This study aimed to investigate the effects of vitamin and antioxidant supplements in the prevention of bladder cancer using a meta-analysis of randomized controlled trials (RCTs). Fourteen RCTs were included in the final analysis. In a fixed-effect meta-analysis, vitamin and antioxidant supplements showed no preventive effect for bladder cancer (relative risk [RR] = 1.04; 95% confidence interval [CI] 0.92–1.17; I² = 39.7%). Also, there was no preventive effect of these supplements in the subgroup meta-analyses by various factors such as type of supplements, type of cancer prevention, methodological quality, providers of supplements, type of control group, and number of participants. Among the subgroup analyses by type of supplements, beta-carotene supplementation alone marginally increased the risk of bladder cancer (RR = 1.44; 95% CI 1.00–2.09; I² = 0.0%; n = 3). The current meta-analysis found that vitamin and antioxidant supplements have no preventive effect against bladder cancer.

PURPOSE: To correlate the value of contrast-enhanced ultrasound (CEUS) with prognostic factors of breast cancer. MATERIALS AND METHODS: 24 breast cancer patients were evaluated with CEUS. As a quantitative analysis, the peak enhancement (PE), wash-in and wash-out area under curve (WiWoAUC), wash-in rate (WiR) and wash-out rate, rise time, fall time, mean transit time, time to peak, and wash-in perfusion index (WiPI) were measured. As a qualitative analysis, the enhancement patterns were evaluated. Pathologic prognostic factors, including histologic grade, hormonal receptors and Ki-67 proliferative index were assessed by immunohistochemistry. Correlation of quantitative and qualitative parameters of CEUS with prognostic factors was assessed. RESULTS: We found that the quantitative CEUS values (PE, WiWoAUC, and WiPI) of estrogen receptor (ER) positive breast cancer were higher than those of ER negative counterpart (all p < 0.05). Lower quantitative CEUS values (PE, WiWoAUC, WiR, and WiPI) were found in triple-negative cancer (TNC) than those of non-TNC (all p < 0.05). No CEUS parameter showed significant difference in distinguishing histologic grade (all p > 0.05). CONCLUSION The CEUS parameters were helpful in predicting prognostic factors, such as ER positivity or triple negativity. However, they could not predict the histologic grade.

This study was conducted to assess the nutrient intake patterns among urban and rural adolescents and to investigate the effects due to parent's socioeconomic status and other factors, such as mother's job, family type and regular exercise on that pattern. 2,455 middle and high school students living in Seoul and Yangpong, Kyounffi-Do participated in a self-administered questionnaire that was used to collect data. The one-day dietary intake was surveyed through a 24-hour recall method. The factors significantly different between urban and rural adolescents according to monthly income, parent's education level, mother's job, family type and exercise. Income, the parents' education level and regular exercise were associated with the patterns of nutrient intakes as a percent of the RDA. So, when adjusted for parental income, the father's and mother's education level and regular exercise, there were no signifcant differences within the patterns of nutritional intake between urban and rural adolescents. The results provided the information regarding the determinants of nutrient status among adolescents and were expected to be helpful for planning school health promotion programs.
Adolescent* ; Education ; Humans ; Parents* ; School Health Services ; Seoul ; Social Class* ; Surveys and Questionnaires

BACKGROUND/AIMS: Proton pump inhibitor-responsive esophageal eosinophilia (PPI-REE) is a newly recognized form of eosinophilic esophagitis (EoE) that responds to PPI therapy. It remains unclear whether PPI-REE represents a subphenotype of gastroesophageal reflux disease, a subphenotype of EoE, or its own distinct entity. The aim was to evaluate the clinicopathologic features of PPI-REE. METHODS: Six patients were diagnosed with PPI-REE based on symptoms, endoscopic abnormalities, esophageal eosinophilia with > or =15 eosinophils/high-power field, and a response to PPI treatment. Symptoms and endoscopic and pathological findings were evaluated. RESULTS: The median follow-up duration was 12 months. Presenting symptoms included dysphagia, heartburn, chest pain, foreign body sensation, acid reflux, and sore throat. All patients had typical endoscopic findings of EoE such as esophageal rings, linear furrows, nodularity, and whitish plaques. Three patients had a concomitant allergic disorder, and one had reflux esophagitis. Four patients exhibited elevated serum IgE, and five had positive skin prick tests. All patients experienced symptomatic resolution within 4 weeks and histologic resolution within 8 weeks after starting PPI therapy. There was no symptomatic recurrence. CONCLUSIONS: PPI therapy induced rapid resolution of symptoms and eosinophil counts in patients with PPI-REE. Large-scale studies with long-term follow-up are warranted.
Adult ; Asian Continental Ancestry Group ; Chest Pain/etiology ; Deglutition Disorders/etiology ; Diagnosis, Differential ; Eosinophilic Esophagitis/complications/*drug therapy/*pathology ; Esophagus/pathology ; Female ; Follow-Up Studies ; Gastroesophageal Reflux/etiology ; Heartburn/etiology ; Humans ; Male ; Middle Aged ; Pharyngitis/etiology ; Phenotype ; Proton Pump Inhibitors/*therapeutic use ; Republic of Korea ; Retrospective Studies ; Sensation Disorders/etiology ; Treatment Outcome ; Young Adult

OBJECTIVE: To determine the diagnostic performance of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and DCE ultrasound (DCE-US) for predicting response to neoadjuvant chemotherapy (NAC) in breast cancer patients. MATERIALS AND METHODS: This Institutional Review Board-approved prospective study was performed between 2014 and 2016. Thirty-nine women with breast cancer underwent DCE-US and DCE-MRI before the NAC, follow-up DCE-US after the first cycle of NAC, and follow-up DCE-MRI after the second cycle of NAC. DCE-MRI parameters (transfer constant [Ktrans], reverse constant [kep], and leakage space [Ve]) were assessed with histograms. From DCE-US, peak-enhancement, the area under the curve, wash-in rate, wash-out rate, time to peak, and rise time (RT) were obtained. After surgery, all the imaging parameters and their changes were compared with histopathologic response using the Miller-Payne Grading (MPG) system. Data from minor and good responders were compared using Wilcoxon rank sum test, chi-square test, or Fisher's exact test. Receiver operating characteristic curve analysis was used for assessing diagnostic performance to predict good response. RESULTS: Twelve patients (30.8%) showed a good response (MPG 4 or 5) and 27 (69.2%) showed a minor response (MPG 1–3). The mean, 25th, 50th, and 75th percentiles of Ktrans and Kep of post-NAC DCE-MRI differed between the two groups. These parameters showed fair to good diagnostic performance for the prediction of response to NAC (AUC 0.76–0.81, p ≤ 0.007). Among DCE-US parameters, the percentage change in RT showed fair prediction (AUC 0.71, p = 0.023). CONCLUSION: Quantitative analysis of DCE-MRI and DCE-US was helpful for early prediction of response to NAC.
Breast Neoplasms* ; Breast* ; Drug Therapy* ; Female ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging* ; Prospective Studies ; ROC Curve ; Ultrasonography*

Ultraviolet (UV) irradiation reduces epidermal hydration, which is paralleled by the reduction of natural moisturizing factors (NMFs). Of various NMFs, free amino acids (AAs) are major constituents generated by filaggrin degradation. In this study, we attempted to determine whether dietary supplementation of royal jelly (RJ) in UV-irradiated mice can alters epidermal levels of hydration, filaggrins, and free AAs as well as of peptidylarginine deiminase-3 (PAD3), an enzyme involved in filaggrin degradation processes. Albino hairless mice were fed either a control diet (group UV+: UV irradiated control) or diets with 1% RJ harvested from different areas in Korea (groups RJ1, RJ2, and RJ3) or imported from China (group RJ4) for six weeks in parallel with UV irradiation. A normal control group (group UV-) was fed a control diet without UV irradiation for six weeks. Reduced epidermal levels of hydration, total filaggrins, and PAD3 were observed in group UV+; in group RJ1, these levels were increased to a level similar to that of group UV-. In addition, profilaggrins, two repeat intermediates (2RI), a precursor with two filaggrin repeats, and filaggrin were increased. Although no alteration of AAs was observed in any of the groups, and glutamate and serine, major AAs of NMF in group RJ1 were higher than in group UV+. Despite the increased levels of PAD3, epidermal levels of hydration, filaggrins, glutamate, and serine in groups RJ2, RJ3, and RJ4 were similar to those in group UV+. Dietary supplementation of RJ1 improves epidermal hydration in parallel with enhanced expression and degradation of filaggrin, but not by increased protein expression of PAD3, along with increased generation of glutamate and serine.
Amino Acids ; Animals ; China ; Diet ; Dietary Supplements ; Fatty Acids ; Glutamic Acid ; Intermediate Filament Proteins ; Korea ; Mice ; Mice, Hairless ; Serine

OBJECTIVES: Gastric resection may predispose gallstone formation. However, the mechanism has not been clearly understood. To evaluate the relationship between gastric resection and gallstone formation, we compared gallbladder(GB) motility in gastrectomized patients and control subjects. METHODS: We compared the GB volume and ejection fraction of the 46 gastrectomized patients with 37 healthy controls using real time ultrasonography. RESULTS: GB volume increased significantly in the gastrectomized group in fasting (30.2 13.9 ml). The GB volume after a fatty meal was greater in the gastrectomized group (12.6 6.4 ml) than in the control group (4.3 3.3 ml) (p +ADw- 0.01). A significant reduction of ejection fraction was found in gastrectomized patients (56.9 13.0+ACU-) in comparison with the control group (75.5 16.1+ACU-) (p +ADw- 0.01). The GB ejection fraction had a poor correlation to the postoperative period (r +AD0- 0.232). CONCLUSION: A gastrectomy appears to be a risk factor of GB dysmotility, which may play a major role in gallstone formation in gastrectomized patients.
Adult ; Aged ; Cholelithiasis/ultrasonography ; Cholelithiasis/etiology+ACo- ; Comparative Study ; Eating ; Endosonography ; Fasting ; Female ; Gallbladder/ultrasonography ; Gallbladder/physiopathology+ACo- ; Gallbladder Emptying ; Gastrectomy/adverse effects+ACo- ; Gastrointestinal Motility ; Human ; Male ; Middle Age ; Probability ; Prospective Studies ; Reference Values ; Risk Assessment ; Stomach Neoplasms/surgery+ACo-

Currently, proton pump inhibitors are used in a wide range of patients with gastroesophageal reflux disease, peptic ulcer, and upper gastrointestinal symptoms such as dyspepsia. In addition, the application of proton pump inhibitors for prevention of gastrointestinal complications induced by non-steroidal anti-inflammatory drugs is expected to increase their use in the future. The use of proton pump inhibitors promotes bacterial growth by reducing gastric acid concentration. If the acidity (pH) of the stomach fluid is lower than 4, most pathogens can be sterilized. However, patients who need to use a proton pump inhibitor should maintain a gastric acidity of at least 5 or 6, and can be at risk of infections such as pneumonia and Clostridium difficile infection. Several infectious diseases associated with the use of proton pump inhibitors were reviewed.
Bacterial Infections* ; Clostridium difficile ; Communicable Diseases ; Dyspepsia ; Gastric Acid ; Gastroesophageal Reflux ; Humans ; Peptic Ulcer ; Pneumonia ; Proton Pump Inhibitors ; Proton Pumps* ; Protons* ; Stomach

BACKGROUND/AIMS: Eosinophilic esophagitis (EoE) is a chronic inflammatory disorder of the esophagus. Similar to asthma, EoE can induce irreversible structural changes in the esophagus as a result of chronic and persistent eosinophilic inflammation. The aim of this study was to analyse changes in symptoms, eosinophil counts and endoscopic findings after treatment. METHODS: Nine patients with EoE (6 men and 3 women; mean age, 36.44 years) were diagnosed with EoE based on typical symptoms, endoscopic abnormalities and infiltration of the esophageal epithelium with > or = 15 eosinophils/high-power field. The average endoscopic follow-up period was 10 months, ranging from 1 to 25 months. Symptoms and endoscopic and pathological findings at initial observation and follow-up were evaluated. RESULTS: Seven of the 9 patients had dysphagia symptoms, which improved in 4 of 6 patients who were treated with proton pump inhibitor. Two patients were unresponsive to proton pump inhibitor and another 2 patients were treated with corticosteroid, which led to symptomatic relief. In 8 patients, esophageal eosinophilia was improved histologically at follow-up after treatment. Six of the 9 patients had typical endoscopic findings of EoE at initial examination. Despite treatment, these findings remained in 5 of the 6 patients at follow-up endoscopy. CONCLUSIONS: After treatment, the symptoms and eosinophil counts were temporarily improved, but the endoscopic findings of EoE were generally not improved. This indicates that deformity of esophageal structure due to eosinophilic inflammation might be irreversible despite proper management.
Asthma ; Congenital Abnormalities ; Deglutition Disorders ; Endoscopy ; Eosinophilia ; Eosinophilic Esophagitis ; Eosinophils ; Epithelium ; Esophagus ; Follow-Up Studies ; Humans ; Inflammation ; Male ; Proton Pumps

BACKGROUND: Nausea and vomiting are predominant accompanying symptoms of migraine attacks. Although the underlying mechanism is not yet clear, gastric stasis is assumed to be the main factor. However, few studies have used direct methods to establish delayed gastric emptying of migraine patients. We compared interictal gastric motility between migraine patients and normal controls with the aid of gastric scintigraphy. METHODS: The study population comprised patients who had been diagnosed with episodic migraine, according to the International Classification of Headache Disorders, edition II. The entire study population was completely free of gastrointestinal symptoms during the headache-free period. Gastric scintigraphy was performed to determine the time to half emptying (T 1/2) and the percentage of radioactive material remaining in the stomach (%RMR) at 30, 60, 90, and 120 min. RESULTS: Twenty-six migraine patients and 12 normal controls were recruited. The mean T 1/2 did not differ between the two groups (101.8 vs 95.2 min; p=0.432). The %RMR values in the stomach at 30, 60, 90, and 120 min also did not differ significantly between the two groups [87.5% vs 88% (p=0.900), 70.8% vs 71.2% (p=0.950), 54.2% vs 53.3% (p=0.753), and 39.0% vs 37.3% (p=0.583), respectively]. CONCLUSIONS: There is no gastric stasis in patients with episodic migraine during headache-free periods. Our results suggest that the main mechanism underlying the nausea and vomiting in migraine patients is not a gastric stasis in interictal periods, but rather a central process, as a result of changes occurring in the brainstem during acute migraine attacks.
Brain Stem ; Gastric Emptying ; Gastroparesis ; Headache Disorders ; Humans ; Migraine Disorders ; Nausea ; Stomach ; Vomiting