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In vitro study on sustained release capsule formulation of acetazolamide.

In the present study formulation of sustained release capsule of acetazolamide 250 mg was tried using nonpareil seeds. Nonpareil seeds were coated with drug, polyvinylpyrrolidone, glyceryl monostearate, microcrystalline wax, and glyceryl distearate either individually or in combination to achieve sustained release capsule 250 mg. In successful formulation 20% drug coated pellets and 80% wax coated pellets were taken. Wax coated pellets for successful formulation contained coating of microcrystalline wax and glyceryl distearate on drug coated pellets of the same concentration of 1.6% w/w. Successful formulated sustained release capsule 250 mg of acetazolamide was compared in in vitro study with theoretical sustained release formulation suggested by wagner and one marketed sustained release capsule 250 mg. Formulated capsule showed result superior to or on par with marketed capsule. For successful formulation pellets were filled in '1' size hard gelatin capsule and stability study was carried out in hot air over at room temperature and 45 degrees C for 5 weeks. The formulation was found stable in respect of drug content and release rate.

Acetazolamide↗

Halofuginone inhibits collagen deposition in fibrous capsules around implants.

Fibrous capsule formation around implants remains a difficult problem that has been studied for decades. The etiology is elusive, but the end result is the deposition of a dense collagenous capsule around implanted materials. The purpose of this study was to determine the effects of a type I collagen synthesis inhibitor, halofuginone, on fibrous capsule formation around implanted materials. Silastic disks were implanted subcutaneously into 4 groups of adult male rats for up to 8 weeks. Group 1 received drug throughout the study, group 2 received drug during the first half only, group 3 received drug during the second half only, and the control group received no drug. Implants were removed and histology of the capsules was examined. A collagen index score was calculated from digital images of trichrome-stained histologic sections, which permitted semiquantitative comparison of collagen content among the 4 groups. The collagen index values clearly indicate that halofuginone effectively inhibited collagen deposition within the capsule around the implanted disks. Halofuginone treatment also resulted in a decrease in the collagen index score in rat skin, indicating that halofuginone may affect preexisting collagenous structures. The ability of halofuginone to inhibit collagen deposition in new and preexisting fibrous capsules suggests that it may be a useful adjunct to minimize the formation of capsules around implantable prostheses.

Animals↗

Video capsule endoscopy in inflammatory bowel disease 2005.

PURPOSE OF REVIEW: Crohn's disease remains a clinical diagnosis based on a typical clinical history, physical examination, small bowel radiography, and ileocolonoscopy with biopsy. Wireless video capsule endoscopy allows direct visualization of the entire small bowel mucosa. This review analyzes recently reported studies assessing diagnostic yield, impact on management, and outcomes associated with this new procedure. Safety issues, particularly capsule retention, are also reviewed. RECENT FINDINGS: A number of recently published studies report 'diagnostic yields' for Crohn's disease from capsule endoscopy of over 70% in patients with negative, or inconclusive, findings on prior small bowel series and ileocolonoscopy. Capsule endoscopy is a more sensitive examination than traditional radiography, but the specificity and positive predictive values remain to be established. Most series report a positive influence on patient outcome based on capsule findings, but the specific details of management changes and specific outcomes are often not adequately described. Furthermore, 'mucosal breaks' are seen in 14% of normal volunteers, even in the absence of recent nonsteroidal antiinflammatory drugs. Capsule retention occurs in less than 1% of patients with suspected Crohn's, but retention rates of 4-6% are reported in patients with established Crohn's. SUMMARY: Capsule endoscopy is an effective tool in the diagnosis and follow-up of patients with Crohn's disease. Prospective comparative studies with adequate control groups and predefined clinical endpoints are necessary to determine the true role of this technology in Crohn's disease.

Endoscopy, Gastrointestinal↗

Result of wireless capsule endoscopy in patients with suspected small bowel disease: the first series from Thailand.

BACKGROUND AND AIMS: Capsule endoscopy (CE) is a promising diagnostic tool for patients with obscure gastrointestinal bleeding. Only a few papers have reported data from Asian countries. This retrospective study aimed to demonstrate result of capsule endoscopy in patients with suspected small bowel disease as the first series from Thailand. METHOD: Twenty-one patients who underwent wireless capsule endoscopy between July 2003 and June 2004 at King Chulalongkorn Memorial Hospital were retrospectively reviewed in the present study. The indications for capsule endoscopy were overt obscure gastro-intestinal bleeding (n= 12), occult obscure gastro-intestinal bleeding (n=5), chronic recurrent abdominal pain (n=3) and chronic diarrhea (n=1). Diagnoses according to findings of capsule endoscopy were classifield into definite, suspicious and negative finding. RESULTS: The mean age of the 21 patients (10 men and 11 women) was 46 (standard deviation, 18.57) years. Of those 17 obscure gastrointestinal bleeding patients, there were positive findings in 11 from 17 patients (65%). Four patients (24%), 3 with tumor and another with AVM, were classified as definite results. Seven patients (41%), 6 with angioectasia and another with a small ulcer, were classified as suspicious because there was no demonstrated active bleeding lesion and no other clinical supportive evidence. Of these 3 patients with recurrent abdominal pain, one patient (33%) with terminal ileum lymphoid hyperplasia was classified as definite result because of clinical improvement after treatment of the lesion. Another case of chronic diarrhea yielded a negative result. CONCLUSION: Wireless capsule endoscopy is a safe and useful mode of investigation for the diagnosis of obscure gastrointestinal bleeding in Thailand. There is not so much difference in capsule endoscopy results between Western and Asian series.

Abdominal Pain↗

[Wireless capsule endoscopy and its role in gastroenterology: our results and a review of the literature].

INTRODUCTION: Since its recent introduction, capsule endoscopy has revolutionized the diagnostics of diseases of the small bowel. The number of studies on the use of this method is constantly increasing. Along with this, our knowledge about the usability and diagnostic power of capsule endoscopy is growing and the indications for this technique are getting progressively more accurate. AIMS: To study the usability of capsule endoscopy in suspected Crohn's disease, in gastrointestinal bleeding of small bowel origin, and in undetermined abdominal complains. METHOD: Capsule endoscopy was performed in 20, previously examined, carefully selected patients. RESULTS: Positive findings were recorded in all patients with gastrointestinal bleeding and in 3/4 of patients with suspected Crohn's disease. However, in patients with indeterminate abdominal complains, the capsule endoscopy proved to be inefficient. CONCLUSION: In the study below, based on their own experience, the authors try to provide an overall picture of capsule endoscopy by reviewing contemporary medical literature. The usability of the capsule endoscopy in suspected Crohn's disease and gastrointestinal bleeding of small bowel origin is suggested by the results of the study.

Adolescent↗

The role of the rotator interval capsule in passive motion and stability of the shoulder.

The purpose of this study was to characterize the role of the capsule in the interval between the supraspinatus and subscapularis tendons with respect to glenohumeral motion, translation, and stability. We used a six-degrees-of-freedom position-sensor and a six-degrees-of-freedom force and torque-transducer to determine the glenohumoral rotations and translations that resulted from applied loads in eight cadaver shoulders. The range of motion of each specimen was measured with the capsule in the rotator interval in a normal state, after the capsule had been sectioned, and after it had been imbricated. Operative alteration of this capsular interval was found to affect flexion, extension, external rotation, and adduction of the humerus with respect to the scapula. Modification of this portion of the capsule also affected obligate anterior translation of the humeral head on the glenoid during flexion. Limitation of motion and obligate translation were increased by operative imbrication and diminished by sectioning of the rotator interval capsule. Passive stability of the glenohumeral joint was evaluated with the use of anterior, posterior, and inferior stress tests. Instability and occasional frank dislocation of the glenohumeral joint occurred inferiorly and posteriorly after section of the rotator interval capsule. Imbrication of this part of the capsule increased the resistance to inferior and posterior translation.

Aged↗

[On the etiology of the loose shoulder--biochemical studies on collagen from joint capsules].

In order to investigate the etiology of loose shoulder, biochemical characteristics of collagens from four major joint capsules of extremities and from joint capsules of loose shoulder have been investigated. Joint capsules of normal shoulder were found to synthesize less collagen fibers comparing to those of other major joints. Furthermore formation of inter-molecular cross-links of collagen from shoulder joint capsule was relatively lower than that of collagens from other major joints. Noteworthy was the fact that collagen fibers from joint capsules of loose shoulder were more soluble and contain less amount of the reducible cross-links than those from joint capsules of the normal shoulder. These data suggest that collagen synthesis and formation of collagen fibers vary with the differences in joint structures, functions and movements. It may also be implied that the joint capsules of loose shoulder produce immature collagen fibers which may reflect the clinical feature of the disease.

Adolescent↗

[Relationship between motor disturbance and involvement of internal capsule in hypertensive thalamic hemorrhage].

We treated a consecutive series of 309 patients with hypertensive thalamic hemorrhage from April 1981 to December 1987. In 99 cases of involvement of the internal capsule, the relationship between the extent of destruction of the internal capsule and motor disturbance was clinically investigated and discussed. First, these 99 cases were classified into three groups on the basis of the location of the hematoma in the internal capsule on the CT image. All the cases were confined to the anterior, middle and posterior portions of the posterior limb of the internal capsule. The correlation between hematoma extension and the severity of motor weakness, its improvement nd prognosis were discussed. The severity of motor weakness was found not to be related to hematoma extension. On the other hand, the prognosis was frequently poor when the hematoma was located at the posterior portion within the posterior limb of the internal capsule. In hypertensive thalamic hemorrhage, there seemed to be a narrow and significant area within the posterior limb of the internal capsule which determined morbidity. And, as a matter of course, the nearer the hematoma was located to the border between the middle and posterior portions, the worse the outcome was. Cases treated by aspiration surgery were evaluated to investigate the utility of aspiration surgery for thalamic hemorrhage. (Special attention was given to the ADL of those cases with severe motor weakness.) When the hematoma was located at the posterior portion of the posterior limb of the internal capsule, the percentage of patients with good outcome was significantly higher in the aspirated group than in the medical group (p less than 0.05).

Brain↗

[A new device for the gastric emptying test--a sulfamethizole capsule food method].

We have developed a simple but reliable method for assessing gastric emptying, a sulfamethizole capsule food method. The capsule food contains egg albumin and sulfamethizole. In saline or hydrochloride solution only a small amount of sulfamethizole, in sodium bicarbonate solution, however, a large amount of the drug was released from the capsule food. In this method, sulfamethizole concentrations in blood were measured in subjects after ingestion of 15 pieces of capsule food containing 1.0 g of sulfamethizole, and area under the curve of the blood concentrations was calculated as an index of gastric emptying. Gastric emptying of capsule food had a lag phase of 15 minutes, which was already reported in gastric emptying of radioisotope labeled solid food. Bread combined with the capsule food caused a delay in gastric emptying and a larger volume of the bread was associated with a longer gastric emptying time. In conclusion, our sulfamethizole capsule food method is useful in clinical practice to assess gastric emptying of solid food.

Gastric Emptying↗

Epithelial-mesenchymal tissue interactions guiding otic capsule formation: the role of the otocyst.

The otocyst is the epithelial anlage of the membranous labyrinth which interacts with surrounding cephalic mesenchyme to form an otic capsule. A series of in vitro studies was performed to gain a better understanding of the epithelial-mesenchymal interactions involved in this process. Parallel series of otocyst/mesenchyme (O/M) and isolated periotic mesenchyme (M) explants provided morphological and biochemical data to define the role of the otocyst in organizing and directing formation of its cartilaginous otic capsule. Explants were made from mouse embryos ranging in age from 10 to 14 days of gestation, and organ cultured under identical conditions until the chronological equivalent of 16 days of gestation. Expression of chondrogenesis was determined by both histology and biochemistry. The in vitro behaviour of periotic mesenchyme explanted either with or without an otocyst supports several hypotheses that explain aspects of otic capsule development. The results indicate that prior to embryonic day 12 the otocyst alone is not sufficient to stimulate chondrogenesis of the otic capsule within O/M explants; the otocyst acts as an inductor of capsule chondrogenesis within O/M explants between embryonic days 12 to 13; isolated mesenchyme within M explants taken from 13-day-old embryos are capable of initiating in vitro chondrogenesis, but without expressing capsule morphology in the absence of the otocyst; and the isolated mesenchyme of M explants obtained from 14-day-old embryos expresses both chondrogenesis and otic capsule morphology in the absence of the otocyst. These findings suggest that the otocyst acts as an inductor of chondrogenesis of periotic mesenchyme tissue between embryonic days 11 to 13, and controls capsular morphogenesis between embryonic days 13 to 14 in the mouse embryo.

Animals↗

[The morphology of sensory corpuscles in the joint capsule--ultrastructural and histochemical study].

Sensory corpuscles in the cat elbow joint were observed by light and electron microscopy. Two types of corpuscles were identified, i.e. Pacini-type and Ruffini-type corpuscles. Silver impregnation revealed a single straight axon terminal in Pacini-type and highly-ramified fine axons in Ruffini-type corpuscles. Pacini-type corpuscles, 100-200 microns long and 30 microns wide, consisted of dense lamellae of lamellar cells and thick capsule. The lamellar portion contained a centrally-located axon terminal, and was similar in organization to the inner core of the typical Pacini corpuscle. The capsule was the continuation of perineurial sheath. This corpuscle was devoid of outer core structure as seen in a typical Pacini corpuscle. Ruffini-type corpuscles, 50-150 microns long and 25-50 microns wide, had the branched axon terminals with varicosities under the incomplete capsule. Axons, which were surrounded by thin Schwann cell processes, were embedded in the dense layers of collagen fibrils. The interior of the corpuscle was separated into small compartments by cell processes extended from the capsule. The axon varicosities contained numerous mitochondria. These fine structures of the corpuscles were similar to those of Ruffini corpuscles reported so far in other regions. Both Pacini-type and Ruffini-type corpuscles were clearly demonstrated by histochemistry for ChE. Inasmuch as the staining feature of corpuscles was different from each other, the distribution pattern of corpuscles in the joint capsules could be obtained by examining semi-serial sections. Pacini-type corpuscles were mainly found in the synovial layer, while Ruffini-type corpuscles were mainly located in the fibrous layer of the joint capsule. Both types of corpuscles were located near the median nerve on the flexor side of the joint. The reaction products of ChE activity were located in the peri-axonal as well as inter-lamellar spaces of Pacini-type corpuscles, and in the peri-axonal region as well as around Schwann cell processes of Ruffini-type corpuscles. No definite reaction product was found within axon terminals. Some reaction products were also found in the rough endoplasmic reticulum and/or nuclear envelope, suggesting that ChE is synthesized by Schwann cells. The significance of these sensory corpuscles with regard to the deep sensation in the joint capsule was discussed from the point of view of the electro-physiological characteristics of the corpuscles.

Animals↗

A prospective study of adhesive capsulitis of the shoulder ("frozen shoulder') in a high risk population.

In order to evaluate risk factors for adhesive capsulitis of the shoulder ("frozen shoulder') a prospective study was carried out in neurosurgical patients, in whom there is a high incidence of capsulitis. Ninety-nine patients were admitted into the study, most of whom had surgical treatment for sub-arachnoid haemorrhage. Ninety-one patients (92 per cent) were followed up at six months, and of these 23 (25.3 per cent) had developed adhesive capsulitis, which was bilateral in three. Three patients developed the shoulder-hand syndrome. By comparing the patients with capsulitis at six months with those in whom no capsulitis was found, we were able to evaluate 28 possible risk factors (Appendix I). The subsequent development of adhesive capsulitis in our patients was associated with, (1) impairment of consciousness, (2) hemiparesis, (3) duration of post-operative intravenous infusion, (4) age, and (5) depressive personality. These five associations were statistically significant. Associations with phenobarbitine therapy and hysterical personality were suggested, but these did not reach statistical significance. Routine treatment with corticosteroids post-operatively did not prevent capsulitis.

Adult↗

A comparative microscopic analysis of the capsule of the nerve to the inferior oblique muscle.

PURPOSE: To delineate the nature of the nerve capsule to the inferior oblique muscle at birth and adulthood, and to compare it to the nerve capsules of other extraocular muscles. METHODS: Fresh autopsy specimens were obtained from a newborn and a 26 year-old male. The length of the inferior oblique nerve was analyzed with high magnification photomicroscopy and electron microscopy and compared to the nerve capsules of the adult medial, lateral, inferior and superior rectus muscles. These were also compared to the intracranial portion of the third cranial nerve of the adult specimen. RESULTS: The collagen layer of the nerve to the inferior oblique was present throughout its course. It is well developed in the newborn and comparable to the adult specimen. The nerves to the medial, inferior, lateral and superior rectus muscles are also surrounded by a similar capsule containing collagen fibers that are aligned parallel to the axon of the nerve. The intracranial portion of the third cranial nerve only has a thin fibrous capsule. CONCLUSION: The nerve capsule of the inferior oblique comprises a surrounding collagen layer, presumably to protect the nerve from stretching. This layer is well developed along the entire course of the nerve and is present from birth. The nerves to the other extraocular muscles have a similar capsule that likely serves a similar function. These findings expand current understanding of the nerves to the extraocular muscles and may be useful for improving treatments.

Adult↗

Magnetic shells for gastrointestinal endoscopic capsules as a means to control their motion.

Wireless endoscopic video capsules are becoming largely used today for non-invasive explorations of the digestive tube. Traditional types of such capsules present a major drawback: their motion can not be controlled, since they proceed by means of the visceral peristalsis only. In order to enable a wireless control of their motion, this paper describes a new concept based on the use of external magnetic fields. The proposed technique exploits magnetic shells to be applied to traditional capsules prior to their use. The shells are capable of interacting with an imposed external magnetic field, providing a means to control the capsule movement and orientation. This solution is readily and cheaply applicable to any commercial endoscopic capsule, avoiding internal modifications. The paper reports results of preliminary bench tests. Prototype elastic shells made of a silicone elastomer mixed with magnetic particles were fabricated and tested with the Given Imaging M2A capsule in simplified experimental conditions. These tests permitted to demonstrate translations, rotations and roto-translations of the capsule/shell complex onto pieces of bovine tissues.

Capsule Endoscopes↗

Restoration of segmental bone defects in rabbit radius by biodegradable capsules containing recombinant human bone morphogenetic protein-2.

Recombinant human bone morphogenetic protein-2 (rhBMP-2) was encapsulated in biodegradable poly(DL-lactide-co-glycolide) (PLGA) capsules to regenerate bone by controlling the release rate of rhBMP-2. The rhBMP-2/PLGA capsules containing 12 microg of rhBMP-2 were implanted in seven 15-mm segmental defects of rabbits radii to examine the healing capacity of the rhBMP-2/PLGA capsules. For the control group, four segmental defects were left empty and two were implanted with ghost PLGA capsules. Healing of the defects was followed for 24 weeks and periodically evaluated by radiographs and histological examination. Mechanical testing was applied to three regenerated bone samples at 24 weeks postoperatively when the mature cortex was observed. Mechanical properties of regenerated bone were not significantly different from normal intact bone statistically. Histologically, the rhBMP-2/PLGA capsules disappeared completely during the process of bone regeneration. These results increased possibilities for clinical application of rhBMP-2/PLGA capsules.

Animals↗

Effect of food and relative bioavailability following single doses of diclofenac 150 mg hydrogel bead (HGB) capsules in healthy humans.

The effect of food on the bioavailability of diclofenac from a 150 mg diclofenac hydrogel bead (HGB) capsule was evaluated in 12 healthy male subjects in a fed and fasted state. Additionally, the fasting bioavailability of diclofenac from a 150 mg diclofenac HGB capsule relative to diclofenac sodium in buffered aqueous solution was evaluated in these same 12 subjects. The study was designed as an open-label, randomized, single-dose, 3 x 3 Latin-square crossover trial balanced for residual effects. A 2-week washout period was maintained between treatments. Blood samples were collected at frequent intervals over a 24-h period with plasma being separated and analyzed for diclofenac using a validated HPLC method. The administration of the 150 mg diclofenac HGB capsule dose within 30 min following a standardized breakfast minimally affected the bioavailability of diclofenac relative to administration under fasted conditions (7 per cent decrease in AUC(0-24), p greater than 0.05). There was, however, a 38 per cent decrease (p less than 0.05) in the Cmax and a three-fold increase (p less than 0.05) in Tmax for the fed HGB capsule administration. Under fasted conditions, significant differences in mean pharmacokinetic parameters were found between the 150 mg diclofenac HGB capsule and diclofenac sodium in buffered aqueous solution. The extent of availability of diclofenac from the HGB capsule was only 59 per cent relative to that from the solution (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗

Production and characterization of liquid-core capsules made from cross-linked acrylamide copolymers for biotechnological applications.

A novel chemistry has been developed for the production of capsules composed of a hydrophobic liquid core surrounded by a cross-linked polyacrylamide/alginate membrane. These liquid-core capsules may be used in capsular perstraction for the removal of inhibitory products from bioprocesses and bioconversions. They have the advantage of having a high surface area to promote rapid mass transfer, while separation of the organic core phase from the aqueous environment by the capsule membrane prevents the formation of stable emulsions and potential problems associated with toxicity of the organic phase for microbial cells or enzymes. Monodisperse spherical liquid-core capsules of between 800 microm and 1.6 mm diameter, with high mechanical resistance, have been prepared by co-extrusion, using the jet break-up technique. Capsules produced from a solution of MBA/total monomer (5%) were found to be more elastic and have a higher burst force when exposed to chelating agents such as phosphate or citrate. The mechanical resistance was unaffected by buffer solutions in the pH range 4-9 and after sterilization at 121 degrees C for 20 min. Capsules having membranes composed of a copolymer of acrylamide and N-hydroxymethylacrylamide exhibited even higher mechanical stability toward chelating agents.

Acrylic Resins↗

Self-assembly, optical behavior, and permeability of a novel capsule based on an azo dye and polyelectrolytes.

A novel capsule composed of an azo dye, Congo red (CR), and different polymers, including poly(styrenesulfonate, sodium salt) (PSS), poly(allylamine hydrochloride) (PAH), and poly(diallyldimethylammonium chloride) (PDDA), have been successfully fabricated by the layer-by-layer self-assembly technique. The stepwise linear deposition process was monitored by means of UV-visible absorption measurements. The formation of hollow capsules was verified by confocal laser scanning microscopy (CLSM) and scanning force microscopy (SFM). The resulting hollow PSS/PAH/CR/PDDA capsules displayed a sensitive response to visible light. Optical changes of the hollow capsules prior to and after the photoreaction were investigated in detail by means of UV-visible spectroscopy, CLSM, and SFM. It was found that the photochemical reaction of the assembled hollow capsules depends strongly on the matrix. Qualitative results on the permeability of the hollow capsule walls with CR as one component indicate that the permeability of the walls can be easily photo-controlled at varying irradiation time intervals without addition of external chemicals.

Azo Compounds↗