https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/172 2025-12-26T03:37:07Z https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/64340 Title: New prognostic model for hospitalized patients with alcoholic cirrhosis and Maddrey's discriminant function <32 Authors: Kim, Tae Hyung; Yim, Hyung Joon; Jung, Young Kul; Song, Do Seon; Yoon, Eileen L.; Kim, Hee Yeon; Kang, Seong Hee; Chang, Young; Yoo, Jeong-Ju; Jun, Baek Gyu; Lee, Sung Won; Park, Jung Gil; Park, Ji Won; Kim, Sung-Eun; Kim, Tae Yeob; Jeong, Soung Won; Suk, Ki Tae; Kim, Moon Young; Kim, Sang Gyune; Kim, Won; Jang, Jae Young; Yang, Jin Mo; Kim, Dong Joon Abstract: Background & aims Few studies have investigated the prognosis of patients with non-severe alcoholic hepatitis (Non-SAH). The study aimed to develop a new prognostic model for patients with especially Non-SAH.Methods We extracted 316 hospitalized patients with alcoholic cirrhosis without severe alcoholic hepatitis, defined as Maddrey's discriminant function score lower than 32, from the retrospective Korean Acute-on-Chronic Liver Failure (KACLiF) cohort to develop a new prognostic model (training set), and validated it in 419 patients from the prospective KACLiF cohort (validation set). Prognostic factors for death and liver transplantation were analyzed to construct a prognostic model.Results Twenty-one and 24 patients died within 6 months in both sets, respectively. In the training set, the highest area under the curve (AUC) of conventional prognostic models was 0.765, 0.732, and 0.684 for 1-, 3-, and 6-month mortality, respectively. Refractory ascites, vasopressor use, and hyponatremia were independently associated with mortality of cirrhotic patients with Non-SAH. The new model consisted of four variables: past deterioration, neutrophil proportion > 70%, Na < 128 mmol/L, and vasopressor use. It showed the highest accuracy for short-term mortality in the training and validation sets (0.803 and 0.786; 0.797 and 0.776; and 0.789 and 0.721 for 1-, 3-, and 6-month mortality, respectively).Conclusion There is a group of patients with high risk among those classified as Non-SAH. The new model will help stratifying cirrhotic patients with Non-SAH more accurately in terms of prognosis. The patients with high Non-SAH score need to monitor closely and might be considered for preemptive liver transplantation. 2024-04-01T00:00:00Z https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/64069 Title: Subclinical diabetes confirmed by 75-g OGTT influence on the prognosis of decompensated cirrhosis Authors: Kang, Seong Hee; Kim, Moon Young; Han, Seul Ki; Baik, Soon Koo Abstract: Background and aimDisorders of glucose metabolism, such as impaired glucose tolerance (IGT) and diabetes mellitus (DM), frequently occur in cirrhosis. We aimed to evaluate who needs to be undertaken a 75-g oral glucose tolerance test (OGTT) to find underlying subclinical diabetes.MethodsThis prospective study included 713 patients with either compensated (Child-Turcotte-Pugh [CTP] class A) or decompensated cirrhosis (CTP class B/C) without previous DM history. All patients underwent a 75-g OGTT. The patients were divided into three groups: normal glucose tolerance (NGT), IGT, and newly diagnosed DM (subclinical DM).ResultsAmong 713 patients, NGT was diagnosed in 139 (19.5%), IGT in 252 (35.3%), and subclinical DM in 322 (45.2%) patients, respectively. During a median follow-up period of 42.0 months, the cumulative survival rates of patients were as follows: NGT, 75.6%; IGT, 57.6%; and subclinical DM, 54.8%. Overall, IGT (adjusted hazard ratio [aHR], 1.605; 95% confidence interval [CI] = 1.009-2.553; P = 0.046) and subclinical DM (aHR, 1.840; 95% CI = 1.183-2.861; P = 0.001) were identified as independent predictors of mortality. In patients with compensated cirrhosis (n = 415), neither IGT nor subclinical DM conferred a higher mortality risk. However, among patients with decompensated cirrhosis (n = 298), those with IGT (aHR, 2.394; P = 0.015) and subclinical DM (aHR, 2.211; P = 0.022) showed a survival rate worse than those with NGT. In addition, subclinical DM was identified as an independent risk factor for infection (aHR, 2.508; P = 0.007).ConclusionsIGT and subclinical diabetes by OGTT are associated with an unfavorable prognosis in cirrhosis, and the effect is pronounced in the decompensated state., Number NCT04828512 ().ConclusionsIGT and subclinical diabetes by OGTT are associated with an unfavorable prognosis in cirrhosis, and the effect is pronounced in the decompensated state., Number NCT04828512 (). 2024-01-01T00:00:00Z https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/63022 Title: Diagnosis and Treatment of Perihilar Cholangiocarcinoma: A National Survey from the Korean Pancreatobiliary Association Authors: Cho, Eunae; Kim, Seong-Hun; Choi, Seong Ji; Jung, Min Kyu; Song, Byeong Jun; Park, Jin Myung; Kang, Jingu; Park, Won Suk; Park, Joo Kyung; Woo, Sang Myung; Kim, Hyo Jung; Study Grp Biliary Dis; Korean Pancreatobiliary Assoc Abstract: Background/Aims Based on their anatomy, cholangiocarcinomas (CCAs) are classified into intrahepatic, hilar, and distal CCAs. Although the diagnosis and treatment of each type of CCA are thought to be different, real-world data studies on the current practice are limited. Therefore, this study was designed to capture the current practice of diagnosing and treating perihilar CCA in Korea. Methods We conducted a survey using an online platform. The questionnaire consisted of 18 questions designed to evaluate the current practice of diagnosing and treating perihilar CCA in Korea. The targets of this survey were biliary endoscopists who are members of the Korean Pancreatobiliary Association. Results In total, 119 biliary endoscopists completed the survey. Of the respondents, 89.9% thought that the use of the International Classification of Diseases, 11th Revision (ICD-11) system is necessary to classify CCA. Approximately half of the respondents would recommend surgery or chemotherapy until patients were 80 years of age. For the pathological diagnosis of CCA, endoscopic retrograde cholangiopancreatography with biopsy was the most preferred modality. Routine preoperative biliary drainage was performed by 44.5% of the respondents. For operable CCAs, 64.7% of the respondents preferred endoscopic biliary drainage using plastic stents. For palliative biliary drainage, 69.7% of the respondents used plastic stents. For palliative endoscopic biliary drainage using metal stents, 63% of the respondents preferred the stent-in-stent method. Conclusions A new coding system using the ICD-11 is needed for classifying CCAs. Guidelines for diagnosing and treating CCA based on the clinical situation in Korea are needed. 2024-01-01T00:00:00Z https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/63550 Title: Evaluation of the Efficacy and Safety of DW1903 in Patients with Gastritis: A Randomized, Double-Blind, Noninferiority, Multicenter, Phase 3 study Authors: Kim, Jie-Hyun; Jung, Hwoon-Yong; Yoo, In Kyung; Park, Seon-Young; Kim, Jae Gyu; Sung, Jae Kyu; Jang, Jin Seok; Cheon, Gab Jin; Kim, Kyoung Oh; Kim, Tae Oh; Lee, Soo Teik; Cho, Kwang Bum; Chun, Hoon Jai; Park, Jong-Jae; Park, Moo In; Jang, Jae-Young; Jeon, Seong Woo; Cho, Jin Woong; Kang, Dae Hwan; Kim, Gwang Ha; Kim, Jae J.; Kim, Sang Gyun; Kim, Nayoung; Lee, Yong Chan; Hong, Su Jin; Kim, Hyun-Soo; Lee, Sora; Lee, Sang Woo Abstract: Background/Aims H2 receptor antagonists (H2RA) have been used to treat gastritis by inhibit-ing gastric acid. Proton pump inhibitors (PPIs) are more potent acid suppressants than H2RA. However, the efficacy and safety of low-dose PPI for treating gastritis remain unclear. The aim was to investigate the efficacy and safety of low-dose PPI for treating gastritis. Methods A double-blind, noninferiority, multicenter, phase 3 clinical trial randomly assigned 476 patients with endoscopic erosive gastritis to a group using esomeprazole 10 mg (DW1903) daily and a group using famotidine 20 mg (DW1903R1) daily for 2 weeks. The full-analysis set in-cluded 319 patients (DW1903, n=159; DW1903R1, n=160) and the per-protocol set included 298 patients (DW1903, n=147; DW1903R1, n=151). The primary endpoint (erosion improvement rate) and secondary endpoint (erosion and edema cure rates, improvement rates of hemorrhage, erythema, and symptoms) were assessed after the treatment. Adverse events were compared. Results According to the full-analysis set, the erosion improvement rates in the DW1903 and DW1903R1 groups were 59.8% and 58.8%, respectively. According to the per-protocol analysis, the erosion improvement rates in the DW1903 and DW1903R1 groups were 61.9% and 59.6%, respectively. Secondary endpoints were not significantly different between two groups except that the hemorrhagic improvement rate was higher in DW1903 with statistical tendency. The number of adverse events were not statistically different. Conclusions DW1903 of a low-dose PPI was not inferior to DW1903R1 of H2RA. Thus, low-dose PPI can be a novel option for treating gastritis (ClinicalTrials.gov Identifier: NCT05163756). (Gut Liver, Published online June 13, 2023) 2024-01-01T00:00:00Z