Publications (78)183.34 Total impact
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Article: High frequency of microsatellite instability in intestinal-type gastric cancer in Korean patients.
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ABSTRACT: Although there have been some reports on microsatellite alterations in gastric cancer, findings are inconsistent regarding the associations between histological classification and microsatellite instability (MSI). In the present study, we attempted to determine whether Lauren's histological subtypes are related with MSI status. Paraffin-embedded tissue samples from 14 diffuse-type and 14 intestinal-type gastric adenocarcinomas were matched up according to patient gender and age. Mononucleotide markers (BAT25 and BAT26) and dinucleotide markers (D2S123, D5S346, and D175S250) were used for MSI analyses. Microsatellite genotypes were categorized in terms of high MSI incidence (MSI-H, >30% positive marker) or low MSI incidence (MSI-L, <30% positive marker). Losses of hMLH1 and hMSH2 protein expression were immunohistochemically studied. MSI-H was observed in 11 cases (78%) of the 14 intestinal-type cases as compared to 3 (21%) of the 14 diffuse-type cases (p=0.007). In MSI-H tumors, 10 cases (71%) showed losses of hMLH1 protein expression, while 2 cases (14%) in MSI-L tumors showed losses of hMLH1 protein expression (p=0.006). MSI-H tumors are more frequently found in intestinal-type gastric cancer, which suggests the possibility that there are different pathogenic pathways in gastric carcinogenesis according to histologic type.The Korean Journal of Internal Medicine 07/2005; 20(2):116-22. -
Article: Cyclin E, p27 and mutant p53 do not predict the prognosis in AJCC stage II colorectal carcinomas.
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ABSTRACT: Carcinogenesis is characterized by the abnormal regulation of cell cycle. The abnormal expression of the regulators of cell cycle may be related to the prognosis. Since the clinical significance of the expression of the three proteins in colorectal carcinomas is still controversial, we evaluated the prognostic value of the expression of cyclin E, p27 and mutant p53 in stage II colorectal cancer. The expression levels of cyclin E, p27 and mutant p53 proteins in 41 patients with stage II colorectal carcinomas were analyzed by immunohistochemistry. In the univariate analysis, the level of CEA at diagnosis was associated with disease relapse. In the multivariate analysis, the clinicopathological variables such as age, gender, site of primary tumor, tumor size, state of tumor differentiation and preoperative plasma CEA level were not associated with disease relapse. When Kaplan-Meier survival curves were constructed to determine the prognosis, cyclin E, p27 and mutant p53 expressions did not predict poor prognosis. Our results suggested that the expression of cyclin E, p27 and mutant p53 proteins did not predict the clinical outcome in the stage II colorectal carcinomas.The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi 01/2005; 44(6):314-20. -
Article: Expression of laminin-5 with amniotic membrane transplantation in excimer laser ablated rat corneas.
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ABSTRACT: To investigate the expression of laminin-5 during epithelial healing and evaluate its expression in vivo using rat corneas on which amniotic membrane was applied to cover the wound after excimer laser photoablation. Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea. Myopic photorefractive keratectomy (PRK) with a 100 microm deep ablation was performed in Sprague Dawley rats killed 6, 12, 24, 48, 72, and 96 hours after the procedure. In the first group of 30 rats, the excimer laser-ablated cornea was covered with amniotic membrane after PRK. Thirty other rats in which no amniotic membrane treatment was used served as controls. Immunohistochemical and immunofluoresce in techniques were used to monitor the expression of laminin-5, gamma2, and gamma1 in the rat corneas. Immunoblotting was used to compare the expression of laminin between the amniotic membrane group and the control group. In the immunoblotting study, laminin-5, alpha3, and gamma2 increased 24 hours after amniotic membrane treatment compared to the control group. At 12 hours, in vivo immunostaining of the corneas in both groups expressed laminin, but laminin-5 and gamma2 were more intensely expressed in the amniotic membrane group. This continued until reepithelialization. Expression of the gamma1 chain was not different between the 2 groups. With the use of amniotic membrane, the expression of laminin-5 and gamma2 was faster and more intense than in a control group during reepithelialization of excimer laser-ablated rat corneas.Journal of Cataract [?] Refractive Surgery 11/2004; 30(10):2192-9. · 2.26 Impact Factor -
Article: The impact of Helicobacter pylori infection on coronary heart disease in a Korean population.
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ABSTRACT: Although several studies have claimed that Helicobacter pylori (H. pylori) infection is related to cardiovascular disease, it is still uncertain whether it is related to the acute process or the chronic inflammatory atherosclerotic changes. The aim of our study was to confirm the impact of active H. pylori infection on coronary heart disease, acute inflammatory factors, and the coagulation factors. A total of 94 patients completed questionnaires about occupation, smoking, past medical history, and socio-economic status. The serum of the subjects was drawn for a low density lipoprotein test, white blood cell count, C reactive protein, fibrinogen, homocysteine, prothrombin time, activated partial thrombin time, plasminogen activator inhibitor type-1, and tissue-type plasminogen test. All of the subjects underwent a coronary angiography and an upper gastrointestinal endoscopy for the diagnosis of coronary heart disease and H. pylori infection, respectively. There was no significant difference in acute inflammatory factors, coagulation factors, atheromatous burden score, and Jeopardy score between the H. pylori-infected group and non-infected group. Odds ratio of H. pylori infection on coronary heart disease was 2.59 (95% CI, 0.80-6.17), but it diminished below 1.0 (95% CI, 0.14-1.36) after adjusting for conventional risk factors such as age, gender, diabetes, hypertension, smoking, body mass index and socio-economic status. H. pylori infection is not an independent risk factor for coronary heart disease, and it does not alter the coagulation system or evoke the systemic inflammatory response.The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi 11/2004; 44(4):193-8. -
Article: Healing rate of EMR-induced ulcer in relation to the duration of treatment with omeprazole.
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ABSTRACT: Although EMR-induced ulcers heal faster and recur less often than noniatrogenic gastric ulcers, there is no consensus regarding the duration of therapy for these ulcers. This study prospectively evaluated healing of EMR-induced ulcers according to the duration of omeprazole therapy. A total of 69 patients were randomly assigned, after EMR, to treatment with omeprazole (20 mg per day) for 7 days (1-week group) or with omeprazole (20 mg per day) for 28 days (4-week group). Four weeks after EMR, ulcer size and stage were compared with those of the initial EMR-induced ulcer. Each patient kept a daily diary of drugs consumed and ulcer-related symptoms during the 4-week period after EMR. Thirty-four patients were randomized to the 4-week group, and 26 were randomized to the 1-week group. No significant differences were observed between the two groups at 4 weeks after EMR in terms of ulcer reduction ratio (p=0.29) or stage (p=0.11). In addition, no difference was observed between the two groups with respect to ulcer-related symptoms or use of additional gastric-coating medication (p=0.48). For EMR-induced ulcer, treatment with omeprazole for 1 week is equivalent to treatment for 4 weeks. Short-term therapy with omeprazole can be considered for EMR-induced ulcer.Gastrointestinal Endoscopy 09/2004; 60(2):213-7. · 4.88 Impact Factor -
Article: Efficacy of electrolyzed acid water in reprocessing patient-used flexible upper endoscopes: Comparison with 2% alkaline glutaraldehyde.
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ABSTRACT: Two percent glutaraldehyde, the most widely used liquid chemical germicide (LCG), may be hazardous to patients and medical personnel. Alternatives to glutaraldehyde, such as electrolyzed acid water (EAW), are being developed, but data from well-controlled studies with patient-used endoscopes are rare. The purpose of the present paper was to evaluate the high-level disinfection capability of EAW and compare it with glutaraldehyde. A random sample of 125 endoscopes was collected immediately after upper endoscopic examination. After careful manual cleaning, endoscopes were divided into a glutaraldehyde and EAW group. After the disinfection procedure, samples from working channel (S-1), insertion tube (S-2), umbilical cord (S-3), and angulation knob (S-4) were taken and cultured. Another twenty endoscopes were experimentally contaminated with hepatitis B virus (HBV) and samples were collected after contamination (T-1), after manual cleaning (T-2), and after final disinfection (T-3). Polymerase chain reaction (PCR) for HBV-DNA was performed. In the EAW group, culture-positive rates were 3.2% in S-1, 9.5% in S-2, 3.2% in S-3, and 27.0% in the S-4 samples. There was no significant difference between the EAW and glutaraldehyde groups for all sampling sites. However, in both groups, disinfection of the angulation knobs (S-4) was less efficient than the others. For the T-1 site, HBV-DNA was detected from all of them, and in 95% (19/20) of T-2. However, HBV-DNA was not detected from T-3 samples. Electrolyzed acid water is as efficient as glutaraldehyde in eliminating bacteria from patient-used endoscopes. After disinfection procedures using both methods, HBV-DNA was not detected from any endoscopes experimentally contaminated with HBV-positive mixed sera. However, some bacteria may remain on the surface of the endoscopes. Therefore, more careful precleaning of the endoscopes may help achieve high-level disinfection in the clinical setting.Journal of Gastroenterology and Hepatology 09/2004; 19(8):897-903. · 2.87 Impact Factor -
Article: [Clinical usefulness of Rockall scoring system in patients with bleeding peptic ulcer--comparison with Forrest classification].
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ABSTRACT: The Rockall risk assessment score was developed to predict the risk of rebleeding and death in patients with upper GI hemorrhage. The validity of this score, however, was not established in Korea. We tried to assess the reliability of the Rockall score to predict outcomes in patients with bleeding peptic ulcer. Medical records of 175 patients with benign peptic ulcer bleeding treated in Samsung Medical Center from January 2000 to May 2003 were retrospectively analyzed. They were classified into three groups: no rebleeding rebleeding, and death and mean Rockall score was compared. Forrest classification was also compared with the Rockall score regarding the clinical usefulness of predicting poor outcomes in patients with bleeding peptic ulcer. One hundred forty five patients did not show rebleeding, with mean Rockall score of 3.5 (SD=1.5). On the other hand, rebleeding occurred in 25 patients and the mean score was 6.4 (SD=1.44). There were 13 deaths with mean score of 7.0 (SD=1.08). The differences between the three groups were significant (p<0.001). In multivariate analysis, Rockall score was a independent risk factor of rebleeding and mortality (odds ratio, OR=2.73 and OR=8.74). The Rockall scoring system is useful to predict poor outcome such as rebleeding and death in patients with bleeding peptic ulcer.The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi 08/2004; 44(2):66-70. -
Article: Rate and predictive factors of rebleeding with obscure-overt gastrointestinal bleeding.
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ABSTRACT: Little information is available on the rate and predictive factors of rebleeding of unknown cause, which is very important in deciding further investigations on obscure-overt gastrointestinal bleeding. The aim of this study was to evaluate the rebleeding rate and related factors in obscure-overt gastrointestinal bleeding patients who revealed normal gastroscopic and colonoscopic findings. A total of 69 patients with negative first-line gastroscopy and colonoscopy were enrolled in this study as obscure-overt gastrointestinal bleeding cases. The relationships between rebleeding and clinical characteristics were analyzed retrospectively. The causes of obscure-overt gastrointestinal bleeding were confirmed in 30 cases among the 69 cases. Small bowel tumors (14 cases) were the most common cause, followed by vascular lesions (6 cases). The mean follow-up period was 28 months and rebleeding was noticed in 19 patients (27.5%). Among these rebleeding patients, 14 cases (73.7%) occurred within 6 months. The past experience of previous bleeding was significantly related with rebleeding (p=0.0009). Close observation and detailed investigations are needed for obscure-overt gastrointestinal bleeding patients with bleeding history, especially during 6 months follow-up.The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi 08/2004; 44(1):19-24. -
Article: Genotypes of the Helicobacter pylori vacA signal sequence differ with age in Korea.
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ABSTRACT: Studies on Helicobacter pylori genotypes have focused on adults in developed countries, and data on the genotypes of Helicobacter pylori recovered from the children are rare. One hundred and twenty-eight biopsy samples from patients with H. pylori infection were studied. The patients' ages ranged from 9 to 83 years. PCR analysis for vacA genotypes was performed using DNA extracted from biopsy specimens. Genotyping of the s-region showed s1a in 33 (25.8%) samples and s1c in 82 (64.1%) samples. When the specimens were grouped by age, the distribution of s-region genotype was found to be significantly different between groups (p = .002). The prevalence of s1a was 45.2% in patients < 20 years old, but 14.9% in patients > or = 50 years old. On the other hand, the prevalence of s1c or recombinant s1a-s1c was higher in those > or = 50 years old. The distribution of the m-region did not differ significantly with age (p = .110). Strain populations infecting Korean adults and children differ.Helicobacter 03/2004; 9(1):54-8. · 3.15 Impact Factor -
Article: Detection of colorectal adenomas by routine chromoendoscopy with indigocarmine.
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ABSTRACT: Nonpolypoid adenomas, which can be important precursors of colorectal cancers, are difficult to find during routine colonoscopy. The aim of this study was to evaluate the usefulness of routine chromoendoscopy in Korea, where the incidence of colorectal cancer is low compared with western countries. Colonoscopy with chromoendoscopy was performed in 74 consecutive patients (48 men, 26 women; mean age 53.0 yr). After a careful examination of the whole colon, a defined segment of the sigmoid colon and rectum (0-30 cm from the anal verge) was stained with 20 ml of 0.2% indigocarmine solution with a spraying catheter. Nonpolypoid lesions were classified as flat or depressed types. Biopsies were taken from all lesions detected before or after staining with indigocarmine. Indications for colonoscopy included routine check-up (21 patients), diarrhea or loose stool (14 patients), abdominal pain (12 patients), constipation (7 patients), bleeding (6 patients), and others (14 patients). Before staining, 58 lesions were found in 30 patients (43.2%). Histology showed tubular adenoma in 41 lesions, hyperplastic or inflammatory changes in 14 lesions, adenocarcinoma in 2 lesions, and villous adenoma in 1 lesion. After indigocarmine staining for normal-looking distal 30 cm colorectal mucosa, 176 lesions were found in 46 patients (62.2%). Histologically, 158 lesions were hyperplastic or inflammatory in nature, and 17 lesions (from 11 patients) were tubular adenomas. There was one serrated adenoma. Eighteen adenomas seen only after spraying indigocarmine were 2.6 +/- 0.6 mm in diameter, and all of them were classified as flat adenomas. There was no depressed-type adenoma. No adenoma with high grade dysplasia, villous histology, or cancer was found after staining. Presence of macroscopic adenomatous lesions or carcinoma before staining could not predict the existence of adenoma after staining. In a large proportion of patients, flat or depressed adenomas could be found after spraying indigocarmine for normal-looking colorectal mucosa in Korea. The clinical significance of these diminutive adenomas that can be found only after spraying contrast agent needs to be further investigated.The American Journal of Gastroenterology 07/2003; 98(6):1284-8. · 7.28 Impact Factor -
Article: Maspin expression in human gastric adenocarcinoma.
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ABSTRACT: Maspin, a member of the serpin family of protease inhibitors, is known to be a tumor suppressor. The relationship between its expression and biological significance in various human cancers has not been elucidated. We studied maspin expression in 30 cases of human gastric adenocarcinoma using immunohistochemistry and reverse transcription-polymerase chain reaction. Twenty-seven cases (90%) of gastric adenocarcinoma, regardless of histological type, and all the cases of gastric epithelial cells with intestinal metaplasia (GECIM) showed diffuse and strong immunoreactivity for maspin. Eighteen of 26 cases (69.2%) of non-metaplastic, non-carcinoma gastric epithelia (NMNCE) showed weak and focal immunoreactivity. The level of maspin expression was higher in the GECIM and lower in the NMNCE than in the adenocarcinoma cases. Maspin mRNA expression was detected in all the samples from non-carcinoma mucosa and gastric adenocarcinoma, and was higher in the gastric adenocarcinoma than in the non-carcinoma mucosa (P < 0.001). The lower carcinoma/non-carcinoma mRNA expression rate correlated to the underexpression of maspin immunohistochemistry (P < 0.001). These data suggest that maspin may contribute to gastric carcinogenesis. In addition, immunohistochemical expression of maspin seems to reflect mRNA expression.Pathology International 08/2002; 52(8):508-13. · 1.62 Impact Factor -
Article: Gastric mucosa-associated lymphoid tissue lymphoma: helical CT findings and pathologic correlation.
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ABSTRACT: The purpose of this study was to describe helical CT findings of gastric mucosa-associated lymphoid tissue (MALT) lymphoma and to correlate them with pathologic findings. We retrospectively reviewed CT examinations of 58 patients with confirmed gastric MALT lymphomas. Using the histopathologic grade of the MALT lymphomas, we divided the patients into two groups: those with high-grade lymphoma (n = 21) and those with low-grade lymphoma (n = 37). Common CT findings for the two groups were reviewed and compared. Forty (69%) of the 58 patients showed at least one abnormality of the stomach on CT. Abnormalities included diffuse or segmental gastric wall thickening (66%, 38/58), lymphadenopathy (40%, 23/58), ulcer (22%, 13/58), and gastric mass (3%, 2/58). Eighteen (31%) of 58 patients were found to have no abnormality. The high-grade group had a higher incidence of abnormalities seen on CT than the low-grade group (100% vs 51%, respectively). Gastric wall thickening in the high-grade group was more diffuse (48% vs 8%) and severe (71% vs 14%; severe or moderate) than that seen in the low-grade group. Lymphadenopathy was visualized in 67% of the high-grade group and in 24% of the low-grade group. Gastric ulcer was found in 57% of the high-grade group and in only 5% of the low-grade group. The gastric mass formation was seen in only two patients in the high-grade group. The CT findings of gastric MALT lymphoma that the two groups had in common were gastric wall thickening and lymphadenopathy. Although our results pointed to no specific CT finding for differentiating high-grade from low-grade gastric MALT lymphomas, we found that the absence of abnormality on CT is highly predictive of low-grade MALT lymphoma.American Journal of Roentgenology 06/2002; 178(5):1117-22. · 2.78 Impact Factor -
Article: Apoptosis and its correlation with proliferative activity in rectal cancer.
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ABSTRACT: Alterations in the normal control of apoptosis and cell proliferation are important factors in multistep colorectal carcinogenesis. The aim of this study was to determine the frequency of apoptosis and cell proliferation in rectal cancers and to examine their relationship to clinicopathological variables and expression of bcl-2 and p53. Terminal deoxynucleotidyl transferase (TdT)-mediated dUTP nick end labeling (TUNEL) staining and immunohistochemical staining for Ki-67, bcl-2, and p53 were performed on paraffin-embedded tissue samples of 57 rectal cancers. There was a positive linear correlation between apoptotic index (AI) and proliferative index (PI) (gamma = 0.276, P = 0.038). Both apoptosis and cell proliferation were more frequently found in rectal cancers with lymph node metastasis (P = 0.045 and 0.010, respectively). However, the ratio of AI and PI was not different by nodal status. There was no association between Dukes stage and AI or PI. The frequency of apoptosis was inversely related to the expression of bcl-2, but was not related to the p53 status of rectal cancer. There were no association between cell proliferation and the expression of bcl-2 or p53. Our results suggest that the susceptibility to apoptosis in rectal cancer is clearly related to the proliferative activity and high turnover rate of tumor cells may contribute to lymph node metastasis.Journal of Surgical Oncology 05/2002; 79(4):236-42. · 2.10 Impact Factor -
Article: Clinical diagnosis of primary epiploic appendagitis: differentiation from acute diverticulitis.
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ABSTRACT: Primary epiploic appendagitis (PEA) is an uncommon cause of abdominal pain that occurs either from appendageal torsion or spontaneous thrombosis of an appendageal draining vein. Primary epiploic appendagitis is frequently misdiagnosed as either appendicitis or diverticulitis, depending on its location. Clinical and radiologic characteristics of 8 patients with PEA were retrospectively reviewed and compared with 18 patients with acute diverticulitis. Patients with PEA presented with lower abdominal pain of recent onset that was localized to the left (seven cases) and right (one case) lower quadrants. Well-localized tenderness without peritoneal irritation sign was usually the only physical finding. Blood tests were not significant. In acute diverticulitis, the pain was more evenly distributed throughout the lower abdomen and findings like nausea, fever, and leukocytosis were more frequently associated than in PEA. Computed tomography findings, such as pedunculated oval fatty mass with streaky densities connected to the serosal surface of the adjacent colon, can lead to the diagnosis of PEA. Symptoms of PEA were resolved within 1 week (mean, 4.7 days) without surgery. When patients with very localized lower abdominal pain and tenderness do not have associated symptoms or laboratory abnormalities, a high index of suspicion for PEA and early radiologic examinations are required.Journal of Clinical Gastroenterology 05/2002; 34(4):435-8. · 3.16 Impact Factor -
Article: TT virus infection in patients on maintenance hemodialysis in Korea.
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ABSTRACT: TT virus is a novel DNA virus that is associated with posttransfusion hepatitis. The prevalence, risk factors, and clinical significance of TT virus infection were evaluated in patients with chronic renal failure who are on hemodialysis. Nested polymerase chain reaction was used to test for TT virus DNA in the serum of patients on hemodialysis as well as in healthy controls. TT virus DNA was detected in 15 (20.0%) of the 75 patients on hemodialysis and 10 (13.2%) of the 76 healthy controls (P > 0.05). In chronic renal failure patients on hemodialysis, the prevalence of TT virus did not differ according to the duration of hemodialysis or the amount of blood transfusion. The prevalence of TT virus was higher in IgG anti-hepatitis B core antibody-positive patients than IgG anti-hepatitis B core antibody-negative patients (27.5% vs. 4.2%, P = 0.03). Two (13.3%) of the 15 TT virus-positive and 6 (10.0%) of the 60 TT virus-negative patients showed elevated alanine aminotransferase levels (P > 0.05). TT virus infection did not occur more frequently in patients on hemodialysis than in healthy controls. No relationship was found between TT virus infection and liver disease. The correlation between TT virus infection and IgG anti-hepatitis B core antibody suggests that TT virus may share some routes of transmission with hepatitis B virus.Hepato-gastroenterology 50(49):170-3. · 0.66 Impact Factor -
Article: Diagnosis and treatment of metachronous gastric cancers after surgical treatment for esophageal squamous cell carcinoma.
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ABSTRACT: With the improvement of the outcome after esophagectomy for esophageal cancer, patients with metachronous gastric cancer (MGC) in the reconstructed thoracic stomach have been observed in clinical practice. This study is a report of experiences with MGC with an emphasis on clinical pictures and treatment results. Medical records were reviewed of 728 patients who underwent surgery for esophageal cancer at Samsung Medical Center between 1994 and 2004. MGC was defined as follows; (1) diagnosed more than 6 months after esophagectomy, (2) squamous cell carcinoma in histology of the surgically resected esophagus, (3) adenocarcinoma in histology of the stomach biopsy or surgical specimen. The clinicopathologic characteristics of MGC were evaluated. Eight patients (1.1%) of 728 patients were diagnosed with MGC. All patients were male and had a history of active smoking and drinking. The median age at the time of diagnosis of MGC was 67.8 years old (range: 62-76). Three patients (37.5%) were asymptomatic. Two patients (25%) complained of epigastric pain and 3 patients (37.5%) complained of obstructive symptoms including regurgitation, aspiration, dysphagia, and vomiting. The median interval between diagnosis of MGC and esophagectomy was 37 months (range: 8-85). Three MGCs (37.5%) were detected by endoscopic examination but not by computed tomography (CT). Three patients (37.5%) received surgery and were alive without recurrence for 12, 18 and 63 months respectively. One patient (12.5%) received radiation therapy and was alive for 69 months. Four patients (50%) received no treatment because of follow-up loss in 2 patients (25%) and death within days of MGC diagnosis in 2 patients (25%). Favorable outcomes can be obtained by active treatment in patients with MGC after esophagectomy. Regular endoscopic follow-up is important for early detection and more effective treatment of MGC, especially in areas where the incidence of gastric cancer is high.Hepato-gastroenterology 55(82-83):457-62. · 0.66 Impact Factor -
Article: Gastrointestinal complications after radiation therapy in patients with hepatocellular carcinoma.
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ABSTRACT: With the recent technical advancement to deliver high doses of radiation to a liver mass, radiation treatment has been increasingly used in patients with hepatocellular carcinoma. The aim of this study was to investigate the clinical characteristics of the gastrointestinal adverse effects after radiation therapy in patients with hepatocellular carcinoma. Between 1994 to 2002, 153 patients with hepatocellular carcinoma have been treated with radiation therapy. Medical records were systemically reviewed. Upper endoscopic examinations were done in 34 patients. Radiation-induced ulcers were found in the stomach (n=9) and duodenum (n= 14). Radiation-induced gastroduodenitis was found in 9 patients. Bleeding from radiation-related lesions in 11 patients (7.2%) was caused by gastroduodenitis (n=7), gastric ulcer (n=2), and duodenal ulcer (n=2). There were 7 patients with rebleeding. Bleeding was fatal in only one patient. Two patients with obstruction were treated by stent insertion. Two patients with perforation improved after surgical repair. Hematologic toxicity was found in 53 patients (34.6%) and hepatobiliary complications were found in 40 patients (26.1%). Radiation-induced pneumonitis was found in 3 patients (2%). We found that radiation-induced complications in patients with hepatocellular carcinoma are rather frequent. However, most complications were effectively managed by intensive treatments including endoscopic hemostasis, stent insertion and surgery.Hepato-gastroenterology 52(66):1759-63. · 0.66 Impact Factor -
Article: Formal documentation of withdrawal time improves the quality of colonoscopic observation.
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ABSTRACT: At least 6-10 min of withdrawal time is currently recommended to optimize polyp yield in screening colonoscopies in individual with intact colon. We aimed to assess whether formal documentation of withdrawal time could improve the quality of colonoscopy observation. During December 2006, we implemented withdrawal time as a mandatory field for formal colonoscopy report. Colonoscopy withdrawal time and adenoma detection rate was compared between periods before (Nov 2006) and after (Jan 2007) formal documentation. A total of 709 colonoscopic procedures, which were performed by 9 colonoscopists in training (fellows) were analyzed. The median withdrawal time of 'negative colonoscopy' increased from 6m06s to 6m36s (p=0.045). The number of adenoma detected in each colonoscopy between the two periods was 0.66 and 0.81 (p=0.813). Two out of 9 colonoscopists increased withdrawal time significantly (6 m 11 s to 7 m 52 s, p=0.001) after formal documentation of withdrawal time and demonstrated higher detection rate for adenoma smaller than 10 mm (0.34 per colonoscopy vs. 0.83 per colonoscopy; p=0.012). Formal documentation of withdrawal time forced colonoscopists to lengthen actual withdrawal time. Routinization of formal documentation of withdrawal time might be helpful in improving quality of colonoscopy.Hepato-gastroenterology 58(107-108):779-84. · 0.66 Impact Factor
Top co-authors
Top Journals
Institutions
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2011
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Seoul National University Hospital
Seoul, Seoul, South Korea
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2004–2011
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Yonsei University Hospital
- Department of Internal Medicine
Seoul, Seoul, South Korea
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2002–2011
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Sungkyunkwan University
- • School of Medicine
- • Department of Internal Medicine
- • Department of Radiology
Seoul, Seoul, South Korea
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2009
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Gachon University
- Department of Pathology
Seoul, Seoul, South Korea
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2005
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Konkuk University
- Department of Internal medicine
Seoul, Seoul, South Korea
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