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| 1 | Diagnostic value of PIVKA-Ⅱ and alpha-fetoprotein in hepatitis B virus-associated hepatocellular carcinoma显示文摘AIM: To determine the cutoff values and to compare the diagnostic role of alpha-fetoprotein(AFP) and prothrombin induced by vitamin K absence-Ⅱ(PIVKA-Ⅱ) in chronic hepatitis B(CHB).METHODS: A total of 1255 patients with CHB, including 157 patients with hepatocellular carcinoma(HCC), 879 with non-cirrhotic CHB and 219 with cirrhosis without HCC, were retrospectively enrolled. The areas under the receiver operating characteristic(AUROC) curves of PIVKA-Ⅱ, AFP and their combination were calculated and compared.RESULTS: The optimal cutoff values for PIVKA-Ⅱ and AFP were 40 m AU/m L and 10 ng/m L, respectively, for the differentiation of HCC from nonmalignant CHB. The sensitivity and specificity were 73.9% and 89.7%, respectively, for PIVKA-Ⅱ and 67.5% and 90.3% for AFP, respectively. The AUROC curves of both PIVKA-Ⅱ and AFP were not significantly different(0.854 vs 0.853, P = 0.965) for the differentiation of HCC from nonmalignant CHB, whereas the AUROC of PIVKA-Ⅱ was significantly better than that of AFP in patients with cirrhosis(0.870 vs 0.812, P = 0.042). When PIVKA-Ⅱ and AFP were combined, the diagnostic power improved significantly compared to either AFP or PIVKA-Ⅱ alone for the differentiation of HCC from nonmalignant CHB(P < 0.05), especially when cirrhosis was present(P < 0.05).CONCLUSION: Serum PIVKA-Ⅱ might be a better tumor marker than AFP, and its combination with AFP may enhance the early detection of HCC in patients with CHB. | Seung In Seo Hyoung Su Kim Won Jin Kim Woon Geon Shin Doo Jin Kim Kyung Ho Kim Myoung Kuk Jang Jin Heon Lee Joo Seop Kim Hak Yang Kim Dong Joon Kim Myung Seok Lee Choong Kee Park | 2015 | World Journal of Gastroenterology2015,21,13: | 60 |
| 2 | Comparison of scoring systems in predicting the severity of acute pancreatitis显示文摘AIM:To investigate the prognostic usefulness of several existing scoring systems in predicting the severity of acute pancreatitis(AP).METHODS:We retrospectively analyzed the prospectively collected clinical database from consecutive patients with AP in our institution between January 2011 and December 2012.Ranson,Acute Physiology and Chronic Health Evaluation(APACHE)-Ⅱ,and bedside index for severity in acute pancreatitis(BISAP)scores,and computed tomography severity index(CTSI)of all patients were calculated.Serum C-reactive protein(CRP)levels were measured at admission(CRPi)and after 24h(CRP24).Severe AP was defined as persistent organ failure for more than 48 h.The predictive accuracy of each scoring system was measured by the area under the receiver-operating curve(AUC).RESULTS:Of 161 patients,21(13%)were classified as severe AP,and 3(1.9%)died.Statistically significant cutoff values for prediction of severe AP were Ranson≥3,BISAP≥2,APACHE-Ⅱ≥8,CTSI≥3,and CRP24≥21.4.AUCs for Ranson,BISAP,APACHE-Ⅱ,CTSI,and CRP24 in predicting severe AP were 0.69(95%CI:0.62-0.76),0.74(95%CI:0.66-0.80),0.78(95%CI:0.70-0.84),0.69(95%CI:0.61-0.76),and0.68(95%CI:0.57-0.78),respectively.APACHE-Ⅱdemonstrated the highest accuracy for prediction of severe AP,however,no statistically significant pairwise differences were observed between APACHE-Ⅱand the other scoring systems,including CRP24.CONCLUSION:Various scoring systems showed similar predictive accuracy for severity of AP.Unique models are needed in order to achieve further improvement of prognostic accuracy. | Joon Hyun Cho Tae Nyeun Kim Hyun Hee Chung Kook Hyun Kim | 2015 | World Journal of Gastroenterology2015,21,8: | 35 |
| 3 | Small sphincterotomy combined with endoscopic papillary large balloon dilation versus sphincterotomy显示文摘AIM:To compare small sphincterotomy combined with endoscopic papillary large balloon dilation(SES+ ELBD)and endoscopic sphincterotomy(EST)for large bile duct stones. METHODS:We compared prospectively SES+ELBD (group A,n=27)with conventional EST(group B, n=28)for the treatment of large bile duct stones(≥ 15 mm).When the stone could not be removed with a normal basket,mechanical lithotripsy was performed. We compared the rates of complete stone removal with one session and application of mechanical lithotripsy. RESULTS:No significant differences were observed in the mean largest stone size(A:20.8 mm,B:21.3 mm), bile duct diameter(A:21.4 mm,B:20.5 mm),number of stones(A:2.2,B:2.3),or procedure time(A:18 min, B:19 min)between the two groups.The rates of complete stone removal with one session was 85%in group A and 86%in group B(P=0.473).Mechanical lithotripsy was required for stone removal in nine of 27 patients(33%)in group A and nine of 28 patients (32%,P=0.527)in group B.CONCLUSION:SES+ELBD did not show significant benefits compared to conventional EST,especially for the removal of large(≥15 mm)bile duct stones. | Hyun Gun Kim Young Koog Cheon Young Deok Cho Jong Ho Moon Do Hyun Park Tae Hoon Lee Hyun Jong Choi Sang-Heum Park Joon Seong Lee Moon Sung Lee | 2009 | World Journal of Gastroenterology2009,15,34: | 34 |
| 4 | Current management of hepatocellular carcinoma:An Eastern perspective显示文摘Hepatocellular carcinoma(HCC) is one of the leading causes of cancer death, especially in Eastern areas. With advancements in diagnosis and treatment modalities for HCC, the survival and prognosis of HCC patients are improving. However, treatment patterns are not uniform between areas despite efforts to promote a common protocol. Although many hepatologists in Asian countries may adopt the principles of the Barcelona Clinic Liver Cancer staging system, they are also independently making an effort to expand the indications of each treatment and to combine therapies for better outcomes. Several expanded criteria for liver transplantation in HCC have been developed in Asian countries. Living donor liver transplantation is much more commonly performed in these countries than deceased donor liver transplantation, and it may be preceded by other treatments such as the down-staging of tumors. Local ablation therapies are often combined with transarterial chemoembolization( TACE) and the outcome is comparable to that of surgical resection. The indications of TACE are expanding, and there are new types of transarterial therapies. Although data on drug-eluting beads, TACE, and radioembolization in Asian countries are still relatively sparse compared with Western countries, these methods are gradually gaining popularity because of better tolerability and the possibility of improved response rates. Hepatic arterial infusion chemotherapy and radiotherapy are not included in Western guidelines, but are currently being used actively in several Asian countries. For more advanced HCCs, appropriate combinations of TACE, radiotherapy, and sorafenib can be considered, and emerging data indicate improved outcomes of combination therapies compared with single therapies. To include these paradigm shifts into newer treatment guidelines, more studies may be needed, but they are certainly in progress. | Hyung Joon Yim Sang Jun Suh Soon Ho Um | 2015 | World Journal of Gastroenterology2015,21,13: | 26 |
| 5 | Histopathology and TB-PCR kit analysis in differentiating the diagnosis of intestinal tuberculosis and Crohn’s disease显示文摘AIM: To compare the histopathologic features of intestinal tuberculosis (ITB) and Crohn’s disease (CD) and to identify whether polymerase chain reaction for Mycobacterium tuberculosis (TB-PCR) would be helpful for differential diagnosis between ITB and CD.METHODS: We selected 97 patients with established diagnoses (55 cases of ITB and 42 cases of CD) who underwent colonoscopic biopsies.Microscopic features of ITB and CD were reviewed,and eight pathologic parameters were evaluated.Nine cases of acid fast bacilli culture-positive specimens and 10 normal colonic tissue specimens were evaluated as the positive and negative control of the TB-PCR test,respectively.PCR assays were done using two commercial kits: kit detected IS6110 and MPB64,and kit detected IS6110 only;a manual in-house PCR method was also performed on formalin-fi xed,paraffi n-embedded colonoscopic biopsy specimens.RESULTS: Statistically significant differences were noted between ITB and CD with regard histopathologic criteria: size of granulomas (P = 0.000),giant cells (P = 0.015),caseation necrosis (P = 0.003),confluent granulomas (P = 0.001),discrete granulomas (P = 0.000),and granulomas with lymphoid cuffs (P = 0.037).However,29 cases (52.7%) of ITB showed less than fi ve kinds of pathologic parameters,resulting in confusion with CD.The sensitivities and specificities of the TB-PCR test by kit ,kit ,and the in-house PCR method were 88.9% and 100%,88.9% and 100%,and 66.7% and 100% in positive and negative controls,respectively.The PCR test done on endoscopic biopsy specimens of ITB and CD were signifi cantly different with kit (P = 0.000) and kit (P = 0.000).The sensitivities and specifi cities of TB-PCR were 45.5% and 88.1%,36.4% and 100%,and 5.8% and 100%,for kit and kit and inhouse PCR method on endoscopic biopsy specimens.Among the 29 cases of histopathologically confusing CD,10 cases assayed using kit and 6 cases assayed using kit were TB-PCR positive.A combination of histologic fi ndings and TB-PCR testing led to an increase of diagnostic sensitivity and the increase (from 47.3% to 58.2) was statistically signifi cant with kit (P = 0.000).CONCLUSION: The TB-PCR test combined with histopathologic factors appears to be a helpful technique in formulating the differential diagnosis of ITB and CD in endoscopic biopsy samples. | Joon Mee Kim Hyung Kil Kim Lucia Kim Suk Jin Choi In Suh Park Jee Young Han Young Chae Chu Kye Sook Kwon Eun Joo Kim | 2010 | World Journal of Gastroenterology2010,16,20: | 20 |
| 6 | Management of the complications of endoscopic submucosal dissection显示文摘Endoscopic submucosal dissection(ESD) is currently widely accepted as a standard treatment option for early gastrointestinal neoplasms in Korea.However,ESD has technical difficulties and a longer procedure time than conventional endoscopic resection.So it may have a higher risk of complications than conventional endoscopic resection techniques.We,the ESD study group of Korean Society of Gastrointestinal Endoscopy,have experienced many complications,mostly treated by endoscopic or conservative management.Here,we introduce and share our experiences for managementof post ESD complications and review published papers on the topic. | Seong Hwan Kim Jeong Seop Moon Young Hoon Youn Ki Myung Lee Sung Joon Lee | 2011 | World Journal of Gastroenterology2011,17,31: | 19 |
| 7 | Treatment strategies using adefovir dipivoxil for individuals with lamivudine-resistant chronic hepatitis B显示文摘AIM:To investigate retrospectively the long-term efficacy of various treatment strategies using adefovir dipivoxil(adefovir) in patients with lamivudine-resistant chronic hepatitis B.METHODS:We included 154 consecutive patients in two treatment groups:the 'add-on' group(n = 79),in which adefovir was added to ongoing lamivudine treatment due to lamivudine resistance,and the 'switch/combination' group(n = 75),in which lamivudine was first switched to adefovir and then re-added later as needed.The 'switch/combination' group was then divided into two subgroups depending on whether participants followed(group A,n = 30) or violated(group B,n = 45) a proposed treatment strategy that determined whether to add lamivudine based on the serum hepatitis B virus(HBV) DNA levels(< 60 IU/mL or not) after 6 mo of treatment(roadmap concept).RESULTS:The cumulative probability of virologic response(HBV DNA < 60 IU/mL) was higher in group A than in the 'add-on' group and in group B(P < 0.001).In contrast,the cumulative probability of virologic breakthrough was lower in the 'add-on' group than in group B(P = 0.002).Furthermore,the risk of virologic breakthrough in the multivariate analysis was significantly lower in the 'add-on' group than in group A(hazard ratio = 0.096;95%CI,0.015-0.629;P = 0.015).CONCLUSION:The selective combination of adefovir with lamivudine based upon early treatment responses increased the odds of virologic breakthrough relative to the use of uniform combination therapy from the beginning of treatment. | Tae Jung Yun Jin Yong Jung Chang Ha Kim Soon Ho Um Hyonggin An Yeon Seok Seo Jin Dong Kim Hyung Joon Yim Bora Keum Yong Sik Kim Yoon Tae Jeen Hong Sik Lee Hoon Jai Chun Chang Duck Kim Ho Sang Ryu | 2012 | World Journal of Gastroenterology2012,18,47: | 19 |
| 8 | Biliary drainage for obstructive jaundice caused by unresectable hepatocellular carcinoma: the endoscopic versus percutaneous approach显示文摘BACKGROUND: For palliative treatment of the obstructive jaundice associated with unresectable hepatocellular carcinoma (HCC), percutaneous transhepatic biliary drainage (PTBD) or endoscopic retrograde biliary drainage (ERBD) has been performed. PTBD is preferred as an initial procedure. Little is known about the better option for patients with obstructive jaundice caused by unresectable HCC. METHODS: Sixty patients who had received ERBD or PTBD for the palliative treatment of obstructive jaundice caused by unresectable HCC between January 2006 and May 2010 were included in this retrospective study. Successful drainage, drainage patency, and the overall survival of patients were evaluated. RESULTS: Univariate analysis revealed that the overall frequency of successful drainage was higher in the ERBD group (22/29, 75.9%) than in the PTBD group (15/31, 48.4%) (P=0.029); but multivariate analysis showed marginal significance (P=0.057). The duration of drainage patency was longer in the ERBD group than in the PTBD group (82 vs 37 days, respectively, P=0.020). Regardless of what procedure was performed, the median survival time of patients who had a successful drainage was much longer than that of the patients who did not have a successful drainage (143 vs 38 days, respectively, P<0.001).CONCLUSION: Besides PTBD, ERBD may be used as the initial treatment option to improve obstructive jaundice in patients with unresectable HCC if there is a longer duration of drainage patency after a successful drainage. | Jongkyoung Choi Ji Kon Ryu Sang Hyub Lee Dong-Won Ahn Jin-Hyeok Hwang Yong-Tae Kim Yong Bum Yoon Joon Koo Han | 2012 | Hepatobiliary & Pancreatic Diseases International2012,11,6: | 17 |
| 9 | The association of benign prostatic hyperplasia with lower urinary tract stones in adult men: A retrospective multicenter study显示文摘Objective:To examine the relationship between benign prostatic hyperplasia(BPH)and the presence of lower urinary tract stones.Methods:We retrospectively reviewed the records of men with lower urinary tract stones who presented to three clinical centers in Korea over a 4-year period.We divided the patients into two groups based on the location of urinary stones:Group 1(bladder calculi)and Group 2(urethral calculi).We compared the characteristics of both groups and performed univariate and multivariate analyses with a logistic regression model to investigate the relationship between BPH and lower urinary tract stones.Results:Of 221 patients,194(87.8%)had bladder calculi and 27(12.2%)had urethral calculi.The mean age of Group 1 was higher than that of Group 2(68.9612.11 years vs.55.7414.20 years,p<0.001).The mean prostate volume of Group 1 was higher than that of Group 2(44.4727.14 mL vs.24.706.41 mL,respectively,p<0.001).Multivariate logistic regression showed that age(OR Z 1.075,95%CI:1.023e1.129)and prostate volume(OR Z 1.069,95%CI:1.017e1.123)were independently associated with increased risk for bladder calculi.Upper urinary tract stones and/or hydronephrosis conferred a 3-fold risk for urethral calculi(OR Z 3.468,95%CI:1.093e10.999).Conclusion:Age and prostate volume are independent risk factors for bladder calculi.In addition,men with upper urinary tract disease are at greater risk for urethral calculi,which may migrate from the upper urinary tract rather than from the bladder. | Jae Hung Jung Jinsung Park Won Tae Kim Hong Wook Kim Hyung Joon Kim Sungwoo Hong Hee Jo Yang Hong Chung | 2018 | Asian Journal of Urology2018,5,2: | 17 |
| 10 | Tenofovir rescue therapy for chronic hepatitis B patients after multiple treatment failures显示文摘AIM:To evaluate the efficacy and safety of tenofovir disoproxil fumarate(TDF) for chronic hepatitis B(CHB) patients after multiple failures.METHODS:A total of 29 CHB patients who had a suboptimal response or developed resistance to two or more previous nucleoside/nucleotide analogue(NA) treatments were included.Study subjects were treated with TDF alone(n = 13) or in combination with lamivudine(LAM,n = 12) or entecavir(ETV,n = 4) for ≥ 6 mo.Complete virologic response(CVR) was defined as an achievement of serum hepatitis B virus(HBV) DNA level ≤ 60 IU/mL by real-time polymerase chain reaction method during treatment.Safety assessment was based on serum creatinine and phosphorus level.Eleven patients had histories of LAM and adefovir dipivoxil(ADV) treatment and 18 patients were exposed to LAM,ADV,and ETV.Twenty-seven patients(93.1%) were hepatitis B e antigen(HBeAg) positive and the mean value of the baseline serum HBV DNA level was 5.5 log IU/mL ± 1.7 log IU/mL.The median treatment duration was 16 mo(range 7 to 29 mo).RESULTS:All the patients had been treated with LAM and developed genotypic and phenotypic resistance to it.Resistance to ADV was present in 7 patients and 10 subjects had a resistance to ETV.One patient had a resistance to both ADV and ETV.The cumulative probabilities of CVR at 12 and 24 mo of TDF containing treatment regimen calculated by the Kaplan Meier method were 86.2% and 96.6%,respectively.Although one patient failed to achieve CVR,serum HBV DNA level decreased by 3.9 log IU/mL from the baseline and the last serum HBV DNA level during treatment was 85 IU/mL,achieving near CVR.No patients in this study showed viral breakthrough or primary non-response during the follow-up period.The cumulative probability of HBeAg clearance in the 27 HBeAg positive patients was 7.4%,12%,and 27% at 6,12,and 18 mo of treatment,respectively.Treatment efficacy of TDF containing regimen was not statistically different according to the presence of specific HBV mutations.History of prior exposure to specific antiviral agents did not make a difference to treatment outcome.Treatment efficacy of TDF was not affected by combination therapy with LAM or ETV.No patient developed renal toxicity and no cases of hypophosphatemia associated with TDF therapy were observed.There were no other adverse events related to TDF therapy observed in the study subjects.CONCLUSION:TDF can be an effective and safe rescue therapy in CHB patients after multiple NA therapy failures. | Yu Jin Kim Dong Hyun Sinn Geum-Youn Gwak Moon Seok Choi Kwang Cheol Koh Seung Woon Paik Byung Chul Yoo Joon Hyeok Lee | 2012 | World Journal of Gastroenterology2012,18,47: | 16 |
| 11 | Neoadjuvant chemoradiotherapy followed by D2 gastrectomy in locally advanced gastric cancer显示文摘AIM:To investigate the efficacy of neoadjuvant chemoradiotherapy(NACRT) for resectability of locally advanced gastric cancer(LAGC).METHODS:Between November 2007 and January 2014,29 patients with LAGC(clinically T3 with distal esophagus invasion/T4 or bulky regional node metastasis) that were treated with NACRT followed by D2 gastrectomy were included in this study.Resectability was evaluated with radiologic and endoscopic exams before and after NACRT.Using threedimensional conformal radiotherapy,patients received 45 Gy,with a daily dose of 1.8 Gy.The entire tumor extent and the regional metastatic lymph nodes were included in the gross tumor volume.Patients presenting with a resectable tumor after NACRT received a total or subtotal gastrectomy with D2 dissection.The pathologic tumor response was evaluated using Japanese Gastric Cancer Association histologic evaluation criteria.Postoperative morbidity was evaluated using the National Cancer Institute-Common Terminology Criteria for Adverse Events version 4.0.Overall survival(OS) and progression-free survival(PFS) rates were estimated using a Kaplan-Meier analysis and compared using the log-rank test.RESULTS:All patients were assessed as unresectable cases.Twenty-four patients(24/29; 82.8%) showed LAGC on positron emission tomography-computed tomography(CT) and contrast-enhanced CT,whereas four patients(4/29; 13.8%) with vague invasion orabutment to an adjacent organ underwent diagnostic laparoscopy.One patient(1/29; 3.4%),initially assessed as a resectable case,underwent an 'open and closure' after the tumor was found to be unresectable.Abutment to an adjacent organ(34.5%) was the most common reason for NACRT.The clinical response rate one month after NACRT was 44.8%.After NACRT,69%(20/29) of patients had a resectable tumor.Of the 20 patients with a resectable tumor,18 patients(62.1%) underwent a D2 gastrectomy.The R0 resection rate was 94.4% and two patients(2/18; 11.1%) showed a complete response.The median follow-up duration was 13.5 mo.The one-year OS and PFS rates were 72.4 and 48.9%,respectively.The one-year OS,PFS,local failure-free survival,and distant metastasis-free survival were higher in patients with a resectable tumor after NACRT(P < 0.001,P < 0.001,P < 0.001,and P =0.078,respectively).No grade 3-4 late treatment-related toxicities or postoperative mortalities were observed.CONCLUSION:NACRT with D2 gastrectomy showed a high rate of R0 resection and promising local control,which may increase the R0 resection opportunity resulting in survival benefit. | Mi Sun Kim Joon Seok Lim Woo Jin Hyung Yong Chan Lee Sun Young Rha Ki Chang Keum Woong Sub Koom | 2015 | World Journal of Gastroenterology2015,21,9: | 15 |
| 12 | Capecitabine and cisplatin with or without cetuximab for patients with previously untreated advanced gastric cancer (EXPAND): a randomised, open-label phase 3 trial显示文摘 | Florian Lordick Yoon-Koo Kang Hyun-Cheol Chung Pamela Salman Sang Cheul Oh Gy?rgy Bodoky Galina Kurteva Constantin Volovat Vladimir M Moiseyenko Vera Gorbunova Joon Oh Park Akira Sawaki Ilhan Celik Heiko G?tte Helena Melezínková Markus Moehler | 2013 | Lancet Oncology2013,,6: | 14 |
| 13 | Cancer stem cell markers CD133 and CD24 correlate with invasiveness and differentiation in colorectal adenocarcinoma显示文摘AIM:To verify that CD markers are available for detecting cancer stem cell populations and to evaluate their clinical significance in colon cancer.METHODS:Immunohistochemistry for CD133,CD24 and CD44 was performed on the tissue microarray of 523 colorectal adenocarcinomas.Medical records were reviewed and clinicopathological analysis was performed.RESULTS:In colorectal adenocarcinoma,128 of 523 cases(24.5%) were positive and 395 cases(75.5%) were negative for CD133 expression.Two hundred and sixty-four of 523 cases(50.5%) were positive and 259 cases(49.5%) were negative for CD24 expression.Five hundred and two of 523 cases(96%) were negative and 21 cases(4%) were positive for CD44 expression.Upon clinicopathological analysis,CD133 expression was present more in male patients(P = 0.002) and in advanced T stage cancer(P = 0.024).Correlation between CD24 expression and clinicopathological factors was seen in the degree of differentiation(P = 0.006).Correlation between CD44 expression and clinicopathological factors was seen in the tumor size(P = 0.001).Survival was not significantly related to CD133,CD24 and CD44 expression.CONCLUSION:CD markers were related to invasiveness and differentiation of colorectal adenocarcinoma.However,CD expression was not closely related to survival. | Dongho Choi Hyo Won Lee Kyung Yul Hur Jae Joon Kim Gyeong-Sin Park Si-Hyong Jang Young Soo Song Ki-Seok Jang Seung Sam Paik | 2009 | World Journal of Gastroenterology2009,15,18: | 14 |
| 14 | Endoscopic submucosal dissection for early gastric cancer with undifferentiated-type histology:A meta-analysis显示文摘AIM: To evaluate the efficacy and safety of endoscopicsubmucosal dissection(ESD) for early gastric cancer(EGC) with undifferentiated-type histology.METHODS: A systematic literature review was conducted using the core databases. Complete resection,curative resection, en bloc resection, recurrence and adverse event rate were extracted and analyzed. A random effect model was applied. The methodological quality of the enrolled studies was assessed using the Newcastle-Ottawa Scale. Publication bias was evaluated using a funnel plot, the trim and fill method, Egger's test,and a rank correlation test.RESULTS: Fourteen retrospective studies between2009 and 2014 were identified(972 EGC lesions with undifferentiated-type histology). The total en bloc and complete resection rates were estimated as92.1%(95%CI: 87.4%-95.2%) and 77.5%(95%CI:69.3%-84%), respectively. The total curative resection rate was 61.4%(95%CI: 44.5%-75.9%). The overall recurrence rate was 7.6%(95%CI: 3.4%-16%).Limited to histologically diagnosed expanded-criteria lesions, the en bloc and complete resection rates were91.2% and 85.6%, respectively. The curative resection rate was 79.8%.CONCLUSION: In this analysis, ESD is a technically feasible treatment modality for EGC with undifferentiatedtype histology. Long-term studies are needed to confirm these therapeutic outcomes. | Chang Seok Bang Gwang Ho Baik In Soo Shin Jing Bong Kim Ki Tae Suk Jai Hoon Yoon Yeon Soo Kim Dong Joon Kim Woon Geon Shin Kyung Ho Kim Hak Yang Kim Hyun Lim Ho Seok Kang Jong Hyeok Kim Jin Bae Kim Sung Won Jung Sea Hyub Kae Hyun Joo Jang Min Ho Choi | 2015 | World Journal of Gastroenterology2015,21,19: | 14 |
| 15 | Clinical significance of CT-defined minimal ascites in patients with gastric cancer显示文摘AIM: To study the clinical significance of minimal ascites,which was only defined by the CT and whose nature was not determined preoperatively, in the relationship with the peritoneal carcinomatosis.METHODS: The medical records and the dynamic CT films of 118 patients with gastric cancer were reviewed.Factors associated with peritoneal carcinomatosis were analyzed in 40 patients who had CT-defined ascites of which the nature was surgically confirmed.RESULTS: Only 12.5-25% of the CT-defined minimal ascites, whose volume was estimated to be less than 50 mL, were associated with peritoneal carcinomatosis.When the estimated CT-defined ascitic volume was 50 mL or more, peritoneal carcinomatosis was identified in 75-100%. When CT-defined lymph node enlargements were not found beyond the regional gastric area,perigastricinvasions were not suspected, and the size of tumor was less than 3 cm, peritoneal carcinomatosis seemed significantly less accompanied at the univariate analysis. However, except for the minimal volume of CTdefined ascites in comparison with the mild or more,other factors were not confirmed multivariately.CONCLUSION: In the patients with gastric cancer, CTdefined minimal ascites alone is rarely associated with peritoneal carcinomatosis, if it does not accompany other signs suggestive of malignant seeding. Therefore,consideration of active curative resection should not be hesitated, if CT-defined minimal ascites is the only delusive sign. | Dong Kyung Chang Ji Won Kim Byung Kwan Kim Kook Lae Lee Chi Sung Song Joon Koo Han In Sung Song | 2005 | World Journal of Gastroenterology2005,11,42: | 14 |
| 16 | Clinical analysis of risk factors contributing to recurrence of pterygium after excision and graft surgery显示文摘AIM: To find the risk factors related to the reproliferation of the pterygial tissue after excision and graft surgery.METHODS: Charts of 130 eyes of 130 patients who had pterygial excision from March 2006 to April 2011 were reviewed. Preoperative pterygium morphology, surgical methods, and adjunctive treatments were statistically analyzed for their relationship with recurrence.RESULTS: During the follow-up period, recurrence was observed in 20 eyes(15.4%). None of the preoperative morphologic features were affected the rate of the recurrence. However, an age <40y [P =0.085, odds ratio(OR) 3.609, 95% confidence interval(CI) 0.838-15.540]and amniotic membrane graft instead of conjunctival autograft(P =0.002, OR 9.093, 95% CI 2.316-35.698) were statistically significant risk factors for recurrence.Multivariate analysis revealed that intraoperative mitomycin C(MMC)(P =0.072, OR 0.298, 95% CI 0.080-1.115)decreased the rate of recurrence. CONCLUSION: Younger age is a risk factor for reproliferation of pterygial tissue after excision and amniotic membrane transplantation(AMT) are less effective in preventing recurrence of pterygium after excision based on the comparison between conjunctival autograft and AMT. Intraoperative MMC application and conjunctival autograft reduce recurrence. | Sang Won Ha Joon Ho Park Im Hee Shin Hong Kyun Kim | 2015 | International Journal of Ophthalmology(English edition)2015,8,3: | 13 |
| 17 | Management of entecavir-resistant chronic hepatitis B with adefovir-based combination therapies显示文摘AIM: To evaluate the long-term efficacy adefovir(ADV)-based combination therapies in entecavir(ETV)-resistant chronic hepatitis B(CHB) patients. METHODS: F i fty CHB pat ient s wi t h genotypic resistance to ETV at 13 medical centers in South Korea were included for the analysis. All the patients received rescue therapy with the combination of ADV plus ETV(ADV/ETV,n = 23) or ADV plus lamivudine(LMV)(ADV/LMV,n = 27) for more than 12 mo. Patients were monitored at least every 3-4 mo during ADV-based combination therapy by clinical examination as well as biochemical and virological assessments. Hepatitis B virus(HBV) DNA levels were measured by realtime PCR and logarithmically transformed for analysis. Cumulative rates of virologic response(VR; HBV DNA < 20 IU/m L) were calculated using the Kaplan-Meier method,and the difference was determined by a logrank test. Multivariate logistic regression and Cox proportional hazards models were used to identify independent risk factors significantly associated with short-term and long-term VR,respectively.RESULTS: Baseline median HBV DNA levels were 5.53(2.81-7.63) log10 IU/m L. The most commonly observed ETV genotypic mutation sites were rt184 and rt202. Patients were treated for a median of 27(12-45) mo. Overall,cumulative VR rates at 6,12,24,and 36 mo were 26%,36%,45%,and 68%,respectively. Patients treated with the ADV/ETV combination showed higher cumulative VR rates(35%,43%,65%,and 76%,respectively) than those with the ADV/LAM combination(18%,30%,30%,and 62%,respectively; P = 0.048). In the multivariate analysis,low baseline HBV DNA levels(< 5.2 log10 IU/m L) and initial virologic response at 3 mo(IVR-3; HBV DNA < 3.3 log10 IU/m L after 3 mo) were independent predictive factors for VR. Patients with favorable predictors achieved cumulative VR rates up to 90% at 36 mo. During the same period,the cumulative incidence of virologic breakthrough was as low as 6% in patients with the both favorable predictors.CONCLUSION: If tenofovir is not available,ADV/ETV combination could be considered in ETV-resistant patients with low HBV DNA titers,and may becontinued if IVR-3 is achieved. | Hyoung Su Kim Hyung Joon Yim Myoung Kuk Jang Ji Won Park Sang Jun Suh Yeon Seok Seo Ji Hoon Kim Bo Hyun Kim Sang Jong Park Sae Hwan Lee Sang Gyune Kim Young Seok Kim Jung Il Lee Jin-Woo Lee In Hee Kim Tae Yeob Kim Jin-Wook Kim Sook-Hyang Jeong Young Kul Jung Hana Park Seong Gyu Hwang | 2015 | World Journal of Gastroenterology2015,21,38: | 13 |
| 18 | Endoscopic ultrasonography does not differentiate neoplastic from non-neoplastic small gallbladder polyps显示文摘AIM:To assess the ability of endoscopic ultrasonography(EUS) to differentiate neoplastic from non-neoplastic polypoid lesions of the gallbladder(PLGs) .METHODS:The uses of EUS and transabdominal ultrasonography(US) were retrospectively analyzed in 94 surgical cases of gallbladder polyps less than 20 mm in diameter.RESULTS:The prevalence of neoplastic lesions with a diameter of 5-10 mm was 17.2%(10/58) ;11-15 mm,15.4%(4/26) ,and 16-20 mm,50%(5/10) .The overall diagnostic accuracies of EUS and US for small PLGs were 80.9% and 63.9%(P < 0.05) ,respectively.EUS correctly distinguished 12(63.2%) of 19 neoplastic PLGs but was less accurate for polyps less than 1.0 cm(4/10,40%) than for polyps greater than 1.0 cm(8/9,88.9%) (P = 0.02) .CONCLUSION:Although EUS was more accurate than US,its accuracy for differentiating neoplastic from non-neoplastic PLGs less than 1.0 cm was low.Thus,EUS alone is not suffi cient for determining a treatment strategy for PLGs of less than 1.0 cm. | Young Koog Cheon Won Young Cho Tae Hee Lee Young Deok Cho Jong Ho Moon Joon Seong Lee Chan Sup Shim | 2009 | World Journal of Gastroenterology2009,15,19: | 12 |
| 19 | Relationship between hepatitis C virus infection and type 2 diabetes mellitus:Meta-analysis显示文摘AIM:To investigate the association between hepatitis C infection and type 2 diabetes mellitus.METHODS:Observational studies assessing the relationship between hepatitis C infection and type 2 diabetes mellitus were identified via electronic and hand searches.Studies published between 1988 to March 2011 were screened,according to the inclusion criteria set for the present analysis.Authors performed separate analyses for the comparisons between hepatitis C virus(HCV) infected and not infected,and HCV infected and hepatitis B virus infected.The included studies were further subgrouped according to the study design.Heterogenity was assessed using I2 statistics.The summary odds ratios with their corresponding 95% CIs were calculated based on a random-effects model.The included studies were subgrouped according to the study design.To assess any factor that could potentially affect the outcome,results were further stratified by age group(proportion of ≥ 40 years),gender(proportion of male gender),body mass index(BMI)(pro-portion of BMI ≥ 27),and family history of diabetes(i.e.,self reported).For stability of results,a sensitivity analysis was conducted including only prospective studies.RESULTS:Combining the electronic database and hand searches,a total of 35 observational studies(in 31 articles) were identified for the final analysis.Based on random-effects model,17 studies(n = 286 084) compared hepatitis C-infected patients with those who were uninfected [summary odds ratio(OR):1.68,95% CI:1.15-2.45].Of these 17 studies,7 were both a cross-sectional design(41.2%) and cohort design(41.2%),while 3 were case-control studies(17.6%).Nineteen studies(n = 51 156) compared hepatitis C-infected participants with hepatitis B-infected(summary OR:1.92,95% CI:1.41-2.62).Of these 19 studies,4(21.1%),6(31.6%) and 9(47.4%) were cross-sectional,cohort and case-control studies,respectively.A sensitivity analysis with 3 prospective studies indicated that hepatitis C-infected patients had a higher risk of developing type 2 diabetes compared with uninfected controls(summary odds ratio:1.41,95% CI:1.17-1.7;I2 = 0%).Among hepatitis C-infected patients,male patients(OR:1.26,95% CI:1.03-1.54) with age over 40 years(summary OR:7.39,95% CI:3.82-9.38) had an increased frequency of type 2 diabetes.Some caution must be taken in the interpretation of these results because there may be unmeasured confounding factors which may introduce bias.CONCLUSION:The findings support the association between hepatitis C infection and type 2 diabetes mellitus.The direction of association remains to be determined,however.Prospective studies with adequate sample sizes are recommended. | Cho Naing Joon Wah Mak Syed Imran Ahmed Mala Maung | 2012 | World Journal of Gastroenterology2012,18,14: | 12 |
| 20 | Plasma levels of acylated ghrelin in patients with functional dyspepsia显示文摘AIM:To investigate the relationship between plasma acylated ghrelin levels and the pathophysiology of functional dyspepsia.METHODS:Twenty-two female patients with functional dyspepsia and twelve healthy volunteers were recruited for the study.The functional dyspepsia patients were each diagnosed based on the Rome Ⅲ criteria.Eligible patients completed a questionnaire concerning the severity of 10 symptoms.Plasma acylated ghrelin levels before and after a meal were determined in the study participants using a commercial human acylated enzyme immunoassay kit;electrogastrograms were performed for 50 min before and after a standardized 10-min meal containing 265 kcal.RESULTS:There were no significant differences in plasma acylated ghrelin levels between healthy volunteers and patients with functional dyspepsia.However,in patients with functional dyspepsia,there was a negative correlation between fasting plasma acylated ghrelin levels and the sum score of epigastric pain(r =-0.427,P = 0.047) and a positive correlation between the postprandial/fasting plasma acylated ghrelin ratio and the sum score of early satiety(r = 0.428,P =0.047).Additionally,there was a negative correlation between fasting acylated ghrelin plasma levels and fasting normogastria(%)(r =-0.522,P = 0.013).Interestingly,two functional dyspepsia patients showed paradoxically elevated plasma acylated ghrelin levels after the meal.CONCLUSION:Abnormal plasma acylated ghrelin levels before or after a meal may be related to several of the dyspeptic symptoms seen in patients with functional dyspepsia. | Yeon Soo Kim Joon Seong Lee Tae Hee Lee Joo Young Cho Jin Oh Kim Wan Jung Kim Hyun Gun Kim Seong Ran Jeon Hoe Su Jeong | 2012 | World Journal of Gastroenterology2012,18,18: | 12 |