Blastomycosis of the epididymis and prostate

We report a case of blastomycosis presenting as epididymitis and prostatitis. The diagnosis was suggested by pathologic findings in the prostate and epididymis and was further supported by serology. The diagnosis was confirmed by culture and special staining. Long-term cure was accomplished after a 12-month course of oral ketoconazole (400 mg/day). Therapy was monitored by culture and serology. Blastomycosis is an unusual but significant pathogen which occasionally presents with genitourinary tract involvement. Effective diagnostic and oral treatment regimens are now available but are dependent on a high degree of suspicion in cases of chronic prostatitis or epididymitis.     

Evaluation of physico-chemical properties of acrylic resin hydrogel and their application to transdermal delivery system

Recently, many attempts have been made to use hydrogels of various polumers as delivery systems of various drugs and bioactive materials to prolong and control their pharmacological activities. In this study, we have evaluated the physico-chemical properties of methacrylic acid-methacrylic acid methyl ester copolymer (Eudispert mv), a acrylic resin hydrogel, and its application to transdermal delivery system. In the dissolution tests, the release rate of salicylic acid (SA) and sodium salicylate (Sod. SA) were faster than lidocain (LD) and lidocain-HCl (LD-HCl). As the concentration of Eudispert mv polymer increased, the extensibility of Eudispert mv hydrogel decreased, whereas the swelling ratio increased. The more NaOH and polymer concentration increased, the more osmotic pressure linearly increased. The skin permeation of Sod. SA, an acidic model drug, was remarkably enhanced by Eudispert mv hydrogel. All fatty acids, except for Sod. glycolate, dramatically increased the skin permeation flux in Eudispert mv hydrogel containing LD-HCl, a basic model drug. Consequently, it is suggested that Eudispert mv hydrogel may be used as potential transdermal delivery vehicle.     

Glycyrrhizin and glycyrrhetinic acid determination from formalin-fixed tissue

Summary Glycyrrhetinic acid (GA), the main metabolic product of glycyrrhizin (GLY), could be detected in formalin-fixed tissue from a man who died 6 hours after therapeutic administration of a GLY-containing agent. GA was extracted from homogenized formalin-fixed liver tissue and 3 ng GA/g could be detected by HPLC. The extraction from formalin-fixed liver tissue gave the same retention time peak as the GLY control. GA could also be detected by mass spectrometry in the blood sample. This confirms that the man had received a GLY-containing agent for therapeutic use prior to his death and that GA can be determined from formalin-fixed tissue.     

Meta-analysis of the effects of respiratory rehabilitation programmes on exercise capacity in accordance with programme characteristics

Aims and objectives. This study was performed to investigate the effects of respiratory rehabilitation programmes on exercise capacity in terms of the programme type, the protocol used and other programme characteristics. Background. As the suitable rehabilitation programmes have not been specified, diverse programmes are provided in clinics. Design. Meta‐analysis of the primary study results Methods. A computerized search through MEDLINE and CINHAL in addition to tracking down references cited in bibliographies of primarily searched studies were performed to obtain sample studies. Finally 19 research reports were examined. Results. The results of meta‐regression showed that the combined effect size of the programmes on exercise capacity was unaffected by forced expiratory volume (in one second), age, the duration and frequency of the programme, or study quality. In addition, the results of meta‐anova indicated that the combined effect size was not affected by (i) whether a programme was hospital based or not, (ii) whether a programme was lower‐extremity or combined low‐ and upper‐extremity exercise training, (iii) measurement time, and (iv) exercise intensity. Conclusions. The effects of programmes on exercise capacity were not differed in terms of the places where rehabilitation programmes were applied, programme content, measurement time, exercise target sites of body, and the duration and frequency of the programme. Relevance to clinical practice. The results of the present study can provide objective data when constructed or applied on a respiratory rehabilitation programme in clinics.     

Claudin-7 is highly expressed in chromophobe renal cell carcinoma and renal oncocytoma

Claudin-7 has recently been suggested to be a distal nephron marker. We tested the possibility that expression of claudin-7 could be used as a marker of renal tumors originating from the distal nephron. We examined the immunohistochemical expression of claudin-7 and parvalbumin in 239 renal tumors, including 179 clear cell renal cell carcinoma (RCC)s, 29 papillary RCCs, 20 chromophobe RCCs, and 11 renal oncocytomas. In addition, the methylation specific-PCR (MSP) of claudin-7 was performed. Claudin-7 and parvalbumin immunostains were positive in 3.4%, 7.8% of clear cell RCCs, 34.5%, 31.0% of papillary RCCs, 95.0%, 80.0% of chromophobe RCCs, and 72.7%, 81.8% of renal oncocytomas, respectively. The sensitivity and specificity of claudin-7 in diagnosing chromophobe RCC among subtypes of RCC were 95.0% and 92.3%. Those of parvalbumin were 80.0% and 88.9%. The expression pattern of claudin-7 was mostly diffuse in chromophobe RCC and was either focal or diffuse in oncocytoma. All of the cases examined in the MSP revealed the presence of unmethylated promoter of claudin-7 without regard to claudin-7 immunoreactivity. Hypermethylation of the promoter might not be the underlying mechanism for loss of its expression in RCC. Claudin-7 can be used as a useful diagnostic marker in diagnosing chromophobe RCC and oncocytoma.     

Anti-inflammatory effect of abciximab-coated stent in a porcine coronary restenosis model

The aim of this study was to examine the anti-inflammatory effect of abciximab-coated stent in a porcine coronary overstretch restenosis model. Ten abciximab-coated stents, ten sirolimus-eluting stents (SES), and ten paclitaxel-eluting stents (PES) were deployed with oversizing (stent/artery ratio 1.3:1) in porcine coronary arteries, and histopathologic analysis was done at 28 days after stenting. There were no significant differences in the neointima area normalized to injury score and inflammation score among the three stent groups (1.58 +/- 0.43 mm(2), 1.57 +/-0.39 mm(2) in abciximab-coated stent group vs. 1.69 +/- 0.57 mm(2), 1.72 +/- 0.49 mm(2) in the SES group vs. 1.92 +/- 0.86 mm(2), 1.79 +/- 0.87 mm(2) in the PES group, respectively). In the neointima, most inflammatory cells were lymphohistiocytes. Significant positive correlations were found between the extent of inflammatory reaction and the neointima area (r=0.567, p<0.001) and percent area stenosis (r=0.587, p<0.001). Significant correlations were found between the injury score and neointimal area (r=0.645, p<0.001), between the injury score and the inflammation score (r=0.837, p<0.001), and between the inflammation score and neointimal area (r=0.536, p=0.001). There was no significant difference in the inflammatory cell counts normalized to injury score among the three stent groups (75.5 +/- 23.1/microL in abciximabcoated stent group vs. 78.8 +/- 33.2/microL in the SES group vs. 130.3 +/- 46.9/microL in the PES group). Abciximab-coated stent showed comparable inhibition of inflammatory cell infiltration and neointimal hyperplasia with other drug-eluting stents in a porcine coronary restenosis model.     

Sociodemographic and smoking behavioral predictors associated with smoking cessation according to follow-up periods: a randomized, double-blind, placebo-controlled trial of transdermal nicotine patches

This study investigated sociodemographic and smoking behavioral factors associated with smoking cessation according to follow-up periods. In this randomized, double-blind, placebo-controlled trial of transdermal nicotine patches, subjects were a total of 118 adult male smokers, who were followed up for 12 months. Univariable logistic regression analysis and stepwise multiple logistic regression analyses were performed to identify the predictors of smoking cessation. The overall self-reported point prevalence rates of abstinence were 20% (24/118) at 12 months follow-up, and there was no significant difference in abstinence rates between placebo and nicotine patch groups. In the univariable logistic regression analysis, predictors of successful smoking cessation were the low consumption of cigarettes per day and the low Fagerstrom Test for Nicotine Dependence (FTND) scores (p<0.05) at 3, 6, and 12 months follow-up. In the stepwise multiple logistic regression analyses, predictors of successful smoking cessation, which were different according to the follow- up periods, were found to be the low consumption of cigarettes per day at the short-term and midterm follow-up (< or =6 months), older age, and the low consumption of cigarettes per day at the long-term follow-up (12 months).     

Regulation of functional phenotypes of cord blood derived eosinophils by gamma-secretase inhibitor

Eosinophils develop from stem cells in the bone marrow under the influence of hematopoietic cytokines, particularly IL-5. Previously, we have demonstrated that blockage of Notch signaling by a gamma-secretase inhibitor (GSI) promotes the differentiation of umbilical cord blood (UCB)-derived eosinophils. These highly major basic protein (MBP)-positive eosinophils cultured in the presence of the inhibitor lack the migratory response to eotaxin, although their CCR3 levels are similar to those of eosinophils cultured without the inhibitor. We investigated the mechanism underlying the differential responses of differentiating eosinophils and their functionalities in response to eosinophil-active cytokines in the presence and absence of GSI. UCB cells cultured for 4 weeks with hematopoietic cytokines in the presence or absence of GSI were monitored for extracellular signal-regulated kinase (ERK) phosphorylation, MBP expression, and functionality. Eosinophil differentiation from UCB cells was accompanied by activation of the ERK1/2 pathway during the 4-week culture period. In particular, strong ERK1/2 phosphorylation was observed in eosinophils during the final stage of culture when GSI was present. Consistent with this finding, ERK inhibition nullified the effect of GSI on eosinophil differentiation. Eosinophils cultured with GSI resembled airway eosinophils rather than peripheral blood eosinophils based on reduced IL-5Ralpha expression, blunted eosinophil cationic protein (ECP) degranulation, and decreased IL-13 and granulocyte macrophage-colony-stimulating factor production. These results suggest that Notch signaling regulates the terminal differentiation and subsequent effector phenotypes of eosinophils, partly through modulation of the ERK pathway. GSI has therapeutic potential for eosinophilic inflammatory diseases, such as asthma.     

Molecular epidemiology of community-associated antimicrobial-resistant Staphylococcus aureus in Seoul, Korea (2003): pervasiveness of multidrug-resistant SCCmec type II methicillin-resistant S. aureus

There is an extremely high incidence of antimicrobial resistance of the clinical isolates of Staphylococcus aureus in Korea. This study carried out a molecular investigation to determine the prevalence of the community-associated antimicrobial-resistant S. aureus and methicillin-resistant S. aureus (MRSA). The percentage resistance from the nasal swabs of healthy volunteers in 2003 in Seoul is as follows: penicillin (91%), erythromycin (EM, 14%), gentamicin (GM, 9.3%), tetracycline (TE, 8.2%), cephalothin (4%), oxacillin (OX, MRSA; 3.8%), clindamycin (CC, 2.6%), ciprofloxacin (CIP, 0.8%), and sulfamethoxazole/trimethoprim (0.6%). The community-associated MRSA (C-MRSA) strains were examined by pulsed-field gel electrophoresis (PFGE) analysis of the SmaI macro-fragments, multilocus sequence typing (MLST), and staphylococcal cassette chromosome mec (SCCmec) typing using the PCR analysis. The Korean C-MRSA isolates were clustered into three distinct groups. One PFGE group containing the C-MRSA strains showed resistance to CC, EM, and GM, a high level (32-96 microg/ml) of resistance to methicillin, sequence type 5 (ST5), and SCCmec type II, which is the most common hospital associated-MRSA (H-MRSA) isolated in Korea. These results highlight the heterogeneous genetic background of the C-MRSA as well as the pervasiveness of the H-MRSA isolates in this community.     

Identification of origin of unknown derivative chromosomes by array-based comparative genomic hybridization using pre- and postnatal clinical samples

Microarray-based comparative genomic hybridization (array CGH) is a high-resolution and comprehensive method for detecting both genome-wide and chromosome-specific copy-number imbalance. We have developed an array CGH analysis system (consisting of an array CGH chip plus its exclusive analysis software) for constitutional genetic diagnosis and have evaluated the suitability of our system for molecular diagnosis using pre- and postnatal clinical samples. In a blind study, each of the 264 sample karyotypes identified by array CGH analysis was consistent with that identified by traditional karyotype analysis – with one exception, case (47, XXX) – and we were able to identify origins, such as small supernumerary marker chromosomes, which cannot be determined by conventional cytogenetics. We also acquired very accurate, fast and reliable results using a diminutive amount of clinical samples. Taken together, the array CGH platform developed in this study is a rapid, powerful and sensitive technology for pre- and postnatal diagnosis using a very small amount of clinical sample. J. Choe, J.-K. Kang, C.-J. Bae and D.-S. Lee contributed equally to this work.