Zoledronic acid for osteoporosis after distal radius fracture surgery: Prospective longitudinal study.

Background: Distal radius fractures (DRFs) are the most frequent first-ever osteoporotic fragility fractures. However, most patients are treated only for fractures and not for osteoporosis. Therefore, we investigated early osteoporosis intervention using zoledronic acid. Methods: This prospective study enrolled 30 patients aged 50 years or older who had no history of fragility fractures or osteoporosis treatment and who underwent surgical treatment for DRFs. Patients whose lumbar spine or femur bone mineral density (BMD) values were less than 80% of the young adult mean (YAM) were treated with a 5-mg intravenous infusion of zoledronic acid. Lumbar spine and femur YAM BMD values, TRACP-5b and PINP were statistically evaluated using the paired t-test. The relationship between adverse effects, age, body mass index (BMI), and creatinine clearance (CCr) was statistically examined using Mann-Whitney's U test. The incidence of the bone fusion and secondary fractures within the 60-months postoperative period were assessed. Results: The mean lumbar spine and femur YAM BMD values before treatment were 76.1 ± 13.1% and 70.7 ± 8.5%. This indicates osteopenia in both locations. These values differed significantly between the pre-treatment period and each subsequent period. Five patients with a target YAM BMD value over 80% within 60 months after treatment were observed. The TRACP-5b and PINP values differed significantly between the pre-treatment period and each subsequent period. Adverse drug reactions were observed in 12 patients (40%). Age, BMI, and CCr did not show statistically significant differences in the occurrence of adverse effects. Bone fusion was confirmed at a mean of 3.6 months postoperatively. Secondary fractures were observed in 3 patients within 60 months after treatment. Conclusion: DRFs occur at a younger age than other fragility fractures, and it is important to intervene aggressively with osteoporosis treatment to prevent secondary fractures. Level of evidence: Level V.

Alteration of chronic inflammatory status by transarterial embolization in frozen shoulder evaluated by fluorine-18 fluorodeoxyglucose positron-emission tomography/computed tomography.

BACKGROUND: Frozen shoulder (FS) is speculated to have an inflammatory etiology. On angiography, abnormal angiogenesis is observed around the affected shoulder, suggesting a possible source of inflammation and pain. The effectiveness and safety of transarterial embolization (TAE) targeting abnormally proliferating blood vessels have been reported. This study investigated changes in chronic inflammatory and hypoxic status before and after TAE in FS by [18F]-fluoro-2-deoxyglucose (FDG) positron-emission tomography/computed tomography as a possible mechanism of the therapeutic response to TAE. METHODS: Fifteen patients with unilateral FS, persistent for more than 6 months, who were refractory to conservative treatments, underwent TAE using the temporary embolic agent imipenem/cilastatin. Patients underwent positron-emission tomography/computed tomography with FDG (as a biomarker of inflammation) before and 8 weeks after TAE. Regional uptake was evaluated by the maximum standardized uptake value. The lesion-side-to-(contralateral-) normal-side uptake ratio was also calculated. Pain and functional scales, range-of-motion, and laboratory tests, including white blood cell, C-reactive protein, interleukin 6, vascular endothelial growth factor, and tumor necrosis factor α were evaluated. RESULTS: On FDG-PET, the average maximum standardized uptake value of the lesion-side was significantly greater than that of the normal-side (maximum standardized uptake value before TAE: 3.11 ± 1.25 vs 1.95 ± 1.15, P = .0001; 8-weeks post-TAE: 2.36 ± 0.74 vs 1.78 ± 0.69, P = .0002). The mean lesion-side-to-(contralateral-) normal-side uptake ratios before TAE (1.71 ± 0.60) decreased after TAE (1.37 ± 0.29, P = .011). The decrease of FDG uptake (-21.1 ± 12.2%) showed a significant correlation with the change in the pain scale score (r = -0.56, P = .039) and extension score (r = -0.59, P = .026). CONCLUSION: Chronic inflammation in FS, as demonstrated by FDG uptake, was decreased after TAE. Thus, chronic inflammation is likely to be an underlying mechanism that should be targeted for symptomatic improvement of frozen shoulder.

In vitro evaluation of the tension band suture method for proximal humerus fracture treatment.

BACKGROUND: Proximal humeral fractures are common, and more than half occur in patients over 65 years of age. Operative treatment may be recommended for displaced, complicated fractures; however, surgery may lead to displacement of the greater tuberosity or humeral head. Supplemental tension band sutures have been recommended to prevent such a complication. In this study, we investigate the best combination of suture, washer, and threading angle for proximal humeral fractures from a mechanical view. METHODS: The mechanical durability of 18 combinations of suture materials (Fiberwire, Ethibond, and Surgilon), threading washers (ring washer, disc washer), and threading angles (15 or 45°) were examined via a cyclic loading test. RESULTS: The most durable combination in the cyclic loading test consisted of threading the Fiber Wire to the washer ring using only one hole (ring washer-1) at 45°. In contrast, the most vulnerable combination was threading Ethibond to the washer disc at 15°. Breakage of all suture materials occurred at the suture-washer interface, and no failure or loosening of the knots was observed. FiberWire gradually eroded until the loss of equilibrium; whereas the rupture of Ethibond and Surgilon occurred suddenly. CONCLUSIONS: From a mechanical viewpoint, we demonstrated that applying a supplemental tension band suture using FiberWire with a single-hole ring washer threaded at a wider angle is recommended.

Giant unilamellar vesicles containing Rhodamine 6G as a marker for immunoassay of bovine serum albumin and lipocalin-2.

Functionalized giant unilamellar vesicles (GUVs) containing a fluorescence dye Rhodamine 6G is proposed as a marker in sandwich-type immunoassay for bovine serum albumin (BSA) and lipocalin-2 (LCN2). The GUVs were prepared by the electroformation method and functionalized with anti-BSA antibody and anti-LCN2 antibody, respectively. The purification of antibody-modified GUVs was achieved by conventional centrifugation and a washing step in a flow system. To antigen on an antibody slip, antibody-modified GUVs were added as a marker and incubated. After wash-out of excess reagents and lysis of the bound GUVs with Triton X-100, the fluorescence image was captured. The fluorometric immunoassays for BSA and LCN2 exhibited lower detection limits of 4 and 80 fg ml(-)(1), respectively.

Visual Assay of Total Iron in Human Serum with Bathophenanthrolin Disulfonate-accommodated MCM-41.

A simple visual method for determining the total iron in human serum is proposed based on color development in the nanospace of mesoporous silica MCM-41 and a chromogenic ligand bathophenathroline disulfonate (BPS). Observing the color intensity of a complex between iron(II) and BPS devloped on the MCM-41 material by the naked eye enabled us to quntify iron(II) with a detection limit of 0.5 µM. The BPS-loaded MCM-41 was successfully applied for quantifying the total iron in human serum.

Pore-forming compounds as signal transduction elements for highly sensitive biosensing.

Pore-forming compounds are attracting much attention due to the signal transduction ability for the development of highly sensitive biosensing. In this review, we describe an overview of the recent advances made by our group in the design of molecular sensing interfaces of spherical and planar lipid bilayers and natural bilayers. The potential uses of pore-forming compounds, such as gramicidin and MCM-41, in lipid bilayers and natural glutamate receptor channels in biomembrane are presented.

Highly sensitive and rapid assay of substance P and streptolysin O in human serum using immuno-liposomes and gramicidin channels.

A highly sensitive and rapid method for the determination of substance P (SP) and streptolysin O (SLO) in human serum is described. The assay is based on enriching the analyte by agglutination/precipitation of immuno-liposomes and enhancing the fluorescence intensity by gramicidin A channels. A mixture of the immuno-liposomes encapsulating a pH-sensitive fluorescence dye BCECF, gramicidin A and a given concentration of SP (or SLO) is preincubated in a solution and captured on anti-SP (or anti-SLO)-modified cover slips, followed by measuring fluorescence images after removing excess liposomes. The method allowed quantifying SP and SLO in the range from sub-pg mL(-1) to pg mL(-1), with detection limits of 0.32 pg mL(-1) and 8 fg mL(-1), respectively. The present method could determine SP and SLO in 50-125 times diluted human serum without any extraction steps. The assay can be completed within 60 min.