Variations in the STK10 gene and possible associations with aspirin-intolerant asthma in a Korean population

BACKGROUND AND OBJECTIVE

Lymphocyte-oriented kinase deficiency encoded by the serine/threonine kinase 10 (STK10) gene correlates with the intracellular adhesion molecule 1 (ICAM-1)/lymphocyte function associated antigen 1 (LFA-1) complex in aspirin hypersensitivity. This study investigated the association between single nucleotide polymorphisms (SNPs) of STK10 and aspirin-intolerant asthma (AIA).

METHODS

A total of 54 SNPs were genotyped in 163 AIA patients and 429 aspirin-tolerant asthma (ATA) controls.

RESULTS

Logistic regression revealed that a synonymous variant (rs2306961G>A) had the most significant association with AIA (P = .008 under the codominant model; P = .004 under the dominant model), suggesting that tissue-specific codon usage between Lys_TTT and Lys_CTT could play a role in regulating expression of STK10 in airway epithelium. Haplotype analysis revealed that 4 haplotypes, including STK10_BL4-ht1, which is unique to rs2306961G>A, were significantly associated with aspirin hypersensitivity in asthmatics (P < .05).

CONCLUSIONS

Although replications in independent cohorts and further functional evaluations are needed, our preliminary findings suggest that STK10 polymorphisms might be susceptible genetic markers of AIA and that gene expression could be mediated by tissue-specific codon usage.

Comparison of multi-echo and single-echo gradient-recalled echo sequences for SPIO-enhanced liver MRI at 3 T

AIM

To assess the utility of a T2*-weighted, multi-echo data imaging combination sequenced on superparamagnetic iron oxide (SPIO)-enhanced liver magnetic resonance imaging (MRI) using a 3 T system.

MATERIALS AND METHODS

Fifty patients underwent SPIO-enhanced MRI at 3 T using T2*-weighted, single-echo, gradient-recalled echo (GRE) sequences [fast imaging with steady precession; repetition time (TR)/echo time (TE), 126 ms/9 ms; flip angle, 30°] and multi-echo GRE (multi-echo data image combination) sequences (TR/TE, 186 ms/9 ms; flip angle, 30°). Three radiologists independently reviewed the images in a random order. The sensitivity and accuracy for the detection of focal hepatic lesions (a total of 76 lesions in 33 patients; 48 solid lesions, 28 non-solid lesions) were compared by analysing the area under the receiver operating characteristic curves. Image artefacts (flow artefacts, susceptibility artefacts, dielectric artefacts, and motion artefacts), lesion conspicuity, and overall image quality were evaluated according to a four-point scale: 1, poor; 2, fair; 3, good; 4, excellent. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of the lesions were compared.

RESULTS

Image artefacts were more frequent with single-echo GRE (p<0.05). The mean scale of image quality assessment for flow, susceptibility, dielectric, and motion artefacts were 2.76, 3.13, 3.42, and 2.89 with single-echo, respectively, compared with 3.47, 3.43, 3.47, and 3.39, respectively, with multi-echo GRE. There was no significant difference in lesion conspicuity between single-echo (3.15) and multi-echo (3.30) GRE sequences. The overall image quality was significantly (p<0.05) better with multi-echo (3.37) than with single-echo GRE (2.89). The mean SNR and CNR of the lesions were significantly (p<0.05) higher on multi-echo (79±23 and 128±59, respectively) images than on single-echo (38±11 and 102±44, respectively) images. Lesion detection accuracy and sensitivity were not significantly different between the two sequences. Mean accuracies and sensitivities were 0.864 and 0.785 for single-echo and 0.847 and 0.785 for multi-echo GRE, respectively.

CONCLUSION

At 3 T, the T2*-weighted, multi-echo data image combination sequence performs comparably to the T2*-weighted, single-echo GRE sequence for SPIO-enhanced MRI with good overall image quality and a decrease in undesired artefacts.

The Immunohistochemical Patterns of the beta-Catenin Expression in Pilomatricoma

BACKGROUND

Pilomatricoma is a benign follicular tumor that is composed of basaloid cells, transitional cells and shadow cells. beta-Catenin is a 92-kDa protein, and it plays important roles in cell-cell adhesion at the cell membrane and signal transduction in the nucleus. beta-Catenin has recently been shown to play an important role in the formation of hair follicle-related tumors, including pilomatricoma. However, the pattern and the intracellular localization of the beta-Catenin expression are still controversial.

OBJECTIVE

We wanted to evaluate the pattern and the intracellular localization of the beta-Catenin expression in pilomatricoma by performing immunohistochemical staining.

METHODS

Twenty-seven paraffin-embedded tissue samples that were diagnosed as pilomatricoma were immunohistochemically stained with beta-Catenin antibody.

RESULTS

Basaloid cells were found 15 samples of the total 27 pilomatricomas. All (15/15) of the basaloid cells strongly expressed beta-Catenin, but the transitional cells and the shadow cells did not. In the basaloid cells, the nuclei and membranes showed prominent beta-Catenin immunoreactivities, but the cytoplasm showed weak beta-Catenin immunoreactivity.

CONCLUSION

This study confirmed that the nucleus and membrane of all the basaloid cells in the pilomatricomas showed a strong beta-Catenin expression, but the transitional cells and shadow cells showed negative beta-Catenin immunoreactivity.

Effects of silybinin, CYP3A4 and P-glycoprotein inhibitor in vitro, on the bioavailability of loratadine in rats

The effect of silybinin on the pharmacokinetics of orally and intravenously administered loratadine in rats was investigated. Pharmacokinetic parameters of loratadine were determined in rats following oral (4 mg x kg(-1)) and intravenous (1 mg x kg(-1)) administration to rats in the presence and absence of silybinin (0.3, 1.5 and 6 mg x kg(-1)). Compared to those animals in an oral control group (given loratadine alone), the area under the plasma concentration-time curve (AUC) and the peak plasma concentration (C(max)) of loratadine were increased significantly (P < 0.05 for 1.5 mg x kg(-1), P < 0.01 for 6 mg x kg(-1)) by 50.0-76.7% and 65.4-90.1%, respectively, by silybinin. Consequently, the absolute bioavailability of loratadine in the presence of silybinin (1.5 and 6 mg x kg(-1)) was 8.6-10.2%, which was significantly (1.5 mg x kg(-1), P < 0.05; 6 mg x kg(-1), P < 0.01) enhanced compared to that in oral control group (5.8%). Moreover, the relative bioavailability of loratadine was 1.50- to 1.77-fold greater than that in the control group. In contrast, silybinin had no effect on any pharmacokinetic parameters of loratadine given intravenously, implying that coadministration of silybinin could inhibit the cytochrome P450 (CYP) 3A4-mediated metabolism of loratadine, resulting in reducing gastrointestinal and hepatic first-pass metabolism, and the P-glycoprotein (P-gp) efflux pump in the small intestine. Silybinin significantly enhanced the oral bioavailability of loratadine, suggesting that concurrent use of silybinin and loratadine should be monitored closely for potential drug interactions.

Experiences and Attitudes of Patients With Terminal Cancer and Their Family Caregivers Toward the Disclosure of Terminal Illness

Purpose

We investigated the experiences of cancer patients and their family caregivers who became aware that the cancer was terminal, how they became aware, and how they felt about disclosure of the information.

Patients and Methods

In this cohort study, we administered questionnaires to 619 consecutive patients determined by physicians to be terminally ill and to their family caregivers.

Results

A total of 481 patients and 381 family caregivers completed the questionnaire. A majority of patients (58.0%) and caregivers (83.4%) were aware of the patient's terminal status. Approximately 28% of patients and 23% of caregivers reported that they guessed it from the patient's worsening condition. The patient group was more likely than the caregiver group (78.6% v 69.6%) to prefer that patients be informed of their terminal status. Patients informed of their terminal diagnosis had a significantly better quality of life and fewer symptoms and had a lower rate of emotional distress than patients who guessed it from their worsening condition. Younger patients and patients who paid the treatment costs themselves were significantly more likely to want to be told when their illness was terminal. If the patient paid the treatment cost and was employed at the time of the cancer diagnosis, the family caregivers were more likely to prefer disclosure of terminal illness.

Conclusion

Most patients with terminal cancer and their family caregivers preferred disclosure, and patients who knew of their terminal diagnosis had a lower rate of emotional distress and a higher health-related quality of life.

Can robots patch-clamp as well as humans? Characterization of a novel sodium channel mutation

Ion channel missense mutations cause disorders of excitability by changing channel biophysical properties. As an increasing number of new naturally occurring mutations have been identified, and the number of other mutations produced by molecular approaches such as in situ mutagenesis has increased, the need for functional analysis by patch-clamp has become rate limiting. Here we compare a patch-clamp robot using planar-chip technology with human patch-clamp in a functional assessment of a previously undescribed Nav1.7 sodium channel mutation, S211P, which causes erythromelalgia. This robotic patch-clamp device can increase throughput (the number of cells analysed per day) by 3- to 10-fold. Both modes of analysis show that the mutation hyperpolarizes activation voltage dependence (8 mV by manual profiling, 11 mV by robotic profiling), alters steady-state fast inactivation so that it requires an additional Boltzmann function for a second fraction of total current (approximately 20% manual, approximately 40% robotic), and enhances slow inactivation (hyperpolarizing shift--15 mV by human,--13 mV robotic). Manual patch-clamping demonstrated slower deactivation and enhanced (approximately 2-fold) ramp response for the mutant channel while robotic recording did not, possibly due to increased temperature and reduced signal-to-noise ratio on the robotic platform. If robotic profiling is used to screen ion channel mutations, we recommend that each measurement or protocol be validated by initial comparison to manual recording. With this caveat, we suggest that, if results are interpreted cautiously, robotic patch-clamp can be used with supervision and subsequent confirmation from human physiologists to facilitate the initial profiling of a variety of electrophysiological parameters of ion channel mutations.

Pregnancy outcome of women transfused during pregnancy with blood products inadvertently obtained from donors treated with acitretin

We assessed the pregnancy outcome of nine women inadvertently transfused with acitretin-contaminated blood products in South Korea. A total of 18 women matched to cases by age, gravidity, and singleton- or twin-pregnancy, and who were transfused with blood products not contaminated with acitretin, was also recruited. There were nine babies born in the case group. No differences (p > 0.05) were observed between cases and controls in the gestational age at delivery (38.3 +/- 1.6 weeks vs 37.8 +/- 2.2 weeks), birth weight (3,146 +/- 874 g vs 3,106 +/- 568 g), rate of pre-term deliveries (22.2% vs 11.1%) and rate of low birth weight (<2,500 g) (33.3% vs 16.7%). There was no case of malformation or neurological abnormalities born in either group. In conclusion, inadvertent exposure to acitretin-contaminated blood products was not associated with adverse pregnancy outcomes, probably because of the removal of acitretin and etretinate during the manufacturing process of blood products.

BaTiO3 doped Na0.5K0.5NbO3 thin films deposited by using eclipse shutter enhanced pulsed laser deposition method

We have investigated structural, electrical, and electro-mechanical properties of lead-free piezoelectric BaTiO3 doped Na0.5K0.5NbO3 (BTO-NKN) thin films deposited by pulsed laser deposition (PLD) methods. BTO-NKN thin films have been deposited on La0.5Sr0.5CoO3 (LSCO) bottom electrodes with LaAlO3 (LAO) substrates. X-ray diffraction data have shown that all the BTO-NKN and bottom electrodes are highly oriented with their c-axes normal to the substrates. In order to improve the morphology of BTO-NKN thin films, we have located an eclipse shutter between a target and a substrate. Root-mean-square roughness was changed from 91 nm to 21 nm with eclipse shutter enhanced PLD (E-PLD) method. Furthermore, the enhanced surface morphology leads to the improvement in electrical or electro-mechanical properties mainly due to increased density. Typical capacitance and d33 values of a BTO-NKN film deposited by E-PLD method are 1000 pF and 30 pmN, respectively.

A case of palmoplantar lichen planus mimicking secondary syphilis

Lichen planus is a chronic inflammatory disease that affects skin, mucous membranes, hairs, and nails. According to the site of involvement, lichen planus can be subdivided into palmoplantar, mucosal, nail, or scalp types. Palmoplantar lichen planus is a rare subtype of lichen planus which may create difficulty in diagnosis, as the lesion is limited to the palms and soles. We report a case of a 37-year-old male with lichen planus who presented with multiple erythematous, scaly, hyperkeratotic papules on his palms and soles mimicking secondary syphilis.

Effects of baicalein, an antioxidant, on the bioavailability of doxorubicin in rats: possible role of P-glycoprotein inhibition by baicalein

The purpose of this thesis is to investigate the effects of baicalein, an antioxidant, on the bioavailability and pharmacokinetics of Doxorubicin (DOX) in rats. Thus, DOX was administered intravenously (i.v.; 10 mg x kg(-1)) or orally (p.o.; 50 mg x kg(-1)) with or without oral baicalein (0.3, 1.5 and 6 mg x kg(-1)). In the presence of 1.5 and 6 mg x kg(-1) of baicalein, the total area under the plasma concentration-time curve from time zero to time infinity (AUC) and the peak concentration (Cmax) of DOX were significantly greater and higher, respectively, than those of the control. Consequently, the absolute bioavailability (AB) of DOX in the presence of baicalein was 3.5-4.4%, which was significantly enhanced compared with that of the control group (2.2%). The relative bioavailability (RB) of DOX was 1.20 to 1.96 times higher than that of the control group. Compared to the intravenous control, the presence of oral baicalein increased the i.v. AUC of DOX and other pharmacokinetic parameters were not significantly affected. The enhanced bioavailability of oral DOX by oral baicalein may be due to the inhibition of both P-glycoprotein (P-gp) and the cytochrome P450 (CYP) 3A subfamily by baicalein in the intestine and/or liver. This result suggests that the development of oral DOX is feasible by combination with baicalein that would be more convenient than the i.v. dosage forms. Furthermore, since the present study raises the awareness about potential drug interactions by concomitant use of DOX with baicalein, the dosage regimen of DOX should be taken into consideration, if this result is confirmed in clinical studies.

Teratogen risk counselling by internet: A prospective cohort study

Although the internet may play a role in providing proper teratogen-risk counselling for pregnant women, the experience with this type of service has not been reported. We aimed to compare the pregnancy outcome of women counselled by the internet to women that received typically in-clinic teratogen risk counselling in the clinic. In a prospective cohort design, 1,011 patients were counselled in the clinic and 235 patients were counselled via the internet. Teratogen risk counselling was provided according with the information obtained from medical literature and specialised software. Information about pregnancy outcome (delivery, spontaneous abortion, or termination of pregnancy and major malformations) was obtained from 903 (89.3%) patients from the clinic group and 141 (60%) from the internet group. The amount of alcohol, cigarettes smoked, and millirads of X-ray were greater ( p < 0.05) in patients counselled by internet than in clinic. The rate of deliveries, ongoing pregnancies, pregnancy terminations, and spontaneous abortions were similar between clinic and internet (chi2 = 1.32; p = 0.7). Of 498 babies born to mothers counselled in the clinic, major malformations were identified in 3.6%. Of 67 babies born to mothers counselled by internet, major malformations were present in 1.5% ( p = 0.6). Teratogen-risk counselling by internet and clinic seems to have a similar efficacy in pregnancy outcome.

Impact of caregivers' unmet needs for supportive care on quality of terminal cancer care delivered and caregiver's workforce performance

GOALS OF WORK

Family caregivers play an important role in caring for cancer patients, but the impact of caregivers' unmet needs on the quality of end-of-life (EOL) care they deliver and on their workplace performance are less understood.

PATIENTS AND METHODS

We identified 1,662 family caregivers of cancer patients who had died at any of 17 hospitals in Korea during 2004. The caregivers answered a telephone questionnaire about needs that were not met when they delivered terminal cancer care and how those unmet their needs affected their workplace performance; they also answered the Quality Care Questionnaire-End of Life (QCQ-EOL).

RESULTS

Compared with caregivers who did not have unmet needs, caregivers who had unmet needs for symptom management, financial support, or community support showed poorer QCQ-EOL scores (P < 0.01). Caregivers who had unmet needs for financial support (adjusted odds ratio (aOR) = 7.55; 95% confidential interval (CI) 3.80-15.00), psychosocial support (aOR = 6.24; 95% CI 2.95-13.05), symptom management (aOR = 3.21; 95% CI 2.26-4.54), community support (aOR = 3.82; 95% CI 2.38-6.11), or religious support (aOR = 4.55; 95% CI 1.84-11.26) were more likely to experience work limitations. Caregivers of patients receiving conventional hospital care were more likely to have unmet needs for symptom management (aOR = 1.21; 95% CI 1.00-1.47), psychosocial support (aOR = 1.99; 95% CI 1.37-2.88), and religious support (aOR = 1.73; 95% CI 1.08-2.78) than those of patients receiving palliative hospice care.

CONCLUSIONS

Caregivers' unmet needs negatively affected both the quality of EOL care they delivered and their workplace performance. More investment in caregiver support and public policies that meet caregiver needs are needed, and hospice use should be encouraged.

Prenatal multivitamins containing folic acid do not decrease prevalence of depression among pregnant women

Several studies have reported an association between depression and folic acid deficiency. We investigated whether intake of prenatal multivitamins containing folic acid (MVandFA) was associated with decreased rates of depression among pregnant women. A questionnaire was given to 1,314 low-risk pregnant women. Of them, 1,277 (97.2%) women completed the questionnaire. The overall prevalence of depression was 8.1%. Of 652 participants who did not take MVandFA, 9.4% had depression, whereas 6.9% of 624 women who had MVandFA had depression (p = 0.11). In a multivariate logistic regression analysis, family history of depression (adjusted OR 3.7; 95% CI 1.9-7.3) and premenstrual syndrome (adjusted OR 3.0, 95% CI 1.8-4.8) were identified as risk factors for depression during pregnancy. In conclusion, intake of MVandFA was not associated with lower rates of depression during pregnancy whereas family history of depression and personal history of premenstrual syndrome were significant risk factors.

Bilateral subdural hemorrhage as a possible adverse event of gefitinib in a patient with non-small cell lung cancer

Gefitinib, a selective inhibitor of epidermal growth factor receptor tyrosine kinase is an effective agent used in the treatment of patients with advanced non-small cell lung cancer (NSCLC). Adverse drug reactions were frequently observed in the skin, gastrointestinal tract, and liver, but they were generally mild in severity and reversible. Therefore, gefitinib has been regarded as a relatively safe agent. As a serious adverse effect, however, acute lung injury has been reported. The present report describes a patient with NSCLC who developed bilateral subdural hemorrhage as a possible adverse drug reaction after gefitinib therapy. We expect that this case may provide a reference for clinicians being involved in the treatment with gefitinib.

Effects of epigallocatechin gallate on the bioavailability and pharmacokinetics of diltiazem in rats

This study investigated the effect of orally administered epigallocatechin gallate (EGCG), a flavonoid, on the bioavailability or pharmacokinetics of diltiazem and its main active metabolites desacetyldiltiazem in rats. Pharmacokinetic parameters of diltiazem and desacetyldiltiazem were determined following the oral administration of diltiazem (15 mg x kg(-1)) in the presence or absence of EGCG (1, 4 and 12 mg x kg(-1)). The area under the plasma concentration-time curve (AUC) and the peak concentration (Cmax) of diltiazem were significantly (P < 0.05, 4 mg x kg(-1) and P < 0.01, 12 mg x kg(-1)) increased in the presence of EGCG. The total body clearance (CL/F) was significantly (P < 0.05, 4 and 12 mg x kg(-1)) decreased in the presence of EGCG. Consequently, the absolute bioavailability (AB%) of diltiazem was significantly (P < 0.05, 4 mg x kg(-1) and P < 0.01, 12 mg x kg(-1)) increased compared with that of the control group. The relative bioavailability (RB%) of diltiazem was from 1.65- to 1.76-fold higher than that of the control group. The terminal half-life (t1/2) and time to reach the peak concentration (Tmax) of diltiazem did not change significantly in the presence of EGCG. EGCG significantly (P < 0.05, 12 mg x kg(-1)) increased the AUC and Cmax of desacetyldiltiazem. Metabolite-parent AUC ratio of desacetyldiltiazem was decreased, but did not change significantly. The presence of EGCG significantly enhanced the oral bioavailability of diltiazem due to inhibiting cytochrome P450 (CYP) 3A4-mediated metabolism and P-glycoprotein (P-gp) mediated efflux of diltiazem in the intestine.

Pregnancy outcome after exposure to oral contraceptives during the periconceptional period

To evaluate whether periconceptional exposure to oral contraceptives (OCs) increased adverse pregnancy outcomes, 136 pregnant women taking OCs within the periconceptional period were identified at the Korean Motherisk Program. Of them, 120 pregnant women accepted to participate in their study and were followed up until completion of the pregnancy. A control group of 240 age- and gravidity-matched pregnant women exposed to non-teratogen drugs for at least 1 month before pregnancy was also included. The median gestational age at delivery was 39.1 (27.0-41.0) weeks in the exposed group and 39.3 (27.4-42.0) weeks in the control group (P = 0.19). In the exposed group, 7.1% of babies were born with low birth weight versus 2.6% in the control group (P = 0.068). The number of preterm deliveries or babies born large for gestational age did not differ between the two groups. In the exposed group, the rate of birth defects was 3.2% (n = 3/99) versus 3.6% (n = 7/193) in the control group (P = 1.0). There were 15 women who took high doses of progesterone (emergency contraception) and no adverse fetal outcomes were observed. In conclusion, periconceptional exposure to OCs does not appear to increase the risk for adverse pregnancy outcomes.

Endoscopic evaluation of significant gastrointestinal lesions in patients with iron deficiency with and without anaemia: a Korean Association for the Study of Intestinal Disease study

BACKGROUND

Although endoscopy is recommended for patients with iron deficiency anaemia, there is, currently, no consensus on the role of endoscopy for iron-deficient patients without anaemia. The goal of this study was to determine the prevalence of serious gastrointestinal (GI) lesions, identified by endoscopy in patients with iron deficiency and anaemia compared with patients with iron deficiency without anaemia.

METHODS

One thousand five hundred and eighteen patients with a ferritin value of <or=50 ng/mL and a total iron-binding capacity >or=300 mg/dL were retrospectively investigated using oesophagogastroduodenoscopy and colonoscopy between January 2005 and September 2006. The lesions identified were classified as clinically important according to standard predetermined criteria.

RESULTS

Among the 1518 cases, 749 patients had anaemia and 769 had normal haemoglobin levels. Clinically important lesions were identified in 24.6% of the patients with anaemia and in 22.8% of the patients without anaemia (P > 0.05). The frequency of lower GI tract lesions (13.6 vs 11.4%, P > 0.05) and upper GI tract lesions (11.9 vs 12.5%, P > 0.05) was similar in the comparisons between the two groups. However, the frequency of malignant GI lesions was higher in the patients with anaemia (5.1 vs 0.7%, P < 0.01). In addition, the patients without anaemia were significantly more likely to have early-stage neoplasia (adenoma, early gastric cancer and Dukes' A and B colon cancer) than were the patients with anaemia (98.4 vs 52.5%, P < 0.01).

CONCLUSION

The results of this study suggest that patients with iron deficiency should undergo endoscopic evaluation of the GI tract, irrespective of whether they have anaemia. The endoscopic evaluation of the GI tract in patients with iron deficiency without anaemia could provide an opportunity for the detection of early-stage neoplasia at a curable stage.

Central bisectionectomy for centrally located hepatocellular carcinoma

BACKGROUND

Central bisectionectomy, which involves the removal of the central hepatic segments (IVA, IVB, V, VIII) for hepatocellular carcinoma (HCC), is performed to reduce the volume of resected liver and to overcome the problem of insufficient future residual volume.

METHODS

Twenty-seven patients with HCC underwent central bisectionectomy from January 1998 to April 2007 in one hospital. The surgical techniques, clinicopathological characteristics and outcomes were reviewed.

RESULTS

The median operating time was 330 min. Twelve patients developed postoperative complications and two died. The most common complication, occurring in five patients, was bile duct injury leading to biloma or bile leakage. Median follow-up was 19.1 (range 1.4-102.2) months and eight patients developed a recurrence. Twenty-four patients were alive at the time of writing.

CONCLUSION

Although biliary complications occur somewhat frequently, central bisectionectomy in centrally located HCC can be performed safely to preserve liver volume.

Poly(vinyl acetate)/clay nanocomposite materials for organic thin film transistor application

Nanocomposite materials of poly(vinyl acetate) (PVAc) and organoclay were fabricated, in order to be utilized as dielectric materials of the organic thin film transistor (OTFT). Spin coating condition of the nanocomposite solution was examined considering shear viscosity of the composite materials dissolved in chloroform. Intercalated structure of the PVAc/clay nanocomposites was characterized using both wide-angle X-ray diffraction and TEM. Fracture morphology of the composite film on silicon wafer was also observed by SEM. Dielectric constant (4.15) of the nanocomposite materials shows that the PVAc/clay nanocomposites are applicable for the gate dielectric materials.

Pregnancy outcomes in women using inhaled fluticasone during pregnancy: a case series

BACKGROUND

The aim of the study was to report the maternal and fetal outcomes of women with respiratory illnesses who were treated with inhaled fluticasone during pregnancy.

MATERIAL AND METHODS

We identified 12 cases treated with inhaled fluticasone during pregnancy out of women who received obstetric and teratogen-risk evaluation at the Korean Motherisk Program. A detailed medical and obstetric history was obtained and cases were followed-up until either spontaneous or voluntary pregnancy termination or delivery occurred.

RESULTS

None of the participants had any obstetric complication. However, in addition to fluticasone, most of the 12 cases were simultaneously exposed to a variety of medications. There were 3 abortions (one spontaneous and 2 requested by the patients arguing personal reasons). Live born babies without any evidence of major congenital malformations included 8 singleton babies and 2 twins. Of them, 3 babies were born prematurely.

CONCLUSIONS

Our results are in agreement with previous large studies where no increased rate of adverse outcomes was reported with the use of inhaled corticosteroids during pregnancy.

Expression profile of tight junction protein claudin 3 and claudin 4 in ovarian serous adenocarcinoma with prognostic correlation

Tight junction proteins claudin 3 (CLDN3) and claudin 4 (CLDN4) are frequently altered in several human cancers, including ovarian carcinomas. Here, we examined the gene expression of CLDN3 and CLDN4 in various tumors, including 19 normal ovaries and 47 ovarian carcinomas by analyzing Affymetrix HG-U133 array data. Furthermore, a total of 114 ovarian serous tumors, including 10 adenomas, 20 borderline tumors and 84 carcinomas, were analyzed immunohistochemically to confirm the expression of two proteins and we assessed the association of their expression with the clinicopathological characteristics and survival of the patients. The microarray experiment revealed CLDN3 and CLDN4 transcripts were significantly up-regulated by 5-fold or more in most subtypes of ovarian epithelial carcinomas while the immunohistochemical analyses indicated that each protein was expressed in 68 (81.0%) and 72 (85.7%) of 84 serous adenocarcinomas, respectively. Borderline serous tumors and adenomas showed significantly lower expression of these proteins than the adenocarcinomas. Kaplan-Meier survival analysis showed that serous adenocarcinoma patients with high CLDN3 expression had substantially shorter survival (P=0.027). Multivariate analysis demonstrated that CLDN3 overexpression is an independent negative prognostic factor. Our findings suggest that CLDN3 overexpression can be used as a prognostic indicator in ovarian serous carcinomas. Moreover, CLDN3 may be a promising target for antibody-based therapy of ovarian carcinomas.

Syringocystadenocarcinoma papilliferum: a case report

Syringocystadenocarcinoma papilliferum (SCACP) is a rare form of adenocarcinoma of the skin. This is the malignant counterpart of syringocystadenoma papilliferum (SCAP) and usually develops on the scalp in a long-standing lesion identified clinically as SCAP. We describe a 65-yr-old Korean man with a nodule on the right supra-pubic area with a 2-yr duration. Histologically this tumor had a similar overall configuration as in SCAP, but the tumor was asymmetric and poorly circumscribed, extending into the deep dermis and showed cytologic atypia. The tumor cells showed positive reaction to GCDFP-15, but negative reaction to CEA and HMFG-1. We established the diagnosis of SCACP in the patient, and a wide excision was performed to remove the tumor. The patient has been well without relapse or metastasis for 2 yr.

Molecular epidemiology of trichophyton tonsurans isolated in Japan using RFLP analysis of non-transcribed spacer regions of ribosomal RNA genes

Trichophyton tonsurans has been reported to be the causative agent of an epidemic of tinea corporis and tinea capitis among Japanese judoists and wrestlers. A molecular method using restriction enzyme analysis of PCR-amplified fragments targeting the non-transcribed spacer (NTS) region of ribosomal RNA genes in fungal nuclei was applied to a total of 232 strains of T. tonsurans isolated in Japan. Six molecular types, i.e., NTS types I, II, III, IV, V, and VI, were clearly detected in restriction analysis of fragments digested with MvaI and AvaI together. Of the 232 strains, 199 were classified as NTS I, 21 as NTS II, 7 as NTS III, 3 as NTS IV, 1 as type V, and 1 as type VI. Whereas the NTS I strains were found nationwide, most of the NTS II and NTS III strains were limited to central Japan. Of 164 strains isolated from judoists, 160 were classified as NTS I, which suggests that the majority of the cases were caused by a clonal lineage. On the other hand, the 48 strains isolated from wrestlers showed more variety, with 27 strains classified as NTS I, 17 as NTS II, and 4 as NTS III. We concluded that the epidemic was caused by at least three lineages of T. tonsurans. NTS VI strains, the major molecular type among sporadically isolated strains, were not observed among the epidemic strains, and strains of this type did not contribute to the present epidemic.

Laparoscopic cholecystectomy only could be an appropriate treatment for selected clinical R0 gallbladder carcinoma

BACKGROUND

Laparoscopic cholecystectomy (LC) for gallbladder carcinoma still is controversial except for the early stages of gallbladder carcinoma (Tis). This study was designed to evaluate and revisit the role of LC in treating gallbladder carcinoma.

METHODS

Available medical records of patients with surgeries for gallbladder carcinoma were retrospectively investigated from August 1992 to February 2005.

RESULTS

Among 219 patients treated for gallbladder carcinoma, 57 (26%) underwent LC. A total of 16 patients (28.1%) underwent subsequent radical cholecystectomy (LC-RC), and 41 (71.9%) were only followed up without radical surgery (LC). Tis was found in 11 patients (19.3%), T1a in 3 patients (5.3%), T1b in 8 patients (14%), T2 in 19 patients (33.3%), and T3 in 16 patients (28.1%). The findings showed R0 in 14 cases of the radical cholecystectomy group, and clinical R0 was noted in 30 cases of the LC-only group. No survival differences were noted between LC and LC-RC (p = 0.2575), especially in the case of T2 lesions (p = 0.6274), nor between the R0 and clinical R0 (p = 0.5839). However, significant survival differences were noted between the R2 and R0 groups, and between R2 and clinical R0, respectively (p < 0.001).

CONCLUSIONS

The findings show that LC could be appropriate treatment for gallbladder carcinoma only in selected cases of clinical R0 lesions.

Assessment of converting from intravenous to oral administration of cyclosporin A in pediatric allogeneic hematopoietic stem cell transplant recipients

We studied the administration method during a transition period from continuous intravenous (i.v.) infusion to oral administration of cyclosporin A (CsA). Thirty-two pediatric hematopoietic stem cell transplant (HSCT) recipients, between the ages of 8 months and 15.6 years (median 7.1 years) participated in this study. The pharmacokinetic properties of CsA was evaluated during the transition period from i.v. to oral CsA. The daily oral dose of CsA was three times higher than the i.v. dose. Oral dosing began immediately after the continuous infusion was discontinued. Whole-blood CsA concentrations were measured by a monoclonal fluorescence polarization immunoassay (FPIA). The mean+/-s.d. value of bioavailability (F), maximum concentration (C(max)), half-life (t(1/2)) of CsA were 43.1+/-14.4%, 1135.3+/-340.6 ng/ml and 3.1+/-1.2 h, respectively. Mean clearance (CL)+/-s.d. was 480.9+/-103.7, 414.9+/-137.1 and 320+/-51.8 ml/h/kg in patients <20, 20-40 and >40 kg of body weight, respectively. The CsA CL of younger children was significantly greater than for older children (P=0.044). CsA trough levels were maintained within the therapeutic range throughout the transition period. Therefore, our findings suggest that the immediate administration of an oral formulation, after discontinuation of the continuous infusion, would be practical and effective for routine clinical use.

Methanolic extract of Pterocarpus santalinus induces apoptosis in HeLa cells

Ptercarpus santalinus (Fabaceae) has been used as a folk remedy in Korea, and it has been shown to exhibit antiinflammations, antiulcers and anticancer effects. In this study, therefore, we report the cytotoxic activity and the mechanism of cell death exhibited by the methanol extract of Ptercarpus santalinus (MEPS) against human cervical adenocarcinoma cell line, HeLa. Treatment of HeLa cells with various concentrations of MEPS resulted in growth inhibition and induction of apoptosis in a dose-dependent manner as determined by cell viability, chromatin condensation, DNA fragmentation and sub-G1 phase accumulation. In Western blot analysis, apoptosis in the HeLa cells was associated with the release of cytochrome C from mitochondria into the cytosol, activation of caspases-3, -8, -9 and proteolytic cleavage of PARP. These results suggest that MEPS exhibits antiproliferative effect on HeLa cells via apoptosis, and it may be a potential candidate in field of anticancer drug discovery.

Biofeedback therapy for rectal intussusception

BACKGROUND

Surgery for isolated internal rectal intussusception is controversial due to high morbidity. Therefore, there is interest in other forms of treatment that are safe and effective. The aim of this study was to determine outcome and identify predictors for success of biofeedback therapy in patients with rectal intussusception.

METHODS

We retrospectively evaluated the results of electromyography (EMG)-based biofeedback in 34 patients with rectal intussusception without any other major pelvic floor or colonic physiologic disorder.

RESULTS

A total of 34 patients (7 men) had undergone at least 2 biofeedback sessions. The patients had a mean age of 68.5 years (SD=11.4 years). In the 27 patients with constipation, the frequency of weekly spontaneous bowel movements (mean+/-SD) was 2.0+/-6.8 before and 4.1+/-4.6 after biofeedback (p<0.05). The frequency of weekly assisted bowel movements decreased from 3.8+/-3.5 before to 1.5+/-2.2 after therapy (p<0.005). The number of patients who experienced incomplete evacuation decreased from 17 (63%) to 9 (33%) (p<0.05). Thirty-three percent of patients had complete resolution of the symptoms, 19% had partial improvement, and 48% had no improvement. Patients with constipation lasting less than nine years had a 78% success rate vs. 13% in patients who were constipated more than 9 years (p<0.01). In seven patients with incontinence, the frequency of daily incontinence episodes decreased from 1.0+/-0.7 before to 0.07+/-0.06 after biofeedback (p<0.05). The fecal incontinence score decreased from 13.1+/-4.2 before to 4.6+/-3.6 after treatment (p<0.005). Two patients (29%) were completely continent following biofeedback, 2 had partial improvement, and 3 (43%) had no significant improvement. There was no mortality in either group.

CONCLUSIONS

Biofeedback is a safe and effective treatment option for constipation and fecal incontinence due to rectal intussusception in patients who are willing to complete the course of treatment. Long-standing constipation is less effectively cured by biofeedback.

Prognostic values of KAI1 and survivin expression in an infiltrating ductal carcinoma of the breast

AIMS

To investigate KAI1 and survivin expression in infiltrating ductal carcinomas, and to evaluate the relationship between clinicopathological factors and KAI1 and survivin expression levels in breast cancers.

METHODS AND RESULTS

KAI and survivin expression levels were measured in 62 patients, using immunohistochemical staining. Western blot analysis was performed on eight frozen cases. DNA ploidy was determined by flow cytometry. The results of the KAI1 expression analyses were as follows: in 14 cases (22.6%) levels were preserved (++), in 30 cases (48.4%) levels were reduced (+), in 18 cases (29.0%) no KAI1 expression was detected, so these were designated 'lost' (-). Results of assessments of survivin expression were as follows: six cases (9.7%) were strong positive (++), 28 cases (45.15%) were positive (+), and 28 cases (45.15%) were negative. Survivin (p=0.0009) and KAI1 (p=0.0091) expression levels were directly correlated with survival rate. However, no significant difference was determined to exist between survivin and KAI1 expression levels and the clinicopathological factors. DNA ploidy did not correlate with survivin and KAI1 expression levels and survival rate. Four different groups, according to their survivin and KAI1 expression levels, correlated with the clinical stage and survival rate.

CONCLUSION

KAI1 and survivin expression levels might be prognostic factors in breast cancers.

Electron beam treatment of textile dyeing wastewater: operation of pilot plant and industrial plant construction

A pilot plant for treating 1000 m3/day of dyeing wastewater with e-beam has been constructed and operated since 1998 in Daegu, Korea together with the biological treatment facility. The wastewater from various stages of the existing purification process has been treated with an electron beam in this plant, and it gave rise to elaborating the optimal technology of the electron beam treatment of wastewater with increased reliability for instant changes in the composition of wastewater. Installation of the e-beam pilot plant resulted in decolorizing and destructive oxidation of organic impurities in wastewater, appreciable reduction of chemical reagent consumption, in reduction of the treatment time, and in increase in the flow rate limit of existing facilities by 30-40%. Industrial plant for treating 10,000 m3/day each, based upon the pilot experimental result, is under construction and will be finished by 2005. This project is supported by the International Atomic Energy Agency (IAEA) and Korean Government.

Rapid differentiation of Aspergillus species from other medically important opportunistic molds and yeasts by PCR-enzyme immunoassay

We developed a PCR-based assay to differentiate medically important species of Aspergillus from one another and from other opportunistic molds and yeasts by employing universal, fungus-specific primers and DNA probes in an enzyme immunoassay format (PCR-EIA). Oligonucleotide probes, directed to the internal transcribed spacer 2 region of ribosomal DNA from Aspergillus flavus, Aspergillus fumigatus, Aspergillus nidulans, Aspergillus niger, Aspergillus terreus, Aspergillus ustus, and Aspergillus versicolor, differentiated 41 isolates (3 to 9 each of the respective species; P < 0.001) in a PCR-EIA detection matrix and gave no false-positive reactions with 33 species of Acremonium, Exophiala, Candida, Fusarium, Mucor, Paecilomyces, Penicillium, Rhizopus, Scedosporium, Sporothrix, or other aspergilli tested. A single DNA probe to detect all seven of the most medically important Aspergillus species (A. flavus, A. fumigatus, A. nidulans, A. niger, A. terreus, A. ustus, and A. versicolor) was also designed. Identification of Aspergillus species was accomplished within a single day by the PCR-EIA, and as little as 0.5 pg of fungal DNA could be detected by this system. In addition, fungal DNA extracted from tissues of experimentally infected rabbits was successfully amplified and identified using the PCR-EIA system. This method is simple, rapid, and sensitive for the identification of medically important Aspergillus species and for their differentiation from other opportunistic fungi.

Relation between deranged antioxidant system and cervical neoplasia

The purpose of this study was to compare the plasma levels of the anti-oxidant system and oxidative stress between a cervical neoplasia group and a normal control group and to investigate the relationship between the levels of micronutrients of antioxidant system and various clinicopathological parameters of cervical carcinoma. A cross-sectional sample of 180 women, including 90 normal controls, was recruited from November 2000 to January 2001. Plasma concentration of malondialdehyde (MDA) was spectrophotometrically measured as the parameter of lipid peroxidation. Plasma levels of antioxidant vitamins were analyzed with the help of reverse-phase, high-pressure liquid chromatography, whereas glutathione peroxidase activity was evaluated by using coupled enzyme procedure. While the activity of glutathione peroxidase and the plasma levels of antioxidant vitamins, such as lutein, beta-carotene, lycopene, and zeaxanthin, were all significantly lower, the concentration of MDA was significantly higher in women with cervical intraepithelial neoplasia (CIN) or invasive cervical cancer, compared to those of the normal control group. The status of the plasma antioxidant system showed no significant correlation with the prognostic factors of cervical cancer. These findings suggest a potential role of oxidative stress-induced lipid peroxidation and the impairment of the anti-oxidant system in the pathogenesis of CIN and carcinoma of the uterine cervix.

A novel angiogenic factor derived from Aloe vera gel: beta-sitosterol, a plant sterol

Aloe vera gel has a beneficial effect on wound healing. Because angiogenesis is an essential process in wound healing, we hypothesized that Aloe vera gel might contain potent angiogenic compounds. Here we demonstrate that Aloe vera gel and its extracts are angiogenic on the chorioallantoic membrane (CAM) of chick embryo. Out of the three compounds purified from the final fraction of Aloe vera gel, beta-sitosterol showed a potent angiogenic activity in the CAM assay. In the presence of heparin, beta-sitosterol stimulated neovascularization in the mouse Matrigel plug assay and the motility of human umbilical vein endothelial cells in an in vitro wound migration assay. Thus beta-sitosterol is a novel plant-derived angiogenic factor which may have potential pharmaceutical applications for the management of chronic wounds.

A novel angiogenic factor derived from Aloe vera gel: beta-sitosterol, a plant sterol

Aloe vera gel has a beneficial effect on wound healing. Because angiogenesis is an essential process in wound healing, we hypothesized that Aloe vera gel might contain potent angiogenic compounds. Here we demonstrate that Aloe vera gel and its extracts are angiogenic on the chorioallantoic membrane (CAM) of chick embryo. Out of the three compounds purified from the final fraction of Aloe vera gel, beta-sitosterol showed a potent angiogenic activity in the CAM assay. In the presence of heparin, beta-sitosterol stimulated neovascularization in the mouse Matrigel plug assay and the motility of human umbilical vein endothelial cells in an in vitro wound migration assay. Thus beta-sitosterol is a novel plant-derived angiogenic factor which may have potential pharmaceutical applications for the management of chronic wounds.

Secondary reconstruction of an ileal reservoir in patients with failed straight ileoanal pull-through: report of two cases

The ileoanal reservoir is a widely accepted option for the treatment of mucosal ulcerative colitis and familial adenomatous polyposis. Function of an ileoanal anastomosis without the reservoir may be unacceptable. The aim of this study was to assess the technical feasibility of conversion of a straight ileoanal anastomosis to an ileoanal reservoir anastomosis. Two patients underwent straight ileoanal anastomosis and then underwent subsequent conversion to an ileoanal reservoir anastomosis. A 16-year-old girl with mucosal ulcerative colitis and a 38-year-old woman with familial adenomatous polyposis presented with 20-25 bowel movements per day and severe diarrheal-related symptoms within 11 months of ileoanal anastomosis. In each case, the anastomosis was reversed and an ileal Jpouch was fashioned and anastomosed to the dentate line; there was no postoperative morbidity. The 38-year-old patient reported 4-5 bowel movements per day without the need for any medication at 1-8 months after ileostomy closure. The 16-year-old patient is waiting ileostomy closure. In conclusion, it is technically possible to convert a straight ileoanal anastomosis to an ileoanal reservoir anastomosis with expectations of improvement in function.

Intraperitoneal gene delivery mediated by a novel cationic liposome in a peritoneal disseminated ovarian cancer model

We have previously synthesized a new cationic liposome that displays high efficiency and low toxicity, 3 beta[l-ornithinamide-carbamoyl] cholesterol (O-Chol), using solid-phase synthesis. In this study, O-Chol was applied to in vitro and in vivo models of ovarian cancer. Intraperitoneal gene delivery for peritoneal disseminated ovarian cancer in nude mice was achieved using a stable chloramphenicol acetyl transferase (CAT)-expressing ovarian cancer cell line (OV-CA-2774/CAT), which allowed us to quantify the exact tumor burden of organs. When luciferase and beta-galactosidase genes were used as reporter genes, O-Chol showed better efficiency than other commercial transfection reagents such as lipofectin, lipofectAMINE, DC-Chol, and FuGENE 6, both in vitro and in vivo. Moreover, the transfection efficiency of this new cationic lipid reagent remained high in serum-containing medium and under serum-free conditions. Furthermore, in vivo transfection with O-Chol showed high levels of gene expression specific to peritoneal tumor cells. Consequently, the O-Chol:DNA lipoplex appears to offer potential advantages over other commercial transfection reagents because of (1) its higher level of gene expression in vitro and in vivo; (2) its reduced susceptibility to serum inhibition; and (3) its highly selective transfection into tumor cells. These results suggest that the O-Chol:DNA lipoplex is a promising tool in gene therapy for patients with peritoneal disseminated ovarian cancer.