논문 상세보기

대한내과학회> The Korean Journal of Internal Medicine> Improving the care of inflammatory bowel disease (IBD) patients: perspectives and strategies for IBD center management

KCI등재SCISCOUPUS

Improving the care of inflammatory bowel disease (IBD) patients: perspectives and strategies for IBD center management

Jihye Park , Sinyoung Park , Shin Ae Lee , Soo Jung Park , Jae Hee Cheon
  • : 대한내과학회
  • : The Korean Journal of Internal Medicine 36권5호
  • : 연속간행물
  • : 2021년 09월
  • : 1040-1048(9pages)
The Korean Journal of Internal Medicine

DOI


목차

INTRODUCTION
THE EPIDEMIOLOGY OF IBD IN KOREA
IBD-RELATED CLINICAL TRIALS IN KOREA
IBD CLINICS/CENTERS AND MULTIDISCIPLINARY TREATMENT
TASKS OF IBD CLINICS/CENTERS: THREE MAJOR CATEGORIES
THE ROLE OF IBD NURSES
EFFECTIVE MANAGEMENT OF AN IBD CLINIC/ CENTER
CONCLUSIONS
REFERENCES

키워드 보기


초록 보기

The incidence and prevalence rates of inflammatory bowel disease (IBD) have been increasing in East Asian countries over the past few decades. Accordingly, the general understanding and awareness of IBD among healthcare professionals has increased considerably in this region. This increase is ultimately associated with the evolving focus of IBD clinicians devoted to comprehensive patient care, especially in establishing IBD clinics/centers capable of providing multi-disciplinary counseling. Comprehensive IBD care at IBD clinics/centers usually includes surgical and medication decision-making, transition from pediatric to adult clinics, care of extraintestinal manifestations, care of infectious diseases in patients undergoing immunomodulatory or biologic therapies, and nutritional, psychosocial, socioeconomic, and pharmacological care. Team members com-prise specialists from various departments related to IBD and can be divided into core and ad hoc members. Usually, the scope of work in IBD clinics/centers involves patient care, patient outreach, and system management. Considering the environmental changes in IBD treatment, it is necessary to perform comprehensive IBD patient care in the form of a program based on competencies, rather than simply following the organization of previous IBD centers. The present review summarizes recent trends in IBD patient care and offers perspectives regarding IBD center management.

UCI(KEPA)

간행물정보

  • : 의약학분야  > 내과학
  • : KCI등재
  • : SCI,SCOPUS
  • : 격월
  • : 1226-3303
  • : 2005-6648
  • : 학술지
  • : 연속간행물
  • : 1986-2021
  • : 2626


저작권 안내

한국학술정보㈜의 모든 학술 자료는 각 학회 및 기관과 저작권 계약을 통해 제공하고 있습니다.

이에 본 자료를 상업적 이용, 무단 배포 등 불법적으로 이용할 시에는 저작권법 및 관계법령에 따른 책임을 질 수 있습니다.

36권6호(2021년 11월) 수록논문
최근 권호 논문
| | | |

KCI등재 SCI SCOPUS

1Hepatic sinusoidal obstruction syndrome/veno-occlusive disease after hematopoietic cell transplantation: historical and current consider-ations in Korea

저자 : Jae-ho Yoon , Chul Won Choi , Jong-ho Won

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 36권 6호 발행 연도 : 2021 페이지 : pp. 1261-1280 (20 pages)

다운로드

(기관인증 필요)

초록보기

Hepatic sinusoidal obstruction syndrome/veno-occlusive disease (SOS/VOD) is a rare but severe complication of hematopoietic cell transplantation (HCT) showing high mortality. Multiple risk factors for SOS/VOD were identified, but it is often confused with other hepatic complications due to nonspecific clinical features. Therefore, diagnostic and severity criteria have been re vised several times. The European Society of Blood and Marrow Transplantation suggested a new guideline that excludes the standard duration of development within 21 days, emphasizes late-onset SOS/VOD, and suggests the importance of Doppler ultrasonography. The severity criteria were further subdivided for guidance to begin active treatment using defibrotide which was approved in Korea since 2016. In a phase 3 trial, defibrotide had superior 100-day survival, compared to best available treatments (38.2% vs. 25.0%). Although several studies of SOS/VOD in Korean patients have been performed after the implementation of HCT, most involved small number of pediatric patients. Recently, the Korean Society of Blood and Marrow Transplantation investigated the incidence of SOS/VOD in the Korean population, and several influential studies of adult patients were published. Here, we summarize recent issues regarding the mechanism, diagnosis, severity criteria, prevention, and treatments of SOS/VOD in Korean patients, as well as recent analyses of nationwide incidence.

KCI등재 SCI SCOPUS

2Role of asymptomatic hyperuricemia in the progression of chronic kidney disease and cardiovascular disease

저자 : Yousuf Waheed , Fan Yang , Dong Sun

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 36권 6호 발행 연도 : 2021 페이지 : pp. 1281-1293 (13 pages)

다운로드

(기관인증 필요)

초록보기

Previous research has investigated whether hyperuricemia serves as an independent risk factor for cardiovascular and renal diseases. Hyperuricemia is defined as an abnormally high level of uric acid (UA; i.e., serum urate level > 6.8 mg/dL). Hyperuricemia has been considered a complication of chronic kidney disease (CKD). However, it seems to play a pathogenic role in the progression of renal diseases. There has been increasing focus on the link between hyperuricemia and CKD. The results of randomized controlled trials have implied independent associations between hyperuricemia and the progression of cardiovascular and renal morbidities. These associations may be mediated by renin-angiotensin system activation, nitric oxide synthase inhibition, and macrovascular/microvascular disease development. There remains controversy regarding the use of serum UA level as an indirect index of renal vascular disease. This literature review focuses on the role of asymptomatic hyperuricemia in the progression of CKD, as well as the association between hyperuricemia and cardiovascular disease. It also provides a general overview of the physiological metabolism of UA.

KCI등재 SCI SCOPUS

3Recent advances in airway imaging using micro-computed tomography and computed tomography for chronic obstructive pulmonary disease

저자 : Naoya Tanabe , Toyohiro Hirai

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 36권 6호 발행 연도 : 2021 페이지 : pp. 1294-1304 (11 pages)

다운로드

(기관인증 필요)

초록보기

Chronic obstructive pulmonary disease (COPD) is a complex lung disease characterized by a combination of airway disease and emphysema. Emphysema is classified as centrilobular emphysema (CLE), paraseptal emphysema (PSE), or panlobular emphysema (PLE), and airway disease extends from the respiratory, terminal, and preterminal bronchioles to the central segmental airways. Although clinical computed tomography (CT) cannot be used to visualize the small airways, micro-CT has shown that terminal bronchiole disease is more severe in CLE than in PSE and PLE, and micro-CT findings suggest that the loss and luminal narrowing of terminal bronchioles is an early pathological change in CLE. Furthermore, the introduction of ultra-high-resolution CT has enabled direct evaluation of the proximal small (1 to 2-mm diameter) airways, and new CT analytical methods have enabled estimation of small airway disease and prediction of future COPD onset and lung function decline in smokers with and without COPD. This review discusses the literature on micro-CT and the technical advancements in clinical CT analysis for COPD. Hopefully, novel micro-CT findings will improve our understanding of the distinct pathogeneses of the emphysema subtypes to enable exploration of new therapeutic targets, and sophisticated CT imaging methods will be integrated into clinical practice to achieve more personalized management.

KCI등재 SCI SCOPUS

4Eosinophilic endotype of chronic obstructive pulmonary disease: similarities and differences from asthma

저자 : Andrew Li , Hiang Ping Chan , Phyllis X.L. Gan , Mei Fong Liew , W.S. Fred Wong , Hui-Fang Lim

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 36권 6호 발행 연도 : 2021 페이지 : pp. 1305-1319 (15 pages)

다운로드

(기관인증 필요)

초록보기

Approximately 25% to 40% of patients with chronic obstructive pulmonary disease (COPD) have the eosinophilic endotype. It is important to identify this group accurately because they are more symptomatic and are at increased risk for exacerbations and accelerated decline in forced expiratory volume in the 1st second. Importantly, this endotype is a marker of treatment responsiveness to inhaled corticosteroid (ICS), resulting in decreased mortality risk. In this review, we highlight differences in the biology of eosinophils in COPD compared to asthma and the different definitions of the COPD eosinophilic endotype based on sputum and blood eosinophil count (BEC) with the corresponding limitations. Although BEC is useful as a biomarker for eosinophilic COPD endotype, optimal BEC cut- offs can be combined with clinical characteristics to improve its sensitivity and specificity. A targeted approach comprising airway eosinophilia and appropriate clinical and physiological features may improve identification of subgroups of patients who would benefit from biologic therapy or early use of ICS for disease modification.

KCI등재 SCI SCOPUS

5Optimizing glucose control for diabetic patients undergoing percutaneous coronary intervention

저자 : Haseong Chang , Sung-Hea Kim

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 36권 6호 발행 연도 : 2021 페이지 : pp. 1320-1322 (3 pages)

다운로드

(기관인증 필요)

키워드 보기
초록보기

KCI등재 SCI SCOPUS

6Is the anti-centromere antibody a marker for a distinct subset of polyautoimmunity in Sjögren's syndrome?

저자 : Yun Jong Lee

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 36권 6호 발행 연도 : 2021 페이지 : pp. 1323-1326 (4 pages)

다운로드

(기관인증 필요)

키워드 보기
초록보기

KCI등재 SCI SCOPUS

7HER-2 positivity is a high risk of recurrence of stage I gastric cancer

저자 : Seonhoo Kim , Yeon-ji Kim , Woo Chul Chung

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 36권 6호 발행 연도 : 2021 페이지 : pp. 1327-1338 (12 pages)

다운로드

(기관인증 필요)

초록보기

Background/Aims: The treatment of gastric cancer remains unsatisfactory. We aimed to investigate the prognostic value of immunohistochemical staining in gastric cancer.
Methods: We analyzed 505 (279 early staged, 226 advanced-staged) gastric cancer tissues from patients who underwent radical gastric resection between January 2014 and December 2016. Available surgical specimens immunohistochemically stained for p53, epidermal growth factor receptor (EGFR), human EGFR 2 (HER-2), E-cadherin, and Ki-67 were reviewed. We evaluated the association between positivity to various biomarkers and disease recurrence, disease-free survival, lymph node metastasis, and microscopic lymphovascular invasion.
Results: The median follow-up duration was 32.5 months (range, 7 to 70). Advanced gastric cancer cases showed high Ki-67 expression; other cases showed un-remarkable expression. Concerning disease recurrence, lymphatic invasion, and disease-free interval, all biomarkers had no prognostic effects. HER-2-positive stage I gastric cancer tended to occur in old patients and in the upper one-third of the stomach (p = 0.01). HER-2 positivity was significantly correlated with disease recurrence (p = 0.01), lymphatic invasion (p = 0.03), and vascular invasion (p = 0.03) in stage I cases.
Conclusions: Only HER-2 was associated with the recurrence of stage I gastric cancer. HER-2-positive stage I gastric cancer requires additional therapy despite curative resection.

KCI등재 SCI SCOPUS

8Longstanding postoperative fluid collection influences recurrence of pancreatic malignancy

저자 : Young Jung Kim , Young Koog Cheon , Tae Yoon Lee , Seong-Hwan Chang , Mi-Hye Yu

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 36권 6호 발행 연도 : 2021 페이지 : pp. 1338-1346 (9 pages)

다운로드

(기관인증 필요)

초록보기

Background/Aims: Postoperative abdominal fluid collection (PAFC) is a frequent complication of pancreatobiliary cancer surgery. The effects of the existence and duration of PAFC are not well known. This study aimed to assess the effects of PAFC on patient prognosis after surgery for pancreatobiliary adenocarcinoma and the association of longstanding PAFC with the recurrence of pancreatic cancer.
Methods: We retrospectively analyzed the data of 194 consecutive patients with pancreatobiliary adenocarcinoma who underwent curative operations from August 2005 to December 2019. The presence of PAFC was assessed using computed tomography within a week of surgery; PAFC lasting > 4 weeks was defined as longstanding PAFC.
Results: Among 194 patients, PAFC occurred in 165 (85.1%), and 74 of these had longstanding PAFC. The recurrence rate of pancreatobiliary adenocarcinoma was significantly higher in patients with longstanding PAFC than in patients with non-longstanding PAFC (p = 0.025). Recurrence was also significantly associated with high T stage (T3, T4; p = 0.040), lymph node involvement (p < 0.001), perineural invasion (p < 0.006), and non-receipt of adjuvant chemotherapy (p = 0.025). Longstanding PAFC was significantly associated with the recurrence of pancreatic adenocarcinoma (p = 0.016). However, cancer-specific survival was related to neither the presence nor the duration of PAFC.
Conclusions: The presence of longstanding PAFC was associated with the recurrence of pancreatic adenocarcinoma. However, a larger prospective study is necessary to confirm the findings.

KCI등재 SCI SCOPUS

9Impact of non-hepatic hyperammonemia on mortality in intensive care unit patients: a retrospective cohort study

저자 : Jae Heon Kim , Hankyu Jeon , Sang Soo Lee , I Re Heo , Jung Woo Choi , Hee Jin Kim , Ra Ri Cha , Jae Min Lee , Hyun Jin Kim

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 36권 6호 발행 연도 : 2021 페이지 : pp. 1347-1362 (16 pages)

다운로드

(기관인증 필요)

초록보기

Background/Aims: The effect of hyperammonemia on the mortality in patients with liver cirrhosis is well documented. However, little is known about the impact of hyperammonemia on mortality among intensive care unit patients without hepatic disease. We aimed to investigate factors associated with non-hepatic hyperammonemia among intensive care unit patients and to evaluate the factors related to the 7- and 90-day mortality.
Methods: Between February 2016 and February 2020, 948 patients without hepatic disease who had 972 episodes of admission to the intensive care unit were retrospectively enrolled and classified as hyperammonemia grades 0 (≤ 80 μg/dL; 585 [60.2%]), 1 (≤ 160 μg/dL; 291 [29.9%]), 2 (≤ 240 μg/dL; 55 [5.7%]), and 3 (> 240 μg/dL; 41 [4.2%]). Factors associated with hyperammonemia and the 7- and 90-day mortality were evaluated by multivariate logistic regression analysis and Cox regression analysis, respectively. Kaplan-Meier survival curves for the 7- and 90-day mortality were constructed.
Results: The independent risk factors for hyperammonemia were male sex (odds ratio, 1.517), age (0.984/year), acute brain failure (2.467), acute kidney injury (1.437), prothrombin time-international normalized ratio (2.272/unit), and albumin (0.694/g/dL). The 90-day mortality rate in the entire cohort was 24.3% and gradually increased with increasing hyperammonemia grade at admission (17.9%, 28.2%, 43.6%, and 61.0% in patients with grades 0, 1, 2, and 3, respectively). Additionally, non-hepatic hyperammonemia was an independent predictor of the 90- day mortality in intensive care unit patients.
Conclusions: Non-hepatic hyperammonemia is common (39.8%) and associated with the 90-day mortality among intensive care unit patients.

KCI등재 SCI SCOPUS

10Clinical analysis of 117 cases with synchronous multiple primary esophageal squamous cell carcinomas

저자 : Zhiqin Chen , Sihan Li , Zheng He , Guang Li

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 36권 6호 발행 연도 : 2021 페이지 : pp. 1356-1364 (9 pages)

다운로드

(기관인증 필요)

초록보기

Background/Aims: We aimed to study the clinical characteristics, treatment modality, and the prognosis of synchronous multiple primary esophageal squamous cell carcinomas (SMPESCC).
Methods: A total of 117 SMPESCC cases were evaluated retrospectively from 2010 to 2015.
Results: The most common locations of SMPESCC were mid- and lower thoracic segments (n = 208, 84.9%). The 1-, 2-, and 3-year overall survival rates were 53.8%, 30.8%, and 15.4%, respectively; the median survival time (MST) was 12.5 months. With definitive radiotherapy and surgery, respectively, the MST of stage I/II patients were 34.2 and 26.7 months, of stage III patients were 8.3 and 13.2 months (p = 0.163), and of stage IV patients were and 8 and 12.6 months (p = 0.379). Clinical stage, family history of cancer, and Karnofsky performance status were independent prognostic factors for the whole cohort by Cox multivariate regression analysis (hazard ratio [HR] = 0.859, p < 0.001; HR = 0.579, p = 0.032; and HR = 0.586, p = 0.013).
Conclusions: Although the prognosis of SMPESCC is poor, stage I/II patients can achieve long-term survival with aggressive treatment, especially those with a Karnofsky performance score 90 or higher and who have no family history of cancer. Definitive radiotherapy could achieve a similar survival rate to definitive surgery at different clinical stages.

123
권호별 보기
같은 권호 다른 논문
| | | | 다운로드

KCI등재SCISCOUPUS

1Strategies for successful implementation and permanent maintenance of a rapid response system

저자 : Myung Jin Song , Yeon Joo Lee

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 36권 5호 발행 연도 : 2021 페이지 : pp. 1031-1039 (9 pages)

다운로드

(기관인증 필요)

초록보기

Rapid response systems (RRSs) have been introduced to intervene with patients experiencing non-code medical emergencies and operate widely around the world. An RRS has four components: an afferent limb, an efferent limb, quality improvement, and administration. A proper triggering system, a hospital culture that embraces the RRS from the afferent limb, experienced primary responders, and dedicated physicians from the efferent limb are key for successful implementation. After initial implementation, quality improvement through objective outcome measures and self-evaluation are crucial, which lead to a better outcome when this process is well performed. Furthermore, better outcomes lead to more investment, which is essential for effective development of the system. The RRS is successfully maintained when these four components are closely interconnected.

KCI등재SCISCOUPUS

2Improving the care of inflammatory bowel disease (IBD) patients: perspectives and strategies for IBD center management

저자 : Jihye Park , Sinyoung Park , Shin Ae Lee , Soo Jung Park , Jae Hee Cheon

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 36권 5호 발행 연도 : 2021 페이지 : pp. 1040-1048 (9 pages)

다운로드

(기관인증 필요)

초록보기

The incidence and prevalence rates of inflammatory bowel disease (IBD) have been increasing in East Asian countries over the past few decades. Accordingly, the general understanding and awareness of IBD among healthcare professionals has increased considerably in this region. This increase is ultimately associated with the evolving focus of IBD clinicians devoted to comprehensive patient care, especially in establishing IBD clinics/centers capable of providing multi-disciplinary counseling. Comprehensive IBD care at IBD clinics/centers usually includes surgical and medication decision-making, transition from pediatric to adult clinics, care of extraintestinal manifestations, care of infectious diseases in patients undergoing immunomodulatory or biologic therapies, and nutritional, psychosocial, socioeconomic, and pharmacological care. Team members com-prise specialists from various departments related to IBD and can be divided into core and ad hoc members. Usually, the scope of work in IBD clinics/centers involves patient care, patient outreach, and system management. Considering the environmental changes in IBD treatment, it is necessary to perform comprehensive IBD patient care in the form of a program based on competencies, rather than simply following the organization of previous IBD centers. The present review summarizes recent trends in IBD patient care and offers perspectives regarding IBD center management.

KCI등재SCISCOUPUS

3Young-onset type 2 diabetes in South Korea: a review of the current status and unmet need

저자 : Ye Seul Yang , Kyungdo Han , Tae Seo Sohn , Nam Hoon Kim

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 36권 5호 발행 연도 : 2021 페이지 : pp. 1049-1058 (10 pages)

다운로드

(기관인증 필요)

초록보기

The prevalence of young-onset (diagnosis at age < 40 years) type 2 diabetes mellitus (T2DM) is increasing globally. Young-onset T2DM has a common pathophysiology of glucose dysregulation as in late-onset T2DM. However, it presents a greater association with obesity and a more rapid decline in β-cell function than late-onset T2DM. Accumulating evidence indicates that disease progression in young-onset T2DM is rapid, resulting in early and frequent development of microvascular and macrovascular complications, as well as premature death. Improper management and low adherence to medical therapy are important issues in young-onset T2DM. This review discusses the epidemiology, disease entity, and clinical issues associated with young-onset T2DM. We also present the prevalence and clinical characteristics of patients with young-onset T2DM in South Korea.

KCI등재SCISCOUPUS

4Development of a Korean-specific cardiovascular risk model in a cohort at high-risk of hypertension

저자 : Il Suk Sohn

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 36권 5호 발행 연도 : 2021 페이지 : pp. 1059-1060 (2 pages)

다운로드

(기관인증 필요)

키워드 보기
초록보기

KCI등재SCISCOUPUS

5Nosocomial exposure to tuberculosis: a snapshot of South Korea

저자 : Hayoung Choi

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 36권 5호 발행 연도 : 2021 페이지 : pp. 1061-1062 (2 pages)

다운로드

(기관인증 필요)

키워드 보기
초록보기

KCI등재SCISCOUPUS

6Second-look endoscopy findings after endoscopic submucosal dissection for colorectal epithelial neoplasms

저자 : Soo-kyung Park , Hyeon Jeong Goong , Bong Min Ko , Haewon Kim , Hyo Sun Seok , Moon Sung Lee

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 36권 5호 발행 연도 : 2021 페이지 : pp. 1063-1074 (12 pages)

다운로드

(기관인증 필요)

초록보기

Background/Aims: Although second-look endoscopy (SLE) is frequently performed after gastric endoscopic submucosal dissection (ESD) to prevent bleeding, no studies have reported SLE findings after colorectal ESD. This study aimed to investigate SLE findings and their role in preventing delayed bleeding after colorectal ESD.
Methods: Post-ESD ulcer appearances were divided into coagulation (with or without remnant minor vessels) and clip closure groups. SLE findings were categorized according to the Forrest classification (high-risk ulcer stigma [type I and IIa] and low-risk ulcer stigma [type IIb, IIc, III, or clip closure]), and risk factors for high-risk ulcer stigma were analyzed.
Results: Among the 375 cases investigated, SLEs were performed in 171 (45.6%) patients. The incidences of high-risk ulcer stigma and low-risk stigma were 5.3% (9/171) and 94.7% (162/171), respectively. During SLE, endoscopic hemostasis was performed more frequently in the high-risk ulcer stigma group than in the low- risk ulcer stigma group (44.4% [4/9] vs. 1.9% [3/162], respectively; p < 0.001), but most of the endoscopic hemostasis in the high-risk ulcer stigma group (3/4, 75.0%) were prophylactic hemostasis. Post-ESD delayed bleeding occurred in three (0.8%) patients belonging to the SLE group, of which, one patient was from the high-risk stigma group and two were from the low-risk stigma group.
Conclusions: The incidence of high-risk ulcer stigma during SLE was low, and delayed bleeding occurred in, both, high-risk and low-risk groups of SLE. SLEs performed after colorectal ESD may not be effective in preventing delayed bleeding, and further prospective studies are needed to evaluate the efficacy of SLE in post-colorectal ESD.

KCI등재SCISCOUPUS

7Risk stratification of patients with gastric lesions indefinite for dysplasia

저자 : Young Sin Cho , Il-kwun Chung , Yunho Jung , Su Jung Han , Jae Kook Yang , Tae Hoon Lee , Sang-heum Park , Sun-joo Kim

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 36권 5호 발행 연도 : 2021 페이지 : pp. 1074-1082 (9 pages)

다운로드

(기관인증 필요)

초록보기

Background/Aims: There are no definite guidelines for the management of gastric lesions diagnosed as indefinite for dysplasia (IND) by endoscopic forceps biopsy (EFB). Therefore, this study aimed to evaluate the clinical outcomes of gastric IND and predictive factors for gastric neoplasm.
Methods: This study included 457 patients with a first diagnosis of gastric IND by EFB between January 2005 and December 2013. Patient characteristics and endoscopic and pathological data were reviewed and compared.
Results: Of the 457 gastric IND patients, 128 (28%) were diagnosed with invasive carcinoma, 21 (4.6%) with high-grade dysplasia, 31 (6.8%) with low-grade dysplasia, and 277 (60.6%) as negative for dysplasia. Of lesions observed, 180 (39.4%) showed upgraded histology. Multivariate analysis revealed that surface erythema (odds ratio [OR], 2.804; 95% confidence interval [CI], 1.741 to 4.516), spontaneous bleeding (OR, 2.618; 95% CI, 1.298 to 5.279), lesion size ≥ 1 cm (OR, 5.762; 95% CI, 3.459 to 9.597), and depressed morphology (OR, 2.183; 95% CI, 1.155 to 4.124) were significant risk factors for high-grade dysplasia or adenocarcinoma. The ORs associated with 2 and ≥ 3 risk factors were 7.131 and 34.86, respectively.
Conclusions: Precautions should be taken in the management of gastric IND patients, especially when risk factors, including surface erythema, spontaneous bleeding, lesion size ≥ 1 cm, and depressed morphology are present. Considering the combined effect of the presence of multiple risk factors on the incidence of high-grade dysplasia or adenocarcinoma, endoscopic resection should be recommended if a gastric IND patient has at two or more of these factors.

KCI등재SCISCOUPUS

8Risk of colorectal cancer in patients with positive results of fecal immunochemical test performed within 5 years since the last colonoscopy

저자 : Yoon Suk Jung , Jinhee Lee , Chang Mo Moon

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 36권 5호 발행 연도 : 2021 페이지 : pp. 1083-1091 (9 pages)

다운로드

(기관인증 필요)

초록보기

Background/Aims: Annual fecal immunochemical tests (FITs) are often repeated within the recommended colonoscopy surveillance intervals. However, it remains unclear whether interval FITs are useful. To answer this question, we assessed the risk of colorectal cancer (CRC) according to the interval from the last colonoscopy to an FIT.
Methods: Using the Korean National Cancer Screening Program database, we collected data on patients who underwent FITs in 2011. Patients with positive FIT results were classified into three groups according to their previous colonoscopy interval: 0.5 to 5 years (group 1), 5 to 10 years (group 2), and ≥ 10 years or no colonoscopy (group 3). CRC incidence was defined as CRC diagnosed within 1 year after an FIT.
Results: Among 177,660 patients with positive FIT results, the incidence of CRC in groups 1, 2, and 3 was 0.72% (n = 214/29,575), 1.28% (n = 116/9,083), and 3.88% (n = 5,387/139,002), respectively. The age- and sex-adjusted risk for CRC was higher in groups 2 (odds ratio [OR], 1.79; 95% confidence interval [CI], 1.43 to 2.25) and 3 (OR, 5.56; 95% CI, 4.85 to 6.38) than in group 1. Among patients who did and did not undergo a polypectomy during the previous colonoscopy, those in group 2 had a higher rate of CRC than those in group 1 (without polypectomy: 1.15% vs. 0.63%; OR, 1.79; 95% CI, 1.37 to 2.34) (with polypectomy: 2.37% vs. 0.93 %; OR, 2.30; 95% CI, 1.44 to 3.69).
Conclusion: In patients with positive FIT results who had undergone a colonoscopy within the past 5 years, the risk of CRC is very low, regardless of whether a polypectomy was performed, suggesting that interval FITs are not useful.

KCI등재SCISCOUPUS

9Impact of liver cirrhosis on the clinical outcomes of patients with COVID-19: a nationwide cohort study of Korea

저자 : Dongsub Jeon , Minkook Son , Jonggi Choi

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 36권 5호 발행 연도 : 2021 페이지 : pp. 1092-1104 (13 pages)

다운로드

(기관인증 필요)

초록보기

Background/Aims: The impact of liver cirrhosis (LC) on the clinical outcomes of patients with coronavirus disease 2019 (COVID-19) remains elusive. This study evaluated the association between LC and the development of severe complications from COVID-19.
Methods: We used the National Health Insurance claims data of Korea. We included 234,427 patients older than 19 years who tested for severe acute respiratory syndrome coronavirus 2. Patients with LC who were infected with COVID-19 (n = 67, LC+ COVID+) were matched with those with cirrhosis only (n = 332, LC+ COVID-) and those with COVID-19 only (n = 333, LC- COVID+) using a propensity score in a 1:5 ratio. The primary outcome was the development of severe complications.
Results: Of the matched patients, the mean age was 60 years and 59.7% were male. Severe complications occurred in 18, 54, and 60 patients in the LC+ COVID+, LC+ COVID-, and LC- COVID+ groups, respectively. After adjusting for comorbidities, there was no significant difference in the risk of developing severe complications from COVID-19 between the LC+ COVID+ and LC- COVID+ groups but significant difference exists between the LC+ COVID+ and LC+ COVID-. Older age, hypertension, cancer, chronic obstructive pulmonary disease, and a higher Charlson comorbidity index were associated with a higher risk of severe complications in patients with cirrhosis and COVID-19.
Conclusions: Our study suggests that LC was not independently associated with the development of severe complications, including mortality, in patients with COVID-19. Our results need to be evaluated through a large, prospective study.

KCI등재SCISCOUPUS

10Clinical features and predictors of masked uncon-trolled hypertension from the Korean Ambulatory Blood Pressure Monitoring Registry

저자 : Hyun-jin Kim , Jeong-hun Shin , Yonggu Lee , Ju Han Kim , Sun Ho Hwang , Woo Shik Kim , Sungha Park , Sang Jae Rhee , Eun Mi Lee , Sang Hyun Ihm , Wook Bum Pyun , Jinho Shin

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 36권 5호 발행 연도 : 2021 페이지 : pp. 1102-1119 (18 pages)

다운로드

(기관인증 필요)

초록보기

Background/Aims: The clinical characteristics of patients with masked uncontrolled hypertension (MUCH) have been poorly defined, and few studies have investigated the clinical predictors of MUCH. We investigated the demographic, clinical, and blood pressure (BP) characteristics of patients with MUCH and pro-posed a prediction model for MUCH in patients with hypertension.
Methods: We analyzed 1,986 subjects who were enrolled in the Korean Ambulatory Blood Pressure Monitoring (Kor-ABP) Registry and taking antihypertensive drugs, and classified them into the controlled hypertension (n = 465) and MUCH (n = 389) groups. MUCH was defined as the presence of a 24-hour ambulatory mean systolic BP ≥ 130 mmHg and/or diastolic BP ≥ 80 mmHg in patients treated with antihypertensive drugs, having normal office BP.
Results: Patients in the MUCH group had significantly worse metabolic profiles and higher office BP, and took significantly fewer antihypertensive drugs com-pared to those in the controlled hypertension group. Multivariate logistic regression analyses identified high office systolic BP and diastolic BP, prior stroke, dyslipidemia, left ventricular hypertrophy (LVH, ≥ 116 g/㎡ for men, and ≥ 96 g/㎡ for women), high heart rate (≥ 75 beats/min), and single antihypertensive drug use as independent predictors of MUCH. A prediction model using these predictors showed a high diagnostic accuracy (C-index of 0.839) and goodness-of-fit for the presence of MUCH.
Conclusions: MUCH is associated with a high-normal increase in office BP and underuse of antihypertensive drugs, as well as dyslipidemia, prior stroke, and LVH, which could underscore achieving optimal BP control. The proposed model accurately predicts MUCH in patients with controlled office BP.

123
발행기관 최신논문
자료제공: 네이버학술정보
발행기관 최신논문
자료제공: 네이버학술정보

내가 찾은 최근 검색어

최근 열람 자료

맞춤 논문

보관함

내 보관함
공유한 보관함

1:1문의

닫기