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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 | Gastric cancer surgery in cirrhotic patients: Result of gastrectomy with D2 lymph node dissection显示文摘AIM: To explore the feasibility of performing gastrectomy with D2 lymphadenectomy in gastric cancer patients with liver cirrhosis.METHODS: A total of 7 178 patients were admitted with a diagnosis of liver cirrhosis from January 1993 to December 2003. We reviewed the records of 142 patients who were diagnosed with liver cirrhosis and gastric adenocarcinoma during the same period. Gastrectomy with D2 lymph node dissection for carcinoma of the stomach was performed in 94 patients with histologically proven hepatic cirrhosis.RESULTS: All but 12 patients were classified as Child's class A. Only 35 patients (37.2%) were diagnosed with cirrhosis before operation. Seventy-three patients underwent a subtotal gastrectomy (77.7%) and 21 patients (22.3%)underwent a total gastrectomy, each with D2 or more lymph node dissection. Two patients (3.8%) who had prophylactic intra-operative drain placement, died of postoperative complications from hepatorenal failure with intractable ascites. Thirty-seven patients (39.4%) experienced postoperative complications. The extent of gastric resection did not influence the morbidity whereas serum aspartate aminotransferase level (P = 0.011) and transfusion did (P= 0.008). The most common postoperative complication was ascites (13.9%) followed by wound infection (10.6%).CONCLUSION: We concluded that the presence of compensated cirrhosis, i.e. Child class A, is not a contraindication against gastrectomy with D2 or more lymph node dissection, when curative resection for gastric cancer is possible. Hepatic reserve and meticulous hemostasis are the likely determinants of operative prognosis. | Jun Ho Lee Junuk Kim Jae Ho Cheong Woo Jin Hyung Seung Ho Choi Sung Hoon Noh | 2005 | World Journal of Gastroenterology2005，11，30： | 25 |
| 3 | The 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 | 2018 | Journal of Animal Science and Biotechnology2018，9，4： | 16 |
| 4 | Piglet gut microbial shifts early in life:causes and effects显示文摘The gut microbiome has long been known to play fundamentally important roles in the animal health and the well-being of its host. As such, the establishment and maintenance of a beneficial gut microbiota early in life is crucial in pigs, since early gut colonizers are pivotal in the establishment of permanent microbial community structures affecting the health and growth performance of pigs later in life. Emphasizing this importance of early gut colonizers, it is critical to understand the factors impacting the establishment of the piglet gut microbiome at weaning. Factors include, among others, diet, in-feed antibiotics, probiotics and prebiotic administration. The impact of these factors on establishment of the gut microbiome of piglets at weaning includes effects on piglet gut microbial diversity, structure, and succession. In this review, we thoroughly reviewed the most recent findings on the piglet gut microbiome shifts as influenced by weaning, and how these microbiome changes brought about by various factors that have been shown to affect the development of microbiota in piglets. This review will provide a general overview of recent studies that can help to facilitate the design of new strategies to modulate the gut microbiome in order to enhance gastrointestinal health, growth performance and well-being of piglets. | Robin B.Guevarra Jun Hyung Lee Sun Hee Lee Min-Jae Seok Doo Wan Kim Bit Na Kang Timothy J.Johnson Richard E.Isaacson Hyeun Bum Kim | 2019 | Journal of Animal Science and Biotechnology2019，10，3： | 13 |
| 5 | Management of entecavir-resistant chronic hepatitis B with adefovir-based combination therapies显示文摘AIM: To evaluate the long-term efficacy adefovir(ADV)-based combination therapies in entecavir(ETV)-resistant chronic hepatitis B(CHB) patients. METHODS: F i fty CHB pat ient s wi t h genotypic resistance to ETV at 13 medical centers in South Korea were included for the analysis. All the patients received rescue therapy with the combination of ADV plus ETV(ADV/ETV,n = 23) or ADV plus lamivudine(LMV)(ADV/LMV,n = 27) for more than 12 mo. Patients were monitored at least every 3-4 mo during ADV-based combination therapy by clinical examination as well as biochemical and virological assessments. Hepatitis B virus(HBV) DNA levels were measured by realtime PCR and logarithmically transformed for analysis. Cumulative rates of virologic response(VR; HBV DNA < 20 IU/m L) were calculated using the Kaplan-Meier method,and the difference was determined by a logrank test. Multivariate logistic regression and Cox proportional hazards models were used to identify independent risk factors significantly associated with short-term and long-term VR,respectively.RESULTS: Baseline median HBV DNA levels were 5.53(2.81-7.63) log10 IU/m L. The most commonly observed ETV genotypic mutation sites were rt184 and rt202. Patients were treated for a median of 27(12-45) mo. Overall,cumulative VR rates at 6,12,24,and 36 mo were 26%,36%,45%,and 68%,respectively. Patients treated with the ADV/ETV combination showed higher cumulative VR rates(35%,43%,65%,and 76%,respectively) than those with the ADV/LAM combination(18%,30%,30%,and 62%,respectively; P = 0.048). In the multivariate analysis,low baseline HBV DNA levels(< 5.2 log10 IU/m L) and initial virologic response at 3 mo(IVR-3; HBV DNA < 3.3 log10 IU/m L after 3 mo) were independent predictive factors for VR. Patients with favorable predictors achieved cumulative VR rates up to 90% at 36 mo. During the same period,the cumulative incidence of virologic breakthrough was as low as 6% in patients with the both favorable predictors.CONCLUSION: If tenofovir is not available,ADV/ETV combination could be considered in ETV-resistant patients with low HBV DNA titers,and may becontinued if IVR-3 is achieved. | Hyoung Su Kim Hyung Joon Yim Myoung Kuk Jang Ji Won Park Sang Jun Suh Yeon Seok Seo Ji Hoon Kim Bo Hyun Kim Sang Jong Park Sae Hwan Lee Sang Gyune Kim Young Seok Kim Jung Il Lee Jin-Woo Lee In Hee Kim Tae Yeob Kim Jin-Wook Kim Sook-Hyang Jeong Young Kul Jung Hana Park Seong Gyu Hwang | 2015 | World Journal of Gastroenterology2015，21，38： | 13 |
| 6 | Peroxisome proliferator-activated receptor-delta agonist ameliorated inflammasome activation in nonalcoholic fatty liver disease显示文摘AIM: To evaluate the inflammasome activation and the effect of peroxisome proliferator-activated receptors(PPAR)-δ agonist treatment in nonalcoholic fatty liver disease(NAFLD) models.METHODS: Male C57BL/6J mice were classified according to control or high fat diet(HFD) with or without PPAR-δ agonist(GW) over period of 12 wk [control, HFD, HFD + lipopolysaccharide(LPS), HFD + LPS + GW group]. Hep G2 cells were exposed to palmitic acid(PA) and/or LPS in the absence or presence of GW.RESULTS: HFD caused glucose intolerance and hepatic steatosis. In mice fed an HFD with LPS, caspase-1 and interleukin(IL)-1β in the liver were significantly increased. Treatment with GW ameliorated the steatosis and inhibited overexpression of pro-inflammatory cytokines. In Hep G2 cells, PA and LPS treatment markedly increased m RNA of several nucleotide-binding andoligomerization domain-like receptor family members(NLRP3, NLRP6, and NLRP10), caspase-1 and IL-1β. PA and LPS also exaggerated reactive oxygen species production. All of the above effects of PA and LPS were reduced by GW. GW also enhanced the phosphorylation of AMPK-α.CONCLUSION: PPAR-δ agonist reduces fatty acidinduced inflammation and steatosis by suppressing inflammasome activation. Targeting the inflammasome by the PPAR-δ agonist may have therapeutic implication for NAFLD. | Hyun Jung Lee Jong Eun Yeon Eun Jung Ko Eileen L Yoon Sang Jun Suh Keunhee Kang Hae Rim Kim Seoung Hee Kang Yang Jae Yoo Jihye Je Beom Jae Lee Ji Hoon Kim Yeon Seok Seo Hyung Joon Yim Kwan Soo Byun | 2015 | World Journal of Gastroenterology2015，21，45： | 9 |
| 7 | Quality of survival in patients treated for malignant biliary obstruction caused by unresectable pancreatic head cancer: surgical versus non-surgical palliation显示文摘BACKGROUND:Appropriate palliation for unresectable pancreatic head cancer is most important.This study was undertaken to compare the survival of patients with biliary obstruction caused by unresectable pancreatic head cancer after surgical and non-surgical palliation. METHODS:We retrospectively reviewed 69 patients who underwent palliative treatment for unresectable pancreatic head cancer.Fifty-two patients with locally advanced disease (local vascular invasion)and 17 with distant metastatic disease were included.The patients were divided into two groups,surgical and non-surgical palliation. RESULTS:Thirty-eight patients underwent biliary bypass surgery and 31 had percutaneous transhepatic biliary drainage(PTBD).There was no significant difference in the early complications,successful biliary drainage, recurrent jaundice,and 30-day mortality between surgical palliation and PTBD.However,in 52 patients whose tumor was unresectable secondary to local vascular invasion,the rate of recurrent jaundice after successful surgical biliary palliation was lower than that in patients who had non- surgical palliation(P<0.05).The patients who underwent surgical palliation had a longer hospital-free survival rate(P<0.001),although they had a longer postoperative hospital stay(P=0.004)during the first admission period.CONCLUSIONS:In patients with preoperative evaluations showing potentially resectable tumors and/or no metastatic lesions,surgical exploration should be performed.Thus,in patients who have unresectable cancer or limited metastatic disease on exploration,surgical palliation should be performed for longer survival and better quality of survival. | Hyung Ook Kim Sang Il Hwang Hungdai Kim Jun Ho Shin | 2008 | Hepatobiliary & Pancreatic Diseases International2008，7，6： | 8 |
| 8 | Efficacy of cap-assisted colonoscopy according to lesion location and endoscopist training level显示文摘AIM: To evaluate the efficacy of cap-assisted colonoscopy(CAC) for detection of colorectal polyps and adenomas according to the lesion location and endoscopist training level.METHODS: Patients 20 years or older, who underwent their first screening colonoscopy in a single tertiary center from May 2011 to December 2012 were enrolled in this study. All patients underwent either CAC or standard colonoscopy(SC), and all of the procedures were performed by 11 endoscopists(8 trainees and 3 experts). All procedures were performed with highdefinition colonoscopes and narrow band imaging. The eight trainees had experiences of performing 150 to 500 colonoscopies, and the three experts had experiences of performing more than 3000 colonoscopies. A 4-mmlong transparent cap was attached to the end of a colonoscope in the CAC group. We retrospectively evaluated the number of polyps and adenomas, polyp detection rate(PDR), and the number of adenomas and adenoma detection rate(ADR) according to the lesion location and endoscopist training level between CAC and SC. We also evaluated the number of polyps and adenomas according to their size between CAC and SC.RESULTS: Overall, PDR and ADR using CAC were significantly higher than those using SC for both whole colon(48.5% vs 40.7%, P = 0.012; 35.7% vs 28.3%, P = 0.012) and right-side colon(35.3% vs 26.6%, P = 0.002; 27.0% vs 16.9%, P < 0.001). The number of polyps and adenomas per patient using CAC was significantly higher than that using SC for both the whole colon(1.07 ± 1.59 vs 0.82 ± 1.31, P = 0.008; 0.72 ± 1.32 vs 0.50 ± 1.01, P = 0.003) and right-side colon(0.66 ± 1.18 vs 0.41 ± 0.83, P < 0.001; 0.46 ± 0.97 vs 0.25 ± 0.67, P < 0.001). In the trainee group, the PDR and ADR using CAC were significantly higher than those using SC for both the whole colon(46.7% vs 39.7%, P = 0.040; 33.9% vs 26.0%, P =0.012) and right-side colon(34.2% vs 26.5%, P = 0.015; 25.3% vs 15.9%, P = 0.001). In the expert group, the PDR and ADR using CAC were significantly higher than those using SC only for the right-side colon(42.1% vs 27.0%, P =0.035; 36.8% vs 21.0%, P = 0.020).CONCLUSION: CAC is more effective than SC for detection of colorectal polyps and adenomas, especially when performed by trainees and when the lesions are located in the right-side colon. | Dong Jun Kim Hyung Wook Kim Su Bum Park Dae Hwan Kang Cheol Woong Choi Joung Boom Hong Byoung Hoon Ji Chang Seok Lee | 2015 | World Journal of Gastroenterology2015，21，20： | 8 |
| 9 | Durability of viral response after off-treatment in HBeAg positive chronic hepatitis B显示文摘AIM:To evaluate the durability in hepatitis B e antigen (HBeAg) positive chronic hepatitis B patients who discontinued antiviral treatment. METHODS:A total of 48 HBeAg positive chronic hepatitis B patients who were administered nucleoside analogues and maintained virological response for ≥ 6 mo [hepatitis B virus (HBV) DNA < 300 copies/mL and HBeAg seroconversion] before cessation of treatment were enrolled between February 2007 and January 2010. The criteria for the cessation of the antiviral treatment were defined as follows:(1) achievement of virological response; and (2) duration of consolidation therapy (≥ 6 mo). After treatment cessation, the patients were followed up at 3-6 mo intervals. The primary endpoint was serologic and virologic recurrence rates after withdrawal of antiviral treatment. Serologic recurrence was defined as reappearance of HBeAg positivity after HBeAg seroconversion. Virologic recurrence was defined as an increase in HBV-DNA level > 104 copies/mL after HBeAg seroconversion with previously undetectable HBV-DNA level. RESULTS:During the median follow-up period of 18.2 mo (range:5.1-47.5 mo) after cessation of antiviral treatment, the cumulative serological recurrence rate was 15 % at 12 mo. The median duration between the cessation of antiviral treatment and serologic recurrence was 7.2 mo (range:1.2-10.9 mo). Of the 48 patients with HBeAg positive chronic hepatitis, 20 (41.6%) showed virological recurrence. The cumulative virologic recurrence rates at 12 mo after discontinuing the antiviral agent were 41%. The median duration between off-treatment and virologic recurrence was 7.6 mo (range:4.3-27.1 mo). The mean age of the virological recurrence group was older than that of the non-recurrence group (46.7 ± 12.1 years vs 38.8 ± 12.7 years, respectively; P = 0.022). Age (> 40 years) and the duration of consolidation treatment (≥ 15 mo) were significant predictive factors for offtreatment durability in the multivariate analysis [P = 0.049, relative risk (RR) 0.31, 95% CI (0.096-0.998) and P = 0.005, RR 11.29, 95% CI (2.054-65.12), respectively]. Patients with age (≤ 40 years) who received consolidation treatment (≥ 15 mo) significantly showed durability in HBeAg positive chronic hepatitis B patients (P = 0.014). These results suggest that additional treatment for more than 15 mo after HBeAg seroconversion in patients who are ≤ 40 years old may be beneficial in providing a sustained virological response. CONCLUSION:Our data suggest that HBeAg seroconversion is an imperfect end point in antiviral treatment. Long-term consolidation treatment (≥ 15 mo) in younger patients is important for producing better prognosis in HBeAg positive chronic hepatitis B. | Myeong Jun Song Do Seon Song Hee Yeon Kim Sun Hong Yoo Si Hyun Bae Jong Young Choi Seung Kew Yoon Yong-Han Paik June Sung Lee Hyun Woong Lee Hyung Joon Kim | 2012 | World Journal of Gastroenterology2012，18，43： | 7 |
| 10 | Is endoscopic ultrasonography essential for endoscopic resection of small rectal neuroendocrine tumors?显示文摘AIM To evaluate the importance of endoscopic ultrasonography(EUS) for small(≤ 10 mm) rectal neuroendocrine tumor(NET) treatment.METHODS Patients in whom rectal NETs were diagnosed by endoscopic resection(ER) at the Pusan National University Yangsan Hospital between 2008 and 2014 were included in this study. A total of 120 small rectal NETs in 118 patients were included in this study. Histologic features and clinical outcomes were analyzed, and the findings of endoscopy, EUS and histology were compared. RESULTS The size measured by endoscopy was not significantly different from that measured by EUS and histology(r = 0.914 and r = 0.727 respectively). Accuracy for the depth of invasion was 92.5% with EUS. No patients showed invasion of the muscularis propria or metastasis to the regional lymph nodes. All rectal NETswere classified as grade 1 and demonstrated an L-cell phenotype. Mean follow-up duration was 407.54 ± 374.16 d. No patients had local or distant metastasis during the follow-up periods. CONCLUSION EUS is not essential for ER in the patient with small rectal NETs because of the prominent morphology and benign behavior. | Su Bum Park Dong Jun Kim Hyung Wook Kim Cheol Woong Choi Dae Hwan Kang Su Jin Kim Hyeong Seok Nam | 2017 | World Journal of Gastroenterology2017，23，11： | 7 |
| 11 | High-temperature Oxidation Behavior of Zircaloy-4 and Zirlo in Steam Ambient显示文摘The oxidation characteristics for Zircaloy-4 and Zirlo in the temperature range of 700-1200°C under steam supply condition were investigated by using a modified thermo-gravimetric analyzer.The specimens were oxidized for 3600 s at each temperature and then quenched in a furnace.The oxidation rate constants were measured from the weight gains to evaluate the oxidation behavior in Zircaloy-4 and Zirlo.The weight gain rates of Zirlo were lower than those of Zircaloy-4,leading to the low rate constants.The different oxidation behaviors between both cladding materials were considered to be due to the difference in their chemical compositions. | Hyung Hoon Kim Jun Ho Kim Jin Young Moon Ho Seong Lee Jeong Joo Kim Young Suck Chai | 2010 | Journal of Materials Science & Technology2010，26，9： | 7 |
| 12 | Outcome of laparoscopic cholecystectomy is not influenced by chronological age in the elderly显示文摘AIM:To evaluate the outcome of laparoscopic cholecystectomy(LC)in patients aged 80 years and older. METHODS:A total of 353 patients aged 65 to 79 years(group 1)and 35 patients aged 80 years and older(group 2)underwent LC.Patients were further classified into two other groups:those with uncomplicated gallbladder disease(group A)or those with complicated gallbladder disease(group B). RESULTS:There were no significant differences between the age groups(groups 1 and 2)with respect to clinical characteristics such as age,gender,comorbid disease,or disease presentation.Mean operative time,conversion rate,and the incidence of major postoperative complications were similar in groups 1 and 2.However,the percentage of high-risk patients was significantly higher in group 2 than in group 1 (20.0%vs 5.7%,P<0.01).Group A comprised 322 patients with a mean age of 71.0±5.3 years,and group B comprised 51 patients with a mean age of 69.9±4.8 years.In group B,mean operative time (78.4±49.3 min vs 58.3±35.8 min,P<0.01),mean postoperative hospital stay(7.9±6.5 d vs 5.0±3.7 d, P<0.01),and the incidence of major postoperative complications(9.8%vs 3.1%,P<0.05)were significantly greater than in group A.The conversion rate tended to be higher in group B,but this difference was not significant. CONCLUSION:Perioperative outcomes in elderly patients who underwent LC seem to be influenced by the severity of gallbladder disease,and not by chronologic age.In octogenarians,LC should be performed at an earlier,uncomplicated stage of the disease whenever possible to improve perioperative outcomes. | Hyung Ook Kim Jung Won Yun Jun Ho Shin Sang Il Hwang Yong Kyun Cho Byung Ho Son Chang Hak Yoo Yong Lai Park Hungdai Kim | 2009 | World Journal of Gastroenterology2009，15，6： | 5 |
| 13 | Needle-knife fistulotomy vs double-guidewire technique in patients with repetitive unintentional pancreatic cannulations显示文摘AIM: To compare the success rates and adverse events of early needle-knife fistulotomy(NKF) and double-guidewire technique(DGT) in patients with repetitive unintentional pancreatic cannulations.METHODS: From a total of 1650 patients admitted for diagnostic or therapeutic endoscopic retrograde cholangiopancreatography(ERCP) at a single tertiary care hospital(Pusan National University Yangsan Hospital, Yangsan, South Korea) between January2009 and December 2012, 134(8.1%) patients with unsuccessful biliary cannulation after 5 min trial of conventional methods, together with 5 or more repetitive unintentional pancreatic cannulations, were enrolled in the study. Early NKF and DGT groups were assigned 67 patients each. In the DGT group, NKF was performed for an additional 7 min if successful cannulation was not achieved.RESULTS: The success rates with early NKF andthe DGT were 79.1%(53/67) and 44.8%(30/67)(P< 0.001), respectively. The incidence of post-ERCP pancreatitis(PEP) was lower in the early NKF group than in the DGT group [4.5%(3/67) vs 14.9%(10/67),P = 0.041]. The mean cannulation times in the early NKF and DGT groups after assignment were 257 s and312 s(P = 0.013), respectively.CONCLUSION: Our data suggest that early NKF should be considered as the first approach to selective biliary cannulation in patients with repetitive unintentional pancreatic cannulations. | Su Jin Kim Dae Hwan Kang Hyung Wook Kim Cheol Woong Choi Su Bum Park Byeong Jun Song Young Mi Hong | 2015 | World Journal of Gastroenterology2015，21，19： | 4 |
| 14 | Surgical palliation of unresectable pancreatic head cancer in elderly patients显示文摘AIM: To determine if surgical biliary bypass would provide improved quality of residual life and safe palliation in elderly patients with unresectable pancreatic head cancer. METHODS: Nineteen patients, 65 years of age or older, were managed with surgical biliary bypass (Group A). These patients were compared with 19 patients under 65 years of age who were managed with surgical biliary bypass (Group B). In addition, the results for group A were compared with those obtained from 17 patients, 65 years of age or older (Group C), who received percutaneous transhepatic biliary drainage to evaluate the quality of residual life. RESULTS: Five patients (26.0%) in Group A had complications, including one intraabdominal abscess, one pulmonary atelectasis, and three wound infections. One death (5.3%) occurred on postoperative day 3. With respect to morbidity, mortality, and postoperative hospitalization, no statistically significant difference was noted between Groups A and B. The number of readmissions and the rate of recurrent jaundice were lower in Group A than in Group C, to a statistically significant degree (P = 0.019, P = 0.029, respectively). The median hospital-free survival period and themedian overall survival were also signifi cantly longer in Group A (P = 0.001 and P < 0.001, respectively). CONCLUSION: Surgical palliation does not increase the morbidity or mortality rates, but it does increase the survival rate and improve the quality of life in elderly patients with unresectable pancreatic head cancer. | Sang Il Hwang Hyung Ook Kim Byung Ho Son Chang Hak Yoo Hungdai Kim Jun Ho Shin | 2009 | World Journal of Gastroenterology2009，15，8： | 4 |
| 15 | InIncidence and clinical features of endoscopic ulcers developing after gastrectomy显示文摘AIM:To determine the precise incidence and clinical features of endoscopic ulcers following gastrectomy.METHODS:A consecutive series of patients who underwent endoscopic examination following gastrectomy between 2005 and 2010 was retrospectively analyzed.A total of 78 patients with endoscopic ulcers and 759 without ulcers following gastrectomy were enrolled.We analyzed differences in patient age,sex,size of the lesions,method of operation,indications for gastric resection,and infection rates of Helicobacter pylori(H.pylori) between the nonulcer and ulcer groups.RESULTS:The incidence of endoscopic ulcers after gastrectomy was 9.3% and that of marginal ulcers was 8.6%.Ulcers were more common in patients with Billroth Ⅱ anastomosis and pre-existing conditions forpeptic ulcer disease(PUD).Infection rates of H.pyloridid not differ significantly between the two groups.The patients who underwent operations to treat PUD had lower initial levels of hemoglobin and higher rates of hospital admission.CONCLUSION:H.pylori was not an important factor in ulcerogenesis following gastrectomy.For patients who underwent surgery for PUD,clinical course of marginal ulcers was more severe. | Woo Chul Chung Eun Jung Jeon Kang-Moon Lee Chang Nyol Paik Sung Hoon Jung Jung Hwan Oh Ji Hyun Kim Kyong-Hwa Jun Hyung Min Chin | 2012 | World Journal of Gastroenterology2012，18，25： | 4 |
| 16 | Stereotactic body radiation therapy for inoperable hepatocellular carcinoma as a local salvage treatment after incomplete transarterial chemoembolization显示文摘 | Jin‐Kyu Kang Mi‐Sook Kim Chul Koo Cho Kwang Mo Yang Hyung Jun Yoo Jin Ho Kim Sun Hyun Bae Da Hoon Jung Kum Bae Kim Dong Han Lee Chul Ju Han Jin Kim Su Cheol Park Young Han Kim | 2012 | Cancer2012，，21： | 3 |
| 17 | Diagnostic delay in inflammatory bowel disease increases the risk of intestinal surgery显示文摘AIM To investigate the factors affecting diagnostic delay and outcomes of diagnostic delay in inflammatory bowel disease(IBD) METHODS We retrospectively studied 165 patients with Crohn's disease(CD) and 130 patients with ulcerative colitis(UC) who were diagnosed and had follow up durations > 6 mo at Korea University Ansan Hospital from January 2000 to December 2015. A diagnostic delay was defined as the time interval between the first symptom onset and IBD diagnosis in which the 76^(th) to 100^(th) percentiles of patients were diagnosed.RESULTS The median diagnostic time interval was 6.2 and 2.4 mo in the patients with CD and UC, respectively. Among the initial symptoms, perianal discomfort before diagnosis(OR = 10.2, 95%CI: 1.93-54.3, P = 0.006) was associated with diagnostic delays in patients with CD; however, no clinical factor was associated with diagnostic delays in patients with UC. Diagnostic delays, stricturing type, and penetrating type were associated with increased intestinal surgery risks in CD(OR = 2.54, 95%CI: 1.06-6.09; OR = 4.44, 95%CI: 1.67-11.8; OR = 3.79, 95%CI: 1.14-12.6, respectively). In UC, a diagnostic delay was the only factor associated increased intestinal surgery risks(OR = 6.81, 95%CI: 1.12-41.4).CONCLUSION A diagnostic delay was associated with poor outcomes, such as increased intestinal surgery risks in patients with CD and UC. | Dong-won Lee Ja Seol Koo Jung Wan Choe Sang Jun Suh Seung Young Kim Jong Jin Hyun Sung Woo Jung Young Kul Jung Hyung Joon Yim Sang Woo Lee | 2017 | World Journal of Gastroenterology2017，23，35： | 3 |
| 18 | Predictors of post-treatment stenosis in cervical esophageal cancer undergoing high-dose radiotherapy显示文摘AIM To evaluate toxicity and treatment outcome of highdose radiotherapy(RT) for cervical esophageal cancer(CEC).METHODS We reviewed a total of 62 consecutive patients who received definitive RT for stage Ⅰ to Ⅲ cervical esophageal cancer between 2001 and 2015. Patients who received < 45 Gy, treated for lesions below sternal notch, treated with palliative aim, treated with subsequent surgical resection, or diagnosed with synchronous hypopharyngeal cancer were excluded. Treatment failures were divided into local(occurring within the RT field), outfield-esophageal, and regional [occurring in regional lymph node(s)] failures. Factors predictive of esophageal stenosis requiring endoscopic dilation were analyzed.RESULTS Grade 1, 2, and 3 esophagitis occurred in 19(30.6%), 39(62.9%), and 4 patients(6.5%), respectively, without grade ≥ 4 toxicities. Sixteen patients(25.8%) developed post-RT stenosis, of which 7 cases(43.8%) were malignant. Four patients(6.5%) developed tracheoesophageal fistula(TEF), of which 3(75%) cases were malignant. Factors significantly correlated with post-RT stenosis were stage T3/4(P = 0.001), complete circumference involvement(P < 0.0001), stenosis at diagnosis(P = 0.024), and endoscopic complete response(P = 0.017) in univariate analysis, while complete circumference involvement was significant in multivariate analysis(P = 0.003). A higher dose(≥ 60 Gy) was not associated with occurrence of postRT stenosis or TEF. With a median follow-up of 24.3(range, 3.4-152) mo, the 2 y local control, outfield esophageal control, progression-free survival, and overall survival(OS) rates were 78.9%, 90.2%, 49.6%, and 57.3%, respectively. Factors significantly correlated with OS were complete circumference involvement(P = 0.023), stenosis at diagnosis(P < 0.0001), and occurrence of post-RT stenosis or TEF(P < 0.001) in univariate analysis, while stenosis at diagnosis(P = 0.004) and occurrence of post-RT stenosis or TEF(P = 0.023) were significant in multivariate analysis. CONCLUSION Chemoradiation for CEC was well tolerated, and a higher dose was not associated with stenosis. Patients with complete circumferential involvement require close follow-up. | Jun Won Kim Tae Hyung Kim Jie-Hyun Kim Ik Jae Lee | 2018 | World Journal of Gastroenterology2018，24，7： | 3 |
| 19 | Prognostic factors in patients with middle and distal bile duct cancers显示文摘AIM:To identify the influence of the surgery type and prognostic factors in middle and distal bile duct cancers.METHODS:Between August 1990 and June 2011,data regarding the clinicopathological factors of 194patients with surgical and pathological confirmation were collected.A total of 133 patients underwent resections(R0,R1,R2;n=102,24,7),whereas 61patients underwent nonresectional surgery.Either pancreaticoduodenectomy(PD)or bile duct resection(BDR)was selected according to the sites of tumors and comorbidities of the patients after confirming resectionmargin by the frozen histology in all cases.Univariate and multivariate analyses of clinicopathologic factors were performed,utilizing the Kaplan-Meyer method and Cox hazard regression analysis.RESULTS:The overall 5-year survival rate for the 133patients who underwent resection(R0,R1,and R2)was 41.2%,whereas no patients survived longer than3 years among the 61 patient who underwent nonresectional surgeries.The 5-year survival rate of the patients who underwent a PD(n=90)was higher than the rate of those who underwent BDR(n=43),although the difference was not statistically significant(46.6%vs 30.0%P=0.105).However,PD had a higher rate of R0 resection than BDR(90.0%vs 48.8%,P<0.0001).If R0 resection was achieved,PD and BDR showed similar survival rates(49.4%vs 46.5%P=0.762).The 5-year survival rates of R0 and R1 resections were not significantly different(49.0%vs 21.0%P=0.132),but R2 resections had lower survival(0%,P=0.0001).Although positive lymph node,presence of perineural invasion,presence of lymphovascular invasion(LVI),7th AJCC-UICC tumor node metastasis(TNM)stage,and involvement of resection margin were significant prognostic factors in univariate analysis,multivariate analysis identified only TNM stage and LVI as independent prognostic factors.CONCLUSION:PD had a greater likelihood of curative resection and R1 resection might have some positive impact.The TNM stage and LVI were independent prognostic factors. | Hyung Jun Kwon Sang Geol Kim Jae Min Chun Won Kee Lee Yoon Jin Hwang | 2014 | World Journal of Gastroenterology2014，20，21： | 3 |
| 20 | Endoscopic resection using band ligation for esophageal SMT in less than 10mm显示文摘AIM:To evaluate the safety and feasibility of endoscopic resection using band ligation(EMR-B) for the diagnostic and therapeutic removal of tumors located in the esophageal subepithelial region having originated from the submucosa.METHODS:From May 2009 to September 2014,after medical chart and endoscopic ultrasonography report review,a total of 15 esophageal tumors located in the submucosal layer were resected by EMR-B.Previous symptom,location,pathology,complete resection rate,incidence of complications,incidence of minor complication,size,length of procedures time and follow up months were evaluated.To evaluate local recurrence at the resection site,periodic follow-up endoscopic examination was undertaken in all of the patients.The first endoscopic examination was performed about 6 mo after the endoscopic resection.Thereafter,the endoscopic follow up were scheduled annually.RESULTS:The mean age was 50.3 ± 9.67 years.The mean tumor size was 6.93 ± 3.15 mm and most of the lesions size was between 5-10 mm in diameter(10/15,66.6%).In all patients,endoscopic en bloc resection was achieved.In one patient,the vertical margin was involved.The mean procedural time was 8.86 ± 3.66 min.In all patients,no evidence of severe complications such as perforation or bleeding occurred.Minor complications such as chest pain(2/15,13.3%) and heartburn(3/15,13.3%) were reported but they symptoms were controlled by proton pump inhibitors,ulcermin and/or analgesics.Histologic assessments of the removed specimens revealed 10 granular cell tumors(66.6%),4 leiomyomas(16.6%) and one lipoma(6.6%).No recurrence was observed during the mean follow up period of 45 ± 3.5 mo(range:5-64 mo).CONCLUSION:EMR-B might be considered safe and effective for the diagnosis and treatment of lesions measuring less than 10 mm in diameter. | Joung Boom Hong Cheol Woong Choi Hyung Wook Kim Dae Hwan Kang Su Bum Park Su Jin Kim Dong Jun Kim | 2015 | World Journal of Gastroenterology2015，21，10： | 3 |
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