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Lens culinaris agglutinin-reactive fraction of alpha-fetoprotein improves diagnostic accuracy for hepatocellular carcinoma

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World Journal of Gastroenterology 2021年第28期27卷 4687-4696页

作者： Han Ah Lee Yoo Ra Lee Young-Sun Lee Young Kul Jung Ji Hoon Kim Hyunggin An Hyung Joon Yim Yoon Tae Jeen jong eun yeon Kwan Soo Byun yeon Seok Seo Department of Internal Medicine Korea University College of MedicineSeoul 02841South Korea Department of Biostatistics Korea University Anam HospitalSeoul 02841South Korea

BACKGROUND Diagnostic accuracy of various tumor markers and their combinations for hepatocellular carcinoma(HCC)was not fully *** To evaluate the diagnostic accuracy of alpha-fetoprotein(AFP),the Lens culinaris agglutinin-reactive fraction of AFP(AFP-L3),and protein induced by vitamin K absence or antagonist-II(PIVKA-II)and their combination for HCC *** Patients with newly detected liver mass or elevated serum AFP levels were considered *** AFP level,AFP-L3 fraction,and PIVKA-II level were measured at the first *** In total,622 patients were included;355 patients(57.1%)had chronic liver disease,and 208(33.4%)had liver *** was diagnosed in 160 patients(25.7%).The area under the receiver operating characteristics curves(AUROCs)of the serum AFP,AFP-L3 fraction,AFP-L3,and PIVKA-II levels for the diagnosis of HCC were 0.775,0.792,0.814,and 0.834,respectively.A novel diagnostic model was developed by classifying patients in a 1:1 ratio into training and validation *** the binary regression analysis of the training cohort,the AFP,AFP-L3 fraction,and PIVKA-II(ALPs)score was calculated as follows:ALPs score=3.8×[serum AFP level(ng/mL)×AFP-L3 fraction(%)×0.01]+0.2×PIVKA-II level(mAU/mL).The AUROC of the ALPs score for diagnosis of HCC was 0.878,significantly higher than that of serum AFP level(P<0.001),AFP-L3 fraction(P<0.001),PIVKA-II level(P=0.036),and AFP-L3 level(P=0.006).The optimal ALPs score cut-off was 5.3(sensitivity,85.0%,specificity 80.1%).The validation cohort showed similar *** The ALPs score calculated using serum AFP level,AFP-L3 fraction,and PIVKA-II level showed improved accuracy in HCC diagnosis.

关键词： Alpha-fetoprotein Lens culinaris agglutinin-reactive fraction of alphafetoprotein Protein induced by vitamin K absence or antagonist-II Hepatocellular carcinoma

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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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Peroxisome proliferator-activated receptor-delta agonist ameliorated inflammasome activation in nonalcoholic fatty liver disease

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World Journal of Gastroenterology 2015年第45期21卷 12787-12799页

作者： Hyun Jung Lee jong eun yeon eun Jung Ko Eileen L Yoon Sang Jun Suh Keunhee Kang Hae Rim Kim Seoung Hee Kang Yang Jae Yoo Jihye Je Beom Jae Lee Ji Hoon Kim yeon Seok Seo Hyung Joon Yim Kwan Soo Byun Department of Internal Medicine Korea University College of Medicine

AIM: To evaluate the inflammasome activation and the effect of peroxisome proliferator-activated receptors(PPAR)-δ agonist treatment in nonalcoholic fatty liver disease(NAFLD) ***: Male C57BL/6J mice were classified according to control or high fat diet(HFD) with or without PPAR-δ agonist(GW) over period of 12 wk [control, HFD, HFD + lipopolysaccharide(LPS), HFD + LPS + GW group]. Hep G2 cells were exposed to palmitic acid(PA) and/or LPS in the absence or presence of ***: HFD caused glucose intolerance and hepatic steatosis. In mice fed an HFD with LPS, caspase-1 and interleukin(IL)-1β in the liver were significantly increased. Treatment with GW ameliorated the steatosis and inhibited overexpression of pro-inflammatory cytokines. In Hep G2 cells, PA and LPS treatment markedly increased m RNA of several nucleotide-binding andoligomerization domain-like receptor family members(NLRP3, NLRP6, and NLRP10), caspase-1 and IL-1β. PA and LPS also exaggerated reactive oxygen species production. All of the above effects of PA and LPS were reduced by GW. GW also enhanced the phosphorylation of AMPK-α.CONCLUSION: PPAR-δ agonist reduces fatty acidinduced inflammation and steatosis by suppressing inflammasome activation. Targeting the inflammasome by the PPAR-δ agonist may have therapeutic implication for NAFLD.

关键词： Nonalcoholic fatty liver disease Nonalcoholic stea

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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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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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Rapid re-emergence of YMDD mutation of hepatitis B virus with hepatic decompensation after lamivudine retreatment

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World Journal of Gastroenterology 2008年第27期14卷 4416-4419页

作者： So Young Kwon Won Hyeok Choe Chang Hong Lee jong eun yeon Kwan Soo Byun Department of Internal Medicine Konkuk University School of Medicine Department of Internal Medicine Korea University College of Medicine

Lamivudine has a high rate of antiviral resistance. Sequential treatment of anti-hepatitis B virus (HBV) is commonly used for lamivudine resistance. We report 4 cases of patients with rapid redetection of HBV mutants during the lamivudine retreatment. The four patients received lamivudine as an initial treatment of HBV and adefovir and lamivudine as a rescue therapy consecutively. HBV-DNA level, YMDD mutations and adefovir -resistant mutations (RFMP) were tested every 3 mo during the sequential treatment. All the patients showed YMDD mutations during the initial lamivudine therapy. After adefovir therapy for lamivudine resistance, they showed viral breakthrough. Adefovir was switched to lamivudine, however, it did not induce viral suppression at all, rather increased HBV-DNA with rapid reemergence of the YMDD mutations. All the patients had ALT flares, and hepatic decompensation occurred in two patients. After switching to adefovir combined with entecavir or lamivudine for a rescue therapy, the patients had reduction in HBV-DNA and ALT improvement. These cases demonstrated that lamivudine retreatment of patients with preexposed lamivudine resistance leads to rapid reemergence of YMDD mutation with significant viral rebounds and subsequent hepatic decompensation. Sequential administration of lamivudine in patients with a prior history of YMDD mutation should be abandoned.

关键词： Hepatitis B Lamivudine Adefovir dipivoxil Mutations

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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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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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Hepatolithiasis and intrahepatic cholangiocarcinoma: A review

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World Journal of Gastroenterology 2015年第48期21卷 13418-13431页

作者： Hyo Jung Kim Jae Seon Kim Moon Kyung Joo Beom Jae Lee Ji Hoon Kim jong eun yeon jong-Jae Park Kwan Soo Byun Young-Tae Bak Department of Internal Medicine Korea University college of MedicineGuro Hospital

Although the incidence of hepatolithiasis is decreasing as the pattern of gallstone disease changes in Asia, the prevalence of hepatolithiasis is persistently high, especially in Far Eastern countries. Hepatolithiasis is an established risk factor for cholangiocarcinoma(CCA), and chronic proliferative inflammation may be involved in biliary carcinogenesis and in inducing the upregulation of cell-proliferating factors. With the use of advanced imaging modalities, there has been much improvement in the management of hepatolithiasis and the diagnosis of hepatolithiasis-associated CCA(HLCCA). However, there are many problems in managing the strictures in hepatolithiasis and differentiating them from infiltrating types of CCA. Surgical resection is recommended in cases of single lobe hepatolithiasis with atrophy, uncontrolled stricture, symptom duration of more than 10 years, and long history of biliaryenteric anastomosis. Even after resection, patients should be followed with caution for development of HL-CCA, because HL-CCA is an independent prognostic factor for survival. It is not yet clear whether hepatic resection can reduce the occurrence of subsequent HL-CCA. Furthermore, there are no consistent findings regarding prediction of subsequent HL-CCA in patients with hepatolithiasis. In the management of hepatolithiasis, important factors are the reduction of recurrence of cholangitis and suspicion of unrecognized HL-CCA.

关键词： Cholangiocarcinoma Hepatolithiasis Intrahepatic Management

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How good is cola for dissolution of gastric phytobezoars?

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World Journal of Gastroenterology 2009年第18期15卷 2265-2269页

作者： Beom Jae Lee jong-Jae Park Hoon Jai Chun Ji Hoon Kim jong eun yeon Yoon Tae Jeen Jae Seon Kim Kwan Soo Byun Sang Woo Lee Jae Hyun Choi Chang Duck Kim Ho Sang Ryu Young-Tae Bak Division of Gastroenterology Department of Internal MedicineKorea University College of MedicineSeoul 152-703South Korea

AIM:To evaluate the efficacy of cola treatment for gastric phytobezoars,including ***:A total of 17 patients(range:48 to 78 years) with symptomatic gastric phytobezoars treated with cola and adjuvant endoscopic therapy were *** liters of cola lavage(10 cases) or drink(7 cases) were initially used,and then endoscopic fragmentation was done for the remnant bezoars by using a lithotripsy basket or a polypectomy *** overall success of dissolving a gastric phytobezoars with using three liters of cola and the clinical and endoscopic findings were compared retrospectively between four cases of complete dissolution by using only cola and 13 cases of partial dissolution with ***:After 3 L of cola lavage or drinking,a complete dissolution of bezoars was achieved in four patients(23.5%),while 13 cases(76.5%) were only partially ***(4 of 6 cases) were observed more frequently than diospyrobezoars(0 of 11) in the group that underwent complete dissolution(P = 0.006).Gender,symptom duration,size of bezoar and method of cola administration were not significantly different between the two *** of 13 patients with residual bezoars were completely treated with a combination of cola and endoscopic ***:The rate of complete dissolution with three liters of cola was 23.5%,but no case of diospyrobezoar was completely dissolved using this ***,pretreatment with cola may be helpful and facilitate endoscopic fragmentation of gastric phytobezoars.

关键词： Gastric phytobezoars Diospyrobezoars Cola Dissolution Clinical efficacy

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