Hyaluronan (HA), a natural glycoaminoglycan featuring an extracellular matrix, has been suggested as an effective biocompatible material. In this study, the effectiveness of HA microparticles as a carrier system for antibiotics was evaluated, and their physicochemical characteristics were determined. Microparticles were fabricated by the gelation of sulfadiazine (SD) loaded HA solution with calcium chloride through either a granulation (GR-microparticles) or encapsulation (EN-microparticles) process, and atelocollagen was incorporated into the microparticles as an additive in order to improve their physical properties. The characteristics of the microparticles were examined by scanning electron microscopy (SEM), differential scanning calorimetry (DSC), and swelling test. In vitro release experiments were performed for 7 days and the released amount of SD was determined using high-performance liquid chromatography (HPLC). Microscopic observations revealed that the collagen incorporated HA particles had a more compact surface than the HA particles. DSC analysis determined a loss of SD crystallinity in the particles. Calcium chloride retarded the swelling of particles, whereas the loaded drug contents did not affect this property. Both GR-and EN-microparticles sustained SD release with initial bursting effect. SD release from EN-microparticles was faster than from GR- microparticles. In addition, the release rate was dependent on the SD content in the microparticles. These results suggest that collagen modified HA microparticles have a potential as a release rate controlling material for crystalline drugs such as SD.
Antibiotics/*administration & dosage ; Calcium Chloride/pharmacology ; Collagen/*pharmacology ; *Drug Carriers ; Hyaluronic Acid/*administration & dosage ; Sulfadiazine/administration & dosage

PURPOSE: To determine the efficacy of intravesical hyaluronic acid (HA) instillation in treating patients with refractory interstitial cystitis/painful bladder syndrome (IC/PBS) and to identify any related factors that influence its therapeutic effect. METHODS: Thirty-three female IC/PBS patients who demonstrated poor or unsatisfactory responses to previous treatments between December 2010 and October 2012 were enrolled. Despite previous treatments, the enrolled patients had visual analogue scale (VAS) pain scores > or =4 and total scores (symptom and bother scores) > or =13 on the pelvic pain and urgency/frequency (PUF) questionnaire and > or =12 on the O'Leary-Sant interstitial cystitis symptoms index (ICSI)/problems index (ICPI). All patients received once weekly intravesical instillations of 40-mg HA diluted in 50-mL saline for 4 weeks. The efficacy of the HA instillation was evaluated by comparing the mean changes in the scores of the VAS and questionnaires from baseline to 4 weeks after treatment. Improvement was defined as a > or =2 decrease in the VAS. Moreover, we investigated the effects of the presence of Hunner's ulcer and previous treatment modalities on the therapeutic outcome of HA instillation. RESULTS: The mean age was 57.0+/-1.8 years (range, 28-75 years). The VAS score significantly decreased from baseline to 4 weeks after treatment (-2.5, P<0.001). The mean changes in the PUF, ICSI, and ICPI from baseline to 4 weeks after the treatment were -3.8 (P<0.001), -2.3 (P<0.001), and -2.7 (P<0.001), respectively. Twenty patients (61%) showed improvements. Previous treatment modalities did not affect the efficacy of HA instillation and the presence of Hunner's ulcer was unrelated to outcomes. No complications were observed. CONCLUSIONS: These results show that intravesical HA instillation is an effective and safe treatment for patients with refractory IC/PBS. Previous treatment modalities and presence of Hunner's ulcer do not affect the efficacy of HA instillation.
Administration, Intravesical ; Cystitis, Interstitial ; Female ; Humans ; Hyaluronic Acid* ; Pelvic Pain ; Sperm Injections, Intracytoplasmic ; Ulcer ; Urinary Bladder*

OBJECTIVETo detect the self-assembly morphology of sodium hyaluronate injection on mica using atomic force microscopy(AFM).

METHODSAtomic force microscopy with nanometer resolution was used to observe the self-assembly morphology of different concentrations of sodium hyaluronate injection on mica at room temperature.

RESULTSThe self-assembly morphology of 0.001, 0.01, and 0.1 mg/ml sodium hyaluronate injection on mica featured piebald, reticular and dendritic structures, respectively. At 1 and 5 mg/ml, sodium hyaluronate injection displayed bacilliform and spherical structures on mica, respectively; the diameter and height of the particles of 5 mg/ml sodium hyaluronate was 197.97±78.48 nm and 30.79±18.67 nm, significantly greater than those of 0.1 mg/ml sodium hyaluronate injection (49.52±11.93 nm and 5.37±1.59 nm, respectively, P<0.05).

CONCLUSIONThe self-assembly morphology of sodium hyaluronate injection on mica varies with its concentration. The piebald and reticular structure may facilitate the function of sodium hyaluronate, and the dendritic feature resembles the representative model of diffusion-limited aggregation (DLA).

Aluminum Silicates ; chemistry ; Hyaluronic Acid ; administration & dosage ; chemical synthesis ; chemistry ; Microscopy, Atomic Force ; Nanostructures ; Surface Properties

Intra-articular injection of hyaluronic acid for osteoarthritis is an old and useful method. According to recent literatures, the following four problems were reviewed in this article: 1) Mechanisms. Real-time PCR was used to detect the transforming growth factor-beta 1 (TGF-beta1), vascular endothelial growth factor (VEGF) and connective tissue growth factor (CTGF) gene expression, which were significantly increased, as well as promoted secretion and synthesis of the tissue inhibitors of metalloproteinase, thus the reaction and cartilage destruction were decreased. 2) Methods. Because of discovering of new HA derivants, single intra-articular treatment with 6 ml hylan G-F 20 had replaced the routine method of once a week. To improve the therapeutic effectiveness, compound drags were applied, such as NSAIDs. 3) Indication. Knee OA (K-L II-III type) was first elected. But at present, the K-L I type was advocated early application. While the K-L IV type, although joint function can not improve, the symptoms relieved. 4) Therapeutic effectiveness. The double-blind place bo-controlled study showed that it was better than corticoid, and persistent and no side-effect. Therefore, this was a safe, persistent effective method.
Humans ; Hyaluronic Acid ; administration & dosage ; pharmacology ; therapeutic use ; Injections, Intra-Articular ; Osteoarthritis ; drug therapy

OBJECTIVETo investigate the biocompatibility and degradation rate of crosslinking sodium hyaluronate gel with different ratio of molecular weight, so as to choose the effective, safe and totally degraded hyaluronate gel for aesthetic injection.

METHODS(1) Compound colloid was formed by cross-linking the divinyl sulphone and sodium hyaluronate with different molecular weight (4 x 10(5), 8 x 10(5), 10 x 10(5), 12 x 10(5)). (2) Healthy level KM mice was randomly divided into two groups to receive hyaluronic acid gel or liquid injection. Each group was subdivided into three subgroup to receive hyaluronic acid with different molecular weight. The biocompatibility and degradation rate, of hyaluronate were observed at 7, 90, 180 days after injection. At the same time, different molecular weight of sodium hyaluronate gel is sealed or exposed respectively under the low temperature preservation to observe its natural degradation rate. (3) The most stable colloid was selected as aesthetic injector for volunteers to observe the aesthetic effect.

RESULTSThe sodium hyaluronate gel with molecular of 4 x 10(5) was completely degraded 90 days later. The sodium hyaluronate gel with molecular of 8 x 10(5) was completely degraded 180 days later. The sodium hyaluronate gel with molecular of 10 x 10(5) was degraded to 90.0% after 180 days. The sodium hyaluronate liquid can be degraded completely within 7 days. The colloid could be kept for at least 12 months when sealed under low temperature, but was totally degraded when exposed for I d. Sodium hyaluronate gel with molecular 10 x 10(5) was confirmed to be kept for at least 6 months in animal experiment and clinical trials.

CONCLUSIONSUnder the same condition of material ratio, the higher the molecular weight is, the lower the degradation rate is. But the liquidity of gel is not good for injection when molecular weight is too large. It suggests that Sodium hyaluronate gel with molecular 10 x 10(5) maybe the best choice in cosmetic injections.

Animals ; Cross-Linking Reagents ; administration & dosage ; chemistry ; Hyaluronic Acid ; administration & dosage ; chemistry ; Injections, Subcutaneous ; Mice ; Molecular Weight ; Random Allocation

OBJECTIVETo investigate the effect of multi-plane Hyaluronic acid (HA) injection for rhinoplasty.

METHODSThe HA was injected below or above the periosteum at the nasal bone, above the perichondrium at the cartilage portion of nose, and between the great alar cartilage at the nasal tip. The HA volume was 1-1.5 ml, according to the nose form and aesthetic assessment. Over-injection was not permitted. Touch-up injection could be performed one week after the first injection if need.

RESULTSFrom Jan. 2010 to Jan. 2012, 60 cases underwent rhinoplasty with HA injection. The patients were followed up for 10-13 months with satisfactory result. The effect lasted about 9 months with the longest period as 12 months and the shortest period as 6 months.

CONCLUSIONSGood results can be achieved with multi-plane HA injection for rhinoplasty.

Adult ; Female ; Follow-Up Studies ; Humans ; Hyaluronic Acid ; administration & dosage ; therapeutic use ; Injections ; Male ; Rhinoplasty ; methods ; Treatment Outcome ; Young Adult

PURPOSE: To introduce a case of iridoschisis patient who underwent cataract surgery successfully without pupil device. METHODS: A 64-year-old female who showed iridoschisis of her both eyes underwent cataract operation at her right eye without a pupillary device. The preoperative and postoperative ophthalmologic examinations including visual acuity, intraocular pressure, reaction of anterior chamber, and degree of damage on iris was evaluated respectively. RESULTS: Cataract surgery was performed under topical anesthesia through a clear corneal incision. Iris fibrils were held in place by ophthalmic viscosurgical device (OVD, sodium hyaluronate 3%-sodium chondroitin sulfate 4%, Viscoat(R)) that was injected into the anterior chamber. A small capsulorrhexis was made and the nucleus was delivered with low-power phacoemulsification, most of which was performed under the anterior capsule. The iris came into contact with the OVDs only and received no mechanical trauma. There were no intraoperative complications such as tear of the iris, hyphema, loss of mydriasis, or rupture of the posterior lens capsule. The edema of corneal stroma and inflammation of anterior chamber was shown at immediate-postoperative period, but completely subsided 2 weeks later. The visual acuity showed improvement from 20/400 to 20/30. CONCLUSIONS: In iridoschisis patients, there is a risk of aspiration of iris fibers during cataract surgery. With adequate use of OVD and careful modulation of surgical devices, cataract surgery was successfully performed without using extra pupil-supporting device.
Anesthesia, Local/methods ; Cataract/*complications ; Chondroitin/administration & dosage ; Drug Combinations ; Female ; Humans ; Hyaluronic Acid/administration & dosage ; Iris Diseases/*complications ; Lens Implantation, Intraocular ; Middle Aged ; Phacoemulsification/*methods ; Visual Acuity

PURPOSE: To introduce a case of iridoschisis patient who underwent cataract surgery successfully without pupil device. METHODS: A 64-year-old female who showed iridoschisis of her both eyes underwent cataract operation at her right eye without a pupillary device. The preoperative and postoperative ophthalmologic examinations including visual acuity, intraocular pressure, reaction of anterior chamber, and degree of damage on iris was evaluated respectively. RESULTS: Cataract surgery was performed under topical anesthesia through a clear corneal incision. Iris fibrils were held in place by ophthalmic viscosurgical device (OVD, sodium hyaluronate 3%-sodium chondroitin sulfate 4%, Viscoat(R)) that was injected into the anterior chamber. A small capsulorrhexis was made and the nucleus was delivered with low-power phacoemulsification, most of which was performed under the anterior capsule. The iris came into contact with the OVDs only and received no mechanical trauma. There were no intraoperative complications such as tear of the iris, hyphema, loss of mydriasis, or rupture of the posterior lens capsule. The edema of corneal stroma and inflammation of anterior chamber was shown at immediate-postoperative period, but completely subsided 2 weeks later. The visual acuity showed improvement from 20/400 to 20/30. CONCLUSIONS: In iridoschisis patients, there is a risk of aspiration of iris fibers during cataract surgery. With adequate use of OVD and careful modulation of surgical devices, cataract surgery was successfully performed without using extra pupil-supporting device.
Anesthesia, Local/methods ; Cataract/*complications ; Chondroitin/administration & dosage ; Drug Combinations ; Female ; Humans ; Hyaluronic Acid/administration & dosage ; Iris Diseases/*complications ; Lens Implantation, Intraocular ; Middle Aged ; Phacoemulsification/*methods ; Visual Acuity

OBJECTIVETo observe the effect of an external film of hyaluronic acid (HA) on the rats wound healing.

METHODSForty-eight SD rats were randomly separated into eight groups of 6 rats each. Bilateral dorsal cuts were performed on each rat, left wound was used as the experiment with HA external film and right wound was used as the control only with normal saline. The process of healing was observed histologically following 1st, 3rd, 5th, 7th, 9th, 14th, 21st, and 28th days postoperatively.

RESULTSInflammation was lighter and epidermal healing was faster in the experimental group than those in the control. The fibroblasts degenerated and the collagen fiber changed to slim and loose bunches in the experimental group.

CONCLUSIONThe results indicated that HA external film could have powerful infiltrating activity at the early stage of wound healing, it could accelerate the healing of epidermis and delay the formation of keratinization layer.

Animals ; Collagen ; metabolism ; Drug Administration Routes ; Fibroblasts ; drug effects ; metabolism ; Hyaluronic Acid ; administration & dosage ; pharmacology ; Male ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Treatment Outcome ; Wound Healing ; drug effects

BACKGROUNDWhile intra-articular injection of sinomenine hydrochloride has a therapeutic effect on osteoarthritis, it has a short half-life, and is thermolabile and photolabile. The aim of this research was to evaluate the sustained-release of sinomenine hydrochloride from an injectable sinomenine hydrochloride and sodium hyaluronate compound (CSSSI) and its therapeutic effect in a rabbit model of osteoarthritis following intra-articular injection.

METHODSAn injectable compound consisting of 1% sodium hyaluronate and 2.5% sinomenine hydrochloride was prepared and kept as the experiment group, and 2.5% sinomenine hydrochloride was prepared and kept as the control group. The cumulative mass release was measured at different time points in each group in vitro. Sixty-five male Zelanian rabbits were randomly divided into five groups: 15 (30 knees) each for the control, sodium hyaluronate, sinomenine hydrochloride, and CSSSI groups respectively, and five (10 knees) for the modeling group. Papain was injected into both knees of each rabbit for model establishment. Subsequently, 0.2 ml of the corresponding drugs was injected into the articular cavities of the remaining experiment groups, while the control group was treated with 0.2 ml normal saline. All groups were treated once a week for 4 weeks. Seven days after the last treatment, knees were anatomized to perform pathological observations and Mankin's evaluation of the synovium. Four groups were compared using the SPSS 13.0 software package.

RESULTSIn the in vitro sustained-release experiments, 90% of the drug was released in the experiment group 360 minutes following the injection. Comparison of the Mankin's evaluations of the four groups illustrated statistical discrepancies (P < 0.05). In further paired comparisons of the CSSSI group vs. modeling control/sodium hyaluronate/sinomenine hydrochloride groups, statistical significance was uniformly obtained. Moreover, sodium hyaluronate and sinomenine hydrochloride treatments showed significant improvement over the modeling control (P < 0.05), whereas sodium hyaluronate vs. sinomenine hydrochloride comparison failed to reach significance (P > 0.05).

CONCLUSIONSCSSSI has a sustained-release effect on sinomenine hydrochloride. Intra-articular injection of CSSSI was significantly better than the sole sodium hyaluronate or sinomenine hydrochloride for the treatment of osteoarthritis in a rabbit model.

Animals ; Hyaluronic Acid ; administration & dosage ; therapeutic use ; Injections, Intra-Articular ; Male ; Morphinans ; administration & dosage ; therapeutic use ; Osteoarthritis ; drug therapy ; Rabbits ; Random Allocation