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1.
Am J Sports Med ; : 3635465211002160, 2021 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-33793351

RESUMO

BACKGROUND: Subchondral insufficiency fracture of the knee (SIFK) is characterized by a subchondral lesion that may lead to end-stage osteoarthritis (OA). In patients who have SIFK in a precollapse state with varus malalignment, a joint-preserving technique such as open wedge high tibial osteotomy (OWHTO) should be considered. PURPOSE: To evaluate the efficacy of OWHTO in primary OA and SIFK-dominant OA by clinical and radiological evaluations including magnetic resonance imaging (MRI). STUDY DESIGN: Cohort study; Level of evidence 3. METHODS: A total of 33 SIFK-dominant OA knees and 66 with primary OA that underwent biplanar OWHTO between March 2014 and February 2016 were included after 1:2 propensity score matching. The MRI Osteoarthritis Knee Score was used to assess bone marrow lesions (BMLs) preoperatively and at follow-up. The weightbearing line ratio, the hip-knee-ankle angle, and the joint line convergence angle were measured. The clinical outcomes assessed were range of motion, the American Knee Society Score, and the Western Ontario and McMaster University (WOMAC) score. RESULTS: The mean follow-up period was 41.2 ± 12.6 months. The distribution of preoperative BML grade in the SIFK-dominant OA group was significantly higher in both the femur and tibia (P < .001 and <.001, respectively) than that in the primary OA group. However, the difference was not significant postoperatively (femur, P = .425; tibia, P = .462). In both groups, postoperative BMLs showed significant improvement compared with preoperative BMLs (primary OA [femur, P < .001; tibia, P = .001] and SIFK-dominant OA [femur, P < .001; tibia, P < .001]). The WOMAC pain score was higher in the SIFK-dominant OA group preoperatively (primary OA, 7.0 ± 3.73; SIFK-dominant OA, 9.17 ± 2.6; P = .032) even though it was not different at the final follow-up (primary OA, 2.11 ± 1.7; SIFK-dominant OA, 1.79 ± 1.32; P = .179). CONCLUSION: OWHTO is an effective procedure not only for primary OA but also for SIFK-dominant OA. OWHTO can improve BMLs, which represent the main pathological feature of SIFK. Therefore, in patients who have SIFK with varus malalignment, OWHTO can be an attractive treatment option for preserving the joint and enhancing subchondral bone healing.

2.
BMC Cancer ; 21(1): 218, 2021 Mar 02.
Artigo em Inglês | MEDLINE | ID: mdl-33653298

RESUMO

BACKGROUND: In Korea, where gastric cancer is highly prevalent, biennial endoscopy is recommended among individuals over 40. Even under regular screening, some are still diagnosed at advanced stages. We aimed to identify characteristics of interval gastric neoplasms (IGNs) with rapid progression. RESULTS: Newly-diagnosed gastric neoplasms detected in screening endoscopy between January 2004 and May 2016 were reviewed. Among them, those who had previous endoscopy within 2 years were enrolled. Endoscopic findings, family history of gastric cancer, smoking, and H. pylori status were analysed. Totally, 297 IGN cases were enrolled. Among them, 246 were endoscopically treatable IGN (ET-IGN) and 51 were endoscopically untreatable IGNs (EUT-IGN) by the expanded criteria for endoscopic submucosal dissection. Among EUT-IGNs, 78% were undifferentiated cancers (40/51) and 33% showed submucosal invasion (13/40). They were median 2.0 cm in size and more commonly located in the proximal stomach than ET-IGNs (70.6% vs. 41.9%, p < 0.001). EUT-IGN was independently related with age < 60 (OR, 2.09; 95%CI, 1.03-4.26, p = 0.042), H. pylori (OR, 2.81; 95%CI, 1.20-6.63, p = 0.018), and absent/mild gastric atrophy (OR, 2.67; 95%CI, 1.25-5.72, p = 0.011). Overall and disease-specific survival were not significantly different between the two groups, however EUT-IGN tended to have short disease-specific survival (overall survival, p = 0.143; disease-specific survival, p = 0.083). CONCLUSIONS: Uniform screening endoscopy with two-year interval seems not enough for rapid-growing gastric neoplasms, such as undifferentiated cancers. They tended to develop in adults younger than 60 with H. pylori infection without severe gastric atrophy. More meticulous screening, especially for proximal lesions is warranted for adults younger than 60 with H. pylori infection before development of gastric atrophy.

3.
J Clin Med ; 10(4)2021 Feb 16.
Artigo em Inglês | MEDLINE | ID: mdl-33669473

RESUMO

BACKGROUND AND AIMS: The impact of proteinuria and its severity on the incidence of inflammatory bowel disease (IBD) has not yet been studied. We aimed to determine the association between proteinuria measured by urine dipstick tests and the development of IBD. METHODS: This nationwide population-based study was conducted using the Korean National Health Insurance Service (NHIS) database. A total of 9,917,400 people aged 20 years or older who had undergone a national health examination conducted by the NHIS in 2009 were followed up until 2017. The study population was classified into four groups-negative, trace, 1+, and ≥ 2+-according to the degree of proteinuria measured by the urine dipstick test. The primary endpoint was newly diagnosed IBD, Crohn's disease (CD), or ulcerative colitis (UC) during the follow-up period. RESULTS: Compared with the dipstick-negative group, the incidence of CD significantly increased according to the degree of proteinuria (adjusted hazard ratio [aHR] with 95% confidence interval [CI], 1.01 [0.703-1.451], 1.515 [1.058-2.162], and 2.053 [1.301-3.24] in the trace, 1+, and ≥ 2+ dipstick groups, respectively; p for trend 0.007). However, there was no significant difference in the incidence of UC according to the degree of proteinuria (aHR with 95% CI, 1.12 [0.949-1.323], 0.947 [0.764-1.174], and 1.009 [0.741-1.373] in the trace, 1+, and ≥ 2+ dipstick groups, respectively; p for trend 0.722). In the subgroup analysis, dipstick-positive proteinuria independently increased the incidence of CD regardless of the subgroup. However, dipstick-positive proteinuria was associated with the risk of UC in those with diabetes mellitus and not in those without diabetes mellitus (aHR, 1.527 vs. 0.846; interaction p-value 0.004). The risk of CD was increased or decreased according to proteinuria changes but not associated with the risk of UC. CONCLUSION: Proteinuria, measured by the dipstick test, is strongly associated with the development of CD.

4.
Arthroscopy ; 2021 Mar 18.
Artigo em Inglês | MEDLINE | ID: mdl-33745941

RESUMO

PURPOSE: The purpose of this study was to identify whether or not retro-tubercle opening-wedge high tibial osteotomy (RT-OWHTO) produces more favorable radiographic outcomes on patellofemoral joint alignment and clinical outcomes than supra-tubercle opening-wedge high tibial osteotomy (ST-OWHTO). METHODS: From January 2017 to July 2018, patients who underwent bi-planar OWHTO were allocated to one of two groups (ST-OWHTO and RT-OWHTO). Plain radiographs and computed tomography were used to analyze patellofemoral alignment and other radiological parameters representing osteotomy configurations. Clinical outcomes were assessed using American Knee Society Score and Western Ontario and McMaster Universities Osteoarthritis Index. RESULTS: In total, 50 knees that underwent ST-OWHTO and 44 knees that underwent RT-OWHTO were enrolled. Patellar height was significantly decreased only after ST-OWHTO (Caton-Deschamps ratio: p=0.007; Blackburne-Peel ratio: p=0.012). Patellar tilt angle was decreased in both groups (p=0.009 and 0.004, respectively). Postoperative posterior tibial slope (PTS) (p=0.013), PTS (△) (p<0.001), retro-tuberosity gap distance (p=0.001), and retro-tuberosity tip distance (p=0.001) were significantly larger in RT-OWHTO. Retro-tuberosity tip distance was significantly correlated with retro-tuberosity gap distance (p=0.002), thickness of 2nd plane osteotomy fragment (p=0.027), and anterior osteotomy ratio (p=0.031) in ST-OWHTO. In RT-OWHTO, it was significantly correlated with PTS (△) (p<0.001), retro-tuberosity gap distance (p<0.001), and sagittal angle of bi-planar osteotomy (p=0.005). There were 2 cases of tibial tuberosity fracture, 9 cases of delayed union on 2nd plane osteotomy and 5 cases of tuberosity protrusion in RT-OWHTO. CONCLUSION: While the RT-OWHTO technique maintains patellofemoral joint alignment, no difference in clinical outcome was detected. The RT-OWHTO has increased risk of tuberosity fracture, delayed union, and prominent tibial tuberosity. The surgeon should consider these negative aspects of the technique and consider adjusting additional stabilization. LEVEL OF EVIDENCE: Level III, Retrospective cohort study.

5.
Dermatology ; : 1-8, 2021 Feb 08.
Artigo em Inglês | MEDLINE | ID: mdl-33556947

RESUMO

BACKGROUND: Emerging data suggest that inflammatory bowel disease (IBD) and psoriasis are associated, sharing common genetic predispositions and immunological mechanisms. However, concrete data on psoriasis risk in IBD patients compared to the general population are limited. OBJECTIVE: We investigated the risk of developing psoriasis in IBD patients compared to controls without IBD. METHODS: Using the Korean National Health Insurance Database, patients diagnosed with Crohn's disease (CD) or ulcerative colitis (UC) between 2005 and 2008 were age- and sex-matched 1:4 to non-IBD subjects from 2003 to 2018. IBD patients were defined by combining the International Classification of Diseases 10th revision code and at least one prescription of IBD-specific medications. Disease phenotypes, including psoriasis severity and psoriatic arthritis, were also identified. We investigated newly diagnosed psoriasis from 2009 to 2018. Incidence rates and risk of psoriasis were assessed with multivariate Cox regression models. Subgroup analyses for age and sex, and sensitivity analysis involving tumor necrosis factor (TNF) inhibitor-naïve patients were performed. RESULTS: During nearly a decade of follow-up, 20,152 IBD patients were identified (14,619 [72.54%] UC and 5,533 [27.46%] CD). Among them, 439 patients were newly diagnosed with psoriasis (incidence rate of 217.68 per 100,000 person-years and 228.62 per 100,000 person-years for UC and CD, respectively). The psoriasis risk was higher in IBD patients than in the matched controls (adjusted hazard ratio, aHR, 2.95, 95% confidence interval, CI, 2.60-3.33). Moreover, IBD patients aged <30 years were at an increased risk (aHR 3.35, 95% CI 2.58-4.35), a trend that was unchanged across all psoriasis phenotypes. Sensitivity analysis of TNF inhibitor-naïve patients revealed consistent results. CONCLUSIONS: IBD patients were more likely to develop psoriasis compared to non-IBD subjects, including younger patients at an elevated risk regardless of TNF inhibitor use. This advocates the interplay between IBD and psoriasis; thus, inspection of cutaneous manifestation and dermatological consultation may be helpful in IBD patients at risk.

6.
PLoS One ; 16(2): e0245052, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33544706

RESUMO

Emerging evidence that an elevated serum gamma-glutamyltransferase (GGT) level is associated with an increased risk of gastrointestinal cancer, but still controversial. The aim of this study to assess the relationship between GGT level and risk of gastrointestinal cancer, and the contribution of the interaction of hyperglycemia with elevated GGT level to the incidence of gastrointestinal cancer by the stratified analysis. A total of 8,120,665 Koreans who received medical checkups in 2009 were included. Subjects were classified according to the quartile of GGT level for women and men. The incidence rates of gastrointestinal cancer for each group were analyzed using Cox proportional hazards models. During follow-up, 129,853 cases of gastrointestinal cancer newly occurred (esophagus, 3,792; stomach, 57,932; and colorectal, 68,789 cases). The highest GGT quartile group showed an increased risk of gastrointestinal cancer (esophagus, hazard ratio = 2.408 [95% confidence interval, 2.184-2.654]; stomach, 1.121 [1.093-1.149]; and colorectal, 1.185 [1.158-1.211]). The risk increased significantly with the rise in GGT quartile level, regardless of the site of cancer. The stratified analysis according to glycemic status showed that the effect of elevated GGT was predominant in the risk of esophageal cancer. The effect of elevated GGT further increased the risk of stomach and colorectal cancers in diabetic patients. An elevated level of GGT was associated with an increased risk of gastrointestinal cancer, regardless of the site of cancer. The effect of the increase in GGT level on the risk of gastrointestinal cancer depended on the type of cancer and glycemic status.

7.
J Crohns Colitis ; 2021 Feb 18.
Artigo em Inglês | MEDLINE | ID: mdl-33599720

RESUMO

BACKGROUND AND AIMS: Ontamalimab, a fully-human monoclonal antibody targeting MAdCAM1, induced remission in patients with moderate-to-severe ulcerative colitis (UC) in TURANDOT. We assessed long-term safety, tolerability and efficacy of ontamalimab in TURANDOT II. METHODS: TURANDOT II was a phase 2, multicentre, open-label (OL) study in patients with moderate-to-severe UC who completed TURANDOT on placebo or ontamalimab. Patients were randomized to 75mg or 225mg ontamalimab every 4 weeks for 72 weeks (OL1). Dosage could be increased to 225mg from week 8 at the investigator's discretion. All patients then received 75mg every 4 weeks for 72 weeks (OL2), followed by 6-month safety follow-up. The primary objective was safety, measured by adverse events (AEs), serious AEs (SAEs) and AEs leading to withdrawal. Mucosal healing (MH; centrally read endoscopy) was assessed. RESULTS: Of 330 patients, 180 completed OL1; 94 escalated to 225mg; 127 completed OL2. Overall, 36.1% experienced drug-related AEs. The most common SAE (10.0%) was worsening/ongoing UC; 5.5% of patients had serious infections, the most common being gastroenteritis (0.9%). One death and four cancers (all unrelated to ontamalimab) occurred. No PML/lymphoproliferative disorders occurred. Geometric mean hsCRP and faecal calprotectin decreased across OL1 in both dose groups. The proportion of patients assigned placebo in TURANDOT achieving MH increased from 8.8% (6/68) at baseline to 35.3% at week 16 (24/68; non-responder imputation). The corresponding increase in the ontamalimab group was from 23.3% (61/262) to 26.7% (70/262). CONCLUSIONS: Ontamalimab was well tolerated up to 144 weeks in patients with moderate-to-severe UC, with good safety and efficacy.

8.
Gut Liver ; 2021 Jan 19.
Artigo em Inglês | MEDLINE | ID: mdl-33462161

RESUMO

Background/Aims: We aimed to evaluate the clinical characteristics and long-term prognosis of elderly-onset ulcerative colitis (EOUC) in Korean patients over a 30-year period using a wellestablished population-based cohort in the Songpa-Kangdong district of Seoul, Korea. Methods: Clinical characteristics and prognosis were compared between two groups: EOUC, defined as UC diagnosed in individuals aged ≥60 years and non-EOUC (N-EOUC), defined as UC diagnosed in individuals aged 18 to 59 years. Results: We identified 99 patients with EOUC (10.3%) and 866 patients with N-EOUC (89.7%) between 1986 and 2015. During the median follow-up of 104.5 months, the overall exposure to medications was comparable between patients with EOUC and N-EOUC (p=0.091 for corticosteroids, p=0.794 for thiopurines, and p=0.095 for anti-tumor necrosis factor agents). The cumulative risks of disease outcomes were also comparable between patients with EOUC and N-EOUC (22.4% vs 30.4% for proximal disease extension [p=0.351], 11.9% vs 18.1% for hospitalization [p=0.240], and 2.3% vs 1.8% for colectomy [p=0.977]) at 10 years after diagnosis. Multivariate Cox regression analysis revealed that corticosteroid use at diagnosis was an independent predictor of proximal disease extension (hazard ratio [HR], 6.216; 95% confidence interval [CI], 1.314 to 28.826) and hospitalization (HR, 11.241; 95% CI, 3.027 to 41.742) in patients with EOUC. Conclusions: In this population-based study from Korea, the pattern of medication use seemed comparable between the EOUC and N-EOUC groups. Moreover, patients with EOUC and those with N-EOUC have a similar disease course in terms of proximal disease extension, hospitalization, and colectomy.

9.
J Am Heart Assoc ; 10(1): e017783, 2021 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-33372535

RESUMO

Background Although occult hemoglobin in feces is universally valued as a screening tool for colorectal cancer (CRC), only few studies investigated the clinical meaning of fecal immunochemical test (FIT) in other diseases. We evaluated the clinical utility of FIT in patients with cardiovascular diseases (namely, ischemic stroke and myocardial infarction [MI]). Methods and Results Using the National Health Insurance database, participants (aged >50 years) with CRC screening records from 2009 to 2012 were screened and followed up. Subjects with a history of cardiovascular diseases and CRC were excluded. Ischemic stroke, MI, and other comorbidities were defined by International Classification of Diseases, Tenth Revision (ICD-10), codes. Age, sex, smoking, alcohol consumption, regular exercise, diabetes mellitus, hypertension, dyslipidemia, and body mass index were adjusted in a multivariate analysis. A total of 6 277 446 subjects were eligible for analysis. During the mean 6.79 years of follow-up, 168 570 participants developed ischemic stroke, 105 983 developed MI, and 11 253 deaths were observed. A multivariate-adjusted model revealed that the risk of ischemic stroke was higher in the FIT-positive population (adjusted hazard ratio [HR], 1.09; 95% CI, 1.07-1.11). Similarly, FIT-positive subjects were at an increased risk of MI (adjusted HR, 1.09; 95% CI, 1.06-1.12). Moreover, increased all-cause mortality was observed in the FIT-positive population (adjusted HR, 1.15; 95% CI, 1.07-1.23). The increased risk remained consistent in the stratified analysis on anemia and CRC status. Conclusions Positive FIT findings were associated with ischemic stroke, MI, and mortality. Occult blood in feces may offer more clinical information than its well-known conventional role in CRC screening.

10.
Artigo em Inglês | MEDLINE | ID: mdl-33300216

RESUMO

Background & Aims While many studies demonstrated an association between visceral adiposity and colorectal adenoma (CRA), the effect of longitudinal changes in body fat composition on CRA is unclear. We investigated the longitudinal association between changes in visceral adiposity and CRA occurrence. METHODS: Between 2006 and 2018, 732 (62.8%) of 1165 subjects in a prospective cohort voluntarily underwent follow-up abdominal fat computed tomography and colonoscopy. We defined incident and recurrent CRA as adenoma detected at follow-up colonoscopy from negative and positive adenoma at baseline colonoscopy, respectively. Multilevel survival analysis examined the longitudinal association between changes in visceral fat and CRA. RESULTS: During a median follow-up of 7.4 years, 400 (54.6%) subjects developed CRA. In multivariable analysis, increasing changes in visceral adipose tissue (VAT) area were associated with higher risk of incident adenoma (hazard ratio [HR] 1.21, 95% confidence interval [CI] 1.00-1.46 for change per 10 cm2 increase; HR 1.79, 95% CI 1.08-2.97 for highest vs. lowest quartile, p values for trend= 0.045). Likewise, increasing changes in VAT area were independently associated with a higher risk of recurrent adenoma (HR 1.35, 95% CI 1.13-1.62 for change per 10 cm2 increase; HR 1.62, 95% CI 1.04-2.52 for highest vs. lowest quartile, p values for trend= 0.001). Changes in subcutaneous adipose tissue area were not independently associated with CRA. CONCLUSION: Increasing changes in VAT area were longitudinally associated with a higher risk of incident and recurrent CRA, independent of risk factors, suggesting that visceral adiposity may be an important target in CRA prevention.

11.
Sci Rep ; 10(1): 21090, 2020 12 03.
Artigo em Inglês | MEDLINE | ID: mdl-33273563

RESUMO

Bacteria can form biofilms, complex microbial communities protected from environmental stress, on food contact surfaces. Brassicaceae plant has been shown to contain bioactive compounds with antimicrobial activities. The objective of this study was to evaluate the synergistic effects of Brassicaceae species and proteinase K against E. coli O157:H7 biofilm. We determined the minimum biofilm inhibitory concentration, the fractional inhibitory concentration indexes, and the synergistic inhibitory effect of Raphanus sativus var. longipinnatus, R. sativus, and Brassica oleracea var. acephala extracts with proteinase K on E. coli O157:H7. The biofilm showed a 49% reduction with 2 mg/mL R. sativus. The combination of proteinase K 25 µg/mL significantly increased the effect of 2 mg/mL R. sativus var. longipinnatus and the combined treatment yielded up to 2.68 log reduction on stainless steel coupons. The results showed that the combination of R. sativus var. longipinnatus extract and proteinase K could serve as an anti-biofilm agent with synergistic effects for inhibiting E. coli O157:H7 biofilm on stainless steel surfaces.

12.
Biomedicines ; 8(11)2020 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-33233771

RESUMO

The aim of this study was to demonstrate the anti-inflammatory effect of Lactobacillus kefirgranum PRCC-1301-derived extracellular vesicles (PRCC-1301 EVs) on intestinal inflammation and intestinal barrier function. Human intestinal epithelial cells (IECs) Caco-2 were treated with PRCC-1301 EVs and then stimulated with dextran sulfate sodium (DSS). Real-time RT-PCR revealed that PRCC-1301 EVs inhibited the expression of pro-inflammatory cytokines in Caco-2 cells. PRCC-1301 EVs enhanced intestinal barrier function by maintaining intestinal cell integrity and the tight junction. Loss of Zo-1, claudin-1, and occludin in Caco-2 cells and the colitis tissues was recovered after PRCC-1301 EVs treatment, as evidenced by immunofluorescence analysis. Acute murine colitis was induced using 4% DSS and chronic colitis was generated in piroxicam-treated IL-10-/- mice. PRCC-1301 EVs attenuated body weight loss, colon shortening, and histological damage in acute and chronic colitis models in mice. Immunohistochemistry revealed that phosphorylated NF-κB p65 and IκBα were reduced in the colon tissue sections treated with PRCC-1301 EVs. Our results suggest that PRCC-1301 EVs may have an anti-inflammatory effect on colitis by inhibiting the NF-κB pathway and improving intestinal barrier function.

13.
Knee ; 27(6): 1942-1952, 2020 Nov 19.
Artigo em Inglês | MEDLINE | ID: mdl-33221692

RESUMO

PURPOSE: To evaluate (1) the outcome of PCL reconstruction with tibial suspensory fixation using a fovea landmark technique based on the tunnel position and serial change of the tunnel configuration after trans-tibial PCL reconstruction, and (2) whether suspensory fixation has any harmful effect on the outcome. METHODS: A total of 48 knees that underwent PCL reconstruction were included. The tunnel position was analyzed using CT. To analyze the tunnel configuration, the tunnel diameter, area, and volume were measured. To evaluate the outcome, pre- and postoperative International Knee Documentation Committee (IKDC) and Lysholm scores were analyzed. To evaluate stability, a side-to-side difference was evaluated using Telos stress radiographs. RESULTS: The greatest configurational change occurred at the mid-portion of tibial tunnel. There was a correlation between stability and tibial tunnel mid-portion configurational change (p < 0.01). Important correlations were found between the tunnel position and serial tunnel configuration between high femoral tunnel and widest site of femoral tunnel and tibia aperture (p < 0.01 and 0.04, respectively). The diameter of widest site of tibia tunnel increased when the tibia tunnel center moved toward the posterior margin of the tibia (p = 0.02) and the percentage of femoral tunnel volume enlargement increased when the tibia tunnel center moved toward the medial edge of the PCL fovea (p = 0.02). CONCLUSIONS: A high femoral tunnel, medial tibial tunnel, and posterior tibial tunnel were related to the serial configurational change. A suspensory tibial fixation produced significant configurational change around the mid-portion of the tibial tunnel, and it induced a negative effect on stability. LEVEL OF EVIDENCE: Level IV.

14.
Sci Rep ; 10(1): 19867, 2020 11 16.
Artigo em Inglês | MEDLINE | ID: mdl-33199767

RESUMO

Intestinal fibrosis induced by chronic and recurrent colitis, which is exacerbated by bowel stenosis, stricture, and obstruction, is challenging to treat. Toll-like receptor 4 (TLR4) stimulates innate and acquired immunity in response to specific microbial components, but the role of TLR4 in intestinal fibrosis is largely unknown. We investigated its role in intestinal fibrosis using not only a murine fibrosis model but also human myofibroblasts and intestinal epithelial cells. Colon fibrosis was induced in TLR4-deficient (TLR4-/-) mice and its wild-type counterparts with 3% dextran sulfate sodium. Absence of TLR4 gene attenuated chronic inflammation and colonic macrophages infiltration; intestinal fibrosis and collagen deposition were suppressed. Also, the production of tumor necrosis factor-α, interleukin-12p40, and transforming growth factor-ß was reduced in TLR4-deficient peritoneal macrophages. TLR4 was silenced in CCD-18Co cells by small interfering RNA (siRNA), and matrix metalloproteinase-1, tissue inhibitor of metalloproteinase, and collagen α1 expression was evaluated. Role of TLR4 in epithelial-mesenchymal transition (EMT) was evaluated in HCT116 cells. Suppression of TLR4 transcription by siRNAs affected myofibroblasts activity, collagen synthesis, and EMT in the human cancer cell line. Thus, we suggest that TLR4 can be an essential mediator in intestinal chronic inflammation and fibrosis, indicating that TLR4 signaling is a potential therapeutic target for intestinal fibrosis.

15.
Gastroenterol Res Pract ; 2020: 4028136, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33144855

RESUMO

Methods: This study was conducted on asymptomatic healthy individuals who underwent upper gastrointestinal endoscopy for the purpose of GC screening. Patients who were diagnosed with GC between October 2003 and December 2013 at Seoul National University Hospital Healthcare System Gangnam Center were identified. Demographic and clinicopathologic characteristics were compared between the groups with and without FHx of GC. Overall survival (OS) and recurrence-free survival (RFS) were assessed as primary outcomes. Results: There were no significant differences in tumor characteristics according to FHx of GC. However, preexisting adenoma was more frequent in patients with FHx than in those without FHx (14.5% vs. 6.3%, p = 0.035). The proportion of patients with microsatellite instability (MSI) was also higher in groups with FHx of GC (43.2% vs. 13.2%, p = 0.006). Helicobacter pylori infection rates of patients with FHx of GC tended to be higher although not significant (70.5% vs. 61.3%, p = 0.188). However, OS and RFS at 5 years of the GC patients with FHx were not significantly different from those of patients without FHx. Conclusion: Preexisting adenoma and GC with MSI are more common in patients with FHx of GC than in those without. There were no significant differences in the survival rate according to FHx.

16.
J Clin Med ; 9(11)2020 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-33138143

RESUMO

The purposes of this study were (1) to evaluate the relationship between lumbosacral flexibility and the effects of total knee arthroplasty (TKA) on whole-body alignment; and (2) to determine the prerequisites of the adjacent joints for successful TKA. A total of 116 patients (156 cases) who had whole-body X-ray and flexion-extension lumbar radiograph available were enrolled. For the sagittal alignment evaluation, hip-knee-ankle (HKA) angle, pelvic tilt (PT), sacral slope (SS), lumbar lordosis (LL), thoracic kyphosis (TK), and C7 plumb line-sacrum distance (SVA) were evaluated on the whole-body radiographs. Lumbar flexibility (LF) was evaluated using the flexion-extension lumbar radiographs, and pelvic flexibility (PF) was evaluated using the pelvic incidence (PI). The disparities in the knee joint between postoperative passive motion and weight-bearing posture were assessed. LF was significantly correlated with ΔLL and ΔSVA (LL: p = 0.039, SVA: p = 0.040; Pearson correlation coefficient (PCC): -0.206 and 0.205, respectively). There were correlations between PF and ΔSS (p < 0.001, PCC: -0.362), and between the disparity and LF (p = 0.005, PCC = -0.275). Linear regression analysis demonstrated that LF was significantly associated with the presence of disparity (p = 0.005, ß = -0.205). LF is an important factor for improved spinal and lower limb alignment after TKA. Additionally, reduced LF may result in knee joint disparity between passive extension and standing extension status. Therefore, surgeons should consider spinopelvic alignment, including lower limb alignment preoperatively, to be able to predict possible changes in whole-body alignment following TKA.

17.
Knee ; 27(5): 1551-1559, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33010773

RESUMO

BACKGROUND: Inappropriate posture during radiographic assessment may lead to misunderstanding of postoperative alignment after total knee arthroplasty (TKA). The EOS system assesses coronal and sagittal alignment simultaneously. This study aimed to evaluate the effect of flexion and/or rotation on alignment, and identify the patterns of knee posture with serial follow-up using the EOS system. METHODS: One-hundred and fifteen patients of TKA and serial whole-body EOS were included. The hip-knee-ankle (HKA) angle in the coronal and sagittal planes, femoral component rotation ratio (FCR), tibial component rotation ratio (TCR), and fibular overlap ratio (FO) were measured immediately and at six months and one year postoperatively. Total and partial correlation, using flexion and rotation as a control variable was performed. RESULTS: The mean HKA values and flexion immediately post-operation were different compared with the values noted at six months and one year postoperatively (for all, P < 0.05). The FCR and FO were correlated with the HKA angle during all periods (for both, P < 0.05). The Pearson correlation coefficients of the HKA angle with rotation parameters decreased when flexion was controlled. CONCLUSIONS: Combined rotation and flexion of the knee joint has a greater effect on coronal alignment compared with isolated flexion or rotation and was more frequently observed during the early postoperative period. Therefore, surgeons should be made aware of the potential knee rotation and flexion errors after TKA.

18.
Knee ; 27(5): 1608-1617, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33010780

RESUMO

BACKGROUND: The purposes of this study were to evaluate whether the planning method using the contralateral limb status is reasonable and to determine the disparity between the preoperative planning and actual postoperative correction status by analyzing lateral cortical hinge fractures (LCHFs) in patients who underwent distal femoral osteotomy (DFO). METHODS: From 2014 to 2018, 31 cases undergoing DFO were evaluated. The patients were divided into two groups according to two preoperative planning methods. The disparity between the preoperative planning and the postoperative weight-bearing line (WBL) ratio and clinical scores were compared. Analysis was performed to determine the causes of the disparity by evaluating the osteotomy configuration, including that of LCHFs. RESULTS: The disparity was observed in the WBL ratio assessment (P < 0.01). In the comparison between two groups, no statistically significant differences were found in the change of WBL ratio (P = 0.78) and postoperative clinical scores. The length of the osteotomy gap was only related to the disparity (R2 = 0.22, P = 0.01), while no statistical significance was found for the regression equation of the displaced LCHF (P > 0.05). The length of the remaining bone between the osteotomy end and opposite cortex was significantly associated with the presence of LCHF (odds ratio, 3.904). CONCLUSIONS: The planning method using a contralateral limb status showed similar results to the classical method, but the two methods produced disparity when the degree of correction was increased. LCHF was mostly related to the remaining bone in the medial closing-wedge DFO.

19.
World J Gastroenterol ; 26(37): 5661-5672, 2020 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-33088159

RESUMO

BACKGROUND: Periodontitis is a chronic inflammation of periodontal tissues. The effect of periodontitis on the development of inflammatory bowel disease (IBD) remains unclear. AIM: To assessed the risk of IBD among patients with periodontitis, and the risk factors for IBD related to periodontitis. METHODS: A nationwide population-based cohort study was performed using claims data from the Korean National Healthcare Insurance Service. In total, 9950548 individuals aged ≥ 20 years who underwent national health screening in 2009 were included. Newly diagnosed IBD [Crohn's disease (CD), ulcerative colitis (UC)] using the International Classification of Disease 10th revision and rare intractable disease codes, was compared between the periodontitis and non-periodontitis groups until 2017. RESULTS: A total of 1092825 individuals (11.0%) had periodontitis. Periodontitis was significantly associated with older age, male gender, higher body mass index, quitting smoking, not drinking alcohol, and regular exercise. The mean age was 51.4 ± 12.9 years in the periodontitis group and 46.6 ± 14.2 years in the non-periodontitis group (P < 0.01), respectively. The mean body mass index was 23.9 ± 3.1 and 23.7 ± 3.2 in the periodontitis and non-periodontitis groups, respectively (P < 0.01). Men were 604307 (55.3%) and 4844383 (54.7%) in the periodontitis and non-periodontitis groups, respectively. The mean follow-up duration was 7.26 years. Individuals with periodontitis had a significantly higher risk of UC than those without periodontitis [adjusted hazard ratio: 1.091; 95% confidence interval (CI): 1.008-1.182], but not CD (adjusted hazard ratio: 0.879; 95% confidence interval: 0.731-1.057). The risks for UC were significant in the subgroups of age ≥ 65 years, male gender, alcohol drinker, current smoker, and reduced physical activity. Current smokers aged ≥ 65 years with periodontitis were at a 1.9-fold increased risk of UC than non-smokers aged ≥ 65 years without periodontitis. CONCLUSION: Periodontitis was significantly associated with the risk of developing UC, but not CD, particularly in current smokers aged ≥ 65 years.

20.
PLoS One ; 15(9): e0238244, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32898174

RESUMO

Anemia is a common manifestation of inflammatory bowel disease (IBD), but it remains unclear whether anemia is associated with the development of IBD. We assessed the risk of developing IBD in anemic patients, and stratified the results with respect to their hemoglobin concentrations. A population-based study was conducted using the National Healthcare Insurance Service database in South Korea. We included individuals over 20 years' old who participated in the national health screening program in 2009 (n = 9,962,064). Anemia was defined as a hemoglobin level less than 13 g/dL in men and less than 12 g/dL in women. We compared the rate of newly diagnosed IBD in anemic patients and non-anemic individuals. Newly diagnosed IBD was identified using both the ICD-10 medical code and specialized V codes for rare intractable diseases in South Korea. During the mean follow-up period of 7.3 years, the incidences of CD and UC in anemic patients were 2.89 and 6.88 per 100,000 person-years, respectively. The risk of CD was significantly higher in anemic patients than in non-anemic individuals [adjusted hazard ratio (aHR), 2.084; 95% confidence interval (CI), 1.769-2.455]. The risk of CD development was inversely proportional to the hemoglobin concentration. A J-curve relationship was observed between age and the risk of CD in anemic patients. The risk of CD in male anemic patients was significantly higher than that in female anemic patients (aHR, 1.432 vs. 1.240, respectively). By contrast, there was no statistically significant difference in the risk of developing UC in anemic and non-anemic individuals (aHR, 0.972; 95% CI, 0.880-1.073). This work indicates that anemia is related to the development of CD, and this risk was inversely proportional to the hemoglobin concentration.


Assuntos
Anemia/complicações , Colite Ulcerativa/etiologia , Doença de Crohn/etiologia , Estudos de Coortes , Colite Ulcerativa/epidemiologia , Doença de Crohn/epidemiologia , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , República da Coreia/epidemiologia , Fatores de Risco
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