In this study, the hydroxyapatite (HAps) containing bovine serum albumin (BSA) were coated on titanium using the electrochemical deposition (ECD) method. Negative electric current pulses were applied to titanium specimens at 37 ℃ using a Ca- and P-containing electrolyte in which BSA was added E-BSA-10, E-BSA-15, and E-BSA-20 groups were prepared by changing the electric current to –10 mA, –15 mA, and –20 mA, respectively. As a comparative group, an E-15 specimen was prepared by applying a current of -15 mA to the specimen in Ca- and P-containing electrolyte without BSA. A coating film composed of nanosheet-shaped crystals was observed on the surface of each specimen, and the size of the nanocrystals on the BSA-containing groups was larger than that of the E-15 group. These crystals were smaller in size and higher in density as the applied current values were increased. All specimens had HAp crystalline structure. BSA-containing specimens showed a tendency of preferential growth of HAp crystals in c-axis orientation, and this tendency decreased as the applied current values were increased. In the FT-IR spectrum, amide peaks that corresponds to BSA were identified. As a result of soaking the BSA-containing group specimens in phosphate-buffered saline (PBS) for 60 hours, it was observed that the crystal structure aligned with the c-axis was disordered, and BSA was released slowly with the decomposition of HAp. This study is expected to be applied to the development of a surface treatment method for coating titanium implants with HAp containing various biological factors in the future.

In this study, the hydroxyapatite (HAps) containing bovine serum albumin (BSA) were coated on titanium using the electrochemical deposition (ECD) method. Negative electric current pulses were applied to titanium specimens at 37 ℃ using a Ca- and P-containing electrolyte in which BSA was added E-BSA-10, E-BSA-15, and E-BSA-20 groups were prepared by changing the electric current to –10 mA, –15 mA, and –20 mA, respectively. As a comparative group, an E-15 specimen was prepared by applying a current of -15 mA to the specimen in Ca- and P-containing electrolyte without BSA. A coating film composed of nanosheet-shaped crystals was observed on the surface of each specimen, and the size of the nanocrystals on the BSA-containing groups was larger than that of the E-15 group. These crystals were smaller in size and higher in density as the applied current values were increased. All specimens had HAp crystalline structure. BSA-containing specimens showed a tendency of preferential growth of HAp crystals in c-axis orientation, and this tendency decreased as the applied current values were increased. In the FT-IR spectrum, amide peaks that corresponds to BSA were identified. As a result of soaking the BSA-containing group specimens in phosphate-buffered saline (PBS) for 60 hours, it was observed that the crystal structure aligned with the c-axis was disordered, and BSA was released slowly with the decomposition of HAp. This study is expected to be applied to the development of a surface treatment method for coating titanium implants with HAp containing various biological factors in the future.

Background/Aims: Owing to the low prevalence of small-bowel adenocarcinoma (SBA), data on the impact of Crohn’s disease (CD) on the survival of patients with SBA are lacking. Therefore, we investigated this issue in this study. Methods: In this bicenter cohort study, patients with histologically confirmed SBA were retrospectively enrolled and classified into two groups: sporadic SBA and CD-associated SBA. Patients with duodenal SBA were excluded. Overall survival, disease-free survival, and factors associated with survival were analyzed. Results: Of 128 patients with SBA, 115 had sporadic SBA and 13 had CD-associated SBA. Ileal involvement and poorly differentiated tumors were more common in the CD-associated SBA group than in the sporadic SBA group (ileal involvement, 53.8% vs 22.6%; poor differentiation, 46.2% vs 14.8%; both p<0.05). In survival analysis, overall survival showed no statistical difference between the sporadic SBA and CD-associated SBA groups (p=0.370). However, when stratified by stage, the adjusted overall survival of the CD-associated SBA group was lower in patients with an advanced disease stage (p=0.029). Disease-free survival showed the same tendency, albeit without clinical significance (p=0.097). CD (hazard ratio [HR], 2.308; p=0.047), older age (≥65 yr) at SBA diagnosis (HR, 2.766; p=0.001), and stage III/IV disease (HR, 3.151; p<0.001) were factors associated with mortality. Conclusions The overall survival of patients with CD-associated SBA did not differ from that of patients with sporadic SBA. However, as CD is an independent risk factor for mortality, vigilant surveillance in high-risk patients may be crucial.

Objectives: It is important that inflammatory bowel disease (IBD) patients adhere to their prescribed medication regimens to avoid the repeat exacerbations, complications, or surgeries associated with this disorder. However, there are few studies on medication adherence in patients with IBD, especially in Asian populations. So, we analyzed the factors associated with medication adherence in Korean IBD patients. Methods: Patients who had been diagnosed with Crohn’s disease (CD) or ulcerative colitis (UC) more than 6 months previously and receiving oral medications for IBD were enrolled. Medication adherence was measured using the Medical Adherence Reporting Scale (MARS-5), a self-reported medication adherence measurement tool. Results: Among 207 patients in the final study population, 125 (60.4%) had CD and 134 (64.7%) were men. The mean age was 39.63 years (SD, 13.16 years) and the mean disease duration was 10.09 years (SD, 6.33 years). The mean medication adherence score was 22.46 (SD, 2.86) out of 25, and 181 (87.4%) patients had score of 20 or higher.In multiple linear regression analysis, self-efficacy (β=0.341, P<0.001) and ≥3 dosing per day (β=–0.192 P=0.016) were revealed to be significant factors associated with medication adherence. Additionally, there was a positive correlation between self-efficacy and medication adherence (r=0.312, P<0.001). However, disease related knowledge, depression, and anxiety were not significantly associated with medication adherence. Conclusion To improve medication adherence among patients with IBD, a reduction in the number of doses per day and an improved self-efficacy will be helpful.

Background/Aims: We aimed to investigate the oral beclomethasone dipropionate’s (BDP) efficacy as an add-on therapy and to clarify the predictive factor for response to oral BDP in Korean ulcerative colitis (UC) patients. Methods: Patients with a stable concomitant drug regimen with exposure to oral BDP (5 mg/day) within 30 days before BDP initiation were included. Partial Mayo score (pMS) was used to evaluate response to oral BDP. Clinical remission (CREM) was defined as a post-treatment pMS ≤ 1 point. Clinical response (CRES) was defined as an at least 2-point decrease in post-treatment pMS and an at least 30% decrease from baseline pMS. Patients without CREM or CRES were considered nonresponders (NRs). Results: Of all, 37 showed CREM, 19 showed CRES, and 44 were NRs. The CREM group included more patients with mild disease activity (75.7% vs. 43.2%, p = 0.011) than NRs. In contrast to NRs, CREM and CRES patients showed significant improvement of post-treatment erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) (ESR with p = 0.001, CRP with p = 0.004, respectively). Moreover, the initial rectal bleeding subscore (RBS) was significantly different between CREM and CRES, or NR (both with p < 0.001). In multivariate analyses, initial stool frequency subscore (SFS) of 0 and RBS of 0 were predictive factors for CREM (odds ratio [OR], 15.359; 95% confidence interval [CI], 1.085 to 217.499; p = 0.043 for SFS, and OR, 11.434; 95% CI, 1.682 to 77.710; p = 0.013 for RBS). Conclusions Oral BDP is an efficacious add-on therapy in Korean UC patients. Patients with initial SFS or RBS of 0 may be particularly good candidates for oral BDP.

Purpose: This study aimed to evaluate the safety of biologics and small molecules for the treatment of inflammatory bowel diseases (IBD) in patients receiving antirejection therapies after organ transplants. Materials and Methods: We reviewed the medical records of patients with IBD who received organ transplants at the Asan Medical Center between January 1989 and December 2021. We compared the parameters of patients receiving biologics or small molecules to those of patients without those therapies. Results: This study included a total of 53 patients (ulcerative colitis, 41; Crohn’s disease, 6; and gastrointestinal Behçet’s disease, 6). Among them, 15 patients were receiving biologics or small molecules and 38 were not. During a mean follow-up of 119 months, the proportion of patients experiencing severe infections was significantly higher in those treated with biologics or small molecules than in those not treated. However, other safety outcomes (e.g., malignancies, adverse events, including organizing pneumonia or hepatic failure, and death) were not different between the two groups. Kaplan–Meier curve analysis revealed no significant difference in the safety outcome rate related to the use of biologics or small molecules. During follow-up, eight patients underwent bowel resections for IBD. The rate of bowel resection was not different between the two groups. Conclusion The use of biologics or small molecules for patients with IBD who received organ transplants did not show a significant difference in safety outcomes. However, the possibility of severe infections must be considered.