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( Choong-kyun Noh ),( Hee-jung Wang ),( Jung-hee Kwon ),( Hyo Jung Cho ),( Soon Sun Kim ),( Bong Wan Kim ),( Sung Won Cho ),( Jae Youn Cheong ) 대한간학회 2016 춘·추계 학술대회 (KASL) Vol.2016 No.1
Aims: Epithelial cell adhesion molecule (EpCAM) is a biomarker for hepatic stem cell because it is expressed in hepatic progenitor cell and fetal hepatoblast. We evaluated the expression of stemness- related markers as a prognostic marker of tumor recurrence and survival in patient with hepatocellular carcinoma (HCC) underwent surgical resection. Methods: We enrolled 204 HCC patients who had performed surgical resection between Jan 2011 and Dec 2014. Protein expression of EpCAM, alpha-fetoprotein (AFP), cytokeratin 19 (CK19), cytokeratin 7 (CK7) and glypican-3 were examined using immunohistochemical stain in resected specimens. The prognostic significance of EpCAM and other markers was analyzed using Kaplan-Meier and Cox regression models. Results: Expression of EpCAM, AFP, CK19, CK7 and glypican-3 were positive in 46.1% (88 out of 191), 47.8% (88 out of 184), 33.3% (31 out of 93), 51.5% (68 out of 132) and 87.5% (162 out of 185), respectively. Univariate Cox regression analysis showed that Edmondson grade (I, II vs III, IV), microvessel invasion, portal vein invasion, hepatic vein invasion, intrahepatic metastasis and EpCAM expression were associated with tumor recurrence (P=0.014) and disease- free survival (DFS)(P=0.019). A Kaplan-Meier survival analysis showed that patients with EpCAM positive staining had significantly higher tumor recurrence (P=0.0123) and lower DFS (P=0.0179) than patients with EpCAM negative staining. Other markers (AFP, CK19, CK7, glypican-3) were not associated with tumor recurrence or survival. In subgroups analysis with hepatitis B virus-related HCC (n=168), EpCAM positivity was also associated with tumor recurrence (P=0.0277) and DFS (P=0.0189) in Kaplan-Meier analysis. Conclusions: EpCAM expression might be a poor prognostic maker of tumor recurrence and survival in patients with HCC after surgical resection.
Choong-Kyun Noh,In Sung Kim,Gil Ho Lee,Jin Woong Park,Eunyoung Lee,Bumhee Park,Hye Jeon Hong,Sun Gyo Lim,Sung Jae Shin,Jin Hong Kim,Kee Myung Lee 거트앤리버 소화기연관학회협의회 2020 Gut and Liver Vol.14 No.4
Background/Aims: Adequate bowel preparation is important for successful colonoscopy. We aimed to evaluate the clinical feasibility and effectiveness of abdominal vibration stimulation in bowel preparation before therapeutic colonoscopy. Methods: A single center, prospective, randomized, investigator-blinded study was performed between January 2016 and December 2016. Patients for therapeutic colonoscopy were prospectively enrolled and assigned to either the vibrator group or walking group. Patients who refused to participate in this study as part of the experimental group consented to register in the control group instead. During the preparation period, patients assigned to the walking group walked ≥3,000 steps, whereas those assigned to the vibrator group received abdominal vibrator stimulation and restricted walking. All patients received the same colon cleansing regimen: 4-L split-dose polyethylene glycol (PEG) solution. Results: Three hundred patients who received PEG solution for therapeutic colonoscopy were finally enrolled in this study (n=100 per group). Bowel cleansing with abdominal vibration stimulation showed almost similar results to that with walking exercise (Boston Bowel Preparation Scale score for the entire colon: vibrator vs walking vs control, 7.38±1.55 vs 7.39±1.55 vs 6.17±1.15, p<0.001). There were no significant differences between the vibrator group and walking group regarding instances of diarrhea after taking PEG, time to first diarrhea after taking PEG, total procedure time, and patient satisfaction. Conclusions: This study indicates that, compared with conventional walking exercise, abdominal vibration stimulation achieved similar rates of bowel cleansing adequacy and colonoscopy success without compromising safety or patient satisfaction.
S-54 : Primary Gastric Histiocytic sarcoma, similar with an inflammatory pseudotumor: A Case report
( Choong Kyun Noh ),( Sook Hee Chung ),( Dakeun Lee ),( Sung Jae Shin ),( Joon Koo Kang ),( Sun Kyo Lim ),( Kee Myung Lee ),( Kyang Jae Lee ) 대한내과학회 2013 대한내과학회 추계학술대회 Vol.2013 No.1
Histiocytic sarcoma is a malignant neoplasm that originated from myeloid-derived macrophages, and related to myelomonocytic or lymphoblastic leukemia. Histiocytic sarcoma rarely occurs in the stomach. In previous reports, a few cases of histiocytic sarcoma in the stomach were reported. In this case, a 45-year-old female had complained of patient epigastric pain and melena for 1 month. In her laboratory data, hemoglobin was 8 g/dl. In endoscopic finding, there was an ulcerofungating mass with irregular base coated with dirty exudates in distal antrum and body. Abdominal Computed tomography showed a large ulcerofungating mass involving from gastric antrum to duodenal bulb with suspicious invasion of pancreas. In PET CT, metastatic lymph nodes in infrapyloric, perigastric and right hilar area were found. In pathologic findings, tumor cells showed band-like infiltration mainly in the mucosa and submucosa, but also penetrated into serosa in some areas. Tumor cells largely had intermediate-size nuclei with plump, pink cytoplasm. Because there was lack of high degree of cellular atypia or pleomorphism in pathologic findings, final diagnosis as gastric Histiocytic sarcoma was confused with inflammatory pseudotumor. In immunohistochemical staining, the tumor cells were positive for CD68, CD163, LCA, lysozyme, but negative for other immunomarkers including CD21, CD1a, and MPO. The patient underwent palliative distal gastrectomy. The resected specimen after operation clearly demonstrated the malignant nature of this tumor. Based upon the examination, the authors finally diagnosed her as histiocytic sarcoma. The patient was referred to oncology department after operation. She received chemotherapy such as Etoposide, Cisplatin and Iphosphamide. She has another schedules for additional chemotherapy in the out-patient department clinics.
( Choong-kyun Noh ),( Kwang Jae Lee ) 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 2020 Journal of Neurogastroenterology and Motility (JNM Vol.26 No.4
Background/Aims The pathophysiology of functional abdominal bloating and distention (FABD) is unclear yet. Our aim is to compare the diversity and composition of fecal microbiota in patients with FABD and healthy individuals, and to evaluate the relationship between small intestinal bacterial overgrowth (SIBO) and dysbiosis. Methods The microbiota of fecal samples was analyzed from 33 subjects, including 12 healthy controls and 21 patients with FABD diagnosed by the Rome IV criteria. FABD patients underwent a hydrogen breath test. Fecal microbiota composition was determined by 16S ribosomal RNA amplification and sequencing. Results Overall fecal microbiota composition of the FABD group differed from that of the control group. Microbial diversity was significantly lower in the FABD group than in the control group. Significantly higher proportion of Proteobacteria and significantly lower proportion of Actinobacteria were observed in FABD patients, compared with healthy controls. Compared with healthy controls, significantly higher proportion of Faecalibacterium in FABD patients and significantly higher proportion of Prevotella and Faecalibacterium in SIBO (+) patients with FABD were found. Faecalibacterium prausnitzii, was significantly more abundant, but Bacteroides uniformis and Bifidobacterium adolescentis were significantly less abundant in patients with FABD, compared with healthy controls. Significantly more abundant Prevotella copri and F. prausnitzii, and significantly less abundant B. uniformis and B. adolescentis were observed in SIBO (+) patients, compared with healthy controls. Conclusion The fecal microbiota profiles in FABD patients are different from those in healthy controls, particularly in SIBO (+) patients, suggesting a role of gut microbiota in the pathogenesis of FABD. (J Neurogastroenterol Motil 2020;26:539-549)
( Choong-kyun Noh ),( Bong Sun Kim ),( Gana Hong ),( Jae Youn Cheong ),( Kwang Jae Lee ) 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 2018 Journal of Neurogastroenterology and Motility (JNM Vol.24 No.3
Background/Aims Probiotics are expected to modify the composition of gut microbiota. We aimed to investigate the changes in the composition and diversity of gut microbiota by the administration of probiotics in healthy individuals. Methods Twelve healthy volunteers with age range of 30-42 years provided baseline fecal samples. Subsequently, they took commercially available probiotic capsules (a mixture for Bifidobacterium, Lactobacillus , and Enterococcus ) for 4 weeks. Fecal samples were collected at 4 weeks of administration and 2 weeks after the stop of administration. Fecal microbiota was analyzed via 16S ribosomal RNA gene sequencing. Results The mean Shannon index was not significantly altered by the 4-week administration of probiotics (4.365 vs 4.556, P > 0.05). The proportion of Bacteroidetes, Actinobacteria, Firmicutes, and Proteobacteria was not significantly changed by the 4-week administration of probiotics. At the genus level, the proportions of Lactobacillus (2.138% vs 2.773%, P = 0.028) and Enterococcus (0.022% vs 2.758%, P = 0.004) significantly increased 4 weeks after the administration of probiotics, but reduced 2 weeks after the stop of administration (2.773% vs 3.292%, P = 0.064 and 2.758% vs 0.001%, P = 0.001). Conclusions The diversity of fecal microbiota is not significantly affected by 4 weeks of probiotics administration. The proportion of fecal microbiota at the genus level is significantly altered by the administration of probiotics. However, this effect does not seem to last long, probably because of homeostasis or dietary influence. (J Neurogastroenterol Motil 2018;24:452-459)
Non-steroidal anti-inflammatory drug-induced enteropathy
( Sung Jae Shin ),( Choong-kyun Noh ),( Sun Gyo Lim ),( Kee Myung Lee ),( Kwang Jae Lee ) 대한장연구학회 2017 Intestinal Research Vol.15 No.4
Non-steroidal anti-inflammatory drugs (NSAIDs) are well known to be associated with serious upper gastrointestinal complications, such as peptic ulcer, bleeding, perforation, and obstruction. Recently, attention has been mainly focused on the small bowel injuries caused by NSAIDs, and new endoscopic techniques such as capsule endoscopy and double balloon endoscopy can help in detecting such injuries. This article reviewed the epidemiology, pathogenesis, clinical manifestations, diagnosis, and treatment of small bowel injuries caused by NSAIDs. Small bowel injures by NSAIDs might occur with a similar frequency and extent as those observed in the upper gastrointestinal tract. The pathogenesis of NSAID-induced enteropathy is complex and not clearly understood. The various lesions observed in the small bowel, including petechiae, reddened folds, loss of villi, erosions, and ulcers can be detected by capsule endoscopy. A drug that could prevent or treat NSAID-induced enteropathy has not yet been developed. Therefore, further investigations should be performed to elucidate the pathogenesis of such enteropathy and develop suitable preventive and treatment strategies. (Intest Res 2017;15:446-455)
( Young-gun Kim ),( Choong-kyun Noh ),( Kwang Jae Lee ) 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 2020 Journal of Neurogastroenterology and Motility (JNM Vol.26 No.4
Background/Aims Low baseline impedance levels (BILs) have been suggested to be evidence of GERD. The aim of this study is to investigate the usefulness of esophageal BILs for the diagnosis of nonerosive reflux disease (NERD) and the proper time for measurement in endoscopy-negative Korean patients with esophageal or supraesophageal symptoms. Methods Endoscopy-negative patients with esophageal or supraesophageal symptoms who underwent esophageal multichannel intraluminal impedance-pH monitoring were included. BILs were measured in the proximal and distal esophagus around 10 minutes before meals, 10 minutes and 30 minutes after meals, 30 minutes before the start of nighttime sleep, and 30 minutes and 60 minutes after the start of nighttime sleep. Results A total of 104 patients were included in the study. Distal and proximal esophageal BILs were decreased after meal ingestion. The BILs of the distal esophagus were significantly lower at all time points in the NERD group, but not in the reflux hypersensitivity (RH) group, compared with the functional group. The area under the receiver operating characteristic curve for the diagnosis of NERD was significant at all time points, but that for the diagnosis of RH was not. The cut-off value of 2375 Ω or 2125 Ω measured around 30 minutes before or 60 minutes after the start of nighttime sleep, respectively, were appropriate for the diagnosis of NERD. Conclusion The BILs of the distal esophagus measured at time points before or after the start of nighttime sleep appear to be useful for the diagnosis of NERD, but not for the diagnosis of RH, in endoscopy-negative Korean patients with esophageal or supraesophageal symptoms. (J Neurogastroenterol Motil 2020;26:463-470)
Hyun, Moon-Seop,Yoo, Jung-Ho,Kwak, Noh-Yeal,Kim, Won,Rhee, Choong-Kyun,Yang, Jun-Mo Korean Society of Microscopy 2012 Applied microscopy Vol.42 No.3
Detailed comparison of low-voltage scanning electron microscopy and electron holography techniques for two-dimensional (2D) dopant profiling was carried out with using the same multilayered p-n junction specimen. The dopant profiles obtained from two methods are in good agreement with each other. It demonstrates that reliability of dopant profile measurement can be increased through precise comparison of 2D profiles obtained from various microscopic techniques.