Pancreatic metastasis of mesenchymal chondrosarcoma: a surgical case report and review of literature.

Introduction: Mesenchymal chondrosarcoma (MC) is a rapidly progressive sarcoma that predominantly impacts the bones. Making up only 3% of chondrosarcomas, about one-third of these tumours develop in extra-skeletal sites. Case presentation: The authors present a clinical case of a 42-year-old patient who was diagnosed with MC 8 years ago, now admitted to the hospital with a palpable epigastric mass. Clinical and laboratory examinations showed consistent results for MC tumours, with metastasis to the body and tail of the pancreas and invasion of the splenic vein. Surgical resection and systemic screening were performed to ensure that there were no lesions elsewhere. Regular follow-up has found no localized lesions or complications after 15 months. Clinical discussion: Metastatic extra-skeletal mesenchymal chondrosarcoma of the pancreas is exceptionally rare. To our current understanding, only 14 such cases have been documented in medical literature. The symptoms of pancreatic metastasis are diverse and the radiographic features of metastatic mesenchymal chondrosarcoma are not typically distinct. Conclusions: Although MC tumours do not frequently occur in sites other than the axial system, a tumour presenting later in a patient with a history of MC should be reviewed to confirm the diagnosis of metastatic MC. Treatment can vary between surgery, radiation therapy and systemic therapy.

Microporous/Macroporous Polycaprolactone Scaffolds for Dental Applications.

This study leverages the advantages of two fabrication techniques, namely, melt-extrusion-based 3D printing and porogen leaching, to develop multiphasic scaffolds with controllable properties essential for scaffold-guided dental tissue regeneration. Polycaprolactone-salt composites are 3D-printed and salt microparticles within the scaffold struts are leached out, revealing a network of microporosity. Extensive characterization confirms that multiscale scaffolds are highly tuneable in terms of their mechanical properties, degradation kinetics, and surface morphology. It can be seen that the surface roughness of the polycaprolactone scaffolds (9.41 ± 3.01 µm) increases with porogen leaching and the use of larger porogens lead to higher roughness values, reaching 28.75 ± 7.48 µm. Multiscale scaffolds exhibit improved attachment and proliferation of 3T3 fibroblast cells as well as extracellular matrix production, compared with their single-scale counterparts (an approximate 1.5- to 2-fold increase in cellular viability and metabolic activity), suggesting that these structures could potentially lead to improved tissue regeneration due to their favourable and reproducible surface morphology. Finally, various scaffolds designed as a drug delivery device were explored by loading them with the antibiotic drug cefazolin. These studies show that by using a multiphasic scaffold design, a sustained drug release profile can be achieved. The combined results strongly support the further development of these scaffolds for dental tissue regeneration applications.

Microfluidic Methods in Janus Particle Synthesis.

Janus particles have been at the center of attention over the years due to their asymmetric nature that makes them superior in many ways to conventional monophase particles. Several techniques have been reported for the synthesis of Janus particles; however, microfluidic-based techniques are by far the most popular due to their versatility, rapid prototyping, low reagent consumption and superior control over reaction conditions. In this review, we will go through microfluidic-based Janus particle synthesis techniques and highlight how recent advances have led to complex functionalities being imparted to the Janus particles.

Polycrystalline diamond coating on 3D printed titanium scaffolds: Surface characterisation and foreign body response.

Titanium-based implants are the leading material for orthopaedic surgery, due to their strength, versatility, fabrication via additive manufacturing and invoked biological response. However, the interface between the implant and the host tissue requires improvement to better integrate the implant material and mitigate foreign body response. The interface can be manipulated by changing the surface energy, chemistry, and topography of the Titanium-based implant. Recently, polycrystalline diamond (PCD) has emerged as an exciting coating material for 3D printed titanium scaffolds showing enhanced mammalian cell functions while inhibiting bacterial attachment in vitro. In this study, we performed in-depth characterisation of PCD coatings investigating the surface topography, thickness, surface energy, and compared its foreign body response in vivo with uncoated titanium scaffold. Coating PCD onto titanium scaffolds resulted in a similar microscale surface roughness (RMS(PCD-coated) = 24 µm; RMS(SLM-Ti) = 28 µm), increased nanoscale roughness (RMS(PCD-coated) = 35 nm; RMS(SLM-Ti) = 66 nm) and a considerable decrease in surface free energy (E(PCD-coated) = 4 mN m-1; E(SLM-Ti) = 16 mN m-1). These surface property changes were supported by X-ray photoelectron spectroscopy (XPS) and Raman spectroscopy as corresponding to observed surface chemistry changes induced by the coating. The underlying mechanism of how the diamond coatings chemical and physical properties changes the wettability of implants was examined. In vivo, the coated scaffolds induced similar level of fibrous encapsulation with uncoated scaffolds. This study thus provides further insight into the physicochemical characteristics of PCD coatings, adding evidence to the promising potential of PCD-coatings of medical implants.

The Efficacy of Silver-Based Electrospun Antimicrobial Dressing in Accelerating the Regeneration of Partial Thickness Burn Wounds Using a Porcine Model.

(1) Background: Wounds with damages to the subcutaneous are difficult to regenerate because of the tissue damages and complications such as bacterial infection. (2) Methods: In this study, we created burn wounds on pigs and investigated the efficacy of three biomaterials: polycaprolactone-gelatin-silver membrane (PCLGelAg) and two commercial burn dressings, Aquacel® Ag and UrgoTulTM silver sulfadiazine. In vitro long-term antibacterial property and in vivo wound healing performance were investigated. Agar diffusion assays were employed to evaluate bacterial inhibition at different time intervals. Minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC) and time-kill assays were used to compare antibacterial strength among samples. Second-degree burn wounds in the pig model were designed to evaluate the efficiency of all dressings in supporting the wound healing process. (3) Results: The results showed that PCLGelAg membrane was the most effective in killing both Gram-positive and Gram-negative bacteria bacteria with the lowest MBC value. All three dressings (PCLGelAg, Aquacel, and UrgoTul) exhibited bactericidal effect during the first 24 h, supported wound healing as well as prevented infection and inflammation. (4) Conclusions: The results suggest that the PCLGelAg membrane is a practical solution for the treatment of severe burn injury and other infection-related skin complications.

In Situ Coatings of Silver Nanoparticles for Biofilm Treatment in Implant-Retention Surgeries: Antimicrobial Activities in Monoculture and Coculture.

Bacterial biofilms are indicated in most medical device-associated infections. Treating these biofilms is challenging yet critically important for applications such as in device-retention surgeries, which can have reinfection rates of up to 80%. This in vitro study centered around our new method of treating biofilm and preventing reinfection. Ionic silver (Ag, in the form of silver nitrate) combined with dopamine and a biofilm-lysing enzyme (α-amylase) were applied to model 4-day-old Staphylococcus aureus biofilms on titanium substrates to degrade the extracellular matrix of the biofilm and kill the biofilm bacteria. In this process, the oxidative self-polymerization of dopamine converted Ag ions into Ag nanoparticles that, together with the resultant self-adhering polydopamine (PDA), formed coatings that strongly bound to the treated substrates. Surprisingly, although these Ag/PDA coatings significantly reduced S. aureus growth in standard bacterial monoculture, they showed much lower antimicrobial activity in coculture of the bacteria and osteoblastic MC3T3-E1 cells in which the bacteria were also found attached to the osteoblasts. This S. aureus- osteoblast interaction was also linked to bacterial survival against gentamicin treatment observed in coculture. Our study thus provided clear evidence suggesting that bacteria's interactions with tissue cells surrounding implants may significantly contribute to their resistance to antimicrobial treatment.

Wavelength-Selective Softening of Hydrogel Networks.

Photoresponsive hydrogels hold key potential in advanced biomedical applications including tissue engineering, regenerative medicine, and drug delivery, as well as intricately engineered functions such as biosensing, soft robotics, and bioelectronics. Herein, the wavelength-dependent degradation of bio-orthogonal poly(ethylene glycol) hydrogels is reported, using three selective activation levels. Specifically, three chromophores are exploited, that is, ortho-nitrobenzene, dimethyl aminobenzene, and bimane, each absorbing light at different wavelengths. By examining their photochemical action plots, the wavelength-dependent reactivity of the photocleavable moieties is determined. The wavelength-selective addressability of individual photoreactive units is subsequently translated into hydrogel design, enabling wavelength-dependent cleavage of the hydrogel networks on-demand. Critically, this platform technology allows for the fabrication of various hydrogels, whose mechanical properties can be fine-tuned using different colors of light to reach a predefined value, according to the chromophore ratios used. The softening is shown to influence the spreading of pre-osteoblastic cells adhering to the gels as a demonstration of their potential utility. Furthermore, the materials and photodegradation processes are non-toxic to cells, making this platform attractive for biomaterials engineering.

Multifunctional Sutures with Temperature Sensing and Infection Control.

The next-generation sutures should provide in situ monitoring of wound condition such as temperature while reducing surgical site infection during wound closure. In this study, functionalized nanodiamond (FND) and reduced graphene oxide (rGO) into biodegradable polycaprolactone (PCL) are incorporated to develop a new multifunctional suture with such capabilities. Incorporation of FND and rGO into PCL enhances its tensile strength by about 43% and toughness by 35%. The sutures show temperature sensing capability in the range of 25-40 °C based on the shift in zero-splitting frequency of the nitrogen-vacancy (NV- ) centers in FND via optically detected magnetic resonance, paving the way for potential detection of infection or excessive inflammation in healing wounds. The suture surface readily coats with antibiotics to reduce bacterial infection risk to the wounds. The new suture thus is promising in monitoring and supporting wound closure.

Controlling Antibiotic Release from Polymethylmethacrylate Bone Cement.

Bone cement is used as a mortar for securing bone implants, as bone void fillers or as spacers in orthopaedic surgery. Antibiotic-loaded bone cements (ALBCs) have been used to prevent and treat prosthetic joint infections by providing a high antibiotic concentration around the implanted prosthesis. High antibiotic concentrations are, on the other hand, often associated with tissue toxicity. Controlling antibiotic release from ALBCS is key to achieving effective infection control and promoting prosthesis integration with the surrounding bone tissue. However, current ALBCs still need significant improvement in regulating antibiotic release. In this review, we first provide a brief introduction to prosthetic joint infections, and the background concepts of therapeutic efficacy and toxicity in antibiotics. We then review the current state of ALBCs and their release characteristics before focusing on the research and development in controlling the antibiotic release and osteo-conductivity/inductivity. We then conclude by a discussion on the need for better in vitro experiment designs such that the release results can be extrapolated to predict better the local antibiotic concentrations in vivo.

Layered Antimicrobial Selenium Nanoparticle-Calcium Phosphate Coating on 3D Printed Scaffolds Enhanced Bone Formation in Critical Size Defects.

Preventing bacterial colonization on scaffolds while supporting tissue formation is highly desirable in tissue engineering as bacterial infection remains a clinically significant risk to any implanted biomaterials. Elemental selenium (Se0) nanoparticles have emerged as a promising antimicrobial biomaterial without tissue cell toxicity, yet it remains unknown if their biological properties are from soluble Se ions or from direct cell-nanoparticle interactions. To answer this question, in this study, we developed a layered coating consisting of a Se nanoparticle layer underneath a micrometer-thick, biomimetic calcium phosphate (CaP) layer. We showed, for the first time, that the release of soluble HSe- ions from the Se nanoparticles strongly inhibited planktonic growth and biofilm formation of key bacteria, Staphylococcus aureus. The Se-CaP coating was found to support higher bone formation than the CaP-only coating in critical-size calvarial defects in rats; this finding could be directly attributed to the released soluble Se ions as the CaP layers in both groups had no detectable differences in the porous morphology, chemistry, and release of Ca or P. The Se-CaP coating was highly versatile and applicable to various surface chemistries as it formed through simple precipitation from aqueous solutions at room temperature and therefore could be promising in bone regeneration scaffolds or orthopedic implant applications.

Nanomaterials for Treating Bacterial Biofilms on Implantable Medical Devices.

Bacterial biofilms are involved in most device-associated infections and remain a challenge for modern medicine. One major approach to addressing this problem is to prevent the formation of biofilms using novel antimicrobial materials, device surface modification or local drug delivery; however, successful preventive measures are still extremely limited. The other approach is concerned with treating biofilms that have already formed on the devices; this approach is the focus of our manuscript. Treating biofilms associated with medical devices has unique challenges due to the biofilm's extracellular polymer substance (EPS) and the biofilm bacteria's resistance to most conventional antimicrobial agents. The treatment is further complicated by the fact that the treatment must be suitable for applying on devices surrounded by host tissue in many cases. Nanomaterials have been extensively investigated for preventing biofilm formation on medical devices, yet their applications in treating bacterial biofilm remains to be further investigated due to the fact that treating the biofilm bacteria and destroying the EPS are much more challenging than preventing adhesion of planktonic bacteria or inhibiting their surface colonization. In this highly focused review, we examined only studies that demonstrated successful EPS destruction and biofilm bacteria killing and provided in-depth description of the nanomaterials and the biofilm eradication efficacy, followed by discussion of key issues in this topic and suggestion for future development.

Effects of polydopamine coatings on nucleation modes of surface mineralization from simulated body fluid.

Polydopamine (PDA) has been recently used as a versatile priming layer for further functionalization of a biomaterial surface, particularly in biomimetic mineralization of biomaterials. Yet most of the existing literature is on inorganic substrates and the underlying effects of the PDA layer coatings on the nucleation and mineralization process and the mineral-substrate interface have not been clearly identified. Here we aimed to investigate the effects of the PDA layer on the nucleation and growth and interfacial morphology of calcium phosphate mineral layer (CaP) from 10× simulated body fluid (10× SBF) on polymeric substrates. It is found that the nucleation of CaP on PDA-coated surface favors a mixed "islanding" and planar growth mode (Stranski-Krastanov) while the "islanding" mode (Volmer-Weber) was observed on the surface without PDA. This different early nucleation stage of mineralization was found to correlate with a more "bonded" interface between the mineral layer and the PDA-coated substrates, a slight increase in the interfacial strength and a different delamination mode. This study therefore provided new insights on how polydopamine priming layer influenced the mineralization process and the interface between the mineral layer and the substrate.

Polydopamine coating of uncrosslinked chitosan as an acellular scaffold for full thickness skin grafts.

There is an unmet need for skin grafting materials that are readily available for large area wounds, due to complex, lengthy and costly manufacturing processes that are not compatible with this type of wounds. Here we developed an acellular skin graft material based on surface coating of uncrosslinked porous (UCLP) chitosan. UCLP chitosan membranes had mechanical properties in ranges suitable for skin grafting. Polydopamine (PDA) coating improved hydrophilicity and resulted in a significant increase in attachment and metabolic activity of mammalian cells in vitro. PDA coating also decreased the attachment of pseudomonas aeruginosa - a common bacteria infecting skin wounds. Finally, the PDA-coated membranes were implanted in full thickness surgical wounds in a rodent model and resulted in complete would closure in 5 days. The current study suggests that PDA-coated UCLP chitosan membranes could be a simple and effective strategy for the development of grafting materials for large area wounds.

High Nanodiamond Content-PCL Composite for Tissue Engineering Scaffolds.

Multifunctional scaffolds are becoming increasingly important in the field of tissue engineering. In this research, a composite material is developed using polycaprolactone (PCL) and detonation nanodiamond (ND) to take advantage of the unique properties of ND and the biodegradability of PCL polymer. Different ND loading concentrations are investigated, and the physicochemical properties of the composites are characterized. ND-PCL composite films show a higher surface roughness and hydrophilicity than PCL alone, with a slight decrease in tensile strength and a significant increase in degradation. Higher loading of ND also shows a higher osteoblast adhesion than the PCL alone sample. Finally, we show that the ND-PCL composites are successfully extruded to create a 3D scaffold demonstrating their potential as a composite material for tissue regeneration.

Biological Roles and Delivery Strategies for Ions to Promote Osteogenic Induction.

Bone is the most studied tissue in the field of tissue regeneration. Even though it has intrinsic capability to regenerate upon injury, several pathologies and injuries could hamper the highly orchestrated bone formation and resorption process. Bone tissue engineering seeks to mimic the extracellular matrix of the tissue and the different biochemical pathways that lead to successful regeneration. For many years, the use of extrinsic factors (i.e., growth factors and drugs) to modulate these biological processes have been the preferred choice in the field. Even though it has been successful in some instances, this approach presents several drawbacks, such as safety-concerns, short release profile and half-time life of the compounds. On the other hand, the use of inorganic ions has attracted significant attention due to their therapeutic effects, stability and lower biological risks. Biomaterials play a key role in such strategies where they serve as a substrate for the incorporation and release of the ions. In this review, the methodologies used to incorporate ions in biomaterials is presented, highlighting the osteogenic properties of such ions and the roles of biomaterials in controlling their release.

3D-Printed Diamond-Titanium Composite: A Hybrid Material for Implant Engineering.

Diamond-based implant materials make up an emerging research area where the materials could be prepared to promote cellular functions, decrease bacteria attachment, and be suitable for potential in situ imaging. Up until now, diamond implants have been fabricated using coating technologies or embedding diamond nanoparticles in polymer matrices. Here we demonstrated a method of manufacturing diamond implants using laser cladding technology to 3D print a composite of diamond and fused titanium material. Using this method, we could prepare composite scaffolds of up to 50% diamond, which has never been achieved before. We next investigated the interfacial properties of these scaffolds for potential applications in implants. The addition of diamond to the biomaterial results in a 30% decrease in the water contact angle, making the scaffolds more hydrophilic and improving cellular adhesion and proliferation.

Immobilization-Enhanced Eradication of Bacterial Biofilms and in situ Antimicrobial Coating of Implant Material Surface - an in vitro Study.

PURPOSE: The aim of this study was to investigate a new method of in situ biofilm treatment for infected prostheses that remove bacterial biofilm and prevent reinfection through the use of an immobilizing agent in combination with the actions of biofilm-lysing enzymes and bactericidal antimicrobials. METHODS: We investigated the combination of self-immobilization chemistry of dopamine with a biofilm-lysing enzyme, α-amylase (Am), and an antimicrobial agent, silver nitrate (Ag), to treat model Staphylococcus aureus (S. aureus) biofilms formed on titanium. The efficacy of biofilm removal and bacterial treatment was analyzed by crystal violet, colony-forming unit assays, confocal laser scanning microscopy, and scanning electron microscopy (SEM). To confirm the in situ coating of the titanium surface with antimicrobial Ag as a strategy to prevent bacterial recolonization, SEM in secondary electron mode (SE), backscatter electron mode, (BSE) and energy-dispersive spectroscopy (EDX) were used. The antimicrobial activity of the coated surface was evaluated by optical density measurement and colony-forming unit assays. RESULTS: Polydopamine (PDA)-assisted treatment showed approximately a 2 log reduction in recoverable CFU and a 15% increase in biofilm removal efficacy compared to treatments that had only Am or Ag. More importantly, PDA-assisted treatment was found to immobilize Ag on the surface after the treatment, rendering them resistant to bacterial recolonization. CONCLUSION: Our in vitro findings suggested that this PDA-assisted treatment and the surface immobilization-enhanced treatment concept could be promising in the development of advanced treatment for implant retention surgery for an infected prosthesis.

Janus particles: recent advances in the biomedical applications.

Janus particles, which are named after the two-faced Roman god Janus, have two distinct sides with different surface features, structures, and compositions. This asymmetric structure enables the combination of different or even incompatible physical, chemical, and mechanical properties within a single particle. Much effort has been focused on the preparation of Janus particles with high homogeneity, tunable size and shape, combined functionalities, and scalability. With their unique features, Janus particles have attracted attention in a wide range of applications such as in optics, catalysis, and biomedicine. As a biomedical device, Janus particles offer opportunities to incorporate therapeutics, imaging, or sensing modalities in independent compartments of a single particle in a spatially controlled manner. This may result in synergistic actions of combined therapies and multi-level targeting not possible in isotropic systems. In this review, we summarize the latest advances in employing Janus particles as therapeutic delivery carriers, in vivo imaging probes, and biosensors. Challenges and future opportunities for these particles will also be discussed.

Microenvironment engineering of osteoblastic bone metastases reveals osteomimicry of patient-derived prostate cancer xenografts.

Representative in vitro models that mimic the native bone tumor microenvironment are warranted to support the development of more successful treatments for bone metastases. Here, we have developed a primary cell 3D model consisting of a human osteoblast-derived tissue-engineered construct (hOTEC) indirectly co-cultured with patient-derived prostate cancer xenografts (PDXs), in order to study molecular interactions in a patient-derived microenvironment context. The engineered biomimetic microenvironment had high mineralization and embedded osteocytes, and supported a high degree of cancer cell osteomimicry at the gene, protein and mineralization levels when co-cultured with prostate cancer PDXs from a lymph node metastasis (LuCaP35) and bone metastasis (BM18) from patients with primary prostate cancer. This fully patient-derived model is a promising tool for the assessment of new molecular mechanisms and as a personalized pre-clinical platform for therapy testing for patients with prostate cancer bone metastases.

Selenium nanoparticles as anti-infective implant coatings for trauma orthopedics against methicillin-resistant Staphylococcus aureus and epidermidis: in vitro and in vivo assessment.

Background: Bacterial infection is a common and serious complication in orthopedic implants following traumatic injury, which is often associated with extensive soft tissue damage and contaminated wounds. Multidrug-resistant bacteria have been found in these infected wounds, especially in patients who have multi trauma and prolonged stay in intensive care units.Purpose: The objective of this study was to develop a coating on orthopedic implants that is effective against drug-resistant bacteria. Methods and results: We applied nanoparticles (30-70nm) of the trace element selenium (Se) as a coating through surface-induced nucleation-deposition on titanium implants and investigated the antimicrobial activity against drug resistant bacteria including Methicillin-resistant Staphylococcus aureus (MRSA) and Methicillin-resistant Staphylococcus epidermidis (MRSE) in vitro and in an infected femur model in rats.The nanoparticles were shown in vitro to have antimicrobial activity at concentrations as low as 0.5ppm. The nanoparticle coatings strongly inhibited biofilm formation on the implants and reduced the number of viable bacteria in the surrounding tissue following inoculation of implants with biofilm forming doses of bacteria. Conclusion: This study shows a proof of concept for a selenium nanoparticle coatings as a potential anti-infective barrier for orthopedic medical devices in the setting of contamination with multi-resistant bacteria. It also represents one of the few (if only) in vivo assessment of selenium nanoparticle coatings on reducing antibiotic-resistant orthopedic implant infections.