Intestinal Research

Original Articles

IBD

Physician education can minimize inappropriate steroid use in patients with inflammatory bowel disease: the ACTION study: Yehyun Park, Chang Hwan Choi, Hyun Soo Kim, Hee Seok Moon, Do Hyun Kim, Jin Ju Kim, Dennis Teng, Dong Il Park; Intest Res 2022;20(4):452-463. Published online March 11, 2022; DOI: https://doi.org/10.5217/ir.2021.00125

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Background/Aims
Epidemiological data on steroid use in South Korean patients with inflammatory bowel disease (IBD) are limited. We documented the steroid use patterns in these patients, and whether physician education on appropriate steroid use affected these patterns.
Methods
ACTION was an observational cohort study conducted in adults (≥19 years) with IBD. A retrospective chart review was performed at baseline (cohort 1) and 1 year after physician training (cohort 2). Eligible cases with excessive or inappropriate steroid use were identified, along with any associated risk factors.
Results
Data were collected during May 2018-July 2019 from patients with Crohn’s disease (CD) and ulcerative colitis (UC) in cohort 1 (n=1,685) and cohort 2 (n=1,649). At baseline, 155 patients (9.2%) had received steroids within the previous 12 months, 46 (29.7%) of whom had used steroids excessively, 16 (34.8%) of these having inappropriately used excessive steroids. Although steroid exposure was similar in cohort 1 (9.2%) and cohort 2 (9.7%), the latter comprised fewer excessive steroid users (20.0% vs. 29.7%). Severe disease was associated with excessive steroid use in cases with UC, but not with CD.
Conclusions
Although, overall steroid use was relatively low in South Korean patients with IBD, one-third of steroid users used them excessively, and one-third among these used excessive steroids inappropriately. High disease activity was the main risk factor for excessive steroid use which may potentially be reduced by physician education, especially in cases with UC. Active screening to minimize excessive and inappropriate steroid use through physician education should be considered.

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The Reliability and Quality of Short Videos as a Source of Dietary Guidance for Inflammatory Bowel Disease: Cross-sectional Study
Zixuan He, Zhijie Wang, Yihang Song, Yilong Liu, Le Kang, Xue Fang, Tongchang Wang, Xuanming Fan, Zhaoshen Li, Shuling Wang, Yu Bai
Journal of Medical Internet Research.2023; 25: e41518. CrossRef
Corticosteroid, a double-edged sword in inflammatory bowel disease management: possibility of reducing corticosteroid use through physician education
Seulji Kim, Seong-Joon Koh
Intestinal Research.2022; 20(4): 389. CrossRef

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Endoscopy

Three-year colonoscopy surveillance after polypectomy in Korea: a Korean Association for the Study of Intestinal Diseases (KASID) multicenter prospective study: Won Seok Choi, Dong Soo Han, Chang Soo Eun, Dong Il Park, Jeong-Sik Byeon, Dong-Hoon Yang, Sung-Ae Jung, Sang Kil Lee, Sung Pil Hong, Cheol Hee Park, Suck-Ho Lee, Jeong-Seon Ji, Sung Jae Shin, Bora Keum, Hyun Soo Kim, Jung Hye Choi, Sin-Ho Jung; Intest Res 2018;16(1):126-133. Published online January 18, 2018; DOI: https://doi.org/10.5217/ir.2018.16.1.126

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<b>Background/Aims</b><br/>

Colonoscopic surveillance is currently recommended after polypectomy owing to the risk of newly developed colonic neoplasia. However, few studies have investigated colonoscopy surveillance in Asia. This multicenter and prospective study was undertaken to assess the incidence of advanced adenoma based on baseline adenoma findings at 3 years after colonoscopic polypectomy.

Methods

A total of 1,323 patients undergoing colonoscopic polypectomy were prospectively assigned to 3-year colonoscopy surveillance at 11 tertiary endoscopic centers. Relative risks for advanced adenoma after 3 years were calculated according to baseline adenoma characteristics.

Results

Among 1,323 patients enrolled, 387 patients (29.3%) were followed up, and the mean follow-up interval was 31.0±9.8 months. The percentage of patients with advanced adenoma on baseline colonoscopy was higher in the surveillance group compared to the non-surveillance group (34.4% vs. 25.7%). Advanced adenoma recurrence was observed in 17 patients (4.4%) at follow-up. The risk of advanced adenoma recurrence was 2 times greater in patients with baseline advanced adenoma than in those with baseline non-advanced adenoma, though the difference was not statistically significant (6.8% [9/133] vs. 3.1% [8/254], P=0.09). Advanced adenoma recurrence was observed only in males and in subjects aged ≥50 years. In contrast, adenoma recurrence was observed in 187 patients (48.3%) at follow-up. Male sex, older age (≥50 years), and multiple adenomas (≥3) at baseline were independent risk factors for adenoma recurrence.

Conclusions

A colonoscopy surveillance interval of 3 years in patients with baseline advanced adenoma can be considered appropriate.

Citations

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When should patients take simethicone orally before colonoscopy for avoiding bubbles: A single-blind, randomized controlled study
Woohyuk Jung, Gyu Man Oh, Jae Hyun Kim, Youn Jung Choi, Min Young Son, Kyoungwon Jung, Sung Eun Kim, Won Moon, Moo In Park, Seun Ja Park
Medicine.2023; 102(19): e33728. CrossRef
Comparison of the efficacy and safety between oral sulfate tablet and polyethylene glycol for bowel preparation before colonoscopy according to age
Jae Hyun Kim, Yong Eun Park, Tae Oh Kim, Jongha Park, Gyu Man Oh, Won Moon, Seun Ja Park
Medicine.2022; 101(27): e29884. CrossRef
Optimization of the surveillance strategy in patients with colorectal adenomas: A combination of clinical parameters and index colonoscopy findings
Chan Hyuk Park, Yoon Suk Jung, Nam Hee Kim, Jung Ho Park, Dong Il Park, Chong Il Sohn
Journal of Gastroenterology and Hepatology.2021; 36(4): 974. CrossRef
Postgastrectomy gastric cancer patients are at high risk for colorectal neoplasia: a case control study
Tae-Geun Gweon, Kyu-Tae Yoon, Chang Hyun Kim, Jin-Jo Kim
Intestinal Research.2021; 19(2): 239. CrossRef
Risk of developing metachronous advanced colorectal neoplasia after resection of low-risk diminutive versus small adenomas
Nam Hee Kim, Yoon Suk Jung, Jung Ho Park, Dong Il Park, Chong Il Sohn
Gastrointestinal Endoscopy.2020; 91(3): 622. CrossRef
Optimal Colonoscopic Surveillance Interval After Normal Baseline Screening Colonoscopy
Jian Dong, Minman Wu, Jiarong Miao, Rana Sami Ullah Khan, Tao Zhi, Tianmei Zhang, Xue Li, Yashi Peng, Gang Yang, Qiong Nan
Gastroenterology Nursing.2020; 43(3): 225. CrossRef
Comparative systematic review and meta-analysis of 1- to 5-mm versus 6- to 9-mm adenomas on the risk of metachronous advanced colorectal neoplasia
Yoon Suk Jung, Tae Jun Kim, Eunwoo Nam, Chan Hyuk Park
Gastrointestinal Endoscopy.2020; 92(3): 692. CrossRef
Appropriate Surveillance Interval after Colonoscopic Polypectomy in Patients Younger than 50 Years
Yoon Suk Jung, Nam Hee Kim, Jung Ho Park, Dong Il Park, Chong Il Sohn
Journal of Korean Medical Science.2019;[Epub] CrossRef
Impact of obesity and metabolic abnormalities on the risk of metachronous colorectal neoplasia after polypectomy in men
Nam Hee Kim, Yoon Suk Jung, Jung Ho Park, Dong Il Park, Chong Il Sohn
Journal of Gastroenterology and Hepatology.2019; 34(9): 1504. CrossRef
What Is Appropriate Upper Endoscopic Interval Among Dyspeptic Patients With Previously Normal Endoscopy? A Multicenter Study With Bayesian Change Point Analysis
Jong Wook Kim, Kee Wook Jung, Joong Goo Kwon, Jung Bok Lee, Jong Kyu Park, Ki Bae Bang, Chung Hyun Tae, Jung Hwan Oh
Journal of Neurogastroenterology and Motility.2019; 25(4): 544. CrossRef
Risk of Developing Metachronous Advanced Colorectal Neoplasia After Polypectomy in Patients With Multiple Diminutive or Small Adenomas
Nam Hee Kim, Yoon Suk Jung, Mi Yeon Lee, Jung Ho Park, Dong Il Park, Chong Il Sohn
American Journal of Gastroenterology.2019; 114(10): 1657. CrossRef

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Case Report

A Case of Ascending Colonic Xanthoma Presenting as a Lateral Spreading Tumor: Sang Hun Kim, Hyun Soo Kim, Yoo Duk Choi, Won Suk Choi, Ban Seok Kim, Seon Young Park, Sung Bum Cho, Chang Hwan Park, Young Eun Joo, Sung Kyu Choi, Jong Sun Rew; Intest Res 2014;12(2):162-165. Published online April 29, 2014; DOI: https://doi.org/10.5217/ir.2014.12.2.162

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Gastrointestinal xanthomas are characterized by foamy cytoplasmic cells containing lipid in lamina propria, and occur almost in the gastric mucosa. Colonic xanthomas have been described in rare case. All reported colonic xanthomas were located in rectosigmoid. Rectosigmoid xanthomas have tended to exhibit small polypoid lesion, on the contrary flat in stomach. We report a case of xanthoma on ascending colon presenting as a laterally spreading tumor resected by endoscopic mucosal resection method.

Citations

Citations to this article as recorded by

Tubular Adenoma Arising Within a Rectosigmoid Xanthoma: A Case Report
Kaley Coffey, Heather L Mateja, William Bowers, Peter DeVito
Cureus.2024;[Epub] CrossRef
Rectal xanthomatous polyp within the context of a normal serum lipid Profile: A case report
Adam Tolulope Rahman, Olutoyin Iretiola Asaolu, Uchenna Simon Ezenkwa
Nigerian Journal of Gastroenterology and Hepatology.2023; 15(1): 16. CrossRef
Adenoma arising from xanthoma in the transverse colon: a case report
Yu Jin Jung, Jun Lee, Seong Jung Kim, Ran Hong
Gastroenterology Report.2022;[Epub] CrossRef
XANTHELASMAS OF THE UPPER GASTROINTESTINAL TRACT: A REPORT OF FOUR CASES
Devojee M, Rajeshwari G, Jagan Mohan Rao K, Akarsh M P
Journal of Evidence Based Medicine and Healthcare.2015; 2(18): 2781. CrossRef

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Review

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)

Citations

Citations to this article as recorded by

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

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Case Reports

A Case of Adenocarcinoma of the Transverse Colon with Humoral Hypercalcemia of Malignancy: Jae Gon Lee, Dong Soo Han, Jae Ha Kim, You Shin Kim, Hyun Soo Kim, Jae Yoon Jeong, Ju Yeon Pyo, Yong Cheol Jeon, Joo Hyun Sohn; Intest Res 2012;10(4):397-399. Published online October 31, 2012; DOI: https://doi.org/10.5217/ir.2012.10.4.397

Abstract PDF

Hypercalcemia is a common electrolyte imbalance in patients with malignancy. Approximately 80% of hypercalcemia is associated with humoral hypercalcemia of malignancy (HHM), but occurs rarely in colorectal carcinomas. A 72-year-old man was admitted with abdominal pain and bowel habit change. Colonoscopy showed a malignant tumor in the transverse colon. Laboratory data showed an elevated serum calcium level (11.6 mg/dL) and elevated parathyroid hormone-related peptide level (12.2 pmol/L). Histology showed poorly differentiated adenocarcinoma. We infused intravenous normal saline, furosemide and pamidronate. The serum calcium level was subsequently normalized. However, the patient died from cancer progression 10 days later. With a review of the relevant literature, we report a case of adenocarcinoma of the transverse colon with HHM. (Intest Res 2012;10:397-399)

Citations

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Esophageal Cancer Initially Presenting as Severe Paraneoplastic Hypercalcemia Requiring Hemodialysis
Hye Shin Ahn, Jong Min Yun, Yeong Bok Lee, Yu Mi Ko, Jung Eun Lee, Hye Sung Won, Sung Soo Kim, Young Ok Kim
The Korean Journal of Gastroenterology.2015; 65(6): 361. CrossRef

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Mucosa-Associated Lymphoid Tissue Lymphoma of the Rectum Cured by Radiotherapy: Joon Gi Min, Jae Ho Choi, Eun Young Kim, Hyun Soo Kim, Jae Myung Cha, Joung Il Lee, Kwang Ro Joo, Hyun Phil Shin, Jae Jun Park, Weon Kyu Chung; Intest Res 2012;10(2):201-205. Published online April 30, 2012; DOI: https://doi.org/10.5217/ir.2012.10.2.201

Abstract PDF

Primary rectal mucosa-associated lymphoid tissue (MALT) lymphoma is a particularly rare disease, comprising ＜1% of gastrointestinal lymphomas. Although antibiotic therapy has been demonstrated effective for gastric MALT lymphoma, the optimal treatment for MALT lymphoma of the rectum is unknown. Radiotherapy or surgery is often used to treat limited stage MALT lymphoma of the rectum. Here, we describe a case of a 44-year-old-man, who was diagnosed with primary MALT lymphoma of the rectum through colonoscopy. Other staging evaluations, including upper gastrointestinal endoscopy, abdomino-pelvic CT, chest CT, 18F fludeoxyglucose-positron emission tomography, and a bone marrow examination showed no other abnormalities, except stage IA para-rectal lymphadenopathy. The patient received 2 months of radiotherapy without major toxicity. A follow-up abdomino-pelvic CT scan revealed marked improvement in the volume of rectal lymphoma and adjacent lymph nodes. Mucosal nodularity of the lower rectum had completely regressed at the follow-up endoscopy and complete remission was confirmed with a biopsy. (Intest Res 2012;10: 0-205)

Citations

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Endoscopic features and clinical outcomes of colorectal mucosa-associated lymphoid tissue lymphoma
Min Kyung Jeon, Hoonsub So, Jooryung Huh, Hee Sang Hwang, Sung Wook Hwang, Sang Hyoung Park, Dong-Hoon Yang, Kee Don Choi, Byong Duk Ye, Seung-Jae Myung, Suk-Kyun Yang, Jeong-Sik Byeon
Gastrointestinal Endoscopy.2018; 87(2): 529. CrossRef

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Original Articles

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

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
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
Resection of Diminutive and Small Colorectal Polyps: What Is the Optimal Technique?
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

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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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Prevalence and Risk Factors of Colorectal Neoplasms according to Coronary Artery Obstructive Disease: Ki Tae Suk, Hyun Soo Kim, Hyun Jun Min, Hong Jun Park, Hyo Keun Jeon, Moon Young Kim, Jae Woo Kim, Soon Koo Baik, Sang Ok Kwon; Intest Res 2011;9(2):112-117. Published online August 30, 2011; DOI: https://doi.org/10.5217/ir.2011.9.2.112

Abstract PDF: Background/Aims
Both colorectal neoplasm (CN) and coronary artery obstructive disease (CAOD) are prevalent and major leading causes of death in Korea. Although CN and CAOD share similar risk factors such as male gender, smoking, hyperlipidemia, diabetes mellitus, and obesity, few studies of both CN and CAOD have been reported. In this study, we evaluated clinical correlations between CN and CAOD. Methods: Between June 2003 and December 2007, 176 patients (Male: 101, average age: 62.1±9.7 yr) who underwent colonoscopy after or before coronary angiography were retrospectively enrolled. The colonoscopic findings (normal, adenoma, or cancer) of patients as well as clinical and laboratory data according to the extent of CAOD (normal, minimal CAOD, or CAOD) were compared. Results: CAOD negative, minimal CAOD, and CAOD patients totaled 36, 40, and 100, respectively. The presence of CN (adenoma and adenocarcinoma) in CAOD negative, minimal CAOD, and CAOD cases was 42%, 48%, and 63%, respectively, which was significantly different (P＜0.05). In multivariate analysis, old age (≥60 yr; P=0.03, odds ratio 2.47) and the presence of CAOD (P=0.02, odds ratio 4.11) were associated with the presence of CN. Conclusions: The prevalence of CN increased in proportion to the severity of CAOD. Colorectal cancer screening by fecal occult blood tests or colonoscopy should be a priority in patients with CAOD, particularly the elderly. (Intest Res 2011;9:112-116)

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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)

Citations

Citations to this article as recorded by

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

2,776 View
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Original Articles

Comparison of Bowel Preparation Depending on Completion Time of Polyethylene Glycol Ingestion and Start Time of Colonoscopy: Jang Hyuk Yoon, Dong Il Park, Jeong Eun Shin, Seong Eun Kim, Sung Ae Jung, Suck Ho Lee, Dong Kyung Chang, Chang Soo Eun, Dong Soo Han, Hyun Soo Kim, Seun Ja Park, Il Hyun Baek, Bora Keum, Yoon Tae Jeen; Intest Res 2010;8(1):24-29. Published online June 30, 2010; DOI: https://doi.org/10.5217/ir.2010.8.1.24

Abstract PDF

Background/Aims
Polyethylene glycol (PEG) solution is the most widely used bowel preparation agent for colonoscopy because of its safety and efficacy in colon cleansing. It has been hypothesized that the timing of colon preparation may influence the quality of colon cleansing, and therefore affect the diagnostic yield of colonoscopy. The aim of this study was to determine the optimal interval of time between complete ingestion of PEG and performing colonoscopy. Methods: We prospectively enrolled 1,355 patients who had undergone a PEG-based bowel preparation on the day of colonoscopy in 11 tertiary hospitals in Korea between March 2008 and February 2009. All colonoscopies were performed in the afternoon. The start time of PEG ingestion, completion time of PEG ingestion, dose of PEG ingested, start time of colonoscopy, and the quality of bowel cleansing were recorded. Results: There was no difference of cleansing quality of bowel preparation between three groups of less than 7 hours of elapsed time (2≤ and <3 hours, 3≤ and <5 hours, 5≤ and <7 hours). However, group of more than 7 hours of elapsed time presented poor cleansing quality than others (P<0.01). Conclusions: If >7 hours elapses after ingestion of PEG, the quality of bowel preparation is poor. Therefore, depending on the time colonoscopy is scheduled, the start time of PEG ingestion may need to be adjusted. (Intest Res 2010;8:24-29)

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Vladimir Kojecky, Jan Matous, Radan Keil, Milan Dastych, Zdena Zadorova, Michal Varga, Radek Kroupa, Jiri Dolina, Miroslav Misurec, Ales Hep, Martin Griva
Digestive and Liver Disease.2018; 50(3): 271. CrossRef
Comparative Study on Bowel Preparation Efficacy of Ascorbic Acid Containing Polyethylene Glycol by Adding Either Simethicone or 1 L of Water in Health Medical Examination Patients: A Prospective Randomized Controlled Study
Se Hwan Yeo, Jae Hoon Kwak, Yeo Un Kim, Tae Ho Kwon, Jeong Bae Park, Jun Hyung Park, Yong Kook Lee, Yun Jeong Lim, Chang Heon Yang
The Korean Journal of Gastroenterology.2016; 67(4): 189. CrossRef
Randomized Controlled Trial of Sodium Phosphate Tablets versus 2 L Polyethylene Glycol Solution for Bowel Cleansing prior to Colonoscopy
Yun Ho Lee, Seong Yeon Jeong, You Sun Kim, Hye Jin Jung, Min Jung Kwon, Cheol Hun Kwak, Song I Bae, Jeong Seop Moon, Ji Won Kim, Su Hwan Kim, Kook Lae Lee
The Korean Journal of Gastroenterology.2015; 65(1): 27. CrossRef
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Clinicopathological Characteristics of Colorectal Cancer according to Microsatellite Instability: Ki Tae Suk, Hyun Soo Kim, Jin Hyung Lee, Bo Ra Kim, Moon Young Kim, Jae Woo Kim, Soon Koo Baik, Sang Ok Kwon, Yosep Chong, Mee Yon Cho; Intest Res 2009;7(1):14-21. Published online June 30, 2009

Abstract PDF: Background/Aims
Microsatellite instability (MSI) is associated with mutations in the DNA mismatch repair system and accounts for 10-15% of all cases of sporadic colorectal cancer (CRC). However, the characteristics and role of MSI as a marker for predicting the prognosis and therapeutic effect on CRC remain unclear. Methods: Between June 2003 and December 2007, 259 patients (males, 159 [61%]; age, 63 [±11] years) who underwent surgery for CRC were retrospectively enrolled. The clinicopathologic characteristics of patients with high-frequency MSI (MSI-H) CRC were reviewed and compared to patients with low-frequency MSI or microsatellite stable CRC. The patient characteristics and MSI-related data were recorded for the following variables: gender, age, clinicopathologic findings, chemotherapy response, recurrence, and survival. Results: MSI-H CRC was diagnosed in 30 patients (12%), low-frequency MSI CRC was diagnosed in 10 patients (4%), and microsatellite stable CRC in was diagnosed in 219 patients (84%). The MSI-H group exhibited the following characteristics: large size, right colon location, positive response to chemotherapy, low recurrence, longer survival, less neural invasion, poor differentiation, diffuse lymphoid reaction, and mucin pool formation. However, in the chemotherapy group (n=180), MSI-H was not a marker of longer survival. Based on Cox-regression analysis, stage IV CRC (OR=6.66; 95% CI, 2.24-53.00), MSI-H (OR=0.17; 95% CI, 0.04-0.73), and a positive response to chemotherapy (OR=0.02; 95% CI, 0.01-0.11) were related to mortality. Conclusions: MSI-H CRC had less neural invasion and diffuse lymphoid reaction. Further studies regarding the relationship between those pathologic findings and survival are needed. (Intest Res 2009;7:14-21)

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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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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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