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| 1 | Characterization of focal liver masses using acoustic radiation force impulse elastography显示文摘AIM:To investigate the diagnostic performance of acoustic radiation force impulse(ARFI) elastography for characterizing focal liver mass by quantifying their stiffness.METHODS:This prospective study included 62 patients with a focal liver mass that was well visualized on conventional ultrasonography performed in our institution from February 2011 to November 2011.Among them,12 patients were excluded for ARFI measurement failure due to a lesion that was smaller than the region of the interest and at an inaccessible location(deeper than 8 cm)(n = 7) or poor compliance to hold their breath as required(n = 5).Finally,50 patients with valid ARFI measurements were enrolled.If a patient had multiple liver masses,only one mass of interest was chosen.The masses were diagnosed by histological examination or clinical diagnostic criteria.During ultrasonographic evaluation,stiffness,expressed as velocity,was checked 10 times per focal liver mass and the surrounding liver parenchyma.RESULTS:After further excluding three masses that were non-diagnostic on biopsy,a total of 47 focal mass lesions were tested,including 39(83.0%) malignant masses [24 hepatocellular carcinomas(HCC),seven cholangiocellular carcinomas(CCC),and eight liver metastases] and eight(17.0%) benign masses(five hemangiomas and three focal nodular hyperplasias,FNH).Thirty-seven(74.0%) masses were confirmed by histological examination.The mean velocity was 2.48 m/s in HCCs,1.65 m/s in CCCs,2.35 m/s in metastases,1.83 m/s in hemangiomas,and 0.97 m/s in FNHs.Although considerable overlap was still noted between malignant and benign masses,significant differences in ARFI values were observed between malignant and benign masses(mean 2.31 m/s vs 1.51 m/s,P = 0.047),as well as between HCCs and benign masses(mean 2.48 m/s vs 1.51 m/s,P = 0.006).The areas under the receiver operating characteristics curves(AUROC) for discriminating the malignant masses from benign masses was 0.724(95%CI,0.566-0.883,P = 0.048),and the AUROC for discriminating HCCs from benign masses was 0.813(95%CI,0.649-0.976,P = 0.008).To maximize the sum of sensitivity and specificity,an ARFI value of 1.82 m/s was selected as the cutoff value to differentiate malignant from benign liver masses.Furthermore,the cutoff value for distinguishing HCCs from benign masses was also determined to be 1.82 m/s.The diagnostic performance of the sum of the ARFI values for focal liver masses and the surrounding liver parenchyma to differentiate liver masses improved(AUROC = 0.853;95%CI,0.745-0.960;P = 0.002 in malignant liver masses vs benign ones and AUROC = 0.948;95%CI,0.896-0.992,P < 0.001 in HCCs vs benign masses).CONCLUSION:ARFI elastography provides additional information for the differential diagnosis of liver masses.However,our results should be interpreted in clinical context,because considerable overlap in ARFI values existed among liver masses. | Hana Park Jun Yong Park Do Young Kim Sang Hoon Ahn Chae Yoon Chon Kwang-Hyub Han Seung Up Kim | 2013 | World Journal of Gastroenterology2013，19，2： | 22 |
| 2 | Clinical application of liver stiffness measurement using transient elastography in chronic liver disease from longitudinal perspectives显示文摘Accurate determination of the presence and degree of fibrosis in liver is of great importance, because the prognosis and management strategies for chronic liver disease depend mainly on these factors. To date, liver biopsy (LB) remains the 'gold standard' for assessing the severity of liver fibrosis; however, LB is often limited by its invasiveness, sampling error, and intra/ inter-observer variability in histological interpretation. Furthermore, repeated LB examinations within a short time interval are indeed ineligible in a real clinical practice. Thus, due to the pressing need for non-invasive surrogates for liver fibrosis, transient elastography (TE),as a novel ultrasound based technology, has allowed a noninvasive measurement of liver stiffness and has gained in popularity over recent years. In the past few years, additional roles for transient TE beyond the initial purpose of a non-invasive surrogate for LB have included the prediction of the most two critical consequences of fibrosis progression: the development of portal hypertension-related complications and hepatocellular carcinoma. This indicates that the role of transient TE is not merely limited to reducing the need for LB, but transient TE can enable the establishment of tailored management strategies by providing more detailed prognostic information. In particular, under the concept in which the clinical course of liver fibrosis is dynamic and bidirectional, especially when appropriate intervention is commenced, transient TE can be used to track the dynamic changes in fibrotic burden during antiviral or antifibrotic treatment. This review discussed extended applications of transient TE in prediction of the development of real clinical endpoints from a longitudinal perspective. | Beom Kyung Kim James Fung Man-Fung Yuen Seung Up Kim | 2013 | World Journal of Gastroenterology2013，19，12： | 14 |
| 3 | Role of surgical resection for multiple hepatocellular carcinomas显示文摘AIM:To clarify the role of surgical resection for multiple hepatocellular carcinomas(HCCs)compared to transarterial chemoembolization(TACE)and liver transplantation(LT). METHODS:Among the HCC patients who were managed at Yonsei University Health System between January 2003 and December 2008,160 patients who met the following criteria were retrospectively enrolled:(1) two or three radiologically diagnosed HCCs;(2)no radiologic vascular invasion;(3)Child-Pugh class A;(4) main tumor smaller than 5 cm in diameter;and(5) platelet count greater than 50 000/mm3.Long-term outcomes were compared among the following three treatment modalities:surgical resection or combined radiofrequency ablation(RFA)(n=36),TACE(n=107), and LT(n=17).The survival curves were computed using the Kaplan-Meier method and compared with a log-rank test.To identify the patients who gained a survival benefit from surgical resection,we also investigated prognostic factors for survival following surgical resection.Multivariate analyses of the prognostic factors for survival were performed using the Cox proportional hazard model. RESULTS:The overall survival(OS)rate was significantly higher in the surgical resection group than in the TACE group(48.1%vs 28.9%at 5 years,P<0.005). LT had the best OS rate,which was better than that of the surgical resection group,although the difference was not statistically significant(80.2%vs 48.1%at 5 years,P=0.447).The disease-free survival rates were also significantly higher in the LT group than in the surgical resection group(88.2%vs 11.2%at 5 years, P<0.001).Liver cirrhosis was the only significant prognostic factor for poor OS after surgical resection. Clinical liver cirrhosis rates were 55.6%(20/36)in the resection group and 93.5%(100/107)in the TACE group.There were 19 major and 17 minor resections. En bloc resection was performed in 23 patients,multisite resection was performed in 5 patients,and combined resection with RFA was performed in 8 patients. In the TACE group,only 34 patients(31.8%)were recorded as having complete remission after primary TACE.Seventy-two patients(67.3%)were retreated with repeated TACE combined with other therapies. In patients who underwent surgical resection,the 16 patients who did not have cirrhosis had higher 5-year OS and disease-free survival rates than the 20 patients who had cirrhosis(80.8%vs 25.5%5-year OS rate, P=0.006;22.2%vs 0%5-year disease-free survival rate,P=0.048).Surgical resection in the 20 patients who had cirrhosis did not provide any survival benefit when compared with TACE(25.5%vs 24.7%5-year OS rate,P=0.225).Twenty-nine of the 36 patients who underwent surgical resection experienced recur-rence.Of the patients with cirrhosis,80%(16/20) were within the Milan criteria at the time of recurrence CONCLUSION:Among patients with two or three HCCs, no radiologic vascular invasion,and tumor diameters≤ 5 cm,surgical resection is recommended only in those without cirrhosis. | Sung Hoon Choi Gi Hong Choi Seung Up Kim Jun Yong Park Dong Jin Joo Man Ki Ju Myoung Soo Kim Jin Sub Choi Kwang Hyub Han Soon Il Kim | 2013 | World Journal of Gastroenterology2013，19，3： | 12 |
| 4 | Factors associated with significant liver fibrosis assessed using transient elastography in general population显示文摘AIM: To investigate the prevalence of significant liver fibrosis assessed using transient elastography(TE) and its predictors in asymptomatic general population.METHODS: A total of 159 subjects without chronic viral hepatitis who underwent comprehensive medical health check-up between January 2012 and July 2012 were prospectively recruited. Significant liver fibrosis was defined as liver stiffness value > 7.0 k Pa.RESULTS: The mean age and body mass index(BMI) of the study population(men 54.7%) was 56.0 years and 24.3 kg/m2. Among the study subjects, 11(6.9%) showed significant liver fibrosis. On univariate analysis, BMI, alanine aminotransferase(ALT), homeostasis model assessment of insulin resistance, carotid intimal media thickness(IMT), number of calcified plaques on carotid ultrasound, and visceral fat area on computed tomography were significantly higher in subjects with significant liver fibrosis than in those without(all P < 0.05). However, on multivariate analysis, BMI [odds ratio(OR) =1.487; P = 0.045], ALT(OR = 1.078; P = 0.014), carotid IMT(OR = 3.244; P = 0.027), and the number of calcified carotid plaques(OR = 1.787; P = 0.031) were independent predictors of significant liver fibrosis. CONCLUSION: The prevalence of significant liver fibrosis assessed using TE was 6.9% in apparently healthy subjects. High BMI, high ALT, thicker carotid IMT, and higher numbers of calcified carotid plaqueswere independently associated with the presence of significant liver fibrosis. | Seng Chan You Kwang Joon Kim Seung Up Kim Beom Kyung Kim Jun Yong Park Do Young Kim Sang Hoon Ahn Won Jae Lee Kwang-Hyub Han | 2015 | World Journal of Gastroenterology2015，21，4： | 7 |
| 5 | Successful hemostasis of intractable rectal variceal bleeding using variceal embolization显示文摘Portal hypertension causes portosystemic shunting along the gastrointestinal tract,resulting in gastrointestinalvarices.Rectal varices and their bleeding is a rare complication,but it can be fatal without appropriate treatment.However,because of its rarity,no established treatment strategy is yet available.In the setting of intractable rectal variceal bleeding,a transjugular intravenous portosystemic shunt can be a treatment of choice to enable portal decompression and thus achieve hemostasis.However,in the case of recurrent rectal variceal bleeding despite successful transjugular intravenous portosystemic shunt,alternative measures to control bleeding are required.Here,we report on a patient with liver cirrhosis who experienced recurrent rectal variceal bleeding even after successful transjugular intravenous portosystemic shunt and was successfully treated with variceal embolization. | Sung Soo Ahn Eun Hye Kim Man Deuk Kim Won Jae Lee Seung Up Kim | 2015 | World Journal of Gastroenterology2015，21，8： | 7 |
| 6 | Non-invasive prediction of forthcoming cirrhosis-related complications显示文摘In patients with chronic liver diseases,identification of significant liver fibrosis and cirrhosis is essential for determining treatment strategies,assessing therapeutic response,and stratifying long-term prognosis.Although liver biopsy remains the reference standard for evaluating the extent of liver fibrosis in patients with chronic liver diseases,several non-invasive methods have been developed as alternatives to liver biopsies.Some of these non-invasive methods have demonstrated clinical accuracy for diagnosing significant fibrosis or cirrhosis in many cross-sectional studies with the histological fibrosis stage as a reference standard.However,non-invasive methods cannot be fully validated through cross-sectional studies since liver biopsy is not a perfect surrogate endpoint marker.Accordingly,recent studies have focused on assessing the performance of non-invasive methods through longterm,longitudinal,follow-up studies with solid clinical endpoints related to advanced stages of liver fibrosis and cirrhosis.As a result,current view is that these alternative methods can independently predict future cirrhosis-related complications,such as hepatic decompensation,liver failure,hepatocellular carcinoma,or liver-related death.The clinical role of non-invasive models seems to be shifting from a simple tool for predicting the extent of fibrosis to a surveillance tool for predicting future liver-related events.In this article,we will summarize recent longitudinal studies of non-invasive methods for predicting forthcoming complications related to liver cirrhosis and discuss the clinical value of currently available non-invasive methods based on evidence from the literature. | Wonseok Kang Seung Up Kim Sang Hoon Ahn | 2014 | World Journal of Gastroenterology2014，20，10： | 4 |
| 7 | Antiviral efficacy of lamivudine versus entecavir in patients with hepatitis B virus‐related advanced hepatocellular carcinoma显示文摘 | Hye Sun Shin Seung Up Kim Jun Yong Park Do Young Kim Kwang‐Hyub Han Chae Yoon Chon Oidov Baatarkhuu Sang Hoon Ahn | 2012 | Journal of Gastroenterology and Hepatology2012，，9： | 3 |
| 8 | Transient elastography in chronic hepatitis B: An Asian perspective显示文摘Transient elastography (TE) is a new non-invasive tool for assessing liver stiffness, which is correlated with the histologic stage of liver fibrosis. Many studies have reported a good accuracy of TE in predicting signif icant fibrosis and an optimal accuracy in predicting cirrhosis. Furthermore, the potential role of TE in screening the general population has also been proven. TE thus helps physicians to decide treatment strategies, predict prog-nosis, and monitor disease progression in patients with chronic liver disease and to screen the general popula-tion to identify high risk patients with potential liver disease. However, most data on the clinical roles of TE have been gathered in European patients with chronic hepatitis C (CHC), because TE was first developed in France. Accordingly, much data on the usefulness of TE in patients with CHC has accumulated. Recently, however, vigorous efforts have been made to apply TEto patients with chronic hepatitis B (CHB), and TE has also proved to have acceptable accuracy in diagnosing liver fibrosis and cirrhosis in these patients. Thus, we focused on TE in the Asian population with CHB in comparison with the European population with CHC and found that the diagnostic performance and cutoff values were different between the 2 populations possibly as a result of several different confounders between Asian and European populations (the etiology of chronic liver disease, histologic features, major fluctuation in alanine aminotransferase levels, and the prevalence of high body mass index and metabolic syndrome). Therefore, further studies tailored to the Asian population with CHB should be performed before the widespread application of TE in Asian populations with CHB. | Seung Up Kim Kwang-Hyub Han Sang Hoon Ahn | 2010 | World Journal of Gastroenterology2010，16，41： | 3 |
| 9 | Efficacy of switching to telbivudine plus adefovir in suboptimal responders to lamivudine plus adefovir显示文摘AIM:To examine the efficacy of telbivudine(LdT)+adefovir(ADV)vs continuation of lamivudine(LAM)+ADV in patients with LAM-resistant chronic hepatitis B(CHB)who show a suboptimal response to LAM+ADV.METHODS:This was a randomized,active-control,open-label,single-center,parallel trial.All eligible patients were enrolled in this study in Severance Hospital,Yonsei University College of Medicine,Seoul,South Korea,between March 2010 and March 2011.Hepatitis Be antigen(HBeAg)-positive CHB patients whose serum hepatitis B virus(HBV)DNA remained detectable despite at least 6 mo of LAM+ADV therapy were included.Enrolled patients were randomized to either switching to LdT(600 mg/d orally)plus ADV(10 mg/d orally)(LdT+ADV group)or to continuation with LAM(100 mg/d orally)plus ADV(10 mg/d orally)(LAM+ADV group),and were followed for 48 wk.One hundred and six patients completed the 48-wk treatment period.Serum HBV DNA,HBeAg status,liver biochemistry and safety were monitored at baseline and week 12,24,36 and 48.RESULTS:The duration of prior LAM+ADV treatment was 18.3(LdT+ADV)and 14.9 mo(LAM+ADV),respectively(P=0.131).No difference was seen in baseline serum HBV DNA between the two groups[3.66(LdT+ADV)vs 3.76(LAM+ADV)log10IU/mL,P=0.729].At week 48,although there was no significant difference in the mean reduction of serum HBV DNA from baseline between LdT+ADV group and LAM+ADV group(-0.81 vs-0.47 log10IU/mL,P=0.167),more patients in the LdT+ADV group had undetectable HBV DNA levels compared to those in the LAM+ADV group(30.2%vs 11.5%,P=0.019).Three patients with LdT+ADV treatment and 2 patients with LAM+ADV treatment achieved HBeAg loss.The patients in both groups tolerated the treatment well without serious adverse events.The proportion of patients with estimated glomerular filtration rate≥90 mL/min per 1.73 m2in the LdT+ADV group increased from 49.1%(26/53)at baseline to 58.5%(31/53)at week 48,while that in the LAM+ADV group decreased from 37.7%(20/53)at baseline to 30.2%(16/53)at week 48.CONCLUSION:The switch to LdT+ADV in suboptimal responders to LAM+ADV showed a significantly higher rate of virologic response at week 48.These results suggest that LdT+ADV could be a therapeutic option for patients who are unable to use enofovir disoproxil fumarate for any reason. | Hana Park Jun Yong Park Seung Up Kim Do Young Kim Kwang-Hyub Han Chae Yoon Chon Sang Hoon Ahn | 2013 | World Journal of Gastroenterology2013，19，43： | 3 |
| 10 | The Laennec staging system for histological sub-classification of cirrhosis is useful for stratification of prognosis in patients with liver cirrhosis显示文摘 | Seung Up Kim Hyun Jung Oh Ian R. Wanless Sarah Lee Kwang-Hyub Han Young Nyun Park | 2012 | Journal of Hepatology2012，，3： | 2 |
| 11 | Controlled attenuation parameter ( CAP ) for detection of hepatic steatosis in patients with chronic liver diseases: a prospective study of a native Korean population显示文摘 | Young Eun Chon Kyu Sik Jung Seung Up Kim Jun Yong Park Young Nyun Park Do Young Kim Sang Hoon Ahn Chae Yoon Chon Hye Won Lee Yehyun Park Kwang‐Hyub Han | 2014 | Liver Int2014，，1： | 2 |
| 12 | Transient elastography-based risk estimation of hepatitis B virus-related occurrence of hepatocellular carcinoma: development and validation of a predictive model显示文摘 | Eun Jin Yoo Sang Hoon Ahn Jun Yong Park Seung Up Kim Ki Jun Song Do Young Kim Kwang-Hyub Han | 2013 | OncoTargets and Therapy . 2013 (defa)2013，，： | 2 |
| 13 | Obesity is an important determinant of severity in newly defined metabolic dysfunction-associated fatty liver disease显示文摘Background: The recently proposed definition of metabolic dysfunction-associated fatty liver disease(MAFLD) is based on the co-existence of hepatic steatosis with other metabolic disorders, including obesity and metabolic risk abnormalities such as hyperglycemia, high blood pressure and dyslipidemia. This study aimed to assess MAFLD severity according to the presence of metabolic abnormalities and obesity. Methods: Using transient elastography, hepatic steatosis and fibrosis severity were assessed by measuring the controlled attenuation parameter and liver stiffness measurement. A total of 1163 patients with MAFLD were categorized into the following four groups according to metabolic risk abnormalities and obesity presence: non-obese without metabolic risk abnormality group(Group 1;reference group);nonobese with metabolic risk abnormality group(Group 2);obese without metabolic risk abnormality group(Group 3);and obese with metabolic risk abnormality group(Group 4). A multiple logistic regression analysis was performed to determine severe hepatic steatosis and fibrosis risk in each group in both unadjusted and adjusted models. Results: In the adjusted model, the odds ratios(ORs) [95% confidence interval(CI)] for severe hepatic steatosis in Groups 2, 3, and 4 were 1.07(0.61-1.88), 2.43(1.44-4.08), and 4.07(2.56-6.48), respectively( P trend < 0.001). For liver fibrosis, compared with Group 1, Group 2 showed no significant increases in OR, whereas Groups 3 and 4(obese groups) showed significant increases(OR = 4.70, 95% CI: 1.24-17.82 and OR = 6.43, 95% CI: 1.88-22.02, respectively). Conclusions: Obesity, rather than metabolic abnormality, is the principal determinant of severe hepatic steatosis and fibrosis in patients with MAFLD. | Ji Hye Huh Kwang Joon Kim Seung Up Kim Bong-Soo Cha Byung-Wan Lee | 2022 | Hepatobiliary & Pancreatic Diseases International2022，21，3： | 2 |
| 14 | The Accuracy of Noninvasive Methods in Predicting the Development of Hepatocellular Carcinoma and Hepatic Decompensation in Patients With Chronic Hepatitis B显示文摘 | Young Eun Chon Eun Suk Jung Jun Yong Park Do Young Kim Sang Hoon Ahn Kwang-Hyub Han Chae Yoon Chon Kyu Sik Jung Seung Up Kim | 2012 | Journal of Clinical Gastroenterology2012，，6： | 2 |
| 15 | Applicability of BCLC stage for prognostic stratification in comparison with other staging systems: single centre experience from long‐term clinical outcomes of 1717 treatment‐na?ve patients with hepatocellular carcinoma显示文摘 | Beom Kyung Kim Seung Up Kim Jun Yong Park Do Young Kim Sang Hoon Ahn Mi Sung Park Eun Hye Kim Jinsil Seong Do Youn Lee Kwang‐Hyub Han | 2012 | Liver Int2012，，7： | 2 |
| 16 | Survival of Hepatocellular Carcinoma Patients May be Improved in Surveillance Interval not More Than 6 Months Compared With More Than 6 Months: A 15-Year Prospective Study显示文摘 | Kwang-Hyub Han Do Young Kim Jun Yong Park Sang Hoon Ahn Jieun Kim Seung Up Kim Ja Kyung Kim Kwan Sik Lee Chae Yoon Chon | 2013 | Journal of Clinical Gastroenterology2013，，6： | 1 |
| 17 | Liver Stiffness Measurement Using Acoustic Radiation Force Impulse (ARFI) Elastography and Effect of Necroinflammation显示文摘 | Ki Tae Yoon Sun Min Lim Jun Yong Park Do Young Kim Sang Hoon Ahn Kwang-Hyub Han Chae Yoon Chon Mong Cho Jun Woo Lee Seung Up Kim | 2012 | Digestive Diseases and Sciences2012，，6： | 1 |
| 18 | Combination treatment of localized concurrent chemoradiation therapy and transarterial chemoembolization in locally advanced hepatocellular carcinoma with intrahepatic metastasis显示文摘 | Mi Sung Park Seung Up Kim Jun Yong Park Do Young Kim Sang Hoon Ahn Kwang Hyub Han Chae Yoon Chon Jinsil Seong | 2013 | Cancer Chemotherapy and Pharmacology2013，，1： | 1 |
| 19 | Non-invasive assessment of changes in liver fibrosis via liver stiffness measurement in patients with chronic hepatitis B: impact of antiviral treatment on fibrosis regression显示文摘 | Seung Up Kim Jun Yong Park Do Young Kim Sang Hoon Ahn Eun Hee Choi Jae Yeon Seok Jung Min Lee Young Nyun Park Chae Yoon Chon Kwang-Hyub Han | 2010 | Hepatology International2010，，4： | 1 |
| 20 | Prediction of postoperative hepatic insufficiency by liver stiffness measurement (FibroScan?) before curative resection of hepatocellular carcinoma: a pilot study显示文摘 | Seung Up Kim Sang Hoon Ahn Jun Yong Park Do Young Kim Chae Yoon Chon Jin Sub Choi Kyung Sik Kim Kwang-Hyub Han | 2008 | Hepatology International2008，，4： | 1 |
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