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Two-year delay in ulcerative colitis diagnosis is associated with anti-tumor necrosis factor alpha use

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World Journal of Gastroenterology 2019年第8期25卷 989-1001页

作者： Ho Suk Kang ja-seol Koo Kang Moon Lee Dae-Bum Kim Ji Min Lee Yoon jae Kim Hyuk Yoon Hyun Joo jang Department of Internal Medicine Hallym Sacred Heart HospitalHallym University College of MedicineAnyang 14068South Korea Division of Gastroenterology and Hepatology Department of Internal MedicineKorea University Ansan HospitalDepartment of Internal MedicineKorea University College of MedicineAnsan 15355South Korea Department of Internal Medicine The Catholic University of KoreaSt.Vincent’s HospitalSuwon 16247South Korea Department of Gastroenterology Gachon Graduate School of Medicine Gil Medical CenterIncheon 21565South Korea Department of Internal Medicine Seoul National University Bundang HospitalSeongnam 13620South Korea Division of Gastroenterology Department of Internal MedicineDongtan Sacred Heart HospitalHallym University College of MedicineHwaseong 18450South Korea

BACKGROUND Ulcerative colitis(UC)is an uncommon inflammatory bowel disease(IBD).However,its incidence has recently increased in South ***,UC diagnoses are frequently delayed,and the relationship between diagnostic delay and UC prognosis has not been extensively studied in South Korean *** To identify meaningful diagnostic delay affecting UC prognosis and to evaluate risk factors associated with diagnostic delay in South Korean *** Medical records of 718 patients with UC who visited the outpatient clinic of six university hospitals in South Korea were reviewed;167 cases were excluded because the first symptom date was *** evaluated the relationship between the prognosis and a diagnostic delay of 3,6,12,18,and 24 mo by comparing the prognostic factors[anti-tumor necrosis factor(TNF)-αuse,admission history due to acute flare-ups,frequent admission due to flare-ups,surgery associated with UC,and the clinical remission state at the latest followup]at each diagnostic *** The mean diagnostic interval was 223.3±483.2 d(median,69 d;75th percentile,195 d).Among the prognostic factors,anti-TNFαuse was significantly increased after a diagnostic delay of 24 *** risk factors predictive of a 24-mo diagnostic delay were age24 mo was associated with increased anti-TNFα***<60 years at diagnosis,smoking history,and misdiagnosis of hemorrhoids were risk factors for delayed diagnosis.

关键词： Ulcerative colitis Diagnostic delay Anti-tumor necrosis factor alpha Smoking

Diagnostic delay in inflammatory bowel disease increases the risk of intestinal surgery

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World Journal of Gastroenterology 2017年第35期23卷 6474-6481页

作者： Dong-won Lee ja seol Koo Jung Wan Choe Sang Jun Suh Seung Young Kim Jong Jin Hyun Sung Woo Jung Young Kul Jung Hyung Joon Yim Sang Woo Lee Division of Gastroenterology and Hepatology Department of Internal MedicineKorea University Ansan Hospital

AIM To investigate the factors affecting diagnostic delay and outcomes of diagnostic delay in inflammatory bowel disease(IBD) METHODS We retrospectively studied 165 patients with Crohn's disease(CD) and 130 patients with ulcerative colitis(UC) who were diagnosed and had follow up durations > 6 mo at Korea University Ansan Hospital from january 2000 to December 2015. A diagnostic delay was defined as the time interval between the first symptom onset and IBD diagnosis in which the 76^(th) to 100^(th) percentiles of patients were *** The median diagnostic time interval was 6.2 and 2.4 mo in the patients with CD and UC, respectively. Among the initial symptoms, perianal discomfort before diagnosis(OR = 10.2, 95%CI: 1.93-54.3, P = 0.006) was associated with diagnostic delays in patients with CD; however, no clinical factor was associated with diagnostic delays in patients with UC. Diagnostic delays, stricturing type, and penetrating type were associated with increased intestinal surgery risks in CD(OR = 2.54, 95%CI: 1.06-6.09; OR = 4.44, 95%CI: 1.67-11.8; OR = 3.79, 95%CI: 1.14-12.6, respectively). In UC, a diagnostic delay was the only factor associated increased intestinal surgery risks(OR = 6.81, 95%CI: 1.12-41.4).CONCLUSION A diagnostic delay was associated with poor outcomes, such as increased intestinal surgery risks in patients with CD and UC.

关键词： Diagnostic delay Intestinal surgery Inflammatory bowel disease Crohn’s disease Ulcerative colitis

Bilateral primary breast lymphoma

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Chinese Medical Journal 2010年第11期123卷 1482-1484页

作者： Jung Im Yi Byung Joo Chae ja Seong Bae Bong Joo Kang Ahwon Lee Byung Joo Song Sang seol Jung Departments of Surgery Catholic University of Korea Seoul Korea Department of Radiology Catholic University of Korea Seoul Korea Department of Pathology Catholic University of Korea Seoul Korea

Pprimary breast lymphoma （PBL） is rare, accounting for 0.04%-0.50% of breast malignancies and 1.7% of extranodal lymphoma The originally descnibect diagnostic criteria for PBL2 remains the standard definition for this disease. These criteria are breast location as the clinical site of presentation, absence of history of previous lymphoma or evidence of widespread disease at diagnosis, close association of lymphoma with breast tissue in pathologic specimens, and involvement of ipsilateral lymph nodes if they develop simultaneously with PBL.

关键词： breast lymphoma treatment

Development of enterohepatic fistula after embolization in ileal gastrointestinal stromal tumor: A case report

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World Journal of Gastroenterology 2013年第43期19卷 7816-7819页

作者： Yun Ho Lee ja seol Koo Chang Ho Jung Sang Yoon Chung jae Joong Lee Seung Young Kim Jong Jin Hyun Sung Woo Jung Rok Seon Choung Sang Woo Lee jai Hyun Choi Division of Gastroenterology Department of Internal MedicineKorea University Ansan Hospital516 Gojan-dongDanwon-guAnsan-siGyeonggi-do 425-707South Korea

Gastrointestinal stromal tumor(GIST)is a rare mesenchymal tumor of the gastrointestinal tract that has been associated with the formation of fistulas to adjacent organs in few case ***,GIST with enterohepatic fistula has not been *** we report the case of an enterohepatic fistula that occurred after embolization of a liver mass originating in the distal *** 87-year-old woman was hospitalized for *** initial conventional endoscopy,a bleeding focus in the gastrointestinal tract was not *** of massive hematochezia,enteroscopy was performed through the anus.A protruding,ulcerative mass was found in the distal ileum that was suspected to be the source of the bleeding;a biopsy sample was *** was not successful in controlling the bleeding;therefore,embolization was *** embolization,the patient developed a high fever and severe abdominal tenderness with rebound ***-up abdominopelvic computed tomography revealed an enterohepatic fistula between the liver and distal *** fistula was treated surgically by segmental resection of the distal ileum and unlooping of the liver mass.

关键词： Gastrointestinal stromal tumor Enterohepatic fistula Therapeutic embolization Bleeding Ileal gastrointestinal stromal tumor