Background/Aims: We aimed to assess the role of vitamin D supplementation in the response to pegylated interferon-α (PEG-IFN-α) plus ribavirin (RBV) treatment in patients with chronic hepatitis C (CHC). Methods: Our study was a multi-center, randomized controlled trial in 11 hospitals. CHC patients were randomly assigned (1:1) to two groups namely, PEGIFN-α plus RBV (control group) or PEG-IFN-α plus RBV + vitamin D (800 IU daily) (vitamin D group). The primary end-point was the rate of sustained virologic response (SVR). Results: One hundred forty eight CHC patients were randomly assigned to two groups. Seventy-one patients received the PEG-IFN-α plus RBV and 77 patients received the PEG-IFN-α plus RBV + vitamin D. A total of 105 patients completed the study (control group, 47 vs. vitamin D group, 58). Baseline characteristics were mostly similar in both the groups. There was a modest but non-significant increase in SVR in the vitamin D group compared to the control group with the intention to treat analysis (64.0% vs. 49.3 %, p = 0.071) as well as in the per protocol analysis (control group vs. vitamin D group: 74.5% vs. 84.5%, p = 0.202). Fifty-two patients (73.2%) in the control group and 63 patients (81.8%) in the vitamin D group experienced at least one adverse event. The drop-out rate due to adverseeffects was not different between both groups (control group vs. vitamin D group: 19.7% vs. 10.4%, p = 0.111). Conclusions Vitamin D supplement did not increase SVR in treatment naïve patients with CHC irrespective of genotype.

BackgroundUntil now, various types of combined therapy with nucleotide analogs and pegylated interferon (Peg-INF) in patients with hepatitis B patients have been tried. However, studies regarding the benefits of de novo combination, late-add on, and sequential treatment are very limited. The objective of the current study was to identify the efficacy of sequential treatment of Peg-INF after short-term antiviral treatment.

MethodsBetween June 2010 and June 2015, hepatitis B e antigen (HBeAg)-positive patients (n = 162) received Peg-IFN for 48 weeks (mono-treatment group, n = 81) and entecavir (ETV) for 12 weeks with a 48-week course of Peg-IFN starting at week 5 of ETV therapy (sequential treatment group, n = 81). The primary endpoint was HBeAg seroconversion at the end of follow-up period after the 24-week treatment. The primary endpoint was analyzed using Chi-square test, Fisher's exact test, and regression analysis.

ResultsHBeAg seroconversion rate (18.2% vs. 18.2%, t = 0.03, P = 1.000) and seroclearance rate (19.7% vs. 19.7%, t = 0.03, P = 1.000) were same in both mono-treatment and sequential treatment groups. The rate of alanine aminotransferase (ALT) normalization (45.5% vs. 54.5%, t = 1.12, P = 0.296) and serum hepatitis B virus (HBV)-DNA <2000 U/L (28.8% vs. 28.8%, t = 0.10, P = 1.000) was not different in sequential and mono-treatment groups at 24 weeks of Peg-INF. Viral response rate (HBeAg seroconversion and serum HBV-DNA <2000 U/L) was not different in the two groups (12.1% vs. 16.7%, t = 1.83, P = 0.457). Baseline HBV-DNA level (7 logU/ml vs. 7.5 logU/ml, t = 1.70, P = 0.019) and hepatitis B surface antigen titer (3.6 logU/ml vs. 4.0 logU/ml, t = 2.19, P = 0.020) were lower and predictors of responder in mono-treatment and sequential treatment groups, respectively.

ConclusionsThe current study shows no differences in HBeAg seroconversion rate, ALT normalization, and HBV-DNA levels between mono-therapy and sequential therapy regimens.

Trial RegistrationClinicalTrials.gov, NCT01220596; https://clinicaltrials.gov/ct2/show/NCT01220596?term=NCT01220596&rank=1.

This study was designed to evaluate the efficacy of an orally administered aqueous extract of glutinous rice (GRE) to protect against acute gastric mucosal lesions induced by ethanol, indomethacin, and water immersion restraint stress in rats and to characterize the active substances responsible for the protection. GRE was shown to dose-dependently prevent the gastric lesions induced by the above ulcerogenic treatments at doses of 30 to 300 mg/kg. GRE treatment increased the gastric mucin content and partially blocked the ethanol-induced depletion of the gastric mucus layer. Also, it increased the nonprotein sulfhydryl concentration in the gastric mucosa. The gastroprotective action of GRE was markedly enhanced by co-treatment with 4-8 mg/kg tea extracts. The activity of GRE was completely lost by heat treatment at 80degrees C for 3 min or treatment with 0.01% pepsin at 37degrees C for 1 h. Protein extraction studies indicated that prolamins are involved in the gastroprotective activity of GRE. Our results suggest that glutinous rice proteins are useful for the prevention and treatment of gastritis and peptic ulcer.
Animals ; Ethanol ; Gastric Mucins ; Gastric Mucosa ; Gastritis ; Hot Temperature ; Immersion ; Indomethacin ; Mucus ; Pepsin A ; Peptic Ulcer ; Prolamins ; Rats ; Tea ; Ulcer ; Water

This was designed to assess the outcomes of side branch (SB) stenosis after implantation of three drug-eluting stents (DES). From 2,645 patients in the ZEST (Comparison of the Efficacy and Safety of Zotarolimus-Eluting Stent with Sirolimus-Eluting and PacliTaxel-Eluting Stent for Coronary Lesions) Trial, 788 patients had 923 bifurcation lesions with SB > or = 1.5 mm were included. SB was treated in 150 lesions, including 35 (3.8%) receiving SB stenting. Of untreated SB with baseline stenosis < 50%, the incidences of periprocedural SB compromise was similar in the zotarolimus (15.8%), sirolimus (17.2%), and paclitaxel (16.6%) stent groups (P = 0.92). At follow-up angiography, delayed SB compromise occurred in 13.9%, 3.2%, and 9.4% (P = 0.010) of these groups. When classified into four groups (< 50%, 50%-70%, 70%-99%, and 100%), 9.0% of untreated SB were worsened, whereas improvement and stationary were observed in 9.6% and 81.4%. In a multivariable logistic regression model, main branch (MB) stenosis at follow-up (%) was the only independent predictor of SB stenosis worsening (odds ratio, 1.03; 95% confidence interval, 1.01-1.04; P < 0.001). After MB stenting in bifurcation lesions, a minority of SB appears to worsen. DES with strong anti-restenotic efficacy may help maintain SB patency.
Acute Disease ; Aged ; Blood Vessels/physiopathology ; Cardiovascular Agents/*therapeutic use ; Coronary Angiography ; Coronary Stenosis/*drug therapy/physiopathology/radiography ; Drug-Eluting Stents/*adverse effects ; Female ; Follow-Up Studies ; Humans ; Logistic Models ; Male ; Middle Aged ; Myocardial Infarction/etiology/radiography ; Myocardial Revascularization ; Odds Ratio ; Paclitaxel/*therapeutic use ; Predictive Value of Tests ; Sirolimus/*analogs & derivatives/*therapeutic use ; Thrombosis/etiology ; Treatment Outcome

OBJECTIVE: To evaluate their roles in the pathophysiology of preterm premature rupture of membranes (PPROM), we checked interleukin (IL)-6, lipid peroxide, oxygen-radical absorbance capacity (ORAC) and antioxidant vitamin in the venous plasma and amniotic fluid of women with PPROM. METHODS: Venous plasma and amniotic fluid was taken from 20 normal pregnant women and 20 PPROM pregnancy women. IL-6 levels was determined by enzyme-linked immunosorbent assay. Lipid peroxide levels were measured by thiobarbituric acid reaction. The ORAC levels and the antioxidant levels were measured by Cao's method and by high performance liquid chromatography. RESULTS: The IL-6 levels in the venous plasma and amniotic fluid of PPROM pregnancy women were significantly higher than normal pregancy (P<0.01, P<0.01). The lipid peroxide levels in the venous plasma and amniotic fluid of PPROM pregnancy women were significantly higher than normal pregancy (P<0.01, P<0.01). The ORAC values in the venous plasma and amniotic fluid of PPROM pregnancy women were significantly higher than normal pregancy (P<0.01, P<0.01). The ORAC values/lipid peroxide levels in the venous plasma and amniotic fluid of PPROM pregnancy women were significantly higher than normal pregancy (P<0.01, P<0.01). The ascorbic acid levels in the venous plasma and amniotic fluid of PPROM pregnancy women were significantly higher than normal pregancy (P<0.05, P<0.01). CONCLUSION: This result suggest that the increased inflammatory bioactivity, increased lipid peroxidation and decreased antioxidant activity may be involved in the pathophysiology of PPROM. Low levels of ascorbic acid appears to be an important determinant of PPROM.
Amniotic Fluid ; Ascorbic Acid ; Chromatography, Liquid ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Interleukin-6 ; Interleukins ; Lipid Peroxidation ; Membranes ; Plasma ; Pregnancy ; Pregnant Women ; Rupture ; Thiobarbiturates ; Vitamins

OBJECTIVE: To investigate the lipid peroxide levels and protein carbonyls levels in the amniotic fluid of pregnant women with preterm premature rupture of membranes (PPROM). METHODS: The lipid peroxide levels in the amniotic fluid of normal pregnancy (n=20) and pregnant women with PPROM (n=20) were measured by thiobarbituric acid reaction. The protein carbonyl contents in the amniotic fluid of normal pregnancy (n=20) and pregnant women with PPROM (n=20) were determined by the 2,4-dinitrophenylhydrazine method. After amniotic fluid of them were mixed and incubated up to 5 hours with 0.2 mL of 1mM moxalactam, cefodizime, amoxacillin, erythromycin, the lipid peroxide levels and protein carbonyl contents in them were measured. RESULTS: 1. The lipid peroxide levels in the amniotic fluid of pregnant women with PPROM was significantly higher than that of normal pregnancy (9.74+/-0.48 vs. 7.20+/-0.38 nmol/mg protein, P<0.01). 2. The protein carbonyl levels in the amniotic fluid of pregnant women with PPROM was significantly higher than that of normal pregnancy (13.0+/-0.33 vs. 11.27+/-0.17 nmol/mg protein P<0.01). 3. The lipid peroxide levels and protein carbonyls formation by moxalactam in the amniotic fluid of pregnant women with PPROM was significantly higher than basal level (12.08+/-0.81 vs. 9.74+/-0.48 nmol/mg protein, 20.08+/-0.66 vs. 13.0+/-0.33 nmol/mg protein, P<0.01). 4. The lipid peroxide levels and protein carbonyls formation by cefodizime in the amniotic fluid of pregnant women with PPROM was significantly lower than basal level (5.04+/-0.33 vs. 9.74+/-0.48 nmol/mg protein, 9.76+/-0.35 vs. 13.0+/-0.33 nmol/mg protein, P<0.01). 5. There were no significant differences in the levels of lipid peroxide and protein carbonyls by amoxacillin and erythromycin in the amniotic fluid of pregnant women with PPROM between antibiotics-induced and basal levels. CONCLUSION: The lipid peroxidation and the protein carbonyls formation were increased in the amniotic fluid of pregnant women with PPROM. Antibiotics-induced lipid peroxide and protein carbonyl levels were changed in the amniotic fluid of pregnant women with PPROM. Further studies on our results may be beneficial in the selection of antibiotics for pregnant women with PPROM.
Amniotic Fluid ; Anti-Bacterial Agents ; Cefotaxime ; Erythromycin ; Female ; Humans ; Lipid Peroxidation ; Membranes ; Moxalactam ; Phenylhydrazines ; Pregnancy ; Pregnant Women ; Protein Carbonylation ; Rupture ; Thiobarbiturates

OBJECTIVE: To investigate and compare the amount of the lipid peroxidation and the protein carbonyls formation in maternal venous plasma of preterm premature rupture of membranes (PPROM) during antibiotics administration. METHODS: PPROM were selected between 25 and 32 weeks of gestation. Eighteen patients (group 1) were treated with amoxicillin and erythromycin for 7 day period, 18 patients (group 2) were treated with 3rd generation cephalosporin (cefodizime, cefditoren) and erythromycin for the same period. Maternal blood were obtained from the two groups before and after the antibiotics administration, day 3 and day 7. Lipid peroxidation levels and protein carbonyl contents were measured by thiobarbituric acid reaction and 2,4-dinitrophenyl hydrazine method. Other 18 women with normal pregnancy between 25 and 32 weeks of gestation of venous blood were checked same things in vitro. Interleukin (IL) -6 was measured by enzyme-linked immunosorbent assay. RESULTS: 1. The lipid peroxidation levels and protein carbonyls formation in the maternal venous plasma of PPROM was significantly higher than that of normal pregnancy (lipid peroxidation levels; 4.77+/-.36 vs 7.11+/-.41 nmol/mg protein, P<001, protein carbonyls formation; 3.55+/-.22 vs 5.69+/-.30 nmol/mg protein, P<001). 2. There were no significant differences in the lipid peroxidation levels and protein carbonyls formation of the maternal venous plasma with PPROM mixed and incubated by amoxicillin, cefodizime, cefditoren, and erythromycin (in vitro). 3. There were no significant differences in the lipid peroxidation levels and protein carbonyls formation of the venous plasma of group 1 between before and after antibiotics administration, day 3 and day 7. 4. There were no significant differences in the lipid peroxide levels of the venous plasma of group 2 between before and after antibiotics administration, day 3 and day 7. 5. The protein carbonyls formation in the venous plasma of group 2 was significantly decreased at day 3 and day 7 after antibiotics administration than that of before (6.04+/-.44 and 5.53+/-.37 vs. 7.04+/-.51 nmol/mg protein, P<005). 6. The levels of IL-6 in the venous plasma of group 2 was significantly decreased at day 7 after antibiotics administration than that of before (7.50+/-.35 vs. 3.13+/-.37 pg/mL, P<005). CONCLUSION: In the maternal venous plasma of PPROM, the lipid peroxidation levels and protein carbonyls formation were increased. The formation of protein carbonyls and IL-6 in the maternal blood of PPROM was decreased by combined treatment of 3rd generation cephalosporin and erythromycin. The results suggest that reactive oxygen species formation by inflammatory reaction is suppressed by the 3rd generation cephalosporins and erythromycin combined treatment.
Amoxicillin ; Anti-Bacterial Agents ; Cefotaxime ; Cephalosporins ; Enzyme-Linked Immunosorbent Assay ; Erythromycin ; Female ; Humans ; Hydrazines ; Interleukin-6 ; Interleukins ; Lipid Peroxidation ; Membranes ; Plasma ; Pregnancy ; Reactive Oxygen Species ; Rupture ; Thiobarbiturates

OBJECTIVE: This controlled trial investigated the effect of supplementation with vitamins C and E on the lipid peroxide, antioxidant ability, and antioxidant vitamin levels in full term maternal and umbilical venous plasma. METHODS: Forty pregnant women were randomized in this study. They were nulliparous or multiparous women with history of preeclampsia or preterm premature rupture of membranes (PPROM). Twenty women were given vitamin C (1,000 mg/day) and vitamin E (400 IU/day) from 15~20 gestational weeks to delivery. The others were not given, as a control group. Maternal venous blood was obtained before vitamin supplementation and just before delivery. Umbilical venous blood was obtained after delivery. Lipid peroxide level and oxygen-radical absorbance capacity (ORAC) were measured by thiobarbituric acid reaction and Cao's method, respectively. Ascorbic acid, uric acid, beta-carotene, retinol, alpha-tocopherol, and gamma-tocopherol were measured by high performance liquid chromatography. Results: Supplementation with vitamins C and E was associated with decrease in lipid peroxide levels and increase in ORAC values and alpha-tocopherol levels in maternal venous plasma. And it was also associated with decrease in lipid peroxide levels and increase in ORAC values and alpha-tocopherol levels in umbilical venous plasma. CONCLUSION: Supplementation with vitamins C and E may be beneficial in the prevention of oxidant-antioxidant imbalance origin diseases such as preeclampsia, PPROM. And it also may affect antioxidant ability of the fetus.
alpha-Tocopherol ; Ascorbic Acid ; beta Carotene ; Female ; Fetus ; gamma-Tocopherol ; Humans ; Membranes ; Plasma ; Pre-Eclampsia ; Pregnant Women ; Rupture ; Thiobarbiturates ; Uric Acid ; Vitamin A ; Vitamin E ; Vitamins

PURPOSE:To investigate the change in the antioxidant vitamin levels in maternal uterine venous plasma (MUVP), amniotic fluid (AF), and chorioamnion after vitamin C and E supplementation during pregnancy. METHODS:Thirty pregnant women who were scheduled for elective cesarean section between 37 and 39 gestational weeks were randomized in this study. Fifteen women were given a daily oral dose of vitamin C 1,000 mg and vitamin E 400 IU from 33~34 gestational weeks to delivery. The other fifteen women were not given, as a control group. Maternal uterine venous blood, AF, and chorioamnion were obtained after cesarean section. Lipid peroxides and oxygen-radical absorbance capacity value were measured by thiobarbituric acid reaction and Cao's method respectively. Ascorbic acid, uric acid, beta-carotene, retinol, alpha-tocopherol, and gamma-tocopherol were measured by high performance liquid chromatography. The tissue sections of chorioamnion were stained with hematoxylin-eosin and Masson-trichrome stain, and immunohistochemical stain for collagen type IV was also performed. RESULTS:The lipid peroxide levels in MUVP of the study group were significantly lower than those of the control group but in contrast, ORAC (Oxygen-radical absorbance capacity) values were lower in the control group. The alpha-tocopherol levels in MUVP, AF, and chorioamnion study group were significantly higher than those of the control group. Amniotic membrane and subepithelial stromal tissue in the study group were thicker than those in the control group. And subchorionic type IV collagen of placenta tissue in the study group was more stained than that of the control group. CONCLUSION:Maternal vitamin C and E supplementation may be beneficial in the prevention of diseases caused by oxidative stress such as preeclampsia and PROM and in increasing fibrin and type IV collagen in chorioamnion.
alpha-Tocopherol ; Amnion ; Amniotic Fluid ; Ascorbic Acid ; beta Carotene ; Cesarean Section ; Chromatography, Liquid ; Collagen Type IV ; Female ; Fibrin ; gamma-Tocopherol ; Humans ; Lipid Peroxides ; Oxidative Stress ; Placenta ; Plasma ; Pre-Eclampsia ; Pregnancy ; Pregnant Women ; Thiobarbiturates ; Uric Acid ; Vitamin A ; Vitamin E ; Vitamins

OBJECTIVE: Our purpose was to investigate Interleukin-6 (IL-6), tumor necrotic factor-alpha (TNF-alpha), lipid peroxide levels, oxygen-radical absorbance capacity (ORAC), and antioxidant levels in umbilical venous blood plasma and to evaluate the roles of them in the pathophysiology of preeclampsia. STUDY DESIGN: Samples of umbilical venous plasma were obtained from 20 normal and 20 preeclamptic women between 33 and 40 weeks gestation. IL-6 and TNF-alpha was assayed by an enzyme-linked immunoassay. Lipid peroxide levels were measured by thiobarbituric acid reaction. The ORAC values were measured by Cao's method. Ascorbic acid, retinol, alpha-tocopherol, and gamma-tocopherol were measured by high performance liquid chromatography. RESULTS: There was no significant differences of IL-6 levels in umbilical venous plasma between women with normal and preeclampsia (2.79+/-0.21 vs. 2.94+/-0.17 ng/ml). TNF-alpha levels in umbilical venous plasma of women with preeclampsia were significantly higher than that of women with preeclampsia (3.04+/-0.01 vs. 1.40+/-0.01 ng/ml, p<0.01). Lipid peroxide levels in umbilical venous plasma of women with preeclampsia were significantly higher than that of women with normal pregnancy (7.32+/-0.09 vs. 5.18+/-0.14, p<0.01). The ORAC values in umbilical venous plasma of women with preeclampsia were significantly lower than that of women with normal pregnancy (12,836.5+/-249.4 vs. 10,490.2+/-276.9 U/ml, p<0.05). Ascorbic acid levels in umbilical venous plasma of women with preeclampsia were significantly lower than those of women with normal pregnancy (320.2+/-48.5 vs. 538.5+/-68.2 nmol/ml, p<0.05). CONCLUSION: The above results in umbilical venous plasma suggest that the imbalance of lipid peroxidation and antioxidant activity in placenta is involved in the pathophysiology of preeclampsia. Increased TNF-alpha in the umbilical venous plasma showed inflammatory reaction in the placenta would be one of the cause of preclampsia. An antioxidant vitamin, ascorbic acid, may act an important antioxidant factor in preeclampsia.
alpha-Tocopherol ; Ascorbic Acid ; Chromatography, Liquid ; Female ; gamma-Tocopherol ; Humans ; Immunoassay ; Interleukin-6* ; Lipid Peroxidation ; Placenta ; Plasma* ; Pre-Eclampsia* ; Pregnancy ; Tumor Necrosis Factor-alpha* ; Vitamin A ; Vitamins