Objective. Patients with hypodontia are relatively common in clinical dentistry. This study was performed to determine the prevalence of hypodontia of permanent teeth in Korean orthodontic patients and whether such prevalence is associated with the type of dental clinic, patient gender, or the type of malocclusion. Materials and Methods. Over a five-year period, we evaluated 3,055 patients (mean age, 15.1 years; range 9~30) from two geographically separated orthodontic clinics: 1,479 from University Hospital and 1,576 from a private clinic. Hypodontia was diagnosed using panoramic radiographs, clinical examination, and dental casts. Results. The overall prevalence of hypodontia, excluding the third molars, was 11.3%, and there was no statistically significant association with the type of dental clinic, gender, or malocclusion patterns. The most commonly missing teeth were the mandibular second premolars (44.2%), followed by the mandibular lateral incisors (36.6%), and the maxillary second premolars (34.0%). In both sexes, 86.0% of patients with hypodontia were missing one or two teeth. Conclusion. The relatively high prevalence of hypodontia emphasizes the importance of dental examination in early childhood with radiographic screening for hypodontia as standard public oral health policy and warrants further investigation of the orthodontic treatment strategies to prevent resultant oral health impairments of hypodontia.
Panax ginseng C. A. Meyer, a perennial herb from the Araliaceae family, is a commonly used medicinal plant. Many studies have been conducted on the biologically active constituents of whole parts of P. ginseng (i.e., roots, leaves, flower buds, and fruits). However, the seeds of P. ginseng have not been intensively investigated. A new sterol glucoside,3-O-b-d-glucopyranosyl-5,22,24-stigmastatrienol (1), and a known sterol, 5,22-stigmastadienol (2), were isolated from seeds of P. ginseng and were evaluated for their inhibitory activities on tumor necrosis factor (TNF)α-induced nuclear factor (NF)-κB and inducible nitric oxide synthase (iNOS) transcription in transfected HepG2 cells. The present work deals with the isolation, identification, and antiinflammatory activities of the two compounds.
Materials and Methods:
The compounds were isolated by a combination of silica gel and YMC R-18 column chromatography, and their structures were identified by analysis of spectroscopic data (1D, 2D-NMR, and MS). The antiinflammatory activities of the isolated compounds 1 and 2 were evaluated by luciferase reporter gene assays.
Two sterols have been isolated from the seeds of P. ginseng. Compound 1 is a previously unreported glucosidyl sterol. Compounds 1 and 2 both inhibited NFκB-luciferase activity, with IC50 values of 8.1 and 4.8΅M, respectively. They also inhibited iNOS-luciferase activity in TNFα-induced HepG2 cells, with IC50 values of 2.2 and 2.9΅M, respectively.
The two isolatedsterols have inhibitory effects on inflammation-related factors in HepG2 cells, as determined by luciferase reporter gene assays. Thus, seeds of P. ginseng are worthy of consideration for the development and research of antiinflammatory agents.
Antiinflammtiory activity; Panax ginseng; seeds; 3-O-β-d-glucopyranosyl-5; 22; 24-stigmastatrienol
AIM: To investigate whether composite yogurt with acacia dietary fiber and Bifidobacterium lactis (B. lactis) has additive effects in irritable bowel syndrome (IBS).
METHODS: A total of 130 patients were randomly allocated to consume, twice daily for 8 wk, either the composite yogurt or the control product. The composite yogurt contained acacia dietary fiber and high-dose B. lactis together with two classic yogurt starter cultures. Patients were evaluated using the visual analog scale via a structured questionnaire administered at baseline and after treatment.
RESULTS: Improvements in bowel habit satisfaction and overall IBS symptoms from baseline were significantly higher in the test group than in the control group (27.16 vs 15.51, P = 0.010, 64.2 ± 17.0 vs 50.4 ± 20.5, P < 0.001; respectively). In constipation-predominant IBS, improvement in overall IBS symptoms was significantly higher in the test group than in the control group (72.4 ± 18.4 vs 50.0 ± 21.8, P < 0.001). In patients with diarrhea-predominant IBS, improvement in bowel habit satisfaction from baseline was significantly higher in the test group than in the control group (32.90 vs 7.81, P = 0.006).
CONCLUSION: Our data suggest that composite yogurt enriched with acacia fiber and B. lactis has greater therapeutic effects in patients with IBS than standard yogurt.
Acacia dietary fiber; Bifidobacterium lactis; Irritable bowel syndrome; Probiotics; Yogurt
The outcomes of bipolar hemiarthoplasty for osteonecrosis of femoral head have been disappointing due to cartilage degeneration and osteolysis. We investigated the cartilage degeneration, joint motion, and factors associated with osteolysis.
We retrospectively reviewed 134 bipolar hemiarthroplasties. The wear rate of acetabular cartilage was calculated. The ranges of motion of outer bearing and inner bearing were determined, and the ratio (O/I ratio) was calculated.
The mean degeneration rate of acetabular cartilage was 0.34 ± 0.35 mm/year. We could observe that the outer bearing motion was dominant, but decreased over time. In addition, the degeneration rate of cartilage and the decline rate of outer bearing motion of the osteolysis group were significantly higher than those of the control group.
Close observation is needed in cases of high degeneration rate of cartilage and rapid decline of outer bearing motion due to possibility of osteolysis.
A 67 year old male at a regular checkup underwent esophagogastroduodenoscopy. On performing esophagogastroduodenoscopy, a lesion about 1.2 cm depressed was noted at the gastric angle. The pathology of the biopsy specimen revealed a well-differentiated adenocarcinoma. On performing an abdominal computed tomography (CT) scan & positron emission tomography-computed tomography (PET-CT) scan, no definite evidence of gastric wall thickening or mass lesion was found. However, lymph node enlargement was found in the left gastric and prepancreatic spaces. This patient underwent laparoscopic assisted distal gastrectomy and D2 lymph node dissection. On final examination, it was found out that the tumor had invaded the mucosal layer. The lymph node was a metastasized large cell neuroendocrine carcinoma with an unknown primary site. The patient refused chemotherapy. He opted to undergo a close follow-up. At the postoperative month 27, he had a focal hypermetabolic lesion in the left lobe of the liver that suggested metastasis on PET-CT scan. He refused to undergo an operation. He underwent a radiofrequency ablation.
Gastric cancer; Neuroendocrine tumors; Neoplasms, unknown primary
Plasminogen activator inhibitor-1 (PAI-1) is important for tumor growth, Invasion, and metastasis. In this study, we investigated the relationship between plasma levels of PAI-1 and colorectal adenomas.
We reviewed the medical records of 3,136 subjects who underwent colonoscopy as a screening exam. The subjects were classified into a case group with adenomas (n=990) and a control group (n=2,146). Plasma PAI-1 levels were categorized into three groups based on tertile.
The plasma levels of PAI-1 were significantly higher in adenoma cases than in controls (p=0.023). The prevalence of colorectal adenomas increased significantly with increasing levels of PAI-1 (p=0.038). In the adenoma group, advanced pathologic features, size, and number of adenomas did not differ among the three groups based on tertiles for plasma PAI-1 levels. Using multivariate analysis, we found that plasma level of PAI-1 was not associated with the risk of colorectal adenomas (p=0.675). Adjusted odds ratios for colorectal adenomas according to increasing plasma levels of PAI-1 were 0.980 (95% confidence interval [CI], 0.768 to 1.251) for the second-highest plasma level and 1.091 (95% CI, 0.898 to 1.326) for the highest level, compared with the lowest levels.
These results suggest that elevated plasma PAI-1 levels are not associated with the risk of colorectal neoplasms.
Plasminogen activator inhibitor 1; Colorectal neoplasms
Ten compounds, including soulameanone (1), isobruceine B (2), 9-methoxy-canthin-6-one (3), bruceolline F (4), niloticine (5), octatriacontan-1-ol (6), bombiprenone (7), α-tocopherol (8), inosine (9), and apigenin 7-O-β-D-glucopyranoside (10), were isolated from the leaves, stems, and roots of Brucea mollis Wall. ex Kurz. Their structures were determined using one-and two-dimensional NMR spectroscopy and mass spectrometry. All compounds were evaluated for their cytotoxic activity against KB (human carcinoma of the mouth), LU-1 (human lung adenocarcinoma), LNCaP (human prostate adeno-carcinoma), and HL-60 (human promyelocytic leukemia) cancer cell lines. Compound 2 showed significant cytotoxic activity against KB, LU-1, LNCaP, and HL-60 cancer cells with IC50 values of 0.39, 0.40, 0.34, and 0.23 μg/mL, respectively. In addition, compounds 3 and 5 showed significant cytotoxic activity against KB, LU-1, LNCaP, and HL-60 cancer cells with IC50 values around 1–4 μg/mL. Compounds 9-methoxycanthin-6-one (3) and niloticine (5) have been discovered for the first time from the Brucea genus.
Brucea mollis; Cytotoxicity; Quassinoids; Alkaloids; Triterpenoids
We compared the effectiveness of the retropubic tension-free vaginal tape (TVT) and the transobturator inside-out tape (TVT-O) in treating symptoms of overactive bladder (OAB) in women with stress urinary incontinence (SUI).
Women with urodynamic SUI and OAB (mean urgency episodes ≥1 and frequency ≥8/24 hours on a 3-day voiding diary) were assigned to the TVT or TVT-O group. Preoperative measures were based on a urodynamic study, 3-day voiding diary, the Bristol Female Lower Urinary Tract Symptoms questionnaire (BFLUTSSF), and the urgency perception scale (UPS). At 12 postoperative months, the 3-day voiding diary, symptoms questionnaire, patient satisfaction, and standing stress test were assessed. The primary endpoint was change in the number of urgency episodes/24 hours from baseline to 12 months.
In this group of 132 women, 42 received TVT and 90 received TVT-O. The mean urgency episodes/24 hours decreased from 6.3±5.5 to 1.6±3.2 in the TVT group and from 5.1±4.4 to 1.8±3.0 in the TVT-O group. The mean percent change was significantly greater after TVT than after TVT-O (73% vs. 60%, P=0.049). All subscales of BFLUTSSF and UPS were significantly improved using either method, with significantly greater improvement seen in the quality of life (QoL) domain after TVT (P=0.002). There were no significant differences in the cure and satisfaction rates between the two groups.
Intervention with the TVT or the TVT-O significantly improved symptoms of OAB in women with SUI and OAB. Urgency and QoL significantly improved after TVT compared with that after TVT-O.
Overactive urinary bladder; Stress urinary incontinence
Information on the impact of cecal insertion time on colorectal neoplasm detection is limited. Our objective was to determine the association between cecal insertion time and colorectal neoplasm detection rate in colonoscopy screening.
We performed a cross-sectional study of 12,679 consecutive subjects aged 40–79 years undergoing screening colonoscopy in routine health check-ups at the Center for Health Promotion of the Samsung Medical Center from December 2007 to June 2009. Fixed effects logistic regression conditioning on colonoscopist was used to eliminate confounding due to differences in technical ability and other characteristics across colonoscopists.
The mean cecal insertion time was 5.9 (SD, 4.4 minutes). We identified 4,249 (33.5%) participants with colorectal neoplasms, of whom 1,956 had small single adenomas (<5 mm), 595 had medium single adenomas (5–9 mm), and 1,699 had multiple adenomas or advanced colorectal neoplasms. The overall rates of colorectal neoplasm detection by quartiles of cecal insertion time were 36.8%, 33.4%, 32.7%, and 31.0%, respectively (p trend <0.001).The odds for small single colorectal adenoma detection was 16% lower (adjusted OR 0.84; 95% CI 0.71 to 0.99) in the fourth compared to the first quartile of insertion time (p trend 0.005). Insertion time was not associated with the detection rate of single adenomas ≥5 mm, multiple adenomas or advanced colorectal neoplasms.
Shorter insertion times were associated with increased rates of detection of small colorectal adenomas <5 mm. Cecal insertion time may be clinically relevant as missed small colorectal adenomas may progress to more advanced lesions.
Cecal insertion time; Colorectal neoplasm; Screening colonoscopy
Inflammation is important in biomedical research, because it plays a key role in inflammatory diseases including rheumatoid arthritis and other forms of arthritis, diabetes, heart disease, irritable bowel syndrome, Alzheimer’s disease, Parkinson’s disease, allergies, asthma, and even cancer. In the present study, we describe the inhibitory effect of crude extracts and steroids isolated from the starfish Astropecten polyacanthus on pro-inflammatory cytokine (Interleukin-12 (IL-12) p40, interleukin-6 (IL-6), and tumor necrosis factor α (TNF-α)) production in lipopolysaccharide (LPS)-stimulated bone marrow-derived dendritic cells (BMDCs). Among those tested, compounds 5 and 7 showed potent inhibitory effects on the production of all three pro-inflammatory cytokines with IC50 values ranging from 1.82 ± 0.11 to 7.00 ± 0.16 μM. Potent inhibitory activities were also observed for compound 1 on the production of IL-12 p40 and IL-6 with values of 3.96 ± 0.12 and 4.07 ± 0.13 μM, respectively, and for compounds 3 and 4 on the production of IL-12 p40 with values of 6.55 ± 0.18 and 5.06 ± 0.16 μM, respectively. Moreover, compounds 2 (IC50 = 34.86 ± 0.31 μM) and 6 (IC50 = 79.05 ± 2.05 μM) exhibited moderate inhibitory effects on the production of IL-12 p40, whereas compounds 3 (IC50 = 22.80 ± 0.21 μM) and 4 (IC50 = 16.73 ± 0.25 μM) moderately inhibited the production of TNF-α and IL-6, respectively.
starfish; Astropecten polyacanthus; IL-12 p40; IL-6; TNF-α; LPS-stimulated BMDCs
In research on anti-human immunodeficiency virus (HIV) agents from natural sources, thirty two extracts of Vietnamese plants and twenty five isolated compounds were screened for their inhibitory effect against the ribonuclease H (RNase H) activity of HIV-1 reverse transcriptase and the cytopathic effect of the HIV virus. At a concentration of 50 μg/mL, eleven plant extracts and five isolated compounds inhibited over 90 percent of RNase H enzymatic activity. Of these, the methanol extracts from the leaves of Phyllanthus reticulatus and Aglaia aphanamixis highly inhibited RNase H activity by 99% and 98%, respectively. Several fucoidans isolated from seaweeds Sargassum kuetzingii, Sargassum polycystum, and Gelidiella acerosa, as well as epigallocatechin-3-gallate isolated from Camellia chinensis also showed strong inhibitory effects over ninety percent. Sixteen plant extracts with inhibition of over seventy five percent in the RNase H assay were tested in a cellular model of HIV-1 cytopathicity; four extracts showed modest activity in protecting against the cytopathic effect of the HIV virus.
RNase H; Cytopathic; Antivirus; Vietnamese plants; Screening
Objective. To compare the amounts of anchorage loss in the upper first molar (U6) and of retraction of the upper central incisor (U1) in cases with Class I malocclusion between orthodontic mini-implants (OMIs) and conventional anchorage reinforcements (CARs). Methods. The subjects were 40 female adult patients with Class I malocclusion who were treated with extraction of the first premolars and sliding mechanics. The subjects were divided into Groups 1 (N = 20, CAR) and 2 (N = 20, OMI) according to anchorage method. Lateral cephalograms were taken before (T0) and after treatment (T1). Seven skeletal and dental variables and ten anchorage variables were measured. Mann-Whitney test was used for statistical analysis. Results. Group 2 showed significantly larger retraction of U1 (U1E-sag, 9.5 mm : 7.1 mm, P < .05) and less anchorage loss of U6 (U6M-sag, 0.2 mm : 2.2 mm, P < .05; U6A-sag, 0.3 mm versus 2.4 mm, P < .01) than Group 1. There was opposite vertical movement in U1 and U6 between Groups 1 and 2 (U1E-ver, 0.9 mm intrusion : 0.7 mm extrusion; U6F-ver, 1.0 mm intrusion : 0.9 mm extrusion, P < .05). Conclusion. Although OMI could not reduce the treatment duration, it could provide better maximum anchorage of U6, greater retraction of U1, intrusion of U1 and U6 than CAR.
The most important function of the larynx is airway protection which is provided through a polysynaptic reflex closure triggered by the receptors in the glottic and supraglottic mucosa, evoking the reflex contraction of the laryngeal muscles especially by strong adduction of vocal cords. Based on the hypotheses that central facilitation is essential for this bilateral adductor reflex and that its disturbance can result in weakened laryngeal closure, we designed this study to elucidate the effect of central facilitation on this protective reflex.
Materials and Methods
Seven adult, 20 kg mongrel dogs underwent evoked response laryngeal electromyography under 0.5 to 1.0 MAC (minimum alveolar concentration) isoflurane anesthesia. The internal branch of the superior laryngeal nerve was stimulated through bipolar platinum-iridium electrodes, and recording electrodes were positioned in the ipsilateral and contralateral thyroarytenoid muscles.
Ipsilateral reflex closure was consistantly recorded regardless of anesthetic levels. However, contralateral reflex responses disappeared as anesthetic levels were deepened. Additionally, late responses (R2) were detected in one animal at lower level of anesthesia.
Deepened level of anesthesia affects central facilitation and results in the loss of the crossed adductor reflex, predisposing to a weakened glottic closure response. Precise understanding of this effect may possibly provide a way to prevent aspiration in unconscious patients.
Glottic closure reflex; anesthesia; central facilitation; aspiration
The purpose of this study was to investigate the contribution of MSX1 gene to the risk of nonsyndromic cleft lip with or without cleft palate (NS-CL ± P) in the Korean population. The samples consisted of 142 NS-CL ± P families (9 with cleft lip, 26 with cleft lip and alveolus, and 107 with cleft lip and palate; 76 trios and 66 dyads). Three single nucleotide polymorphisms (SNPs: rs3821949, rs12532, and rs4464513) were tested for association with NS-CL ± P case-parent trios using transmission disequilibrium test (TDT) and conditional logistic regression models (CLRMs). Minor allele frequency, heterozygosity, χ2 test for Hardy-Weinberg equilibrium, and pairwise linkage disequilibrium (LD) at each SNP were computed. The family- and haplotype-based association test programs were used to perform allelic and genotypic TDTs for individual SNPs and to fabricate sliding windows of haplotypes. Genotypic odds ratios (GORs) were obtained from CLRMs using R software. Although the family-based TDT indicated a meaningful association for rs3821949 (P = 0.028), the haplotype analysis did not reveal any significant association with rs3821949, rs12532, or rs4464513. The A allele at rs3821949 had a significant increased risk of NS-CL ± P (GOR, 1.64; 95% confidence interval,1.03-2.63; P = 0.038, additive model). A positive association is suggested between MSX1 rs3821949 and NS-CL ± P in the Korean population.
MSX1 SNP; Nonsyndromic Cleft Lip with or without Palate; Korean; Association Analysis
In continuation of our research to find biological components from Panax stipuleanatus, four oleanane-type triterpenes (12 to 15) were isolated successively. Fifteen oleanane-type saponins (1 to 15) were evaluated for nuclear factor (NF)-κB activity using a luciferase reporter gene assay in HepG2 cells. Compounds 6 to 11 inhibited NF-κB, with IC50 values between 3.1 to 18.9 μM. The effects on inducible nitric oxide synthase and cyclooxygenase-2 by compounds 8, 10, and 11 were also examined using reverse transcription-polymerase chain reaction. Three compounds (8, 10, and 11) inhibited NF-κB activity by reducing the concentration of inflammatory factors in HepG2 cells.
Panax ginseng; Panax stipuleanatus; Oleanane-type triterpenoid; Nuclear factor-κB
KOB03 is a polyherbal medicine that originated from the oriental prescription for the treatment of chronic allergic diseases such as rhinitis and asthma. This study aims to evaluate the effect of KOB03 on ovalbumin (OVA)-induced allergic rhinitis (AR) in guinea pigs.
Hartley guinea pigs were sensitized to OVA by intraperitoneal injection on days 0, 7, and 14 and challenged with intranasal exposure to OVA three times for 7 days after the last sensitization. KOB03 at doses of 200 and 500 mg/kg were orally administrated to guinea pigs once daily during challenge. The serum levels of histamine, OVA-specific immunoglobulin (Ig) E, eosinophil cationic protein (ECP) and cytokines (TNF-α, IL-4 and IFN-γ) in OVA sensitization/challenge-induced AR guinea pigs were measured. We also observed histological changes in nasal tissues of AR guinea pigs by staining with H&E, Periodic acid-Schiff, and toluidine blue.
The administration of KOB03 at a dose of 500 mg/kg significantly decreased the serum levels of histamine (P = 0.001), OVA-specific IgE (P = 0.0017), ECP (P = 0.008), and TNF-α (P = 0.0003) in OVA-sensitized/challenged guinea pigs compared with controls. KOB03 significantly decreased the serum levels of a Th2 cytokine, IL-4 (P = 0.017), while significantly increasing the levels of a Th1 cytokine, IFN-γ (P = 0.0006) in OVA-sensitized/challenged guinea pigs compared with controls. In addition, KOB03 suppressed the epithelial destruction, goblet cell hyperplasia and eosinophilic infiltration into nasal mucosa associated with AR.
KOB03 may regulate allergic inflammation in AR by inhibiting nasal damage, the release of allergic mediators and modulating the balance of Th1/Th2 cytokines.
We investigated the molecular and kinetic properties of two acetylcholinesterases (AmAChE1 and AmAChE2) from the Western honey bee, Apis mellifera. Western blot analysis revealed that AmAChE2 has most of catalytic activity rather than AmAChE1, further suggesting that AmAChE2 is responsible for synaptic transmission in A. mellifera, in contrast to most other insects. AmAChE2 was predominately expressed in the ganglia and head containing the central nervous system (CNS), while AmAChE1 was abundantly observed not only in the CNS but also in the peripheral nervous system/non-neuronal tissues. Both AmAChEs exist as homodimers; the monomers are covalently connected via a disulfide bond under native conditions. However, AmAChE2 was associated with the cell membrane via the glycophosphatidylinositol anchor, while AmAChE1 was present as a soluble form. The two AmAChEs were functionally expressed with a baculovirus system. Kinetic analysis revealed that AmAChE2 has approximately 2,500-fold greater catalytic efficiency toward acetylthiocholine and butyrylthiocholine than AmAChE1, supporting the synaptic function of AmAChE2. In addition, AmAChE2 likely serves as the main target of the organophosphate (OP) and carbamate (CB) insecticides as judged by the lower IC50 values against AmAChE2 than against AmAChE1. When OP and CB insecticides were pre-incubated with a mixture of AmAChE1 and AmAChE2, a significant reduction in the inhibition of AmAChE2 was observed, suggesting a protective role of AmAChE1 against xenobiotics. Taken together, based on their tissue distribution pattern, molecular and kinetic properties, AmAChE2 plays a major role in synaptic transmission, while AmAChE1 has non-neuronal functions, including chemical defense.
Ginseng, an ancient and famous medicinal herb in the Orient, has been used as a valuable tonic and for the treatment of various diseases including hepatic disorders. Ginseng saponins, commonly known as ginsenosides, are principal constituents and have believed to be responsible for multiple ginseng health benefits. There are more 40 ginsenosides isolated from ginseng. To date, treatment options for common liver diseases such as cirrhosis, fatty liver, and chronic hepatitis remain problematic. In this regard, ginseng extracts and individual ginsenosides have shown a wide array of beneficial role in the regulation of regular liver functions and the treatment of liver disorders of acute/chronic hepatotoxicity, hepatitis, hepatic fibrosis/cirrhosis, hepatocellular carcinoma, and so on in various pathways and mechanisms. In this paper, we first outline the pharmacological effects of ginseng and ginsenosides on the liver functions.
Homocysteine is involved in a one-carbon transfer reaction, which is important for DNA synthesis and methylation. High level of plasma homocysteine, biochemical marker of folate status, is known to be a risk factor for cancer. However, it is inconclusive as to whether plasma homocysteine concentration can predict colorectal adenoma. We conducted a case-control study to determine whether hyperhomocysteinemia is a risk factor for adenoma. Data from 1,039 subjects who underwent a colonoscopy and plasma homocysteine concentration determination during health examinations at single center over a two-year period were analyzed. The subjects were classified into two groups (422 adenoma and 617 controls). Subjects defined as having advanced adenomas were those with more than three adenomas, over 1 cm in size, high grade dysplasia, or villous components. Male, old age, high body mass index, low high-density lipoprotein-cholesterol, smoking, fasting glucose, and past history of colon polyps were significantly associated with adenoma according to multiple logistic regression. According to subgroup analysis by gender, plasma homocysteine concentration was not associated with adenoma in males; however, a high plasma homocysteine concentration significantly increased the risk of adenoma as well as advanced adenoma in females. Hyperhomocysteinemia is a risk factor for colorectal adenoma in women.
risk factors; homocysteine; adenoma
We evaluated the risk factors for late complications and functional outcome after total proctocolectomy (TPC) with ileal pouch-anal anastomosis (IPAA) for ulcerative colitis (UC).
Pre- and postoperative clinical status and follow-up data were obtained for 55 patients who underwent TPC with IPAA between 1999 and 2010. The median follow-up duration was 4.17 years. Late complications were defined as those that appeared at least one month after surgery. For a functional assessment, telephone interviews were conducted using the Global Assessment of Functioning Scale. Twenty-eight patients completed the interview.
Late complications were found in 20 cases (36.3%), comprising pouchitis (n = 8), bowel obstruction (n = 5), ileitis (n = 3), pouch associated fistula (n = 2), and intra-abdominal infection (n = 2). The preoperative serum albumin level for patients with late complications was lower than for patients without (2.4 ± 0.5 vs. 2.9 ± 0.7, P = 0.04). Functional outcomes were not significantly associated with clinical characteristics, follow-up duration, operation indication, or late complications.
This study demonstrated that a low preoperative albumin level could be a risk factor for late complications of TPC with IPAA. Preoperative nutritional support, especially albumin, could reduce late complications. Functional outcomes are not related to late complications.
Ulcerative colitis; Proctocolectomy; Complications
Determination of the profile of genes that are commonly methylated aberrantly in colorectal cancer (CRC) will have substantial value for diagnostic and therapeutic applications. However, there is limited knowledge of the DNA methylation pattern in CRC.
Materials and Methods
We analyzed the methylation profile of 27,578 CpG sites spanning more than 14,000 genes in CRC and in the adjacent normal mucosa using beadchip array-based technology.
We identified 621 CpG sites located in promoter regions and CpG islands that were significantly hypermethylated in CRC compared to normal mucosa. The genes on chromosome 18 showed promoter hypermethylation most frequently. According to gene ontology analysis, the most common biologically relevant class of genes affected by methylation was the class associated with the cadherin signaling pathway. Compared to the genome-wide expression array, mRNA expression was more likely to be down-regulated in the genes demonstrating promoter hypermethylation, even though this was not statistically significant. We validated 10 CpG sites that were hypermethylated (ADHFE1, BOLL, SLC6A15, ADAMTS5, TFPI2, EYA4, NPY, TWIST1, LAMA1, GAS7) and 2 CpG sites showing hypomethylation (MAEL, SFT2D3) in CRC compared to the normal mucosa in the array studies using pyrosequencing. The methylation status measured by pyrosequencing was consistent with the methylation array data.
Methylation profiling based on beadchip arrays is an effective method for screening aberrantly methylated genes in CRC. In addition, we identified novel methylated genes that are candidate diagnostic or prognostic markers for CRC.
Panax ginseng (PG) is a globally utilized medicinal herb. The medicinal effects of PG are primarily attributable to ginsenosides located in the root and leaf. The leaves of PG are known to be rich in various bioactive ginsenosides, and the therapeutic effects of ginseng extract and ginsenosides have been associated with immunomodulatory and anti-inflammatory activities. We examined the effect of PG leaf extract and the isolated ginsenosides, on nuclear factor (NF)-κB transcriptional activity and target gene expression by applying a luciferase assay and reverse transcription polymerase chain reaction in tumor necrosis factor (TNF)-α-treated hepatocarcinoma HepG2 cells. Air-dried PG leaf extract inhibited TNF-α-induced NF-κB transcription activity and NF-κB-dependent cyclooxygenase (COX)-2 and inducible nitric oxide synthase (iNOS) gene expression more efficiently than the steamed extract. Of the 10 ginsenosides isolated from PG leaves, Rd and Km most significantly inhibited activity in a dose-dependent manner, with IC50 values of 12.05±0.82 and 8.84±0.99 μM, respectively. Furthermore, the ginsenosides Rd and Km inhibited the TNF-α-induced expression levels of the COX-2 and iNOS gene in HepG2 cells. Air-dried leaf extracts and their chemical components, ginsenoside Rd and Km, are involved in the suppression of TNF-α-induced NF-κB activation and NF-κB-dependent iNOS and COX-2 gene expression. Consequently, air-dried leaf extract from PG, and the purified ginsenosides, have therapeutic potential as anti-inflammatory.
Panax ginseng; Anti-inflammation; Nuclear factor-κB; Panax ginseng leaves; Inducible nitric oxide synthase; Cyclooxygenase-2
The present study was aimed to determine whether endoscopist specialty is associated with high-quality endoscopy.
Materials and Methods
We prospectively collected endoscopy quality related data based on the Endoscopy Quality Rating Scale (EQRS) of 277 endoscopy units in a hospital setting from the National Cancer Screening Program of Korea in 2009. Gastroenterology medical professors (n=154) from university hospitals visited each endoscopy unit and graded the unit according to the EQRS. The scores from the EQRS were analyzed and compared in relation to endoscopy training during residency and endoscopy subspecialist certification.
After excluding data from 3 endoscopy units, EQRS data from 274 endoscopy units were analyzed: 263 esophagogastroduodenoscopy (EGD) screening units and 90 colonoscopy screening units. There were no significant differences in the scores of EQRS with respect to endoscopy training during residency (p=no significance), except for scores of EGDs for "Facility and Equipment" (p=0.030). However, EQRS scores were significantly higher in the endoscopy units where endoscopy subspecialists performed the endoscopies than those where Endoscopy Subspecialists did not perform the endoscopies (p<0.05, except p=0.08 for the "Process" criteria of EGD).
Endoscopist specialty is an important determinant of high-quality endoscopy in Korea.
Endoscopy; Endoscopy Quality Rating Scale (EQRS); endoscopist; quality; specialty
Now colorectal cancer is the second most common cancer in males and the fourth most common cancer in females in Korea. Since most of colorectal cancers occur after the prolonged transformation of adenomas into carcinomas, early detection and removal of colorectal adenomas are one of the most effective methods to prevent colorectal cancer. Considering the increasing incidence of colorectal cancer and polyps in Korea, it is very important to establish Korean guideline for colorectal cancer screening and polyp detection. The guideline was developed by the Korean Multi-Society Take Force and we tried to establish the guideline by evidence-based methods. Parts of the statements were draw by systematic reviews and meta-analyses. Herein we discussed epidemiology of colorectal cancers and adenomas in Korea and optimal methods for screening of colorectal cancer and detection of adenomas including fecal occult blood tests, radiologic tests, and endoscopic examinations.
Early detection of cancer; Colorectal neoplasms; Occult blood; Colonoscopy; Computed tomographic colonography