Fatty liver disease and the risk of erosive oesophagitis in the Korean population: a cross-sectional study

Objectives To investigate an association between fatty liver disease (FLD) and erosive oesophagitis. Design and setting This was a cross-sectional study of subjects selected from examinees who underwent health check-up, including oesophagogastroduodenoscopy in one hospital between 2004 and 2011. Erosive oesophagitis was classified according to the Los Angeles classification and FLD was diagnosed with ultrasonography. The anthropometric and laboratory data of the subjects were analysed using X-2 test and multivariate logistic regression. Additionally, we have analysed our data with two-stage least square estimation using the Baltagi-Chang one-way model to clarify unobserved confounding variable. Primary outcome measure The effect of FLD on erosive oesophagitis. Results Among the 14 723 eligible subjects, 4232 (28.7%) subjects diagnosed with FLD were classified into the fatty liver group and 10 491 (71.3%) subjects without FLD were classified into the non-fatty liver group. The incidence rate of erosive oesophagitis was significantly higher in the fatty liver group than in the non-fatty liver group (10.4% vs6.1%, p< 0.0001). The multivariate analysis revealed that the fatty liver group was significantly associated with erosive oesophagitis (OR 1.19, 95% CI 1.03 to 1.37, p= 0.016). Conclusion FLD diagnosed by ultrasonography is an independent risk factor of erosive oesophagitis. It suggests that FLD-related metabolic abnormality may be associated with erosive oesophagitis

A case of emphysematous hepatitis with spontaneous pneumoperitoneum in a patient with hilar cholangiocarcinoma

An 80-year-old woman with hilar cholangiocarcinoma was hospitalized due to sudden-onset abdominal pain. Computed tomography revealed hepatic necrosis accompanied with emphysematous change in the superior segment of the right liver (S7/S8), implying spontaneous rupture, based on the presence of perihepatic free air. Although urgent percutaneous drainage was performed, neither pus nor fluids were drained. These findings suggest emphysematous hepatitis with a hepatic mass. Despite the application of intensive care, the patient's condition deteriorated rapidly, and she died 3 days after admission to hospital. Liver gas has been reported in some clinical diseases (e.g., liver abscess) to be caused by gas-forming organisms; however, emphysematous hepatitis simulating emphysematous pyelonephritis is very rare. The case reported here was of fatal emphysematous hepatitis in a patient with hilar cholangiocarcinoma

Post-intervention Status in Patients With Refractory Myasthenia Gravis Treated With Eculizumab During REGAIN and Its Open-Label Extension

OBJECTIVE: To evaluate whether eculizumab helps patients with anti-acetylcholine receptor-positive (AChR+) refractory generalized myasthenia gravis (gMG) achieve the Myasthenia Gravis Foundation of America (MGFA) post-intervention status of minimal manifestations (MM), we assessed patients' status throughout REGAIN (Safety and Efficacy of Eculizumab in AChR+ Refractory Generalized Myasthenia Gravis) and its open-label extension. METHODS: Patients who completed the REGAIN randomized controlled trial and continued into the open-label extension were included in this tertiary endpoint analysis. Patients were assessed for the MGFA post-intervention status of improved, unchanged, worse, MM, and pharmacologic remission at defined time points during REGAIN and through week 130 of the open-label study. RESULTS: A total of 117 patients completed REGAIN and continued into the open-label study (eculizumab/eculizumab: 56; placebo/eculizumab: 61). At week 26 of REGAIN, more eculizumab-treated patients than placebo-treated patients achieved a status of improved (60.7% vs 41.7%) or MM (25.0% vs 13.3%; common OR: 2.3; 95% CI: 1.1-4.5). After 130 weeks of eculizumab treatment, 88.0% of patients achieved improved status and 57.3% of patients achieved MM status. The safety profile of eculizumab was consistent with its known profile and no new safety signals were detected. CONCLUSION: Eculizumab led to rapid and sustained achievement of MM in patients with AChR+ refractory gMG. These findings support the use of eculizumab in this previously difficult-to-treat patient population. CLINICALTRIALSGOV IDENTIFIER: REGAIN, NCT01997229; REGAIN open-label extension, NCT02301624. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that, after 26 weeks of eculizumab treatment, 25.0% of adults with AChR+ refractory gMG achieved MM, compared with 13.3% who received placebo

Minimal Symptom Expression' in Patients With Acetylcholine Receptor Antibody-Positive Refractory Generalized Myasthenia Gravis Treated With Eculizumab

The efficacy and tolerability of eculizumab were assessed in REGAIN, a 26-week, phase 3, randomized, double-blind, placebo-controlled study in anti-acetylcholine receptor antibody-positive (AChR+) refractory generalized myasthenia gravis (gMG), and its open-label extension

Expression of MicroRNA in Host Cells Infected with Helicobacter pylori

Background/AimsMicroRNAs (miRNAs) regulate gene expression. We assess miRNA regulation by Helicobacter pylori infection and elucidate their role in H. pylori-infected gastric epithelial cells.Methods : The relationship between miRNA expression and DNA methylation was examined. Cells were treated with the nuclear factor-kappaB (NF-κB) inhibitor Bay 11-7082 to determine the relationship between miRNA expression and NF-κB signal transduction.Results : In the negative control cells infected with H. pylori 26695, the expression of six miRNAs was increased, whereas the expression of five miRNAs was decreased. The expression of upregulated miRNAs was increased when the host cells were treated with H. pylori and an NF-κB inhibitor. miR-127-5p, -155, and -181 were associated with increased interleukin 6 (IL-6) secretion in H. pylori infected cells treated with anti-miRNA. The expression of miR-155, -127-5p, -195, -216, -206, and -488 increased by approximately 3-fold following treatment with the methylation inhibitor Aza.Conclusion : sWe found novel miR-NAs in H. pylori-infected negative control cells using miRNA microarrays. Upregulated miRNA expression was inversely related to the transcription of NF-κB. miR-195 and miR-488 appear to play a pivotal role in controlling IL-6 activity in H. pylori infection. miRNA expression in H. pylori infection was affected by methylation

High-resolution endoscopic ultrasound imaging and the number of needle passages are significant factors predicting high yield of endoscopic ultrasound-guided fine needle aspiration for pancreatic solid masses without an on-site cytopathologist

S jedne strane moderan sjedilački način života, s druge strane pretjerana aktivnost, oboje popraćeni nepravilnim izvođenjem pokreta dovode do niza problema i narušenog zdravlja lokomotornog sustava čovjeka. Lokomotorni sustav čovjeka je kompleksan, a kao jedan od njegovih bitnijih dijelova, pa tako i jedan od najosjetljivijih, ističe se koljeni zglob. Uzimajući u obzir da gotovo svaka ozljeda vodi ka reduciranoj mobilnosti koljenog zgloba te da je ponuda proizvoda na tržištu, koji bi taj problem sanirali, slaba, dolazi do potrebe za razvijanjem fizioterapeutskog pomagala koje bi olakšalo provedbu terapijskih djelovanja za rehabilitaciju navedenog problema, što je cilj ovoga rada. Nakon uvoda, gdje je pojašnjen problem i cilj rada, opisan je čitav koljeni zglob. Osim što se time uvodi u cjelokupnu temu i problematiku, opisom anatomije, biomehanike i mogućih ozljeda zgloba dolazi se do vrsta rehabilitacija gdje se dokazuje smislenost izrade ovakvog tipa uređaja. Nakon upoznavanja sa problematikom i uvođenja u tematiku, definirani su problemi, zahtjevi i ciljevi te je analizirano tržište. Na temelju navedenog, izvedene su smjernice za razvoj iz kojih su generirani i vrednovani koncepti. Konačno, iz vrednovanja koncepata odabrano je najbolje rješenje čiji su nedostatci prepravljeni rješenjima iz drugih koncepata. Konačno rješenje prikazano je 3D modelima, gdje se jasno vidi princip rada uređaja i njegove prednosti. Rješenje se očituje jednostavnošću izrade i korištenja, a vidi se i potencijal za daljnji razvoj proizvoda u smislu sprave za jačanje mišića kvadricepsa, posebice m. Vastus medialisa, krucijalnog za zadnjih 15° ekstenzije u koljenom zglobu.On the one hand, a modern sedentary lifestyle, on the other hand, excessive activity, both accompanied by improper performance of movements lead to a number of problems and impaired health of the human locomotor system. The locomotor system of man is complex, and as one of its most important parts, and thus one of the most sensitive, the knee joint stands out. Considering that almost every injury leads to reduced mobility of the knee joint and that the supply of products on the market that would cure this problem is weak, there is a need for development physiotherapy aid that would facilitate the implementation of therapeutic actions that are used for rehabilitation of this problem, which is the goal of this paper. After the introduction, where the problem and the goal of the paper are explained, the whole knee joint is described. In addition to introducing it to the entire topic and issue, the description of anatomy, biomechanics and possible joint injuries leads to a series of rehabilitations where the sense of making this type of device is proven. After getting acquainted with the problem and introduction to the topic, the problems, requirements and goals are defined and the market is analyzed. Based on the above, development guidelines were derived from which concepts were generated and evaluated. Finally, the best solution was selected from the evaluation of concepts, the shortcomings of which were corrected by solutions from other concepts. The final solution is presented in 3D models, where the principle of operation of the device and its advantages are clearly seen. The solution is manifested in the simplicity of manufacture and use, and the potential for further product development in terms of a device for strengthening the quadriceps muscle, especially m. Vastus medialis, crucial for the last 15° extension in the knee joint, is also noticable

NRF2 Knockdown Resensitizes 5-Fluorouracil-Resistant Pancreatic Cancer Cells by Suppressing HO-1 and ABCG2 Expression

Chemoresistance is a leading cause of morbidity and mortality in patients with pancreatic cancer and remains an obstacle to successful treatment. The antioxidant transcription factor nuclear factor (erythroid-derived 2)-related factor 2 (NRF2), which plays important roles in tumor angiogenesis and invasiveness, is upregulated in pancreatic ductal adenocarcinoma (PDAC), where it correlates with poor survival. Here, we investigated the role of NRF2 in two 5-Fluourouracil-resistant (5-FUR) PDAC cell lines: BxPC-3 and CFPAC-1. Levels of NRF2 and antioxidants, such as heme oxygenase 1 (HO-1), NAD(P)H quinone dehydrogenase 1 (NQO1), and superoxide dismutase 2 (SOD2), were higher in the chemoresistant cells than in their chemosensitive counterparts. Expression of epithelial mesenchymal transition (EMT) markers, stemness markers, including Nanog, Oct4, and CD133, and that of the drug transporter ATP binding cassette, subfamily G, member A2 (ABCG2) was also upregulated in 5-FUR PDAC cells. NRF2 knockdown reversed 5-FU resistance of PDAC cells via suppression of ABCG2 and HO-1. In summary, these data indicate that NRF2 is a potential target for resensitizing 5-FUR PDAC cells to 5-FU to improve treatment outcomes in patients with pancreatic cancer