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Ukashi Offir,Soffer Shelly,Klang Eyal,Eliakim Rami,Ben-Horin Shomron,Kopylov Uri 거트앤리버 소화기연관학회협의회 2023 Gut and Liver Vol.17 No.4
Video capsule endoscopy (VCE) of the small-bowel has been proven to accurately diagnose small-bowel inflammation and to predict future clinical flares among patients with Crohn’s disease (CD). In 2017, the panenteric capsule (PillCam Crohn’s system) was introduced for the first time, enabling a reliable evaluation of the whole small and large intestines. The great advantage of visualization of both parts of the gastrointestinal tract in a feasible and single procedure, holds a significant promise for patients with CD, enabling determination of the disease extent and severity, and potentially optimize disease management. In recent years, applications of machine learning, for VCE have been well studied, demonstrating impressive performance and high accuracy for the detection of various gastrointestinal pathologies, among them inflammatory bowel disease lesions. The use of artificial neural network models has been proven to accurately detect/classify and grade CD lesions, and shorten the VCE reading time, resulting in a less tedious process with a potential to minimize missed diagnosis and better predict clinical outcomes. Nevertheless, prospective, and real-world studies are essential to precisely examine artificial intelligence applications in real-life inflammatory bowel disease practice.
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( Yue Zhao ),( Baili Chen ),( Yao He ),( Shenghong Zhang ),( Yun Qiu ),( Rui Feng ),( Hongsheng Yang ),( Zhirong Zeng ),( Shomron Ben-horin ),( Minhu Chen ),( Ren Mao ) 대한장연구학회 2020 Intestinal Research Vol.18 No.2
Background/Aims: Crohn’s disease (CD) primarily affects young female adults of reproductive age. Few studies have been conducted on this population’s ovarian reserve status. The aim of study was to investigate potential risk factors associated with low ovarian reserve, as reflected by serum anti-Müllerian hormone (AMH) in women of reproductive age with CD. Methods: This was a case-control study. Cases included 87 patients with established CD, and healthy controls were matched by age, height and weight in a 1:1 ratio. Serum AMH levels were measured by enzyme-linked immunosorbent assay. Results: The average serum AMH level was significantly lower in CD patients than in control group (2.47±2.08 ng/mL vs. 3.87±1.96 ng/mL, respec tively, P<0.001). Serum AMH levels were comparable between CD patients and control group under 25 years of age (4.41±1.52 ng/mL vs. 3.49±2.10 ng/mL, P=0.06), however, serum AMH levels were significantly lower in CD patients over 25 years of age compared to control group (P<0.05). Multivariable analysis showed that an age greater than 25 (odds ratio [OR], 10.03; 95% confidence interval [CI], 1.90-52.93, P=0.007), active disease state (OR, 27.99; 95% CI, 6.13-127.95, P<0.001) and thalidomide use (OR, 15.66; 95% CI, 2.22-110.65, P=0.006) were independent risk factors associated with low ovarian reserve (serum AMH levels <2 ng/mL) in CD patients. Conclusions: Ovarian reserve is impaired in young women of reproductive age with CD. Age over 25 and an active disease state were both independently associated with low ovarian reserve. Thalidomide use could result in impaired ovarian reserve. (Intest Res 2020; 18:200-209)
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Surgical management of inflammatory bowel disease in China: a systematic review of two decades
( Qiao Yu ),( Ren Mao ),( Lei Lian ),( Siew Chien Ng ),( Shenghong Zhang ),( Zhihui Chen ),( Yanyan Zhang ),( Yun Qiu ),( Baili Chen ),( Yao He ),( Zhirong Zeng ),( Shomron Ben-horin ),( Xinming Song 대한장연구학회 2016 Intestinal Research Vol.14 No.4
Background/Aims: The past decades have seen increasing incidence and prevalence of inflammatory bowel disease (IBD) in China. This article aimed to summarize the current status and characteristics of surgical management for IBD in China. Methods: We searched PubMed, Embase, and Chinese databases from January 1, 1990 to July 1, 2014 for all relevant studies on the surgical treatment IBD in China. Eligible studies with sufficient defined variables were further reviewed for primary and secondary outcome measures. Results: A total of 74 studies comprising 2,007 subjects with Crohn`s disease (CD) and 1,085 subjects with ulcerative colitis (UC) were included. The percentage of CD patients misdiagnosed before surgery, including misdiagnosis as appendicitis or UC, was 50.8%±30.9% (578/1,268). The overall postoperative complication rate was 22.3%±13.0% (267/1,501). For studies of UC, the overall postoperative complication rate was 22.2%±27.9% (176/725). In large research centers (n>50 surgical cases), the rates of emergency operations for CD (P =0.032) and in-hospital mortalities resulting from both CD and UC were much lower than those in smaller research centers (n≤50 surgical cases) (P =0.026 and P <0.001, respectively). Regarding the changes in CD and UC surgery over time, postoperative complications (P =0.045 for CD; P =0.020 for UC) and postoperative in-hospital mortality (P =0.0002 for CD; P =0.0160 for UC) both significantly improved after the year 2010. Conclusions: The surgical management of IBD in China has improved over time. However, the rates of misdiagnosis and postoperative complications over the past two decades have remained high. Large research centers were found to have relatively better capacity for surgical management than the smaller ones. Higher quality prospective studies are needed in China. (Intest Res 2016;14:322-332)
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