59 results on '"Jung Won Jeon"'
Search Results
2. Clinical Outcomes of Endoscopic Resection for Low-Grade Dysplasia and High-Grade Dysplasia on Gastric Pretreatment Biopsy: Korea ESD Study Group
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Chul-Hyun Lim, Jung Won Jeon, Sun-Moon Kim, Chan Gyoo Kim, Su Jin Hong, Soojin Kim, Jae Myung Park, Si Hyung Lee, Jae Young Jang, Gwang Ho Baik, Jae Kyu Sung, and Seong Woo Jeon
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medicine.medical_specialty ,Biopsy ,education ,Gastroenterology ,Helicobacter Infections ,Lesion ,03 medical and health sciences ,0302 clinical medicine ,High-grade dysplasia ,Stomach Neoplasms ,Internal medicine ,Republic of Korea ,medicine ,Humans ,Endoscopic resection ,Low-grade dysplasia ,Retrospective Studies ,Alimentary Tract ,Helicobacter pylori ,Hepatology ,medicine.diagnostic_test ,High grade dysplasia ,business.industry ,Stomach ,Cancer ,medicine.disease ,digestive system diseases ,Low grade dysplasia ,medicine.anatomical_structure ,Risk factors ,Dysplasia ,030220 oncology & carcinogenesis ,Original Article ,030211 gastroenterology & hepatology ,medicine.symptom ,Gastric cancer ,business ,Precancerous Conditions - Abstract
Background/Aims: Some cases of gastric low-grade dysplasia (LGD) and high-grade dysplasia (HGD) on forceps biopsy (FB) are diagnosed as gastric cancer (GC) after endoscopic resection (ER). This study aims to evaluate the clinical outcomes of ER for gastric LGD and HGD on pretreatment FB and to identify the factors that predict pathologic upstaging to GC. Methods: Patients who underwent ER for LGD and HGD on pretreatment FB from March 2005 to February 2018 in 14 hospitals in South Korea were enrolled, and the patients’ medical records were reviewed retrospectively. Results: This study included 2,150 cases of LGD and 1,534 cases of HGD diagnosed by pretreatment FB. In total, 589 of 2,150 LGDs (27.4%) were diagnosed as GC after ER. Helicobacter pylori infection, smoking history, tumor location in the lower third of the stomach, tumor size >10 mm, depressed lesion, and ulceration significantly predicted GC. A total of 1,115 out of 1,534 HGDs (72.7%) were diagnosed with GC after ER. Previous history of GC, H. pylori infection, smoking history, tumor location in the lower third of the stomach, tumor size >10 mm, depressed lesion, and ulceration were significantly associated with GC. As the number of risk factors predicting GC increased in both LGD and HGD on pretreatment FB, the rate of upstaging to GC after ER increased. Conclusions: A substantial proportion of LGDs and HGDs on pretreatment FB were diagnosed as GC after ER. Accurate ER procedures such as endoscopic submucosal dissection should be recommended in cases of LGD and HGD with factors predicting pathologic upstaging to GC. (Gut Liver 2021;15:225-231)
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- 2021
3. Combination Therapy With Polydeoxyribonucleotide and Pirfenidone Alleviates Symptoms of Acute Respiratory Distress Syndrome in Human Lung Epithelial A549 Cells
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Jung Won Jeon, Lakkyong Hwang, Sang-Hoon Kim, Cheon Woong Choi, Jae Joon Hwang, Bok Soon Chang, Seung Sook Paik, Jun-Jang Jin, and Il-Gyu Ko
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0301 basic medicine ,ARDS ,Combination therapy ,Urology ,Pharmacology ,lcsh:RC870-923 ,03 medical and health sciences ,0302 clinical medicine ,Medicine ,Acute respiratory distress syndrome ,business.industry ,Therapeutic effect ,Interleukin ,Pirfenidone ,lcsh:Diseases of the genitourinary system. Urology ,medicine.disease ,Pulmonary edema ,Polydeoxyribonucleotide ,CTGF ,030104 developmental biology ,Pirfenidone, Combination therapy ,Neurology ,030220 oncology & carcinogenesis ,Tumor necrosis factor alpha ,Original Article ,Neurology (clinical) ,business ,medicine.drug - Abstract
Purpose: Acute respiratory distress syndrome (ARDS) is characterized by its acute onset of symptoms such as bilateral pulmonary infiltrates, severe hypoxemia, and pulmonary edema. Many patients with ARDS survive in the acute phase, but then die from significant lung fibrosis.Methods: The effect of combination therapy with polydeoxyribonucleotide (PDRN) and pirfenidone on ARDS was investigated using human lung epithelial A549 cells. ARDS environment was induced by treatment with lipopolysaccharide and transforming growth factor (TGF)-β. Enzyme-linked immunoassay for connective tissue growth factor (CTGF) and hydroxyproline were conducted. Western blot for collagen type I, fibroblast growth factor (FGF), tumor necrosis factor (TNF)-α, and interleukin (IL)-6 was performed.Results: In this study, 8-μg/mL PDRN enhanced cell viability. Combination therapy with PDRN and pirfenidone and pirfenidone monotherapy suppressed expressions of CTGF and hydroxyproline and inhibited expressions of collagen type I and FGF. Combination therapy with PDRN and pirfenidone and PDRN monotherapy suppressed expression of TNF-α and IL-1β.Conclusions: The combination therapy with PDRN and pirfenidone exerted stronger therapeutic effect against lipopolysaccharide and TGF-β-induced ARDS environment compared to the PDRN monotherapy or pirfenidone monotherapy. The excellent therapeutic effect of combination therapy with PDRN and pirfenidone on ARDS was shown by promoting the rapid anti-inflammatory effect and inhibiting the fibrotic processes.
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- 2020
4. Pretreatment with Ranitidine Bismuth Citrate May Improve Success Rates of Helicobacter pylori Eradication: A Prospective, Randomized, Controlled and Open-Label Study
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Jung Won Jeon, Jin Young Yoon, Min Seob Kwak, and Jae Myung Cha
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Adult ,Male ,medicine.medical_specialty ,Ranitidine ,Gastroenterology ,General Biochemistry, Genetics and Molecular Biology ,Drug Administration Schedule ,Esomeprazole ,Helicobacter Infections ,Internal medicine ,Clarithromycin ,Medicine ,Humans ,Prospective Studies ,Treatment Failure ,Aged ,biology ,Helicobacter pylori ,business.industry ,Standard treatment ,Amoxicillin ,General Medicine ,Middle Aged ,biology.organism_classification ,Bacterial Load ,Anti-Bacterial Agents ,Clinical trial ,Regimen ,Treatment Outcome ,Tolerability ,Histamine H2 Antagonists ,Drug Therapy, Combination ,Female ,business ,Bismuth ,medicine.drug - Abstract
Effective Helicobacter pylori (H. pylori) eradication is a major public health concern; however, eradication failure rates with the standard triple therapy remain high. We aimed to investigate the effectiveness and tolerability of ranitidine bismuth citrate (RBC) pretreatment before standard triple therapy for H. pylori eradication. A prospective, randomized, controlled, and open-label clinical trial was conducted from June to December 2019. H. pylori eradication rate, safety, and tolerability were compared between the standard treatment group (esomeprazole, amoxicillin, and clarithromycin for 7 days) and RBC pretreatment group (RBC for 2 weeks before standard triple therapy). This trial ended earlier than estimated owing to the N-nitrosodimethylamine concerns with ranitidine. Success rates of H. pylori eradication were 80.9% and 67.3% in the RBC pretreatment (n = 47) and standard treatment (n = 52) (p = 0.126) groups, respectively. Our trial was discontinued earlier than planned; however, a statistical significance would be achieved by expansion of our data (p = 0.031) if patient enrollment numbers reached those initially planned. Adverse event rates were comparable between groups (25.5% in the pretreatment group vs. 28.8% in the standard treatment group), without serious event. Tolerability was excellent in both groups, recorded as 97.9% and 100% in the pretreatment and standard treatment groups, respectively. Compared with the standard triple regimen, RBC pretreatment for 2 weeks may achieve higher H. pylori eradication rates, with excellent safety and tolerability. However, this study necessitates further validation as it was discontinued early owing to the N-nitrosodimethylamine issues of ranitidine.
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- 2021
5. The current capacity and quality of colonoscopy in Korea
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Jung Won Jeon, Jin Young Yoon, Jae Ho Choi, Min Seob Kwak, Jae Myung Cha, and Hyun Phil Shin
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Quality management ,Concordance ,media_common.quotation_subject ,Colonoscopy ,lcsh:Medicine ,Guideline ,Colorectal neoplasms ,03 medical and health sciences ,0302 clinical medicine ,Medicine ,Quality (business) ,lcsh:RC799-869 ,media_common ,medicine.diagnostic_test ,business.industry ,lcsh:R ,Gastroenterology ,medicine.disease ,Quality ,Current practice ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,Original Article ,lcsh:Diseases of the digestive system. Gastroenterology ,Medical emergency ,business ,Surveys and questionnaires - Abstract
BACKGROUND/AIMS Little is known for the capacity and quality of colonoscopy, and adherence to colonoscopy surveillance guidelines in Korea. This study aimed to investigate the present and potential colonoscopic capacity, colonoscopic quality, and adherence to colonoscopy surveillance guidelines in Korea. METHODS We surveyed representative endoscopists of 72 endoscopy units from June to August 2015, using a 36-item questionnaire regarding colonoscopic capacity, quality, and adherence to colonoscopy surveillance guidelines of each hospitals. RESULTS Among the 62 respondents who answered the questionnaire, 51 respondents were analyzed after exclusion of 11 incomplete answers. Only 1 of 3 of endoscopy units can afford to perform additional colonoscopies in addition to current practice, and the potential maximum number of colonoscopies per week was only 42. The quality of colonoscopy was variable as reporting of quality indicators of colonoscopy were considerably variable (29.4%-94.1%) between endoscopy units. Furthermore, there are substantial gaps in the adherence to colonoscopy surveillance guidelines, as concordance rate for guideline recommendation was less than 50% in most scenarios. CONCLUSIONS The potential capacity and quality of colonoscopy in Korea was suboptimal. Considering suboptimal reporting of colonoscopic quality indicators and low adherence rate for colonoscopy surveillance guidelines, quality improvement of colonoscopy should be underlined in Korea.
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- 2019
6. PI3K-Akt-Wnt Pathway Is Implicated in Exercise-Induced Improvement of Short-term Memory in Cerebral Palsy Rats
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Jung-Wan Cho, Jin Hee Han, Dae-Young Kim, Jung-Won Jeon, Yong-Rak Chung, Hyun-Hee Choi, and Sun-Young Jung
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0301 basic medicine ,Glycogen synthase kinase-3β ,medicine.medical_specialty ,Urology ,Hippocampal formation ,lcsh:RC870-923 ,Cerebral palsy ,03 medical and health sciences ,0302 clinical medicine ,Protein kinase B ,Internal medicine ,Memory improvement ,medicine ,Short-term memory ,PI3K/AKT/mTOR pathway ,Fundamental Science for Neurourology ,business.industry ,Neurogenesis ,Wnt signaling pathway ,lcsh:Diseases of the genitourinary system. Urology ,medicine.disease ,030104 developmental biology ,Endocrinology ,Neurology ,Synaptic plasticity ,Original Article ,Neurology (clinical) ,business ,Phosphatidylinositol 3-kinase ,030217 neurology & neurosurgery - Abstract
Purpose Maternal lipopolysaccharide (LPS) injection induces neurodevelopmental disorders, such as cerebral palsy. Exercise activates phosphatidylinositol 3-kinase (PI3K)-protein kinase B (Akt) signaling pathway that enhances neurogenesis. Wnt ligands are also implicated in the hippocampal neurogenesis and synaptic plasticity. Glycogen synthase kinase-3β (GSK-3β) is a downstream molecule of Akt, and GSK-3β is known to modulate hippocampal neurogenesis negatively. Methods Cerebral palsy was made by maternal LPS-injection. On the 5 weeks after birth, treadmill running was applied to the rat pups of the exercise groups, for 30 minutes, 5 times a week during 6 weeks. Results Treadmill running alleviated short-term memory impairments of the cerebral palsy rat pups. Hippocampal cell proliferation was increased and hippocampal apoptosis was suppressed by treadmill running in the cerebral palsy rat pups. Hippocampal phosphorylated-PI3K/PI3K ratio, phosphorylated-Akt/Akt ratio, and Wnt expression were enhanced by treadmill running in the cerebral palsy rat pups. In contrast, hippocampal phosphorylated-GSK-3β/GSK-3β ratio and β-catenin expression were suppressed by treadmill running in the cerebral palsy rat pups. Conclusions The results of this study showed that short-term memory improvement due to treadmill running in cerebral palsy occurs via activation of the PI3K-Akt-Wnt pathway.
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- 2018
7. Development of a Novel Prognostic Model for Predicting Lymph Node Metastasis in Early Colorectal Cancer: Analysis Based on the Surveillance, Epidemiology, and End Results Database
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Jung Won Jeon, Hyun Phil Shin, Ji Hyun Ahn, Min Seob Kwak, Jae Myung Cha, Jin Young Yoon, and Hun Hee Lee
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Cancer Research ,Prognostic variable ,Colorectal cancer ,colorectal cancer ,computer.software_genre ,Logistic regression ,lcsh:RC254-282 ,Metastasis ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Surveillance, Epidemiology, and End Results ,metastasis ,Original Research ,model ,Database ,business.industry ,prediction ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,medicine.disease ,Regression ,Clinical trial ,machine learning ,Oncology ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,business ,computer ,Predictive modelling - Abstract
BackgroundIdentification of a simplified prediction model for lymph node metastasis (LNM) for patients with early colorectal cancer (CRC) is urgently needed to determine treatment and follow-up strategies. Therefore, in this study, we aimed to develop an accurate predictive model for LNM in early CRC.MethodsWe analyzed data from the 2004-2016 Surveillance Epidemiology and End Results database to develop and validate prediction models for LNM. Seven models, namely, logistic regression, XGBoost, k-nearest neighbors, classification and regression trees model, support vector machines, neural network, and random forest (RF) models, were used.ResultsA total of 26,733 patients with a diagnosis of early CRC (T1) were analyzed. The models included 8 independent prognostic variables; age at diagnosis, sex, race, primary site, histologic type, tumor grade, and, tumor size. LNM was significantly more frequent in patients with larger tumors, women, younger patients, and patients with more poorly differentiated tumor. The RF model showed the best predictive performance in comparison to the other method, achieving an accuracy of 96.0%, a sensitivity of 99.7%, a specificity of 92.9%, and an area under the curve of 0.991. Tumor size is the most important features in predicting LNM in early CRC.ConclusionWe established a simplified reproducible predictive model for LNM in early CRC that could be used to guide treatment decisions. These findings warrant further confirmation in large prospective clinical trials.
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- 2021
8. Deep Convolutional Neural Network-Based Lymph Node Metastasis Prediction for Colon Cancer Using Histopathological Images
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Jung Won Jeon, Ha Il Kim, Hun Hee Lee, Min Seob Kwak, Jae Myung Cha, Jin Young Yoon, and Jae Min Yang
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0301 basic medicine ,Oncology ,Cancer Research ,medicine.medical_specialty ,Lymphovascular invasion ,Colorectal cancer ,colorectal cancer ,lcsh:RC254-282 ,Metastasis ,histology ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Medicine ,metastasis ,Pathological ,Original Research ,Univariate analysis ,business.industry ,Cancer ,medicine.disease ,Institutional review board ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,prognostic score ,Clinical trial ,030104 developmental biology ,Lymphatic system ,030220 oncology & carcinogenesis ,Tissue bank ,business ,deep learning–artificial neural network - Abstract
Background: Human evaluation of pathological slides cannot accurately predict lymph node metastasis (LNM), which is urgently needed to determine treatment and follow-up strategies for colon cancer. We aimed to develop an accurate histopathological feature for LNM in colon cancer. Methods: We developed a deep convolutional neural network model to distinguish the cancer tissue component of colon cancer using data from the tissue bank of the National Center for Tumor Diseases and the pathology archive at the University Medical Center Mannheim in German. This model was applied to whole-slide pathological images of colon cancer patients from The Cancer Genome Atlas (TCGA). The predictive value of the peri-tumoral stroma (PTS) score for LNM was assessed. Findings: A total of 164 patients with stage I, II, and III colon cancer from TCGA were analyzed. The mean PTS score was 0.380 (±SD = 0.285), and significantly higher PTS scores were observed in patients in the LNM-positive group than those in the LNM-negative group (P < 0.001). In the univariate analyses, the PTS scores for the LNM-positive group were significantly higher than the scores for LNM-negative group (P < 0.001). Further, the PTS scores in lymphatic invasion and any one of perineural, lymphatic, or venous invasion were significantly increased in the LNM-positive group (P < 0.001 and P < 0.001). Interpretation: We established the PTS score, a simplified reproducible parameter, for predicting LNM in colon cancer using computer-based analysis that could be used to guide treatment decisions. These findings warrant further confirmation through large prospective clinical trials. Funding Statement: This research was supported by the Basic Science Research Program of National Research Foundation of Korea (NRF), which is funded by the Korean Ministry of Science, ICT and Future Planning (grant number: NRF-2019R1C1C1003524). Declaration of Interests: None of the authors have any conflicts of interest or financial ties to disclose. Ethics Approval Statement: This study was reviewed and approved by the Institutional Review Board of the Kyung Hee University Hospital at Gangdong (KHNMC IRB 2020-09-025). The need for informed consent was waived because all data used in this study were de-identified.
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- 2020
9. Polydeoxyribonucleotide Exerts Protective Effect Against CCl4-Induced Acute Liver Injury through Inactivation of NF-κB/MAPK Signaling Pathway in Mice
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Jung Won Jeon, Ha Il Kim, Jin Hee Han, Hyun Phil Shin, Jun-Jang Jin, Lakkyong Hwang, Chang-Ju Kim, Sang-Hoon Kim, Seung Hwan Lee, and Il-Gyu Ko
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Agonist ,MAPK/ERK pathway ,Male ,mitogen-activated protein kinase ,Adenosine A2 Receptor Agonists ,medicine.drug_class ,MAP Kinase Signaling System ,medicine.medical_treatment ,Intraperitoneal injection ,Adenosine A2A receptor ,CCL4 ,Inflammation ,Pharmacology ,acute liver injury ,Catalysis ,Article ,Inorganic Chemistry ,lcsh:Chemistry ,Mice ,Polydeoxyribonucleotides ,medicine ,Animals ,Physical and Theoretical Chemistry ,Phosphorylation ,Molecular Biology ,lcsh:QH301-705.5 ,Carbon Tetrachloride ,Spectroscopy ,business.industry ,nuclear factor-kappa B ,Organic Chemistry ,apoptosis ,NF-kappa B ,General Medicine ,respiratory tract diseases ,Computer Science Applications ,Oxidative Stress ,Treatment Outcome ,lcsh:Biology (General) ,lcsh:QD1-999 ,Gene Expression Regulation ,Apoptosis ,inflammation ,DMPX ,medicine.symptom ,polydeoxyribonucleotide ,Chemical and Drug Induced Liver Injury ,business ,Injections, Intraperitoneal - Abstract
Acute liver injury (ALI) causes life-threatening clinical problem, and its underlying etiology includes inflammation and apoptosis. An adenosine A2A receptor agonist, polydeoxyribonucleotide (PDRN), exhibits anti-inflammatory and anti-apoptotic effects by inhibiting the secretion of pro-inflammatory cytokines. In the current study, the protective effect of PDRN against carbon tetrachloride (CCl4)-induced ALI was investigated using mice. For the induction of ALI, mice received intraperitoneal injection of CCl4 twice over seven days. Mice from the PDRN-treated groups received an intraperitoneal injection of 200 &mu, L saline containing PDRN (8 mg/kg), once a day for seven days, starting on day 1 after the first CCl4 injection. In order to confirm that the action of PDRN occurs through the adenosine A2A receptor, 8 mg/kg 3,7-dimethyl-1-propargylxanthine (DMPX), an adenosine A2A receptor antagonist, was treated with PDRN. Administration of CCl4 impaired liver tissue and increased the liver index and histopathologic score. The expression of pro-inflammatory cytokines was increased, and apoptosis was induced by the administration of CCl4. Administration of CCl4 activated nuclear factor-kappa B (NF-&kappa, B) and facilitated phosphorylation of signaling factors in mitogen-activated protein kinase (MAPK). In contrast, PDRN treatment suppressed the secretion of pro-inflammatory cytokines and inhibited apoptosis. PDRN treatment inactivated NF-&kappa, B and suppressed phosphorylation of signaling factors in MAPK. As a result, liver index and histopathologic score were reduced by PDRN treatment. When PDRN was treated with DMPX, the anti-inflammatory and anti-apoptotic effect of PDRN disappeared. Therefore, PDRN can be used as an effective therapeutic agent for acute liver damage.
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- 2020
10. Adenosine A2A receptor agonist polydeoxyribonucleotide ameliorates short-term memory impairment by suppressing cerebral ischemia-induced inflammation via MAPK pathway
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Sang-Hoon Kim, Jin Hee Han, Il-Gyu Ko, Jung Won Jeon, Chang-Ju Kim, Jun-Jang Jin, Jun Young Chung, and Lakkyong Hwang
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0301 basic medicine ,MAPK/ERK pathway ,Male ,Cell signaling ,Adenosine ,Physiology ,Glycobiology ,Cancer Treatment ,Adenosine A2A receptor ,Hippocampus ,Pharmacology ,Signal transduction ,Biochemistry ,Brain Ischemia ,0302 clinical medicine ,Immune Physiology ,Cyclic AMP ,Medicine and Health Sciences ,Medicine ,Phosphorylation ,Cyclic AMP Response Element-Binding Protein ,Immune Response ,Cerebral Ischemia ,Innate Immune System ,Multidisciplinary ,Pharmaceutics ,Signaling cascades ,Brain ,Nucleosides ,Glycosylamines ,Adenosine A2 Receptor Antagonists ,Memory, Short-Term ,Neurology ,Oncology ,DMPX ,Cytokines ,medicine.symptom ,Anatomy ,Research Article ,Agonist ,Cell biology ,MAPK signaling cascades ,Adenosine A2 Receptor Agonists ,Receptor, Adenosine A2A ,medicine.drug_class ,MAP Kinase Signaling System ,Science ,Immunology ,Ischemia ,Inflammation ,Cytokine Therapy ,03 medical and health sciences ,Polydeoxyribonucleotides ,Signs and Symptoms ,Drug Therapy ,Animals ,Humans ,Memory Disorders ,Biology and life sciences ,business.industry ,Antagonist ,Molecular Development ,medicine.disease ,Disease Models, Animal ,030104 developmental biology ,Immune System ,Clinical Medicine ,business ,Gerbillinae ,030217 neurology & neurosurgery ,Receptor Antagonist Therapy ,Developmental Biology - Abstract
Cerebral ischemia causes tissue death owing to occlusion of the cerebral blood vessels, and cerebral ischemia activates mitogen-activated protein kinase (MAPK) and induces secretion of pro-inflammatory cytokines. Adenosine A2A receptor agonist, polydeoxyribonucleotide (PDRN), suppresses the secretion of pro-inflammatory cytokines and exhibits anti-inflammatory effect. In the current study, the therapeutic effect of PDRN on cerebral ischemia was evaluated using gerbils. For the induction of cerebral ischemia, the common carotid arteries were exposed, and then aneurysm clips were used to occlude the common carotid arteries bilaterally for 7 minutes. In the PDRN-treated groups, the gerbils were injected intraperitoneally with 0.3 mL of saline containing 8 mg/kg PDRN, per a day for 7 days following cerebral ischemia induction. In order to confirm the participation of the adenosine A2A receptor in the effects mediated by PDRN, 8 mg/kg 7-dimethyl-1-propargylxanthine (DMPX), adenosine A2A receptor antagonist, was treated with PDRN. In the current study, induction of ischemia enhanced the levels of pro-inflammatory cytokines and increased phosphorylation of MAPK signaling factors in the hippocampus and basolateral amygdala. However, treatment with PDRN ameliorated short-term memory impairment by suppressing the production of pro-inflammatory cytokines and inactivation of MAPK signaling factors in cerebral ischemia. Furthermore, PDRN treatment enhanced the concentration of cyclic adenosine-3,5’-monophosphate (cAMP) as well as phosphorylation of cAMP response element-binding protein (p-CREB). Co-treatment of DMPX and PDRN attenuated the therapeutic effect of PDRN on cerebral ischemia. Based on these findings, PDRN may be developed as the primary treatment in cerebral ischemia.
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- 2020
11. Polydeoxyribonucleotide Exerts Therapeutic Effect by Increasing VEGF and Inhibiting Inflammatory Cytokines in Ischemic Colitis Rats
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Jung Won Jeon, Sung Eun Kim, Il-Gyu Ko, Jun-Jang Jin, Lakkyong Hwang, Jin Hee Han, Chang-Ju Kim, and Sang-Hoon Kim
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0301 basic medicine ,Male ,Vascular Endothelial Growth Factor A ,Colon ,H&E stain ,Apoptosis ,Pharmacology ,General Biochemistry, Genetics and Molecular Biology ,Ischemic colitis ,Proinflammatory cytokine ,Rats, Sprague-Dawley ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Polydeoxyribonucleotides ,Western blot ,medicine ,Animals ,Colitis ,General Immunology and Microbiology ,medicine.diagnostic_test ,business.industry ,General Medicine ,medicine.disease ,Rats ,Vascular endothelial growth factor ,030104 developmental biology ,chemistry ,030220 oncology & carcinogenesis ,Medicine ,Cytokines ,Tumor necrosis factor alpha ,business ,Skin Temperature ,Colitis, Ischemic ,Research Article - Abstract
Ischemic colitis is resulted from an inadequate blood supply to a segment or entire colon. Polydeoxyribonucleotide (PDRN), extracted from salmon sperm, has been reported to exert anti-inflammatory and anti-ischemic effects through the adenosine A2A receptor (A2AR). We investigated whether PDRN possesses therapeutic effectiveness on ischemic colitis rats. Ischemic colitis was induced by selective devascularization. The skin temperature on the ischemic colitis-induced region was determined. To assess the colonic damage score and collagen deposition, colonic tissue sections were stained with hematoxylin and eosin (H&E), and Masson trichrome staining was performed. Western blot analysis for A2AR, vascular endothelial growth factor (VEGF), cyclooxygenase-2 (COX-2), tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and IL-6, Bax, Bcl-2, and extracellular signal-regulated kinase 1/2 (ERK1/2) was performed. Skin temperature was increased and mucosal damage and collagen deposition were observed in the affected colonic tissues in the ischemic colitis rats. Expressions of inflammatory cytokines (TNF-α, IL-1β, and IL-6) and inflammatory mediator (COX-2) were upregulated in the ischemic colitis rats. Apoptosis was increased by decreasing the ratio of Bcl-2 to Bax and by suppressing the phosphorylated form of ERK1/2 expression in the ischemic colitis rats. Treatment with PDRN alleviated mucosal damage reduced the expressions of inflammatory cytokines and COX-2 and inhibited apoptosis in the ischemic colitis rats. PDRN treatment more enhanced the expressions of A2AR and VEGF in the ischemic colitis rats. PDRN showed therapeutic effectiveness on ischemic colitis by increasing VEGF expression and inhibiting inflammatory cytokines and COX-2 through enhancing A2AR expression.
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- 2020
12. Probiotics Ameliorate Stool Consistency in Patients with Chronic Constipation: A Randomized, Double-Blind, Placebo-Controlled Study
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Ju Kyoung Oh, Jung Won Jeon, Hyun Phil Shin, Jin Young Yoon, Sae Hun Kim, Pei Lei Tan, Min Seob Kwak, and Jae Myung Cha
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Adult ,Male ,medicine.medical_specialty ,Constipation ,Physiology ,Placebo-controlled study ,Placebo ,Gastroenterology ,law.invention ,Irritable Bowel Syndrome ,Feces ,03 medical and health sciences ,Probiotic ,0302 clinical medicine ,Blood serum ,Double-Blind Method ,law ,Internal medicine ,medicine ,Humans ,Irritable bowel syndrome ,Chronic constipation ,business.industry ,Probiotics ,Middle Aged ,medicine.disease ,030220 oncology & carcinogenesis ,Cytokines ,Functional constipation ,Female ,030211 gastroenterology & hepatology ,medicine.symptom ,business - Abstract
The efficacy of probiotics for improving clinical symptoms, altering the fecal microbiota, and regulating serum immune cytokine levels was investigated in patients with irritable bowel syndrome-constipation (IBS-C) or functional constipation (FC). A randomized, double-blind, placebo-controlled trial was conducted at Kyung Hee University Hospital between October 2016 and February 2017. Consecutive 18–75-year-old patients with diagnosis of IBS-C or FC (based on Rome IV criteria) consumed probiotics (3.0 × 108 CFU/g Streptococcus thermophilus MG510 and 1.0 × 108 CFU/g Lactobacillus plantarum LRCC5193) or a placebo daily for 4 weeks (weeks 1–4) and were followed up for a 4-week washout period without intervention (weeks 5–8). The primary outcomes of the study were Bristol Stool Form Scale and Complete Spontaneous Bowel Movements (CSBM). Efficacy was assessed by per protocol. Stool consistency measured by the Bristol Stool Form Scale was significantly better in the probiotic group (n = 88) than in the placebo group (n = 83) at 4 and 8 weeks (3.7 ± 1.1 vs. 3.1 ± 1.1 at 8 weeks, P = 0.002). No significant difference was found in CSBM. The quality of life was significantly better in the probiotic group than in the placebo group at 4 weeks (P = 0.044) and 8 weeks (P = 0.049). The relative abundance of L. plantarum among the fecal microbiomes was significantly greater in the probiotic group than in the placebo group at 4 weeks (P = 0.029). However, the levels of other microbiomes and of serum cytokines (IL-10/IL-12 ratio and TNF-α) did not differ significantly between the two groups. Probiotics significantly ameliorated stool consistency in patients with chronic constipation. In addition, the beneficial effect of L. plantarum on stool consistency remained after the probiotic supplementation was discontinued. The mechanism whereby probiotics benefit patients with chronic constipation should be clarified in further studies.
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- 2018
13. Combination therapy with polydeoxyribonucleotide and proton pump inhibitor enhances therapeutic effectiveness for gastric ulcer in rats
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Chang-Ju Kim, Min Seop Kwak, Jung Won Jeon, Il-Gyu Ko, Lakkyong Hwang, Hyun Phil Shin, In Taik Hong, Jin Hee Han, Jin Young Yoon, Eun-Sang Ji, Sung Eun Kim, and Jun-Jang Jin
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Male ,0301 basic medicine ,Combination therapy ,medicine.drug_class ,Indomethacin ,Proton-pump inhibitor ,Adenosine A2A receptor ,Pharmacology ,General Biochemistry, Genetics and Molecular Biology ,Rats, Sprague-Dawley ,03 medical and health sciences ,chemistry.chemical_compound ,Polydeoxyribonucleotides ,0302 clinical medicine ,Oral administration ,Animals ,Medicine ,Stomach Ulcer ,General Pharmacology, Toxicology and Pharmaceutics ,Pantoprazole ,business.industry ,Anti-Inflammatory Agents, Non-Steroidal ,Therapeutic effect ,Proton Pump Inhibitors ,General Medicine ,Rats ,Vascular endothelial growth factor ,030104 developmental biology ,chemistry ,030220 oncology & carcinogenesis ,Gastric acid ,Drug Therapy, Combination ,business ,Signal Transduction ,medicine.drug - Abstract
Aims The main action of proton pump inhibitors (PPIs) is to inhibit gastric acid secretion, and PPIs are widely used to treat gastric ulcer (GU). However, if the action of promoting gastric mucosal regeneration is added, the effectiveness of GU treatment can be enhanced. Thus, in order to improve the therapeutic effect on GU, we tried to develop combination therapy promoting regeneration in injured tissue besides suppressing gastric acid secretion. Main methods Polydeoxyribonucleotide (PDRN) was selected to evaluate tissue regeneration, and pantoprazole was chosen as one of the PPIs. GU was induced by oral administration of indomethacin once a day for 7 days. Rats in drug-administered groups were intraperitoneally injected with 100 μL normal saline, containing each drug at the indicated concentration, once a day for 14 days after inducing GU. Key findings PDRN and PPI combination therapy potently improved tissue regeneration and inhibited production of pro-inflammatory cytokines. PDRN treatment with or without PPI increased the concentration of cyclic adenosine-3,5′-monophosphate (cAMP) and the ratio of phosphorylated cAMP response element-binding protein (p-CREB) to cAMP response element-binding protein (CREB). PDRN treatment with or without PPI also increased the expressions of vascular endothelial growth factor (VEGF) and adenosine A2A receptor. Significance PDRN and PPI combination therapy showed more potent therapeutic effect on GU compared to the PDRN monotherapy or PPI monotherapy. The excellent therapeutic effect of PDRN and PPI combination therapy on GU appeared by promoting regeneration of damaged tissue as well as inhibiting gastric acid secretion.
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- 2018
14. Quality Metrics of a Fecal Immunochemical Test-Based Colorectal Cancer Screening Program in Korea
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Dae Ho Kim, Jung Won Jeon, Young Hak Cho, Joung Il Lee, Min Seob Kwak, Jin Young Yoon, Jae Myung Cha, Kwang Ro Joo, and Hyun Phil Shin
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Male ,medicine.medical_specialty ,media_common.quotation_subject ,Colonoscopy ,Asymptomatic ,Colorectal neoplasms ,Fecal occult blood test ,Feces ,03 medical and health sciences ,0302 clinical medicine ,Predictive Value of Tests ,Internal medicine ,Republic of Korea ,Humans ,Medicine ,Quality (business) ,Intestinal Mucosa ,Early Detection of Cancer ,Aged ,media_common ,Hepatology ,medicine.diagnostic_test ,business.industry ,Immunochemistry ,Gastroenterology ,Cancer ,Odds ratio ,Middle Aged ,medicine.disease ,Quality ,Confidence interval ,Colorectal cancer screening ,Fecal Immunochemical Test ,Occult Blood ,030220 oncology & carcinogenesis ,Screening ,Original Article ,Female ,030211 gastroenterology & hepatology ,medicine.symptom ,business - Abstract
Background/Aims Knowledge regarding the quality metrics of fecal immunochemical test (FIT)-based colorectal cancer screening programs is limited. The aim of this study was to investigate the performance and quality metrics of a FIT-based screening program. Methods In our screening program, asymptomatic subjects aged ≥50 years underwent an annual FIT, and subjects with positive FIT results underwent a subsequent colonoscopy. The performance of the FIT and colonoscopy was analyzed in individuals with a positive FIT who completed the program between 2009 and 2015 at a university hospital. Results Among the 51,439 screened participants, 75.1% completed the FIT. The positive rate was 1.1%, and the colonoscopy completion rate in these patients was 68.6%. The positive predictive values of cancer and advanced neoplasia were 5.5% and 19.1%, respectively. The adenoma detection rate in the patients who underwent colonoscopy after a positive FIT was 48.2% (60.0% for men and 33.6% for women). The group with the highest tertile quantitative FIT level showed a significantly higher detection rate of advanced neoplasia than the group with the lowest tertile (odds ratio, 2.6; 95% confidence interval, 1.4 to 5.1; p
- Published
- 2018
15. Age-adapted Variation in Screening Interval of Fecal Immunochemical Test May Improve its Participation and Colonoscopy Acceptance
- Author
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Joung Il Lee, Jung Won Jeon, Jin Young Yoon, Kwang Ro Joo, Hyun Phil Shin, Min Seob Kwak, and Jae Myung Cha
- Subjects
Male ,medicine.medical_specialty ,Time Factors ,Seoul ,Colorectal cancer ,Colonoscopy ,Gastroenterology ,Feces ,03 medical and health sciences ,0302 clinical medicine ,Predictive Value of Tests ,Internal medicine ,Biomarkers, Tumor ,Odds Ratio ,medicine ,Humans ,Early Detection of Cancer ,Aged ,Retrospective Studies ,Chi-Square Distribution ,medicine.diagnostic_test ,business.industry ,Age Factors ,Retrospective cohort study ,Odds ratio ,Middle Aged ,Patient Acceptance of Health Care ,medicine.disease ,Immunohistochemistry ,Confidence interval ,Annual Screening ,Logistic Models ,030220 oncology & carcinogenesis ,Predictive value of tests ,Female ,030211 gastroenterology & hepatology ,Colorectal Neoplasms ,business ,Chi-squared distribution ,Program Evaluation ,Demography - Abstract
GOALS We determined appropriate intervals for administering the fecal immunochemical test (FIT) and performance outcomes in an Asian national colorectal cancer (CRC) screening program. BACKGROUND The optimal interval for FIT in CRC screening is unclear, especially in Asian populations. STUDY Between January 2009 and December 2015, 13,480 individuals aged 50 years or older with an initial negative FIT result underwent 2 rounds of FIT screening at intervals of 1 (annual group, 5333), 2 (biennial group, 7363), or 3 years (triennial group, 784). Positive rates of FIT, colonoscopy acceptance, colonoscopy findings, and detection rates for CRC and advanced neoplasia were compared according to FIT intervals. RESULTS The overall positivity rate of FIT in the second screening round was significantly higher in men and in older subjects than in the entire sample. Younger subjects were less likely to undergo annual FIT (36.0% vs. 46.4%, P
- Published
- 2017
16. Rocuronium Bromide Inhibits Inflammation and Pain by Suppressing Nitric Oxide Production and Enhancing Prostaglandin E2 Synthesis in Endothelial Cells
- Author
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Jung Won Jeon, Jae Woo Yi, Mal Soon Shin, Jin Hee Han, Jun Young Chung, Sang Woong Moon, Boksoon Chang, and Sang Bin Baek
- Subjects
0301 basic medicine ,Urology ,Inflammation ,Pharmacology ,Nitric oxide ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Bromide ,medicine ,Rocuronium ,Prostaglandin E2 ,Rocuronium Bromide ,biology ,business.industry ,Neuromuscular-blocking drug ,Nitric oxide synthase ,030104 developmental biology ,Neurology ,chemistry ,Anesthesia ,biology.protein ,Neurology (clinical) ,medicine.symptom ,business ,030217 neurology & neurosurgery ,medicine.drug - Abstract
PURPOSE Rocuronium bromide is a nondepolarizing neuromuscular blocking drug and has been used as an adjunct for relaxation or paralysis of the skeletal muscles, facilitation of endotracheal intubation, and improving surgical conditions during general anesthesia. However, intravenous injection of rocuronium bromide induces injection pain or withdrawal movement. The exact mechanism of rocuronium bromide-induced injection pain or withdrawal movement is not yet understood. We investigated whether rocuronium bromide treatment is involved in the induction of inflammation and pain in vascular endothelial cells. METHODS For this study, calf pulmonary artery endothelial (CPAE) cells were used, and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay, Western blot, nitric oxide detection, and prostaglandin E2 immunoassay were conducted. RESULTS Rocuronium bromide treatment inhibited endothelial nitric oxide synthase and suppressed nitric oxide production in CPAE cells. Rocuronium bromide activated cyclooxygenase-2, inducible nitric oxide synthase and increased prostaglandin E2 synthesis in CPAE cells. CONCLUSIONS Rocuronium bromide induced inflammation and pain in CPAE cells. Suppressing nitric oxide production and enhancing prostaglandin E2 synthesis might be associated with rocuronium bromide-induced injection pain or withdrawal movement.
- Published
- 2016
17. Evaluating the mucoprotective effect of polydeoxyribonucleotide against indomethacin-induced gastropathy via the MAPK/NF-κB signaling pathway in rats
- Author
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Min Seop Kwak, Jung Won Jeon, Chang-Ju Kim, Jin Hee Han, Jun Jang Jin, Il-Gyu Ko, Sang-Hoon Kim, Lakkyong Hwang, and Jin Young Yoon
- Subjects
0301 basic medicine ,MAPK/ERK pathway ,Agonist ,Male ,medicine.drug_class ,medicine.medical_treatment ,Indomethacin ,Adenosine A2A receptor ,Inflammation ,Pharmacology ,Protective Agents ,Rats, Sprague-Dawley ,03 medical and health sciences ,0302 clinical medicine ,Polydeoxyribonucleotides ,medicine ,Animals ,Stomach Ulcer ,Kinase ,business.industry ,Anti-Inflammatory Agents, Non-Steroidal ,NF-kappa B ,030104 developmental biology ,Cytokine ,Apoptosis ,Gastric Mucosa ,Tumor necrosis factor alpha ,medicine.symptom ,Mitogen-Activated Protein Kinases ,business ,030217 neurology & neurosurgery ,Signal Transduction - Abstract
Non-steroidal anti-inflammatory drugs (NSAIDs) cause gastric mucosal damage and gastric ulceration. Among the most commonly used NSAIDs, indomethacin upregulates mucosal tumor necrosis factor-α, which activates nuclear factor-kappa B (NF-κB), and mitogen-activated protein kinases (MAPK) to induce various pro-inflammatory mediators. Polydeoxyribonucleotide (PDRN) is an adenosine A2A receptor agonist that exerts anti-inflammatory effects. In this study, we evaluated the efficacy of PDRN in the initial treatment of gastropathy against that of ecabet sodium and irsoglandin maleate, which are commonly used medications. The rats were administrated indomethacin once a day for 7 days after 24 h of fasting to induce gastropathy. Rats in the drug-treated groups were orally administrated 500 μl of distilled water containing the drug once daily for 7 days 1 h after indomethacin administration. Indomethacin administration caused mucosal damage and increased pro-inflammatory cytokine release. Both NF-κB and MAPK cascade factors were increased by indomethacin administration. PDRN therapy more potently suppressed the expressions of NF-κB and MAPK cascade factors compared to other drugs. The expression of cyclic adenosine-3′,5′-monophosphate was also increased by PDRN treatment in the indomethacin-induced gastropathy rats. These changes led to a reduction in pro-inflammatory cytokines and apoptotic factors, which ultimately promote recovery of damaged gastric tissue. Therefore, PDRN may serve as a new therapeutic option in the initial treatment of NSAIDs-induced gastropathy.
- Published
- 2019
18. Bleeding after Endoscopic Resection in Patients with End-Stage Renal Disease on Dialysis: A Multicenter Propensity Score-Matched Analysis
- Author
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Chan Gyoo Kim, Jung Won Jeon, Jun-Won Chung, In Kyung Yoo, Joon Sung Kim, Su Jin Hong, Youn-Kyung Oh, Young Ju Suh, Byoung Wook Bang, Gwang Ho Baik, Chul-Hyun Lim, Sun Moon Kim, and Young Dae Kim
- Subjects
lcsh:Internal medicine ,medicine.medical_specialty ,medicine.medical_treatment ,Medicine (miscellaneous) ,urologic and male genital diseases ,End stage renal disease ,03 medical and health sciences ,End-stage renal disease ,0302 clinical medicine ,medicine ,Radiology, Nuclear Medicine and imaging ,Clinical significance ,lcsh:RC799-869 ,lcsh:RC31-1245 ,Generalized estimating equation ,Dialysis ,business.industry ,Medical record ,Bleeding ,Gastroenterology ,Odds ratio ,Confidence interval ,female genital diseases and pregnancy complications ,Surgery ,Endoscopic resection ,030220 oncology & carcinogenesis ,Propensity score matching ,lcsh:Diseases of the digestive system. Gastroenterology ,030211 gastroenterology & hepatology ,Original Article ,business - Abstract
Background/Aims Frequent bleeding after endoscopic resection (ER) has been reported in patients with end-stage renal disease (ESRD). We aimed to evaluate the association and clinical significance of bleeding with ER in ESRD patients on dialysis. Methods Between February 2008 and December 2018, 7,571 patients, including 47 ESRD patients on dialysis who underwent ER for gastric neoplasia, were enrolled. A total of 47 ESRD patients on dialysis were propensity score-matched 1:10 to 470 non-ESRD patients, to adjust for between-group differences in variables such as age, sex, comorbidities, anticoagulation use, tumor characteristics, and ER method. Matching was performed using an optimal matching algorithm. For the matched data, clustered comparisons were performed using the generalized estimating equation method. Medical records were retrospectively reviewed. Frequency and outcomes of post-ER bleeding were evaluated. Results Bleeding was more frequent in the ESRD with dialysis group than in the non-ESRD group. ESRD with dialysis conferred a significant risk of post-ER bleeding (odds ratio, 6.1; 95% confidence interval, 2.7–13.6; p
- Published
- 2019
19. Scolopendra subspinipes mutilans Extract Suppresses Inflammatory and Neuropathic Pain In Vitro and In Vivo
- Author
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Il-Gyu Ko, Sang-Hoon Kim, Jung Won Jeon, Lakkyong Hwang, Jin Hee Han, Jun-Jang Jin, and Chang-Ju Kim
- Subjects
0301 basic medicine ,Article Subject ,Lipopolysaccharide ,medicine.medical_treatment ,Pharmacology ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,In vivo ,medicine ,business.industry ,lcsh:Other systems of medicine ,Sciatic nerve injury ,lcsh:RZ201-999 ,medicine.disease ,In vitro ,030104 developmental biology ,Peripheral neuropathy ,Anticonvulsant ,medicine.anatomical_structure ,Complementary and alternative medicine ,chemistry ,Peripheral nervous system ,Neuropathic pain ,business ,030217 neurology & neurosurgery ,Research Article - Abstract
Background. Sciatic nerve injury develops from a variety of pathological causes, including traumatic injury and neuroinflammatory disorders, which are accompanied by pathological changes that have a critical impact on neuropathic pain and locomotor activity. Extracts of Scolopendra subspinipes mutilans (SSM) are used in traditional medicine for the treatment of a wide range of neuropathic diseases, including lower back pain, peripheral neuropathy, and sciatic nerve injury. Although SSM shows anti-inflammatory, antibacterial, and anticonvulsant activities, its diverse mechanisms of action remain unclear. Thus, the present study examined the effects of SSM in vitro and in vivo. Methods. To estimate the anti-inflammatory effects of SSM, inflammatory conditions were induced using lipopolysaccharide (LPS) in RAW 264.7 cells, and inflammatory-related factors were evaluated by enzyme-linked immunosorbent assay (ELISA) and western blotting analyses. Sciatic nerve crush injury (SNCI) was induced in rats using a surgical clip instrument. The effects of SSM in the SNCI model were evaluated in behavioral tests by calculating the sciatic functional index (SFI) and measuring thermal hyperalgesia sensitivity and by monitoring inflammatory factors expression in western blotting analyses. Results. We observed the anti-inflammatory effects of SSM treatment both in vitro and in vivo. The PGE2 and NO production were suppressed by SSM. Protein analyses indicated that expression of NF-κB and degradation of IκBα were suppressed by SSM treatment. In addition, the levels of iNOS, TNF-α, IL-6, and COX-2 expression were reduced by SSM treatment in RAW 264.7 cells and in the SNCI-induced animals. In behavioral studies, SSM treatment enhanced the SFI and improved the thermal sensitivity test results. Conclusions. Our results suggest that SSM suppresses the production of inflammatory factors via the NF-κB pathway and accelerates the morphological and functional recovery of the peripheral nervous system. Hence, SSM may be a useful therapeutic candidate for treatment of neuropathic pain diseases.
- Published
- 2018
20. The Clinical Outcomes of Lower Gastrointestinal Bleeding Are Not Better than Those of Upper Gastrointestinal Bleeding
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Joung Il Lee, Jin Young Yoon, Jung Won Jeon, Kwang Ro Joo, Hyun Phil Shin, Min Seob Kwak, Jae Myung Cha, and Yong Jae Han
- Subjects
Adult ,Male ,medicine.medical_specialty ,Gastrointestinal bleeding ,Lower gastrointestinal bleeding ,Hematochezia ,Gastroenterology ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Internal medicine ,medicine ,Odds Ratio ,Humans ,Gastrointestinal Bleeding ,Endoscopy, Digestive System ,Mortality ,Propensity Score ,Survival rate ,Aged ,Retrospective Studies ,Gastroenterology & Hepatology ,business.industry ,Retrospective cohort study ,General Medicine ,Colonoscopy ,Length of Stay ,Middle Aged ,medicine.disease ,Prognosis ,Survival Rate ,C-Reactive Protein ,030220 oncology & carcinogenesis ,Propensity score matching ,030211 gastroenterology & hepatology ,Original Article ,Female ,Upper gastrointestinal bleeding ,medicine.symptom ,Rockall score ,business ,Gastrointestinal Hemorrhage - Abstract
The incidence of lower gastrointestinal bleeding (LGIB) is increasing; however, predictors of outcomes for patients with LGIB are not as well defined as those for patients with upper gastrointestinal bleeding (UGIB). The aim of this study was to identify the clinical outcomes and the predictors of poor outcomes for patients with LGIB, compared to outcomes for patients with UGIB. We identified patients with LGIB or UGIB who underwent endoscopic procedures between July 2006 and February 2013. Propensity score matching was used to improve comparability between LGIB and UGIB groups. The clinical outcomes and predictors of 30-day rebleeding and mortality rate were analyzed between the two groups. In total, 601 patients with UGIB (n = 500) or LGIB (n = 101) were included in the study, and 202 patients with UGIB and 101 patients with LGIB were analyzed after 2:1 propensity score matching. The 30-day rebleeding and mortality rates were 9.9% and 4.5% for the UGIB group, and 16.8% and 5.0% for LGIB group, respectively. After logistic regression analysis, the Rockall score (P = 0.013) and C-reactive protein (CRP; P = 0.047) levels were significant predictors of 30-day mortality in patients with LGIB; however, we could not identify any predictors of rebleeding in patients with LGIB. The clinical outcomes for patients with LGIB are not better than clinical outcomes for patients with UGIB. The clinical Rockall score and serum CRP levels may be used to predict 30-day mortality in patients with LGIB., Graphical Abstract
- Published
- 2016
21. Cerebral venous thrombosis in a patient with Crohn's disease
- Author
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Jung Won Jeon, Hye-Jin Ki, Il Hyun Baek, In Taik Hong, Kwang Ro Joo, Jun Uk Lim, Hyun Phil Shin, Jae Myung Cha, Young Hak Cho, Joung Il Lee, Min Kyu Chae, and Jae Bin Kang
- Subjects
medicine.medical_specialty ,Population ,Venography ,lcsh:Medicine ,Case Report ,Inflammatory bowel diseases ,Inflammatory bowel disease ,03 medical and health sciences ,Anticoagulation ,0302 clinical medicine ,medicine ,030212 general & internal medicine ,lcsh:RC799-869 ,education ,Rivaroxaban ,education.field_of_study ,Crohn's disease ,medicine.diagnostic_test ,business.industry ,lcsh:R ,Gastroenterology ,Crohn disease ,medicine.disease ,Thrombosis ,Surgery ,Venous thrombosis ,Cerebral venous thrombosis ,030211 gastroenterology & hepatology ,lcsh:Diseases of the digestive system. Gastroenterology ,Radiology ,business ,Complication ,medicine.drug ,Superior sagittal sinus - Abstract
Patients with inflammatory bowel disease (IBD) have an elevated risk of venous thromboembolism compared with the general population. The most common sites of venous thromboembolism in IBD patients are the deep veins of the legs, the pulmonary system, and portal and mesenteric veins. However, cerebral venous thrombosis is rarely associated with IBD. This report describes a case of cerebral venous thrombosis in a patient with Crohn's disease. A 17-year-old girl, diagnosed 4 years earlier with Crohn's disease, presented with headache and vomiting. Magnetic resonance imaging of the brain with venography showed venous thrombosis in the cortical veins, superior sagittal sinus, right transverse sinus, and right internal jugular vein. The patient immediately started anticoagulation therapy with intravenous heparin infusion followed by daily oral rivaroxaban 10 mg. Follow-up imaging after 2 weeks showed resolution of the thrombosis, with recanalization of the cortical veins, superior sagittal sinus, right transverse sinus, and right internal jugular vein. She continued rivaroxaban therapy for 6 months, and remained well, without neurologic sequelae. A high level of concern for cerebral venous thrombosis may be important when treating active IBD patients, because anticoagulation treatment can prevent fatal complications.
- Published
- 2016
22. Evaluation of scoring systems without endoscopic findings for predicting outcomes in patients with upper gastrointestinal bleeding
- Author
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Jung Won Jeon, Bok Soon Chang, Sung Eun Kim, Jin Hee Han, Il-Gyu Ko, Joung Il Lee, Jin Young Yoon, Hyun Phil Shin, Sang-Hyun Kim, Min Seob Kwak, and Jae Myung Cha
- Subjects
Male ,medicine.medical_specialty ,Scoring system ,30-day mortality ,Need of interventions ,Risk Assessment ,Sensitivity and Specificity ,Severity of Illness Index ,Endoscopy, Gastrointestinal ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Severity of illness ,medicine ,Cutoff ,Humans ,In patient ,Blood Transfusion ,lcsh:RC799-869 ,Upper gastrointestinal bleeding ,Aged ,Retrospective Studies ,Aged, 80 and over ,business.industry ,Hemostatic Techniques ,Gastroenterology ,Retrospective cohort study ,General Medicine ,Hepatology ,Middle Aged ,medicine.disease ,Prognosis ,ROC Curve ,030220 oncology & carcinogenesis ,Area Under Curve ,lcsh:Diseases of the digestive system. Gastroenterology ,030211 gastroenterology & hepatology ,Female ,Rockall score ,business ,Risk assessment ,Prediction ,Gastrointestinal Hemorrhage ,Research Article - Abstract
Background Risk scoring systems are used to evaluate patients with upper gastrointestinal bleeding (UGIB). We compared Glasgow-Blatchford score (GBS), modified GBS (mGBS), and Pre-endoscopy Rockall score (Pre-E RS) for immediate application without endoscopic findings in predicting the need of interventions and the 30-day mortality in patients with UGIB. Methods Patients who visited the emergency room with UGIB from January 2007 to June 2016 were included. GBS, mGBS, and Pre-E RS were obtained for all patients. The area under the receiver-operating characteristic curves (AUC) was used to assess the accuracy of the scoring systems to determine the need for interventions and 30-day mortality. Also, we investigated the potential cutoff scores for predicting 30-day mortality and the need for interventions. Results In predicting the need for interventions, GBS (AUC = 0.727) and mGBS (AUC = 0.733) outperformed Pre-E RS (AUC = 0.564, P
- Published
- 2017
23. Anaphylactic Shock Caused by Ingestion of Polyethylene Glycol
- Author
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Sun Hee Lee, Jung Won Jeon, Kwang Ro Joo, Hyun Phil Shin, Il Hyun Baek, Jung Lok Lee, Hyae Min Lee, Jun Uk Lim, Jae Myung Cha, Young Hak Cho, and Joung Il Lee
- Subjects
medicine.medical_specialty ,Colonoscopy ,lcsh:Medicine ,Case Report ,Gastroenterology ,Internal medicine ,PEG ratio ,medicine ,Ingestion ,lcsh:RC799-869 ,Adverse effect ,Anaphylaxis ,medicine.diagnostic_test ,business.industry ,Adverse effects ,lcsh:R ,Polyethylene glycols ,Shock ,medicine.disease ,Surgery ,Shock (circulatory) ,Vomiting ,lcsh:Diseases of the digestive system. Gastroenterology ,medicine.symptom ,Complication ,business - Abstract
Colonoscopy is the current standard method for evaluation of the colon. The diagnostic accuracy and therapeutic safety of colonoscopy depend on the quality of colonic cleansing and preparation. Generally, all these preparations have been demonstrated to be safe for use in healthy individuals without significant comorbid conditions. Based on safety and efficacy concerns, polyethylene glycol (PEG) is most commonly utilized as a bowel preparation solution for colonoscopy. Adverse events in patients receiving PEG are mostly clinically non-significant. However, fatal adverse events rarely have been shown to occur in the few individuals who experience vomiting or aspiration. Anaphylactic shock associated with ingestion of PEG electrolyte solution is an extremely rare fatal complication, and reported mainly in Western countries. Here, we report the first case of anaphylactic shock following the ingestion of PEG solution in Korea.
- Published
- 2015
24. Adenosine A2A-receptor agonist polydeoxyribonucleotide promotes gastric ulcer healing in Mongolian gerbils
- Author
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Jung Won Jeon, Kwang Ro Joo, Hyun Phil Shin, Chang-Ju Kim, Sang-Hoon Kim, Sung Eun Kim, Il-Gyu Ko, Joung Il Lee, Jun-Jang Jin, and Jae Myung Cha
- Subjects
TUNEL assay ,business.industry ,Stomach ,Adenosine A2A receptor ,Interleukin ,Pharmacology ,Adenosine ,General Biochemistry, Genetics and Molecular Biology ,Vascular endothelial growth factor ,chemistry.chemical_compound ,medicine.anatomical_structure ,chemistry ,Immunology ,Gastric mucosa ,Medicine ,Animal Science and Zoology ,Wound healing ,business ,medicine.drug - Abstract
Polydeoxyribonucleotide (PDRN) interacts with the adenosine A2A-receptor and stimulates vascular endothelial growth factor (VEGF) expression. While it has been indicated that PDRN might accelerate wound healing, its impact on gastric ulcers (GU) is still unknown. We investigated the effects of PDRN on VEGF expression in relation to inflammation and apoptosis in GU by using Mongolian gerbils. GU was induced by injection of acetic acid into the subserosal surface of the stomach. The gerbils in the PDRN-treated groups received daily intraperitoneal injections of PDRN over 2 weeks. Reverse transcriptase-polymerase chain reaction (RT-PCR) for tumor necrosis factor-alpha (TNF-α), interleukin (IL)-1β, and IL-6, as well as terminal deoxynucleotidyltransferase-mediated dUTP nick-end labeling (TUNEL) assay, immunohistochemistry for caspase-3, and western blot for VEGF, Bax, and Bcl-2 were conducted. Acetic acid injection induced GU, and VEGF expression in the gastric mucosa was enhanced by GU. PDRN treatment decrea...
- Published
- 2014
25. Predictive Factors for Endoscopic Visibility and Strategies for Pre-endoscopic Prokinetics Use in Patients with Upper Gastrointestinal Bleeding
- Author
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Jung Won Jeon, Kwang Ro Joo, Hyun Phil Shin, Jae Jun Park, Sung Won Jung, Sunyong Kim, Young Hoon Youn, Jun Uk Lim, Joung Il Lee, and Jae Myung Cha
- Subjects
Adult ,Male ,medicine.medical_specialty ,Physiology ,Endoscopy, Gastrointestinal ,Upper Gastrointestinal Tract ,Gastrointestinal Agents ,Internal medicine ,medicine ,Humans ,In patient ,Aged ,Retrospective Studies ,Univariate analysis ,medicine.diagnostic_test ,business.industry ,Decision Trees ,Visibility (geometry) ,Gastroenterology ,Retrospective cohort study ,Guideline ,Middle Aged ,Hepatology ,medicine.disease ,Surgery ,Endoscopy ,Preoperative Period ,Female ,Upper gastrointestinal bleeding ,Gastrointestinal Hemorrhage ,business - Abstract
Although current guideline recommends selective use of pre-endoscopic prokinetics to increase diagnostic yield in upper gastrointestinal bleeding (UGIB) patients, no data to guide the use of these drugs are available. We aimed to investigate predictive factors for endoscopic visibility and develop simple and useful strategies for pre-endoscopic prokinetics use in UGIB patients. A total of 220 consecutive patients who underwent upper endoscopy for suspicious UGIB were enrolled. Patients were randomly allocated to either a training or a validation set at a 2:1 ratio. Significant parameters on univariate analysis were subsequently tested by a classification and regression tree (CART) analysis. Time to endoscopy and nasogastric aspirate findings were independently related to endoscopic visibility. The CART analysis generated algorithms proposed sequential use of time to endoscopy (≤5.2 vs. >5.2 h) and nasogastric aspirate findings (red blood or coffee rounds vs. clear aspirate) for predicting endoscopic visibility. Prediction of unacceptable visibility in the validation set produced sensitivity, specificity, positive predictive value, and negative predictive value of 75.8, 67.5, 65.8, and 77.1 %, respectively. Accurate prediction for visibility was identified in 52 of 73 patients (71.2 %). Time to endoscopy and nasogastric aspirate findings were independently related to endoscopic visibility in patients with UGIB. A decision-tree model incorporating these two variables may be useful for selecting UGIB patients who benefit from pre-endoscopic prokinetics use.
- Published
- 2014
26. Prognostic value of KRAS codon 13 gene mutation for overall survival in colorectal cancer: Direct and indirect comparison meta-analysis
- Author
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Joung Il Lee, Min Seob Kwak, Jae Myung Cha, Jung Won Jeon, Hyung Kyung Kim, Jin Young Yoon, Hyejung Chang, Kwang Ro Joo, and Hyun Phil Shin
- Subjects
0301 basic medicine ,Oncology ,medicine.medical_specialty ,Colorectal cancer ,Subgroup analysis ,colorectal cancer ,Gene mutation ,medicine.disease_cause ,Proto-Oncogene Proteins p21(ras) ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,KRAS ,Medicine ,Humans ,Clinical significance ,Codon ,neoplasms ,business.industry ,Hazard ratio ,General Medicine ,medicine.disease ,Prognosis ,digestive system diseases ,ErbB Receptors ,meta-analysis ,030104 developmental biology ,030220 oncology & carcinogenesis ,Meta-analysis ,Mutation (genetic algorithm) ,ComputingMethodologies_DOCUMENTANDTEXTPROCESSING ,codon 13 mutation ,business ,Colorectal Neoplasms ,Systematic Review and Meta-Analysis ,Research Article - Abstract
Supplemental Digital Content is available in the text, Background: The clinical significance of KRAS codon 13 mutation in patients with colorectal cancer (CRC) remains controversial. A systematic review and meta-analysis is necessary for a more precise estimation of the predictive role of KRAS codon 13 mutations in CRC patients. Methods: We performed a systematic search using the MEDLINE, EMBASE, and Cochrane library databases from January 2000 to November 2016. The prognostic value of KRAS codon 13 mutation for overall survival (OS) was investigated by measuring the hazard ratio (HR) and 95% confidence interval (CI). Data were analyzed with Review Manager Version 5.3 and the Canadian Agency for Drugs and Technologies in Health software. Results: OS in CRC patients with KRAS codon 13 mutation was worse than that in CRC patients with KRAS wild-type (pooled HR = 1.37, 95% CI: 1.03–1.81, P = .03). Subgroup analysis of studies of enrolled CRC patients treated with antiepidermal growth factor receptor (EGFR) therapy showed no significant difference in OS associated with KRAS codon 13 mutation in comparison to KRAS wild-type (pooled HR = 1.57, 95% CI: 0.98–2.51, P = .06). In the indirect comparison, no statistically significant association was observed between codon 12 and 13 mutations for OS in CRC patients (pooled HR = 0.88, 95% CI: 0.65–1.20, P = .43). Conclusion: The current meta-analysis suggests that Codon 13 mutation of KRAS gene seems to correlate with the OS of patients with CRC, but has similar OS to those with KRAS wild-type in patients receiving anti-EGFR therapy. No difference was detected in the OS of CRC patients with codon 13 mutation versus codon 12 mutation.
- Published
- 2017
27. Inhibitory Effects of Isoquinoline Alkaloid Berberine on Ischemia-Induced Apoptosis via Activation of Phosphoinositide 3-Kinase/Protein Kinase B Signaling Pathway
- Author
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Mal Soon Shin, Jung Won Jeon, Young Joon Kim, Mia Kim, Hey Ran Choi, Jae-Min Lee, Han Sam Cho, and Chang-Ju Kim
- Subjects
Berberine ,Urology ,Apoptosis ,Pharmacology ,lcsh:RC870-923 ,chemistry.chemical_compound ,Brain ischemia ,medicine ,Short-term memory ,Protein kinase B ,PI3K/AKT/mTOR pathway ,Phosphoinositide 3-kinase ,biology ,business.industry ,medicine.disease ,lcsh:Diseases of the genitourinary system. Urology ,Astrogliosis ,Neurology ,chemistry ,Protein kinase B signaling ,biology.protein ,Original Article ,Neurology (clinical) ,Signal transduction ,business ,Phosphatidylinositol 3-kinases - Abstract
Purpose Berberine is a type of isoquinoline alkaloid that has been used to treat various diseases. A neuroprotective effect of berberine against cerebral ischemia has been reported; however, the effects of berberine on apoptosis in relation to reactive astrogliosis and microglia activation under ischemic conditions have not yet been fully evaluated. In the present study, we investigated the effects of berberine on global ischemia-induced apoptosis, and focused on the phosphoinositide 3-kinase (PI3K)/protein kinase B (Akt) signaling pathway in the hippocampus using gerbils. Methods Gerbils received berberine orally once a day for 14 consecutive days, starting one day after surgery. In this study, a step-down avoidance task was used to assess short-term memory. Furthermore, we employed the terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) assay to evaluate DNA fragmentation, immunohistochemistry to investigate glial fibriallary acidic protein, CD11b, and caspase-3, and western blot to assess PI3K, Akt, Bax, Bcl-2, and cytochrome c. Results Our results revealed that berberine treatment alleviated ischemia-induced short-term memory impairment. Treatment with berbeine also attenuated ischemia-induced apoptosis and inhibited reactive astrogliosis and microglia activation. Furthermore, berberine enhanced phospho-PI3K and phospho-Akt expression in the hippocampus of ischemic gerbils. Conclusions Berberine exerted a neuroprotective effect against ischemic insult by inhibiting neuronal apoptosis via activation of the PI3K/Akt signaling pathway. The antiapoptotic effect of berberine was achieved through inhibition of reactive astrogliosis and microglia activation. Berberine may therefore serve as a therapeutic agent for stroke-induced neurourological problems.
- Published
- 2014
28. Fermented milk containing Lactobacillus paracasei and Glycyrrhiza glabra has a beneficial effect in patients with Helicobacter pylori infection
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Seong Soo Hong, Min Seob Kwak, Jae Myung Cha, Jung Won Jeon, Hyun Phil Shin, Hyung Kyung Kim, and Jin Young Yoon
- Subjects
Helicobacter pylori infection ,Lactobacillus paracasei ,biology ,Traditional medicine ,business.industry ,Placebo-controlled study ,food and beverages ,General Medicine ,biology.organism_classification ,Double blind ,03 medical and health sciences ,0302 clinical medicine ,030220 oncology & carcinogenesis ,Medicine ,Glycyrrhiza ,In patient ,Fermentation ,030212 general & internal medicine ,business ,Medicinal plants - Abstract
Background:Lactobacillus paracasei and Glycyrrhiza glabra have been reported as having beneficial effects on Helicobacter pylori infection. We aimed to assess the efficacy and safety of fermented milk containing L paracasei HP7 and G glabra in patients with H pylori infection.Methods:This mu
- Published
- 2019
29. Efficacy and safety of Gelidium elegans intake on bowel symptoms in obese adults
- Author
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Jung Won Jeon, Jin Young Yoon, In-Kyung Jeong, Soojin Kim, Hyoung Il Choi, In-Jin Cho, Min Seob Kwak, and Jae Myung Cha
- Subjects
medicine.medical_specialty ,Constipation ,Human studies ,business.industry ,Placebo-controlled study ,General Medicine ,Placebo ,Gastroenterology ,Gelidium elegans ,Treatment period ,law.invention ,Double blind ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,030220 oncology & carcinogenesis ,Internal medicine ,medicine ,030212 general & internal medicine ,medicine.symptom ,business - Abstract
Background/aims Gelidium elegans (GE) is known to have antiobesity effects and beneficial effects on functional bowel symptoms in preclinical studies. The aim of this study was to determine the efficacy and safety of GE intake on bowel symptoms in obese human adults. Methods This 12-week single-center randomized double-blind placebo-controlled study was performed from September 2016 to May 2017. Consecutive obese subjects were randomly assigned (1:1) to either GE (1 g) or placebo (1 g) once daily group for 12 weeks. Patients' bowel symptoms were evaluated using the Bristol Stool Form Scale, Constipation Scoring System (CSS), and Patient Assessment of Constipation-Symptoms (PAC-SYM) questionnaire. Results The stool symptom score of PAC-SYM significantly improved in the GE group compared with the placebo group after the 12-week treatment (P = .041). Abdominal discomfort score of CSS significantly decreased at 12 weeks compared to that at baseline in the GE group (P = .003), but not in the placebo group (P = .398). In addition, abdominal discomfort score of CSS slightly decreased in the GE group compared with the placebo group after the 12-week treatment (P = .060). However, stool consistency, total CSS score, and PAC-SYM score did not change significantly in both GE group and the placebo group over the 12-week treatment period. Conclusions GE treatment for 12 weeks improved the stool symptom score on the PAC-SYM and abdominal discomfort score on the CSS in obese adults. However, further research is needed in large-scale human studies.
- Published
- 2019
30. Mucoepidermoid Carcinoma of the Esophagus
- Author
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Sang Youn Shin, Jung Won Jeon, Min Seob Kwak, Min Kyu Chae, Jae Myung Cha, and Jin Young Yoon
- Subjects
medicine.medical_specialty ,business.industry ,Carcinoma ,lcsh:R ,lcsh:Medicine ,Endoscopic mucosal resection ,mucoepidermoid ,General Medicine ,medicine.disease ,Complete resection ,Metastasis ,Esophagus ,medicine.anatomical_structure ,Mucoepidermoid carcinoma ,Medicine ,Endoscopic resection ,Radiology ,business ,Ligation - Abstract
Mucoepidermoid carcinoma is a malignant tumor that occurs mainly in the salivary glands of adults and children, but rarely in the esophagus. A surgical resection is the primary treatment for mucoepidermal carcinoma, and the prognosis has been reported to be poor. A 61-year-old man was diagnosed with an esophageal nodule in upper gastrointestinal endoscopy for the purpose of a medical examination without any special symptoms and an endoscopic resection was performed for an accurate diagnosis. An endoscopic mucosal resection was performed using a band ligation for a complete resection and continuous follow-up with no evidence of recurrence or metastasis. The unknown prognosis of endoscopic resection makes it necessary to follow the patient carefully.
- Published
- 2019
31. A Case of Toxic Hepatitis by Weight-Loss Herbal Supplement Containing Garcinia cambogia
- Author
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Jung Won Jeon, Jung Lok Lee, Kwang Ro Joo, Hyun Phil Shin, Jae Myung Cha, and Joung Il Lee
- Subjects
Hepatitis ,Toxic hepatitis ,medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Garcinia cambogia ,Jaundice ,medicine.disease ,Weight loss ,Liver biopsy ,Internal medicine ,medicine ,medicine.symptom ,business ,Adverse effect ,Pathological - Abstract
We report a case of patient with acute toxic hepatitis induced by weight-loss herbal supplement. A patient took natural extract supplement containing Garcinia cambogia for only two days and visited Kyung Hee University Hospital at Gangdong complaining of abdominal discomfort and jaundice. Serum ceruloplasmin level was decreased and hepatic copper levels on liver biopsy specimen were increased. Although, those were mimicking Wilson’s disease, pathological findings and clinical manifestations were consistent with drug-induced acute hepatitis. Genetic test was negative for Wilson’s disease. After one month of hospitalization, the patient improved and was discharged home in good condition. She was followed up for four months and her symptoms and signs of hepatitis continued to improve steadily with normal liver function tests. Our case emphasizes the importance of taking a caution when taking herbal supplements for the purpose of weight loss. This case also demonstrates the importance of suspicion of medication-related adverse events, even though the duration of taking the materials seems to be too short to affect the patients.
- Published
- 2014
32. Successful Endoscopic Hemostasis Is a Protective Factor for Rebleeding and Mortality in Patients with Nonvariceal Upper Gastrointestinal Bleeding
- Author
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Jung Won Jeon, Yong Jae Han, Kwang Ro Joo, Jae Myung Cha, Hyun Phil Shin, Jae Hyun Park, and Joung Il Lee
- Subjects
Male ,medicine.medical_specialty ,Gastrointestinal bleeding ,Physiology ,Protective factor ,Gastroenterology ,03 medical and health sciences ,Upper Gastrointestinal Tract ,0302 clinical medicine ,Recurrence ,Risk Factors ,Internal medicine ,medicine ,Humans ,030212 general & internal medicine ,Risk factor ,Aged ,business.industry ,Mortality rate ,Hemostasis, Endoscopic ,Odds ratio ,Hepatology ,Middle Aged ,medicine.disease ,Confidence interval ,Logistic Models ,Multivariate Analysis ,030211 gastroenterology & hepatology ,Female ,Upper gastrointestinal bleeding ,business ,Gastrointestinal Hemorrhage - Abstract
Rebleeding and mortality rates remain high in patients with nonvariceal upper gastrointestinal bleeding. To identify clinical and endoscopic risk factors for rebleeding and mortality in patients with nonvariceal upper gastrointestinal bleeding. This study was performed in patients with nonvariceal upper gastrointestinal bleeding who underwent upper endoscopic procedures between July 2006 and February 2013. Clinical and endoscopic characteristics were compared among patients with and without rebleeding and mortality. Logistic regression analysis was performed to determine independent risk factors for rebleeding and mortality. After excluding 64 patients, data for 689 patients with nonvariceal upper gastrointestinal bleeding were analyzed. Peptic ulcer (62.6 %) was by far the most common source of bleeding. Endoscopic intervention was performed within 24 h in 99.0 % of patients, and successful endoscopic hemostasis was possible in 80.7 % of patients. The 30-day rebleeding rate was 13.1 % (n = 93). Unsuccessful endoscopic hemostasis was found to be the only independent risk factor for rebleeding (odds ratio 79.6; 95 % confidence interval 37.8–167.6; p = 0.000). The overall 30-day mortality rate was 3.2 % (n = 23). Unsuccessful endoscopic hemostasis (odds ratio 4.9; 95 % confidence interval 1.7–13.9; p = 0.003) was also associated with increased 30-day mortality in patients with nonvariceal upper gastrointestinal bleeding. Successful endoscopic hemostasis is an independent protective factor for both rebleeding and mortality in patients with nonvariceal upper gastrointestinal bleeding.
- Published
- 2015
33. Efficacy of Entecavir and Adefovir Combination Therapy for Patients with Lamivudine- and Entecavir-Resistant Chronic Hepatitis B
- Author
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Joung Il Lee, Jun Uk Lim, Jung Won Jeon, Sunyong Kim, Jae Myung Cha, Kwang Ro Joo, Hyun Phil Shin, Jae Jun Park, and Kyuseong Lim
- Subjects
Adult ,Male ,Hepatitis B virus ,medicine.medical_specialty ,Guanine ,Combination therapy ,Physiology ,Organophosphonates ,Virus Replication ,Antiviral Agents ,Gastroenterology ,Hepatitis B, Chronic ,Transplant surgery ,Liver Function Tests ,Chronic hepatitis ,Internal medicine ,Drug Resistance, Viral ,Adefovir ,Humans ,Medicine ,Aged ,business.industry ,Adenine ,Optimal treatment ,Lamivudine ,Entecavir ,Middle Aged ,Viral Load ,Hepatology ,Treatment Outcome ,DNA, Viral ,Drug Therapy, Combination ,Female ,Drug Monitoring ,business ,medicine.drug - Abstract
The optimal treatment of patients with chronic hepatitis B (CHB) who develop resistance to both lamivudine (LMV) and entecavir (ETV) after sequential monotherapy of LMV and ETV remains little known.We evaluated the efficacy of entecavir (ETV) plus adefovir dipivoxil (ADV) combination therapy for patients with resistance to LMV and ETV. We reviewed the medical records of 12 patients, and treated all 12 patients with ETV plus ADV combination therapy for at least 18 months. Quantitative hepatitis B virus (HBV) DNA levels, serologic markers, and hepatic panel values were monitored at baseline and 3-month intervals thereafter for 18 months.The baseline mean serum HBV DNA level was 7.26 ± 1.11 log(10) copies/ml. The mean reductions in serum HBV DNA levels from baseline to 3, 6, 9, 12, 15, and 18 months were -1.98 ± 1.03, -2.87 ± 1.02, -3.32 ± 1.10, -3.92 ± 1.30, -4.36 ± 1.22, and -4.57 ± 1.18 log(10) copies/ml, respectively. Complete virological response (HBV DNA of2 log(10) copies/ml) at 6, 12, and 18 months was observed in 1 (8.3%), 4 (33.3%), and 6 (50.0%) patients, respectively. The 2 patients with baseline HBV DNA of6 log(10) copies/ml achieved complete virological response at 18 months, while 4 of 10 patients with baseline HBV DNA of ≥6 log(10) copies/ml achieved complete virological response at 18 months. None of the 12 patients experienced virological breakthrough during follow-up.ETV plus ADV combination therapy effectively reduced serum HBV DNA levels in patients with CHB who developed resistance to both LMV and ETV. Additional long-term studies are needed to assess the effect of long-term treatment with these drugs.
- Published
- 2011
34. Flexible Spectral Imaging Color Enhancement (FICE) Is Useful to Discriminate Among Non-neoplastic Lesion, Adenoma, and Cancer of Stomach
- Author
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Kyu Seong Lim, Jung Won Jeon, Jun Uk Lim, Joung Il Lee, Eun Kyeong Lee, Jae Jun Park, Se Hyun Kim, Sung Won Jung, Jae Myung Cha, Kwang Ro Joo, and Hyun Phil Shin
- Subjects
Adenoma ,medicine.medical_specialty ,Physiology ,Stomach Diseases ,Color ,Sensitivity and Specificity ,Endoscopy, Gastrointestinal ,Diagnosis, Differential ,Lesion ,Stomach Neoplasms ,Humans ,Medicine ,Retrospective Studies ,Observer Variation ,medicine.diagnostic_test ,business.industry ,Stomach ,Magnifying endoscopy ,Gastroenterology ,Cancer ,Image Enhancement ,medicine.disease ,Endoscopy ,Spectral imaging ,medicine.anatomical_structure ,Color enhancement ,Radiology ,medicine.symptom ,business - Abstract
Studies regarding the discrimination of non-neoplastic lesion, adenoma, and cancer of the stomach using magnifying endoscopy with flexible spectral imaging color enhancement system (FIME) in each different channel of that system have not yet been reported.To ascertain the usefulness of FIME discriminating among the three kinds of gastric lesions.When finding a lesion to be a possible neoplasm using conventional endoscopy, the examiner discriminated among the three kinds of gastric lesions by observing the pit pattern on the lesion using magnifying endoscopy with white light (WLME) and then recorded the image. The procedure was repeated three more times with FIME with channel 0, 2, and 4. The four recorded images per lesion were then given to four raters for discriminating among the three kinds of gastric lesions.The proportion of agreement and the degree of agreement between endoscopic and pathological diagnosis (AEP) by WLME were 0.85 and 0.76, respectively, and those by FIME were 0.91 and 0.86, respectively. All AEPs from discriminations with FIME was higher than that with WLME. AEPs from the discriminations with FIME with channel 4 were higher than those with FIME with channel 0 or 2. The degree of interobserver agreement among the results of the four raters was 0.42 for WLME and 0.50-0.59 for FIME with each of the three different channels.FICE is useful in discriminating among non-neoplastic lesions, adenoma, and cancer of the stomach, and channel 4 of the FICE is better than channel 0 and 2 for the discriminations.
- Published
- 2011
35. Needle-Knife Fistulotomy With Percutaneous Transhepatic Cholangioscopy for Managing Complete Bilioenteric Anastomosis Occlusion
- Author
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Jae Myung Cha, Jung Won Jeon, Kwang Ro Joo, Hyun Phil Shin, Jae Jun Park, Joung Il Lee, and Jun Uk Lim
- Subjects
medicine.medical_specialty ,Biliary Fistula ,Bilioenteric anastomosis ,Biliary cirrhosis ,Fistula ,Jejunostomy ,Anastomosis ,Fistulotomy ,Occlusion ,Humans ,Medicine ,Cholestasis ,business.industry ,Anastomosis, Roux-en-Y ,Middle Aged ,medicine.disease ,Percutaneous transhepatic cholangioscopy ,Dilatation ,Surgery ,Bile Ducts, Intrahepatic ,Needles ,Balloon dilation ,Female ,Laparoscopy ,Radiology ,business - Abstract
Untreated benign biliary stricture can lead to serious complications including recurrent cholangitis, biliary cirrhosis, hepatic failure, and death. Benign stricture of a postoperative anastomosis site is also a problematic issue after biliary surgery. Percutaneous transhepatic cholangioscopy (PTCS) with balloon dilatation is a recently introduced noninvasive therapeutic option for biliary stricture. Guidewire insertion through the stricture site is essential for the success of PTCS treatment. Recently, we treated a difficult case with complete bilioenteric anastomosis stricture that failed to allow passage of the guidewire for balloon dilation. The stricture was treated with artificial bilioenteric fistula using a needle-knife papillotome during the PTCS.
- Published
- 2014
36. Gastrointestinal endoscopy satisfaction questionnaire is a valid tool to measure patient satisfaction in Asian country
- Author
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Kwang Ro Joo, Hyun Phil Shin, Jung Won Jeon, Min Seob Kwak, Jae Myung Cha, Jin Young Yoon, and Joung Il Lee
- Subjects
Adult ,Male ,medicine.medical_specialty ,Validation study ,Asia ,patient satisfaction ,Observational Study ,translation ,gastrointestinal endoscopy ,Endoscopy, Gastrointestinal ,03 medical and health sciences ,Key quality indicators ,0302 clinical medicine ,Patient satisfaction ,Surveys and Questionnaires ,Republic of Korea ,Asian country ,Humans ,Medicine ,030212 general & internal medicine ,Aged ,Language ,Gastrointestinal endoscopy ,validation ,medicine.diagnostic_test ,business.industry ,Reproducibility of Results ,General Medicine ,Satisfaction questionnaire ,Middle Aged ,Translating ,Endoscopy ,quality ,Family medicine ,Female ,030211 gastroenterology & hepatology ,Observational study ,business ,Research Article - Abstract
Patient satisfaction is a key quality indicator of gastrointestinal endoscopy (GIE). The gastrointestinal endoscopy satisfaction questionnaire (GESQ) was recently developed to assess patient satisfaction undergoing GIE in Europe; however, it was not validated in Asian countries. We aimed to translate and validate the GESQ in Korea and identify predictors for patient satisfaction during GIE. Translation of the original GESQ was performed according to accepted linguistic validation guidelines. Between March 2016 and July 2016, 350 consecutive patients were asked to complete a GESQ after GIE at Kyung Hee University Hospital. Total sum of scores was transformed from 0 to 100 by the formula: (Score-lowest possible/Score range) × 100. Exploratory and confirmatory factor analyses for construct validation reconfirmed that 4 factors were extracted from the Korean GESQ. Internal consistency reliability was acceptable with an overall Cronbach α score of 0.87. Female and nonsmoker were associated with less satisfaction with GIE (P = .021 and .006, respectively). Other factors, including age, alcohol, education or economic level, sedative endoscopy, gastroscopy with or without colonoscopy, experience of previous endoscopy, and additional examinations such as biopsy, were not associated with patient satisfaction during GIE. The Korean version of the GESQ was a valid and acceptable tool to measure satisfaction in patients who had undergone a GIE in Korea. Patient satisfaction measurement could contribute to systematic improvement of qualified GIE.
- Published
- 2018
37. Real-world single-center experience with entecavir and tenofovir disoproxil fumarate in treatment-naïve and experienced patients with chronic hepatitis B
- Author
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Jung Won Jeon, Kwang Ro Joo, Hyun Phil Shin, Joung Il Lee, Jin Young Yoon, Young Min Kim, Min Seob Kwak, and Jae Myung Cha
- Subjects
Adult ,Liver Cirrhosis ,Male ,Hepatitis B virus ,medicine.medical_specialty ,Guanine ,Tenofovir ,efficacy ,Single Center ,Antiviral Agents ,Gastroenterology ,Therapy naive ,03 medical and health sciences ,Hepatitis B, Chronic ,0302 clinical medicine ,Chronic hepatitis ,Internal medicine ,Republic of Korea ,medicine ,Humans ,Hepatitis B e Antigens ,lcsh:RC799-869 ,Complete virological response ,Retrospective Studies ,business.industry ,Incidence ,Incidence (epidemiology) ,Medical record ,Alanine Transaminase ,Entecavir ,Middle Aged ,Hepatitis B ,medicine.disease ,tenofovir ,Treatment Outcome ,030220 oncology & carcinogenesis ,lcsh:Diseases of the digestive system. Gastroenterology ,Female ,Original Article ,030211 gastroenterology & hepatology ,hepatitis B ,business ,entecavir ,medicine.drug - Abstract
Background/Aim: The goal of antiviral therapy for chronic hepatitis B (CHB) is to improve survival of the patients by achieving a complete virological response (CVR). This study aimed to evaluate long-term efficacy of entecavir (ETV) and tenofovir disoproxil fumarate (TDF) in nucleos(t)ide analog (NA)-naïve and NA-experienced Korean patients with CHB and to determine the incidence of cirrhosis-related complications in these patients. Patients and Methods: We retrospectively reviewed medical records of all patients treated with ETV or TDF from July 2007 to January 2017. We examined CVR and analyzed the predictive factors influencing the rate of CVR and evaluated the incidences of cirrhosis-related complications. Results: The proportion of patients who achieved CVR was 94.2% in the ETV group and 91.1% in the TDF group (P = 0.358). Among patients who achieved CVR, the mean time to CVR was 13.5 ± 14.3 months in the ETV group and 11.5 ± 10.6 months in the TDF group (P = 0.169). Positive predictive factors for CVR included the current treatment with TDF, a low hepatitis B virus DNA level, negative hepatitis B e-antigen status, and high alanine aminotransferase level in baseline laboratory test. The annual incidence rate of HCC was 127 per 10,000 patient-years (1.27% per year) in ETV group, and 85 per 10,000 patient-years (0.85% per year) in TDF group (P = 0.526). Conclusion: Both ETV and TDF therapy resulted in a high CVR, and the annual incidence rates of HCC and other cirrhosis-related complications were not significantly different between the two treatment groups.
- Published
- 2018
38. Life-threatening Duodenal Ulcer Bleeding from a Ruptured Gastroduodenal Artery Aneurysm in a Patient with Neurofibromatosis Type 1
- Author
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Sunyong Kim, Joung Il Lee, Jung Won Jeon, Jae Myung Cha, Kyu Sung Im, Jae Jun Park, Kwang Ro Joo, Hyun Phil Shin, and Jun Uk Lim
- Subjects
Adult ,Male ,medicine.medical_specialty ,Neurofibromatosis 1 ,medicine.medical_treatment ,Peptic Ulcer Hemorrhage ,Gastroduodenal artery ,Aneurysm ,Hepatic Artery ,medicine.artery ,Gastroscopy ,medicine ,Humans ,Embolization ,Neurofibromatosis ,Neurofibromatoses ,business.industry ,General Medicine ,Arteries ,medicine.disease ,Embolization, Therapeutic ,Surgery ,Radiography ,Head and Neck Neoplasms ,Hemostasis ,Radiology ,Upper gastrointestinal bleeding ,business - Abstract
Vasculopathy is rarely reported in neurofibromatosis type 1, but when it occurs it primarily involves the aorta and its main branches. Among vasculopathies, aneurysmal dilatation is the most common form. Although several case reports concerning aneurysms or pseudoaneurysms of visceral arteries in neurofibromatosis type 1 patients have been reported, there are no reports describing gastroduodenal artery aneurysms associated with neurofibromatosis type 1. We experienced a case of life-threatening duodenal ulcer bleeding from a ruptured gastroduodenal artery aneurysm associated with neurofibromatosis type 1. We treated our patient by transarterial embolization after initial endoscopic hemostasis. To our knowledge, this is the first reported case of its type. High levels of suspicion and prompt diagnosis are required to select appropriate treatment options for patients with neurofibromatosis type 1 experiencing upper gastrointestinal bleeding. Embolization of the involved arteries should be considered an essential treatment over endoscopic hemostasis alone to achieve complete hemostasis and to prevent rebleeding.
- Published
- 2015
39. Small Bowel Perforation Caused by Press-through Package
- Author
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Jung Won Jeon, Jin Young Yoon, Jung Seok Kim, Min Seob Kwak, Kwang Ro Joo, Jae Myung Cha, Hyun Phil Shin, Hye Young Kim, and Joung Il Lee
- Subjects
Abdominal pain ,medicine.medical_specialty ,Fistula ,Perforation (oil well) ,lcsh:Medicine ,Physical examination ,03 medical and health sciences ,0302 clinical medicine ,Edema ,Medicine ,medicine.diagnostic_test ,business.industry ,lcsh:R ,Small intestine ,General Medicine ,medicine.disease ,Surgery ,Foreign body ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,Intestinal perforation ,medicine.symptom ,business ,Small bowel perforation - Abstract
With an increased use of the press-through package (PTP) tablet, there has also been an increase in mis-swallowing cases, especially in elderly patients. We report a rare case of PTP-induced small bowel perforation and fistula formation with adjacent small bowel in a healthy elderly patient, who experienced persistent abdominal pain of unknown cause. A 62-year-old healthy man was admitted to our hospital with left abdominal pain that started one month ago. Neither abdominal tenderness nor rebound tenderness was present on physical examination. His vital signs and all other test results were within normal limits. However, a 2.5 cm curved radiopaque material within his thickened small intestine was incidentally detected on an abdominal computed tomography. He underwent laparoscopic small bowel resection, which revealed foreign body in the distal small intestine. Edema, perforation, and adhesions with the surrounding tissues were also noticed in the distal small intestine. Foreign body was turned out to be PTP, and this was considered to be responsible for the small bowel perforation and fistula formation. Precautions regarding PTP usage are necessary to prevent inadvertent PTP ingestion and its related complications, such as perforation, especially in the elderly population.
- Published
- 2017
40. High C-reactive protein level is associated with high-risk adenoma
- Author
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Joung Il Lee, Hyae Min Lee, Jung Won Jeon, Jung Lok Lee, Jae Myung Cha, Kwang Ro Joo, Hyun Phil Shin, and Jin Young Yoon
- Subjects
medicine.medical_specialty ,Adenoma ,Colon ,lcsh:Medicine ,Colorectal adenoma ,Asymptomatic ,Gastroenterology ,C-reactive protein ,03 medical and health sciences ,0302 clinical medicine ,Neoplasms ,Internal medicine ,medicine ,lcsh:RC799-869 ,Risk factor ,Inflammation ,biology ,business.industry ,lcsh:R ,Colonoscopy ,Odds ratio ,medicine.disease ,Confidence interval ,Quartile ,030220 oncology & carcinogenesis ,biology.protein ,lcsh:Diseases of the digestive system. Gastroenterology ,Original Article ,030211 gastroenterology & hepatology ,medicine.symptom ,business - Abstract
Background/Aims: There is substantial evidence supporting a role of inflammation in the pathogenesis of colorectal cancer; however, little is known about the association between serum C-reactive protein (CRP) and the risk of colorectal adenoma. This study was conducted to investigate the association between serum CRP and colorectal adenoma risk.Methods: A retrospective cross-sectional study was performed on first-time screening colonoscopies in asymptomatic subjects who also had their serum CRP level measured during a routine health check-up between September 2006 and September 2009 in Korea. Serum CRP level was compared between high-risk and low-risk adenoma groups and independent predictors of high-risk adenoma were analyzed using multivariate regression analysis.Results: Among the 3,309 eligible patients, the high-risk adenoma group had higher serum CRP levels than the low-risk adenoma group (P=0.000). In addition, patients with a high-risk adenoma were more frequently included in the high CRP group than in the low CRP group (8.6% vs. 4.0%, P
- Published
- 2017
41. Determining the optimal surveillance interval after a colonoscopic polypectomy for the Korean population?
- Author
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Jung Won Jeon, Joung Il Lee, Kwang Ro Joo, Min Seob Kwak, Hyun Phil Shin, Dong Il Park, Jin Young Yoon, Jae Myung Cha, Jung Lok Lee, and Hyemin Lee
- Subjects
medicine.medical_specialty ,Multivariate analysis ,Adenoma ,medicine.medical_treatment ,lcsh:Medicine ,Colonoscopy ,Guideline ,Colorectal neoplasms ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Colonoscopic Polypectomy ,lcsh:RC799-869 ,Surveillance ,medicine.diagnostic_test ,business.industry ,Korean population ,lcsh:R ,Gastroenterology ,medicine.disease ,Polypectomy ,030220 oncology & carcinogenesis ,lcsh:Diseases of the digestive system. Gastroenterology ,Original Article ,030211 gastroenterology & hepatology ,business ,Index Colonoscopy - Abstract
Background/Aims: Western surveillance strategies cannot be directly adapted to the Korean population. The aim of this study was to estimate the risk of metachronous neoplasia and the optimal surveillance interval in the Korean population.Methods: Clinical and pathological data from index colonoscopy performed between June 2006 and July 2008 and who had surveillance colonoscopies up to May 2015 were compared between low- and high-risk adenoma (LRA and HRA) groups. The 3- and 5-year cumulative risk of metachronous colorectal neoplasia in both groups were compared.Results: Among 895 eligible patients, surveillance colonoscopy was performed in 399 (44.6%). Most (83.3%) patients with LRA had a surveillance colonoscopy within 5 years and 70.2% of patients with HRA had a surveillance colonoscopy within 3 years. The cumulative risk of metachronous advanced adenoma was 3.2% within 5 years in the LRA group and only 1.7% within 3 years in the HRA group. The risk of metachronous neoplasia was similar between the surveillance interval of
- Published
- 2017
42. Osteoporosis is associated with the risk of colorectal adenoma in women
- Author
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Jae Jun Park, Kwang Ro Joo, Hyun Phil Shin, Jung Won Jeon, Joung Il Lee, Jae Myung Cha, and Jun Uk Lim
- Subjects
Oncology ,Adenoma ,Male ,medicine.medical_specialty ,Colorectal cancer ,Osteoporosis ,Colorectal adenoma ,Bone Density ,Risk Factors ,Internal medicine ,Medicine ,Humans ,Risk factor ,Family history ,Aged ,Retrospective Studies ,Bone mineral ,Univariate analysis ,business.industry ,Rectal Neoplasms ,Gastroenterology ,General Medicine ,Middle Aged ,medicine.disease ,Menopause ,Cross-Sectional Studies ,Colonic Neoplasms ,Multivariate Analysis ,Female ,business - Abstract
BACKGROUND: Recently, it was reported that postmenopausal women with lower bone mineral density have an increased risk of colorectal cancer. An association between lower bone mineral density and colorectal cancer suggests that colorectal adenoma, which is a precursor of colorectal cancer, may also be associated with lower bone mineral density. OBJECTIVE: The aim of this study was to determine the association between colorectal adenoma and osteoporosis. DESIGN AND PATIENTS: We conducted a retrospective cross-sectional study between January 2007 and May 2011. Women older than 50 years of age who underwent dual-energy x-ray absorptiometry for bone mineral density and screening colonoscopy at Gangdong Kyung Hee University Hospital in Korea during a routine health checkup were eligible for this study. We performed multivariate analysis adjusted for age, family history of colorectal cancer, alcohol consumption, current smoking, regular aspirin use, exercise, menopause, and postmenopausal hormone use to identify independent predictors for the presence of colorectal adenoma. MAIN OUTCOME MEASURES: The primary outcome measured was the prevalence of colorectal adenoma according to the bone mineral density level. RESULTS: A total of 992 women older than 50 years were assigned to an osteoporosis group (n = 231) or a control group (n = 231) after menopause matching. In univariate analysis, the proportion of colorectal adenoma was significantly higher in the osteoporosis group than in the control group (29.9% vs 20.8%, p = 0.025). Furthermore, osteoporosis (OR = 1.592, 95% CI = 1.004–2.524, p = 0.048) was found to be an independent risk factor for the presence of colorectal adenoma. CONCLUSIONS: Osteoporosis is associated with an increased risk of colorectal adenoma in women older than 50 years.
- Published
- 2013
43. Successful en bloc resection of an esophageal hemangioma by combined EBL & EMR: a case report and technical review
- Author
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Jung Won Jeon, Kyu Yeoun Won, Il Hyun Baek, Kwang Ro Joo, Joung Il Lee, Hyun Phil Shin, Kyeong Won Min, and Jae Myung Cha
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,Case Report ,Endoscopic mucosal resection ,Hemangioma ,03 medical and health sciences ,0302 clinical medicine ,Sclerotherapy ,medicine ,cardiovascular diseases ,030212 general & internal medicine ,Hepatology ,medicine.diagnostic_test ,business.industry ,Gastroenterology ,En bloc resection ,medicine.disease ,eye diseases ,Surgery ,Endoscopy ,body regions ,Esophagectomy ,030220 oncology & carcinogenesis ,sense organs ,Esophageal Hemangioma ,Ligation ,business - Abstract
A 58-year-old male was diagnosed esophageal hemangioma during a endoscopy in regular examination. The patient was referred to the department of gastroenterology in our hospital to treatment. Combined endoscopic band ligation (EBL) and endoscopic mucosal resection (EMR) was performed for diagnostic treatment. Histopathological results revealed hemangioma. Even though several approaches such as esophagectomy, endoscopic removal, sclerotherapy, and laser therapy have been used to remove the esophageal hemangiomas, recently less invasive methods were preferred. Here we describe a case of esophageal hemangioma removed by EBL & EMR.
- Published
- 2016
44. The box simulator is useful for training novice endoscopists in basic endoscopic techniques
- Author
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Jung Won Jeon, Kwang Ro Joo, Jae Jun Park, Hyun Phil Shin, Jun Uk Lim, Kyuseong Lym, Joung Il Lee, and Jae Myung Cha
- Subjects
simulator ,training ,Gastroenterology & Hepatology ,business.industry ,Training course ,Endoscopy ,General Medicine ,Endoscopy, Gastrointestinal ,Education ,Surveys and Questionnaires ,Medicine ,Humans ,Computer Simulation ,Original Article ,business ,First impression (psychology) ,Simulation ,Gastrointestinal endoscopy - Abstract
Purpose The present study was aimed at evaluating the usefulness of box simulators for training novice endoscopists. Materials and methods An explanation of the goals, contents, and features of the simulator was given to study participants. The participants then received "hands-on training" in gastrointestinal endoscopy techniques using a box simulator. Subsequently, they were asked to answer 19 structured questions about the simulator. Ratings were scored on a scale from 1 to 5 for questions concerning their first impression of the simulator. Questions on the usefulness of the simulator and the training course were answered as "agree", "disagree", or "no opinion". Results A total of 32 participants filled out the questionnaire. The mean scores on the simulator's usefulness, features, and realistic movements before the training were between 1.5 and 2.0. There were no significant differences between the mean values of the scores given by novice users compared to non-novice users. However, after receiving training on the simulator, 90.6% of the participants considered the box simulator a generally useful tool for learning basic endoscopic techniques, and 90.6% agreed that the simulator was useful for improving hand-eye coordination. Conclusion Box simulators may be useful for training novice endoscopists in basic gastrointestinal endoscopic techniques.
- Published
- 2012
45. The risk of postpolypectomy bleeding during colonoscopy in patients with early liver cirrhosis
- Author
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Joung Il Lee, Jung Won Jeon, Jae Jun Park, Kyuseong Lim, Kwang Ro Joo, Hyun Phil Shin, Jun Uk Lim, Kwan Mi Pack, and Jae Myung Cha
- Subjects
Liver Cirrhosis ,Male ,medicine.medical_specialty ,Cirrhosis ,medicine.medical_treatment ,Blood Loss, Surgical ,Colonoscopy ,Colonic Polyps ,Single Center ,Gastroenterology ,Risk Factors ,Internal medicine ,medicine ,Colonoscopic Polypectomy ,Humans ,Intraoperative Complications ,Retrospective Studies ,Prothrombin time ,medicine.diagnostic_test ,business.industry ,General surgery ,Retrospective cohort study ,Middle Aged ,medicine.disease ,digestive system diseases ,Polypectomy ,Surgery ,Female ,business ,Abdominal surgery - Abstract
Colonoscopists are often hesitant to perform endoscopic polypectomy in patients with liver cirrhosis (LC) because of the risk for postpolypectomy bleeding (PPB). However, little is known about the risk of PPB in these patients. We performed a retrospective study of patients with early LC who underwent colonoscopic polypectomy at a single center between September 2006 and May 2011. We investigated the incidence of immediate PPB (IPPB) and delayed PPB (DPPB) in these patients. In addition, we investigated which LC-related and polyp-related factors were associated with IPPB. Thirty patients with LC were included in our study, and 29 (96.7 %) of them were classified in Child-Pugh class A or B. The mean prothrombin time was 1.27 ± 0.23, and the mean platelet count was 136.77 ± 106.49 × 103/L. A total of 66 polyps in 30 patients were removed. In terms of IPPB, only 2 (3.03 %) of the 66 removed polyps presented with mild oozing and were controlled by hemostatic procedures using hemoclips. DPPB did not occur in any of the patients in the IPPB or the non-IPPB group. Although the IPPB polyp group was too small to detect statistical significance, the IPPB polyps were larger than the non-IPPB polyps (22.5 ± 10.61 vs. 7.22 ± 3.01 mm), and the gross morphology of both IPPB polyps was the pedunculated type. However, LC-related variables such as platelet counts and Child-Pugh scores did not significantly differ between the IPPB and non-IPPB groups. In patients with early LC, the risk of postpolypectomy bleeding was acceptably low and there was no case with DPPB. Therefore, polypectomy can be performed with caution. IPPB was associated with the size and the gross morphology of the polyps. However, LC-related variables in patients with early LC did not impact IPPB.
- Published
- 2011
46. A novel animal model for studying pancreatic regeneration by employing photochemical reaction
- Author
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Shengjun Han, Youngbuhm Huh, Kwang Ro Joo, Hyun Phil Shin, Jae Myung Cha, Jun Uk Lim, Jung Won Jeon, and Jae Jun Park
- Subjects
Male ,Pathology ,medicine.medical_specialty ,Necrosis ,Photochemistry ,Endocrinology, Diabetes and Metabolism ,Femoral vein ,Lesion ,Rats, Sprague-Dawley ,chemistry.chemical_compound ,medicine ,Rose bengal ,Animals ,Regeneration ,Pancreas ,Rose Bengal ,Hepatology ,business.industry ,Regeneration (biology) ,Mesenchymal stem cell ,Gastroenterology ,Pancreatic Diseases ,Staining ,Rats ,medicine.anatomical_structure ,chemistry ,Bromodeoxyuridine ,Models, Animal ,medicine.symptom ,business - Abstract
Purpose We present photochemical-induced pancreatic necrosis (PIPN) as a novel induction method for studying pancreatic regeneration in an animal model. Methods Photosensitive Rose Bengal was injected through the femoral vein in rats, followed by illumination of the surface of the pancreas with a cool halogen light for a period of 20 min. At 3, 6, and 24 h, and 7, 10, 14, and 20 days, experimental animals were sacrificed; all the animals received intravenous injection with 5-bromo-2-deoxyuridine (BrdU) 1 h prior to sacrifice. Results At 3–6 h of induction of PIPN, pancreatic necrosis was superficially observed in the illuminated field. At 24 h, there was a slight increase in the depth and width of the lesion along with appearance of vascular congestion and thrombosis in the lesion. On days 7–10, the area of illumination was totally replaced by necrotic pancreatic tissue, inflammatory cell infiltrates, and newly appearing cellular components, including mesenchymal and epithelial cells, which formed tubular complexes. On day 14, clusters of tubular complexes intermingled with acinar cells, which were proven as newly formed acinar tissue by BrdU staining. On day 20, all the lesions had returned to a normal state of pancreatic tissue. Conclusion This study demonstrates the potential of PIPN as a valuable method for production of an animal model for studying healing processes or regeneration of pancreatic tissue after injury.
- Published
- 2011
47. Early use of needle-knife fistulotomy is safe in situations where difficult biliary cannulation is expected
- Author
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Jung Won Jeon, Jun Uk Lim, Joung Il Lee, Jae Jun Park, Sun-Hyung Joo, Bum-Soo Kim, Kwang Ro Joo, Hyun Phil Shin, and Jae Myung Cha
- Subjects
Male ,medicine.medical_specialty ,Physiology ,Biliary Tract Diseases ,Perforation (oil well) ,Blood Loss, Surgical ,Fistulotomy ,Catheterization ,Sphincterotomy, Endoscopic ,Internal medicine ,medicine ,Humans ,Needle knife ,Cholangiopancreatography, Endoscopic Retrograde ,Rupture ,Endoscopic retrograde cholangiopancreatography ,medicine.diagnostic_test ,business.industry ,General surgery ,Gastroenterology ,Pancreatic Ducts ,Hepatology ,Middle Aged ,medicine.disease ,Surgical Instruments ,Surgery ,Catheter ,Outcome and Process Assessment, Health Care ,Pancreatitis ,Acute pancreatitis ,Female ,business - Abstract
Difficult cannulation is a well known risk for post-ERCP pancreatitis. This study evaluated the outcomes of needle-knife fistulotomy (NKF) used prior to being faced with difficult biliary cannulation. Patients who underwent endoscopic retrograde cholangiopancreatography (ERCP) for the purpose of biliary endotherapy between January 2007 and December 2008 were eligible for this study; 218 patients were recruited. Biliary cannulation was performed only by a standard catheter or a pull type papillotome, without wire-guided assistance in all patients. If selective cannulation was not achieved within five cannulation attempts, NKF was performed, and the results were compared with the easy cannulation group that succeeded biliary cannulation within five attempts. Needle-knife fistulotomy (NKF) was performed in 72 (33.0%) of the 218 patients. The total success rate of the ERCP was 98.2% (214/218), and for the NKF group the success rate was 94.4% (68/72). The rate of complications in patients with NKF did not increase compared to patients in the easy cannulation group (P > 0.05): 4.2% (3/72) versus 3.4% (5/146) for acute pancreatitis, 6.9% (5/72) versus 6.8% (10/146) for bleeding, and 1.4% (1/72) versus 0% (0/146) for perforation, respectively. Our results suggest that the use of NKF for biliary cannulation might be safe and effective. Therefore, in experienced hands, early use of NKF might be recommended.
- Published
- 2011
48. A Case of Cavernous Lymphangioma of the Small Bowel Mesentery
- Author
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Jung Won Jeon, Il Hyun Baek, Joung Il Lee, Jae Myung Cha, Kwang Ro Joo, Jun Uk Lim, Hyun Phil Shin, and In Taik Hong
- Subjects
Pathology ,medicine.medical_specialty ,Liposarcoma ,Benign tumor ,Peritoneal Neoplasm ,Cavernous lymphangioma ,Intestine, Small ,Lymphangioma ,medicine ,Humans ,Mesentery ,Laparoscopy ,Peritoneal Neoplasms ,medicine.diagnostic_test ,business.industry ,General Medicine ,Middle Aged ,medicine.disease ,body regions ,Lymphatic system ,medicine.anatomical_structure ,Female ,Tomography, X-Ray Computed ,business - Abstract
Lymphangioma is a benign vascular lesion with characteristics of subepithelial tumor which can proliferate in the lymphatic system. Lymphangioma of the small-bowel mesentery is rare, having been reported in less than 2% of all lymphangiomas. Lymphangioma does not require any specific treatment because it is absolutely a benign tumor. However, surgical exploration is rarely required for cases with disease-related symptoms or complications, or for those misdiagnosed as a malignant lesion. We recently experienced a case of mesenteric cavernous lymphangomas in a 53-year-old female who was misdiagnosed as having a liposarcoma. The final diagnosis was confirmed by a pathologic examination of the specimen that was obtained via laparoscopic exploration. Herein, we report a very rare case of mesenteric cavernous lymphangioma along with a brief review of relevant literature.
- Published
- 2015
49. A Patient with Duodenal Mucinous Adenocarcinoma Presenting as a Laterally Spreading Tumor
- Author
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Jung Won Jeon, Il Hyun Baek, Kwang Ro Joo, Joung Il Lee, Hyun Phil Shin, Myung Joon Chae, Jun Uk Lim, and Yu Mi Oh
- Subjects
Adenoma ,Pathology ,medicine.medical_specialty ,business.industry ,Duodenal neoplasms ,Gastroenterology ,Medicine (miscellaneous) ,Case Report ,Adenocarcinoma ,medicine.disease ,Asymptomatic ,Lesion ,medicine.anatomical_structure ,Tubular adenoma ,Duodenum ,Medicine ,Duodenal Carcinoma ,Mucinous ,Radiology, Nuclear Medicine and imaging ,medicine.symptom ,business ,Duodenal Neoplasm - Abstract
Primary duodenal carcinoma is rare. Duodenal mucinous adenocarcinoma (DMA) is even rarer, and its associated manifestations and typical endoscopic or imaging findings are not well characterized. Herein, we report a case of primary DMA in an asymptomatic 58-year-old man who visited our hospital for a regular health screening. Upper endoscopy revealed an approximately 4-cm lesion in the second portion of the duodenum, but the mass was not visualized on computed tomography. Biopsies revealed a tubular adenoma that was subsequently resected. Frozen biopsies demonstrated DMA with a background of low-grade tubular adenoma for which we performed Roux-en-Y duodenojejunostomy and jejunojejunostomy. To our knowledge, this is the first report of a patient with DMA in Korea.
- Published
- 2015
50. Mo1569 Prediabetes Is Associated With Increased Risk of Aggressive Colorectal Adenoma
- Author
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Kwang Ro Joo, Hyun Phil Shin, Jun Uk Lim, Jung Won Jeon, Jae Myung Cha, and Joung Il Lee
- Subjects
medicine.medical_specialty ,Increased risk ,business.industry ,Internal medicine ,Gastroenterology ,Medicine ,Radiology, Nuclear Medicine and imaging ,Colorectal adenoma ,Prediabetes ,business ,medicine.disease - Published
- 2013
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