Irritable bowel syndrome (IBS) is a chronic, disabling, and functional bowel disorder that significantly affects social functioning and reduces quality of life and increases social costs. The Korean Society of Neurogastroenterology and Motility published clinical practice guidelines on the management of IBS based on a systematic review of the literature in 2017, and planned to revise these guidelines in light of new evidence on the pathophysiology, diagnosis, and management of IBS. The current revised version of the guidelines is consistent with the previous version and targets adults diagnosed with or suspected of having IBS. These guidelines were developed using a combination of de novo and adaptation methods, with analyses of existing guidelines and discussions within the committee, leading to the identification of key clinical questions. Finally, the guidelines consisted of 22 recommendations, including 3 concerning the definition and risk factors of IBS, 4 regarding diagnostic modalities and strategies, 2 regarding general management, and 13 regarding medical treatment. For each statement, the advantages, disadvantages, and precautions were thoroughly detailed. The modified Delphi method was used to achieve expert consensus to adopt the core recommendations of the guidelines. These guidelines serve as a reference for clinicians (including primary care physicians, general healthcare providers, medical students, residents, and other healthcare professionals) and patients, helping them to make informed decisions regarding IBS management.

Irritable bowel syndrome (IBS) is a chronic, disabling, and functional bowel disorder that significantly affects social functioning and reduces quality of life and increases social costs. The Korean Society of Neurogastroenterology and Motility published clinical practice guidelines on the management of IBS based on a systematic review of the literature in 2017, and planned to revise these guidelines in light of new evidence on the pathophysiology, diagnosis, and management of IBS. The current revised version of the guidelines is consistent with the previous version and targets adults diagnosed with or suspected of having IBS. These guidelines were developed using a combination of de novo and adaptation methods, with analyses of existing guidelines and discussions within the committee, leading to the identification of key clinical questions. Finally, the guidelines consisted of 22 recommendations, including 3 concerning the definition and risk factors of IBS, 4 regarding diagnostic modalities and strategies, 2 regarding general management, and 13 regarding medical treatment. For each statement, the advantages, disadvantages, and precautions were thoroughly detailed. The modified Delphi method was used to achieve expert consensus to adopt the core recommendations of the guidelines. These guidelines serve as a reference for clinicians (including primary care physicians, general healthcare providers, medical students, residents, and other healthcare professionals) and patients, helping them to make informed decisions regarding IBS management.

Irritable bowel syndrome (IBS) is a chronic, disabling, and functional bowel disorder that significantly affects social functioning and reduces quality of life and increases social costs. The Korean Society of Neurogastroenterology and Motility published clinical practice guidelines on the management of IBS based on a systematic review of the literature in 2017, and planned to revise these guidelines in light of new evidence on the pathophysiology, diagnosis, and management of IBS. The current revised version of the guidelines is consistent with the previous version and targets adults diagnosed with or suspected of having IBS. These guidelines were developed using a combination of de novo and adaptation methods, with analyses of existing guidelines and discussions within the committee, leading to the identification of key clinical questions. Finally, the guidelines consisted of 22 recommendations, including 3 concerning the definition and risk factors of IBS, 4 regarding diagnostic modalities and strategies, 2 regarding general management, and 13 regarding medical treatment. For each statement, the advantages, disadvantages, and precautions were thoroughly detailed. The modified Delphi method was used to achieve expert consensus to adopt the core recommendations of the guidelines. These guidelines serve as a reference for clinicians (including primary care physicians, general healthcare providers, medical students, residents, and other healthcare professionals) and patients, helping them to make informed decisions regarding IBS management.

OBJECTIVES: There is a great deal of interest in the possibility that environmental factors may influence the risk of developing allergic rhinitis (AR) in early life. We investigated the simultaneous effects of mode of delivery and duration of breastfeeding on the development of AR in children. METHODS: Data from 1,374 children participating in the Allergic Rhinitis Cohort Study for kids (ARCO-kids study) was analyzed. All subjects were divided into AR or non-allergic rhinitis (NAR) groups. Data on environmental factors, mode of delivery and duration of breastfeeding were collected using a questionnaire. RESULTS: Compared with short-term breastfeeding (<6 months), long-term breastfeeding (≥12 months) was significantly associated with a lower prevalence of AR (adjusted odds ratio [aOR], 0.54; 95% confidence interval [CI], 0.34 to 0.88). Children in the AR group also had a higher cesarean delivery rate than those in the NAR group (39.1% vs. 32.8%, P=0.05). Regarding the combined effects of mode of delivery and duration of breastfeeding, long-term breastfeeding with a vaginal delivery strongly suppressed the development of AR, compared to short-term breastfeeding with a cesarean delivery (aOR, 0.47; 95% CI, 0.30 to 0.73). CONCLUSION: Long-term breastfeeding (≥12 months) and a vaginal delivery are associated with a lower risk of developing childhood AR.
Breast Feeding ; Cesarean Section ; Child ; Cohort Studies ; Delivery, Obstetric ; Female ; Humans ; Odds Ratio ; Pregnancy ; Prevalence ; Rhinitis ; Rhinitis, Allergic

We estimated the effect of various immunosuppressants (ISs) and metformin (M) to provide theoretical background of optimal therapeutic strategy for de novo colon cancer after liver transplantation (LT). Three colon cancer cell lines (HT29, SW620, and HCT116) were used in in vitro studies. HT29 was also used in BALB/c-nude mice animal models. Following groups were used in both in vitro and in vivo studies: sirolimus (S), tacrolimus (T), cyclosporin A (CsA), M, metformin/sirolimus (Met/S), metformin/tacrolimus (Met/T), and metformin/cyclosporin A (Met/CsA). 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay was performed and western blot analyses were performed for mTOR pathway proteins, apoptosis proteins, and epithelial-mesenchymal-transition (EMT) proteins. Tumor volume was measured for 4 weeks after inoculation. MTT-assay revealed significant cell viability inhibition in all 3 colon cancer cell lines in groups of S, M, and Met/S. Of note, group Met/S showed synergistic effect compare to M or S group. Western blot analysis showed significant low levels of all investigated proteins in groups of S and Met/S in both in vitro and in vivo experiment. Tumor growth was significantly inhibited only in the Met/S group. Combination of Met and S showed the most potent inhibition in all colon cancer cell lines. This finding might have application for de novo colon cancer.
Animals ; Apoptosis ; Blotting, Western ; Cell Line ; Cell Survival ; Colon* ; Colonic Neoplasms* ; Cyclosporine ; Immunosuppression ; Immunosuppressive Agents ; In Vitro Techniques* ; Liver Transplantation ; Metformin* ; Mice ; Models, Animal ; Sirolimus* ; Tacrolimus ; Tumor Burden

PURPOSE: The aim of this study was to investigate the anti-inflammatory effects of a new herbal formula (WSY-1075) in a nonbacterial prostatitis rat model. MATERIALS AND METHODS: Prostatitis was induced in male Wistar rats (n=32) by treatment with 17 beta-estradiol and dihydrotestosterone for 4 weeks. After the induction of prostatitis, the rats were randomly divided into one of four treatment groups: control (n=8), ciprofloxacin (n=8), WSY-1075 (100 mg/kg) (n=8), and WSY-1075 (400 mg/kg) (n=8). After 4 weeks of treatment, the prostatic proinflammatory cytokine (tumor necrosis factor-alpha, interleukin [IL]-6, and IL-8) levels and histological findings were noted. RESULTS: The ciprofloxacin and WSY-1075 treatment groups showed significantly decreased proinflammatory cytokine levels compared with the control group. Histologically, treatment with ciprofloxacin and WSY-1075 significantly suppressed the severity of prostatitis lesions compared with those in the control group. No differences in the proinflammatory cytokine levels or histologic findings were observed with the dose dependent treatment of WSY-1075. CONCLUSIONS: The new herbal formula, WSY-1075, showed effective anti-inflammatory activities in the prostate and may be useful for the clinical treatment of nonbacterial prostatitis. Our findings suggest that WSY-1075 has a beneficial effect on the prevention and treatment of nonbacterial prostatitis.
Animals ; Ciprofloxacin ; Dihydrotestosterone ; Estradiol ; Humans ; Inflammation ; Interleukins ; Male ; Prostate ; Prostatitis ; Rats ; Rats, Wistar

OBJECTIVE: To evaluate the diagnostic accuracy of a new ultrasound (US) classification system for differentiating between benign and malignant solid thyroid nodules. MATERIALS AND METHODS: In this study, we enrolled 191 consecutive patients who received real-time US and subsequent US diagnoses for solid thyroid nodules, and underwent US-guided fine-needle aspiration. Each thyroid nodule was prospectively classified into 1 of 5 diagnostic categories by real-time US: "malignant," "suspicious for malignancy," "borderline," "probably benign," and "benign". We evaluated the diagnostic accuracy of thyroid US and the cut-off US criteria by comparing the US diagnoses of thyroid nodules with cytopathologic results. RESULTS: Of the 191 solid nodules, 103 were subjected to thyroid surgery. US categories for these 191 nodules were malignant (n = 52), suspicious for malignancy (n = 16), borderline (n = 23), probably benign (n = 18), and benign (n = 82). A receiver-operating characteristic curve analysis revealed that the US diagnosis for solid thyroid nodules using the 5-category US classification system was very good. The sensitivity, specificity, positive and negative predictive values, and accuracy of US diagnosis were 86%, 95%, 91%, 92%, and 92%, respectively, when benign, probably benign, and borderline categories were collectively classified as benign (negative). CONCLUSION: The diagnostic accuracy of thyroid US for solid thyroid nodules is high when the above-mentioned US classification system is applied.
Biopsy, Fine-Needle ; Cytodiagnosis ; Diagnosis, Differential ; Female ; Humans ; Male ; Middle Aged ; Predictive Value of Tests ; Sensitivity and Specificity ; Thyroid Neoplasms/classification/congenital/pathology/*ultrasonography ; Thyroid Nodule/classification/pathology/*ultrasonography ; Ultrasonography, Interventional

Background: DNA prevalence and type distribution of human papillomavirus (HPV) varies geographically. We investigated HPV prevalence and type distribution in Korean women using the MyHPV DNA chip testing. Methods: A total of 2,368 women from five regions of the country underwent Pap smear examination and MyHPV chip testing. Results: Overall HPV positivity was 15.8% and 78.4% in women with normal and abnormal cytology, respectively. High-risk HPV infection was strongly correlated with cytological atypia. In women with abnormal cytology, the five most common HPV types were 16, 58, 18, 52, and 56/53, and HPV16 was significantly the most common type in most geographical regions. After HPV16, HPV58, and 52 were the next most frequently detected types. Women with normal cytology, in contrast, showed heterogeneity in HPV type distribution. High-grade intraepithelial lesions infected with HPV16, 18, 31 or 45 are more likely to progress to carcinoma. Conclusions: The HPV chip test can provide useful data regarding HPV positivity and type. The most common HPV type in Korean women with abnormal cytology is HPV16, with HPV58 and 52 being frequently present. Our data may have important implications for vaccination programs and the development of cervical screening.
Cervix Uteri ; DNA ; Female ; Genotype ; Humans ; Mass Screening ; Oligonucleotide Array Sequence Analysis ; Population Characteristics ; Prevalence ; Republic of Korea ; Vaccination ; Vaginal Smears

PURPOSE: We evaluated the changes of the erectile function and histology of the corpus cavernosum in a rat model of metabolic syndrome. MATERIALS AND METHODS: We used male spontaneous hypertensive rats (SHRs) as an experimental group (n=6) and Wistar-Kyoto rats as a control group (n=6). The SHRs were fed with a high fat diet, but the Wistar-Kyoto rats were fed with a normal fat diet for 12 weeks. All the groups were then checked for body weight and various biochemiclal parameters. To investigate penile erection, the intracavernosal pressure (ICP), mean arterial pressure (MAP) and cGMP level of the corpus cavernosum were recorded for all the groups. Serial sections of the penis were used to perform Masson's trichrome staining and immunohistochemistry for determining the TGF-beta 1 expression. RESULTS: We confirmed that metabolic syndrome was induced in the experimental group by the significant difference of the various biochemical parameters. (ED note: For the results of erectile function? This wasn't clear.)As a result of erectile function, the ICP/MAP ratios were checked as 51.0+/-7.5% and 31.0+/-5.5%, respectively, for the control and experimental groups. So the ICP/MAP ratio of the latter was markedly decreased compared with the former and the cGMP level of the corpus cavernosum was the same for both groups. On Masson's trichrome staining, the number of smooth muscle cell was decreased and the collagen fibers with an irregular, distorted arrangement were increased in the experimental group. The immunoreactivity for TGF-beta 1 tended to increase in the experimental group. These histological findings revealed that fibrosis of the corpus cavernosum occurred in the experimental group. CONCLUSIONS: Our results demonstrate that metabolic syndrome is harmful to erectile function and it leads to histological changes of the corpus cavernosum according to a rat model of metabolic syndrome.
Animals ; Arterial Pressure ; Body Weight ; Collagen ; Diet ; Diet, High-Fat ; Erectile Dysfunction ; Fibrosis ; Humans ; Immunohistochemistry ; Male ; Myocytes, Smooth Muscle ; Penile Erection ; Penis ; Rats ; Transforming Growth Factor beta

PURPOSE: We evaluated the changes of storage symptoms after tension-free vaginal tape(TVT) procedures in stress urinary incontinence(SUI) patients, and we investigated the factors predicting the changes of storage symptoms. MATERIALS AND METHODS: From January 2000 to August 2003, 713 patients with SUI were operated on with using suburethral sling procedures(TVT). A follow-up study was conducted for over a one year period with 495 patients. We analyzed the one year outcomes of TVT surgeries and the changes of storage symptoms after TVT. RESULTS: The rates of cure and improvements at one year after TVT were 80.8% and 12.3%, respectively. At one month after TVT, 59 of 180(33%) patients with urgency before TVT were improved, and 60 of 72(83.6%) patients with urgency incontinence before TVT were improved. In 86 of 180(47.8%) patients, the urgency is improved, and in 65 of 72(90.1%) patients, the urgency incontinence disappeared at one year after TVT procedure. Urgency developed in 65 of the 243(26.9%) patients who had no urgency before TVT, but after 1 year, only 28(10.2%, 25/243) these 243 patients had urgency. 102(31.6%) of the patients with frequency before TVT were improved after TVT. Of the 92 patients with nocturia, 22 (23.4%) patients were improved. There were no statically significant factors predicting the changes of the storage symptoms. CONCLUSIONS: The total improvement rate (cure+improvements) of stress urinary incontinence was 93.1% at one year. We can expect the improvement of urgency(47.1%) and urgency incontinence(90.1%) after TVT procedures, but not improvement of the frequency and nocturia.
Follow-Up Studies ; Humans ; Nocturia ; Suburethral Slings* ; Urinary Bladder, Overactive ; Urinary Incontinence* ; Urinary Incontinence, Urge