Do we need colonoscopy verification in patients with fundic gland polyp?

Background/AimsThe aim of this study was to evaluate the prevalence of colorectal neoplasia in subjects with fundic gland polyps (FGPs) and the relationship between FGPs and colorectal neoplasia in Korea.MethodsWe analyzed 128 consecutive patients with FPGs who underwent colonoscopy between January 2009 and December 2013. For each case, age- (±5 years) and sex-matched controls were identified from among patients with hyperplastic polyps, gastric neoplasms, and healthy controls. Clinical characteristics were reviewed from medical records, colonoscopic findings, pathologic findings, and computed tomography images. The outcome was evaluated by comparison of advanced colonic neoplasia detection rates.ResultsOf the 128 patients, seven (5.1%) had colon cancers and seven (5.1%) had advanced adenomas. A case-control study revealed that the odds of detecting a colorectal cancer was 3.8 times greater in patients with FGPs than in the age- and sex-matched healthy controls (odds ratio [OR], 3.80; 95% confidence interval [CI], 1.09–13.24; P =0.04) and 4.1 times greater in patients with FGPs than in healthy controls over 50 years of age (OR, 4.10; 95% CI, 1.16–14.45; P =0.04). Among patients with FGPs over 50 years old, male sex (OR, 4.83; 95% CI, 1.23–18.94; P =0.02), and age (OR, 9.90; 95% CI, 1.21–81.08; P =0.03) were associated with an increased prevalence of advanced colorectal neoplasms.ConclusionsThe yield of colonoscopy in colorectal cancer patients with FGPs was substantially higher than that in average-risk subjects. Colonoscopy verification is warranted in patients with FGPs, especially in those 50 years of age or older

Distribution and degradation of Bisphenol A (BPA) substitutes BPAF and BPS compared to BPA in aerobic soil and anaerobic

Recently, worries regarding BPA’s known endocrine disrupting potential encouraged the development of alternative chemicals such as bisphenol AF (BPAF) and bisphenol S (BPS). As their names suggest, BPS and BPAF have similar structures to Bisphenol A, which has been used for a variety of purposes. However, BPS and BPAF also have the potential to be endocrine disrupting chemicals (EDCs). Unlike BPA, little is known about their persistence of the alternatives once they enter the environment or in the wastewater treatment process. The present research pursued evaluating the partitioning behavior of BPA, BPS and BPAF and their degradation in aerated soil and anaerobic sludge from a wastewater treatment system. BPA and the alternative BPA analogues have two ionizable acid groups (pKa value range ∼ 7.4 to 10.4), thus exist as an anion or a neutral molecule in the environment depending on pH. Measured octanol-water distribution coefficients of the neutral forms followed: BPAF \u3e BPA \u3e BPS. For adsorption isotherms on four different soils with varying soil properties, organic matter (OM) was the primary factor controlling sorption with sorption increased in the soil pH range investigated (4.3-8.6) with increasing OM. Soil pH had only a secondary role since the neutral species dominated at range of most soil pH. Unlike the trends with, BPS had a higher sorption affinity than BPA. In anaerobic sludge, no degradation of any of the three bisphenols was observed during the 4-week incubation study under methanogenic conditions. Loss of bisphenols from the solution phase was due to sorption to the sludge solids with the following affinity: BPAF \u3e BPA \u3e BPS. This means that the substitutes will persist during treatment and as their uses increase, their concentrations will increase in solid residuals. In aerobic degradation studies conducted in the two slightly acidic soils containing different % organic matter, half-lives for both BPA and BPS were less than one day whereas BPAF persisted much longer with half-lives of 22-36 days. Although BPA degrades quickly under aerobic conditions, the impact of BPA has been a concern due to its high loading to the environment from massive production and potential harmful effects. Replacement of BPA by its alternatives may lead to similar concerns and impact especially for the more persistent BPAF. This study reduced the data gaps that existed by quantifying the behavior of BPS and BPAF in soils as well as estimating the fundamental properties necessary to predict the environmental fate and transport of these alternatives

Matricellular Protein Periostin Mediates Intestinal Inflammation through the Activation of Nuclear Factor κB Signaling.

Periostin is a matricellular protein that interacts with various integrin molecules on the cell surface. Although periostin is expressed in inflamed colonic mucosa, its role in the regulation of intestinal inflammation remains unclear. We investigated the role of periostin in intestinal inflammation using Postn-deficient (Postn-/-) mice. Intestinal epithelial cells (IECs) were transfected by Postn small interfering RNAs. Periostin expression was determined in colon tissue samples from ulcerative colitis (UC) patients. Oral administration of dextran sulfate sodium (DSS) or rectal administration of trinitrobenzene sulfonic acid, induced severe colitis in wild-type mice, but not in Postn-/- mice. Administration of recombinant periostin induced colitis in Postn-/- mice. The periostin neutralizing-antibody ameliorated the severity of colitis in DSS-treated wild-type mice. Silencing of Postn inhibited inteleukin (IL)-8 mRNA expression and NF-κB DNA-binding activity in IECs. Tumor necrosis factor (TNF)-α upregulated mRNA expression of Postn in IECs, and recombinant periostin strongly enhanced IL-8 expression in combination with TNF-α, which was suppressed by an antibody against integrin αv (CD51). Periostin and CD51 were expressed at significantly higher levels in UC patients than in controls. Periostin mediates intestinal inflammation through the activation of NF-κB signaling, which suggests that periostin is a potential therapeutic target for inflammatory bowel disease

The Effect of DPP-4 Inhibitors on Metabolic Parameters in Patients with Type 2 Diabetes

BackgroundWe evaluated the effects of two dipeptidyl peptidase-4 (DPP-4) inhibitors, sitagliptin and vildagliptin, on metabolic parameters in patients with type 2 diabetes mellitus.MethodsA total of 170 type 2 diabetes patients treated with sitagliptin or vildagliptin for more than 24 weeks were selected. The patients were separated into two groups, sitagliptin (100 mg once daily, n=93) and vildagliptin (50 mg twice daily, n=77). We compared the effect of each DPP-4 inhibitor on metabolic parameters, including the fasting plasma glucose (FPG), postprandial glucose (PPG), glycated hemoglobin (HbA1c), and glycated albumin (GA) levels, and lipid parameters at baseline and after 24 weeks of treatment.ResultsThe HbA1c, FPG, and GA levels were similar between the two groups at baseline, but the sitagliptin group displayed a higher PPG level (P=0.03). After 24 weeks of treatment, all of the glucose-related parameters were significantly decreased in both groups (P=0.001). The levels of total cholesterol and triglycerides were only reduced in the vildagliptin group (P=0.001), although the sitagliptin group received a larger quantity of statins than the vildagliptin group (P=0.002).The mean change in the glucose- and lipid-related parameters after 24 weeks of treatment were not significantly different between the two groups (P=not significant). Neither sitagliptin nor vildagliptin treatment was associated with a reduction in the high sensitive C-reactive protein level (P=0.714).ConclusionVildagliptin and sitagliptin exert a similar effect on metabolic parameters, but vildagliptin exerts a more potent beneficial effect on lipid parameters

Periostin mediates intestinal inflammation in murine models of colitis.

<p>(A and B) Mice were divided into four groups in the DSS-induced colitis model (n = 5): wild-type control, <i>Postn</i>^-/- control, wild-type treated with DSS, or <i>Postn</i>^-/- treated with DSS. <i>Postn</i>^-/- mice showed significant attenuation in the body weight reduction and the disease activity index three days after DSS administration. (C) Histological evaluations of the colons in the DSS-induced acute murine colitis model. The total histological scores were derived from the severity and extent of inflammation and crypt damage (mean ± SD). Results are representative of at least three separately examined sites. (D) Histological evaluations of colons in the TNBS-induced colitis (mean ± SD). Mice were divided into four groups in the TNBS-induced colitis model: wild-type control (n = 4), <i>Postn</i>^-/- control (n = 4), wild-type treated with TNBS (n = 5), or <i>Postn</i>^-/- treated with TNBS (n = 7). Results are representative of at least three separately examined sites. (E) Immunoreactivity index for phosphorylated IκB kinase (pIKK)-α/β (mean ± SD) of the colonic epithelium in DSS-induced murine colitis. DSS exposure in wild-type mice induced pIKK activity in the colonic epithelium. Periostin deficiency significantly attenuated phosphorylated pIKK-α/β activity in the colonic mucosa. (F) Representative H&E staining and immunostained images of pIKK-α/β and periostin in the colon tissues (Magnification x 200). These results are representative of three independent experiments. WT, wild-type; <i>Postn</i>^-/-, <i>Postn</i>-deficient; DSS, dextran sulfate sodium; TNBS, trinitrobenzene sulfonic acid; pIKK, phosphorylated-IκB kinase *<i>P</i> < 0.05 compared with wild-type mice without DSS or TNBS, ^# <i>P</i> < 0.05 compared with wild-type mice treated with DSS or TNBS.</p