Stabilization of an inserted tricalcium phosphate spacer enhances the healing of a segmental tibial defect in sheep

The effect of inserting a tricalcium phosphate (TCP) spacer stabilized by a rigid or non-rigid fixation technique on the healing of segmental tibial defects of critical size was established. The osteotomized tibiae, 11 with and 8 without TCP spacers, were fixed by an external circular device in 11 mature sheep and by plates in 8 mature sheep, respectively. Healing was evaluated roentgenographically 16 weeks after the operation. Compared with the defects without TCP spacers, enhanced stability and healing were observed in the defects with TCP spacers under an identical external fixation. Furthermore, a significantly higher incidence of healing was obtained with plate fixation than with external device fixation in the TCP-implanted defects (P < 0.04). An abundant bridging callus was roentgenograpically demonstrated in most of the healed defects, but none in the unhealed defects. The TCP spacer with its mechanical integrity enhances the stability of external fixation, and the stable immobilization provided by rigid fixation is essential for osteoconduction of an inserted TCP spacer in the healing of segmental diaphyseal defects in sheep.     

Autologous calvarial and iliac onlay bone grafts in miniature swine

Calvarial bone has been reported to be superior to iliac bone for onlay bone grafting due to decreased resorption. This study evaluated the physical, histologic, and radiographic characteristics of calvarial and corticocancellous iliac onlay bone grafts in nine Pitman-Moore miniature swine at 2 weeks, and at 1-, 2-, 4-, 6-, 7-, 8-, 10-, and 12-month intervals. Compared with iliac grafts, the calvarial onlay grafts had more than a twofold greater radiographic density. Statistical analysis of the mature grafts using the standard of estimated means of the bone graft volumes revealed 85% retention of the calvarial grafts compared with 34% retention of the grafted iliac bone. There was no subjective difference in the rate or degree of revascularization between the two grafted materials.     

Expression of the osteogenic phenotype in porous hydroxyapatite implanted extraskeletally in baboons

A porous hydroxyapatite was used as a morphogenetic matrix to study early tissue formation preceding the morphogenesis of bone in extraskeletal sites of the baboon (Papio ursinus). Porous hydroxyapatites, obtained by hydrothermal conversion of the calcium carbonate exoskeleton of coral, were implanted extraskeletally in 16 baboons. Specimens were harvested at days 30, 60 and 90, and processed to obtain decalcified sections for histomorphometry, and undecalcified sections for enzyme histochemical demonstration of alkaline phosphatase, immunohistochemical demonstration of laminin and type I collagen, and for comparative histologic analysis. At day 30, the tissue that invaded the porous spaces showed mesenchymal condensations at the hydroxyapatite interface, and prominent vascular penetration. Collagen type I staining was localized within mesenchymal condensations. Bone had not formed in any specimen harvested at day 30. At days 30 and 60, alkaline phosphatase staining was initially localized in the invading vasculature, and subsequently found in cellular condensations prior to their transformation into bone, and in capillaries close to cellular condensations. Laminin staining was localized around invading capillaries adjacent to and within mesenchymal condensations, and in capillaries in direct contact with the hydroxyapatite. Bone had formed by day 60; cartilage, however, was never observed. By day 90, bone formation within the porous spaces was often extensive. Goldner's trichrome stain and fluorescence microscopy of tetracycline-labeled specimens demonstrated nascent mineralization within condensations during initial bone morphogenesis. Coating the hydroxyapatite with collagen type I prepared from baboon bone did not increase the amount of bone formation. In this hydroxyapatite-induced osteogenesis model in primates, vascular invasion and bone differentiation appear to be accompanied by a specific temporal sequence of alkaline phosphatase expression. The differentiation of osteogenic cells in direct apposition to the hydroxyapatite suggests that this substratum may act as a solid state matrix for adsorption and controlled release of endogenously-produced bone morphogenetic proteins. The porous hydroxyapatite, as used in this bioassay in primates, may be an appropriate delivery system for bone morphogenetic proteins for the controlled initiation of therapeutic osteogenesis.     

Surgical preparation of miniature swine for atherosclerosis research

A 2-stage surgical procedure for chronic intestinal, vascular, and lymphatic sampling in miniature swine is described. Cannulas were placed in the jejunum and ileum, followed by a 2nd implantation of indwelling catheters in the portal and hepatic veins, caudal vena cava, abdominal aorta, and cisterna chyli. The techniques used proved that miniature swine can be surgically adapted to meet experimental requirements.     

Formation of hydroxyapatite in new calcium phosphate cements

Tetracalcium phosphate (TTCP) has been shown previously to be an essential component of self-setting calcium phosphate cements that form hydroxyapatite (HA) as the only end-product. We report herein on a new self-setting calcium phosphate cement that does not contain TTCP. These cements consist of dicalcium phosphate anhydrous (DCPA), dicalcium phosphate dihydrate (DCPD), alpha-tricalcium phosphate, or amorphous calcium phosphate and, as an additional source of calcium, calcium hydroxide or calcium carbonate. These cements require the use of a phosphate (0.2 moll(-1) or higher) solution or a high pH solution as the cement liquid. The cements harden in relatively short time (5-30 min) and form HA as the dominant end-product in 24 h. The diametral tensile strengths of the 24-h samples are in the range of 0.2 to 7.5 MPa. Results from X-ray diffraction studies suggest that the cement setting is caused by rapid HA formation induced by the high phosphate concentration of the cement liquid. Because DCPA and DCPD are highly soluble at pH values above 12.7, which is the pK3 of phosphoric acid, high phosphate concentration in the slurry solution was also attainable by using a highly alkaline solution as the cement liquid. The physicochemical properties of these cements are comparable to those of TTCP-containing cements, and the new cements may be expected to have in vivo characteristics similar to those of TTCP-containing cements as well.     

Long-term biocompatibility of a miniature stimulator implanted in feline hind limb muscles

Chronic foreign-body responses and muscular changes were examined following the implantation of active miniature stimulators into the hind limb muscles of cats for periods of up to three months. The radio-frequency (RF)-powered stimulators were injected into muscles through a 12-gauge hypodermic needle. The tissue responses around the active stimulators were compared histologically to those provoked by passive devices, broken glass, silicone tubing, polyester suture material coated with polybutylate, and two of the internal components of the stimulator (ferrite, integrated circuit chip). Active and passive stimulators produced similar, benign foreign-body reactions that resulted in an essentially identical fibrous capsule over time. The responses were similar to those produced by the internal components and the suture material, and were more modest than those produced by the broken glass. The capsule did not appear to interfere with the functionality of active devices because thresholds measured during the post-implantation survival period did not change significantly over time. Unexpectedly, the severity of the reaction differed significantly amongst the various target muscles. Medial gastrocnemius exhibited the most severe response, whereas tibialis anterior had the least reaction.     

Skeletal muscle biochemical adaptations to exercise training in miniature swine

The primary purpose of this study was to test the hypothesis that endurance exercise training induces increased oxidative capacity in porcine skeletal muscle. To test this hypothesis, female miniature swine were either trained by treadmill running 5 days/wk over 16-20 wk (Trn; n = 35) or pen confined (Sed; n = 33). Myocardial hypertrophy, lower heart rates during submaximal stages of a maximal treadmill running test, and increased running time to exhaustion during that test were indicative of training efficacy. A variety of skeletal muscles were sampled and subsequently assayed for the enzymes citrate synthase (CS), 3-hydroxyacyl-CoA dehydrogenase, and lactate dehydrogenase and for antioxidant enzymes. Fiber type composition of a representative muscle was also determined histochemically. The largest increase in CS activity (62%) was found in the gluteus maximus muscle (Sed, 14.7 +/- 1.1 mumol.min-1.g-1; Trn, 23.9 +/- 1.0; P < 0.0005). Muscles exhibiting increased CS activity, however, were located primarily in the forelimb; ankle and knee extensor and respiratory muscles were unchanged with training. Only two muscles exhibited higher 3-hydroxyacyl-CoA dehydrogenase activity in Trn compared with Sed. Lactate dehydrogenase activity was unchanged with training, as were activities of antioxidant enzymes. Histochemical analysis of the triceps brachii muscle (long head) revealed lower type IIB fiber numbers in Trn (Sed, 42 +/- 6%; Trn, 10 +/- 4; P < 0.01) and greater type IID/X fiber numbers (Sed, 11 +/- 2; Trn, 22 +/- 3; P < 0.025). These findings indicate that porcine skeletal muscle adapts to endurance exercise training in a manner similar to muscle of humans and other animal models, with increased oxidative capacity. Specific muscles exhibiting these adaptations, however, differ between the miniature swine and other species.     

Biological effects and cytotoxicity of the composite composed by tricalcium phosphate and glutaraldehyde cross-linked gelatin

The purpose of this study was to prepare and evaluate the feasibility and cytocompatibility of a composite (GTG) as a large defect bone substitute. The composite is combined with tricalcium phosphate ceramic particles and glutaraldehyde cross-linked gelatin. Gelatin had been reported as an adhesive and biocompatible binder that could accelerate the recovery of damaged soft tissue, but the effects of gelatin when acting on the bone tissue is not clear. Thus, it is necessary to determine if the substances released from the GTG composite can facilitate the growth of bone cells. The substances released from the GTG composites after being soaked in deionized distilled water were analyzed by gas chromatography (GC), ultraviolet and visible absorption spectroscopy (UV-VIS), and inductive-coupled plasma-atomic emission spectrometry (ICP-AES). The cytotoxicity of the GTG composites was assessed by coculture of rat osteoblasts in vitro. Extracts were obtained by soaking the GTG composites in deionized distilled water for 1, 2, 4, 7, 14, 28 and 42 d. The extract mixed with complete medium in a ratio of 1:1 was added into the cell culture wells containing 1 x 10(4) cells ml(-1) osteoblasts. After culturing for 2 days, the cells attached to the surface of wells were trypsinized and the number calculated by the Neubauer counting-chamber under the optical microscope. Finally, three samples in each GTG group were examined by scanning electron microscopy (SEM) to observe the morphology of the osteoblasts attached to the surfaces of GTG composites. The examinations of osteoblasts cocultured with the developed GTG composites were used to decide the ideal concentration of glutaraldehyde as a cross-linking agent. The results of extracts cocultured with osteoblasts showed that the extracts obtained from the 2, 4 and 8% glutaraldehyde cross-linked GTG composites would inhibit the growth of osteoblasts in the first 4 soaking days. During the 4-7 days soaking, the cell numbers quickly increased with the soaking time, thereafter, the cell numbers almost reached a constant value. In the analyses of substances released from the GTG composites, it was found that the gelatin and calcium were gradually released from the GTG composites, which were supposed to be nutritious for the growth of the osteoblast. The results of osteoblasts cocultured with the GTG composites showed that the concentration of glutaraldehyde used as a cross-linking agent should be lower than 8%. Compared to the GTF (composite combined with tricalcium phosphate ceramic particles and formaldehyde cross-linked gelatin), GTG composites were much suitable for a large defect bone substitute in the near future.     

放电等离子烧结钛基磷酸三钙陶瓷复合材料的力学性能与生物活性

采用放电等离子烧结法制备钛基磷酸三钙(Ti/α-TCP)复合材料,利用扫描电镜(SEM),能谱分析仪(EDS)和X射线衍射仪(XRD)对该材料的组织结构与界面反应进行观察与分析,并测试其抗压强度与生物活性,研究烧结温度与钛含量对Ti/TCP复合材料组织与性能的影响。结果表明:烧结温度在900℃以上时,Ti与α-TCP界面发生反应;增加钛含量有利于提高复合材料的强度。在Ti/α-TCP混合粉末中添加钛网作为骨架时,界面反应更复杂,并且温度越高,反应产物越多,当烧结温度达到1 100℃时,生成Ti的氧化物以及TixPy和CaTiO_3。在900℃烧结的70Ti/α-TCP/钛网复合材料抗压强度最高,达到590 MPa,浸入模拟体液中14天后表面形成一层厚厚的磷灰石,该材料作为骨植入替换材料具有很大的应用价值。     

Periradicular healing in response to Diaket root-end filling material with and without tricalcium phosphate

The healing of the periradicular tissues was evaluated when the polyvinyl resin Diaket with and without tricalcium phosphate was used as surgical root-end filling material. Non-surgical root canal treatment was performed on 56 mandibular premolar roots in mongrel dogs. Following root-end resection, root-end cavity preparations were filled with Diaket, the comparative material, or Diaket in combination with tricalcium phosphate, the experimental material. Postsurgically, healing of the tissues adjacent to the filling materials and in the surrounding surgical site were evaluated at 30 and 60 days. There was virtually no statistically significant difference between the experimental and comparative group at or within the 30- or 60-day period with regard to inflammation, connective tissue formation, root-end encapsulation, cementum formation, or bone apposition. Findings suggest that cementogenesis occurred over both materials. The overall healing of the periradicular tissues was favourable.     

Inverse effect of chronically elevated blood flow on atherogenesis in miniature swine

The effect of chronically elevated blood flow on the development of atherosclerosis in miniature swine was studied. Fistulas connecting the right external iliac artery and vein were surgically created in four swine, while three were not fistulated. Pulsed Doppler velocity detection cuffs placed around the abdominal aorta and both iliac arteries of all pigs permitted chronic measurements of blood velocity, blood velocity distributions, and blood flow. All swine were fed an atherogenic diet consisting of 20% beef tallow, 3% cholesterol, and 5% cholic acid for 6 months. This diet elevated the serum cholesterol to values exceeding 500 mg/100 ml. Creation of the arteriovenous fistula (AVF) markedly elevated blood velocity and flow in the abdominal aorta and in the shunted iliac artery. In the shunted animals the aortic blood flow was 42.1 +/- 2.0 ml/sec compared with 17.3 +/- 1.4 ml/sec in the unshunted swine. The velocity distribution pattern across the vessel was also indicative of an elevated wall shear stress. After 6 months, the animals were killed and the arterial vessels examined macroscopically and microscopically for the presence of atherosclerotic lesions. In the shunted pigs, 17 +/- 15% of the lumenal surface was occupied by sudanophilic lesions, whereas 80 +/- 8% of the surface was covered by lesions in the unshunted (control) pigs. From these studies, it is apparent that mechanical factors related to blood flow rates can influence the development of atherosclerotic lesions in swine.     

Effects of regional stimulation using a miniature stimulator implanted in feline posterior biceps femoris

The effects of placement of a miniature implantable stimulator on motor unit recruitment were examined in the posterior head of cat biceps femoris. The implantable stimulator (13-mm long x 2-mm diameter) was injected either proximally near the main nerve branch, or distally near the muscle insertion, through a 12-gauge hypodermic needle. Glycogen-depletion methods were used to map the distribution of fibers activated by electrical stimulation. Muscle fibers were found to be depleted at most or all proximodistal levels of the muscle, but the density of depleted fibers varied transversely according to the stimulus strength and proximity of the device to the nerve-entry site. Thus, muscle cross sections often had a "patchy" appearance produced because different proportions of depleted fibers intermingled with undepleted fibers in different parts of the cross section. In other preparations, the force of muscle contraction was measured when stimuli of varying strengths were delivered by the stimulator positioned at the same proximal or distal sites within the muscle. Devices placed close to the nerve-entry site produced the greatest forces. Those placed more distally produced less force. As stimulus current and/or pulse width increased, muscle force increased, often in steps, until a maximum was reached, which was usually limited by the compliance voltage of the device to less than the force produced by whole nerve stimulation.     

Coronary blood flow during +Gz stress in +Gz conditioned adult miniature swine

Four female adult miniature swine were acceleration conditioned for a period of 1 month using repeated acute exposure to simulated aerial combat maneuver profiles which exposed the animals to an average of +4.5G, for 106s. This period of conditioning produced adaptation as evidenced by decreased maximal heart rates during +Gz and by the absence of any +Gz induced gross cardiac pathology. Coronary blood flow was measured in these conditioned animals with the radiolabeled microsphere technique. Blood flows were measured under resting conditions, during 60s exposures to +3Gz and +5Gz and 10 min after +5Gz exposure. Coronary flow was increased 2-3 fold during +3Gz and +5Gz. The regional distribution of coronary blood flow during +Gz was similar to that under resting control conditions. There were no significant differences between coronary blood flows during +Gz in these conditioned animals and the values previously reported from the initial exposure of miniature swine to similar levels of +Gz. These results indicate that 1 month of acceleration conditioning of the types used in these studies has no significant effect on the response of coronary blood flow to +3Gz and +5Gz stress.     

A quantitative study of the sintering and mechanical properties of hydroxyapatite/phosphate glass composites

Previous work has shown that small additions of a phosphate glass (CaO-P2O5) can significantly enhance the sinterability and strength of hydroxyapatite. However, there are no quantitative phase analyses available for these materials which would provide indicators of biocompatibility and resorbability. Similarly, there is little information available about the mechanical properties, especially with high glass additions. In this study, the effects of sintering hydroxyapatite with phosphate glass additions of 2.5, 5, 10, 25, and 50 wt.% are quantified. Each composition was sintered over a range of temperatures, and quantitative phase analysis was carried out using XRD. In addition, the microstructures were studied using RLOM and SEM, and mechanical properties (Vickers hardness, KIC, and MOR) measured. These results may be used to indicate which compositions and processing conditions may provide materials suitable for use in hard tissue replacement. Composites containing up to 10 wt.% glass additions formed dense HA/TCP composite materials possessing flexural strength and fracture toughness values up to 200% those of pure HA. The HA/TCP ratio was strongly dependent on the percentage glass addition. Higher glass additions resulted in composites containing beta-TCP together with large amounts of alpha- or beta-calcium pyrophosphate, and having similar mechanical strengths to pure HA.     

Stability of the mandibular position in occlusion of mandibulectomy patients with lateral discontinuity defect

In mandibulectomy patients with lateral discontinuity defect, the mandible is severely deviated and the occlusion is considered to be unstable. A thorough understanding of the mandibular occlusal position of these patients is important to achieve desirable results in their occlusal rehabilitation. This study compared the stability of the mandibular positions in occlusion, when the opening distance or the biting force was changed during mandibular movements, by simultaneously measuring four points on the mandible three-dimensionally. This study indicated that the mandibular positions in occlusion of these patients were extremely unstable as compared with those of the normal subjects and were considerably different from each other when the opening distance or the biting force was changed during mandibular movements.     

In situ calibration of miniature sensors implanted into the anterior cruciate ligament part I: strain measurements

The goals of this study were to (a) evaluate the differential variable reluctance transducer as an instrument for measuring tissue strain in the anteromedial band of the anterior cruciate ligament, (b) develop a series of calibration curves (for simple states of knee loading) from which resultant force in the ligament could be estimated from measured strain levels in the anteromedial band of the ligament, and (c) study the effects of knee flexion angle and mode of applied loading on output from the transducer. Thirteen fresh-frozen cadaveric knee specimens underwent mechanical isolation of a bone cap containing the tibial insertion of the anterior cruciate ligament and attachment of a load cell to measure resultant force in the ligament. The transducer (with barbed prongs) was inserted into the anteromedial band of the anterior cruciate ligament to record local elongation of the instrumented fibers as resultant force was generated in the ligament. A series of calibration curves (anteromedial bundle strain versus resultant force in the anterior cruciate ligament) were determined at selected knee flexion angles as external loads were applied to the knee. During passive knee extension, strain readings did not always follow the pattern of resultant force in the ligament; erratic strain readings were often measured beyond 20 degrees of flexion, where the anteromedial band was slack. For anterior tibial loading, the anteromedial band was a more active contributor to resultant ligament force beyond 45 degrees of flexion and was less active near full extension; mean resultant forces in the range of 150-200 N produced strain levels on the order of 3-4%. The anteromedial band was also active during application of internal tibial torque; mean resultant forces on the order of 180-220 N produced strains on the order of 2%. Resultant forces generated by varus moment were relatively low, and the anteromedial band was not always strained. Mean coefficients of variation for resultant force in the ligament (five repeated measurements) ranged between 0.038 and 0.111. Mean coefficients of variation for five repeated placements of the strain transducer in the same site ranged from 0.209 to 0.342. Insertion and removal of this transducer at the anteromedial band produced observable damage to the ligament. In our study, repeatable measurements were possible only if both prongs of the transducer were sutured to the ligament fibers.