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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. [ABSTRACT FROM AUTHOR]

Biosurfactants have been synthesizedusing a low energy, environmentallyfriendly process by the derivatization of inulin with octenyl (OSA)and dodecenyl (DDSA) succinic anhydrides in aqueous solution. Theinulin and its derivatives have been characterized using gel permeationchromatography/multi angle light scattering (GPC/MALLS), high-performanceanion exchange chromatography with pulsed amperometric detection (HPAEC-PAD),Fourier transform infrared spectroscopy (FTIR), and NMR, and the reactionefficiency was found to be between 59 and 95%. The efficiency wasgenerally higher for OSA derivatives compared to DDSA derivatives.The hydrophobic derivatives were found to aggregate in solution andthe critical aggregation concentration (CAC) was determined usingdye solubilization, surface tension, dynamic light scattering (DLS),and conductivity. There was reasonable agreement in the CAC valuesobtained by the different techniques except for conductivity. It wasfound that the CAC decreased with increasing alkenyl chain lengthand degree of modification, and the values were significantly lowerfor the DDSA derivatives compared to the OSA derivatives. GPC elutionprofiles for the DDSA-inulin using 12 mol % reagent confirmed thepresence of aggregates with a molecular mass of ∼2.5 ×106g/mol and a radius of gyration of ∼25 nm correspondingto ∼550 inulin molecules. DLS study was undertaken to determinethe hydrodynamic radius, and values obtained for the DDSA (12%) derivativewere 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 derivativeshave potential application in the stabilization of particulate dispersionsand emulsions and also in the encapsulation and delivery of drugs. [ABSTRACT FROM AUTHOR]

Study Design: The courses of protruded masses in cervical disc herniations were traced on preoperative computed tomography discograms of patients with myelopathy or radiculopathy. Objective: To characterize the courses of protruded masses in cervical disc herniation. Summary Of Background Data: No studies have been reported on the varied courses of protruded masses in cervical disc herniation. Methods: This study investigated the preoperative CT discograms of 150 patients with myelopathy and 50 patients with radiculopathy who had undergone anterior cervical discectomy and fusion for disc herniation. The courses of herniations were traced from the penetration sites on the deep layer of the posterior longitudinal ligament through their locations in the spinal canal, and were divided into one median, two paramedian, and two lateral sections. Results: Of the 150 discs in the patients with myelopathy, 87% had a median penetration and 13% had a paramedian one. No discs had a lateral penetration. It was found that 45% of the median penetrations led to median herniation through a straight course and 55% to paramedian herniation through an oblique course, and that 95% of the paramedian penetrations led to paramedian herniation through a straight course. Of the 50 discs in the patients with radiculopathy, 70% had a median penetration, 26% a paramedian penetration, and 4% a lateral penetration. Lateral penetration was observed only at C7-T1. All of the median penetrations led to the paramedian or lateral herniation, and 92% of the paramedian penetrations led to lateral herniation through oblique courses. Conclusions: In the cervical spine, most herniated masses penetrate the deep layer of the posterior longitudinal ligament in the middle, where the posterior intervertebral space is widest. Oblique courses to paramedian or lateral herniation are common. Only at C7-T1, where there are no Luschka joints, lateral penetration was observed. The narrow space of the Luschka joint may prevent fragments from penetrating laterally. Preoperative information from the CT discograms on the characteristic courses of the herniation may facilitate the complete removal of herniated mass in anterior decompressive surgery. [ABSTRACT FROM AUTHOR]

Cold-dense plasma sheet (CDPS) is known to appear during extended northward IMF periods. Its appearance suggests enhanced entry of the solar wind into the magnetosphere during the times when it is supposed to be most closed, in a manner totally different from active times, and that on to closed field lines. To understand the CDPS formation mechanism, which still remains open, anatomy of CDPS is performed in this study. By inspecting the ion spectrum characteristics CDPS is classified into three categories. Dawn-dusk asymmetry is revealed as the spatial distributions of the three categories are plotted separately, which indicates that different heating/transport processes are operative on different sides of the magnetotail. On dawnside a group of data characterized by the highest temperature from one of the CDPS categories is distributed at the plasma sheet inner-edge and is connected to the hot-dense ions (HDIs) at the further inner region. An independent analysis indicates that HDIs not associated with elevated solar wind dynamic pressure appear in the dawnside inner-magnetosphere during extended northward IMF. Both studies points to the idea that HDIs are the inner-magnetosphere extension of dawnside CDPS and that there is significant dawn-dusk asymmetry in heating and transport in the magnetotail under northward IMF. [Copyright &y& Elsevier]

Purpose: The combination of a facet fracture and a contralateral facet dislocation at the same intervertebral level of the cervical spine (a fracture and contralateral dislocation of the twin facet joints) has not been described in detail. The aims of this study are to report a series of 11 patients with this injury, to clarify the clinical features and to discuss its pathomechanism.Methods: Among 251 patients with lower cervical spine fractures and/or dislocations surgically treated, 11 (9 males and 2 females, averaged age, 52 years) had this kind of injury. Medical charts and medical images were reviewed retrospectively.Results: Injury levels were C4-5, C5-6 and C6-7 in 1, 4 and 6 patients, respectively. A fracture was found at the superior facet in 6, and at the inferior facet in 5. The anterior displacement of the vertebral body ranged from 7 to 19 mm. The unilateral horizontal facet appearance on an anteroposterior radiograph and the triple image on a CT composed of a separated fracture fragment, the base of the fractured facet, and the neighboring non-fractured facet were characteristic. All patients had neurological deficits from Frankel A to D, and were surgically treated by posterior fusion using wire or cable, or combined anterior and posterior spinal fusion.Conclusions: The fracture and contralateral dislocation of the twin facet joints can cause severe neurological deficits because of its gross anterior displacement. Its plausible pathomechanism is extension force exerted to the cervical spine when it is maximally bent laterally. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Background: Patients with crowned dens syndrome typically present with severe neck pain and have calcium deposits around the odontoid process of the axis on radiographs. To our knowledge, the cases of only thirty-five patients have been reported in the English-language literature and the clinical features remain unclear. The purposes of this study were to examine the clinical features of crowned dens syndrome, determine treatment outcomes, and propose diagnostic criteria.Methods: Forty patients with severe neck pain had calcium deposition around the odontoid process on computed tomography scans, and they were thus diagnosed as having crowned dens syndrome. Data were collected in relation to these patients, including the date of onset of neck pain, the presence of inflammatory indicators (increased body temperature, C-reactive protein levels, and white blood-cell count), and treatment outcomes.Results: The male-to-female ratio was 0.6, and two-thirds of the patients were more than seventy years of age. All patients had markedly restricted neck motion, particularly in rotation, and all had one or more positive inflammatory indicators. Calcium deposition was detected in all areas around the odontoid process, but chiefly behind the process. Pain was typically relieved by nonsteroidal anti-inflammatory drugs, prednisolone, or both. A combination of both appeared to be the most effective.Conclusions: We believe that crowned dens syndrome is more common than previously recognized, especially in elderly patients. It is diagnosed on the basis of acute and severe neck pain; marked restriction of neck motion, particularly in rotation; the presence of inflammatory indicators, such as an elevated C-reactive protein level; calcium deposition around the odontoid process detected by computed tomography; no history of trauma; and the exclusion of other inflammatory diseases and tumors. Prednisolone and nonsteroidal anti-inflammatory drugs in combination are the recommended treatment for symptom relief. [ABSTRACT FROM AUTHOR]

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 × 2.5 cm mass in the right inguinal canal and a 5.4 cm × 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. [ABSTRACT FROM AUTHOR]

Background It is well known that anterior cruciate ligament (ACL) injuries are commoner in female athletes. Accordingly, we hypothesized that serum estrogen may play some role in this sex difference. We evaluated the relationship between serum estrogen levels and the mechanical properties of the ACL in rabbits. Animals and methods In 40 ovariectomized rabbits, the serum estrogen levels (SEL) were controlled by intramuscular injection of 17[beta]-estradiol. The mean SEL in each rabbit was defined as the average of 5 determinations done at 1, 2, 3, 4 and 5 weeks after ovariectomy. The animals were divided into 4 groups according to the dose of estradiol administered (low, medium, high and control: L, M, H and C, respectively) and into 2 groups according to the mean SEL (high-SEL group and low-SEL group). The medial portions of ACL attached to both femur and tibia harvested at 5 weeks after ovariectomy were examined mechanically. Results The mean serum estrogen levels in groups C, L, M and H were 37, 50, 60 and 231 pg/mL. Statistically significant differences in the mean serum estrogen levels were seen among the 4 groups, except between groups L and M. Statistically significant differences were found between groups M and H in both the ultimate tensile stress and linear stiffness. In the comparison between 2 groups using the mean SEL value, both ultimate tensile stress and linear stiffness were lower in the high-SEL group. In all animals, a positive correlation was found between ultimate tensile stress and linear stiffness. Interpretation Our findings suggest that high SEL might be one of the factors in the multifactorial pathogenesis of ACL rupture. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To investigate whether the abnormal expression of matrix metalloproteinases (MMPs) 3, 9, and 13 and ADAMTS-4 by human osteoarthritic (OA) chondrocytes is associated with epigenetic 'unsilencing.' METHODS: Cartilage was obtained from the femoral heads of 16 patients with OA and 10 control patients with femoral neck fracture. Chondrocytes with abnormal enzyme expression were immunolocalized. DNA was extracted, and the methylation status of the promoter regions of MMPs 3, 9, and 13 and ADAMTS-4 was analyzed with methylation-sensitive restriction enzymes, followed by polymerase chain reaction amplification. RESULTS: Very few chondrocytes from control cartilage expressed the degrading enzymes, whereas all clonal chondrocytes from late-stage OA cartilage were immunopositive. The overall percentage of non-methylated sites was increased in OA patients (48.6%) compared with controls (20.1%): 20% versus 4% for MMP-13, 81% versus 47% for MMP-9, 57% versus 30% for MMP-3, and 48% versus 0% for ADAMTS-4. Not all CpG sites were equally susceptible to loss of methylation. Some sites were uniformly methylated, whereas in others, methylation was generally absent. For each enzyme, there was 1 specific CpG site where the demethylation in OA patients was significantly higher than that in controls: at -110 for MMP-13, -36 for MMP-9, -635 for MMP-3, and -753 for ADAMTS-4. CONCLUSION: This study provides the first evidence that altered synthesis of cartilage-degrading enzymes by late-stage OA chondrocytes may have resulted from epigenetic changes in the methylation status of CpG sites in the promoter regions of these enzymes. These changes, which are clonally transmitted to daughter cells, may contribute to the development of OA. [ABSTRACT FROM AUTHOR]

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.Journal of Human Hypertension (2004) 18, 823-828. doi:10.1038/sj.jhh.1001740 Published online 10 June 2004 [ABSTRACT FROM AUTHOR]

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. [Copyright &y& Elsevier]

We present an analysis of sporadic and recurrent injections of magnetospheric ions in the midnight auroral oval during substorms and of the associated ionospheric ion outflows. The source of plasma sheet precipitating ions is determined using a simple method, based on the measured relation between the ion inverse velocity and time (l = v × t). This method is applied here to two typical passes of the Interball-Auroral (IA) satellite at distances of ∼ 3 RE above the auroral regions. Substorm related ion injections are shown to be mainly due to time of flight effects. In contrast with particle trajectory computations (Sauvaud et al., 1999), the inverse velocity method does not require magnetic and electric field models and can thus be used systematically for the detection of time of flight dispersed ion structures (TDIS). This allowed us to build a large database of TDIS events and to perform a statistical analysis of their spatial distribution. For the cases presented here the source region of the injected ions is found at radial distances from 18 to 30 RE near the equatorial magnetosphere. At Interball altitudes (∼ 3 RE), ion injections detected at the poleward boundary of the nighside auroral oval are associated with shear Alfve´n waves superimposed over large-scale quasi-static current structures. We show that the most poleward TDIS are collocated with a large outflow of ionospheric H+ and O+ displaying pitch-angle distributions peaked in the pitch-angle range 90°–120°. These ions are thus accelerated perpendicularly to the magnetic field not only in the main auroral acceleration region but also up to at least 3 RE. The expanding auroral bulge thus constitutes a significant source of H+ and O+ ions for the mid-tail magnetosphere. [Copyright &y& Elsevier]

An unusual case of endometriosis involving the right round ligament in a 40-yearold 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 3cm in diameter, was palpable in her right inguinal region. Magnetic resonance imaging demonstrated a 2×3 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. [ABSTRACT FROM AUTHOR]

We performed a multi-instrument ground-based and satellite study of substorm-related phenomena during auroral breakup. Our study is limited to the short (a few minutes) time interval around the breakup onset. A mapping made on the basis of event-oriented mangnetospheric model places the pre-breakup arc into the near-Earth region (r ≈ 10 RE) where thin and intense current sheet develops. Disruption of the current sheet was observed in the same region. The plasmoid was observed in the mid-tail. Backtracing the plasmoid onset time and location confirmed that reconnection related to the substorm onset could operate in the near-Earth thin current sheet. These observations are in agreement with the idea that the reconnection and current disruption signatures, as well as auroral breakup are different manifestations of the one process. [Copyright &y& Elsevier]

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. [ABSTRACT FROM AUTHOR]

Reports on the case of a 55-year-old female diagnosed with extraskeletal osteosarcoma arising in the buttock. Medical history; Initial diagnosis; Treatment and chemotherapy.

Study Design: A retrospective case study. Objective: To confirm the remodeling potential of the kyphotic malunited odontoid fracture in the pediatric spine. Summary Of Background Data: Nonsurgical reduction and immobilization is the gold standard for the odontoid fracture in infancy. However, the reduction occasionally results in incomplete repositioning of the odontoid process. The cervical spine is subsequently immobilized until fusion in most cases in the hope of achieving remodeling with the growth of the remaining displacement and kyphotic angulation, although there are no precise data on the acceptable limit of the deformity. Methods: Three patients (age at injury = 1 year 2 months to 3 years) with odontoid process fracture in infancy were treated conservatively and the fractures were observed on plain lateral radiographs until at least the age of 20 years. For evaluation of the angulated odontoid process, we used our original measurement method of the odontoid process tilting angle (OPTA). In addition, the OPTAs were also measured in 127 Japanese adult patients (57 male patients and 70 female patients; average age = 43 years) without a history of odontoid fracture, as normal controls. Results: The OPTA in the normal controls was -21.4° ± 23.3°. The OPTAs ranged from 41° to 62° at the initial evaluation, from 12° to 30° at the time of bony union, and from -4° to -14° at the final follow-up at more than 20 years of age, which were all within one standard deviation of the mean in the normal adult controls. Conclusion: Angulated odontoid fractures with the OPTA around 30° at the time of bony union in infants younger than 3 years of age could have the capacity for remodeling to the normal morphology. No surgical reduction might be needed to recommend complete apposition of the odontoid process in the absence of severe or deteriorating neural impairment. [ABSTRACT FROM AUTHOR]