Intestinal Research

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

<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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Brief Summary of Outcomes in Multicenter Studies by KASID: Sang Kil Lee; Intest Res 2007;5(1):99-101. Published online June 30, 2007

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TLR Signaling in Intestinal Epithelial Tolerance of Commensals: Sang Kil Lee, Hyo Jong Kim; Intest Res 2005;3(2):91-95. Published online December 30, 2005

Abstract PDF: Toll-like receptors (TLR) is emerging as a key mediator of innate host defense in the intestinal mucosa, crucially involved in maintaining mucosal as well as commensal homeostasis. Through spatial and functional localization of TLR, the normal gut maintains a state of controlled inflammation, By contrast, patients with inflammatory bowel disease (IBD) demonstrated inflammation in response to the normal flora. Recent observations suggest new (patho-) physiologic mechanisms of how functional versus dysfunctional TLR pathways may oppose or favor IBD. A better understanding of the delicate regulation of TLR in the gut may lead to improved treatment for enteric infections and IBD. (Intestinal Research 2005;3:91-95)

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Oral Pigmentations of Laugier-Hunziker Syndrome: An Important Differential Diagnosis for Peutz-Jeghers Syndrome: Bark Lynn Lew, Kyung Kook Hong, Sang Kil Lee, Hyo Jong Kim, Mu Hyoung Lee; Intest Res 2005;3(2):145-149. Published online December 30, 2005

Abstract PDF: Oral pigmentation is seen fairly commonly in dermatologic practice. Oral pigmentation associated with Laugier-Hunziker syndrome (LHS) is an uncommon condition that shares some dermatologic features with Peutz-Jeghers syndrome (PJS). It is benign and asymptomatic, with no known cause, and is often associated with pigmentation of the nails and other mucosal surfaces. LHS and PJS show very similar skin manifestations but there age of onset, genetics, predilection site and associated systemic disease are different. However, evaluation of intestinal polyps should be performed for accurate differential diagnosis. We present seven patients whose conditions highlight the clinical syndrome known as LHS, and use the opportunity to review its clinical and pathologic features, and the relevant literature. (Intestinal Research 2005;3:145-149)

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Role of Peroxisome Proliferator-Activated Receptor g in Inflammatory Bowel Disease and Colon Cancer: Sang Kil Lee, Hyo Jong Kim; Intest Res 2004;2(2):53-57. Published online December 22, 2004

Abstract PDF: The peroxisome proliferator-activated receptor γ (PPARγ) and its partner the retinoid X receptor (RXR) are two nuclear receptors that are expressed mainly in adipose tissue and which have a role in lipid metabolism and insulin sensitization. New sites of PPARγ expression have been described, especially in the intestinal tract. Concomitantly, new functions have been attributed to PPARγ in regulation of inflammation and carcinogenesis. These new functions of PPARγ have led to novel ideas about pathophysiology of inflammatory bowel disease and colon cancer to development of innovative treatment strategies with PPARγ agonist. (Intestinal Research 2004;2:53-57)

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A Roles of Apoptotic Genes in Colon Cancers: Jae Young Jang, Hyo Jong Kim, Sung-Gil Chi, Kil Yeon Lee, Ki Deuk Nam, Nam Hoon Kim, Sang Kil Lee, Kwang Ro Joo, Seok Ho Dong, Byung-Ho Kim, Young Woon Chang, Joung Il Lee, Rin Chang; Intest Res 2004;2(2):71-76. Published online December 22, 2004

Abstract PDF: Badkground/Aims: X-linked inhibitor of apoptosis (XIAP) is the most potent member of the IAP family that exerts antiapoptotic effects. Recently, XIAP-associated factor 1 (XAF1) and two mitochondrial proteins, Smac/DIABLO and HtrA2, have been identified to negatively regulate the caspase-inhibiting activity of XIAP. We explored the candidacy of XAF1, Smac/DIABLO and HtrA2 as a tumor suppressor in colonic carcinogenesis. Methods: The expression and mutation status of the genes were assessed in 10 colorectal carcinoma cell lines. Results: XAF1 transcript was not expressed or present at extremely low levels in 60% (6/10) of cancer cell lines whereas Smac/DIABLO and HtrA2 are normally expressed in all cell lines examined. XAF1 transcript was reactivated in all low expressor cell lines by treatment with the demethylating agent 5-aza-2'-deoxycytidine. Moreover, bisulfite DNA sequencing analysis for 34 CpG sites in the promoter region revealed a strong association between hypermethylation and gene silencing. Restoration of XAF1 expression resulted in enhanced apoptotic response to etoposide and 5-flurouracil. Conclusions: XAF1 undergoes epigenetic gene silencing in a considerable proportion of human colon cancers by aberrant promoter hypermethylation, suggesting that XAF1 inactivation might be implicated in colonic tumorigenesis. (Intestinal Research 2004;2:71-76)

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Bioflor^Ⱂ Suppresses Expression of Interleukin-8 in HT-29 cell: Sang Kil Lee, Hyo Jong Kim, Sung Gil Chi, Jae Young Jang, Ki Deok Nam, Nam Hoon Kim, Kwang Ro Joo, Seok Ho Dong, Byung Ho Kim, Young Woon Chang, Joung Il Lee, Rin Chang; Intest Res 2004;2(2):96-101. Published online December 22, 2004

Abstract PDF: Background/Aims
Nowadays, there is a growing interest in probiotics as a safe way of changing the intestinal bacterial flora. Probiotics may have potential in several gastroenterological conditions. The nonpathogenic yeast, Saccharomyces boulardii (S. boulardii, Bioflor^Ⱂ), has been used empirically in the treatment of acute infectious diarrhea and antibiotics-associated diarrhea. Recently, S. boulardii was reported to be beneficial in the treatment of inflammatory bowel disease, however, little is known about their mechanisms of action. We examined the ability of S. boulardii to modulate inflammatory response in human colon cells. Methods: Effects of Bioflor^Ⱂ on survival and proliferation of HT-29 human colon cells were assessed by MTT and [3H]thymidine incorporation assays. Interleukin-8 (IL-8) expression was stimulated with tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), or lipopolysacharide (LPS). IL-8 was assessed by RT-PCR. Results: Bioflor^Ⱂ did not affect viability and proliferation of HT-29 cell. Pretreatment of HT-29 cells with Bioflor^Ⱂ blocked IL-8 up-regulation by TNF-α, IL-1β, or LPS to these proinflammatory factors. Conclusions: Bioflor^Ⱂ reduces responses to proinflammatory cytokines in human colon cells. (Intestinal Research 2004;2:96-101)

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A Case of Anikiasis Invading the Ascending Colon: Doo Hyun Woo, Hyo Jong Kim, Han Soo Kim, Jae Young Chang, Ki Duk Nam, Nam Hoon Kim, Sang Kil Lee, Kwang Roh Joo, Seok Ho Dong, Byung Ho Kim, Young Woon Chang, Joung Il Lee, Rin Chang; Intest Res 2004;2(2):120-123. Published online December 22, 2004

Abstract PDF: Anisakiasis is a human disease caused by the accidental ingestion of larval nematodes, belonging to the family Anisakidae. The disease is caused by eating raw seafood dishes or undercooked fish and squid dishes. Considering the popularity of eating the raw fish in Korea, the incidence of anisakiasis has been increasing. The entire gastrointestinal tract from the esophagus to the rectum can be involved. Colonic anisakiasis is very rare, and it is relatively hard to diagnose compared with gastric anisakiasis. We are reporting a case of anisakiasis involving the ascending colon, which was treated by colonoscopic removal. (Intestinal Research 2004;2:120-123)

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Two Cases of Desmoid Tumor After the Total Colectomy in FAP Patients: Bo Young Hwang, Hyo Jong Kim, Jae Young Chang, Nam Hoon Kim, Sang Kil Lee, Kwnag Ro Joo, Seok Ho Dong, Joung Il Lee, Byung Ho Kim, Young Woon Chang, Rin Chang; Intest Res 2004;2(1):31-35. Published online April 16, 2004

Abstract PDF: Desmoid tumors (DT) are rare and slow-growing tumor that consist of proliferation of well-differentiated fibroblast. Although the typical characteristics of malignant tumors, such as distant metastasis, are absent, the tumor are locally aggressive and grow into neighbouring structures and have a high propensity for recurrence after surgical resection. Surgical trauma, genetic predisposition and hormonal factors are considered to be correlated with the development and growth of DT. The prevalence of desmoid tumors in patients with familial adenomatous polyposis (FAP) is 7-12%. The lifetime risk of developing desmoid tumors is about 20%. Inpatients with FAP, desmoids often appear after total colectomy as descrete masses in surgical scars of the abdominal wall or as infiltrating fibroblast sheets within the abdominal mesentery or retroperitoneum. Intra-abdominal or mesenteric desmoids pose a serious management problem because of their propensity to surroud and compress major blood vessels and viscera. Next to colorectal cancer, desmoid tumors are the most frequent cause of death in FAP. There are no standard medical approaches. Recently we experienced two cases of desmoid tumor associated with FAP after total colectomy. One case treated with non steroidal anti-inflammatory drug (NSAID) and tamoxifen, the other with combination chemotherpy. We report comparision of two cases with review of the literatures. (Intestinal Research 2004;2:31-35)

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A Case of Small Bowel Bleeding not Being Found by Capsule Endoscopy: Myung Ryul Lee, Hyo Jong Kim, Sang Kil Lee, Nam Hoon Kim, Jae Young Chang, Kwang Ro Joo, Seok Ho Dong, Byung-Ho Kim, Young Woon Chang, Joung Il Lee, Rin Chang; Intest Res 2004;2(1):40-42. Published online April 16, 2004

Abstract PDF: Diagnostic tool for the study of patients with obscure gastrointestinal bleeding is not confirmed. Recently,capsule endoscopy was used to the effective diagnostic tool for patients with obscure gastrointestinaI bleeding, and was well tolerated and better accepted by patient. But the diagnostic result of this technique has not been adequately studied. We reported a case of finding small bowel beeding due to intraoperative endoscopy with negative capsule endoscopic result. (Intestinal Research 2004;2:40-42)

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