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| 1 | Limited 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 | 2010 | World Journal of Gastroenterology2010，16，34： | 26 |
| 2 | Alcoholic liver disease: Treatment显示文摘The excess consumption of alcohol is associated with alcoholic liver diseases(ALD). ALD is a major healthcare problem, personal and social burden, and significant reason for economic loss worldwide. The ALD spectrum includes alcoholic fatty liver, alcoholic hepatitis, cirrhosis, and the development of hepatocellular carcinoma. The diagnosis of ALD is based on a combination of clinical features, including a history of significant alcohol intake, evidence of liver disease, and laboratory findings. Abstinence is the most important treatment for ALD and the treatment plan varies according to the stage of the disease. Various treatments including abstinence, nutritional therapy, pharmacological therapy, psychotherapy, and surgery are currently available. For severe alcoholic hepatitis, corticosteroid or pentoxifylline are recommended based on the guidelines. In addition, new therapeutic targets are being under investigation. | Ki Tae Suk Moon Young Kim Soon Koo Baik | 2014 | World Journal of Gastroenterology2014，20，36： | 20 |
| 3 | 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 |
| 4 | Probucol inhibits LPS-induced microglia activation and ameliorates brain ischemic injury in normal and hyperlipidemic mice显示文摘瞄准:增加的证据建议那 probucol,有抗氧化剂活动的一个类脂化合物阴沉的代理人,可能为有经由在胆固醇和 neuroinflammation 的减小的 hyperlipidemia 的 ischemic 击的治疗有用。在这研究,我们检验了 probucol 是否能在正常和 hyperlipidemic mice.Methods 经由 anti-neuroinflammatory 行动免于大脑 ischemic 损害:主要老鼠 microglia 和鼠科的 BV2 microglia 不为 3 h,和版本暴露于 lipopolysaccharide (LPS ) , PGE2, IL-1β并且在 NF-κ 的 IL-6,以及变化; B,表明小径的 MAPK 和 AP-1 被估计。ApoE 击倒老鼠被喂包含 0.004% 的一本高脂肪的食谱, 0.02% , 0.1%(wt/wt ) 为 10 个星期的 probucol 而正常 C57BL/6J 老鼠收到了 probucol (3, 10, 30 mg· kg -1·d-1, po ) 为 4 d。然后,所有老鼠通过中间的服的动脉吸藏(MCAO ) 受到焦点的服的局部缺血。神经病学的赤字被获得在外科以后的 24 h,然后大脑为测量服的梗塞尺寸和支持 inflammatory mediators.Results 的生产被移开:在对待 LPS 的 BV2 房间和主要 microglial 房间,有 probucol 的预告的处理(1, 5, 10 μ mol/L ) dose-dependently 禁止了版本没有, PGE2, IL-1β并且 IL-6,它发生在抄写铺平。而且, probucol 的禁止的行动与 NF-κ 的 downregulation 被联系;表明小径的 B, MAPK 和 AP-1。在有 MCAO 的正常鼠标, probucol 的管理前 dose-dependently 减少了梗塞卷和改进神经病学的功能。这些效果被支持 inflammatory 调停人的减少的生产伴随(iNOS, COX-2, IL-1, IL-6 ) 。在 ApoE 击倒,老鼠喂了一本高脂肪的食谱, 0.1% probucol 的管理前显著地减少了梗塞体积,改进了跟随 MCAO 的神经病学的赤字,并且减少全部胆固醇并且 LDL 胆固醇 levels.Conclusion:Probucol 禁止导致 LPS 的 microglia 激活并且改善在经由它的 anti-neuroinflammatory 行动的正常和 hyperlipidemic 老鼠的服的 ischemic 损害,建议那 probucol 为 ischemic 击和 hyperlipidemia 为病人的治疗有潜力与或在风险。 | Yeon Suk JUNG Jung Hwa PARK Hyunha KIM So Young KIM Ji Young HWANG Ki Whan HONG Sun Sik BAE Byung Tae CHOI Sae-Won LEE Hwa Kyoung SHIN | 2016 | Acta Pharmacologica Sinica2016，37，8： | 16 |
| 5 | 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 |
| 6 | Prevalence 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 | 2009 | World Journal of Gastroenterology2009，15，1： | 15 |
| 7 | Diagnostic value of maximal-outer-diameter and maximal-mural-thickness in use of ultrasound for acute appendicitis in children显示文摘AIM: To evaluate the maximal-outer-diameter (MOD) and the maximal-mural-thickness (MMT) of the appendix in children with acute appendicitis and to determine their optimal cut-off values to diagnose acute appendicitis. METHODS: In total, 164 appendixes from 160 children between 1 and 17 years old (84 males, 76 females; mean age, 7.38 years) were examined by high-resolution abdominal ultrasound for acute abdominal pain and the suspicion of acute appendicitis. We measured the MOD and the MMT at the thickest point of the appendix. Patients were categorized into two groups according to their medical records: patients who had surgery (surgical appendix group) and patients who did not have surgery (non-surgical appendix group). Data were analyzed by MedCalc v.9.3. The rank sum test (Mann-Whitney test) was used to evaluate the difference in the MOD and the MMT between the two groups. ROC curve analysis was used to determine the optimal cut-off value of the MOD and the MMT on diagnosis of acute appendicitis. RESULTS: There were 121 appendixes (73.8%) in the non-surgical appendix group and 43 appendixes (26.2%) in the surgical appendix group. The median MOD differed significantly between the two groups (0.37 cm vs 0.76 cm, P < 0.0001), and the median MMT also differed (0.15 cm vs 0.33 cm, P < 0.0001). The optimal cut-off value of the MOD and the MMT for diagnosis of acute appendicitis in children was > 0.57 cm (sensitivity 95.4%, specificity 93.4%) and > 0.22 cm (sensitivity 90.7%, specificity 79.3%), respectively. CONCLUSION: The MOD and the MMT are reliable criteria to diagnose acute appendicitis in children. An MOD > 0.57 cm and an MMT > 0.22 cm are the optimal criteria. | Bo-Kyung Je Sung-Bum Kim Seung Hwa Lee Ki Yeol Lee Sang Hoon Cha | 2009 | World Journal of Gastroenterology2009，15，23： | 14 |
| 8 | 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 |
| 9 | Quality of healing of gastric ulcers: Natural products beyond acid suppression显示文摘Gastric ulcer is a chronic disease featured with unexpected complications, including bleeding, stenosis and perforation, as well as a high incidence of recurrence. Clinical treatments for gastric ulcer have allowed the rapid development of potent anti-ulcer drugs during the last several decades. Gastric ulcer healing is successful with conventional treatments including H2-receptor antagonists, and proton pump inhibitors(PPIs) have been essential for ulcer healing and prevention of complications. Additionally, Helicobacter pylori eradication therapy is effective in reducing ulcer recurrence and leads to physiological changes in the gastric mucosa which affect the ulcer healing process. However, in spite of these advancements, some patients have suf-fered from recurrence or intractability in spite of continuous anti-ulcer therapy. A new concept of the quality of ulcer healing(QOUH) was initiated that considers the reconstruction of the mucosal structure and its function for preventing ulcer recurrence. Although several gastroprotection provided these achievements of the QOUH, which PPI or other acid suppressants did not accomplish, we found that gastroprotection that originated from natural products, such as a newer formulation from either Artemisia or S-allyl cysteine from garlic, were very effective in the QOUH, as well as improving clinical symptoms with fewer side effects. In this review, we will introduce the importance of the QOUH in ulcer healing and the achievements from natural products. | Napapan Kangwan Jong-Min Park Eun-Hee Kim Ki Baik Hahm | 2014 | World Journal of Gastrointestinal Pathophysiology2014，5，1： | 14 |
| 10 | Microbiota-based treatments in alcoholic liver disease显示文摘Gut microbiota plays a key role in the pathogenesis of alcoholic liver disease(ALD). Consumption of alcohol leads to increased gut permeability, small intestinal bacterial overgrowth, and enteric dysbiosis. These factors contribute to the increased translocation of microbial products to the liver via the portal tract. Subsequently, bacterial endotoxins such as lipopolysaccharide, in association with the Toll-like receptor 4 signaling pathway, induce a gamut of damaging immune responses in the hepatic milieu. Because of the close association between deleterious inflammation and ALD-induced microbiota imbalance, therapeutic approaches that seek to reestablish gut homeostasis should be considered in the treatment of alcoholic patients. To this end, a number of preliminary studies on probiotics have confirmed their effectiveness in suppressing proinflammatory cytokines and improving liver function in the context of ALD. In addition, there have been few studies linking the administration of prebiotics and antibiotics with reduction of alcoholinduced liver damage. Because these preliminary results are promising, large-scale randomized studies are warranted to elucidate the impact of these microbiotabased treatments on the gut flora and associated immune responses, in addition to exploring questions about optimal delivery. Finally, fecal microbiota transplant has been shown to be an effective method of modulating gut microbiota and deserve further investigation as a potential therapeutic option for ALD. | Hotaik Sung Seung Woo Kim Meegun Hong Ki Tae Suk | 2016 | World Journal of Gastroenterology2016，22，29： | 12 |
| 11 | 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 |
| 12 | Effect of Korean red ginseng on blood pressure and nitric oxide production显示文摘AIM: To investigate the effect of crude saponin and non-saponin fraction of Korean red ginseng (KRG) on the blood pressure and nitric oxide (NO) production in the conscious rats and cultured endothelial cell line, ECV 304 cells. METHODS: Systolic blood pressure and heart rate were monitored in the conscious rats. Nitric oxide levels and the expression of nitric oxide synthase were measured by a spectrophotometric assay using Griess reagents and Western blotting, respectively. Nitric-oxide synthase activity was measured based on the conversion rate of [3H]arginine to [3H]citrulline. RESULTS: Systolic blood pressure was decreased by crude saponin (100 mg/kg, iv) of KRG in the conscious control and one-kidney, one-clip Goldblatt hypertensive (IK, 1C-GBH) rats. The hypotensive effect induced by crude saponin of KRG reached maximum at 2 - 4 min and slowly recovered after 20 min to the initial level in both groups. Crude saponin of KRG induced tachycardia in the conscious rats but induced bradycardia in the | JEON Byeong Hwa KIM Cuk Seong KIM Hoe-Suk PARK Jin-Bong NAM Ki Yeul CHANG Seok Jong | 2000 | Acta Pharmacologica Sinica2000，21，12： | 12 |
| 13 | Staging of liver fibrosis or cirrhosis: The role of hepatic venous pressure gradient measurement显示文摘Liver fibrosis is a common histological change of chronic liver injury and it is closely related with portalhypertension which is hemodynamic complication of chronic liver disease. Currently, liver fibrosis has been known as a reversible dynamic process in previous literatures. Although liver biopsy is a gold standard for assessing the stage of liver fibrosis, it may not completely represent the stage of liver fibrosis because of sampling error or semi-quantative measurement. Recent evidences suggested that histologic, clinical, hemodynamic, and biologic features are closely associated in patients with chronic liver disease. Hepatic venous pressure gradient(HVPG) measurement has been known as a modality to evaluate the portal pressure. The HVPG measurement has been used clinically for fibrosis diagnosis, risk stratification, preoperative screening for liver resection, monitoring the efficacy of medical treatments, and assessing the prognosis of liver fibrosis. Therefore, the HVPG measurement can be used to monitor areas the chronic liver disease but also other important areas of chronic liver disease. | Ki Tae Suk Dong Joon Kim | 2015 | World Journal of Hepatology2015，7，3： | 11 |
| 14 | Efficacy of Saam acupuncture treatment on improvement of immune cell numbers in cancer patients:a pilot study显示文摘OBJECTIVE: To collect preliminary data on the effects of Saam acupuncture with regard to the immunity in cancer patients.METHODS: Ten cancer patients were analyzed for improvements in immunity. Acupuncture was applied at the 5 acupuncture points, Jingqu(LU 8), Zutonggu(BL 66), Yanggu(SI 5), Yangchi(TE 4), and Zhongwan(CV 12) for 2 weeks with 4 sessions. We assessed the effect of Korean Saam acupuncture on the immune system in cancer patients by measuring particular blood cell subsets, including CD3 +,CD4+, CD8+, CD19+, and CD56+ cells, as well as total white blood cell count, absolute neutrophil count, and fatigue score. The measurement was performed before and after acupuncture and at a 2-week follow-up.RESULTS: There was a statistically significant increase in the number of CD3+(P=0.023) and CD8+ cells(P<0.001) and T-cell subsets, as well as a decrease in the fatigue severity scale(FSS) score(P=0.001) after Saam acupuncture using the 5 acupoints.CONCLUSION: Acupuncture may improve the immune system by increasing the counts of a few immune cells and relieve fatigue in cancer patients by decreasing FSS scores. Although this was a non-controlled study, it constitutes preliminary research investigating the potential effects of Saam acupuncture in increasing the counts of several immune cells in cancer patients. | Dae-Joon Kim Seong-Hoon Park Jung-Chul Seo Kyung Soon Kim Ki Cheul Sohn Im Hee Shin Hun Mo Ryoo | 2014 | Journal of Traditional Chinese Medicine2014，34，5： | 11 |
| 15 | Gastric leptomeningeal carcinomatosis: Multi-center retrospective analysis of 54 cases显示文摘AIM: To identify the clinical features and outcomes of infrequently reported leptomeningeal carcinomatosis (LMC) of gastric cancer.METHODS: We analyzed 54 cases of cytologically confirmed gastric LMC at four institutions from 1994 to 2007.RESULTS: The male-to-female ratio was 32:22, and the patients ranged in age from 28 to 78 years (median,48.5 years). The majority of patients had advanced disease at initial diagnosis of gastric cancer. The clini-cal or pathologic tumor, node and metastasis stage ofthe primary gastric cancer wasin 38 patients (70%).The median interval from diagnosis of the primarymalignancy to the diagnosis of LMC was 6.3 mo, rang-ing between 0 and 73.1 mo. Of the initial endoscopic f indings for the 45 available patients, 23 (51%) of the patients were Bormann typeand 15 (33%) patientswere Bormann type. Pathologically, 94% of cases proved to be poorly differentiated adenocarcinomas. Signet ring cell component was also observed in 40% of patients. Headache (85%) and nausea/vomiting (58%) were the most common presenting symptoms of LMC. A gadolinium-enhanced magnetic resonance imaging was conducted in 51 patients. Leptomeningeal enhancement was noted in 45 cases (82%). Intrathecal (IT) chemotherapy was administered to 36 patients-primarily methotrexate alone (61%), but also in combi-nation with hydrocortisone/± Ara-C (39%). The median number of IT treatments was 7 (range, 1-18). Concomitant radiotherapy was administered to 18 patients, and concomitant chemotherapy to seven patients. Sev-enteen patients (46%) achieved cytological negative conversion. Median overall survival duration from the diagnosis of LMC was 6.7 wk (95% CI: 4.3-9.1 wk). In the univariate analysis of survival duration, hemoglobin, IT chemotherapy, and cytological negative conversion showed superior survival duration (P = 0.038, P = 0.010, and P = 0.002, respectively). However, in our multivariate analysis, only cytological negative conversion was predictive of relatively longer survival duration (3.6, 6.7 and 14.6 wk, P = 0.030, RR: 0.415, 95% CI: 0.188-0.918).CONCLUSION: Although these patients had a fatal clinical course, cytologic negative conversion by IT chemotherapy may improve survival. | Sung Yong Oh Su-Jin Lee Jeeyun Lee Suee Lee Sung-Hyun Kim Hyuk-Chan Kwon Gyeong-Won Lee Jung Hun Kang In Gyu Hwang Joung-Soon Jang Ho Yeong Lim Young Suk Park Won Ki Kang Hyo-Jin Kim | 2009 | World Journal of Gastroenterology2009，15，40： | 10 |
| 16 | Delayed hypersensitivity reaction resulting in maculopapular-type eruption due to entecavir in the treatment of chronic hepatitis B显示文摘Several clinical trials have demonstrated the potent antiviral efficacy of entecavir(ETV), and this relatively new nucleoside analogue drug has rapidly become a frequently prescribed therapy for chronic hepatitis B(CHB) worldwide. While the studies have also shown a good overall safety profile for ETV, adverse drug reactions(ADRs) in patients with advanced cirrhosis have been reported and represent a broad spectrum of drug-induced injuries, including lactic acidosis, myalgia, neuropathy, azotemia, hypophosphatemia, muscular weakness, and pancreatitis, as well as immunemediated responses(i.e., allergic reactions). Cutaneous ADRs associated with ETV are very rare, with only two case reports in the publicly available literature; both of these cases were classified as unspecified hypersensitivity allergic(type I) ADR, but neither were reported as pathologically proven or as evaluated by cytokine release analysis. Here, we report the case of a 45-yearold woman who presented with a generalized maculopapular rash after one week of ETV treatment for lamivudine-resistant CHB. The patient reported having experienced a similar skin eruption during a previous three-month regimen of ETV, for which she had selfdiscontinued the medication. Histopathological analysis of a skin biopsy showed acanthotic epidermis with focal parakeratosis and a perivascular lymphocytic infiltrate admixed with interstitial eosinophils in the papillary and reticular dermis, consistent with a diagnosis of drug sensitivity. A lymphocyte stimulation test showed significantly enhanced IL-4, indicating a classification of type Ⅳb delayed hypersensitivity. The patient was switched to an adefovir-lamivudine combination regimen and the skin eruption resolved two weeks after the ETV withdrawal. This case represents the first pathologically and immunologically evidenced ETV-induced delayed type hypersensitivity skin reaction reported to date. Physicians should be aware of the potential, although rare, for cutaneous ADRs associated with ETV treatment. | Jeong Tae Kim Hye Won Jeong Ki Hwa Choi Tae Young Yoon Nohyun Sung Young Ki Choi Eun Ha Kim Hee Bok Chae | 2014 | World Journal of Gastroenterology2014，20，42： | 10 |
| 17 | Cerebral and pulmonary embolisms after transcatheter arterial chemoembolization for hepatocellular carcinoma显示文摘A cerebral lipiodol embolism is an extremely rare complication of transcatheter arterial chemoem bolization for hepatocellular carcinoma. We present a case of cerebral lipiodol embolism that occurred afte the third arterial chemoembolization, report the clinica and radiological findings, and review the medica literature. | Chang Soo Choi Ki Hoon Kim Geom Seog Seo Eun Young Cho Hyo Jeong Oh Suck Chei Choi Tae Hyeon Kim Haak Cheoul Kim Byung Suk Roh | 2008 | World Journal of Gastroenterology2008，14，30： | 10 |
| 18 | Clinicopathologic significance of expression of nuclear factor-kB RelA and its target gene products in gastric cancer patients显示文摘AIM:To assess the prognostic significance of nuclear factor-kB (NF-kB) and its target genes in gastric cancer. METHODS:The tumor tissues of 115 patients with gastric cancer were immunohistochemically evaluated using monoclonal antibodies against NF-kB RelA. Preoperative serum levels of vascular endothelial growth factor (VEGF), interleukin-6 (IL-6) were assessed via enzyme-linked immuno-sorbent assay. C-reactive protein (CRP) and serum amyloid A (SAA) were measured via immunotrubidimetry. RESULTS:Positive rate of NF-kB RelA was 42.6%. NF-kB RelA expression in tumor tissues was also related to serum levels of IL-6 (P = 0.044) and CRP (P = 0.010). IL-6, SAA, CRP were related to depth of invasion, VEGF and SAA were correlated with lymph node metastasis. IL-6, VEGF, SAA and CRP were related to the stage. Univariate analysis demonstrated that immunostaining of NF-kB RelA, levels of IL-6, VEGF, SAA were significantly related with both disease free survival and over-all survival (OS). Multivariate analysis verified that NF-kB RelA [hazard ratio (HR): 3.40, P = 0.024] and SAA (HR: 3.39, P = 0.045) were independently associated with OS. CONCLUSION: Increased expression of NF-kB RelA and high levels of serum SAA were associated with poor OS in gastric cancer patients. | Hyuk-Chan Kwon Sung-Hyun Kim Sung Yong Oh Suee Lee Ji Hyun Lee Jin Seok Jang Min Chan Kim Ki Han Kim Su-Jin Kim Seong-Geun Kim Hyo-Jin Kim | 2012 | World Journal of Gastroenterology2012，18，34： | 9 |
| 19 | Urgent ERCP for acute cholangitis reduces mortality and hospital stay in elderly and very elderly patients显示文摘BACKGROUND: Acute cholangitis in old people is a cause of mortality and prolonged hospital stay. We evaluated the effects of methods and timing of biliary drainage on the outcomes of acute cholangitis in elderly and very elderly patients.METHODS: We analyzed 331 patients who were older than 75 years and were diagnosed with acute calculous cholangitis. They were admitted to our hospital from 2009 to 2014. Patients' demographics, severity grading, methods and timing of biliary drainage, mortality, and hospital stay were retrospectively obtained from medical records. Clinical parameters and outcomes were compared between elderly(75-80 years, n=156) and very elderly(≥81 years, n=175) patients. We analyzed the effects of methods [none, endoscopic retrograde cholangiopancreatography(ERCP), percutaneous transhepatic biliary drainage, or failure] and timing(urgent or early) of biliary drainage on mortality and hospital stay in these patients.RESULTS: Acute cholangitis in older patients manifested as atypical symptoms characterized as infrequent Charcot's triad(4.2%) and comorbidity in one-third of the patients. Patients were graded as mild, moderate, and severe cholangitis in 104(31.4%), 175(52.9%), and 52(15.7%), respectively. Urgent biliary drainage(≤24 hours) was performed for 80.5%(247/307) of patients. Very elderly patients tended to have more severe grades and were treated with sequential procedures of transient biliary drainage and stone removal at different sessions. Hospital stay was related to methods and timing of biliary drainage. Mortality was very low(1.5%) and not related to patient age but rather to the success or failure of biliary drainage and severity grading of the acute cholangitis.CONCLUSIONS: The methods and timing used for biliary drainage and severity of cholangitis are the major determinants of mortality and hospital stay in elderly and very elderly patients with acute cholangitis. Urgent successful ERCP is mandatory for favorable prognosis in these patients. | Chan Sun Park Hee Seok Jeong Ki Bae Kim Joung-Ho Han Hee Bok Chae Sei Jin Youn Seon Mee Park | 2016 | Hepatobiliary & Pancreatic Diseases International2016，15，6： | 9 |
| 20 | Clinicopathologic factors influencing the accuracy of EUS for superficial esophageal carcinoma显示文摘AIM:To identify clinicopathologic factors influencing the accuracy of a high-frequency catheter probe endoscopic ultrasonography(EUS)for superficial esophageal carcinomas(SECs).METHODS:A total of 126 patients with endoscopically suspected SEC,who underwent EUS and curative treatment at Pusan National University Hospital during2005-2013,were enrolled.We reviewed the medical records of the 126 patients and compared EUS findings with histopathologic results according to clinicopathologic factors.RESULTS:A total of 114 lesions in 113 patients were included in the final analysis.The EUS assessment of tumor invasion depth was accurate in 78.9%(90/114)patients.Accuracy did not differ according to histologic type,tumor differentiation,tumor location,or macroscopic shape.However,accuracy significantly decreased for tumors≥3 cm in size(P=0.002).Overestimation and underestimation of the invasion depth occurred for 11(9.6%)and 13 lesions(11.4%),respectively.In multivariate analyses,tumor size≥3 cm was the only factor significantly associated with EUS accuracy(P=0.031),and was specifically associated with the underestimation of invasion depth.CONCLUSION:EUS using a high-frequency catheter probe generally provides highly accurate assessments of SEC invasion depth,but its accuracy decreases for tumors≥3 cm. | Jung Im Jung Gwang Ha Kim Hoseok I Do Youn Park Tae Kyun Kim Young Hwa Cho Yong Wan Sung Mun Ki Choi Bong Eun Lee Geun Am Song | 2014 | World Journal of Gastroenterology2014，20，20： | 9 |
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