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Endoscopic submucosal dissection of a large colonic lipoma:Report of two cases

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World Journal of Gastroenterology 2015年第10期21卷 3127-3131页

作者： jae min lee Jeong Ho Kim Myungsung Kim Jun Hyoung Kim Young Bae lee jae Hyuk lee Che Wan Lim Department of Internal Medicine Myongji Hospital

A colonic lipoma is a very rare benign tumor that is usually asymptomatic and is found incidentally by *** with a large colonic lipoma may present with symptoms such as abdominal pain,bleeding,and colonic obstruction or *** report two patients with large colonic lipomas and *** endoscopic submucosal dissection(ESD) was performed to remove the lipomas instead of conventional surgical bowel *** complications were observed during or after the *** tumors were resected en bloc,and the patients were discharged 2 d after ESD with a regular *** results indicate that ESD can be applied as safe and effective treatment for a large colonic lipoma.

关键词： Colon lipoma Endoscopic submucosal dissection

Clinical outcomes of endoscopic papillectomy of ampullary adenoma: A multi-center study

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World Journal of Gastroenterology 2022年第17期28卷 1845-1859页

作者： Seong Ji Choi Hong Sik lee Jiyeong Kim Jung Wan Choe jae min lee Jong Jin Hyun Jai Hoon Yoon Hyo Jung Kim jae Seon Kim Ho Soon Choi Department of Internal Medicine Hanyang University College of MedicineSeoul 04763South Korea Division of Gastroenterology and Hepatology Department of Internal MedicineKorea University College of MedicineSeoul 02841South Korea Lab of Biostatistical Consulting and Research Medical Research Collaborating CenterIndustry-University Cooperation FoundationHanyang UniversitySeoul 04763South Korea

BACKGROUND Ampullary adenoma is a rare premalignant lesion,but its incidence is *** papillectomy has become the first treatment of choice for ampullary adenomas due to its safety and effectiveness,thereby replacing surgical ***,recurrence rates and adverse events after endoscopic papillectomy were reported in up to 30%of *** To review the long-term outcomes of endoscopic papillectomy and investigate the factors that affect these *** We retrospectively analyzed the data of patients who underwent endoscopic papillectomy for ampullary adenoma at five tertiary hospitals between 2013 and *** evaluated clinical outcomes and their risk *** definitions of outcomes were as follow:(1)curative resection:complete endoscopic resection without recurrence;(2)endoscopic success:treatment of ampullary adenoma with endoscopy without surgical intervention;(3)early recurrence:reconfirmed adenoma at the first endoscopic surveillance;and(4)late recurrence:reconfirmed adenoma after the first endoscopic *** A total of 106 patients were included for *** the included patients,81(76.4%)underwent curative resection,99(93.4%)had endoscopic success,showing that most patients with noncurative resection were successfully managed with *** patients(15.1%)had piecemeal resection,22 patients(20.8%)had shown positive/uncertain resection margin,11 patients(16.1%)had an early recurrence,13 patients(10.4%)had a late recurrence,and 6 patients(5.7%)had a *** multivariate analysis,a positive/uncertain margin[Odds ratio(OR)=4.023,P=0.048]and piecemeal resection(OR=6.610,P=0.005)were significant risk factors for early and late recurrence,*** resection was also a significant risk factor for non-curative resection(OR=5.424,P=0.007).Twenty-six patients experienced adverse events(24.5%).CONCLUSION Endoscopic papillectomy is a safe and effective treatment for ampullary ***

关键词： Endoscopic papillectomy Ampullary adenoma Clinical outcome Recurrence Adverse event

Endoscopic bilateral stent-in-stent placement for malignant hilar obstruction using a large cell type stent

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Hepatobiliary & Pancreatic Diseases International 2016年第6期15卷 633-639页

作者： Jin Myung Park Sang Hyub lee Kwang Hyun Chung Dong Kee Jang Ji Kon Ryu Yong-Tae Kim jae min lee Woo Hyun Paik Department of Internal Medicine and Liver Research Institute Seoul National University HospitalSeoul National University College of Medicine Department of Internal Medicine Kangwon National University HospitalKangwon National University School of Medicine Department of Internal Medicine Gyeongsang National University HospitalGyeongsang National University College of Medicine Department of Internal Medicine Inje University Ilsan Paik Hospital

BACKGROUND： Bilateral stent-in-stent （SIS） self-expandable metal stent placement is technically chghallenging for palliation of unresectable malignant hilar obstruction. In the SIS technique, the uniform large cell type biliary stent facilitates contralateral stent deployment through the mesh of the first metallic stent. This study aimed to assess the technical success and clinical effectiveness of this technique with a uniform large cell type biliary stent. METHODS： Thirty-one patients who underwentlbilateral SIS placement using a large cell type stent were reviewed retrospectively. All patients showed malignant hilarl obstruction （Bismuth types Ⅱ, Ⅲ, Ⅳ） with different etiologies. RESULTS： Sixteen （51.6%） patients were male. The mean age of the patients was 67.0±14.0 years. Most patients were diagnosed as having hilar cholangiocarcinoma （58.1%） and gallbladder cancer （29.0%）. Technical success rate was 83.9%. Success was achieved more frequently in patients without masses obstructing the biliary confluence （MOC） than those with MOC （95.2% vs 60.0%, P=0.03）. Functional success rate was 77.4%. Complications occurred in 29.0% of the patients. These tended to occur more frequently in patients with MOC （50.0% vs 19.0%, P=0.11）. Median time to recurrent biliary obstruction was 188 days and median survival was 175 days. CONCLUSIONS： The large cell type stent can be used efficiently for bilateral SIS placement in malignant hilar obstruction. However, the risk of technical failure increases in patients with MOC, and caution is needed to prevent complications for these patients.

关键词： biliary tract disease cholangiocarcinoma endoscopic biliary drainage stent insertion

Comparison of the efficacy and safety of once-daily dosing and on-demand use of udenafil for type 2 diabetic patients with erectile dysfunction

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Asian Journal of Andrology 2015年第1期17卷 143-148,I0011,I0012页

作者： Soon Hyun Park Sung Woo Park Bong Yun Cha Ie Byung Park Kyung Wan min Yeon Ah Sung Tae Hwa Kim jae min lee Kang Seo Park Department of Internal Medicine Eulji University School of Medicine Daejeon 302-799 South Korea Department of Endocrinology and Metabolism Kangbuk Samsung Hospital Sungkyunkwan University School of Medicine Seou1110-746 South Korea Department of Endocrinology and Metabolism College of Medicine the Catholic University of Korea Seou1137-701 South Korea Department of Internal Medicine Gachon University of Medicine and Science Graduate School of Medicine Incheon 405-760 South Korea Department of Internal Medicine Eulji University School of Medicine Seou1139-872 South Korea Department of Endocrinology Ewha Woman's University School of Medicine Seoul 158-710 South Korea Department of Internal Medicine College of Medicine Hanyang University Seoul 133-792 South Korea.

We compared the efficacy and safety between once-daily dosing and on-demand use of udenafil for type 2 diabetic patients with erectile dysfunction （ED）. A multi-center, randomized, open-label, parallel-group, 12-week study was conducted. 161 patients who improved with on-demand 200 mg of udenafil according to Sexual Encounter Profile （SEP） diary Question 2 and 3 （Q2 and Q3） were randomized into 200 mg on-demand （n = 80） or 50 mg once-daily （n = 81） dosing groups for 8 weeks. The dosing period was followed by a 4-week treatment-free period. The primary efficacy endpoint was the change of the International Index of Erectile Function （IIEF） erectile function domain （EFD） score. The secondary efficacy endpoints included changes to the SEP diary Q2, Q3, IIEF Q3, Q4, other domains of IIEF, Global Assessment Question, and shift to the normal rate （EFD 〉 26）. Vascular endothelial markers were also assessed. The IIEF-EFD score of both groups improved after 8 weeks of treatment （P 〈 0.0001）. There was no statistically significant difference between two groups. Improvement was not maintained after the treatment-free follow-up period. Similar results were observed in the secondary efficacy endpoints. There was also no significant difference in vascular endothelial markers. Daily udenafil was well-tolerated, and there was no significant difference in the adverse drug reactions and adverse events between the two groups. Flushing and headache were the most frequent adverse events. Both regimens improved ED in diabetic patients and were well-tolerated. Further studies are needed to assess the effect of daily udenafil treatment in diabetic patients.

关键词： erectile dysfunction International Index of Erectile Function once-daily dosing ptiosphodiesterase type 5 inhibitor type 2 diabetes mellitus udenafil

Intraductal papillary bile duct adenocarcinoma and gastrointestinal stromal tumor in a case of neurofibromatosis type 1

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World Journal of Gastroenterology 2018年第4期24卷 537-542页

作者： Jung min lee jae min lee Jong Jin Hyun Hyuk Soon Choi Eun Sun Kim Bora Keum Yoon Tae Jeen Hoon Jai Chun Hong Sik lee Chang Duck Kim Dong Sik Kim Joo Young Kim Division of Gastroenterology and Hepatology Department of Internal Medicine Institute of Gastrointestinal Medical Instrument Research Korea University College of Medicine Division of Gastroenterology and Hepatology Department of Internal Medicine Korea University Anam Hospital Division of HBP Surgery and Liver Trans- plantation Department of Surgery Korea University College of Medicine Department of Pathology Korea University College of Medicine

We report our experience with a synchronous case of gastrointestinal stromal tumor(GIST) and intraductal papillary neoplasm of the bile duct(IPNB) in anelderly woman with neurofibromatosis type 1(NF-1). A 72-year-old woman presented with a 2-mo history of right upper abdominal pain unrelated to diet and indigestion. Fourteen years earlier, she had been diagnosed with NF-1, which manifested as café au lait spots and multiple nodules on the skin. Computed tomography(CT) revealed a multilocular low-density mass with septation, and mural nodules in the right hepatic lobe, as well as a 1.7-cm-sized well-demarcated enhancing mass in the third portion of the duodenum. The patient subsequently underwent right hepatectomy and duodenal wedge resection. We present here the first report of a case involving a synchronous IPNB and GIST in a patient with NF-1. Our findings demonstrate the possibility of various tumors in NF-1 patients and the importance of diagnosis at an early

关键词： Neurofibromatosis type 1 Intraductal papillary neoplasm of the bile duct Gastrointestinal stromal tumor Synchronous

Prognostic value of inflammation-based markers in patients with pancreatic cancer administered gemcitabine and erlotinib

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World Journal of Gastrointestinal Oncology 2016年第7期8卷 555-562页

作者： jae min lee Hong Sik lee Jong Jin Hyun Hyuk Soon Choi Eun Sun Kim Bora Keum Yeon Seok Seo Yoon Tae Jeen Hoon Jai Chun Soon Ho Um Chang Duck Kim Division of Gastroenterology and Hepatology Department of Internal Medicine Korea University College of Medicine

AIM: To evaluate the value of systemic inflammationbased markers as prognostic factors for advanced pancreatic cancer(PC). METHODS: Data from 82 patients who underwent combination chemotherapy with gemcitabine and erlotinib for PC from 2011 to 2014 were collected retrospectively. Data that included the neutrophil-to-lymphocyte ratio(NLR), the platelet-to-lymphocyte ratio, and the C-reactive protein(CRP)-to-albumin(CRP/Alb) ratio were analyzed. Kaplan-Meier curves, and univariate and multivariate Cox proportional hazards regression analyses were used to identify the prognostic factors associated with progression-free survival(PFS) and overall survival(OS). RESULTS: The univariate analysis demonstrated the prognostic value of the NLR(P = 0.049) and the CRP/Alb ratio(P = 0.047) in relation to PFS, and a positiverelationship between an increase in inflammation-based markers and a poor prognosis in relation to OS. The multivariate analysis determined that an increased NLR(hazard ratio = 2.76, 95%CI: 1.33-5.75, P = 0.007) is an independent prognostic factor for poor OS. There was no association between the PLR and the patients' prognoses in those who had received chemotherapy that comprised gemcitabine and erlotinib in combination. The Kaplan-Meier method and the log-rank test determined significantly worse outcomes in relation to PFS and OS in patients with an NLR > 5 or a CRP/Alb ratio > ***: Systemic inflammation-based markers, including increases in the NLR and the CRP/Alb ratio, may be useful for predicting PC prognoses.

关键词： Pancreatic cancer Neutrophil-to-lymphocyte ratio C-reactive protein Albumin Prognostic factor

Rare case of pancreatic cancer with leptomeningeal carcinomatosis

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World Journal of Gastroenterology 2015年第3期21卷 1020-1023页

作者： In Kyung Yoo Hong Sik lee Chang Duk Kim Hoon Jai Chun Yoon Tae Jeen Bora Keum Eun Sun Kim Hyuk Soon Choi jae min lee Seung Han Kim Seung Joo Nam Jong Jin Hyun Division of Gastroenterology and Hepatology Department of Internal MedicineInstitute of Digestive Disease and NutritionKorea University College of MedicineSeoul 136-705South Korea Division of Gastroenterology and Hepatology Department of Internal MedicineKorea University Ansan Hospital 123Gyeonggi-do 425-707South Korea

Leptomeningeal carcinomatosis occurs very rarely in patients with pancreatic *** is characterized by multifocal seeding of the leptomeninges by malignant cells that originate from a solid *** the best of our knowledge,brain metastasis from pancreatic cancer is extremely *** carcinomatosis is estimated to occur in 3% to 8% of cases of solid *** clinical manifestation usually involves neurological symptoms,including dizziness,headache,vomiting,nausea,and hemiparesis,symptoms similar to those of meningitis or brain *** methods for leptomeningeal carcinomatosis include brain magnetic resonance imaging and cerebrospinal fluid ***,we describe a case of leptomeningeal carcinomatosis in which the primary tumor was later determined to be pancreatic *** magnetic resonance imaging findings showed mild enhancement of the leptomeninges,and cerebrospinal fluid cytology was negative at ***,after repeated spinal taps,atypical cells were observed on cerebrospinal fluid analysis and levels of tumor markers such as carbohydrate antigen 19-9 in cerebrospinal fluid were *** computed tomography,performed to determine the presence of extracerebral tumors,revealed pancreatic *** cancer was confirmed histopathologically on examination of an endoscopic ultrasound-guided fine needle aspiration specimen.

关键词： Pancreatic cancer Radiation therapy Tumor marker L

Spontaneous Absorption of a Lumbar Epidural Hematoma after Interlaminar Epidural Steroid Injection in a Patient with Spinal Stenosis： Close Observation as a Treatment Strategy

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Chinese Medical Journal 2018年第1期131卷 117-118页

作者： Soo Hyang Kim Yun Joung Han Young Hoon Kim jae min lee Yoo Mi Kim Hue Jung Park Department of Anesthesiology and Pain Medicine College of Medicine Seoul St. Mary's Hospital The Catholic University of Korea Seoul 06591 Korea

To the Editor： A lumbar epidural block is used to treat patients with a herniated intervertebral disc, spinal stenosis, or lumbosacral radiculopathy. This approach reduces radicular pain by decreasing inflammation of nerve roots through epidural corticosteroid injection. Patients with moderate-to-severe spinal stenosis who taking various anticoagulant agents have more risk for epidural hematoma.

关键词： Spontaneous Absorption a Lumbar Epidural Hematoma after Interlaminar

Risk factors of organ failure in cholangitis with bacteriobilia

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World Journal of Gastroenterology 2015年第24期21卷 7506-7513页

作者： jae min lee Sang Hyub lee Kwang Hyun Chung Jin Myung Park Ban Seok lee Woo Hyun Paik Joo Kyung Park Ji Kon Ryu Yong-Tae Kim Departments of Internal Medicine and Liver Research Institute Seoul National University College of Medicine Seoul National University Hospital Department of Internal Medicine Gyeongsang National University College of Medicine Gyeongsang National University Hospital Department of Internal Medicine Kangwon National University School of Medicine Kangwon National University Hospital Department of Internal Medicine Inje University Ilsan Paik Hospital Department of Gastroenterology Department of Medicine Samsung Medical Center Sungkyunkwan University School of Medicine

AIM: To identify the risk factors for organ failure(OF) in cholangitis with ***: This study included 182 patients with acute cholangitis who underwent percutaneous transhepatic biliary drainage between January 2005 and April 2013. We conducted a retrospective analysis of comprehensive clinical and laboratory ***: There were 24 cases(13.2%) of OF and five deaths(2.7%). Bile culture was positive for microbial growth in 130 out of 138(94.2%) patients. In multivariate analysis of 130 patients with positivebile cultures, significant predictive factors for OF were the presence of extended-spectrum beta-lactamase(ESBL) organisms in blood cultures, pre-existing renal dysfunction, and choledocholithiasis as an etiology, with odds ratios of 15.376, 6.319, and 3.573, respectively. We developed a scoring system with a regression coefficient of each significant variable. The OF score was calculated using the following equation:(2.7 × ESBL organisms in blood cultures) +(1.8 × pre-existing renal dysfunction) +(1.3 × choledocholithiasis). This scoring system for predicting OF was highly specific(99.1%) and had a positive predictive value of 86.2%.CONCLUSION: ESBL organisms in blood cultures, preexisting renal dysfunction, and choledocholithiasis are risk factors for OF in cholangitis with bacteriobilia. The OF scoring system may aid clinicians to identify a poor prognosis group.

关键词： Acute cholangitis Bacteriobilia Bile culture Organ failure