Publications (35)100.17 Total impact
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Article: Effect of biofeedback therapy in constipation according to rectal sensation.
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ABSTRACT: BACKGROUNDAIMS: The pathophysiologic mechanism of rectal hyposensitivity (RH) is not well documented, and the significance of RH in biofeedback therapy (BFT) has not been evaluated. Thus, we aimed to assess the effect of BFT in constipated patients according to the presence of RH. Five hundred and ninety constipated patients (238 males and 352 females) underwent anorectal physiologic assessments. Of these, anorectal manometry was performed before and after BFT in 244 patients (63 RH and 181 non-RH patients). The success rate of BFT was 56% in the RH and 61% in the non-RH group (p=0.604). The measurements of resting pressure, squeezing pressure, desire to defecate volume, urge to defecate volume, and maximum volume were decreased after BFT in the RH group (p<0.05), whereas only resting and squeezing pressures were decreased in the non-RH group (p<0.05). Among the RH group, individuals who responded to BFT showed decreased resting pressure, squeezing pressure, desire to defecate, urge to defecate, and maximum volume and increased balloon expulsion rate; among those who did not respond to BFT, only desire to defecate volume was improved. In constipated patients with RH, changes of anorectal manometric findings differed in comparison to patients without RH. The responses to BFT showed both anorectal muscle relaxation and restoration of rectal sensation.Gut and liver 03/2013; 7(2):157-62. · 0.83 Impact Factor -
Article: Biofeedback therapy in constipated, female patients and caused by radical hysterectomy or vaginal delivery.
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ABSTRACT: BACKGROUND/AIMS: Chronic constipation is frequently seen in women who have undergone hysterectomy or delivery. However, reports regarding anorectal physiologic features in those patients are rare. We analyzed the constipated patients associated with either radical hysterectomy or vaginal delivery in order to clarify the anorectal physiologic features and the effectiveness of biofeedback therapy. METHODS: Of the constipated patients, we included a hysterectomy group (n=40), delivery group (n=41), and a control group (n=89), who had no history of either surgery or delivery before developing functional constipation. We investigated their anorectal physiological tests and the effectiveness of biofeedback therapy. RESULTS: The volume of desire to defecate was greater in the hysterectomy group than in the control group (86.5±55.0 mL vs. 62.9±33.7 mL; P=0.03), and more than 240 ml of maximal volume of toleration was more frequently noted in the hysterectomy group (32.5%) than in the delivery group (14.6%) and control group (13.5%) (P=0.02).The failure of balloon expulsion was more frequently noted in delivery group (44.0%) than in the hysterectomy group (15.0%) and control group (25.0%) (P=0.01). The defecation satisfaction score was significantly increased after biofeedback therapy in the hysterectomy group (2.0 ± 2.7 vs. 7.8 ± 1.5, P<0.001), the delivery group (1.6 ± 2.1 vs. 6.7 ± 2.0, P<0.001) and the control group (2.5 ± 2.7 vs. 6.9 ± 2.1, P<0.001). CONCLUSIONS: Rectal hyposensitivity could have been the characteristic mechanism in the hysterectomy group, whereas dyssynergic defecation could have been the cause in the delivery group. Biofeedback therapy was effective for both groups.Journal of Gastroenterology and Hepatology 02/2013; · 2.87 Impact Factor -
Article: Frequency of rebleeding events in obscure gastrointestinal bleeding with negative capsule endoscopy.
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ABSTRACT: BACKGROUND AND AIM: Although capsule endoscopy (CE) is widely used as a first-line diagnostic modality for obscure gastrointestinal bleeding (OGIB), the rebleeding rate after negative CE varies according to different studies. We tried to elucidate the outcomes after negative CE for OGIB and to determine the risk factors associated with rebleeding. METHODS: We retrospectively reviewed data from 125 patients who had received CE for OGIB. RESULTS: PillCam(TM) SB capsules were used for 92 patients (73.6%) and SB2 capsules for the other 33 (26.4%). The complete visualization of the small bowel was achieved in 93 patients (74.4%). Of the 63 patients (50.4%) who showed negative CE results, 60 patients did not receive any further specific treatment for OGIB, and were analyzed for the rebleeding rate and risk factors for rebleeding. Of the 60 patients, rebleeding episodes were observed in 16 patients (26.7%) and the cumulative rebleeding rates after 6, 12, 24, and 36 months were 12.4%, 14.3%, 28.7%, and 35.9%, respectively. Substantial rebleeding events were observed with similar frequency both after negative CE without subsequent treatment (26.7%) and after positive CE without specific treatment (21.2%) (p = 0.496). CONCLUSIONS: Considerable rebleeding episodes were observed after negative CE result for OGIB. Further complementary diagnostic work-ups and close follow-up are needed to be considered for patients with OGIB and negative CE results.Journal of Gastroenterology and Hepatology 02/2013; · 2.87 Impact Factor -
Article: Inhibition of 15-hydroxyprostaglandin dehydrogenase by Helicobacter pylori in Human gastric carcinogenesis.
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ABSTRACT: Helicobacter pylori (H pylori) infection induces a chronic inflammatory response, which promotes gastric carcinogenesis. 15-hydroxyprostaglandin dehydrogenase (15-PGDH) plays a key role as a tumor suppressor in gastrointestinal cancers. The aim of this study was to elucidate the role of 15-PGDH in gastric carcinogenesis associated with H pylori. 15-PGDH expression in gastric biopsies from H pylori-infected (n=25) and non-infected (n=15) subjects was analyzed by quantitative real-time PCR, western blot analysis, and immunohistochemisty. 15-PGDH DNA methylation was evaluated by methylation specific PCR and pyrosequencing. The expression of 15-PGDH, Snail, ERK1/2, TLR4 and MyD88 in response to H pylori infection was assessed by immunoblot analysis. Compared to negative specimens, H pylori positive specimens had 2-fold lower 15-PGDH mRNA levels and significantly less 15-PGDH protein. In four H pylori infected subjects with longitudinal follow-up, the suppression of 15-PGDH expression was reversed by H pylori eradication therapy. In parallel with suppressing 15-PGDH expression, H pylori infection activated expression of TLR4 and MyD88 expression, increased levels of phospho-ERK1/2, and increased expression of epidermal growth factor receptor (EGFR)-Snail. Inhibition of Snail and MyD88 reversed suppression of 15-PGDH expression and small interfering Myd88 reduced phosphorylated ERK1/2. Similarly, treatment with an ERK1/2 and EGFR inhibitor also restored 15-PGDH expression. Heliocobacter pylori appeared to promote gastric carcinogenesis by suppressing15-PGDH. This process is mediated by the TLR4/MyD88 pathway via ERK1/2 or EGFR - Snail transcriptional regulation. 15-PGDH may be a useful marker and a potential therapeutic target in H pylori-induced gastric carcinogenesis.Cancer Prevention Research 02/2013; · 4.91 Impact Factor -
Article: The Characteristics of Ulcerative Colitis Associated With Autoimmune Pancreatitis.
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ABSTRACT: GOALS:: To determine the prevalence of ulcerative colitis (UC) in autoimmune pancreatitis (AIP) patients in a tertiary referral hospital and to compare the clinical and pathologic characteristics and outcomes of UC associated with AIP (AIP-UC) and UC patients. BACKGROUND:: Recently, it was suggested that UC is associated with AIP. However, the prevalence of UC in AIP, together with the clinical characteristics and outcomes of AIP-UC are not clear. STUDY:: We retrospectively reviewed the medical records of AIP patients diagnosed at the Asan Medical Center. RESULTS:: Of the 104 patients with AIP, 6 (5.8%) were also diagnosed with UC. Serum immunoglobulin G (IgG) and IgG4 were elevated in 1 patient (16.7%), respectively, and 4 (66.7%) showed idiopathic duct-centric pancreatitis (type 2 AIP). Compared with 24 matched patients with UC only, AIP-UC patients had a lower body mass index (P=0.003), higher C-reactive protein levels (P=0.048), and higher Mayo scores (P=0.006) at diagnosis of UC. Two AIP-UC patients (33.3%), but none with UC only showed increased infiltration of IgG4-positive cells into the colonic tissues (P=0.006). During follow-up, 2 AIP-UC patients (33.3%) underwent colectomy and 1 (16.7%) died, but no colectomies or deaths occurred in the UC only group. CONCLUSIONS:: AIP patients seem to have a higher risk of UC compared with the general population. The increased IgG4-positive cellular infiltration in the colonic tissue suggests that UC may be an extrapancreatic manifestation of AIP.Journal of clinical gastroenterology 02/2013; · 2.21 Impact Factor -
Article: [A case of a perivascular epithelioid cell tumor mimicking colon cancer].
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ABSTRACT: Perivascular epithelioid cell tumor (PEComa) is extremely rare, which originated from mesenchymal cells in the intestine, and composed of histologically and immunohistochemically distinctive perivascular epithelioid cells. We report here on a case of PEComa in the sigmoid colon. A 62-year-old woman presented with hematochzia 10 days ago. Her abdominal computed tomography scan showed a 5 cm sized intraluminal fungating heterogeneously enhanced, high density mass, which infiltrated pericolic tissue surrounding the sigmoid colon. Colonoscopy showed a purple colored polypoid mass with lobulating contour in the sigmoid colon. She underwent laparoscopic anterior resection. On the histologic examination, the tumor consisted of polygonal epithelioid cells with sheet-like growth of nests, which looked like alveolar tissues in lung. The tumor cells were strongly positive stained with human melanoma black-45 (HMB-45). Pathologic examination was compatible with PEComa. Sixteen months after surgery, she did well without tumor recurrence after surgery. We review the literatures concerning PEComa of the intestine focusing on endoscopic findings. (Korean J Gastroenterol 2012;60:377-381).The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi 12/2012; 60(6):377-81. -
Article: Long-term Prognosis of the Jejunal Involvement of Crohn's Disease.
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ABSTRACT: GOALS:: We investigated the prognosis of Crohn's disease (CD) in Korean patients with jejunal involvement. BACKGROUND:: Although jejunal involvement is considered a poor prognostic factor of CD in whites, it has never been validated in Asian populations. METHODS:: We retrospectively reviewed the medical records of 1403 Korean CD patients (median age at diagnosis, 23 years; male patients, 72.3%; median follow-up duration, 65 mo). Probabilities of medication use, surgery, and hospitalization were analyzed by a Cox proportional hazards model and a Poisson regression model. RESULTS:: Jejunal involvement was observed in 198 of 1403 (14.1%) patients at diagnosis. There were more ileal location (28.3% vs. 20.6%, P<0.001) and stricturing behavior (16.7% vs. 9.4%, P=0.001) in the jejunal group than in the non-jejunal group. In univariate analyses, the cumulative probabilities of treatment with corticosteroids (P=0.014) and thiopurines (P=0.008), the first major surgery (P=0.021), and the first hospitalization (P=0.015) were significantly higher in the jejunal than in the non-jejunal group. In multivariate analyses, jejunal involvement was independently associated with the more common use of corticosteroids [hazard ratio, 1.24; 95% confidence interval (CI), 1.02-1.50] and thiopurines (hazard ratio, 1.26; 95% CI, 1.06-1.49), higher incidence rates of strictureplasties [relative risk (RR), 2.52; 95% CI, 1.60-3.96] and hospitalizations (RR, 1.29; 95% CI, 1.14-1.47), and longer hospitalization duration (RR, 1.30; 95% CI, 1.25-1.34). CONCLUSIONS:: Korean CD patients are more likely to have jejunal involvement than western patients. Jejunal involvement is one of the poor prognostic factors in Korean CD patients, as it is in westerners.Journal of clinical gastroenterology 12/2012; · 2.21 Impact Factor -
Article: EBV-associated lymphoproliferative disorders misdiagnosed as Crohn's disease.
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ABSTRACT: Epstein-Barr virus (EBV) plays an etiological role in various diseases. EBV-associated lymphoproliferative disorder (LPD) is usually observed in individuals with congenital or acquired immune deficiencies but was also recently reported in non-immunocompromised individuals. Two cases of immunocompetent patients with EBV-associated T-cell LPD of the small bowel and colon who were initially misdiagnosed as Crohn's disease (CD) are reported here. EBV-associated T-cell LPD with primary gastrointestinal tract involvement can manifest as multiple discrete ulcers of the small and/or large bowel that are similar to the lesions found in CD or intestinal tuberculosis. However, when patients have multiple intestinal ulcers that are not typical of CD or intestinal tuberculosis and the clinical course is unusual, clinicians should consider the possibility of EBV-associated LPD that involves the gastrointestinal tract because the treatment strategy and prognosis are completely different.Journal of Crohn s and Colitis 10/2012; · 2.57 Impact Factor -
Article: A New Technique Using Ultra-slim Endoscopy for High-Grade Crohn's Stricture.
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ABSTRACT: Crohn's disease (CD) is a chronic inflammatory bowel disease of unknown etiology. Most patients with CD will eventually develop a stricturing or penetrating complication. Colonoscopic findings may predict the clinical course in patients with CD. Moreover, since CD patients are at increased risk for developing dysplasia and colorectal cancer, surveillance colonoscopy is necessary for the detection of malignancies. We describe here a CD patient with a high-grade anorectal stricture who successfully underwent a total colon examination with an ultra-slim upper endoscope after an insertion failure with a standard colonoscope and gastroscope.Journal of the Korean Society of Coloproctology 10/2012; 28(5):271-4. -
Article: Risk factors and outcome of acute severe lower gastrointestinal bleeding in Crohn's disease.
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ABSTRACT: Acute severe lower gastrointestinal bleeding in Crohn's disease is uncommon, but is a diagnostic and therapeutic challenge. We aimed to identify risk factors for acute lower gastrointestinal bleeding in patients with Crohn's disease and assess the cumulative probability of rebleeding in relation to therapeutic modality. We retrospectively reviewed the medical records of 70 Crohn's patients (4.0%) with acute severe lower gastrointestinal bleeding and compared these with matched 140 Crohn's patients without bleeding. The cumulative probability of bleeding after diagnosis of Crohn's disease was 1.7%, 3.6%, 6.5%, and 10.3% after 1, 5, 10, and 20 years respectively. At presentation, the median haemoglobin concentration was 8.4g/dL (range, 4.7-11.6g/dL). Use of azathioprine/6-mercaptopurine decreased the risk of lower gastrointestinal bleeding (OR: 0.525, 95% CI: 0.304-0.906, p=0.021). Bleeding recurred in 29 patients (41.4%) after a median time of 3.2 months (range, 15 days-94.7 months). One out of eleven patients treated with infliximab rebled. The cumulative probability of rebleeding tended to be lower in patients treated with infliximab than in those receiving other treatments (p=0.076). Azathioprine/6-mercaptopurine may reduce the risk of acute severe lower gastrointestinal bleeding. The rebleeding is common, but infliximab may decrease rebleeding.Digestive and Liver Disease 04/2012; 44(9):723-8. · 3.05 Impact Factor -
Article: Clinical courses of chronic hepatitis B virus infection and inflammatory bowel disease in patients with both diseases.
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ABSTRACT: Little is known about the clinical features of hepatitis B virus (HBV) infection in patients with inflammatory bowel disease (IBD). We therefore evaluated the influence of immunosuppressive treatment for IBD on the course of HBV infection and the effect of HBV infection on the therapeutic strategy and clinical course of IBD patients. We retrospectively evaluated the incidence of and risk factors for liver dysfunction in hepatitis B surface antigen (HBsAg)-positive IBD patients. Also, the clinical course of IBD patients with HBV infection was compared with matched IBD controls without HBV infection. Of 4153 patients diagnosed with IBD between July 1989 and May 2011, 134 were HBsAg-positive, including 54 with Crohn's disease (CD) and 80 with ulcerative colitis (UC). Liver dysfunction was observed in 23 of the 134 (17.2%) HBsAg-positive patients. Prolonged immunosuppression (>3 months) was an independent predictor of liver dysfunction (odds ratio [OR] 3.06; 95% confidence interval [CI] 1.02-9.16). The rate of use of immunosuppressants, including corticosteroids (P = 0.005), azathioprine/6-mercaptopurine (P < 0.001), and infliximab (P = 0.026), was significantly lower in HBsAg-positive than HBsAg-negative IBD patients. Clinical outcomes, including admission rate, mean number of admissions, total proctocolectomy in UC patients, and mortality were worse in HBsAg-positive than HBsAg-negative IBD patients during the follow-up period. Liver dysfunction in HBsAg-positive IBD patients was more frequent in those with prolonged immunosuppression. IBD patients with chronic HBV infection used immunosuppressants less frequently and had a worse prognosis than those without it. (Inflamm Bowel Dis 2012;).Inflammatory Bowel Diseases 02/2012; 18(11):2004-10. · 4.86 Impact Factor -
Article: Enterovenous fistulization: a rare complication of Crohn's disease.
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ABSTRACT: The presence of hepatic portal venous gas (HPVG) is associated with numerous diseases, and has been regarded as a serious, even catastrophic condition. However, anecdotal reports mention that some patients with inflammatory bowel disease (IBD), who developed HPVG after diagnostic examinations of the colon, were successfully managed with antibiotic therapy and have followed benign courses. In contrast, among IBD patients, the development of HPVG is rarely caused by enterovenous fistula. We describe a 32-year-old man with Crohn's ileocolitis who presented with hypotension and fever associated with HPVG, as well as superior mesenteric vein thrombosis, possibly caused by enterovenous fistula, who was successfully managed by surgery. We also review the literature concerning portal venous gas associated with Crohn's disease.World Journal of Gastroenterology 12/2011; 17(47):5227-30. · 2.47 Impact Factor -
Article: EUS-guided fine needle aspiration and trucut needle biopsy for examination of rectal and perirectal lesions.
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ABSTRACT: Few studies have assessed the diagnostic efficacy of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) and/or trucut biopsy (TCB) in patients with rectal and perirectal lesions. We aimed to evaluate the diagnostic utility of EUS-FNA and/or TCB in patients with rectal and perirectal lesions. We also assessed their influence on the management and clinical course of these patients. We performed EUS-FNA and/or TCB in 11 consecutive patients (4 men and 7 women, 33-69 years) with rectal and perirectal lesions for whom conventional diagnostic tools could not provide definitive diagnoses. Patients with definite intraluminal cancer were excluded. The 11 patients underwent 12 procedures, with 9 being EUS-FNA alone and 3 being EUS-FNA and TCB. Seven patients had rectal lesions and four had perirectal lesions. Initial EUS-FNA and/or TCB established a diagnosis of malignancy in five patients and of benign lesions in four. EUS-FNA plus TCB confirmed malignant lymphoma after diagnostic failure of initial EUS-FNA in one patient. In one other patient with suspicious secondary linitis plastica, EUS-FNA could not establish a definitive diagnosis. Correct diagnoses were obtained in 10 out of 11 patients who underwent EUS-FNA and/or TCB. EUS-FNA and/or TCB changed clinical courses, which included avoidance of unnecessary surgeries, having a chance of anal sphincter-saving surgeries, and timely administration of chemotherapy. No serious complications related to the use of EUS-FNA or TCB were evident. EUS-FNA and/or TCB are useful in the diagnostic evaluation of and appropriate therapeutic plan in patients with rectal and perirectal lesions.Scandinavian journal of gastroenterology 09/2011; 46(12):1510-8. · 2.08 Impact Factor -
Article: Clinical characteristics of ulcerative colitis associated with primary sclerosing cholangitis in Korea.
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ABSTRACT: Primary sclerosing cholangitis (PSC) is well known as one of the extraintestinal manifestations of ulcerative colitis (UC). However, the prevalence of PSC in UC patients together with the clinical characteristics and outcomes of UC associated with PSC (UC-PSC) are not clear in Asians. We retrospectively reviewed the medical records of UC patients who were registered and followed up at the Asan Medical Center. The prevalence of PSC in UC and the clinical features of UC-PSC compared with matched UC without PSC were investigated. A total of 1849 patients diagnosed with UC between July 1977 and September 2009 were reviewed. Among these, 21 UC-PSC patients (1.1%) were identified. The cumulative probability of PSC after diagnosis of UC was 0.71% after 1-5 years, 1.42% after 10 years, 2.59% after 15 years, and 3.35% after 20-25 years. Compared with 63 matched UC alone patients, UC-PSC showed pancolitis (95.2%), rectal sparing (38.1%), and backwash ileitis (42.9%) more frequently (P < 0.001). During follow-up, three of 21 UC-PSC patients (14.3%) were diagnosed with colorectal neoplasia and three patients (14.3%) died of PSC-associated complications. UC-PSC patients were associated with increased probability of colorectal neoplasia development (P = 0.036) and a trend toward increased mortality compared with the UC alone group. The prevalence of PSC in Korean UC patients appears to be lower than that of Western patients. Similar to Caucasians, UC-PSC shows unique colonoscopic features and is associated with more frequent colorectal neoplasia development and poor prognosis in Korea.Inflammatory Bowel Diseases 09/2011; 17(9):1901-6. · 4.86 Impact Factor -
Article: Gallstone ileus successfully treated with endoscopic fragmentation by using double-balloon endoscopy (with video).
Gastrointestinal endoscopy 07/2011; 74(1):228-30. · 6.71 Impact Factor -
Article: Endoscopic submucosal dissection with or without snaring for colorectal neoplasms.
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ABSTRACT: Despite a high en bloc resection rate, its technical difficulty and risk of complications limit the widespread use of colorectal endoscopic submucosal dissection (ESD). To analyze outcomes after colorectal ESD and ESD with snaring (ESD-S), a simplified modification of ESD. A retrospective observational study. A single, tertiary-care, referral center. ESD was performed on 163 lesions in 162 patients and ESD-S on 74 lesions in 71 patients. All lesions were nonpedunculated colorectal neoplasms of 15 mm or larger. We analyzed procedure-related variables such as en bloc resection rate, procedure time, and complications. Histopathologic results were reviewed. Follow-up data were analyzed. The en bloc resection rate was higher for ESD than for ESD-S (87% vs 64%, P < .01). The histologically complete resection rate was also higher for ESD. However, both rates for resection of lesions of <20 mm were not different between ESD and ESD-S groups. The rates of perforation and bleeding were similar for both groups. Submucosal cancers were present in 21% and 31% of the ESD and ESD-S groups, respectively. One patient from each group developed a local adenoma recurrence. Retrospective design. Both ESD and ESD-S were safe and effective for resection of colorectal neoplasms. The higher en bloc resection rate for ESD suggests that it should be the first option for resection of suspected superficial submucosal cancers in the colorectum. ESD-S can be a good alternative to ESD for en bloc resection of colorectal lesions of <20 mm.Gastrointestinal endoscopy 06/2011; 74(5):1075-83. · 6.71 Impact Factor -
Article: Pneumoperitoneum in a patient with ulcerative colitis after sigmoidoscopy: is this always an indication for surgery?
Inflammatory Bowel Diseases 06/2011; 17(6):E54-6. · 4.86 Impact Factor -
Article: Clear water filling and puncture: sufficient for endoscopic diagnosis of pneumatosis cystoides intestinalis? (with video).
Gastrointestinal endoscopy 01/2011; 74(5):1170-1. · 6.71 Impact Factor -
Article: Anorectal function and the effect of biofeedback therapy in ambulatory spinal cord disease patients having constipation.
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ABSTRACT: Constipation in patients with mild spinal cord disease is not well investigated yet. We aimed to investigate anorectal function and the effect of biofeedback therapy in constipated patients with mild spinal cord diseases. A total of 14 constipated patients with myelopathy and 32 with radiculopathy were enrolled retrospectively. All patients were able to walk independently. The control group comprised of 100 constipated patients without any neurologic problem. Colonic transit time and the presence of dyssynergia were assessed before biofeedback therapy. All patients answered structured questionnaires on constipation, before and after biofeedback therapy. The mean rectosigmoid colonic transit time of the myelopathy group was significantly delayed (myelopathy, 18.6 ± 14.6 h; radiculopathy, 12.8 ± 11.9 h; control, 9.6 ± 11.2 h; p = 0.032). Delay in total colonic transit time was more frequent in the myelopathy group (myelopathy, 57.1%; radiculopathy, 23.3%; control, 18.5%; p = 0.004). On anorectal manometry, the squeezing pressure of the anal sphincter was decreased in the myelopathy group (myelopathy, 132.3 ± 73.3 mmHg; radiculopathy, 179.9 ± 86.1 mmHg; control 200.4 ± 82.4 mmHg; p < 0.05). The success rate of biofeedback therapy was lower in the myelopathy group (28.6% for myelopathy vs. 62.0% for control group; p = 0.034). The response rate to biofeedback therapy was similar between radiculopathy and control group (62.5% for radiculopathy vs. 62.0% for control group; p = 1.000). In constipation associated with mild myelopathy, delayed colonic transit and dyssynergic defecation were major pathophysiologic abnormalities and biofeedback was less effective compared with control group. However, in the radiculopathy group, biofeedback was as effective as in the control group.Scandinavian journal of gastroenterology 11/2010; 45(11):1281-8. · 2.08 Impact Factor -
Article: Clinical features and long-term prognosis of Crohn's disease in Korea.
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ABSTRACT: Recent studies have suggested that the clinical characteristics and genetic background of Crohn's disease (CD) patients differ between Asian and Caucasian individuals. However, the clinical features and course of CD in Asian patients remain unclear. Therefore, we investigated the clinical features and long-term prognosis of CD in a Korean population. We retrospectively analyzed 278 Korean patients with CD first diagnosed at the Asan Medical Center between March 1991 and February 2007. The male-to-female ratio was 2.2:1 and the median age at diagnosis was 23 years. The median duration of follow-up was 71 months (range, 1-210 months). At diagnosis, 187 patients (67.3%) had disease in both small bowel and colon, 68 (24.4%) had isolated small bowel disease, and 23 (8.3%) had isolated colonic disease. The number of patients with stricturing or penetrating behavior as defined by the Montreal classification increased from 87 (31.3%) at diagnosis to 141 (50.7%) at final evaluation. One hundred and thirty patients (46.8%) experienced perianal fistulas before and/or after diagnosis of CD. A total of 71 patients (25.5%) underwent intestinal resection and the cumulative probability of intestinal resection after 1, 5, and 10 years was 15.5%, 25.0%, and 32.8%, respectively. Korean CD patients differed from Western patients in gender distribution, disease location, and perianal fistula occurrence. Korean CD patients may also have better clinical courses than Western patients, as indicated by the lower intestinal resection rate.Scandinavian journal of gastroenterology 10/2010; 45(10):1178-85. · 2.08 Impact Factor
Top co-authors
Top Journals
Institutions
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2013
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Seegene Institute of Life Sciences
Seoul, Seoul, South Korea
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2011–2013
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Asan Medical Center
- Department of Gastroenterology
Seoul, Seoul, South Korea -
Ulsan University Hospital
Ulsan, Ulsan, South Korea
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