TOMOGRAPHIC RELATIONSHIPS BETWEEN RETINAL NEOVASCULARIZATION AND THE POSTERIOR VITREOUS IN PROLIFERATIVE DIABETIC RETINOPATHY.

PURPOSE: To describe anatomical relationships of retinal neovascular complexes (NVCs) and the posterior vitreous in proliferative diabetic retinopathy using spectral domain optical coherence tomography. METHODS: Cross-sectional study. Neovascular complexes were imaged using spectral domain optical coherence tomography in 51 eyes of 37 patients. The relationship of NVCs to the posterior vitreous cortex and posterior vitreous spaces, such as the premacular bursa, prevascular vitreous fissures, and perimacular cisterns, was analyzed. RESULTS: In the 77 NVCs evaluated, 61 (79%) had grown along the outer surface of the posterior hyaloid face, and vitreoschisis was present in 37 (48%). The "wolf's jaw" configuration was present in 9% and resulted from NVC arising from the arcades and proliferating along the posterior hyaloid face. By contrast, NVCs that invaded the bursa originated from smaller venous tributaries more distant from the arcades. The premacular bursa and prevascular vitreous fissure/perimacular cistern were invaded infrequently, respectively, in 15% and 38% (P = 0.137). CONCLUSION: Tomographic analysis of diabetic NVCs showed that most NVCs arise and grow along the posterior hyaloid face and that vitreoschisis is more prevalent than what has been found in ultrasound studies. The wolf's jaw configuration does not seem to result from the invasion of the bursa, as previously suggested.

Rapid hemostatic and mild polyurethane-urea foam wound dressing for promoting wound healing.

A novel rapid hemostatic and mild polyurethane-urea foam (PUUF) wound dressing was prepared by the particle leaching method and vacuum freeze-drying method using 4, 4-Methylenebis(cyclohexyl isocyanate), 4,4-diaminodicyclohexylmethane and poly (ethylene glycol) as raw materials. And X-ray diffraction (XRD), tensile test, differential scanning calorimetry (DSC) and thermogravimetry (TG) were used to its crystallinity, stress and strain behavior, and thermal properties, respectively. Platelet adhesion, fibrinogen adhesion and blood clotting were performed to evaluate its hemostatic effect. And H&E staining and Masson Trichrome staining were used to its wound healing efficacy. The results revealed the pore size of PUUF is 50-130µm, and its porosity is 71.01%. Porous PUUF exhibited good water uptake that was benefit to adsorb abundant wound exudates to build a regional moist environment beneficial for wound healing. The PUUF wound dressing exhibit better blood coagulation effect than commercial polyurethane dressing (CaduMedi). Though both PUUF and CaduMedi facilitated wound healing generating full re-epithelialization within 13days, PUUF was milder and lead to more slight inflammatory response than CaduMedi. In addition, PUUF wound dressing exhibited lower cytotoxicity than CaduMedi against NIH3T3 cells. Overall, porous PUUF represents a novel mild wound dressing with excellent water uptake, hemostatic effect and low toxicity, and it can promote wound healing and enhance re-epithelialization.

Scaffolds from alternating block polyurethanes of poly(ɛ-caprolactone) and poly(ethylene glycol) with stimulation and guidance of nerve growth and better nerve repair than autograft.

Nerve repair scaffolds from novel alternating block polyurethanes (PUCL-alt-PEG) based on PCL and PEG without additional growth factors or proteins were prepared by a particle leaching method. The scaffolds have pore size 10-20 µm and porosity 92%. Mechanical tests showed that the polyurethane scaffolds have maximum loads of 5.97 ± 0.35 N and maximal stresses of 8.84 ± 0.5 MPa. Histocompatiblity of the nerve repair scaffolds was tested in a SD rat model for peripheral nerve defect treatment. Two types of treatments including PUCL-alt-PEG scaffolds and autografts were compared in rat model. After 32 weeks, bridging of a 12 mm defect gap by the regenerated nerve was observed in all rats. The nerve regeneration was systematically characterized by sciatic function index (SFI), electrophysiology, histological assessment including HE staining, immunohistochemistry, ammonia sliver staining, Masson's trichrome staining and TEM observation. Results revealed that nerve repair scaffolds from PUCL-alt-PEG exhibit better regeneration effects compared to autografts. Electrophysiological recovery was seen in 90% and 87% of rats in PUCL-alt-PEG and autograft groups respectively. Biodegradation in vitro and in vivo shows good degradation match of PUCL-alt-PEG scaffolds with nerve regeneration. It demonstrates that plain nerve repair scaffolds from PUCL-alt-PEG biomaterials can achieve peripheral nerve regeneration satisfactorily.

Scaffolds from block polyurethanes based on poly(ɛ-caprolactone) (PCL) and poly(ethylene glycol) (PEG) for peripheral nerve regeneration.

Nerve guide scaffolds from block polyurethanes without any additional growth factors or protein were prepared using a particle leaching method. The scaffolds of block polyurethanes (abbreviated as PUCL-ran-EG) based on poly(ɛ-caprolactone) (PCL-diol) and poly(ethylene glycol) (PEG) possess highly surface-area porous for cell attachment, and can provide biochemical and topographic cues to enhance tissue regeneration. The nerve guide scaffolds have pore size 1-5 µm and porosity 88%. Mechanical tests showed that the polyurethane nerve guide scaffolds have maximum loads of 4.98 ± 0.35 N and maximum stresses of 6.372 ± 0.5 MPa. The histocompatibility efficacy of these nerve guide scaffolds was tested in a rat model for peripheral nerve injury treatment. Four types of guides including PUCL-ran-EG scaffolds, autograft, PCL scaffolds and silicone tubes were compared in the rat model. After 14 weeks, bridging of a 10 mm defect gap by the regenerated nerve was observed in all rats. The nerve regeneration was systematically characterized by sciatic function index (SFI), histological assessment including HE staining, immunohistochemistry, ammonia silver staining, Masson's trichrome staining and TEM observation. Results revealed that polyurethane nerve guide scaffolds exhibit much better regeneration behavior than PCL, silicone tube groups and comparable to autograft. Electrophysiological recovery was also seen in 36%, 76%, and 87% of rats in the PCL, PUCL-ran-EG, and autograft groups respectively, whilst 29.8% was observed in the silicone tube groups. Biodegradation in vitro and in vivo show proper degradation of the PUCL-ran-EG nerve guide scaffolds. This study has demonstrated that without further modification, plain PUCL-ran-EG nerve guide scaffolds can help peripheral nerve regeneration excellently.

Alternating block polyurethanes based on PCL and PEG as potential nerve regeneration materials.

Polyurethanes with regular and controlled block arrangement, i.e., alternating block polyurethanes (abbreviated as PUCL-alt-PEG) based on poly(ε-caprolactone) (PCL-diol) and poly(ethylene glycol) (PEG) was prepared via selectively coupling reaction between PCL-diol and diisocyanate end-capped PEG. Chemical structure, molecular weight, distribution, and thermal properties were systematically characterized by FTIR, (1)H NMR, GPC, DSC, and TGA. Hydrophilicity was studied by static contact angle of H2O and CH2I2. Film surface was observed by scanning electron microscope (SEM) and atomic force microscopy, and mechanical properties were assessed by universal test machine. Results show that alternating block polyurethanes give higher crystal degree, higher mechanical properties, and more hydrophilic and rougher (deep ravine) surface than their random counterpart, due to regular and controlled structure. Platelet adhesion illustrated that PUCL-alt-PEG has better hemocompatibility and the hemacompatibility was affected significantly by PEG content. Excellent hemocompatibility was obtained with high PEG content. CCK-8 assay and SEM observation revealed much better cell compatibility of fibroblast L929 and rat glial cells on the alternating block polyurethanes than that on random counterpart. Alternating block polyurethane PUC20-a-E4 with optimized composition, mechanical, surface properties, hemacompatibility, and highest cell growth and proliferation was achieved for potential use in nerve regeneration.

Synthesis, characterizations, and biocompatibility of block poly(ester-urethane)s based on biodegradable poly(3-hydroxybutyrate-co-4-hydroxybutyrate) (P3/4HB) and poly(ε-caprolactone).

A type of block poly(ester-urethane)s (abbreviated as PUBC) based on bacterial copolyester poly(3-hydroxybutyrate-co-4-hydroxybutyrate) (P3/4HB) and biodegradable poly(ε-caprolactone) (PCL) was synthesized by melting polymerization using 1,6-hexamethylene diisocyanate (HDI) as the coupling agent, with different 3HB, 4HB and PCL contents and segment lengths. Stannous octanoate (Sn(Oct)(2)) was used as catalyst. The chemical structure, molecular weight and thermal property were characterized by (1)H NMR, FTIR GPC, DSC and TGA. DSC analysis revealed that the PUBC polyurethanes exhibit amorphous to semi-crystalline (20.9% crystallinity degree) with T(g) range from -39.7 to -21.5 °C. The hydrophilicity was investigated by static contact angle of deionized water and CH(2)I(2). The obtained PUBCs are hydrophobic (water contact angle 73.7-90.2°). Platelet adhesion study and plasma recalcification time revealed that the block polyurethanes possess hemastasis ability. CCK-8 assay illuminated that the no cytotoxic polyurethanes maintain rat aortic smooth muscle cells (RaSMCs) good viability. It was found that the 4HB content in the materials is an important factor to affect the sustainable cell viability.

Surface biocompatible modification of polyurethane by entrapment of a macromolecular modifier.

A macromolecular biocompatible surface modifier for polyurethane (PU), namely, polyurethane-block-poly(vinylpyrrolidone) (PU-b-PVP) copolymer, was synthesized by coupling hydroxyl-terminated PVP with diisocyanate-terminated poly(ethylene glycol) using 1,6-hexamethylene diisocyanate (HDI) as coupling agent. The chemical structure and molecular weight of the synthesized copolymer were systematically characterized by nuclear magnetic resonance spectrum ((1)H NMR), Fourier transform infrared spectroscopy (FTIR) and gel permeation chromatography (GPC). The synthesized surface modifier was blended with PU and effectively increased the hydrophilicity of PU. To evaluate the hemocompatibility of the PU/PU-b-PVP blend films, the extent of platelet adsorption, plasma recalcification time and hemolysis were measured. To determine if the blend films were toxic to mammalian cells, viability of the cells cultured on the blend films was assayed. All results indicated that the blood and cell compatibilities of the PU films were improved significantly after entrapment of a few PU-b-PVP copolymers into PU.

Enhanced proliferation and differentiation of neural stem cells grown on PHA films coated with recombinant fusion proteins.

Polyhydroxyalkanoates (PHAs) belong to a family of copolyesters with demonstrated biocompatibility. We hypothesize that genetically fusing evolutionarily preserved cell binding motifs, such as RGD or IKVAV, to the PHA-binding protein phasin (PhaP) for surface functionalization of PHA materials could better support the growth and differentiation of neural stem cells (NSCs). This hypothesis is tested on three polyester materials of the same aliphatic family: poly(L-lactic acid) (PLA) and two PHB copolymers, poly(3-hydroxybutyrate-co-3-hydroxyhexanoate) and poly(3-hydroxybutyrate-co-3-hydroxyvalerate-co-3-hydroxyhexanoate) (PHBVHHx). Experimental results indicate that surface coating of the two fusion proteins, PhaP-RGD and PhaP-IKVAV, provides short-term advantages in promoting the adhesion, proliferation and neural differentiation of rat NSCs compared to the PhaP-coated or uncoated material. Among the tested samples, the combination of coating PhaP-IKVAV on an PHBVHHx surface yields the highest levels in cell adhesion and proliferation, while the PLA film coated with PhaP-IKVAV promotes better neural differentiation and neurite outgrowth in the early stage. Because both PhaP-RGD and PhaP-IKVAV could be produced in an inexpensive manner, our data suggest that PhaP-IKVAV is an ideal nonspecific coating agent to functionalize hydrophobic biomaterials in the application of neural tissue engineering.

The behaviour of neural stem cells on polyhydroxyalkanoate nanofiber scaffolds.

Polyhydroxyalkanoates (PHA) have demonstrated their potentials as medical implant biomaterials. Neural stem cells (NSCs) grown on/in PHA scaffolds may be useful for repairing central nervous system (CNS) injury. To investigate this possibility, nanofiber matrices (scaffolds) prepared from several PHA via a novel phase separation process were studied to mimic natural extracellular matrix (ECM), and rat-derived NSCs grown in the PHA matrices were characterized regarding their in vitro differentiation behaviors. All three PHA materials including poly(3-hydroxybutyrate) (PHB), copolymer of 3-hydroxybutyrate and 4-hydroxybutyrate (P3HB4HB), and copolymer of 3-hydroxybutyrate and 3-hydroxyhexanoate (PHBHHx) supported NSC growth and differentiation both on their 2D films and 3D matrices. Among three PHA nanofiber matrices, PHBHHx one showed the strongest potentials to promote NSC differentiation into neurons which is beneficial for CNS repair. Compared to the 2D films, 3D nanofiber matrices appeared to be more suitable for NSC attachment, synaptic outgrowth and synaptogenesis. It was suggested that PHBHHx nanofiber scaffolds (matrices) that promote NSC growth and differentiation, can be developed for treating central nervous system injury.