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        임상적 관해기의 궤양성 대장염 환자에서 Escherchia coli Nissle 1917의 치료 효과: 단일 병원 코호트 연구

        오규만 ( Gyu Man Oh ),문원 ( Won Moon ),서광일 ( Kwang Il Seo ),정경원 ( Kyoungwon Jung ),김재현 ( Jae Hyun Kim ),김성은 ( Sung Eun Kim ),박무인 ( Moo In Park ),박선자 ( Seun Ja Park ) 대한소화기학회 2021 대한소화기학회지 Vol.77 No.1

        Background/Aims: Escherichia coli Nissle 1917 (EcN) alone therapy is as effective as mesalamine in inducing and maintaining remission in ulcerative colitis (UC). The efficacy and safety of EcN in combination with standard therapies have not been studied. This study examined the changes in the inflammation markers and symptoms following the additional administration of EcN to patients showing the clinical remission of UC. Methods: UC patients who received EcN after being in clinical remission for more than 3 months at Kosin University Gospel Hospital between 2013 and 2018 were evaluated through the retrospective medical-record-based review. The partial Mayo score, fecal calprotectin (FC), BMI, hemoglobin, serum cholesterol, serum albumin levels, and the safety profiles were examined at 3rd and 6th months after initiating EcN. Results: Ninety-four patients were included. After 3 months of treatment, there was no significant change in FC (156.3 μg/g to 141.1 μg/g) (p=0.653). On the other hand, partial Mayo score decreased significantly from 0.085 to 0.014 (p=0.025), and the bodyweight (p=0.001), BMI (p<0.001), hemoglobin (p=0.009), and cholesterol level increased (p=0.148). One patient (1.1%) experienced a serious adverse event with UC flare-up, and 14 patients (14.9%) discontinued EcN due to adverse events; all developed within 3 months. Conclusions: Additional administration of EcN to clinically remission-attained UC patients may improve the UC symptoms without changing the FC levels. EcN-associated adverse events develop within the early few weeks. (Korean J Gastroenterol 2021;77:12 -21)

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        관해 상태인 크론병 환자에서 Saccharomyces Boulardii 복용 후 Crohn's Disease Activity Index의 변화: 단일 기관 후향적 연구

        오규만 ( Gyu Man Oh ),문원 ( Won Moon ),서광일 ( Kwang Il Seo ),정경원 ( Kyoungwon Jung ),김재현 ( Jae Hyun Kim ),김성은 ( Sung Eun Kim ),박무인 ( Moo In Park ),박선자 ( Seun Ja Park ) 대한소화기학회 2020 대한소화기학회지 Vol.76 No.6

        Background/Aims: Crohn’s disease (CD) is characterized by uncontrolled inflammation of the intestine. Saccharomyces boulardii (S. boulardii), a probiotic, stabilizes the intestinal wall. This study examined the changes in the CD activity index (CDAI) after taking S. boulardii in patients with CD in clinical remission. Methods: In this single hospital-based retrospective cohort study, the medical records of CD patients in clinical remission, who had received S. boulardii for more than 6 months, were reviewed. The CDAI, BMI, and serum levels of hemoglobin (Hb), ferritin, iron, vitamin B12, folate, total protein, albumin, total cholesterol, CRP, and fecal calprotectin (FC) between the initiation and the 6th month were compared. The timing and reasons for the discontinuation were also investigated. Results: One hundred and fifty-four patients were included, and 92 patients, who received for more than 6 months, were analyzed. The changes in CDAI, BMI, Hb, and total cholesterol were significant as follows: CDAI from 38.52 to 30.53 (p<0.01), BMI (kg/m<sup>2</sup>) from 23.38 to 23.97 (p<0.01), Hb (g/dL) from 13.73 to 14.03 (p<0.01), and total cholesterol (mg/dL) from 154.9 to 161.5 (p<0.01). On the other hand, the changes in FC, CRP, ferritin, vitamin B12, folate, total protein, and albumin were not statistically significant. Only one patient stopped due to a flare-up, but this was not believed to be related to the drug. Conclusions: In patients with CD in remission, S. boulardii appears to improve the CDAI, BMI, serum Hb, and total cholesterol level without safety issues. Further randomized controlled studies will be needed. (Korean J Gastroenterol 2020;76:314-321)

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