PURPOSE: Poloxamer 407 (P407) thermo-sensitive hydrogel formulations were developed to enhance the retention time in the urinary bladder after intravesical instillation. MATERIALS AND METHODS: P407 hydrogels (P407Gels) containing 0.2 w/w% fluorescein isothiocyanate dextran (FD, MW 4 kDa) as a fluorescent probe were prepared by the cold method with different concentrations of the polymer (20, 25, and 30 w/w%). The gel-forming capacities were characterized in terms of gelation temperature (G-Temp), gelation time (G-Time), and gel duration (G-Dur). Homogenous dispersion of the probe throughout the hydrogel was observed by using fluorescence microscopy. The in vitro bladder simulation model was established to evaluate the retention and drug release properties. P407Gels in the solution state were administered to nude mice via urinary instillation, and the in vivo retention behavior of P407Gels was visualized by using an in vivo imaging system (IVIS). RESULTS: P407Gels showed a thermo-reversible phase transition at 4℃ (refrigerated; sol) and 37℃ (body temperature; gel). The G-Temp, G-Time, and G-Dur of FD-free P407Gels were approximately 10℃–20℃, 12–30 seconds, and 12–35 hours, respectively, and were not altered by the addition of FD. Fluorescence imaging showed that FD was spread homogenously in the gelled P407 solution. In a bladder simulation model, even after repeated periodic filling-emptying cycles, the hydrogel formulation displayed excellent retention with continuous release of the probe over 8 hours. The FD release from P407Gels and the erosion of the gel, both of which followed zero-order kinetics, had a linear relationship (r²=0.988). IVIS demonstrated that the intravesical retention time of P407Gels was over 4 hours, which was longer than that of the FD solution ( < 1 hour), even though periodic urination occurred in the mice. CONCLUSIONS: FD release from P407Gels was erosion-controlled. P407Gels represent a promising system to enhance intravesical retention with extended drug delivery.
Administration, Intravesical* ; Animals ; Dextrans ; Drug Liberation ; Fluorescein ; Hydrogel* ; Hydrogels* ; In Vitro Techniques ; Kinetics ; Methods ; Mice* ; Mice, Nude ; Microscopy, Fluorescence ; Optical Imaging ; Phase Transition ; Poloxamer* ; Polymers ; Urinary Bladder* ; Urination

Although the incidence of bleeding complications during extracorporeal membrane oxygenator (ECMO) support has decreased in various trials, bleeding is still the most fatal complication. We investigated the ideal dosage and efficacy of nafamostat mesilate for use with ECMO in patients with acute cardiac or respiratory failure. We assessed 73 consecutive patients who received ECMO due to acute cardiac or respiratory failure between January 2006 and December 2009. To evaluate the efficacy of nafamostat mesilate, we divided the patients into 2 groups according to the anticoagulants used during ECMO support. All patients of nafamostat mesilate group were male with a mean age of 49.2 yr. Six, 3, 5, and 3 patients were diagnosed with acute myocardial infarction, cardiac arrest, septic shock, and acute respiratory distress syndrome, respectively. The mean dosage of nafamostat mesilate was 0.64 mg/kg/hr, and the mean duration of ECMO was 270.7 hr. The daily volume of transfused packed red blood cells, fresh frozen plasma, and cryoprecipitate and the number of complications related to hemorrhage and thrombosis was lower in the nafamostat mesilate group than in the heparin group. Nafamostat mesilate should be considered as an alternative anticoagulant to heparin to reduce bleeding complications during ECMO.
Acute Disease ; Anticoagulants/*administration & dosage ; Dose-Response Relationship, Drug ; *Extracorporeal Membrane Oxygenation ; Female ; Guanidines/*administration & dosage ; Heart Failure/diagnosis/mortality/therapy ; Heparin/administration & dosage ; Humans ; Male ; Middle Aged ; Myocardial Infarction/diagnosis/mortality/therapy ; Respiratory Distress Syndrome, Adult/diagnosis/mortality/therapy ; Retrospective Studies ; Shock, Septic/diagnosis/mortality/therapy ; Survival Analysis

In the WHO-EORTC (World Health Organization-European Organization for Research and Treatment of Cancer) classification, the primary cutaneous B-cell lymphomas were divided into 4 groups: primary cutaneous marginal zone B-cell lymphoma, primary cutaneous follicle center cell lymphoma, primary cutaneous diffuse large B-cell lymphoma, other, and primary cutaneous diffuse large B-cell lymphoma, leg type (PCLBCL LT). PCLBCL LT is known to have more aggressive clinical behavior and a worse prognosis than the other groups of primary cutaneous B-cell lymphomas. We report here on a case of PCLBCL LT in a 55-year-old male who presented witha multiple erythematous nodules on the right leg. After chemotherapy, the skin lesions had almost cleared, but afterward the tumor was revealed to have metastasized to the brain during 1 year.
B-Lymphocytes ; Brain ; Humans ; Leg ; Lymphoma ; Lymphoma, B-Cell ; Lymphoma, B-Cell, Marginal Zone ; Male ; Middle Aged ; Neoplasm Metastasis ; Prognosis ; Skin ; World Health Organization

Eczema herpeticum is the dissemination of herpes simplex virus in the setting of a preexisting skin disease. Hailey- Hailey disease [familial benign chronic pemphigus] is a blistering dermatosis that is inherited as an autosomal dominant trait and it usually presents itself around the third or fourth decades. Coexistence of eczema herpeticum and Hailey-Hailey disease is an infrequent occurrence. Four such cases have been reported in the English and German medical literature. We report here on an unusual case of eczema herpeticum that coexisted with Hailey-Hailey disease in a 47 years old man and we review the relevant literatures.
Blister ; Eczema ; Kaposi Varicelliform Eruption ; Methylmethacrylates ; Pemphigus, Benign Familial ; Polystyrenes ; Simplexvirus ; Skin Diseases

PURPOSE: Serine-threonine kinase11 (STK11) was originally identified in 1997 as the causative mutation that's responsible for Peutz-Jeghers Syndrome (PJS). Several recent studies have reported that the STK11 gene is an important human tumor suppressor gene in lung cancer. We evaluated the associations between the polymorphisms of the STK11 promoter region and the risk of lung cancer in 901 Koreans. MATERIALS AND METHODS: By direct sequencing, we first discovered three novel polymorphisms (-1,795 T>C, -981 C>T and -160 G>T) and four known polymorphisms (-1,580 C>T, -1,494 A>C, -881 A>G and -458 G>C) of the STK11 promoter region in 24 blood samples of 24 Korean lung cancer patients. Further genotype analyses were then performed on 443 lung cancer patients and 458 controls. RESULTS: We discovered three novel polymorphisms and we identified four known polymorphisms of the STK11 promoter region in a Korean population. Statistical analyses revealed that the genotypes and haplotypes in the STK11 gene were not significantly associated with the risk of lung cancer in a Korean population. CONCLUSION: This is the first study that's focused on the association of STK11 promoter polymorphisms and the risk of lung cancer in a Korean population. To evaluate the role of the STK11 gene for the risk of lung cancer, the genotypes of the STK11 promoter region (-1,795 T>C, -1,494 A>C and -160 G>T) were determined in 901 Koreans, yet the result revealed no significant difference between the lung cancer patients and the controls. These results suggest that the three promoter polymorphisms we studied are not important risk factors for the susceptibility to lung cancer in Koreans.
Genes, Tumor Suppressor ; Genotype ; Haplotypes ; Humans ; Lung ; Lung Neoplasms ; Peutz-Jeghers Syndrome ; Promoter Regions, Genetic ; Risk Factors

Thyroid stimulating hormone (TSH)-secreting pituitary adenomas are rare tumors of the pituitary gland and represent 1~2% of all pituitary adenomas. A TSH-secreting pituitary adenoma shows as a normal or elevated thyrotropin level in a hyperthyroid patient. We present a 32-year-old woman who was diagnosed with a TSH-secreting pituitary microadenoma. She had a high free T4, with a normal TSH and alpha-subunit. Bilateral inferior petrosal sinus sampling (IPSS) was done to confirm the alpha-subunit secreting adenoma, and the concentration of the alpha-subunit was high on the tumor side. The pituitary microadenoma was removed, and her TSH and free T4 levels decreased to normal. IPSS may help give an accurate diagnosis in the patient with a normal alpha-subunit.
Adenoma ; Adult ; Female ; Humans ; Petrosal Sinus Sampling ; Pituitary Gland ; Pituitary Neoplasms ; Thyrotropin

BACKGROUND: As the proportion of old-aged people is currently increasing, the incidence of herpes zoster is also increasing. Yet there has not been any report on the epidemiology of herpes zoster in the Province of Chungcheongnam-do. OBJECTIVE: The purpose of this study was to determine the epidemiological and clinical characteristics of herpes zoster in the Province of Chungcheongnam-do. METHODS: The authors retrospectively evaluated 915 cases of herpes zoster with regard to the annual, monthly and seasonal incidences, the age and gender ratios, the associated conditions, the anatomical distribution and the complications at the Department of Dermatology in Soonchunhyang University hospital in Cheonan during 3 years from 2004 to 2006. RESULTS: The results were as follows: The annual rate of new outpatients at our dermatology clinic ranged from 1.6% to 1.9% (mean: 1.7%), and the ratio of males to females was 0.74:1. The peak incidence on monthly analysis was in August and the lowest incidence on the monthly and seasonal analysis were in February and winter for the herpes zoster inpatients. Herpes zoster was seen most frequently in the over 70 year-old group (38.0%). The most frequent involved dermatome of the herpes zoster inpatients was the thoracic dermatome (35.4%) and others included the trigeminal (26.9%), lumbar (13.8%), cervical (11.5%) and sacral (2.7%) areas. 26 (8.8%) patients had disease involving 2 different dermatomes. Of the 297 herpes zoster inpatients, associated conditions were observed for 167 patients (56.2%); hypertension (32.1%), diabetes (17.5%), malignancy (10.4%), asthma (7.5%) and so on. Complications were observed for 121 (40.7%) inpatients and the most common complication was postherpetic neuralgia (30.0%), followed by secondary bacterial infection (9.8%), ophthalmologic complications (7.7%), neurogenic bladder (1.4%) and so on. CONCLUSION: The results of our study showed higher proportions of females and old-age people with herpes zoster and a higher proportion of old-age people with postherpetic neuralgia.
Asthma ; Bacterial Infections ; Dermatology ; Female ; Herpes Zoster ; Humans ; Hypertension ; Incidence ; Inpatients ; Male ; Neuralgia, Postherpetic ; Outpatients ; Retrospective Studies ; Seasons ; Urinary Bladder, Neurogenic

Solitary fibrous tumors are spindle-cell neoplasms that usually develop in the pleura and peritoneum, and rarely arise in the stomach. To our knowledge, there is only one case reporting a solitary fibrous tumor arising from stomach in the English literature. Here we report the case of a 26-year-old man with a large solitary fibrous tumor arising from the stomach which involved the submucosa and muscular layer and resembled a gastrointestinal stromal tumor in the stomach, based on what was seen during abdominal computed tomography. A solitary fibrous tumor arising from the stomach, although rare, could be considered as a diagnostic possibility for gastric submucosal tumors.
Adult ; Humans ; Male ; Neoplasms, Fibrous Tissue/*pathology ; Stomach/pathology/radiography ; Stomach Neoplasms/*pathology ; Tomography, X-Ray Computed

A 70-year-old man with past history of hemicolectomy due to colon cancer underwent a follow-up abdominal/pelvic CT scan. CT revealed a right adrenal metastasis and then he underwent FDG-PET/CT study to search for other possible tumor recurrence. In PET images, other than right adrenal gland, there was an unexpected intense FDG uptake at right inguinal region and at first, it was considered to be an inguinal metastasis. However, correlation of PET images to concurrent CT data revealed it to be a bladder herniation. This case provides an example that analysis of PET images without corresponding CT images can lead to an insufficient interpretation or false positive diagnosis. Hence, radiologists should be aware of the importance of a combined analysis of PET and CT data in the interpretation of integrated PET/CT and rare but intriguing conditions, such as bladder herniation, during the evaluation of PET scans in colon cancer patients.
Abdominal Neoplasms/radionuclide imaging/secondary ; Aged ; Colonic Neoplasms/pathology/radiography/radionuclide imaging ; Diagnosis, Differential ; False Positive Reactions ; Fluorodeoxyglucose F18/*diagnostic use ; Hernia, Inguinal/radiography/*radionuclide imaging ; Humans ; Male ; *Positron-Emission Tomography ; Radiopharmaceuticals/*diagnostic use ; Tomography, X-Ray Computed ; Urinary Bladder Diseases/radiography/*radionuclide imaging

OBJECTIVE: The aim of our study was to compare the accuracy of CT and 18F-FDG PET for detecting peritoneal metastasis in patients with gastric carcinoma. MATERIALS AND METHODS: One-hundred-twelve patients who underwent a histologic confirmative exam or treatment (laparotomy, n = 107; diagnostic laparoscopy, n = 4; peritoneal washing cytology, n = 1) were retrospectively enrolled. All the patients underwent CT and 18F-FDG PET scanning for their preoperative evaluation. The sensitivities, specificities and accuracies of CT and 18F-FDG PET imaging for the detection of peritoneal metastasis were calculated and then compared using Fisher's exact probability test (p < 0.05), on the basis of the original preoperative reports. In addition, two board-certified radiologists and two board-certified nuclear medicine physicians independently reviewed the CT and PET scans, respectively. A receiver-operating characteristic curve analysis was performed to compare the diagnostic performance of CT and 18F-FDG PET imaging for detecting peritoneal metastasis. RESULTS: Based on the original preoperative reports, CT and 18F-FDG PET showed sensitivities of 76.5% and 35.3% (p = 0.037), specificities of 91.6% and 98.9% (p = 0.035), respectively, and equal accuracies of 89.3% (p = 1.0). The receptor operating characteristics curve analysis showed a significantly higher diagnostic performance for CT (Az = 0.878) than for PET (Az = 0.686) (p = 0.004). The interobserver agreement for detecting peritoneal metastasis was good (κ value = 0.684) for CT and moderate (κ value = 0.460) for PET. CONCLUSION: For the detection of peritoneal metastasis, CT was more sensitive and showed a higher diagnostic performance than PET, although CT had a relatively lower specificity than did PET.
*Tomography, Emission-Computed ; Stomach Neoplasms/*pathology ; Sensitivity and Specificity ; Retrospective Studies ; Radiopharmaceuticals/diagnostic use ; ROC Curve ; *Positron-Emission Tomography ; Peritoneal Neoplasms/*radiography/*radionuclide imaging/*secondary ; Middle Aged ; Male ; Iohexol/analogs & derivatives/diagnostic use ; Humans ; Fluorodeoxyglucose F18/diagnostic use ; Female ; Contrast Media ; Aged, 80 and over ; Aged ; Adult ; Adolescent