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Gut and Liver update

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수록범위 : 1권1호(2007)~12권5호(2018) |수록논문 수 : 1,091
Gut and Liver
12권5호(2018년 09월) 수록논문
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KCI등재 SCI SCOPUS

1Syndecan-2 Methylation as a New Biomarker for Early Detection of Colorectal Neoplasm

저자 : Ji Hyun Kim , Sung Chul Park

발행기관 : 대한소화기내시경학회 간행물 : Gut and Liver 12권 5호 발행 연도 : 2018 페이지 : pp. 479-480 (2 pages)

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3Diagnostic Endoscopic Ultrasound: Technique, Current Status and Future Directions

저자 : Tiing Leong Ang , Andrew Boon Eu Kwek , Lai Mun Wang

발행기관 : 대한소화기내시경학회 간행물 : Gut and Liver 12권 5호 발행 연도 : 2018 페이지 : pp. 483-496 (14 pages)

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Endoscopic ultrasound (EUS) is now well established as an important tool in clinical practice. From purely diagnostic imaging, it has progressed to include tissue acquisition, which provided the basis for therapeutic procedures. Even as interventional EUS developed, there has been ongoing progress in EUS diagnostic capabilities due to improved imaging systems, better needles for tissue acquisition and development of enhanced imaging functions such as contrast harmonic EUS (CHEUS) and EUS elastography. EUS is well established for differentiation of subepithelial lesions, for T-staging of luminal gastrointestinal and pancreaticobiliary malignancies, for differentiation of benign pancreaticobiliary disorders and for diagnostic tissue acquisition, which can be achieved by EUS-guided fine needle aspiration or by EUS-guided fine needle biopsy using dedicated biopsy needles. This review briefly describes the technique of performing EUS and then discusses its clinical utility in terms of gastrointestinal cancer staging, the evaluation of pancreaticobiliary disorders and tissue acquisition. Enhanced imaging techniques such as CHEUS and EUS elastography are briefly reviewed. (Gut Liver 2018;12:483-496)

KCI등재 SCI SCOPUS

4Immunotherapy for Chronic Hepatitis B Virus Infection

저자 : Antonio Bertoletti , Nina Le Bert

발행기관 : 대한소화기내시경학회 간행물 : Gut and Liver 12권 5호 발행 연도 : 2018 페이지 : pp. 497-507 (11 pages)

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While new therapies for chronic hepatitis C virus infection have delivered remarkable cure rates, curative therapies for chronic hepatitis B virus (HBV) infection remain a distant goal. Although current direct antiviral therapies are very efficient in controlling viral replication and limiting the progression to cirrhosis, these treatments require lifelong administration due to the frequent viral rebound upon treatment cessation, and immune modulation with interferon is only effective in a subgroup of patients. Specific immunotherapies can offer the possibility of eliminating or at least stably maintaining low levels of HBV replication under the control of a functional host antiviral response. Here, we review the development of immune cell therapy for HBV, highlighting the potential antiviral efficiency and potential toxicities in different groups of chronically infected HBV patients. We also discuss the chronic hepatitis B patient populations that best benefit from therapeutic immune interventions. (Gut Liver 2018;12:497-507)

KCI등재 SCI SCOPUS

5Analysis of Syndecan-2 Methylation in Bowel Lavage Fluid for the Detection of Colorectal Neoplasm

저자 : Young Sook Park , Dong Shin Kim , Sang Woo Cho , Jong Won Park ,

발행기관 : 대한소화기내시경학회 간행물 : Gut and Liver 12권 5호 발행 연도 : 2018 페이지 : pp. 508-515 (8 pages)

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Background/Aims: Syndecan-2 (SDC2 ) methylation was previously reported as a sensitive serologic biomarker for the early detection of colorectal cancer (CRC). The purpose of this study was to investigate whether SDC2 methylation is detectable in precancerous lesions and to determine the feasibility of using SDC2 methylation for the detection of CRC and precancerous lesions in bowel lavage fluid (BLF). Methods: A total of 190 BLF samples were collected from the rectum at the beginning of colonoscopy from patients with colorectal neoplasm and healthy normal individuals. Fourteen polypectomy specimens were obtained during colonoscopy. A bisulfite pyrosequencing assay and quantitative methylation-specific polymerase chain reaction were conducted to measure SDC2 methylation in tissues and BLF DNA. Results: SDC2 methylation was positive in 100% of villous adenoma (VA) and high-grade dysplasia, and hyperplastic polyp samples; 88.9% of tubular adenoma samples; and 0% of normal mucosa samples. In the BLF DNA test for SDC2 methylation, the sensitivity for detecting CRC and VA was 80.0% and 64.7%, respectively, at a specificity of 88.9%. The BLF of patients with multiple tubular adenomas, single tubular adenoma and hyperplastic polyps showed 62.8%, 26.7% and 28.6% rates of methylation-positive SDC2, respectively. Conclusions: Our results demonstrated that SDC2 methylation was a frequent event in precancerous lesions and showed high potential in BLF for detecting patients with colorectal neoplasm. (Gut Liver 2018;12:508-515)

KCI등재 SCI SCOPUS

6Efficacy and Safety of UI05MSP015CT in Functional Dyspepsia: A Randomized, Controlled Trial

저자 : Hyuk Yoon , Dong Ho Lee , Yong-hyun Lee , Ju-cheol Jeong , Soo

발행기관 : 대한소화기내시경학회 간행물 : Gut and Liver 12권 5호 발행 연도 : 2018 페이지 : pp. 516-522 (7 pages)

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Background/Aims: To evaluate the efficacy and safety of a controlled release, once-daily formulation of mosapride (UI05MSP015CT) in patients with functional dyspepsia (FD). Methods: Patients with FD were randomly assigned (1:1) to receive either UI05MSP015CT (15 mg once a day, study group) or mosapride (5 mg three times a day, control group) and corresponding placebo for 4 weeks. The primary endpoint was a change in the gastrointestinal symptom score (GIS) evaluated at enrollment and after 4 weeks. Secondary endpoints were changes in the Nepean Dyspepsia Index-Korean version (NDI-K), rate of satisfactory symptom relief, and rate of adverse events. Results: A total of 138 patients were enrolled (female, 73.9%; mean age, 44.0±15.4 years). After excluding patients who violated the study protocol, 59 and 58 patients from the study and control groups, respectively, were included in the per-protocol analysis. No difference was observed in drug compliance between the control and study groups (97.07%±4.52% vs 96.85%±6.05%, p=0.870). Changes in GIS scores were -9.69±6.44 and -10.01±5.92 in the study and control groups. The mean difference in GIS change between groups was 0.33 (95% confidence interval, -1.75 to 2.41), demonstrating non-inferiority of UI-05MSP015CT (p=0.755). The rate of satisfactory symptom relief was not different between the study and control groups (39.0% vs 56.9%, p=0.053). No differences in change in NDI-K score (14.3 vs 16.9, p=0.263) or rates of adverse events (12.9% vs. 4.4%, p=0.062) were observed between the study and control groups. Conclusions: Once-daily mosapride is not inferior to conventional mosapride in efficacy and is safe in patients with FD. (Gut Liver 2018;12:516-522)

KCI등재 SCI SCOPUS

7Clinical Implication and Risk Factors for Malignancy of Atypical Gastric Gland during Forceps Biopsy

저자 : Min Seong Kim , Sang Gyun Kim , Hyunsoo Chung , Jung Kim , Hyo

발행기관 : 대한소화기내시경학회 간행물 : Gut and Liver 12권 5호 발행 연도 : 2018 페이지 : pp. 523-529 (7 pages)

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Background/Aims: Although forceps biopsy is performed for suspicious gastric tumors during endoscopy, it is difficult to determine treatment strategies for atypical gastric glands due to uncertainty of the diagnosis. The aim of this study was to investigate clinical implications and risk factors for predicting malignancy in atypical gastric glands during forceps biopsy. Methods: We retrospectively reviewed medical records of 252 patients with a diagnosis of atypical gastric gland during forceps biopsy. Predictors of malignancy were analyzed using initial endoscopic findings and clinical data. Results: The final diagnosis for 252 consecutive patients was gastric cancer in 189 (75%), adenoma in 26 (10.3%), and gastritis in 37 (14.7%). In the multivariate analysis, lesion sizes of more than 10 mm (odds ratio [OR], 3.021; 95% confidence interval [CI], 1.480 to 6.165; p=0.002), depressed morphology (OR, 3.181; 95% CI, 1.579 to 6.406, p=0.001), and surface nodularity (OR, 3.432; 95% CI, 1.667 to 7.064, p=0.001) were significant risk factors for malignancy. Conclusions: Further evaluation and treatment should be considered for atypical gastric gland during forceps biopsy if there is a largesized (>10 mm) lesion, depressed morphology, or surface nodularity. (Gut Liver 2018;12:523-529)

KCI등재 SCI SCOPUS

8Long-Term Outcomes of Endoscopic Balloon Dilation for Benign Strictures in Patients with Inflammatory Bowel Disease

저자 : Hye Won Lee , Soo Jung Park , Seong Ran Jeon , Byong Duk Ye ,

발행기관 : 대한소화기내시경학회 간행물 : Gut and Liver 12권 5호 발행 연도 : 2018 페이지 : pp. 530-536 (7 pages)

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Background/Aims: Benign intestinal strictures are common complications in patients with inflammatory bowel disease (IBD). This study aimed to assess the long-term prognosis of endoscopic balloon dilation (EBD) to treat benign strictures in IBD patients. Methods: Patients with IBD who had benign strictures and who underwent EBD in four tertiary referral university hospitals between January 2004 and February 2014 were retrospectively reviewed. Technical success was defined as the ability to pass the scope through the stricture after balloon dilation, and clinical success was defined as improved obstructive symptoms. Results: Forty-two benign strictures were identified in 30 patients (15 males and 15 females). Technical success was achieved in 26 patients (86.7%) at the first EBD attempt and in all 30 patients (100%) at the second EBD attempt. Clinical success was seen in 28 patients (93.3%). The median follow-up duration was 134.8 months (range, 10.2 to 252.0 months), and recurrence occurred in eight patients (26.7%), who required repeat EBD. The median duration to relapse was 1.7 months (range, 0.2 to 6.3 months). During repeat EBD, perforation occurred in two cases (6.7%), which were both clipped successfully. Finally, only one patient (3.3%) underwent surgery for the relief of recurrent obstructive symptoms during the follow-up period. Conclusions: The experience of 10 years shows that EBD is safe and effective for the treatment of benign strictures in IBD patients. Importantly, EBD may allow long-term effective palliation of the symptoms associated with benign intestinal strictures in IBD patients. (Gut Liver 2018;12:530-536)

KCI등재 SCI SCOPUS

9Frequency and Characteristics of Interval Colorectal Cancer in Actual Clinical Practice: A KASID Multicenter Study

저자 : Kyeong Ok Kim , Kyu Chan Huh , Sung Pil Hong , Won Hee Kim , H

발행기관 : 대한소화기내시경학회 간행물 : Gut and Liver 12권 5호 발행 연도 : 2018 페이지 : pp. 537-543 (7 pages)

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Background/Aims: The aims of the present study were to determine the frequency of interval colorectal cancers (CRCs) after surveillance colonoscopy and to compare the clinicopathologic features and survival outcomes with those of noninterval CRCs. Methods: From January 2003 to December 2013, 66,016 follow-up colonoscopies for 38,412 patients performed within recommended time were reviewed retrospectively based on data from 11 tertiary hospitals in South Korea. To compare clinicopathologic features and survival rates for interval CRC, 106 patients with non-interval CRC matched in age and gender were included. Results: Among the 66,016 colonoscopies performed within the surveillance period, 63 cases (63/66,016) of interval CRC were detected, and 53 were finally included in the analysis. The mean age was 69.9±8.8 years, and the male to female ratio was 1.94:1. Although the occurrence rate of cancer in the right side colon was higher than that of non-interval CRC, interval CRCs were predominantly left sided. Other clinicopathologic features and overall survival were not significantly different between the two groups. Missed lesion was suspected to be the most common cause (29 cases, 54.7%). Conclusions: The frequency of interval CRC among patients who had undergone a surveillance colonoscopy was 0.095%. While sharing some similar clinical features and survival outcomes, interval CRCs in Korea developed more often in males and on the left side in contrast to results from Western studies. (Gut Liver 2018;12:537-543)

KCI등재 SCI SCOPUS

10Association of Perianal Fistulas with Clinical Features and Prognosis of Crohn's Disease in Korea: Results from the CONNECT Study

저자 : Jaeyoung Chun , Jong Pil Im , Ji Won Kim , Kook Lae Lee , Chan

발행기관 : 대한소화기내시경학회 간행물 : Gut and Liver 12권 5호 발행 연도 : 2018 페이지 : pp. 544-554 (11 pages)

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Background/Aims: The disease course and factors associated with poor prognosis in Korean patients with Crohn's disease (CD) have not been fully determined. The aim of this study was to explore potential associations between the clinical characteristics and long-term outcomes of CD and perianal fistulas in a Korean population. Methods: The retrospective Crohn's Disease Clinical Network and Cohort (CONNECT) study enrolled patients diagnosed with CD between July 1982 and December 2008 from 32 hospitals. Those followed for <12 months were excluded. Clinical outcomes were CD-related surgery and complications, including nonperianal fistulas, strictures, and intra-abdominal abscesses. Results: The mean follow-up period was 8.77 years (range, 1.0 to 25.8 years). A total of 1,193 CD patients were enrolled, of whom 465 (39.0%) experienced perianal fistulas. Perianal fistulizing CD was significantly associated with younger age, male gender, CD diagnosed at primary care clinics, and ileocolonic involvement. Both nonperianal fistulas (p=0.034) and intra-abdominal abscesses (p=0.020) were significantly more common in CD patients with perianal fistulas than in those without perianal fistulas. The rates of complicated strictures and CD-related surgery were similar between the groups. Independently associated factors of nonperianal fistulas were perianal fistulas (p=0.015), female gender (p=0.048), CD diagnosed at referral hospital (p=0.003), and upper gastrointestinal (UGI) involvement (p=0.001). Furthermore, perianal fistulas (p=0.048) and UGI involvement (p=0.012) were independently associated with the risk of intra-abdominal abscesses. Conclusions: Perianal fistulas predicted the development of nonperianal fistulas and intra-abdominal abscesses in Korean CD patients. Therefore, patients with perianal fistulizing CD should be carefully monitored for complicated fistulas or abscesses. (Gut Liver 2018;12:544-554)

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