ABSTRACT
Polyguluronate (PG) is an acidic homopolymer of α-(1,4)-l-guluronate separated from alginate. In this study, PG was first grafted with soy protein isolate (SPI) through the Maillard reaction to obtain a new glycoprotein (SPI-PG). Then, this novel glycoprotein was used to prepare nanoparticles to encapsulate the resveratrol (RES). Our results showed that SPI-PG-RES had better pH stability, storage stability and ionic stability than SPI-RES. In vitro digestion experiments showed that the RES bioavailability of SPI-PG-RES was much higher than that of free RES and SPI-RES. Furthermore, the in vitro antioxidant capacity of SPI-PG-RES was much stronger than that of free RES and SPI-RES. In addition, SPI-PG-RES was more effective in preventing the symptoms of DSS-induced colitis than RES and SPI-RES. These results suggested that the protein nanoparticles prepared using SPI-PG were a stable and effective hydrophobic polyphenol carrier and could be applied to food-grade components in functional foods and nutritional supplements.
Subject(s)
Nanoparticles , Soybean Proteins , Resveratrol , Soybean Proteins/chemistry , Antioxidants/chemistry , Nanoparticles/chemistryABSTRACT
Polyguluronic acid (PG) is a type of polysaccharide found in edible brown seaweeds. This study synthesized a new sulfated saccharide (SOGA) by sulfating PG-derived unsaturated oligoguluronic acid (OGA). The molecular weight and degree of sulfate-group substitution of SOGA were 1.6 kDa and 1.03, respectively. The structures of PG, OGA, and SOGA were elucidated using FT-IR and NMR spectroscopy. Furthermore, the immunomodulatory effects of PG, OGA, and SOGA on LPS-triggered RAW264.7 and BV2 cells were evaluated. SOGA, but not PG or OGA, significantly reduced the LPS-stimulated overproduction of proinflammatory mediators and suppressed the activation of corresponding signalling pathways. Also, SOGA could actively regulate immune balance by inhibiting apoptosis and pyroapoptosis. These results suggested that SOGA is a potential therapeutic agent for the prevention of diseases associated with immune disorders owing to its remarkable immunomodulatory effects, and that sulfate groups in the carbohydrate chain play a crucial role for its bioactivities.
Subject(s)
Lipopolysaccharides , Sulfates , Lipopolysaccharides/pharmacology , Spectroscopy, Fourier Transform Infrared , Sulfur Oxides , ImmunomodulationABSTRACT
BACKGROUND: The prevention of AIDS among undergraduates in Wuhan is a public health priority. An important strategy for students to prevent AIDS is to establish correct moral concepts and cultivate a healthy lifestyle. INTRODUCTION: Through the investigation of MSM and non-MSM population in college students, this study seeks for possible influencing factors and solutions for AIDS prevention in colleges and universities. METHODS: This study was carried out in 15 universities in Wuhan. We recruited 127 MSM students through peer promotion, and 510 non-MSM students were selected by random cluster sampling. The two groups were investigated by anonymous questionnaire, and the questionnaire information was statistically analyzed. RESULTS: The awareness rate of AIDS-related knowledge among MSM students was 90.8%, while that among non-MSM students, it was 64.6%; neither meets the national requirements. The self- -recognition of MSM undergraduates was 95.0%. Among the 497 non-MSM undergraduates, 65.4% were willing to make friends with the MSM undergraduates. There were statistical differences in the social discrimination attitudes of those who knew AIDS-related knowledge (P<0.01), and the attitudes of those with knowledge of AIDS were more positive. CONCLUSION: The MSM students reported a high incidence of high-risk sexual behaviors and a gap between knowledge and behaviors. This study focuses on the comparison of the characteristics of knowledge, attitude, and behavior on AIDS between the two groups of people. AIDS prevention in colleges and universities requires a new way of thinking.
Subject(s)
Acquired Immunodeficiency Syndrome , HIV Infections , Sexual and Gender Minorities , Acquired Immunodeficiency Syndrome/epidemiology , Acquired Immunodeficiency Syndrome/prevention & control , China/epidemiology , Health Knowledge, Attitudes, Practice , Homosexuality, Male , Humans , Male , Sexual Behavior , Students , Surveys and QuestionnairesABSTRACT
Medial epicondyle fractures are the 3rd most common pediatric elbow fractures. Regardless of treatment method, some degree of elbow motion loss has been reported. The purpose of our study was to determine the relationship between the amount of anterior fracture displacement and loss of elbow passive extension in an adult cadaveric medial epicondyle fracture model. Fifteen fresh frozen adult cadavers were procured to create fracture models at scenarios of 2, 5, 10 mm, and maximum displacement. Terminal elbow extension was recorded for each cadaveric model at each fracture scenario. A linear mixed model regression analysis was used to test the association between fracture displacement and loss of terminal elbow passive extension. At 2 mm of displacement, the average loss of terminal extension was 3.89°; at 5 mm, it was 7°; at 10 mm, it was 10.7°; at maximum displacement (~15 mm), it was 17°. A statistically significant positive linear association between fracture displacement and loss of terminal elbow extension was observed (5 mm of displacement = loss of ~4.7°). In our fracture model, when the medial epicondyle displaced anteriorly, we noticed a change in the tension of the medial collateral ligaments which lead to a decrease in terminal elbow extension. However, this only contributed partially to the loss of motion observed clinically in the literature. Even though our findings did not support the recommendation of surgical intervention to prevent loss of elbow motion in medial epicondyle fractures, we still encourage physicians to consider the consequence of displacement and its potential influence of elbow range of motion.
Subject(s)
Humeral Fractures/physiopathology , Adult , Cadaver , Child , Fracture Fixation, Internal , Humans , Range of Motion, ArticularABSTRACT
PURPOSE: Obtaining elbow flexion to improve hand-to-mouth reach capability is an essential component of achieving functional independence in pediatric patients with arthrogryposis. This study analyzed the long-term outcomes of elbow release and tricepsplasty in a series of children with arthrogryposis at a tertiary institution. METHODS: Medical records of patients with arthrogryposis who underwent elbow release and tricepsplasty from 1993 to 2015, with at least 2 years of follow-up, were reviewed. Collected measures included preoperative elbow passive range of motion (ROM), postoperative elbow passive and active ROM, shoulder passive and active ROM, and Pediatric Outcomes Data Collection Instrument (PODCI) scores. Our analysis compared pre- and postoperative follow-up of elbow passive ROM and reviewed PODCI scores with age-adjusted normative values. RESULTS: Seventeen patients (4 female and 13 male) with 24 affected upper extremities (10 left elbow and 14 right elbow) were included in final analysis. Age at final follow-up averaged 11 years (range, 4-20 years), mean age at surgery was 2.7 years (range, 9.6 months-9.3 years) with mean follow-up by extremity at 8.3 years (range, 2-18 years). Differences in pre- and post-operative passive elbow ROM were significant for extension, flexion, and total arc of motion. Most parent and self-reported PODCI scores were less than the age-adjusted normal population, except in the domains of Comfort and Pain and Happiness. CONCLUSION: Long-term follow-up of elbow release and tricepsplasty in patients with arthrogryposis indicates both increased and sustained elbow flexion and arc of motion. Although PODCI scores were lower compared with the age-adjusted norm, pediatric patients with arthrogryposis were just as happy and had no more discomfort than their unaffected age-adjusted norms. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.
Subject(s)
Arthrogryposis , Elbow Joint , Arthrogryposis/surgery , Child , Elbow , Elbow Joint/surgery , Female , Follow-Up Studies , Humans , Male , Range of Motion, Articular , Retrospective StudiesABSTRACT
BACKGROUND: Controversy exists with regard to the amount of fracture displacement that warrants surgical fixation of medial epicondyle fractures. Inaccurate determination of degree of displacement on plain radiographs may account for the disputed management. Recently, a novel distal humerus axial radiograph technique has been developed to improve the accuracy of radiographs. The purposes of the study are 2-fold; to identify the anatomic orientation of the medial elbow epicondyle physis in children and to compare the accuracy of determining fracture displacement between axial radiographs and standard anterior-posterior (AP) radiographs in a cadaveric medial epicondyle fracture model. METHODS: Twelve pediatric elbow computed tomographic scans and 19 pediatric elbow magnetic resonance imaging scans were analyzed for the orientation of the medial elbow physis. After determining the correct orientation, 15 adult cadaveric medial epicondyle fracture models were created at displacements of 2, 5, 10 mm, and maximum displacement with elbow at 90 degrees of flexion. A linear mixed model regression analysis was used to compare displacement based on the axial versus the AP radiographic methods. RESULTS: The medial epicondyle physis was found to be a posterior structure angled distally at ~36 degrees (range, 10.7 to 49.6) and angled posteriorly at 45 degrees (range, 32.2 to 59). The AP radiograph significantly underestimated displacement relative to the axial radiograph at 5 mm [mean difference, -1.6; 95% confidence interval (CI), -2.9 to -0.3], at 10 mm (mean difference, -4.5; 95% CI, -5.8 to -3.2 mm), and at maximal displacement (mean, 15 mm; range, 13 to 20 mm) (mean difference, -7.1; 95% CI, -8.3 to -5.8). CONCLUSIONS: The medial epicondyle physis of the distal humerus is a posterior structure angled distally and posteriorly. When displacement was >5 mm, the distal humerus axial radiograph technique was significantly more accurate than the AP radiograph technique at determining actual fracture displacement in our adult cadaveric fracture models. Therefore, we recommend clinicians to include the axial radiograph view during the evaluation of patients with medial epicondyle fractures. CLINICAL RELEVANCE: This study provides further insight into the location and orientation of the medial humeral epicondyle physis, and further supports the improved accuracy of the distal humerus axial radiograph at detecting displacement in medial epicondyle fractures.
Subject(s)
Growth Plate/diagnostic imaging , Humeral Fractures/diagnostic imaging , Humerus/diagnostic imaging , Magnetic Resonance Imaging/methods , Tomography, X-Ray Computed/methods , Adolescent , Cadaver , Child , Elbow Joint/diagnostic imaging , Epiphyses/anatomy & histology , Epiphyses/diagnostic imaging , Growth Plate/anatomy & histology , Humans , Humerus/anatomy & histologyABSTRACT
PURPOSE: To investigate the ideal suture material to test strain at nerve repair sites. Based on nerve strain tolerance, we aimed to determine which suture reliably failed by an average of 5% and a maximum of 8% strain when loaded to failure. METHODS: The median nerve of 19 cadavers was exposed in the distal forearm, transected proximally, and attached to a spring gauge. It was marked 5 cm on either side of its midpoint to measure strain. A laceration was created at its midpoint. We performed a tension-free end-to-end repair with a single epineural suture. Load to failure of the repair site was recorded. We recorded strain at failure and mode of failure (pullout vs breakage). Eight different sutures were tested: 6-0, 8-0, 9-0, and 10-0 nylon; and 6-0, 7-0, 8-0, and 10-0 polypropylene. RESULTS: Average strain at failure of 9-0 nylon most closely approximated 5% (4.9%). Moreover, 8-0 polypropylene and 10-0 nylon and polypropylene failed with average strains less than 5% and a maximum strain of failure less than 8%. Regardless of type, 6-0 to 8-0 caliber suture failed primarily by pullout of the suture from the epineurium whereas 9-0 and 10-0 nylon and polypropylene failed by suture breakage. Decreased precision through increased variability was seen when testing sutures failing via pullout. CONCLUSIONS: Nylon suture size 8-0 has been advocated as the suggested intraoperative aid to test strain at nerve repair sites. Our study suggests that 9-0 nylon may be a more appropriate testing suture because of its more predictable failure via breakage and its failure by a threshold of 5% to 8% strain. Although 8-0 nylon and polypropylene may also represent reasonable testing sutures, 8-0 nylon failed on average above 5% strain, with strains exceeding 8%, and both failed via the mechanism of pullout. CLINICAL RELEVANCE: This study's findings provide information for surgeons attempting to decide during surgery whether to perform direct nerve repair.
Subject(s)
Median Nerve/surgery , Suture Techniques , Sutures , Tensile Strength , Cadaver , Humans , Materials Testing , Nylons , Polypropylenes , Weight-BearingABSTRACT
Thoracic obstruction is mainly attributed to the scope of coronary heart disease in modern medicine, and traditional Chinese medicine(TCM) shows a significant effect in the treatment of thoracic obstruction. In this research, a network pharmacology method was carried out to systemically study the underlying mechanism of the core herbal compatibility in TCM on the thoracic obstruction. First, we collected the literature about TCM prescriptions for treating thoracic obstruction from CNKI. Then, a prescription database was establish by TCM inheritance support platform system(V2.5) to determine the medication rules and core herbal compatibility in TCM. Finally, to obtain the potential signaling pathways, KEGG pathway analysis was performed by BATMAN-TCM online analysis tool. Results showed that the potential signal pathway of core herbal compatibility in TCM for the clinical treatment of thoracic obstruction was calcium ion and cGMP-PKG signaling pathway. This study provided a new research strategy for the study of the medication rules and mechanism of traditional Chinese medicine in the treatment of thoracic obstruction.
Subject(s)
Coronary Disease/drug therapy , Medicine, Chinese Traditional , HumansABSTRACT
BACKGROUND: Smartphone-based thermal imaging (SBTI) allows noninvasive temperature measurements. Its validity compared with a conventional infrared probe temperature scanner (IPTS) has not been studied. This study compares temperature measurements between the 2 technologies on human participants. METHODS: Bilateral index finger temperature measurements were obtained on 30 healthy participants using IPTS and SBTI devices. Dominant versus nondominant sides (side-to-side difference) and individual side measurements between the 2 methods were compared for repeatability (precision) and agreement. RESULTS: A total of 23 female and 7 male participants were tested. Based on nonoverlapping confidence intervals (CIs), intraclass correlation coefficient of repeatability was higher for SBTI than for IPTS measurements in side-to-side differences: 0.97 (95% CI, 0.96-0.99) versus 0.89 (95% CI, 0.82-0.95). The SBTI method recorded higher side-to-side difference and individual side measurements: 0.56°C (limits of agreement [LOA], -1.09°C to 2.20°C) and 2.64°C (LOA, 0.96°C-4.32°C), respectively. CONCLUSIONS: In addition to higher precision, SBTI offers added benefits of instantaneous acquisition of the temperature map of the entire hand, allowing quick comparisons of the uninjured and injured fingers. SBTI measurements consistently yielded higher temperature readings in the side-to-side difference as well as individual measurements. This suggested that both devices are not interchangeable for absolute temperature comparisons but are interchangeable in monitoring the changes in temperatures. This study suggests the potential for SBTI devices to be used in the clinical settings and may be of special benefit in telemedicine.
ABSTRACT
BACKGROUND: Optimization of the electronic medical record (EMR) is essential to support the clinician and to improve the quality and efficiency of patient care. The present report describes the development and implementation of a standardized template that is embedded in the EMR and is focused on a comprehensive physical examination during the evaluation of pediatric supracondylar humeral fractures. We compared the completeness of physical examinations as well as the timing of detection and documentation of neurovascular injuries before and after implementation of the template. We hypothesized that the use of a template would increase the completeness of examinations and would lead to earlier documentation of neurovascular injuries. METHODS: A multidisciplinary quality-improvement task force was created to address neurovascular documentation practices for patients who underwent operative treatment of supracondylar humeral fractures. Following a series of formative and process evaluations, a standardized EMR template was implemented. Neurovascular examination documentation practices that were in use before (pre-template group, n = 224) and after (template group, n = 300) the implementation of the template were compared. Logistic regression analyses of the 2 groups were used to compare the likelihood of a complete neurovascular examination and the timing of neurovascular injury identification. RESULTS: There was significant improvement in the documentation of the vascular (odds ratio [OR], 70.7; 95% confidence interval [CI], 39.5 to 126.6; p < 0.0001), motor (OR, 17.6; 95% CI, 9.5 to 32.7; p < 0.0001), and sensory (OR, 23.9; 95% CI, 12.9 to 44.4; p < 0.0001) examinations in the template group. Neurological injuries were more likely to be identified preoperatively in the template group compared with the pre-template group (OR, 6.8; 95% CI, 1.7 to 27.1; p = 0.0067). CONCLUSIONS: The incorporation of a standardized template in the EMR improved the completeness and timing of documentation of neurological injury. Standardized EMR templates developed by a clinically driven multidisciplinary task force have the potential to improve the quality of clinical documentation and to ease communication among providers. LEVEL OF EVIDENCE: Level III. See Instructions for Authors for a complete description of levels of evidence.
ABSTRACT
In this study, ropivacaine chitosan-loaded microspheres for subcutaneous administration were developed. The systems were characterized in terms of surface morphology, particle size, encapsulation efficiency, and in vitro release behavior. Results showed that the microspheres had drug loading rate of 7.3% and encapsulation efficiency of 91.2%, and their average diameter was 2.62±0.76 µm. The morphology study revealed that the microspheres are uniform monodispersed spheres and did not form aggregates in aqueous solution. It was clearly observed that the release profile of ropivacaine microspheres exhibited a biphasic pattern: the initial burst release within the first 2 hours and a following slower and sustained release over a long time. In vivo, a greater area under the plasma concentration-time curve from 0 to t (AUC0- t ) was obtained from the microspheres (4.27-fold), than from the injection group, which indicated that there was a significantly improved systemic exposure to ropivacaine. Pharmacodynamics result showed that preparing ropivacaine as microsphere preparation could not only extend the drug effect time but also decrease the administration dosage.
Subject(s)
Amides/administration & dosage , Amides/pharmacology , Microspheres , Nerve Block/methods , Sciatic Nerve/drug effects , Amides/chemistry , Animals , Injections, Subcutaneous , Mice , Mice, Inbred Strains , Particle Size , Rats , Rats, Sprague-Dawley , Ropivacaine , Surface PropertiesABSTRACT
Elbow fracture-dislocations destabilize the elbow, preventing functional rehabilitation. If left untreated, they commonly result in functional compromise and poor outcomes. The "terrible triad" injury is classically described as a combination of a coronoid process and radial head fractures, as well as a posterolateral elbow dislocation. Surgical treatment to restore stable elbow range of motion has evolved in the past few decades based on increased understanding of elbow biomechanics and the anatomy of these injuries. This article highlights current concepts in the treatment of these complicated injuries.
Subject(s)
Elbow Injuries , Elbow Joint/physiopathology , Elbow Joint/surgery , Fracture Fixation, Internal/methods , Humans , Joint Dislocations/surgery , Radius Fractures/surgery , Range of Motion, Articular , Ulna Fractures/surgeryABSTRACT
OBJECTIVE: To investigate the computed tomography (CT) manifestations of liver involvement in children with Langerhans cell histiocytosis (LCH). METHODS: Retrospective analysis was performed on 9 LCH children with liver involvement confirmed by clinical, laboratory and pathological examinations to investigate the CT manifestations of this condition. These children, including 6 males and 3 females, had undergone both plain CT scan and dual-phase (the arterial and portal venous phases) contrast-enhanced CT scan. RESULTS: The main CT manifestations included hepatomegaly (8 cases); periportal dendritic hypodense lesions or "periportal halo sign" (7 cases) which were mildly or moderately enhanced in the arterial phase; intrahepatic bile duct dilatation (5 cases); lymphadenopathy in the hepatic hilar or retroperitoneal region (4 cases); and diffuse small hypodense nodules (3 cases), which showed annular enhancement on the contrast-enhanced CT scan. CONCLUSIONS: CT findings may be helpful in the early diagnosis and treatment of LCH in children.
Subject(s)
Histiocytosis, Langerhans-Cell/diagnostic imaging , Liver/diagnostic imaging , Tomography, X-Ray Computed/methods , Child , Child, Preschool , Female , Hepatomegaly/diagnostic imaging , Histiocytosis, Langerhans-Cell/complications , Humans , Infant , Liver/pathology , Male , Retrospective StudiesABSTRACT
We report herein the synthesis of a series of 7-[3-alkoxyimino-4-(methyl)aminopiperidin-1-yl]quinolone/naphthyridone derivatives. In vitro antibacterial activity of these derivatives was evaluated against representative strains, and compared with ciprofloxacin (CPFX), levofloxacin (LVFX) and gemifloxacin (GMFX). The results reveal that all of the target compounds 19a-c and 20 have considerable Gram-positive activity, although they are generally less active than the reference drugs against the Gram-negative strains with some exceptions. Especially, novel compounds 19a2, 19a4 and 19a5 were found to show strong antibacterial activity (MICs: <0.008-0.5µg/mL) against all of the tested 15 Gram-positive strains including MRSA, LVFX- and GMFX-resistant MRSE, and CPFX-, LVFX- and GMFX-resistant MSSA.
Subject(s)
Anti-Bacterial Agents/chemical synthesis , Piperidines/chemistry , Quinolones/chemistry , Anti-Bacterial Agents/chemistry , Anti-Bacterial Agents/pharmacology , Drug Resistance, Bacterial/drug effects , Gram-Negative Bacteria/drug effects , Gram-Positive Bacteria/drug effects , Microbial Sensitivity Tests , Quinolones/chemical synthesis , Quinolones/pharmacology , Structure-Activity RelationshipABSTRACT
A series of novel gemifloxacin (GMFX) derivatives containing a substituted benzyloxime moiety with remarkable improvement in lipophilicity were synthesized. The target compounds evaluated for their in vitro antibacterial activity against representative strains. Our results reveal that most of the target compounds have considerable potency against all of the tested gram-positive strains including MRSA and MRSE (MIC: <0.008-8 µg/mL), although they are generally less active than the references against the gram-negative strains. In particular, compound 11l (MIC: <0.008-4 µg/mL) was found to be 8-2048 and 2-128 times more potent than levofloxacin (LVFX) and GMFX against the gram-positive strains, respectively. Moreover, against MRSA clinical isolates, 11l (MIC(90): 1 µg/mL) is 8-fold more active than GMFX, and 2-fold more active than GMFX and moxifloxacin against MRSE clinical isolates (MIC(90): 4 µg/mL).
Subject(s)
Anti-Bacterial Agents/chemical synthesis , Anti-Bacterial Agents/pharmacology , Bacteria/drug effects , Fluoroquinolones/chemical synthesis , Fluoroquinolones/pharmacology , Naphthyridines/chemical synthesis , Naphthyridines/pharmacology , Oximes/chemistry , Anti-Bacterial Agents/chemistry , Chemistry Techniques, Synthetic , Fluoroquinolones/chemistry , Gemifloxacin , Hydrophobic and Hydrophilic Interactions , Microbial Sensitivity Tests , Naphthyridines/chemistryABSTRACT
Ischemia reperfusion (IR) injury occurs when tissue is reperfused following a period of ischemia, and results from acute inflammation involving various mechanisms. IR injury can occur following a range of circumstances, ranging from a seemingly minor condition to major trauma. The intense inflammatory response has local as well as systemic effects because of the physiological, biochemical and immunological changes that occur during the ischemic and reperfusion periods. The sequellae of the cellular injury of IR may lead to the loss of organ or limb function, or even death. There are many factors which influence the outcome of these injuries, and it is important for clinicians to understand IR injury in order to minimize patient morbidity and mortality. In this paper, we review the pathophysiology, the effects of IR injury in skeletal muscle, and the associated clinical conditions; compartment syndrome, crush syndrome, and vascular injuries.
Subject(s)
Compartment Syndromes/physiopathology , Cytokines/metabolism , Muscle, Skeletal/physiopathology , Neutrophils/metabolism , Reactive Oxygen Species/metabolism , Reperfusion Injury/physiopathology , Animals , Compartment Syndromes/complications , Compartment Syndromes/immunology , Humans , Muscle, Skeletal/blood supply , Reperfusion Injury/complications , Reperfusion Injury/immunology , Time FactorsABSTRACT
We report herein the design and synthesis of novel 7-(3-alkoxyimino-5-amino/methylaminopiperidin-1-yl)fluoroquinolone derivatives based on the structures of new fluoroquinolones IMB and DZH. The antibacterial activity of these newly synthesized compounds was also evaluated and compared with gemifloxacin, ciprofloxacin, and levofloxacin. Results revealed that all of the target compounds 10-27 have good potency in inhibiting the growth of Staphylococcus aureus including MSSA (MIC: 0.125-8 µg/mL), Staphylococcus epidermidis including MRSE (MIC: 0.25-16 µg/mL), Streptococcus pneumoniae (MIC: 0.125-4 µg/mL), and Escherichia coli (MIC: 0.25-0.5 µg/mL). In particular, some compounds showed useful activity against several fluoroquinolone-resistant strains, and the most active compound 15 was found to be 16-128, 2-32, and 4-8-fold more potent than the three reference drugs against fluoroquinolone-resistant MSSA, MRSA, and MRSE.
Subject(s)
Anti-Bacterial Agents/chemical synthesis , Fluoroquinolones/chemistry , Anti-Bacterial Agents/chemistry , Anti-Bacterial Agents/pharmacology , Drug Resistance, Bacterial/drug effects , Escherichia coli/drug effects , Fluoroquinolones/chemical synthesis , Fluoroquinolones/pharmacology , Microbial Sensitivity Tests , Staphylococcus aureus/drug effects , Staphylococcus epidermidis/drug effects , Streptococcus pneumoniae/drug effectsABSTRACT
BACKGROUND: Volar locking plates provide significant structural stability to the distal radius. Failure of a volar locked plating is a rarely reported complication in the literature. CASE PRESENTATION: A 40 year-old, obese female patient who presented with a displaced extraarticular distal radius fracture, underwent open reduction and internal fixation of the fracture using a volar locking plate. Radiographs taken at 10 weeks postoperatively showed failure of fixation with breakage of the four distal locking screws. A hardware removal was performed at 6 months, and the patient was then lost to follow-up. She presented again at 18 months after the first surgery, with significant pain, and radiographic signs of a radial collapse and a fracture-nonunion. A total wrist fusion was performed as the method of choice at that point in time. CONCLUSION: Volar locked plating represents the new "gold standard" of distal radius fracture fixation. However, despite the stability provided by locking plates, hardware failure may occur and lead to a cascade of complications which will ultimately require a wrist fusion, as outlined in this case report. Additional structural support by bone grafting may be needed in selected cases of volar locked plating, particularly in patients with a high risk of developing a fracture-nonunion.
ABSTRACT
AIM: To study the diagnosis of hepatocellular carcinoma (HCC) presenting as bile duct tumor thrombus with no detectable intrahepatic mass. METHODS: Six patients with pathologically proven bile duct HCC thrombi but no intrahepatic mass demonstrated on the preoperative imaging or palpated intrahepatic mass during operative exploration, were collected. Their clinical and imaging data were retrospectively analyzed. The major findings or signs on comprehensive imaging were correlated with the surgical and pathologic findings. RESULTS: Jaundice was the major clinical symptom of the patients. The elevated serum total bilirubin, direct bilirubin and alanine aminotransferase levels were in concordance with obstructive jaundice and the underlying liver disease. Of the 6 patients showing evidence of viral hepatitis, 5 were positive for serum alpha fetoprotein and carbohydrate antigen 19-9, and 1 was positive for serum carcinoembryonic antigen. No patient was correctly diagnosed by ultrasound. The main features of patients on comprehensive imaging were filling defects with cup-shaped ends of the bile duct, with large filling defects presenting as casting moulds in the expanded bile duct, hypervascular intraluminal nodules, debris or blood clots in the bile duct. No obvious circular thickening of the bile duct walls was observed. CONCLUSION: Even with no detectable intrahepatic tumor, bile duct HCC thrombus should be considered in patients predisposed to HCC, and some imaging signs are indicative of its diagnosis.
Subject(s)
Bile Ducts/pathology , Carcinoma, Hepatocellular/diagnosis , Cholestasis/etiology , Jaundice, Obstructive/etiology , Liver Neoplasms/diagnosis , Alanine Transaminase/blood , Bile Ducts/diagnostic imaging , Bilirubin/blood , CA-19-9 Antigen/blood , Carcinoembryonic Antigen/blood , Carcinoma, Hepatocellular/blood , Carcinoma, Hepatocellular/complications , Carcinoma, Hepatocellular/pathology , Cholangiopancreatography, Endoscopic Retrograde , Cholangiopancreatography, Magnetic Resonance , Cholestasis/blood , Cholestasis/pathology , Female , Humans , Jaundice, Obstructive/blood , Jaundice, Obstructive/pathology , Liver Neoplasms/blood , Liver Neoplasms/complications , Liver Neoplasms/pathology , Male , Middle Aged , Neoplasm Invasiveness , Retrospective Studies , Tomography, X-Ray Computed , Ultrasonography , alpha-Fetoproteins/analysisABSTRACT
We report herein the synthesis of novel 7-(4-alkoxyimino-3-aminomethyl-3-methylpiperidin-1-yl) fluoroquinolone derivatives. The antibacterial activity of the newly synthesized compounds was evaluated and correlated with their physicochemical properties. Results reveal that all of the target compounds have good potency in inhibiting the growth of Staphylococcus aureus and Staphylococcus epidermidis including MRSE (MIC: 0.125-4 microg/mL). Compounds 12, 13 are more potent than or comparable to levofloxacin against MRSA, Streptococcus pyogenes, Escherichia coli, Klebsiella pneumoniae, and Shigella sonnei. Compound 17 is more active than or comparable to levofloxacin against S. aureus including MRSA, S. epidermidis and S. pyogenes.