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Lee J, Park JS, Jeong S, Lee DH, Lim JH, Cho SG, Kwon CI, Hyun JJ, Choe JW, Cho JH, Jang SI. Prognostic Impact of Minimal Pelvic Fluid in Locally Advanced Pancreatic Cancer: A Multicenter Retrospective Study. Turk J Gastroenterol 2023; 34:1249-1256. [PMID: 37860834 PMCID: PMC10765202 DOI: 10.5152/tjg.2023.23309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 09/08/2023] [Indexed: 10/21/2023]
Abstract
BACKGROUND/AIMS Minimal pelvic fluid (MPF) is occasionally encountered on computed tomography (CT) scans during the initial staging of newly diagnosed pancreatic cancer. However, its clinical relevance has scarcely been studied. This study intends to explore the incidence of minimal pelvic fluid and its relevance in terms of survival in locally advanced pancreatic cancer (LAPC) patients. MATERIALS AND METHODS The medical records of patients with LAPC at 4 tertiary referral institutions were retrospectively reviewed from January 2005 to December 2015. Minimal pelvic fluid was defined as a fluid collection volume in the pelvic cavity of <100 mL as determined by abdominal CT. The association between the presence of MPF and patient survival was evaluated. RESULTS A total of 59 patients (male:female, 33:26; median age, 68 years; range 46-82 years) with LAPC were enrolled. Of the 59 patients, 22.0% (n = 13) had MPF, and 78.0% (n = 46) had no pelvic fluid (NPF). Baseline clinical characteristics in the 2 groups, including extent of the tumor stage, extent of spread to the lymph nodes stage, and pattern of treatments, were not significantly different. However, median overall survival was significantly less in the MPF group [9.7 months, (95% CI, 5.9-13.5)] than in the NPF group as determined by the log-rank test [16.9 months, (95% CI, 9.3-24.5)] (P = .002), and univariate and multivariate analyses showed that the presence of MPF independently predicted a poor prognosis. CONCLUSION The presence of MPF was found to be significantly associated with reduced survival and an independent poor prognostic biomarker in LAPC patients.
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Affiliation(s)
- Jungnam Lee
- Division of Gastroenterology, Department of Internal Medicine, Inha University Hospital, Inha University College of Medicine, Incheon, Republic of Korea
| | - Jin-Seok Park
- Division of Gastroenterology, Department of Internal Medicine, Inha University Hospital, Inha University College of Medicine, Incheon, Republic of Korea
- National Center of Efficacy Evaluation for the Development of Health Products Targeting Digestive Disorders (NCEED), Inha University Hospital, Incheon, Republic of Korea
| | - Seok Jeong
- Division of Gastroenterology, Department of Internal Medicine, Inha University Hospital, Inha University College of Medicine, Incheon, Republic of Korea
- National Center of Efficacy Evaluation for the Development of Health Products Targeting Digestive Disorders (NCEED), Inha University Hospital, Incheon, Republic of Korea
| | - Don Haeng Lee
- Division of Gastroenterology, Department of Internal Medicine, Inha University Hospital, Inha University College of Medicine, Incheon, Republic of Korea
- National Center of Efficacy Evaluation for the Development of Health Products Targeting Digestive Disorders (NCEED), Inha University Hospital, Incheon, Republic of Korea
- Utah-Inha DDS & Advanced Therapeutics Research Center, Incheon, Republic of Korea
| | - Jung-Hyun Lim
- Division of Gastroenterology, Department of Internal Medicine, Inha University Hospital, Inha University College of Medicine, Incheon, Republic of Korea
| | - Soon Gu Cho
- Department of Radiology, Inha University Hospital, Inha University College of Medicine, Incheon, Republic of Korea
| | - Chang Il Kwon
- Department of Internal Medicine, Digestive Disease Center, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
| | - Jong Jin Hyun
- Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea
| | - Jung Wan Choe
- Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea
| | - Jae Hee Cho
- Department of Internal Medicine, Digestive Disease Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sung Ill Jang
- Department of Internal Medicine, Digestive Disease Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
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Kim WH, Yoo JH, Yoo IK, Kwon CI, Hong SP. Effects of Mesenchymal Stem Cells Treatment on Radiation-Induced Proctitis in Rats. Yonsei Med J 2023; 64:167-174. [PMID: 36825342 PMCID: PMC9971437 DOI: 10.3349/ymj.2022.0342] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 01/03/2023] [Accepted: 01/06/2023] [Indexed: 02/25/2023] Open
Abstract
PURPOSE There are no effective treatment methods with which to control complications of radiation proctitis with fistula or recurrent bleeding following radiation treatment for prostate, cervical, or rectal cancer. Mesenchymal stem cells (MSCs) can induce immune modification, resulting in tissue repair and regeneration. Therefore, we used a rat model of radiation-induced proctitis and observed the effects of using human placenta-derived (PD) and adipose tissue-derived (AD) MSCs. MATERIALS AND METHODS Female Sprague Dawley rats were irradiated at the pelvic area with 25 Gy. We injected 1×106 cells of human PD-MSCs, human AD-MSCs, human foreskin fibroblasts, and control media into the rectal submucosa following irradiation. We sacrificed rats for pathologic evaluation. RESULTS Fibrosis on the rectum was reduced in both MSC groups, compared to the control group. Mucosal Ki-67 indices of both MSC injected groups were higher than those in the control group. Although caspase-3 positive cells in the mucosa gradually increased and decreased in the control group, those in both MSC injected groups increased rapidly and decreased thereafter. CONCLUSION We demonstrated the effects of regional MSC injection treatment for radiation-induced proctitis in rats. MSC injection reduced fibrosis and increased proliferation in rat mucosa. Human AD-MSCs and PD-MSCs had similar effectiveness.
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Affiliation(s)
- Won Hee Kim
- Digestive Disease Center, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Jun Hwan Yoo
- Digestive Disease Center, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - In Kyung Yoo
- Digestive Disease Center, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Chang Il Kwon
- Digestive Disease Center, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Sung Pyo Hong
- Digestive Disease Center, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
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Kim H, Ok JM, Cha S, Jang BG, Kwon CI, Kohama Y, Kindo K, Cho WJ, Choi ES, Jo YJ, Kang W, Shim JH, Kim KS, Kim JS. Quantum transport evidence of isolated topological nodal-line fermions. Nat Commun 2022; 13:7188. [PMID: 36418308 PMCID: PMC9684491 DOI: 10.1038/s41467-022-34845-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 11/08/2022] [Indexed: 11/25/2022] Open
Abstract
Anomalous transport responses, dictated by the nontrivial band topology, are the key for application of topological materials to advanced electronics and spintronics. One promising platform is topological nodal-line semimetals due to their rich topology and exotic physical properties. However, their transport signatures have often been masked by the complexity in band crossings or the coexisting topologically trivial states. Here we show that, in slightly hole-doped SrAs3, the single-loop nodal-line states are well-isolated from the trivial states and entirely determine the transport responses. The characteristic torus-shaped Fermi surface and the associated encircling Berry flux of nodal-line fermions are clearly manifested by quantum oscillations of the magnetotransport properties and the quantum interference effect resulting in the two-dimensional behaviors of weak antilocalization. These unique quantum transport signatures make the isolated nodal-line fermions in SrAs3 desirable for novel devices based on their topological charge and spin transport.
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Affiliation(s)
- Hoil Kim
- grid.410720.00000 0004 1784 4496Center for Artificial Low Dimensional Electronic Systems, Institute for Basic Science (IBS), Pohang, 37673 Korea ,grid.49100.3c0000 0001 0742 4007Department of Physics, Pohang University of Science and Technology (POSTECH), Pohang, 37673 Korea
| | - Jong Mok Ok
- grid.410720.00000 0004 1784 4496Center for Artificial Low Dimensional Electronic Systems, Institute for Basic Science (IBS), Pohang, 37673 Korea ,grid.49100.3c0000 0001 0742 4007Department of Physics, Pohang University of Science and Technology (POSTECH), Pohang, 37673 Korea ,grid.262229.f0000 0001 0719 8572Department of Physics, Pusan National University, Busan, 46241 Korea
| | - Seyeong Cha
- grid.15444.300000 0004 0470 5454Department of Physics, Yonsei University, Seoul, 03722 Korea
| | - Bo Gyu Jang
- grid.49100.3c0000 0001 0742 4007Department of Chemistry, Pohang University of Science and Technology (POSTECH), Pohang, 37673 Korea
| | - Chang Il Kwon
- grid.410720.00000 0004 1784 4496Center for Artificial Low Dimensional Electronic Systems, Institute for Basic Science (IBS), Pohang, 37673 Korea ,grid.49100.3c0000 0001 0742 4007Department of Physics, Pohang University of Science and Technology (POSTECH), Pohang, 37673 Korea
| | - Yoshimitsu Kohama
- grid.26999.3d0000 0001 2151 536XInstitute for Solid State Physics, University of Tokyo, Kashiwa, Chiba 277-8581 Japan
| | - Koichi Kindo
- grid.26999.3d0000 0001 2151 536XInstitute for Solid State Physics, University of Tokyo, Kashiwa, Chiba 277-8581 Japan
| | - Won Joon Cho
- grid.419666.a0000 0001 1945 5898Material Research Center, Samsung Advanced Institute of Technology (SAIT), Samsung Electronics Co., Ltd, Suwon-si, Gyeonggi-do 16678 Korea
| | - Eun Sang Choi
- grid.481548.40000 0001 2292 2549National High Magnetic Field Laboratory, Florida State University, Tallahassee, FL 32310 USA
| | - Youn Jung Jo
- grid.258803.40000 0001 0661 1556Department of Physics, Kyungpook National University, Daegu, Korea
| | - Woun Kang
- grid.255649.90000 0001 2171 7754Department of Physics, Ewha Womans University, Seoul, 03760 Republic of Korea
| | - Ji Hoon Shim
- grid.49100.3c0000 0001 0742 4007Department of Chemistry, Pohang University of Science and Technology (POSTECH), Pohang, 37673 Korea
| | - Keun Su Kim
- grid.15444.300000 0004 0470 5454Department of Physics, Yonsei University, Seoul, 03722 Korea
| | - Jun Sung Kim
- grid.410720.00000 0004 1784 4496Center for Artificial Low Dimensional Electronic Systems, Institute for Basic Science (IBS), Pohang, 37673 Korea ,grid.49100.3c0000 0001 0742 4007Department of Physics, Pohang University of Science and Technology (POSTECH), Pohang, 37673 Korea
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Yoon SY, Jeon GS, Lee SJ, Kim DJ, Kwon CI, Park MH. Embolization of pancreatic arteriovenous malformation: A case report. World J Clin Cases 2020; 8:1471-1476. [PMID: 32368539 PMCID: PMC7190961 DOI: 10.12998/wjcc.v8.i8.1471] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 04/09/2020] [Accepted: 04/16/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Pancreatic arteriovenous malformation (AVM) is a rare disease with a number of different reported treatment methods, but there are as yet no established or definite treatments for the disease.
CASE SUMMARY A 43-year-old man visited the hospital due to periumbilical pain. The patient underwent imaging study and laboratory testing for evaluation of cause. Pancreatic AVM associated with pancreatitis was suspected on computed tomography and magnetic resonance imaging. The patient was diagnosed with pancreatic AVM with pancreatitis on imaging study and angiography. Transcatheter arterial embolization with various embolic materials was performed. Follow-up computed tomography scan revealed progressive regression of AVM and improvement of pancreatitis. At two-year follow-up, the patient showed no recurrence of symptom or pancreatitis.
CONCLUSION Transcatheter arterial embolization can be considered an effective treatment modality for selective cases of pancreatic AVM.
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Affiliation(s)
- So Yeon Yoon
- Department of Radiology, CHA Bundang Medical Center, College of Medicine, CHA University, Seongnam-si 13496, Gyeonggi-do, South Korea
| | - Gyeong Sik Jeon
- Department of Radiology, CHA Bundang Medical Center, College of Medicine, CHA University, Seongnam-si 13496, Gyeonggi-do, South Korea
| | - Shin Jae Lee
- Department of Radiology, Research Institute of Radiological Science, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin-si 17046, South Korea
| | - Dae Joong Kim
- Department of Radiology, CHA Bundang Medical Center, College of Medicine, CHA University, Seongnam-si 13496, Gyeonggi-do, South Korea
| | - Chang Il Kwon
- Department of Internal Medicine, Digestive Disease Center, CHA Bundang Medical Center, College of Medicine, CHA University, Seongnam-si 13496, Gyeonggi-do, South Korea
| | - Mi Hyun Park
- Department of Radiology, Dankook University Hospital, Chungcheongnam-do 31116, South Korea
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Fukutani K, Stania R, Jung J, Schwier EF, Shimada K, Kwon CI, Kim JS, Yeom HW. Electrical Tuning of the Excitonic Insulator Ground State of Ta_{2}NiSe_{5}. Phys Rev Lett 2019; 123:206401. [PMID: 31809082 DOI: 10.1103/physrevlett.123.206401] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Indexed: 06/10/2023]
Abstract
We demonstrate that the excitonic insulator ground state of Ta_{2}NiSe_{5} can be electrically controlled by electropositive surface adsorbates. Our studies utilizing angle-resolved photoemission spectroscopy reveal intriguing wave-vector-dependent deformations of the characteristic flattop valence band of this material upon potassium adsorption. The observed band deformation indicates a reduction of the single-particle band gap due to the Stark effect near the surface. The present study provides the foundation for the electrical tuning of the many-body quantum states in excitonic insulators.
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Affiliation(s)
- Keisuke Fukutani
- Center for Artificial Low Dimensional Electronic Systems, Institute for Basic Science (IBS), Pohang 37673, Republic of Korea
| | - Roland Stania
- Center for Artificial Low Dimensional Electronic Systems, Institute for Basic Science (IBS), Pohang 37673, Republic of Korea
| | - Jiwon Jung
- Center for Artificial Low Dimensional Electronic Systems, Institute for Basic Science (IBS), Pohang 37673, Republic of Korea
- Department of Physics, Pohang University of Science and Technology (POSTECH), Pohang 37673, Republic of Korea
| | - Eike F Schwier
- Hiroshima Synchrotron Radiation Center, Hiroshima University, 2-313 Kagamiyama, Higashi-Hiroshima, Hiroshima, Japan
| | - Kenya Shimada
- Hiroshima Synchrotron Radiation Center, Hiroshima University, 2-313 Kagamiyama, Higashi-Hiroshima, Hiroshima, Japan
| | - Chang Il Kwon
- Center for Artificial Low Dimensional Electronic Systems, Institute for Basic Science (IBS), Pohang 37673, Republic of Korea
- Department of Physics, Pohang University of Science and Technology (POSTECH), Pohang 37673, Republic of Korea
| | - Jun Sung Kim
- Center for Artificial Low Dimensional Electronic Systems, Institute for Basic Science (IBS), Pohang 37673, Republic of Korea
- Department of Physics, Pohang University of Science and Technology (POSTECH), Pohang 37673, Republic of Korea
| | - Han Woong Yeom
- Center for Artificial Low Dimensional Electronic Systems, Institute for Basic Science (IBS), Pohang 37673, Republic of Korea
- Department of Physics, Pohang University of Science and Technology (POSTECH), Pohang 37673, Republic of Korea
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Lee JW, Choi SH, Chon HJ, Kim DJ, Kim G, Kwon CI, Ko KH. Robotic transduodenal ampullectomy: A novel minimally invasive approach for ampullary neoplasms. Int J Med Robot 2019; 15:e1979. [PMID: 30578741 DOI: 10.1002/rcs.1979] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 12/03/2018] [Accepted: 12/12/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND The adoption of minimally invasive surgery for transduodenal ampullectomy has been slow because of special characteristics and complexity of this procedure. METHODS Six patients underwent robotic transduodenal ampullectomy. We employed novel methods to facilitate exposure of the ampulla. RESULTS All patients completed robotic transduodenal ampullectomy, but one patient was immediately converted to robotic pancreaticoduodenectomy because of presence of invasive carcinoma on frozen biopsy. The final pathologic report revealed high-grade dysplasia in four patients, low-grade dyplasia in one, and T2N0 in one patient who converted to pancreaticoduodenectomy. There was no immediate postoperative complication or mortality. One patient was readmitted after 3 months because of stricture of the bile duct outlet. There was no recurrence over a median follow-up period of 20 months. CONCLUSION An appropriate combination of patient positioning and retraction method helps the robot surgical system to provide competent performance for sophisticated and precise manipulation of ampullary lesions.
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Affiliation(s)
- Jin Woo Lee
- Department of Surgery, CHA Bundang Medical Center, CHA University, Seongnam, South Korea
| | - Sung Hoon Choi
- Department of Surgery, CHA Bundang Medical Center, CHA University, Seongnam, South Korea
| | - Hong Jae Chon
- Medical oncology, CHA Bundang Medical Center, CHA University, Seongnam, South Korea
| | - Dae Jung Kim
- Radiolgy, CHA Bundang Medical Center, CHA University, Seongnam, South Korea
| | - Gwangil Kim
- Pathology, CHA Bundang Medical Center, CHA University, Seongnam, South Korea
| | - Chang Il Kwon
- Gastroenterology, CHA Bundang Medical Center, CHA University, Seongnam, South Korea
| | - Kwang Hyun Ko
- Gastroenterology, CHA Bundang Medical Center, CHA University, Seongnam, South Korea
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Park JM, Han YM, Jeong M, Chung MH, Kwon CI, Ko KH, Hahm KB. Synthetic 8-hydroxydeoxyguanosine inhibited metastasis of pancreatic cancer through concerted inhibitions of ERM and Rho-GTPase. Free Radic Biol Med 2017; 110:151-161. [PMID: 28602912 DOI: 10.1016/j.freeradbiomed.2017.06.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 06/02/2017] [Accepted: 06/06/2017] [Indexed: 01/10/2023]
Abstract
8-hydroxydeoxyguanosine (8-OHdG) is generated consequent to oxidative stress, but its paradoxical anti-oxidative, anti-inflammatory, and anti-mutagenic effects via Rho-GTPase inhibition were noted in various models of inflammation and cancer. Metastasis occurs through cell detachment, epithelial-mesenchymal transition (EMT), and cell migration; during these processes, changes in cell morphology are initiated through Rho-GTPase-dependent actin cytoskeleton polymerization. In this study, we explored the anti-metastatic mechanisms of 8-OHdG in Panc-1 pancreatic cancer cells. 8-OHdG inhibits cell migration by inactivating ERM and Rho-GTPase proteins, and inhibiting focal adhesion kinase (FAK) and matrix metalloproteinases (MMPs). At 15min, 8-OHdG significantly inactivated ERM (p < 0.05) and led to a significant retardation of wound healing; siERM and H1152 (ROCK inhibitor) had similar effects (p < 0.05). However, FAK inhibitor 14, DPI (NOX inhibitor), and NAC (antioxidant) significantly delayed wound healing without inhibiting ERM or CD44 (p < 0.05). In the experiments on cell migration, siERM, siCD44, DPI, and 8-OHdG significantly inhibited MMPs. 8-OHdG significantly decreased DCF-DA activation in Panc-1 pancreatic cancer cells and down-regulated NOXs (nox-1, nox-2, and nox-3). Finally, all of these anti-migration actions of 8-OHdG resulted in significant inhibition of EMT, as evidenced by the up-regulation of ZO-1 and claudin-1 and down-regulation of vimentin. We found significant inhibition of lung metastasis of Panc-1 cells by 8-OHdG. In conclusion, exogenous 8-OHdG had potent anti-metastasis effects mediated by either ERM or Rho GTPase inhibition in metastasis-prone pancreatic cancer cells.
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Affiliation(s)
- Jong-Min Park
- CHA Cancer Prevention Research Center, CHA Bio Complex, Seongnam 13488, Republic of Korea
| | - Young-Min Han
- CHA Cancer Prevention Research Center, CHA Bio Complex, Seongnam 13488, Republic of Korea
| | - Migyeong Jeong
- CHA Cancer Prevention Research Center, CHA Bio Complex, Seongnam 13488, Republic of Korea
| | - Myung Hee Chung
- Lee Gil Ya Diabetes and Cancer Institute, Gachon University School of Medicine, Incheon 21999, Republic of Korea
| | - Chang Il Kwon
- CHA University Bundang Medical Center, Digestive Disease Center, Seongnam 13496, Republic of Korea
| | - Kwang Hyun Ko
- CHA University Bundang Medical Center, Digestive Disease Center, Seongnam 13496, Republic of Korea
| | - Ki Baik Hahm
- CHA Cancer Prevention Research Center, CHA Bio Complex, Seongnam 13488, Republic of Korea; CHA University Bundang Medical Center, Digestive Disease Center, Seongnam 13496, Republic of Korea.
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Yoon H, Kwon CI, Jeong S, Lee TH, Han JH, Song TJ, Hwang JC, Kim DJ. Clinical Significance of Biliary Dilatation and Cholelithiasis after Subtotal Gastrectomy. Korean J Gastroenterol 2016; 66:33-40. [PMID: 26194127 DOI: 10.4166/kjg.2015.66.1.33] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND/AIMS The well-organized study to support that increased cholelithiasis and bile duct dilatation can occur after gastrectomy has not been reported. The aim of this study was to determine the incidence of cholelithiasis and the degree of common bile duct (CBD) dilatation in patients undergoing subtotal gastrectomy, compared to those undergoing endoscopic treatment for gastric cancer. METHODS Patients who diagnosed with gastric cancer and received treatment at six academic referral centers were investigated for the incidence and time of cholelithiasis and the degree of CBD dilatation after treatment by analysis of 5-year follow-up CTs. The operation group underwent subtotal gastrectomy without vagotomy, while in the control group endoscopic treatment was administered for gastric cancer. RESULTS A total of 802 patients were enrolled in 5-year analysis (735 patients in the operation group and 67 patients in the control group). Cholelithiasis occurred in 47 patients (6.39%) in the operation group and 3 patients (4.48%) in the control group (p=0.7909). The incidences of cholelithiasis were 4.28% in Billoth-I and 7.89% in Billoth-II (p=0.0487). The diameter of proximal CBD and distal CBD increased by 1.11 mm and 1.41 mm, respectively, in the operation group, compared to 0.4 mm and 0.38 mm, respectively, in the control group (p0.05). Patients with increased CBD dilatation more than 5 mm showed statistically significant increases in alkaline phosphatase and gamma-glutamyltransferase. CONCLUSIONS The incidence of cholelithiasis was not increased due to subtotal gastrectomy without vagotomy, but the incidence was higher after Billoth-II compared to Billoth-I. In addition, significant change in the CBD diameter was observed after subtotal gastrectomy.
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Affiliation(s)
- Harry Yoon
- Digestive Disease Center, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Chang Il Kwon
- Digestive Disease Center, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Seok Jeong
- Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea
| | - Tae Hoon Lee
- Division of Gastroenterology & Hepatology, Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Joung Ho Han
- Division of Gastroenterology, Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Tae Jun Song
- Division of Gastroenterology, Department of Internal Medicine, Inje University Ilsan Paik Hospital, Ilsan, Korea
| | - Jae Chul Hwang
- Department of Gastroenterology, Ajou University School of Medicine, Suwon, Korea
| | - Dae Jung Kim
- Department of Radiology, CHA Bundang Medical Center, CHA University, Seongnam, Korea
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Park JM, Lee S, Chung MK, Kwon SH, Kim EH, Ko KH, Kwon CI, Hahm KB. Antioxidative phytoceuticals to ameliorate pancreatitis in animal models: An answer from nature. World J Gastroenterol 2014; 20:16570-16581. [PMID: 25469025 PMCID: PMC4248200 DOI: 10.3748/wjg.v20.i44.16570] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Revised: 03/10/2014] [Accepted: 05/14/2014] [Indexed: 02/06/2023] Open
Abstract
Despite enthusiastic efforts directed at elucidating critical underlying mechanisms towards the identification of novel therapeutic targets for severe acute pancreatitis (SAP), the disease remains without a specific therapy to be executed within the first hours to days after onset of symptoms. Although earlier management for SAP should aim to either treat organ failure or reduce infectious complications, the current standard of care for the general management of AP in the first hours to days after onset of symptoms include intravenous fluid replacement, nutritional changes, and the use of analgesics with a close monitoring of vital signs. Furthermore, repeated evaluation of severity is very important, as the condition is particularly unstable in the early stages. In cases where biliary pancreatitis is accompanied by acute cholangitis or in cases where biliary stasis is suspected, an early endoscopic retrograde cholangiopancreatography is recommended. However, practice guidelines regarding the treatment of pancreatitis are suboptimal. In chronic pancreatitis, conservative management strategies include lifestyle modifications and dietary changes followed by analgesics and pancreatic enzyme supplementation. Recently, attention has been focused on phytoceuticals or antioxidants as agents that could surpass the limitations associated with currently available therapies. Because oxidative stress has been shown to play an important role in the pathogenesis of pancreatitis, antioxidants alone or combined with conventional therapy may improve oxidative-stress-induced organ damage. Interest in phytoceuticals stems from their potential use as simple, accurate tools for pancreatitis prognostication that could replace older and more tedious methods. Therefore, the use of antioxidative nutrition or phytoceuticals may represent a new direction for clinical research in pancreatitis. In this review article, recent advances in the understanding of the pathogenesis of pancreatitis are discussed and the paradigm shift underway to develop phytoceuticals and antioxidants to treat it is introduced. Despite the promise of studies evaluating the effects of antioxidants/phytoceuticals in pancreatitis, translation to the clinic has thus far been disappointing. However, it is expected that continued research will provide solid evidence to justify the use of antioxidative phytoceuticals in the treatment of pancreatitis.
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Ko KH, Han NY, Kwon CI, Lee HK, Park JM, Kim EH, Hahm KB. Recent advances in molecular imaging of premalignant gastrointestinal lesions and future application for early detection of barrett esophagus. Clin Endosc 2014; 47:7-14. [PMID: 24570878 PMCID: PMC3928495 DOI: 10.5946/ce.2014.47.1.7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2013] [Revised: 12/06/2013] [Accepted: 12/08/2013] [Indexed: 12/13/2022] Open
Abstract
Recent advances in optical molecular imaging allow identification of morphologic and biochemical changes in tissues associated with gastrointestinal (GI) premalignant lesions earlier and in real-time. This focused review series introduces high-resolution imaging modalities that are being evaluated preclinically and clinically for the detection of early GI cancers, especially Barrett esophagus and esophageal adenocarcinoma. Although narrow band imaging, autofluorescence imaging, and chromoendoscopy are currently applied for this purpose in the clinic, further adoptions of probe-based confocal laser endomicroscopy, high-resolution microendoscopy, optical coherence tomography, and metabolomic imaging, as well as imaging mass spectrometry, will lead to detection at the earliest and will guide predictions of the clinical course in the near future in a manner that is beyond current advancements in optical imaging. In this review article, the readers will be introduced to sufficient information regarding this matter with which to enjoy this new era of high technology and to confront science in the field of molecular medical imaging.
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Affiliation(s)
- Kwang Hyun Ko
- Digestive Disease Center, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Na Young Han
- Gachon University College of Pharmacy, Incheon, Korea
| | - Chang Il Kwon
- Digestive Disease Center, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Hoo Keun Lee
- Gachon University College of Pharmacy, Incheon, Korea
| | - Jong Min Park
- Cancer Prevention Research Center, CHA University, Seoul, Korea
| | - Eun Hee Kim
- Cancer Prevention Research Center, CHA University, Seoul, Korea
| | - Ki Baik Hahm
- Digestive Disease Center, CHA Bundang Medical Center, CHA University, Seongnam, Korea
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Ko KH, Kwon CI, Park SH, Han NY, Lee HK, Kim EH, Hahm KB. Application of Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Imaging Mass Spectrometry (MALDI-TOF IMS) for Premalignant Gastrointestinal Lesions. Clin Endosc 2013; 46:611-9. [PMID: 24340253 PMCID: PMC3856261 DOI: 10.5946/ce.2013.46.6.611] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2013] [Accepted: 10/11/2013] [Indexed: 02/06/2023] Open
Abstract
Imaging mass spectrometry (IMS) is currently receiving large attention from the mass spectrometric community, although its use is not yet well known in the clinic. As matrix-assisted laser desorption/ionization time-of-flight (MALDI)-IMS can show the biomolecular changes in cells as well as tissues, it can be an ideal tool for biomedical diagnostics as well as the molecular diagnosis of clinical specimens, especially aimed at the prompt detection of premalignant lesions much earlier before overt mass formation, or for obtaining histologic clues from endoscopic biopsy. Besides its use for pathologic diagnosis, MALDI-IMS is also a powerful tool for the detection and localization of drugs, proteins, and lipids in tissue. Measurement of parameters that define and control the implications, challenges, and opportunities associated with the application of IMS to biomedical tissue studies might be feasible through a deep understanding of mass spectrometry. In this focused review series, new insights into the molecular processes relevant to IMS as well as other field applications are introduced.
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Affiliation(s)
- Kwang Hyun Ko
- Digestive Disease Center, CHA Bundang Medical Center, CHA University, Seongnam, Korea
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12
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Song SH, Kim KW, Kim WH, Kwon CI, Ko KH, Hahm KB, Park PW, Hong SP. Gastrointestinal cancers in a peutz-jeghers syndrome family: a case report. Clin Endosc 2013; 46:572-5. [PMID: 24143323 PMCID: PMC3797946 DOI: 10.5946/ce.2013.46.5.572] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2012] [Revised: 11/30/2012] [Accepted: 12/05/2012] [Indexed: 01/28/2023] Open
Abstract
A 17-year-old man was diagnosed as Peutz-Jeghers syndrome (PJS) because of pigmented lip and multiple gastrointestinal polyps. He had anemia and underwent polypectomy on the duodenum and colon. His maternal family members were patients with PJS. His mother used to be screened with endoscopy to remove large polyps. One and half years later, he underwent jejunal segmental resection due to intussusceptions. He underwent endoscopic polypectomy every 2 to 3 years. When he was 23 years old, high-grade dysplasia was found in colonic polyp and his mother underwent partial pancreatectomy due to intraductal papillary mucinous carcinoma. When he was 27 years old, diffuse gastric polyps on the greater curvature of corpus expanded and grew. Therefore, wide endoscopic polypectomy was done. Histological examination revealed focal intramucosal carcinoma and low-grade dysplasia in hamartomatous polyps. We report cases of cancers occurred in first-degree relatives with PJS.
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Affiliation(s)
- Sang Hee Song
- Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea
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13
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Hong YR, Chung CW, Kim JW, Kwon CI, Ahn DH, Kwon SW, Kim SK. Hyperbilirubinemia is a significant indicator for the severity of acute appendicitis. J Korean Soc Coloproctol 2012. [PMID: 23185704 PMCID: PMC3499425 DOI: 10.3393/jksc.2012.28.5.247] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Purpose This study aims to reveal more effective clinical or laboratory markers for the diagnosis of acute appendicitis and to score the severity based on a sufficiently large number of patients with acute appendicitis. Methods We identified 1,195 patients with acute appendicitis after excluding those with other causes of hyperbilirubinemia among the 1,271 patients that underwent a laparoscopic or an open appendectomy between 2009 and 2010. A retrospective chart review of the medical records, including laboratory and histologic results, was conducted. We then analyzed the data using univariate and multivariate analyses. Results Among the 1,195 patients, a laparoscopic appendectomy was performed in 685 cases (57.32%), and an open appendectomy was performed in 510 cases (42.68%). The univariate analysis demonstrated significant differences for white blood cell count (P < 0.0001), segmented neutrophils (P = 0.0035), total bilirubin (P < 0.0001), and systemic inflammatory response syndrome (SIRS) score between groups (P < 0.0001). The multivariate analysis demonstrated that total bilirubin (odds ratio, 1.772; 95% confidence interval, 1.320 to 2.379; P = 0.0001) and SIRS score (odds ratio, 1.583; 95% confidence interval, 1.313 to 1.908; P < 0.0001) have statistically significant diagnostic value for perforated appendicitis. Conclusion Hyperbilirubinemia is a statistically significant diagnostic marker for acute appendicitis and the likelihood of perforation.
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Affiliation(s)
- Young Ran Hong
- Department of Surgery, Bundang CHA Hospital, CHA University College of Medicine, Seongnam, Korea
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14
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Affiliation(s)
- W H Kim
- Digestive Disease Center, CHA Bundang Medical Center, CHA University, Seongnam, South Korea
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Yun SP, Seon HG, Ok CS, Yoo KH, Kang MK, Kim WH, Kwon CI, Ko KH, Hwang SG, Park PW, Hong SP. Rifaximin Plus Levofloxacin-Based Rescue Regimen for the Eradication of Helicobacter pylori. Gut Liver 2012; 6:452-6. [PMID: 23170149 PMCID: PMC3493725 DOI: 10.5009/gnl.2012.6.4.452] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2012] [Revised: 03/05/2012] [Accepted: 03/11/2012] [Indexed: 12/17/2022] Open
Abstract
Background/Aims This study assessed the efficacy of a rifaximin plus levofloxacin-based rescue regimen in patients that had failed both triple and quadruple standard regimens for the eradication of Helicobacter pylori. Methods We treated patients for H. pylori between August 2009 and April 2011. The triple regimen consisted of combined treatment with amoxicillin, clarithromycin, and pantoprazole for 1 week. For failed cases, a quadruple regimen of tetracycline, metronidazole, bismuth dicitrate, and lansoprazole for 1 week was administered. The rescue regimen for persistently refractory cases was rifaximin 200 mg t.i.d., levofloxacin 500 mg q.d., and lansoprazole 15 mg b.i.d. for 1 week. Results In total, 482 patients were enrolled in this study. The eradication rates associated with the first and second regimens were 58% and 60%, respectively. Forty-seven out of 58 patients who failed with the second-line regimen received rifaximin plus levofloxacin-based third-line therapy. The eradication rate for the third regimen was 65%. The cumulative eradication rates were 58%, 85%, and 96% for each regimen, respectively. Conclusions A rifaximin plus levofloxacin-based regimen could be an alternative rescue therapy in patients with resistance to both triple and quadruple regimens for the eradication of H. pylori.
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Affiliation(s)
- Sang-Pil Yun
- Department of Internal Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
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Lee JE, Hong SP, Ahn DH, Jeon TJ, Kang MK, Kwon CI, Ko KH, Hwang SG, Park PW, Rim KS. The role of 18F-FDG PET/CT in the evaluation of gastric cancer recurrence after curative gastrectomy. Yonsei Med J 2011; 52:81-8. [PMID: 21155039 PMCID: PMC3017712 DOI: 10.3349/ymj.2011.52.1.81] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
PURPOSE (18)F-fluorodeoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) scans are frequently performed for the screening or staging of malignant tumors. This study aimed to assess the usefulness of (18)F-FDG PET/CT in detection of gastric cancer recurrence after curative gastrectomy. MATERIALS AND METHODS Eighty nine patients who had undergone curative gastrectomy due to gastric cancer and had (18)F-FDG PET/CT and contrast CT scans within 2 weeks for surveillance in asymptomatic patients (n = 11) or to clarify suspected recurrence (n = 78) were consecutively collected and retrospectively analyzed. They had clinical follow-up for at least 12 months after PET/CT and CT scans. RESULTS Fifteen of the 89 patients (16.9%) were diagnosed with recurrent gastric cancer in 21 organs. Forty one organs showed an increase in FDG uptake, and only 9 of these organs were diagnosed with recurrent gastric cancer by (18)F-FDG PET/CT. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of the (18)F-FDG PET/CT were 42.9%, 59.7%, 29.3%, 78.2%, and 57.3%, respectively. On the CT scan, 18 of 21 recurrent gastric cancers were detected, and 7 cases were in agreement with the (18)F-FDG PET/CT. The sensitivity and specificity of the CT scan were 85.8% and 87.3%, respectively, which are superior to the (18)F-FDG PET/CT. When we diagnosed a recurrence based on either (18)F-FDG PET/CT or CT scans, the sensitivity increased to 95.2% and the specificity decreased to 45.6%, when compared with the contrast CT scan alone. CONCLUSION (18)F-FDG PET/CT is an insufficient diagnostic method in detection of recurrence after curative gastrectomy, and even less accurate than contrast CT scan alone.
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Affiliation(s)
- Ji Eun Lee
- Digestive Disease Center, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Sung Pyo Hong
- Digestive Disease Center, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Dae Ho Ahn
- Digestive Disease Center, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Tae Joo Jeon
- Department of Nuclear Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Min Kyung Kang
- Digestive Disease Center, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Chang Il Kwon
- Digestive Disease Center, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Kwang Hyun Ko
- Digestive Disease Center, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Seong Gyu Hwang
- Digestive Disease Center, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Pil Won Park
- Digestive Disease Center, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Kyu Sung Rim
- Digestive Disease Center, CHA Bundang Medical Center, CHA University, Seongnam, Korea
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Kim JH, Kwon CI, Ko EH, Kim DY, Kim HY, Jung SH, Ko KH, Hong SP, Shin SJ, Hwang SG, Park PW, Rim KS. [Abnormal liver function tests in pregnancy: a single institution experience]. Korean J Gastroenterol 2007; 50:36-41. [PMID: 18172357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
BACKGROUND/AIMS Elevated transaminase levels are often detected during pregnancy. Causes are variable and difficult to differentiate. Furthermore, there is no practical guideline for abnormal transaminase levels in pregnancy. The aim of this study was to suggest a strategy for managing elevated transaminase level during pregnancy. METHODS One hundred and fifty-five women with elevated transaminase level were included from an antenatal care center between January 1, 2003 and December 31, 2004. Another 221 women with normal transaminase levels were enrolled as control group. We analyzed documented causes, changes in laboratory tests, and pregnancy outcomes. RESULTS Two groups showed no difference in baseline characteristics except the duration of pregnancy, parity, and albumin level. Of abnormal results, 39.4% occurred between 30 and 40 gestational weeks while 29% occurred between 10 and 20 gestational weeks. Common causes were hyperemesis gravidarum followed by pre-eclampsia, viral hepatitis, and HELLP syndrome. Excluding viral hepatitis, 69 patients showed abnormal results in the first two trimesters and the results were normalized during the follow-up period. AST and ALT levels were 52.9 (+/-49.6) IU/L and 83.3 (+/-77.0) IU/L during the first two trimesters in the patient group. Abnormal results during the third trimester were associated with shorter duration of pregnancy. CONCLUSIONS Elevated transaminase levels up to 3 to 4 times of the upper normal limit during the first two trimesters could be safely observed with careful history taking and hepatitis viral antigen tests. However, abnormal results in the third trimester were associated with a shorter duration of pregnancy and should be managed carefully.
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Affiliation(s)
- Jung Hyun Kim
- Departments of Internal Medicine and Obstetric, College of Medicine, Pochon CHA University, Seongnam, Korea
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Lee JH, Hong SP, Kwon CI, Phyun LH, Lee BS, Song HU, Ko KH, Hwang SG, Park PW, Rim KS, Kim S. [The efficacy of levofloxacin based triple therapy for Helicobacter pylori eradication]. Korean J Gastroenterol 2006; 48:19-24. [PMID: 16861877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
BACKGROUND/AIMS The failure rates of first and second line therapies of Helicobacter pylori (H. pylori) eradication range from 15 to 20%. This study was aimed to evaluate the efficacy and safety of levofloxacin based triple therapy compared with standard triple or quadruple therapy for H. pylori eradication in Korea. METHODS We enrolled two hundred and sixty seven patients with presence of H. pylori infection. One hundred and forty-one patients were treated with levofloxacin based triple therapy (LAP; levofloxacin, amoxicillin, proton pump inhibitor; PPI), and 126 patients were treated with standard triple therapy (CAP; clarithromycin, amoxicillin, PPI). We retreated the patients who had failed in H. pylori eradication with standard quadruple second-line therapy (MTPB; metronidazole, tetracycline, PPI, bismuth subcitrate) or levofloxacin based therapy (LAP or LCP; levofloxacin, clarithromycin, PPI). RESULTS In first line therapy of H. pylori eradication, the eradication rates of levofloxacin based triple therapy and standard triple therapy were 69.8% and 74.0% respectively (p=0.52). In second-line therapy, the eradication rate of levofloxacin based triple therapy and standard quadruple therapy were 62.5% and 40.0% respectively (p=0.34). CONCLUSIONS Levofloxacin based triple therapy is effective as standard regimen to eradicate H. pylori infection and is useful for an alternative rescue therapy as well.
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Affiliation(s)
- Ji Hyun Lee
- Department of Internal Medicine, Bundang CHA Hospital, Pochon CHA University College of Medicine, Seongnam, Korea
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