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대한소화기학회> 대한소화기학회지

대한소화기학회지 update

The Korean Journal of Gastroenterology

  • : 대한소화기학회
  • : 의약학분야  >  내과학
  • : KCI등재
  • :
  • : 연속간행물
  • : 월간
  • : 1598-9992
  • : 2233-6869
  • : 대한소화기병학회잡지(~1989) → 대한소화기병학회지(1990~) → 대한소화기학회지(1995~)

수록정보
77권5호(2021) |수록논문 수 : 11
간행물 제목
78권4호(2021년 10월) 수록논문
최근 권호 논문
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KCI등재

1악성 담관 협착에서 내시경적 담관내 고주파 소작술의 최신 지견

저자 : 조재희 ( Jae Hee Cho ) , 장성일 ( Sung Ill Jang ) , 도민영 ( Min Young Do ) , 이동기 ( Dong Ki Lee )

발행기관 : 대한소화기학회 간행물 : 대한소화기학회지 78권 4호 발행 연도 : 2021 페이지 : pp. 205-212 (8 pages)

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Malignant biliary strictures are caused by pancreatobiliary cancer and other metastatic malignancies. Most of them are unresectable at diagnosis with a dismal prognosis. Various new ablation methods have been introduced. Of them, ERCP-guided intraductal radiofrequency ablation (ID-RFA) appears to be the most promising minimally invasive endoscopic treatment by delivering a high-frequency alternating current to the target tissue, leading to coagulative necrosis. Thus far, many studies have provided evidence that ERCP-guided ID-RFA is a safe, feasible, and effective treatment modality for stent patency and overall survival. Compared to other ablation treatments, ERCP-guided ID-RFA has several advantages, including ease of delivery, controlled application of thermal energy, low cost, and fewer systemic side effects with an acceptable safety profile. Therefore, ERCP-guided ID-RFA can be considered an adjunctive treatment for the palliation of unresectable malignant biliary strictures. On the other hand, the decision of local ablation treatment should be individualized by multidisciplinary team support due to the lack of comparative studies. (Korean J Gastroenterol 2021;78:205-212)

KCI등재

2비후성 또는 켈로이드 창상 흉터는 식도암 수술 후 식도-위 문합 부위의 협착에 대한 위험인자인가?

저자 : 성용원 ( Yong Won Seong ) , 김지현 ( Jee Hyun Kim ) , 옥유정 ( You Jung Ok ) , 오세진 ( Se Jin Oh ) , 최재성 ( Jae-sung Choi ) , 이정상 ( Jeong Sang Lee ) , 문현종 ( Hyeon Jong Moon )

발행기관 : 대한소화기학회 간행물 : 대한소화기학회지 78권 4호 발행 연도 : 2021 페이지 : pp. 213-218 (6 pages)

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Background/Aims: Anastomotic stricture at the esophagus and the conduit anastomosis site after the surgical resection of esophageal cancer is relatively common. This study examined whether a hypertrophic scar or keloid formation at a surgical wound is related to an anastomotic stricture.
Methods: From March 2007 to July 2017, 59 patients underwent curative surgery for esophageal cancer. In 38 patients, end-to-end anastomosis (EEA) of the esophagus and the conduit was performed using EEA 25 mm. A hypertrophic wound scar was defined when the width of the midline laparotomy wound scar exceeded 2 mm. The relationship between the hypertrophic scar and stricture and the other risk factors for anastomotic stricture in these 38 patients was analyzed.
Results: Of the 38 patients, eight patients (21.1%) had an anastomotic stricture, and a hypertrophic skin scar was observed in 14 patients (36.8%). Univariate analysis revealed lower BMI and hypertrophic scars as risk factors (p=0.032, p=0.001 respectively). Multivariate analysis revealed a hypertrophic scar as an independent risk factor for an anastomotic stricture (p=0.010, OR=27.06, 95% CI 2.19-334.40).
Conclusions: Hypertrophic wound scars can be a risk factor for anastomotic stricture after surgery for esophageal cancer. An earlier prediction of anastomotic stricture by detecting hypertrophic wound healing in patients undergoing esophagectomy may improve the patients' quality of life and surgical outcomes by earlier treatments. (Korean J Gastroenterol 2021;78:213-218)

KCI등재

3한국인 만성 변비 환자에서 프루칼로프라이드의 안전성과 유효성: 시판 후 조사

저자 : 연상은 ( Sang Eun Yeon ) , 김수연 ( Su Youn Kim ) , 정우철 ( Woo Chul Chung ) , 전성우 ( Seong Woo Jeon ) , 박수정 ( Soo Jung Park ) , 최창환 ( Chang Hwan Choi ) , 최명규 ( Myung Gyu Choi )

발행기관 : 대한소화기학회 간행물 : 대한소화기학회지 78권 4호 발행 연도 : 2021 페이지 : pp. 219-226 (8 pages)

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Background/Aims: Constipation is a common gastrointestinal disorder. Prucalopride is a dihydrobenzofurancarboxamide derivative with gastrointestinal prokinetic activities and is recommended as an appropriate choice in patients unresponsive to laxatives. This study assessed the safety and efficacy of prucalopride in Korean patients with chronic constipation, in whom laxatives were ineffective.
Methods: This prospective, non-interventional post-marketing surveillance of prucalopride was conducted from 2012 to 2018 at 28 hospitals in Korea. Adults who received prucalopride for the symptomatic treatment of chronic constipation were included. The patients received 2 mg of prucalopride once daily or 1 mg once daily in patients older than 65 years. The baseline characteristics, adverse events (AEs), and seven-point scale of Clinical Global Impression-Improvement were collected.
Results: Of 601 patients, 67.7% were female, and the mean age was 62.3 years. Three hundred patients (49.9%) were older than 65 years. At the baseline, 70.0% of patients reported less than two instances of spontaneous complete bowel movements per week. AEs were reported in 107 patients (17.7%), including headache (3.2%) and diarrhea (2.8%). Seven serious AEs (SAEs) were reported in five patients (0.8%). The SAEs were resolved without complications; there were no cases of death. All SAEs were assessed as 'unlikely' causality with prucalopride. In 72.7% of patients, chronic constipation was improved by the prucalopride treatment during the study period.
Conclusions: This study demonstrated the promising safety and efficacy profile of prucalopride in clinical practice. Thus, prucalopride should be considered in patients with chronic constipation when bowel symptoms are refractory to simple laxatives. (Korean J Gastroenterol 2021;78:219-226)

KCI등재

4Effects of Switching from Fenofibrate to Pemafibrate for Asymptomatic Primary Biliary Cholangitis

저자 : Kazufumi Dohmen , Shin-ya Onohara , Shigeru Harada

발행기관 : 대한소화기학회 간행물 : 대한소화기학회지 78권 4호 발행 연도 : 2021 페이지 : pp. 227-234 (8 pages)

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Background/Aims: The addition of a fibrate to ursodeoxycholic acid (UDCA) is the standard treatment for asymptomatic primary biliary cholangitis (aPBC) with an incomplete response to UDCA. Among the fibrates, bezafibrate and fenofibrate increase the serum creatinine level and reduce the estimated glomerular filtration rate (eGFR). Pemafibrate is an selective peroxisome proliferator-activated receptor alpha modulator (SPPARM-α) mainly metabolized by the liver that was recently approved to treat dyslipidemia. This study confirmed the changes in the biochemical markers after switching from fenofibrate to pemafibrate in aPBC patients.
Methods: This study examined the effects of switching treatment from fenofibrate to pemafibrate in 16 aPBC patients. The biological parameters of these patients were examined at the initiation of fenofibrate and after switching to pemafibrate, then at 24 and 48 weeks later, respectively.
Results: Among patients with aPBC treated with UDCA and fenofibrate, the ALP, GGT, and serum IgM levels decreased significantly (p<0.0001) over 48 weeks. On the other hand, serum creatinine levels increased significantly, and eGFR decreased significantly (p<0.0001). After switching to pemafibrate plus UDCA, patients with aPBC exhibited significantly lower serum creatinine levels (p=0.007) and significantly higher eGFR levels (p=0.014).
Conclusions: Pemafibrate has therapeutic efficacy for aPBC patients with an inadequate response to UDCA. Pemafibrate might be another option for aPBC patients given its beneficial effects on renal function, but larger, multicenter studies with a longer follow-up are needed. (Korean J Gastroenterol 2021;78:227-234)

KCI등재

5직장에 발생한 거대한 위장관 기질종양의 성공적인 내시경 절제

저자 : 김성중 ( Seong Jung Kim ) , 정윤 ( Yun Jung ) , 홍란 ( Ran Hong ) , 이준 ( Jun Lee )

발행기관 : 대한소화기학회 간행물 : 대한소화기학회지 78권 4호 발행 연도 : 2021 페이지 : pp. 235-239 (5 pages)

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Preoperative imatinib treatment for rectal gastrointestinal stromal tumors (GISTs) has been reported to reduce the tumor size and help preserve the anal sphincter function. On the other hand, preoperative imatinib may prevent an accurate assessment of the recurrent risk. The endoscopic resection of rectal GIST is rarely reported because of challenges that include securing the visual field and avoiding perforation. This paper reports a case in which a 5.5×4.0 cm sized rectal GIST was treated effectively by an endoscopic submucosal dissection (ESD) without preoperative imatinib. To date, the patient had no tumor recurrence or complications and is receiving adjuvant imatinib treatment. This case shows that ESD may be a good treatment option to preserve the anus in rectal GIST treatment. (Korean J Gastroenterol 2021;78:235-239)

KCI등재

6신생아 담즙정체 유전자 패널을 통해 진단된 C형 니만-픽병

저자 : 박선우 ( Sun Woo Park ) , 박지홍 ( Ji Hong Park ) , 문혜정 ( Hye Jeong Moon ) , 신민수 ( Minsoo Shin ) , 문진수 ( Jin Soo Moon ) , 고재성 ( Jae Sung Ko )

발행기관 : 대한소화기학회 간행물 : 대한소화기학회지 78권 4호 발행 연도 : 2021 페이지 : pp. 240-245 (6 pages)

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Niemann-Pick disease type C (NPC) is a neurovisceral lysosomal storage disorder caused by mutations in the NPC1 and NPC2 genes. These mutations cause the accumulation of unesterified cholesterol and other lipids in the lysosomes. NPC has a broad spectrum of clinical manifestations, depending on the age of onset. A 15-day-old infant presented at the Seoul National University Children's Hospital with neonatal cholestasis and hepatosplenomegaly, with the onset of jaundice at 5 days of age. Despite supportive treatment, the patient was considered for a liver transplant because of progressive liver failure. Unfortunately, the patient died from gastrointestinal bleeding before undergoing the transplant. The neonatal cholestasis gene panel revealed two novel likely pathogenic variants in the NPC1 gene (c.1145C>G [p.Ser382*] and c.2231_2233del [p.Val744del]). The patient was diagnosed with NPC, and both parents were found to be carriers of each variant. In infants presenting with neonatal cholestasis, a gene panel can help diagnose NPC. (Korean J Gastroenterol 2021;78:240-244)

KCI등재

7담낭염과 동반된 결핵성 담낭관 림프절염

저자 : 허태길 ( Tae Gil Heo ) , 홍성우 ( Seong Woo Hong ) , 장여구 ( Yeo Goo Chang ) , 이우용 ( Woo Yong Lee ) , 오행진 ( Haeng Jin Ohe ) , 최경운 ( Kyeong Woon Choi ) , 강윤경 ( Yun Kyung Kang )

발행기관 : 대한소화기학회 간행물 : 대한소화기학회지 78권 4호 발행 연도 : 2021 페이지 : pp. 245-248 (4 pages)

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Tuberculosis of the cystic duct lymph node is very rare. Only four cases have been reported in the literature. This paper presents the case of a young male patient with a tuberculous cystic duct lymph node and chronic cholecystitis, who was diagnosed with cystic duct stones and a gall bladder polyp preoperatively. (Korean J Gastroenterol 2021;78:245-248)

KCI등재

8수포성 유천포창의 식도 침범

저자 : 이준석 ( Junseak Lee ) , 문상곤 ( Sanggon Moon ) , 임철현 ( Chul-hyun Lim )

발행기관 : 대한소화기학회 간행물 : 대한소화기학회지 78권 4호 발행 연도 : 2021 페이지 : pp. 249-251 (3 pages)

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9대장 선종 발견율에 따른 장기적 대장암 발생의 위험성

저자 : 이정원 ( Jung Won Lee )

발행기관 : 대한소화기학회 간행물 : 대한소화기학회지 78권 4호 발행 연도 : 2021 페이지 : pp. 252-254 (3 pages)

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대장내시경은 대장암 조기 진단과 치료에 큰 역할을 담당하고 있다. 대장내시경을 통해 대장암의 전구 병변으로 여겨지는 선종을 제거할 경우, 추적 대장내시경 검사가 필요하다. 현재의 대장 폴립 제거 후 추적 검사는 제거된 선종의 특성을 주로 고려하도록 설계되어 있으며, 대장내시경을 수행한 의사의 성과, 구체적으로 선종 발견율(adenoma detection rate)은 고려 대상에 들어가 있지 않다. 하지만, 최근 증가한 중간암(interval cancer)에 대해 축적된 지식을 바탕으로 대장 내시경 의사의 선종 발견율이 장기적으로 대장암 발생에 영향을 끼칠 수 있을 것이라는 가설을 바탕으로 이 연구가 기획되었다. 이 연구에는 2000년에서 2011년 사이 폴란드의 대장암 선별 프로그램을 수행한 대상자가 포함되었다. 기준 대장내시경검사(index colonoscopy)에서 고위험 대장 선종(high-risk adenoma), 저위험 선종(low-risk adenoma) 및 정상 내시경검사 결과를 가진 사람을 각각 층화 분석하였고, 대장내시경의사의 성과 또한 선종 발견율을 기준으로 층화 분석되었다. 고위험 대장 선종은 제거된 선종의 크기가 1.0 cm 이상이거나 고도이형성(high-grade dysplasia)을 동반하거나 villous 또는 tubulovillous type이거나, 3개 이상의 선종이 제거된 경우로 정의하였다.
총 262명의 의사에 의해 대장내시경을 받은 173,228명의 대상자가 이 연구에 포함되었다. 선종 발견율 20% 이상을 보이는 의사를 고성과자(high performance), 20% 미만을 저성과자(low performance)로 분류하였을 때, 102명(38.9%)이 고성과자였고 160명(61.1%)이 저성과자였다. 내시경을 받은 대상자 중 82.2%에서 선종이 없었고, 11.1%는 저위험 선종, 6.6%에서 고위험 선종이 제거되었다. 10년간의 추적 관찰 기간 중 443명에서 대장암이 진단되었다. 저위험 선종을 가진 대상자들의 경우, 10년간 누적 대장암 발생율은 저성과자에게 검사 받은 경우 0.55% (95% CI 0.40-0.75)이고 고성과자에게 검사 받은 경우 0.22% (95% CI 0.14-0.34)로 위험비(hazard ratio, HR)는 2.35였으며, p-value는 0.004로 확인되었다. 고위험 선종을 가진 대상자의 경우, 10년간 누적 대장암 발생율은 저성과자에게 검사 받은 경우 1.14%였고 고성과자에게 검사 받은 경우 0.43%로 HR은 2.69였으며, p-value는 0.001 미만으로 확인되었다. 저성과자에게 검사를 받거나, 선별 내시경에서 고위험 선종이 확인된 경우에 중간암의 위험도가 높아지는 것을 확인할 수 있었다. 또, 기준 대장내시경 당시 고위험 선종이었으나 고성과자에게 검사 받은 경우 중간암의 위험도는 매우 낮았다. 반대로 저성과자가 고위험 선종을 가진 대상자에게 선별 검사를 시행한 경우, 10년 동안 누적되는 대장암 발생의 위험도는 1%로 상당히 높아지는 것이 확인되었다. 이러한 경향은 오스트리아 검증 코호트에서도 재현됨을 확인하였다. 따라서 이 연구는 대장내시경 검사 후 대장암 발생의 위험성을 결정하는 데 있어, 대장 폴립의 특성과 더불어 선종 발견율로 대표되는 대장내시경 의사의 수행 능력, 성과가 중요한 영향을 끼칠 수 있음을 확인할 수 있었다. 결론적으로 현재의 선별 검사 지침에 대장내시경 의사의 수행 능력, 성과지표를 추가할 필요성이 이 연구에서 확인되었다.

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KCI등재

1소화기내과 전임의 수련에 대한 COVID-19의 영향

저자 : 신현필 ( Hyun Phil Shin ) , 차재명 ( Jae Myung Cha ) , 김범경 ( Beom Kyung Kim ) , 명대성 ( Dae-seong Myung ) , 문성훈 ( Sung-hoon Moon ) , 송명준 ( Myeong Jun Song ) , 윤승배 ( Seung Bae Yoon ) , 유인경 ( In Kyung Yoo ) , 이정훈 ( Jeong Hoon Lee ) , 전백규 ( Baek Gyu Jun ) , 현종진 ( Jon

발행기관 : 대한소화기학회 간행물 : 대한소화기학회지 77권 5호 발행 연도 : 2021 페이지 : pp. 205-213 (9 pages)

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목적: COVID-19 유행은 다양한 사회 문화적 변화를 야기하였지만, 소화기내과 전임의 교육에 대한 영향에 대한 연구는 거의 없었다. 이번 연구에서는 소화기내과 전임의 수련에 대한 COVID-19의 영향에 대해 조사하였다.
대상 및 방법: 2021년 2월 15일부터 3월 15일까지 국내 소화기내과 전임의들에게 온라인 기반 설문조사를 발송하였다. 설문은 소화기내과 전임의의 특성, COVID-19의 유행에 대한 인식도, COVID-19과 비대면 진료의 소화기내과 전임의 교육에 대한 영향에 대한 내용으로 구성되었다.
결과: 111건의 설문 결과들 중 94건의 설문 응답을 분석하였다. 소화기내과 전임의들은 COVID-19 유행에 대해 충분한 정보를 제공받고 있었으며(74.7%), 개인보호장구 착용에 대해 잘 교육받고 있었고, 충분히 제공받고 있었다(각각 74.7% 및 83.9%). 하지만, 외래 진료 스케줄과 환자 수는 각각 25.5%와 37.8%의 응답자들이 감소하였다고 응답하였고, 소화기 내시경 검사 세션과 환자 수도 각각 51.1%와 65.6%의 응답자들이 감소하였다고 응답하였다. 그 결과, 응답자들의 78.9%는 COVID-19의 유행으로 교육에 부정적인 영향을 받았다고 답변하였다. COVID-19 유행 동안에 도입된 비대면 진료가 각각 환자와 의사 측면에서 긍정적인 면이 있다고 답변한 응답자들은 불과 20.0%와 10.6%에 불과하였다. 게다가, 응답자들의 25.9%만이 수가가 적절하게 보상되더라도 비대면 진료를 이용하겠다고 응답하였으며, 68.2%의 응답자들은 비대면 진료가 교육에 부정적인 영향이 있다고 응답하였다.
결론: COVID-19 유행은 외래 진료 감소, 소화기 내시경 검사 감소, 온라인 컨퍼런스, 비대면 진료 도입을 통해 국내 소화기내과 전임의들의 교육에 부정적인 영향이 있었다. COVID-19와 같은 감염병 유행 시에 소화기내과 전임의 교육에 대한 대책 마련이 필요하다.

KCI등재

2전임의 교육 및 수련을 위한 수련기관과 학회의 역할

저자 : 이정훈 ( Jeong Hoon Lee )

발행기관 : 대한소화기학회 간행물 : 대한소화기학회지 77권 5호 발행 연도 : 2021 페이지 : pp. 214-216 (3 pages)

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The training and education of GI fellows are crucial issues for the training institutions and academic societies. Current circumstances about GI fellows are changing rapidly according to shortage of training period of the internal medicine residency program and growing up of multimedia and web-based education system. Recently, the education board of Korean Society of Gastroenterology revised the educational objectives considering 2 years program of GI fellows. We also need to develop a concrete education program through cooperation with related organizations including the training institutions and academic societies. All of these efforts should be made with the goal of making a good gastroenterologist, not just making an endoscopist. (Korean J Gastroenterol 2021;77:214-216)

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3복부초음파 교육 지도전문의를 위한 교육수련 가이드라인 제언

저자 : 김문영 ( Moon Young Kim )

발행기관 : 대한소화기학회 간행물 : 대한소화기학회지 77권 5호 발행 연도 : 2021 페이지 : pp. 217-219 (3 pages)

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In order to revitalize and improve the system of abdominal ultrasonography training specialists, expansion of the internal medicine ultrasonography examination at the training institution must precede. Through this, a cycle of re-education of existing ultrasonography training specialists and the improvement of ability, training new ultrasonography training specialists will be established. Education goals and processes should be aligned to ensure quality it requires the will of institutions and educators to support. With one prerequisite, retraining and re-education of existing ultrasonography training specialists and establishment of management guidelines to improve quality, and ultrasonography education I look forward to becoming the basis for taking a place little by little. (Korean J Gastroenterol 2021;77:217-219)

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4소아기 발병성 염증성 장질환 치료는 성인과 어떤 차이가 있는가?

저자 : 최소윤 ( Soyoon Choi ) , 문원 ( Won Moon )

발행기관 : 대한소화기학회 간행물 : 대한소화기학회지 77권 5호 발행 연도 : 2021 페이지 : pp. 220-226 (7 pages)

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Pediatric-onset inflammatory bowel disease differs from adults in its epidemiological and clinical characteristics and courses. Since it is diagnosed at a young age, the duration of the disease is relatively longer than in adults. Therefore, it is necessary to select drugs in consideration of long-term risks and benefits, and efforts such as therapeutic drug monitoring to maximize the treatment effects and minimize side effects are required. In addition, special considerations for treating pediatric-onset inflammatory bowel disease include attention to the effects of the disease on growth and development, nutrition, and psychosocial problems. In children, more aggressive treatment is needed to avoid missing therapeutic window of opportunity during periods of rapid growth and development. Finally, efforts should be made to ensure that the therapeutic goals of mucosal healing are achieved, the quality of life is restored, and the transition to adult therapy is well carried out. (Korean J Gastroenterol 2021;77:220-226)

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5염증성 장질환 진료에 있어서 소아청소년에서 성인으로의 성공적인 전환은 어떻게 할 수 있는가?

저자 : 김미진 ( Mi Jin Kim ) , 홍성노 ( Sung Noh Hong ) , 김영호 ( Young-ho Kim ) , 최연호 ( Yon Ho Choe )

발행기관 : 대한소화기학회 간행물 : 대한소화기학회지 77권 5호 발행 연도 : 2021 페이지 : pp. 227-230 (4 pages)

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With the increasing incidence of pediatric inflammatory bowel disease (IBD) in children and its impact throughout life, transition care has become an important issue. In Korea, no guidelines have been proposed to support the transition from the pediatric clinic to the adult IBD clinic. This paper reviews the current issues related to IBD patient care during the transition from pediatrics to adults to identify the barriers and critical elements for a successful transition. Thus far, a multi-disciplinary pediatric/adult clinic or alternate visits between pediatric and adult health care providers is the best model for pediatric to adult IBD clinics. Self-reliance and independence of patients with pediatric IBD are also essential for a successful transition. In addition, the timing of the transition from a pediatric clinic to an adult IBD clinic should not be determined because the issue is not the chronological age but rather the individual maturity. (Korean J Gastroenterol 2021;77:227-230)

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6고령에서 염증성 장질환의 치료 - 무엇이 다르고 무엇을 알아야 하는가?

저자 : 나수영 ( Soo-young Na )

발행기관 : 대한소화기학회 간행물 : 대한소화기학회지 77권 5호 발행 연도 : 2021 페이지 : pp. 231-240 (10 pages)

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As the incidence of inflammatory bowel disease (IBD) are increasing with an ageing population, the incidence and prevalence of IBD in the elderly continue to increase. Older IBD patients can be classified into two groups; elderly-onset IBD patients and elderly IBD patients who were diagnosed at a young age and transitioning into advanced age. Clinicians must consider elderly-onset specific phenotypes or prognosis and age-related concerns in the treatment of elderly IBD patients. There is a paucity of evidence whether there is a different disease process when IBD occurs in older age yet. Clinicians may expect similar therapeutic effects in older and younger patients in drug selection, but since older patients are often excluded from clinical trials, evidence to support this assumption is currently lacking. Also, the risk of side effects may be higher in elderly patients. Therefore, when making management decisions in the elderly, clinicians should assess an individual's frailty rather than only considering an individual's chronological and biological age. Knowing specific requirements for managing older IBD patients may help to make an appropriate therapeutic strategy for this patient group. (Korean J Gastroenterol 2021;77:231-240)

KCI등재

7성별에 따라 염증성 장질환의 치료적 접근은 어떻게 달라져야 하는가?

저자 : 김성은 ( Seong-eun Kim )

발행기관 : 대한소화기학회 간행물 : 대한소화기학회지 77권 5호 발행 연도 : 2021 페이지 : pp. 241-247 (7 pages)

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Although not as prominent, there are gender/sex differences in incidence/prevalence, clinical manifestation and disease course, comorbidities, therapeutic response, and patients coping strategy to the disease of inflammatory bowel disease (IBD). In this review, current knowledge about gender-specific differences in IBD would be provided and how to apply this in clinical practice be discussed. (Korean J Gastroenterol 2021;77:241-247)

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8MPV17 관련 간뇌 사립체 DNA 고갈 증후군

저자 : 홍기택 ( Ki Teak Hong ) , 임병찬 ( Byung Chan Lim ) , 문진수 ( Jin Soo Moon ) , 고재성 ( Jae Sung Ko )

발행기관 : 대한소화기학회 간행물 : 대한소화기학회지 77권 5호 발행 연도 : 2021 페이지 : pp. 248-252 (5 pages)

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Mitochondrial DNA (mtDNA) depletion syndrome comprises diseases resulting from a deficiency of proteins involved in mtDNA synthesis. MPV17 is a mitochondrial membrane protein whose mutation causes mitochondrial deoxynucleotide insufficiency. MPV17-related hepatocerebral mtDNA depletion syndrome is a rare autosomal recessive disease. This case report describes the clinical manifestations of MPV17-related hepatocerebral mtDNA depletion syndrome analyzed by performing whole-exome sequencing (WES). A 17-month-old girl presented with developmental delay, jaundice, and failure to thrive. The laboratory findings revealed cholestatic hepatitis, increased lactate-to-pyruvate ratio, and prolongation of the prothrombin time. She developed a hypoglycemic seizure. Brain magnetic resonance imaging revealed extensive demyelination of the white matter. WES detected the p.Leu151fs and p.Pro98Leu variants in MPV17. Her parents and sibling were found to be MPV17 heterozygous carriers. She was administered supportive treatment, such as replacement of fat-soluble vitamins and cornstarch to prevent further hypoglycemic events. The patient is currently being considered for liver transplantation. Overall, WES can help diagnose hepatocerebral mtDNA depletion syndrome in patients with hepatopathy, developmental delay, lactic acidosis, and hypomyelination based on brain magnetic resonance imaging. (Korean J Gastroenterol 2021;77:248-252)

KCI등재

9총담관결석증 환자에서 침형절개도 누공형성술 후 유도선을 이용한 담도 삽관 과정 중 발생한 간문맥 내 삽관 1예

저자 : 이원동 ( Won Dong Lee ) , 송재선 ( Jae Sun Song ) , 김병선 ( Byung Sun Kim ) , 양민아 ( Min A Yang ) , 이영재 ( Young Jae Lee ) , 정금모 ( Gum Mo Jung ) , 조용근 ( Yong Keun Cho ) , 조진웅 ( Jin Woong Cho ) , 김지웅 ( Ji Woong Kim )

발행기관 : 대한소화기학회 간행물 : 대한소화기학회지 77권 5호 발행 연도 : 2021 페이지 : pp. 253-257 (5 pages)

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Cannulation of the portal vein is a rare complication of ERCP. This paper reports a case of portal vein catheterization during ERCP in a patient with choledocholithiasis. A 62-year-old man was admitted to the Presbyterian Medical Center with right upper quadrant pain and jaundice. ERCP was performed under the suspicion of obstructive jaundice caused by a radiolucent stone. Bile duct cannulation using a pull-type papillotome was attempted, but it failed. After needle-knife fistulotomy, wire-guided cannulation was performed successfully, and 10 mL contrast was injected. On the other hand, the fluoroscopy image showed that the contrast medium disappeared very quickly. Pure blood was collected when the catheter was aspirated to identify the bile reflux, indicating possible cannulation of the portal vein. The procedure was terminated immediately and abdominal computed tomography showed air in the portal vein. One day after, a follow-up CT scan showed no air in the portal vein. The patient underwent repeated ERCP, and the common bile duct was cannulated. In most cases, isolated portal vein cannulation does not result in severe morbidity. However, it is important to aware of this rare complication so that no further invasive procedure is performed on the patient. (Korean J Gastroenterol 2021;77:253-257)

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10증상을 동반한 식도 평활근종

저자 : 최윤진 ( Yoon Jin Choi ) , 박성용 ( Sung Yong Park )

발행기관 : 대한소화기학회 간행물 : 대한소화기학회지 77권 5호 발행 연도 : 2021 페이지 : pp. 258-260 (3 pages)

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