Factors associated with incomplete colonoscopy at a Japanese academic hospital

AIM: To evaluate significant risk factors for incomplete colonoscopy at a Japanese academic hospital.

Seasonal variations in the onset of ulcerative colitis in Japan

AIM:To investigate seasonal variations in the onset and relapse of ulcerative colitis(UC)in Japanese patients.METHODS:Between 1994 and 2006,198 Japanese patients diagnosed with UC according to conventional criteria in an academic hospital were enrolled for onset evaluation.Among 265 Japanese patients with UC who were observed for more than 12 mo,165 patients relapsed(239 times)and were enrolled for relapse evaluation.The patients’symptoms were recorded each month for 12 consecutive years.RESULTS:There was monthly seasonality in symptom onset during October and March for UC.The onset of symptoms in UC patients frequently occurred during the winter.Variation in UC onset was observed according to both month(P=0.015)and season(P=0.048).Relapse commonly occurred in October,and variations in relapse were not significant either in month(P=0.52)or season(P=0.12).Upper respiratory inflammation was the main factor responsible for relapse.CONCLUSION:Our results suggest that environmental factors associated with winter and spring seasonality may be responsible for triggering the clinical onset of UC in Japan.

Relationship between genetic polymorphisms of ALDH2 and ADH1B and esophageal cancer risk:A meta-analysis

AIM:To evaluate the contribution of alcohol dehydrogenase-1B(ADH1B)and aldehyde dehydrogenase-2 (ALDH2)polymorphisms to the risk of esophageal cancer.METHODS:Nineteen articles were included by searching MEDLINE,EMBASE and the Chinese Biomedical Database,13 on ADH1B and 18 on ALDH2.We performed a meta-analysis of case-control studies including 13 studies on ADH1B(cases/controls:2390/7100)and 18 studies on ALDH2(2631/6030).RESULTS:The crude odds ratio[OR(95%confidence interval)]was 2.91(2.04-4.14)for ADH1B*1/*1(vs ADH1B*2/*2)and 1.32(1.17-1.49)for ADH1B*1/*2.The crude OR for ALDH2*1/*2(vs ALDH2*1/*1)was 2.52(1.76-3.61).ADH1B*1/*1 increased the risk of esophageal cancer among never/rare[1.56(0.93-2.61)],moderate[2.71(1.37-5.35)],and heavy drinkers[3.22 (2.27-4.57)].ADH1B*1/*2 was associated with a modest risk among moderate drinkers[1.43(1.09-1.87)].ALDH2*1/*2 increased the risk among never/rare[1.28 (0.91-1.80)],moderate[3.12(1.95-5.01)],and heavy [7.12(4.67-10.86)]drinkers,and among ex-drinkers [5.64(1.57-20.25)].ALDH2*2/*2 increased the risk among drinkers[4.42(1.72-11.36)].ADH1B*1/*1 plus ALDH2*1/*2 was associated with the highest risk for heavy drinkers[12.45(2.9-53.46)].The results of the meta-regression analysis showed that the effects of ADH1B*1/*1 and ALDH2*1/*2 increased with the level of alcohol consumption.ALDH2*1/*2 was associated with a high risk among Taiwan Chinese and Japanese drinkers,as opposed to a moderate risk among drinkers in high-incidence regions of China's Mainland.ADH1B*1/*1 in heavy drinkers and ALDH2*1/*2 in moderate-toheavy drinkers was associated with similarly high risk among both men and women.CONCLUSION:ADH1B/ALDH2 genotypes affect the risk of esophageal cancer,and the risk is modified by alcohol consumption,ethnicity,and gender.

Presence of columnar-lined esophagus is negatively associated with the presence of esophageal varices in Japanese alcoholic men

AIM To determine whether the presence of columnar-lined esophagus(CLE) is associated with the presence of esophageal varices(EVs) in male Japanese alcoholics. METHODS The subjects were 1614 Japanese alcohol-dependent men(≥ 40 years of age) who had undergone upper gastrointestinal endoscopic screening. Digitalized records of high-quality endoscopic images that included the squamocolumnar junction and esophagogastric junction were retrospectively jointly reviewed by four expert endoscopists for the purpose of diagnosing CLE. The authors investigated whether and to what extent there were associations between the presence of CLE and the presence of EVs, especially in the group with liver cirrhosis(LC).RESULTS CLE ≥ 5 mm in length was found in 355 subjects(≥ 30 mm in 6 of them), LC without EVs in 152 subjects, LC with EVs in 174 subjects, and EVs without LC in 6 subjects. Advanced EVs, i.e., nodular, large or coiled forms, red color sign, or post-treatment, were found in 88 subjects. The incidence of CLE ≥ 5 mm decreased in the following order(P < 0.0001): 23.3% in the group without EVs, 17.4% in the group with small and straight EVs, and 5.7% in the group with advanced EVs. The multivariate ORs(95%CI) for EVs and advanced EVs in the group with LC were lower when CLE ≥ 5 mm was present [0.46(0.23-0.93) and 0.24(0.08-0.74), respectively, vs 0-4 mm CLE]. CONCLUSION The presence of CLE in male Japanese alcoholics was negatively associated with the presence of EVs.