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1Small 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 2009World Journal of Gastroenterology2009,15,34:34
2Limited endoscopic sphincterotomy plus large balloon dilation for choledocholithiasis with periampullary diverticula显示文摘AIM: To investigate the effectiveness and safety of limited endoscopic sphincterotomy (EST) plus large balloon dilation (LBD) for removing choledocholithiasis in patients with periampullary diverticula (PAD). METHODS: A total of 139 patients with common bile duct (CBD) stones were treated with LBD (10-20 mm balloon diameter) after limited EST. Of this total, 73 patients had PAD and 66 patients did not have PAD (controls). The results of stone removal and complications were retrospectively evaluated. RESULTS: There were no significant differences between the PAD and the control groups in overall successful stone removal (94.5% vs 93.9%), stone removal in first session (69.9% vs 81.8%), mechanical lithotripsy (12.3% vs 13.6%), and complications (11.0% vs 7.6%). Clinical outcomes were also similar between the types of PAD, but the rate of stone removal in first session and the number of sessions were significantly lower and more frequent, respectively, in type B PAD (papilla located near the diverticulum) than controls [23/38 (60.5%) vs 54/66 (81.8%), P = 0.021; and 1 (1-2) vs 1 (1-3), P = 0.037, respectively] and the frequency of pancreatitis was significantly higher in type A PAD (papilla located inside or in the margin of the diverticulum) than in controls (16.1% vs 3.0%, P = 0.047). CONCLUSION: Limited EST plus LBD was an effective and safe procedure for removing choledocholithiasis in patients with PAD. However, some types of PAD should be managed with caution.Hyung Wook Kim Dae Hwan Kang Cheol Woong Choi Jong Hwan Park Jin Ho Lee Min Dae Kim Il Doo Kim Ki Tae Yoon Mong Cho Ung Bae Jeon Suk Kim Chang Won Kim Jun Woo Lee 2010World Journal of Gastroenterology2010,16,34:26
3Overexpression of the M2 isoform of pyruvate kinase is an adverse prognostic factor for signet ring cell gastric cancer显示文摘AIM:To investigate M2 isoform of pyruvate kinase(PKM2) expression in gastric cancers and evaluate its potential as a prognostic biomarker and an anticancer target.METHODS:All tissue samples were derived from gastric cancer patients underwent curative gastrectomy as a primary treatment.Clinical and pathological information were obtained from the medical records.Gene expression microarray data from 60 cancer and 19 noncancer gastric tissues were analyzed to evaluate the expression level of PKM2 mRNA.Tissue microarrays were constructed from 368 gastric cancer patients.Immunohistochemistry was used to measure PKM2 expression and PKM2 positivity of cancer was determined by proportion of PKM2-positive tumor cells and staining intensity.Association between PKM2 expression and the clinicopathological factors was evaluated and the correlation between PKM2 and cancer prognosis was evaluated.RESULTS:PKM2 mRNA levels were increased more than 2-fold in primary gastric cancers compared to adjacent normal tissues from the same patients(log transformed expression level:7.6 ± 0.65 vs 6.3 ± 0.51,P < 0.001).Moreover,differentiated type cancers had significantly higher PKM2 mRNA compared to undifferentiated type cancers(log transformed expression level:7.8 ± 0.70 vs 6.7 ± 0.71,P < 0.001).PKM2 protein was mainly localized in the cytoplasm of primary cancer cells and detected in 144 of 368(39.1%) human gastric cancer cases.PKM2 expression was not related with stage(P = 0.811),but strongly correlated with gastric cancer differentiation(P < 0.001).Differentiated type cancers expressed more PKM2 protein than did the undifferentiated ones.Well differentiated adenocarcinoma showed 63.6% PKM2-positive cells;in contrast,signet-ring cell cancers showed only 17.7% PKM2-positive cells.Importantly,PKM2 expression was correlated with shorter overall survival(P < 0.05) independent of stage only in signet-ring cell cancers.CONCLUSION:PKM2 expression might be an adverse prognostic factor for signet-ring cell carcinomas.Its function and potential as a prognostic marker should be further verified in gastric cancer.Jae Yun Lim Sun Och Yoon So Young Seol Soon Won Hong Jong Won Kim Seung Ho Choi Jae Yong Cho 2012World Journal of Gastroenterology2012,18,30:19
4The dynamics of the piglet gut microbiome during the weaning transition in association with health and nutrition显示文摘Background: Understanding the composition of the microbial community and its functional capacity during weaning is important for pig production as bacteria play important roles in the pig's health and growth performance. However,limited information is available regarding the composition and function of the gut microbiome of piglets in early-life.Therefore, we performed 16 S rRNA gene and whole metagenome shotgun sequencing of DNA from fecal samples from healthy piglets during weaning to measure microbiome shifts, and to identify the potential contribution of the early-life microbiota in shaping piglet health with a focus on microbial stress responses, carbohydrate and amino acid metabolism.Results: The analysis of 16 S rR NA genes and whole metagenome shotgun sequencing revealed significant compositional and functional differences between the fecal microbiome in nursing and weaned piglets. The fecal microbiome of the nursing piglets showed higher relative abundance of bacteria in the genus Bacteroides with abundant gene families related to the utilization of lactose and galactose. Prevotel a and Lactobacil us were enriched in weaned piglets with an enrichment for the gene families associated with carbohydrate and amino acid metabolism. In addition, an analysis of the functional capacity of the fecal microbiome showed higher abundances of genes associated with heat shock and oxidative stress in the metagenome of weaned piglets compared to nursing piglets.Conclusions: Overal, our data show that microbial shifts and changes in functional capacities of the piglet fecal microbiome resulted in potential reductions in the effects of stress, including dietary changes that occur during weaning.These results provide us with new insights into the piglet gut microbiome that contributes to the growth of the animal.Robin B.Guevarra Sang Hyun Hong Jin Ho Cho Bo-Ra Kim Jiwon Shin Jun Hyung Lee Bit Na Kang Young Hwa Kim Suphot Wattanaphansak Richard E.Isaacson Minho Song Hyeun Bum Kim 2018Journal of Animal Science and Biotechnology2018,9,4:16
5Prevalence of clonorchiasis in patients with gastrointestinal disease: A Korean nationwide multicenter survey显示文摘AIM: To investigate prevalence of Clonorchis sinensis in patients with gastrointestinal symptoms, and the relation of the infection to hepatobiliary diseases in 26 hospitals in Korea.METHODS: Consecutive patients who had been admitted to the Division of Gastroenterology with gastrointestinal symptoms were enrolled from March to April 2005. Of those who had been diagnosed with clonorchiasis, epidemiology and correlation between infection and hepatobiliary diseases were surveyed by questionnaire.RESULTS: Of 3080 patients with gastrointestinal diseases, 396 (12.9%) had clonorchiasis and 1140 patients (37.2%) had a history of eating raw freshwater fish. Of those with a history of raw freshwater fish ingestion, 238 (20.9%) patients had clonorchiasis. Cholangiocarcinoma was more prevalent in C. sinensis-infected patients than non-infected patients [34/396 (8.6%) vs 145/2684 (5.4%), P = 0.015]. Cholangiocarcinoma and clonorchiasis showed statistically significant positive cross-relation (P = 0.008). Choledocholithiasis, cholecystolithiasis, cholangitis, hepatocellular carcinoma, and biliary pancreatitis did not correlate with clonorchiasis.CONCLUSION: Infection rate of clonorchiasis was still high in patients with gastrointestinal diseases in Korea, and has not decreased very much during the last two decades. Cholangiocarcinoma was related to clonorchiasis, which suggested an etiological role for the parasite.Ho Gak Kim Jimin Han Myung-Hwan Kim Kyu Hyun Cho Im Hee Shin Gwang Ha Kim Jae Seon Kim Jin Bong Kim Tae Nyeun Kim Tae Hyeon Kim Tae Hyo Kim Jae Woo Kim Ji Kon Ryu Young-Soo Moon Jong Ho Moon Sung Jae Park Chan Guk Park Sung-Jo Bang Chang Heon Yang Kyo-Sang Yoo Byung Moo Yoo Kyu Taek Lee Dong Ki Lee Byung Seok Lee Sang Soo Lee Seung Ok Lee Woo Jin Lee Chang Min Cho Young-Eun Joo Gab Jin Cheon Young Woo Choi Jae Bok Chung Yong Bum Yoon 2009World Journal of Gastroenterology2009,15,1:15
6Hepatectomy vs radiofrequency ablation for colorectal liver metastasis:A propensity score analysis显示文摘AIM:To compare outcomes from radiofrequency ablation(RFA) and hepatectomy for treatment of colorectal liver metastasis(CRLM).METHODS:From January 2000 to December 2009,408 patients underwent curative intent treatment for CRLM.We excluded patients using the criteria:size of CRLM > 3 cm,number of CRLM ≥ 5,percutaneous RFA,follow-up period < 12 mo,double primary cancer,or treatment with both RFA and hepatectomy.We matched 51 patients who underwent RFA with 102 patients who underwent hepatectomy by propensity scores.RESULTS:The median follow-up period was 45 mo(range,12 mo to 158 mo).Hepatic recurrence was more frequent in the RFA than the hepatectomy group(P = 0.021) although extrahepatic recurrence curves were similar(P = 0.716).Survival curves of hepatectomy group were better than that of RFA for multiple,large(> 2 cm) CRLM(P = 0.034).However,survival curves were similar for single or small(≤ 2 cm) CRLM(P = 0.714,P = 0.740).CONCLUSION:Hepatectomy is better than RFA for the treatment of CRLM.However,RFA might be suitable for selected patients with single,small(≤ 2 cm) CRLM.Huisong Lee Jin Seok Heo Yong Beom Cho Seong Hyeon Yun Hee Cheol Kim Woo Yong Lee Seong Ho Choi Dong Wook Choi 2015World Journal of Gastroenterology2015,21,11:14
7Peri-infarct reorganization of an injured corticospinal tract in a patient with cerebral infarction显示文摘Corticospinal tract(CST), a major neural tract in the human brain for motor function, is involved mainly in the movement of the distal extremities(Jang and Lee, 2019). Recovery of an injured CST is essential for good recovery of impaired motor function in stroke patients(Jang and Lee, 2019). Peri-infarct reorganization of an injured CST is an important mechanism underlying recovery of motor function in stroke patients(Jang, 2007). In this study, we reported on a patient with cerebral infarction who showed recovery of an injured CST by periinfarct reorganization using diffusion tensor tractography(DTT) and transcranial magnetic stimulation(TMS).Min Kyeong Cho Sung Ho Jang 2021Neural Regeneration Research2021,16,8:13
8Endoscopic 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 2009World Journal of Gastroenterology2009,15,19:12
9Intrahepatic biliary cystadenoma:Is there really an almost exclusively female predominance?显示文摘Biliary cystic tumors,such as cystadenomas and cystadenocarcinomas,are rare cystic tumors of the liver,accounting for less than 5% of all intrahepatic cysts of biliary origin.Biliary cystadenomas have been known to occur predominantly in women (> 85%),and 38%-44% of biliary cystadenocarcinomas have occurred in males.We wrote this letter to comment on a brief article (World J Gasteroenterol 2011 January 21;17(3):361-365) regarding a case of intrahepatic biliary cystic neoplasm treated with surgery.The adenoma-carcinoma sequence is the possible mechanism of carcinogenesis.If the carcinogenesis of biliary cystadenocarcinoma occurs in the adenoma-carcinoma sequence,we believe that the male-to-female ratio of cystadenoma should be higher than the incidence rate that has been reported to date.Ho Hyun Kim Young Hoe Hur Yang Seok Koh Chol Kyoon Cho Jin Woong Kim 2011World Journal of Gastroenterology2011,17,25:12
10Pulmonary metastasectomy for colorectal cancer: How many nodules, how many times?显示文摘Colorectal cancer(CRC)is one of the most common cancers worldwide,with 5%-15%of CRC patients eventually developing lung metastasis(LM).Despite doubts about the role of locoregional therapy in the management of systemic disease,many surgeons have performed pulmonary metastasectomy(PM)for CRC in properly selected patients.However,the use of pulmonary metastasectomy remains controversial due to the lack of randomized controlled studies.This article reviews the results of surgical treatment of pulmonary metastases for CRC,focusing on(1)current treatment guidelines and surgical techniques of PM in patients with LM from CRC;(2)outcomes of PM and its prognostic factors;and(3)controversial issues in PM,focusing on repeated metastasectomy,bilateral multiple metas-tases,and combined liver and lung metastasectomy.Hong Kwan Kim Jong Ho Cho Ho Yun Lee Jeeyun Lee Jhingook Kim 2014World Journal of Gastroenterology2014,20,20:12
11Endoscopic features suggesting gastric cancer in biopsy-proven gastric adenoma with high-grade neoplasia显示文摘AIM:To elucidate the endoscopic features that predict the cancer following endoscopic submucosal dissection(ESD)in patients with high-grade neoplasia(HGN).METHODS:We retrospectively analyzed the medical records of patients who underwent ESD of gastric neoplasms from January 2007 to September 2010.ESD was performed in 555 cases involving 550 patients.A total of 112 lesions from 110 consecutive patients were initially diagnosed as HGN without cancer by forceps biopsy,and later underwent ESD.We classified lesions into two groups according to histologic discrepancies between the biopsy and ESD diagnosis.Gastric adenoma in the final diagnosis by ESD specimens were defined as adenoma group.Lesions with coexisting cancer after ESD were defined as cancer group.RESULTS:The mean age was 65.3 years,and 81 patients were male.There was no significant difference in the age or gender distribution between the adenoma(n=52)and cancer(n=60)groups.Thirty-six of these lesions(32.1%)showed histologic concordance between the forceps biopsy and ESD specimens,16(14.3%)showed a downgraded histology(low-grade neoplasia),and 60(53.6%)showed an upgraded histology(cancer).A red color change of the mucosal surface on endoscopy was found in 27/52(51.9%)of cases in the adenoma group and in 46/60(76.7%)of cases in the cancer group(P=0.006).Ulceration of the mucosal surface on endoscopy was found in 5(9.6%)of 52 lesions in the adenoma group and in 17(28.3%)of 60 lesions in the cancer group(P=0.013).In the multivariate analysis,a reddish surface color change and mucosal ulceration were significant predictive factors correlated with cancer after ESD of the HGN by forceps biopsy.CONCLUSION:HGN with a red color change or mucosal ulceration correlated with the presence of gastric cancer.These finding may help to guide the diagnosis and treatment.Jung Ho Kim Yoon Jae Kim Jungsuk An Jong Joon Lee Jae Hee Cho Kyoung Oh Kim Jun-Won Chung Kwang An Kwon Dong Kyun Park Ju Hyun Kim 2014World Journal of Gastroenterology2014,20,34:10
12Overexpression of miR-196b and HOXA10 characterize a poor-prognosis gastric cancer subtype显示文摘AIM:To identify molecular biologic differences between two gastric adenocarcinoma subgroups presenting different prognoses through the analysis of microRNA and protein expression.METHODS:Array technologies were used to generate1146 microRNAs and 124 proteins expression profiles of samples from 60 patients with gastric cancer.For the integrative analysis,we used established mRNA expression data published in our previous study.Whole mRNA expression levels were acquired from microarray data for 60 identical gastric cancer patients.Two gastric adenocarcinoma subgroups with distinct mRNA expression profiles presented distinctly different prognoses.MicroRNA and protein expression patterns were compared between gastric cancer tissue and normal gastric tissue and between two different prognostic groups.Aberrantly expressed microRNA,associated mRNA,and protein in patients with poor-prognosis gastric cancer were validated by quantitative reverse transcription polymerase chain reaction and immunochemistry in independent patients.RESULTS:We obtained the expression data of 1146microRNAs and 124 cancer-related proteins.Four microRNAs were aberrantly expressed in the two prognostic groups and in cancer vs non-cancer tissues(P<0.05).In the poor-prognosis group,miR-196b,miR-135b,and miR-93 were up-regulated and miR-29c*was down-regulated.miR-196b expression positively correlated with Homeobox A10(HOXA10)expression(r=0.726,P<0.001),which was significantly increased in poor-prognosis patients(P<0.001).Comparing gastric cancer with non-cancer tissues,46/124 proteins showed differential expression(P<0.05);COX2(P<0.001)and cyclin B1(P=0.017)were clearly overexpressed in the poor-prognosis group.CONCLUSION:Co-activation of miR-196b and HOXA10characterized a poor-prognosis subgroup of patients with gastric cancer.Elucidation of the biologic function of miR-196b and HOXA10 is warranted.Jae Yun Lim Sun Och Yoon So-Young Seol Soon Won Hong Jong Won Kim Seung Ho Choi Ju-Seog Lee Jae Yong Cho 2013World Journal of Gastroenterology2013,19,41:10
13Adjuvant capecitabine and oxaliplatin for gastric cancer after D2 gastrectomy (CLASSIC): a phase 3 open-label, randomised controlled trial显示文摘Yung-Jue Bang Young-Woo Kim Han-Kwang Yang Hyun Cheol Chung Young-Kyu Park Kyung Hee Lee Keun-Wook Lee Yong Ho Kim Sang-Ik Noh Jae Yong Cho Young Jae Mok Yeul Hong Kim Jiafu Ji Ta-Sen Yeh Peter Button Florin Sirzén Sung Hoon Noh 2012The Lancet2012,,9813:10
14Intraoperative radiofrequency ablation with or without tumorectomy for hepatocellular carcinoma in locations difficult for a percutaneous approach显示文摘BACKGROUND:Although hepatic resection is widely accepted as a proper modality for treating hepatocellular carcinoma(HCC),a majority of patients are unable to undergo surgical resection due to various tumor and patient factors.Radiofrequency ablation(RFA)has mostly been used as a therapeutic alternative to resection for treating HCC.The objective of this study was to evaluate the results of intraoperative RFA for HCCs in locations difficult for a percutaneous approach.METHODS:Eight patients(male,seven;age,49-67 years) with 8 HCCs in difficult locations were treated by intraoperative RFA.Six of the patients had local tumor progression after initial transarterial chemoembolization or ultrasound(US)guided percutaneous RFA.The locations of the tumors were hepatic dome in six patients,posterior subcapsule in one,and caudate lobe in one.The tumor size was 2.0 to 6.4 cm(mean,3.9 cm).Intraoperative RFA was performed at the tumor itself and an anticipated resection line under US guidance with 3 cm monopolar single or clustered internally cooled electrodes.Tumor resection was performed in six patients.One month later,treatment response was assessed by contrast material-enhanced computed tomography(CT).CT studies were performed every 2 or 3 months after RFA.RESULTS:RFA was technically successful in all tumors,and the contrast-enhanced CT images acquired one month later showed complete disappearance of tumor enhancement.One pneumothorax occurred.After a median follow-up of 18 months(range,6-30 months),no tumors showed local progression.During the follow-up period,four new recurrent tumors were observed in three patients.Four patients were alive at the time of this report and the other four died of hepatorenal syndrome,liver failure,and progression of new recurrent tumors.CONCLUSION:Intraoperative RFA with tumor resection can be an alterative treatment option for HCC in locations difficult for a percutaneous approach.Hyung Ook Kim Seung Kwon Kim Byung Ho Son Chang Hak Yoo Hyun Pyo Hong Yong Kyun Cho Byung Ik Kim 2009Hepatobiliary & Pancreatic Diseases International2009,8,6:9
15Biopathologic features and clinical significance of micrometatasis in the lymph node of early gastric cancer显示文摘AIM: To evaluate the biopathologic features and clinical significance of nodal micrometastasis(MI) in early gastric cancer(EGC).METHODS: Among 1022 EGC patients who underwent gastrectomy with lymphadenectomy of D1 + β or more from March 2001 to December 2005 at the Korean National Cancer Center, available nodal metastasis was found in 90 p T1N1 patients. Nodal metastasis was confirmed by immunohistochemistry(IHC) with cytokeratin and patients were classified into MI and macrometastasis(MA) groups based on the main tumor burden according to the 6th International Union Against Cancer/American Joint Committee on Cancer staging system; the main tumor burden with a diameter of greater than 0.2 mm but no greater than 2 mm as MI, and greater than 2 mm as MA of the representative metastatic node. Proliferative and apoptotic activities of the primary tumor and the nodal metastasis were measured by IHC with Ki-67 and terminal deoxynucleotidyl transferase d UTP nick end labeling, respectively. Biopathologic and clinical features of the patients were analyzed and compared between MI and MA groups. Patients with recurrence were compared with those without recurrence to identify risk factors for recurrence.RESULTS: Thirty-seven patients showed MI and the other 53 patients revealed MA in the lymph node; the incidence of patients with MI and MA was 41.1% and 58.9%. The main tumor burden was 0.9 and 4.6 mm in the representative metastatic node, respectively. Japanese N2 stations were more frequently involved in MA group(20.9%) than in MI group(10.3%) butthe difference was not statistically different(P = 0.338). Proliferative and apoptotic activities of MI were decreased than those of MA(26.7% vs 40.5%, P = 0.004 and 1.0% vs 3.0%, P < 0.001, respectively). However, nodal MI in the current study showed a relatively high proliferative activity and an equivalent apoptotic activity compared to other cancers in the previously published studies. Recurrence was observed in 6 patients during the mean follow up period of 87.6 ± 26.2 mo. The recurrence was significantly associated with the presence of MA(P = 0.041) and lymphovascular invasion of the primary tumor(P = 0.032).CONCLUSION: Lymphadenectomy of D1 + β or more might be necessary in patients with MI in sentinel node to prevent recurrence by clearing MI involving Japanese N2 station.Min Jung Jo Ji Yeon Park Joon Seon Song Myeong-Cherl Kook Keun Won Ryu Soo-Jeong Cho Jun Ho Lee Byung-Ho Nam Eun Kyung Hong Il Ju Choi Young-Woo Kim 2015World Journal of Gastroenterology2015,21,2:9
16Clinical significance and risk factors of postembolization fever in patients with hepatocellular carcinoma显示文摘AIM:To investigate tumor response and survival in patients with postembolization fever(PEF) and to determine the risk factors for PEF.METHODS:Four hundred forty-three hepatocellular carcinoma(HCC) patients who underwent the first session of transcatheter arterial chemoembolization(TACE) between January 2005 and December 2009 were analyzed retrospectively.PEF was defined as a body temperature greater than 38.0 ℃ that developed within 3 d of TACE without evidence of infection.The tumor progression-free interval was defined as the interval from the first TACE to the second TACE based on mRECIST criteria.Clinical staging was based on the American Joint Committee on Cancer tumor,node,metastases(TNM) classification of malignant tumors.All patients were admitted before their 1 st TACE treatment,and blood samples were obtained from all patients before and after treatment.Clinicoradiological variables and host-related variables were compared between two groups:patients with PEF vs patients without PEF.Additionally,variables related to 20-mo mortality and tumor progression-free survival were analyzed.RESULTS:The study population comprised 370(85.4%) men and 73(14.6%) women with a mean age of 62.29 ± 10.35 years.A total of 1836 TACE sessions were conducted in 443 patients,and each patient received between 1 and 27(mean:4.14 ± 3.57) TACE sessions.The mean follow-up duration was 22.23 ± 19.6 mo(range:0-81 mo).PEF developed in 117 patients(26.41%) at the time of the first TACE session.PEF was not associated with 20-mo survival(P = 0.524) or computed tomography(CT) response(P = 0.413) in a univariate analysis.A univariate analysis further indicated that diffuse-type HCC(P = 0.021),large tumor size(≥ 5 cm)(P = 0.046),lipiodol dose(≥ 7 mL,P = 0.001),poor blood glucose control(P = 0.034),alanine aminotransferase(ALT) value after TACE(P = 0.004) and C-reactive protein(CRP) value after TACE(P = 0.036) served as possible risk factors correlated with PEF.The ALT value after TACE(P = 0.021) and lipiodol dose over 7 mL(P = 0.011) were independent risk factors for PEF in the multivariate analysis.For the 20-mo survival,poor blood sugar control(P < 0.001),portal vein thrombosis(P = 0.001),favorable CT response after TACE(P < 0.001),initial aspartate aminotransferase(P = 0.02),initial CRP(P = 0.042),tumor size(P < 0.001),TNM stage(P < 0.001) and lipiodol dose(P < 0.001) were possible risk factors in the univariate analysis.Tumor size(P = 0.03),poor blood sugar control(P = 0.043),and portal vein thrombosis(P = 0.031) were significant predictors of survival in the multivariate analysis.Furthermore,the tumor progression-free interval was closely associated with CRP > 1 mg/dL(P = 0.003),tumor size > 5 cm(P < 0.001),tumor type(poorly defined)(P < 0.001),and lipiodol dose(> 7 mL,P < 0.001).CONCLUSION:PEF has no impact on survival at 20 mo or radiologic response.However,the ALT level after TACE and the lipiodol dose represent significant risk factors for PEF.Chung Hwan Jun Ho Seok Ki Hoon Ki Lee Kang Jin Park Seon Young Park Sung Bum Cho Chang Hwan Park Young Eun Joo Hyun Soo Kim Sung Kyu Choi Jong Sun Rew 2013World Journal of Gastroenterology2013,19,2:7
17Adjuvant capecitabine and oxaliplatin for gastric cancer after D2 gastrectomy (CLASSIC): a phase 3 open-label, randomised controlled trial显示文摘Yung-Jue Bang Young-Woo Kim Han-Kwang Yang Hyun Cheol Chung Young-Kyu Park Kyung Hee Lee Keun-Wook Lee Yong Ho Kim Sang-Ik Noh Jae Yong Cho Young Jae Mok Yeul Hong Kim Jiafu Ji Ta-Sen Yeh Peter Button Florin Sirzén Sung Hoon Noh 2012The Lancet . 2012 (9813)2012,,9813:7
18Predicting tumor response after preoperative chemoradiation using clinical parameters in rectal cancer显示文摘AIM: To evaluate the clinical parameters and identify a better method of predicting pathological complete response (pCR). METHODS: We enrolled 249 patients from a database of 544 consecutive rectal cancer patients who underwent surgical resection after preoperative chemoradiation therapy (PCRT). A retrospective review of morphological characteristics was then performed to collect data regarding rectal examination findings. A scoring model to predict pCR was then created. To validate the ability of the scoring model to predict complete regression.RESULTS: Seventy patients (12.9%) achieved a pCR. A multivariate analysis found that pre-CRT movability (P = 0.024), post-CRT size (P = 0.018), post-CRT morphology (P = 0.023), and gross change (P = 0.009) were independent predictors of pCR. The accuracy of the scoring model was 76.8% for predicting pCR with the threshold set at 4.5. In the validation set, the accuracy was 86.7%. CONCLUSION: Gross changes and morphological findings are important predictors of pathological response. Accordingly, PCRT response is best predicted by a combination of clinical, laboratory and metabolic information.Chan Ho Park Hee Cheol Kim Yong Beom Cho Seong Hyeon Yun Woo Yong Lee Young Suk Park Doo Ho Choi Ho-Kyung Chun 2011World Journal of Gastroenterology2011,17,48:6
19Undifferentiated embryonal sarcoma of the liver presenting as a hemorrhagic cystic tumor in an adult显示文摘BACKGROUND:Undifferentiated embryonal sarcoma (UES) of the liver is a rare,highly malignant neoplasm with a poor prognosis occurring almost exclusively in late childhood (6-10 years of age).Only a few cases have been reported in adults accounting for less than 1% of all primary liver neoplasms.METHODS:A 47-year-old woman presented with a palpable mass in the left upper abdomen.Magnetic resonance imaging revealed a 12×10 cm cystic mass with hemorrhage in the left lateral segment of the liver.The initial impression was a hemorrhagic cystic tumor of the liver.The patient underwent a left lateral sectionectomy of the liver.Histopathology and immunohistochemistry helped make a diagnosis of UES.RESULTS:The patient recovered uneventfully and received systemic chemotherapy.Radiologic examination for follow-up revealed a metastatic lesion in the lumbar spine (L5).She was subjected to radiotherapy at the lumbar spine.She survived 48 months.CONCLUSION:Although hepatic cyst as UES of the liver is difficult to diagnose because of its rarity in adults and lack of specific findings,it should be considered in a differential diagnosis.Ho Hyun Kim Jung Chul Kim Eun Kyu Park Young Hoe Hur Yang Seok Koh Chol Kyoon Cho Hyung Seok Kim Hyun Jong Kim 2011Hepatobiliary & Pancreatic Diseases International2011,10,6:6
20Efficacy of hepatic arterial infusion chemotherapy in advanced hepatocellular carcinoma显示文摘AIM:To investigate the efficacy of hepatic arterial infusion chemotherapy(HAIC) using floxuridine(FUDR) in patients with advanced hepatocellular carcinoma(HCC) confined to the liver.METHODS:Thirty-four patients who had advanced HCC with unresectability or unsuccessful previous therapy in the absence of extrahepatic metastasis were treated with intra-arterial FUDR chemotherapy at ourhospital between March 2005 and May 2008.Among the 34 patients,9 patients were classified as Child class C,and 18 patients had portal vein tumor thrombus(PVTT).One course of chemotherapy consisted of continuous infusion of FUDR(0.3 mg/kg during day 1-14) and dexamethasone(10 mg on day 1,4,7 and 11),and this treatment was repeated every 28 d.RESULTS:Two patients(5.9%) displayed a complete response,and 12 patients(35.3%) had a partial response.The tumor control rate was 61.8%.The median overall survival times were 15.3 mo,12.4 mo and 4.3 mo for the patients who were classified as Child class A,Child class B and Child class C,respectively(P = 0.0392).The progression-free survival was 12.9 mo,7.7 mo and 2.6 mo for the patients who were classified as Child class A,Child class B and Child class C,respectively(P = 0.0443).The cumulative survival differed significantly according to the Child-Pugh classification and the presence of PVTT.In addition to hepatic reserve capacity and PVTT,the extent of HCC was an independent factor in determining a poor prognosis.The most common adverse reactions to HAIC were mucositis,diarrhea and peptic ulcer disease,but most of these complications were improved by medical treatment and/or a delay of HAIC.CONCLUSION:The present study demonstrates that intra-arterial FUDR chemotherapy is a safe and effective treatment for advanced HCC that is recalcitrant to other therapeutic modalities,even in patients with advanced cirrhosis.Yang Hyun Baek Kyoung Tae Kim Sung Wook Lee Jin Sook Jeong Byeong Ho Park Kyung Jin Nam Jin Han Cho Young Hoon Kim Young Hoon Roh Hyung Sik Lee Young Min Choi Sang Young Han 2012World Journal of Gastroenterology2012,18,26:6
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