Fabrication of a silver particle-integrated silicone polymer-covered metal stent against sludge and biofilm formation and stent-induced tissue inflammation.

To reduce tissue or tumor ingrowth, covered self-expandable metal stents (SEMSs) have been developed. The effectiveness of covered SEMSs may be attenuated by sludge or stone formation or by stent clogging due to the formation of biofilm on the covering membrane. In this study, we tested the hypothesis that a silicone membrane containing silver particles (Ag-P) would prevent sludge and biofilm formation on the covered SEMS. In vitro, the Ag-P-integrated silicone polymer-covered membrane exhibited sustained antibacterial activity, and there was no definite release of silver ions from the Ag-P-integrated silicone polymer membrane at any time point. Using a porcine stent model, in vivo analysis demonstrated that the Ag-P-integrated silicone polymer-covered SEMS reduced the thickness of the biofilm and the quantity of sludge formed, compared with a conventional silicone-covered SEMS. In vivo, the release of silver ions from an Ag-P-integrated silicone polymer-covered SEMS was not detected in porcine serum. The Ag-P-integrated silicone polymer-covered SEMS also resulted in significantly less stent-related bile duct and subepithelium tissue inflammation than a conventional silicone polymer-covered SEMS. Therefore, the Ag-P-integrated silicone polymer-covered SEMS reduced sludge and biofilm formation and stent-induced pathological changes in tissue. This novel SEMS may prolong the stent patency in clinical application.

Generalized pustular psoriasis and hepatic dysfunction associated with oral terbinafine therapy.

We report a case of 61-yr-old man with stable psoriasis who progressively developed generalized pustular eruption, erythroderma, fever, and hepatic dysfunction following oral terbinafine. Skin biopsy was compatible with pustular psoriasis. After discontinuation of terbinafine and initiating topical corticosteroid and calcipotriol combination with narrow band ultraviolet B therapy, patient's condition slowly improved until complete remission was reached 2 weeks later. The diagnosis of generalized pustular psoriasis (GPP) induced by oral terbinafine was made. To our knowledge, this is the first report of GPP accompanied by hepatic dysfunction associated with oral terbinafine therapy.

Treatment of atrophies secondary to trilinear scleroderma en coup de sabre by autologous tissue cocktail injection.

BACKGROUND: The atrophies are left after regression of linear scleroderma "en coup de sabre." They are often irreversible and disfiguring. Several surgical techniques have been attempted to correct atrophies secondary to linear scleroderma en coup de sabre. However, the result often has proved unsatisfactory. METHODS: A patient with atrophies secondary to trilinear scleroderma en coup de sabre was treated with autologous tissue cocktail injection. RESULTS: Autologous tissue cocktail injection provided excellent cosmetic results for the treatment of atrophies secondary to trilinear scleroderma en coup de sabre. There were no complications at the donor and recipient site in the postoperative period. CONCLUSION: Autologous tissue cocktail injection appears to be a useful method for the correction of depressed atrophy of linear scleroderma en coup de sabre.

A case of porocarcinoma from pre-existing hidroacanthoma simplex: need of early excision for hidroacanthoma simplex?

BACKGROUND: Hidroacanthoma simplex (HAS) is an uncommon eccrine neoplasm of the skin. It is a benign neoplasm, but some cases of malignant change were reported in the literature. OBJECTIVE: To describe a rare case of porocarcinoma in a relatively short period from pre-existing HAS on the abdomen. METHODS: Wide local excision was performed on this neoplasm. RESULTS: There was no recurrence for 72 months after wide excision. CONCLUSION. : We recommend an early excision and careful attention in the case of HAS because of its potential malignant change.