Min-Ju Kim

Radiofrequency ablation as an alternative to hepatic resection for single small hepatocellular carcinomas.

This study aimed to investigate whether radiofrequency ablation (RFA) is an alternative to surgical resection for hepatocellular carcinoma (HCC) within the context of current guidelines.

Risk factors and clinical outcomes of gastric cancer identified by screening endoscopy: a case-control study.

A customized screening program for gastric cancer would optimize the benefits of screening endoscopy. This study investigated the risk factors for gastric cancer detected during screening and factors affecting clinical outcomes.

Association between non-alcoholic fatty liver disease and cancer incidence rate

BACKGROUND & AIMSnLittle is known about the association between non-alcoholic fatty liver disease (NAFLD) and cancer development. This study investigated the cancer incidence rates in NAFLD and analysed the association between NAFLD and cancer development.nnnMETHODSnThis historical cohort study included subjects who were followed up for >1u202fyear after having a heath checkup at a tertiary hospital in Korea from September 1, 2004 to December 31, 2005. NAFLD was diagnosed by ultrasonographic detection of hepatic steatosis in the absence of other known liver disease, including alcoholic or viral hepatitis. Cox proportional hazards regression model was conducted to assess the association between NAFLD and cancer development.nnnRESULTSnOf 25,947 subjects, 8,721 (33.6%) had NAFLD. During the total follow-up of 164,671 person-years (median 7.5u202fyears), the cancer incidence rate of the NAFLD group was higher than that of the non-NAFLD group (782.9 vs. 592.8 per 100,000 person-years; hazard ratio [HR] 1.32; 95% confidence interval [CI] 1.17-1.49; pu202f<0.001). When demographic and metabolic factors were adjusted for, NAFLD showed a strong association with three cancers: hepatocellular carcinoma ([HCC]; HR 16.73; 95% CI 2.09-133.85; pu202f=u202f0.008), colorectal cancer in males (HR 2.01; 95% CI 1.10-3.68; pu202f=u202f0.02), and breast cancer in females (HR 1.92; 95% CI 1.15-3.20; pu202f=u202f0.01). A high NAFLD fibrosis score (NFS) and a high fibrosis-4 (FIB-4) score were associated with the development of all cancers and HCC.nnnCONCLUSIONnNAFLD was associated with the development of HCC, colorectal cancer in males, and breast cancer in females. A high NFS and a high FIB-4 score showed a strong association with the development of all cancers and HCC.nnnLAY SUMMARYnNon-alcoholic fatty liver disease (NAFLD) is associated with developing hepatocellular carcinoma (HCC). There have been limited data on the association between NAFLD and extrahepatic cancers. This study demonstrated that patients with NAFLD showed a higher association with the development of HCC, colorectal cancer in males, and breast cancer in females. A high NAFLD fibrosis score and a high fibrosis-4 score showed a strong association with the development of all cancers and HCC.

Long term follow-up of appendiceal and distal right-sided colonic inflammation.

The aim of this study was to investigate the possibility of appendiceal orifice inflammation (AOI) as a preceding lesion in the development of ulcerative colitis. A total of 20 patients were identified (mean age 41.2 years; 11 males) who had ulcerative colitis-like inflammatory lesions at the appendiceal orifice without concomitant typical features of ulcerative colitis, such as rectal involvement. A total of 19 patients were followed up endoscopically for a mean duration of 18.4 months (range 2u200a-u200a84 months). Typical ulcerative colitis developed in five patients (25u200a%; four proctitis, one pancolitis) in a mean time of 18.4 months (range 2u200a-u200a36 months). Negative conversion of all inflammatory lesions occurred in seven patients (35u200a%) after a mean follow-up of 20 months (range 3u200a-u200a84 months). In the remaining seven patients (35u200a%), initial lesions did not progress to ulcerative colitis and did not go into remission during a mean follow-up of 16.9 months (range 2u200a-u200a42 months). These results suggest that, at least in some cases, AOI precedes development of ulcerative colitis.

Clinical and Endoscopic Features of Metastatic Tumors in the Stomach

Background/Aims Metastasis to the stomach is rare. The aim of this study was to describe and analyze the clinical outcomes of cancers that metastasized to the stomach. Methods We reviewed the clinicopathological aspects of patients with gastric metastases from solid organ tumors. Thirty-seven cases were identified, and we evaluated the histology, initial presentation, imaging findings, lesion locations, treatment courses, and overall patient survival. Results Endoscopic findings indicated that solitary lesions presented more frequently than multiple lesions and submucosal tumor-like tumors were the most common appearance. Malignant melanoma was the tumor that most frequently metastasized to the stomach. Twelve patients received treatments after the diagnosis of gastric metastasis. The median survival period from the diagnosis of gastric metastasis was 3.0 months (interquartile range, 1.0 to 11.0 months). Patients with solitary lesions and patients who received any treatments survived longer after the diagnosis of metastatic cancer than patients with multiple lesions and patients who did not any receive any treatments. Conclusions Proper treatment with careful consideration of the primary tumor characteristics can increase the survival period in patients with tumors that metastasize to the stomach, especially in cases with solitary metastatic lesions in endoscopic findings.

Novel endoscopic categorization for prediction of chemoradiotherapy response in locally advanced esophageal cancer: Post-CRT evaluation of esophageal cancer

Preoperative chemoradiotherapy (CRT) followed by esophagectomy is a well‐known treatment modality for patients with locally advanced esophageal cancer (EC). This study developed an algorithm to predict pathological complete response (CR) in these patients using post‐CRT endoscopic category with biopsy and validated the proposed algorithm.

Fecal calprotectin predicts complete mucosal healing and better correlates with the ulcerative colitis endoscopic index of severity than with the Mayo endoscopic subscore in patients with ulcerative colitis.

BackgroundWe aimed to evaluate the role of fecal calprotectin (FC) as a noninvasive marker for the disease activity of ulcerative colitis (UC) in a Korean cohort.MethodsA total of 181 fecal samples were collected from 181 consecutive UC patients between April 2015 and September 2016. FC levels were measured using the Quantum Blue® Calprotectin rapid test. The laboratory test results, partial Mayo Score (pMS), and colonoscopic imaging findings at FC level measurement were retrospectively reviewed. The Mayo endoscopic subscore (MES) and UC endoscopic index of severity (UCEIS) were graded by 2 certified endoscopists after training with 50 other cases.ResultsThe FC levels were significantly correlated with pMS (Spearman correlation coefficient rxa0=xa00.428, pxa0<xa00.001), MES (rxa0=xa00.304, pxa0<xa00.001), UCEIS (rxa0=xa00.430, pxa0<xa00.001), and CRP (rxa0=xa00.379, pxa0<xa00.001). FC levels exhibited a significantly better correlation with UCEIS than with MES (Meng’s zxa0=xa0− 2.457, pxa0=xa00.01). The FC cut-off level of 187.0xa0mg/kg indicated complete mucosal healing (MESxa0=xa00; UCEIS =0) with a sensitivity and specificity of 0.857 and 0.891, respectively (area under the curve, 0.883; 95% confidence interval, 0.772–1.000).ConclusionThe FC level is significantly correlated with the clinical disease activity index, endoscopic indices, and serum inflammatory biomarkers in a Korean UC cohort. FC is highly predictive of complete mucosal healing in UC. UCEIS exhibits a stronger correlation with the FC level, as compared to MES. Thus, FC could be used as a reliable noninvasive indicator for evaluating disease activity and mucosal healing in UC.

Prediction of the Risk of a Metachronous Advanced Colorectal Neoplasm Using a Novel Scoring System

AbstractBackground and AimThis study aimed to develop and validate a risk score model to estimate the probability of a metachronous advanced colorectal neoplasm (ACRN) at surveillance colonoscopy.nMethodsA retrospective analysis of a prospectively obtained database of 11,042 asymptomatic subjects who underwent surveillance colonoscopy after a screening colonoscopy was conducted. Subjects were randomly divided into derivation (nxa0=xa07730) and validation sets (nxa0=xa03312). From the derivation cohort, risk factors for a metachronous ACRN were identified by a multivariable analysis. Risk points were allocated to each risk factor based on the hazard ratio to develop the Metachronous Advanced colorectal neoplasm Prediction Scoring (MAPS) model, the performance of which was assessed in the validation cohort.ResultsIn the derivation cohort, age, male, sessile serrated adenoma/polyp, and a high-risk CRN (ACRN or ≥3 adenomas) at screening colonoscopy were independent risk factors for a metachronous ACRN. These variables were incorporated into the MAPS model, and the risk score ranged 0–17 (high MAPS risk arbitrarily defined as 10–17). At the 3-year surveillance colonoscopy, ACRN was found in 5.1xa0% of the high MAPS risk group versus 3.9xa0% of the high-risk CRN group. The colonoscopy number needed to detect one metachronous ACRN at the 3-year surveillance was 19.5 (95xa0% CI 11.7–33.2) for the high MAPS risk group versus 25.8 (95xa0% CI 15.4–44.0) for the high-risk CRN group. These findings were similarly confirmed in the validation cohort.ConclusionsOur MAPS model based on clinical and colonoscopic parameters effectively predicts the risk of a metachronous ACRN.

Inactivation of the DevS Histidine Kinase of Mycobacterium smegmatis by the Formation of the Intersubunit Disulfide Bond

The DevSR two-component system is a major regulatory system involved in redox sensing in Mycobacterium smegmatis. The DevSR system consists of the DevS histidine kinase and its cognate DevR response regulator. When exposed to hypoxic conditions, the DevS histidine kinase is activated to phosphorylate the DevR response regulator, leading to the transcriptional activation of the DevR regulation. The ligand-binding state of the heme embedded in the N-terminal GAF domain of DevS determines the kinase activity of DevS. In this study, we demonstrated that the redox-responsive cysteine (C547) in the C-terminal kinase domain is involved in the redox-dependent control of DevS kinase activity. The formation of an intersubunit disulfide bond between the C547 residues in the presence of O₂ led to inactivation of DevS kinase activity. The reduction of the oxidized DevS with reductants such as β-mercaptoethanol and dithiothreitol resulted in the restoration of DevS kinase activity. It was demonstrated in vivo by complementation test that the substitution of C547 to alanine partially impaired the sensory function of DevS in M. smegmatis.