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Clinical characteristics of peptic ulcer perforation in Korea

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World Journal of Gastroenterology 2017年第14期23卷 2566-2574页

作者： Young Joo Yang Chang Seok Bang suk Pyo Shin tae Young Park ki tae suk Gwang Ho Baik Dong Joon kim Department of Internal Medicine Hallym University College of Medicine Chuncheon Sacred Heart Hospital

AIM To elucidate the epidemiological characteristics and associated risk factors of perforated peptic ulcer(PPU).METHODS We retrospectively reviewed medical records of patients who were diagnosed with benign PPU from 2010 through 2015 at 6 Hallym university-affiliated *** A total of 396 patients were identified with postoperative complication rate of 9.1% and mortality rate of 0.8%. Among 174(43.9%) patients who were examined for Helicobacter pylori(H. pylori) infection, 78(44.8%) patients were positive for H. pylori infection, 21(12.1%) were on non-steroidal anti-inflammatory drugs(NSAIDs) therapy, and 80(46%) patients were neither infected of H. pylori nor treated by any kinds of NSAIDs. Multivariate analysis indicated that older age(OR = 1.09, 95%CI: 1.04-1.16) and comorbidity(OR = 4.11, 95%CI: 1.03-16.48) were risk factors for NSAID-associated PPU compared with non-H. pylori, non-NSAID associated PPU and older age(OR = 1.04, 95%CI: 1.02-1.07) and alcohol consumption(OR = 2.08, 95%CI: 1.05-4.13) were risk factors for non-H. pylori, non-NSAID associated PPU compared with solely H. pylori positive *** Elderly patients with comorbidities are associated with NSAIDs-associated PPU. Non-H. pylori, non-NSAID peptic ulcer is important etiology of PPU and alcohol consumption is associated risk factor.

关键词： Helicobacter pylori Non-steroidal anti-inflammatory drugs Peptic ulcer perforation Stomach ulcer Duodenal ulcer

Alcoholic liver disease: Treatment

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World Journal of Gastroenterology 2014年第36期20卷 12934-12944页

作者： ki tae suk Moon Young kim Soon Koo Baik Department of Internal Medicine Hallym University College of Medicine Chuncheon 200-704 South Korea Department of Internal Medicine Wonju College of Medicine Wonju Severance Christian Hospital Yonsei University Wonju 220-701 South Korea

The excess consumption of alcohol is associated with alcoholic liver diseases(ALD). ALD is a major healthcare problem, personal and social burden, and significant reason for economic loss worldwide. The ALD spectrum includes alcoholic fatty liver, alcoholic hepatitis, cirrhosis, and the development of hepatocellular carcinoma. The diagnosis of ALD is based on a combination of clinical features, including a history of significant alcohol intake, evidence of liver disease, and laboratory findings. Abstinence is the most important treatment for ALD and the treatment plan varies according to the stage of the disease. Various treatments including abstinence, nutritional therapy, pharmacological therapy, psychotherapy, and surgery are currently available. For severe alcoholic hepatitis, corticosteroid or pentoxifylline are recommended based on the guidelines. In addition, new therapeutic targets are being under investigation.

关键词： Liver disease Alcoholic Treatment

Microbiota-based treatments in alcoholic liver disease

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World Journal of Gastroenterology 2016年第29期22卷 6673-6682页

作者： Hotaik Sung Seung Woo kim Meegun Hong ki tae suk Department of Molecular and Cell Physiology University of Cincinnati College of Medicine Department of Biomedical Science Hallym University College of Medicine Department of Internal Medicine Hallym University Chuncheon Sacred Heart Hospital Hallym University College of Medicine

Gut microbiota plays a key role in the pathogenesis of alcoholic liver disease(ALD). Consumption of alcohol leads to increased gut permeability, small intestinal bacterial overgrowth, and enteric dysbiosis. These factors contribute to the increased translocation of microbial products to the liver via the portal tract. Subsequently, bacterial endotoxins such as lipopolysaccharide, in association with the Toll-like receptor 4 signaling pathway, induce a gamut of damaging immune responses in the hepatic milieu. Because of the close association between deleterious inflammation and ALD-induced microbiota imbalance, therapeutic approaches that seek to reestablish gut homeostasis should be considered in the treatment of alcoholic patients. To this end, a number of preliminary studies on probiotics have confirmed their effectiveness in suppressing proinflammatory cytokines and improving liver function in the context of ALD. In addition, there have been few studies linking the administration of prebiotics and antibiotics with reduction of alcoholinduced liver damage. Because these preliminary results are promising, large-scale randomized studies are warranted to elucidate the impact of these microbiotabased treatments on the gut flora and associated immune responses, in addition to exploring questions about optimal delivery. Finally, fecal microbiota transplant has been shown to be an effective method of modulating gut microbiota and deserve further investigation as a potential therapeutic option for ALD.

关键词： Alcoholic liver disease Gut Microbiota Probiotics Treatment

Evidence from a familial case suggests maternal inheritance of primary biliary cholangitis

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World Journal of Gastroenterology 2017年第39期23卷 7191-7197页

作者： Saeam Shin In Ho Moh Young Sik Woo Sung Won Jung Jin Bae kim Ji Won Park ki tae suk Hyoung Su kim Mineui Hong Sang Hoon Park Myung Seok Lee Department of Laboratory Medicine Kangnam Sacred Heart Hospital Hallym University College of Medicine Division of Gastroenterology and Hepatology Department of Internal Medicine Kangnam Sacred Heart Hospital Hallym University College of Medicine Department of Pathology Kangnam Sacred Heart Hospital Hallym University College of Medicine

Primary biliary cholangitis(PBC) is an idiopathic autoimmune liver disease characterized by chronic cholestasis and destruction of the intrahepatic bile ducts. Similar to other autoimmune diseases, the pathogenesis of PBC is considered to be a complex etiologic phenomenon involving the interaction of genetic and environmental factors. Although a number of common variants associated with PBC have been reported from genome-wide association studies, a precise genetic mechanism underlying PBC has yet to be identified. Here, we describe a family with four sisters who were diagnosed with PBC. After the diagnosis of the index patient who was in an advanced stage of PBC, one sister presented with acute hepatitis, and two sisters were subsequently diagnosed with PBC. Notably, one half-sister with a different mother exhibited no evidence of PBC following clinical investigation. Our report suggests the possibility of a maternal inheritance of PBC susceptibility. Moreover, judging from the highpenetrance of the disease observed in this family, we inferred that a pathogenic genetic variant might be the cause of PBC development. We describe a family that exhibited diverse clinical presentations of PBC that included asymptomatic stages with mildly increased liver enzyme levels and symptomatic stages with acute hepatitis or advanced liver fibrosis. Additional studies are needed to investigate the role of genetic factors in the pathogenesis of this rare autoimmune disease.

关键词： Primary biliary cholangitis Family history Genetic susceptibility

Staging of liver fibrosis or cirrhosis: The role of hepatic venous pressure gradient measurement

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World Journal of Hepatology 2015年第3期7卷 607-615页

作者： ki tae suk Dong Joon kim Department of Internal Medicine Hallym University College of Medicine

Liver fibrosis is a common histological change of chronic liver injury and it is closely related with portalhypertension which is hemodynamic complication of chronic liver disease. Currently, liver fibrosis has been known as a reversible dynamic process in previous literatures. Although liver biopsy is a gold standard for assessing the stage of liver fibrosis, it may not completely represent the stage of liver fibrosis because of sampling error or semi-quantative measurement. Recent evidences suggested that histologic, clinical, hemodynamic, and biologic features are closely associated in patients with chronic liver disease. Hepatic venous pressure gradient(HVPG) measurement has been known as a modality to evaluate the portal pressure. The HVPG measurement has been used clinically for fibrosis diagnosis, risk stratification, preoperative screening for liver resection, monitoring the efficacy of medical treatments, and assessing the prognosis of liver fibrosis. Therefore, the HVPG measurement can be used to monitor areas the chronic liver disease but also other important areas of chronic liver disease.

关键词： Fibrosis Liver Venous pressure

Transarterial chemoembolization in Barcelona Clinic Liver Cancer Stage 0/A hepatocellular carcinoma

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World Journal of Gastroenterology 2014年第3期20卷 745-754页

作者： Heung Cheol kim ki tae suk Dong Joon kim Jai Hoon Yoon Yeon Soo kim Gwang Ho Baik Jin Bong kim Chang Hoon kim Hotaik Sung Jong Young Choi Kwang Hyub Han Seung Ha Park Department of Radiology Hallym University College of Medicine Department of Internal Medicine Hallym University College of Medicine College of Medicine Upstate Medical UniversityState University of New York Department of Biology Stanford University Department of Internal Medicine Catholic University College of Medicine Liver Cirrhosis Clinical Research Center Yonsei University College of Medicine Department of Internal Medicine Inje University College of Medicine

AIM: To evaluate the clinical characteristics of patients with Barcelona Clinic Liver Cancer (BCLC) stage 0 and A hepatocellular carcinoma (HCC) after transarterial chemoembolization (TACE).

关键词： Carcinoma Hepatocellular Chemoembolization Therapeutic Survival Stage Efficacy

Trends in the eradication rates of Helicobacter pylori infection for eleven years

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World Journal of Gastroenterology 2012年第45期18卷 6628-6634页

作者： Jai Hoon Yoon Gwang Ho Baik Kyoung Min Sohn Dae Yong kim Yeon Soo kim ki tae suk Jin Bong kim Dong Joon kim Jin Bae kim Woon Geon Shin Hak Yang kim Il Hyun Baik Hyun Joo Jang Department of Internal Medicine Hallym University College of MedicineChuncheon Sacred Heart Hospital153Gyo-dongChuncheonGangwon-do 200-704South Korea Department of Internal Medicine Hallym University College of MedicineKangnam Sacred Heart HospitalSeoul 150-950South Korea Department of Internal Medicine Hallym University College of MedicineKangdong Sacred Heart HospitalSeoul 134-814South Korea Department of Internal Medicine Hallym University College of MedicineHallym University Sacred Heart HospitalAnyang 431-070South Korea Department of Internal Medicine Hallym University College of MedicineHangang Sacred Heart HospitalSeoul 150-719South Korea

AIM:To evaluate the trends in the eradication rate of Helicobacter pylori(***) over the past 11 years in a single ***:This retrospective study covered the period from January 2000 to December *** evaluated 5746 patients diagnosed with gastric ulcers(GU),duodenal ulcers(DU),GU + DU,or nonpeptic ulcers associated with an *** *** treated them annually with the 2 wk standard first-line triple regimen,proton pump inhibitor(PPI) + amoxicilin + clarithromycin(PAC;PPI,clarithromycin 500 mg,and amoxicillin 1 g,all twice a day).The follow-up test was performed at least 4 wk after the completion of the 2 wk standard *** eradication using the PAC *** also assessed the eradication rates of 1 wk second-line therapy with a quadruple standard regimen(PPI b.i.d.,tripotassium dicitrate bismuthate 300 mg q.i.d.,metronidazole 500 mg t.i.d.,and tetracycline 500 mg q.i.d.) after the failure of the first-line *** analysis was performed with 95%CI for the differences in the annual eradication ***:A total of 5746 patients [2333 males(58.8%),1636 females(41.2%);mean age of males vs females 51.31 ± 13.1 years vs 52.76 ± 13.6 years,P < 0.05,total mean age 51.9 ± 13.3 years(mean ± SD)] were *** these patients,1674 patients were excluded:35 patients refused treatment;18 patients ceased *** eradication due to side effects;1211 patients had inappropriate indications for *** eradication,having undergone stomach cancer operation or chemotherapy;and 410 patients did not undergo the *** also excluded 103 patients who wanted to stop eradication treatment after only 1 wk due to poor compliance or the side effects mentioned ***,we evaluated the annual eradication success rates in a total of 3969 patients who received 2 wk first-line PAC *** endoscopic and clinical findings in patients who received the 2 wk PAC were as follows:gastric ulcer in 855(21.5%);duodenal ulcer in 878(22.1%);

关键词： Helicobacter pylori Eradication Protonpump inhibitor Therapy Clarithromycin

Efficacy of chemotherapy containing bevacizumab in patients with metastatic colorectal cancer according to programmed cell death ligand 1

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World Journal of Gastrointestinal Oncology 2024年第8期16卷 3521-3528页

作者： Shin Woo Kang Sung Hee Lim Min-Ji kim Jeeyun Lee Young suk Park Ho Yeong Lim Won ki Kang Seung tae kim Division of Hematology Oncology Department of MedicineSamsung Medical CenterSungkyunkwan University School of MedicineSeoul 06351South Korea Samsung Biomedical Research Institute Samsung Medical CenterSeoul 06351South Korea

BACKGROUND Bevacizumab,an anti-vascular endothelial growth factor(VEGF)monoclonal antibody,inhibits angiogenesis and reduces tumor *** VEGF-C,lactate dehydrogenase,and inflammatory markers have been reported as predictive markers related to bevacizumab *** cell death ligand 1(PD-L1)could act upon VEGF receptor 2 to induce cancer cell angiogenesis and *** To investigate the efficacy of bevacizumab-containing chemotherapy in patients with metastatic colorectal cancer(CRC)according to the expression of *** This analysis included CRC patients who received bevacizumab plus FOLFOX or FOLFIRI as first-line therapy between June 24,2014 and February 28,2022,at Samsung Medical Center(Seoul,South Korea).Analysis of patient data included evaluation of PD-L1 expression by the combined positive score(CPS).We analyzed the efficacy of bevacizumab according to PD-L1 expression status in patients with *** A total of 124 patients was included in this *** all patients were treated with bevacizumab plus FOLFIRI or FOLFOX as the first-line *** 77%of patients received FOLFOX,23%received FOLFIRI as backbone first-line *** numbers of patients with a PD-L1 CPS of 1 or more,5 or more,or 10 or more were 105(85%),64(52%),and 32(26%),*** results showed no significant difference in progression-free survival(PFS)and overall survival(OS)with bevacizumab treatment between patients with PDL1 CPS less than 1 and those with PD-L1 CPS of 1 or more(PD-L1<1%vs PD-L1≥1%;PFS:P=0.93,OS:P=0.33),between patients with PD-L1 CPS less than 5 and of 5 or more(PD-L1<5%vs PD-L1≥5%;PFS:P=0.409,OS:P=0.746),and between patients with PD-L1 CPS less than 10 and of 10 or more(PD-L1<10%vs PD-L1≥10%;PFS:P=0.529,OS:P=0.568).CONCLUSION Chemotherapy containing bevacizumab can be considered as first-line therapy in metastatic CRC irrespective of PD-L1 expression.

关键词： Bevacizumab Colorectal cancer Programmed cell death ligand 1 expression First-line chemotherapy Metastatic colorectal cancer

Deciphering metastatic route-specific signals and their microenvironment interactions in peritoneal metastasis of gastric cancer

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Cancer Communications 2024年第4期44卷 514-517页

作者： ki tae kim Jae Eun Lee Jae-Ho Cheong In Cho Yoon Young Choi Department of Molecular Genetics&Dental Pharmacology School of DentistrySeoul National UniversitySeoulRepublic of Korea Dental Research Institute and Dental Multi-omics Center Seoul National UniversitySeoulRepublic of Korea Portrai Inc. SeoulRepublic of Korea Department of Surgery Yonsei University Health SystemYonsei University College of MedicineSeoulRepublic of Korea Department of Surgery Soonchunhyang Bucheon HospitalSoonchunhyang University College of MedicineBucheonRepublic of Korea

Gastric cancer(GC)is a pervasive global malignancy with high mortality rates due to distant metastasis[1].GC metastasis can occur via hematogenous route,peri-toneal route,and specifically through ovarian spread in females[2].Among these,peritoneal metastasis is the most prevalent and challenging condition to treat[3].The Cancer Genome Atlas(TCGA)has uncovered four molec-ular subtypes of GC:microsatellite instability,Epstein-Barr virus-related,chromosomal instability,and genomically stable[4].

关键词： metastasis peritoneal cancer