Jang Eon Kim

Seoul National University Bundang Hospital, Sŏul, Seoul, South Korea

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Publications (6)4.22 Total impact

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    ABSTRACT: Numerous medications have the potential to induce acute pancreatitis. However, isoniazid-induced acute pancreatitis is extremely rare. Drug-induced acute pancreatitis can be diagnosed by improvement after stopping the drug and recurrence of pancreatitis when rechallenged. We present a case of severe acute pancreatitis accompanied by multiple large pseudocysts after isoniazid treatment for pulmonary tuberculosis. We confirmed that isoniazid induced pancreatitis by rechallenging after treatment cessation. Most previous reports of isoniazid-induced pancreatitis have been clinically mild forms, and the patient fully recovered with supportive management. However, this case presents severe and permanent pancreatic damage that developed with 5 weeks of isoniazid treatment. When a patient presents with manifestations of pancreatitis during treatment of tuberculosis that includes isoniazid, the physician should consider isoniazid-induced pancreatitis.
    No preview · Article · Jan 2012
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    ABSTRACT: To investigate the preoperative factors that can predict neoplastic polypoid lesions of the gallbladder (PLGs) as well as malignant PLGs. A retrospective analysis was conducted on the 210 consecutively enrolled patients who underwent cholecystectomy due to a PLG larger than 10 mm, as was determined by preoperative trans-abdominal ultrasonography or endoscopic ultrasonography. We analyzed the medical, laboratory, radiologic data and the pathologic results. In 210 cases, 146 had non-neoplastic polyps (69.5%) and 64 cases were neoplastic polyps (30.5%). An older age (≥ 65 years), the presence of diabetes mellitus (DM) and the size of polyp (≥ 15 mm) were revealed to be independent predictive variables for neoplastic polyps with odd ratios (OR) of 2.27 (P = 0.044), 2.64 (P = 0.021) and 4.94 (P < 0.01), respectively. Among the neoplastic PLGs, an older age (≥ 65 years), the presence of DM and polyp size (≥ 15 mm) were associated with malignancy with ORs of 4.97 (P = 0.005), 6.13 (P = 0.001) and 20.55 (P < 0.001), respectively. Among patients with PLGs larger than 10 mm in size, higher risk groups such as elderly patients more than 65 years old, those with DM or a large polyp size (≥ 15 mm) should be managed by cholecystectomy.
    Full-text · Article · May 2011 · World Journal of Gastroenterology
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    ABSTRACT: Endoscopic retrograde cholangiopancreatograpy (ERCP) is often used for the diagnosis and treatment of pancreaticobiliary diseases in the elderly patients. However, few studies have assessed its efficacy and safety in the very elderly. The purpose of this study was to evaluate the clinical outcomes of ERCP in the very elderly patients. Eight hundreds two patients who underwent ERCP at Seoul National University Bundang hospital were enrolled retrospectively. They were divided into three groups according to their ages (non-elderly group, elderly group and very-elderly group; <65, 65-79 and >or=80, respectively). The indications and clinical outcomes including the complications of ERCP were compared among groups. The most common indication of ERCP was acute cholangitis in all the three groups. Periampullary diverticulum was more frequently observed in elderly and very-elderly patients than in younger patients. Mean duration of hospitalization was not different among three groups. ERCP success rate in all enrolled patients was approximately 90%, and there was no difference in terms of technical success rate between groups (p=0.1). However, the number of ERCP sessions was significantly higher in the very-elderly patients compared to in the non-elderly and elderly (1.38 vs. 1.13 and 1.18 respectively; p<0.001). There was no difference in mortality and complication rate between groups. ERCP can be performed safely in very-elderly patients. Therefore, only age should not be regarded as one of the major determining factors whether to perform ERCP.
    Full-text · Article · Apr 2011 · The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi
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    ABSTRACT: The aim of this study was to investigate the overall clinical characteristics of elderly patients with acute pancreatitis. We retrospectively evaluated 227 consecutively enrolled patients who were admitted with acute pancreatitis. The clinical features, the radiological and laboratory data and the clinical outcome were analyzed according to the age groups (≥ 65 years vs. <65 years). Among the 227 enrolled patients with acute pancreatitis, there were 85 elderly patients and 142 non-elderly. The mean age of the elderly patients was 72.3 ± 5.5 years and that of the non-elderly was 44.7 ± 11.7 (p<0.001). For the elderly patients, biliary pancreatitis was the most common cause (56.5%), but alcoholic pancreatitis was most common in the non-elderly patients (45.8%). Although the computed tomography (CT) severity index was significantly higher for the non-elderly patients (p<0.001), the acute physiology and chronic health evaluation (APACHE II) score was significantly higher for the elderly than that for the non-elderly (p<0.001). However, the duration of the hospital stay (10.3 ± 9.6 days vs. 11.9 ± 10.1 days, p=0.619) and mortality (3.5% vs. 0.7%, p=0.148) were not different between the age-groups. In our study, chronological age had no significant influence on the clinical outcome in spite of the different etiologies and severity of acute pancreatitis.
    No preview · Article · Feb 2011 · Archives of gerontology and geriatrics
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    ABSTRACT: Effective bowel preparation is essential for accurate diagnosis of colon disease. We investigated efficacy and safety of 2 L polyethylene glycol (PEG) solution with 90 mL sodium phosphate (NaP) solution compared with 4 L PEG method. Between August 2009 and April 2010, 526 patients were enrolled who visited Seoul National University Bundang Hospital for colonoscopy. We allocated 249 patients to PEG 4 L group and 277 patients to PEG 2 L with NaP 90 mL group. Detailed questionnaires were performed to investigate compliance, satisfaction and preference of each method. Bowel preparation quality and segmental quality were evaluated. Success was defined as cecal intubation time less than 20 minutes without any help of supervisors. Both groups revealed almost the same baseline characteristics except the experience of operation. PEG 4 L group's compliance was lower than PEG 2 L with NaP 90 mL group. Success rate and cecal intubation time was not different between two groups. Overall bowel preparation quality of PEG 2 L with NaP 90 mL group was better than PEG 4 L group. Segmental bowel preparation quality of PEG 2 L with NaP 90 mL group was also better than PEG 4 L group in all segments, especially right side colon. Occurrence of hyperphosphatemia was higher in PEG 2 L with NaP 90 mL group than PEG 4 L group. However, significant adverse event was not reported. PEG 2 L with NaP 90 mL method seems to be more effective bowel preparation than PEG 4 L method.
    Preview · Article · Nov 2010 · The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi
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    ABSTRACT: The human leukocyte antigen (HLA) system is an integral component of immune response. Highly polymorphic HLA genes may play a pivotal role in the response of antiviral therapy. We investigated the effects of HLA gene polymorphism on the clinical outcome of chronic hepatitis B patients who received lamivudine treatment. Depending on their clinical response to lamivudine therapy, a total of sixty one patients were divided into following groups; non-responders, viral breakthroughers, relapsers, and seroconverters. HLA-A, -B, -Cw, -DRB and HLA-DRB1 alleles typing was performed on each group through the polymerase chain reaction and the sequence-specific oligonucleotide hybridization method. The distribution patterns of HLA-A, HLA-B, HLA-Cw, HLA-DRB, and HLA-DRB1 were then analysed. When non-responders were compared to the other groups, high frequencies in HLA-Cw1, HLA-DRB14 and HLA-DRB4 (p=0.015, 0.033 and 0.004 respectively) were evident. When seroconverters were compared to viral breakthroughers, high frequencies in HLA-A2 and HLA-DRB4 (p=0.048, 0.025 respectively) were evident. Our data suggests that HLA-A2, HLA-Cw1, HLA-DRB14 genes are related to the clinical outcomes of lamivudine treatment in chronic hepatitis B patients. These genes may be used in the prediction of the clinical outcome of lamivudine therapy in chronic hepatitis B patients.
    No preview · Article · Jan 2009 · The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi