Study in bactericidal properties of chlorhexidine grafting on the modified titanium.

Chlorhexidine (CHX) is widely used in a number of dental applications to reduce inflammation as well as swelling of gums and gum bleeding. We investigate anti-adherent effect of CHX grafted titanium on oral pathogens such as S. mutans and S. aureus respectively. CHX grafted titanium surfaces show good anti-adherent properties.

Two-year clinical outcome after abciximab-coated stent implantation in patients with coronary artery disease.

BACKGROUND: Despite abciximab-coated stents having an inhibitory effect on coronary artery restenosis, the medium-term clinical outcome is unknown. METHODS AND RESULTS: This prospective, randomized study compared the effects of the abciximab-coated stent, which was implanted in 95 patients, with those of control bare metal stents (BMS) implanted in 93 patients for de novo coronary lesions. Stent implantation was performed without any complications associated with the procedure. The 6-month intravascular ultrasound analysis showed that the area of neointimal hyperplasia was significantly smaller in the abciximab-coated stent group compared with the control stent group (+2.0+/-1.6 mm(2) vs +3.4+/-1.7 mm(2), P=0.001). However, at 2-year clinical follow up, there were no statistically significant differences in the incidences of total major adverse cardiac events (16% vs 24%, P=0.19) and cardiac death (0% vs 1.1%, P=0.3), target vessel revascularization (16% vs 21%, P=0.4) or non-fatal myocardial infarction (0% vs 2.3%, P=0.16) in the abciximab-coated stent group compared with the control stent group. CONCLUSIONS: Although abciximab-coated stents are safe and inhibit neointimal hyperplasia, they have no superiority over BMS in 2-year clinical outcome.

Preparation of TiO2 nanoparticle from Ti-salt flocculated sludge with dye wastewater.

Dye wastewater flocculation using TiCl4 and FeSO4 coagulants was studied for organic removal and precipitation efficiency. Moreover, TiCl4 was assessed in a pilot-scale flocculation process to investigate organic removal and solution pH effect. A large amount of TiO2 was produced from sludge of Ti-salt flocculation in dye wastewater. This flocculation process simultaneously reduces a large amount of sludge produced from wastewater. The TiO2 nanoparticle was characterized in terms of physical and chemical properties. Results showed that 77.6% of organic matter was removed from dye wastewater when using FeSO4 as coagulant, while TiCl4 degraded 75.9% of organic matter. On the other hand, floc precipitation efficiency was better for TiCl4 if compared with FeSO4. The optimum concentration of TiCl4 for pilot-scale flocculation was found to be equal to 2.1 g/L. DWT (Dye wastewater titania) size was 15-20 nm, mainly doped with carbon atoms and exhibited a dominant anatase structure. DWT was similar to P-25 in decomposing acetaldehyde under UV-irradiation and complete photocatalytic degradation was achieved after 140 min.

Surface modification of orthodontic wires with photocatalytic titanium oxide for its antiadherent and antibacterial properties.

OBJECTIVE: To test the antiadherent and antibacterial properties of surface modification of orthodontic wires with photocatalytic titanium oxide (TiO(2)). MATERIALS AND METHODS: TiO(2) was coated on the surface of the orthodontic wires by a sol-gel thin film dip-coating method. Bacterial adhesion to the wires was evaluated by the weight change of the wires. The antibacterial activity of the surface-modified orthodontic wires was demonstrated by the dilution agar plate method for Streptococcus mutans and spectrophotometry for Porphyromonas gingivalis. RESULTS: The orthodontic wires coated with the photocatalytic TiO(2) showed an antiadherent effect against S. mutans compared with the uncoated wires. The bacterial mass that bound to the TiO(2)-coated orthodontic wires remained unchanged, whereas that of the uncoated wires increased by 4.97%. Furthermore, the TiO(2)-coated orthodontic wires had a bactericidal effect on S. mutans and P. gingivalis, which cause dental caries and periodontitis, respectively. The antiadherent and antibacterial mechanisms of TiO(2) to break down the cell wall of those bacteria were revealed by scanning electron microscopy. CONCLUSION: The surface modification of orthodontic wires with photocatalytic TiO(2) can be used to prevent the development of dental plaque during orthodontic treatment.

Cloning, expression and characterization of an extracellular enolase from Leuconostoc mesenteroides.

Enolase on the surface of streptococci putatively facilitates pathogenic invasion of the host organisms. The related Leuconostoc mesenteroides 512FMCM is nonpathogenic, but it too has an extracellular enolase. Purified isolates of extracellular dextransucrase from cultures of L. mesenteroides contain minute amounts of enolase, which separate as small crystals. Expression of L. mesenteroides enolase in Escherichia coli provides a protein (calculated subunit mass of 47 546 Da) catalyzing the conversion of 2-phsopho-D-glycerate to phosphoenolpyruvate. The pH optimum is 6.8, with Km and kcat values of 2.61 mM and 27.5 s(-1), respectively. At phosphate concentrations of 1 mM and below, fluoride is a noncompetitive inhibitor with respect to 2-phospho-D-glycerate, but in the presence of 20 mM phosphate, fluoride becomes a competitive inhibitor. Recombinant enolase significantly inhibits the activity of purified dextransucrase, and does not bind human plasminogen. Results here suggest that in some organisms enolase may participate in protein interactions that have no direct relevance to pathogenic invasion.

Effect of abciximab-coated stent on in-stent intimal hyperplasia in human coronary arteries.

The investigators tested whether abciximab-coated stents prevent neointimal hyperplasia (NIH) formation in coronary de novo lesions. Abciximab-coated stents were compared with control stents. All patients underwent follow-up coronary angiography and intravascular ultrasound (IVUS). All stents were successfully deployed, and patients were discharged home without clinical events. At follow-up coronary angiography, the restenosis rate and late loss were 14% and 0.33 +/- 0.28 mm in the abciximab-coated stent group and 28.6% and 0.64 +/- 0.32 mm in the control stent group (p = 0.099 and p = 0.014, respectively). At follow-up IVUS, the intrastent luminal area and intrastent NIH area were 5.7 +/- 1.6 and 2.0 +/- 1.6 mm(2), respectively, in the abciximab-coated stent group and 4.2 +/- 0.8 and 3.4 +/- 1.7 mm(2), respectively, in the control stent group (p = 0.001 and p = 0.001, respectively). Abciximab-coated stents are feasible and significantly inhibit NIH, with potential therapeutic benefit in preventing stent restenosis.

Effect of polymer-free TiO2 stent coated with abciximab or alpha lipoic acid in porcine coronary restenosis model.

BACKGROUND: Polymer-free drug-eluting stents (DES) may overcome the shortcomings of polymer-based DES. The aim of this study was to examine the effect of the polymer-free TiO2 film-coated stent with abciximab or alpha lipoic acid in a porcine coronary overstretch restenosis model. METHODS: Pigs were randomized into four groups in which the coronary arteries (24 pigs, 48 coronaries in each group) had TiO2 film-coated stent with abciximab (TCA, n = 12), TiO2 film-coated stent with alpha lipoic acid (TCALA, n = 12), biolimus A9-eluting stents with biodegradable polymer (BES, n = 12), and TiO2 film-coated stent (TCstent, n = 12). Histopathologic analysis was performed at 28 days after stenting. RESULTS: There was no significant difference in the injury score and internal elastic lamina (IEL) among the four groups. There were significant differences in the lumen area, neointima area, percent area stenosis, fibrin score, and inflammation score among the four groups [2.7 ± 1.0mm(2), 2.6 ± 0.94 mm(2), 48.9 ± 16.25%, 1.0 (range 0.0-3.0), 1.0 (range 0.0-2.0) in TCA stent group vs. 2.7 ± 1.24 mm(2), 2.9 ± 0.83 mm(2), 53.5 ± 17.19%, 1.0 (range 0.0-2.0), 1.0 (range 0.0-2.0) in TCALA stent group vs. 2.7 ± 1.30 mm(2), 2.6 ± 1.06 mm(2), 50.1 ± 23.20%, 2.0 (range 1.0-3.0), 2.0 (range 1.0-3.0) in BES group vs. 1.7 ± 0.63 mm(2), 3.3 ± 0.58 mm(2), 60.2 ± 10.12%, 0.5 (range 0.0-2.0), 1.0 (range 0.0-2.0) in TC stent group, respectively]. CONCLUSION: TCA and TCALA are more effective to reduce neointimal hyperplasia compared to TC. Moreover, fibrin and inflammation scores are significantly lower in TCA and TCALA than BES in porcine coronary restenosis model.

Effect of atorvastatin-eluting stents in a rabbit iliac artery restenosis model.

Statins have pleiotropic effects, which include the inhibition of neointima hyperplasia, the inhibition of vascular inflammation, and platelet inhibition. The aim of this study was to examine the effect of an atorvastatin-eluting stent (AES) in a rabbit iliac artery overstretch restenosis model. Ten rabbits were used in this study (10 rabbits, 10 iliac arteries for each stent). An AES and paclitaxel-eluting stent (PES) were implanted in the left and right iliac arteries in a rabbit (2 stents in each rabbit). The stents were deployed with oversizing (stent/artery ratio 1.3:1), and histopathologic analysis was assessed at 28 days after stenting. There were no significant differences in the injury score, lumen area, or inflammation score. There were significant differences in the neointimal area (0.7±0.18 mm(2) in the AES group vs. 0.4±0.25 mm(2) in the PES group, p<0.01), in the percentage stenosis area (14.8±5.06% in the AES group vs. 10.5±6.80% in the PES group, p<0.05), and in the fibrin score (0.4±0.51 in the AES group vs. 2.7±0.48 in the PES group, p<0.001). Although the AES did not suppress neointimal hyperplasia compared with the PES, it showed a superior arterial healing effect in a rabbit iliac artery overstretch restenosis model.

Histopathological Comparison among Biolimus, Zotarolimus and Everolimus-Eluting Stents in Porcine Coronary Restenosis Model.

BACKGROUND AND OBJECTIVES: The aim of this study was to examine the histolopathogical effects among the biolimus, zotarolimus, and everolimus eluting stent (EES) in the porcine coronary restenosis model. SUBJECTS AND METHODS: Pigs were randomized into three groups in which the coronary arteries (15 pigs, 10 coronaries in each group) had either a biolimus A9 eluting stent (BES, n=10), zotarolimus eluting stent (ZES, n=10) or an EES (n=10). Histopathologic analysis was performed at 28 days after stenting. RESULTS: There were no significant differences in the injury score among the three groups. There was a significant difference in the internal elastic lamina, lumen area, neointima area, percent area stenosis, and the fibrin and inflammation score among the three groups (4.3±0.53 mm(2), 2.5±0.93 mm(2), 1.8±1.03 mm(2), 40.7±20.80%, 1.7±0.41, 1.4±0.72 in the BES group vs. 5.1±0.55 mm(2), 2.3±1.14 mm(2), 2.8±1.00 mm(2), 55.4±21.23%, 2.0±0.39, 1.6±0.76 in the ZES group vs. 4.4±0.53 mm(2), 1.7±1.22 mm(2), 2.8±1.23 mm(2), 64.0±26.00%, 1.8±0.76, 2.1±0.90 in the EES group, respectively). BES is more effective in inhibiting neointimal hyperplasia compared to ZES and EES (p<0.0001). According to the fibrin and inflammation score, BES and EES are more effective in decreasing the fibrin deposition compared to ZES (p<0.001). Moreover, BES and ZES are more effective in reducing the inflammatory reaction compared to EES (p<0.001). CONCLUSION: The result demonstrates that BES shows better histopathological characteristics than ZES and EES at one month after stenting in the porcine coronary restenosis model.

Effect of a dual drug-coated stent with abciximab and alpha-lipoic Acid in a porcine coronary restenosis model.

BACKGROUND AND OBJECTIVES: The aim of this study was to examine the anti-proliferative and anti-inflammatory effects of a stent coated with abciximab and alpha-lipoic acid (ALA) in a porcine coronary overstretch restenosis model. MATERIALS AND METHODS: A total of 10 pigs were randomized into two groups (10 pigs, 10 coronaries in each group) in which the coronary arteries were stented with a dual-coated stent and a bare metal stent (control) by randomization. Stents were deployed with oversizing (stent/artery ratio 1.3 : 1) in the porcine coronary arteries, and histopathology was assessed 28 days after stenting. RESULTS: There was no significant difference in the injury score between the two groups. In the neointima, the lymphohistiocyte count was significantly lower in dual-coat stent group compared with the control stent group (120±85 cells vs. 159±80 cells, p=0.048). There was no significant difference in the fibrin score between the two groups (0.16±0.34 in the dual-coated stent group vs. 0.25±0.48 in the control stent group, p=0.446). The neointima area was not significantly different between both groups (1.55±0.8 mm(2) in dual-coated stent group vs. 1.40±0.86 mm(2) in the control stent group, p=0.447). CONCLUSION: Although the dual-coated stent with abciximab and ALA showed no significant difference in inhibition of neointimal hyperplasia when compared with the bare metal stent, it was associated with a reduced inflammatory reaction when compared with the control stent in a porcine coronary restenosis model.

Effects of ramiprilat-coated stents on neointimal hyperplasia, inflammation, and arterial healing in a porcine coronary restenosis model.

BACKGROUND AND OBJECTIVES: The renin-angiotensin-aldosterone system has been implicated in the pathogenesis of neointimal hyperplasia, and a role for angiotensin II in the migration and proliferation of vascular smooth muscle cells in restenotic lesions has been proposed. The aim of this study was to determine the anti-proliferative and anti-inflammatory effects of ramiprilat-coated stents in a porcine coronary overstretch restenosis model. SUBJECTS AND METHODS: Pigs were randomized into two groups in which the coronary arteries {16 pigs (16 coronaries in each group)} had a 3.0×17 mm ramiprilat-coated MAC stent or a 3.0×17 mm control MAC stent (AMG, Munich, Germany) implanted with oversizing (stent-to-artery ratio, 1.3 : 1) in porcine coronary arteries, and histopathologic analysis was assessed 28 days after stenting. RESULTS: There were no significant differences in the injury and inflammation scores between the two groups (1.20±0.43 vs. 1.23±0.57, p=0.8; and 1.21±0.39 vs. 1.25±0.49, p=0.6, respectively). Within the neointima, most inflammatory cells were lymphohistiocytes. Significant positive correlations existed between inflammatory cell counts and the neointima areas (r=0.567, p<0.001), and between inflammatory cell counts and the percent area stenosis (r=0.478, p<0.001). There was no significant difference in the inflammatory cell counts normalized to the injury (110±89 vs. 123±83, p=0.4) and fibrin scores (0.15±0.06 vs. 0.17±0.07, p=0.8) between the 2 groups. There were trends toward a smaller neointima area (1.06±0.51 mm(2) vs. 1.28±0.35 mm(2), p=0.083) and a smaller percent area stenosis (18.9±8.7% vs. 21.8±7.2%, p=0.088) in the ramiprilat-coated stent group. CONCLUSION: Although the ramiprilat-coated stent did not show significant inhibitory effects on neointimal hyperplasia, the ramiprilat-coated stent showed good effects on the inflammatory reaction and arterial healing similar to the control stent in a porcine coronary restenosis model.

Effect of alpha lipoic acid in a porcine in-stent restenosis model.

BACKGROUND: The aim of this study was to investigate the effect of alpha lipoic acid (α-LA) on a porcine in-stent restenosis (ISR) model. METHODS: In protocol 1, porcine vascular smooth muscle cells (PVSMC) were stimulated by granulocyte-colony stimulating factor (G-CSF) in the presence or absence of α-LA. MTT (3-[4,5-dimethylthiazole-2-yl] 2,5-diphenyl tetrazolium bromide) assay and western blotting were used to determine the cell growth inhibitory rate and anti-inflammatory effect associated with nuclear factor-κb (NF-κb) and extracellular signal-regulated kinase (ERK). In protocol 2, 28 days after balloon overdilation injuries, 24 bare metal stents were placed in coronary artery of 12 pigs. The pigs were randomly divided to receive control diet with or without α-LA (100 mg/kg). In protocol 3, 8 control stents and 8 α-LA coated stents were randomly implanted in 2 coronary arteries of 8 pigs and follow-up coronary angiogram and histopathologic assessment were performed 4 weeks after stenting. RESULTS: Protocol 1. The proliferation of PVSMC was inhibited and protein expression of NF-κb and ERK were attenuated by α-LA pretreatment. Protocol 2. On histopathologic analysis, the neointimal area (4.0+/-1.0 mm(2) vs. 1.5+/-0.7 mm(2), p<0.001) and histopathologic area of stenosis (66.7+/-10.7% vs. 24.2+/-9.7%, p<0.001) were reduced in the α-LA feeding group compared to controls. Protocol 3. On histopathologic analysis, the neointimal area (3.9+/-0.8 mm(2) vs. 1.0+/-0.4 mm(2), p<0.001), and the histopathologic area of stenosis (67.1+/-8.8% vs. 17.4+/-10.0%, p<0.001) were reduced in the α-LA coated stent group compared to the control stent group. CONCLUSIONS: α-LA feeding and α-LA coated stents inhibit neointimal hyperplasia in porcine ISR, possibly through inhibiting the activation of NF-κb pathway and proliferation of PVSMC.

The clinical results of a platelet glycoprotein IIb/IIIa receptor blocker (abciximab: ReoPro)-coated stent in acute myocardial infarction.

OBJECTIVES: This study is a prospective randomized trial investigating clinical outcomes of patients with acute myocardial infarction (AMI) treated with abciximab (ReoPro)-coated stents. BACKGROUND: Recently we have demonstrated that abciximab-coated stents have inhibitory effects in the prevention of coronary restenosis. METHODS: Ninety-six patients with AMI were randomly allocated into two groups; group I received abciximab-coated stents (n = 48, 57.1 +/- 12.0 years), and group II received bare metal control stents (n = 48, 58.4 +/- 11.6 years). RESULTS: At baseline, clinical characteristics, percent diameter stenosis, and minimal luminal diameter were no different between the two groups. One patient in group II had reinfarction and target lesion reintervention during hospital stay. Follow-up coronary angiography was obtained in 77.1% (37 of 48) in group I and 75.0% (36 of 48) in group II. Percent diameter stenosis and late loss were significantly lower in group I than group II (18.9 +/- 5.54% vs. 37.9 +/- 6.25%, p = 0.008; and 0.39 +/- 0.29 mm vs. 0.88 +/- 0.45 mm; p = 0.008, respectively). At follow-up intravascular ultrasound, intrastent lumen area and intrastent neointimal hyperplasia (NIH) area were 5.4 +/- 1.8 mm2 and 2.2 +/- 1.5 mm2, respectively, in group I and 4.3 +/- 1.6 mm2 and 3.4 +/- 1.8 mm2, respectively, in group II (p = 0.045). And, in-stent restenosis rate was lower in group I than group II (p = 0.011 and p = 0.008, respectively). During 1-year follow-up, two patients in group II (4.1%) had AMI, whereas no patient in group I suffered AMI. Target lesion revascularization and total major adverse cardiac events rates were relatively lower in group I compared with those in group II (10.4% [5 of 48] vs. 20.8% [10 of 48], p = 0.261, and 10.4% vs. 25.0%, p = 0.107, respectively). CONCLUSIONS: Abciximab-coated stent implantation was safe and effective without stent thrombosis in AMI patients.

The long-term clinical results of a platelet glycoprotein IIb/IIIa receptor blocker (Abciximab: Reopro) coated stent in patients with coronary artery disease.

BACKGROUND: Previously, the inhibition of coronary restenosis with Abciximab (ReoPro)-coated stent in a porcine model was reported. ReoPro inhibits platelet aggregation, the proliferation of vascular smooth muscle cells and the inflammatory reaction. METHODS: A prospective randomized trial was performed to compare two types of stent for revascularization in the native coronary artery. The primary effective end points were major adverse coronary events (MACE): cardiac death, acute myocardial infarction, target vessel revascularization (TVR) and restenosis at the 6-month clinical and angiographic follow-ups. RESULTS: One hundred and fifty-five patients were enrolled between August 2001 and June 2003. The mean ages (56.0 +/- 10.0 vs. 56.9 +/- 10.8 years), baseline diameter of stenosis and minimal luminal diameter were no different between the two groups. There was one myocardial infarction and revascularization during the hospital stay in control stent group. During the clinical follow-up there were two myocardial infarctions in control group. Follow-up coronary angiograms were performed in 62.3% (48/77) and 65.4% (51/78) of the coated and control groups, respectively. The diameter of stenosis and late loss were significantly less in the ReoPro-coated stent group compared with the controls (16.4 +/- 5.8% vs. 34.3 +/- 6.1%, p = 0.009; and 0.33 +/- 0.28 mm vs. 0.88 +/- 0.41 mm; p = 0.002). The restenosis and TVR rates of the ReoPro-coated stent were relatively lower compared with the control stent [14.6% (7/48) vs. 29.4% (15/51), p = 0.062; and 9.2% (7/76) vs. 14.7% (11/75); p = 0.327]. CONCLUSION: A ReoPro-coated stent is safe, and may be effective in the prevention of coronary restenosis.