Background:Coronavirus disease 2019(COVID-19)is a global pandemic issue.In addition to the well-known respiratory and fever symptoms,gastrointestinal symptoms have also been reported.This study aimed to evaluate the p...Background:Coronavirus disease 2019(COVID-19)is a global pandemic issue.In addition to the well-known respiratory and fever symptoms,gastrointestinal symptoms have also been reported.This study aimed to evaluate the prevalence and prognosis of patients with COVID-19 infection complicated with acute pancreatitis in intensive care unit(ICU).Methods:This was a retrospective observational cohort study,and patients aged 18 years or older,ad-mitted into the ICU in a single tertiary center from January 1,2020,to April 30,2022 were enrolled.Patients were identified by electronic medical records and reviewed manually.The primary outcome was the prevalence of acute pancreatitis among ICU patients with COVID-19.The secondary outcomes were the length of hospital stay,need for mechanical ventilation(MV),need for continuous renal replacement therapy(CRRT),and in-hospital mortality.Results:A total of 4133 patients,admitted into the ICU,were screened.Among these patients,389 were infected by COVID-19,and 86 were diagnosed with acute pancreatitis.COVID-19 positive patients were more likely to present with acute pancreatitis than COVID-19 negative patients(odds ratio=5.42,95%confidence interval:2.35-6.58,P<0.01).However,the length of hospital stay,need for MV,need for CRRT,and in-hospital mortality were not significantly different between acute pancreatitis patients with and without COVID-19 infection.Conclusions:Severe COVID-19 infections may cause acute pancreas damage in critically ill patients.How-ever,the prognosis may not differ between acute pancreatitis patients with and without COVID-19 infec-tion.展开更多
Gastric remnants are an inevitable consequence of partial gastrectomy following resection for gastric cancer.The presence of gastric stumps is itself a risk factor for redevelopment of gastric cancer.Helicobacter pylo...Gastric remnants are an inevitable consequence of partial gastrectomy following resection for gastric cancer.The presence of gastric stumps is itself a risk factor for redevelopment of gastric cancer.Helicobacter pylori(H.pylori)infection is also a well-known characteristic of gastric carcinogenesis.H.pylori colonization in the remnant stomach therefore draws special interest from clinicians in terms of stomach cancer development and pathogenesis;however,the H.pylori-infected gastric remnant is quite different from the intact organ in several aspects and researchers have expressed conflicting opinions with respect to its role in pathogenesis.For instance,H.pylori infection of the gastric stump produced controversial results in several recent studies.The prevalence of H.pylori infection in the gastric stump has varied among recent reports.Gastritis developing in the remnant stomach presents with a unique pattern of inflammation that is different from the pattern seen in ordinary gastritis of the intact organ.Bilerefluxate also has a significant influence on the colonization of the stomach stump,with several studies reporting mixed results as well.In contrast,the elimination of H.pylori from the gastric stump has shown a dramatic impact on eradication rate.H.pylori elimination is recognized to be important for cancer prevention and considerable agreement of opinion is seen among researchers.To overcome the current discrepancies in the literature regarding the role of H.pylori in the gastric stump,further research is required.展开更多
AIM: To evaluate the efficacy of radiotherapy (RT) in patients with advanced unresectable hepatocellular carcinoma (HCC). METHODS: A total of 65 patients were treated with RT in the Korea University Medical Center. Th...AIM: To evaluate the efficacy of radiotherapy (RT) in patients with advanced unresectable hepatocellular carcinoma (HCC). METHODS: A total of 65 patients were treated with RT in the Korea University Medical Center. The median age of the patients was 60 years, and 86.2% were men. 18.5% and 81.5% of the patients were diagnosed as TNM stage Ⅲ and Ⅳ-A, respectively. Treatment response was assessed 4 mo after initiation of RT. Tumor regression rate 1 mo after initiation of RT (TRR1m) was also assessed. Duration of survival was calculated from the initiation of RT. RESULTS: The objective treatment response was 56.9%. The 12 mo survival rate was 34.7%. Predictive factors for survival were Child-Pugh grade, α-fetoprotein level and treatment response. An objective response was achieved more frequently in patients with TRR1m ≥ 20% than in those with TRR1m < 20% (P < 0.001). CONCLUSION: RT is effective in treating advanced HCC with a tumor response rate of 56.9%.展开更多
Pre-procedural cleansing of the bowel can maximize the effectiveness and efficiency of colonoscopy.Yet,efficacy of the current gold standard colonic preparation method-high-volume oral administration of purgative agen...Pre-procedural cleansing of the bowel can maximize the effectiveness and efficiency of colonoscopy.Yet,efficacy of the current gold standard colonic preparation method-high-volume oral administration of purgative agents 12-24 h prior to the procedure-is limited by several factors,such as patient compliance(due to poor palatability and inconvenience of the dosing regimen)and risks of complications(due to drug interactions or intolerance).Attempts to resolve these limitations have included providing adjunctive agents and methods to promote the colonic cleansing ability of the principal purgative agent,with the aim of lessening unpleasant side effects(such as bloating)and reducing the large ingested volume requirement.Several promising adjunctive agents are bisacodyl,magnesium citrate,senna,simethicone,metoclopramide,and prokinetics,and each are being investigated for their potential.This review provides an up to date summary of the reported investigations into the potencies and weaknesses of the key adjuncts currently being applied in clinic as supplements to the traditional bowel preparation agents.While the comparative analysis ofthese adjuncts showed that no single agent or method has yet achieved the goal of completely overcoming the limitations of the current gold standard preparation method,they at least provide endoscopists with an array of alternatives to help improve the suboptimal efficacy of the main cleansing solutions when used alone.To aid in this clinical endeavor,a subjective grade was assigned to each adjunct to indicate its practical value.In addition,the systematic review of the currently available agents and methods provides insight into the features of each that may be overcome or exploited to create novel drugs and strategies that may become adopted as effective bowel cleansing adjuncts or alternatives.展开更多
基金conducted in accordance with the Declaration of Helsinki and approved by the institutional review board of Kang-nam Sacred Heart Hospital,Seoul,Korea(No.2022-06-008-001).
文摘Background:Coronavirus disease 2019(COVID-19)is a global pandemic issue.In addition to the well-known respiratory and fever symptoms,gastrointestinal symptoms have also been reported.This study aimed to evaluate the prevalence and prognosis of patients with COVID-19 infection complicated with acute pancreatitis in intensive care unit(ICU).Methods:This was a retrospective observational cohort study,and patients aged 18 years or older,ad-mitted into the ICU in a single tertiary center from January 1,2020,to April 30,2022 were enrolled.Patients were identified by electronic medical records and reviewed manually.The primary outcome was the prevalence of acute pancreatitis among ICU patients with COVID-19.The secondary outcomes were the length of hospital stay,need for mechanical ventilation(MV),need for continuous renal replacement therapy(CRRT),and in-hospital mortality.Results:A total of 4133 patients,admitted into the ICU,were screened.Among these patients,389 were infected by COVID-19,and 86 were diagnosed with acute pancreatitis.COVID-19 positive patients were more likely to present with acute pancreatitis than COVID-19 negative patients(odds ratio=5.42,95%confidence interval:2.35-6.58,P<0.01).However,the length of hospital stay,need for MV,need for CRRT,and in-hospital mortality were not significantly different between acute pancreatitis patients with and without COVID-19 infection.Conclusions:Severe COVID-19 infections may cause acute pancreas damage in critically ill patients.How-ever,the prognosis may not differ between acute pancreatitis patients with and without COVID-19 infec-tion.
文摘Gastric remnants are an inevitable consequence of partial gastrectomy following resection for gastric cancer.The presence of gastric stumps is itself a risk factor for redevelopment of gastric cancer.Helicobacter pylori(H.pylori)infection is also a well-known characteristic of gastric carcinogenesis.H.pylori colonization in the remnant stomach therefore draws special interest from clinicians in terms of stomach cancer development and pathogenesis;however,the H.pylori-infected gastric remnant is quite different from the intact organ in several aspects and researchers have expressed conflicting opinions with respect to its role in pathogenesis.For instance,H.pylori infection of the gastric stump produced controversial results in several recent studies.The prevalence of H.pylori infection in the gastric stump has varied among recent reports.Gastritis developing in the remnant stomach presents with a unique pattern of inflammation that is different from the pattern seen in ordinary gastritis of the intact organ.Bilerefluxate also has a significant influence on the colonization of the stomach stump,with several studies reporting mixed results as well.In contrast,the elimination of H.pylori from the gastric stump has shown a dramatic impact on eradication rate.H.pylori elimination is recognized to be important for cancer prevention and considerable agreement of opinion is seen among researchers.To overcome the current discrepancies in the literature regarding the role of H.pylori in the gastric stump,further research is required.
基金A grant from the Korea Health 21 R&D Project, Ministry of Health and Welfare, Republic of Korea, No. A050021
文摘AIM: To evaluate the efficacy of radiotherapy (RT) in patients with advanced unresectable hepatocellular carcinoma (HCC). METHODS: A total of 65 patients were treated with RT in the Korea University Medical Center. The median age of the patients was 60 years, and 86.2% were men. 18.5% and 81.5% of the patients were diagnosed as TNM stage Ⅲ and Ⅳ-A, respectively. Treatment response was assessed 4 mo after initiation of RT. Tumor regression rate 1 mo after initiation of RT (TRR1m) was also assessed. Duration of survival was calculated from the initiation of RT. RESULTS: The objective treatment response was 56.9%. The 12 mo survival rate was 34.7%. Predictive factors for survival were Child-Pugh grade, α-fetoprotein level and treatment response. An objective response was achieved more frequently in patients with TRR1m ≥ 20% than in those with TRR1m < 20% (P < 0.001). CONCLUSION: RT is effective in treating advanced HCC with a tumor response rate of 56.9%.
文摘Pre-procedural cleansing of the bowel can maximize the effectiveness and efficiency of colonoscopy.Yet,efficacy of the current gold standard colonic preparation method-high-volume oral administration of purgative agents 12-24 h prior to the procedure-is limited by several factors,such as patient compliance(due to poor palatability and inconvenience of the dosing regimen)and risks of complications(due to drug interactions or intolerance).Attempts to resolve these limitations have included providing adjunctive agents and methods to promote the colonic cleansing ability of the principal purgative agent,with the aim of lessening unpleasant side effects(such as bloating)and reducing the large ingested volume requirement.Several promising adjunctive agents are bisacodyl,magnesium citrate,senna,simethicone,metoclopramide,and prokinetics,and each are being investigated for their potential.This review provides an up to date summary of the reported investigations into the potencies and weaknesses of the key adjuncts currently being applied in clinic as supplements to the traditional bowel preparation agents.While the comparative analysis ofthese adjuncts showed that no single agent or method has yet achieved the goal of completely overcoming the limitations of the current gold standard preparation method,they at least provide endoscopists with an array of alternatives to help improve the suboptimal efficacy of the main cleansing solutions when used alone.To aid in this clinical endeavor,a subjective grade was assigned to each adjunct to indicate its practical value.In addition,the systematic review of the currently available agents and methods provides insight into the features of each that may be overcome or exploited to create novel drugs and strategies that may become adopted as effective bowel cleansing adjuncts or alternatives.
