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Gut and Liver update

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수록범위 : 1권1호(2007)~12권4호(2018) |수록논문 수 : 1,076
Gut and Liver
12권4호(2018년) 수록논문
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KCI등재 SCI SCOPUS

1Effects of Antiplatelet Agents on Bleeding after Endoscopic Resection of Gastric Tumor

저자 : Ji Yong Ahn

발행기관 : 대한소화기학회 간행물 : Gut and Liver 12권 4호 발행 연도 : 2018 페이지 : pp. 369-370 (2 pages)

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2Long-Term Clinical Efficacy and Safety of Endoscopic Submucosal Dissection for Early Gastric Cancer in Korea

저자 : Yong Hwan Kwon

발행기관 : 대한소화기학회 간행물 : Gut and Liver 12권 4호 발행 연도 : 2018 페이지 : pp. 371-372 (2 pages)

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3Does Estrogen Contribute to the Esophageal Barrier Function in Women?

저자 : Katsunori Iijima

발행기관 : 대한소화기학회 간행물 : Gut and Liver 12권 4호 발행 연도 : 2018 페이지 : pp. 373-374 (2 pages)

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4Update on the Pathophysiology and Management of Anorectal Disorders

저자 : Tanisa Patcharatrakul , Satish S. C. Rao

발행기관 : 대한소화기학회 간행물 : Gut and Liver 12권 4호 발행 연도 : 2018 페이지 : pp. 375-384 (10 pages)

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Anorectal disorders are common and present with overlapping symptoms. They include several disorders with both structural and functional dysfunction(s). Because symptoms alone are poor predictors of the underlying pathophysiology, a diagnosis should only be made after evaluating symptoms and physiologic and structural abnormalities. A detailed history, a thorough physical and digital rectal examination and a systematic evaluation with high resolution and/or high definition three-dimensional (3D) anorectal manometry, 3D anal ultrasonography, magnetic resonance defecography and neurophysiology tests are essential to correctly identify these conditions. These physiological and imaging tests play a key role in facilitating a precise diagnosis and in providing a better understanding of the pathophysiology and functional anatomy. In turn, this leads to better and more comprehensive management using medical, behavioral and surgical approaches. For example, patients presenting with difficult defecation may demonstrate dyssynergic defecation and will benefit from biofeedback therapy before considering surgical treatment of coexisting anomalies such as rectoceles or intussusception. Similarly, patients with significant rectal prolapse and pelvic floor dysfunction or patients with complex enteroceles and pelvic organ prolapse may benefit from combined behavioral and surgical approaches, including an open, laparoscopic, transabdominal or transanal, and/or robotic-assisted surgery. Here, we provide an update on the pathophysiology, diagnosis, and management of selected common anorectal disorders. (Gut Liver 2018;12:375-384)

KCI등재 SCI SCOPUS

5Optical Diagnosis for Colorectal Polyps: A Useful Technique Now or in the Future?

저자 : Ignasi Puig , Tonya Kaltenbach

발행기관 : 대한소화기학회 간행물 : Gut and Liver 12권 4호 발행 연도 : 2018 페이지 : pp. 385-392 (8 pages)

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In the last few years, interest in the optical diagnosis of colorectal polyps has increased among gastroenterologists. Several studies have shown that the optical diagnosis of small colorectal polyps is safe and feasible in routine clinical practice and is comparable to histopathology. The Narrow-band Imaging International Colorectal Endoscopic Classification provides a validated criterion for the classification of neoplastic and nonneoplastic polyps as well as polyps with deep submucosal invasion using narrow band imaging during real-time colonoscopy. The aim of the present review is to assess the current evidence for and limitations of optical diagnosis and to propose a systematic approach for transferring research findings to patient care. (Gut Liver 2018;12:385-392)

KCI등재 SCI SCOPUS

6Continuous Use of Thienopyridine May Be as Safe as Low-Dose Aspirin in Endoscopic Resection of Gastric Tumors

저자 : Sooyeon Oh , Sang Gyun Kim , Jung Kim , Ji Min Choi , Joo Hyun

발행기관 : 대한소화기학회 간행물 : Gut and Liver 12권 4호 발행 연도 : 2018 페이지 : pp. 393-401 (9 pages)

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Background/Aims: Current guidelines recommend withholding antiplatelets for 5-7 days before high-risk endoscopic procedures. We investigated whether this reduces post-endoscopic submucosal dissection (ESD) bleeding. Methods: Gastric ESD cases with antiplatelets were retorospectively reviewed. Withholding antiplatelets for 5-7 days before ESD was defined as cessation and 0-4 days as continuation. The rate and risk of post-ESD bleeding according to the types and cessation of antiplatelets were assessed. Results: Among the 215 patients (117 adenoma and 98 early gastric cancer), 161 patients were on single (94 aspirin, 56 thienopyridine, and 11 other agents), 51 on dual, and 3 on triple antiplatelets. Post-ESD bleeding rates were 12.8% in aspirin users, 3.6% in thienopyridine, 27.5% in dual, 33.3% in triple therapy, and 9.7% in the cessation and 15.0% in the continuation group. Multiple antiplatelets (odds ratio [OR], 2.41; 95% confidence interval [CI], 1.01 to 5.76) and specimen size ≥ 5.5 cm (OR, 2.84; 95% CI, 1.04 to 7.73) were the risk of bleeding, while continuation of thienopyridine (OR, 0.23; 95% CI, 0.05 to 1.09) and antiplatelets (OR, 1.83; 95% CI, 0.68 to 4.94) did not increase the risk of bleeding. Conclusions: Continuing thienopyridine and aspirin did not increase the risk of post-ESD. Multiple antiplatelet therapy and a large specimen size were independent risk factors of post-ESD bleeding. (Gut Liver 2018;12:393-401)

KCI등재 SCI SCOPUS

7Long-Term Clinical Outcomes of Endoscopic Submucosal Dissection in Patients with Early Gastric Cancer: A Prospective Multicenter Cohort Study

저자 : Sang Gyun Kim , Chan Mi Park , Na Rae Lee , Jiyoung Kim , Da H

발행기관 : 대한소화기학회 간행물 : Gut and Liver 12권 4호 발행 연도 : 2018 페이지 : pp. 402-410 (9 pages)

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Background/Aims: Endoscopic submucosal dissection (ESD) has been regarded as a curative treatment for early gastric cancer (EGC) in indicated cases. The aim of this study was to evaluate the nationwide long-term clinical outcomes of ESD for EGC in Korea. Methods: A prospective multicenter cohort study was performed to evaluate the long-term efficacy of ESD for EGC within pre-defined indications at 12 institutes in Korea. The cases that met the expanded criteria upon pathological review after ESD were followed for 5 years. The primary outcome was 5-year disease specific free survival. Results: Six hundred ninety-seven patients with 722 EGCs treated with ESD were prospectively enrolled and followed for 5 years. Complete resection was achieved in 81.3% of the cases, and curative resection was achieved in 86.1%. During the 5-year follow-up, the overall survival rate was 96.6%, and the disease specific free survival rate was 90.6%. Local recurrence developed in 0.9%, and metachronous tumor development occurred in 7.8%; both conditions were treated by endoscopic or surgical treatment. Distant metastasis developed in 0.5% during follow-up. Conclusions: ESD showed excellent long-term clinical outcomes and can be accepted as a curative treatment for patients with EGC who meet the expanded criteria in final pathology studies. (Gut Liver 2018;12:402-410)

KCI등재 SCI SCOPUS

8Comparison of Tight Junction Protein-Related Gene mRNA Expression Levels between Male and Female Gastroesophageal Reflux Disease Patients

저자 : Jin Joo Kim , Nayoung Kim , Ji Hyun Park , Young Sun Kim , Sun

발행기관 : 대한소화기학회 간행물 : Gut and Liver 12권 4호 발행 연도 : 2018 페이지 : pp. 411-419 (9 pages)

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Background/Aims: Male predominance has been observed in the erosive reflux disease (ERD), but reverse finding in nonerosive reflux disease (NERD). This suggests sex-specific medicine approach is needed but its mechanism is remained to be elucidated. We aimed to compare clinical characteristics and mRNA expression levels of tight junction-related proteins between male and female gastroesophageal reflux disease (GERD). Methods: Sixteen healthy controls, 45 ERD, and 14 NERD patients received upper endoscopies and completed questionnaires. Quantitative real-time polymerase chain reactions of occludin (OCLN), zonal occludens (ZO) 1, claudin-1 (CLDN1) and claudin-4 (CLDN4), and neurokinin 1 receptor (NK1R) were performed in the distal esophageal mucosal specimen. These results were analyzed by sex. Results: Female GERD patients were affected more by reflux symptoms than males. The impairment of overall quality of life was more prominent in female patients with reflux symptoms than male patients (5.6±0.2 vs 4.9±0.6, p=0.009). The levels of OCLN mRNA expression were significantly lower in the male ERD group. On the other hand, those of CLDN1, CLDN4, and NK1R except ZO-1 were significantly higher in the male ERD group. Conclusions: We demonstrated that female ERD/NERD patients were affected more by GERD and male ERD patients showed significant changes of tight junction protein mRNA expression levels. (Gut Liver 2018;12:411-419)

KCI등재 SCI SCOPUS

9An Elevated Platelet Count Increases the Risk of Relapse in Ulcerative Colitis Patients with Mucosal Healing

저자 : Asuka Nakarai , Jun Kato , Sakiko Hiraoka , Shiho Takashima ,

발행기관 : 대한소화기학회 간행물 : Gut and Liver 12권 4호 발행 연도 : 2018 페이지 : pp. 420-425 (6 pages)

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Background/Aims: Although mucosal healing (MH) has been considered a treatment goal for patients with ulcerative colitis (UC), the risk factors predictive of relapse in patients who achieve MH are unknown. Because the platelet count has been shown to be a marker of inflammation in inflammatory bowel diseases, this study aimed to assess whether the platelet count could predict relapse in UC patients with MH. Methods: A prospective observational study was performed. UC patients with MH were consecutively enrolled in the study and monitored for at least 2 years or until relapse. The correlation between the incidence of relapse and the platelet count at the time of study enrollment was examined. Results: In total, 43 patients were enrolled, and 14 patients (33%) relapsed. The median platelet count at the time of enrollment in the patients who relapsed significantly differed from that in the patients who did not relapse (27.2×104/μL vs 23.8×104/μL, respectively; p=0.016). A platelet count >25.0×104/μL was a significant risk factor for relapse based on a multivariate analysis (hazard ratio, 4.85; 95% confidence interval, 1.07 to 25.28), and according to the Kaplan-Meier analysis, this cutoff could identify patients susceptible to relapse (p=0.041, log-rank test). Conclusions: The platelet count could be used as a predictor of relapse in UC patients with MH. (Gut Liver 2018;12:420-425)

KCI등재 SCI SCOPUS

10Guideline Adherence to Colonoscopic Surveillance Intervals after Polypectomy in Korea: Results from a Nationwide Survey

저자 : Seri Hong , Mina Suh , Kui Son Choi , Boyoung Park , Jae Myung

발행기관 : 대한소화기학회 간행물 : Gut and Liver 12권 4호 발행 연도 : 2018 페이지 : pp. 426-432 (7 pages)

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Background/Aims: People around the world are increasingly choosing to undergo colorectal cancer screening via colonoscopy. As a result, guideline adherence to postpolypectomy colonoscopy surveillance has drawn increasing attention. The present study was performed to assess recognition and adherence to guidelines among primary care physicians and gastroenterologists and to identify characteristics associated with compliance. Methods: A nationwide sample of primary care physicians employed at cancer screening facilities and registered members of the Korean Society of Gastrointestinal Endoscopy were recruited. Participants were asked to complete a survey of six hypothetical clinical scenarios designed to assess their potential course of action in response to screening or follow-up colonoscopy results. Frequencies and odds ratios and 95% confidence intervals for guideline adherence were estimated. Results: The proportions of doctors recommending shortened colonoscopy surveillance intervals for low- and high-risk adenomas were greater than 90% among primary physicians and were much lower among gastroenterologists. Guideline adherence was relatively good among groups of doctors who were young, had a specialty in gastroenterology, worked at tertiary hospitals, and cared for an appropriate number of patients. Conclusions: The present study reveals a remaining discrepancy between practitioner recommendations and current guidelines for postpolypectomy surveillance. Several factors were shown to be related to guideline adherence, suggesting a need for appropriate control and continuing education or training programs among particular groups of practitioners. (Gut Liver 2018;12:426-432)

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