간행물

Gut and Liver update

  • : 대한소화기기능성질환·운동학회
  • : 의약학분야  >  내과학
  • : KCI등재
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수록정보
15권4호(2021) |수록논문 수 : 17
간행물 제목
16권3호(2022년 05월) 수록논문
최근 권호 논문
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1Ulcerative Colitis and Patient's Quality of Life, Especially in Early Stage

저자 : Jung Won Lee

발행기관 : 대한소화기기능성질환·운동학회 간행물 : Gut and Liver 16권 3호 발행 연도 : 2022 페이지 : pp. 317-318 (2 pages)

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2Waiting for Multi-Stakeholders' Consensus Position Statement on New Nonalcoholic Fatty Liver Disease Nomenclature

저자 : Eileen L. Yoon , Dae Won Jun

발행기관 : 대한소화기기능성질환·운동학회 간행물 : Gut and Liver 16권 3호 발행 연도 : 2022 페이지 : pp. 319-320 (2 pages)

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3Advancements in the Diagnosis of Gastric Subepithelial Tumors

저자 : Osamu Goto , Mitsuru Kaise , Katsuhiko Iwakiri

발행기관 : 대한소화기기능성질환·운동학회 간행물 : Gut and Liver 16권 3호 발행 연도 : 2022 페이지 : pp. 321-330 (10 pages)

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A diagnosis of subepithelial tumors (SETs) is sometimes difficult due to the existence of overlying mucosa on the lesions, which hampers optical diagnosis by conventional endoscopy and tissue sampling with standard biopsy forceps. Imaging modalities, by using computed tomography and endoscopic ultrasonography (EUS) are mandatory to noninvasively collect the target's information and to opt candidates for further evaluation. Particularly, EUS is an indispensable diagnostic modality for assessing the lesions precisely and evaluating the possibility of malignancy. The diagnostic ability of EUS appears increased by the combined use of contrast-enhancement or elastography. Histology is the gold standard for obtaining the final diagnosis. Tissue sampling requires special techniques to break the mucosal barrier. Although EUS-guided fine-needle aspiration (EUS-FNA) is commonly applied, mucosal cutting biopsy and mucosal incision-assisted biopsy are comparable methods to definitively obtain tissues from the exposed surface of lesions and seem more useful than EUS-FNA for small SETs. Recent advancements in artificial intelligence (AI) have a potential to drastically change the diagnostic strategy for SETs. Development and establishment of noninvasive methods including AI-assisted diagnosis are expected to provide an alternative to invasive, histological diagnosis. (Gut Liver 2022;16:321-330)

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4Postinfection Irritable Bowel Syndrome

저자 : Uday C Ghoshal

발행기관 : 대한소화기기능성질환·운동학회 간행물 : Gut and Liver 16권 3호 발행 연도 : 2022 페이지 : pp. 331-340 (10 pages)

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Following acute gastroenteritis (AGE) due to bacteria, viruses, or protozoa, a subset of patients develop new onset Rome criteria positive irritable bowel syndrome (IBS), called postinfection IBS (PI-IBS). The pooled prevalence of PI-IBS following AGE was 11.5%. PI-IBS is the best natural model that suggests that a subset of patients with IBS may have an organic basis. Several factors are associated with a greater risk of development of PI-IBS following AGE including female sex, younger age, smoking, severity of AGE, abdominal pain, bleeding per rectum, treatment with antibiotics, anxiety, depression, somatization, neuroticism, recent adverse life events, hypochondriasis, extroversion, negative illness beliefs, history of stress, sleep disturbance, and family history of functional gastrointestinal disorders (FGIDs), currently called disorder of gut-brain interaction. Most patients with PI-IBS present with either diarrhea-predominant IBS or the mixed subtype of IBS, and overlap with other FGIDs, such as functional dyspepsia is common. The drugs used to treat non-constipation IBS may also be useful in PI-IBS treatment. Since randomized controlled trials on the efficacy of drugs to treat PI-IBS are rare, more studies are needed on this issue. (Gut Liver 2022;16:331-340)

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52021 Korean Society of Gastrointestinal Endoscopy Clinical Practice Guidelines for Endoscopic Sedation

저자 : Hong Jun Park , Byung-wook Kim , Jun Kyu Lee , Yehyun Park , Jin Myung Park , Jun Yong Bae , Seung Young Seo , Jae Min Lee , Jee Hyun Lee , Hyung Ku Chon , Jun-won Chung , Hyun Ho Choi , Myung Ha Kim ,

발행기관 : 대한소화기기능성질환·운동학회 간행물 : Gut and Liver 16권 3호 발행 연도 : 2022 페이지 : pp. 341-356 (16 pages)

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Sedation can resolve anxiety and fear in patients undergoing endoscopy. The use of sedatives has increased in Korea. Appropriate sedation is a state in which the patient feels subjectively comfortable while maintaining the airway reflex for stable spontaneous breathing. The patient should maintain a state of consciousness to the extent that he or she can cooperate with the needs of the medical staff. Despite its benefits, endoscopic sedation has been associated with cardiopulmonary complications. Such cardiopulmonary complications are usually temporary, and most patients recover without sequelae. However, these events may progress to serious complications, such as cardiovascular collapse. Therefore, it is essential to screen high-risk patients before sedation and reduce complications by meticulous monitoring. Additionally, physicians should be familiar with the management of emergencies. The first Korean clinical practice guideline for endoscopic sedation was developed based on previous worldwide guidelines for endoscopic sedation using an adaptation process. The guideline consists of nine recommendations based on a critical review of currently available data and expert consensus when the guideline was drafted. These guidelines should provide clinicians, nurses, medical school students, and policy makers with information on how to perform endoscopic sedation with minimal risk. (Gut Liver 2022;16:341-356)

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6Type 2 Autoimmune Pancreatitis: Consensus and Controversies

저자 : Yoh Zen

발행기관 : 대한소화기기능성질환·운동학회 간행물 : Gut and Liver 16권 3호 발행 연도 : 2022 페이지 : pp. 357-365 (9 pages)

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Autoimmune pancreatitis (AIP) has attracted much attention in the last two decades, and due to the diagnostic value of immunoglobulin G4 (IgG4), the number of cases diagnosed in clinical practice has markedly increased. However, in contrast to prototypic IgG4-related type 1 AIP, a minor subtype of AIP, referred to as type 2 AIP, is less widely known and has thus not yet been characterized in detail. Type 2 AIP is unrelated to IgG4 and is a completely distinct entity from type 1 AIP. One confusing factor is that the two types of AIP share patterns of clinical presentation (e.g., acute pancreatitis and painless jaundice) and imaging abnormalities (e.g., diffuse or segmental enlargement). Since there are currently no established serum markers, the diagnosis of type 2 AIP is highly challenging and requires the tissue confirmation of neutrophilic injury to the pancreatic ducts, a finding designated as a granulocytic epithelial lesion. Approximately one-third of cases are associated with inflammatory bowel disease, particularly ulcerative colitis; however, the pathological relationship between these two conditions has not yet been clarified. Unanswered questions relate to its pathophysiology, the potential development of a similar granulocytic injury in other organs, and the characteristics of pediatric cases. This review summarizes consensus and controversies surrounding type 2 AIP, with the aim of increasing awareness and highlighting the unmet needs of this underrecognized condition. (Gut Liver 2022;16:357-365)

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7The Incidence and Risk Factors for Metachronous Gastric Cancer in the Remnant Stomach after Gastric Cancer Surgery

저자 : Yonghoon Choi , Nayoung Kim , Hyuk Yoon , Cheol Min Shin , Young Soo Park , Dong Ho Lee , Young Suk Park , Sang-hoon Ahn , Yun-suhk Suh , Do Joong Park , Hyung Ho Kim

발행기관 : 대한소화기기능성질환·운동학회 간행물 : Gut and Liver 16권 3호 발행 연도 : 2022 페이지 : pp. 366-374 (9 pages)

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Background/Aims: Less invasive surgical treatment is performed in East Asia to preserve postoperative digestive function and reduce complications such as postgastrectomy syndromes, but there is an issue of metachronous gastric cancer (GC) in the remaining stomach. This study aimed to analyze the incidence of metachronous GC and its risk factors in patients who had undergone partial gastrectomy.
Methods: A total of 3,045 GC patients who had undergone curative gastric partial resection at Seoul National University Bundang Hospital were enrolled and analyzed retrospectively for risk factors, including age, sex, smoking, alcohol, Helicobacter pylori status, family history of GC, histological type, and surgical method.
Results: Metachronous GC in the remaining stomach occurred in 35 of the 3,045 patients (1.1%): 23 in the distal gastrectomy group (18 with Billroth-I anastomosis, five with Billroth-II anastomosis), seven in the proximal gastrectomy (PG) group, and five in the pylorus-preserving gastrectomy (PPG) group. Univariate and multivariate Cox regression analyses showed that age ≥60 years (p=0.005) and surgical method used (PG or PPG, p<0.001) were related risk factors for metachronous GC, while male sex and intestinal type histology were potential risk factors.
Conclusions: Metachronous GC was shown to be related to older age and the surgical method used (PG or PPG). Regular and careful follow-up with endoscopy should be performed in the case of gastric partial resection, especially in patients with male sex and intestinal type histology as well as those aged ≥60 years undergoing the PG or PPG surgical method. (Gut Liver 2022;16:366-374)

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8Seronegative Celiac Disease in Patients with Isolated Refractory Dyspepsia and Gastroesophageal Reflux Disease

저자 : Salih Tokmak , Baris Boral , Yuksel Gumurdulu

발행기관 : 대한소화기기능성질환·운동학회 간행물 : Gut and Liver 16권 3호 발행 연도 : 2022 페이지 : pp. 375-383 (9 pages)

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Background/Aims: To investigate the presence of seronegative celiac disease in patients with isolated refractory dyspepsia and gastroesophageal reflux disease (GERD)-related complaints.
Methods: This was a single-center, prospective study performed at a tertiary care referral hospital. Among 968 consecutive patients, 129 seronegative patients with tissue damage consistent with Marsh IIIa classification or above were included. The patients were divided into two groups: dyspepsia (n=78) and GERD (n=51). Biopsies were taken from the duodenum regardless of endoscopic appearance, and patients with Marsh IIIa or above damage were advised to consume a gluten-free diet. The Glasgow Dyspepsia Severity (GDS) score, Reflux Symptom Index (RSI), and Biagi score were calculated at baseline and every 3 months. Control endoscopy was performed every 6 months during follow-up.
Results: The median follow-up time was 19.9 months (range, 6 to 24 months) in the dyspepsia group and 19.2 months (range, 6 to 24 months) in the GERD group. All the patients were positive for the HLA-DQ2 and DQ8 haplotypes. The differences between the mean GDS scores (14.3±2.1 vs 1.1±0.2, respectively, p<0.05), RSI scores (6.3±0.8 vs 0.7±0.1, respectively, p<0.05), and Biagi scores (3.1±0.4 vs 0.7±0.3 in the dyspepsia group and 2.5±0.4 vs 0.5±0.2 in GERD group) before and after implementation of the gluten-free diet were statistically significant. The decreases in the scores were consistent with improvements in the histological findings. There was no significant correlation between endoscopic appearance and histological examination results (p=0.487).
Conclusions: Seronegative celiac disease may be considered in this group of patients. Even if a patient is seronegative and has normal endoscopic findings, duodenal biopsy should be considered. (Gut Liver 2022;16:375-383)

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9Quality of Life in Newly Diagnosed Moderate-to-Severe Ulcerative Colitis: Changes in the MOSAIK Cohort Over 1 Year

저자 : Ik Hyun Jo , Kang-moon Lee , Dae Bum Kim , Ji Won Kim , Jun Lee , Yoon Tae Jeen , Tae-oh Kim , Joo Sung Kim , Jae Jun Park , Sung Noh Hong , Dong Il Park , Hyun-soo Kim , Yoo Jin Lee , Youngdoe Kim

발행기관 : 대한소화기기능성질환·운동학회 간행물 : Gut and Liver 16권 3호 발행 연도 : 2022 페이지 : pp. 384-395 (12 pages)

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Background/Aims: Improving quality of life has been gaining importance in ulcerative colitis (UC) management. The aim of this study was to investigate changes in health-related quality of life (HRQL) and related factors in patients with moderate-to-severe UC.
Methods: A multicenter, hospital-based, prospective study was performed using a Moderateto- Severe Ulcerative Colitis Cohort in Korea (the MOSAIK). Changes in HRQL, evaluated using the 12-Item Short Form Health Survey (SF-12) and Inflammatory Bowel Disease Questionnaire (IBDQ), were analyzed at the time of diagnosis and 1 year later.
Results: In a sample of 276 patients, the mean age was 38.4 years, and the majority of patients were male (59.8%). HRQL tended to increase in both the IBDQ and SF-12 1 year after diagnosis. A higher partial Mayo score was significantly related to poorer HRQL on the IBDQ and SF-12 in a linear mixed model (p<0.01). Inflammatory markers such as C-reactive protein (CRP) or erythrocyte sedimentation rate also showed a negative correlation on HRQL (p<0.05). Patients whose IBDQ score improved by 16 or more (71.2%) in 1 year were younger, tended to be nonsmokers, and had a lower partial Mayo score and CRP than those whose IBDQ score did not. There was no significant association between HRQL and disease extent, treatments at diagnosis, or the highest treatment step during the 1-year period.
Conclusions: Optimally controlled disease status improves HRQL in patients with moderate-to-severe UC. The partial Mayo score and inflammatory markers may be potential indicators reflecting the influence of UC on patient`s daily lives. (Gut Liver 2022;16:384-395)

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10Clinical Course of Hepatitis B Viral Infection in Patients Undergoing Anti-Tumor Necrosis Factor α Therapy for Inflammatory Bowel Disease

저자 : Ji Min Lee , Shu-chen Wei , Kang-moon Lee , Byong Duk Ye , Ren Mao , Hyun-soo Kim , Soo Jung Park , Sang Hyoung Park , Eun Hye Oh , Jong Pil Im , Byung Ik Jang , Dae Bum Kim , Ken Takeuchi

발행기관 : 대한소화기기능성질환·운동학회 간행물 : Gut and Liver 16권 3호 발행 연도 : 2022 페이지 : pp. 396-403 (8 pages)

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Background/Aims: Little is known about the clinical course of hepatitis B virus (HBV)-infected patients undergoing anti-tumor necrosis factor α (TNF-α) therapy for inflammatory bowel disease (IBD). We aimed to investigate the clinical course of HBV infection and IBD and to analyze liver dysfunction risks in patients undergoing anti-TNF-α therapy.
Methods: This retrospective multinational study involved multiple centers in Korea, China, Taiwan, and Japan. We enrolled IBD patients with chronic or resolved HBV infection, who received anti-TNF-α therapy. The patients' medical records were reviewed, and data were collected using a web-based case report form.
Results: Overall, 191 patients (77 ulcerative colitis and 114 Crohn's disease) were included, 28.3% of whom received prophylactic antivirals. During a median follow-up duration of 32.4 months, 7.3% of patients experienced liver dysfunction due to HBV reactivation. Among patients with chronic HBV infection, the proportion experiencing liver dysfunction was significantly higher in the non-prophylaxis group (26% vs 8%, p=0.02). Liver dysfunction occurred in one patient with resolved HBV infection. Antiviral prophylaxis was independently associated with an 84% reduction in liver dysfunction risk in patients with chronic HBV infection (odds ratio, 0.16; 95% confidence interval, 0.04 to 0.66; p=0.01). The clinical course of IBD was not associated with liver dysfunction or the administration of antiviral prophylaxis.
Conclusions: Liver dysfunction due to HBV reactivation can occur in HBV-infected IBD patients treated with anti-TNF-α agents. Careful monitoring is needed in these patients, and antivirals should be administered, especially to those with chronic HBV infection. (Gut Liver 2022;16:396- 403)

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1Benefits of a Molecular-Based Method for the Detection of Clarithromycin-Resistant Helicobacter pylori

저자 : Batsaikhan Saruuljavkhlan , Yoshio Yamaoka

발행기관 : 대한소화기기능성질환·운동학회 간행물 : Gut and Liver 15권 4호 발행 연도 : 2021 페이지 : pp. 487-489 (3 pages)

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2Direct Hyperbilirubinemia as a Predictor of Mortality in Patients with Liver Cirrhosis

저자 : Chang Hun Lee , In Hee Kim

발행기관 : 대한소화기기능성질환·운동학회 간행물 : Gut and Liver 15권 4호 발행 연도 : 2021 페이지 : pp. 490-491 (2 pages)

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3Current Status of Mucosal Imaging with Narrow-Band Imaging in the Esophagus

저자 : Keng Hoong Chiam , Seon Ho Shin , Kun Cheong Choi , Florencia Leiria , Mariana Militz , Rajvinder Singh

발행기관 : 대한소화기기능성질환·운동학회 간행물 : Gut and Liver 15권 4호 발행 연도 : 2021 페이지 : pp. 492-499 (8 pages)

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Recent advances in endoscopic imaging of the esophagus have revolutionized the diagnostic capability for detecting premalignant changes and early esophageal malignancy. In this article, we review the practical application of narrow-band imaging focusing on diseases of the esophagus, including Barrett's esophagus, adenocarcinoma, and squamous cell carcinoma. (Gut Liver 2021;15:492-499)

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4Tumor-Associated Macrophages in Hepatocellular Carcinoma: Friend or Foe?

저자 : Dexi Zhou , Jiajie Luan , Cheng Huang , Jun Li

발행기관 : 대한소화기기능성질환·운동학회 간행물 : Gut and Liver 15권 4호 발행 연도 : 2021 페이지 : pp. 500-516 (17 pages)

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Hepatocellular carcinoma (HCC) is one of the most common malignancies worldwide, and it has diverse etiologies with multiple mechanisms. The diagnosis of HCC typically occurs at advanced stages when there are limited therapeutic options. Hepatocarcinogenesis is considered a multistep process, and hepatic macrophages play a critical role in the inflammatory process leading to HCC. Emerging evidence has shown that tumor-associated macrophages (TAMs) are crucial components defining the HCC immune microenvironment and represent an appealing option for disrupting the formation and development of HCC. In this review, we summarize the current knowledge of the polarization and function of TAMs in the pathogenesis of HCC, as well as the mechanisms underlying TAM-related anti-HCC therapies. Eventually, novel insights into these important aspects of TAMs and their roles in the HCC microenvironment might lead to promising TAM-focused therapeutic strategies for HCC. (Gut Liver 2021;15:500-516)

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5Management of Gallstones and Acute Cholecystitis in Patients with Liver Cirrhosis: What Should We Consider When Performing Surgery?

저자 : Shang Yu Wang , Chun Nan Yeh , Yi Yin Jan , Miin Fu Chen

발행기관 : 대한소화기기능성질환·운동학회 간행물 : Gut and Liver 15권 4호 발행 연도 : 2021 페이지 : pp. 517-527 (11 pages)

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Acute cholecystitis and several gallbladder stone-related conditions, such as impacted common bile duct stones, cholangitis, and biliary pancreatitis, are common medical conditions in daily practice. An early cholecystectomy or drainage procedure with delayed cholecystectomy is the current standard of treatment based on published clinical guidelines. Cirrhosis is not only a condition of chronically impaired hepatic function but also has systemic effects in patients. In cirrhotic individuals, several predisposing factors, including changes in the bile acid composition, increased nucleation of bile, and decreased motility of the gallbladder, contribute to the formation of biliary stones and the possibility of symptomatic cholelithiasis, which is an indication for surgical treatment. In addition to these predisposing factors for cholelithiasis, systemic effects and local anatomic consequences related to cirrhosis lead to anesthesiologic risks and perioperative complications in cirrhotic patients. Therefore, the treatment of the aforementioned biliary conditions in cirrhotic patients has become a challenging issue. In this review, we focus on cholecystectomy for cirrhotic patients and summarize the surgical indications, risk stratification, surgical procedures, and surgical outcomes specific to cirrhotic patients with symptomatic cholelithiasis. (Gut Liver 2021;15:517-527)

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6Types of 23S Ribosomal RNA Point Mutations and Therapeutic Outcomes for Helicobacter pylori

저자 : Sang Yoon Kim , Jae Myung Park , Chul-hyun Lim , Hye Ah Lee , Ga-yeong Shin , Younghee Choe , Yu Kyung Cho , Myung-gyu Choi

발행기관 : 대한소화기기능성질환·운동학회 간행물 : Gut and Liver 15권 4호 발행 연도 : 2021 페이지 : pp. 528-536 (9 pages)

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Background/Aims: Point mutations in the 23S ribosomal RNA gene have been associated with Helicobacter pylori clarithromycin resistance. This study aimed to detect the prevalence of these point mutations and to investigate the role of different point mutations in the success of eradication therapy.
Methods: We retrospectively investigated a total of 464 consecutive patients who underwent an endoscopic examination and dual-priming oligonucleotide-based multiplex polymerase chain reaction for H. pylori between June 2014 and October 2019. For 289 patients with negative point mutations, standard triple therapy was used in 287 patients, and the bismuth-quadruple regimen was used in two patients. For 175 patients with positive point mutations (A2142G, A2143G, and both mutations), standard triple and bismuth-quadruple therapies were used in 37 patients and 138 patients, respectively.
Results: The eradication rates of standard triple and bismuth-quadruple therapies showed no significant difference in mutation-negative patients or those with the A2142G point mutation. However, the eradication rate with bismuth-quadruple therapy was significantly higher than that with standard triple therapy in the group with the A2143G mutation or with the double mutation. The eradication rates for standard triple and bismuth-quadruple therapies, respectively, were 25.8% and 92.1% in the per-protocol group (p<0.001) and 24.2% and 85.2% in the intention-totreat analysis (p<0.001).
Conclusions: The A2143G point mutation is the most prevalent cause of clarithromycin resistance. Bismuth-quadruple therapy is superior to standard triple therapy in patients with the A2143G or double point mutation. (Gut Liver 2021;15:528-536)

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7Clinical Significance of TWIST-Positive Circulating Tumor Cells in Patients with Esophageal Squamous Cell Carcinoma

저자 : Hyun Jung Lee , Gwang Ha Kim , Su Jin Park , Chae Hwa Kwon , Moon Won Lee , Bong Eun Lee , Dong Hoon Baek , Hoseok I

발행기관 : 대한소화기기능성질환·운동학회 간행물 : Gut and Liver 15권 4호 발행 연도 : 2021 페이지 : pp. 533-541 (9 pages)

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Background/Aims: Unlike other gastrointestinal tract cancers, there are relatively few reports on the clinical significance of circulating tumor cells (CTCs) and TWIST, a marker of epithelial-mesenchymal transition, in patients with esophageal squamous cell carcinoma (ESCC). This study aimed to evaluate the clinical significance of TWIST expression in CTCs in patients with ESCC.
Methods: Peripheral blood samples for CTC analyses were prospectively obtained from 52 patients with ESCC prior to treatment between September 2017 and September 2019. CTCs were detected using a centrifugal microfluidic system based on a fluid-assisted separation technique, and CTCs positive for TWIST on immunostaining were defined as TWIST (+) CTCs.
Results: Of the 52 patients with ESCC, CTCs and TWIST (+) CTCs were detected in 44 patients (84.6%) and 39 patients (75.0%), respectively. The CTC and TWIST (+) CTC counts were significantly higher in patients aged >65 years and those who had a large tumor (>3 cm) than in those aged ≤65 years and those who had a small tumor (≤3 cm), respectively. There were no differences in CTC and TWIST (+) CTC counts according to tumor location, histologic grade, or TNM stage. TWIST (+) CTCs were significantly associated with histologic grade; a proportion of TWIST (+) CTCs ≥0.5 was significantly associated with advanced histologic grade. Other clinicopathologic characteristics such as sex, age, tumor location, tumor size, and TNM stages were not significantly associated with TWIST (+) CTCs.
Conclusions: Our study showed that TWIST (+) CTCs were frequently detected in patients with ESCC, and a high proportion of TWIST (+) CTCs was associated with poor differentiation. (Gut Liver 2021;15:553-561)

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8A Nationwide Cohort Study Shows a Sex-Dependent Change in the Trend of Peptic Ulcer Bleeding Incidence in Korea between 2006 and 2015

저자 : Yong Sung Kim , Joonki Lee , Aesun Shin , Jung Min Lee , Jong Heon Park , Hwoon-yong Jung

발행기관 : 대한소화기기능성질환·운동학회 간행물 : Gut and Liver 15권 4호 발행 연도 : 2021 페이지 : pp. 537-545 (9 pages)

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Background/Aims: The incidence of peptic ulcer disease has decreased in past decades; however, the trends in peptic ulcer bleeding (PUB) are inconsistent among regions. This study aimed to investigate the trends in PUB incidence and the effect of risk factors on PUB in Korea.
Methods: The records of patients hospitalized with PUB from 2006 to 2015 were retrieved from the Korean National Health Insurance Service Database. Standardized incidences of PUB were calculated, and the clinical characteristics such as age, sex, Helicobacter pylori infection, drug exposure, comorbidities, and mortality were obtained.
Results: In total, 151,507 hospitalizations with PUB were identified. The overall annual hospitalization rate was 34.98 per 100,000 person-years. The incidence of PUB showed no significant change from 2006 to 2008 and decreased from 2008 to 2015, with an annual change of -2.7% (p<0.05); however, this change was only significant in men. The incidence of PUB was higher in men than in women between 40 and 70 years old and higher in women than in men older than 80 years. From 2006 to 2015, the H. pylori infection rate increased significantly in patients with PUB; however, there was no significant change in exposure to nonsteroidal anti-inflammatory drugs or other drugs that increase the risk of PUB.
Conclusions: Over the past decade, the incidence of PUB has decreased in a sex-specific manner. There has been a decreasing trend in the H. pylori infection rate and no change in exposure to drugs that increase the risk of PUB in Korea. (Gut Liver 2021;15:537-545)

KCI등재

9The Usefulness of the Measurement of Esophagogastric Junction Distensibility by EndoFLIP in the Diagnosis of Gastroesophageal Reflux Disease

저자 : Jung Min Lee , In Kyung Yoo , Eunju Kim , Sung Pyo Hong , Joo Young Cho

발행기관 : 대한소화기기능성질환·운동학회 간행물 : Gut and Liver 15권 4호 발행 연도 : 2021 페이지 : pp. 546-552 (7 pages)

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Background/Aims: Increased esophagogastric junction (EGJ) relaxation is the most important mechanism involved in gastroesophageal reflux disease (GERD). An endoscopic functional luminal imaging probe (EndoFLIP) is a device used to quantify EGJ distensibility in routine endoscopy. The aim of the current study was to assess the usefulness of EndoFLIP for the diagnosis of GERD compared to normal controls.
Methods: We analyzed EndoFLIP data from 204 patients with erosive reflux disease (ERD), 310 patients with nonerosive reflux disease (NERD), and 277 normal subjects. EndoFLIP uses impedance planimetry to measure 16 cross-sectional areas (CSAs) in conjunction with the corresponding intrabag pressure within a 4.6 cm cylindrical segment of a fluid-filled bag. The EGJ distensibility was assessed using 40 mL volume-controlled distensions.
Results: The mean distensibility index values were 13.98 ㎟/mm Hg in ERD patients, 11.42 ㎟/mm Hg in NERD patients, and 9.1 ㎟/mm Hg in normal subjects. There were significant differences in EGJ distensibility among the three groups (p<0.001). In addition, the CSAs were significantly higher in the ERD (291.03±160.77 ㎟) and NERD groups (285.87±155.47 ㎟) than in the control group (249.78±144.76 ㎟, p=0.004). We determined the distensibility index cutoff value of EGJ as 10.95 for the diagnosis of GERD by receiver operating characteristic curve analysis.
Conclusions: The EGJ distensibilities of GERD patients were higher than those of normal subjects, regardless of the presence of reflux esophagitis. Thus, the measurement of EGJ distensibility using the EndoFLIP system could be useful in the diagnosis of GERD. (Gut Liver 2021;15:546-552)

KCI등재

10Pain Intensity at Injection Site during Esophagogastroduodenoscopy Using Long- and Medium- Chain versus Long-Chain Triglyceride Propofol: A Randomized Controlled Double-Blind Study

저자 : Joon Seop Lee , Eun Soo Kim , Kwang Bum Cho , Kyung Sik Park , Yoo Jin Lee , Ju Yup Lee

발행기관 : 대한소화기기능성질환·운동학회 간행물 : Gut and Liver 15권 4호 발행 연도 : 2021 페이지 : pp. 562-568 (7 pages)

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Background/Aims: The intensities of injection pain resulting from the use of long- and mediumchain triglyceride (LCT/MCT) propofol and conventional LCT propofol during esophagogastroduodenoscopy (EGD) have yet to be compared. We aimed to determine the pain intensity caused by different formulations of propofol and to evaluate the formulation that would be preferred by patients as a sedative agent during their next procedure.
Methods: This study was a single-center, randomized, controlled, and double-blind trial. Pain intensity was estimated 30 seconds after propofol injection by an examiner who was blinded to the group assignment using a numeric (0-10) pain rating scale (NPRS). After 1 week, the patients were asked whether they could recall the pain and were willing to receive the same agent for their next EGD.
Results: One hundred twenty-nine patients were randomly assigned to LCT/MCT or LCT group. Although there was no significant difference in pain incidence between the LCT/MCT and LCT groups (52.9% vs 65.6%, p=0.156), the pain intensity was significantly lower in the LCT/MCT group (NPRS median [interquartile range]; 1 (0-2) vs 2 (0-5), p=0.005). After 1 week, fewer patients in the LCT/MCT group recalled the pain (19.1% vs 63.9%, p<0.001) and more patients in the LCT/MCT group were more willing to use the same agent for their next procedure (86.8% vs 72.1%, p=0.048) than in the LCT group.
Conclusions: LCT/MCT propofol significantly reduced injection pain intensity compared to LCT propofol during EGD and preferred by patients as a sedative agent during their next EGD. (Gut Liver 2021;15:562-568)

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