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Survival outcome of patients with spontaneously ruptured hepatocellular carcinoma treated surgically or by transarterial embolization

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World Journal of Gastroenterology 2013年第28期19卷 4537-4544页

作者： Young-Joo Jin Jin-Woo Lee Seoung-Wook Park Jung Il Lee Don Haeng Lee Young Soo Kim Soon Gu Cho Yong Sun Jeon Kun Young Lee seung-ik ahn Department of Internal Medicine Inha University Hospital Inha University School of Medicine Incheon 400-711 South Korea Department of Internal Medicine Yonsei University College of Medicine Seoul 120-752 South Korea Department of Internal Medicine and Center for Advanced Medical Education by Brain Korea 21 Project Inha University School of Medicine and Utah-Inha DDS and Advanced Therapeutics Research Center Incheon 400-711 South Korea Department of Radiology Inha University Hospital Inha University School of Medicine Incheon 400-711 South Korea Department of Surgery Inha University Hospital Inha University School of Medicine Incheon 400-711 South Korea

AIM: To evaluate clinical outcomes of patients that underwent surgery, transarterial embolization (TAE), or supportive care for spontaneously ruptured hepatocellular carcinoma (HCC). METHODS: A consecutive 54 patients who diagnosed as spontaneously ruptured HCC at our institution between 2003 and 2012 were retrospectively enrolled. HCC was diagnosed based on the diagnostic guidelines issued by the 2005 American Association for the Study of Liver Diseases. HCC rupture was defined as disruption of the peritumoral liver capsule with enhanced fluid collection in the perihepatic area adjacent to the HCC by dynamic liver computed tomography, and when abdominal paracentesis showed an ascitic red blood cell count of > 50000 mm 3 /mL in bloody fluid. RESULTS: Of the 54 patients, 6 (11.1%) underwent surgery, 25 (46.3%) TAE, and 23 (42.6%) supportive care. The 2-, 4and 6-mo cumulative survival rates at 2, 4 and 6 mo were significantly higher in the surgery (60%, 60% and 60%) or TAE (36%, 20% and 20%) groups than in the supportive care group (8.7%, 0% and 0%), respectively (each, P < 0.01), and tended to be higher in the surgical group than in the TAE group. Multivariate analysis showed that serum bilirubin (HR = 1.09, P < 0.01), creatinine (HR = 1.46, P = 0.04), and vasopressor requirement (HR = 2.37, P = 0.02) were significantly associated with post-treatment mortality, whereas surgery (HR = 0.41, P < 0.01), and TAE (HR = 0.13, P = 0.01) were inversely associated with posttreatment mortality. CONCLUSION: Post-treatment survival after surgery or TAE was found to be better than after supportive care, and surgery tended to provide better survival benefit than TAE.

关键词： Ruptured hepatocellular carcinoma Surgery Transarterial embolization

Effect of preoperative biliary drainage on surgical results after pancreaticoduodenectomy in patients with distal common bile duct cancer:Focused on the rate of decrease in serum bilirubin

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World Journal of Gastroenterology 2008年第7期14卷 1102-1107页

作者： Yun Mee Choi Eung-Ho Cho Keon-Young Lee seung-ik ahn Sun Keun Choi Sei Joong Kim Yoon Seok Hur Young Up Cho Kee-Chun Hong Seok-Hwan Shin Kyung Rae Kim Ze-Hong Woo Department of Surgery College of MedicineInha UniversityIncheonKorea

AIM: To examine if the rate of decrease in serum bilirubin after preoperative biliary drainagecan be used as a predicting factor for surgical complications and postoperative recovery after pancreaticoduodenectomy in patients with distal common bile duct ***: A retrospective study was performed in 49 consecutive patients who underwent pancrea-ticoduodenectomy for distal common bile duct cancer. Potential risk factors were compared between the complicated and uncomplicated groups. Also, the rates of decrease in serum bilirubin were compared pre- and postoperatively. RESULTS: Preoperative biliary drainage (PBD) was performed in 40 patients (81.6%). Postoperative morbidity and mortality rates were 46.9% (23/49) and 6.1% (3/49), respectively. The presence or absence of PBD was not different between the complicated and uncomplicated groups. In patients with PBD, neither the absolute level nor the rate of decrease in serum bilirubin was significantly different. Patients with rapid decrease preoperatively showed faster decrease during the first postoperative week (5.5 ± 4.4 μmol/L vs -1.7 ± 9.9 μmol/L, P = 0.004).CONCLUSION: PBD does not affect the surgical outcome of pancreaticoduodenectomy in patients with distal common bile duct cancer. There is a certain group of patients with a compromised hepatic excretory function, which is represented by the slow rate of decrease in serum bilirubin after PBD.

关键词： Distal bile duct cancer Drainage Bilirubin Rate

Tc-99m ciprofloxacin imaging in acute cholecystitis

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World Journal of Gastroenterology 2007年第23期13卷 3249-3252页

作者： Yun-Mee Choe Wonsick Choe Keon-Young Lee seung-ik ahn Kwang Kim Young Up Cho Sun Keun Choi Yoon-Seok Hur Sei-Joong Kim Kee-Chun Hong Seok-Hwan Shin Kyung-Rae Kim Ze- Hong Woo Department of Surgery Inha University Hospital Incheon South Korea Department of Nuclear Medicine Gachon Medical School Incheon South Korea

AIM: To evaluate the eff icacy of a new nuclear imaging Infecton (Tc-99m ciprofloxacin) for the diagnosis of acute cholecystitis. METHODS: Sixteen patients thought to have acute cholecystitis were included in this study. The diagnosis of acute cholecystitis was made based on clinical symptoms and ultrasonographic and pathologic f indings. RESULTS: The 16 patients were composed of 12 acute and 4 chronic cholecystitis patients. Twelve patients with acute cholecystitis were image-positive, including one false-positive. Four patients with chronic cholecystitis were image-negative, of whom three were true-negative. This nuclear imaging had a sensitivity of 91.7%, a specificity of 75%, a positive-predictive value of 91.7%, and a negative-predictive value of 75%. CONCLUSION: Tc-99m ciprofloxacin imaging is easy to perform and applicable for the diagnosis of acute cholecystitis.

关键词： Acute cholecystitis Diagnosis Tc-99m ciprofloxacin nuclear imaging

Risk factors affecting pancreatic fistulas after pancreaticoduodenectomy

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World Journal of Gastroenterology 2008年第45期14卷 6970-6974页

作者： Yun-Mee Choe Keon-Young Lee Cheong-Ah Oh Joung-Bum Lee Sun Keun Choi Yoon-Seok Hur Sei-Joong Kim Young Up Cho seung-ik ahn Kee-Chun Hong Seok-Hwan Shin Kyung-Rae Kim Department of Surgery Inha University Hospital

AIM: To analyze the risk factors of pancreatic leakage after ***: We retrospectively reviewed 172 consecutive patients who had undergone pancreatico-duodenectomy at Inha University Hospital between April 1996 and March 2006. We analyzed the pancreatic fistula rate according to the clinical characteristics, the pathologic and laboratory findings, and the anastomotic ***: The incidence of developing pancreatic fistulas in patients older than 60 years of age was 21.7% (25/115), while the incidence was 8.8% (5/57) for younger patients; the difference was significant (P = 0.03). Patients with a dilated pancreatic duct had a lower rate of post-operative pancreatic fistulas than patients with a non-dilated duct (P = 0.001). Other factors, including clinical features, anastomotic methods, and pathologic diagnosis, did not show any statistical difference. CONCLUSION: Our study demonstrated that pancreatic fistulas are related to age and a dilated pancreatic duct. The surgeon must take these risk factors into consideration when performing a pancre-aticoduodenectomy.

关键词： Pancreaticoduodenectomy Pancreatic fistula Pancreatic leakage

Successful treatment of multiple hepatocellular adenomas with percutaneous radiofrequency ablation

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World Journal of Gastroenterology 2013年第42期19卷 7480-7486页

作者： Sun Young ahn Soo Young Park Young Oh Kweon Won Young Tak Han ik Bae seung Hyun Cho Department of Internal Medicine Kyungpook National University HospitalDaegu 700-721South Korea Department of Pathology Kyungpook National University HospitalDaegu 700-721South Korea Department of Radiology Kyungpook National University HospitalDaegu 700-721South Korea

Hepatocellular adenoma (HCA) is one of the important complications of glycogen storage disease type?Ia (GSD-Ia) because it can be transformed into hepatocellular carcinoma. Although surgical resection is a standard treatment of choice for solitary HCA, multiple HCAs in GSD-Ia patients present as therapeutic challenges for curative treatment. Therefore, treatment strategy according to malignant potential is important in management of HCAs in GSD-Ia. The authors present a case of histologically proven multiple HCAs without β-catenin mutations occurred in a GSD-Ia patient treated successfully with percutaneous radiofrequency ablation as a minimally invasive therapy.

关键词： Glycogen storage disease Hepatocellular adenoma Radiofrequency ablation β-catenin activation Glycogen storage disease

Randomized clinical trial of a bladder neck plication stitch during robot-assisted radical prostatectomy

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Asian Journal of Andrology 2015年第2期17卷 304-308,I0011页

作者： seung-Kwon Choi Sejun Park Hanjong ahn Department of Urology University of Ulsan College of Medicine Asan Medical Center Seoul Korea Department of Urology University of Ulsan College of Medicine Ulsan University Hospital Utsan Korea

Urinary incontinence after robot-assisted radical prostatectomy （RARP） is one of the most bothersome complications affecting patients＇ daily lives. The efficacy of the bladder neck plication stitch technique in promoting an earlier return of continence was prospectively evaluated in 158 patients who underwent RARP for clinically localized prostate cancer by a single surgeon at our institute from March 2012 to January 2013. Patients were randomized 1：1 to undergo surgery with （n = 79） or without （n = 79） the bladder neck plication stitch, and their time to recovery from incontinence, defined as being pad free, was compared. Recovery from incontinence at 1, 3, and 6 months were observed in 22 （27.8%）, 42 （53.2%）, and 57 （72.2%） patients, respectively, treated with, and 23 （29.1%）, 47 （59.5%）, and 59 （74.7%） patients, respectively, treated without the bladder neck plication stitch, with no significant difference in time to recovery from incontinence between the two groups. Multivariate analysis showed that age, membranous urethral length and shape of the prostatic apex on magnetic resonance imaging were independent predictors of early recovery from urinary incontinence after RARP. The bladder neck plication stitch had no effect on time to recovery from postoperative urinary incontinence following RARR

关键词： prostatectomy prostatic neoplasms urinary incontinence urologic surgical procedures

Transient elastography in chronic hepatitis B: An Asian perspective

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World Journal of Gastroenterology 2010年第41期16卷 5173-5180页

作者： seung Up Kim Kwang-Hyub Han Sang Hoon ahn Department of Internal Medicine Institute of Gastroenterology Yonsei University College of Medicine Seoul 120-752 South Korea Liver Cirrhosis Clinical Research Center Seoul 120-752 South Korea Brain Korea 21 Project for Medical Science Seoul 120-752 South Kore

Transient elastography (TE) is a new non-invasive tool for assessing liver stiffness, which is correlated with the histologic stage of liver fibrosis. Many studies have reported a good accuracy of TE in predicting signif icant fibrosis and an optimal accuracy in predicting cirrhosis. Furthermore, the potential role of TE in screening the general population has also been proven. TE thus helps physicians to decide treatment strategies, predict prog-nosis, and monitor disease progression in patients with chronic liver disease and to screen the general popula-tion to identify high risk patients with potential liver disease. However, most data on the clinical roles of TE have been gathered in European patients with chronic hepatitis C (CHC), because TE was first developed in France. Accordingly, much data on the usefulness of TE in patients with CHC has accumulated. Recently, however, vigorous efforts have been made to apply TEto patients with chronic hepatitis B (CHB), and TE has also proved to have acceptable accuracy in diagnosing liver fibrosis and cirrhosis in these patients. Thus, we focused on TE in the Asian population with CHB in comparison with the European population with CHC and found that the diagnostic performance and cutoff values were different between the 2 populations possibly as a result of several different confounders between Asian and European populations (the etiology of chronic liver disease, histologic features, major fluctuation in alanine aminotransferase levels, and the prevalence of high body mass index and metabolic syndrome). Therefore, further studies tailored to the Asian population with CHB should be performed before the widespread application of TE in Asian populations with CHB.

关键词： Asia Chronic hepatitis B Fibroscan Hepatitis B virus Liver stiffness measurement Transient elas-tography

Non-invasive prediction of forthcoming cirrhosis-related complications

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World Journal of Gastroenterology 2014年第10期20卷 2613-2623页

作者： Wonseok Kang seung Up Kim Sang Hoon ahn Department of Internal Medicine Institute of Gastroenterology Yonsei University College of Medicine Seoul 120-752 South Korea Liver Cirrhosis Clinical Research Center Seoul 120-752 South Korea

In patients with chronic liver diseases,identification of significant liver fibrosis and cirrhosis is essential for determining treatment strategies,assessing therapeutic response,and stratifying long-term *** liver biopsy remains the reference standard for evaluating the extent of liver fibrosis in patients with chronic liver diseases,several non-invasive methods have been developed as alternatives to liver *** of these non-invasive methods have demonstrated clinical accuracy for diagnosing significant fibrosis or cirrhosis in many cross-sectional studies with the histological fibrosis stage as a reference ***,non-invasive methods cannot be fully validated through cross-sectional studies since liver biopsy is not a perfect surrogate endpoint ***,recent studies have focused on assessing the performance of non-invasive methods through longterm,longitudinal,follow-up studies with solid clinical endpoints related to advanced stages of liver fibrosis and *** a result,current view is that these alternative methods can independently predict future cirrhosis-related complications,such as hepatic decompensation,liver failure,hepatocellular carcinoma,or liver-related *** clinical role of non-invasive models seems to be shifting from a simple tool for predicting the extent of fibrosis to a surveillance tool for predicting future liver-related *** this article,we will summarize recent longitudinal studies of non-invasive methods for predicting forthcoming complications related to liver cirrhosis and discuss the clinical value of currently available non-invasive methods based on evidence from the literature.

关键词： Non-invasive model Prediction Cirrhosis Complication Liver-related events

Nanoscale visualization of hot carrier generation and transfer at non-noble metal and oxide interface

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Journal of Materials Science & Technology 2022年第3期98卷 151-159页

作者： Ranveer Singh Qadeer Akbar Sial seung-ik Han Sanghee Nah Ji-Yong Park Hyungtak Seo Department of Materials Science and Engineering Ajou UniversitySuwon16499Republic of Korea Department of Energy Systems Research Ajou UniversitySuwon16499Republic of Korea Seoul Center Korea Basic Science InstituteSeoul02841Republic of Korea Department of Physics Ajou UniversitySuwon16499Republic of Korea

The conversion efficiency of energy-harvesting devices can be increased by utilizing hot-carriers(HCs).However,due to ultrafast carrier-carrier scattering and the lack of carrier injection dynamics,HC-based devices have low *** the present work,we report the effective utilization of HCs at the nanoscale and their transfer dynamics from a non-noble metal to a metal oxide interface by means of real-space photocurrent mapping by using local probe techniques and conducting femtosecond transient absorption(TA)*** photocurrent maps obtained under white light unambiguously show that the HCs are injected into the metal oxide layer from the TiN layer,as also confirmed by conductive atomic force *** addition,the increased photocurrent in the bilayer structure indicates the injection of HCs from both layers due to the broadband absorption efficiency of TiN layer,passivation of the surface states by the top TiN layer,and smaller barrier height of the ***,electrostatic force microscopy and Kelvin probe force microscopy provide direct evidence of charge injection from TiN to the MoO_(x)film at the *** TA absorption spectra show a strong photo-bleaching signal over wide spectral range and ultrafast decaying behavior at the picosecond time scale,which indicate efficient electron transfer from TiN to MoO_(x).Thus,our simple and effective approach can facilitate HC collection under white light,thereby achieving high conversion efficiency for optoelectronic devices.

关键词： Non-noble metal Hot carrier Real-space photocurrent mapping Local-probe force microscopy