLa JollaCAUSA Department of Medicine University of California San DiegoLa JollaCAUSA National Center for Microscopy and Imaging Research Department of NeurosciencesUniversity of California San DiegoLa JollaCAUSA

Glaucoma is a multifactorial eye disorder that can cause vision loss and irreversible blindness,affecting individ uals aged 40 to 80 yea rs *** to the aging population,it is expected that the number of people affected by glaucoma will surpass 111 million by 2040 as the disease becomes more *** primarily contributes to optic nerve axon loss and the progressive degeneration of retinal ganglion cells (RGCs),subsequently leading to vision impairment.

关键词： irreversible pass primarily

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Aligned Ion Conduction Pathway of Polyrotaxane‑Based Electrolyte with Dispersed Hydrophobic Chains for Solid‑State Lithium–Oxygen Batteries

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Nano-Micro Letters 2025年第2期17卷 169-186页

作者： Bitgaram Kim Myeong‑Chang Sung Gwang‑Hee Lee Byoungjoon hwang Sojung Seo Ji‑Hun Seo Dong‑Wan Kim Department of Materials Science and Engineering Korea University145 Anam‑RoSeongbuk‑GuSeoul 02841Republic of Korea School of Civil Environmental and Architectural EngineeringKorea University145 Anam‑RoSeongbuk‑GuSeoul 02841Republic of Korea Materials Science and Chemical Engineering Center Institute for Advanced Engineering(IAE)Yongin 17180Republic of Korea

A critical challenge hindering the practical application of lithium–oxygen batteries(LOBs)is the inevitable problems associated with liquid electrolytes,such as evaporation and safety *** study addresses these problems by proposing a modified polyrotaxane(mPR)-based solid polymer electrolyte(SPE)design that simultaneously mitigates solvent-related problems and improves ***-SPE exhibits high ion conductivity(2.8×10^(−3)S cm^(−1)at 25℃)through aligned ion conduction pathways and provides electrode protection ability through hydrophobic chain *** this mPR-SPE into solid-state LOBs resulted in stable potentials over 300 *** situ Raman spectroscopy reveals the presence of an LiO_(2)intermediate alongside Li_(2)O_(2)during oxygen *** situ X-ray diffraction confirm the ability of the SPE to hinder the permeation of oxygen and moisture,as demonstrated by the air permeability *** present study suggests that maintaining a low residual solvent while achieving high ionic conductivity is crucial for restricting the sub-reactions of solid-state LOBs.

关键词： Solid polymer electrolyte Lithium-oxygen batteries Polyrotaxane ion conductivity Hydrophobic chain

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