Intestinal Research

Original Articles

IBD

Clinical outcomes and predictors of response for adalimumab in patients with moderately to severely active ulcerative colitis: a KASID prospective multicenter cohort study: Seung Yong Shin, Soo Jung Park, Young Kim, Jong Pil Im, Hyo Jong Kim, Kang-Moon Lee, Ji Won Kim, Sung-Ae Jung, Jun Lee, Sang-Bum Kang, Sung Jae Shin, Eun Sun Kim, You Sun Kim, Tae Oh Kim, Hyun-Soo Kim, Dong Il Park, Hyung Kil Kim, Eun Soo Kim, Young-Ho Kim, Do Hyun Kim, Dennis Teng, Jong-Hwa Kim, Wonyong Kim, Chang Hwan Choi, on behalf of the IBD Research Group of the Korean Association for the Study of Intestinal Diseases; Intest Res 2022;20(3):350-360. Published online July 23, 2021; DOI: https://doi.org/10.5217/ir.2021.00049

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Background/Aims
This study assessed the efficacy and safety of adalimumab (ADA) and explored predictors of response in Korean patients with ulcerative colitis (UC).
Methods
A prospective, observational, multicenter study was conducted over 56 weeks in adult patients with moderately to severely active UC who received ADA. Clinical response, remission, and mucosal healing were assessed using the Mayo score.
Results
A total of 146 patients were enrolled from 17 academic hospitals. Clinical response rates were 52.1% and 37.7% and clinical remission rates were 24.0% and 22.0% at weeks 8 and 56, respectively. Mucosal healing rates were 39.0% and 30.1% at weeks 8 and 56, respectively. Prior use of anti-tumor necrosis factor-α (anti-TNF-α) did not affect clinical and endoscopic responses. The ADA drug level was significantly higher in patients with better outcomes at week 8 (P<0.05). In patients with lower endoscopic activity, higher body mass index, and higher serum albumin levels at baseline, the clinical response rate was higher at week 8. In patients with lower Mayo scores and C-reactive protein levels, clinical responses, and mucosal healing at week 8, the clinical response rate was higher at week 56. Serious adverse drug reactions were identified in 2.8% of patients.
Conclusions
ADA is effective and safe for induction and maintenance in Korean patients with UC, regardless of prior anti-TNF-α therapy. The ADA drug level is associated with the efficacy of induction therapy. Patients with better short-term outcomes were predictive of those with an improved long-term response.

Citations

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Prospective Observational Evaluation of the Time-Dependency of Adalimumab Immunogenicity and Drug Concentration in Ulcerative Colitis Patients: the POETIC II Study
Sivan Harnik, Chaya M Abitbol, Ola Haj Natour, Miri Yavzori, Ella Fudim, Orit Picard, Timna Naftali, Efrat Broide, Ayal Hirsch, Limor Selinger, Eyal Shachar, Doron Yablecovitch, Ahmad Albshesh, Daniel Coscas, Uri Kopylov, Rami Eliakim, Shomron Ben-Horin,
Journal of Crohn's and Colitis.2024; 18(3): 341. CrossRef
Rapidly achieving clinical remission in ulcerative colitis indicates better endoscopic and histological outcomes
Rirong Chen, Yizhe Tie, Yongle Huang, Xi Zhang, Zhirong Zeng, Minhu Chen, Li Li, Shenghong Zhang
United European Gastroenterology Journal.2024; 12(4): 459. CrossRef
Effectiveness of adalimumab in severe ulcerative colitis: A systematic review and a meta‐analysis
Saleh Azadbakht, Masomeh Seighali, Salehe Azadbakht, Morteza Azadbakht
Health Science Reports.2024;[Epub] CrossRef
Dynamic changes in the gut microbiota composition during adalimumab therapy in patients with ulcerative colitis: implications for treatment response prediction and therapeutic targets
Han Na Oh, Seung Yong Shin, Jong-Hwa Kim, Jihye Baek, Hyo Jong Kim, Kang-Moon Lee, Soo Jung Park, Seok-Young Kim, Hyung-Kyoon Choi, Wonyong Kim, Woo Jun Sul, Chang Hwan Choi
Gut Pathogens.2024;[Epub] CrossRef
Real-world effectiveness and safety of advanced therapies for the treatment of moderate-to-severe ulcerative colitis: Evidence from a systematic literature review
Peter M. Irving, Peter Hur, Raju Gautam, Xiang Guo, Severine Vermeire
Journal of Managed Care & Specialty Pharmacy.2024; 30(9): 1026. CrossRef
Korean clinical practice guidelines on biologics and small molecules for moderate-to-severe ulcerative colitis
Soo-Young Na, Chang Hwan Choi, Eun Mi Song, Ki Bae Bang, Sang Hyoung Park, Eun Soo Kim, Jae Jun Park, Bora Keum, Chang Kyun Lee, Bo-In Lee, Seung-Bum Ryoo, Seong-Joon Koh, Miyoung Choi, Joo Sung Kim
Intestinal Research.2023; 21(1): 61. CrossRef
Changes in fecal metabolic and lipidomic features by anti-TNF treatment and prediction of clinical remission in patients with ulcerative colitis
Seok-Young Kim, Seung Yong Shin, Soo Jung Park, Jong Pil Im, Hyo Jong Kim, Kang-Moon Lee, Ji Won Kim, Sung-Ae Jung, Jun Lee, Sang-Bum Kang, Sung Jae Shin, Eun Sun Kim, You Sun Kim, Tae Oh Kim, Hyun-Soo Kim, Dong Il Park, Hyung Kil Kim, Eun Soo Kim, Young-
Therapeutic Advances in Gastroenterology.2023;[Epub] CrossRef
Reviewing not Homer’s Iliad, but “Kai Bao Ben Cao”: indigo dye—the past, present, and future
Yusuke Yoshimatsu, Tomohisa Sujino, Takanori Kanai
Intestinal Research.2023; 21(2): 174. CrossRef
Precision medicine and drug optimization in adult inflammatory bowel disease patients
Sophie Vieujean, Edouard Louis
Therapeutic Advances in Gastroenterology.2023;[Epub] CrossRef
Real-world effectiveness and safety of adalimumab in Korean patients with intestinal Behcet’s disease: a Korean Association for the Study of Intestinal Diseases (KASID) multicenter study
Seung Bum Lee, Hee Seung Hong, Chang Kyun Lee, Bo-In Lee, Sol Kim, Seong-Joon Koh, Hosun Yu, Jung-Bin Park, Sung Wook Hwang, Byong Duk Ye, Suk-Kyun Yang, Sang Hyoung Park
The Korean Journal of Internal Medicine.2023; 38(5): 661. CrossRef
Advancements in the Management of Moderate-to-Severe Ulcerative Colitis: A Revised 2023 Korean Treatment Guidelines
Soo-Young Na
The Korean Journal of Medicine.2023; 98(5): 223. CrossRef
Prediction of Clinical Remission with Adalimumab Therapy in Patients with Ulcerative Colitis by Fourier Transform–Infrared Spectroscopy Coupled with Machine Learning Algorithms
Seok-Young Kim, Seung Yong Shin, Maham Saeed, Ji Eun Ryu, Jung-Seop Kim, Junyoung Ahn, Youngmi Jung, Jung Min Moon, Chang Hwan Choi, Hyung-Kyoon Choi
Metabolites.2023; 14(1): 2. CrossRef
Association of C-reactive Protein and Partial Mayo Score With Response to Tofacitinib Induction Therapy: Results From the Ulcerative Colitis Clinical Program
Marla C Dubinsky, Fernando Magro, Flavio Steinwurz, David P Hudesman, Jami A Kinnucan, Ryan C Ungaro, Markus F Neurath, Nicole Kulisek, Jerome Paulissen, Chinyu Su, Dario Ponce de Leon, Miguel Regueiro
Inflammatory Bowel Diseases.2022;[Epub] CrossRef
Effectiveness and Safety of Golimumab in Patients with Ulcerative Colitis: A Multicenter, Prospective, Postmarketing Surveillance Study
Jongwook Yu, Soo Jung Park, Hyung Wook Kim, Yun Jeong Lim, Jihye Park, Jae Myung Cha, Byong Duk Ye, Tae Oh Kim, Hyun-Soo Kim, Hyun Seok Lee, Su Young Jung, Youngdoe Kim, Chang Hwan Choi
Gut and Liver.2022; 16(5): 764. CrossRef
Pharmacogenetics-based personalized treatment in patients with inflammatory bowel disease: A review
Ji Young Chang, Jae Hee Cheon
Precision and Future Medicine.2021; 5(4): 151. CrossRef

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Inflammatory bowel diseases

A glycolipid adjuvant, 7DW8-5, provides a protective effect against colonic inflammation in mice by the recruitment of CD1d-restricted natural killer T cells: Chansu Lee, Sung Noh Hong, Young-Ho Kim; Intest Res 2020;18(4):402-411. Published online April 8, 2020; DOI: https://doi.org/10.5217/ir.2019.00132

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Background/Aims
The modulation of CD1d-restricted natural killer T (NKT) cells by glycolipids has been considered as a potential therapy against immunologic diseases, including inflammatory bowel disease. A recently identified a glycolipid analog, 7DW8-5, which is derived from α-galactosylceramide (α-GalCer), is as much as 100-fold more active at stimulating both human and mice NKT cells when compared to α-GalCer. We explored the effects of 7DW8-5 in mouse models of acute and chronic colitis.
Methods
We investigated the effects of 7DW8-5 on intestinal inflammation by assessing the effects of 7dW8-5 on a murine dextran sulfate sodium (DSS)-induced acute colitis model and a chronic colitis-associated tumor model.
Results
The acute DSS-induced colitis model showed a dose-dependent response to 7DW8-5, as mice administered 7DW8-5 showed a significant improvement in DSS-induced colitis based on their disease activity index, histologic analysis, and serum C-reactive protein levels, when compared to mice administered vehicle alone. However, DSS-induced colitis in CD1d-KO mice showed no response to 7DW8-5. A fluorescence-activating cell sorting analysis revealed an increase in NKT cells in colonic tissues of 7DW8-5-treated mice. RNA-seq and real-time quantitative polymerase chain reaction showed a significant increase in the expression of interleukin (IL)-4, IL-13, and interferon-gamma in 7DW8-5-treated mice. In addition, 7DW8-5 treatment reduced colitis-associated tumor development in an azoxymethane/DSS mouse model.
Conclusions
7DW8-5 activates NKT cells through CD1d and provides a protective effect against intestinal inflammation in mice. Therefore, 7DW8-5 may be a promising therapeutic agent for treatment of inflammatory bowel disease.

Citations

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Role of CD1d and iNKT cells in regulating intestinal inflammation
Sung Won Lee, Hyun Jung Park, Luc Van Kaer, Seokmann Hong
Frontiers in Immunology.2024;[Epub] CrossRef
An immunostimulatory glycolipid that blocks SARS-CoV-2, RSV, and influenza infections in vivo
Moriya Tsuji, Manoj S. Nair, Kazuya Masuda, Candace Castagna, Zhenlu Chong, Tamarand L. Darling, Kuljeet Seehra, Youngmin Hwang, Ágata Lopes Ribeiro, Geovane Marques Ferreira, Laura Corredor, Jordana Grazziela Alves Coelho-dos-Reis, Yukiko Tsuji, Munemasa
Nature Communications.2023;[Epub] CrossRef
Inhibition of the Occurrence and Development of Inflammation-Related Colorectal Cancer by Fucoidan Extracted from Sargassum fusiforme
Xiang Li, Shijun Xin, Xiaoqun Zheng, Liqin Lou, Shiqing Ye, Shengkai Li, Qilong Wu, Qingyong Ding, Ling Ji, Chunrong Nan, Yongliang Lou
Journal of Agricultural and Food Chemistry.2022; 70(30): 9463. CrossRef
Sex-Specific Differences in Cytokine Induction by the Glycolipid Adjuvant 7DW8-5 in Mice
Felicia N. Watson, Caroline J. Duncombe, Anya C. Kalata, Ethan Conrad, Sumana Chakravarty, B. Kim Lee Sim, Stephen L. Hoffman, Moriya Tsuji, Melanie J. Shears, Sean C. Murphy
Biomolecules.2022; 13(1): 8. CrossRef

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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

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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)

Citations

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Development of New Molecularly Targeted Agents in Inflammatory Bowel Disease
Hiroshi Nakase
Internal Medicine.2025;[Epub] CrossRef
Novel Histone Deacetylase 6 Inhibitor Confers Anti-inflammatory Effects and Enhances Gut Barrier Function
Jae-Young Lee, Hyun Woo Ma, Ji Hyung Kim, I Seul Park, Mijeong Son, Keun Ho Ryu, Jieun Shin, Seung Won Kim, Jae Hee Cheon
Gut and Liver.2023; 17(5): 766. CrossRef
Downregulation of Heat Shock Protein 72 Contributes to Fibrostenosis in Crohn’s Disease
Seung Won Kim, Jae-Young Lee, Han Cheol Lee, Jae Bum Ahn, Ji Hyung Kim, I Seul Park, Jae Hee Cheon, Duk Hwan Kim
Gut and Liver.2023; 17(6): 905. CrossRef
Targeting Immune Cell Trafficking – Insights From Research Models and Implications for Future IBD Therapy
Maximilian Wiendl, Emily Becker, Tanja M. Müller, Caroline J. Voskens, Markus F. Neurath, Sebastian Zundler
Frontiers in Immunology.2021;[Epub] CrossRef
Renin–angiotensin system in intestinal inflammation—Angiotensin inhibitors to treat inflammatory bowel diseases?
Hanne Salmenkari, Riitta Korpela, Heikki Vapaatalo
Basic & Clinical Pharmacology & Toxicology.2021; 129(3): 161. CrossRef
Anti-integrin drugs in clinical trials for inflammatory bowel disease (IBD): insights into promising agents
Virginia Solitano, Tommaso Lorenzo Parigi, Elisa Ragaini, Silvio Danese
Expert Opinion on Investigational Drugs.2021; 30(10): 1037. CrossRef
Emerging therapeutic options in inflammatory bowel disease
Jesus K Yamamoto-Furusho, Norma N Parra-Holguín
World Journal of Gastroenterology.2021; 27(48): 8242. CrossRef

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7 Crossref

Editorial

IBD

Home-based fecal calprotectin test is expected to play an important role in patients with inflammatory bowel diseases: Young-Ho Kim; Intest Res 2018;16(4):507-508. Published online October 25, 2018; DOI: https://doi.org/10.5217/ir.2018.00136

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Citations

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Prevalence and Characteristics of Ocular and Systemic Manifestations in Iraqi Patients with Behçet’s Disease
Mohammad Assad Abbas, Muthanna Basheer Yasir, Luay Salim Rasheed
The Open Ophthalmology Journal.2025;[Epub] CrossRef
Fecal calprotectin levels in COVID-19: Lessons from a systematic review on its use in inflammatory bowel disease during the pandemic
Anuraag Jena, Praveen Kumar-M, Anupam Kumar Singh, Vishal Sharma
Digestive and Liver Disease.2021; 53(3): 295. CrossRef

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2 Crossref

Original Articles

Microbiota

Characterization of the fecal microbiota differs between age groups in Koreans: Sun-Young Kook, Yunjeong Kim, Ben Kang, Yon Ho Choe, Young-Ho Kim, Seokjin Kim; Intest Res 2018;16(2):246-254. Published online April 30, 2018; DOI: https://doi.org/10.5217/ir.2018.16.2.246

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Background/Aims

Tens of trillions of microorganisms constitute the gut microbiota of the human body. The microbiota plays a critical role in maintaining host immunity and metabolism. Analyses of the gut microbial composition in Korea are limited to a few studies consisting of small sample sizes. To investigate the gut microbial community in a large sample of healthy Koreans, we analyzed the 16S ribosomal RNA of 4 representative bacterial genera Lactobacillus, Bifidobacterium, Bacteroides, and Clostridium.

Methods

A total of 378 DNA samples extracted from 164 infants and 214 adults were analyzed using quantitative real-time polymerase chain reaction.

Results

Analysis of 16S ribosomal RNA of 4 representative bacterial genera Lactobacillus, Bifidobacterium, Bacteroides, and Clostridium showed that the gut microbiota in infants had higher relative abundances of Bifidobacterium and Lactobacillus than that in adults, which was dominated by Bacteroides and Clostridium.

Conclusions

To the best of our knowledge, this was the first study evaluating the distinct characteristics of the microbial community of Korean infants and adults. The differences between the 2 populations suggest that external factors such as age, diet, and the environment are important contributing factors to the change in gut microbial composition during development.

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Effects of Administration of Prebiotics Alone or in Combination with Probiotics on In Vitro Fermentation Kinetics, Malodor Compound Emission and Microbial Community Structure in Swine
Maro Lee, Yeonjae Choi, Joel Bayo, Andrew Wange Bugenyi, Yangseon Kim, Jaeyoung Heo
Fermentation.2023; 9(8): 716. CrossRef
Statistical Optimization of Culture Conditions for Lactobacillus Strains using Response Surface Methodology
Young Min Hwang, Hee-Seok Lee
Journal of Food Hygiene and Safety.2023; 38(5): 338. CrossRef
The correlation of the fecal microbiome with the biochemical profile during menopause: a Brazilian cohort study
Thayane Christine Alves da Silva, Jennefer Aparecida dos Santos Gonçalves, Laura Alves Cota e Souza, Angélica Alves Lima, R. Guerra-Sá
BMC Women's Health.2022;[Epub] CrossRef
The Effect of Kefir Supplementation on Improving Human Endurance Exercise Performance and Antifatigue
Mon-Chien Lee, Wei-Lun Jhang, Chia-Chia Lee, Nai-Wen Kan, Yi-Ju Hsu, Chin-Shan Ho, Chun-Hao Chang, Yi-Chen Cheng, Jin-Seng Lin, Chi-Chang Huang
Metabolites.2021; 11(3): 136. CrossRef
Space, time and captivity: quantifying the factors influencing the fecal microbiome of an alpine ungulate
Sarah E Haworth, Kevin S White, Steeve D Côté, Aaron B A Shafer
FEMS Microbiology Ecology.2019;[Epub] CrossRef
Isolation and characterization of five novel probiotic strains from Korean infant and children faeces
Sun-Young Kook, Eui-Chun Chung, Yaelim Lee, Dong Wan Lee, Seokjin Kim, Sudarshan Kumar
PLOS ONE.2019; 14(10): e0223913. CrossRef
Characteristics of Faecal Microbiota in Korean Patients withClostridioides difficile-associated Diarrhea
Yong Duk Jeon, Hea Won Ann, Woon Ji Lee, Jun Hyoung Kim, Hye Seong, Jung Ho Kim, Jin Young Ahn, Su Jin Jeong, Nam Su Ku, Joon Sup Yeom, Dongeun Yong, Kyungwon Lee, Jun Yong Choi
Infection & Chemotherapy.2019; 51(4): 365. CrossRef

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Clinical characteristics of patients with serrated polyposis syndrome in Korea: comparison with Western patients: Eun Ran Kim, Jaryong Jeon, Jin Hee Lee, Yoon Jung Lee, Sung Noh Hong, Dong Kyung Chang, Young-Ho Kim; Intest Res 2017;15(3):402-410. Published online June 12, 2017; DOI: https://doi.org/10.5217/ir.2017.15.3.402

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Background/Aims

Serrated polyposis syndrome (SPS) has been shown to increase the risk of colorectal cancer (CRC). However, little is known about the characteristics of Asian patients with SPS. This study aimed to identify the clinicopathological features and risk of CRC in Korean patients with SPS as well as the differences between Korean and Western patients based on a literature review.

Methods

This retrospective study included 30 patients with SPS as defined by World Health Organization classification treated at Samsung Medical Center, Korea, between March 1999 and May 2011.

Results

Twenty patients (67%) were male. The median patient age at diagnosis was 56 years (range, 39–76 years). A total of 702 polyps were identified during a median follow-up of 43 months (range, 0–149 months). Serrated polyps were noted more frequently in the distal colon (298/702, 55%). However, large serrated polyps and serrated adenomas were mainly distributed throughout the proximal colon (75% vs. 25% and 81% vs. 19%, respectively); 73.3% had synchronous adenomatous polyps. The incidence of CRC was 10% (3/30 patients), but no interval CRC was detected. A total of 87% of the patients underwent esophagogastroduodenoscopy and 19.2% had significant lesions.

Conclusions

The phenotype of SPS in Korean patients is different from that of Western patients. In Korean patients, SPS is more common in men, there were fewer total numbers of serrated adenoma/polyps, and the incidence of CRC was lower than that in Western patients. Korean patients tend to more frequently have abnormal gastric lesions. However, the prevalence of synchronous adenomatous polyps is high in both Western and Korean patients.

Citations

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Risk of Colorectal Cancer in Serrated Polyposis Syndrome: A Systematic Review and Meta-analysis
Charles Muller, Akihiro Yamada, Sachie Ikegami, Haider Haider, Yuga Komaki, Fukiko Komaki, Dejan Micic, Atsushi Sakuraba
Clinical Gastroenterology and Hepatology.2022; 20(3): 622. CrossRef
Synchronized early gastric cancer occurred in a patient with serrated polyposis syndrome: A case report
Ying-Ze Ning, Guan-Yi Liu, Xiao-Long Rao, Yong-Chen Ma, Long Rong
World Journal of Clinical Cases.2022; 10(8): 2644. CrossRef
Usefulness of narrow-band imaging for the detection of remnant sessile-serrated adenoma (SSA) tissue after endoscopic resection: the KASID multicenter study
Yunho Jung, Jung Rock Moon, Seong Ran Jeon, Jae Myung Cha, Hyo-Joon Yang, Suyeon Park, Yumi Ahn, Jeong-Sik Byeon, Hyun Gun Kim
Surgical Endoscopy.2021; 35(9): 5217. CrossRef
Serrated Polyposis Syndrome with a Synchronous Colon Adenocarcinoma Treated by an Endoscopic Mucosal Resection
Sang Hoon Lee, Sung Joon Lee, Sung Chul Park, Seung-Joo Nam, Myeong Ho Kang, Tae Suk Kim, Seung Koo Lee
The Korean Journal of Gastroenterology.2020; 76(3): 159. CrossRef

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Current practices in endoscopic submucosal dissection for colorectal neoplasms: a survey of indications among Korean endoscopists: Tae Jun Kim, Eun Ran Kim, Sung Noh Hong, Young-Ho Kim, Dong Kyung Chang; Intest Res 2017;15(2):228-235. Published online April 27, 2017; DOI: https://doi.org/10.5217/ir.2017.15.2.228

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Background/Aims

The indications for colorectal endoscopic submucosal dissection (ESD) vary in clinical practice. To establish colorectal ESD as a standard treatment, standard indications are essential. For establishing standard indications for colorectal ESD, we surveyed the preferences and criteria of endoscopists for colorectal ESD in their practices.

Methods

A multiple-choice questionnaire was sent to 27 members of the Korean Society of Gastrointestinal Endoscopy/ESD group. The indications of endoscopists for selecting ESD as a treatment for colorectal tumors ≥2 cm in diameter were surveyed.

Results

On the basis of the preprocedural assessment of histology, adenoma with high-grade dysplasia, mucosal cancer, and shallow submucosa invasive cancer were included in the indication for ESD. Based on gross morphology, laterally spreading tumor (LST) granular nodular mixed type, LST-nongranular (LST-NG) flat elevated type, and LST-NG pseudodepressed type were included. On the basis of the pit pattern by Kudo classification, types III, IV, and V-I were included. Based on the narrow band imaging pattern by Sano classification, types II and III-a were included. Other lesions, such as sporadic localized tumors in chronic inflammation and local residual early carcinoma after endoscopic resection, were also included in the indication for ESD.

Conclusions

The indications of Korean endoscopists for colorectal ESD are broader than those in recent guidelines, and tend to include more benign-looking tumors. To find the appropriate indications for colorectal ESD, systematic data collection and analysis are required to reach a consensus in a timely manner.

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Ji Hyun Kim, Sung Chul Park
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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
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Chan Hyuk Park, Dong-Hoon Yang, Jong Wook Kim, Jie-Hyun Kim, Ji Hyun Kim, Yang Won Min, Si Hyung Lee, Jung Ho Bae, Hyunsoo Chung, Kee Don Choi, Jun Chul Park, Hyuk Lee, Min-Seob Kwak, Bun Kim, Hyun Jung Lee, Hye Seung Lee, Miyoung Choi, Dong-Ah Park, Jong
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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
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Chan Hyuk Park, Dong-Hoon Yang, Jong Wook Kim, Jie-Hyun Kim, Ji Hyun Kim, Yang Won Min, Si Hyung Lee, Jung Ho Bae, Hyunsoo Chung, Kee Don Choi, Jun Chul Park, Hyuk Lee, Min-Seob Kwak, Bun Kim, Hyun Jung Lee, Hye Seung Lee, Miyoung Choi, Dong-Ah Park, Jong
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Yanqin Xu, Shishun Zhong, Wei Liang, Xiao Lu Lin
Expert Review of Gastroenterology & Hepatology.2020; 14(11): 1083. CrossRef
Clinical outcomes of endoscopic resection for colorectal laterally spreading tumors with advanced histology
Jin-Sung Jung, Ji-Yun Hong, Hyung-Hoon Oh, Sun-Seog Kweon, Jun Lee, Sang-Wook Kim, Geom-Seog Seo, Hyun-Soo Kim, Young-Eun Joo
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Clinicopathological feature and treatment outcome of patients with colorectal laterally spreading tumors treated by endoscopic submucosal dissection
Young-Hoon Jeong, Jun Lee, Sang-Wook Kim, Geom-Seog Seo, Hyun-Soo Kim, Young-Eun Joo
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Outcomes of ulcerative colitis‐associated dysplasia patients referred for potential endoscopic submucosal dissection
Dong‐Hoon Yang, Jihun Kim, Eun Mi Song, Kiju Chang, Sun‐Ho Lee, Sung Wook Hwang, Sang Hyoung Park, Byong Duk Ye, Jeong‐Sik Byeon, Seung‐Jae Myung, Suk‐Kyun Yang
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Recurrence rate of lateral margin-positive cases after en bloc endoscopic submucosal dissection of colorectal neoplasia
Seohyun Lee, Jihun Kim, Jae Seung Soh, Jungho Bae, Sung Wook Hwang, Sang Hyoung Park, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Dong-Hoon Yang
International Journal of Colorectal Disease.2018; 33(6): 735. CrossRef
Risk factors for procedure-related complications after endoscopic resection of colorectal laterally spreading tumors
Ji-Yun Hong, Sun-Seog Kweon, Jun Lee, Sang-Wook Kim, Geom-Seog Seo, Hyun-Soo Kim, Young-Eun Joo
Medicine.2018; 97(41): e12589. CrossRef

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Case Report

Wernicke's encephalopathy after total parenteral nutrition in patients with Crohn's disease: In Seub Shin, Hyeri Seok, Yeong Hee Eun, You-Bin Lee, Seung-Eun Lee, Eun Ran Kim, Dong Kyung Chang, Young-Ho Kim, Sung Noh Hong; Intest Res 2016;14(2):191-196. Published online April 27, 2016; DOI: https://doi.org/10.5217/ir.2016.14.2.191

Abstract PDF PubReader ePub

Micronutrient deficiencies in Crohn's disease (CD) patients are not uncommon and usually result in a combination of reduced dietary intake, disease-related malabsorption, and a catabolic state. Decreased serum thiamine levels are often reported in patients with CD. Wernicke's encephalopathy (WE) is a severe form of thiamine deficiency that can cause serious neurologic complications. Although WE is known to occur frequently in alcoholics, a number of non-alcoholic causes have also been reported. Here, we report two cases of non-alcoholic WE that developed in two severely malnourished CD patients who were supported by prolonged total parenteral nutrition without thiamine supplementation. These patients complained of sudden-onset ophthalmopathy, cerebellar dysfunction, and confusion. Magnetic resonance imaging allowed definitive diagnosis for WE despite poor sensitivity. The intravenous administration of thiamine alleviated the symptoms of WE dramatically. We emphasize the importance of thiamine supplementation for malnourished patients even if they are not alcoholics, especially in those with CD.

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Roshaani Rasiah, Claudia Gregoriano, Beat Mueller, Alexander Kutz, Philipp Schuetz
Mayo Clinic Proceedings.2024; 99(5): 740. CrossRef
LLL 44 – Module 3: Micronutrients in Chronic disease
Hanna-Liis Lepp, Karin Amrein, Oguzhan S. Dizdar, Michael P. Casaer, Kursat Gundogan, Angélique M.E. de Man, Serge Rezzi, Arthur R.H. van Zanten, Alan Shenkin, Mette M. Berger
Clinical Nutrition ESPEN.2024; 62: 285. CrossRef
The use of parenteral nutrition in patients with inflammatory bowel disease: A detailed guide on the indications, risks, and benefits
David Kohler, Hannah Freid, Jennifer Cholewka, Megan Miller, Stephanie L. Gold
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Novel XIAP mutation with early-onset Crohn’s disease complicated with acute heart failure: a case report
Chendong Peng, Yuang Jiang, Xianhong Ou, Lei Liao, Chengying Yang, Qiao Zhou, Yan Wei, Lijia Chang, Xinrong Fan
BMC Cardiovascular Disorders.2023;[Epub] CrossRef
A COMBINATION REVIEW ON EFFECT OF CITRUS JUICE AND METRONIDAZOLE IN INFLAMMATORY BOWEL DISEASE
Deeksha, Shalini Saini, Meenakshi Bhatt
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Wernicke's encephalopathy in Crohn's disease and ulcerative colitis
Erik Oudman, Jan W. Wijnia, Misha J. Oey, Mirjam van Dam, Albert Postma
Nutrition.2021; 86: 111182. CrossRef
Stability of high-dose thiamine in parenteral nutrition for treatment of patients with Wernicke's encephalopathy
Maciej Stawny, Aleksandra Gostyńska, Rafał Olijarczyk, Anna Jelińska, Magdalena Ogrodowczyk
Clinical Nutrition.2020; 39(9): 2929. CrossRef
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Kompal Jain, Jasveer Singh, Anant Jain, Tanvi Khera
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Vitamin D deficiency is associated with disease activity in patients with Crohn’s disease
Kyoung Ho Ko, You Sun Kim, Bo Kyung Lee, Jong Hyun Choi, Yong Moon Woo, Jin Young Kim, Jeong Seop Moon
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A Case of Iatrogenic Wernicke Encephalopathy Following Prolonged Total Parenteral Nutrition
Mustafa ÇETİNER, Sibel Canbaz Kabay, Özgül Ocak, Selahattin Ayas
Mustafa Kemal Üniversitesi Tıp Dergisi.2018; 9(34): 99. CrossRef
Metronidazole-induced encephalopathy in a patient with Crohn's disease
Jihye Kim, Jaeyoung Chun, Jae Yong Park, Seung Wook Hong, Joo Young Lee, Jin Woo Kang, Seongjun Hwang, Sang-Bae Ko, Jong Pil Im, Joo Sung Kim
Intestinal Research.2017; 15(1): 124. CrossRef
Vitamins and Minerals in Inflammatory Bowel Disease
Fayez K. Ghishan, Pawel R. Kiela
Gastroenterology Clinics of North America.2017; 46(4): 797. CrossRef
A case report: Non-alcoholic Wernicke encephalopathy associated with polyneuropathy
Hudong Liang, Lan Wu, Ling-ling Liu, Jinming Han, Jie Zhu, Tao Jin
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Micronutrient deficiencies in inflammatory bowel disease: trivial or crucial?
Soon Man Yoon
Intestinal Research.2016; 14(2): 109. CrossRef

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14 Crossref

Original Articles

Clinical features of active tuberculosis that developed during anti-tumor necrosis factor therapy in patients with inflammatory bowel disease: Jang Wook Lee, Chang Hwan Choi, Ji Hoon Park, Jeong Wook Kim, Sang Bum Kang, Ja Seol Koo, Young-Ho Kim, You Sun Kim, Young Eun Joo, Sae Kyung Chang; Intest Res 2016;14(2):146-151. Published online April 27, 2016; DOI: https://doi.org/10.5217/ir.2016.14.2.146

Abstract PDF PubReader ePub

Background/Aims

Anti-tumor necrosis factor (TNF) therapy for active ulcerative colitis (UC) and Crohn's disease (CD) is associated with increased risks of tuberculosis (TB) infection. We analyzed the incidence and clinical features of Korean patients with inflammatory bowel disease (IBD) who developed active TB during anti-TNF therapy.

Methods

Ten cases of active TB developed in patients treated with infliximab (n=592) or adalimumab (n=229) for UC (n=160) or CD (n=661) were reviewed. We analyzed demographics, interval between start of anti-TNF therapy and active TB development, tests for latent TB infection (LTBI), concomitant medications, and the details of diagnosis and treatments for TB.

Results

The incidence of active TB was 1.2% (10/821): 1.5% (9/592) and 0.4% (1/229) in patients receiving infliximab and adalimumab, respectively. The median time to the development of active TB after initiation of anti-TNF therapy was three months (range: 2–36). Three patients had past histories of treatment for TB. Positive findings in a TB skin test (TST) and/or interferon gamma releasing assay (IGRA) were observed in three patients, and two of them received anti-TB prophylaxis. Two patients were negative by both TST and IGRA. The most common site of active TB was the lungs, and the active TB was cured in all patients.

Conclusions

Active TB can develop during anti-TNF therapy in IBD patients without LTBI, and even in those with histories of TB treatment or LTBI prophylaxis. Physicians should be aware of the potential for TB development during anti-TNF therapy, especially in countries with a high prevalence of TB.

Citations

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(Re-)introduction of TNF antagonists and JAK inhibitors in patients with previous tuberculosis: a systematic review
Thomas Theo Brehm, Maja Reimann, Niklas Köhler, Christoph Lange
Clinical Microbiology and Infection.2024; 30(8): 989. CrossRef
Real-world effectiveness of ustekinumab in maintenance therapy for Crohn´s disease
O.V. Knyazev, O.B. Schukina, A.V. Kagramanova, A.A. Lishchinskaya, I.A. Li, E.A. Sabelnikova, B.A. Nanaeva, M.Yu. Timanovskaya, T.A. Kosacheva, N.A. Fadeeva, K.A. Nikolskaya, E.Yu. Zhulina, N.V. Kamzarakova, A.I. Parfenov
Dokazatel'naya gastroenterologiya.2023; 12(3): 29. CrossRef
Five-Year Efficacy and Safety of Ustekinumab Treatment in Crohn’s Disease: The IM-UNITI Trial
William J. Sandborn, Rory Rebuck, Yuhua Wang, Bin Zou, Omoniyi J. Adedokun, Christopher Gasink, Bruce E. Sands, Stephen B. Hanauer, Stephan Targan, Subrata Ghosh, Willem J.S. de Villiers, Jean-Frederic Colombel, Brian G. Feagan, John P. Lynch
Clinical Gastroenterology and Hepatology.2022; 20(3): 578. CrossRef
Monitoring frequency of interferon gamma release assay for tuberculosis surveillance following infliximab therapy in patients with Crohn's disease
Qin Yu Yang, Yi Juan Liu, Ye Xu, Lin Zhang, Cheng Dang Wang
Journal of Digestive Diseases.2021; 22(8): 473. CrossRef
Clinical Features and Outcomes of Tuberculosis in Inflammatory Bowel Disease Patients Treated with Anti-tumor Necrosis Factor Therapy
Jihye Kim, Jong Pil Im, Jae-Joon Yim, Chang Kyun Lee, Dong Il Park, Chang Soo Eun, Sung-Ae Jung, Jeong Eun Shin, Kang-Moon Lee, Jae Hee Cheon
The Korean Journal of Gastroenterology.2020; 75(1): 29. CrossRef
Increased Risk of Herpes Zoster in Young and Metabolically Healthy Patients with Inflammatory Bowel Disease: A Nationwide Population-Based Study
Hosim Soh, Jaeyoung Chun, Kyungdo Han, Seona Park, Gukhwan Choi, Jihye Kim, Jooyoung Lee, Jong Pil Im, Joo Sung Kim
Gut and Liver.2019; 13(3): 333. CrossRef
Discontinuation of Biological Treatments in Inflammatory Bowel Disease
Shomron Ben-Horin, Ren Mao, Yun Qiu, Minhu Chen
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Asian Organization for Crohn's and Colitis and Asia Pacific Association of Gastroenterology consensus on tuberculosis infection in patients with inflammatory bowel disease receiving anti-tumor necrosis factor treatment. Part 2: management
Dong Il Park, Tadakazu Hisamatsu, Minhu Chen, Siew Chien Ng, Choon Jin Ooi, Shu Chen Wei, Rupa Banerjee, Ida Normiha Hilmi, Yoon Tae Jeen, Dong Soo Han, Hyo Jong Kim, Zhihua Ran, Kaichun Wu, Jiaming Qian, Pin-Jin Hu, Katsuyoshi Matsuoka, Akira Andoh, Yasu
Intestinal Research.2018; 16(1): 17. CrossRef
Novel treatments for inflammatory bowel disease
Hyo Sun Lee, Soo-Kyung Park, Dong Il Park
The Korean Journal of Internal Medicine.2018; 33(1): 20. CrossRef
Nonimmunity against hepatitis B virus infection in patients newly diagnosed with inflammatory bowel disease
Seong Jae Yeo, Hyun Seok Lee, Byung Ik Jang, Eun Soo Kim, Seong Woo Jeon, Sung Kook Kim, Kyeong Ok Kim, Yoo Jin Lee, Hyun Jik Lee, Kyung Sik Park, Yun Jin Jung, Eun Young Kim, Chang Heon Yang
Intestinal Research.2018; 16(3): 400. CrossRef
Asian Organization for Crohn's and Colitis and Asia Pacific Association of Gastroenterology consensus on tuberculosis infection in patients with inflammatory bowel disease receiving anti‐tumor necrosis factor treatment. Part 2: Management
Dong Il Park, Tadakazu Hisamatsu, Minhu Chen, Siew Chien Ng, Choon Jin Ooi, Shu Chen Wei, Rupa Banerjee, Ida Normiha Hilmi, Yoon Tae Jeen, Dong Soo Han, Hyo Jong Kim, Zhihua Ran, Kaichun Wu, Jiaming Qian, Pin‐Jin Hu, Katsuyoshi Matsuoka, Akira Andoh, Yasu
Journal of Gastroenterology and Hepatology.2018; 33(1): 30. CrossRef
Changing treatment paradigms for the management of inflammatory bowel disease
Jong Pil Im, Byong Duk Ye, You Sun Kim, Joo Sung Kim
The Korean Journal of Internal Medicine.2018; 33(1): 28. CrossRef
Incidence of Active Tuberculosis within One Year after Tumor Necrosis Factor Inhibitor Treatment according to Latent Tuberculosis Infection Status in Patients with Inflammatory Bowel Disease
Jieun Kang, Dae Hyun Jeong, Minkyu Han, Suk-Kyun Yang, Jeong-Sik Byeon, Byong Duk Ye, Sang Hyoung Park, Sung Wook Hwang, Tae Sun Shim, Kyung-Wook Jo
Journal of Korean Medical Science.2018;[Epub] CrossRef
CD8 + CD28 + /CD8 + CD28 − T cell equilibrium can predict the active stage for patients with inflammatory bowel disease
Shi-xue Dai, Hong-xiang Gu, Qian-yi Lin, Shao-zhuo Huang, Tiao-si Xing, Qing-fang Zhang, Gang Wu, Min-hua Chen, Wan-er Tan, Hong-jian Jian, Zhong-wen Zheng, Tao Zhong, Min-hai Zhang, Xing-fang Cheng, Peng Huang, Guang-jie Liao, Wei-hong Sha
Clinics and Research in Hepatology and Gastroenterology.2017; 41(6): 693. CrossRef

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Gastric lesions in patients with Crohn's disease in Korea: a multicenter study: Hoonsub So, Byong Duk Ye, Young Soo Park, Jihun Kim, Joo Sung Kim, Won Moon, Kang-Moon Lee, You Sun Kim, Bora Keum, Seong-Eun Kim, Kyeong Ok Kim, Eun Soo Kim, Chang Kyun Lee, Sung Pil Hong, Jong Pil Im, Ja Seol Koo, Chang Hwan Choi, Jeong Eun Shin, Bo In Lee, Kyu Chan Huh, Young-Ho Kim, Hyun-Soo Kim, Young Sook Park, Dong Soo Han; Intest Res 2016;14(1):60-68. Published online January 26, 2016; DOI: https://doi.org/10.5217/ir.2016.14.1.60

Abstract PDF PubReader ePub

Background/Aims

Gastric pathology and Helicobacter pylori (H. pylori) infection among Asian patients with Crohn's disease (CD) are still unclear. We evaluated gastric histologic features and frequency of H. pylori infection in Korean patients with CD.

Methods

Among 492 patients with CD receiving upper gastrointestinal (GI) endoscopic evaluation in 19 Korean hospitals, we evaluated the endoscopic findings and gastric histopathologic features of 47 patients for our study. Histopathologic classification was performed using gastric biopsy tissues, and H. pylori infection was determined using the rapid urease test and histology.

Results

There were 36 men (76.6%), and the median age of patients at the time of upper GI endoscopy was 23.8 years (range, 14.2–60.5). For CD phenotype, ileocolonic disease was observed in 38 patients (80.9%), and non-stricturing, non-penetrating disease in 31 patients (66.0%). Twenty-eight patients (59.6%) complained of upper GI symptoms. Erosive gastritis was the most common gross gastric feature (66.0%). Histopathologically, H. pylori-negative chronic active gastritis (38.3%) was the most frequent finding. H. pylori testing was positive in 11 patients (23.4%), and gastric noncaseating granulomata were detected in 4 patients (8.5%). Gastric noncaseating granuloma showed a statistically significant association with perianal abscess/fistula (P=0.0496).

Conclusions

H. pylori-negative chronic active gastritis appears to be frequent among Korean patients with CD. The frequency of H. pylori infection was comparable with previous studies. An association with perianal complications suggests a prognostic value for gastric noncaseating granuloma in patients with CD.

Citations

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Endoscopic findings in the upper gastrointestinal tract in patients with Crohn’s disease are common, highly specific, and associated with chronic gastritis
Katarzyna Graca-Pakulska, Wojciech Błogowski, Iwona Zawada, Anna Deskur, Krzysztof Dąbkowski, Elżbieta Urasińska, Teresa Starzyńska
Scientific Reports.2023;[Epub] CrossRef
Detection Rates of Non-Cavitary Epithelioid Cell Granuloma by Gastrointestinal Biopsy in Patients with Treatment-Naïve Crohn’s Disease
Katsuya Endo, Yoko Kawakami, Yuki Yoshino, Shiho Kondo, Daisuke Fukushi, Atsuko Takasu, Takayuki Kogure, Morihisa Hirota, Kazuhiro Murakami, Kennichi Satoh
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Hala El‐Zimaity, Robert H Riddell
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Endoscopic and Histopathological Findings of the Esophagus, Stomach, and Duodenum in Patients with Crohn’s Disease from a Reference Center in Bahia, Brazil
Andrea Maia Pimentel, Luiz Antônio Rodrigues de Freitas, Rita de Cássia Reis Cruz, Isaac Neri de Novais Silva, Laíla Damasceno Andrade, Paola Nascimento Marques, Júlia Cordeiro Braga, Flora Maria Lorenzo Fortes, Katia Rejane Marques Brito, Jaciane Araújo
Clinics and Practice.2021; 11(2): 374. CrossRef
The gastric microbiota in patients with Crohn’s disease; a preliminary study
Jerzy Ostrowski, Maria Kulecka, Iwona Zawada, Natalia Żeber-Lubecka, Agnieszka Paziewska, Katarzyna Graca-Pakulska, Krzysztof Dąbkowski, Karolina Skubisz, Patrycja Cybula, Filip Ambrożkiewicz, Elżbieta Urasińska, Michał Mikula, Teresa Starzyńska
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Associations between the Presence of Granulomata and Disease Phenotype and Outcomes in Children Diagnosed with Crohn’s Disease
Laura Appleton, Euan Watt, Fiona Jagger, Richard Hansen, Richard B. Gearry, Andrew S. Day
Gastrointestinal Disorders.2020; 2(2): 164. CrossRef
Ovarian Crohn’s Disease: A Case Report and Review of the Literature
Hamza Mohammed, Rana Bokhary, Mohammed Nassif, Mahmoud Mosli, Haruhiko Sugimura
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Andréa Maia Pimentel, Raquel Rocha, Genoile Oliveira Santana
World Journal of Gastrointestinal Pharmacology and Therapeutics.2019; 10(2): 35. CrossRef
Prognostic significance of granulomas in children with Crohn’s disease
Benjamin Rothschild, Firas Rinawi, Yonatan Herman, Osnat Nir, Raanan Shamir, Amit Assa
Scandinavian Journal of Gastroenterology.2017; 52(6-7): 716. CrossRef
Endoscopic Bamboo Joint-like Appearance of the Stomach in Crohn's Disease
Kwang Il Seo, Won Moon
The Korean Journal of Gastroenterology.2017; 69(2): 151. CrossRef
Characteristics of Upper Gastrointestinal Tract Involvement in Korean Pediatric Crohn's Disease: A Multicenter Study
Ji Hyoung Park, Hye Na Nam, Ji-Hyuk Lee, Jeana Hong, Dae Yong Yi, Eell Ryoo, In Sang Jeon, Hann Tchah
Pediatric Gastroenterology, Hepatology & Nutrition.2017; 20(4): 227. CrossRef
Increased duodenal expression of miR-146a and -155 in pediatric Crohn’s disease
Dániel Szűcs, Nóra Judit Béres, Réka Rokonay, Kriszta Boros, Katalin Borka, Zoltán Kiss, András Arató, Attila J Szabó, Ádám Vannay, Erna Sziksz, Csaba Bereczki, Gábor Veres
World Journal of Gastroenterology.2016; 22(26): 6027. CrossRef

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Is Colonoscopy Necessary after Computed Tomography Diagnosis of Acute Diverticulitis?: Min Jung Kim, Young Sik Woo, Eun Ran Kim, Sung Noh Hong, Dong Kyung Chang, Poong-Lyul Rhee, Jae J. Kim, Soon Jin Lee, Young-Ho Kim; Intest Res 2014;12(3):221-228. Published online July 25, 2014; DOI: https://doi.org/10.5217/ir.2014.12.3.221

Abstract PDF PubReader ePub

Background/Aims

A diagnosis of acute diverticulitis is based on computed tomography (CT). Colonoscopy is commonly performed after the acute event to exclude other diagnoses. This study aimed to determine whether colonoscopy is necessary and what additional information is gained from a colonoscopy after acute diverticulitis.

Methods

Acute diverticulitis was diagnosed by clinical criteria and characteristic CT findings. We analyzed the number of patients in whom colorectal cancers were diagnosed and other incidental findings of polyps and other diseases.

Results

A total of 177 patients were analyzed retrospectively. The mean age was 43.3±15.3 years (range, 13-82 years) and 97 patients (54.8%) were male. Sixty-one patients had undergone a colonoscopy within 1 year of the acute attack. Advanced adenomatous lesions and colonic malignancy were not detected. Nineteen patients (31.1%) had ≥1 polyp and 11 patients (18.0%) had an adenomatous polyp. No new or different diagnosis was made after colonoscopy. None of the 116 patients who did not undergo colonoscopy within a year after acute diverticulitis had a diagnosis of colorectal cancer registered with the Korea Central Cancer Registry.

Conclusions

Routine colonoscopy yields little benefit in patients with acute diverticulitis diagnosed by typical clinical symptoms and CT. The current practice of a colonoscopy after acute diverticulitis needs to be reevaluated.

Citations

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Philip S. Barie, Lillian S. Kao, Mikayla Moody, Robert G. Sawyer
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Leena-Mari Mäntymäki, Juha Grönroos, Markus Riskumäki, Tero Vahlberg, Jukka Karvonen
Scandinavian Journal of Surgery.2023; 112(3): 157. CrossRef
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Jae Gon Lee, Yong Eun Park, Ji Young Chang, Hyun Joo Song, Duk Hwan Kim, Young Joo Yang, Byung Chang Kim, Shin Hee Lee, Myung-Won You, Seong-Eun Kim
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Diagnosis and Treatment of Colonic Diverticular Disease
You Sun Kim
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Diverticulitis does not increase the long-term risk of developing colon cancer: a systematic review and meta-analysis
Laura Quitzau Mortensen, Jens Buciek, Kristoffer Andresen, Jacob Rosenberg
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Fadi Abu Baker, Mohanad Ganayem, Amir Mari, Randa Taher, Mohamad Suki, Yael Kopelman
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Chee Hoe Koo, Jasmine H.E. Chang, Nicholas L. Syn, Ian J.Y. Wee, Ronnie Mathew
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Risk of Colorectal Cancer in Patients With Acute Diverticulitis: A Systematic Review and Meta-analysis of Observational Studies
Jeremy Meyer, Lorenzo A. Orci, Christophe Combescure, Alexandre Balaphas, Philippe Morel, Nicolas C. Buchs, Frédéric Ris
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Aline de Araújo Naves, Giuseppe D'Ippolito, Luis Ronan Marquez Ferreira Souza, Sílvia Portela Borges, Glênio Moraes Fernandes
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Carl Johan Grahnat, Sebastian Hérard, Annicka Ackzell, Roland E. Andersson
World Journal of Surgery.2016; 40(9): 2283. CrossRef
Colonoscopy after Hinchey I and II left-sided diverticulitis: utility or futility?
Avery S. Walker, Jason R. Bingham, Karmon M. Janssen, Eric K. Johnson, Justin A. Maykel, Omar Ocampo, John P. Gonzalez, Scott R. Steele
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Review

Clinical Application of Genetics in Management of Colorectal Cancer: Eun Ran Kim, Young-Ho Kim; Intest Res 2014;12(3):184-193. Published online July 25, 2014; DOI: https://doi.org/10.5217/ir.2014.12.3.184

Abstract PDF PubReader ePub

The extensive study of genetic alterations in colorectal cancer (CRC) has led to molecular diagnostics playing an increasingly important role in CRC diagnosis and treatment. Currently, it is believed that CRC is a consequence of the accumulation of both genetic and epigenetic genomic alterations. It is known that there are at least 3 major pathways that lead to colorectal carcinogenesis: (1) the chromosomal instability pathway, (2) the microsatellite instability pathway, and (3) the cytosine-phospho-guanine island methylator phenotype pathway. With recent advances in CRC genetics, the identification of specific molecular alterations responsible for CRC pathogenesis has directly influences clinical care. Patients at high risk for developing CRC can be identified by genetic testing for specific molecular alterations, and the use of molecular biomarkers for predictive and prognostic purposes is also increasing. This is clearly supported by the recent advances in genetic testing for CRC whereby specific molecular alterations are identified for the purpose of guiding treatment with targeting therapies such as anti-endothelial growth factor receptor monoclonal antibodies.

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Korean Guidelines for Post-polypectomy Colonoscopic Surveillance: Dong-Hoon Yang, Sung Noh Hong, Young-Ho Kim, Sung Pil Hong, Sung Jae Shin, Seong-Eun Kim, Bo In Lee, Suck-Ho Lee, Dong Il Park, Hyun-Soo Kim, Suk-Kyun Yang, Hyo Jong Kim, Se Hyung Kim, Hyun Jung Kim, Multi-Society Task Force for Development of Guidelines for Colorectal Polyp Screening, Surveillance; Intest Res 2012;10(1):89-109. Published online February 29, 2012; DOI: https://doi.org/10.5217/ir.2012.10.1.89

Abstract PDF

Post-polypectomy surveillance has become a major indication for colonoscopy as a result of increased use of screening colonoscopy in Korea. However, because the medical resource is limited, and the first screening colonoscopy produces the greatest effect on reducing the incidence and mortality of colorectal cancer, there is a need to increase the efficiency of postpolypectomy surveillance. In the present report, a careful analytic approach was used to address all available evidences to delineate the predictors for advanced neoplasia at surveillance colonoscopy. Based on the results of review of the evidences, we elucidated the high risk findings of the index colonoscopy as follows: 1) 3 or more adenomas, 2) any adenoma larger than 10 mm, 3) any tubulovillous or villous adenoma, 4) any adenoma with high-grade dysplasia, and 5) any serrated polyps larger than 10 mm. In patients without any high-risk findings at the index colonoscopy, surveillance colonoscopy should be performed five years after index colonoscopy. In patients with one or more high risk findings, surveillance colonoscopy should be performed three years after polypectomy. However, the surveillance interval can be shortened considering the quality of the index colonoscopy, the completeness of polyp removal, the patient's general condition, and family and medical history. This practical guideline cannot totally take the place of clinical judgments made by practitioners and should be revised and supplemented in the future as new evidence becomes available. (Intest Res 2012;10:89-109)

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Korean Guidelines for Colorectal Cancer Screening and Polyp Detection: Bo In Lee, Sung Pil Hong, Seong-Eun Kim, Se Hyung Kim, Hyun-Soo Kim, Sung Noh Hong, Dong-Hoon Yang, Sung Jae Shin, Suck-Ho Lee, Young-Ho Kim, Dong Il Park, Hyun Jung Kim, Suk-Kyun Yang, Hyo Jong Kim, Hae Jeong Jeon, Multi-Society Task Force for Development of Guidelines for Colorectal Polyp Screening, Surveillance; Intest Res 2012;10(1):67-88. Published online February 29, 2012; DOI: https://doi.org/10.5217/ir.2012.10.1.67

Abstract PDF

Colorectal cancer is the second most common cancer in males and the fourth most common in females in Korea. Since the most of colorectal cancer occur through the prolonged transformation of adenomas into carcinomas, early detection and removal of colorectal adenomas are one of the most effective methods to prevent colorectal cancer. Considering the increasing incidence of colorectal cancer and polyps in Korea, it is very important to establish Korean guideline for colorectal cancer screening and polyp detection. Korean Multi-Society Take Force developed the guidelines with evidence-based methods. Parts of the statements drawn by systematic reviews and meta-analyses. Herein we discussed the epidemiology of colorectal cancers and adenomas in Korea, optimal screening methods for colorectal cancer, and detection for adenomas including fecal occult blood tests, radiologic tests, and endoscopic examinations. (Intest Res 2012;10:67-88)

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Association between dietary fat intake and colorectal adenoma in korean adults
Jeehyun Kim, Seung-Won Oh, Young-Sun Kim, Hyuktae Kwon, Hee-Kyung Joh, Ji-Eun Lee, Danbee Park, Jae-Hong Park, Ah-Ryoung Ko, Ye-Ji Kim
Medicine.2017; 96(1): e5759. CrossRef
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Guidelines for the Management of Crohn's Disease: Byong Duk Ye, Suk-Kyun Yang, Sung Jae Shin, Kang Moon Lee, Byung Ik Jang, Jae Hee Cheon, Chang Hwan Choi, Young-Ho Kim, Heeyoung Lee, IBD Study Group of the Korean Association for the Study of Intestinal Diseases; Intest Res 2012;10(1):26-66. Published online February 29, 2012; DOI: https://doi.org/10.5217/ir.2012.10.1.26

Abstract PDF

Crohn's disease (CD) is a chronic inflammatory bowel disease (IBD) with uncertain etiopathogenesis. CD can involve any site of gastrointestinal tract from the mouth to anus and is associated with serious complications such as bowel strictures, perforations, and fistula formation. The incidence and prevalence rates of CD in Korea are still lower than those of Western countries, but have been rapidly increasing during the past decades. Although there are no definitive curative modalities for CD, various medical and surgical therapies are currently applied for diverse clinical situations of CD. However, a lot of decisions on the management of CD are made depending on the personal experiences and choices of physicians. To suggest preferable approaches to diverse problems of CD and to minimize the variations according to physicians, guidelines for the management of CD are needed. Therefore, IBD Study Group of the Korean Association for the Study of the Intestinal Diseases has set out to develop the guidelines for the management of CD in Korea. These guidelines were developed using the adaptation methods and encompass the treatment of inflammatory disease, stricturing disease, and penetrating disease. The guidelines also cover the indication of surgery, prevention of recurrence after surgery, and CD in pregnancy and lactation. These are the first Korean guidelines for the management of CD and the update with further scientific data and evidences is needed. (Intest Res 2012;10:26-66)

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Postoperative course of Crohn disease according to timing of bowel resection
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Medicine.2018; 97(16): e0459. CrossRef
Second Korean Guidelines for the Management of Crohn's Disease
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The Korean Journal of Gastroenterology.2017; 69(1): 29. CrossRef
Second Korean guidelines for the management of Crohn's disease
Jae Jun Park, Suk-Kyun Yang, Byong Duk Ye, Jong Wook Kim, Dong Il Park, Hyuk Yoon, Jong Pil Im, Kang Moon Lee, Sang Nam Yoon, Heeyoung Lee
Intestinal Research.2017; 15(1): 38. CrossRef
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Young Sun Kim, Sung-Ae Jung, Kang-Moon Lee, Soo Jung Park, Tae Oh Kim, Chang Hwan Choi, Hyun Gun Kim, Won Moon, Chang Mo Moon, Hye Kyoung Song, Soo-Young Na, Suk-Kyun Yang
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Computed Tomography Enterography and Magnetic Resonance Enterography in the Diagnosis of Crohn's Disease
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Crohn's Disease Clinical Network and Cohort (CONNECT) Study: The First Step Toward Nationwide Multicenter Research of Crohn's Disease in Korea
Jae Hee Cheon, You Sun Kim, Byong Duk Ye, Kang Moon Lee, Young Ho Kim, Joo Sung Kim, Dong Soo Han, Won Ho Kim
Intestinal Research.2014; 12(3): 173. CrossRef
Crohn's disease in Korea: past, present, and future
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Patients with Crohn's disease on anti-tumor necrosis factor therapy are at significant risk of inadequate response to the 23-valent pneumococcal polysaccharide vaccine
Chang Kyun Lee, Hyun-Soo Kim, Byong Duk Ye, Kang-Moon Lee, You Sun Kim, Sang Youl Rhee, Hyo-Jong Kim, Suk-Kyun Yang, Won Moon, Ja-Seol Koo, Suck-Ho Lee, Geom Seog Seo, Soo Jung Park, Chang Hwan Choi, Sung-Ae Jung, Sung Noh Hong, Jong Pil Im, Eun Soo Kim
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Nam Hee Kim, Yoon Suk Jung, Chang Mo Moon, Shin Yeong Lee, Eun Ran Kim, Young Ho Kim, Chang Kyun Lee, Suck Ho Lee, Jae Hak Kim, Kyu Chan Huh, Soon Man Yoon, Hyun Joo Song, Sun-Jin Boo, Hyun Joo Jang, You Sun Kim, Kang-Moon Lee, Jeong Eun Shin, Dong Il Par
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The Korean Journal of Gastroenterology.2013; 61(5): 270. CrossRef

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Korean Guidelines for Colonoscopic Polypectomy: Suck-Ho Lee, Sung Jae Shin, Dong Il Park, Seong-Eun Kim, Sung Pil Hong, Sung Noh Hong, Dong-Hoon Yang, Bo In Lee, Young-Ho Kim, Hyun-Soo Kim, Suk-Kyun Yang, Hyo Jong Kim, Se Hyung Kim, Hyun Jung Kim, Multi-Society Task Force for Development of Guidelines for Colorectal Polyp Screening, Surveillance; Intest Res 2012;10(1):110-124. Published online February 29, 2012; DOI: https://doi.org/10.5217/ir.2012.10.1.110

Abstract PDF

There are indirect evidences to suggest that 80% of colorectal cancers (CRC) develop from adenomatous polyps and that, on average, it takes 10 years for a small polyp to transform into invasive CRC. In multiple cohort studies, colonoscopic polypectomy has been shown to significantly reduce the expected incidence of CRC by 76% to 90%. Colonoscopic polypectomy is performed frequently in primary outpatient clinics and secondary and tertiary medical centers in Korea. However, there are no evidence-based, procedural guidelines for the appropriate performance of this procedure, including the technical aspects. For the guideline presented here, PubMed, Medline, and Cochrane Library literature searches were performed. When little or no data from well-designed prospective trials were available, an emphasis was placed on the results from large series and reports from recognized experts. Thus, these guidelines for colonoscopic polypectomy are based on a critical review of the available data as well as expert consensus. Further controlled clinical studies are needed to clarify aspects of this statement, and revision may be necessary as new data become available. This guideline is intended to be an educational device to provide information that may assist endoscopists in providing care to patients. This guideline is not a rule and should not be construed as a legal standard of care or as encouraging, advocating, requiring, or discouraging any particular treatment. Clinical decisions for any particular case involve a complex analysis of the patient's condition and the available courses of action. (Intest Res 2012;10:110-124)

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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 Research.2013; 11(4): 276. CrossRef

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Guidelines for the Management of Ulcerative Colitis: Chang Hwan Choi, Young-Ho Kim, You Sun Kim, Byong Duk Ye, Kang Moon Lee, Bo In Lee, Sung-Ae Jung, Won Ho Kim, Heeyoung Lee, IBD Study Group of the Korean Association for the Study of Intestinal Diseases; Intest Res 2012;10(1):1-25. Published online February 29, 2012; DOI: https://doi.org/10.5217/ir.2012.10.1.1

Abstract PDF

Ulcerative colitis (UC) is a chronic inflammatory bowel disorder characterized by a relapsing and remitting course. The quality of life can decrease significantly during exacerbations of the disease. The incidence and prevalence of UC in Korea are still lower than those of Western countries, but have been rapidly increasing during the past decades. Various medical and surgical therapies are currently used for the management of UC. However, many challenging issues exist and sometimes these lead to differences in practice between clinicians. Therefore, Inflammatory Bowel Diseases (IBD) Study Group of the Korean Association for the Study of Intestinal Diseases (KASID) set out the Korean guidelines for the management of UC. These guidelines are made by the adaptation using several foreign guidelines and encompass treatment of active colitis, maintenance of remission and indication for surgery in UC. The specific recommendations are presented with the quality of evidence. These are the first Korean treatment guidelines for UC and will be revised with new evidences on treatment of UC. (Intest Res 2012;10:1-25)

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Original Articles

Association between Thyroid Cancer and Advanced Colorectal Neoplasia: Da Min Kim, Jung Ha Kim, Jun Young Park, Byung Woo Jun, Lim Hwa Song, Hyun Ae Jung, Young-Ho Kim; Intest Res 2011;9(3):206-210. Published online December 30, 2011; DOI: https://doi.org/10.5217/ir.2011.9.3.206

Abstract PDF: Background/Aims
Colorectal cancer and thyroid cancer are common diseases with relatively higher survival rates compared with other cancers. The number of patients identified with colorectal cancer or thyroid cancer who develop multiple primary malignancy during long-term follow-up is increasing with advances in diagnostic techniques and treatment modalities. However, the association between colorectal cancer and thyroid cancer is uncertain, and few data have been reported in Korea. This study examined the association between thyroid cancer and colorectal neoplasm. Methods: We retrospectively investigated 363 patients who underwent a colonoscopy, among patients diagnosed with thyroid cancer between January 2004 and December 2008 at Samsung Medical Center. The control group was comprised of 2,494 patients who underwent screening colonoscopy for the first time within the study period at the center for health promotion at Samsung Medical Center between March 2004 and December 2005. Results: The detection rates in patients with thyroid cancer were 4.7% (17/363) for advanced adenomas and 2.8% (10/363) for colorectal cancer. In the control group, it was 3.2% (79/2,494) for advanced adenomas and 0.3% (7/2,494) for colorectal cancer. A multivariate analysis revealed that the presence of thyroid cancer had an odds ratio of 1.893 (95% confidence interval, 0.868-4.128, P=0.109) in favor of finding at least one advanced colorectal neoplasm. Conclusions: The results indicate that thyroid cancer is not associated with advanced colorectal neoplasm. Survivors of thyroid and colorectal cancer live longer and hence are at risk for second primary cancers. Therefore, further studies that prospectively evaluate the association between thyroid cancer and colorectal advanced neoplasm are needed. (Intest Res 2011;9:206-210)

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A Korean National Survey for Treatment Modality in Colon Polypectomy: Sung Jae Shin, Suck-Ho Lee, Dong Il Park, Sung Noh Hong, Seong-Eun Kim, Dong-Hoon Yang, Sung Pil Hong, Bo In Lee, Hyun Soo Kim, Young-Ho Kim, Suk-Kyun Yang, Hyo Jong Kim, Se Hyung Kim, Multi-Society Task Force for the Guidelines for Colorectal Polyp Screening, Surveillance and Managem; Intest Res 2011;9(3):196-205. Published online December 30, 2011; DOI: https://doi.org/10.5217/ir.2011.9.3.196

Abstract PDF

Background/Aims
There are no evidence-based, procedural guidelines to appropriately perform a colon polypectomy. Thus, we investigated the treatment modality for colon polypectomy in Korea, using a web-based e-mail survey. Methods: A questionnaire of preferred treatment modality for colon polypectomy was sent via e-mail to members of the Korean Association for the Study of Intestinal Diseases and primary care physicians who performed colonoscopies as a screening or surveillance program nationwide. Among 425 colonoscopists who were sent the e-mail, 263 replied. We analysed data from 252 colonoscopists who had performed colon polypectomies. Results: The stopping time for antiplatelet and anticoagulation therapy before a colon polypectomy had a tendency to increase and the restarting time for these drugs was delayed as polyp size increased. Colonoscopists preferred cold biopsy removal for polyps <5 mm in size and a hot snare polypectomy after injecting normal saline and epinephrine mixture for polyps ≥5 mm in size. More than half of colonoscopists preferred observation rather than additional procedures for adenomas with incomplete resection. In contrast, most colonoscopists recommended additional procedures, such as endoscopic mucosal resection, endoscopic submucosal dissection or surgery for an advanced adenoma with incomplete resection. The most preferred prophylactic treatment for immediate postpolypectomy bleeding washemoclipping. Conclusions: Various treatment modalities were used for a colon polypectomy because there are few guidelines for performing a colon polypectomy based on a critical review of the available data. Further well-designed, prospective studies are needed to develop evidence-based guidelines for colon polypectomy. (Intest Res 2011;9:196- 205)

Citations

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Survey of the Actual Practices Used for Endoscopic Removal of Colon Polyps in Korea: A Comparison with the Current Guidelines
Jeongseok Kim, Tae-Geun Gweon, Min Seob Kwak, Su Young Kim, Seong Jung Kim, Hyun Gun Kim, Sung Noh Hong, Eun Sun Kim, Chang Mo Moon, Dae Seong Myung, Dong-Hoon Baek, Shin Ju Oh, Hyun Jung Lee, Ji Young Lee, Yunho Jung, Jaeyoung Chun, Dong-Hoon Yang, Eun R
Gut and Liver.2025; 19(1): 77. CrossRef
A survey of current practices in post-polypectomy surveillance in Korea
Jeongseok Kim, Tae-Geun Gweon, Min Seob Kwak, Su Young Kim, Seong Jung Kim, Hyun Gun Kim, Eun Ran Kim, Sung Noh Hong, Eun Sun Kim, Chang Mo Moon, Dae Seong Myung, Dong Hoon Baek, Shin Ju Oh, Hyun Jung Lee, Ji Young Lee, Yunho Jung, Jaeyoung Chun, Dong-Hoo
Intestinal Research.2024; 22(2): 186. CrossRef
Cold polypectomy techniques for small and diminutive colorectal polyps: a systematic review and network meta-analysis of randomized controlled trials
Mohamed Abuelazm, Ahmed K. Awad, Islam Mohamed, Abdelrahman Mahmoud, Hosam Shaikhkhalil, Nour Shaheen, Omar Abdelwahab, Ahmed M. Afifi, Basel Abdelazeem, Mohamed O. Othman
Current Medical Research and Opinion.2023; 39(10): 1329. CrossRef
Risk of post-polypectomy bleeding after endoscopic mucosal resection in patients receiving antiplatelet medication: comparison between the continue and hold groups
Sang Hyun Park, Soo-Kyung Park, Hyo-Joon Yang, Yoon Suk Jung, Jung Ho Park, Chong Il Sohn, Dong Il Park
Surgical Endoscopy.2022; 36(9): 6410. CrossRef
Colonoscopic Polypectomy Preferences of Asian Endoscopists: Results of a Survey-Based Study
Dong-Hoon Yang, Bayasgalan Luvsandagva, Quang Trung Tran, Achmad Fauzi, Panida Piyachaturawat, Thida Soe, Zhiqin Wong, Jeong-Sik Byeon
Gut and Liver.2021; 15(3): 391. CrossRef
Comparative efficacy of cold polypectomy techniques for diminutive colorectal polyps: a systematic review and network meta-analysis
Yoon Suk Jung, Chan Hyuk Park, Eunwoo Nam, Chang Soo Eun, Dong Il Park, Dong Soo Han
Surgical Endoscopy.2018; 32(3): 1149. CrossRef
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Jun Lee
Clinical Endoscopy.2016; 49(4): 355. CrossRef

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A Survey for Post-polypectomy Surveillance: Sung Noh Hong, Dong-Hoon Yang, Young-Ho Kim, Seong-Eun Kim, Sung Jae Shin, Sung Pil Hong, Bo In Lee, Suck-Ho Lee, Dong Il Park, Hyun Soo Kim, Suk-Kyun Yang, Hyo Jong Kim, Se Hyung Kim, Multi-Society Task Force for the Guidelines for Colorectal Polyp Screening, Surveillance and Managem; Intest Res 2011;9(2):118-128. Published online August 30, 2011; DOI: https://doi.org/10.5217/ir.2011.9.2.118

Abstract PDF

Background/Aims
There is a paucity of information on postpolypectomy surveillance currently practiced in Korea. Thus, we investigated the present state of postpolypectomy surveillance in Korea using a web-based survey. Methods: A multiple choice questionnaire was used to determine the preferred surveillance modality, the colonoscopic surveillance interval used in 11 case scenarios, and clinical factors influencing surveillance intervals. The form was sent via e-mail to members of the Korean Association for the Study of Intestinal Diseases and primary care physicians involved in a colonoscopy surveillance program. Of 425 colonoscopists contacted, 263 replied (response rate, 62%). Of the respondents, 94% were internists and 54% practiced in tertiary referral hospitals. Results: All respondents chose colonoscopy as a preferred surveillance modality following polyp removal. Colonoscopy at 3 years was the most frequent answer after removal of 1 or 2 tubular adenoma(s) ＜1 cm in size, while 1 year was the most frequent answer after removal of an advanced adenoma or ≥3 adenomas, and 6 months was the most frequent choice after removal of adenoma with high-grade dysplasia or a sessile polyp ≥2 cm. The agreement rate for the time of first surveillance between preferred guideline recommendations and respondent answers was in the low range at 14-43%. Conclusions: A significant disagreement exists between current postpolypectomy surveillance practices of Korean colonoscopists and preferred guideline recommendations. This discrepancy may be due to the fact that the guidelines do not reflect recent studies and the specific medical environment in Korea. Thus, there is a need to develop new evidence-based Korean guidelines for postpolypectomy surveillance. (Intest Res 2011;9:118-128)

Citations

Citations to this article as recorded by

A survey of current practices in post-polypectomy surveillance in Korea
Jeongseok Kim, Tae-Geun Gweon, Min Seob Kwak, Su Young Kim, Seong Jung Kim, Hyun Gun Kim, Eun Ran Kim, Sung Noh Hong, Eun Sun Kim, Chang Mo Moon, Dae Seong Myung, Dong Hoon Baek, Shin Ju Oh, Hyun Jung Lee, Ji Young Lee, Yunho Jung, Jaeyoung Chun, Dong-Hoo
Intestinal Research.2024; 22(2): 186. CrossRef
The current capacity and quality of colonoscopy in Korea
Jae Ho Choi, Jae Myung Cha, Jin Young Yoon, Min Seob Kwak, Jung Won Jeon, Hyun Phil Shin
Intestinal Research.2019; 17(1): 119. CrossRef
Guideline Adherence to Colonoscopic Surveillance Intervals after Polypectomy in Korea: Results from a Nationwide Survey
Seri Hong, Mina Suh, Kui Son Choi, Boyoung Park, Jae Myung Cha, Hyun-Soo Kim, Jae Kwan Jun, Dong Soo Han
Gut and Liver.2018; 12(4): 426. 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
A Survey of Colonoscopic Surveillance After Polypectomy
Dae Kyung Sohn
Annals of Coloproctology.2014; 30(2): 88. CrossRef
Clinical Practice of Surveillance Colonoscopy according to the Classification of Colorectal Intraepithelial Neoplasia in Korea: High-grade Dysplasia/CarcinomaIn SituVersus 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 Research.2013; 11(4): 276. CrossRef
A Korean National Survey for Colorectal Cancer Screening and Polyp Diagnosis Methods Using Web-based Survey
Seong-Eun Kim, Sung Pil Hong, Hyun-Soo Kim, Bo In Lee, Se Hyung Kim, Sung Noh Hong, Dong-Hoon Yang, Suck Ho Lee, Sung Jae Shin, Dong Il Park, Young-Ho Kim, Suk-Kyun Yang, Hyo Jong Kim
The Korean Journal of Gastroenterology.2012; 60(1): 26. CrossRef

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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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Review

Genomic Instability and Epigenetic Alteration in Colorectal Carcinogenesis: Young-Ho Kim; Intest Res 2007;5(2):111-121. Published online December 30, 2007

Abstract PDF: Colorectal cancer results from the progressive accumulation of genetic and epigenetic alterations that lead to cellular transformation and tumor progression, which is known as the adenoma-carcinoma sequence. Genomic instability, including chromosomal instability and microsatellite instability, creates a permissive state in which a cell acquires enough mutations to be transformed to a cancer cell. Epigenetic alteration is a more recently appreciated heritable alteration that has been found to occur commonly in colorectal cancer. Epigenetic alterations are clonal changes in gene expression without accompanying changes in primary DNA coding sequences. A subset of colorectal cancer shows cancer-specific promoter hypermethylation of several genes simultaneously, so-called CpG island methylator phenotype (CIMP) positive. The understanding of genetic and epigenetic alterations in colorectal carcinogenesis will yield more effective diagnostic and therapeutic strategies for colorectal cancer. (Intest Res 2007;5:111-121)

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Case Report

A Case of Pulmonary Tuberculosis Misdiagnosed as Lung Metastases after Curative Resection of Early Colon Cancer: Chang Joon Kim, Dong Il Park, Sung Keun Park, Jung Ho Park, Chong Il Sohn, Woo Kyu Jeon, Young-Ho Kim, Sun-Young Lee; Intest Res 2007;5(2):196-199. Published online December 30, 2007

Abstract PDF: Early colon cancer can be cured by endoscopic mucosal resection (EMR). However, the possibility of complete resection depends on the depth of cancer invasion. Ten percent of cancers invading the submucosal layer are associated with local lymph node metastasis. Therefore, colon cancers confirmed to invade the submucosal layer after EMR require surgical resection. We treated a woman with adenocarcinoma at the hepatic flexure with submucosal invasion diagnosed after piecemeal EMR. Subsequent right hemicolectomy with lymph node dissection revealed no residual cancer. However, after 21 months, multiple pulmonary nodules were incorrectly diagnosed as pulmonary metastases, based on the radiological findings. The final diagnosis of pulmonary tuberculosis was made after lung metastasectomy. (Intest Res 2007;5:196-199)

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Original Articles

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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The Different Colonoscopic Manifestations of Primary Colorectal Lymphomas by Their Cellular Origin: Won Hyeok Choe, Young-Ho Kim, Beom Jin Kim, Jae Uk Lee, Jun Haeng Lee, Hee Jung Son, Poong-Lyul Rhee, Jae J. Kim, Seung Woon Paik, Jong Chul Rhee, Young Hyeh Ko, Woo Yong Lee, Ho kyung Chun; Intest Res 2003;1(1):22-30. Published online May 27, 2003

Abstract PDF: Background/Aims
There were few reports of primary colorectal lymphoma mainly focusing on the colonoscopic findings. The aim of this study was to review the colonoscopic findings and clinical characteristics of primary colorectal lymphomas by their cellular origin. Methods: Clinical information was retrospectively obtained from 18 cases with primary colorectal lymphoma from January 1994 to December 2001. The extent of disease was defined as focal or diffuse. Colonoscopic images were reviewed and classified into superficial, ulcerative, ulceroinfiltrative, and fungating types. Results: The study included thirteen men and five women, with a mean age of 48.6±13.3 years at disease onset. The most common presenting symptom was abdominal pain and the most frequent involvement was cecum. The endoscopic type was fungating in 6 cases, ulceroinfiltrative in 5 cases, ulcerative in 5 cases, and superficial in 2 cases. The lymphomas were B-cell lineage in 13 cases and T-cell lineage in 5 cases. Between B-cell and T-cell lymphomas, there was no statistically significant difference in age, gender, and the stage of the disease. All B-cell lymphomas were focally located, whereas 80% of T-cell lymphomas were diffuse (p=0.002). T-cell lymphomas were classified as ulcerative type in four cases and superficial type in one case. On the other hand, the most common colonoscopic feature of primary B-cell colorectal lymphoma was the fungating type (p=0.009). Conclusions: We found that primary colorectal lymphomas have different colonoscopic features by their cellular origin. (Intestinal Research 2003;1:22-30)

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