Gut and Liver最新文献

{"title":"Risk of Ischemic Stroke in Relation to <i>Helicobacter pylori</i> Infection and Eradication Status: A Large-Scale Prospective Observational Cohort Study.","authors":"Eun-Bi Jeon, Nayoung Kim, Beom Joon Kim, In-Chang Hwang, Sang Bin Kim, Ji-Hyun Kim, Yonghoon Choi, Yu Kyung Jun, Hyuk Yoon, Cheol Min Shin, Young Soo Park, Dong Ho Lee, Soyeon Ahn","doi":"10.5009/gnl230458","DOIUrl":"10.5009/gnl230458","url":null,"abstract":"<p><strong>Background/aims: </strong>: A few studies have suggested the association between <i>Helicobacter pylori</i> (HP) infection and ischemic stroke. However, the impact of HP eradication on stroke risk has not been well evaluated. This study aimed to assess the influence of HP eradication on the incidence of ischemic stroke, considering the potential effect of sex.</p><p><strong>Methods: </strong>: This prospective observational cohort study was conducted at Seoul National University Bundang Hospital, from May 2003 to February 2023, and involved gastroscopy-based HP testing. Propensity score (PS) matching was employed to ensure balanced groups by matching patients in the HP eradicated group (n=2,803) in a 3:1 ratio with patients in the HP non-eradicated group (n=960). Cox proportional hazard regression analysis was used to evaluate the risk of ischemic stroke.</p><p><strong>Results: </strong>: Among 6,664 patients, multivariate analysis after PS matching indicated that HP eradication did not significantly alter the risk of ischemic stroke (hazard ratio, 0.531; 95% confidence interval, 0.221 to 1.270; p=0.157). Sex-specific subgroup analyses, both univariate and multivariate, did not yield statistically significant differences. However, Kaplan-Meier analysis revealed a potential trend: the females in the HP eradicated group exhibited a lower incidence of ischemic stroke than those in the HP non-eradicated group, although this did not reach statistical significance (p=0.057).</p><p><strong>Conclusions: </strong>: This finding suggests that HP eradication might not impact the risk of ischemic stroke. However, there was a trend showing that females potentially had a lower risk of ischemic stroke following HP eradication, though further investigation is required to establish definitive evidence.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":"642-653"},"PeriodicalIF":3.4,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140854479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Achieving Sufficient Therapeutic Outcomes of Surgery in Elderly Hepatocellular Carcinoma Patients through Appropriate Selection.","authors":"Han Ah Lee","doi":"10.5009/gnl240279","DOIUrl":"10.5009/gnl240279","url":null,"abstract":"","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":"18 4","pages":"556-557"},"PeriodicalIF":3.4,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141616216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Discordance Rate and Risk Factor of Other Diagnostic Modalities for Small Bowel Tumors Detected by Device-Assisted Enteroscopy: A Korean Association for the Study of Intestinal Disease (KASID) Multicenter Study.","authors":"Jihye Park, Jin Su Kim, Joo Hye Song, Kwangwoo Nam, Seong-Eun Kim, Eui Sun Jeong, Jae Hyun Kim, Seong Ran Jeon","doi":"10.5009/gnl240030","DOIUrl":"10.5009/gnl240030","url":null,"abstract":"<p><strong>Background/aims: </strong>Despite advances in imaging and endoscopic technology, diagnostic modalities for small bowel tumors are simultaneously performed. We investigated the discrepancy rate between each modality and predictive factors of discrepancy in patients with definite small bowel tumors.</p><p><strong>Methods: </strong>Data of patients with definite small bowel tumors who underwent both device-assisted enteroscopy (DAE) and computed tomography (CT) were retrieved from web-based enteroscopy registry database in Korea. Predictive risk factors associated with discrepancy were analyzed using logistic regression analysis.</p><p><strong>Results: </strong>Among 998 patients, 210 (21.0%) were diagnosed with small bowel tumor using DAE, in 193 patients with definite small bowel tumor, DAE and CT were performed. Of these patients, 12 (6.2%) showed discrepancy between examinations. Among 49 patients who underwent DAE and video capsule endoscopy (VCE) examination, 13 (26.5%) showed discrepancy between examinations. No significant independent risk factors were associated with concordance between DAE and CT in multivariate logistic regression analysis among the patients. In a multivariate logistic regression analysis, red blood cell transfusion was negatively associated with concordance between DAE and VCE in patients with small bowel tumor (odds ratio, 0.163; 95% confidence interval, 0.026 to 1.004; p=0.050).</p><p><strong>Conclusions: </strong>For small bowel tumors, the discrepancy rate between DAE and CT was 6.2%, and 26.5% between DAE and VCE. Despite developments in cross-sectional imaging (VCE and DAE modalities), discrepancies still exist. For small bowel bleeding that require significant transfusion while showing insignificant VCE findings, DAE should be considered as the next diagnostic approach, considering the possibility of missed small bowel tumor.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":"686-694"},"PeriodicalIF":3.4,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140897883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Novel Retractable Robotic Device for Colorectal Endoscopic Submucosal Dissection.","authors":"Sang Hyun Kim, Chanwoo Kim, Bora Keum, Junghyun Im, Seonghyeon Won, Byung Gon Kim, Kyungnam Kim, Taebin Kwon, Daehie Hong, Han Jo Jeon, Hyuk Soon Choi, Eun Sun Kim, Yoon Tae Jeen, Hoon Jai Chun, Joo Ha Hwang","doi":"10.5009/gnl230280","DOIUrl":"10.5009/gnl230280","url":null,"abstract":"<p><strong>Background/aims: </strong>: Appropriate tissue tension and clear visibility of the dissection area using traction are essential for effective and safe endoscopic submucosal dissection (ESD). In this study, we developed a retractable robot-assisted traction device and evaluated its performance in colorectal ESD.</p><p><strong>Methods: </strong>: An experienced endoscopist performed ESD 18 times on an <i>ex vivo</i> porcine colon using the robot and 18 times using the conventional method. The outcome measures were procedure time, dissection speed, procedure-related adverse events, and blind dissection rate.</p><p><strong>Results: </strong>: Thirty-six colonic lesions were resected from <i>ex vivo</i> porcine colon samples. The total procedure time was significantly shorter in robot-assisted ESD (RESD) than in conventional ESD (CESD) (20.1±4.1 minutes vs 34.3±8.3 minutes, p<0.05). The submucosal dissection speed was significantly faster in the RESD group than in the CESD group (36.8±9.2 mm²/min vs 18.1±4.7 mm²/min, p<0.05). The blind dissection rate was also significantly lower in the RESD group (12.8%±3.4% vs 35.1%±3.9%, p<0.05). In an <i>in vivo</i> porcine feasibility study, the robotic device was attached to a colonoscope and successfully inserted into the proximal colon without damaging the colonic wall, and ESD was successfully performed.</p><p><strong>Conclusions: </strong>: The dissection speed and safety profile improved significantly with the retractable RESD. Thus, our robotic device has the potential to provide simple, effective, and safe multidirectional traction during colonic ESD.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":"677-685"},"PeriodicalIF":3.4,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249931/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140855953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Plate to Stomach: Exploring the Dietary Influence on Gastric Cancer.","authors":"Tae-Se Kim, Jun Haeng Lee","doi":"10.5009/gnl240264","DOIUrl":"10.5009/gnl240264","url":null,"abstract":"","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":"18 4","pages":"551-552"},"PeriodicalIF":3.4,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249945/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141616220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Daily Diet and Nutrition Risk Factors for Gastric Cancer Incidence in a Japanese Population.","authors":"Ayaka Takasu, Takuji Gotoda, Sho Suzuki, Chika Kusano, Chiho Goto, Hideki Ishikawa, Hirofumi Kogure","doi":"10.5009/gnl230354","DOIUrl":"10.5009/gnl230354","url":null,"abstract":"<p><strong>Background/aims: </strong>: Nutritional factors associated with gastric cancer (GC) are not completely understood. We aimed to determine the effect of nutrient intake on the incidence of GC.</p><p><strong>Methods: </strong>: This was a <i>post hoc</i> analysis of a prospective trial that evaluated modalities for GC screening in participants aged 30 to 74 years living in high-risk areas for GC in Japan between June 2011 and March 2013. The patients were followed up for GC incidence for 6 years. All participants completed a self-administered food frequency questionnaire (FFQ) upon enrollment before GC screening. Daily nutrient intake was calculated from the FFQ and dichotomized at each cutoff value using receiver operating characteristic analysis. Risk factors associated with GC incidence were investigated in terms of nutrient intake and participant characteristics using Cox proportional hazards regression analysis.</p><p><strong>Results: </strong>: Overall, 1,147 participants were included in this analysis. The median age was 62 years, and 50.7% of the participants were men. The median follow-up period was 2,184 days. GC was detected in 25 participants during the follow-up. Multivariate Cox proportional hazards regression analysis revealed that the intake of sodium (adjusted hazards ratio [aHR], 3.905; 95% confidence interval [CI], 1.520 to 10.035; p=0.005) and vitamin D (aHR, 2.747; 95% CI, 1.111 to 6.788, p=0.029) were positively associated with GC incidence, whereas the intake of soluble dietary fiber (aHR, 0.104; 95% CI, 0.012 to 0.905; p=0.040) was inversely associated with GC incidence.</p><p><strong>Conclusions: </strong>: Daily high intake of sodium and vitamin D and low soluble dietary fiber intake are associated with GC incidence.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":"602-610"},"PeriodicalIF":3.4,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249943/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139930862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of Palliative Chemotherapy for Ampulla of Vater Adenocarcinoma: A Multicenter Cohort Study.","authors":"Dong Kee Jang, So Jeong Kim, Hwe Hoon Chung, Jae Min Lee, Seung Bae Yoon, Jong-Chan Lee, Dong Woo Shin, Jin-Hyeok Hwang, Min Kyu Jung, Yoon Suk Lee, Hee Seung Lee, Joo Kyung Park","doi":"10.5009/gnl230164","DOIUrl":"10.5009/gnl230164","url":null,"abstract":"<p><strong>Background/aims: </strong>: Palliative chemotherapy (PC) is not standardized for patients with advanced ampulla of Vater adenocarcinoma (AA). This multicenter, retrospective study evaluated first-line PC outcomes in patients with AA.</p><p><strong>Methods: </strong>: Patients diagnosed with AA between January 2010 and December 2020 who underwent PC were enrolled from 10 institutions. Overall survival (OS) and progression-free survival (PFS) according to the chemotherapy regimen were analyzed.</p><p><strong>Results: </strong>: Of 255 patients (mean age, 64.0±10.0 years; male, 57.6%), 14 (5.5%) had locally advanced AA and 241 (94.5%) had metastatic AA. Gemcitabine plus cisplatin (GP) was administered as first-line chemotherapy to 192 patients (75.3%), whereas capecitabine plus oxaliplatin (CAPOX) was administered to 39 patients (15.3%). The median OS of all patients was 19.8 months (95% confidence interval [CI], 17.3 to 22.3), and that of patients who received GP and CAPOX was 20.4 months (95% CI, 17.2 to 23.6) and 16.0 months (95% CI, 11.2 to 20.7), respectively. The median PFS of GP and CAPOX patients were 8.4 months (95% CI, 7.1 to 9.7) and 5.1 months (95% CI, 2.5 to 7.8), respectively. PC for AA demonstrated improved median outcomes in both OS and PFS compared to conventional bile duct cancers that included AA.</p><p><strong>Conclusions: </strong>: While previous studies have shown mixed prognostic outcomes when AA was analyzed together with other biliary tract cancers, our study unveils a distinct clinical prognosis specific to AA on a large scale with systemic anticancer therapy. These findings suggest that AA is a distinct type of tumor, different from other biliary tract cancers, and AA itself could be expected to have a favorable response to PC.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":"729-736"},"PeriodicalIF":3.4,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249934/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138829319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of Factors Predicting the Real-World Efficacy of Atezolizumab and Bevacizumab in Patients with Advanced Hepatocellular Carcinoma.","authors":"Byeong Geun Song, Myung Ji Goh, Wonseok Kang, Dong Hyun Sinn, Geum-Youn Gwak, Moon Seok Choi, Joon Hyeok Lee, Yong-Han Paik","doi":"10.5009/gnl240085","DOIUrl":"10.5009/gnl240085","url":null,"abstract":"<p><strong>Background/aims: </strong>Atezolizumab and bevacizumab have shown promising results for the treatment of advanced hepatocellular carcinoma (HCC) in clinical trials. In this study, the real-world efficacy and safety of atezolizumab and bevacizumab in treating advanced HCC were evaluated.</p><p><strong>Methods: </strong>In this retrospective study of patients at a Korean tertiary cancer center, 111 patients with Barcelona Clinic Liver Cancer stage B or C HCC received atezolizumab and bevacizumab as first-line therapy from May 2022 to June 2023. We assessed the progression-free survival (PFS), overall response rate (ORR), disease control rate (DCR), and adverse events.</p><p><strong>Results: </strong>Patients with Barcelona Clinic Liver Cancer stage C HCC and Child-Pugh class A liver function were included in the study. The median PFS was 6.5 months, with an ORR of 27% and a DCR of 63%. Several factors, including the albumin-bilirubin grade, age, C-reactive protein and α-fetoprotein in immunotherapy score, macrovascular invasion, lung metastases, and combined radiotherapy, were found to significantly influence PFS (p<0.05). Patients with peritoneal seeding showed an higher ORR. The safety profile was consistent with that observed in clinical trials.</p><p><strong>Conclusions: </strong>Atezolizumab and bevacizumab demonstrated real-world efficacy in the treatment of advanced HCC, with ORRs and DCRs aligning with those observed in clinical trials. Variations in PFS and ORR based on specific risk factors highlight the potential of atezolizumab and bevacizumab in precision medicine for advanced HCC.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":"709-718"},"PeriodicalIF":3.4,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249941/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141456362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can Epigenetic and Gastric Microbiome Markers Predict the Risk of <i>Helicobacter pylori</i>-Negative Gastric Cancer?","authors":"Cheol Min Shin","doi":"10.5009/gnl240280","DOIUrl":"10.5009/gnl240280","url":null,"abstract":"","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":"18 4","pages":"553-555"},"PeriodicalIF":3.4,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141616217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges and Advancements in Palliative Chemotherapy for Ampullary Adenocarcinoma.","authors":"Eui Joo Kim","doi":"10.5009/gnl240283","DOIUrl":"10.5009/gnl240283","url":null,"abstract":"","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":"18 4","pages":"560-561"},"PeriodicalIF":3.4,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249936/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141616218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}