Intestinal Research

Original Article

IBD

Effects of COVID-19 vaccines on patient-reported outcomes in patients with inflammatory bowel disease: a multicenter survey study in Korea: Jung Hyun Ji, Seung Hwan Shin, Yong Eun Park, Jihye Park, Jae Jun Park, Jae Hee Cheon, Tae Il Kim, Sang-Bum Kang, Sang Hyoung Park, Soo Jung Park, IBD Research Group of the Korean Association for the Study of Intestinal Diseases (KASID); Intest Res 2024;22(3):336-350. Published online March 26, 2024; DOI: https://doi.org/10.5217/ir.2023.00077

Abstract PDF PubReader ePub: Background/Aims
The impact of vaccination on inflammatory bowel disease (IBD) patients is still unknown, and no studies have assessed the changes in patient-reported outcomes (PROs) after vaccination in patients with IBD. Therefore, in this study, we investigated the impact of vaccines on the PROs of patients with IBD.
Methods
We conducted a questionnaire survey of patients with IBD who visited outpatient clinics at 4 specialized IBD clinics of referral university hospitals from April 2022 to June 2022. A total of 309 IBD patients were included in the study. Patient information was collected from a questionnaire and their medical records, including laboratory findings, were reviewed retrospectively. Risk factors associated with an increase in PROs after COVID-19 vaccination were analyzed using logistic regression analyses. In addition, we assessed whether there were differences in variables by vaccine order using the linear mixed model.
Results
In multivariate analysis, young age ( < 40 years) and ulcerative colitis (UC) were found to be independent risk factors for aggravation of PROs in patients with IBD. In all patients, platelet count significantly increased with continued vaccination in multiple pairwise comparisons. In UC patients, PROs such as the short health scale, UC-abdominal signs and symptoms, and UC-bowel signs and symptoms were aggravated significantly with continued vaccination. There was no significant increase in the variables of patients with Crohn’s disease.
Conclusions
Therefore, there may be a need to counsel patients with IBD younger than 40 years of age, and patients with UC before they receive COVID-19 vaccinations.

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Review

Colorectal neoplasia

Screening and surveillance for hereditary colorectal cancer: Hee Man Kim, Tae Il Kim; Intest Res 2024;22(2):119-130. Published online February 6, 2024; DOI: https://doi.org/10.5217/ir.2023.00112

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Hereditary colorectal cancer is a type of cancer that is caused by a genetic mutation. Individuals with a family history of colorectal cancer, or who have a known hereditary syndrome, are at an increased risk of developing the disease. Screening and surveillance are important tools for managing the risk of hereditary colorectal cancer. Screening involves a combination of tests that can detect precancerous or cancerous changes in the colon and rectum. Surveillance involves regular follow-up examinations to monitor disease progression and to identify new developments. The frequency and type of screening and surveillance tests may vary depending on an individual’s risk factors, genetic profile, and medical history. However, early detection and treatment of hereditary colorectal cancer can significantly improve patient outcomes and reduce mortality rates. By implementing comprehensive screening and surveillance strategies, healthcare providers can help individuals at risk of hereditary colorectal cancer to receive timely interventions and make informed decisions about their health. Specific examples of screening and surveillance tests for hereditary colorectal cancer include colonoscopy, genetic testing, and imaging tests. In this review article, we will discuss detailed screening and surveillance of hereditary colorectal cancer.

Citations

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Efficacy of Oral Sulfate Tablet and 2 L-Polyethylene Glycol with Ascorbic Acid for Bowel Preparation: A Prospective Randomized KASID Multicenter Trial
Yunho Jung, Hyun Gun Kim, Dong-Hoon Yang, Hyoun Woo Kang, Jae Jun Park, Dong Hoon Baek, Jaeyoung Chun, Tae-Geun Gweon, Hyeon Jeong Goong, Min Seob Kwak, Hyun Jung Lee, Soo-Kyung Park, Jong Hoon Lee
Journal of Korean Medical Science.2024;[Epub] CrossRef

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Original Articles

Colorectal neoplasia

Clinical characteristics and risk factors related to polyposis recurrence and advanced neoplasm development among patients with non-hereditary colorectal polyposis: Jihun Jang, Jihye Park, Soo Jung Park, Jae Jun Park, Jae Hee Cheon, Tae Il Kim; Intest Res 2023;21(4):510-517. Published online May 31, 2023; DOI: https://doi.org/10.5217/ir.2022.00139

Abstract PDF PubReader ePub

Background/Aims
Patients with more than 10 cumulative polyps might involve a greater genetic risk of colorectal neoplasia development. However, few studies have investigated the risk factors of polyposis recurrence and development of advanced neoplasms among patients with non-hereditary colorectal polyposis.
Methods
This study included patients (n=855) with 10 or more cumulative polyps diagnosed at Severance Hospital from January 2012 to September 2021. Patients with known genetic mutations related to polyposis, known hereditary polyposis syndromes, insufficient information, total colectomy, and less than 3 years of follow-up were excluded. Finally, 169 patients were included for analysis. We collected clinical data, including colonoscopy surveillance results, and performed Cox regression analyses of risk factors for polyposis recurrence and advanced neoplasm development.
Results
The 169 patients were predominantly male (84.02%), with a mean age of 64.19±9.92 years. The mean number of adenomas on index colonoscopy was 15.33±8.47. Multivariable analysis revealed history of cancer except colon cancer (hazard ratio [HR], 2.23; 95% confidence interval [CI], 1.23–4.01), current smoking (HR, 2.39; 95% CI, 1.17–4.87), and detection of many polyps (≥15) on index colonoscopy (HR, 2.05; 95% CI, 1.21–3.50) were significant risk factors for recurrence of polyposis. We found no statistically significant risk factors for advanced neoplasm development during surveillance among our cohort.
Conclusions
The presence of many polyps (≥15) on index colonoscopy, history of cancer except colon cancer, and current smoking state were significant risk factors for polyposis recurrence among patients with non-hereditary colorectal polyposis.

Citations

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Screening and surveillance for hereditary colorectal cancer
Hee Man Kim, Tae Il Kim
Intestinal Research.2024; 22(2): 119. 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

Abstract PDF Supplementary Material PubReader ePub

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.

Citations

Citations to this article as recorded by

Outcomes of dietary management approaches in active ulcerative colitis: A systematic review
Abigail Marsh, Sophie Rindfleish, Kalina Bennett, Anthony Croft, Veronique Chachay
Clinical Nutrition.2022; 41(2): 298. CrossRef
Effect of Ramadan intermittent fasting on inflammatory markers, disease severity, depression, and quality of life in patients with inflammatory bowel diseases: A prospective cohort study
Mohamed Negm, Ahmed Bahaa, Ahmed Farrag, Rania M. Lithy, Hedy A. Badary, Mahmoud Essam, Shimaa Kamel, Mohamed Sakr, Waleed Abd El Aaty, Mostafa Shamkh, Ahmed Basiony, Ibrahim Dawoud, Hany Shehab
BMC Gastroenterology.2022;[Epub] CrossRef
Circadian Influences of Diet on the Microbiome and Immunity
Danping Zheng, Karina Ratiner, Eran Elinav
Trends in Immunology.2020; 41(6): 512. CrossRef

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Brief Communication

Endoscopy

Probe-based confocal laser endomicroscopy in the differential diagnosis of inflammatory bowel diseases: a case series: Jung Won Park, Tae Il Kim, Jae Hee Cheon; Intest Res 2018;16(4):641-645. Published online October 10, 2018; DOI: https://doi.org/10.5217/ir.2018.00035

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Original Article

IBD

Magnetic resonance enterography predicts the prognosis of Crohn's disease: Ji Hoon Lee, Yong Eun Park, Nieun Seo, Hyun Jung Lee, Soo Jung Park, Tae Il Kim, Won Ho Kim, Joon Seok Lim, Jae Hee Cheon; Intest Res 2018;16(3):445-457. Published online July 27, 2018; DOI: https://doi.org/10.5217/ir.2018.16.3.445

Abstract PDF PubReader ePub

Background/Aims

Magnetic resonance enterography (MRE) has emerged as an important tool in the diagnosis and follow-up of Crohn's disease (CD). The aim of this study was to evaluate whether MRE findings could predict the prognosis of CD.

Methods

In this retrospective study, a total of 173 patients with clinical remission of CD (n=61) or active CD (n=112) were identified. The outcomes of clinical relapse, admission, surgery, and need for other medications according to the MRE findings were evaluated.

Results

The presence of active inflammation on MRE was observed in 93 (83%) patients with clinically active CD and in 44 (72.1%) patients with clinical remission of CD, without a statistically significant difference (P=0.091). In multivariate analysis, active inflammation on MRE increased the risk for clinical relapse (hazard ratio [HR], 6.985; 95% confidence interval [CI], 1.024–47.649) in patients with clinical remission of CD. In patients with clinically active CD, active inflammation on MRE increased the risk for CD-related hospitalization (HR, 2.970; 95% CI, 1.006–8.772).

Conclusions

The presence of active inflammation on MRE was significantly associated with poor prognosis both in patients with clinical remission of CD and in those with active CD.

Citations

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The Spectrum of Magnetic Resonance Enterography Findings and the Role of Diffusion-Weighted Imaging in Patients with Active Crohn’s Disease
Arvin Arian, Ghazal Roostaei, Seyede Sahel Rasoulighasemlouei, Foroogh Alborzi Avanaki, Nasser Ebrahimi Daryani
Middle East Journal of Digestive Diseases.2024; 16(1): 23. CrossRef
Distribution of small bowel involvement and its association with clinical outcomes in patients with Crohn’s disease
Jin Park, Hae Young Kim, Yoon Jin Lee, Hyuk Yoon, Cheol Min Shin, Young Soo Park, Nayoung Kim, Dong Ho Lee
Medicine.2023; 102(40): e35040. CrossRef
Combined Endoscopic and Radiologic Healing Is Associated With a Better Prognosis Than Endoscopic Healing Only in Patients With Crohn's Disease Receiving Anti-TNF Therapy
Kyunghwan Oh, Eun Hye Oh, Soo Min Noh, Seong Ho Park, Nayoung Kim, Sung Wook Hwang, Sang Hyoung Park, Dong-Hoon Yang, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Byong Duk Ye
Clinical and Translational Gastroenterology.2022; 13(1): e00442. CrossRef
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Giuseppe Cicero, Silvio Mazziotti
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Eléonore Hallé, Mustapha Azahaf, Nicolas Duveau, Thomas Lambin, Maria Nachury, Julien Branche, Romain Gérard, Clémentine Lauriot Dit Prevost, Pauline Wils, Pierre Desreumaux, Olivier Ernst, Benjamin Pariente
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Hyun Seok Lee, Yun Jeong Lim, Jin-Hee Jung, Ji Hyung Nam, Junseok Park, Sun Hyung Kang, Ki Bae Kim, Hoon Jai Chun
Gastroenterology Research and Practice.2020; 2020: 1. CrossRef
Beyond Crohn Disease
Michael S. Furman, Edward Y. Lee
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Salvatore Cucchiara, Giulia D’Arcangelo, Sara Isoldi, Marina Aloi, Laura Stronati
Expert Review of Gastroenterology & Hepatology.2020; 14(5): 335. CrossRef
Changes in the Management of Patients with Crohn’s Disease Based on Magnetic Resonance Enterography Patterns
Evelyn Sayuri S. Chinem, Barbara C. Esberard, Andre da L. Moreira, Tatiana G. Barbassa, Guilherme M. da Cunha, Antonio Jose de V. Carneiro, Heitor S. de Souza, Ana Teresa P. Carvalho
Gastroenterology Research and Practice.2019; 2019: 1. CrossRef

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Focused Review: Colorectal Cancer

Colorectal neoplasia

Serrated neoplasia pathway as an alternative route of colorectal cancer carcinogenesis: Soon Young Kim, Tae Il Kim; Intest Res 2018;16(3):358-365. Published online July 27, 2018; DOI: https://doi.org/10.5217/ir.2018.16.3.358

Abstract PDF PubReader ePub

In the past two decades, besides conventional adenoma pathway, a subset of colonic lesions, including hyperplastic polyps, sessile serrated adenoma/polyps, and traditional serrated adenomas have been suggested as precancerous lesions via the alternative serrated neoplasia pathway. Major molecular alterations of sessile serrated neoplasia include BRAF mutation, high CpG island methylator phenotype, and escape of cellular senescence and progression via methylation of tumor suppressor genes or mismatch repair genes. With increasing information of the morphologic and molecular features of serrated lesions, one major challenge is how to reflect this knowledge in clinical practice, such as pathologic and endoscopic diagnosis, and guidelines for treatment and surveillance.

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Carol Rouphael, Jessica El Halabi, James Bena, John McMichael, Carol A. Burke
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Serum DNA methylome of the colorectal cancer serrated pathway enables non‐invasive detection
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Different modifiable risk factors for the development of non-advanced adenoma, advanced adenomatous lesion, and sessile serrated lesions, on screening colonoscopy
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Scientific Reports.2024;[Epub] CrossRef
Accuracy and Inter-observer Agreement Among Endoscopists for Visual Identification of Colorectal Polyps Using Endoscopy Images
Thi Khuc, Amol Agarwal, Feng Li, Sergey Kantsevoy, Bryan Curtin, Matilda Hagan, Mary Harris, Anurag Maheshwari, Amit Raina, Elinor Zhou, Paul Thuluvath
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Indian Journal of Pathology and Oncology.2023; 10(4): 332. CrossRef
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Journal of Clinical Pathology.2021; 74(11): 712. CrossRef
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Virchows Archiv.2021; 478(5): 915. CrossRef
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Brief Communication

Miscellaneous

Efficacy and tolerability of methotrexate therapy for refractory intestinal Behçet's disease: a single center experience: Jihye Park, Jae Hee Cheon, Yehyun Park, Soo Jung Park, Tae Il Kim, Won Ho Kim; Intest Res 2018;16(2):315-318. Published online April 30, 2018; DOI: https://doi.org/10.5217/ir.2018.16.2.315

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Citations

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Behçet's syndrome
Giacomo Emmi, Alessandra Bettiol, Gülen Hatemi, Domenico Prisco
The Lancet.2024; 403(10431): 1093. CrossRef
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Yesim Ozguler, Sinem Nihal Esatoglu, Gulen Hatemi
Expert Opinion on Pharmacotherapy.2023; 24(2): 221. CrossRef
Treatment Options in Pediatric Behçet’s Disease
Teresa Giani, Angela Flavia Luppino, Giovanna Ferrara
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Jae Hee Cheon
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Lactobacillus plantarum CBT LP3 ameliorates colitis via modulating T cells in mice
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Successful combination therapy using adalimumab and 5-aminosalicylic acid for a resistant case of intestinal Behçet’s disease
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Original Articles

Accuracy of three different fecal calprotectin tests in the diagnosis of inflammatory bowel disease: Hui Won Jang, Hyun Sook Kim, Soo Jung Park, Sung Pil Hong, Tae Il Kim, Won Ho Kim, Jae Hee Cheon; Intest Res 2016;14(4):305-313. Published online October 17, 2016; DOI: https://doi.org/10.5217/ir.2016.14.4.305

Abstract PDF PubReader

Background/Aims

Several studies have found that the measurement of fecal calprotectin is useful for the early diagnosis of inflammatory bowel disease (IBD). We compared the effectiveness of three different fecal calprotectin kits for initial diagnosis in patients with suspected IBD.

Methods

We enrolled 31 patients with IBD (18 Crohn's disease [CD], 11 ulcerative colitis [UC], and two intestinal Behçet's disease), five with irritable bowel syndrome (IBS), and five with other colitis (four infectious colitis and one intestinal tuberculosis). Diagnosis was based on clinical, laboratory, and endoscopic examinations. Fecal samples were obtained at the first diagnosis and calprotectin levels were measured using three different kits (Quantum Blue® Calprotectin, EliA™ Calprotectin, and RIDASCREEN® Calprotectin).

Results

The overall accuracy for differentiating IBD from IBS or other colitis was 94% and 91%, respectively, for Quantum Blue® (cutoff, 50 µg/g); 92% and 89%, respectively, for EliA™ (cutoff, 50 µg/g); and 82% and 76%, respectively, for RIDASCREEN® (cutoff, 50 µg/g). In patients with CD, the results of Quantum Blue® Calprotectin and EliA™ Calprotectin correlated significantly with levels of the Crohn's disease activity index (Spearman's rank correlation coefficient, r=0.66 and r=0.49, respectively). In patients with UC, the results of EliA™ Calprotectin correlated significantly with the Mayo score (r=0.70).

Conclusions

Fecal calprotectin measurement is useful for the identification of IBD. The overall accuracies of the three fecal calprotectin kits are comparable.

Citations

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Sujia Liu, Yongle Liu, Shuhua Lai, Yingling Xie, Wenlong Xiu, Changyi Yang
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Yujin Jeong, Seong Ran Jeon, Hyun Gun Kim, Jung Rock Moon, Tae Hee Lee, Jae Young Jang, Jun-Hyung Cho, Jun Seok Park, Heesu Park, Ki-hun Lee, Jin-Oh Kim, Joon Seong Lee, Bong Min Ko, Suyeon Park
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Jong-Mi Lee, Joo Hee Jang, Ji Hyeong Ryu, Jaeeun Yoo, Bo-In Lee, Seung-Jun Kim, Eun-Jee Oh, Hsu-Heng Yen
PLOS ONE.2021; 16(8): e0255974. CrossRef
Endoscopy within 7 days after detecting high calprotectin levels can be useful for therapeutic decision-making in ulcerative colitis
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Christopher Ma, Robert Battat, Claire E. Parker, Reena Khanna, Vipul Jairath, Brian Gordon Feagan
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Parambir S. Dulai, Laurent Peyrin-Biroulet, Silvio Danese, Bruce E. Sands, Axel Dignass, Dan Turner, Gerassimos Mantzaris, Juergen Schölmerich, Jean-Yves Mary, Walter Reinisch, William J. Sandborn
Gastroenterology.2019; 157(4): 1032. CrossRef
Faecal calprotectin to detect inflammatory bowel disease: a systematic review and exploratory meta-analysis of test accuracy
Karoline Freeman, Brian H Willis, Hannah Fraser, Sian Taylor-Phillips, Aileen Clarke
BMJ Open.2019; 9(3): e027428. CrossRef
Extraction, isolation, and concentration of calprotectin antigen (S100A8/S100A9) from granulocytes
Tom Nilsen, Siri Helen Haugen, Anders Larsson
Health Science Reports.2018;[Epub] CrossRef
Fecal Immunochemical Test and Fecal Calprotectin Measurement Are Noninvasive Monitoring Tools for Predicting Endoscopic Activity in Patients with Ulcerative Colitis
Ji Young Chang, Jae Hee Cheon
Gut and Liver.2018; 12(2): 117. CrossRef
Fecal calprotectin is not superior to serum C-reactive protein or the Harvey–Bradshaw index in predicting postoperative endoscopic recurrence in Crohn’s disease
Cristina Verdejo, Daniel Hervías, Óscar Roncero, Ángel Arias, Abdelmouneim Bouhmidi, Rufo Lorente, Irina Salueña, Alfredo J. Lucendo
European Journal of Gastroenterology & Hepatology.2018; 30(12): 1521. CrossRef
Experience of patients with inflammatory bowel disease in using a home fecal calprotectin test as an objective reported outcome for self-monitoring
Shu-Chen Wei, Chien-Chih Tung, Meng-Tzu Weng, Jau-Min Wong
Intestinal Research.2018; 16(4): 546. CrossRef
Serum Adipocytokine Levels as Surrogate Markers for Disease Activity of Crohn’s Disease
Su Hwan Kim, Seung Hyeon Jang, Ji Won Kim, Byeong Gwan Kim, Kook Lae Lee, You Sun Kim, Dong Soo Han, Joo Sung Kim
The American Journal of the Medical Sciences.2017; 353(5): 439. CrossRef
Fecal biomarkers in inflammatory bowel disease: how, when and why?
Paula Ministro, Diana Martins
Expert Review of Gastroenterology & Hepatology.2017; 11(4): 317. CrossRef
Could fecal calprotectin enter mainstream use for diagnosing and monitoring inflammatory bowel disease?
Shu Chen Wei
Intestinal Research.2016; 14(4): 293. CrossRef

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Vaccination and Complementary and Alternative Medicine in Patients with Inflammatory Bowel Disease: Sung Bae Kim, Soo Jung Park, Sook Hee Chung, Kyu Yeon Hahn, Do Chang Moon, Sung Pil Hong, Jae Hee Cheon, Tae Il Kim, Won Ho Kim; Intest Res 2014;12(2):124-130. Published online April 29, 2014; DOI: https://doi.org/10.5217/ir.2014.12.2.124

Abstract PDF PubReader

Background/Aims

Vaccinations in patients with inflammatory bowel disease (IBD) are recommended to prevent infectious diseases. However, there are few reports of vaccination in IBD patients in Korea. The frequency of complementary and alternative medicine (CAM) use is high despite its uncertain effectiveness. This study aimed to identify the rates of vaccination and use of CAM in patients with IBD.

Methods

A total of 219 patients attended an education session for IBD patients held at Severance Hospital on March 23, 2013. We conducted a survey on vaccination and CAM use in IBD patients; 120 patients completed the questionnaire.

Results

The influenza vaccination rate was 44.2% and pneumococcal vaccination rate was 4.2%. Thirty-one (66%) patients were aware of the importance of vaccination. The vaccination rate was higher in patients who were aware of the importance of vaccination compared with that in patients who were unaware of the importance of vaccination (70.1% vs. 41.7%, P=0.004). The rate of CAM use was 30.0%. The most commonly used CAMs were oral products: vitamins (33.3%), red ginseng (25.0%), and probiotics (19.4%).

Conclusions

Awareness of the importance of vaccination and actual vaccination rates were low in IBD patients. Despite insufficient evidence on the effectiveness of CAMs in IBD patients, many patients used CAMs. We believe that repeated education and promotion of vaccination are important. Further large-scale studies to investigate the efficacy and safety of CAMs are warranted in patients with IBD.

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Factors associated with the prescription of probiotics in patients with inflammatory bowel disease: a cross-sectional study
Joo Kyung Kim, Jae Hee Cheon
Journal of Yeungnam Medical Science.2023; 40(1): 37. CrossRef
Adherence to Recommended Immunization Schedules in Patients with Inflammatory Bowel Disease on Biologics and Small Molecule Therapies
Mohammad Shehab, Ranim Almatar, Rawan Almohammad, Ahmad Alfadhli
Gastroenterology Insights.2023; 14(3): 383. CrossRef
SARS-CoV-2 vaccination for adult patients with inflammatory bowel disease: expert consensus statement by KASID
Yoo Jin Lee, Seong-Eun Kim, Yong Eun Park, Ji Young Chang, Hyun Joo Song, Duk Hwan Kim, Young Joo Yang, Byung Chang Kim, Jae Gon Lee, Hee Chan Yang, Miyoung Choi, Seung-Jae Myung
Intestinal Research.2022; 20(2): 171. CrossRef
Vaccinations and inflammatory bowel disease – a systematic review
Webber Chan, Ennaliza Salazar, Teong Guan Lim, Wan Chee Ong, Hang Hock Shim
Digestive and Liver Disease.2021; 53(9): 1079. CrossRef
SARS-CoV-2 Vaccination for Adult Patients with Inflammatory Bowel Disease: Expert Consensus Statements by KASID
Yoo Jin Lee, Seong-Eun Kim, Yong Eun Park, Ji Young Chang, Hyun Joo Song, Duk Hwan Kim, Young Joo Yang, Byung Chang Kim, Jae Gon Lee, Hee Chan Yang, Miyoung Choi, Seung-Jae Myung
The Korean Journal of Gastroenterology.2021; 78(2): 117. CrossRef
A recent update on the use of Chinese medicine in the treatment of inflammatory bowel disease
Lin Yang, Hua Luo, Dechao Tan, Siyuan Zhang, Zhangfeng Zhong, Shengpeng Wang, Chi Teng Vong, Yitao Wang
Phytomedicine.2021; 92: 153709. CrossRef
Insufficient vaccination and inadequate immunization rates among Korean patients with inflammatory bowel diseases
Han Hee Ryu, Kiju Chang, Nayoung Kim, Ho-Su Lee, Sung Wook Hwang, Sang Hyoung Park, Dong-Hoon Yang, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Byong Duk Ye
Medicine.2021; 100(45): e27714. CrossRef
Complementary and alternative medicine in patients with inflammatory bowel disease: hype or evidence?
Jae Myung Cha
Intestinal Research.2020; 18(2): 141. CrossRef
Complementary and Alternative Medicine Use in Children With Inflammatory Bowel Disease
Uma P. Phatak, Arik Alper, Dinesh S. Pashankar
Journal of Pediatric Gastroenterology and Nutrition.2019; 68(2): 157. CrossRef
Prevalence and indicators of use of complementary and alternative medicine in Austrian patients with inflammatory bowel disease
Hans Peter Gröchenig, Thomas Waldhör, Thomas Haas, Heimo Wenzl, Pius Steiner, Robert Koch, Thomas Feichtenschlager, Gerald Eckhardt, Andreas Mayer, Andreas Kirchgatterer, Othmar Ludwiczek, Reingard Platzer, Pavol Papay, Johanna Gartner, Harry Fuchssteiner
European Journal of Gastroenterology & Hepatology.2019; 31(10): 1211. CrossRef
The who-when-why triangle of complementary and alternative medicine use among Portuguese IBD patients
Francisco Portela, Camila C. Dias, Paulo Caldeira, Marilia Cravo, João Deus, Raquel Gonçalves, Paula Lago, Henrique Morna, Paula Peixe, Jaime Ramos, Helena Sousa, Lurdes Tavares, Helena Vasconcelos, Fernando Magro, Paula Ministro
Digestive and Liver Disease.2017; 49(4): 388. CrossRef
Chlorogenic acid suppresses lipopolysaccharide-induced nitric oxide and interleukin-1β expression by inhibiting JAK2/STAT3 activation in RAW264.7 cells
Sang-Hun Kim, Sun-Young Park, Young-Lan Park, Dae-Seong Myung, Jong-Sun Rew, Young-Eun Joo
Molecular Medicine Reports.2017; 16(6): 9224. CrossRef
Vaccination in Inflammatory Bowel Disease Patients: Attitudes, Knowledge, and Uptake
Gurtej Malhi, Amir Rumman, Reka Thanabalan, Kenneth Croitoru, Mark S. Silverberg, A. Hillary Steinhart, Geoffrey C. Nguyen
Journal of Crohn's and Colitis.2015; 9(6): 439. CrossRef
Ideal Vaccination Strategy in Inflammatory Bowel Disease
Chang Kyun Lee
The Korean Journal of Gastroenterology.2015; 65(3): 159. CrossRef

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Clinical Practice of Surveillance Colonoscopy according to the Classification of Colorectal Intraepithelial Neoplasia in Korea: High-grade Dysplasia/Carcinoma In Situ Versus Intramucosal Carcinoma: Sung Pil Hong, Tae Il Kim, Hyun Gun Kim, Hyun-Soo Kim, Seong-Eun Kim, Kyu Chan Huh, Jeong Eun Shin, Jae Myung Cha, Suck-Ho Lee, Intestinal Tumor Research Group, Korean Association for the Study of the Intestinal Disease; Intest Res 2013;11(4):276-282. Published online October 30, 2013; DOI: https://doi.org/10.5217/ir.2013.11.4.276

Abstract PDF

Background/Aims
Recent guidelines strongly recommend that the interval of surveillance colonoscopy be determined according to the risk stratification obtained at index colonoscopy. However, because of the differences in perception of the classification of colorectal intraepithelial neoplasia between Asian and Western countries, there is some confusion about surveillance colonoscopy. The aim of the present study was to evaluate the clinicopathological characteristics and the interval of surveillance colonoscopy between patients with high-grade dysplasia/carcinoma in situ and those with intramucosal carcinoma. Methods: From January 2003 to June 2010, 727 patients were included from 8 tertiary centers. Four hundred fifteen patients (57.1%) had high-grade dysplasia /carcinoma in situ (group A), and 312 (43.9%) had intramucosal carcinoma (group B). Clinicopathological data were reviewed retrospectively. Results: Group A had a significantly more frequent family history of colorectal cancer (3.1% vs. 0.6%, P<0.001), smaller polyp size (12 mm vs. 15 mm, P=0.001), and more proximal location (31.1% vs. 21.8%, P=0.005) than did group B. Among 727 patients, surveillance colonoscopy was performed within 6 months in 55.8% of patients and within 12 months in 77.8%. Group B had a significantly shorter interval of surveillance colonoscopy than did group A (P<0.001). There was no difference in detection of advanced neoplasia at surveillance colonoscopy between the 2 groups (6.6% vs. 5.4%, P=0.638). Conclusions: The recommended interval of surveillance colonoscopy is not followed in Korea. More education about post-polypectomy surveillance guidelines is required. (Intest Res 2013;11:276-282)

Citations

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Risk of developing advanced colorectal neoplasia after removing high‐risk adenoma detected at index colonoscopy in young patients: A KASID study
Soo‐Kyung Park, Nam Hee Kim, Yoon Suk Jung, Won Hee Kim, Chang Soo Eun, Bong Min Ko, Geom Seog Seo, Jae Myung Cha, Jae Jun Park, Kyeong Ok Kim, Chang Mo Moon, Yoonho Jung, Eun Soo Kim, Seong Ran Jeon, Chang Kyun Lee, Dong Il Park
Journal of Gastroenterology and Hepatology.2016; 31(1): 138. CrossRef
The Risk of Metachronous Advanced Colorectal Neoplasia Rises in Parallel with an Increasing Number of High-Risk Findings at Baseline
Seung Min Lee, Jeong Hwan Kim, In Kyung Sung, Sung Noh Hong
Gut and Liver.2015; 9(6): 741. CrossRef
Colonic Chicken Skin Mucosa is an Independent Endoscopic Predictor of Advanced Colorectal Adenoma
Eun Ju Chung, Ji Young Lee, Jaewon Choe, Hye-Sook Chang, Jongcheol Kim, Dong Hoon Yang, Byong Duk Ye, Jeong-Sik Byeon, Kyung-Jo Kim, Suk-Kyun Yang, Jin-Ho Kim, Seung-Jae Myung
Intestinal Research.2015; 13(4): 318. CrossRef
Surveillance Colonoscopy after Polypectomy: Actual Practice in Korea
Kyeong Ok Kim
Intestinal Research.2014; 12(1): 83. CrossRef

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Reviews

Stem Cells in Colorectal Cancer: New Potential Therapeutic Target: Tae Il Kim; Intest Res 2013;11(2):85-91. Published online April 30, 2013; DOI: https://doi.org/10.5217/ir.2013.11.2.85

Abstract PDF: Within the crypts of the intestinal mucosa, intestinal epithelium is a permanently renewing tissue, the architecture of which is maintained by the ability of the intestinal stem cells to self-renew and to generate a hierarchy of proliferative and differentiated cells. In the hierarchical structure of intestinal epithelia, the balance between proliferation and cell death is important for homeostasis. This unique structure of intestinal mucosa, crypt axis, is supported by micro-environmental factors, and the disruption of the homeostasis of the crypt axis can develop colorectal neoplasia. Recent evidence suggests that colorectal cancer may arise from mutated colorectal stem or progenitor cells termed colorectal cancer stem cells (CSC) or initiating cells because of their exclusive ability to sustain tumor formation. Colorectal CSC have been identified based on the expression of cell surface markers such as CD133, CD44 and CD166, and these cells have stem/progenitor cell properties, the ability to self-renew, differentiate, and proliferate indefinitely to drive continuous expansion of the malignant cell population. The CSCs, in limited number within the bulk of the tumor, may account for their capability of escaping conventional therapies, thus leading to disease relapse and metastasis. To overcome these malignant features of cancer, the researchers emphasize the importance of better characterizing CSC to target the CSC. (Intest Res 2013;11:85-91)

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Variable Clinical Classifications and Diagnostic Coding Systems of Colorectal Neuroendocrine Tumor: Byung Chang Kim, Cheol Hee Park, Tae Il Kim, Suck-Ho Lee, Jin-Oh Kim, Hyun Soo Kim, Dong-Hoon Yang, Bora Keum, Sung Pil Hong, Seong-Eun Kim, Hyun Gun Kim, Jeong Eun Shin, Jae Myung Cha, Young Eun Joo, Dong Il Park, Hwang Choi, Kyu Chan Huh, Seung-Jae Myung, Dong Kyung Chang, Seun Ja Park; Intest Res 2013;11(1):14-22. Published online January 31, 2013; DOI: https://doi.org/10.5217/ir.2013.11.1.14

Abstract PDF

The incidence of colorectal carcinoid tumor is recently increasing as screening colonoscopy increased. Traditional carcinoid tumor had been known as low grade, malignant neuroendocrine cell orign tumor. In 2000, World Health Organization (WHO) suggested that carcinoid was called well-differentiated neuroendocrine tumor (NET). It recently updated in 2010 by WHO; according to the differentiation and malignant potential, NET classified with NET Grade 1, Grade 2, and neuroendocrine carcinoma. They suggested that NET had malignant potential in accordance with histopathologic characteristics. Therefore, WHO recommended the behavior code of NET as malignant. However, European Neuroendocrine Tumor Society (ENETS) proposed the behavior of NET to four grades based on the histopathologic features; benign, benign or low grade malignant, low grade malignant, and high grade malignant. Also, American Joint Committee on Cancer (AJCC) suggested that topography codes of NET were defined as malignant. Korean Standard Classification of Diseases (KCD) described the different codings of carcinoid (NET). The discrepancies of behavior code or coding system exist among WHO, ENETS, AJCC and KCD. Also, there were differences in the perception for topographic coding system between clinicians and pathologists. NETs of colorectum were reported with the variable clinical characteristics (especially, metastasis) and long term prognosis from many studies. Especially, risk of metastasis and long term prognosis of small sized NET (<1 cm) had some discrepancies and should be investigated prospectively. Therefore, the consensus about topographic codes of NET should be needed with multidisplinary approach among gastroenterologists, pathologists and surgeons. (Intest Res 2013;11:14-22)

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Efficacy of Precut Endoscopic Mucosal Resection for Treatment of Rectal Neuroendocrine Tumors
Hoonsub So, Su Hyun Yoo, Seungbong Han, Gwang-un Kim, Myeongsook Seo, Sung Wook Hwang, Dong-Hoon Yang, Jeong-Sik Byeon
Clinical Endoscopy.2017; 50(6): 585. CrossRef
Diagnostic Coding for Intramucosal Carcinoma and Neuroendocrine Tumor in the Colorectum: Proposal for Avoiding Confusing Coding in Korea
Dong Soo Han, Jin Hee Sohn, Jeong-Sik Byeon, Hwang Choi, Joon Mee Kim
Clinical Endoscopy.2015; 48(3): 216. CrossRef
Highlights from the 50th Seminar of the Korean Society of Gastrointestinal Endoscopy
Eun Young Kim, Il Ju Choi, Kwang An Kwon, Ji Kon Ryu, Seok Ho Dong, Ki Baik Hahm
Clinical Endoscopy.2014; 47(4): 285. CrossRef

2,584 View
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3 Crossref

Original Article

The Rebleeding Risk and Prognostic Factors of Acute Hemorrhagic Rectal Ulcer: Bun Kim, Min Seok Han, Dong Hoo Joh, Dong Jun Lee, Hye Sun Shin, Soo Jung Park, Sung Pil Hong, Jae Hee Cheon, Tae Il Kim, Won Ho Kim; Intest Res 2012;10(4):343-349. Published online October 31, 2012; DOI: https://doi.org/10.5217/ir.2012.10.4.343

Abstract PDF

Background/Aims
Acute hemorrhagic rectal ulcer (AHRU) is an important etiology of lower gastrointestinal bleeding in intensive care unit patients and hospital inpatients. Moreover, with increasing elderly populations, and improved survival in critically ill patients, the incidence of AHRU has increased. The aim of this study is to determine rebleeding risk and prognostic factors of AHRU patients. Methods: We retrospectively reviewed 32 patients with AHRU in Severance Hospital from February 2006 to October 2010, collected clinical data, and analyzed their association with the recurrence of bleeding and mortality of patients. Results: The mean age of patients was 65.5 years, and 27 patients (84.4%) showed Eastern Cooperative Oncology Group performance status 3-4. Nineteen patients (59.4%) had recurrent bleeding. Hypoalbuminemia (≤2.5 g/dL) was a risk factor of rebleeding in univariate and multivariate analysis. For patients with chronic liver disease, hypoalbuminemia (≤2.5 g/dL), renal dysfunction (>2 mg/dL) and thrombocytopenia (<150,000/ՌL) showed relatively earlier rebleeding than those without (P=0.007, P=0.009, P=0.027 and P=0.043, respectively). The endoscopic hemostasis at the first bleeding event was associated with lower early rebleeding rate (P=0.048). In univariate analysis, chronic liver disease, hypoalbuminemia (≤2.5 g/dL) and the prolongation of activated partial thromboplastin time (>40 seconds) increased mortality (P=0.028, P=0.008 and P=0.027, respectively) and the patients with rebleeding showed a tendency toward higher mortality, compared to those without (57.9% vs. 23.1%, P=0.051). Conclusions: In AHRU patients, hypoalbuminemia was a risk factor of rebleeding, and chronic liver disease, hypoalbuminemia, renal dysfunction, thrombocytopenia and no endoscopic treatment at the first bleeding event was correlated with relatively earlier rebleeding. (Intest Res 2012;10:343-349)

Citations

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Rebleeding Risk of Acute Hemorrhagic Rectal Ulcer: A Multicenter Retrospective Study
Takahiro Muramatsu, Masakatsu Fukuzawa, Akira Madarame, Yasuyuki Kagawa, Miho Kikuchi, Sho Taniguchi, Satoshi Shimai, Sho Matsumoto, Fumito Yamanishi, Yuka Suzuki, Daiki Nemoto, Hirokazu Shinohara, Taisuke Matsumoto, Yohei Koyama, Kumiko Uchida, Hayato Ya
Internal Medicine.2024; 63(18): 2481. CrossRef
Acute hemorrhagic rectal ulcer syndrome: Comparison with non‐hemorrhagic rectal ulcer lower gastrointestinal bleeding
Joo Hyuk Jung, Jong Wook Kim, Hyun Woo Lee, Min Yong Park, Woo Hyun Paik, Won Ki Bae, Nam‐Hoon Kim, Kyung‐Ah Kim, June Sung Lee
Journal of Digestive Diseases.2017; 18(9): 521. CrossRef

2,342 View
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2 Crossref

Case Report

Recurrent Acute Pericarditis Induced by 5-aminosalicylates in a Patient with Inflammatory Bowel Disease: A Ra Choi, Mi Na Kim, Ji Hoon Lee, Yong Kang Lee, Yoon Hea Park, Hye Sun Shin, Tak Geun Oh, Hee Jin Park, Min Suk Park, Seungtaek Lim, Soo Jung Park, Sung Pil Hong, Tae Il Kim, Won Ho Kim, Jae Hee Cheon; Intest Res 2012;10(3):289-294. Published online July 31, 2012; DOI: https://doi.org/10.5217/ir.2012.10.3.289

Abstract PDF: Inflammatory bowel disease (IBD) is an idiopathic chronic inflammation of the intestines. IBD treatment may require anti-inflammatory agents such as sulfasalazine or 5-aminosalicylate (5-ASA) and immunomodulators to control the symptoms. However, these agents have a variety of common adverse effects such as nausea, vomiting, skin rash, leukopenia, thrombocytopenia, and infections. Moreover, rare side effects such as nephrotic syndrome, pneumonitis, and pericarditis can occur. A 21-year-old male was admitted to the hospital due to acute chest pain, fever, and sweating. The patient had a history of Crohn's disease and had been taking mesalazine for 3 weeks. Chest x-ray, echocardiography, and clinical manifestations revealed that the patient had acute pericarditis. However, we did not recognize the relationship between these findings and 5-ASA at that time. Two years later, the patient took 5-ASA again, and similar symptoms occurred, which led us to confirm that he suffered from pericarditis induced by this drug. We report a case of acute recurrent pericarditis that developed after taking 5-ASA for IBD treatment with a review of the literature. (Intest Res 2012;10: 0-294)

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Original Articles

The Clinical Utility of Positron Emission Tomography-computed Tomography in the Evaluation of Inflammatory Bowel Diseases: Sung Ho Ryu, Jae Hee Cheon, Won Jun Kang, Jin Young Kim, Bo Kyung Kim, Jin Young Yoon, Yoon Suk Jung, Hyun Mi Heo, Jin Ha Lee, Soung Min Jeon, Sung Pil Hong, Tae Il Kim, Won Ho Kim; Intest Res 2011;9(2):97-104. Published online August 30, 2011; DOI: https://doi.org/10.5217/ir.2011.9.2.97

Abstract PDF: Background/Aims
Positron emission tomography-computed tomography (PET-CT) is a nuclear imaging technique that provides noninvasive, three dimensional, quantitative images. Recently, PET-CT has been shown to be valuable in assessing patients with inflammatory diseases; however, the clinical utility of PET-CT in the evaluation of inflammatory bowel disease (IBD) has not been defined. Thus, the aim of this study was to determine the clinical utility of PET-CT in the evaluation of IBD. Methods: Between November 2006 and September 2010, clinical, endoscopic, and radiological data on 14 patients (6 males and 8 females: age range, 33-79 years) with suspected IBD were collected. The standard work-up method for a definite diagnosis of IBD included ileocolonoscopy. Results: The 14 patients were divided into the following five groups: ulcerative colitis (n=4, 29%), intestinal Behcet's disease (n=3, 21%), intestinal tuberculosis (n=2, 14%), malignancy (n=2, 14%), and no abnormal findings with colonoscopy (n=3, 21%). A PET-CT based-diagnosis of IBD correlated with a colonoscopic diagnosis in nine cases (64.3%), but the matching ratio of the distribution of lesions between PET-CT findings and colonoscopic findings was only 18.1% (2/11). Conclusions: The utility of PET-CT in the diagnosis of IBD requires further evaluation. (Intest Res 2011;9:97-104)

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The Early Diagnostic Accuracy for Gastrointestinal T-cell Lymphoma from a Perspective of Gastroenterologists: Sung Ho Ryu, Jae Hee Cheon, Jin Young Kim, Bo Kyung Kim, Jin Young Yoon, Yoon Suk Jung, Hyun Mi Heo, Jin Ha Lee, Soung Min Jeon, Sung Pil Hong, Tae Il Kim, Won Ho Kim; Intest Res 2011;9(1):19-26. Published online April 30, 2011; DOI: https://doi.org/10.5217/ir.2011.9.1.19

Abstract PDF

Background/Aims
Primary T-cell lymphoma of the gastrointestinal tract is a very difficult disease entity to diagnose, and has an extremely poor prognosis. The aim of this study was to determine the early diagnostic accuracy for gastrointestinal T-cell lymphoma by gastroenterologists. Methods: Between January 2000 and October 2010, the clinical features of 15 patients with primary gastrointestinal T-cell lymphomas, including endoscopic findings, radiologic diagnosis, endoscopic biopsy findings, and final diagnosis, were retrospectively reviewed. Results: The most common initial presenting symptoms of primary gastrointestinal T-cell lymphomas was abdominal pain (n=11, 73%). The anatomic location of the primary lesion the small bowel (n=8, 53%), colon (n=5, 33%), and stomach (n=3, 20%). There were no cases of T-cell lymphomas diagnosed based on clinical symptoms, radiologic findings, or endoscopic findings without biopsy alone. Pathologic confirmation of T-cell lymphomas by endoscopic examination was achieved in 7 cases (64%) and the remaining cases (n=8, 53%) were diagnosed with T-cell lymphomas based on pathologic examination after surgery. Conclusions: All of the patients with primary T-cell lymphomas of the gastrointestinal tract were diagnosed exclusively by endoscopic or surgical pathologic examainations, suggesting that gastroenterologists should scrutinize and suspect this disease with caution due to atypical gastrointestinal ulcers. (Intest Res 2011;9: 6-26)

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Colonic Diffuse Large B-cell Lymphoma Hidden in Actinomycosis
Sang Hoon Lee, Seung-Joo Nam, Sung Joon Lee, Sung Chul Park, Chang Don Kang, Dae Hee Choi, Jin Myung Park, Seung Koo Lee
The Korean Journal of Gastroenterology.2019; 74(1): 46. CrossRef
A Case of Fungating Type Natural Killer Like T Cell Lymphoma of the Ascending Colon
Chang Seok Lee, Dong Hoon Shin, Cheol Woong Choi, Hyung Wook Kim, Dae Hwan Kang, Kyung Won Koh, Byoung Hoon Ji, Su Bum Park
The Korean Journal of Gastroenterology.2014; 64(4): 229. CrossRef

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2 Crossref

Review

Clinical Classification of Colorectal Epithelial Tumors and Proposal for Diagnostic Coding: Hyun Gun Kim, Jin-Oh Kim, Suck-Ho Lee, Chang Kyun Lee, Hyun Soo Kim, Hwang Choi, Dong-Hoon Yang, Bora Keum, Sung Pil Hong, Seong-Eun Kim, Byung Chang Kim, Jeong Eun Shin, Cheol Hee Park, Chang Soo Eun, Tae Il Kim, Dong Il Park, Kyu Chan Huh, Dong Kyung Chang, Seun Ja Park; Intest Res 2011;9(1):1-11. Published online April 30, 2011; DOI: https://doi.org/10.5217/ir.2011.9.1.1

Abstract PDF

The Korean Standard Classification of Diseases (KCD), which reflects the International Classification of Diseases (ICD), is a fundamental coding system for the diagnosis of colorectal epithelial tumors. The KCD coding of colorectal lesions is entirely up to the clinician and is based on pathologic reports. However, coding discrepancies have arisen among physicians using the KCD and pathologists using the ICD for Oncology-3 (ICD-O-3). The Korean Society of Pathologists recently proposed a standardized pathology-reporting format and guidelines for the coding of colorectal cancer to decrease these discrepancies among pathologists. However, ICD and ICD-O are simple classification codes based on pathologic reports, and are neither intended nor suitable for indexing of distinct clinical entities. For appropriate diagnostic coding using the KCD, a corrected coding principle based upon pathologic reports is required, and unified coding between KCD and ICD-O is necessary. A standardized pathologic report format and communication with understanding between physicians and pathologists should be established. Additionally, the private medical insurance system for colorectal cancer should be revised to reduce conflicts among patients, clinicians, and insurance companies over the medical coding system. (Intest Res 2011;9: 2-11)

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Diagnostic Coding for Intramucosal Carcinoma and Neuroendocrine Tumor in the Colorectum: Proposal for Avoiding Confusing Coding in Korea
Dong Soo Han, Jin Hee Sohn, Jeong-Sik Byeon, Hwang Choi, Joon Mee Kim
Clinical Endoscopy.2015; 48(3): 216. CrossRef
Diminutive and Small Colorectal Polyps: The Pathologist's Perspective
Yun Kyung Kang
Clinical Endoscopy.2014; 47(5): 404. CrossRef
Early Colorectal Epithelial Neoplasm in Korea: A Multicenter Survey of Pathologic Diagnosis
Yun Kyung Kang, So-Young Jin, Mee Soo Chang, Jung Yeon Kim, Gyeong Hoon Kang, Hye Seung Lee, Jin Hee Sohn, Ho Sung Park, Kye Won Kwon, Mi Jin Gu, Young Hee Maeng, Jong Eun Joo, Haeng Ji Kang, Hee Kyung Kim, Kee-Taek Jang, Mi Ja Lee, Hee Kyung Chang, Joon
Korean Journal of Pathology.2013; 47(3): 245. CrossRef
Update on the Proposal for Creating a Guideline for Cancer Registration of the Gastrointestinal Tumors (I-2)
Eun Sun Jung, Yun Kyung Kang, Mee-Yon Cho, Joon Mee Kim, Won Ae Lee, Hee Eun Lee, Sunhoo Park, Jin Hee Sohn, So-Young Jin
Korean Journal of Pathology.2012; 46(5): 443. CrossRef

2,787 View
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Case Reports

Colitis Cystica Profunda Masquerading as a Pneumatosis Cystoides Intestinalis: A Case Report: Eun Suk Jung, Jae Hee Cheon, Kyong Joo Lee, Hyun Jung Lee, Hui Won Jang, Young Eun Chon, Kyu Sik Jung, Seonjung Chang, Sung Pil Hong, Tae Il Kim, Won Ho Kim; Intest Res 2010;8(2):187-190. Published online December 30, 2010; DOI: https://doi.org/10.5217/ir.2010.8.2.187

Abstract PDF: Colitis Cystica Profunda (CCP) is an uncommon and benign disease entity characterized by mucoid cysts located in the submucosal layer of the colon. It can mimic cystic submucosal tumors or mucinous adenocarcinoma and is usually located in the rectum. CCP is found in the ascending colon less frequently. CCP manifesting as multiple cystic tumors, similar to pneumatosis cystoides intestinalis, has not yet been reported. Recently, a case of CCP mimicking pneumatosis cystoides intestinalis in the ascending colon was treated. Here this case is reported and the literature reviewed. (Intest Res 2010;8:187-190)

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Postradiation Malignant Fibrous Histiocytoma of the Colon: A Case Report: Jin Young Yoon, Do Kyung Kim, Jae Hee Cheon, Chang Mo Moon, Jae Jun Park, Joo Won Chung, Eun Young Kim, Tae Hoon Kim, Chan Joo Lee, Eun Young Park, Sang Hoon Shin, Sung Pil Hong, Tae Il Kim, Nam Kyu Kim, Ho Guen Kim, Won Ho Kim; Intest Res 2010;8(1):75-79. Published online June 30, 2010; DOI: https://doi.org/10.5217/ir.2010.8.1.75

Abstract PDF: Post-radiation soft tissue sarcomas are recognized as rare complications of radiation therapy. The most common type of post-radiation soft tissue sarcoma is a malignant fibrous histiocytoma (MFH), which originates from mesenchymal cells with a predominance of histiocytes and fibroblasts. The two most common sites of occurrence for post-radiation soft tissue sarcomas are the chest wall and pelvic cavity. Post-radiation colorectal MFHs are extremely rare and all of the reported cases of post-radiation sarcomas have occurred ＞3 years after radiation therapy. Recently, we managed a case of colorectal MFH which developed in a 48-year-old male who had undergone a low anterior resection for rectal adenocarcinoma and had received chemoradiotherapy as adjuvant treatment. Twelve months after radiotherapy, a 4 cm mass was detected 8 cm superior to the anastomosis site on colonoscopic examination. A soft tissue sarcoma was suspected on pathologic examination of the biopsy specimen. Therefore, he underwent a Hartmann's operation and the final pathologic finding revealed MFH with a storiform pattern of tumor cells composed of pleomorphic, multinucleated giant cells. This is the first case of MFH that had a latency period ＜3 years (i.e., 1 year) between the time of radiotherapy and diagnosis. (Intest Res 2010;8:75-79)

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Clinical Experience of Thalidomide in the Treatment of Korean Patients with Intestinal BehcӇet's Disease: Pilot Experience in a Single Center: Hyun Jung Lee, Jae Hee Cheon, Kyong Joo Lee, Hui Won Jang, Kyu Sik Jung, Eun Suk Jung, Jin Ha Lee, Seung Min Jeon, Sung Pil Hong, Tae Il Kim, Won Ho Kim; Intest Res 2010;8(1):63-69. Published online June 30, 2010; DOI: https://doi.org/10.5217/ir.2010.8.1.63

Abstract PDF

Intestinal BehcӇet's disease (BD) often leads to severe complications, such as perforation or massive bleeding, and therefore is one of the major causes of morbidity and mortality. As thalidomide has been identified and its anti-inflammatory and immunomodulatory properties clarified, this drug has been used in cases of systemic BD with some success. Herein we report a case series of four patients with intestinal BD to share our clinical experience with thalidomide treatment. We studied the effects of thalidomide in four patients who had a chronic relapse of intestinal BD requiring the frequent use of systemic steroids due to refractoriness to prior treatments, such as 5-aminosalycylic acid and immunosuppressants. Pre- and post-treatment clinical and laboratory data, including clinical symptoms, laboratory data, disease activity index for intestinal BD, and thalidomide toxicity were recorded. Three of the four patients had a clinical and radiologic improvement after thalidomide treatment and all of the patients discontinued steroid therapy. Although two patients tolerated thalidomide, two patients could not continue the treatment because they suffered from edema and neutropenia. Thalidomide could be considered a therapeutic option for the treatment of intestinal BD. (Intest Res 2010;8:63-69)

Citations

Citations to this article as recorded by

Advances in Management of Intestinal Behçet’s Disease: A Perspective From Gastroenterologists
Jae Hee Cheon
Journal of Rheumatic Diseases.2021; 28(1): 4. CrossRef
An Overview of Conventional and Recent Treatment Options for Behcet’s Disease
Kader Cetin Gedik, Micol Romano, Roberta A. Berard, Erkan Demirkaya
Current Treatment Options in Rheumatology.2020; 6(2): 99. CrossRef
Updated treatment strategies for intestinal Behçet’s disease
Yong Eun Park, Jae Hee Cheon
The Korean Journal of Internal Medicine.2018; 33(1): 1. CrossRef
Update on the Medical Management of Gastrointestinal Behçet’s Disease
Giuseppe Lopalco, Donato Rigante, Vincenzo Venerito, Claudia Fabiani, Rossella Franceschini, Michele Barone, Giovanni Lapadula, Mauro Galeazzi, Bruno Frediani, Florenzo Iannone, Luca Cantarini
Mediators of Inflammation.2017; 2017: 1. CrossRef
An update on the diagnosis, treatment, and prognosis of intestinal Behçet's disease
Jae Hee Cheon, Won Ho Kim
Current Opinion in Rheumatology.2015; 27(1): 24. CrossRef
Update on the Treatment of Intestinal Behçet's Disease
Kyung-Jo Kim
Journal of Rheumatic Diseases.2014; 21(4): 176. CrossRef
The Medical Treatments of Intestinal Behçet's Disease: An Update
Hye Won Lee, Won Ho Kim, Jae Hee Cheon
Intestinal Research.2013; 11(3): 155. CrossRef
Efficacy of Infliximab in Intestinal Behçet’s Disease
Jin Ha Lee, Jae Hee Cheon, Seong Woo Jeon, Byong Duk Ye, Suk-Kyun Yang, Young-Ho Kim, Kang-Moon Lee, Jong Pil Im, Joo Sung Kim, Chang Kyun Lee, Hyo Jong Kim, Eun Young Kim, Kyeong Ok Kim, Byung Ik Jang, Won Ho Kim
Inflammatory Bowel Diseases.2013; : 1. CrossRef

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Original Article

A Survey of Actual Clinical Practice Patterns in the Treatment of Inflammatory Bowel Disease in Korea: Jae Hak Kim, Jae Hee Cheon, Tae Il Kim, Won Ho Kim; Intest Res 2009;7(2):79-85. Published online December 30, 2009

Abstract PDF: Background/Aims
The aim of this study was to determine the actual practice patterns of clinicians caring for Korean patients with inflammatory bowel diseases (IBDs). Methods: Questionnaires, including te indications and doses of 5-aminosalicylic acid (5-ASA), corticosteroids, or azathioprine/6-mercaptopurine (AZA/6-MP), assessment of response, the surveillance method, and the interval for adverse effects, were distributed during the 2008 KASID annual lecture. Thirty questionnaires were collected. Results: Most of the responders (93.3%) were board-certified with sub-specialty training in gastroenterology. For active diseases, 43.3% of the responders escalated the dose of 5-ASA from conventional to maximal doses. Of the patients in disease remission, 36.7% were maintained on the conventional or a reduced dose for a fixed period of time. Corticosteroids were prescribed by dose-base (20/30 [66.7%]). In most cases, the starting dose was 40 mg/d (15/19 [78.9%]), and tapered within a 1 (43.3%) or 2 week interval (40.0%). There were various definitions of corticosteroid-refractoriness and -dependency among the responders. Most of the responders initiated AZA at 50 mg/d; 68.4% of the patients increased the dose by 25 mg and 55.6% of the patients increased the dose within a 4-week interval. For monitoring adverse events, such as leukopenia, 63.3% of the patients checked a complete blood count for 2 weeks in the 1st month of therapy. Conclusions: There were various patterns of practice in the treatment of Korean IBD patients, especially in terms of the prescribing patterns of drugs and assessment of response, which suggests that standard therapeutic guidelines of IBD should be established in Korea. (Intest Res 2009;7:79-85)

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Case Report

A Case of Ileal Mucormycosis in a Patient with Gastrointestinal Behcet's Disease: Song Yi Han, Duk Hwan Kim, Jae Jun Park, Chang Mo Moon, Eun Soo Kim, Jae Hee Cheon, Tae Il Kim, Seung Hyuk Baik, Hogeun Kim, Won Ho Kim; Intest Res 2008;6(2):140-144. Published online December 30, 2008

Abstract PDF: Zygomycosis (mucormycosis) is a rare fungal infectious disease, usually found in association with an immunocompromised state. Gastrointestinal mucormycosis is extremely rare and fatal, thus it is important to detect and manage this disease at an early stage in an effort to improve survival. To date, no cases of mucormycosis superimposed on gastrointestinal Behcet's disease have been reported. Herein we report a case in which gastrointestinal mucormycosis occurred in a 17-year-old-female with Behcet's disease. The patient recovered from her disease after undergoing an ileocecectomy. (Intest Res 2008;6:140-144)

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Original Articles

Clinical Significance of Screening Colonoscopy in Elderly: A KASID Multi-center Study: Sung Geun Park, Dong Il Park, Young-Ho Kim, Hyun Soo Kim, Won Ho Kim, Tae Il Kim, Hyo Jong Kim, Suk-Kyun Yang, Jeong-Sik Byeon, Moon Sung Lee, Il Kwon Jung, Moon Kwan Chung, Sung-Ae Jung, Yoon Tae Jeen, Jai Hyun Choi, Hwang Choi, Dong Soo Han, Jae Suk Song; Intest Res 2008;6(1):25-30. Published online June 30, 2008

Abstract PDF: Background/Aims
Currently, screening colonscopy is widely performed in the medical field. The initial time of screening is recommended at an age of 50 years, but the age to cease screening is unknown. Accordingly, we have investigated the diagnostic yield of colonoscopy according to indications in the elderly, and we evaluated if screening colonoscopy is useful in the elderly. Methods: We recruited asymptomatic individuals undergoing screening colonoscopy according to age (2830 subjects aged 50-74 years and 111 subjects ≥75 years-old), The colonoscopy findings of the study subjects were compared. In addition, colonoscopy findings of asymptomatic subjects more than 75 years-old were compared with the findings of symptomatic subjects with the same age. Results: The yield for overall neoplasia and advanced adenoma was higher in the group of subjects ≥75 years-old than in the 50-74 years age group (overall adenoma: 49.54% versus 24.98%, p＜0.001; advanced adenoma: 16.2% versus 8.23%, p=0.003). The overall frequency of neoplasms was higher in asymptomatic subjects ≥75 years-old than in symptomatic subjects ≥75 years-old (49.54% versus 28.19%, p＜0.001). Conclusions: The prevalence of advanced adenoma increased with age. Screening colonoscopy was still significantly effective in elderly subjects ≥75 years-old. The lack of a decline in the frequency of adenoma, including advanced adenoma, justifies continuing screening colonoscopy in the elderly. (Intest Res 2008;6:25-30)

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Differences in the Sensitivity to Apoptosis Based on the Degree of Differentiation of Caco-2 Cells: Tae Il Kim, Kyoung Min Yang, Boah Chae, Soo Hyun Jin, Won Ho Kim; Intest Res 2005;3(2):96-103. Published online December 30, 2005

Abstract PDF: Background/Aims
The balance between proliferation and apoptosis is important for homeostasis during differentiation in crypt-villus axis of intestinal epithelium. In addition, cellular responses to diverse stimuli also vary by the degree of cellular differentiation. We investigated the differences in apoptotic sensitivities in genotoxin- and indomethacin-induced apoptosis, based on the degree of differentiation of epithelial cells. Methods: Differentiation was induced by post-confluence culture or treatment of sodium butyrate in Caco-2 cells. Indomethacin, VP-16 and MMS (methyl methanesulfonate), which is a direct-acting DNA alkylating agent, were used for apoptosis induction. Degree of differentiation was measured by alkaline phosphatase activity assay. The apoptotic cell death was measured by MTT assay and flow cytometry. Results: Compared to the subconfluent Caco-2 cells, both 7 days post-confluent cells and sodium butyrate-treated cells showed significantly increased alkaline phosphatase activity. Both post-confluence- and butyrate-induced differentiated cells showed increased resistance to MMS- or VP-16-induced apoptosis. While post-confluence-induced differentiated cells showed increased resistance to indomethacin-induced apoptosis, butyrate-induced differentiated cells showed increased sensitivity to indomethacin-induced apoptosis. Conclusions: Our data demonstrate that differentiated Caco-2 cells induced resistance to genotoxin- and indomethacin- induced apoptosis, although indomethacin-induced apoptosis was increased in butyrate-induced differentiated Caco-2 cells. (Intestinal Research 2005;3:96-103)

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Clinical Value of Distal Colon Polyps for Prediction of Advanced Proximal Neoplasia: The KASID Prospective Multicenter Study: Bora Keum, Yoon Tae Jeen, Jai Hyun Choi, Sung-Ae Jung, Hyun Soo Kim, Young-Ho Kim, Won Ho Kim, Tae Il Kim, Hyo Jong Kim, Suk Kyun Yang, Seung Jae Myung, Jeong Sik Byeon, Moon Sung Lee, Il Kwon Jung, Moon Kwan Chung, Hwang Choi, Dong Soo Han, Jae Suk Song; Intest Res 2005;3(2):121-126. Published online December 30, 2005

Abstract PDF: Backgroud/Aims: Proximal lesion without distal finding is weak point in colon cancer screening. Clinical significance of distal finding for advanced proximal neoplasia (APN) is uncertain. Aims of this study were to assess distal finding for prediction of APN. Methods: Asymptomatic 826 adults (age≥50) were collected in KASID prospective study, who underwent colonoscopy and polypectomy. Polyps located distal to splenic flexure were defined as distal polyps. Age, gender, size, appearance, histology of distal polyps were analyzed as risk factor of APN (adenoma≥10 mm or villous histology or high grade dysplasia or invasive cancer). Sensitivity and positive predictive value of distal polyp on APN were assessed. Results: APN were found in 98 patients and 45 (45.9%) patients of them were not associated with any distal findings. Risk factors of APN were male, size of distal polyp and advanced distal polyp. Sensitivity of distal polyp size≥10 mm on APN was 38.8% and advanced distal polyp also 38.8%. Positive predictive value of distal polyp size≥10 mm and advanced distal polyp were 13.3%, 14.4% respectively. Conclusions: Although distal colon findings were helpful to predict APN in asymptomatic 50 years of age or order patients screening, more careful examination is required considering APN without distal polyps. (Intestinal Research 2005;3:121-126)

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Clinicopathological Characteristics and Malignant Potential of Colonic Flat Adenomas Compared to That of Polypoid Adenomas: Myeong Gwan Jee, Hyun Soo Kim, Won Ho Kim, Tae Il Kim, Dong Il Park, Young-Ho Kim, Hyo Jong Kim, Jeong-Sik Byeon, Suk-Kyun Yang, Moon Sung Lee, Il Kwon Jung, Sung-Ae Jung, Yoon Tae Jeen, Jai Hyun Choi, Hwang Choi, Kyu Yong Choi, Dong Soo Han; Intest Res 2005;3(2):127-132. Published online December 30, 2005

Abstract PDF: Background/Aims
Colorectal flat adenomas have been a topic of debate in the view of malignant potential. The aims of this study are to investigate the clinicopathological features of flat adenomas compared to that of polypoid adenomas and to identify the determinants for malignant transformation in colorectal flat and polypoid adenomas. Methods: This was a prospective, cross sectional study of 3,360 patients who diagnosed as adenomas via total colonoscopy and polypectomy at 13 tertiary medical centers between July 2003 and July 2004. Potential risk factors for malignant transformation were analyzed. Results: Out of 3,360 adenomas, 207 (6.2%) were flat adenomas and 3,153 (93.8%) were polypoid adenomas. The patients with flat adenoma were older (59.6 vs. 57.1, p＜0.01) and more frequently located in the right colon than polypoid adenomas (49.3% vs. 32.0%, p<0.01). The incidence of high grade dysplasia or cancer in flat adenomas was similar to that of polypoid adenomas (5.4% vs. 4.6%, p=0.36). Multivariate analysis revealed that the size ≥11 mm (OR 6.8; 95% CI 4.8-9.7) and location of adenoma in the left colon (OR 1.6; 95% CI 1.07-2.38) were significant determinants for malignant potential of colonic adenoma. Conclusions: Clinicopathological determinants for malignant potential in colorectal adenomas were not gross morphology but size and location of adenoma. (Intestinal Research 2005;3:127-132)

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The Characteristics of Colorectal Adenoma with Colonoscopic Polypectomy in Population under 50 Years Old: The KASID Prospective Multicenter Study: Hyun Joo Song, Sung-Ae Jung, Hyun Soo Kim, Young-Ho Kim, Won Ho Kim, Tae Il Kim, Hyo Jong Kim, Suk Kyun Yang, Seung Jae Myung, Jeong Sik Byeon, Moon Sung Lee, Il Kwon Jung, Moon Kwan Chung, Yoon Tae Jeen, Jai Hyun Choi, Hwang Choi, Dong Soo Han, Jae Suk Song; Intest Res 2005;3(1):18-26. Published online June 30, 2005

Abstract PDF: Background/Aims
The current practice of colonoscopic polypectomy reduce the risk of colorectal cancer. However, clinicopathologic charateristics of colorectal adenoma in population under 50 years old are uncertain. This study was performed to investigate clinicopathologic characteristics of colorectal adenoma and to determine colonoscopic indication of advanced adenoma in this population. Methods: A large scale, multicenter, prospective study was conducted from July 2003 through June 2004. Of the total 19,288 patients performed colonoscopy at 11 tertiary medical centers, we analysed 3,366 patients who undergone polypectomy and divided two groups by age of 50. Results: Among colonoscopic polypectomy, 10.7 percent (831/7,789) was younger patients and 22.0 percent (2.535/11,499) was older patients (p＜0.001), and the detection rate of advanced adenoma was significantly lower in younger patients than older patients (17.7% vs. 21.1%, p＜0.0050). In younger patients, the indications of colonoscopy were asymptomatic screening (32.7%), bowel habit change (24.0%), abdominal pain (16.8%), hematochezia (9.2%) and so on. The risk factors for advanced adenoma as colonoscopic indications in younger patients were hematochezia (OR 1.9, 95% CI 1.1-3.3) and referred patients from primary clinic (OR 2.0, 95% CI 1.3-3.0). Conclusions: This study documents lower prevalence of adenoma requiring polypectomy in younger patients compared with older patients and the low detection rate of advanced adenoma. Also, in this younger population, the colonoscopic polypectomy should be the first consideration in polyps with hamatochezia patients or referred patients from primary clinic. (Intest Res 2005;3:18-26)

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Review

Azathioprine and 6-Mercaptopurine in Ulcerative Colitis: Won Ho Kim, In Hye Park, Jae Hee Cho, Tae Il Kim; Intest Res 2003;1(1):5-18. Published online May 27, 2003

Abstract PDF: Most of patients with ulcerative colitis have intermittent chronic disease demonstrating recurrent flare-ups of bloody diarrhea and symptom-free periods. Sulfasalazine and mesalazine are the first-line medical therapy in patients with mild to moderate activity, as both of them are effective in inducing and maintenance of remission. However, significant proportion of patients needs stronger drugs such as corticosteroids. As corticosteroids are ineffective for the prevention of relapse and associated with frequents side-effects, immunosuppressors, 6-mercaptopurine (6-MP) and its prodrug azathioprine, have been used in selected patients. After absorption azatioprine is rapidly converted to 6-MP non-enzymatically and 6-MP is either inactivated by thiopurine methyltransferase (TPMT) to 6-methylmercaptopurine or by xanthine oxidase to 6-thiouric acid, or it is activated via a multistep enzymatic pathway to the putative active metabolites, 6-thioguanine nucleotides (6-TGN). Clinical responsiveness and side effects are associated with TPMT genotype and phenotype, because the enzymatic activity of TPMT is genetically determined. Until now, significant proportion of patients with proper indication are not receiving immunosuppressors because of safety concern and delayed onset of action. Recently, however, gastroenterologists' acceptance for immunomodulators is increasing based on favorable results regarding efficacy and safety. The recent application of the study of variability in drug response due to genetic factors, termed pharmacogenetics, has provided a chance for tailored dosing in the individual patients. (Intestinal Research 2003;1:5-18)

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