BACKGROUND Enema administration is a common procedure in the emergency department(ED). However, several published case reports on enema-related ischemic colitis(IC) have raised the concerns regarding the safety of ene...BACKGROUND Enema administration is a common procedure in the emergency department(ED). However, several published case reports on enema-related ischemic colitis(IC) have raised the concerns regarding the safety of enema agents. Nevertheless, information on its true incidence and characteristics are still lacking.AIM To investigate the incidence, timing, and risk factors of IC in patients receiving enema.METHODS We consecutively collected the data of all adult patients receiving various enema administrations in the ED from January 2010 to December 2018 and identified patients confirmed with IC following enema. Of 8320 patients receiving glycerin enema, 19 diagnosed of IC were compared with an age-matched control group without IC.RESULTS The incidence of IC was 0.23% among 8320 patients receiving glycerin enema;however, there was no occurrence of IC among those who used other enema agents. The mean age ± standard deviation(SD) of patients with glycerin enemarelated IC was 70.2 ± 11.7. The mean time interval ± SD from glycerin enema administration to IC occurrence was 5.5 h ± 3.9 h(range 1-15 h). Of the 19 glycerin enema-related IC cases, 15(79.0%) were diagnosed within 8 h. The independent risk factors for glycerin-related IC were the constipation score [Odds ratio(OR), 2.0;95% confidence interval(CI): 1.1-3.5, P = 0.017] and leukocytosis(OR, 4.5;95%CI: 1.4-14.7, P = 0.012).CONCLUSION The incidence of glycerin enema-related IC was 0.23% and occurred mostly in the elderly in the early period following enema administration. Glycerin enemarelated IC was associated with the constipation score and leukocytosis.展开更多
The degradation of structural collagen contributes to the characteristic appearance of wrinkles. The anti-wrinkle effects of a variety of substances have been studied, but the potential anti-wrinkle effects of topical...The degradation of structural collagen contributes to the characteristic appearance of wrinkles. The anti-wrinkle effects of a variety of substances have been studied, but the potential anti-wrinkle effects of topical applications of collagen for periorbital wrinkles have not been investigated. To evaluate the effects of topical application of succinylated atelocollagen on periorbital wrinkles and to compare the results of treatment with adenosine, a clinical study on Korean participants was carried out. Each participant’s right or left periorbital area was treated with either a solution containing succinylated atelocollagen and adenosine or a solution containing only succinylated atelocollagen for two months. A placebo solution was applied to the opposite periorbital area of each patient’s face for two months. Based on objective and subjective measurements of clinical improvement, the assessment scores for treated sites were statistically significantly higher than scores for placebo sites after two months of treatment. Analysis of silicone casts of periorbital wrinkles demonstrated partial effects of succinylated atelocollagen on periorbital wrinkles. However, we did not observe any effects of adenosine on periorbital wrinkles. Succinylated atelocollagen may be an effective treatment option for periorbital wrinkles, but further studies including a longer treatment period and larger subject group are needed to verify these results.展开更多
Background:Keloid scarring is a fibroproliferative disease caused by aberrant genetic activation with an unclear underlying mechanism.Genetic predisposition,aberrant cellular responses to environmental factors,increas...Background:Keloid scarring is a fibroproliferative disease caused by aberrant genetic activation with an unclear underlying mechanism.Genetic predisposition,aberrant cellular responses to environmental factors,increased inflammatory cytokines and epithelial-mesenchymal transition(EMT)phenomena are known as major contributors.In this study,we aimed to identify the molecular drivers that initiate keloid pathogenesis.Methods:Bulk tissue RNA sequencing analyses of keloid and normal tissues along with ex vivo and in vitro tests were performed to identify the contributing genes to keloid pathogenesis.An animal model of inflammatory keloid scarring was reproduced by replication of a skin fibrosis model with intradermal bleomycin injection in C57BL/6 mice.Results:Gene set enrichment analysis revealed upregulation of Wnt family member 5A(WNT5A)expression and genes associated with EMT in keloid tissues.Consistently,human keloid tissues and the bleomycin-induced skin fibrosis animal model showed significantly increased expression ofWNT5A and EMT markers.Increased activation of the interleukin(IL)-6/Janus kinase(JAK)/signal transducer and activator of transcription(STAT)pathway and subsequent elevation of EMT markerswas also observed in keratinocytes co-cultured withWNT5A-activated fibroblasts or keloid fibroblasts.Furthermore,WNT5A silencing and the blockage of IL-6 secretion via neutralizing IL-6 antibody reversed hyperactivation of the STAT pathway and EMT markers in keratinocytes.Lastly,STAT3 silencing significantly reduced the EMT-like phenotypes in both keratinocytes and IL-6-stimulated keratinocytes.Conclusions:Intercellular communication via the WNT5A and STAT pathways possibly underlies a partial mechanism of EMT-like phenomena in keloid pathogenesis.IL-6 secreted from WNT5A-activated fibroblasts or keloid fibroblasts activates the JAK/STAT signaling pathway in adjacent keratinocytes which in turn express EMT markers.A better understanding of keloid development and the role of WNT5A in EMT will promote the development of next-generation targeted treatments for keloid scars.展开更多
文摘BACKGROUND Enema administration is a common procedure in the emergency department(ED). However, several published case reports on enema-related ischemic colitis(IC) have raised the concerns regarding the safety of enema agents. Nevertheless, information on its true incidence and characteristics are still lacking.AIM To investigate the incidence, timing, and risk factors of IC in patients receiving enema.METHODS We consecutively collected the data of all adult patients receiving various enema administrations in the ED from January 2010 to December 2018 and identified patients confirmed with IC following enema. Of 8320 patients receiving glycerin enema, 19 diagnosed of IC were compared with an age-matched control group without IC.RESULTS The incidence of IC was 0.23% among 8320 patients receiving glycerin enema;however, there was no occurrence of IC among those who used other enema agents. The mean age ± standard deviation(SD) of patients with glycerin enemarelated IC was 70.2 ± 11.7. The mean time interval ± SD from glycerin enema administration to IC occurrence was 5.5 h ± 3.9 h(range 1-15 h). Of the 19 glycerin enema-related IC cases, 15(79.0%) were diagnosed within 8 h. The independent risk factors for glycerin-related IC were the constipation score [Odds ratio(OR), 2.0;95% confidence interval(CI): 1.1-3.5, P = 0.017] and leukocytosis(OR, 4.5;95%CI: 1.4-14.7, P = 0.012).CONCLUSION The incidence of glycerin enema-related IC was 0.23% and occurred mostly in the elderly in the early period following enema administration. Glycerin enemarelated IC was associated with the constipation score and leukocytosis.
文摘The degradation of structural collagen contributes to the characteristic appearance of wrinkles. The anti-wrinkle effects of a variety of substances have been studied, but the potential anti-wrinkle effects of topical applications of collagen for periorbital wrinkles have not been investigated. To evaluate the effects of topical application of succinylated atelocollagen on periorbital wrinkles and to compare the results of treatment with adenosine, a clinical study on Korean participants was carried out. Each participant’s right or left periorbital area was treated with either a solution containing succinylated atelocollagen and adenosine or a solution containing only succinylated atelocollagen for two months. A placebo solution was applied to the opposite periorbital area of each patient’s face for two months. Based on objective and subjective measurements of clinical improvement, the assessment scores for treated sites were statistically significantly higher than scores for placebo sites after two months of treatment. Analysis of silicone casts of periorbital wrinkles demonstrated partial effects of succinylated atelocollagen on periorbital wrinkles. However, we did not observe any effects of adenosine on periorbital wrinkles. Succinylated atelocollagen may be an effective treatment option for periorbital wrinkles, but further studies including a longer treatment period and larger subject group are needed to verify these results.
基金supported by the Health Fellowship Foundation,Seoul,Korea.
文摘Background:Keloid scarring is a fibroproliferative disease caused by aberrant genetic activation with an unclear underlying mechanism.Genetic predisposition,aberrant cellular responses to environmental factors,increased inflammatory cytokines and epithelial-mesenchymal transition(EMT)phenomena are known as major contributors.In this study,we aimed to identify the molecular drivers that initiate keloid pathogenesis.Methods:Bulk tissue RNA sequencing analyses of keloid and normal tissues along with ex vivo and in vitro tests were performed to identify the contributing genes to keloid pathogenesis.An animal model of inflammatory keloid scarring was reproduced by replication of a skin fibrosis model with intradermal bleomycin injection in C57BL/6 mice.Results:Gene set enrichment analysis revealed upregulation of Wnt family member 5A(WNT5A)expression and genes associated with EMT in keloid tissues.Consistently,human keloid tissues and the bleomycin-induced skin fibrosis animal model showed significantly increased expression ofWNT5A and EMT markers.Increased activation of the interleukin(IL)-6/Janus kinase(JAK)/signal transducer and activator of transcription(STAT)pathway and subsequent elevation of EMT markerswas also observed in keratinocytes co-cultured withWNT5A-activated fibroblasts or keloid fibroblasts.Furthermore,WNT5A silencing and the blockage of IL-6 secretion via neutralizing IL-6 antibody reversed hyperactivation of the STAT pathway and EMT markers in keratinocytes.Lastly,STAT3 silencing significantly reduced the EMT-like phenotypes in both keratinocytes and IL-6-stimulated keratinocytes.Conclusions:Intercellular communication via the WNT5A and STAT pathways possibly underlies a partial mechanism of EMT-like phenomena in keloid pathogenesis.IL-6 secreted from WNT5A-activated fibroblasts or keloid fibroblasts activates the JAK/STAT signaling pathway in adjacent keratinocytes which in turn express EMT markers.A better understanding of keloid development and the role of WNT5A in EMT will promote the development of next-generation targeted treatments for keloid scars.
