Jung Hoon Song and You Sun Kim. Gut and Liver 1999;0:. https://doi.org/10.5009/gnl18071

The American Journal of Gastroenterology is published by Nature Publishing Group (NPG) on behalf of the American College of Gastroenterology (ACG). Ranked the #1 clinical journal covering gastroenterology and hepatology*, The American Journal of Gastroenterology (AJG) provides practical and professional support for clinicians dealing with the gastroenterological disorders seen most often in patients. Published with practicing clinicians in mind, the journal aims to be easily accessible, organizing its content by topic, both online and in print. www.amjgastro.com, *2007 Journal Citation Report (Thomson Reuters, 2008)

Several studies have reported a significant rate of missed colorectal polyps during colonoscopy. This study aimed to determine the variables that affect the miss rate of colorectal polyps. We performed a retrospective observational study of patients who, between January 2007 and December 2014, had undergone a second colonoscopy within 6 months of their first. In all patients, the first colonoscopy constituted a screening or surveillance colonoscopy as part of a health check-up, and the patients were referred to the endoscopic clinic if there were meaningful polyps. The miss rate of colorectal polyps was evaluated, as were the variables related to these missed lesions. Among 659 patients (535 men), the miss rate of colorectal polyps was 17.24% (372/2158 polyps), and 38.69% of patients (255/659 patients) had at least 1 missed polyp. The most common site for missed polyps was the ascending colon (29.8%), followed by the sigmoid colon (27.8%). The miss rate of polyps was higher in men [odds ratio (OR) = 1.611, 95% confidence interval (95% CI) = 1.024–2.536], patients with multiple polyps at their first colonoscopy (OR = 1.463, 95% CI = 0.992–2.157), and patients who had a history of polyps (OR = 23.783, 95% CI = 3.079–183.694). Multiple missed polyps were more frequently located in the right colon (OR = 2.605, 95% CI = 1.458–4.657), and the risk of sessile serrated adenoma/polyp was greater in the right colon (OR = 10.418, 95% CI = 2.073–52.353). Endoscopists should pay careful attention in patients who have multiple polyps and in those who have a history of polyps, because such patients are at a high risk of missed polyps in colonoscopy.

Song JH, et al. Korean J Intern Med. 2010 Jun;25(2):140-146. http://dx.doi.org/10.3904/kjim.2010.25.2.140

It remains controversial whether or not cytomegalovirus infection in patients with active ulcerative colitis reflects a nonpathogenic colonization or a pathogenic disease warranting antiviral therapy. The aim of this study was to determine the prevalence of cytomegalovirus infection in patients with active ulcerative colitis and the therapeutic efficacy of ganciclovir against cytomegalovirus infection in patients with steroid-refractory ulcerative colitis. A prospective, multicenter study was conducted in 72 patients with moderate-to-severe ulcerative colitis who were treated with intravenous steroids. The presence of cytomegalovirus was evaluated serologically and histopathologic examination, including immunohistochemical staining. In patients with steroid-refractory ulcerative colitis, cytomegalovirus infections were treated with intravenous ganciclovir. In patients with steroid-responsive ulcerative colitis, steroid therapy was continued irrespective of cytomegalovirus infection. The evidence of cytomegalovirus infection was found in 31 patients (43%) with moderate-to-severe active ulcerative colitis. In patients with steroid-refractory ulcerative colitis, the cytomegalovirus infection rate increased to 67% (14 of 21). No significant clinical and endoscopic differences existed between patients with and without a cytomegalovirus infection; however, the amount of steroids used during the flare-up period was significantly higher in patients with a cytomegalovirus infection (P = 0.013). Eleven of 14 patients (79%) with steroid-refractory ulcerative colitis and a cytomegalovirus infection improved with ganciclovir treatment. Cytomegalovirus infections in the steroid-responsive group (17 of 31) did not require ganciclovir therapy. Cytomegalovirus infections are frequently observed in patients with moderate-to-severe ulcerative colitis, especially steroid-refractory ulcerative colitis. Ganciclovir was effective in patients with steroid-refractory ulcerative colitis who had a cytomegalovirus infection.