Background/Aims: The prospective Crohn’s Disease Clinical Network and Cohort Study is a nationwide multicenter cohort study of patients with Crohn’s disease (CD) in Korea, aiming to prospectively investigate the clinical features and long-term prognosis associated with CD. Methods: Patients diagnosed with CD between January 2009 and September 2019 were prospectively enrolled. They were divided into two cohorts according to the year of diagnosis: cohort 1 (diagnosed between 2009 and 2011) versus cohort 2 (between 2012 and 2019). Results: A total of 1,175 patients were included, and the median follow-up duration was 68 months (interquartile range, 39.0 to 91.0 months). The treatment-free durations for thiopurines (p<0.001) and anti-tumor necrosis factor agents (p=0.018) of cohort 2 were shorter than those of cohort 1. Among 887 patients with B1 behavior at diagnosis, 149 patients (16.8%) progressed to either B2 or B3 behavior during follow-up. Early use of thiopurine was associated with a reduced risk of behavioral progression (adjusted hazard ratio [aHR], 0.69; 95% confidence interval [CI], 0.50 to 0.90), and family history of inflammatory bowel disease was associated with an increased risk of behavioral progression (aHR, 2.29; 95% CI, 1.16 to 4.50). One hundred forty-one patients (12.0%) underwent intestinal resection, and the intestinal resection-free survival time was significantly longer in cohort 2 than in cohort 1 (p=0.003). The early use of thiopurines (aHR, 0.35;95% CI, 0.23 to 0.51) was independently associated with a reduced risk of intestinal resection. Conclusions The prognosis of CD in Korea appears to have improved over time, as evidenced by the decreasing intestinal resection rate. Early use of thiopurines was associated with an improved prognosis represented by a reduced risk of intestinal resection.

Traditionally, urologists recommend an interval of at least 4 weeks after prostate biopsy before radical prostatectomy. The aim of our study was to evaluate whether the interval from prostate biopsy to radical prostatectomy affects immediate operative outcomes, with a focus on differences in surgical approach. The study population of 1,848 radical prostatectomy patients was divided into two groups according to the surgical approach: open or minimally invasive. Open group included perineal and retropubic approach, and minimally invasive group included laparoscopic and robotic approach. The cut-off of the biopsy-to-surgery interval was 4 weeks. Positive surgical margin status, operative time and estimated blood loss were evaluated as endpoint parameters. In the open group, there were significant differences in operative time and estimated blood loss between the <4-week and > or =4-week interval subgroups, but there was no difference in positive margin rate. In the minimally invasive group, there were no differences in the three outcome parameters between the two subgroups. Multivariate analysis revealed that the biopsy-to-surgery interval was not a significant factor affecting immediate operative outcomes in both open and minimally invasive groups, with the exception of the interval > or =4 weeks as a significant factor decreasing operative time in the minimally invasive group. In conclusion, performing open or minimally invasive radical prostatectomy within 4 weeks of prostate biopsy is feasible for both approaches, and is even beneficial for minimally invasive radical prostatectomy to reduce operative time.
Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures/*statistics & numerical data ; *Operative Time ; Postoperative Hemorrhage/*epidemiology ; Prevalence ; Prostatectomy/*statistics & numerical data ; Prostatic Neoplasms/epidemiology/*pathology/*surgery ; Republic of Korea/epidemiology ; Retrospective Studies ; Time-to-Treatment/*statistics & numerical data ; Treatment Outcome

Malignant glioma is the most frequent type in brain tumors. The prognosis of this tumor has not been significantly improved for the past decades and the average survival of patients is less than one year. Thus, an effective novel therapy is urgently needed. TNF-related apoptosis inducing ligand (TRAIL), known to have tumor cell-specific killing activity, has been investigated as a novel therapeutic for cancers. We have developed Ad-stTRAIL, an adenovirus delivering secretable trimeric TRAIL for gene therapy and demonstrated the potential to treat malignant gliomas. Currently, this Ad-stTRAIL gene therapy is under phase I clinical trial for malignant gliomas. Here, we report preclinical studies for Ad-stTRAIL carried out using rats. We delivered Ad-stTRAIL intracranially and determined its pharmacokinetics and biodistribution. Most Ad-stTRAIL remained in the delivered site and the relatively low number of viral genomes was detected in the opposite site of brain and cerebrospinal fluid. Similarly, only small portion of the viral particles injected was found in the blood plasma and major organs and tissues, probably due to the brain-blood barrier. Multiple administrations did not lead to accumulation of Ad-stTRAIL at the injection site and organs. Repeated delivery of Ad-stTRAIL did not show any serious side effects. Our data indicate that intracranially delivered Ad-stTRAIL is a safe approach, demonstrating the potential as a novel therapy for treating gliomas.
Adenoviridae/genetics ; Animals ; Blood-Brain Barrier ; Brain/drug effects/*metabolism/pathology ; Brain Neoplasms/genetics/metabolism/pathology/*therapy ; Clinical Trials, Phase I as Topic ; DNA, Viral/metabolism ; Disease Models, Animal ; Drug Delivery Systems ; Drug Evaluation, Preclinical ; *Gene Therapy ; Glioma/genetics/metabolism/pathology/*therapy ; Humans ; Liver/drug effects/metabolism/pathology ; Protein Multimerization/genetics ; Rats ; Spleen/drug effects/metabolism/pathology ; TNF-Related Apoptosis-Inducing Ligand/genetics/*pharmacokinetics

Malignant glioma is the most frequent type in brain tumors. The prognosis of this tumor has not been significantly improved for the past decades and the average survival of patients is less than one year. Thus, an effective novel therapy is urgently needed. TNF-related apoptosis inducing ligand (TRAIL), known to have tumor cell-specific killing activity, has been investigated as a novel therapeutic for cancers. We have developed Ad-stTRAIL, an adenovirus delivering secretable trimeric TRAIL for gene therapy and demonstrated the potential to treat malignant gliomas. Currently, this Ad-stTRAIL gene therapy is under phase I clinical trial for malignant gliomas. Here, we report preclinical studies for Ad-stTRAIL carried out using rats. We delivered Ad-stTRAIL intracranially and determined its pharmacokinetics and biodistribution. Most Ad-stTRAIL remained in the delivered site and the relatively low number of viral genomes was detected in the opposite site of brain and cerebrospinal fluid. Similarly, only small portion of the viral particles injected was found in the blood plasma and major organs and tissues, probably due to the brain-blood barrier. Multiple administrations did not lead to accumulation of Ad-stTRAIL at the injection site and organs. Repeated delivery of Ad-stTRAIL did not show any serious side effects. Our data indicate that intracranially delivered Ad-stTRAIL is a safe approach, demonstrating the potential as a novel therapy for treating gliomas.
Adenoviridae/genetics ; Animals ; Blood-Brain Barrier ; Brain/drug effects/*metabolism/pathology ; Brain Neoplasms/genetics/metabolism/pathology/*therapy ; Clinical Trials, Phase I as Topic ; DNA, Viral/metabolism ; Disease Models, Animal ; Drug Delivery Systems ; Drug Evaluation, Preclinical ; *Gene Therapy ; Glioma/genetics/metabolism/pathology/*therapy ; Humans ; Liver/drug effects/metabolism/pathology ; Protein Multimerization/genetics ; Rats ; Spleen/drug effects/metabolism/pathology ; TNF-Related Apoptosis-Inducing Ligand/genetics/*pharmacokinetics

A human case of Centrocestus armatus (Heterophyidae) infection was proved by identifying an adult worm collected after treatment with praziquantel in Korea. The case is 42-year old man who resides in a rural area in Sanchung-gun, Kyeongsangnam-do. The case was concomitantly infected with Clonorchis sinensis and had the history of eating raw freshwater fishes including Zacco platypus, which are known to be the second intermediate host of C. armatus in Korea.. This is the first report of natural human infection by C. armatus in the literature.
parasitology-helminth-trematoda ; Centrocestus armatus ; intestine ; Heterophyidae ; Clonorchis sinensis ; case report

The life cycle of Fibricola seoulensis was studied in the laboratory and in the field, with special interests in the larval developments within the eggs and in the intermediate hosts. The first emergence of miracidia after incubation of eggs in 26C water began on the ninth day. The miracidia, elongate and cylindrical shape, had epidermal plates in the formula of 6, 9, 4 and 3, with two pairs of flame cells and lateral processes. A kind of fresh water snail, Hippeutis (H.) cantori, was found to shed furcocercous cercariae from the 13th day after experimental challenge with miracidia while Physa acuta failed to shed. The same kind of snail collected from the field also shed the same cercariae. The cercariae were equipped with 2 pairs of penetration glands and 5 pairs of flame cells. The tadpoles of Rana nigromaculata were found susceptible to experimental infection with the cercariae. The same kind of tadpoles collected from various areas were also found naturally infected. The metacercariae in the tadpoles which were infected experimentally became infective to the definitive host in 21 days. The metacercariae were located free in the body cavity of tadpoles, and attained sexual maturity in rats in 7 days. The present study successfully followed the complete life cycle of F. seoulenis and found that it is possible to maintain the life cycle in the laboratory.
parasitology-helminth-termatoda ; Fibricola seoulensis ; biology ; rat ; Hippeutis cantori ; Rana nigromaculata ; Physa acuta ; intermediate host

Two adult specimens of heterophyid fluke, which belong to the genus Stictodora, were collected from the stool of a 24-year old man after chemotherapy. The flukes were morphologically characterized by their small body size (0.90~0.98 mm long and 0.38 mm wide) and peculiar structure of ventrogenital sac with armed gonotyl (with about 12~15 spines) not enveloping genital pore. Species identification is deferred until more worms are obtained, although they closely resemble Stictodora fuscatum (Onji and Nishio, 1916). The patient used to eat raw flesh of mullets and gobies, which are regarded as the infection source of Stictodora sp., together with 3 other kinds of heterophyids described elsewhere. This is the first record of human Stictodora infection in the literature.
parasitology-helminth-trematoda ; case report ; Stictodora sp. ; Heterophyidae ; intestine

Two human cases of Heterophyes heterophyes and H. dispar infections were proven by the recovery of their adult worms. The cases were 38-year and 40-year old Korean workers who had been in Saudi Arabia for 4-6 years and returned home in 1983 or 1984 with gastrointestinal troubles. In Saudi Arabia they had eaten raw brackish water fishes such as the mullet. After the treatment with 10 mg/kg praziquantel and purgation with magnesium salt, a total of 19 specimens of H.heterophyes and 140 of H. dispar were collected. It is of interest that the worms persisted in a patient although he had been back in Korea for 14 months. This is the first report on imported heterophyiasis in Korea. Human infection by H. dispar is the first record in the literature.
parasitology-helminth-trematoda ; Heterophyes heterophyes ; Heterophyes dispar ; case report ; praziquantel ; intestine

The tegumental ultrastructures of Echinostoma hortense adults were observed by scanning electron microscopy. The worms of 4 weeks of age were harvested from albino rats experimentally infected with the metacercariae obtained from the loach. The results were as follows: The worms were leaf-like and their anterior end portion, including oral sucker and head crown, ventrally curved to face posteriorly. The tegument of whole body was wrinkled transversely and covered with cobblestone-like cytoplasmic processes. The oral sucker had roundly swollen (type II) sensory papillae on the ventral half of its lip and uni-ciliated knob-like (type I) sensory papillae, arranged in 2-3 rows, on the dorsal outer surface. Aspinous ventral sucker had many of type I papillae arranged in a circular band on its outer surface. The tegument around the genital opening was of similar feature to the ventral sucker, but sensory papillae were hardly found around the former. Scale-like spines with broad base and round tip were distributed densely on the tegument anterior to the ventral sucker but they became sparse in posterior half of the ventral surface, finally to disappear at posterior extremity. A few number of type I papillae were observed on the ventral surface. The results suggest that the tegument of E. hortense is similar to that of other echinostomes especially E. revolutum. But the number and arrangement of collar spines, and/or the type and distribution of sensory papillae seem characteristic features of E. hortense differed from other echinostomes.
parasitology-helminth-trematoda ; Echinostoma hortense ; electron microscopy

The growth and development of Pygidiopsis summa were studied in experimental rats and mice, and a special reference was given to its morphological characters differed from the type species, P. genata. The metacercariae were obtained from young mullets (Mugil sp.), and total 21 rats and mice infected each with 1,000 metacercariae. Worms of various ages of infection, from 3 to 28 days, were subjected to a microscopic observation. The worms grew rapidly and remarkably in size up to 10 days of infection, to become 0.53-0.82 mm long and 0.31-0.39 mm wide, but nearly stopped the growth thereafter. Their genital organs developed more rapidly and fully matured within 3-5 days. At 3 days several eggs were found in uterus. The presence of two groups of small spines, 5-6 on the right and 7-9 on the left side of the genital apparatus, was a new finding in this study and considered a distinct character of P. summa. The morphology of ventral sucker and intestinal ceca was also different from P. genata. This study confirms the validity of the species, P. summa.
parasitology-helminth-trematoda ; Pygidiopsis summa ; morphology ; development ; rat