OBJECTIVE: To investigate the causes, clinical manifestation and treatment principles of frontal sinus tract after the frontal approach craniotomy. METHOD: The clinic data of 13 patients with frontal skin sinus tract after the frontal approach craniotomy were retrospectively analyzed. All of them were described in the clinical record to have undergone frontal sinus mucosa pushing down or shaving and bone wax filling in the frontal sinus during the surgery, of whom 3 cases had history of frontal abscess incision drainage. All patients were performed endoscopic frontal sinus surgery and forehead skin sinus tract excision and suture. RESULT: All of the patients successfully recovered after one-stage operation, and the frontal skin sinus tract was healed. CONCLUSION The frontal approach craniotomy with postoperative frontal sinus tract was related with the improper use of bone wax tamponade and sealing of frontal sinus. The treatment principles were to remove bone wax, remove inflammatory granulation tissue around the sinus tract, and to open frontal sinus and promote frontal sinus drainage.
Craniotomy ; methods ; Drainage ; Endoscopy ; Forehead ; Frontal Sinus ; surgery ; Granulation Tissue ; surgery ; Humans ; Palmitates ; Retrospective Studies ; Waxes

A case of delayed progressive extradural pneumatocele after microvascular decompression (MVD) is presented. A 60-year-old male underwent MVD for hemifacial spasm; the mastoid air cell was opened and sealed with bone wax during surgery. One month after surgery, the patient complained of tinnitus, and progressive extradural pneumatoceles without cerebrospinal fluid (CSF) leakage was observed. Revision surgery was performed and the opened mastoid air cell was completely sealed with muscle patch and glue. The patient's symptoms were resolved, with no recurrence of pneumatoceles at 6 month follow up. Progressive extradural pneumatocele without CSF leakage after posterior fossa surgery is a very rare complication. Previous reports and surgical management of this rare complication are discussed.
Adhesives ; Decompression ; Follow-Up Studies ; Humans ; Male ; Mastoid ; Microvascular Decompression Surgery ; Middle Aged ; Muscles ; Palmitates ; Recurrence ; Tinnitus ; Waxes

Lipase (EC3.1.1.3) from Candida sp. 99-125 was immobilized on chitosan by chemical covalence. Lipase was first immobilized to chitosan beads by activating its hydroxyl groups with carbodiimide followed by cross-linking more lipase to the amino groups with glutaraldehyde. In this article, different factors that influenced the immobilization were investigated, and the optimum conditions were ascertained. Comparative studies of organic solvent and thermal stability between free lipase and immobilized lipase were conducted. Immobilization enhanced the lipase stability against changes of temperature and organic solvent. Immobilization lipase can be reused in the synthesis system of palmitate hexadecyl. Operational stability tests indicated that the immobilized lipase occurs after 16 consecutive batches, the conversion rate remained 85%. Such results revealed good potential for recycling under esterification system.
Candida ; enzymology ; Carbodiimides ; chemistry ; Chitosan ; chemistry ; Cross-Linking Reagents ; Enzyme Stability ; Enzymes, Immobilized ; Lipase ; metabolism ; Palmitates ; chemistry

Ischemia and reperfusion (I/R) injury is a major cause of hepatic failure after liver surgery, but no method could monitor or predict it real-time during surgery. We measured bioelectrical impedance (BEI) and cell viability to assess the usefulness of BEI during I/R in rat liver. A 70% partial liver ischemia model was used. BEI was measured at various frequencies. Adenosine triphosphate (ATP) content, and palmitic acid oxidation rate were measured, and histological changes were observed in order to quantify liver cell viability. BEI changed significantly during ischemia at low frequency. In the ischemia group, BEI increased gradually during 60 min of ischemia and had a tendency to plateau thereafter. The ATP content decreased below 20% of the baseline level. In the I/R group, BEI recovered to near baseline level. After 24 hr of reperfusion, the ATP contents decreased to below 50% in 30, 60 and 120 min of ischemia and the palmitic acid metabolic rates decreased to 91%, 78%, and 74%, respectively, compared with normal liver. BEI may be a good tool for monitoring I/R during liver surgery. The liver is relatively tolerant to ischemia, however after reperfusion, liver cells may be damaged depending upon the duration of ischemia.
Adenosine Triphosphate/metabolism ; Animals ; *Cell Survival ; Electric Impedance ; Energy Metabolism ; Ischemia/*metabolism ; Liver/*metabolism/pathology ; Male ; Palmitates/metabolism ; Rats ; Rats, Sprague-Dawley ; *Reperfusion ; Reperfusion Injury/metabolism/pathology

OBJECTIVE: Schizophrenia is a chronic and persistent mental illness and requires continuous treatment. Nevertheless, a majority of schizophrenia subjects show non-adherence to oral antipsychotics due to many factors including a lack of insight and a decline in their cognitive function. Medication non-adherence is associated with an increase in relapse and hospitalization and incurs a heavy burden not only to subjects and caregivers, but also to society. Treatment with antipsychotic long acting injection can maintain a consistent plasma drug concentration and has been shown to prevent relapse and re-hospitalization. This study aims to assess the cost-effectiveness of paliperidone palmitate long acting injection (PLAI) compared with atypical oral antipsychotics (risperidone, olanzapine, aripiprazole and paliperidone) in schizophrenia subjects who are non-adherent to oral atypical antipsychotics. METHODS: A decision-tree model was constructed to compare the clinical and economic outcomes of PLAI and oral comparator over 1 year in schizophrenia subjects who are non-adherent to oral atypical antipsychotics. Clinical data such as relapse rate, extra pyramidal symptoms (EPS) rate, suicide rate and non-adherence rate were obtained from published literature. Utility values for each schizophrenia health state were calculated based on an Australian study to measure the utility values for schizophrenia patients. Direct medical cost data were obtained from domestic literature. Sensitivity analyses were performed on major variables. RESULTS: Based on model estimates, PLAI can increase quality-adjusted life years (QALY) per patient by 0.39 and is associated with a 2.93-fold lower probability of relapse compared with the weighted average of the oral treatments (0.2204 vs 0.6462). The total annual medical costs per patient (including medication, inpatient and outpatient cost) were 4.51 million Korean Won for PLAI, and 5.19 million Korean Won for the weighted average of oral atypical antipsychotics, leading to a cost reduction of 0.68 million Korean Won with PLAI. CONCLUSION: With lower total medical cost and improved treatment outcomes compared to oral treatments, PLAI was assessed to be a dominant treatment option for schizophrenia patients who are non-adherent to oral atypical antipsychotics.
Antipsychotic Agents ; Benzodiazepines ; Caregivers ; Hospitalization ; Humans ; Inpatients ; Isoxazoles ; Medication Adherence ; Outpatients ; Palmitates ; Piperazines ; Plasma ; Pyrimidines ; Quality-Adjusted Life Years ; Quinolones ; Recurrence ; Republic of Korea ; Schizophrenia ; Suicide ; Aripiprazole ; Paliperidone Palmitate

AIMTo prepare amylopectin anchored dipyridamole (DIP) liposome and to study its tissue distribution in mice.

METHODSThe regular DIP liposomes were prepared by film-scatter method. The amphiphilic O-palmitoyl amylopectin was synthesized and added to modify the surface of liposome. The entrapping efficiency, zeta potential, mean diameter, span of modified and regular liposomes were assayed. The RP-HPLC was used for the determination of DIP concentration in mice tissue.

RESULTSAfter modification, the entrapping efficiency depressed, zeta potential was raised, mean diameter and span had no obvious change. The level of DIP in lung, liver and spleen for regular liposomes were higher than that of injections. Compared with regular liposomes, the modified liposomes increased the DIP level in lung, and decreased the DIP level in liver, spleen, moreover, lengthened the retention time of DIP in lung.

CONCLUSIONThe distribution of modified liposome in mice was markedly changed as compared with regular liposomes and injections. The modified liposomes had obvious lung targeting property.

Amylopectin ; analogs & derivatives ; chemistry ; Animals ; Area Under Curve ; Dipyridamole ; administration & dosage ; chemistry ; pharmacokinetics ; Drug Delivery Systems ; Liposomes ; Lung ; metabolism ; Male ; Mice ; Palmitates ; chemistry ; Particle Size ; Tissue Distribution

AIMTo study the effects of various liposomes formulations and preparation methods on the stability of acyclovir palmitate (ACV-C16) liposomes on storage at 4 degrees C and 25 degrees C over a 6 months period.

METHODSThe mean particle size, Zeta potential, pH and leaking ratio of ACV-C16 liposomes were the parameters chosen to indicate the stability of liposomes. All of the parameters were compared among various lipid compositions [egg lecithin/cholesterol/hosphatidylserine (PC/CH/PS), egg lecithin/cholesterol/stearylamine (PC/CH/SA), egg lecithin/cholesterol/cholesteryl sulphate (PC/CH/CS), bovine brain ceramides/cholesterol/palmitic acid/cholesteryl sulphate (CM/CH/PA/CS)], different preparation methods (film dispersing, reverse phase evaporation, dehydration/rehydration), charges (positive, negative), as well as among multilamellar vesicles liposomes (MLV), large unilamellar vesicles liposomes (LUV) and dehydration/rehydration vesicles liposomes (DRV).

RESULTSAn analysis of various parameters led to the conclusion that the stability of liposomes followed the order of PC/CH/CS > CM/CH/PA/CS > PC/CH/PS > PC/CH/SA at the same storage conditions; the positively charged system showed the most unstable delivery system of liposomes as compared to the other three systems. As far as stability was concerned, LUV liposomes proved to be superior to MLV liposomes and DRV liposomes, and the modified reverse phase evaporation method of Szoka provided the best preparation method. The stability in systems was enhanced when systems were stored at 4 degrees C as compared to storage at 25 degrees C.

CONCLUSIONThe stability of liposomes was significantly interrelated with lipid composition of various liposomes, preparation method and different storage conditions.

Acyclovir ; administration & dosage ; Chemistry, Pharmaceutical ; Drug Carriers ; Drug Delivery Systems ; Drug Stability ; Liposomes ; chemistry ; Palmitates ; chemistry ; Particle Size ; Technology, Pharmaceutical ; methods

OBJECTIVETo establish an in vitro cell model to investigate hepatic steatosis of non-alcoholic fatty liver disease.

METHODSHepG2 cells cultured in MEM containing 10 % fetal bovine serum were divided into control group and model group. At 7 0%-80 % confluency, HepG2 cells in model group were exposed to a long-chain mixture of free fatty acids (oleate and palmitate) for 24 h, cells in control group were subject to fresh medium. Lipid droplets were observed with oil red O stain and electron microscope, triglyceride and malonaldehyde were detected by respective assay kits.

RESULTA large number of lipid droplet were detected in model HepG2 cells; the level of triglyceride increased. However,malonaldehyde did not increase significantly compared with control group.

CONCLUSIONA large number of lipid droplet were detected in model HepG2 cells; the level of triglyceride increased. However, malonaldehyde did not increase significantly compared with control group.

Culture Media ; pharmacology ; Fatty Acids, Nonesterified ; pharmacology ; Fatty Liver ; Hep G2 Cells ; Humans ; Models, Biological ; Non-alcoholic Fatty Liver Disease ; Oleic Acid ; pharmacology ; Palmitates ; pharmacology

Heterotrimeric guanine nucleotide binding regulatory proteins (G proteins) transduce extracellular signals into intracellular signals by coupling receptors and effectors. Because most of the G protein-coupled receptors are integral proteins, the G proteins need to have a membrane binding capacity to receive signals from the receptors. The alpha subunit of G protein binds tightly to the cytoplasmic face of the plasma membrane without any membrane spanning domain. Fatty acylation of G alpha with myristic acid or palmitic acid, in addition to the beta gamma subunits, plays an important role in anchoring the G alpha subunit. The reversible and dynamic palmitoylation of the alpha subunit of stimulatory G protein (Gs alpha) has been suggested as essential for its membrane attachment. However, in our previous experiments, Gs alpha deleted in the amino terminus containing palmitoylation site, retained its binding capacity when expressed in COS cells. Thus, to evaluate the role of palmitoylation in Gs alpha membrane binding, we constructed and expressed non-palmitoylated mutants of Gs alpha and analyzed their subcellular distributions in COS-1 cells. We found that non-palmitoylated mutants of Gs alpha, C3S- and G2A/C3S Gs alpha, retained their membrane binding capacities in COS-1 cells, demonstrating that palmitoylation is not essential for membrane binding of Gs alpha in COS-1 cells. We also found that the palmitoylation did not change significantly the distribution of Gs alpha in Triton X-114 partition. These results suggest that the palmitoylation of Gs alpha may produce different effects on membrane binding depending on cell types.
Animal ; Blotting, Western ; COS Cells ; Cell Membrane/metabolism ; Detergents/pharmacology ; G-Protein, Stimulatory Gs/metabolism* ; G-Protein, Stimulatory Gs/genetics ; Immunoblotting ; Isoproterenol/metabolism ; Mutagenesis ; Palmitates/metabolism* ; Polyethylene Glycols/pharmacology ; Rats ; Transfection

BACKGROUNDGlucolipotoxicity might play an important role in the β cell decompensation stage during the development of obesity-associated type 2 diabetes. Tissue inhibitor of metalloproteinase-1 (TIMP-1) inhibits matrix metalloproteinase (MMP) activity and regulates proliferation and apoptosis of a variety of cell types, including pancreatic β-cells. In the present study, we investigated whether TIMP-1 counteracts glucolipotoxicity in the pancreatic β-cell line INS-1.

METHODSINS-1 cells were incubated in normal or high glucose, with or without palmitate (0.4 mmol/L), in the presence of TIMP-1 or MMP inhibitor GM60001. In some experiments, cells were pretreated with phosphatidylinositol-3 (PI-3) kinase inhibitor, LY294002 or wortmannin. The amount of dead INS-1 cells was determined by HO342 and propidium iodide staining. Akt phosphorylation was evaluated by Western blotting analysis to investigate a possible mechanism of TIMP-1's action.

RESULTSTIMP-1 protected INS-1 cells from glucolipotoxicity independent of MMP inhibition. TIMP-1 stimulated Akt phosphorylation. Inhibition of the PI-3 kinase pathway abolished the survival effect of TIMP-1.

CONCLUSIONTIMP-1 may counteract glucolipotoxicity induced β-cell death via a PI-3 kinase pathway.

Animals ; Cell Line ; Glucose ; pharmacology ; Insulin-Secreting Cells ; drug effects ; metabolism ; Palmitates ; pharmacology ; Phosphatidylinositol 3-Kinases ; Phosphorylation ; drug effects ; Proto-Oncogene Proteins c-akt ; metabolism ; Rats ; Signal Transduction ; Tissue Inhibitor of Metalloproteinase-1 ; pharmacology