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Vegetarianism as a protective factor for asymptomatic colonic diverticulosis in Asians: a retrospective cross-sectional and case-control study
Jihun Bong, Hyoun Woo Kang, Hyeki Cho, Ji Hyung Nam, Dong Kee Jang, Jae Hak Kim, Jun Kyu Lee, Yun Jeong Lim, Moon-Soo Koh, Jin Ho Lee
Intest Res 2020;18(1):121-129.   Published online November 1, 2019
DOI: https://doi.org/10.5217/ir.2019.00106
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
Dietary fiber intake is considered a protective factor for diverticular disease such as diverticulitis. However, evidence for an inverse connection between dietary fiber consumption and asymptomatic colonic diverticulosis is lacking. Specifically, few studies have investigated this subject in Asians with different presentations of diverticulosis. Therefore, we assessed the protective effects of a vegetarian diet for asymptomatic colonic diverticulosis in Buddhist monks who are obligatory vegetarians for spiritual reasons compared with the general population.
Methods
A retrospective, cross-sectional, case-control study was conducted in age- and sex-matched Buddhist monks and the general population who underwent colonoscopy for screening at a Korean health promotion center from August 2005 to June 2018. We compared the prevalence of asymptomatic diverticulosis between the 2 groups using a self-administered questionnaire.
Results
In this study, a total of 1,316 individuals were included (Buddhist monks of 658 and general population of 658) with a mean age of 52.6±9.5 years. The prevalence of asymptomatic diverticulosis in Buddhist monks was lower compared with the general population (6.7% [44/658] vs. 10.8% [71/658], P=0.008). Buddhist monks had a higher rate of high body mass index (BMI) and metabolic syndrome. By a multivariate regression analysis model, a nonvegetarian diet (odds ratio [OR], 1.82; 95% confidence interval [CI], 1.21–2.72, P=0.004), old age (OR, 4.53; 95% CI, 1.36–15.12; P=0.014), male sex (OR, 1.91; 95% CI, 1.28–2.85; P=0.002), and a high BMI (OR, 1.50; 95% CI, 1.01–2.23; P=0.047) were independent predictors of asymptomatic diverticulosis. Moreover, a nonvegetarian diet was associated with both right-sided and left-sided diverticulosis.
Conclusions
A nonvegetarian diet may increase a risk of asymptomatic colonic diverticulosis in Asians.

Citations

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  • Association of Metabolic Syndrome Components and Colonic Diverticulosis in the Very Elderly: A Tertiary Health Network Study
    Hammad Liaquat, Farah Harmouch, Nishit Patel, Zarian Prenatt, Jill Stoltzfus, Berhanu Geme, Noel Martins, Kimberly Chaput
    Cureus.2024;[Epub]     CrossRef
  • Not all acute colonic diverticulitis follows the same course: a potential risk for immunocompromised individuals
    Yehyun Park
    Intestinal Research.2023; 21(4): 415.     CrossRef
  • Age, alcohol, sex, and metabolic factors as risk factors for colonic diverticulosis
    Ye Yan, Jian-Sheng Wu, Shuang Pan
    World Journal of Clinical Cases.2022; 10(1): 136.     CrossRef
  • Diagnosis and Treatment of Colonic Diverticular Disease
    You Sun Kim
    The Korean Journal of Gastroenterology.2022; 79(6): 233.     CrossRef
  • The prevalence of right‐sided colonic diverticulosis in a New Zealand population
    Greg A. Turner, Michael J. O'Grady, Sajith C. Senadeera, Chris J. Wakeman, Andrew McCombie, Rachel V. Purcell, Frank A. Frizelle
    ANZ Journal of Surgery.2021; 91(10): 2110.     CrossRef
  • The Epidemiology and Etiology of Right-Sided Colonic Diverticulosis: A Review
    Greg A. Turner, Michael J. O’Grady, Rachel V. Purcell, Frank A. Frizelle
    Annals of Coloproctology.2021; 37(4): 196.     CrossRef
  • 7,054 View
  • 233 Download
  • 6 Web of Science
  • 6 Crossref
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Functional bowel disorder
Proinflammatory cytokines in irritable bowel syndrome: a comparison with inflammatory bowel disease
Antigony Mitselou, Vasileios Grammeniatis, Anna Varouktsi, Stamatis S Papadatos, Konstantinos Katsanos, Vasiliki Galani
Intest Res 2020;18(1):115-120.   Published online January 30, 2020
DOI: https://doi.org/10.5217/ir.2019.00125
AbstractAbstract PDFPubReaderePub
Background/Aims
Irritable bowel syndrome (IBS) is a common disease often considered as a functional intestinal disorder. Inflammation in IBS is a quite intriguing theory. The aim of this study was to investigate tumor necrosis factor (TNF)-α, interleukin (IL)-1β and IL-6 expression in inflammatory bowel disease (IBD) patients, IBS patients and normal controls.
Methods
IBS and IBD patients along with normal controls were recruited in the study. In all groups, 2 pinch biopsies were taken at each of 3 anatomical sites (terminal ileum, cecum, and rectum). IBS patients were also subcategorized according to the syndrome clinical manifestations. Two monoclonal antibodies (mAb), TNF-α mAb and IL-6 mAb, and one polyclonal antibody IL-1β mAb were applied for immunohistochemical analysis.
Results
In IBD patients intensity of TNF-α and IL-1β were lower than in IBS patients or controls, while IL-6 was significantly increased comparing to the aforementioned groups. In IBS patients TNF-α was increased comparing to IBD patients or controls, while IL-6 and IL-1β were similar to controls. In IBS subgroups, TNF-α was lower in diarrhea predominant IBS patients and higher constipation predominant IBS patients. Differences among IBS subgroups regarding IL-6 and IL-1β were nonsignificant.
Conclusions
IL-6 seems to be the most important proinflammatory cytokine in IBD patients, while TNF-α could play a more significant role in IBS pathogenesis.

Citations

Citations to this article as recorded by  
  • Guardians at the Gate: Immune System in Gastrointestinal Diseases
    Elena Layunta, Jose Emilio Mesonero, Eva Latorre
    International Journal of Molecular Sciences.2024; 25(11): 5933.     CrossRef
  • Novel Dairy Fermentates Have Differential Effects on Key Immune Responses Associated with Viral Immunity and Inflammation in Dendritic Cells
    Dearbhla Finnegan, Claire Connolly, Monica A. Mechoud, Jamie A. FitzGerald, Tom Beresford, Harsh Mathur, Lorraine Brennan, Paul D. Cotter, Christine E. Loscher
    Foods.2024; 13(15): 2392.     CrossRef
  • The Latest Data Concerning the Etiology and Pathogenesis of Irritable Bowel Syndrome
    Vlad Alexandru Ionescu, Gina Gheorghe, Teodor Florin Georgescu, Nicolae Bacalbasa, Florentina Gheorghe, Camelia Cristina Diaconu
    Journal of Clinical Medicine.2024; 13(17): 5124.     CrossRef
  • Morphological Changes of the Pituitary Gland in Patients with Irritable Bowel Syndrome Using Magnetic Resonance Imaging
    Jessica Abou Chaaya, Jennifer Abou Chaaya, Batoul Jaafar, Lea Saab, Jad Abou Chaaya, Elie Al Ahmar, Elias Estephan
    Journal of Imaging.2024; 10(9): 226.     CrossRef
  • Evaluation of two laboratory model methods for diarrheal irritable bowel syndrome
    Qian Chen, Hua Zhang, Chang-Yue Sun, Qing-Ying He, Rui-Rong Zhang, Bin-Fei Luo, Zi-Hao Zhou, Xiao-Fan Chen
    Molecular Medicine.2023;[Epub]     CrossRef
  • Structural properties and anti-inflammatory activity of purified polysaccharides from Hen-of-the-woods mushrooms (Grifola frondosa)
    Xiaoyi Liu, Shuai Chen, Huijuan Liu, Jiao Xie, K. M. Faridul Hasan, Qibing Zeng, Shaofeng Wei, Peng Luo
    Frontiers in Nutrition.2023;[Epub]     CrossRef
  • An Asian perspective on irritable bowel syndrome
    Kee Wook Jung, Seung-Jae Myung
    Intestinal Research.2023; 21(2): 189.     CrossRef
  • Molecular Mechanisms of the Antitumor Effects of Mesalazine and Its Preventive Potential in Colorectal Cancer
    Joanna Słoka, Marcel Madej, Barbara Strzalka-Mrozik
    Molecules.2023; 28(13): 5081.     CrossRef
  • Structure and Metabolic Activity of the Gut Microbiota in Diarrhea-Predominant Irritable Bowel Syndrome Combined with Functional Dyspepsia
    Aleksandra Kovaleva, Elena Poluektova, Roman Maslennikov, Oxana Zolnikova, Oleg Shifrin, Anna Kudryavtseva, George Krasnov, Maria Fedorova, Anna Karchevskaya, Vladimir Ivashkin
    Gastrointestinal Disorders.2023; 5(3): 296.     CrossRef
  • NK cells vs. obesity: A tale of dysfunction & redemption
    Conor De Barra, Donal O'Shea, Andrew E. Hogan
    Clinical Immunology.2023; 255: 109744.     CrossRef
  • Non-invasive neuromodulation: an emerging intervention for visceral pain in gastrointestinal disorders
    Md Jahangir Alam, Jiande D. Z. Chen
    Bioelectronic Medicine.2023;[Epub]     CrossRef
  • Gut–Brain Axis, Microbiota and Probiotics—Current Knowledge on Their Role in Irritable Bowel Syndrome: A Review
    Cristina Maria Marginean, Mihaela Popescu, Andrei Ioan Drocas, Sergiu Marian Cazacu, Radu Mitrut, Iulia Cristina Marginean, George Alexandru Iacob, Marian Sorin Popescu, Anca Oana Docea, Paul Mitrut
    Gastrointestinal Disorders.2023; 5(4): 517.     CrossRef
  • Comparative treatment of Sulfasalazine+Ezetimibe combination and Sulfasalazine in a rat model with induced colitis
    Farrah Rasool Jaafar, Ahmed Abu-Raghif
    Journal of Medicine and Life.2023; 16(8): 1165.     CrossRef
  • Screening and Evaluation of Probiotics for Reducing Intestinal Inflammation
    雅君 陈
    Hans Journal of Food and Nutrition Science.2022; 11(01): 44.     CrossRef
  • Protection against ulcerative colitis and colorectal cancer by evodiamine via anti‑inflammatory effects
    Yongfeng Zhang, Yaqin Zhang, Yang Zhao, Wanyue Wu, Weiqi Meng, Yulin Zhou, Ye Qiu, Chenliang Li
    Molecular Medicine Reports.2022;[Epub]     CrossRef
  • The Role of Neuro-Immune Interaction in Chronic Pain Conditions; Functional Somatic Syndrome, Neurogenic Inflammation, and Peripheral Neuropathy
    Elaine Meade, Mary Garvey
    International Journal of Molecular Sciences.2022; 23(15): 8574.     CrossRef
  • Ameliorating effects of electroacupuncture on the low‐grade intestinal inflammation in rat model of diarrhea‐predominant irritable bowel syndrome
    Xuemei Li, Kuiyu Ren, Xiaojuan Hong, Sha Guo, Shuguang Yu, Sha Yang
    Journal of Gastroenterology and Hepatology.2022; 37(10): 1963.     CrossRef
  • Healthy Sleep Every Day Keeps the Doctor Away
    Cailan Lindsay Feingold, Abbas Smiley
    International Journal of Environmental Research and Public Health.2022; 19(17): 10740.     CrossRef
  • Compositional Changes in the Gut Microbiota of Responders and Non-responders to Probiotic Treatment Among Patients With Diarrhea-predominant Irritable Bowel Syndrome: A Post Hoc Analysis of a Randomized Clinical Trial
    Seung Yong Shin, Sein Park, Jung Min Moon, Kisung Kim, Jeong Wook Kim, Jongsik Chun, Tae Hee Lee, Chang Hwan Choi
    Journal of Neurogastroenterology and Motility.2022; 28(4): 642.     CrossRef
  • Overlap of Functional Gastrointestinal Disorders: Common Mechanisms of Pathogenesis as a Key to Rational Therapy
    S. N. Mekhdiyev, O. A. Mekhdieva, O. M. Berko
    Russian Journal of Gastroenterology, Hepatology, Coloproctology.2022; 32(4): 95.     CrossRef
  • Effect of Heat-Killed Lactobacillus casei DKGF7 on a Rat Model of Irritable Bowel Syndrome
    Gyeol Seong, Seungbaek Lee, Yang Won Min, Yeon Sil Jang, Hong Seog Kim, Eui-Joong Kim, So-Young Park, Cheol-Hyun Kim, Dong Kyung Chang
    Nutrients.2021; 13(2): 568.     CrossRef
  • A Comprehensive Review: Sphingolipid Metabolism and Implications of Disruption in Sphingolipid Homeostasis
    Brianna M. Quinville, Natalie M. Deschenes, Alex E. Ryckman, Jagdeep S. Walia
    International Journal of Molecular Sciences.2021; 22(11): 5793.     CrossRef
  • Lactiplantibacillus plantarum 299v (LP299V®): three decades of research
    E. Arvidsson Nordström, C. Teixeira, C. Montelius, B. Jeppsson, N. Larsson
    Beneficial Microbes.2021; 12(5): 441.     CrossRef
  • Immunohistochemical Study of Adhesion Molecules in Irritable Bowel Syndrome
    Antigony Mitselou, Vasileios Grammeniatis, Anna Varouktsi, Stamatis S. Papadatos, Antonios Klaroudas, Konstantinos Katsanos, Vasiliki Galani
    Advanced Biomedical Research.2021; 10(1): 21.     CrossRef
  • TNF-α, IL-17, and IL-22 production in the rectal mucosa of nonceliac wheat sensitivity patients: role of adaptive immunity
    Pasquale Mansueto, Diana Di Liberto, Francesca Fayer, Maurizio Soresi, Girolamo Geraci, Antonio Giulio Giannone, Aurelio Seidita, Alberto D’Alcamo, Francesco La Blasca, Marianna Lo Pizzo, Ada Maria Florena, Francesco Dieli, Antonio Carroccio
    American Journal of Physiology-Gastrointestinal and Liver Physiology.2020; 319(3): G281.     CrossRef
  • Sudachinoid- and Ichangensin-Type Limonoids from Citrus junos Downregulate Pro-Inflammatory Cytokines
    Jihun Shin, Hwa Young Song, Mina Lee
    International Journal of Molecular Sciences.2020; 21(18): 6963.     CrossRef
  • Differential clusterization of soluble and extracellular vesicle-associated cytokines in myocardial infarction
    Anna Lebedeva, Wendy Fitzgerald, Ivan Molodtsov, Alexander Shpektor, Elena Vasilieva, Leonid Margolis
    Scientific Reports.2020;[Epub]     CrossRef
  • Lactoferrin in the Prevention and Treatment of Intestinal Inflammatory Pathologies Associated with Colorectal Cancer Development
    Antimo Cutone, Giusi Ianiro, Maria Stefania Lepanto, Luigi Rosa, Piera Valenti, Maria Carmela Bonaccorsi di Patti, Giovanni Musci
    Cancers.2020; 12(12): 3806.     CrossRef
  • 6,641 View
  • 187 Download
  • 27 Web of Science
  • 28 Crossref
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Colorectal neoplasia
Microvascular density under magnifying narrow-band imaging endoscopy in colorectal epithelial neoplasms
Takahiro Gonai, Keisuke Kawasaki, Shotaro Nakamura, Shunichi Yanai, Risaburo Akasaka, Kunihiko Sato, Yousuke Toya, Kensuke Asakura, Jun Urushikubo, Yasuko Fujita, Makoto Eizuka, Noriyuki Uesugi, Tamotsu Sugai, Takayuki Matsumoto
Intest Res 2020;18(1):107-114.   Published online November 4, 2019
DOI: https://doi.org/10.5217/ir.2019.00061
AbstractAbstract PDFPubReaderePub
Background/Aims
Magnifying endoscopic classification systems, such as the Japan narrow-band imaging (NBI) Expert Team (JNET) classification, have been widely used for predicting the histologic diagnosis and invasion depth of colorectal epithelial tumors. However, disagreement exists among observers regarding magnifying endoscopic diagnosis, because these classification systems are subjective. We herein investigated the utility of endoscopic microvascular density (eMVD) calculated from magnifying NBI endoscopic images in colorectal tumors.
Methods
We reviewed magnifying NBI endoscopic images from 169 colorectal epithelial tumors (97 adenomas, 72 carcinomas/high-grade dysplasias) resected endoscopically or surgically. The eMVD on magnifying NBI endoscopic images was evaluated using image-editing software, and relationships between eMVD and clinical, endoscopic, and pathological findings were retrospectively analyzed.
Results
The eMVD in carcinomas (0.152 ± 0.079) was significantly higher than that in adenomas (0.119 ± 0.059, P< 0.05). The best cutoff value for distinguishing carcinoma from adenoma was 0.133. Sensitivity, specificity, and accuracy were 56.9%, 67.0%, and 62.7%, respectively. In addition, JNET type 2B tumors showed significantly higher eMVD (0.162 ± 0.079) compared to type 2A tumors (0.111 ± 0.050, P< 0.05).
Conclusions
The eMVD as determined by magnifying NBI endoscopy is considered to be a possible objective indicator for differentiating colorectal carcinomas from adenomas.

Citations

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  • Novel physiological analysis using blood flow velocity for colonic polyps: Pilot study
    Eiji Kamba, Takashi Murakami, Naoki Tsugawa, Kei Nomura, Keiichi Haga, Yoichi Akazawa, Hirofumi Fukushima, Hiroya Ueyama, Kenshi Matsumoto, Tomoyoshi Shibuya, Takeshi Terai, Takashi Yao, Akihito Nagahara
    Endoscopy International Open.2024; 12(06): E781.     CrossRef
  • Feasibility of moxifloxacin and proflavine dual fluorescence imaging for detecting gastrointestinal neoplastic lesions: A prospective study
    Kwangwoo Nam, Noseong Park, Seunghun Lee, Suil Jeon, Jungbin Lee, Seung‐Mo Hong, Sung Wook Hwang, Sang Hyoung Park, Dong‐Hoon Yang, Byong Duk Ye, Jeong‐Sik Byeon, Suk‐Kyun Yang, Jeong Hoon Lee, Do Hoon Kim, Ki Hean Kim, Seung‐Jae Myung
    Lasers in Surgery and Medicine.2023; 55(4): 378.     CrossRef
  • Application of artificial intelligence in diagnosis and treatment of colorectal cancer: A novel Prospect
    Zugang Yin, Chenhui Yao, Limin Zhang, Shaohua Qi
    Frontiers in Medicine.2023;[Epub]     CrossRef
  • Chicken skin mucosa surrounding small colorectal cancer could be an endoscopic predictive marker of submucosal invasion
    Ying-Jie Zhang, Wu Wen, Fan Li, Yi Jian, Chuan-Ming Zhang, Meng-Xia Yuan, Ye Yang, Feng-Lin Chen
    World Journal of Gastrointestinal Oncology.2023; 15(6): 1062.     CrossRef
  • A review on self-healing featured soft robotics
    Md. Ariful Islam, Labanya Talukder, Md. Firoj Al, Subrata K. Sarker, S. M. Muyeen, Prangon Das, Md. Mehedi Hasan, Sajal K. Das, Md. Manirul Islam, Md. Robiul Islam, Sumaya Ishrat Moyeen, Faisal R. Badal, Md. Hafiz Ahamed, Sarafat Hussain Abhi
    Frontiers in Robotics and AI.2023;[Epub]     CrossRef
  • Emergence of a New Optical Marker for Colorectal Neoplasms: To What Extent Should We Accept It?
    Han Hee Lee
    Clinical Endoscopy.2022; 55(2): 315.     CrossRef
  • Endoscopic diagnosis and treatment of early colorectal cancer
    Seung Wook Hong, Jeong-Sik Byeon
    Intestinal Research.2022; 20(3): 281.     CrossRef
  • Colonic Chicken Skin Mucosa Surrounding Colon Polyps Is an Endoscopic Predictive Marker for Colonic Neoplastic Polyps
    Yu Mi Lee, Kyung Ho Song, Hoon Sup Koo, Choong-Sik Lee, Inseok Ko, Sang Hyuk Lee, Kyu Chan Huh
    Gut and Liver.2022; 16(5): 754.     CrossRef
  • Artificial intelligence-based colorectal polyp histology prediction using narrow-band image-magnifying colonoscopy: a stepping stone for clinical practice
    Ji Young Chang
    Clinical Endoscopy.2022; 55(5): 699.     CrossRef
  • Response to Artificial intelligence-based colorectal polyp histology prediction using narrow-band image-magnifying colonoscopy: a stepping stone for clinical practice
    Istvan Racz, Andras Horvath, Zoltán Horvath
    Clinical Endoscopy.2022; 55(5): 701.     CrossRef
  • Photoacoustic endoscopy: A progress review
    Heng Guo, Ying Li, Weizhi Qi, Lei Xi
    Journal of Biophotonics.2020;[Epub]     CrossRef
  • Diagnostic efficacy of the Japan Narrow-band-imaging Expert Team and Pit pattern classifications for colorectal lesions: A meta-analysis
    Yu Zhang, Hui-Yan Chen, Xiao-Lu Zhou, Wen-Sheng Pan, Xin-Xin Zhou, Hang-Hai Pan
    World Journal of Gastroenterology.2020; 26(40): 6279.     CrossRef
  • 6,593 View
  • 115 Download
  • 11 Web of Science
  • 12 Crossref
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Colorectal neoplasia
Clinical outcomes of submucosal colorectal cancer diagnosed after endoscopic resection: a focus on the need for surgery
Yun Sik Choi, Wan Soo Kim, Sung Wook Hwang, Sang Hyoung Park, Dong-Hoon Yang, Byong Duk Ye, Seung-Jae Myung, Suk-Kyun Yang, Jeong-Sik Byeon
Intest Res 2020;18(1):96-106.   Published online January 30, 2020
DOI: https://doi.org/10.5217/ir.2019.00092
AbstractAbstract PDFPubReaderePub
Background/Aims
We aimed to investigate the proportion of and risk factors for residual cancer and/or lymph node metastasis after surgery was performed because of high-risk pathological features in endoscopic resection specimen of suspected superficial submucosal colorectal cancer (SSMC).
Methods
We reviewed medical records of 497 patients (58.8 ± 9.8 years, 331 males) undergoing endoscopic resection of suspected SSMC. High-risk pathological features included: deep submucosal cancer invasion ≥ 1,000 μm; positive lymphovascular and/or perineural invasion; poorly differentiated adenocarcinoma; and positive resection margin. We investigated the occurrence of additional surgery and residual cancer and/or lymph node involvement in the surgical specimen.
Results
En bloc resection was performed in 447 patients (89.9%). High-risk pathological features were detected in 372 patients (74.8%). Additional surgery was performed in 336 of 372 patients with high-risk pathological features. Of these, 47 surgical specimens (14.0%) showed residual cancer and/or lymph node metastasis. Piecemeal resection was more common in those with residual cancer and/or lymph node involvement than those without (9/47 [19.1%] vs. 24/289 [8.3%], P= 0.032). Positive resection margin was also significantly associated with positive residual cancer and/or lymph node involvement. As the number of high-risk pathological features increased, the risk of regional lymph node metastasis increased proportionally (P= 0.002).
Conclusions
High-risk pathological features were frequently detected after endoscopic resection of suspected SSMC while residual cancer and/or lymph node metastasis were not commonly present in the additional surgical specimen. Further optimized strategy for proper endoscopic management of suspected SSMC is necessary.

Citations

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  • Curative criteria for endoscopic treatment of colorectal cancer
    Lucille Quénéhervé, Mathieu Pioche, Jérémie Jacques
    Best Practice & Research Clinical Gastroenterology.2024; 68: 101883.     CrossRef
  • Early Rectal Cancer and Local Excision: A Narrative Review
    Cecilia Binda, Matteo Secco, Luigi Tuccillo, Chiara Coluccio, Elisa Liverani, Carlo Felix Maria Jung, Carlo Fabbri, Giulia Gibiino
    Journal of Clinical Medicine.2024; 13(8): 2292.     CrossRef
  • Prediction of Lymph Node Metastasis in T1 Colorectal Cancer Using Artificial Intelligence with Hematoxylin and Eosin-Stained Whole-Slide-Images of Endoscopic and Surgical Resection Specimens
    Joo Hye Song, Eun Ran Kim, Yiyu Hong, Insuk Sohn, Soomin Ahn, Seok-Hyung Kim, Kee-Taek Jang
    Cancers.2024; 16(10): 1900.     CrossRef
  • How secure can we expect the surveillance policies to be after the implementation in T1 polyps with carcinoma?
    Cristina Mateos Sanchez, Elvira Quintanilla Lazaro, Luis Ramon Rabago
    World Journal of Gastrointestinal Endoscopy.2024; 16(9): 502.     CrossRef
  • Comment on " Positive fecal immunochemical test results are associated with non-colorectal cancer mortality"
    Yong Eun Park
    The Korean Journal of Internal Medicine.2023; 38(2): 264.     CrossRef
  • Long-term outcomes after endoscopic versus surgical resection of T1 colorectal carcinoma
    Hyun Jin Bae, Hoyeon Ju, Han Hee Lee, Jinsu Kim, Bo-In Lee, Sung Hak Lee, Daeyoun David Won, Yoon Suk Lee, In Kyu Lee, Young-Seok Cho
    Surgical Endoscopy.2023; 37(2): 1231.     CrossRef
  • Comparative Cost Analysis Between Endoscopic Resection and Surgery for Submucosal Colorectal Cancer
    Soo Min Noh, Sung Wook Hwang, Sang Hyoung Park, Dong-Hoon Yang, Byong Duk Ye, In Ja Park, Seok-Byung Lim, Jeong-Sik Byeon
    Diseases of the Colon & Rectum.2023; 66(5): 723.     CrossRef
  • Incidence of colonoscopy-related perforation and risk factors for poor outcomes: 3-year results from a prospective, multicenter registry (with videos)
    Jieun Lee, Yoo Jin Lee, Jong Won Seo, Eun Soo Kim, Sung Kook Kim, Min Kyu Jung, Jun Heo, Hyun Seok Lee, Joon Seop Lee, Byung Ik Jang, Kyeong Ok Kim, Kwang Bum Cho, Eun Young Kim, Dae Jin Kim, Yun Jin Chung
    Surgical Endoscopy.2023; 37(8): 5865.     CrossRef
  • Usage trends of colorectal endoscopic submucosal dissection according to hospital types based on nationwide claims data
    Ji Eun Na, Bohyoung Kim, Sung Hoon Jung, Arum Choi, Sukil Kim, Tae-Oh Kim
    Medicine.2023; 102(43): e35514.     CrossRef
  • Risk and Time Pattern of Recurrences After Local Endoscopic Resection of T1 Colorectal Cancer: A Meta-analysis
    Hao Dang, Nik Dekkers, Saskia le Cessie, Jeanin E. van Hooft, Monique E. van Leerdam, Philip P. Oldenburg, Louis Flothuis, Jan W. Schoones, Alexandra M.J. Langers, James C.H. Hardwick, Jolein van der Kraan, Jurjen J. Boonstra
    Clinical Gastroenterology and Hepatology.2022; 20(2): e298.     CrossRef
  • Emergence of a New Optical Marker for Colorectal Neoplasms: To What Extent Should We Accept It?
    Han Hee Lee
    Clinical Endoscopy.2022; 55(2): 315.     CrossRef
  • Deep Submucosal Invasion Is Not an Independent Risk Factor for Lymph Node Metastasis in T1 Colorectal Cancer: A Meta-Analysis
    Liselotte W. Zwager, Barbara A.J. Bastiaansen, Nahid S.M. Montazeri, Roel Hompes, Valeria Barresi, Katsuro Ichimasa, Hiroshi Kawachi, Isidro Machado, Tadahiko Masaki, Weiqi Sheng, Shinji Tanaka, Kazutomo Togashi, Chihiro Yasue, Paul Fockens, Leon M.G. Moo
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  • Utility of artificial intelligence with deep learning of hematoxylin and eosin-stained whole slide images to predict lymph node metastasis in T1 colorectal cancer using endoscopically resected specimens; prediction of lymph node metastasis in T1 colorecta
    Joo Hye Song, Yiyu Hong, Eun Ran Kim, Seok-Hyung Kim, Insuk Sohn
    Journal of Gastroenterology.2022; 57(9): 654.     CrossRef
  • Endoscopic diagnosis and treatment of early colorectal cancer
    Seung Wook Hong, Jeong-Sik Byeon
    Intestinal Research.2022; 20(3): 281.     CrossRef
  • Long-term prognosis of curative endoscopic submucosal dissection for early colorectal cancer according to submucosal invasion: a multicenter cohort study
    Jongbeom Shin, Eun Ran Kim, Hyun Joo Jang, Dong Hoon Baek, Dong-Hoon Yang, Bo-In Lee, Kwang Bum Cho, Jin Woong Cho, Sung-Ae Jung, Su Jin Hong, Bong Min Ko, Jung-Won Jeon, Weon Jin Ko, Sun Moon Kim, Young Dae Kim, Kim Chan Gyoo, Gwang Ho Baik, In Kyung Yoo
    BMC Gastroenterology.2022;[Epub]     CrossRef
  • Artificial intelligence-based colorectal polyp histology prediction using narrow-band image-magnifying colonoscopy: a stepping stone for clinical practice
    Ji Young Chang
    Clinical Endoscopy.2022; 55(5): 699.     CrossRef
  • 6,213 View
  • 170 Download
  • 16 Web of Science
  • 16 Crossref
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Inflammatory bowel diseases
Is fasting beneficial for hospitalized patients with inflammatory bowel diseases?
Yong Eun Park, Yehyun Park, Soo Jung Park, Tae Il Kim, Won Ho Kim, Jung Nam Kim, Na Rae Lee, Jae Hee Cheon
Intest Res 2020;18(1):85-95.   Published online July 19, 2019
DOI: https://doi.org/10.5217/ir.2019.00055
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
Patients with inflammatory bowel disease (IBD) are usually hospitalized because of aggravated gastrointestinal symptoms. Many clinicians empirically advise these patients to fast once they are admitted. However, there has been no evidence that maintaining a complete bowel rest improves the disease course. Therefore, we aimed to investigate the effects of fasting on disease course in admitted patients with IBD or intestinal Behçet’s disease.
Methods
A total of 222 patients with IBD or intestinal Behçet’s disease, who were admitted for disease-related symptoms, were retrospectively analyzed. We divided them into 2 groups: fasting group (allowed to take sips of water but no food at the time of admission) and dietary group (received liquid, soft, or general diet).
Results
On admission, 124 patients (55.9%) started fasting and 98 patients (44.1%) started diet immediately. Among patients hospitalized through the emergency room, a significantly higher proportion underwent fasting (63.7% vs. 21.4%, P<0.001); however, 96.0% of the patients experienced dietary changes. Corticosteroid use (P<0.001; hazard ratio, 2.445; 95% confidence interval, 1.506–3.969) was significantly associated with a reduction in the disease activity score, although there was no significant difference between the fasting group and the dietary group in disease activity reduction (P=0.111) on multivariate analysis.
Conclusions
In terms of disease activity reduction, there was no significant difference between the fasting and dietary groups in admitted patients with IBD, suggesting that imprudent fasting is not helpful in improving the disease course. Therefore, peroral diet should not be avoided unless not tolerated by the patient.

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  • Outcomes of dietary management approaches in active ulcerative colitis: A systematic review
    Abigail Marsh, Sophie Rindfleish, Kalina Bennett, Anthony Croft, Veronique Chachay
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Inflammatory bowel diseases
The prevalence of sarcopenia and its effect on prognosis in patients with Crohn’s disease
Chan Hyung Lee, Hyuk Yoon, Dong Jun Oh, Jae Min Lee, Yoon Jin Choi, Cheol Min Shin, Young Soo Park, Nayoung Kim, Dong Ho Lee, Joo Sung Kim
Intest Res 2020;18(1):79-84.   Published online January 30, 2020
DOI: https://doi.org/10.5217/ir.2019.00107
AbstractAbstract PDFPubReaderePub
Background/Aims
Crohn’s disease is associated with altered body composition, such as low muscle mass, which can affect clinical outcomes. However, there are few studies regarding the effect of sarcopenia on prognosis of Crohn’s disease. In this study, we evaluated the body composition at the initial diagnosis of Crohn’s disease and analyzed the clinical meaning of sarcopenia.
Methods
We conducted a retrospective review of medical records of patients who were diagnosed as Crohn’s disease and underwent computed tomography within 3 months after diagnosis. Sarcopenia was defined as an L3 skeletal muscle index (SMI) of < 49 cm2/m2 for men and < 31 cm2/m2 for women. Outcomes such as need for hospitalization, surgery, use of steroids, immunomodulators and biologics were analyzed.
Results
A total of 79 patients (male, 73.4%; mean age, 29.9 years) were included and 40 patients (51%) were diagnosed as sarcopenia. C-reactive protein (CRP) level was correlated with sarcopenia (P= 0.044). Erythrocyte sedimentation rate (ESR) showed a tendency to decrease inversely with SMI (r = –0.320, P= 0.008) and hemoglobin and albumin tended to increase in proportion to SMI (hemoglobin: r = 0.271, P= 0.016 and albumin: r = 0.350, P= 0.002). However, there was no statistically significance in time-to-first-event analysis in aspects of sarcopenia.
Conclusions
Approximately 50% of patients with newly diagnosed as Crohn’s disease had sarcopenia. CRP levels were higher in the sarcopenia group and SMI correlated with ESR, hemoglobin, and albumin. However, none of prognostic values were demonstrated.

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Inflammatory bowel diseases
5-Aminosalicylic acid intolerance is associated with a risk of adverse clinical outcomes and dysbiosis in patients with ulcerative colitis
Shinta Mizuno, Keiko Ono, Yohei Mikami, Makoto Naganuma, Tomohiro Fukuda, Kazuhiro Minami, Tatsuhiro Masaoka, Soichiro Terada, Takeshi Yoshida, Keiichiro Saigusa, Norimichi Hirahara, Hiroaki Miyata, Wataru Suda, Masahira Hattori, Takanori Kanai
Intest Res 2020;18(1):69-78.   Published online January 30, 2020
DOI: https://doi.org/10.5217/ir.2019.00084
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
5-Aminosalicylic acid (ASA) causes intolerance reactions in some patients. This study was performed to examine the prognosis of patients with ulcerative colitis (UC) and 5-ASA intolerance, and to evaluate the potential interaction between 5-ASA intolerance and the intestinal microbiota.
Methods
We performed a retrospective cohort study of patients with UC who visited participating hospitals. The primary endpoint was to compare the incidence of hospitalization within 12 months between the 5-ASA intolerance group and the 5-ASA tolerance group. The secondary endpoint was to compare the risk of adverse clinical outcomes after the start of biologics between the 2 groups. We also assessed the correlation between 5-ASA intolerance and microbial change in an independently recruited cohort of patients with UC.
Results
Of 793 patients, 59 (7.4%) were assigned to the 5-ASA intolerance group and 734 (92.5%) were assigned to the 5-ASA tolerance group. The admission rate and incidence of corticosteroid use were significantly higher in the intolerance than tolerance group (P< 0.001). In 108 patients undergoing treatment with anti-tumor necrosis factor biologics, 5-ASA intolerance increased the incidence of additional induction therapy after starting biologics (P< 0.001). The 5-ASA intolerance group had a greater abundance of bacteria in the genera Faecalibacterium, Streptococcus, and Clostridium than the 5-ASA tolerance group (P< 0.05).
Conclusions
In patients with UC, 5-ASA intolerance is associated with a risk of adverse clinical outcomes and dysbiosis. Bacterial therapeutic optimization of 5-ASA administration may be important for improving the prognosis of patients with UC.

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    Daichi Hayashi, Tsutomu Nishida, Naoto Osugi, Yasuo Kusunoki, Satoru Okabe, Yoshifumi Fujii, Dai Nakamatsu, Kengo Matsumoto, Masashi Yamamoto, Koji Fukui
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    Huanhuan Chen, Huimin Wang, XiaoJing Xu, Ya'nan Hu, Jing Su, Dongdong Li, Zimu Li, Shixiang Feng, Jinming Liu, Huanxiang Zhang, Xiaoyan Wang
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    Hiroshi Matsumoto, Momoyo Sasahira, Tei Tei Go, Shogen Yo, Takehiro Ninomiya, Motoyasu Osawa, Osamu Handa, Eiji Umegami, Ryo Inoue, Akiko Shiotani
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Inflammatory bowel diseases
Predictive factors for achievement of mucosal healing by budesonide 2-mg foam in ulcerative colitis: a pooled analysis of data from two clinical trials
Toshifumi Hibi, Makoto Naganuma, Eisei Oda, Yoji Yamada, Yoshitomo Chujoh, Ryoichi Yoshihara, Mamoru Watanabe
Intest Res 2020;18(1):56-68.   Published online December 11, 2019
DOI: https://doi.org/10.5217/ir.2019.00064
AbstractAbstract PDFPubReaderePub
Background/Aims
Mucosal healing (MH) of distal lesions in ulcerative colitis (UC) has recently been confirmed with budesonide 2-mg foam (BF) treatment in 2 clinical trials; however, few studies have investigated the predictive factors for complete MH.
Methods
We conducted a post hoc analysis using pooled data from phase II and III clinical trials evaluating the efficacy and safety of BF for UC. Additionally, we analyzed the relationships between complete MH and baseline factors and clinical symptoms from baseline to week 6.
Results
Among the 291 Japanese patients from the 2 pooled clinical studies, 119 patients in the BF twice a day group and 117 in the placebo group were included in the full analysis set. The proportion of patients with a rectal bleeding (RB) subscore of 0 was significantly higher in the BF group than in the placebo group after a 5-day treatment (P<0.05). After a 2-day treatment, significantly more patients in the BF group had a stool frequency (SF) subscore of 0 than patients in the placebo group (P<0.05). Multivariate analysis showed that complete MH at week 6 was influenced by baseline SF subscore and 5-aminosalicylic acid (5-ASA) enema or suppository use (P=0.0086 and P=0.0015, respectively). The relationship between complete MH at week 6 and RB subscore after week 2 was also confirmed.
Conclusions
Normal SF at baseline, history of 5-ASA topical product use, and elimination of RB after week 2 are suggested predictors of complete MH at week 6 with twice-daily BF treatment.

Citations

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Inflammatory bowel diseases
Anti-MAdCAM-1 antibody (PF-00547659) for active refractory Crohn’s disease in Japanese and Korean patients: the OPERA study
Masayuki Saruta, Dong Il Park, Young-Ho Kim, Suk-Kyun Yang, Byung-Ik Jang, Jae Hee Cheon, Jong Pil Im, Takanori Kanai, Tatsuro Katsuno, Yoh Ishiguro, Makoto Nagaoka, Naoki Isogawa, Yinhua Li, Anindita Banerjee, Alaa Ahmad, Mina Hassan-Zahraee, Robert Clare, Kenneth J. Gorelick, Fabio Cataldi, Mamoru Watanabe, Toshifumi Hibi
Intest Res 2020;18(1):45-55.   Published online January 30, 2020
DOI: https://doi.org/10.5217/ir.2019.00039
AbstractAbstract PDFPubReaderePub
Background/Aims
PF-00547659 is a monoclonal antibody against human mucosal addressin cell adhesion molecule-1 (MAdCAM-1) that prevents the binding of α4β7+ lymphocytes to MAdCAM-expressing sites in the gastrointestinal tract with high affinity and selectivity, and is being developed for the treatment of Crohn’s disease (CD).
Methods
OPERA is a randomized, multicenter, double-blind, placebo-controlled study to investigate the efficacy, safety, and pharmacokinetics of PF-00547659 following subcutaneous administration in subjects with active CD, a history of failure or intolerance to anti-tumor necrosis factor and/or immunosuppressants, high-sensitivity C-reactive protein > 3.0 mg/L, and ulcers on colonoscopy. The primary endpoint was Crohn’s Disease Activity Index-70 response at week 8 or 12. Subpopulation analyses for Asian subjects were performed as some differences are observed in genetics and clinical phenotypes in Asian CD patients compared with Western patients.
Results
In this study, 265 CD subjects were randomized, with a subpopulation of 21 subjects (8 Japanese and 13 Korean) defined as the Asian population. In the overall and Asian populations; PF-00547659 was pharmacologically active as evidenced by soluble MAdCAM and circulating β7+ central memory CD4+ T-lymphocytes, although no clear evidence of efficacy was observed in any clinical endpoints; pharmacokinetics of PF-00547659 in the Asian subpopulation was generally comparable to the overall population; and the safety profile of PF-00547659 appeared acceptable up to 12 weeks of treatment.
Conclusions
In the overall and Asian populations, efficacy of PF-00547659 could not be demonstrated using any clinical endpoints compared with placebo. Pharmacokinetics and safety of PF-00547659 were generally comparable. Further studies with larger numbers of patients are required to confirm our results. (Trial Registration Number: NCT01276509)

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Inflammatory bowel diseases
Biosimilars: concept, current status, and future perspectives in inflammatory bowel diseases
Sang Hyoung Park, Jae Cheol Park, Milan Lukas, Martin Kolar, Edward V. Loftus, Jr
Intest Res 2020;18(1):34-44.   Published online January 30, 2020
DOI: https://doi.org/10.5217/ir.2019.09147
AbstractAbstract PDFPubReaderePub
The inflammatory bowel diseases (IBD), which consist of Crohn’s disease and ulcerative colitis, are chronic, incurable immunemediated inflammatory disorders of the intestine. As IBD incidence continues to increase globally and its mortality is low, prevalent cases of IBD are rapidly increasing, thereby leading to a substantial increase in health care costs. Although the introduction of biologic agents for IBD management has revolutionized the armamentarium of IBD therapy, the high cost of this therapy is concerning. With the expirations of patents for existing biologic agents (originals), biosimilars with cheaper costs have been highlighted in the field of IBD. Despite concerns regarding their short- and long-term efficacy, safety, immunogenicity, and interchangeability, increasing evidence via prospective observations and phase III or IV clinical trials, which aim to prove the “biosimilarity” of biosimilars to originals, has partly confirmed their efficacy, safety, and interchangeability. Additionally, although patients and physicians are reluctant to use biosimilars, a positive budget impact has been reported owing to their use in different countries. In the near future, multiple biosimilars with lower costs, and efficacy and safety profile similar to originals, could be used to treat IBD; thus, further consideration and knowledge dissemination are warranted in this new era of biosimilars.

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Inflammatory bowel diseases
Prevention and management of viral hepatitis in inflammatory bowel disease: a clinical practice guideline by the Korean Association for the Study of Intestinal Diseases
Soo-Kyung Park, Chang Hwan Choi, Jaeyoung Chun, Heeyoung Lee, Eun Sun Kim, Jae Jun Park, Chan Hyuk Park, Bo-In Lee, Yunho Jung, Dong-Il Park, Do Young Kim, Hana Park, Yoon Tae Jeen, IBD Research Group of the Korean Association for the Study of Intestinal Diseases
Intest Res 2020;18(1):18-33.   Published online January 30, 2020
DOI: https://doi.org/10.5217/ir.2019.09155
AbstractAbstract PDFPubReaderePub
The treatment of inflammatory bowel disease (IBD) has been revolutionized for the last 10 years by the increasing use of immunomodulators and biologics. With immunosuppression of this kind, opportunistic infection is an important safety concern for patients with IBD. In particular, viral hepatitis is determined by the interaction between the virus and the host’s immunity, and the risk of reactivation increases if immunity is compromised by immunosuppression therapy. Parts of Asia, including Korea, still show intermediate endemicity for the hepatitis A virus and hepatitis B virus compared with the United States and Western Europe. Thus, members of IBD research group of the Korean Association for the Study of Intestinal Diseases have produced a guideline on the prevention and management of viral hepatitis in IBD.

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Inflammatory bowel diseases
Pediatric to adult inflammatory bowel disease transition: the Asian experience
Bernice Tan, David Ong
Intest Res 2020;18(1):11-17.   Published online January 30, 2020
DOI: https://doi.org/10.5217/ir.2019.09144
AbstractAbstract PDFPubReaderePub
Many tertiary inflammatory bowel disease (IBD) centers recognize that a structured transition program is fundamental for an IBD unit. However, the path to ensuring a seamless transition for all stakeholders is often fraught with challenges. In this review, we go through current evidence, identify the requirementsof a successful transition program, and the barriers to seamless transfer. We also aim to shed light on differences in needs between the Western and Asian adolescent IBD populations. Majority of healthcare providers viewed having a structured transition program to be very important. The lack of a standard protocol led us to come up with a list of requirements ofa successful program. These include: multidisciplinary team meetings, alternating visits between the adultand pediatric clinics, proper documentation of records, and determining the ideal timing for transfer. The difficulties forthe Asian adolescent IBD population may be attributed to the reliance on parental support to make decisions regarding medicaltreatment. Lastly, there are various physician, patient and disease factors which are barriers to seamless transition. These includethe lack of proper documentation, and lack of patient self-efficacy. We also propose a standardized template for documentation of medical records for IBD patients.

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Inflammatory bowel diseases
Update of endoscopic management of Crohn’s disease strictures
Akshay Pokala, Bo Shen
Intest Res 2020;18(1):1-10.   Published online January 30, 2020
DOI: https://doi.org/10.5217/ir.2019.09158
AbstractAbstract PDFPubReaderePub
One of the most common complications of Crohn’s disease (CD) is the formation of strictures. Endoscopy plays a vital role not only in the diagnosis, differential diagnosis, and disease monitoring of CD, but also the delivery of effective treatment. The purpose of this review is to update the endoscopic management of strictures in CD. Endoscopic therapy has provided minimally invasive treatment for CD. Commonly used endoscopic treatment modalities include balloon dilation, endoscopic stricturotomy, endoscopic strictureplasty, and endoscopic stenting. The pros and cons of these endoscopic treatment modalities are discussed.

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  • Crohn's disease: an update
    Ella Cockburn, Shahed Kamal, Andrea Chan, Vikram Rao, Tianwei Liu, Joanna Y Huang, Jonathan P Segal
    Clinical Medicine.2023; 23(6): 549.     CrossRef
  • Documento de posicionamiento. Recomendaciones del grupo español de trabajo en enfermedad de Crohn y colitis ulcerosa (GETECCU) sobre el tratamiento de la estenosis en la enfermedad de Crohn
    Carme Loras, Miriam Mañosa, Xavier Andújar, Vicente Sánchiz, Marc Martí-Gallostra, Yamile Zabana, Ana Gutiérrez, Manuel Barreiro-de Acosta
    Gastroenterología y Hepatología.2022; 45(4): 315.     CrossRef
  • Endoscopic Balloon Dilation Is Cost-Effective for Crohn’s Disease Strictures
    Kate E. Lee, Francesca Lim, Adam S. Faye, Bo Shen, Chin Hur
    Digestive Diseases and Sciences.2022; 67(12): 5462.     CrossRef
  • Position Statement. Recommendations of the Spanish Group on Crohn’s Disease and Ulcerative Colitis (GETECCU) on the treatment of strictures in Crohn’s disease
    Carme Loras, Miriam Mañosa, Xavier Andújar, Vicente Sánchiz, Marc Martí-Gallostra, Yamile Zabana, Ana Gutiérrez, Manuel Barreiro-de Acosta
    Gastroenterología y Hepatología (English Edition).2022; 45(4): 315.     CrossRef
  • Endoscopic activity in inflammatory bowel disease: clinical significance and application in practice
    Kyeong Ok Kim
    Clinical Endoscopy.2022; 55(4): 480.     CrossRef
  • Esophageal Manifestations of Dermatological Diseases, Diagnosis, and Management
    Amr M. Arar, Kelli DeLay, David A. Leiman, Paul Menard-Katcher
    Current Treatment Options in Gastroenterology.2022; 20(4): 513.     CrossRef
  • Active Assessment of Inflammatory Bowel Disease
    金良 肖
    Advances in Clinical Medicine.2022; 12(12): 11023.     CrossRef
  • Long-Term Outcome of Endoscopic Balloon Dilation for Duodenal Crohn’s Disease-Associated Strictures
    Juanjuan Zhang, Yi Li, Yanqing Diao, Binlin Da, Zhiming Wang
    Digestive Diseases and Sciences.2021; 66(10): 3570.     CrossRef
  • Story of strictures, stents, and many more
    Saiprasad Girish Lad, Kailash M. Kolhe, Shamshersingh G. Chauhan, Meghraj A. Ingle, Mayur Gattani, Harshad Khairnar
    Gastrointestinal Endoscopy.2021; 93(2): 535.     CrossRef
  • Enteroscopy in Crohn’s Disease: Are There Any Changes in Role or Outcomes Over Time? A KASID Multicenter Study
    Seong Ran Jeon, Jin-Oh Kim, Jeong-Sik Byeon, Dong-Hoon Yang, Bong Min Ko, Hyeon Jeong Goong, Hyun Joo Jang, Soo Jung Park, Eun Ran Kim, Sung Noh Hong, Jong Pil Im, Seong-Eun Kim, Ja Seol Koo, Chang Soo Eun, Dong Kyung Chang
    Gut and Liver.2021; 15(3): 375.     CrossRef
  • Managing Stricturing Crohn's Disease: Resect? Strictureplasty? Dilate?
    Lea Lowenfeld, Fabrizio Michelassi
    Journal of Laparoendoscopic & Advanced Surgical Techniques.2021; 31(8): 881.     CrossRef
  • Crohn’s disease at radiological imaging: focus on techniques and intestinal tract
    Giuseppe Cicero, Silvio Mazziotti
    Intestinal Research.2021; 19(4): 365.     CrossRef
  • 8,218 View
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Images of the Issue
IBD
Stroke and neck bruit in a boy with Crohn’s disease
Ryosaku Tomiyama, Akira Hokama, Erika Koga, Kohei Shimabukuro, Yuiko Oishi, Tetsuya Ohira, Atsushi Iraha, Tetsu Kinjo, Jiro Fujita
Intest Res 2019;17(4):565-566.   Published online April 15, 2019
DOI: https://doi.org/10.5217/ir.2019.00019
PDFPubReaderePub
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Case Report
Colorectal neoplasia
Primary malignant melanoma without melanosis of the colon
Nam Hee Yi, Sang Heon Lee, Sang Heon Lee, Ji Hyun Kim, Sam Ryong Jee, Sang Yong Seol
Intest Res 2019;17(4):561-564.   Published online August 5, 2019
DOI: https://doi.org/10.5217/ir.2019.00020
AbstractAbstract PDFPubReaderePub
Primary malignant melanoma (PMM) of the gastrointestinal tract is rare. Reported cases of PMM of the lower gastrointestinal tract typically describe anal and rectal involvement rather than colonic lesions. This report describes a rare case of a 50-year-old woman with PMM originating in the colon. The patient presented to Inje University Busan Paik Hospital with a 3-day history of blood-tinged stools. She underwent colonoscopy for a diagnosis of hematochezia. The colonoscopic examination revealed a large-sized semi-pedunculated sigmoid colon polyp with a reddish-colored mucosal surface. Endoscopic mucosal resection was performed, and the final histopathological findings were consistent with a diagnosis of malignant melanoma. Systemic work-up was performed for assessment of metastasis and to identify the primary tumor considering the high metastatic rate of gastrointestinal malignant melanoma; however, no other malignant lesion was detected. Thus, she was diagnosed with colonic PMM. She underwent laparoscopic low anterior resection and lymph node dissection and has been recurrence-free for > 2 years.

Citations

Citations to this article as recorded by  
  • Malignant primary melanoma of the colon: a case report
    Claire K Foley, Marybeth S Hughes, Charles T Hehman
    Journal of Surgical Case Reports.2023;[Epub]     CrossRef
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  • 180 Download
  • 4 Web of Science
  • 1 Crossref
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Original Articles
Miscellaneous
Primary epiploic appendagitis: compared with diverticulitis and focused on obesity and recurrence
Youn I Choi, Hyun Sun Woo, Jun-Won Chung, Young Sup Shim, Kwang An Kwon, Kyoung Oh Kim, Yoon Jae Kim, Dong Kyun Park
Intest Res 2019;17(4):554-560.   Published online October 14, 2019
DOI: https://doi.org/10.5217/ir.2018.00148
AbstractAbstract PDFPubReaderePub
Background/Aims
There is limited data to compare the clinical characteristics and recurrence rates between left-sided primary epiploic appendagitis (PEA) versus left-sided acute colonic diverticulitis (ACD), and right-sided PEA versus right-sided ACD, respectively.
Methods
We retrospectively reviewed the medical records and radiologic images of the patients who presented with left-sided or right-sided acute abdominal pain and had computer tomography performed at the time of presentation showing radiological signs of PEA or ACD between January 2004 and December 2014. We compared the clinical characteristics of left PEA versus left ACD and right PEA versus right ACD, respectively.
Results
Fifty-six patients (left:right = 27:29) and 308 patients (left:right = 24:284) were diagnosed with symptomatic PEA and ACD, respectively. Left-sided PEA were statistically significantly younger (50.2 ± 15.4 years vs. 62.1 ± 15.8 years, P= 0.009), more obese (body mass index [BMI]: 26.3 ± 2.9 kg/m2 vs. 22.3 ± 3.1 kg/m2 , P< 0.001), and had more tendencies with normal or mildly elevated high-sensitivity C-reactive protein (hsCRP) (1.2 ± 1.3 mg/dL vs. 8.4 ± 7.9 mg/dL, P< 0.001) than patients with left-sided ACD. The discriminative function of age, BMI and CRP between left-sided PEA versus left-sided ACD was 0.71 (cutoff: age ≤ 59 years, sensitivity of 66.7%, specificity of 77.8%), 0.83 (cutoff: BMI > 24.5 kg/m2 , sensitivity of 80.0%, specificity of 80.0%) and 0.80 (cutoff: CRP < 1.8 mg/dL, sensitivity of 72.2%, specificity of 85.7%).
Conclusions
If patients with left lower quadrant abdominal pain are less than 60 years, obese (BMI > 24.5 kg/m2 ) with or without normal to mild elevated CRP levels (CRP < 1.8 mg/dL), it might be necessary for clinicians to suspect the diagnosis of PEA rather than ACD.

Citations

Citations to this article as recorded by  
  • Diagnosis and treatment of epiploic appendagitis in a Middle Eastern country: An observational retrospective analysis of 156 cases
    Ayman El‐Menyar, Syed G. A. Naqvi, Omer Al‐Yahri, Abdelaziz MA Abusal, Abdulwahhab Al‐Shaikhli, Sadia Sajid, Husham Abdelrahman, Ahmad G. Kloub, Muhamed Ibnas, Rifat Latifi, Yasser M. R. Toble, Hassan Al‐Thani
    World Journal of Surgery.2024; 48(6): 1363.     CrossRef
  • Epiploic Adipose Tissue (EPAT) in Obese Individuals Promotes Colonic Tumorigenesis: A Novel Model for EPAT-Dependent Colorectal Cancer Progression
    Rida Iftikhar, Patricia Snarski, Angelle N. King, Jenisha Ghimire, Emmanuelle Ruiz, Frank Lau, Suzana D. Savkovic
    Cancers.2023; 15(3): 977.     CrossRef
  • Recurrencia en pacientes con apendagitis epiploica: un reporte de caso
    Mía Alejandra Gómez Corrales, Fabian Andrés Chávez Ecos, Jackeline Alexandra Espinoza Utani, Carlos Alberto Dávila Hernández
    Revista colombiana de Gastroenterología.2023; 38(1): 94.     CrossRef
  • 7,625 View
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  • 3 Crossref
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Functional bowel disorders
Is fecal calprotectin always normal in children with irritable bowel syndrome?
You Jin Choi, Su Jin Jeong
Intest Res 2019;17(4):546-553.   Published online September 4, 2019
DOI: https://doi.org/10.5217/ir.2019.00009
AbstractAbstract PDFPubReaderePub
Background/Aims
Fecal calprotectin (FC) is a marker of intraluminal intestinal inflammation. Intestinal inflammation may contribute to the pathophysiology of irritable bowel syndrome (IBS). This study evaluated FC levels in children with IBS and differences in FC levels in children stratified by IBS subtype and healthy controls (HCs).
Methods
A total of 157 children with IBS and 56 HCs aged 4–16 years (119 boys, 94 girls, mean age of 9.48 years) were included in this prospective study. Children with IBS were diagnosed using the Rome III criteria and classified into 4 subtypes: IBS with constipation (IBS-C, n=37), IBS with diarrhea (IBS-D, n=54), IBS with alternating constipation and diarrhea (IBS-M, n=49), and IBS unsubtyped (IBS-U, n=17); postinfectious IBS (PI-IBS) was also considered. The FC concentration in stool samples was analyzed using an enzyme-linked immunosorbent assay. All participants answered a questionnaire regarding several demographic and clinical characteristics.
Results
Children with IBS had significantly higher levels of FC than the HCs (88.71 μg/g vs. 17.77 μg/g). Among the 4 IBS subtypes, the FC concentration was highest in children with IBS-D, followed by those with IBS-M, IBS-C, and IBS-U (169.94 μg/g vs. 45.04, 31.22, and 33.52 μg/g, respectively), and these differences were statistically significant. For PI-IBS, 90% of cases were in the IBS-D group.
Conclusions
The FC level was significantly higher in children with IBS than in HCs and differed depending on the IBS subtype, supporting the notion that IBS is a type of low-grade bowel inflammation.

Citations

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  • Markers of Intestinal Permeability and Inflammation in Enterally Fed Children with Cerebral Palsy
    Dorota Mickiewicz-Góra, Katarzyna Sznurkowska, Karolina Skonieczna-Żydecka, Arleta Drozd, Anna Borkowska, Maciej Zagierski, Joanna Troch, Agnieszka Szlagatys-Sidorkiewicz
    Nutrients.2024; 16(15): 2447.     CrossRef
  • Role of inflammation in pediatric irritable bowel syndrome
    Giovanni Di Nardo, Cesare Cremon, Annamaria Staiano, Vincenzo Stanghellini, Osvaldo Borrelli, Caterina Strisciuglio, Claudio Romano, Saverio Mallardo, Elena Scarpato, Giovanni Marasco, Silvia Salvatore, Letizia Zenzeri, Enrico Felici, Licia Pensabene, Sim
    Neurogastroenterology & Motility.2023;[Epub]     CrossRef
  • The Role of Bovine Kappa-Casein Glycomacropeptide in Modulating the Microbiome and Inflammatory Responses of Irritable Bowel Syndrome
    Yunyao Qu, Si Hong Park, David C. Dallas
    Nutrients.2023; 15(18): 3991.     CrossRef
  • Evaluating the Potential of Casein Glycomacropeptide in Adult Irritable Bowel Syndrome Management: A Pilot Study
    Yunyao Qu, Si Hong Park, David C. Dallas
    Nutrients.2023; 15(19): 4174.     CrossRef
  • Association between body mass index and fecal calprotectin levels in children and adolescents with irritable bowel syndrome
    Jun Hwan Kim, Dae Yong Yi, Yoo Min Lee, You Jin Choi, Ju Young Kim, Yong Hee Hong, Ji Young Park, Su Yeong Kim, Na Mi Lee, Sin Weon Yun, Soo Ahn Chae, In Seok Lim, Eung Sang Choi, In Sook Jeong
    Medicine.2022; 101(32): e29968.     CrossRef
  • Infantile Colic and the Subsequent Development of the Irritable Bowel Syndrome
    Ju Hee Kim, Seung Won Lee, Yoowon Kwon, Eun Kyo Ha, Jaewoo An, Hye Ryeong Cha, Su Jin Jeong, Man Yong Han
    Journal of Neurogastroenterology and Motility.2022; 28(4): 618.     CrossRef
  • Irritable bowel syndrome in Indonesian adolescents
    Yudianita Kesuma, Rini Sekartini, Ina S. Timan, Agnes Kurniawan, Saptawati Bardosono, Agus Firmansyah, Yvan Vandenplas
    Jornal de Pediatria.2021; 97(2): 197.     CrossRef
  • An Update on the Assessment and Management of Pediatric Abdominal Pain
    Craig Friesen, Jennifer M Colombo, Amanda Deacy, Jennifer V Schurman
    Pediatric Health, Medicine and Therapeutics.2021; Volume 12: 373.     CrossRef
  • Increasing Evidence That Irritable Bowel Syndrome and Functional Gastrointestinal Disorders Have a Microbial Pathogenesis
    Caterina Carco, Wayne Young, Richard B. Gearry, Nicholas J. Talley, Warren C. McNabb, Nicole C. Roy
    Frontiers in Cellular and Infection Microbiology.2020;[Epub]     CrossRef
  • 9,745 View
  • 165 Download
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Functional bowel disorders
Frequency and intensity of gastrointestinal symptoms in exercisers individuals at rest and during physical exercise: an internet-based survey
Claudio Andre Barbosa de Lira, Ricardo Borges Viana, Kaylla Priscilla Mesquista, Douglas de Assis Teles Santos, Mário Hebling Campos, Marília Santos Andrade, Rodrigo Luiz Vancini
Intest Res 2019;17(4):537-545.   Published online May 7, 2019
DOI: https://doi.org/10.5217/ir.2018.00162
AbstractAbstract PDFPubReaderePub
Background/Aims
Despite the evidence of a modest to high prevalence of gastrointestinal (GI) symptoms in recreational runners and endurance athletes, the frequency and intensity of GI symptoms in exercisers, but nonathletes, individuals from different modalities have been less investigated. Therefore, the present study aimed to assess the prevalence of GI symptoms in individuals that practice moderate or vigorous physical exercise, at rest and during physical exercise training session.
Methods
The sample consisted of 142 exercisers individuals (64 women and 78 men with mean age of 32.9 ± 10.7 years). Out of the 142 participants, 71 reported to perform moderate physical exercise and 71 reported to perform vigorous physical exercise. Participants were assessed by an internet-based questionnaire designed to assess the frequency and intensity (at rest and during physical exercise training session) of 18 GI symptoms.
Results
The GI symptoms most frequently reported by the respondents (during rest and physical exercise training session, respectively) were flatulence (90.8% and 69.7%), abdominal noise (77.5% and 41.5%), and eructation (73.9% and 52.1%). Overall, the frequency and intensity of symptoms were higher (P< 0.050) during rest than physical exercise training session for who perform moderate and vigorous physical exercise.
Conclusions
It can be concluded that GI symptoms in exercisers, but nonathletes, individuals are more prevalent during rest than during physical exercise training session, suggesting that moderate and vigorous physical exercise may act as a regulator of the GI tract.

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  • The Frequency and Severity of Gastrointestinal Symptoms in Rugby Players
    Sarah Chantler, Ruth Wood-Martin, Adrian Holliday, Glen Davison, Daniel R. Crabtree, Clint Readhead, Ben Jones
    International Journal of Sports Medicine.2024; 45(04): 323.     CrossRef
  • Exercise-Induced Gastrointestinal Symptoms in Endurance Sports: A Review of Pathophysiology, Symptoms, and Nutritional Management
    Emanuela Ribichini, Giulia Scalese, Alessandra Cesarini, Chiara Mocci, Nadia Pallotta, Carola Severi, Enrico Stefano Corazziari
    Dietetics.2023; 2(3): 289.     CrossRef
  • Comparison of physiological and psychobiological acute responses between high intensity functional training and high intensity continuous training
    Douglas A.T. Santos, Naiane S. Morais, Ricardo B. Viana, Gustavo C.T. Costa, Marilia S. Andrade, Rodrigo L. Vancini, Katja Weiss, Beat Knechtle, Claudio A.B. de Lira
    Sports Medicine and Health Science.2023;[Epub]     CrossRef
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  • 163 Download
  • 1 Web of Science
  • 3 Crossref
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Colorectal neoplasia
Parthenolide inhibits transforming growth factor β1-induced epithelial-mesenchymal transition in colorectal cancer cells
Shi Mao Zhu, Yong Ran Park, Seung Yong Seo, In Hee Kim, Soo Teik Lee, Sang Wook Kim
Intest Res 2019;17(4):527-536.   Published online August 23, 2019
DOI: https://doi.org/10.5217/ir.2019.00031
AbstractAbstract PDFPubReaderePub
Background/Aims
Transforming growth factor-β1 (TGF-β1) induction of epithelial-mesenchymal transition (EMT) is one of the mechanisms by which colorectal cancer (CRC) cells acquire migratory and invasive capacities, and subsequently metastasize. Parthenolide (PT) expresses multiple anti-cancer and anti-inflammatory activities that inhibit nuclear factor κB by targeting the IκB kinase complex. In the present study, we aimed to investigate whether PT can inhibit TGF-β1-induced EMT in CRC cell lines.
Methods
HT-29 and SW480 cell lines were used in the experiment. Cell viability was detected by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay and sub-G1 analysis was measured by flow cytometry. The induction of EMT by TGF-β1 and inhibition of the process by PT was analyzed by phase contrast microscopy, wounding healing, cellular migration and invasion assays, and Western blotting.
Results
TGF-β1 inhibits HT-29 cell proliferation, but has no effect on SW480 cell proliferation; different concentrations of TGF-β1 did not induce apoptosis in HT-29 and SW480 cells. PT attenuates TGF-β1-induced elongated, fibroblast-like shape changing in cells. PT inhibits TGF-β1-induced cell migration and cell invasion. In addition, other EMT markers such as β-catenin, Vimentin, Snail, and Slug were suppressed by PT, while E-cadherin was increased by PT.
Conclusions
Our findings show that PT inhibits TGF-β1-induced EMT by suppressing the expression of the mesenchymal protein and increasing expression of the epithelial protein. These findings suggest a novel approach for CRC treatment by suppression of TGF-β1-induced EMT.

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  • Cumin (Cuminum cyminum L.) seeds accelerates wound healing in rats: Possible molecular mechanisms
    Khaled Abdul‐Aziz Ahmed, Ahmed A. J. Jabbar, Yaseen Galali, Ayman M. Al‐Qaaneh, Gökhan Akçakavak, Nur Ain Salehen, Rawaz Rizgar Hassan, Ramzi A. Mothana, Mahmood Ameen Abdulla, Omer I. Fantoukh, Sidig Hasson, Mohammed F. Hawwal
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    Allan M. Johansen, Steven D. Forsythe, Callum T. McGrath, Grayson Barker, Hugo Jimenez, Ravi K. Paluri, Boris C. Pasche
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    Ana R. Costa, Ana C. Duarte, Ana R. Costa-Brito, Isabel Gonçalves, Cecília R.A. Santos
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  • Parthenolide inhibits proliferation and invasion, promotes apoptosis, and reverts the cell–cell adhesion loss through downregulation of NF‐κB pathway TNF‐α‐activated in colorectal cancer cells
    Adriana S. Gehren, Waldemir F. de Souza, Annie C. M. Sousa‐Squiavinato, Diego A. A. Ramos, Bruno R. B. Pires, Eliana S. F. W. Abdelhay, Jose A. Morgado‐Diaz
    Cell Biology International.2023; 47(9): 1638.     CrossRef
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    Soad L. Kabil, Hayam E. Rashed, Noura Mostafa Mohamed, Nisreen E. Elwany
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    Medical Oncology.2023;[Epub]     CrossRef
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    Tao An, Huanhuan Yin, Yanting Lu, Feng Liu
    Drug Design, Development and Therapy.2022; Volume 16: 1255.     CrossRef
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    Hazera Binte Sufian, Julianna Maria Santos, Zeina S. Khan, Sobia Ahsan Halim, Ajmal Khan, Maliha Tabassum Munir, MD Khurshidul Zahid, Ahmed Al-Harrasi, Lauren S. Gollahon, Fazle Hussain, Shaikh Mizanoor Rahman
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    Athicha Kittiwattanokhun, Sukanda Innajak, Etsu Tashiro, Masaya Imoto, Ramida Watanapokasin
    Scientia Pharmaceutica.2022; 90(2): 30.     CrossRef
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    Justyna Sakowska, Łukasz Arcimowicz, Martyna Jankowiak, Ines Papak, Aleksandra Markiewicz, Katarzyna Dziubek, Małgorzata Kurkowiak, Sachin Kote, Karolina Kaźmierczak-Siedlecka, Karol Połom, Natalia Marek-Trzonkowska, Piotr Trzonkowski
    Frontiers in Immunology.2022;[Epub]     CrossRef
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    Yubo Dong, Xuanjin Qian, Jian Li, Ahmed Faeq Hussein
    Computational and Mathematical Methods in Medicine.2022; 2022: 1.     CrossRef
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    Wamidh H. Talib, Safa Daoud, Asma Ismail Mahmod, Reem Ali Hamed, Dima Awajan, Sara Feras Abuarab, Lena Hisham Odeh, Samar Khater, Lina T. Al Kury
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  • Parthenolide Inhibits Angiogenesis in Esophageal Squamous Cell Carcinoma Through Suppression of VEGF


    Bo Tian, Yuhang Xiao, Junliang Ma, Wei Ou, Hui Wang, Jie Wu, Jinming Tang, Baihua Zhang, Xiaojuan Liao, Desong Yang, Zhining Wu, Xu Li, Yong Zhou, Min Su, Wenxiang Wang
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  • Aniline-containing derivatives of parthenolide: Synthesis and anti-chronic lymphocytic leukaemia activity
    Alex S. Quy, Xingjian Li, Louise Male, Tatjana Stankovic, Angelo Agathanggelou, John S. Fossey
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    Chang Hoon Lee
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  • 19 Web of Science
  • 17 Crossref
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Colorectal neoplasia
Clinical outcomes of positive resection margin after endoscopic mucosal resection of early colon cancers
Junseok Park, Hyun Gun Kim, Shin Ok Jeong, Hoon gil Jo, Hyo Yeop Song, Jeeyeon Kim, Seri Ryu, Youngyun Cho, Hyun Jin Youn, Seong Ran Jeon, Jin-Oh Kim, Bong Min Ko, Yoon Mi Jeen, So-Young Jin
Intest Res 2019;17(4):516-526.   Published online May 31, 2019
DOI: https://doi.org/10.5217/ir.2018.00169
AbstractAbstract PDFPubReaderePub
Background/Aims
When determining the subsequent management after endoscopic resection of the early colon cancer (ECC), various factors including the margin status should be considered. This study assessed the subsequent management and outcomes of ECCs according to margin status.
Methods
We examined the data of 223 ECCs treated by endoscopic mucosal resection (EMR) from 215 patients during 2004 to 2014, and all patients were followed-up at least for 2 years.
Results
According to histological analyses, the margin statuses of all lesions after EMR were as follows: 138 cases (61.9%) were negative, 65 cases (29.1%) were positive for dysplastic cells on the resection margins, and 20 cases (8.9%) were uncertain. The decision regarding subsequent management was affected not only by pathologic outcomes but also by the endoscopist’s opinion on whether complete resection was obtained. Surgery was preferred if the lesion extended to the submucosa (odds ratio [OR], 25.46; 95% confidence interval [CI], 7.09–91.42), the endoscopic resection was presumed incomplete (OR, 15.55; 95% CI, 4.28–56.56), or the lymph system was invaded (OR, 13.69; 95% CI, 1.76–106.57). Fourteen patients (6.2%) had residual or recurrent malignancies at the site of the previous ECC resection and were significantly associated with presumed incomplete endoscopic resection (OR, 4.59; 95% CI, 1.21–17.39) and submucosal invasion (OR, 5.14; 95% CI, 1.18–22.34).
Conclusions
Subsequent surgery was associated with submucosa invasion, lymphatic invasion, and cancer-positive margins. Presumed completeness of the resection may be helpful for guiding the subsequent management of patients who undergo endoscopic resection of ECC.

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  • Long-term outcomes after endoscopic versus surgical resection of T1 colorectal carcinoma
    Hyun Jin Bae, Hoyeon Ju, Han Hee Lee, Jinsu Kim, Bo-In Lee, Sung Hak Lee, Daeyoun David Won, Yoon Suk Lee, In Kyu Lee, Young-Seok Cho
    Surgical Endoscopy.2023; 37(2): 1231.     CrossRef
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    Han Hee Lee
    Clinical Endoscopy.2022; 55(2): 315.     CrossRef
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    Eun Hye Oh, Nayoung Kim, Sung Wook Hwang, Sang Hyoung Park, Dong-Hoon Yang, Byong Duk Ye, Seung-Jae Myung, Suk-Kyun Yang, Chang Sik Yu, Jin Cheon Kim, Jeong-Sik Byeon
    Gastrointestinal Endoscopy.2021; 94(2): 394.     CrossRef
  • Clinical outcomes of submucosal colorectal cancer diagnosed after endoscopic resection: a focus on the need for surgery
    Yun Sik Choi, Wan Soo Kim, Sung Wook Hwang, Sang Hyoung Park, Dong-Hoon Yang, Byong Duk Ye, Seung-Jae Myung, Suk-Kyun Yang, Jeong-Sik Byeon
    Intestinal Research.2020; 18(1): 96.     CrossRef
  • 7,879 View
  • 168 Download
  • 3 Web of Science
  • 4 Crossref
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Inflammatory bowel diseases
Infliximab biosimilar CT-P13 is interchangeable with its originator for patients with inflammatory bowel disease in real world practice
Tomoo Nakagawa, Taku Kobayashi, Kiyohiro Nishikawa, Fumika Yamada, Satoshi Asai, Yukinori Sameshima, Yasuo Suzuki, Mamoru Watanabe, Toshifumi Hibi
Intest Res 2019;17(4):504-515.   Published online August 23, 2019
DOI: https://doi.org/10.5217/ir.2019.00030
AbstractAbstract PDFPubReaderePub
Background/Aims
An interim analysis of post-marketing surveillance of CT-P13, an infliximab biosimilar, was performed to evaluate its safety and efficacy in Japanese patients with inflammatory bowel disease.
Methods
Patients were prospectively enrolled between November 2014 and March 2017, after the launch of CT-P13 in Japan, and case report forms of patients followed for at least 4 months were analyzed as of July 2018.
Results
Of 523 patients in the analysis set, 372 remained on CT-P13 therapy, while 54 (20.2%) of 267 patients with Crohn’s disease, and 97 (37.9%) of 256 patients with ulcerative colitis were withdrawn during follow-up. A total of 144 adverse drug reactions (ADRs) were reported in 106 patients (20.3%). Infusion reaction was the most frequent ADR observed in 49 patients (9.4%). Efficacy parameters decreased immediately after the start of treatment in naïve patients to anti-tumor necrosis factor-α antibody. In the patients switched from originator infliximab for nonmedical reasons, the decreased parameters due to proceeded treatment with the originator were maintained in low ranges, and the treatment continuation rate was high with low ADR incidence. In contrast, in patients switched for medical reasons such as adverse event or loss of response, the incidence of ADRs was high. However, the efficacy parameters were improved, and the treatment continuation rate was not significantly different from that of the naïve patient group.
Conclusions
In this interim analysis, CT-P13 was comparable to the originator infliximab with respect to ADRs and efficacy, and is therefore considered to be a cost-efficient interchangeable biosimilar for Japanese patients with inflammatory bowel disease.

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    Akimichi Morita, Kiyohiro Nishikawa, Fumika Yamada, Keiichi Yamanaka, Hideki Nakajima, Mamitaro Ohtsuki
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Inflammatory bowel diseases
Polypharmacy is a risk factor for disease flare in adult patients with ulcerative colitis: a retrospective cohort study
Jingzhou Wang, Takahiro I Nakamura, Anne G Tuskey, Brian W Behm
Intest Res 2019;17(4):496-503.   Published online October 14, 2019
DOI: https://doi.org/10.5217/ir.2019.00050
AbstractAbstract PDFPubReaderePub
Background/Aims
Polypharmacy is a common clinical problem with chronic diseases that can be associated with adverse patient outcomes. The present study aimed to determine the prevalence and patient-specific characteristics associated with polypharmacy in an ulcerative colitis (UC) population and to assess the impact of polypharmacy on disease outcomes.
Methods
A retrospective chart review of patients with UC who visited a tertiary medical center outpatient clinic between 2006 and 2011 was performed. Polypharmacy was defined as major ( ≥ 5 non-UC medications) or minor (2–4 non-UC medications). UC medications were excluded in the polypharmacy grouping to minimize the confounding between disease severity and polypharmacy. Outcomes of interest include disease flare, therapy escalation, UC-related hospitalization, and surgery within 5 years of the initial visit.
Results
A total of 457 patients with UC were eligible for baseline analysis. Major polypharmacy was identified in 29.8% of patients, and minor polypharmacy was identified in 40.9% of the population. Polypharmacy at baseline was associated with advanced age (P< 0.001), female sex (P= 0.019), functional gastrointestinal (GI) disorders (P< 0.001), and psychiatric disease (P< 0.001). Over 5 years of follow-up, 265 patients remained eligible for analysis. After adjusting for age, sex, functional GI disorders, and psychiatric disease, major polypharmacy was found to be significantly associated with an increased risk of disease flare (odds ratio, 4.00; 95% confidence interval, 1.66–9.62). However, major polypharmacy was not associated with the risk of therapy escalation, hospitalization, or surgery.
Conclusions
Polypharmacy from non-inflammatory bowel disease medications was present in a substantial proportion of adult patients with UC and was associated with an increased risk of disease flare.

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Inflammatory bowel diseases
Familial aggregation of inflammatory bowel disease in India: prevalence, risks and impact on disease behavior
Rupa Banerjee, Partha Pal, Susan Hutfless, B Girish Ganesh, D Nageshwar Reddy
Intest Res 2019;17(4):486-495.   Published online August 6, 2019
DOI: https://doi.org/10.5217/ir.2018.00174
AbstractAbstract PDFPubReaderePub
Background/Aims
Information about familial aggregation of inflammatory bowel disease (IBD) in Asia is limited. We aimed to analyze the prevalence and risk of familial IBD in an Indian cohort and compare familial and sporadic cases.
Methods
Familial IBD cases were identified from a large prospectively maintained IBD registry. The prevalence of IBD in first- and seconddegree relatives of index cases was evaluated. The disease behavior was compared to that of sporadic cases.
Results
Total 3,553 patients (ulcerative colitis [UC], 2,053; Crohn’s disease [CD], 1,500) were included. Familial IBD was noted in 4.13% of CD and 4.34% of UC patients. Family history was commoner in pediatric group (< 18 years) (P= 0.0002; odds ratio [OR], 2.8; 95% confidence interval [CI], 1.6–4.8). Majority had paternal transmission (UC, 67.42%; CD, 70.97%). Concordance of disease type was higher in UC (79.7%) compared to CD (37.1%). Familial IBD was associated with higher cumulative relapse rate (CD, P< 0.001; UC, P< 0.001), higher cumulative rate of surgery (CD, P< 0.001; UC, P< 0.001) and higher rate of biologic use (CD, P= 0.010; UC, P= 0.015). Pan-colitis was higher in familial UC (P= 0.003; OR, 1.935; 95% CI, 1.248–3.000). Fistulizing disease was commoner in familial CD (P= 0.041; OR, 2.044; 95% CI, 1.030–4.056).
Conclusions
The prevalence of familial IBD in India appears comparable to rest of Asia but lower than the West. It is associated with a younger age of onset, higher incidence of pan-colitis in UC and fistulizing complications in CD. Familial IBD has higher cumulative relapse, surgery and biologic use rates. Hence, family history of IBD could have important prognostic implications.

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Inflammatory bowel diseases
Tacrolimus for ulcerative colitis in children: a multicenter survey in Japan
Tadahiro Yanagi, Kosuke Ushijima, Hidenobu Koga, Takeshi Tomomasa, Hitoshi Tajiri, Reiko Kunisaki, Takashi Isihige, Hiroyuki Yamada, Katsuhiro Arai, Atsushi Yoden, Tomoki Aomatsu, Satoru Nagata, Keiichi Uchida, Yoshikazu Ohtsuka, Toshiaki Shimizu
Intest Res 2019;17(4):476-485.   Published online August 31, 2019
DOI: https://doi.org/10.5217/ir.2019.00027
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
Tacrolimus is effective for refractory ulcerative colitis in adults, while data for children is sparse. We aimed to evaluate the effectiveness and safety of tacrolimus for induction and maintenance therapy in Japanese children with ulcerative colitis.
Methods
We retrospectively reviewed the multicenter survey data of 67 patients with ulcerative colitis aged < 17 years treated with tacrolimus between 2000 and 2012. Patients’ characteristics, disease activity, Pediatric Ulcerative Colitis Activity Index (PUCAI) score, initial oral tacrolimus dose, short-term (2-week) and long-term (1-year) outcomes, steroid-sparing effects, and adverse events were evaluated. Clinical remission was defined as a PUCAI score < 10; treatment response was defined as a PUCAI score reduction of ≥ 20 points compared with baseline.
Results
Patients included 35 boys and 32 girls (median [interquartile range] at admission: 13 [11–15] years). Thirty-nine patients were steroid-dependent and 26 were steroidrefractory; 20 had severe colitis and 43 had moderate colitis. The initial tacrolimus dose was 0.09 mg/kg/day (range, 0.05–0.12 mg/kg/day). The short-term clinical remission rate was 47.8%, and the clinical response rate was 37.3%. The mean prednisolone dose was reduced from 19.2 mg/day at tacrolimus initiation to 5.7 mg/day at week 8 (P< 0.001). The adverse event rate was 53.7%; 6 patients required discontinuation of tacrolimus therapy.
Conclusions
Tacrolimus was a safe and effective second-line induction therapy for steroid-dependent and steroid-refractory ulcerative colitis in Japanese children.

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    You Sun Kim
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  • Tacrolimus in pediatric ulcerative colitis: does it have a role?
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  • 10 Web of Science
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Focused Reviews
IBD
Nutritional approach as therapeutic manipulation in inflammatory bowel disease
Jin Young Yoon
Intest Res 2019;17(4):463-475.   Published online October 28, 2019
DOI: https://doi.org/10.5217/ir.2019.00078
AbstractAbstract PDFPubReaderePub
Malnutrition is observed more frequently in patients with inflammatory bowel disease (IBD) than in the general population and associated with adverse clinical outcomes. This study aimed to review the current knowledge regarding the efficacy of dietary and nutritional intervention in IBD patients. Exclusive enteral nutrition might be inferior to corticosteroid treatment in adults with active Crohn’s disease (CD) but might even be superior considering the adverse effects of corticosteroid treatment in children. Total parenteral nutrition has no advantage over enteral nutrition, which is considered a more physiologic modality in organ function. Current guidelines do not yet recommend ω3-polyunsaturated fatty acid supplementation for the prevention and maintenance of remission in IBD patients. Dietary fiber supplementation could be effective in the relief of symptoms and maintenance of remission in ulcerative colitis (UC). Although vitamin D may be favorable to clinical course of IBD and bone density. Probiotic supplementation has proven to be effective in preventing and treating pouchitis for UC but is less effective in treating CD. Nutritional interventions not only correct nutritional deficiencies but also improve symptoms and clinical courses of the disease. Hence, nutritional approaches need to be developed to significantly evaluate the effectiveness of dietary interventions used to treat IBD.

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  • 233 Download
  • 7 Web of Science
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Colorectal neoplasia
Nutritional issues in patients with cancer
Duk Hwan Kim
Intest Res 2019;17(4):455-462.   Published online October 14, 2019
DOI: https://doi.org/10.5217/ir.2019.00076
AbstractAbstract PDFPubReaderePub
Cancer is a catabolic inflammatory disease that causes patients to often experience weight loss, or even cachexia in severe cases. Undernourishment in patients with cancer impairs the quality of life and therapeutic response, further leading to poor prognosis. Active and frequent nutritional screening and assessment using valid tools are important for fast and appropriate nutritional intervention. Additionally, a suitable individualized nutritional intervention strategy should be established based on the nutritional assessment result. In general, nutritional intervention begins with nutritional counseling of patients diagnosed with cancer, and a well-planned nutritional counseling improves the treatment adherence and nutritional status. When planning nutritional supplementation for cancer patients, specific nutrients, including amino acids and fatty acids, should be considered. However, there has been no consistent result showing that any particular nutrient significantly improves the prognosis of cancer patients. Hence, continuous attention from clinical physicians is needed to plan nutritional improvement in patients with cancer.

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Microbiota
Importance of nutritional therapy in the management of intestinal diseases: beyond energy and nutrient supply
Seong-Eun Kim
Intest Res 2019;17(4):443-454.   Published online September 4, 2019
DOI: https://doi.org/10.5217/ir.2019.00075
AbstractAbstract PDFPubReaderePub
The gut is an immune-microbiome-epithelial complex. Gut microbiome-host interactions have widespread biological implications, and the role of this complex system extends beyond the digestion of food and nutrient absorption. Dietary nutrients can affect this complex and play a key role in determining gut homeostasis to maintain host health. In this article, we review various dietary nutrients and their contribution to the pathogenesis and treatment of various intestinal diseases including inflammatory bowel disease, irritable bowel syndrome, colorectal cancer, and diverticulitis, among other such disorders. A better understanding of diet-host-gut microbiome interactions is essential to provide beneficial nutrients for gut health and to limit nutritional hazards to ensure successful nutritional management of gastrointestinal conditions in clinical practice.

Citations

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  • 403 Download
  • 7 Web of Science
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Editorial
IBD
Tacrolimus in pediatric ulcerative colitis: does it have a role?
Seung Kim
Intest Res 2019;17(4):441-442.   Published online October 28, 2019
DOI: https://doi.org/10.5217/ir.2019.00124
PDFPubReaderePub
  • 4,745 View
  • 106 Download
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Images of the Issue
IBD
A pulmonary nodule in a patient with Crohn’s disease
Akira Hokama, Shusaku Haranaga, Takanobu Sasaki, Hirofumi Matsumoto, Tetsuya Ohira, Atsushi Iraha, Tetsu Kinjo, Saifun Nahar, Jiro Fujita
Intest Res 2019;17(3):438-439.   Published online February 11, 2019
DOI: https://doi.org/10.5217/ir.2019.00010
PDFPubReaderePub
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Brief Communication
Miscellaneous
Fecal microbiota transplant via colonoscopy may be preferred due to intraprocedure findings
Janice M. Cho, Laura Pestana, Ryan Pardi, Darrell S. Pardi, Sahil Khanna
Intest Res 2019;17(3):434-437.   Published online May 31, 2019
DOI: https://doi.org/10.5217/ir.2019.00056
PDFPubReaderePub

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  • Retrospective subgroup analysis of fecal microbiota, live-jslm (REBYOTA®) administered by colonoscopy under enforcement discretion for the prevention of recurrent Clostridioides difficile infection
    Whitfield L. Knapple, David S. Yoho, Alexander Sheh, Joan Thul, Paul Feuerstadt
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    Raseen Tariq, Molly B Disbrow, John K Dibaise, Robert Orenstein, Srishti Saha, Dipesh Solanky, Edward V Loftus, Darrell S Pardi, Sahil Khanna
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    Niloufar Roshan, Annabel K. Clancy, Thomas J. Borody
    Infectious Diseases and Therapy.2020; 9(4): 935.     CrossRef
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