Rejected

Eosinophilic gastrointestinal disorder (EoGID) is an emerging disease condition in Korean children, but its diagnosis requires invasive endoscopic biopsies. Fecal calprotectin (FCal) is a noninvasive biomarker for intestinal inflammation to differentiate organic gastrointestinal diseases from functional abdominal pain disorder. This study aimed to evaluate the diagnostic accuracy of FCal and to determine the optimal cutoff to differentiate EoGID from functional abdominal pain disorder.

The ATP binding cassette subfamily B member 4 (ABCB4) gene on chromosome 7 encodes the ABCB4 protein (alias multi drug resistance 3 protein [MDR3]), a P-glycoprotein in the canalicular membrane of the hepatocytes that acts as a translocator of phospholipids into bile. Several variants in ABCB4 have been identified so far that lead to ABCB4 deficiency accounting for a disease spectrum ranging from progressive familial cholestasis type 3 (PFIC-3) to less severe forms presenting as low phospholipid associated cholelithiasis (LPAC), intrahepatic cholestasis of pregnancy (ICP) or drug-induced liver injury (DILI). Furthermore, whole genome sequencing identified ABCB4 variants to be associated with an increased incidence of gallstone disease, gallbladder and cholangiocarcinoma, liver cirrhosis or elevated liver function tests. Diagnosis of ABCB4 deficiency related diseases is based on clinical presentation, serum biomarkers, imaging techniques, liver histology and genetic testing. Nevertheless, the clinical presentation can vary widely and clear genotype-phenotype correlations are lacking so far. Ursodeoxycholic acid is the most commonly used medical treatment, but confirmation of its benefit by large controlled clinical studies is still lacking. Future pharmacological options may include stimulation/restoration of residual function by chaperones (e.g. 4-phenyl butyric acid, curcumin) or induction of ABCB4 transcription by farnesoid X receptor (FXR) agonists or PPARα-ligands/fibrates. In cirrhotic patients with end stage liver disease or patients with intractable pruritus orthotopic liver transplantation remains the last and often only therapeutic option.

To investigate the prevalence of dry eye among all adult age categories and to discover independent risk factors by investigating a wide range of etiological categories.

Delayed postoperative cerebrospinal fluid (CSF) leaks are uncommon and largely unstudied complications. In this study we aim to identify their etiology and understand the efficacy of various reconstruction strategies.

This study aimed to compare low-residual diet (LRD) with clear liquid diet (CLD) for bowel preparation before colonoscopy.

Fighting cancer is a costly battle, and understanding the relationship between patient-reported financial toxicity (FT) and health outcomes can help inform interventions for post-treatment cancer survivors.

To address the relative influence of psychological factors on variation in PROMIS PF CAT and ODI scores.

Elderly-onset RA (EORA) and polymyalgia rheumatica (PMR) are common rheumatic diseases in the elderly. Oxylipins are bioactive lipids derived from omega-6 (n-6) and omega-3 (n-3) polyunsaturated fatty acids (PUFA) that serve as activators or suppressors of systemic inflammation. We hypothesized that arthritic symptoms in the elderly were related to oxylipins-related perturbations. Arthritis in the Elderly (ARTIEL) is an observational prospective cohort with 64 patients >60 years of age with newly diagnosed arthritis. Patients' blood samples at baseline and 3 months posttreatment were compared with 18 controls. A thorough clinical examination was conducted. Serum oxylipins were determined by mass spectrometry. Data processing and statistical analysis were performed in R. Forty-four patients were diagnosed with EORA and 20 with PMR. At diagnosis, EORA patients had a mean DAS28CRP (Disease Activity Score 28 using C reactive protein) of 5.77 (SD, 1.02). 100% of PMR patients reported shoulder pain and 90% reported pelvic pain. Several n-6- and n-3-derived oxylipin species were significantly different between controls and arthritis patients. The ratio of n-3/n-6 PUFA was significantly downregulated in EORA but not in PMR patients as compared to controls. The top two candidates as biomarkers for differentiating PMR from EORA were 4-HDoHE, a hydroxydocosahexaenoic acid, and 8,15-dihydroxy-eicosatrienoic acid (8,15-diHETE). The levels of n-3 derived anti-inflammatory species increased in EORA after treatment. These results suggest that certain oxylipins may be key effectors in arthritis in the elderly and that the imbalance between n-6 and n-3 derived oxylipins might be related to pathobiology in this population.