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ABSTRACT: Thrombophlebitis of the portal venous system (PVS) with superimposed bacterial infection (septic pylephlebitis) is an extremely rare complication of Crohn's disease (CD), and therefore diagnosis of septic pylephlebitis is difficult without high clinical suspicion. A 16-year old male patient who was diagnosed with CD 3 months earlier was admitted with recurrent fever and abdominal pain. CD activity had been well controlled with conventional medical treatment during a follow-up period. Abdominal contrast-enhanced computed tomography showed massive thrombosis in the PVS without evidence of intra-abdominal infection, and blood cultures were positive for Streptococcus viridians. There was no evidence of deep vein thrombosis or pulmonary thromboembolism, and all laboratory tests for thrombophilia were normal. Based on these findings, the patient was diagnosed with septic pylephlebitis complicated with CD, and was successfully treated with intravenous antibiotic therapy combined with anticoagulation. This case suggests that early comprehensive evaluation is crucial for immediate diagnosis and proper treatment of septic pylephlebitis in patients with CD who present with fever and abdominal pain of unknown origin, even with stable disease activity and absence of other intra-abdominal infections. (Korean J Gastroenterol 2013;61:219-224).
The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi 04/2013; 61(4):219-24.
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ABSTRACT: BACKGROUND/AIM: As the prevalence of reflux esophagitis increases, so does the use of gastric acid suppressants. This study aimed to document the prevalence of Candida esophagitis (CE) at a single Korean university hospital over the last 5 years and to evaluate its risk factors. METHODS: To investigate the prevalence of CE, we conducted a retrospective analysis of 55,314 individuals who underwent a screening esophagogastroduodenoscopy as part of a health check-up between January 2006 and December 2010 at Kyung Hee University Hospital in Seoul, Korea. A total of 250 patients who were treated for CE between January 2008 and August 2011 and 500 age- and sex-matched non-CE patients were enrolled in this study. The rates of recent gastric acid suppression therapy and other well-known risk factors in the two groups were compared. RESULTS: The prevalence of CE was 0.35 % and increased each year (linear-by-linear association, P = 0.001). Univariate analysis showed that gastric acid suppression therapy, malignancy, DM and steroid therapy were related to CE. Multivariate analysis also showed that gastric acid suppression therapy (OR 5.11, 95 % CI 2.92-8.93 and P < 0.001), malignancy (OR 18.68, 95 % CI 6.37-54.75 and P < 0.001), DM (OR 2.67, 95 % CI 1.70-4.21 and P < 0.001) and steroids therapy (OR 6.74, 95 % CI 1.37-33.05 and P = 0.019) were related to CE. CONCLUSIONS: The prevalence of CE in Korea is increasing. Also, our results indicate that acid suppression therapy is a meaningful risk factor for CE.
Digestive Diseases and Sciences 01/2013; · 2.12 Impact Factor
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ABSTRACT: BACKGROUND AND AIM: Common endoscopic findings in stomachs with Helicobacter pylori infections include antral nodularity, thickened gastric folds, and visible submucosal vessels. These findings are suggestive but not diagnostic of H. pylori infection. Magnifying endoscopy can reveal more precisely the abnormal mucosal patterns in an H. pylori-infected stomach; however, it requires more training, expertise and time. We aimed to establish a new classification for predicting H. pylori-infected stomachs by non-magnifying standard endoscopy alone. METHODS: A total of 617 participants were underwent gastroscopy were prospectively enrolled from August 2011 to January 2012. We performed a careful close-up examination of the corpus at the greater curvature maintaining a distance ≤ 10 mm between the endoscope tip and the mucosal surface. We classified gastric mucosal patterns into four categories: normal regular arrangement of collecting venules (RAC; numerous minute red dots), mosaic-like appearance (type A; swollen areae gastricae or snake skin appearance), diffuse homogenous redness (type B), and untypical pattern (type C; irregular redness with groove) to predict H. pylori infection status. RESULTS: The frequencies of H. pylori infection in patients with a normal RAC pattern and types A, B, C patterns were 9.4%, 87.7%, 98.1%, and 90.9%, respectively. The sensitivity, specificity, and positive and negative predictive values of all abnormal patterns for prediction of H. pylori infection were 93.3%, 89.1%, 92.3%, and 90.6%, respectively. The overall accuracy was 91.6%. CONCLUSIONS: Careful close-up observation of the gastric mucosal pattern with standard endoscopy can predict H. pylori infection status.
Journal of Gastroenterology and Hepatology 11/2012; · 2.87 Impact Factor
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Seong-Eun Kim,
Sung Pil Hong,
Hyun-Soo Kim,
Bo In Lee,
Se Hyung Kim,
Sung Noh Hong,
Dong-Hoon Yang,
Suck Ho Lee,
Sung Jae Shin,
Dong Il Park,
Young-Ho Kim,
Suk-Kyun Yang, Hyo Jong Kim
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ABSTRACT: There is a paucity of national guideline for colorectal cancer screening and polyp diagnosis in Korea. Thus, we investigated the present state of colorectal cancer screening and polyp diagnosis methods using web-based survey to use as reference data for developing a guideline.
A multiple choice questionnaires of screening recommendations was sent via e-mail to members of the Korean Association for the Study of Intestinal Diseases and primary care physicians who participated in the national colonoscopy surveillance program. Among 425 colonoscopists, a total 263 colonoscopists replied (response rate, 61.9%).
The most commonly recommended starting age for colorectal cancer screening and polyp diagnosis was 50 years old in the average risk group, and 40 years old in groups who had a family history of colon cancer (64.3% and 65.0% respectively). Surgeons had a tendency to recommend screening in younger people than internist do. Ninety-eight percent of physicians recommended screening colonoscopy to asymptomatic, average-risk patients as a first choice. Only 2% of physicians chose sigmoidoscopy as a screening tool. When the initial colonoscopy showed a negative finding, over 60% of internists repeated the exam 5 years later, whereas 62% of surgeons did so within 3 years.
The starting age of colorectal cancer screening and the interval of the colorectal polyp examination are not uniform in various medical environments, and there is a discrepancy between the practical recommendations and western guidelines. Thus, a new evidence-based national practice guideline for colorectal cancer screening and polyp diagnosis should be developed.
The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi 07/2012; 60(1):26-35.
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Tae-Kyu Ha,
Nam-Gu Her,
Min-Goo Lee,
Byung-Kyu Ryu,
Jin-Hee Lee,
Jikhyon Han,
Seong-In Jeong,
Min-Ju Kang,
Nam-Hoon Kim, Hyo-Jong Kim,
Sung-Gil Chi
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ABSTRACT: Caveolin-1 (CAV1) acts as a growth suppressor in various human malignancies, but its expression is elevated in many advanced cancers, suggesting the oncogenic switch of its role during tumor progression. To understand the molecular basis for the growth-promoting function of CAV1, we characterized its expression status, differential roles for tumor growth, and effect on glucose metabolism in colorectal cancers. Abnormal elevation of CAV1 was detected in a substantial fraction of primary tumors and cell lines and tightly correlated with promoter CpG sites hypomethylation. Depletion of elevated CAV1 led to AMPK activation followed by a p53-dependent G1 cell-cycle arrest and autophagy, suggesting that elevated CAV1 may contribute to ATP generation. Furthermore, CAV1 depletion downregulated glucose uptake, lactate accumulation, and intracellular ATP level, supporting that aerobic glycolysis is enhanced by CAV1. Consistently, CAV1 was shown to stimulate GLUT3 transcription via an HMGA1-binding site within the GLUT3 promoter. HMGA1 was found to interact with and activate the GLUT3 promoter and CAV1 increased the HMGA1 activity by enhancing its nuclear localization. Ectopic expression of HMGA1 increased glucose uptake, whereas its knockdown caused AMPK activation. In addition, GLUT3 expression was strongly induced by cotransfection of CAV1 and HMGA1, and its overexpression was observed predominantly in tumors harboring high levels of CAV1 and HMGA1. Together, these data show that elevated CAV1 upregulates glucose uptake and ATP production through HMGA1-mediated GLUT3 transcription, suggesting that CAV1 may render tumor cells growth advantages by enhancing aerobic glycolysis.
Cancer Research 06/2012; 72(16):4097-109. · 7.86 Impact Factor
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ABSTRACT: Among malignant tumors of the stomach, adenocarcinoma takes up about 95% and the remaining are mostly lymphomas, being less than 5%. The majority of lymphomas are B cell lymphomas, and the most common types are low-grade B cell lymphoma of mucosa-associated lymphoid tissue and diffuse large B cell lymphoma (DLBL). The synchronous occurrence of adenocarcinoma and lymphoma in the stomach is being reported rarely. Especially the concurrence of adenocarcinoma and DLBL is very scarce and less than 10 cases have been reported inside and outside this country. In the past, the general treatment for cases of concurrence of adenocarcinoma and DLBL when surgery is possible according to cancer stages was gastrectomy, followed by single or combined chemotherapy and radiation treatment. However, when considering that most cases of concurrent adenocarcinoma were early gastric cancer which is limited to the mucosa, endoscopic submucosal dissection (ESD) can become an alternative treatment method for gastrectomy. We report the experience with chemotherapy and ESD done together instead of surgery, in patients concurrently diagnosed with early gastric cancer and gastric lymphoma.
The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi 05/2012; 59(5):377-81.
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Dong-Hoon Yang,
Sung Noh Hong,
Young-Ho Kim,
Sung Pil Hong,
Sung Jae Shin,
Seong-Eun Kim,
Bo In Lee,
Suck-Ho Lee,
Dong Il Park,
Hyun-Soo Kim,
Suk-Kyun Yang, Hyo Jong Kim,
Se Hyung Kim,
Hyun Jung Kim
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ABSTRACT: Postpolypectomy surveillance has become a major indication for colonoscopy as a result of increased use of screening colonoscopy in Korea. In this report, a careful analytic approach was used to address all available evidences to delineate the predictors for advanced neoplasia at surveillance colonoscopy and we elucidated the high risk findings of the index colonoscopy as follows: 3 or more adenomas, any adenoma larger than 10 mm, any tubulovillous or villous adenoma, any adenoma with high-grade dysplasia, and any serrated polyps larger than 10 mm. Surveillance colonoscopy should be performed five years after the index colonoscopy for those without any high-risk findings and three years after the index colonoscopy for those with one or more high risk findings. However, the surveillance interval can be shortened considering the quality of the index colonoscopy, the completeness of polypectomy, the patient's general condition, and family and medical history.
Clinical endoscopy. 03/2012; 45(1):44-61.
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Suck-Ho Lee,
Sung Jae Shin,
Dong Il Park,
Seong-Eun Kim,
Hae Jeong Jeon,
Se Hyung Kim,
Sung Pil Hong,
Sung Noh Hong,
Dong-Hoon Yang,
Bo In Lee,
Young-Ho Kim,
Hyun-Soo Kim,
Hyun Jung Kim,
Suk-Kyun Yang, Hyo Jong Kim
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ABSTRACT: There is indirect evidence to suggest that 80% of colorectal cancers (CRC) develop from adenomatous polyps and that, on average, it takes 10 years for a small polyp to transform into invasive CRC. In multiple cohort studies, colonoscopic polypectomy has been shown to significantly reduce the expected incidence of CRC by 76% to 90%. Colonoscopic polypectomy is performed frequently in primary outpatient clinics and secondary and tertiary medical centers in Korea. However, there are no evidence-based, procedural guidelines for the appropriate performance of this procedure, including the technical aspects. For the guideline presented here, PubMed, Medline, and Cochrane Library literature searches were performed. When little or no data from well-designed prospective trials were available, an emphasis was placed on the results from large series and reports from recognized experts. Thus, these guidelines for colonoscopic polypectomy are based on a critical review of the available data as well as expert consensus. Further controlled clinical studies are needed to clarify aspects of this statement, and revision may be necessary as new data become available. This guideline is intended to be an educational device to provide information that may assist endoscopists in providing care to patients. This guideline is not a rule and should not be construed as a legal standard of care or as encouraging, advocating, requiring, or discouraging any particular treatment. Clinical decisions for any particular case involve a complex analysis of the patient's condition and the available courses of action.
Clinical endoscopy. 03/2012; 45(1):11-24.
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Bo-In Lee,
Sung Pil Hong,
Seong-Eun Kim,
Se Hyung Kim,
Hyun-Soo Kim,
Sung Noh Hong,
Dong-Hoon Yang,
Sung Jae Shin,
Suck-Ho Lee,
Dong Il Park,
Young-Ho Kim,
Hyun Jung Kim,
Suk-Kyun Yang, Hyo Jong Kim,
Hae Jeong Jeon
[show abstract]
[hide abstract]
ABSTRACT: Now colorectal cancer is the second most common cancer in males and the fourth most common cancer in females in Korea. Since most of colorectal cancers occur after the prolonged transformation of adenomas into carcinomas, early detection and removal of colorectal adenomas are one of the most effective methods to prevent colorectal cancer. Considering the increasing incidence of colorectal cancer and polyps in Korea, it is very important to establish Korean guideline for colorectal cancer screening and polyp detection. The guideline was developed by the Korean Multi-Society Take Force and we tried to establish the guideline by evidence-based methods. Parts of the statements were draw by systematic reviews and meta-analyses. Herein we discussed epidemiology of colorectal cancers and adenomas in Korea and optimal methods for screening of colorectal cancer and detection of adenomas including fecal occult blood tests, radiologic tests, and endoscopic examinations.
Clinical endoscopy. 03/2012; 45(1):25-43.
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Bo In Lee,
Sung Pil Hong,
Seong-Eun Kim,
Se Hyung Kim,
Hyun-Soo Kim,
Sung Noh Hong,
Dong-Hoon Yang,
Sung Jae Shin,
Suck-Ho Lee,
Young-Ho Kim,
Dong Il Park,
Hyun Jung Kim,
Suk-Kyun Yang, Hyo Jong Kim,
Hae Jeong Jeon
[show abstract]
[hide abstract]
ABSTRACT: Colorectal cancer is the second most common cancer in males and the fourth most common in females in Korea. Since the most of colorectal cancer occur through the prolonged transformation of adenomas into carcinomas, early detection and removal of colorectal adenomas are one of the most effective methods to prevent colorectal cancer. Considering the increasing incidence of colorectal cancer and polyps in Korea, it is very important to establish Korean guideline for colorectal cancer screening and polyp detection. Korean Multi-Society Take Force developed the guidelines with evidence-based methods. Parts of the statements drawn by systematic reviews and meta-analyses. Herein we discussed the epidemiology of colorectal cancers and adenomas in Korea, optimal screening methods for colorectal cancer, and detection for adenomas including fecal occult blood tests, radiologic tests, and endoscopic examinations.
The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi 02/2012; 59(2):65-84.
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Sung Noh Hong,
Dong-Hoon Yang,
Young-Ho Kim,
Sung Pil Hong,
Sung Jae Shin,
Seong-Eun Kim,
Bo In Lee,
Suck-Ho Lee,
Dong Il Park,
Hyun-Soo Kim,
Suk-Kyun Yang, Hyo Jong Kim,
Se Hyung Kim,
Hyun Jung Kim
[show abstract]
[hide abstract]
ABSTRACT: Post-polypectomy surveillance has become a major indication for colonoscopy as a result of increased use of screening colonoscopy in Korea. However, because the medical resource is limited, and the first screening colonoscopy produces the greatest effect on reducing the incidence and mortality of colorectal cancer, there is a need to increase the efficiency of postpolypectomy surveillance. In the present report, a careful analytic approach was used to address all available evidences to delineate the predictors for advanced neoplasia at surveillance colonoscopy. Based on the results of review of the evidences, we elucidated the high risk findings of the index colonoscopy as follows: 1) 3 or more adenomas, 2) any adenoma larger than 10 mm, 3) any tubulovillous or villous adenoma, 4) any adenoma with high-grade dysplasia, and 5) any serrated polyps larger than 10 mm. In patients without any high-risk findings at the index colonoscopy, surveillance colonoscopy should be performed five years after index colonoscopy. In patients with one or more high risk findings, surveillance colonoscopy should be performed three years after polypectomy. However, the surveillance interval can be shortened considering the quality of the index colonoscopy, the completeness of polyp removal, the patient's general condition, and family and medical history. This practical guideline cannot totally take the place of clinical judgments made by practitioners and should be revised and supplemented in the future as new evidence becomes available.
The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi 02/2012; 59(2):99-117.
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Suck-Ho Lee,
Sung Jae Shin,
Dong Il Park,
Seong-Eun Kim,
Sung Pil Hong,
Sung Noh Hong,
Dong-Hoon Yang,
Bo In Lee,
Young-Ho Kim,
Hyun-Soo Kim,
Suk-Kyun Yang, Hyo Jong Kim,
Se Hyung Kim,
Hyun Jung Kim
[show abstract]
[hide abstract]
ABSTRACT: There are indirect evidences to suggest that 80% of colorectal cancers (CRC) develop from adenomatous polyps and that, on average, it takes 10 years for a small polyp to transform into invasive CRC. In multiple cohort studies, colonoscopic polypectomy has been shown to significantly reduce the expected incidence of CRC by 76% to 90%. Colonoscopic polypectomy is performed frequently in primary, secondary and tertiary and medical centers in Korea. However, there are no evidence-based, procedural guidelines for the appropriate performance of this procedure, including the technical aspects. For the guideline presented here, Pubmed, Medline, and Cochrane Library literature searches were performed. When little or no data from well-designed prospective trials were available, an emphasis was placed on the results from large series and reports from recognized experts. Thus, these guidelines for colonoscopic polypectomy are based on a critical review of the available data as well as expert consensus. Further controlled clinical studies are needed to clarify aspects of this statement, and revision may be necessary as new data become available. This guideline is intended to be an educational device to provide information that may assist endoscopists in providing care to patients. This guideline is not a rule and should not be construed as a legal standard of care or as encouraging, advocating, requiring, or discouraging any particular treatment. Clinical decisions for any particular case involve a complex analysis of the patient's condition and the available courses of action.
The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi 02/2012; 59(2):85-98.
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Jin-Hee Lee,
Min-Ju Kang,
Hye-Yeon Han,
Min-Goo Lee,
Seong-In Jeong,
Byung-Kyu Ryu,
Tae-Kyu Ha,
Nam-Goo Her,
Jikhyon Han,
Sun Jin Park,
Kil Yeon Lee, Hyo-Jong Kim,
Sung-Gil Chi
[show abstract]
[hide abstract]
ABSTRACT: PRKCDBP is a putative tumor suppressor in which alteration has been observed in several human cancers. We investigated expression and function of PRKCDBP in colorectal cells and tissues to explore its candidacy as a suppressor in colorectal tumorigenesis.
Expression and methylation status of PRKCDBP and its effect on tumor growth were evaluated. Transcriptional regulation by NF-κB signaling was defined by luciferase reporter and chromatin immunoprecipitation assays.
PRKCDBP expression was hardly detectable in 29 of 80 (36%) primary tumors and 11 of 19 (58%) cell lines, and its alteration correlated with tumor stage and grade. Promoter hypermethylation was commonly found in cancers. PRKCDBP expression induced the G(1) cell-cycle arrest and increased cellular sensitivity to various apoptotic stresses. PRKCDBP was induced by TNFα, and its level correlated with tumor cell sensitivity to TNFα-induced apoptosis. PRKCDBP induction by TNFα was disrupted by blocking NF-κB signaling while it was enhanced by RelA transfection. The PRKCDBP promoter activity was increased in response to TNFα, and this response was abolished by disruption of a κB site in the promoter. PRKCDBP delayed the formation and growth of xenograft tumors and improved tumor response to TNFα-induced apoptosis.
PRKCDBP is a proapoptotic tumor suppressor which is commonly altered in colorectal cancer by promoter hypermethylation, and its gene transcription is directly activated by NF-κB in response to TNFα. This suggests that PRKCDBP inactivation may contribute to tumor progression by reducing cellular sensitivity to TNFα and other stresses, particularly under chronic inflammatory microenvironment.
Clinical Cancer Research 12/2011; 17(24):7551-62. · 7.74 Impact Factor
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ABSTRACT: Percutaneous endoscopic gastrostomy (PEG) has been widely used for patients with swallowing dysfunction. However, its beneficial effects in the treatment of gastroesophageal reflux (GER) are controversial. The aim of this study was to evaluate the effect of PEG on the prevention of GER in patients with nasogastric tube (NGT) feeding.
Continuous 24-hour pH monitoring was performed prospectively in 21 patients receiving NGT feeding before and 7.3±2.2 days after PEG placement to compare the severity of GER.
We studied 21 patients with a mean age of 59.8±14.1 years. The mean duration of NGT placement was 5.8±5.4 months. The causes of swallowing dysfunction included cerebral infarction, cerebral hemorrhage and other central nervous system (CNS) lesions. When all of the patients were considered, there were no significant differences in reflux parameters after PEG placement compared to before PEG placement. However, all seven patients who had preexisting GER showed significant improvement (p<0.05) of the reflux parameters, including the frequency of acid reflux, duration of acid reflux, total time with a pH below 4.0 and the fraction of time with a pH below 4.0, after PEG placement.
PEG might prevent GER in patients receiving NGT feeding, especially in those patients with GER.
Gut and liver 09/2011; 5(3):288-92. · 0.83 Impact Factor
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Young Hwangbo,
Jae Young Jang,
Hyoung Jung Kim,
Youn Wha Kim,
Soon Do Park,
Jaejun Shim,
Seok Ho Dong, Hyo Jong Kim,
Byung Ho Kim,
Young Woon Chang,
Rin Chang
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ABSTRACT: Colonic gastrointestinal stromal tumors (GISTs) account for only 5%-10% of tumors arising in the digestive tract. Spontaneous rupture is a very rare manifestation of a GIST; however, we report what to our knowledge is the first documented case of pneumoretroperitoneum caused by the rupture of a GIST. A 77-year-old woman was admitted to our hospital with acute abdominal pain and hematochezia. Colonoscopy showed luminal narrowing in the sigmoid colon, but no definite mucosal defect. Computed tomography (CT) showed an air-containing heterogeneous mass, 9.7 × 9.3 cm, in the pelvic cavity and a small amount of air in the retroperitoneum. Emergency laparotomy revealed a ruptured sigmoid colonic GIST with localized peritonitis. Pathologic examination confirmed that the tumor was composed mainly of round epithelioid cells. It was immunohistochemically positive for CD34 and negative for C-kit protein. This report describes how we successfully managed pneumoretroperitoneum with localized peritonitis caused by the spontaneous rupture of an epithelioid GIST originating from the sigmoid colon.
Surgery Today 08/2011; 41(8):1085-90. · 1.22 Impact Factor
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ABSTRACT: To investigate pathophysiological consequences and spontaneous recovery after cavernous nerve crush injury (CNCI) in a rat model.
Twenty 4-week-old male Sprague-Dawley rats were divided into the following groups: sham-operated group (n=10) and bilateral CNCI groups (n=10) for two different durations (12 and 24 weeks). At both time points, CN electrical stimulation was used to assess erectile function by measuring the intracavernous pressure. The expression of hypoxia inducible factor (HIF)-1α and sonic hedgehog (SHH) was examined in penile tissue. Immunohistochemical staining was performed for nerve growth factor (NGF), endothelial nitric oxide synthase (eNOS), neuronal nitric oxide synthase (nNOS), and smooth muscle α-actin.
CNCI significantly decreased erectile function at 12 weeks (51.7% vs. 71.9%, mean ICP/BP ratio, p<0.05) and increased the expression of HIF-1α and decreased the expression of eNOS, nNOS, and SHH. At 24 weeks, erectile function in the CNCI group was improved with no significant difference versus the sham group (70.5% vs. 63.3%, mean ICP/BP ratio, p<0.05) or the CN group at 12 weeks (51.7% vs. 63.3%, mean ICP/BP ratio, p<0.05). By RT-PCR, the increase in HIF-1α and decrease in SHH mRNA was restored at 24 weeks. By immunohistochemistry, the expression of eNOS and nNOS was increased at 24 weeks.
CN injury induces significantly impaired erectile function and altered gene and protein expression, which suggests that local hypoxic and inflammatory processes may contribute to this change. Significant spontaneous recovery of erectile function was observed at 6 months after CN crush injury.
Korean journal of urology 08/2011; 52(8):560-5.
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Yeonghwan Kim,
Miran Jang,
Sangbin Lim,
Hyeran Won,
Kyung-Sik Yoon,
Jae-Hoon Park, Hyo Jong Kim,
Byung-Ho Kim,
Won-Sang Park,
Joohun Ha,
Sung-Soo Kim
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ABSTRACT: Cyclophilin B (CypB) performs diverse roles in living cells, but its role in hepatocellular carcinoma (HCC) is largely unclear. To reveal its role in HCC, we investigated the induction of CypB under hypoxia and its functions in tumor cells in vitro and in vivo. Here, we demonstrated that hypoxia-inducible factor 1α (HIF-1α) induces CypB under hypoxia. Interestingly, CypB protected tumor cells, even p53-defective HCC cells, against hypoxia- and cisplatin-induced apoptosis. Furthermore, it regulated the effects of HIF-1α, including those in angiogenesis and glucose metabolism, via a positive feedback loop with HIF-1α. The tumorigenic and chemoresistant effects of CypB were confirmed in vivo using a xenograft model. Finally, we showed that CypB is overexpressed in 78% and 91% of the human HCC and colon cancer tissues, respectively, and its overexpression in these cancers reduced patient survival. CONCLUSIONS: These results indicate that CypB induced by hypoxia stimulates the survival of HCC via a positive feedback loop with HIF-1α, indicating that CypB is a novel candidate target for developing chemotherapeutic agents against HCC and colon cancer.
Hepatology 07/2011; 54(5):1661-78. · 11.66 Impact Factor
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ABSTRACT: Surgical or endoscopic resection is recommended for the management of gastric high-grade dysplasia (HGD). However, there are no proper guidelines for the management of gastric low-grade dysplasia (LGD). We evaluated clinical parameters, histological results, and endoscopic follow-up to find a management strategy of LGD.
A total of 590 patients with LGD, HGD, functional dyspepsia (FD), and early or advanced gastric cancer (EGC or AGC, respectively) were consecutively enrolled. We examined the association of clinical parameters including low serum pepsinogen (PG) I/II ratio of 3.0 or less with the disease phenotypes. Histological results between initial forceps biopsy and final endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD) specimens were compared. Complications and recurrence were evaluated after EMR or ESD.
The PG I/II ratio in FD was 4.2±1.7 (mean±SD), but was significantly lower in LGD (2.8±1.6, P<0.0001). The PG I/II ratio was not any lower in the HGD, EGC, and AGC groups. In patients with FD having a PG I/II ratio of 3.0 or less, multiple logistic regression analysis showed smoking habits and high salt intake were independent risk factors for gastric dysplasia or gastric cancer. About 11% (n=8/70) of LGD lesions were upgraded to HGD (6/70) or EGC (2/70) after EMR or ESD. Neither serious complications nor recurrence at the primary site after EMR or ESD were found in LGD.
It is proposed that endoscopic resection followed by endoscopic surveillance might be a beneficial strategy for patients with LGD having a PG I/II ratio of 3.0 or less.
European journal of gastroenterology & hepatology 04/2011; 23(5):405-10. · 1.66 Impact Factor
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Jaejun Shim,
Kyung Yup Kim,
Byung-Ho Kim,
Heekyung Chun,
Mi Suk Lee,
Young Hwangbo,
Jae Young Jang,
Seok Ho Dong, Hyo Jong Kim,
Young Woon Chang,
Rin Chang
[show abstract]
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ABSTRACT: Vaccination against hepatitis B virus (HBV) is recommended for health care workers (HCWs), but it is not clear whether HBV vaccination is required for HCWs who have isolated antibody to hepatitis B core antigen (anti-HBc), or whether prevaccination screening for anti-HBc is needed in HCWs. Among 1812 HCWs, subjects with isolated anti-HBc and those with no HBV markers (control) were screened. The anamnestic response (antibody to hepatitis B surface antigen over 50 mIU/mL after the first vaccine injection) was compared prospectively between the two groups. The prevalence of isolated anti-HBc was 2.3%. Their anamnestic response was lower than that of controls (27.5% vs. 46.9%, P=0.020). The subjects who had isolated anti-HBc were older and predominantly male, compared with the controls. Multivariate analysis revealed that age (odds ratio [OR], 0.67; confidence interval [CI], 0.51-0.90) and prior vaccination (OR, 3.36; CI, 2.04-5.54) were independent predictors of the anamnestic response, regardless of the anti-HBc status. Serum HBV DNA was not detected in any subject. Anti-HBs seroconversion was achieved in most of the anti-HBc-positive subjects after full vaccination, and the rate was comparable with controls (89.5% vs. 96.6%, P=0.067). Isolated anti-HBc-positive HCWs are rare and most of them respond to vaccination. Anti-HBc testing is not a prerequisite for vaccination. This serology suggests a loss of acquired anti-HBs rather than occult HBV infection. Their reduced immunity to vaccination may be related to old age.
Vaccine 02/2011; 29(8):1721-6. · 3.77 Impact Factor
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Hyun Joo Song,
Jin-Yong Kim,
Sung-Ae Jung,
Seong-Eun Kim,
Hye-Sook Park,
Yoolwon Jeong,
Sung Pil Hong,
Jae Hee Cheon,
Won Ho Kim, Hyo-Jong Kim,
Byong Duk Ye,
Suk-Kyun Yang,
Sang-Woo Kim,
Sung-Jae Shin,
Hyun-Soo Kim,
Jae-Kyu Sung,
Eun Young Kim
[show abstract]
[hide abstract]
ABSTRACT: Antibiotic-associated diarrhea (AAD) is a common complication of antibiotic use. There is growing interest in probiotics for the treatment of AAD and Clostridium difficile infection because of the wide availability of probiotics. The aim of this multicenter, randomized, placebo-controlled, double-blind trial was to assess the efficacy of probiotic Lactobacillus (Lacidofil® cap) for the prevention of AAD in adults. From September 2008 to November 2009, a total of 214 patients with respiratory tract infection who had begun receiving antibiotics were randomized to receive Lactobacillus (Lacidofil® cap) or placebo for 14 days. Patients recorded bowel frequency and stool consistency daily for 14 days. The primary outcome was the proportion of patients who developed AAD within 14 days of enrollment. AAD developed in 4 (3.9%) of 103 patients in the Lactobacillus group and in 8 (7.2%) of 111 patients in the placebo group (P=0.44). However, the Lactobacillus group showed lower change in bowel frequency and consistency (50/103, 48.5%) than the placebo group (35/111, 31.5%) (P=0.01). Although the Lacidofil® cap does not reduce the rate of occurrence of AAD in adult patients with respiratory tract infection who have taken antibiotics, the Lactobacillus group maintains their bowel habits to a greater extent than the placebo group.
Journal of Korean medical science 12/2010; 25(12):1784-91. · 0.84 Impact Factor
