Archives
-
Review Article 2025-01-25 2025-01-25
0
208
133
Upper GI Tract
전이성 위암의 항암치료
Chemotherapy for Metastatic Gastric Cancer
Sung Eun Kim, Moo In Park
, Myung Hun Lee
AbstractGastric cancer is the fourth most common malignancy in Korea and remains the fifth and seventh leading cause of cancer death in males and females, respectively. Although the survival rates for gastric cancer have improved, unresectable or metastatic gastric cancer still has an abysmal prognosis, and the five-year survival rate for patients with stage IV gastric cancer is approximately 6.6% in Korea. The treatment of patients with unresectable or metastatic gastric cancer is based on chemotherapy. A combination of fluoropyrimidine and platinum is the most widely used first-line treatment for gastric cancer worldwide. In recent decades, a better understanding of cancer biology has led to targeted therapies becoming the treatment paradigm for many cancers, including gastric cancer. In addition, immunotherapies have also been reported to improve survival in several cancers, particularly in patients with unresectable or metastatic gastric cancer who have failed multiple lines of chemotherapy. This review evaluates landmark studies on chemotherapy for unresectable or metastatic gastric cancer, including targeted therapies and immunotherapies. -
Review Article 2025-01-25 2025-01-25
0
159
97
Pancreas and Biliary Tract
Relationship between Abnormal Lipid Metabolism and Gallstone Formation
Xiang Li1,2,3*, Xiaodan Yin1,2,3*, Jun Xu1,2,3, Lei Geng1,2,3
, Zhengtao Liu4
AbstractCholelithiasis is a common biliary system disease with a high incidence worldwide. Abnormal lipid metabolism has been shown to play a key role in the mechanism of gallstones. Therefore, recent research literature on the genes, proteins, and molecular substances involved in lipid metabolism during the pathogenesis of gallstones has been conducted. This study aimed to determine the role of lipid metabolism in the pathogenesis of gallstones and provide insights for future studies using previous research in genomics, metabolomics, transcriptomics, and other fields. -
Special Article 2025-01-25 2025-01-25
1
155
68
Others
대한소화기학회는 다양성, 형평성, 포용성을 어떻게 이뤄나갈 것인가?
How to Achieve Diversity, Equity, and Inclusion in The Korean Society of Gastroenterology?
Nayoung Kim1, Kwangwoo Nam2, Ki-Nam Shim3, Hyo Jung Kim4, Su Youn Nam5, Sae Kyung Joo6, Seun Ja Park7, Yonghoon Choi8, Yoon Ju Jung9, Yong Sung Kim10, Ja Kyung Kim11, Seon Mee Park12
AbstractWith the increasing emphasis on diversity, equity, and inclusion (DEI) in organizations and institutions, academic societies in gastroenterology and hepatology are beginning to take actionable steps toward achieving DEI. The successful implementation of DEI initiatives leads to excellence in the field, improved patient outcomes, particularly in areas where health disparities are prevalent, and advances in the gastrointestinal discipline. Such implementation also results in a workforce that better reflects the growing diversity of the population. This review defines DEI and introduces the DEI policies and strategies adopted by the academic societies of gastroenterology in other countries. This paper proposes strategies to integrate DEI better into the Korean Society of Gastroenterology, emphasizing the importance of embedding DEI into the culture and strategic framework. The key strategies include establishing a DEI committee, setting clear targets, and conducting formal assessments to measure DEI progress. This study focused on enhancing workforce diversity, particularly among women and young doctors, and advocates for the need to support their academic development through male allyship and the promotion of equitable and inclusive academic cultures. -
Editorial 2025-01-25 2025-01-25
0
86
31
Others
포용적 연구를 위한 다양성과 형평성: 성별을 중심으로
Diversity and Equity for Inclusive Research: A Gender Perspective
-
Original Article 2025-01-25 2025-01-25
0
182
110
Lower GI Tract
저도이형성증이 진단된 한국인 염증성장질환에서 진행성 신생물의 발생빈도 및 위험인자
Frequency and Risk Factors of Advanced Neoplasia in Korean Inflammatory Bowel Disease Patients with Low-grade Dysplasia
Yong Eun Park1, Kyeong Ok Kim2
, Dong Hyun Kim3, Soo-Kyung Park4, Yoo Jin Lee5, Chang Kyun Lee6, IBD Research Group of the Korean Association for the Study of Intestinal Diseases (KASID)
AbstractBackground/Aims: Studies on the clinical outcomes after detecting low-grade dysplasia (LGD) in patients with inflammatory bowel disease (IBD) are insufficient. This study evaluated the clinical features, frequency, and risk factors for advanced neoplasia in patients with IBD after an LGD diagnosis.
Methods: The medical records of 166 patients with IBD from six university hospitals in Korea from 2010 to 2019 were reviewed retrospectively. LGD was diagnosed in all patients during surveillance. The frequency and risk factors for advanced neoplasia were evaluated, and the clinical features of patients with and without advanced neoplasia were compared.
Results: Advanced neoplasia developed in 12 patients (six with large LGD, three with tubulovillous adenoma, and three with high-grade dysplasia), and all cases developed from UC. Patients with advanced neoplasia had significantly higher Mayo scores, and colitis-associated dysplasia was more common than sporadic lesions (83.3% vs. 29.9%; p<0.001). Multivariate analysis showed that colitis-associated LGD significantly increased the risk of developing advanced neoplasia (odds ratio [OR], 10.516; 95% confidence interval [CI], 2.064–53.577). Among patients with colitis-associated lesions, a significant risk factor for advanced neoplasia was a prior history of LGD (OR, 9.429; 95% CI, 1.330–66.863).
Conclusions: Advanced neoplasia developed in 7.2% of patients with IBD and LGD. Most advanced neoplasms developed from colitis-associated lesions, and the risk was higher in patients with a history of LGD before index colonoscopy. -
Original Article 2025-01-25 2025-01-25
0
229
118
Upper GI Tract
위식도역류질환 환자에서 에소메프라졸 이중지연방출제형의 유효성과 안전성 평가: 다기관, 전향적, 비중재적 관찰연구
Efficacy and Safety of Dual Delayed-Release Formulation of Esomeprazole in Patients with Gastroesophageal Reflux Disease: A Multicenter, Prospective, Observational Study
AbstractBackground/Aims: Gastroesophageal reflux disease (GERD) is a chronic and recurrent condition requiring constant dietary management and medication. This study evaluated the efficacy and safety of HIP1601, a dual delayed-release formulation of esomeprazole, in patients with GERD in a clinical setting.
Methods: This prospective, multicenter, observational study was conducted at 309 medical institutions in Korea between June 2021 and March 2023. HIP1601 was administered at daily doses of 40 mg or 20 mg to 5,407 patients requiring treatment or prevention of erosive esophagitis. The primary outcome was the improvement rate of GERD symptoms at four weeks. GERD-related symptoms and treatment-emergent adverse events were also analyzed.
Results: This study included 5,282 patients in the safety analysis set and 5,232 in the full analysis set. At four weeks, the improvement rate of GERD symptoms was 92.1% (95% confidence interval [CI]: 91.3–92.8%). By eight weeks, the improvement rate increased to 94.6% (95% CI: 94.0–95.3%). After HIP1601 administration, the severity scores for all four GERD symptoms decreased to less than 1, with statistically significant changes in the scores (p<0.001). HIP1601 was well-tolerated, with minimal adverse events reported (0.17%), and the treatment-emergent adverse events were mild to moderate in severity.
Conclusions: HIP1601 showed strong efficacy and safety in managing GERD symptoms, with high rates of symptom relief at four and eight weeks. Its extended action and improved symptom control make it a promising therapeutic option for GERD patients. -
Original Article 2025-01-25 2025-01-25
0
161
91
Pancreas and Biliary Tract
담낭 신생물성 용종 예측을 위한 현행 수술 적응증과 수술 전 영상의 역할
Predicting Neoplastic Gallbladder Polyps: The Role of Current Surgical Indications and Preoperative Images
Ik Hyun Jo1, Chang Nyol Paik1
, Hong Geun Ahn1, Dong Do You2, Jae Hyun Han2, Hyun A Kim3
AbstractBackground/Aims: Cholecystectomy for gallbladder (GB) polyps is performed primarily based on preoperative images. This study examined the accuracy of surgical indications commonly used in clinical practice for detecting neoplastic polyps and investigated further clues for predicting neoplastic polyps.
Methods: This retrospective study included 385 patients who underwent a cholecystectomy for GB polyps. The predictive performances of seven surgical indications were compared by fitting the receiver operating characteristic curves. Logistic regression analysis was used to identify the candidate variables associated with predicting neoplastic polyps.
Results: Neoplastic polyps were identified in 18.9% (n=62) of the 385 patients assessed. The neoplastic group contained more females than males, larger polyps, more frequent solitary lesions, and lower platelet counts than the non-neoplastic group. Current surgical indications revealed an unsatisfactory prediction for neoplastic polyps. The optimal cutoff polyp size for neoplastic polyps by ultrasound (US) was larger than by computed tomography (CT) (12 mm vs. 10 mm). The proportion of pathologic neoplastic polyps was higher when both US and CT images were used than that predicted using a single test. Logistic regression analysis revealed larger polyps, increasing age, female sex, and lower platelet count to be associated with neoplastic polyps.
Conclusions: The current indications for cholecystectomy in GB polyps have a low predictive value for neoplastic lesions that can lead to overtreatment. Combining the polyp size from US and CT images may reduce unnecessary surgery. In addition, knowledge of the patient's age, sex, and platelet count could help make more selective surgical decisions for neoplastic polyps. -
Original Article 2025-01-25 2025-01-25
0
238
141
Liver
Long-Term Real-World Outcomes of Tenofovir Alafenamide in Chronic Hepatitis B: Detailed Analysis of Treatment-Naive and Experienced Patients
Yu-Xuan Song, Guang-Jun Song, Hui Ma, Bo Feng, Yan-Di Xie
AbstractBackground/Aims: This study assessed the long-term efficacy and safety of tenofovir alafenamide (TAF) in real-world settings.
Methods: Patients who were candidates for TAF treatment and were followed up at 12-week intervals over 192 weeks were enrolled in this study.
Results: One hundred and forty-four patients (50 treatment-naive and 94 treatment-experienced) were included in this study. The cumulative incidence rates of cirrhosis and hepatocellular carcinoma at 192 weeks were 3.9% and 0.7%, respectively. In treatment- naive patients, the rates of a virological response, HBeAg conversion, and HBsAg loss at 192 weeks were 100%, 33.3%, and 2%, respectively. The treatment-naive patients exhibited higher baseline HBsAg levels than the treatment-experienced patients (4.31 log10IU/mL vs. 3.97 log10IU/mL). A significant decrease in the HBsAg levels from the baseline was observed at 144 and 192 weeks in the treatment-naive patients (p=0.01). The baseline body mass index (BMI) <25 kg/m2 (p=0.02) and HBsAg <3.3 log10IU/mL (p=0.04) were identified as predictive factors for a decrease in HBsAg ≥0.5 log10IU/mL at 48 weeks. The eGFR levels were consistently lower in the treatment-experienced patients throughout the study. Although the treatment-naive patients showed no abnormal increases in urinary URBP, the treatment-experienced patients showed elevated urinary β2MG and NAG levels at the baseline, which decreased over the treatment course. The total cholesterol, triglyceride, and low-density lipoprotein levels were similar in both groups.
Conclusions: Prolonging the TAF treatment duration enhances the virological response rate. The decline in HBsAg levels was more significant in the treatment-naive patients than in the treatment-experienced patients. The baseline BMI <25 kg/m2 and HBsAg <3.3 log10IU/mL were predictive factors for a significant decline in HBsAg at 48 weeks. TAF has high renal safety and no significant impact on lipid levels. -
Case Report 2025-01-25 2025-01-25
0
208
93
Pancreas and Biliary Tract
Microangiopathic Hemolytic Anemia: A Rare Complication of Acute Pancreatitis
Syedda Ayesha1
, Masood Muhammad Karim1, Maria Ali2, Abdul Hadi Shahid3, Salman Naseem Adil2
AbstractMicroangiopathic hemolytic anemia (MAHA) is a rare subtype of hemolytic anemia characterized by elevated hemolytic markers and red blood cell destruction. Though uncommon, MAHA can occur as a complication of acute pancreatitis because of the associated inflammatory response. Patients with MAHA secondary to pancreatitis show favorable outcomes when treated with plasma exchange. This paper presents the case of a patient diagnosed with acute pancreatitis-induced hemolytic anemia and thrombocytopenia, who was managed successfully with plasma exchange, steroids, and rituximab. Clinicians should maintain a high index of suspicion in patients with acute pancreatitis who present with anemia, thrombocytopenia, and schistocytes on peripheral smears, even in the absence of end-organ injuries and with normal ADAMTS13 activity. The early initiation of plasmapheresis can be lifesaving. The timely introduction of rituximab in cases where plasma exchange and steroids are insufficient, despite the ADAMTS13 activity status, may lead to better outcomes. -
Case Report 2025-01-25 2025-01-25
0
204
104
Liver
단독 간농양으로 발현된 속립성 결핵
Miliary Tuberculosis Initially Presenting as an Isolated Hepatic Abscess
Chang Won Ha, Sang Deok Shin, Myung Ji Goh, Byeong Geun Song
, Wonseok Kang, Dong Hyun Sinn, Geum-Youn Gwak, Yong-Han Paik, Moon Seok Choi, Joon Hyeok Lee
AbstractHepatic tuberculosis, typically associated with miliary tuberculosis, can occasionally present as localized liver lesions. This case report describes a 77-year-old male presenting with persistent abdominal pain and fever, following an endoscopic retrograde cholangiopancreatography for bile duct sludge removal. Subsequent computed tomography revealed focal liver lesions. Despite initial treatment with antibiotics for a suspected inflammatory liver abscess, his condition did not improve. A liver biopsy was performed, revealing caseous granulomas, and the tuberculosis polymerase chain reaction result was positive. The patient was diagnosed with primary hepatic tuberculosis, which later disseminated. Oral anti-tuberculosis therapy was initiated and is currently being closely monitored. This case emphasizes the importance of considering hepatic tuberculosis in the differential diagnosis of liver lesions, particularly in cases involving cholestatic liver function tests, and persistent symptoms unresponsive to conventional antibiotics.
- 1
- 2