Rectal carcinoids are low-grade malignancies that are usually treated by endoscopic resection. However, on pathologic examination, resection margins that are positive for carcinoid cells are ...frequently found. Patient outcomes were reviewed after endoscopic resection of rectal carcinoids and the clinical significance of possible residual disease, as defined by pathologic and endoscopic examination, was evaluated.
The medical records and endoscopic findings of 347 patients presenting with rectal carcinoids to 14 university hospitals in Korea between January 1999 and June 2007 were retrospectively analyzed.
A total of 304 patients were treated with endoscopic resection, and 43 patents were treated with surgery. In the endoscopic resection group, the complete resection rate was 88.2% based on endoscopic appearance (CR-E) and 60.2% based on pathologic evaluation (CR-P). The agreement between CR-E and CR-P was low (κ=0.192). No residual tumors were found in 77 of 85 patients (90.6%) who were CR-E but not CR-P and who had endoscopic biopsy taken at 24-month follow-up. The receiver-operating characteristic curve identified an optimal cut-off value of 10.5 mm, at which the sensitivity and the specificity for metastasis were 100% and 89%, respectively. The risk factors for metastasis by multivariate analysis were tumor size, increased mitotic rate, and lymphovascular invasion.
Endoscopic resection is a safe and effective modality for treating well-differentiated rectal carcinoids smaller than 10 mm in diameter. Discrepancies were observed between CR-E and CR-P. The risk factors for metastasis were tumor size, increased mitotic rate, and lymphovascular invasion.
This paper presents a walking pattern classification and a walking distance estimation algorithm using gait phase information. A gait phase information retrieval algorithm was developed to analyze ...the duration of the phases in a gait cycle (i.e., stance, push-off, swing, and heel-strike phases). Based on the gait phase information, a decision tree based on the relations between gait phases was constructed for classifying three different walking patterns (level walking, walking upstairs, and walking downstairs). Gait phase information was also used for developing a walking distance estimation algorithm. The walking distance estimation algorithm consists of the processes of step count and step length estimation. The proposed walking pattern classification and walking distance estimation algorithm have been validated by a series of experiments. The accuracy of the proposed walking pattern classification was 98.87%, 95.45%, and 95.00% for level walking, walking upstairs, and walking downstairs, respectively. The accuracy of the proposed walking distance estimation algorithm was 96.42% over a walking distance.
Abstract
Background
We aimed to conduct a study comparing the fecal and oral microbiomes of Korean Crohn's disease patients with those of healthy individuals. Since most of microbial study of ...inflammatory bowel disease patients are conducted overseas, this study would reveal if the microbiome of Korean patients and patients of other countries are the same or not. Also, since the process of fecal sample collection is inconvenient, saliva sample analysis was performed to find a relevance of disease activity.
Methods
This single center study recruited patients with CD between September 2022 and January 2023. At first visitation, stool collecting tube and saliva collecting tube were given to CD patient. Collected stools samples and saliva samples were sent to the environmental bioengineering laboratory in Korea University and assessed by 16S rRNA sequencing.
Results
26 CD patients and 6 healthy individuals were enrolled to this study. In the comparison of helathy individual’s fecal microbiome, the flora of fecal sample of CD patients were slightly different. The diversity of microbiome was decreased in CD patients compared to healthy individuals. There were 17 species existed only in CD patient’s feces. The most frequently detected one was Ruminococcus gnavus, and the the highest abundance was Unclassified Fusobacterium. In the phylum level of bacteria, Bacteroidota, Firmicutes, and Proteobacteria were predominant. Saliva samples showed no significant difference between CD patient and control.
Conclusion
Fecal sampling can be usefully used as a diagnostic test technique that can reflect CD patients’ microbiota. Similar to patient in overseas, dysbiosis of fecal microbiome and abundant species were detected.
Background
Probiotics can be beneficial in irritable bowel syndrome (IBS). Mosapride citrate, a selective 5‐HT4 receptor agonist, stimulates gastrointestinal motility. We investigated the efficacy of ...combination therapy with probiotics and mosapride for non‐diarrheal‐type IBS.
Methods
Two hundred and eighty‐five IBS patients were randomly assigned to either a combination of probiotics (Bacillus subtilis and Streptococcus faecium) and mosapride at one of four different doses or a placebo for 4 weeks. The primary outcome was the proportion of patients experiencing adequate relief (AR) of global IBS symptoms at week 4. The secondary outcomes included subject's global assessment (SGA) of IBS symptom relief, individual symptoms, stool parameters, and IBS‐quality of life.
Key Results
The proportion of AR at week 4 was significantly higher in all treatment groups compared to the placebo group (53.7% in group 1, 55.0% in group 2, 55.2% in group 3, 53.6% in group 4 the highest dose, and 35.1% in placebo group, respectively, p < 0.05). The proportion of patients reporting ‘completely or considerably relieved’ in the SGA was higher in the treatment groups than in the placebo group. The abdominal pain/discomfort score in the treatment group 4 was more prominently improved compared with that of the placebo group. In patients with constipation‐predominant IBS, the improvements in stool frequency and consistency were significantly higher in the treatment groups 4 and 1, respectively, than those in the placebo group.
Conclusions & Inferences
Combination therapy with probiotics and mosapride is effective for relief of symptoms in patients with non‐diarrheal‐type IBS. The study has been registered in the US National Library of Medicine (http://www.clinicaltrials.gov, NCT01505777).
The combination therapy with probiotics and mosapride is effective and safe for managing IBS symptoms and stool frequency and consistency in patients with non‐diarrheal‐type IBS. The highest dose of the study drug was most effective for producing improvement in abdominal pain/discomfort and spontaneous complete bowel movements.
The findings of several studies suggest that liver stiffness values can be affected by the degree of intrahepatic congestion respiration influence intrahepatic blood volume and may affect liver ...stiffness. We evaluated the influence of respiration on liver stiffness. Transient elastography (TE) was performed at the end of inspiration and at the end of expiration in patients with chronic liver disease. The median values obtained during the inspiration set and during the expiration set were defined as inspiratory and expiratory liver stiffness, respectively. A total of 123 patients with chronic liver disease were enrolled (mean age 49 years; 64.2% men). Liver cirrhosis coexisted in 29 patients (23.6%). Expiratory liver stiffness was significantly higher than inspiratory liver stiffness (8.7 vs 7.9 kPa, P = 0.001), while the expiratory interquartile range/median ratio (IQR ratio) did not differ from the inspiratory IQR ratio. Expiratory liver stiffness was significantly higher than inspiratory liver stiffness in 49 (39.8%) patients (HE group), expiratory liver stiffness was significantly lower than inspiratory stiffness in 15 (12.2%) patients, and there was no difference in 59 (48.0%) patients. Liver cirrhosis was more frequent in those who had a lower liver stiffness reading in expiration, and only the absence of liver cirrhosis was significantly associated with a higher reading in expiration in multivariate analysis. In conclusion, liver stiffness was significantly elevated during expiration especially in patients without liver cirrhosis. The effect of respiration should be kept in mind during TE readings.
Background & Aims: We assessed the relationship between antibodies to infliximab (ATI) and the loss of response postinfliximab, infusion reactions and, in a randomized trial, investigated whether ...intravenous hydrocortisone premedication can reduce ATI. Methods: Initially, we prospectively evaluated clinical response, adverse events, and ATI levels in 53 consecutive patients with Crohn's disease who received 199 infliximab (5 mg/kg) infusions. Subsequently, 80 patients with Crohn's disease were randomized to intravenous hydrocortisone 200 mg or placebo immediately before their first and subsequent infliximab infusions. The primary endpoint was reduction in median ATI levels at week 16. Analysis was by intention to treat. Results: Nineteen of our initial 53 patients (36%) developed ATI, including all 7 patients with serious infusion reactions (median ATI level, 19.6 μg/mL). Eleven of 15 patients (73%) who lost their initial response were ATI positive compared with none of 21 continuous responders, (8.9 vs. 0.7 μg/mL, P < 0.0001). Administering a second infusion within 8 weeks of the first (OR, 0.13; 95% CI, 0.03-0.5; P = 0.0007) or concurrent immunosuppressants (OR, 0.19; 95% CI, 0.04-1.03; P = 0.007) significantly reduced ATI formation. In the placebo-controlled trial, ATI levels were lower at week 16 among hydrocortisone-treated patients (1.6 vs. 3.4 μg/mL, P = 0.02), and 26% of hydrocortisone-treated patients developed ATI compared with 42% of placebo-treated patients, P = 0.06. Conclusions: Loss of initial response and infusion reactions post-infliximab is strongly related to ATI formation and level. Administering a second infusion within 8 weeks of the first and concurrent immunosuppressant therapy significantly reduce ATI formation. Intravenous hydrocortisone premedication significantly reduces ATI levels but does not eliminate ATI formation or infusion reactions.
Abstract
Background
Olfactory receptors (ORs) are one of the largest gene family of human genome and the GPCRS. Ectopic expression of ORs have been detected not only in the nose, but also various non ...olfactory organs, including testis, prostate, kidney and GI tracts. Some ORs have been demonstrated to have an effect on cell growth and cancer progression or inhibition. But their exact functions have not yet been fully investigated. Here, we identified OR gene in ulcerative colitis patients using RNA-sequencing analysis and real-time PCR. In order to analyse the functional role of OR gene, we used the organoids from both human and mice colon and DSS colitis model.
Methods
Colon tissues (seven naive ulcerative colitis patients with moderate to severe grade and seven normal patients for control) were obtained from endoscopic biopsy for RNA-sequencing and qPCR. Organoids were generated from normal human colon tissue obtained from endoscopic biopsies and B6J mice colon. For the assessment of functional role of OR gene in colon, we generated colonic organoids from both human and mice (B6J) and gene expression patterns were analysed after inflammatory cytokines stimulation including TNF-a and IL-6 treatment. For in vivo assay, 3% DSS colitis mice model were used for the OR expression assay.
Results
We identified three candidate OR genes (OR 51E2, OR51E1 and OR56B4) in RNA-sequencing analysis and OR51E2 was significantly highly expressed in naïve ulcerative colitis tissue in the validating q PCR assessment. In vivo assessment using DSS colitis model, Olf 78, which is homologous to human OR 51E2, was significantly increased in DSS treated mice colon. We test the expression changes of OR51E2 and a mouse olfactory receptor gene, in both human and mice organoid after treatment with TNF-a (10ng/ml). Organoid culture with low dose TNF-a (10ng/ml) yielded the decreased expression of OR51E2 in human colonic organoid but not in mice organoid.
Conclusions
This study show the possibility that ectopically expressed olfactory receptor, OR51E2 has a role in the pathogenesis of ulcerative colitis. The findings can provide the basis for alternative pathways of IBD development.
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