Histomorphometry evaluation of bone anabolism promoted by prostaglandin E1 and its relation to hypercalcemia / Evaluación histomorfométrica del anabolismo óseo en la reparación promovida por la prostaglandina E1 y su relación con la hipercalcemia

Abstract Background: At present, parathyroid hormone is the only existing anabolic bone therapy but produces hypercalcemia. Prostaglandin E1 (PGE1) has been suggested as a bone anabolic agent that allows bone modeling formation without producing hypercalcemia. This study aimed to corroborate these PGE1 properties. Methods: For 22 days, rabbits (n = 30) were divided into three groups (n = 10 each group) and received intravenous solutions: vehicle (control group), palate disjunction + vehicle (sham group), and palate disjunction + 50 mg of PGE1 (PGE1 group). On days 1, 3, and 22, palatine suture X-rays were taken. On day 22, bone formation markers were analyzed, and the rabbits were sacrificed. Bone palate undecalcified samples were processed. Histomorphometry software was used to analyze bone parameters, and the mineralization front was stained with toluidine blue. Scalloped lines reflect remodeling-based bone formation (RBF), and smooth lines reflect modeling-based formation (MBF). Results: X-rays showed more significant palatal disjunction in the PGE1 group; this group exhibited significant calcitriol serum increments. Hypercalciuria was observed in the PGE1 group, and resorption markers (N-telopeptides) remained stable. Sutural bones in the PGE1 group exhibited significant anabolism in structural parameters. RBF was 20%, and MBF was 6% in the sham group; in the PGE1 group, RBF was 8.6%, and MBF was 17%. In the PGE1 group, mineralization was significantly accelerated, but resorption remained stable. Conclusions: This model suggests that PGE1 favors palate disjunction, calcitriol synthesis, and shortens the mineralization. Therefore, PGE1 is an important bone anabolic molecule predominantly of modeling-based form and no hypercalcemia.

Resumen Introducción: La hormona paratiroidea es la única molécula anabólica ósea, pero ocasiona hipercalcemia. La prostaglandina E1 (PGE1) sugiere ser un anabólico óseo con formación por modelación predominante y generalmente no ocasiona hipercalcemia. El objetivo de este estudio fue corroborar estas propiedades de la PGE1. Métodos: Por 22 días, 30 conejos divididos en tres grupos (n = 10 cada grupo) recibieron una solución por vía intravenosa: vehículo (grupo control), disyunción palatina más vehículo (grupo sham) y disyunción palatina más 50 mg de PGE1 (grupo PGE1). A los días 1, 3 y 22 se obtuvieron radiografías de la sutura palatina. En el día 22 se analizaron los marcadores bioquímicos de formación ósea y se sacrificó a los conejos. Las suturas y los huesos suturales se procesaron sin descalcificar. La evaluación histomorfométrica fue digitalizada y el frente de mineralización ósea se tiñó con azul de toluidina. Las líneas irregulares reflejan resorción (remodelación) y las líneas rectas no resorción (modelación). Resultados: Radiográficamente, la disyunción palatina fue mayor en el grupo PGE1. Este grupo mostró una hipercalcitonemia significativa, pero la calcemia y los marcadores resortivos (N-telopéptidos) se mantuvieron estables. Por histomorfometría, los huesos suturales del grupo PGE1 mostraron anabolismo significativo en parámetros estructurales. En el grupo sham, la remodelación ósea fue del 20% y la modelación fue del 6%; en el grupo PGE1, la remodelación fue del 8.6% y la modelación fue del 17%. En este mismo grupo, la mineralización fue significativamente acelerada, pero la resorción se mantuvo igual. Conclusiones: Este modelo sugiere que la PGE1 favorece la disyunción palatina y el aumento del calcitriol, y acelera la mineralización y el anabolismo óseo por modelación predominante sin hipercalcemia.

Clinical profile and outcome of congenital cyanotic heart disease in neonatal period: a retrospective study

Background: Congenital Cyanotic Heart Disease (CCHD) is under reported during neonatal period and mortality rate is high in India. Aims and objectives of the study determine clinical presentation, maternal and neonatal risk factors and outcome of CCHD during neonatal period.Methods: A retrospective study conducted over 15-month period during March 2017 to June 2018 in a tertiary out born NICU. Neonates with echocardiographically confirmed case of structurally abnormal heart disease were analyzed.Results: Among 106 CCHD neonates, 60% neonates were asymptomatic, 22% had persistent cyanosis and 19% had tachypneic at birth. Cyanosis (35%) and tachypnea (30%) were common initial presentation in postnatal period. 22% neonates were readmitted with initial clinical symptom after discharge from birthing centre. CCHD were more common in male and term neonate, 34% were small for age, median age at admission and discharge were 5days (2-12) and 5 days (2.7-9.2) days respectively. Nineteen percent neonates had fetal distress and 6% neonates required aggressive resuscitation at birth. First trimester abortion (16%), maternal diabetes (10%) and hypothyroidism (7%) were common maternal risk factor. Nearly 20% neonates were diagnosed at referring hospital and 4.7% were transported with PGE1 during transport. TGA (17%) was most common lesion noted followed by pulmonary atresia (10%). Fourteen percent neonates died during the neonatal period. Disease specific death rate was highest for Single ventricle (42%) followed by TGA with IVS (37.5%) and aortic arch anomaly (28.5%) in this study.Conclusions: Early diagnosis and management may improve the survival in CCHD neonates.

Evaluation of antipyretic activity of alcoholic extract of Murraya koenigii leaves in rabbits

Background: The present study was carried out to evaluate the antipyretic activity of alcoholic extract of Murraya koenigii leaves in rabbits by using PGE1 induced hyperpyrexia method. We found that not much work has been done on the antipyretic effect of this plant.Methods: Laboratory breed New Zealand strains of rabbits of either sex weighing 1000-1500 gm were used in the study. The animals were divided into five groups (n=6). The rabbits of all the groups were made febrile by injecting misoprostol (PGE1) subcutaneously in the dose of 100 mcg/kg. For group 1 and 2, normal saline 2ml/kg as control and aspirin 28mg/kg as standard were given respectively. Alcoholic extract of Murraya koenigii leaves in the doses of 200, 400 and 800mg/kg were administered in remaining three groups respectively. Rectal temperatures were recorded with help of digital thermometer for every 30 min after drug treatment.Results: Alcoholic extract of Murraya koenigii produced highly significant (p<0.001) antipyretic effect in 400 and 800 mg/kg doses. But onset of action was fast with 800mg/kg dose.Conclusions: This study concludes that Alcoholic extract of Murraya koenigii has fast onset of action and also exhibited sustained anti pyretic action in New Zealand rabbits.

Comparative Analysis of the Combined Therapeutic Effects of Lipoprostaglandin E1 on Sudden Idiopathic Sensorineural Hearing Loss

BACKGROUND AND OBJECTIVES: Viral and vascular disorders are considered to be a major cause of idiopathic sudden sensorineural hearing loss (ISSNHL). Lipoprostaglandin E₁ (lipo-PGE₁) has vasodilating activity and has been used to treat ISSNHL. The purpose of this study was to determine the specific therapeutic effects of lipo-PGE₁ and compare them to other treatment modalities for ISSNHL. SUBJECTS AND METHODS: The study group had 1,052 patients diagnosed with ISSNHL. All were treated with steroid, carbogen inhalation, stellate ganglion block (SGB), or PGE₁. The CP group (steroid, carbogen inhalation, and PGE1 injection; 288 patients) was treated with lipo-PGE₁ and carbogen inhalation, the CS group (steroid, carbogen inhalation, and stellate ganglion block; 232 patients) with steroid, carbogen inhalation, and SGB, the C group (steroid and carbogen inhalation; 284 patients) with steroid and carbogen, and the control group (steroid only; 248 patients) with steroid only. Patients in the groups receiving lipo-PGE₁ received a continuous infusion of 10 µL lipo-PGE₁. RESULTS: The overall recovery rate after treatment was 52.2%, and recovery rates by group were 67.7% in the CP group, 54.3% in the CS group, 52.1% in the C group, and 32.2% in the control group. Therefore, the therapeutic results in groups treated with lipo-PGE₁ were better than results in other groups. The difference was statistically significant. CONCLUSIONS: The study results suggested that the CP group received effective treatment modalities for ISSNHL. The combined therapy of lipo-PGE₁ with carbogen inhalation in patients with ISSNHL was more beneficial than other treatment modalities.

Influence of Lipo PGE1 on ET-1 and IL-6 in exhaled breath condensate of patients with chronic obstructive pulmonary disease and pulmonary hypertension / 安徽医科大学学报

Objective To explore the influence of Lipo PGE1 on endothelin (ET-1) and interleukin (IL-6) in exhaled breath condensate(EBC) of patients with chronic obstructive pulmonary disease (COPD) and pulmonary hypertension(PH) and its clinical significance.Methods A total of 40 cases of patients with COPD and PH were randomly divided into thecontrol group and the treatment group,20 cases in each group.The control group was administered with the conventional treatments such as anti-infection,bronchodilator,antiasthma,expectorant and oxygen therapy;the treatment group was administered with Lipo PGE1 (10 μg/d,iv,for 10 days) besides the conventional treatments.ET-1 and IL-6 in EBC,pulmonary artery systolic pressure(PASP),arterial blood PaO2 and PaCO2,lung function FEV1/FVC,FEV1%pred in both groups were assayedbefore and after the treatment.Results There were no statistical difference between the two groups in the ET-1 and IL-6 in EBC,PASP,arterial blood PaO2 and PaCO2,FEV1/FVC,FEV1% pred before the treatment.After the treatment,the ET-1,IL-6 in EBC,PASP and arterial blood PaCO2 of the treatment group were lower than thoseof the control group (P<0.05);the arterial blood PaO2,FEV1/FVC,FEV1% pred of the treatment group were higher than those of the control group (P<0.05);The levels of ET-1 and IL-6 in EBC wereboth positivelycorrelated with PASP in the two groups.Conclusion Lipo PGE1 can reduce the levels of ET-1 and IL-6 in EBC of patients with COPD and PH.ET-1 and IL-6 may become a curative effect judgment index of COPD and PH,which has a certain clinical significance.

Comparative Study of Efficacy of Misoprostol Vs Dinoprostone Gel For Induction of Labour.

Abstract This study has been undertaken to compare the safety and efficacy of intra-vaginal misoprostol (PGE1 analogue) with intra-cervical dinoprostone (PGE2) in progress and induction of labour, the maternal side effects and the foetal outcome. Group I comprised of 50 patients who underwent induction with misoprostol vaginal tablets and Group II comprised of 50 patients who underwent induction with dinoprostone intra cervical gel. Labour induction was considered successful if subjects delivered within 24 hours of initiation of either of two methods. The maternal and foetal outcome were measured i.e., Bishop's score, time intervals from induction to delivery, need for oxytocin, mode of delivery, maternal and foetal side effects. The results of the present study show that the time intervals from induction-delivery intervals were significantly shorter and the requirement of oxytocin was less for augmentation of the labour in the misoprostol group than dinoprostone gel group. Intravaginal misoprostol is an effective agent for induction of labour than intra cervical gel. The drug is easy to use, effective and safe to mother and the foetus. Misoprostol can be routinely used for induction of labour than dinoprostone gel.

Clinical observation of Shenxiong glucose injection combined with lipo PGE1 injection in treatment of lower extremity arteriosclerotic occlusive disease / 中国生化药物杂志

Objective To observe the clinical efficacy and safety of Shenxiong glucose injection and lipo PGE1 injection in treating the lower extremity arteriosclerotic occlusive disease (LEAOD).Methods 80 patients with LEAOD were randomly divided into control group and treatment group. Both groups were given conventional therapy, including reducing blood pressure, blood sugar, blood lipid and anti-infection therapy.Control group was additonally given intra-femoral arterial infusion with urokinase 150000 units plus 15mL 0.9% sodium chloride and 10 mg anisodamine alternately every other day, 5 days for one course, stopping 3 days after another course.Treatment group was treated with intravenous injection Lipo PGE1 injection plus 10 mL 0.9% sodium chloride and intravenous Shenxiong glucose injection per day for 14 days.Clinical efficacy, changes in clinical symptoms, whole blood viscosity, high sensitivity C-reactive protein(hs-CRP), fibrinogen, ankle-brachial index(ABI), the inner diameter of the dorsalis pedis and the peak systolic velocity( PSV) of dorsalis pedis were compared and analyzed pre and post-treatment.Adverse drug reactions were recorded during the treatment.ResuIts The efficiency for the patients in the treatment group (90.0%) was higher than that in control groups(72.5%) (P<0.05).The symptoms of numbness and cold limbs, whole blood viscosity, ABI, hs-CRP improved more significantly in the treatment group (P<0.05).No adverse event occurred in the treatment group and 2 patients in control group had mild dry mouth.ConcIusion Shenxiong glucose injection combined with lipo PGE1 injection for the treatment of LEAOD is effective and safe and should be introduced in clinical practice.

PGE1 alleviates cognitive impairment and upregulates the VEGF and BDNF expression in VD rats / 中国神经精神疾病杂志

Objective To explore the effect of PGE1 on the cognitive impairment and the expression of VEGF and BDNF in the hippocampus after bilateral common carotid artery occlusion in adult rats. Methods Forty-eight rats were randomly divided into PGE1 group (10μg·kg-1·d-1, iv), PGE1+VEGFR antagonist group (PGE1, 10μg·kg-1·d-1, iv;SU5416, 25 mg·kg-1·d-1, ip), saline group and sham group (n=12 each). Morris Water Maze test (MWM) was used to examine cognitive function in rats. Drugs and saline were given to VD rats at 24 d for 7 consecutive days following opera?tion. Half of the rats in each group were sacrificed for Western Blot at 6 days after MWM test. Western Blot was conduct?ed to examine the relative expression levels of VEGF and BDNF in the hippocampus. Results Compared to saline and PGE1+VEGFR antagonist groups, the escape latency in PGE1 group was shorter (P0.05) compared with PGE1+VEGFR antagonist group, while the aug?ment of BDNF in PGE1 group was remarkable (0.481±0.049 vs. 0.373±0.034, P<0.05). Conclusions PGE1 can upregu?late VEGF and BDNF expression and modify cognitive impairment in VD rats, while the effects of PGE1 on cognitive function and BDNF expression can be partially blocked by VEGFR antagonist SU5416.

Application of prostaglandin E1 in treatment of patients with chronic renal failure / 中国基层医药

Objective To investigate the clinical effects of prostaglandin E1 (PGE1) in the treatment ot chronic renal failure in the 2nd ～ 4th period.Methods 128 patients with CKDs at stage 2 to 4 were selected and randomly divided into the observation group and control group,64 cases in each group.Patients in control group were given routine drug treatment,and patients in observation group were given PGE1 on the basis of the control group.They all treated for 3 months.Renal function indicators before and after treatment,curative effect and adverse reaction were compared.Results There were no statistical differences in renal function indicators before treatment in two groups (t =0.27 ～ 0.95,P ＞ 0.05).After treatment,the 24 hours urinary protein (t =3.41,P ＜ 0.05),creatinine clearance rate (t =4.04,P ＜ 0.05),serum creatinine (t =4.15,P ＜ 0.05),serum urea nitrogen (t =3.92,P ＜ 0.05) between the two groups had statistical differences.Total effective rate of the observation group was 84.37％,which was significantly higher than 57.81％ of the control group (x2 =5.63,P ＜ 0.05).There was no adverse reaction observed in observation group.Conclusion PGE1 might improve patients' proteinuria and renal function in the current situation of lacking effective treatment.

Comparative Study of Misoprostol Versus Dinoprostone for Induction of Labour.

Induction of labour means initiation of uterine contractions (after the period of viability) by any method (medical, surgical or combined) for the purpose of vaginal delivery. It is helpful when the risks of continuation of pregnancy either to the mother or the fetus is more. Some unfavourable conditions like IUGR, PROM, Post –term pregnancy, IUD, Chorioamnionitis, Maternal medical problems like PIH, Diabetes Mellitus, Renal diseases, COPD, Cardiac diseases may call for induction of labour. Various Pharmacological methods have been introduced for both pre-induction cervical ripening and induction of labour are as follows- 1) Prostaglandins 2) Oxytocin 3) Steroid receptor antagonist-Mifepristone 4) Relaxin This study was conducted on nulliparous females in the age group of 20-30yrs, with gestational age more than 34 wks in the Dept. Of Obstetrics and Gynaecology, Index Medical College Hospital and Research Centre Khudel, Indore over a period of 1 year with a sample size of 100 and they were randomized into Group A-receiving 50mcg of misoprost tablet vaginally and Group B -receiving endocervical cerviprime gel. Hence the purpose of this study is to emphasize that misoprostol is a better alternative than dinoprostone for induction of labour at rural hospital setup by comparing their- 1) Success Rate 2) Induction –delivery interval 3) Number of doses required, their cost effectiveness 4) Maternal complications 5) Fetal complications Among these prostaglandins especially prostaglandin E1,because of their short induction delivery interval, easy availability, low price, easy storage at room temperature, low maternal and fetal complication appear to be especially useful.

Interference mechanism of liposome PGE1 on survival of expanded flap / 中华医学美学美容杂志

Objective To investigate the mechanism of liposome PGE1 on the survival of the expanded flap.Methods The minipigs were set up as an animal model.They were divided into 2 groups.The expanded flaps (8 cm ×2 cm) were designed and elevated on the back of an minipig.An image analysis technology was used to evaluate the survival rate of the expanded flap,while realtimePCR technique was used to investigate the molecular mechanism.Results The survival area of the expanded flap in the Lipo PGE1 group was significantly enlarged (P＜0.01) compared with the control group.The VEGF,iNOS and Ang-1 gene expression decreased,but TGF-β1 gene expression increased.But there was no significant difference between two groups (P＞0.05).Conclusions The Lipo PGE1 could promote survival rate of the expanded flap,but the mechanism does not involve the regulation of VEGF,iNOS,Ang-1 and TGF-β1 gene expression.

Effects of Lipo-PGE1 on the expression of T-cell specific transcription factors T-bet/Gata-3 in acutelung injury / 中华急诊医学杂志

Objective To investigate the effects of Lipo-PGE1 on the expression of T-bet and Gata-3,and its potential mechanisms causing the shift of T cells from Th1 to Th2 on Acute lung injury(ALI)induced by Lipopolysaccharide(LPS)in mice.Methods Sixty male BALB-C mice were randomly divided into three groups(n =20 in each group):(1)control group,mice were treated with intravenous injection of NS in dose of 10 ml/kg,(2)LPS group,mice were exposed to LPS with dosage of 5 mg/kg(0.5 g/ml diluted in saline),and(3)LPS + PGE1 group,mice were treated with Lipo-PGE1 in dose of 15μg/kg.Sixhours after injection,the lungs were removed for observing the histopathological changes and determination of wet/dry lung weight(W/D)ratio.The levels of Th1 and Th2 were determined by flow cytometry,and the expressions of T-bet and Gata-3 mRNA were detected by using RT-PCR.One-way ANOVA was used for comparing differences between groups,and all data were presented in((x)± s).Results The histological changes of lung injury were lessened by PGEC ompared with the W/D ratio(5.74 ± 0.31)in LPS group,the one(4.92 ±0.27)in LPS +PGE1 group was lower significantly(P ＜0.01).The levels of Th1 and Th2 and their ratio Were higher in LPS +PGE1 group[(20.31 ±2.20)％,(10.50±0.80)％,(1.93±0.05)]than in LPS group[(16.65 ±1.70)％,(9.40 ±1.25)％,(1.73 ±0.03)](P＜0.01).Compared with control group,the expressions ofT-bet mRNA(1.183 ±0.495),and Gata-3 mRNA(0.693±0.285),and their ratio(1.713 ± 0.131)were lower(P ＜0.01); compared with LPS group,PGE1 significantly increased the expressions of T-bet mRNA(1.827 ± 0.705)and the ratio of T-bet/Gata-3 (2.502 ±0.352)(P ＜0.01),while didn(t)increased the expressions of Gata-3 mRNA(0.7191 ±0.186)significantly(P ＞ 0.05).Conclusions Lipo-PGE1 may up-regulate transcription factor T-bet which participates in the Th1 differentiation ratio,and then improve the inflammatorv svmntom.

Analysis of Frostbite (1)

PURPOSE: Frostbite can affect people involved in winter sports, homeless and soldiers. It results in tissue necrosis from direct cellular damage and indirect damage secondary to vasospasm and the progressive microvascular thrombosis following reperfusion of the ischemic limb. However, the frostbite is under-estimated by the physicians. We describe the assessment and management of frostbite and identify the challenges of managing these complex tissue injuries. METHODS: A retrospective analysis of 62 injuries (61 men, average age; 20.5 yo) was conducted between August 2009 to April 2011 in the burn center of AFCH. We sought to determine the demographic characteristics, identification of soft tissue injury, treatment and complications. RESULTS: The 62 were treated as outpatients (n=23, 37.1%) or inpatients (n=39, 62.9%). The superficial degree was 38 (61.3%), while 24 (38.7) have deep degree. The 47.4% of superficial and 87.5% of deep frostbite were admitted. The sites most prone to frostbite were feet (95.2%), followed by hands (27.4%). The toes had the more deep injuries. The 6 cases (9.7%) occurred in wet circumstances. They had suffered more deep injuries than dry circumstances (66.6% vs 35.8%). Thirteen (33.3%) of inpatients were transferred to center 14 days after exposure. The increased levels of isoenzymes did not present the degree of injuries. The bone scan was performed in 22 (56.4%) of inpatients at average 11.3 PFD. We believe it showed an excellent correlation with clinical course, though not confirmed statistically. The patient was treated with rapid rewarming (7; 11.3%), hydrotherapy (11; 17.7%), STSG (3; 12.5 of deep frostbite), berasil (14; 22.6%) and ibuprofen (5; 8.1%). The PGE1 was administered to 34 (87.2%) of inpatients for 8.8 days. We believe the effect of PGE1 to prevent amputations, though not confirmed in evidence base. The sequelae of 9 (23.1%) inpatients included of paresthesia (10.3%), LOM (10.3%), Raynaud's syndrome (7.7%) and hyperhydrois (2.6%). CONCLUSION: In a military context, health education of troops is necessary to avoid moisture circumstances and to protect from cold injuries. We need new guideline to recommend early rewarming and evacuation to specialized units so that the degree of frostbite can be alleviated and rate of complication can be lowered. We need new principles to use NSAIDs, pentoxifylline, antiprostaglandin agents and thrombolytic therapy in amelioration of tissue damage. Together with initial aids, use of radiological assessment, triple phase bone scanning, Duplex studies, Plethysmograpy and future advancements should allow for a more aggressive and active approach to the management of tissue viability. This information is only a primer and requires continuous updating to improve patient outcomes.

The protective effects of pretreatment with Lipo-PGE1 on fiver injury after hemorrhagic shock and resuscitation in rats / 中华急诊医学杂志

Objective To observe the effects and mechanism of pretreatment in rats with prostaglandin E1 on liver after hemorrhagic shock and resuscitation(HSR).Method In total,32 male SD rats were randomly(random number)divided into four groups(n=8):group A(sham group),group B(shock group),group C(HSR group)and group D(Lipo-PGEl+HSR).In group B,rats were sacrificed 90 min after shock,and in group C,rats were anesthetized and then subjected to hemorrhagic shock followed by resuscitation.In group D,rats were pretreated with Lipo-PGEI one hour before HSR.Liver function,NO and ET.1 were measured,and pathological changes of liver tissue in each group were observed,and the expres8ions of iNOS and ET.1 of liver tissue were measured by using immunohistochemistry 6 hours after HSR.Data were analyzed by analysis of variance,and P<0.05 was considered as significantly different in statitistics.Results The levels of liver iNOS and ET-I increased in HSR group compared with shock group [(O.225±0.080)vs.(0.082±0.021)and(0.292±0.047)vs.(0.082±0.035),P<0.05].Pretreatment with Lipo-PGEl markedly reduced the damage of Liver function,and lowered the levels of NO and ET-I.which were consistent with decrease in iNOS and ET-16 hours after HSR[(0.116±0.034)vs.(0.225±0.080)and(0.198±0.041)vs.(0.292±0.047),P<0.05].Conclusions Pretreatment with Lipo-PGEl could reduce liver injury after HSR.The mechanisms might be attributed to inhibiting iNOS and ET-1,regulating the balance of NO/ET-I.

The Effect of Lipo-PGE1 on the Viability of Injected Adipose Tissue on Mouse Model

PURPOSE: With the recent recognition of the importance of soft-tissue fillers, fat grafting has been assumed an increasingly important role as both an adjunctive and a primary procedure in aesthetic and reconstructive surgery. The main problem in achieving long-term soft-tissue augmentation is partial absorption of the injected fat and hence the need for overcorrection and re-injection. The purpose of this study is to improve the viability of the injected fat by the use of Lipo-PGE1. METHODS: Human adipose tissue, obtained by suction-assisted lipectomy, was re-injected into the subcutaneous layer in the scalp of ICR mice. Lipo-PGE1 (0.5 microgram/kg) was injected intravenously in experimental group for 7 days from the operation day and saline was injected in control group. There were 5 animals in each group. The animals were euthanized 4 weeks after the procedure. Graft weight and volume were measured and histologic evaluation was performed. RESULTS: Histologic analysis demonstrated significantly less cyst formation and less inflammatory reaction in the group treated with Lipo-PGE1. No significant difference was found between the groups regarding graft volume or the other histologic parameters investigated. Significant differences were demonstrated in microvascular density count. CONCLUSION: Less cyst formation, less inflammation, more angiogenesis indicating improved quality of the injected fat can be obtained by the addition of Lipo-PGE1. Further studies of various dosages of Lipo-PGE1 and their long-term effect are required before these encouraging results could be applied clinically.

In-vivo Studies on Effect of Lipo-PGE1 on Neoangiogenesis of Composite Graft in a Rabbit Model

PURPOSE: The survival of composite graft is dependent on three steps, (1) plasmatic imbibitions, (2) inosculation, and (3) neovascularization. Among the many trials to increase the survival rate of composite graft, prostaglandin E1 (PGE1) has beneficial effects on the microcirculatory level with vasodilating, antithrombotic, anti-inflammatory and neoangiogenic properties. Lipo-PGE1 which is lipid microspheres containing PGE1 had developed to compensate the systemic and local side effects of PGE1. This study was proposed to determine whether Lipo-PGE1 administration enhanced the survival of composite graft through neovascularization quantitatively in a rabbit ear model. METHODS: Fourteen New Zealand White Rabbits each weighing 3~4 kg were divided in two groups: (1) intravenous Lipo-PGE1 injection group and (2) control group. A 2 x 1 cm sized, full-thickness rectangular composite graft was harvested in each auricle. Then, the graft was reaaproximated in situ using a 5-0 nylon suture. For the experimental group, 3 microgram/kg/day of Lipo-PGE1 (5 microgram/mL) was administered intravenously through the marginal vein of the ear for 14 days. The control group was received no pharmacologic treatment. On the 14th postoperative day, composite graft of the ear was harvested and immunochemistry staining used Monoclonal mouse anti-CD 31 antibody was performed. Neoangiogenesis was quantified by counting the vessels that showed luminal structures surrounded by the brown color-stained epithelium and counted from 10 random high-power fields (400x) by independent blinded observer. Statistical analysis (Wilcoxon Signed Ranks test for nonparametric data) was performed using SPSS v12.0, with values of p<0.05 considered significant. RESULTS: The mean number of the microvessels was 15.48 +/- 8.65 in the experimental group and 9.82 +/- 7.25 in the control group (p=0.028). CONCLUSION: The use of Lipo-PGE1 facilitated the neoangiogenesis, resulted in the improvement of the survival rate of graft. On the basis of this results, we could support wider application of Lipo-PGE1 for more effective therapeutic angiogenesis and successful survival in various cases of composite graft in the human.

The Study for Combined Therapeutic Effects of Lipoprostaglandin E1 with Carbogen Inhalation on Sudden Sensorineural Hearing Loss / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Sudden sensorineural hearing loss (SSNHL) is a disease, which occur rapidly within 3 days with unknown causes. Vascular and viral mechanisms are considered as the main cause, but an etiologcal background for vascular factors is more assumed. Carbogen inhalation and lipoprostaglandin E1, both of which have vasodilation effects, are used as treatment modalities in SSNHL. The purpose of this study was to recognize the effectiveness of lipo-PGE1 combined with carbogen inhalation, and to compare with other treatment modalities. SUBJECTS AND METHOD: The study group consisted of 224 patients (110 males, 114 females) diagnosed with SSNHL. We retrospectively reviewed patients who were admitted and treated from January 2001 to December 2005. All patients were treated with carbogen inhalation and drugs. Stellate ganglion block (SGB) and lipo-PGE1 were applied to patients selectively. Eighty-six patients (DCP group) were treated with lipo-PGE1, 49 patient (DCS group) with SGB, and 89 patients (DC group) without SGB. RESULTS: The overall recovery rates after the treatment were 59.8%. Therapeutic results of lipo-PGE1 group were better than those of other groups. CONCLUSION: Although various treatments for SSNHL have been proposed, lipo-PGE1 and carbogen inhalation were more effective and lipo-PGE1 is considered to be more helpful for SSNHL.

Early Diagnosis and Therapy of Non-occlusive Mesenteric Ischemia after Open Heart Surgery / 日本心臓血管外科学会雑誌

Non-occlusive mesenteric ischemia (NOMI) is a rare but often fatal event following cardiac surgery. Early diagnosis of NOMI is difficult because the related abdominal symptoms are not very specific. From April 1999 to September 2003, 1,040 patients underwent cardiac surgery, among whom 5 patients who underwent angiography were given a diagnosis of NOMI. A catheter was used for immediate intra-arterial infusion of 500<i>μ</i>g prostaglandin E1 into the superior mesenteric artery over a period of 30min. Prior to angiography, all patients had cutis marmorata and elevated serum lactate levels. Three patients showed peritoneal signs and therefore underwent laparotomy. Of the 5 patients, 4 survived. In conclusion, if mesenteric ischemia is suspected, selective angiography must be performed as soon as possible for diagnosis and treatment. Additionally, the presence of other findings such as cutis marmorata and elevated serum lactate levels proved to be useful in the early diagnosis of NOMI.

The Effect of Intravenous Lipo-Prostaglandin E1 Injectioin in a Rat Foraminal Stenosis Model / 대한통증학회지

BACKGROUND: Lipo-prostaglandin E1 (Lipo-PGE1) has vasodilating and platelet aggregation inhibitory characteristics and it has been used as a treatment for patients with blood flow dysfunction disease. Based on the mechanisms of lumbar spinal stenosis, including veno congestion, neuro-ischemia and mechanical compression, we aimed to study whether intravenous Lipo-PGE1 injection has any therapeutic effect on hyperalgesia in a rat foraminal stenosis model. METHODS: In this study, twenty male Sprague-Dawley rats were divided into the control (n = 10) and Lipo-PGE(1)(n = 10) groups. A small stainless steel rod was inserted into the L5-6 intervertebral foramen to induce intervertebral foramen stenosis and chronic DRG compression. In the Lipo-PGE1 group, 0.15micron g/kg of Lipo-PGE(1) were injected intravenously via a tail vein for 10 days starting from the 3rd day after operation. Behavioral testing for mechanical and thermal hyperalgesia was performed for 3 weeks after the injections. RESULTS: From the 10th day after Lipo-PGE(1) injection, the rats in the experimental group showed significant recovery of their mechanical threshold, and this effect was maintained for 3 weeks. No significant differences of the thermal hyperalgesia were observed between the two groups. CONCLUSIONS: These findings suggest that intravenously injected Lipo-PGE1 may be effective for alleviating neuropathic pain, which isthe main symptom of spinal stenosis, by improving the blood flow dysfunction.

Clinical Observation of Low Molecular Weight Heparin and PGE_1 in the Treatment of Unstable Angina Pectoris / 中国药房

OBJECTIVE:To observe the therapeutic effectiveness of low molecular weight heparin combined with PGE1 in the treatment of unstable angina pectoris(UAP).METHODS:Select Oct.2006 to Oct.2009 in our hospital,128 cases of UAP were randomly divided into 3 groups.Group A(43 cases)were given general treatment,low molecular weight heparin and PGE1.Group B(43 cases)were given general treatment and low molecular weight heparin.Group C(42 cases)received general treatment and PGE1.Remission of angina pectoris and the recovery rate of ischemia ST-T segment were observed as well as side effects of low molecular weight heparin and PGE1.The levels of PT,APTT,FIB and D-Dimer in 3 groups were measured before and after treatment.RESULTS:The relief rate of group A was significantly different from that of group B and group C on 7 days after admission(P