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Seo SY, Lee ST, Kim SK, Chun HJ, Song GA, Lee DH, Kim JJ, Kim JI, Lee YC, Kim TN, Jee SR, Park SY, Kim JG, Park JJ, Kim SG, Park JM, Park JH, Park SJ, Lee OY. Efficacy and safety of CKD-495 in acute and chronic gastritis: A Phase III superiority clinical trial. Medicine (Baltimore) 2023; 102:e35926. [PMID: 38065906 PMCID: PMC10713194 DOI: 10.1097/md.0000000000035926] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 10/12/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Despite the availability of numerous treatment options, many patients with gastritis experience only partial symptom relief. CKD-495, a newly developed product with the active ingredient extracted from Cinnamomum cassia Presl., has demonstrated anti-inflammatory and antioxidant activity in vitro and an in vivo protective effect against gastric damage by stimulating mucus secretion. This study compared the efficacy and safety of CKD-495 with Artemisiae argyi folium (AAF) for the treatment of acute and chronic gastritis. AAF, a gastric mucosa protective agent that promotes gastric mucosa regeneration, has been used clinically for about 20 years. METHODS This phase III multicenter, randomized, double-blind, parallel-group trial (ClinicalTrials.gov; NCT04255589) assigned 242 patients with endoscopically-proven gastric mucosal erosions to receive CKD-495 75 mg (n = 122) or AAF 60 mg (n = 120), respectively, with placebo (for double-blind purposes) 3 times a day for 2 weeks. The primary efficacy endpoint was the erosion improvement rate. Secondary endpoints included erosion cure rates, and improvement rates for edema, redness, hemorrhage, and gastrointestinal (GI) symptoms. Drug-related adverse events were evaluated. RESULTS The erosion improvement rate was significantly higher in the CKD-495 group than in the AAF group for both the full analysis set (55.9% vs 39.4%, P = .0063) and per-protocol set (54.6% vs 38.2%, P = .0084). In addition, the erosion improvement rate in patients with acute or chronic gastritis showed that the CKD-495 group had better improvement of erosion than the AAF group, especially in patients with chronic gastritis. Analysis of secondary endpoints, which included erosion cure rate and the improvement rates of edema, redness, hemorrhage, and GI symptoms, showed that the CKD-495 group was more effective than the AAF group. There were no significant between-group differences in safety profiles. No serious adverse events or adverse drug reactions occurred. CONCLUSIONS These results demonstrate that CKD-495 75 mg is superior to AAF 60 mg in terms of the endoscopic improvement rate of erosions in patients with acute or chronic gastritis. This new mucoprotective agent, CKD-495, can be considered the therapy of choice for symptomatic relief and healing of gastritis.
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Affiliation(s)
- Seung Young Seo
- Department of Internal Medicine, Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea
| | - Soo Teik Lee
- Department of Internal Medicine, Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea
| | - Sung Kook Kim
- Department of Internal Medicine, Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu, Korea
| | - Hoon Jai Chun
- Department of Internal Medicine, Korea University College of Medicine Anam Hospital, Seoul, Korea
| | - Geun Am Song
- Department of Internal Medicine, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
| | - Dong Ho Lee
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoungnam Korea
| | - Jae Jun Kim
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jin Il Kim
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Yeouido St. Mary’s Hospital, Seoul, Korea
| | - Young Chan Lee
- Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Tae Nyeun Kim
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Sam Ryong Jee
- Department of Internal Medicine, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Seon-Young Park
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Jae Gyu Kim
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Jong-Jae Park
- Department of Internal Medicine, Korea University College of Medicine Guro Hospital, Seoul, Korea
| | - Sang Gyun Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Jae Myung Park
- Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jung Ho Park
- Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Shin Jung Park
- Chong Kun Dang Research Institute, Chong Kun Dang Pharmaceutical Corporation, Seoul, Korea
| | - Oh Young Lee
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
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Robinson ML, Hahn PG, Inouye BD, Underwood N, Whitehead SR, Abbott KC, Bruna EM, Cacho NI, Dyer LA, Abdala-Roberts L, Allen WJ, Andrade JF, Angulo DF, Anjos D, Anstett DN, Bagchi R, Bagchi S, Barbosa M, Barrett S, Baskett CA, Ben-Simchon E, Bloodworth KJ, Bronstein JL, Buckley YM, Burghardt KT, Bustos-Segura C, Calixto ES, Carvalho RL, Castagneyrol B, Chiuffo MC, Cinoğlu D, Cinto Mejía E, Cock MC, Cogni R, Cope OL, Cornelissen T, Cortez DR, Crowder DW, Dallstream C, Dáttilo W, Davis JK, Dimarco RD, Dole HE, Egbon IN, Eisenring M, Ejomah A, Elderd BD, Endara MJ, Eubanks MD, Everingham SE, Farah KN, Farias RP, Fernandes AP, Fernandes GW, Ferrante M, Finn A, Florjancic GA, Forister ML, Fox QN, Frago E, França FM, Getman-Pickering AS, Getman-Pickering Z, Gianoli E, Gooden B, Gossner MM, Greig KA, Gripenberg S, Groenteman R, Grof-Tisza P, Haack N, Hahn L, Haq SM, Helms AM, Hennecke J, Hermann SL, Holeski LM, Holm S, Hutchinson MC, Jackson EE, Kagiya S, Kalske A, Kalwajtys M, Karban R, Kariyat R, Keasar T, Kersch-Becker MF, Kharouba HM, Kim TN, Kimuyu DM, Kluse J, Koerner SE, Komatsu KJ, Krishnan S, Laihonen M, Lamelas-López L, LaScaleia MC, Lecomte N, Lehn CR, Li X, Lindroth RL, LoPresti EF, Losada M, Louthan AM, Luizzi VJ, Lynch SC, Lynn JS, Lyon NJ, Maia LF, Maia RA, Mannall TL, Martin BS, Massad TJ, McCall AC, McGurrin K, Merwin AC, Mijango-Ramos Z, Mills CH, Moles AT, Moore CM, Moreira X, Morrison CR, Moshobane MC, Muola A, Nakadai R, Nakajima K, Novais S, Ogbebor CO, Ohsaki H, Pan VS, Pardikes NA, Pareja M, Parthasarathy N, Pawar RR, Paynter Q, Pearse IS, Penczykowski RM, Pepi AA, Pereira CC, Phartyal SS, Piper FI, Poveda K, Pringle EG, Puy J, Quijano T, Quintero C, Rasmann S, Rosche C, Rosenheim LY, Rosenheim JA, Runyon JB, Sadeh A, Sakata Y, Salcido DM, Salgado-Luarte C, Santos BA, Sapir Y, Sasal Y, Sato Y, Sawant M, Schroeder H, Schumann I, Segoli M, Segre H, Shelef O, Shinohara N, Singh RP, Smith DS, Sobral M, Stotz GC, Tack AJM, Tayal M, Tooker JF, Torrico-Bazoberry D, Tougeron K, Trowbridge AM, Utsumi S, Uyi O, Vaca-Uribe JL, Valtonen A, van Dijk LJA, Vandvik V, Villellas J, Waller LP, Weber MG, Yamawo A, Yim S, Zarnetske PL, Zehr LN, Zhong Z, Wetzel WC. Plant size, latitude, and phylogeny explain within-population variability in herbivory. Science 2023; 382:679-683. [PMID: 37943897 DOI: 10.1126/science.adh8830] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 09/27/2023] [Indexed: 11/12/2023]
Abstract
Interactions between plants and herbivores are central in most ecosystems, but their strength is highly variable. The amount of variability within a system is thought to influence most aspects of plant-herbivore biology, from ecological stability to plant defense evolution. Our understanding of what influences variability, however, is limited by sparse data. We collected standardized surveys of herbivory for 503 plant species at 790 sites across 116° of latitude. With these data, we show that within-population variability in herbivory increases with latitude, decreases with plant size, and is phylogenetically structured. Differences in the magnitude of variability are thus central to how plant-herbivore biology varies across macroscale gradients. We argue that increased focus on interaction variability will advance understanding of patterns of life on Earth.
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Affiliation(s)
- M L Robinson
- Department of Entomology, Michigan State University, East Lansing, MI, USA
- Department of Biology, Utah State University, Logan, UT, USA
| | - P G Hahn
- Entomology and Nematology Department, University of Florida, Gainesville, FL, USA
| | - B D Inouye
- Department of Biological Science, Florida State University, Tallahassee, FL, USA
| | - N Underwood
- Department of Biological Science, Florida State University, Tallahassee, FL, USA
| | - S R Whitehead
- Department of Biological Sciences, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - K C Abbott
- Department of Biology, Case Western Reserve University, Cleveland, OH, USA
| | - E M Bruna
- Center for Latin American Studies, University of Florida, Gainesville, FL, USA
- Department of Wildlife Ecology and Conservation, University of Florida, Gainesville, FL, USA
| | - N I Cacho
- Instituto de Biología, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - L A Dyer
- Biology Department, University of Nevada, Reno, Reno, NV, USA
| | - L Abdala-Roberts
- Departamento de Ecología Tropical, Universidad Autónoma de Yucatán, Mérida, Yucatán, México
| | - W J Allen
- Bio-Protection Research Centre, University of Canterbury, Christchurch, New Zealand
| | - J F Andrade
- Departamento de Sistemática e Ecologia Universidade Federal da Paraíba, João Pessoa, Brazil
| | - D F Angulo
- Centro de Investigación Científica de Yucatán, Departamento de Recursos Naturales, Mérida, Yucatán, México
| | - D Anjos
- Instituto de Biologia, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil
| | - D N Anstett
- Department of Entomology, Michigan State University, East Lansing, MI, USA
- Plant Resilience Institute, Michigan State University, East Lansing, MI, USA
- Department of Plant Biology, Michigan State University, East Lansing, MI, USA
| | - R Bagchi
- Department of Ecology and Evolutionary Biology, University of Connecticut, Storrs, CT, USA
| | - S Bagchi
- Centre for Ecological Sciences, Indian Institute of Science, Bangalore, Karnataka, India
| | - M Barbosa
- Department of Genetics, Ecology and Evolution, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - S Barrett
- Department of Biodiversity Conservation & Attractions Western Australia, Albany, Western Australia, Australia
| | - C A Baskett
- Institute of Science and Technology Austria, Klosterneuburg, Austria
| | - E Ben-Simchon
- Department of Natural Resources, Institute of Plant Sciences, Agricultural Research Organization - Volcani Institute, Rishon Le Tzion, Israel
- Robert H. Smith Faculty of Agriculture, Food, and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
| | - K J Bloodworth
- Department of Biology, University of North Carolina Greensboro, Greensboro, NC, USA
| | - J L Bronstein
- Department of Ecology and Evolutionary Biology, University of Arizona, Tucson, AZ, USA
| | - Y M Buckley
- School of Natural Sciences, Zoology, Trinity College Dublin, Dublin, Ireland
| | - K T Burghardt
- Department of Entomology, University of Maryland, College Park, MD, USA
| | - C Bustos-Segura
- Institute of Biology, University of Neuchatel, Neuchatel, Switzerland
| | - E S Calixto
- Entomology and Nematology Department, University of Florida, Gainesville, FL, USA
| | - R L Carvalho
- Institute of Advanced Studies, University of São Paulo, São Paulo, Brazil
| | | | - M C Chiuffo
- Grupo de Ecología de Invasiones, INIBIOMA, Universidad Nacional del Comahue, CONICET, San Carlos de Bariloche, Río Negro, Argentina
| | - D Cinoğlu
- Department of Integrative Biology, The University of Texas at Austin, Austin, TX, USA
| | - E Cinto Mejía
- Department of Entomology, Michigan State University, East Lansing, MI, USA
| | - M C Cock
- Facultad de Ciencias Exactas y Naturales, Instituto de Ciencias de la Tierra y Ambientales de La Pampa, Santa Rosa, La Pampa, Argentina
| | - R Cogni
- Department of Ecology, University of São Paulo, São Paulo, Brazil
| | - O L Cope
- Department of Entomology, Michigan State University, East Lansing, MI, USA
- Department of Biology, Whitworth University, Spokane, WA, USA
| | - T Cornelissen
- Department of Genetics, Ecology and Evolution, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - D R Cortez
- Department of Biology, California State University San Bernardino, San Bernardino, CA, USA
| | - D W Crowder
- Department of Entomology, Washington State University, Pullman, WA, USA
| | - C Dallstream
- Department of Biology, McGill University, Montreal, Quebec, Canada
| | - W Dáttilo
- Red de Ecoetología, Instituto de Ecología AC, Xalapa, Veracruz, Mexico
| | - J K Davis
- Department of Entomology, Cornell University, Ithaca, NY, USA
| | - R D Dimarco
- Department of Biology and Biochemistry, University of Houston, Houston, TX, USA
- Grupo de Ecología de Poblaciones de Insectos, IFAB, San Carlos de Bariloche, Río Negro, Argentina
| | - H E Dole
- Department of Entomology, Michigan State University, East Lansing, MI, USA
| | - I N Egbon
- Department of Animal and Environmental Biology, University of Benin, Benin City, Nigeria
| | - M Eisenring
- Forest Entomology, Swiss Federal Research Institute WSL, Birmensdorf, Switzerland
| | - A Ejomah
- Department of Animal and Environmental Biology, University of Benin, Benin City, Nigeria
| | - B D Elderd
- Department of Biological Sciences, Louisiana State University, Baton Rouge, LA, USA
| | - M-J Endara
- Grupo de Investigación en Ecología y Evolución en los Trópicos-EETROP, Universidad de las Américas, Quito, Ecuador
| | - M D Eubanks
- Department of Entomology, Texas A&M University, College Station, TX, USA
| | - S E Everingham
- Institute of Plant Sciences, University of Bern, Bern, Switzerland
- Evolution & Ecology Research Centre, University of New South Wales Sydney, Sydney, Australia
| | - K N Farah
- Department of Biology, Washington University in St. Louis, St. Louis, MO, USA
| | - R P Farias
- Instituto de Biologia, Universidade Federal da Bahia, Salvador, Bahia, Brasil
| | - A P Fernandes
- Department of Botany, Ganpat Parsekar College of Education Harmal, Pernem, Goa, India
| | - G W Fernandes
- Department of Genetics, Ecology and Evolution, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
- Knowledge Center for Biodiversity, Brazil
| | - M Ferrante
- Faculty of Agricultural Sciences and Environment, University of the Azores, Ponta Delgada, Portugal
- Department of Crop Sciences, University of Göttingen, Göttingen, Germany
| | - A Finn
- School of Natural Sciences, Zoology, Trinity College Dublin, Dublin, Ireland
| | - G A Florjancic
- Department of Biological Sciences, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - M L Forister
- Biology Department, University of Nevada, Reno, Reno, NV, USA
| | - Q N Fox
- Department of Biology, Washington University in St. Louis, St. Louis, MO, USA
| | - E Frago
- CIRAD, UMR CBGP, INRAE, Institut Agro, IRD, Université Montpellier, Montpellier, France
| | - F M França
- School of Biological Sciences, University of Bristol, Bristol, UK
- Programa de Pós-Graduação em Ecologia, Universidade Federal do Pará, Belém, Pará, Brasil
| | | | - Z Getman-Pickering
- Department of Mechanical and Industrial Engineering, University of Massachusetts Amherst, Amherst, MA, USA
| | - E Gianoli
- Departamento de Biología, Universidad de La Serena, La Serena, Chile
| | - B Gooden
- CSIRO Black Mountain Laboratories, CSIRO Health and Biosecurity, Canberra, Australia
| | - M M Gossner
- Forest Entomology, Swiss Federal Research Institute WSL, Birmensdorf, Switzerland
- Institute of Terrestrial Ecosystems, Department of Environmental Systems Science, ETH Zurich, Zurich, Switzerland
| | - K A Greig
- Department of Integrative Biology, The University of Texas at Austin, Austin, TX, USA
| | - S Gripenberg
- School of Biological Sciences, University of Reading, Reading, UK
| | - R Groenteman
- Manaaki Whenua - Landcare Research, Lincoln, New Zealand
| | - P Grof-Tisza
- Institute of Biology, University of Neuchatel, Neuchatel, Switzerland
| | - N Haack
- Independent Institute for Environmental Issues, Halle, Germany
| | - L Hahn
- Molecular Evolution and Systematics of Animals, University of Leipzig, Leipzig, Germany
| | - S M Haq
- Wildlife Crime Control Division, Wildlife Trust of India, Noida, Uttar Pradesh, India
| | - A M Helms
- Department of Entomology, Texas A&M University, College Station, TX, USA
| | - J Hennecke
- Systematic Botany and Functional Biodiversity, Leipzig University, Leipzig, Germany
- German Centre for Integrative Biodiversity Research (iDiv), Leipzig, Germany
| | - S L Hermann
- Department of Entomology, The Pennsylvania State University, University Park, PA, USA
| | - L M Holeski
- Department of Biological Sciences and Center for Adaptive Western Landscapes, Northern Arizona University, Flagstaff, AZ, USA
| | - S Holm
- Department of Environmental and Biological Sciences, University of Eastern Finland, Joensuu, Finland
- Department of Zoology, University of Tartu, Tartu, Estonia
| | - M C Hutchinson
- Department of Life and Environmental Sciences, University of California, Merced, Merced, CA, USA
| | - E E Jackson
- School of Biological Sciences, University of Reading, Reading, UK
| | - S Kagiya
- Field Science Center for Northern Biosphere, Hokkaido University, Sapporo, Hokkaido, Japan
| | - A Kalske
- Department of Biology, University of Turku, Turku, Finland
| | - M Kalwajtys
- Department of Entomology, Michigan State University, East Lansing, MI, USA
| | - R Karban
- Department of Entomology and Nematology, University of California Davis, Davis, CA, USA
| | - R Kariyat
- Department of Entomology and Plant Pathology, University of Arkansas, Fayetteville, AR, USA
| | - T Keasar
- Department of Biology and the Environment, University of Haifa - Oranim, Oranim, Tivon, Israel
| | - M F Kersch-Becker
- Department of Entomology, The Pennsylvania State University, University Park, PA, USA
| | - H M Kharouba
- Department of Biology, University of Ottawa, Ottawa, Ontario, Canada
| | - T N Kim
- Department of Entomology, Kansas State University, Manhattan, KS, USA
| | - D M Kimuyu
- Department of Natural Resources, Karatina University, Karatina, Kenya
| | - J Kluse
- Department of Biological Sciences, Louisiana State University, Baton Rouge, LA, USA
| | - S E Koerner
- Department of Biology, University of North Carolina Greensboro, Greensboro, NC, USA
| | - K J Komatsu
- Department of Biology, University of North Carolina Greensboro, Greensboro, NC, USA
- Smithsonian Environmental Research Center, Edgewater, MD, USA
| | - S Krishnan
- Center for Sustainable Future, Amrita University and EIACP RP, Amrita Viswa Vidyapeetham, Coimbatore, India
| | - M Laihonen
- Biodiversity Unit, University of Turku, Turku, Finland
| | - L Lamelas-López
- Faculty of Agricultural Sciences and Environment, University of the Azores, Ponta Delgada, Portugal
| | - M C LaScaleia
- Department of Ecology and Evolutionary Biology, University of Connecticut, Storrs, CT, USA
| | - N Lecomte
- Canada Research Chair in Polar and Boreal Ecology, Department of Biology and Centre d'Études Nordiques, Université de Moncton, Moncton, Canada
| | - C R Lehn
- Biological Sciences Course, Instituto Federal Farroupilha, Panambi, RS, Brazil
| | - X Li
- College of Resources and Environmental sciences, Jilin Agricultural University, Changchun, China
| | - R L Lindroth
- Department of Entomology, University of Wisconsin-Madison, Madison, WI, USA
| | - E F LoPresti
- Department of Biological Sciences, University of South Carolina, Columbia, SC, USA
| | - M Losada
- Department of Soil Science and Agricultural Chemistry, University of Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
| | - A M Louthan
- Division of Biology, Kansas State University, Manhattan, KS, USA
| | - V J Luizzi
- Department of Ecology and Evolutionary Biology, University of Arizona, Tucson, AZ, USA
| | - S C Lynch
- Division of Biology, Kansas State University, Manhattan, KS, USA
| | - J S Lynn
- Department of Biological Sciences, University of Bergen, Bergen, Norway
- Department of Earth and Environmental Sciences, University of Manchester, Manchester, UK
| | - N J Lyon
- Department of Entomology, Michigan State University, East Lansing, MI, USA
| | - L F Maia
- Bio-Protection Research Centre, University of Canterbury, Christchurch, New Zealand
- School of Biological Sciences, University of Bristol, Bristol, UK
| | - R A Maia
- Department of Genetics, Ecology and Evolution, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - T L Mannall
- Institute of Plant Sciences, University of Bern, Bern, Switzerland
| | - B S Martin
- Department of Plant Biology, Michigan State University, East Lansing, MI, USA
- Ecology, Evolution, and Behavior Program, Michigan State University, East Lansing, MI, USA
| | - T J Massad
- Department of Scientific Services, Gorongosa National Park, Sofala, Mozambique
| | - A C McCall
- Biology Department, Denison University, Granville, OH, USA
| | - K McGurrin
- Department of Entomology, University of Maryland, College Park, MD, USA
| | - A C Merwin
- Department of Biology and Geology, Baldwin Wallace University, Berea, OH, USA
| | - Z Mijango-Ramos
- Department of Integrative Biology, The University of Texas at Austin, Austin, TX, USA
| | - C H Mills
- Evolution & Ecology Research Centre, University of New South Wales Sydney, Sydney, Australia
| | - A T Moles
- Evolution & Ecology Research Centre, University of New South Wales Sydney, Sydney, Australia
| | - C M Moore
- Department of Biology, Colby College, Waterville, ME, USA
| | - X Moreira
- Misión Biológica de Galicia, Consejo Superior de Investigaciones Científicas, Pontevedra, Galicia, Spain
| | - C R Morrison
- Department of Integrative Biology, The University of Texas at Austin, Austin, TX, USA
| | - M C Moshobane
- South African National Biodiversity Institute, Pretoria National Botanical Garden, Brummeria, Silverton, South Africa
- Centre for Functional Biodiversity, University of KwaZulu-Natal, Scottsville, Pietermaritzburg, South Africa
| | - A Muola
- Division of Biotechnology and Plant Health, Norwegian Institute of Bioeconomy Research, Tromsø, Norway
| | - R Nakadai
- Faculty of Environment and Information Sciences, Yokohama National University, Yokohama, Kanagawa, Japan
| | - K Nakajima
- Insitute of Science and Engineering, Chuo University, Tokyo, Japan
- Institute of Cave Research, Shimohei-guun, Iwate Prefecture, Japan
| | - S Novais
- Red de Interacciones Multitróficas, Instituto de Ecología A.C., Xalapa, Veracruz, Mexico
| | - C O Ogbebor
- Nigerian Institute for Oil Palm Research, Benin City, Edo State, Nigeria
| | - H Ohsaki
- Department of Biological Sciences, Hirosaki University, Hirosaki, Aomori, Japan
| | - V S Pan
- Ecology, Evolution, and Behavior Program, Michigan State University, East Lansing, MI, USA
- Department of Integrative Biology, Michigan State University, East Lansing, MI, USA
| | - N A Pardikes
- Department of Biology, Utah State University, Logan, UT, USA
| | - M Pareja
- Departamento de Biologia Animal, Universidade Estadual de Campinas, Campinas, Brazil
| | - N Parthasarathy
- Department of Ecology and Evironmental Sciences, Pondicherry University, Puducherry, India
| | | | - Q Paynter
- Manaaki Whenua - Landcare Research, Auckland, New Zealand
| | - I S Pearse
- U.S. Geological Survey, Fort Collins Science Center, Fort Collins, CO, USA
| | - R M Penczykowski
- Department of Biology, Washington University in St. Louis, St. Louis, MO, USA
| | - A A Pepi
- Department of Biology, Tufts University, Medford, MA, USA
| | - C C Pereira
- Department of Genetics, Ecology and Evolution, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - S S Phartyal
- School of Ecology & Environment Studies, Nalanda University, Rajgir, India
| | - F I Piper
- Millennium Nucleus of Patagonian Limit of Life and Instituto de Ciencias Biológicas, Universidad de Talca, Talca, Chile
- Institute of Ecology and Biodiversity, Ñuñoa, Santiago
| | - K Poveda
- Department of Entomology, Cornell University, Ithaca, NY, USA
| | - E G Pringle
- Biology Department, University of Nevada, Reno, Reno, NV, USA
| | - J Puy
- School of Natural Sciences, Zoology, Trinity College Dublin, Dublin, Ireland
- Estación Biológica de Doñana, Consejo Superior de Investigaciones Científicas, Sevilla, Spain
| | - T Quijano
- Departamento de Ecología Tropical, Universidad Autónoma de Yucatán, Mérida, Yucatán, México
| | - C Quintero
- INIBIOMA, CONICET - Universidad Nacional del Comahue, San Carlos de Bariloche, Río Negro, Argentina
| | - S Rasmann
- Institute of Biology, University of Neuchatel, Neuchatel, Switzerland
| | - C Rosche
- German Centre for Integrative Biodiversity Research (iDiv), Leipzig, Germany
- Institute of Geobotany and Botanical Garden, Martin Luther University Halle-Wittenberg, Halle, Germany
| | - L Y Rosenheim
- Department of Entomology and Nematology, University of California Davis, Davis, CA, USA
| | - J A Rosenheim
- Department of Entomology and Nematology, University of California Davis, Davis, CA, USA
| | - J B Runyon
- Rocky Mountain Research Station, USDA Forest Service, Bozeman, MT, USA
| | - A Sadeh
- Department of Natural Resources, Newe Ya'ar Research Center, Volcani Institute, Ramat Yishay, Israel
| | - Y Sakata
- Department of Biological Environment, Akita Prefectural University, Shimoshinjyo-Nakano, Akita, Japan
| | - D M Salcido
- Biology Department, University of Nevada, Reno, Reno, NV, USA
| | - C Salgado-Luarte
- Instituto de Investigación Multidisciplinario en Ciencia y Tecnología, Universidad de La Serena, La Serena, Chile
| | - B A Santos
- Departamento de Sistemática e Ecologia Universidade Federal da Paraíba, João Pessoa, Brazil
| | - Y Sapir
- The Botanic Garden, School of Plant Sciences and Food Security, Faculty of Life Science, Tel Aviv University, Tel Aviv, Israel
| | - Y Sasal
- INIBIOMA, CONICET - Universidad Nacional del Comahue, San Carlos de Bariloche, Río Negro, Argentina
| | - Y Sato
- Department of Evolutionary Biology and Environmental Studies, University of Zurich, Zurich, Switzerland
| | - M Sawant
- Department of Ecology, University of Pune, Maharashtra, India
| | - H Schroeder
- Department of Entomology, Cornell University, Ithaca, NY, USA
| | - I Schumann
- Department of Human Genetics, University of Leipzig, Leipzig, Germany
| | - M Segoli
- Mitrani Department of Desert Ecology, Blaustein Institutes for Desert Research, Ben-Gurion University of the Negev, Midreshet Ben-Gurion, Israel
| | - H Segre
- Department of Natural Resources, Institute of Plant Sciences, Agricultural Research Organization - Volcani Institute, Rishon Le Tzion, Israel
- Robert H. Smith Faculty of Agriculture, Food, and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
- Department of Natural Resources, Newe Ya'ar Research Center, Volcani Institute, Ramat Yishay, Israel
| | - O Shelef
- Department of Natural Resources, Institute of Plant Sciences, Agricultural Research Organization - Volcani Institute, Rishon Le Tzion, Israel
| | - N Shinohara
- Graduate School of Life Sciences, Tohoku University, Sendai, Japan
| | - R P Singh
- McGuire Center for Lepidoptera and Biodiversity, Florida Museum of Natural History, University of Florida, Gainesville, FL, USA
| | - D S Smith
- Department of Biology, California State University San Bernardino, San Bernardino, CA, USA
| | - M Sobral
- Department of Soil Science and Agricultural Chemistry, University of Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
| | - G C Stotz
- Department of Plant and Environmental Sciences, Clemson University, Clemson, SC, USA
| | - A J M Tack
- Department of Ecology, Environment and Plant Sciences, Stockholm University, Stockholm, Sweden
| | - M Tayal
- Department of Plant and Environmental Sciences, Clemson University, Clemson, SC, USA
| | - J F Tooker
- Department of Entomology, The Pennsylvania State University, University Park, PA, USA
| | - D Torrico-Bazoberry
- Laboratorio de Comportamiento Animal y Humano, Centro de Investigación en Complejidad Social, Universidad del Desarrollo, Las Condes, Chile
| | - K Tougeron
- Écologie et Dynamique des Systèmes Anthropisés, Université de Picardie Jules Verne, UMR 7058 CNRS, Amiens, France
- Ecology of Interactions and Global Change, Institut de Recherche en Biosciences, Université de Mons, Mons, Belgium
| | - A M Trowbridge
- Department of Forest and Wildlife Ecology, University of Wisconsin, Madison, WI, USA
| | - S Utsumi
- Field Science Center for Northern Biosphere, Hokkaido University, Sapporo, Hokkaido, Japan
| | - O Uyi
- Department of Animal and Environmental Biology, University of Benin, Benin City, Nigeria
- Department of Entomology, University of Georgia, Tifton, GA, USA
| | - J L Vaca-Uribe
- Programa de ingeniría agroecológica, Corporación Universitaria Minuto de Dios, Bogotá, Colombia
| | - A Valtonen
- Department of Environmental and Biological Sciences, University of Eastern Finland, Joensuu, Finland
| | - L J A van Dijk
- Department of Ecology, Environment and Plant Sciences, Stockholm University, Stockholm, Sweden
- Department of Bioinformatics and Genetics, Swedish Museum of Natural History, Stockholm, Sweden
| | - V Vandvik
- Department of Biological Sciences, University of Bergen, Bergen, Norway
| | - J Villellas
- Department of Life Sciences, University of Alcalá, Madrid, Spain
| | - L P Waller
- Bioprotection Aotearoa, Lincoln University, Lincoln, New Zealand
| | - M G Weber
- Department of Ecology and Evolutionary Biology, University of Michigan, Ann Arbor, MI, USA
| | - A Yamawo
- Department of Biological Sciences, Hirosaki University, Hirosaki, Aomori, Japan
- Center for Ecological Research, Kyoto University, Otsu, Japan
| | - S Yim
- Biology Department, University of Nevada, Reno, Reno, NV, USA
| | - P L Zarnetske
- Ecology, Evolution, and Behavior Program, Michigan State University, East Lansing, MI, USA
- Department of Integrative Biology, Michigan State University, East Lansing, MI, USA
| | - L N Zehr
- Department of Entomology, Michigan State University, East Lansing, MI, USA
| | - Z Zhong
- Institute of Grassland Science, Key Laboratory of Vegetation Ecology, Ministry of Education/Jilin Songnen Grassland Ecosystem National Observation and Research Station, Northeast Normal University, Changchun, Jilin Province, China
- Institute of Plant Protection, Chinese Academy of Agricultural Sciences, State Key Laboratory for Biology of Plant Diseases and Insect Pests, Beijing, China
| | - W C Wetzel
- Department of Entomology, Michigan State University, East Lansing, MI, USA
- Plant Resilience Institute, Michigan State University, East Lansing, MI, USA
- Ecology, Evolution, and Behavior Program, Michigan State University, East Lansing, MI, USA
- Department of Integrative Biology, Michigan State University, East Lansing, MI, USA
- W.K. Kellogg Biological Station, Michigan State University, Hickory Corners, MI, USA
- Land Resources and Environmental Sciences, Montana State University, Bozeman, MT, USA
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Kim SB, Kim KH, Kim TN. Comparison of endoscopic retrograde cholangiopancreatography outcomes between cap-fitted forward and side viewing endoscopes in patients with Billroth II anastomosis. BMC Gastroenterol 2023; 23:115. [PMID: 37024780 PMCID: PMC10080899 DOI: 10.1186/s12876-023-02701-x] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 02/27/2023] [Indexed: 04/08/2023] Open
Abstract
BACKGROUND There have been no previous studies that directly compared outcomes between cap-fitted forward-viewing and side viewing endoscopes (SE). This study aimed to compare the technical success rate and occurrence of adverse events between the side viewing and cap-fitted forward-viewing endoscope (CE) groups among patients with Billroth II anatomy who underwent ERCP. METHODS The medical records of patients with a previous history of subtotal gastrectomy using Billroth II reconstruction who underwent ERCP at Yeungnam University Hospital between January 2004 and December 2020 were reviewed retrospectively. The patients were divided into CE and SE group. Propensity score matching analysis was performed to minimize selection bias. RESULTS Propensity score matching resulted in 55 matched pairs for further analysis. Patients' characteristics were comparable in the matched cohorts. Final success rate of selective bile duct cannulation was not significantly different between the SE and CE groups (98.2% vs. 94.5%, p = 0.308). The complete CBD stone removal rate in CBD stone and successful biliary drainage rate in malignant biliary obstruction were not significantly different between the two groups. The rate of total ERCP-related adverse events was higher in the CE group than in the SE group, but the difference was not statistically significant (10.9% vs. 7.3%, p = 0.507). Among adverse events, the rate of post-ERCP pancreatitis showed higher tendency in the CE group than in the SE group (10.9% vs. 5.5%, p = 0.297). CONCLUSION In conclusion, CE seems to be equally effective as SE for ERCP in patients with Billroth II anatomy. However, attention should be paid to development of post ERCP complications, especially pancreatitis, when performed by CE.
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Affiliation(s)
- Sung Bum Kim
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea.
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, 170 Hyeonchung-ro, Nam-gu, Daegu, 42415, Korea.
| | - Kook Hyun Kim
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Tae Nyeun Kim
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
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Lee DW, Kim HG, Cho CM, Jung MK, Heo J, Cho KB, Kim SB, Kim KH, Kim TN, Han J, Kim H. Natural Course of Early Detected Acute Peripancreatic Fluid Collection in Moderately Severe or Severe Acute Pancreatitis. Medicina (Kaunas) 2022; 58:medicina58081131. [PMID: 36013598 PMCID: PMC9415644 DOI: 10.3390/medicina58081131] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 08/11/2022] [Accepted: 08/17/2022] [Indexed: 11/16/2022]
Abstract
Background and Objectives: Acute peripancreatic fluid collection (APFC) is an acute local complication of acute pancreatitis (AP) according to the revised Atlanta classification. Sometimes APFC resolves completely, sometimes it changes into a pseudocyst or walled-off necrosis (WON), so called late complications. The aim of this study is to investigate the natural course of APFC detected on early computed tomography (CT) in moderately severe (MSAP) or severe AP (SAP). Materials and Methods: From October 2014 to September 2015, patients with MSAP or SAP were enrolled if there was APFC within 48 h of onset on imaging studies at six medical centers. The status of fluid collection was followed 4–8 weeks after onset. Initial laboratory findings, CT findings and clinical scoring systems were analyzed. Results: A total of 68 patients were enrolled and APFC was completely resolved in 32 (66.7%) patients in the MSAP group and 9 (34.6%) in the SAP group. Patients with a high bedside index for severity in acute pancreatitis (BISAP) score (≥3 points) were common in the SAP group. C-reactive protein (CRP) after 48 h from admission and BUN level were also high in the SAP group. In multivariate analysis, BISAP score (≥3 points), elevation of CRP after 48 h (≥150 mg/L) and nasojejunal feeding after 48 h were risk factors for the development of late complications. Conclusions: Spontaneous resolution of APFC was more common in MSAP group and APFC can be changed to pseudocyst or WON in patients with elevated BISAP score, CRP level after 48 h, and non-improved abdominal pain.
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Affiliation(s)
- Dong Wook Lee
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu 41944, Korea
| | - Ho Gak Kim
- Department of Internal Medicine, Daegu Catholic University School of Medicine, Daegu 42472, Korea
- Correspondence:
| | - Chang Min Cho
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu 41944, Korea
| | - Min Kyu Jung
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu 41944, Korea
| | - Jun Heo
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu 41944, Korea
| | - Kwang Bum Cho
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu 42601, Korea
| | - Sung Bum Kim
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu 42415, Korea
| | - Kook Hyun Kim
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu 42415, Korea
| | - Tae Nyeun Kim
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu 42415, Korea
| | - Jimin Han
- Department of Internal Medicine, Daegu Catholic University School of Medicine, Daegu 42472, Korea
| | - Hyunsoo Kim
- Department of Internal Medicine, Daegu Fatima Hospital, Daegu 41199, Korea
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Kim KH, Kim SB, Kim TN. Changes in endoscopic patterns before and during COVID-19 outbreak: Experience at a single tertiary center in Korean. World J Clin Cases 2021; 9:3576-3585. [PMID: 34046457 PMCID: PMC8130062 DOI: 10.12998/wjcc.v9.i15.3576] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 01/04/2021] [Revised: 01/28/2021] [Accepted: 04/08/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The surge of coronavirus disease 2019 (COVID-19) patients has markedly influenced the treatment policies of tertiary hospitals because of the need to protect medical staff and contain viral transmission, but the impact COVID-19 had on emergency gastrointestinal endoscopies has not been determined.
AIM To compare endoscopic activities and analyze the clinical outcomes of emergency endoscopies performed before and during the COVID-19 outbreak in Daegu, the worst-hit region in South Korea.
METHODS This retrospective cohort study was conducted on patients aged ≥ 18 years that underwent endoscopy from February 18 to March 28, 2020, at a tertiary hospital in Daegu. Demographics, laboratory findings, types and causes of emergency endoscopies, and endoscopic reports were reviewed and compared with those obtained for the same period in 2018 and 2019.
RESULTS From February 18 to March 28, a total of 366 emergent endoscopic procedures were performed: Upper endoscopy (170, 50.6%), endoscopic retrograde cholangiopancreatography (113, 33.6%), and colonoscopy with sigmoidoscopy (53, 15.8%). The numbers of procedures performed in 2018 and 2019 dropped by 48.8% and 54.8%, respectively, compared with those in 2020. During the COVID-19 outbreak, the main indications for endoscopy were melena (36.7%), hematemesis (30.6%), and hematochezia (10.2%). Of the endoscopic abnormalities detected, gastrointestinal bleeding was the most common: 39 cases in 2018, 51 in 2019, and 35 in 2020.
CONCLUSION The impact of COVID-19 is substantial and caused dramatic reductions in endoscopic procedures and changes in patient behaviors. Long-term follow-up studies are required to determine the effects of COVID-19 induced changes in the endoscopy field.
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Affiliation(s)
- Kook Hyun Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu 42415, South Korea
| | - Sung Bum Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu 42415, South Korea
| | - Tae Nyeun Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu 42415, South Korea
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Lee YS, Cho CM, Cho KB, Heo J, Jung MK, Kim SB, Kim KH, Kim TN, Lee DW, Han J, Kim HG, Kim D, Kim H. Difficult Biliary Cannulation from the Perspective of Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis: Identifying the Optimal Timing for the Rescue Cannulation Technique. Gut Liver 2021; 15:459-465. [PMID: 32000469 PMCID: PMC8129666 DOI: 10.5009/gnl19304] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [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: 09/10/2019] [Revised: 11/03/2019] [Accepted: 11/18/2019] [Indexed: 12/17/2022] Open
Abstract
Background/Aims Recently, the European Society of Gastrointestinal Endoscopy (ESGE) proposed criteria for “difficult biliary cannulation” during endoscopic retrograde cholangiopancreatography (ERCP). This study aimed to investigate the clinical relevance of the ESGE criteria from the perspective of post-ERCP pancreatitis (PEP). Methods An ERCP database was prospectively maintained between November 2014 and December 2015 across six teaching hospitals in South Korea. The ESGE criteria (biliary cannulation time, the number of cannulation attempts, and inadvertent pancreatic duct [PD] manipulation) were recorded in this database as well as other technical factors. Logistic regression analysis was used to identify risk factors for PEP. Then, the PEP prediction model was investigated using decision tree analysis. Results We analyzed 1,067 consecutive patients with naïve papilla. The overall rate of PEP was 6.6%. Multivariate analysis revealed that female sex (odds ratio [OR], 1.860; 95% confidence interval [CI], 1.124 to 3.078), a selective biliary cannulation duration >5 minutes (OR, 3.282; 95% CI, 1.641 to 6.566), and inadvertent PD manipulation (OR, 2.614; 95% CI, 1.480 to 4.617) were significant factors affecting PEP. Decision tree analysis revealed that biliary cannulation time (χ2=49.857, p<0.001) and inadvertent PD manipulation (χ2=8.556, p=0.010) were decisive factors. PEP occurred in 3.9%, 11.8%, and 16.2% of patients with biliary cannulation duration lasting 3 to 5 minutes, >5 minutes, and >5 minutes with inadvertent PD manipulation, respectively. Conclusions Biliary cannulation time and inadvertent PD manipulation could be relevant indicators of PEP, and 5 minutes might be used as a cutoff value for the implementation of the rescue cannulation technique. (Gut Liver 2021;15-465)
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Affiliation(s)
- Yoon Suk Lee
- Department of Internal Medicine, Inje University College of Medicine, Goyang, Korea
| | - Chang Min Cho
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Kwang Bum Cho
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea
| | - Jun Heo
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Min Kyu Jung
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Sung Bum Kim
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Kook Hyun Kim
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Tae Nyeun Kim
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Dong Wook Lee
- Department of Internal Medicine, Daegu Catholic University School of Medicine, Daegu, Korea
| | - Jimin Han
- Department of Internal Medicine, Daegu Catholic University School of Medicine, Daegu, Korea
| | - Ho Gak Kim
- Department of Internal Medicine, Daegu Catholic University School of Medicine, Daegu, Korea
| | - Daejin Kim
- Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Korea
| | - Hyunsoo Kim
- Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Korea
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Kim GH, Lee HL, Joo MK, Park HJ, Jung SW, Lee OJ, Kim H, Chun HJ, Lee ST, Kim JW, Jeon HH, Chung IK, Kim HS, Lee DH, Kim KO, Lim YJ, Park SJ, Cho SJ, Kim BW, Ko KH, Jeon SW, Kim JG, Sung IK, Kim TN, Sung JK, Park JJ. Efficacy and Safety of Rebamipide versus Its New Formulation, AD-203, in Patients with Erosive Gastritis: A Randomized, Double- Blind, Active Control, Noninferiority, Multicenter, Phase 3 Study. Gut Liver 2021; 15:841-850. [PMID: 33827990 PMCID: PMC8593495 DOI: 10.5009/gnl20338] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 11/12/2020] [Revised: 12/10/2020] [Accepted: 12/28/2020] [Indexed: 11/22/2022] Open
Abstract
Background/Aims The mucoprotective drug rebamipide is used to treat gastritis and peptic ulcers. We compared the efficacy of MucostaⓇ (rebamipide 100 mg) and its new formulation, AD-203 (rebamipide 150 mg), in treating erosive gastritis. Methods This double-blind, active control, noninferiority, multicenter, phase 3 clinical trial randomly assigned 475 patients with endoscopically proven erosive gastritis to two groups AD-203 twice daily or MucostaⓇ thrice daily for 2 weeks. The intention-to-treat (ITT) analysis included 454 patients (AD-203, n=229; MucostaⓇ, n=225), and the per-protocol (PP) analysis included 439 patients (AD-203, n=224; MucostaⓇ, n=215). The posttreatment assessments included the primary (erosion improvement rate) and secondary endpoints (erosion and edema cure rates; improvement rates of redness, hemorrhage, and gastrointestinal symptoms). Drug-related adverse events were evaluated. Results According to the ITT analysis, the erosion improvement rates (posttreatment) in AD-203-treated and MucostaⓇ-treated patients were 39.7% and 43.8%, respectively. According to the PP analysis, the erosion improvement rates (posttreatment) in AD-203-treated and MucostaⓇ-treated patients were 39.3% and 43.7%, respectively. The one-sided 97.5% lower limit for the improvement rate difference between the study groups was −4.01% (95% confidence interval [CI], –13.09% to 5.06%) in the ITT analysis and −4.44% (95% CI, –13.65% to 4.78%) in the PP analysis. The groups did not significantly differ in the secondary endpoints in either analysis. Twenty-four AD-203-treated and 20 MucostaⓇ-treated patients reported adverse events but no serious adverse drug reactions; both groups presented similar adverse event rates. Conclusions The new formulation of rebamipide 150 mg (AD-203) twice daily was not inferior to rebamipide 100 mg (MucostaⓇ) thrice daily. Both formulations showed a similar efficacy in treating erosive gastritis.
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Affiliation(s)
- Gwang Ha Kim
- Department of Internal Medicine, Pusan National University College of Medicine, and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Hang Lak Lee
- Department of Internal Medicine, Hanyang University Hospital, Seoul, Korea
| | - Moon Kyung Joo
- Division of Gastroenterology, Department of Internal Medicine, Korea University Guro Hospital, Seoul, Korea
| | - Hong Jun Park
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Sung Woo Jung
- Division of Gastroenterology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Ok-Jae Lee
- Department of Internal Medicine, Gyeongsang National University College of Medicine, Jinju, Korea
| | - Hyungkil Kim
- Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea
| | - Hoon Jai Chun
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Institute of Gastrointestinal Medical Instrument Research, Korea University College of Medicine, Seoul, Korea
| | - Soo Teik Lee
- Department of Internal Medicine, Jeonbuk National University Hospital, Jeonju, Korea
| | - Ji Won Kim
- Department of Internal Medicine, SMG-SNU Boramae Medical Center, Seoul National University of College of Medicine, Seoul, Korea
| | - Han Ho Jeon
- Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Il-Kwun Chung
- Department of Internal Medicine, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Hyun-Soo Kim
- Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Korea
| | - Dong Ho Lee
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Kyoung-Oh Kim
- Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - Yun Jeong Lim
- Department of Internal Medicine, Dongguk University College of Medicine, Seoul, Korea
| | - Seun-Ja Park
- Department of Internal Medicine, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Korea
| | - Soo-Jeong Cho
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Byung-Wook Kim
- Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kwang Hyun Ko
- Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Seong Woo Jeon
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Jae Gyu Kim
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - In-Kyung Sung
- Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Tae Nyeun Kim
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Jae Kyu Sung
- Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Korea
| | - Jong-Jae Park
- Division of Gastroenterology, Department of Internal Medicine, Korea University Guro Hospital, Seoul, Korea
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Lee HJ, Cho CM, Heo J, Jung MK, Kim TN, Kim KH, Kim H, Cho KB, Kim HG, Han J, Lee DW, Lee YS. Impact of Hospital Volume and the Experience of Endoscopist on Adverse Events Related to Endoscopic Retrograde Cholangiopancreatography: A Prospective Observational Study. Gut Liver 2021; 14:257-264. [PMID: 31060119 PMCID: PMC7096235 DOI: 10.5009/gnl18537] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [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: 12/07/2018] [Revised: 03/17/2019] [Accepted: 03/24/2019] [Indexed: 12/21/2022] Open
Abstract
Background/Aims Few studies have addressed the relationship between the occurrence of adverse events (AEs) in endoscopic retrograde cholangiopancreatography (ERCP) and hospital case volume or endoscopist’s experience with inconsistent results. The aim of our study was to investigate the impact of hospital case volume and endoscopist’s experience on the AEs associated with ERCP and to analyze patient- and procedure-related risk factors for post-ERCP AEs. Methods From January 2015 to December 2015, we prospectively enrolled patients with naïve papilla who underwent ERCP at six centers. Patient- and procedure-related variables were recorded on data collection sheets at the time of and after ERCP. Results A total of 1,191 patients (median age, 71 years) were consecutively enrolled. The overall success rate of biliary cannulation was 96.6%. Overall, 244 patients (20.5%) experienced post-ERCP AEs, including pancreatitis (9.0%), bleeding (11.8%), perforation (0.4%), cholangitis (1.2%), and others (0.9%). While post-ERCP pancreatitis (PEP) was more common when the procedure was performed by less experienced endoscopists, bleeding was more common in high-volume centers and by less experienced endoscopists. Multivariate analysis showed that a less experience in ERCP was significantly associated with PEP (odds ratio [OR], 1.630; 95% confidence interval [CI], 1.050 to 2.531; p=0.030) and post-ERCP bleeding (OR, 1.439; 95% CI, 1.003 to 2.062; p=0.048). Conclusions Our study demonstrated that overall AEs following ERCP were associated with the experience of the endoscopist. To minimize post-ERCP AEs, rigorous training with a sufficient case volume is required, and treatment strategies should be modified according to the endoscopist’s expertise.
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Affiliation(s)
- Hyun Jik Lee
- Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea
| | - Chang Min Cho
- Center for Pancreatobiliary Tumor, Kyungpook National University Chilgok Hospital, Daegu, Korea.,Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Jun Heo
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Min Kyu Jung
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Tae Nyeun Kim
- Department of Internal Medicine, Yeungnam University Medical Center, Daegu, Korea
| | - Kook Hyun Kim
- Department of Internal Medicine, Yeungnam University Medical Center, Daegu, Korea
| | - Hyunsoo Kim
- Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Korea
| | - Kwang Bum Cho
- Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea
| | - Ho Gak Kim
- Department of Internal Medicine, Daegu Catholic University Medical Center, Daegu, Korea
| | - Jimin Han
- Department of Internal Medicine, Daegu Catholic University Medical Center, Daegu, Korea
| | - Dong Wook Lee
- Department of Internal Medicine, Daegu Catholic University Medical Center, Daegu, Korea
| | - Yoon Suk Lee
- Department of Internal Medicine, Inje University College of Medicine, Busan, Korea
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Paik WH, Lee HS, Lee KJ, Jang SI, Lee WJ, Hwang JH, Cho CM, Park CH, Han J, Woo SM, Jeong S, Chon HK, Kim TN, Lee JK, Han JH, Yoon JH, Kim YT, Cho JH. Malignant potential of small pancreatic neuroendocrine neoplasm and its risk factors: A multicenter nationwide study. Pancreatology 2021; 21:208-214. [PMID: 33281058 DOI: 10.1016/j.pan.2020.11.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 10/24/2020] [Accepted: 11/24/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Pancreatic neuroendocrine neoplasms (PNENs) show heterogeneous biological behavior, and most small PNENs show indolent features. Consequently, selected cases can be considered for observation only, according to the National Comprehensive Cancer Network guideline, however, supporting clinical evidence is lacking. We investigated the clinical course of small PNENs and their risk factors for malignant potential. METHODS A total of 158 patients with small pathologically confirmed PNENs ≤2 cm in initial imaging were retrospectively enrolled from 14 institutions. The primary outcome was any metastasis or recurrence event during follow-up. RESULTS The median age was 57 years (range, 22-82 years), and 86 patients (54%) were female. The median tumor size at initial diagnosis was 13 mm (range, 7-20 mm). PNENs were pathologically confirmed by surgery in 137 patients and by EUS-guided fine needle aspiration biopsy (EUS-FNAB) in 21 patients. Eight patients underwent EUS-FNAB followed by surgical resection. The results of WHO grade were available in 150 patients, and revealed 123 grade 1, 25 grade 2, and 2 neuroendocrine carcinomas. A total of 145 patients (92%) underwent surgical resection, and three patients had regional lymph node metastasis. During the entire follow-up of median 45.6 months, 11 metastases or recurrences (7%) occurred. WHO grade 2 (HR 13.97, 95% CI 2.60-75.03, p = 0.002) was the only predictive factor for malignant potential in multivariable analysis. CONCLUSIONS WHO grade is responsible for the malignant potential of small PNENs ≤2 cm. Thus, EUS-FNAB could be recommended in order to provide early treatment strategies of small PNENs.
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Affiliation(s)
- Woo Hyun Paik
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, South Korea
| | - Hee Seung Lee
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Kyong Joo Lee
- Department of Internal Medicine, Wonju Severance Christian Hospital, Yonsei University, Wonju, South Korea
| | - Sung Ill Jang
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Woo Jin Lee
- Center for Liver and Pancreatobiliary Cancer, National Cancer Center, Goyang, South Korea
| | - Jin-Hyeok Hwang
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea
| | - Chang Min Cho
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, South Korea
| | - Chang-Hwan Park
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, South Korea
| | - Jimin Han
- Division of Gastroenterology, Department of Internal Medicine, Daegu Catholic University School of Medicine, Daegu, South Korea
| | - Sang Myung Woo
- Center for Liver and Pancreatobiliary Cancer, National Cancer Center, Goyang, South Korea
| | - Seok Jeong
- Department of Internal Medicine, Inha University School of Medicine, Incheon, South Korea
| | - Hyung Ku Chon
- Department of Internal Medicine, Wonkwang University College of Medicine, Iksan, South Korea
| | - Tae Nyeun Kim
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, South Korea
| | - Jun Kyu Lee
- Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang, South Korea
| | - Joung-Ho Han
- Department of Internal Medicine, Chungbuk National University College of Medicine, Chungbuk National University Hospital, Cheongju, South Korea
| | - Jai Hoon Yoon
- Department of Internal Medicine, Hanyang University College of Medicine, Hanyang University Seoul Hospital, Seoul, South Korea
| | - Yong-Tae Kim
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, South Korea.
| | - Jae Hee Cho
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.
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Kim SB, Kim SY, Kim KH, Kim TN. Oxaliplatin-induced Sudden Hearing Loss in a Patient with Pancreatic Cancer. Korean J Gastroenterol 2020; 76:261-264. [PMID: 33234775 DOI: 10.4166/kjg.2020.121] [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: 08/14/2020] [Revised: 09/10/2020] [Accepted: 09/11/2020] [Indexed: 06/11/2023]
Abstract
Oxaliplatin is a new generation of platinum derivatives used frequently to treat solid organ malignancies, including colorectal and ovarian cancer. Recently, an oxaliplatin-based chemotherapeutic regimen was adopted for advanced pancreatic cancer. Although oxaliplatin has extensive therapeutic potential, its use can be limited by significant adverse effects, particularly ototoxicity. This paper reports a rare case of irreversible unilateral hearing loss in a 48-year-old female that developed after the intravenous infusion of oxaliplatin during pancreatic cancer treatment. To the best of the authors' knowledge, this is the second reported case of oxaliplatin-related ototoxicity in pancreatic cancer.
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Affiliation(s)
- Sung Bum Kim
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - So Yeong Kim
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Kook Hyun Kim
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Tae Nyeun Kim
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
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11
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Kang MK, Kim KO, Kim MC, Cho JH, Kim SB, Park JG, Kim KH, Lee SH, Jang BI, Kim TN. Clinical characteristics of coronavirus disease 2019 patients with diarrhea in Daegu. Korean J Intern Med 2020; 35:1261-1269. [PMID: 32872734 PMCID: PMC7652658 DOI: 10.3904/kjim.2020.196] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 05/04/2020] [Accepted: 07/13/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND/AIMS Coronavirus disease 2019 (COVID-19) can reportedly cause gastrointestinal symptoms. Therefore, we investigated the clinical characteristics of COVID-19 patients with diarrhea. METHODS We included 118 COVID-19 patients admitted to a single hospital from February 20 to March 31, 2020. Medical records with clinical characteristics, laboratory data, treatment course, and clinical outcomes were compared based on the presence or absence of diarrhea. Prognostic factors for disease severity and mortality in COVID-19 were also assessed. RESULTS Among patients, 54 (45.8%) had diarrhea, whereas seven (5.9%) had only diarrhea. The median age of patients with diarrhea was 59 years (44 to 64), and 22 (40.7%) were male. Systemic steroid use, intensive care unit admission, septic shock, and acute respiratory distress syndrome were less frequent in the diarrhea group than in the non-diarrhea group. No significant differences were observed in total hospital stay and mortality between groups. On multivariate analysis, age (odds ratio [OR], 1.06; 95% confidence interval [CI], 1.01 to 1.12; p = 0.044), diabetes (OR, 3.00; 95% CI, 1.25 to 20.47; p = 0.042), and dyspnea (OR, 41.19; 95% CI, 6.60 to 823.16; p < 0.001) were independent risk factors for septic shock. On Cox regression analysis, diabetes (hazard ratio [HR], 4.82; 95% CI, 0.89 to 26.03; p = 0.043) and chronic obstructive pulmonary disease (HR, 16.58; 95% CI, 3.10 to 88.70; p = 0.044) were risk factors for mortality. CONCLUSION Diarrhea was present in 45.8% of patients and was a common symptom of COVID-19. Although patients with diarrhea showed less severe clinical features, diarrhea was not associated with disease severity or mortality.
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Affiliation(s)
- Min Kyu Kang
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Kyeong Ok Kim
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
- Correspondence to Kyeong Ok Kim, M.D. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, 170 Hyeonchung-ro, Nam-gu, Daegu 42415, Korea Tel: +82-53-620-3830 Fax: +82-53-654-8386 E-mail:
| | - Min Cheol Kim
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Joon Hyun Cho
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Sung Bum Kim
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Jung Gil Park
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Kook Hyun Kim
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - See Hyung Lee
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Byung Ik Jang
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Tae Nyeun Kim
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
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Kim KH, Kim SB, Kim TN. Needle Fracture, a Rare Endoscopic Ultrasound-Guided Fine-Needle Aspiration Complication and Why? Clin Endosc 2020; 54:774-776. [PMID: 32819049 PMCID: PMC8505191 DOI: 10.5946/ce.2020.128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 06/27/2020] [Indexed: 11/14/2022] Open
Affiliation(s)
- Kook Hyun Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Sung Bum Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Tae Nyeun Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
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13
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Kim KH, Kim SB, Kim TN. A "One Accessory and One Guidewire-in-One Channel" Technique in a Patient with Billroth II Anastomosis. Clin Endosc 2020; 54:139-140. [PMID: 32631038 PMCID: PMC7939769 DOI: 10.5946/ce.2020.087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 05/14/2020] [Indexed: 11/16/2022] Open
Affiliation(s)
- Kook Hyun Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Sung Bum Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Tae Nyeun Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
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14
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Kim SB, Kim KH, Kim TN, Cho CW, Choi JH. A rare case of an enlarged celiac lymph node diagnosed as an epidermal inclusion cyst. Korean J Intern Med 2020; 35:480-481. [PMID: 30654604 PMCID: PMC7060998 DOI: 10.3904/kjim.2018.358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Accepted: 11/10/2018] [Indexed: 11/27/2022] Open
Affiliation(s)
- Sung Bum Kim
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Kook Hyun Kim
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Tae Nyeun Kim
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
- Correspondence to Tae Nyeun Kim, M.D. Tel: +82-53-620-3842 Fax: +82-53-654-8386 E-mail:
| | - Chan Woo Cho
- Department of Surgery, Yeungnam University College of Medicine, Daegu, Korea
| | - Joon Hyuk Choi
- Department of Pathology, Yeungnam University College of Medicine, Daegu, Korea
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Abstract
Although cholecystectomy is generally recommended for acute acalculous cholecystitis (AAC) treatment, non-surgical management can be considered in patients at a high risk for surgery. This study compared outcomes of surgical and non-surgical management and analyzed the long-term outcomes of AAC patients managed non-surgically.We retrospectively analyzed 89 patients diagnosed with AAC between January 1, 2007 and April 30, 2014. These patients were divided into 2 groups: non-surgical (n = 41) and surgical (n = 48). Non-surgical management methods were percutaneous cholecystostomy (PC, n = 14) and antibiotics only (n = 27). The non-surgical group was followed up for >3 years after treatment.The mean age was slightly higher in the non-surgical group than in the surgical group without significant difference. The prevalence of cerebrovascular accident in the non-surgical group was significantly higher than that in the surgical group (26.8% vs 8.3%, P = .020). Mean hospital stay was not statistically different between two groups. The surgical group had a significantly higher incidence of posttreatment complications than the non-surgical group (18.8% vs 2.4%, P = .015). During the mean follow-up of 5.7 years, AAC recurred in 4 (9.8%) patients in the non-surgical group. Three patients underwent cholecystectomy, 1 was treated with antibiotics, and no recurrence-related death occurred. The recurrence rate of AAC was not different between PC and antibiotics only groups (14.3% vs 7.4%, P = .596).Recurrence was observed in 9.8% of AAC patients treated non-surgically and the outcome in the non-surgical group was not inferior to that in the surgical group.
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Abstract
Background and aims: Few studies have been conducted in Asia on the recurrence of acute pancreatitis (AP). This study was designed to investigate characteristics of the disease to predict recurrence.Methods: We retrospectively analyzed 617 patients that experienced a first AP attack between January 2009 and December 2014. Based on reviews of clinical and follow-up data, we attempted to identify risk factors of recurrence using Cox regression analysis.Results: During a median follow-up of 3.2 years (range 3-72 months), 100(16.2%) of the 617 study subjects experienced one or more episodes of recurrent acute pancreatitis (RAP). Of these 100 patients, 75(75%) experienced one relapse, 12(12%) two relapses, and 13(13%) three or more relapses. The etiologies of RAP were an alcohol (48%), gallstone (31%), idiopathic (14%), and others (7%). Univariate analysis showed that an age of <60 years, male gender, smoking, an alcohol-associated etiology, and a local complication at index admission were significant risk factors of RAP. Cox regression analysis showed that an age of <60 years (HR = 1.602, 95% CI: 1.029-2.493), male gender (HR = 1.927, 95% CI: 1.127-3.295), and the presence of a local complication (HR = 3.334, 95% CI: 2.211-5.026) were significant risk factors of RAP development.Conclusion: A local complication at index admission was found to be the strongest risk factor of RAP, and a male gender and an age of <60 years were significantly associated with RAP. Special attention and close follow-up should be afforded to patients with a local complication at index admission or male patients <60 years old.
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Affiliation(s)
- Joon Hyun Cho
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Republic of Korea
| | - Yo Han Jeong
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Republic of Korea
| | - Kook Hyun Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Republic of Korea
| | - Tae Nyeun Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Republic of Korea
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17
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Wills BD, Kim TN, Fox AF, Gratton C, Landis DA. Reducing Native Ant Abundance Decreases Predation Rates in Midwestern Grasslands. Environ Entomol 2019; 48:1360-1368. [PMID: 31713603 PMCID: PMC6894410 DOI: 10.1093/ee/nvz127] [Citation(s) in RCA: 5] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Indexed: 06/10/2023]
Abstract
Diverse and robust predator communities are important for effective prey suppression in natural and managed communities. Ants are ubiquitous components of terrestrial systems but their contributions to natural prey suppression is relatively understudied in temperate regions. Growing evidence suggests that ants can play a significant role in the removal of insect prey within grasslands, but their impact is difficult to separate from that of nonant predators. To test how ants may contribute to prey suppression in grasslands, we used poison baits (with physical exclosures) to selectively reduce the ant population in common garden settings, then tracked ant and nonant ground predator abundance and diversity, and removal of sentinel egg prey for 7 wk. We found that poison baits reduced ant abundance without a significant negative impact on abundance of nonant ground predators, and that a reduction in ant abundance decreased the proportion of sentinel prey eggs removed. Even a modest decrease (~20%) in abundance of several ant species, including the numerically dominant Lasius neoniger Emery (Hymenoptera: Formicidae), significantly reduced sentinel prey removal rates. Our results suggest that ants disproportionately contribute to ground-based predation of arthropod prey in grasslands. Changes in the amount of grasslands on the landscape and its management may have important implications for ant prevalence and natural prey suppression services in agricultural landscapes.
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Affiliation(s)
- B D Wills
- Department of Entomology and DOE Great Lakes Bioenergy Research Center, Michigan State University, East Lansing, MI
| | - T N Kim
- Department of Entomology and DOE Great Lakes Bioenergy Research Center, University of Wisconsin-Madison, Madison, WI
| | - A F Fox
- Department of Entomology and DOE Great Lakes Bioenergy Research Center, Michigan State University, East Lansing, MI
| | - C Gratton
- Department of Entomology and DOE Great Lakes Bioenergy Research Center, University of Wisconsin-Madison, Madison, WI
| | - D A Landis
- Department of Entomology and DOE Great Lakes Bioenergy Research Center, Michigan State University, East Lansing, MI
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18
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Lee KJ, Son BK, Kim GH, Jung H, Jung H, Chung I, Sung I, Kim JI, Kim JH, Lee JS, Kwon JG, Park JH, Huh KC, Park KS, Park M, Kim N, Lee OY, Jee SR, Lee SK, Youn SJ, Kim SK, Lee ST, Hong SJ, Choi SC, Kim TN, Youn YH, Park HJ, Kang MJ, Park CH, Kim BT, Youn S, Song GS, Rhee P. Randomised phase 3 trial: tegoprazan, a novel potassium-competitive acid blocker, vs. esomeprazole in patients with erosive oesophagitis. Aliment Pharmacol Ther 2019; 49:864-872. [PMID: 30843245 PMCID: PMC6594096 DOI: 10.1111/apt.15185] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 06/25/2018] [Accepted: 01/18/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Tegoprazan is a novel potassium-competitive acid blocker that has a fast onset of action and can control gastric pH for a prolonged period, which could offer clinical benefit in acid-related disorders. AIM To confirm the non-inferiority of tegoprazan to esomeprazole in patients with erosive oesophagitis (EE). METHODS In this multicentre, randomised, double-blind, parallel-group comparison study, 302 Korean patients with endoscopically confirmed EE (Los Angeles Classification Grades A-D) were randomly allocated to either tegoprazan (50 or 100 mg) or esomeprazole (40 mg) treatment groups for 4 or 8 weeks. The primary endpoint was the cumulative proportion of patients with healed EE confirmed by endoscopy up to 8 weeks from treatment initiation. Symptoms, safety and tolerability were also assessed. RESULTS The cumulative healing rates at week 8 were 98.9% (91/92), 98.9% (90/91) and 98.9% (87/88) for tegoprazan 50 mg, tegoprazan 100 mg and esomeprazole 40 mg, respectively. Both doses of tegoprazan were non-inferior to esomeprazole 40 mg. The incidence of adverse events was comparable among the groups, and tegoprazan was well-tolerated. CONCLUSION Once daily administration of tegoprazan 50 or 100 mg showed non-inferior efficacy in healing EE and tolerability to that of esomeprazole 40 mg.
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Koo JY, Kim KH, Kim TN. Primary large cell neuroendocrine carcinoma of the common hepatic duct mimicking a Klatskin tumor. Korean J Intern Med 2019; 34:452-453. [PMID: 29466852 PMCID: PMC6406100 DOI: 10.3904/kjim.2017.188] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 09/06/2017] [Indexed: 11/27/2022] Open
Affiliation(s)
- Ji Yeon Koo
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Kook Hyun Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Tae Nyeun Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
- Correspondence to Tae Nyeun Kim, M.D. Tel: +82-53-620-3842 Fax: +82-53-654-8386 E-mail:
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20
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Cho JH, Goo EJ, Kim KO, Lee SH, Jang BI, Kim TN. Efficacy of 0.5-L vs 1-L polyethylene glycol containing ascorbic acid as additional colon cleansing methods for inadequate bowel preparation as expected by last stool examination before colonoscopy. World J Clin Cases 2019; 7:39-48. [PMID: 30637251 PMCID: PMC6327135 DOI: 10.12998/wjcc.v7.i1.39] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 09/20/2018] [Revised: 11/19/2018] [Accepted: 11/24/2018] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND No consensus has been reached in patients suspected of having inadequate bowel preparation regarding optimal salvage methods, which negatively affects the efficacy and quality of colonoscopy. The most ideal and reasonable rescue option involves early suspicion and identification of patients with inadequate preparation before sedation, additional oral ingestion of a suitable preparation formulation, and same-day colonoscopy.
AIM To compare 0.5-L and 1-L polyethylene glycol containing ascorbic acid (PEG + Asc) as additional bowel cleansing methods after a 2-L split-dose PEG + Asc regimen in patients with expected inadequate bowel preparation before colonoscopy.
METHODS Individuals with expected inadequate bowel preparation based on last stool form, such as turbid liquid, particulate liquid, or liquid with small amounts of feces, were randomized to either a 0.5-L PEG + Asc group or a 1-L PEG + Asc group. The primary endpoint was bowel preparation as assessed using the Aronchick bowel preparation scale (ABPS) and Boston bowel preparation scale (BBPS) scores. The secondary endpoints were cecal intubation time, withdrawal time, polyp detection rate (PDR), adenoma detection rate (ADR), individual compliance with additional PEG + Asc, and patient satisfaction.
RESULTS Initially, 98 patients were included, but 8 were later excluded due to withdrawal of consent to participate in the study. Adequate bowel preparation (as assessed by ABPS) was observed in 80.9% (38/47) of subjects in the 0.5-L group and in 88.4% (38/43) of subjects in the 1-L group (P = 0.617). Mean total BBPS was 6.7 points in the 0.5-L group and 7.0 points in the 1-L group (P = 0.458). ADRs and PDRs were similar in the two groups, and cecal intubation and withdrawal times were not significantly different. However, mean patient satisfaction score was significantly higher in the 0.5-L group (P = 0.041).
CONCLUSION The bowel cleaning efficacy of additional 0.5-L PEG + Asc was not inferior to that of 1-L PEG + Asc. Additional 0.5-L PEG + Asc is worthwhile when inadequate bowel preparation is expected before colonoscopy.
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Affiliation(s)
- Joon Hyun Cho
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu 42415, South Korea
| | - Eun Joo Goo
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu 42415, South Korea
| | - Kyeong Ok Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu 42415, South Korea
| | - Si Hyung Lee
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu 42415, South Korea
| | - Byung Ik Jang
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu 42415, South Korea
| | - Tae Nyeun Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu 42415, South Korea
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Affiliation(s)
- Sung Bum Kim
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Kook Hyun Kim
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Tae Nyeun Kim
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
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Woo DH, Kim KO, Kang MK, Lee SH, Jang BI, Kim TN. Predictors and clinical outcomes of follow-up loss in patients with inflammatory bowel disease. J Gastroenterol Hepatol 2018; 33:1834-1838. [PMID: 29664147 DOI: 10.1111/jgh.14258] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 03/27/2018] [Accepted: 04/03/2018] [Indexed: 01/28/2023]
Abstract
BACKGROUND AND AIM Nonadherence is a risk factor of disease worsening in inflammatory bowel disease (IBD). We analyzed the frequency, predictors, and clinical outcomes of patients with IBD who are lost to follow-up in outpatient clinics. METHODS Medical records of 784 IBD patients visiting our IBD clinic between January 2010 and December 2015 were reviewed retrospectively. Overall, 285 newly diagnosed IBD patients who were followed up for at least 12 months were included in the analysis. RESULTS For 285 IBD patients (161 ulcerative colitis and 124 Crohn's disease), the mean disease duration was 66.3 ± 34.0 months (7-137 months). Forty-two patients (14.7%; 27 ulcerative colitis and 15 Crohn's disease) were lost to follow-up. On multivariate regression analysis, travel time to clinic (odds ratio, 2.37; 95% confidence interval, 1.63-3.45; P = 0.01) and C-reactive protein levels at diagnosis (odds ratio, 0.63; 95% confidence interval, 0.43-0.68; P = 0.01) were significantly associated with follow-up loss. Among the 42 patients lost to follow-up, 36 (85.7%) revisited the clinic. The cause of revisit was disease flare-up in 22 patients (61.1%). Step-up treatment was needed in 15 patients (41.7%). Steroid was introduced in 14 patients (38.9%). Azathioprine and an antitumor necrosis factor agent were newly prescribed in three patients (8.3%) and one patient (2.8%), respectively. CONCLUSIONS Follow-up loss rate for IBD patients in remission state was 14.7%, and the predictors were far from hospital and low C-reactive protein levels. Because most of follow-up loss patients experienced flare-up, clinicians need to try to encourage patients to keep their adherence.
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Affiliation(s)
- Dae Hyung Woo
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Kyeong Ok Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Min Kyu Kang
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Si Hyung Lee
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Byung Ik Jang
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Tae Nyeun Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
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Cho JH, Koo JY, Kim KO, Lee SH, Jang BI, Kim TN. On-demand versus half-dose continuous therapy with esomeprazole for maintenance treatment of gastroesophageal reflux disease: A randomized comparative study. Medicine (Baltimore) 2018; 97:e12732. [PMID: 30412065 PMCID: PMC6221682 DOI: 10.1097/md.0000000000012732] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND AND AIMS No consensus has been established regarding optimal long-term maintenance therapy in symptomatic gastroesophageal reflux disease (GERD). The aim of this study was to compare the efficacies of on-demand and continuous therapy with esomeprazole as maintenance treatments for GERD. METHODS Patients with upper gastrointestinal (GI) endoscopy-proven GERD who received initial proton pump inhibitor (PPI) therapy for 8 weeks were randomized to an on-demand group (esomeprazole 40 mg) or a continuous group (esomeprazole 20 mg). Intensities and frequencies of heartburn and acid regurgitation were assessed using a 6-point Likert scale (0 = no symptoms; 5 = very severe symptoms) and a 6-point frequency scale (0 = none; 5 = symptoms for > 5 days per week) at baseline (start of maintenance treatment) and after 12 weeks of treatment. Alleviation of symptoms was quantified using percentages of patients with a Likert scale or frequency scale of 0 or 1. RESULTS Of the 88 patients enrolled, 8 patients were excluded due to follow-up loss in early period of this study, and finally, 39 in the on-demand group and 41 in the continuous group were analyzed. No significant intergroup difference was found between Likert scale or frequency scale of heartburn or regurgitation at baseline. Percentages of symptom alleviations in the on-demand and continuous groups for intensity of heartburn were 56.4%/48.8% at baseline (P = .523) and 82.1%/87.8% at 12 weeks (P = .471), for frequency of heartburn were 61.5%/46.3% at baseline (P = .173) and 76.9%/87.8% at 12 weeks (P = .200), for intensity of regurgitation was 53.8%/43.9% at baseline (P = .374) and 82.1%/87.8% at 12 weeks (P = .471), and for frequency of regurgitation was 61.5%/56.1% at the baseline (P = .621) and 82.1%/82.9% at 12 weeks (P = .918), respectively. Furthermore, no significant intergroup difference was found for convenience of medication or subjective satisfaction. CONCLUSIONS Intensities and frequencies of heartburn and regurgitation responded well to maintenance treatment in patients in the on-demand and continuous groups. On-demand therapy with esomeprazole 40 mg appears to be sufficient for maintenance treatment in GERD patients.
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Affiliation(s)
- Joon Hyun Cho
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Republic of Korea
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Kang MK, Goo EJ, Kim SB, Kim KH, Kim TN. Hepatobiliary and Pancreatic: Intrahepatic cholangiocarcinoma with distant cutaneous metastases to the face. J Gastroenterol Hepatol 2018; 33:1435. [PMID: 29767442 DOI: 10.1111/jgh.14091] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Affiliation(s)
- M K Kang
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - E J Goo
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - S B Kim
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - K H Kim
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - T N Kim
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
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Hwang MJ, Kim KO, Kim AL, Lee SH, Jang BI, Kim TN. Histologic discrepancy between endoscopic forceps biopsy and endoscopic mucosal resection specimens of colorectal polyp in actual clinical practice. Intest Res 2018; 16:475-483. [PMID: 30090047 PMCID: PMC6077297 DOI: 10.5217/ir.2018.16.3.475] [Citation(s) in RCA: 5] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 03/03/2018] [Accepted: 03/07/2018] [Indexed: 12/11/2022] Open
Abstract
Background/Aims We aimed to assess the rate of histologic discrepancy (HD) between endoscopic forceps biopsy (EFB) and totally resected specimens in colorectal polyp and analyze the risk factors of discordant group, especially under-diagnosis (UD) cases before complete removal of colorectal polyp. Methods From 2010 to 2015, a total of 290 polyps in 210 patients which had baseline pathology report before endoscopic resection (ER) were analyzed. UD cases were defined as those in which the diagnosis changed to a more advanced histologic feature after ER. Results A change in the final histology after ER was noted in 137 cases (47.2%), and after excluding 9 insignificant cases, 128 cases were further categorized into over-diagnosed and under-diagnosed group. UD occurred in 86 cases (29.7%) and change from benign to malignancy was noted in 26 cases (8.9%). On univariate analysis, a larger polyp size (>10 mm) was significantly associated with both HD (P<0.001) and UD (P<0.001). Regarding polyp morphology, protruding or flat was not significantly important. On multivariate analysis, polyp size >10 mm was the single most significant predictor of both HD (P<0.001) and UD (P<0.001). Conclusions The HD and UD rates were 47.2% and 29.7%, respectively. Polyp size >10 mm was the most important predictor of both HD and UD. We should be careful in making treatment strategy of colorectal polyp based on histologic report of EFB especially when the size of polyp is >10 mm.
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Affiliation(s)
- Moon Joo Hwang
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Kyeong Ok Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - A Lim Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Si Hyung Lee
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Byung Ik Jang
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Tae Nyeun Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
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Woo DH, Kim KO, Jeong DE, Nam YJ, Lee SH, Jang BI, Kim TN. Prospective analysis of factors associated with inadequate bowel preparation for colonoscopy in actual clinical practice. Intest Res 2018; 16:293-298. [PMID: 29743843 PMCID: PMC5934603 DOI: 10.5217/ir.2018.16.2.293] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [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: 07/20/2017] [Revised: 10/17/2017] [Accepted: 10/20/2017] [Indexed: 12/13/2022] Open
Abstract
Background/Aims Inadequate bowel preparation can result in prolonged procedure time and increased missed lesion and complication rates. This prospective study aimed to evaluate bowel preparation quality and identify the predictive factors for inadequate bowel preparation in actual clinical practice. Methods We included 399 patients who underwent colonoscopy between June 2015 and July 2016. Using the Aronchick bowel preparation scale, we defined a score ≤2 as adequate preparation and a score >2 as inadequate preparation. Results Mean patient age was 58.38±12.97 years; 60.6% were male. Indications for colonoscopy included screening (69.7%) and surveillance after polyp removal (21.3%). A split-dose regimen was prescribed to 55.4% of patients. The inadequate bowel preparation rate was 28.1%. Overall, the median time between the last bowel preparation agent dose and start of colonoscopy was 5.0 hours (range, 1.5-16.0 hours); that of the adequate group was 5.0 hours (range, 1.5-16.0 hours); and that of the inadequate group was 5 hours (range, 2-23 hours). The mean bowel preparation scale score of the ascending colon (1.94±0.25) was significantly higher than that of other colon segments. On multivariate analysis, elderly age, history of cerebrovascular disease, history of gastrectomy or appendectomy, and total preparation solution uptake <2 L were the independent predictors of inadequate bowel preparation. Conclusions The inadequate bowel preparation rate was 28.1%. Risk factors included elderly age and history of cerebrovascular disease or abdominal surgery. Patients with these risk factors require special care and education.
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Affiliation(s)
- Dae Hyung Woo
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Kyeong Ok Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Da Eun Jeong
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Yoon Jeong Nam
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Si Hyung Lee
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Byung Ik Jang
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Tae Nyeun Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
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Kang MK, Kim TN. Hepatobiliary and Pancreatic: Hepatocellular carcinoma diagnosed by proptosis due to metastatic orbital mass. J Gastroenterol Hepatol 2018. [PMID: 29542243 DOI: 10.1111/jgh.14062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Affiliation(s)
- M K Kang
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - T N Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
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Lee KH, Choi EY, Hyun MS, Eun JR, Jang BI, Kim TN, Lee HJ, Lee DS, Yun SS, Kim HJ, Kim JH, Kim JR. Cellular Mechanisms of Hepatocyte Growth Factor-Mediated Urokinase Plasminogen Activator Secretion by MAPK Signaling in Hepatocellular Carcinoma. Tumori 2018; 94:523-30. [DOI: 10.1177/030089160809400414] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aims and Background The hepatocyte growth factor, its receptor c-Met, and urokinase-type plasminogen mediate various cellular responses on activation, including proliferation, survival, invasion, and metastasis. The regulatory mechanisms for the proliferation and the particular invasive phenotypes of hepatocellular carcinoma are not yet fully understood. In order to clarify the intracellular downstream signal for hepatocyte growth factor/c-Met signaling in tumor progression and metastasis in hepatoma, we determined the effects of a specific MEK1 inhibitor (PD 098059) and a p38 kinase inhibitor (SB 203580) on hepatocyte growth factor-mediated cell proliferation and urokinase-type plasminogen expression in hepatoma cell lines (HepG2 and Hep3B). Results Hepatocyte growth factor treatment induced the phosphorylation of ERK and p38 kinase in a dose-dependent manner, resulting in an early peak of phosphorylation at 3 to 10 min, which then rapidly decreased to a near basal level. Pretreatment with PD 098059 reduced hepatocyte growth factor-mediated cell proliferation and urokinase-type plasminogen secretion. In contrast, SB 203580 pretreatment enhanced cell proliferation and urokinase-type plasminogen secretion due to induction of ERK phosphorylation. Treatment with PD 098059 and SB 203580 resulted in a decrease in phospho-ERK activity. Stable expression of dominant negative-MEK1 in HepG2 cells showed a decrease in hepatocyte growth factor-mediated urokinase-type plasminogen secretion. Conclusions Such results suggest that interaction of an MEK/ERK and a p38 kinase might be critical in intrahepatic invasion and metastasis of human hepatoma cells.
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Affiliation(s)
- Kyung Hee Lee
- Department of Hemato-Oncology, College of Medicine, Yeungnam University, Daegu, Republic of Korea
| | - Eun Young Choi
- Department of Hemato-Oncology, College of Medicine, Yeungnam University, Daegu, Republic of Korea
| | - Myung Soo Hyun
- Department of Hemato-Oncology, College of Medicine, Yeungnam University, Daegu, Republic of Korea
| | - Jong Ryul Eun
- Department of Gastro-Enterology, College of Medicine, Yeungnam University, Daegu, Republic of Korea
| | - Byung Ik Jang
- Department of Gastro-Enterology, College of Medicine, Yeungnam University, Daegu, Republic of Korea
| | - Tae Nyeun Kim
- Department of Gastro-Enterology, College of Medicine, Yeungnam University, Daegu, Republic of Korea
| | - Heon Ju Lee
- Department of Gastro-Enterology, College of Medicine, Yeungnam University, Daegu, Republic of Korea
| | - Dong Shik Lee
- General Surgery, College of Medicine, Yeungnam University, Daegu, Republic of Korea
| | - Sung Su Yun
- General Surgery, College of Medicine, Yeungnam University, Daegu, Republic of Korea
| | - Hong Jīn Kim
- General Surgery, College of Medicine, Yeungnam University, Daegu, Republic of Korea
| | - Jung Hye Kim
- Biochemistry and Molecular Biology, College of Medicine, Yeungnam University, Daegu, Republic of Korea
| | - Jae-Ryong Kim
- Biochemistry and Molecular Biology, College of Medicine, Yeungnam University, Daegu, Republic of Korea
- Aging-associated Vascular Disease Research Center, College of Medicine, Yeungnam University, Daegu, Republic of Korea
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Kim SB, Kim TN, Kim KH. Tuberculous Lymphadenitis Mimicking Gastric Subepithelial Tumor Diagnosed Using Endoscopic Ultrasound-guided Fine-needle Aspiration. Korean J Helicobacter Up Gastrointest Res 2018. [DOI: 10.7704/kjhugr.2018.18.1.65] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Sung Bum Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Tae Nyeun Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Kook Hyun Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
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Kim M, Lee EJ, Shin HM, Jung HS, Kim TK, Kim TN, Kwon MJ, Lee SH, Rhee BD, Park JH. The effect of PPARγ agonist on SGLT2 and glucagon expressions in alpha cells under hyperglycemia. J Endocrinol Invest 2017; 40:1069-1076. [PMID: 28391584 DOI: 10.1007/s40618-017-0659-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 12/09/2016] [Accepted: 03/17/2017] [Indexed: 12/28/2022]
Abstract
BACKGROUND Although sodium glucose cotransporter 2 (SGLT2) inhibitors have many beneficial effects for type 2 diabetes, including decreased cardiovascular death, recent reports that they increased glucagon through SGLT2 inhibition raised some concern. Troglitazone, Peroxisome proliferator-activated receptor γ (PPAR-γ) agonist, was reported to increase SGLT2 in renal proximal tubule cells, but its role on pancreatic alpha cells have not been reported. We investigated the effect of troglitazone on SGLT2 expression in alpha cells and subsequent glucagon regulation in hyperglycemia. METHODS An Alpha TC1-6 cell line was cultured in control (5 mM) or hyperglycemia (HG, 15 mM) for 72 h. We applied troglitazone with or without PPARγ antagonist (GW9662 10 μM). To investigate the involvement of PI3K/Akt pathway, we applied troglitazone with or without Wortmanin. We measured sodium glucose transporter 2 (SGLT2) and glucagon (GCG) mRNA and protein expression. PPAR gamma, PI3K and Akt protein were also measured. RESULTS Exposure of alpha TC cells to HG for 72 h increased glucagon mRNA and protein expression. HG decreased SGLT2 mRNA and protein expression. Troglitazone significantly reversed HG-induced reduction of SGLT2 expression and increase of glucagon secretion. PPARγ antagonist (GW9662 10 μM) decreased the expression of SGLT2 and increased glucagon as HG did. Hyperglycemia increased PI3K and pAkt expression in alpha cells. Wortmanin (PI3K inhibitor, 1 μM) reversed HG-induced SGLT2 decrease and glucagon increase. Troglitazone treatment decreased PI3K and pAkt expression in HG. CONCLUSION In conclusion, PPARγ agonist, troglitazone improved glucose transport SGLT2 dysfunction and subsequent glucagon dysregulation in alpha cell under hyperglycemia. Those effects were through the involvement of PI3K/pAkt signaling pathway. This study may add one more reason for the ideal combination of PPARγ agonist and SGLT2 inhibitor in clinical practice.
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Affiliation(s)
- M Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Inje University, 875, Hauendae-ro, Hauendae-gu, Busan, 612-862, South Korea.
- Molecular Therapy Lab, Paik Institute for Clinical Research, Inje University, Busan, South Korea.
| | - E J Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Inje University, 875, Hauendae-ro, Hauendae-gu, Busan, 612-862, South Korea
| | - H M Shin
- Molecular Therapy Lab, Paik Institute for Clinical Research, Inje University, Busan, South Korea
| | - H S Jung
- Molecular Therapy Lab, Paik Institute for Clinical Research, Inje University, Busan, South Korea
| | - T K Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Inje University, 875, Hauendae-ro, Hauendae-gu, Busan, 612-862, South Korea
| | - T N Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Inje University, 875, Hauendae-ro, Hauendae-gu, Busan, 612-862, South Korea
| | - M J Kwon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Inje University, 875, Hauendae-ro, Hauendae-gu, Busan, 612-862, South Korea
| | - S H Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Inje University, 875, Hauendae-ro, Hauendae-gu, Busan, 612-862, South Korea
| | - B D Rhee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Inje University, 875, Hauendae-ro, Hauendae-gu, Busan, 612-862, South Korea
| | - J H Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Inje University, 875, Hauendae-ro, Hauendae-gu, Busan, 612-862, South Korea
- Molecular Therapy Lab, Paik Institute for Clinical Research, Inje University, Busan, South Korea
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Abstract
This study aims to evaluate the prevalence, risk factors, and relative risk of gallstones and associated disease in patients with ulcerative colitis (UC). Medical records of 311 patients diagnosed with UC between January 2004 and February 2015 were reviewed retrospectively. To assess relative risk, 622 patients matched by age, sex, and body mass index were included as a control group. Gallstones were detected in 8% (25/311) of UC patients and in 3.9% (24/622) of the control group. Prevalence was significantly higher in the UC group (odds ratio [OR], 2.178; P = .007). Mean age of gallstone patients was 57.1 ± 17.8 years in the UC group, and mean disease duration of UC was 67.2 ± 38.8 months. The male-to-female ratio of gallstone patients in the UC group was 2.13:1. Mean interval from diagnosis of UC to detection of gallstones was 17.8 ± 30 months. Six UC patients with gallstones underwent cholecystectomy or endoscopic retrograde cholangiography for symptomatic disease and complications. In univariate analysis, diabetes, hypertension, age ≥65 years, and history of more than 3 admissions were significantly associated with gallstone in UC patients. In multivariate analysis, age ≥65 years (OR, 2.655; P = .033) and hospitalization ≥3 times (OR, 4.1; P = .001) were statistically significant risk factors for gallstones in UC patients. This study shows that UC patients have a significantly higher risk of gallstones compared to the general population (OR, 2.178; P = .007), especially those who are older, with a history of multiple admissions.
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Affiliation(s)
- Kook Hyun Kim
- Division of Gastroenterology and Hepatology, Department of Internal medicine, Yeungnam University College of Medicine, Daegu, Republic of Korea
| | - Tae Nyeun Kim
- Division of Gastroenterology and Hepatology, Department of Internal medicine, Yeungnam University College of Medicine, Daegu, Republic of Korea
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Abstract
Caroli disease (CD) is a rare congenital malformation of the liver characterized by non-obstructive, segmental, cystic dilatation of the intrahepatic bile ducts (IHDs). The clinical course is usually asymptomatic for the first 5–20 years, and symptoms may seldom occur throughout the patient’s life. Bile stagnation leads to recurrent episodes of cholangitis, stone formation, or liver abscesses, and biliary cirrhosis usually occurs years later. Here we report on a 42-year-old man diagnosed with diffuse-type CD with a characteristic central dot sign, who had multiple intrahepatic and common bile duct (CBD) stones. CBD stones were treated successfully with endoscopic retrograde cholangiopancreatography (ERCP).
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Affiliation(s)
- Moon Joo Hwang
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Tae Nyeun Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
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Kang SH, Kim KH, Kim TN, Jung MK, Cho CM, Cho KB, Han JM, Kim HG, Kim HS. Therapeutic outcomes of endoscopic papillectomy for ampullary neoplasms: retrospective analysis of a multicenter study. BMC Gastroenterol 2017; 17:69. [PMID: 28558658 PMCID: PMC5450406 DOI: 10.1186/s12876-017-0626-5] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [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: 12/04/2016] [Accepted: 05/19/2017] [Indexed: 12/11/2022] Open
Abstract
Background Endoscopic papillectomy (EP) is reported to be a relatively safe and reliable procedure for complete resection of ampullary neoplasms. The aim of this study was to evaluate the therapeutic outcomes and complications of EP for ampullary neoplasms. Methods A retrospective multicenter study was conducted with 5 participating centers from January 2007 to July 2014. A total of 104 patients who underwent EP for ampullary neoplasms were reviewed retrospectively. EP was performed by snare resection with or without submucosal lifting of the lesion. Results The mean age of patients was 60.5 ± 12.1 years, and the male-to-female ratio was 2.0:1. En bloc resection was possible in 94 patients (90.3%). A biliary and a pancreatic stent were placed after EP in 42 patients and in 60 patients, respectively. A pathologically incomplete resection was noted in 11 cases (10.6%), and 5 of these patients were treated with additional endoscopic procedure. Histology of resected specimens was as follows: low grade adenoma (43.2%), high grade adenoma (14.4%), adenocarcinoma (16.3%), hyperplastic polyp (7.7%), and others (18.4%). Of the 75 cases with low grade adenoma on biopsy specimen, 21.3% turned out to have high grade adenoma (12%) or adenocarcinoma (9.3%). Procedure-related complications occurred in 33 patients (31.7%); bleeding (18 cases, 17.3%), pancreatitis (16 cases, 15.4%), and perforation (8 cases, 7.7%). Pre-EP ERCP, saline lifting, sphincterotomy, biliary stenting, pancreatic stenting, specimen size, and cauterization were not related to post EP complications. Surgery was performed in 6 cases with pathological incomplete resection and 2 cases with complications after EP, and there were 2 cases of mortality due to complications. During follow-up endoscopy after initial success of EP, remnant tumors were found in 7 patients, one of whom underwent surgery and the others were treated endoscopically. Consequently, the overall endoscopic success rate of EP was 89.4%. Conclusions Endoscopic papillectomy appears to be an effective treatment for ampullary neoplasms, and can be considered as an alternative to surgery. However, relatively high risk of procedure related complications is a problem that must be considered.
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Affiliation(s)
- Sung Hoon Kang
- Division of Gastroenterology and hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, 317-1 Daemyung-dong, 705-717, Nam-gu, Daegu, South Korea
| | - Kook Hyun Kim
- Division of Gastroenterology and hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, 317-1 Daemyung-dong, 705-717, Nam-gu, Daegu, South Korea
| | - Tae Nyeun Kim
- Division of Gastroenterology and hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, 317-1 Daemyung-dong, 705-717, Nam-gu, Daegu, South Korea.
| | - Min Kyu Jung
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, South Korea
| | - Chang Min Cho
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, South Korea
| | - Kwang Bum Cho
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu, South Korea
| | - Ji Min Han
- Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, South Korea
| | - Ho Gak Kim
- Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, South Korea
| | - Hyun Soo Kim
- Department of Internal Medicine, Daegu Fatima Hospital, Daegu, South Korea
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Sohn SH, Kim KH, Park JH, Kim TN. Predictors of Mortality in Korean Patients with Pyogenic Liver Abscess: A Single Center, Retrospective Study. Korean J Gastroenterol 2017; 67:238-44. [PMID: 27206434 DOI: 10.4166/kjg.2016.67.5.238] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/07/2022]
Abstract
BACKGROUND/AIMS The mortality rate of pyogenic liver abscess (PLA) has decreased dramatically, but it remains a potentially life threatening disease. Most cases are cryptogenic or occur in elderly men with underlying biliary tract disease. Although several studies have addressed the characteristics and etiology of PLA, research on factors affecting PLA-associated mortality is lacking. This study intended to identify the clinical and radiological features, pathogens, complications, and predictors of mortality in Korean PLA patients. METHODS The medical records of 231 PLA patients diagnosed at Yeungnam University Medical Center between January 2010 and January 2014 were analyzed. A diagnosis of PLA was made based on imaging studies and blood and abscess cultures. The clinical, radiological, and laboratory findings of patients were analyzed. RESULTS The mean patient age was 64.0±12.9 years and the male to female ratio was 1.5:1. Klebsiella pneumoniae was the predominant organism isolated from hepatic abscesses (69.9%) and blood (74.2%). The most common complication was pleural effusion (35.8%) and most common co-infection was cholangitis (8.2%). The overa ll mortality rate of PLA was 6.9% (16/231), and was significantly higher in patients with a history of liver abscess (OR 5.970, 95% CI 1.207-29.529; p=0.028), bilirubinemia (>2 mg/dL) (OR 9.541, 95% CI 2.382-38.216; p=0.001), thrombocytopenia (< 140×10(3)/L) (OR 4.396, 95% CI 1.130-17.106; p=0.033), or anemia (< 12 g/dL) (OR 13.277, 95% CI 1.476-119.423; p=0.021). CONCLUSIONS The prognosis of PLA appears to be dependent on underlying pathologies and severity of condition. More aggressive treatment should be considered if a poor prognosis is expected.
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Affiliation(s)
- Se Hoon Sohn
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Kook Hyun Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Jae Hyun Park
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Tae Nyeun Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
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Kim SB, Kim TN, Chung HH, Kim KH. Small Gallstone Size and Delayed Cholecystectomy Increase the Risk of Recurrent Pancreatobiliary Complications After Resolved Acute Biliary Pancreatitis. Dig Dis Sci 2017; 62:777-783. [PMID: 28035552 DOI: 10.1007/s10620-016-4428-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Accepted: 12/19/2016] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Acute biliary pancreatitis (ABP) is a severe complication of gallstone disease with considerable mortality, and its recurrence rate is reported as 50-90% for ABP patients who do not undergo cholecystectomy. However, the incidence of and risk factors for recurrent pancreatobiliary complications after the initial improvement of ABP are not well established in the literature. The aims of this study were to determine the risk factors for recurrent pancreatobiliary complications and to compare the outcomes between early (within 2 weeks after onset of pancreatitis) and delayed cholecystectomy in patients with ABP. METHODS Patients diagnosed with ABP at Yeungnam University Hospital from January 2004 to July 2016 were retrospectively reviewed. The following risk factors for recurrent pancreatobiliary complications (acute pancreatitis, acute cholecystitis, and acute cholangitis) were analyzed: demographic characteristics, laboratory data, size and number of gallstones, severity of pancreatitis, endoscopic sphincterotomy, and timing of cholecystectomy. Patients were categorized into two groups: patients with recurrent pancreatobiliary complications (Group A) and patients without pancreatobiliary complications (Group B). RESULTS Of the total 290 patients with ABP (age 66.8 ± 16.0 years, male 47.9%), 56 (19.3%) patients developed recurrent pancreatobiliary complications, of which 35 cases were acute pancreatitis, 11 cases were acute cholecystitis, and 10 cases were acute cholangitis. Endoscopic sphincterotomy and cholecystectomy were performed in 134 (46.2%) patients and 95 (32.8%) patients, respectively. Age, sex, BMI, diabetes, number of stone, severity of pancreatitis, and laboratory data were not significantly correlated with recurrent pancreatobiliary complications. The risk of recurrent pancreatobiliary complications was significantly increased in the delayed cholecystectomy group compared with the early cholecystectomy group (45.5 vs. 5.0%, p < 0.001). Based on the multivariate logistic regression analyses, two factors, size of gallstone less than or equal to 5 mm and delayed cholecystectomy, were found as risk factors associated with recurrent pancreatobiliary complications. CONCLUSION The incidence of recurrent pancreatobiliary complications was 19.3% and was significantly increased in patients with size of gallstone less than or equal to 5 mm and in those who underwent delayed cholecystectomy.
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Affiliation(s)
- Sung Bum Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, 317-1 Daemyung-dong, Nam-gu, Daegu, 705-717, Republic of Korea
| | - Tae Nyeun Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, 317-1 Daemyung-dong, Nam-gu, Daegu, 705-717, Republic of Korea.
| | - Hyun Hee Chung
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, 317-1 Daemyung-dong, Nam-gu, Daegu, 705-717, Republic of Korea
| | - Kook Hyun Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, 317-1 Daemyung-dong, Nam-gu, Daegu, 705-717, Republic of Korea
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Kim SB, Kim KH, Kim TN, Heo J, Jung MK, Cho CM, Lee YS, Cho KB, Lee DW, Han JM, Kim HG, Kim HS. Sex differences in prevalence and risk factors of asymptomatic cholelithiasis in Korean health screening examinee: A retrospective analysis of a multicenter study. Medicine (Baltimore) 2017; 96:e6477. [PMID: 28353587 PMCID: PMC5380271 DOI: 10.1097/md.0000000000006477] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [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: 12/14/2022] Open
Abstract
The aim of this study was to evaluate sex difference in the prevalence and risk factors for asymptomatic cholelithiasis in Korean health screening examinees.Examinees who underwent examination through health promotion center at 5 hospitals of Daegu-Gyeongbuk province in 2014 were analyzed retrospectively. All examinees were checked for height, weight, waist circumference, and blood pressure, and underwent laboratory tests and abdominal ultrasound. Diagnosis of cholelithiasis was made by ultrasound.Of the total of 30,544 examinees, mean age was 47.3 ± 10.9 years and male to female ratio was 1.4:1. Asymptomatic cholelithiasis was diagnosed in 1268 examinees with overall prevalence of 4.2%. In age below 40 years, females showed higher prevalence of asymptomatic cholelithiasis than males (2.7% vs. 1.9%, P = 0.020), whereas prevalence of asymptomatic cholelithiasis was higher in males than females older than 50 years (6.2% vs. 5.1%, P = 0.012). Multiple logistic regression analysis revealed age (≥50 years), obesity, and high blood pressure as risk factors for asymptomatic cholelithiasis in males and age, obesity, hypertriglyceridemia, and chronic hepatitis B infection in females (P < 0.05).Overall prevalence of asymptomatic cholelithiasis was 4.2% in Korean health screening examinees. Females showed higher prevalence of asymptomatic cholelithiasis than males younger than 40 years, whereas it was higher in males older than 50 years. Age and obesity were risk factors for asymptomatic cholelithiasis in both sexes. Males had additional risk factors of high blood pressure and females had hypertriglyceridemia and chronic hepatitis B infection.
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Affiliation(s)
- Sung Bum Kim
- Department of Internal Medicine, Yeungnam University College of Medicine
| | - Kook Hyun Kim
- Department of Internal Medicine, Yeungnam University College of Medicine
| | - Tae Nyeun Kim
- Department of Internal Medicine, Yeungnam University College of Medicine
| | - Jun Heo
- Department of Internal Medicine, Kyungpook National University School of Medicine
| | - Min Kyu Jung
- Department of Internal Medicine, Kyungpook National University School of Medicine
| | - Chang Min Cho
- Department of Internal Medicine, Kyungpook National University School of Medicine
| | - Yoon Suk Lee
- Department of Internal Medicine, Keimyung University School of Medicine
| | - Kwang Bum Cho
- Department of Internal Medicine, Keimyung University School of Medicine
| | - Dong Wook Lee
- Department of Internal Medicine, Catholic University of Daegu School of Medicine
| | - Ji Min Han
- Department of Internal Medicine, Catholic University of Daegu School of Medicine
| | - Ho Gak Kim
- Department of Internal Medicine, Catholic University of Daegu School of Medicine
| | - Hyun Soo Kim
- Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Korea
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Chung SM, Kim KH, Kim KO, Kim TN. Hepatobiliary and Pancreatic: Hepatic portal vein gas accompanied by acute enterocolitis improved with non-surgical treatment. J Gastroenterol Hepatol 2017; 32:294. [PMID: 28221690 DOI: 10.1111/jgh.13605] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/23/2016] [Indexed: 12/09/2022]
Affiliation(s)
- S M Chung
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - K H Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - K O Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - T N Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
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Sohn SH, Park JH, Kim KH, Kim TN. Complications and management of forgotten long-term biliary stents. World J Gastroenterol 2017; 23:622-628. [PMID: 28216968 PMCID: PMC5292335 DOI: 10.3748/wjg.v23.i4.622] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [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: 11/09/2016] [Revised: 12/16/2016] [Accepted: 12/21/2016] [Indexed: 02/06/2023] Open
Abstract
AIM To evaluate complications and management outcomes of retained long-term plastic biliary stents.
METHODS Endoscopic plastic biliary stent placement was performed in 802 patients at Yeungnam University Hospital between January 2000 and December 2014. Follow-up loss with a subsequently forgotten stent for more than 12 mo occurred in 38 patients. We retrospectively examined the cause of biliary stent insertion, status of stents, complications associated with biliary stents and management outcomes of long-term plastic biliary stents. Continuous variables were analyzed using the t test. Observed frequencies in subsets of the study population were compared using Fisher’s exact test and χ2 tests. Statistical significance was defined as P < 0.05 (two-tailed).
RESULTS Mean age of patients was 73.7 ± 12 years and male-to-female ratio was 2.2:1. Indications of plastic biliary stent insertion were bile duct stones (63.2%, 24/38) and benign bile duct stricture (52.6%, 20/38). Mean duration of retained plastic stent was 22.6 ± 12.2 mo, and in 10 cases (26.3%), stents were retained for more than 24 mo. Common bile duct (CBD) stones or sludge were found in most cases (92.1%, 35/38). The most common complication was acute cholangitis (94.7%, 36/38). Stent removal by endoscopic approach was successfully performed in 92.1% (35/38) of the cases. In 3 cases, an additional plastic stent was inserted alongside the previous stent due to failure of the stent removal. Endoscopic removal of bile duct stones was successful in 73.7% (28/38) of the cases. When patients were divided into two groups by duration of stent placement (12 to 24 mo vs over 24 mo), there were no differences in the development of cholangitis, presence of biliary stones, and success rate of endoscopic removal of stones and biliary stents.
CONCLUSION The most common complication of retained long-term plastic biliary stents was acute cholangitis associated with CBD stones. Endoscopic management was successfully performed in most cases.
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Kim SB, Lee SH, Kim KO, Jang BI, Kim TN. [Ten-day Sequential Therapy versus Bismuth Based Quadruple Therapy as Second Line Treatment for Helicobacter pylori Infection]. Korean J Gastroenterol 2017; 66:261-7. [PMID: 26586348 DOI: 10.4166/kjg.2015.66.5.261] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND/AIMS Ten-day sequential therapy has been evaluated as the first line therapy for Helicobacter pylori eradication but studies on sequential therapy as a second line therapy is lacking. The aim of this study was to compare the efficacy of 10-day sequential therapy and quadruple therapy as second line treatment for H. pylori eradication after failure of standard triple therapy. METHODS Patients who did not respond to standard triple therapy for H. pylori eradication were assigned to either 10-day sequential or bismuth based quadruple therapy as second line treatment from January 2009 to December 2014 at Yeungnam University Medical Center. Post treatment H. pylori status was determined by rapid urease test, giemsa staining, or (13)C-urea breath test. Eradication rate and side effects of both therapies were compared. RESULTS A total of 158 H. pylori infected patients were included and 70 patients were treated by bismuth based quadruple therapy and 88 patients by 10-day sequential therapy. Age and sex were not significantly different between the two groups. Eradication rate was 84.3% (59/70) in quadruple group and 56.8% (50/88) in sequential group. Side effects occurred significantly higher in quadruple group than sequential group (27.1% vs. 11.4%, p=0.011). CONCLUSIONS For second line H. pylori eradication after failure of standard triple therapy, bismuth based quadruple therapy showed significantly higher H. pylori eradication rate than 10-day sequential therapy. Further prospective studies are needed to evaluate the efficacy of 10-day sequential therapy as a second line H. pylori eradication treatment.
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Affiliation(s)
- Sung Bum Kim
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Si Hyung Lee
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Kyeong Ok Kim
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Byung Ik Jang
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Tae Nyeun Kim
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
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Kim SB, Lee SH, Bae SI, Jeong YH, Sohn SH, Kim KO, Jang BI, Kim TN. Association between Helicobacter pylori status and metachronous gastric cancer after endoscopic resection. World J Gastroenterol 2016; 22:9794-9802. [PMID: 27956803 PMCID: PMC5124984 DOI: 10.3748/wjg.v22.i44.9794] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [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: 07/22/2016] [Revised: 09/24/2016] [Accepted: 10/27/2016] [Indexed: 02/06/2023] Open
Abstract
AIM To investigate the effect of Helicobacter pylori (H. pylori) status test and H. pylori eradication on the occurrence of metachronous gastric cancer (MGC) after endoscopic submucosal dissection (ESD) of early gastric cancer (EGC) and risk factors of MGC.
METHODS The authors retrospectively reviewed the medical records of 433 patients (441 lesions) who underwent ESD for EGC from January 2005 to January 2015 in Yeungnam University Hospital. Patients were categorized into two groups; the H. pylori tested group (n = 257) and the H. pylori non-tested group (n = 176) based on performance of H. pylori status test after ESD of EGC. The H. pylori tested group was further categorized into three subgroups based on H. pylori status; the H. pylori-eradicated subgroup (n = 120), the H. pylori-persistent subgroup (n = 42), and the H. pylori-negative subgroup (n = 95). Incidences of MGC and risk factors of MGC were identified.
RESULTS Median follow-up duration after ESD was 30.00 mo (range, 6-107 mo). Total 15 patients developed MGC during follow-up. MGC developed in 11 patients of the H. pylori tested group (7 in the H. pylori-negative subgroup, 3 in the H. pylori-eradicated subgroup, and 1 in the H. pylori-persistent subgroup) and 4 patients of the H. pylori non-tested group (P > 0.05). The risk factors of MGC were endoscopic mucosal atrophy in the H. pylori tested group and intestinal metaplasia in all patients.
CONCLUSION H. pylori eradication and H. pylori status test seems to have no preventive effect on the development of MGC after ESD for EGC. The risk factors of MGC development were endoscopic mucosal atrophy in the H. pylori tested group alone and intestinal metaplasia in all patients.
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Song J, Kim SB, Kim KH, Kim TN, Lee KH. A case report of motesanib-induced biliary sludge formation causing obstructive cholangitis with acute pancreatitis treated by endoscopic sphincterotomy. Medicine (Baltimore) 2016; 95:e4645. [PMID: 27631212 PMCID: PMC5402555 DOI: 10.1097/md.0000000000004645] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 11/05/2022] Open
Abstract
BACKGROUND Gallbladder toxicity was reported in most motesanib studies with varying frequency and at variable times after initiation of treatment. METHOD AND RESULTS A 44-year-old man was admitted due to severe epigastric pain. The patient was diagnosed with non-small cell lung cancer 9 months ago and received 6 cycles of chemotherapy with motesanib, paclitaxel, and carboplatin. Ultrasonography showed a large amount of sludge within gallbladder. Computed tomography scan demonstrated diffuse dilatation of biliary tree with distended gallbladder without evidence of stone and mild pancreatic swelling. Endoscopic retrograde cholangiopancreatography showed yellowish viscous mucoid plug impacting ampullary orifice and dilated bile duct with amorphous filling defect at distal half of common duct. Endoscopic sphincterotomy was performed to prevent biliary obstruction and recurrent pancreatitis after removal of mucoid material. CONCLUSION To the best of our knowledge, this is the first report of obstructive cholangitis and acute pancreatitis associated with sludge formation during motesanib therapy. Endoscopic sphincterotomy appears to be useful to treat and prevent biliary obstruction caused by motesanib-induced biliary sludge.
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Affiliation(s)
- Jay Song
- Division of Gastroenterology and Hepatology
| | | | | | - Tae Nyeun Kim
- Division of Gastroenterology and Hepatology
- Correspondence: Tae Nyeun Kim, Yeungnam University, College of Medicine, Daegu, Republic of Korea (e-mail: )
| | - Kyung Hee Lee
- Division of Hematology-oncology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Republic of Korea
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Jeong YH, Kim TN, Kim KH. Subphrenic hematoma mimicking malpositioned gallbladder during endoscopic retrograde cholangiopancreatography. Endoscopy 2016; 47 Suppl 1 UCTN:E521. [PMID: 26528681 DOI: 10.1055/s-0034-1393043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- Yo Han Jeong
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Tae Nyeun Kim
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Kook Hyun Kim
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
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Lee JW, Kim TN, Kim SB, Kim KH. Splenic rupture following transcatheter arterial embolization of splenic artery pseudoaneurysm caused by acute pancreatitis. Korean J Intern Med 2016; 31:620-1. [PMID: 26922943 PMCID: PMC4855104 DOI: 10.3904/kjim.2015.238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Revised: 09/24/2015] [Accepted: 09/24/2015] [Indexed: 11/27/2022] Open
Affiliation(s)
| | - Tae Nyeun Kim
- Correspondence to Tae Nyeun Kim, M.D. Tel: +82-53-620-3842 Fax: +82-53-654-8386 E-mail:
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Hyun JJ, Lee HS, Kim CD, Dong SH, Lee SO, Ryu JK, Lee DH, Jeong S, Kim TN, Lee J, Koh DH, Park ET, Lee IS, Yoo BM, Kim JH. Efficacy of Magnesium Trihydrate of Ursodeoxycholic Acid and Chenodeoxycholic Acid for Gallstone Dissolution: A Prospective Multicenter Trial. Gut Liver 2016; 9:547-55. [PMID: 26087862 PMCID: PMC4478000 DOI: 10.5009/gnl15015] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [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] [Indexed: 01/07/2023] Open
Abstract
Background/Aims Cholecystectomy is necessary for the treatment of symptomatic or complicated gallbladder (GB) stones, but oral litholysis with bile acids is an attractive alternative therapeutic option for asymptomatic or mildly symptomatic patients. This study was conducted to evaluate the efficacy of magnesium trihydrate of ursodeoxycholic acid (UDCA) and chenodeoxycholic acid (CDCA) on gallstone dissolution and to investigate improvements in gallstone-related symptoms. Methods A prospective, multicenter, phase 4 clinical study to determine the efficacy of orally administered magnesium trihydrate of UDCA and CDCA was performed from January 2011 to June 2013. The inclusion criteria were GB stone diameter ≤15 mm, GB ejection fraction ≥50%, radiolucency on plain X-ray, and asymptomatic/mildly symptomatic patients. The patients were prescribed one capsule of magnesium trihydrate of UDCA and CDCA at breakfast and two capsules at bedtime for 6 months. The dissolution rate, response rate, and change in symptom score were evaluated. Results A total of 237 subjects were enrolled, and 195 subjects completed the treatment. The dissolution rate was 45.1% and the response rate was 47.2% (92/195) after 6 months of administration of magnesium trihydrate of UDCA and CDCA. Only the stone diameter was significantly associated with the response rate. Both the symptom score and the number of patients with symptoms significantly decreased regardless of stone dissolution. Adverse events necessitating discontinuation of the drug, surgery, or endoscopic management occurred in 2.5% (6/237) of patients. Conclusions Magnesium trihydrate of UDCA and CDCA is a well-tolerated bile acid that showed similar efficacy for gallstone dissolution and improvement of gallstone-related symptoms as that shown in previous studies.
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Affiliation(s)
- Jong Jin Hyun
- Department of Internal Medicine, Korea University College of Medicine, Korea
| | - Hong Sik Lee
- Department of Internal Medicine, Korea University College of Medicine, Korea
| | - Chang Duck Kim
- Department of Internal Medicine, Korea University College of Medicine, Korea
| | - Seok Ho Dong
- Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea
| | - Seung-Ok Lee
- Department of Internal Medicine, Chonbuk National University Medical School, Jeonju, Korea
| | - Ji Kon Ryu
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Don Haeng Lee
- Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea
| | - Seok Jeong
- Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea
| | - Tae Nyeun Kim
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Jin Lee
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Dong Hee Koh
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Eun Taek Park
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - In-Seok Lee
- Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Byung Moo Yoo
- Department of Internal Medicine, Ajou University School of Medicine, Suwon, Korea
| | - Jin Hong Kim
- Department of Internal Medicine, Ajou University School of Medicine, Suwon, Korea
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Scott D, Park MS, Kim TN, Ryu JY, Hong HC, Yoo HJ, Baik SH, Jones G, Choi KM. Associations of Low Muscle Mass and the Metabolic Syndrome in Caucasian and Asian Middle-aged and Older Adults. J Nutr Health Aging 2016; 20:248-55. [PMID: 26892573 DOI: 10.1007/s12603-015-0559-z] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Age-related declines in skeletal muscle mass may confer significant metabolic consequences for older adults. Associations of low muscle mass and metabolic syndrome (MetS) in Caucasians, and comparisons with associations observed in Asian populations, have not been reported. We examined associations of low muscle mass and metabolic syndrome (MetS) in Asian and Caucasian middle-aged and older men and women using criteria for low muscle mass. DESIGN, SETTING AND PARTICIPANTS Two population-based studies of Australian (Tasmanian Older Adult Cohort Study; TASOAC; N=1005) and Korean (Korean Sarcopenic Obesity Study; KSOS; N=376) community-dwelling adults, mean age 62 and 58 years, respectively. MEASUREMENTS Appendicular lean mass (aLM) determined by dual-energy X-ray absorptiometry and normalised to height squared (aLM/Ht2), weight (aLM/Wt) or body mass index (aLM/BMI). Participants in the lowest sex-specific 20% for aLM measures were defined as having low muscle mass. MetS was defined according to National Cholesterol Education Program Adult Treatment Panel III criteria. RESULTS Although Australians demonstrated generally unfavourable anthropometric and metabolic characteristics compared to Koreans, prevalence of MetS was similar (29.5% in Australians and 31.4% in Koreans, respectively). Low aLM/Ht2 was associated with significantly reduced likelihood of MetS in both Australians (OR: 0.30, 95% CI 0.19 - 0.46) and Koreans (OR: 0.31, 95% CI 0.16 - 0.62). Conversely, low aLM/BMI was associated with increased odds for MetS in Australians (OR: 1.78, 95% CI 1.12 - 2.84), but not Koreans (OR: 1.33, 95% CI = 0.67 - 2.64). CONCLUSION Low aLM/BMI is associated with significantly increased likelihood of MetS in Australian adults, but not Koreans, suggesting potential differences in effects of low muscle mass relative to body mass on cardiometabolic health in Caucasian and Asian middle-aged and older adults. Low muscle mass relative to height is associated with reduced likelihood of MetS in both populations.
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Affiliation(s)
- D Scott
- Prof. Kyung Mook Choi, Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Guro Hospital, 80 Guro-Dong, Guro-Gu, Seoul 152-050, Korea. E-mail: , Tel.: 822-2626-3043, Fax: 822-2626-1096
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Kim SB, Lee SH, Kim KO, Jang BI, Kim TN, Jeon SW, Kwon JG, Kim EY, Jung JT, Park KS, Cho KB, Kim ES, Kim HJ, Park CK, Park JB, Yang CH. Risk Factors Associated with Rebleeding in Patients with High Risk Peptic Ulcer Bleeding: Focusing on the Role of Second Look Endoscopy. Dig Dis Sci 2016; 61:517-22. [PMID: 26297133 DOI: 10.1007/s10620-015-3846-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [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: 04/27/2015] [Accepted: 08/04/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND Re-bleeding after initial hemostasis in peptic ulcer bleeding can be life threatening. Identification of factors associated with re-bleeding is important. The aims of this study were to determine incidence of rebleeding in patients with high risk peptic ulcer bleeding and to evaluate factors associated with rebleeding. METHODS Among patients diagnosed as upper gastrointestinal hemorrhage at seven hospitals in Daegu-Gyeongbuk, and one hospital in Gyeongnam, South Korea, from Feb 2011 to Dec 2013, 699 patients diagnosed as high risk peptic ulcer bleeding with Forrest classification above llb were included. The data were obtained in a prospective manner. RESULTS Among 699 patients, re-bleeding occurred in 64 (9.2 %) patients. Second look endoscopy was significantly more performed in the non-rebleeding group than the rebleeding group (81.8 vs 62.5 %, p < 0.001). In multivariate analysis, use of non-steroidal anti-inflammatory agents, larger transfusion volume (≥5 units), and non-performance of second look endoscopy were found as risk factors for rebleeding in high risk peptic ulcer bleeding. CONCLUSION In our study, rebleeding was observed in 9.2 % of patients with high risk peptic ulcer bleeding. Performance of second look endoscopy seems to lower the risk of rebleeding in high risk peptic ulcer bleeding patients and caution should be paid to patients receiving high volume transfusion and on medication with NSAIDs.
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Affiliation(s)
- Sung Bum Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, 317-1 Daemyung-dong, Nam-gu, 705-703, Republic of Korea
| | - Si Hyung Lee
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, 317-1 Daemyung-dong, Nam-gu, 705-703, Republic of Korea.
| | - Kyeong Ok Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, 317-1 Daemyung-dong, Nam-gu, 705-703, Republic of Korea
| | - Byung Ik Jang
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, 317-1 Daemyung-dong, Nam-gu, 705-703, Republic of Korea
| | - Tae Nyeun Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, 317-1 Daemyung-dong, Nam-gu, 705-703, Republic of Korea
| | - Seong Woo Jeon
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Republic of Korea
| | - Joong Goo Kwon
- Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Republic of Korea
| | - Eun Young Kim
- Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Republic of Korea
| | - Jin Tae Jung
- Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Republic of Korea
| | - Kyung Sik Park
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Republic of Korea
| | - Kwang Bum Cho
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Republic of Korea
| | - Eun Soo Kim
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Republic of Korea
| | - Hyun Jin Kim
- Department of Internal Medicine, Gyeongsang National University School of Medicine, Jinju, Republic of Korea
| | - Chang Keun Park
- Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Republic of Korea
| | - Jeong Bae Park
- Department of Internal Medicine, Dongguk University School of Medicine, Daegu, Republic of Korea
| | - Chang Heon Yang
- Department of Internal Medicine, Dongguk University School of Medicine, Daegu, Republic of Korea
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Nam YJ, Lee SH, Kim KO, Jang BI, Kim TN, Kim YJ. [Endoscopic Resection of Sporadic Non-ampullary Duodenal Neoplasms: A Single Center Study]. Korean J Gastroenterol 2016; 67:8-15. [PMID: 26809626 DOI: 10.4166/kjg.2016.67.1.8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND/AIMS Sporadic non-ampullary duodenal neoplasms are rare and optimal treatment for these lesions remains undefined. Endoscopic resection of duodenal neoplasms is widely used recently and it is an alternative treatment strategy to surgical excision. This study aimed to evaluate the safety and efficacy of endoscopic resection of duodenal neoplasms and to determine its outcomes. METHODS Patients who underwent endoscopic resection for non-ampullary duodenal neoplasms between January 2005 and December 2014 were analyzed retrospectively. Data including size, morphology, histology, location and endoscopic procedural technique were reviewed. The main outcome measurements were success rate, complication, recurrence and follow-up assessments. RESULTS The study included 33 patients with duodenal neoplasms. The mean size of resected lesion was 8.58 mm. The results of histologic examination were as follows: 23 (69.7%) adenomas, 2 (6.1%) adenocarcinoma, 3 (9.1%) Brunner's gland tumor and 3 (9.1%) neuroendocrine tumor. Tubular adenoma was the most common type (63.6%) of non-ampullary duodenal neoplasms. Eighteen (54.5%) lesions were found in the second portion of the duodenum, and 10 (30.3%) lesions on bulb and 3 (9.1%) lesions on superior duodenal angle. Of the 33 cases, 32 (97.0%) were managed by endoscopic mucosal resection technique during a single session and one case was managed by endoscopic submucosal dissection (ESD). One episode of perforation occurred after ESD. During a median follow-up period of 5.76 months, recurrence was observed in only one case of in a patient with tubular adenoma. CONCLUSIONS Endoscopic resection of duodenal neoplasm is a safe and effective treatment modality that can replace surgical resection in many cases. Careful endoscopic follow-up is essential to manage recurrence or residual lesions.
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Affiliation(s)
- Yoon Jeong Nam
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Si Hyung Lee
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Kyeong Ok Kim
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Byung Ik Jang
- Departments of Internal Medicine and Pathology1, Yeungnam University College of Medicine, Daegu, Korea
| | - Tae Nyeun Kim
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Yong Jin Kim
- Department of Pathology, Yeungnam University College of Medicine, Daegu, Korea
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Jung YS, Kim KO, Lee SH, Jang BI, Kim TN. Comparison on Oral versus Intravenous Proton Pump Inhibitors for Prevention of Bleeding after Endoscopic Submucosal Dissection of Gastric Lesions. Korean J Gastroenterol 2016; 67:74-80. [DOI: 10.4166/kjg.2016.67.2.74] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Yeoun Su Jung
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Kyeong Ok Kim
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Si Hyung Lee
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Byung Ik Jang
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Tae Nyeun Kim
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
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Lee HC, Kim KO, Jeong YH, Lee SH, Jang BI, Kim TN. Clinical Outcomes in Hospitalized Patients withClostridium difficileInfection by Age Group. Korean J Gastroenterol 2016; 67:81-6. [DOI: 10.4166/kjg.2016.67.2.81] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Ho Chan Lee
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Kyeong Ok Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Yo Han Jeong
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Si Hyung Lee
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Byung Ik Jang
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Tae Nyeun Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
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