-
C H Park,
K O Kim,
I H Baek,
M H Choi,
H J Jang,
S H Kae,
J B Kim,
G H Baik,
W G Shin,
K H Kim, H Y Kim
[show abstract]
[hide abstract]
ABSTRACT: The prevalence of gastroesophageal reflux disease in Korea has been believed to be low, but the incidence of gastroesophageal reflux disease in Korea is expected to increase because of the longer life expectancy and more ingestion of westernized food. The aim of this study was to report differences in the risk factors of reflux esophagitis (RE) according to age in Korea. We prospectively recruited the subjects who had RE among those who visited a health promotion center for upper gastrointestinal cancer surveillance at Hallym Medical Center (five institutions) between January 2008 and February 2009. The enrolled study participants comprised 742 subjects with RE and 1484 healthy controls. The independent risk factors of RE in young and adult group were male sex, smoking, coffee, body mass index ≥ 25, hiatal hernia, and Helicobacter pylori negativity. The risk factors of RE in elderly group were smoking, coffee, and hiatal hernia. The risk factors for RE according to age group were found to differ. In elderly group, Helicobacter pylori infection was not a significant protective factor contrary to young and adult groups.
Diseases of the Esophagus 09/2012; · 1.81 Impact Factor
-
J W Park,
H S Kim,
D D Seo,
J S Jang,
W G Shin,
K H Kim,
M K Jang,
J H Lee, H Y Kim,
D J Kim,
M S Lee,
C K Park
[show abstract]
[hide abstract]
ABSTRACT: This study aimed to evaluate the long-term efficacy of entecavir (ETV) in adefovir (ADV)-refractory chronic hepatitis B (CHB) patients with prior lamivudine (LMV) resistance. A total of 55 ADV-refractory CHB patients with prior LMV resistance, who received rescue therapy with ETV 1 mg daily for at least 12 months, were consecutively enrolled and analysed. Forty-four patients were men, and their median age was 47 (25-69). Ten patients had liver cirrhosis and 46 patients were positive for hepatitis B e antigen (HBeAg). Median hepatitis B virus DNA levels were 6.6 (4.3-8.0) log(10) copies/mL, and the median duration of ETV therapy was 24 (12-47) months. Cumulative virologic response rates at 6, 12, 24 and 36 months were 18%, 29%, 58% and 75%, respectively. HBeAg loss occurred in 10 (21.7%) of 46 HBeAg-positive patients. In multivariate analysis, only initial virologic response at 3 months remained as an independent predictor for virologic response (RR 3.143; 95% CI 1.387-7.120; P = 0.006). The patients with a virological response at 3 months had not only a significantly higher probability of achieving a virologic response (P < 0.001) but also lower probability of experiencing a virologic breakthrough (P = 0.043) than the patients without an early response. Viral breakthrough was observed in 29 patients during the follow-up period. Cumulative breakthrough rates at 6, 12, 24 and 36 months were 0%, 15%, 45% and 73%, respectively. ETV monotherapy may be considerably efficacious in cases with an initial virological response but its efficacy is attenuated by frequent emergence of ETV resistance in ADV-refractory CHB patients with prior LMV resistance.
Journal of Viral Hepatitis 10/2011; 18(10):e475-81. · 4.09 Impact Factor
-
Y S Kim,
S J Kim,
J H Yoon,
K T Suk,
J B Kim,
D J Kim,
D Y Kim,
H J Min,
S H Park,
W G Shin,
K H Kim, H Y Kim,
G H Baik
[show abstract]
[hide abstract]
ABSTRACT: The eradication rates of Helicobacter pylori (H. pylori) using a proton pump inhibitor (PPI)-based triple therapy have declined due to antibiotic resistance worldwide.
To compare the eradication rate of the 10-day sequential therapy for H. pylori infection with that of the 14-day standard PPI-based triple therapy.
This was a prospective, randomised, controlled study. A total of 409 patients with H. pylori infection were randomly assigned to receive either the 10-day sequential therapy regimen, which consisted of pantoprazole (40 mg) plus amoxicillin (1000 mg) twice a day for 5 days, then pantoprazole (40 mg) with clarithromycin (500 mg) and metronidazole (500 mg) twice a day for another five consecutive days or the 14-day PPI-based triple therapy regimen, which consisted of pantoprazole (40 mg) with amoxicillin (1000 mg) and clarithromycin (500 mg) twice a day for 14 days. The pre- and post-treatment H. pylori status were assessed by rapid urease test, urea breath test, or histology. Successful eradication was confirmed at least 4 weeks after finishing the treatment.
In the intention-to-treat analysis, the eradication rates of the 10-day sequential therapy and of the 14-day PPI-based triple therapy were 85.9% (176/205) and 75.0% (153/205), respectively (P = 0.006). In the per-protocol analysis, the eradication rates were 92.6% (175/205) and 85% (153/204), respectively (P = 0.019). There was no statistically significant difference between the two investigated groups regarding the occurrence of adverse event rates (18.9% vs. 13.3%, P = 0.143).
The 10-day sequential therapy achieved significantly higher eradication rates than the 14-day standard PPI-based triple therapy in Korea.
Alimentary Pharmacology & Therapeutics 09/2011; 34(9):1098-105. · 3.77 Impact Factor
-
Endoscopy 05/2006; 38(4):438. · 5.21 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Intussusception following gastric surgery is a rare postoperative complication. It may develop in clinical situations following gastroenterostomy, Billroth II gastric surgery with or without Braun anastomosis, or Roux-en-Y gastrojejunostomy. The patients may present with either an acute surgical emergency or with a chronic, relapsing form. The mortality may be up to 50 % in these cases if not treated appropriately, but little is known about the mechanism underlying the condition. Early diagnosis with a high index of suspicion and prompt treatment of the acute form are therefore important. Surgical reduction with laparotomy is mandatory, although definitive corrective and preventative measures have not yet been established.
Endoscopy 01/2006; 37(12):1237-43. · 5.21 Impact Factor
-
Journal of Gastroenterology and Hepatology 06/2005; 20(5):789. · 2.87 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Hepatopulmonary syndrome (HPS) is a condition of significant hypoxia due to intrapulmonary shunting (IPS) in patients with advanced liver disease. Reversibility of HPS after liver transplantation (LT) has been suggested, but the results of LT for HPS remain poorly defined. We studied 78 patients with decompensated liver disease who underwent LT after a preoperative evaluation including contrast echocardiography. We compared the baseline characteristics and outcomes after LT in patients with HPS (n = 13) with those of patients without HPS (n = 65, controls). Before LT, prolongation of prothrombin time was more severe and an advanced Child-Pugh class were more frequent among HPS, patients compared with controls (INR 2.5 +/- 0.8 vs 1.9 +/- 0.7, P = .01; Child-Pugh class A:B:C = 0%:31%:69% vs 14%:65%:21%, P < .01). After LT, no significant differences were observed between the two groups in: clinical outcomes, duration of endotracheal intubation (4.5 +/- 7.7 vs 4.4 +/- 15.0 days), duration of intensive care unit stay (12.0 +/- 8.7 vs 14.4 +/- 19.4 days), duration of total hospital stay (40.0 +/- 33.5 vs 39.8 +/- 23.0), rate of pulmonary complications (7.7% vs 9.2%), or 3-month survival rates (92.3% vs 86.1%). These findings suggest that the presence of HPS does not significantly affect LT outcomes in patients with decompensated liver disease.
Transplantation Proceedings 12/2004; 36(9):2762-3. · 1.00 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Cytotoxic T lymphocytes are essential components of immune responses during chronic hepatitis B (CHB). It has been known that Fas ligand (FasL) and perforin/granzyme B-based mechanisms account for all T cell-mediated cytotoxicity. In the present work, we examined the correlation between injury of the hepatocytes and mRNA expression of FasL and perforin/granzyme B in liver tissue to investigate the roles of both the FasL and the perforin/granzyme B pathways in CHB. Reverse transcription-polymerase chain reaction was used to identify intrahepatic expression of FasL and perforin/granzyme B in liver biopsy specimens from 24 patients with hepatitis B virus (HBV) infection. In addition, the transferase-mediated deoxyuridine triphosphate nick end-labelling (TUNEL) method was used to determine the degree of apoptosis. The degree of mRNA expression and apoptosis were compared with the histologic activity index (HAI) and serology, including alanine aminotransferase (ALT). Intrahepatic mRNA expression rates of FasL, perforin and granzyme B were seen in 79.2, 62.5 and 33.3% of patients, respectively, and correlated with ALT levels (P < 0.05). Intrahepatic expression of FasL and perforin mRNA were significantly correlated with HAI (P < 0.05). Also, apoptosis documented by the TUNEL assay was correlated with HAI and intrahepatic mRNA expression of FasL and perforin (P < 0.05). Our results show that the T-cell mediated perforin death pathway as well as the Fas system play important roles in liver cell injury in HBV infection and that apoptosis mediated by the Fas/FasL system is closely correlated with HAI in chronic HBV infection.
Journal of Viral Hepatitis 03/2004; 11(2):130-5. · 4.09 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: We evaluated the association between HMGI(Y) expression and the detection of malignant cells by simple reverse transcriptase-polymerase chain reaction (RT-PCR) and correlated the level of HMGI(Y) expression and the clinicopathological data in gastric cancer.
We analysed HMGI(Y) expression in 62 gastric cancer tissues and 28 normal gastric tissues by RT-PCR and immunohistochemical study. HMGI(Y) expression evidenced by RT-PCR was observed in 42 (67.7%) of 62 gastric cancer samples, whereas eight (28.6%) of 28 normal gastric tissues were positive (P = 0.001). In immunohistochemical staining for HMGI(Y), 48 (77.4%) of 62 gastric cancers were positive for HMGI(Y), whereas four (6.5%) of 62 normal gastric mucosae around the tumour were weakly positive, particularly in cells of some hyperplastic glands (P < 0.001). There was no significant correlation between the levels of HMGI(Y) expression and stage, tumour size, histological grade, invasion depth, or lymph node metastasis.
Our results suggest that HMGI(Y) expression could be associated with malignant phenotype in human gastric tissue, and that HMGI(Y) may contribute to gastric tumorigenesis.
Histopathology 05/2003; 42(5):466-71. · 3.08 Impact Factor
-
W K Chang, H Y Kim,
D J Kim,
J Lee,
C K Park,
J Y Yoo,
H J Kim,
M K Kim,
B Y Choi,
H S Choi,
K N Park
[show abstract]
[hide abstract]
ABSTRACT: Gastric cancer is still the most common malignant tumor in Koreans. Although many reports have supported the association of Helicobacter pylori infection and the development of gastric cancer, few studies have been adjusted by variable factors such as age. sex, education, and economic status. Furthermore, most results from areas with a high incidence of gastric cancer, such as China and Korea, have failed to document any relationship between H. pylori infection and gastric cancer. We conducted a prospective case-controlled study, with controls matched for and adjusted by age, sex, education, and economic status, to evaluate the causal relationship between H. pylori infection and gastric cancer in Korean people.
From March 1997 to October 1998, 136 consecutive patients with gastric cancer, diagnosed by endoscopic histology, and 136 age- and sex-matched control subjects, confirmed to be free of gastric cancer by endoscopy during the same period, were enrolled in the study. The presence of H. pylori infection was determined by enzyme immunoassay (EIA) serology test.
Seventy-two of the 136 gastric cancer patients (53%) were positive for H. pylori infection and 54 of the 136 control subjects (40%) were positive for H. pylori infection. The odds ratio (OR), adjusted by variable risk factors, such as age, sex, education, and economic status, for gastric cancer in H. pylori-infected patients was 1.82 (95% confidence internal [CI], 1.10-3.00; P = 0.019). The age- and sex-matched OR by conditional logistic regression was 1.6 (95% CI., 1.01-2.53; P = 0.043).
H. pylori infection may be one of the important risk factors for the development of gastric cancer in Korea, an area of high prevalence of H. pylori infection and a high incidence of gastric cancer.
Journal of Gastroenterology 01/2002; 36(12):816-22. · 4.16 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: We analyzed serologic data that were obtained from the Korea Association of Health from 1995 to 1999 to estimate the reliable prevalence of HBV in South Korea.
603,375, 639,465, 621,476, 612,705 and 650,398 serum samples were annually tested for HBsAg. Of HBsAg positive persons whose serum samples were available, HBeAg positivity was checked.
HBsAg positivities among subjects between 6 and 19 years old were 8.2%, 3.9%, 2.1%, 2.6% and 1.3%. HBsAg positivities among subjects above 20 years old were 8.9%, 6.4%, 5.9%, 5.4% and 5.4%. The positive rates of HBeAg were 39.8 to 62.9% among subjects between 6 and 19 years old, and 18.3 to 37.9% among persons above 20 years old, in each year. In both subgroups, HBsAg positivity in the latter year was significantly lower than that in the former year (p < 0.001). It also showed that HBsAg positivities among subjects between 6 and 19 years old have been significantly lower than those among subjects above 20 years old, but those of HBeAg the exact reverse of HBsAg since 1996 (p < 0.001).
It was observed that prevalence of HBV infection in the late 1990s, especially in the group between 6 and 19 years old, was conspicuously lower than that in the past. The nationwide vaccination programme might be one of the most important contributors to this tendency in Korea.
The Korean Journal of Internal Medicine 10/2001; 16(3):153-9.
-
[show abstract]
[hide abstract]
ABSTRACT: Primary hepatic lymphoma is rare. The usual type is a large-cell, high-grade malignant B-cell lymphoma, although T-cell types have been described. Several cases of primary hepatic lymphoma of B-cell origin developing in patients with chronic hepatitis C virus infection have been reported. Recently, new findings have raised the question of the induction of lymphoma by hepatitis C virus. However, the causal relationship between hepatitis C viral infection and primary hepatic lymphoma remains obscure. This article reports a case of histologically proven primary hepatic lymphoma of T-cell origin, which was confined to the liver, in the setting of hepatitis C liver cirrhosis. This association has not previously been reported.
The American Journal of Gastroenterology 10/2000; 95(9):2377-80. · 7.28 Impact Factor
-
S K Yang,
W S Hong,
Y I Min, H Y Kim,
J Y Yoo,
P L Rhee,
J C Rhee,
D K Chang,
I S Song,
S A Jung,
E B Park,
H M Yoo,
D K Lee,
Y K Kim
[show abstract]
[hide abstract]
ABSTRACT: Ulcerative colitis (UC) is regarded as a rare disease in developing countries, but accurate data are generally lacking. We performed the present study to evaluate the incidence and prevalence of UC in Korea.
A retrospective study was performed from 1986 to 1997 in the Songpa-Kangdong district of Seoul, Korea. To recruit UC patients as completely as possible, multiple information sources including all medical facilities in the study area and three referral centres located nearby, but outside the study area were used. The incidence and prevalence rates were adjusted using the 1997 Korean population statistics.
During the study period, a total of 94 incident cases were identified, for an adjusted mean annual incidence rate of 0.68 per 100,000 inhabitants. On 31 December 1997, 91 patients with UC lived in the study area, giving an adjusted prevalence rate of 7.57 per 100,000 inhabitants. By using the Poisson regression analysis, the annual incidence rate increased significantly from 0.20 per 100,000 inhabitants in 1986-1988 to 1.23 per 100,000 inhabitants in 1995-1997 (P < 0.005). Patient age at diagnosis, the interval from onset of symptoms to diagnosis, and the disease extent at diagnosis were fairly constant throughout the study period.
The incidence and prevalence of UC in our study area are still low compared with those of Western countries, but the incidence rate is steadily increasing.
Journal of Gastroenterology and Hepatology 09/2000; 15(9):1037-42. · 2.87 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The association of gastric cancer and chronic duodenal ulcer disease is considered rare. In fact duodenal ulcer disease is believed to somehow "protect" against the development of gastric cancer. Helicobacter pylori infection is an important factor in the development of gastric cancer. No detailed investigation on the prevalence of H. pylori in coexistence of gastric cancer and duodenal ulcer disease has been performed. We evaluated the frequency of H. pylori infection in the patients with co-existence of gastric cancer and duodenal ulcer disease.
During the period March 1994 to February 1995, we collected data from 3,652 patients in whom esophagogastroduodenoscopy was done. During this period, when the cancerous or ulcerative lesions in stomach or duodenum were found, rapid urease tests were performed.
Six patients had concurrent gastric carcinoma and duodenal ulcer disease. Three of the cases had early gastric carcinoma; 2 had active duodenal ulcers and one had a duodenal ulcer scar; all 3 had positive rapid urease tests. The patients with early gastric cancer were younger than the individuals with advanced gastric cancer.
The co-existence of both diseases may be higher than reported from Western countries or from Peru which may either reflect the high prevalence of circulation of H. pylori ulcer and cancer strains in Korea and the co-infection with both types of organism in some individuals.
Helicobacter 01/1998; 2(4):205-9. · 3.15 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Helicobacter pylori infection has been associated with chronic atrophic gastritis, a precursor of gastric cancer. We conducted a prospective, case-controlled study to investigate whether H. pylori infection increases the risk of gastric cancer in Korean people with a high risk of gastric cancer. We enrolled 160 gastric cancer patients who were confirmed by endoscopic biopsy during 1994 and 160 age-matched control subjects with non-ulcer dyspepsia were compared to document the relationship between H. pylori infection and gastric cancer. The presence of H. pylori infection was determined by the rapid urease test and/or histology by Wright-Giemsa staining. The overall presence of H. pylori infection was 60% in gastric cancer patients and 51.9% in age-matched control subjects (odds ratio 1.39; 95% confidence interval 0.894-2.17; P = 0.143). Carcinomas of cardia, body and antrum were not associated with H. pylori infection (odds ratio 1.43, 1.69 and 1.29, respectively; 95% confidence interval, 0.271-7.52, 0.787-3.62 and 0.689-2.43, respectively; P = 0.178, 0.177 and 0.642, respectively) nor was the intestinal or diffuse type of cancer (odds ratio 1.39 and 1.40, respectively; 95% confidence interval 0.791-2.45 and 0.681-2.87, respectively; P = 0.250 and 0.835, respectively). Gender was not a risk for gastric cancer. In contrast to previous studies, these results do not provide evidence of H. pylori infection for gastric carcinogenesis in Korea.
Journal of Gastroenterology and Hepatology 03/1997; 12(2):100-3. · 2.87 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Numerous epidemiologic data have documented that chronic infection by hepatitis C virus (HCV) is a major risk factor for the development of hepatocellular carcinoma (HCC). But the molecular mechanism underlying these strong epidemiologic associations between HCV and HCC has not be elucidated. We observed the changes of HCV in HCC to investigate the association of HCV with HCC.
We used competitive and quantitative polymerase chain reaction and dideoxy-nucleotide chain termination method to compare HCV titers and sequences of the hypervariable region of E2/NS1 region of four isolates from the HCC and surrounding cirrhotic liver tissues in tow anti-HCV positive patients.
The copy numbers of HCV-RNA were 1 x 10(6) and 4 x 10(6)/gm wet weight of HCC, and 8 x 10(7) and 3.2 x 10(8)/gm wet weight of cirrhotic liver tissues from patient-1 and -2. The sequence differences between HCV RNA in HCC and in cirrhotic liver were two and five nucleotides in patient-1 and in patient-2 respectively. The amino acid sequences were changed in one and two site in each patient.
These findings may suggest the possible etiological role of HCV in carcinogenesis of HCC, but complete sequence analysis of HCV including multiple isolates in the same patient, should be performed in many cases.
The Korean Journal of Internal Medicine 02/1997; 12(1):28-33.
-
[show abstract]
[hide abstract]
ABSTRACT: A 32-year-old male patient, diagnosed as a hepatic solitary angiomyolipoma post-operatively, is reported. The tumor was well definedly inhomogenous fat density mass on ultrasonography, computerized tomography (CT) and magnetic resonance imaging (MRI). The lesion was hypervascular on arteriography. The diagnosis was confirmed by an extended right lobectomy and histological examination.
The Korean Journal of Internal Medicine 02/1995; 10(1):73-7.
-
[show abstract]
[hide abstract]
ABSTRACT: After the discovery of type C hepatitis virus, the studies on this virus are extensively progressing. The treatment of this viral infection is also widely progressing. Among many agents, recombinant interferon alpha therapy is generally accepted as an effective single agent. To evaluate the efficacy of interferon and to observe the changes of serum aminotransferase (ALT), antibody to hepatitis C virus (anti-HCV) and HCV ribonucleic acid (HCV-RNA), we treated 10 patients with chronic type C hepatitis for 6 months.
Patients were randomly divided into 2 groups: 5 patients in group A received interferon and the other 5 in group B received no therapy. Interferon was administered at a dose of 3 million units (MU) daily for the first month and thrice weekly for the following 5 months, and followed up for 2 years.
In group A, serum ALT returned to normal in 4: 3, starting at the first month and one at the 3rd month of therapy and maintained normal throughout the follow-up period. In contrast, serum ALT level persistently fluctuated in 4 patients in group B. In one patient, serum ALT returned to normal one and a half years later. Regardless of therapy, serum anti-HCV titer remained unchanged in all patients. However, HCV-RNA, using polymerized chain reaction (PCR), became undetectable in all responded patients and in one untreated patient whose serum ALT returned to normal spontaneously.
This study suggested that interferon alpha therapy in patients with chronic type C hepatitis may be clinically effective. Our study also indicated that the detection of HCV-RNA by PCR is useful to predict the prognosis of chronic type C hepatitis.
The Korean Journal of Internal Medicine 02/1992; 7(1):13-7.
-
[show abstract]
[hide abstract]
ABSTRACT: Although intestinal metastases from lung cancer are not rare at postmortem studies, the development of clinically significant symptoms from the gastrointestinal metastases is very unusual. We report a case of small intestinal hemorrhage leading to intestinal perforation secondary to metastases from a large cell carcinoma of the lung in a 31-year-old man along with a review of the literature.
The Korean Journal of Internal Medicine 08/1991; 6(2):79-84.
-
[show abstract]
[hide abstract]
ABSTRACT: Ten patients with severe chronic type B hepatitis confirmed by liver biopsy were treated with prednisolone for eight weeks and followed up for more than one year. The patients were comprised of 6 males and 4 females, ages 17 to 45 (mean 32) yrs. Serum alanine aminotransferase (ALT) was elevated more than one month before the treatment in all (mean: 379 U/L, range: 87 to 772 U/L). Initial serological tests showed hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) in all and hepatitis B virus DNA (HBV-DNA) in 7/10 (70%). Liver biopsy showed severe chronic active hepatitis with confluent necrosis or acinar hepatitis in all. Prednisolone, 60 mg/day, was administered initially and the dose was tapered every 2 weeks over the 8 weeks period. Two to six months after cessation of treatment, 5 of 10 patients showed a disappearance of HBeAg and serum HBV-DNA and return of serum ALT level to normal (responders). The initial serum ALT level in responders was slightly higher than that of non-responders (mean: 404 vs. 355 U/L), but there was no statistical significance. Among 5 responders, serum HBV-DNA was detected in three patients initially and was transiently detected in one patient during treatment. In non-responders, HBeAg persisted during and after the treatment and serum HBV-DNA persisted in three, but serum ALT was decreased in all. One patient who did not show any clinical or serological improvement, died of jaundice, ascites and hepatic encephalopathy 4 months later.(ABSTRACT TRUNCATED AT 250 WORDS)
The Korean Journal of Internal Medicine 02/1989; 4(1):80-5.
