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1Endoscopic removal of gastric ectopic pancreas:An initial experience with endoscopic submucosal dissection显示文摘AIM:To evaluate the therapeutic usefulness and safety of endoscopic resection in patients with gastric ectopic pancreas.METHODS:A total of eight patients with ectopic pancreas were included.All of them underwent endoscopic ultrasonography before endoscopic resection.Endo-scopic resection was performed by two methods:endo-scopic mucosal resection(EMR)by the injection-and-cut technique or endoscopic mucosal dissection(ESD).RESULTS:We planned to perform EMR in all eight cases but EMR was successful in only four cases.In the other four cases,saline spread into surrounding normal tissues and the lesions becameattened,which made it impossible to remove them by EMR.Inthose four cases,we performed ESD and removed the lesions without any complications.CONCLUSION:If conventional EMR is difficult to remove gastric ectopic pancreas,ESD is a feasible alternative method for successful removal.Dong Yup Ryu Gwang Ha Kim Do Youn Park Bong Eun Lee Jae Hoon Cheong Dong Uk Kim Hyun Young Woo Jeong Heo Geun Am Song 2010World Journal of Gastroenterology2010,16,36:24
2Effect of pronase as mucolytic agent on imaging quality of magnifying endoscopy显示文摘AIM:To investigate the efficacy of premedication with pronase,a proteolytic enzyme,in improving imagequality during magnifying endoscopy.METHODS:The study was of a blinded,randomized,prospective design.Patients were assigned to groups administered oral premedication of either pronase and simethicone(Group A)or simethicone alone(Group B).First,the gastric mucosal visibility grade(1-4)was determined during conventional endoscopy,and then a magnifying endoscopic examination was conducted.The quality of images obtained by magnifying endoscopy at the stomach and the esophagus was scored from1 to 3,with a lower score indicating better visibility.The endoscopist used water flushes as needed to obtain satisfactory magnifying endoscopic views.The main study outcomes were the visibility scores during magnifying endoscopy and the number of water flushes.RESULTS:A total of 144 patients were enrolled,and data from 143 patients(M:F=90:53,mean age 57.5 years)were analyzed.The visibility score was significantly higher in the stomach following premedication with pronase(73%with a score of 1 in Group A vs 49%in Group B,P<0.05),but there was no difference in the esophagus visibility scores(67%with a score of 1in Group A vs 58%in Group B).Fewer water flushes[mean 0.7±0.9 times(range:0-3 times)in Group A vs 1.9±1.5 times(range:0-6 times)in Group B,P<0.05]in the pronase premedication group did not affect the endoscopic procedure times[mean 766 s(range:647-866 s)for Group A vs 760 s(range:678-854 s)for Group B,P=0.88].The total gastric mucosal visibility score was also lower in Group A(4.9±1.5 vs 8.3±1.8in Group B,P<0.01).CONCLUSION:The addition of pronase to simethicone premedication resulted in clearer images during magnifying endoscopy and reduced the need for water flushes.Gwang Ha Kim Yu Kyung Cho Jae Myung Cha Sun-Young Lee Il-Kwun Chung 2015World Journal of Gastroenterology2015,21,8:21
3Globus pharyngeus:A review of its etiology,diagnosis and treatment显示文摘Globus is a persistent or intermittent non-painful sensation of a lump or foreign body in the throat.It is a commonly encountered clinical condition that is usually long-lasting,difficult to treat,and has a tendency to recur.Furthermore,due to the uncertain etiology of globus,it remains difficult to establish standard investigation and treatment strategies for affected patients. As a first step for managing globus,careful history taking and nasolaryngoscopy are essential.Given the benign nature of the condition and the recent notion that gastroesophageal reflux disease is a major cause of globus,empirical therapy with a high dose of proton pump inhibitors is reasonable for patients with typical globus.If patients are nonresponsive to this therapy, definitive assessments such as endoscopy,multichannel intraluminal impedance/pH monitoring,and ma-nometry should be considered.Speech and language therapy,anti-depressants,and cognitive-behavioral therapy can be helpful in patients whose symptoms persist despite negative investigations.Bong Eun Lee Gwang Ha Kim 2012World Journal of Gastroenterology2012,18,20:17
4Somatostatin adjunctive therapy for non-variceal upper gastrointestinal rebleeding after endoscopic therapy显示文摘AIM:To evaluate the effect of pantoprazole with a somatostatin adjunct in patients with acute non-variceal upper gastrointestinal bleeding(NVUGIB).METHODS:We performed a retrospective analysis of a prospective database in a tertiary care university hospital.From October 2006 to October 2008,we enrolled 101 patients with NVUGIB that had a high-risk stigma on endoscopy.Within 24 h of hospital admission,all patients underwent endoscopic therapy.After successful endoscopic hemostasis,all patients received an 80-mg bolus of pantoprazole followed by continuous intravenous infusion(8 mg/h for 72 h).The somatostatin adjunct group(n=49)also received a 250-μg bolus of somatostatin,followed by continuous infusion (250μg/h for 72 h).Early rebleeding rates,disappearance of endoscopic stigma and risk factors associated with early rebleeding were examined.RESULTS:Early rebleeding rates were not significantly different between treatment groups(12.2%vs 14.3%,P=0.766).Disappearance of endoscopic stigma on the second endoscopy was not significantly different between treatment groups(94.2%vs 95.9%,P=0.696).Multivariate analysis showed that the complete Rockall score was a significant risk factor for early rebleeding(P =0.044,OR:9.080,95%CI:1.062-77.595).CONCLUSION:The adjunctive use of somatostatin was not superior to pantoprazole monotherapy after successful endoscopic hemostasis in patients with NVUGIB.Cheol Woong Choi Dae Hwan Kang Hyung Wook Kim Su Bum Park Kee Tae Park Gwang Ha Kim Geun Am Song Mong Cho 2011World Journal of Gastroenterology2011,17,29:15
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
6Endoscopic 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 2015World Journal of Gastroenterology2015,21,19:14
7Long-term follow up of endoscopic resection for type 3 gastric NET显示文摘AIM:To clarify the short and long-term results and to prove the usefulness of endoscopic resection in type 3gastric neuroendocrine tumors(NETs).METHODS:Of the 119 type 3 gastric NETs diagnosed from January 1996 to September 2011,50 patients treated with endoscopic resection were enrolled in this study.For endoscopic resection,endoscopic mucosal resection(EMR)or endoscopic submucosal dissection(ESD)was used.Therapeutic efficacy,complications,and follow-up results were evaluated retrospectively.RESULTS:EMR was performed in 41 cases and ESD in 9 cases.Pathologically complete resection was performed in 40 cases(80.0%)and incomplete resection specimens were observed in 10 cases(7 vs 3 patients in the EMR vs ESD group,P=0.249).Upon analysis of the incomplete resection group,lateral or vertical margin invasion was found in six cases(14.6%)in the EMR group and in one case in the ESD group(11.1%).Lymphovascular invasions were observed in two cases(22.2%)in the ESD group and in one case(2.4%)in the EMR group(P=0.080).During the follow-up period(43.73;13-60 mo),there was no evidence of tumor recurrence in either the pathologically complete resection group or the incomplete resection group.No recurrence was reported during follow-up.In addition,no mortality was reported in either the complete resection group or the incomplete resection group for the duration of the follow-up period.CONCLUSION:Less than 2 cm sized confined submucosal layer type 3 gastric NET with no evidence of lymphovascular invasion,endoscopic treatment could be considered at initial treatment.Yong Hwan Kwon Seong Woo Jeon Gwang Ha Kim Jin Il Kim Il-Kwun Chung Sam Ryong Jee Heung Up Kim Geom Seog Seo Gwang Ho Baik Kee Don Choi Jeong Seop Moon 2013World Journal of Gastroenterology2013,19,46:14
8Efforts to increase image quality during endoscopy:The role of pronase显示文摘Clear visualization of the gastrointestinal mucosal surface is essential for thorough endoscopy. An unobstructed assessment can reduce the need for additional timeconsuming manipulations such as frequent washing and suction,which tend to prolong total procedure time. However,mucus,foam,and bubbles often hinder clear visibility during endoscopy. Premedication with pronase,a compound of mixed proteolytic enzymes,has been studied in order to improve mucosal visibility during endoscopy. Although its effects differ according to the location in the stomach,premedication with pronase 10 to 20 min before endoscopy significantly improves mucosal visibility without affecting the accuracy of Helicobacter pylori identification. The effects of pronase as premedication also extend to chromoendoscopy,narrow-band imaging,magnifying endoscopy,and endoscopic ultrasonography. In addition,endoscopic flushing with pronase during endoscopy may improve the quantity and the quality of a biopsy to some degree. Although improved mucosal visibility does not necessarily improve clinical outcomes,premedication with pronase may be helpful for increasing the detection rate of early cancers.Gwang Ha Kim Yu Kyung Cho Jae Myung Cha Sun-Young Lee Il-Kwun Chung 2016World Journal of Gastrointestinal Endoscopy2016,8,5:13
9New magnifying endoscopic classification for superficial esophageal squamous cell carcinoma显示文摘AIM To assess the accuracy of a new magnifying endoscopy(ME)classification for predicting depth of invasion of superficial esophageal squamous cell carcinoma(SESCC).METHODS This study included a total of 70 lesions in 69 patients with SESCC who underwent ME with narrow-band imaging(ME-NBI)before resection from August 2010 to July 2016.Accuracy of ME-NBI for predicting depth of invasion of SESCC was analyzed by using a new ME classification proposed by the Japan Esophageal Society(JES),and interobserver agreement was assessed.RESULTS Overall accuracy of ME-NBI for estimating depth of invasion of SESCC was 78.6%.Sensitivity and specificity of type B1 for tumors limited to the epithelial layer(m1)or invading into the lamina propria(m2)were 71.4%and 100%,respectively.Sensitivity and specificity of type B2 for tumors invading into the muscularis mucosa(m3)or superficial submucosa(≤200μm,sm1)were94.4%and 73.1%,respectively,while those of type B3for tumors invading into the deep submucosa(>200μm,sm2)were 75.0%and 97.8%,respectively.Interobserver agreement was excellent(κ=0.86,95%CI:0.76-0.95).CONCLUSION The recently developed JES ME classification is useful for predicting depth of invasion of SESCC,with reliable interobserver agreement.Su Jin Kim Gwang Ha Kim Moon Won Lee Hye Kyung Jeon Dong Hoon Baek Bong Eun Lee Geun Am Song 2017World Journal of Gastroenterology2017,23,24:13
10Is it possible to differentiate gastric GISTs from gastric leiomyomas by EUS?显示文摘AIM: To evaluate the ultrasonog raphy (EUS) features of gastric gastrointestinal stromal tumors (GISTs) as compared with gastric leiomyomas and then to determine the EUS features that could predict malignant GISTs.METHODS: We evaluated the endoscopic EUS features in 53 patients with gastric mesenchymal tumors conf irmed by histopathologic diagnosis. The GISTs were classif ied into benign and malignant groups according to the histological risk classif ication.RESULTS: Immunohistochemical analyses demon-strated 7 leiomyomas and 46 GISTs. Inhomogenicity, hyperechogenic spots, a marginal halo and higher echogenicity as compared with the surrounding muscle layer appeared more frequently in the GISTs than in the leiomyomas (P < 0.05). The presence of at least two of these four features had a sensitivity of 89.1% and a specifi city of 85.7% for predicting GISTs. Except for tumor size and irregularity of the border, most of the EUS features were not helpful for predicting the malignant potential of GISTs. On multivariate analysis, only the maximal diameter of the GISTs was an independent predictor. The optimal size for predicting malignant GISTs was 35 mm. The sensitivity and specificity using this value were 92.3% and 78.8%, respectively.CONCLUSION: EUS may help to differentiate gastric GISTs from gastric leiomyomas. Once GISTs are suspected, surgery should be considered if the size is greater than 3.5 cm.Gwang Ha Kim Do Youn Park Suk Kim Dae Hwan Kim Dong Heon Kim Cheol Woong Choi Jeong Heo Geun Am Song 2009World Journal of Gastroenterology2009,15,27:12
11Intravoxel incoherent motion diffusion-weighted imaging for monitoring chemotherapeutic efficacy in gastric cancer显示文摘AIM: To assess intravoxel incoherent motion diffusionweighted imaging(IVIM-DWI) for monitoring early efficacy of chemotherapy in a human gastric cancer mouse model.METHODS: IVIM-DWI was performed with 12 b-values(0-800 s/mm2) in 25 human gastric cancer-bearing nude mice at baseline(day 0), and then they were randomly divided into control and 1-, 3-, 5- and 7-d treatment groups(n = 5 per group). The control group underwent longitudinal MRI scans at days 1, 3, 5 and 7, and the treatment groups underwent subsequent MRI scans after a specified 5-fluorouracil/calciumfolinate treatment. Together with tumor volumes(TV), the apparent diffusion coefficient(ADC) and IVIM parameters [true water molecular diffusion coefficient(D), perfusion fraction(f) and pseudo-related diffusion coefficient(D*)] were measured. The differences in those parameters from baseline to each measurement(ΔTV%, ΔADC%, ΔD%, Δf% and ΔD*%) were calculated. After image acquisition, tumor necrosis, microvessel density(MVD) and cellular apoptosis were evaluated by hematoxylin-eosin(HE), CD31 and terminal-deoxynucleotidyl transferase mediated nick end labeling(TUNEL) staining respectively, to confirm the imaging findings. Mann-Whitney test and Spearman's correlation coefficient analysis were performed.RESULTS: The observed relative volume increase(ΔTV%) in the treatment group were significantly smaller than those in the control group at day 5(ΔTV_(treatment)% = 19.63% ± 3.01% and ΔTVcontrol% = 83.60% ± 14.87%, P = 0.008) and day 7(ΔTV_(treatment)% = 29.07% ± 10.01% and ΔTV_(control)% = 177.06% ± 63.00%, P = 0.008). The difference in ΔTV% between the treatment and the control groups was not significant at days 1 and 3 after a short duration of treatment. Increases in ADC in the treatment group(ΔADC%_(treatment), median, 30.10% ± 18.32%, 36.11% ± 21.82%, 45.22% ± 24.36%) were significantly higher compared with the control group(ΔADC%_(control), median, 4.98% ± 3.39%, 6.26% ± 3.08%, 9.24% ± 6.33%) at days 3, 5 and 7(P = 0.008, P = 0.016, P = 0.008, respectively). Increases in D in the treatment group(ΔD%_(treatment), median 17.12% ± 8.20%, 24.16% ± 16.87%, 38.54% ± 19.36%) were higher than those in the control group(ΔD%_(control), median-0.13% ± 4.23%, 5.89% ± 4.56%, 5.54% ± 4.44%) at days 1, 3, and 5(P = 0.032, P = 0.008, P = 0.016, respectively). Relative changes in f were significantly lower in the treatment group compared with the control group at days 1, 3, 5 and 7 follow-up(median,-34.13% ± 16.61% vs 1.68% ± 3.40%, P = 0.016;-50.64% ± 6.82% vs 3.01% ± 6.50%, P = 0.008;-49.93% ± 6.05% vs 0.97% ± 4.38%, P = 0.008, and-46.22% ± 7.75% vs 8.14% ± 6.75%, P = 0.008, respectively). D* in the treatment group decreased significantly compared to those in the control group at all time points(median,-32.10% ± 12.22% vs 1.85% ± 5.54%, P = 0.008;-44.14% ± 14.83% vs 2.29% ± 10.38%, P = 0.008;-59.06% ± 19.10% vs 3.86% ± 5.10%, P = 0.008 and-47.20% ± 20.48% vs 7.13% ± 9.88%, P = 0.016, respectively). Furthermore, histopathologic findings showed positive correlations with ADC and D and tumor necrosis(r_s = 0.720, P < 0.001; r_s = 0.522, P = 0.007, respectively). The cellular apoptosis of the tumor also showed positive correlations with ADC and D(r_s = 0.626, P = 0.001; r_s = 0.542, P = 0.005, respectively). Perfusionrelated parameters(f and D*) were positively correlated to MVD(r_s = 0.618, P = 0.001; r_s = 0.538, P = 0.006, respectively), and negatively correlated to cellular apoptosis of the tumor(r_s =-0.550, P = 0.004; r_s =-0.692, P < 0.001, respectively).CONCLUSION: IVIM-DWI is potentially useful for predicting the early efficacy of chemotherapy in a human gastric cancer mouse model.Xiao-Li Song Heoung Keun Kang Gwang Woo Jeong Kyu Youn Ahn Yong Yeon Jeong Yang Joon Kang Hye Jung Cho Chung Man Moon 2016World Journal of Gastroenterology2016,22,24:12
12Self-expandable metallic stents for palliation of patients with malignant gastric outlet obstruction caused by stomach cancer显示文摘AIM: To ascertain clinical outcome and complications of self-expandable metal stents for endoscopic palliation of patients with malignant obstruction of the gastrointestinal (GI) tract. METHODS: A retrospective review was performed throughout August 2000 to June 2005 of 53 patients with gastric outlet obstruction caused by stomach cancer. All patients had symptomatic obstruction including nausea, vomiting, and decreased oral intake. All received self-expandable metallic stents. RESULTS: Stent implantation was successful in all 53 (100%) patients. Relief of obstructive symptoms was achieved in 43 (81.1%) patients. No immediate stent-related complications were noted. Seventeen patients had recurrent obstruction (tumor ingrowth in 14 patients, tumor overgrowth in 1 patient, and partial distal stent migration in 2 patients). The mean survival was 145 d. Median stent patency time was 187 d. CONCLUSION: Endoscopic placement of self-expandable metallic stents is a safe and effective treatment for the palliation of patients with inoperable malignant gastric outlet obstruction caused by stomach cancer.Tae Oh Kim Dae Hwan Kang Gwang Ha Kim Jeong Heo Geun Am Song Mong Cho Dong Heon Kim Mun Sup Sim 2007World Journal of Gastroenterology2007,13,6:11
13Unveiling lymph node metastasis in early gastric cancer显示文摘With respect to gastric cancer treatment,improvements in endoscopic techniques and novel therapeutic modalities[such as endoscopic mucosal resection(EMR)and endoscopic submucosal dissection(ESD)]have been developed.Currently,EMR/ESD procedures are widely accepted treatment modalities for early gastric cancer(EGC).These procedures are most widely accepted in Asia,including in Korea and Japan.In the present era of endoscopic resection,accurate prediction of lymph node(LN)metastasis is a critical component of selecting suitable patients for EMR/ESD.Generally,indications for EMR/ESD are based on large Japanese datasets,which indicate that there is almost no risk of LN metastasis in the subgroup of EGC cases.However,there is some controversy among investigators regarding the validity of these criteria.Further,there are currently no accurate methods to predict LN metastasis in gastric cancer(for example,radiologic methods or methods based on molecular biomarkers).We recommend the use of a 2-step method for the management of early gastric cancer using endoscopic resection.The first step is the selection of suitable patients for endoscopic resection,based on endoscopic and histopathologic findings.After endoscopic resection,additional surgical intervention could be determined on the basis of a comprehensive review of the endoscopic mucosal resection/endoscopic submucosal dissection specimen,including lymphovascular tumor emboli,tumor size,histologic type,and depth of invasion.However,evaluation of clinical application data is essential for validating this recommendation.Moreover,gastroenterologists,surgeons,and pathologists should closely collaborate and communicate during these decisionmaking processes.Nari Shin Tae-Yong Jeon Gwang Ha Kim Do Youn Park 2014World Journal of Gastroenterology2014,20,18:10
14H pylori eradication:A randomized prospective study of triple therapy with or without ecabet sodium显示文摘AIM: To investigate whether adding ecabet sodium to the standard triple therapy for H pylori infection improve eradication rate. METHODS: Two hundred and fifty-seven H pylori-infected patients were randomly assigned to standard triple therapy (group A, n = 129) or triple therapy plus ecabet sodium (group B, n = 128). Successful eradication was defined as a negative 13C-urea breath test 6-8 wk after completion of treatment. RESULTS: After completion of therapy, 194/257 patients showed negative 13C-urea breath test results. According to intention-to-treat analysis, the infection was eradicated in 93/129 (72.1%) patients in group A and 101/128 (78.9%) in group B (P = 0.204). Per-protocol analysis showed successful eradication in 93/118 (78.8%) patients from group A and 101/114 (88.6%) from group B (P = 0.044). There were no significant differences in the side effects experienced by the patients in the two treatment groups. CONCLUSION: Our results suggest that the addition of ecabet sodium improves the efficacy of the standard triple therapy for H pylori.Hyung Wook Kim Gwang Ha Kim Jong Yun Cheong Ung Suk Yang Seung Keun Park Chul Soo Song Dae Hwan Kang Geun Am Song 2008World Journal of Gastroenterology2008,14,6:9
15Clinicopathologic 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 2014World Journal of Gastroenterology2014,20,20:9
16Diffusion-weighted imaging of biliopancreatic disorders:Correlation with conventional magnetic resonance imaging显示文摘Diffusion-weighted magnetic resonance imaging(DWI)is a well established method for the evaluation of intracranial diseases,such as acute stroke.DWI for extracranial application is more difficult due to physiological motion artifacts and the heterogeneous composition of the organs.However,thanks to the newer technical development of DWI,DWI has become increasingly used over the past few years in extracranial organs including the abdomen and pelvis.Most previous studies of DWI have been limited to the evaluation of diffuse parenchymal abnormalities and focal lesions in abdominal organs,whereas there are few studies about DWI for the evaluation of the biliopancreatic tract.Although further studies are needed to determine its performance in evaluating bile duct,gallbladder and pancreas diseases,DWI has potential in the assessment of the functional information on the biliopancreatic tract concerning the status of tissue cellularity,because increased cellularity is associated with impeded diffusion,as indicated by a reduction in the apparent diffusion coefficient.The detection of malignant lesions and their differentiation from benign tumor-like lesions in the biliopancreatic tract could be improved using DWI in conjunction with findings obtained with conventional magnetic resonance cholagiopancreatography.Additionally,DWI can be useful for the assessment of the biliopancreatic tract in patients with renal impairment because contrast-enhanced computed tomography or magnetic resonance scans should be avoided in these patients.Nam Kyung Lee Suk Kim Gwang Ha Kim Dong Uk Kim Hyung Il Seo Tae Un Kim Dae Hwan Kang Ho Jin Jang 2012World Journal of Gastroenterology2012,18,31:8
17Risk of lymph node metastasis in mixed-type early gastric cancer determined by the extent of the poorly differentiated component显示文摘AIM: To predict the rate of lymph node(LN) metastasis in diffuse- and mixed-type early gastric cancers(EGC) for guidelines of the treatment.METHODS: We reviewed 550 cases of EGC withdiffuse- and mixed-type histology. We investigated the clinicopathological factors and histopathological components that influence the probability of LN metastasis, including sex, age, site, gross type, presence of ulceration, tumour size, depth of invasion, perineural invasion, lymphovascular invasion, and LN metastasis status. We reviewed all slides and estimated the proportions of each tumour component; pure diffuse type, mixed-predominantly diffuse type(diffuse > intestinal type), mixed-predominantly intestinal type(intestinal > diffuse type), and mixed diffuse = intestinal type. We calculated the extents of the respective components.RESULTS: LN metastasis was observed in 12.9%(71/550) of early gastric cancers cases [15/288 mucosal EGCs(5.2%) and 56/262 submucosal EGCs(21.4%)]. Of 550 cases, 302 were diffuse-type and 248 were mixed-type EGCs. Of 248 mixed-type EGCs, 163 were mixed-predominantly diffuse type, 82 were mixed-predominantly intestinal type, and 3 were mixed diffuse = intestinal type. Mixed-type cases with predominantly diffuse type histology showed a higher frequency of LN metastasis(20.2%) than cases of pure diffuse type(9.3%) and predominantly intestinal type(12.2%) histology. We measured the dimensions of each component(intestinal and diffuse type) to determine the association of the extent of each component with LN metastasis in mixed-type gastric carcinoma. The total tumour size and the extent of poorly differentiated components was associated with LN metastasis, while that of signet ring cell components was not.CONCLUSION: We recommend careful identification and quantitative evaluation of mixed-type early gastric cancer components after endoscopic resection to determine the intensity of the treatment.Chung-Su Hwang Sangjeong Ahn Bong-Eun Lee So-Jeong Lee Ahrong Kim Chang In Choi Dae Hwan Kim Tae-Yong Jeon Gwang Ha Kim Geum Am Song Do Youn Park 2016World Journal of Gastroenterology2016,22,15:8
18Attempts to enhance the eradication rate of helicobacter pylori infection显示文摘Increasing rates of antimicrobial resistance to clarithromycin and metronidazole present challenges in maintaining optimal eradication rates.Knowledge of local antibiotic resistance and consumption pattern is important in selecting a reliable regimen.In addition,adverse effect profiles of therapeutic regimens are important and must be addressed to enhance compliance rates.Various methods of enhancing the eradication rates of Helicobacter pylori(H.pylori)have been investigated,including changing combinations or durations of established drugs,adding adjuvant drugs,or development of new molecules or agents.Bismuth-containing quadruple,sequential,concomitant,and levofloxacin-based triple therapies are replacing the long-standing standard of the triple regimen.Despite the encouraging results of these regimens,individualized approaches like treatment after antibiotics resistance test or CYP2C19genotyping would be the mainstream of future therapy.Because scientific,economic,and technical problems make these advance therapies unfit for widespread use,future development for H.pylori therapy should be directed to overcome individualized antibiotic resistance.Although various novel regimens and additive agents have indicated favorable outcomes,more studies or validations are needed to become a mainstream H.pylori therapy.Chang Seok Bang Gwang Ho Baik 2014World Journal of Gastroenterology2014,20,18:8
19Associated factors for a hyperechogenic pancreas on endoscopic ultrasound显示文摘AIM: To identify the associated risk factors for hyperechogenic pancreas (HP) which may be observed on endoscopic ultrasound (EUS) and to assess the relationship between HP and obesity. METHODS: From January 2007 to December 2007, we prospectively enrolled 524 consecutive adults who were scheduled to undergo EUS. Patients with a history of pancreatic disease or with hepatobiliary or advanced gastrointestinal cancer were excluded. Finally,284 patients were included in the analyses. We further analyzed the risk of HP according to the categories of visceral adipose tissue (VAT) and subcutaneous adipose tissue in 132 patients who underwent abdominal computed tomography scans. RESULTS: On univariate analysis, age older than 60 years, obesity (body mass index > 25 kg/m 2 ), fatty liver, diabetes mellitus, hypertension and hypercholesterolemia were identified as risk factors associated with HP (P < 0.05). On multivariate analysis, fatty liver [P = 0.008, odds ratio (OR) = 2.219], male gender (P = 0.013, OR = 2.636), age older than 60 years (P = 0.001, OR = 2.874) and hypertension (P = 0.044, OR = 2.037) were significantly associated with HP. In the subgroup analysis, VAT was a statistically significant risk factor for HP (P = 0.010, OR = 5.665, lowest quartile vs highest quartile). CONCLUSION: HP observed on EUS was associated with fatty liver, male gender, age older than 60 years, hypertension and VAT.Cheol Woong Choi Gwang Ha Kim Dae Hwan Kang Hyung Wook Kim Dong Uk Kim Jeong Heo Geun Am Song Do Youn Park Suk Kim 2010World Journal of Gastroenterology2010,16,34:8
20Long-term outcomes of endoscopic submucosal dissection for early gastric cancer: a single-center experience显示文摘Mun Ki Choi Gwang Ha Kim Do Youn Park Geun Am Song Dong Uk Kim Dong Yup Ryu Bong Eun Lee Jae Hoon Cheong Mong Cho 2013Surgical Endoscopy2013,,11:6
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