Purpose
To investigate the effect of COL8A2 repression on corneal endothelial cells (CECs) in vitro and in vivo.
Methods
Cultured human CECs (hCECs) were transfected with
COL8A2
siRNA (
siCOL8A2
), and the cell viability and proliferation rate were measured. The expression of cell proliferation–associated molecules was evaluated by Western blotting and real-time reverse transcription PCR. Cell shape, Wingless-INT (WNT) signaling, and mitochondrial oxidative stress were also measured. For in vivo experiments,
siCOL8A2
was transfected into rat CECs (rCECs), and corneal opacity and corneal endothelium were evaluated.
Results
After transfection with
siCOL8A2
, COL8A2 expression was reduced (80%). Cell viability, cell proliferation rate, cyclin D1 expression, and the number of cells in the S-phase were reduced in
siCOL8A2
-treated cells. The cell attained a fibroblast-like shape, and SNAI1, pSMAD2, and β-catenin expression, along with mitochondrial mass and oxidative stress levels, were altered. Corneal opacity increased, and the CECs were changed in rats in the
siCOL8A2
group.
Conclusions
COL8A2 is required to maintain normal wound healing and CEC function.
INTRODUCTION:
We investigated to compare the effect of empirical therapy
vs
clarithromycin resistance–guided tailored therapy (tailored therapy) for eradication of
Helicobacter pylori
.
METHODS:
In this prospective, single center, open-label randomized controlled trial, we enrolled 72 patients with
H. pylori
infection from January 2019 through June 2019 in Korea. The patients were randomly assigned to both groups received empirical (n = 36) or tailored therapy (n = 36). Empirical therapy was defined as triple therapy with esomeprazole, amoxicillin, and clarithromycin for 10 days irrespective of clarithromycin resistance. Tailored therapy was triple or quadruple therapy with esomeprazole, metronidazole, tetracycline, and bismuth for 10 days based on genotype markers of resistance determined by gastric biopsy. Resistance-associated mutations in 23S rRNA were confirmed by multiplex polymerase chain reaction. Eradication status was assessed by
13
C-urea breath test, and the primary outcome was eradication rates.
RESULTS:
H
.
pylori
was eradicated in 27 patients (75.0%), given empirical therapy and 32 patients (88.9%) treated with tailored therapy (
P
= 0.136) in intention-to-treat analysis. In per protocol analysis, the eradication rate was 97.0% and 81.8% in tailored
vs
empirical groups (
P
= 0.046). Although clarithromycin-resistant
H. pylori
was eradicated in 3/9 (33.3%) with empirical therapy, it was treated in 11/12 (91.7%) with tailored therapy (
P
= 0.009). There was no difference in compliance between 2 groups. The rate of adverse events of the tailored group was higher than that of the empirical group (
P
= 0.036) because quadruple therapy had more side effects than those of triple therapy (
P
= 0.001).
DISCUSSION:
Tailored therapy based on polymerase chain reaction is a good alternative to increase eradication rates in a region of high prevalence of clarithromycin resistance (see Visual Abstract, Supplementary Digital Content 1,
http://links.lww.com/CTG/A342
).
INTRODUCTION:
Endoscopic submucosal dissection (ESD) is a preferred treatment option for superficial esophageal squamous cell carcinoma (SESCC). However, only few studies compared long-term survival outcomes of ESD with surgery. This study compared the overall survival (OS), recurrence-free survival, and complication rates of ESD with those of surgery.
METHODS:
We reviewed patients who underwent ESD (n = 70) or surgery (n = 114) for SESCC at Seoul National University Hospital from 2011 to 2017. A propensity score-matched analysis was used to reduce selection bias. To increase the precision of our results interpretation, subgroups were analyzed according to the depth of tumor invasion.
RESULTS:
In the matching study, the ESD group (n = 34) showed comparable survival outcomes with the surgery group (n = 34). The 5-year OS rates were 89.4% vs 87.8% for the ESD and the surgery groups, respectively; similarly, the 5-year recurrence-free survival rates were 90.9% and 91.6%, respectively. The ESD group showed a lower early major complication rate (2.9% [1 of 34] vs 23.5% [8 of 34],
P
< 0.001) and shorter hospital stay (median, 3.0 days vs 16.5 days,
P
< 0.001) than the surgery group. In the tumor
in situ
(Tis)-subgroup, ESD showed better OS than esophagectomy (
P
= 0.030). Between-group comparisons of survival outcomes in the T1a and T1b subgroups revealed no significant differences.
DISCUSSION:
Long-term outcomes of ESD are comparable with surgery for patients with SESCC. For early major complications and duration of hospital stay, ESD was associated with better outcomes than radical surgery. These results support ESD as the preferred treatment option for SESCC.
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