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Ashokkumar P, Kuppusamy SK, Chinnasamy R. Effects of melatonin on postoperative pain and sensory recovery following zygomaticomaxillary complex fractures - A randomized controlled trial. J Craniomaxillofac Surg 2024:S1010-5182(24)00137-9. [PMID: 38609755 DOI: 10.1016/j.jcms.2024.03.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 03/30/2024] [Indexed: 04/14/2024] Open
Abstract
Posttraumatic and postsurgical sensory disturbance is a known complication of almost all zygomaticomaxillary (ZMC) complex fractures involving the infraorbital nerve, for which few treatments are effective. Our study used neurosensory assessments to evaluate the efficacy of melatonin on pain and nerve healing following ZMC surgery. Sixty-four randomly allocated ZMC fracture patients were prophylactically administered either oral melatonin or an identical placebo for 15 consecutive days. Pre- and postsurgical clinical parameters included subjective pain, numbness, and objective neurosensory function. Melatonin significantly reduced subjective pain perception in the early postoperative days, with a significant difference in VAS scores between the groups from postoperative day 3 (p = 0.048) until day 7 (p = 0.002). The VAS assessment of subjective numbness perception showed significantly lower self-perceived neurosensory disturbance for patients in the interventional group from the first month (p = 0.039) until the third month (p = 0.005). Objective neurosensory assessment using the pinprick test and two-point discrimination showed statistically significant improvement to almost normal sensation by the first month (p = 0.014) to fully normal sensation by the third month (p = 0.001). The study findings suggest that the prophylactic administration of melatonin confers significant clinical benefits in terms of reduced postoperative pain and improved sensory recovery.
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Affiliation(s)
- Pavithran Ashokkumar
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, Sri Ramachandra Institute of Higher Education and Research, Chennai, 9894339889, India.
| | - Santhosh Kumar Kuppusamy
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, Sri Ramachandra Institute of Higher Education and Research, Chennai, 9894339889, India.
| | - Ravindran Chinnasamy
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, Sri Ramachandra Institute of Higher Education and Research, Chennai, 9894339889, India.
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Li X, Fu J, Zhou H, Dong Y, Alhaskawi A, Wang Z, Lai J, Yao C, Ezzi SHA, Kota VG, Abdulla MHAH, Guan M, Lou X, Lu H. The effects of melatonin in the treatment of acute brachial plexus compression injury in rats. Front Neurol 2023; 14:1111101. [PMID: 36937512 PMCID: PMC10015383 DOI: 10.3389/fneur.2023.1111101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 01/30/2023] [Indexed: 03/05/2023] Open
Abstract
Introduction Brachial plexus injury (BPI) is one of the most destructive peripheral nerve injuries and there is still a lack of effective treatment. Methods This study was conducted to evaluate the effects of melatonin in the treatment of acute brachial plexus compression injury in rats using histopathological, histomorphometric, immunohistochemical and electrophysiological methods. Forty-eight adult male Sprague Dawley rats were randomly allocated into three groups: sham, melatonin and vehicle groups. The brachial plexus compression injury model was performed by a vascular clamp. Melatonin group received intraperitoneal injection of melatonin at doses of 10 mg/kg for 21 days after crush injury. The conduction velocity and amplitude of compound muscle action potential (CAMP) in the regenerated nerve, and nerve histomorphometry, as well as levels of myelin protein zero (P0) protein of the crush region were assessed. Results Compared with the vehicle group, the melatonin group which reported significant increased CMAP conduction velocity and amplitude also showed thicker myelin sheath and lower levels of P0 protein. Discussion Our results suggest that melatonin effectively promotes nerve regeneration and improves the function of damaged nerves. Melatonin treatment is a promising strategy for the treatment of acute brachial plexus compression injury.
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Affiliation(s)
- Xigong Li
- Department of Orthopedics, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Jing Fu
- Department of Stomatology, Affiliated Hangzhou Xixi Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Haiying Zhou
- Department of Orthopedics, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Yanzhao Dong
- Department of Orthopedics, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Ahmad Alhaskawi
- Department of Orthopedics, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Zewei Wang
- Department of Clinical Medicine, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Jingtian Lai
- Department of Clinical Medicine, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Chengjun Yao
- Department of Clinical Medicine, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Sohaib Hasan Abdullah Ezzi
- Department of Orthopaedics of the 3rd Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Vishnu Goutham Kota
- Department of Clinical Medicine, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | | | - Ming Guan
- Department of Orthopedics, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Xianfeng Lou
- Department of Orthopedics, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Hui Lu
- Department of Orthopedics, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
- Alibaba-Zhejiang University Joint Research Center of Future Digital Healthcare, Zhejiang University, Hangzhou, Zhejiang, China
- *Correspondence: Hui Lu
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Govindasamy N, Chung Chok K, Ying Ng P, Yian Koh R, Moi Chye S. Melatonin Induced Schwann Cell Proliferation and Dedifferentiation Through NF-ĸB, FAK-Dependent but Src-Independent Pathways. Rep Biochem Mol Biol 2022; 11:63-73. [PMID: 35765532 PMCID: PMC9208554 DOI: 10.52547/rbmb.11.1.63] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 08/15/2021] [Indexed: 06/15/2023]
Abstract
BACKGROUND Peripheral nerve injury (PNI) is a common condition that compromises motor and sensory functions. Peripheral nerves are known to have regenerative capability and the pineal hormone, melatonin, is known to aid nerve regeneration. However, the role of Schwann cells and the pathways involved remain unclear. Thus, the aim of this study is to identify the effects of melatonin on Schwann cell proliferation, dedifferentiation, and the involvement of nuclear factor kappa light chain enhancer of activated B cells (NF-ĸB), focal adhesion kinase (FAK) and proto-oncogene tyrosine-protein kinase, Src pathways in this process. METHODS Schwann cells was treated with melatonin and its proliferation and dedifferentiation were identified using MTT assay and immunofluorescence staining for SRY (sex determining region Y)-box 2 (SOX2). Next, the protein expressions of NF-ĸB, FAK and Src pathways were identified by Western blot. RESULTS MTT results confirmed increased proliferation of Schwann cells with melatonin treatment, and it was highest at 10 μM melatonin. Immunofluorescent staining revealed an increase in the green fluorescence staining for SOX2 in melatonin-treated cells, showing enhanced dedifferentiation. Western blot assay revealed melatonin increased phospho-NF-ĸB (PNF-ĸB), IKK-α, FAK (D2R2E), phospho-FAK (Tyr 576/577 and Tyr 397) protein expressions as compared with control. However, Src (32G6), Lyn (C13F9), Fyn, Csk (C74C1) protein expressions were not increased as compared with control. CONCLUSION Melatonin promotes Schwann cell proliferation and dedifferentiation via NF-ĸB, FAK-dependent but Src-independent pathways.
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Affiliation(s)
- Navishaa Govindasamy
- School of Medicine, International Medical University, 57000 Kuala Lumpur, Malaysia
| | - Kian Chung Chok
- School of Health Science, International Medical University, 57000 Kuala Lumpur, Malaysia.
| | - Pei Ying Ng
- School of Postgraduate, International Medical University, 57000 Kuala Lumpur, Malaysia.
| | - Rhun Yian Koh
- Division of Biomedical Science and Biotechnology, School of Health Science, International Medical University.
| | - Soi Moi Chye
- Division of Biomedical Science and Biotechnology, School of Health Science, International Medical University.
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The effects of melatonin prophylaxis on sensory recovery and postoperative pain following orthognathic surgery: a triple-blind randomized controlled trial and biochemical analysis. Int J Oral Maxillofac Surg 2020; 49:446-453. [DOI: 10.1016/j.ijom.2019.07.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 05/21/2019] [Accepted: 07/04/2019] [Indexed: 01/30/2023]
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Shabeeb D, Musa AE, Keshavarz M, Hassanzadeh G, Hadian MR, Nowrouzi A, Shirazi A, Najafi M. Melatonin Ameliorates Radiation-induced Sciatic Nerve Injury. LETT DRUG DES DISCOV 2019. [DOI: 10.2174/1570180816666190617160434] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:
Radiotherapy is a treatment method for cancer mostly utilized for about
60% of cancer patients. Peripheral neuropathy is one of the severe complications of radiotherapy.
Two stages of neuropathy will occur following irradiation; electrophysiological and biochemical
variations as the first stage, while the second stage involves fibrosis of soft tissues surrounding the
exposed nerve. This novel study aimed to investigate the radioprotective effects of melatonin against
ionizing radiation-induced sciatic nerve damage.
Methods:
60 rats were randomly assigned to four groups; C (Control), M (Melatonin), R (Radiation),
MR (Radiation + Melatonin). Their right legs were exposed to 30 Gy single dose gamma rays. Melatonin
(100 mg/kg) was administered 30 min before irradiation and once daily (5 mg/kg) till the day
of rats’ sacrifice. Their exposed nerve tissues were evaluated for biochemical changes in addition to
Electromyography (EMG) and Nerve Conduction Study (NCS).
Results:
4, 12 and 20 weeks post-irradiation, EMG and NCS examinations in R group showed reduced
Compound Muscle Action Potential (CMAP) representing axonal degeneration when compared
with C and M groups. Prolonged latency and a decrease in Conduction Velocity (CV) gave an
indication of demyelinating neuropathy at 12 and 20 weeks. EMG and NCS results of R group
showed partial nerve lesion. Biochemical assessments showed that irradiation of sciatic nerve led to
increased MDA level, as well as decreased CAT and SOD activities. However, in all cases, treatment
with melatonin can reverse these effects.
Conclusion:
We conclude that melatonin can improve electrophysiological, oxidative stress and
antioxidant defense features of irradiated rats’ sciatic nerves. We would also recommend the use of
melatonin in an optimal and safe dose. It should be administered over a long period of time for effective
protection of the peripheral nerve tissues, as well as improving the therapeutic ratio of radiotherapy.
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Affiliation(s)
- Dheyauldeen Shabeeb
- Department of Medical Physics and Biomedical Engineering, School of Medicine, Tehran University of Medical Sciences, International Campus, Tehran, Iran
| | - Ahmed Eleojo Musa
- Department of Medical Physics and Biomedical Engineering, School of Medicine, Tehran University of Medical Sciences, International Campus, Tehran, Iran
| | - Mansoor Keshavarz
- Electrophysiology Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Gholamreza Hassanzadeh
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammed Reza Hadian
- Brain and Spinal Cord Injury, Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Azin Nowrouzi
- Department of Biochemistry, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Shirazi
- Department of Medical Physics and Biomedical Engineering, School of Medicine, Tehran University of Medical Sciences, International Campus, Tehran, Iran
| | - Masoud Najafi
- Radiology and Nuclear Medicine Department, School of Paramedical Sciences, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Histopathological and Functional Evaluation of Radiation-Induced Sciatic Nerve Damage: Melatonin as Radioprotector. ACTA ACUST UNITED AC 2019; 55:medicina55080502. [PMID: 31430996 PMCID: PMC6722514 DOI: 10.3390/medicina55080502] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 08/15/2019] [Accepted: 08/16/2019] [Indexed: 12/11/2022]
Abstract
Background and Objectives: Radiotherapy uses ionizing radiation for cancer treatment. One of the side effects of radiotherapy is peripheral neuropathy. After irradiation, the first stage of neuropathy involves electrophysiological, biochemical and histopathological variations, while the fibrosis of soft tissues surrounding the exposed nerve occurs in the second stage. The present study aimed to examine the radioprotective effects of melatonin against ionizing radiation-induced sciatic nerve damage. Materials and Methods: Sixty male Wistar rats were assigned to four groups: C (Control + Vehicle), M (Melatonin), R (Radiation + Vehicle), MR (Radiation + Melatonin). Their right legs were irradiated with a 30 Gy single dose of gamma rays. Then, 100 mg/kg melatonin was administered to the animals 30 min before irradiation once daily (5 mg/kg) until the day of rats' sacrifice. Their exposed nerve tissues were assessed using the sciatic functional index (SFI) and histological evaluation. Results: Four, 12 and 20 weeks post irradiation, the SFI results showed that irradiation led to partial loss of motor nerve function after 12 and 20 weeks. Histological evaluation showed the various stages of axonal degeneration and demyelination compared to the C and M groups. Scar-like tissues were detected around the irradiated nerves in the R group at 20 weeks, but were absent in the MR group. The SFI and histological results of the R group showed partial nerve lesion. However, in all cases, treatment with melatonin prevented these effects. Conclusions: Results showed that melatonin has the potential to improve functional and morphological features of exposed sciatic nerves. This could possibly improve the therapeutic window of radiotherapy.
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Tuna Edizer D, Dönmez Z, Gül M, Yiğit Ö, Yiğitcan B, Adatepe T, Uzun N. Effects of Melatonin and Dexamethasone on Facial Nerve Neurorrhaphy. J Int Adv Otol 2018; 15:43-50. [PMID: 30541731 DOI: 10.5152/iao.2018.3273] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES To investigate the effects of topical and systemic administrations of melatonin and dexamethasone on facial nerve regeneration. MATERIALS AND METHODS In total, 50 male albino Wistar rats underwent facial nerve axotomy and neurorrhaphy. The animals were divided into 5 groups: control, topical melatonin, systemic melatonin, topical dexamethasone, and systemic dexamethasone. Nerve conduction studies were performed preoperatively and at 3, 6, 9, and 12 weeks after drug administrations. Amplitude and latency of the compound muscle action potentials were recorded. Coapted facial nerves were investigated under light and electron microscopy. Nerve diameter, axon diameter, and myelin thickness were recorded quantitatively. RESULTS Amplitudes decreased and latencies increased in both the melatonin and dexamethasone groups. At the final examination, the electrophysiological evidence of facial nerve degeneration was not significantly different between the groups. Histopathological examinations revealed the largest nerve diameter in the melatonin groups, followed by the dexamethasone and control groups (p<0.05). Axon diameter of the control group was smaller than those of the melatonin (topical and systemic) and topical dexamethasone groups (p<0.05). The melatonin groups had almost normal myelin ultrastructure. CONCLUSION Electrophysiological evaluation did not reveal any potential benefit of dexamethasone and melatonin in contrast to histopathological examination, which revealed beneficial effects of melatonin in particular. These agents may increase the regeneration of facial nerves, but electrophysiological evidence of regeneration may appear later.
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Affiliation(s)
- Deniz Tuna Edizer
- Department of Otorhinolaryngology, İstanbul Training and Research Hospital, İstanbul, Turkey
| | - Zehra Dönmez
- Department of Otorhinolaryngology, İstanbul Training and Research Hospital, İstanbul, Turkey
| | - Mehmet Gül
- Department of Histology and Embryology, İnönü University School of Medicine, Malatya, Turkey
| | - Özgür Yiğit
- Department of Otorhinolaryngology, İstanbul Training and Research Hospital, İstanbul, Turkey
| | - Birgül Yiğitcan
- Department of Histology and Embryology, İnönü University School of Medicine, Malatya, Turkey
| | - Turgut Adatepe
- Department of Electrophysiology, İstanbul Training and Research Hospital, İstanbul, Turkey
| | - Nurten Uzun
- Department of Neurology, İstanbul University-Cerrahpaşa, Cerrahpaşa School of Medicine, İstanbul, Turkey
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Kuklina EM. [Melatonin as an inducing factor for multiple sclerosis]. Zh Nevrol Psikhiatr Im S S Korsakova 2016; 116:102-105. [PMID: 27437545 DOI: 10.17116/jnevro201611651102-105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Melatonin is one of the most multifunctional regulators in the organism. It plays a key role in the control of nerve, endocrine, and immune systems. Due to hormone neuroprotective activity, the possibility is now discussed on its clinical usage in treating neurodegenerative diseases, including multiple sclerosis. At the same time, melatonin is an effective regulator of immune reactions, in part, the reactions toward autoantigens. In this respect, the subset ofT lymphocytes producing IL-17 (Th17) is of special interest. As the Th17 subset plays a key role iri multiple sclerosis pathogenesis, the immunomodulating hormone effects toward Th17, may, in theory, nullify its positive neuroprotective activity.
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Affiliation(s)
- E M Kuklina
- Institute of Ecology and Genetics of Microorganisms, Russian Academy of Sciences, Perm, Russia
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Melatonin attenuates intermittent hypoxia-induced lipid peroxidation and local inflammation in rat adrenal medulla. Int J Mol Sci 2014; 15:18437-52. [PMID: 25314303 PMCID: PMC4227224 DOI: 10.3390/ijms151018437] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Revised: 09/26/2014] [Accepted: 10/02/2014] [Indexed: 12/28/2022] Open
Abstract
Chronic intermittent hypoxia (CIH) induces lipid peroxidation and leads to cardiovascular dysfunction, in which impaired activities of the adrenal medulla are involved. This may be caused by CIH-induced injury in the adrenal medulla, for which the mechanism is currently undefined. We tested the hypothesis that melatonin ameliorates the CIH-induced lipid peroxidation, local inflammation and cellular injury in rat adrenal medulla. Adult Sprague–Dawley rats were exposed to air (normoxic control) or hypoxia mimicking a severe recurrent sleep apnoeic condition for 14 days. The injection of melatonin (10 mg/kg) or vehicle was given before the daily hypoxic treatment. We found that levels of malondialdehyde and nitrotyrosine were significantly increased in the vehicle-treated hypoxic group, when compared with the normoxic control or hypoxic group treated with melatonin. Also, the protein levels of antioxidant enzymes (superoxide dismutase (SOD)-1 and SOD-2) were significantly lowered in the hypoxic group treated with vehicle but not in the melatonin group. In addition, the level of macrophage infiltration and the expression of inflammatory cytokines (tumor necrosis factor (TNF)-α, interleukin (IL)-1β and IL-6) and mediators (inducible nitric oxide synthase (iNOS), cyclooxygenase-2 (COX-2)) were elevated in the vehicle-treated hypoxic group, but were significantly ameliorated by the melatonin treatment. Moreover, the amount of apoptotic cells in the hypoxic groups was significantly less in the melatonin-treated group. In conclusion, CIH-induced lipid peroxidation causes local inflammation and cellular injury in the adrenal medulla. The antioxidant and anti-inflammatory actions of melatonin are indicative of a protective agent against adrenal damage in patients with severe obstructive sleep apnea syndrome.
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Jo JI, Lin X, Nakahara T, Aoki I, Saga T, Tabata Y. Preparation of Polymer-Based Magnetic Resonance Imaging Contrast Agent to Visualize Therapeutic Angiogenesis. Tissue Eng Part A 2013; 19:30-9. [DOI: 10.1089/ten.tea.2012.0131] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Affiliation(s)
- Jun-ichiro Jo
- Department of Biomaterials, Institute for Frontier Medical Sciences, Kyoto University, Kyoto, Japan
- Diagnostic Imaging Program, Molecular Imaging Center, National Institute of Radiological Sciences, Chiba, Japan
| | - Xue Lin
- Department of Biomaterials, Institute for Frontier Medical Sciences, Kyoto University, Kyoto, Japan
| | - Teppei Nakahara
- Diagnostic Imaging Program, Molecular Imaging Center, National Institute of Radiological Sciences, Chiba, Japan
| | - Ichio Aoki
- Diagnostic Imaging Program, Molecular Imaging Center, National Institute of Radiological Sciences, Chiba, Japan
| | - Tsuneo Saga
- Diagnostic Imaging Program, Molecular Imaging Center, National Institute of Radiological Sciences, Chiba, Japan
| | - Yasuhiko Tabata
- Department of Biomaterials, Institute for Frontier Medical Sciences, Kyoto University, Kyoto, Japan
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Liu J, Jo JI, Kawai Y, Aoki I, Tanaka C, Yamamoto M, Tabata Y. Preparation of polymer-based multimodal imaging agent to visualize the process of bone regeneration. J Control Release 2012; 157:398-405. [DOI: 10.1016/j.jconrel.2011.09.090] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2010] [Revised: 09/21/2011] [Accepted: 09/23/2011] [Indexed: 10/17/2022]
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12
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Design of iron oxide nanoparticles with different sizes and surface charges for simple and efficient labeling of mesenchymal stem cells. J Control Release 2010; 142:465-73. [DOI: 10.1016/j.jconrel.2009.11.014] [Citation(s) in RCA: 72] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2009] [Revised: 11/04/2009] [Accepted: 11/15/2009] [Indexed: 01/05/2023]
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