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Recently, significant improvements have been made in artificial intelligence. The artificial neural network was introduced in the 1950s. However, because of the low computing power and insufficient datasets available at that time, artificial neural networks suffered from overfitting and vanishing gradient problems for training deep networks. This concept has become more promising owing to the enhanced big data processing capability, improvement in computing power with parallel processing units, and new algorithms for deep neural networks, which are becoming increasingly successful and attracting interest in many domains, including computer vision, speech recognition, and natural language processing. Recent studies in this technology augur well for medical and healthcare applications, especially in endoscopic imaging. This paper provides perspectives on the history, development, applications, and challenges of deep-learning technology. Clin Endosc 2020;53:117-126

Supplemental material, sj-docx-2-tag-10.1177_17562848211043017 for Short-term tolerability and effectiveness of methotrexate monotherapy in adult patients with Crohn’s disease: a retrospective study by Hee Seung Hong, Kyuwon Kim, Kyunghwan Oh, Jae Yong Lee, Seung Wook Hong, Jin Hwa Park, Sung Wook Hwang, Dong-Hoon Yang, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang and Sang Hyoung Park in Therapeutic Advances in Gastroenterology

Supplemental material, sj-docx-1-tag-10.1177_17562848211043017 for Short-term tolerability and effectiveness of methotrexate monotherapy in adult patients with Crohn’s disease: a retrospective study by Hee Seung Hong, Kyuwon Kim, Kyunghwan Oh, Jae Yong Lee, Seung Wook Hong, Jin Hwa Park, Sung Wook Hwang, Dong-Hoon Yang, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang and Sang Hyoung Park in Therapeutic Advances in Gastroenterology

Supplemental material, sj-docx-2-tag-10.1177_17562848211043017 for Short-term tolerability and effectiveness of methotrexate monotherapy in adult patients with Crohn’s disease: a retrospective study by Hee Seung Hong, Kyuwon Kim, Kyunghwan Oh, Jae Yong Lee, Seung Wook Hong, Jin Hwa Park, Sung Wook Hwang, Dong-Hoon Yang, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang and Sang Hyoung Park in Therapeutic Advances in Gastroenterology

Supplemental material, sj-docx-1-tag-10.1177_17562848211043017 for Short-term tolerability and effectiveness of methotrexate monotherapy in adult patients with Crohn’s disease: a retrospective study by Hee Seung Hong, Kyuwon Kim, Kyunghwan Oh, Jae Yong Lee, Seung Wook Hong, Jin Hwa Park, Sung Wook Hwang, Dong-Hoon Yang, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang and Sang Hyoung Park in Therapeutic Advances in Gastroenterology

Supplemental material, sj-docx-3-tag-10.1177_17562848211043017 for Short-term tolerability and effectiveness of methotrexate monotherapy in adult patients with Crohn’s disease: a retrospective study by Hee Seung Hong, Kyuwon Kim, Kyunghwan Oh, Jae Yong Lee, Seung Wook Hong, Jin Hwa Park, Sung Wook Hwang, Dong-Hoon Yang, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang and Sang Hyoung Park in Therapeutic Advances in Gastroenterology

Background While treatment optimisation using therapeutic drug monitoring (TDM) of anti-TNF-α agents has become more common in clinical practices, studies comparing its correlation with clinical remission (CR), biochemical remission (BR) and mucosal healing (MH) in patients with ulcerative colitis (UC) are still lacking Methods Trough levels of infliximab/adalimumab (TLIs/TLAs) and levels of antibody to infliximab/adalimumab (ATI/ATA levels) were measured using serum samples collected between August 2017 and September 2019 from patients with UC on anti-TNF-α maintenance therapy. CR, BR and MH were defined as partial Mayo score of 0–1, within normal range of both ESR and serum C-reactive protein (CRP) level, and Mayo endoscopic subscore of 0–1, respectively. Results This study included 115 patients (72.8%, 91 [76.5%] on infliximab and 24 [61.5%] on adalimumab) in CR and 43 patients (27.2%) in non-CR. ATI/ATA were positive in 31 (26.1%) and 2 (5.1%) patients on infliximab/adalimumab therapy, respectively. TLI showed significant differences according to stats of CR (2.146 [0.273–4.296] vs. 0.405 [0.001–2.962], p = 0.019), BR (2.843 [0.282–4.835] vs. 0.987 [0.022–2.914], p = 0.007) and MH (2.411 [0.282–4.439] vs. 0.240 [0.001–1.674], p = 0.001), however, TLA didn’t (p = 0.783, 0.893 and 0.853, respectively) (Table 1 and Figure 1). In receiver operating characteristics (ROC) curve analysis, TLI of 2.314 μg/ml was identified as cut-off value discriminating MH (area under ROC 0.705, p = 0.001, sensitivity 0.527, specificity 0.885, negative predictive value [NPV] 0.343, positive predictive value [PPV] 0.942). After excluding 36 patients with MH even though their TLI < 1ug/ml, AUROC increased to 0.931 (p < 0.001, sensitivity 0.860, specificity 0.885, NPV 0.742, PPV 0.942) while cut-off TLI remained same. In incremental graph by ranges of TLI, MH rates showed plateau over 4 μg/ml of TLI. In multivariate logistic regression analysis, extensive colitis (hazard ratio [HR] 0.289, 95% confidence interval [CI] 0.079–1.060, p = 0.061) and TLI (HR 1.282, 95% CI 0.974–1.687, p = 0.076) were marginally associated with MH (Table 2). Conclusion In this study, TLIs correlated with CR, BR and MH, while TLAs did not. TLI should be targeted to be above 2.3 μg/ml.

Recently the pathological actions of CagA of Helicobacter pylori (H. pylori) on gastric epithelial cells have been reported. CagA is directly injected into the host cytoplasm and undergoes tyrosine phosphorylation in the cells. In addition, translocated CagA forms a physical complex with SHP-2. There are two major CagA subtypes according to the amino acid sequence in the 3`region of CagA; i) the East Asian type (A-B-D of EPIYA motifs) and ii) the Western type (A-B-C of EPIYA motifs). Repeated EPIYA motifs in the 3`region of CagA are involved in the interaction with SHP-2. The East Asian type conferred stronger SHP-2 binding activity than the Westrrn type of CagA. Here we analyzed the amino acid sequences of the SHP-2 binding site of cagA gene in H. pyzori, and investigated whether there is my relationship between the diversities of cagA and the disease out-come in Korea. Most of Korean H. pylori strains showed A-B-D motifs(the East Asian type), and only one strain showed A-B-B-D motifs. In Korea, the incidence of atrophic gastritis and gastric cancer is significantly high compared with Western countries. The high frequency of the East Asian type CagA among Korean H. pylori strains would be involved in increasing the risk of gastric cancer in Korean populations.