Biphasic calcium phosphate concept applied to artificial bone, implant coating and injectable bone substitute

The development of calcium phosphate ceramics and other related biomaterials for bone graft involved a better control of the process of biomaterials resorption and bone substitution. The bioactive concept was developed for biphasic calcium phosphate ceramics (BCP). An optimum balance of the more stable phase of HA and more soluble TCP was obtained for controlling gradual dissolution in the body, seeding new bone formation as it releases calcium and phosphate ions into the biological medium. The bone/material interface and the events occurring in the development of this dynamic interface such as cellular response, biodegradation or bioresorption of the materials and their transformation to carbonate hydroxyapatite (CHA) were described. These processes were observed in both bulk samples, implant coating and injectable bone substitute (IBS).     

Sintered carbonate apatites as bioresorbable bone substitutes

The dissolution behavior of sintered carbonate apatite was investigated in a 10 mM/L acetic acid solution adjusted to pH 5.0 at 37 degrees C, and compared to that of sintered hydroxyapatite and bone apatite for the purpose of establishing some similarities between the physicochemical dissolution of apatite biomaterials in vitro and their ability to be resorbed by osteoclasts in vivo. Both the sintered carbonate apatite and the bone apatite dissolved to an appreciable extent. Their solution compositions changed in an almost identical manner until toward the end of the reaction. The solution compositions for sintered carbonate apatite at 30 s was comparable with that for sintered hydroxyapatite at 3.8 days with respect to the degree of supersaturation, indicating that the former specimen is much more soluble than the latter specimen. Osteoclasts which were obtained from the long bones of 1-day-old neonatal rabbits resorbed bone and sintered carbonate apatite, but not sintered hydroxyapatite. These findings suggest that sintered carbonate apatites, which have characteristics that can be favorably compared with those of bone, especially with respect to its reactivity to acid media, would be useful as bioresorbable bone substitutes.     

含碳羟磷灰石矿石中磷的物相分析方法

将磷物相分作胶磷矿含磷，含磷白云石，含磷褐铁矿及石英等硅铅酸盐含磷4相，并重点研究了陵磷矿的分相。     

Transmission FT-IR microspectroscopy of mineral phases in calcified tissues

Fourier-transform infrared microspectroscopy (FT-IRM) was used to study bone mineralization processes in an in vivo model and in enamel in osteogenesis imperfecta. Finally, the ability of FT-IRM to map new bone formed in implanted macroporous calcium phosphate biomaterial from sections was reported for the first time. FT-IRM allowed the correlation of the microstructure of bone formation in the in vivo model with modifications in carbonate and phosphate environments of the mineral phases during maturation. FR-IRM analysis on enamel sections revealed changes in the mineral environment of carbonate and phosphate ions and probably in the size of enamel crystals. These modifications contributed to the fragility of enamel in osteogenesis imperfecta. The infrared functional group imaging of a part of implanted biomaterial and the bone ingrowth provided the visualization of chemical modifications occurring in biomaterial implants at 20 microns spatial resolution. The use of FT-IRM, in conjunction with appropriate sampling methods and data analysis should provide further insight into the molecular structure of mineral phases of calcified tissues and help to elucidate mineralization processes, skeletal disorders and properties of the biomaterials used as bone substitute.     

Radical prostatectomy and prognostic factors

We investigated ectopic bone formation by biphasic calcium phosphate (BCP) combined with recombinant human bone morphogenetic protein-2 (rhBMP-2) in the rat dorsum. Under reduced pressure, rhBMP-2 was adsorbed onto BCP, which consisted of 80% beta-tricalcium phosphate and 20% hydroxyapatite uniformly distributed in granules. Twenty Wistar rats were separated into 4 groups consisting of 5 animals each dosed with 2, 10, and 50 micrograms/700 microliters of rhBMP-2 and a control group (BCP only). Pieces of the BCP-BMP complex or only BCP were implanted under the dorsal skin of the rats. Histological sections were examined three weeks later. New bone was formed in all rats given 50 micrograms doses, but not in the 2 micrograms and control groups. These results indicated that BCP combined with rhBMP-2 induced ectopic bone formation without additional carriers. Therefore, BCP granules alone can function as carriers for rhBMP-2 to induce bone formation.     

A novel skeletal drug-delivery system using self-setting calcium phosphate cement. 4. Effects of the mixing solution volume on the drug-release rate of heterogeneous aspirin-loaded cement

The effect of the mixing solution volume was investigated on the in vitro drug-release rate of a novel drug-delivery device based on a self-setting bioactive calcium phosphate cement containing aspirin as a model drug. Equimolar mixtures of metastable calcium phosphate powders containing various proportions (3-40 w/w %) of seed hydroxyapatite crystals transformed into hydroxyapatite after being mixed with dilute phosphoric acid. The drug release from cement pellets in vitro into a 0.1 mol/L phosphate buffer at pH 7.40 and 37 degrees C by the rotating disk method continued for more than 1 week. The drug-release rate from the cement increased with increasing volumes of mixing solution. The relationship between the liquid/powder ratio and the porosity of the cement was a straight line, indicating that the cement porosity depended on the amount of the mixing solution, but was independent of the amount of seed crystals. Drug release from the cement followed the modified Fick's law, with the rate increasing with the amount of mixing solution, since the porosity depended on the amount. The tortuosity of the cements was estimated from the modified Fick's equation, and the relationships between the drug release rate and the tortuosity of the pore in the drug-loaded cement in the plots were nonlinear. The results suggested that the drug-release rates from the cement were controlled by the drug diffusion in the pores.     

Effect of demineralized bone matrix on bone growth within a porous HA material: a histologic and histometric study

Coralline hydroxyapatite (cHA) is an osteoconductive material currently being used as a bone graft substitute. Created by the hydrothermal conversion of the calcium carbonate skeleton of coral to hydroxyapatite, this material has a porous structure similar to cancellous bone. Addition of demineralized bone matrix (DBM) would conceivably create a composite with both osteoconductive and osteoinductive properties. This pilot study evaluated the healing of rabbit cranial defects that had been filled with cHA or cHA augmented with a DBM gel formed by adding glycerol to the DBM particulate. Data from these were then compared to unfilled defects from a previous study. Results indicated enhancement of new bone formation and an increase in the rate of healing in the defects filled with the cHA-DBM gel composite. Further studies are warranted.     

Phosphates precipitating from artificial urine and fine structure of phosphate renal calculi

Phosphates precipitating from artificial urine in the pH range 6-8 were identified using X-ray diffraction, chemical analysis and scanning electron microscopy. The influence of magnesium and citrate on phases precipitating from urine was established. From urine containing a normal quantity of magnesium (around 70 ppm), brushite accompanied by hydroxyapatite (HAP) precipitated at pH < or = 7.0 and struvite with HAP at pH > 7.0. HAP was formed exclusively from magnesium deficient urine at pH 7.0. Newberyite, octacalcium phosphate and whitlockite were not identified. The chemical and phase composition and inner fine structure of 14 phosphate calculi were studied. Three types of stones were distinguished based on their magnesium content: (i) stones rich in magnesium composed of struvite, hydroxyapatite and abundant organic matter, (ii) stones with low magnesium content constituted by calcium deficient hydroxyapatite, up to 5% of struvite, considerable amount of organic matter and occasionally brushite, and (iii) calculi without magnesium consisting of brushite, hydroxyapatite and little organic matter. Conditions prevaling during stone-formation assessed for each type of stone were confirmed by corresponding urinary biochemical data and corroborate the in vitro studies of phosphates precipitation.     

Risk Assessment of Metal Leaching into Groundwater from Phosphate and Thermal Treated Sediments

Beneficial reuse as an alternative to disposal is increasingly being considered in management of contaminated sediments dredged from harbors. The risk of metal leaching into groundwater in reuse of phosphate and thermal treated sediments was assessed with sequential extraction, synthetic precipitation leaching procedure (SPLP), and leaching as a function of pH and liquid to solid ratio (L/S). Sequential extraction revealed that phosphate addition at 5% by dry weight, followed by calcination at 700°C reduced metal association with exchangeable/carbonate and organic phases and increased that with sparingly soluble residuals. Over the pH range 4 to 9, metal leachability varied by two to four orders of magnitude while varying L/S over 5 to 100 showed little difference. The SPLP revealed that risk to groundwater criteria based on applying a dilution attenuation factor (DAF) of 13 (New Jersey) to groundwater quality levels were achieved. Risk criteria based on a DAF of 1 (Florida and Wisconsin) were exceeded for Pb, Cd, and Mn; thermodynamic analysis demonstrates that the criteria cannot be satisfied should dissolution control pore water concentrations.     

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.     

Maltose phosphorylase from Lactobacillus brevis: purification, characterization, and application in a biosensor for ortho-phosphate

With the goal to obtain maltose phosphorylase as a tool to determine ortho-phosphate, the enzyme from Lactobacillus brevis was purified to 98% by an expeditious FPLC-aided procedure which included anion exchange chromatography, gel filtration, and hydroxyapatite chromatography. The native maltose phosphorylase had a molecular mass of 196 kDa and consisted of two 88 kDa subunits. In isoelectric focusing two isoforms with pI values of 4.2 and 4.6 were observed. Maximum enzyme activity was obtained at 36 degrees C and pH 6.5 and was independent of pyridoxal 5'-phosphate. The apparent K(m) values with maltose and phosphate as substrates were 0.9 mmol l-1 and 1.8 mmol l-1, respectively. Maltose phosphorylase could be stored in 10 mM phosphate buffer pH 6.5 at 4 degrees C with a loss of activity of only 7% up to 6 months. The stability of the enzyme at high temperatures was enhanced significantly using additives like phosphate, citrate, and imidazole. The purified maltose phosphorylase was used as key enzyme in a phosphate sensor consisting of maltose phosphorylase and glucose oxidase. A detection limit of 0.1 microM phosphate was observed and the sensor response was linear in the range between 0.5 and 10 microM.     

DNA degradation during standard alkaline of thermal denaturation

Essential degradation 8 DNA (up to 10 per cent) with liberation of acid-soluble fragments takes place on the standard alkaline (0,01 M sodium phosphate, pH 12, 60 degrees, 15 min) or thermal (0.06 M sodium phosphate buffer, pH 6.8, 102 degrees C, 15 min) denaturation. This degradation is more or less selective: fraction of low molecular weight fragments, isolated by hydroxyapatite cromatography and eluted by 0.06 M sodium phosphate buffer, pH 6.8 is rich in adenine and thymine and contains about 2 times less 5-methylcytosine than the total wheat germ DNA. The degree of degradation of DNA on thermal denaturation is higher than on alkaline degradation. Therefore while studying reassociation of various DNA, one and the same standard method of DNA denaturation should be used. Besides, both the level of DNA degradation and the nature of the resulting products (fragments) should be taken into account.     

Morphology and microstructure of electrochemically deposited calcium phosphates in a modified simulated body fluid

Calcium phosphates were deposited on a pure titanium plate for various loading times under 1.3 and 12.9 mA/cm2 in a modified simulated body fluid at 52-92 degrees C. The plate-like crystals formed under 1.3 mA/cm2 were identified to be octacalcium phosphate (OCP) and/or carbonate-containing apatite. OCP converted to carbonate-containing apatite with the elapsing time of the loading current. The needle-like precipitates formed under 12.9 mA/cm2 were identified to be carbonate-containing apatite crystals elongated parallel to the c-axis direction. The degrees of crystallinity of the deposits formed under 1.3 mA/cm2 showed the highest value around 72 degrees C, whereas those under 12.9 mA/cm2 increased with the electrolyte temperature. The carbonate content of the deposits decreased with the electrolyte temperature and the flow current. The degree of crystallinity of the electrochemically deposited calcium phosphates decreased with the carbonate content.     

Characterization of calcium phosphates precipitated from simulated body fluid of different buffering capacities

The purpose of this experiment was to study the properties of calcium phosphate precipitated from simulated body fluids (SBFs) with different buffering capacities. The Ca/P molar ratios of the precipitates were determined and the microstructure of a sintered precipitate was studied. The results indicate that the pH of the SBF increases during calcium phosphate precipitations, which affects the Ca/P molar ratios and chemical compositions of these precipitates. A precipitate with a Ca/P molar ratio close to the stoichiometric molar ratio of hydroxyapatite was obtained when the pH of the SBF was continuously adjusted to 7.26 during precipitation. This precipitate has a fine-grained and laminated microstructure after sintering at 1000 degrees C in air. It seems that SBF can be used as a tool to study apatite-like precipitation in vitro when the pH of the solution is carefully controlled.     

Comparison of hydroxyapatite granules to autogenous bone graft in fusion cages in a goat model

BACKGROUND: With the increased use of fusion cages to achieve lumbar intervertebral fusion, the question arises as to the potential for bone ingrowth from the host bone through the entire cage. Is it even necessary to have an autogenous graft to achieve total bone incorporation? METHODS: Nine adult male goats had fusion cages implanted into three vertebral bodies. The design was Surgical Dynamics/Ray Fusion Cage, measuring 21 mm x 14 mm. In each animal, one fusion cage was filled with autogenous graft, one with hydroxyapatite, porous granules, and the other with nonporous granules. Amount of new bone formation was determined by backscatter electron microscopy at 3 months post implantation in all animals. RESULTS: The histologic section shows that there was total incorporation in all specimens at 3 months. There was slightly more new bone (43%) with the nonporous granules compared with the porous granules (35%). The amount of residual void space was about the same in all specimens, indicating that the amount of new bone formation was similar and not statistically different in cages filled with hydroxyapatite granules versus granules of autogenous bone. CONCLUSION: This study confirms that total incorporation by ingrowth of new bone can be expected in fusion cages. The amount of ingrowth is about the same for autogenous graft versus hydroxyapatite granules. Apparently, it is not necessary to use bone graft to achieve successful bone incorporation if an acceptable biocompatable lattice, such as hydroxyapatite granules, is used.     

Calcification of cervical ligamentum flavum--analysis of calcium compounds and histopathological findings

We operated 3 patients with cervical myelopathy due to calcification of ligamentum flavum (CLF). Specimens collected surgically were subjected to X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR) and Raman spectroscopy (Raman) analysis and also histopathological examination. The calcium compounds deposited were calcium pyrophosphate dihydrate (CPPD) in Case 1, apatite in Case 2, and a double-layer structure with an outer CPPD layer and an inner carbonate apatite layer in Case 3. Histopathologically, CPPD deposition in Case 1 could be distinguished from apatite deposition in Case 2 and 3 by hematoxylin-eosin stain. Chondrocytes were observed in all 3 cases, suggesting the chondrocytes may have played a role in calcification in these three cases. To date, 62 cases of CLF (including the present cases) have been reported, and analysis of calcium compound has been performed for 29 of them. Of these 29, 15 were analyzed as calcium phosphate compounds, 9 as CPPD and 4 cases as mixed crystals like Case 3. However the analysis method and result about CPPD are no problem, the analysis result of calcium phosphate compounds depends on the using methods. Calcium phosphate or undetectable compounds was identified by XRD as hydroxyapatite (HAp), and by FTIR as calcium phosphate or undetectable compound. Analysis of calcium phosphate compounds should be condacted and identified by XRD, FTIR, and Raman. We propose two possible mechanisms for the formation of the double-layer structure in Case 3: one is formation of apatite first followed by deposition of CPPD outside, and the other is formation of CPPD first followed by conversion of CPPD in the central region to apatite. What the process of formation of the double-layer was in this cases remains unclear.     

Analysis of anti-U1 RNA antibodies in patients with connective tissue disease. Association with HLA and clinical manifestations of disease

Histatin 1 is a histidine-rich phosphoprotein present in human parotid saliva that possesses candidacidal activity and functions in mineralization by adsorbing to hydroxyapatite. The objective of the present study was to develop a system for recombinant production of histatin 1 and to examine the role of phosphorylation in the functional activities of this molecule. Native histatin 1 (containing a phosphoserine at residue 2) was purified from parotid saliva, whereas a bacterial expression system was used to produce a recombinant form of histatin 1 (re-Hst1) that lacked phosphorylated serine. Histatin 1 cDNA was inserted into the vector pGEX-3X, which expresses foreign genes as soluble fusion proteins attached to the carboxyl-terminus of glutathione S-transferase (GST). The GST/re-Hst1 fusion protein was isolated from cell lysates by affinity chromatography on glutathione (GSH)-Sepharose and digested with cyanogen bromide to separate re-Hst1 from the GST fusion partner. The digest was subjected to reversed-phase high-performance liquid chromatography on a C18 column, and re-Hst1 was eluted as a well-defined peak. The yield of re-Hst1 was 4 mg/L of bacterial culture. Amino-terminal sequencing and amino acid analysis confirmed the final product as re-Hst1. Sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) showed that native histatin 1 and re-Hst1 had the same apparent molecular weights, while cationic PAGE showed that re-Hst1 was more basic. Phosphate analysis indicated 1 mol phosphate/mol of native histatin 1, while re-Hst1 lacked any detectable phosphate. Re-Hst1 demonstrated candidacidal activity comparable to that of native histatin 1, but displayed substantially lower binding to hydroxyapatite. These results show that phosphorylation of histatin 1 at residue 2 contributes significantly to its ability to bind to hydroxyapatite.     

Importance of intrinsic calf vasodilator capacity in determining distribution of skeletal muscle perfusion during supine bicycle exercise in patients with left ventricular dysfunction

Although there is interest in forming synthetic analogs of hard tissues at physiologic temperature, significant gaps in knowledge exist with respect to the mechanisms by which precursor solids convert to apatites and also with respect to the apatite compositions that may be formed. In this study calcium-deficient HAp [Ca9(HPO4)(PO4)5OH] was prepared by hydrolysis of tricalcium phosphate (TCP), alpha-Ca3(PO4)2. The kinetics of HAp formation were studied as a function of temperature by isothermal calorimetry. TCP hydrolyzed completely within about 12 h, and the hydrolysis reaction evolved 133 kJ/mol of HAp formed. Although the kinetics of hydrolysis exhibited a strong temperature dependence, the mechanistic path taken appeared independent of temperature. The fluoridation of hydroxyapatite compositions having Ca/P ratios higher than 1.59 previously has been investigated. However, little work has been done on the fluoridation of more calcium-deficient hydroxyapatite. Ca9(HPO4)(PO4)5OH was formed at temperatures between 37.4 degrees and 55 degrees C to vary its morphology. These preparations then were reacted in NaF solution and the kinetics of fluoride incorporation studied. Solution chemical analyses were used to determine the amounts of fluoride incorporated. The extent of hydroxyl replacement by fluoride ranged from 17 to 72% and correlated with the surface area of the parent HAp.     

Crystallization, fluoridation and some properties of apatite thin films prepared through rf-sputtering from CaO-P2O5 glasses

Using calcium phosphate glass targets with the CaO/P2O5 molar ratios of 1.50-0.50, much lower than the stoichiometric value of 3.3 for hydroxyapatite, thin films of stoichiometric hydroxy-, nonstoichiometric oxyhydroxy- and Ca-deficient oxyhydroxy-apatites were prepared on alumina ceramic substrates by rf-sputtering followed by post-annealing. Based on the present results, a phase diagram for CaO-P2O5 at low temperatures in the ambience of air was depicted for thin films. The ambient H2O vapor had an influence on the phase diagram: Tricalcium phosphate was changed to apatite in the presence of H2O vapor. Dense fluorohydroxyapatite thin films were prepared by fluoridation of those apatite thin films at a low temperature such as 200 degrees C. In the present report, some functional properties of thin films thus prepared were also shown.     

Preimplantation alteration of adenine nucleotides in cryopreserved heart valves

To assess the initial metabolic phase of cellular injury from cardiac valve processing, high-energy phosphate concentrations were analyzed in valve leaflets subsequent to critical processing steps. Using a porcine model, valves were processed in a manner identical to human homografts, with 58 randomly assigned to five groups representing distinct preparation phases. Group I (controls) sustained 40 minutes of warm ischemia concluded by liquid nitrogen immersion. Remaining groups similarly endured 40 minutes of ischemia, but were subsequently prepared according to stepwise design: II, warm ischemia + 24 hours of 4 degrees C ischemia; III, warm ischemia + 24 hours of 4 degrees C antibiotic disinfection; IV, warm ischemia + 24 hours at 4 degrees C (without antibiotics) + cryopreservation (-1 degrees C/min cryoprotected freezing); and V, warm ischemia+disinfection+cryopreservation. At each regimen's conclusion leaflet extracts were assayed by high-performance liquid chromatography for high-energy adenine nucleotides (adenosine triphosphate, adenosine diphosphate, adenosine monophosphate) and catabolites. A 47% and 86% decrease in cellular adenosine triphosphate level was observed in group III and group V leaflets, respectively. The level of total adenine nucleotides was maintained up to cryopreservation; thereafter a 74% decrease was noted. Catabolite analysis confirmed incomplete degradation of adenine nucleotides indicating cellular metabolic resilience throughout standard homograft preparation in valves previously exposed to 40 minutes of warm ischemia.