In-vitro and in-vivo measurement of the animal's middle ear acoustical response by partially implantable fiber-optic sensing system.

The main obstacle in realization of a totally implantable hearing aid is a lack of reliable implantable microphone. In this paper we have described a potentially miniature fiber-optic vibrometer based on a modified Michelson interferometer, designed to serve as a middle-ear microphone for totally implantable cochlear- or middle-ear hearing aids. A model of the sensing system was used for in-vitro and in-vivo investigation of acoustical response of sheep's middle-ear ossicles. Surgical and implantation procedure of introducing the sensing optical fiber into the middle-ear and its aiming at the incus was investigated and described here in detail. The frequency responses of the incus was measured while a cadaver and living sheep was exposed to the sinusoidal acoustical excitation of 40-90dB SPL, in the frequency range from 100Hz to 10kHz. The amplitude of the incus vibration was found to be in the range between 10pm to 100nm, strongly depending on the frequency, with a lot of resonant peaks, corresponding mainly to the natural outer ear canal gain. The noise floor in the experiments was about 2pm/Hz1/2, but recently we have decreased it to < 0.5pm/Hz1/2, which corresponds to a minimal detectable sound level of 31-35dB(A) SPL for humans. The histological examination of temporal bones of cadaver animals and the intensity of in-vivo optical signal demonstrated that the aiming of the sensing fiber to the target has been preserved for five months after the implantation.

Effects of intraoperatively applied glucocorticoid hydrogels on residual hearing and foreign body reaction in a guinea pig model of cochlear implantation.

CONCLUSION: The intraoperative application of glucocorticoid-loaded hydrogels seems to cause a reduction in neutrophil infiltration. No beneficial effect on hearing thresholds was detected. OBJECTIVES: To evaluate the application of dexamethasone- and triamcinolone acetonide-loaded hydrogels for effects on hearing preservation and foreign body reaction in a guinea pig model for cochlear implantation (CI). METHODS: A total of 48 guinea pigs (n = 12 per group) were implanted with a single channel electrode and intraoperatively treated with 50 µl of a 20% w/v poloxamer 407 hydrogel loaded with 6% dexamethasone or 30% triamcinolone acetonide, a control hydrogel, or physiological saline. Click- and tone burst-evoked compound action potential thresholds were determined preoperatively and directly postoperatively as well as on days 3, 7, 14, 21, and 28. At the end of the experiment, temporal bones were prepared for histological evaluation by a grinding/polishing technique with the electrode in situ. Three ears per treatment group were serially sectioned and evaluated for histological alterations. RESULTS: The intratympanic application of glucocorticoid-loaded hydrogels did not improve the preservation of residual hearing in this cochlear implant model. The foreign body reaction to the electrode appeared reduced in the glucocorticoid-treated animals. No correlation was found between the histologically described trauma to the inner ear and the resulting hearing threshold shifts.

Correlative 3D-imaging of Pipistrellus penis micromorphology: Validating quantitative microCT images with undecalcified serial ground section histomorphology.

Detailed knowledge of histomorphology is a prerequisite for the understanding of function, variation, and development. In bats, as in other mammals, penis and baculum morphology are important in species discrimination and phylogenetic studies. In this study, nondestructive 3D-microtomographic (microCT, µCT) images of bacula and iodine-stained penes of Pipistrellus pipistrellus were correlated with light microscopic images from undecalcified surface-stained ground sections of three of these penes of P. pipistrellus (1 juvenile). The results were then compared with µCT-images of bacula of P. pygmaeus, P. hanaki, and P. nathusii. The Y-shaped baculum in all studied Pipistrellus species has a proximal base with two club-shaped branches, a long slender shaft, and a forked distal tip. The branches contain a medullary cavity of variable size, which tapers into a central canal of variable length in the proximal baculum shaft. Both are surrounded by a lamellar and a woven bone layer and contain fatty marrow and blood vessels. The distal shaft consists of woven bone only, without a vascular canal. The proximal ends of the branches are connected with the tunica albuginea of the corpora cavernosa via entheses. In the penis shaft, the corpus spongiosum-surrounded urethra lies in a ventral grove of the corpora cavernosa, and continues in the glans under the baculum. The glans penis predominantly comprises an enlarged corpus spongiosum, which surrounds urethra and baculum. In the 12 studied juvenile and subadult P. pipistrellus specimens the proximal branches of the baculum were shorter and without marrow cavity, while shaft and distal tip appeared already fully developed. The present combination with light microscopic images from one species enabled a more reliable interpretation of histomorphological structures in the µCT-images from all four Pipistrellus species.

Radiological assessment of the inferior alveolar artery course in human corpse mandibles.

OBJECTIVES: CT assessment of the entire course of the inferior alveolar artery (IAA) within the mandibular canal. METHODS: After contrast medium injection (180 or 400 mg/ml iodine concentration) into the external carotid arteries of 15 fresh human cadaver heads, the main IAA's position in the canal (cranial, buccal, lingual or caudal) was assessed in dental CT images of partially edentulous mandibles. RESULTS: The course of the main IAA could be followed at both iodine concentrations. The higher concentration gave the expected better contrast, without creating artefacts, and improved visibility of smaller arteries, such as anastomotic sections, dental branches and the incisive branch. The main IAA changed its position in the canal more often than so far known (mean 4.3 times, SD 1.24, range 2-7), but with a similar bilateral course. A cranial position was most often detected (42 %), followed by lingual (36 %), caudal (16 %) and buccal ( 6 %). CONCLUSIONS: With this non-invasive radiologic method, the entire course of the main IAA in the mandibular canal could be followed simultaneously with other bone structures on both sides of human cadaver mandibles. This methodology allows one to amend existing anatomical and histological data, which are important for surgical interventions near the mandibular canal. KEY POINTS: • Contrast medium injection displayed the inferior alveolar artery's course on mandibular CTs • An iodine concentration of 400 mg/ml enabled visibility until the chin • Frequent position changes of the artery in the mandibular canal were detected • Cranial and lingual positions were most often determined • Course similarities on the respective left and right sides were found.

The role of materials biocompatibility for functional electrical stimulation applications.

The biocompatibility of all metallic, polymeric, or ceramic materials used for functional electrical stimulation is governed by the inevitable inflammatory tissue response, but possibly also by immunological reactions to the bulk material or released constituents. Besides chemical, physical, and corrosion properties of the conductive electrode materials, increased surface area and roughness of the electrode can influence tissue contact and signal delivery, and can also affect electrode-tissue impedance due to increased connective tissue encapsulation. The polymeric materials used for electrode insulation and those for leads and stimulator packaging seem more or less compatible in an aggressive biological environment. For the long-term performance of electrodes and leads, the relative motion in the various implant bed situations also has to be considered.

Histomorphology of the penis bone (Baculum) in the gray long-eared bat Plecotus austriacus (Chiroptera, Vespertilionidae).

For the first time, the histomorphology of the penis bone of a bat (Plecotus austriacus) was examined in detail. From Plecotus austriacus, 14 whole penes and 11 isolated bacula were studied and compared to bacula of Plecotus auritus and Plecotus macrobullaris. The baculum was located on specimen microradiographs and in micro-CT images in the tip of the penis. Using serial semithin sections and surface-stained, undecalcified ground sections, the types of bone and other tissues constituting the baculum were examined by light microscopy. 3D reconstructions were generated from the serial semithin sections and from micro-CT images. The shaft and the proximal branches of the Y-shaped baculum form a tubular bone around a medullary cavity. Since the small diameter of this channel and the main lamellar bone around it resemble a Haversian canal, the baculum is equivalent to a single-osteon bone. Several oblique nutrient canals enter this medullary cavity in the shaft and branches. All ends of the baculum consist predominantly of woven bone. The collagen fiber bundles of the tunica albuginea of both corpora cavernosa insert via fibrocartilage into the woven bone of the branches. Thus, the microscopic structures support the hypothesis that the baculum functions as a stiffening element in the erect penis. In this study, several microscopic imaging techniques were evaluated for displaying the microscopic structures of the baculum. Specimen microradiography, but especially micro-CT proved to be suitable nondestructive methods for accurate and reproducible demonstration and comparison of the three-dimensional structures of the baculum in different bat species.

Gingivomorphometry - esthetic evaluation of the crown-mucogingival complex: a new method for collection and measurement of standardized and reproducible data in oral photography.

OBJECTIVES: A new method is introduced for the esthetic evaluation of the periimplant mucogingival complex through collection of standardized oral photographs and computer-assisted measurement of reproducible data. Using this method, different soft tissue and crown parameters in the dentogingival complex can be measured and the esthetic outcome monitored. MATERIAL AND METHODS: A photographic device for standardized oral photography and a standard protocol for the esthetic evaluation of the crown-mucogingival complex is presented, comprising six soft tissue parameters: (1) mesial and (2) distal papilla areas, (3) mesial and (4) distal papilla heights, (5) soft tissue-crown perimeter, and (6) gingival recession. In order to demonstrate the reproducibility of standardized oral photographs and the accuracy of the measurement of the six parameters, the data obtained in each of two such standardized clinical photographs, taken at 10-14 days intervals, of the anterior maxillary region from 10 patients with no apparent dental disease were compared. For the statistical analysis of the reproducibility of these dependent data the 95% confidence interval and the coefficients of variation were calculated from measurement means and ranges of each of the above parameters, pooled from all 10 patients. RESULTS: Statistical analysis revealed high reproducibility with no significant differences between the range of mean values of all six parameter measurements on the first and second standardized oral photograph of the same patient, respectively. CONCLUSION: Gingivomorphometry on standardized oral photographs can be considered to be an accurate and reproducible method for the evaluation and measurement of different dentogingival and periimplant parameters.

Microanatomy of the palatal mucosa of the semiaquatic malayan box turtle, Cuora amboinensis, and functional implications.

Scanning Electron Microscopy (SEM) revealed that the palate of Cuora amboinensis has a flat surface with keratinized and non-keratinized regions. Keratinization is reflected in disc-shaped keratinized dead cells with rough microplicae on the surface, and is concentrated close to the rhamphotheca. The surface of the non-keratinized hexagonal epithelial cells is dotted with microvilli and sometimes with cilia. Taste buds are present both in lightly keratinized and non-keratinized regions and exhibit a crater-like shape. Light microscopy shows the different tissue layers of the oral mucosa and the different epithelial structures. In keratinized regions, keratinocytes mature from basal to superficial, where they build up keratin layers of varying thickness. In non-keratinized regions, the epithelial cells are arranged in a stratified fashion, and cuboidal to cylindric cells form a superficial layer. Goblet cells appear to be diffusely distributed, but are often organized in goblet cell fields which can be folded into crypts. Taste buds consist of slender epithelial cells, exhibit the typical barrel-like shape and are specially concentrated in the anterior, praechoanal palate. This anterior concentration of taste buds is shown by kinematographic analysis to correlate with the food prehension mode in Cuora amboinensis. The lamina propria of the palatal mucosa consists of loose connective tissue with inflammatory cells between capillaries. All these structures of the oral mucosa act as a functional entity and help determine how successfully an organism adapts ecologically to the environment.

Histomorphometric and fluorescence microscopic evaluation of interfacial bone healing around 3 different dental implants before and after radiation therapy.

PURPOSE: Radiation therapy influence on bone healing around 3 types of endosseous dental implants in dogs was evaluated. MATERIALS AND METHODS: Implants with 3 different surfaces (A = machined commercially pure titanium screws, B = commercially pure titanium plasma spray-coated cylinders, C = hydroxyapatite [HA] -ceramic coated cylinders) were first implanted unilaterally into the right posterior edentulous mandibles of 7 dogs as nonirradiated controls. After 12 weeks without functional loading and after sequential fluorochrome labeling these implants were retrieved by block dissection. In this same surgery, implants were placed on the contralateral side. Three weeks postimplantation the implant-containing hemimandibles were Cobalt 60 irradiated with the biologic equivalent of 5,000 cGy. Twelve weeks postimplantation and after labeling these irradiated implants were retrieved at sacrifice. On scanning electron, light, and fluorescence microscopic images of undecalcified longitudinal ground sections of the implants with surrounding tissues, percent bone-to-implant contact (% BIC), bone formation, and remodeling were histometrically and subjectively evaluated. RESULTS: Woven bone formation started 1 week after implantation at the implant interfaces on both the nonirradiated and the irradiated sides. Average BICs (total/cortical/spongious bone bed) of 26%/49%/36% for surface A, 46%/48%/64% for surface B, and 81%/83%/78% for surface C were observed. In the irradiated hemimandibles average BICs (total/cortical/spongious bone bed) were reduced to 11%/9%/4% for surface A, 43%/46%/43% for surface B, and 63%/85%/76% for surface C, with increased resorption of peri-implant bone and retarded bone formation after irradiation. DISCUSSION: Reductions of total % BIC in all irradiated implants, though not statistically significant, were significant (P < or = .05) on implant surfaces A and B in the spongious bone bed. CONCLUSION: Retarded bone formation on surfaces A and B in the spongious bone bed represented a more radiation-sensitive situation at the time of radiation onset compared to advanced bone formation and maturation at surface C.

Computer-assisted quantification of occlusion and coil densities on angiographic and histological images of experimental aneurysms.

OBJECTIVE: Occlusion rates (OR) and coil densities were quantified by computer-assisted morphometry on angiograms and histological ground sections of coil-embolized experimental aneurysms. The aims of this study were 1) to develop computer-assisted evaluations of angiographic OR and histometrical OR, 2) to compare these results to subjectively estimated angiographic OR from clinical practice, and 3) to test the correlation between histometrical data of coil density and occlusion. METHODS: Eight rabbit carotid-bifurcation aneurysms had been followed by digital subtraction angiography (DSA) before and after Guglielmi detachable coil embolization and at sacrifice (1 h to 24 wk postembolization). Angiographic OR was subjectively estimated, then determined by computer-assisted density-gradient distinction on digitized DSAs. Histometrically, maximum length, neck width, total area, recanalized area, and coil-occupied area were measured on digitized and calibrated color micrographs from surface-stained histological ground sections of the aneurysms. Histometrical OR and coil density were calculated as indirect parameters. RESULTS: Subjective versus computer-assisted angiographic OR yielded for one aneurysm, 100% versus 100%, and for three aneurysms less than 90% versus 65 to 60% occlusion. For four aneurysms, OR was estimated greater than 90%, whereas computer-assisted OR ranged between 45 to 80%, the latter being more precise because of better definition of the aneurysm's total area on digitized DSA. Histometrical OR ranged between 32.8 and 87.6%, but did not correlate significantly with computer-assisted angiographic OR (r = 0.467, P > 0.1) because of differences in two aneurysms. Coil densities between 5.5 and 22.1% were slightly lower than reported in literature but significantly correlated to histometrical OR (r = 0.646, P < 0.05). CONCLUSION: Computer-assisted DSA evaluation, delivering more precise values than subjectively estimated occlusion, may be a useful tool for follow-up studies. Comparing computer-assisted angiographic with histometrical occlusion demonstrates limits of DSA in displaying the real morphology of coil-embolized aneurysms. The clinically postulated correlation of OR and coil densities was statistically corroborated.

Periapical tissue responses and cementum regeneration with amalgam, SuperEBA, and MTA as root-end filling materials.

The purpose of this study was to compare the periapical tissue responses and cementum regeneration in response to three widely used root-end filling materials, amalgam, SuperEBA, and Mineral Trioxide Aggregate (MTA). These materials were placed using modern microsurgical techniques on endodontically treated dog premolars and molars. After 5 months, the cell and tissue reactions of surface-stained un-decalcified ground sections were evaluated by light microscopy and statistically analyzed. The major difference in the tissue responses to the three retrofilling materials were the degree of inflammation and types of inflammatory cells, number of fibrous capsule formations, cementum neoformation over these materials, osseous healing and resulting periodontal ligament thickness. MTA showed the most favorable periapical tissue response, with neoformation of cemental coverage over MTA. SuperEBA was superior to amalgam as a root-end filling material.

Histomorphometrical and clinical comparison of submerged and nonsubmerged implants subjected to experimental peri-implantitis in dogs.

OBJECTIVES: Soft and hard tissue healing around submerged and nonsubmerged versions of one dental implant design was evaluated in an experimental canine peri-implantitis model. MATERIAL AND METHODS: Forty-eight c.p. Ti-implants with integrated (one-piece=OPI) or screw-on (two-piece=TPI) abutments were inserted in edentulous mandibles of eight beagle dogs, one OPI and one TPI with connected abutments for nonsubmerged and one TPI without abutment (SMI) for submerged healing. After 3 months, all implants were functionally loaded, and at 4 months peri-implantitis was ligature-induced in one jaw side. Intravital polyfluorochrome labeling, monthly conventional radiography and gingival probing of all 48 implants were performed until sacrifice 8 months postimplantation. Undecalcified ground sections in the bucco-lingual and mesio-distal planes of four dogs (23 implants, one implant lost) were evaluated by light and fluorescence microscopy. The immunohistochemical and SEM-vascular corrosion cast results of the four other dogs (24 implants) will be reported elsewhere. Levels of alveolar bone-to-implant contact (ABICL), alveolar crest (ACL) and junctional epithelium-to-implant contact were determined by computer-assisted histometry. Peri-implant alveolar bone loss (=saucerization) was assessed on the radiographs and calculated as ACL minus ABICL from histometric data. RESULTS: Around SMIs and OPIs without ligature less plaque adhesion and lower gingival indices were found when compared to TPIs. Radiologically, all ligatured, but also some nonligatured implants showed alveolar bone loss. Histometry demonstrated reduced ABICL around all these implants. Saucerization was more pronounced on the lingual and mesio-distal sides. Particularly around TPIs, bone resorption was still active or bone formation was impaired on fluorochrome labeling. Only around SMIs and one OPI without ligature continuing alveolar bone formation reflected by gains in ABICL were found. CONCLUSION: The clinical and histometric results of this study demonstrate that healing of submerged SMIs was not impaired by the two-stage procedure, resulting in equally good healing as around nonsubmerged OPIs. However, peri-implantitis plaque-induced by ligature and/or dilated abutment connection microgaps in TPIs affected alveolar bone-to-implant contacts more than transmucosal or submerged healing mechanisms.

Three-dimensional histomorphometric analysis of distraction osteogenesis using an implanted device for mandibular lengthening in sheep.

The aim of this study was to lengthen the sheep mandible with a fully buried device and to quantitatively analyze the tissue regenerate in the distraction gap by means of two-dimensional and three-dimensional histomorphometry. A custom-made device for continuous distraction was used in five adult sheep and fixed with three bicortical screws on either side of an osteotomy, anterior to the premolar region of the mandible. A cable-connected power and control unit was implanted in the neck region. After a 5-day latency period, distraction was activated every 2 hours and advanced at a rate of 1.01 mm per day. The distraction period was planned for 14 days, but because of stability problems and cable breakage, the actual distraction period ranged from 2 to 17 days, resulting in gap distances from 1.7 to 17.1 mm (mean, 0.95 mm/day). Osteogenesis was followed by radiographic imaging, and after a 6-week consolidation period, the harvested mandibles were serially sectioned for histologic and two-dimensional histomorphometric analysis, with three-dimensional reconstruction. Histologic examination of the specimens demonstrated predominantly membranous bone formation with remodeling bridging the distraction gap mainly in the periosteal region of the lingual side. In addition, cartilaginous areas and chondral bone formation were observed where the bridging appeared incomplete. Because of device fixation on the buccal side of the mandible, the preservation of the lingual periosteum seemed to play the major role for sufficient bone repair in the distraction gap. Cartilage within the distraction gap suggests fixation instability in this animal model.

Inhibition of neointimal formation after stent placement with adenovirus-mediated gene transfer of I kappa B alpha in the hypercholesterolemic rabbit model: initial results.

PURPOSE: To evaluate the feasibility and efficacy of the local application of a replication-defective adenovirus construct for the expression of the antiinflammatory protein I kappa B alpha, inhibitor of nuclear factor kappa B (NF-kappa B), to reduce neointimal formation after stent placement. MATERIALS AND METHODS: Nitinol stents were implanted in the iliac arteries of hypercholesterolemic rabbits, followed by balloon dilation (30 seconds at 6 atm). Local adenovirus-mediated transfer of I kappa B alpha (3 mL of 10(9) plaque-forming units per milliliter at 6 atm) was performed and compared with three control groups: stent alone, stent plus local delivery of phosphate-buffered saline (PBS) (3 mL at 6 atm), and stent plus local delivery of control adenovirus coding for green fluorescent protein (GFP) (3 mL of 10(9) plaque-forming units per milliliter at 6 atm). A multichannel balloon was used for local drug delivery and balloon dilation. Animals were sacrificed 1 or 4 weeks after treatment. Effective transfection was demonstrated with immunofluorescence staining. Angiographic patency and luminal diameter were evaluated at quantitative angiography. Luminal and neointimal areas were measured on surface-stained ground sections with methylmethacrylate embedding and the cutting-grinding technique. RESULTS: All vessels with stents were patent at angiography. Neointimal area was negligible in all groups 1 week after stent placement (range, 0.42-0.52 mm(2); P =.44; analysis of variance). Neointimal formation was demonstrated in all groups 4 weeks after implantation but was significantly reduced with I kappa B alpha treatment compared with treatment with stent alone (by 22%, from 2.80 mm(2) +/- 0.20 to 2.28 mm(2) +/- 0.14, P =.05), stent plus PBS (by 43%, from 3.26 mm(2) +/- 0.25 to 2.28 mm(2) +/- 0.14, P =.005), and stent plus GFP (by 53%, from 2.32 mm(2) +/- 0.19 to 1.51 mm(2) +/- 0.08, P <.005). CONCLUSION: Local adenovirus-mediated I kappa B alpha gene transfer has the potential to reduce intimal hyperplasia after stent placement.