Intestinal Research

Original Articles

A real-world comparison of subcutaneous to intravenous administration of infliximab in patients with inflammatory bowel disease: Kwang Woo Kim, Hyoun Woo Kang, Seong-Joon Koh, Hyuk Yoon, Sihyun Kim, Yukyung Jun, Hyun Jung Lee, Jong Pil Im, Young Soo Park, Ji Won Kim, Joo Sung Kim, Seoul National University Inflammatory Bowel Disease Research Network (SIRN); Received January 5, 2025 Accepted April 2, 2025 Published online June 23, 2025; DOI: https://doi.org/10.5217/ir.2025.00001 [Epub ahead of print]

Abstract PDF Supplementary Material PubReader ePub: Background/Aims
We compared intravenous and subcutaneous infliximab (IFX) as treatment for inflammatory bowel disease (IBD).
Methods
This retrospective, multicenter, observational study enrolled patients treated with either intravenous or subcutaneous IFX. Sequential parameters were compared at baseline, 6 months, and 12 months following the initiation of treatment with either type of IFX. The primary outcome was the comparison of the IFX trough levels after 12 months of treatment.
Results
In total, 183 participants were included in this study. After 6 months, the subcutaneous group exhibited significant differences compared to the intravenous group; in terms of clinical disease activity (0% vs. 15%, P= 0.007) and IFX trough level (21.72 ± 8.71 μg/mL vs. 7.70 ± 16.65 μg/mL, P= 0.002). After 12 months, subcutaneous, as compared to intravenous, achieved improved clinical disease activity (0% vs. 15%, P= 0.044) and IFX trough level (20.41 ± 12.91 μg/mL vs. 7.06 ± 6.81 μg/mL, P< 0.001). Analyzing the sequential changes compared with baseline data within each group, we observed significant alterations in subcutaneous; 6 months fecal calprotectin (676.3 ± 976.6 μg/g vs. 253.9 ± 483.9 μg/g, P= 0.014), 6 months IFX trough level (7.00 ± 5.67 μg/mL vs. 18.44 ± 6.34 μg/mL, P= 0.026), and 12 months IFX trough level (7.00 ± 5.67 μg/mL vs. 21.33 ± 4.50 μg/mL, P= 0.034).
Conclusions
This study indicates the potential suitability of subcutaneous IFX as an alternative treatment option for IBD.

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IBD

Predictors of histologic remission in patients with biologic-naïve, moderate-to-severe ulcerative colitis treated with first-line biologic agents and small-molecule drugs: a single-center, retrospective cohort study: Kijae Jo, Kwang Woo Kim, Hyun Jung Lee, Jong Pil Im, Joo Sung Kim, Seong-Joon Koh; Intest Res 2024;22(4):453-463. Published online May 22, 2024; DOI: https://doi.org/10.5217/ir.2024.00044

Abstract PDF PubReader ePub: Background/Aims
The prevalence and incidence of ulcerative colitis (UC) in Korea is increasing. Each patient has a different disease course and treatment response. Recently, with the development of biologic agents, histological remission has become a treatment goal. In this study, we aimed to identify the predictors of histological remission after first-line biologic agent treatment in patients with biologic agent-naïve UC.
Methods
We retrospectively analyzed the medical records of 92 patients who had been diagnosed with UC and treated with first-line biologic agent treatment at our center, between 2015 and 2022. The clinical characteristics, laboratory test results, and endoscopic and biopsy findings were analyzed. Histological remission was defined as the absence of cryptitis, crypt abscesses, and inflammatory cells on histology. Univariate and multivariate logistic regression analyses were performed to identify the predictors of histological remission after first-line treatment.
Results
Of the total 92 patients, 25 (27.2%) achieved histological remission. Each cohort had a varied body mass index (BMI) distribution, with a statistically significant overweight ratio, as defined by the Asian-Pacific BMI category of 23–25 kg/m², of 48.0% in the histological remission cohort (P= 0.026). A causal correlation between the overweight category and histological remission was confirmed (odds ratio, 3.883; 95% confidence interval, 1.141–13.212; P= 0.030).
Conclusions
We confirmed that the overweight category was a predictor of histological remission after first-line treatment with a biological agent. However, as BMI does not account for skeletal muscle mass, future studies are required to confirm the correlation between skeletal muscle mass and histological remission.

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Review

IBD

Korean clinical practice guidelines on biologics for moderate to severe Crohn’s disease: Seong-Joon Koh, Sung Noh Hong, Soo-Kyung Park, Byong Duk Ye, Kyeong Ok Kim, Jeong Eun Shin, Yong Sik Yoon, Hong Sub Lee, Sung Hoon Jung, Miyoung Choi, Soo-Young Na, Chang Hwan Choi, Joo Sung Kim, on behalf of the IBD Research Group of the Korean Association for the Study of Intestinal Diseases; Intest Res 2023;21(1):43-60. Published online October 18, 2022; DOI: https://doi.org/10.5217/ir.2022.00029

Abstract PDF PubReader ePub

Crohn’s disease (CD) is a relapsing and progressive condition characterized by diarrhea, abdominal pain, weight loss, and hematochezia that results in serious complications such as perforations, fistulas, and abscesses. Various medications, interventions, and surgical treatments have been used to treat CD. The Korean guidelines for CD management were distributed in 2012 and revised in 2017 by the Inflammatory Bowel Disease (IBD) Research Group of the Korean Association for the Study of Intestinal Diseases. Substantial progress in mucosal immunologic research has elucidated the pathophysiology of IBD, leading to development of biological agents for treatment of CD. The first developed biologic agent, tumor necrosis factor-α agents, were shown to be efficacious in CD, heralding a new era in management of CD. Subsequently, vedolizumab, a monoclonal antibody against integrin α4β7, and ustekinumab, a human monoclonal antibody that inhibits the common p40 subunit of interleukin-12 and interleukin-23, were both approved for clinical use and are efficacious and safe for both induction and maintenance of remission in moderate-to-severe CD patients. Moreover, a recent study showed the non-inferiority of CT-P13, an infliximab biosimilar, compared with infliximab in CD patients. The third Korean guidelines for CD management provide updated information regarding treatment of moderate-to-severe CD patients with biologic agents.

Citations

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Young Joo Yang, Seong Ran Jeon
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IFN-γ-Induced intestinal epithelial cell-type-specific programmed cell death: PANoptosis and its modulation in Crohn’s disease
Chansu Lee, Ji Eun Kim, Yeo-Eun Cha, Ji Hwan Moon, Eun Ran Kim, Dong Kyung Chang, Young-Ho Kim, Sung Noh Hong
Frontiers in Immunology.2025;[Epub] CrossRef
Population Pharmacokinetic Model for the Use of Intravenous or Subcutaneous Infliximab in Patients with Inflammatory Bowel Disease: Real-World Data from a Prospective Cohort Study
Joo Hye Song, Sung Noh Hong, Myeong Gyu Kim, Minjung Kim, Seong Kyung Kim, Eun Ran Kim, Dong Kyung Chang, Young-Ho Kim
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Impact of early aggressive treatment on long-term biochemical marker patterns in inflammatory bowel disease
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Annual Therapeutic Drug Monitoring in Patients with Inflammatory Bowel Disease During Infliximab Maintenance Therapy: Balancing Efficacy with Risk of Pharmacokinetic Failure
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Digestive Diseases and Sciences.2025;[Epub] CrossRef
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Ji Young Chang, Soo Jung Park, Jae Jun Park, Tae Il Kim, Jae Hee Cheon, Jihye Park
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So Yoon Choi, Sujin Choi, Byung-Ho Choe, Jae Hong Park, Kwang-Hae Choi, Hae Jeong Lee, Ji Sook Park, Ji-Hyun Seo, Jae Young Kim, Hyo-Jeong Jang, Suk Jin Hong, Eun Young Kim, Yeoun Joo Lee, Ben Kang
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Original Article

IBD

Concomitant ankylosing spondylitis can increase the risk of biologics or small molecule therapies to control inflammatory bowel disease: Yu Kyung Jun, Hyuk Yoon, Seong-Joon Koh, A Hyeon Kim, Kwang Woo Kim, Jun Won Park, Hyun Jung Lee, Hyoun Woo Kang, Jong Pil Im, Young Soo Park, Joo Sung Kim, on behalf of Seoul National University Inflammatory Bowel Disease Research Network (SIRN); Intest Res 2023;21(2):244-251. Published online August 8, 2022; DOI: https://doi.org/10.5217/ir.2022.00057

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
Patients with inflammatory bowel disease (IBD) are diagnosed with ankylosing spondylitis (AS) often. However, the disease course of patients with both IBD and AS is not well understood. This study aims to evaluate the effect of concomitant AS on IBD outcomes.
Methods
Among the 4,722 patients with IBD who were treated in 3 academic hospitals from 2004 to 2021, 55 were also diagnosed with AS (IBD-AS group). Based on patients’ electronic medical records, the outcomes of IBD in IBD-AS group and IBD group without AS (IBD-only group) were appraised.
Results
The proportion of patients treated with biologics or small molecule therapies was significantly higher in IBD-AS group than the proportion in IBD-only group (27.3% vs. 12.7%, P= 0.036). Patients with both ulcerative colitis and AS had a significantly higher risk of biologics or small molecule therapies than patients with only ulcerative colitis (P< 0.001). For univariable logistic regression, biologics or small molecule therapies were associated with concomitant AS (odds ratio, 4.099; 95% confidence interval, 1.863–9.021; P< 0.001) and Crohn’s disease (odds ratio, 3.552; 95% confidence interval, 1.590–7.934; P= 0.002).
Conclusions
Concomitant AS is associated with the high possibility of biologics or small molecule therapies for IBD. IBD patients who also had AS may need more careful examination and active treatment to alleviate the severity of IBD.

Citations

Citations to this article as recorded by

Author's Reply: “Association of early antibiotic use with risk of ulcerative colitis”
Junseok Park, Sungjin Woo, Seong-Joon Koh
Digestive and Liver Disease.2025; 57(3): 795. CrossRef
Risk of all-cause and cause-specific mortality associated with immune-mediated inflammatory diseases in Korea
Oh Chan Kwon, See Young Lee, Jaeyoung Chun, Kyungdo Han, Yuna Kim, Ryul Kim, Min-Chan Park, Jie-Hyun Kim, Young Hoon Youn, Hyojin Park
Frontiers in Medicine.2023;[Epub] CrossRef

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455 Download
2 Web of Science
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Review

IBD

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, on behalf of the IBD Research Group of the Korean Association for the Study of Intestinal Diseases; Intest Res 2023;21(1):61-87. Published online May 31, 2022; DOI: https://doi.org/10.5217/ir.2022.00007

Abstract PDF Supplementary Material PubReader ePub

Ulcerative colitis (UC), a relapsing-remitting chronic inflammatory bowel disease (IBD), has a variable natural course but potentially severe disease course. Since the development of anti-tumor necrosis factor (TNF) agents has changed the natural disease course of moderate-to-severe UC, therapeutic options for patients who failed conventional treatments are expanding rapidly. IBD clinical trials have demonstrated the potential efficacy and safety of novel biologics such as anti-integrin α4β7 and anti-interleukin-12/23 monoclonal antibodies and small molecules such as a Janus kinase inhibitor. Anti-TNF biosimilars also have been approved and are widely used in IBD patients. Wise drug choices should be made considering evidence-based efficacy and safety. However, the best position of these drugs remains several questions, with limited data from direct comparative trials. In addition, there are still concerns to be elucidated on the effect of therapeutic drug monitoring and combination therapy with immunomodulators. The appropriate treatment regimens in acute severe UC and the risk of perioperative use of biologics are unclear. As novel biologics and small molecules have been approved in Korea, we present the Korean guidelines for medical management of adult outpatients with moderate-to-severe UC and adult hospitalized patients with acute severe UC, focusing on biologics and small molecules.

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Impact of early aggressive treatment on long-term biochemical marker patterns in inflammatory bowel disease
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Predictors of histologic remission in patients with biologic-naïve, moderate-to-severe ulcerative colitis treated with first-line biologic agents and small-molecule drugs: a single-center, retrospective cohort study
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Original Articles

Inflammatory bowel diseases

The prevalence of sarcopenia and its effect on prognosis in patients with Crohn’s disease: Chan Hyung Lee, Hyuk Yoon, Dong Jun Oh, Jae Min Lee, Yoon Jin Choi, Cheol Min Shin, Young Soo Park, Nayoung Kim, Dong Ho Lee, Joo Sung Kim; Intest Res 2020;18(1):79-84. Published online January 30, 2020; DOI: https://doi.org/10.5217/ir.2019.00107

Abstract PDF PubReader ePub

Background/Aims
Crohn’s disease is associated with altered body composition, such as low muscle mass, which can affect clinical outcomes. However, there are few studies regarding the effect of sarcopenia on prognosis of Crohn’s disease. In this study, we evaluated the body composition at the initial diagnosis of Crohn’s disease and analyzed the clinical meaning of sarcopenia.
Methods
We conducted a retrospective review of medical records of patients who were diagnosed as Crohn’s disease and underwent computed tomography within 3 months after diagnosis. Sarcopenia was defined as an L3 skeletal muscle index (SMI) of < 49 cm²/m² for men and < 31 cm²/m² for women. Outcomes such as need for hospitalization, surgery, use of steroids, immunomodulators and biologics were analyzed.
Results
A total of 79 patients (male, 73.4%; mean age, 29.9 years) were included and 40 patients (51%) were diagnosed as sarcopenia. C-reactive protein (CRP) level was correlated with sarcopenia (P= 0.044). Erythrocyte sedimentation rate (ESR) showed a tendency to decrease inversely with SMI (r = –0.320, P= 0.008) and hemoglobin and albumin tended to increase in proportion to SMI (hemoglobin: r = 0.271, P= 0.016 and albumin: r = 0.350, P= 0.002). However, there was no statistically significance in time-to-first-event analysis in aspects of sarcopenia.
Conclusions
Approximately 50% of patients with newly diagnosed as Crohn’s disease had sarcopenia. CRP levels were higher in the sarcopenia group and SMI correlated with ESR, hemoglobin, and albumin. However, none of prognostic values were demonstrated.

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IBD

The effect of vitamin D administration on inflammatory markers in patients with inflammatory bowel disease: Jae Chang Jun, Hyuk Yoon, Yoon Jin Choi, Cheol Min Shin, Young Soo Park, Nayoung Kim, Dong Ho Lee, Joo Sung Kim; Intest Res 2019;17(2):210-217. Published online November 27, 2018; DOI: https://doi.org/10.5217/ir.2018.00081

Abstract PDF PubReader ePub

Background/Aims
The exact relationship between vitamin D deficiency and inflammatory bowel disease (IBD) remains unclear. We evaluated the effect of vitamin D3 administration on inflammatory responses and disease severity in patients with IBD.
Methods
We investigated the serum 25-hydroxyvitamin D3 [25-(OH)D] and C-reactive protein (CRP) levels and the partial Mayo score (PMS) in patients with IBD. Vitamin D3 was administered in patients with either vitamin D deficiency or insufficiency and CRP serum vitamin D levels and PMS were re-examined at 6 months of administration.
Results
In 88 patients with Crohn’s disease (CD), a negative correlation was found between serum vitamin D and CRP. In 178 patients with ulcerative colitis (UC), serum vitamin D showed no association with CRP or PMS. Serum vitamin D increased from 11.08±3.63 to 22.69±6.11 ng/mL in 29 patients with CD and from 11.45±4.10 to 24.20±6.61 ng/mL in 41 patients with UC who received vitamin D3 treatment (P<0.001 and P<0.001, respectively). In patients with CD, median ΔCRP was –0.24 in the normalized vitamin D group and –0.11 in the non-normalized group (P=0.308). In patients with UC, median ΔCRP was −0.01 in the normalized vitamin D group and 0.06 in the non-normalized group (P=0.359).
Conclusions
Although a negative correlation was found between serum vitamin D and CRP levels in patients with CD, administration of vitamin D did not improve the CRP level in patients with CD. In patients with UC, serum vitamin D level was unrelated to CRP or PMS.

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Effects of a Single Oral Megadose of Vitamin D3 on Inflammation and Oxidative Stress Markers in Overweight and Obese Women: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial
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The effects of consuming a low-fat yogurt fortified with nano encapsulated vitamin D on serum pro-oxidant-antioxidant balance (PAB) in adults with metabolic syndrome; a randomized control trial
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Vitamin D and inflammatory bowel disease: what do we know so far?
Antonio María Caballero Mateos, Raúl Vicente Olmedo-Martín, Amparo Roa-Colomo, María del Mar Díaz Alcázar, Manuel Valenzuela Barranco
Revista Española de Enfermedades Digestivas.2020;[Epub] CrossRef
Inflammatory Bowel Disease and Vitamin D
Ki Bae Kim, Hyoung Woo Kim, Jun Su Lee, Soon Man Yoon
The Korean Journal of Gastroenterology.2020; 76(6): 275. CrossRef
Vitamin D in Inflammatory Bowel Disease: Biological, Clinical and Therapeutic Aspects
Raúl Vicente Olmedo-Martín, Inmaculada González-Molero, Gabriel Olveira, Víctor Amo-Trillo, Miguel Jiménez-Pérez
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Arnold De Loof, Liliane Schoofs
Frontiers in Endocrinology.2019;[Epub] CrossRef

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Colorectal neoplasia

Clinical features and outcomes in spontaneous intramural small bowel hematoma: cohort study and literature review: Eun Ae Kang, Seung Jun Han, Jaeyoung Chun, Hyun Jung Lee, Hyunsoo Chung, Jong Pil Im, Sang Gyun Kim, Joo Sung Kim, Hyuk Yoon, Cheol Min Shin, Young Soo Park, Nayoung Kim, Dong Ho Lee, Hyun Chae Jung; Intest Res 2019;17(1):135-143. Published online October 10, 2018; DOI: https://doi.org/10.5217/ir.2018.00085

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
Spontaneous intramural small bowel hematoma (SISBH) is an extremely rare complication of anticoagulant or antiplatelet therapy. We assessed the clinical characteristics and outcomes of patients with SISBH according to the anatomical location of the hematoma.
Methods
From January 2003 to February 2016, medical records for all patients hospitalized for SISBH at 2 tertiary referral hospitals were retrospectively reviewed. The primary outcome was requirement for surgery.
Results
A total of 37 patients were enrolled. The mean age was 74.1 years. Among them, 33 patients (89.2%) were taking anticoagulant and/or antiplatelet agents. Duodenal intramural hematoma was detected in 4 patients (10.8%), jejunal in 16 (43.2%), and ileal in 17 (45.9%). Compared to jejunal and ileal involvement, duodenal intramural hematoma was significantly associated with high Charlson comorbidity index and low levels of white blood cells, hemoglobin, and platelets in the blood. SISBH in the duodenum was related to thrombocytopenia in 3 patients following systemic chemotherapy for malignancy. All patients with SISBH showed clinical improvement with conservative therapy. Mean length of hospital stay was 9.35 days. Independent predictors of a hospital stay of more than 7 days were body weight less than 60 kg (odds ratio [OR], 12.213; 95% confidence interval [CI], 1.755–84.998; P=0.011) and a history of cerebrovascular accidents (OR, 6.667; 95% CI, 1.121–39.650; P=0.037).
Conclusions
Compared to jejunal and ileal involvement, thrombocytopenia may result in spontaneous duodenal intramural hematoma among patients who are treated with systemic chemotherapy for malignancies. Patients with SISBH have excellent clinical outcomes with conservative therapy regardless of the anatomical location of the hematoma.

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Drug-Induced Spontaneous Intramural Hematoma of the Gastrointestinal Tract: A Real-World Pharmacovigilance Analysis
Xuehong Wang, Min Luo, Wenyu Li, Yuqian Zhou
Journal of Cardiovascular Pharmacology.2025; 85(4): 297. CrossRef
Idiopathic Duodenal Hematoma: A Case Report and Literature Review
Ebtesam Al-Najjar, Abdullah Esmail, Bayan Khasawneh, Saifudeen Abdelrahim, Maen Abdelrahim
Reports.2025; 8(2): 73. CrossRef
A Case of Direct-Acting Oral Anticoagulant-Induced Intramural Colon Hematoma Successfully Treated by Laparoscopic Surgery
Daisuke Tomita, Shigeo Toda, Ryo Miyazaki, Shuichiro Matoba, Hiroya Kuroyanagi
Cureus.2024;[Epub] CrossRef
Spontaneous Intramural Small Bowel Hematoma in an Elderly Man with Multiple Myeloma
Sigrid L. Williamson, Aishwarya Suresh, Adrian Ong
The American Surgeon™.2023; 89(6): 2816. CrossRef
Intramural duodenal hematoma: diagnosis and management of a rare entity
Álvaro Pérez-Rubio, Juan Carlos Sebastián-Tomás, Sergio Navarro-Martínez, Marta Córcoles Córcoles, Carlos Domingo del Pozo
Cirugía Española (English Edition).2023; 101(7): 515. CrossRef
Hematoma intramural duodenal: diagnóstico y manejo de una entidad infrecuente
Álvaro Pérez-Rubio, Juan Carlos Sebastián-Tomás, Sergio Navarro-Martínez, Marta Córcoles Córcoles, Carlos Domingo del Pozo
Cirugía Española.2023; 101(7): 515. CrossRef
Jejunal intramural haematoma in a captive African lion (Panthera leo)
Richelle G. Butcher, Baukje Lenting, Alison S. Clarke, Kelly Buckle, Cristina Gans
Veterinary Record Case Reports.2023;[Epub] CrossRef
Spontaneous Duodenal Hematoma: A Rare Complication of Triple Antithrombotic Therapy Case Report
Mazin N Habhab, Asad J Torabi, Julie M Clary, George E Revtyak
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Karim El Aidaoui, Wahib Lahlou, Abderrahim Bourial, Nawal Bouknani, Chafik El Kettani
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Intramural Hematoma of Gastrointestinal Tract in People with Hemophilia A and B
Wei-Jung Teng, Ching-Huei Kung, Mei-Mei Cheng, Jia-Ruey Tsai, Chia-Yau Chang
Journal of Clinical Medicine.2023; 12(9): 3093. CrossRef
Endoscopic management of intramural spontaneous duodenal hematoma: A case report
Giorgio Valerii, Vittorio Maria Ormando, Carlo Cellini, Luca Sacco, Carmelo Barbera
World Journal of Gastroenterology.2022; 28(20): 2243. CrossRef
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Ding-Han Chen, Khay-Seng Soh, Ying-Tso Wang, Te-Chun Shen
Medicine.2022; 101(35): e30335. CrossRef
Spontaneous duodenal haematoma in a patient taking rivaroxaban
Rebeca de Barros Lopes, Finn McLennan Battleday, Toby Calvert, Rob Gwynne‐Jones, Rebecca Thomas
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Sergio Gil Rojas, Luis Miguel Estela Villa, Elsa María Jiménez Vicente
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Case Report

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; Intest Res 2017;15(1):124-129. Published online January 31, 2017; DOI: https://doi.org/10.5217/ir.2017.15.1.124

Abstract PDF PubReader ePub

Metronidazole is a widely used antibiotic for the treatment of anaerobic bacterial infections. Metronidazole-induced encephalopathy (MIEP) is a rare but potentially reversible disease. The mechanism of MIEP remains unclear, and differences in the neurotoxic effects of oral versus intravenous (IV) metronidazole administration have not yet been determined. We report the case of a Crohn's disease (CD) patient who experienced encephalopathy immediately after a single IV dose of metronidazole following long-term exposure to the oral form of the drug. The 64-year-old man with intractable CD experienced a sudden change in mental status, aphasia, and muscle weakness after IV administration of metronidazole. He had previously taken metronidazole orally for 13 years and received intermittent IV metronidazole treatments for CD exacerbation. Brain magnetic resonance imaging (MRI) showed high-intensity signals in the bilateral medial thalamus and the midbrain and pontine tegmentum on fluid-attenuated inversion recovery images. After discontinuation of metronidazole, the high-intensity brain MRI signals resolved and the patient's mental status dramatically improved; however, the patient exhibited mild cognitive dysfunction 2 months after the onset of encephalopathy.

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Gollapudi Hithesh, Swathy Moorthy, Lakshmi M, Emmanuel Bhaskar
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Mehri Salari, Masoud Etemadifar, Helia Ashourizadeh
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MRI Findings and Topographic Distribution of Lesions in Metronidazole-Induced Encephalopathy
Ambreen Fatima, Sachin Khanduri, Sadaf Sultana, Surbhi ., Saim A Siddiqui, Ashkrit Gupta, Vaibhav Pathak, Mohsin Mulani, Salma Khan, Tanya Bansal
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Guilherme A. Soares, Deivid W. Pires, Leonardo A. Pinto, Gustavo S. Rodrigues, André G. Prospero, Gabriel G. A. Biasotti, Gabriela N. Bittencourt, Erick G. Stoppa, Luciana A. Corá, Ricardo B. Oliveira, José R. A. Miranda
Pharmaceutics.2021; 13(8): 1274. CrossRef
Metronidazole-induced encephalopathy: a systematic review
Caspar Godthaab Sørensen, William Kristian Karlsson, Faisal Mohammad Amin, Mette Lindelof
Journal of Neurology.2020; 267(1): 1. CrossRef
Gut microbiota mediates intermittent-fasting alleviation of diabetes-induced cognitive impairment
Zhigang Liu, Xiaoshuang Dai, Hongbo Zhang, Renjie Shi, Yan Hui, Xin Jin, Wentong Zhang, Luanfeng Wang, Qianxu Wang, Danna Wang, Jia Wang, Xintong Tan, Bo Ren, Xiaoning Liu, Tong Zhao, Jiamin Wang, Junru Pan, Tian Yuan, Chuanqi Chu, Lei Lan, Fei Yin, Enriq
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Anti-protozoal Activity of Conifer Green Needle Complex against Trichomonas vaginalis
Lidia B. Kulyashova, Natalia Roschina, Tamara V. Nikitina, Vagif S. Soultanov
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Reversible metronidazole-induced neurotoxicity after 10 weeks of therapy
Wafa AlDhaleei, Ayesha AlMarzooqi, Nouran Gaber
BMJ Case Reports.2018; 2018: bcr-2017-223463. CrossRef

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Original Articles

Thirty-day mortality after percutaneous gastrostomy by endoscopic versus radiologic placement: a systematic review and meta-analysis: Joo Hyun Lim, Seung Ho Choi, Changhyun Lee, Ji Yeon Seo, Hae Yeon Kang, Jong In Yang, Su Jin Chung, Joo Sung Kim; Intest Res 2016;14(4):333-342. Published online October 17, 2016; DOI: https://doi.org/10.5217/ir.2016.14.4.333

Abstract PDF PubReader

Background/Aims

A percutaneous gastrostomy can be placed either endoscopically (percutaneous endoscopic gastrostomy, PEG) or radiologically (radiologically-inserted gastrostomy, RIG). However, there is no consistent evidence of the safety and efficacy of PEG compared to RIG. Recently, 30-day mortality has become considered as the most important surrogate index for evaluating the safety and efficacy of percutaneous gastrostomy. The aim of this meta-analysis was to compare the 30-day mortality rates between PEG and RIG.

Methods

Major electronic databases (MEDLINE, Embase, Scopus, and Cochrane library) were queried for comparative studies on the two insertion techniques of gastrostomy among adults with swallowing disturbance. The primary outcome was the 30-day mortality rate after gastrostomy insertion. Forest and funnel plots were generated for outcomes using STATA version 14.0.

Results

Fifteen studies (n=2,183) met the inclusion criteria. PEG was associated with a lower risk of 30-day mortality after tube placement compared with RIG (odds ratio, 0.60; 95% confidence interval [CI], 0.38–0.94; P=0.026). The pooled prevalence of 30-day mortality of PEG was 5.5% (95% CI, 4.0%–6.9%) and that of RIG was 10.5% (95% CI, 6.8%–14.3%). No publication bias was noted.

Conclusions

The present meta-analysis demonstrated that PEG is associated with a lower probability of 30-day mortality compared to RIG, suggesting that PEG should be considered as the first choice for long-term enteral tube feeding. Further prospective randomized studies are needed to evaluate and compare the safety of these two different methods of gastrostomy.

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Surgical Laparoscopy, Endoscopy & Percutaneous Techniques.2025;[Epub] CrossRef
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Syed Shezal Hussain, Nosheen Umar, Umair Kamran, Benjamin Coupland, Fumi Varyani, Nigel Trudgill
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Stephan C. Bischoff, Jann Arends, Christiane Decker-Baumann, Elisabeth Hütterer, Sebastian Koch, Stefan Mühlebach, Ingeborg Roetzer, Andrea Schneider, Claudia Seipt, Ralph Simanek, Zeno Stanga
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Matheus Coelho Meine, Isabela Ho Tusato, Nathalia Hoffmeister, Gilmara Coelho Meine
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Direct Percutaneous Endoscopic Gastrostomy Versus Radiological Gastrostomy in Patients Unable to Undergo Transoral Endoscopic Pull Gastrostomy
Divyanshoo R. Kohli, Craig Smith, Omer Chaudhry, Madhav Desai, Dion DePaolis, Prateek Sharma
Digestive Diseases and Sciences.2023; 68(3): 852. CrossRef
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Najla Alrasheed, Haneen S Khair, Renad M Aljohani, Noof M Alharbi, Nahlah N Alotaibi, Shahad F AlEdrees, Aamir Omair
Cureus.2023;[Epub] CrossRef
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Heather Parr, Lloyd Thomas, Prabhsimran Singh, Salma Mohammed, Khin Nu, John S. Kane, Fred Lee, Thomas Welbank, Andrew D. Hopper, Mark E. McAlindon, Elizabeth A. Williams, David S. Sanders
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World Journal of Meta-Analysis.2023; 11(6): 277. CrossRef
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Hicham Bouchiba, Maarten A J M Jacobs, Gerd Bouma, Dewkoemar Ramsoekh
JGH Open.2022; 6(1): 57. CrossRef
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Kasenee Tiankanon, Satimai Aniwan, Julalak Karuehardsuwan, Sumitra Wiangngoen, Rungsun Rerknimitr
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Gastroenterology Insights.2022; 13(3): 245. CrossRef
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Umair Kamran, Pui Chi Lee, Ben Coupland, Abdullah Abbasi, Helen Steed, Sissi Ispoglou, Fumi Varyani, Nigel Trudgill
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Divyanshoo R. Kohli, Kevin F. Kennedy, Madhav Desai, Prateek Sharma
Gastrointestinal Endoscopy.2021; 93(5): 1077. CrossRef
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Balqees Omari, Huthaifa Asmer, Hani Al‐Najjar, Issa Mohamad, Omar Al‐Saraireh, Basil J. Ammori
International Journal of Clinical Practice.2021;[Epub] CrossRef
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Xudong Liu, Zhengqiang Yang, Shun He, Guiqi Wang
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Wisam Sbeit, Anas Kadah, Amir Shahin, Samer Shbat, Moeen Sbeit, Tawfik Khoury
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Characteristics and outcomes of endoscopically resected colorectal cancers that arose from sessile serrated adenomas and traditional serrated adenomas: Ji Yeon Seo, Seung Ho Choi, Jaeyoung Chun, Changhyun Lee, Ji Min Choi, Eun Hyo Jin, Sung Wook Hwang, Jong Pil Im, Sang Gyun Kim, Joo Sung Kim; Intest Res 2016;14(3):270-279. Published online June 27, 2016; DOI: https://doi.org/10.5217/ir.2016.14.3.270

Abstract PDF PubReader ePub

Background/Aims

The efficacy and safety of endoscopic resection of colorectal cancer derived from sessile serrated adenomas or traditional serrated adenomas are still unknown. The aims of this study were to verify the characteristics and outcomes of endoscopically resected early colorectal cancers developed from serrated polyps.

Methods

Among patients who received endoscopic resection of early colorectal cancers from 2008 to 2011, cancers with documented pre-existing lesions were included. They were classified as adenoma, sessile serrated adenoma, or traditional serrated adenoma according to the baseline lesions. Clinical characteristics, pathologic diagnosis, and outcomes were reviewed.

Results

Overall, 208 colorectal cancers detected from 198 patients were included: 198 with adenoma, five with sessile serrated adenoma, and five with traditional serrated adenoma. The sessile serrated adenoma group had a higher prevalence of high-grade dysplasia (40.0% vs. 25.8%, P<0.001) than the adenoma group. During follow-up, local recurrence did not occur after endoscopic resection of early colorectal cancers developed from serrated polyps. In contrast, two cases of metachronous recurrence were detected within a short follow-up period.

Conclusions

Cautious observation and early endoscopic resection are recommended when colorectal cancer from serrated polyp is suspected. Colorectal cancers from serrated polyp can be treated successfully with endoscopy.

Citations

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Small sessile serrated polyps might not be at a higher risk for future advanced neoplasia than low-risk adenomas or polyp-free groups
Eun Hyo Jin, Ji Yeon Seo, Jung Ho Bae, Jooyoung Lee, Ji Min Choi, Yoo Min Han, Joo Hyun Lim
Scandinavian Journal of Gastroenterology.2022; 57(1): 99. CrossRef
The incidence and risk factors of sessile serrated adenomas in left side colon cancer patients after curative surgery
Myung Hee Kim, Hee Seok Moon, In Sun Kwon, Ju Seok Kim, Sun Hyung Kang, Jae Kyu Sung, Eaum Seok Lee, Seok Hyun Kim, Byung Seok Lee, Hyun Yong Jeong
Medicine.2020; 99(29): e20799. CrossRef
Improved Real-Time Optical Diagnosis of Colorectal Polyps Following a Comprehensive Training Program
Jung Ho Bae, Changhyun Lee, Hae Yeon Kang, Min-Sun Kwak, Eun Young Doo, Ji Yeon Seo, Ji Hyun Song, Sun Young Yang, Jong In Yang, Seon Hee Lim, Jeong Yoon Yim, Joo Hyun Lim, Goh Eun Chung, Su Jin Chung, Eun Hyo Jin, Boram Park, Joo Sung Kim
Clinical Gastroenterology and Hepatology.2019; 17(12): 2479. CrossRef
Clinical outcomes of surveillance colonoscopy for patients with sessile serrated adenoma
Sung Jae Park, Hyuk Yoon, In Sub Jung, Cheol Min Shin, Young Soo Park, Na Young Kim, Dong Ho Lee
Intestinal Research.2018; 16(1): 134. CrossRef
Surveillance colonoscopy in patients with sessile serrated adenoma
Ji Hyung Nam, Hyoun Woo Kang
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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.

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Special Review

Inflammatory Bowel Disease Cohort Studies in Korea: Present and Future: Jung Won Lee, Jong Pil Im, Jae Hee Cheon, You Sun Kim, Joo Sung Kim, Dong Soo Han; Intest Res 2015;13(3):213-218. Published online June 9, 2015; DOI: https://doi.org/10.5217/ir.2015.13.3.213

Abstract PDF PubReader

Inflammatory bowel disease (IBD) is defined as a chronic and relapsing inflammatory disorder of the intestine. Intestinal inflammation in IBD has been proposed to be attributable to the interplay between microbial, genetic, environmental, and immunological factors. The incidence and prevalence rates of IBD are rapidly increasing apparently in other parts of the world, with dramatic increases especially in East Asia. Generally, cohort studies are useful for estimating the incidence, prevalence, natural course, prognosis, and risk factors of diseases. In particular, cohort studies performed in Western countries have well described the prevalence, risk factors, and natural course of IBD and investigated its genetic pathophysiology. However, the outcomes of IBD cohort studies performed in Korea are not as persuasive as those of Western studies because of the relatively low prevalence of IBD and short follow-up periods of the cohorts in Korea. Despite this critical limitation, members of the Korean Association for the Study of Intestinal Diseases have demonstrated outstanding results. Some unique features of IBD patients in Korea are well demonstrated, such as thiopurine-induced leukopenia or risks of opportunistic tuberculosis infection in patients receiving tumor necrosis factor-α inhibitors. In this review, the present authors summarized the key points of the results of the cohort studies performed in Korea and explored future perspectives.

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Original Articles

Usefulness of the Cytomegalovirus Antigenemia Assay in Patients With Ulcerative Colitis: Jaeyoung Chun, Changhyun Lee, Ji-eun Kwon, Sung Wook Hwang, Sang Gyun Kim, Joo Sung Kim, Hyun Chae Jung, Jong Pil Im; Intest Res 2015;13(1):50-59. Published online January 29, 2015; DOI: https://doi.org/10.5217/ir.2015.13.1.50

Abstract PDF PubReader

Background/Aims

Patients with ulcerative colitis (UC) are at high risk for cytomegalovirus (CMV) reactivation. The usefulness of the CMV antigenemia assay in active UC patients has rarely been studied. We assessed whether the assay detects CMV colitis and predicts clinical outcomes in patients with UC.

Methods

We retrospectively reviewed the medical records of patients hospitalized for moderate-to-severe UC from 2003 to 2012. Positive CMV antigenemia was defined as ≥1 pp65-positive cell per 2×10⁵ polymorphonuclear neutrophils. CMV colitis was defined as the presence of inclusion bodies and/or positive immunohistochemistry in the colonic mucosa. The primary outcome was steroid refractoriness, defined as the absence of clinical improvement after intravenous high-dose steroid administration.

Results

A total of 43 patients were enrolled. CMV antigenemia was detected in 12 (27.9%) patients. Positive CMV antigenemia was significantly associated with CMV colitis (P =0.001). The sensitivity and specificity of positive CMV antigenemia for diagnosing CMV colitis were 66.7% and 87.1%, respectively. Steroid refractoriness was found in 11 of 12 (91.7%) and 12 of 31 (38.7%) patients with positive and negative CMV antigenemia, respectively (P =0.002). The independent predictors for steroid refractoriness were positive CMV antigenemia (adjusted odds ratio [OR], 7.73; 95% confidence interval [CI], 1.22-49.19; P =0.030) and a shorter duration from the diagnosis of UC (adjusted OR, 0.99; 95% CI, 0.98-0.99; P =0.025).

Conclusions

The CMV antigenemia assay shows low sensitivity but high specificity for detecting CMV colitis and may predict steroid-refractory UC. Early rescue therapy might be considered in UC patients positive for CMV antigenemia.

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Iļja Drjagunovs, Sniedze Laivacuma, Indra Zeltiņa, Aleksejs Derovs
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Hamideh Molaei, Leila Khedmat, Eghlim Nemati, Zohreh Rostami, Seyed Hassan Saadat
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Yafei Qin, Grace Wang, Dejun Kong, Guangming Li, Hongda Wang, Hong Qin, Hao Wang
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Saransh Jain, Divya Namdeo, Pabitra Sahu, Saurabh Kedia, Peush Sahni, Prasenjit Das, Raju Sharma, Vipin Gupta, Govind Makharia, Lalit Dar, Simon PL Travis, Vineet Ahuja
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Yoshihiro Yokoyama, Tsukasa Yamakawa, Takehiro Hirano, Tomoe Kazama, Daisuke Hirayama, Kohei Wagatsuma, Hiroshi Nakase
International Journal of Molecular Sciences.2020; 21(7): 2438. CrossRef
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Fadi H Mourad, Jana G Hashash, Viraj C Kariyawasam, Rupert W Leong
Journal of Crohn's and Colitis.2020; 14(8): 1162. CrossRef
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Alexandre Jentzer, Pauline Veyrard, Xavier Roblin, Pierre Saint-Sardos, Nicolas Rochereau, Stéphane Paul, Thomas Bourlet, Bruno Pozzetto, Sylvie Pillet
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Ali Y. Fakhreddine, Catherine T. Frenette, Gauree G. Konijeti
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Yinghong Wang, Pankaj Aggarwal, Xiuli Liu, Haiyan Lu, Lei Lian, Xianrui Wu, Shibin Guo, Nitin Aggarwal, Bret Lashner, Bo Shen
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Cytomegalovirus Enterocolitis and Cytomegalovirus Colitis Complicating Ulcerative Colitis
Kiyotaka Okawa, Tetsuya Aoki, Wataru Ueda, Koji Sano, Hiroshi Ono, Syusuke Nakauchi
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Sung Chul Park, Yoon Mi Jeen, Yoon Tae Jeen
The Korean Journal of Internal Medicine.2017; 32(3): 383. CrossRef
Cytomegalovirus and ulcerative colitis: Place of antiviral therapy
Sylvie Pillet
World Journal of Gastroenterology.2016; 22(6): 2030. CrossRef
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Hiroshi Nakase, Kei Onodera
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Ho-Su Lee, Sang Hyoung Park, Sung-Han Kim, Jihun Kim, Jene Choi, Hyo Jeong Lee, Wan Soo Kim, Jeong-Mi Lee, Min Seob Kwak, Sung Wook Hwang, Dong-Hoon Yang, Kyung-Jo Kim, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Yong Sik Yoon, Chang Sik Yu, Jin-Ho Ki
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When is an Assay of Cytomegalovirus Antigenemia Useful in Detecting Cytomegalovirus Colitis?
Kyeong Ok Kim
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Author's Reply
Jaeyoung Chun, Jong Pil Im
Intestinal Research.2015; 13(2): 184. CrossRef
Evaluation of a multiplex PCR assay for detection of cytomegalovirus in stool samples from patients with ulcerative colitis
Saifun Nahar
World Journal of Gastroenterology.2015; 21(44): 12667. CrossRef

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Prediction of Tumor Recurrence in Patients with Non-Gastric Gastrointestinal Stromal Tumors Following Resection according to the Modified National Institutes of Health Criteria: Seung Hyeon Jang, Ji Eun Kwon, Jee Hyun Kim, June Young Lee, Sang Gyun Kim, Joo Sung Kim, Hyun Chae Jung, Jong Pil Im; Intest Res 2014;12(3):229-235. Published online July 25, 2014; DOI: https://doi.org/10.5217/ir.2014.12.3.229

Abstract PDF PubReader ePub

Background/Aims

Few studies have investigated the prognosis of non-gastric gastrointestinal stromal tumors (GISTs) under the modified National Institutes of Health (NIH) consensus criteria in Korea. This study aims to clarify the clinical usefulness of the modified NIH criteria for risk stratification.

Methods

From January 2000 through October 2012, 88 patients who underwent curative resection for primary GISTs were included in this study. The enrolled patients were stratified to predict recurrence by the original NIH criteria and modified NIH criteria.

Results

In all, 88 patients had non-gastric GISTs, including 82 and 6 patients with GISTs of the small intestine and colorectum, respectively. The mean age was 57.3±13.0 years, and the median follow-up duration was 3.40 years (range, 0.02-12.76 years). All patients who were placed in the intermediate-risk category according to the original NIH criteria were reclassified into the high-risk category according to the modified NIH criteria. Therefore, the proportion of cases in the intermediate-risk category declined to 0.0% from 25.0% (22/88), and the proportion of cases in the high-risk category increased to 43.2% (38/88) from 18.2% (16/88) under the modified NIH criteria. Among the 22 reclassified patients, 6 (27.3%) suffered a recurrence during the observational period, and the recurrence rate of high-risk category patients was 36.8% (14/38).

Conclusions

Patients in the high-risk category according to the modified NIH criteria had a high GIST recurrence rate. Therefore, the modified NIH criteria are clinically useful in selecting patients who need imatinib adjuvant chemotherapy after curative surgical resection.

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Ying Sun, Luojie Liu, Dongtao Shi, Chao Ma, Xiaodan Xu
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Lauren Theiss, Carlo M. Contreras
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Michael Schmieder, Doris Henne-Bruns, Benjamin Mayer, Uwe Knippschild, Claudia Rolke, Matthias Schwab, Klaus Kramer
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A High Risk Group in the Modified National Institutes of Health Consensus Criteria for the Gastrointestinal Stromal Tumor: A Clear Indication of the Adjuvant Imatinib
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Commentary

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; Intest Res 2014;12(3):173-175. Published online July 25, 2014; DOI: https://doi.org/10.5217/ir.2014.12.3.173

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Masoud M Malekzadeh, Alireza Sima, Sudabeh Alatab, Anahita Sadeghi, Nasser Ebrahimi Daryani, Payman Adibi, Iradj Maleki, Hassan Vossoughinia, Hafez Fakheri, Abbas Yazdanbod, Seyed Alireza Taghavi, Rahim Aghazadeh, Mohammad Hassan Somi, Kazem Zendedel, Hom
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Postoperative course of Crohn disease according to timing of bowel resection
Ji Min Lee, Kang-Moon Lee, Joo Sung Kim, You Sun Kim, Jae Hee Cheon, Byong Duk Ye, Young-Ho Kim, Dong Soo Han, Chang Kyun Lee, Hyun-Ju Park
Medicine.2018; 97(16): e0459. CrossRef
Association of Perianal Fistulas with Clinical Features and Prognosis of Crohn's Disease in Korea: Results from the CONNECT Study
Jaeyoung Chun, Jong Pil Im, Ji Won Kim, Kook Lae Lee, Chang Hwan Choi, Hyunsoo Kim, Jae Hee Cheon, Byong Duk Ye, Young-Ho Kim, You Sun Kim, Yoon Tae Jeen, Dong Soo Han, Won Ho Kim, Joo Sung Kim
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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
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
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Serum Adipocytokine Levels as Surrogate Markers for Disease Activity of Crohn’s Disease
Su Hwan Kim, Seung Hyeon Jang, Ji Won Kim, Byeong Gwan Kim, Kook Lae Lee, You Sun Kim, Dong Soo Han, Joo Sung Kim
The American Journal of the Medical Sciences.2017; 353(5): 439. CrossRef
A coding variant inFTOconfers susceptibility to thiopurine-induced leukopenia in East Asian patients with IBD
Han Sang Kim, Jae Hee Cheon, Eun Suk Jung, Joonhee Park, Sowon Aum, Soo Jung Park, Sungho Eun, Jinu Lee, Ulrich Rüther, Giles S H Yeo, Marcella Ma, Kyong Soo Park, Takeo Naito, Yoichi Kakuta, Ji Hyun Lee, Won Ho Kim, Min Goo Lee
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Development of a Novel Predictive Model for the Clinical Course of Crohnʼs Disease
Yehyun Park, Jae Hee Cheon, Yi Lang Park, Byong Duk Ye, You Sun Kim, Dong Soo Han, Joo Sung Kim, Sung Noh Hong, Young Ho Kim, Seong Ran Jeon, Won Ho Kim
Inflammatory Bowel Diseases.2017; 23(7): 1071. CrossRef
Influence of age at diagnosis on the clinical characteristics of Crohn's disease in Korea: Results from the CONNECT study
Sung Wook Hwang, Jee Hyun Kim, Jong Pil Im, Byong Duk Ye, Hoon Sup Koo, Kyu Chan Huh, Jae Hee Cheon, You Sun Kim, Young Ho Kim, Dong Soo Han, Won Ho Kim, Joo Sung Kim
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Bun Kim, Jae Hee Cheon, Hyun Jin Moon, Yi Rang Park, Byong Duk Ye, Suk‐Kyun Yang, Geom Seog Seo, Byung Ik Jang, You Sun Kim, Joo Sung Kim, Dong Soo Han, Young‐Ho Kim, Won Ho Kim
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Deep resequencing of 131 Crohn's disease associated genes in pooled DNA confirmed three reported variants and identified eight novel variants
Sung Noh Hong, Changho Park, Soo Jung Park, Chang Kyun Lee, Byong Duk Ye, You Sun Kim, Seungbok Lee, Jeesoo Chae, Jong-Il Kim, Young-Ho Kim
Gut.2016; 65(5): 788. CrossRef
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Case Reports

A Case of Immune Thrombocytopenic Purpura Associated with Preexisting Ulcerative Colitis Treated with Colectomy and Splenectomy: Jee Hye Kwon, Changhyun Lee, Ji Min Choi, Yoo Min Han, Young Hoon Choi, June Young Lee, Hyuk Yoon, Jaeyoung Chun, Kyu Joo Park, Jong Pil Im, Sang Gyun Kim, Joo Sung Kim, Hyun Chae Jung; Intest Res 2013;11(4):310-316. Published online October 30, 2013; DOI: https://doi.org/10.5217/ir.2013.11.4.310

Abstract PDF

Ulcerative colitis is a chronic inflammatory bowel disease of unknown etiology, associated with extraintestinal manifestations, including the rarely reported immune thrombocytopenic purpura. Here, we present a case of immune thrombocytopenic purpura associated with preexisting ulcerative colitis. The patient was diagnosed with ulcerative colitis 13 years ago. Two years after diagnosis, he presented with hematochezia and active ulcerative colitis. Despite steroid use, the platelet count gradually decreased to 21,000/mm3. Hematochezia and the platelet count recovered after the administration of cyclosporine, and ulcerative colitis was in near complete remission for 11 years. However, the patient was re-admitted for hematochezia and thrombocytopenia persisting over a month. Medical management including increased doses of steroids in combination with cyclosporin failed to control hematochezia and thrombocytopenia. Immune thrombocytopenic purpura was suspected on the basis of normocellular marrow with a normal number of megakaryocytes. To treat uncontrolled colitis and steroid-refractory thrombocytopenia, total proctocolectomy with ileal pouch-anal anastomosis and splenectomy were performed. The patient was followed up for 10 months after surgery and was found to be in good health with a normal platelet count. Therefore, colectomy alone or in combination with splenectomy should be considered in cases of life-threatening ulcerative colitis complicated with steroid-refractory immune thrombocytopenic purpura. (Intest Res 2013;11:310-316)

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Resolved Hypereosinophilic Syndrome and Immune Thrombocytopenic Purpura in Ulcerative Colitis Patients Post Colectomy: A Case Series and Literature Review
Ahmed Hussein Subki, Manal Ismail Bokhary, Sultan Abdulrahman Alandijani, Mohannad Abdulrahman Aljehani, Ahmed Wasel Alharbi, May Alzahrani, Saud Suliman Almuhammadi, Bassim Tahseen Albeirouti, Mohamed Abdulmajid Abduljabar, Silvio Danese
Journal of Inflammation Research.2022; Volume 15: 6373. CrossRef
A Case of Immune Thrombocytopenic Purpura Accompanying Ulcerative Colitis
Hyun Tae Kim, Tae Oh Kim, Hyung Jun Kim, Soon Il Lee, Gi Jung Jeon, Eun Ji Lee, Seunghyun Park, Taehoon No
The Korean Journal of Gastroenterology.2014; 64(4): 234. CrossRef

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Clinical Characteristics of Lower Gastrointestinal Cancer in Crohn's Disease: Case Series of 5 Patients: Ji Min Choi, Changhyun Lee, Yoo Min Han, Minjong Lee, Dong Kee Jang, Jeehye Kwon, Jong Pil Im, Sang Gyun Kim, Joo Sung Kim, Hyun Chae Jung; Intest Res 2013;11(2):127-133. Published online April 30, 2013; DOI: https://doi.org/10.5217/ir.2013.11.2.127

Abstract PDF

Crohn's disease is a chronic inflammatory disease that can involve the entire gastrointestinal tract. Several studies indicate that Crohn's patients with long disease duration have an increased risk of small bowel or colorectal cancer. In Korea, only a few cases of Crohn's disease-related small bowel or colorectal cancer have been reported. Here, we described 3 cases of colorectal cancer and 2 cases of small bowel cancer in patients with Crohn's disease. Among 5 patients, 3 had Crohn's disease-related lower gastrointestinal malignancy and the other 2 had sporadic lower gastrointestinal malignancies. Since the diagnosis of Crohn's disease-related lower gastrointestinal malignancy tends to be delayed, the development of malignancy should be considered in patients with long duration of Crohn's disease if patients have refractory symptoms despite intensive medical treatment. Surgical consultation should not be delayed. (Intest Res 2013;11:127-133)

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Citations to this article as recorded by

Metastatic Recurrence of Small Bowel Cancer in Crohn's Disease
Ji Min Choi, Changhyun Lee, Jong Pil Im
The Korean Journal of Gastroenterology.2014; 63(4): 258. CrossRef

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1 Crossref

A Case of Chronic Colonic Pseudo-obstruction with Visceral Myopathy: Kyoung Sup Hong, Kyu Joo Park, Sung Hye Park, Sang Gyun Kim, Hyun Chae Jung, In Sung Song, Joo Sung Kim; Intest Res 2008;6(2):145-149. Published online December 30, 2008

Abstract PDF: Chronic colonic pseudo-obstruction is a rare disease that results in colorectal dilatation without any obstructing lesions. Colonic dilatation does not usually cause colonic wall thickening and colonic visceral myopathy with muscular hypertrophy has not been reported in Korea. A 31-year-old female patient was transferred for treatment of refractory constipation accompanied by megacolon. She had suffered from recurrent attacks of severe abdominal pain with the sensation of a mass in the left lower quadrant. An abdominal CT revealed a large luminal dilatation of the sigmoid colon where massive stool was impacted. There was no obstructing lesion or luminal dilatation of the rectum. To relieve her refractory symptoms, a total colectomy with an ileorectal anastomosis was performed. Pathologic examination of the sigmoid colon revealed that the muscle layers were dysplastic and hypertrophied, and the innervations into the muscle fibers were markedly decreased. She was discharged without any intra-abdominal symptoms. (Intest Res 2008;6:145-149)

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Original Articles

Factors Affecting the Efficacy of Tegaserod in Patients with Chronic Constipation: Hwang Choi, Sang Heon Yoon, Won Chul Lee, Joo Sung Kim, Dong Kyung Chang, Yoon Tae Jeen, Jin Oh Kim, Dong Soo Han, Hyo Jong Kim, Sang Yong Seol, Won Ho Kim, Suk Kyun Yang, Jin Ho Kim; Intest Res 2007;5(2):170-176. Published online December 30, 2007

Abstract PDF: Background/Aims
The effect of tegaserod has been found to differ for Caucasian and black patients. The aims of this study were to demonstrate the efficacy of tegaserod on bowel habits and to investigate the factors affecting the efficacy of tegaserod in Korean patients suffering from chronic constipation (CC). Methods: This was an open-label, multi-center, observational study. Analysis of covariance with repeated measures was used to determine the overall effect of treatment and was used to determine the changes in the number of complete spontaneous bowel movements (CSBM) from baseline during the 8-week treatment period. Demographic and baseline characteristics were compared between responders (3 or more CSBM at 8-weeks) and non-responders by the use of multivariate analysis. Results: A total of 1,798 patients were included in the study. Tegaserod treatment resulted in a significant increase in the mean number of CSBM per week over weeks 2-8 from baseline levels (from 1.0 to 3.1 CSBM per week, p＜0.0001). Tegaserod treatment was more effective for female patients, younger patients (age less than 65 years), patients with a high Bristol score at baseline, and patients with a short duration of constipation symptoms. Conclusions: Treatment with tegaserod improved bowel movements and more effective in female patients, patients under the age of 65 years, patients with a high Bristol score at baseline, and patients with a short duration of constipation symptoms. (Intest Res 2007;5:170-176)

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Clinical Features and Therapeutic Responses of Abdominal Actinomycosis: Ji Won Kim, Ji Bong Jeong, Yong Jin Jung, Byung Kwan Kim, Kook Lae Lee, Su Jong Yu, Mi Na Kim, Joo Sung Kim, Hyun Chae Jung, In Sung Song; Intest Res 2007;5(2):177-183. Published online December 30, 2007

Abstract PDF: Background/Aims
Abdominal actinomycosis is a rare entity and difficult to differentiate from a malignant neoplasm. A study of clinical features and therapeutic responses will contribute to the understanding of this disease. Methods: We analyzed the clinical features and therapeutic responses of 12 cases of abdominal actinomycosis from 1989 to 2007. Results: The male to female ratio of patients was 1：1, and the patients had a median age of 50 years (range 38-60 years). Abdominal pain was the most common symptom, and seven of twelve patients had a history of abdominal surgery, trauma, DM or IUD (intrauterine device) use. An abdominal CT examination revealed infiltrative lesions with disruption of the tissue plane in eight cases, and colonoscopic findings showed luminal stenosis, nodular lesions and ulceration in four cases. Surgical resection was performed in eleven cases with a right hemicolectomy with or without a salpingo-ooporectomy, a left hemicolectomy or mass excision. Of the eleven patients who underwent surgical resection, seven patients received intravenous penicillin G (10-15×106 U) followed by administration of oral antibiotics for a median 8 months (range 4-12 months) according to the presence of symptoms and signs. Conclusions: With combined adequate surgical resection and high-dose antibiotic therapy, the therapeutic responses are favorable in most of the abdominal actinomycosis patients. (Intest Res 2007;5:177-183)

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Case Report

A Case of Cytomegalovirus Colitis Complicated by Perforation after Short-term Steroid Therapy in a Patient with Eosinophilia: Jong Pil Im, Yoon Kyung Jeon, Sang Gyun Kim, Joo Sung Kim, Hyun Chae Jung, In Sung Song; Intest Res 2007;5(1):81-86. Published online June 30, 2007

Abstract PDF: Cytomegalovirus (CMV) infection is a rare event that has been reported mainly in immunocompromised patients who have HIV infection or receive immunosuppressive medication. Although CMV infection is generally asymptomatic in healthy individuals, CMV colitis in immunocompetent host can be potentially severe disease with significant morbidity, especially in older patients. We report a case of CMV colitis complicated by colonic perforation after short term steroid therapy in a patient with eosinophilia who has no evidence of immunosuppression. A high index of suspicion is crucial for early diagnosis of CMV colitis especially in older patients, even though obvious evidence of immunodeficiency is lacking. Colonoscopic examination including multiple biopsies is mandatory for diagnosis of CMV colitis, and antiviral agents should be started once the diagnosis is confirmed. (Intest Res 2007;5:81-86)

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Review

Epithelial Homeostasis: Role of NF-κB: Joo Sung Kim; Intest Res 2006;4(2):83-86. Published online December 30, 2006

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Original Articles

The Effect of DA-6034, a Synthetic Derivative of Flavonoid, on NF-κB Activity Stimulated with Lipopolysaccharide and Tumor Necrosis actor-α in Human Colonic Epithelial Cell Line: Ji Won Kim, Yong-Jin Jung, Ji Bong Jeong, Byeong Gwan Kim, Kook Lae Lee, Joo Sung Kim, Hyun Chae Jung, In Sung Song; Intest Res 2005;3(1):38-47. Published online June 30, 2005

Abstract PDF: Background/Aims
The nuclear factor-κB (NF-κB) is associated with expression of proinflammatory cytokines such as tumor necrosis factor-α (TNF-α) and interleukin-8 (IL-8). DA-6034, a derivative of flavonoid, has shown a potent anti-inflammatory effect in IBD animal model. The aim of this study was to characterize the anti-inflammatory activity of DA-6034 in terms of regulation of NF-κB. Methods: HT-29 cells were stimulated with lipopolysaccharide (LPS) or TNF-α alone or pretreated with DA-6034. The influence of DA-6034 on NF-κB DNA binding activity and inhibitory protein κB (IκB) activity was determined using an electrophoretic mobility shift assay (EMSA) and Western blot analysis. The RT-PCR method was used to determine the degree of gene expression of TNF-α and IL-8. Production of TNF-α and IL-8 protein was measured by ELISA. Results: DA-6034 prevented NF-κB activation stimulated with LPS and TNF-α and inhibited LPS- and TNF-α-induced IκB degradation. LPS-induced TNF-α mRNA expression and TNF-α-induced IL-8 mRNA expression were significantly decreased by DA-6034 pretreatment as compared to the absence of DA-6034 pretreatment. Conclusions: These results suggest that the inhibitory effect of DA-6034 on the production of TNF-α in LPS-stimulated and IL-8 in TNF-α-stimulated HT-29 cells may involve transcription regulation by suppression of NF-κB activation by interfering with IκB degradation. (Intest Res 2005; 3:38-47)

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Expression of Human T cell-activating CXC Chemokines in inflammatory bowel disease: Byeong Gwan Kim, Ji Won Kim, Ji Bong Jeong, Geum Yeon Kwak, Kook Lae Lee, Young Soo Park, Na Young Kim, Dong Ho Lee, Joo Sung Kim, Hyun Chae Jung, In Sung Song; Intest Res 2004;2(2):58-64. Published online December 22, 2004

Abstract PDF: Background/Aims
Colonic epithelial cells are increasingly recognized as playing an important role in host defense against microorganisms in the intestinal lumen and in inflammatory responses. When human intestinal epithelial cells are stimulated with proinflammatory cytokines or infected with microbial pathogens, they up-regulate a program of proinflammatory genes whose products are chemoattractant neutrophils and monocytes. However, little is known about the regulated production of T-cell chemoattractants by the intestinal epithelium. Methods: We studied chemokine (IP-10, Mig, I-TAC) expression of the human colonic mucosa by using enzyme-linked immunosorbent assay. Results: Expression of T-cell chemokine (IP-10, Mig, I-TAC) was increased in the mucosa of patients with Crohn's disease and ulcerative colitis. The production level of T-cell chemokine (IP-10, Mig, I-TAC) was decreased in the mucosa of patients with Crohn's disease after remission. Conclusions: Our finding indicated that under inflammatory conditions, mucosal T-cell chemokine production increased and attracted inflammatory cells. This result suggests that, at least in an inflammatory process, T-cell chemokine (IP-10, Mig, I-TAC) play a role in the pathogenesis of inflammatory bowel disease. (Intestinal Research 2004;2:58-64)

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