[Clinical outcomes of lamivudine therapy and HLA alleles in chronic hepatitis B patients].

BACKGROUND/AIMS: The human leukocyte antigen (HLA) system is an integral component of immune response. Highly polymorphic HLA genes may play a pivotal role in the response of antiviral therapy. We investigated the effects of HLA gene polymorphism on the clinical outcome of chronic hepatitis B patients who received lamivudine treatment. METHODS: Depending on their clinical response to lamivudine therapy, a total of sixty one patients were divided into following groups; non-responders, viral breakthroughers, relapsers, and seroconverters. HLA-A, -B, -Cw, -DRB and HLA-DRB1 alleles typing was performed on each group through the polymerase chain reaction and the sequence-specific oligonucleotide hybridization method. The distribution patterns of HLA-A, HLA-B, HLA-Cw, HLA-DRB, and HLA-DRB1 were then analysed. RESULTS: When non-responders were compared to the other groups, high frequencies in HLA-Cw1, HLA-DRB14 and HLA-DRB4 (p=0.015, 0.033 and 0.004 respectively) were evident. When seroconverters were compared to viral breakthroughers, high frequencies in HLA-A2 and HLA-DRB4 (p=0.048, 0.025 respectively) were evident. CONCLUSIONS: Our data suggests that HLA-A2, HLA-Cw1, HLA-DRB14 genes are related to the clinical outcomes of lamivudine treatment in chronic hepatitis B patients. These genes may be used in the prediction of the clinical outcome of lamivudine therapy in chronic hepatitis B patients.

[Retreatment of Helicobacter pylori infection with triple therapy after initial treatment failure].

BACKGROUND/AIMS: Helicobacter pylori (H. pylori) treatments fail at least in 10-20% of patients. However, retreatment strategies after failure of initial treatment have not been established. This study was conducted to evaluate the eradication rate of retreatment choices. METHODS: Twenty-seven peptic ulcer patients who were retreated with OAC (omeprazole + amoxicillin + clarithromycin) or BMT (bismuth + metronidazole + tetracycline) after failure of BMT or OAC were included. Quadruple therapy (omeprazole + BMT) was also tried after failure of two successive triple therapies. Furthermore, the effect of resistance of metronidazole or clarithromycin on the eradication of H. pylori was evaluated. RESULTS: Among 13 patients who were retreated with OAC after failure of BMT regimen, H. pylori was eradicated in 10 patients (76.9%). Among 14 patients retreated with BMT after failure of OAC regimen, H. pylori was eradicated in 11 patients (78.6%). Resistance of H. pylori to metronidazole or clarithromycin decreased the efficacy of BMT or OAC, respectively. CONCLUSIONS: Eradication regimen should be decided considering the resistance to H. pylori. However, in case of unknown state of resistance, OAC can be chosen if BMT fails. Similarly, BMT can be tried in cases that OAC therapy failed. After failures of both triple therapies, quadruple therapy can be tried as the next step.

A fruit and dairy dietary pattern is associated with a reduced risk of metabolic syndrome.

This study examines the relationship between adherence to different dietary patterns and the presence of metabolic syndrome and its components among Korean adults. The sample consisted of 406 Korean adults aged 22 to 78 years recruited from hospitals. Metabolic syndrome was defined according to the criteria issued by the Adult Treatment Panel III, with the exception of central obesity, which was defined according to the Asian-Pacific criteria. Dietary information was obtained by means of a 24-hour recall and a 3-day food record, and factor analysis was used to define dietary patterns. Factor analysis identified 4 major dietary patterns, which explained 28.8% of the total variance, based on the percentage of total daily energy intake from each food group: Korean traditional, alcohol and meats, sweets and fast foods, and fruit and dairy. After controlling for all potential confounders, we found that the Korean traditional dietary pattern was not associated with individual components of the metabolic syndrome but was significantly associated with increased odds of having metabolic syndrome. The fruit and dairy pattern was significantly associated with decreased odds of impaired blood glucose, hypertriglyceridemia, and metabolic syndrome. Our findings suggest that the fruit and dairy pattern is associated with reduced risk of having metabolic syndrome.

The Relation Between Sox9, TGF-beta1, and Proteoglycan in Human Intervertebral Disc Cells.

OBJECTIVE: The aim of this study is to elucidate the effects of transforming growth factor-beta (TGF-beta)1 and L-ascorbic acid on proteoglycan synthesis, and the relationship between Sox9, proteoglycan, and TGF-beta1 in intervertebral disc cells. METHODS: Human intervertebral disc tissue was sequentially digested to 0.2% pronase and 0.025% collagenase in DMEM/F-12 media and extracted cells were cultured in 37, 5% CO(2) incubator. When intervertebral disc cells were cultured with TGF-beta1 or L-ascorbic acid, the production level of sulfated glycosaminoglycan (sGAG) was estimated by dimethyl methyleneblue (DMMB) assay. The changes of Sox9 mRNA and protein levels via TGF-beta1 were detected by RT-PCR and Western blot analysis in each. RESULTS: The amount of sGAG was increased with the lapse of time during incubation, and sGAG content of pellet cultured cells was much larger than monolayer culture. When primary cultured intervertebral disc cells in monolayer and pellet cultures were treated by TGF-beta1 20 ng, sGAG content of experimental group was increased significantly compared to control group in both cultures. L-Ascorbic acid of serial concentrations (50-300 ug/ml) increased sGAG content of mono layer cultured intervertebral disc cells significantly in statistics. The co-treatment of TGF-beta1 and L-ascorbic acid increased more sGAG production than respective treatment. After treating with TGF-beta1, Sox9 mRNA and protein expression rates were significantly increased in disc cells compared with the control group. CONCLUSION: This study suggests that TGF-beta1 would increase sulfated glycosaminoglycan (sGAG) and other proteoglycans such as versican by elevating Sox9 mRNA and protein expressions in order.

Helicobacter pylori infection and development of gastric cancer in Korea: long-term follow-up.

BACKGROUND AND AIM: Infection of Helicobacter pylori is viewed as a major driver of progression to the precancerous state or to gastric cancer. This study was performed to investigate the effect of H. pylori infection on gastric cancer development and to determine to what extent H. pylori eradication is likely to reduce the prevalence of gastric cancer. METHODS: Gastric cancer development was investigated in 1790 Korean subjects who underwent gastroscopy and H. pylori testing between 1992 and 1998. The effects of H. pylori-positive and eradicated states on gastric cancer development were analyzed. RESULTS: Gastric cancer developed in 5 of the study cohort during a mean follow-up period of 9.4 years. All of these patients were positive for H. pylori infection, and 4 of the 5 had antral intestinal metaplasia (IM) at the time of study enrollment. One of these 5 patients was in an eradicated state when the gastric cancer was diagnosed, and had histologic IM before eradication therapy was performed. Gastric cancer was found to develop 10.9 times more frequently in the presence of IM than in its absence. CONCLUSIONS: The present study shows a close relationship between H. pylori infection and IM, and between IM and the development of gastric cancer. In addition, our finding suggests that chronic H. pylori infection looks like an important risk factor for the development of gastric cancer in Korea, where the prevalence of H. pylori remains high. This study indicates that to prevent gastric cancer H. pylori eradication is best performed before the development of IM.

Seroconversion of Helicobacter pylori in Korean male employees.

OBJECTIVE: Helicobacter pylori infections are acquired primarily during childhood, but also occur in adults. As no published estimates are available on the seroconversion rate of H. pylori in the Korean population, the purpose of this study was to evaluate the incidence and prevalence of H. pylori infection in male Korean employees. MATERIAL AND METHODS: Levels of anti-H. pylori IgG were measured by ELISA, and gastroscopic findings were checked in 588 employees of the Subway Corporation (aged 40-60 years, male) in 1997, 1998, 1999, 2000, and 2003. Questionnaire responses concerning socio-economic state, education level, and type of job were analyzed versus serologic test results. RESULTS: Out of the 588 subjects, 455 (77.4%) were positive for anti-H. pylori IgG. Multivariate analysis showed that abnormal gastroscopic findings, especially duodenal ulcers, were more frequent in the H. pylori-positive group (17.6) than in the initially H. pylori-negative group (9.0%) (OR: 1.71, 95% CI: 1.07-2.81). Among the multiple questionnaires, only the proportion of white-collar workers was significant; that is, it was lower in the H. pylori-positive group (44/6) than in the initial H. pylori-negative group (57.9%) (OR: 0.62, 95% CI: 0.41-0.92). Seventeen of 133 subjects (12.8%) who were initially seronegative underwent seroconversion during a 6-year follow-up period, a seroconversion rate of 2.13%/annum. CONCLUSIONS: The seroprevalence of H. pylori infection in this study group was 77.4% and duodenal ulcer was more frequent in H. pylori-positive subjects, thus confirming the relationship between H. pylori infection and duodenal ulcer. Seroconversion of H. pylori infection in the Korean male employees was determined to be 2.13% per year, suggesting that new infections occur continuously even during late adulthood.