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Digestive and Liver Disease 11/2012; · 3.05 Impact Factor
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Hyuk Soon Choi,
Kyoung-Oh Kim,
Hoon Jai Chun,
Bora Keum,
Yeon Seok Seo,
Yong Sik Kim,
Yoon-Tae Jeen,
Soon Ho Um,
Hong Sik Lee,
Chang Duck Kim,
Ho Sang Ryu
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ABSTRACT: Epigastric pain management following endoscopic submucosal dissection is an important consideration. This study aimed to investigate the utility and safety of fentanyl patches for pain relief after the procedure.
Patients who were scheduled to undergo endoscopic submucosal dissection were prospectively randomised to either a transdermal fentanyl patch group or a placebo control group. An additional pethidine was intravenously administered when pain developed and a numerical rating scale was used to evaluate both pre- and post-procedural pain.
One hundred and ten patients were randomly assigned to receive either a 12mcg/h fentanyl patch or a control patch on the night before the procedure. The fentanyl patch group had significantly lower pain scores immediately following the procedure (mean, 5.17 vs. 4.26, p=0.030). Maximal pain scores during the first 24h (5.43 vs. 4.46, p=0.038) and pain scores on the day after the procedure (2.98 vs. 1.20, p<0.001) were also lower in the fentanyl patch group. In addition, the fentanyl patch group required a significantly lower dose of pethidine for pain management (24.54 vs. 11.25, p=0.004).
The application of a transdermal fentanyl patch is an effective, convenient, and safe method to control epigastric pain after endoscopic submucosal dissection.
Digestive and Liver Disease 07/2012; 44(11):925-9. · 3.05 Impact Factor
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Gastrointestinal endoscopy 07/2012; 76(1):225-6; author reply 226. · 6.71 Impact Factor
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Hyuk Soon Choi,
Hoon Jai Chun,
Sang Hoon Park,
Bora Keum,
Yeon Seok Seo,
Yong Sik Kim,
Yoon-Tae Jeen,
Soon Ho Um,
Hong Sik Lee,
Chang Duck Kim,
Ho Sang Ryu
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ABSTRACT: To compare the effectiveness of sequential therapy for Helicobacter pylori (H. pylori) infection with that of triple therapy of varying durations.
The 460 patients enrolled in this study had H. pylori-associated gastritis or a gastric or duodenal ulcer. After screening, H. pylori-infected patients were randomly assigned to receive either conventional triple therapy for 7, 10 or 14 d, or a new 10-d sequential therapy. Each of the 4 treatment groups included 115 patients. The outcomes of eradication therapy were assessed 4 wk after treatment by the urea breath test and histology.
The overall eradication rate was 81.0%, and eradication rates were 75.7% for 7-d conventional triple therapy, 81.9% for 10-d conventional triple therapy, 84.4% for 14-d conventional triple therapy, and 82.0% for 10-d sequential therapy. Neither intention-to-treat analysis nor per protocol analysis showed significant differences in eradication rates using sequential therapy or the standard triple therapy (P = 0.416 and P = 0.405, respectively).
There are no significant differences between 10-d sequential eradication therapy for H. pylori and any duration of standard triple treatment in Korean patients.
World Journal of Gastroenterology 05/2012; 18(19):2377-82. · 2.47 Impact Factor
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Dong Jin Kim,
Hyun Seok Kang, Hyuk Soon Choi,
Hye Jin Cho,
Eun Sun Kim,
Bora Keum,
Hyonggin An,
Ji Hoon Kim,
Yeon Seok Seo,
Yong Sik Kim,
Hyung Joon Yim,
Yoon Tae Jeen,
Hong Sik Lee,
Soon Ho Um,
Chang Duck Kim,
Ho Sang Ryu
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ABSTRACT: Several studies suggested that serum cystatin C (CysC) is more useful than serum creatinine (Cr) for the assessment of renal function in patients with liver cirrhosis. This study evaluated the clinical significance of CysC in patients with cirrhotic ascites and normal Cr level.
We enrolled patients with cirrhotic ascites and a normal serum Cr level (<1.2 mg/dL). GFR was measured by (99m)Tc-DTPA renal scan. Serum Cr, CysC, and Cr clearance (CCr) were measured on the same day. Significant renal impairment and severe renal impairment were defined as GFR <60 mL/min and GFR <30 mL/min, respectively.
Eighty-nine patients with cirrhotic ascites were enrolled in the study (63 men and 26 women; age, 55±11 years). Forty-seven (52.8%) and 42 (47.2%) patients were in Child-Pugh grade B and C, respectively. Serum Cr and CysC levels and GFR were 0.8±0.2 mg/dL, 1.1±0.3 mg/L, and 73.4±25.5 mL/min, respectively. Significant and severe renal impairment were noted in 28 (31.5%) and 2 (2.2%) patients, respectively. GFR was well correlated with serum Cr, CysC, and e-GFR(MDRD), while it was not correlated with e-GFR(C&G). In multivariate analysis, only CysC was significantly correlated with GFR (β, 45.620; 95% CI, 23.042-68.198; P<0.001). Serum CysC level was the only independent predictor for significant renal impairment.
Significant renal dysfunction was not rare in patients with cirrhotic ascites, even their serum Cr level is normal. Serum CysC is a useful marker for detecting significant renal dysfunction in these patients.
The Korean Journal of Hepatology 06/2011; 17(2):130-8.
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ABSTRACT: Herbs are widely used as treatments for various symptoms. However, several herbs have been reported to be inducers of liver injury. We report herein a case of hepatotoxicity induced by Corydalis speciosa Max. A 37-year-old male complained of jaundice and mild abdominal discomfort. A thorough history was taken, and laboratory investigation, diagnostic imaging studies, and percutaneous liver biopsy sampling were conducted to determine the cause of liver injury. An accurate cause was not revealed. We administered supportive management for acute cholestatic hepatitis of unknown origin, after which his symptoms disappeared and serum aminotransferase levels decreased gradually to near normal levels. However, at 2 months after discharge, the symptoms and the elevation of aminotransferase levels recurred. At that time he told us that he had repeatedly but unintentionally eaten a herb called "Hwang-geun cho"(Corydalis speciosa Max.). Thus, we diagnosed his case as herbal hepatotoxicity.
The Korean Journal of Hepatology 12/2009; 15(4):517-23.
