Family history influences the early onset of hepatocellular carcinoma

AIM: To evaluate the relationship between a positive family history of primary liver cancer and hepatocellular carcinoma (HCC) development in Korean HCC patients. METHODS: We studied a total of 2242 patients diagnosed with HCC between January 1990 and July 2008, whose family history of primary liver cancer was clearly described in the medical records.positive family history of HCC and 2077 (92.6%) did not. The male to female ratio was 3.6:1, and the major causes of HCC were chronic hepatitis B virus (HBV) infection in 75.1%, chronic hepatitis C virus infection in 13.2% and alcohol in 3.1%. The median ages at diag- nosis in the positiveand negative-history groups were 52 years (range: 29-79 years) and 57 years (range: 18-89 years), respectively (P < 0.0001). Furthermore, among 1713 HCC patients with HBV infection, the number of patients under 45 years of age out of 136 patients with positive family history was 26 (19.1%), whereas those out of 1577 patients with negative family history was 197 (12.5%), suggesting that a positive family history may be associated with earlier development of HCC in the Korean population (P = 0.0028). CONCLUSION: More intensive surveillance maybe recommended to those with a positive family history of HCC for earlier diagnosis and proper management especially when HBV infection is present.

PSCA, Cox-2, and Ki-67 are independent, predictive markers of biochemical recurrence in clinically localized prostate cancer： a retrospective study

Prostate cancer is the second most common male cancer, with half of all patients going on to develop metastases. To better identify patients at high risk for prostate cancer progression and reduce prostate cancer-related mortality, improved prognostic factors are required. In this study, we used immunohistochemistry （IHC） to determine the prognostic values of multiple tissue biomarkers in hormone-na＇l＇ve prostatectomy specimens of prostate cancer. Using 510 prostatectomy specimens collected between 2002 and 2012, IHC analysis was performed for Cerb-2, Cyclin D1, VEGF, EGFR, Rb, PSCA, p53, Bcl-2, Cox-2, PMS2, and Ki-67 on formalin-fixed paraffin-embedded sections. The Cox proportional hazard model was used to determine the predictive risk factors for biochemical recurrence （BCR） of prostate cancer. During a median 44-month follow-up, 128 （25.1%） patients developed BCR. A multivariate regression analysis revealed that Ki-67 （hazard ratio [HR]. 1.60, P = 0.033）, PSCA （HR： 0.42, P 〈 0.001）, and Cox-2 （HR： 2.05, P = 0.003） were the only significant prognostic tissue markers of BCR. Resection margin status （HR： 1.67, P = 0.010）, pathologic pTO/l/2 stage （vs pT3/4; HR： 0.20, P = 0.002）, preoperative PSA levels （HR.. 1.03, P 〈 0.001）, biopsied （HR： 1.30, P = 0.022） and pathologic （HR： 1.42, P = 0.005） Gleason scores, and prostate size （HR： 0.97, P = 0.003） were significant clinicopathologic factors. The expression of Ki-67, PSCA, and Cox-2 biomarkers along with other clinicopathologic factors were prognostic factors for BCR in patients with clinically localized prostate cancer following radical prostatectomy.

Efficacy and Safety of ＂URSA Complex＂ in Subjects with Physical Fatigue： A Multicenter, Randomized, Double-blind, Placebo-controlled Trial

Background： Fatigue is a common symptom both in diseases status and in healthy subjects. Various supplements and nutraceuticals for relieving of fatigue have been used. However, there are a few studies to evaluate the efficacy and the safety of the drug tbr fatigue alleviation, we conducted using URSA Complex to evaluate the efficacy on physical fatigue via score changes in the checklist individual strength （CIS）. Methods： The study was designed as a multicenter, randomized, double-blind, placebo-controlled trial, with subjects randomized to one of the two arms, receiving either placebo or URSA Complex administered as identical capsules. The primary efficacy endpoints of this clinical trials are the ratio of improving CIS scores 〈 76 points in patients at the end （4 weeks）. Secondary efficacy variables are as follows one is an improvement of fatigue and the other is an improvement of the liver enzyme. Results： The fatigue recovery rate in who had improved CIS scores of 〈 76 points were 70.0%, 50.9% in the therapy group and placebo group, respectively （P = 0.0l 9）. The fatigue recovery rate in CIS score was higher in URSA Complex therapy group than placebo group. The difference between therapy group and placebo group was statistically significant at 4 weeks later, but not 2 weeks. Conclusions： Our results provided that the URSA Complex was effective in alleviating physical fatigue. The adverse event frequency in the therapy groups was similar to that in the placebo group.

Long-term effects of various types of 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors on changes in glomerular filtration rate in Korea

Few long-term follow-up studies have compared the changes in renal function according to the type of statin used in Korea.We compared the long-term effects of statin intensity and type on the changes in the glomerular filtration rate(GFR).We extracted data of patients who took statin for the first time.We analyzed whether or not different statins affect the changes in GFR at 3 months after baseline and 4 years after.We included 3678 patients and analyzed the changes in GFR.The GFR decreased by 3.2%±0.4%on average 4 years after the first statin prescription,indicating statistically significant deterioration(from 83.5±0.4 mL/min/1.73 m2 to 79.9±0.4 mL/min/1.73 m2,P<0.001).When comparing the GFR among different statins,significant differences were observed between atorvastatin and fluvastatin(−5.3%±0.7%vs.1.2%±2.2%,P<0.05)and between atorvastatin and simvastatin(−5.3%±0.7%vs.−0.7%±0.8%,P<0.05).In pitavastatin(odds ratio[OR]=0.64,95%confidence interval[CI]=0.46-0.87,P<0.005)and simvastatin(OR=0.69,95%CI=0.53-0.91,P<0.008),the GFR rate that decreased by<60 mL/min/1.73 m2 was significantly lower than that of atorvastatin.Regarding long-term statin intake,GFR changed with the type of statin.This work is the first in Korea to compare each statin in terms of changes in the GFR after the statin prescription.