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World Journal of Clinical Cases 2021年第1期9卷 262-266页

作者： Hee-Sung Kim Yook Kim joung-ho han Department of Internal Medicine Chungbuk National University HospitalChungbuk National University College of MedicineCheongju-si 28644South Korea Department of Radiology Chungbuk National University HospitalCheongju-si 28644South Korea

BACKGROUND Endoscopic approach could effectively manage postoperative anastomotic *** endoscopic methods have been developed for the treatment of anastomotic *** SUMMARY A 53-year-old woman developed anastomotic leak after laparoscopic proximal *** clip closure failed due to strong wall tension;therefore,a fully covered self-expandable esophageal metal stent(fc-SEMS)was placed to cover the leak after it was filled with a mixture of fibrin glue and ***,fluoroscopy with gastrograffin showed dye leaking out of the *** the previous fluoroscopic image for guidance,a catheter was inserted at the leakage *** radiocontrast dye was injected and was seen spreading along the sinus ***,histoacryl was *** days after the last procedure,upper gastrointestinal contrast studies showed no *** patient was subsequently discharged 9 d after histoacryl injection without any *** To seal an anastomosis leak after stent application,salvage technique using histoacryl injection at the leakage site with fluoroscopy guidance could be considered cautiously.

关键词： Anastomotic leak Stent Histoacryl Endoscopy Gastrectomy Gastric cancer Case report

Bile-derived circulating extracellular mi R-30d-5p and mi R-92a-3p as potential biomarkers for cholangiocarcinoma

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Hepatobiliary & Pancreatic Diseases International 2020年第1期19卷 41-50页

作者： Hye Sook han Mi Jin Kim joung-ho han Jieun Yun Hee Kyung Kim Yaewon Yang Ki Bae Kim Seon Mee Park Department of Internal Medicine Chungbuk National University HospitalCheongju 28644Korea Departments of Internal Medicine Chungbuk National University College of MedicineCheongju 28644Korea Department of Pharmaceutical Engineering College of Science EngineeringCheongju UniversityCheongju 28644Korea

Background: Cholangiocarcinoma (CCA) is from cholangiocytes, and therefore bile is a potentially rich source of biomarkers for CCA. The aim of the study was to identify and validate microRNAs (miRNAs) in bile samples that are differentially expressed between benign biliary disease (BBD) and CCA. Methods: Bile samples from 106 patients with obstructive biliary disease were allocated consecutively to a discovery set (10 patients with BBD and 11 with CCA) and then a validation set (48 patients with BBD and 37 with CCA). An miRNA microarray platform was used to screen 1209 miRNAs in the discovery set. Quantitative real-time reverse transcription polymerase chain reaction (qRT-PCR) was used to validate the pro ling results in the discovery and validation sets. In addition, the levels of carbohydrate antigen 19-9 (CA19-9) and carcinoembryonic antigen (CEA) were determined from patient serum samples. Results: Microarray pro ling showed that miR-30d-5p and miR-92a-3p were signi cantly upregulated in bile from the CCA group compared with those from the BBD group. qRT-PCR results indicated that the expression levels of miR-30d-5p and of miR-92a-3p were signi cantly upregulated in the CCA group compared to the BBD group, validating the miRNA microarray results. Pathway analysis suggested that putative target genes of miR-30d-5p and of miR-92a-3p were involved in CCA-associated signalling path- ways, such as Hippo, Wnt, p53, MAPK, and EGFR. Receiver operating curve analysis revealed that the areas under the curve for bile miR-30d-5p, miR-92a-3p, serum CA19-9, and CEA were 0.730, 0.652, 0.675, and 0.603, respectively, and bile miR-30d-5p showed the best diagnostic performance with a sensitivity of 81.1% and a speci city of 60.5%. Conclusions: The levels of extracellular miR-30d-5p and miR-92a-3p in bile were signi cantly higher in patients with CCA than those in patients with BBD. Bile-derived circulating extracellular miR-30d-5p and miR-92a-3p are potential biomarkers for discr

关键词： Bile Biomarkers Cholangiocarcinoma MicroRNA

Endoluminal closure of an unrecognized penetrating stab wound of the duodenum with endoscopic band ligation: A case report

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World Journal of Clinical Cases 2019年第20期7卷 3271-3275页

作者： Dae hoon Kim hanlim Choi Ki Bae Kim Hyo Yung Yun joung-ho han Department of Surgery Chungbuk National University HospitalChungbuk National University College of MedicineCheongju-si 28644South Korea Department of Internal Medicine Chungbuk National University HospitalChungbuk National University College of MedicineCheongju-si 28644South Korea

BACKGROUND A penetrating injury of a hollow viscus is an obvious indication for an exploratory laparotomy,but is not typically an indication for endoscopic *** SUMMARY A 27-year-old man visited the emergency department with a self-inflicted abdominal stab *** to the colon and ileum were detected,but an injury to the second portion of the duodenum was *** the day following admission to our institution,the patient became hemodynamically unstable with massive hematochezia,although there was no evidence of bleeding in the Levin tube or Jackson-Pratt *** thus performed an upper gastrointestinal endoscopy and discovered a missed duodenal injury that was actively *** endoscopic band ligation was performed for hemostasis and closure of the *** patient was subsequently discharged without any *** A penetrating injury of the duodenum can be overlooked,so careful abdominal exploration is very *** a missed duodenal injury is suspected,a cautious endoscopic approach may be helpful.

关键词： Penetrating abdominal injury Endoluminal treatment Unrecognized duodenal injury Case report

Rescue endoscopic band ligation of iatrogenic gastric perforations following failed endoclip closure

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World Journal of Gastroenterology 2013年第6期19卷 955-959页

作者： joung-ho han Tae hoon Lee Yunho Jung Suck-ho Lee Hyun Kim Hye-Suk han Heebok Chae Seon Mee Park Seijin Youn Division of Gastroenterology Department of Internal medicineChungbuk National University College of MedicineCheongju 361-711South Korea Division of Gastroenterology Department of Internal MedicineSoon Chun Hyang University College of MedicineCheonan HospitalCheonan 330-721South Korea

Iatrogenic gastric perforation is one of the most serious complications during therapeutic endoscopy,despite significant advances in endoscopic techniques and *** case study evaluated the clinical efficacy and safety of the rescue endoscopic band ligation (EBL) technique in iatrogenic gastric wall perforation following the failure of primary endoclip *** patients were enrolled in this *** patients underwent emergency endoscopy following the onset of acute gastric wall perforation during endoscopic *** outcome measurements were primary technical success and immediate or delayed procedure-related *** endoscopic closure using band ligation was reported in all patients,with no complication *** conclude that EBL may be a feasible and safe alternate technique for the management of acute gastric perforation,especially in cases where closure is difficult with endoclips.

关键词： Gastric perforation Endoscopy Band ligation

Efficacy of cap-assisted endoscopy for routine examining the ampulla of Vater

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World Journal of Gastroenterology 2013年第13期19卷 2037-2043页

作者： Young Rak Choi joung-ho han Young Shim Cho Hye-Suk han Hee Bok Chae Seon Mee Park Sei Jin Youn Department of Internal Medicine College of MedicineChungbuk National University

AIM: To determine the efficacy of a cap-assisted endoscopy (CAE) to completely visualize the ampulla of Vater (AV) in patients failed by conventional endoscopy. METhoDS: A prospective study was conducted on 120 patients > 20 years of ages who visited the Health Promotion Center of Chungbuk National University hospital for conscious sedation esophagogastroduodenoscopy (EGD) as a screening test from July to October, 2011. First, forward-viewing endoscopy was performed with reasonable effort using a push and pull method. We considered complete visualization of the AV when we could observe the entire AV including the orifice clearly, and reported the observation as complete or incomplete (partial or not found at all). Second, in cases of complete failure of the observation, an additional AV examination was conducted by attaching a short cap (D-201-10704, Olympus Medical Systems, Tokyo, Japan) to the tip of a forward-viewing endoscope. Third, if the second method failed, we replaced the short cap with a long cap (MH-593, Olympus Medical Systems) and performed a re-examination of the AV. RESULTS: Conventional endoscopy achieved complete visualization of the AV in 97 of the 120 patients (80.8%) but was not achieved in 23 patients (19.2%). Age (mean ± SD) and gender [male (%)] were not significantly different between the complete observation and the incomplete observation groups. Additional short CAE was performed in patients in whom we could not completely visualize the AV. This group included 13 patients (10.9%) with partial observation of the AV and 10 (8.3%) in which the AV was not found. Short CAE permitted a complete observation of the AV in 21 of the 23 patients (91.3%). Patients in whom visualization of the AV failed with short CAE had satisfactory outcomes by replacing the short cap with a long cap. The additional time for CAE took an average of 141 ± 88 s. There were no complications and no significant mucosal trauma. CONCLUSION: CAE is safe to use as a salvage me

关键词： Ampulla of Vater Conventional endoscopy Cap-assisted endoscopy Screening test Complete observation

Preoperative CA 125 is significant indicator of curative resection in gastric cancer patients

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World Journal of Gastroenterology 2015年第4期21卷 1216-1221页

作者： Dae hoon Kim Hyo Yung Yun Dong Hee Ryu Hye-Suk han joung-ho han Soon Man Yoon Sei Jin Youn Department of Surgery Chungbuk National University College of MedicineCheongju 361-763South Korea Internal Medicine Chungbuk National University College of MedicineCheongju 361-763South Korea

AIM: To investigate the correlation among tumor markers, curative resection, and recurrence in gastric ***: The patients with preoperative tumormakers [Carcinoembryonic antigen, Carbohydrate antigen(CA) 19-9, and CA 125] and elective gastrectomy between January 2000 and December 2009 at Chungbuk National University hospital were enrolled in this study. We analyzed the relationship among the tumor makers, curative resection and recurrence, ***: Among the 679 patients with gastric cancer, curative resection was 93.6%(n = 636) and noncurative resection was 6.4%(n = 43). The independent risk factors for the non-curative resection were tumor location and the positivity of preoperative serum CA 19-9 and CA 125 levels. After curative resection, the independent prognostic risk factors for recurrence in curative resection were gender, stage, and preoperative increased serum CA 125 level(HR = 2.431, P =0.020), in a multivariate analysis. CONCLUSION: Preoperative CA 125 is a useful predictive biomarker for curative resection and prognostic biomarker for recurrence in gastric cancer patients.

关键词： Gastric Cancer Tumor Marker Carcinoembryonic antig

Long-term survival after gastrectomy and metastasectomy for gastric cancer with synchronous bone metastasis

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World Journal of Gastroenterology 2018年第1期24卷 150-156页

作者： Young Jin Choi Dae hoon Kim Hye Suk han joung-ho han Seung-Myoung Son Dong Soo Kim Hyo Yung Yun Department of Surgery Chungbuk National University Hospital Chungbuk National University College of Medicine Department of Internal Medicine Chungbuk National University Hospital Chungbuk National University College of Medicine Department of Pathology Chungbuk National University Hospital Chungbuk National University College of Medicine Department of Orthopedics Chungbuk National University Hospital Chungbuk National University College of Medicine

Bone metastasis is a rare event in patients with gastric cancer, but pathologic fracture, paralysis, pain and hematological disorders associated with the bone metastasis may influence the quality of life. We report herein the case of a 53-year-old man who presented with primary remnant gastric cancer with bone metastasis. The patient requested further investigations after detection of a metastatic lesion in the 2 nd lumbar vertebra during evaluation for back pain that had persisted for 3 mo. No other metastatic lesions were detected. He underwent total gastrectomy and palliative metastasectomy to aid in reduction of symptoms, and he received combination chemotherapy with tegafur(S-1) and cisplatin. The patient survived for about 60 mo after surgery. Currently, there is no treatment guideline for gastric cancer with bone metastasis, and we believe that gastrectomy plus metastasectomy may be an effective therapeutic option for improving qualityof life and survival in patients with resectable primary gastric cancer and bone metastasis.

关键词： Stomach neoplasms Gastrectomy Bone neoplasms Neoplasm metastasis Metastasectomy

Gallbladder Metastasis of Non-small Cell Lung Cancer Presenting as Acute Cholecystitis

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Chinese Journal of Cancer Research 2012年第3期24卷 249-252页

作者： Yu-Sook Jeong Hye-Suk han Sung-Nam Lim Mi-Jin Kim joung-ho han Min-ho Kang Dong-Hee Ryu Ok-Jun Lee Ki-Hyeong Lee Seung-Taik Kim Department of Internal Medicine College of MedicineChungbuk National University Department of Radiology College of MedicineChungbuk National University Department of Surgery College of MedicineChungbuk National University Department of Pathology College of MedicineChungbuk National University Department of Internal Medicine College of MedicineChungbuk National University

Although non-small cell lung cancer （NSCLC） can metastasize to almost any organ, metastasis to the gallbladder with significant clinical manifestation is relatively rare. Here, we report a case of gallbladder metastasis of NSCLC presenting as acute cholecystitis. A 79-year-old man presented with pain in the right upper quadrant and fever. A computed tomography （CT） scan of the chest and abdomen showed a cavitary mass in the right lower lobe of the lung and irregular wall thickening of the gallbladder. Open cholecystectomy and needle biopsy of the lung mass were performed. Histological examination of the gallbladder revealed a moderately-differentiated squamous cell carcinoma displaying the same morphology as the lung mass assessed by needle biopsy. Subsequent immunohistochemical examination of the gallbladder and lung tissue showed that the tumor cells were positive for P63 but negative for cytokeratin 7, cytokeratin 20 and thyroid transcription factor-1. A second primary tumor of the gallbladder was excluded by immunohistochemical methods, and the final pathological diagnosis was gallbladder metastasis of NSCLC. Although the incidence is extremely rare, acute cholecystitis can occur in association with lung cancer metastasis to the gallbladder.

关键词： Cholecystitis Gallbladder Non-small cell lung cancer Metastasis

Urgent ERCP for acute cholangitis reduces mortality and hospital stay in elderly and very elderly patients

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Hepatobiliary & Pancreatic Diseases International 2016年第6期15卷 619-625页

作者： Chan Sun Park Hee Seok Jeong Ki Bae Kim joung-ho han Hee Bok Chae Sei Jin Youn Seon Mee Park Department of Internal Medicine Chungbuk National University College of Medicine

BACKGROUND： Acute cholangitis in old people is a cause of mortality and prolonged hospital stay. We evaluated the effects of methods and timing of biliary drainage on the outcomes of acute cholangitis in elderly and very elderly patients. METhoDS： We analyzed 331 patients who were older than 75 years and were diagnosed with acute calculous cholangitis. They were admitted to our hospital from 2009 to 2014. Patients＇ demographics, severity grading, methods and timing of biliary drainage, mortality, and hospital stay were retrospectively obtained from medical records. Clinical parameters and outcomes were compared between elderly （75-80 years, n= 156） and very elderly （≥81 years, n=175） patients. We analyzed the effects of methods [none, endoscopic retrograde cholangio- pancreatography （ERCP）, percutaneous transhepatic biliary drainage, or failure] and timing （urgent or early） of biliary drainage on mortality and hospital stay in these patients. RESULTS： Acute cholangitis in older patients manifested as atypical symptoms characterized as infrequent Charcot＇s triad （4.2%） and comorbidity in one-third of the patients. Patients were graded as mild, moderate, and severe cholangitis in 104 （31.4%）, 175 （52.9%）, and 52 （15.7%）, respectively. Urgent bili-ary drainage （≤24 hours） was performed for 80.5% （247/307） of patients. Very elderly patients tended to have more severe grades and were treated with sequential procedures of transient hiliary drainage and stone removal at different sessions. hospital stay was related to methods and timing of biliary drainage. Mortality was very low （1.5%） and not related to patient age but rather to the success or failure of biliary drainage and severity grading of the acute cholangitis. CONCLUSIONS： The methods and timing used for biliary drainage and severity of cholangitis are the major determinants of mortality and hospital stay in elderly and very elderly patients with acute cholangitis. Urgent successful ERCP is mandatory for favorable

关键词： acute cholangitis biliary drainage prognosis elderly very elderly

Corticotropin-releasing factor stimulates colonic motility via muscarinic receptors in the rat

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World Journal of Gastroenterology 2017年第21期23卷 3825-3831页

作者： Kyung-Jo Kim Ki Bae Kim Soon Man Yoon joung-ho han Hee Bok Chae Seon Mee Park Sei Jin Youn Department of Gastroenterology University of Ulsan College of Medicine Asan Medical Center Department of Internal Medicine Chungbuk National University College of Medicine

AIM To measure exogenous corticotropin-releasing factor(CRF)-induced motility of the isolated rat colon and to demonstrate the effect of pharmacologic inhibition on CRF-induced motility. METhoDS The isolated vascularly-perfused rat colon was used. Luminal pressure was monitored via microtip catheter pressure transducers in the proximal and distal colon. At first, exogenous CRF was administered in a stepwise manner and the concentration of CRF yielding maximal colonic motility was selected. After recording basal colonic motility, hexamethonium, phentolamine, propranolol, atropine and tetrodotoxin were infused into the isolated colon. Initially, only the test drug was infused; then, CRF was added. The motility index was expressed as percentage change over basal level. RESULTS Administration of 1.4, 14.4, 144 and 288 pmol/L CRF progressively increased colonic motility in the proximal and distal colon. Infusion of atropine or tetrodotoxin reduced CRF-induced motility of both the proximal and distal colon, whereas hexamethonium, phentolamine and propranolol had no *** CRF-induced colonic motility appears to be mediated by local cholinergic signaling via muscarinic receptors. Muscarinic receptors are potential targets for counteracting CRF-induced colonic hypermotility.

关键词： Gastrointestinal motility Rats Stress Colon Corticotropin-releasing factor