Epidemiological Characteristics of Gallbladder Cancer in Jeju Island: A Single-Center, Clinically Based, Age-Sex-Matched, Case-Control Study

Cha, Byung Hyo Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.18

Background: Gallbladder cancer (GBC) is a rare but highly invasive malignancy characterized by poor survival. In a national cancer survey, the age-standardized incidence rate of GBC was highest in Jeju Island among the 15 provinces in South Korea. The aim of this descriptive epidemiological study was to suggest the modifiable risk factors for this rare malignant disease in Jeju Island by performing an age-sex-matched case-control study. Materials and Methods: The case group included patients diagnosed with GBC at the Department of Internal Medicine of Cheju Halla General Hospital, Jeju, South Korea, within the 5-year study period. The control group consisted of age-sex-matched subjects selected from among the participants of the health promotion center at the same institute and in the same period. We compared 78 case-control pairs in terms of clinical variables such as histories of hypertension, diabetes, vascular occlusive disorders, alcohol and smoking consumption, obesity, and combined polypoid lesions of the gallbladder (PLG) or gallstone diseases (GSDs). Results: Among the relevant risk factors, alcohol consumption, parity ${\geq}2$, PLG, and GSDs were significant risk factors in the univariate analysis. PLG (p < 0.01; OR, 51.1; 95% confidence interval [CI], 2.98-875.3) and GSD (p < 0.01; OR, 54.9; 95% CI, 3.00-1001.8) were associated risk factors of GBC in the multivariate analysis with the conditional logistic regression model. However, we failed to find any correlation between obesity and GBC. We also found a negative correlation between alcohol consumption history and GBC in the multivariate analysis (p < 0.01; OR, 0.06; 95% CI, 0.01-0.31). Conclusions: These results suggest that combined PLG and GSDs are strongly associated with the GBC in Jeju Island and mild to moderate alcohol consumption may negatively correlate with GBC risk.

Survival Benefit of Intraductal Radiofrequency Ablation for Malignant Biliary Obstruction: A Systematic Review with Meta-Analysis

Byung Hyo Cha,Myoung-Jin Jang,Sang Hyub Lee 대한소화기내시경학회 2021 Clinical Endoscopy Vol.54 No.1

Background/Aims: Cholangiocarcinoma (CCA) is a rare but aggressive disease with a poor survival. Recent trials have shownimproved survival with intraductal radiofrequency ablation (RFA) therapy. We performed a systematic review with meta-analysis todetermine the survival benefit of endoscopic RFA for unresectable extrahepatic CCA with malignant biliary obstruction (MBO). Methods: A systematic search from 1970 to 2020 was performed in MEDLINE, EMBASE, Cochrane Library, and ClinicalTrials. gov. We selected eligible studies reporting relative risks, hazard ratios (HRs), or odds ratios, adjusted by controlling for confoundingfactors of survival rate and stent patency duration, among patients with extrahepatic CCA with MBO treated with RFA with stentinsertion or stent insertion only. Results: A total of eight trials (three randomized and five nonrandomized) with a total of 420 patients were included in the metaanalysis. Pooled overall survival analysis favored RFA treatment with stent insertion (HR, 0.47; 95% confidence interval [CI], 0.34–0.64; I2=47%; p=0.09); however, no significant difference was found in the duration of stent patency between the groups (HR, 0.79;95% CI, 0.57–1.09; I2=7%; p=0.36). Conclusions: RFA therapy with stent insertion may confer a survival benefit compared with stent insertion only in patients withCCA and MBO.

Comparison of Clinical Outcomes of Incidental and Non-Incidental Gallbladder Cancers: A Single-Center Cross-Sectional Study

Cha, Byung Hyo,Bae, Jong-Myun Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.3

Background: Gallbladder cancer (GBC) is a rare malignancy characterized by high invasiveness and poor survival. In a nation-wide cancer survey, the age-standardized incidence rate of GBC was the highest in Jeju Island compared to 15 other provinces in Korea. The purpose of this study was to compare the clinical outcomes of GBC according to the nature of diagnosis, that is, incidental versus non-incidental. Materials and Methods: Consecutive patients who were newly diagnosed with GBC at the Digestive Disease Center and Department of Internal Medicine, Cheju Halla General Hospital, between November 2008 and November 2011, were enrolled and divided into 2 groups: incidental gallbladder cancer (IGBC) and non-incidental gallbladder cancer (NIGBC). Clinical outcomes were retrospectively compared between the two groups. Results: Seventy-nine patients were enrolled and analyzed in our study. Thirty-three (41.8%) and 46 (58.2%) were identified as IGBC and NIGBC, respectively. The proportions of patients with gallstone disease, gallbladder polyp, and cholecystectomy were significantly different between the two groups. Additionally, the median survival rate was significantly higher for patients with IGBC than for those with NIGBC (11.4, 95% confidence interval, 5.6-13.7 vs 4.0, 95% confidence interval 3.03-5.96 months; p=0.01) during a median follow-up period of 5.7 months. Conclusions: Patients with IGBC showed better clinical prognosis than those with NIGBC. Therefore, patients with gallstone disease or gallbladder polyps, major predictive risk factors for IGBC, should undergo advanced work-up for chelecystectomy.

Alcohol Consumption Can Reduce the Risk of Gallstone Disease: A Systematic Review with a Dose-Response Meta-Analysis of Case-Control and Cohort Studies

( Byung Hyo Cha ),( Myoung-jin Jang ),( Sang Hyub Lee ) 대한간학회 2019 Gut and Liver Vol.13 No.1

Background/Aims: Gallstone disease (GSD) is a common gastrointestinal disorder. Clinical epidemiological studies revealed that alcohol consumption has a preventive effect on the development of GSD. This study aimed to evaluate the relative risks of drinking for GSD development and investigate the dose-response relationships. Methods: A systematic search of the MEDLINE, EMBASE, and Cochrane Library databases for studies published up to 2018 was performed. All studies that satisfied the following eligibility criteria were included: patients with GSD with or without cholecystitis; and cohort or case-control studies investigating the association between alcohol consumption and GSD development. Results: Sixteen case-control studies including 24,401 gallstone cases and 76,185 controls, and eight cohort studies with 14,693 GSD cases among 2,432,471 person-years were enrolled. Alcohol consumption presented a decreased overall risk of GSD (pooled relative ratio [RR], 0.84; 95% confidence interval [CI], 0.79 to 0.89; p=0.02). Subgroup analyses according to drinking levels indicated a gradual risk reduction for GSD compared to nondrinkers (light: RR, 0.96; 95% CI, 0.94 to 0.99; p=0.75; moderate: RR, 0.80; 95% CI, 0.75 to 0.85; p=0.27; high: RR, 0.66; 95% CI, 0.56 to 0.79; p<0.01). A nonlinear risk reduction was observed in a doseresponse meta-analysis of all the studies (n=14, p<0.01 for nonlinearity). Conclusions: In this systematic review with meta-analysis, alcohol consumption could decrease the risk of GSD, and the dose-response analysis revealed a dosedependent linear risk reduction and a weakened linear trend between alcohol consumption levels less than and greater than 28 g/day. (Gut Liver 2019;13:114-131)

The Korean Society of Gastroenterology& SLDDS 2023 : Slide Session ; K-BP-13 : Pancreatobiliary ; Clinical Outcome of Incidental Gallbladder Cancer: A Single Center, Descriptive Study in Jeju Island

( Byung Hyo Cha ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Background: Gallbladder cancer (GBC) is a rare malignancy characterized by high invasiveness and poor survival. In a nation-wide cancer survey, the age-standardized incidence rate of GBC was the highest in Jeju Island compared to 15 other provinces in Korea. The purpose of this study was to compare the clinical outcomes of GBC according to the nature of diagnosis, that is, incidental versus non-incidental. Methods: Consecutive patients who were newly diagnosed with GBC at the Digestive Disease Center and Department of Internal Medicine, Cheju Halla General Hospital, between November 2009 and November 2013 were enrolled in this study. Patients were divided into 2 groups: incidental gallbladder cancer (IGBC) and non-incidental gallbladder cancer (NIGBC). Clinical outcomes were retrospectively compared between the two groups. Results: Seventy-nine patients were enrolled and analyzed in our study. Thirty-three (41.8%) and 46 (58.2%) patients were identifi ed as having IGBC and NIGBC, respectively. The median survival rate was signifi cantly higher for patients with IGBC than for those with NIGBC (11.4, 95% confi dence interval, 5.6-13.7 vs. 4.0, 95% confi dence interval 3.03-5.96 months; p = 0.01) during a median follow-up period of 5.7 months. Conclusions: Patients with IGBC showed better clinical prognosis than those with NIGBC. Therefore, patients with gallstone disease or gallbladder polyps, major predictive risk factors for IGBC, should undergo aggressive work-up for cholecystectomy.

Biliary Cancer Treatment

( Byung Hyo Cha ) 대한간학회 2020 춘·추계 학술대회 (KASL) Vol.2020 No.1

Aims: Cholangiocarcinoma (CCA) is rare malignant disease in gastrointestinal system and accounted as aggressive disease with poor survival. Recently, many trials have attempted to improve survival by new promising intraductal radiofrequency ablation (RFA) therapy. The aim of this study is to prove the survival benefit of endoscopic RFA for unresectable extrahepatic CCA with malignant biliary obstruction (MBO). Methods: Systematic search was performed from MEDLINE, EMBASE, Cochrane’s Library and ClinicalTrials since 1970 and eligible studies (CCT) reporting relative risk (RR), hazard risk (HR) or odd ratio (OR) regarding survival rate and stent patency period between RFA with stent and stent only group among extrahepatic CCA with MBO cases were selected. Pooled HRs among studies and their 95% CIs (confidence intervals) were estimated using the random-effects model. Risk of bias and quality of the study were assessed. Results: Total 7 studies, 2 randomized and 5 non-randomized trials, with total 368 patients were included for meta-analy sis. Pooled overall survival analysis showed favored in patient treated by RFA with sent (HR, 0.44, 95% CI, 0.31-0.61, I square=45%, P =0.09), however, we failed to prove the longer duration of stent patency in same groups (HR, 0.79, 95% CI,49-1.28, I square=48%, P =0.20). Conclusion: According to recently published studies, RFA therapy with stent insertion might have survival benefit compared to stent only among the patient with CCA with MBO.

국소 Caroli병

차병효 ( Byung Hyo Cha ),이상협 ( Sang Hyub Lee ),황진혁 ( Jin Hyeok Hwang ),김소연 ( So Yeon Kim ),김혜령 ( Hae Ryoung Kim ) 대한소화기학회 2009 대한소화기학회지 Vol.54 No.4

수술 고위험 중증 환자에게서 발생한 급성 담낭염의 경피적 담낭배액술 단독 치료와 담낭절제술 비교; 단일 기관, 단면 연구

차병효 ( Byung Hyo Cha ),송하헌 ( Ha Hun Song ),김영남 ( Young Nam Kim ),전원중 ( Won Jung Jeon ),이상진 ( Sang Jin Lee ),김진동 ( Jin Dong Kim ),이학현 ( Hak Hyun Lee ),이반석 ( Ban Seok Lee ),이상협 ( Sang Hyub Lee ) 대한소화기학회 2014 대한소화기학회지 Vol.63 No.1

Background/Aims: Percutaneous cholecystostomy (PC) is an effective treatment for cholecystitis in high-risk surgical patients. However, there is no definitive agreement on the need for additional cholecystectomy in these patients. Methods: All patients who were admitted to Cheju Halla General Hospital (Jeju, Korea) for acute cholecystitis and who underwent ultrasonography-guided PC between 2007 and 2012 were consecutively enrolled in this study. Among 82 total patients enrolled, 35 underwent laparoscopic cholecystectomy after recovery and 47 received the best supportive care (BSC) without additional surgery. Results: The technical and clinical success rates for PC were 100% and 97.5%, respectively. The overall mean survival was 12.8 months. In the BSC group, mean survival was 5.4 months, and in the cholecystectomy group, mean survival was 22.4 months (p<0.01). However, there was no significant difference between these groups in multivariate analysis (relative risk [RR]=1.92; 95% CI, 0.77-4.77; p=0.16). However, advanced age (RR=1.05; 95% CI, 1.02-1.08; p=0.001) and higher class in the American Society of Anesthesiologists` physical status (RR=3.06; 95% CI, 1.37-6.83, p=0.006) were significantly associated with survival in the multivariate analysis. Among the 47 patients in the BSC group, the cholecystostomy tube was removed in 31 patients per protocol. Recurrent cholecystitis was not observed in either group of patients during the follow-up period. Conclusions: In high-risk surgical patients, PC without additional cholecystectomy might be the best definitive management. Furthermore, the cholecystostomy drainage catheter can be safely removed in certain patients. (Korean J Gastroenterol 2014;63:32-38)

증례 : 소화기 ; Isoniazid에 의한 가성용종을 동반한 급성췌장염 1예

차병효 ( Byung Hyo Cha ),이상협 ( Sang Hyub Lee ),황진혁 ( Jin Hyeok Hwang ),김장언 ( Jang Eon Kim ),이상진 ( Sang Jin Lee ),이충식 ( Chung Sik Lee ),김현 ( Hyun Kim ) 대한내과학회 2012 대한내과학회지 Vol.82 No.5

Numerous medications have the potential to induce acute pancreatitis. However, isoniazid-induced acute pancreatitis is extremely rare. Drug-induced acute pancreatitis can be diagnosed by improvement after stopping the drug and recurrence of pancreatitis when rechallenged. We present a case of severe acute pancreatitis accompanied by multiple large pseudocysts after isoniazid treatment for pulmonary tuberculosis. We confirmed that isoniazid induced pancreatitis by rechallenging after treatment cessation. Most previous reports of isoniazid-induced pancreatitis have been clinically mild forms, and the patient fully recovered with supportive management. However, this case presents severe and permanent pancreatic damage that developed with 5 weeks of isoniazid treatment. When a patient presents with manifestations of pancreatitis during treatment of tuberculosis that includes isoniazid, the physician should consider isoniazid-induced pancreatitis. (Korean J Med 2012;82:594-598)

Laser Induced Impedance Changes in Hollow Cathode Lamps

Byung Chul Cha,Jae Jung Lee,Ki Beom Lee,Hyo Jin Kim,Gae Ho Lee,Hasuck Kim Korean Chemical Society 1993 Bulletin of the Korean Chemical Society Vol.14 No.5

Laser induced impedance changes in hollow cathode lamps containing sputtered metal atoms have been employed to measure the spectroscopic properties of metal. This technique, known as optogalvanic spectroscopy, has been shown to be a powerful and inexpensive technique for the investigation of atomic and molecular species. Characteristic optogalvanic signals from hollow cathode lamps (HCL) made of different metal species and induced with a pulsed dye laser were observed, and the dependence of the optogalvanic signal on the discharge current and wavelength of laser was measured. Based on the results obtained, the mechanisms involved in evoking the optogalvanic signals were consisted of single-photon absorption, multi-photon absorption, and photoionization. Moreover the current dependence of the optogalvanic signal indicates that the optogalvanic technique could be one of the most sensitive optical methods of detecting atomic species.