Colors of vegetables and fruits and the risks of colorectal cancer

Lee, Jeeyoo,Shin, Aesun,Oh, Jae Hwan,Kim, Jeongseon Baishideng Publishing Group Inc 2017 WORLD JOURNAL OF GASTROENTEROLOGY Vol.23 No.14

<P><B>AIM</B></P><P>To investigate the relationship between the colors of vegetables and fruits and the risk of colorectal cancer in Korea.</P><P><B>METHODS</B></P><P>A case-control study was conducted with 923 colorectal cancer patients and 1846 controls recruited from the National Cancer Center in Korea. We classified vegetables and fruits into four groups according to the color of their edible parts (<I>e.g</I>., green, orange/yellow, red/purple and white). Vegetable and fruit intake level was classified by sex-specific tertile of the control group. Logistic regression models were used for estimating the odds ratios (OR) and their 95% confidence intervals (CI).</P><P><B>RESULTS</B></P><P>High total intake of vegetables and fruits was strongly associated with a reduced risk of colorectal cancer in women (OR = 0.32, 95%CI: 0.21-0.48 for highest <I>vs</I> lowest tertile) and a similar inverse association was observed for men (OR = 0.60, 95%CI: 0.45-0.79). In the analysis of color groups, adjusted ORs (95%CI) comparing the highest to the lowest of the vegetables and fruits intake were 0.49 (0.36-0.65) for green, and 0.47 (0.35-0.63) for white vegetables and fruits in men. An inverse association was also found in women for green, red/purple and white vegetables and fruits. However, in men, orange/yellow vegetables and fruits (citrus fruits, carrot, pumpkin, peach, persimmon, ginger) intake was linked to an increased risk of colorectal cancer (OR = 1.61, 95%CI: 1.22-2.12).</P><P><B>CONCLUSION</B></P><P>Vegetables and fruits intake from various color groups may protect against colorectal cancer.</P>

Secondary endoscopic submucosal dissection for locally recurrent or incompletely resected gastric neoplasms

Jung, Da Hyun,Youn, Young Hoon,Kim, Jie-Hyun,Park, Jae Jun,Park, Hyojin Baishideng Publishing Group Inc 2018 WORLD JOURNAL OF GASTROENTEROLOGY Vol.24 No.33

<P><B>AIM</B></P><P>To investigate the feasibility and safety of secondary endoscopic submucosal dissection (ESD) for residual or locally recurrent gastric tumors.</P><P><B>METHODS</B></P><P>Between 2010 and 2017, 1623 consecutive patients underwent ESD for gastric neoplasms at a single tertiary referral center. Among these, 28 patients underwent secondary ESD for a residual or locally recurrent tumor. Our analysis compared clinicopathologic factors between primary ESD and secondary ESD groups.</P><P><B>RESULTS</B></P><P>The en bloc resection and curative rate of resection of secondary ESD were 92.9% and 89.3%, respectively. The average procedure time of secondary ESD was significantly longer than primary ESD (78.2 min <I>vs</I> 55.1 min, <I>P</I> = 0.004), and the adverse events rate was not significantly different but trended slightly higher in the secondary ESD group compared to the primary ESD group (10.7% <I>vs</I> 3.8%, <I>P</I> = 0.095). Patients who received secondary ESD had favorable outcomes without severe adverse events. During a mean follow-up period, no local recurrence occurred in patients who received secondary ESD.</P><P><B>CONCLUSION</B></P><P>Secondary ESD of residual or locally recurrent gastric tumors appears to be a feasible and curative treatment though it requires greater technical efficiency and longer procedure time.</P>

Sex disparity in viral load, inflammation and liver damage in transgenic mice carrying full hepatitis B virus genome with the W4P mutation in the preS1 region

Lee, Seoung-Ae,Lee, So-Young,Choi, Yu-Min,Kim, Hong,Kim, Bum-Joon Baishideng Publishing Group Inc 2018 WORLD JOURNAL OF GASTROENTEROLOGY Vol.24 No.10

<P><B>AIM</B></P><P>To study sex disparity in susceptibility to hepatocellular carcinoma (HCC), we created a transgenic mouse model that expressed the full hepatitis B virus (HBV) genome with the W4P mutation.</P><P><B>METHODS</B></P><P>Transgenic mice were generated by transferring the pHY92-1.1x-HBV-full genome plasmid (genotype A2) into C57Bl/6N mice. We compared serum levels of hepatitis B surface antigen (HBsAg), interleukin (IL)-6, and the liver enzymes alanine aminotransferase (ALT) and aspartate transaminase (AST), as well as liver histopathological features in male and female transgenic (W4P TG) mice and in nontransgenic littermates of 10 mo of age.</P><P><B>RESULTS</B></P><P>W4P TG males exhibited more pronounced hepatomegaly, significantly increased granule generation in liver tissue, elevated HBsAg expression in the liver and serum, and higher serum ALT and IL-6 levels compared to W4P TG females or littermate control groups.</P><P><B>CONCLUSION</B></P><P>Together, our data indicate that the W4P mutation in preS1 may contribute to sex disparity in susceptibility to HCC by causing increased HBV virion replication and enhanced IL-6-mediated inflammation in male individuals. Additionally, our transgenic mouse model that expresses full HBV genome with the W4P mutation in preS1 could be effectively used for the studies of the progression of liver diseases, including HCC.</P>

Benefit of neoadjuvant concurrent chemoradiotherapy for locally advanced perihilar cholangiocarcinoma

Jung, Jang Han,Lee, Hyun Jik,Lee, Hee Seung,Jo, Jung Hyun,Cho, In Rae,Chung, Moon Jae,Park, Jeong Youp,Park, Seung Woo,Song, Si Young,Bang, Seungmin Baishideng Publishing Group Inc 2017 WORLD JOURNAL OF GASTROENTEROLOGY Vol.23 No.18

<P><B>AIM</B></P><P>To clarify the role of neoadjuvant concurrent chemoradiotherapy (NACCRT) followed by surgical resection for localized or locally advanced perihilar cholangiocarcinoma (CCA).</P><P><B>METHODS</B></P><P>We retrospectively reviewed 57 patients who underwent surgical resection with or without NACCRT for perihilar CCA; 12 patients received NACCRT and 45 patients did not received NACCRT. Patients with locally advanced perihilar CCA requiring NACCRT were defined as follows: (1) a mass involving unilateral branches of the portal vein or hepatic artery with insufficient volume of the anticipated remnant lobe; or (2) an infiltrating mass in the main portal vein that was too long for reconstruction, identified at preoperative staging.</P><P><B>RESULTS</B></P><P>The median disease-free survival (DFS) durations of the neoadjuvant and non-neoadjuvant CCRT groups were 26.0 and 15.1 mo, respectively (<I>P</I> = 0.91). The median overall survival (OS) durations of the neoadjuvant and non-neoadjuvant CCRT groups were 32.9 and 27.1 mo, respectively (<I>P</I> = 0.26). The NACCRT group showed a downstaging tendency compared to the non-NACCRT group as compared with the tumor stage confirmed by histological examination after surgery and the tumor stage confirmed by imaging test at the time of diagnosis (<I>P</I> = 0.01).</P><P><B>CONCLUSION</B></P><P>NACCRT does not prolong DFS and OS in localized or locally advanced perihilar CCA. However, NACCRT may allow tumor downstaging and improve tumor resectability.</P>

Melatonin modulates adiponectin expression on murine colitis with sleep deprivation

Kim, Tae Kyun,Park, Young Sook,Baik, Haing-Woon,Jun, Jin Hyun,Kim, Eun Kyung,Sull, Jae Woong,Sung, Ho Joong,Choi, Jin Woo,Chung, Sook Hee,Gye, Myung Chan,Lim, Ju Yeon,Kim, Jun Bong,Kim, Seong Hwan Baishideng Publishing Group Inc 2016 WORLD JOURNAL OF GASTROENTEROLOGY Vol.22 No.33

<P><B>AIM</B></P><P>To determine adiponectin expression in colonic tissue of murine colitis and systemic cytokine expression after melatonin treatments and sleep deprivation.</P><P><B>METHODS</B></P><P>The following five groups of C57BL/6 mice were used in this study: (1) group I, control; (2) group II, 2% DSS induced colitis for 7 d; (3) group III, 2% DSS induced colitis and melatonin treatment; (4) group IV, 2% DSS induced colitis with sleep deprivation (SD) using specially designed and modified multiple platform water baths; and (5) group V, 2% DSS induced colitis with SD and melatonin treatment. Melatonin (10 mg/kg) or saline was intraperitoneally injected daily to mice for 4 d. The body weight was monitored daily. The degree of colitis was evaluated histologically after sacrificing the mice. Immunohistochemical staining and Western blot analysis was performed using anti-adiponectin antibody. After sampling by intracardiac punctures, levels of serum cytokines were measured by ELISA.</P><P><B>RESULTS</B></P><P>Sleep deprivation in water bath exacerbated DSS induced colitis and worsened weight loss. Melatonin injection not only alleviated the severity of mucosal injury, but also helped survival during stressful condition. The expression level of adiponectin in mucosa was decreased in colitis, with the lowest level observed in colitis combined with sleep deprivation. Melatonin injection significantly (<I>P</I> < 0.05) recovered the expression of adiponectin. The expression levels of IL-6 and IL-17 were increased in the serum of mice with DSS colitis but decreased after melatonin injection.</P><P><B>CONCLUSION</B></P><P>This study suggested that melatonin modulated adiponectin expression in colonic tissue and melatonin and adiponectin synergistically potentiated anti-inflammatory effects on colitis with sleep deprivation.</P>

Diets, functional foods, and nutraceuticals as alternative therapies for inflammatory bowel disease: Present status and future trends

Mijan, Mohammad Al,Lim, Beong Ou Baishideng Publishing Group Inc 2018 World journal of gastroenterology Vol.24 No.25

<P>Inflammatory bowel disease (IBD) is a serious health concern among western societies. The disease is also on the rise in some East Asian countries and in Australia. Health professionals and dietitians around the world are facing an unprecedented challenge to prevent and control the increasing prevalence of IBD. The current therapeutic strategy that includes drugs and biological treatments is inefficient and are associated with adverse health consequences. In this context, the use of natural products is gaining worldwide attention. <I>In vivo</I> studies and clinical evidence suggest that well-planned dietary regimens with specific nutrients can alleviate gastrointestinal inflammation by modulating inflammatory cytokines, such as tumor necrosis factor α (TNF-α), interleukin 1 (IL-1), IL-6, IL-1β, and IL-10. Alternatively, the avoidance of high-fat and high-carbohydrate diets is regarded as an effective tool to eliminate the causes of IBD. Many functional foods and bioactive components have received attention for showing strong therapeutic effects against IBD. Both animal and human studies suggest that bioactive functional foods can ameliorate IBD by downregulating the pro-inflammatory signaling pathways, such as nuclear factor κB, STAT1, STAT6, and pro-inflammatory cytokines, including IL-1β, IL-4, IL-6, COX-2, TNF-α, and interferon γ. Therefore, functional foods and diets have the potential to alleviate IBD by modulating the underlying pathogenic mechanisms. Future comprehensive studies are needed to corroborate the potential roles of functional foods and diets in the prevention and control of IBD.</P>

Adverse events related to colonoscopy: Global trends and future challenges

Kim, Su Young,Kim, Hyun-Soo,Park, Hong Jun Baishideng Publishing Group Inc 2019 World journal of gastroenterology Vol.25 No.2

<P>Colonoscopy is a widely used method for diagnosing and treating colonic disease. The number of colonoscopies is increasing worldwide, and concerns about associated adverse events are growing. Large-scale studies using big data for post-colonoscopy complications have been reported. A colon perforation is a severe complication with a relatively high mortality rate. The perforation rate, as reported in large studies (≥ 50,000 colonoscopies) published since 2000, ranges from 0.005-0.085%. The trend in the overall perforation rate in the past 15 years has not changed significantly. Bleeding is a more common adverse event than perforation. Recent large studies (≥ 50,000 colonoscopies) have reported post-colonoscopy bleeding occurring in 0.001-0.687% of cases. Most studies about adverse events related to colonoscopy were performed in the West, and relatively few studies have been conducted in the East. The incidence of post-colonoscopy complications increases in elderly patients or patients with inflammatory bowel diseases. It is important to use a unified definition and refined data to overcome the limitations of previous studies. In addition, a structured training program for endoscopists and a systematic national management program are needed to reduce post-colonoscopy complications. In this review, we discuss the current trends in colonoscopy related to adverse events, as well as the challenges to be addressed through future research.</P>

Naturally occurring mutations in the reverse transcriptase region of hepatitis B virus polymerase from treatment-naïve Korean patients infected with genotype C2

Kim, Ji-Eun,Lee, So-Young,Kim, Hong,Kim, Ki-Jeong,Choe, Won-Hyeok,Kim, Bum-Joon Baishideng Publishing Group Inc 2017 WORLD JOURNAL OF GASTROENTEROLOGY Vol.23 No.23

<P><B>AIM</B></P><P>To report naturally occurring mutations in the reverse transcriptase region (RT) of hepatitis B virus (HBV) polymerase from treatment naïve Korean chronic patients infected with genotype C2.</P><P><B>METHODS</B></P><P>Here, full-length HBV reverse transcriptase RT sequences were amplified and sequenced from 131 treatment naïve Korean patients chronically infected with hepatitis B genotype C2. The patients had two distinct clinical statuses: 59 patients with chronic hepatitis (CH) and 72 patients with hepatocellular carcinoma (HCC). The deduced amino acids (AAs) at 42 previously reported potential nucleos(t)ide analog resistance (NAr) mutation positions in the RT region were analyzed.</P><P><B>RESULTS</B></P><P>Potential NAr mutations involving 24 positions were found in 79 of the 131 patients (60.3%). Notably, AA substitutions at 2 positions (rt184 and rt204) involved in primary drug resistance and at 2 positions (rt80 and rt180) that functioned as secondary/compensatory mutations were detected in 10 patients (1 CH patient and 9 HCC patients) and 7 patients (1 CH and 6 HCC patients), respectively. The overall mutation frequencies in the HCC patients (3.17%, 96/3024 mutations) were significantly higher than the frequencies in the CH patients (2.09%, 52/2478 mutations) (<I>P</I> = 0.003). In addition, a total of 3 NAr positions, rt80, rt139 and rt204 were found to be significantly related to HCC from treatment naïve Korean patients.</P><P><B>CONCLUSION</B></P><P>Our data showed that naturally occurring NAr mutations in South Korea might contribute to liver disease progression (particularly HCC generation) in chronic patients with genotype C2 infections.</P>

Naturally occurring hepatitis B virus reverse transcriptase mutations related to potential antiviral drug resistance and liver disease progression

Choi, Yu-Min,Lee, So-Young,Kim, Bum-Joon Baishideng Publishing Group Inc 2018 World journal of gastroenterology Vol.24 No.16

<P>The annual number of deaths caused by hepatitis B virus (HBV)-related disease, including cirrhosis and hepatocellular carcinoma (HCC), is estimated as 887000. The reported prevalence of HBV reverse transcriptase (RT) mutation prior to treatment is varied and the impact of preexisting mutations on the treatment of naïve patients remains controversial, and primarily depends on geographic factors, HBV genotypes, HBeAg serostatus, HBV viral loads, disease progression, intergenotypic recombination and co-infection with HIV. Different sensitivity of detection methodology used could also affect their prevalence results. Several genotype-dependent HBV RT positions that can affect the emergence of drug resistance have also been reported. Eight mutations in RT (rtL80I, rtD134N, rtN139K/T/H, rtY141F, rtM204I/V, rtF221Y, rtI224V, and rtM309K) are significantly associated with HCC progression. HBeAg-negative status, low viral load, and genotype C infection are significantly related to a higher frequency and prevalence of preexisting RT mutations. Preexisting mutations are most frequently found in the A-B interdomain of RT which overlaps with the HBsAg “a” determinant region, mutations of which can lead to simultaneous viral immune escape. In conclusion, the presence of baseline RT mutations can affect drug treatment outcomes and disease progression in HBV-infected populations via modulation of viral fitness and host-immune responses.</P>

Effects of Lizhong Tang on gastrointestinal motility in mice

Lee, Min Cheol,Ha, Wooram,Park, Jinhyeong,Kim, Junghoon,Jung, Yunjin,Kim, Byung Joo Baishideng Publishing Group Inc 2016 WORLD JOURNAL OF GASTROENTEROLOGY Vol.22 No.34

<P><B>AIM</B></P><P>To investigate the effects of Lizhong Tang, a traditional Chinese medicine formula, on gastrointestinal motility in mice.</P><P><B>METHODS</B></P><P>The <I>in vivo</I> effects of Lizhong Tang on GI motility were investigated by measuring the intestinal transit rates (ITRs) and gastric emptying (GE) values in normal mice and in mice with experimentally induced GI motility dysfunction (GMD).</P><P><B>RESULTS</B></P><P>In normal ICR mice, the ITR and GE values were significantly and dose-dependently increased by Lizhong Tang (ITR values: 54.4% ± 1.9% <I>vs</I> 65.2% ± 1.8%, <I>P</I> < 0.01 with 0.1 g/kg Lizhong Tang and 54.4% ± 1.9% <I>vs</I> 83.8% ± 1.9%, <I>P</I> < 0.01 with 1 g/kg Lizhong Tang; GE values: 60.7% ± 1.9% <I>vs</I> 66.8% ± 2.1%, <I>P</I> < 0.05 with 0.1 g/kg Lizhong Tang and 60.7% ± 1.9% <I>vs</I> 72.5% ± 1.7%, <I>P</I> < 0.01 with 1 g/kg Lizhong Tang). The ITRs of the GMD mice were significantly reduced compared with those of the normal mice, which were significantly and dose-dependently reversed by Lizhong Tang. Additionally, in loperamide- and cisplatin-induced models of GE delay, Lizhong Tang administration reversed the GE deficits.</P><P><B>CONCLUSION</B></P><P>These results suggest that Lizhong Tang may be a novel candidate for development as a prokinetic treatment for the GI tract.</P>