Human Chondrocytes, Metabolism of Articular Cartilage, and Strategies for Application to Tissue Engineering.

Hyaline cartilage, which is characterized by the absence of vascularization and innervation, has minimal self-repair potential in case of damage and defect formation in the chondral layer. Chondrocytes are specialized cells that ensure the synthesis of extracellular matrix components, namely type II collagen and aggregen. On their surface, they express integrins CD44, α1ß1, α3ß1, α5ß1, α10ß1, αVß1, αVß3, and αVß5, which are also collagen-binding components of the extracellular matrix. This article aims to contribute to solving the problem of the possible repair of chondral defects through unique methods of tissue engineering, as well as the process of pathological events in articular cartilage. In vitro cell culture models used for hyaline cartilage repair could bring about advanced possibilities. Currently, there are several variants of the combination of natural and synthetic polymers and chondrocytes. In a three-dimensional environment, chondrocytes retain their production capacity. In the case of mesenchymal stromal cells, their favorable ability is to differentiate into a chondrogenic lineage in a three-dimensional culture.

A Cost-Effective, Integrated Haptic Device for an Exoskeletal System.

The paper presents an innovative integrated sensor-effector designed for use in exoskeletal haptic devices. The research efforts aimed to achieve high cost-effectiveness for a design assuring proper monitoring of joint rotations and providing passive force feedback. A review of market products revealed that there is space for new designs of haptic devices with such features. To determine the feasibility of the proposed solution, a series of simulations and experiments were conducted to verify the adopted design concept. The focus was set on an investigation of the force of attraction between one and two magnets interacting with a steel plate. Further, a physical model of an integrated joint was fabricated, and its performance was evaluated and compared to a similar commercially available device. The proposed solution is cost-effective due to the use of standard parts and inexpensive components. However, it is light and assures a 19 Nm braking torque adequate for the intended use as a haptic device for upper limbs.

Implantation of a 3D-printed titanium sternum in a patient with a sternal tumor.

BACKGROUND: Primary malignant or metastatic sternal tumors are uncommon. A subtotal or total sternectomy can offer a radical form of treatment. The issue is to restore the structural integrity of the chest wall. CASE PRESENTATION: We report the implantation of an individualized 3D-printed titanium sternum in a patient with a sternal tumor. CONCLUSIONS: We believe that tridimensional print technologies may also change the strategy of chest wall reconstruction.

First clinical results of minimally invasive vector lumbar interbody fusion (MIS-VLIF) in spondylodiscitis and concomitant osteoporosis: a technical note.

PURPOSE: First description of MIS-VLIF, a minimally invasive lumbar stabilization, to evaluate its safety and feasibility in patients suffering from weak bony conditions (lumbar spondylodiscitis and/or osteoporosis). METHODS: After informed consent, 12 patients suffering from lumbar spondylodiscitis underwent single level MIS-VLIF. Eight of them had a manifest osteoporosis, either. Pre- and postoperative clinical status was documented using numeric rating scale (NRS) for leg and back pain. In all cases, the optimal height for the cage was preoperatively determined using software-based range of motion and sagittal balance analysis. CT scans were obtained to evaluate correct placement of the construct and to verify fusion after 6 months. RESULTS: Since 2013, 12 patients with lumbar pyogenic spondylodiscitis underwent MIS-VLIF. Mean surgery time was 169 ± 28 min and average blood loss was less than 400 ml. Postoperative CT scans showed correct placement of the implants. Eleven patients showed considerable postoperative improvement in clinical scores. In one patient, we observed screw loosening. After documented bony fusion in the CT scan, the fixation system was removed in two cases to achieve lower material load. CONCLUSIONS: The load-bearing trajectories (vectors) of MIS-VLIF are different from those of conventional coaxial pedicle screw implantation. The dorsally converging construct combines the heads of the dorsoventral pedicle screws with laminar pedicle screws following cortical bone structures within a small approach. In case of lumbar spondylodiscitis and/or osteoporosis, MIS-VLIF relies on cortical bony structures for all screw vectors and the construct does not depend on conventional coaxial pedicle screws in the presence of inflamed, weak, cancellous or osteoporotic bone. MIS-VLIF allows full 360° lumbar fusion including cage implantation via a small, unilateral dorsal midline approach.

Importance Rat Liver Morphology and Vasculature in Surgical Research.

BACKGROUND The laboratory rat is one of the most popular experimental models for the experimental surgery of the liver. The objective of this study was to investigate the morphometric parameters, physiological data, differences in configuration of liver lobes, biliary system, and vasculature (arteries, veins, and lymphatic vessels) of the liver in laboratory rats. In addition, this study supports the anatomic literature and identified similarities and differences with human and other mammals. MATERIAL AND METHODS Forty laboratory rats were dissected to prepare corrosion casts of vascular system specimens (n=20), determine the lymph vessels and lymph nodes (n=10), and for macroscopic anatomical dissection (n=10) of the rat liver. The results are listed in percentages. The anatomical nomenclature of the liver morphology, its arteries, veins, lymph nodes, and lymphatic vessels are in accordance with Nomina Anatomica Veterinaria. RESULTS We found many variations in origin, direction, and division of the arterial, venous, and lymphatic systems in rat livers, and found differences in morphometric parameters compared to results reported by other authors. The portal vein was formed by 4 tributaries in 23%, by 3 branches in 64%, and by 2 tributaries in 13%. The liver lymph was drained to the 2 different lymph nodes. The nomenclature and morphological characteristics of the rat liver vary among authors. CONCLUSIONS Our results may be useful for the planing of experimental surgery and for cooperation with other investigation methods to help fight liver diseases in human populations.

Torsional Vibrations in the Resonance of High-Speed Rotor Bearings Reduced by Dynamic Properties of Carbon Fiber Polymer Composites.

The present study deals with the harmful torsional resonance vibrations of textile rotor bearings, the amplitudes of which are reduced mainly by the use of high-capacity damping materials, characterized by an internal hierarchical structure and macroshape, added into the machine mechanical system. The additional materials are polymer matrix composites reinforced either by carbon nanofibers or carbon chopped microfibers and either aramid or carbon continuous fibers. The macroshape is based on a honeycomb with internal cavities. Torsional vibrations arise in mechanical systems as a result of fluctuations in the low-level pressing load of the flat belt driving the rotor-bearing pin and the changing of kinematic conditions within it, which, in the resonance area, leads to cage slip and unwanted impulsive torsional vibrations. Moreover, this occurs during high-frequency performance at around 2100 Hz, i.e., 126,000 min-1. The condition, before the redesign, was characterized by significantly reduced textile rotor-bearing life due to significant impulse torsional vibrations in the resonance area. The study showed a significant reduction in average and maximum torsional amplitudes in the resonance area by 33% and 43%, respectively. Furthermore, the paper provides visualization of the propagation of a stress wave at the microscale obtained by the explicit finite element method to show the dispersion of the wave and the fibers as one of the sources of high damping.

Complex Analysis of Power Output and Emission Parameters of High-Power Motorcycles at Application of Advanced and Sustainable Fuels and Their Mixtures.

The presented scientific study is focused on a complex analysis of power output and emission parameters concerning an experimental motorcycle. In spite of the fact that there are at disposal considerable theoretical and experimental results, which include also matters of the L-category vehicles, there is, in general, a lack of data covering the experimental tests and power output characteristics of racing, high-power engines that represent a technological peak in the given segment. This situation is caused by an aversion of motorcycle producers to publicize their newest information, especially in the case of the latest high-tech applications. The given study is focused on all the main results obtained from the operational tests performed on the motorcycle engine in two testing cases: first with the original arrangement of the installed piston combustion engine series produced and second with the modified engine configuration proposed in order to increase the combustion process efficiency. Three kinds of engine fuel were tested and mutually compared within the performed research work: the first was the experimental top fuel used in the world motorcycle competition 4SGP, the second was the sustainable experimental fuel, the so-called superethanol e85 developed for maximum power output and minimum emission, and the third was the standard fuel, which is commonly available at gas stations. Applicable fuel mixtures were also created with the aim to analyze their power output and emission parameters. Finally, these fuel mixtures were compared with the top technological products available in the given area.

Predictive analysis of the scoliotic curve using a subject's 3D model.

A predictive analysis of the conservative scoliosis treatment is necessary, in which a 3D model of an optimal treatment algorithm is a basic part in the design of a prosthetic corset. Since CAD technology has proven to be very useful in the field of prosthetics and orthotics, we used an open-source software to plan the correction of the scoliotic curve on a virtual model of the subject's torso. The shape of the scoliosis was simplified by means of a directional polygon, which was drawn in a reverse manner depending on the directional arcs of the scoliotic curve. The resulting scoliosis correction, simulated in a predictive analysis, was defined by changing the Cobb angle, eccentricity, and torso height. With the proposed low-cost method of predictive analysis, it is possible to help CPOs to a more accurate and effective design of orthoses and corrective aids and to comprehensively determine the entire treatment procedure.

3D Printing of Individual Running Insoles - A Case Study.

Purpose: The study's starting point is to find a low-cost and best-fit solution for comfortable movement for a recreational runner with knee pain using an orthopedic device. It is a case study. The research aims to apply digitization, CAD/CAM tools, and 3D printing to create an individual 3D running insole. The objective is to incorporate flexible shape optimization would provide comfort reductions in foot plantar pressures in one subject with knee pain while running. The test hypothesis was if it is possible to make it from one material. For this purpose, we created a new digital workflow based on the Decision Tree method and analyzed pain and comfort scores during user testing of prototypes. Patient and Methods: The input data were obtained during a professional examination by a specialist doctor in the orthopedic outpatient clinic in the motion laboratory (DIERS 4D Motion Lab, Germany) with the output of data on the proband's complex movement stereotype. Surface and volumetric data were obtained in the biomedical laboratory with the 3D scanner. We modified the digital 3D foot models in 3D mesh software, developed the design in SW Gensole (Gyrobot, UK), and finally incorporated the internal structure and the surface layer of the insole data of the knowledge from the medical examination, comfort analyses, and scientific studies findings. Results: Four complete 3D-printed prototypes (n=4) with differences in density and correction elements were designed. All of them were fabricated on a 3D printer (Prusa i3 MK3S, Czech Republic) with flexible TPU material suitable for skin contact. The Participant tested each of them five times in the field during a workout and final insoles three months on the routine training. Conclusion: A novel workflow was created for designing, producing, and testing full 3D-printed insoles. The product is fit for immediate use.

Biodegradable Materials for Tissue Engineering: Development, Classification and Current Applications.

The goal of this review is to map the current state of biodegradable materials that are used in tissue engineering for a variety of applications. At the beginning, the paper briefly identifies typical clinical indications in orthopedics for the use of biodegradable implants. Subsequently, the most frequent groups of biodegradable materials are identified, classified, and analyzed. To this end, a bibliometric analysis was applied to evaluate the evolution of the scientific literature in selected topics of the subject. The special focus of this study is on polymeric biodegradable materials that have been widely used for tissue engineering and regenerative medicine. Moreover, to outline current research trends and future research directions in this area, selected smart biodegradable materials are characterized, categorized, and discussed. Finally, pertinent conclusions regarding the applicability of biodegradable materials are drawn and recommendations for future research are suggested to drive this line of research forward.

Literature Review of an Anterior Deprogrammer to Determine the Centric Relation and Presentation of Cases.

The increasing demand for dental aesthetics, articulation corrections, and solutions for pain and frequent bruxism demands quick and effective restorative dental management. The biomedical research aimed to create a beneficial, ecological, and readily available anterior deprogrammer to determine the centric relation (CR) of cases. This medical device is additively manufactured from a biocompatible material. Size is customizable based on the width of the patient's anterior central incisors. This is a pilot study with two subjects. The task was to develop a complete data protocol for the production process, computer-aided design (CAD), and three-dimensional (3D) printing of the anterior deprogrammers. The research focused on creating simple and practically applicable tools for the dentist's prescription (anterior deprogrammer in three sizes), and secondly for the communication between the dentist and the patient (computer application). The tested hypothesis was whether, according to these novel tools, it is possible to produce functional occlusal splints, which could be manufactured using current technologies. This study compared a traditional splint with a digitally designed and 3D-printed one. The tested hypothesis was whether manufactured occlusal splints differ in patients' subjective perception of comfort. Each conservative treatment was monitored for ten weeks. Initial results are promising; no statistically significant difference was found between the productive technologies.

Evaluation of Biocompatibility of PLA/PHB/TPS Polymer Scaffolds with Different Additives of ATBC and OLA Plasticizers.

One of the blends that is usable for 3D printing while not being toxic to cell cultures is the lactic acid (PLA)/polyhydroxybutyrate (PHB)/thermoplastic starch (TPS) blend. The addition of plasticizers can change the rate of biodegradation and the biological behavior of the material. In order to evaluate the potential of the PLA/PHB/TPS material in combination with additives (plasticizers: acetyl tributyl citrate (ATBC) and oligomeric lactic acid (OLA)), for use in the field of biomedical tissue engineering, we performed a comprehensive in vitro characterization of selected mixture materials. Three types of materials were tested: I: PLA/PHB/TPS + 25% OLA, II: PLA/PHB/TPS + 30% ATBC, and III: PLA/PHB/TPS + 30% OLA. The assessment of the biocompatibility of the materials included cytotoxicity tests, such as monitoring the viability, proliferation and morphology of cells and their deposition on the surface of the materials. The cell line 7F2 osteoblasts (Mus musculus) was used in the experiments. Based on the test results, the significant influence of plasticizers on the material was confirmed, with their specific proportions in the mixtures. PLA/PHB/TPS + 25% OLA was evaluated as the optimal material for biocompatibility with 7F2 osteoblasts. The tested biomaterials have the potential for further investigation with a possible change in the proportion of plasticizers, which can have a fundamental impact on their biological properties.

[Statistics in clinical and experimental medicine]. / Statistika v klinické a experimentální medicíne

The paper presents a brief overview of statistical methods used in clinical and experimental medicine, ranging from basic indicators and parameters of descriptive statistics and hypotheses testing (parametric as well as non-parametric methods) to a description of the most frequently used multivariate methods in medical scientific publications, to logistic regression. The paper also describes Principle Component Analysis (PCA), which is one of the methods used to decrease a data dimensionality. The proper use of statistical methods is demonstrated on specific clinical cases.

Analysis of PLA/PHB Biopolymer Material with Admixture of Hydroxyapatite and Tricalcium Phosphate for Clinical Use.

One trend in tissue engineering and regenerative medicine is the development of degradable composite polymers. The aim of this study was the comprehensive analysis of Polylactic acid (PLA)/Polyhydroxybutyrate (PHB) + Hydroxyapatite (HA)/Tricalcium phosphate (TCP) material from filament production to mechanical testing of samples with different infills and the production of an implant replacement for an intervertebral disc. Filament Maker-Composer 450 (3devo; Netherlands) was used to produce filaments. Experimental samples and the implant for the intervertebral disc were made using FDM technology using a DeltiQ2 3D printer (Trilab, Czech Republic). Mechanical testing of experimental samples was performed on an Inspekt TABLE 5 kN (Hegewald & Peschke, Nossen, Germany). Microscopic analysis, cytotoxicity test, and filament diameter analysis using descriptive statistics were also part of the focus. The results of the analysis of the diameter of the filament show that the filament meets the prescribed standard. The cytotoxicity test for PLA/PHB + HA/TCP material showed no toxicity. Microscopic analysis showed an even distribution of the ceramic component in the composite polymer. Mechanical testing showed a reduction in mechanical properties with 75% and 50% of the filling of experimental samples. All experimental samples subjected to mechanical testing showed higher tensile and compressive strength values compared to the values of the mechanical properties of vertebral trabecular bones, as reported in the literature. It can therefore be concluded that the material under investigation, PLA/PHB + HA/TCP appears to be a suitable candidate for hard tissue replacement.

In Vitro Model of Human Trophoblast in Early Placentation.

The complex process of placental implantation and development affects trophoblast progenitors and uterine cells through the regulation of transcription factors, cytokines, adhesion receptors and their ligands. Differentiation of trophoblast precursors in the trophectoderm of early ontogenesis, caused by the transcription factors, such as CDX2, TEAD4, Eomes and GATA3, leads to the formation of cytotrophoblast and syncytiotrophoblast populations. The molecular mechanisms involved in placental formation inside the human body along with the specification and differentiation of trophoblast cell lines are, mostly due to the lack of suitable cell models, not sufficiently elucidated. This review is an evaluation of current technologies, which are used to study the behavior of human trophoblasts and other placental cells, as well as their ability to represent physiological conditions both in vivo and in vitro. An in vitro 3D model with a characteristic phenotype is of great benefit for the study of placental physiology. At the same time, it provides great support for future modeling of placental disease.

Modal Analysis Using Digital Image Correlation Technique.

The present paper discusses a new approach for the experimental determination of modal parameters (resonant frequencies, modal shapes and damping coefficients) based on measured displacement values, using the non-contact optical method of digital image correlation (DIC). The output is a newly developed application module that, based on a three-dimensional displacement matrix from the experimental measurement results, can construct a frequency response function (FRF) for the purpose of experimental and operational modal analysis. From this frequency response function, the modal parameters of interest are able to be determined. The application module has been designed for practical use in Scilab 6.1.0, and its code interfaces directly with the ISTRA4D high-speed camera software. The module was built on measurements of a steel plate excited by an impact hammer to simulate experimental modal analysis. Verification of the correctness of the computational algorithm or the obtained modal parameters of the excited sheet metal plate was performed by simulation in the numerical software Abaqus, whose modal shapes and resonant frequencies showed high agreement with the results of the newly developed application.

Interaction between Mesenchymal Stem Cells and the Immune System in Rheumatoid Arthritis.

Rheumatoid arthritis (RA) is an autoimmune disease that causes damage to joints. This review focuses on the possibility of influencing the disease through immunomodulation by mesenchymal stem cells (MSCs). There is an occurrence of rheumatoid factor and RA-specific autoantibodies to citrullinated proteins in most patients. Citrulline proteins have been identified in the joints of RA patients, and are considered to be the most suitable candidates for the stimulation of anti-citrulline protein antibodies production. Fibroblast-like proliferating active synoviocytes actively promote inflammation and destruction in the RA joint, in association with pro-inflammatory cells. The inflammatory process may be suppressed by MSCs, which are a population of adherent cells with the following characteristic phenotype: CD105+, CD73+, CD90+, CD45-, CD34- and HLA DR-. Following the stimulation process, MSCs are capable of immunomodulatory action through the release of bioactive molecules, as well as direct contact with the cells of the immune system. Furthermore, MSCs show the ability to suppress natural killer cell activation and dendritic cells maturation, inhibit T cell proliferation and function, and induce T regulatory cell formation. MSCs produce factors that suppress inflammatory processes, such as PGE2, TGF-ß, HLA-G5, IDO, and IL-10. These properties suggest that MSCs may affect and suppress the excessive inflammation that occurs in RA. The effect of MSCs on rheumatoid arthritis has been proven to be a suitable alternative treatment thanks to successful experiments and clinical studies.

Therapy of Extensive Chronic Skin Defects after a Traumatic Injury Due to Microbial Contamination Using a Surface Implant Made of a Biocompatible Polycaprolactone-A Pilot Case Study.

This case study describes the use of additive manufacturing technology combining a biodegradable polymer material, polycaprolactone (PCL), and innovative procedures for creating superficial wound dressing, a scaffold in the therapy of extensive contaminated skin defects caused by a traumatic injury. Chronic and contaminated wounds represent a clinical problem and require intensive wound care. The application of a temporary scaffold-facilitated bridging of the wound edges resulted in faster tissue regeneration and a shorter defect closure time, compared to other conservative and surgical methods used in therapy of chronic wounds. Although this procedure has proven to be an optimal alternative to autologous transplants, further studies with a larger number of patients would be beneficial.

Impact of In Vitro Degradation on the Properties of Samples Produced by Additive Production from PLA/PHB-Based Material and Ceramics.

The present study deals with preparing a polymer-based material with incorporated ceramics and monitoring changes in properties after in vitro natural degradation. The developed material is a mixture of polymers of polylactic acid and polyhydroxybutyrate in a ratio of 85:15. Ceramic was incorporated into the prepared material, namely 10% hydroxyapatite and 10% tricalcium phosphate of the total volume. The material was processed into a filament form, and types of solid and porous samples were prepared using additive technology. These samples were immersed in three different solutions: physiological solution, phosphate-buffered saline, and Hanks' solution. Under constant laboratory conditions, changes in solution pH, material absorption, weight loss, changes in mechanical properties, and surface morphology were monitored for 170 days. The average value of the absorption of the solid sample was 7.07%, and the absorption of the porous samples was recorded at 8.33%, which means a difference of 1.26%. The least change in pH from the reference value of 7.4 was noted with the phosphate-buffered saline solution. Computed tomography was used to determine the cross-section of the samples. The obtained data were used to calculate the mechanical properties of materials after degradation. The elasticity modulus for both the full and porous samples degraded in Hanks' solution (524.53 ± 13.4 MPa) has the smallest deviation from the non-degraded reference sample (536.21 ± 22.69 MPa).