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Kang JY, Kim JM, Park SK, Lee HL, Heo HJ. A Mixture of Artemisia argyi and Saururus chinensis Improves PM 2.5-Induced Cognitive Dysfunction by Regulating Oxidative Stress and Inflammatory Response in the Lung and Brain. Plants (Basel) 2023; 12:1230. [PMID: 36986919 PMCID: PMC10059966 DOI: 10.3390/plants12061230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 02/28/2023] [Accepted: 03/04/2023] [Indexed: 06/18/2023]
Abstract
This study was performed to investigate the improving effect of a mixture of Artemisia argyi and Saururus chinensis (AASC) on cognitive dysfunction in mice with long-term exposure to fine particles (particulate matter smaller than 2.5 µm: PM2.5). The main compounds of AASC were identified as dicaffeoylquinic acid isomers of A. argyi and a quercetin-3-glucoside of S. chinesis. As a result of behavioral tests for the evaluation of cognitive function, it was confirmed that cognitive dysfunction was induced in the PM2.5 exposure group, and a tendency to improve in the AASC group was confirmed. Increased oxidative stress and inflammatory response and mitochondrial dysfunction were observed in the brain and lung tissues of the PM group. Damage to the brain and lung affected the accumulation of amyloid beta (Aβ) in the brain. It increased Aβ and induced the cholinergic dysfunction, hyperphosphorylation of the tau protein, and activation of apoptosis, leading to cognitive impairment. However, AASC suppressed brain and lung oxidative stress and inflammation, thereby suppressing brain Aβ expression. Consequently, this study shows the potential that a steady intake of plant resources with antioxidant and anti-inflammatory activity could prevent cognitive impairment caused by PM2.5.
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Affiliation(s)
- Jin-Yong Kang
- Division of Applied Life Science (BK21), Institute of Agriculture and Life Science, Gyeongsang National University, Jinju 52828, Republic of Korea
- Research and Development Division, World Institute of Kimchi, Gwangju 61755, Republic of Korea
| | - Jong-Min Kim
- Division of Applied Life Science (BK21), Institute of Agriculture and Life Science, Gyeongsang National University, Jinju 52828, Republic of Korea
| | - Seon-Kyeong Park
- Division of Applied Life Science (BK21), Institute of Agriculture and Life Science, Gyeongsang National University, Jinju 52828, Republic of Korea
- Korea Food Research institute, Wanju-Gun 55365, Republic of Korea
| | - Hyo-Lim Lee
- Division of Applied Life Science (BK21), Institute of Agriculture and Life Science, Gyeongsang National University, Jinju 52828, Republic of Korea
| | - Ho-Jin Heo
- Division of Applied Life Science (BK21), Institute of Agriculture and Life Science, Gyeongsang National University, Jinju 52828, Republic of Korea
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Cho MJ, Kim YJ, Kim MJ, Kim YS, Park E, Choi KH, Kang JY, Kim HO, Koong MK, Kim YS, Yoon TK, Ko JJ, Lee JH. P–205 Epothilone D as an actin cytoskeleton stabilizer improved mitochondria bioenergenesis and blastocyst formation of mouse preimplantation embryo. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study question
What is primary factor of bioenergetics product activity between microtubule instability and the functional activity of mitochondria in embryo?
Summary answer
The actin cytoskeleton instability is presumably the primary cause for the bioenergenesis of mitochondrial function to the preimplantation embryo development.
What is known already
Mitochondria are cellular organelles dynamically moving and morphological changes. It provides for homeostatic energy to the cell. The dynamic property of the mitochondria is associated with the microtubule network in the cell. However, the stability of the microtubule was clearly identified for preimplantation embryo development.
Study design, size, duration
This study is designed to assess the ATP productivity of the mitochondria, and specifically to observe what its primary factor is in terms of providing microtubule stability in mammalian cells. Additionally, we investigated the relationship between blastocyst formation and actin cytoskeleton stabilization by EpD with 2-cell mice.
Participants/materials, setting, methods
We prepared the microtubule stability regulation model with the HEK293 cell line by using the microtubule stabilizer as an Epothilone D (EpD). Then we analyzed the metabolic activity of the cells through oxidative phosphorylation (OXP) ratios analysis. Also, we performed confocal live imaging to observe mitochondria morphology depending on the cells’ microtubule. Next, we treated EpD to 2-cell culture media for the analysis of blastocyst development ratios.
Main results and the role of chance
EpD significantly increased fusion form. Also, EpD enhance bioenergy ratios like OXP in the mitochondria and functional activity related marker, like mTOR compared with the control. These results suggest that microtubule stabilization enhances mitochondrial metabolism by increasing oxygen consumption. Also, EpD in 2-cell culture media led to a significant increase in the speed of development and 50% higher hatched out blastocyst formation ratios compared to the control group.
Limitations, reasons for caution
This study had limited animal experiments. For the next study, we are planning with an aim to improve the quality and development ratios of human embryos by EpD.
Wider implications of the findings: Microtubule stabilizer has a possibility to recover the mitochondria’s functional activity in the preimplantation embryo development. Mitochondrial functional activity along the actin cytoskeleton may play a pivotal role in determining the embryo quality and development ratios for archive pregnancy.
Trial registration number
non-clinical trials
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Affiliation(s)
- M J Cho
- CHA University, Biomedical Sciences, Seoul, Korea- South
| | - Y J Kim
- CHA Medical Group, Reproductive and Molecular Medicine, Seoul, Korea- South
| | - M J Kim
- CHA Fertility Center Seoul Station, Clinic, Seoul, Korea- South
| | - Y S Kim
- CHA Fertility Center Seoul Station, Clinic, Seoul, Korea- South
| | - E Park
- CHA Fertility Center Seoul Station, Embryology lab, Seoul, Korea- South
| | - K H Choi
- CHA Fertility Center Seoul Station, Embryology lab, Seoul, Korea- South
| | - J Y Kang
- CHA Fertility Center Seoul Station, Embryology lab, Seoul, Korea- South
| | - H O Kim
- CHA Fertility Center Seoul Station, Clinic, Seoul, Korea- South
| | - M K Koong
- CHA Fertility Center Seoul Station, Clinic, Seoul, Korea- South
| | - Y S Kim
- CHA Fertility Center Seoul Station, Clinic, Seoul, Korea- South
| | - T K Yoon
- CHA Fertility Center Seoul Station, Clinic, Seoul, Korea- South
| | - J J Ko
- CHA University, Biomedical Sciences, Seoul, Korea- South
| | - J H Lee
- CHA fertility seoul center seoul sequare 3floor, Reproductive and Molecular Medicine., Seoul, Korea- South
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Yoo SK, Kim JM, Lee U, Kang JY, Park SK, Han HJ, Park HW, Kim HJ, Kim CW, Kim MJ, Heo HJ. Immature Persimmon Suppresses Amyloid Beta (Aβ) Mediated Cognitive Dysfunction via Tau Pathology in ICR Mice. Curr Issues Mol Biol 2021; 43:405-422. [PMID: 34205542 PMCID: PMC8928982 DOI: 10.3390/cimb43010033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 06/18/2021] [Accepted: 06/18/2021] [Indexed: 11/16/2022] Open
Abstract
This study confirmed the ameliorating effect of immature persimmon (Diospyros kaki) ethanolic extract (IPEE) on neuronal cytotoxicity in amyloid beta (Aβ)1-42-induced ICR mice. The administration of IPEE ameliorated the cognitive dysfunction in Aβ1-42-induced mice by improving the spatial working memory, the short-term and long-term memory functions. IPEE protected the cerebral cholinergic system, such as the acetylcholine (ACh) level and acetylcholinesterase (AChE) activity, and antioxidant system, such as the superoxide dismutase (SOD), reduced glutathione (GSH) and malondialdehyde (MDA) contents. In addition, mitochondrial dysfunction against Aβ1-42-induced toxicity was reduced by regulating the reactive oxygen species (ROS), mitochondrial membrane potential and ATP contents. In addition, IPEE regulated the expression levels of tau signaling, such as TNF-α, p-JNK, p-Akt, p-GSK3β, p-tau, p-NF-κB, BAX and caspase 3. Finally, gallic acid, ellagic acid and quercetin 3-O-(6″-acetyl-glucoside) were identified as the physiological compounds of IPEE using ultra-performance liquid chromatography ion mobility separation quadrupole time-of-flight/tandem mass spectrometry (UPLC IMS Q-TOF/MS2).
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Affiliation(s)
- Seul-Ki Yoo
- Division of Applied Life Science (BK21), Institute of Agriculture and Life Science, Gyeongsang National University, Jinju 52828, Korea; (S.-K.Y.); (J.-M.K.); (J.-Y.K.); (S.-K.P.); (H.-J.H.); (H.-J.K.)
| | - Jong-Min Kim
- Division of Applied Life Science (BK21), Institute of Agriculture and Life Science, Gyeongsang National University, Jinju 52828, Korea; (S.-K.Y.); (J.-M.K.); (J.-Y.K.); (S.-K.P.); (H.-J.H.); (H.-J.K.)
| | - Uk Lee
- Division of Special Forest Resources, National Institute of Forest Science, Suwon 16631, Korea; (U.L.); (H.-W.P.); (C.-W.K.); (M.-J.K.)
| | - Jin-Yong Kang
- Division of Applied Life Science (BK21), Institute of Agriculture and Life Science, Gyeongsang National University, Jinju 52828, Korea; (S.-K.Y.); (J.-M.K.); (J.-Y.K.); (S.-K.P.); (H.-J.H.); (H.-J.K.)
| | - Seon-Kyeong Park
- Division of Applied Life Science (BK21), Institute of Agriculture and Life Science, Gyeongsang National University, Jinju 52828, Korea; (S.-K.Y.); (J.-M.K.); (J.-Y.K.); (S.-K.P.); (H.-J.H.); (H.-J.K.)
| | - Hye-Ju Han
- Division of Applied Life Science (BK21), Institute of Agriculture and Life Science, Gyeongsang National University, Jinju 52828, Korea; (S.-K.Y.); (J.-M.K.); (J.-Y.K.); (S.-K.P.); (H.-J.H.); (H.-J.K.)
| | - Hyo-Won Park
- Division of Special Forest Resources, National Institute of Forest Science, Suwon 16631, Korea; (U.L.); (H.-W.P.); (C.-W.K.); (M.-J.K.)
| | - Hyun-Jin Kim
- Division of Applied Life Science (BK21), Institute of Agriculture and Life Science, Gyeongsang National University, Jinju 52828, Korea; (S.-K.Y.); (J.-M.K.); (J.-Y.K.); (S.-K.P.); (H.-J.H.); (H.-J.K.)
| | - Chul-Woo Kim
- Division of Special Forest Resources, National Institute of Forest Science, Suwon 16631, Korea; (U.L.); (H.-W.P.); (C.-W.K.); (M.-J.K.)
| | - Mahn-Jo Kim
- Division of Special Forest Resources, National Institute of Forest Science, Suwon 16631, Korea; (U.L.); (H.-W.P.); (C.-W.K.); (M.-J.K.)
| | - Ho-Jin Heo
- Division of Applied Life Science (BK21), Institute of Agriculture and Life Science, Gyeongsang National University, Jinju 52828, Korea; (S.-K.Y.); (J.-M.K.); (J.-Y.K.); (S.-K.P.); (H.-J.H.); (H.-J.K.)
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Min J, Kang JY, Kim J, Yang J, Kwon Y, Shim E, Park HK, Kim JS, Lee SS, Park JS. Impact of COVID-19 on TB services in Korea. Int J Tuberc Lung Dis 2021; 25:400-402. [PMID: 33977909 DOI: 10.5588/ijtld.20.0942] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- J Min
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Daejeon St Mary´s Hospital, Republic of Korea
| | - J Y Kang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul St Mary´s Hospital, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea
| | - J Kim
- Division of Tuberculosis Prevention and Control, Republic of Korea
| | - J Yang
- Division of Tuberculosis Prevention and Control, Republic of Korea
| | - Y Kwon
- Division of Tuberculosis Prevention and Control, Republic of Korea
| | - E Shim
- Division of Tuberculosis Prevention and Control, Republic of Korea
| | - H K Park
- Bureau of Infectious Disease Policy, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - J S Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Incheon St Mary´s Hospital, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea
| | - S-S Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea
| | - J S Park
- Division of Pulmonary Medicine, Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Republic of Korea
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Soh AYS, Kang JY, Siah KTH, Scarpignato C, Gwee KA. Searching for a definition for pharmacologically refractory constipation: A systematic review. J Gastroenterol Hepatol 2018; 33:564-575. [PMID: 28960557 DOI: 10.1111/jgh.13998] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 08/24/2017] [Accepted: 09/13/2017] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND AIM Surgery and other non-pharmacological treatments such as sacral nerve stimulation are used for the treatment of difficult-to-treat chronic constipation. Novel pharmacological therapeutic agents are also being introduced. To evaluate the efficacy of these treatments, it is imperative to have a consistent definition of pharmacologically refractory constipation. A systematic review of studies on refractory, difficult-to-treat or surgically treated constipation was carried out to determine the criteria that various authors used to define this group of patients. METHODS A systematic review was performed for literature published from June 2005 to June 2015 using PubMed, Cochrane, and Scopus databases, as well as manual searches. Studies on patients with refractory or intractable constipation were extracted. Criteria used for defining refractory constipation, as well as pharmacological agents tried including dosage, frequency, and duration, were reviewed. RESULTS Sixty-one studies were included in this review. Forty-eight involved surgical treatment of constipation, while 13 examined non-surgical therapies for refractory constipation. There is no generally accepted definition of refractory constipation. Authors consider constipation to be refractory when response to management is suboptimal, but there is no consensus on the choice of drug, order of usage, and dosage or treatment duration. Prior medical therapy was not mentioned at all in five studies. CONCLUSIONS There is need for a detailed definition of pharmacologically refractory constipation before submitting patients to invasive treatments and to evaluate new pharmacological agents.
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Affiliation(s)
- Alex Yu Sen Soh
- Department of Gastroenterology and Hepatology, National University Hospital, Singapore
| | - Jin-Yong Kang
- Department of Gastroenterology, St George's Hospital, London, UK.,Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Kewin Tien Ho Siah
- Department of Gastroenterology and Hepatology, National University Hospital, Singapore
| | - Carmelo Scarpignato
- Clinical Pharmacology and Digestive Pathophysiology Unit, Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy
| | - Kok-Ann Gwee
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Sperber AD, Dumitrascu D, Fukudo S, Gerson C, Ghoshal UC, Gwee KA, Hungin APS, Kang JY, Minhu C, Schmulson M, Bolotin A, Friger M, Freud T, Whitehead W. The global prevalence of IBS in adults remains elusive due to the heterogeneity of studies: a Rome Foundation working team literature review. Gut 2017; 66:1075-1082. [PMID: 26818616 DOI: 10.1136/gutjnl-2015-311240] [Citation(s) in RCA: 311] [Impact Index Per Article: 44.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Revised: 12/31/2015] [Accepted: 01/06/2016] [Indexed: 01/06/2023]
Abstract
OBJECTIVES The global prevalence of IBS is difficult to ascertain, particularly in light of the heterogeneity of published epidemiological studies. The aim was to conduct a literature review, by experts from around the world, of community-based studies on IBS prevalence. DESIGN Searches were conducted using predetermined search terms and eligibility criteria, including papers in all languages. Pooled prevalence rates were calculated by combining separate population survey prevalence estimates to generate an overall combined meta-prevalence estimate. The heterogeneity of studies was assessed. RESULTS 1451 papers were returned and 83, including 288 103 participants in 41 countries, met inclusion criteria. The mean prevalence among individual countries ranged from 1.1% in France and Iran to 35.5% in Mexico. There was significant variance in pooled regional prevalence rates ranging from 17.5% (95% CI 16.9% to 18.2%) in Latin America, 9.6% (9.5% to 9.8%) in Asia, 7.1% (8.0% to 8.3%) in North America/Europe/Australia/New Zealand, to 5.8% (5.6% to 6.0%) in the Middle East and Africa. There was a significant degree of heterogeneity with the percentage of residual variation due to heterogeneity at 99.9%. CONCLUSIONS The main finding is the extent of methodological variance in the studies reviewed and the degree of heterogeneity among them. Based on this, we concluded that publication of a single pooled global prevalence rate, which is easily calculated, would not be appropriate or contributory. Furthermore, we believe that future studies should focus on regional and cross-cultural differences that are more likely to shed light on pathophysiology.
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Affiliation(s)
- Ami D Sperber
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Dan Dumitrascu
- 2nd Medical Department of Internal Medicine, University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Shin Fukudo
- Department of Behavioral Medicine, Tohoku University Graduate School of Medicine, Seiryo Aoba, Japan
| | - Charles Gerson
- Division of Gastroenterology, Mt. Sinai School of Medicine, Mind-Body Digestive Center, New York, New York, USA
| | - Uday C Ghoshal
- Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGI), Lucknow, India
| | - Kok Ann Gwee
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - A Pali S Hungin
- Durham University School of Medicine, Pharmacy and Health, Wolfson Research Institute, Stockton-on-Tees, UK
| | - Jin-Yong Kang
- Department of Gastroenterology, St. George's Hospital, London, UK
| | - Chen Minhu
- Department of Gastroenterology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Max Schmulson
- Laboratory of Liver, Pancreas and Motility (HIPAM), Unit of Research in Experimental Medicine, Faculty of Medicine, Universidad Nacional Autonoma de Mexico (UNAM), Hospital General de México, Mexico City, Mexico
| | - Arkady Bolotin
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Michael Friger
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Tamar Freud
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - William Whitehead
- Center for Functional GI & Motility Disorders, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Fang X, Francisconi CF, Fukudo S, Gerson MJ, Kang JY, Schmulson W MJ, Sperber AD. Multicultural Aspects in Functional Gastrointestinal Disorders (FGIDs). Gastroenterology 2016; 150:S0016-5085(16)00179-7. [PMID: 27144623 DOI: 10.1053/j.gastro.2016.02.013] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2016] [Accepted: 02/09/2016] [Indexed: 12/12/2022]
Abstract
Cross-cultural factors are important in functional gastrointestinal disorders (FGIDs). In the setting of FGIDs, the aims of this review were to: 1) engender interest in global aspects; 2) gain a clearer understanding of culture, race and ethnicity and their effect on patient care and research; 3) facilitate cross-cultural clinical and research competency; and 4) improve and foster the quality and conduct of cross-cultural, multinational research. Cultural variables are inevitably present in the physician-patient context. Food and diets, which differ among cultural groups, are perceived globally as related to or blamed for symptoms. From an individual perspective, biological aspects, such as genetics, the microbiome, environmental hygiene, cytokines and the nervous system, which are affected by cultural differences, are all relevant. Of equal importance are issues related to gender, symptom reporting and interpretation, and family systems. From the physician's viewpoint, understanding the patient's explanatory model of illness, especially in a cultural context, affects patient care and patient education in a multicultural environment. Differences in the definition and use of Complementary and Alternative Medicine and other issues related to healthcare services for the FGIDs are also a relevant cross-cultural issue. This paper highlights the importance of cross-cultural competence in clinical medicine and research.
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Affiliation(s)
- Xiucai Fang
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 1(#)Shuaifuyuan, Dongcheng District, Beijing, 100730, China
| | - Carlos F Francisconi
- Full Professor, Department Internal Medicine, Universidade Federal do Rio Grande do Sul, Chief, Gastroenterology Division, Hospital de Clínicas de Porto Alegre Address: Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos 2350 CEP 90035-003 Porto Alegre RS Brazil.
| | - Shin Fukudo
- PhD, Department of Behavioral Medicine, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba, Sendai 980-8575 Japan
| | - Mary-Joan Gerson
- Adjunct Clinical Professor, and Director of the Advanced Specialization Program in Couple and Family Therapy at the New York University Postdoctoral Program in Psychotherapy and Psychoanalysis; Faculty, Mount Sinai School of Medicine, Division of Gastroenterology
| | - Jin-Yong Kang
- Parkside Hospital, 53 Parkside, London, SW17 5NX, United Kingdom
| | - Max J Schmulson W
- MD, Professor of Medicine, Laboratorio de Hígado, Páncreas y Motilidad (HIPAM)-Unit of Research in Experimental Medicine, Faculty of Medicine-Universidad Nacional Autónoma de México (UNAM), Hospital General de México, Dr. Balmis #148, Col. Doctores C.P.06726, México D.F.-México
| | - Ami D Sperber
- Emeritus Professor of Medicine, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Kang JY, Song SH, Yun J, Jeon MS, Kim HP, Han SW, Kim TY. Disruption of CTCF/cohesin-mediated high-order chromatin structures by DNA methylation downregulates PTGS2 expression. Oncogene 2015; 34:5677-84. [PMID: 25703332 DOI: 10.1038/onc.2015.17] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Revised: 12/15/2014] [Accepted: 01/16/2015] [Indexed: 12/25/2022]
Abstract
The CCCTC-binding factor (CTCF)/cohesin complex regulates gene transcription via high-order chromatin organization of the genome. De novo methylation of CpG islands in the promoter region is an epigenetic hallmark of gene silencing in cancer. Although the CTCF/cohesin complex preferentially targets hypomethylated DNA, it remains unclear whether the CTCF/cohesin-mediated high-order chromatin structure is affected by DNA methylation during tumorigenesis. We found that DNA methylation downregulates the expression of prostaglandin-endoperoxide synthase 2 (PTGS2), which is an inducible, rate-limiting enzyme for prostaglandin synthesis, by disrupting CTCF/cohesin-mediated chromatin looping. We show that the CTCF/cohesin complex is enriched near a CpG island associated with PTGS2 and that the PTGS2 locus forms chromatin loops through methylation-sensitive binding of the CTCF/cohesin complex. DNA methylation abolishes the association of the CTCF/cohesin complex with the PTGS2 CpG island. Disruption of chromatin looping by DNA methylation abrogates the enrichment of transcriptional components, such as positive elongation factor b, at the transcriptional start site of the PTGS2 locus. These alterations result in the downregulation of PTGS2. Our results provide evidence that CTCF/cohesin-mediated chromatin looping of the PTGS2 locus is dynamically influenced by the DNA methylation status.
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Affiliation(s)
- J Y Kang
- Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - S H Song
- Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - J Yun
- Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - M S Jeon
- Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - H P Kim
- Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - S W Han
- Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - T Y Kim
- Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
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Hewett R, Chhaya V, Chan D, Kang JY, Poullis A. Differences in intestinal metaplasia in Barrett's esophagus patients in an ethnically diverse south London population. Indian J Gastroenterol 2015; 34:399-403. [PMID: 26541341 DOI: 10.1007/s12664-015-0597-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 10/14/2015] [Indexed: 02/04/2023]
Abstract
Barrett's esophagus (BE) is the replacement of any portion of the normal distal squamous epithelial mucosa by metaplastic columnar epithelium and is the only known precursor for esophageal adenocarcinoma. We undertook a study to identify ethnic differences for the presence of intestinal metaplasia (IM) in BE in patients in an ethnically diverse south London population. Retrospective analysis was done using the endoscopy database of St George's Hospital NHS Trust, which serves a large ethnically diverse London population. Gastroscopy records between 2009 and 2012 were retrieved, and patients with an endoscopic diagnosis of BE were identified. Patients of Indian subcontinent Asian origin (ISCA) were further identified. The presence of IM was retrieved from hospital pathology databases and was the primary outcome measured. Multivariate logistic regression analysis was performed to determine the odds of having IM by ethnic origin. ISCAs were 70% less likely to have IM compared to non-ISCAs (OR 0.32, 95% CI: 0.16-0.61, p = 0.001). This is the first study to identify differences in histological findings in ISCAs with BE living in the UK. Our findings may be useful for the future risk stratification of BE patients. Identification of environmental factors responsible for this difference would be of great therapeutic value.
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Affiliation(s)
- Rhys Hewett
- Department of Gastroenterology, St George's Hospital NHS Trust, Blackshaw Road, London, SW17 0QT, UK.
| | - Vivek Chhaya
- Department of Gastroenterology, St George's Hospital NHS Trust, Blackshaw Road, London, SW17 0QT, UK
| | - Derek Chan
- Department of Gastroenterology, St George's Hospital NHS Trust, Blackshaw Road, London, SW17 0QT, UK
| | - Jin-Yong Kang
- Department of Gastroenterology, St George's Hospital NHS Trust, Blackshaw Road, London, SW17 0QT, UK
| | - Andrew Poullis
- Department of Gastroenterology, St George's Hospital NHS Trust, Blackshaw Road, London, SW17 0QT, UK
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Kang JY, Kang AHY, Amin Z, Chong H. Acute exacerbation of dysphagia due to foreign body impaction in an oesophageal stricture due to eosinophilic esophagitis. BMJ Case Rep 2015; 2015:bcr-2014-208616. [PMID: 25766442 DOI: 10.1136/bcr-2014-208616] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
A 43-year woman with a 4-year history of swallowing difficulty for solids presented with absolute dysphagia, which was only slightly relieved by intravenous relaxant given in the emergency department. Barium swallow showed a smooth polypoid filling defect in the mid-oesophagus, with a hold-up at this level. Gastroscopy showed a narrowed ringed oesophagus with an impacted foreign body. This was extracted with a basket, with relief of the dysphagia. Oesophageal biopsies confirmed the diagnosis of eosinophilic esophagitis.
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Affiliation(s)
- Jin-Yong Kang
- Department of Gastroenterology, St George's Hospital, London, UK Parkside Hospital, London, UK
| | | | - Zahir Amin
- Department of Radiology (Imaging), University College Hospital, London, USA
| | - Heung Chong
- Department of Histopathology, St George's Hospital, London, UK
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11
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Kang JHE, Kang JY. Lifestyle measures in the management of gastro-oesophageal reflux disease: clinical and pathophysiological considerations. Ther Adv Chronic Dis 2015; 6:51-64. [PMID: 25729556 DOI: 10.1177/2040622315569501] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Several lifestyle and dietary factors are commonly cited as risk factors for gastro-oesophageal reflux disease (GORD) and modification of these factors has been advocated as first-line measures for the management of GORD. We performed a systematic review of the literature from 2005 to the present relating to the effect of these factors and their modification on GORD symptoms, physiological parameters of reflux as well as endoscopic appearances. Conflicting results existed for the association between smoking, alcohol and various dietary factors in the development of GORD. These equivocal findings are partly due to methodology problems. There is recent good evidence that weight reduction and smoking cessation are beneficial in reducing GORD symptoms. Clinical and physiological studies also suggest that some physical measures as well as modification of meal size and timing can also be beneficial. However, there is limited evidence for the role of avoiding alcohol and certain dietary ingredients including carbonated drinks, caffeine, fat, spicy foods, chocolate and mint.
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Affiliation(s)
- J H-E Kang
- Green Templeton College, University of Oxford, Oxford, UK
| | - J Y Kang
- Department of Gastroenterology, St George's Hospital, Blackshaw Road, London SW17 0QT, UK
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12
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Hayat JO, Gabieta-Somnez S, Yazaki E, Kang JY, Woodcock A, Dettmar P, Mabary J, Knowles CH, Sifrim D. Pepsin in saliva for the diagnosis of gastro-oesophageal reflux disease. Gut 2015; 64:373-80. [PMID: 24812000 DOI: 10.1136/gutjnl-2014-307049] [Citation(s) in RCA: 112] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE Current diagnostic methods for gastro-oesophageal reflux disease (GORD) have moderate sensitivity/specificity and can be invasive and expensive. Pepsin detection in saliva has been proposed as an 'office-based' method for GORD diagnosis. The aims of this study were to establish normal values of salivary pepsin in healthy asymptomatic subjects and to determine its value to discriminate patients with reflux-related symptoms (GORD, hypersensitive oesophagus (HO)) from functional heartburn (FH). DESIGN 100 asymptomatic controls and 111 patients with heartburn underwent MII-pH monitoring and simultaneous salivary pepsin determination on waking, after lunch and dinner. Cut-off value for pepsin positivity was 16 ng/mL. Patients were divided into GORD (increased acid exposure time (AET), n=58); HO (normal AET and + Symptom Association Probability (SAP), n=26) and FH (normal AET and-SAP, n=27). RESULTS 1/3 of asymptomatic subjects had pepsin in saliva at low concentration (0(0-59)ng/mL). Patients with GORD and HO had higher prevalence and pepsin concentration than controls (HO, 237(52-311)ng/mL and GORD, 121(29-252)ng/mL)(p<0.05). Patients with FH had low prevalence and concentration of pepsin in saliva (0(0-40) ng/mL). A positive test had 78.6% sensitivity and 64.9% specificity for diagnosis of GORD+HO (likelihood ratio: 2.23). However, one positive sample with >210 ng/mL pepsin suggested presence of GORD+HO with 98.2% specificity (likelihood ratio: 25.1). Only 18/84 (21.4%) of GORD+HO patients had 3 negative samples. CONCLUSION In patients with symptoms suggestive of GORD, salivary pepsin testing may complement questionnaires to assist office-based diagnosis. This may lessen the use of unnecessary antireflux therapy and the need for further invasive and expensive diagnostic methods.
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Affiliation(s)
- Jamal O Hayat
- Centre for Digestive Diseases, Barts and the London School of Medicine and Dentistry, London, UK Department of Gastroenterology, St.George's, University of London, UK
| | - Shirley Gabieta-Somnez
- Centre for Digestive Diseases, Barts and the London School of Medicine and Dentistry, London, UK
| | - Etsuro Yazaki
- Centre for Digestive Diseases, Barts and the London School of Medicine and Dentistry, London, UK
| | - Jin-Yong Kang
- Department of Gastroenterology, St.George's, University of London, UK
| | | | | | | | - Charles H Knowles
- Centre for Digestive Diseases, Barts and the London School of Medicine and Dentistry, London, UK
| | - Daniel Sifrim
- Centre for Digestive Diseases, Barts and the London School of Medicine and Dentistry, London, UK
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13
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Hewett R, Chan D, Kang JY, Poullis A. New Barrett's oesophagus surveillance guidelines: significant cost savings over the next 10 years on implementation. Frontline Gastroenterol 2015; 6:6-10. [PMID: 28840903 PMCID: PMC5369555 DOI: 10.1136/flgastro-2014-100478] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Accepted: 06/10/2014] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVE We aimed to estimate the cost saving (over the next 10 years) by our trust implementing the new British Society of Gastroenterology (BSG) surveillance guidelines for Barrett's oesophagus (BO). DESIGN Retrospective endoscopy database analysis. SETTING Two endoscopy units of St George's Hospital NHS Trust, London. PATIENTS Gastroscopy records between 2009 and 2012 were retrieved and patients with an endoscopic diagnosis of BO were identified. BO segment length was recorded and the presence (or absence) of intestinal metaplasia in the oesophageal biopsy samples was reviewed from pathology databases. Patients were then stratified into risk groups in accordance with the new BSG guidelines. INTERVENTIONS Nil. MAIN OUTCOME MEASURES The projected surveillance costs using the new and the old guidelines were calculated over the next 10 years and the cost saving by the implementation of the new guidelines thus determined. RESULTS The 10 year projected cost saving for our trust by implementing the new BO surveillance guidelines was £720 330 (or £72 033 per annum). Projected across the NHS, implementation of the new guidance may save £100 million over the next 10 years. CONCLUSIONS All trusts should review their Barrett's surveillance population and implement these new recommendations expeditiously.
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Affiliation(s)
- Rhys Hewett
- Department of Gastroenterology, St George's Healthcare NHS Trust, London, UK
| | - Derek Chan
- Department of Gastroenterology, St George's Healthcare NHS Trust, London, UK
| | - Jin-Yong Kang
- Department of Gastroenterology, St George's Healthcare NHS Trust, London, UK
| | - Andrew Poullis
- Department of Gastroenterology, St George's Healthcare NHS Trust, London, UK
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14
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Cho HJ, Shin SC, Seo DY, Cho JM, Kang JY, Yoo TK, Yu JH, Sung LH, Moon HS. Comparison of alfuzosin 10 mg with or without propiverine 10 mg, 20 mg in men with lower urinary tract symptom and an overactive bladder: randomised, single-blind, prospective study. Int J Clin Pract 2014; 68:471-7. [PMID: 24471868 DOI: 10.1111/ijcp.12339] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
PURPOSE The efficacy and safety of treatment with alfuzosin 10 mg plus propiverine 10 or 20 mg in men with lower urinary tract symptoms (LUTS) and an overactive bladder were investigated. MATERIALS AND METHODS In this parallel-arm, prospective, multicentre, single-blind study, men who were ≥ 40 years old, had an International Prostate Symptom Score (IPSS) of ≥ 8, an Overactive Bladder Symptom Score (OABSS) of ≥ 3 and an OABSS urgency item score of ≥ 2 were randomised in a 1 : 1 :1 ratio to receive alfuzosin 10 mg alone (Group A) or with propiverine 10 mg (Group B) or 20 mg (Group C) for 8 weeks. Four and 8 weeks after commencing treatment, OABSS was measured along with IPSS, maximal urinary flow rate (Qmax ) and postvoid residual volume (PVR). Adverse events were recorded. RESULTS A total of 135 men, including 43 in Group A, 48 in Group B and 44 in Group C, completed the study. Relative to baseline, all groups demonstrated significant reductions in OABSS and the IPSS after eight treatment weeks (p < 0.005). The improvement of OABSS in Group C was significantly greater than Group A and B (Group A: 0.70 ± 1.94; Group B: 2.50 ± 2.98; Group C: 4.30 ± 3.40; p < 0.005). An observed improvement of Qmax and PVR in the three groups did not achieve statistical significance. Overall adverse event rates were higher in Group C but not significant compared with others. CONCLUSION In patients with LUTS and overactive bladder, combined therapy with alfuzosin 10 mg plus propiverine 20 mg was significantly more effective than alfuzosin monotherapy and propiverine 10 mg combined therapy in terms of improving OABSS while not significantly affecting Qmax or PVR.
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Affiliation(s)
- H J Cho
- Eulji general hospital, Eulji University School of Medicine, Seoul, Korea
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15
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Fitzgerald RC, di Pietro M, Ragunath K, Ang Y, Kang JY, Watson P, Trudgill N, Patel P, Kaye PV, Sanders S, O'Donovan M, Bird-Lieberman E, Bhandari P, Jankowski JA, Attwood S, Parsons SL, Loft D, Lagergren J, Moayyedi P, Lyratzopoulos G, de Caestecker J. British Society of Gastroenterology guidelines on the diagnosis and management of Barrett's oesophagus. Gut 2014; 63:7-42. [PMID: 24165758 DOI: 10.1136/gutjnl-2013-305372] [Citation(s) in RCA: 809] [Impact Index Per Article: 80.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
These guidelines provide a practical and evidence-based resource for the management of patients with Barrett's oesophagus and related early neoplasia. The Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument was followed to provide a methodological strategy for the guideline development. A systematic review of the literature was performed for English language articles published up until December 2012 in order to address controversial issues in Barrett's oesophagus including definition, screening and diagnosis, surveillance, pathological grading for dysplasia, management of dysplasia, and early cancer including training requirements. The rigour and quality of the studies was evaluated using the SIGN checklist system. Recommendations on each topic were scored by each author using a five-tier system (A+, strong agreement, to D+, strongly disagree). Statements that failed to reach substantial agreement among authors, defined as >80% agreement (A or A+), were revisited and modified until substantial agreement (>80%) was reached. In formulating these guidelines, we took into consideration benefits and risks for the population and national health system, as well as patient perspectives. For the first time, we have suggested stratification of patients according to their estimated cancer risk based on clinical and histopathological criteria. In order to improve communication between clinicians, we recommend the use of minimum datasets for reporting endoscopic and pathological findings. We advocate endoscopic therapy for high-grade dysplasia and early cancer, which should be performed in high-volume centres. We hope that these guidelines will standardise and improve management for patients with Barrett's oesophagus and related neoplasia.
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16
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Kang JHE, Kang JY, Morgan R. Renal infarction due to spontaneous dissection of the renal artery: an unusual cause of non-visceral type abdominal pain. BMJ Case Rep 2013; 2013:bcr-2013-200167. [PMID: 24049091 DOI: 10.1136/bcr-2013-200167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A 44-year-old man presented with very severe right upper quadrant pain of sudden onset. This was exacerbated by movement but unaffected by food or defaecation. It was continuous-day and night -but resolved over a 1-week period. The physical examination was normal at presentation, by which time the pain had resolved. His white cell count, alanine transaminase and C reactive protein were elevated but normalised after 10 days. An abdominal CT showed low density lesions in the right kidney consistent with segmental infarcts. CT angiogram showed a dissection of the right renal artery. The patient remained asymptomatic and normotensive when reviewed 1 month later.
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Affiliation(s)
- James H-E Kang
- Green Templeton College, University of Oxford, Oxford, UK
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17
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Kang JY, Kang AHY, Green A, Gwee KA, Ho KY. Systematic review: worldwide variation in the frequency of coeliac disease and changes over time. Aliment Pharmacol Ther 2013; 38:226-45. [PMID: 23782240 DOI: 10.1111/apt.12373] [Citation(s) in RCA: 161] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2012] [Revised: 10/28/2012] [Accepted: 05/26/2013] [Indexed: 12/24/2022]
Abstract
BACKGROUND Coeliac disease (CD), originally thought to be largely confined to Northern Europe and Australasia and uncommon in North America and the Middle East, is now recognised to be equally common in all these countries. It is still thought to be rare in the Orient and Sub-Saharan Africa. AIM To assess geographical differences and time trends in the frequency of CD. METHODS Medline and Embase searches were conducted on 10 November 2012, from 1946 and 1980 respectively, using the key words: coeliac disease or celiac disease + prevalence or incidence or frequency. RESULTS There were significant intra- and inter-country differences in the prevalence and incidence of CD. Only 24 ethnic Chinese and Japanese patients have been reported in the English literature. Of CD-associated HLA DQ antigens, DQ2 occurs in 5-10% of Chinese and sub-Saharan Africans, compared to 5-20% in Western Europe. DQ8 occurs in 5-10% of English, Tunisians and Iranians, but in <5% of Eastern Europeans, Americans and Asians. The prevalence and incidence of both clinically and serologically diagnosed CD increased in recent years. These geographical and temporal differences seem genuine, although variable indices of suspicion and availability of diagnostic facilities are confounding factors. CONCLUSIONS Coeliac disease is increasing in frequency, with significant geographical differences. Although few cases have been described to date in the Orient and Sub-Saharan Africa, there is a significant prevalence of HLA DQ2 and wheat consumption is of the same order as that in Western Europe. CD may therefore become more common in the future in these countries.
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Affiliation(s)
- J Y Kang
- Department of Gastroenterology, St George's Hospital, London, UK.
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18
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Son H, Cho SY, Park S, Kang JY, Kim CS, Kim HG. A retrospective study of clinical outcomes of α-blocker or finasteride monotherapy followed by combination therapy: determination of the period of combination therapy of α-blocker and finasteride. Int J Clin Pract 2013; 67:351-5. [PMID: 23521327 DOI: 10.1111/ijcp.12045] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
AIMS We investigated outcomes after discontinuing alpha-blockers or finasteride in patients who initially received combination therapy and compared differences by duration of combination therapy. METHODS Patients with international prostate symptom score ≥ 8, serum prostatic-specific antigen (PSA) < 4 ng/ml, prostate volume > 25 cm(3) and combination therapy of alpha-blockers and finasteride for more than 6 months were classified into three groups. Group 1 continued combination therapy; group 2, alpha-blockers monotherapy; and group 3, finasteride monotherapy. All parameters were evaluated before and after changing to monotherapy. Patients who received combination therapy for 6-9 months and those who received combination therapy for longer were comparatively analysed. RESULTS Mean age of the 106 patients was 66.9 ± 7.8 years. No significant differences in baseline symptom scores, PSA or prostate volume were found. Following combination therapy, symptom scores, and quality of life (QoL) decreased for all groups. Group 1 maintained decreased PSA and prostate volume, and improved uroflowmetric profiles. No differences in uroflowmetric parameters were found after 6 months. Group 2 maintained improved symptoms, QoL and uroflowmetric profiles, although PSA and prostate volume returned to baseline. Group 3 maintained lowered PSA and prostate volume, whereas Qmax returned to baseline. QoL scores showed no change. Patients who received combination therapy for ≥9 months improved more in symptoms and QoL than those who received shorter combination therapy. CONCLUSIONS Discontinuation of alpha-blockers or finasteride after combination therapy for ≥ 6 months maintained improvements in symptoms. The appropriate period of combination therapy was ≥ 9 months.
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Affiliation(s)
- H Son
- Department of Urology, Seoul National University, Boramae Medical Center, Seoul, Korea
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19
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Jang DH, Sung IY, Kang JY, Lee SI, Park JY, Yuk JS, Byun EM. Reliability and validity of the Korean version of the manual ability classification system for children with cerebral palsy. Child Care Health Dev 2013; 39:90-3. [PMID: 22708965 DOI: 10.1111/j.1365-2214.2012.01408.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/22/2012] [Indexed: 11/29/2022]
Abstract
BACKGROUND To investigate the inter- and intra-rater reliability of the Korean version of the Manual Ability Classification System (MACS) for children with cerebral palsy. METHODS After a two-step forward and one-step backward translation, the inter-rater reliability of the Korean version of the MACS was assessed separately by parents, occupational therapists and physicians. A second assessment for intra-rater reliability was performed 4 weeks later. RESULTS Sixty-nine children were enrolled. The intra-class correlation coefficients were 0.956 between occupational therapists and physicians, 0.927 between parents and physicians, and 0.960 between parents and occupational therapists. Intra-rater reliability ranged from 0.965 to 0.987. CONCLUSIONS The Korean version of the MACS is reliable and valid and is suitable for assessing manual ability in Korean children with cerebral palsy.
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Affiliation(s)
- D-H Jang
- Department of Rehabilitation, Incheon St. Mary's Hospital, The Catholic University of Korea, Incheon, Korea
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20
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Chatu S, Chhaya V, Holmes R, Neild P, Kang JY, Pollok RC, Poullis A. Factors associated with vitamin D deficiency in a multicultural inflammatory bowel disease cohort. Frontline Gastroenterol 2013; 4:51-56. [PMID: 28839700 PMCID: PMC5369785 DOI: 10.1136/flgastro-2012-100231] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2012] [Revised: 09/05/2012] [Accepted: 09/06/2012] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVE The aim of this study was to determine the prevalence of vitamin D deficiency in a multicultural inflammatory bowel disease (IBD) cohort and determine predictors of deficiency including ethnicity. DESIGN Patients with IBD were recruited into a dedicated database over a 6-month period and evaluated retrospectively. SETTING Department of Gastroenterology, St George's University Hospital, London, UK. OUTCOMES MEASURED Clinical data including demographics, ethnic group, disease phenotype by the Montreal classification, vitamin D level and season tested were recorded from clinical and electronic medical records. Vitamin D levels were classified as normal (≥50 nmol/l) and deficient (<50 nmol/l). RESULTS 168 patients had a vitamin D level measured subsequent to diagnosis. There was no significant difference in the median vitamin D level between patients with Crohn's disease (CD) and ulcerative colitis (UC) (39 nmol/l (IQR 23-56) vs 28 nmol/l (IQR 17-51), p=0.35). Overall the median vitamin D level was significantly lower in non-Caucasians (Asian and Black) versus Caucasians (28 nmol/l (IQR 17-41) vs 41 nmol/l (IQR 25-63), p<0.0001). Multiple regression analysis revealed IBD related surgery (OR 2.9) and ethnicity (OR 6.0 non-Caucasian vs Caucasian) in CD and ethnicity (OR 5.0 non-Caucasian vs Caucasian) in UC were independently associated with vitamin D deficiency. CONCLUSIONS Vitamin D deficiency is common in IBD patients; therefore, we suggest monitoring of vitamin D levels and correction with supplements especially in non-Caucasians and those with a history of IBD related surgery.
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Affiliation(s)
- Sukhdev Chatu
- Department of Gastroenterology, St George's University Hospital, London, UK
| | - Vivek Chhaya
- Department of Gastroenterology, St George's University Hospital, London, UK
| | - Rosamund Holmes
- Department of Gastroenterology, St George's University Hospital, London, UK
| | - Penny Neild
- Department of Gastroenterology, St George's University Hospital, London, UK
| | - Jin-Yong Kang
- Department of Gastroenterology, St George's University Hospital, London, UK
| | - Richard C Pollok
- Department of Gastroenterology, St George's University Hospital, London, UK
| | - Andrew Poullis
- Department of Gastroenterology, St George's University Hospital, London, UK
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21
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Firwana BM, Hasan R, Chalhoub W, Ferwana M, Kang JY, Aron J, Lieber J. Nephrotic syndrome after treatment of Crohn's disease with mesalamine: Case report and literature review. Avicenna J Med 2012; 2:9-11. [PMID: 23210014 PMCID: PMC3507066 DOI: 10.4103/2231-0770.94804] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Inflammatory bowel disease and its various treatments may affect the kidney in several ways. Recently, case reports have been published documenting the development of nephrotic syndrome after the treatment for inflammatory bowel disease with 5-aminosalicylic acid derivatives. We report a 50-year-old patient who was diagnosed with Crohn's disease and was treated with mesalamine. The patient subsequently developed nephrotic syndrome and a renal biopsy showed minimal change disease. He was treated with losartan and rosuvastatin and showed improvement in his renal function and serum cholesterol level. This is the first reported case in Crohn's disease although there have been six previous case reports of nephrotic syndrome following salicylic acid derivatives for ulcerative colitis.
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Affiliation(s)
- Belal M Firwana
- Elmhurst Hospital Center, Mount Sinai School of Medicine, Elmhurst, NY, USA ; Department of Internal Medicine, University of Missouri, Columbia, MO, USA
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22
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Musa SA, Brecker SJ, Rahman TM, Kang JY. Upper gastrointestinal haemorrhage in the acute cardiac care setting: antiplatelets and endoscopy. Scott Med J 2012; 57:88-91. [PMID: 22555229 DOI: 10.1258/smj.2012.012006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Upper gastrointestinal haemorrhage (UGIH) in cardiac patients receiving antiplatelets presents a difficult management problem. The aim of this study was to describe a series of cardiac inpatients receiving antiplatelets who underwent endoscopy for an acute UGIH. Cardiac inpatients receiving antiplatelets and requiring endoscopy for UGIH over an 18-month period were followed up. Forty-one patients were studied. Most patients (25 [61%]) presented with melaena. Antiplatelets were withheld in 34 (83%) patients; predominantly in those with higher pre-endoscopy Rockall scores (median, 4; interquartile range [IQR], 3-5 versus median, 3; IQR, 2-4; P < 0.05). Positive findings were identified at endoscopy in 80%. Duodenal ulcers were the most common lesion and adrenaline the most common method of haemostasis. Median time to first endoscopy was 0 (IQR, 0-1) days. Seven (17%) patients re-bled, median Rockall score was six (IQR, 4-8). Three (7%) patients experienced procedural complications, two patients became hypoxic and one patient died. Following endoscopy, antiplatelets were restarted after a median of three (IQR, 3-5) days. On discharge, 27/28 (96%) patients continued with antiplatelet and proton-pump inhibitor therapy. Thirty-day inpatient mortality was 7% (3 patients). One patient re-bled within six months of discharge. Endoscopy helped assess the risk of re-bleeding and timing of antiplatelet re-introduction in cardiac inpatients experiencing UGIH.
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Affiliation(s)
- S A Musa
- Department of Gastroenterology and Hepatology, St George's Hospital, London, England, UK
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23
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Kang JY, Min GE, Son H, Kim HT, Lee HL. National-wide data on the treatment of BPH in Korea. Prostate Cancer Prostatic Dis 2011; 14:243-7. [PMID: 21502967 PMCID: PMC3157607 DOI: 10.1038/pcan.2011.12] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2010] [Revised: 01/24/2011] [Accepted: 02/21/2011] [Indexed: 11/25/2022]
Abstract
The healthcare system in Korea provides coverage to all the people who are residing in Korea, so the data of the Korea healthcare system are national-wide and relatively accurate. We obtained the recent 5-year data (2004-2008) on the treatment of BPH from the national health insurance system. We tried to determine the trends or changes of BPH treatments in Korea. Over 3.8 million men visited clinics and were prescribed one or more BPH medications, and more than 44 000 men underwent surgical treatment during 2004-2008. Compared with the year 2004, two times the patients were prescribed BPH medications in 2008. With respect to the surgical treatment, the number of cases was increased 1.6 times in 2006 compared with the previous years. The most commonly used surgical option was TURP before 2006, but laser therapy was carried out as much as TURP in 2006 and in the following years. The relative risk of laser therapy in the 50 s is 1.53 (95% CI is 1.47-1.59). In conclusion, our national-wide data for the Korean BPH patients show that these patients' medical treatment increased during the 5 years from 2004 to 2008. Laser treatment had increased and it might replace TURP in several years.
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Affiliation(s)
- J Y Kang
- Department of Urology, Eulji University Eulji Hospital, Seoul, Korea
| | - G E Min
- Department of Urology, School of Medicine, Kyung Hee University, Seoul, Korea
| | - H Son
- Department of Urology, Seoul National University Boramae Hospital, Seoul, Korea
| | - H T Kim
- Department of Urology, Yeungnam University, Daegu, Korea
| | - H-L Lee
- Department of Urology, School of Medicine, Kyung Hee University, Seoul, Korea
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24
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Kang JY, Firwana B, Green AE, Matthews H, Poullis A, Barnabas A, Tan LT, Lim AG. Uncomplicated diverticular disease is not a common cause of colonic symptoms. Aliment Pharmacol Ther 2011; 33:487-94. [PMID: 21158878 DOI: 10.1111/j.1365-2036.2010.04540.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Colonic diverticular disease is common among older individuals whereas colonic symptoms, such as those of irritable bowel syndrome, are frequent in the general population. AIM To determine among patients in secondary care, if uncomplicated diverticular disease is a common cause of colonic symptoms. METHODS Patients aged ≥50 years attending gastroenterology out-patient clinics or scheduled for colonoscopy or barium enema in a secondary care hospital were invited to take part. Those with structural gastrointestinal diseases were excluded. Participants completed a locally validated Rome II questionnaire on colonic symptoms. Patients with diverticular disease were compared with those without. RESULTS Seven hundred and eighty four patients with no structural pathology other than diverticular disease or benign colonic polyps completed the study. A total of 744 patients underwent colonoscopy, 40 barium enema. Of these, 281 patients had diverticular disease. Among patients with and without diverticular disease, the frequency of abdominal pain, diarrhoea, constipation and irritable bowel syndrome were 123 (44%) and 226 (46%), 44 (16%) and 80 (17%), 38 (14%) and 80 (17%) and 66 (25%) and 119 (25%), respectively (N.S.). CONCLUSION Uncomplicated colonic diverticular disease is not a common cause of colonic symptoms among patients in secondary care.
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Affiliation(s)
- J Y Kang
- Department of Gastroenterology, St George's Hospital, London, UK.
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Choi SJ, Ahn HJ, Yang MK, Kim CS, Sim WS, Kim JA, Kang JG, Kim JK, Kang JY. Comparison of desaturation and resaturation response times between transmission and reflectance pulse oximeters. Acta Anaesthesiol Scand 2010; 54:212-7. [PMID: 19719816 DOI: 10.1111/j.1399-6576.2009.02101.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND In general, there is a response time between actual arterial hypoxemia and its detection by pulse oximeters. We compared the desaturation and resaturation response times between two types of pulse oximeters, transmission and reflectance pulse oximeters, to find out which oximeter has a more rapid response time. METHODS Thirty-three ASA 1 or 2 patients were enrolled in this study. A transmission pulse oximeter was placed on the index finger and a reflectance pulse oximeter was placed on the forehead and monitored simultaneously. After the induction of general anesthesia without pre-oxygenation, we waited until the oxygen saturation value of any of two pulse oximeters declined to 90%, and then mask ventilation was started with 100% oxygen. Oxygen saturation was recorded at an interval of 2 s during this time. RESULTS The desaturation response time of SpO(2) to 95% after apnea was 82.0 s (interquartile range: 67.0-98.5 s) vs. 94.0 s (interquartile range: 84.0-106.5 s) (P<0.001) and SpO(2) to 90% was 94.0 s (interquartile range: 75.5-109.5 s) vs. 100.0 s (interquartile range: 84.5-114.5 s) (P<0.001) in the reflectance and transmission oximeters, respectively. The resaturation response time from mask ventilation to 100% SpO(2) was 23.2+/-5.6 vs. 28.9+/-7.6 s (P<0.001) in the reflectance and transmission oximeters, respectively. CONCLUSION In clinical situations in which rapid changes in oxygen saturation are expected, we recommend the forehead reflectance pulse oximeter because it responds more quickly in detecting oxygen desaturation and resaturation compared with the transmission pulse oximeter.
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Affiliation(s)
- S J Choi
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Kangnam-Ku, Seoul, Korea
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Kim SJ, Kim JS, Kim SC, Kim YK, Kim YK, Kang JY, Yoon HK, Song JS, Lee SH, Moon HS, Kim JW, Kim KH, Kim CH, Shim BY, Kim HK. A multicenter phase II study of belotecan, new camptothecin analogue, in patients with previously untreated extensive stage disease small cell lung cancer. Lung Cancer 2009; 68:446-9. [PMID: 19683359 DOI: 10.1016/j.lungcan.2009.07.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2009] [Revised: 06/26/2009] [Accepted: 07/04/2009] [Indexed: 10/20/2022]
Abstract
Belotecan (Camtobell, CKD602) is a new camptothecin derivative antitumor agent that belongs to the topoisomerase inhibitors. The aim of this phase II study was to evaluate the efficacy and safety of single agent belotecan in patients with small cell lung cancer (SCLC). Patients with previously untreated extensive stage disease (ED) SCLC were entered into the study. Belotecan was given by daily intravenous infusion at 0.5mg/m(2)/day for 5 consecutive days, every 3 weeks. 62 patients were enrolled in this study. The overall response rate to chemotherapy on an intention-to-treat basis was 53.2%. The median overall survival was 10.4 months, the median time to progression 4.6 months, and the 1-year survival rate 49.9%. The most common toxicity was hematologic. Grade 3/4 neutropenia occurred in 71.0% of patients and grade 3/4 thrombocytopenia 12.9%. Non-hematologic toxicity of grade 3 or 4 was low. The results suggest that belotecan is relatively active and well tolerable as single agent in patients with ED SCLC. Further investigations with platinum or other active agents are needed.
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Affiliation(s)
- S J Kim
- Division of Pulmonology, Department of Internal Medicine, Kangnam St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea
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Fang ZL, Lin DQ, Kang JY, Kong JF, Shen WZ. Interface modification of the InGaN/GaN quantum wells: the strain pre-relief effect. Nanotechnology 2009; 20:235401. [PMID: 19448299 DOI: 10.1088/0957-4484/20/23/235401] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Interface modification by inserting an ultrathin low-temperature GaN layer prior to the growth of high-temperature GaN barriers followed by an annealing process was employed to improve the properties of the InGaN/GaN quantum wells. By detailed studies and comparisons of the surface morphology, photoluminescence and the surface compositions of the InGaN/GaN quantum wells at different growth stages with and without the interface modification, we find that with the interface modification the surface morphology was significantly improved with better smoothness, and smaller and shallower pits of lower density compared with that without interface modification; further, the indium aggregation and phase separation were suppressed. The physical phenomena are attributed to the 'strain pre-relief effect' by the formation of quasi-dots (approximately 20 nm in diameter) prior to temperature ramping and growth of high-temperature GaN barriers. Furthermore, the ultrathin low-temperature GaN layers have a good protection property as confirmed by PL and XPS measurements.
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Affiliation(s)
- Z L Fang
- Semiconductor Photonics Research Center, Department of Physics, Xiamen University, Xiamen 361005, People's Republic of China.
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Abstract
Surface modification of GaN films by in situ droplet homoepitaxy of thin GaN layers was employed for improvement of the surface/interface qualities characterized by atomic smoothness, low defect density and surface chemistry being close to stoichiometry. We find that, with surface modification of the GaN films the surface morphology of the subsequently grown InGaN/GaN single quantum well (SQW) was improved with less density of surface pits and indium-rich inclusions. The improvement in surface smoothness and InGaN/GaN surface/interface qualities is desirable for the growth of high-quality multiple QWs (MQWs) structures and fabrication of high-performance and reliable LEDs. PL results show that with surface modification the QW luminescence was significantly enhanced by more than 50% than that without surface modification.
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Affiliation(s)
- Z L Fang
- Semiconductor Photonics Research Center, Department of Physics, Xiamen University, Xiamen 361005, People's Republic of China.
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Subramanian V, Saxena S, Kang JY, Pollok RCG. Preoperative steroid use and risk of postoperative complications in patients with inflammatory bowel disease undergoing abdominal surgery. Am J Gastroenterol 2008; 103:2373-81. [PMID: 18616660 DOI: 10.1111/j.1572-0241.2008.01942.x] [Citation(s) in RCA: 156] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
CONTEXT Corticosteroids are the mainstay of medical therapies to induce remission in acute episodes of inflammatory bowel disease (IBD). However, evidence suggests that this may increase the risk of postoperative complications among patients with IBD who go on to have abdominal surgery. OBJECTIVE To estimate the risk of postoperative complications following abdominal surgery in patients with IBD on steroids at the time of abdominal surgery. DESIGN Meta-analysis of observational studies. METHODS We searched medical electronic databases for full journal articles published after 1965 reporting on postoperative complications in patients with IBD undergoing abdominal surgery provided they compared patients treated with steroids with those not on steroids. We hand searched the reference lists of all retrieved articles. Two independent reviewers extracted data from studies meeting the inclusion criteria and any discrepancies were resolved by discussion. We carried out fixed effects meta-analysis, funnel plot and sensitivity analyses. RESULTS A total of seven observational studies involving 1,532 patients met the inclusion criteria for risk of total complications, and five observational studies involving 1,714 patients met the inclusion criteria for risk of infectious complications. Pooled analysis showed an increased risk of all postoperative complications (OR 1.41, 95% confidence interval 1.07-1.87), as well as an increased risk of postoperative infectious complications (OR 1.68, 95% confidence interval 1.24-2.28) among patients on steroids. Patients who received higher doses of perioperative oral steroids (>40 mg) had a higher risk of total complications (OR 2.04 (95% CI 1.28-3.26). CONCLUSIONS There is an increased risk of total as well as infectious complications following the use of steroids in patients with IBD.
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Thomson SJ, Westlake S, Rahman TM, Cowan ML, Majeed A, Maxwell JD, Kang JY. Chronic liver disease--an increasing problem: a study of hospital admission and mortality rates in England, 1979-2005, with particular reference to alcoholic liver disease. Alcohol Alcohol 2008; 43:416-22. [PMID: 18385412 DOI: 10.1093/alcalc/agn020] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
AIMS To determine time trends in hospital admissions for chronic liver disease in England between 1989/1990 and 2002/2003, mortality rates in England and Wales between 1979 and 2005, and the influence of alcohol-related disease on these trends. METHODS Hospital episode statistics for admissions in England were obtained from the Information Center for Health and Social Care and mortality data for England and Wales from the Office for National Statistics. RESULTS Hospital admission rates for chronic liver disease increased by 71% in males and 43% in females over the study period. This increase was largely due to alcoholic liver disease, admission rates for which more than doubled between 1989/1990 and 2002/2003. While there was a smaller rise for chronic viral hepatitis B and C, admission rates declined for hepatitis A, autoimmune hepatitis, and primary biliary cirrhosis. Mortality rates for chronic liver disease more than doubled between 1979 and 2005. Two thirds of these deaths were attributable to alcohol-related liver disease in 2005. The highest rate of alcoholic liver disease mortality was in the 45-64 age group, and the largest percentage increase between 1979 and 2005 occurred in the 25-34 age group. CONCLUSIONS Hospital admissions and mortality in England from chronic liver disease are increasing. The underlying reasons are complex, but alcohol-induced liver disease makes a major contribution. There are clear social and health implications if the trend continues and addressing alcohol-related liver disease should be a public health priority.
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Affiliation(s)
- Sam J Thomson
- Department of Gastroenterology and Hepatology, St George's Hospital, Blackshaw Rd, London, England, SW17 0QT, UK
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Kang JY, Khan MNA, Park NH, Cho JY, Lee MC, Fujii H, Hong YK. Antipyretic, analgesic, and anti-inflammatory activities of the seaweed Sargassum fulvellum and Sargassum thunbergii in mice. J Ethnopharmacol 2008; 116:187-90. [PMID: 18079077 DOI: 10.1016/j.jep.2007.10.032] [Citation(s) in RCA: 96] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2007] [Accepted: 10/22/2007] [Indexed: 05/25/2023]
Abstract
Dichloromethane, ethanol, and boiling water extracts of the brown seaweeds Sargassum fulvellum and Sargassum thunbergii were examined for antipyretic, analgesic, and anti-inflammatory activities in mice. The activities were evaluated against yeast-induced pyrexia, tail-flick test, and phorbol myristate acetate-induced inflammation (edema, erythema, and blood flow). The dichloromethane extract (0.4 mg/ear) of Sargassum fulvellum inhibited an inflammatory symptom of mouse ear edema by 79.1%. The ethanol extract (0.4 mg/ear) of Sargassum thunbergii also inhibited edema by 72.1%. No acute toxicity was observed after p.o. administration of each extract (5 g/kg bw). These findings are consistent with various claims that these seaweeds can be used as remedies for inflammation-related symptoms.
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Affiliation(s)
- J Y Kang
- Department of Biotechnology, Pukyong National University, Namku, Busan 608-737, Republic of Korea
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Affiliation(s)
- J Y Kang
- Department of Gastroenterology, St George's Hospital, London SW17 0QT, UK.
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Cano AE, Neil AK, Kang JY, Barnabas A, Eastwood JB, Nelson SR, Hartley I, Maxwell D. Gastrointestinal symptoms in patients with end-stage renal disease undergoing treatment by hemodialysis or peritoneal dialysis. Am J Gastroenterol 2007; 102:1990-7. [PMID: 17511755 DOI: 10.1111/j.1572-0241.2007.01321.x] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES The aim of this study was to determine the prevalence of gastrointestinal symptoms in patients with end-stage renal disease undergoing hemodialysis (HD) or peritoneal dialysis (PD) treatment. METHODS Patients undergoing HD or chronic ambulatory PD in the Department of Renal Medicine of our hospital were asked to complete a locally validated Rome II questionnaire. The same questionnaire was also administered to age- and gender-matched medical outpatients without renal failure, and community subjects. Patients on HD and their outpatient controls also completed the Hospital Anxiety and Depression Scale. RESULTS A total of 148 patients with end-stage renal disease (HD 100, PD 48) completed the study. Their results were compared with those of 148 age- and gender-matched medical outpatients without renal failure and 148 randomly selected community controls. Patients on dialysis treatment were more likely to have abdominal pain, use laxatives, and report symptoms consistent with functional vomiting and irritable bowel syndrome (IBS) (70%, 55%, 16%, and 25%) than age- and gender-matched medical outpatients without renal failure (21%, 11%, 1%, and 6%) and community controls (16%, 4%, 0%, and 8%). Among HD patients and their outpatient controls, the differences appeared to be unrelated to anxiety or depression. CONCLUSIONS Abdominal pain, laxative use, functional vomiting, and IBS were more common in uremic individuals than in controls without renal failure. Our data have not shown whether these differences are due to the uremic state itself, or, alternatively, its treatment.
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Affiliation(s)
- Alicia E Cano
- Department of Gastroenterology, St George's Hospital, London, UK
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Courtney ED, Matthews S, Finlayson C, Di Pierro D, Belluzzi A, Roda E, Kang JY, Leicester RJ. Eicosapentaenoic acid (EPA) reduces crypt cell proliferation and increases apoptosis in normal colonic mucosa in subjects with a history of colorectal adenomas. Int J Colorectal Dis 2007; 22:765-76. [PMID: 17216221 DOI: 10.1007/s00384-006-0240-4] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/13/2006] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND AIMS Omega-3 fatty acids in fish oil exert a protective effect on the development of colorectal cancer in animal models. Patients with colorectal adenomas have been shown to have increased crypt cell proliferation and decreased apoptosis in macroscopically normal appearing colonic mucosa. We investigated whether dietary supplementation with eicosapentaenoic acid (EPA) could alter crypt cell proliferation and apoptosis in such patients. PATIENTS/METHODS Thirty subjects were randomised to either 3 months of highly purified EPA in free fatty acid form (2 g/day) or to no treatment. Colonic biopsies were taken at the initial colonoscopy and repeated 3 months later, and analysed for cell proliferation and apoptosis (immunohistochemistry) and mucosal fatty acid content. RESULTS/FINDINGS Crypt cell proliferation was significantly reduced whilst apoptosis was significantly increased after EPA supplementation. Neither crypt cell proliferation nor apoptosis were altered in the control group. EPA in the mucosa increased significantly after EPA supplementation, whereas there was no significant change in controls. CONCLUSIONS Dietary supplementation with EPA significantly increases levels of this fatty acid in colonic mucosa, associated with significantly reduced proliferation and increased mucosal apoptosis. Further studies are needed to assess the potential efficacy of EPA supplementation in preventing polyps in the chemoprevention of colorectal cancer.
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Affiliation(s)
- E D Courtney
- Department of Colorectal Surgery, St George's Hospital, London, UK.
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Price LC, Poullis A, Grubnic S, Kang JY, Rayner CFJ. Mesalazine-induced bronchiectasis and eosinophilia in a patient with ulcerative colitis: a case report. J R Soc Med 2007. [PMID: 17339311 DOI: 10.1258/jrsm.100.3.151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Affiliation(s)
- L C Price
- Department of Respiratory Medicine, St George's Hospital, London, UK
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Price LC, Poullis A, Grubnic S, Kang JY, Rayner CFJ. Mesalazine-induced bronchiectasis and eosinophilia in a patient with ulcerative colitis: a case report. J R Soc Med 2007; 100:151-2. [PMID: 17339311 PMCID: PMC1809164 DOI: 10.1177/014107680710000314] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Affiliation(s)
- L C Price
- Department of Respiratory Medicine, St George's Hospital, London, UK
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Abstract
BACKGROUND Gastro-oesophageal reflux disease affects approximately 20% of western populations. Barrett's oesophagus, associated with severe gastro-oesophageal reflux disease, is premalignant and regular endoscopic surveillance is generally performed. In contrast, mild gastro-oesophageal reflux disease is thought not to progress and is not generally subjected to endoscopic follow-up. Aim To investigate whether gastro-oesophageal reflux disease progresses endoscopically. METHODS Systematic review of the literature. RESULTS Well-designed prospective studies are few, diagnostic criteria were not always standardized, management strategies varied and various sources of bias could not be excluded. Whilst most patients do not progress to more severe forms of gastro-oesophageal reflux disease, and some cases actually regress, progression is seen in a small proportion of patients. Annual progression rates for non-erosive gastro-oesophageal reflux disease developing erosive oesophagitis ranged from 0% to 30%. About 1-22% of patients with mild erosive oesophagitis developed more severe inflammation annually, while 1-13% of patients with erosive oesophagitis developed Barrett's oesophagus each year. CONCLUSION Although most patients with gastro-oesophageal reflux disease do not progress, and some actually regress, progression does occur in a minority. Better data are required to determine whether patients with mild gastro-oesophageal reflux disease would benefit from increased surveillance with the aim of detecting more advanced disease.
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Affiliation(s)
- M Fullard
- Department of Gastroenterology, St George's Hospital, London, UK
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Abstract
BACKGROUND While overall hospital admission rates for peptic ulcer declined in England in the 1990 s, they increased among the elderly, especially for complicated ulcer. However, peptic ulcer admissions fell for all age groups in the United States. AIM To examine time trends in the incidence of hospital admissions, mortality and operations because of peptic ulcer in Scotland from 1982 to 2002, and the use of various drugs relevant to the aetiology and treatment of peptic ulcer from 1992 to 2002. RESULTS There was a general decrease in admission rates, especially for younger individuals. For individuals aged above 74 years, admission rates actually increased for gastric ulcer with haemorrhage among men, and for duodenal ulcer haemorrhage between both sexes. The number of operations fell dramatically, especially for younger patients. Mortality rates generally declined. Case fatality rates were greater for women than men, and declined over the study period for gastric ulcer, but increased for duodenal ulcer. The use of low-dose aspirin, oral anticoagulants, selective serotonin reuptake inhibitors and proton-pump inhibitors increased while those of non-steroidal anti-inflammatory drugs and histamine-2 antagonists declined. CONCLUSIONS Admission rates for peptic ulcer generally fell for younger individuals, but increased for older people with haemorrhage.
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Affiliation(s)
- J Y Kang
- Department of Gastroenterology, St George's Hospital, London, UK.
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Shack LG, Wood HE, Kang JY, Brewster DH, Quinn MJ, Maxwell JD, Majeed A. Small intestinal cancer in England & Wales and Scotland: time trends in incidence, mortality and survival. Aliment Pharmacol Ther 2006; 23:1297-306. [PMID: 16629934 DOI: 10.1111/j.1365-2036.2006.02891.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND Time trends in mortality from small intestinal cancer have not been studied for the 1990s. OBJECTIVE To examine secular trends in incidence of, mortality from, and survival from, small intestinal cancer in England & Wales and Scotland from 1975 to 2002, considering also histological type (incidence), subsite (incidence) and indices of social deprivation (incidence and survival). METHODS Data were extracted from the Scottish Cancer Registry database and the General Register Office for Scotland, and from the National Cancer Intelligence Centre at the Office for National Statistics for England & Wales. RESULTS Incidence rates for small intestinal cancer increased for both England & Wales and Scotland over the study period. They were highest among older individuals and generally greater for males than for females. Despite the increase in incidence rates, mortality rates from small intestinal tumours tended to remain stable over the study period, and the general trend was towards increasing survival. Indices of social deprivation were not obviously related to the incidence of small intestinal cancer and did not influence survival. CONCLUSIONS Incidence rates for small intestinal cancer for both England & Wales and Scotland increased in the last quarter of the 20th century, but survival rates improved and mortality rates declined.
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Affiliation(s)
- L G Shack
- Scottish Cancer Registry, Information & Statistics Division, Edinburgh, UK
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Wood HE, Gupta S, Kang JY, Quinn MJ, Maxwell JD, Mudan S, Majeed A. Pancreatic cancer in England and Wales 1975-2000: patterns and trends in incidence, survival and mortality. Aliment Pharmacol Ther 2006; 23:1205-14. [PMID: 16611282 DOI: 10.1111/j.1365-2036.2006.02860.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Rates and time trends in mortality from pancreatic cancer vary considerably between countries. AIM To examine trends and patterns in the incidence of, and the survival and mortality from, pancreatic cancer in England and Wales from 1975 to 2000; in particular, whether incidence and survival rates are related to socio-economic deprivation. METHODS We calculated annual age-specific and overall age-standardized incidence and mortality rates by sex for pancreatic cancer in total, and by subsite. We also estimated survival by sex and age group and by subsite. RESULTS In males, the age-standardized rate fluctuated in the late 1970s, to peak at 13.0 per 100,000 in 1979, declined steadily by an average of 1.3% per year to around 10.3 per 100,000 in the mid-1990s and then levelled off. For females, the rate peaked at 8.4 per 100,000 in the late 1980s before declining and fluctuating around 7.7 per 100,000 in the late 1990s. Patterns and trends in mortality rates were closely similar to those in incidence, due to the very low survival rates: only 2-3% at 5 years from diagnosis. Survival rates improved only minimally over the period 1971-99. Incidence and mortality rates were slightly higher in both males and females living in the most deprived areas, but survival was not consistently related to socio-economic deprivation. CONCLUSIONS The incidence of, and mortality from, pancreatic cancer in England and Wales have fallen from peak levels observed in the 1970s and 1980s, and levelled off in the 1990s for both sexes; survival rates remain very low.
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Affiliation(s)
- H E Wood
- National Cancer Intelligence Centre, Office for National Statistics, London, UK
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Abstract
OBJECTIVES This study aimed to determine time trends in the frequency of endoscopic esophagitis, and Helicobacter pylori (H. pylori) infection in a large Singaporean teaching hospital over a 10-yr period. METHODS We studied a consecutive series of 16,375 patients who had been newly referred for diagnostic esophagogastroduodenoscopy from 1992 to 2001. All endoscopic findings were prospectively recorded. From 1995, an antral biopsy was taken from 6,185 unselected patients for an in-house biopsy urease test. Endoscopic esophagitis was defined as the presence of erosions and/or ulceration. The relationship between erosive esophagitis and various relevant factors was analyzed. RESULTS The overall prevalence of endoscopic esophagitis was 6.9% (95% CI, 6.5-7.3). It was 7.3% (95% CI, 6.2-8.4) in patients with a positive urease test, and 9.0% (95% CI, 8.1-9.9) in those in whom the urease test was negative (p < 0.001). From 1992 to 2001, the frequency of endoscopic esophagitis increased (p < 0.001 for trend) while that of positive urease test decreased from 1995 to 2001 (p < 0.001 for trend). The increase in the prevalence of endoscopic esophagitis (RR 1.99, 95% CI 1.18-3.36, p= 0.0098), and its inverse relationship with positive urease test results (RR 0.991, 95% CI 0.983-0.999, p= 0.049) remained significant even after adjusting for age, gender, ethnic distribution, and hiatal hernia. CONCLUSIONS The frequency of endoscopic esophagitis increased in Singapore from 1992 to 2001. This increase within a short period of time suggests that environmental factors, of which the decreasing rate of H. pylori infection may be one, are important in the pathogenesis of gastroesophageal reflux disease.
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Affiliation(s)
- Khek-Yu Ho
- Department of Medicine, National University of Singapore, Singapore
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Abstract
BACKGROUND Irritable bowel syndrome has been said to be less common in developing countries compared with western populations. In some case series of irritable bowel syndrome from the Indian subcontinent and Africa, the female predominance typical of western patients did not occur. AIM AND METHODS A systematic review was performed on Medline, of community prevalence studies of irritable bowel syndrome, chronic constipation and chronic diarrhoea using standardized criteria, with special reference to the effect of geography and ethnicity, and the gender distribution in different countries. RESULTS There is a wide variation, depending in part on the criteria used and differences in diagnostic practices and health care utilization. No convincing evidence emerged of a difference between east and west. Most series, eastern or western showed a female predominance or no gender difference. Several US studies in communities and specific populations suggest that stool frequency is lower, and the prevalence of constipation higher, among Afro-Caribbean Americans compared with white individuals. CONCLUSIONS Community studies in multi-racial populations are a useful way of assessing possible ethnic differences in the frequency of irritable bowel syndrome, chronic constipation and diarrhoea, and would additionally present opportunities to relate any ethnic differences to dietary and other environmental factors.
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Affiliation(s)
- J Y Kang
- Department of Gastroenterology, St George's Hospital, London SW17 0QT, UK.
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Abstract
BACKGROUND Many observers believe that gastro-oesophageal reflux disease is more common among white individuals compared with Asians and Afro-Caribbean subjects. AIM To perform a systematic review regarding geographical and ethnic factors in the prevalence of reflux symptoms, endoscopic oesophagitis, hiatus hernia and Barrett's oesophagus. RESULTS Differences in definitions and methodology make comparison between studies difficult. Overall, however, the community prevalence of reflux symptoms, as well as the prevalence of endoscopic oesophagitis, hiatus hernia and Barrett's oesophagus among patients undergoing upper endoscopy, were lower among Asian and Afro-Caribbean subjects compared with white individuals. There may also be a north-south gradient in the prevalence of gastro-oesophageal reflux disease among western countries. Gastro-oesophageal reflux disease may be moderately common in the Middle East. There are suggestions that the prevalence of gastro-oesophageal reflux disease is increasing in the Far East. CONCLUSIONS More data are required, especially from Africa, South America, the Middle East, and the Indian subcontinent. Suggestions are made regarding definitions and methodology to facilitate comparison between future studies from different countries.
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Affiliation(s)
- J Y Kang
- Department of Gastroenterology, St George's Hospital, London, UK.
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Abstract
A sliding hiatus hernia disrupts both the anatomy and physiology of the normal antireflux mechanism. It reduces lower oesophageal sphincter length and pressure, and impairs the augmenting effects of the diaphragmatic crus. It is associated with decreased oesophageal peristalsis, increases the cross-sectional area of the oesophago-gastric junction, and acts as a reservoir allowing reflux from the hernia sac into the oesophagus during swallowing. The overall effect is that of increased oesophageal acid exposure. The presence of a hiatus hernia is associated with symptoms of gastro-oesophageal reflux, increased prevalence and severity of reflux oesophagitis, as well as Barrett's oesophagus and oesophageal adenocarcinoma. The efficacy of treatment with proton pump inhibitors is reduced. Our view on the significance of the sliding hiatus hernia in gastro-oesophageal reflux disease has changed enormously in recent decades. It was initially thought that a hiatus hernia had to be present for reflux oesophagitis to occur. Subsequently, the hiatus hernia was considered an incidental finding of little consequence. We now appreciate that the hiatus hernia has major patho-physiological effects favouring gastro-oesophageal reflux and hence contributing to oesophageal mucosal injury, particularly in patients with severe gastro-oesophageal reflux disease.
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Affiliation(s)
- C Gordon
- Department of Gastroenterology, St George's Hospital, London, UK
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45
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Affiliation(s)
- J Y Kang
- Department of Gastroenterology, St George's Hospital, London SW17 0QT, UK.
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46
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Kang JY, Dhar A, Pollok R, Leicester RJ, Benson MJ, Kumar D, Melville D, Neild PJ, Tibbs CJ, Maxwell JD. Diverticular disease of the colon: ethnic differences in frequency. Aliment Pharmacol Ther 2004; 19:765-9. [PMID: 15043517 DOI: 10.1111/j.1365-2036.2004.01908.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Colonic diverticular disease is more common in Western populations than in developing countries. AIM To determine whether the frequency of colonic diverticular disease is different in British patients of Indian-subcontinent Asian origin compared with other ethnic groups. METHODS All colonoscopies performed over a 3-year period in a London hospital were studied. Patients of Indian-subcontinent Asian origin were identified by name. RESULTS Five of 134 Indian-subcontinent Asian males (4%) had colonic diverticular disease, compared with 278 of 1268 patients of other ethnic groups (22%; P < 0.001). Five of 91 Indian-subcontinent Asian females (6%) had colonic diverticular disease, compared with 333 of 1486 patients of other ethnic groups (23%; P < 0.001). Although patients of Indian-subcontinent Asian origin (54.8 +/- 15.8 years) were younger than those of other ethnic groups (60.3 +/- 17.8 years; P < 0.0001), the ethnic difference in the frequency of diverticular disease persisted even when age was taken into account. CONCLUSION There is a lower frequency of colonic diverticular disease in Indian-subcontinent Asians presenting for colonoscopy, compared with other ethnic groups. This cannot be explained by sex or age differences. Our findings require confirmation, but may provide opportunities for research into the aetiology of colonic diverticular disease.
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Affiliation(s)
- J Y Kang
- Department of Gastroenterology, St George's Hospital, London, UK.
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47
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Kang JY, Majeed A, Williamson RCN, Maxwell JD. Authors' reply (for related letter see Br J Surg 2003; 91: 254): Decline in admission rates for acute appendicitis in England ( Br J Surg 2003; 90: 1586-1592). Br J Surg 2004. [DOI: 10.1002/bjs.4585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- J Y Kang
- Department of Gastroenterology, St George's Hospital, Blackshaw Road, London SW17 0QT, UK
| | - A Majeed
- Office for National Statistics, London, UK
| | | | - J D Maxwell
- Department of Gastroenterology, St George's Hospital, Blackshaw Road, London SW17 0QT, UK
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48
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Abstract
BACKGROUND The incidence of acute appendicitis declined in western countries between the 1930s and the early 1990s. The aim of this study was to determine time trends in hospital admissions for acute appendicitis in England between 1989-1990 and 1999-2000, and in population mortality rates for appendicitis from 1979 to 1999. METHODS : Hospital Episode Statistics for admissions were obtained from the Department of Health and mortality data from the Office for National Statistics. RESULTS Between 1989-1990 and 1999-2000, age-standardized hospital admission rates for acute appendicitis decreased by 12.5 per cent in male patients and by 18.8 per cent in female patients. The proportions of admissions that resulted in operation remained stable. Admission rates for non-specific mesenteric lymphadenitis fell. Admission rates for abdominal pain increased between 1989-1990 and 1995-1996, at which time the International Classification of Diseases codes changed. Between 1995-1996 and 1999-2000, admission rates for abdominal pain declined. Analysis of age-specific admission rates for acute appendicitis and abdominal pain from 1989-1990 to 1995-1996 showed that the decline in acute appendicitis could not be accounted for by a change in diagnostic practice. Mortality rates for acute appendicitis remained stable over the study period. CONCLUSION Admission rates for acute appendicitis declined over the study period. This decline cannot be explained by reclassification.
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Affiliation(s)
- J Y Kang
- Department of Gastroenterology, St George's Hospital, University College London, London, UK.
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Kang JY, Majeed A. Hospitalization and mortality rates from peptic ulcer in the 1990s. Am J Gastroenterol 2003; 98:1896; author reply 1896-7. [PMID: 12907356 DOI: 10.1111/j.1572-0241.2003.07612.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Kang JY, Hoare J, Tinto A, Subramanian S, Ellis C, Majeed A, Melville D, Maxwell JD. Diverticular disease of the colon--on the rise: a study of hospital admissions in England between 1989/1990 and 1999/2000. Aliment Pharmacol Ther 2003; 17:1189-95. [PMID: 12752356 DOI: 10.1046/j.1365-2036.2003.01551.x] [Citation(s) in RCA: 169] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Diverticular disease emerged as a common problem in Western countries over the course of the 20th century. AIMS To determine the time trends in diverticular disease for hospital admissions in England between 1989/1990 and 1999/2000 and population mortality rates from 1979 to 1999. METHODS Hospital Episode Statistics were obtained from the Department of Health and mortality data from the Office for National Statistics. RESULTS Between 1989/1990 and 1999/2000, annual age-standardized hospital admission rates for diverticular disease increased by 16% for males (from 20.1 to 23.2 per 100,000) and 12% for females (from 28.6 to 31.9 per 100,000). Female rates were significantly higher than male rates throughout the study period. The proportions of admissions with an operation increased by 16% for males (from 22.9% to 24.1%) and 14% for females (from 19.7% to 22.3%). Older patients were less likely to undergo operation than younger patients. In-patient case fatality rates and population mortality rates remained unchanged. CONCLUSIONS Admission rates for diverticular disease increased over the study period. The proportion of patients who underwent operation increased, but in-patient and population mortality rates remained unchanged. With an ageing population, diverticular disease will become an increasingly important clinical problem in England.
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Affiliation(s)
- J Y Kang
- Department of Gastroenterology, St George's Hospital, London, UK.
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