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1.
J Microsc ; 255(1): 20-9, 2014 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24802370

RESUMO

In orthopaedic surgery the tissues damaged by injury or disease could be replaced using constructs based on biocompatible materials, cells and growth factors. Scaffold design, porosity and early colonization are key components for the implant success. From biological point of view, attention may be also given to the number, type and size of seeded cells, as well as the seeding technique and cell morphological and volumetric alterations. This paper describes the use of the microCT approach (to date used principally for mineralized matrix quantification) to observe construct colonization in terms of cell localization, and make a direct comparison of the microtomographic sections with scanning electron microscopy images and confocal laser scanning microscope analysis. Briefly, polycaprolactone scaffolds were seeded at different cell densities with MG63 osteoblastic-like cells. Two different endpoints, 1 and 2 weeks, were selected for the three-dimensional colonization and proliferation analysis of the cells. By observing all images obtained, in addition to a more extensive distribution of cells on scaffolds surfaces than in the deeper layers, cell volume increased at 2 weeks compared to 1 week after seeding. Combining the cell number quantification by deoxyribonucleic acid analysis and the single cell volume changes by confocal laser scanning microscope, we validated the microCT segmentation method by finding no statistical differences in the evaluation of the cell volume fraction of the scaffold. Furthermore, the morphological results of this study suggest that an effective scaffold colonization requires a precise balance between different factors, such as number, type and size of seeded cells in addition to scaffold porosity.


Assuntos
Regeneração Óssea/genética , Regeneração Óssea/fisiologia , DNA/genética , Imageamento Tridimensional/métodos , Microscopia Confocal/métodos , Microscopia Eletrônica de Varredura/métodos , Polímeros/metabolismo , Materiais Biocompatíveis/metabolismo , Contagem de Células/métodos , Linhagem Celular Tumoral , Tamanho Celular , Humanos , Poliésteres/metabolismo , Porosidade , Microtomografia por Raio-X/métodos
2.
J Biomed Mater Res A ; 82(1): 213-21, 2007 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-17266017

RESUMO

In this study we coated a new biocompatible, nanostructured titanium alloy, Ti13Nb13Zr, with a thin layer of hydroxyapatite nanocrystals and we investigated the response of human bone-marrow-derived mesenchymal cells. The coating was realized using a slightly supersaturated CaP solution, which provokes a fast deposition of nanocrystalline hydroxyapatite. A thin layer of deposition is appreciable on the etched Ti13Nb13Zr substrates after just 1.5 h soaking in the CaP solution, and it reaches a thickness of 1-2 mum after 3 h soaking. The coating seems thinner than that deposited on Ti6Al4V, which was examined for comparison, likely because of the different roughness profiles of the two etched alloys, and it is constituted of elongated HA nanocrystals, with a mean length of about 100 nm. Mesenchymal stem cells were seeded onto coated and uncoated Ti alloys and cultured for up to 35 days. Cell morphology, proliferation and differentiation were evaluated. The cells display good adhesion and proliferation on the uncoated substrates, whereas the presence of hydroxyapatite coating slightly reduces cell proliferation and induces differentiation of MSCs towards a phenotypic osteoblastic lineage, in agreement with the increase of the expression of osteopontin, osteonectin and collagen type I, evaluated by means of rt-PCR. Type I collagen expression is higher in Ti13Nb13Zr MSC culture compared to Ti6Al4V, standing for a more efficient extracellular matrix deposition.


Assuntos
Materiais Revestidos Biocompatíveis/química , Durapatita/química , Células-Tronco Mesenquimais/citologia , Nanopartículas/química , Titânio/química , Ligas/química , Sequência de Bases , Células da Medula Óssea/citologia , Células da Medula Óssea/metabolismo , Adesão Celular , Técnicas de Cultura de Células/métodos , Diferenciação Celular , Proliferação de Células , Colágeno Tipo I/genética , Primers do DNA/genética , Expressão Gênica , Humanos , Teste de Materiais , Células-Tronco Mesenquimais/metabolismo , Microscopia Eletrônica de Varredura , Osteoblastos/citologia , Osteoblastos/metabolismo , Osteonectina/genética , Osteopontina/genética
3.
Micron ; 38(6): 618-25, 2007.
Artigo em Inglês | MEDLINE | ID: mdl-17084088

RESUMO

Small titanium particles may detach from titanium plasma sprayed (TPS) implants during implant insertion, when no preliminary tapping is used, probably for the frictional force between titanium coating and host bone. Aim of this study was to investigate the destination of these titanium particles observed in the peri-implant environment. Twenty-four TPS screws were implanted in tibiae of two sheep. Fourteen and 90 days after implantation the implants with the surrounding bone were removed and processed to be analyzed by light microscope and scanning electron microscope (secondary electron and back-scattered electron probes). Small titanium particles detached from the unloaded TPS implants were observed both in the newly-formed bone matrix and in marrow tissue. Histomorphometric analysis showed that both at 14 and 90 days after implantation the titanium particles appeared more concentrated in marrow tissue than in calcified bone matrix, decreasing by 66.4% over time. In particular, smaller particles (<250 microm(2)) decreased by 81.5%, whereas the larger ones (250-2000 microm(2)) did not show any significant variations over time, suggesting that most of the smaller particles may undergo to ionic dissolution, probably migrating into the peri-implant marrow lacunae. A slight migration of titanium particles from the implant surface towards the more distant peri-implant tissues was also demonstrated over time.


Assuntos
Parafusos Ósseos/efeitos adversos , Próteses e Implantes/efeitos adversos , Tíbia/química , Tíbia/cirurgia , Titânio , Animais , Medula Óssea/química , Medula Óssea/ultraestrutura , Materiais Revestidos Biocompatíveis , Osseointegração , Ovinos , Tíbia/ultraestrutura
4.
Int J Artif Organs ; 30(2): 163-72, 2007 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-17377911

RESUMO

To evaluate how aging and estrogen deficiency influence the success rate of Sandblasted Titanium (Ti/SA) implants, the osteointegration of Ti/SA rods was studied in the cortical and trabecular bone of 5 young, 5 aged and 5 ovariectomized (OVX) sheep. The characterization of the host bone by transiliac biopsies of the iliac crest showed a progressive rarefaction of trabecular bone in aged and OVX animals when compared to young ones. A significant reduction, both in cortical and trabecular bone, of the osteointegration rate of Ti/SA rods in the presence of estrogen deficiency compared to young animals was observed, while only a minor reduction was observed in aged animals. These results were confirmed by the pushout test in cortical bone. Bone quality affected the biological response of bone to Ti/SA implants in both trabecular and cortical bone; consequently, strategies to maximize the bone osteogenic properties of osteoporotic patients should be adopted.


Assuntos
Envelhecimento/fisiologia , Estrogênios/fisiologia , Osseointegração/fisiologia , Ovariectomia , Próteses e Implantes , Titânio , Animais , Fenômenos Biomecânicos , Feminino , Osteoporose/fisiopatologia , Carneiro Doméstico , Propriedades de Superfície
5.
Int J Artif Organs ; 30(4): 352-62, 2007 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-17520574

RESUMO

This study comparatively investigates the in vitro and in vivo behavior of injectable polymeric materials for the treatment of bone defects. The tested materials were three injectable and biodegradable PLA/PGA 50/50 copolymers dispersed in different matrices: Fisograft-gel (GEL) was dispersed in an aqueous matrix of poly-ethyl-glycole (PEG); Slurry2 (SL2) was dispersed in an aqueous matrix of PEG and dextran; and Slurry6 (SL6) was dispersed in a 3% agarose matrix. The biological characterization of these materials was studied by in vitro and in vivo tests: the in vitro test assessed the cellular response in terms of viability, differentiation and synthetic activity, while the in vivo test evaluated the healing capacity of bone defects treated with these biomaterials. GEL and SL2 induced a similar response for viability and differentiation of MG63 osteoblast-like cells after a 7-day culture, while SL6 caused a higher production of both interleukin-6 and type I collagen. Since the results showed that the materials were biocompatible and not cytotoxic in vitro, the in vivo study was carried out: materials were implanted, under general anesthesia, in critical size defects of rabbit femoral condyles; after 4 and 12 weeks, the healing rates and the quality of the regenerated bone were histomorphometrically calculated. The SL2-treated defects healed better at 12 weeks with a more similar microarchitecture of the newly formed bone to normal bone in comparison with other materials, as demonstrated by bone volume fraction and trabecular thickness values.


Assuntos
Materiais Biocompatíveis/química , Substitutos Ósseos/química , Ácido Láctico/química , Ácido Poliglicólico/química , Polímeros/química , Implantes Absorvíveis , Animais , Materiais Biocompatíveis/uso terapêutico , Doenças Ósseas/cirurgia , Regeneração Óssea/efeitos dos fármacos , Substitutos Ósseos/uso terapêutico , Diferenciação Celular/efeitos dos fármacos , Proliferação de Células/efeitos dos fármacos , Sobrevivência Celular/efeitos dos fármacos , Células Cultivadas , Colágeno Tipo I/análise , Dextranos/química , Portadores de Fármacos , Fêmur/cirurgia , Humanos , Interleucina-6/análise , Ácido Láctico/uso terapêutico , Teste de Materiais , Osteoblastos/citologia , Osteoblastos/efeitos dos fármacos , Polietilenoglicóis/química , Ácido Poliglicólico/uso terapêutico , Copolímero de Ácido Poliláctico e Ácido Poliglicólico , Polímeros/uso terapêutico , Coelhos , Reologia , Sefarose/química , Cicatrização/efeitos dos fármacos
6.
G Ital Med Lav Ergon ; 29(3 Suppl): 830-2, 2007.
Artigo em Italiano | MEDLINE | ID: mdl-18409986

RESUMO

The International Agency for Research on Cancer RC) has classified wood dust as carcinogenic to humans based on demiological and experimental evidence. Exposure to wood dust may use respiratory and dermal symptoms and diseases. The aim of this work was to estimate occupational exposure to inhalable wood dust adopting the formal procedure described by UNI EN 689/97. The exposure of 23 workers in three different working day was measured. In total, 69 personal air samplings were carried out at five wood working factories. Inhalable fraction of airborne dust was collected on 5 microm pore size, 25 mm diameter PVC filters utilizing the IOM samplers. The quantity of the wood dust was determined with gravimetric method. The results show that about 13% of the exposure values exceed the limit of 5 mg/m3 specified by the Italian Law Decree 66/2000 and about 48% of personal exposures are lower then the limit value. Prevention measures, technological solutions and personal protection equipment should be adopted in order to reduce worker's exposure.


Assuntos
Poluentes Atmosféricos/efeitos adversos , Poeira , Exposição Ocupacional/estatística & dados numéricos , Madeira , Humanos , Medição de Risco
7.
Med Hypotheses ; 109: 70-72, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-29150298

RESUMO

Women are at greater risk of developing osteoporosis (OP). However, in the past few years it has become more widely recognized that OP is a significant problem also in men although OP is frequently under-diagnosed and, consequently, under treated in men. Most guidelines, screening and fracture risk evaluation methods as well as pharmacologic agents have been developed for women and then adapted to men. Bone Mineral Density (BMD) measurement by Dual X-ray Absorptiometry (DEXA) is reported as T score and the capability of DEXA to diagnose OP and predict fracture risk is still debated. In addition, the use of female T score references for the diagnosis of OP in men is incorrect for the following reasons: 1) DXA definition was developed just for Caucasian women, 2) men and women display structural differences in terms of bone growth, catabolism and size; 3) aging men have more periosteal apposition, less cortical porosity and endocortical resorption than aging women; and 4) T scores results, both in man and in women, can be affected by the presence of co-morbidities and it is known that in men OP is often secondary. From a biological point of view, OP is mainly due to increased osteoclastic activity leading to an imbalance in bone remodeling that favors resorption. However, some evidence suggests a more complex identity for osteoclasts (OCs) over and above their simple role of 'bone eaters'. In our laboratory, we observed spontaneous OCs formation in vitro in peripheral blood mononuclear cells (PBMC) from OP patients (n.12 female patients and n.6 male patients; DXA T score-2.5 or less). Some researchers demonstrated OCs gender differences in bone resorption activity of female-derived versus male-derived OCs. Indeed, further data from our laboratory also showed gender differences in number of spontaneously differentiated OCs and differentiation time. Therefore, we hypothesized that it would be possible to perform OP screening and diagnosis observing and measuring PBMCs different ability to differentiate spontaneously into OCs in male and female patients. If this hypothesis will be confirmed, it will result in an effective and efficient strategy for OP screening, diagnosis, monitoring and fracture prevention, targeting health service resources on selected patients. However, our hypothesis must be tested in a properly designed clinical trial and several key issues still need to be addressed.


Assuntos
Osteoclastos/patologia , Osteoporose/diagnóstico , Osteoporose/patologia , Absorciometria de Fóton , Algoritmos , Densidade Óssea , Comorbidade , Feminino , Consolidação da Fratura , Humanos , Leucócitos Mononucleares/citologia , Masculino , Programas de Rastreamento , Osteogênese
8.
J Orthop Res ; 24(5): 877-88, 2006 May.
Artigo em Inglês | MEDLINE | ID: mdl-16609976

RESUMO

The repair of confined trabecular bone defects in rabbits treated by autologous bone marrow stromal cells (BMSC), platelet-rich plasma (PRP), freeze-dried bone allografts (FDBA) alone and in combination (BMSC + PRP; FDBA + BMSC; FDBA + PRP; FDBA + PRP + BMSC) was compared. A critical size defect was created in the distal part of the femurs of 48 adult rabbits. Histology and histomorphometry were used in the evaluation of healing at 2, 4, and 12 weeks after surgery. The healing rate (%) was calculated by measuring the residual bone defect area. Architecture of the newly formed bone was compared with that of bone at the same distal femur area of healthy rabbits. The defect healing rate was higher in PRP + BMSC, FDBA + PRP, FDBA + BMSC, and FDBA + PRP + BMSC treatments, while lower values were achieved with PRP treatment at all experimental times. The highest bone-healing rate at 2 weeks was achieved with FDBA + PRP + BMSC treatment, which resulted significantly different from PRP (p < 0.05) and BMSC (p < 0.05) treatments. At 4 weeks, the bone-healing rate increased except for PRP treatment. Finally, the bone-healing rate of FDBA + PRP, FDBA + BMSC, and FDBA + PRP + BMSC was significantly higher than that of PRP at 12 weeks (p < 0.05). At 12 weeks, significant differences still existed between PRP, BMSC, and FDBA groups and normal bone (p < 0.05). These results showed that the combination of FDBA, BMSC and PRP permitted an acceleration in bone healing and bone remodeling processes.


Assuntos
Células da Medula Óssea/citologia , Transplante Ósseo , Transfusão de Plaquetas , Células Estromais/transplante , Cicatrização , Animais , Fêmur/cirurgia , Liofilização , Osteogênese , Coelhos , Transplante Homólogo
9.
J Biomed Mater Res A ; 78(4): 739-45, 2006 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-16739178

RESUMO

We have recently developed a new calcium phosphate bone cement enriched with gelatin (GEL-CP), which exhibits improved mechanical properties with respect to the control cement (C-CP). In a previous study, we demonstrated the good response of osteoblast-like cells to the new biomimetic bone cement. Herein, we extend the investigation to primary culture of osteoblasts derived from healthy and pathological bones. Osteoblasts derived from normal (N-OB) and osteopenic (O-OB) sheep bones were cultured on samples of GEL-CP, and their behavior was compared with that of cells cultured on C-CP as control. Cell morphology, proliferation, and differentiation were evaluated at 3 and 7 days. SEM analysis revealed that both N-OB and O-OB showed a normal morphology when cultured on GEL-CP. Biological tests demonstrated that the gelatin-enriched cement improves osteoblasts' activity and differentiation of O-OB cultures, with respect to the control samples. The data indicate that the new composite cement positively stimulates alkaline phosphatase activity, collagen type I, and osteocalcin production, not only in N-OB, but also in O-OB culture. The improvement due to the presence of gelatin suggests that the biomimetic composite material could be successfully applied as bone substitute also in the presence of osteopenic bone.


Assuntos
Cimentos Ósseos , Doenças Ósseas Metabólicas/patologia , Fosfatos de Cálcio , Gelatina , Mimetismo Molecular , Osteoblastos/citologia , Animais , Células Cultivadas , Modelos Animais de Doenças , Feminino , Microscopia Eletrônica de Varredura , Osteoblastos/ultraestrutura , Ovinos
10.
J Biomed Mater Res A ; 78(3): 449-58, 2006 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-16721758

RESUMO

The goal of the study was the evaluation of the effect of modification of titanium implants by acrylic acid surface grafting-collagen I coupling. Tests were performed on titanium samples treated by galvanostatic anodization to create a porous surface topography. Surface characterization by X-ray photoelectron spectroscopy (XPS) and scanning electron microscopy (SEM) confirms the biochemical modification of the surface and shows a surface topography characterized by pores mostly below 1 mum diameter. In vitro evaluation involving human mesenchymal cells shows enhanced cell growth on collagen coated surfaces as compared to titanium ones. Four weeks in vivo evaluation of implants in rabbit femur trabecular bone shows improvements of bone-to-implant contact, while improvement of bone ingrowth is slightly not significant (p = 0.056), when compared to the control. Overall, these data indicate that integration in trabecular, or cancellous, bone can be enhanced by the surface collagen layer, confirming previous findings obtained by modification of machined surfaces by the same approach in cortical bone implants.


Assuntos
Substitutos Ósseos , Materiais Revestidos Biocompatíveis , Colágeno Tipo I , Mesoderma/fisiologia , Próteses e Implantes , Titânio , Animais , Células da Medula Óssea , Adesão Celular/fisiologia , Células Cultivadas , Humanos , Mesoderma/citologia , Coelhos
11.
Biomed Pharmacother ; 60(8): 458-62, 2006 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-16930935

RESUMO

Electrochemotherapy (ECT) is a new treatment for metastatic nodules of solid tumors on the skin or subcutaneous tissue. ECT is a combination of a physical effect, cell membrane poration, and cytotoxic drug administration. Cell membrane poration is achieved by applying short intense electric filed pulses. Pore formation on the cell membrane allows low permeant drugs like bleomycin or cisplatin to enter the cell and thus locally increase their toxicity: up to 10.000 times for bleomycin and 80 times for cisplatin. ECT has been investigated in a multicenter study European Standard Operating Procedures for Electrochemotherapy (ESOPE) that demonstrates how by ECT over 80% of the cutaneous or subcutaneous metastatic nodules can be healed, thus confirming the results of previous studies. ECT efficacy is independent of tumor histology. The experience gathered in the ESOPE study allowed to prepare standard operating procedures that are key to the dissemination of the technology. ECT is safe effective, the treatment is completed in one session usually on an out-patient basis with minimum side-effects. ECT is cost-effective and, although palliative, it ameliorates patients' quality of life. ECT is the treatment of choice for tumors refractory to conventional treatment, can be used in form of cytoreductive therapy before conventional treatment for organ sparing and functions saving, finally can be adopted to treat hemorrhagic or painful nodules, it can be applied in previously irradiated areas.


Assuntos
Eletroquimioterapia , Neoplasias Cutâneas/tratamento farmacológico , Neoplasias Cutâneas/secundário , Animais , Antineoplásicos/uso terapêutico , Bleomicina/uso terapêutico , Linhagem Celular Tumoral , Cisplatino/uso terapêutico , Ensaios Clínicos como Assunto , Ensaios de Seleção de Medicamentos Antitumorais , Humanos
12.
Biomed Pharmacother ; 60(8): 365-9, 2006 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-16930939

RESUMO

This paper describes the effect of surface functionalization on surface composition and cell adhesion to titanium samples by high and low molecular weight Hyaluronan (HA). HA was covalently linked to aminated Ti surfaces obtained by two different surface functionalization techniques, that is polyethyleneimine (PEI) adsorption and deposition from allylamine plasma. The two approaches yield very different surface densities of available amino groups, affecting this way the number and frequency of surface-HA bonds and the configurational freedom of the latter. Results of cell adhesion test are dependent on the surface functionalization approach adopted, low molecular weight HA coupled to PEI functionalized Ti does not yield the same degree of resistance to cell adhesion found on other samples. These results indicate that the details of the surface functionalization step are crucial for surface engineering of implant devices by biological molecules.


Assuntos
Adesão Celular , Ácido Hialurônico/química , Titânio/química , Alilamina/química , Animais , Células L , Camundongos , Peso Molecular , Polietilenoimina/química , Propriedades de Superfície , Tecnologia Farmacêutica/métodos
13.
Biomed Pharmacother ; 60(8): 380-5, 2006 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-16928425

RESUMO

The effects of systemic administration of glucocorticoids (GC) on Achilles tendons of rats was studied. After the animal euthanasia, Achilles tendons were removed in sterile conditions from Sprague Dawley adult female rats to isolate tenocytes. Animals have been daily treated for 8 weeks with 4 mg/kg methylprednisolone or Sham-treated with saline solution. In vitro, cell proliferation (WST-1), extra-cellular matrix (ECM) synthesis (collagen type I, CICP; proteoglycans, PG; and fibronectin, FBN), and transforming growth factor (TGF-beta1) were evaluated at 3 and 7 days of culture. The effect of glucocorticoids (GC) on tenocytes was evident both at 3 and 7 days of culture, and caused a significant decreases in cell proliferation (P<0.01), CICP (P<0.01) and PG synthesis (P<0.01) as compared to NT tenocytes. In conclusion, GC systemic treatment seems to compromise the normal proliferation rate and synthetic activity of cultured tenocytes. This study was helpful in understanding the fundamental biological processes that occur during corticosteroid systemic administration and tenocyte cultures may be used to further study to improve knowledge of these cell behaviour also in the ambit of tendon tissue-engineered therapies.


Assuntos
Tendão do Calcâneo/citologia , Tendão do Calcâneo/metabolismo , Glucocorticoides/efeitos adversos , Metilprednisolona/efeitos adversos , Animais , Proliferação de Células/efeitos dos fármacos , Células Cultivadas , Colágeno Tipo I/metabolismo , Matriz Extracelular/metabolismo , Feminino , Fibronectinas/metabolismo , Proteoglicanas/metabolismo , Ratos , Ratos Sprague-Dawley , Fator de Crescimento Transformador beta1/metabolismo
14.
Biomed Pharmacother ; 60(8): 393-5, 2006 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-16905290

RESUMO

Recent guidelines for the evaluation of thyroid nodules clarify the diagnostic algorithm while also reporting important differences. The performance of fine needle aspiration (FNA) for cytological examination follows serum TSH determination and thyroid ultrasonography. Thyroid scintigraphy is recommended following a low TSH value and/or FNA yielding an indeterminate follicular cytology. The use of thyroid ultrasonography is the source of some controversy: though it is recommended as a principal first test, its real-time use to guide FNA ranges from routine to only following an FNA yielding an inadequate or nondiagnostic cytological result. In clinical practice, the proportion of physicians utilizing ultrasonography, scintigraphy and FNA varies and frequently deviates from recommended guidelines. The development of guidelines is necessary to bring about consistency and optimization to the diagnostic work-up of thyroid nodules. It is likely that novel diagnostic procedures, such as molecular markers, large needle aspiration biopsy and thyroid imaging with tracers beyond conventional radioactive iodine or (99m)Tc pertechnetate, will lead to improved performance and implementation of guidelines.


Assuntos
Fidelidade a Diretrizes , Guias de Prática Clínica como Assunto , Nódulo da Glândula Tireoide/diagnóstico , Biópsia por Agulha Fina/estatística & dados numéricos , Análise Custo-Benefício , Humanos , Cintilografia , Glândula Tireoide/diagnóstico por imagem , Glândula Tireoide/patologia , Nódulo da Glândula Tireoide/patologia , Tireotropina/sangue , Ultrassonografia
15.
Biomed Pharmacother ; 60(9): 548-56, 2006 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-16950593

RESUMO

This article reports on recent advances on metastatic breast cancer. Detection, prognostic factors, predictors of response to therapy and therapy, with particular regard to targeted therapies, were examined. DETECTION: Unlike current guidelines that yet do not routinely recommend intensive clinical-instrumental post-operative follow-up of breast cancer patients, relatively large data collected in the last decades have shown that an intensive post-operative follow-up with 'dynamic evaluation' of a suitable tumour marker panel precedes a few months as average the clinical and/or instrumental sign of a pending relapse in most relapsed patients and largely limits the use of the common instrumental examinations. PROGNOSIS AND THERAPY PREDICTORS: Disease-free interval (DFI)24 months and disease confined to bony skeleton are prognostic factors more often correlated with relatively poor or prolonged survival, respectively. Estrogen receptor (ER) expression in primary tumour and at the relapse correlates strongly with response to salvage hormone therapy and data from large trials showed that 38-59% of ER and/or PR+ post-menopausal patients had clinical benefit from first line tamoxifen or aromatase inhibitors. An inverse correlation of ER with epidermal growth factor receptor (EGFR) has been found. The co-expression of HER-2/neu and/or elevated serum HER-2/neu protein level were associated with a low rate and shorter duration of response of ER+ patients to first line hormone therapy. Accordingly, ER-EGFR- compared with ER-EGFR+ tumours are usually more responsive to endocrine therapy. High class III beta-tubulin expression or fall in insulin-like growth factor binding protein-3 (IGFBP-3) from baseline levels have been found to significantly predict resistance to chemotherapeutic agents. THERAPY: Liposomes as carrier of doxorubicin (Caelix, Evacet, Myocet) is one approach to decrease the anthracycline-related cardiac toxicity. Weekly paclitaxel or docetaxel and oral formulation of vinorelbine and 5-fluorouracil (5-FU) (capecitabine) provide new effective and well tolerated options that reach greater dose intensity and cumulative dose than with the conventional schedules. As to the so called 'tailored' or targeted therapies, the more potent and highly selective third generation of aromatase inhibitors (letrozole, anastrozole, exemestane) targeting ER+ tumours by estrogen deprivation, challenge tamoxifen as current standard first line therapy in postmenopausals. One pilot study showed that stimulation of cellular immunity by the addition of beta-interferon-interleukin-2 sequence in patients on clinical benefit on first line tamoxifen significantly prolonged median overall survival (OS) and duration of response compared to that observed in similar patients only treated with tamoxifen. Trastuzumab, a humanised monoclonal antibody to extracellular domain of HER-2, plus conventional chemotherapy has become a standard of care for women with overexpressing HER-2 tumours. Bevacizumab is a recombinant humanised monoclonal antibody to vascular endothelial growth factor (VEGF) that in refractory metastatic breast cancer doubled the response rate of capecitabine although it did not affect survival. Finally, the so called 'oligometastatic' and a few stage IV diseases are conditions amenable to be rendered with no evidence of disease (NED) after local surgery and/or radiation. In both, as well as in complete responders to chemotherapy, minimal residual disease (m.r.d.) likely continues to be present. Recent data suggest that 'biological' therapy (immunomodulators and/or retinoids with or without hormone therapy), might be suitable to be successfully tested in these patients as maintenance treatment given soon after local intervention or chemotherapy.


Assuntos
Neoplasias da Mama/tratamento farmacológico , Inibidores da Angiogênese/uso terapêutico , Anticorpos Monoclonais/uso terapêutico , Anticorpos Monoclonais Humanizados , Antineoplásicos/uso terapêutico , Neoplasias da Mama/patologia , Feminino , Humanos , Metástase Neoplásica , Neoplasia Residual , Prognóstico , Tamoxifeno/uso terapêutico , Trastuzumab
16.
Biomed Pharmacother ; 60(8): 386-92, 2006 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-16930938

RESUMO

A non-porous poly-DL-lactide tubular chamber filled by demineralised bone matrix (DBM) and bone marrow stromal cells (BMSC) in combination, was evaluated as a scaffold for guided bone regeneration (GBR) in an experimental model using the rabbit radius. The tubular chamber had an internal diameter of 4.7 mm, a wall thickness of 0.4 mm and a length of 18 mm. Autologous BMSC were obtained, under general anaesthesia from rabbit iliac crest and isolated by centrifugation technique. Allogenic DBM was obtained from cortico-cancellous bone of rabbits. In general anaesthesia, a 10-mm defect was bilaterally created in the radii of 10 rabbits. On the right side (experimental side) the defect was bridged with the chamber filled with both BMSC and DBM. On the left side (control side) the defect was treated by positioning DBM and BMSC between the two stumps. At an experimental time of 4 months histology and histomorphometry demonstrated that the presence of a tubular chamber significantly improved bone regrowth in the defect The mean thickness of newly-formed bone inside the chamber was about 56.7+/-3.74% of the normal radial cortex, in comparison with 46.7+/-10.7% when DBM and BMSC without the chamber were placed in the defect, P<0.05). These results confirmed the effectiveness of the chamber as a container for factors promoting bone regeneration.


Assuntos
Implantes Absorvíveis , Células da Medula Óssea/citologia , Matriz Óssea/citologia , Regeneração Óssea , Poliésteres/química , Animais , Técnica de Desmineralização Óssea , Masculino , Coelhos , Rádio (Anatomia) , Células Estromais/citologia
17.
J Bone Joint Surg Br ; 88(1): 123-8, 2006 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-16365135

RESUMO

We investigated the effect of stimulation with a pulsed electromagnetic field on the osseointegration of hydroxyapatite in cortical bone in rabbits. Implants were inserted into femoral cortical bone and were stimulated for six hours per day for three weeks. Electromagnetic stimulation improved osseointegration of hydroxyapatite compared with animals which did not receive this treatment in terms of direct contact with the bone, the maturity of the bone and mechanical fixation. The highest values of maximum push-out force (F(max)) and ultimate shear strength (sigma(u)) were observed in the treated group and differed significantly from those of the control group at three weeks (F(max); p < 0.0001; sigma(u), p < 0.0005).


Assuntos
Durapatita/química , Campos Eletromagnéticos , Prótese Articular , Osseointegração , Animais , Fenômenos Biomecânicos , Diáfises/patologia , Fêmur/patologia , Prótese de Quadril , Masculino , Teste de Materiais/métodos , Coelhos , Resistência ao Cisalhamento
18.
J Biomed Mater Res B Appl Biomater ; 79(2): 320-4, 2006 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-16850480

RESUMO

The electrochemical impedance spectroscopy (EIS) technique was used for the study of the electrochemical behavior of an equiatomic NiTi alloy and an implant quality AISI 316 stainless steel type ASTM F138. Experiments were carried out using four different different test solutions: phosphate buffered saline (PBS), Dulbecco minimum essential medium (MEM), MEM + fetal calf serum (FCS), and MEM + fetal calf serum + fibroblast cell (CELL). Specimens were finished to 600-grit SiC paper and were tested in conditions that did not provoke abrupt mechanical damage of the passive film. Bode-phase spectra showed the presence of two maxima and were fitted with an equivalent circuit characterized by two parallel combinations (R, resistance; CPE, constant phase element). The R(1) and CPE(1) branch was assigned to the inner compact passive film and the R(2) and CPE(2) branch to the external porous film. The resistance of the inner film R(1), roughly corresponding to the polarization resistance (R(p)), which is inversely proportional to the material's corrosion rate, increased with the immersion time and was generally greater in PBS than in other media. With the exception of FCS solution, R(1) for NiTi alloy is better or similar to that of ASTM F138.


Assuntos
Materiais Biocompatíveis , Níquel , Aço Inoxidável , Titânio , Corrosão , Impedância Elétrica , Eletroquímica , Próteses e Implantes , Análise Espectral
19.
Int J Artif Organs ; 29(8): 772-80, 2006 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-16969755

RESUMO

The development of novel mechanical and chemical surface modification treatments to improve the osteointegration properties of osseointegrated dental implants is nowadays a topic of great applicative interest. The aim of the present study was to analyse the role of surface topography and chemistry of four different surface treatments on titanium by an in vitro human osteosarcoma immortalised cell line model (MG63). The surface treatments considered were (a) machined titanium, (b) chemical etched on machined titanium, (c) sandblasted titanium and (d) chemical etching on sandblasted titanium. Chemical and physical surface properties were investigated by Scanning Electron Microscopy, Thin Film-X ray Diffraction and by Laser Profilometry. The in vitro biological response was characterised using the MG63 cell line by elution cytotoxicity tests, cell morphology, adhesion, proliferation activity, alkaline phosphatase activity and total DNA content in order to show a relationship between osteoblast response and surface features. Chemical and physical characterisation showed that the considered treatments differently modify the surface morphology in the micro and sub-micrometric scale. Although some differences in alkaline phosphatase activity were observed in the biological characterisation, depending on the specific material's surface finishing, the results showed that cells were well responsive on all the tested materials and grew and differentiated with similar proliferation rate.


Assuntos
Corrosão Dentária/métodos , Implantes Dentários , Materiais Dentários/química , Osseointegração/fisiologia , Osteoblastos/fisiologia , Titânio/química , Abrasão Dental por Ar , Fosfatase Alcalina/análise , Adesão Celular , Linhagem Celular Tumoral , Proliferação de Células , Tamanho Celular , DNA/análise , Microanálise por Sonda Eletrônica , Humanos , Lasers , Microscopia Eletrônica de Varredura , Osteossarcoma/patologia , Dióxido de Silício , Propriedades de Superfície , Difração de Raios X
20.
Med Lav ; 97(1): 36-43, 2006.
Artigo em Italiano | MEDLINE | ID: mdl-17009669

RESUMO

BACKGROUND: Mount Reventino, a massif located in the Calabria Region of Italy, has several ophiolite outcrops of greenstone. These deposits are an important economical resource in the surrounding area. Some rock layers contain tremolite, a type of asbestos fibre. OBJECTIVES: The aim of this paper was to analyze the chemical and physical structure of the outcrops of Mount Reventino, and to assess and reduce the risk to workers associated with exposure to airborne fibres. METHODS: Personal and environmental samples were collected and analysed by Scanning Electron Microscopy equipped with energy-dispersive X-ray analysis. RESULTS: The analysis of samples showed a difference in mineralogical features not only between the quarries under study, but also between the two opposite sides of the mountain. Exploitation of the quarries produces a fibre dispersion that is higher than the natural emission. Occupational exposure to asbestos fibres during greenstone transformation was confirmed by by the results of analysis of the collected samples. CONCLUSIONS: This study made it possible to identify working activities with highest exposure to asbestos and establish the correct procedures to abate fibre dispersion, in order to reduce the correlated risk. Environmental samples collected in the urban area surrounding the quarries showed that the asbestos fibre concentrations were very low, however, further studies are needed in order to confirm these findings.


Assuntos
Poluição do Ar/análise , Amiantos Anfibólicos/análise , Exposição Ocupacional/análise , Humanos , Itália , Microscopia Eletrônica de Varredura
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