1.Clinical practice guideline for endoscopic resection of early gastrointestinal cancer
Chan Hyuk PARK ; Dong-Hoon YANG ; Jong Wook KIM ; Jie-Hyun KIM ; Ji Hyun KIM ; Yang Won MIN ; Si Hyung LEE ; Jung Ho BAE ; Hyunsoo CHUNG ; Kee Don CHOI ; Jun Chul PARK ; Hyuk LEE ; Min-Seob KWAK ; Bun KIM ; Hyun Jung LEE ; Hye Seung LEE ; Miyoung CHOI ; Dong-Ah PARK ; Jong Yeul LEE ; Jeong-Sik BYEON ; Chan Guk PARK ; Joo Young CHO ; Soo Teik LEE ; Hoon Jai CHUN
Intestinal Research 2021;19(2):127-157
Although surgery was the standard treatment for early gastrointestinal cancers, endoscopic resection is now a standard treatment for early gastrointestinal cancers without regional lymph node metastasis. High-definition white light endoscopy, chromoendoscopy, and image-enhanced endoscopy such as narrow band imaging are performed to assess the edge and depth of early gastrointestinal cancers for delineation of resection boundaries and prediction of the possibility of lymph node metastasis before the decision of endoscopic resection. Endoscopic mucosal resection and/or endoscopic submucosal dissection can be performed to remove early gastrointestinal cancers completely by en bloc fashion. Histopathological evaluation should be carefully made to investigate the presence of risk factors for lymph node metastasis such as depth of cancer invasion and lymphovascular invasion. Additional treatment such as radical surgery with regional lymphadenectomy should be considered if the endoscopically resected specimen shows risk factors for lymph node metastasis. This is the first Korean clinical practice guideline for endoscopic resection of early gastrointestinal cancer. This guideline was developed by using mainly de novo methods and encompasses endoscopic management of superficial esophageal squamous cell carcinoma, early gastric cancer, and early colorectal cancer. This guideline will be revised as new data on early gastrointestinal cancer are collected.
2.Apparent treatment-resistant hypertension among ambulatory hypertensive patients: a cross-sectional study from 13 general hospitals
Sehun KIM ; Jin Joo PARK ; Mi-Seung SHIN ; Choong Hwan KWAK ; Bong-Ryeol LEE ; Sung-Ji PARK ; Hae-Young LEE ; Sang-Hyun KIM ; Seok-Min KANG ; Byung-Su YOO ; Joong-Wha CHUNG ; Si Wan CHOI ; Sang-Ho JO ; Jinho SHIN ; Dong-Ju CHOI
The Korean Journal of Internal Medicine 2021;36(4):888-897
Background/Aims:
To examine the prevalence and clinical characteristics of apparent treatment-resistant hypertension among ambulatory hypertensive patients.
Methods:
We enrolled adult ambulatory hypertensive patients at 13 well-qualified general hospitals in Korea from January to June 2012. Apparent resistant hypertension was defined as an elevated blood pressure > 140/90 mmHg with the use of three antihypertensive agents, including diuretics, or ≥ 4 antihypertensives, regardless of the blood pressure. Controlled hypertension was defined as a blood pressure within the target using three antihypertensives, including diuretics.
Results:
Among 16,915 hypertensive patients, 1,172 (6.9%) had controlled hypertension, and 1,514 (8.9%) had apparent treatment-resistant hypertension. Patients with apparent treatment-resistant hypertension had an earlier onset of hypertension (56.8 years vs. 58.8 years, p = 0.007) and higher body mass index (26.3 kg/m2 vs. 24.9 kg/m2, p < 0.001) than those with controlled hypertension. Drug compliance did not differ between groups. In the multivariable analysis, earlier onset of hypertension (odds ratio [OR], 0.98; 95% confidence interval [CI], 0.97 to 0.99; p < 0.001) and the presence of comorbidities (OR, 2.06; 95% CI, 1.27 to 3.35; p < 0.001), such as diabetes mellitus, ischemic heart disease, heart failure, and chronic kidney disease, were independent predictors. Among the patients with apparent treatment-resistant hypertension, only 5.2% were receiving ≥ 2 antihypertensives at maximally tolerated doses.
Conclusions
Apparent treatment-resistant hypertension prevalence is 8.9% among ambulatory hypertensive patients in Korea. An earlier onset of hypertension and the presence of comorbidities are independent predictors. Optimization of medical treatment may reduce the rate of apparent treatment-resistant hypertension.
3.Changes in Mucin Production in Human Airway Epithelial Cells After Exposure to Electronic Cigarette Vapor With or Without Nicotine
Si-Youn SONG ; Hyung Gyun NA ; So Young KWAK ; Yoon Seok CHOI ; Chang Hoon BAE ; Yong-Dae KIM
Clinical and Experimental Otorhinolaryngology 2021;14(3):303-311
Objectives:
. The emergence of electronic cigarettes (e-cigarettes) has created new perceptions of the tobacco market. Unlike traditional tobacco, the greatest advantage of e-cigarettes is that they have less smell and are convenient and inexpensive. Most e-cigarette smokers believe that e-cigarette smoking is less harmful than traditional smoking. Information on the effects of e-cigarettes on human health is limited, and the issue remains controversial.
Methods:
. We studied the effects of e-cigarette vapor on mucin (MUC5AC and MUC5B) and the change of MUC5AC and MUC5B from e-cigarette liquid with or without nicotine in respiratory epithelial cells. The effects of e-cigarette vapor with or without nicotine on mucin, along with the involved signaling pathways, were investigated using reverse transcriptase-polymerase chain reaction (PCR), real-time PCR, enzyme immunoassays, and immunoblot analysis with several specific inhibitors and small interfering RNA.
Results:
. E-cigarette vapor with or without nicotine stimulated MUC5AC, but not MUC5B, expression in respiratory epithelial cells. In addition, we showed that e-cigarette vapor with and without nicotine induced MUC5AC expression via activation of the mitogen-activated protein kinase (MAPK; extracellular signal-regulated kinase [ERK] 1/2 and p38) and nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) signaling pathways in human airway epithelial cells.
Conclusion
. E-cigarette vapor with and with nicotine significantly increased MUC5AC expression in human airway epithelial cells.
4.Apparent treatment-resistant hypertension among ambulatory hypertensive patients: a cross-sectional study from 13 general hospitals
Sehun KIM ; Jin Joo PARK ; Mi-Seung SHIN ; Choong Hwan KWAK ; Bong-Ryeol LEE ; Sung-Ji PARK ; Hae-Young LEE ; Sang-Hyun KIM ; Seok-Min KANG ; Byung-Su YOO ; Joong-Wha CHUNG ; Si Wan CHOI ; Sang-Ho JO ; Jinho SHIN ; Dong-Ju CHOI
The Korean Journal of Internal Medicine 2021;36(4):888-897
Background/Aims:
To examine the prevalence and clinical characteristics of apparent treatment-resistant hypertension among ambulatory hypertensive patients.
Methods:
We enrolled adult ambulatory hypertensive patients at 13 well-qualified general hospitals in Korea from January to June 2012. Apparent resistant hypertension was defined as an elevated blood pressure > 140/90 mmHg with the use of three antihypertensive agents, including diuretics, or ≥ 4 antihypertensives, regardless of the blood pressure. Controlled hypertension was defined as a blood pressure within the target using three antihypertensives, including diuretics.
Results:
Among 16,915 hypertensive patients, 1,172 (6.9%) had controlled hypertension, and 1,514 (8.9%) had apparent treatment-resistant hypertension. Patients with apparent treatment-resistant hypertension had an earlier onset of hypertension (56.8 years vs. 58.8 years, p = 0.007) and higher body mass index (26.3 kg/m2 vs. 24.9 kg/m2, p < 0.001) than those with controlled hypertension. Drug compliance did not differ between groups. In the multivariable analysis, earlier onset of hypertension (odds ratio [OR], 0.98; 95% confidence interval [CI], 0.97 to 0.99; p < 0.001) and the presence of comorbidities (OR, 2.06; 95% CI, 1.27 to 3.35; p < 0.001), such as diabetes mellitus, ischemic heart disease, heart failure, and chronic kidney disease, were independent predictors. Among the patients with apparent treatment-resistant hypertension, only 5.2% were receiving ≥ 2 antihypertensives at maximally tolerated doses.
Conclusions
Apparent treatment-resistant hypertension prevalence is 8.9% among ambulatory hypertensive patients in Korea. An earlier onset of hypertension and the presence of comorbidities are independent predictors. Optimization of medical treatment may reduce the rate of apparent treatment-resistant hypertension.
5.Changes in Mucin Production in Human Airway Epithelial Cells After Exposure to Electronic Cigarette Vapor With or Without Nicotine
Si-Youn SONG ; Hyung Gyun NA ; So Young KWAK ; Yoon Seok CHOI ; Chang Hoon BAE ; Yong-Dae KIM
Clinical and Experimental Otorhinolaryngology 2021;14(3):303-311
Objectives:
. The emergence of electronic cigarettes (e-cigarettes) has created new perceptions of the tobacco market. Unlike traditional tobacco, the greatest advantage of e-cigarettes is that they have less smell and are convenient and inexpensive. Most e-cigarette smokers believe that e-cigarette smoking is less harmful than traditional smoking. Information on the effects of e-cigarettes on human health is limited, and the issue remains controversial.
Methods:
. We studied the effects of e-cigarette vapor on mucin (MUC5AC and MUC5B) and the change of MUC5AC and MUC5B from e-cigarette liquid with or without nicotine in respiratory epithelial cells. The effects of e-cigarette vapor with or without nicotine on mucin, along with the involved signaling pathways, were investigated using reverse transcriptase-polymerase chain reaction (PCR), real-time PCR, enzyme immunoassays, and immunoblot analysis with several specific inhibitors and small interfering RNA.
Results:
. E-cigarette vapor with or without nicotine stimulated MUC5AC, but not MUC5B, expression in respiratory epithelial cells. In addition, we showed that e-cigarette vapor with and without nicotine induced MUC5AC expression via activation of the mitogen-activated protein kinase (MAPK; extracellular signal-regulated kinase [ERK] 1/2 and p38) and nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) signaling pathways in human airway epithelial cells.
Conclusion
. E-cigarette vapor with and with nicotine significantly increased MUC5AC expression in human airway epithelial cells.
6.Clinical practice guideline for endoscopic resection of early gastrointestinal cancer
Chan Hyuk PARK ; Dong-Hoon YANG ; Jong Wook KIM ; Jie-Hyun KIM ; Ji Hyun KIM ; Yang Won MIN ; Si Hyung LEE ; Jung Ho BAE ; Hyunsoo CHUNG ; Kee Don CHOI ; Jun Chul PARK ; Hyuk LEE ; Min-Seob KWAK ; Bun KIM ; Hyun Jung LEE ; Hye Seung LEE ; Miyoung CHOI ; Dong-Ah PARK ; Jong Yeul LEE ; Jeong-Sik BYEON ; Chan Guk PARK ; Joo Young CHO ; Soo Teik LEE ; Hoon Jai CHUN
Intestinal Research 2021;19(2):127-157
Although surgery was the standard treatment for early gastrointestinal cancers, endoscopic resection is now a standard treatment for early gastrointestinal cancers without regional lymph node metastasis. High-definition white light endoscopy, chromoendoscopy, and image-enhanced endoscopy such as narrow band imaging are performed to assess the edge and depth of early gastrointestinal cancers for delineation of resection boundaries and prediction of the possibility of lymph node metastasis before the decision of endoscopic resection. Endoscopic mucosal resection and/or endoscopic submucosal dissection can be performed to remove early gastrointestinal cancers completely by en bloc fashion. Histopathological evaluation should be carefully made to investigate the presence of risk factors for lymph node metastasis such as depth of cancer invasion and lymphovascular invasion. Additional treatment such as radical surgery with regional lymphadenectomy should be considered if the endoscopically resected specimen shows risk factors for lymph node metastasis. This is the first Korean clinical practice guideline for endoscopic resection of early gastrointestinal cancer. This guideline was developed by using mainly de novo methods and encompasses endoscopic management of superficial esophageal squamous cell carcinoma, early gastric cancer, and early colorectal cancer. This guideline will be revised as new data on early gastrointestinal cancer are collected.
7.cal Practice Guideline for Endoscopic Resection of Early Gastrointestinal Cancer
Chan Hyuk PARK ; Dong-Hoon YANG ; Jong Wook KIM ; Jie-Hyun KIM ; Ji Hyun KIM ; Yang Won MIN ; Si Hyung LEE ; Jung Ho BAE ; Hyunsoo CHUNG ; Kee Don CHOI ; Jun Chul PARK ; Hyuk LEE ; Min-Seob KWAK ; Bun KIM ; Hyun Jung LEE ; Hye Seung LEE ; Miyoung CHOI ; Dong-Ah PARK ; Jong Yeul LEE ; Jeong-Sik BYEON ; Chan Guk PARK ; Joo Young CHO ; Soo Teik LEE ; Hoon Jai CHUN
The Korean Journal of Gastroenterology 2020;75(5):264-291
Although surgery was the standard treatment for early gastrointestinal cancers, endoscopic resection is now a standard treatment for early gastrointestinal cancers without regional lymph node metastasis. High-definition white light endoscopy, chromoendoscopy, and image-enhanced endoscopy such as narrow band imaging are performed to assess the edge and depth of early gastrointestinal cancers for delineation of resection boundaries and prediction of the possibility of lymph node metastasis before the decision of endoscopic resection. Endoscopic mucosal resection and/or endoscopic submucosal dissection can be performed to remove early gastrointestinal cancers completely by en bloc fashion. Histopathological evaluation should be carefully made to investigate the presence of risk factors for lymph node metastasis such as depth of cancer invasion and lymphovascular invasion. Additional treatment such as radical surgery with regional lymphadenectomy should be considered if the endoscopically resected specimen shows risk factors for lymph node metastasis. This is the first Korean clinical practice guideline for endoscopic resection of early gastrointestinal cancer. This guideline was developed by using mainly de novo methods and encompasses endoscopic management of superficial esophageal squamous cell carcinoma, early gastric cancer, and early colorectal cancer. This guideline will be revised as new data on early gastrointestinal cancer are collected.
8.Clinical Practice Guideline for Endoscopic Resection of Early Gastrointestinal Cancer
Chan Hyuk PARK ; Dong-Hoon YANG ; Jong Wook KIM ; Jie-Hyun KIM ; Ji Hyun KIM ; Yang Won MIN ; Si Hyung LEE ; Jung Ho BAE ; Hyunsoo CHUNG ; Kee Don CHOI ; Jun Chul PARK ; Hyuk LEE ; Min-Seob KWAK ; Bun KIM ; Hyun Jung LEE ; Hye Seung LEE ; Miyoung CHOI ; Dong-Ah PARK ; Jong Yeul LEE ; Jeong-Sik BYEON ; Chan Guk PARK ; Joo Young CHO ; Soo Teik LEE ; Hoon Jai CHUN
The Korean Journal of Helicobacter and Upper Gastrointestinal Research 2020;20(2):117-145
Although surgery was the standard treatment for early gastrointestinal cancers, endoscopic resection is now a standard treatment for early gastrointestinal cancers without regional lymph node metastasis. High-definition white light endoscopy, chromoendoscopy, and image-enhanced endoscopy such as narrow band imaging are performed to assess the edge and depth of early gastrointestinal cancers for delineation of resection boundaries and prediction of the possibility of lymph node metastasis before the decision of endoscopic resection. Endoscopic mucosal resection and/or endoscopic submucosal dissection can be performed to remove early gastrointestinal cancers completely by en bloc fashion. Histopathological evaluation should be carefully made to investigate the presence of risk factors for lymph node metastasis such as depth of cancer invasion and lymphovascular invasion. Additional treatment such as radical surgery with regional lymphadenectomy should be considered if the endoscopically resected specimen shows risk factors for lymph node metastasis. This is the first Korean clinical practice guideline for endoscopic resection of early gastrointestinal cancer. This guideline was developed by using mainly de novo methods and encompasses endoscopic management of superficial esophageal squamous cell carcinoma, early gastric cancer, and early colorectal cancer. This guideline will be revised as new data on early gastrointestinal cancer are collected.
10.Clinical Practice Guideline for Endoscopic Resection of Early Gastrointestinal Cancer
Chan Hyuk PARK ; Dong-Hoon YANG ; Jong Wook KIM ; Jie-Hyun KIM ; Ji Hyun KIM ; Yang Won MIN ; Si Hyung LEE ; Jung Ho BAE ; Hyunsoo CHUNG ; Kee Don CHOI ; Jun Chul PARK ; Hyuk LEE ; Min-Seob KWAK ; Bun KIM ; Hyun Jung LEE ; Hye Seung LEE ; Miyoung CHOI ; Dong-Ah PARK ; Jong Yeul LEE ; Jeong-Sik BYEON ; Chan Guk PARK ; Joo Young CHO ; Soo Teik LEE ; Hoon Jai CHUN
Journal of Digestive Cancer Report 2020;8(1):1-50
Although surgery was the standard treatment for early gastrointestinal cancers, endoscopic resection is now a standard treatment for early gastrointestinal cancers without regional lymph node metastasis. High-definition white light endoscopy, chromoendoscopy, and image-enhanced endoscopy such as narrow band imaging are performed to assess the edge and depth of early gastrointestinal cancers for delineation of resection boundaries and prediction of the possibility of lymph node metastasis before the decision of endoscopic resection. Endoscopic mucosal resection and/or endoscopic submucosal dissection can be performed to remove early gastrointestinal cancers completely by en bloc fashion. Histopathological evaluation should be carefully made to investigate the presence of risk factors for lymph node metastasis such as depth of cancer invasion and lymphovascular invasion. Additional treatment such as radical surgery with regional lymphadenectomy should be considered if the endoscopically resected specimen shows risk factors for lymph node metastasis. This is the first Korean clinical practice guideline for endoscopic resection of early gastrointestinal cancer. This guideline was developed by using mainly de novo methods and encompasses endoscopic management of superficial esophageal squamous cell carcinoma, early gastric cancer, and early colorectal cancer. This guideline will be revised as new data on early gastrointestinal cancer are collected.

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