Radiopaque Material Research Articles

Creating a virtual patient for completely edentulous computer-aided implant surgery: A dental technique

A fully digital workflow for generating a virtual patient for completely edentulous computer-aided implant surgery is described. Existing dentures are temporarily relined with a radiopaque dental silicone material, and a cone beam computed tomography scan is made with the relined denture inserted. Then, scans of the relined denture are made with an intraoral scanner. The radiopaque silicone material increases the stability of the dentures and allows the a cone beam computed tomography images and the scans of the dentures to be superimposed to create a virtual patient. This technique may reduce laboratory work steps, clinical chairside time, and treatment costs.

Comparison of radiopaque dye materials for localization of pulmonary nodules before video-assisted thoracic surgery.

BackgroundAlthough a mixture of pigments and radiopaque materials was reported to be useful material for lung nodule localization, the optimal combination has not been well investigated. The purpose of this study is to evaluate the characteristics of various combinations of pigments and radiopaque materials for localization of pulmonary nodules prior to video-assisted thoracic surgery (VATS).MethodsWe compared stability, viscosity, and visibility of 6 radiopaque dye materials of (I) mixture of indigo carmine and lipiodol; (II) mixture of indigo carmine, lipiodol, and lidocaine gel; (III) mixture of indocyanine green in water solution (w-ICG) and lipiodol; (IV) mixture of w-ICG, lipiodol, and lidocaine gel; (V) ICG in contrast medium solution (cm-ICG); and (VI) mixture of cm-ICG and lidocaine gel. Stability was evaluated by observing changes in the mixtures in the test tube with time visually and radiographically. Viscosities were measured by rotational viscometer. Materials were injected into an expanded pig-lung phantom, and area on CT and visibility on thoracoscopy camera were evaluated.ResultsSeparation could be seen 15 min after preparation in (I) and (III), and 1 h after preparation in (II), both visually and radiographically. In (IV), separation could be seen on the photographs but not on the X-ray images from 3 h after preparation. (V) and (VI) showed no changes within the 2-day observation period. The viscosities of the materials were (I) 0.2±0.1, (II) 2.9±0.1, (III) 0.2±0.1, (IV) 2.6±0.1, (V) 0.2±0.1, and (VI) 1.2±0.1 dPa·s. The area on CT showed very strong negative correlation with viscosity (r=−0.97). The injection point of each material was easily detected on thoracoscopy camera.ConclusionsRadiopaque dye materials appear useful for localizing pulmonary nodules before VATS; their diffusion in the lung parenchyma can be suppressed by using materials of high viscosity.

Relationship between the prevalence of soft tissue radiopacities on panoramic radiographs and medical conditions.

This study aimed to describe radiographic characteristics and the prevalence of selected anatomical structures and soft tissue radiopacities on panoramic radiographs and their relationship to medical conditions. A retrospective cross-sectional study was conducted with 814 consecutive patients aged 35-88 years and their panoramic radiographs. Soft tissue calcifications found in the mandibular angle area were recorded according to gender, age, and bilaterally. Patient medical records were reviewed for atherogenic risk factors including hypertension, diabetes, dyslipidemia, chronic renal disease, menopause, drug usage and any other systemic condition. Data were analyzed with the χ2 test and Fisher's Exact test; P<0.05 was considered statistically significant. Among the 814 patients, a total of 74 (9.1%) calcified carotid artery atheromas (CCAA) were identified, of which 34 (4.17%), 40 (3.19%), and 14 (1.7%) were right, left, and bilateral, respectively. Orthopantomographic examination revealed triticeous cartilage (7.3%) in the cervical bifurcation region, asymptomatic styloid process elongation 192 (23.5%), tonsilloliths 27 (3.3%), sialoliths 37 (4.5%), calcified lymph nodes 46 (5.7%), impacted roots 109 (13.4%), and foreign radiopaque materials 23 (%2.8). There was a significant age and gender difference between type II diabetes and CCAA. A positive correlation was found between styloid process elongation and temporomandibular joint disorders and antidepressant use. Soft tissue radiopacities can be a validated risk indicator of cardiovascular events or misdiagnosed pain. Dental practitioners must be aware of these atypical findings as they may be related to serious disease states and may require referral for further investigation.

Intradural Disc Extrusion in a Dog

Background: Intervertebral disc extrusion is an important cause of spinal cord dysfunction in dogs. Intradural localization of the extruded disc material is rare, and is generally associated with a traumatic event or with recurrence of disc extrusion at a previously affected site. We report the clinical presentation, diagnostic workup, and treatment of a dog with intradural intervertebral disc extrusion not preceded by a traumatic event.Case: A 6-year-old male Dachshund was referred for neurological evaluation due to acute onset of hind-end paralysis preceded by claudication of the left hindlimb. The patient had been receiving conservative treatment to no effect. Neurological examination revealed asymmetric non-ambulatory paraparesis, absence of postural reactions and decreased muscle tone in both hindlimbs, a bilaterally diminished patellar reflex, and a hindlimb withdrawal reflex which was normal on the right and greatly diminished to absent on the left. The lower back was tender to epaxial palpation. Plain radiographs of the lumbar spine in the lateral projection showed calcified material within the spinal canal between the third and fourth lumbar vertebrae. Myelography was suggestively abnormal at the same level, with epidural leakage of contrast at L3-L4. Considering the clinical history, breed, age, neurological signs, and radiographic findings, intervertebral disc disease was suspected despite the inconclusive myelography findings. A dorsolateral lumbar hemilaminectomy was performed. Intraoperatively, the diagnosis was confirmed by visualization of a discolored spinal cord and absence of extradural material. The intradural space was accessed via durotomy. A firm, straw-yellow material was seen compressing the spinal cord and removed. Subsequent histopathological examination confirmed that this material consisted of extruded intervertebral disc contents. Postoperatively, the patient underwent physiotherapy and achieved a satisfactory recovery.Discussion: The most common cause of paraparesis in chondrodystrophic dog breeds is intervertebral disc extrusion. Intradural extrusion of the intervertebral disc is a rare phenomenon, often associated with vigorous exercise that causes laceration of the dura mater, allowing penetration of disc material into the intradural space. Although there were no classic signs of intervertebral disc disease on plain radiography, radiopaque material was visible within the spinal canal, which can occur in cases of calcified intervertebral disc extrusion. Myelography was inconclusive, but the decision was made to operate nevertheless, considering that the patient had not responded to conservative treatment and that surgicaltreatment is the most suitable approach for dogs with non-ambulatory paraparesis or paraplegia secondary to intervertebral disc extrusion. The surgical technique consisted of a hemilaminectomy and durotomy. Our diagnostic suspicion was confirmed intraoperatively, as in most cases of intradural disc extrusion in humans. Intradural disc extrusion is anuncommon phenomenon in dogs, and the diagnosis is usually only established intraoperatively. This unusual variant of intravertebral disc disease should be included in the differential diagnosis of spinal cord dysfunction in chondrodystrophic breeds, even in the absence of a history of trauma or preexisting intervertebral disc disease. Clinical treatment appears ineffective in these cases. Conversely, surgical treatment can yield good outcomes, and even functional recovery.

Advancements in the development on new liquid embolic agents for use in therapeutic embolisation.

Liquid formulations have a well-established role in therapeutic embolisation of blood vessels with the widespread use of cyanoacrylate glues, precipitating polymer suspensions, sclerosing agents and viscous emulsions of oil and chemotherapeutic agents. There is currently an emerging market for next generation liquid embolics which aim to address some of the short-comings of the currently used products. These next generation systems use varying chemistries in their approach to formulate new systems including polymerising, precipitating and phase-transitioning mechanisms to form solidified masses in situ within the vasculature. Some of these emerging technologies have been developed to possess improved imaging properties such as inherent radiopacity, rather than relying on having to mixing with radiopaque materials such as tantalum powder and reduction of X-ray imaging artefacts (streaking). Others offer solvent-free formulations which gel on contact with blood thereby allowing precise control over gel formation during the embolisation process without the use of potentially toxic solvents. In this review, we discuss the role of liquid agents in therapeutic embolisation and the potential of emerging technologies under development for use in the next generation of embolics.

Ultrasonography of subcutaneous foreign bodies: differences depending on their nature, complications, and potential diagnostic errors

Patients with penetrating wounds with suspected foreign bodies retained in the wound are often seen in emergency departments. Imaging studies are necessary to rule out the presence of retained foreign bodies. Plain-film X-rays, however, are only useful when the foreign bodies contain radiopaque material (metal, glass, stone, and some plastics). In cases with strong diagnostic suspicion and negative plain films, other imaging tests are necessary. Ultrasonography has proven useful in the identification and location of both radiopaque and radiotransparent foreign bodies. Ultrasonography enables excellent assessment of adjacent anatomical structures (muscles, tendons, ligaments, and neurovascular structures) and of associated lesions. The different materials found in foreign bodies have characteristic ultrasonographic patterns that are useful for diagnosis. Finally, it is important to be familiar with the diagnostic pitfalls to avoid false positives.

PREVALENCE OF ROOT FILLED TEETH IN AN ADULT POPULATION (LVIV, UKRAINE) FOUND ON DIGITAL PANORAMIC RADIOGRAPHS

The aim of this study was to determine the frequency of endodontic treatment in an adult Ukrainian population in relation to the age and its distribution depending on the type of the teeth. Materials and methods: A total of 435 digital panoramic radiographs of adults (aged 18 to 72 years) were examined. A tooth was qualified as root filled (endodontically treated), if radiopaque root-filling material was determined in the pulp chamber and/or in the root canals. Pearson's chi-squared test (χ2) and Spearman's rank correlation were applied for data analysis. Results: It was revealed that 82.5% of patients had previously received endodontic treatment of the teeth. The overall percentage of root filled teeth in adult dentition is 12.08%. The analysis of the rate of endodontically treated teeth in different age groups identified an increasing of treated teeth with age - from 5.2% in the youngest cohort (18-19 years old) to 24.9% in the oldest cohorts. It was revealed that 822 teeth (14.2%) on maxilla and 569 (9.9%) on the mandible were endodontically treated. Most often root filled teeth were first mandibular molars (39.3%), first maxillary molars (26.7%) and second maxillary premolars (20.4%). Much lower rate of endodontic treatment were considered in lower mandibular incisors and canines (0.7%, 0.9% and 1.5% respectively). Conclusions: A total of 82.5% examined adults had one or more endodontically treated teeth in this study. The obtained results prove the necessity of prevention of carieswith special emphasis on the first maxillary and mandibular molars, and maxillary second premolars, which have significantly higher frequency of root canal treatment in comparison to other teeth groups.

AMELOBLASTIC FIBRO-ODONTOMA—A RARE CASE REPORT

An 11-year-old girl presented to our specialized department with her mother who reported pain and facial alteration in the last 2 months. Intraoral examination showed dental crowding between teeth #11 and #12 and discrete volume increase in this region. A panoramic radiograph revealed a radiolucent unilocular lesion, circumscribed containing foci of radiopaque material and promoting root divergence between teeth #12 and #11. Computed tomography showed vestibular and palatine cortices disruptions. The diagnostic hypothesis was calcifying epithelial odontogenic tumor. We performed an exploratory puncture biopsy (which was positive for citrine liquid), an enucleation of the lesion, and reconstruction with bone graft (Bio-Oss with Bio-Gide membrane). The histopathologic diagnosis was ameloblastic fibro-odontoma. The patient is under follow-up. This case underscores the importance of clinical, radiographic, and histopathologic features providing correct diagnosis and adequate treatment of the patients.

In vitro evaluation of doxorubicin-eluting porous titania microspheres for transcatheter arterial chemoembolization

ABSTRACTPreparing drug-eluting beads (DEBs) from radiopaque materials such as titania (TiO2) can meet clinical need for directly visualizing DEBs during drug-eluting bead transcatheter arterial chemoembolization (DEB-TACE). Porous anatase-type TiO2 microspheres with mean volume diameters of approximately 30 µm were obtained when silica nanoparticles (SiNPs) were introduced into the TiO2 matrix by a sol–gel process involving a water-in-oil emulsion, and the SiNPs were then dissolved by subsequent treatment with NaOH solution. Of special note, microspheres prepared using SiNPs of approximately 20 – 25 nm in diameter had a high specific surface area of ~120 m2·g−1 and a high doxorubicin (DOX)-adsorption capacity of ~150 mg·mL−1, and they gradually released ~10% of the adsorbed DOX within 5 days. The DOX-loaded microspheres were non-cytotoxic, moreover, and exerted anticancer effects on HeLa cells. We propose that the present TiO2 microspheres are potentially useful as novel radiopaque embolic materials for DEB-TACE.

Gastric evacuation in endangered Russian sturgeon ( Acipenser gueldenstaedtii ): Effects of body and meal sizes

This study aimed to parameterize the effects of body and meal sizes on the gastric evacuation (GE) of farmed Russian sturgeon (Acipenser gueldenstaedtii) fed on live food (whiting fish) or commercial pellets. The radiography technique was used to monitor the evacuation of food from the stomach into the intestine at postprandial time. Acipenser gueldenstaedtii of different body sizes (total length ranged 82–105 cm) were fed on meal sizes ranged from 23 to 72 g composed of either live food or commercial pellets (had a 20% of BaSO₄ as a radiopaque material). The square root model was found to adequality describe the process of GE in A. gueldenstaedtii independently of meal type and size. The effects of fish size on GER was described by simple power model and can be summarized by dStdt=-ρLL1.84St·(g·h-1), where ρL was 0.000053 for live food and 0.000062 for commercial pellets (estimated from combined GE data), Sₜ is stomach contents (g), L is fish total length (cm) and t is time (h). The results of this study will provide a useful tool to estimate the stomach fullness of A. gueldenstaedtii at postprandial time t. Such information should assess the feeding strategy to minimize feed wastage and optimize the fish growth.

Development of hybrid shape memory polyurethane composites for endovascular applications

Interventional radiology technique (IRT) is being increasingly used to embolize the blood vessels or prevent the flow of blood into the diseased part of a blood vessel in a human body. Shape memory polyurethane (SMPU) has been identified as an alternate embolic agent for IRT, which can overcome vital issues such as non-target embolization, incomplete occlusion, coil migration, and others. However, its inherent lack of radiopacity and bioinertness restrict potential applications of it in IRT. The objective of the present work is to study the effect of combining SMPU and radiopaque filler materials on the mechanical, thermal, shape recovery characteristics, and radiopacity. Hybrid composite materials having Barium sulphate (BaSO4) nanoparticles and hydroxyapatite (HaP) nanoparticles in the SMPU matrix are fabricated using a twin-screw extruder, and their properties are compared with that of the composites containing only single filler. The addition of the filler in SMPU is not found to affect its shape-holding characteristics. However, the shape recovery characteristics of the hybrid composites are decreased by 20–30% during the 1st cycle, which was then recovered to more than 90% during the 2nd recovery cycle. It is observed that the shape recovery rate of the SMPU can be fine-tuned by changing its programming temperature. It is also noted that the tensile strength of composites is decreased with an increase of filler concentration due to their agglomeration and voids in the composites. In case of 10 wt% hybrid composites, the reduction of tensile strength is found to be in the range of 24–28% irrespective of individual filler concentration, and it showed better mechanical properties than individual filler at the same concentration. The radiopacity of the composites is observed to be increased with filler concentration, where BaSO4 played a dominant role in comparison to that of hydroxyapatite nanoparticles. Hence, the developed SMPU hybrid nanocomposites can be explored as embolic agents for IRT due to their suitable mechanical properties, actuation profiles, and enhanced radiopacity.

1482 Chalk Eating: A Culturally-Accepted Form of Pica in Georgia?

INTRODUCTION: Pica is the persistent intake of nonnutritive and nonfood substances seen commonly in children, pregnant women, institutionalized persons, patients with developmental disabilities and iron deficiency. Kaolin ingestion in the form of chalk, white dirt or white clay, is a lesser known form of pica but a common occurrence in Central Georgia. We present a case of a young black female from Georgia who presented with a partial bowel obstruction from eating chalk. CASE DESCRIPTION/METHODS: A 35-year-old black female from Augusta Georgia with iron deficiency anemia and depression presented with worsening abdominal pain, distention and constipation with the last bowel movement 2 weeks prior to presentation. She ate 5 lbs of chalk with each meal for the previous 10 years, like her mother. Her cravings for chalk increased with worsening anemia. Physical exam was pertinent for abdominal distention and tenderness. Laboratory tests revealed iron deficiency anemia but normal calcium and vitamin D level. The abdominal x-ray showed radiopaque material opacifying the lumen of the colon with nonobstructive bowel gas pattern. Flexible sigmoidoscopy was performed for mechanical disimpaction using endoscopic accessories was unsuccessful. Gastrograffin enema was then performed twice with resulting bowel movements. The patient received intravenous iron therapy and was evaluated by psychiatry. She was discharged home on iron supplements and laxatives. DISCUSSION: Kaolin is a soft white clay and an important ingredient in making porcelain, paper and rubber. It is not absorbed systemically but acts locally in the intestines where it adsorbs toxins and is used as an anti-diarrheal agent. The prevalence of kaolin ingestion especially among black female residents in Central Georgia represents a cultural-bound syndrome shared by family members or friends such as in our patient. Although our patient had iron deficiency anemia which could be associated with pica, the cultural practice of eating chalk is widely accepted in their community and believed that ingesting chalk helps with nausea, indigestion, and even constipation! Complications from this form of pica include anemia, malnutrition, constipation, intestinal obstruction, and even colon perforation. Management include medical, endoscopic or surgical removal of these substances and most importantly cognitive behavioral treatment. It is important to have a high index of suspicion for pica when multiple opacities are noted in the colon especially among residents of Georgia.

Ecografía de los cuerpos extraños subcutáneos: diferencias según naturaleza, complicaciones y potenciales errores diagnósticos

Patients with penetrating wounds with suspected foreign bodies retained in the wound are often seen in emergency departments. Imaging studies are necessary to rule out the presence of retained foreign bodies. Plain-film X-rays, however, are only useful when the foreign bodies contain radiopaque material (metal, glass, stone, and some plastics). In cases with strong diagnostic suspicion and negative plain films, other imaging tests are necessary. Ultrasonography has proven useful in the identification and location of both radiopaque and radiotransparent foreign bodies. Ultrasonography enables excellent assessment of adjacent anatomical structures (muscles, tendons, ligaments, and neurovascular structures) and of associated lesions. The different materials found in foreign bodies have characteristic ultrasonographic patterns that are useful for diagnosis. Finally, it is important to be familiar with the diagnostic pitfalls to avoid false positives.

Ameloblastic fibro-odontoma: clinical case report

Background: The ameloblastic fibro-odontoma is a tumor of mixed odontogenic origin (epithelial and mesenchymal). It has a higher incidence in young adults and in posterior regions of lower jaw. Normally discovered in routine imaging tests for unerupted teeth, it presents as a radiolucent image circumscribed with radiopaque material calcified inside.

Erosive Enteritis and Intestinal Obstructions Caused by Decomposed Granite in a Flock of Lesser Flamingos (Phoeniconaias minor).

Decomposed granite is a material commonly used in zoos as a base for flamingo exhibits. In 2012, the artificial turf over the decomposed granite in the Fort Worth Zoo flamingo exhibit was removed and pressure washed, the granite was replaced, and the turf was then restretched in place. Approximately 8 months later, 3 lesser flamingos (Phoeniconaias minor) showed signs of lethargy and hematochezia. Results of physical examination revealed poor body condition in all birds, with variable hematologic abnormalities, including anemia, hypoproteinemia, and electrolyte disturbances. Radiographs of birds showed large amounts of radiopaque material in the ventriculus and dilated intestinal loops. Two birds died either during treatment or surgery, and 1 bird was euthanatized. Postmortem examination of all 3 birds revealed large amounts of fine, granite-like material in the ventriculus and intestines, severe congestion of intestinal mucosa, and obstruction of intestinal lumen by caseous plugs surrounded by fecal material. Microscopic evaluation of the material removed from the ventriculus showed birefringent crystals that corresponded to microscopic silica grains, consistent with the decomposed granite from the exhibit. Histologic examination of tissues showed marked chronic erosive colitis, mild erosive proventriculitis, and lesions in the muscular layer of the ventriculus. Subsequently, 82 remaining flamingos in the flock were radiographed. Results showed the same material in the ventriculus of most birds, but no intestinal obstructions were identified. Different treatment techniques were attempted unsuccessfully to remove the material from the flamingos that had the largest amount of decomposed granite in their gastrointestinal tracts. Ultimately, all birds were treated with oral gastrointestinal protectants, adsorbents, laxatives, and lubricants, along with antibiotics administered in drinking water. No further mortalities occurred once medical treatments were implemented.

Biodegradable and biocompatible radiopaque iodinated poly-3-hydroxy butyrate: synthesis, characterization and in vitro/in vivo X-ray visibility

Some novel radiopaque biodegradable and biocompatible iodinated polymers based on poly-3-hydroxy butyrate (PHB) were obtained. Following the attachment of diethanol amine to PHB, the hydroxyl ends were capped with 4-iodobenzoic acid and 2,3,5-tri-iodobenzoic acid. In this manner, tri-novel radiopaque polymers were obtained. The resulting polymers were structurally characterized by NMR technique. They were evaluated with respect to their possible use as radiopaque implant biomaterials indicating X-ray visibility in a noninvasive manner using routine X-ray absorption imaging techniques. These polymers exhibited good radiopacity with conventional imaging X-ray techniques in vivo. Additionally, biocompatibility of these iodinated polymers was also evaluated. There were no signs of infection or abscess formation on the surgical area. These novel radiopaque PHBs should be promising biomaterials for a new-generation radiopaque materials.

Coronary Angiography and Intravascular Ultrasound in an Ex-Vivo Perfused Heart Using the Organ Care System (OCS)

Purpose To describe technical aspects of angiography and intravascular ultrasound (IVUS) in ex-vivo perfused hearts using the Organ Care System (OCS, TransMedics, Andover, MA USA). Methods During ex-vivo perfusion of a pig heart a moderate stenosis of the mid left anterior descending coronary artery (LAD) was created in order to test the sensitivity of angiography and IVUS. The operating table was removed and the OCS was lifted by 45 cm to achieve an AP position of the heart within the X-ray system. As tilted or rotated projections are limited by radiopaque materials within the OCS, the heart had to be rotated to facilitate different views. Results The standard heart position in the OCS revealed good visualization of the right coronary artery(RCA) using a 5 Fr. JR catheter (Fig 1). Using a JL catheter the left coronary artery(LCA) ostium could be intubated easily, however, visualization was suboptimal. Therefore the heart was rotated 90°-clockwise, which led to good LAD and suboptimal circumflex artery(RCx) visualization. 135°-anticlockwise-rotation(-45° from standard position) led to good LAD and RCx projection(Fig 2). The LAD stenosis could be visualized in the angiography and confirmed by IVUS. Conclusion Coronary angiogram of hearts during ex-vivo perfusion is feasible. As the OCS allows only AP fluoroscopy, the heart needs to be rotated to achieve sufficient views for coronary diagnostics. IVUS can be implemented to extend the diagnostic value.

Easy Technique for Radiographic Evaluation of Stump-socket Fit in Below-knee Amputees.

The alignment of a prosthesis affects the way load is transferred to the stump through the socket; this is critically important for its comfort and function. The aim of the study was to assess the value of radiopaque materials in evaluation of stump-socket fit in people with below-knee amputation. Thirty-two amputees (skin breakdown group) had cutaneous lesions in the stump, and another 26 amputees (control group) had no lesion in the stump after training with their prosthesis. Metallic markers were attached to weight-bearing points in the internal socket. X-rays were taken in the antero-posterior and lateral projections. In the antero-posterior view, the weight-bearing points of the stump did not correspond to the metallic markers placed over the patellar tendon and the tibial tuberosity points in the socket in 78.1% of the 32 amputees in the skin breakdown group. This malalignment was present in 42.3% of the 26 amputees in the control group (Pearson Chi-Square, p&lt;0.007). In the lateral view, in 65.6% of the 32, the weight-bearing points of the stump did not correspond to the metallic markers placed over the patellar tendon and the tibial tuberosity points in the socket. This malalignment was noted in 23.1% of the 26 patients in the other group (Pearson Chi-Square, p&lt;0.002). 1. The conflict between the prosthesis and residual limb is the cause of skin disruption at different sites of the stump and can be successfully treated by prosthetic socket modification. 2. Efforts should be made to systematically identify any discrepancies between the stump and the soc-ket. 3. Correct adaptation of the prosthesis to the weight-bearing points of the stump will offer clinicians the possibility of quantification and visualization of this interaction using simple radiographic techniques.

Angiogenesis involvement by octacalcium phosphate-gelatin composite-driven bone regeneration in rat calvaria critical-sized defect

Effect of octacalcium phosphate/gelatin composite (OCP/Gel) on angiogenesis was studied by its implantation in rat calvaria critical-sized defect in relation to bone regeneration for 2 and 4 weeks. The implantation of OCP/Gel disks was analyzed by radiomorphometry using a radiopaque material perfusion (Microfil®) method and histomorphometry by hematoxylin and eosin-staining before and after the decalcification. Effect of the OCP dose in the range up to 4 mg per well on the capillary-like tube formation by human umbilical vein endothelial cells (HUVECs) was also examined in a transwell cell culture. The results showed that the blood vessels formation by OCP/Gel group was significantly higher at 2 weeks than other groups but decreased at 4 weeks during the advancement of new bone formation. The capillary-like tube formation was highest in an OCP dose of 1 mg per well while other OCP doses above or below 1 mg did not show such a stimulatory effect. The results established both in vivo and in vitro confirmed that OCP has a positive effect on angiogenesis during bone regeneration in a suitable dose ranges, suggesting that the angiogenesis stimulated by OCP could be involved in the OCP/Gel-enhanced bone regeneration. Statement of significanceWe have reported that octacalcium phosphate (OCP) materials display stimulatory capacities on the bone tissue-related cells. However, the effect of OCP on the angiogenesis and its relation to the OCP-enhanced bone regeneration is unknown. This study confirmed the capacity of OCP on angiogenesis before increasing the new bone mass after the implantation of a composite of OCP and gelatin (OCP/Gel). The blood vessels formation took place associated with the area beginning of the new bone formation, which finally decreased together with development of bone formation. Because OCP was ascertained stimulating the capillary-like tube formation in HUVEC culture with a certain OCP dose, the present study is the first report showing the capacity of OCP on angiogenesis during the OCP/Gel-enhanced bone regeneration.

The Novel X-Ray Visible Zein-Based Non-adhesive Precipitating Liquid Embolic HEIE1_2017: An Exploratory Study.

To investigate the novel zein-based non-adhesive precipitating liquid embolic HEIE1_2017. Zein-based liquid embolics are an own class of embolization material. In this study, HEIE1_2017, a novel zein-based liquid embolic, was investigated. Visibility was assessed in vitro in CT and MRI phantoms, embolization characteristics were assessed in vivo in the kidneys of 12 pigs. Components of HEIE1_2017 were zein as occlusion material, ethanol as solvent, and iodized oil as radiopaque material. HEIE1_2017 was used in pure (HEI-PURE) and manually modified (HEI-MOD) form and compared with 6% ethylene vinyl alcohol copolymer (EVOH). Different radiological methods (CT, MRI, DSA, cone-beam CT, and micro-CT) and histopathologic analyses were applied to compare visibility and vascular occlusion patterns. In CT phantoms, all embolics were definitely visible as hyperdense materials. In MRI phantoms, signal-to-noise ratio was highest for HEI-PURE, followed by HEI-MOD and EVOH. In all kidneys, embolization procedures were technically successful and without complications. In DSA, all embolics were definitely visible during and after embolization. Only EVOH caused substantial artifacts in cone-beam CT and CT. In micro-CT and histopathology, HEI-PURE showed a homogeneous occlusion from segmental arteries to glomerular capillaries. HEI-MOD demonstrated the deepest vascular penetration (up to the level of peritubular capillaries), but with an inhomogeneous distribution. For EVOH, there was inhomogeneous vascular occlusion from segmental arteries to glomerular capillaries. HEIE1_2017 is a promising novel zein-based liquid embolic. Further preclinical and clinical studies with higher case numbers and long-term follow-up are needed to further assess the value of this embolic material.