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대한장연구학회> Intestinal research (Intest Res)

Intestinal research (Intest Res) update

  • : 대한장연구학회
  • : 의약학분야  >  내과학
  • : KCI등재
  • : SCOPUS
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  • : 1598-9100
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수록정보
수록범위 : 1권1호(2003)~18권3호(2020) |수록논문 수 : 797
Intestinal research (Intest Res)
18권3호(2020년 07월) 수록논문
최근 권호 논문
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KCI등재 SCOPUS

1Tumor necrosis factor-α inhibitor use in patients with malignancy: is it safe?

저자 : Gyu Man Oh , Won Moon

발행기관 : 대한장연구학회 간행물 : Intestinal research (Intest Res) 18권 3호 발행 연도 : 2020 페이지 : pp. 245-246 (2 pages)

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2Education levels and survival in colorectal cancer: is there really an obvious association?

저자 : Bruna Valiati , Rodrigo Oliva Perez , Paulo Gustavo Kotze

발행기관 : 대한장연구학회 간행물 : Intestinal research (Intest Res) 18권 3호 발행 연도 : 2020 페이지 : pp. 247-248 (2 pages)

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3Pathogenesis and clinical perspectives of extraintestinal manifestations in inflammatory bowel diseases

저자 : Jung Min Kim , Jae Hee Cheon

발행기관 : 대한장연구학회 간행물 : Intestinal research (Intest Res) 18권 3호 발행 연도 : 2020 페이지 : pp. 249-264 (16 pages)

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A considerable number of patients with inflammatory bowel disease (IBD) experience extraintestinal manifestations (EIMs), which can present either before or after IBD diagnosis. Unraveling the pathogenic pathways of EIMs in IBD is challenging because of the lack of reliable criteria for diagnosis and difficulty in distinguishing EIMs from external pathologies caused by drugs or other etiologies. Optimizing treatment can also be difficult. Early diagnosis and management of EIM revolve around multidisciplinary teams, and they should have the resources necessary to make and implement appropriate decisions. In addition, specialists of the affected organs should be trained in IBD treatment. Furthermore, patient awareness regarding the extraintestinal symptoms of IBD is of paramount importance for improving patient understanding of disease and health outcomes. Herein, we review the pathogenesis and clinical perspectives of EIMs in IBD. (Intest Res 2020;18:249-264)

KCI등재 SCOPUS

4Capsule endoscopy in inflammatory bowel disease: when and how

저자 : Ida Hilmi , Taku Kobayashi

발행기관 : 대한장연구학회 간행물 : Intestinal research (Intest Res) 18권 3호 발행 연도 : 2020 페이지 : pp. 265-274 (10 pages)

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Capsule endoscopy (CE) is emerging as an important investigation in inflammatory bowel disease (IBD); common types include the standard small bowel CE and colon CE. More recently, the pan-enteric CE was developed to assess the large and small bowel in patients with Crohn's disease (CD). Emerging indications include noninvasive assessment for mucosal healing (both in the small bowel and the colon) and detection of postoperative recurrence in patients with CD. Given the increasing adoption, several CE scoring systems have been specifically developed for IBD. The greatest concern with performing CE, particularly in CD, is capsule retention, but this can be overcome by performing cross-sectional imaging such as magnetic resonance enterography and using patency capsules before performing the procedure. The development of software for automated detection of mucosal abnormalities typically seen in IBD may further increase its adoption. (Intest Res 2020;18:265-274)

KCI등재 SCOPUS

5NUDT15 gene variants and thiopurine-induced leukopenia in patients with inflammatory bowel disease

저자 : Katsuyoshi Matsuoka

발행기관 : 대한장연구학회 간행물 : Intestinal research (Intest Res) 18권 3호 발행 연도 : 2020 페이지 : pp. 275-281 (7 pages)

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Thiopurine has been used to maintain remission and to reduce antidrug antibody formation in monoclonal antibody therapy in patients with inflammatory bowel disease (IBD). The use of thiopurine is limited by side effects such as leukopenia. Thiopurine S-methyltransferase (TPMT) variants are associated with thiopurine-induced leukopenia in Westerners, but the frequency of the risk alleles is low in Asians. Recently, a variant in the nudix hydrolase 15 (NUDT15) gene (R139C, c.415C>T) was reported to be associated with early severe leukopenia in Asians. NUDT15 is an enzyme that converts 6-thio-(deoxy)guanosine triphosphate (6-T(d)GTP) to 6-thio-(deoxy)guanosine monophosphate (6-T(d)GMTP). The R139C variant impairs the stability of the protein and increases incorporation of 6-TGTP and 6-TdGTP into RNA and DNA, respectively, resulting in leukopenia. The frequency of C/C, C/T, and T/T are approximately 80%, 20%, and 1%, respectively in East Asians. Early leukopenia occurred in less than 3% of patients with C/C and in around 20% of those with C/T, whereas it occurred in almost all patients with T/T. Patients homozygous for this variant also develop severe hair loss. The measurement of NUDT15 R139C can increase the safety of thiopurine dramatically and is a successful example of personalized medicine in the field of IBD. (Intest Res 2020;18:275-281)

KCI등재 SCOPUS

6Safety of tumor necrosis factor inhibitor use in patients with concomitant malignancy

저자 : Hiep Phan , Rick A. Weideman , Daisha J. Cipher , Linda A. Feagins

발행기관 : 대한장연구학회 간행물 : Intestinal research (Intest Res) 18권 3호 발행 연도 : 2020 페이지 : pp. 282-288 (7 pages)

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Background/Aims: Safety for tumor necrosis factor inhibitors (TNFi) in cancer has been focused on risk of incident malignancies, but studies on prognostic effects have been scarce. We determined survival and recurrence rates at 1, 2, and 5 years after cancer diagnosis in patients with and without concurrent TNFi use. Methods: Chart reviews were performed between 1996 and 2015 at the VA North Texas Healthcare System. Cases were patients with inflammatory disease, concomitant malignancy, and TNFi use while controls were patients with inflammatory disease, concomitant malignancy but no TNFi use. Cases and controls were matched for type of malignancy. Analysis was performed with log-rank tests on Kaplan-Meier curves. Results: Thirty-six cases and 72 controls were identified. For cases, survival at 1, 2, and 5 years were 32 (89%), 31 (86%), and 29 (81%) compared to 63 (90%), 61 (87%), and 51 (73%) for the control group (P=0.985). For cases, recurrence rates at 1, 2, and 5 years were 3 (8%), 5 (14%), and 6 (17%) compared to 2 (3%), 5 (7%), and 7 (10%) for the control group (P=0.158). Conclusions: Our findings suggest TNFi may be safely used in select inflammatory disease patients with concurrent cancer if therapy is needed for proper disease control. However, case-by-case consideration in conjunction with an oncologist is recommended while considering the apparent safety of TNFi for patients suffering from active inflammatory diseases despite having a concomitant malignancy. (Intest Res 2020;18:282-288)

KCI등재 SCOPUS

7Presentation and outcomes among inflammatory bowel disease patients with concurrent pneumatosis intestinalis: a case series and systematic review

저자 : Youran Gao , Meka Uffenheimer , Michael Ashamallah , Gregory Grimaldi , Arun Swaminath , Keith Sultan

발행기관 : 대한장연구학회 간행물 : Intestinal research (Intest Res) 18권 3호 발행 연도 : 2020 페이지 : pp. 289-296 (8 pages)

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Background/Aims: Inflammatory bowel disease (IBD) involves chronic inflammation of the colon with ulcerative colitis (UC), and the colon and/or small intestine with Crohn's disease (CD). Pneumatosis intestinalis (PI), characterized by compromise of the intestinal wall with gas-filled cysts, has rarely been reported with IBD. The presentation, best management and outcomes of PI with IBD are poorly defined. Methods: We conducted a search for PI in all abdominal computed tomography (CT) reports at 2 large tertiary care hospitals from January 1, 2010 to December 31, 2017, cross referenced to ICD codes for IBD. CT and chart review was performed to confirm PI and IBD respectively. A systematic review excluding case reports was performed for PI with IBD for comparison. Results: Of 5,990 patients with a CT abdomen report mentioning PI, we identified 11 cases of PI with IBD, 4 UC, 6 CD, and 1 indeterminate colitis. PI was limited to the small bowel in 5 patients, the right colon in 5, and small bowel and colonic in 1. All 3 mortalities had CD, small intestinal PI and portal/mesenteric venous gas. The systematic literature search identified 9 articles describing 58 patients with IBD and PI. These cases were mostly included in larger cohorts of PI patients without extractable data on presentation or outcomes in the IBD subpopulation. Conclusions: Ours appears to be the first reporting of presentations and outcomes, outside of case reports, for those with PI and IBD. The high mortality for those with CD and PI of the small bowel appears to define a group requiring more than supportive medical care. (Intest Res 2020;18:289- 296)

KCI등재 SCOPUS

8Hypermethylated promoters of tumor suppressor genes were identified in Crohn's disease patients

저자 : Tae-oh Kim , Yu Kyeong Han , Joo Mi Yi

발행기관 : 대한장연구학회 간행물 : Intestinal research (Intest Res) 18권 3호 발행 연도 : 2020 페이지 : pp. 297-305 (9 pages)

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Background/Aims: Overwhelming evidence suggests that inflammatory bowel disease (IBD) is caused by a complicated interplay between the multiple genes and abnormal epigenetic regulation in response to environmental factors. It is becoming apparent that epigenetic factors are significantly associated with the development of the disease. DNA methylation remains the most studied epigenetic modification, and hypermethylation of gene promoters is associated with gene silencing. Methods: DNA methylation alterations may contribute to the many complex diseases development by regulating the interplay between external and internal environmental factors and gene transcriptional expression. In this study, we used 15 tumor suppressor genes (TSGs), originally identified in colon cancer, to detect promoter methylation in patients with Crohn's disease (CD). Methylation specific polymerase chain reaction and bisulfite sequencing analyses were performed to assess methylation level of TSGs in CD patients. Results: We found 6 TSGs (sFRP1, sFRP2, sFRP5, TFPI2, Sox17, and GATA4) are robustly hypermethylated in CD patient samples. Bisulfite sequencing analysis confirmed the methylation levels of the sFRP1, sFRP2, sFRP5, TFPI2, Sox17, and GATA4 promoters in the representative CD patient samples. Conclusions: In this study, the promoter hypermethylation of the TSGs observed indicates that CD exhibits specific DNA methylation signatures with potential clinical applications for the noninvasive diagnosis of IBD and the prognosis for patients with IBD. (Intest Res 2020;18:297-305)

KCI등재 SCOPUS

9Concordance between tuberculin skin test and interferon-gamma release assay for latent tuberculosis screening in inflammatory bowel disease

저자 : Saad Alrajhi , Pascale Germain , Myriam Martel , Peter Lakatos , Talat Bessissow , Talal Al-taweel , Waqqas Afif

발행기관 : 대한장연구학회 간행물 : Intestinal research (Intest Res) 18권 3호 발행 연도 : 2020 페이지 : pp. 306-316 (11 pages)

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Background/Aims: Latent tuberculosis screening is mandatory prior to initiating anti-tumor necrosis factor (anti-TNF) medications. Guidelines recommend interferon-gamma release assays (IGRA) as first line screening method for the general population. Studies provided conflicting evidence on IGRA and tuberculin skin test (TST) performance in inflammatory bowel disease (IBD) patients. We assessed test concordance and the effects of immunosuppression on their performance in IBD patients. Methods: We searched MEDLINE, Embase and Cochrane databases (2011-2018) for studies testing TST and IGRA in IBD. Primary outcome was TST and IGRA concordance. Secondary outcomes were effects of immunosuppressive therapy on performance. Immunosuppression defined as either steroids, thiopurine, methotrexate or cyclosporine use. We used the pooled random effects model to adjust for heterogeneity analyzed using (I2-Q statistics). We compared the fixed model to exclude smaller study effects. Results: Sixteen studies (2,488 patients) were included. Pooled TST and IGRA concordance was 85% (95% confidence interval [CI], 81%-88%; P=0.01). Effects of immunosuppression were reported in 8 studies (814 patients). The odds ratio of testing positive by IGRA decreased to 0.57 if immunosuppressed (95% CI, 0.31-1.03; P=0.06). The odds ratio of testing positive by TST if immunosuppressed was 1.14 (95% CI, 0.61-2.12; P=0.69). The fixed model yielded similar results, however the negative effect of immunosuppression on IGRA reached statistical significance (P=0.01). Conclusions: While concordance was 85% between TST and IGRA, the performance of IGRA seems to be negatively affected by immunosuppression. Given the importance of detecting latent tuberculosis prior to anti-TNF initiation, further randomized controlled trials comparing the performance of TST and IGRA in IBD patients are needed. (Intest Res 2020;18:306-314)

KCI등재 SCOPUS

10Factors associated with the survival of colorectal cancer in Mexico

저자 : Carlos Quezada-gutiérrez , María Teresa Álvarez-bañuelos , Jaime Morales-romero , Clara Luz Sampieri , Raúl Enrique Guzmán-garcía , Evangelina Montes-villaseñor

발행기관 : 대한장연구학회 간행물 : Intestinal research (Intest Res) 18권 3호 발행 연도 : 2020 페이지 : pp. 315-324 (10 pages)

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Background/Aims: Colorectal cancer (CRC) is a public health problem. In Mexico, there have been no recent studies conducted on survival in terms of this pathology or on the influence of prognostic factors. The study aims to determine the probability of survival in patients with CRC presence of low levels of schooling and a rural population, adjusted for clinical stage and type of treatment. Methods: A retrospective study was conducted in a cohort of 305 patients with CRC treated at State Cancer Center, located in Veracruz-Mexico; the follow-up period of 60 months (2012-2016). The survival probability was calculated using the Kaplan-Meier estimator and the log-rank test with 95% confidence intervals (CIs). Prognostic factors were determined using hazard ratio (HR) multivariate Cox regression analysis. Results: Overall survival was 40% at 60 months. Subjects in the age group ≥65 years had a low survival rate of 28% (P=0.026) and an advanced clinical stage of 22% (P<0.001). Of the patients with bone metastasis, none survived longer than 5 years (P=0.008). With respect to the unfavorable prognostic factors identified in the multivariate analysis, a decreased level of schooling was associated with an HR of 7.6 (95% CI, 1.1-54.7), advanced clinical stage was associated with an HR of 2.1 (95% CI, 1.2-4.0), and the presence of metastasis had an HR of 1.8 (95% CI, 1.1-2.9). Conclusions: Poor prognostic factors include an advanced clinical stage, the presence of metastasis and a low level of schooling. These findings confirm the importance of screening for early diagnosis, diminishing the barriers to accessing treatment and prospectively monitoring the population. (Intest Res 2020;18:315-324)

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