Byung-Wook Kim

Catholic University of Korea, Sŏul, Seoul, South Korea

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Publications (65)121.41 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Gastric adenoma with low-grade dysplasia (LGD) can progress to gastric cancer; however, the optimal therapeutic modality for LGD has not been established. The aim of this study was to assess the efficacy, safety of and local recurrence following endoscopic mucosal resection (EMR) for LGD. Specifically, we compared EMR with circumferential precutting (EMR-P) and EMR using a dual-channel endoscope (EMR-D) for the treatment of LGD ≤2 cm. A total of 158 lesions from 147 patients with LGD treated by EMR were retrospectively analyzed. The en bloc resection rate, complete resection rate, procedure time, complication rate and local recurrence rate were compared between EMR-P and EMR-D. The en bloc resection and complete resection rates of EMR were 91.1% and 90.5%, respectively. The bleeding and perforation rates were 1.3% and 1.3%, respectively. The local recurrence rate following EMR was 2.2%. The en bloc resection and complete resection rates did not differ between EMR-P and EMR-D (88.2% vs. 92.5%, p = not significant (NS); and 90.2% vs. 90.7%, p = NS, respectively). The procedure time was significantly longer for EMR-P compared with EMR-D (16 (5-141) vs. 7 (2-48) min, p < 0.001), and the complication rate was significantly higher for EMR-P (7.8% vs. 0.0%, p = 0.010). Local recurrence was not found in EMR-P, whereas the recurrence rate was 3.2% in EMR-D. EMR is an effective method for the treatment of LGD ≤2 cm. Compared with EMR-P, EMR-D appears to be the more effective, technically simple and safer method.
    Scandinavian Journal of Gastroenterology 05/2015; DOI:10.3109/00365521.2015.1045023 · 2.33 Impact Factor
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    ABSTRACT: Biliary-enteric communications caused by duodenal ulcers are uncommon, and choledochoduodenal fistula (CDF) is by far the most common type. Usually in this situation, food material does not enter the common bile duct because the duodenal lumen is intact. Here, we report a case in which cholangitis occurred due to food materials impacted through a CDF. Duodenal obstruction secondary to duodenal ulcer prevented food passage into the duodenum in this case. Surgical management was recommended; however, the patient refused surgery because of poor general condition. Consequently, the patient expired with sepsis secondary to ascending cholangitis.
    05/2015; 48(3):265-7. DOI:10.5946/ce.2015.48.3.265
  • Joon Sung Kim · Sung Min Park · Byung-Wook Kim
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    ABSTRACT: Eradication of Helicobacter pylori (H. pylori) infection with triple therapy (TT) has declined in many countries prompting the search for alternative regimens. Sequential therapy (ST) and concomitant therapy (CT) has been suggested as first line regimens in areas of high clarithromycin resistance. We performed a meta-analysis to compare the eradication rates of CT with ST for H. pylori. A comprehensive literature search for studies comparing the efficacy of CT with ST was performed. Dichotomous data were pooled to obtain the odds ratio (OR) of the eradication rate with 95% confidence intervals (CIs). The eradication rates were considered both on an intention-to-treat (ITT) and on a per-protocol basis (PP). A total of 7 studies provided data on 2412 adult patients. Pooled estimates of the studies revealed no significant differences between CT and ST. The pooled OR was 1.116 (95% CI 0.795-1.567, P=0.526) for ITT analysis and 1.153 (95% CI 0.793-1.677, P=0.455) for PP analysis. There was no difference in the rate of adverse events (OR: 1.229; 95% CI 0.971-1.556, P=0.086) and compliance (OR: 0.945; 95% CI 0.722-1.237, P=0.681) between the two regimens. Subgroup analysis was performed to compare CT of 10 days and 5 days with ST of 10 days. The pooled OR was 1.518 for CT of 10days and 0.636 for CT of 5 days. CT regimens did not achieve higher eradication rates compared to the ST regimen. The adverse events and adherence to medications were not different between the two regimens. This article is protected by copyright. All rights reserved.
    Journal of Gastroenterology and Hepatology 04/2015; DOI:10.1111/jgh.12984 · 3.63 Impact Factor
  • Joon Sung Kim · Byung-Wook Kim
    The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi 04/2015; 65(4):197. DOI:10.4166/kjg.2015.65.4.197
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    ABSTRACT: The optimal technique for removal of diminutive or small colorectal polyps is debatable. To compare the complete resection rates of cold snare polypectomy (CSP) and cold forceps polypectomy (CFP) for the removal of adenomatous polyps ≤7 mm. Prospective randomized controlled study. A university hospital. A total of 139 patients who were found to have ≥1 colorectal adenomatous polyps ≤7 mm. Polyps were randomized to be treated with either CSP or CFP. After the initial polypectomy, additional EMR was performed at the polypectomy site to assess the presence of residual polyp tissue. Absence of residual polyp tissue in the EMR specimen of the polypectomy site was defined as complete resection. Among a total of 145 polyps, 128 (88.3%) were adenomatous polyps. The overall complete resection rate for adenomatous polyps was significantly higher in the CSP group compared with the CFP group (57/59, 96.6% vs 57/69, 82.6%; P = .011). Although the complete resection rates for adenomatous polyps ≤4 mm were not different (27/27, 100% vs 31/32, 96.9%; P = 1.000), the complete resection rates for adenomatous polyps sized 5 to 7 mm was significantly higher in the CSP group compared with the CFP group (30/32, 93.8% vs 26/37, 70.3%; P = .013). Single-center study. CSP is recommended for the complete resection of colorectal adenomatous polyps ≤7 mm. ( NCT01665898.). Copyright © 2015 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.
    Gastrointestinal Endoscopy 03/2015; 81(3). DOI:10.1016/j.gie.2014.11.048 · 4.90 Impact Factor
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    Joon Sung Kim · Sung Min Park · Byung-Wook Kim
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    ABSTRACT: Acute upper gastrointestinal bleeding is a common medical emergency around the world and the major cause is peptic ulcer bleeding. Endoscopic treatment is fundamental for the management of peptic ulcer bleeding. Despite recent advances in endoscopic treatment, mortality from peptic ulcer bleeding has still remained high. This is because the disease often occurs in elderly patients with frequent comorbidities and are taking ulcerogenic medications. Therefore, the management of peptic ulcer bleeding is still a challenge for clinicians. This article reviews the various endoscopic methods available for management of peptic ulcer bleeding and the techniques in using these methods.
    03/2015; 48(2):106-11. DOI:10.5946/ce.2015.48.2.106
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    ABSTRACT: To compare the Helicobacter pylori (H. pylori) eradication rate of clarithromycin-based triple therapy, metronidazole-based triple therapy, sequential therapy and concomitant therapy. A total of 680 patients infected with H. pylori were divided into 4 groups and each group was treated with a different eradication therapy. Clarithromycin-based triple therapy was applied to the first group [rabeprazole, amoxicillin and clarithromycin (PAC) group: proton pump inhibitor (PPI), amoxicillin, clarithromycin], whereas the second group was treated with metronidazole-based triple therapy [rabeprazole, amoxicillin and metronidazole (PAM) group: PPI, amoxicillin, metronidazole]. The third group was treated with rabeprazole and amoxicillin, followed by rabeprazole, clarithromycin and metronidazole (sequential group). The final group was simultaneously treated with rabeprazole, amoxicillin clarithromycin and metronidazole (concomitant therapy group). In the case of a failure to eradicate H. pylori, second-line quadruple and third-line eradication therapies were administered. The per protocol (PP) analysis was performed on 143, 139, 141 and 143 patients in the PAC, PAM, sequential and concomitant groups, respectively. We excluded patients who did not receive a C(13)-urea breath test (22, 20, 23 and 22 patients, respectively) and patients with less than an 80% compliance level (5, 11, 6 and 5 patients, respectively). The eradication rates were 76.2% (109/143) in the PAC group, 84.2% (117/139) in the PAM group, 84.4% (119/141) in the sequential group and 94.4% (135/143) in the concomitant group (P = 0.0002). All 14 patients who failed second-line therapy were treated with third-line eradication therapy. Among these 14 patients, 6 infections were successfully eradicated with the third-line therapy. Both PP and intention-to-treat analysis showed an eradication rate of 42.9% (6/14). In the PAC group, 3 of 4 patients were successfully cured (3/4, 75%); 2 of 2 patients in the PAM group (2/2, 100%) and 1 of 5 patients in the sequential group (1/5, 20%) were also cured. In the concomitant group, all 3 patients failed (0/3, 0%). The eradication rate for the concomitant therapy was much higher than those of the standard triple therapy or sequential therapy (ClinicalTrials.gov number NCT01922765).
    World Journal of Gastroenterology 01/2015; 21(1):351-9. DOI:10.3748/wjg.v21.i1.351 · 2.43 Impact Factor
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    ABSTRACT: Objectives. Sessile nonampullary duodenal tumors (SNADTs) are relatively rare and endoscopic resection of these lesions is considered more challenging than in other parts of the gastrointestinal tract. The aim of this study was to evaluate the feasibility of endoscopic resection for SNADT. Methods. Medical records including endoscopic resection for SNADT from July 2002 to July 2013 from 5 centers affiliated to The Catholic University of Korea were reviewed retrospectively. Demographic features and clinical outcomes such as complete resection and complications were analyzed. Results. A total of 56 lesions from 54 patients were enrolled in this study. Forty-five lesions were resected by endoscopic mucosal resection (EMR), 6 lesions by endoscopic submucosal dissection (ESD), and 5 lesions by simple polypectomy. Histologic examination after endoscopic resection revealed adenocarcinoma in 2, low grade adenoma in 25, high grade adenoma in 11, and carcinoid tumor in 18 lesions. En bloc resection rates and histological complete resection rates were 78.6% (44/56) and 80.0% (28/35), respectively. Bleeding which required additional endoscopic intervention occurred in 1.8% (1/56) and perforation in 7.1% (4/56). There was no procedure-related mortality. Conclusions. Endoscopic resection techniques including ESD might be safe and effective modalities for the management of SNADT.
    Gastroenterology Research and Practice 01/2015; 2015:692492. DOI:10.1155/2015/692492 · 1.75 Impact Factor
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    ABSTRACT: Objectives. This study was performed to evaluate the effectiveness of education for trainees on the gross findings identified by conventional white-light endoscopy (CWE), the microvascular patterns identified by magnifying narrow-band imaging endoscopy (MNE), and the pit patterns identified by magnifying chromoendoscopy (MCE) in estimation of the invasion depth of colorectal tumors. Methods. A total of 420 endoscopic images of 35 colorectal tumors were used. Five trainees estimated the invasion depth of the tumors by reviewing the CWE images before education. Afterwards, the trainees estimated the invasion depth of the same tumors after brief education on CWE, MNE and MCE images, respectively. Results. The initial diagnostic accuracy for deep submucosal invasion before education and after education on CWE, MNE, and MCE findings was 54.3%, 55.4%, 67.4%, and 76.6%, respectively. The diagnostic accuracy increased significantly after MNE education (P = 0.028). The specificity for deep submucosal invasion before education and after education on CWE, MNE, and MCE findings was 47.9%, 45.7%, 65.0%, and 80.7%, respectively. The specificity increased significantly after MNE (P = 0.002) and MCE (P = 0.005) education. Conclusion. Brief education on microvascular pattern identification by MNE and pit pattern identification by MCE significantly improves trainees' estimations of the invasion depth of colorectal tumors.
    Gastroenterology Research and Practice 05/2014; 2014:245396. DOI:10.1155/2014/245396 · 1.75 Impact Factor
  • 04/2014; 19(2):90-93. DOI:10.15279/kpba.2014.19.2.90
  • Joon Sung Kim · Byung-Wook Kim · In-Soo Shin
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    ABSTRACT: Although endoscopic submucosal dissection (ESD) has grown popular in resecting lesions in the stomach, the application of ESD to the esophagus has been limited by greater technical difficulty. An increasing number of series have recently reported the application of ESD to esophageal lesions. The aim of the present systemic review and meta-analysis was to evaluate the efficacy and safety of ESD for esophageal lesions. Comprehensive literature searches (1999-2012) were performed on studies that reported ESD for the removal of esophageal neoplasia. Primary outcome measures were pooled estimates of complete resection rate and en bloc resection rate. Secondary outcome measures were pooled estimates of complication rates. A total of 15 studies provided data on 776 ESD-treated lesions. The pooled estimate of complete resection rate was 89.4 % (95 % CI 86.2-91.9 %). The pooled estimate of en bloc resection was 95.1 % (95 % CI 92.6-96.8 %). The pooled estimates of complications of ESD such as bleeding, perforation, and stenosis were 2.1, 5.0, and 11.6 %, respectively. ESD appeared to be an extremely effective technique to achieve complete resection of esophageal neoplasia. The very low rate of complications also shows the potential safety of this approach.
    Digestive Diseases and Sciences 03/2014; 59(8). DOI:10.1007/s10620-014-3098-2 · 2.55 Impact Factor
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    ABSTRACT: Clinical presentation and patterns of peptic ulcer disease (PUD) have changed because surival of people in Korea have increased. Other factors such as declining Helicobacter pylori infection rate and increased consumption of non-steroidal anti-inflammatory drugs (NSAID) including aspirin also affect the clinical patterns of PUD. The aim of this study was to evaluate the current clinical characteristics of PUD in Korea.
    01/2014; 14(1):31. DOI:10.7704/kjhugr.2014.14.1.31
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    ABSTRACT: Atrophic gastritis (AG) and intestinal metaplasia (IM) are commonly encountered pathologic conditions during gastroscopy in Korea. These conditions were considered as pre-neoplastic lesions in many previous studies. Management and follow-up of these lesions have been performed arbitrarily since there are no standard guidelines. The aim of this study was to investigate the endoscopists' opinions on these conditions using web-based survey.
    01/2014; 14(4):242. DOI:10.7704/kjhugr.2014.14.4.242
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    Joon Sung Kim · Byung-Wook Kim
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    ABSTRACT: Although there have been reports showing a decreasing trend in the global prevalence of peptic ulcer diseases (PUD), PUD is still one of the most common upper gastrointestinal diseases. Helicobacter pylori is a major cause of PUD and the prevalence of H. pylori infection has been reported to be declining in Korea. However the use of ulcerogenic drugs such as non-steroidal anti-inflammatory drugs and aspirin has been reported to be increasing in Korea. The purpose of this review was to investigate how these changing trends affect the prevalence of PUD in Korea. In this review, we identified the risk factors for PUD and assessed the prevalence of PUD in Korea according to different time trends.
    01/2014; 14(1):1. DOI:10.7704/kjhugr.2014.14.1.1
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    ABSTRACT: To evaluate the efficacy and safety of grasper type scissors (GTS) for endoscopic submucosal dissection (ESD) of gastric epithelial neoplasia. The study was performed by 4 endoscopists in 4 institutions affiliated to The Catholic University of Korea. ESD was performed in 76 consecutive patients with gastric epithelial neoplasia by using the GTS (37 patients) or the hook knife plus coagrasper (HKC) (39 patients). The complete resection rate, complication rate, total time elapsed and elapsed time per square centimeter of the dissected specimen were analyzed between the GTS and HKC group. The mean age of the GTS group was 62.3 ± 11.4 years and mean age of the HKC group was 65.6 ± 10.1 years. Differentiated adenocarcinoma was found in 32.4% in the GTS group and 33.3% in the HKC group. The procedures were performed without interruption in every case in both groups. The en bloc resection rates of both groups were 100%. The total time elapsed during the procedure was 44.54 ± 21.72 min in the GTS group and 43.77 ± 21.84 min in the HKC group (P = 0.88) and the time elapsed per square centimeter of the resected lesion was 7.53 ± 6.35 min/cm(2) in the GTS group and 6.92 ± 5.93 min/cm(2) in the HKC group (P = 0.66). The overall complication rate was not significantly different between the two groups. GTS is a safe and effective device for ESD compared with HKC. ESD can be performed with GTS alone, which can reduce the costs for ESD.
    World Journal of Gastroenterology 10/2013; 19(37):6221-6227. DOI:10.3748/wjg.v19.i37.6221 · 2.43 Impact Factor
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    ABSTRACT: Chronic intestinal pseudo-obstruction is a rare clinical syndrome which is characterized by intestinal obstruction without occluding lesions in the intestinal lumen and pregnancy is one of the important aggravating factors. Here, we report a case of a woman with intractable intestinal pseudo-obstruction that was precipitated by pregnancy. She could not make any stool passage for more than 4 weeks until a fetal gestational age of 17 weeks was reached. However, the patient could be maintained by repetitive colonoscopic decompressions and finally total colectomy could be performed successfully at a fetal gestational age of 21 weeks.
    09/2013; 46(5):591-4. DOI:10.5946/ce.2013.46.5.591
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    ABSTRACT: Sequential therapy (ST) for Helicobacter pylori infection in countries other than Korea has shown higher eradication rates than triple therapy (TT). The aim of this study was to evaluate the efficacy of ST in Korea by performing a meta-analysis. We performed a comprehensive literature search on the efficacy of ST as a first-line therapy. The odds ratios (ORs) of eradicating H. pylori infection after ST compared with TT were pooled. Pooled estimates of the eradication rates of ST and TT were also calculated. A total of six studies provided data on 1,759 adult patients. The ORs for the intention to treat (ITT) and the per-protocol (PP) eradication rate were 1.761 (95% confidence interval [CI], 1.403 to 2.209) and 1.966 (95% CI, 1.489 to 2.595). Pooled estimates of the ITT and PP eradication rate were 79.4% (95% CI, 76.3% to 82.2%) and 86.4% (95% CI, 83.5% to 88.8%), respectively, for the ST group, and 68.2% (95% CI, 62.1% to 73.8%) and 78.9% (95% CI, 68.9% to 81.7%), respectively, for the TT group. Although ST presented a higher eradication rate than TT in Korea, the pooled eradication rates were lower than expected. Further studies are needed to validate ST as a first-line treatment for H. pylori in Korea.
    Gut and liver 09/2013; 7(5):546-51. DOI:10.5009/gnl.2013.7.5.546 · 1.49 Impact Factor
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    ABSTRACT: Endoscopic management of upper gastrointestinal obstruction is safe and feasible. However, its technical and clinical success rate is about 90%, which is primarily due to inability to pass a guide-wire through the stricture. The aim of this study was to evaluate the usefulness of an ultrathin endoscope for correct placement of guide wire to avoid technical failure in upper gastrointestinal obstruction. Retrospective assessment of ultrathin endoscope to traverse the stenosis of the upper gastrointestinal tract in technically difficult cases was performed. Technical and clinical success rates and immediate complications were analyzed. Nine cases were included in this study (eight cases of stent insertion and one case of balloon dilatation). Technical success was achieved in all of the patients (100%) and oral feeding was feasible in all of the cases (100%). Immediate complications, such as migration, perforation, and hemorrhage, did not develop in any of the cases. Ultrathin endoscope-assisted method for upper gastrointestinal obstruction is potentially safe and useful to avoid technical failure.
    07/2013; 46(4):373-8. DOI:10.5946/ce.2013.46.4.373
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    ABSTRACT: Background. Clarithromycin-resistant Helicobacter pylori (H. pylori) is associated with point mutations in the 23S rRNA gene.Methods. Total 1,232 patients participated and were divided into two control groups and one case group. Patients in the APC control group, which consisted of 308 randomly assigned participants, were treated by standard triple therapy with amoxicillin, rabeprazole, and clarithromycin; 308 participants in the APM control group were treated with amoxicillin, rabeprazole, and metronidazole. For the 616 participants in the case group, a test for point mutations in the 23S rRNA gene of H. pylori was conducted. In the 218 patients out of 616 participants, a new method of 'tailored therapy' was devised, in which amoxicillin, rabeprazole, and clarithromycin were given in the absence of a mutation, while clarithromycin was replaced by metronidazole when the mutation was detected.Results. The eradication rate of H. pylori for the tailored group was 91.2% (176/193), and significantly higher than those of APC and APM control groups which are 75.9% (214/282, P<.001) and 79.1% (219/277, P<.001), respectively.Conclusion. The eradication rate for the tailored therapy according to clarithromycin resistance using PCR was much higher than the standard triple therapy.
    The Journal of Infectious Diseases 06/2013; 208(7). DOI:10.1093/infdis/jit287 · 5.78 Impact Factor
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    ABSTRACT: Extraintestinal manifestations are not uncommon in Crohn's disease, and a thromboembolic event is a disastrous potential complication. Deep vein thrombosis is the most common manifestation of a thromboembolic event and typically occurs in association with active inflammatory disease. Peripheral neuropathy in Crohn's disease has rarely been reported and is considered an adverse effect of metronidazole therapy. Here, we describe a patient who was initially diagnosed with Crohn's disease complicated with deep vein thrombosis and ulnar neuropathy without metronidazole exposure. The simultaneous occurrence of these complications in the early stage of Crohn's disease has never been reported in the English literature.
    Gut and liver 03/2013; 7(2):252-4. DOI:10.5009/gnl.2013.7.2.252 · 1.49 Impact Factor

Publication Stats

254 Citations
121.41 Total Impact Points

Institutions

  • 2004–2015
    • Catholic University of Korea
      • Department of Internal Medicine
      Sŏul, Seoul, South Korea
  • 2011–2013
    • Incheon St. Mary’s Hospital, Catholic Medical Center
      Bucheon, Gyeonggi Province, South Korea