Usefulness of the Cytomegalovirus Antigenemia Assay in Patients With Ulcerative Colitis

( Jaeyoung Chun ),( Changhyun Lee ),( Ji Eun Kwon ),( Sung Wook Hwang ),( Sang Gyun Kim ),( Joo Sung Kim ),( Hyun Chae Jung ),( Jong Pil Im ) 대한장연구학회 2015 Intestinal Research Vol.13 No.1

Background/Aims: Patients with ulcerative colitis (UC) are at high risk for cytomegalovirus (CMV) reactivation. The useful-ness of the CMV antigenemia assay in active UC patients has rarely been studied. We assessed whether the assay detects CMV colitis and predicts clinical outcomes in patients with UC. Methods: We retrospectively reviewed the medical records of pa-tients hospitalized for moderate-to-severe UC from 2003 to 2012. Positive CMV antigenemia was defined as ≥1 pp65-positive cell per 2×105 polymorphonuclear neutrophils. CMV colitis was defined as the presence of inclusion bodies and/or positive im-munohistochemistry in the colonic mucosa. The primary outcome was steroid refractoriness, defined as the absence of clinical improvement after intravenous high-dose steroid administration. Results: A total of 43 patients were enrolled. CMV antigen-emia was detected in 12 (27.9%) patients. Positive CMV antigenemia was significantly associated with CMV colitis (P=0.001). The sensitivity and specificity of positive CMV antigenemia for diagnosing CMV colitis were 66.7% and 87.1%, respectively. Steroid refractoriness was found in 11 of 12 (91.7%) and 12 of 31 (38.7%) patients with positive and negative CMV antigenemia, respectively (P=0.002). The independent predictors for steroid refractoriness were positive CMV antigenemia (adjusted odds ratio [OR], 7.73; 95% confidence interval [CI], 1.22-49.19; P=0.030) and a shorter duration from the diagnosis of UC (adjusted OR, 0.99; 95% CI, 0.98-0.99; P=0.025). Conclusions: The CMV antigenemia assay shows low sensitivity but high specificity for detecting CMV colitis and may predict steroid-refractory UC. Early rescue therapy might be considered in UC patients positive for CMV antigenemia. (Intest Res 2015;13:50-59)

Adalimumab or infliximab: which is better for perianal fistula in Crohn`s disease?

( Jong Pil Im ) 대한장연구학회 2017 Intestinal Research Vol.15 No.2

Proton Pump Inhibitor Use before Percutaneous Endoscopic Gastrostomy Is Associated with Adverse Outcomes

( Jong Pil Im ),( Jae Myung Cha ),( Ji Won Kim ),( Seong Eun Kim ),( Dong Yup Ryu ),( Eun Young Kim ),( Eun Ran Kim ),( Dong Kyung Chang ) 대한소화기학회 2014 Gut and Liver Vol.8 No.3

Background/Aims: Knowledge of the risk factors associated with adverse outcomes after percutaneous endoscopic gastrostomy (PEG) may be helpful for developing PEG recommendations. The purpose of this study was to identify the clinical risk factors associated with adverse clinical outcomes after PEG, especially regarding the use of proton pump inhibitors (PPIs). Methods: We retrospectively reviewed the data from PEG patients at seven university hospitals between June 2006 and January 2012. All patients were followed up through February 2012 after PEG, and the clinical risk factors for adverse clinical outcomes after PEG were analyzed. Results: Data from 1,021 PEG patients were analyzed. PPI users were more frequently included in the complication group than the noncomplication group (p=0.040). PEG-related complications (p=0.040) and mortality (p=0.003) were more frequent in the PPI group than in the control group. In the subgroup analysis of complicated PEG cases, infectious complications were more frequently found in the PPI group than in the control group (35.8% vs 27.8%). After adjustment for multiple possible confounding factors, PPI users (odds ratio, 1.531; 95% confidence interval, 1.017 to 2.305) and diabetic patients had increased mortality after PEG. Conclusions: PPI use may be associated with adverse outcomes in patients with PEG; however, further prospective studies investigating this issue are warranted.

Changing treatment paradigms for the management of inflammatory bowel disease

Jong Pil Im,Byong Duk Ye,You Sun Kim,Joo Sung Kim 대한내과학회 2018 The Korean Journal of Internal Medicine Vol.33 No.1

Inf lammatory bowel disease (IBD) is a chronic and progressive inf lammatory condition of the gastrointestinal tract causing bowel damage, hospitalizations, surgeries, and disability. Although there has been much progress in the management of IBD with established and evolving therapies, most current approaches have failed to change the natural course. Therefore, the treatment approach and follow-up of patients with IBD have undergone a significant change. Usage of immunosuppressants and/or biologics early during the course of the disease, known as top-down or accelerated step-up approach, was shown to be superior to conventional management in patients who had been recently diagnosed with IBD. This approach can be applied to selected groups based on prognostic factors to control disease activity and prevent progressive disease. Therapeutic targets have been shifted from clinical remission mainly based on symptoms to objective parameters such as endoscopic healing due to the discrepancies observed between symptoms, objectively evaluated inf lammatory activity, and intestinal damage. The concept of treat-to-target in IBD has been supported by population-based cohort studies, post hoc analysis of clinical trials, and meta-analysis, but more evidence is needed to support this concept to be applied to the clinical practice. In addition, individualized approach with tight monitoring of non-invasive biomarker such as C-reactive protein and fecal calprotectin and drug concentration has shown to improve clinical and endoscopic outcomes. An appropriate de-escalation strategy is considered based on patient demographics, disease features, current disease status, and patients’ preferences.

Poster Session : PS 0866 ; Lower GI Tract : Disease Phenotype, Activity, and Clinical Course Based on the C-Reactive Protein Level at Diagnosis in Crohn`s Disease: Results from the Connect Study

( Jong Pil Im ),( Jee Hye Kwon ),( Joo Sung Kim ),( Jae Hee Cheon ),( Won Ho Kim ),( You Sun Kim ),( Byong Duk Ye ),( Kang Moon Lee ),( Young Ho Kim ),( Dong Soo Han ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Backgroud: Disease course of CD is unpredictable and clinical manifestation is heterogeneous with phenotypic change. Although several clinical factors, serologic, and genetic biomarkers may be used for the prediction of clinical course, definite prognostic factor has not been established. CRP is easily measurable noninvasive marker to evaluate disease activity and there`s controversy about the role for prediction of clinical course. Therefore, we designed a study to investigate whether CRP at diagnosis is valuable for identification of disease phenotype, activity, and clinical course in CD. Methods: We retrospectively analyzed 705 CD patients with measurable CRP level who were enrolled into Crohn`s Disease Clinical Network and Cohort (CONNECT) study in 32 hospitals. Those patients divided into CRP > 2 or CRP = 2 mg/dL at diagnosis. Patient`s demographic, clinical characteristics, and use of immunosuppressive or biological agents were investigated. Disease location, behavior, number of admission, operation/reoperation were also analyzed based on the CRP. Results: Of 705 CD patients, 52.9% had CRP > 2 mg/dL at diagnosis. High CRP was associated with young age, steroid use at diagnosis, CDAI at diagnosis, and ileocolonic location (P<0.001, <0.001, 0.001, and <0.001, respectively). Longitudinal ulcer and cobblestone appearance were higher in high CRP group (P<0.001). In disease progress, patients with high CRP were found to have more stricturing feature (P=0.027). There were significant differences in use of 5-aminosalicylic acid, antibiotics, corticosteroid, and azathioprine (P<0.001, < 0.001, <0.001, and <0.001, respectively). Readmission was also higher in patients with high CRP. Conclusion: Our study suggested that high CRP level at diagnosis was associated with stricturing phenotype, high disease activity, and more severe clinical course. Patients with high CRP could be considered strict follow-up strategy and examination for early aggressive treatment.

호산구증가증에 대한 단기간 스테로이드 치료 후 대장천공으로 발현한 거대세포바이러스 대장염 1예

임종필 ( Jong Pil Im ),전윤경 ( Yoon Kyung Jeon ),김상균 ( Sang Gyun Kim ),김주성 ( Joo Sung Kim ),정현채 ( Hyun Chae Jung ),송인성 ( In Sung Song ) 대한장연구학회 2007 Intestinal Research Vol.5 No.1

Cytomegalovirus (CMV) infection is a rare event that has been reported mainly in immunocompromised patients who have HIV infection or receive immunosuppressive medication. Although CMV infection is generally asymptomatic in healthy individuals, CMV colitis in immunocompetent host can be potentially severe disease with significant morbidity, especially in older patients. We report a case of CMV colitis complicated by colonic perforation after short term steroid therapy in a patient with eosinophilia who has no evidence of immunosuppression. A high index of suspicion is crucial for early diagnosis of CMV colitis especially in older patients, even though obvious evidence of immunodeficiency is lacking. Colonoscopic examination including multiple biopsies is mandatory for diagnosis of CMV colitis, and antiviral agents should be started once the diagnosis is confirmed. (Intest Res 2007;5:81-86)

성인 남성에서 과민성 장증후군과 하부 요로 증상과의 연관성 -인터넷 설문 조사-

임종필 ( Jong Pil Im ),김병관 ( Byeong Gwan Kim ),김지원 ( Ji Won Kim ),이국래 ( Kook Lae Lee ),손환철 ( Hwan Cheol Son ),김주성 ( Joo Sung Kim ),정현채 ( Hyun Chae Jung ),송인성 ( In Sung Song ) 대한소화기학회 2009 대한소화기학회지 Vol.53 No.6

목적: 이번 연구는 젊은 성인 남성에서 과민성 장증후군과 하부 요로 증상과의 연관성과 삶의 질에 미치는 영향을 알아보고자 하였다. 대상 및 방법: 인터넷 전문 설문업체에 등록된 총 23,594명의 20-59세까지의 남성에게 이메일을 발송하여 성실히 설문에 응답한 601명을 최종 분석에 포함하였다. 과민성 장증후군은 로마 기준 II, 하부 요로 증상은 국제 전립선 증상 점수표(International Prostate Symptom Score, IPSS)를 사용하여 평가하였다. 결과: 대상자의 평균 연령은 35.5세였으며, 118명(19.6%)이 로마 기준 II에 근거한 과민성장증후군에 해당하였다. 과민성 장증후군에서 총 IPSS를 이용한 배뇨 증상 점수는 평균 9.6으로 대조군의 7.0보다 유의하게 높았다(p<0.01). 과민성 장증후군에서 `중등증`과 `중증`의 요로 증상을 호소한 분율이 각각 33.9%와 13.6%로 대조군보다 유의하게 높았다(26.9%와 5.2%) (p<0.01). 다변량 회귀분석에서 과민성 장증후군만이 중등증 이상의 하부 요로 증상과 유의한 상관 관계를 나타냈다(OR, 1.91; 95% CI, 1.27-2.88). 또한, 과민성 장증후군에서 대조군보다 요로 증상에 의한 삶의 질 점수가 더욱 불량한 것으로 나타났다. 결론: 과민성 장증후군을 가진 젊은 성인 남성에서 더욱 심한 하부 요로 증상을 호소하며, 이로 인하여 삶의 질 저하가 동반되었다. Background/Aims: Patients with irritable bowel syndrome (IBS) are more likely to experience certain urinary symptoms. The aims of this study were to investigate the association between lower urinary tract symptoms (LUTS) and IBS, and to determine their impact on the quality of life. Methods: E-mails were sent to 23,594 men who were registered at an internet survey company. Subjects were requested to fill out the questionnaires regarding IBS and LUTS assessed by the International Prostate Symptom Score (IPSS). Results: Among 601 subjects (mean age, 35.5±8.4) included in the final analysis, 118 (19.6%) fulfilled the Rome II criteria for the diagnosis of IBS. The total mean IPSS of IBS subjects was 9.6, which was significantly higher than the 7.0 of non-IBS subjects (p<0.01). When IPSS was subcategorized into mild, moderate, and severe symptom categories, the proportions with the moderate and severe symptoms among IBS subjects were 33.9% and 13.6% respectively, which were significantly higher than those of non-IBS subjects; (26.9 and 5.2%) (p<0.01). In multivariate analysis, statistically significant association was found between IBS and moderate to severe LUTS (OR, 1.91; 95% CI, 1.27-2.88). IBS subjects also showed a poorer quality of life score than non-IBS subjects (2.24 vs. 1.65, p<0.001). Conclusions: LUTS in adult men with IBS are more severe and have a more negative impact on the quality of life than in non-IBS subjects. (Korean J Gastroenterol 2009;53:348-354)

Enhanced electrochemical performance of template-free carbon-coated iron(II, III) oxide hollow nanofibers as anode material for lithium-ion batteries

Im, Mi Eun,Pham-Cong, De,Kim, Ji Yoon,Choi, Hun Seok,Kim, Jae Hyun,Kim, Jong Pil,Kim, Jinwoo,Jeong, Se Young,Cho, Chae Ryong Elsevier 2015 Journal of Power Sources Vol.284 No.-

<P><B>Abstract</B></P> <P>Carbon-coated Fe<SUB>3</SUB>O<SUB>4</SUB> hollow nanofibers (Fe<SUB>3</SUB>O<SUB>4</SUB>/C hNFs) as a lithium ion battery anode material are prepared through electrospinning, annealing, and hydrothermal processing. At a high current density of 1000 mAg<SUP>−1</SUP>, the template-free Fe<SUB>3</SUB>O<SUB>4</SUB>/C hNFs exhibit high 1st- and 150th-cycle specific capacities of ∼963 and 978 mAhg<SUP>−1</SUP>, respectively. Moreover, Fe<SUB>3</SUB>O<SUB>4</SUB>/C hNFs have excellent and stable rate capability, compared to that of the Fe<SUB>3</SUB>O<SUB>4</SUB> hNFs, and a capacity of 704 mAhg<SUP>−1</SUP> at a current density of 2000 mAg<SUP>−1</SUP>. Owing to the carbon layer, the Li-ion diffusion coefficient of the Fe<SUB>3</SUB>O<SUB>4</SUB>/C hNFs, 8.10 × 10<SUP>−14</SUP> cm<SUP>2</SUP> s<SUP>−1</SUP>, is 60 times higher than that (1.33 × 10<SUP>−15</SUP> cm<SUP>2</SUP> s<SUP>−1</SUP>) of the Fe<SUB>3</SUB>O<SUB>4</SUB> hNFs. These results indicate that Fe<SUB>3</SUB>O<SUB>4</SUB>/C hNFs may have important implications for developing high performance anodes for next-generation lithium ion batteries.</P> <P><B>Highlights</B></P> <P> <UL> <LI> Fe<SUB>3</SUB>O<SUB>4</SUB> hollow nanofibers are fabricated by electrospinning and annealing process. </LI> <LI> Carbon-coated Fe<SUB>3</SUB>O<SUB>4</SUB> hollow nanofibers are formed by using hydrothermal process. </LI> <LI> Physical and electrochemical properties of the samples are investigated in detail. </LI> <LI> Carbon-coated Fe<SUB>3</SUB>O<SUB>4</SUB> hollow nanofibers are showing better electrochemical performance. </LI> </UL> </P>

Torque Maximization Control of 3-Phase BLDC Motors in the High Speed Region

Im, Won-Sang,Kim, Jong-Pil,Kim, Jang-Mok,Baek, Kwang-Ryul The Korean Institute of Power Electronics 2010 JOURNAL OF POWER ELECTRONICS Vol.10 No.6

This paper proposes a new torque control algorithm for BLDC motors to get the maximum torque in the high speed region. The delay of the phase currents is severe due to the stator reactance. The torque fluctuations of BLDC motors increase and the average torque is decreases due to a slow rise in the phase current when compared to the back EMF. In this paper, the phase current of BLDC motors under the high speed condition is analyzed and a torque maximization control is developed on the basis of using numerical analysis. Computer simulations and experimental results show the usefulness of the proposed control algorithm.

Poster Session : PS 0908 ; Lower GI Tract : Polyp and Adenoma Detection Rate for the Colonoscopy Performed by Trainees

( Jong Kyoung Choi ),( Jong Pil Im ),( Joo Sung Kim ),( Hyun Chae Jung ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Background: The polyp detection rate (PDR) has been used an alternative quality indicator of colonoscopy to the adenoma detection rate (ADR). Both PDR and ADR are calculated for the entire colon, but recent studies have demonstrated that PDR accurately estimated ADR in the right colon, but not in the rectum and sigmoid. Littleis known about the correlation between PDR and ADR in depending on colonscopic training level. The aim of this study is to assess the effect of training level to determine whether the PDRs correlate with their ADRs in individual colonic segments. Methods: This is a prospective study for first-year gastrointestinal fellows at an academic hospital during an 8-month training period. We excluded incomplete and emergency procedures, and those performed in patients with inflammatory bowel disease, history of colorectal surgery or colorectal cancer. We calculated the PDR and ADR (number of colonoscopies with at least 1 polyp or adenoma detected, respectively, divided by the number of colonoscopies) for each endoscopists, using data from the entire colon and then for each colonic segment separately.Results: During 2386 colonoscopies, 2122 polyps were removed; 1398(65.8%) were adenomas. The mean of the PDR and the ADR were 0.45±0.05 and 0.32±0.03, respectively. Endoscopist`s PDRs correlated well with their ADRs (Pearson`s correlation coeffi - cient r = 0.73, p=0.02). There was no signifi cant difference in the correlation between PDR and ADR depending on learning curve as well as colonic segment.Conclusions: We observed a well correlation in PDR and ADR regardless of training level and in colonoscopies by fellows. The PDR may be as a surrogate for ADR, regardless of the learning curve.