Preparation, structure characterization, and stability analysis of peptide-calcium complex derived from porcine nasal cartilage type II collagen.

BACKGROUND: Porcine nasal cartilage type II collagen-derived peptides (PNCPs) may be complexed with calcium to provide a highly bioavailable, low-cost, and effective calcium food supplement. However, the calcium-binding characteristics of PNCPs have not yet been investigated. In the present study, calcium-binding peptides were derived from porcine nasal cartilage type II collagen and the resulting PNCPs-Ca complex was characterized. RESULTS: The study reveals that the calcium-binding capacity of PNCPs is closely related to enzymatic hydrolysis conditions. The highest calcium-binding capacity of PNCPs was observed at a hydrolysis time of 4 h, temperature of 40 °C, enzyme dosage of 1%, and solid-to-liquid ratio of 1:10. Scanning electron microscopy and energy dispersive X-ray spectroscopy revealed that the PNCPs had a pronounced capacity for calcium binding, with the PNCPs-Ca complex exhibiting a clustered structure consisting of aggregated spherical particles. Fourier-transform infrared spectroscopy, fluorescence spectroscopy, X-ray diffraction, dynamic light scattering, amino acid composition, and molecular weight distribution analyses all indicated that the PNCPs and calcium complexed via the carboxyl oxygen and amino nitrogen atoms, leading to the formation of a ß-sheet structure during the chelation process. In addition, the stability of the PNCPs-Ca complex was maintained over a range of pH values consistent with those found in the human gastrointestinal tract, facilitating calcium absorption. CONCLUSION: These research findings suggest the feasibility of converting by-products from livestock processing into calcium-binding peptides, providing a scientific basis for the development of novel calcium supplements and the potential reduction of resource waste. © 2023 Society of Chemical Industry.

Percutaneous rhinolift procedure for droopy tip.

OBJECTIVE: Droopy tip may lead to functional impairment due to nasal valve insufficiency. There are several techniques available in order to correct under rotated tip, including sutures, resection and grafting. The major drawback of these standart procedures is the correction of nasal cartilage framework rather than droopy skin envelope. In this study, we demonstrated the long-term results of percutaneous rhinolift procedure which aids in the correction of cartilage framework position and droopy skin at the same time, in patients who had isolated nasal tip ptosis. METHODS: Seventeen patients with nasal tip ptosis who underwent rhinolift procedure under local anesthesia, between September 2016 and February 2017, included in the study. Nasal obstruction was evaluated by Nasal Obstruction Symptom Evaluation (NOSE) Scale and Visual Analog Scale (VAS) before the procedure, and 1st month and 3rd month after the procedure. Long-term follow-up scores were also analyzed. RESULTS: There was a significant difference between preoperative NOSE scores and 1st, 3rd month and long-term follow-up scores (p < 0.001). When we analyzed the VAS scores of patients, there was significant difference between preoperative scores and 1st month, 3rd month and long-term follow-up scores (p < 0.001). DISCUSSION: Suspension sutures have been used to hang and lift the ptotic tissues of nasal tip. In this study, we found that rhinolift procedure is an effective method for droopy nasal tip cases especially with excess skin volume who cannot undergo a major invasive surgical operation. IMPLICATIONS FOR PRACTICE: It is a conservative and cheap method which does not require general anesthesia.

Guggulipid ameliorates adjuvant-induced arthritis and liver oxidative damage by suppressing inflammatory and oxidative stress mediators.

BACKGROUND: Arthritis is a common degenerative joint disease characterized by deterioration of articular cartilage, subchondral bone, and associated with immobility, pain and inflammation. The incessant action of reactive oxygen species (ROS) during progressive arthritis causes severe oxidative damage to vital organs and circulatory system. PURPOSE: In this study we investigated the ability of guggulipid (GL), a lipid rich extract from the gum resin of the plant Commiphora whighitii to suppress the progressive arthritis and associated liver oxidative stress both in vivo and in vitro. STUDY DESIGN/METHODS: The anti-arthritic ability of GL was demonstrated in vitro using IL-1ß stimulated bovine nasal cartilage model and in vivo Freund's complete adjuvant-induced arthritic rat model. Collagen/proteoglycan degradation and pro-inflammatory mediators were monitored in the harvested culture medium of nasal cartilage by estimating the levels of matrix metalloproteinases (MMPs), hydroxy proline, glycosaminoglycans and inflammatory mediators. Further, anti-arthritic ability of GL was evaluated in vivo by measuring enzymatic and non-enzymatic mediators of cartilage degradation, inflammation and oxidative stress markers. RESULTS: GL significantly inhibited the IL-1ß stimulated cartilage degradation in vitro by mitigating the MMPs activity, collagen degradation and secretion of pro-inflammatory mediators. Further, GL significantly reduced the adjuvant-induced paw swelling and body weight loss in vivo. GL remarkably reduced the MMPs and hyaluronidases activities in serum and bone homogenate along with altered hematological parameters. GL also mitigated the elevated bone resorbing enzymes cathepsins, exoglycosidases and phosphatases. Additionally, GL effectively mitigated ROS and oxidative stress-mediators recuperating the altered serum/liver oxidative stress and liver damage incurred during arthritic progression. CONCLUSION: In summary, the study clearly demonstrates the protective efficacy of GL against arthritis and its associated oxidative stress, particularly, liver oxidative damage. Hence, GL could be a potential alternative and complementary medicine to treat inflammatory joint diseases.

Innovations in nasal valve surgery.

PURPOSE OF REVIEW: This article reviews current practices in nasal valve repair and highlights recent innovations in the medical literature. RECENT FINDINGS: A surgeon's choice regarding a proper nasal valve repair technique depends heavily on the patient's site of obstruction. While classical maneuvers to improve the internal and external nasal valves have been employed for several decades, increasing understanding of lateral wall insufficiency and its role in nasal valve compromise has led to improvement of proposed methods for correcting the nasal valve. Radiofrequency-induced thermotherapy, the upper lateral strut graft, stairstep graft, and nasal valve lift techniques are described in detail. These four techniques offer innovative means of dealing with the challenge of nasal valve collapse resulting in nasal obstruction. SUMMARY: This review article provides an overview of the current practice in the field of nasal valve repair and summarizes recent technical advances in the field.

The Soft Triangle: An Often Neglected Area in Rhinoplasty.

BACKGROUND: This study aims to focus on one of the lesser mentioned topics in discussions of aesthetic nose operations, the soft triangle. In addition to outlining the characteristics of the area, the various complications specific to the soft triangle are discussed along with methods and techniques utilized by the authors to avoid such complications. METHODS: One hundred twenty-seven of 841 (15 %) patients who were assessed both preoperatively and intraoperatively for the presence of an anatomical issue of the soft triangle were included in the study. Patients were divided into three groups according to their anatomical features that were identified intraoperatively. The preoperative and postoperative photographs of all patients were compared to assess the effects of the respective soft triangle grafts on both nostril length and the nostril/lobule harmony. RESULTS: The average follow-up time of the patients was 27 months (6-60). Postoperative notching (of various degrees) was found in six (6/127) total patients: one (1/31) patient in the first group, two (2/24) patients in the second group, and three (3/72) patients in the third group. CONCLUSION: Neglecting the soft triangle area might yield grim results in terms of cosmetic and functional aspects. To avoid these problems, incisions should be planned purposefully, and patients who have anatomically weak support should be identified so that additional precautions should be taken for these cases. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Poly(γ-Glutamic Acid) as an Exogenous Promoter of Chondrogenic Differentiation of Human Mesenchymal Stem/Stromal Cells.

Cartilage damage and/or aging effects can cause constant pain, which limits the patient's quality of life. Although different strategies have been proposed to enhance the limited regenerative capacity of cartilage tissue, the full production of native and functional cartilaginous extracellular matrix (ECM) has not yet been achieved. Poly(γ-glutamic acid) (γ-PGA), a naturally occurring polyamino acid, biodegradable into glutamate residues, has been explored for tissue regeneration. In this work, γ-PGA's ability to support the production of cartilaginous ECM by human bone marrow mesenchymal stem/stromal cells (MSCs) and nasal chondrocytes (NCs) was investigated. MSC and NC pellets were cultured in basal medium (BM), chondrogenic medium (CM), and CM-γ-PGA-supplemented medium (CM+γ-PGA) over a period of 21 days. Pellet size/shape was monitored with time. At 14 and 21 days of culture, the presence of sulfated glycosaminoglycans (sGAGs), type II collagen (Col II), Sox-9, aggrecan, type XI collagen (Col XI), type X collagen (Col X), calcium deposits, and type I collagen (Col I) was analyzed. After excluding γ-PGA's cytotoxicity, earlier cell condensation, higher sGAG content, Col II, Sox-9 (day 14), aggrecan, and Col X (day 14) production was observed in γ-PGA-supplemented MSC cultures, with no signs of mineralization or Col I. These effects were not evident with NCs. However, Sox-9 (at day 14) and Col X (at days 14 and 21) were increased, decreased, or absent, respectively. Overall, γ-PGA improved chondrogenic differentiation of MSCs, increasing ECM production earlier in culture. It is proposed that γ-PGA incorporation in novel biomaterials has a beneficial impact on future approaches for cartilage regeneration.

Nasal anatomy for the dermatological surgeon.

The nose is an important site of skin pathology and skin cancer in particular, underlining the importance of the nose to the practice of dermatology. This article is intended to serve as an overview of the anatomy of the nose for dermatologists and dermatological surgeons. Areas of clinical relevance are emphasized with examples.

Identification of proteoglycan from salmon nasal cartilage.

There has been no structural information about the core protein of salmon nasal cartilage proteoglycan although its physiological activities have been investigated. Internal amino acid sequencing using nano-LC/MS/MS revealed that the salmon proteoglycan was aggrecan. Primer walk sequencing based on the amino acid information determined that the salmon aggrecan cDNA is comprised of 4207bp nucleotides predicted to encode 1324 amino acids with a molecular mass of 143,276. It exhibited significant similarities to predicted pufferfish aggrecan, zebrafish similar to aggrecan, zebrafish aggrecan, bovine aggrecan and human aggrecan isoform 2 precursor; whose amino acid identities were 56%, 55%, 49%, 31% and 30%, respectively. Salmon cartilage aggrecan had globular domains G1, G2 and G3 as in mammalian aggrecans. Neither the putative keratan sulfate attachment domain enriched with serine, glutamic acid and proline, nor the putative chondroitin sulfate attachment domain with repeating amino acid sequence containing serine-glycine, found in mammalian aggrecans were observed in salmon, however, random serine-glycine (or glycine-serine) sequences predicted to the sugar chain attachment sites were observed. Based on cDNA analysis and amino acid analysis after ß-elimination, the ratio of serine attached to sugar chains was calculated to be approximately 37.7% of total serine, that is, 46 of 123 serine residues.

Infrared laser therapy after surgically assisted rapid palatal expansion to diminish pain and accelerate bone healing.

The aim of this study was to illustrate how gallium arsenite aluminum diode laser (824 nm) irradiation can reduce postsurgical edema and discomfort and accelerate sutural osseous regeneration after surgically assisted rapid palatal expansion (SARPE). An adult patient with an 8-mm transverse maxillary discrepancy was treated with SARPE. Infrared laser therapy was started on the 7th postoperative day, with a total of eight sessions at intervals of 48 hours. The laser probe spot had a size of 0.2827 cm2 and was positioned in contact with the following (bilateral) points: infraorbital foramen, nasal alar, nasopalatine foramen, median palatal suture at the height of the molars, and transverse palatine suture distal to the second molars. The laser was run in continuous mode with a power of 100 mW and a fluency of 1.5 J/cm2 for 20 seconds at each point. Subsequently, an absence of edema and pain was observed. Further, fast bone regeneration in the median palatal suture could be demonstrated by occlusal radiographs. These findings suggest that laser therapy can accelerate bone regeneration of the median palatal suture in patients who have undergone SARPE.

Regional nerve blockade prior to direct injection to achieve anaesthesia of the nasal ala.

BACKGROUND: Dermatological surgical procedures involving the nasal alae are commonplace in clinical practice. Direct infiltration of local anaesthetic into the nasal ala is extremely uncomfortable. OBJECTIVES: In this prospective clinical study, we investigate the effectiveness of alar anaesthesia provided by an infraorbital nerve block (IOB). METHODS: We recruited 100 consecutive patients requiring dermatological surgical procedures involving the nasal ala (or other sites necessitating an IOB). Following topical mucosal anaesthesia, an IOB was administered via the intraoral route. Effectiveness of anaesthesia was assessed after 10 min by testing the perception of a sharp stimulus at five standardized reference points on the nasal ala. If the ala was not completely anaesthetized, blockade of the external nasal branch of the anterior ethmoidal nerve (external nerve block, ENB) was performed. Sensation of the nasal ala was re-assessed after 10 min using the above method. RESULTS: Complete anaesthesia of the nasal ala was achieved with an IOB in 66 of 100 (66%) patients. Of the remaining 34 patients, the addition of an ENB achieved complete anaesthesia in 15 (44%). CONCLUSIONS: An IOB provides effective alar anaesthesia in the majority of patients. In those where it is ineffective for complete anaesthesia, an ENB is a useful adjunct. We recommend using an IOB (and ENB if required) prior to direct infiltration of local anaesthetic into the nasal ala to reduce patient discomfort.

Sulfasalazine blocks the release of proteoglycan and collagen from cytokine stimulated cartilage and down-regulates metalloproteinases.

OBJECTIVE: To investigate the effect of SSZ on the release of GAG and collagen fragments from bovine nasal cartilage and MMP and ADAMTS (a disintegrin and metalloproteinase domain with thrombospondin motifs) proteinases from human articular chondrocytes (HACs) stimulated with IL-1alpha and oncostatin M (OSM). METHODS: SSZ was added to bovine nasal explant cultures stimulated to resorb with IL-1alpha and OSM, and the release of GAG and collagen has been determined. Collagenolytic activity was measured using the radio-labelled collagen bioassay. HACs were treated with IL-1alpha and OSM with and without SSZ, and MMP-1 and -13 and ADAMTS-4 and -5 were measured for protein and gene expression by ELISA and RT-PCR, respectively. RESULTS: SSZ blocked GAG and collagen fragment release from bovine cartilage, and reduced active and total collagenase activity in a dose-dependent manner. SSZ transcriptionally blocked MMP-1, -13 and ADAMTS-4, and reduced the protein levels of MMP-1 and -13 in a dose-dependent manner following stimulation of HACs with IL-1alpha and OSM. CONCLUSION: This study shows for the first time that SSZ blocks release of proteoglycan and collagen fragments from resorbing cartilage and lowers the levels of proteoglycan and collagen-degrading enzymes. These results indicate that in addition to acting as an anti-inflammatory agent, SSZ may have a therapeutic role in protecting cartilage from damage in OA.

The effects of laser irradiation of cartilage on chondrocyte gene expression and the collagen matrix.

OBJECTIVES: Laser reshaping of cartilage is an emerging technology aimed at replacing conventional techniques for aesthetic and reconstructive surgery. Little is known about the mechanisms of wound healing following the photothermal heating during laser reshaping and, ultimately, how collagen remodels in the irradiated tissue. Healthy hyaline and elastic cartilage as found in the ear, nose, larynx, and trachea does not express collagen type I which is characteristic of fibro-cartilage and scar tissue. The aim of the study was to determine if collagen I and II gene expression occurs within laser irradiated rabbit septal cartilage. METHODS: Nasal septum harvested from freshly euthanized New Zealand White rabbits were irradiated with an Nd:YAG laser. After 2 weeks in culture, the laser spot and surrounding non-irradiated regions were imaged using immunofluorescence staining and evaluated using reverse transcription polymerase chain reaction (RT-PCR) to determine the presence of collagen I and II, and ascertain collagen I and II gene expression, respectively. RESULTS: All laser irradiated specimens showed a cessation in collagen II gene expression within the center of the laser spot. Collagen II was expressed in the surrounding region encircling the laser spot and within the non-irradiated periphery in all specimens. Immunohistochemistry identified only type II collagen. Neither collagen I gene expression nor immunoreactivity were identified in any specimens regardless or irradiation parameters. CONCLUSIONS: Laser irradiation of rabbit septal cartilage using dosimetry parameters similar to those used in laser reshaping does not result in the detection of either collagen I gene expression or immunoreactivity. Only collagen type II was noted after laser exposure in vitro following cell culture, which suggests that the cellular response to laser irradiation is distinct from that observed in conventional wound healing. Laser irradiation of cartilage can leave an intact collagen matrix which likely allows chondrocyte recovery on an intact scaffold.

Long-term outcomes of a rhinolift procedure for obstructive symptoms in the aging nose in 2 patients.

Age-related changes in the structure of the nose can obstruct the nasal airway and adversely affect quality of life. Several procedures are available to restore the patency of the airway, but not all are appropriate for all patients. Also, long-term outcomes data on such procedures are lacking. We describe our use of a rhinolift procedure with local anesthesia to correct nasal obstruction caused by nasal tip ptosis in 2 elderly men. In both cases, the procedure resulted in a complete or near-complete resolution of obstructive symptoms. We also conducted long-term follow-up of these 2 patients. Both experienced a recurrence of symptoms 1 to 2 years postoperatively. We conclude that the rhinolift procedure we describe is safe and effective for the short-term relief of age-related nasal obstruction in selected patients.

Surgical correction of the short nose.

The primary emphasis of the operation to achieve maximum nasal lengthening is based on: (l) a release of soft tissue including the mucoperichondrium; (2) release of the soft tissue between the upper lateral cartilage and the lower lateral cartilage; and (3) attachment of a batten graft to the septum to project the tip cartilages caudally. Case examples of the results of the open approach are given. In those cases in which the closed technique must be used, a modified technique is utilized. This involves a hemitransfixion incision and elevation of the mucoperichondrium bilaterally, followed by a batten graft.