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Cecal intubation is essential during colonoscopy, and observation of the terminal ileum is performed in most clinical practices. However, data on terminal ileal (TI) ulcers observed incidentally during colonoscopy are rare. We aimed to identify the characteristics and clinical course of TI ulcers observed incidentally during colonoscopy. Between January 2008 and December 2018, medical records from multi-centers reporting asymptomatic subjects who underwent biopsy on TI ulcers during colonoscopy were retrospectively reviewed. The characteristics of endoscopic findings and clinical course of TI ulcers were analyzed, and the factors affecting the clinical course of TI ulcers were evaluated. The median follow-up durations from first to second colonoscopy and from second to third colonoscopy were 20 months (interquartile range, 12–36) and 24 months (interquartile range, 12–34), respectively. A total of 134 subjects were included in the analysis. The histopathologic findings of TI ulcers were mostly chronic or active ileitis/inflammation (92.7%). On the second colonoscopy, 59 (44.0%) patients had no ulcers, 38 (28.4%) showed a decrease in size or number, and 37 (27.6%) patients showed no change in ulcers. Among 62 subjects who underwent a third colonoscopy, 14 (10.4%) had decreased size or number, 10 (7.5%) had no ulcer change, and two (1.5%) had increased ulcer size or number. In multivariate logistic regression analysis, a star shape was the only factor affecting continuation without improvement of incidental TI ulcers. Most TI ulcers observed incidentally showed no unusual findings on biopsy and improved on follow-up colonoscopy without treatment.

Extracellular matrix (ECM) molecules are essential structural components that exhibit important functional roles in the control of key cellular events, including cell adhesion, migration, proliferation, differentiation, and survival. The ECM remodeling pathway is also important for tumorigenesis and the metastatic progression of cancer. In this study, we determined the methylation pattern of nineteen ECM genes in colon cancer cell lines and demonstrated that these genes were frequently hypermethylated in primary colon tissues. Upon extracting gene expression profile data of the mouse epithelium and mesenchymal compartments, we found that several ECM genes (CD109, EVL, FBN2, FLNC, IGFBP3, MMP2, and LAMA1) were highly expressed in the mesenchymal compartment. These results were confirmed via reverse transcription polymerase chain reaction analysis. Moreover, we demonstrated the correlation between transcriptional silencing and the promoter hypermethylation of LAMA1, FBN2, and IGFBP3 during the transformation of the mesenchymal stem cell model system using key genetic alterations that develop during human malignance. Interestingly, MMP2, IGFBP3, and LAMA1 mRNA levels were significantly decreased during the transformation. In terms of transcriptional silencing by promoter DNA hypermethylation, the lack of LAMA1 mRNA expression was associated with its promoter hypermethylation in the last step of transformation, which develops to malignancies. Overall, our data suggest that ECM alterations by hypermethylated genes may contribute to carcinogenesis through the silencing of ECM pathway genes by epigenetic alterations.

Mobile genetic elements within genomes have been known to drive genome evolution in diverse ways. Since developing high-technology for whole-genome sequencing, many researchers have focused on not only how mobile genetic elements have affected the evolution of genes and their function, particularly of human and mammals, but also how these elements involve in gene activation or inactivation associated with a number of human diseases. Here we describe what kind of biological changes by mobile genetic elements contribute to disease, especially cancer and present an overview of what is known about this large, and largely unexplored, segment of the genome. Finally, we discuss understanding the genomic changes or cellular responses to genotoxic stress such as radiation may permit to implicate for potential clinical application.

Background and Aims Adequate bowel cleansing is essential for a high-quality, effective, and safe colonoscopy. The aims of this study were to compare the efficacy and tolerability of split-dose polyethylene glycol with aqueous sodium phosphate for outpatients who underwent scheduled colonoscopy. Methods In this prospective trial, 207 outpatients (aged between 18 and 65 years, with normal renal function, at low risk for renal damage) were randomized to receive split-dose preparation of PEG (2 L/2 L) (N = 103) or NaP (45 mL/45 mL, 12 h apart) (N = 104) without strict diet restriction the day before colonoscopy. The bowel cleansing efficacy of preparations was rated according to the Ottawa scale and the patient tolerability was assessed using a patient questionnaire. Results There was no significant difference between the two groups for the mean total score using the Ottawa bowel preparation scale (P = 0.181). Significantly greater residual colonic fluid was observed in the split-dose PEG group (1.24 ± 0.49) than in the NaP group (1.04 ± 0.53) (P = 0.007). Patient compliance, preference, and acceptance of a two preparation regimen were similar with no significant differences (P = 0.095, P = 0.280 and P = 0.408, respectively). The overall incidence of adverse events was not significantly different between the two groups; however, the split-dose PEG group tended to have fewer adverse events (52/103 [50.5%], 66/104 [63.5%], P = 0.059) and had significantly less nausea and vomiting (P = 0.036). Conclusions Split-dose PEG, compared with split-dose NaP, is associated with more residual colonic fluid, but produces equivalent colon cleansing efficacy and results in less nausea and vomiting, which might improve patient tolerability (clinical trial registration number NCT01229800).

Radiation proctitis is a common complication of pelvic radiation for which an optimal treatment remains undetermined. We assessed the efficacy of oral and topical mesalazine combination therapy for patients with naive radiation proctitis. A total of 23 patients with radiation proctitis were enrolled in the study over a period of 2 years. Three of these patients were excluded due to severe bleeding during the study. Twenty patients (mean age 60.3 years; two males, 18 females) were treated with oral mesalazine (3 × 1 g per day) plus a daily mesalazine suppository (1 g per day at bedtime) for 4 weeks. The efficacy of treatment was assessed according to the Subjective Objective Management Analytic (SOMA) scale for alleviation of clinical symptoms of rectal toxicity and sigmoidoscopic findings. The mean bleeding score improved significantly from 2.10 to 1.70 (p = 0.002) with mesalazine treatment. However, scores were not improved for pain (0.30–0.20, p = 0.163), tenesmus (0.50–0.45, p = 0.577), or stool frequency (0.35–0.30, p = 0.577). The improvements in the mean telangiectasia score (1.80–1.45, p = 0.005), bleeding point score (1.60–1.05, p

DYX1C1 has three alternatively spliced transcripts. Therefore, we expect that alternative transcripts of DYX1C1 are used as a biomarker to detect specific cancer. RT-PCR analysis is conducted in order to detect expression of the DYX1C1 gene and the PCR products were analyzed using the Image J program to compare the expression levels of each transcript. We found one of the transcripts was directly associated with an HERV-H LTR element that could be translated into protein sequence. Four new alternative transcripts were identified by RT-PCR analysis with various human tissue samples including 10 normal and adjacent tumor tissue sets. Semi-quantitative RT-PCR analysis showed the transcriptional activity of V3 and V2 was higher in tumor than in normal tissue samples, especially in the colorectal tissue samples. Our results indicated that alternatively spliced transcript variants of the DYX1C1 gene could be used as cancer biomarkers to detect colorectal cancer.

The endoscopic grade of the gastroesophageal flap valve (GEFV) is suggested to be a good predictor of reflux status. The aim of this study was to investigate the association of the GEFV and gastroesophageal and gastropharyngeal reflux.A total of 364 patients (151 men and 233 women; mean age, 52.2 years) who underwent endoscopy, esophageal manometry, and ambulatory 24-h dual-probe pH monitoring were included. GEFV was graded I through IV using Hill's classification; then, GEFV was classified into two groups: a normal GEFV group (grades I and II) and an abnormal GEFV group (grades III and IV). Findings of endoscopy, esophageal manometry, and ambulatory pH monitoring were compared between the groups.Increased GEFV grade was significantly associated with an increased prevalence of both reflux esophagitis and Barrett's epithelium (P0.001). Lower esophageal sphincter pressure was significantly lower in the abnormal GEFV group than in the normal GEFV group (P0.001). All variables showing gastroesophageal reflux in the distal probe were significantly higher in the abnormal GEFV group than in the normal GEFV group (P0.001). In addition, all variables, except the supine time of pH4, showing gastropharyngeal reflux in the proximal probe were significantly higher in the abnormal GEFV group than in the normal GEFV group (P0.001). The frequency of gastroesophageal reflux disease and of gastropharyngeal reflux disease was significantly higher in the abnormal GEFV group than in the normal GEFV group (P0.001).Endoscopic grading of the GEFV is easy and provides useful information about the status of gastroesophageal and gastropharyngeal reflux.

A gas-phase synthesis route based on spray pyrolysis with a residence/heating time of less than 0.1 s was designed to directly prepare Eu-doped Y2O3 phosphor nanoparticles. The average size of the phosphor particles decreased from the submicron size to around 10 nm when the concentration of the starting solution was increased. By increasing the operating temperature, from 1500 to 1700 °C, the submicron-particles were converted into a nano-particle phosphor, and their photoluminescence intensities at 611 nm (254-nm excitation) were greatly improved. This synthesis procedure has considerable potential for preparing a variety of doped luminescent nanoparticles without the need for post-treatment processing.