Search

a 180 36 59 \$348 \$235 33% b 127 30 50 \$292 \$194 27% c 132 47 55 \$267 \$193 33% d 123 27 50 \$325 \$226 24% e 85 41 65 \$304 \$183 28% f 140 24 41 \$343 \$202 27% g 118 20 39 \$300 \$200 21% h 141 35 44 \$261 \$163 33% i 141 25 67 \$496 \$404 20% j 76 20 36 \$243 \$243 15% k 116 33 57 \$358 \$223 29% l 82 28 40 \$313 \$180 63% m 42 19 26 \$171 \$137 83% n 24 38 54 \$254 \$176 65% o 55 20 40 \$280 \$257 44% p 50 34 50 \$280 \$257 70% q 52 21 37 \$312 \$202 57% r 37 30 49 \$239 \$188 61% s 35 34 57 \$286 \$190 60% t 41 24 29 \$171 \$156 73%

Background/Aims: Although several studies have claimed that Helicobacter pylori (H. pylori) infection is related to cardiovascular disease, it is still uncertain whether it is related to the acute process or the chronic inflammatory atherosclerotic changes. The aim of our study was to confirm the impact of active H. pylori infection on coronary heart disease, acute inflammatory factors, and the coagulation factors. Methods: A total of 94 patients completed questionnaires about occupation, smoking, past medical history, and socio-economic status. The serum of the subjects was drawn for a low density lipoprotein test, white blood cell count, C reactive protein, fibrinogen, homocysteine, prothrombin time, activated partial thrombin time, plasminogen activator inhibitor type-1, and tissue-type plasminogen test. All of the subjects underwent a coronary angiography and an upper gastrointestinal endoscopy for the diagnosis of coronary heart disease and H. pylori infection, respectively. Results: There was no significant difference in acute inflammatory factors, coagulation factors, atheromatous burden score, and Jeopardy score between the H. pylori-infected group and non-infected group. Odds ratio of H. pylori infection on coronary heart disease was 2.59 (95% CI, 0.80-6.17), but it diminished below 1.0 (95% CI, 0.14-1.36) after adjusting for conventional risk factors such as age, gender, diabetes, hypertension, smoking, body mass index and socio-economic status. Conclusions: H. pylori infection is not an independent risk factor for coronary heart disease, and it does not alter the coagulation system or evoke the systemic inflammatory response.

BACKGROUND/AIMS Probiotics are live non-pathogenic organisms that belong to the resident microflora, and confer health benefits by multiple mechanisms. Lactobacillus rhamnosus GG (LGG) is one of the probiotic bacteria that ameliorates intestinal injury and inflammation caused by various stimuli. We aimed to evaluate the anti-inflammatory effect and mechanism of LGG in lipopolysaccharide (LPS)-stimulated HT-29 cells. METHODS HT-29 cells were stimulated with interleukin (IL)-1β (2 ng/mL), tumor necrosis factor (TNF)-α (20 ng/mL), and LPS (20 μg/mL) in the presence or absence of LGG (10⁷-10⁹ colony forming units/mL). Production of the pro-inflammatory chemokine IL-8 was measured by ELISA and semi-quantitative PCR. Transcriptional activity of NF-kB-responsive gene was evaluated by luciferase assay with reporter gene. Toll-like receptor 4 (TLR4) mRNA expression was assessed by semi-quantitative PCR. The IκBa degradation was evaluated by western blot and intranuclear translocation of NF-κB was determined by western blot and immunofluorescence. RESULTS LGG did not affect the viability of HT-29 cells. Pretreatment of HT-29 cells with LGG significantly blocked TNF-α, and LPS induced IL-8 activation at both mRNA and protein level (p

We developed an ultra-low field (ULF)-nuclear magnetic resonance (NMR) measurement system capable of working with a measurement field (Bm) of several micro-tesla and performed basic NMR studies with a double relaxation oscillation superconducting quantum interference device (DROS) instead of conventional dc-SQUIDs. DROS is a SQUID sensor utilizing a relaxation oscillation between a dc-SQUID and a relaxation circuit; the new unit consists of an inductor and a resistor, and is connected in parallel with the SQUID. DROS has a 10 times larger flux-to-voltage transfer coefficient (∼mV/ϕ0) than that of the dc-SQUID, and this large transfer coefficient enables the acquisition of the SQUID signal with a simple flux-locked-loop (FLL) circuit using room temperature pre-amplifiers. The DROS second-order gradiometer showed average field noise of 9.2 μϕ0/√Hz in a magnetically shielded room (MSR). In addition, a current limiter formed of a Josephson junction array was put in a flux-transformer of DROS to prevent excess...

Patients with inflammatory bowel disease are at increased risk for thromboembolic complications. Its prevalence rate ranges from 1% to 7% in clinical studies and reaches 39% in autopsy series. The cause of thrombotic complications in inflammatory bowel disease is generally considered to be associated with hypercoagulability. We experienced a case of ulcerative colitis associated with Budd-Chiari syndrome and superior mesenteric vein thrombosis. This rare complication of ulcerative colitis was successfully managed by conventional treatment for ulcerative colitis and anticoagulation therapy.

Background: Although, chemotherapy is one of the main treatment modalities for patients with unresectable advanced gastric cancer, it is difficult to find a universally applicable regimen. Recently, adenosine triphosphate based chemotherapy response assay (ATP-CRA) showed positive correlation with treatment response and survival in some human cancers. It is not certain whether this test can be applicable to gastric cancer, yet. Also, most studies used ATP-CRA on single anticancer drug while combination regimen is commonly used in practice.We prospectively conducted ATP-CRA based on doublet chemotherapeutic regimens in unresectable gastric cancer. Methods: Fifty-five patients with gastric cancer (with written informed consents) were consecutively enrolled between April 2007 and June 2009. ATPCRAs were tested to tumor cells obtained through endoscopic biopsy, using paclitaxel/ cisplatin [DDP], docetaxel/DDP, and irinotecan/DDP as well as single regimen including 5FU, cisplatinum, paclitaxel, docetaxel and irinotecan. All patients were randomly treated with one of above DDP-based doublet regimens into either tailored group where the doublet regimens showing the highest inhibition rate in ATP-CRAs using 3 combinations were administered, or empirical group where blindly chosen combinations were given regardless of ATP-CRA results. Results: The overall success rate of ATP-CRA was 96.4% (53/55). Evaluable thirty-two cases were analzyed (male:female=26:6, mean age: 57.9 years). Median follow up duration was 7.8 months (1.9-24.9). 18 cases and 14 cases were randomly assigned in tailored and empirical group, respectively. The disease control rate was 55.6% and 64.3%, respectively. The median progression-free survival (PFS) and overall survivals (OS) were 120 and 274 days, respectively in tailored group and 148 and 312 days in empirical group (p>0.05). Also, median PFS andOS inmatched group (where administered regimens included the drug with the highest inhibition rate in ATP-CRAs using paclitaxel, docetaxel and irinotecan, 10 cases) were 120 and 177days, respectively and 122 and 312days in unmatched group (remainings beside matched group, 22cases) (p>0.05). Conclusion: ATP-CRA was successfully performed with high success rate in gastric cancer with small amounts of tissue taken endoscopically. Prediction of response to combined chemotherapeutic agents by ATPCRA was not superior to that of empirical combined chemotherapy in advanced gastric cancer. A further study with larger number of patient will be required to confirm the clinical significance of combination chemotherapy assessed by ATP-CRA in unresectable gastric cancer.

Synthetic RNA-based regulatory systems are used to program higher-level biological functions that could be exploited, among many applications, for in vivo diagnostic and therapeutic applications. Chen and colleagues have recently reported a significant technological advance by producing an RNA modular device based on a hammerhead ribozyme and successfully tested its ability to control the proliferation of mammalian T lymphocytes. Like all exciting research, this work raises a lot of significant questions. How quickly will such knowledge be translated into clinical practice? How efficient will this system be in human clinical trials involving adaptive T-cell therapy? We discuss the possible advantages of using such new technologies for specific therapeutic applications.

BACKGROUND/AIMS Saccharomyces boulardii has been reported to be beneficial in the treatment of inflammatory bowel disease. The aim of this work was to evaluate the effect of S. boulardii in a mice model of 2,4,6-trinitrobencene sulfonic acid (TNBS) induced colitis and analyze the expression of genes in S. boulardii treated mice by microarray. METHODS BALB/c mice received TNBS or TNBS and S. boulardii treatment for 4 days. Microarray was performed on total mRNA form colon, and histologic evaluation was also performed. RESULTS In mice treated with S. boulardii, the histological appearance and mortality rate were significantly restored compared with rats receiving only TNBS. Among 330 genes which were altered by both S. boulardii and TNBS (>2 folds), 193 genes were down-regulated by S. boulardii in microarray. Most of genes which were down-regulated by S. bouardii were functionally classified as inflammatory and immune response related genes. CONCLUSIONS S. boulardii may reduce colonic inflammation along with regulation of inflammatory and immune responsive genes in TNBS-induced colitis.

Endoscopic mucosal resection (EMR) results in the formation of iatrogenic gastric ulcers and the optimal treatments for such ulcers are still unclear. We aimed to evaluate the efficacy of rebamipide in the management of EMR-induced ulcers by comparing it with an H(2) receptor antagonist. After EMR, patients were randomly assigned into either rebamipide or famotidine groups. All patients received a one-week lansoprazole 30 mg q.d. therapy followed by three-week famotidine (20 mg b.i.d.) or rebamipide (100 mg t.i.d.) therapy. Four weeks after the treatments, ulcer sizes, stages, bleeding rates, and ulcer-related symptoms were compared using endoscopy and a questionnaire. A total of 63 patients were enrolled in this study. Finally, 51 patients were analyzed, 26 in rebamipide and 25 in famotidine group. Baseline characteristics were not significantly different between the two groups. Four weeks after EMR, the two groups were comparable in terms of ulcer reduction ratio (P=0.297), and ulcer stage (P=1.000). Moreover, no difference was observed with regard to ulcer-related symptoms, drug compliance, adverse drug event rates, and bleeding rates. Our data suggest that rebamipide is not inferior to famotidine in healing iatrogenic gastric ulcers, and could be a therapeutic option in the treatment of such ulcers.

Background: Gastric adenoma is a direct precursor of gastric adenocarcinoma. However, natural history remains unclear and controversy persists around treatment of gastric adenoma, especially low grade dysplasia. Aim: By analysing the histological discrepancies between forcep biopsy and EMR specimen of the gastric adenoma and their clinicopathologic characteristics, we aimed to propose the indication for endoscopic resection of gastric adenoma. Methods: A total of 538 gastric adenomas (387 low grade dysplasia (LGD) and 151 high grade dysplasia (HGD) histologically proven on forcep biopsies) which were removed by EMR in Severance Hospital between Jan. 2004 and Dec. 2007 Non-neoplastic polyps, submucosal tumors, and gastric adenoma without preceding biopsies before EMR were excluded. Histologic gradings were based on Vienna classification. LGD on forcep biopsies were designated as group I, HGD on forcep biopsies as group II. Univariate and multivariate analyses of the clinical and endoscopic characteristics were performed to analyze factors affecting histologic discrepancies; lesion size, number of biopsy fragments, EMR methods, size of EMR specimen, and endoscopic findings such as surface type, presence of unevenness, fold change, erythema and ulcer. Results: Final diagnoses after EMR included 303 (56.3 %) LGD, 89 (16.5 %) HGD, 104 (19.3 %) differentiated adenocarcinoma, 8 (1.5 %) undifferentiated adenocarcinoma, and 34 nonneoplastic conditions. In group I, 87 (22.5 %) cases showed discordant histology after endoscopic resection; 48 (12.4 %) HGD, 31 (8.0 %) differentiated adenocarcinoma, and 4 (1.0%) undifferentiated adenocarcinoma. In group II, 110 (72.8 %) cases showed discordant findings after EMR; 37 (24.5%) LGD, 69 (45.7%) differentiated adenocarcinoma and 19 (12.6%) undifferentiated adenocarcinoma. In the univariate analysis of group I, lesion size, EMR methods, size of EMR specimen, erythema showed significant relationship with the histological discrepancy. (p=0.025, p=0.000, p= 0.001, and p=0.003, respectively). In the multivariate analysis, erythema was found to be statistically significant factor affecting histologic discrepancies. (p=0.034, OR=2.09, 95% CI=1.057-4.132) In the univariate analysis of group II, lesion size showed significant relationship with the histological discrepancy. (p=0.042) Conclusions: HGD on forcep biopsies needs to be endoscopically resected regardless of their endoscopic characteristics based upon our results. LGD on forcep biopsies with larger size, flat/depressed type, or erythema should be considered candidates for EMR.

uL) (hazard ratio 2.25; p=0.005). Conclusion: The incidence of PNALD is quite high in a cohort of infants with NEC undergoing surgical treatment. Although the strongest risk factor is pre-operative PN exposure, thrombocytopenia, resection of small intestine and loss of the ileocecal valve are also associated with the development of PNALD. Further analysis is underway to define other risk factors in this multicenter, prospective study.

Sclerosing encapsulating peritonitis (SEP) is a poorly understood and rarely documented cause of small bowel obstruction. Although recurrent peritonitis has been reported as the main contributory factor leading to secondary SEP, the pathogenesis of primary (idiopathic) SEP is still uncertain. A 40-year-old woman with a history of total abdominal hysterectomy due to gestational trophoblastic disease presented with progressive lower abdominal pain and abdominal distension. Ultrasonography and contrast-enhanced abdomen-pelvis computed tomography of the abdomen revealed encapsulation of the entire small bowel with a sclerotic capsule. At laparotomy, a fibrous thick capsule encasing small bowel loops was revealed. Extensive adhesiolysis and removal of the capsule from the bowel loops were performed. The patient recovered uneventfully; she was discharged without complications. SEP is a rare cause of small bowel obstruction. We treated a case of abdominal cocoon with intestinal partial obstruction in a woman with a history of abdominal hysterectomy due to gestational trophoblastic disease. Surgical treatment was effective and the patient recovered without complication.

Saccharomyces Boulardii Ameliorates Trinitrobenzenesulphonic Acid-Induced Experimental Colitis in Rats: Attenuation of Pro-Inflammatory Gene Expression Sang Kil Lee, Hyo Jong Kim, Sung Gil Chi, Yoon Wha Kim Objectives: Saccharomyces boulardii (S. boulardii) is a nonpathogenic yeast used in the treatment of Clostridium difficile diarrhea and colitis. Recently S. boulardii was known to be beneficial in the treatment of inflammatory bowel disease. We have reported that S. boulardii reduces response of human colon cells to pro-inflammatory cytokines. The aim of this study was to further evaluate the effect of S. boulardii in the rats with trinitrobenzenesulphonic acid (TNBS) induced colitis. Methods: Rats were divided into three groups; Group 1 rats (untreated) were exposed only to TNBS (30mg) dissolved in 50% ethanol; Group 2 rats were exposed to TNBS and were then given lyophilized S. boulardii (10 mg suspended in 0.5 ml saline) twice a day by orogastric intubation for 7 days. Group 3 rats served as controls. Different biochemical markers of colonic inflammation were assayed by RT-PCR: interleukin-1b, interleukin-6, interleukin-8, tumor necrosis factor-a, and colonic inducible nitric oxide synthase expression. Macroscopic and microscopic findings of the colon were compared after sacrifice of the rats. Results: Intrarectal administration of TNBS dramatically induced the weight loss, colonic damage, and mucosal ulceration. Administration of S. boulardii attenuated TNBS-induced body weight loss and mortality (P ! 0.05, respectively), but did not improved colitis histologic score. Furthermore administration of S. boulardii significantly suppressed expressions of interleukin-1b, interleukin-6, interleukin-8, tumor necrosis factor-a, and colonic inducible nitric oxide synthase (p ! 0.01, respectively). Conclusions: These results suggest that S. bouladii down-regulates the expression of proinflammatory cytokines in the rats with TNBS induced colitis.

Colonoscopic Diagnosis of Mucocele of the Appendix Simon A. Zanati, Norman E. Marcon, Gregory B. Haber, Gabor Kandel, Paul Kortan Aims: Mucoceles of the appendix are an uncommon and heterogeneous group of cystic neoplasms characterized by distension of the appendiceal lumenwithmucus. They may come to attention by causing pain or vague right lower quadrant symptoms or, occasionally, are an incidental finding at abdominal imaging or colonoscopy. There have been no reported series of colonoscopically-diagnosed mucoceles with clinico-pathological correlation. Methods: A retrospective review of colonoscopies performed at our institution over the past 12 years was undertaken. For those reports identifying a mucocele of the appendix, patient demographics, clinical data, surgical outcomes and histopathology were obtained from hospital records. Results: Eight patients (7 female) with mucocele of the appendix were identified at colonoscopy. Four had complained of right lower quadrant pain. Of 5 patients who have had surgical resection to date, histopathological review has demonstrated mucinous cystadenoma in all cases. No cases have revealed carcinoma and there have been no deaths related to any mucocele. One patient is awaiting surgery. Conclusions:Mucocele of the appendix has a characteristic endoscopic appearance, creating a smooth bulbous indentation of the cecum with an ‘‘eye’’ formed by the appendiceal orifice. Its recognition at colonoscopy is important as it enables accurate diagnosis and directs management. Surgery is recommended in all cases given the risk for malignancy or perforation with resultant pseudomyxoma peritonei.

AIM: To deduce strategic guideline of gastric mucosa associated lymphoid tissue lymphoma (MALTOMA) by evaluating the long-term outcome of patients in respect to various treatment modalities. METHODS: A total of 55 patients with MALTOMA from May 1992 to August 2002 were retrospectively reviewed. RESULTS: Complete remission was obtained in 24 (82.8%) of 29 patients treated with anti Helicobacter pylori (H pylori) regimen only. The duration to reach complete remission was 12 months (85 percentile, 2-33 months). Five patients showed complete remission with radiation therapy (26-86 months). Two of them were H pylori treatment failure cases. CONCLUSION: H pylori eradication is an effective primary treatment option for low grade MALTOMA and radiation therapy could be considered in patients with no evidence of H pylori infection or who do not respond to H pylori eradication therapy 12 months after successful eradication.

We investigated the effect of thalidomide on transcriptional and post-transcriptional cyclooxygenase-2 (COX-2) expression, including a pathway leading to COX-2 mRNA destabilization. We found that thalidomide inhibited the interleukin-1β (IL-1β)-mediated induction of COX-2 protein and mRNA in Caco-2 cells. Transient transfection with a COX-2 promoter construct demonstrated that thalidomide did not affect IL-1βinduced transcriptional activation of COX-2, although it did decrease the stability of COX-2 mRNA and suppress IL-1β-induced cytoplasmic shuttling of an mRNA stabilizing protein, HuR. Thalidomide also suppressed IL-1β-induced p38 mitogen-activated protein kinase (MAPK) activation, while a p38 MAPK inhibitor destabilized COX-2 mRNA and the cytoplasmic shuttling of HuR induced by IL-1β. These data suggest that one of the molecular mechanisms of thalidomide may be destabilization of COX-2 mRNA through inhibition of cytoplasmic shuttling of HuR and p38 MAPK.