BACKGROUND/AIMS: The disease course and factors associated with poor prognosis in Korean patients with Crohn’s disease (CD) have not been fully determined. The aim of this study was to explore potential associations between the clinical characteristics and long-term outcomes of CD and perianal fistulas in a Korean population. METHODS: The retrospective Crohn’s Disease Clinical Network and Cohort (CONNECT) study enrolled patients diagnosed with CD between July 1982 and December 2008 from 32 hospitals. Those followed for < 12 months were excluded. Clinical outcomes were CD-related surgery and complications, including nonperianal fistulas, strictures, and intra-abdominal abscesses. RESULTS: The mean follow-up period was 8.77 years (range, 1.0 to 25.8 years). A total of 1,193 CD patients were enrolled, of whom 465 (39.0%) experienced perianal fistulas. Perianal fistulizing CD was significantly associated with younger age, male gender, CD diagnosed at primary care clinics, and ileocolonic involvement. Both nonperianal fistulas (p=0.034) and intra-abdominal abscesses (p=0.020) were significantly more common in CD patients with perianal fistulas than in those without perianal fistulas. The rates of complicated strictures and CD-related surgery were similar between the groups. Independently associated factors of nonperianal fistulas were perianal fistulas (p=0.015), female gender (p=0.048), CD diagnosed at referral hospital (p=0.003), and upper gastrointestinal (UGI) involvement (p=0.001). Furthermore, perianal fistulas (p=0.048) and UGI involvement (p=0.012) were independently associated with the risk of intra-abdominal abscesses. CONCLUSIONS: Perianal fistulas predicted the development of nonperianal fistulas and intra-abdominal abscesses in Korean CD patients. Therefore, patients with perianal fistulizing CD should be carefully monitored for complicated fistulas or abscesses.
Abdominal Abscess ; Abscess ; Cohort Studies ; Constriction, Pathologic ; Crohn Disease ; Female ; Fistula* ; Follow-Up Studies ; Humans ; Korea* ; Male ; Primary Health Care ; Prognosis* ; Rectal Fistula ; Referral and Consultation ; Retrospective Studies

BACKGROUND: Skin laser treatment has improved significantly and has become an effective treatment approach for many skin diseases while also having applications for beauty treatments. However, since skin laser transfers energy directly to the skin, the misuse of such treatment may result in permanent damage to skin tissues. OBJECTIVE: This survey of Korean adults, conducted to obtain their perspectives on and their treatment experience with skin laser treatment, will be used to determine the current status of skin laser treatment and to identify necessary changes to ensure proper and safe conduct of skin laser treatment. METHODS: From April 5th to April 12th, 2016, a survey was conducted to obtain information regarding the perspectives and the treatment experience of adults aged 20~59 years. RESULTS: Approximately 50% of the participants had experience with skin laser treatment, and among these, 24.7% had not received treatment at a dermatology clinic. Compared to treatment at a dermatology clinic, the danger of side effects was 1.7 times higher at a non-dermatology clinic, 2 times higher at a skin care shop, and 5.3 times higher at an Oriental medical clinic. Among patients who received skin laser treatment, 16.1% experienced side effects, and among these, 1 out of 4 patients visited a non-dermatologist for treatment of these side effects. CONCLUSION: The results of the survey showed that in order for the public to receive safe and effective skin laser treatment based on professional diagnosis, there is a definitive need to provide correct information to the public and to implement changes to ensure proper understanding of skin laser treatment among this population.
Adult ; Beauty ; Dermatology ; Diagnosis ; Humans ; Skin Care ; Skin Diseases ; Skin*

Objective To observe the clinical efficacy and safety of deprogesterone tablets in the treatment of climacteric syndrome.Methods A total of 86 women with climacteric syndrome were randomly divided into control group and treatment group with 43 cases per group.Control group received placebo 10 mg per time,qd,orally.Treatment group was treated with deprogesterone 10 per time,qd,orally.Two groups were treated for one month.The clinical efficacy,the levels of sex hormone and blood lipid,adverse drug reactions were compared between two groups.Results After treatment,the total effective rates of treatment and control groups were 93.02％ (40 cases/43 cases) and 72.09％ (31 cases/43 cases) with statistically significant difference (P ＜ 0.05).After treatment,the main indexes in treatment and control groups were compared:luteinizing hormone were (11.70 ± 1.13) and (28.36 ± 4.48) U · L-1,follicle stimulating hormone were (36.31 ±4.24) and (60.77 ± 7.75) U · L-1,estradiol were (71.76±9.37) and (45.43 ±5.21)pmol · L-1,triglyceride were (1.23 ± 0.24) and (1.72 ± 0.20) mmol · L-1,total cholesterol were (4.94 ± 0.66) and (5.82 ± 0.58) mmol · L-1,low density lipoprotein cholesterol were (2.64 ± 0.36) and (3.25 ±0.31)mmol · L-1,high density lipoprotein cholesterol were (1.66 ±0.21) and (1.38 ±0.13) mmol · L-1,the differences were statistically significant (all P ＜ 0.05).The adverse drug reactions in treatment group were based on insomnia (2 cases) and headache (2 cases).And there was no adverse drug reaction in the control group.The incidences of adverse drug reactions in treatment and control groups were 9.30％ and 0 without significant difference (P ＞ 0.05).Conclusion Deprogesterone tablets have a definitive clinical efficacy in the treatment of climacteric syndrome,which can effectively adjust the levels of sex hormone and blood lipid,without increasing the incidence of adverse drug reactions.

To investigate the effects of gambognic acid (GA) on TRAIL-induced apoptosis of cancer cells, human colon HT-29 cancer cells were treated with GA to promote apoptosis. Inhibition of the cell proliferation was measured with MTT assay and cell apoptosis was detected with formation of DNA ladders in agarose gel electrophoresis, and activation of caspase activity. The content of cytosolic reactive oxygen species (ROS) was measured with flow cytometry. The activities of Caspase-3, -8, -9 were detected using spectrophotometric assay. The levels of c-FLIP, CHOP, DR4 and DR5 in cells were tested by Western blot. Combination of GA (1 µg · mL(-1)) and TRAIL (40 ng · mL(-1)) significantly reduced proliferation and increased apoptosis of HT-29 cells over those induced by each agent alone. Percentage of apoptotic cells was increased to 45.5%. GA markedly enhanced the intracellular ROS generation. Expression of CHOP, DR4 and DR5 was up-regulated to 7.38, 5.41, and 4.85 times of the control group, respectively. GA promoted activation of Caspase-3, -8, and -9 by TRAIL (P<0.05). Furthermore, the expression of anti-apoptotic protein c-FLIP was down-regulated to 0.22 ± 0.08 times of the control group. In conclusion, GA sensitizes HT-29 cells to TRAIL-induced apoptosis by promoting ROS-activated ERS pathways, up-regulating of DR4 and DR5, and inhibiting c-FLIP expression.
Apoptosis ; Apoptosis Regulatory Proteins ; metabolism ; Caspases ; metabolism ; Cell Line, Tumor ; Cell Proliferation ; Colonic Neoplasms ; metabolism ; Down-Regulation ; HT29 Cells ; Humans ; Reactive Oxygen Species ; metabolism ; TNF-Related Apoptosis-Inducing Ligand ; pharmacology ; Up-Regulation ; Xanthones ; pharmacology