Association between coenzyme Q 10-related genetic polymorphisms and statin-associated myotoxicity in Korean stroke patients.

Introduction: The purpose of this study is to identify the relationship between coenzyme Q 10 (CoQ10)-related gene polymorphisms and statin-related myotoxicity (SRM). Methods: We retrospectively analyzed prospectively collected samples from February to May 2021. To investigate the association between CoQ10-related genetic factors and SRM, we selected 37 single nucleotide polymorphisms from five genes (COQ2, COQ3, COQ5, COQ6, and COQ7). The odds ratio (OR) and adjusted OR with 95% confidence intervals (CI) were calculated for univariate and multivariable logistic regression analyses, respectively. Results: A total of 688 stroke patients were included in the analysis, including 56 SRM cases. In the multivariable analysis, two models were constructed using demographic factors only in model I, and demographic and genetic factors in model II. Compared to other statins, atorvastatin decreased the SRM risk whereas ezetimibe use increased the SRM risk in model I and model II. Patients with COQ2 rs4693075 G allele, COQ3 rs11548336 TT genotype, and COQ5 rs10849757 A allele had a 2.9-fold (95% CI: 1.6-5.3), 1.9-fold (95% CI: 1.1-3.5), and 3.3-fold (95% CI: 1.5-8.3) higher risk of SRM, respectively. Conclusion: This study could be utilized to develop a personalized medicine strategy in patients treated with statins.

Transporter Genes and statin-induced Hepatotoxicity.

PURPOSE: Hepatotoxicity has emerged as a major cause of statin treatment interruption. Although organic anion-transporting polypeptide 1B1 (SLCO1B1), multidrug resistance protein 1 (ABCB1), and breast cancer resistance protein (ABCG2) have been identified as transporters of statins, knowledge of their role in statin-associated hepatotoxicity remains limited. Therefore, we aimed to conduct a comprehensive analysis to elucidate the association between hepatotoxicity and SLCO1B1, ABCB1, and ABCG2 polymorphisms. METHODS: This study retrospectively analyzed prospectively collected samples. We selected 10 single nucleotide polymorphisms (SNPs) of SLCO1B1, 9 SNPs of ABCB1, and 12 SNPs of ABCG2. We developed two models for multivariable analyses (Model I: clinical factors only; Model II: both clinical and genetic factors), and the attributable risk (%) of variables in Model II was determined. RESULTS: Among 851 patients, 66 (7.8%) developed hepatotoxicity. In Model I, lipophilic statins, atrial fibrillation (Afib), and diabetes mellitus showed a significant association with hepatotoxicity. In Model II, lipophilic statins and Afib, SLCO1B1 rs11045818 A allele, SLCO1B1 rs4149035 T allele, and ABCG2 rs2622629 TT genotype were associated with higher hepatotoxicity risk. Among them, the SLCO1B1 rs11045818 A allele exhibited the highest attributable risk (93.2%). The area under the receiver operating characteristic curve in Model I was 0.62 (95% CI: 0.55-0.69), and it was increased to 0.71 in Model II (95% CI: 0.64-0.77). CONCLUSION: This study investigated the correlation between hepatotoxicity and polymorphisms of transporter genes in patients taking statins. The findings could help improve personalized treatments for patients receiving statin therapy.

Virtual reality education program for women with uterine tumors treated by high-intensity focused ultrasound.

This study aimed to develop and determine the effects of a nursing education program using virtual reality (VR) for women with uterine tumors undergoing treatment with high-intensity focused ultrasound (HIFU). Various nursing education methods need to be developed alongside new treatment methods and their effects should be clinically verified. Nursing intervention using VR has recently been attempted. The study comprises a pre- and post-test design with a non-equivalent control group. We assigned 54 women to experimental (n = 26) and control (n = 28) groups. The patients were diagnosed with benign uterine tumors and were treated with HIFU at two women's hospitals in D city. Data collected from these hospitals were analyzed using descriptive statistics, a pre-test of homogeneity, independent t-tests, and repeated measures analysis of variance. In the experimental group, uncertainty (t = 4.26, p < 0.001) and anxiety (t = 4.09, p < 0.001) were significantly lower compared to the control group. However, nursing satisfaction was significantly higher in the experimental group than in the control group (t = -4.50, p < 0.001). The VR education program is an educational nursing intervention that reduces uncertainty and anxiety and improves nursing satisfaction among women with uterine tumors treated by HIFU. We suggest that future nursing research integrates and converges disciplines according to progressive treatment methods and technological advancements for patients.

Construction of a risk scoring system using clinical factors and RYR2 polymorphisms for bleeding complications in patients on direct oral anticoagulants.

Introduction: Bleeding is one of the most undesirable complications of direct oral anticoagulants (DOACs). While the ryanodine receptor (RYR2) has been related to cardiac diseases, research on bleeding complications is lacking. This study aimed to elucidate the association between RYR2 and bleeding risk to develop the risk scoring system in patients treated with DOACs. Methods: This study was a retrospective analysis of prospectively collected samples. We selected ten SNPs within the RYR2 gene, and two models were constructed (Model I: demographic factors only, Model II: demographic and genetic factors) in multivariable analysis. Independent risk factors for bleeding were used to develop a risk scoring system. Results: A total of 447 patients were included, and 49 experienced either major bleeding or clinically relevant non-major bleeding. In Model I, patients using rivaroxaban and experiencing anemia exhibited an increased bleeding risk after adjusting for covariates. Upon incorporating genetic factors into Model I, a significant association with bleeding was also observed in cases of overdosing on DOACs and in patients with a creatinine clearance (CrCl) < 30 mL/min, in addition to rivaroxaban and anemia (Model II). Among genetic factors, RYR2 rs12594 GG, rs17682073 AA, rs3766871 GG, and rs6678625 T alleles were associated with bleeding complications. The area under the receiver operating characteristic curve (AUROC) of Model I was 0.670, whereas that of Model II increased to 0.803, demonstrating better performance with the inclusion of genetic factors. Using the significant variables in Model II, a risk scoring system was constructed. The predicted bleeding risks for scores of 0, 1-2, 3-4, 5-6, 7-8, and 9-10 points were 0%, 1.2%, 4.6%, 15.7%, 41.7%, and 73.3%, respectively. Conclusion: This study revealed an association between RYR2 and bleeding complications among patients taking DOACs and established a risk scoring system to support individualized DOAC treatment for these patients.

The impact of circulatory arrest with selective antegrade cerebral perfusion on brain functional connectivity and postoperative cognitive function.

Aortic surgery is one of the most challenging types of surgeries, which is possibly related to cognitive sequelae. We aimed to investigate the changes in resting-state functional connectivity (rsFC) associated with intraoperative circulatory arrest (CA) in aortic surgery, exploring the relationship between the altered connectivity and postoperative cognitive functions. Thirty-eight patients participated in this study (14 with CA, 24 without). Functional magnetic resonance imaging was scanned on the fifth day after surgery or after the resolution of delirium if it was developed. We assessed the differences in the development of postoperative cognitive changes and rsFC between patients with and without CA. The occurrence of postoperative delirium and postoperative cognitive dysfunction was not significantly different between the patients with and without the application of CA. However, patients with CA showed increased in posterior cingulate cortex-based connectivity with the right superior temporal gyrus, right precuneus, and right hippocampus, and medial prefrontal cortex-based connectivity with the dorsolateral prefrontal cortex. The application of moderate hypothermic CA with unilateral antegrade cerebral perfusion is unlikely to affect aspects of postoperative cognitive changes, whereas it may lead to increased rsFC of the default mode network at a subclinical level following acute brain insults.

Mid-term outcomes of hybrid debranching endovascular aortic arch repair in landing zones 0-2.

OBJECTIVES: The aim of this study is to summarize a single-center experience of hybrid debranching endovascular repair of the aortic arch and proximal descending thoracic aorta (DTA) with regard to the mid-term outcomes with highlighting the difference between the landing zones 0-2. METHODS: A retrospective review of data from a prospectively collected registry (Gangnam Severance Endovascular Aortic Registry) was performed. From among 332 patients whose aortic pathology was managed with TEVAR, 112 patients who underwent hybrid arch repair during the study period between 2012 and 2016 were identified. The patients were grouped into three cohorts according to the proximal landing zones (0, 1, and 2) of Ishimaru. The early outcome (30-days) in terms of mortality, morbidity, supra-aortic vessels patency, and presence of endoleak were analyzed. The survival, freedom from re-intervention, and major complications during follow-up were demonstrated. RESULTS: During the study period. 112 patients (mean age 65±7, 79% males) were included. The patients were distributed in three cohorts: 8 (7%) patients with proximal landing zone 0, 20 (18%) with zone 1, and 80 (75%) with zone 2 hybrid aortic arch repair. Technical success was achieved in 7 (88%), 19 (90%), and 79 (94%) patients for zones 0, 1, and 2, respectively. The mean intensive care unit (ICU) stay was shorter in zone 2 (p = .005). The mean total hospital stay was shorter in zone 2 (p = .03). The overall in-hospital mortality rate was 5% (4/112). There was no spinal cord ischemia or early surgical conversion. Renal function deterioration was seen more but not significantly in zone 0 patients (p = .08). Respiratory failure was seen significantly in zone 0 patients (p = .01). Stroke occurred in 6/44 (14%) patients with degenerative aneurysm versus 1/60 (2%) patients with aortic dissection (p =.06). Early CTA showed 100% patency of the supra-aortic vessels. The early endoleak rate was significant in zone 0 patients (p = .008). The mean follow-up period was (32±19 months). The survival rates and freedom from re-intervention were not statistically significant among the three zones. However, the survival rate and freedom from intervention tend to be higher in zone 2 versus zone 0 (p = .07 and .09), respectively. CONCLUSION: Hybrid debranching endovascular aortic arch repair is feasible and relatively safe with acceptable mid-term outcomes. Zone 0 patients has worse early and late outcomes in comparison to other zones. Careful patient selection and improved endovascular technology may be the key to improve the outcomes.

Associations between breastfeeding intention, breastfeeding practices and post-natal depression during the COVID-19 pandemic: A multi-country cross-sectional study.

Associations between breastfeeding intention, duration and post-natal depression (PND) have been shown in pre-COVID-19 studies. However, studies during COVID-19 have not examined the associations between breastfeeding intention, breastfeeding practices, and PND in an international sample of post-natal women, taking into consideration COVID-19 related factors. This is the first study to address this gap as both PND and breastfeeding may be affected by COVID-19, and have important long-term effects on women's and infant's health. A cross-sectional internet-based survey was conducted with 3253 post-natal women from five countries: Brazil, South Korea, Taiwan, Thailand, and the United Kingdom from July to November 2021. The results showed that women who intended to breastfeed during pregnancy had lower odds of having PND than women who did not intend to. Women who had no breastfeeding intention but actually breastfed had greater odds (AOR 1.75) of having PND than women who intended to breastfeed and actually breastfed. While there was no statistical significance in expressed breast milk feeding in multivariable logistic regression models, women who had shorter duration of breastfeeding directly on breast than they planned had greater odds (AOR 1.58) of having PND than those who breastfed longer than they planned even after adjusting for covariates including COVID-19-related variables. These findings suggested the importance of working with women on their breastfeeding intention. Tailored support is required to ensure women's breastfeeding needs are met and at the same time care for maternal mental health during and beyond the pandemic.

Note the descending aorta: predictors of postoperative major adverse aortic event in pure acute type A intramural hematoma.

BACKGROUND: Intramural hematomas (IMHs) may originate from small intimal tears. Although most surgeries for acute type A IMH are conventionally performed solely at the proximal aorta, regardless of the primary intimal tear site, the remnant aortic remodeling stays important during the follow-up period after surgery. METHODS: Forty-seven patients with "pure" acute type A IMHs who underwent surgery from January 2008 to December 2019 were retrospectively analyzed. Acute type A IMH in the entire region without penetrating aortic ulcer (PAU) and aortic dissection (AD), which upon initial computed tomography (CT), can be considered as an intimal tear site, was defined as "pure" type. The maximal diameter of the aorta, maximal thickness of the IMH, and hematoma thickness ratio (HTR) of the ascending and descending aortae were measured from the preoperative computed tomographic scan. The hematoma thickness index was defined as the HTR of the descending aorta divided by that of the ascending aorta. Major adverse aortic events (MAAEs) were defined as AD, rupture, or newly developed PAU and aortic death. Predictors for postoperative MAAEs were analyzed using preoperative computed tomographic findings. RESULTS: The measurements of the descending aorta were larger and those of the ascending aorta were smaller in the MAAEs group, than in the corresponding other. The hematoma thickness index was significantly higher in the group with MAAEs, than in the group without; this variable was an independent predictor of MAAEs. During surgery, intimal tears were found in 16/47 (34%) patients. The hematoma thickness index was significantly smaller in the group with intimal tears than in the group without the tears. The aortic measurement appears to reflect the tear site. CONCLUSIONS: Hematoma thickness index was an independent predictor of MAAE after acute type A IMH surgery. Long-term periodical follow-up with early reintervention may, therefore, be necessary to improve outcome in these patients. As the optimal treatment method is still controversial, inferring the location of the primary tear through the hematoma thickness index can be helpful in determining the treatment method.

Bacillus subtilis as a robust host for biochemical production utilizing biomass.

Bacillus subtilis is regarded as a suitable host for biochemical production owing to its excellent growth and bioresource utilization characteristics. In addition, the distinct endogenous metabolic pathways and the suitability of the heterologous pathways have made B. subtilis a robust and promising host for producing biochemicals, such as: bioalcohols; bioorganic acids (lactic acids, α-ketoglutaric acid, and γ-aminobutyric acid); biopolymers (poly(γ-glutamic acid, polyhydroxyalkanoates (PHA), and polysaccharides and monosaccharides (N-acetylglucosamine, xylooligosaccharides, and hyaluronic acid)); and bioflocculants. Also for producing oligopeptides and functional peptides, owing to its efficient protein secretion system. Several metabolic and genetic engineering techniques, such as target gene overexpression and inactivation of bypass pathways, have led to the improvement in production titers and product selectivity. In this review article, recent progress in the utilization of robust B. subtilis-based host systems for biomass conversion and biochemical production has been highlighted, and the prospects of such host systems are suggested.

Evaluation of optimal conditions for anionic surfactant removal in wastewater.

This study was conducted to find the optimal conditions for removing anionic surfactants in wastewater using the coagulant-flocculant method. Optimal conditions must be found to minimize the amount of metal materials that can cause secondary contamination and to improve performance. Five parameters were selected to investigate their influence on surfactant removal. The ranges of the independent variables were 0.5-5% for coagulant concentration, 0.1-1% for flocculant concentration, and 20-650 mg/L for surfactant concentration; the coagulant type was FeCl3·6H2O or Ca(OH)2; and the pH ranged from 2 to 10. The experimental results were analyzed with Minitab 19.1 to find the optimal conditions to maximize the removal rate of surfactant. In this study, a total of 20 experiments were carried out using a half fractional factorial design (FFD) including two center points with a resolution of 5 and a pseudo-center point. The results demonstrated that coagulant concentration, flocculant concentration, and pH were significant independent variables with respect to surfactant removal. The fitted regression equation confirmed that the surfactant removal rate was maximized when the coagulant concentration was 5%, the flocculant concentration was 0.1%, and the pH was 10.

The Effect of a Breathing Relaxation Therapy for Pregnant Women with Preterm Labor Pain: a Systematic Review and Meta-Analysis / 계명의대학술지

To evaluate the effects of abdominal breathing relaxation therapy on anxiety, stress, pain for pregnant women with preterm labor pain. Electronic databases, including PubMed, OVID MEDLINE, RISS, Google Scholar and Korean databases and were searched through April 2021. 401 studies were identified; 5 were suitable for meta-analysis. Cochrane’s risk of bias tool and the R version 3.5.2(Meta-analysis with R) program were used. The authors performed a meta-analysis of 5 trials that met eligibility criteria. Two randomized, controlled trials (RCTs) and three non-RCTs examined a total of 533 pregnant women with preterm labor pain patients who received breathing relaxation therapy were compared with those who received control or usual care (no intervention). The findings in this study indicate that effect size of breathing relaxation therapy for anxiety was Hedges' g = -0.93 (95% CI: -1.46 to -0.41), as indicated by a “large effect size” and the effect size of stress was Hedges' g = -0.59 (95% CI: 0.22 to 0.95) as indicated by a “moderate effect size”. The effect size of BP was Hedges’ g = -1.03 (95% CI: -1.43 to -0.63), as indicated by a “large effect size”. Overall, abdominal breathing relaxation therapy had beneficial effects on anxiety, stress and BP, and it was statistically significant. In the meta-subgroup analyses by approach type, intervention duration had a significant effect. These results indicate that abdominal breathing may be an effective nursing intervention for pregnant women with preterm labor.

The Effect of a Breathing Relaxation Therapy for Pregnant Women with Preterm Labor Pain: a Systematic Review and Meta-Analysis / 계명의대학술지

To evaluate the effects of abdominal breathing relaxation therapy on anxiety, stress, pain for pregnant women with preterm labor pain. Electronic databases, including PubMed, OVID MEDLINE, RISS, Google Scholar and Korean databases and were searched through April 2021. 401 studies were identified; 5 were suitable for meta-analysis. Cochrane’s risk of bias tool and the R version 3.5.2(Meta-analysis with R) program were used. The authors performed a meta-analysis of 5 trials that met eligibility criteria. Two randomized, controlled trials (RCTs) and three non-RCTs examined a total of 533 pregnant women with preterm labor pain patients who received breathing relaxation therapy were compared with those who received control or usual care (no intervention). The findings in this study indicate that effect size of breathing relaxation therapy for anxiety was Hedges' g = -0.93 (95% CI: -1.46 to -0.41), as indicated by a “large effect size” and the effect size of stress was Hedges' g = -0.59 (95% CI: 0.22 to 0.95) as indicated by a “moderate effect size”. The effect size of BP was Hedges’ g = -1.03 (95% CI: -1.43 to -0.63), as indicated by a “large effect size”. Overall, abdominal breathing relaxation therapy had beneficial effects on anxiety, stress and BP, and it was statistically significant. In the meta-subgroup analyses by approach type, intervention duration had a significant effect. These results indicate that abdominal breathing may be an effective nursing intervention for pregnant women with preterm labor.

Phenethyl Isothiocyanate Protects against High Fat/Cholesterol Diet-Induced Obesity and Atherosclerosis in C57BL/6 Mice.

This study concerns obesity-related atherosclerosis, hyperlipidemia, and chronic inflammation. We studied the anti-obesity and anti-atherosclerosis effects of phenethyl isothiocyanate (PEITC) and explored their underlying mechanisms. We established an animal model of high fat/cholesterol-induced obesity in C57BL/6 mice fed for 13 weeks. We divided the mice into five groups: control (CON), high fat/cholesterol (HFCD), HFCD with 3 mg/kg/day gallic acid (HFCD + G), and HFCD with PEITC (30 and 75 mg/kg/day; HFCD + P30 and P75). The body weight, total cholesterol, and triglyceride were significantly lower in the HFCD + P75 group than in the HFCD group. Hepatic lipid accumulation and atherosclerotic plaque formation in the aorta were significantly lower in both HFCD + PEITC groups than in the HFCD group, as revealed by hematoxylin and eosin (H&E) staining. To elucidate the mechanism, we identified the expression of genes related to inflammation, reverse cholesterol transport, and lipid accumulation pathway in the liver. The expression levels of peroxisome proliferator activated receptor gamma (PPARγ), liver-X-receptor α (LXR-α), and ATP binding cassette subfamily A member 1 (ABCA1) were increased, while those of scavenger receptor A (SR-A1), cluster of differentiation 36 (CD36), and nuclear factor-kappa B (NF-κB) were decreased in the HFCD + P75 group compared with those in the HFCD group. Moreover, PEITC modulated H3K9 and H3K27 acetylation, H3K4 dimethylation, and H3K27 di-/trimethylation in the HFCD + P75 group. We, therefore, suggest that supplementation with PEITC may be a potential candidate for the treatment and prevention of atherosclerosis and obesity.

Functionalized cellulose to remove surfactants from cosmetic products in wastewater.

A flocculant composed of paper mulberry dicarboxylic cellulose (PM-DCC) made from using paper mulberry (Broussonetia kazinoki Siebold and Zucc.) has been developed to reduce the amount of inorganic coagulants needed to remove surfactants in wastewater. The characteristics of PM and soda pulp were determined according to the degree of polymerization, α-cellulose, lignin, free sugar, and extract contents. FTIR, XRD, the aldehyde content, the carboxyl content and coagulant-flocculation experiments were conducted to confirm the properties of PM-DCC and paper mulberry dialdehyde cellulose (PM-DAC). A dramatic removal efficiency (95.62 %) was revealed when 0.3 % PM-DCC was added into a linear alkylbenzene sulfonate (LAS) solution with 1% FeCl3·6H2O at pH 2. This means that PM-DCC contributes to both a lower amount of inorganic coagulant needed and a reduction of water pollution by an ecofriendly method.

[Development and effects of a labor nursing education program using a high-fidelity simulator for nursing students]. / 간호대학생 대상의 ê³ ì¶©ì‹¤ë„ ì‹œë®¬ë ˆì´í„°ë¥¼ 이용한 분만 간호 교육프로그램의 개발 및 효과.

Purpose: This study was conducted to investigate the effects of an education program using a high-fidelity simulator of labor and delivery on nursing knowledge, critical thinking, and clinical performance among nursing students who had not yet experienced clinical practicum. Methods: The development of a 5-week maternity nursing education programs using high-fidelity simulators included modules containing case-oriented scenarios, knowledge, and skills required for maternity care. A randomized controlled study was conducted to verify the effects of the developed program. Data were collected from October 21 to December 9, 2019. The experimental group (n=36) participated in a 5-week high-fidelity simulation program on care for the woman in labor, whereas the control group (n=36) received standard education as lecture and practice with delivery model. The collected data were analyzed using descriptive statistics (frequency, percentage, mean, and standard deviation), the Chi-square test, Fisher exact test, and t-test. Results: For participants who received education using the high-fidelity simulation program, nursing knowledge (t=2.33, p=.011), critical thinking (t=3.73, p<.001), and clinical performance (t=2.53, p=.006) were significantly higher than in the control group. Conclusion: Even for students with no clinical experience, high-fidelity simulation-based nursing education was effective in improving nursing knowledge, critical thinking, and clinical performance among nursing students. Nurse educators will be able to use this high-fidelity simulator effectively, especially in situations where direct clinical practicum may not be feasible.

Development and effects of a labor nursing education program using a high-fidelity simulator for nursing students in Korea

Purpose@#This study was conducted to investigate the effects of an education program using a high-fidelity simulator of labor and delivery on nursing knowledge, critical thinking, and clinical performance among nursing students. @*Methods@#In this randomized controlled study, data were collected from October 21 to December 9, 2019. To verify the effects of the program, 36 nursing students in the experimental group participated in a high-fidelity simulation program, whereas 36 students in the control group received the standard education on this topic. The collected data were analyzed using descriptive statistics (frequency, percentage, mean, and standard deviation), the chi-square test, Fisher exact test, and t-test. @*Results@#In the experimental group, in which participants received education using the high-fidelity simulation program, nursing knowledge (t=2.33, p=.011), critical thinking (t=3.73, p<.001), and clinical performance (t=2.53, p=.006) were significantly higher than in the control group. @*Conclusion@#High-fidelity simulation-based nursing education was useful for improving nursing knowledge, critical thinking, and clinical performance among nursing students.

Clinical Response of Rifaximin Treatment in Patients with Abdominal Bloating.

BACKGROUND/AIMS: Abdominal bloating is a troublesome complaint due to insufficient understanding of the pathophysiology. The aim of this study was to evaluate the efficacy of rifaximin in reducing bloating associated with functional gastrointestinal disorders (FGIDs). METHODS: A total of 63 patients were treated with rifaximin for FGIDs with bloating or gas-related symptoms between 2007 and 2013 at Seoul National University Bundang Hospital. Rifaximin was administered at a dose between 800 mg/day and 1,200 mg/day for 5 to 14 days. The proportion of patients who had adequate relief of global FGID symptoms and FGID-related bloating was retrospectively assessed. The response was recorded when the symptoms were reduced by at least 50% at the follow-up after treatment cessation. RESULTS: The mean age was 56.8±14.2 years; 49.2% were females. According to Rome III criteria, 20.6% (13/63) had irritable bowel syndrome (IBS) with constipation, 9.5% (6/63) had IBS with diarrhea, 4.8% (3/63) had mixed IBS, 23.8% (15/63) had functional dyspepsia, and 12.7% (8/63) had functional bloating. Of the 51 subjects who were followed-up, 30 (58.8%) had adequate relief of global FGID symptoms and 26 (51.0%) experienced improvement of abdominal bloating after rifaximin treatment. The proportion of female was slightly higher in non-response group than in the response group (60.0% vs. 34.6%, p=0.069). Otherwise, there was no difference between the two groups. CONCLUSIONS: Despite the limitations of this retrospective study, our data confirms that rifaximin may be beneficial for abdominal bloating. Further prospective clinical trial with a larger cohort is needed.

Characteristics of cytomegalovirus enterocolitis in patients with or without inflammatory bowel diseases.

OBJECTIVES: Cytomegalovirus (CMV) disease is more common in immunocompromised patients but may occur in people with normal immune function. In addition, CMV enterocolitis can aggravate inflammatory bowel diseases (IBD), but there was little knowledge of differences in clinical and endoscopic features of CMV enterocolitis between patients with IBD and without IBD. The aim of this study was to determine the difference in clinical implication in CMV enterocolitis between the IBD patients and non-IBD patients. METHODS: This was a retrospective study of 82 patients with CMV enterocolitis based on the pathologic findings at two tertiary referral hospitals from 2003 to 2013. Clinical and endoscopic characteristics and clinical course were analyzed according to the presence of IBD. RESULTS: Of the 82 patients, 25 (30.5%) had IBD and 57 (69.5%) did not have IBD. Hematochezia was more common in IBD patients (84.0% vs. 35.1%; p = .001), but fever and positive CMV antigenemia were more common in non-IBD patients (50.9% vs. 12.0%; p = .001; 54.4% vs. 28.0; p = .027). Endoscopic findings showed more ulcer with inflammation in IBD patients (68.0% vs. 35.2%; p = .005). Sixty-four patients were treated with antiviral agents and 12 patients who did not receive antiviral agents recovered spontaneously. All naturally healed patients were in normal immune status. CONCLUSIONS: Hematochezia is more common in IBD patients and fever/CMV antigenemia is more common in patients without IBD. In patients without IBD, the natural resolution of CMV enterocolitis is expected at least in normal immune function.

Green tea extracts for the prevention of metachronous colorectal polyps among patients who underwent endoscopic removal of colorectal adenomas: A randomized clinical trial.

OBJECTIVES: To determine the preventive effect of green tea extract (GTE) supplements on metachronous colorectal adenoma and cancer in the Korean population. MATERIALS AND METHODS: One hundred seventy-six subjects (88 per each group) who had undergone complete removal of colorectal adenomas by endoscopic polypectomy were enrolled. They were randomized into 2 groups: supplementation group (0.9 g GTE per day for 12 months) or control group without GTE supplementation. The 72-h recall method was used to collect data on food items consumed by participants at baseline and the 1-year follow-up during the past 48 h. Follow-up colonoscopy was conducted 12 months later in 143 patients (71 in control group and 72 in the GTE group). RESULTS: Of the 143 patients completed in the study, the incidences of metachronous adenomas at the end-point colonoscopy were 42.3% (30 of 71) in control group and 23.6% (17 of 72) in GTE group (relative risk [RR], 0.56; 95% confidence interval [CI], 0.34-0.92). The number of relapsed adenoma was also decreased in the GTE group than in the control group (0.7 ± 1.1 vs. 0.3 ± 0.6, p = 0.010). However, there were no significant differences between the 2 groups in terms of body mass index, dietary intakes, serum lipid profiles, fasting serum glucose, and serum C-reactive protein levels (all p > 0.05). CONCLUSION: This study of GTE supplement suggests a favorable outcome for the chemoprevention of metachronous colorectal adenomas in Korean patients (ClinicalTrials.gov number, NCT02321969).