An Open-labeled Clinical Study to Evaluate the Safety and Efficacy of “Anuloma DS” in Improving Constipation

Background: Constipation is a common gastrointestinal problem in the general population. Despite a plethora of well-established and safe treatment options, the improvement is not satisfactory for many patients. This has prompted interest in alternative therapeutic strategies for constipation. Methods: This open-label, non-comparative single-arm clinical study evaluated the efficacy and safety of the polyherbal formulation “Anuloma DS”, 1 tablet daily at bedtime, in improving bowel movements in 30 adult patients with functional constipation. Patients were evaluated at baseline (Visit 1, Day 0) and follow-ups during Visit 2 (Day 7 ± 2), Visit 3 (Day 14 ± 2) and Visit 4 (End of the Study) at Day 30 ± 2. Results: There was a significant increase in the mean of spontaneous bowel movement every week from day 7 to days 14 and 30. All constipation symptoms such as abdominal bloating (aadmana), abdominal pain/discomfort (aanaha), feeling of incomplete evacuation and straining during passing stool improved significantly as did the SGA and the PGA scores. Conclusion: Anuloma DS is highly effective for the treatment of chronic functional constipation. No treatment-related side effects were reported by the study participants.

An Open-label Prospective Noncomparative Clinical Study to Evaluate the Efficacy and Safety of Beliv: An Ayurvedic Medicine in Improving Liver Function

An open-label prospective noncomparative study was conducted to examine the efficacy and safety of Beliv tablet, a polyherbal Ayurvedic medicine, in 30 adult patients suffering from liver disorders. Two tablets were administered daily for 56 days. Patients were evaluated at Day 0, Day 21, Day 42 and at Day 56. The primary end point of the study was a change in liver function test parameters measured by the levels of serum glutamic-oxaloacetic transaminase (SGOT), serum glutamic-pyruvic transaminase (SGPT) and total bilirubin at all assessment points. Results showed a significant reduction in the serum levels of SGOT, SGPT and total bilirubin from baseline to 21 days, 42 days and 56 days. The total icterus symptom score was also significantly reduced from 5.17 ± 2.26 (baseline) to 2.6 ± 1.48, 1.37 ± 1.13 and 0.77 ± 0.73 at Days 21, 42 and 56, respectively. The Subjective Global Assessment (SGA) decreased significantly from 3.33 ± 1.16 (Day 21) to 2.33 ± 1.16 and 1.80 ± 0.76 at Days 42 and 56, respectively. The Physician Global Assessment (PGA) score was also significantly reduced from 3.0 ± 1.02 (Day 21) to 2.07 ± 0.83 and 1.70 ± 0.79 at Days 42 and 56, respectively. A significant reduction in serum creatinine level was observed at Day 56. No adverse effects or serious adverse effects were observed during the study period. The study concluded that Beliv tablet was highly effective for the treatment of liver disorders, as evidenced by the reduction in serum levels of SGOT, SGPT, total bilirubin, icterus symptoms and PGA and SGA scores. No treatment-related side effects were reported by any of the study participants suggesting that it was safe for clinical use in humans for the treatment of liver disorders.

PLA/PGA and its co-Polymers in Alveolar Bone Regeneration. A Systematic Review / PLA/PGA y sus Copolímeros en Regeneración Ósea Alveolar. Una Revisión Sistemática

ABSTRACT: The aim of this research was to perform a systematic review to identify the most frequent uses of PLA/ PGA in alveolar bone regeneration and their results. A study was designed to answer the question: What are the most frequent uses of PLA/PLGA and their copolymers in alveolar bone regeneration?. A systematic search was done on MEDLINE, EMBASE and LILACS from April 1993 to December 2017. The search string used on MEDLINE was: (((polylactic acid) OR PLA) OR PLA-based copolymers) OR PLA blends) OR PLA scaffolds)) AND ((("Bone Regeneration"[Mesh]) OR bone regeneration) OR guided bone regeneration). The search was complemented by a manual review of the references from the articles included. Most of the studies selected were weak and, regarding the most frequent uses of PLA/PGA, 13 studies used it as a resorbable membrane, two as an absorbable mesh, one as an absorbable screw and three as filling material. Based on our results, the authors consider that PLA/PGA requires a delicate relation between the mechanical resistance and the degradation process. PLA/PGA does not interrupt bone regeneration; however, the influence in cellular events related to bone regeneration and later osseointegration have not been identified.

RESUMEN: El objetivo de esta revisión fue realizar una revisión sistemática de la literatura para identificar los usos más frecuentes de PLA/PGA en regeneración ósea en área maxilofacial y sus resultados. Se diseñó un estudio para responder a la pregunta: ¿Cuáles son los usos más frecuentes de PLA/PLGA y sus copolímeros en regeneración ósea en el sector maxilofacial?. Los estudios seleccionados fueron en su mayoría débiles y sobre los usos más frecuentes de PLA/PGA, 13 estudios lo utilizaron como membrana reabsorbible, 2 estudios como malla absorbible, un estudio como tornillo absorbible y 3 estudios como material de relleno. En base a nuestros resultados, los autores estiman que PLA/PGA requiere una delicada relación entre la resistencia mecánica que ofrece y la degradación que se produce; PLA/ PGA no interrumpe la regeneración ósea, sin embargo, no se ha identificado la potencialidad o influencia que presenta en los eventos celulares de la regeneración y posterior oseointegración.

Incidence of infections associated with use of bioabsorbable implants in orthopedic surgeries

Background: The incidence of placement of osteosynthetic materials has grown worldwide. Bioabsorbable materials are more commonly used now days in Orthopedic surgeries. Implants modify the risk of infection by bacterial adhesion, tissue integration, and immunomodulation. Bacterial adhesion to implant leads to interaction between bacteria and implant. Aim: To evaluate the incidence of infections associated with use of bioabsorbable implants in Orthopedic surgeries. Materials and methods: The infection rates among 1057 patients were treated with bioabsorbable osteosynthesis devices was investigated. The implant material used was PGA in approximately three fourths of the patients. Results: Depending on the bioabsorbable material used, the infection rates varied from 0.7% (SRPLLA) to 6.5% (SR-PGA and SR-PLLA together). In a comparison with metallic osteosynthesis devices, a total 522 ankle fracture patients were studied. There was no significant difference between the infection rates of the bioabsorbable fixation group (3.2%) and metallic fixation group (4.1%). The effect of bioabsorbable implants volume on wound infections showing a significant positive correlation between the incidence of infection and the implant volume when non-stained SR-PGA or SR-PLLA implants were used. In fracture patients the raising of the implant-bone volume ratio correlated with the rising incidence of infection. Conclusion: Increasing the implant volume causes a higher incidence of wound infection when modern, non-stained implants are used. The increase in the incidence of infection is most prominent when SR-PLLA implants are used. Increasing the implant-bone volume ratio causes a higher incidence of wound infection on the tibial side.

Cadaveric Study of Varoations in Branching Pattern of Splenic Artery.

Introduction: Splenic artery was previously called as Lineal artery. Splenic artery is the largest branch of the celiac trunk and is the most tortuous artery in the body. Splenic artery mainly supplies spleen and gives off branches to the stomach and the pancreas. Splenic artery divides into terminal branches before entering into the hilum of the spleen which may be Magistral or Distributed type. Sometimes it may pass through the hilum without dividing and supplies the spleen. Materials and methods: The study was done on 50 embalmed cadavers during routine dissection practices for undergraduates in the dissection hall of Gandhi Medical College, Secunderabad, and from the Department of Anatomy Osmania medical college, Hyderabad, during the period of 3years.The variations in the branching pattern of the splenic artery was observed and photographed. The prime objective of the study is to compare the prevalence of variations in the branching pattern of splenic artery. Results and conclusion: The variations in the present study were almost correlated with the available literature. In some instances the left gastro epiploic artery, the posterior gastric artery and the accessory left gastric artery took origin from the interior of spleen. so care should be taken during splenectomy. Hence, the arterial blood supply of spleen is so varied that no two vascular patterns are ever the same.

Human platelet releasates combined with polyglycolic acid scaffold promote chondrocyte differentiation and phenotypic maintenance.

In the present study, we aimed to demonstrate the differentiating properties of platelet-rich plasma releasates (PRPr) on human chondrocytes seeded on a polygtlycolic acid (PGA) 3D scaffold. Gene expression and biochemical analysis were carried out to assess the improved quality of our PGA-based cartilage constructs supplemented with PRPr. We observed that the use of PRPr as cell cultures supplementation to PGA-chondrocyte constructs may promote chondrocyte differentiation, and thus may contribute to maintaining the chondrogenic phenotype longer than conventional supplementation by increasing high levels of important chondrogenic markers (e.g. sox9, aggrecan and type II collagen), without induction of type I collagen. Moreover, our constructs were analysed for the secretion and deposition of important ECM molecules (sGAG, type II collagen, etc.). Our results indicate that PRPr supplementation may synergize with PGA-based scaffolds to stimulate human articular chondrocyte differentiation, maturation and phenotypic maintenance.

Effects of poly-gamma-glutamic acid on serum and brain concentrations of glutamate and GABA in diet-induced obese rats

Poly-gamma-glutamic acid (gamma-PGA) is a mucilaginous and biodegradable compound produced by Bacillus subtilis from fermented soybeans, and is found in the traditional Korean soy product, cheongkukjang. This study was carried out to evaluate the effects of gamma-PGA from a food source on the concentration of the neurotransmitter GABA and its metabolic precursor glutamate in diet-induced obese rats. Eight-week old male Sprague-Dawley rats (n=60) were used. The rats were divided into two groups and obesity was induced by providing either a 10% control fat or 45% high fat diet for 5 weeks. The rats were then blocked into 6 groups and supplemented with a 0.1% gamma-PGA diet for 4 weeks. After sacrifice, brain and serum GABA and glutamate concentrations were analyzed by high performance liquid chromatography with fluorometric detection. The rats fed the high fat diet had significantly increased body weights. gamma-PGA supplementation significantly increased serum concentrations of glutamate and GABA in the control fat diet groups while this effect was not found in the high fat groups. In the brain, glutamate concentrations were significantly higher in the gamma-PGA supplemented groups both in rats fed the normal and high fat diets than in the no gamma-PGA controls. GABA concentrations showed the same tendency. The results indicated that gamma-PGA intake increased GABA concentrations in the serum and brain. However, the effects were not shown in obese rats.

Isolation and Identification of BLN-2 Producing Poly-?-Glutamic Acid and Studies on Its Solid-state Fermentation / 微生物学通报

A poly-?-glutamic acid producing strain--BLN-2, was isolated from the soybean products. According to the biochemical characteristics and 16S rRNA, the strain was identified as Bacillus subtilis. Using soybeans as culture, the solid-state fermentation conditions of BLN-2 have been studied. The results showed that the optimal carbon and nitrogen sources of BLN-2 were glucose, fructose, NaNO3 and KNO3, respectively. The orthrogonal experiments showed, when the final concentration of the fructose which was added to the soybean culture was 0.5%, the glucose, NaNO3 and KNO3 final concentraion were 2.0%, the production of ?-PGA was the highest--89.05 g/kg. It is 48.42% higher than other comparable soybean medium under the same conditions.

Studies on HepG2 Growth Under Simulated Microgravity:to Establish a Method for Three-dimensional Cultivation In vitro as an Research Model / 生物化学与生物物理进展

Human hepatocarcinoma cells, HepG2 were cultured onto biodegradable polyglycolic acid (PGA) polymer scaffolds, which were cultured in a rotating cell culture system (RCCS) to form a three-dimensional (3D) multicellular culture in vitro. The RCCS can simulate microgravity effects with low shear stress and well exchanging for gas. Then the growth characteristics and some mechanism of the cells in RCCS were detected by scanning electron microscopy (SEM), transmission electron microscopy (TEM), RT-PCR and flow cytometry (FCM). The results indicate that the cells grew well with polyhedron morphology and lots of microvilli, mitochondria and tight junctions in this system, which means that this system is useful for cells to form 3D structure to mimic cell status in vivo. The expression of some cell adhesion molecules (CAMs) were changed markedly, which are closely associated with cancer invasion and metastasis. The characters of increased expression of integrin ?1(CD29), CD44, intercellular adhesion molecule-1(CD54) and depressed expression of E-cadherin presumably show that the HepG2 cells cultured in RCCS could recur some characters of primary liver cancer in vivo, the capacity of invasion and metastasis. It is necessary for acquiring perfect and external results to select an appropriate research model for studying in vitro. This 3D culture in vitro under simulated microgravity can provide a useful and reasonable model for oncology, anticancer drugs research and other research.

Peripheral nerve regeneration using polyglycolic acid conduit and brain-derived neurotrophic factor gene transfected Schwann cells in rat sciatic nerve

PURPOSE: The essential triad for nerve regeneration is nerve conduit, supporting cell and neurotrophic factor. In order to improve the peripheral nerve regeneration, we used polyglycolic acid(PGA) tube and brain-derived neurotrophic factor(BDNF) gene transfected Schwann cells in sciatic nerve defects of SD rat. MATERIALS AND METHODS: Nerve conduits were made with PGA sheet and outer surface was coated with poly(lactic-co-glycolic acid) for mechanical strength and control the resorption rate. The diameter of conduit was 1.8mm and the length was 17mm. Schwann cells were harvested from dorsal root ganglion(DRG) of SD rat aged 1 day. Schwann cells were cultured on the PGA sheet to test the biocompatibility adhesion of Schwann cell. Human BDNF gene was obtained from cDNA library and amplified using PCR. BDNF gene was inserted into E1 deleted region of adenovirus shuttle vector, pAACCMVpARS. BDNF-adenovirus was multiplied in 293 cells and purified. The BDNF-Adenovirus was then infected to the cultured Schwann cells. Left sciatic nerve of SD rat (250g weighing) was exposed and 14mm defects were made. After bridging the defect with PGA conduit, culture medium(MEM), Schwann cells or BDNFAdenovirus infected Schwann cells were injected into the lumen of conduit, respectively. 12 weeks after operation, gait analysis for sciatic function index, electrophysiology and histomorphometry was performed. RESULTS: Cultured Schwann cells were well adhered to PGA sheet. Sciatic index of BDNF transfected group was -53.66+/-13.43 which was the best among three groups. The threshold of compound action potential was between 800 to 1000microA in experimental groups which is about 10 times higher than normal sciatic nerve. Conduction velocity and peak voltage of action potential of BDNF group was the highest among experimental groups. The myelin thickness and axonal density of BDNF group was significantly greater than the other groups. CONCLUSION: BDNF gene transfected Schwann cells could regenerate the sciatic nerve gap(14mm) of rat successfully.

Experimental study on regeneration of articular cartilage defects in rabbits with bone marrow stromal cells / 中华创伤骨科杂志

Objective To observe whether the full-thickness defects of articular cartilage at the knee joint of rabbits could be repaired by implantation of polyglycolic-acid(PGA) composites adhered with bone marrow stromal cells (BMSCs). Methods Culture-expanded rabbits’BMSCs were seeded onto porous PGA scaffolds. After a 72-hour co-culturing, the cell-adhered PGA was implanted into the articular cartilage defect at the intercondylar fossa of the femur. The rabbits were sacrificed 12 weeks later after the operation and the specimens were examined histologically for morphologic features, and stained immunohistochemically for type Ⅱcollagen. Results The specimens harvested from BMSCs-PGA composite demonstrated a hyaline cartilage formation. No obvious progressive degeneration sign was found in the newly formed tissue. The control groups showed no hyaline-like cartilage formation. Conclusion PGA composites adhered with in vitro culture-expanded autologous BMSCs can facilitate formation of hyaline-like cartilage in rabbits.

The Correlation of Child-Pugh Score, PGA Index and MELD Score in the Patient with Liver Cirrhosis and Hepatocellular Carcinoma According to the Cause of Alcohol and Hepatitis B Virus / 대한간학회지

BACKGROUND/AIMS: To determine the treatment modalities and the prognosis of a patient with liver cirrhosis, quantitative estimation of liver function is important. We assessed the Child-Pugh score (CPS), the common method as a severity index for the cirrhosis, the Promthombin, gamma GT, and Apolipoprotein A1 (PGA) index and model for end-stage liver disease (MELD) score. The purpose of this study was to evaluate the correlation between these indices in the patients with cirrhosis only and hepatocellular carcinoma (PHC), according to underlying causes (HBV and alcohol). METHODS: We reviewed medical records of 339 cirrhotic patients with/without hepatocellular carcinoma and divided patient groups by disease and underlying cause: cirrhosis caused by alcohol; LC-Al, cirrhosis caused by HBV; LC-B, hepatocellular carcinoma with cirrhosis caused by alcohol; HCC-Al, hepatocellular carcinoma with cirrhosis caused by HBV; HCC-B. We assessed the CPS, PGA index and MELD score and calculated the correlation coefficient between these scores. RESULTS: Among the total of 339 patients, 201 patients were diagnosed on the liver cirrhosis only, and 138 patients on the hepatocellular carcinoma with cirrhosis. In each groups, mean score values were not significantly different in CPS, PGA index and MELD score. The correlation of CPS, PGA index and MELD score in all groups, except for the correlation of PGA index and MELD score in HCC-Al group, was significantly positive (p<0.05). Compared to correlation coefficients between three indices, the patients with cirrhosis only had higher tendencies than the patients with hepatocellular carcinoma. The patients by HBV had higher tendencies than by alcohol. CONCLUSIONS: The correlations between CPS, PGA index and MELD score showed significantly positive correlations in the patients with liver cirrhosis only and hepatocellular carcinoma with cirrhosis (except in HCC-Al group). The patients with cirrhosis only had higher correlation coefficients than the patients with PHC and the patients by HBV had higher than by alcohol.

The effects of polylactic/polyglycolic copolymer (PLA/PGA) membrane on the healing of 1-wall intrabony defects in beagle dogs / 대한치주과학회지

The goal of periodontal treatment is regeneration of the periodontium. Bone graft and absorbable PLA/PGA membrane have been used for this purpose. In this study, 4x4mm 1-wall intrabony defects were surgically created bilaterally in the mandible of five male beagles. The control group went through a conventional flap operation, while the experimental group I was treated with absorbable PLA/PGA membranes only, group II was treated with absorbable membrane and calcium phosphate. The results are the following : 1. The defect height was 4.82+/-0.45mm in the control group, 4.93+/-0.79mm in the experimental I group, and 4.92+/-0.62mm in the experimental II group. There was no statistically significant difference among 3 groups(P<0.05). 2. The amount of junctional epithelium migration was 30.90+/-9.92% of the defect height in the control group, 39.16+/-7.51% in the experimental I group, and 38.68+/-12.22% in the experimental II group. There was no statistically significant difference among 3 groups(P<0.05). 3. The amount of connective tissue adhesion was 36.38+/-9.03% in the control group, 14.73+/-3.93% in experimental I group, and 27.87+/-9.70% experimental II group. Experimental group I was a statistically significantly different from control group(P<0.05). 4. The amount of new cementum regeneration was 32.92+/-10.51%, 50.04+/-7.61%, and 39.62+/-12.14% for the control, experimental I, and experimental II group respectively. Experimental group I was a statistically significantly different from control group(P<0.05). 5. The amount of new alveolar bone regeneration was 27.24+/-7.49%, 40.75+/-8.03%, and 36.47+/-15.11% for the control, experimental I, and experimental II group respectively. Experimental group I was a statistically significantly different from control group(P<0.05). The results suggest that the use of PLA/PGA membrane in 1-wall intrabony defect of beagle dogs may promote periodontal regeneration. Further studies are required to determine their regeneration effects.

Tissue Engineered Neocartilage using Polyglycolic Acid(PGA) and Chondrocyte

Neomorphogenesis using tissue engineering technique by cell transplantation with biodegradable polymer has been introduced as a new method to achieve organ replacement or to create new tissues. Using this tissue engineering technique, neocartilage formation can be possible when isolated chondrocyte is combined with biocompatible and biodegradable polymer scaffolds. The purposes of this study are to investigate whether chondrocyte-polyglycolic acid(PGA) polymer can be designed to induce cartilage formation in a predetermined shape, to analyze the properties of neocartilage by histologic and immunohistochemical study. Chondrocytes were isolated from the articular cartilage of swine shoulder joint and seeded onto four PGA polymers(disc shape, diameter;1cm, thickness; 0.3 cm) at a concentration of 5 x 107 chondrocytes per cm3. Chondrocyte-PGA polymers were implanted into left side of subcutaneous pockets on the dorsa of 4 athymic mice. PGA polymers without chondrocyte were implanted into the right side of subcutaneous pockets of the same animals as a control study. The chondrocyte-PGA polymers were harvested 2, 4, 6 and 8 weeks after implantation and investigated grossly, histologically and immunohistochemically. Chondrocytes were also cultured in Ham's F-12 medium under 5% CO2 incubator at 37degrees C and analyzed by histologic and immunohistologic study. The analysis confirmed the following results: 1. In vitro study, it was confirmed by Hematoxylin-Eosin (H-E) stain and toluidine blue stain that histologic findings of cultured chondrocyte corresponded to normal chondrocyte. 2. After 4 weeks of implantation of chondrocyte-PGA polymer, specimens changed in gross finding to pearly white opalescence and firm on palpation and this findings were accentuated progressively. But PGA polymers without chondrocyte could not maintain its shape and were resolved gradually. 3. The appearance of normal immature cartilage was detected at 2 weeks of implantation of chondrocyte-PGA polymer in H-E stain and toluidine blue stain. Maturation process of cultured chondrocyte was observed by steps in the 4th, 6th and 8th week. 4. Using the immunohistochemistric study, the presences of Type II collagen and CD44 were confirmed in cultured chondrocytes. This finding meant that neocartilage could inherit the original properties of chondrocyte. 5. Nipple-shaped cartilage discs which could assure the mechanical and histologic properties of normal cartilage were successfully created. It seems to be possible to apply this method to other kinds of manufacture with various shaped-PGA polymer. This study showed not only new cartilage formation could be possible using chondrocyte and PGA polymer but also engineered tissue could be one of the modalities to treat the patients suffering from the shortage of tissue in the future. With further prudent researches, tissue engineering technique can be a distinguished armament in reconstruction of human body including cartilage.

Sox-4 is a positive regulator of Hep3B and HepG2 cells' apoptosis induced by prostaglandin (PG)A2 and 12-PGJ2

We reported earlier that expression of Sox-4 was found to be elevated during prostaglandin (PG) A2 and delta(12)-PGJ(12) induced apoptosis in human hepatocarcinoma Hep3B cells. In this study, the role of Sox-4 was examined using human Hep3B and HepG2 cell lines. Sox-4 induction by several apoptotic inducer such as A23187 (Ca(2+) ionophore) and etoposide (topoisomerase II inhibitor) and Sox-4 transfection into the cells were able to induce apoptosis as observed by the cellular DNA fragmentation. Antisense oligonucleotide of Sox-4 inhibited the induction of Sox-4 expression and blocked the formation of DNA fragmentation by PGA(2) and delta(12)-PGJ(12) in Hep3B and HepG2 cells. Sox-4-induced apoptosis was accompanied with caspase-1 activation indicating that caspase cascade was involved in this apoptotic pathway. These results indicate that Sox-4 is involved in Hep3B and HepG2 cells apoptosis as an important apoptotic mediator.

The Histopathologic Findings after Insertion of Biodegradible Polymer Sheet Made of PGA and PLGA/5-FU with Filtering Surgery in the Rabbit

PURPOSE: To evaluate the histopathologic changes after insertion of polymer made of poly- glycolic acid(PGA) and poly(lactic acid-co-glycolic acid)(PLGA)/5-FU following filtering surgery in the rabbit. METHOD: A polymer with 0.3 mm thickness made of PGA and PLGA/5-Fluorouracil(5-FU, 10% by weight) composite were made in a size of 3 x 7 mm. After full-thickness filtration surgery performed, PGA was inserted under the conjunctiva in group I, PLGA/5-FU was inserted in group II and none in control group. Twelve rabbit eyes were enrolled in each group. RESULT: Postoperatively, no serious complication was found in anterior segment. In the control eyes inflammatory cell reaction was minimal at 2 weeks after surgery and decreased thereafter. While severe fibrovascular tissue reaction with loss of conjunctival filtration space was noted at 2 and 4 weeks after surgery in group I, the filtration space was well maintained without fibrovascular tissue reaction until 4 weeks after surgery in group II. At 8 weeks after surgery, fibrous tissue reaction was observed in group I, but not in group II and contol. The polymer was not found and the filtration space was obliterated at 8 weeks after surgery in group I and II. CONCLUSION: PLGA/5-FU may be used as an effective adjunct to improve the success rate of the filtration surgery, without inducing serious fibrous tissue reaction. PGA was not suitable.

Effects of TGF- beta 3 pretreatment in vitro on the differentiation of rabbit mesenchymal stem cell in vivo / 대한정형외과연구학회지

PURPOSE: Bone and cartilage were manufactured by using tissue engineering of mesenchymal stem cell (MSC) which can differentiate into variety of cell types. MATERIAL AND METHOD: MSC was isolated and cultured from the rabbit weighing 500g, and it was seeded into PGA mesh and pre-cultured for 1 week with different TGF- beta 3 treated conditions. It was implanted into nude mice and tissues generated were recovered from 1, 2, 3, 4, 8 ,and 12 weeks respectively. Degree of bone and cartilage formation was analyzed with histology and immunohistochemistry assay. RESULT: Pre-culture condition with TGF- beta 3 treatment showed early start of chondrogenic differentiation, and degree of bone and cartilage formation was promoted as time passed. But both of the cases differentiated into complete bone after 12 weeks. CONCLUSION: The results show that pretreatment of TGF- beta 3 promotes the differentiation process in vivo condition under the in vivo system where MSC differentiate into bone via cartilage formation.

HEMI-MANDIBULAR RECONSTRUCTION USING RIB AND PMCB WITH BIOABSORBABLE POLY(PLLA-PGA) MESH TRAY

Loss of mandibular continuity can occur secondary to trauma, infection, or tumor resection. The basic goal of mandibular reconstruction is to restore bony continuity, arch form, osseous bulk, acceptable facial form. During the mandibular reconstruction is considered, surgical choices of using autogenous bone are divided into non-vascularized cortico-cancellous bone block graft, vascularized transfer of a cortico-cancellous bone block, and particulate marrow and cancellous bone(PMCB) graft. The PMCB has been successfully used for the reconstruction of mandibular osseous defect since introduced by Boyne, et al. This graft transplants a great density of osteocompetent cells, and promotes an early revascularization with vascular ingrowth with their particulate nature. However, because of their particulate nature, require tray or crib for containing PMCB. The Titanium mesh and Dacron-urethane trays have been used widely for this purpose, and allogenic mandible or rib, ilium have been also used. Recently, bioabsorbable polymer material is used to surgeon for treatment of craniofacial fracture and congenital anomaly of craniofacial skeleton in the form of plate, mesh and screw. In different natures to metal material, secondary operation is unnecessary due to biological degradation and resorption in the body with timing, and it can give adequate strength during the bone healing period. and it can be contoured easily during the operation. Especially, in pediatric applications, it can diminish the possibility of growth disturbance and back-scattering effects diminished when radiation therapy applied. Recently, the literature was reported for jaw reconstruction with PMCB and bioabsorbable polymer tray with animal study. In this case, 18-years old woman, who was diagnosed as ameloblastoma, was shown hemimandibular osseous defects. We performed secondary reconstruction using PMCB from posterior ilium, and rib bone with bioabsorbable poly(PLLA-PGA) mesh as a tray, and some favorable results were obtained and we report it preliminarily, with literature reviews.

Fluorouracil-Polyglycolic Acid Composite as an Intraperitoneal Chemotherapeutic Agent

BACKGROUND: There is a great need for a new drug delivery system that provides higher sustained exposure of the anticancer drug to the peritoneal surface or lymphatics with a lower systemic toxicity. Intraperitoneal chemotherapy will be an effective therapeutic strategy for disseminated microscopic disease and small miliary nodules remaining on the peritoneal surface after surgery. The auther has made a fluorouracil-polyglycolic acid composite disk (Fu-PGA disk) for a more effective intraperitoneal chemotherapeutic agent. METHODS: The Fu-PGA disk(s) was (were) inserted in the peritoneal cavity of a rat, and a pharmacokinetic study was performed to measure fluorouracil concentration in the peritoneal fluid, plasma, liver, kidney and heart tissue at day 1, day 3, day 7, and day 14 after administration of the agent. The myelosuppressive action of this composite was also determined following its administration. RESULTS: After administration of the Fu-PGA disks, the 5-Fu concentration of the peritoneal fluid of the rat was much higher than that of the plasma. Also, the 5-Fu concentrations of the liver, kidney and heart tissue were very low. The numbers of white cells and platelets decreased after administration of the Fu-PGA disks, but they were almost recovered to normal range at day 14th. Only focal necrosis around the central veins of the liver and minimal vacuolar degeneration in the proximal tubules of the kidney were observed microscopically. CONCLUSION: This animal study suggests that the Fu-PGA composite can be used as a new biodegradable drug delivery system for releasing the drug in a controlled manner with the peritoneum as its target. This Fu-PGA device may overcome some of the disadvantages of conventional anticancer chemotherapy and improve the efficacy of intraperitoneal chemotherapy.

A Case of Polyglandular Autoimmune Syndrome

When dysfunction of two or more endocrine glands occurs in association with circulating organ specific antibodies directed against the involved glands, the term polyglandular autoimmune (PGA) syndrome is applied. This syndrome is usually classified into three groups. The autoimmune nature of this disease has been based on the presence of lymphocytic infiltration of the affected glands, organ specific autoantibody in serum, cellular immune defects and association with HLA DR/DQ genes. A 12-year-old girl developed PGA syndrome, type III manifesting Grave's disease and insulin-dependent diabetes mellitus. The thyroid microsomal Ab, TSH receptor Ab and pancreatic islet cell Ab were positive. She should be observed for the possible development of adrenal insufficiency and/or other autoimmune disease.