ObjectiveThe association between proton pump inhibitor (PPI) use and gastric cancer related to Helicobacter pylori eradication has not been fully investigated in geographical regions with high risk of gastric cancer. We aimed to evaluate the association between PPIs and gastric cancer in Korea.DesignThis study analysed the original and common data model versions of the Korean National Health Insurance Service database from 2002 to 2013. We compared the incidence rates of gastric cancer after 1-year drug exposure, between new users of PPIs and other drugs excluding PPIs, by Cox proportional hazards model. We also analysed the incidence of gastric cancer among PPI users after H. pylori eradication.ResultsThe analysis included 11 741 patients in matched PPI and non-PPI cohorts after large-scale propensity score matching. During a median follow-up of 4.3 years, PPI use was associated with a 2.37-fold increased incidence of gastric cancer (PPI≥30 days vs non-PPI; 118/51 813 person-years vs 40/49 729 person-years; HR 2.37, 95% CI 1.56 to 3.68, p=0.001). The incidence rates of gastric cancer showed an increasing trend parallel to the duration of PPI use. In H. pylori-eradicated subjects, the incidence of gastric cancer was significantly associated with PPI use over 180 days compared with the non-PPI group (PPI≥180 days vs non-PPI; 30/12 470 person-years vs 9/7814 person-years; HR 2.22, 95% CI 1.05 to 4.67, p=0.036).ConclusionPPI use was associated with gastric cancer, regardless of H. pylori eradication status. Long-term PPIs should be used with caution in high-risk regions for gastric cancer.

Osteoarthritis (OA) is the most prevalent joint disease in older people and is characterized by the progressive destruction of articular cartilage, synovial inflammation, changes in subchondral bone and peri-articular muscle, and pain. Because our understanding of the aetiopathogenesis of OA remains incomplete, we haven’t discovered a cure for OA yet. This review appraises novel therapeutics based on recent progress in our understanding of the molecular pathogenesis of OA, including pro-inflammatory and pro-catabolic mediators and the relevant signalling mechanisms. The changes in subchondral bone and peri-articular muscle accompanying cartilage damage are also reviewed.

Objective. To evaluate the relationships between fat mass, muscle mass, fat:muscle mass ratio, metabolic syndrome, and musculoskeletal pain in community residents.Methods. In the Korean Health and Genome Study, 1,530 participants (mean ؎ SD age 60.8 ؎ 8.60 years) completed pain questionnaires and underwent dual x-ray absorptiometry to calculate body composition. Pain was categorized according to the number of pain regions, such that widespread pain, defined as pain above the waist, below the waist, on both sides of the body, and in the axial region, represented the most severe pain. Metabolic syndrome was defined using the International Diabetes Federation 2005 recommendations, and the association between metabolic syndrome and pain was evaluated by dividing the population into 4 groups, according to the presence/absence of metabolic syndrome and of high body mass index (BMI).Results. Total fat mass and fat:muscle mass ratio were significantly and positively associated with musculoskeletal pain among female subjects only. Compared to the lowest quartile of fat:muscle mass ratio, the odds ratios for widespread pain among subjects in other quartiles were significantly increased after adjustment for confounders. Widespread pain was more prevalent among subjects with metabolic syndrome whether their BMI was high or normal, especially among female subjects.Conclusion. Increased fat mass and fat:muscle mass ratio were significantly associated with musculoskeletal pain among women. Widespread pain was significantly associated with a high fat:muscle mass ratio after adjustment for confounders. Understanding the relationship between fat mass and pain may provide insights into preventative measures and therapeutic strategies for musculoskeletal pain.

HRQOL levels were differentially associated with clinical facets in pSS and non-SS sicca patients, although the groups had similar clinical symptoms and HRQOL reduction. Because depression and ESSPRI are major determinants of HRQOL in Korean pSS patients, ESSPRI is suggested to be disease-specific for pSS.