Similar Inflammatory Reactions Research Articles

Translational characterization of macrophage responses to stable and non-stable CoCrMo wear and corrosion debris generated in-situ for total hip replacement

Metal wear and corrosion debris remain a limiting factor for long-term durability of total hip replacement (THR). Common wear particle production techniques for research differ from the actual tribocorrosion processes at the implant site, potentially causing loss of valuable information. The aim of this study was to investigate reactions to freshly generated and time-stabilized particles and ions released from CoCrMo-alloy using a bio-tribometer, which mimics conditions of the periprosthetic environment.THP-1 macrophages were challenged with freshly produced or time-stabilized wear debris. Wear generation took place in a custom-built bio-tribometer inside a CO2 incubator operating with a reciprocating rotation of an Al2O3 ball against a CoCrMo disc. Two different electrochemical conditions with increasingly forced corrosion rates were tested: +0.45 V (passive domain) and +0.67 V (transition to transpassive domain). Cell viability, proinflammatory cytokines, electrochemical measurements and ICP-MS metal ion content analyses were performed.Cobalt/ chromium concentrations were 6.6/ 1.6 ppm in the passive domain and almost doubled to 11.4/ 3.0 ppm in the passive-transpassive domain. Under those electrochemical conditions, freshly produced and time-stabilized CoCrMo wear decreased cell viability to the same extent. Secretion of proinflammatory cytokines were not significantly different for freshly produced and time-stabilized debris.This study suggests that freshly generated and time-stabilized metal particles/ions cause similar toxicity and inflammatory reactions in macrophages, indicating that standard practices for generating wear debris are valid methods to evaluate wear particle disease. Other cell types, materials, and corrosion potentials need to be studied in the future to solidify the conclusion.

Novel Histomorphometrical Approach to Evaluate the Integration Pattern and Functionality of Barrier Membranes.

GBR (guided bone regeneration) is a standard procedure for building up bony defects in the jaw. In this procedure, resorbable membranes made of bovine and porcine collagen are increasingly being used, which, in addition to many possible advantages, could have the potential disadvantage of a shorter barrier functionality, especially when augmenting large-volume defects. Thus, it is of importance to evaluate the integration behavior and especially the standing time of barrier membranes using specialized methods to predict its respective biocompatibility. This study is intended to establish a new histomorphometrical analysis method to quantify the integration rate of collagen-based barrier membranes. Three commercially available barrier membranes, i.e., non-crosslinked membranes (BioGide® and Jason® membrane), a ribose-crosslinked membrane (Ossix® Plus), and a newly developed collagen–hyaluronic acid-based (Coll-HA) barrier membrane were implanted in the subcutaneous tissue of 48 6–8-week-old Wistar rats. The explants, after three timepoints (10, 30, and 60 days), were processed and prepared into histological sections for histopathological (host tissue response) and histomorphometrical (cellular invasion) analyses. 10 days after implantation, fragmentation was not evident in any of the study groups. The sections of the Coll-HA, Jason® and BioGide® membranes showed a similar mild inflammatory reaction within the surrounding tissue and an initial superficial cell immigration. Only in the Ossix® Plus group very little inflammation and no cell invasion was detected. While the results of the three commercially available membranes remained intact in the further course of the study, only fragments of the Coll-HA membrane were found 30 and 60 days after implantation. Histomorphometrically, it can be described that although initially (at 10 days post-implantation) similar results were found in all study groups, after 30 days post-implantation the cellular penetration depth of the hyaluronic acid-collagen membrane was significantly increased with time (**** p < 0.0001). Similarly, the percentage of cellular invasion per membrane thickness was also significantly higher in the Coll-HA group at all timepoints, compared to the other membranes (**** p < 0.0001). Altogether, these results show that the histomorphometrical analysis of the cellular migration can act as an indicator of integration and duration of barrier functionality. Via this approach, it was possible to semi-quantify the different levels of cellular penetration of GBR membranes that were only qualitatively analyzed through histopathological approaches before. Additionally, the results of the histopathological and histomorphometrical analyses revealed that hyaluronic acid addition to collagen does not lead to a prolonged standing time, but an increased integration of a collagen-based biomaterial. Therefore, it can only partially be used in the dental field for indications that require fast resorbed membranes and a fast cell or tissue influx such as periodontal regeneration processes.

Delayed inflammatory reaction of hyaluronic acid fillers against the background of flu-like illness

Traditionally, it is considered that inflammatory reactions with delayed onset that occur due to the use of fillers based on hyaluronic acid (HA) are included in the category of rare complications. But in recent years, due to the increasing popularity of injection procedures, such reactions have become more common, which attracts the attention of both the scientific community and clinicians.&#x0D; This article presents a clinical case of a late inflammatory response, describes the diagnosis and tactics of therapy, and provides an overview of the etiology, pathogenesis, diagnosis, and therapy of such reactions. 7 months ago, HA filler was injected into the area of both tear troughs. 3 months after the procedure, the patient underwent acute respiratory viral infection, against which for the first time she noted the sudden appearance of inflammation. 3 months after the first episode of an inflammatory reaction in the tear troughs, against the background of acute pharyngitis, its relapse occurred, accompanied by similar symptoms.&#x0D; Similar inflammatory reactions can occur with any HA filler, but their frequency may vary depending on various factors. Timely detection and proper treatment can successfully eliminate the inflammatory reaction within a few days.

Early Predictive Value of Procalcitonin for the Diagnosis of Pulmonary Infections after Off-pump Coronary Artery Bypass Grafting

Cardiac surgery can cause similar inflammatory reactions with infection; antibacterial treatment may be inappropriately used. Early and accurate diagnosis of infection still is a difficult problem worldwide. Procalcitonin (PCT) helps to identify sepsis caused by bacterial infections. However, its application in the diagnosis of pulmonary infections after off-pump coronary artery bypass grafting (OPCABG) has not been well studied. We investigated the early predictive value of PCT for the diagnosis of pulmonary infections after OPCABG. We retrospectively analyzed the clinical data, including conditions in the intensive care unit, postoperative complications, mortality rate, plasma PCT in the morning on the first postoperative day, routine white blood cell (WBC) count, and high-sensitivity C-reactive protein (hs-CRP) levels of patients who underwent elective OPCABG. Patients were divided into an infection group and a noninfection group, according to the occurrence of pulmonary infections. A receiver operating characteristic (ROC) curve was used to analyze the predictive value of PCT for the diagnosis of postsurgical infections. In total, 131 patients who underwent OPCABG were included, of whom 23 (17.6%) developed pulmonary infections. The plasma PCT level significantly was higher in the infection group than in the noninfection group (6.0 ± 6.3 ng/ml vs. 2.0 ± 2.2 ng/ml, P = 0.007). WBC and hs-CRP values were not significantly different between the infection group and the noninfection group (12.3 ± 3.9×109/L vs. 11.1 ± 2.8×109/L, P = 0.171 and 12.4 ± 0.7 mg/L vs. 12.4 ± 0.8 mg/L, P = 0.903, respectively). The area under the ROC for predicting pulmonary infections after OPCABG by plasma PCT was 0.783 (P < 0.001, with a 95% confidence interval of 0.674-0.893), with a cut-off value of 3.55 ng/ml, a sensitivity of 0.609, and a specificity of 0.861. From our study results, we postulate that PCT has a high early predictive value for the diagnosis of pulmonary infections after OPCABG.

In vivo evaluation of Vivere bovine pericardium valvular bioprosthesis with a new anti-calcifying treatment.

The objective of this study was to evaluate the effect of chemical treatment with glutamic acid to avoid calcification of biological cardiac valves. The bovine pericardium (BP) tissues were fixed with 0.5% glutaraldehyde (BP/GA), followed by treatment with glutamic acid (BP/GA+Glu) for neutralization of the free aldehyde groups. Microscopic analysis showed that the wavy structure of collagen fibrils was preserved, but changes in elastin's integrity occurred. However, the treatment did not promote undesirable changes in the thermal and mechanical properties of the modified BPs. These samples were systematically studied in rat subcutaneous tissue: control (BP/GA) and anticalcificant (BP/GA+Glu). After 60days, both groups induced similar inflammatory reactions. In terms of calcification, BP/GA+Glu remained more stable with a lower index (3.1±0.2μg Ca2+ /mg dry tissue), whereas for BP/GA it was 5.7±1.3μg Ca2+ /mg dry tissue. Bioprostheses made from BP/GA+Glu were implanted in the pulmonary position in sheep, and in vivo echocardiographic analyses revealed maintenance of valvar function after 180days, with low gradients and minimal valve insufficiency. The explanted tissues of the BP/GA+Glu group had a lower average calcium content 3.8±3.0μg Ca2+ /mg dry tissue. The results indicated high anticalcification efficiency of BP/GA+Glu in both subcutaneous implant in rats and in the experimental sheep model, which is an advantage that should encourage the industrial application of these materials for the manufacture of bioprostheses.

The effects of chemical crosslinking manners on the physical properties and biocompatibility of collagen type I/hyaluronic acid composite hydrogels

It is necessary to use chemical crosslinking to regulate the mechanical properties, biodegradability and biocompatibility of hydrogels. In this study, three kinds of collagen type I (Col I)/hyaluronic acid (HA) hydrogels with the same ratio and different chemical crosslinking manners were designed and fabricated, and the effects of chemical crosslinking manners on the physical properties and biocompatibility of hydrogels were investigated. The gelation time, mechanical property, swelling and degradability of hydrogels were characterized. Chondrocytes were encapsulated into these hydrogels to detect their effects on cell survival, proliferation, morphology and ECM secretion. Furthermore, the hydrogels were implanted into the back of SD rats to evaluate their biodegradability and biocompatibility in vivo. The results showed that chemical crosslinking manners of hydrogels could affect their physical properties to some extent. Chondrocytes encapsulated into these hydrogels showed a round or oval shape. ECM secretion of cells encapsulated in hydrogels increased with the elongation of culture duration, and cells encapsulated in hydrogels HA-sNHS/Col I (HSC) and HA-CHO/Col I (HCC) secreted more ECM than others. In vivo studies demonstrated that these hydrogels showed similar and acceptable inflammatory reaction.

Modification of collagen-based sponges can induce an upshift of the early inflammatory response and a chronic inflammatory reaction led by M1 macrophages: an in vivo study

BackgroundThe present study evaluated the cellular tissue reaction of two equine-derived collagen hemostatic sponges (E-CHS), which differed in thickness after pressing, over 30 days in vivo. The inflammatory response during physiological wound healing in sham-operated animals was used as control group.Material and methodsFirst, the E-CHS was pressed by applying constant pressure (6.47 ± 0.85 N) for 2 min using a sterile stainless-steel cylinder until the material was uniformly flattened. Consequently, the original (E-CHS), the pressed (P-E-CHS), as well as the control group (CG; sham operation) were studied independently. The 3 groups were evaluated in vivo after subcutaneous implantation in Wistar rats during 3, 15, and 30 days. Histochemical and immunohistochemical methods provided observations of biomaterial degradation rate, cellular inflammatory response, and vascularization pattern. A derivative of human blood known as platelet-rich fibrin (PRF) was used as an ex vivo model to simulate the initial biomaterial-cell interaction. Segments of E-CHS and P-E-CHS were cultivated for 3 and 6 days with PRF, and the release of pro-inflammatory proteins was measured using ELISA. PRF cultivated alone was used as a control group.ResultsAt day 3, the CG induced a statistically significant higher presence of monocytes/macrophages (CD68+), pro-inflammatory macrophages (M1; CCR7+), and pro-wound healing macrophages (M2; CD206+) compared to E-CHS and P-E-CHS. At the same time point, P-E-CHS induced a statistically significant higher presence of CD68+ cells compared to E-CHS. After 15 days, E-CHS was invaded by cells and vessels and showed a faster disintegration rate compared to P-E-CHS. On the contrary, cells and vessels were located only in the outer region of P-E-CHS and the biomaterial did not lose its structure and accordingly did not undergo disintegration. The experimental groups induced similar inflammatory reaction primarily with positive pro-inflammatory CD68+/CCR7+ macrophages and a low presence of multinucleated giant cells (MNGCs). At this time point, significantly lower CD68+/CCR7+ macrophages and no MNGCs were detected within the CG when compared to the experimental groups (P < 0.05). After 30 days, E-CHS and P-E-CHS were fully degraded. All groups showed similar inflammatory reaction shifted to a higher presence CD206+ macrophages. A low number of CCR7+ MNGCs were still observable in the implantation bed of both experimental groups. In the ex vivo model, the cells and fibrin from PRF penetrated E-CHS. However, in the case of P-E-CHS, the cells and fibrin stayed on the surface and did not penetrate towards materials central regions. The cultivation of P-E-CHS with PRF induced a statically significant higher release of pro-inflammatory proteins compared to the CG and E-CHS after 3 days.ConclusionAltering the original presentation of a hemostatic sponge biomaterial by pressing modified the initial biomaterial-cell interaction, delayed the early biomaterial’s degradation rate, and altered the vascularization pattern. A pressed biomaterial seems to induce a higher inflammatory reaction at early time points. However, altering the biomaterial did not modify the polarization pattern of macrophages compared to physiologic wound healing. The ex vivo model using PRF was shown to be an effective model to simulate the initial biomaterial-cell interaction in vivo.Clinical relevanceA pressed hemostatic sponge could be applied for guided tissue regeneration and guided bone regeneration. In that sense, within the limitations of this study, the results show that the same biomaterial may have two specific clinical indications.

Cytotoxicity, inflammation, biomineralization, and immunoexpression of IL-1β and TNF-α promoted by a new bioceramic cement.

Aim To evaluate the cytotoxicity, biocompatibility and mineralization capacity of BIO-C PULPO, and MTA.Methodology L929 fibroblasts were cultured and MTT assay was used to determine the material cytotoxicity on 6, 24, and 48 h. A total of 30 male rats (Wistar) aged between 4 and 6 months, weighing between 250 and 300 g were used. Polyethylene tubes containing BIO-C PULPO, MTA, and empty tubes were implanted into dorsal connective tissue. After the experimental periods (7, 15, 30, 60, and 90 days) the tubes were histologically analyzed using hematoxylin-eosin (H&E), immunolabeling of IL-1β and TNF-α, and von Kossa staining, or without staining for polarized light analysis. The average number of inflammatory cells was quantified; the mineralization assessment was determined by the area marked in μm2 and semiquantitative immunolabeling analyses of IL-1β and TNF-α were performed. Then, data underwent statistical analysis with a 5% significance level.Results It was observed that BIO-C PULPO and MTA presented cytocompatibility at 6, 24, and 48 similar or higher than control for all evaluated period. On periods 7 and 15 days, BIO-C PULPO was the material with the highest number of inflammatory cells (p<0.05). On periods 30, 60, and 90 days, BIO-C PULPO and MTA presented similar inflammatory reactions (p>0.05). No statistical differences were found between Control, BIO-C PULPO, and MTA for immunolabeling of IL-1β and TNF-α in the different periods of analysis (p<0.05). Positive von Kossa staining and birefringent structures under polarized light were observed in all analyzed periods in contact with both materials, but larger mineralization area was found with BIO-C PULPO on day 90 (p<0.05).ConclusionBIO-C PULPO was biocompatible and induced mineralization similar to MTA.

Evaluation of Tissue Response in Sites Sutured with Cyanoacrylate and Submitted to Low Power Laser Therapy: A Randomized Clinical Trial

This study aimed to qualitatively evaluate the inflammatory response in sites sutured with nylon and 2-octyl cyanoacrylate and submitted to low-power laser therapy. Background: 2-octyl cyanoacrylate acts as both a bonding agent for incisional wounds and a substitute for conventional suture methods after topical application, forming an occlusive layer that prevents the entry of any exogenous agent into the wound. Tissue reactions such as granuloma formation are cited in the literature as possible outcomes following 2-octyl cyanoacrylate use. Methods: Thirty wistar rats, were randomized into groups of five, of which fifteen were sutured with 2-octyl cyanoacrylate and another fifteen with nylon thread. In the postoperative period, all the animals were submitted to low power laser therapy in a single centralised region, with light perpendicular to the surgical wound, applied every 48 hours via the ArGaAl laser, with a wavelength of 685nm, a dose of 4J/cm2 and power level of 35mW. All the animals were kept in separate cages, under similar conditions, and provided with water and ad libitum feed. Animals were euthanized at 1 day (D1), 3 days (D2) and 7 days (D3). Tissue samples were removed from the central region of the wound and the slides were stained with hematoxylin and eosin. Results: Histological sections were analysed by evaluating inflammatory parameters and in accordance with a previously standardized scale. Similar inflammatory reactions were observed between sutured wounds with nylon and cyanoacrylate, with no statistically significant differences observed. Conclusions: Results suggest that there is no difference in the association between 2-octyl cyanoacrylate and laser therapy and nylon sutures with and the same As-Ga-Al laser application dosage

Acute effects of aerobic intensities on the cytokine response in women with mild multiple sclerosis

BackgroundThere is limited information as to the effects of aerobic exercise on the immune system in people with multiple sclerosis (PwMS). One of the unresolved questions is which training intensity level is optimal for PwMS. ObjectiveThe purpose of this study is to compare the effects of moderate intensity with the effects of vigorous intensity on cytokine levels in women with mild MS. MethodsThe study included 15 women with MS and a control of 10 healthy women. The initial session determined the value of the maximum oxygen consumption and was carried out on an instrumented treadmill with a portable system for monitoring gases. During the second session, the participant walked on the treadmill for 15-minutes at a moderate capacity level (∼50% VO2 peak). Blood samples were taken at baseline, immediately after exercise and two hours later. IL-4, IL-6, IL-10, IL-17A, TNF-α and IFN-ɣ cytokines were tested. The third session was identical to the second except for a vigorous training intensity session (∼80% VO2 peak). ResultsIL-6 increased after moderate exercise for both the MS (p = 0.02) and control group (p = 0.02). IL-10 decreased during the vigorous session only in the MS group (p = 0.02). No other differences were seen over time in either group for all other cytokine measurements. ConclusionsWith the exception of IL-10, women with mild MS have similar inflammatory reactions to moderate and high intensity exercise as do healthy women.

Comparison of Clinical Results and Pathological Examinations Between Locally Synthesized Bone-derived Hydroxyapatite and Medpor® Orbital Implants in Animal Models.

We aimed to compare clinical and pathological reactions towards locally synthesized bovine bone derived from hydroxyapatite (bone docosahexaenoic acid (dHA)) and commercially available porous polyethylene (Medpor®, Porex Surgical Incorporation, Georgia, USA) orbital implants in animal models. An experimental study was performed on 14 New Zealand white rabbits. Group A (n=7) was implanted with bovine bone dHA and group B (n=7) was implanted with Medpor®. Clinical examinations were performed on Days 1, 7, 14, 28, and 42 post-implantation. The implanted eyes were enucleated on Day 42 and were sent for pathological evaluation. Serial clinical examinations included urine color and odor; feeding and physical activity demonstrated normal wellbeing in all the subjects. Localized minimal infection was observed in both groups during the first two weeks following implantation, and the subjects responded well to topical moxifloxacin. Both groups exhibited evidence of wound breakdown. No signs of implant migration or extrusion were observed in either group. The histopathological examination revealed no statistically significant difference in inflammatory cell reactions and fibrovascular tissue maturation between both types of implants. However, all (100%) of the bovine bone dHA implants displayed complete fibrovascular ingrowth compared to Medpor® implants (57.1%) at six weeks post-implantation (p=0.001). In conclusion, bovine bone dHA and Medpor® orbital implants were well-tolerated clinically and displayed similar inflammatory reactions and fibrovascular tissue maturation. Locally synthesized bovine bone dHA orbital implants displayed significantly greater complete fibrovascular ingrowth in comparison with Medpor® implants.

The Role of Danger Signals in the Pathogenesis and Perpetuation of Critical Illness.

The innate immune system induces inflammation through induction of multiple pathways including the TNFα/NF-κB signaling as well as the NLRP3 inflammasome cascade activation with production of inflammatory molecules. Pathogen associated molecular patterns are immunogenic costimulatory molecules that can activate the innate immune system in the presence of foreign pathogens. These molecularly distinct, foreign, particles initiate inflammatory and cell death cascades of the innate immune response through the binding of pathogen recognition receptors such as toll like receptors. The concept of danger associated molecular patterns was proposed in the 1990s based on observations that noninfectious critical illness produces similar inflammatory reactions. Endogenous danger signals are commonly intracellular molecules, such as nuclear or mitochondrial nucleic acids, that have individual biologic roles in non-inflammatory states. However, once released into the extracellular space, these molecular patterns stimula...

Early endothelialization associated with a biolimus A9 bioresorbable polymer stent in a porcine coronary model.

Although Nobori®, with a bioresorbable polymer and biolimus A9 abluminal coating, has unique characteristics, few data exist regarding endothelialization early after implantation. Fifteen Nobori® and 14 control bare-metal stents (S-stent™) were implanted in 12 pigs. Histopathology of stented segments, inflammation, and intimal fibrin content was evaluated on the 2nd and 14th day after implantation. On the 2nd day, endothelial cells were morphologically and immunohistologically confirmed on the surface of both stents, although some inflammatory cells might be involved. Stent surface endothelialization evaluated with a scanning electron microscope showed partial cellular coverage in both stents. On the 14th day, neointimal thickness and percentage of the neointimal area were significantly lower in Nobori® than in S-stent™ (51.4±4.5 vs. 76.4±23.6µm, p<0.05 and 10.8±2.6 vs. 14.1±4.2%, p<0.01). No significant differences were found in these parameters on the 2nd day (17.3±14.9 vs. 26.7±13.6µm and 3.7±3.0 vs. 6.7±3.7%), in inflammatory and intimal fibrin content scores. These results demonstrate that endothelialization could occur early after Nobori® implantation with similar inflammatory reaction to bare-metal stents, probably contributing to low frequency of in-stent thrombosis and restenosis.

Imaging of traumatic injury and impingement of anterior knee fat

Fat is not just used by the body as bulk tissue. In addition to its role in storing energy and regulating hormone action, fat is used in some parts of the body for its mechanical properties. The anatomy of anterior knee fat is more complex than it appears at first sight and is capable of withstanding considerable compressive and shear stress. Specific lesions occur when such mechanical stress exceeds the physiological limits and are yet little known. Superficial fat can be the site of either acute injury by closed degloving called the Morel-Lavallée lesion or chronic injury, when subject to repeat excessive shear forces, due to more complex and less well-defined disruptions that result in pseudo-bursitis. There are three main anterior, intracapsular and extrasynovial fat pads in the knee joint, which are the infrapatellar fat pad (IFP) or Hoffa's fat pad, the quadriceps fat pad and the prefemoral fat pad. The IFP plays an important role as a mechanical shock absorber and guides the patella tendon and even the patella itself during flexion-extension movements. In response to repeated excessive stress, an inflammatory reaction and swelling of the IFP is first observed, followed by a fibrotic reaction with metaplastic transformation into fibrous, cartilaginous or bone tissue. More rarely, the two other deep fat pads (quadriceps and prefemoral) can, if subject to repeated stress, undergo similar restructuring inflammatory reactions with metaplasia resulting in tissue hardening, anterior pain and partial loss of function.

Tissue reactions after subcutaneous and intraosseous implantation of iRoot SP, MTA and AH Plus.

The purpose of this study was to evaluate the reactions of rat subcutaneous connective tissue and bone tissue to iRoot SP, ProRoot MTA, and AH Plus. Specimens were implanted in the dorsal subcutaneous connective tissue and tibias of 36 Wistar rats. Tissue specimens were collected after rats were sacrificed at 7, 30, and 60 days after implantation. Histologic evaluations comprising inflammation severity and new bone formation were blindly made on hematoxylin and eosin-stained sections. In subcutaneous implant test, AH Plus group showed more infiltration of inflammatory cells than the other three groups at 30 days (p<0.05). In intraosseous implant test, number of inflammatory cells decreased in all groups at 7, 30, and 60 days after implantation with no statistically significant differences. Given the similar inflammatory reactions to iRoot SP and MTA, it was concluded that iRoot SP and MTA were biocompatible with the subcutaneous and intraosseous tissues of rats.

Abstract 17559: Ultra-Early Endothelialization of Biolimus A9 With Bioresorbable Polymer Stent (Nobori ® ) in Porcine Coronary Model: Possible Mechanism for Low Frequency of In-stent Thrombosis and Restenosis

Background: The stent with biolimus A9 coated by a bioresorbable polymer (Nobori ® ) has the potential to reduce thrombosis by degradation of polymer over the period. However, few data exist regarding the vessel response and endothelialization at ultra-early phase after its implantation. Therefore, we examined ultra-early endothelialization of Nobori ® in porcine model. Methods and Results: Fifteen Nobori ® and 14 control bare-metal stents (S-Stent TM ) were implanted in 12 swine (mean weight 31.9 kg). Histopathological evaluation of stented segments were performed at 2 and 14 days after implantation. Morphometric analysis of the inflammation (graded as score 0 to 3) and the intimal fibrin content (graded as score 1 to 3) was also assessed. At 14 days, neointimal thickness and % neointimal area, defined as 100 х neointimal area / stent area, were significantly lower in Nobori ® than in S-Stent TM (51.4 ± 5.9 μm vs 76.4 ± 9.6 μm, p &lt; 0.05 and 11.2 ± 1.1 % vs 15.7 ± 1.3 %, p &lt; 0.01, respectively). Importantly, there were no significant differences in these parameters between 2 groups at 2 days (17.3 ± 6.1 μm vs 26.7 ± 6.1 μm, p = NS and 3.8 ± 1.3% vs 6.9 ± 1.7%, p = NS, respectively). Under these conditions, stent surface endothelialization evaluated by scanning electron microscope at 2 days showed similar appearance of endothelial coverage above the struts in Nobori ® compared with S-Stent TM (Figure). Furthermore, there were no significant differences in inflammatory (1.3 ± 0.1 vs 1.3 ± 0.1, p = NS) and intimal fibrin content (2.5 ± 0.1 vs 2.3 ± 0.1, p = NS) scores. Conclusion: These results demonstrated that endothelialization could occur at ultra-early phase after Nobori ® implantation with similar inflammatory reaction to bare-metal stent, probably contributing to low frequency of in-stent thrombosis and restenosis. The use of Nobori ® may have a potential benefit even at early phase before the degradation of polymer as well as long-term benefit.

Biocompatibility of new nanostructural materials based on active silicate systems and hydroxyapatite: in vitro and in vivo study.

To evaluate in vitro cytotoxicity and in vivo inflammatory response to new nanostructural materials based on active calcium silicate systems (CS) and hydroxyapatite (HA-CS). Cytotoxicity of eluates of new nanostructural noncommercial materials CS and HA-CS, and MTA (White MTA, Angelus(®) Soluções Odontológicas, Londrina, Brazil) as a control, were tested using the MTT assay on MRC-5 cells. Eluates of set materials were tested in 100% and 50% concentrations, 24 h, 7 days and 21 days post-elution. The pH values were determined for undiluted eluates of set materials. Polyethylene tubes containing the test materials (CS, HA-CS, MTA) were implanted in subcutaneous tissue of Wistar rats. Histopathological examinations were conducted at 7, 15, 30 and 60 days after the implantation. Data were statistically analyzed using three-way and one-way anova Tukey's post hoc test as well as Kruskall-Wallis test with Dunn's post hoc test at α = 0.05. All materials significantly reduced cell viability; especially when undiluted eluates were used (P < 0.001). After 24 h elution, cell viability was 10 ± 1.8%, 49.5 ± 4.2% and 61 ± 7.4%, for MTA, and HA-CS, respectively. However, CS and HA-CS were significantly less toxic than the control material MTA (P < 0.05). Cytotoxicity could be at least partially attributed to pH kinetics over time. Dilution of eluates of all tested materials resulted in better cell survival. Histopathological examination indicated similar inflammatory reaction, vascular congestion and connective tissue integrity associated with CS, HA-CS and MTA at each observation period (P > 0.05). The only significant difference was found for capsule thickness, that is thicker capsule was associated with HA-CS compared to MTA at 60 days (P = 0.0039). HA-CS induced moderately thick capsules (median score 3, score range 2-3), whereas MTA resulted in thin capsule formation (median score 2, score range 1-3). Evaluation of cytotoxicity and inflammatory response indicated better biocompatibility of CS and HA-CS, in comparison with MTA (White MTA, Angelus(®) Soluções Odontológicas, Londrina, Brazil).

Outcome of inflammatory response after normothermia during cardiopulmonary bypass surgery in infants with isolated ventricular septal defect.

PurposeA recent study analyzing several cytokines reported that long cardiopulmonary bypass (CPB) time and long aortic cross clamp (ACC) time were accompanied by enhanced postoperative inflammation, which contrasted with the modest influence of the degree of hypothermia. In this present study, we aimed to examine the effect of CPB temperature on the clinical outcome in infants undergoing repair of isolated ventricular septal defect (VSD).MethodsOf the 212 infants with isolated VSD who underwent open heart surgery (OHS) between January 2001 and December 2010, 43 infants were enrolled. They were classified into 2 groups: group 1, infants undergoing hypothermic CPB (26℃-28℃; n=19) and group 2, infants undergoing near-normothermic CPB (34℃-36℃; n=24).ResultsThe age at the time of the OHS, and number of infants aged<3 months showed no significant differences between the groups. The CPB time and ACC time in group 1 were longer than those in group 2 (88 minutes vs. 59 minutes, P=0.002, and 54 minutes vs. 37 minutes, P=0.006 respectively). The duration of postoperative mechanical ventilation was 1.6 days in group 1 and 1.8 days in group 2. None of the infants showed postoperative neurological and developmental abnormalities. Moreover, no postoperative differences in the white blood cell count and C-reactive protein levels were noted between two groups.ConclusionThis study revealed that hypothermic and near-normothermic CPB were associated with similar clinical outcomes and inflammatory reactions in neonates and infants treated for simple congenital heart disease.

Deposition, characterization, and in vivo performance of parylene coating on general-purpose silicone for examining potential biocompatible surface modifications

In this study, a thorough investigation of parylene coatings was conducted, as follows: microstructure (i.e., X-ray diffractometer (XRD) and cold field emission scanning electron microscope (FESEM)), mechanical property (i.e., pencil hardness and cross-cut adhesion test), surface property (i.e., water contact angle measurement, IR, and X-ray photoelectron spectroscopy (XPS)), and biocompatibility tests (i.e., fibroblast cell culture, platelet adhesion, and animal studies). The results revealed that parylene, a crystalline and brittle coating, exhibited satisfactory film adhesion and relative hydrophobicity, thereby contributing to its effective barrier properties. Fibroblast cell culturing on the parylene-deposited specimen demonstrated improved cell proliferation and equivalent to or superior blood compatibility than that of the medical-grade silicone (currently used clinically). In the animal study, parylene coatings exhibited similar subcutaneous inflammatory reactions compared with the medical-grade silicone. Both in vitro and in vivo tests demonstrated the satisfactory biocompatibility of parylene coatings.

Corneal cell response after flap creation using a mechanical microkeratome or a 200 kHz femtosecond laser

To compare the inflammatory cell response within the corneal flap interface created by a mechanical microkeratome and a femtosecond laser. Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany. Experimental in vitro study. Corneoscleral buttons of 12 enucleated human eyes not suitable for transplantation were put into organ culture. Corneal flaps were created using a 200 kHz femtosecond laser (Visumax) (femtosecond group) or a mechanical microkeratome (Amadeus) (microkeratome group). Flaps were not lifted after treatment. In 2 corneas, no treatment was performed (control group). Corneas were kept in organ culture for 12 hours thereafter. To evaluate cell-mediated immune reaction, immunofluorescent staining for leucocytes (cluster of differentiation 45) and specifically for dendritic cells (human leukocyte antigen-DR) was performed in every group. A terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assay was used to determine apoptosis reaction. The ratio of dendritic cells in the femtosecond group compared with the microkeratome group was 1.2 (P=.02), the ratio of leucocytes was 1.4 (P=.06), and the ratio of apoptotic cells was 1.0 (P=.59). There was no marked significant difference in the distribution of inflammatory cell reaction. The control group showed neither specific inflammatory reaction nor apoptosis. This in vitro series of human corneas showed similar inflammatory tissue reaction after femtosecond laser-assisted and microkeratome-assisted flap creation (P<.05). No author has a financial or proprietary interest in any material or method mentioned.