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Comparative study of rendezvous techniques in post-liver transplant biliary stricture

World Journal of Gastroenterology 2012年第41期18卷 5957-5964页

作者： Jae Hyuck Chang In Seok Lee Ho jong Chun jong young choi Seung Kyoo Yoon Dong Goo Kim young Kyoung You Myung-Gyu choi Sok Won Han Department of Internal Medicine College of MedicineThe Catholic University of KoreaSeoul 137-701South Korea Department of Radiology College of MedicineThe Catholic University of KoreaSeoul 137-701South Korea Department of Surgery College of MedicineThe Catholic University of KoreaSeoul 137-701South Korea

AIM： To investigate the usefulness of a new rendezvous technique for placing stents using the Kumpe （KMP） catheter in angulated or twisted biliary strictures. METHODS： The rendezvous technique was performed in patients with a biliary stricture after living donor liver transplantation （LDLT） who required the exchange of percutaneous transhepatic biliary drainage catheters for inside stents. The rendezvous technique was performed using a guidewire in 19 patients （guidewire group） and using a KMP catheter in another 19 （KMP catheter group）. We compared the two groups retrospectively. RESULTS： The baseline characteristics did not differ between the groups. The success rate for placing insidestents was 100% in both groups. A KMP catheter was easier to manipulate than a guidewire. The mean pro- cedure time in the KMP catheter group （1012 s, range： 301-2006 s） was shorter than that in the guidewire group （2037 s, range： 251-6758 s, P = 0.022）. The cu- mulative probabilities corresponding to the procedure time of the two groups were significantly different （P = 0.008）. The factors related to procedure time were the rendezvous technique method, the number of inside stents, the operator, and balloon dilation of the stric- ture （P 〈 0.05）. In a multivariate analysis, the rendez- vous technique method was the only significant factor related to procedure time （P = 0.010）. The procedural complications observed included one case of mild acute pancreatitis and one case of acute cholangitis in the guidewire group, and two cases of mild acute pancre- atitis in the KMP catheter group. CONCLUSION： The rendezvous technique involving use of the KIVlp catheter was a fast and safe method for placing inside stents in patients with LDLT biliary stric- ture that represents a viable alternative to the guide- wire rendezvous technique,

关键词： Rendezvous Biliary stricture Liver trans-plantation Endoscopic retrograde cholangiography Percutaneous transhepatic biliary drainage

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Relative skeletal muscle mass and non-alcoholic fatty liver disease: from association to causation

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Hepatobiliary Surgery and Nutrition 2019年第5期8卷 509-511页

作者： Hee Yeon Kim jong young choi Yong-Moon Park Division of Hepatology Department of Internal MedicineCollege of MedicineThe Catholic University of KoreaSeoulKorea Epidemiology Branch National Institute of Environmental Health SciencesNational Institutes of HealthResearch Triangle ParkNCUSA

The prevalence of nonalcoholic fatty liver disease(NAFLD)and its associated metabolic risk factors,including obesityand metabolic syndrome,have increased over the lastdecade in both developed and developing countries(1).NAFLD is considered to be the hepatic manifestation ofmetabolic syndrome and insulin resistance which is oneof multiple hits leading to NAFLD(2).

关键词： NAFLD liver hepatic

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Epirubicin,Cisplatin,5-FU combination chemotherapy in sorafenib-refractory metastatic hepatocellular carcinoma

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World Journal of Gastroenterology 2014年第1期20卷 235-241页

作者： Ji Eun Lee Si Hyun Bae jong young choi Seung Kew Yoon young Kyoung You Myung Ah Lee Division of Medical Oncology Hepato-Biliary-Pancreatic Cancer CenterCancer Research Institute Seoul St. Mary’s HospitalCollege of MedicineThe Catholic University of KoreaSeoul 137-040South Korea Department of Internal Medicine Hepato-Biliary-Pancreatic Cancer CenterCancer Research InstituteSeoul St. Mary’s HospitalCollege of MedicineThe Catholic University of KoreaSeoul 137-040South Korea Division of Hepatology Hepato-Biliary-Pancreatic Cancer CenterCancer Research Institute Seoul St. Mary’s HospitalCollege of MedicineThe Catholic University of KoreaSeoul 137-040South Korea Department of Surgery Hepato-Biliary-Pancreatic Cancer CenterCancer Research InstituteSeoul St. Mary’s HospitalCollege of MedicineThe Catholic University of KoreaSeoul 137-040South Korea

AIM: To evaluate the clinical efficacy and safety of epirubicin, cisplatin, and 5-FU combination chemotherapy for the sorafenib-refractory metastatic hepatocellular carcinoma (HCC).

关键词： Hepatocellular carcinoma Sorafenib Epirubicin Cisplatin 5-FU

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Severe thrombocytopenia before liver transplantation is associated with delayed recovery of thrombocytopenia regardless of donor type

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World Journal of Gastroenterology 2008年第37期14卷 5723-5729页

作者： Jae Hyuck Chang jong young choi Hyun young Woo Jung Hyun Kwon Chan Ran You Si Hyun Bae Seung Kew Yoon Myung-Gyu choi In-Sik Chung Dong Goo Kim Department of Internal Medicine College of Medicine the Catholic University of Korea505 Banpo-Dong Seocho-Gu Seoul 137-040 Korea Department of Surgery College of Medicine the Catholic University of Korea505 Banpo-Dong Seocho-Gu Seoul 137-040 Korea

AIM： To compare the recovery of thrombocytopenia and splenomegaly during long-term follow-up after liver transplantation in patients receiving a living donor transplant or a cadaveric donor transplant. METHODS： This was a retrospective cohort study of 216 consecutive liver transplant patients who survived for 〉 6 mo after transplantation; 169 received a liver transplant from a living donor and 47 from a cadaveric donor. The platelet counts or spleen volumes were examined before transplant, i, 6, and 12 mo after transplant, and then annually until 5 years after transplant. RESULTS： The mean follow-up period was 49 mo （range, 21-66）. Platelet counts increased continuously for 5 years after orthotopic liver transplant. The restoration of platelet counts after transplant was significantly slower in patients with severe pretransplant thrombocytopenia （〈 50000/μL） until 4 years after transplant （P = 0.005）. Donor type did not significantlyaffect the recovery of platelet count and spleen volume in either patient group. In multivariate analysis, pretransplant severe thrombocytopenia （〈 50000/μL） was an independent factor associated with sustained thrombocytopenia （P 〈 0.001, odds ratio 6.314; confidence interval, 2.828-14.095）. Thrombocytopenia reappeared after transplant in seven patients with portal flow disturbance near the anastomosis site. CONCLUSION： Our study suggests that severe thrombocytopenia before transplant is closely associated with delayed recovery of platelet count after transplant and donor type did not affect the recovery of thrombocytopenia. The reappearance of thrombocytopenia after transplant should be considered a possible indicator of flow disturbance in the portal vein.

关键词： Liver transplantation Thrombocytopenia Splenomegaly Hypersplenism

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Predictive value of ^(18)F-fluorodeoxyglucose PET/CT for transarterial chemolipiodolization of hepatocellular carcinoma

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World Journal of Gastroenterology 2012年第25期18卷 3215-3222页

作者： Myeong Jun Song Si Hyun Bae Ie Ryung Yoo Chung-Hwa Park Jeong Won Jang Ho jong Chun Byung Gil choi Hae Giu Lee jong young choi Seung Kew Yoon Department of Internal Medicine College of MedicineThe Catholic University of KoreaSeoul 137-040South Korea Department of Nuclear Medicine College of MedicineThe Catholic University of KoreaSeoul 137-040South Korea Department of Radiology College of MedicineThe Catholic University of KoreaSeoul 137-040South Korea

AIM： To investigate the correlation of 18F-fluorodeoxy- glucose （18F-FDG） positron emission tomography （PET） with clinical features and the prediction of treatment response. METHODS： A total of 83 hepatocellular carcinoma （HCC） patients undergoing 18F-FDG PET before transar- terial chemolipiodolization with systemic chemo-infusion between October, 2006 and May, 2009 were retrospec-tively enrolled. The patients included 68 men and 15 women （mean age, 60 ~ 10.7 years）. The effect of 18F- FDG-monitored PET uptake on clinical features and on the evaluated treatment response was ascertained with modified Response Evaluation Criteria in Solid Tumors. The PET parameters of maximal standardized uptake value of the tumor （Tsuvmax）, the ratio of the tumor maximal standardized uptake value （SUV） to the liver maximal SUV （Tsuvmax/Lsuwax） and the ratio of tumor maximal SUV to the liver mean SUV （msuvmax/LSUVrnean） were tested as predictive factors. RESULTS： Among the 3 SUV parameters, the TSUV- =maxdLsuvmean ratio （cutoff value of 1.90） was significantly associated with tumor burden including tumor size, tu- mor number, α-fetoprotein levels and tumor stage （P 〈 0.001, P = 0.008, P = 0.011, P 〈 0.001, respectively）. The objective response rates in patients with a high SUV ratio （≥ 1.90） were significantly better than those with a low SUV ratio （〈 1.90）（P = 0.020）. The overall survival rates of patients exhibiting a low Tsuvmax/Lsu- Vmean ratio （〈 1.90） and those with a high SUV ratio （≥1.90） was 38.2 and 10.3 mo, respectively （P 〈 0.01）. However, the time to progression showed no significant difference between the groups （P = 0.15）. CONCLUSION： 18F-FDG PET can be an important predictor of HCC treatment. In particular, the Tsuvmax/ Lsuwean ratio （cutoff value of 1.90） can provide useful information in treatment prognosis for HCC patients treated with Iocoregional therapy.

关键词： 18F-fluorodeoxyglucose positron emissiontomography Transarterial chemolipiodolization withsystemic chemo-infusion Treatment response Predic-tive factor, Overall survival

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Low skeletal muscle mass is associated with non-alcoholic fatty liver disease in Korean adults： the Fifth Korea National Health and Nutrition Examination Survey

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Hepatobiliary & Pancreatic Diseases International 2016年第1期15卷 39-47页

作者： hee yeon kim chang wook kim chung-hwa park jong young choi kyungdo han anwar t merchant yong-moon park division of hepatology department of internal medicinecollege of medicinethe catholic university of korea222Banpo-daeroSeocho-guSeou1 06591Republic of Korea department of biostatistics college of medicinethe catholic university of korea222Banpo-daeroSeocho-guSeou1 06591Republic of Korea department of epidemiology and biostatistics arnold school of public healthuniversity of south carolinaColumbiaSC 29208USA epidemiology branch national institute of environmental health sciencesnational institutes of healthdepartment of health and human servicesResearch Triangle ParkNC 27709USA

BACKGROUND： Sarcopenia and non-alcoholic fatty liver dis- ease （NAFLD） share similar pathophysiological mechanisms, and the relationship between sarcopenia and NAFLD has been recently investigated. The study investigated whether low skel- etal muscle mass is differentially associated with NAFLD by gender in Korean adults. METHODS： We conducted a cross-sectional analysis of the data from the Fifth Korea National Health and Nutrition Examination Survey. The skeletal muscle index （SMI） was obtained by the appendicular skeletal muscle mass divided by the weight. NAFLD was defined as a fatty liver index （FLI）〉60 in the absence of other chronic liver disease. RESULTS： Among the included subjects, 18.3% （SE： 1.4%） in men and 7.0% （SE： 0.7%） in women were classified as having FLI-defined NAFLD. Most of the risk factors for FLI-defined NAFLD showed a significant negative correlation with the SMI in both genders. Multiple logistic regression analysis showed that low SMI was associated with FLI-defined NAFLD, inde- pendent of other metabolic and lifestyle parameters in both genders [males： odds ratio （OR）=1.35; 95% confidence inter- val （CI）： 1.17-1.54; females： OR=1.36; 95% CI： 1.18-1.55]. The magnitude of the association between FLI-defined NAFLD and low SMI was higher in middle aged to elderly males （OR-1.50; 95% CI： 1.22-1.84） than in males less than 45 years of age （OR=1.25; 95% CI： 1.02-1.52） and in premenopausal females （OR=l.50; 95% CI： 1.12-2.03） than in postmenopausal females （OR-1.36; 95% CI： 1.20-1.54）.CONCLUSIONS： Low SMI is associated with the risk of FLI- defined NAFLD independent of other well-known metabolic risk factors in both genders. This association may differ ac- cording to age group or menopausal status. Further studies are warranted to confirm this relationship.

关键词： Korea National Health and Nutrition Examination Survey non-alcoholic fatty liver disease sarcopenia skeletal muscle

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Family history influences the early onset of hepatocellular carcinoma

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World Journal of Gastroenterology 2012年第21期18卷 2661-2667页

作者： Chung-Hwa Park Seung-Hee Jeong Hyeon-Woo Yim Jin Dong Kim Si Hyun Bae jong young choi Seung Kew Yoon Department of Internal Medicine The Catholic University of KoreaSeoul 137-701 South Korea Department of Preventive Medicine College of Medicine The Catholic University of KoreaSeoul 137-701 South Korea Clinical Research Coordinating Center of Catholic Medical Center The Catholic University of KoreaSeoul 137-701 South Korea

AIM: To evaluate the relationship between a positive family history of primary liver cancer and hepatocellular carcinoma (HCC) development in Korean HCC patients. METHODS: We studied a total of 2242 patients diagnosed with HCC between January 1990 and July 2008, whose family history of primary liver cancer was clearly described in the medical *** family history of HCC and 2077 (92.6%) did not. The male to female ratio was 3.6:1, and the major causes of HCC were chronic hepatitis B virus (HBV) infection in 75.1%, chronic hepatitis C virus infection in 13.2% and alcohol in 3.1%. The median ages at diag- nosis in the positiveand negative-history groups were 52 years (range: 29-79 years) and 57 years (range: 18-89 years), respectively (P < 0.0001). Furthermore, among 1713 HCC patients with HBV infection, the number of patients under 45 years of age out of 136 patients with positive family history was 26 (19.1%), whereas those out of 1577 patients with negative family history was 197 (12.5%), suggesting that a positive family history may be associated with earlier development of HCC in the Korean population (P = 0.0028). CONCLUSION: More intensive surveillance maybe recommended to those with a positive family history of HCC for earlier diagnosis and proper management especially when HBV infection is present.

关键词： Liver cancer Hepatocellular carcinoma Family history Epidemiology

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Association between the early high level of serum tacrolimus and recurrence of hepatocellular carcinoma in ABO-incompatible liver transplantation

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World Journal of Gastrointestinal Surgery 2023年第12期15卷 2727-2738页

作者： Ji Won Han jong young choi Eun Sun Jung Ji Hoon Kim Hee Sun Cho Jae-Sung Yoo Pil Soo Sung Jeong Won Jang Seung Kew Yoon Ho Joong choi young Kyoung You Department of Internal Medicine The Catholic University of KoreaSeoul 06591South Korea The Catholic University Liver Research Center College of MedicineThe Catholic University of KoreaSeoul 06591South Korea Department of Hospital Pathology The Catholic University of KoreaSeoul 06591South Korea Department of Surgery The Catholic University of KoreaSeoul 06591South Korea

BACKGROUND Clinical factors predicting graft survival(GS)after ABO-incompatible(ABOi)liver transplantation(LT),and differences between recipients with and without hepatocellular carcinoma(HCC)are *** To analyze the impact of serial serum tacrolimus trough concentration in recipients with or without(HCC)in ABOi living-donor liver transplantation(LDLT).METHODS We analyzed a historical cohort of 89 recipients who underwent ABOi LDLT,including 47 patients with *** The 1-,3-,5-,and 10-year GS rates were 85.9%,73.3%,71.4%,and 71.4%,respectively,and there were no significant differences between HCC and non-HCC *** multivariate Coxregression analyses,tacrolimus trough concentrations below 5.4 ng/mL at 24 wk post-LT,in addition to the antibody-mediated rejection(AMR)were associated with poor-graft *** HCC patients,AMR[hazard ratio(HR)=63.20,P7.3 ng/mL were significant predictive factors for HCC *** propensity score matching,patients with high tacrolimus concentrations at 4 wk had significantly poor recurrence-free *** Elevated tacrolimus levels at 4 wk after ABOi LDLT have been found to correlate with HCC ***,careful monitoring and control of tacrolimus levels are imperative in ABOi LT recipients with HCC.

关键词： ABO-incompatible Liver transplantation Tacrolimus Hepatocellular carcinoma

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Short-term overlap lamivudine treatment with adefovir dipivoxil in patients with lamivudine-resistant chronic hepatitis B

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World Journal of Gastroenterology 2008年第11期14卷 1781-1784页

作者： Soon Woo Nam Si Hyun Bae Seung Woo Lee Yeon Soo Kim Sang Bum Kang jong young choi Se Hyun Cho Seung Kew Yoon Joon-Yeol Han Jin Mo Yang young Suk Lee Division of Gastroenterology and Hepatology Department ofInternal medicineMedical College of the Catholic University ofKoreaDaejeon St.Mary's Hospital#62 Daeheung-dongChung-guDaejeonRepublic of Korea

AIM： To evaluate the efficacy of short-term overlap lamivudine therapy with adefovir in patients with lamivudine-resistant and naive chronic hepatitis B, we compared patients receiving overlap therapy with those receiving adefovir alone. METHODS： Eighty patients who had received lamivudine treatment for various periods and had a lamivudineo resistant liver function abnormality were enrolled. Forty of these patients received adefovir treatment combined with lamivudine treatment for ≥ 2 mo, while the other 40 received adefovir alone. We assessed the levels of hepatitis B virus （HBV） DNA at 0, 12 and 48 wk and serum alanine aminotransferase （ALT） levels after 0, 12, 24 and 48 wk of adefovir treatment in each group. RESULTS： We found serum ALT became normalized in 72 （87.5%） of the 80 patients, and HBV DNA decreased by ≥ 2 Ioglo copies/mL in 60 （75%） of the 80 patients at the end of a 48-wk treatment. HBV DNA levels were not significantly different between the groups. The improvements in serum ALT were also not significantly different between the two groups. CONCLUSION： These findings suggest short-term overlap lamivudine treatment results in no better virological and biological outcomes than non-overlap adefovir monotherapy.

关键词： Adefovir dipivoxil Chronic hepatitis B Hepatitis B virus DNA Overlap

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Durability of viral response after off-treatment in HBeAg positive chronic hepatitis B

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World Journal of Gastroenterology 2012年第43期18卷 6277-6283页

作者： Myeong Jun Song Do Seon Song Hee Yeon Kim Sun Hong Yoo Si Hyun Bae jong young choi Seung Kew Yoon Yong-Han Paik June Sung Lee Hyun Woong Lee Hyung Joon Kim Departments of Internal Medicine College of Medicine The Catholic University of Korea Seoul 137-040 South Korea Departments of Internal Medicine Samsung Medical Center Sungkyunkwan University School of Medicine Seoul 135-710 South Korea Departments of Internal Medicine College of Medicine Inje University Ilsan Paik Hospital of The Korea Goyang-si 411-706 South Korea Departments of Internal Medicine College of Medicine The Chung-Ang University of Korea Seoul 156-755 South Korea

AIM:To evaluate the durability in hepatitis B e antigen (HBeAg) positive chronic hepatitis B patients who discontinued antiviral treatment. METHODS:A total of 48 HBeAg positive chronic hepatitis B patients who were administered nucleoside analogues and maintained virological response for ≥ 6 mo [hepatitis B virus (HBV) DNA 104 copies/mL after HBeAg seroconversion with previously undetectable HBV-DNA level. RESULTS:During the median follow-up period of 18.2 mo (range:5.1-47.5 mo) after cessation of antiviral treatment, the cumulative serological recurrence rate was 15 % at 12 mo. The median duration between the cessation of antiviral treatment and serologic recurrence was 7.2 mo (range:1.2-10.9 mo). Of the 48 patients with HBeAg positive chronic hepatitis, 20 (41.6%) showed virological recurrence. The cumulative virologic recurrence rates at 12 mo after discontinuing the antiviral agent were 41%. The median duration between off-treatment and virologic recurrence was 7.6 mo (range:4.3-27.1 mo). The mean age of the virological recurrence group was older than that of the non-recurrence group (46.7 ± 12.1 years vs 38.8 ± 12.7 years, respectively; P = 0.022). Age (> 40 years) and the duration of consolidation treatment (≥ 15 mo) were significant predictive factors for offtreatment durability in the multivariate analysis [P = 0.049, re

关键词： Durability Seroconversion Chronic hepatitis B Hepatitis B e antigen positive Recurrence Consolidation

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