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Rapidly growing primary anal canal lymphoma:a case report and literature review

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Gastroenterology Report 2023年第1期11卷 582-584页

作者： Yu Kyung Chung su bum park Department of Internal Medicine Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and TechnologyPusan National University Yangsan HospitalYangsanRepublic of Korea

Introduction Anal cancer is a rare cancer accounting for2%of all gastrointestinal tract malignancies[1].Among anal cancers,squamous cell cancer(SCC)is the most common and lymphoma is one of the least *** gastrointestinal tract is the most common site for extranodal non-Hodgkin’s lymphoma(NHL),and diffuse large B-cell lymphoma(DLBCL)is the most common histologic ***,primary colorectal lymphoma accounts for only 0.3%of all large intestinal malignancies and3%of all gastrointestinal lymphomas[2].Anal canal SCC and lymphomas are treated differently;thus,accurate diagnosis is crucial.

关键词： lymphoma gastrointestinal diagnosis

Advantage of endoscopic mucosal resection with a cap for rectal neuroendocrine tumors

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World Journal of Gastroenterology 2015年第31期21卷 9387-9393页

作者： su bum park Hyung Wook Kim Dae Hwan Kang Cheol Woong Choi su Jin Kim Hyeong Seok Nam Department of Internal Medicine Pusan National University School of Medicine Research institute for Convergence of Biomedical Science and Technology Pusan National University Yangsan Hospital

AIM: To compare the outcomes of endoscopic mucosal resection with a cap(EMR-C) with those of endoscopic submucosal dissection(ESD) for the resection of rectal neuroendocrine ***: One hundred and sixteen lesions in 114 patients with rectal neuroendocrine tumor(NET) resected with EMR-C or ESD were included in the study. This study was performed at Pusan National University Yangsan Hospital between July 2009 and August 2014. We analyzed endoscopic complete resection rate,pathologic complete resection rate,procedure time,and adverse events in the EMR-C(n = 65) and ESD(n = 51) groups. We also performed a subgroup analysis by tumor ***: Mean tumor size was 4.62 ± 1.66 mm in the EMR-C group and 7.73 ± 3.14 mm in the ESD group(P < 0.001). Endoscopic complete resection rate was 100% in both groups. Histologic complete resection rate was significantly greater in the EMR-C group(92.3%) than in the ESD group(78.4%)(P = 0.042). Mean procedure time was significantly longer in the ESD group(14.43 ± 7.26 min) than in the EMR-C group(3.83 ± 1.17 min)(P < 0.001). Rates of histologic complete resection without complication were similar for tumor diameter ≤ 5 mm(EMR-C,96%; ESD,100%,P = 0.472) as well as in cases of 5 mm < tumor diameter ≤ 10 mm(EMR-C,80%; ESD,71.0%,P = 0.524).CONCLUSION: EMR-C may be simple,faster,and more effective than ESD in removing rectal NETs and may be preferable for resection of small rectal NETs.

关键词： Neuroendocrine tumor Endoscopic mucosal resection

Efficacy and safety of limited endoscopic sphincterotomy before self-expandable metal stent insertion for malignant biliary obstruction

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World Journal of Gastroenterology 2017年第9期23卷 1627-1636页

作者： Hyeong Seok Nam Dae Hwan Kang Hyung Wook Kim Cheol Woong Choi su bum park su Jin Kim Dae Gon Ryu Department of Internal Medicine Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and TechnologyPusan National University Yangsan HospitalYangsan-siGyeongsangnam-do 50612South Korea

To evaluate the safety and efficacy of limited endoscopic sphincterotomy (ES) before placement of self-expandable metal stent (SEMS).METHODSThis was a retrospective analysis of 244 consecutive patients with unresectable malignant biliary obstruction, who underwent placement of SEMSs following limited ES from December 2008 to February 2015. The diagnosis of malignant biliary obstruction and assessment of patient eligibility for the study was established by a combination of clinical findings, laboratory investigations, imaging and pathological results. All patients were monitored in the hospital for at least 24 h following endoscopic retrograde cholangio pancreatography (ERCP). The incidence of immediate or early post-ERCP complications such as post-ERCP pancreatitis (PEP) and bleeding related to limited ES were considered as primary outcomes. Also, characteristics and complications according to the cancer type were *** the 244 patients included, the underlying diagnosis was cholangiocarcinoma in 118 patients, pancreatic cancer in 79, and non-pancreatic or non-biliary malignancies in the remaining 47 patients. Early post-ERCP complications occurred in 9 patients (3.7%), with PEP in 7 patients (2.9%; mild, 6; moderate, 1) and mild bleeding in 2 patients (0.8%). There was no significant association between the incidence of post-ERCP complications and the type of malignancy (cholangiocarcinoma vs pancreatic cancer vs others, P = 0.696) or the type of SEMS used (uncovered vs covered, P = 1.000). Patients who had more than one SEMS placed at the first instance were at a significantly higher risk of post-ERCP complications (one SEMS vs two SEMS, P = 0.031). No other factors were predictive of post-ERCP *** ES is feasible and safe, and effectively facilitates the placement of SEMS, without any significant risk of PEP or severe bleeding.

关键词： Endoscopic sphincterotomy Endoscopic retrograde cholangio pancreatography Complications Pancreatitis Bleeding Cholestasis Self-expandable metal stent

Is endoscopic ultrasonography essential for endoscopic resection of small rectal neuroendocrine tumors?

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World Journal of Gastroenterology 2017年第11期23卷 2037-2043页

作者： su bum park Dong Jun Kim Hyung Wook Kim Cheol Woong Choi Dae Hwan Kang su Jin Kim Hyeong Seok Nam Department of Internal Medicine Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and TechnologyPusan National University Yangsan HospitalYangsanGyeongsangnam-do 626-770South Korea

AIM To evaluate the importance of endoscopic ultrasonography(EUS) for small(≤ 10 mm) rectal neuroendocrine tumor(NET) *** Patients in whom rectal NETs were diagnosed by endoscopic resection(ER) at the Pusan National University Yangsan Hospital between 2008 and 2014 were included in this study. A total of 120 small rectal NETs in 118 patients were included in this study. Histologic features and clinical outcomes were analyzed, and the findings of endoscopy, EUS and histology were compared. REsuLTS The size measured by endoscopy was not significantly different from that measured by EUS and histology(r = 0.914 and r = 0.727 respectively). Accuracy for the depth of invasion was 92.5% with EUS. No patients showed invasion of the muscularis propria or metastasis to the regional lymph nodes. All rectal NETswere classified as grade 1 and demonstrated an L-cell phenotype. Mean follow-up duration was 407.54 ± 374.16 d. No patients had local or distant metastasis during the follow-up periods. CONCLUSION EUS is not essential for ER in the patient with small rectal NETs because of the prominent morphology and benign behavior.

关键词： Neuroendocrine tumor Small Rectal Endoscopic ultrasonography Histology Endoscopy

Assessment of disease activity by fecal immunochemical test in ulcerative colitis

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World Journal of Gastroenterology 2016年第48期22卷 10617-10624页

作者： Dae Gon Ryu Hyung Wook Kim su bum park Dae Hwan Kang Cheol Woong Choi su Jin Kim Hyeong Seok Nam Department of Internal Medicine Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology Pusan National University Yangsan Hospital

AIM To evaluate the efficacy of quantitative fecal immunochemical test(FIT) as biomarker of disease activity in ulcerative colitis(UC).METHODS Between February 2013 and November 2014, a total of 82 FIT results, obtained in conjunction with colonoscopies, were retrospectivelyevaluated for 63 patients with UC. The efficacy of FIT for evaluation of disease activity was compared to colonoscopic findings. Quantitative fecal blood with automated equipment examined from collected feces. Endoscopic disease severity were assessed using the Mayo endoscopic subscore(MES) classification. The extent of disease were classified by proctitis(E1), left sided colitis(E2), and extensive colitis(E3). Clinical activity were subgrouped by remission or *** All of 21 patients with MES 0 had negative FIT( 134.89 ng/m L. The sensitivity, specificity, positive predictive value(PPV), negative predictive value(NPV) and accuracy of negative FIT about mucosal healing were 73.33%, 81.82%, 91.49%, 51.43% and 73.17%, respectively. The sensitivity, specificity, PPV, NPV and accuracy of predictive value of positive FIT(cutoff value > 100 ng/mL) about active disease status were 45.45%, 93.33%, 71.43%, 82.35%and 26.83%, respectively. Among patients with clinical remission, FIT was negative in 31(81.6%) of 38 cases, with a mean fecal hemoglobin concentration of 6.12 ng/mL(range, negative to 80.9 ng/mL) for this group of patients. Among patients with clinical active disease, FIT was negative in 16(36.4%) out of 44 cases, with a mean fecal hemoglobin concentration > 167.4 ng/mL for this group of patients. FIT was positively correlated with endoscopic activity(r = 0.626, P < 0.01) and clinical activity(r = 0.496, P < 0.01). But, FIT did not correlate with the extent of disease(r =-0.047, P = 0.676)CONCLUSION Quantitative FIT can be a non-invasive and effective biomarker for evaluation of clinical and endoscopic activity in UC, but not

关键词： Ulcerative colitis Fecal immunochemical test Mayo endoscopic subscore Biomarker Disease activity

Sphincterotomy by triple lumen needle knife using guide wire in patients with Billroth Ⅱ gastrectomy

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World Journal of Gastroenterology 2013年第48期19卷 9405-9409页

作者： su bum park Hyung Wook Kim Dae Hwan Kang Cheol Woong Choi Ki Tae Yoon Mong Cho Byeong Jun Song Department of Internal Medicine Pusan National University School of Medicine Research Institute for Convergence of Biomedical Science and Technology Pusan National University Yangsan Hospital Yangsan-si Gyeongsangnam-do 626-770South Korea

AIM:To investigate the usefulness of a guide wire and triple lumen needle knife for removing stones in BillrothⅡ(B-Ⅱ)gastrectomy ***:Endoscopic sphincterotomy in patients with B-Ⅱgastrectomy is *** used a new guide wire technique involving sphincterotomy by triple lumen needle knife through a forward-viewing *** technique was performed in nine patients between August 2010 and June *** as described above was *** sphincterotomy,successful stone removal,and complications were investigated ***:Sphincterotomy by triple lumen needle knife using guide wire was successful in all nine *** started towards the 4-5 o’clock direction and continued to the upper margin of the papillary *** stone removal in one session was achieved in all *** were no procedure related complications,such as bleeding,pancreatitis,or ***:In patients with B-Ⅱgastrectomy,guide wire using sphincterotomy by triple lumen needle knife through a forward-viewing endoscopy seems to be an effective and safe procedure for the removal of common bile duct stones.

关键词： Billroth Ⅱ gastrectomy Endoscopic sphincterotomy Forward-viewing endoscopy Guide wire Triple lumen needle knife

Efficacy of cap-assisted colonoscopy according to lesion location and endoscopist training level

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World Journal of Gastroenterology 2015年第20期21卷 6261-6270页

作者： Dong Jun Kim Hyung Wook Kim su bum park Dae Hwan Kang Cheol Woong Choi Joung Boom Hong Byoung Hoon Ji Chang Seok Lee Department of Internal Medicine Medical Research InstitutePusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology Pusan National University Yangsan Hospital Department of Internal Medicine Dong-eui Medical Center Department of Internal Medicine Bongseng Memorial Hospital

AIM: To evaluate the efficacy of cap-assisted colonoscopy(CAC) for detection of colorectal polyps and adenomas according to the lesion location and endoscopist training ***: Patients 20 years or older, who underwent their first screening colonoscopy in a single tertiary center from May 2011 to December 2012 were enrolled in this study. All patients underwent either CAC or standard colonoscopy(SC), and all of the procedures were performed by 11 endoscopists(8 trainees and 3 experts). All procedures were performed with highdefinition colonoscopes and narrow band imaging. The eight trainees had experiences of performing 150 to 500 colonoscopies, and the three experts had experiences of performing more than 3000 colonoscopies. A 4-mmlong transparent cap was attached to the end of a colonoscope in the CAC group. We retrospectively evaluated the number of polyps and adenomas, polyp detection rate(PDR), and the number of adenomas and adenoma detection rate(ADR) according to the lesion location and endoscopist training level between CAC and SC. We also evaluated the number of polyps and adenomas according to their size between CAC and ***: Overall, PDR and ADR using CAC were significantly higher than those using SC for both whole colon(48.5% vs 40.7%, P = 0.012; 35.7% vs 28.3%, P = 0.012) and right-side colon(35.3% vs 26.6%, P = 0.002; 27.0% vs 16.9%, P < 0.001). The number of polyps and adenomas per patient using CAC was significantly higher than that using SC for both the whole colon(1.07 ± 1.59 vs 0.82 ± 1.31, P = 0.008; 0.72 ± 1.32 vs 0.50 ± 1.01, P = 0.003) and right-side colon(0.66 ± 1.18 vs 0.41 ± 0.83, P < 0.001; 0.46 ± 0.97 vs 0.25 ± 0.67, P < 0.001). In the trainee group, the PDR and ADR using CAC were significantly higher than those using SC for both the whole colon(46.7% vs 39.7%, P = 0.040; 33.9% vs 26.0%, P =0.012) and right-side colon(34.2% vs 26.5%, P = 0.015; 25.3% vs 15.9%, P = 0.001). In the expert group, the PDR and ADR using CAC were si

关键词： Colonoscopy Cap-assisted colonoscopy Colonic polyps Adenoma Colorectal neoplasm

Somatostatin adjunctive therapy for non-variceal upper gastrointestinal rebleeding after endoscopic therapy

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World Journal of Gastroenterology 2011年第29期17卷 3441-3447页

作者： Cheol Woong Choi Dae Hwan Kang Hyung Wook Kim su bum park Kee Tae park Gwang Ha Kim Geun Am Song Mong Cho Department of Internal Medicine Pusan National University School of Medicine and Medical Research InstituteYangsan-siGyeongsangnam-do 626-770South Korea

AIM:To evaluate the effect of pantoprazole with a somatostatin adjunct in patients with acute non-variceal upper gastrointestinal bleeding(NVUGIB).METHODS:We performed a retrospective analysis of a prospective database in a tertiary care university *** October 2006 to October 2008,we enrolled 101 patients with NVUGIB that had a high-risk stigma on *** 24 h of hospital admission,all patients underwent endoscopic *** successful endoscopic hemostasis,all patients received an 80-mg bolus of pantoprazole followed by continuous intravenous infusion(8 mg/h for 72 h).The somatostatin adjunct group(n=49)also received a 250-μg bolus of somatostatin,followed by continuous infusion (250μg/h for 72 h).Early rebleeding rates,disappearance of endoscopic stigma and risk factors associated with early rebleeding were ***:Early rebleeding rates were not significantly different between treatment groups(12.2%vs 14.3%,P=0.766).Disappearance of endoscopic stigma on the second endoscopy was not significantly different between treatment groups(94.2%vs 95.9%,P=0.696).Multivariate analysis showed that the complete Rockall score was a significant risk factor for early rebleeding(P =0.044,OR:9.080,95%CI:1.062-77.595).CONCLUSION:The adjunctive use of somatostatin was not superior to pantoprazole monotherapy after successful endoscopic hemostasis in patients with NVUGIB.

关键词： Somatostatin Pantoprazole Gastrointestinal bleeding Rebleeding

Cross-Domain Bilateral Access Control on Blockchain-Cloud Based Data Trading System

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Computer Modeling in Engineering & Sciences 2024年第10期141卷 671-688页

作者： Youngho park su Jin Shin Sang Uk Shin Electronics and Information Communications Research Center Pukyong National UniversityBusan48513Republic of Korea Department of Information Security Graduate SchoolPukyong National UniversityBusan48513Republic of Korea Division of Computer Engineering Pukyong National UniversityBusan48513Republic of Korea

Data trading enables data owners and data requesters to sell and purchase *** the emergence of blockchain technology,research on blockchain-based data trading systems is receiving a lot of ***,to reduce the on-chain storage cost,a novel paradigm of blockchain and cloud fusion has been widely considered as a promising data trading ***,the fact that data can be used for commercial purposes will encourage users and organizations from various fields to participate in the data *** the data marketplace,it is a challenge how to trade the data securely outsourced to the external cloud in a way that restricts access to the data only to authorized users across multiple *** this paper,we propose a cross-domain bilateral access control protocol for blockchain-cloud based data trading *** consider a system model that consists of domain authorities,data senders,data receivers,a blockchain layer,and a cloud *** proposed protocol enables access control and source identification of the outsourced data by leveraging identity-based cryptographic *** the proposed protocol,the outsourced data of the sender is encrypted under the target receiver’s identity,and the cloud provider performs policy-match verification on the authorization tags of the sender and receiver generated by the identity-based signature ***,data trading can be achieved only if the identities of the data sender and receiver simultaneously meet the policies specified by each *** demonstrate efficiency,we evaluate the performance of the proposed protocol and compare it with existing studies.

关键词： Bilateral access control blockchain data sharing policy-match