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Is percutaneous endoscopic gastrostomy tube placement safe in patients with ventriculoperitoneal shunts?

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World Journal of Gastroenterology 2009年第25期15卷 3148-3152页

作者： Jin-Soo Kim Yong-Wan Park Hyung-Keun Kim young-Seok Cho Sung-Soo Kim Na-Ri youn Hiun-Suk Chae Division of Gastroenterology Department of Internal MedicineCollege of MedicineThe Catholic University of KoreaUijeongbu St. Mary's Hospital

AIM:To investigate whether percutaneous endoscopic gastrostomy (PEG) tube placement is safe in patients with ventriculoperitoneal (VP) ***: This was a retrospective study of all patients undergoing PEG insertion at our institution between June 1999 and June 2006. Post-PEG complications were compared between two groups according to the presence or absence of VP shunts. VP shunt infection rates, the interval between PEG placement and VP shunt catheter insertion, and long-term follow-up were also ***: Fifty-five patients qualified for the study. Seven patients (12.7%) had pre-existing VP shunts. All patients received prophylactic antibiotics. The complication rate did not differ between VP shunt patients undergoing PEG (PEG/VP group) and non-VP shunt patients undergoing PEG (control group) [1 (14.3%) vs 6 (12.5%), P=1.000]. All patients in the PEG/VP group had undergone VP shunt insertion prior to PEG placement. The mean interval between VP shunt insertion and PEG placement was 308.7 d (range, 65-831 d). The mean follow-up duration in the PEG/VP group was 6.4 mo (range, 1-15 mo). There were no VP shunt infections, although one patient in the PEG/VP group developed a minor peristomal infection during ***: Complications following PEG placement in patients with VP shunts were infrequent in this study.

关键词： Percutaneous endoscopic gastrostomy Ventriculoperitoneal shunt Complication Ventriculo- peritoneal shunt infection Prophylactic antibiotic

Tailored eradication vs empirical bismuth-containing quadruple therapy for first-line Helicobacter pylori eradication: A comparative,open trial

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World Journal of Gastroenterology 2019年第46期25卷 6743-6751页

作者： youn I Choi Jun Won Chung Dong Kyun Park Kyoung Oh Kim Kwang An Kwon Yoon Jae Kim Ja young Seo Department of Gastroenterology Gil Medical CenterGachon UniversityIncheon 21565South Korea Department of Laboratory Medicine Gil Medical CenterGachon UniversityIncheon 21565South Korea

BACKGROUND Few studies have compared the efficacy and safety profile of a tailored eradication(TR)strategy based on the presence of a 23S ribosomal RNA point mutation with those of empirical bismuth-based quadruple therapy(EBQT)for first-line eradication of Helicobacter pylori(***)in Korean *** To compare the efficacy and safety of a TR strategy and those of EBQT regimen as first-line eradication therapy for *** This is an open-label,comparative study in which we prospectively enrolled patients over 18 years of age with *** infection and retrospectively reviewed their ***-positive patients diagnosed by rapid urease test,Giemsa staining,or dual priming oligonucleotide polymerase chain reaction(DPO-PCR)were enrolled from May 2016 to September 2018 at Gil Medical *** with *** infection received either a TR regimen or the EBQT *** the tailored therapy group that underwent DPO-PCR testing,patients with A2142G and/or A2143G point mutations were treated with a bismuth-containing quadruple *** eradication rate,patient-reported side effect rate,and *** eradication success rate were evaluated and compared between the *** A total of 150 patients were assigned to the TR(n=50)or EBQT group(n=100).The first-line eradication rate of *** did not differ between the groups(96.0%vs 95.7%,P=0.9).The rate of eradication-related side effects for TR was 12.0%,which differed significantly from that of EBQT(43.0%)for first-line treatment(P<0.001).CONCLUSION DPO-PCR-based TR for *** eradication may be equally efficacious,with less treatment-related complications,compared to EBQT in Korea,where clarithromycin resistance is high.

关键词： Helicobacter pylori Eradication Tailored Empirical Quadruple

Impact of statin intensity on adverse cardiac and cerebrovascular events in older adult patients with myocardial infarction

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Journal of Geriatric Cardiology 2021年第8期18卷 609-622页

作者： In Tae Moon Si-Hyuck Kang Wonjae Lee youngjin Cho Jin Joo Park Yeonyee EYoon Il-young Oh Chang-Hwan Yoon Jung-Won Suh Tae-Jin youn In-Ho Chae Dong-Ju Choi young-Seok Cho Uijeongbu Eulji Medical Center Eulji University School of MedicineUijeongbuSouth Korea Seoul National University Bundang Hospital SeongnamSouth Korea Department of Cardiology Incheon Sejong HospitalIncheonSouth Korea

BACKGROUND There is insufficient evidence regarding the effect of high-intensity statin therapy in older *** study aimed to investigate the effects of high-intensity statin treatment on the clinical outcomes in older adults with myocardial infarc-tion(MI).METHODS Consecutive patients with MI aged at least 75 years were analyzed *** primary endpoint was major adverse cardiac and cerebrovascular events(MACCE),defined as a composite of all-cause death,MI,rehospitalization due to un-stable angina,repeat revascularization,and ischemic *** high-intensity group was compared to the low-to-moderate in-tensity group in the propensity score-matched *** Average age of total 546 patients was 81 *** them,84%of patients underwent percutaneous coronary *** unadjusted seven-year MACCE rate differed by statin intensity(high-intensity statin group:38%,moderate-intensity statin group:42%,low-intensity statin group:56%,and no-statin group:61%,P=0.004).However,among these groups,many baseline characteristics were significantly *** the 74 propensity score-matched pairs,which lacked any significant differences in all baseline characteristics,the high-intensity group had a significantly lower rate of MACCE than the low-to-moderate intensity group(37%vs.53%,P=0.047).Follow-up low-density lipoprotein cholesterol levels were significantly lower in the high-intensity group than that in the low-to-moderate intensity group(69.4±16.0 mg/dL vs.77.9±25.9 mg/dL,P=0.026).CONCLUSIONS In older adult patients with MI,the use of high-intensity statin caused significantly less occurrence of MACCE in comparison to that in low-to-moderate intensity for up to seven years of follow-up.

关键词： patients cardiac intensity

Prognostic value of decision criteria for emergency liver transplantation in patients with wild mushroom induced acute liver injury

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Hepatobiliary & Pancreatic Diseases International 2018年第3期17卷 210-213页

作者： youn-Jung Kim Hyung Joo Lee Seung Mok Ryoo Shin Ahn Chang Hwan Sohn Dong-Woo Seo Kyoung Soo Lim Won young Kim Department of Emergency Medicine University of Ulsan College of Medicine Asan Medical Center

Background： The reported mortality rate of mushroom-induced acute liver failure with conventionaltreatment is 1.4%–16.9%. Emergency liver transplantation may be indicated and can be the only curativetreatment option. This study aimed to assess the prognostic value of criteria for emergency livertransplantation in predicting 28-day mortality in patients with mushroom-induced acute liver ***： A retrospective cohort study was performed between January 2005 and December 2015. Alladult patients aged≥18 years admitted with mushroom intoxication at our emergency department wereevaluated. All patients with acute liver injury, defined as elevation of serum liver enzymes （〉5 timesthe upper limit of normal, ULN） or moderate coagulopathy （INR 〉 2.0） were included. The ability of the King’s College, Ganzert’s, and Escudié’s criteria to predict 28-day mortality was evaluated.

关键词： Liver failure Mushroom poisoning Liver transplantation Clinical decision making

Cardiac mucosa at the gastroesophageal junction:An Eastern perspective

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World Journal of Gastroenterology 2015年第30期21卷 9126-9133页

作者： Ahrong Kim Won-young Park Nari Shin Hyun Jung Lee young Keum Kim So Jeong Lee Cheong-Soo Hwang Do youn Park Gwang Ha Kim Bong Eun Lee Hong-Jae Jo Department of Pathology Bio Medical Research InstitutePusan National University Hospital Pusan National University School of Medicine Department of Internal Medicine Bio Medical Research InstitutePusan National University Hospital Department of Surgery Pusan National University Hospital

AIM:To investigate the nature and origin of cardiac mucosa(CM).METHODS:Biopsy samples from sixty-one individuals were included in this study. The specimens were taken "at","just below",or "just above" the gastroesophageal junction,including the histologic squamocolumnar junction. Clinical data were obtained by reviewing electronic medical records for each patient. Patients with a history of stomach adenoma or carcinoma and esophageal carcinoma were excluded,and cases that were endoscopically suspicious of Barrett's esophagus or a polyp were also ruled out. Histologic and endoscopic reviews were performed blinded to the patient's clinical data. Histologic evaluation wasconducted by two pathologists,and endoscopic review was performed by a endoscopist with wide experience in the field. Histologically,the columnar epithelium of squamocolumnar junction,presence and severity of acute and chronic inflammation,atrophy,intestinal metaplasia,and presence of carditis were evaluated. Endoscopically,reflux esophagitis was evaluated by Los Angeles(LA) classification,hiatal hernias were classified by Hill grade,and gastroesophageal flap valves were assessed. RESULTS:Fifty-nine of the 61(96.7%) patients were Korean; 65.6%(40/61) of the patients underwent endoscopy according to the schedule of the National Health Insurance Program as a screening inspection. Of these,only 20.0%(8/40) of cases had reflux s y m p t o m s. C M w a s p r e s e n t i n 4 1 / 6 1( 6 7. 2 %) individuals,and its presence was associated with older age compared to oxyntocardiac mucosa/oxyntic mucosa(60.59 ± 2.02 years vs 51.55 ± 3.35 years; P = 0.018). The presence of CM was associated with endoscopic diagnosis of esophagitis according to the LA classification(P = 0.022). CM was associated with mononuclear cell infiltration and neutrophilic infiltration,which were statistically significant(P = 0.001,and P = 0.004,respectively). The inflammation of CM,"carditis",showed a statistically significant association w

关键词： Cardiac mucosa Carditis Gastroesophagealjunction Gastroesophageal reflux disease Histopathology

Hepatocellular carcinoma,decompensation,and mortality based on hepatitis C treatment:A prospective cohort study

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World Journal of Gastroenterology 2022年第30期28卷 4182-4200页

作者： Gwang Hyeon Choi Eun Sun Jang young Seok Kim youn Jae Lee In Hee Kim Sung Bum Cho Han Chu Lee Jeong Won Jang Moran Ki Hwa young Choi Dahye Baik Sook-Hyang Jeong Department of Internal Medicine Seoul National University Bundang HospitalSeoul National University College of MedicineSeongnam 13620South Korea Department of Internal Medicine Soonchunhyang University Bucheon HospitalBucheon 14584South Korea Department of Internal Medicine Inje University Busan Paik HospitalBusan 47392South Korea Department of Internal Medicine Chonbuk National University HospitalJeonju 54907JeonbukSouth Korea Department of Internal Medicine Chonnam National University Hwasun HospitalHwasun 58128South Korea Department of Gastroenterology Asan Medical CenterUniversity of Ulsan College of MedicineSeoul 05505South Korea Department of Internal Medicine The Catholic University of KoreaSeoul 06591South Korea Cancer Control and Population Health Graduate School of Cancer Science and PolicyNational Cancer CenterGoyang 10408South Korea

BACKGROUND Prospective studies of the long-term outcomes of patients with hepatitis C virus(HCV)infection after treatment with interferon-based therapy(IBT)or directacting antivirals(DAA)are limited in many Asian *** To elucidate the incidences of hepatocellular carcinoma(HCC)and death/transplantation based on treatment with IBT or DAA,to compare the outcomes of the sustained virologic response(SVR)to IBT and DAA,and to investigate outcome-determining factors after *** This cohort included 2054 viremic patients(mean age,57 years;46.5%male;27.4%with cirrhosis)prospectively enrolled at seven hospitals between 2007 and *** were classified as the untreated group(n=619),IBT group(n=578),and DAA group(n=857).Outcomes included the incidences of HCC and death/*** incidences of the outcomes for each group according to treatment were calculated using an exact method based on the Poisson distribution.A multivariate Cox regression analysis was performed to determine the factors associated with HCC or death/transplantation,followed by propensity score matching to confirm the *** During a median of 4.1 years of follow-up,HCC and death/transplantation occurred in 113 and 206 patients,respectively,in the entire *** with the untreated group,the incidences of HCC and death/transplantation were significantly lower in the IBT group[adjusted hazard ratio(aHR)0.47,95%CI:0.28-0.80 and aHR 0.28,95%CI:0.18-0.43,respectively]and the DAA group(aHR 0.58,95%CI:0.35-0.96,and aHR 0.19,95%CI:0.20-0.68,respectively).Among 1268 patients who attained SVR with IBT(n=451)or DAA(n=816),the multivariable-adjusted analysis showed no differences in the risks of HCC(HR 2.03;95%CI:0.76-5.43)and death/transplantation(HR 1.38;95%CI:0.55-3.49)between the two *** was confirmed by a propensity score-matching *** factors for HCC after SVR were age,genotype 1,and the presence of *** Treatment and achieving SVR

关键词： Hepatitis C virus Direct-acting antiviral Sustained virologic response Hepatocellular carcinoma Mortality

Tailored eradication strategy vs concomitant therapy for Helicobacter pylori eradication treatment in Korean patients

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World Journal of Gastroenterology 2021年第31期27卷 5247-5258页

作者： youn I Choi Jun-Won Chung Kyoung Oh Kim Kwang An Kwon Yoon Jae Kim Jung Ho Kim Ja young Seo Dong Kyun Park Division of Internal Medicine Department of GastroenterologyGachon University College of MedicineGil Medical CenterInchoen 21565South Korea Department of Laboratory Medicine Gil Medical CenterGachon UniversityInchoen 21565South Korea Health IT Research Center Gachon University Gil HospitalIncheon 21565South Korea

BACKGROUND Antibiotic resistance to Helicobacter pylori(***)infection,which ultimately results in eradication failure,has been an emerging issue in the clinical ***,to overcome this problem,an antibiotic sensitivity-based tailored therapy(TT)for *** infection has received *** To investigate the efficacy and safety profiles of TT for *** infection treatment compared to a non-bismuth quadruple therapy,concomitant therapy(CT)*** We included patients(>18 years)with an *** infection and without a history of Helicobacter eradication who visited the Gil Medical Center between March 2016 and October *** being randomly assigned to either the TT or CT treatment group in 1 to 1 manner,patient compliance,eradication success rate(ESR),and patient-reported side effects profiles were assessed and compared between the two *** infection was diagnosed using a rapid urease test,Giemsa stain,or dual priming oligonucleotide polymerase chain reaction(DPO-PCR).Tailored eradication strategy based through the presence of a 23S ribosomal RNA point *** the TT group,a DPO-PCR test,which detected A2142G and/or A2143G point mutations,and a clarithromycin resistance test were *** in the clarithromycin-resistant group were treated with a bismuth-containing quadruple combination therapy,while those with sensitive results were treated with the standard triple *** Of the 217 patients with a treatment naive *** infection,110 patients[mean age:58.66±13.03,men,n=55(50%)]were treated with TT,and 107 patients[mean age:56.67±10.88,men,n=52(48.60%)]were treated with *** compliance(TT vs CT,100%vs 98.13%,P=0.30),and follow-up loss rates(8.18%vs 9.35%,P=0.95)were not significantly different between the *** ESR after treatment was also not statistically different between the groups(TT vs CT,82.73%vs 82.24%,P=0.95).However,the treatment-related and patient-reported side effects were signifi

关键词： Helicobacter pylori Eradication Tailored therapy Conco-mitant therapy regimen

Endoscopic and clinicopathologic characteristics of early gastric cancer with high microsatellite instability

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World Journal of Gastroenterology 2012年第27期18卷 3571-3577页

作者： Jaehoon Jahng young Hoon youn Kwang Hyun Kim Junghwan Yu Yong Chan Lee Woo Jin Hyung Sung Hoon Noh Hyunki Kim Hoguen Kim Hyojin Park Sang In Lee Department of Internal Medicine Gangnam Severance HospitalYonsei University College of MedicineSeoul 135-720South Korea Department of Internal Medicine Institute of GastroenterologyYonsei University College of MedicineSeoul 100-753South Korea Department of Surgery Yonsei University College of MedicineSeoul 100-753South Korea Department of Pathology Yonsei University College of MedicineSeoul 100-753South Korea

AIM： To investigate endoscopic and clinicopathologic characteristics of early gastric cancer （EGC） according to microsatellite instability phenotype. METHODS： Data were retrospectively collected from a single tertiary referral center. Of 981 EGC patients surgically treated between December 2003 and October 2007, 73 consecutive EGC patients with two or more microsatellite instability （MSI） mutation [high MSI （MSI-H）] and 146 consecutive EGC patients with one or no MSI mutation （non-MSI-H） were selected. The endoscopic and clinicopathologic features were compared between the MSI-H and non-MSI-H EGC ***： In terms of endoscopic characteristics, MSI-H EGCs more frequently presented with elevated pattern （OR 4.38, 95% Cl： 2.40-8.01, P 〈 0.001）, moderate- to-severe atrophy in the surrounding mucosa （OR 1.91, 95% CI： 1.05-3.47, P = 0.033）, antral location （OR 3.99, 95% CI： 2.12-7.52, P 〈 0.001） and synchronous le- sions, compared to non-MSI-H EGCs （OR 2.65, 95% CI： 1.16-6.07, P = 0.021）. Other significant clinicopatholog- ic characteristics of MSI-H EGC included predominance of female sex （OR 2.77, 95% CI： 1.53-4.99, P 〈 0.001）, older age （〉 70 years）（OR 3.30, 95% CI： 1.57-6.92, P = 0.002）, better histologic differentiation （OR 2.35, 95% Cl： 1.27-4.34, P = 0.007）, intestinal type by Lau- ren classification （OR 2.34, 95% CI： 1.15-4.76, P = 0.019）, absence of a signet ring cell component （OR 2.44, 95% CI： 1.02-5.86, P = 0.046）, presence of mu- cinous component （OR 5.06, 95% Cl： 1.27-20.17, P = 0.022）, moderate-to-severe lymphoid stromal reaction （OR 3.95, 95% CI： 1.59-9.80, P = 0.003）, and co-exist- ing underlying adenoma （OR 2.66, 95% CI： 1.43-4.95, P = 0.002）. CONCLUSION： MSI-H EGC is associated with unique endoscopic and clinicopathologic characteristics includ- ing frequent presentation in protruded type, co-exist- ing underlying adenoma, and synchronous lesions.

关键词： Microsatellite instability Early gastric can-cer Endoscopic characteristic Advanced gastric cancer

Endoscopic removal of gastric ectopic pancreas:An initial experience with endoscopic submucosal dissection

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World Journal of Gastroenterology 2010年第36期16卷 4589-4593页

作者： Dong Yup Ryu Gwang Ha Kim Do youn Park Bong Eun Lee Jae Hoon Cheong Dong Uk Kim Hyun young Woo Jeong Heo Geun Am Song Department of Internal Medicine Pusan National University School of Medicine and Medical Research InstitutePusan National University HospitalBusan 602-739South Korea Department of Pathology Pusan National University School of MedicineBusan 602-739South Korea

AIM:To evaluate the therapeutic usefulness and safety of endoscopic resection in patients with gastric ectopic ***:A total of eight patients with ectopic pancreas were *** of them underwent endoscopic ultrasonography before endoscopic ***-scopic resection was performed by two methods:endo-scopic mucosal resection(EMR)by the injection-and-cut technique or endoscopic mucosal dissection(ESD).RESULTS:We planned to perform EMR in all eight cases but EMR was successful in only four *** the other four cases,saline spread into surrounding normal tissues and the lesions becameattened,which made it impossible to remove them by *** four cases,we performed ESD and removed the lesions without any ***:If conventional EMR is difficult to remove gastric ectopic pancreas,ESD is a feasible alternative method for successful removal.

关键词： Ectopic pancreas Endoscopic resection Endoscopic ultrasonography