1.Characteristics of Pediatric Ulcerative Colitis at Diagnosis in Korea: Results From a Multicenter, Registry-Based, Inception Cohort Study
Jin Gyu LIM ; Ben KANG ; Seak Hee OH ; Eell RYOO ; Yu Bin KIM ; Yon Ho CHOE ; Yeoun Joo LEE ; Minsoo SHIN ; Hye Ran YANG ; Soon Chul KIM ; Yoo Min LEE ; Hong KOH ; Ji Sook PARK ; So Yoon CHOI ; Su Jin JEONG ; Yoon LEE ; Ju Young CHANG ; Tae Hyeong KIM ; Jung Ok SHIM ; Jin Soo MOON
Journal of Korean Medical Science 2024;39(49):e303-
Background:
We aimed to investigate the characteristics of pediatric ulcerative colitis (UC) at diagnosis in Korea.
Methods:
This was a multicenter, registry-based, inception cohort study conducted in Korea between 2021 and 2023. Children and adolescents newly diagnosed with UC < 18 years were included. Baseline clinicodemographics, results from laboratory, endoscopic exams, and Paris classification factors were collected, and associations between factors at diagnosis were investigated.
Results:
A total 205 patients with UC were included. Male-to-female ratio was 1.59:1, and the median age at diagnosis was 14.7 years (interquartile range 11.9–16.2). Disease extent of E1 comprised 12.2% (25/205), E2 24.9% (51/205), E3 11.2% (23/205), and E4 51.7% (106/205) of the patients. S1 comprised 13.7% (28/205) of the patients. The proportion of patients with a disease severity of S1 was significantly higher in patients with E4 compared to the other groups (E1: 0% vs. E2: 2% vs. E3: 0% vs. E4: 24.5%, P < 0.001). Significant differences between disease extent groups were also observed in Pediatric Ulcerative Colitis Activity Index (median 25 vs. 35 vs. 40 vs. 45, respectively, P < 0.001), hemoglobin (median 13.5 vs.13.2 vs. 11.6 vs. 11.4 g/dL, respectively, P < 0.001), platelet count (median 301 vs. 324 vs. 372 vs. 377 × 103 /μL, respectively, P = 0.001), C-reactive protein (median 0.05 vs. 0.10 vs. 0.17 vs. 0.38 mg/dL, respectively, P < 0.001), and Ulcerative Colitis Endoscopic Index of Severity (median 4 vs. 4 vs. 4 vs. 5, respectively, P = 0.006). No significant differences were observed in factors between groups divided according to sex and diagnosis age.
Conclusion
This study represents the largest multicenter pediatric inflammatory bowel disease cohort in Korea. Disease severity was associated with disease extent in pediatric patients with UC at diagnosis.
2.Characteristics of Pediatric Ulcerative Colitis at Diagnosis in Korea: Results From a Multicenter, Registry-Based, Inception Cohort Study
Jin Gyu LIM ; Ben KANG ; Seak Hee OH ; Eell RYOO ; Yu Bin KIM ; Yon Ho CHOE ; Yeoun Joo LEE ; Minsoo SHIN ; Hye Ran YANG ; Soon Chul KIM ; Yoo Min LEE ; Hong KOH ; Ji Sook PARK ; So Yoon CHOI ; Su Jin JEONG ; Yoon LEE ; Ju Young CHANG ; Tae Hyeong KIM ; Jung Ok SHIM ; Jin Soo MOON
Journal of Korean Medical Science 2024;39(49):e303-
Background:
We aimed to investigate the characteristics of pediatric ulcerative colitis (UC) at diagnosis in Korea.
Methods:
This was a multicenter, registry-based, inception cohort study conducted in Korea between 2021 and 2023. Children and adolescents newly diagnosed with UC < 18 years were included. Baseline clinicodemographics, results from laboratory, endoscopic exams, and Paris classification factors were collected, and associations between factors at diagnosis were investigated.
Results:
A total 205 patients with UC were included. Male-to-female ratio was 1.59:1, and the median age at diagnosis was 14.7 years (interquartile range 11.9–16.2). Disease extent of E1 comprised 12.2% (25/205), E2 24.9% (51/205), E3 11.2% (23/205), and E4 51.7% (106/205) of the patients. S1 comprised 13.7% (28/205) of the patients. The proportion of patients with a disease severity of S1 was significantly higher in patients with E4 compared to the other groups (E1: 0% vs. E2: 2% vs. E3: 0% vs. E4: 24.5%, P < 0.001). Significant differences between disease extent groups were also observed in Pediatric Ulcerative Colitis Activity Index (median 25 vs. 35 vs. 40 vs. 45, respectively, P < 0.001), hemoglobin (median 13.5 vs.13.2 vs. 11.6 vs. 11.4 g/dL, respectively, P < 0.001), platelet count (median 301 vs. 324 vs. 372 vs. 377 × 103 /μL, respectively, P = 0.001), C-reactive protein (median 0.05 vs. 0.10 vs. 0.17 vs. 0.38 mg/dL, respectively, P < 0.001), and Ulcerative Colitis Endoscopic Index of Severity (median 4 vs. 4 vs. 4 vs. 5, respectively, P = 0.006). No significant differences were observed in factors between groups divided according to sex and diagnosis age.
Conclusion
This study represents the largest multicenter pediatric inflammatory bowel disease cohort in Korea. Disease severity was associated with disease extent in pediatric patients with UC at diagnosis.
3.Characteristics of Pediatric Ulcerative Colitis at Diagnosis in Korea: Results From a Multicenter, Registry-Based, Inception Cohort Study
Jin Gyu LIM ; Ben KANG ; Seak Hee OH ; Eell RYOO ; Yu Bin KIM ; Yon Ho CHOE ; Yeoun Joo LEE ; Minsoo SHIN ; Hye Ran YANG ; Soon Chul KIM ; Yoo Min LEE ; Hong KOH ; Ji Sook PARK ; So Yoon CHOI ; Su Jin JEONG ; Yoon LEE ; Ju Young CHANG ; Tae Hyeong KIM ; Jung Ok SHIM ; Jin Soo MOON
Journal of Korean Medical Science 2024;39(49):e303-
Background:
We aimed to investigate the characteristics of pediatric ulcerative colitis (UC) at diagnosis in Korea.
Methods:
This was a multicenter, registry-based, inception cohort study conducted in Korea between 2021 and 2023. Children and adolescents newly diagnosed with UC < 18 years were included. Baseline clinicodemographics, results from laboratory, endoscopic exams, and Paris classification factors were collected, and associations between factors at diagnosis were investigated.
Results:
A total 205 patients with UC were included. Male-to-female ratio was 1.59:1, and the median age at diagnosis was 14.7 years (interquartile range 11.9–16.2). Disease extent of E1 comprised 12.2% (25/205), E2 24.9% (51/205), E3 11.2% (23/205), and E4 51.7% (106/205) of the patients. S1 comprised 13.7% (28/205) of the patients. The proportion of patients with a disease severity of S1 was significantly higher in patients with E4 compared to the other groups (E1: 0% vs. E2: 2% vs. E3: 0% vs. E4: 24.5%, P < 0.001). Significant differences between disease extent groups were also observed in Pediatric Ulcerative Colitis Activity Index (median 25 vs. 35 vs. 40 vs. 45, respectively, P < 0.001), hemoglobin (median 13.5 vs.13.2 vs. 11.6 vs. 11.4 g/dL, respectively, P < 0.001), platelet count (median 301 vs. 324 vs. 372 vs. 377 × 103 /μL, respectively, P = 0.001), C-reactive protein (median 0.05 vs. 0.10 vs. 0.17 vs. 0.38 mg/dL, respectively, P < 0.001), and Ulcerative Colitis Endoscopic Index of Severity (median 4 vs. 4 vs. 4 vs. 5, respectively, P = 0.006). No significant differences were observed in factors between groups divided according to sex and diagnosis age.
Conclusion
This study represents the largest multicenter pediatric inflammatory bowel disease cohort in Korea. Disease severity was associated with disease extent in pediatric patients with UC at diagnosis.
4.Characteristics of Pediatric Ulcerative Colitis at Diagnosis in Korea: Results From a Multicenter, Registry-Based, Inception Cohort Study
Jin Gyu LIM ; Ben KANG ; Seak Hee OH ; Eell RYOO ; Yu Bin KIM ; Yon Ho CHOE ; Yeoun Joo LEE ; Minsoo SHIN ; Hye Ran YANG ; Soon Chul KIM ; Yoo Min LEE ; Hong KOH ; Ji Sook PARK ; So Yoon CHOI ; Su Jin JEONG ; Yoon LEE ; Ju Young CHANG ; Tae Hyeong KIM ; Jung Ok SHIM ; Jin Soo MOON
Journal of Korean Medical Science 2024;39(49):e303-
Background:
We aimed to investigate the characteristics of pediatric ulcerative colitis (UC) at diagnosis in Korea.
Methods:
This was a multicenter, registry-based, inception cohort study conducted in Korea between 2021 and 2023. Children and adolescents newly diagnosed with UC < 18 years were included. Baseline clinicodemographics, results from laboratory, endoscopic exams, and Paris classification factors were collected, and associations between factors at diagnosis were investigated.
Results:
A total 205 patients with UC were included. Male-to-female ratio was 1.59:1, and the median age at diagnosis was 14.7 years (interquartile range 11.9–16.2). Disease extent of E1 comprised 12.2% (25/205), E2 24.9% (51/205), E3 11.2% (23/205), and E4 51.7% (106/205) of the patients. S1 comprised 13.7% (28/205) of the patients. The proportion of patients with a disease severity of S1 was significantly higher in patients with E4 compared to the other groups (E1: 0% vs. E2: 2% vs. E3: 0% vs. E4: 24.5%, P < 0.001). Significant differences between disease extent groups were also observed in Pediatric Ulcerative Colitis Activity Index (median 25 vs. 35 vs. 40 vs. 45, respectively, P < 0.001), hemoglobin (median 13.5 vs.13.2 vs. 11.6 vs. 11.4 g/dL, respectively, P < 0.001), platelet count (median 301 vs. 324 vs. 372 vs. 377 × 103 /μL, respectively, P = 0.001), C-reactive protein (median 0.05 vs. 0.10 vs. 0.17 vs. 0.38 mg/dL, respectively, P < 0.001), and Ulcerative Colitis Endoscopic Index of Severity (median 4 vs. 4 vs. 4 vs. 5, respectively, P = 0.006). No significant differences were observed in factors between groups divided according to sex and diagnosis age.
Conclusion
This study represents the largest multicenter pediatric inflammatory bowel disease cohort in Korea. Disease severity was associated with disease extent in pediatric patients with UC at diagnosis.
5.Factors Associated with Reaching Mid-Parental Height in Patients Diagnosed with Inflammatory Bowel Disease in Childhood and Adolescent Period
So Yoon CHOI ; Sujin CHOI ; Byung-Ho CHOE ; Jae Hong PARK ; Kwang-Hae CHOI ; Hae Jeong LEE ; Ji Sook PARK ; Ji-Hyun SEO ; Jae Young KIM ; Hyo-Jeong JANG ; Suk Jin HONG ; Eun Young KIM ; Yeoun Joo LEE ; Ben KANG
Gut and Liver 2024;18(1):106-115
Background/Aims:
The recent update on the Selecting Therapeutic Targets in Inflammatory Bowel Disease initiative has added normal growth in children as an intermediate target in Crohn’s disease and ulcerative colitis. We aimed to investigate factors associated with reaching midparental height (MPH) in patients diagnosed with inflammatory bowel disease in childhood and the adolescent period.
Methods:
This multicenter retrospective observational study included pediatric patients with inflammatory bowel disease that had reached adult height. Factors associated with reaching MPH were investigated by logistic regression analyses.
Results:
A total of 166 patients were included in this study (128 Crohn’s disease and 38 ulcerative colitis). Among them, 54.2% (90/166) had reached their MPH. Multivariable logistic regression analysis revealed that height Z-score at diagnosis and MPH Z-score were independently associated with reaching MPH (odds ratio [OR], 8.45; 95% confidence interval [CI], 4.44 to 17.90;p<0.001 and OR, 0.11; 95% CI, 0.04 to 0.24; p<0.001, respectively). According to the receiver operating characteristic curve analysis, the optimal cutoff level of "height Z-score at diagnosis minus MPH Z-score" that was associated with reaching MPH was –0.01 with an area under the curve of 0.889 (95% CI [0.835 to 0.944], sensitivity 88.9%, specificity 84.2%, positive predictive value 87.0%, negative predictive value 86.5%, p<0.001).
Conclusions
Height Z-score at diagnosis and MPH Z-score were the only factors associated with reaching MPH. Efforts should be made to restore growth in pediatric patients who present with a negative “height Z-score at diagnosis minus MPH Z-score.”
7.Clinical Experiences and Selection of Accessory Devices for Pediatric Endoscopic Foreign Body Removal: A Retrospective Multicenter Study in Korea
Yeoun Joo LEE ; Ji-Hyuk LEE ; Kie Young PARK ; Ji Sook PARK ; Jae Hong PARK ; Taek Jin LIM ; Jun-Pyo MYONG ; Jae Hun CHUNG ; Ji-Hyun SEO
Journal of Korean Medical Science 2023;38(1):e2-
Background:
Swallowing of foreign bodies (FBs) is the most common indication of therapeutic endoscopy in children. Endoscopic removal may be necessary depending on the type of FB, age of the child, and location of the FB. We attempted to analyze the characteristics of each device used for the endoscopic removal of FBs in children.
Methods:
Medical records of the patient’s age, sex, weight, type, location, size, shape, type of device used for endoscopic removal, and endoscopic time were retrospectively collected.
Results:
A total of 424 FB removal procedures were analyzed. The average age of the patients at the time of FB removal was 4.1 ± 3.7 years. Coins were the most common FBs (192, 45.3%). The most common locations of the FBs were the esophagus (45.7%) and the stomach (48.3%), respectively. For a total of 371 cases, forceps were used in 96 cases (25.9%) for esophageal FBs and in 25 cases for gastric FBs (6.7%), while nets were used in 250 cases (67.4%) for gastric FBs retrieval; the average durations of the procedures were 7.2 ± 7.4 minutes, 8.5 ± 7.2 minutes, and 5.7 ± 7.3 minutes, respectively (P = 0.003). The procedure time was significantly shorter, in the group of patients with low body weights, when nets were used than when forceps were used to remove gastric FBs (P = 0.001).
Conclusion
The endoscopic procedure duration, in low-weight children, was shorter when retrieval nets were used than that with forceps.
8.Validation and Reliability of the Cataract-related Visual Function Questionnaire (CVFQ)
Eun Jin KOH ; Jong Min LEE ; Dong Hui LIM ; Danbee KANG ; Juhee CHO ; Min Kyung SONG ; In Kwon CHUNG ; Hun Jin CHOI ; Ji Woong CHANG ; Jong Hyun LEE ; Tae Young CHUNG ; Young Sub EOM ; Yeoun Sook CHUN ; So Hyang CHUNG ; Eun Chul KIM ; Joon Young HYON ; Do Hyung LEE
Journal of the Korean Ophthalmological Society 2023;64(11):1030-1040
Purpose:
To evaluate the reliability and validity of the Cataract-related Visual Function Questionnaire (CVFQ).
Methods:
A prospective cross-sectional study of 141 cataract patients was conducted from March 2022 to June 2022. The questionnaire was created based on a literature review and advice from an expert panel. This study determined its construct validity, criterion validity, internal consistency, and test-retest reliability.
Results:
The CVFQ consists of 15 items distributed among five categories: overall visual quality, overall visual function, distance vision, near vision, and glare. In the exploratory factor analysis of validity, the first three principal components explained 77.8% of the variance. The p-values in the Spearman correlation test comparing the pre- and postoperative total CVFQ score and best-corrected visual acuity (BCVA) were 0.006 and 0.004, respectively. In the reliability analysis, Cronbach’s alpha was > 0.9 for internal consistency and the p-values of each subcategory were all significant in the analysis of test-retest reliability.
Conclusions
Our results indicate that the CVFQ is useful for measuring the visual quality and visual function of cataract patients in Korea.
9.A Case of Primary Cutaneous Extraskeletal Ewing Sarcoma on the Abdomen
Jin Wook LEE ; Dong Min KIM ; Ji Yeoun LEE ; Tae Young YOON
Annals of Dermatology 2022;34(1):72-75
Primary cutaneous extraskeletal Ewing sarcoma (EWS) is a primitive neuroectodermal tumor that usually occurs as a small, localized tumor on the trunk or extremities of young adults. The prognosis is typically reported to be quite favorable. It is extremely rare; only three cases of primary cutaneous EWS have been reported in Korea. In the first report, molecular genetic testing was not performed to make a definitive diagnosis. In the second report, reverse transcription polymerase chain reaction (RT-PCR) for EWS-FLI1 gene arrangement was done, but the result was negative. Although RT-PCR and fluorescence in situ hybridization (FISH) were performed in the third report, none of the results were shown in the article. Considering that genetic testing is an essential diagnostic tool for certain diseases, such as some brain tumors, we report a case of primary cutaneous extraskeletal EWS, including the result of RT-PCR. A 36-year-old Korean female presented with a cutaneous mass on the abdomen. Histological evaluation revealed solid sheets of primitive, small, uniform cells with hyperchromatic nuclei and scant cytoplasm. Immunohistochemistry stains were positive for CD99 and FLI1. RT-PCR showed a t(11;22) EWSR1 (Ewing sarcoma region 1)-FLI1 (Friend leukemia virus integration 1) translocation.
10.Differences in Clinical Responses to Ustekinumab Treatment among Body Regions: Results from a Real-World Prospective, Observational, and Multi-Center Study in Korea
Sang Wook SON ; Dae Young YU ; Youngdoe KIM ; Hyo Hyun AHN ; Yong Hyun JANG ; Joo Young ROH ; Young Bok LEE ; Ji Yeoun LEE ; Myung Hwa KIM ; YoungJa LEE ; Gyeong-Hun PARK ; Hyun-Sun YOON ; Sang Woong YOUN ;
Annals of Dermatology 2022;34(1):14-21
Background:
In psoriasis treatment, not all body regions improve simultaneously after clinical interventions.
Objective:
This study was aimed at evaluating clinical responses across body regions, which may differentially influence patient treatment plans.
Methods:
This prospective, observational, and multi-center study was conducted in Koreans who adhered to ustekinumab treatment based on criteria per local label and reimbursement guidelines. A total of 581 were included in this analysis.
Results:
The mean (±standard deviation) psoriasis area severity index (PASI) score at baseline, age, disease duration, and body surface area (%) were 18.9±9.69, 44.2±13.29 years, 11.3±9.65 years, and 27.8±17.83, respectively. Across the head and neck, upper extremities, trunk, and lower extremities, the correlation between the PASI sub-scores for the upper and lower extremities was the highest (r=0.680). The mean PASI sub-score for the lower extremities was the highest at baseline. PASI90 and PASI100 scores were the highest for the head and neck region, indicating the highest response rates, while those for the lower extremities were consistently low at all visits.
Conclusion
We found differences in regional ustekinumab responses, with the lower extremities being the most difficult to treat. These findings should be considered in psoriasis treatment.

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