The Role of Sex-specific Long Non-coding RNAs in Cancer Prevention and Therapy

The functions of a large number of non-coding genes in human DNA have yet to be accurately identified. Long non-coding RNA (lncRNA) measuring 10 kb or less in length regulates transcription or post-transcriptional events. The lncRNAs have attracted increased attention of researchers in recent years. In this review, we summarize the recently published lncRNAs which are known to influence cancer development and progression. We also discuss recent studies investigating tumor-specific lncRNA expression. These lncRNAs provide very useful information that allows prediction of the degree of malignancy and a survival rate in cancer patients as clinically relevant biomarkers. Because symptoms and progression of cancer differ from onset to death between males and females, it is important to consider the gender of the patient when diagnosing cancer and predicting the progression. Considering the importance of gender difference, we also examine the influence of sex hormones involved in the expression and regulation of lncRNAs as biomarkers. Many of the lncRNAs examined in this review have been studied in cancers occurring in the female or male reproductive organs, but the association between lncRNAs and sex hormones has also been reported in common organs such as the lung, renal and colon. Although lncRNAs have not yet been widely used as definitive cancer indicators, recent studies have demonstrated the potential role of lncRNAs as biomarkers and therapeutic targets reflecting sex-specificity in a number of different cancers.

The Role of Sex-specific Long Non-coding RNAs in Cancer Prevention and Therapy

The functions of a large number of non-coding genes in human DNA have yet to be accurately identified. Long non-coding RNA (lncRNA) measuring 10 kb or less in length regulates transcription or post-transcriptional events. The lncRNAs have attracted increased attention of researchers in recent years. In this review, we summarize the recently published lncRNAs which are known to influence cancer development and progression. We also discuss recent studies investigating tumor-specific lncRNA expression. These lncRNAs provide very useful information that allows prediction of the degree of malignancy and a survival rate in cancer patients as clinically relevant biomarkers. Because symptoms and progression of cancer differ from onset to death between males and females, it is important to consider the gender of the patient when diagnosing cancer and predicting the progression. Considering the importance of gender difference, we also examine the influence of sex hormones involved in the expression and regulation of lncRNAs as biomarkers. Many of the lncRNAs examined in this review have been studied in cancers occurring in the female or male reproductive organs, but the association between lncRNAs and sex hormones has also been reported in common organs such as the lung, renal and colon. Although lncRNAs have not yet been widely used as definitive cancer indicators, recent studies have demonstrated the potential role of lncRNAs as biomarkers and therapeutic targets reflecting sex-specificity in a number of different cancers.

Sex-Biased Molecular Signature for Overall Survival of Liver Cancer Patients

Sex/gender disparity has been shown in the incidence and prognosis of many types of diseases, probably due to differences in genes, physiological conditions such as hormones, and lifestyle between the sexes. The mortality and survival rates of many cancers, especially liver cancer, differ between men and women. Due to the pronounced sex/gender disparity, considering sex/ gender may be necessary for the diagnosis and treatment of liver cancer. By analyzing research articles through a PubMed literature search, the present review identified 12 genes which showed practical relevance to cancer and sex disparities. Among the 12 sex-specific genes, 7 genes (BAP1, CTNNB1, FOXA1, GSTO1, GSTP1, IL6, and SRPK1) showed sex-biased function in liver cancer. Here we summarized previous findings of cancer molecular signature including our own analysis, and showed that sexbiased molecular signature CTNNB1High , IL6High , RHOAHigh and GLIPR1Low may serve as a female-specific index for prediction and evaluation of OS in liver cancer patients. This review suggests a potential implication of sex-biased molecular signature in liver cancer, providing a useful information on diagnosis and prediction of disease progression based on gender.

Quality of care in inflammatory bowel disease in Asia: the results of a multinational web-based survey in the 2nd Asian Organization of Crohn's and Colitis (AOCC) meeting in Seoul

BACKGROUND/AIMS: The quality of care in inflammatory bowel disease (IBD) has not been systematically estimated. The aim of this study was to investigate the current status of quality of IBD care in Asian countries. METHODS: A questionnaire-based survey was conducted between March 2014 and May 2014. The questionnaire was adopted from "An adult inflammatory bowel disease physician performance measure set" developed by the American Gastroenterological Association. If the respondent executed the performance measure in more than 70% of patients, the measure was regarded as well performed. RESULTS: A total of 353 medical doctors from Asia completed the survey (116 from Korea, 114 from China, 88 from Japan, 17 from Taiwan, 8 from Hong-Kong, 4 from India, 3 from Singapore, and 1 each from the Philippines, Malaysia and Indonesia). The delivery of performance measures, however, varied among countries. The documentation of IBD and tuberculosis screening before anti-tumor necrosis factor therapy were consistently performed well, while pneumococcal immunization and prophylaxis of venous thromboembolisms in hospitalized patients were performed less frequently in all countries. Physician awareness was positively associated with the delivery of performance measures. Variations were also noted in reasons for non-performance or low performance of quality measures, and the two primary reasons cited were consideration of the measure to be unimportant and lack of time. CONCLUSIONS: The delivery of performance measures varies among physicians in Asian countries, and reflects variations in the quality of care among the countries. This variation should be recognized to improve the quality of care in Asian countries.

Muscle mass is a strong correlation factor of total hip BMD among Korean premenopausal women

OBJECTIVES: This study was to investigate mean Z-score of BMD of Korean premenopausal women and also to investigate the relationship between BMD and body composition, such as skeletal muscle (SM) mass, body fat mass, and abdominal adiposity among healthy Korean premenopausal women in their forties. METHODS: A total of 2711 premenopausal women in her forties (40-49 years) who had taken dual energy X-ray absorptiometry (DXA) for BMD screening and body composition analyser (InBody J10®) from 2012 to 2013 at health promotion center of Ewha Womans university Mokdong hospital were analyzed retrospectively. Demographic data such as body mass index (BMI), waist circumference (WC), hip circumference (HC), waist hip ratio (WHR), SM mass, body fat mass, and serum lipid profile were included in this study. The Pearson's correlation coefficient (CC) was used to identify co-efficiency between BMD and other parameters. RESULTS: The mean age was 44.2 ± 4.44 (years) and mean BMI was 22.43 ± 2.99 (kg/m2). Mean Z-score of BMD-lumbar 1-4 (BMD-L) and BMD-femur total hip (BMD-F) was 0.33 ± 1.14 and -0.19 ± 0.85. Mean of BMD-L and BMD-F were 1.18 ± 0.16 (g/cm2) and 0.96 ± 0.12 (g/cm2). Skeletal muscle mass showed a strong significant correlation coefficient (CC) only with BMD-F (CC = 0.13, p-value = 4.78 × 10(-11)). However serum lipid profile, body fat mass, and WHR did not show significant CC with mean Z-score of BMD-F and BMD-L. CONCLUSION: Skeletal muscle mass measured by body composition analyzer of BIA method is a strong correlation factor for BMD especially of hip bone among healthy Korean premenopausal women in their forties.

Bone Mineral Density of Young Korean Women and Its Correlation with Thyroid Stimulating Hormone / 대한골다공증학회지

OBJECTIVES: The bone mineral density (BMD) of young aged women was not fully investigated because of the limited indication of BMD test. This study was to investigate mean Z-score of BMD in healthy young aged Korean women and to find out factors influencing the BMD score in her twenties and thirties. METHODS: A total 876 young aged (20-40 years) women who had taken dual energy X-ray absorptiometry (DXA) for BMD screening from 2010 to 2014 were analyzed retrospectively using demographic data including body mass index (BMI), waist circumference (WC), thyroid stimulating hormone (TSH), and serum lipid profile. We compared the two age groups, in her twenties and thirties, regarding BMD and other parameters.

Caustic Injury of Upper Gastrointestinal Tract: 20 Year Experience at a Tertiary Referral Center / 대한소화기학회지

BACKGROUND/AIMS: Caustic ingestion can cause severe injury to upper gastrointestinal tract. There were few studies about clinical characteristics and treatments of caustic injury in Korea. We investigated the changes in clinical features of caustic injury over the past 20 years including pattern of endoscopic mucosal injury and treatment modality. METHODS: This study was a retrospective review of medical records from patients with caustic injury from September 1993 through December 2012. Patients were classified into two groups based on the year when caustic ingestion occurred: patients who visited the hospital from 1993 to 2002 (early group) and patients who visited the hospital from 2003 to 2012 (late group). RESULTS: A total 140 patients were included (early group [n=50] vs. late group [n=90]). Annual number of caustic ingestions did not show decreasing tendency over the past 20 years. Alkali ingestion increased (20.0% vs. 65.6%, p<0.001) and cases with more than grade 2b of esophageal mucosal injury decreased (41.3% vs. 20.7%, p=0.012) in late group. There were no differences between two groups in sex, age, proportion of accidental ingestion, and systemic/gastrointestinal complications. Use of gastric lavage (p<0.01) and broad spectrum antibiotics (p=0.03) decreased in late group. However, there was no difference in use of steroid between two groups. CONCLUSIONS: In this study, overall caustic ingestion did not decrease and ingestion of alkali agents increased over the past 20 years. Tighter legislation on caustic agents is required and we need to be alert to the best management of caustic injury.

Associations of Colorectal Cancer Incidence with Nutrient and Food Group Intakes in Korean Adults: A Case-Control Study

This study aimed to examine the associations between intakes of various nutrients and food groups and colorectal cancer risk in a case-control study among Koreans aged 20 to 80 years. A total of 150 new cases and 116 controls were recruited with subjects' informed consent. Dietary data were collected using the food frequency questionnaire developed and validated by the Korea Centers for Disease Control and Prevention. Multivariate logistic regression models were used to estimate odds ratios (ORs) and corresponding 95% confidence intervals (CIs) for colorectal cancer incidence. High intakes of total lipid (OR(T3 vs T1) = 4.15, 95% CI: 1.33-12.96, p for trend = 0.034), saturated fatty acid (OR(T3 vs T1) = 2.96, 95% CI: 1.24-7.04, p for trend = 0.016) and monounsaturated fatty acid (OR(T3 vs T1) = 3.04, 95% CI: 1.23-7.54, p for trend = 0.018) were significantly associated with increased incidence of colorectal cancer. High dietary fiber (OR(T3 vs T1) = 0.22, 95% CI: 0.08-0.56, p for trend = 0.002) and vitamin C (OR(T3 vs T1) = 0.38, 95% CI: 0.14-1.05, p for trend = 0.021) intakes were significantly associated with reduced colorectal cancer incidence. From the food group analysis, bread (OR(T3 vs T1) = 2.26, 95% CI: 0.96-5.33, p for trend = 0.031), red meat (OR(T3 vs T1) = 7.33, 95% CI: 2.98-18.06, p for trend < 0.001), milk.dairy product (OR(T3 vs T1) = 2.42, 95% CI: 1.10-5.31, p for trend = 0.071) and beverage (OR(T3 vs T1) = 3.17, 95% CI: 1.35-7.48, p for trend = 0.002) intakes were positively associated with colorectal cancer risk. On the other hand, high intake of traditional rice cake (OR(T3 vs T1) = 0.35, 95% CI: 0.14-0.86, p for trend = 0.024) was linked with lower colorectal cancer incidence. In conclusion, eating a diet high in total lipid, saturated fatty acids and monounsaturated fatty acids is associated with higher incidence of colorectal cancer, whereas a diet high in dietary fiber and vitamin C was found to lower the incidence in Korean adults. Interestingly high traditional rice cake consumption is associated inversely with colorectal cancer incidence, warranting a future study.

The Effects of Flumazenil on the Recovery Time and Satisfaction of the Use of Sedative Endoscopy with Midazolam / 대한소화기내시경학회지

BACKGROUND/AIMS: Treatment with flumazenil results in rapid reversal from sedation. In addition, the use of flumazenil can prevent accidents or memory loss after endoscopy. This study was conducted to evaluate the role of flumazenil according to dose. METHODS: A total of 150 consecutive outpatients were randomly allocated into three groups: patients given normal saline (control group), patients given 0.25 mg flumazenil (0.25 mg flumazenil group) and patients given 0.5 mg flumazenil (0.5 mg flumazenil group). Flumazenil or normal saline was injected 10 minutes after the completion of endoscopy. We evaluated the recovery time, time to discharge, patient satisfaction, and memory loss after discharge. RESULTS: The control group consisted of 44 subjects, the 0.25 mg flumazenil group consisted of 46 subjects and the 0.5 mg flumazenil group consisted of 45 subjects. The recovery time was significantly shorter in the two flumazenil groups as compared to the control group (28.5+/-15.0 min, 13.8+/-3.7 min, 12.4+/-1.7 min for the control group, 0.25 mg flumazenil group and 0.5 mg flumazenil group, respectively)(p<0.001). The time to discharge after an examination was shorter in the flumazenil groups and showed dose-dependency (41.2+/-20.5 min, 22.1+/-10.9 min, 16.4+/-2.2 min for the control group, 0.25 mg flumazenil group and 0.5 mg flumazenil group, respectively) (p<0.001). There was no significant difference in patient satisfaction among the three groups. The degree of memory recall was better in the 0.5 mg flumazenil group than in the other two groups (p<0.001). CONCLUSIONS: Flumazenil reversal of midazolam sedative endoscopy results in fast recovery and is helpful to minimize memory loss after an examination without interference of satisfaction.

Clinical Factors Associated with Response to Biofeedback Therapy for Patients with Chronic Constipation / 대한소화기학회지

BACKGROUND/AIMS: Biofeedback therapy has been widely used for the treatment of constipated patients. However, there are only a few reports about the clinical factors that can predict the effectiveness of biofeedback therapy. The aim of this study was to evaluate prognostic factors before the initiation of biofeedback treatment in constipated patients. METHODS: Biofeedback treatment was performed in 114 patients with constipation. After classifying the patients into two groups, responder and non-responder by subjective and objective parameters, univariate and multivariate analysis were performed to evaluate the factors associated with effectiveness of biofeedback therapy. RESULTS: Eighty-five patients (74.6%) responded to biofeedback therapy. Pre-treatment balloon expulsion test, paradoxical contraction on manometry, defecation index and anal residual pressure during straining were the factors that influenced the results of biofeedback treatment. On multivariate analysis, defecation index (odds ratio=67.5, p<0.05) and paradoxical contraction on manometry (odds ratio=0.053, p<0.05) were the factors that showed significant difference between the responders and non-responders. CONCLUSIONS: This study suggests that several pre-treatment prognostic factors are associated with response to biofeedback for the constipated patients. Using prognostic factors, we may be able to evaluate the patterns of pelvic floor dysfunction and responsiveness of biofeedback therapy for the patients with constipation.

A Case of Solitary Rectal Ulcer Syndrome with Characteristic Findings of Evacuation and Magnetic Resonance (MR) Defecography / 대한소화관운동학회지

Solitary rectal ulcer syndrome is an uncommon, chronic benign condition characterized by rectal bleeding, the passage of mucus, tenesmus and excessive straining during defecation. Occasionally, solitary rectal ulcer syndrome has been reported to be associated with defecation disorder such as pelvic floor dyssynergia, rectal intussusception and rectal prolapse. However, it is ambiguous how these associated defecation disorders contribute to make the rectal ulcer. We report a case of solitary rectal ulcer syndrome suggesting the pathophysiology of rectal ulcer by typical findings of evacuation defecography and MR defecography. A 40-year-old man presented with lower abdominal pain, rectal bleeding, passage of mucus and tenesmus intermittently for the past 4 years. Colonoscopy showed a large geographic and circumferential ulcer at the 10 cm distance from the anal verge. A biopsy revealed fibromuscular proliferation of laminar propria, hyperplasia of crypt and focal superficial ulceration. Finally, he was diagnosed as solitary rectal ulcer syndrome. Evacuation defecography showed paradoxical movement of puborectal sling and unusual invagination of rectal walls during defecation. In addition, rectum showed spastic movement and anterior rectal wall directly merged into posterior rectal wall making a kissing appearance. The invagination of the rectum at evacuation defecography proved to be the rectal wall thickening at MR defecography. After 9 sessions of biofeedback therapy, his defecation symptoms improved. However, ulcer was still observed without interval change.

Biliary Stricture Associated with Common Bile Duct Stone Caused by Endoscopic Snare Papillectomy of Ampullary Adenoma / 대한소화기내시경학회지

Neoplasms of the major duodenal papilla or the ampulla of Vater are rare but are clinically important since they are premalignant. Recently endoscopic snare papillectomy for the ampullary adenoma is being increasingly performed. The procedure is now regarded as a clinically effective treatment, however, various complications such as bleeding, perforation, cholangitis, and pancreatitis have been reported. To our knowledge, biliary stricture of this case has not been reported as a complication of endoscopic snare papillectomy for ampullary adenoma. Also, secondary common bile duct stone was formed by biliary stasis associated with biliary stricture in our case. We performed the balloon dilation at the biliary stricture site and could remove the stone successfully by endoscopic method.

A Case of Mucinous Adenocarcinoma with Characteristic Colonoscopic Findings / 대한소화기내시경학회지

We report a case of mucinous adenocarcinoma in the ascending colon. A 55-year-old woman was admitted to Asan Medical Center due to right lower quadrant abdominal pain. On physical examination, an approximately 5X5 cm sized tender mass was palpated in the right lower quadrant. Colonoscopy revealed a fungating mass covered with gelatinous, yellow-whitish mucoid material in the ascending colon. Abdominal computed tomography showed irregular wall thickening from ileocecal valve to mid ascending colon with pericolic fat thickening. She underwent right hemicolectomy and surgical specimen revealed well differentiated tubulopapillary adenocarcinoma with mucinous background consistent with mucinous adenocarcinoma.