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Risk factors for postoperative recurrence after primary bowel resection in patients with Crohn's disease

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World Journal of Gastroenterology 2017年第38期23卷 7016-7024页

作者： Kwan Mo yang Chang Sik Yu Jong Lyul Lee Chan Wook Kim Yong Sik Yoon In Ja Park Seok-Byung Lim Sang Hyoung Park Byong Duk Ye suk-kyun yang Jin Cheon Kim Division of Colon and Rectal Surgery Department of Surgery University of Ulsan College of Medicine Asan Medical Center De-partment of Gastroenterology University of Ulsan College of Medicine Asan Medical Center

AIM To evaluate the risk factors for postoperative recurrence after primary bowel resection in a cohort of Korean Crohn's disease(CD) *** This study included 260 patients with no history of previous bowel surgery who underwent primary surgery for CD between January 2000 and December 2010 at Asan Medical Center(Seoul, South Korea). The median follow-up period was 101 *** During the follow-up period, 66 patients(25.4%) underwent a second operation for disease *** 1, 5 and 10 years after the first operation, the cumulative rate of surgical recurrence was 1.1%, 8.3% and 35.9% and clinical recurrence occurred in 1.2%, 23.6% and 68.1%, respectively. In multivariate analysis, undergoing an emergency operation was a significant risk factor for surgical recurrence-free survival(SRFS) [HR = 2.431, 95%CI: 1.394-4.240, P = 0.002], as were the presence of perianal disease after the first operation(HR = 1.715, 95%CI: 1.005-2.926, P = 0.048) and history of smoking(HR = 1.798, 95%CI: 1.088-2.969, P = 0.022). The postoperative use of antitumor necrosis factor(TNF) agents reduced SRFS risk(HR = 0.521, 95%CI: 0.300-0.904, P = 0.02).CONCLUSION History of smoking, postoperative perianal disease and undergoing an emergency operation were independent risk factors for surgical recurrence. Using anti-TNF agents may reduce surgical recurrence.

关键词： Crohn’s disease Recurrence Risk factor

Clinical course of ulcerative colitis patients who develop acute pancreatitis

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World Journal of Gastroenterology 2017年第19期23卷 3505-3512页

作者： Jong Wook Kim Sung Wook Hwang Sang Hyoung Park Tae Jun Song Myung-Hwan Kim Ho-Su Lee Byong Duk Ye Dong-Hoon yang kyung-Jo Kim Jeong-Sik Byeon Seung-Jae Myung suk-kyun yang Department of Internal Medicine Inje University Ilsan Paik Hospital Department of Gastroenterology University of Ulsan College of MedicineAsan Medical Center Department of Biochemistry and Molecular Biology University of Ulsan College of Medicine

To investigate the clinical course of ulcerative colitis (UC) patients who develop acute *** analyzed 3307 UC patients from the inflammatory bowel disease registry at Asan Medical Center from June 1989 to May 2015. The clinical course of UC patients who developed acute pancreatitis was compared with that of non-pancreatitis UC *** 51 patients who developed acute pancreatitis, 13 (0.40%) had autoimmune, 10 (0.30%) had aminosalicylate-induced, and 13 (1.73%) had thiopurine-induced pancreatitis. All 13 patients with autoimmune pancreatitis (AIP) had type 2 AIP. Two (15.4%) patients had pre-existing AIP, and three (23.1%) patients developed AIP and UC simultaneously. Compared to non-pancreatitis patients, AIP patients had UC diagnosed at a significantly younger age (median, 22.9 years vs 36.4 years; P = 0.001). AIP and aminosalicylate-induced pancreatitis patients had more extensive UC compared to non-pancreatitis patients. All patients with pancreatitis recovered uneventfully, and there were no recurrences. Biologics were used more frequently in aminosalicylate- and thiopurine-induced pancreatitis patients compared to non-pancreatitis patients [adjusted OR (95%CI), 5.16 (1.42-18.67) and 6.90 (1.83-25.98), respectively]. Biologic utilization rate was similar among AIP and non-pancreatitis patients [OR (95%CI), 0.84 (0.11-6.66)]. Colectomy rates for autoimmune, aminosalicylate-induced, and thiopurine-induced pancreatitis, and for non-pancreatitis patients were 15.4% (2/13), 20% (2/10), 15.4% (2/13), and 7.3% (239/3256), respectively; the rates were not significantly different after adjusting for baseline disease *** patients show a non-significant increase in colectomy, after adjusting for baseline disease extent.

关键词： Ulcerative colitis Pancreatitis Autoimmune Colectomy Clinical course

Risk factors and prognostic value of acute severe lower gastrointestinal bleeding in Crohn’s disease

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World Journal of Gastroenterology 2021年第19期27卷 2353-2365页

作者： Jiyoung Yoon Dae Sung Kim Ye-Jee Kim Jin Wook Lee Seung Wook Hong Ha Won Hwang Sung Wook Hwang Sang Hyoung Park Dong-Hoon yang Byong Duk Ye Jeong-Sik Byeon Seung-Jae Myung suk-kyun yang Department of Gastroenterology Asan Medical CenterUniversity of Ulsan College of MedicineSeoul 05505South Korea Department of Clinical Epidemiology and Biostatistics Asan Medical CenterUniversity of Ulsan College of MedicineSeoul 05505South Korea

BACKGROUND Acute severe lower gastrointestinal bleeding(LGIB)is an uncommon but challenging complication of Crohn’s disease(CD).AIM To identify the predictors of acute severe LGIB and to evaluate the impact of acute severe LGIB on the subsequent clinical course in CD *** A retrospective inception cohort study was conducted in 75 CD patients with acute severe LGIB and 1359 CD patients without acute severe LGIB who were diagnosed between February 1991 and November 2019 at Asan Medical Center,a tertiary university hospital in *** analysis with Cox proportional hazard regression was performed to identify the risk factors for acute severe LGIB.A matched analysis using 72 patients with bleeding and 267 matched patients without within the cohort was also conducted to investigate whether acute severe LGIB is a predictor of clinical outcomes of *** Multivariable Cox regression analysis revealed that early use of thiopurines[hazard ratio(HR):0.23,95%confidence interval(CI):0.12-0.48;P<0.001]and female sex(HR:0.51,95%CI:0.27-0.94;P=0.031)were significantly associated with a lower risk of acute severe *** cumulative risks of behavioral progression and intestinal resection were not significantly different between the two matched groups(P=0.139 and P=0.769,respectively).The hospitalization rate was higher in the bleeding group than in the matched non-bleeding group(22.1/100 vs 13.2/100 patient-years;P=0.012).However,if hospitalizations due to bleeding episodes were excluded from the analysis,the hospitalization rate was not significantly different between the bleeding group and the matched nonbleeding group(14.5/100 vs 13.2/100 patient-years;P=0.631).CONCLUSION Early use of thiopurines may reduce the risk of acute severe *** of acute severe LGIB may not have a significant prognostic value in patients with CD.

关键词： Gastrointestinal hemorrhage Lower gastrointestinal tract Crohn’s disease Risk factors Cohort studies Clinical course

Clinical correlations of infliximab trough levels and antibodies to infliximab in South Korean patients with Crohn's disease

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World Journal of Gastroenterology 2017年第8期23卷 1489-1496页

作者： Eun Hye Oh Dae-Hyun Ko Hyungil Seo Kiju Chang Gwang-Un Kim Eun Mi Song Myeongsook Seo Ho-Su Lee Sung Wook Hwang Dong-Hoon yang Byong Duk Ye Jeong-Sik Byeon Seung-Jae Myung suk-kyun yang Sang Hyoung Park Department of Internal Medicine University of Ulsan College of MedicineAsan Medical Center Department of Laboratory Medicine Hallym University College of MedicineDongtan Sacred Heart Hospital Department of Gastroenterology University of Ulsan College of MedicineAsan Medical Center Health Screening and Promotion Center University of Ulsan College of MedicineAsan Medical Center

To investigate the clinical implications of infliximab trough levels (IFX-TLs) and antibodies to infliximab (ATI) levels in Crohn’s disease (CD) patients in Asian ***-TL and ATI level were measured using prospectively collected samples obtained with informed consent from CD patients being treated at Asan Medical Center, South Korea. We analyzed the correlations between IFX-TLs/ATI levels and the clinical activity of CD (quiescent vs active disease) based on the CD activity index, C-reactive protein level, and physician’s judgment of patients’ clinical status at enrollment. The impact of concomitant immunomodulators was also *** study enrolled 138 patients with CD (84 with quiescent and 54 with active disease). In patients with quiescent and active diseases, the median IFX-TLs were 1.423 μg/mL and 0.163 μg/mL, respectively (P < 0.001) and the median ATI levels were 8.064 AU/mL and 11.209 AU/mL, respectively (P < 0.001). In the ATI-negative and -positive groups, the median IFX-TLs were 1.415 μg/mL and 0.141 μg/mL, respectively (P < 0.001). In patients with and without concomitant immunomodulator use, there were no differences in IFX-TLs (0.632 μg/mL and 1.150 μg/mL, respectively; P = 0.274) or ATI levels (8.655 AU/mL and 9.017 AU/mL, respectively; P = 0.083).CONCLUSIONIFX-TL/ATI levels were well correlated with the clinical activity in South Korean CD patients. Our findings support the usefulness of IFX-TLs/ATI levels in treating CD patients receiving IFX in clinical practice.

关键词： Infliximab Drug effect Antibody Crohn’s disease Drug monitoring

Temporal trends in the misdiagnosis rates between Crohn's disease and intestinal tuberculosis

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World Journal of Gastroenterology 2017年第34期23卷 6306-6314页

作者： Hyungil Seo Seohyun Lee Hoonsub So Donghoi Kim Seon-Ok Kim Jae Seung Soh Jung Ho Bae Sun-Ho Lee Sung Wook Hwang Sang Hyoung Park Dong-Hoon yang kyung-Jo Kim Jeong-Sik Byeon Seung-Jae Myung suk-kyun yang Byong Duk Ye Department of Gastroenterology University of Ulsan College of MedicineAsan Medical Center Division of Gastroenterology Department of Internal MedicineCenter for Health PromotionSeoul National University Hospital Department of Clinical Epidemiology and Biostatistics University of Ulsan College of MedicineAsan Medical Center Division of Gastroenterology Department of Internal MedicineHallym University College of Medicine Hallym University Sacred Heart Hospital Department of Gastroenterology Seoul National University College of MedicineSeoul National University Hospital Gangnam Center Inflammatory Bowel Disease Center University of Ulsan College of MedicineAsan Medical Center

AIM To investigate the temporal trends in the misdiagnosis rate between Crohn's disease(CD) and intestinal tuberculosis(ITB) in South Korea. METHODS We retrospectively reviewed the medical records of patients managed for CD or ITB at Asan Medical Center, a tertiary referral hospital, Seoul, Korea between 1996 and 2014. The temporal trends in the misdiagnosis rates between the two diseases were analyzed. The demographic and clinical characteristics were compared between CD patients who were initially misdiagnosed as ITB(final CD group) and vice versa(final ITB group). Final diagnostic criteria for ITB and medication for CD before definite diagnosis of TB were also analyzed in final ITB *** In total, 2760 patients were managed for CD and 772 patients for ITB between 1996 and 2014. As well, 494 of the 2760 CD patients(17.9%) were initially misdiagnosed as ITB and 83 of the 772 ITB patients(10.8%) as CD. The temporal trend in misdiagnosing CD as ITB showed a decrease(OR = 0.89, 95%CI: 0.87-0.91, P < 0.001), whereas the temporal trend in misdiagnosing ITB as CD showed an increase(OR = 1.06, 95%CI: 1.01-1.11, P = 0.013). Age at diagnosis, presenting symptoms, and proportion of patients with active/past perianal fistula and active/inactive pulmonary tuberculosis(TB) were significantly different between final CD group and final ITB group. Forty patients(48.2%) in final ITB group were diagnosed by favorable response to empirical anti-TB treatment. Seventeen patients(20.5%) in final ITB group had inappropriately received corticosteroids and/or thiopurines due to misdiagnosis as CD. However, there were no mortalities in both groups. CONCLUSION Cases of CD misdiagnosed as ITB have been decreasing, whereas cases of ITB misdiagnosed as CD have been increasing over the past two decades.

关键词： Crohn’s disease Intestinal tuberculosis Misdiagnosis

Comparison of postpolypectomy bleeding between epinephrine and saline submucosal injection for large colon polyps by conventional polypectomy:A prospective randomized,multicenter study

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World Journal of Gastroenterology 2007年第21期13卷 2973-2977页

作者： Suck-Ho Lee Il-Kwun Chung Sun-Joo Kim Jin-Oh Kim Bong-Min Ko Won-Ho Kim Hyun-Soo Kim Dong-IL Park Hyo-Jong Kim Jeong-Sik Byeon suk-kyun yang Byeong Ik Jang Sung-Ae Jung Yoon-Tae Jeen Jai-Hyun Choi Hwang Choi Dong-Soo Han Jae suk Song Department of Internal Medicine University of Soonchunhyang at CheonanCheonan & Seoul & BucheonRepublic of Korea Department of Internal Medicine University of Yonsei at SeoulSeoul & WonjuRepublic of Korea Department of Internal Medicine University of Sungkyunkwan at SeoulSeoulRepublic of Korea Department of Internal Medicine University of Kyunghee at SeoulSeoulRepublic of Korea Department of Internal Medicine University of Ulsan at SeoulSeoulRepublic of Korea Department of Internal Medicine University of Youngnam at TaeguTaeguRepublic of Korea Department of Internal Medicine University of Ewha at SeoulSeoulRepublic of Korea Department of Internal Medicine University of Korea at SeoulSeoul & AnsanRepublic of Korea Department of Internal Medicine University of Catholic at BucheonBucheonRepublic of Korea Department of Internal Medicine University of Hanyang at KuriKuriRepublic of Korea Department of Preventive Medicine University of KwandongKangneungRepublic of Korea

AIM:To evaluate and compare the clinical outcomes of prophylactic submucosal saline-epinephrine injection and saline injection alone for large colon polyps by conventional polypectomy. METHODS:A prospective study was conducted from July 2003 to July 2004 at 11 tertiary endoscopic centers. Large colon polyps (> 10 mm in diameter) wererandomized to undergo endoscopic polypectomy with submucosal saline-epinephrine injection (epinephrine group) or normal saline injection (saline group). Endoscopic polypectomy was performed by the conventional snare method,and early ( 2 cm) and neoplastic polyps were independently and significantly associated with the presence of PPB. CONCLUSION:The prophylactic submucosal injection of diluted epinephrine does not appear to provide an additional advantage over the saline injection alone for the prevention of PPB.

关键词： Colonoscopic polypectomy Bleeding submucosal injection Saline Epinephrine

PGLYRP1 protein as a novel mediator of cellular dialogue in neuroinflammation

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Neural Regeneration Research 2025年第7期20卷 1993-1994页

作者： Anup Bhusal Won-Ha Lee Kyoungho suk Department of Pharmacology School of MedicineKyungpook National UniversityDaeguRepublic of Korea BK21 Plus KNU Biomedical Convergence Program Department of Biomedical ScienceSchool of MedicineKyungpook National UniversityDaeguRepublic of Korea School of Life Sciences BK21 plus KNU Creative BioResearch GroupKyungpook National UniversityDaeguRepublic of Korea Brain Science and Engineering Institute Kyungpook National UniversityDaeguRepublic of Korea

Neuroinflammation has been identified as a crucial element in several neurological disorders. Glial cells play a critical role in directing neuroinflammation, both in deleterious and beneficial ways.

关键词： inflammation considerably

Anomalous quality factor evolution of induced transparency in a virtualized coupled-oscillator system

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Science China(Physics,Mechanics & Astronomy) 2025年第1期Mechanics & Astronomy) .卷 148-155页

作者： Yunhan yang Han Jia Tuo Liu Yuzhen yang Jun yang Key Laboratory of Noise and Vibration Research Institute of Acoustics Chinese Academy of Sciences University of Chinese Academy of Sciences State Key Laboratory of Acoustics Institute of Acoustics Chinese Academy of Sciences

The phenomenon of induced transparency, characterized by a high quality(Q) factor, holds significant importance in the fields of high-precision sensing, energy storage and wave manipulation. Conventional transparency systems are often constrained by the limited experimentally accessible parameter space and the lack of independent control over intrinsic parameters, thereby hindering advanced research on high-Q effects. Here we propose a virtualized coupled-oscillator system that enables reconfigurable induced transparency in the reflection spectrum. By virtually incorporating a pair of coupled oscillators into an individual acoustic meta-atom, we achieve the manipulation of induced transparency in a decoupled, wide-ranging, and elaborate manner. Exploiting the diverse evolutions across the intrinsic parameter space, we show experimentally a counter-intuitive increase in the Q-factor of the transparency window, which is attributed to the enhanced dissipation of the bright ***, a constant group delay at the center frequency is observed accompanying this evolution. Our work demonstrates an intriguing platform as well as a novel strategy to engineer high-Q induced transparency phenomenon, and paves the way towards applications in programmable acoustic sensors, filters and slow-wave devices.

关键词： induced transparency acoustic meta-atom high quality-factor scattering programmable intrinsic parameter

Regulation of sleep by astrocytes in the hypothalamic ventrolateral preoptic nucleus

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Neural Regeneration Research 2025年第4期20卷 1098-1100页

作者： Jae-Hong Kim Ruqayya Afridi Il-Sung Jang Maan Gee Lee Kyoungho suk Brain Korea 21 four KNU Convergence Educational Program of Biomedical Sciences for Creative Future Talents School of MedicineKyungpook National UniversityDaeguRepublic of Korea Department of Pharmacology School of MedicineKyungpook National UniversityDaeguRepublic of Korea Department of Pharmacology School of DentistryKyungpook National UniversityDaeguRepublic of Korea Brain Science&Engineering Institute Kyungpook National UniversityDaeguRepublic of Korea

Astrocytes are functionally dynamic cells that support neurons in multiple ways throughout an organism’s *** astrocytic regulation of neuronal activity has been increasingly recognized in recent *** are now recognized as playing a more complex role than mere bystanders in the central nervous ***,their role in regulating the sleep neurocircuitry is not well *** this perspective,we highlight the role of astrocytes in sleep modulation,with a particular focus on regulatory mechanisms related to the ventrolateral preoptic nucleus(VLPO)of the *** briefly discuss recent literature reporting the role of VLPO astrocytes in regulating sleep-associated behaviors.

关键词： sleep ventrolateral astrocytes