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Background/Aims: Subepithelial tumors (SETs) are small, mostly asymptomatic lesions with normal overlying mucosa, usually identified incidentally on endoscopy. The aim of this study was to evaluate the pathologic diagnosis of SETs, and to assess the diagnostic yield and impact of endoscopic submucosal dissection (ESD) biopsy on the management of patients with SETs.Materials and Methods: We included 52 subepithelial lesions in this study during the study period. Inclusion criteria included size of the SET >2 cm, and a gastrointestinal stromal tumor (GIST) that cannot be excluded using EUS. We performed an endoscopic biopsy of each SET using the ESD technique.Results: The mean diameter of the lesions was 24.15±6.0 mm. The diagnostic yield of this method was 96.15%. Among the 52 participants, 45 were located in the stomach, four in the esophagus, and three in the duodenum. The pathologic diagnoses included: 17 leiomyomas, 13 GISTs, 11 ectopic pancreases, two carcinomas, two inflammatory fibroid polyps, two Brunner’s gland hyperplasia, two lipomas, one glomus tumor, and two remained undiagnosed. The mean duration of the procedure was 13.44±2.41 minutes. Three complications were associated with the procedure.Conclusions: Deep biopsy via ESD is useful in determining the histopathologic nature of SETs. This method minimizes the need for unnecessary surgery in benign SETs.

Background/Aims: To date, studies on various noninvasive techniques have been suggested to evaluate the degree of liver fibrosis. We aimed to investigate the diagnostic performance of serum asialo α1-acid glycoprotein (AsAGP) in the diagnosis of liver cirrhosis compared with chronic hepatitis for clinically useful result. Methods: We conducted a case-control study of 96 patients with chronic liver disease. Chronic hepatitis was defined as the presence of chronic liver disease on ultrasonography, with a liver stiffness of less than 5.0 kPa as shown on magnetic resonance elastography (MRE). Liver cirrhosis was defined as liver stiffness of more than 5.0 kPa on MRE. The serum AsAGP concentration was compared between the two groups. Results: Serum AsAGP levels were significantly higher in patients with cirrhosis than in those with chronic hepatitis (1.83 μg/mL vs 1.42 μg/mL, p

Tyrosine kinase inhibitors are widely used as targeted treatments for various malignancies. Sorafenib is an orally active tyrosine kinase inhibitor that blocks the signaling pathways of several growth factors. Its use is approved for various malignancies such as unresectable hepatocellular carcinoma, renal cell carcinoma, and gastrointestinal stromal tumors. Several adverse effects have been reported in the literature; however, cardiotoxicity is rare. We present a case of recurrent coronary vasospasm caused by short-term administration (5 days) of sorafenib. Since it caused refractory ischemia after re-administration, we had no choice but to stop the treatment. (J Liver Cancer 2020;20:67-71)

BACKGROUNDS/AIMS: Interval gastric cancers (GCs) can be encountered during screening gastroscopy. This study investigated the rate of interval GCs and their risk factors. MATERIALS AND METHODS: We retrospectively investigated subjects who underwent screening gastroscopy from 2005 to 2017 in a university hospital and were diagnosed with GC. Subjects were grouped based on their endoscopic images and descriptive results into interval GC and initially diagnosed GC groups. Interval GCs were defined when endoscopic results within the previous 3 years were negative for GC. The clinico-pathological characteristics of the groups and risk factors for interval GCs were evaluated. RESULTS: Of 54 724 subjects who underwent screening gastroscopy, 234 were diagnosed with GC, of which 43 were interval GCs. The rate of interval GCs was 18.4% (43/234, mean age 61.6 years). Interval GCs were smaller than initially diagnosed GCs (1.6 vs 1.9 cm, P = .011). They were located in the low-to-mid-body in 44.2%, antrum in 48.8%, and high body and cardia in 7%. Their observation time was shorter (248.74 vs 410.64 sec, P = .032). In multivariate analysis, they were associated with short observation time (odds ratio [OR] 0.99, 95% CI 0.994-0.998, P < .001) and location in the low-to-mid-body (OR 2.12, 95% CI 1.071-4.181, P = .031), although differentiation, ulcerated type, metaplasia, Helicobacter pylori infection, and endoscopists’ experience were not associated with interval GCs. CONCLUSIONS: The rate of interval GCs was significant during screening gastroscopy. They might be reduced by increasing observation time, focusing on smaller lesions, and observing the low-to-mid-body of the stomach more carefully.

Background The use of antibiotics increases recently. Accordingly, the incidence of antibiotics associated with drug induced liver injury (DILI) also increases. The purpose of this study is to evaluate the proportion and the clinical characteristics of antibiotic associated with DILI. Methods This study is a retrospective study of analyzed adult patients who were referred to the department of hepatology for the elevation of liver function tests and the frequency of elevated liver enzyme of patients with prescribed antibiotics during the same period at outpatient setting as a validation set. Results Antibiotics associated with DILI (64.0%) are the most common reason agent among consulting to hepatology department. Rheumatoid arthritis related drugs (11.0%), health supplements (5.0%), herbal medicines (4.0%), anti-viral drugs, anti-inflammatory analgesics/acetaminophen and lipid-lowering agents (3.0%) were next common causative drug for DILI in inpatients setting (training set). The frequency of antibiotics associated with DILI was high in order of flomoxef, cetrazole, ceftriaxone, vancomycin, piperacillin/tazobactam and amoxicillin/clavulanate. In the same period, 32% of the patients who prescribed flomoxef showed elevated liver enzyme levels above the upper normal limit. The prevalence of flomoxef induced DILI (>3 folds of ALT) was 13% and liver enzyme levels were five times higher than upper normal limits in 5% of flomoxef groups. Hypertension or diabetes was the risk factor of flomoxef associated with DILI. Conclusions The Prevalence of antibiotics associated with DILI was 2-14%. Co-morbidity with diabetes and hypertension was the risk factor of flomoxef associated with DILI.

Summary Background & aims Most people with nonalcoholic fatty liver disease (NAFLD) are obese, and they usually eat more while being less physically active as compared to healthy individuals. However, little is known about the lifestyle patterns of non-obese or obese patients with NAFLD. The aim of this study was to investigate nutrition components and behavioral differences between non-obese and obese patients with NAFLD. Methods This is a cross-sectional study comprising of 209 patients. Nutritional components and physical activity status were compared in obese and non-obese subjects with NAFLD against healthy controls. Dietary intake was assessed using the 5-day food diary. Physical activity was measured using the protocol of Korea Health and Nutrition Examination Survey. Total and regional body composition analysis was conducted using anthropometry and tetrapolar multi-frequency bio-impedance. Visceral adipose tissue, total abdominal adipose tissue, abdominal subcutaneous adipose tissue as well as liver fat were measured using abdomen tomography. Results Non-obese subjects with NAFLD had higher levels of ALT, AST, GGT, triglyceride, fasting glucose; higher carbohydrate energy ratio; higher visceral fat area, subcutaneous area, body muscle mass, fat free mass and body fat compared to subjects without NAFLD. Subjects with obesity and NAFLD had higher ALT, AST, visceral fat, fasting glucose and HOMA-IR (homeostatic model assessment-insulin resistance), and less moderate-level physical activity compared to those with obesity who do not have NAFLD. Obese subjects with NAFLD also had higher blood pressure, visceral fat area, subcutaneous fat area, body fat, body fat percent and GGT compared to non-obese subjects with NAFLD. In multivariate analysis, carbohydrate energy ratio and physical activity less than moderate-level ( Conclusions Percentage of carbohydrate intake percent and physical activity, less than moderate-level were independent predictors of NAFLD in non-obese subjects. Meanwhile, physical activity, less than moderate-level, was an independent predictor in obese subjects.

Background/Aims To date, studies on various noninvasive techniques have been suggested to evaluate the degree of liver fibrosis. We aimed to investigate the diagnostic performance of serum asialo α1-acid glycoprotein (AsAGP) in the diagnosis of liver cirrhosis compared with chronic hepatitis for clinically useful result. Methods We conducted a case-control study of 96 patients with chronic liver disease. Chronic hepatitis was defined as the presence of chronic liver disease on ultrasonography, with a liver stiffness of less than 5.0 kPa as shown on magnetic resonance elastography (MRE). Liver cirrhosis was defined as liver stiffness of more than 5.0 kPa on MRE. The serum AsAGP concentration was compared between the two groups. Results Serum AsAGP levels were significantly higher in patients with cirrhosis than in those with chronic hepatitis (1.83 μg/mL vs 1.42 μg/mL, p

Background and Aim: The risk and benefit of non-selective propranolol in patients with tense ascites are controversial. This study aimed to investigate the effect of propranolol as secondary prophylaxis on varix rebleeding and overall mortality in patients with tense ascites. Methods: This study used a database of the Health Insurance Review and Assessment Service (HIRAS), which provides health insurance to 97.2% of the total population in Korea. A total of 80,071 patients first variceal bleeding as the first decompensated complication enrolled from 2007 to 2014. Results: There were 2274 patients with large-volume ascites prescribed propranolol as secondary prophylaxis after first varix bleeding. The average prescription dose of propranolol as secondary prophylaxis was 74 mg/day in patients with large-volume ascites. The mean duration of rebleeding was 22.8 months. Result of analysis showed that low-dose propranolol (40&ndash, 120 mg/day) compared to inadequate propranolol dose (&lt, 40 mg/day) as secondary prophylaxis decreased overall mortality and varix rebleeding in patients with tense ascites. Conclusions: Low-dose propranolol (40&ndash, 120 mg/day) as secondary prophylaxis for variceal re-bleeding decreased overall mortality and varix rebleeding recurrence in patients with tense ascites.

Background/Aims Gallstone pathogenesis is linked to mucin hypersecretion and bacterial infection. Several mucin genes have been identified in gallbladder epithelial cells (GBECs). We investigated MUC expression in cholesterol-associated gallbladder disease and evaluated the relationship between mucin and bacterial infection. Methods The present study involved 20 patients with cholesterol stones with cholecystitis, five with cholesterol stones with cholesterolosis, six with cholesterol polyps, two with gallbladder cancer, and six controls. Canine GBECs treated with lipopolysaccharide were also studied. MUC3, MUC5AC, MUC5B, and MUC6 antibodies were used for dot/slot immunoblotting and immunohistochemical studies of the gallbladder epithelial tissues, canine GBECs, and bile. Reverse-transcription polymerase chain reaction was performed to evaluate MUC3 and MUC5B expression. Results MUC3, MUC5AC, MUC5B, and MUC6 were expressed in the normal gallbladder epithelium, and of those, MUC3 and MUC5B exhibited the highest expression levels. Greatly increased levels of MUC3 and MUC5B expression were observed in the cholesterol stone group, and slightly increased levels were observed in the cholesterol polyp group; MUC3 and MUC5B mRNA was also upregulated in those groups. Canine GBECs treated with lipopolysaccharide also showed upregulation of MUC3 and MUC5B. Conclusions The mucin genes with the highest expression levels in gallbladder tissue in cholesterol-associated diseases were MUC3 and MUC5B. Cholesterol stones and gallbladder infections were associated with increased MUC3 and MUC5B expression.

Background and purpose: Gastrointestinal stromal tumors (GISTs) are rare diseases of the gastrointestinal tract but they are the most common gastrointestinal tumors of mesenchymal origin. Since most GISTs have malignant potential, their probability of malignant progression must be evaluated. This study was conducted to examine the correlation between three-dimensional GIST volume measured by CT and malignant potential. Materials and methods: A retrospective study was performed on 70 patients diagnosed with GIST after surgical resection in Hanyang University Seoul Hospital from 2012 to 2017. Linear regression analysis was used to establish which between the length of the long axis of GISTs, originally considered a predictor of malignancy, and their volume was a more accurate predictor of malignancy. Tumor dimensions were measured by CT. Results: Data were analyzed using the chi-square test or Student&rsquo, s t-test and logistic regression. Of the GISTs, 53 (75.71%) were in the stomach, 3 (4.29%) in the small intestine, and 14 (20.0%) in the large intestine. The mean age of the malignant GIST group was significantly higher than that of the benign GIST group (p = 0.032), their tumor long axes were significantly greater (p = 0.073), their tumor volumes were significantly larger (p = 0.001), and the frequency of tumor necrosis was higher (p = 0.001). In multivariate analysis, malignant GIST was associated with location in organs other than the stomach (OR 7.846, 95% CI 1.293&ndash, 47.624, p = 0.025), longer axis (OR 1.037, 95% CI 1.011&ndash, 1.065, p = 0.006), larger volume (OR 1.003, 95% CI 1.000&ndash, 1.006, p = 0.029), and necrosis (OR 12.222, 95% CI 1.945&ndash, 76.794, p = 0.008). The mean age of the recurrent GIST group was higher than that of the non-recurrent group (p = 0.045), their tumor long axes were significantly longer (p = 0.005), and their volumes were greater, but this last difference was not significant (p = 0.072). Conclusions: Tumor volume can be considered an additional risk factor in assessing the malignant potential of GISTs and tends to increase in recurrent GISTs.

Aminotransferase activity is a surrogate marker of liver injury showing strong correlations with obesity and metabolic syndrome. However, elevated aminotransferase activity is not uncommon in non-obese and non-alcoholic patients in clinical practice.To examine the relationship between sarcopenia and aminotransferase activity in a large population-based cohort.Data from the Korean National Health and Nutrition Examinations were used. A total of 13,431 subjects were included. A whole-body dual X-ray absorptiometry scan was performed on each patient to measure total and regional muscle mass. Appendicular skeletal muscle mass indices were also obtained.The prevalence of sarcopenia was significantly higher in the group with elevated aminotransferase levels than in the normal liver enzyme group (males: 26.5% vs. 16.9%; females: 38.3% vs. 22.1%, p0.05). The skeletal muscle index was negatively correlated with most cardiometabolic risk factors, including fasting glucose and cholesterol levels. The frequency of elevated aminotransferase increased in male patients with sarcopenia after adjusting for potential confounding factors including age, body mass index, fasting glucose level, dietary, and exercise habits. However, the correlation was no longer observed in women after adjusting for body mass index.Sarcopenia is a risk factor for elevated aminotransferase in men, independently of body mass index, dietary habits, and physical activity.

Tumor lysis syndrome is rare in hepatocellular carcinoma (HCC), but it has been reported more frequently recently in response to treatments such as transcatheter arterial chemoembolization (TACE), radiofrequency thermal ablation (RFTA), and sorafenib. Tumor lysis syndrome induced by low-dose steroid appears to be very unusual in HCC. We report a patient with hepatitis-C-related liver cirrhosis and HCC in whom tumor lysis syndrome occurred due to low-dose steroid (10 mg of prednisolone). The patient was a 90-year-old male who presented at the emergency room of our hospital with general weakness and poor oral intake. He had started to take prednisolone to treat adrenal insufficiency 2 days previously. Laboratory results revealed hyperuricemia, hyperphosphatemia, and increased creatinine. These abnormalities fulfilled the criteria in the Cairo-Bishop definition of tumor lysis syndrome. Although the patient received adequate hydration, severe metabolic acidosis and acute kidney injury progressed unabated. He finally developed multiple organ failure, and died 3 days after admission. This was a case of tumor lysis syndrome caused by administration of low-dose steroid in a patient with HCC.

AIM : Although numerous animal studies suggest that probiotic therapy has beneficial effects in various liver diseases, the evidence for beneficial effects in human liver disease is controversial. This study was carried out to investigate the efficacy of probiotic therapy in alleviating small intestinal bacterial overgrowth (SIBO) and permeability in chronic liver disease. METHODS Fifty-three patients with chronic liver disease were randomized to either probiotic therapy or placebo. Six bacterial species were used: Bifidobacterium bifidum, Bifidobacterium lactis, Bifidobacterium longum, Lactobacillus acidophilus, Lactobacillus rhamnosus, and Streptococcus thermophilus. After 4 weeks, changes in the composition of fecal bacteria, SIBO, intestinal permeability, and clinical symptoms were examined. RESULTS Three of the six probiotic species, B. lactis, L. rhamnosus, and L. acidophilus, increased in the feces of the probiotic therapy group (P

Rationale: Recently tenofovir disoproxil fumarate (TDF) has been widely used as a first-line therapy for chronic hepatitis B (CHB) infection. Although TDF demonstrates successful viral suppression, the possibility of renal failure and lactic acidosis has been proposed with TDF administration, especially in human immunodeficiency virus co-infected patients. However, TDF induced lactic acidosis has never been reported in CHB mono-infected patients. Patient concerns: A 59-year-old man received TDF for hepatitis B associated with cirrhosis. After ten days of TDF administration, nausea, vomiting and abdominal pain developed. High anion gap acidosis with elevated lactate level (pH 7.341, pCO2 29.7 mmHg, HCO3- 15.6mmHg, lactate 3.2mmol/L, anion gap 15.4 mEq/L) was developed. Diagnosis: With no infection, normal diagnostic paracentesis, and urinalysis together with high anion gap and increased blood lactate levels suggested lactic acidosis. Interventions: TDF was stopped, and haemodialysis was performed to control lactic acidosis. Outcomes: Although stopping TDF instantly and treating lactic acidosis using hemodialysis, the patient died. Lessons: Although, Fatal lactic acidosis is very rare in TDF patient, however, decompensated cirrhotic patients should be closely observed to keep the possibility of lactic acidosis in mind.

The relationship between fat distribution and lymph node metastasis has not been well studied. The goal of this study was to determine the impact of visceral obesity on lymph node metastasis in gastric cancer. Metastatic lymph node ratio (MLR) was defined as the number of involved nodes by tumor divided by the total number of resected lymph nodes. Visceral (VFA) and subcutaneous fat areas (SFA) were determined by measuring abdominal fat volume distribution via CT scan, and visceral obesity was defined as a VFA to total fat area ratio (V/T) >0.29. With lymph node metastasis as a dependent variable, the following factors were significant in multivariate analysis among 495 patients: pathologic T stage (P

Background and study aims: Preoperative pathological diagnosis may improve clinical management decisions in patients with upper gastrointestinal subepithelial tumors (SETs). The aims of this study were to evaluate the diagnostic yield of deep biopsy via an endoscopic submucosal dissection (ESD) technique, the complications associated with the procedure, and the impact on management of patients with upper gastrointestinal SETs. Patients and methods: A total of 68 patients with SETs in the stomach or esophagus were voluntarily assigned to two groups. One group underwent endoscopic ultrasound (EUS) and endoscopic deep biopsy using the ESD technique (40 patients), and the other group (28 patients) underwent surgical resection after EUS without obtaining preoperative pathological diagnosis, in accordance with accepted clinical management algorithms. Results: The diagnostic yield of deep biopsy was 90 % (36/40). The results of deep biopsy changed the treatment plans in 14/40 patients (35 %). One patient with lymphoepithelial carcinoma was scheduled for surgical resection, and 13 patients with benign SETs of diameter ≥ 2 cm avoided surgery. Of the 28 patients who underwent surgical resection without preoperative pathological diagnosis, 12 (42.9 %) were confirmed to have benign lesions. The mean procedure time for deep biopsy was 13.7 minutes. There were no procedure-related complications in the deep biopsy group. Conclusions: Deep biopsy by the ESD technique is a safe, high-yield, diagnostic method in patients with upper gastrointestinal SETs. Pathologic confirmation could improve clinical decision making in the management of patients with upper gastrointestinal SETs. Clinical trial registration: NCT 01993199

우수한 성능을 지닌 대형 구조의 섬유강화 고분자(FRP) 복합재료 제품을 제조하기 위해 저온 경화형 프리프레그 개발이 활발히 진행되고 있다. 본 연구에서는 저온 경화형 프리프레그 제조에 적합한 매트릭스 수지를 확보하기 위하여 에폭시 수지, 경화제, 경화 촉진제로 구성된 저온 경화형 에폭시 수지 조성물의 경화거동 및 화학유변학을 고찰하였다. 경화반응 특성은 시차주사열량분석법과 유변물성측정법을 활용하여 승온 및 등온 조건에서 분석하였다. 연구 결과 매트릭스 수지로 제안된 저온 경화형 에폭시 수지 조성물은 80 oC에서 3시간에 경화시킬 수 있었고, 80과 90 oC에서의 젤화 시간은 각각 120분과 20분인 것으로 나타났다. 저온 경화형 수지를 경화시킨 수지 경화물의 열적, 기계적 물성은 고온 경화형 수지 경화물의 물성과 거의 동등하였다.

Background/Aims Because of the similarities in the clinical presentations of Crohn's disease (CD) and intestinal tuberculosis (ITB), differential diagnosis is critical. Mesenteric adipose tissue hypertrophy and creeping fat are characteristic features of CD. The purpose of this study was to assess the usefulness of visceral fat for the differential diagnosis of CD and ITB. Methods We conducted a retrospective review of 50 patients with findings of CD or ITB between January 2005 and July 2008. Abdominal computed tomography (CT) was performed on all subjects during their first evaluation. The abdominal fat area was assessed using quantitative abdominal CT. Results The ratio of visceral fat to total fat (VF/TF) was significantly higher in male CD patients than in male ITB patients. The ratio of visceral fat to subcutaneous fat (VF/SF) was also higher in CD patients than in patients with ITB. For a VF/TF cut-off value of 0.46, the sensitivity and specificity for the diagnosis of CD were 42.1% and 93.3% respectively, with positive and negative predictive values of 88.9% and 56.0%, respectively. Conclusion Measurement of the abdominal fat area using CT can be clinically useful for the differential diagnosis of CD and ITB.

Background and Aim The efficacy of treatment with multispecies probiotics on irritable bowel syndrome (IBS) symptoms and the alterations of gut microbiota in patients who have taken probiotics were investigated. Methods This randomized, double-blind, placebo-controlled trial involved 49 IBS patients (probiotics: 25, placebo: 24) diagnosed according to the Rome III criteria. Patients were randomly assigned to two groups: either to receive multispecies probiotics (a mixture of Bifidobacterium longum, B. bifidum, B. lactis, Lactobacillus acidophilus, L. rhamnosus, and Streptococcus thermophilus) twice a day for 4 weeks or to receive a placebo twice a day for 4 weeks. The primary efficacy end-point was the proportion of participants whose IBS symptoms were substantially relieved at week 4. Secondary end-points were the intensity of abdominal pain/discomfort, bloating, stool frequency/consistency, alterations in fecal microflora over the 4 weeks. Fecal microflora were analyzed in 34 patients (probiotics: 17, placebo: 17) by quantitative real-time polymerase chain reaction assays. Results The proportion of patients whose IBS symptoms were substantially relieved at week 4 was significantly higher in the probiotics group than in the placebo group: 68.0% (17/25) versus 37.5% (9/24) (P

This work was supported by the research fund of National Research Foundation of Korea 2011-0007127.

Percutaneous endoscopic gastrostomy (PEG) is a commonly performed procedure for patients with severe dysphagia leading to malnutrition. Improved knowledge of risk factors for PEG-related complications might decrease patient discomfort and healthcare costs.The aim of the present study was to investigate factors associated with complications after PEG.A retrospective review was performed for all patients referred for PEG placement from December 2002 to December 2012 in single-tertiary care center. PEG-related complications and risk factors were evaluated through chart reviews, endoscopic reports, and endoscopic and radiologic images.Among a total of 245 consecutive individuals (146 male, mean age 59.2 ± 12.6 years) enrolled, 43 major complications had developed. Multivariate analysis revealed that patients with an internal bolster of a PEG tube in the upper body of stomach were at significant risk for early [OR 6.127 (95 % CI 1.447-26.046)] and late complications [OR 6.710 (95 % CI 1.692-26.603)]. Abnormal leukocyte counts [OR 3.198 (95 % CI 1.174-8.716)], stroke as an indication for PEG [OR 3.047 (95 % CI 1.174-8.882)], and PEG tube placement by an inexperienced endoscopist [OR 3.401 (95 % CI 1.073-10.779)] were significantly associated with early complications.A PEG tube should not be inserted into the upper body of stomach to reduce complication risk, and PEG procedures should be performed by skilled endoscopists to prevent early complications. An abnormal leukocyte count can be a predictor of early complication, and care is needed when PEG is performed for patients with stroke.

A 73-year-old woman presented with intermittent abdominal pain and weight loss of 15 kg for 2 years. Colonoscopy revealed an erythematous polypoid tumor with a long and wide stalk in the cecum, but with air inflation, it abruptly went away through the ileocecal valve (ICV). An abdominal computed tomography showed a well-demarcated pedunculated subepithelial mass of 2.6×2.7 cm size with fat attenuation in the terminal ileum. It was an intussusceptum of the ileal lipoma through the ICV. This ileal lipoma was causing her symptoms because repeated ileocolic intussusceptions resulted in intermittent intestinal obstructions. In order to avoid surgical sequelae of ileal resection, snare polypectomy using cap-assisted colonoscopy technique was performed within the ileum without complications. The histopathology report confirmed it as a subepithelial lipoma. After endoscopic resection of the ileal lipoma, the patient has been free of symptoms and was restored to the original weight.

Carbon fiber reinforced polymer (CFRP) composites consist of carbon fibers in a polymer matrix. Recently, CFRP composites having high thermal stability and low outgassing are finding their use in high performance materials for aerospace and electronics applications under high temperature and high vacuum conditions. Cyanate ester resin is one of the most suitable matrix resins for this purpose. In this study, proper combination of cyanate ester and catalyst, curing behavior, and cure cycle were determined by chemorheology. Optimum condition was found to be catalyst content of 100 ppm and curing temperature of . Thermal stability and outgassing of cured resin composition were analyzed and the results showed thermal decomposition temperature of and total mass loss of 0.29%. The CFRP prepregs and subsequent composites were fabricated by predetermined resin composition and the cure condition. Tensile moduli of the composites were compared with theoretical models and the results were very consistent.

Background and aim: The widely accepted range of upper limits of normal (ULN) alanine aminotransferase (ALT) levels (ULN < 40 U/L) was recently challenged by several reports. Both ALT and aspartate aminotransferase (AST) are commonly used as surrogate markers of liver disease, but almost all studies of aminotransferase activity were conducted on ALT. We investigated not only ULN of ALT but also AST activity and to identify factors modulating them in healthy Korean. Methods: A cross-sectional study of 411,240 registered blood donors in all nationwide blood banks belonging to the Korean Red Cross were conducted. ULN of ALT and AST was evaluated adjusting their age according to the national population census database. "Decision tree model" was used to identify the affecting factors of ALT and AST and optimal cut-off points of affecting factors. Results: "ULN of ALT" was 34 U/L in men and 24 U/L in women and "ULN of AST" was 32 U/L in men and 26 U/L in women in the blood donor database. Decision tree analysis showed that ALT levels were mostly influenced by body mass index level and its critical two cut-off points were 23.5 kg/m2 and 25.8 kg/m2 , respectively. The most affecting factor of AST was gender. Conclusion: Upper limits of normal of ALT and AST in Koreans were lower than conventional accepted values (< 40 U/L) but higher than recently suggested values (male < 30 U/L and female < 19 U/L). Body mass index was the most determining factor for ALT and gender was the most influencing factor for AST activity.

Background: 5-hydroxytryptamine (5-HT) receptors are upregulated in activated hepatic stellate cells (HSCs), and are therefore thought to play an important role in their activation. Aim: The aim of this study was to determine whether 5-HT2A receptor antagonists affect the activation or apoptosis of HSCs in vitro and/or in vivo. Methods: For the in vitro experiments, the viability, apoptosis and wound healing ability of LX-2 cells were examined after treatment with various 5-HT2A receptor antagonists. Levels of HSC activation markers (procollagen type I, a-SMA, TGF-b and Smad 2/3) were measured. For in vivo experiments, rats were divided into three groups: (i) a control group, (ii) a disease group, in which cirrhosis was induced by thioacetamide (iii) a treatment group, in which cirrhosis was induced and a 5-HT2A receptor antagonist (sarpogrelate, 30 mg/kg) was administered. Results: 5-HT2A, but not 5-HT2B receptor mRNA increased with time upon HSC activation. 5-HT2A receptor antagonists (ketanserin and sarpogrelate) inhibited viability and wound healing in LX-2 cells and induced apoptosis. Expression of a-SMA and procollagen type I was also inhibited. In the in vivo study, lobular inflammation was reduced in the sarpogrelate-treated group, but there was only slight and statistically insignificant attenuation of periportal fibrosis. Expression of a-SMA, TGF-b and Smad 2/3 was also reduced in the treatment group. Conclusions: 5-HT2A receptor antagonists can reduce inflammation and the activation of HSCs in this cirrhotic model. The total amount of 5-hydroxytryptamine (5-HT, also known as serotonin) in the human body is around 10 mg, with approximately 95% of this in the gastrointestinal tract and the remaining 5% in the brain (1). It is secreted by enterochromaffin cells into the blood, where it is actively taken up by platelets (2). It is involved in a variety of functions such as regulation of emotion, appetite, sleep, gastrointestinal motility, secretion, vascular contraction, relaxation and platelet aggregation (3, 4). 5-HT has an important role in proliferation of hepatocytes as reported in recent studies. 5-HT secreted from platelets was found to play an important role in the regeneration of hepatocytes (5, 6). Recently, Nagao et al. demonstrated an involvement of 5-HT in the thrombocytotic effect in splenectomy-induced liver regeneration, and in the amelioration of fibrosis in rat liver with secondary biliary cirrhosis (6). Tian et al. showed that 5-HT could prevent small-for-size liver graft failure in mice by enhancing hepatocyte regeneration via the IL-6 pathway (7). These studies are consistent with previous work demonstrating that platelets promote liver regeneration (5). These evidences indicate that 5-HT has protective role against hepatic ischaemic and reperfusion injury. Until now most studies have focused on the promotion of hepatic regeneration by 5-HT via preservation of the hepatic microcirculation and IL-6 pathway, but 5-HT has other effects on the liver. For example, the increased levels of reactive oxygen species produced by 5-HT degradation aggravate steatohepatitis (8), and expression of 5-HT receptors is upregulated in activated HSCs (9). This interesting pleiotropic influence of 5-HT on the liver suggested that comprehensive investigation of its cell type specific expression patterns and its roles in various liver conditions would be valuable, along with studies involving selective blockade. There are as yet no published data on the effects of selective 5-HT blockers on in vitro or in vivo hepatic stellate cell (HSC) activation. Renal mesangial cells, which have similar properties to HSCs, produce increased levels of TGF-b and connective tissue growth factor in response to activation of 5-HT2A receptors (10–12). 5-HT2 receptors are also

Recent studies have shown that mast cells play an important role in irritable bowel syndrome (IBS). We investigated the relationship between mast cells and the gut hormones substance P and vasoactive intestinal peptide (VIP) in irritable bowel syndrome with diarrhea (IBS-D).Colonoscopic biopsies were performed on the rectal mucosa of 43 subjects (IBS-D patients: 22, healthy volunteers: 21) diagnosed according to the Rome III criteria. Mast cells, and substance PVIP were evaluated by quantitative immunohistology and image analysis. Mast cells were counted as tryptase-positive cells in the lamina propria, and substance P and VIP levels were expressed as percentages of total areas of staining.Mast cell counts were higher in IBS-D patients than healthy volunteers (9.6 ± 3.3 vs. 5.7 ± 2.5/high power field (HPF), p0.01). Substance P was also elevated (0.11 ± 0.08% vs. 0.03 ± 0.02 %, p0.01) while VIP was only high in women with IBS-D. Mast cell counts were positively correlated with levels of substance PVIP in women but not men (women: r = 0.625, p0.01 for substance P and r = 0.651, p0.01 for VIP). However, mast cell counts were not correlated with IBS symptoms including abdominal pain.Mast cells are activated leading to the raised levels of substance PVIP in IBS-D patients. However, the correlation between mast cells and levels of substance PVIP differs according to gender.

Background/Aims DA-6034 has anti-inflammatory activities and exhibits cytoprotective effects in acute gastric injury models. However, explanations for the protective effects of DA-6034 on intestinal permeability are limited. This study sought to investigate the effect of DA-6034 on intestinal permeability in an indomethacin-induced small intestinal injury model and its protective effect against small intestinal injury. Methods Rats in the treatment group received DA-6034 from days 0 to 2 and indomethacin from days 1 to 2. Rats in the control group received indomethacin from days 1 to 2. On the fourth day, the small intestines were examined to compare the severity of inflammation. Intestinal permeability was evaluated by using fluorescein isothiocyanate-labeled dextran. Western blotting was performed to confirm the association between DA-6034 and the extracellular signal-regulated kinase (ERK) pathway. Results The inflammation scores in the treatment group were lower than those in the control group, but the difference was statistically insignificant. Hemorrhagic lesions in the treatment group were broader than those in the control group, but the difference was statistically insignificant. Intestinal permeability was lower in the treatment group than in the control group. DA-6034 enhanced extracellular signal-regulated kinase expression, and intestinal permeability was negatively correlated with ERK expression. Conclusions DA-6034 may decrease intestinal permeability in an indomethacin-induced intestinal injury model via the ERK pathway.

Background/Aims Post-operative ileus (POI) is a common complication of abdominal surgery. DA-9701, an extract of Pharbitis Semen and Corydalis Tuber, is a new prokinetic agent that also alleviates visceral pain. The aim of this study was to investigate whether DA-9701 can ameliorate POI in rats. Methods A total of 32 rats were divided into 4 groups: no surgery/no medication (NSNM), no surgery/medication (NSM), surgery/no medication (SNM), and surgery/medication (SM). Gastrointestinal transit (GIT), which is assessed by migration of charcoal, and cumulative stool weight were measured at 24 hours after surgery. Results GIT was significantly more delayed in the SNM group than in the other groups (SNM vs NSNM, P < 0.001; SNM vs NSM, P < 0.001; SNM vs SM, P = 0.005). Cumulative stool weight in that group was also lower than in the no surgery groups (SNM vs NSNM, P = 0.007; SNM vs NSM, P = 0.033), and there was no significant difference between the SM group and the no surgery groups (SM vs NSM, P = 0.703; SM vs NSNM, P = 0.347). Conclusion DA-9701 can ameliorate POI by reducing delayed GIT and improving defecation in a rat model of POI.

Background/Aims In Asian countries including Korea, the prevalence of gastroesophageal reflux disease (GERD) is on the rise and its clinical impact has been emphasized. The purpose of this study was to investigate the clinical characteristics of esophagitis patients with or without symptoms, and their association with psychological factors. Methods Subjects diagnosed as erosive esophagitis of Los Angeles-A or more in screening by upper gastrointestinal endoscopy were enrolled. Questionnaires regarding GERD symptoms and Symptom Checklist-90-Revision were used to identify the presence of psychological symptoms. Results There was no difference between the subjects` general characteristics (gender, age, body mass index, smoking and alcohol intake) according to the existence of typical symptoms in these patients with erosive esophagitis. Patients with typical GERD symptoms were more likely to have atypical symptoms, dyspepsia and higher scores on psychological symptoms (somatization, obsessive-compulsiveness and phobic anxiety) than those without. Conclusions Psychological symptoms and other gastrointestinal symptoms should be considered in the patients with erosive esophagitis. (J Neurogastroenterol Motil 2012;18:284-290)

In this paper, a new simple PWM method for Vienna rectifier is proposed. The previous SVPWM method for Vienna rectifier is very complex and difficult to implement. To solve these problems, a new single-carrier comparison PWM method for voltage control of Vienna rectifier is proposed. Because of using the only single carrier, implementation of the proposed PWM is very simple. In the proposed PWM method, carrier comparison parts of the PWM block is only changed from the 2 level PWM control block. The usefulness of the proposed PWM method is verified by the simulation and experiment.

Background/aims The incidental finding of gastrointestinal subepithelial tumors (SETs) is increasing with national cancer screening endoscopy. In a Swedish population, screening endoscopy found a prevalence of SETs of 0.36%. However, the prevalence of gastric SETs in Korean patients has not been described. Therefore, this study evaluated the prevalence of SETs of the stomach in a Korean patient population. Methods We reviewed endoscopic reports of 11,712 subjects who underwent screening esophagogastroduodenoscopy (EGD) at Hanyang University Hospital between July 2012 and June 2013. Results Among 11,712 patients, 194 (1.7%) had SET of the stomach. Of these, 71 (prevalence, 0.6%) were male and 123 (prevalence, 1.1%) were female. When grouped by age, the prevalence of SET was as follows: 1.0% for patients in their twenties, 6.2% for those in their thirties, 19.1% for those in their forties, 33.0% for those in their fifties, 30.4% for those in their sixties, and 10.3% for those over 70 years of age. Conclusions The overall prevalence of gastric SET among healthy examinees was 1.7%. The prevalence of gastric SET increased with age and was higher in female.

본 논문에서는 비엔나 정류기의 전압제어를 위한 반송파 비교 PWM 방법에 대하여 논한다. 일반적으로 산업용 및 통신용 등 여러 응용분야에서 2레벨 정류기가 주로 사용되어 왔다. 하지만 2레벨 정류기는 효율을 높이고, THD를 낮추는데 한계가 있기 때문에 3레벨 정류기에 대한 연구가 진행 되어 왔다. 3레벨 정류기의 대표적인 회로가 비엔나 정류기이다. 기존의 비엔나 정류기는 대부분 전압 명령으로부터 인가 공간전압 벡터를 선택하고, 공간전압 벡터 인가시간을 직접 계산하여, 그 시간동안 전압 명령을 인가하는 공간 전압 변조 방식이 사용된다. 하지만 이 방법은 전압 명령 생성 및 전압 벡터의 인가시간 계산이 매우 복잡하여, 구현이 어려운 단점이 있다. 이 단점을 보완하기 위해 기존의 3레벨 인버터에 사용되던 반송파 비교 PWM 방법을 비엔나 정류기에 적용할 수 있도록 수정하여, 비엔나 정류기를 위한 간단한 전압제어를 위한 반송파 비교 PWM방식을 도출하고 시뮬레이션 및 실험을 통해 검증 한다. 【In this paper, carrier comparison PWM method for voltage control of Vienna rectifier is discussed. In general, in industrial and communications applications, the two-level rectifier is used. However, this two-level rectifier has the limit of high THD and low efficiency. So, the studies of three-level rectifier has been carried out so far, and the Vienna rectifier circuit is the representative. The space vector pulse width modulation(SVPWM) method is generally used for Vienna rectifier, in which voltage vectors and duration time are calculated from the voltage reference. However, this method require very sophisticated and complex calculations, so realizing this method by software is very difficult. To overcome this disadvantage, simple carrier comparison PWM method for Vienna rectifier is proposed which is modified from the carrier comparison method for 3 level inverter. Furthermore, to verify the usefulness of the Vienna rectifier carrier comparison PWM the simulation and experiment are carried out.】

Background: Mitochondria are the main sites for fatty acid oxidation andplay a central role in lipotoxicity and nonalcoholic steatohepatitis. Aims: Weinvestigated whether carnitine prevents free fatty acid (FFA)-induced lipo-toxicity in vitro and in vivo. Methods: HepG2 cells were incubated withFFA, along with carnitine and carnitine complexes. Mitochondrial b-oxida-tion, transmembrane potential, intracellular ATP levels and changes inmitochondrial copy number and morphology were analysed. Otsuka Long-Evans Tokushima Fatty and Long-Evans Tokushima Otsuka rats were seg-regated into three experimental groups and fed for 8 weeks with (i) normalchow, (ii) a methionine choline-deficient (MCD) diet or (iii) an L -carni-tine-supplemented MCD diet. Results: Carnitine prevented FFA-inducedapoptosis (16% vs. 3%, P < 0.05). FFA treatment resulted in swollen mito-chondria with increased inner matrix density and loss of cristae. However,mitochondria co-treated with carnitine had normal ultrastructure. Themitochondrial DNA copy number was higher in the carnitine treatmentgroup than in the palmitic acid treatment group (375 vs. 221 copies,P < 0.05). The carnitine group showed higher mitochondrial b-oxidationthan did the control and palmitic acid treatment groups (597 vs. 432 and395 ccpm, P < 0.05). Carnitine treatment increased the mRNA expressionof carnitine palmitoyltransferase 1A and peroxisome proliferator-activatedreceptor-c, and carnitine-lipoic acid further augmented the mRNA expres-sion. In the in vivo model, carnitine-treated rats showed lower alaninetransaminase levels and lesser lobular inflammation than did the MCD-treated rats. Conclusions: Carnitine and carnitine-lipoic acid prevent lipo-toxicity by increasing mitochondrial b-oxidation and reducing intracellularoxidative stress.Nonalcoholic steatohepatitis (NASH) is caused byexcessive fat accumulation and increased oxidativestress in the liver. It is associated with metabolic syn-drome resulting from insulin resistance. Although themechanism underlying NASH has not yet been clearlyidentified, mitochondria have been shown to play animportant role in the pathogenesis of steatohepatitis.Changes in the number and quality of mitochondriaare frequently observed in NASH. The peripheral bloodof patients with diabetes has a low copy number ofmitochondrial DNA (mtDNA), and this reduction isobserved before the onset of the disease (1–2). Mito-chondria burn excessive intrahepatic fat by b-oxidation.This reaction generates not only ATP but also intracel-lular reactive oxygen species (ROS). Current evidencesupports the concept that if an excessive number ofelectrons are produced during fatty acid oxidation, thenthe mitochondrial ROS produced can damage mtDNA;this in turn decreases the cell’s ATP level and eventuallyleads to cell death. However, reduction in the numberor activity of mitochondria leads to increased fat oxida-tion in peroxisomes and microsomes, and the resultingincrease in ROS further exacerbates cell damage (3–4).An increase in ROS levels not only damages mitochon-dria but also induces insulin resistance and diabetes,which are important in the pathophysiology of steato

An interior permanent magnet synchronous motor(IPMSM) has been applied to the electric vehicle due to its high efficiency, compact volume, and wide operating speed ranges. This paper presents the analysis of the flux weakening operating regions at high speeds for the IPMSM that has back emf harmonics. The effect of the back emf harmonics on the motor speed and the maximum torque is analyzed. Also the dq currents for maximum torque operation under the voltage and the current limit conditions are analyzed. The conventional analysis and the presented analysis for the flux weakening operating regions are compared and the maximum torque - speeds characteristics for both analysis are verified through the experiment.

†† † Background/Aims: Acute gastric injury by alcohol or indomethacin has been reported to be prevented by DA-9601, an extract of the herb Artemisia asiatica. Ghrelin, an endogenously produced gastrointestinal peptide hormone, has also been demonstrated to play a role in gastric mucosal defense. The aim of this study was to investigate the effects of DA9601 on ghrelin in an acute gastric injury model induced by alcohol or indomethacin. Methods: A total of 140 SpragueDawley rats were divided into two groups, a placebo group and a DA-9601-pretreated group. Thirty minutes later, half of the rats in each group received ethanol injury and the other half received indomethacin injury. Levels of serum ghrelin and gastric mucosal ghrelin mRNA were measured by ELISA and RT-PCR, respectively. Results: Immediately after ethanol administration, ghrelin increased in both groups pretreated with DA-9601 and placebo. However, the increase occurred more rapidly and was higher in the DA-9601-pretreated rats than in the controls that did not receive DA-9601-pretreatment. Similarly, from 30 minutes to 2 hours after indomethacin administration, the DA-9601-pretreated rats showed a significant increase in serum and gastric mucosal ghrelin concentrations, whereas placebo-pretreated rats showed only a mild increase. Conclusions: DA-9601 potentiates the endogenous production and secretion of ghrelin in acute gastric injury models induced by ethanol or indomethacin. (Gut Liver 2011;5:52-56)

Background Accurate detection of synchronous multifocal gastric cancer is mandatory for the successful management of stomach cancer. Objective We compared the sensitivities of gastroscopy and the current criterion standard of surgical resection and investigated the risk factors involved when clinicians fail to recognize additional gastric lesions. Design We performed a retrospective examination of the clinicopathological features of synchronous multifocal gastric carcinoma in a recent sample of gastrectomy patients. Patients In this study, we enrolled a total of 51 patients (5.17%) with synchronous multifocal gastric carcinoma who had undergone gastrectomy between 2005 and 2008. During that time, 80.43% of patients who had multifocal lesions underwent gastric resection. Main Outcome Measurements We compared preoperative gastroscopic findings with surgically resected stomach specimens. Results Synchronous multifocal gastric carcinoma was more frequent in older patients, males, and those with early gastric cancer. Using upper endoscopy, we missed accessory lesions in 14 (27.5%) of 51 patients. A total of 109 lesions were present in the resected stomachs, and upper endoscopy detected 93 of these (85.3% sensitivity). Thus, 16 lesions (14.67%) were missed out of a total of 109 gastric lesions. We found that small lesion size was the major risk factor for endoscopic failure to recognize additional lesions. Limitations Our study sample was small, and a large-scale study exploring these risk factors is warranted. Most of the study sample (80.39%) underwent subtotal gastrectomy; therefore, whole-stomach pathology could not be evaluated. Because early gastric cancer has a higher likelihood of being treated by EMR without surgery, there can be problems associated with reliance on surgical specimens. The findings of this study might have been affected by the higher rate of gastric cancers seen in East Asians. Conclusions The entire stomach should be examined with particular care during endoscopy procedures, especially when endoscopic resections of tumors are to be performed. Further, to improve detection, the approaches used to evaluate patients for multifocal tumors need to be improved. A large-scale prospective study is necessary to follow up on our findings.

Background/Aims Although a few recent studies have reported the effectiveness of endoscopic pancreatic sphincterotomy (EPST), none has compared physicians' skills and complications resulting from the procedure. Thus, we examined the indications, complications, and safety of EPST performed by a single physician at a single center. Methods Among 2,313 patients who underwent endoscopic retrograde cholangiopancreatography between January 1996 and March 2008, 46 patients who underwent EPST were included in this retrospective study. We examined the indications, complications, safety, and effectiveness of EPST, as well as the need for a pancreatic drainage procedure and the concomitant application of EPST and endoscopic sphincterotomy (EST). Results Diagnostic indications for EPST were chronic pancreatitis (26 cases), pancreatic divisum (4 cases), and pancreatic cancer (8 cases). Therapeutic indications for EPST were removal of a pancreaticolith (10 cases), stent insertion for pancreatic duct stenosis (9 cases), nasopancreatic drainage (7 cases), and treatment of sphincter of Oddi dysfunction (1 case). The success rate of EPST was 95.7% (44/46). Acute complications of EPST included five cases (10.9%) of pancreatitis and one of cholangitis (2.2%). EPST with EST did not reduce biliary complications. Endoscopic pancreatic drainage procedures following EPST did not reduce pancreatic complications. Conclusions EPST showed a low incidence of complications and a high rate of treatment success; thus, EPST is a relatively safe procedure that can be used to treat pancreatic diseases. Pancreatic drainage procedures and additional EST following EPST did not reduce the incidence of procedure-related complications.

Background and Aims: There were no objective data presented about the association between erosive esophagitis and abdominal fat. We conducted this study to examine the association of abdominal fat and gastroesophageal reflux disease-related erosive esophagitis. Methods: Between May 2004 and October 2005, a total of 100 erosive esophagitis patients diagnosed by upper endoscopy were evaluated in a prospective manner. All study patients and controls underwent abdominal computed tomography (CT) scan. Body fat distribution was assessed by CT with a 10-mm-thick slice at the level of the fourth lumbar vertebra. Results: Erosive esophagitis patients presented with a significantly higher mean visceral fat (VF) area (104.68 ± 39.47 vs. 75.90 ± 49.10 cm 2 , P = 0.014) than the control group. However, there was no association between erosive esophagitis and subcutaneous fat area (109.72 ± 49.09 vs. 98.66 ± 52.43 cm 2 , P - 0.379) or total fat area (214.41 ± 78.78 vs. 172.59 ± 90.49cm2, P = 0.054). Multi-variate logistic regression analysis demonstrated that high VF areas (P = 0.0035), VF/subcutaneous fat area (P = 0.005), hiatal hernia (P = 0.001), high body mass index (P = 0.047), high waist-to-hip ratio (P = 0.042), and smoking (P = 0.005) are independent risk factors of erosive esophagitis. Conclusions: These results suggest a role for visceral obesity, quantified by CT, as a risk factor for erosive esophagitis.

Background and Aims: Lafutidine is a novel H2-receptor antagonist with gastroprotective activity that includes enhancement of gastric mucosal blood flow. The aim of the present study was to test the efficacy of 7- or 14-day lafutidine–clarithromycin–amoxicillin therapy versus a lansoprazole-based regimen for Helicobacter pylori eradication. Methods: Four hundred and sixty-three patients with H. pylori-infected peptic ulcer disease were randomized to one of four regimens: (1) lafutidine (20 mg b.i.d.), clarithromycin (500 mg b.i.d.) and amoxicillin (1000 mg b.i.d.) for 7 days (the 7LFT group) or (2) for 14 days (the 14LFT group); (3) lansoprazole (30 mg b.i.d.), clarithromycin (500 mg b.i.d.), and amoxicillin (1000 mg b.i.d.) for 7 days (the 7LPZ group); or (4) for 14 days (the 14LPZ group). The eradication rates, drug compliance, and adverse effects among the four regimens were compared. Results: The eradication rates by the intention-to-treat and per-protocol analyses in the 7LFT and 7LPZ groups were 76.5% and 81.6%, and 76.9% and 82.0% (p = .94 and .95), respectively. The eradication rates by intention-to-treat and per-protocol analyses in the 14LFT and 14LPZ groups were 78.2% and 82.2%, and 80.4% and 85.9% (p = .70 and .49), respectively. The treatment duration for 7 days or 14 days did not affect the eradication rates. In addition, the adverse effect rates and discontinuation rates were similar among the four groups. Furthermore, the ulcer cure rate and symptom response rate were similar in the lafutidine and lansoprazole groups. Conclusion: The results of this study showed that lafutidine–clarithromycin–amoxicillin therapy was a safe and effective as lansoprazole-based triple therapy for the eradication rate of H. pylori, and could be considered as an additional treatment option.

The purpose of this study was to examine the changes in gastric ghrelin and leptin with respect to Helicobacter pylori infection and whether such changes affect the plasma levels of leptin and ghrelin. In addition, we examined the relationship between changes in gastric mucosal ghrelin and leptin levels and gastrointestinal symptoms. Sixty-three patients diagnosed with chronic gastritis were enrolled in the study. Twenty-nine patients were Helicobacter pylori negative and 34 were Helicobacter pylori positive. Expression of ghrelin and leptin mRNA in the gastric mucosa was measured using endoscopic biopsies from the fundus. Plasma levels of ghrelin and leptin were measured by radioimmunoassay. Expression of leptin mRNA in the gastric mucosa was significantly higher in Helicobacter pylori-positive patients than in negative patients (0.38 +/- 0.17 vs. 0.24 +/- 0.12, p = 0.039). The expression of ghrelin was lower in positive patients than in the negative group, although this difference was not significant (p = 0.07). However, there was no significant difference in plasma leptin and ghrelin levels. Gastric mucosal ghrelin mRNA expression was significantly lower in patients with dyspepsia than in those without (0.15 +/- 0.11 vs. 0.23 +/- 0.20, p = 0.05). Helicobacter pylori infection and gastrointestinal symptoms could be associated with leptin and ghrelin expression in the gastric mucosa.

Background The relationship between visceral obesity and colon cancer outcome has not been well studied. The goal of this study was to determine the impact of visceral obesity on lymph node (LN) metastasis and overall survival (OS) in colon cancer. Materials and Methods Metastatic LN ratio (MLR) was defined as the number of involved nodes by tumor divided by the total number of resected LNs. Visceral (VFA) and subcutaneous fat areas (SFA) were determined by measuring abdominal fat volume distribution via CT scan, and visceral obesity was defined as a VFA to total fat area ratio (V/T) > 0.29. Results In a multivariate analysis among 186 patients, there were inverse associations between V/T and MLR (OR = 0.413, 95 % CI = 0.216–0.789, P = 0.007). Furthermore, patients with visceral obesity tended to have significantly better OS than patients with non-visceral obesity. Conclusions Higher V/T ratios which indicate referring to visceral obesity was significantly associated with decreased MLR and better OS for CRC.