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Jin Y.-J.,Inha University | Lee J.-W.,Inha University | Park S.-W.,Inha University | Lee J.I.,Yonsei University | And 7 more authors.
World Journal of Gastroenterology | Year: 2013

AIM: To evaluate clinical outcomes of patients that underwent surgery, transarterial embolization (TAE), or supportive care for spontaneously ruptured hepatocellular carcinoma (HCC). METHODS: A consecutive 54 patients who diagnosed as spontaneously ruptured HCC at our institution between 2003 and 2012 were retrospectively enrolled. HCC was diagnosed based on the diagnostic guidelines issued by the 2005 American Association for the Study of Liver Diseases. HCC rupture was defined as disruption of the peritumoral liver capsule with enhanced fluid collection in the perihepatic area adjacent to the HCC by dynamic liver computed tomography, and when abdominal paracentesis showed an ascitic red blood cell count of > 50000 mm3/mL in bloody fluid. RESULTS: Of the 54 patients, 6 (11.1%) underwent surgery, 25 (46.3%) TAE, and 23 (42.6%) supportive care. The 2-, 4- and 6-mo cumulative survival rates at 2, 4 and 6 mo were significantly higher in the surgery (60%, 60% and 60%) or TAE (36%, 20% and 20%) groups than in the supportive care group (8.7%, 0% and 0%), respectively (each, P < 0.01), and tended to be higher in the surgical group than in the TAE group. Multivariate analysis showed that serum bilirubin (HR = 1.09, P < 0.01), creatinine (HR = 1.46, P = 0.04), and vasopressor requirement (HR = 2.37, P = 0.02) were significantly associated with post-treatment mortality, whereas surgery (HR = 0.41, P < 0.01), and TAE (HR = 0.13, P = 0.01) were inversely associated with posttreatment mortality. CONCLUSION: Post-treatment survival after surgery or TAE was found to be better than after supportive care, and surgery tended to provide better survival benefit than TAE. © 2013 Baishideng. All rights reserved. Source

Stirland D.L.,University of Utah | Nichols J.W.,University of Utah | Jarboe E.,University of Utah | Adelman M.,University of Utah | And 4 more authors.
Journal of Controlled Release | Year: 2015

This project uses an ex vivo human perfusion model for studying transport in benign, fibrous tumors. The uterine arteries were cannulated to perfuse the organ with a buffer solution containing blood vessel stain and methylene blue to analyze intratumoral transport. Gross examination revealed tissue expansion effects and a visual lack of methylene blue in the fibroids. Some fibroids exhibited regions with partial methylene blue penetration into the tumor environment. Histological analysis comparing representative sections of fibroids and normal myometrium showed a smaller number of vessels with decreased diameters within the fibroid. Imaging of fluorescently stained vessels exposed a stark contrast between fluorescence within the myometrium and relatively little within the fibroid tissues. Imaging at higher magnification revealed that fibroid blood vessels were indeed perfused and stained with the lipophilic membrane dye; however, the vessels were only the size of small capillaries and the blood vessel coverage was only 12% that of the normal myometrium. The majority of sampled fibroids had a strong negative correlation (Pearson's r = - 0.68 or beyond) between collagen and methylene blue staining. As methylene blue was able to passively diffuse into fibroid tissue, the true barrier to transport in these fibroids is likely high interstitial fluid pressure, correlating with high collagen content and solid stress observed in the fibroid tissue. Fibroids had an average elevated interstitial fluid pressure of 4 mm Hg compared to - 1 mm Hg in normal myometrium. Our findings signify relationships between drug distribution in fibroids and between vasculature characteristics, collagen levels, and interstitial fluid pressure. Understanding these barriers to transport can lead to developments in drug delivery for the treatment of uterine fibroids and tumors of similar composition. © 2015, Elsevier B.V. All rights reserved. Source

Nadithe V.,University of Utah | Bae Y.H.,University of Utah | Bae Y.H.,Utah Inha and Advanced Therapeutics Research Center
International Journal of Biological Macromolecules | Year: 2010

Hemoglobin (Hb) conjugated with the antioxidant enzymes (SOD and CAT), by employing dicarboxymethylated poly(ethylene glycol), was designed for protection of hemoglobin against free radicals. In this study, the conjugation process was confirmed by employing SDS-PAGE and SEC techniques. The average molecular weight of the conjugates was estimated to be around 1000. kDa. The enzymatic activities of the SOD and CAT in the conjugates (Hb-SOD-CAT) after conjugation were found to retain greater than 70% and 90% of the original bioactivity. Results show that antioxidant enzymes helped minimize methemoglobin (non-carrier of oxygen) formation during the conjugation process and also during storage at 4 °C over a period of 1 month. In summary, the optimized (1:10 Hb/PEG) crosslinked conjugates with antioxidant enzymes showed protective properties from severe free radical stresses when incubated with hydrogen peroxide (0.1 and 1. mM) and xanthine (1. mM)/xanthine oxidase (10 and 20. mU/ml) system © 2010 Elsevier B.V. Source

Ahn S.,Korea Advanced Institute of Science and Technology | Lee I.-H.,Korea Advanced Institute of Science and Technology | Lee E.,Utah Inha and Advanced Therapeutics Research Center | Kim H.,Gwangju Institute of Science and Technology | And 2 more authors.
Journal of Controlled Release | Year: 2013

Despite the therapeutic potential of exendin-4 asa glucagon-like peptide-1 (GLP-1) mimetic for the treatment of type 2 diabetes, its utility has so far been limited because of the low level of patient compliance due to the requirement for frequent injections. In this study, an orally available exendin-4 was produced by conjugating it to low molecular weight chitosan (LMWC). Conjugation between the LMWC and cysteinylated exendin-4 was carried out using a cleavable linker system in order to maximize the availability of the active peptide. The LMWC-exendin-4 conjugate formed a nanoparticle structure with a mean particle size of 101 ± 41 nm through complexation between the positively charged LMWC backbone and the negatively charged exendin-4 of individual conjugate molecules. The biological activity of the LMWC-exendin-4 conjugate was evaluated inanINS-1 cell line. The LMWC-exendin-4 conjugate stimulated insulin secretion in a dose dependent manneras similar as that of native exendin-4. From the pharmacokinetic study after oral administration of the conjugate, a Cmax value of 344 pg/mL and a Tmax of 6 h were observed, and the bioavailability, relative to the subcutaneous counterpart, was found to be 6.4%. Furthermore, the absorbed exendin-4 demonstrated a significantly enhanced hypoglyce-mic effect. These results suggest that the LMWC-exendin-4 conjugate could be used as a potential oral anti-diabetic agent for the treatment of type 2 diabetes. © 2013 Elsevier B.V. All rights reserved. Source

Ramasamy T.,Utah Inha and Advanced Therapeutics Research Center | Ramasamy T.,Vels University | Ramasamy T.,P.A. College | Khandasami U.S.,P.A. College | And 3 more authors.
Macromolecular Research | Year: 2012

The aim of this study was to formulate and evaluate Ketoconazole-loaded solid lipid nanoparticles (KSLN) for topical application. The purpose of this study was to improve the therapeutic activity of Ketoconazole. KSLN was prepared by a hot homogenization method and characterized for shape, surface morphology, particle size, drug entrapment, cytotoxicity, and rheological analysis. The optimized formulation of solid lipid nanoparticles (SLN) was spherical in shape with a smooth surface and possessed an average size of 172.2±0.75 nm with zeta potential of -44.12±0.76 mV. To guarantee the stability of the desired SLN, they were lyophilized using cryo-protectants. The particle size of the SLN significantly enlarged for formulations which were lyophilized without the cryo-protectants. Cell viability assay performed on National Institute of Health-3-day transfer, inoculum 3×105 cells (NIH-3T3) fibroblast cells showed that properties of the SLN remain unchanged during the process of freeze-drying and were not cytotoxic. An in vitro drug release study showed that KSLN-incorporated hydrogel exhibited a sustained drug release comparing to KSLN dispersion and Ketoconazole loaded hydrogel over a 24 h period. The in vivo studies suggested that the KSLN-incorporated hydrogel was more efficient in the treatment of candidiasis. It may therefore be interpreted that the KSLN-incorporated hydrogel provides a sustained release of Ketoconazole for topical fungal infections and might be a promising delivery system to enhance the therapeutic activity of Ketoconazole. Source

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