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Gut and Liver update

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수록범위 : 1권1호(2007)~14권3호(2020) |수록논문 수 : 1,242
Gut and Liver
14권3호(2020년 05월) 수록논문
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KCI등재 SCI SCOPUS

1To Do or Not to Do: Whether to Hold or Continue Antithrombotics before Endoscopy

저자 : Joon Sung Kim , Byung-wook Kim

발행기관 : 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 간행물 : Gut and Liver 14권 3호 발행 연도 : 2020 페이지 : pp. 275-276 (2 pages)

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KCI등재 SCI SCOPUS

2Strategies to Increase the Participation Rate of Colorectal Cancer Screening

저자 : Yoon Suk Jung

발행기관 : 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 간행물 : Gut and Liver 14권 3호 발행 연도 : 2020 페이지 : pp. 277-278 (2 pages)

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4Preventing Metachronous Gastric Cancer after the Endoscopic Resection of Gastric Epithelial Neoplasia: Roles of Helicobacter pylori Eradication and Aspirin

저자 : Jiro Watari , Toshihiko Tomita , Katsuyuki Tozawa , Tadayuki Oshima , Hirokazu Fukui , Hiroto Miwa

발행기관 : 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 간행물 : Gut and Liver 14권 3호 발행 연도 : 2020 페이지 : pp. 281-290 (10 pages)

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Whether Helicobacter pylori eradication actually reduces the risk of metachronous gastric cancer (MGC) development remains a controversial question. In this review, we addressed this topic by reviewing the results of clinical investigations and molecular pathological analyses of the roles of H. pylori eradication and aspirin administration in the prevention of MGC. In regard to the clinical studies, the results of meta-analyses and randomized control trials differ from those of retrospective studies: the former trials show that H. pylori eradication has a preventive effect on MGC, while the latter studies do not. This discrepancy may be at least partly attributable to differences in the follow-up periods: H. pylori eradication is more likely to prevent MGC over a long-term follow-up period (≥5 years) than over a short-term follow-up period. In addition, many studies have shown that aspirin may have an additive effect on MGC-risk reduction after H. pylori eradication has been achieved. Both H. pylori eradication and aspirin use induce molecular alterations in the atrophic gastritis mucosa but not in the intestinal metaplasia. Unfortunately, the molecular pathological analyses of these interventions have been limited by short follow-up periods. Therefore, a long-term prospective cohort is needed to clarify the changes in molecular events caused by these interventions. (Gut Liver 2020;14:281-290)

KCI등재 SCI SCOPUS

5The Role of Intestinal Fungi and Its Metabolites in Chronic Liver Diseases

저자 : Ningning You , Lili Zhuo , Jingxin Zhou , Yu Song , Junping Shi

발행기관 : 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 간행물 : Gut and Liver 14권 3호 발행 연도 : 2020 페이지 : pp. 291-296 (6 pages)

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Current studies have confirmed that liver diseases are closely related to intestinal microorganisms; however, those studies have mainly concentrated on bacteria. Although the proportion of intestinal microorganisms accounted for by colonizing fungi is very small, these fungi do have a significant effect on the homeostasis of the intestinal microecosystem. In this paper, the characteristics of intestinal fungi in patients with chronic liver diseases such as alcoholic liver disease, nonalcoholic fatty liver disease and cirrhosis are summarized, and the effects of intestinal fungi and their metabolites are analyzed and discussed. It is important to realize that not only bacteria but also intestinal fungi play important roles in liver diseases. (Gut Liver 2020;14:291-296)

KCI등재 SCI SCOPUS

6Management of Difficult Bile Duct Stones by Large Balloon, Cholangioscopy, Enteroscopy and Endosonography

저자 : Yousuke Nakai , Tatsuya Sato , Ryunosuke Hakuta , Kazunaga Ishigaki , Kei Saito , Tomotaka Saito , Naminatsu Takahara , Tsuyoshi Hamada , Suguru Mizuno , Hirofumi Kogure , Minoru Tada , Hiroyuki Isayama , K

발행기관 : 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 간행물 : Gut and Liver 14권 3호 발행 연도 : 2020 페이지 : pp. 297-305 (9 pages)

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Endoscopic management of bile duct stones is now the standard of care, but challenges remain with difficult bile duct stones. There are some known factors associated with technically difficult bile duct stones, such as large size and surgically altered anatomy. Endoscopic mechanical lithotripsy is now the standard technique used to remove large bile duct stones, but the efficacy of endoscopic papillary large balloon dilatation (EPLBD) and cholangioscopy with intraductal lithotripsy has been increasingly reported. In patients with surgically altered anatomy, biliary access before stone removal can be technically difficult. Endotherapy using two new endoscopes is now utilized in clinical practice: enteroscopy-assisted endoscopic retrograde cholangiopancreatography and endoscopic ultrasound-guided antegrade treatment. These new approaches can be combined with EPLBD and/or cholangioscopy to remove large bile duct stones from patients with surgically altered anatomy. Since various endoscopic procedures are now available, endoscopists should learn the indications, advantages and disadvantages of each technique for better management of bile duct stones. (Gut Liver 2020;14:297-305)

KCI등재 SCI SCOPUS

7Mesenchymal Stem Cells for the Treatment of Liver Disease: Present and Perspectives

저자 : Seong Hee Kang , Moon Young Kim , Young Woo Eom , Soon Koo Baik

발행기관 : 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 간행물 : Gut and Liver 14권 3호 발행 연도 : 2020 페이지 : pp. 306-315 (10 pages)

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Mesenchymal stem cell transplantation is an emerging therapy for treating chronic liver diseases. The potential of this treatment has been evaluated in preclinical and clinical studies. Although the mechanisms of mesenchymal stem cell transplantation are still not completely understood, accumulating evidence has revealed that their immunomodulation, differentiation, and antifibrotic properties play a crucial role in liver regeneration. The safety and therapeutic effects of mesenchymal stem cells in patients with chronic liver disease have been observed in many clinical studies. However, only modest improvements have been seen, partly because of the limited feasibility of transplanted cells at present. Here, we discuss several strategies targeted at improving viable cell engraftment and the potential challenges in the use of extracellular vesicle-based therapies for liver disease in the future. (Gut Liver 2020;14:306-315)

KCI등재 SCI SCOPUS

8Clinical Practice and Guidelines for Managing Antithrombotics before and after Endoscopy: A National Survey Study

저자 : Seong Woo Jeon , Su Jin Hong , Soo Teik Lee , Hyungkil Kim , Hoon Jai Chun

발행기관 : 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 간행물 : Gut and Liver 14권 3호 발행 연도 : 2020 페이지 : pp. 316-322 (7 pages)

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Background/Aims: The proper handling of antithrombotics is critical, and this study aimed to assess guideline adherence in the management of antithrombotics before and after endoscopy. Methods: A survey questionnaire was developed. The respondents' demographic information was included, and the questionnaire was divided into the first section for forceps biopsy, the second for polypectomy, and the third for endoscopic submucosal dissection (ESD) in which aspirin, clopidogrel, combination therapy (aspirin and clopidogrel), warfarin, and direct oral anticoagulants (apixaban) were prescribed to imaginary patients. Results: A total of 415 endoscopists completed this survey (response rate of 6.2%, 415/6,673). The percentage of respondents who chose to proceed with biopsy for patients taking aspirin, those taking clopidogrel, those under combination therapy, those taking warfarin, and those taking apixaban was 89.4%, 74.2%, 61.0%, 38.6%, and 50.4%, respectively. Most respondents answered that they would discontinue aspirin, clopidogrel, and a combination of both drugs for 5 days before polypectomy or ESD (69.4%/76.9%, 83.6%/83.9%, and 53.3%/65.8%, respectively). The answers indicated that warfarin should be discontinued with heparin bridge therapy in high thromboembolic risk patients (polypectomy 70.1%, ESD 73.5%). Regarding apixaban use in polypectomy and ESD, 63.9% and 58.1% of respondents, respectively, chose answers consistent with the guidelines. Conclusions: The gap between the guidelines and clinical practice in the management of antithrombotics before and after endoscopy is considerable and should be addressed via educational strategies. (Gut Liver 2020;14:316-322)

KCI등재 SCI SCOPUS

9Increase in the Colorectal Cancer Screening Rate by a Round-Mailed Fecal Immunochemical Testing Kit and Associated Factors in Underserved Regions of Korea: A Community-Based Intervention Study

저자 : Seri Hong , Hye Young Shin , Bomyee Lee , Na Rae Hwang , Sang-hyun Hwang , Jae Kwan Jun

발행기관 : 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 간행물 : Gut and Liver 14권 3호 발행 연도 : 2020 페이지 : pp. 323-330 (8 pages)

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Background/Aims: Postal distribution of a fecal immunochemical test (FIT) kit has been recommended as an effective method of increasing participation in colorectal cancer (CRC) screening. The present study was performed to assess the impact of the round-mailed FIT kit on screening participation in underserved regions of Korea and to identify factors related to nonparticipation. Methods: Residents were recruited from three rural regions of Korea that lack screening units for the National Cancer Screening Program. A package containing a FIT kit for stool self-sampling and a return envelope addressed to the local health center was postally distributed to each subject. Thirty days after the kits were mailed, nonresponders were reminded via telephone as the second intervention. The participation rates and odds ratios with 95% confidence intervals (CIs) for each intervention response were calculated to evaluate the effect of the interventions and factors related to screening participation in response to the interventions. Results: CRC screening participation rates increased from 24.5% (95% CI, 21.6% to 27.4%) to 42.6% (95% CI, 39.3% to 46.0%) as a result of postal screening and increased further to 51.4% (95% CI, 48.0% to 54.9%) after the telephone reminder. After controlling for the sex, age, and household type of each subject, factors associated with poor response to postal screening were identified as low educational attainment and poor previous participation in the National Cancer Screening Program. Conclusions: Round-mailed FIT kits with phone call reminders were an effective intervention, nearly doubling the screening rate in underserved regions of Korea. (Gut Liver 2020;14:323-330)

KCI등재 SCI SCOPUS

10Risk Factors for Postoperative Recurrence in Korean Patients with Crohn's Disease

저자 : Sung Bae Kim , Jae Hee Cheon , Jae Jun Park , Eun Soo Kim , Seong Woo Jeon , Sung-ae Jung , Dong Il Park , Chang Kyun Lee , Jong Pil Im , You Sun Kim , Hyun Soo Kim , Jun Lee , Chang Soo Eun , Jeong Mi

발행기관 : 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 간행물 : Gut and Liver 14권 3호 발행 연도 : 2020 페이지 : pp. 331-337 (7 pages)

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Background/Aims: A considerable number of patients with Crohn's disease still need intestinal resection surgery. Postoperative recurrence is an important issue in Crohn's disease management, including the selection of high-risk patients. Eastern Asian patients showed several differences from Caucasian patients. Therefore, we investigated the postoperative surgical recurrence outcome and identified risk factors in Korean patients. Methods: Clinical data of 372 patients with Crohn's disease who underwent first intestinal resection between January 2004 and August 2014 at 14 hospitals in Korea were retrospectively reviewed. Results: Over the follow-up period, 50 patients (17.1%) showed surgical recurrence. The cumulative surgical recurrence rate was 6.5% at 1 year and 15.4% at 7 years. Age under 16 (p=0.011; hazard ratio [HR], 5.136; 95% confidence interval [CI], 1.576 to 16.731), colonic involvement (p=0.023; HR , 2.011; 95% CI, 1.102 to 3.670), and the presence of perianal disease at surgery (p=0.008; HR, 2.239; 95% CI, 1.236 to 4.059) were independent risk factors associated with surgical recurrence. Postoperative thiopurine treatment (p=0.002; HR, 0.393; 95% CI, 0.218 to 0.710) was a protective factor for surgical recurrence. Conclusions: Among the disease characteristics at surgery, younger age, colonic location, and perianal lesions were independent risk factors for surgical recurrence. Postoperative thiopurine treatment significantly reduced the incidence of surgical recurrence. (Gut Liver 2020;14:331-337)

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