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Recent trends in the epidemiology and clinical outcomes of inflammatory bowel disease in South Korea,2010-2018

World Journal of Gastroenterology 2024年第9期30卷 1154-1163页

作者： Seulji kim Hyun Jung Lee Seung Woo Lee Sanghyun Park Seong-Joon Koh Jong Pil Im byeong gwan kim Kyung-Do Han Joo Sung kim Department of Internal Medicine Korea Institute of Radiological and Medical SciencesSeoul 01812South Korea Department of Internal Medicine and Liver Research Institute Seoul National University College of MedicineSeoul 03080South Korea Department of Statistics and Actuarial Science Soongsil UniversitySeoul 06978South Korea

BACKGROUND Inflammatory bowel disease(IBD)was previously regarded as a Western disease;however,its incidence is increasing in the *** epidemiology of IBD in Asia differs significantly from the patterns in the *** To comprehensively investigate the epidemiology of IBD in South Korea,inclu-ding its incidence,prevalence,medication trends,and *** We analyzed claims data from the Health Insurance Review and Assessment Service and Rare and Intractable Diseases(RIDs),operated by the National Health Insurance Service of South *** with IBD were identified based on the International Classification of Diseases,Tenth Revision,and RID diagnostic codes for Crohn’s disease(CD)and ulcerative colitis(UC)from 2010 to *** In total,14498 and 31409 patients were newly diagnosed with CD and UC,respectively,between 2010 and *** annual average incidence of CD was 3.11 cases per 105 person-years,and that of UC was 6.74 cases per 10^(5) *** 2014,the incidence rate of CD has been stable,while that of UC has steadily increased,shifting the peak age group from 50-year-olds in 2010 to 20-year-olds in *** CD and UC prevalence increased consistently over the study period;the use of 5-aminosali-cylates and corticosteroids gradually decreased,while that of immunomodulators and biologics steadily increased in both CD and *** clinical outcomes of IBD,such as hospitalization and surgery,decreased during the study *** The CD incidence has been stable since 2014,but that of UC has increased with a shift to a younger age at peak incidence between 2010 and *** clinical outcomes improved over time,with increased use of immunomodu-lators and biologics.

关键词： Inflammatory bowel disease Crohn’s disease Ulcerative colitis Incidence Prevalence

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Proton pump inhibitors as a risk factor for recurrence of Clostridium-difficile-associated diarrhea

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World Journal of Gastroenterology 2010年第28期16卷 3573-3577页

作者： Ji Won kim Kook Lae Lee Ji Bong Jeong byeong gwan kim Sue Shin Joo Sung kim Hyun Chae Jung In Sung Song Division of Gastroenterology and Hepatology Department of Internal MedicineSeoul National University Boramae Hospital Seoul National University College of Medicine Seoul 156-707South Korea Department of Laboratory Medicine Seoul National University Boramae Hospital Division of Gastroenterology and Hepatology Department of Internal MedicineSeoul National University Hospital Seoul National University College of Medicine Seoul 110-744South Korea

AIM:To investigate the risk factors for Clostridiumdifficile-associated diarrhea(CDAD)recurrence,and its relationship with proton pump inhibitors(PPIs). METHODS:Retrospective data of 125 consecutive hospitalized patients diagnosed with CDAD between January 2006 and December 2007 were collected by medical chart *** data included patient characteristics at baseline,underlying medical disease, antibiotic history before receiving a diagnosis of CDAD, duration of hospital stay,severity of CDAD,concurrenttreatment with PPIs,laboratory parameters,response to CDAD therapy,and recurrence of disease within 90 d of successful *** clinical and laboratory parameters were compared in patients in whom CDAD did or did not recur. RESULTS:Of the 125 patients(mean age,67.6± 13.9 years)that developed CDAD,98(78.4%)did not experience recurrence(non-recurrent group)and 27 (21.6%)experienced one or more recurrences(recurrent group).Prior to the development of CDAD,96% of the 125 patients were prescribed antibiotics,and 56(44.8%)of the patients received *** older than 65 years(P=0.021),feeding via nasogastric tube(NGT)(P=0.045),low serum albumin level(P =0.025),and concurrent use of PPIs(P=0.014) were found to be risk factors for CDAD recurrence by univariate ***,sex,length of hospital stay,duration and type of antibiotics used,severity of disease,leukocyte count and C-reactive protein(CRP) were not associated with risk of CDAD *** multivariate analysis,the important risk factors were advanced age(>65 years,adjusted OR:1.32,95% CI:1.12-3.87,P=0.031),low serum albumin level(< 2.5 g/dL,adjusted OR:1.85,95%CI:1.35-4.91,P= 0.028),and concurrent use of PPIs(adjusted OR:3.48, 95%CI:1.64-7.69,P=0.016). CONCLUSION:Advanced age,serum albumin level< 2.5 g/dL,and concomitant use of PPIs were found to be significant risk factors for CDAD recurrence.

关键词： Clostridium difficile Diarrhea Recurrence Risk factors Proton pump inhibitors

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Survival benefit of concurrent chemoradiotherapy for advanced ampulla of Vater cancer

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World Journal of Clinical Cases 2024年第2期12卷 267-275页

作者： Chae Hwa Kwon Hyung Il Seo Dong Uk kim Sung Yong Han Suk kim Nam Kyung Lee Seung Baek Hong Ji Hyun Ahn Young Mok Park byeong gwan Noh BioMedical Research Institute Pusan National University HospitalBusan 49241South Korea Department of Surgery Pusan National University School of Medicine and Biomedical Research InstitutePusan National University HospitalBusan 49241South Korea Department of Internal Medicine Pusan National University School of Medicine and Biomedical Research InstitutePusan National University HospitalBusan 49241South Korea Department of Radiology Pusan National University School of Medicine and Biomedical Research InstitutePusan National University HospitalBusan 49241South Korea Department of Pathology and Biomedical Research Institute Pusan National University HospitalBusan 49241South Korea

BACKGROUND Currently,there is no standard adjuvant therapy for patients with resected ampulla of Vater(AoV)*** To evaluate the effectiveness of adjuvant concurrent chemoradiotherapy(CCRT)in patients with advanced AoV cancer who underwent curative *** This single-centered,retrospective study included 29 patients with advanced AoV cancer who underwent pancreaticoduodenectomy between 2006 and *** impact of CCRT on advanced AoV cancer was *** The 1-,3-,and 5-yr recurrence-free survival(RFS)rates for patients with advanced AoV cancer were 82.8%,48.3%,and 40.8%,respectively,and the overall survival(OS)rates were 89.7%,62.1%,and 51.7%,***-cular invasion was found to be a significant risk factor for RFS and OS in patients with advanced AoV cancer in the univariate analysis,whereas T stage and lymph node metastasis were significantly associated with OS in the multivariate *** to the patients who did not receive adjuvant CCRT,those who received adjuvant CCRT did not show statistically significant improvements in the RFS and OS,although they had a significantly lower average age and significantly higher platelet-to-lymphocyte *** Adjuvant CCRT did not improve survival outcomes in patients with advanced AoV *** findings contribute to existing knowledge on the effectiveness of CCRT in this patient population and provide important insights for clinical decision-making.

关键词： Advanced ampulla of Vater cancer Adjuvant concurrent chemoradiotherapy Recurrence Survival Vater cancer

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Role of ascites adenosine deaminase in differentiating between tuberculous peritonitis and peritoneal carcinomatosis

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World Journal of Gastroenterology 2012年第22期18卷 2837-2843页

作者： Seung Joo Kang Ji Won kim Jee Hyun Baek Se Hyung kim byeong gwan kim Kook Lae Lee Ji Bong Jeong Yong Jin Jung Joo Sung kim Hyun Chae Jung In Sung Song Department of Internal Medicine and Liver Research Institute Seoul National University College of Medicine Department of Internal Medicine Seoul National University Boramae Hospital Department of Radiology Seoul National University College of Medicine

AIM: To investigate the usefulness of tumor markers and adenosine deaminase in differentiating between tuberculous peritonitis (TBP) and peritoneal carcinoma- tosis (PC). METHODS: A retrospective analysis of data was performed on consecutive patients who underwent perito-neoscopic and abdominal computed tomography (CT) evaluations. Among 75 patients at the Seoul National University Hospital from January 2000 to June 2010 who underwent both tests, 27 patients (36.0%) and 25 patients (33.3%) were diagnosed with TBP and PC, respectively. Diagnosis was confirmed by peritoneoscopic biopsy. RESULTS: Serum c-reactive protein (7.88 ± 6.62 mg/ dL vs 3.12 ± 2.69 mg/dL, P = 0.01), ascites adenosine deaminase (66.76 ± 32.09 IU/L vs 13.89 ± 8.95 IU/L, P < 0.01), ascites lymphocyte proportion (67.77 ± 23.41% vs 48.36 ± 18.78%, P < 0.01), and serumascites albumin gradient (0.72 ± 0.49 g/dL vs 1.05 ± 0.50 g/dL, P = 0.03) were significantly different between the two groups. Among tumor markers, serum and ascites carcinoembryonic antigen, serum carbohydrate antigen 19-9 showed significant difference between two groups. Abdominal CT examinations showed that smooth involvement of the parietal peritoneum was more common in the TBP group (77.8% vs 40.7%) whereas nodular involvement was more common in the PC group (14.8% vs 40.7%, P = 0.04). From receiver operating characteristic (ROC) curves ascites adenosines deaminase (ADA) showed better discriminative capability than tumor markers. An ADA cut-off level of 21 IU/L was found to yield the best results of differential diagnosis; sensitivity, specificity, positive predictive value, and negative predictive value were 92.0%, 85.0%, 88.5% and 89.5%, respectively. CONCLUSION: Besides clinical and radiologic findings, ascitic fluid ADA measurement is helpful in the differential diagnosis of TBP and PC.

关键词：腺苷脱氨酶癌胚抗原腹膜炎腹水结核肿瘤标志物分化 C-反应蛋白

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Fatty liver is an independent risk factor for gallbladder polyps

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World Journal of Gastroenterology 2020年第44期26卷 6979-6992页

作者： Dong-Won Ahn Ji Bong Jeong Jinwoo Kang Su Hwan kim Ji Won kim byeong gwan kim Kook Lae Lee Sohee Oh Soon Ho Yoon Sang Joon Park Doo Hee Lee Department of Internal Medicine Seoul National University College of MedicineSeoul 03080South Korea Department of Internal Medicine Seoul Metropolitan Government Seoul National University Boramae Medical CenterSeoul 07061South Korea Department of Biostatistics Medical Research Collaborating CenterSeoul Metropolitan Government Seoul National University Boramae Medical CenterSeoul 07061South Korea Department of Radiology Seoul National University College of MedicineSeoul National University HospitalSeoul 03080South Korea Department of Research and Development MEDICALIP Co.Ltd.Seoul 03127South Korea

BACKGROUND Gallbladder polyps(GBPs)are known to be associated with obesity and metabolic ***,to date,the relationship between GBPs and abnormal body fat distribution,such as fatty liver,visceral obesity,or sarcopenia,has not yet been *** To evaluate whether GBPs are associated with fatty liver,visceral obesity,or *** We retrospectively reviewed the medical records of subjects who underwent various laboratory tests,body composition measurement with a non-invasive body composition analyzer,and abdominal ultrasonography during health checkups.A total of 1405 subjects with GBPs were compared with 2810 age-and sex-matched *** The mean age of the subjects was 46.8±11.7 years,and 63.8%were *** to multiple logistic regression analysis,the presence of fatty liver[odds ratio(OR)1.413;95%confidence interval(CI)1.218-1.638;P<0.001]was an independent risk factor for GBP,together with low levels of alanine aminotransferase(OR 0.993;95%CI 0.989-0.996;P<0.001).Additionally,fatty liver showed both independent(OR 1.629;95%CI,1.335-1.988;P<0.001)and dosedependent(moderate to severe fatty liver;OR 2.137;95%CI,1.662-2.749;P<0.001)relationship with large GBPs(≥5 mm).The presence of sarcopenia and high visceral fat area were not significantly associated with *** Fatty liver was found to be closely associated with GBPs irrespective of sarcopenia and visceral obesity.

关键词： Gallbladder polyp Fatty liver Sarcopenia Visceral obesity Risk factors Body fat distribution

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Stress and sleep quality in doctors working on-call shifts are associated with functional gastrointestinal disorders

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World Journal of Gastroenterology 2017年第18期23卷 3330-3337页

作者： Soo-Kyung Lim Seung Jin Yoo Dae Lim Koo Chae A Park Han Jun Ryu Yong Jin Jung Ji Bong Jeong byeong gwan kim Kook Lae Lee Seong-Joon Koh Department of Internal Medicine Seoul National University College of MedicineSeoul National University Boramae Hospital Department of Neurology Seoul National University Boramae HospitalSeoul National University College of Medicine

AIM To investigate the role of sleep quality and psychosocial problems as predictors of functional gastrointestinal disorders(FGIDs) in doctors that work 24 hour-on-call *** In this cross-sectional observation study, using the Rome Ⅲ Questionnaire and Pittsburgh Sleep Quality Index(PSQI), we analyzed 170 doctors with 24 houron-call shifts. RESULTS Among the participants that had experienced a 24 hour-on-call shift within the last 6 mo, 48(28.2%) had FGIDs. Overall prevalence of irritable bowel syndrome(IBS) and functional dyspepsia(FD) were 16.5% and 17.1%, respectively, with 5.3% exhibiting both. Sleep scores(PSQI)(8.79 ± 2.71 vs 7.30 ± 3.43, P = 0.008), the presence of serious psychosocial alarm(83.3%vs 56.6%, P = 0.004), and the proportion of doctors who experienced over two months of recent on-call work(81.2% vs 68.9%, P = 0.044) were significantly different between individuals with or without FGIDs. Multivariate analysis revealed that presenting serious psychosocial alarm was an independent risk factor for prevalence of FD(OR = 5.47, 95%CI: 1.06-28.15, P = 0.042) and poor sleep quality(PSQI ≥ 6) was a predictor of IBS(OR = 4.17, 95%CI: 1.92-19.02, P = 0.016). CONCLUSION Physicians should recognize the role of sleep impairment and psychological stress in the development of FGIDs and a comprehensive approach should be considered to manage patients with FGIDs.

关键词： Psychosocial 应力睡觉 24 hour-on-call 移动医生功能的胃肠的混乱

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Restraint stress induces and exacerbates intestinal inflammation in interleukin-10 deficient mice

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World Journal of Gastroenterology 2015年第28期21卷 8580-8587页

作者： Seong-Joon Koh Ji Won kim byeong gwan kim Kook Lae Lee Joo Sung kim Department of Internal Medicine Seoul National University Boramae Hospital Seoul National University College of Medicine Department of Internal Medicine and Liver Research Institute Seoul National University College of Medicine

AIM:To investigate the effects of restraint stress on chronic colitis in interleukin(IL)-10 deficient(IL-10^(-/-))***:The first experiment compared the effect of restraint stress on the development of intestinal inflammation in wild-type and IL-10^(-/-) *** wildtype and IL-10^(-/-) mice were physically restrained in a well-ventilated,50 cm3 conical polypropylene tube for2 h per day for three consecutive *** second experiment was performed to assess the effect of restraint stress on exacerbation of colitis induced by piroxicam in IL-10^(-/-) *** IL-10^(-/-) mice were exposed to restraint stress for 2 h per day for 3consecutive days,and then treated with piroxicam for4 d at a dose of 200 ppm administered in the rodent ***:In the first experiment,none of the wildtype mice with or without restraint stress showed clinical and histopathological abnormality in the ***,IL-10^(-/-) mice exposed to restraint stress exhibited histologically significant intestinal inflammation as compared to those without restraint *** the second experiment,restraint stress significantly reduced body weight and increased the severity of intestinal inflammation assessed by histopathologic grading in IL-10^(-/-) *** IL12p40 mRNA expression was strongly increased in mice exposed to restraint ***:This novel animal model could be useful in future study of psychological stress in the pathogenesis of inflammatory bowel disease.

关键词： Stress Colitis Interleukin-10 Inflammatorybowel disease Mouse model

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Comparison between uncovered and covered self-expandable metal stent placement in malignant duodenal obstruction

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World Journal of Gastroenterology 2015年第5期21卷 1580-1587页

作者： Ji Won kim Ji Bong Jeong Kook Lae Lee byeong gwan kim Dong Won Ahn Jae Kyung Lee Su Hwan kim Department of Internal Medicine Seoul National University Boramae Hospital Seoul National University College of Medicine Seoul 156-707South Korea

AIM:To compare the clinical outcomes of uncovered and covered self-expandable metal stent placements in patients with malignant duodenal ***:A total of 67 patients were retrospectivelyenrolled from January 2003 to June *** patients had symptomatic obstruction characterized by nausea,vomiting,reduced oral intake,and weight *** exclusion criteria included asymptomatic duodenal obstruction,perforation or peritonitis,concomitant small bowel obstruction,or duodenal obstruction caused by benign *** technical and clinical success rate,complication rate,and stent patency were compared according to the placement of uncovered(n = 38) or covered(n = 29) ***:The technical and clinical success rates did not differ between the uncovered and covered stent groups(100% vs 96.6% and 89.5% vs 82.8%).There were no differences in the overall complication rates between the uncovered and covered stent groups(31.6% vs 41.4%).However,stent migration occurred more frequently with covered than uncovered stents [20.7%(6/29) vs 0%(0/38),P < 0.05].Moreover,the overall cumulative median duration of stent patency was longer in uncovered than in covered stents [251 d(95%CI:149.8 d-352.2 d) vs 139 d(95%CI:45.5 d-232.5 d),P < 0.05 by log-rank test] The overall cumulative median survival period was not different between the uncovered stent(70 d) and covered stent groups(60 d).CONCLUSION:Uncovered stents may be preferable in malignant duodenal obstruction because of their greater resistance to stent migration and longer stent patency than covered stents.

关键词： Duodenal obstruction Stents Palliative treatment G

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Highly Elastic,Bioresorbable Polymeric Materials for Stretchable,Transient Electronic Systems

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Nano-Micro Letters 2024年第6期16卷 1-13页

作者： Jeong‑Woong Shin Dong‑Je kim Tae‑Min Jang Won Bae Han Joong Hoon Lee gwan‑Jin Ko Seung Min Yang Kaveti Rajaram Sungkeun Han Heeseok Kang Jun Hyeon Lim Chan‑Hwi Eom Amay J.Bandodkar Hanul Min Suk‑Won Hwang KU‑KIST Graduate School of Converging Science and Technology Korea University145 Anam‑roSeongbuk‑guSeoul 02841Republic of Korea SK Hynix 2091Gyeongchung‑daeroBubal‑eupIcheon‑siGyeonggi‑do 17336Republic of Korea Hanwha Systems Co. Ltd.188Pangyoyeok‑roBundang‑guSeongnam‑siGyeonggi‑do 13524Republic of Korea Department of Electrical and Computer Engineering North Carolina State UniversityRaleighNC 27606USA Center for Advanced Self‑Powered Systems of Integrated Sensors and Technologies(ASSIST) North Carolina State UniversityRaleighNC 27606USA Department of Integrative Energy Engineering Korea University145 Anam‑roSeongbuk‑guSeoul 02841Republic of Korea Biomaterials Research Center Korea Institute of Science and Technology(KIST)5 Hwarang‑ro 14‑gilSeongbuk‑guSeoul 02792Republic of Korea Semiconductor R&D Center Samsung Electronics Co.Ltd.Hwaseong‑siGyeonggi‑do 18448Republic of Korea Center for Advanced Biomolecular Recognition Biomedical Research DivisionKorea Institute of Science and Technology(KIST)Seoul 02792Republic of Korea

Substrates or encapsulants in soft and stretchable formats are key components for transient,bioresorbable electronic systems;however,elastomeric polymers with desired mechanical and biochemical properties are very limited compared to nontransient ***,we introduce a bioresorbable elastomer,poly(glycolide-co-ε-caprolactone)(PGCL),that contains excellent material properties including high elongation-at-break(<1300%),resilience and toughness,and tunable dissolution *** of PGCLs as polymer matrices,in combination with conducing polymers,yields stretchable,conductive composites for degradable interconnects,sensors,and actuators,which can reliably function under external *** of device components with wireless modules demonstrates elastic,transient electronic suture system with on-demand drug delivery for rapid recovery of postsurgical wounds in soft,time-dynamic tissues.

关键词： Biodegradable elastomer Conductive polymer composites Biomedical device Transient electronics

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Long-term outcome in patients with obscure gastrointestinal bleeding after negative capsule endoscopy

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World Journal of Gastroenterology 2013年第10期19卷 1632-1638页

作者： Seong-Joon Koh Jong Pil Im Ji Won kim byeong gwan kim Kook Lae Lee Sang Gyun kim Joo Sung kim Hyun Chae Jung Department of Internal Medicine Seoul National University Boramae HospitalSeoul National University College of MedicineSeoul 110-744South Korea Department of Internal Medicine and Liver Research Institute Seoul National University College of MedicineSeoul 110-744South Korea

AIM:To investigate long-term outcome in obscure gastrointestinal bleeding(OGIB) after negative capsule endoscopy(CE) and identify risk factors for ***:A total of 113 consecutive patients underwent CE for OGIB from May 2003 to June 2010 at Seoul National University ***-five patients(84.1%) with a subsequent follow-up after CE of at least 6 mo were enrolled in this ***-up data were obtained from the patients' medical *** CE images were reviewed by two board-certified gastroenterologists and consensus diagnosis was used in all *** primary outcome measure was the detection of rebleeding after CE,and factors associated with rebleeding were evaluated using multivariate ***:Of the 95 enrolled patients(median age 61 years,range 17-85 years),62 patients(65.3%) were *** median duration of follow-up was 23.7 mo(range 6.0-89.4 mo).Seventy-three patients(76.8%) underwent CE for obscure-overt *** examination of the small bowel was achieved in 77 cases(81.1%).Significant lesions were found in 38 patients(40.0%).The overall rebleeding rate was 28.4%.The rebleeding rate was higher in patients with positive CE(36.8%) than in those with negative CE(22.8%).However,there was no significant difference in cumulative rebleeding rates between the two groups(log rank test;P = 0.205).Anticoagulation after CE examination was an independent risk factor for rebleeding(hazard ratio,5.019;95%CI,1.560-16.145;P = 0.007),regardless of CE ***:Patients with OGIB and negative CE have a potential risk of ***,close observation is required and alternative modalities should be considered in suspicious cases.

关键词： Capsule endoscopy Gastrointestinal hemorrhage Risk factors Prognosis Enteroscopy

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