75 results on '"Moon, Won"'
Search Results
2. Clinical Significance of TWIST-Positive Circulating Tumor Cells in Patients with Esophageal Squamous Cell Carcinoma.
- Author
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Hyun Jung Lee, Gwang Ha Kim, Su Jin Park, Chae Hwa Kwon, Moon Won Lee, Bong Eun Lee, Dong Hoon Baek, and Hoseok
- Subjects
SQUAMOUS cell carcinoma ,ESOPHAGEAL cancer ,SEXUAL dimorphism ,EPITHELIAL-mesenchymal transition ,GASTROINTESTINAL cancer ,GASTROINTESTINAL tumors - Abstract
Background/Aims: Unlike other gastrointestinal tract cancers, there are relatively few reports on the clinical significance of circulating tumor cells (CTCs) and TWIST, a marker of epithelial-mesenchymal transition, in patients with esophageal squamous cell carcinoma (ESCC). This study aimed to evaluate the clinical significance of TWIST expression in CTCs in patients with ESCC. Methods: Peripheral blood samples for CTC analyses were prospectively obtained from 52 patients with ESCC prior to treatment between September 2017 and September 2019. CTCs were detected using a centrifugal microfluidic system based on a fluid-assisted separation technique, and CTCs positive for TWIST on immunostaining were defined as TWIST (+) CTCs. Results: Of the 52 patients with ESCC, CTCs and TWIST (+) CTCs were detected in 44 patients (84.6%) and 39 patients (75.0%), respectively. The CTC and TWIST (+) CTC counts were significantly higher in patients aged >65 years and those who had a large tumor (>3 cm) than in those aged ≤65 years and those who had a small tumor (≤3 cm), respectively. There were no differences in CTC and TWIST (+) CTC counts according to tumor location, histologic grade, or TNM stage. TWIST (+) CTCs were significantly associated with histologic grade; a proportion of TWIST (+) CTCs ≥0.5 was significantly associated with advanced histologic grade. Other clinicopathologic characteristics such as sex, age, tumor location, tumor size, and TNM stages were not significantly associated with TWIST (+) CTCs. Conclusions: Our study showed that TWIST (+) CTCs were frequently detected in patients with ESCC, and a high proportion of TWIST (+) CTCs was associated with poor differentiation. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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3. Clinical Application of Circulating Tumor Cells in Gastric Cancer.
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Moon Won Lee, Gwang Ha Kim, Hye Kyung Jeon, and Su Jin Park
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STOMACH cancer , *CANCER cells , *HEMATOMA , *EARLY diagnosis , *BIOPSY - Abstract
Early detection and accurate monitoring of cancer is important for improving clinical outcomes. Endoscopic biopsy and/ or surgical resection specimens are the gold standard for diagnosing gastric cancer and are also useful for selecting therapeutic strategies based on the analysis of genomic/ immune parameters. However, these approaches cannot be easily performed because of their invasiveness and because these specimens do not always reflect tumor dynamics and drug sensitivities during therapeutic processes, especially chemotherapy. Accordingly, many researchers have tried to develop noninvasive novel biomarkers that can monitor realtime tumor dynamics for early diagnosis, prognostic evaluation, and prediction of recurrence and therapeutic efficacy. Circulating tumor cells (CTCs) are metastatic cells that are released from the primary tumors into the blood stream and comprise a crucial step in hematogenous metastasis. CTCs, as a liquid biopsy, have received a considerable amount of attention from researchers since they are easily accessible in peripheral blood, avoiding the invasiveness associated with traditional biopsy techniques; they can also be used to derive clinical information for monitoring disease status. In this review, with respect to CTCs, we summarize the metastatic cascade, detection methods, clinical applications, and prospects for patients with gastric cancer. [ABSTRACT FROM AUTHOR]
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- 2019
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4. Bismuth-Based Quadruple Therapy for Clarithromycin-Resistant Helicobacter pylori Infection: Effectiveness and Cost-Efficiency.
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Moon Won Lee and Gwang Ha Kim
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MEDICAL research - Published
- 2022
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5. Metachronous Gastric Cancer: Another Hurdle for Successful Endoscopic Treatment for Early Gastric Cancer?
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Moon Won Lee and Gwang Ha Kim
- Subjects
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STOMACH cancer , *HELICOBACTER pylori infections , *ENDOSCOPIC surgery - Published
- 2020
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6. Comparison of 2012 and 2017 International Consensus Guideline in Terms of Mural Nodule for Predicting Malignant Intraductal Papillary Mucinous Neoplasms.
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Sung Yong Han, Dong Uk Kim, Moon Won Lee, Young Joo Park, Dong Hoon Baek, Gwang Ha Kim, and Geun Am Song
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PANCREATIC cysts ,ENDOSCOPIC ultrasonography ,MAGNETIC resonance imaging ,CARCINOEMBRYONIC antigen ,TUMORS ,COMPUTED tomography - Abstract
Background/Aims The mural nodule is a key point of differential diagnosis of malignant intraductal papillary mucinous neoplasm (IPMN). As the consensus guideline of IPMN was revised in 2017, the criteria for the worrisome feature and high risk stigmata of the mural nodule were changed. The purpose of this study was to investigate the predictive rate of malignancy between 2012 and 2017 guideline. Methods We retrospectively analyzed patients who underwent surgery caused of cystic neoplasm from March 2011 to August 2018. A total of 61 patients were included. Among these patients, MCN and main duct type IPMN were excluded. Finally, total of 25 patients were included. Results Fourteen patients were male and the median age was 68 years old. Four patients were diagnosed as malignant IPMN. The median serum CA 19-9 was 8.5 IU/mL; carcinoembryonic antigen was 2.5 IU/mL; and median largest cyst size was 35 mm. Computed tomography (CT) and magnetic resonance imaging (MRI) were revealed CE mural nodules in three cases and non-CE mural nodule in four cases. Endoscopic ultrasound (EUS) was revealed mural nodule in seven cases. Total 11 patients have mural nodule that was proven by CT/MRI/EUS. Nine patients have a mural nodule 5 mm or more at EUS or CE mural nodule at CT/MRI. The sensitivity of malignant IPMN diagnosis was 100%; the specificity was 66.6%; and the positive predictive value was 36.4% in 2012 guideline. When we investigate the mural nodule based on the 2017 guideline; there were 100% of sensitivity; 76.2% of specificity and 44.4% of positive predictive value. Conclusions The 2017 revised guideline have slightly higher specificity and positive predictive value than those of the 2012 guideline for malignant IPMN diagnosis. The 2017 revised guideline was more accurate method to detect malignancy in terms of mural nodule. [ABSTRACT FROM AUTHOR]
- Published
- 2019
7. Comparison of First-Line Chemotherapy for Pancreatic Cancer: Aspect of Prognosis According to Chemoresponse of CA19-9.
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Sung Yong Han, Dong Uk Kim, Moon Won Lee, Young Joo Park, Dong Hoon Baek, Gwang Ha Kim, and Geun Am Song
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PANCREATIC cancer ,CANCER chemotherapy ,CANCER prognosis ,C++ ,METASTASIS - Abstract
Background/Aims Gemcitabine plus nab-paclitaxel (GA) and FOLFIRINOX have been widely used as standard first-line treatment in pancreatic cancer. We evaluated retrospective analysis comparing the result of GA and FOLFIRINOX. Methods We analyzed 84 patients who presented with pancreatic cancer were underwent chemotherapy GA (n=44) or FOLFIRINOX (n=38) as a first line treatment between 2013 and 2019 April. The study was additionally analyzed three subgroups: carbohydrate antigen 19-9 (CA19-9) below 200 IU/mL before chemotherapy, patients has over 200 IU/mL, but CA19-9 level was decreased over 50% after 1st cycle of chemotherapy, patients with high CA19-9 and that was not decreased after 1st chemotherapy. Results There was no significantly differences between the two groups in baseline characteristics, excepts high ratio of metastasis in AG group. The response rates (15.9% vs 7.9%) was higher in GA group and median overall survival (OS) (386 days vs 298 days) and progression- free survival (PFS) (229 days vs 211 days) was comparable between two groups (p=0.119, p=0.131, and p=521, respectively). However, in patient with metastatic pancreatic cancer, GA group has longer median OS (405 days vs 209 days, p=0.012) and PFS (244 days vs 147 days, p=0.031). Subgroup C has a poor prognosis. However, subgroup B was not significantly difference with subgroup A. When compared subgroup C with: A plus B, there was significantly difference in overall OS and PFS (OS: A+B 359 days vs C 223 days, p=0.029; PFS: A+B 265 days vs C 158 days, p=0.034). Conclusions GA and FOLFIRINOX showed comparable efficacy outcomes. GA was more effective in metastatic pancreatic cancer. CA19-9, which decreases by more than 50% after chemotherapy, is not associated with poor prognosis. [ABSTRACT FROM AUTHOR]
- Published
- 2019
8. [Risks of Cancer Associated with Therapeutic Drugs for Inflammatory Bowel Disease].
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Moon W and Park JJ
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- Humans, Immunosuppressive Agents therapeutic use, Immunosuppressive Agents adverse effects, Antibodies, Monoclonal therapeutic use, Antibodies, Monoclonal adverse effects, Neoplasms drug therapy, Risk Factors, Colitis, Ulcerative drug therapy, Inflammatory Bowel Diseases drug therapy
- Abstract
Crohn's disease and ulcerative colitis are lifelong chronic inflammatory conditions, with many patients requiring ongoing immunomodulatory drug therapy for maintenance treatment. Recent therapeutic goals in inflammatory bowel disease (IBD) are not only aimed at symptomatic remission but also at achieving mucosal healing to improve the natural course of the disease. In this context, therapeutic approaches are being applied in clinical settings that involve early and appropriate use of drugs, such as immunomodulators or biologics, that have the potential to induce healing of the inflamed intestine before irreversible intestinal damage occurs. All drugs that continuously control intestinal inflammation in IBD can heal the mucosa and potentially reduce the incidence of colitis-associated bowel cancer; however, the continuous use of immunosuppressants can potentially increase the risk of malignancies. The safety issues of the drugs used in clinical practice are partly confirmed during their development processes or shortly after initial marketing, but in other cases, they are estimated through post-marketing case reports or epidemiological studies, sometimes decades after drug approval. This review explores the risks associated with malignancies related to the treatment of IBD, focusing on drugs currently approved in Republic of Korea.
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- 2024
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9. Effective Endoscopic Submucosal Dissection of a Huge Esophageal Liposarcoma: A Case Report.
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Lee MJ, Lee MW, Joo DC, Hong SM, Baek DH, Lee BE, Kim GH, and Song GA
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- Humans, Male, Middle Aged, Tomography, X-Ray Computed, Cyclin-Dependent Kinase 4 metabolism, Proto-Oncogene Proteins c-mdm2 metabolism, Esophagoscopy, Esophageal Neoplasms surgery, Esophageal Neoplasms pathology, Esophageal Neoplasms diagnosis, Endoscopic Mucosal Resection, Liposarcoma surgery, Liposarcoma pathology, Liposarcoma diagnosis
- Abstract
This case report presents the successful endoscopic submucosal dissection (ESD) of a well-differentiated esophageal liposarcoma in a 51-year-old male with persistent dysphagia. The cause was initially diagnosed as a 10 cm pedunculated lesion extending from the upper esophageal sphincter to the mid-esophagus. An ESD was chosen over traditional surgery because it is less invasive. The procedure involved a precise submucosal injection and excision with special techniques to manage bleeding from a central vessel. Despite the extraction challenges owing to the size of the lesion, it was successfully removed orally. A histopathological examination of the 8.3×4.2×2.3 cm specimen revealed the characteristic features of a well-differentiated liposarcoma, including MDM2 and CDK4 positivity. The follow-up revealed no recurrence, and active surveillance has been performed since. This report highlights the versatility of ESD in treating significant esophageal tumors and provides evidence for its efficacy as a minimally invasive alternative.
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- 2024
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10. A Case of Esophageal MALT Lymphoma Mimicking a Subepithelial Tumor.
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Lee HE, Kim GH, Kim MJ, Kim KB, Joo DC, Jeon HK, Lee MW, and Lee BE
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- Humans, Diagnosis, Differential, Male, Middle Aged, Lymphoma, B-Cell, Marginal Zone diagnosis, Lymphoma, B-Cell, Marginal Zone pathology, Esophageal Neoplasms diagnosis, Esophageal Neoplasms pathology, Tomography, X-Ray Computed, Endosonography
- Abstract
Mucosa-associated lymphoid tissue (MALT) lymphoma, also known as extranodal marginal zone lymphoma, is a low-grade B-cell lymphoma that can develop in the mucosal layer of various organs, including the gastrointestinal tract, salivary glands, lungs, and skin. The most common site is the gastrointestinal tract, particularly the stomach. On the other hand, primary esophageal lymphomas are extremely rare. MALT lymphomas can undergo histological transformation into more aggressive B-cell lymphomas, such as diffuse large B-cell lymphoma, resulting in a poor prognosis. This paper reports a rare case of primary esophageal MALT lymphoma mimicking a subepithelial tumor located in the lower esophagus that was treated successfully with radiotherapy. MALT lymphoma should be included in a differential diagnosis when subepithelial tumors are found in the esophagus, particularly if endoscopic ultrasonography reveals the tumor to be located in the deep mucosal and submucosal layers. Following the precise diagnosis, accurate staging and appropriate treatment are crucial. Regular follow-up is necessary to assess the possibility of recurrence or transformation to high-grade lymphoma.
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- 2024
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11. Comparison of the Clinical Outcomes of Esophagectomy and Concurrent Chemoradiotherapy in Patients with Locally Advanced Esophageal Squamous Cell Carcinoma.
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Lee MH, Park MI, Lee JW, Jung K, Kim JH, Kim SE, Moon W, and Park SJ
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- Humans, Retrospective Studies, Esophagectomy, Prospective Studies, Chemoradiotherapy methods, Esophageal Squamous Cell Carcinoma therapy, Esophageal Squamous Cell Carcinoma pathology, Esophageal Neoplasms therapy
- Abstract
Background/aims: The efficacy of concurrent chemoradiotherapy (CCRT) or esophagectomy for locally advanced esophageal squamous cell carcinoma (ESCC) is unclear. This study compared the survival and recurrence of patients with locally advanced ESCC after definitive CCRT and surgery., Methods: A retrospective study was conducted on patients with locally advanced ESCC who underwent CCRT or esophagectomy at Kosin University Gospel Hospital from January 2010 to December 2016. The patients' baseline characteristics, pathology, recurrence rate, and three-year/five-year overall survival were obtained., Results: This study evaluated ESCC patients with cT1-T2, N+ or cT3-T4, or N, who were treated by definitive CCRT (n=14) or esophagectomy (n=32). No significant difference was noted between the two groups, except for the location of the cancer and performance state. The respective three- and five-year overall survival rates were 30.8% and 23.1% in the CCRT group and 40.2% and 22.5% in the esophagectomy group (p=0.685). In the CCRT group, three patients (21.4%) had a complete response, and two (66.7%) had a recurrence. In the esophagectomy group, an R0 resection was achieved in 28 (87.5%) patients, and a recurrence occurred in 18 (64.3%). The median disease-free survival in the CCRT and esophagectomy groups was 14 and 17 months, respectively (p=0.882)., Conclusions: These results showed no significant difference in survival between the definitive CCRT and surgery as the initial treatment. Nevertheless, larger prospective studies will be needed because of the retrospective nature and small number of patients in this study.
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- 2024
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12. [A Case of Type II Achalasia Occurring in a Nonagenarian Diagnosed with Acute Food Impaction].
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Koh SH, Park MI, Jung WH, Jung K, Kim SE, Moon W, and Park SJ
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- Aged, 80 and over, Female, Humans, Nonagenarians, Hospitals, Peristalsis, Esophageal Achalasia diagnosis, Esophageal Motility Disorders
- Abstract
Achalasia is an esophageal motility disorder characterized by loss of esophageal peristalsis and impaired relaxation of the lower esophageal sphincter. Patients with achalasia often complain of persistent symptoms for several years before diagnosis. On the other hand, achalasia diagnosed as a sudden esophageal food impaction is uncommon, and no report has been issued on the diagnosis and successful treatment of achalasia in a 95-year-old patient. We report a case of achalasia diagnosed by high-resolution esophageal manometry and timed barium esophagography after food material removal by endoscopy in a 95-year-old woman who visited the hospital due to sudden esophageal food impaction and was successfully treated by endoscopic balloon dilatation.
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- 2024
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13. Improvement of Severe Colon Stricture after Rituximab Therapy for Concomitant Mucosa-associated Lymphoid Tissue Lymphoma in a Patient with Ulcerative Colitis.
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Park HJ, Moon W, Park SJ, Park MI, Kim SE, Kim JH, Jung K, Seo KI, Lee EM, and Jung M
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- Female, Humans, Adult, Rituximab therapeutic use, Constriction, Pathologic etiology, Inflammation, Lymphoma, B-Cell, Marginal Zone complications, Lymphoma, B-Cell, Marginal Zone diagnosis, Lymphoma, B-Cell, Marginal Zone drug therapy, Colitis, Ulcerative complications, Colitis, Ulcerative diagnosis, Colitis, Ulcerative drug therapy
- Abstract
Colorectal strictures are uncommon in patients with ulcerative colitis (UC). An extranodal marginal zone B-cell lymphoma of mucosa- associated lymphoid tissue (MALT) lymphoma is rarely involved in the colon but may be associated with inflammatory bowel diseases. A 41-year-old female with a six-year history of UC presented with a severe stricture of the sigmoid colon that prevented the passage of a colonoscope. A histological examination revealed non-specific inflammation and fibrosis without dysplasia or cancer. Despite conventional treatment, including mesalazine and azathioprine for one year after that visit, the stricture persisted. In addition, diffuse, edematous exudative inflammation and multiple shallow ulcers were observed in the distal rectum, revealing a MALT lymphoma testing positive for CD20, CD43, CD5, and Bcl-2, but negative for CD3, CD10, CD23, and cyclin-D1. Four weekly doses of rituximab were administered. Follow-up colonoscopy performed one month after treatment revealed slight improvement in the rectal lesion without remnant histological evidence of a MALT lymphoma. In addition, the stricture showed marked improvement, and the colonoscope could pass easily through the stricture site. This is the first case report on an improvement of a severe sigmoid colon stricture in a patient with UC after rituximab treatment for a concomitant rectal MALT lymphoma.
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- 2023
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14. Case of Concomitant Endoscopic Treatment of Achalasia with Superficial Esophageal Cancer.
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Lee MH, Jung K, Kim JH, Kim SE, Moon W, Park MI, and Park SJ
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- Male, Humans, Aged, Esophageal Sphincter, Lower, Esophagoscopy, Treatment Outcome, Esophageal Achalasia complications, Esophageal Achalasia diagnosis, Natural Orifice Endoscopic Surgery, Esophageal Neoplasms complications, Esophageal Neoplasms diagnosis
- Abstract
Achalasia, a rare motility disorder of the esophagus, is generally accepted as a premalignant disorder. This paper presents the case of a 72-year-old male with achalasia and synchronous superficial esophageal cancer who experienced dysphagia symptoms for five years. As achalasia is associated with an increased risk of esophageal cancer, both can be treated simultaneously if detected at the time of diagnosis. Achalasia and synchronous esophageal cancer are rarely detected and treated endoscopically. This paper reports a case of concurrent successful treatment.
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- 2023
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15. A Gastric Magnetic Foreign Body Incidentally Detected Several Years after Ingestion.
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Joo DC, Lee MW, Hong SM, Baek DH, Lee BE, Kim GH, and Song GA
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- Male, Child, Adult, Humans, Middle Aged, Stomach, Eating, Magnetic Phenomena, Intellectual Disability complications, Foreign Bodies complications, Foreign Bodies diagnosis
- Abstract
Foreign body ingestion is commonly seen in children. However, occasionally it may also be seen among adults and is often associated with intellectual disability, psychiatric disorders, and alcoholism. Ingestion of a magnetic foreign body may cause complications such as gastrointestinal tract perforation, wherein emergency endoscopic removal of the foreign body is generally required. Here, we report a rare case of a 59-year-old male with an intellectual disability and psychiatric disorder in whom metallic objects in the stomach cavity were accidentally discovered during abdominal CT. Esophagogastroduodenoscopy revealed several metallic objects attached to two magnets, which had been ingested several years before and had remained in the stomach cavity. The magnets and metallic objects were safely removed endoscopically using rat-tooth forceps without complications.
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- 2023
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16. Endoscopic Resection for Gastric Adenocarcinoma of the Fundic Gland Type: A Case Series.
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Lee HJ, Kim GH, Joo DC, Lee MW, Lee BE, and Kim K
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- Humans, Stomach Neoplasms diagnosis, Stomach Neoplasms surgery, Helicobacter Infections, Helicobacter pylori, Adenocarcinoma diagnosis, Adenocarcinoma surgery
- Abstract
The fundic gland type (GA-FG) of gastric adenocarcinoma is a rare variant of gastric cancer recently included in the 5th edition of the World Health Organization's classification of digestive system tumors. Five patients with GA-FG underwent an endoscopic resection at our institution. None of the patients had a Helicobacter pylori infection. Four lesions were located in the upper third of the stomach, and one was in the lower third. Three lesions had a IIa shape, while two resembled a subepithelial tumor. An endoscopic submucosal dissection was performed in four patients and endoscopic mucosal resection in one. Tumor cells were composed of well-differentiated columnar cells mimicking fundic gland cells, and the median tumor size was 10 mm. Three lesions exhibited submucosal invasion. No lymphatic or venous invasion was observed. Tumor cells were positive for MUC6 in all five cases; one case was focally positive for MUC5AC. No recurrence was observed during a median follow-up period of 13 months. An endoscopic resection can be a safe treatment modality for GA-FG, considering its small size and low risk of recurrence or metastasis.
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- 2023
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17. [Pediatric-onset Inflammatory Bowel Disease: What Are Different from Adult in the Treatment?]
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Choi S and Moon W
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- Adult, Child, Humans, Nutritional Status, Quality of Life, Colitis, Inflammatory Bowel Diseases diagnosis, Inflammatory Bowel Diseases drug therapy
- Abstract
Pediatric-onset inflammatory bowel disease differs from adults in its epidemiological and clinical characteristics and courses. Since it is diagnosed at a young age, the duration of the disease is relatively longer than in adults. Therefore, it is necessary to select drugs in consideration of long-term risks and benefits, and efforts such as therapeutic drug monitoring to maximize the treatment effects and minimize side effects are required. In addition, special considerations for treating pediatric-onset inflammatory bowel disease include attention to the effects of the disease on growth and development, nutrition, and psychosocial problems. In children, more aggressive treatment is needed to avoid missing therapeutic window of opportunity during periods of rapid growth and development. Finally, efforts should be made to ensure that the therapeutic goals of mucosal healing are achieved, the quality of life is restored, and the transition to adult therapy is well carried out.
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- 2021
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18. Therapeutic Potential of Escherichia coli Nissle 1917 in Clinically Remission-attained Ulcerative Colitis Patients: A Hospital-based Cohort Study.
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Oh GM, Moon W, Seo KI, Jung K, Kim JH, Kim SE, Park MI, and Park SJ
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- Adult, Aged, Feces chemistry, Female, Humans, Inflammation diagnosis, Leukocyte L1 Antigen Complex analysis, Male, Middle Aged, Remission Induction, Retrospective Studies, Young Adult, Colitis, Ulcerative diagnosis, Colitis, Ulcerative therapy, Escherichia coli, Inflammation therapy, Probiotics adverse effects, Probiotics therapeutic use
- Abstract
Background/aims: Escherichia coli Nissle 1917 (EcN) alone therapy is as effective as mesalamine in inducing and maintaining remission in ulcerative colitis (UC). The efficacy and safety of EcN in combination with standard therapies have not been studied. This study examined the changes in the inflammation markers and symptoms following the additional administration of EcN to patients showing the clinical remission of UC., Methods: UC patients who received EcN after being in clinical remission for more than 3 months at Kosin University Gospel Hospital between 2013 and 2018 were evaluated through the retrospective medical-record-based review. The partial Mayo score, fecal calprotectin (FC), BMI, hemoglobin, serum cholesterol, serum albumin levels, and the safety profiles were examined at 3rd and 6th months after initiating EcN., Results: Ninety-four patients were included. After 3 months of treatment, there was no significant change in FC (156.3 μg/g to 141.1 μg/g) (p=0.653). On the other hand, partial Mayo score decreased significantly from 0.085 to 0.014 (p=0.025), and the bodyweight (p=0.001), BMI (p<0.001), hemoglobin (p=0.009), and cholesterol level increased (p=0.148). One patient (1.1%) experienced a serious adverse event with UC flare-up, and 14 patients (14.9%) discontinued EcN due to adverse events; all developed within 3 months., Conclusions: Additional administration of EcN to clinically remission-attained UC patients may improve the UC symptoms without changing the FC levels. EcN-associated adverse events develop within the early few weeks.
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- 2021
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19. Changes in the Crohn's Disease Activity Index and Safety of Administering Saccharomyces Boulardii in Patients with Crohn's Disease in Clinical Remission: A Single Hospital-based Retrospective Cohort Study.
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Oh GM, Moon W, Seo KI, Jung K, Kim JH, Kim SE, Park MI, and Park SJ
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- Hospitals, Humans, Leukocyte L1 Antigen Complex, Retrospective Studies, Severity of Illness Index, Crohn Disease therapy, Saccharomyces boulardii
- Abstract
Background/aims: Crohn's disease (CD) is characterized by uncontrolled inflammation of the intestine. Saccharomyces boulardii ( S. boulardii ), a probiotic, stabilizes the intestinal wall. This study examined the changes in the CD activity index (CDAI) after taking S. boulardii in patients with CD in clinical remission., Methods: In this single hospital-based retrospective cohort study, the medical records of CD patients in clinical remission, who had received S. boulardii for more than 6 months, were reviewed. The CDAI, BMI, and serum levels of hemoglobin (Hb), ferritin, iron, vitamin B12, folate, total protein, albumin, total cholesterol, CRP, and fecal calprotectin (FC) between the initiation and the 6th month were compared. The timing and reasons for the discontinuation were also investigated., Results: One hundred and fifty-four patients were included, and 92 patients, who received for more than 6 months, were analyzed. The changes in CDAI, BMI, Hb, and total cholesterol were significant as follows: CDAI from 38.52 to 30.53 (p<0.01), BMI (kg/m
2 ) from 23.38 to 23.97 (p<0.01), Hb (g/dL) from 13.73 to 14.03 (p<0.01), and total cholesterol (mg/dL) from 154.9 to 161.5 (p<0.01). On the other hand, the changes in FC, CRP, ferritin, vitamin B12, folate, total protein, and albumin were not statistically significant. Only one patient stopped due to a flare-up, but this was not believed to be related to the drug., Conclusions: In patients with CD in remission, S. boulardii appears to improve the CDAI, BMI, serum Hb, and total cholesterol level without safety issues. Further randomized controlled studies will be needed.- Published
- 2020
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20. Efficacy of Seven-day High-dose Esomeprazole-based Triple Therapy versus Seven-day Standard Dose Non-esomeprazole-based Triple Therapy as the First-line Treatment of Patients with Helicobacter pylori Infection.
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Lee YD, Kim SE, Park SJ, Park MI, Moon W, Kim JH, Jung K, and Song J
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- Adult, Aged, Anti-Bacterial Agents therapeutic use, Breath Tests, Drug Administration Schedule, Drug Therapy, Combination, Female, Helicobacter Infections microbiology, Helicobacter pylori isolation & purification, Humans, Male, Middle Aged, Retrospective Studies, Treatment Outcome, Esomeprazole therapeutic use, Helicobacter Infections drug therapy, Proton Pump Inhibitors therapeutic use
- Abstract
Background/aims: The rates of Helicobacter pylori ( H. pylori ) eradication have declined with the use of proton pump inhibitor- amoxicillin-clarithromycin as the first-line triple therapy. On the other hand, several studies have suggested that high gastric pH levels could affect the H. pylori eradication rate by enhancing the efficacy of antimicrobials. This study compared the efficacy of seven-day high-dose esomeprazole-based triple therapy (7-HEAC) for first-line H. pylori eradication with the seven-day standard dose non-esomeprazole-based triple therapy (7-NEAC) to identify the risk factors related to eradication failure., Methods: This study included 223 patients who were diagnosed with a H. pylori infection and received 7-HEAC or 7-NEAC between June 2016 and January 2017. The H. pylori eradication rates, as well as demographic and clinical factors, were investigated retrospectively. H. pylori eradication was confirmed by a
13 C-urea breath test or rapid urease test at least 4 weeks after the completion of therapy., Results: The eradication rates were 67.7% (105/155; 95% CI 59.5-74.8%) in the 7-NEAC group and 80.9% (55/68; 95% CI 69.9-89.8%) in the 7-HEAC group (p=0.045). The adverse event rates were 5.8% (9/155) in the 7-NEAC group and 7.4% (5/68) in the 7-HEAC group (p=0.661). Multivariate analysis revealed being female (OR 2.08; 95% CI 1.15-3.76) to be associated with the failure of H. pylori eradication therapy., Conclusions: The eradication rate of the 7-HEAC group was higher than that of the 7-NEAC group. Nevertheless, more effective first-line therapies may be necessary for H. pylori eradication in the near future.- Published
- 2020
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21. Eosinophilic Esophagitis with Angina Pectoris.
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Son MY, Kim SE, Park SJ, Park MI, Moon W, Kim JH, Jung K, Choi GS, and Im SI
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- Angina Pectoris complications, Asthma complications, Asthma diagnosis, Coronary Angiography, Endoscopy, Digestive System, Eosinophilic Esophagitis complications, Eosinophilic Esophagitis drug therapy, Eosinophils cytology, Histamine Antagonists therapeutic use, Humans, Male, Middle Aged, Thorax diagnostic imaging, Tomography, X-Ray Computed, Angina Pectoris diagnosis, Eosinophilic Esophagitis diagnosis
- Abstract
Eosinophilic esophagitis (EoE) is an immune or antigen-mediated chronic inflammatory esophageal disorder that is relatively rare in Asian countries. The main symptoms of EoE are dysphagia and food impaction. Although chest pain is a symptom of EoE, it is also a symptom of coronary heart disease. This paper reports a case of EoE with angina pectoris in a 45-year-old male who was referred to the authors' hospital for chest pain. He was diagnosed with angina pectoris because of mild stenosis in the left coronary artery on coronary angiography. On the other hand, the symptoms did not improve with angina medication therapy. Therefore, he underwent a chest CT scan, which revealed esophageal thickening. Esophagogastroduodenoscopy was performed. His endoscopic findings showed linear furrows with edema, and >90 eosinophils existed per high-power field on the histology findings. He was diagnosed with EoE. Through additional examinations, he was also diagnosed with asthma. The patient was treated with a proton pump inhibitor and a fluticasone inhaler. His symptoms and abnormal endoscopic findings disappeared after eight weeks of treatment. This case shows that physicians should consider the possibility of the symptoms for EoE when unexplained chest pain persists.
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- 2020
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22. Endoscopy-assisted Removal of a Large Rectal Foreign Body by the Valsalva Maneuver.
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Son MY, Park SJ, Moon W, Oh GM, Park MI, Kim SE, Kim JH, and Jung K
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- Humans, Male, Middle Aged, Rectal Diseases diagnosis, Valsalva Maneuver, Colonoscopy methods, Foreign Bodies, Rectal Diseases surgery
- Abstract
Although not as common as foreign bodies in the upper gastrointestinal tract, rectal foreign body insertion is often encountered in emergency departments. The diverse types of rectal foreign bodies have led to various removal methods. When removing a foreign body, the first thing to consider is which method is the least invasive and safest for the patient. This paper reports the successful removal of a rectal foreign body from the rectum using the Valsalva maneuver without anesthesia in a patient.
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- 2020
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23. Survival Benefit of Palliative Primary Tumor Resection Based on Tumor Location in Patients with Metastatic Colorectal Cancer: A Single-center Retrospective Study.
- Author
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Kim JH, Jin S, Jeon MJ, Jung HY, Byun S, Jung K, Kim SE, Moon W, Park MI, and Park SJ
- Subjects
- Adult, Aged, Aged, 80 and over, Colorectal Neoplasms pathology, Colorectal Neoplasms surgery, Female, Follow-Up Studies, Humans, Kaplan-Meier Estimate, Male, Middle Aged, Neoplasm Metastasis, Prognosis, Progression-Free Survival, Proportional Hazards Models, Retrospective Studies, Colorectal Neoplasms mortality
- Abstract
Backgrounds/aims: The molecular underpinnings of colorectal cancer (CRC) vary according to the tumor location. The advantages of a palliative primary tumor resection in patients with metastatic CRC are controversial. This study examined the survival outcomes of a palliative primary tumor resection based on the tumor location in patients with metastatic CRC., Methods: The medical records of 600 patients diagnosed with metastatic CRC between January 2000 and June 2018 were reviewed retrospectively. Patients undergoing surgery for both the primary tumor and metastatic lesions were excluded. The clinical factors affecting the long-term outcomes were evaluated according to the primary tumor location, and the long-term survival was compared between patients with and without a palliative primary tumor resection. The data were analyzed using the Kaplan-Meier estimator and multivariate Cox regression models., Results: The median follow-up duration was 18 months (interquartile range, 10-28). Patients with right-sided CRC had a poor overall- and progression-free survival compared to those with left-sided CRC. In multivariate Cox regression analysis, the palliative primary tumor resection was an independent prognostic factor predicting better overall survival in patients with metastatic CRC, regardless of the primary tumor location., Conclusions: The primary tumor location influences the prognosis, and that a primary tumor resection can improve the overall survival in patients with metastatic CRC, regardless of the primary tumor location.
- Published
- 2020
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- View/download PDF
24. Mucosa-associated Lymphoid Tissue Lymphoma-mimicking Primary Gastrointestinal Small Lymphocytic Lymphoma.
- Author
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Yeo SH, Jung K, Park MI, Kim SJ, Kim JH, Kim SE, Moon W, and Park SJ
- Subjects
- Abdomen diagnostic imaging, Antigens, CD20 metabolism, Colon metabolism, Colon physiology, Diagnosis, Differential, Endoscopy, Digestive System, Gastrointestinal Neoplasms diagnosis, Gastrointestinal Neoplasms pathology, Humans, Leukemia, Lymphocytic, Chronic, B-Cell pathology, Lymphoma, Non-Hodgkin diagnosis, Lymphoma, Non-Hodgkin pathology, Male, Middle Aged, Stomach pathology, Stomach Neoplasms diagnosis, Stomach Neoplasms pathology, Tomography, X-Ray Computed, Ultrasonography, Leukemia, Lymphocytic, Chronic, B-Cell diagnosis
- Abstract
Malignant lymphoma in the gastrointestinal tract is mainly secondary. Primary gastric malignant lymphoma constitutes 1-4% of gastric malignant tumors without specific endoscopic findings, and histopathologically, it is mainly classified as non-Hodgkin lymphoma of B-cell origin. Otherwise, a rare type of gastrointestinal lymphoma is small lymphocytic lymphoma (SLL). SLL is the same as a chronic lymphocytic lymphoma and tends to grow slowly. Here, we report a case of a patient diagnosed with primary gastrointestinal SLL upon endoscopy screening with non-specific mucosal findings.
- Published
- 2020
- Full Text
- View/download PDF
25. [Optimal Laxatives for Oral Colonoscopy Bowel Preparation: from High-volume to Novel Low-volume Solutions].
- Author
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Na SY and Moon W
- Subjects
- Citrates administration & dosage, Citrates adverse effects, Colorectal Neoplasms diagnosis, Dose-Response Relationship, Drug, Humans, Laxatives adverse effects, Organometallic Compounds administration & dosage, Organometallic Compounds adverse effects, Picolines administration & dosage, Picolines adverse effects, Polyethylene Glycols administration & dosage, Polyethylene Glycols adverse effects, Sulfates administration & dosage, Sulfates adverse effects, Vomiting etiology, Colonoscopy, Laxatives administration & dosage
- Abstract
Optimal bowel preparation is essential for a more accurate, comfortable, and safe colonoscopy. The majority of postcolonoscopy colorectal cancers can be explained by procedural factors, mainly missed polyps or inadequate examination. Therefore the most important goal of optimal bowel preparation is to reduce the incidence of colorectal cancer. Although adequate preparation should be achieved in 85-90% or more of all colonoscopy as a quality indicator, unfortunately 20-30% shows inadequate preparation. Laxatives for oral colonoscopy bowel preparation can be classified into polyethylene glycol (PEG)-electrolyte lavage solution, osmotic laxatives, stimulant laxatives, and divided into high-volume solution (≥3 L) and low-volume solution (<3 L). The updated 2019 European Society of Gastrointestinal Endoscopy (ESGE) guideline is broadly similar to the 2014 American Society for Gastrointestinal Endoscopy (ASGE) recommendations and reaffirms the importance of split-dosing. However, new ESGE guideline, unlike the 2014 ASGE recommendation, suggests the use of high volume or low volume PEG-based regimens as well as that of non-PEG based agents that have been clinically validated for most outpatient scenarios. For effective, safe, and highly adherent bowel preparation, physicians who prescribe and implement colonoscopy should properly know the advantages and limitations, the dosing, and the timing of regimens. Recently many studies have attempted to find the most ideal regimens, and more convenient, effective, and safe regimens have been developed by reducing the dosing volume and improving the taste. The high tolerability and acceptability of the new low-volume regimens suggest us how we should use it to increase the participation of the national colorectal cancer screening program.
- Published
- 2020
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26. Adult Ileocolic Intussusception Caused by Diffuse Large B Cell Lymphoma.
- Author
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Park JW, Song GA, Baek DH, Kim GH, Lee BE, Lee MW, Han SY, Park YJ, and Park EY
- Subjects
- Aged, Antineoplastic Agents therapeutic use, Chemotherapy, Adjuvant, Endoscopy, Gastrointestinal, Humans, Ileal Diseases complications, Ileum pathology, Intussusception complications, Lymphoma, Large B-Cell, Diffuse complications, Lymphoma, Large B-Cell, Diffuse drug therapy, Male, Tomography, X-Ray Computed, Ileal Diseases diagnosis, Intussusception diagnosis, Lymphoma, Large B-Cell, Diffuse pathology
- Abstract
Intussusception is a medical condition, in which a proximal part of the intestine folds into the distal intestine. Adult intussusceptions are rare and account for approximately 5% of all cases of intussusceptions. The anatomical leading points include tumors, diverticulums, polyps, and strictures in 80-90% of adult intussusceptions, and 65% of colon intussusceptions and 30% of small bowel intussusceptions originate from malignant tumors. Treatments for adult intussusception have not been established, but most cases require surgical treatment. The gastrointestinal tract is the most common extranodal site for non-Hodgkin lymphoma. The symptoms are mostly non-specific, but they rarely lead to complications, such as bleeding, perforation, and intussusception. Furthermore, few cases of primary gastrointestinal lymphomas causing intussusception have been reported. This paper reports a case of small bowel diffuse large B cell lymphoma that caused ileocolic intussusception in a 69-year-old woman with no medical history. She underwent a small bowel resection and received six cycles of adjuvant chemotherapy with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone. Since then, she has been in complete remission.
- Published
- 2020
- Full Text
- View/download PDF
27. Knowledge and Viewpoints on Biosimilar Monoclonal Antibodies among Asian Physicians: Comparison with European Physicians.
- Author
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Park SK, Moon W, Kim ES, Park SH, and Park DI
- Subjects
- Asia, Colitis drug therapy, Crohn Disease drug therapy, Europe, Female, Humans, Male, Surveys and Questionnaires, Antibodies, Monoclonal therapeutic use, Biosimilar Pharmaceuticals therapeutic use, Inflammatory Bowel Diseases drug therapy, Knowledge, Physicians psychology
- Abstract
Background/aims: Current knowledge and viewpoints regarding biosimilars among physicians in Asia are unknown, even though these were investigated by European Crohn's and Colitis Organization (ECCO) members in 2013 and 2015. Thus, this study conducted a multinational survey to assess the awareness of biosimilar monoclonal antibodies among Asian physicians., Methods: A 17-question multiple-choice anonymous web survey was conducted with the logistic support of the Asian Organization of Crohn's and Colitis (AOCC). Randomly selected AOCC members were invited by e-mail to participate between February 24, 2017 and March 26, 2017., Results: In total, 151 physicians from eight Asian countries responded to the survey. Most of the participants were gastroenterologists (96.6%), and 77.5% had cared for inflammatory bowel diseases (IBD) patients for more than 5 years. The majority of the respondents (66.2%) were aware that a biosimilar is similar but not equivalent to the originator. The majority of respondents (77.5%) considered cost saving to be the main advantage of biosimilars, but a high percentage of respondents (38.4%) were concerned about a different immunogenicity from that of the originator (92.4% and 27.1% respectively in ECCO 2015). Only 19.2% considered that the originator and biosimilars were interchangeable, and only 6.0% felt very confident in the use of biosimilars (44.4% and 28.8% respectively in ECCO 2015)., Conclusions: Asian gastroenterologists in 2017 are generally well informed about biosimilars. On the other hand, compared to the ECCO members surveyed in 2015, Asian gastroenterologists had more concerns and less confidence about the use of biosimilars in clinical practice. Thus, IBD-specific data on the comparison of the efficacy, safety, and immunogenicity in Asian patients are needed.
- Published
- 2019
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28. [Mixed Neuroendocrine-non-neuroendocrine Neoplasm of the Stomach that is Distributed in Depth on the Same Tumor: Inconsistent with the Definition of Mixed Adenoneuroendocrine Carcinoma in the 2010 World Health Organization Classification of Tumors of the Digestive System].
- Author
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Jeong J, Jung K, Kim JH, Kim SE, Moon W, Park MI, and Park SJ
- Subjects
- Adenocarcinoma classification, Adenocarcinoma pathology, Adenocarcinoma surgery, Aged, Carcinoma, Neuroendocrine classification, Carcinoma, Neuroendocrine pathology, Carcinoma, Neuroendocrine surgery, Endoscopy, Digestive System, Humans, Male, Stomach Neoplasms classification, Stomach Neoplasms pathology, Stomach Neoplasms surgery, Ultrasonography, World Health Organization, Adenocarcinoma diagnosis, Carcinoma, Neuroendocrine diagnosis, Stomach Neoplasms diagnosis
- Abstract
A mixed adenoneuroendocrine carcinoma (MANEC) of the stomach is a rare disease entity that was first defined by the World Health Organization (WHO) classification (2010) for tumors of the digestive system. According to the WHO classification (2010), MANEC is referred to as a tumor with both neuroendocrine and non-neuroendocrine neoplasms; each component of the tumor should be at least 30%. On the other hand, this cut-off value lacks clinical evidence and does not explain the characteristics and heterogeneity of this tumor. A 66-year-old male diagnosed with early gastric cancer (EGC) at a community hospital was referred to the Kosin University Gospel Hospital for further evaluation of gastric cancer. Esophagogastroduodenoscopy and EUS performed at the Kosin University Gospel Hospital revealed a sub-mucosal tumor-like component. In addition, a re-biopsy revealed a neuroendorine tumor at different depths of the same tumor. The final pathologic-diagnosis through surgery revealed a mixed neuroendocrine- non-neuroendocrine neoplasm, which is inconsistent with the definition of MANEC. Clinicians should consider EUS when a tumor has atypical endoscopic findings, even if EGC has already been diagnosed.
- Published
- 2019
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29. Risk of Delayed Bleeding after a Colorectal Endoscopic Mucosal Resection without Prophylactic Clipping: Single Center, Observational Study.
- Author
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Kim H, Kim JH, Choi YJ, Kwon HJ, Chang HK, Kim SE, Moon W, Park MI, and Park SJ
- Subjects
- Adult, Aged, Aged, 80 and over, Colorectal Neoplasms surgery, Female, Gastrointestinal Hemorrhage epidemiology, Gastrointestinal Hemorrhage etiology, Humans, Incidence, Intestinal Polyps pathology, Intestinal Polyps surgery, Male, Middle Aged, Risk Factors, Time Factors, Young Adult, Endoscopic Mucosal Resection adverse effects, Gastrointestinal Hemorrhage diagnosis
- Abstract
Background/aims: Bleeding is one of the major complications of a colorectal polypectomy. The aim of this study was to identify the risk of delayed bleeding, particularly after a colorectal endoscopic mucosal resection (EMR) without prophylactic clipping., Methods: Between April 2014 and August 2014, patients who underwent colorectal EMR (≥6 mm and <2 cm) without prophylactic clipping were included. This study evaluated the incidence of delayed bleeding and the associated factors after colorectal EMR without prophylactic clipping., Results: A total of 717 colorectal polyps (≥6 mm and <2 cm) of 243 patients resected by colorectal EMR in the study period were evaluated. The mean age of the patients was 63 years; 165 patients were men and 78 patients were women. The mean polyp size removed by colorectal EMR was 9.0 mm (range 6.0-19.0), and the number of polyps larger than 1 cm was 212 (29.6%). Delayed bleeding after colorectal EMR occurred in 12 polyps (1.7%) in eight patients (3.3%), and there were no significant risk factors affecting delayed bleeding., Conclusions: This study identified that the incidence of delayed bleeding on colorectal polyps (≥6 mm and <2 cm) after EMR without prophylactic clipping was 3.3%, but no significant risk factors affecting delayed bleeding were found.
- Published
- 2019
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30. The Clinical Significance of Microsatellite Instability in Patients with Right-sided Colorectal Cancer.
- Author
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Han SA, Kim JH, Choi JH, Lee DH, Jung K, Kim SE, Moon W, Park MI, and Park SJ
- Subjects
- Aged, Colorectal Neoplasms genetics, Colorectal Neoplasms mortality, Disease-Free Survival, Female, Humans, Kaplan-Meier Estimate, Male, Middle Aged, Neoplasm Staging, Proportional Hazards Models, Retrospective Studies, Sex Factors, Colorectal Neoplasms pathology, Microsatellite Instability
- Abstract
Background/aims: Colorectal cancer (CRC) with microsatellite instability (MSI) has a better prognosis than CRC with microsatellite stable (MSS). Recent studies have reported biological differences according to tumor location in CRC. In this study, we investigated the clinical significance of MSI in patients with right-sided CRC., Methods: The medical records of 1,009 CRC patients diagnosed at our institute between October 2004 and December 2016 with MSI test results were retrospectively reviewed. The long-term outcomes of CRC patients with MSI were assessed with respect to tumor location using Kaplan-Meier curves and Cox regression models., Results: The median follow-up duration for all 1,009 study subjects was 25 months (interquartile range, 15-38). One hundred twenty-four of the study subjects had MSI (12.3%) and 250 had right-sided CRC (24.8%). The patients with MSI and right-sided CRC had better disease-free survival (DFS) than those with MSS as determined by the log-rank test (p=0.013), and this result was significant in females (p=0.035) but not in males with right-sided CRC. Multivariate Cox regression analysis showed MSS significantly predicted poor DFS in patients with right-sided CRC (hazard ratio 3.97, 95% CI 1.30-12.15, p=0.016) and in female patients (hazard ratio 4.69, 95% CI 1.03-21.36, p=0.045)., Conclusions: The study shows MSI is a useful predictor of DFS in patients with right-sided CRC, especially in female patients.
- Published
- 2019
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31. Effect of 7-day Bismuth Quadruple Therapy versus 14-day Moxifloxacin Triple Therapy for Second-line Helicobacter pylori Eradication Therapy.
- Author
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Kim SE, Roh JH, Park MI, Park SJ, Moon W, Kim JH, Jung K, and Heo JJ
- Subjects
- Adult, Aged, Amoxicillin therapeutic use, Anti-Bacterial Agents therapeutic use, Drug Administration Schedule, Drug Therapy, Combination, Female, Humans, Male, Metronidazole therapeutic use, Middle Aged, Proton Pump Inhibitors therapeutic use, Retrospective Studies, Treatment Outcome, Bismuth therapeutic use, Helicobacter Infections drug therapy, Moxifloxacin therapeutic use
- Abstract
Background/aims: Both bismuth-containing quadruple therapy and moxifloxacin-containing triple therapy have been suggested as second-line eradication therapy for Helicobacter pylori ( H. pylori ) infection. We aimed to evaluate the efficacy of 14-day moxifloxacin-containing triple therapy (14-EAM) in second-line H. pylori eradication in comparison to 7-day bismuth-containing quadruple therapy (7-RBMT)., Methods: From January 2011 to December 2015, a total of 569 patients who failed to respond to first-line triple therapy and who subsequently received second-line 7-RBMT or 14-EAM were retrospectively enrolled. The eradication rates were identified using per-protocol (PP) analysis. H. pylori eradication was confirmed by a ¹³C-urea breath test (UBiT-IR300
® ; Otsuka Electronics, Co., Ltd., Osaka, Japan) or a rapid urease test (CLOtest® Delta West, Bentley, Australia) at least 4 weeks after completion of eradication therapy., Results: A total of 487 and 82 patients received 7-RBMT and 14-EAM, respectively. PP eradication rates were 93.6% (366/391; 95% CI, 91.0-95.9%) with 7-RBMT and 73.8% (48/65; 95% CI, 63.1-84.6%) with14-EAM (p<0.001). Therefore, the eradication rates with 7-RBMT were significantly higher than with 14-EAM according to the PP analysis. The adverse event rate was 17.1% (67/391) with 7-RBMT and 7.7% (5/65) with 14-EAM (p=0.065). In terms of risk factors, multivariate analysis revealed that 14-EAM (OR, 5.47; 95% CI, 2.74-10.93) was related to H. pylori eradication failure., Conclusions: 7-RBMT may be an effective second-line therapy in patients who failed to respond to first-line triple therapy in Korea, where there is a high prevalence of H. pylori infection.- Published
- 2019
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32. Diagnostic Value of Carcinoembryonic Antigen in Ascites for Colorectal Cancer with Peritoneal Carcinomatosis.
- Author
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Song SE, Choi P, Kim JH, Jung K, Kim SE, Moon W, Park MI, and Park SJ
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Area Under Curve, Ascitic Fluid chemistry, Colorectal Neoplasms pathology, Female, Humans, Logistic Models, Male, Middle Aged, Odds Ratio, Peritoneal Neoplasms secondary, ROC Curve, Retrospective Studies, Young Adult, Biomarkers, Tumor analysis, Carcinoembryonic Antigen analysis, Colorectal Neoplasms diagnosis, Peritoneal Neoplasms diagnosis
- Abstract
Background/aims: Diagnostic tests for carcinoembryonic antigen (CEA) in ascites have been performed in various malignant cases, but there is only few data on the applicability of CEA for colorectal cancer (CRC) patients with peritoneal carcinomatosis. We aimed to determine the usefulness of CEA in ascites (aCEA) as a diagnostic parameter for CRC with peritoneal carcinomatosis., Methods: Between January 2000 and May 2013, the medical records of 259 patients who underwent paracentesis for the evaluation of ascites were retrospectively reviewed. CRC patients with ascites (n=82) and patients with non-malignant ascites (n=177) were evaluated. Patients who had other malignancies, including gastric or ovarian cancer, with ascites were excluded. The optimal diagnostic cut-off value of aCEA for CRC with peritoneal carcinomatosis was determined using receiver operating characteristic curve analysis. The value of aCEA for predicting the occurrence of peritoneal carcinomatosis was evaluated using a logistic regression model., Results: The optimal cut-off value of aCEA to diagnose CRC with peritoneal carcinomatosis was 3.89 ng/mL, and the area under the curve for aCEA was 0.996 (sensitivity 96.3%, specificity 100%, positive predictive value 100%, negative predictive value 98.3%). Multivariate logistic regression analysis showed that aCEA was an independent factor predicting the occurrence of peritoneal carcinomatosis., Conclusions: In this study, we showed that aCEA may be a useful parameter for diagnosing CRC with peritoneal carcinomatosis, and we propose an optimal aCEA cut-off value of 3.89 ng/mL. Further study that includes patients with other malignant ascites may be necessary to validate these findings.
- Published
- 2018
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33. [Evolving Therapeutic Strategies in the Inflammatory Bowel Disease].
- Author
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Na SY and Moon W
- Subjects
- Biomarkers blood, Colitis, Ulcerative diagnosis, Colitis, Ulcerative pathology, Colitis, Ulcerative therapy, Crohn Disease diagnosis, Crohn Disease pathology, Crohn Disease therapy, Feces chemistry, Humans, Inflammatory Bowel Diseases diagnosis, Inflammatory Bowel Diseases pathology, Quality of Life, Remission Induction, Inflammatory Bowel Diseases therapy
- Abstract
It is important to have effective therapeutic strategies and goals in clinical practice and research of inflammatory bowel disease. Conventional end points for clinical trials in Crohn's disease and ulcerative colitis have been based on composite indices, such as the Crohn's Disease Activity Index and the Mayo Clinic Score. Although these indices have been shown to reduce the intestinal injury to some extent, satisfactory results have not been obtained in improving the quality of life of patients. Recently, alternative measures of outcome and definitions of response are being developed beyond symptoms. Mucosal healing as a clinical response and treatment goal has showed better long-term outcomes. Patient-reported outcomes (PROs) are emerging instrument directly created by patient to quantify symptoms. Coprimary realistic treatment 'target', comprising mucosal healing and PROs, can offer a clinically valid endpoint and can be readily applied in practice compare to existing composite indices. 'Treat-to-target' algorithm based on mucosal healing and PROs, in which therapy is progressively intensified until a specific personal treatment goal is reached, could improve quality of life of patient by reducing disease-related disability. Furthermore, histologic remission is an area of increased research focus and has the potential to guide treatment decisions in the future.
- Published
- 2018
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34. [The Additional Role of Symptom-Reflux Association Analysis of Diagnosis of Gastroesophageal Reflux Disease Using Bravo Capsule pH Test].
- Author
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Jung K, Park MI, Park SJ, Moon W, Kim SE, and Kim JH
- Subjects
- Adult, Aged, Esophagitis, Peptic etiology, Female, Gastroesophageal Reflux drug therapy, Gastroesophageal Reflux pathology, Humans, Male, Middle Aged, Proton Pump Inhibitors therapeutic use, Retrospective Studies, Severity of Illness Index, Esophageal pH Monitoring adverse effects, Gastroesophageal Reflux diagnosis
- Abstract
Background/aims: Since the development of ambulatory esophageal pH monitoring test to diagnose gastroesophageal reflux disease (GERD), several parameters have been introduced. The aim of this study was to assess whether using the symptom index (SI), symptom sensitivity index (SSI), and symptom association probability (SAP), in addition to the DeMeester score (DS), would be useful for interpreting the Bravo pH monitoring test., Methods: A retrospective study, which included 68 patients with reflux symptoms refractory to proton pump inhibitor (PPI) therapy who underwent a Bravo capsule pH test between October 2006 and May 2015, was carried out. Acid reflux parameters and symptom reflux association parameters were analyzed., Results: The median percent time of total pH<4 and DS were 2.90% (interquartile range [IQR] 1.13-6.03%) and 11.10 (IQR 4.90-22.80), respectively. According to the analysis of the day-to-day variation in percent time of total pH<4 (r=0.724) and DS (r=0.537), there was a significant correlation between Day 1 and Day 2. The positive rate of Bravo test according to DS was 27 (39.7%). Although thirty patients experienced symptoms during the test, there were no significant differences of reflux parameters compared with other patients. In the symptom group, 7 patients (23.3%) were identified as having negative DS and an abnormal symptom-related index. There were no significant test-related complications., Conclusions: In addition to the analysis of traditional acid parameters of the Bravo capsule pH test, diagnosis of GERD, including reflux hypersensitivity, can be improved by performing an analysis of the symptom-reflux association and of the day-to-day variation.
- Published
- 2017
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35. Malignant Melanoma of the Anus Found during Routine Colonoscopy in Ulcerative Colitis.
- Author
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Seo KI, Moon W, Kim SE, Park MI, and Park SJ
- Subjects
- Anus Neoplasms pathology, Azathioprine therapeutic use, Colitis, Ulcerative complications, Colitis, Ulcerative drug therapy, Colonoscopy, Female, Humans, Immunosuppressive Agents therapeutic use, Melanins metabolism, Melanoma pathology, Middle Aged, Positron Emission Tomography Computed Tomography, Skin Neoplasms pathology, Tomography, X-Ray Computed, Melanoma, Cutaneous Malignant, Anus Neoplasms diagnosis, Colitis, Ulcerative diagnosis, Melanoma diagnosis, Skin Neoplasms diagnosis
- Abstract
Inflammatory bowel disease (IBD) is characterized by recurrent or chronic inflammation of the gastrointestinal tract, which results in increased risk of developing cancer. Anorectal malignant melanoma is often misdiagnosed as either hemorrhoids or benign anorectal conditions in inflammatory bowel disease. Therefore, the overall prognosis and survival of IBD are poor. To date, the best treatment strategy remains controversial. Only early diagnosis and complete excision yield survival benefit. Here, we report a 64-year-old woman with ulcerative colitis, who was found to have anal malignant melanoma on routine colonoscopy. The lesion was confined to the mucosa with no distant metastasis. She underwent complete trans-anal excision. There was no recurrence at the four-year follow-up. Physicians should be aware of increased risk of cancer development in IBD patients and remember the importance of meticulous inspection of the anal canal.
- Published
- 2017
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36. [Minimal Resection of Jejuna Dieulafoy's Lesion Using an Intraoperative Fluoroscopic Localization of the Metallic Coils Used in Angiography].
- Author
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Seo KI, Moon W, Lee CW, Park SJ, Park MI, Kim SE, Kim JH, Yoon KY, and Chang HK
- Abstract
This correction is being published to correct the 6th author's English name in above article.
- Published
- 2017
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37. A Case of Tuberculous Peritonitis Presenting as Small Bowel Obstruction.
- Author
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Kim HK, Kim SE, Park MI, Park SJ, Moon W, Kim JH, Jung K, and Nam YJ
- Subjects
- Aged, 80 and over, Antitubercular Agents therapeutic use, Female, Humans, Intestinal Obstruction surgery, Intestine, Small pathology, Laparoscopy, Peritoneum pathology, Peritonitis, Tuberculous drug therapy, Tomography, X-Ray Computed, Peritonitis, Tuberculous diagnosis
- Abstract
The peritoneum is one of the common extrapulmonary sites of tuberculosis infection. Patients with underlying end-stage renal or liver disease are frequently complicated by tuberculous peritonitis; however, the diagnosis of the tuberculous peritonitis is difficult due to its insidious nature, well as its variability in presentation and limitation of available diagnostic tests. Once diagnosed, the preferred treatment is usually antituberculous therapy in uncomplicated cases. However, surgical treatment may also be required for complicated cases, such as small bowel obstruction or perforation. An 85-year-old woman was referred our hospital for abdominal pain with ileus. Despite medical therapy, prolonged ileus and progression to sepsis were shown, she underwent surgery to confirm the diagnosis and relief of mechanical ileus. Intraoperative peritoneal biopsy and macroscopic findings confirmed tuberculous peritonitis. Therefore, physicians should consider the possibility of tuberculous peritonitis in patients with unexplained small bowel obstruction.
- Published
- 2017
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38. Trichuris trichiura Infection in North Korean Defector Resulted in Chronic Abdominal Pain and Growth Retardation.
- Author
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Kim JB, Seo KI, and Moon W
- Subjects
- Adult, Animals, Cecum parasitology, Cecum pathology, Colon parasitology, Colon pathology, Colonoscopy, Democratic People's Republic of Korea, Dysentery diagnosis, Emigrants and Immigrants, Humans, Male, Ovum pathology, Trichuriasis complications, Trichuriasis parasitology, Trichuris growth & development, Trichuris isolation & purification, Abdominal Pain etiology, Trichuriasis diagnosis
- Abstract
Trichuris trichiura infection is a common helminth infection, which is transmitted via soil, with worldwide distribution, especially in rural areas of developing countries. Occasionally, sporadic cases occur in non-endemic, developed areas due to the widespread of immigration. We experienced a case of Trichuris dysentery syndrome in a young North Korean defector, who had been suffering from chronic abdominal pain for 10 years. He is relatively short and thin compared with his older brother. Unexpectedly, the diagnosis, made by a colonoscopy, revealed numerous, small, white, and gently moving worms at the cecum and ascending colon. After 3 days of albendazole (400 mg once daily) administration, clinical symptoms subsided dramatically. On the follow-up colonoscopy, which was performed two months after the completion of his treatment, complete eradication was identified. Soil-transmitted helminths, including Trichuris trichiura , are disappearing becoming less prevalent in South Korea as a result of both national driving force and environmental improvement. However, these diseases should be considered when we meet foreign patients from developing countries, like North Korea, presenting chronic abdominal pain. Moreover, proper treatment of North Korean defectors and performing cohort studies of them would help to prepare for the possible unification era in the field of gastroenterology.
- Published
- 2017
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39. The Effect of Anti-reflux Therapy on Patients Diagnosed with Minor Disorders of Peristalsis in High-resolution Manometry.
- Author
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Jeong J, Kim SE, Park MI, Park SJ, Moon W, Kim JH, Jung K, Choi YJ, Lee JY, and Lee YD
- Subjects
- Adult, Age Factors, Esophageal Motility Disorders complications, Esophageal Sphincter, Lower physiology, Esophageal pH Monitoring, Esophagogastric Junction physiology, Esophagoscopy, Female, Gastroesophageal Reflux complications, Gastroesophageal Reflux drug therapy, Humans, Male, Manometry, Middle Aged, Peristalsis, Proton Pump Inhibitors therapeutic use, Retrospective Studies, Treatment Outcome, Esophageal Motility Disorders diagnosis, Gastroesophageal Reflux diagnosis
- Abstract
Background/aims: Minor disorders of peristalsis are esophageal motility disorders categorized by the Chicago Classification (CC), version 3.0, which was announced in 2014. This study evaluated the efficacy of anti-reflux therapy in patients with minor peristaltic disorders., Methods: Patients with minor peristaltic disorders in accordance with CC v3.0 were included. We reviewed the medical records of patients with esophageal high-resolution manometry findings, and investigated the demographic and clinical information as well as the medical therapy. Thereafter, the response to treatment was assessed after at least 4 weeks of treatment., Results: A total of 24 patients were identified as having minor disorders of peristalsis from January 2010 to December 2015. The mean follow-up period was 497 days, and there were 17 patients (70.8%) patients with ineffective esophageal motility. In terms of anti-reflux therapy, proton pump inhibitors (PPIs) with prokinetic agents and PPIs alone were prescribed in 19 patients (79.2%) and 5 patients (20.8%), respectively. When the rate of response to the treatment was assessed, the responders rate (complete+satisfactory [≥50%] responses) was 54.2% and the non-responders rate (partial [<50%]+refractory responses) was 45.8%. Patients in the responder group were younger than those in the non-responder group (p=0.020). Among them, 13 patients underwent 24-hour multichannel intraluminal impedance-pH, and 10 patients (76.9%) were pathologic gastroesophageal reflux., Conclusions: The majority of esophageal minor peristaltic disorders were accompanied by gastroesophageal reflux, and therefore, they might respond to acid inhibitor. Further well-designed, prospective studies are necessary to confirm the effect of anti-reflux therapy in these patients.
- Published
- 2017
- Full Text
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40. Recurrent Abdominal Pain after Laparoscopic Appendectomy.
- Author
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Seo KI, Kim SE, Park MI, Park SJ, Moon W, Kim JH, Jung K, and Park JG
- Subjects
- Adult, Anticoagulants therapeutic use, Female, Humans, Laparoscopy, Mesenteric Veins, Tomography, X-Ray Computed, Venous Thrombosis diagnostic imaging, Venous Thrombosis drug therapy, Abdominal Pain etiology, Appendectomy adverse effects, Appendicitis surgery, Venous Thrombosis diagnosis
- Abstract
Laparoscopic surgical approaches, compared with open surgical approaches, provide comparable clinical outcomes, but lower complications. Unfortunately, a rare complication-portomesenteric vein thrombosis-had been reported after laparoscopic surgery. A 42-year-old woman was referred our hospital for recurrent abdominal pain after laparoscopic appendectomy from acute appendicitis. It was determined that abdominal pain was due to postoperative superior mesenteric vein thrombus. A six-month anticoagulation therapy is an excellent treatment for superior mesenteric vein thrombus . Therefore, physicians should be aware of portomesenteric vein thrombosis in patients with newly developed abdominal pain after successful laparoscopic surgical management.
- Published
- 2017
- Full Text
- View/download PDF
41. [Second Korean Guideline for the Management of Ulcerative Colitis].
- Author
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Choi CH, Moon W, Kim YS, Kim ES, Lee BI, Jung Y, Yoon YS, Lee H, Park DI, and Han DS
- Subjects
- Administration, Oral, Antibodies, Monoclonal therapeutic use, C-Reactive Protein analysis, Colitis, Ulcerative diagnosis, Colitis, Ulcerative pathology, Cyclosporine therapeutic use, Humans, Mercaptopurine therapeutic use, Mesalamine therapeutic use, Parenteral Nutrition, Prednisolone therapeutic use, Severity of Illness Index, Steroids therapeutic use, Tumor Necrosis Factor-alpha immunology, Anti-Inflammatory Agents, Non-Steroidal therapeutic use, Colitis, Ulcerative drug therapy
- Abstract
Ulcerative colitis (UC) is a chronic inflammatory bowel disorder characterized by a relapsing and remitting course. The direct and indirect costs of the treatment of UC are high, and the quality of life of patients is reduced, especially during exacerbation of the disease. The incidence and prevalence of UC in Korea are still lower than those of Western countries, but have been rapidly increasing during the past decades. Various medical and surgical therapies, including biologics, are currently used for the management of UC. However, many challenging issues exist, which sometimes lead to differences in practice between clinicians. Therefore, the Inflammatory Bowel Disease Study Group of the Korean Association for the Study of Intestinal Diseases established the first Korean guideline for the management of UC in 2012. This is an update of the first guideline. It was generally made by the adaptation of several foreign guidelines as was the first edition, and encompasses treatment of active colitis, maintenance of remission, and indication of surgery for UC. The specific recommendations are presented with the quality of evidence and classification of recommendations.
- Published
- 2017
- Full Text
- View/download PDF
42. [Patient Monitoring and Associated Devices during Endoscopic Sedation].
- Author
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Moon SH, Kim HK, Myung DS, Yoon SM, and Moon W
- Subjects
- Blood Gas Monitoring, Transcutaneous, Blood Pressure physiology, Consciousness Monitors, Electrocardiography, Humans, Monitoring, Physiologic instrumentation, Oximetry, Endoscopy, Gastrointestinal, Monitoring, Physiologic methods
- Abstract
Sedation is an essential component for gastrointestinal endoscopy. It allows patients to tolerate unpleasant endoscopic procedures by relieving anxiety, discomfort, or pain. It also reduces patient's risk of physical injury during endoscopic procedures, while providing the endoscopist with an adequate setting for a detailed examination. For the safety during endoscopic sedation, patient monitoring is crucial. Minimal monitoring requirements during endoscopic sedation are periodic assessment of blood pressure and application of continuous pulse oximetry. Continuous electrocardiography is recommended in selected patients with high risk for sedation or have cardiopulmonary diseases. Continuous supplemental oxygen is also recommended for endoscopic sedation. This study describes detailed monitoring and associated devices based on the current guidelines and recommendations from gastrointestinal society of America, Europe, and Korea.
- Published
- 2017
- Full Text
- View/download PDF
43. [Golimumab Therapy in Ulcerative Colitis].
- Author
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Moon W
- Subjects
- Antibodies, Monoclonal blood, Antibodies, Monoclonal, Humanized therapeutic use, Clinical Trials as Topic, Drug Administration Schedule, Humans, Treatment Outcome, Tumor Necrosis Factor-alpha immunology, Antibodies, Monoclonal therapeutic use, Colitis, Ulcerative drug therapy
- Abstract
Ulcerative colitis is a chronic inflammatory condition of the colon, characterized by diffuse mucosal inflammation and blood-mixed diarrhea. The main treatment has been 5-aminosalicylic acid, steroid, thiopurine, and anti-tumor necrosis factor alpha (TNF-α) antibodies including infliximab, adalimumab, and golimumab. Golimumab, a new anti-TNF-α agent has been recently approved for patients with moderate to severe ulcerative colitis. Its efficacy and safety has been demonstrated in line with infliximab and adalimumab in preclinical and clinical studies. This review will focus on golimumab therapy in ulcerative colitis.
- Published
- 2016
- Full Text
- View/download PDF
44. [Efficacy and Safety of FOLFIRI after Failure of FOLFOX-4 in Advanced Gastric Cancer].
- Author
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Kwon HJ, Park MI, Park SJ, Moon W, Kim SE, Lee HW, Choi YJ, and Kim JH
- Subjects
- Adult, Aged, Anemia etiology, Antineoplastic Combined Chemotherapy Protocols adverse effects, Camptothecin adverse effects, Camptothecin therapeutic use, Disease Progression, Female, Fluorouracil adverse effects, Fluorouracil therapeutic use, Humans, Kaplan-Meier Estimate, Leucovorin adverse effects, Leucovorin therapeutic use, Male, Middle Aged, Neoplasm Staging, Organoplatinum Compounds adverse effects, Organoplatinum Compounds therapeutic use, Retrospective Studies, Stomach Neoplasms mortality, Stomach Neoplasms pathology, Treatment Outcome, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Camptothecin analogs & derivatives, Stomach Neoplasms drug therapy
- Abstract
Background/aims: The purpose of this study was to investigate the efficacy and safety of irinotecan based FOLFIRI chemotherapy as a second-line treatment after failure of FOLFOX-4 chemotherapy in patients with advanced gastric cancer., Methods: Fifty-two patients who were pathologically diagnosed with unresectable gastric cancer and received FOLFIRI chemotherapy after failure of FOLFOX-4 chemotherapy between September 2005 and February 2012 were enrolled in this study. Data were collected by retrospectively reviewing the medical records. The response to chemotherapy was assessed every 3 cycles by World Health Organization criteria and long term survival was analyzed. The toxicities were evaluated for every course of chemotherapy according to National Cancer Institution (NCI) toxicity criteria version 3.0., Results: Median age of the patients was 57 years. Median overall survival (OS) and time to progression (TTP) were 7.8 and 5 months, respectively. The number of patients showing complete remission, partial remission, stable disease, and progressive disease were 0 (0.0%), 9 (17.3%), 30 (57.7%), and 13 (25.0%), respectively. The overall response rate was 17.3%. During a total of 345 cycles, anemia worse than NCI toxicity grade 3 occurred in 2.9%, leukopenia in 20.3%, neutropenia in 12.2%, and thrombocytopenia in 1.5%. Patients with less organ involvement by metastasis, less than 34 U/mL of CA 19-9 and good responsiveness to third cycle of second line chemotherapy were associated with longer OS and TTP., Conclusions: FOLFIRI chemotherapy has a modest efficacy with acceptable toxicities in patients with advanced gastric cancer as a second-line treatment. Further well-controlled studies are needed to elucidate the efficacy of FOLFIRI chemotherapy as second-line treatment in patients with advanced stomach cancer.
- Published
- 2015
- Full Text
- View/download PDF
45. Differential diagnosis of colorectal polyps with narrow band imaging colonoscopy without magnification.
- Author
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Kim BJ, Park MI, Park SJ, Moon W, Park ET, Kim SE, Lim CS, Yoo JH, and Kang SJ
- Subjects
- Adenoma diagnosis, Adult, Aged, Aged, 80 and over, Carcinoma diagnosis, Colonic Neoplasms pathology, Colonoscopy, Diagnosis, Differential, Female, Humans, Male, Middle Aged, Narrow Band Imaging, Retrospective Studies, Colonic Neoplasms diagnosis, Colonic Polyps pathology
- Abstract
Background/aims: Narrow band imaging (NBI) endoscopy can be used for gross differentiation between the types of colonic polyps. This study was conducted as a retrospective study for estimation of the interobserver and intra-observer agreement of the pit pattern of the mucosal surface and the accuracy of histology prediction., Methods: A total of 159 patients underwent complete colonoscopy and 219 polyps examined by NBI endoscopy without magnification were assessed. Interobserver and intra-observer agreement were calculated by investigators in each group for determination of the surface pattern and prediction of histology based on the modified Kudo's classification using intraclass correlation coefficient., Results: Interobserver agreement for the surface pit pattern and prediction of polyp type was 0.84 and 0.73 in experienced endoscopists, and 0.86 and 0.62 in trainees, respectively. Intra-observer agreement for the surface pit patterns and prediction of polyp type was 0.81, 0.83, 0.85, 0.83, 0.56, 0.84, 0.51, 0.83, and 0.71; and 0.71, 0.70, 0.82, 0.54, 0.72, 0.37, 0.51, 0.34, and 0.30, respectively. The diagnostic accuracy for prediction of polyp type was 69.4% for experienced endoscopists and 72.9% for trainees., Conclusions: NBI endoscopy without magnification showed fairly good inter and intra-observer agreement for the pit pattern of the mucosal surface and the accuracy of histology prediction; however, it had some limitation for differentiation of colon polyp histologic type. Training and experience with NBI is needed for improvement of accuracy.
- Published
- 2014
- Full Text
- View/download PDF
46. Solitary extramedullary plasmacytoma in the gastrointestinal tract: report of two cases and review of literature.
- Author
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Han YJ, Park SJ, Park MI, Moon W, Kim SE, Ku KH, and Ock SY
- Subjects
- Colonic Neoplasms pathology, Colonic Neoplasms therapy, Endoscopy, Gastrointestinal, Humans, Immunohistochemistry, Male, Middle Aged, Plasmacytoma pathology, Plasmacytoma therapy, Positron-Emission Tomography, Stomach Neoplasms pathology, Stomach Neoplasms therapy, Tomography, X-Ray Computed, Colonic Neoplasms diagnosis, Plasmacytoma diagnosis, Stomach Neoplasms diagnosis
- Abstract
Solitary extramedullary plasmacytoma (EMP) is a plasma cell neoplasm without bone marrow involvement. EMPs are rare in the gastrointestinal (GI) tract. We report two cases of primary EMP, one in the transverse colon and the other in the stomach. In the first case, a mass on the transverse colon was found on colonoscopy. The patient underwent left hemicolectomy and has been followed-up for 3 years without recurrence postoperatively. The latter case had several masses in the stomach. The patient underwent bypass surgery and has received supportive care for 1 month. Histopathologic specimens of both the cases showed a monoclonal lambda chain EMP. Subsequent investigations included a bone marrow biopsy, serum IgA, IgG, IgM and serum protein electrophoresis, and the results were negative for multiple myeloma in both the cases. Solitary EMP in the GI tract can be mistaken for colon cancer or stomach cancer on endoscopy; therefore, a sufficient number of biopsy specimens can help diagnose solitary EMPs. Surgical resection alone or with radiation therapy in cases with positive surgical margin is currently the only treatment for solitary EMP in the GI tract. Further study is necessary to determine disease prognosis and to investigate other treatment methods.
- Published
- 2014
- Full Text
- View/download PDF
47. Prognostic factors for metastatic colorectal cancer after first-line chemotherapy with FOLFOX-4 or FOLFIRI regimen.
- Author
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Kim JH, Choi PR, Park SJ, Park MI, Moon W, Kim SE, and Lee GW
- Subjects
- Adult, Aged, Aged, 80 and over, Camptothecin therapeutic use, Colorectal Neoplasms mortality, Colorectal Neoplasms surgery, Female, Fluorouracil administration & dosage, Fluorouracil therapeutic use, Hemoglobins analysis, Humans, Kaplan-Meier Estimate, Leucovorin administration & dosage, Leucovorin therapeutic use, Male, Middle Aged, Neoplasm Metastasis, Odds Ratio, Organoplatinum Compounds therapeutic use, Prognosis, Retrospective Studies, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Camptothecin analogs & derivatives, Colorectal Neoplasms diagnosis, Colorectal Neoplasms drug therapy
- Abstract
Background/aims: Information on prognostic factors for metastatic colorectal cancer is an important basis for planning the treatment and predicting the outcomes of the patients; however, it has not been well established. The aim of this study was to identify factors that predict results of chemotherapy and to establish a plan for treatment of patients whose tumors are inoperable due to metastatic colorectal cancer., Methods: We conducted a retrospective review of records from 75 patients treated for colorectal cancer in Kosin University Gospel Hospital, from October 2004 to September 2008. Patients with inoperable tumors due to metastasis at the time of diagnosis who were treated with oxaliplatin or irinotecan as the first-line treatment were included in this study. We investigated the factors that might have an effect on overall survival., Results: A total of 75 patients were included in this study. Results of univariate analysis showed that hemoglobin (Hb) ≥10 g/dL at the time of diagnosis, no increase in CEA on the follow-up examination after chemotherapy, chemotherapy plus surgery, and better response to chemotherapy were significant prognostic factors. Results of multivariate analysis showed that Hb ≥10 g/dL at the time of diagnosis (p<0.001), surgery after chemotherapy (p=0.001), and better response to chemotherapy (p=0.014) were significant prognostic factors., Conclusions: In this study, Hb ≥10 g/dL at the time of diagnosis, surgery after chemotherapy, and better response to chemotherapy were significant prognostic factors for metastatic colorectal cancer.
- Published
- 2014
- Full Text
- View/download PDF
48. FOLFIRI as second-line chemotherapy after failure of FOLFOX4 in advanced colorectal cancer: a Korean single-center experience.
- Author
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Kim JH, Park SJ, Park MI, Moon W, Kim SE, Ku KH, Song SE, and Kim JH
- Subjects
- Adult, Aged, Aged, 80 and over, Camptothecin administration & dosage, Camptothecin therapeutic use, Colorectal Neoplasms mortality, Drug Administration Schedule, Female, Fluorouracil administration & dosage, Fluorouracil therapeutic use, Humans, Injections, Intravenous, Irinotecan, Leucovorin administration & dosage, Leucovorin therapeutic use, Male, Middle Aged, Neoplasm Staging, Organoplatinum Compounds administration & dosage, Organoplatinum Compounds therapeutic use, Oxaliplatin, Republic of Korea, Retrospective Studies, Survival Analysis, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Camptothecin analogs & derivatives, Colorectal Neoplasms drug therapy
- Abstract
Background/aims: The incidence of colorectal cancer has been increasing every year in Korea. Irinotecan- or oxaliplatin-based regimens including biologic agents are known to be effective in patients with advanced colorectal cancer. But in practice, FOLFOX (combination of oxaliplatin, 5-fluorouracil, and leucovorin) or FOLFIRI (combination of irinotecan, 5-fluorouracil, and leucovorin) regimens without biologic agents are more commonly used in Korea due to of the high costs of biologic agents. The aim of this study was to evaluate the efficacy and toxicity of FOLFIRI following FOLFOX4 in patients with advanced colorectal cancer., Methods: A total of 54 patients with advanced colorectal cancer who were treated between May 2005 and May 2013 with FOLFOX4 as first-line chemotherapy and with FOLFIRI as second-line chemotherapy at Kosin University Gospel Hospital (Busan, Korea) were reviewed retrospectively., Results: A total of 54 patients received second-line FOLFIRI chemotherapy. Five patients (9.3%) had a partial response, 29 patients (53.7%) had a stable disease. The median overall survival was 8.90 months and the median time to progression was 4.33 months. Toxicities were tolerable., Conclusions: In a Korean population, FOLFIRI as second-line chemotherapy is effective and well tolerated in patients with advanced colorectal cancer after failure of FOLFOX4. Although the efficacy of FOLFIRI in this study was lower than that of second-line FOLFIRI with biologic agents, these results can help in the formulation of a treatment strategy for financially troubled patients.
- Published
- 2014
- Full Text
- View/download PDF
49. [A case of intestinal tuberculosis with perianal fistula diagnosed after 30 years].
- Author
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Cheon JH, Moon W, Park SJ, Park MI, Kim SE, Choi YJ, Kim JB, and Kwon HJ
- Subjects
- Anal Canal, Anti-Inflammatory Agents, Non-Steroidal therapeutic use, Antitubercular Agents therapeutic use, Colon pathology, Colonoscopy, Crohn Disease diagnosis, Crohn Disease drug therapy, Diagnosis, Differential, Fistula pathology, Humans, Ileocecal Valve physiopathology, Male, Mesalamine therapeutic use, Middle Aged, Protein C analysis, Tuberculosis, Gastrointestinal drug therapy, Fistula diagnosis, Tuberculosis, Gastrointestinal diagnosis
- Abstract
Tuberculosis can occur anywhere in the gastrointestinal tract. However, anorectal tuberculosis has rarely been reported. A 46-years-old male presented with abdominal pain and perianal discharge of 30 years' duration. The patient had received operations for anal fistula and inflammation three times. Although he had been taking mesalazine for the past three years after being diagnosed with Crohn's disease, his symptoms persisted. Colonoscopy performed at our hospital revealed cicatricial change of ileocecal valve and diffuse ulcer scar with mild luminal narrowing of the ascending, transverse, and descending colon without active lesions. Multiple large irregular active ulcers were observed in the distal sigmoid and proximal rectum. An anal fistula opening with much yellowish discharge and background ulcer scar was observed in the anal canal. However, cobble-stone appearance and pseudopolyposis were not present. Therefore, we clinically diagnosed him as having intestinal tuberculosis with anal fistula and prescribed antituberculosis medications. Follow-up colonoscopy performed 3 months later showed much improved multiple large irregular ulcers in the distal sigmoid colon and proximal rectum along with completely resolved anal fistula without evidence of pus discharge.
- Published
- 2013
- Full Text
- View/download PDF
50. A rare case of free bowel perforation associated with infliximab treatment for stricturing Crohn's disease.
- Author
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Lim CS, Moon W, Park SJ, Park MI, Kim HH, Kim JB, Choi JM, Chang HK, and Lee SH
- Subjects
- Adolescent, Anti-Inflammatory Agents, Non-Steroidal adverse effects, Colonoscopy, Dietary Fiber, Female, Fibrosis pathology, Humans, Ileum surgery, Infliximab, Intestinal Perforation surgery, Tomography, X-Ray Computed, Anti-Inflammatory Agents, Non-Steroidal therapeutic use, Antibodies, Monoclonal adverse effects, Antibodies, Monoclonal therapeutic use, Crohn Disease drug therapy, Intestinal Perforation chemically induced
- Abstract
Crohn's disease is characterized by chronic transmural inflammation of the bowel and is associated with serious complications, such as bowel strictures, abscesses, fistula formation, and perforation. As neither medical nor surgical therapy provides a cure for Crohn's disease, the primary goals of therapy are to induce and maintain remission and prevent complications. As a biologic agent, infliximab, a monoclonal antibody to tumor necrosis factor, is indicated for refractory luminal and fistulizing Crohn's disease that does not respond to other medical therapies or surgery. Infliximab has proven to be very effective for inducing and maintaining remission in Crohn's disease; however, infliximab treatment has several potential complications. Here, we report a case of free perforation following a therapeutic response after an initial dose of infliximab for Crohn's disease. This is the first case report describing a free perforation in a Crohn's disease patient after an initial dose of infliximab.
- Published
- 2013
- Full Text
- View/download PDF
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