The Korean Society of Gastroenterology & SIDDS 2014
508 32nd World Congress of Internal Medicine (October 24-28, 2014)
K-MO-10 GI Motility
The Effect of Emotional Stress and Depression on the Prevalence of Digestive Diseases
Sang Pyo Lee1, In-Kyung Sung1, Jeong Hwan Kim1, Sun-Young Lee1, Hyung Seok Park1, Chan Sup Shim1
Konkuk University Medical Center, Korea1
Background: Epidemiological data indicate that emotional stress and depression might infl uence the development of cancer and functional GI disorders. However it is still unclear whether stress and depression are related to many different digestive diseases.
The aims were to investigate the effect of stress and depression on the prevalence of digestive diseases and to identify whether stress and depression are risk factors of the diseases.
Methods: A total of 23,698 subjects who had a medical check-up including upper and lower endoscopy were enrolled. By reviewing the subject’s self-reporting questionnaire and endoscopic fi ndings, we investigated the digestive diseases, including functional dyspepsia (FD), irritable bowel syndrome (IBS), refl ux esophagitis, peptic ulcer disease (PUD), adenoma and carcinoma of stomach and colon. Depression and stress scores were measured by a Korean version of the Beck’s Depression Inventory and Brief En- counter Psychosocial Instrument- Korean version.
Results: Emotional stress and depression were related to FD, IBS, and refl ux esophagi- tis. Depression was also linked to PUD and adenoma/carcinoma of colon and stomach.
Multivariate analysis revealed that stress and depression were independent risk factors of FD (OR, 1.713 and 1.984, p<0.001) and IBS (OR, 1.730 and 3.508, p<0.001). Subjects with depression were at signifi cant risk of gastric adenoma and carcinoma (OR, 4.543;
95% CI, 2.415-8.549, p<0.001).
Conclusions: Stress and depression are related to many digestive diseases and they may be predisposing factor of FD and IBS. Depression may also be a cause of gastric cancer. Psychological evaluation of gastroenterology patients will be essential.
K-MO-11 GI Motility
Validation of the EQ-5D Questionnaire in Female Patients with Chronic Constipation in a Tertiary Care Center
Kee Wook Jung1, Min-Woo Jo2, Seon-Ha Kim2, Woo-Seung Son2, Hyo Jeong Lee1, Dong-Hoon Yang1, In Ja Yoon1, So Young Seo1, Hyun Sook Koo1, Ji-Beon Kim1, Sang Hyoung Park1, Kyung Jo Kim1, Byong Duk Ye1, Jeong-Sik Byeon1, Hwoon-Yong Jung1, Suk-Kyun Yang1, Jin-Ho Kim1, Seung-Jae Myung1
Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Korea1, De- partment of Preventive Medicine, Asan Medical Center, University of Ulsan College of Medicine, Korea2 Background: Previous studies using Short Form-36 (SF-36) and Patient Assessment of Constipation Quality of Life (PAC-QOL) have shown a reduced quality of life (QOL) in patients with chronic constipation. However, these questionnaires were composed of more than 26 items, and these surveys taken at outpatient clinics were time-con- suming. European Quality of Life-5 Dimensions (EQ-5D) is composed of 5 dimensions with 3 levels measuring people’s utility. However, the psychometric properties of EQ- 5D in chronic constipation have not been evaluated. We aimed to investigate the validity and reliability of EQ-5D and compare them with those of PAC-QOL and SF-36 in women with chronic constipation.
Methods: Constipated 150 women (54 ± 16 years) who visited a constipation clinic were prospectively enrolled. They were asked to fi ll in bowel- and QOL-related ques- tionnaires. Construct validity was examined by determining the difference between the EQ-5D indexes among the questionnaires. In addition, differences in the EQ-5D index on the PAC-QOL score were analyzed.
Results: The mean duration of constipation and the use of laxatives were 15.1 ± 13.6 years and 6.7 ±8.3 years, respectively. The EQ-5D index showed signifi cant differences in age, education, and comorbidities (all P< 3 times of bowel movement/week) than those with a higher frequency of defecation (= 3 times of bowel movement/week) (P Conclusions: The EQ-5D appears to be effective in measuring QOL in patients with chronic constipation. EQ-5D can be complementary to the previously used PAC-QOL and SF-36 in outpatient clinic settings.
K-GIO-01 GI Oncology
Omega 3-Fatty Acids Prevent Tumor Developmentiin Helicobacter pylori-Infected Mice
Eun-Hee Kim1, Young-Min Han1, Napapan Kangwan1, Sung Pyo Hong2, Kwang Hyun Ko2, Ki-Baik Hahm2
CHA Cancer Prevention Research Center, CHA Cancer Institute, CHA University, Korea1, Department of Gastroenterology, CHA Bundang Medical Center, Korea2
Background: Helicobacter pylori (H. pylori) infection has been well known in acute gastritis, chronic atrophic gastritis, peptic ulcers as well as gastric cancer. Although the benefi ts of ω3 polyunsaturated fatty acids (ω3-PUFA) in diverse clinical diseases has been reported to the amelioration against infl ammation and cancer, there is no convincing experimental evidence that the ω3-PUFAs can prevent H. pylori-induced infl ammatory responses and carcinogenesis. In this study, we investigated ω3-PUFA might prevent H. pylori-induced gastric injury, especially in fat-1 transgenic mice, which can generate ω3-PUFA due to overexpression of 6-desaturase, converting ω6 into ω3-PUFA.
Methods: Wild-type C57BL/6 and fat-1 transgenic mice at 4 weeks were inoculated with H. pylori (Sidney strain 1), mice were treated proton pump inhibitor for higher H. pylori infection rate before inoculation. For the serial sacrifi ce study, stomachs from wild-type C57BL/6 and fat-1 transgenic mice at 16, 24, 32 and 45 weeks of age were harvested.
Results: H. pylori infection induced the discoloration, surface destruction, ulcerative and erosive lesions, infi ltration of infl ammatory cells on H. pylori-infected mice. As antici- pated, ω3-PUFA imposed signifi cant protection from H. pylori-induced gastritis as well as attenuated incidence of H. pylori-induced gastric tumorigenesis in vivo. The average number of tumors per mice was reduced (P<0.05) in fat-1 mice, with an average of 0.7 tumors per mouse compared with an average of 1.5 tumors per mouse in the wild- type C57BL/6 mice. ω3-PUFA also showed the signifi cant anti-infl ammatory effects on H. pylori-infected gastritis through inhibiting the mucosal damages, the expression of infl ammatory enzymes, cytokines and pathologic fi nding in H. pylori-infected mice.
Conclusions: In conclusion, ω3-PUFA can be anticipating novel substance to impose both action of anti-infl ammation and anti-tumorigenesis against H. pylori infection.
K-GIO-02 GI Oncology
8-Hydroxydeoxyguanosine Inhibits the Metastasis of Pancreatic Cancer Cells Via Suppression of Erm Pathway
Jong-Min Park1, Mi-Kyoung Jung1, Eun-Hee Kim1, Chang-Il Kwon2, Seong-Gyu Hwang2, Kyu-Sung Lim2, Sung Pyo Hong2, Ki-Baik Hahm2
CHA Cancer Prevention Research Center, CHA Cancer Institute, CHA University, Korea1, Department of Gastroenterology, CHA Bundang Medical Center, Korea2
Background: 8-hydroxydeoxyguanosine (8-OHdG), traditionally has been acknowledged as a marker of oxidative stress-related mutagenesis, could paradoxically exerted potent anti-infl ammatory and anti-oxidant action in various models. In this study, we investi- gated the chemopreventive effects of 8-OHdG in pancreatic cancer metastasis model Methods: We treated with 8-OHdG to Panc-1, pancreatic cancer cell line, in order to observe the anti-metastasis effects. We performed wound migration assay, invasion assay, zymography, immunoprecipitation assay, confocal microscopy, RT-PCR and western blot analysis. Tail vein in vivo models of metastasis in nude mice were used to assess cancer cell metastasis.
Results: OHdG had fabulous efficacy on the metastasis of panc-1 cell which was further confi rmed by wound migration assay and invasion assay. 8-OHdG suppressed cell migration by inhibiting ERM phosphorylation via reducing of Rho-GTP activation, thereby decreasing of CD44 expression and interaction between ERM and actin.
The expression of various MMPs family was also decreased after 8-OHdG treat- ment. Moreover, 8-OHdG inhibits epithelial-mesenchymal transition (EMT) through down-regulation of Vimentin and up-regulation of Claudin1 and Zo-1 expression.
Notably, 8-OHdG prevented formation of lung metastatic lesions in tail-vein models of metastasis in immunodefi cient mice.
Conclusions: In conclusion, exogenous 8-OHdG, recognized as the product of oxida- tive stress, elucidates anti-metastasis actions in carcinogenesis. This inhibitory effect of 8-OHdG on the migration and invasion was mediated by blocking interaction be- tween ERM and actin via the suppression of pERM and CD44.
