[Intermittent opening of a mechanical mitral valve prosthesis due to pannus formation; report of a case].

A 76-year-old woman with a history of severe mitral valve stenosis had undergone mitral valve replacement with a 27 mm St. Jude Medical (SJM) valve in 1991. Follow-up transthoracic echocardiography revealed an increase in the pressure gradient across the mitral prosthesis 16 years after the surgery. Prosthetic valve dysfunction was suspected, but transesophageal echocardiography and cineradiography failed to show mechanical valve dysfunction. Two years later, she presented with dyspnea on exertion and leg edema. Cineradiography revealed intermittent restriction of the opening of the mechanical valve leaflet approximately every 10 beats. Thus, we diagnosed intermittent prosthetic valve dysfunction and performed a reoperation. On inspection of the prosthesis, we observed semicircular pannus formation around the posterior leaflet in the ventricular side. It was considered that the pannus tissue had interfered with 1 leaflet opening of the mitral valve prosthesis, resulting in intermittent valve dysfunction. We replaced the prosthesis with a new 25 mm SJM valve. The patient was discharged after confirmation of normal prosthetic function.

Apatite containing aspartic acid for selective protein loading.

Physico-chemical modifications of hydroxyapatite (HAp) materials are considered as pre-requisites for the development of new bioactive carrier materials for drug delivery and tissue engineering applications. Since acidic amino acids have well-documented affinities to both HAp and basic proteins, HAp modified by aspartic acid (Asp, acidic amino acid) might be one of the candidate substrates for a basic protein carrier. Here, we synthesized HAp in the presence of various concentrations of Asp and observed that HAp crystallinity and other physico-chemical properties were effectively modulated. Detailed studies indicated that Asp was not incorporated in the HAp crystal lattice, but rather was trapped in HAp crystals. Protein adsorption studies indicated that the HAp particles modified by Asp had a selective loading capacity for basic protein. Therefore, HAp particles containing Asp might have potential in drug delivery applications, especially as the carrier of basic proteins including bFGF and BMP.

Modification of apatite materials for bone tissue engineering and drug delivery carriers.

Apatite-related calcium phosphate, the main component of biological hard tissue, has good biocompatibility and is an economical material. Methods for the synthesis of apatite materials including hydroxyapatite (HAp) have previously been established. Therefore, for many years, apatite materials have been utilized as substitute materials for bone in orthopedic and dental fields. Such types of conventional substitute materials, which are implanted in the human body, should ostensibly be chemically stable to maintain their quality over time. However, recent advances in tissue engineering have altered this concept. Physicians and researchers now seek to identify materials that alter their properties temporally and spatially to achieve ideal tissue regeneration. In order to use apatite materials for tissue engineering and as drug delivery systems, the materials require both a high affinity for cells, tissues and/or functional molecules (e.g. growth factors and genes) and controllable bioabsorbability. To achieve these properties, various physicochemical modifications of apatite materials have been attempted. In addition, fabrication desiring three-dimensional structures (e.g. size, morphology and porosity) of apatite materials for implant sites could be one of the crucial techniques used to obtain ideal prognoses. In this review, the latest research trends relating to the techniques for the fabrication and modification of apatite materials are introduced.

Biocompatibility of dense hydroxyapatite prepared using an SPS process.

In the present study, the preparation of dense hydroxyapatite (HAp) materials at relative low temperatures using a spark plasma sintering was carried out. The bioactivity of HAp samples prepared by a spark plasma sintering method was investigated by in vitro tests and compared with HAp obtained by a conventional hot-pressing method. No growth of bone-like HAp crystals on surface of HAp sintered by a conventional hot-pressing method at 1200 degrees C was observed after immersion in a simulated body fluid (SBF) for 2 days. However, many large bone-like HAp crystals were observed on the surface of HAp samples prepared by a spark plasma sintering at 1200 degrees C after 2 days in the SBF immersion test. Especially, the negatively charged surface of the HAp samples prepared by spark plasma sintering was covered with larger HAp crystals compared with the positively charged surface. The electric poling of HAp was measured using a thermally simulated current technique. This rapid growth of bone-like HAp crystals of the HAp samples made by spark plasma sintering was believed to be related with the OH(-) and/or Ca(2(+) ) ion deficiency at the grain boundaries of the HAp matrix grains as well as a small electric poling effect resulting during the spark plasma sintering process.

Synthesis and evaluation of various layered octacalcium phosphates by wet-chemical processing.

Octacalcium phosphate was synthesized by hydrolysis of alpha-tricalcium phosphate through a wet-chemical processing. Using the same wet-chemical processing in presence of various succinate ions, the preparation of some complexed octacalcium phosphates was attempted. The products were examined by X-ray diffraction method. These complexed octacalcium phosphates intercalated with succinic acid, L-asparatic acid, and methyl succinic acid showed an expanded basal spacing in the octacalcium phosphate unit cell dimensions. The microstructure was observed by scanning and transmission electron microscopy.