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Gut and Liver update

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수록범위 : 1권1호(2007)~15권4호(2021) |수록논문 수 : 1,369
Gut and Liver
15권4호(2021년 07월) 수록논문
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KCI등재 SCI

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

저자 : Batsaikhan Saruuljavkhlan , Yoshio Yamaoka

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

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KCI등재 SCI

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

저자 : Chang Hun Lee , In Hee Kim

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

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KCI등재 SCI

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 : 대한소화기학회 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)

KCI등재 SCI

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

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

발행기관 : 대한소화기학회 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)

KCI등재 SCI

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 : 대한소화기학회 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)

KCI등재 SCI

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 : 대한소화기학회 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)

KCI등재 SCI

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 : 대한소화기학회 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)

KCI등재 SCI

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 : 대한소화기학회 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 SCI

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 : 대한소화기학회 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 SCI

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 : 대한소화기학회 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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