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Comparison of brush and basket cytology in differential diagnosis of bile duct stricture at endoscopic retrograde cholangiopancreatography

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Hepatobiliary & Pancreatic Diseases International 2014年第6期13卷 622-627页

作者： Ki Bae Bang Hong Joo Kim Jung Ho Park Dong Il Park Yong kyun Cho Chong Il Sohn woo kyu jeon Byung Ik Kim Department of Internal Medicine Sungkyunkwan University Kangbuk Samsung Hospital 108 Pyung-Dong Jongro-Ku Seoul 110-746 Korea

BACKGROUND： A previous report has identified a significantly higher sensitivity of cancer detection for dedicated grasping basket than brushing at endoscopic retrograde cholangiopancreato- graphy （ERCP）. This study aimed to compare the diagnostic accuracy of Geenen brush and Dormia basket cytology in the differential diagnosis of bile duct stricture. METHOD： The current study enrolled one hundred and fourteen patients who underwent ERCP with both Geenen brush and Dormia basket cytology for the differential diagnosis of bile duct stricture at our institution between January 2008 and December 2012. RESULTS： We adopted sequential performances of cytologic samplings by using initial Geenen brush and subsequent Dormia basket cytology in 59 patients and initial Dormia basket and subsequent Geenen brush cytology in 55 patients. Presampling balloon dilatations and biliary stentings for the stricture were performed in 17 （14.9%） and 107 patients （93.9%）, respectively. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of Geenen brush cytology for the diagnosis of malignant bile duct stricture were 75.0%, 100.0%, 100.0%, 66.7% and 83.3%, respectively, and those of Dormia basket cytology were 64.5%, 100.0%, 100.0%, 58.5% and 76.3%, respectively （P=0.347 and 0.827 for sensitivity and accuracy, respectively）. The good and excellent cellular yields （≥grade 2） were obtained by Geenen brush and Dormia basket cytology in 88 （77.2%） and 79 （69.3%） patients, respectively.CONCLUSION： The sensitivity, specificity and accuracy of biliary sampling with a Dormia basket are comparable to those with conventional Geenen brush cytology in the detection of malignant bile duct stricture.

关键词： bile duct stricture cholangiocarcinoma brush cytology basket cytology

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Increased intestinal macromolecular permeability and urine nitrite excretion associated with liver cirrhosis with ascites

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World Journal of Gastroenterology 2008年第24期14卷 3884-3890页

作者： Soong Lee Seung-Cheol Son Moon-Jong Han woo-Jin Kim Soo-Hyun Kim Hye-Ran Kim woo-kyu jeon Ki-Hong Park Myung-Geun Shin Department of Internal Medicine College of MedicineSeonam University and Seonam University Hospital Department of Laboratory Medicine Chonnam National University Medical School and Chonnam National University Hwasun Hospital Brain Korea 21 Project Center for Biomedical Human Resources at Chonnam National University Medical School Department of Internal Medicine Kangbuk Samsung HospitalSungkyunkwan University School of Medicine Korea Polymer Testing & Research Institute Ltd.

AIM: To determine intestinal permeability,the serum tumor necrosis factor (TNF)-α level and urine nitric oxide (NO) metabolites are altered in liver cirrhosis (LC) with or without ascites. METHODS: Fifty-three patients with LC and 26 healthy control subjects were enrolled in the study. The intestinal permeability value is expressed as the percentage of polyethylene glycol (PEG) 400 and 3350 retrieval in 8-h urine samples as determined by high performance liquid chromatography. Serum TNF-α concentrations and urine NO metabolites were determined using an enzyme-linked immunosorbent assay (ELISA) and Greiss reaction method,respectively. RESULTS: The intestinal permeability index wassignif icantly higher in patients with LC with ascites than in healthy control subjects or patients with LC without ascites (0.88 ± 0.12 vs 0.52 ± 0.05 or 0.53 ± 0.03,P < 0.05) and correlated with urine nitrite excretion (r = 0.98). Interestingly,the serum TNF-α concentra-tion was significantly higher in LC without ascites than in control subjects or in LC with ascites (198.9 ± 55.8 pg/mL vs 40.9 ± 12.3 pg/mL or 32.1 ± 13.3 pg/mL,P < 0.05). Urine nitrite excretion was significantly higher in LC with ascites than in the control subjects or in LC without ascites (1170.9 ± 28.7 μmol/L vs 903.1 ± 55.1 μmol/L or 956.7 ± 47.7 μmol/L,P < 0.05). CONCLUSION: Increased intestinal macromolecular permeability and NO is probably of importance in the pathophysiology and progression of LC with ascites,but the serum TNF-α concentration was not related to LC with ascites.

关键词：肠内渗透性肿瘤氧化氮肝硬化腹水

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Metabolic syndrome is associated with erosive esophagitis

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World Journal of Gastroenterology 2008年第35期14卷 5442-5447页

作者： Jung Ho Park Dong IL Park Hong Joo Kim Yong kyun Cho Chong IL Sohn woo kyu jeon Byung Ik Kim Department of Medicine Kangbuk Samsung HospitalSungkyunkwan University School of MedicineSeoulSouth Korea

AIM: To clarify whether insulin resistance and metabolic syndrome are risk factors for erosive esophagitis. METHODS: A case-control study was performed using the database of the Kangbuk Samsung Hospital Medical Screening Center. RESULTS: A total of 1679 cases of erosive esophagitis and 3358 randomly selected controls were included. Metabolic syndrome was diagnosed in 21% of the cases and 12% of the controls (P < 0.001). Multiple logistic regressions confirmed the association between erosive esophagitis and metabolic syndrome (Odds ratio, 1.25; 95% CI, 1.04-1.49). Among the components of metabolic syndrome, increased waist circumference, elevated serum triglyceride levels and hypertension were significant risk factors for erosive esophagitis (all P < 0.01). Furthermore, increased insulin resistance (Odds ratio, 0.91; 95% CI, 0.85-0.98) and fatty liver, as diagnosed by ultrasonography (Odds ratio, 1.39; 95% CI, 1.20-1.60), were also related to erosive esophagitis even after adjustment for a series of confounding factors. CONCLUSION: Metabolic syndrome and increased insulin resistance are associated with an increased risk of developing erosive esophagitis.

关键词：新陈代谢综合症侵蚀性食道炎胰岛素抵抗脂肪肝

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Different risk factors for advanced colorectal neoplasm in young adults

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World Journal of Gastroenterology 2016年第13期22卷 3611-3620页

作者： Ji Yeon Kim Yoon Suk Jung Jung Ho Park Hong Joo Kim Yong kyun Cho Chong Il Sohn woo kyu jeon Byung Ik Kim kyu Yong Choi Dong Il Park Comprehensive Health Care Center Korea Cancer Center Hospital Korea Institute of Radiological and Medical Sciences Department of Internal Medicine Kangbuk Samsung Hospital Sungkyunkwan University School of Medicine

AIM: To compare the risk of developing advanced colorectal neoplasm(ACRN) according to age in Koreans.METHODS: A total of 70428 Koreans from an occupational cohort who underwent a colonoscopy between 2003 and 2012 at Kangbuk Samsung Hospital were retrospectively selected. We evaluated and compared odds ratios(OR) for ACRN between the young-adults(YA < 50 years) and in the older-adults(OA ≥ 50 years). ACRN was defined as an adenoma ≥ 10 mm in diameter, adenoma with any component of villous histology, high-grade dysplasia, or invasive cancer.RESULTS: In the YA group, age(OR = 1.08, 95%CI: 1.06-1.09), male sex(OR = 1.26, 95%CI: 1.02-1.55), current smoking(OR = 1.37, 95%CI: 1.15-1.63), family history of colorectal cancer(OR = 1.46, 95%CI: 1.01-2.10), diabetes mellitus related factors(OR = 1.27, 95%CI: 1.06-1.54), obesity(OR = 1.23, 95%CI: 1.03-1.47), CEA(OR = 1.04, 95%CI: 1.01-1.09) and low-density lipoprotein-cholesterol(OR = 1.01, 95%CI: 1.01-1.02) were related with an increased risk of ACRN. However, age(OR = 1.08, 95%CI: 1.06-1.09), male sex(OR = 2.12, 95%CI: 1.68-2.68), current smoking(OR = 1.38, 95%CI: 1.12-1.71), obesity(OR = 1.34, 95%CI: 1.09-1.65) and CEA(OR = 1.05, 95%CI: 1.01-1.09) also increased the risk of ACRN in the OA group.CONCLUSION: The risks of ACRN differed based on age group. Different colonoscopic screening strategies are appropriate for particular subjects with risk factors for ACRN, even in subjects younger than 50 years.

关键词： Young-adult Advanced colorectal neoplasm Risk factors Age Metabolic abnormality

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Epidermal growth factor upregulates Skp2/Cks1 and p27^(kip1) in human extrahepatic cholangiocarcinoma cells

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World Journal of Gastroenterology 2014年第3期20卷 755-773页

作者： Ja-yeon Kim Hong Joo Kim Jung Ho Park Dong Il Park Yong kyun Cho Chong Il Sohn woo kyu jeon Byung Ik Kim Dong Hoon Kim Seoung Wan Chae Jin Hee Sohn Kangbuk Samsung Medical Research Institute Sungkyunkwan University Kangbuk Samsung Hospital Department of Internal Medicine Sungkyunkwan University Kangbuk Samsung Hospital Department of Pathology Sungkyunkwan University Kangbuk Samsung Hospital

AIM:To evaluate the expression status of S-phase kinase-associated protein 2(Skp2)/cyclin-dependent kinases regulatory subunit 1(Cks1)and p27kip1,and assess the prognostic significance of Skp2/Cks1 expression with p27kip1in patients with extrahepatic cholangiocarcinoma.METHODS:Seventy-six patients who underwent curative resection for histologically confirmed extrahepatic cholangiocarcinoma at our institution from December1994 to March 2008 were enrolled.Immunohistochemical staining for Skp2,Cks1,p27kip1,and Ki67,along with other relevant molecular biologic experiments,were performed.RESULTS:By Cox regression analyses,advanced age(>65 years),advanced AJCC tumor stage,poorly differentiated histology,and higher immunostaining intensity of Skp2 were identified as independent prognostic factors in patients with extrahepatic cholangiocarcinoma.Exogenous epidermal growth factor(EGF,especially 0.1-10 ng/mL)significantly increased the proliferation indices by MTT assay and the mRNA levels of Skp2/Cks1 and p27kip1in SNU-1196,SNU-1079,and SNU-245 cells.The protein levels of Skp2/Cks1(from nuclear lysates)and p27kip1(from cytosolic lysate)were also significantly increased in these cells.There were significant reductions in the protein levels of Skp2/Cks1and p27kip1(from nuclear lysate)after the treatment of LY294002.By chromatin immunoprecipitation assay,we found that E2F1 transcription factor directly binds to the promoter site of Skp2.CONCLUSION:Higher immunostaining intensity of Skp2/Cks1 was an independent prognostic factor for patients with extrahepatic cholangiocarcinoma.EGF upregulates the mRNA and protein levels of Skp2/Cks1and p27kip1via the PI3K/Akt pathway and direct binding of E2F1 transcription factor with the Skp2 promoter.

关键词： S-phase kinase-associated protein 2 Cyclindependen

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Pre-operative predictive factors for gallbladder cholesterol polyps using conventional diagnostic imaging

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World Journal of Gastroenterology 2008年第44期14卷 6831-6834页

作者： Ji-Hoon Choi Jung-Won Yun Yong-Sung Kim Eun-A Lee Sang-Tae Hwang Yong-kyun Cho Hong-Joo Kim Jung-Ho Park Dong-Il Park Chong-Il Sohn woo-kyu jeon Byung-Ik Kim Hyoung-Ook Kim Jun-Ho Shin Department of Internal Medicine Kangbuk Samsung HospitalSungkyunkwan University School of MedicineSeoul 110-746South Korea Department of Surgery Kangbuk Samsung HospitalSungkyunkwan University School of MedicineSeoul 110-746South Korea

AIM:To determine the clinical data that might be useful for differentiating benign from malignant gallbladder (GB) polyps by comparing radiological methods,including abdominal ultrasonography (US) and computed tomography (CT) scanning,with postoperative pathology fi ndings. METHODS:Fifty-nine patients underwent laparoscopic cholecystectomy for a GB polyp of around 10 mm. They were divided into two groups,one with cholesterol polyps and the other with non-cholesterol polyps. Clinical features such as gender,age,symptoms,size and number of polyps,the presence of a GB stone,the radiologically measured maximum diameter of the polyp by US and CT scanning,and the measurements of diameter from postoperative pathology were recorded for comparative analysis. RESULTS:Fifteen of the 41 cases with cholesterol polyps (36.6%) were detected with US but not CT scanning,whereas all 18 non-cholesterol polyps were observed using both methods. In the cholesterol polyp group,the maximum measured diameter of the polyp was smaller by CT scan than by US.Consequently,the discrepancy between those two scanning measurements was greater than for the non-cholesterol polyp group. CONCLUSION:The clinical signs indicative of a cholesterol polyp include:(1) a polyp observed by US but not observable by CT scanning,(2) a smaller diameter on the CT scan compared to US,and (3) a discrepancy in its maximum diameter between US and CT measurements. In addition,US and the CT scan had low accuracy in predicting the polyp diameter compared to that determined by postoperative pathology.

关键词：胆固醇息肉胆囊计算机断层摄影术超声检查

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Absence of enhancement in a lesion does not preclude primary central nervous system T-cell lymphoma:A case report

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World Journal of Clinical Cases 2024年第2期12卷 374-382页

作者： Chan-Seop Kim Chi-Hoon Choi kyung Sik Yi Yook Kim Jisun Lee Chang Gok woo Young Hun jeon Department of Radiology Chungbuk National University HospitalChungbuk National University College of MedicineCheongju-si 28644Chungcheongbuk-doSouth Korea Department of Pathology Chungbuk National University HospitalChungbuk National University College of MedicineCheongju-si 28644Chungcheongbuk-doSouth Korea Department of Radiology Seoul National University HosptialSeoul 03080South Korea

BACKGROUND Primary central nervous system lymphoma(PCNSL)is a non-Hodgkin lymphoma that originates in the central nervous system(CNS)and is exclusively limited to the CNS.Although most PCNSLs are diffuse large B-cell lymphomas,primary CNS T-cell lymphomas(PCNSTLs)are rare.PCNSTLs typically demonstrate some degree of enhancement on contrast-enhanced magnetic resonance imaging(MRI).To the best of our knowledge,non-enhancing PCNSTL has not been reported previously.CASE SUMMARY A 69-year-old male presented to the neurology department with complaints of mild cognitive impairment and gradual onset of left lower leg weakness over a span of two weeks.Initial MRI showed asymmetric T2-hyperintense lesions within the brain.No enhancement was observed on the contrast-enhanced T1 image.The initial diagnosis was neuro-Behçet’s disease.Despite high-dose steroid therapy,no alterations in the lesions were identified on initial MRI.The patient’s symptoms deteriorated further.An MRI performed one month after the initial scan revealed an increased lesion extent.Subsequently,brain biopsy confirmed the diagnosis of PCNSTL.The patient underwent definitive combined chemoradiotherapy.However,the patient developed bacteremia and died of septic shock approximately three months after diagnosis.CONCLUSION The absence of enhancement in the lesion did not rule out PCNSTL.A biopsy approach is advisable for pathological confirmation.

关键词： Central nervous system neoplasms Non-Hodgkin Lymphoma T-cell Lymphoma Primary central nervous system lymphoma Primary central nervous system T-cell lymphoma Case report

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Pedicled abdominal flap using deep inferior epigastric artery perforators for forearm reconstruction: A case report

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World Journal of Clinical Cases 2024年第4期12卷 828-834页

作者： Jae Hyung jeon kyung wook Kim Hong Bae jeon Department of Plastic and Reconstructive Surgery Dankook University HospitalCheonan 31116ChungnamSouth Korea Department of Orthopaedic Surgery Dankook University HospitalDankook University College of MedicineCheonan 31116ChungnamSouth Korea Department of Plastic and Reconstructive Surgery Dankook University HospitalDankook University College of MedicineCheonan 31116ChungnamSouth Korea

BACKGROUND Pedicled abdominal flaps are a widely used surgical technique for forearm reconstruction in patients with soft tissue defects.However,some drawbacks include restricted flap size,partial flap loss,and donor-site morbidity.To address these concerns,we present a case of a pedicled abdominal flap using the deep inferior epigastric artery perforators(DIEP)for forearm reconstruction in a patient with a large soft tissue defect.CASE SUMMARY A 46-year-old male patient was admitted to our hospital with forearm injury caused by a pressing machine.A 15 cm×10 cm soft tissue defect with complete rupture of the ulnar side structures of the forearm was found.One week after orthopedic management of the neurovascular injury and fractures using the first stage of Masquelet technique,the patient was referred to the plastic and recon-structive surgery department for wound coverage.Surgical debridement and negative-pressure wound therapy revealed a 20 cm×15 cm soft tissue defect.A pedicle abdominal flap with the DIEP was used to cover the defect.Three weeks later,the flap was detached from the abdomen,and the abdominal defect was directly closed.Subsequently,the second stage of Masquelet technique was performed at the fracture site at week 10.Finally,all donor and recipient sites healed without complications,such as flap dehiscence,infection,hematoma,or necrosis.Fracture site osteosynthesis was achieved without complications.CONCLUSION Pedicled abdominal flap using the DIEP provides a reliable option for forearm reconstruction in patients with large soft tissue defects.

关键词： Forearm injury Open fracture reduction Perforator flap Deep inferior epigastric artery perforators Case report

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Design of multifunctional polymeric binders in silicon anodes for lithium‐ion batteries

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Carbon Energy 2024年第4期6卷 140-163页

作者： Masytha Nuzula Ramdhiny Ju‐Won jeon Department of Chemistry Kookmin UniversitySeoulRepublic of Korea Correspondence

Silicon(Si)is a promising anode material for lithium‐ion batteries(LIBs)owing to its tremendously high theoretical storage capacity(4200 mAh g−1),which has the potential to elevate the energy of LIBs.However,Si anodes exhibit severe volume change during lithiation/delithiation processes,resulting in anode pulverization and delamination with detrimental growth of solid electrolyte interface layers.As a result,the cycling stability of Si anodes is insufficient for commercialization in LIBs.Polymeric binders can play critical roles in Si anodes by affecting their cycling stability,although they occupy a small portion of the electrodes.This review introduces crucial factors influencing polymeric binders'properties and the electrochemical performance of Si anodes.In particular,we emphasize the structure–property relationships of binders in the context of molecular design strategy,functional groups,types of interactions,and functionalities of binders.Furthermore,binders with additional functionalities,such as electrical conductivity and self‐healability,are extensively discussed,with an emphasis on the binder design principle.

关键词： conductivity lithium‐ion batteries molecular interactions polymeric binders self‐healability Si anodes

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Potential reduction in carbon fixation capacity under climate change in a Pinus koraiensis forest

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Forest Ecosystems 2024年第2期11卷 152-161页

作者： Dong Kook woo Department of Civil Engineering Keimyung UniversityDaegu42601Republic of Korea

There has been an increasing recognition of the crucial role of forests, responsible for sequestering atmospheric CO_(2), as a moral imperative for mitigating the pace of climate change. The complexity of evaluating climate change impacts on forest carbon and water dynamics lies in the diverse acclimations of forests to changing environments. In this study, we assessed two of the most common acclimation traits, namely leaf area index and the maximum rate of carboxylation(V_(cmax)), to explore the potential acclimation pathways of Pinus koraiensis under climate change. We used a mechanistic and process-based ecohydrological model applied to a P. koraiensis forest in Mt. Taehwa, South Korea. We conducted numerical investigations into the impacts of(i) Shared Socioeconomic Pathways 2–4.5(SSP2-4.5) and 5–8.5(SSP5-8.5),(ii) elevated atmospheric CO_(2) and temperature, and(iii) acclimations of leaf area index and V_(cmax)on the carbon and water dynamics of P. koraiensis. We found that there was a reduction in net primary productivity(NPP) under the SSP2-4.5 scenario, but not under SSP5-8.5, compared to the baseline, due to an imbalance between increases in atmospheric CO_(2) and temperature. A decrease in leaf area index and an increase in V_(cmax)of P. koraiensis were expected if acclimations were made to reduce its leaf temperature. Under such acclimation pathways, it would be expected that the well-known CO_(2) fertilizer effects on NPP would be attenuated.

关键词： Climate change NEP Pinus koraiensis Warming Acclimation

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