Comparison of General and Spinal Anaesthesia on Systemic Inflammatory Response in Patients Undergoing Total Knee Arthroplasty: A Propensity Score Matching Analysis.

Background and Objectives: Some of the postoperative complications following orthopaedic surgeries are associated with a systemic inflammatory response (SIR), which varies depending on the anaesthetic technique. We aimed to compare the effects of general and spinal anaesthesia on the SIR after total knee arthroplasty (TKA), based on C-reactive protein (CRP) levels, the platelet-lymphocyte ratio (PLR), and the neutrophil-lymphocyte ratio (NLR). Materials and Methods: Patients who underwent TKA between January 2014 and December 2018 were included. Electronic medical records of the patients were retrospectively reviewed and analysed. To reduce the impact of potential confounding factors, we performed propensity score matching according to the anaesthetic technique. Results: A total of 1311 TKA cases were analysed. After propensity score matching, the maximal CRP value and changes in CRP levels in the general anaesthesia group were higher than those in the spinal anaesthesia group. However, the maximal NLR and PLR and the changes in NLR and PLR were not different between the two groups. There were no differences in postoperative clinical outcomes. Conclusion: Spinal anaesthesia tended to induce a lower inflammatory response than general anaesthesia when considering CRP levels in patients undergoing TKA. However, the effects of anaesthetic techniques on the overall outcomes were not significant.

Pharmacokinetics and four-week repeated-dose toxicity of hyaluronic acid and ketorolac combination following intra-articular administration in normal rats.

Intra-articular (IA) injection of hyaluronic acid (HA) in combination with nonsteroidal anti-inflammatory drugs, such as ketorolac (KL), have been clinically investigated to provide more rapid and profound pain relief in patients with osteoarthritis. However, its safety, local tolerance, and potential for pharmacokinetic interaction have not been assessed. In this study, the pharmacokinetics and toxicity of a combination of HA and KL were evaluated in normal rats following four-week repeated-dose injection. Rats received HA or KL alone at 4 mg/kg or 16 mg/kg, respectively, or HA/KL combination at 4/4 mg/kg, 4/8 mg/kg, or 4/16 mg/kg on a weekly basis. The rats exhibited temporal, reversible changes in hematology, serum chemistry, and urinalysis caused primarily by KL treatment. No deleterious effects were observed on the joint following repeated IA HA/KL administration, which showed only minimal to mild levels of temporary inflammatory changes in synovial membrane. The plasma KL level following IA injection rose as fast as that of intra-muscular injection, with no alteration with the co-administered HA. In conclusion, repeated IA administration of HA/KL combination was tolerated well in normal rats, encouraging future studies of IA injection of HA/KL combination on osteoarthritis-induced animal models and even patients.

Effect of Zn on Pore Characteristics in Lotus-Type Porous Cu.

The effect of Zn on pore characteristics in lotus-type porous Cu alloy was investigated. The lotustype porous Cu-Zn alloys were fabricated with Zn content from 0.01 to 0.1 at% by the centrifugal casting method. The results demonstrated that the porosity was rarely affected by Zn content. However, the average pore diameter and pore number density of the lotus type porous Cu-Zn alloys were significantly affected by the Zn content. The average pore diameter decreased as the Zn content increased up to 0.01 at%, and then increased as the Zn content increased up to 0.1 at%. In contrast, the variations in the pore number density of the lotus-type porous Cu-Zn alloys showed the reversed tendency with respect to that of the average pore diameter. The increase in heterogeneous nucleation sites for pores attributed to the decreased average pore diameter and the increased pore number density.

High-risk metachronous polyps are more frequent in patients with traditional serrated adenomas than in patients with conventional adenomas: a multicenter prospective study.

BACKGROUND AND AIMS: Although the malignant progression of serrated polyps has been clearly documented, the malignant potential of the traditional serrated adenoma (TSA) subtype has not been established. We compared the prevalence of metachronous polyps in surveillance colonoscopies between patients with TSA and those with conventional adenomas (CAs). METHODS: Four hundred twenty patients were diagnosed with TSAs by current diagnostic criteria at 10 tertiary care university hospitals in Korea from January 2003 to December 2005; 186 patients who received surveillance colonoscopy after removal of initial polyps were enrolled. During the same time period, 372 age- and sex-matched patients diagnosed with CAs were used as a control group. RESULTS: TSA patients had a significantly higher recurrence rate of colorectal polyps compared with CA patients (66.1% vs 43.5%, respectively). TSA patients had a greater number (3 vs 2) and larger size (8.6 ± 5.7 vs 6.3 ± 5.2 mm) of recurrent polyps compared with CA patients. TSA patients also had a higher rate of CA (54.8% vs 37.9%), serrated adenoma (14.0% vs. 0.8%), and hyperplastic polyp (33.3% vs. 13.7%) recurrence compared with CA patients. TSA patients had significantly greater odds of having a recurrent high-risk polyp than CA patients (odds ratio, 2.37; 95% confidence interval, 1.55-3.63). CONCLUSIONS: In comparison with patients with CAs, patients with TSAs have a higher metachronous occurrence rate of all polyp subtypes including CAs, serrated adenomas, and hyperplastic polyps. Moreover, the presence of TSAs is an independent predictor of a high-risk polyp occurrence.

Update of Vocal Fold Shortening With Retrodisplacement of Anterior Commissure for Voice Feminization.

OBJECTIVES: To assess the efficacy and long-term durability of the enhanced technique of Type II Vocal Fold Shortening and Retrodisplacement of the Anterior Commissure (VFSRAC) for voice feminization compared with the preceding Type I method. METHODS: A retrospective analysis encompassed 506 patients drawn from a cohort of 1025 MtF transgender women who underwent VFSRAC between 2003 and 2021. The study period included cases from 2015 to 2021, during which the Type II update technique was implemented, involving a modification to the suture technique. Subjective and perceptual evaluations, aerodynamic and acoustic assessments, real-time pitch analysis, and videostroboscopic reviews were conducted pre- and postoperatively in the MtF transgender women cohort. Comparative statistical analyses were performed to discern differences between the earlier Type I method (2003-2014) and the more recent Type II method (2015-2021). RESULTS: The preoperative mean speech fundamental frequency (sF0) for Type II VFSRAC was 134.5 Hz. Postoperatively, the mean sF0 increased to 196.7 Hz, 212.3 Hz, and 207.5 Hz at 3 months, 6 months, and beyond 1 year, respectively, exceeding outcomes observed with the Type I method. Postoperative subjective and objective assessments indicated an augmentation in voice femininity. Acoustic and aerodynamic indices were within the normal range, and the regularity of the vocal fold mucosal wave was preserved within normal parameters. These results suggest that patients achieved a natural phonation pattern after surgery. CONCLUSIONS: The application of our updated type II VFSRAC has demonstrated feasibility and consistently yielded favorable results for individuals desiring a naturally feminine voice. LEVEL OF EVIDENCE: 3 Laryngoscope, 2024.

Enhanced Electrical Properties and Stability in IGZO TFTs via Low-Temperature Activation with MgOx Layer.

We propose the introduction of a magnesium oxide (MgOx) layer to reduce the temperature required for the activation of indium gallium zinc oxide (IGZO) thin films. By incorporating the MgOx layer between the IGZO channel layer and the gate insulator layer, the required activation temperature is lowered from 300 to 200 °C while enhancing the electrical performance of the IGZO thin-film transistor (TFT). Specifically, the field effect mobility is improved from 6.40 to 16.12 cm2/(V s), the on/off current ratio is enhanced from 1.62 × 109 to 7.16 × 109, and subthreshold swing is enhanced from 0.48 to 0.46 V/decade. Furthermore, IGZO TFTs with the MgOx layer exhibit enhancements in threshold voltage (VTH) shift compared to TFTs without the MgOx layer under positive bias stress (VGS = 20 V and VDS = 0.1 V for 10,000 s) and negative bias stress (VGS = -20 V and VDS = 0.1 V for 10,000 s): the VTH shifts are decreased from 2.40 to 1.72 V and from 0.56 to 0.53 V, respectively. These enhancements are verified through various analyses and are attributed to the diffusion of Mg atoms into the IGZO front channel during the low-temperature activation process, which results in the formation of Mg-doped IGZO between the MgOx and IGZO channel layers.

Insufficient joint forces of first-generation articulating instruments for laparoendoscopic single-site surgery.

BACKGROUND: The current articulating instruments used in laparoendoscopic single-site surgery do not appear to provide the joint forces required. Thus, we measured the joint forces of first-generation articulating laparoscopic instruments. To compare these forces with those necessary in the surgical context, we evaluated the forces sufficient to produce secure surgical ties in an animal model. METHODS: The articulating instruments tested were Laparo-Angle (Cambridge Endoscopic Devices Inc, Framingham, MA), RealHand (Novare Surgical Systems Inc, Cupertino, CA), and Roticulator (Covidien Inc, Mansfield, MA). For each, we measured the angle between the end-effector and the shaft in proportion to the articulating force using a push-pull gauge. Two fixed-position configurations of the instruments were predetermined: the neutral and the fully articulated positions. The forces required to secure surgical ties for the ureter, renal artery, and renal vein were evaluated using kidneys harvested from a female pig. RESULTS: The bending forces required to bend from the neutral position to 30° were 5.6 ± 1.2 and 4.7 ± 1.0 N with the Laparo-Angle and RealHand, respectively. Furthermore, the slippage forces in the fully articulated state were 1.8 ± 0.3, 1.6 ± 0.2, and 1.5 ± 0.2 N in the above order. In contrast, the mean forces to produce surgical ties of the ureter, renal artery, and renal vein were 14.5 ± 2.3, 11.5 ± 0.8, and 10.3 ± 2.3 N, respectively. CONCLUSION: The joint forces of first-generation articulating instruments for laparoendoscopic single-site surgery are not sufficient to meet the usual operative needs. Improved articulating instruments with greater articulating forces should be developed.

Effect of Operating Conditions on the Gasification of Pet-Coke Water Slurry in an Entrained-Flow Gasifier Simulation.

Petroleum coke, commonly known as pet-coke, represents a promising and cost-effective alternative fuel source, produced as a byproduct of large-scale heavy crude oil refining. This study first simulated the gasification process of pet-coke slurry using a three-dimensional computational fluid dynamics (CFD) approach based on the Eulerian-Lagrangian method. The simulation was carried out in a 2-ton-per-day (2TPD) entrained-flow gasifier, aiming to optimize the production of hydrogen (H2) and carbon monoxide (CO) as synthetic gases. This study investigated the effects of operational parameters, including the oxygen/slurry ratio and moisture content in the slurry, on various aspects such as fluid dynamics, temperature distribution, particle trajectories, carbon conversion, and gas composition within the pet-coke slurry gasifier. The base conditions of the simulation were meticulously cross-validated with high-precision experimental data. The results indicated that higher oxygen/slurry ratios led to increased concentrations of carbon dioxide (CO2) and decreased fractions of H2, primarily due to the prevalence of the reverse water-gas shift reaction. Moreover, raising the moisture content in the pet-coke slurry led to decreased CO levels and enhanced production of H2 and CO2, triggered by the activation of the forward water-gas shift reaction. These results underscore the potential of pet-coke slurry as a favorable feedstock for syngas production and the achievement of carbon neutrality through the careful optimization of operational conditions. Our findings provide valuable insights for further experimental exploration and the development of practical applications for pet-coke gasification.

Enhanced lysosomal activity is involved in Bax inhibitor-1-induced regulation of the endoplasmic reticulum (ER) stress response and cell death against ER stress: involvement of vacuolar H+-ATPase (V-ATPase).

Bax inhibitor-1 (BI-1) is an evolutionarily conserved protein that protects cells against endoplasmic reticulum (ER) stress while also affecting the ER stress response. In this study, we examined BI-1-induced regulation of the ER stress response as well as the control of the protein over cell death under ER stress. In BI-1-overexpressing cells (BI-1 cells), proteasome activity was similar to that of control cells; however, the lysosomal fraction of BI-1 cells showed sensitivity to degradation of BSA. In addition, areas and polygonal lengths of lysosomes were greater in BI-1 cells than in control cells, as assessed by fluorescence and electron microscopy. In BI-1 cells, lysosomal pH was lower than in control cells and lysosomal vacuolar H(+)-ATPase(V-ATPase), a proton pump, was activated, suggesting high H(+) uptake into lysosomes. Even when exposed to ER stress, BI-1 cells maintained high levels of lysosomal activities, including V-ATPase activity. Bafilomycin, a V-ATPase inhibitor, leads to the reversal of BI-1-induced regulation of ER stress response and cell death due to ER stress. In BI-1 knock-out mouse embryo fibroblasts, lysosomal activity and number per cell were relatively lower than in BI-1 wild-type cells. This study suggests that highly maintained lysosomal activity may be one of the mechanisms by which BI-1 exerts its regulatory effects on the ER stress response and cell death.

Development of chitosan-based ondansetron buccal delivery system for the treatment of emesis.

BACKGROUND: For the buccal drug delivery, chitosan (CS) can be used to improve drug absorption and reduce application frequency and drug amount. The aim of this study is to develop and evaluate mucoadhesive ondansetron buccal films for the treatment of emesis using CS as a mucoadhesive polymer. METHODS: The film prepared by solvent casting method was comprised of ondansetron (approximately 65 µg)-loaded mucoadhesive gels containing 1, 2 or 3% CS and impermeable backing layer. Rheological property of the gels, physiochemical properties of the films (weight, thickness, drug content, swelling ratio, adhesion time and mucoadhesive force) and in vitro ondansetron release profile from the films were determined to evaluate the formulation. The films containing 3% CS (diameter: 0.5 cm; thickness: 170 µm) was selected as the novel formulation, and were used for the in vivo study. Comparative pharmacokinetic studies of ondansetron with this film and oral solution were performed at the same dose in hamsters. RESULTS: The mean values of T(max) and C(max) of the film and oral solution were similar. However, the half-life, mean residence time and AUC(0-24 h) of the film were about 1.7, 1.4 and 2.0-fold higher than those of the oral solution, respectively. The film showed enhanced bioavailability and prolonged efficacy compared to the oral solution. CONCLUSIONS: The mucoadhesive ondansetron buccal film may be a potential alternative to the marketed oral formulation, parenterals and solid suppositories with better patient compliance and higher bioavailability for the treatment of emesis.

Delayed cauda equina syndrome by nerve root incarceration after caudal epidural block: A case report.

INTRODUCTION AND IMPORTANCE: Caudal epidural block has been commonly practiced in recent years and is used for management of pain before surgery and chronic back pain in adult spine diseases. CASE PRESENTATION: A 58-year-old man visited the outpatient clinic complaining of recently aggravated severe low back pain, saddle anesthesia, and unbearable radiating pain in his left leg, with a previous history of caudal epidural block. He had problems with bladder and bowel function. Emergency exploration for cauda equina syndrome (CES) was performed. Decompression, extradural herniation, and entrapment of a cauda equina filament through a dural defect were observed, and surgical reduction with dural repair was performed. CLINICAL DISCUSSION: The clinical signs at onset suggested cauda equina dysfunction after caudal epidural block. Magnetic resonance imaging showed spinal canal stenosis with a paracentral herniated intervertebral disc at the L4-L5 level without any other dural or nerve root abnormality. Exploration was the only option to identify the lesion. CONCLUSION: This is the first case report of CES caused by extradural nerve root herniation and strangulation after caudal epidural block.

Tailored Self-Assembled Monolayer using Chemical Coupling for Indium-Gallium-Zinc Oxide Thin-Film Transistors: Multifunctional Copper Diffusion Barrier.

Controlling the contact properties of a copper (Cu) electrode is an important process for improving the performance of an amorphous indium-gallium-zinc oxide (a-IGZO) thin-film transistor (TFT) for high-speed applications, owing to the low resistance-capacitance product constant of Cu. One of the many challenges in Cu application to a-IGZO is inhibiting high diffusivity, which causes degradation in the performance of a-IGZO TFT by forming electron trap states. A self-assembled monolayer (SAM) can perfectly act as a Cu diffusion barrier (DB) and passivation layer that prevents moisture and oxygen, which can deteriorate the TFT on-off performance. However, traditional SAM materials have high contact resistance and low mechanical-adhesion properties. In this study, we demonstrate that tailoring the SAM using the chemical coupling method can enhance the electrical and mechanical properties of a-IGZO TFTs. The doping effects from the dipole moment of the tailored SAMs enhance the electrical properties of a-IGZO TFTs, resulting in a field-effect mobility of 13.87 cm2/V·s, an on-off ratio above 107, and a low contact resistance of 612 Ω. Because of the high electrical performance of tailored SAMs, they function as a Cu DB and a passivation layer. Moreover, a selectively tailored functional group can improve the adhesion properties between Cu and a-IGZO. These multifunctionally tailored SAMs can be a promising candidate for a very thin Cu DB in future electronic technology.

Transdermal delivery of low molecular weight heparin loaded in flexible liposomes with bioavailability enhancement: comparison with ethosomes.

Low molecular weight heparin (LMWH)-loaded flexible liposomes (flexosomes) were formulated for transdermal delivery, and their physicochemical and pharmacokinetic parameters were compared with LMWH-loaded ethosomes. Flexosomes had similar particle size compared with ethosomes, but their deformability was higher than that of ethosomes (76.7% vs. 46.8%). In vitro, flexosomes demonstrated 2.6-fold higher permeability coefficient than ethosomes. In comparison to LMWH aqueous solution, skin deposition of flexosome increased 3.2-fold, while that of ethosome increased only 2.0-fold. In vivo, after the topical application of flexosome to hairless mouse, [anti-Xa](max) was 1.11 IU/mL, while ethosomes showed only 0.32 IU/mL. Moreover, AUC(0-24 h) of flexosomes was 2.5-fold higher than ethosomes. In conclusion, the enhanced skin permeation and bioavailability of LMWH can be achieved with flexosomes in comparison with ethosomes. The LMWH transdermal delivery via flexosomes has the potential to replace the parenteral dosage forms for the treatment of venous thromboembolism, pulmonary embolism and cardiovascular events.

Low Psoas Lumbar Vertebral Index Is Associated with Mortality after Hip Fracture Surgery in Elderly Patients: A Retrospective Analysis.

The psoas-to-lumbar index (PLVI) has been reported as a simple and easy way to measure central sarcopenia. However, only few studies have evaluated the association between PLVI and survival in surgical patients. This study evaluated the association between preoperative PLVI and mortality in elderly patients who underwent hip fracture surgery. We retrospectively analyzed 615 patients who underwent hip fracture surgery between January 2014 and December 2018. The median value of each PLVI was calculated according to sex, and the patients were categorized into two groups on the basis of the median value (low PLVI group vs. high PLVI group). Cox regression analysis was performed to evaluate the risk factors for 1 year and overall mortalities. The median values of PLVI were 0.62 and 0.50 in men and women, respectively. In the Cox regression analysis, low PLVI was significantly associated with higher 1 year (hazard ratio (HR): 1.87, 95% confidence interval (CI): 1.18-2.96, p = 0.008) and overall mortalities (HR: 1.51, 95% CI: 1.12-2.03, p = 0.006). Low PLVI was significantly associated with a higher mortality. Therefore, PLVI might be an independent predictor of mortality in elderly patients undergoing hip fracture surgery.

Photo-induced Reactive Oxygen Species Activation for Amorphous Indium-Gallium-Zinc Oxide Thin-Film Transistors Using Sodium Hypochlorite.

We proposed a novel material named sodium hypochlorite (NaClO) solution as a source of activation for amorphous indium-gallium-zinc oxide (a-IGZO) thin-film transistors (TFTs). We reduced the activation temperature from 300 to 150 °C using NaClO solution (concentration: 50%) and obtained satisfactory electrical characteristics of a-IGZO TFTs. The field-effect mobility, threshold voltage, on/off ratio, subthreshold swing, and threshold voltage (Vth) shift under negative bias illumination stress (VG = -20 V and VD = 10.1 V for 10,000 s) of NaClO (50%)-activated a-IGZO TFTs were 10.41 cm2/V·s, 1.51 V, 2.78 × 108, 0.37 V/dec, and -5.43 V, respectively. Also, the Vth shifts of the NaClO (50%)-activated a-IGZO TFTs (150 °C) under the positive bias stress test decreased from 5.01 to 1.87 V (VG = 20 V and VD = 10.1 V for 10,000 s) compared with that of only-annealed (300 °C) a-IGZO TFTs. Also, the mechanism of NaClO activation for a-IGZO TFTs is clarified through photo-assisted oxygen radical (POR) and heat-driven oxygen radical (HOR) effects. The POR and HOR effects generated the reactive oxygen species (ROS) from NaClO solution (50%), which activated a-IGZO TFTs at a low temperature (150 °C). When the NaClO solution (50%) was exposed to external energy, it generated ROS such as hydroxyl radicals (OH•), hydroperoxyl radicals (HO2•), and oxygen radicals (O•), which promoted the formation of strong metal-oxide bonds in a-IGZO TFTs. Furthermore, NaClO solution (50%) was applied to a-IGZO TFTs on a flexible polyimide substrate and electrohydrodynamic printing process for selective deposition.

Vertically Graded Oxygen Deficiency for Improving Electrical Characteristics and Stability of Indium Gallium Zinc Oxide Thin-Film Transistors.

We investigated a facile fabrication method, which is an insertion of a carrier-induced interlayer (CII) between the oxygen-rich a-IGZO channel and the gate insulator to improve the electrical characteristics and stability of amorphous indium-gallium-zinc-oxide thin-film transistors (a-IGZO TFTs). The a-IGZO channel is deposited with additional oxygen gas flow during a-IGZO channel deposition to improve the stability of the a-IGZO TFTs. The CII is a less than 10 nm thick deposited thin film that acts to absorb the oxygen from the a-IGZO front channel through oxidation. Through oxidation of the CII, the oxygen concentration of the a-IGZO front channel is decreased compared to that of the oxygen-rich back channel, which forms a vertically graded oxygen deficiency (VGO) in the a-IGZO channel. Therefore, the electrical characteristics of the VGO TFTs are improved by increasing the carrier concentration of the front channel as the oxygen vacancy concentration in the front channel is increased through the oxidation of the CII. At the same time, the stability of the VGO TFTs is improved by maintaining a high oxygen concentration in the back channel even after oxidation of the CII. The field-effect mobility (µFET) of the VGO TFTs improved compared to that of the a-IGZO TFTs from 7.16 ± 0.6 to 12.0 ± 0.7 cm2/V·s. The threshold voltage (Vth) shifts under positive bias temperature stress and negative bias temperature illumination stress decreased from 6.00 to 2.95 V and -15.58 to -8.99 V, respectively.

Ultrasound-Guided Anterior Quadratus Lumborum Block Reduces Postoperative Opioid Consumption and Related Side Effects in Patients Undergoing Total Hip Replacement Arthroplasty: A Propensity Score-Matched Cohort Study.

Quadratus lumborum block (QLB) has been shown to be effective for pain relief after hip surgery. This study evaluated the efficacy of ultrasound-guided anterior QLB in pain control after total replacement hip arthroplasty (TRHA). A total of 115 patients receiving anterior QLB were propensity score-matched with 115 patients who did not receive the block. The primary outcome was opioid consumption at 24, 24-48, and 48 postoperative hours. Secondary outcomes included pain scores at the post-anesthesia care unit (PACU), 8, 16, 24, 32, 40, and 48 h length of hospital stay, time to first ambulation, and the incidence of opioid-related side effects. Postoperative opioid consumption 48 h after surgery was significantly lower in the QLB group. Resting, mean, worst, and the difference of resting pain scores compared with preoperative values were significantly lower in the QLB group during the 48 postoperative hours. The length of hospital stay was shorter in the QLB group. The incidence of postoperative nausea and vomiting was significantly lower in the QLB group during the 48 postoperative hours, except at the PACU. This study suggests that anterior QLB provides effective postoperative analgesia for patients undergoing THRA performed using the posterolateral approach.

Multifunctional Oxygen Scavenger Layer for High-Performance Oxide Thin-Film Transistors with Low-Temperature Processing.

In this study, the oxygen scavenger layer (OSL) is proposed as a back channel in the bilayer channel to enhance both the electrical characteristics and stability of an amorphous indium-gallium-zinc oxide thin-film transistor (a-IGZO TFT) and also to enable its fabrication at low temperature. The OSL is a hafnium (Hf)-doped a-IGZO channel layer deposited by radio-frequency magnetron cosputtering. Amorphous IGZO TFTs with the OSL, even if annealed at a low temperature (200 °C), exhibited improved electrical characteristics and stability under positive bias temperature stress (PBTS) compared to those without the OSL, specifically in terms of field-effect mobility (31.08 vs 9.25 cm2/V s), on/off current ratio (1.73 × 1010 vs 8.68 × 108), and subthreshold swing (0.32 vs 0.43 V/decade). The threshold voltage shift under PBTS at 50 °C for 10,000 s decreased from 9.22 to 2.31 V. These enhancements are attributed to Hf in the OSL, which absorbs oxygen ions from the a-IGZO front channel near the interface between a-IGZO and the OSL.

p38 Mitogen-activated protein kinase is involved in endoplasmic reticulum stress-induced cell death and autophagy in human gingival fibroblasts.

Inflammation or hypoxia in gingival tissue can induce endoplasmic reticulum (ER) stress, which is related with autophagy. The autophagy is a catabolic process involving the degradation of a cell's own components. Although autophagy resulting in the total destruction of the cell is one of cell death types, no conclusive evidence exists for such a process. In order to examine the association of ER stress and autophagy in gingival system, ER stress agents brefeldin A, thapsigargin, and tunicamycin were exposed to human gingival cells. The ER stress agents induced cell death and the expression of ER stress proteins, glucose-regulated protein of 78 kDa (GRP78) and CCAAT/enhancer-binding protein (C/EBP) homologous protein (CHOP). ER stress also increased the formation of autophagic vesicles with the expression of beclin and LC-3 (microtubule-associated protein1 light chain 3) II, two autophagic markers. ER stress induced the phosphorylation of p38MAPK (mitogen-activated protein kinase), and the p38MPAK inhibitor, SB203580, inhibited the resulting cell death and autophagy. In summary, ER stress induces cell death and autophagy through p38MAPK in human gingival cells.

Effect of zinc oxide on the rheological and mucoadhesive properties of poloxamer 407-based mucoadhesive thermosensitive gel.

BACKGROUND: To improve the therapeutic efficacy of drugs for hemorrhoid, mucoadhesive thermosensitive gel (MTG) system was developed. METHODS: The MTG was prepared using poloxamer 407 (P407, 13% and 14%), polycarbophil (PC, 0.2% w/v), phenylephrine hydrochloride (0.25% w/v), lidocaine hydrochloride (1.88% w/v), and prednisolone acetate (0.05% w/v). Then, zinc oxide (ZnO) was added as an astringent as well as mucoadhesiveness-enhancing agent. Two kinds of poloxamer-based MTGs were compared in aspects of rheology, mucoadhesiveness, syringeability, and in vitro release study. RESULTS: Both the two MTGs (13% and 14% P407) showed Newtonian behavior at 20°C whereas pseudoplastic flow at 37°C. The addition of ZnO into MTGs enhanced the mucoadhesiveness and syringeability and led the drug components to be released in accordance with Fickian mechanism. CONCLUSIONS: Taken together, the MTG-containing ZnO can be a more effective and convenient delivery system for the treatment of hemorrhoid with a reduced dosage interval.