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대한소화기내시경학회> Gut and Liver> Intraductal Radiofrequency Ablation for Residual Adenoma after Endoscopic Papillectomy: An Additional Treatment Modality Expected to Be Safe and Effective

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Intraductal Radiofrequency Ablation for Residual Adenoma after Endoscopic Papillectomy: An Additional Treatment Modality Expected to Be Safe and Effective

Jae Hee Cho
  • : 대한소화기내시경학회
  • : Gut and Liver 15권2호
  • : 연속간행물
  • : 2021년 03월
  • : 151-152(2pages)

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UCI(KEPA)

간행물정보

  • : 의약학분야  > 내과학
  • : KCI등재
  • : SCI
  • : 격월
  • : 1976-2283
  • :
  • : 학술지
  • : 연속간행물
  • : 2007-2021
  • : 1351


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1Infliximab versus Adalimumab, Which One Is Better for Ulcerative Colitis?

저자 : Eun Soo Kim

발행기관 : 대한소화기내시경학회 간행물 : Gut and Liver 15권 2호 발행 연도 : 2021 페이지 : pp. 149-150 (2 pages)

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3Efficacy and Safety of Peroral Endoscopic Myotomy in Achalasia Patients with Failed Previous Intervention: A Systematic Review and Meta-analysis

저자 : Shali Tan , Chunyu Zhong , Yutang Ren , Xujuan Luo , Jin Xu , Xiangsheng Fu , Yan Peng , Xiaowei Tang

발행기관 : 대한소화기내시경학회 간행물 : Gut and Liver 15권 2호 발행 연도 : 2021 페이지 : pp. 153-167 (15 pages)

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Peroral endoscopic myotomy (POEM) has emerged as a rescue treatment for recurrent or persistent achalasia after failed initial management. Therefore, we aimed to investigate the efficacy and safety of POEM in achalasia patients with failed previous intervention. We searched the MEDLINE, Embase, Cochrane, and PubMed databases using the queries “achalasia,” “peroral endoscopic myotomy,” and related terms in March 2019. Data on technical and clinical success, adverse events, Eckardt score and lower esophageal sphincter (LES) pressure were collected. The pooled event rates, mean differences (MDs) and risk ratios (RR) were calculated. A total of 15 studies with 2,276 achalasia patients were included. Overall, the pooled technical success, clinical success and adverse events rate of rescue POEM were 98.0% (95% confidence interval [CI], 96.6% to 98.8%), 90.8% (95% CI, 88.8% to 92.4%) and 10.3% (95% CI, 6.6% to 15.8%), respectively. Seven studies compared the clinical outcomes of POEM between previous failed treatment and the treatment naïve patients. The RR for technical success, clinical success, and adverse events were 1.00 (95% CI, 0.98 to 1.01), 0.98 (95% CI, 0.92 to 1.04), and 1.17 (95% CI, 0.78 to 1.76), respectively. Overall, there was significant reduction in the pre- and post-Eckardt score (MD, 5.77; p<0.001) and LES pressure (MD, 18.3 mm Hg; p<0.001) for achalasia patients with failed previous intervention after POEM. POEM appears to be a safe, effective and feasible treatment for individuals who have undergone previous failed intervention. It has similar outcomes in previously treated and treatment-naïve achalasia patients. (Gut Liver 2021;15:153-167)

4Evidence-Based Guidelines for the Treatment of Helicobacter pylori Infection in Korea 2020

저자 : Hye-kyung Jung , Seung Joo Kang , Yong Chan Lee , Hyo-joon Yang , Seon-young Park , Cheol Min Shin , Sung Eun Kim , Hyun Chul Lim , Jie-hyun Kim , Su Youn Nam , Woon Geon Shin , Jae Myung Park , Il Ju Choi

발행기관 : 대한소화기내시경학회 간행물 : Gut and Liver 15권 2호 발행 연도 : 2021 페이지 : pp. 168-195 (28 pages)

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Helicobacter pylori infection is one of the most common infectious diseases worldwide. Although the prevalence of H. pylori is gradually decreasing, approximately half of the world's population still becomes infected with this disease. H. pylori is responsible for substantial gastrointestinal morbidity worldwide, with a high disease burden. It is the most common cause of gastric and duodenal ulcers and gastric cancer. Since the revision of the H. pylori clinical practice guidelines in 2013 in Korea, the eradication rate of H. pylori has gradually decreased with the use of a clarithromycin-based triple therapy for 7 days. According to a nationwide randomized controlled study conducted by the Korean College of Helicobacter and Upper Gastrointestinal Research released in 2018, the intention-to-treat eradication rate was only 63.9%, which was mostly due to increased antimicrobial resistance, especially from clarithromycin. The clinical practice guidelines for the treatment of H. pylori were updated according to evidence-based medicine from a meta-analysis conducted on a target group receiving the latest level of eradication therapy. The draft recommendations developed based on the meta-analysis were finalized after an expert consensus on three recommendations regarding the indication for treatment and eight recommendations for the treatment itself. These guidelines were designed to provide clinical evidence for the treatment (including primary care treatment) of H. pylori infection to patients, nurses, medical school students, policymakers, and clinicians. These may differ from current medical insurance standards and will be revised if more evidence emerges in the future. (Gut Liver 2021;15:168-195)

5Endoscopic Ultrasound-Guided Hepaticogastrostomy: Technical Review and Tips to Prevent Adverse Events

저자 : Takeshi Ogura , Kazuhide Higuchi

발행기관 : 대한소화기내시경학회 간행물 : Gut and Liver 15권 2호 발행 연도 : 2021 페이지 : pp. 197-206 (10 pages)

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Most patients who require biliary drainage can be treated by endoscopic retrograde cholangiopancreatography (ERCP)-guided procedures. However, ERCP can be challenging in patients with complications, such as malignant duodenal obstruction, or a surgically-altered anatomy, such as a Roux-en-Y anastomosis, which prevent advancement of the duodenoscope into the ampulla of Vater. Recently, endoscopic ultrasound (EUS)-guided biliary drainage via transhepatic or transduodenal approaches has emerged as an alternative means of biliary drainage. Typically, EUS-guided gallbladder drainage or choledochoduodenostomy can be performed via both approaches, as can EUS-guided hepaticogastrostomy (HGS). EUS-HGS, because of its transgastric approach, can be performed in patients with malignant duodenal obstruction. Technical tips for EUS-HGS have reached maturity due to device and technical developments. Although the technical success rates of EUS-HGS are high, the rate of adverse events is not low, with stent migration still being reported despite many preventive efforts. In this review, we described technical tips for EUS-HGS related to bile duct puncture, guidewire insertion, fistula dilation, and stent deployment, along with a literature review. Additionally, we provided technical tips to improve the technical success of EUS-HGS. (Gut Liver 2021;15:196-205)

6Recent Epidemiology of Nonalcoholic Fatty Liver Disease

저자 : Soumya Murag , Aijaz Ahmed , Donghee Kim

발행기관 : 대한소화기내시경학회 간행물 : Gut and Liver 15권 2호 발행 연도 : 2021 페이지 : pp. 206-216 (11 pages)

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The ongoing obesity epidemic and the increasing recognition of metabolic syndrome have contributed to the growing prevalence of nonalcoholic fatty liver disease (NAFLD), the most common form of liver disease worldwide. It is imperative to understand the incidence and prevalence of NAFLD as it is associated with a profound economic burden of hospitalizations, including the shifting trends in liver transplantation. The long-term cumulative healthcare cost of NAFLD patients has been shown to be 80% higher than that of non-NAFLD patients. We explore diagnostic challenges in identifying those with NAFLD who have a higher predilection to progress to end-stage liver disease. We aim to assess all-cause and cause-specific mortality as it relates to NAFLD. (Gut Liver 2021;15:206-216)

7A Comparative Study on Aqueous Chitosan Solution and Various Submucosal Injection Fluids Using a Three-Dimensional Sensor

저자 : Han Jo Jeon , Seung Jeong , Hyuk Soon Choi , Se Hyun Jang , Sang Hoon Kim , Seung Han Kim , Jae Min Lee , Eun Sun Kim , Bora Keum , Yoon Tae Jeen , Hong Sik Lee , Hoon Jai Chun , Jong Hoon Chung , Seong

발행기관 : 대한소화기내시경학회 간행물 : Gut and Liver 15권 2호 발행 연도 : 2021 페이지 : pp. 217-224 (8 pages)

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Background/Aims: Chitosan, a natural polymer widely used in the biomaterials field, has been proposed as a potential submucosal injection solution. The purpose of this study was to compare the performance and efficacy of aqueous chitosan solution and commercialized submucosal injection fluids using a three-dimensional sensor and to evaluate the efficacy of the measured parameters.
Methods: Normal saline (0.9% NaCl), as a control, Eleview® (Poloxamer 188), Blue EyeTM (0.4% hyaluronic acid), and aqueous chitosan solution (2.0%) were injected into the submucosa of porcine stomachs ex vivo. The mucosal elevation height, elevated surface area, and angle of the tangent of the submucosal fluid cushion were measured using a three-dimensional sensor. The rates of change for each variable were calculated, and the correlation between parameters was analyzed. Tissue specimens were stained with hematoxylin and eosin.
Results: All variables exhibited the highest values under chitosan injection. The mucosal elevation height rate of change differed significantly between normal saline and chitosan solution (p=0.024). The elevated surface area rates of change for normal saline and Eleview® were significantly different from those for TS-905 and chitosan solution (p=0.006 and p=0.009, respectively). Further, height, area, and angle showed a positive correlation (p<0.001). A histological examination revealed an even distribution of aqueous chitosan within the submucosa without tissue damage.
Conclusions: Aqueous chitosan was superior to normal saline and Eleview® and was noninferior to TS-905. A three-dimensional sensor and the measured parameters were effective and useful for evaluating the performance of submucosal fluids. (Gut Liver 2021;15:217-224)

8Clinical Outcomes of Endoscopic Resection for Low-Grade Dysplasia and High-Grade Dysplasia on Gastric Pretreatment Biopsy: Korea ESD Study Group

저자 : Jung Won Jeon , Soo Jin Kim , Jae Young Jang , Sun-moon Kim , Chul-hyun Lim , Jae Myung Park , Su Jin Hong , Chan Gyoo Kim , Seong Woo Jeon , Si Hyung Lee , Jae Kyu Sung , Gwang Ho Baik

발행기관 : 대한소화기내시경학회 간행물 : Gut and Liver 15권 2호 발행 연도 : 2021 페이지 : pp. 225-231 (7 pages)

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Background/Aims: Some cases of gastric low-grade dysplasia (LGD) and high-grade dysplasia (HGD) on forceps biopsy (FB) are diagnosed as gastric cancer (GC) after endoscopic resection (ER). This study aims to evaluate the clinical outcomes of ER for gastric LGD and HGD on pretreatment FB and to identify the factors that predict pathologic upstaging to GC.
Methods: Patients who underwent ER for LGD and HGD on pretreatment FB from March 2005 to February 2018 in 14 hospitals in South Korea were enrolled, and the patients' medical records were reviewed retrospectively.
Results: This study included 2,150 cases of LGD and 1,534 cases of HGD diagnosed by pretreatment FB. In total, 589 of 2,150 LGDs (27.4%) were diagnosed as GC after ER. Helicobacter pylori infection, smoking history, tumor location in the lower third of the stomach, tumor size >10 mm, depressed lesion, and ulceration significantly predicted GC. A total of 1,115 out of 1,534 HGDs (72.7%) were diagnosed with GC after ER. Previous history of GC, H. pylori infection, smoking history, tumor location in the lower third of the stomach, tumor size >10 mm, depressed lesion, and ulceration were significantly associated with GC. As the number of risk factors predicting GC increased in both LGD and HGD on pretreatment FB, the rate of upstaging to GC after ER increased.
Conclusions: A substantial proportion of LGDs and HGDs on pretreatment FB were diagnosed as GC after ER. Accurate ER procedures such as endoscopic submucosal dissection should be recommended in cases of LGD and HGD with factors predicting pathologic upstaging to GC. (Gut Liver 2021;15:225-231)

9Comparison of Long-term Outcomes of Infliximab versus Adalimumab Treatment in Biologic-Naïve Patients with Ulcerative Colitis

저자 : Yong Il Lee , Yehyun Park , Soo Jung Park , Tae Il Kim , Won Ho Kim , Jae Hee Cheon

발행기관 : 대한소화기내시경학회 간행물 : Gut and Liver 15권 2호 발행 연도 : 2021 페이지 : pp. 232-242 (11 pages)

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Background/Aims: The tumor necrosis factor-α inhibitors infliximab and adalimumab are standard treatments for moderate to severe ulcerative colitis (UC). However, there has been no headto- head comparison of treatment efficacy and outcomes between the two agents. The aim of this study was to compare the efficacy and long-term outcomes of infliximab versus adalimumab treatment in biologic-naïve patients with UC.
Methods: We retrospectively analyzed the records of 113 biologic-naïve patients with UC who were treated between September 2012 and December 2017 (the infliximab group [n=83] and the adalimumab group [n=30]). We compared remission and response rates between these groups at 8 and 52 weeks. We used Kaplan-Meier curves to compare long-term outcomes, and logistic regression analysis and Cox-proportional hazard regression models to assess factors affecting outcomes.
Results: The median follow-up duration was 25.8 months. Baseline clinical characteristics were similar between groups. There were no significant differences between the two groups in the rate of clinical remission or clinical response at 8 or 52 weeks. Multivariate analyses also showed that long-term outcomes were not significantly different (adjusted hazard ratio [HR], 1.45; 95% confidence interval [CI], 0.81 to 2.56; p=0.208). An elevated C-reactive protein level (greater than 5 mg/L) was a significant predictive factor for poor outcomes (adjusted HR, 2.25; 95% CI, 1.37 to 3.70; p=0.001). During the follow-up period, the rates of adverse event were not significantly different between the two groups (p=0.441).
Conclusions: In our study, infliximab and adalimumab had similar treatment efficacy and longterm outcomes in biologic-naïve patients with moderate to severe UC. (Gut Liver 2021;15:232- 242)

10Characteristics of the Gut Microbiome of Healthy Young Male Soldiers in South Korea: The Effects of Smoking

저자 : Hyuk Yoon , Dong Ho Lee , Je Hee Lee , Ji Eun Kwon , Cheol Min Shin , Seung-jo Yang , Seung-hwan Park , Ju Huck Lee , Se Won Kang , Jung-sook Lee , Byung-yong Kim

발행기관 : 대한소화기내시경학회 간행물 : Gut and Liver 15권 2호 발행 연도 : 2021 페이지 : pp. 243-252 (10 pages)

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Background/Aims: South Korean soldiers are exposed to similar environmental factors. In this study, we sought to evaluate the gut microbiome of healthy young male soldiers (HYMS) and to identify the primary factors influencing the microbiome composition.
Methods: We prospectively collected stool from 100 HYMS and performed next-generation sequencing of the 16S rRNA genes of fecal bacteria. Clinical data, including data relating to the diet, smoking, drinking, and exercise, were collected.
Results: The relative abundances of the bacterial phyla Firmicutes, Actinobacteria, Bacteroidetes, and Proteobacteria were 72.3%, 14.5%, 8.9%, and 4.0%, respectively. Fifteen species, most of which belonged to Firmicutes (87%), were detected in all examined subjects. Using cluster analysis, we found that the subjects could be divided into the two enterotypes based on the gut microbiome bacterial composition. Compared with enterotype 2 subjects, subjects classified as enterotype 1 tended to be characterized by higher frequencies of potentially harmful lifestyle habits (current smoker: 55.6% vs 36.6%, p=0.222; heavy drinker: 16.7% vs 3.7%, p=0.120; insufficient physical activity: 27.8% vs 14.6%, p=0.318). We identified a significant difference in the microbiome compositions of current and noncurrent smokers (p=0.008); the former differed from the latter mainly in a relatively lower abundance of Bifidobacterium species and a higher abundance of Negativicutes.
Conclusions: A high abundance of Actinobacteria and low abundance of Bacteroidetes were the main features distinguishing the gut microbiomes of HYMS, and current smokers could be differentiated from noncurrent smokers by their lower abundance of Bifidobacterium and higher abundance of Negativicutes. (Gut Liver 2021;15:243-252)

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