Safety, efficacy, and response predictors of anticoagulation for the treatment of nonmalignant portal-vein thrombosis in patients with cirrhosis: a propensity score matching analysis

Background/AimsPortal-vein thrombosis (PVT) develops in 10-25% of cirrhotic patients and may aggravate portal hypertension. There are few data regarding the effects of anticoagulation on nonmalignant PVT in liver cirrhosis. The aim of this study was to elucidate the safety, efficacy, and predictors of response to anticoagulation therapy in cirrhotic patients.MethodsPatients with liver cirrhosis and nonmalignant PVT were identified by a hospital electronic medical record system (called BESTCARE). Patients with malignant PVT, Budd-Chiari syndrome, underlying primary hematologic disorders, or preexisting extrahepatic thrombosis were excluded from the analysis. Patients were divided into two groups (treatment and nontreatment), and propensity score matching analysis was performed to identify control patients. The sizes of the thrombus and spleen were evaluated using multidetector computed tomography.ResultsTwenty-eight patients were enrolled in this study between 2003 and 2014: 14 patients who received warfarin for nonmalignant PVT and 14 patients who received no anticoagulation. After 112 days of treatment, 11 patients exhibited significantly higher response rates (complete in 6 and partial in 5) compared to the control patients, with decreases in thrombus size of >30%. Compared to nonresponders, the 11 responders were older, and had a thinner spleen and fewer episodes of previous endoscopic variceal ligations, whereas pretreatment liver function and changes in prothrombin time after anticoagulation did not differ significantly between the two groups. Two patients died after warfarin therapy, but the causes of death were not related to anticoagulation.ConclusionsWarfarin can be safely administered to cirrhotic patients with nonmalignant PVT. The presence of preexisting portal hypertension is a predictor of nonresponse to anticoagulation

Effect of vitamin E in nonalcoholic fatty liver disease with metabolic syndrome: A propensity score-matched cohort study

Background/AimsVitamin E improves the biochemical profiles and liver histology in nonalcoholic steatohepatitis, but the role of vitamin E is not clearly defined in the management of nonalcoholic fatty liver disease (NAFLD) which includes both simple steatosis and steatohepatitis. Co-morbid metabolic syndrome increases the probability of steatohepatitis in NAFLD. In this study, we aimed to determine the short-term effects of vitamin E and off-treatment durability of response in a propensity-score matched cohort of NAFLD patients with metabolic syndrome.MethodsA retrospective cohort was constructed by retrieving 526 consecutive NAFLD patients from the electronic medical record data warehouse of a tertiary referral hospital in South Korea. Among them, 335 patients (63.7%) had metabolic syndrome and were eligible for vitamin E therapy. In order to assess the effect of vitamin E, propensity score matching was used by matching covariates between control patients (n=250) and patients who received vitamin E (n=85).ResultsThe PS-matched vitamin E group (n=58) and control group (n=58) exhibited similar baseline metabolic profiles. After 6 months of vitamin E therapy, the mean ALT levels decreased significantly compared to PS-matched control (P<0.01). The changes in metabolic profiles (body weight, lipid and glucose levels) did not differ between control and vitamin E groups during the study period.ConclusionsShort-term vitamin E treatment significantly reduces ALT levels in NAFLD patients with metabolic syndrome, but metabolic profiles are not affected by vitamin E

Efficacy of Lactic Acid Bacteria (LAB) supplement in management of constipation among nursing home residents

<p>Abstract</p> <p>Background</p> <p>Constipation is a significant problem in the elderly, specifically nursing home and/or extended-care facility residents are reported to suffer from constipation. Lactic acid bacteria (LAB) are beneficial probiotic organisms that contribute to improved nutrition, microbial balance, and immuno-enhancement of the intestinal tract, as well as diarrhea and constipation effect. The objective of this study was to investigate the efficacy of this LAB supplement in the management of nursing home residents.</p> <p>Methods</p> <p>Nineteen subjects (8M, 11F; mean age 77.1 ± 10.1) suffering with chronic constipation were assigned to receive LAB (3.0 × 10¹¹CFU/g) twice (to be taken 30 minutes after breakfast and dinner) a day for 2 weeks in November 2008. Subjects draw up a questionnaire on defecation habits (frequency of defecation, amount and state of stool), and we collected fecal samples from the subjects both before entering and after ending the trial, to investigate LAB levels and inhibition of harmful enzyme activities. Results were tested with SAS and Student's t-test.</p> <p>Results</p> <p>Analysis of questionnaire showed that there was an increase in the frequency of defecation and amount of stool excreted in defecation habit after LAB treatment, but there were no significant changes. And it also affects the intestinal environment, through significantly increase (<it>p </it>< 0.05) fecal LAB levels. In addition, tryptophanase and urease among harmful enzyme activities of intestinal microflora were significantly decreased (<it>p </it>< 0.05) after LAB treatment.</p> <p>Conclusion</p> <p>LAB, when added to the standard treatment regimen for nursing home residents with chronic constipation, increased defecation habit such as frequency of defecation, amount and state of stool. So, it may be used as functional probiotics to improve human health by helping to prevent constipation.</p

The long-term effects of the fenestration in patients with extracardiac Fontan circulation—a multicenter Korean cohort study based on national Fontan registry

IntroductionThe long-term effects of fenestration in patients with Fontan circulation remain unclear. We aim to evaluate the fenestration impact on early and late outcomes in patients with extracardiac Fontan (ECF) using a propensity score matching analysis.MethodsWe performed an extensive retrospective multicenter clinical data review of the Korean Fontan registry and included 1,233 patients with surgical ECF (779 fenestrated, 454 non-fenestrated). Demographics, baseline, and follow-up data were collected and comprehensively analyzed. Patients were divided into two groups according to the baseline presence or absence of surgical fenestration. Subsequently, patients were sub-divided according to the fenestration status at the last follow-up. Propensity-score matching was performed to account for collected data between the 2 groups using a multistep approach. The primary outcomes were survival and freedom from Fontan failure (FFF). We also looked at postoperative hemodynamics, cardiopulmonary exercise test results, oxygen saturations, and functional status.ResultsAfter propensity-score matching (454 matched pairs), there was no difference in survival or FFF between the 2 groups. However, ECF patients with baseline fenestration had significantly lower oxygen saturation (p = 0.001) and lower functional status (p &lt; 0.001). Patients with fenestration had significantly longer bypass times, higher postoperative central venous pressure, higher postoperative left atrial pressure, and less prolonged pleural effusion in the early postoperative period. The propensity score matching according to the fenestration status at the last follow-up (148 matched pairs) showed that patients with a persistent fenestration had significantly lower oxygen saturation levels (p &lt; 0.001). However there were no intergroup differences in the functional status, survival and FFF.ConclusionsOur results showed no long-term benefits of the Fenestration in terms of survival and FFF. Patients with persistent fenestration showed oxygen desaturation but no difference in exercise intolerance was shown between the 2 groups

Radio-Frequency/Microwave Gas Sensors Using Conducting Polymer

In this review, the advances in radio-frequency (RF) /microwave chemical gas sensors using conducting polymers are discussed. First, the introduction of various conducting polymers is described. Only polyaniline (PANi), polypyrrole (PPy) and poly(3,4-ethylenedioxythiophene) (PEDOT), which are mainly used for gas sensors in RF/microwave region, are focused in this review. Sensing mechanism of the three conducting polymers are presented. And the RF/microwave characteristics and RF/microwave applications of the three conducting polymers are discussed. Moreover, the gas sensors using conducting polymers in RF/microwave frequencies are described. Finally, the the challenges and the prospects of the next generation of the RF/microwave based chemical sensors for wireless applications are proposed

Enhanced thermomechanical property of a self-healing polymer via self-assembly of a reversibly cross-linkable block copolymer

We report the preparation and thermomechanical properties of hetero-nanostructured self-healing polymers (HSPs) bearing a hindered urea bond (HUB) by varying the content of a self-healable block copolymer (BCP). The micellar morphology of the BCP blend in a matrix polymer was studied using transmission electron microscopy and grazing-incidence small-angle X-ray scattering with various organic solvent types and BCP contents. The self-healing efficiency of the HSPs was obtained from single-scratch tests through optical microscopy and atomic force microscopy. To confirm self-healing at the molecular level, the mechanical properties of the cross-cut and healed HSPs were also analyzed using a universal testing machine. Thermomechanical properties associated with HUB were measured by dynamic mechanical analysis and temperature-oscillating rheometry. The results showed that blending the BCP improved the toughness, the hardness, and the modulus up to 21.7, 25.3, and 24.8%, respectively. Moreover, at high temperatures, the temperature range of the rubbery plateau was greatly widened without a noticeable decrease in the self-healing capability

Catalytic effects of zirconium on scratch-healing and mechanical properties of urethane-acrylate automotive clearcoat

This work describes the effect of zirconium(IV) acetylacetonate (Zr(acac)(4)) on the self-healing and thermomechanical properties of urethane-acrylate copolymers, and which were compared with dibutyltin dilaurate (DBTDL). For prepolymer synthesis, glyceryl methacrylate (GlyMA) and 2-hydroxyethyl methacrylate (HEMA) were chosen and copolymerized with methyl methacrylate (MMA) and butyl acrylate (BA) at a concentration of 8 mol%. The prepolymers (G8 and H8) were then crosslinked with HDI trimer to prepare self-healing copolymers, and DBTDL or Zr(acac)(4) was used as both crosslinking and self-healing catalysts. The self-healing performance of new carbonate bond formation by DBTDL and transesterification by Zr(acac)(4) were studied and compared using single scratch test with atomic force microscopy (AFM). Owing to the secondary hydroxyl groups of GlyMA, DBTDL shows scratch-healing capability only in the GlyMA-based copolymer (G8) within 1 h at 55 and 75 degrees C. On the other hand, Zr(acac) 4 shows scratch-healing capability in both copolymers (G8 and H8) within 1 h at 55 and 75 degrees C; however, transesterification may result in the changes of storage modulus and glasstransition temperature (T-g). This was confirmed from dynamic mechanical analysis (DMA) that a low temperature (similar to 55 degrees C) exhibited excellent self-healing performance with minimal hardness change by transesterification

Fermented Oyster Extract Prevents Ovariectomy-Induced Bone Loss and Suppresses Osteoclastogenesis

There is growing interest in bioactive substances from marine organisms for their potential use against diverse human diseases. Osteoporosis is a skeletal disorder associated with bone loss primarily occurring through enhanced osteoclast differentiation and resorption. Recently, we reported the anti-osteoclastogenic activity of fermented Pacific oyster (Crassostrea gigas) extract (FO) in vitro. The present study focused on investigating the anti-osteoporotic efficacy of FO in bone loss prevention in an experimental animal model of osteoporosis and elucidating the mechanism underlying its effects. Oral administration of FO significantly decreased ovariectomy-induced osteoclast formation and prevented bone loss, with reduced serum levels of bone turnover biomarkers including osteocalcin and C-terminal telopeptide fragment of type I collagen C-terminus (CTX). FO significantly suppressed receptor activator of nuclear factor-&kappa;B ligand (RANKL)-induced differentiation of bone marrow-derived macrophages (BMMs) into osteoclasts and attenuated the induction of osteoclast-specific genes required for osteoclastogenesis and bone resorption. Furthermore, FO inhibited RANKL-mediated I&kappa;B&alpha; and p65 phosphorylation in BMMs. Taken together, these results demonstrate that FO effectively suppresses osteoclastogenesis in vivo and in vitro, and that FO can be considered as a potential therapeutic option for the treatment of osteoporosis and osteoclast-mediated skeletal diseases