Entrapment Research Articles

In vitro and In vivo assessment of lawsone microsphere loaded chitosan scaffolds

Objective: To prepare, assess the lawsone loaded chitosan scaffolds for antibacterial and wound healing activity. Methods: The work was focused is to develop a topical formulation preferably, natural biodegradable scaffolds of lawsone drug for treating skin wounds and bacterial infections. Here, lawsone loaded chitosan microspheres were impregnated into chitosan scaffolds. The lawsone microspheres prepared by emulsification and cross linking method. Incorporation of lawsone loaded chitosan microspheres into chitosan scaffolds by emulsification and freeze drying technique. The lawsone a microspheres characterized by FT-IR, SEM, evaluated through entrapment efficiency, percentage yield, in vitro drug release studies. Lawsone scaffolds was assessed for wound healing ability using albino rats and anti bacterial activity by agar disc diffusion method. Results: the FT-IR spectra showing almost similar peaks within the same wave length range indicating the there is no possible interaction between the drug and polymer. The SEM of Lawsone microspheres and prepared scaffolds showing oval shape, slightly rough, porous surface, slightly aggregated and interconnected porous structure of the scaffolds was slightly reddish brown in colour. The lawsone loaded chitosan scaffolds had exhibited antibacterial activity against different bacrial strains and wound healing potential in albino rats. Conclusion: The schematic process of lawsone loaded chitosan microspheres imparts quality in the in the topical formulation and obtained results were judicious.

Analysis of misdiagnosis of 65 cases of left renal vein entrapment syndrome

Objective Through the analysis of misdiagnosis left renal vein entrapment syndrome, to improve the understanding and reduce the misdiagnosis of this disease. Methods 82 cases of left renal vein compression syndrome were diagnosed with ultrasound, 65 cases were misdiagnosed.Clinical data of these 65 patients were analyzed. Results In 82 cases, only 11 doctors from renal department of internal medicine, pediatrics, department of urology wrote application for it.Among the 65 misdiagnosed cases, 30 cases of male, female 35 cases.The age ranged from 6 to 37 years old, the average age was 16.1 years.The misdiagnosis duration ranged from 2 months to 42 months, the median time was 7 months.43 cases of low back pain or backache, urinary tract irritation in 5 cases, 60 cases of abnormal urinalysis: a simple urinary protein in 15 cases, 21 cases of simple hematuria, proteinuria, hematuria 24 cases.31 cases were misdiagnosed as chronic glomerulonephritis, occult nephritis(asymptomatic proteinuria and hematuria syndrome) in 11 cases, acute nephritis comprehensive sign in 9 cases, 7 cases of lumbar muscle strain, urinary tract infection in 4 cases, 1 case of urinary tract stones, pelvic inflammatory disease in 2 cases.In the 16 cases complicated with glomerular nephritis, were treated as the glomerular nephritis before (11 cases of chronic nephritis, 5 cases of asymptomatic proteinuria and hematuria syndrome).12 cases of abnormal urine fluctuation, after a delay of 3-16 months referral doctor was diagnosed with left renal vein entrapment syndrome. Conclusion The disease has no characteristic clinical manifestations, and most clinicians were short in understanding of the disease, so the misdiagnosis rate is high.The clinicians should improve the understanding of the disease, in order to reduce the misdiagnosis rate. Key words: Renal veins; Vascular diseases; Diagnostic errors; Adolescent

External Cross-linked Mucoadhesive Microbeads for Prolonged Drug Release: Development and In vitro Characterization.

Mucoadhesive microbeads of low methoxyl pectin were prepared, either alone or in combinations with hydroxypropyl methyl cellulose, sodium carboxymethyl cellulose, methyl cellulose and carbopol 934P, by ionotropic gelation. The influence of copolymers on mucoadhesivity, microbeads characteristics and in vitro drug release was investigated. Spherical microbeads with 78.69±0.59 to 85.84±0.78% drug entrapment and of a size of 791.90±4.58 to 960.88±4.61 μm were prepared. The concentration of cross linking agent affects the encapsulation efficiency of microbeads. Mucoadhesiveness of microbeads was dependent on the concentration of copolymers. The formulations exhibiteda pH-dependent release and followed diffusion-controlled first-order kinetics.

Lumbosciatalgia Due to Pyramidal Syndrome

Piriformis syndrome is a poorly known cause of sciatica and there are few cases reported in the international literature where sciatica is the form of presentation. It is caused by compression or entrapment of the sciatic nerve due to piriformis muscle pathology. A 65-year-old Caucasian man was admitted in Department of Neurology because he suffered from sciatica and weakness of the left lower limb, so initially a disc herniation was suspected. Upon physical examination, he presented marked gluteal muscle atrophy, mild quadriceps muscle atrophy and paresis of the left lower extremity with distal dominance. Electroneuromyography provided evidence of left sciatic nerve injury of severe intensity and profuse signs of active denervation present. MRI lumbar plexus revealed asymmetrical enlargement of the left piriformis muscle that obliterated the ipsilateral greater sciatic foramen, compressing the left sciatic nerve. As a result, secondary atrophy of the gluteus maximus and medius can be observed on this side. Due to the severity of the symptoms, surgery was performed to release the nerve. Piriformis syndrome rarely occurs as sciatica. The diagnosis is usually delayed because of the absence of further pathognomic testing and established diagnostic criteria, which are based on clinical manifestations. This syndrome is often confused with lumbar-sacral or hip disease. So, in a disease such as the case presented, the piriformis syndrome should be considered. We think that it is very interesting to know that a piriformis syndrome can debut as a lumbosciatalgia and it can be confused with lumbar disc pathology, so this may delay the diagnosis and cause further suffering to the patient. J Med Cases. 2016;7(6):248-251 doi: http://dx.doi.org/10.14740/jmc2503w

Progress in diagnosis and care of fractures of the femoral head

Fractures of the femoral head (FFH) are mainly seen in young adults, and the majority mechanism is due to dashboard injury in crushing vehicles. FFH can be present with or without posterior dislocation of the hip joint. Except for periarticular pain and hip dysfunction, the typical signs include flexion, adduction and internal rotation of the hip and shortening of involved limb. CT and MRI get their popularity as diagnostic methods for FFH. An emergency open reduction should be indicated in the scenario of failed closed reduction in FFH with posterior dislocation, of FFH with femoral neck fractures, of unmatched head and acetabulum following closed reduction and of deteriorating sciatic nerve damage. Pipkin as well as Brumback classification is still the most popularly used methods, which have great significance for establishment of surgical strategy and prediction of prognosis. More and more clinical evidences show conservative care of FFH should only be indicated for non-displaced fractures or displacement less than 2 mm. These cases must meet the following criteria simultaneously, including stable hip joint, concentric head and acetabulum, no free fractured fragments in the joint space and no labrum entrapment. Operative care is naturally the treatment of choice. Surgical approaches for FFH are hot topics in recent years. In previous control studies to compare Kocher-Langenbeck (K-L) and Smith-Peterson (S-P) approach, it is revealed less operative time, less blood loss and better operative field you can get in S-P approach, however, the incidence of ectopic ossification is higher. Ganz approach, which is characterized by osteotomy of great trochanter, hip capsulotomy and surgical dislocation of the hip, is a novel pattern for operative care of FFH. Ganz approach can show the entire femoral head, while can not damage medial femoral circumflex artery (MFCA) and induce iatrogenic osteonecrosis of the femoral head (ONFH). Various screws are the main implants for the fixation of fractured femoral head. Osteoarthritis and ONFH are two principal complications following FFH, which not only closely associate with severity and mechanism of primary injury, but also correlate with reduction quality and iatrogenic factors. Artificial hip joint replacement is a rational choice for extremely comminuted femoral head and these FFH in the elderly.

The anatomy of the medial collateral ligament of the knee and its significance in joint stability

The medial collateral ligament (MCL) is the most important stabilizer of the medial side of the knee together with the capsuloligamentous complex. As such, it has a distinctive role in joint stability, as far as its biomechanics are concerned, and major joint stability issues onset when it is injured or deficient. One of the main functions of the medial collateral ligament is mechanical as it passively stabilizes the knee and help in guiding it through its normal range of motion when a tensile load is applied. It exhibits nonlinear anisotropic mechanical behaviour, like all ligaments, and under low loading conditions it is relatively compliant, perhaps due to recruitment of “crimped” collagen fibres as well as to viscoelastic behaviours and interactions of collagen and other matrix materials. Continued ligament-loading results in increasing stiffness until a stage is reached where it exhibits nearly linear stiffness and beyond this it continues to absorb energy until it is disrupted. In addition, the function of the MCL has to do with its viscoelasticity which assists the maintainance of joint congruity and homeostasis. The treatment of grade III medial collateral ligament injuries (with gross valgus instability at 0° of flexion) is still controversial. The most severe injuries (especially with severe valgus alignment, intra-articular medial collateral ligament entrapment, large bony avulsions, or multiple ligament involvement) may require acute operative repair or augmentation. In addition, surgical reconstruction is indicated for isolated symptomatic chronic medial collateral ligament laxity. The optimal surgical treatment remains controversial. More studies with evidence of level I and II are required in order to clarify the pros and cons of any solution.

Popliteal artery thrombosis caused by osteochondroma: A rare presentation

Popliteal entrapment syndrome should be considered as a cause of lower limb vascular insufficiency in young adults. It is often caused by musculotendinous structures and bony abnormalities are rarely implicated. Early diagnosis and prompt surgical treatment are the key factors for a better prognosis. This report describes a rare case of popliteal artery thrombosis cause by an osteochondroma treated by surgical resection with good results.

Rare association of Amniotic Band Sequence (ABS) with meningocele

Amniotic Band Syndrome also known as amniotic band sequence(ABS) is a group of congenital birth defects caused by entrapment of fetal parts in fibrous amniotic bands while in utero. Other synonyms are ADAM complex, Congenital constriction bands and Pseudoainhum . Defects usually involves longer central digits of the hand (middle, long, and index fingers). Up to 50% of cases have other congenital anomalies including cleft lip, cleft palate, and clubfoot deformity.But here we present a rare case of ABS with lumbar meningocele.

Formation of suprascapular foramen as a result of ossification of superior transverse scapular ligament: a case report and short review of the literature

Ossification of superior transverse scapular ligament resulting in a bony suprascapular foramen is of fundamental anatomical and clinical importance. In this case report, we describe a special case of a suprascapular foramen. Its specificity lies in foraminal dimensions, resulting in a unique morphometrical pattern in comparison with reported similar cases. This pattern is of great anatomical and clinical importance, because ossification of suprascapular foramen leads to limitation of suprascapular notch, over which suprascapular nerve passes. Ossification can consequently constitute a major predisposing factor for suprascapular nerve entrapment and subsequent neuropathy. Therefore, this anatomic variation should be considered from surgeons and other healthcare professionals.

Factorial design approach for optimization of floating microspheres of diltiazem hydrochloride

The aim of this study was to perform optimization of floating microspheres of diltiazem hydrochloride for the prolongation of gastric residence time. The microspheres were prepared by a nonaqueous solvent evaporation method using polycarbonate. A full factorial design was applied to optimize the formulation. Preliminary studies revealed that the concentration of polymer and stirring speed significantly affected the characteristics of floating microspheres.The optimum batch of microsphere exhibited smooth surfaces with good flow and packing properties, prolonged sustained drug release, remained buoyant for more than 10 h, high entrapment efficiency up to 97% w/w. Scanning electron microscopy confirmed the hollow structure with particle size in the order of 190 μm. The studies revealed that the increase in concentration of polycarbonate increased the drug release from the floating microspheres.The results of two third full factorial design revealed that the concentration of polycarbonate (X1) and stirring speed (X2) significantly affected drug entrapment efficiency, percentage release. Key words: Diltiazem hydrochloride, factorial design, floating microspheres, polycarbonate

Moral Subversion and Structural Entrapment

Moral Subversion and Structural Entrapment

Formulation and development of industry feasible proniosomal transdermal drug delivery system of granisetron hydrochloride

Proniosomes gel is semisolid liquid crystal products of nonionic surfactants, which converted into niosomes upon hydration. A proniosome based transdermal drug delivery system of granisetron hydrochloride (GRA HCL) developed by coacervation phase separation method. Formulation optimized by use of 32 full factorial design. Span 60 and cholesterol selected as independent variables, while entrapment efficiency (EE) and flux selected as dependent variables. Proniosomes evaluated for EE, in vitro permeation study, stability study, microscopial examination by photomicroscopy, scanning electron microscopy, particle size analysis. F5 batch containing 90 mg span 60, and 10 mg cholesterol show maximum entrapment (66.57 ± 0.20%) and flux (7.94 ± 0390 μg/cm2/h). Comparative in vitro drug release study of plain drug solution and drug in proniosomal gel form was carried out for 48 h on guinea pig skin. It was found that cumulative release and flux of proniosomal gel was nearly two times more than drug solution containing same drug concentration.The study demonstrated the effectiveness of proniosomal transdermal patch containing GRA HCL for effective management of chemotherapy induced nausea and vomiting. Key words: Factorial design, industry feasible, niosomes, proniosomes, stability, transdermal drug delivery

In vitro study of folate receptor-targeted and paclitaxel-loaded ultrasound contrast agent

Objective To prepare the folate receptor-targeted and paclitaxel-loaded ultrasound contrast agent (folate-poly(lactide-co-glycolide)-paclitaxel, FOL-PLGA-PTX) and to investigate its targeting and imaging performance in vitro. Methods Paclitaxel-loaded PLGA-COOH microcapsules with a core of liquid perfluorocarbon (PLGA-PTX) were prepared using single emulsion technique and then conjugated with folate by carbodiimide method. The size, surface potential, entrapment efficiency and drug loading efficiency were measured by Malvern laser detector and HPLC. The connectivity condition of PLGA-PTX with folate and the binding rate of fluorescent antibody were detected by immunofluorescence staining and flow cytometry. The targeting performance of FOL-PLGA-PTX was checked after co-incubated with human SKOV3 cell lines in vitro and compared with that of non-targeted group and free folic acid intervention group. In vitro experiments were performed to explore the effects of FOL-PLGA-PTX on the enhancement of ultrasound imaging after irradiation by high intensity focused ultrasound (HIFU). Two-sample t test and one-way analysis of variance were used to analyze data. Results The average diameter of FOL-PLGA-PTX was (244.43±13.32) nm, with the drug entrapment efficiency of (86.23±1.23)% and loading amount of (8.62±0.12)%. The binding rate of folate was as high as (98.49±1.28)%. The connection rate of FOL-PLGA-PTX on SKOV3 cells was higher than that of non-targeted group ((84.32±4.25)% vs (16.45±2.89)%; F=289.45, t=10.654, P<0.01) and the free folic acid intervention group ((36.33±3.23)%; t=8.923, P<0.01). During in vitro ultrasound imaging, the average grey scale of FOL-PLGA-PTX before HIFU irradiation was significantly lower than that after HIFU irradiation (39.32±3.64 vs 126.44±7.15; t=4.829, P<0.01). Conclusion FOL-PLGA-PTX has been prepared successfully, with high entrapment efficiency and much drug loading, which can target to SKOV3 cells specifically and effectively in vitro, and enhance the ultrasound imaging greatly after HIFU irradiation. Key words: Ovarian neoplasms; Receptors, folic acid; Contrast media; Paclitaxel; Ultrasonography

The Effect of Static Wrist Position on Median Nerve over Six Hours

Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy, caused by the compression of the median nerve in the carpal tunnel over the wrist. The purpose of this study is to demonstrate how different wrist positions change median nerve image and their corresponding results of nerve conduction study (NCS). In this study, we investigated 40 normal wrists and 32 wrists with CTS. In both groups, subjects were randomly assigned to wear a splint, and the wrist was placed at 0, 15, 30 and 45 degrees of extension. Ultrasonography was performed before splinting, immediately after splinting and repeated again 2, 4 and 6 hours later. Ultrasonographic examination evaluated the flattening ratio and cross-sectional area of the median nerve at carpal tunnel. NCS was performed before splinting and repeated again 2, 4 and 6 hours later. The motor and sensory components of nerve conduction over median nerve were tested. The results showed that the neutral position was associated with the lowest median nerve compression over time. All the extended wrist positions were associated with significant median nerve flattening at the proximal carpal tunnel level. But there were no significant electrophysiological differences between different wrist positions. The proper wrist position is a very important factor in preventing median nerve compression, and the ultrasonographic finding is more sensitive for earlier detection concerning median nerve compression.

Endoscopy-assisted sialolithectomy for the calculus of the Stensen's duct

To investigate the clinical effects of endoscopy-assisted sialolithectomy for the calculus in the Stensen's duct. From August 2005 to July 2013, 67 consecutive patients with calculus (or foreign bodies) in the Stensen's duct underwent explorative and interventional endoscopy in our hospital. The stones (or foreign bodies) were removed by endoscopy-assisted technique. After operation, the patients were followed-up periodically, and treatment effects were analyzed. Among the 67 patients, the stones (or foreign bodies) were completely removed in 58 cases, and almost completely removed in 3 cases, with a success rate of 87% (58/67). Among the 61 stone-removed cases, treatment options included direct removal with aid of basket or forceps (24 cases), basket entrapment and opening-up of the ostium (21 cases), basket entrapment and mucosal incision near the ostium (8 cases), open removal via buccal incision (2 cases) and open removal via pre-auricular flap (6 cases). During the 6-90 months' follow-up of the 61 cases, 48 cases were asymptomatic, 7 had mild symptoms, 3 developed ductal obturation, 1 had numbness in the parotid region, and the remaining 2 were missed. Endoscopy-assisted sialolithectomy is a safe and effective gland-preservation technique for the patients with parotid gland calculus.

Preparation and Properties of Butylene Fipronil-loaded Microcapsules

Butylene fipronil-loaded microcapsules were prepared by layer-by-layer self-assembly of oppositely charged chitosan and sodium alginate as shell materials. Sodium dodecyl benzene sulfonate was selected as the dispersant by flowing point method. The prepared microcapsules were characterized. The effect of drug loadings,entrapment efficiency,release profiles and photo degradation rate with the increase of layers was systematically studied. The results show that microcapsules with six to eight layers are the best with the entrapment efficiency up to 80%,the release time of 60 h and the photolysis rate down to 20%.

Variations in extensor carpi radialis longus and brevis - A cadaveric study

The Extensor Carpi Radialis Longus (ECRL) and Extensor Carpi Radialis Brevis (ECRB) are two of the superficial muscles of e xtensor compartment of forearm. The extensor carpi radialis brevis is involved in tennis elbow. The surgeons performing Z shaped tenotomy on tennis elbow to lengthen the tendon of ECRB must be aware of the variation in order to avoid unwanted complications. Recently, ECRB has also gained importance for use in free functional muscle transfer. In cases of variation of extensor muscles like fusion of muscle bellies or splitting of tendon and in cases of absent ECRB, the entrapment neuropathy of Radial nerve or Posterior interosseous nerve should also be kept in mind. In this study, w e have described some variations of ECRL and ECRB which were different from what has already been reported as they are clinically important. Methods: 30 upper limbs from 15 formalin fixed adult human cadavers were dissected to study the ECRL and ECRB. Results: Out of 15, 4 cadavers showed variations. ECRL showed a split of its tendon into two in 3 limbs belonging to 2 cadavers in which one cadaver showed bilateral split. ECRB showed a similar split of tendon in two limbs. One of the limbs showed complete absence of ECRB. Bellies of ECRL and ECRB fused to form a single mass in 3 limbs. Conclusions: The additional tendons noted in the present study could be utilized effectively and reliably in tendon transfers and in surgi cal rehabilitation in patients with paralytic disorders. Keywords: Tennis elbow, Variations, Tendon transfer.

A Bicipital Rib; Case report

Congenital anomalies of the ribs are rare. Incidence of 0.3% of fused first and second ribs has been reported in a study based on chest radiograph. Bicipital rib is an unusual anatomical peculiarity results due to fusion of shaft of cervical rib with first rib or the first rib and second rib.We found the Bicipital rib belonging to left side in osteology lab, Department of Anatomy, Vijayanagar Institute of medical sciences, Bellary, Karnataka, India. Detailed morphological examination was done and relevant measurements recorded. A rib anomaly may indicate underlying systemic disease causing musculoskeletal pain or intercostals nerve entrapment and may also cause Thoracic outlet syndrome. Thus the bicipital rib is anatomically, clinically and surgically important variation.

Cleavable PEG modified paclitaxel loaded liposome for tumor targeting and therapy

Objective To prepared cleavable PEG modified paclitaxel loaded liposome （CLP-PTX） and to study its capability for tumor targeting.Methods Liposome was prepared by film-ultrasonic method.Cellular uptake by HepG2 cells was explored.The anti-proliferation efficiency of CLP-PTX was evaluated by MTF assay.HepG2 cells were xenografted in athymic nude mice to establish the animal models,which were used to evaluate the anti-cancer effect.Results The mean size of CLP-PTX was （95±9.5） nm with the Zeta potential of （-3±1.05） mV,and the entrapment efficiency of PTX was 85.6%.The cellular uptake of liposomes with addition of cysteine （Cys）was 2.8 times as high as that in the absence of Cys,and the difference was statistically significant （P〈0.01）.Fluorescent microscopy qualitative observation demonstrated that the cells showed higher fluorescence intensity in the presence of Cys.The MTT assay showed the anti-proliferative activity against HepG2 cells of CLP-PTX depended on the paclitaxel concentration,and the inhibition ratio of CLP-PTX with addition of Cys was 1.6 times as high as that in the absence of Cys （P〈0.01）,which was consistent with the cellular uptake results.Conclusions Comparing with paclitaxel,CLP-PTX inhibited the proliferation of HepG2 cells more persistently.Thus,CLP-PTX,as a new nanometer drug,has a special application value for tumor therapy. Key words: Cleavable polyethylene glycol; Liposome; Tumor

Coronary artery bypass graft surgery for right coronary artery: balloon catheter entrapment

Aterosklerotik kalp hastaliklarinda perkutan koroner girisimler yaygin uygulanmakta olup, neredeyse hastane yatisi gerektirmeden uygulanabilecek hale gelmistir. Ancak, invaziv bir girisim oldugu icin, koroner anjiyografi ve perkutan koroner girisimlerin bazi ciddi komplikasyonlari olabilmektedir. Bu yazida, perkutan koroner girisim sirasinda sag koroner arter icerisinde sikisan ve acil koroner arter baypas grefleme gerektiren perkutan koroner girisimin bir komplikasyonunun goruldugu 81 yasinda bir erkek olgu sunuldu. Bu yazi, son yillara ait bazi saygin kilavuzlarda gerekli gorulmemis olmasina ragmen, perkutan koroner girisimlerin uygulandigi hastanelerde kardiyovaskuler ekibin gerekliligini vurgulamak amaciyla kaleme alinmistir.