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1Systematic review on the surgical treatment for T1 gallbladder cancer显示文摘AIM:To evaluate the efficacy of simple and extended cholecystectomy for mucosa(T1a) or muscularis(T1b) gallbladder(GB) cancer. METHODS:Original studies on simple and extended cholecystectomy for T1a or T1b GB cancer were searched from MEDLINE(PubMed) ,Cochrane Library,EMBase,and CancerLit using the search terms of GB,cancer/carcinoma/tumor/neoplasm. RESULTS:Twenty-nine out of the 2312 potentially relevant publications met the eligibility criteria.Of the 1266 patients with GB cancer included in the publications,706(55.8%) and 560(44.2%) had T1a and T1b GB cancer,respectively.Simple cholecystectomy for T1a and T1b GB cancer was performed in 590(83.6%) and 375(67.0%) patients,respectively(P<0.01) .In most series,the treatment of choice was simple cholecystectomy for T1a GB cancer patients with a 5-year survival rate of 100%.Lymph node metastasis was detected in 10.9% of the T1b GB cancer patients and in 1.8%of the T1a GB cancer patients,respectively(P<0.01) .Eight patients(1.1%) with T1a GB cancer and 52 patients(9.3%) with T1b GB cancer died of recurrent GB cancer(P<0.01) . CONCLUSION:Simple cholecystectomy represents the adequate treatment of T1a GB cancer.There is no definite evidence that extended cholecystectomy is advantageous over simple cholecystectomy for T1b GB cancer.Seung Eun Lee Jin-Young Jang Chang-Sup Lim Mee Joo Kang Sun-Whe Kim 2011World Journal of Gastroenterology2011,17,2:69
2Hepatolithiasis and intrahepatic cholangiocarcinoma: A review显示文摘Although the incidence of hepatolithiasis is decreasing as the pattern of gallstone disease changes in Asia, the prevalence of hepatolithiasis is persistently high, especially in Far Eastern countries. Hepatolithiasis is an established risk factor for cholangiocarcinoma(CCA), and chronic proliferative inflammation may be involved in biliary carcinogenesis and in inducing the upregulation of cell-proliferating factors. With the use of advanced imaging modalities, there has been much improvement in the management of hepatolithiasis and the diagnosis of hepatolithiasis-associated CCA(HLCCA). However, there are many problems in managing the strictures in hepatolithiasis and differentiating them from infiltrating types of CCA. Surgical resection is recommended in cases of single lobe hepatolithiasis with atrophy, uncontrolled stricture, symptom duration of more than 10 years, and long history of biliaryenteric anastomosis. Even after resection, patients should be followed with caution for development of HL-CCA, because HL-CCA is an independent prognostic factor for survival. It is not yet clear whether hepatic resection can reduce the occurrence of subsequent HL-CCA. Furthermore, there are no consistent findings regarding prediction of subsequent HL-CCA in patients with hepatolithiasis. In the management of hepatolithiasis, important factors are the reduction of recurrence of cholangitis and suspicion of unrecognized HL-CCA.Hyo Jung Kim Jae Seon Kim Moon Kyung Joo Beom Jae Lee Ji Hoon Kim Jong Eun Yeon Jong-Jae Park Kwan Soo Byun Young-Tae Bak 2015World Journal of Gastroenterology2015,21,48:63
3Factors related to lymph node metastasis and surgical strategy used to treat early gastric carcinoma显示文摘AIM:The prognosis of early gastric carcinoma (EGC) is generally excellent after surgery. The presence or absence of lymph node metastasis in EGC is an important prognostic factor. The survival and recurrence rates of node-negative EGC are much better than those of node-positive EGC. This study examined the factors related to lymph node metastasis in EGC to determine the appropriate treatment for EGC.METHODS: We investigated 748 patients with EGC who underwent surgery between January 1985 and December 1999 at the Division of Gastroenterologic Surgery, Department of Surgery, Chonnam National University Hospital. Several clinicopathologic factors were investigated to analyze their relationship to lymph node metastasis: age, sex, tumor location, tumor size, gross type, histologic type, depth of invasion, extent of lymph node dissection, type of operation,and DNA ploidy.RESULTS:Lymph node metastases were found in 75 patients (10.0%). Univariate analysis showed that male sex, tumor size larger than 2.0cm, submucosal invasion of tumor, histologic differentiation, and DNA ploidy pattern were risk factors for regional lymph node metastasis in EGC patients. However, a multivariate analysis showed that three risk factors were associated with lymph node metastasis:large tumor size, undifferentiated histologic type and submucosal invasion. No statistical relationship was found for age, sex, tumor location, gross type, or DNA ploidy in multivariate analysis. The 5-year survival rate was 94.2% for those without lymph node metastasis and 87.3% for those with lymph node metastasis, and the difference was significant (P<0.05).CONCLUSION: In patients with EGC, the survival rate of patients with positive lymph nodes is significantly worse than that of patients with no lymph node metastasis. Therefore,a standard D2 lymphadenectomy should be performed in patients at high risk of lymph node metastasis: large tumor size, undifferentiated histologic type and submucosal invasion.Dong Yi Kim Jae Kyoon Joo Seong Yeob Ryu Young Jin Kim Shin Kon Kim 2004World Journal of Gastroenterology2004,10,5:68
4Diagnostic value of PIVKA-Ⅱ and alpha-fetoprotein in hepatitis B virus-associated hepatocellular carcinoma显示文摘AIM: To determine the cutoff values and to compare the diagnostic role of alpha-fetoprotein(AFP) and prothrombin induced by vitamin K absence-Ⅱ(PIVKA-Ⅱ) in chronic hepatitis B(CHB).METHODS: A total of 1255 patients with CHB, including 157 patients with hepatocellular carcinoma(HCC), 879 with non-cirrhotic CHB and 219 with cirrhosis without HCC, were retrospectively enrolled. The areas under the receiver operating characteristic(AUROC) curves of PIVKA-Ⅱ, AFP and their combination were calculated and compared.RESULTS: The optimal cutoff values for PIVKA-Ⅱ and AFP were 40 m AU/m L and 10 ng/m L, respectively, for the differentiation of HCC from nonmalignant CHB. The sensitivity and specificity were 73.9% and 89.7%, respectively, for PIVKA-Ⅱ and 67.5% and 90.3% for AFP, respectively. The AUROC curves of both PIVKA-Ⅱ and AFP were not significantly different(0.854 vs 0.853, P = 0.965) for the differentiation of HCC from nonmalignant CHB, whereas the AUROC of PIVKA-Ⅱ was significantly better than that of AFP in patients with cirrhosis(0.870 vs 0.812, P = 0.042). When PIVKA-Ⅱ and AFP were combined, the diagnostic power improved significantly compared to either AFP or PIVKA-Ⅱ alone for the differentiation of HCC from nonmalignant CHB(P < 0.05), especially when cirrhosis was present(P < 0.05).CONCLUSION: Serum PIVKA-Ⅱ might be a better tumor marker than AFP, and its combination with AFP may enhance the early detection of HCC in patients with CHB.Seung In Seo Hyoung Su Kim Won Jin Kim Woon Geon Shin Doo Jin Kim Kyung Ho Kim Myoung Kuk Jang Jin Heon Lee Joo Seop Kim Hak Yang Kim Dong Joon Kim Myung Seok Lee Choong Kee Park 2015World Journal of Gastroenterology2015,21,13:60
5Long-term result of endoscopic Histoacryl (N-butyl-2-cyanoacrylate)injection for treatment of gastric varices显示文摘AIM:To evaluate the long-term efficacy and safety of endoscopic obliteration with Histoacryl  for treatment of gastric variceal bleeding and prophylaxis.METHODS:Between January 1994 and March 2010 at SoonChunHyang University Hospital,a total of 127 patients with gastric varices received Histoacryl  injections endoscopically.One hundred patients underwent endoscopic Histoacryl  injections because of variceal bleeding,the other 27 patients received such injections as a prophylactic procedure.RESULTS:According to Sarin classification,56 patients were GOV1,61 patients were GOV2 and 10 patients were IGV.Most of the varices were large(F2 or F3,111 patients).The average volume of Histoacryl  per each session was 1.7±1.3 cc and mean number of sessions was 1.3±0.6.(1 session-98 patients,2 sessions-25 patients,≥3 sessions-4 patients).Twenty-seven patients with high risk of bleeding(large or fundal or RCS+or Child C) received Histoacryl  injection as a primary prophylactic procedure.In these patients,hepatitis B virus was the major etiology of cirrhosis,25 patients showed GOV1 or 2(92.6%)and F2 or F3 accounted for 88.9%(n=24).The rate of initial hemostasis was 98.4%and recurrent bleeding within one year occurred in 18.1%of patients.Successful hemostasis during episodes of rebleeding was achieved in 73.9%of cases.Median survival was 50 mo (95%CI 30.5-69.5).Major complications occurred in 4 patients(3.1%).The rebleeding rate in patients with hepatocellular carcinoma or GOV2 was higher than in those with other conditions.None of the 27 subjects who were treated prophylactically experienced treatment-related complications.Cumulative survival rates of the 127 patients at 6 mo,1,3,and 5 years were 92.1%,84.2%,64.2%,and 45.3%,respectively.The 6 mo cumulative survival rate of the 27 patients treated prophylactically was 75%.CONCLUSION:Histoacryl  injection therapy is an effective treatment for gastric varices and also an effective prophylactic treatment of gastric varices which carry high risk of bleeding.Eun Jung Kang Soung Won Jeong Jae Young Jang Joo Young Cho Sae Hwan Lee Hyun Gun Kim Sang Gyune Kim Young Seok Kim Young Koog Cheon Young Deok Cho Hong Soo Kim Boo Sung Kim 2011World Journal of Gastroenterology2011,17,11:41
6Clinicopathologic characteristics of gastric carcinoma in elderly patients: A comparison with young patients显示文摘AIM:To examine the clinicopathologic features of elderly patients with gastric carcinoma and to investigate the relationship between prognosis and age.METHODS: We reviewed the hospital records of 2 014patients with gastric carcinoma retrospectively to compare the clinicopathologic findings in elderly (age >70 years) and young (age <36 years) patients during the period from 1986 to 2000 in a tertiary referral center in Gwangju, Korea. Overall survival was the main outcome measure.RESULTS: Of the 2 014 patients, 194 (9.6%) were in the elderly group and 137 (6.8%) were in the young group.The elderly and young patients had similar distributions with respect to depth of invasion, nodal involvement, hepatic metastasis, peritoneal dissemination, tumor stage at the initial diagnosis, and type of surgery. Synchronous multiple carcinomas were found in 14/194 (7.2%) of the elderly group and 4/137 (2.9%) of the young group (P<0.05). Using the Borrmann classification, type Ⅳ was more frequent in the young patients than in the elderly patients (P<0.05).Significantly more elderly patients had a well or moderately differentiated histology, and more young patients had a poorly differentiated histology and signet ring cell carcinoma (P<0.001). The 5-year survival rates of elderly and young patients did not differ statistically (52.8% vs 46.5%,P = 0.5290). Multivariate analysis showed that the histologic type, nodal involvement and operative curability were significant prognostic factors, and age itself was not an independent prognostic factor of survival for elderly gastric carcinoma patients.CONCLUSION: Elderly patients with gastric carcinoma do not have a worse prognosis than young patients. The important prognostic factor is whether the patients undergo a curative resection.Dong-Yi Kim Jae-Kyoon Joo Seong-Yeob Ryu Young-Kyu Park Young-Jin Kim Shin-Kon Kim 2005World Journal of Gastroenterology2005,11,1:39
7Clinical significance of the neutrophil-lymphocyte ratio as an early predictive marker for adverse outcomes in patients with acute pancreatitis显示文摘AIM To investigated the prognostic value of the neutrophillymphocyte ratio(NLR) in patients with acute pancreatitis and determined an optimal cut-off value for the prediction of adverse outcomes in these patients.METHODS We retrospectively analyzed 490 patients with acute pancreatitis diagnosed between March 2007 and December 2012. NLRs were calculated at admission and 24, 48, and 72 h after admission. Patients were grouped according to acute pancreatitis severity and organ failure occurrence, and a comparative analysis was performed to compare the NLR between groups. RESULTS Among the 490 patients, 70 had severe acute pancreatitis with 31 experiencing organ failure. The severe acute pancreatitis group had a significantly higher NLR than the mild acute pancreatitis group on all 4 d(median, 6.14, 6.71, 5.70, and 4.00 vs 4.74, 4.47, 3.20, and 3.30, respectively, P < 0.05). The organ failure group had a significantly higher NLR than the group without organ failure on all 4 d(median, 7.09, 6.72, 6.27, and 6.24 vs 4.85, 4.49, 3.35, and 2.34, respectively, P < 0.05). The optimal cut-off value for baseline NLR was 4.76 in predicting severity and 4.88in predicting organ failure in acute pancreatitis. CONCLUSION Elevated baseline NLR correlates with severe acute pancreatitis and organ failure.Tae Joo Jeon Ji Young Park 2017World Journal of Gastroenterology2017,23,21:37
8Bedside index for severity in acute pancreatitis:comparison with other scoring systems in predicting severity and organ failure显示文摘BACKGROUND:The early identification of severe acute pancreatitis is important for the management and for improving outcomes.The bedside index for severity in acute pancreatitis(BISAP)has been considered as an accurate method for risk stratification in patients with acute pancreatitis.This study aimed to evaluate the comparative usefulness of the BISAP.METHODS:We retrospectively analyzed 303 patients with acute pancreatitis diagnosed at our hospital from March 2007to December 2010.BISAP,APACHE-II,Ranson criteria,and CT severity index(CTSI)of all patients were calculated.We stratified the number of patiants with severe pancreatitis,pancreatic necrosis,and organ failure as well as the number of deaths by BISAP score.We used the area under the receiveroperating curve(AUC)to compare BISAP with other scoring systems,C-reactive protein(CRP),hematocrit,and body mass index(BMI)with regard to prediction of severe acute pancreatitis,necrosis,organ failure,and death.RESULTS:Of the 303 patiants,31(10.2%)were classified as having severe acute pancreatitis.Organ failure occurred in 23(7.6%)patients,pancreatic necrosis in 40(13.2%),and death in6(2.0%).A BISAP score of 2 was a statistically significant cutoff value for the diagnosis of severe acute pancreatitis,organ failure,and mortality.AUCs for BISAP predicting severe pancreatitis and death were 0.80 and 0.86,respectively,which were similar to those for APACHE-II(0.80,0.87)and Ranson criteria(0.74,0.74)and greater than AUCs for CTSI(0.67,0.42).The AUC for organ failure predicted by BISAP,APACHE-II,Ranson criteria,and CTSI was 0.93,0.95,0.84 and 0.57,respectively.AUCs for BISAP predicting severity,organ failure,and death were greater than those for CRP(0.69,0.80,0.72),hematocrit(0.45,0.35,0.14),and BMI(0.41,0.47,0.17).CONCLUSION:The BISAP predicts severity,death,and especially organ failure in acute pancreatitis as well as APACHE-II does and better than Ranson criteria,CTSI,CRP,hematocrit,and BMI.Ji Young Park Tae Joo Jeon Tae Hwan Ha Jin Tae Hwang Dong Hyun Sinn Tae-Hoon Oh Won Chang Shin Won-Choong 2013Hepatobiliary & Pancreatic Diseases International2013,12,6:33
98-Hydroxydeoxyguanosine:Not mere biomarker for oxidative stress,but remedy for oxidative stress-implicated gastrointestinal diseases显示文摘Reactive oxygen species (ROS) attack guanine bases in DNA easily and form 8-hydroxydeoxyguanosine (8-OHdG),which can bind to thymidine rather than cytosine,based on which,the level of 8-OHdG is gen-erally regarded as a biomarker of mutagenesis conse-quent to oxidative stress.For example,higher levels of 8-OHdG are noted in Helicobacter pylori-associated chronic atrophic gastritis as well as gastric cancer.However,we have found that exogenous 8-OHdG can paradoxically reduce ROS production,attenuate thenuclear factor-κB signaling pathway,and ameliorate the expression of proinflammatory mediators such as interleukin (IL)-1,IL-6,cyclo-oxygenase-2,and induc-ible nitric oxide synthase in addition to expression of nicotinamide adenine dinucleotide phosphate oxidase (NOX)-1,NOX organizer-1 and NOX activator-1 in vari-ous conditions of inflammation-based gastrointestinal (GI) diseases including gastritis,inflammatory bowel disease,pancreatitis,and even colitis-associated carci-nogenesis.Our recent finding that exogenous 8-OHdG was very effective in either inflammation-based or oxidative-stress-associated diseases of stress-related mucosal damage has inspired the hope that synthetic 8-OHdG can be a potential candidate for the treatment of inflammation-based GI diseases,as well as the pre-vention of inflammation-associated GI cancer.In this editorial review,the novel fact that exogenous 8-OHdG can be a functional molecule regulating oxidative-stress-induced gastritis through either antagonizing Rac-guanosine triphosphate binding or blocking the signals responsible for gastric inflammatory cascade is introduced.Chan-Young Ock Eun-Hee Kim Duck Joo Choi Ho Jae Lee Ki-Baik Hahm Myung Hee Chung 2012World Journal of Gastroenterology2012,18,4:30
10Efficacy and safety of 0.4 percent sodium hyaluronate for endoscopic submucosal dissection of gastric neoplasms显示文摘AIM:To evaluate the efficacy and safety of sodium hyaluronate solution(SH) in endoscopic submucosal dissection(ESD) of gastric neoplasms.METHODS:A prospective multicenter randomized,double blind,controlled trial was designed and utilized in this study.A total of 76 patients with 5-20 mm sized gastric neoplasms were enrolled at three academic hospitals in South Korea from June 2011 to October 2011.Patients were randomly assigned to the 0.4% sodium hyaluronate or control groups.All lesions underwent endoscopic ESD.ESD was performed with 0.4%SH and normal saline(NS) solution for submucosal injection.Efficacy was assessed using en bloc resection and the number of additional injections.Secondary evaluation variables were the volume of injection material,steepness of mucosal elevation,bleeding rate,procedural time and operator satisfaction.Finally,the safety was assessed by analyzing adverse events during the study.RESULTS:The usefulness rate in the 0.4%SH group and the controlled group had statistically significant difference under intention to treat(ITT) analysis(90.91% vs 61.11% P = 0.0041).Under per protocol(PP),the usefulness rate is statistically significant different(93.10% vs 61.76%,P = 0.0036).The difference in volume of the solution injected between 0.4%SH group and the controlled group and NS group was also statistically significant under intention to treat and per protocol analysis(ITT:0.03 ± 0.02 mL vs 0.06 ± 0.03 mL,P = 0.0003,PP:0.03 ± 0.02 mL vs 0.06 ± 0.03 mL,P = 0.0004).Satisfaction above the grade good was significantly higher in the SH group under intention to treat and per protocol analysis(ITT:90.91% vs 61.11%,P = 0.0041,PP = 93.11% vs 61.77%,P = 0.0022).Adverse events above grade 3 were not noticed in either group.All adverse events were treated and were judged as not associated with the submucosal injection solutions.CONCLUSION:0.4%SH solution is a safe and effective agent that doesn't cause any significant adverse events and is useful for submucosal injection during ESD.Young Dae Kim Jun Lee Ju Yeon Cho Seok Won Kim Seong Hwan Kim Young Kwan Cho Jin Seok Jang Ji Sun Han Joo Young Cho 2013World Journal of Gastroenterology2013,19,20:26
11A Comparison of Brain Activity between Healthy Subjects and Stroke Patients on fMRI by Acupuncture Stimulation显示文摘目的将在击病人在针灸期间调查大脑活动模式,并且用功能的磁性的回声成像(fMRI ) 把结果与正常题目作比较。有马达软弱和 10 个健康题目的 11 个击病人全部的方法 A 被学习。fMRI 在点 Quchi (LI11 ) 和 Zusanli (ST36 ) 在左边上在针灸期间被执行。数据用针灸刺激导致的大脑激活的统计参量的地图被分析。结果显示出的结果 LI11 和 ST36 的刺激生产了在二之间的显著地不同的大脑激活模式,这组织。正常的组比击组显示出更大的全面激活。在正常的组,正面的脑叶的部分,顶骨脑叶,亚 lobar,小脑和中脑,区域被针灸在左 LI11 激活。在另一方面,仅仅劣等的顶骨腹片区域的右边在击病人被激活。当左 ST36 在正常的组被刺激时,正面的脑叶,顶骨脑叶,时间的脑叶,和亚 lobar 的双方,和枕骨的脑叶的左边,和小脑和中脑区域的右边被激活。为在击组的一样的刺激,仅仅劣等的顶骨腹片和小脑区域的双方被激活(P < 0.05,簇水平) 。释放模式没在两个组在任何针灸刺激期间被注意。结论大脑信号激活在一样的针灸期间是不同的在之间健康并且击病人,和效果显示出不同针灸点的关联。Seung-Yeon Cho Mia Kim Jong Joo Sun Geon-Ho Jahng Hengjun J Kim Seong-Uk Park Woo-Sang Jung Chang-Nam Ko Jung-Mi Park 2013Chinese Journal of Integrative Medicine2013,19,4:25
12State-of-the-art preoperative staging of gastric cancer by MDCT and magnetic resonance imaging显示文摘Gastric cancer is one of the most common and fatal cancers.The importance of accurate staging for gastric cancer has become more critical due to the recent introduction of less invasive treatment options,such as endoscopic mucosal resection or laparoscopic surgery.The tumor-node-metastasis staging system is the generally accepted staging system for predicting the prognosis of patients with gastric cancer.Multidetector row computed tomography(MDCT)is a widely accepted imaging modality for the preoperative staging of gastric cancer that can simultaneously assess locoregional staging,including the gastric mass,regional lymph nodes,and distant metastasis.The diagnostic performance of MDCT for T-and N-staging has been improved by the technical development of isotropic imaging and 3D reformation.Although magnetic resonance imaging(MRI)was not previously used to evaluate gastric cancer due to the modality’s limitations,the development of high-speed sequences has made MRI a feasible tool for the staging of gastric cancer.Joon-Il Choi Ijin Joo Jeong Min Lee 2014World Journal of Gastroenterology2014,20,16:26
13Amygdalin inhibits genes related to cell cycle in SNU-C4 human colon cancer cells显示文摘AIM: The genes were divided into seven categories according to biological function; apoptosis-reiated, immune response-related, signal transduction-related, cell cyclerelated, cell growth-related, stress response-related and transcription-related genes.METHODS: We compared the gene expression profiles of SNU-C4 cells between amygdalin-treated (5 mg/mL,24 h) and non-treated groups using cDNA microarray analysis. We selected genes downregulated in cDNA microarray and investigated mRNA levels of the genes by RT-PCR. RESULTS: Microarray showed that amygdalin downregulated especially genes belonging to cell cycle category: exonuclease 1 (EXO1), ATP-binding cassette, sub-family F, member 2 (ABCF2), MRE11 meiotic recombination 11 homolog A (MRE114), topoisomerase (DNA) I (TOP1), and FK506 binding protein 12-rapamycin-associated protein 1 (FRAP1). RT-PCR analysis revealed that mRNA levels of these genes were also decreased by amygdalin treatment in SNU-C4 human colon cancer cells.CONCLUSION: These results suggest that amygdalin have an anticancer effect via downregulation of cell cycle-related genes in SNU-C4 human colon cancer cells,and might be used for therapeutic anticancer drug.Hae-Jeong Park Seo-Hyun Yoon Long-Shan Han Long-Tai Zheng Kyung-Hee Jung Yoon-Kyung Uhm Je-Hyun Lee Ji-Seon Jeong Woo-Sang Joo Sung-Vin Yim Joo-Ho Chung Seon-Pyo Hong 2005World Journal of Gastroenterology2005,11,33:23
14Ever-changing endoscopic treatment for early gastric cancer:Yesterday-today-tomorrow显示文摘Endoscopic resection has been an optimal treatment for selected patients with early gastric cancer(EGC) based on advances in endoscopic instruments and techniques. As endoscopic submucosal dissection(ESD) has been widely used for treatment of EGC along with expanding ESD indication, concerns have been asked to achieve curative resection for EGC while guaranteeing precise prediction of lymph node metastasis(LNM). Recently, new techniques including ESD or endoscopic full-thickness resection combined with sentinel node navigation enable minimal tumor resection and a laparoscopic lymphadenectomy in cases of EGC with high risk of LNM. This review covers the development and challenges of endoscopic treatment for EGC. Moreover, a new microscopic imaging and endoscopic techniques for precise endoscopic diagnosis and minimally invasive treatment of EGC are introduced.Mi-Young Kim Jun-Hyung Cho Joo Young Cho 2014World Journal of Gastroenterology2014,20,37:21
15Histopathology and TB-PCR kit analysis in differentiating the diagnosis of intestinal tuberculosis and Crohn’s disease显示文摘AIM: To compare the histopathologic features of intestinal tuberculosis (ITB) and Crohn’s disease (CD) and to identify whether polymerase chain reaction for Mycobacterium tuberculosis (TB-PCR) would be helpful for differential diagnosis between ITB and CD.METHODS: We selected 97 patients with established diagnoses (55 cases of ITB and 42 cases of CD) who underwent colonoscopic biopsies.Microscopic features of ITB and CD were reviewed,and eight pathologic parameters were evaluated.Nine cases of acid fast bacilli culture-positive specimens and 10 normal colonic tissue specimens were evaluated as the positive and negative control of the TB-PCR test,respectively.PCR assays were done using two commercial kits: kit detected IS6110 and MPB64,and kit detected IS6110 only;a manual in-house PCR method was also performed on formalin-fi xed,paraffi n-embedded colonoscopic biopsy specimens.RESULTS: Statistically significant differences were noted between ITB and CD with regard histopathologic criteria: size of granulomas (P = 0.000),giant cells (P = 0.015),caseation necrosis (P = 0.003),confluent granulomas (P = 0.001),discrete granulomas (P = 0.000),and granulomas with lymphoid cuffs (P = 0.037).However,29 cases (52.7%) of ITB showed less than fi ve kinds of pathologic parameters,resulting in confusion with CD.The sensitivities and specificities of the TB-PCR test by kit ,kit ,and the in-house PCR method were 88.9% and 100%,88.9% and 100%,and 66.7% and 100% in positive and negative controls,respectively.The PCR test done on endoscopic biopsy specimens of ITB and CD were signifi cantly different with kit (P = 0.000) and kit (P = 0.000).The sensitivities and specifi cities of TB-PCR were 45.5% and 88.1%,36.4% and 100%,and 5.8% and 100%,for kit and kit and inhouse PCR method on endoscopic biopsy specimens.Among the 29 cases of histopathologically confusing CD,10 cases assayed using kit and 6 cases assayed using kit were TB-PCR positive.A combination of histologic fi ndings and TB-PCR testing led to an increase of diagnostic sensitivity and the increase (from 47.3% to 58.2) was statistically signifi cant with kit (P = 0.000).CONCLUSION: The TB-PCR test combined with histopathologic factors appears to be a helpful technique in formulating the differential diagnosis of ITB and CD in endoscopic biopsy samples.Joon Mee Kim Hyung Kil Kim Lucia Kim Suk Jin Choi In Suh Park Jee Young Han Young Chae Chu Kye Sook Kwon Eun Joo Kim 2010World Journal of Gastroenterology2010,16,20:20
16Prognostic factors in patients with node-negative gastric carcinoma:A comparison with node-positive gastric carcinoma显示文摘瞄准:识别淋巴的 clinicopathological 特征节点否定的胃的癌,并且另外在淋巴评估结果指示物节点否定的病人。方法:2848 个胃的癌病人,(53.5%) 1524 是淋巴节点否定。统计分析用艇长模型被执行估计结果指示物。结果:在在节点否定的淋巴和淋巴之间的再发率有有效差量节点积极的病人(14.4% 对 41.0% , P<0.001 ) 。5 年的幸存率在比在淋巴节点积极的淋巴是显著地更低的节点否定的病人(31.1% 对 77.4% , P<0.001 ) 。Univariate 分析表明下列因素影响了 5 年的幸存率:耐心的年龄,肿瘤尺寸,侵略的深度,肿瘤地点,起作用的类型,和在起始的诊断的肿瘤舞台。比例的危险回归建模的艇长表明那种肿瘤尺寸, serosal 侵略,和治愈可能性是独立的,淋巴的统计上重要的、预示的指示物节点否定的胃的癌。结论:淋巴节点否定的病人与相对大的肿瘤和 serosal 侵略让对高治愈可能性,而是病人可归因的有利结果有差的预后。治愈可能性是为淋巴的长期的幸存的最可靠的预言者之一节点否定的胃的癌病人。Dong Yi Kim Kyeung Won Seo Jae Kyoon Joo Young Kyu Park Seong Yeob Ryu Hyeong Rok Kim Young Jin Kim Shin Kon Kim 2006World Journal of Gastroenterology2006,12,8:20
17Real time shear wave elastography in chronic liver diseases:Accuracy for predicting liver fibrosis,in comparison with serum markers显示文摘AIM:To evaluate the correlation between liver stiffness measurement(LSM)by real-time shear wave elastography(SWE)and liver fibrosis stage and the accuracy of LSM for predicting significant and advanced fibrosis,in comparison with serum markers.METHODS:We consecutively analyzed 70 patients with various chronic liver diseases.Liver fibrosis was staged from F0 to F4 according to the Batts and Ludwig scoring system.Significant and advanced fibrosis was defined as stage F≥2 and F≥3,respectively.The accuracy of prediction for fibrosis was analyzed using receiver operating characteristic curves.RESULTS:Seventy patients,15 were belonged to F0-F1 stage,20 F2,13 F3 and 22 F4.LSM was increased with progression of fibrosis stage(F0-F1:6.77±1.72,F2:9.98±3.99,F3:15.80±7.73,and F4:22.09±10.09,P<0.001).Diagnostic accuracies of LSM for prediction of F≥2 and F≥3 were 0.915(95%CI:0.824-0.968,P<0.001)and 0.913(95%CI:0.821-0.967,P<0.001),respectively.The cut-off values of LSM for prediction of F≥2 and F≥3 were 8.6kPa with 78.2%sensitivity and 93.3%specificity and10.46 kPa with 88.6%sensitivity and 80.0%specificity,respectively.However,there were no significant differences between LSM and serum hyaluronic acid and typeⅣcollagen in diagnostic accuracy.CONCLUSION:SWE showed a significant correlation with the severity of liver fibrosis and was useful and accurate to predict significant and advanced fibrosis,comparable with serum markers.Jae Yoon Jeong Tae Yeob Kim Joo Hyun Sohn Yongsoo Kim Woo Kyoung Jeong Young-Ha Oh Kyo-Sang Yoo 2014World Journal of Gastroenterology2014,20,38:19
18Acupuncture treatment in gastrointestinal diseases: A systematic review显示文摘The purpose of this work was to assess the evidence for effectiveness of acupuncture (AC) treatment in gastrointestinal diseases. A systematic review of the Medline-cited literature for clinical trials was performed up to May 2006. Controlled trials assessing acupuncture point stimulation for patients with gastrointestinal diseases were considered for inclusion. The search identified 18 relevant trials meeting the inclusion criteria. Two irritable bowel syndrome (IBS) trials, 1 Crohn's disease and 1 colitis ulcerosa trial had a robust random controlled trial (RCT) design. In regard to other gastrointestinal disorders, study quality was poor. In all trials, quality of life (QoL) improved significantly independently from the kind of acupuncture, real or sham. Real AC was significantly superior to sham acupuncture with regard to disease activity scores in the Crohn and Colitis trials. Effi cacy of acupuncture related to QoL in IBS may be explained by unspecific effects. This is the same for QoL in in? ammatory bowel diseases (IBD), whereas specific acupuncture effects may be found in clinical scores. Further trials for IBDs and in particular for all other gastrointestinal disorders would be necessary to evaluate the efficacy of acupuncture treatment. However, it must be discussed on what terms patients benefi t when this harmless and obviously powerful therapy with regard to QoL is demystifi ed by further placebo controlled trials.Antonius Schneider Konrad Streitberger Stefanie Joos 2007World Journal of Gastroenterology2007,13,25:18
19Early expressions of hypoxia-inducible factor 1alpha and vascular endothelial growth factor increase the neuronal plasticity of activated endogenous neural stem cells after focal cerebral ischemia显示文摘Endogenous neural stem cells become 'activated' after neuronal injury, but the activation sequence and fate of endogenous neural stem cells in focal cerebral ischemia model are little known. We evaluated the relationships between neural stem cells and hypoxia-inducible factor-1α and vascular endothelial growth factor expression in a photothromobotic rat stroke model using immunohistochemistry and western blot analysis. We also evaluated the chronological changes of neural stem cells by 5-bromo-2′-deoxyuridine(BrdU) incorporation. Hypoxia-inducible factor-1α expression was initially increased from 1 hour after ischemic injury, followed by vascular endothelial growth factor expression. Hypoxia-inducible factor-1α immunoreactivity was detected in the ipsilateral cortical neurons of the infarct core and peri-infarct area. Vascular endothelial growth factor immunoreactivity was detected in bilateral cortex, but ipsilateral cortex staining intensity and numbers were greater than the contralateral cortex. Vascular endothelial growth factor immunoreactive cells were easily found along the peri-infarct area 12 hours after focal cerebral ischemia. The expression of nestin increased throughout the microvasculature in the ischemic core and the peri-infarct area in all experimental rats after 24 hours of ischemic injury. Nestin immunoreactivity increased in the subventricular zone during 12 hours to 3 days, and prominently increased in the ipsilateral cortex between 3–7 days. Nestin-labeled cells showed dual differentiation with microvessels near the infarct core and reactive astrocytes in the peri-infarct area. BrdU-labeled cells were increased gradually from day 1 in the ipsilateral subventricular zone and cortex, and numerous BrdU-labeled cells were observed in the peri-infarct area and non-lesioned cortex at 3 days. BrdU-labeled cells rather than neurons, were mainly co-labeled with nestin and GFAP. Early expressions of hypoxia-inducible factor-1α and vascular endothelial growth factor after ischemia made up the microenvironment to increase the neuronal plasticity of activated endogenous neural stem cells. Moreover, neural precursor cells after large-scale cortical injury could be recruited from the cortex nearby infarct core and subventricular zone.Seung Song Jong-Tae Park Joo Young Na Man-Seok Park Jeong-Kil Lee Min-Cheol Lee Hyung-Seok Kim 2014Neural Regeneration Research2014,9,9:17
20Proton pump inhibitor administration delays rebleeding after endoscopic gastric variceal obturation显示文摘AIM:To clarify the efficacy of proton pump inhibitors(PPIs)after endoscopic variceal obturation(EVO)with N-butyl-2-cyanoacrylate.METHODS:A retrospective study was performed on16 liver cirrhosis patients with gastric variceal bleeding that received EVO with injections of N-butyl-2-cyanoacrylate at a single center(Kyung Hee University Hospital at Gangdong)from January 2008 to December 2012.Medical records including patient characteristics and endoscopic findings were reviewed.Treatment results,liver function,serum biochemistry and cirrhosis etiology were compared between patients receiving PPIs and those that did not.Furthermore,the rebleeding interval was compared between patients that received PPI treatment after EVO and those who did not.RESULTS:The patient group included nine males and seven females with a mean age of 61.8±11.7years.Following the EVO procedure,eight of the 12patients that received PPIs and three of the four nonPPI patients experienced rebleeding.There were no differences between the groups in serum biochemistry or patient characteristics.The rebleeding rate was not significantly different between the groups,however,patients receiving PPIs had a significantly longer rebleeding interval compared to non-PPI patients(22.2±11.2mo vs 8.5±5.5 mo;P=0.008).The duration of PPI use was not related to the rebleeding interval.A total of six patients,who had ulcers at the injection site,exhibited a shorter rebleeding interval(16.8±5.9 mo)than patients without ulcers(19.9±3.2 mo),though this difference was not statistically significant.CONCLUSION:PPI therapy can extend the rebleeding interval,and should therefore be considered after EVO treatment for gastric varices.Won Seok Jang Hyun Phil Shin Joung Ⅱ Lee Kwang Ro Joo Jae Myung Cha Jung Won Jeon Jun Uk Lim 2014World Journal of Gastroenterology2014,20,45:17
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