Chong Il Sohn

HER-2/neu amplification is an independent prognostic factor in gastric cancer.

The HER-2/neu protein is intimately involved with normal cell proliferation and tissue growth and is extensively homologous and related to the epidermal growth factor receptor. HER-2/neu protein expression has been most intensively studied in the context of breast carcinoma, in which its amplification and overexpression correlate with the overall course of disease, and with a poor prognosis, and constitute a predictive factor of poor response to chemotherapy and endocrine therapy. In this study, we investigated the relationship between the expression of HER-2/neu and the clinicopathological characteristics of tumors, including survival. This study was performed with a view toward the future introduction of Herceptin therapy for gastric cancer patients. HER-2/neu overexpression and gene amplification was examined with semiquantitative standardized immunohistochemical staining, chromogenic in situ hybridization (CISH), and fluorescence in situ hybridization (FISH) in 182 gastric cancer patients who underwent curative surgery at the Kangbuk Samsung Hospital. Twenty-nine (15.9%) of 182 patients expressed the HER-2/neu protein by immunohistochemistry. HER-2/neu gene amplification was detected in seven patients by CISH and FISH. Intestinal-type cancers exhibited higher rates of HER-2/neu amplification than did diffuse-type cancers (P < 0.05). Tumors with HER-2/neu amplification were associated with poor mean survival rates (922 vs 3243 days) and 5-year survival rates (21.4% vs 63.0%; P < 0.05). Age, TNM stage, and amplification of HER-2/neu were found to be independently related to survival by multivariate analysis. HER-2/neu amplification may constitute an independent prognostic factor in gastric cancer patients, and patients exhibiting HER-2/neu amplification might constitute potential candidates for new adjuvant therapies which involve the use of humanized monoclonal antibodies.

Insulin resistance and C‐reactive protein as independent risk factors for non‐alcoholic fatty liver disease in non‐obese Asian men

Background and Aim:  Although insulin resistance is often considered the link between obesity and non‐alcoholic fatty liver disease (NAFLD), the role of insulin resistance, independent of obesity, as a NAFLD risk factor in non‐obese men has been less well established. Systemic inflammation may be accompanied by insulin resistance in healthy subjects. The goal of the present study was to examine if insulin resistance and systemic inflammatory markers are independent predictors of NAFLD in non‐obese men.

Treatment of patients with gastric variceal hemorrhage: Endoscopic N-butyl-2-cyanoacrylate injection versus balloon-occluded retrograde transvenous obliteration

Background and Aim:  Our study aimed to evaluate the therapeutic results of endoscopic N‐butyl‐2‐cyanoacrylate injection (EBC) and balloon‐occluded retrograde transvenous obliteration (BRTO) in patients with gastric variceal hemorrhage (GVH) and/or high‐risk gastric varices (GV).

HER-2/neu overexpression is an independent prognostic factor in colorectal cancer

Background and aimsThe HER-2/neu protein is intimately involved with normal cell proliferation and tissue growth, as it is extensively homologous and is related to the epidermal growth factor receptor. This phenomenon has been most intensively studied in the context of breast carcinoma, in which its amplification and overexpression correlate with the overall course of disease and poor prognoses, and also constitute a predictive factor of poor response to chemotherapy and endocrine therapy. In this study, we investigated the relationships between the expression of HER-2/neu and the clinicopathological characteristics of colorectal cancer, including survival. This study was performed with a view toward the future introduction of Herceptin therapy for colorectal cancer patients.Patients and methodsHER-2/neu overexpression and gene amplification were examined via semiquantitative standardized immunohistochemical staining and fluorescence in situ hybridization (FISH) in 137 colorectal cancer patients who underwent curative surgery at the Kangbuk Samsung Hospital.ResultsSixty-five (47.4%) out of 137 patients were determined by immunohistochemistry to have overexpressed HER-2/neu protein. HER-2/neu gene amplification was detected in two patients by FISH. Tumors with HER-2/neu overexpression showed higher postoperative recurrence rate (39.3% vs 14.6%, p=0.013). Tumors with HER-2/neu overexpression were associated with poor 3-year (70.8% vs 83.7%) and 5-year survival rates (55.1% vs 78.3%, p<0.05). Advanced TNM stage, postoperative recurrence, and overexpression of HER-2/neu were found to be independently related to survival by multivariate analysis.ConclusionHER-2/neu overexpression may constitute an independent prognostic factor in colorectal cancer patients, and patients exhibiting HER-2/neu overexpression might constitute potential candidates for a new adjuvant therapy which involves the use of humanized monoclonal antibodies.

Relationship of non-alcoholic fatty liver disease to colorectal adenomatous polyps

Background and Aims:  Metabolic syndrome and insulin resistance are associated with a higher risk of colon cancer. Non‐alcoholic fatty liver disease (NAFLD) is regarded as a manifestation of metabolic syndrome in the liver. This investigation was initiated to determine whether NAFLD has a relationship to colorectal adenomatous polyps.

The Effect of Probiotics and Mucoprotective Agents on PPI‐Based Triple Therapy for Eradication of Helicobacter pylori

Background/Aims:  Recent studies have found that probiotics have anti‐Helicobacter pylori (HP) properties. We evaluated the additive effects of (i) Saccharomyces boulardii combined with proton pump inhibitor (PPI)‐based triple therapy and (ii) S. boulardii and a mucoprotective agent (DA‐9601) coupled with PPI‐based triple therapy for HP eradication.

Abdominal obesity is an independent risk factor for erosive esophagitis in a Korean population

Background:  The relationship between obesity and gastroesophageal reflux disease (GERD) is controversial. The aim of the present study was to investigate the potential roles of body mass index (BMI) and waist circumference on GERD in a Korean population.

Rescue therapy for lamivudine-resistant chronic hepatitis B: comparison between entecavir 1.0 mg monotherapy, adefovir monotherapy and adefovir add-on lamivudine combination therapy.

Background and Aim:  There have been no reports comparing the therapeutic results of adefovir (ADV) and entecavir (ETV) rescue therapy for patients with lamivudine (LAM)‐resistant chronic hepatitis B (CHB). We aimed to compare the cumulative efficacy and resistance of ETV 1.0 mg monotherapy, ADV monotherapy and ADV add‐on LAM combination therapy in LAM‐refractory patients.

Body fat distribution and insulin resistance: beyond obesity in nonalcoholic fatty liver disease among overweight men.

Objective: The aim of this study was to characterize the relationship between nonalcoholic fatty liver disease (NAFLD) and body fat distribution and insulin resistance in a sample of non-diabetic overweight men. Subjects and Methods: We conducted a cross-sectional survey of 117 overweight men with NAFLD, as well as 117 controls, who were matched with regard to age and body mass index. None of the study subjects exhibited signs of alcohol abuse, hepatitis B or C, diabetes or fasting hyperglycemia, or hypertension. The diagnosis of NAFLD was based on dual findings of elevated alanine aminotransferase levels and sonographically-determined fatty liver. Body fat distribution was assessed via bioelectrical impedance. Insulin resistance was evaluated via homeostasis model assessment (HOMA-IR). Results: The risk of developing NAFLD was found to be profoundly associated with elevated measurements of waist circumference, fat mass, percentage of body fat and abdominal fat, iron, triglycerides, apolipoprotein B, and results of HOMA-IR. Multivariate analysis revealed that NAFLD was significantly associated with elevated measurements of waist circumference, iron, apolipoprotein B, and HOMA-IR. Conclusions: Our study provides evidence for a profound and dose-dependent association of NAFLD with central adiposity, insulin resistance in overweight men lacking complications of metabolic syndrome. Overweight subjects with insulin resistance or central adiposity were at more risk of NAFLD than were those subjects with less insulin resistance or central adiposity, even those with a similar degree of obesity.

Mucosal mast cell count is associated with intestinal permeability in patients with diarrhea predominant irritable bowel syndrome

Background/Aims Although mucosal mast cell tryptase is known to significantly increase intestinal permeability, the relationship between mucosal mast cells and intestinal permeability remains unclear. The objective of this study was to evaluate the correlation among intestinal permeability, tryptase activity and mucosal mast cell count. Methods Rectal biopsies from 16 patients with diarrhea-predominant irritable bowel syndrome (IBS-D) and 7 normal subjects were assessed for tryptase activity and macromolecular permeability using horseradish peroxidase in Ussing chambers. In addition, mucosal mast cell levels were immunohistochemically quantified via image analysis. Results Rectal biopsy of tissues from IBS-D patients showed significantly increased permeability compared with those from normal controls (0.644 ± 0.08 and 0.06 ± 0.00 ng/2 hr/mm2, P < 0.01). Tryptase activity was also substantially higher in rectal biopsy samples from IBS-D patients than those from normal controls (0.86 ± 0.18 and 0.28 ± 0.04 mU/mg protein, P < 0.05). Mucosal mast cell counts were not significantly different between the 2 groups (P > 0.05). However, correlation analysis revealed that only mucosal mast cell count was significantly correlated with intestinal permeability in IBS-D patients (r = 0.558, P < 0.05). Conclusions This study demonstrated a positive correlation between the number of mucosal mast cells and intestinal permeability, suggesting that mucosal mast cells play an important role for increased intestinal permeability in patients with IBS-D.