Intestinal Research

Original Articles

IBD

Prevalence and risk factors of gallstone disease in Korean patients with ulcerative colitis: Kwangwoo Nam, Jae Yong Lee, Sang Hyoung Park, Ha Won Hwang, Ho-Su Lee, Kyunghwan Oh, Hee Seung Hong, Kyuwon Kim, Jin Hwa Park, Seung Wook Hong, Sung Wook Hwang, Dong-Hoon Yang, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang; Intest Res 2025;23(4):455-463. Published online November 29, 2024; DOI: https://doi.org/10.5217/ir.2024.00070

Background/Aims
The prevalence of gallstone disease in patients with ulcerative colitis (UC) is higher than in the general population. However, risk factors of gallstone disease in these patients remain unclear. Thus, we investigated the prevalence and risk factors of gallstone disease in Korean patients with UC.
Methods
Patients diagnosed with UC who underwent abdominal imaging studies between 1997 and 2020 were investigated using a well-established referral center-based large volume inflammatory bowel disease cohort. The prevalence and clinical characteristics of patients with gallstone disease were evaluated and compared with those without gallstone disease.
Results
Overall, 2,811 patients with UC were enrolled. During the follow-up period (mean, 5.7 years), 198 patients (7.0%) were diagnosed with gallstone disease and compared with those without gallstone disease (n = 2,613). The proportion of extensive colitis at maximum extent, primary sclerosing cholangitis (PSC), history of cytomegalovirus, corticosteroid use, immunomodulatory use, colectomy, and appendectomy were significantly higher in the gallstone group (all P< 0.05). In multivariate analyses, age ≥ 60 years at gallstone evaluation (odds ratio [OR], 1.027; 95% confidence interval [CI], 1.002–1.052; P= 0.033), PSC (OR, 6.304; 95% CI, 3.162–12.565; P< 0.001), and history of colectomy (OR, 2.494; 95% CI, 1.222–5.087; P= 0.012) were significant risk factors for gallstone disease in patients with UC.
Conclusions
The prevalence of gallstone disease in Korean patients with UC was 7.0%, and age ≥ 60 years at gallstone evaluation, PSC, and history of colectomy were significant risk factors for UC patients with gallstone disease.

Citations

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Gallstone burden and risk in Korean patients with ulcerative colitis
Seong Ran Jeon
Intestinal Research.2025; 23(4): 391. CrossRef

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IBD

Clinical characteristics and long-term disease course in patients with Crohn’s disease as diagnosed by video capsule endoscopy: a multicenter retrospective matched case-control study: June Hwa Bae, Su Hyun Park, Jung-Bin Park, Ji Eun Baek, Seung Wook Hong, Sung Wook Hwang, Dong-Hoon Yang, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Kyeong Ok Kim, Byung Ik Jang, Mi Rae Lee, Eun Soo Kim, Sang Hyoung Park; Intest Res 2025;23(3):290-301. Published online August 29, 2024; DOI: https://doi.org/10.5217/ir.2024.00056

Abstract PDF PubReader ePub: Background/Aims
Video capsule endoscopy is rarely used to diagnose Crohn’s disease in patients with negative ileocolonoscopy or cross-sectional image findings. We evaluated clinical characteristics and long-term outcomes of these rare cases.
Methods
This multicenter study included patients with Crohn’s disease from 3 tertiary hospitals from January 2007 to October 2022. Patients with normal findings on ileocolonoscopy and computed tomography (CT)/magnetic resonance (MR) enterography but had ulcerations at the small bowel detected by video capsule endoscopy were included. The controls were patients with abnormal findings on endoscopy or CT/MR enterography. Controls were case-matched in a ratio of 3:1 for sex, calendar year of diagnosis, and age at diagnosis.
Results
Among 3,752 patients, 24 (0.6%) were diagnosed with Crohn’s disease using video capsule endoscopy findings. The disease location (P< 0.001) and behavior at diagnosis (P= 0.013) of the cases significantly differed from that of controls. The perianal fistula modifier (25.0% vs. 33.3%, P= 0.446) did not differ significantly between the 2 groups. Initial disease activity and C-reactive protein and fecal calprotectin levels were significantly lower in cases versus controls. The median Lewis score was 838 (interquartile range, 393–1,803). Over 10 years of follow-up, the cases showed significantly lower cumulative risk of complicated behavior, biologics use, Crohn’s disease-related hospitalization, and surgeries (log-rank test P< 0.05).
Conclusions
Patients with Crohn’s disease whose lesions were observed only by video capsule endoscopy were rare, and exhibit different clinical characteristics and a more favorable long-term disease course compared to those who were conventionally diagnosed.

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Statement

Endoscopy

Use of device-assisted enteroscopy in small bowel disease: an expert consensus statement by the Korean Association for the Study of Intestinal Diseases: Han Hee Lee, Jin Su Kim, Hyeon Jeong Goong, Shin Hee Lee, Eun Hye Oh, Jihye Park, Min Cheol Kim, Kwangwoo Nam, Young Joo Yang, Tae Jun Kim, Seung-Joo Nam, Hee Seok Moon, Jae Hyun Kim, Duk Hwan Kim, Seong-Eun Kim, Seong Ran Jeon, Seung-Jae Myung, The Small Intestine Research Group of the Korean Association for the Study of Intestinal Diseases (KASID); Intest Res 2023;21(1):3-19. Published online January 31, 2023; DOI: https://doi.org/10.5217/ir.2022.00108

Abstract PDF PubReader ePub

The introduction of device-assisted enteroscopy (DAE) in the beginning of 21st century has revolutionized the diagnosis and treatment of diseases of the small intestine. In contrast to capsule endoscopy, the other main diagnostic modality of the small bowel diseases, DAE has the unique advantages of observing the region of interest in detail and enabling tissue acquisition and therapeutic intervention. As DAE becomes an essential procedure in daily clinical practice, there is an increasing need for correct guidelines on when and how to perform it and what technical factors should be considered. In response to these needs, the Korean Association for the Study of Intestinal Diseases developed an expert consensus statement on the performance of DAE by reviewing the current evidence. This expert consensus statement particularly focuses on the indications, choice of insertion route, therapeutic intervention, complications, and relevant technical points.

Citations

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Effect of Different Types of Antithrombotic Agents on Clinical Outcomes in Patients With Small Bowel Bleeding Who Underwent Balloon‐Assisted Enteroscopy: A KASID Multicenter Study
Jihye Park, Jin Su Kim, Joo Hye Song, Kwangwoo Nam, Seong‐Eun Kim, Eui Sun Jeong, Jae Hyun Kim, Seong Ran Jeon
Journal of Gastroenterology and Hepatology.2025; 40(2): 456. CrossRef
Balloon-assisted enteroscopy in the management of adult small-bowel intussusception: a comparative analysis of with and without double-balloon enteroscopy
Won Shik Kim, Beom Jae Lee, Moon Kyung Joo, Seung Han Kim, Jong-Jae Park
Surgical Endoscopy.2025; 39(3): 2044. CrossRef
Comparative Study of MiroCam MC2000 and PillCam SB3 in Detecting Small Bowel Bleeding: A Multicenter Prospective Randomized Crossover Study
Ji Eun Kim, Eun Ran Kim, Jae Jun Park, Kyeong Ok Kim, Yehyun Park, Young Joo Yang, Hyun Joo Jang
Gut and Liver.2025; 19(4): 569. CrossRef
From Data to Insights: How Is AI Revolutionizing Small-Bowel Endoscopy?
Joana Mota, Maria João Almeida, Francisco Mendes, Miguel Martins, Tiago Ribeiro, João Afonso, Pedro Cardoso, Helder Cardoso, Patrícia Andrade, João Ferreira, Miguel Mascarenhas, Guilherme Macedo
Diagnostics.2024; 14(3): 291. CrossRef
Role of Device-Assisted Enteroscopy in Crohn’s Disease
Giulia Catassi, Clelia Marmo, Antonio Gasbarrini, Maria Elena Riccioni
Journal of Clinical Medicine.2024; 13(13): 3919. CrossRef
Discordance Rate and Risk Factor of Other Diagnostic Modalities for Small Bowel Tumors Detected by Device-Assisted Enteroscopy: A Korean Association for the Study of Intestinal Disease (KASID) Multicenter Study
Jihye Park, Jin Su Kim, Joo Hye Song, Kwangwoo Nam, Seong-Eun Kim, Eui Sun Jeong, Jae Hyun Kim, Seong Ran Jeon
Gut and Liver.2024; 18(4): 686. CrossRef

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Review

Functional bowel disorder

An Asian perspective on irritable bowel syndrome: Kee Wook Jung, Seung-Jae Myung; Intest Res 2023;21(2):189-195. Published online May 31, 2022; DOI: https://doi.org/10.5217/ir.2021.00136

Abstract PDF PubReader ePub

Irritable bowel syndrome (IBS) is a prevalent chronic disorder, and its epidemiology depends on the diagnostic criteria used. Recently, the Rome IV criteria for IBS were published by changing the frequency of abdominal pain and excluding abdominal discomfort from the previously used Rome III criteria. However, the recent Asian consensus on IBS recommends the inclusion of abdominal discomfort and abdominal pain as diagnostic criteria. The low fermentable oligo-, di-, mono-saccharides, and polyols (FODMAP) diet has been proven to be effective in Western patients. Moreover, recent well-designed studies reported its effectiveness and the microbial changes after implementing it in Asian patients with IBS. However, traditional Korean foods including kimchi, one of representative FODMAP-rich food, exhibited a poor correlation with the food-related symptoms of IBS. Therefore, the low FODMAP diet protocol should be cautiously applied to IBS patients, especially to Korean patients with IBS. In Asian countries, there are lots of traditional herbal medicines and treatments for IBS; however, these studies have limitations including the heterogeneity of herbal mixtures and relatively small sample size. Therefore, well-designed studies based on large samples are required to validate complementary and alternative medicine in the treatment of Asian patients with IBS.

Citations

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Rome III Versus Rome IV Criteria for Diagnosing Irritable Bowel Syndrome in a Southeast Asian Population: Insights From the Rome Foundation Global Epidemiology Study Household Survey
Daniel Martin Simadibrata, Thai Hau Koo, Amanda Pitarini Utari, Mina Ayad, Kueh Yee Cheng, Ami D. Sperber, Bangdiwala Shrikant, Olafur S. Palsson, Ari Fahrial Syam, Yeong Yeh Lee
Journal of Gastroenterology and Hepatology.2026; 41(1): 168. CrossRef
Treatment of Irritable Bowel Syndrome With Antispasmolytics in Taiwan, Hong Kong, and Vietnam: A Delphi Expert Consensus Statement
Sabera Hashim, Shan Wang, Benjamin Burr, Swarali Tadwalkar, Radhika Mehta, Ankur Gupta
Journal of Neurogastroenterology and Motility.2025; 31(4): 512. CrossRef
The Role of Diet in the Management of Irritable Bowel Syndrome: A Comprehensive Review
Maleesha Jayasinghe , Vinuri Karunanayake, Ali Mohtashim, Dilushini Caldera , Piyalka Mendis , Omesh Prathiraja, Fatemeh Rashidi, John A Damianos
Cureus.2024;[Epub] CrossRef
Downregulated APOD and FCGR2A correlates with immune infiltration and lipid-induced symptoms of irritable bowel syndrome
Yamei Ran, Kangqi Wu, Chenglin Hu, Renzheng Liang, Li Zhang, Juan Xiao, Yongmei Peng, Wenjing Sun
Scientific Reports.2023;[Epub] CrossRef
Technical Feasibility of Quantitative Measurement of Various Degrees of Small Bowel Motility Using Cine Magnetic Resonance Imaging
Ji Young Choi, Jihye Yun, Subin Heo, Dong Wook Kim, Sang Hyun Choi, Jiyoung Yoon, Kyuwon Kim, Kee Wook Jung, Seung-Jae Myung
Korean Journal of Radiology.2023; 24(11): 1093. CrossRef
Letter to the Editor: Survey-Based Analysis of Clinical Treatment Status of Irritable Bowel Syndrome in Korea: Suggestions for Future Research
Ji Young Chang
Journal of Korean Medical Science.2023;[Epub] CrossRef
Effectiveness of Medilac-S as an Adjuvant to Conventional Irritable Bowel Syndrome Treatments: A Systematic Review with Meta-Analysis
Annie Tremblay, Xiaoyu Xu, James Colee, Thomas A. Tompkins, Sylvie Binda
Gastroenterology Insights.2023; 14(4): 491. CrossRef
Comments on Efficacy of a Synbiotic Containing Lactobacillus paracasei DKGF1 and Opuntia humifusa in Elderly Patients with Irritable Bowel Syndrome: A Randomized, Double-Blind, Placebo-Controlled Trial
Kwang Woo Kim
Gut and Liver.2023; 17(6): 954. CrossRef

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Original Article

IBD

Fecal S100A12 is associated with future hospitalization and step-up of medical treatment in patients with Crohn’s disease in clinical remission: a pilot study: Sun-Ho Lee, Sung Wook Hwang, Sang Hyoung Park, Dong-Hoon Yang, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Byong Duk Ye; Intest Res 2022;20(2):203-212. Published online April 29, 2022; DOI: https://doi.org/10.5217/ir.2021.00020

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
Fecal S100A12 (FS) and serum S100A12 (SS) have been reported as novel biomarkers that accurately reflect intestinal inflammation. We evaluated if FS and SS in comparison to fecal calprotectin (FC) are associated with poor future outcomes in clinically quiescent Crohn’s disease (CD) patients.
Methods
We prospectively enrolled 49 CD patients in clinical remission (Crohn’s Disease Activity Index [CDAI] < 150 for the past 6 months). Patients were followed for a median period of 4.4 years (interquartile range [IQR], 4.3–4.5). The following outcomes were evaluated: clinical relapse, CD-related hospitalization, step-up of medical treatment, and CD-related intestinal resection. Cox proportional-hazard regression model was constructed to assess the association of baseline markers with time-to-event outcomes.
Results
The median levels of baseline FS, FC, and SS were 0.042 mg/kg (IQR, 0.005–0.179), 486.8 mg/kg (IQR, 203.5–886.8) and 1,398.2 ng/mL (IQR, 791.8–2,759.9), respectively. FS correlated with FC (r = 0.689), erythrocyte sedimentation rate (r = 0.524), C-reactive protein (r = 0.499), and albumin (r = –0.446), but not with CDAI (r = 0.045). Interestingly, increased FS (top quartile) was associated with a 4.9-fold increased rate of future CD-related hospitalization (P= 0.009) and a 2.8-fold increased rate of step-up of medical treatment (P= 0.032), whereas increased FC and SS were not. These findings remained significant after adjusting for age, sex, disease duration, current smoking, C-reactive protein, serum albumin, CDAI, and FC, individually.
Conclusions
In this pilot study, increased FS and not FC or SS, was significantly associated with increased rates of future CD-related hospitalization and step-up of medical treatment among CD patients in clinical remission.

Citations

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Recent developments in biomarker guided therapy for Crohn’s disease
André Bargas, Joana Torres, Bram Verstockt
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Systematic analysis and characterization of long non-coding RNA genes in inflammatory bowel disease
Rania Velissari, Mirolyuba Ilieva, James Dao, Henry E Miller, Jens Hedelund Madsen, Jan Gorodkin, Masanori Aikawa, Hideshi Ishii, Shizuka Uchida
Briefings in Functional Genomics.2024; 23(4): 395. CrossRef
The role of fecal biomarkers in individuals with inflammatory bowel disease
Teagan S. Edwards, Andrew S. Day
Expert Review of Molecular Diagnostics.2024; 24(6): 497. CrossRef
Pursuing neutrophils: systematic scoping review on blood-based biomarkers as predictors of treatment outcomes in inflammatory bowel disease
Diogo Magalhaes, Laurent Peyrin-Biroulet, Maria Manuela Estevinho, Silvio Danese, Fernando Magro
Therapeutic Advances in Gastroenterology.2023;[Epub] CrossRef

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Letters to the Editor

IBD

Update on SARS-CoV-2 vaccination of patients with inflammatory bowel disease: what clinicians need to know: Yoo Jin Lee, Seong-Eun Kim, Yong Eun Park, Ji Young Chang, Hyun Joo Song, Duk Hwan Kim, Young Joo Yang, Byung Chang Kim, Jae Gon Lee, Hee Chan Yang, Seung-Jae Myung, Clinical Practice Guideline Committee of the Korean Association for the Study of Intestinal Diseases; Intest Res 2022;20(3):386-388. Published online March 11, 2022; DOI: https://doi.org/10.5217/ir.2020.00172

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Statements

IBD

Korean Association for the Study of Intestinal Diseases guidance for clinical practice of adult inflammatory bowel disease during the coronavirus disease 2019 pandemic: expert consensus statements: Yong Eun Park, Yoo Jin Lee, Ji Young Chang, Hyun Joo Song, Duk Hwan Kim, Young Joo Yang, Byung Chang Kim, Jae Gon Lee, Hee Chan Yang, Miyoung Choi, Seong-Eun Kim, Seung-Jae Myung; Intest Res 2022;20(4):431-444. Published online January 5, 2022; DOI: https://doi.org/10.5217/ir.2021.00111

Abstract PDF PubReader ePub

Many unexpected problems have resulted from the unprecedented coronavirus disease 2019 (COVID-19) pandemic. The optimal management of patients with inflammatory bowel disease (IBD) during the COVID-19 pandemic has also been a challenge. Therefore, the Korean Association for the Study of Intestinal Diseases (KASID) developed a consensus statement of experts regarding the management of IBD during the COVID-19 pandemic. This consensus statement made recommendations regarding the risk and treatment of COVID-19 in IBD patients. This statement emphasizes that IBD is not a risk factor for COVID-19, and care should be taken not to exacerbate IBD in patients in remission state by maintaining their medications, except for corticosteroids.

Citations

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Mobile monitoring system detects the disease activity pattern and shows the association with clinical outcomes in patients with newly diagnosed Crohn’s disease
Yoo Jin Lee, Sang Gyu Kwak, Eun Soo Kim, Sung Kook Kim, Hyun Seok Lee, Yun Jin Chung, Byung Ik Jang, Kyeong Ok Kim, Jeongseok Kim, Hyeong Ho Jo, Eun Young Kim
Scientific Reports.2024;[Epub] CrossRef
Update on SARS-CoV-2 vaccination of patients with inflammatory bowel disease: what clinicians need to know
Yoo Jin Lee, Seong-Eun Kim, Yong Eun Park, Ji Young Chang, Hyun Joo Song, Duk Hwan Kim, Young Joo Yang, Byung Chang Kim, Jae Gon Lee, Hee Chan Yang, Seung-Jae Myung
Intestinal Research.2022; 20(3): 386. CrossRef

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IBD

SARS-CoV-2 vaccination for adult patients with inflammatory bowel disease: expert consensus statement by KASID: Yoo Jin Lee, Seong-Eun Kim, Yong Eun Park, Ji Young Chang, Hyun Joo Song, Duk Hwan Kim, Young Joo Yang, Byung Chang Kim, Jae Gon Lee, Hee Chan Yang, Miyoung Choi, Seung-Jae Myung, The Clinical Practice Guideline Committee of the Korean Association for the Study of the Intestinal Diseases (KASID); Intest Res 2022;20(2):171-183. Published online January 5, 2022; DOI: https://doi.org/10.5217/ir.2021.00098

Abstract PDF PubReader ePub

Coronavirus disease 2019 (COVID-19), caused by the novel coronavirus, is threatening global health worldwide with unprecedented contagiousness and severity. The best strategy to overcome COVID-19 is a vaccine. Various vaccines are currently being developed, and mass vaccination is in progress. Despite the very encouraging clinical trial results of these vaccines, there is insufficient information on the safety and efficacy of vaccines for inflammatory bowel disease (IBD) patients facing various issues. After reviewing current evidence and international guidelines, the Korean Association for the Study of Intestinal Diseases developed an expert consensus statement on COVID-19 vaccination issues for Korean IBD patients. This expert consensus statement emphasizes that severe acute respiratory syndrome coronavirus 2 vaccination be strongly recommended for IBD patients, and it is safe for IBD patients receiving immunomodulatory therapy.

Citations

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COVID-19 vaccine updates for people under different conditions
Yijiao Huang, Weiyang Wang, Yan Liu, Zai Wang, Bin Cao
Science China Life Sciences.2024; 67(11): 2323. CrossRef
Effects of COVID-19 vaccines on patient-reported outcomes in patients with inflammatory bowel disease: a multicenter survey study in Korea
Jung Hyun Ji, Seung Hwan Shin, Yong Eun Park, Jihye Park, Jae Jun Park, Jae Hee Cheon, Tae Il Kim, Sang-Bum Kang, Sang Hyoung Park, Soo Jung Park
Intestinal Research.2024; 22(3): 336. CrossRef
Vaccination in patients with inflammatory bowel disease–Asian perspectives: the results of a multinational web-based survey in the 8th Asian Organization for Crohn’s and Colitis meeting
Su Bum Park, Kyeong Ok Kim, Hong Sub Lee, Chang Hwan Choi, Shu Chen Wei, Min Hu Chen, Katsuyoshi Matsuoka
Intestinal Research.2023; 21(3): 363. CrossRef
Beyond the survey, to the ideal therapy for Asian
Ki Jae Jo, Jong Pil Im
Intestinal Research.2023; 21(3): 280. CrossRef
Update on SARS-CoV-2 vaccination of patients with inflammatory bowel disease: what clinicians need to know
Yoo Jin Lee, Seong-Eun Kim, Yong Eun Park, Ji Young Chang, Hyun Joo Song, Duk Hwan Kim, Young Joo Yang, Byung Chang Kim, Jae Gon Lee, Hee Chan Yang, Seung-Jae Myung
Intestinal Research.2022; 20(3): 386. CrossRef
Vaccination strategies for Korean patients with inflammatory bowel disease
Yoo Jin Lee, Eun Soo Kim
The Korean Journal of Internal Medicine.2022; 37(5): 920. CrossRef
SARS-CoV-2 Infection and Outcomes in Children with Inflammatory Bowel Diseases: A Systematic Review
Anastasia Batsiou, Petros Mantzios, Daniele Piovani, Andreas G. Tsantes, Paschalia Kopanou Taliaka, Paraskevi Liakou, Nicoletta Iacovidou, Argirios E. Tsantes, Stefanos Bonovas, Rozeta Sokou
Journal of Clinical Medicine.2022; 11(23): 7238. CrossRef

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Review

IBD

Endoscopic molecular imaging in inflammatory bowel disease: Nam Seok Ham, Seung-Jae Myung; Intest Res 2021;19(1):33-44. Published online April 20, 2020; DOI: https://doi.org/10.5217/ir.2019.09175

Abstract PDF PubReader ePub

Molecular imaging is a technique for imaging the processes occurring in a living body at a molecular level in real-time, combining molecular cell biology with advanced imaging technologies using molecular probes and fluorescence. Gastrointestinal endoscopic molecular imaging shows great promise for improving the identification of neoplasms, providing characterization for patient stratification and assessing the response to molecular targeted therapy. In inflammatory bowel disease, endoscopic molecular imaging can be used to assess disease severity and predict therapeutic response and prognosis. Endoscopic molecular imaging is also able to visualize dysplasia in the presence of background inflammation. Several preclinical and clinical trials have evaluated endoscopic molecular imaging; however, this area is just beginning to evolve, and many issues have not been solved yet. In the future, it is expected that endoscopic molecular imaging will be of increasing interest among clinicians as a new technology for the identification and evaluation of colorectal neoplasm and colitis-associated cancer.

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Transforming Gastrointestinal Diagnosis with Molecular Endoscopy: Challenges and Opportunities
Giuseppe Dell’Anna, Francesco Mandarino, Lucia Centanni, Ilaria Lodola, Jacopo Fanizza, Ernesto Fasulo, Sarah Bencardino, Lorenzo Fuccio, Antonio Facciorusso, Gianfranco Donatelli, Tommaso Lorenzo Parigi, Federica Furfaro, Ferdinando D’Amico, Sara Massiro
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Original Articles

Inflammatory bowel diseases

Changes in prevalence and perception of complementary and alternative medicine use in Korean inflammatory bowel disease patients: results of an 8-year follow-up survey: Sun-Ho Lee, Kiju Chang, Ki Seok Seo, Yun Kyung Cho, Eun Mi Song, Sung Wook Hwang, Dong-Hoon Yang, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Sang Hyoung Park; Intest Res 2020;18(2):192-199. Published online April 3, 2020; DOI: https://doi.org/10.5217/ir.2019.00115

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
The use of complementary and alternative medicine (CAM) is a global phenomenon, including inflammatory bowel disease (IBD) patients. We aimed to assess the change in prevalence and patterns of CAM use, and attitudes towards CAM over an 8-year time interval (2006 vs. 2014) among IBD patients in Korea.
Methods
A total of 221 IBD patients (CD=142, UC=79) were asked to complete a questionnaire regarding CAM at two time points: at enrollment (2006) and 8 years later (2014/2015).
Results
The proportion of patients ever using CAM increased significantly from 60.2% in 2006 to 79.6% in 2014 (P<0.001), while the proportion of current CAM users increased slightly (35.7% to 38.0%, P=0.635); 21.7% used CAM consistently at both time points. The proportion of patients who felt CAM was less effective (P<0.001) and more expensive (P=0.04) than conventional treatments increased over time. Also, the proportion among ever CAM users who perceived a positive effect from CAM significantly decreased in 2014 compared to 2006 (P=0.004). Higher education (adjusted odds ratio [aOR], 2.10), prior side effects to conventional therapies (aOR, 2.23), and prior use of corticosteroids (aOR, 2.51) were associated with CAM use. Interestingly, use of CAM before IBD diagnosis (aOR, 2.73) was significantly associated with consistent CAM use.
Conclusions
Although the attitudes toward CAM have become less favorable, the majority of IBD patients have experienced CAM with an overall increase of current CAM users over time. Moreover, more than half of current CAM users used CAM consistently over time.

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Sowon Park, Jihye Noh, Chaelin Kim, Hyeji Lim, Eun Joo Lee, Hong Koh, Andrew S Day, Angharad Vernon-Roberts
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Nahid Rajai, Zahra Abbasi, Amir Hosein Pishgooie, Fatemeh Teymouri, Mohammad Imanipour
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John Triantafillidis, Aristofanis Gikas, Georgia Kontrarou, Manousos Konstantoulakis, Apostolos Papalois
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Hsiao-Yun Chang, Yu-Yao Huang, Chin-Jung Chung, Feng-Hsuan Liu
BMC Complementary Medicine and Therapies.2023;[Epub] CrossRef
Perspectives of East Asian patients and physicians on complementary and alternative medicine use for inflammatory bowel disease: results of a cross-sectional, multinational study
Eun Soo Kim, Chung Hyun Tae, Sung-Ae Jung, Dong Il Park, Jong Pil Im, Chang Soo Eun, Hyuk Yoon, Byung Ik Jang, Haruhiko Ogata, Kayoko Fukuhara, Fumihito Hirai, Kazuo Ohtsuka, Jing Liu, Qian Cao
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Jae Song Kim, Min Jung Geum, Eun Sun Son, Yun Mi Yu, Jae Hee Cheon, Kyeng Hee Kwon
Gut and Liver.2022; 16(5): 736. CrossRef
Comprehensive study on the administrative, economic, regional, and regulatory prospects of complementary and alternative medicine (CAM) in inflammatory bowel disease (IBD)
Taraneh Mousavi, Shekoufeh Nikfar, Mohammad Abdollahi
Expert Review of Clinical Pharmacology.2021; 14(7): 865. CrossRef
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Jae Myung Cha
Intestinal Research.2020; 18(2): 141. CrossRef

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Colorectal neoplasia

Clinical outcomes of submucosal colorectal cancer diagnosed after endoscopic resection: a focus on the need for surgery: Yun Sik Choi, Wan Soo Kim, Sung Wook Hwang, Sang Hyoung Park, Dong-Hoon Yang, Byong Duk Ye, Seung-Jae Myung, Suk-Kyun Yang, Jeong-Sik Byeon; Intest Res 2020;18(1):96-106. Published online January 30, 2020; DOI: https://doi.org/10.5217/ir.2019.00092

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Background/Aims
We aimed to investigate the proportion of and risk factors for residual cancer and/or lymph node metastasis after surgery was performed because of high-risk pathological features in endoscopic resection specimen of suspected superficial submucosal colorectal cancer (SSMC).
Methods
We reviewed medical records of 497 patients (58.8 ± 9.8 years, 331 males) undergoing endoscopic resection of suspected SSMC. High-risk pathological features included: deep submucosal cancer invasion ≥ 1,000 μm; positive lymphovascular and/or perineural invasion; poorly differentiated adenocarcinoma; and positive resection margin. We investigated the occurrence of additional surgery and residual cancer and/or lymph node involvement in the surgical specimen.
Results
En bloc resection was performed in 447 patients (89.9%). High-risk pathological features were detected in 372 patients (74.8%). Additional surgery was performed in 336 of 372 patients with high-risk pathological features. Of these, 47 surgical specimens (14.0%) showed residual cancer and/or lymph node metastasis. Piecemeal resection was more common in those with residual cancer and/or lymph node involvement than those without (9/47 [19.1%] vs. 24/289 [8.3%], P= 0.032). Positive resection margin was also significantly associated with positive residual cancer and/or lymph node involvement. As the number of high-risk pathological features increased, the risk of regional lymph node metastasis increased proportionally (P= 0.002).
Conclusions
High-risk pathological features were frequently detected after endoscopic resection of suspected SSMC while residual cancer and/or lymph node metastasis were not commonly present in the additional surgical specimen. Further optimized strategy for proper endoscopic management of suspected SSMC is necessary.

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Case Report

IBD

A case of ulcerative colitis presenting with cerebral venous thrombosis: Junghwan Lee, Sung Wook Hwang, Jinhee Lee, Kyung Hwa Jung, Ha Il Kim, Sang Hyoung Park, Dong-Hoon Yang, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang; Intest Res 2018;16(2):306-311. Published online April 30, 2018; DOI: https://doi.org/10.5217/ir.2018.16.2.306

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Patients with inflammatory bowel disease (IBD) have been reported to have an increased risk of thromboembolism. Cerebral venous thrombosis (CVT) is a rare but serious extraintestinal manifestation of IBD. Due to its highly variable manifestation and low incidence, CVT is not usually readily recognized by physicians. Herein, we report a case of a 35-year-old male presenting with CVT associated with ulcerative colitis (UC). The patient was admitted with chief complaints of bloody diarrhea that had started 3 days prior. Sigmoidoscopy showed hyperemic and edematous mucosa, friability, and shallow ulcers from the sigmoid colon to the rectum suggestive of IBD. Three days later, the patient started complaining of a headache, and gradually developed a decreased level of consciousness. Magnetic resonance imaging of the brain revealed CVT with hemorrhagic infarctions. An angiogram was obtained to evaluate the extent of CVT, and anticoagulation therapy was initiated with intravenous heparin. During hospitalization, he was diagnosed with UC and treated with 5-aminosalicylic acid. After discharge, the patient was recovered without neurological deficit, and remission of UC was also obtained. The presence of headache or acute worsening of neurological status in a patient with IBD should alert the health professionals about the possibility of CVT.

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Natalia Ziolkowski, Jana Dengler, Cory S Goldberg
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Cerebral venous thrombosis as presenting manifestation of inflammatory bowel disease (IBD)
Katie Stamp, Alison Pattinson, Paul Maliakal, Thekootu Nandakumar, Shaji Sebastian
GastroHep.2019; 1(1): 45. CrossRef

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Original Articles

Local recurrence and subsequent endoscopic treatment after endoscopic piecemeal mucosal resection with or without precutting in the colorectum: Myeongsook Seo, Eun Mi Song, Gwang Un Kim, Sung Wook Hwang, Sang Hyoung Park, Dong-Hoon Yang, Kyung-Jo Kim, Byong Duk Ye, Seung-Jae Myung, Suk-Kyun Yang, Jeong-Sik Byeon; Intest Res 2017;15(4):502-510. Published online October 23, 2017; DOI: https://doi.org/10.5217/ir.2017.15.4.502

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Background/Aims

Precutting before endoscopic piecemeal mucosal resection (EPMR) may increase colorectal polyp resection effectiveness. We aimed to identify risk factors for recurrence after conventional EPMR (CEPMR) and precut EPMR (PEPMR) and investigated endoscopic treatment outcomes for recurrent cases.

Methods

The medical records of patients with colorectal polyps treated by EPMR were analyzed. Patients without follow-up surveillance colonoscopies were excluded.

Results

Among 359 lesions, the local recurrence rate on the first surveillance colonoscopy was 5.8% (18/312) and 6.4% (3/47) after CEPMR and PEPMR, respectively. Among lesions without recurrence at the first surveillance colonoscopy, the rates of late recurrence on subsequent surveillance colonoscopy were 3.9% (6/152) and 0% after CEPMR and PEPMR, respectively. Larger tumor size was the only independent risk factor for recurrence (odds ratio, 7.93; 95% confidence interval, 1.95–32.30; P<0.001). Endoscopic treatment was performed for all 27 recurrences. A combination of ≥2 endoscopic treatment modalities was used in 19 of 27 recurrences (70.4%). Surveillance colonoscopies were performed in 20 of 27 recurrences after endoscopic treatment. One (5.0%) had a re-recurrence and was treated by surgical resection because recurrence occurred at the appendiceal orifice. Nineteen of 20 lesions (95.0%) could be cured endoscopically, although 3 of the 19 showed second or third recurrences and were treated by repeat endoscopic resection.

Conclusions

The local recurrence rates after CEPMR and PEPMR were similar. Larger tumor size was an independent risk factor for local recurrence after EPMR. Endoscopic treatment of recurrences resulted in high cure rates, although combination methods were necessary in many cases.

Citations

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Chang Kyo Oh, Young Wook Cho, Young-Seok Cho
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Talia F. Malik, Babu P. Mohan, Smit Deliwala, Lena L. Kassab, Saurabh Chandan, Neil R. Sharma, Douglas G. Adler
Journal of Clinical Gastroenterology.2024; 58(9): 889. CrossRef
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Cong Ding, Jian-feng Yang, Xia Wang, Yi-feng Zhou, Hayat Khizar, Zheng Jin, Xiao-feng Zhang
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Does precutting prior to endoscopic piecemeal resection of large colorectal neoplasias reduce local recurrence? A KASID multicenter study
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Maria Azevedo Silva, Carina Leal, André Ruge, Alexandra Fernandes, Liliana Eliseu, Helena Vasconcelos
GE - Portuguese Journal of Gastroenterology.2022; 29(4): 247. CrossRef
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Matthew Symer, James Connolly, Heather Yeo
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Yasar Colak, Badar Hasan, Walid Hassaballa, Mamoon Ur Rashid, Victor Strassmann, Giovanna DaSilva, Steven D. Wexner, Tolga Erim
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Nam Seok Ham, Jeongseok Kim, Eun Hye Oh, Sung Wook Hwang, Sang Hyoung Park, Dong-Hoon Yang, Byong Duk Ye, Seung-Jae Myung, Suk-Kyun Yang, Jeong-Sik Byeon
Digestive Diseases and Sciences.2020; 65(4): 969. CrossRef
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Cold snare piecemeal EMR of large sessile colonic polyps ≥20 mm (with video)
Dileep Mangira, Karla Cameron, Koen Simons, Simon Zanati, Richard LaNauze, Spiro Raftopoulos, Gregor Brown, Alan Moss
Gastrointestinal Endoscopy.2020; 91(6): 1343. CrossRef

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Clinical outcome of endoscopic management in delayed postpolypectomy bleeding: Jeong-Mi Lee, Wan Soo Kim, Min Seob Kwak, Sung-Wook Hwang, Dong-Hoon Yang, Seung-Jae Myung, Suk-Kyun Yang, Jeong-Sik Byeon; Intest Res 2017;15(2):221-227. Published online April 27, 2017; DOI: https://doi.org/10.5217/ir.2017.15.2.221

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Background/Aims

The clinical course after endoscopic management of delayed postpolypectomy bleeding (DPPB) has not been clearly determined. This study aimed to assess clinical outcomes after endoscopic hemostasis of DPPB and evaluate risk factors for rebleeding after initial hemostasis.

Methods

We reviewed medical records of 198 patients who developed DPPB and underwent endoscopic hemostasis between January 2010 and February 2015. The performance of endoscopic hemostasis was assessed. Rebleeding negative and positive patients were compared.

Results

DPPB developed 1.4±1.6 days after colonoscopic polypectomy. All patients achieved initial hemostasis. Clipping was the most commonly used technique. Of 198 DPPB patients, 15 (7.6%) had rebleeding 3.3±2.5 days after initial hemostasis. The number of clips required for hemostasis was higher in the rebleeding positive group (3.2±1.6 vs. 4.2±1.9, P=0.047). Combinations of clipping with other modalities such as injection methods were more common in the rebleeding positive group (67/291, 23.0% vs. 12/17, 70.6%; P<0.001). Multivariate analysis showed a large number of clips and combination therapy were independent risk factors for rebleeding. All the rebleeding cases were successfully managed by repeat endoscopic hemostasis.

Conclusions

Endoscopic hemostasis is effective for the management of DPPB because of its high initial hemostasis rate and low rebleeding rate. Endoscopists should carefully observe patients in whom a large number of clips and/or combination therapy have been used to manage DPPB because these may be related to the severity of DPPB and a higher risk of rebleeding.

Citations

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Delphi consensus statement for the management of delayed post-polypectomy bleeding
Enrique Rodríguez de Santiago, Sandra Pérez de la Iglesia, Diego de Frutos, José Carlos Marín-Gabriel, Carolina Mangas-SanJuan, Raúl Honrubia López, Hugo Uchima, Marta Aicart-Ramos, Miguel Ángel Rodríguez Gandía, Eduardo Valdivielso Cortázar, Felipe Ramos
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Hisham Wehbe, Aditya Gutta, Mark A. Gromski
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Matthew A. O’Mara, Peter G. Emanuel, Aaron Tabibzadeh, Robert J. Duve, Jonathan S. Galati, Gregory Laynor, Samantha Gross, Seth A. Gross
Journal of Clinical Gastroenterology.2024; 58(8): 739. CrossRef
Is endoscopic hemostasis safe and effective for delayed post-polypectomy bleeding?
Jae-Yong Cho, Yunho Jung, Han Hee Lee, Jung-Wook Kim, Kee Myung Lee, Hyun Lim, Geun-Hyuk Choi, Seong Woo Choi, Bo-In Lee
International Journal of Gastrointestinal Intervention.2024; 13(4): 122. CrossRef
Endoscopic management of delayed bleeding after polypectomy of small colorectal polyps: two or more clips may be safe
Xue-Feng Guo, Xiang-An Yu, Jian-Cong Hu, De-Zheng Lin, Jia-Xin Deng, Ming-Li Su, Juan Li, Wei Liu, Jia-Wei Zhang, Qing-Hua Zhong
Gastroenterology Report.2022;[Epub] CrossRef
Management and Outcomes of Bleeding Within 30 Days of Colonic Polypectomy in a Large, Real-Life, Multicenter Cohort Study
Enrique Rodríguez de Santiago, Maria Hernández-Tejero, Liseth Rivero-Sánchez, Oswaldo Ortiz, Irene García de la Filia-Molina, Jose Ramon Foruny-Olcina, Hector Miguel Marcos Prieto, Maria García-Prada, Almudena González-Cotorruelo, Miguel Angel De Jorge Tu
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A. Rajendran, S. Pannick, S. Thomas‐Gibson, S. Oke, C. Anele, N. Sevdalis, A. Haycock
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Child-Pugh B or C Cirrhosis Increases the Risk for Bleeding Following Colonoscopic Polypectomy
Hosim Soh, Jaeyoung Chun, Seung Wook Hong, Seona Park, Yun Bin Lee, Hyun Jung Lee, Eun Ju Cho, Jeong-Hoon Lee, Su Jong Yu, Jong Pil Im, Yoon Jun Kim, Joo Sung Kim, Jung-Hwan Yoon
Gut and Liver.2020; 14(6): 755. CrossRef
Post-polypectomy Visible Vessel
Matthew Woo, Robert Bechara
Journal of the Canadian Association of Gastroenterology.2018; 1(2): 51. CrossRef
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Tae-Geun Gweon, Jinsu Kim
International Journal of Gastrointestinal Intervention.2018; 7(3): 123. CrossRef

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15-Hydroxyprostaglandin dehydrogenase as a marker in colon carcinogenesis: analysis of the prostaglandin pathway in human colonic tissue: Dong-Hoon Yang, Yeon-Mi Ryu, Sun-Mi Lee, Jin-Yong Jeong, Soon Man Yoon, Byong Duk Ye, Jeong-Sik Byeon, Suk-Kyun Yang, Seung-Jae Myung; Intest Res 2017;15(1):75-82. Published online January 31, 2017; DOI: https://doi.org/10.5217/ir.2017.15.1.75

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Background/Aims

Cyclooxygenase-2 (COX-2), 15-hydroxyprostaglandin dehydrogenase (15-PGDH), and microsomal prostaglandin E synthase-1 (mPGEs-1) regulate prostaglandin E₂ (PGE₂) expression and are involved in colon carcinogenesis. We investigated the expression of PGE₂ and its regulating genes in sporadic human colon tumors and matched normal tissues.

Methods

Twenty colonic adenomas and 27 colonic adenocarcinomas were evaluated. COX-2 and 15-PGDH expression was quantified by real-time polymerase chain reaction. The expression of PGE₂ and mPGEs-1 was measured using enzyme-linked immunosorbent assay and Western blotting, respectively.

Results

The expression of COX-2, mPGEs-1, and PGE₂ did not differ between the adenomas and matched distant normal tissues. 15-PGDH expression was lower in adenomas than in the matched normal colonic tissues (P<0.001). In adenocarcinomas, mPGEs-1 and PGE₂ expression was significantly higher (P<0.001 and P=0.020, respectively), and COX-2 expression did not differ from that in normal tissues (P=0.207). 15-PGDH expression was significantly lower in the normal colonic mucosa from adenocarcinoma patients than in the normal mucosa from adenoma patients (P=0.018).

Conclusions

Early inactivation of 15-PGDH, followed by activation of COX-2 and mPGEs-1, contributes to PGE₂ production, leading to colon carcinogenesis. 15-PGDH might be a novel candidate marker for early detection of field defects in colon carcinogenesis.

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Case Report

Chronic intractable diarrhea caused by gastrointestinal mastocytosis: Hyungil Seo, Sang Hyoung Park, Jeong-Sik Byeon, Chang Gok Woo, Seung-Mo Hong, Kiju Chang, Hoonsub So, Minseob Kwak, Wan Soo Kim, Jeong-Mi Lee, Dong-Hoon Yang, Kyung-Jo Kim, Byong Duk Ye, Seung-Jae Myung, Suk-Kyun Yang; Intest Res 2016;14(3):280-284. Published online June 27, 2016; DOI: https://doi.org/10.5217/ir.2016.14.3.280

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As mast cells have been highlighted in the pathogenesis of diarrhea-predominant irritable bowel syndrome, a new term "mastocytic enterocolitis" was suggested by Jakate and colleagues to describe an increase in mucosal mast cells in patients with chronic intractable diarrhea and favorable response to treatment with antihistamines. Although it is not an established disease entity, two cases have been reported in the English medical literature. Here, for the first time in Asia, we report another case of chronic intractable diarrhea caused by gastrointestinal mastocytosis. The patient was a 70-year-old male with chronic intractable diarrhea for 3 months; the cause of the diarrhea remained obscure even after exhaustive evaluation. However, biopsy specimens from the jejunum were found to have increased mast cell infiltration, and the patient was successfully treated with antihistamines.

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John A. Damianos, Kristina A. Matkowskyj, Thanai Pongdee, Joseph A. Murray
Journal of Clinical Gastroenterology.2025;[Epub] CrossRef
Mastocytic Enterocolitis: An Overlooked Diagnosis for Unexplained Chronic Diarrhea in a Patient With Colon Polyps and a Family History of Colon Cancer
Leeann Hu, Liliana Franco, Jignesh Parikh, Vania Zayat
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Systemic Mastocytosis: A Rare Cause of Diarrhea
Leonard Hamera, Andrew M Santos, Sean-Patrick A Prince, Sreekanth Chandrupatla, Jeffrey Jordan
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Gastrointestinal Manifestations of Hypereosinophilic Syndromes and Mast Cell Disorders: a Comprehensive Review
Vivian C. Nanagas, Anna Kovalszki
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Mastocytosis
Jingtao Chen, Patrick Brady, Jay Mamel
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Original Articles

Change in the diagnosis of inflammatory bowel disease: a hospital-based cohort study from Korea: Ho-Su Lee, Jaewon Choe, Hyo Jeong Lee, Sung Wook Hwang, Sang Hyoung Park, Dong-Hoon Yang, Kyung-Jo Kim, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Yong Sik Yoon, Chang Sik Yu, Jin-Ho Kim, Suk-Kyun Yang; Intest Res 2016;14(3):258-263. Published online June 27, 2016; DOI: https://doi.org/10.5217/ir.2016.14.3.258

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Background/Aims

Accurately diagnosing inflammatory bowel disease (IBD) remains a challenge, but is crucial for providing proper management for affected patients. The aim of the present study was to evaluate the frequency of change in diagnosis in Korean patients who were referred to our institution with a diagnosis of IBD.

Methods

We enrolled 1,444 patients diagnosed with ulcerative colitis (UC) and 1,452 diagnosed with Crohn's disease (CD), who had been referred to the Asan Medical Center between January 2010 and December 2014. These patients were assessed and subsequently classified as having UC, CD, indeterminate colitis, possible IBD, or non-IBD.

Results

During a median follow-up of 15.9 months, 400 of the 2,896 patients (13.8%) analyzed in this study experienced a change in diagnosis. A change in diagnosis from UC to CD, or vice-versa, was made in 24 of 1,444 patients (1.7%) and 23 of 1,452 patients (1.6%), respectively. A change to a non-IBD diagnosis was the most common modification; 7.5% (108 of 1444) and 12.7% (184 of 1452) of the patients with a referral diagnosis of UC and CD, respectively, were reclassified as having non-IBD. Among the 292 patients who were ultimately determined not to have IBD, 135 (55 UC and 80 CD cases) had received IBD-related medication.

Conclusions

There are diagnostic uncertainties and difficulties in relation to IBD. Therefore, precise assessment and systematic follow-up are essential in the management of this condition.

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Harold Duarte, Adrienne Stolfi, Courtney McCall, Shehzad Saeed, Kelly Sandberg
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Muhammad Z Ali, Muhammad Usman Tariq, Muhammad Hasan Abid, Hamma Abdulaziz, Mohmmad AlAdwani, Arif Khurshid, Muhammad Rashid, Fawaz Al Thobaiti , Amjad Althagafi
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Guglielmo Albertini Petroni, Laura Francesca Pisani, Edoardo Borsotti, Maria Doria, Maria Laura Annunziata
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Thirty-year Trend in Inflammatory Bowel Disease on Jeju Island, South Korea
Jin Woo Kim, Hyun Joo Song, Sun-Jin Boo, Heung Up Kim, Ki Soo Kang, Soo-Young Na
The Korean Journal of Gastroenterology.2023; 81(6): 243. CrossRef
PD-1-positive cells contribute to the diagnosis of inflammatory bowel disease and can aid in predicting response to vedolizumab
Min Kyu Kim, Su In Jo, Sang-Yeob Kim, Hyun Lim, Ho Suk Kang, Sung‑Hoon Moon, Byong Duk Ye, Jae Seung Soh, Sung Wook Hwang
Scientific Reports.2023;[Epub] CrossRef
IBD barriers across the continents – East Asia
Joyce Wing Yan Mak, Agnes Hiu Yan Ho, Siew Chien Ng
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Inflammatory bowel disease in Korea: epidemiology and pathophysiology
Jung Won Lee, Chang Soo Eun
The Korean Journal of Internal Medicine.2022; 37(5): 885. CrossRef
Systematic evaluation of the diagnostic approach of inflammatory bowel disease guidelines
Bing‐He Xiao, Xu‐Dong Ma, Jia‐Jun Lv, Ting Yang, Xin‐Jie Liu, Li‐Ya An, Yu‐Xing Qi, Ming‐Liang Lu, Yong‐Qing Duan, Da‐Li Sun
International Journal of Clinical Practice.2021;[Epub] CrossRef
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Yong-Sung Choi, Jong-Kyu Kim, Wan-Jung Kim
World Journal of Gastrointestinal Endoscopy.2021; 13(9): 407. CrossRef
Current status of inflammatory bowel diseases in Korea
Suk-Kyun Yang
Journal of the Korean Medical Association.2021; 64(9): 572. CrossRef
EpidemIBD: rationale and design of a large-scale epidemiological study of inflammatory bowel disease in Spain
María Chaparro, Manuel Barreiro-de Acosta, José Manuel Benítez, José Luis Cabriada, María José Casanova, Daniel Ceballos, María Esteve, Hipólito Fernández, Daniel Ginard, Fernando Gomollón, Rufo Lorente, Pilar Nos, Sabino Riestra, Montserrat Rivero, Pilar
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Illuminating an Invisible Epidemic: A Systemic Review of the Clinical and Economic Benefits of Early Diagnosis and Treatment in Inflammatory Disease and Related Syndromes
Lukasz S. Wylezinski, Jamieson D. Gray, Julia B. Polk, Andrew J. Harmata, Charles F. Spurlock
Journal of Clinical Medicine.2019; 8(4): 493. CrossRef
Impact of Cumulative Corticosteroid Dosage on Preventable Hospitalization among Taiwanese Patients with Ankylosing Spondylitis and Inflammatory Bowel Disease
Beth I. Wallace, Chelsea A. Harris, Lu Wang, Mochuan Liu, Jung-Sheng Chen, Chang-Fu Kuo, Kevin C. Chung
Journal of Clinical Medicine.2019; 8(5): 614. CrossRef
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M. Baimas-George, L. Cetrulo, A. Kao, K.R. Kasten
International Journal of Surgery Case Reports.2018; 49(C): 126. CrossRef
Assessment of factors associated with smoking cessation at diagnosis or during follow‐up of Crohn's disease
Eun Mi Song, Gwang‐Un Kim, Myeongsook Seo, Sung Wook Hwang, Sang Hyoung Park, Eunja Kwon, Ho‐Su Lee, Dong‐Hoon Yang, Kyung‐Jo Kim, Byong Duk Ye, Jeong‐Sik Byeon, Seung‐Jae Myung, Suk‐Kyun Yang
Journal of Gastroenterology and Hepatology.2018; 33(1): 180. CrossRef
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Yoon Suk Jung, Minkyung Han, Won Ho Kim, Sohee Park, Jae Hee Cheon
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Amanda D. Williams, Olga Y. Korolkova, Amos M. Sakwe, Timothy M. Geiger, Samuel D. James, Roberta L. Muldoon, Alan J. Herline, J. Shawn Goodwin, Michael G. Izban, Mary K. Washington, Duane T. Smoot, Billy R. Ballard, Maria Gazouli, Amosy E. M'Koma, Shree
PLOS ONE.2017; 12(8): e0179710. CrossRef
Clinical course of ulcerative colitis patients who develop acute pancreatitis
Jong Wook Kim, Sung Wook Hwang, Sang Hyoung Park, Tae Jun Song, Myung-Hwan Kim, Ho-Su Lee, Byong Duk Ye, Dong-Hoon Yang, Kyung-Jo Kim, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang
World Journal of Gastroenterology.2017; 23(19): 3505. CrossRef
Overall and cause‐specific mortality in Korean patients with inflammatory bowel disease: A hospital‐based cohort study
Ho‐Su Lee, Jaewon Choe, Seon‐Ok Kim, Sun‐Ho Lee, Hyo Jeong Lee, Hyungil Seo, Gwang‐Un Kim, Myeongsook Seo, Eun Mi Song, Sung Wook Hwang, Sang Hyoung Park, Dong‐Hoon Yang, Kyung‐Jo Kim, Byong Duk Ye, Jeong‐Sik Byeon, Seung‐Jae Myung, Yong Sik Yoon, Chang S
Journal of Gastroenterology and Hepatology.2017; 32(4): 782. CrossRef
Endoscopic Diagnosis and Differentiation of Inflammatory Bowel Disease
Ji Min Lee, Kang-Moon Lee
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Clinical Features and Prognosis of Resectable Primary Colorectal Signet-Ring Cell Carcinoma: Ho-Su Lee, Jae Seung Soh, Seohyun Lee, Jung Ho Bae, Kyung-Jo Kim, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Sun A Kim, Young Soo Park, Seok-Byung Lim, Jin Cheon Kim, Chang Sik Yu, Dong-Hoon Yang; Intest Res 2015;13(4):332-338. Published online October 15, 2015; DOI: https://doi.org/10.5217/ir.2015.13.4.332

Abstract PDF PubReader ePub

Background/Aims

We attempted to investigate the prognosis of signet-ring cell carcinoma (SRC) patients who underwent curative surgery by comparing them with age-, sex-, and stage-matched non-mucinous adenocarcinoma (NMAC) patients.

Methods

Between January 2003 and December 2011, 19 patients with primary SRC of the colorectum underwent curative surgery. Four SRC patients under the age of 40 were excluded, and the clinicopathological data of 15 patients (7 men; median age, 56 years) were reviewed and compared with the data of 75 NMAC patients matched by age, sex, and pathologic stage.

Results

The median follow-up duration was 30.1 months for the SRC group and 43.7 months for the NMAC group (P=0.141). Involvement of the left side of the colon (73.3% vs. 26.7%, P=0.003) and infiltrative lesions such as Borrmann types 3 and 4 (85.7% vs. 24.0%, P=0.001) were more common in the SRC group than in the NMAC group. The five-year overall survival rate was significantly lower for patients with SRC than for those with NMAC (46.0% vs. 88.7%, hazard ratio, 6.99; 95% confidence interval, 2.33-20.95, P=0.001).

Conclusions

Patients with even resectable primary colorectal SRC had a poorer prognosis than age-, sex-, and stage-matched colorectal NMAC patients.

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Comprehensive Characterization of the Immune Microenvironment of Colorectal and Gastric Signet Ring Cell Cancer
Jianqing Zhang, Robin Collingwood, Sameer Al Diffalha, Deborah Della Manna, Ravi Kumar Paluri, Haider A. Mejbel, Olumide Gbolahan
Cells.2025; 15(1): 30. CrossRef
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Nan Yao, Wenqiang Li, Jiwei Wang, Hongyuan Chu, Ning Duan, Xinyu Niu, Guoyong Yu, Jun Qu
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Systematic review of risk factors, prognosis, and management of colorectal signet-ring cell carcinoma
Frederiek Nuytens, Vincent Drubay, Clarisse Eveno, Florence Renaud, Guillaume Piessen
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Chung-Ming Lo, Yi-Wen Yang, Jen-Kou Lin, Tzu-Chen Lin, Wei-Shone Chen, Shung-Haur Yang, Shih-Ching Chang, Huann-Sheng Wang, Yuan-Tzu Lan, Hung-Hsin Lin, Sheng-Chieh Huang, Hou-Hsuan Cheng, Jeng-Kai Jiang, Chun-Chi Lin
Computerized Medical Imaging and Graphics.2023; 107: 102242. CrossRef
Metastatic colorectal carcinoma with signet-ring cells: Clinical, histological and molecular description from an Association des Gastro-Entérologues Oncologues (AGEO) French multicenter retrospective cohort
Marion Allart, Florence Leroy, Stephano Kim, David Sefrioui, Mihane Nayeri, Aziz Zaanan, Benoit Rousseau, Meher Ben Abdelghani, Christelle de la Fouchardière, Wulfran Cacheux, Romain Legros, Samy Louafi, David Tougeron, Olivier Bouché, Nadim Fares, Guilla
Digestive and Liver Disease.2022; 54(3): 391. CrossRef
The Molecular Associations of Signet-Ring Cell Carcinoma in Colorectum: Meta-Analysis and System Review
Xueting Liu, Litao Huang, Menghan Liu, Zhu Wang
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Michael G. Fadel, George Malietzis, Vasilis Constantinides, Gianluca Pellino, Paris Tekkis, Christos Kontovounisios
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Lili Zhu, Chunrun Ling, Tao Xu, Jinglin Zhang, Yujie Zhang, Yingjie Liu, Chao Fang, Lie Yang, Wen Zhuang, Rui Wang, Jie Ping, Mojin Wang
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Jie Mao, Peng Du, Han-teng Yang, Huan Hu, Shi-Yao Wang, Xia Wu, Zhi-Bin Cheng
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Yong-Ping Yang, Ling-Yun Yu, Jian Shi, Jian-Nan Li, Xin-Yu Wang, Tong-Jun Liu
Medicine.2020; 99(26): e20985. CrossRef
Prognosis of Signet Ring Cell Carcinoma of the Colon and Rectum and their Distinction of Mucinous Adenocarcinoma with Signet Ring Cells. A Comparative Study
Luis I. Pozos-Ochoa, Leonardo S. Lino-Silva, Alberto M. León-Takahashi, Rosa A. Salcedo-Hernández
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Impact of histological subtype on the prognosis of patients undergoing surgery for colon cancer
Fabio Bagante, Gaya Spolverato, Eliza Beal, Katiuscha Merath, Qinyu Chen, Ozgür Akgül, Robert A. Anders, Timothy M. Pawlik
Journal of Surgical Oncology.2018; 117(7): 1355. CrossRef
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Chun-Run Ling, Rui Wang, Mo-Jin Wang, Jie Ping, Wen Zhuang
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Renjie Wang, Xiaoji Ma, Yaqi Li, Yiping He, Dan Huang, Sanjun Cai, Junjie Peng, Javier S Castresana
PLOS ONE.2016; 11(8): e0160527. CrossRef
Younger Age Is Associated with Poorer Survival in Patients with Signet-Ring Cell Carcinoma of the Colon without Distant Metastasis
Ben Huang, Mengdong Ni, Chen Chen, Yang Feng, Sanjun Cai
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Colonic Chicken Skin Mucosa is an Independent Endoscopic Predictor of Advanced Colorectal Adenoma: Eun Ju Chung, Ji Young Lee, Jaewon Choe, Hye-Sook Chang, Jongcheol Kim, Dong Hoon Yang, Byong Duk Ye, Jeong-Sik Byeon, Kyung-Jo Kim, Suk-Kyun Yang, Jin-Ho Kim, Seung-Jae Myung; Intest Res 2015;13(4):318-325. Published online October 15, 2015; DOI: https://doi.org/10.5217/ir.2015.13.4.318

Abstract PDF PubReader ePub

Background/Aims

Chicken skin mucosa (CSM), surrounding colorectal adenoma, is an endoscopic finding with pale yellow-speckled mucosa; however, its clinical significance is unknown. This study aimed to evaluate the prevalence and clinical characteristics of CSM, and the association between colorectal carcinogenesis and CSM.

Methods

This cross-sectional study was performed in 733 consecutive patients who underwent endoscopic polypectomy for colorectal adenoma after the screening of colonoscopy at the Asan Health Promotion Center between June 2009 and December 2011. The colonoscopic and pathological findings of colorectal adenoma including number, size, location, dysplasia, morphology, and clinical parameters were reviewed.

Results

The prevalence of CSM was 30.7% (225 of 733 patients), and most CSM-related adenomas were located in the distal colon (93.3%). Histological analysis revealed lipid-laden macrophages in the lamina propria of the mucosa. Multivariate analyses showed that CSM was significantly associated with advanced pathology, including villous adenoma and high-grade dysplasia (odds ratio [OR], 2.078; 95% confidence interval [CI], 1.191-3.627; P=0.010), multiple adenomas (i.e., ≥2 adenomas; OR, 1.692; 95% CI, 1.143-2.507; P=0.009), and a protruding morphology (OR, 1.493; 95% CI, 1.027-2.170; P=0.036). There were no significant differences in polyp size or clinical parameters between patients with and without CSM.

Conclusions

CSM-related adenoma was mainly found in the distal colon, and was associated with advanced pathology and multiple adenomas. CSM could be a potential predictive marker of the carcinogenetic progression of distally located colorectal adenomas.

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Jiaming Lei, Ling Wu
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Mucosa color and size may indicate malignant transformation of chicken skin mucosa-positive colorectal neoplastic polyps
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Ying-Jie Zhang, Wu Wen, Fan Li, Yi Jian, Chuan-Ming Zhang, Meng-Xia Yuan, Ye Yang, Feng-Lin Chen
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Jie Dong, Tian-Shi Ma, Yuan-Hong Xu, Peng Li, Wan-Yuan Chen, Jiang-Feng Tu, You-Wei Chen
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Yu Mi Lee, Kyung Ho Song, Hoon Sup Koo, Choong-Sik Lee, Inseok Ko, Sang Hyuk Lee, Kyu Chan Huh
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Case Report

Natural Course of an Untreated Metastatic Perirectal Lymph Node After the Endoscopic Resection of a Rectal Neuroendocrine Tumor: Sang Hyung Kim, Dong-Hoon Yang, Jung Su Lee, Soyoung Park, Ho-Su Lee, Hyojeong Lee, Sang Hyoung Park, Kyung-Jo Kim, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Jin-Ho Kim, Chan Wook Kim, Jihun Kim; Intest Res 2015;13(2):175-179. Published online April 27, 2015; DOI: https://doi.org/10.5217/ir.2015.13.2.175

Abstract PDF PubReader

Lymph node metastasis is rare in small (i.e., <10 mm) rectal neuroendocrine tumors (NETs). In addition to tumor size, pathological features such as the mitotic or Ki-67 proliferation index are associated with lymph node metastasis in rectal NETs. We recently treated a patient who underwent endoscopic treatment of a small, grade 1 rectal NET that recurred in the form of perirectal lymph node metastasis 7 years later. A 7-mm-sized perirectal lymph node was noted at the time of the initial endoscopic treatment. The same lymph node was found to be slightly enlarged on follow-up and finally confirmed as a metastatic NET. Therefore, the perirectal lymph node metastasis might have been present at the time of the initial diagnosis. However, the growth rate of the lymph node was extremely low, and it took 7 years to increase in size from 7 to 10 mm. NETs with low Ki-67 proliferation index and without mitotic activity may grow extremely slowly even if they are metastatic.

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Jian-Ning Liu, Hui Chen, Nian Fang
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Soo-Young Na, Seong Jung Kim, Hyoun Woo Kang
International Journal of Gastrointestinal Intervention.2023; 12(3): 105. CrossRef
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Byung-Soo Park, Sung Hwan Cho, Gyung Mo Son, Hyun Sung Kim, Su Jin Kim, Su Bum Park, Cheol Woong Choi, Hyung Wook Kim, Dong Hoon Shin
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Ho Suk Kang, Mi Jung Kwon, Tae-Hwan Kim, Junhee Han, Young-Su Ju
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P. Leon, A. Balduzzi, M. Troian, N. de Manzini
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Usefulness of endoscopic resection using the band ligation method for rectal neuroendocrine tumors
Ju Seung Kim, Yoon Jae Kim, Jun-Won Chung, Jung Ho Kim, Kyoung Oh Kim, Kwang An Kwon, Dong Kyun Park, Jung Suk An
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Lymphovascular invasion in more than one-quarter of small rectal neuroendocrine tumors
Mi Jung Kwon, Ho Suk Kang, Jae Seung Soh, Hyun Lim, Jong Hyeok Kim, Choong Kee Park, Hye-Rim Park, Eun Sook Nam
World Journal of Gastroenterology.2016; 22(42): 9400. CrossRef
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Dong-Hoon Yang, Yangsoon Park, Sang Hyoung Park, Kyung-Jo Kim, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang
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Original Articles

Patient Descriptions of Rectal Effluents May Help to Predict the Quality of Bowel Preparation With Photographic Examples: Hoonsub So, Sun-Jin Boo, Hyungil Seo, Ho-Su Lee, Hyojeong Lee, Sang Hyoung Park, Kyung-Jo Kim, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Jin-Ho Kim, Seungbong Han, Dong-Hoon Yang; Intest Res 2015;13(2):153-159. Published online April 27, 2015; DOI: https://doi.org/10.5217/ir.2015.13.2.153

Abstract PDF PubReader

Background/Aims

Previous studies have suggested a weak correlation between self-reported rectal effluent status and bowel preparation quality. We aim to evaluate whether photographic examples of rectal effluents could improve the correlation between patient descriptions of rectal effluents and bowel preparation quality.

Methods

Before colonoscopy, patients were asked to describe the nature of their last three rectal effluents. Photographic examples of rectal effluents were provided as a reference for scoring. Bowel preparation was subsequently assessed by a single endoscopist using a global preparation assessment scale. Preparation outcomes were grouped into two levels (excellent to good vs. fair to inadequate). Both univariate and multivariate logistic regression models were used to find any association between bowel preparation quality and patient characteristics.

Results

A total of 138 patients completed the questionnaires. The mean age was 56.5±10.4 years. The mean sum of the last three rectal effluent scores was 5.9±2.0. Higher rectal effluent scores (odds ratio [OR], 0.82; P=0.043) and the presence of diverticula (OR, 0.16; P<0.001) were risk factors for suboptimal preparation.

Conclusions

Photographic example-guided patient descriptions of rectal effluents showed a statistically significant association with bowel preparation quality. However, clinical significance seemed to be low. The presence of diverticula was an independent predictive factor for suboptimal bowel preparation quality.

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Serdar Senol, Mustafa Kusak, Kevser Uzunoglu Yıldırım, Mustafa Gun, Mıne Gızem Bıdıl
Diagnostics.2025; 15(13): 1717. CrossRef
Individualized intervention based on a preparation-related prediction model improves adequacy of bowel preparation: A prospective, multi-center, randomized, controlled study
Long Chen, Xiaoyu Kang, Gui Ren, Hui Luo, Linhui Zhang, Limei Wang, Jianghai Zhao, Rongchun Zhang, Xiaoying Zhang, Lina Zhao, Yanglin Pan
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Evaluating the practice of canceling colonoscopies for presumed inadequate bowel preparation
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Hyo-Joon Yang, Dong Il Park, Soo-Kyung Park, Sunyong Kim, Taeheon Lee, Yunho Jung, Chang Soo Eun, Dong Soo Han
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Comparison of Bowel Cleansing Efficacy, Safety, Bowel Movement Kinetics, and Patient Tolerability of Same-Day and Split-Dose Bowel Preparation Using 4 L of Polyethylene Glycol: A Prospective Randomized Study
Myeongsook Seo, Tae-Geun Gweon, Cheal Wung Huh, Jeong Seon Ji, Hwang Choi
Diseases of the Colon & Rectum.2019; 62(12): 1518. CrossRef
Randomized trial comparing oral sulfate solution with 4‐L polyethylene glycol administered in a split dose as preparation for colonoscopy
Hyo‐Joon Yang, Soo‐Kyung Park, Jee Hyun Kim, Jong Pil Im, Dong Han Yeom, Geom Seog Seo, Dong Il Park
Journal of Gastroenterology and Hepatology.2017; 32(1): 12. CrossRef
Patient Description of Rectal Effluents With Photographic Examples as a Predictive Indicator for the Quality of Bowel Preparation
Hyoun Woo Kang
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Author's Reply
Hoonsub So, Seungbong Han, Dong-Hoon Yang
Intestinal Research.2015; 13(4): 364. CrossRef

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The Clinical Usefulness of Endoscopic Ultrasound-Guided Fine Needle Aspiration and Biopsy for Rectal and Perirectal Lesions: Jae Seung Soh, Ho-Su Lee, Seohyun Lee, Jungho Bae, Hyo Jeong Lee, Sang Hyoung Park, Dong-Hoon Yang, Kyung-Jo Kim, Byong Duk Ye, Seung-Jae Myung, Suk-Kyun Yang, Jin-Ho Kim, Jeong-Sik Byeon; Intest Res 2015;13(2):135-144. Published online April 27, 2015; DOI: https://doi.org/10.5217/ir.2015.13.2.135

Abstract PDF PubReader

Background/Aims

Endoscopic ultrasound-guided fine needle aspiration and/or biopsy (EUS-FNA/B) have been used to diagnose subepithelial tumors (SETs) and extraluminal lesions in the gastrointestinal tract. Our group previously reported the usefulness of EUS-FNA/B for rectal and perirectal lesions. This study reports our expanded experience with EUS-FNA/B for rectal and perirectal lesions in terms of diagnostic accuracy and safety. We also included our new experience with EUS-FNB using the recently introduced ProCore needle.

Methods

From April 2009 to March 2014, EUS-FNA/B for rectal and perirectal lesions was performed in 30 consecutive patients. We evaluated EUS-FNA/B performance by comparing histological diagnoses with final results. We also investigated factors affecting diagnostic accuracy.

Results

Among 10 patients with SETs, EUS-FNA/B specimen results revealed a gastrointestinal stromal tumor in 4 patients and malignant lymphoma in 1 patient. The diagnostic accuracy of EUS-FNA/B was 50% for SETs (5/10). Among 20 patients with non-SET lesions, 8 patients were diagnosed with malignant disease and 7 were diagnosed with benign disease based on both EUS-FNA/B and the final results. The diagnostic accuracy of EUS-FNA/B for non-SET lesions was 75% (15/20). The size of lesions was the only factor related to diagnostic accuracy (P=0.027). Two complications of mild fever and asymptomatic pneumoperitoneum occurred after EUS-FNA/B.

Conclusions

The overall diagnostic accuracy of EUS-FNA/B for rectal and perirectal lesions was 67% (20/30). EUS-FNA/B is a clinically useful method for cytological and histological diagnoses of rectal and perirectal lesions.

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Recurrent vaginal squamous cell carcinoma mimicking peri-rectal abscess: The role of endoscopic ultrasound
Taha Bin Arif, Tahir Shaikh
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Girish Mishra, Anne Marie Lennon, Nonthalee Pausawasdi, Vanessa M. Shami, Reem Z. Sharaiha, B. Joseph Elmunzer
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Quality Indicators for EUS
Girish Mishra, Anne Marie Lennon, Nonthalee Pausawasdi, Vanessa M. Shami, Reem Z. Sharaiha, B. Joseph Elmunzer
American Journal of Gastroenterology.2025; 120(5): 973. CrossRef
Clinical Utility of Endoscopic Ultrasound‐Guided Fine‐Needle Aspiration and Biopsy for Rectal and Perirectal Lesions With Categorization of Their Indications
June Hwa Bae, Jung‐Bin Park, Ji Eun Baek, Seung Wook Hong, Sung Wook Hwang, Sang Hyoung Park, Dong‐Hoon Yang, Byong Duk Ye, Seung‐Jae Myung, Suk‐Kyun Yang, Jeong‐Sik Byeon
Journal of Digestive Diseases.2025; 26(5-6): 193. CrossRef
Colonoscopic Ultrasound-Guided Fine-Needle Aspiration Using a Curvilinear Array Transducer: A Single-Center Retrospective Cohort Study
Spencer Cheng, Sergio E. Matuguma, Guilherme H. P. de Oliveira, Gustavo L.R. Silva, Henrique Cheng, Sergio A. Sánchez-Luna, Mauricio K Minata
Diseases of the Colon & Rectum.2022; 65(2): e80. CrossRef
Diagnosis and Management of Rectal Neuroendocrine Tumors (NETs)
Francesco Maione, Alessia Chini, Marco Milone, Nicola Gennarelli, Michele Manigrasso, Rosa Maione, Gianluca Cassese, Gianluca Pagano, Francesca Paola Tropeano, Gaetano Luglio, Giovanni Domenico De Palma
Diagnostics.2021; 11(5): 771. CrossRef
Long-term experience with percutaneous biopsies of pelvic lesions using CT guidance
Petr Hoffmann, Michal Balik, Martina Hoffmannova, Jiri Spacek, Jiri Vanasek, Adam Rezac, Petr Dvorak
Science Progress.2021;[Epub] CrossRef
Prospective histological evaluation of a 20G core trap with a forward-cutting bevel needle for EUS-FNA of pancreatic lesions
Nobu Nishioka, Takeshi Ogura, Yoshitaka Kurisu, Miyuki Imanishi, Saori Onda, Wataru Takagi, Tatsushi Sano, Atsushi Okuda, Akira Miyano, Mio Amano, Kazuhide Higuchi
Surgical Endoscopy.2018; 32(10): 4125. CrossRef
Concise review on the comparative efficacy of endoscopic ultrasound-guided fine-needle aspiration vs core biopsy in pancreatic masses, upper and lower gastrointestinal submucosal tumors
Tawfik Khoury, Wisam Sbeit, Nicholas Ludvik, Divya Nadella, Alex Wiles, Caitlin Marshall, Manoj Kumar, Gilad Shapira, Alan Schumann, Meir Mizrahi
World Journal of Gastrointestinal Endoscopy.2018; 10(10): 267. CrossRef
Endoscopic ultrasound-guided fine needle aspiration of extra-rectal lesions
J. Lim, S. A. Norton, N. A. Wong, M. G. Thomas
Techniques in Coloproctology.2017; 21(5): 393. CrossRef
Application of Endoscopic Ultrasonography in the Diagnosis and Treatment of Lower Gastrointestinal Disease
Eun Young Kim
Intestinal Research.2015; 13(2): 101. CrossRef
Benign Prostatic Hyperplasia Mimicking a Symptomatic Rectal Submucosal Tumor
Seung Wook Hong, Jaeyoung Chun, Kyu Joo Park, Cheol Kwak, Joo Sung Kim
Soonchunhyang Medical Science.2015; 21(2): 164. CrossRef

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Case Report

A Case of Cronkhite-Canada Syndrome Showing Spontaneous Remission: Dong-Uk Kang, Dong-Hoon Yang, Yunsik Choi, Ji-Beom Kim, Ho-Su Lee, Hyo Jeong Lee, Sang Hyoung Park, Kee Wook Jung, Kyung-Jo Kim, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Jin-Ho Kim; Intest Res 2013;11(4):317-322. Published online October 30, 2013; DOI: https://doi.org/10.5217/ir.2013.11.4.317

Abstract PDF

Cronkhite-Canada syndrome (CCS) is a rare, noninherited gastrointestinal polyposis syndrome associated with ectodermal changes such as alopecia, nail dystrophy, and cutaneous hyperpigmentation. The etiology and pathogenesis of CCS are not known, but diarrhea, malnutrition, gastrointestinal bleeding, and infection may occur in the affected patient; moreover, this condition could be fatal. However, previous reports have described several cases of spontaneous remission. We report a 60-year-old man who was incidentally found to have colonic polyposis, alopecia, and hypogeusia and was diagnosed to have CCS. However, this patient experienced spontaneous remission, including regrowth of body hair and alleviation of bowel inflammation, without any specific medications such as steroids, antibiotics, or proton pump inhibitors. (Intest Res 2013;11:317-322)

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Cronkhite-Canada Syndrome Showing Good Early Response to Steroid Treatment
Woohee Cho, Kwangwoo Nam, Ki Bae Bang, Hyun Deok Shin, Jeong Eun Shin
The Korean Journal of Gastroenterology.2018; 71(4): 239. CrossRef

3,571 View
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1 Crossref

Original Article

Near-infrared Fluorescence Imaging Using a Protease-activatable Nanoprobe in Tumor Detection: Comparison with Narrow-band Imaging: Soon Man Yoon, In-Wha Kim, Miyeoun Song, Eun-Ju Do, Ju Hee Ryu, Kwangmeyung Kim, Ick Chan Kwon, Mi Jung Kim, Dae Hyuk Moon, Dong-Hoon Yang, Kyoung Jo Kim, Byong Duk Ye, Jeong-Sik Byeon, Suk-Kyun Yang, Jin-Ho Kim, Seung-Jae Myung; Intest Res 2013;11(4):268-275. Published online October 30, 2013; DOI: https://doi.org/10.5217/ir.2013.11.4.268

Abstract PDF

Background/Aims
Advances in endoscopic technology seek to improve the accuracy of neoplastic tumor detection. Recently developed endoscopy devices such as narrow-band imaging (NBI) nevertheless have limitations in morphologic diagnosis. The purpose of this study was to investigate whether a novel imaging technique—near-infrared fluorescence (NIRF) imaging using a protease-activatable nanoprobe—could provide more accurate neoplastic tumor detection, compared to NBI. Methods: Images of the intestines of ApcMin/+ mice were obtained by NIRF using a matrix metalloproteinase (MMP)-sensing probe, which was based on a nanoparticle platform. Immediately after imaging, endoscopy with NBI capability was performed on the same excised intestine. Macroscopic and microscopic findings in the intestines were assessed, and MMP expression was analyzed by Western blotting and real-time polymerase chain reaction. Results: Numerous tiny polypoid lesions were present in the intestines of aged ApcMin/+ mice. These lesions included adenomas, lymphoid follicles, and protruding normal tissues. When using NIRF imaging with an MMP-activatable nanoprobe, adenomatous polyps showed higher fluorescence, compared to lymphoid follicles or adjacent normal tissues. The expression of MMP was higher in the adenomatous tissue than in the other tissues. The sensitivity and specificity for adenoma detection were 88.9% and 82.2%, respectively, when using NIRF imaging with a MMP-nanoprobe, compared to 77.8% and 66.7%, respectively, when using NBI (P<0.05). Conclusions: Near-infrared fluorescence imaging with a protease-activatable nanoprobe could aid in the differentiation of tumor characteristics. Clinical application of this approach may improve the endoscopic detection of neoplastic tumors. (Intest Res 2013;11:268-275)

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Feasibility of moxifloxacin and proflavine dual fluorescence imaging for detecting gastrointestinal neoplastic lesions: A prospective study
Kwangwoo Nam, Noseong Park, Seunghun Lee, Suil Jeon, Jungbin Lee, Seung‐Mo Hong, Sung Wook Hwang, Sang Hyoung Park, Dong‐Hoon Yang, Byong Duk Ye, Jeong‐Sik Byeon, Suk‐Kyun Yang, Jeong Hoon Lee, Do Hoon Kim, Ki Hean Kim, Seung‐Jae Myung
Lasers in Surgery and Medicine.2023; 55(4): 378. CrossRef
Molecular Imaging of Colorectal Tumors by Targeting Colon Cancer Secreted Protein-2 (CCSP-2)
Jaeil Kim, Eun-ju Do, Helen Moinova, Sang Mun Bae, Ja Young Kang, Seung-Mo Hong, Stephen P. Fink, Jinmyoung Joo, Young-Ah Suh, Se Jin Jang, Sung Wook Hwang, Sang Hyoung Park, Dong-Hoon Yang, Byong Duk Ye, Jeong-Sik Byeon, Jaewon Choe, Suk-Kyun Yang, Sanfo
Neoplasia.2017; 19(10): 805. CrossRef
Introduction of Molecular Imaging in Gastrointestinal Endoscopy: Towards a New Horizon
Jae Jun Park
Intestinal Research.2013; 11(4): 233. CrossRef

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3 Crossref

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)

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

3,620 View
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Original Article

Endoscopic Resection for Rectal Carcinoid Tumor: Efficacy and Clinical Results of Follow-up: Gwang Un Kim, Byong Duk Ye, Jeong-Sik Byeon, Hwan Sung Park, Tae Jin Ok, Dong-Hoon Yang, Kee Wook Jung, Kyung Jo Kim, Seung-Jae Myung, Suk-Kyun Yang, Jin-Ho Kim; Intest Res 2011;9(3):217-224. Published online December 30, 2011; DOI: https://doi.org/10.5217/ir.2011.9.3.217

Abstract PDF

Background/Aims
With the growing volume of screening colonoscopies, the incidence of rectal carcinoids and the number of endoscopic resections for rectal carcinoids are also increasing. However, the prognosis including recurrence and metachronous lesions after endoscopic resection is unclear. Methods: The medical records of 255 patients who had undergone endoscopic resection for rectal carcinoids between October 1999 and April 2010 were retrospectively reviewed. Results: The number of males was 150 (58.8%), and the mean age was 54.1 years (range, 27-85 years). Mean tumor size was 6.9 mm. In total, 162 cases (63.5%) were treated with endoscopic mucosal resection and 93 (36.5%) were treated with endoscopic submucosal dissection. Although endoscopic complete resections were achieved in all cases, the histological examination showed 47 cases with a positive resection margin (18.4%) and three with lymphovascular invasion (1.2%). In the 54 patients with a free resection margin, who were followed for more than 12 months, abdominopelvic computed tomography and endoscopy did not show recurrence after a median of 30.5 and 36 months, respectively. Three patients with lymphovascular invasion did not show recurrence during follow-up period of 13, 30, and 37 months, respectively. Metachronous rectal carcinoids were detected in four patients at 23, 58, 61, and 89 months, respectively, after initial endoscopic resection, leading to a second endoscopic treatment. Conclusions: Small rectal carcinoids completely resected grossly and pathologically without lymphovascular invasion appear to have low probability of short-term recurrence. However, considering the slow growth rate of carcinoids, long-term follow-up for recurrence and metachronous carcinoids is required. (Intest Res 2011;9:217-224)

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Clinical outcomes and risk factors associated with poor prognosis after endoscopic resection of 10–20 mm rectal neuroendocrine tumors: a multicenter, retrospective study of 10-year experience
Ja Jun Goo, Dong Hoon Baek, Hyung Wook Kim, Hong Sub Lee, Jong Yoon Lee, Su Bum Park, Geun Am Song, Sang Heon Lee, Jong Hoon Lee
Surgical Endoscopy.2023; 37(7): 5196. CrossRef
Risk Factors for Lymph Node Metastasis and Oncologic Outcomes in Small Rectal Neuroendocrine Tumors with Lymphovascular Invasion
Seung-Joo Nam, Byung Chang Kim, Hee Jin Chang, Han Ho Jeon, Junho Kim, Su Young Kim
Gut and Liver.2022; 16(2): 228. CrossRef
Multiple small, rectal neuroendocrine tumors with numerous micronests
Sung Sil Park, Nayoung Han, Jihyeon Lee, Hee Jin Chang, Jae Hwan Oh, Dae Kyung Sohn
Journal of Digestive Diseases.2018; 19(9): 572. CrossRef
Clinical outcomes of endoscopic mucosal resection for rectal neuroendocrine tumor
Jihye Kim, Jee Hyun Kim, Joo Young Lee, Jaeyoung Chun, Jong Pil Im, Joo Sung Kim
BMC Gastroenterology.2018;[Epub] CrossRef
Are Small Rectal Neuroendocrine Tumors Safe?
Jae Ho Choi, Jae Myung Cha
Intestinal Research.2015; 13(2): 103. CrossRef
Appendiceal Neuroendocrine Tumor with Lymph Node Metastasis in a Teenager
Keun Young Kim, Won Cheol Park
The Korean Journal of Gastroenterology.2015; 65(2): 127. CrossRef

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Review

Molecular Imaging of Gastrointestinal Malignancies: Jong Wook Kim, Soon Man Yoon, Seung-Jae Myung; Intest Res 2011;9(2):90-96. Published online August 30, 2011; DOI: https://doi.org/10.5217/ir.2011.9.2.90

Abstract PDF

Endoscopic detection of gastrointestinal cancer currently depends in large part on white light images, which show mucosal surface changes in real time. Molecular imaging is a rapidly growing new field in gastrointestinal endoscopy, which could provide additional information about molecular expression of cells and processes involved in cancer biology. It uses the molecular signature of cells for minimally-invasive, targeted imaging of gastrointestinal pathologies. Exogenous fluorescent agents serve as molecular beacons and include labeled peptides and antibodies, and probes with tumor-specific activation. An advantage of molecular imaging in digestive tract is the opportunity to apply such agents topically, overcoming the hurdles for delivery of these agents to the region of involvement, including immunogenic reaction and potential toxicity. Recently developed molecular targets include proteolytic enzymes, endothelial-specific markers, and apoptosis reporters. Molecular imaging has the potential to greatly impact on future endoscopy in gastroenterology. (Intest Res 2011;9:90-96)

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Endoscopic molecular imaging in inflammatory bowel disease
Nam Seok Ham, Seung-Jae Myung
Intestinal Research.2021; 19(1): 33. CrossRef

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1 Crossref

Case Report

A Case of Isolated Ileal Ganglioneuroma: Ju Hyung Song, Byong Duk Ye, Yong Sik Yoon, Mi-Jung Kim, Dong-Hoon Yang, Kee Wook Jung, Kyung-Jo Kim, Jung-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Jin-Ho Kim; Intest Res 2011;9(1):46-50. Published online April 30, 2011; DOI: https://doi.org/10.5217/ir.2011.9.1.46

Abstract PDF

Ganglioneuromas of the gastrointestinal tract are rare, but have an established association with genetic disorders, such as the multiple endocrine neoplasia (MEN) syndrome (type 2b) and neurofibromatosis (type 1). However, solitary ganglioneuromas are not associated with an increased risk for MEN 2b, neurofibromatosis type 1, or any other systemic conditions. Ganglioneuromas of the gastrointestinal tract have been reported to predominantly involve the colon and rectum, and are thereby occasionally detected during colonoscopy or surgery. Although there are no characteristic symptoms of solitary ganglioneuromas, symptoms can be induced by solitary ganglioneuromas, such as abdominal pain, bleeding, or obstruction, depending on the location and size. Herein we report a case of a solitary ganglioneuroma of the ileum. A 34-year-old man sought evaluation at our hospital for anemia. The medical and family histories were benign and there was no history of genetic disorders. The evaluation for anemia revealed iron-deficiency anemia and CT enterography revealed a single mass in the ileum. Laparoscopic resection of the lesion was performed and the pathologic examination confirmed an ileal ganglioneuroma. (Intest Res 2011;9: 11-50)

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A Case of Duodenal Ganglioneuroma Manifesting as a Subepithelial Tumor
Dong Chan Joo, Gwang Ha Kim, Chul Byung Chae, So Jeong Lee, Do Youn Park
The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2018; 18(4): 271. CrossRef

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1 Crossref

Original Articles

Clinical Characteristics of Constipation with Hypothyroidism: Jaeil Kim, Seung-Jae Myung, Dong-Hoon Yang, In Ja Yoon, So Young Seo, Heun Sook Ku, Soon Man Yoon, Kyung-Jo Kim, Byong Duk Ye, Jung-Sik Byeon, Suk-Kyun Yang, Jin-Ho Kim; Intest Res 2010;8(1):48-57. Published online June 30, 2010; DOI: https://doi.org/10.5217/ir.2010.8.1.48

Abstract PDF

Background/Aims
Constipation is a well-recognized gastrointestinal symptom in patients with untreated hypothyroidism. Although thyroid function tests are recommended to exclude hypothyroidism in patients with constipation, there have been no reports to determine the causal relationship between thyroid function and constipation. The aim of this study was to determine the prevalence of hypothyroidism in constipated patients and the clinical features of constipation associated with hypothyroidism. Methods: A total of 1,481 constipated patients were included. These patients were divided into overt hypothyroidism, subclinical hypothyroidism, and normal thyroid function groups based on thyroid function tests. We reviewed the clinical presentation, anorectal function, colonic transit time, defecographic findings, and response to biofeedback therapy. Results: The prevalence of overt and subclinical hypothyroidism was 0.41% (men, 0.36%; women, 0.53%) and 1.76% (men, 1.28%; women 2.03%), respectively. There were no differences in total or segmental colonic transit times and subtypes of constipation among the normal thyroid function (n=54), overt hypothyroidism (n=4), and subclinical hypothyroidism groups (n=21). On anorectal manometry, the prevalence of dyssynergic defecation did not differ between the three groups. Rectal hyposensitivity was more frequent in the overt hypothyroidism group (overt hypothyroidism group, 50.0%; subclinical hypothyroidism group, 19.0%; normal thyroid function group, 20.4%) without statistical significance (P=0.372). Conclusions: The prevalence of overt and subclinical hypothyroidism in constipated patients was very low. The colonic transit time is not affected by thyroid function. (Intest Res 2010;8:48-57)

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Long-Term Risks of Parkinson’s Disease, Surgery, and Colorectal Cancer in Patients With Slow-Transit Constipation
Eun Mi Song, Hyo Jeong Lee, Kee Wook Jung, Mi Jung Kim, Sung Wook Hwang, Sang Hyoung Park, Dong-Hoon Yang, Byong Duk Ye, Jeong-Sik Byeon, Jaewon Choe, Suk-Kyun Yang, Satish S.C. Rao, Seung-Jae Myung
Clinical Gastroenterology and Hepatology.2021; 19(12): 2577. CrossRef
Chronic Constipation in the Elderly Patient: Updates in Evaluation and Management
Amir Mari, Mahmud Mahamid, Hana Amara, Fadi Abu Baker, Afif Yaccob
Korean Journal of Family Medicine.2020; 41(3): 139. CrossRef
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Kok-Ann Gwee, Uday C Ghoshal, Sutep Gonlachanvit, Andrew Seng Boon Chua, Seung-Jae Myung, Shaman Rajindrajith, Tanisa Patcharatrakul, Myung-Gyu Choi, Justin C Y Wu, Min-Hu Chen, Xiao-Rong Gong, Ching-Liang Lu, Chien-Lin Chen, Nitesh Pratap, Philip Abraham
Journal of Neurogastroenterology and Motility.2013; 19(2): 149. CrossRef

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The Efficacy of Bedside Colonoscopy for Critically Ill Patients with Acute Lower Gastrointestinal Hemorrhage: Jongha Park, Byong Duk Ye, Jae Keun Lee, Dong-Hoon Yang, Soon Man Yoon, Kyung-Jo Kim, Jung-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Jin-Ho Kim; Intest Res 2009;7(2):86-92. Published online December 30, 2009

Abstract PDF: Background/Aims
Most studies on acute gastrointestinal (GI) hemorrhage of intensive care unit (ICU) patients have focused on upper GI hemorrhage (UGIH), but reports on acute lower GI hemorrhage (LGIH) with the role of bedside colonoscopy are still lacking. Therefore, we determined the clinical characteristics of acute LGIH in ICU patients and the efficacy of bedside colonoscopy in ICU setting. Methods: We reviewed the medical records of 76 ICU patients who underwent bedside colonoscopy for acute LGIH between January 2005 and December 2007. The clinical characteristics of the patients, the outcomes of colonoscopy, and the clinical course after colonoscopy were investigated. Results: Of 76 patients, 43 patients (56.6%) were males and the median age was 67 years. End-stage renal diseases were the most common underlying diseases, followed by cardiovascular diseases. Cecal intubation was possible in 18 patients (23.7%) and bleeding foci were identified in 41 patients (53.9%). The two main causes of bleeding were rectal ulcers (48.8%) and ischemic colitis (22.0%). Endoscopic treatments were successful in 12 patients (15.8%), and there was only 1 case of rebleeding after 7 days. There were no severe complications associated with bedside colonoscopy; 3 patients (3.9%) died of uncontrolled LGIH during hospital period. Conclusions: Bedside colonoscopy is effective and safe for the diagnosis of acute LGIH in ICU patients. In addition, endoscopic treatment can be successfully performed in select patients. Therefore, in acute LGIH of ICU patients, bedside colonoscopy can be performed as a first-line procedure. (Intest Res 2009;7:86-92)

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The Safety and Efficacy of Azathioprine and 6-Mercaptopurine in the Treatment of Korean Patients with Crohn's Disease: Hyun Ju Lee, Suk-Kyun Yang, Kyung-Jo Kim, Jae-Won Choe, Soon Man Yoon, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Jin-Ho Kim; Intest Res 2009;7(1):22-31. Published online June 30, 2009

Abstract PDF: Background/Aims
This study aimed to evaluate the adverse events and efficacy of azathioprine (AZA) and 6-mercaptopurine (6-MP) in Korean patients with Crohn's disease (CD). Methods: We retrospectively analyzed 700 patients with CD (male：female=469：231; median age at diagnosis, 22 years; agerange, 9-74 years) who were treated at the Asan Medical Center between January 1997 and January 2006. Results: Of 700 patients, 372 (53.1%) were treated with AZA/6-MP. The cumulative rates of AZA/6-MP treatment at 1, 5, 10, and 20 years were 17.4%, 51.6%, 73.1%, and 94.5%, respectively. Of 372 patients treated with AZA/6-MP, 217 patients (58.3%) experienced 291 adverse events, requiring discontinuation of therapy in 41 patients (11%). Nausea occurred in 120 patients (32.3%) and led to discontinuation of therapy in 11 patients (3.0%). Leukopenia developed in 116 patients (31.2%), requiring dose adjustments in 100 patients (26.9%) and discontinuation of medications in 16 patients (4.3%). Other adverse events included infections (2.7%), abnormal liver function tests (2.7%), fever (0.8%), hair loss (0.8%), arthralgias (0.5%), pancreatitis (0.5%), headaches (0.5%), and skin rashes (0.3%). Complete corticosteroids withdrawal was achieved in 70.9% of the patients based on an intention-to-treat analysis. The remission rate of perianal fistulas was 32.6%. Conclusions: The risk of leukopenia by AZA/6-MP is higher in Korean patients with CD than in Western patients. Although the adverse events of AZA/6-MP are not uncommon in Korean patients with CD, the actual discontinuation rate of the treatment is low. Therefore, AZA/6-MP can be administered to most Korean patients with CD without serious adverse events. (Intest Res 2009;7:22-31)

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Diverticulitis: Focused on Clinical Course and Relapse: Kwi-Sook Choi, Jeong-Sik Byeon, Soon Man Yoon, Kyung-Jo Kim, Byong Duk Ye, Seung-Jae Myung, Suk-Kyun Yang, Jin-Ho Kim; Intest Res 2008;6(1):37-44. Published online June 30, 2008

Abstract PDF: Background/Aims
There are a limited number of studies concerning the outcomes of diverticulitis in the Oriental population. We sought to evaluate the clinical features and the long-term outcomes of diverticulitis in Korean patients. Methods: We retrospectively reviewed the clinical courses of 104 patients (59 men, 45 women; median age 48.5 years [range: 24-83 years]) hospitalized for their first episode of diverticulitis between 1989 and 2005. Results: Right-sided diverticulitis was more common (71/104, 68%). However, the proportion of left-sided diverticulitis increased as age increased. Thirty-two patients underwent operations: 30 because of complications and 2 because of presumed appendicitis. Left-sided diverticulitis was an independent risk factor for complications (OR=7.6, p＜ 0.001), and it required surgical treatment more often than right-sided diverticulitis did (61% vs. 17%, p＜0.001). Eighty-five patients were followed for a median of 36 months. Four of the 62 medically treated patients developed recurrence of diverticulitis, with a 3-year cumulative recurrence rate of 4.8%. None of the 4 recurrences showed complications, and all were successfully managed using conservative treatment. No predictive factors for the recurrence of diverticulitis could be determined. Conclusions: The recurrence rate and risk of complications associated with recurrence are low in patients treated conservatively for the first episode of diverticulitis. Therefore, elective surgery to prevent recurrence and complications should be utilized sparingly in patients with diverticulitis. (Intest Res 2008;6:37-44)

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Response to Biofeedback Therapy for Patients with Rectal Hyposensitivity: Kee Wook Jung, Seung-Jae Myung, Jeong-Sik Byeon, In Ja Yoon, Jung Eun Ko, So Young Seo, Soon Man Yoon, Mi Young Do, Do Hoon Kim, Benjamin Kim, Seunghyun Kwon, Byong Duk Ye, Hwoon-Yong Jung, Suk-Kyun Yang, Jin-Ho Kim; Intest Res 2008;6(1):56-69. Published online June 30, 2008

Abstract PDF: Background/Aims
Rectal hyposensitivity (RH) has been treated with conventional biofeedback therapy (BFT), whereas the effectiveness and long term results of this therapy are not known. We aimed to investigate the effectiveness of BFT for patients with RH by conducting a retrospective review of prospectively collected data. Methods: From June 2004 to March 2007, we enrolled those RH patients who underwent BFT. BFT was performed two or three times every week. Six months after BFT, the clinical response was evaluated by subjective and objective parameters. Results: A total of 82 RH patients underwent BFT. Fifty three patients finished BFT and the other 29 patients dropped out during BFT. Thirty six patients (67.9%) showed responsiveness (R) to BFT and 17 (31.5%) showed non-responsiveness (NR). The characteristics between the two groups showed no difference, except for the "desire to defecate" volume (116.1±25.2 in the R group vs. 140.0±43.9 in the NR group, p value ＜0.05) and the rectoanal inhibitory reflex (RAIR) (15.6±0.5 in the R group R vs. 27.6±18.2 in the NR group, p value ＜0.05). The R group showed a shorter colon transit time compared to NR group. At six months after BFT, a total of 20 patients were interviewed; 15 patients answered that they still had responsiveness (75%). Conclusions: The patients with RH showed a similar BFT response to that of the constipated patients. However, the patients with a more hyposensitive rectum and a longer colonic transit showed NR to BFT, suggesting RH is an important factor in BFT responsiveness. (Intest Res 2008;6:56-69)

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Case Report

Usefulness of C-Reactive Protein Level before and during Antimycobacterial Therapy in the Differential Diagnosis between Crohn's Disease andIntestinal Tuberculosis: Seok Won Jung, In Du Jeong, Do Ha Kim, Sang Hyun Park, Suk-Kyun Yang, Seung-Jae Myung; Intest Res 2007;5(2):204-206. Published online December 30, 2007

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Original Articles

Usefulness of C-reactive Protein Level before and during Antimycobacterial Therapy in the Differential Diagnosis between Crohn's Disease and Intestinal Tuberculosis: Sang Hyun Park, Suk-Kyun Yang, Seung-Jae Myung, Jeong-Sik Byeon, Byongduk Ye, Seunghyun Kwon, Benjamin Kim, Soon Man Yoon, Mi Young Do, Do Hoon Kim, Sai-Hui Kim, Jin Ho Kim; Intest Res 2007;5(1):19-25. Published online June 30, 2007

Abstract PDF: Background/Aims
Crohn's disease (CD) and intestinal tuberculosis (TB) are chronic inflammatory bowel disorders that are difficult to differentiate. Therefore, a therapeutic trial of antimycobacterial drugs is often used to differentiate CD from TB. This study aimed to evaluate the usefulness of C-reactive protein (CRP) level before or during antimycobacterial therapy to differentiate CD from TB. Methods: A total of 26 CD patients and 52 TB patients who received antimycobacterial therapy at the Asan Medical Center were included. CRP levels before or during antimycobacterial therapy were compared between CD and TB patients. A positive response to antimycobacterial therapy was defined as the decrease of CRP level below 50% of its baseline value. Results: The baseline CRP level was normal in only 1 of 26 CD patients (3.8%), while it was in 26 of 52 TB patients (50%). The rate of positive response to antimycobacterial therapy was significantly different between CD and TB patients whose baseline CRP level was abnormal: 28.0% (7/25) vs 88.5% (23/26) in 2 weeks, 34.8% (8/23) vs 84.6% (22/26) in 4 weeks, and 43.5% (10/23) vs 92.3% (24/26) in 8 weeks of antimycobacterial therapy. The rate of normalization in CRP level was also significantly different between the two groups: 0% (0/25) vs 73.1% (19/26) in 2 weeks, 13.0% (3/23) vs 69.2% (18/26) in 4 weeks, and 8.7% (2/23) vs 80.8% (21/26) in 8 weeks of antimycobacterial therapy. Conclusions: The CRP level before and during antimycobacterial therapy may be used as a supplementary tool in the differential diagnosis between CD and TB patients. (Intest Res 2007;5:19-25)

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Usefulness of Sigmoidoscopy in Pseudomembranous Colitis: Focused on the Comparison with Immunological Assay for C. difficile Toxin and the Role as a Predictive Factor for Clinical Outcome: Jun-Won Chung, Jeong-Sik Byeon, Kwi-Sook Choi, Benjamin Kim, Seunghyun Kwon, Byong Duk Ye, Seung-Jae Myung, Suk-Kyun Yang, Jin-Ho Kim; Intest Res 2007;5(1):45-51. Published online June 30, 2007

Abstract PDF: Background/Aims
Pseudomembranous colitis (PMC) shows a diverse clinical course. The aim of this study is to evaluate the usefulness of sigmoidoscopy in PMC. Methods: Sigmoidoscopic findings and medical records were analyzed in 74 patients with PMC (male：female=38：36, 62⁑16 years). Sigmoidoscopic grades of PMC were classified into mild (n=45) when pseudomembrane covered ＜1/3 of lumen, moderate (n=18) when it covered 1/3-2/3 of lumen, and severe (n=11) when its extent was ＞2/3 of lumen. Results: In comparison to sigmoidoscopy, diagnostic sensitivity of enzyme immunoassay (EIA) for C. difficile toxin A was 29%. EIA sensitivity was 38% in mild, 28% in moderate, 0% in severe sigmoidoscopic grade (p=0.02). Risk factors for severe sigmoidoscopic grade were ileus, nasogastric tube insertion, and serum albumin below 2.3 g/dL. Initial treatment success rate was lower in severe grade (33%) than mild (96%) and moderate grade (83%) (p＜0.01). One year mortality rate was lower in severe grade (17%) than mild (85%) and moderate grade (84%) (p=0.01). Old age and severe sigmoidoscopic grade were risk factors for death. Conclusions: Sigmoidoscopic severity grading may be useful in the prediction of prognosis in PMC patients. Sigmoidoscopy may also be useful in the diagnosis of PMC, especially in patients with severe PMC. (Intest Res 2007;5:45-51)

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Clinical Factors Predicting the Detection of Abnormalities by Double Balloon Endoscopy in Patients with Obscure Overt Gastrointestinal Bleeding: Jun-Won Chung, Jeong-Sik Byeon, Kee Don Choi, Kwi-Sook Choi, Benjamin Kim, Seung-Jae Myung, Suk-Kyun Yang, Jin-Ho Kim; Intest Res 2006;4(2):95-100. Published online December 30, 2006

Abstract PDF: Background/Aims
The most frequent indication of double balloon endoscopy (DBE) is obscure gastrointestinal bleeding (OGIB). The aim of the study was to evaluate the clinical factors predicting the detection of bleeding focus by DBE in patients with overt OGIB. Methods: Twenty eight patients (male：female=16：12, 13-82 years) with overt OGIB who underwent DBE were enrolled. Medical records were reviewed and analyzed. Results: Bleeding focus was found in 21 patients (75.0%). Age, gender, time interval between the last blood passage and DBE, transfusion amount, hemodynamic instability, and the number of past bleeding episodes were not different between patients whose bleeding focus was found by DBE and those whose bleeding focus was not found. Duration of bleeding was significantly longer in patients whose bleeding focus was found by DBE than those whose bleeding focus was not found (196.8⁑238.5 vs. 15.5⁑13.7 days, p=0.04). Conclusions: Duration of bleeding may be a useful clinical parameter which predicts the detection of bleeding focus by DBE in overt OGIB. (Intestinal Research 2006;4:95-100)

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Clinical Characteristics and Long-term Course of Ulcerative Colitis in Korea: Young Min Kim, Sang Hyoung Park, Suk-Kyun Yang, Jae-Won Choe, Sai-Hui Kim, Jeong-Sik Byeon, Seung-Jae Myung, Yun Kyung Cho, Chang-Sik Yu, Kwi-Sook Choi, Jun-Won Chung, Benjamin Kim, Kee Don Choi, Jin-Ho Kim; Intest Res 2006;4(1):12-21. Published online June 30, 2006

Abstract PDF: Background/Aims
Clinical characteristics of ulcerative colitis (UC) in Asian populations are not well recognized. We therefore investigated the clinical features and natural history of UC in Korea. Methods: We retrospectively analyzed 304 Korean UC patients first diagnosed at Asan Medical Center between June 1989 and August 2005. Results: The male to female ratio was 0.94：1 and the median age at diagnosis was 40.0 years (range, 12-72 years). At diagnosis, proctitis was noted in 134 patients (44.1%), left-sided colitis in 69 (22.7%), and extensive colitis in 101 (33.2%). Disease activity at diagnosis was mild in 149 patients (49.0%), moderate in 125 (41.1%), and severe in 26 (8.6%). In addition, 4 (1.3%) asymptomatic patients were detected as a result of a screening colonoscopy. Clinical remission after the first attack was documented in 97.4% of patients. The cumulative relapse rates at 1, 5, 10 years were 30.2%, 72.0%, and 88.4%, respectively. The cumulative risk of proximal extension in patients with proctitis or left-sided colitis was 33.0% at 5 years and 44.5% at 10 years. The cumulative probability of colectomy was 2.0% at 1 year, 2.8% at 3 years, and 3.3% at 5-15 years. The cumulative survival rates at 1, 5, and 10 years were 100%, 99.4%, and 97.4%, respectively. Conclusions: Clinical features of Korean UC patients at diagnosis are similar to those of Westerners. However, UC in Koreans may have a milder course than in Westerners, since Koreans have a lower rate of colectomy. (Intestinal Research 2006;4:12-21)

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The Incidence and Natural History of Perianal Fistulas in Korean Patients with Crohn's Disease: Ja Young Kim, Suk-Kyun Yang, Jeong-Sik Byeon, Seung-Jae Myung, Jae-Won Choe, Ji-Yun Jo, Dong-Hoon Yang, Yun Kyung Cho, Jin-Ho Kim; Intest Res 2006;4(1):22-31. Published online June 30, 2006

Abstract PDF: Background/Aims
We performed this study to investigate the incidence and natural history of perianal fistulas in Korean patients with Crohn's disease (CD). Methods: A total of 546 patients diagnosed with CD at Asan Medical Center were included. Results: Perianal fistulas occurred in 265 patients (48.5%), with 355 episodes. Eighty-two patients (15.0%) initially presented with perianal fistulas in the absence of other symptoms suggestive of CD. Out of 265 patients who developed perianal fistulas, 205 (77.4%) presented with perianal fistulas before, or at the time of, the diagnosis of CD. The cumulative incidence of perianal fistulas at 1, 5, 10, 20 years was 40.7%, 48.2%, 55.3% and 62.1%, respectively. Medical treatment was done in 30.7%, and surgery in 80.8% of perianal fistulas. The remission rate was 23.9% with medical treatment, and 83.6% with surgery. At least 1 recurrent fistula occurred in 77 patients (29.1%). The cumulative recurrence rate of perianal fistulas at 1, 5, 10, 20 years was 10.1%, 26.9%, 42.4% and 68.8%, respectively. Conclusions: The incidence of perianal fistulas in Korean patients with CD appears to be higher than that of Western patients. Also, the proportion of patients who develop perianal fistulas before the diagnosis of CD is very high. Therefore, we should consider the possibility of CD in patients with perianal fistulas to manage them properly, and thereby to reduce there complications. (Intestinal Research 2006;4:22-31)

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Clinical Manifestations and Course of Intestinal Behet's Disease: An Analysis in Relation to Disease Subtypes: Dae-Kyoum Kim, Suk-Kyun Yang, Jeong-Sik Byeon, Seung-Jae Myung, Ji-Yun Jo, Kee Don Choi, Gin Hyug Lee, Hwoon-Yong Jung, Weon-Seon Hong, Jin-Ho Kim, Young Il Min, Chang Sik Yu; Intest Res 2005;3(1):48-54. Published online June 30, 2005

Abstract PDF: Background/Aims
Intestinal Behet's disease (BD) is one of the main causes of morbidity and mortality of BD because it frequently results in serious complications such as perforation and bleeding. But clinical course of intestinal BD is not well-known. The aim of this study was to review clinical manifestations of intestinal BD, and to compare clinical findings of complete and incomplete types with those of suspected type. Methods: From June 1989 to January 2005, 87 patients who had colonoscopic evidence of intestinal BD and met the criteria proposed by BD Research Committee of Japan were enrolled in this study. Clinical manifestations were collected by retrospective review of medical records. Results: Mean age at diagnosis was 38.4 years (14-66) and sex ratio was 2：1. Abdominal pain was the most frequent gastrointestinal symptom. A single, round ulcer localized at the ileocecal area was the most common colonoscopic finding. Cumulative incidence of first and second operation in 10 years was 30.9% and 38.2%, respectively. Clinical manifestations of suspected type were not different from those of complete and incomplete types. Conclusions: Long-term follow up and close observation is needed for patients with intestinal BD. Although suspected type does not meet the criteria proposed by International Study Group for BD, it should be considered as BD. (Intest Res 2005; 3:48-54)

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Clinical Usefulness of Telomerase and hTERT for the Detection of Colon Cancer in Ulcerative Colitis: Kyu-Jong Kim, Seung-Jae Myung, Seong Soo Hong, Sun-Mi Lee Lee, Jeong-Sik Byeon, Suk-Kyun Yang, Weon-Seon Hong, Jin-Ho Kim, Young Il Min; Intest Res 2004;2(1):15-20. Published online April 16, 2004

Abstract PDF: Background/Aims
Telomerase and telomerase reverse transcriptase (hTERT), are specifically expressed in cancer cells, making them candidate markers for the early detection of cancer. The aims of our study were to determine whether these assays may be useful in the diagnosis of colorectal cancer (CRC) developed in ulcerative colitis (UC) patients. Methods: Luminal washings and biopsies were collected during colonoscopy in 66 patients; 34 with CRC, 21 with UC, and 11 controls. Telomerase activity was detected by telomeric repeat amplification protocol (TRAP) and hTERT was assayed by RT-PCR. Results: Telomerase activity was detected in biopsies from 33/34 (97%) CRC, 14/21 (67%) UC, and 3/11 (27%) controls. hTERT was positive in biopsies from 32/34 (94%) CRC, 12/21 (57%) UC, and 5/11 (45%) controls. In washing fluid, 21/34 (62%) of CRC patients were positive for telomerase, but UC patients and controls were negative. The sensitivity of telomerase for CRC was 97% in tissues and 62% in washing fluid. The specificity of telomerase in washing fluid was 100%, whereas the specificity of telomerase or hTERT mRNA in tissues was 47% each. Conclusions: The low specificity of telomerase and hTERT in colonic tissue suggest that these are not candidate markers for CRC arising in UC. Telomerase in colonoscopic luminal washings, however, may be a novel marker for early CRC in UC. (Intestinal Research 2004;2:15-20)

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The Prevalence of Colorectal Neoplasms and the Role of Screening Colonoscopy in Asymptomatic Korean Adults: Hye-Sook Chang, Jae-Won Choe, Suk-Kyun Yang, Seung-Jae Myung, Hwoon-Yong Jung, Gin Hyug Lee, Weon-Seon Hong, Jin-Ho Kim, Young-Il Min; Intest Res 2003;1(2):179-185. Published online November 27, 2003

Abstract PDF: Background/Aims
Recent studies have reported the importance of screening colonoscopy for colorectal cancer. However, the prevalence of colorectal neoplasms in asymptomatic Korean population has not been determined until now. The purpose of this study was to evaluate the prevalence of colorectal neoplasms in asymptomatic Korean population and to assess the role of colonoscopy in colorectal cancer screening. Methods: We reviewed the endoscopic and pathologic reports of 3,325 patients who underwent colonoscopy at the Health Promotion Center, Asan Medical Center, from 1998 to 2002. Of them, 2,208 asymptomatic patients who underwent colonoscopy for the purpose of colorectal cancer screening were enrolled. Results: The mean age was 49.2 years and 70.8% were men. The overall prevalence of colorectal neoplasms was 18.6% and the prevalence among patients 50 years of age or older was 26.3%. The prevalence of neoplasms increased with age and was higher in the male. Patients with distal neoplasms were more likely to have proximal neoplasms than those without distal neoplasms. However, 69.2% of the patients with advanced proximal neolplasms had no synchronous distal neoplasms. Conclusions: The prevalence of colorectal neoplasms in asymptomatic average-risk Koreans seems to be lower than that in corresponding Westerns and shows a gender-difference. These results should be considered when establishing a guideline for colorectal cancer screening in Korea. Over half of the patients with advanced proximal neoplasms will not be detected if only those with distal neoplasms undergo colonoscopic screening. Therefore, colonoscopy may be useful as a screening test for colorectal cancer. (Intestinal Research 2003;2:179-185)

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Case Report

Familial Occurrence of Ulcerative Colitis in All 4 Family Members: Jeong-Sik Byeon, Suk-Kyun Yang, Yun Jung Lee, Jae Won Choe, Gin Hyug Lee, Seung-Jae Myung, Hwoon-Yong Jung, Weon-Seon Hong, Jin-Ho Kim, Young Il Min; Intest Res 2003;1(1):72-82. Published online May 27, 2003

Abstract PDF: The pathogenesis of ulcerative colitis is complicated and both the genetic and environmental factors contribute to its development. Familial occurrence is an example indicating that both the genetic and environmental factors play some parts in the development of ulcerative colitis because family members have similar genetic characteristics and have been exposed to similar environment. Familial ulcerative colitis is observed in about 10% to 20% of patients. Most such families contain only 2 affected members and families containing more than 2 affected members are relatively rare. We experienced a case of familial ulcerative colitis in which all 4 members (both spouses and their 2 sons) were affected. They had lived together for 29 years before all 4 members were affected. The first patient was diagnosed after 14 years of cohabitation and the rest were affected 13, 14, and 15 years after the first diagnosis. We report this case with a review of literature. (Intestinal Research 2003;1:72-77)

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