Bone augmentation using a highly porous PLGA/ß-TCP scaffold containing fibroblast growth factor-2.

BACKGROUND AND OBJECTIVE: Beta-tricalcium phosphate (ß-TCP), a bio-absorbable ceramic, facilitates bone conductivity. We constructed a highly porous three-dimensional scaffold, using ß-TCP, for bone tissue engineering and coated it with co-poly lactic acid/glycolic acid (PLGA) to improve the mechanical strength and biological performance. The aim of this study was to examine the effect of implantation of the PLGA/ß-TCP scaffold loaded with fibroblast growth factor-2 (FGF-2) on bone augmentation. MATERIAL AND METHODS: The ß-TCP scaffold was fabricated by the replica method using polyurethane foam, then coated with PLGA. The PLGA/ß-TCP scaffold was characterized by scanning electron miscroscopy (SEM), transmission electron microscopy (TEM), X-ray diffraction, compressive testing, cell culture and a subcutaneous implant test. Subsequently, a bone-forming test was performed using 52 rats. The ß-TCP scaffold, PLGA-coated scaffold, and ß-TCP and PLGA-coated scaffolds loaded with FGF-2, were implanted into rat cranial bone. Histological observations were made at 10 and 35 d postsurgery. RESULTS: SEM and TEM observations showed a thin PLGA layer on the ß-TCP particles after coating. High porosity (> 90%) of the scaffold was exhibited after PLGA coating, and the compressive strength of the PLGA/ß-TCP scaffold was six-fold greater than that of the noncoated scaffold. Good biocompatibility of the PLGA/ß-TCP scaffold was found in the culture and implant tests. Histological samples obtained following implantation of PLGA/ß-TCP scaffold loaded with FGF-2 showed significant bone augmentation. CONCLUSION: The PLGA coating improved the mechanical strength of ß-TCP scaffolds while maintaining high porosity and tissue compatibility. PLGA/ß-TCP scaffolds, in combination with FGF-2, are bioeffective for bone augmentation.

Two cases of systemic Candida glabrata infection following in vitro fertilization and embryo transfer.

Presented here are two cases of systemic Candida glabrata infection diagnosed in two expectant mothers and their fetuses at 34 and 22 weeks' gestation. The underlying risk factors in case 1 were in vitro fertilization and embryo transfer, recurrent yeast vaginitis and two intravenous injections of betamethasone. The risk factors in case 2 were in vitro fertilization and embryo transfer, recurrent yeast vaginitis, antibiotics for treatment of a urinary tract infection due to Morganella morganii and amniocentesis. In both cases, vaginal fluid yielded growth of a yeast that was not identified. Candida glabrata was isolated from samples obtained from the mothers and their babies. Since Candida glabrata lacks hyphae, membranitis and infection of the fetuses were demonstrated only on slides stained with Gomori Grocott and periodic acid-Schiff. Both cases suggest that for such pregnancies the follow-up of vaginal fluid should include the identification of any yeasts grown on selective Candida medium. In case of premature rupture of membranes, systematic sampling of mothers and their infants or fetuses should be associated with microscopic study of placentas, membranes and stillborn fetuses with Gomori Grocott and periodic acid-Schiff staining techniques.

Value of autoantibodies to beta(2)-glycoprotein 1 in the diagnosis of antiphospholipid syndrome.

OBJECTIVES: To define the specificity and positive predictive value of anti-beta(2)-glycoprotein 1 (anti-beta(2)GP1) antibodies for the diagnosis of antiphospholipid syndrome (APS). METHODS: We determined the presence of anticardiolipin (aCL) antibodies and anti-beta(2)-glycoprotein 1 (anti-beta(2)GP1) immunoglobulin (Ig) G and IgM in 191 consecutive sera from 191 patients and reviewed clinical data separately. aCL IgG and IgM were detected separately using commercial ELISA kits. Anti-beta(2)GP1 antibodies were detected with an in-house ELISA using beta(2)GP1. RESULTS: Seven patients were diagnosed as having APS and 184 as having other diseases. Thirty-six patients were aCL-positive and 12 were anti-beta(2)GP1-positive, seven of these 12 were APS patients. The specificity for anti-beta(2)GP1 in our population was 97%, with a positive predictive value (PPV) of 58%. Among the aCL-positive patients, specificity was 90% and PPV 70-87%. CONCLUSIONS: This study shows that anti-beta(2)GP1 antibodies have a higher specificity and PPV than aCL for APS. The PPV of anti-beta(2)GP1 was greater in aCL-positive than in all patients. We conclude that screening for anti-beta(2)GP1 antibodies in aCL-positive patients increases the specificity and the PPV of aCL testing. In addition, we show that there is no need to screen for anti-beta(2)GP1 antibodies in the absence of aCL antibodies and in the absence of strong clinical suspicion of APS.