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대한내과학회> The Korean Journal of Internal Medicine

The Korean Journal of Internal Medicine update

  • : 대한내과학회
  • : 의약학분야  >  내과학
  • : KCI등재
  • : SCOPUS
  • : 연속간행물
  • : 격월
  • : 1226-3303
  • : 2005-6648
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수록정보
수록범위 : 1권1호(1986)~37권5호(2022) |수록논문 수 : 2,751
The Korean Journal of Internal Medicine
37권5호(2022년 09월) 수록논문
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KCI등재 SCOPUS

저자 : Jihye Park , Jae Hee Cheon

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 37권 5호 발행 연도 : 2022 페이지 : pp. 895-905 (11 pages)

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The incidence and prevalence of inflammatory bowel diseases (IBDs) are rapidly increasing worldwide. IBDs are considered an emerging problem not only in Western countries but also in developing counties. The relapses and complications of active IBD mandate various medications. Nevertheless, hospitalization, emergency room visits, or surgery may be required, resulting in a socioeconomic burden. Great advances have been made in the development of new therapeutic options for IBD to achieve induction and maintenance remission. Nevertheless, conventional therapy is still the mainstay in the treatment of IBD. This review article provides an update on recent advances in conventional therapies, including 5-aminosalicylates, corticosteroids, immunomodulators, and anti-tumor necrosis factor-α agents to treat IBD.

KCI등재 SCOPUS

저자 : Jung Won Lee , Chang Soo Eun

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 37권 5호 발행 연도 : 2022 페이지 : pp. 895-904 (10 pages)

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Inflammatory bowel disease (IBD) refers to a group of disorders, including Crohn's disease and ulcerative colitis, that exhibit similar but distinct manifestations. These diseases are characterized by refractory and chronic inflammation of the bowel. IBD is usually accompanied by severe symptoms. When a patient presents with suspected IBD, physicians encounter various challenges in terms of diagnosis and treatment. In addition, given such characteristics, the associated medical expenses gradually increase. Although IBD was formerly known as a disease of Western countries, the incidence and prevalence are increasing in Korea. Korean investigators have accumulated a great deal of knowledge about the regional characteristics and epidemiology of the disease, especially via well-organized, joint cohort studies. Against this background, this article describes the epidemiology of IBD in Korea compared to that in the West. In addition, an overview of the pathophysiology of the disease is provided, focusing on the latest results.

KCI등재 SCOPUS

저자 : Soo-young Na , You Sun Kim

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 37권 5호 발행 연도 : 2022 페이지 : pp. 906-919 (14 pages)

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The incidence and prevalence of inflammatory bowel disease (IBD), comprising Crohn's disease and ulcerative colitis, have increased in Asia and developing countries. In the past two decades, anti-tumor necrosis factor (TNF) agents have revolutionized the treatment of IBD, in part by decreasing the rates of complications and surgery. Although anti-TNF agents have changed the course of IBD, there are unmet needs in terms of primary and secondary non-responses and side effects such as infections and malignancies. Novel biologics and small-molecule drugs have been developed for IBD, and the medical treatment options have improved. These drugs include sphingosine-1-phosphate receptor modulators and anti-integrins to block immune cell migration, and cytokine and Janus kinase inhibitors to block immune cell communications. In this review, we discuss the approved novel biologics and small-molecule drugs, including several of those in the late stages of development, for the treatment of IBD.

KCI등재 SCOPUS

저자 : Yoo Jin Lee , Eun Soo Kim

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 37권 5호 발행 연도 : 2022 페이지 : pp. 920-930 (11 pages)

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Patients with inflammatory bowel disease (IBD) are vulnerable to vaccine-preventable infectious diseases. Immunosuppressive drugs, which are often used to manage IBD, may increase this vulnerability and attenuate vaccine efficacy. Thus, healthcare providers should understand infectious diseases and schedule vaccinations for them to reduce the infection-related burden of patients with IBD. All patients with IBD should be assessed in terms of immunity to vaccine-preventable diseases at the time of IBD diagnosis, and be vaccinated appropriately. Vaccination is becoming more important because of the unprecedented coronavirus disease 2019 (COVID-19) global health crisis. This review focuses on recent updates to vaccination strategies for Korean patients with IBD.

KCI등재 SCOPUS

저자 : Chan Joo Lee , Minjae Yoon , Hyun-jae Kang , Byung Jin Kim , Sung Hee Choi , In-kyung Jeong , Sang-hak Lee

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 37권 5호 발행 연도 : 2022 페이지 : pp. 931-944 (14 pages)

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Familial hypercholesterolemia (FH) is the most common monogenic disorder. Due to the marked elevation of cardiovascular risk, the early detection, diagnosis, and proper management of this disorder are critical. Herein, the 2022 Korean guidance on this disease is presented. Clinical features include severely elevated low-density lipoprotein cholesterol (LDL-C) levels, tendon xanthomas, and premature coronary artery disease. Clinical diagnostic criteria include clinical findings, family history, or pathogenic mutations in the LDLR, APOB, or PCSK9. Proper suspicion of individuals with typical characteristics is essential for screening. Cascade screening is known to be the most efficient diagnostic approach. Early initiation of lipid-lowering therapy and the control of other risk factors are important. The first-line pharmacological treatment is statins, followed by ezetimibe, and PCSK9 inhibitors as required. The ideal treatment targets are 50% reduction and < 70 or < 55 mg/dL (in the presence of vascular disease) of LDL-C, although less strict targets are frequently used. Homozygous FH is characterized by untreated LDL-C > 500 mg/dL, xanthoma since childhood, and family history. In children, the diagnosis is made with criteria, including items largely similar to those of adults. In women, lipid-lowering agents need to be discontinued before conception.

KCI등재 SCOPUS

저자 : Yangjin Jegal

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 37권 5호 발행 연도 : 2022 페이지 : pp. 945-946 (2 pages)

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KCI등재 SCOPUS

저자 : Sung Hye Kong

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 37권 5호 발행 연도 : 2022 페이지 : pp. 947-948 (2 pages)

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KCI등재 SCOPUS

저자 : Soo-kyung Park , Sang-bum Kang , Sangsoo Kim , Tae Oh Kim , Jae Myung Cha , Jong Pil Im , Chang Hwan Choi , Eun Soo Kim , Geom Seog Seo , Chang Soo Eun , Dong Soo Han , Dong Il Park

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 37권 5호 발행 연도 : 2022 페이지 : pp. 949-962 (14 pages)

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Background/Aims: In ulcerative colitis (UC) patients, Escherichia coli Nissle 1917 (EcN) is equivalent to mesalazine for preventing disease relapse; however, evidence of the ability of EcN to increase health-related quality of life or induce remission remains scarce. We investigated the efficacy of EcN as an add-on therapy for UC.
Methods: In this multicentre, double-blind, randomised, placebo-controlled study, a total of 133 UC patients were randomly assigned to receive either EcN or placebo once daily for 8 weeks. Inflammatory bowel disease questionnaire (IBDQ) scores (primary endpoint) and clinical remission and response rates (secondary endpoints) were compared (Clinical trial registration number: NCT04969679).
Results: In total, 118 patients (EcN, 58; placebo, 60) completed the study. The number of patients reaching the primary endpoint did not differ between the EcN and placebo groups (30 [51.7%] vs. 31 [51.7%]; per-protocol analysis, p = 1.0; intention-to-treat analysis, p = 0.86). However, significantly fewer patients in the EcN group exhibited a decreased IBDQ score (1 [1.7%] vs. 8 [13.3%]; per-protocol analysis, p = 0.03; intention-to-treat analysis, p = 0.02). Moreover, a significantly higher number of patients in the EcN group displayed clinical response at 4 weeks (23 [39.7%] vs. 13 [21.7%], p = 0.04) and endoscopic remission at 8 weeks (26 [46.4%] vs. 16 [27.1%], p = 0.03).
Conclusions: Although the number of patients reaching the primary endpoint did not differ between the EcN and placebo groups, EcN was found to be safe and effective in preventing the exacerbation of IBDQ scores and achieving clinical responses and endoscopic remission in patients with mild-to-moderate UC.

KCI등재 SCOPUS

저자 : Ji Eun Ryu , Myeong Jun Song , Seok-hwan Kim , Jung Hyun Kwon , Sun Hong Yoo , Soon Woo Nam , Hee Chul Nam , Hee Yeon Kim , Chang Wook Kim , Hyun Yang , Si Hyun Bae , Do Seon Song , U Im Chang , Jin Mo

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 37권 5호 발행 연도 : 2022 페이지 : pp. 958-968 (11 pages)

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Background/Aims: To evaluate the effectiveness and safety of direct acting antivirals (DAAs) available in chronic kidney disease (CKD) patients with hepatitis C virus (HCV) infection in Korea.
Methods: In a retrospective, multicenter cohort study, 362 patients were enrolled from 2015 to 2019. The effectiveness and safety of DAAs including glecaprevir/pibrentasvir, sofosubvir/ribavirin, ledipasvir/sofosbuvir, and daclatasvir/asunaprevir were analyzed for patients according to CKD stage. We evaluated sustained virologic response at week 12 after treatment (SVR12) as primary endpoint. The effectiveness and safety were also evaluated according to CKD stage.
Results: Among 362 patients, 307 patients completed DAAs treatment and follow-up period after end of treatment. The subjects comprised 87 patients (62 with CKD stage 3 and 25 with CKD stage (4-5), of whom 22 were undergoing hemodialysis). HCV patients with CKD stage 1 and 2 (estimated glomerular filtration rate [eGFR] ≥ 60 mL/min/1.73 ㎡) showed SVR12 of 97.2% and 95.4% respectively. SVR12 of CKD stage 3 and 4-5 (eGFR < 60 mL/min/1.73 ㎡) patients was 91.9% and 91.6% respectively. Patients undergoing hemodialysis achieved SVR12 (90.9%). Treatment failure of DAAs in stage 1, 2, 3, and 4-5 was 2.8%, 2.7%, 1.6%, and 4%. DAAs showed good safety profile and did not affect deterioration of renal function.
Conclusions: DAAs shows comparable SVR12 and safety in CKD patients (stage 3, 4, and 5) with HCV compared with patients with stage 1 and 2. The effectiveness and safety of DAAs may be related to the treatment duration. Therefore, it is important to select adequate regimens of DAAs and to increase treatment adherence.

KCI등재 SCOPUS

저자 : Ilsoo Kim , Han Hee Lee , Young Jae Ko , Ho Eun Chang , Dae Young Cheung , Bo-in Lee , Young-seok Cho , Jin Il Kim , Myung-gyu Choi

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 37권 5호 발행 연도 : 2022 페이지 : pp. 969-978 (10 pages)

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Background/Aims: Recent epidemiologic studies have shown a continued increase in colorectal cancer incidence among younger adults. Little is known about the factors that contribute to the development of young-onset colorectal neoplasia (CRN).
Methods: A cross-sectional analysis was performed for individuals younger than 40 years who underwent colonoscopy in Seoul St. Mary's Hospital and its affiliated health screening center. High-risk CRN was defined as adenoma or sessile serrated lesion ≥ 10 mm, with three or more adenomas, villous histology, high grade dysplasia, or carcinoma.
Results: Of these 13,621 included participants, 2,023 (14.9%) had one and more CRN. Young patients with CRN tended to be elderly, male, obese, smoker, having a habit of drinking, and having comorbidities such as hypertension, dyslipidemia, diabetes, and chronic kidney disease. In a multivariate analysis adjusted for age, sex, obesity, smoking status, and alcohol intake, old age (odds ratio [OR], 1.086; 95% confidence interval [CI], 1.054 to 1.119), male sex (OR, 1.748; 95% CI, 1.247 to 2.451), obesity (OR, 1.439; 95% CI, 1.133 to 1.828), and smoking (OR, 1.654; 95% CI, 1.287 to 2.127) were independent risk factors for overall CRN. Obesity and smoking as two modifiable factors increased the risk for high-risk CRN even more than for overall CRN (OR, 1.734; 95% CI, 1.168 to 2.575 and OR, 1.797; 95% CI, 1.172 to 2.753, respectively).
Conclusions: Obesity and smoking were modifiable risk factors for CRN in young adults. They increased the risk for high-risk CRN even more than for overall CRN. A colonoscopy might be beneficial for young individuals with these factors.

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