Journal of Yeungnam Medical Science

Original article

Gastroenterology and Hepatology
Clinical association between histological activity at diagnosis and endoscopic response in patients with ulcerative colitis: a retrospective study: Jae-Sung Yoo, Kyeong Ok Kim, Min Cheol Kim, Byung Ik Jang; J Yeungnam Med Sci. 2025;42:39. Published online June 22, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.39 [Epub ahead of print]

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Abstract PDF: Background
Histological activity in ulcerative colitis (UC) has been accepted to be associated with clinical outcomes. This study aimed to investigate the association between the histological activity at diagnosis and endoscopic findings, either at diagnosis or at the first follow-up, in patients with UC.
Methods
Through a retrospective review of 1 year of medical records, this study evaluated the association between histological and endoscopic activity in 51 patients newly diagnosed with UC at our hospital between March 2015 and February 2022. The Nancy histological index was used to assess histological activity, classifying patients into low (0–2) and high (3–4) groups. The Mayo Endoscopic Subscore and the Ulcerative Colitis Endoscopic Index of Severity (UCEIS) were used for endoscopic activity scoring.
Results
At diagnosis, UCEIS demonstrated no statistically significant difference histologically (p=0.065), and histological and endoscopic activities were not significantly correlated (r=0.18, p=0.200). During the first follow-up, 40 patients (78.4%) exhibited low histological activity, and the number of patients with high histological activity decreased after treatment. The first follow-up endoscopy revealed that 30 patients (58.8%) achieved an endoscopic response, including 9 (56.2%) and 21 patients (60.0%) in the high and low groups, respectively, with no significant difference (p=0.800). However, the high group at diagnosis demonstrated a positive correlation with UCEIS endoscopic activity during the first follow-up (r=0.37, p<0.001).
Conclusion
High histological activity at diagnosis was positively correlated with endoscopic activity at the first follow-up. More active care should be provided to patients with high histological activity during diagnosis.

Review article

Gastroenterology and Hepatology
Recent updates on classification and unsolved issues of diverticular disease: a narrative review: Kyeong Ok Kim; J Yeungnam Med Sci. 2024;41(4):252-260. Published online August 30, 2024; DOI: https://doi.org/10.12701/jyms.2024.00542

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Abstract PDF: Recently, a paradigm shift has occurred in the classification of diverticular disease and the understanding of its pathogenesis. Diverticular disease is now defined as a variety of clinically significant conditions such as diverticulitis, diverticular bleeding, symptomatic uncomplicated diverticular disease, and segmental colitis associated with diverticulosis. Low-grade inflammation, visceral hypersensitivity, abnormal intestinal motility, and genetic factors have emerged as the key contributors to the pathogenesis of diverticular disease. Routine antibiotic use is no longer recommended for all cases of diverticulitis, and simple recurrence is not an indication for surgical treatment. Early colonoscopy with proper preparation is recommended for the treatment of diverticular bleeding, although recent studies have not shown significant efficacy in preventing recurrence. The roles of dietary fiber, nonabsorbable antibiotics, 5-aminosalicylates, and probiotics in the prevention of diverticular disease are controversial and require further investigation.

Original article

Gastroenterology and Hepatology
Efficacy of ramosetron in combination with polyethylene glycol of preparing for a colonoscopy: Min Kyu Kang, Byung Ik Jang, Jun Suk Park, Kyeong Ok Kim; Yeungnam Univ J Med. 2019;36(2):99-104. Published online December 28, 2018; DOI: https://doi.org/10.12701/yujm.2019.00080

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Abstract PDF

Background
Because of its efficacy and safety, polyethylene glycol (PEG) is generally used to prepare for colonoscopy. However, the side effects of PEG, including nausea, vomiting, abdominal discomfort, pain, and general weakness, tend to decrease patient compliance and satisfaction. The aim of this study is to investigate the efficacy and safety of PEG with 0.1 mg ramosetron on colonoscopy patients who had difficulty taking PEG due to side effects or large volume.
Methods
From January to August in 2012, 28 patients who visited Yeungnam University hospital for a colonoscopy were prospectively enrolled. All enrolled patients were previous history underwent colonoscopy using PEG only in our hospital. The efficacy and safety of ramosetron were assessed through the use of a questionnaire, and compared previous bowel preparation.
Results
Compared to previous examination, the patients using the ramosetron reported less nausea, vomiting, abdominal discomfort, and abdominal pain, as well as a higher degree of compliance and satisfaction of the patient. There were no side effects reported with the use of ramosetron. However, overall bowel preparation quality was not better than the previous examination.
Conclusion
In case of the use of ramosetron in combination with PEG for bowel preparation, patients experienced a higher rate of compliance and tolerance. Looking forward, ramosetron may become an option of pretreatment for bowel preparation.

Citations

Citations to this article as recorded by

Tolerance to colonoscopy preparation with Fortrans and predictors of negative effects
I. A. Matveev, B. K. Gibert, A. I. Matveev, M. P. Kozlov
Bulletin of Siberian Medicine.2021; 20(1): 83. CrossRef

Case Reports

Gastroenterology and Hepatology
A Case of Duodenal Brunner's Gland Adenoma Treated by Endoscopic Rescetion.: Sung Joon Kim, Min Geun Gu, Jun Suk Park, Kyeong Ok Kim, Si Hyung Lee, Tae Nyeun Kim, Jun Hyuk Choi; Yeungnam Univ J Med. 2011;28(1):84-89. Published online June 30, 2011; DOI: https://doi.org/10.12701/yujm.2011.28.1.84

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Abstract PDF

Brunneroma, also known as Brunner's gland adenoma or harmatoma, is a very rare benign tumor of the duodenum, which is usually asymptomatic, and is discovered incidentally during endoscopic exam. These lesions are most commonly located in the duodenal bulb and clinical manifestations are variable. We report on a case of a large Brunner's gland adenoma in a 54-year-old man, which was successfully removed by endoscopic resection without complications, such as bleeding or perforation. Microscopically, it was composed entirely of variable Brunner's gland.

Citations

Citations to this article as recorded by

Solitary schwannoma of the ascending colon
Myeong Su Chu, Hyun Mo Kang, Hyeong Ju Sun, Dong Min Kim, Hyong Jong Kwak
Yeungnam University Journal of Medicine.2016; 33(1): 37. CrossRef

Gastroenterology and Hepatology
A Case of Primary Rectal Colon Mucosa associated Lymphoid Tissue Lymphoma.: Jun Suk Park, Byung Ik Jang, Jun Hyuk Choi, Kyeong Ok Kim, Min Geun Gu, Min Kyu Kang; Yeungnam Univ J Med. 2010;27(2):150-154. Published online December 31, 2010; DOI: https://doi.org/10.12701/yujm.2010.27.2.150

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Abstract PDF: The gastrointestinal tract(GI) is the most frequently involved site of mucosa associated lymphoid tissue (MALT) lymphoma. Stomach is the most common site of involvement among the GI tract. In some case of MALT lymphoma, it is detected in colon. Almost all diagnosis is established by pathological examination of the surgical or endoscopic specimens. We reported a case of rectal MALT lymphoma by colonoscopic polypectomy.

Gastroenterology and Hepatology
A Case of Esophageal Bullous Pemphigoid Manifestated by Upper Gastrointestinal Bleeding: Kyeong Ok Kim, Byung Ik Jang, Jong Ryul Eun, Tae Nyun Kim; Yeungnam Univ J Med. 2007;24(2 Suppl):S671-675. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S671

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Abstract PDF

Bullous pemphiogid (BP) is a chronic vesicular disorder and an autoimmune disease which has an autoantibodies to hemidesmosime in the keratinocyte. The authors report a case of gastrointestinal bleeding caused by BP involved with esophagus. A seventy year old man visited our clinic due to melena for a week. He had a quadriplegia due to fracture of cervical spine and was on therapy with corticosteroid and immunomodulatory drug for the diagnosis of BP. On endoscopic examination, multiple bullae filled with blood at lower esophagus was revealed and there was no other bleeding focus in stomach and duodenum. Medical treatment for BP with supportive care was done. The patient died due to sepsis caused by pneumonia. BP is common in elderly or poor conditioned patients. We need to consider the invasion of esophagus in case of gastrointestinal bleeding in patients with BP.

Citations

Citations to this article as recorded by

Esophageal Involvement of Bullous Pemphigoid
Junseak Lee, Sanggon Moon, Chul-Hyun Lim
The Korean Journal of Gastroenterology.2021; 78(4): 249. CrossRef

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