The interfacial, emulsification and encapsulation properties of hydrophobically modified inulin.

Octenyl- and dodecenyl succinic anhydride derivatives (OSA- and DDSA-) of inulin have been synthesised and their solution and interfacial properties have been determined and compared to a commercially available alkylated inulin, Inutec SP1. All samples formed micellar aggregates in solution above a critical concentration (critical aggregation concentration) and were able to 'dissolve' a hydrophobic dye. They were also able to form stable oil-in-water (O/W) emulsions as assessed by measurements of their droplet size as a function of time. DDSA-inulin with a high degree of substitution was found to be effective at encapsulating beta carotene using the solvent evaporation method which yielded a solid which dissolved readily in simulated gastric fluid. The results confirm the potential application of these materials in a number of areas including, drug delivery, pharmaceuticals, neutraceuticals, cosmetics and personal care.

Synthesis, characterization and self-assembly of biosurfactants based on hydrophobically modified inulins.

Biosurfactants have been synthesized using a low energy, environmentally friendly process by the derivatization of inulin with octenyl (OSA) and dodecenyl (DDSA) succinic anhydrides in aqueous solution. The inulin and its derivatives have been characterized using gel permeation chromatography/multi angle light scattering (GPC/MALLS), high-performance anion exchange chromatography with pulsed amperometric detection (HPAEC-PAD), Fourier transform infrared spectroscopy (FTIR), and NMR, and the reaction efficiency was found to be between 59 and 95%. The efficiency was generally higher for OSA derivatives compared to DDSA derivatives. The hydrophobic derivatives were found to aggregate in solution and the critical aggregation concentration (CAC) was determined using dye solubilization, surface tension, dynamic light scattering (DLS), and conductivity. There was reasonable agreement in the CAC values obtained by the different techniques except for conductivity. It was found that the CAC decreased with increasing alkenyl chain length and degree of modification, and the values were significantly lower for the DDSA derivatives compared to the OSA derivatives. GPC elution profiles for the DDSA-inulin using 12 mol % reagent confirmed the presence of aggregates with a molecular mass of ∼2.5 × 10(6) g/mol and a radius of gyration of ∼25 nm corresponding to ∼550 inulin molecules. DLS study was undertaken to determine the hydrodynamic radius, and values obtained for the DDSA (12%) derivative were 30 nm in both water and 0.1 M sodium nitrate, while for the OSA (12%) derivative values of 13 and 7 nm were obtained. The derivatives have potential application in the stabilization of particulate dispersions and emulsions and also in the encapsulation and delivery of drugs.

Clinical significance of intramedullary Gd-DTPA enhancement in cervical myelopathy.

STUDY DESIGN: Prospective multicenter study. OBJECTIVE: To clarify the significance of intramedullary Gd-DTPA enhancement in cervical myelopathy, the prevalence, morphologic features, clinical relevance and postoperative change were investigated. SETTING: Four hospitals in Japan. METHODS: A total of 683 patients with cervical myelopathy who underwent decompressive surgery were consecutively examined. T1, 2 and Gd-DTPA-enhanced MRI were taken before surgery. Fifty consecutive cases without intramedullary enhancement were allocated in the non-enhancement group. The following variables were investigated: prevalence of the enhancement, the morphologic feature, the relationship between the enhancement and T2 high-intensity areas, the change of the Japanese Orthopedic Association (JOA) score for cervical myelopathy and the change of the enhancement after surgery. RESULTS: Intramedullary enhancement was observed in 50 cases (7.3%). The enhancements were observed between the most severely compressed disc and the cranial half of the lower vertebral body. On axial images, they were observed at the posterior or posterolateral periphery of the spinal cord. Enhancement areas were observed within T2 high-intensity areas and smaller than them. The preoperative JOA score was 9.8+/-2.8 points in the enhancement group and 9.8+/-3.3 points in the non-enhancement group (NS). The postoperative JOA score was 12.7+/-2.9 points in the enhancement group and 14.2+/-2.4 in the non-enhancement group (P=0.006). Intramedullary enhancement disappeared in 60% of the patients 1 year after surgery. CONCLUSION: Intramedullary enhancement indicated not the severity of preoperative symptoms, but a sign of a worse prognosis.

Intramembranous bone tissue response to biodegradable octacalcium phosphate implant.

Previous studies showed that synthetic octacalcium phosphate (OCP) enhances bone formation coupled with its own osteoclastic biodegradation more than non-biodegradable hydroxyapatite (HA), including sintered HA ceramic, when implanted in animal bone defects. The present study was designed to investigate whether synthetic OCP in granule form has biodegradable characteristics when implanted in the subperiosteal area of mouse calvaria in comparison with non-sintered stoichiometric HA, especially in relatively short periods after implantation. OCP crystals exhibited plate-like morphology, whereas HA crystals had a sphere-like structure. Both crystals had large pore volumes >75% in total, with micropores within the granules. Direct bonding of newly formed bone was discernible in HA until 35 days after implantation by element analysis for calcium and phosphorus. However, histomorphometric analysis demonstrated that bone formation was facilitated on OCP surfaces with greater alkaline phosphatase activity than on HA up to 21 days. The surfaces attacked by tartrate-resistant acid phosphatase positive osteoclast-like cells were significantly greater than those of HA. OCP became encapsulated and replaced with new bone with prolonged implantation periods up to 180 days. The results suggest that the enhanced bone formation in mouse calvaria could be associated with the biodegradable nature of OCP, and that OCP could be used in augmenting intramembranous bone volume.

Inguinal endometriosis attaching to the round ligament.

We report a case of endometriosis in the right inguinal region, attached to the right round ligament in a 28-year-old woman. At the age of 20, laparoscopic left ovarian cystectomy and pelvic adhesiolysis for endometriosis was carried out. She noticed a right tender groin mass 7 months previously, and the tumour size fluctuated with the menstrual cycle. A poorly circumscribed elastic hard mass, measuring 3 cm in diameter, was palpated in her right inguinal region. Magnetic resonance imaging showed a 2.5 cm x 2.5 cm mass in the right inguinal canal and a 5.4 cm x 6.8 cm mass was seen in the left ovary. The mass enlarged during menstruation. The groin mass was removed, in addition to carrying out laparoscopic ovarian cystectomy. At operation, the groin mass was found to be in continuity with the round ligament of extraperitoneal portion. Histological diagnosis of endometriosis was made in both ovarian and inguinal tumours. After surgery, the pain disappeared completely. Worth mentioning is that MRI clearly showed the change of tumour size depending on the menstrual cycle, which aided in arriving at the correct diagnosis of endometriosis in an unusual location.

One-stage lateral rhachotomy and posterior spinal fusion with compression hooks for Pott's paralysis in the elderly.

PURPOSE: To evaluate the safety and effectiveness of one-stage lateral rhachotomy and posterior fusion with compression hooks, for the treatment of Pott's paralysis in the elderly. METHODS: 11 elderly patients underwent lateral rhachotomy (costotransversectomy and pediculectomy) to debride the tuberculosis focus extending into the epidural space and to decompress the spinal cord. After debridement, the interbody cavity was packed with autologous iliac bone chips. For stabilisation, posterior fusion was performed using a compression lamina hook system. Patients were followed up for at least 2 years for complications. Neurological status was assessed using the Frankel score. The kyphotic deformity was measured on lateral radiographs taken before surgery and at follow-up. RESULTS: During separation of the adhesion around the abscess, a dural tear occurred in one patient and a pleural tear in another. Both tears were successfully repaired. One patient had mild pneumonia after surgery. The Frankel scores of the 11 patients improved from C or D before surgery to D or E after surgery. No relapse of spinal tuberculosis was encountered. The mean deformity angle was 25.5 degrees before surgery and 23.2 degrees at the final follow-up. Spinal fusion was achieved in all patients. CONCLUSION: Without the need of thoracotomy, one-stage lateral rhachotomy with posterior spinal fusion using compression hooks was an effective option for treating Pott's paralysis in the elderly.

Ossification of the Achilles tendon--a case report.

Ossification of the Achilles tendon is a very unusual condition. We report a case with bilateral Achilles tendon ossification followed up for twelve years, treated twice surgically on the left side and conservatively on the right side. At the age of 51, the patient's plain radiogram showed bilateral ossifications of the Achilles tendon (right 55 mm, left 15 mm in length). The left side small mass was removed. The right side mass was decided to be followed up because of its large size. At the age of 61, ossification recurred on the left side. Conservative treatment with etidronate disodium for two years failed to prevent ossification from progressing. At the age of 63, the mass on the right and left sides increased to 70 mm and 45 mm in length, respectively. The mass of the left side was excised again, and dull pain disappeared postoperatively on the left side.

The role of sex hormones in the kinetics of chondrocytes in the growth plate. A study in the rabbit.

Sex hormones play important roles in the regulation of the proliferation, maturation and death of chondrocytes in the epiphyseal growth plate. We have investigated the effects of male castration on the cell kinetics of chondrocytes as defined by the numbers of proliferating and dying cells. The growth plates of normal rabbits and animals castrated at eight weeks of age were obtained at 10, 15, 20 and 25 weeks of age. Our study suggested that castration led to an increase in apoptosis and a decrease in the proliferation of chondrocytes in the growth plate. In addition, the number of chondrocytes in the castrated rabbits was less than that of normal animals of the same age.

The microsatellite alleles on chromosome 1 associated with essential hypertension and blood pressure levels.

Essential hypertension (EH) is thought to be a polygenic disease. Several candidate genes of this disease have been investigated in studies using polymorphic genetic markers, but some studies have failed to show any association of EH with these genes. In this experiment, we used microsatellite markers on chromosome 1, and performed an association study between EH and control subjects. Genomic DNA was amplified with fluorescently labelled primers from the Applied Biosystems PRISM linkage mapping set HD-5 comprising 63 highly polymorphic microsatellite markers with an average spacing of 4.5 cM. We isolated three loci showing significant differences: D1S507, D1S2713 and D1S2842. The P-values of the allele with the greatest post hoc contributions in D1S507, D1S2713 and D1S2842 were 0.0008, 0.0062 and 0.0084, respectively. All these values were significant after Bonferroni correction. Furthermore, we found that the three microsatellite alleles were associated with the levels of systolic blood pressure. These data suggest that there are at least the three susceptibility loci for EH on chromosome 1, and that a case-control study using microsatellite markers on genomewide basis is a useful method for isolating the susceptibility loci of multifactorial disorders.

Closed reduction of developmental dislocation of the hip by prolonged traction.

The efficacy of traction before an attempted closed reduction for patients with developmental dislocation of the hip remains controversial. We treated 55 children (62 dislocations of the hip) by preliminary, prolonged traction for a mean of eight weeks. All were followed up for at least two years in order to observe the development of any avascular changes within the femoral head. Of the 55 children, 27 (31 dislocations) were followed up until they were over six years of age. Fifty-seven of the 62 hips (92%) showed a successful closed reduction. Only one had radiological evidence of avascular necrosis of the femoral head. Of the 31 hips which were followed up to over six years of age, 15 (48%) showed residual subluxation. Our method of prolonged preliminary traction leads to a high rate of successful closed reduction, a low incidence of avascular necrosis and a reduced need for secondary operations.

Avascular necrosis associated with fractures of the femoral neck in children: histological evaluation of core biopsies of the femoral head.

There is no well-documented effective treatment for avascular necrosis following fractures of the femoral neck in children. Six children who suffered avascular necrosis following these fractures were treated with a long period of non-weight bearing. We tried to predict the advisable period of non-weight bearing by histological finding on core biopsy taken from the femoral head and present long-term follow-up results. The time interval for the biopsy ranged from 4 to 21 months after injury. Two specimens obtained within 1 year after injury showed total necrosis. The other four specimens taken more than 1 year after injury showed partial repair. Two specimens obtained from patients who had minimally displaced fractures also revealed necrotic tissue. Four patients were initially placed non-weight bearing for over 1 year. Two patients started weight bearing immediately after surgery, and late segmental collapse occurred within 1 year. They were then placed non-weight bearing for a further period in excess of 1 year. All patients, including those who had severely displaced fractures, avoided severe collapse of the femoral head. To avoid severe collapse of the femoral head due to avascular necrosis after pediatric femoral neck fractures, a long period of non-weight bearing of at least 1 year may be recommended treatment.

Ectopic bone formation by electroporatic transfer of bone morphogenetic protein-4 gene.

Orthopedic surgeons have long awaited the clinical application of bone morphogenetic proteins (BMPs) for bone regeneration. However, such possible applications involving proteins or genes transferred with virus vectors have encountered many problems, including high cost, immunological reactions, viral infection, etc. We adopted a new gene transfer system of in vivo electroporation with a plasmid expression vector. A solution of plasmid DNA containing mouse BMP-4 (pMiw-BMP4) was injected into the gastrocnemius of BALB/cA mice, and electric pulses were applied through paired-needle electrodes inserted percutaneously. As a control plasmid, LacZ-containing plasmid (pMiwZ) was transferred by electroporation. A control group in which pMiw-BMP4 was injected and not electroporated was also introduced. In these groups, the gastrocnemius was harvested at 7, 14, 21, and 28 days after electroporation (n = 6 in each). As nonplasmid controls, electroporation with saline injection (n = 6), electroporation without injection (n = 6), and saline injection only (n = 3) were prepared. In these groups, the mice were killed 7 days after experimentation. Ectopic calcification or ossification was examined by histology as well as soft X-ray. In all electroporated groups (pMiwZ, pMiw-BMP4, saline injection, and without injection), dystrophic calcification of muscle bundles and infiltration of mesenchymal cells were observed histologically. Ectopic bone formation was observed only in the pMiw-BMP4 electroporation group. At 7 days after pMiw-BMP4 electroporation, extracellular eosinophilic matrix in a collection of mesenchymal cells was observed. Between 14 and 28 days after electroporation, ectopic bone was observed in 44% of mice, and bone marrow-like cells observed in 22%. The newly formed bone was woven. Injection of pMiw-BMP4 or saline induced neither calcification nor ossification. Our findings indicate that BMP-4 transferred by electroporation can induce in vivo and in situ ectopic bone formation in skeletal muscle.

A case of inguinal endometriosis with difficulty in preoperative diagnosis.

An unusual case of endometriosis involving the right round ligament in a 40-year-old woman is presented. After giving birth to two children, she first noticed a tender mass in the right groin at the age of 36. It didn't change in size but pain appeared at the age of 38, disturbing her daily life. A poorly circumscribed elastic hard mass, measuring 3 cm in diameter, was palpable in her right inguinal region. Magnetic resonance imaging demonstrated a 2x3 cm mass in the right inguinal canal. At operation, a mass was found to be in continuity with the round ligament at the inguinal canal. Histological diagnosis was endometriosis. After operation, she was completely relieved of pain. It is important to include endometriosis in the differential diagnosis for painful inguinal masses in women of childbearing age.

[Expression of urokinase-type plasminogen activator (uPA) and uPA receptor (uPAR) plays a role in destruction of joint tissue in rapidly destructive coxarthropathy (RDC)].

OBJECTIVE: Proliferation of small vessels including capillaries in joint tissues is one of the significant histopathological features of rapidly destructive coxarthropathy (RDC). To examine the relationship between the angiogenesis and bone destruction, expression of urokinase-type plasminogen activator (uPA) and uPA receptor (uPAR), which are necessary for angiogenesis was histochemically investigated. MATERIALS AND METHODS: Synovia and cartilage-bone tissues of femoral head were obtained from RDC patients at total hip replacement (THR). These joint tissues were fixed with 4% paraformaldehyde, and cartilage-bone tissues were decalcified, additionally. Immunohistochemical staining was performed on paraffin sections, using monoclonal antibodies against human uPA and uPAR. RESULT: There was a difference between expression of uPA and that of uPAR. Expression of uPA was observed in many types of cells such as osteoclasts, giant cells, fibroblast-like cells and macrophages, of which osteoclasts and giant cells were most prominent. On the other hand, expression of uPAR was detected mainly in fibroblast-like cells and macrophages and rarely seen in osteoclasts and giant cells. CONCLUSION: These results indicate that uPA-plasmin system contributes to bone destruction in RDC, and furthermore, that fibroblast-like cells and macrophages play an important role in activation of uPA-plasmin system.

Glomus tumors with cystic changes around the ankle.

Sizable glomus tumors with cystic changes in the ankle are extremely uncommon. This paper describes painless glomus tumors with cystic changes arising in the ankle of a 22-year-old woman. At the age of 14, a painless mass was noticed on the lateral side of the left ankle, and at age 21, another mass appeared on the medial side of the same ankle. Magnetic resonance imaging (MRI) and computed tomography (CT) scanning revealed 4.5 x 4.0 cm and 2.0 x 2.0 cm sized masses on the medial side and a 3.0 x 4.0 cm sized cystic mass on the lateral side of the ankle. The tumors were removed en bloc. Microscopically, the tumor consisted of perivascularly arranged cells with punched-out, round, and regular nuclei. Immunohistochemically, the tumor cells expressed SMA and HHF-35, indicating smooth muscle cell characters. The patient had no recurrence at 2 years after surgery.

Comparison of spinal cord gray matter and white matter softness: measurement by pipette aspiration method.

OBJECT: Although the gray matter of the spinal cord has been thought to be softer than the white matter, there is no evidence to support this belief. Because the spinal cord is extremely soft, it has been difficult to measure the mechanical properties of the gray and white matter. The modulis of elasticity of the gray and white matter were measured in situ by using a pipette aspiration method. METHOD: The spinal cord specimens were excised from Japanese white rabbits. Specimens were cut to display the surfaces of axial, frontal, and sagittal sections. The surfaces of the gray and white matter were aspirated using a 0.8-mm-inner-diameter glass pipette while monitoring with a video microscope, and the deformed length in the pipette was measured on a monitor. In each case the modulus of elasticity was calculated by comparing the relationship between the aspiration pressure and aspirated volume of the specimen with that determined by finite element analysis. The moduli of elasticity of the gray and white matter were 3.4+/-1.4 kPa (mean +/- standard deviation) and 3.4+/-0.9 kPa in the axial section, 3+/-0.3 kPa and 3.5+/-0.5 kPa in the frontal section, and 3.5+/-0.9 kPa and 2.8+/-0.4 kPa in the sagittal section, respectively. CONCLUSIONS: No significant difference in modulus of elasticity was shown between the gray and white matter of the spinal in sections made in various directions.

Primary leiomyosarcoma with the invasion into the intertrabecular space of bone: a case report and the review of the literatures.

Primary leiomyosarcoma of bone is very rare. Most of reported cases were osteolytic. We report a primary leiomyosarcoma arising from the neck of the femur of a 43-year-old woman who had no remarkable abnormalities on plain radiographs. Magnetic resonance imaging (MRI) clearly depicted the lesion. Biopsy revealed it leiomyosarcoma. Gynecological and gastrointestinal examinations ruled out metastatic leiomyosarcoma. Wide excision of the tumor was performed and followed by endoprosthetic replacement of the proximal femur. Microscopic examination revealed tumor cells infiltrating into the intertrabecular space.

Idiopathic herniation of the thoracic spinal cord: report of three cases.

STUDY DESIGN: Cases are reported and the literature is reviewed. OBJECTIVE: To present three cases involving idiopathic herniation of the thoracic cord. SUMMARY OF BACKGROUND DATA: Idiopathic spinal cord herniation is a very rare condition. Only 20 cases have been reported. The radiographic and intraoperative findings concerning this herniation remain insufficient, and its pathophysiology is less understood. METHODS: Idiopathic herniation of the thoracic spine was managed operatively in the three cases. The clinical, radiologic, and intraoperative features in these cases are described, and the pathophysiology of this disorder is discussed from a review of the literature. RESULTS: Two of the three patients had a defect in the inner layer of the duplicated ventral dura mater through which the spinal cord was herniated. The third patient had a ventral epidural cyst into which the spinal cord had protruded. Operative reduction of the spinal cord improved motor power in all three patients, although sensory disturbance remained unchanged. CONCLUSIONS: There should be several types of idiopathic spinal cord herniation. This is the first report of this herniation that focuses the abnormalities of the ventral dura mater, together with image and intraoperative findings.

Imaging features of intraosseous lipomas of the calcaneus.

We report two cases of intraosseous lipoma arising in the calcaneus of a 36-year-old and a 22-year-old women complaining of heel pain. Plain radiographs and computed tomography scans revealed cystic lesions in the calcaneus triangle. On magnetic resonance images, the lesions had high signal intensities on both T1-weighted and T2-weighted images, corresponding to adipose tissue. Histological examination revealed mature fat cells with small bone fragments. Curettage and bone grafting were performed. There was no recurrence identified on plain radiographs 2 years following the surgery.

Vascular supply to slipped capital femoral epiphysis.

The etiology of avascular necrosis associated with slipped capital femoral epiphysis has not been well understood. The aims of this study were to clarify the blood supply to the slipped epiphysis and to examine whether this vascular supply is damaged before the reduction. Twelve patients (12 hips) underwent selective angiography of the medial circumflex femoral artery. There were seven stable slips and five unstable slips. All patients with slips underwent angiography before reduction, and one patient with an unstable slip underwent angiography both before and after reduction. The superior retinacular artery (SRA) was filled in all stable slips. This result was in accordance with the previous report that stable slips result in low rates of avascular necrosis. Of five unstable slips, the SRA was stained in two and was not filled in three. In one slip examined both before and after the manipulative reduction, the SRA was not seen before it but was well stained after it. These results have suggested that in some unstable slips the vascular injury occurs at the time of injury, before reduction, and that the reduction dose not necessarily contribute to the risk of avascular necrosis after slipped capital femoral epiphysis.