Prognostic Value of Terminal Ileal Inflammation in Patients with Ulcerative Colitis

( Jongwook Yu ),( Jihye Park ),( Eun Ae Kang ),( Soo Jung Park ),( Jae Jun Park ),( Tae Il Kim ),( Won Ho Kim ),( Jae Hee Cheon ) 대한간학회 2021 Gut and Liver Vol.15 No.6

Background/Aims: Few studies have investigated terminal ileal lesions and their prognostic value in patients with ulcerative colitis (UC). We evaluated the clinical significance of these lesions as a prognostic factor in patients with UC who were in clinical remission. Methods: We retrospectively selected 567 of 4,066 colonoscopy reports that included positive findings from orificial observations of the terminal ileum (TI) and appendix in patients with UC. We finally recruited patients who were in clinical remission (n=204). We compared the clinical courses, including relapse and other prognostic parameters associated with UC, between the groups. Results: The baseline patient characteristics were not significantly different between patients with (n=69, TI+ group) and without TI lesions (n=135, TI- group), although there were more never-smokers in the TI+ group (n=57 [82.6%] in the TI+ group; n=86 [63.7%] in the TI- group; p=0.005). Of note, appendiceal orifice inflammation (AOI) was less frequently found in the TI+ group (14.5%) than in the TI- group (71.9%, p<0.001). The cumulative relapse rate was numerically higher in the TI- group, but it was not significantly different according to the Kaplan-Meier analysis (p=0.116). Multivariate Cox regression analysis also revealed advanced age at diagnosis as the most significant factor (adjusted hazard ratio, 0.964; 95% confidence interval, 0.932 to 0.998; p=0.037), but neither TI inflammation nor AOI were significantly associated with the cumulative relapse rate in patients with UC in clinical remission. Conclusions: For patients with UC in clinical remission, neither terminal ileal lesions nor AOI had significant clinical or predictive value for future relapse. (Gut Liver 2021;15:858-866)

S-215 Prognostic value of soluble ST2 in patients with ST-segment elevation MI undergoing primary PCI

( Jongwook Yu ),( Pyung Chun Oh ),( Myeongjoo Son ),( Kyunghee Byun ),( Woong Chol Kang ) 대한내과학회 2016 대한내과학회 추계학술발표논문집 Vol.2016 No.1

Background: Soluble ST2, an interleukin 33-related substance is a marker of biomechanical strain and has shown to be an independent predictor for adverse outcome in heart failure. We evaluated the prognostic value of soluble ST2 in ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI). Methods: A total of 323 patients with STEMI undergoing primary PCI were enrolled and divided into two groups based on the median level of ST-2 measured at the time of presentation: the high ST2 group (ST2 ≥654 pg/mL, n=162) and the low ST2 group (ST2 <654 pg/mL, n=161). The primary endpoint was 1-year major adverse cardiovascular and cerebrovascular events (MACCE), defined as the composite of all-cause death, non-fatal MI, non-fatal stroke, and ischemia-driven revascularization. Results: Demographic, echocardiographic and angiographic characteristics were similar between the high and low ST2 groups. The cumulative incidence of MACCE at 1 year was significantly higher in the high ST2 group than in the low ST2 group (15.4% vs. 8.1%, p=0.044, Figure). By multivariate Cox regression analysis adjusting for age, sex, diabetes, anterior wall infarction, and systolic dysfunction (ejection fraction <40%), the high ST2 level was independently associated with 1-year MACCE (adjusted hazard ratio 2.09, 95% CI 1.01-4.29, p=0.046). Conclusions: The level of ST2 measured at the time of presentation can be a powerful, independent predictor of 1-year adverse clinical outcomes in patients with STEMI.

Microbial Modulation in Inflammatory Bowel Diseases

Yu Jongwook,Cheon Jae Hee 대한면역학회 2022 Immune Network Vol.22 No.6

Gut dysbiosis is one of prominent features in inflammatory bowel diseases (IBDs) which are of an unknown etiology. Although the cause-and-effect relationship between IBD and gut dysbiosis remains to be elucidated, one area of research has focused on the management of IBD by modulating and correcting gut dysbiosis. The use of antibiotics, probiotics either with or without prebiotics, and fecal microbiota transplantation from healthy donors are representative methods for modulating the intestinal microbiota ecosystem. The gut microbiota is not a simple assembly of bacteria, fungi, and viruses, but a complex organ-like community system composed of numerous kinds of microorganisms. Thus, studies on specific changes in the gut microbiota depending on which treatment option is applied are very limited. Here, we review previous studies on microbial modulation as a therapeutic option for IBD and its significance in the pathogenesis of IBD.

Effectiveness and Safety of Golimumab in Patients with Ulcerative Colitis: A Multicenter, Prospective, Postmarketing Surveillance Study

Yu Jongwook,Park Soo Jung,Kim Hyung Wook,Lim Yun Jeong,Park Jihye,차재명,Ye Byong Duk,Tae Oh Kim,Kim Hyun-Soo,Lee Hyun Seok,Jung Su Young,Kim Youngdoe,Choi Chang Hwan 거트앤리버 소화기연관학회협의회 2022 Gut and Liver Vol.16 No.5

Background/Aims: Golimumab has been used for patients with ulcerative colitis (UC) since 2013. However, there is limited data on the effectiveness and safety of the real-world use of golimumab in Asian patients. Methods: This was a multicenter, prospective, observational study. We enrolled patients with moderate-to-severe UC who were administered subcutaneous golimumab at 46 medical centers between May 2014 and November 2019. The primary outcome was the effectiveness and safety of golimumab at week 22. Clinical outcomes and adverse events were assessed according to partial Mayo score at weeks 0, 2, 6, 14, and 22. Results: A total of 130 patients were included (mean age: 45.7±16.0 years). The clinical response/ remission rates at weeks 2, 6, 14, and 22 were 40.4%/22.9%, 56.0%/35.8%, 70.6%/49.5%, and 67.9%/48.6%, respectively. Based on full Mayo score at week 14, clinical response and remission rates were 84.2% and 39.5%, respectively. Mucosal healing rate was 65.8%. In multivariate analysis with logistic regression, longer disease duration was significantly associated with a higher clinical response rate (adjusted odds ratio [aOR], 1.136; 95% confidence interval [CI], 1.006 to 1.282; p=0.040 at week 6; aOR, 1.256; 95% CI, 1.049 to 1.503; p=0.013 at week 22). A higher baseline Mayo endoscopic subscore was significantly associated with a lower clinical response rate at week 6 (aOR, 0.248; 95% CI, 0.089 to 0.692; p=0.008). The incidence of adverse drug reactions was 4.6% (6/130, nine events). No serious unexpected adverse drug reactions or deaths were reported. Conclusions: Golimumab was effective and safe as an induction and maintenance treatment for Korean patients with moderate-to-severe UC.

Continued Postoperative Use of Tumor Necrosis Factor-α Inhibitors for the Prevention of Crohn’s Disease Recurrence

Yu Jongwook,Hyun Hye Kyung,박지혜,Kang Eun Ae,박수정,박재준,김태일,김원호,천재희 거트앤리버 소화기연관학회협의회 2022 Gut and Liver Vol.16 No.3

Background/Aims: Many patients with Crohn’s disease (CD) undergo intestinal resection during the disease course. Despite surgery, postoperative recurrence (POR) commonly occurs. Although postoperative use of tumor necrosis factor α (TNF-α) inhibitors is known to be effective in preventing POR, few studies have evaluated the effectiveness of continuing the same TNF-α inhibitors postoperatively in patients who received TNF-ɑ inhibitors before surgery. Methods: This retrospective observational study was performed in a single tertiary medical center. We retrospectively reviewed patients who had undergone the first intestinal resection due to CD and divided them into two groups: TNF-α inhibitor users in both the preoperative and postoperative periods, and TNF-α inhibitor users in only the preoperative period. We compared the clinical outcomes between these two groups. Results: In total, 45 patients who used TNF-α inhibitors preoperatively were recruited. Among them, TNF-α inhibitors were used postoperatively in 20 patients (44.4%). The baseline characteristics except age at diagnosis were similar in both groups. The rates of surgical and endoscopic recurrence were not different between the two groups, but the cumulative clinical recurrence rate was significantly lower in the postoperative TNF-α inhibitors group (log-rank p=0.003). In multivariate Cox regression analysis, postoperative TNF-α inhibitors use was significantly associated with a decreased risk of clinical recurrence (adjusted hazard ratio, 0.204; 95% confidence interval, 0.060 to 0.691; p=0.011). Conclusions: Continuing TNF-α inhibitors postoperatively in patients who were receiving TNF-α inhibitors before surgery significantly reduced the rate of clinical recurrence. For patients with CD who received TNF-α inhibitors preoperatively, continuing their use after surgery could be recommended.

전복 섭취 후 발생한 아나필락시스 1예

유종욱 ( Jongwook Yu ),손은숙 ( Eun Suk Son ),김준환 ( Joonhwan Kim ),박홍석 ( Hong Suk Park ),이소정 ( Sojung Lee ),이상민 ( Sang Min Lee ),박정웅 ( Jeong-woong Park ),이상표 ( Sang Pyo Lee ) 대한천식알레르기학회 2016 Allergy Asthma & Respiratory Disease Vol.4 No.6

Abalone is popular seafood in Asia; however, allergy to abalone was rarely reported. We report a case of anaphylaxis after consumption of abalone. A 24-year-old female visited an Emergency Department, complaining of cough, dyspnea, rhinorrhea, generalized urticaria, facial edema, and wheezing that had developed 1 hour after consumption of abalone. She was discharged when her symptoms subsided after antihistamine and dexamethasone were given. One month later, she was referred to our outpatient clinic. We performed skin prick tests, measurement of serum specific IgE antibody level, and sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) with IgE immunoblotting. Both skin prick and specific IgE antibody tests were positive for abalone crude extract. In SDS-PAGE with IgE immunoblotting, we identified possible antigens sized 55, 100, and 25 kDa, respectively. This is the first case of abalone-induced anaphylaxis in Korea. (Allergy Asthma Respir Dis 2016:4:449-452)

위성 MF-TDMA Network에서의 라우터 간 ARP 획득 방안

이종욱(Jongwook Lee),김문(Moon Kim),김규형(Kyuheoung Kim),유기남(Kinam Yu),김준환(Junwhan Kim) 한국항공우주학회 2017 한국항공우주학회 학술발표회 논문집 Vol.2017 No.11

차기 위성 PTP 링크를 위한 Bit stuffing 방안

유기남(Kinam Yu),이종욱(Jongwook Lee),김규형(Kuheung Kim) 한국항공우주학회 2017 한국항공우주학회 학술발표회 논문집 Vol.2017 No.11

Radiology plus ileocolonoscopy versus radiology alone in Crohn’s disease: prognosis prediction and mutual agreement

Hye Kyung Hyun,Jongwook Yu,Eun Ae Kang,박지혜,박수정,박재준,김태일,김원호,천재희 대한내과학회 2022 The Korean Journal of Internal Medicine Vol.37 No.3

Background/Aims: The optimal tools for monitoring Crohn’s disease (CD) are controversial. We compared radiology plus ileocolonoscopy and radiology alone in terms of prognosis prediction and evaluated the agreement between radiologic and ileocolonoscopic findings in patients with CD. Methods: Patients with CD who were followed up with computed tomography enterography (CTE) or magnetic resonance enterography (MRE) alone or CTE or MRE plus ileocolonoscopy were retrospectively recruited. Time to relapse was investigated to evaluate the difference in prognosis using the log-rank and Cox regression tests, and the agreement between radiologic and ileocolonoscopic findings was determined using a kappa value. Results: A total of 501 patients with CD in clinical remission who underwent CTE or MRE and/or ileocolonoscopy were analyzed. Of these, 372 (74.3%) patients underwent CTE or MRE alone and 129 (25.7%) patients underwent CTE or MRE plus ileocolonoscopy. The cumulative maintenance rate of clinical remission between the two groups was not significantly different (p = 0.526, log-rank test). In multivariate analysis, age <40 years (hazard ratio [HR], 2.756; 95% confidence interval [CI], 1.263 to 6.013) and a history of steroid use (HR, 2.212; 95% CI, 1.258 to 3.577) were found to independently predict an increased risk for clinical relapse in patients with CD in clinical remission. Radiologic and ileocolonoscopic findings had a moderate degree of agreement (κ = 0.401, –0.094 to 0.142). The comparison of agreement between radiologic and ileocolonoscopic findings was the highest in the anastomotic site (κ = 0.749, –0.168 to 0.377). Conclusions: Radiology plus ileocolonoscopy was not superior to radiology alone in predicting the prognosis of CD.

Metastasectomy for Recurrent or Metastatic Biliary Tract Cancers: A Single Center Experience

Joonhwan Kim,Youngwoo Jang,Jungwoo Shim,Jongwook Yu,Dong Bok Shin,nkeun Park 순천향대학교 순천향의학연구소 2016 Journal of Soonchunhyang Medical Science Vol.22 No.1

Objective: Efficacy or long-term result of metastasectomy for recurrent or metastatic biliary tract carcinoma (BTC) is not well established. We conducted a retrospective review of the outcomes of metastasectomy for recurrent or metastatic BTCs. Methods: The clinicopathological features and outcomes of consecutive patients with BTCs who underwent surgical resection for primary and metastatic disease at a tertiary referral hospital from 2003 to 2013 were reviewed retrospectively. Results: We found 19 eligible patients. Median age of patients was 57 years old (range, 27 to 68 years old), and 11 patients (58%) were female. Primary sites were gallbladder cancer (seven patients, 37%), intrahepatic cholangiocarcinoma (five patients, 26%), distal common bile duct cancer (three patients, 16%), proximal common bile duct cancer (two patients, 11%), and ampulla of Vater cancer (two patients, 11%). Eight patients (42%) had synchronous metastasis, while 11 (58%) had metachronous metastasis. The most common metastatic site was liver (nine patients, 47%), lymph node (nine patients, 47%), and peritoneum (three patients, 16%). Nine patients (47%) achieved R0 resection, while four (21%) and six (32%) patients had R1 and R2 resection, respectively. With a median follow-up period of 26.7 months, the estimated median overall survival (OS) was 18.2 months (95% confidence interval [CI], 13.6 to 22.9 months). Lower Eastern Cooperative Oncology Group performance status (P=0.023), metachronous metastasis (P=0.04), absence of lymph node metastasis (P=0.009), lower numbers of metastatic organs (P<0.001), normal postoperative carbohydrate antigen 19-9 level (P=0.034), and time from diagnosis to metastasectomy more than one year (P=0.019) were identified as prognostic factors for a longer OS after metastasectomy. Conclusion: For recurrent or metastatic BTCs, metastasectomy can be a viable option for selected patients.