Intestinal Research

Original Articles

Endoscopy

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

Background/Aims

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

Methods

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

Results

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

Conclusions

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

Citations

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

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The Effect of Infliximab on Patients with Ulcerative Colitis in Korea: Hyun Il Seo, Dong Il Park, Tae Oh Kim, You Sun Kim, Suck-Ho Lee, Ji Won Kim, Jae Hak Kim, Jeong Eun Shin; Intest Res 2014;12(3):214-220. Published online July 25, 2014; DOI: https://doi.org/10.5217/ir.2014.12.3.214

Abstract PDF PubReader ePub

Background/Aims

Infliximab was introduced recently as a rescue therapy for ulcerative colitis (UC) patients refractory to conventional treatments such as therapy with 5-amiono salicylic acids (5-ASA), immune modulators, and corticosteroids. However, there is insufficient data about its efficacy and safety in Korea.

Methods

From 7 tertiary referral hospitals, 33 patients who were treated with infliximab for moderate to severe (Mayo score 6-12) UC refractory to conventional treatment were recruited to this study. Clinical remission was defined as a total Mayo score of 2 or lower and every subscore less than 2. Partial response was defined as a decrease of Mayo score at least 3 points from baseline.

Results

Twenty-three patients (69.7%) showed clinical remission and 29 patients (87.8%) showed partial response in the observation period. When the remission and non-remission groups were compared in univariate analysis, only a higher total Mayo score at base line (11.0±0.9 vs. 9.9±1.5; P=0.04) was related to remission. The remission maintenance rate decreased with time in the Kaplan-Meier analysis. Two patients experienced re-remission after the first remission followed by aggravation during infliximab treatment. Three patients stopped infliximab treatment owing to adverse events including rhabdomyolysis, pneumonia, and fever of unknown origin.

Conclusions

If there is no choice except surgery for UC patients refractory to conventional treatment, infliximab is an effective and relatively safe treatment option for these patients in Korea.

Citations

Citations to this article as recorded by

Efficacy of Anti-TNF Therapy for the Treatment of Patients with Moderate-to-Severe Inflammatory Bowel Disease; a First Iranian Report
Samaneh Mohagheghi Darehranj, Sudabeh Alatab, Homayoon Vahedi, Anahita Sadeghi, Alireza Sima, Masoud Malekzadeh, Amir Anoshiravani, Hafez Fakheri, Nasser Ebrahimi Daryani, Abdolhamid Mousavi, Fariborz Mansour-Ghanaei, Mohammad Javad Zahedi, Reza Malekzade
Middle East Journal of Digestive Diseases.2019; 12(1): 12. CrossRef
Novel treatments for inflammatory bowel disease
Hyo Sun Lee, Soo-Kyung Park, Dong Il Park
The Korean Journal of Internal Medicine.2018; 33(1): 20. CrossRef
Long-term outcomes of infliximab treatment and predictors of response in 195 patients with ulcerative colitis: a hospital-based cohort study from Korea
Hyungil Seo, Kiju Chang, Sun-Ho Lee, Eun-Mi Song, Gwang-Un Kim, Myeongsook Seo, Ho-Su Lee, Sung-Wook Hwang, Dong-Hoon Yang, Kyung-Jo Kim, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Sang Hyoung Park
Scandinavian Journal of Gastroenterology.2017; 52(8): 857. CrossRef
Colectomy rates in patients with ulcerative colitis following treatment with infliximab or ciclosporin
Kymberley Thorne, Laith Alrubaiy, Ashley Akbari, David G. Samuel, Sian Morrison-Rees, Stephen E. Roberts
European Journal of Gastroenterology & Hepatology.2016; 28(4): 369. CrossRef
Efficacy and safety of CT‐P13, a biosimilar of infliximab, in patients with inflammatory bowel disease: A retrospective multicenter study
Yoon Suk Jung, Dong Il Park, Young Ho Kim, Ji Hyun Lee, Pyoung Ju Seo, Jae Hee Cheon, Hyoun Woo Kang, Ji Won Kim
Journal of Gastroenterology and Hepatology.2015; 30(12): 1705. CrossRef
Inflammatory Bowel Disease Cohort Studies in Korea: Present and Future
Jung Won Lee, Jong Pil Im, Jae Hee Cheon, You Sun Kim, Joo Sung Kim, Dong Soo Han
Intestinal Research.2015; 13(3): 213. CrossRef
Circulating Ghrelin Levels and Obestatin/Ghrelin Ratio as a Marker of Activity in Ulcerative Colitis
Ja Young Jung, Ji Bong Jeong, Ji Won Kim, Su Hwan Kim, Seong-Joon Koh, Byeong Gwan Kim, Kook Lae Lee
Intestinal Research.2015; 13(1): 68. CrossRef
How to Write Bibliographies for Citing Domestic Academic Resources
Hyun Jung Yi
The Korean Journal of Gastroenterology.2015; 65(1): 70. CrossRef
Does the Cyclosporine Still Have a Potential Role in the Treatment of Acute Severe Steroid-Refractory Ulcerative Colitis?
Chang Soo Eun, Dong Soo Han
Gut and Liver.2015;[Epub] CrossRef
Current and Emerging Biologics for Ulcerative Colitis
Sung Chul Park, Yoon Tae Jeen
Gut and Liver.2015; 9(1): 18. CrossRef

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Clinical Practice of Surveillance Colonoscopy according to the Classification of Colorectal Intraepithelial Neoplasia in Korea: High-grade Dysplasia/Carcinoma In Situ Versus Intramucosal Carcinoma: Sung Pil Hong, Tae Il Kim, Hyun Gun Kim, Hyun-Soo Kim, Seong-Eun Kim, Kyu Chan Huh, Jeong Eun Shin, Jae Myung Cha, Suck-Ho Lee, Intestinal Tumor Research Group, Korean Association for the Study of the Intestinal Disease; Intest Res 2013;11(4):276-282. Published online October 30, 2013; DOI: https://doi.org/10.5217/ir.2013.11.4.276

Abstract PDF

Background/Aims
Recent guidelines strongly recommend that the interval of surveillance colonoscopy be determined according to the risk stratification obtained at index colonoscopy. However, because of the differences in perception of the classification of colorectal intraepithelial neoplasia between Asian and Western countries, there is some confusion about surveillance colonoscopy. The aim of the present study was to evaluate the clinicopathological characteristics and the interval of surveillance colonoscopy between patients with high-grade dysplasia/carcinoma in situ and those with intramucosal carcinoma. Methods: From January 2003 to June 2010, 727 patients were included from 8 tertiary centers. Four hundred fifteen patients (57.1%) had high-grade dysplasia /carcinoma in situ (group A), and 312 (43.9%) had intramucosal carcinoma (group B). Clinicopathological data were reviewed retrospectively. Results: Group A had a significantly more frequent family history of colorectal cancer (3.1% vs. 0.6%, P<0.001), smaller polyp size (12 mm vs. 15 mm, P=0.001), and more proximal location (31.1% vs. 21.8%, P=0.005) than did group B. Among 727 patients, surveillance colonoscopy was performed within 6 months in 55.8% of patients and within 12 months in 77.8%. Group B had a significantly shorter interval of surveillance colonoscopy than did group A (P<0.001). There was no difference in detection of advanced neoplasia at surveillance colonoscopy between the 2 groups (6.6% vs. 5.4%, P=0.638). Conclusions: The recommended interval of surveillance colonoscopy is not followed in Korea. More education about post-polypectomy surveillance guidelines is required. (Intest Res 2013;11:276-282)

Citations

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Risk of developing advanced colorectal neoplasia after removing high‐risk adenoma detected at index colonoscopy in young patients: A KASID study
Soo‐Kyung Park, Nam Hee Kim, Yoon Suk Jung, Won Hee Kim, Chang Soo Eun, Bong Min Ko, Geom Seog Seo, Jae Myung Cha, Jae Jun Park, Kyeong Ok Kim, Chang Mo Moon, Yoonho Jung, Eun Soo Kim, Seong Ran Jeon, Chang Kyun Lee, Dong Il Park
Journal of Gastroenterology and Hepatology.2016; 31(1): 138. CrossRef
The Risk of Metachronous Advanced Colorectal Neoplasia Rises in Parallel with an Increasing Number of High-Risk Findings at Baseline
Seung Min Lee, Jeong Hwan Kim, In Kyung Sung, Sung Noh Hong
Gut and Liver.2015; 9(6): 741. CrossRef
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
Intestinal Research.2015; 13(4): 318. CrossRef
Surveillance Colonoscopy after Polypectomy: Actual Practice in Korea
Kyeong Ok Kim
Intestinal Research.2014; 12(1): 83. CrossRef

2,790 View
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4 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)

Citations

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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

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Case Report

Rare Case of Ogilvie Syndrome Associated with Herpes Zoster: Ji Hyun Kim, Suck-Ho Lee, Gyeong Jae Na, Su Jin Lee, Yeong Geol Jo, Tae Hoon Lee, Il Kwun Chung, Sang Heum Park, Sun Joo Kim; Intest Res 2012;10(4):379-382. Published online October 31, 2012; DOI: https://doi.org/10.5217/ir.2012.10.4.379

Abstract PDF

Acute colonic pseudo-obstruction (Ogilvie syndrome) associated with herpes zoster is extremely rare, and few cases have been reported. An 81-year-old woman diagnosed with herpes zoster was referred for accompanying colonic ileus. The diameter of the cecum was 7 cm and a computed tomographic scan showed no definite obstructive cause. Because the patient showed minimal improvement with conservative treatment, endoscopic colonic decompression was performed successfully. Previous studies revealed that the treatment of Ogilvie syndrome associated with herpes zoster does not differ from that of other conditions, and the role of the varicella-zoster virus in this syndrome is unclear. Here, we present the first case of Ogilvie syndrome associated with herpes zoster in Korea, which was improved by endoscopic colonic decompression. (Intest Res 2012;10:379-382)

Citations

Citations to this article as recorded by

Looking back to move forward: a twenty-year audit of herpes zoster in Asia-Pacific
Liang-Kung Chen, Hidenori Arai, Liang-Yu Chen, Ming-Yueh Chou, Samsuridjal Djauzi, Birong Dong, Taro Kojima, Ki Tae Kwon, Hoe Nam Leong, Edward M. F. Leung, Chih-Kuang Liang, Xiaohong Liu, Dilip Mathai, Jiun Yit Pan, Li-Ning Peng, Eduardo Rommel S. Poblet
BMC Infectious Diseases.2017;[Epub] CrossRef
Acute Colonic Pseudo-Obstruction (Ogilvie’s syndrome) as a Complication of Herpes Zoster
Kyung-Sun Min
The Korean Journal of Medicine.2016; 90(4): 318. CrossRef

2,408 View
14 Download
2 Crossref

Original Articles

Comparison of Bowel Preparation Quality between Clear-liquid Diet and No Diet Restriction: Woo Shin Jeong, Dong Il Park, Hyo Sun Seok, Seong Eun Kim, Suck-Ho Lee, Chang Kyun Lee, Chang Soo Eun, Dong Soo Han; Intest Res 2012;10(3):272-279. Published online July 31, 2012; DOI: https://doi.org/10.5217/ir.2012.10.3.272

Abstract PDF

Background/Aims
Adequate bowel preparation is essential for full visualization of colonic mucosa because detection of small polyps and neoplasms depends on the quality of bowel cleansing. The aims of this study were to compare the efficacy, tolerability of preparation and side effect between two groups: clear-liquid diet with polyethylene glycol (PEG) solution versus no diet restriction with PEG solution. Methods: This was a randomized single-blind prospective study. A total of 330 patients were randomly assigned to receive either 2 L PEG solution with a clear-liquid diet on the day before colonoscopy and another 2 L PEG solution on the day of the procedure (group 1) or 2 L PEG solution with a general diet on the day before colonoscopy and another 2 L PEG solution on the day of the procedure (group 2). Results: 162 patients were assigned to group 1 and 168 patients to group 2. The satisfactory quality of bowel preparation was not significantly different between the two groups (80.2%, 78.6%, P=0.707). Patient's compliance of the clear-liquid diet in group 1 was 50%. The satisfactory quality of bowel preparation was weakly better when the clear-liquid diet was given 2 or 3 times a day (group 1A) than 0 or once a day (group 1B) (74.1%, 86.4%, P=0.048). The tolerability of the PEG solution and side effects of preparation were not significantly different in the two groups (P=0.573, 0.686). Conclusions: Bowel preparation with no diet restriction and split-dose PEG solution was similar to preparation with a clear-liquid diet in efficacy, tolerability and side effect. Therefore, the use of the clear-liquid diet protocol should improve patient's compliance. (Intest Res 2012;10: 0-279)

Citations

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Comparative Study on Bowel Preparation Efficacy of Ascorbic Acid Containing Polyethylene Glycol by Adding Either Simethicone or 1 L of Water in Health Medical Examination Patients: A Prospective Randomized Controlled Study
Se Hwan Yeo, Jae Hoon Kwak, Yeo Un Kim, Tae Ho Kwon, Jeong Bae Park, Jun Hyung Park, Yong Kook Lee, Yun Jeong Lim, Chang Heon Yang
The Korean Journal of Gastroenterology.2016; 67(4): 189. CrossRef

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Frequency of Bone Marrow Toxicity by Using Pattern of Azathioprine in Inflammatory Bowel Disease Patients: Kyung Hee Hyun, Suck-Ho Lee, Jae Min Shin, Dong Il Park, Chang Kyun Lee, Jeong Eun Shin, Chang Soo Eun, Kyu Chan Huh, Young Hwangbo; Intest Res 2012;10(3):244-250. Published online July 31, 2012; DOI: https://doi.org/10.5217/ir.2012.10.3.244

Abstract PDF

Background/Aims
The most important adverse effect of azathioprine (AZA) is bone marrow toxicity (BMT). Many physicians have preferred a gradual dose increment (GDI) policy for the prevention of BMT. The aim of this study was to evaluate the efficacy of GDI for the prevention of AZA-induced BMT in inflammatory bowel disease (IBD) patients. Methods: The medical records of IBD patients who received AZA in 6 university hospitals were reviewed. The patients were divided into two groups: the GDI group (initial dose ＜1.5 mg/kg, gradually increased to a therapeutic dose) and the non-GDI group (initial therapeutic dose ≥2 mg/kg). Results: A total of 308 patients were enrolled (male to female ratio, 1:2.3; mean age, 34.91±14.19 years; ulcerative colitis, 43.5%; Crohn's disease, 55.2%; and intermediate colitis, 1.3%). The overall incidence of BMT was 16.2% (50/308). BMT developed most frequently between fourth to eighth week (26%, 13/50). The rate of BMT of the non-GDI group was significantly higher than that of the GDI group (27.5%, 11/40 vs. 14.6%, 39/268, P=0.038). A multivariate analysis showed that the only factor related to BMT was a non-GDI policy (P=0.036; odds ratio, 2.41; 95% confidence interval, 1.06-5.49). Conclusions: A GDI policy could be useful for reducing AZA-induced BMT in Korean IBD patients. (Intest Res 2012;10: 0-250)

Citations

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Use of Thiopurines in Inflammatory Bowel Disease: A Consensus Statement by the Korean Association for the Study of Intestinal Diseases (KASID)
Kang-Moon Lee, You Sun Kim, Geom Seog Seo, Tae Oh Kim, Suk-Kyun Yang
Intestinal Research.2015; 13(3): 193. CrossRef
Determining the Dose of Azathioprine Based on the Lower Limit of Leukocyte Count in Patients with Crohn's Disease
Geom Seog Seo
The Korean Journal of Gastroenterology.2013; 62(2): 83. CrossRef
How Should Azathioprine Be Dosed in Crohn's Disease? A Novel Strategy of Maximum Dose-titration Based on the Lower Limit of Leukocyte Count and Tolerability
Chang Sup Lim, Won Moon, Seun Ja Park, Moo In Park, Jeong Moon Choi, Jae Hoon Yoo, Jong Bin Kim, Jun Sik Lee
The Korean Journal of Gastroenterology.2013; 62(2): 111. CrossRef

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Special Reviews

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

Abstract PDF

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

Citations

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A survey of current practices in post-polypectomy surveillance in Korea
Jeongseok Kim, Tae-Geun Gweon, Min Seob Kwak, Su Young Kim, Seong Jung Kim, Hyun Gun Kim, Eun Ran Kim, Sung Noh Hong, Eun Sun Kim, Chang Mo Moon, Dae Seong Myung, Dong Hoon Baek, Shin Ju Oh, Hyun Jung Lee, Ji Young Lee, Yunho Jung, Jaeyoung Chun, Dong-Hoo
Intestinal Research.2024; 22(2): 186. CrossRef
Impact of obesity and metabolic abnormalities on the risk of metachronous colorectal neoplasia after polypectomy in men
Nam Hee Kim, Yoon Suk Jung, Jung Ho Park, Dong Il Park, Chong Il Sohn
Journal of Gastroenterology and Hepatology.2019; 34(9): 1504. CrossRef
Risk of advanced colorectal neoplasm by the proposed combined United States and United Kingdom risk stratification guidelines
Soo-Kyung Park, Hyo-Joon Yang, Yoon Suk Jung, Jung Ho Park, Chong Il Sohn, Dong Il Park
Gastrointestinal Endoscopy.2018; 87(3): 800. CrossRef
Risk of developing metachronous advanced colorectal neoplasia after colonoscopic polypectomy in patients aged 30 to 39 and 40 to 49 years
Nam Hee Kim, Yoon Suk Jung, Jung Ho Park, Dong Il Park, Chong Il Sohn
Gastrointestinal Endoscopy.2018; 88(4): 715. CrossRef
Number of advanced adenomas on index colonoscopy: Important risk factor for metachronous advanced colorectal neoplasia
Soo-Kyung Park, Hyo-Joon Yang, Yoon Suk Jung, Jung Ho Park, Chong Il Sohn, Dong Il Park
Digestive and Liver Disease.2018; 50(6): 568. CrossRef
Serrated neoplasia pathway as an alternative route of colorectal cancer carcinogenesis
Soon Young Kim, Tae Il Kim
Intestinal Research.2018; 16(3): 358. CrossRef
Do Serrated Polyps Increase the Risk of Colorectal Cancer Development?
Su Hwan Kim, Ji Won Kim
The Korean Journal of Gastroenterology.2016; 67(3): 161. CrossRef
Metabolic syndrome is a risk factor for adenoma occurrence at surveillance colonoscopy
Nam Hee Kim, Jung Ho Park, Dong Il Park, Chong Il Sohn, Kyuyong Choi, Yoon Suk Jung
Medicine.2016; 95(32): e4454. CrossRef
Diminutive and Small Colorectal Polyps: The Pathologist's Perspective
Yun Kyung Kang
Clinical Endoscopy.2014; 47(5): 404. CrossRef
Surveillance Colonoscopy after Polypectomy: Actual Practice in Korea
Kyeong Ok Kim
Intestinal Research.2014; 12(1): 83. CrossRef
Clinical Practice of Surveillance Colonoscopy according to the Classification of Colorectal Intraepithelial Neoplasia in Korea: High-grade Dysplasia/CarcinomaIn SituVersus Intramucosal Carcinoma
Sung Pil Hong, Tae Il Kim, Hyun Gun Kim, Hyun-Soo Kim, Seong-Eun Kim, Kyu Chan Huh, Jeong Eun Shin, Jae Myung Cha, Suck-Ho Lee
Intestinal Research.2013; 11(4): 276. CrossRef
Early Colorectal Epithelial Neoplasm in Korea: A Multicenter Survey of Pathologic Diagnosis
Yun Kyung Kang, So-Young Jin, Mee Soo Chang, Jung Yeon Kim, Gyeong Hoon Kang, Hye Seung Lee, Jin Hee Sohn, Ho Sung Park, Kye Won Kwon, Mi Jin Gu, Young Hee Maeng, Jong Eun Joo, Haeng Ji Kang, Hee Kyung Kim, Kee-Taek Jang, Mi Ja Lee, Hee Kyung Chang, Joon
Korean Journal of Pathology.2013; 47(3): 245. CrossRef

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

Abstract PDF

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

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Syndecan-2 Methylation as a New Biomarker for Early Detection of Colorectal Neoplasm
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Association between dietary fat intake and colorectal adenoma in korean adults
Jeehyun Kim, Seung-Won Oh, Young-Sun Kim, Hyuktae Kwon, Hee-Kyung Joh, Ji-Eun Lee, Danbee Park, Jae-Hong Park, Ah-Ryoung Ko, Ye-Ji Kim
Medicine.2017; 96(1): e5759. CrossRef
Anaphylactic Shock Caused by Ingestion of Polyethylene Glycol
Sun Hee Lee, Jae Myung Cha, Joung Il Lee, Kwang Ro Joo, Hyun Phil Shin, Il Hyun Baek, Jung Won Jeon, Jun Uk Lim, Jung Lok Lee, Hyae Min Lee, Young-Hak Cho
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Fasting serum insulin levels and insulin resistance are associated with colorectal adenoma in Koreans
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Journal of Diabetes Investigation.2014; 5(3): 297. CrossRef
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Difference in Adenoma Detection Rates according to Colonoscopic Withdrawal Times and the Level of Expertise
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The Korean Journal of Gastroenterology.2014; 64(5): 278. CrossRef

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

Abstract PDF

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

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Clinical Practice of Surveillance Colonoscopy according to the Classification of Colorectal Intraepithelial Neoplasia in Korea: High-grade Dysplasia/CarcinomaIn SituVersus Intramucosal Carcinoma
Sung Pil Hong, Tae Il Kim, Hyun Gun Kim, Hyun-Soo Kim, Seong-Eun Kim, Kyu Chan Huh, Jeong Eun Shin, Jae Myung Cha, Suck-Ho Lee
Intestinal Research.2013; 11(4): 276. CrossRef

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Original Articles

Endoscopic Treatment Strategy for Large Laterally Spreading Tumor: Endoscopic Piecemeal Mucosal Resection or Endoscopic Submucosal Dissection: Sang Goo Kang, Suck-Ho Lee, Seung Kyu Chung, Jae Min Shin, Seong Ran Jeon, Tae Hee Lee, Hyun Gun Kim, Jin Oh Kim; Intest Res 2011;9(3):211-216. Published online December 30, 2011; DOI: https://doi.org/10.5217/ir.2011.9.3.211

Abstract PDF

Background/Aims
The therapeutic strategy between endoscopic piecemeal mucosal resection (EPMR) and endoscopic submucosal dissection (ESD) for large laterally spreading tumors (LSTs) has not been clearly defined. The aim of this study was to compare the clinical outcomes between EPMR and ESD in patients with large LST. Methods: From July 2006 to September 2010, 106 patients who underwent endoscopic resection for large (＞20 mm) LSTs were included in our retrospective analysis. Results: Baseline characteristics of the patients and tumors were not different between two groups except for location (EPMR-right colon, ESD-rectum). The en bloc resection rate and complete resection rate were significantly higher in the ESD group than those in the EPMR group (EPMR vs. ESD, 53.5% vs. 88.6, P＜0.01, 45.1% vs. 71.4%, P=0.01, respectively). However, total procedure time was significantly shorter in the EPMR group (21.3 min vs. 44.4 min, P＜0.01). Furthermore, the rates of complication including perforation and bleeding were significantly lower in the EPMR group than those in the ESD group (perforation, 1.4% vs. 11.4%, P=0.02; bleeding, 4.2% vs. 17.1%, P=0.03, respectively). During 19.9 months of follow-up, no significant difference was observed in terms of recurrence (1.5% vs. 3.2%). Non-granular, pseudo-depressed type (LST-PD) showed a significantly higher presence of adenocarcinoma and deeper submucosal invasion than other types of LSTs. Conclusions: The therapeutic strategy for choosing between EPMR and ESD for large LST lesions should be determined based on the macroscopic findings of their subtype. En bloc resection with ESD should be applied to LST-PDs due to their higher rate of submucosal invasion. (Intest Res 2011;9:211-216)

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Long‐term clinical outcomes of endoscopic submucosal dissection for colorectal neoplasia with or without the hybrid technique
DU Kang, JC Park, SW Hwang, SH Park, DH Yang, KJ Kim, BD Ye, SJ Myung, SK Yang, JS Byeon
Colorectal Disease.2020; 22(12): 2008. CrossRef
Current practices in endoscopic submucosal dissection for colorectal neoplasms: a survey of indications among Korean endoscopists
Tae Jun Kim, Eun Ran Kim, Sung Noh Hong, Young-Ho Kim, Dong Kyung Chang
Intestinal Research.2017; 15(2): 228. CrossRef

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

Abstract PDF

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

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

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Comparison of Infliximab and Infliximab/Azathioprine for Maintenance Therapy in Korean Patients with Luminal Crohn's Disease: Hyun Sun Won, Dong Il Park, Chang Uk Chon, Hyo Sun Seok, Tae Wan Kim, Woon Je Heo, Chang Kyun Lee, Chang Soo Eun, Dong Soo Han, Suck-Ho Lee; Intest Res 2011;9(3):189-195. Published online December 30, 2011; DOI: https://doi.org/10.5217/ir.2011.9.3.189

Abstract PDF

Background/Aims
The benefits and risks of concomitant immunomodulators with infliximab maintenance therapy in patients with luminal Crohn's disease (CD) have not been adequately evaluated. We studied the influence of immunomodulator discontinuation in patients in remission with infliximab therapy through a restrospective case- control study. Methods: Medical records of 37 patients with luminal CD who received infliximab at four medical centers were retrospectively analyzed. We compared clinical and follow-up data of patients who were treated with infliximab alone with that of patients with combination therapy. Results: Among 37 patients, 31 (83.7%) were treated with infliximab plus azathioprine and six (16.2%) were treated with infliximab alone. Of the 31 patients receiving combination maintenance therapy, 26 (83.9%) were in complete remission after 12 months, as compared with five of six patients (83.3%) receiving infliximab alone. No significant difference was observed in remission rate between two groups (P=0.735). In total, 16.1% of patients in combination therapy and 16.7% in infliximab alone group reported side effects (P=1.000), but serious adverse events such as reactivation of tuberculosis were noted in only one patient in combination therapy group. Conclusions: Concomitant immunomodulators did not improve efficacy in patients with luminal CD who received scheduled infliximab maintenance. (Intest Res 2011;9:189-195)

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Clinical Outcome of Treatment with Infliximab in Crohn's Disease: A Single-Center Experience
Yeon-Ju Kim, Jung-Wook Kim, Chang Kyun Lee, Hyun Jin Park, Jae-Jun Shim, Jae Young Jang, Suk Ho Dong, Hyo Jong Kim, Byung-Ho Kim, Young Woon Chang
The Korean Journal of Gastroenterology.2013; 61(5): 270. CrossRef

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

Abstract PDF

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

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A survey of current practices in post-polypectomy surveillance in Korea
Jeongseok Kim, Tae-Geun Gweon, Min Seob Kwak, Su Young Kim, Seong Jung Kim, Hyun Gun Kim, Eun Ran Kim, Sung Noh Hong, Eun Sun Kim, Chang Mo Moon, Dae Seong Myung, Dong Hoon Baek, Shin Ju Oh, Hyun Jung Lee, Ji Young Lee, Yunho Jung, Jaeyoung Chun, Dong-Hoo
Intestinal Research.2024; 22(2): 186. CrossRef
The current capacity and quality of colonoscopy in Korea
Jae Ho Choi, Jae Myung Cha, Jin Young Yoon, Min Seob Kwak, Jung Won Jeon, Hyun Phil Shin
Intestinal Research.2019; 17(1): 119. CrossRef
Guideline Adherence to Colonoscopic Surveillance Intervals after Polypectomy in Korea: Results from a Nationwide Survey
Seri Hong, Mina Suh, Kui Son Choi, Boyoung Park, Jae Myung Cha, Hyun-Soo Kim, Jae Kwan Jun, Dong Soo Han
Gut and Liver.2018; 12(4): 426. CrossRef
The Risk of Metachronous Advanced Colorectal Neoplasia Rises in Parallel with an Increasing Number of High-Risk Findings at Baseline
Seung Min Lee, Jeong Hwan Kim, In Kyung Sung, Sung Noh Hong
Gut and Liver.2015; 9(6): 741. CrossRef
A Survey of Colonoscopic Surveillance After Polypectomy
Dae Kyung Sohn
Annals of Coloproctology.2014; 30(2): 88. CrossRef
Clinical Practice of Surveillance Colonoscopy according to the Classification of Colorectal Intraepithelial Neoplasia in Korea: High-grade Dysplasia/CarcinomaIn SituVersus Intramucosal Carcinoma
Sung Pil Hong, Tae Il Kim, Hyun Gun Kim, Hyun-Soo Kim, Seong-Eun Kim, Kyu Chan Huh, Jeong Eun Shin, Jae Myung Cha, Suck-Ho Lee
Intestinal Research.2013; 11(4): 276. CrossRef
A Korean National Survey for Colorectal Cancer Screening and Polyp Diagnosis Methods Using Web-based Survey
Seong-Eun Kim, Sung Pil Hong, Hyun-Soo Kim, Bo In Lee, Se Hyung Kim, Sung Noh Hong, Dong-Hoon Yang, Suck Ho Lee, Sung Jae Shin, Dong Il Park, Young-Ho Kim, Suk-Kyun Yang, Hyo Jong Kim
The Korean Journal of Gastroenterology.2012; 60(1): 26. CrossRef

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Usefulness of Polyp Detection Rate as a Quality Indicator in Colonoscopy: Su Hee Lee, Dong Il Park, Jun Mo Sung, Jae Hyun Jang, Seung Ho Ryu, Young Ho Kim, Suck-Ho Lee, Chang Kyun Lee, Chang Soo Eun, Dong Soo Han; Intest Res 2011;9(2):105-111. Published online August 30, 2011; DOI: https://doi.org/10.5217/ir.2011.9.2.105

Abstract PDF

Background/Aims
The adenoma detection rate (ADR) has been proposed as a quality indicator of colonoscopy; however, ADR cannot be measured easily with commonly used endoscopy reporting systems because substantial time and effort is required to acquire data from histologic assessments. The purpose of this study was to determine if polyp detection rate (PDR) could be used as a valid proxy for ADR. Methods: A total of 1,156 consecutive, asymptomatic, individuals of average risk between 50 and 75 years-of-age who underwent screening colonoscopies at four tertiary medical centers by 27 gastroenterologists were included in this study. Each individual endoscopist performed at least 10 colonoscopies during the study period. The ADR and PDR were calculated as the proportion of an endoscopist's cases with an adenoma or polyp divided by the total number of colonoscopies. Pearson's correlation coefficient and the intraclass correlation coefficient were used to determine the level of agreement between ADR and PDR. Results: The mean PDR and ADR for endoscopists was 47.4% (range, 21.7-75.0) and 36.5% (range, 13.0-66.7), respectively. There was a strong correlation between PDR and ADR (Pearson's correlation coefficient 0.94, P＜0.001) and there was also good agreement between performance quintiles defined by ADR and PDR (intraclass correlation coefficient 0.94, P＜0.001). Conclusions: PDR is a valid proxy for ADR and may be useful for quality assurance at centers where ADR cannot be easily measured. (Intest Res 2011;9:105-111)

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Usefulness of Polyp and Adenoma Detection Rate in the Proximal and Distal Colon
Sung Youn Choi, Dong Il Park, Chang Kyun Lee, Jae Myung Cha, Suck Ho Lee, Young Whangbo, Chang Soo Eun, Dong Soo Han, Bo In Lee, Jeong Eun Shin
The Korean Journal of Gastroenterology.2014; 63(1): 11. CrossRef
Correlation between Adenoma Detection Rate and Advanced Adenoma Detection Rate
Shin Yeoung Lee, Nam Hee Kim, Hyun Beom Chae, Ki Joong Han, Tae Hoon Lee, Choel Min Jang, Kyung Mo Yoo, Yoon Suk Jung, Jung Ho Park, Hong Joo Kim, Yong Kyun Cho, Chong Il Sohn, Woo Kyu Jeon, Byung Ik Kim, Dong Il Park
The Korean Journal of Gastroenterology.2014; 64(1): 18. CrossRef
The Correlation between Polyp Detection Rate and Adenoma Detection Rate: Mainly Determined by the Colon Segment
Geom Seog Seo
The Korean Journal of Gastroenterology.2014; 63(1): 1. CrossRef

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Review

Clinical Classification of Colorectal Epithelial Tumors and Proposal for Diagnostic Coding: Hyun Gun Kim, Jin-Oh Kim, Suck-Ho Lee, Chang Kyun Lee, Hyun Soo Kim, Hwang Choi, Dong-Hoon Yang, Bora Keum, Sung Pil Hong, Seong-Eun Kim, Byung Chang Kim, Jeong Eun Shin, Cheol Hee Park, Chang Soo Eun, Tae Il Kim, Dong Il Park, Kyu Chan Huh, Dong Kyung Chang, Seun Ja Park; Intest Res 2011;9(1):1-11. Published online April 30, 2011; DOI: https://doi.org/10.5217/ir.2011.9.1.1

Abstract PDF

The Korean Standard Classification of Diseases (KCD), which reflects the International Classification of Diseases (ICD), is a fundamental coding system for the diagnosis of colorectal epithelial tumors. The KCD coding of colorectal lesions is entirely up to the clinician and is based on pathologic reports. However, coding discrepancies have arisen among physicians using the KCD and pathologists using the ICD for Oncology-3 (ICD-O-3). The Korean Society of Pathologists recently proposed a standardized pathology-reporting format and guidelines for the coding of colorectal cancer to decrease these discrepancies among pathologists. However, ICD and ICD-O are simple classification codes based on pathologic reports, and are neither intended nor suitable for indexing of distinct clinical entities. For appropriate diagnostic coding using the KCD, a corrected coding principle based upon pathologic reports is required, and unified coding between KCD and ICD-O is necessary. A standardized pathologic report format and communication with understanding between physicians and pathologists should be established. Additionally, the private medical insurance system for colorectal cancer should be revised to reduce conflicts among patients, clinicians, and insurance companies over the medical coding system. (Intest Res 2011;9: 2-11)

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Diagnostic Coding for Intramucosal Carcinoma and Neuroendocrine Tumor in the Colorectum: Proposal for Avoiding Confusing Coding in Korea
Dong Soo Han, Jin Hee Sohn, Jeong-Sik Byeon, Hwang Choi, Joon Mee Kim
Clinical Endoscopy.2015; 48(3): 216. CrossRef
Diminutive and Small Colorectal Polyps: The Pathologist's Perspective
Yun Kyung Kang
Clinical Endoscopy.2014; 47(5): 404. CrossRef
Early Colorectal Epithelial Neoplasm in Korea: A Multicenter Survey of Pathologic Diagnosis
Yun Kyung Kang, So-Young Jin, Mee Soo Chang, Jung Yeon Kim, Gyeong Hoon Kang, Hye Seung Lee, Jin Hee Sohn, Ho Sung Park, Kye Won Kwon, Mi Jin Gu, Young Hee Maeng, Jong Eun Joo, Haeng Ji Kang, Hee Kyung Kim, Kee-Taek Jang, Mi Ja Lee, Hee Kyung Chang, Joon
Korean Journal of Pathology.2013; 47(3): 245. CrossRef
Update on the Proposal for Creating a Guideline for Cancer Registration of the Gastrointestinal Tumors (I-2)
Eun Sun Jung, Yun Kyung Kang, Mee-Yon Cho, Joon Mee Kim, Won Ae Lee, Hee Eun Lee, Sunhoo Park, Jin Hee Sohn, So-Young Jin
Korean Journal of Pathology.2012; 46(5): 443. CrossRef

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Selected Summary

Natural Orifice Translumenal Endoscopic Surgery (NOTES) Applied Totally to Sigmoidectomy: An Original Technique with Survival in a Porcine Model(Surgical Endoscopy 2009;23:24-30): Suck-Ho Lee; Intest Res 2010;8(1):87-90. Published online June 30, 2010; DOI: https://doi.org/10.5217/ir.2010.8.1.87

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Case Reports

A Case of Ischemic Colitis Following Oral Osmotic Laxative for Bowel Preparation: Chang Kyun Lee, Suck-Ho Lee, Jun Young Lee, Sang Pil Kim, Il-Kwun Chung, Sun-Joo Kim, Hyun-Deuk Cho; Intest Res 2008;6(2):135-139. Published online December 30, 2008

Abstract PDF: Ischemic colitis is the most prevalent form of ischemic vascular compromise of the gastrointestinal tract. Although frequent in the elderly with co-morbidity, numerous pharmacologic agents including diuretics, pseudoephedrine, nonsteroidal anti-inflammatory drugs, oral contraceptives, and cocaine may produce colonic ischemia by mesenteric vasoconstriction. Oral hyperosmotic laxatives are frequently used as cleansing agents in bowel preparation for both radiologic and endoscopic studies. They are regarded as safe and effective agents, but can produce a rapid osmotic-mediated fluid loss, resulting in transient meseneteric hypoperfusion and subsequent ischemic colitis. Here, we describe a case of acute ischemic colitis caused by the oral osmotic laxative magnesium citrate, which was given for bowel preparation before a barium enema in a young healthy patient without underlying disease. (Intest Res 2008;6:135-139)

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A Case of Drug-induced Interstitial Lung Disease in a Patient withUlcerative Colitis Receiving Mesalamine: Tae Hoon Lee, Suck-Ho Lee, Young-Sin Cho, Ji-Young Park, Jeong Hoon Park, Do Hyun Park, Il-Kwun Chung, Hong Soo Kim, Sang-Heum Park, Sun-Joo Kim, Mee-Hye Oh; Intest Res 2007;5(2):192-195. Published online December 30, 2007

Abstract PDF: Pulmonary involvement in ulcerative colitis is very rare and may present as a variety of disorders. Pulmonary disease in patients with inflammatory bowel disease may be due to lung involvement in the disease itself or to drugs used for treatment, such as sulfasalazine or mesalamine. The use of mesalamine was initially thought to be free of adverse effects. Recently, however, pulmonary diseases related to the use of mesalamine have been reported. In this report, we describe a patient with ulcerative colitis and mesalamine induced interstitial lung disease. (Intest Res 2007;5:192-195)

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Original Article

The Relationship between Endoscopic Features and Unconsciousness in Pseudomembranous Colitis Patients: Il-Kwun Chung, Suck-Ho Lee, Jung-Hoon Park, Do Hyun Park, Hong-Soo Kim, Sang-Heum Park, Sun-Joo Kim; Intest Res 2006;4(2):101-105. Published online December 30, 2006

Abstract PDF: Background/Aims
Unconsciousness can create problems in diagnosing and treating pseudomembranous colitis (PMC). While early recognition of clostridium difficile infection and immediate medical therapy can lead to a good prognosis, delayed diagnosis can lead to complex, recurrent and even fatal PMC. The relationships between endoscopic clinical features and unconsciousness are not well documented. The aim of this study was to determine the relationships between PMC endoscopic clinical features and the level of consciousness. Methods: Fifty three patients with confirmed PMC during the past 2 years were analyzed retrospectively. Patients were categorized as being in either a conscious state (CS) (i.e. alert) or an unconscious state (US) (i.e. drowsy, stupor, semicoma or coma). Endoscopic patterns of pseudomembranous plaques were classified as grade I=only friability or erosion without plaque, grade II=granular plaque, grade III=nodular plaque, or grade IV=confluent plaque. Clinical features including diagnostic interval (from initial prescription of antibiotic to confirming PMC), endoscopic severity, treatment method, treatment duration and prognosis were compared in between CS and US groups. Results: Mean patient age was 65.7⁑14.9 (male 47.2%, female 52.8%). The overall diagnostic interval was 9.37⁑4.35 days. Frequently causative antibiotics were cephalosporin (52.8%, 28/53), clindamycin (13.2%, 7/53) and imipenam (9.4%, 5/53). Of the 53 patients, 60.4% (32/53) were categorized as CS, and 39.6% (21/53) as US. In terms of pseudomembranous plaque endoscopic patterns, 18.9% (10/53) were grade I, 28.3% (15/53) were grade II, 32.1% (17/53) were grade III, and 20.8% (11/53) were grade IV. Treatment involved oral administration only. The overall complete treatment rate was 94.3% (50/53). The overall recurrence rate was 5.7% (3/53), and of these one patient died, and two patients were successfully managed by re-treatment. One recurrent and the fatal case occurred in the US group. The US group was positively correlated with longer diagnostic interval, and showed more severe endoscopic features and longer treatment duration compared to the CS group (p＜0.05). Conclusions: Endoscopic and clinical features were more serious in unconscious PMC patients. Compared to conscious patients, unconscious patients being administrated antibiotics must be given greater attention in terms of early diagnosis and successful management of PMC. (Intestinal Research 2006;4:101-105)

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