Long-term in vitro degradation and in vivo evaluation of resorbable bioceramics.

An essential criterion for the selection of resorbable bioceramics is their ability to degrade inside human body within a reasonable time frame. Furthermore, if the bioceramic can release beneficial ions, such as strontium, as it degrades, recovery time might be shortened. The present study demonstrates that strontium-containing calcium sulfate (Sr,Ca)SO4 can fulfill these criteria. A long-term in vitro degradation analysis for 12 weeks using sintered (Sr,Ca)SO4 discs in phosphate buffered solution (PBS) was conducted. The sintered (Sr,Ca)SO4 disc was then implanted into defects in the distal femur of rats. The degradation rate of (Sr,Ca)SO4 discs showed a strong dependence on the Sr content. Similar results were observed between the long-term in vitro degradation analysis and the in vivo evaluation. The sintered (3.8%Sr,Ca)SO4 disc lost more than 80% of its initial weight after soaking in PBS with shaking at 37 °C for 12 weeks. After 12 weeks in vivo, the remaining volume of the (3.8%Sr,Ca)SO4 disc within the bone defect was ~25%. Over the same time period, new bone was formed at a relative volume of 40%. This study demonstrates the potential of (Sr,Ca)SO4 bioceramic, and the benefits of using a long-term degradation test during the evaluation of resorbable bioceramics.

Limitation of the antibiotic-eluting bone graft substitute: An example of gentamycin-impregnated calcium sulfate.

Patients with inadequate volume of alveolar processes or bone defects commonly require graft substitutes in oral, maxillofacial or orthopedic surgery. Ridge augmentation and reconstruction of facial bony defects with bone graft materials achieve better outcomes in functional and aesthetic rehabilitation. The injectable calcium sulfate filler is used widely in intra-operative applications. Calcium sulfate bone filler has been shown to upregulate bone formation-related mRNA genes in vitro and improve osseointegration in vivo. In addition, the bone graft substitute can be used as a drug delivery system for antibiotics to treat or prevent infections based on the clinical experiences. However, the influences of antibiotics addition on the calcium sulfate are not fully understood. In this study, calcium sulfate impregnated with gentamycin in different weight ratios was characterized. The results showed that gentamycin prolonged the hydration process and extended initial/final setting times of calcium sulfate. The addition of gentamycin slowed the conversion from calcium sulfate hemihydrate to dihydrate and changed the crystalline phase and microstructure. Higher amounts of gentamycin added resulted in faster degradation and lower mechanical strength of calcium sulfate. This study reveals that the extended setting time, decreased compressive strength, and the accelerated degradation of the gentamycin-impregnated calcium sulfate bone graft substitutes should be considered during intra-operative applications. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 80-87, 2018.

Influences of doping mesoporous magnesium silicate on water absorption, drug release, degradability, apatite-mineralization and primary cells responses to calcium sulfate based bone cements.

In this study, composite cements containing mesoporous magnesium silicate (m-MS) and calcium sulfate (CS) were fabricated. The results revealed that the setting time of the m-MS/CS composite cements (m-MSC) slightly prolonged with the increase of m-MS content while the compressive strength suffered a little loss. The doping of m-MS improved the water absorption, drug release (vancomycin) and degradability of the m-MSC in Tris-HCl solution (pH=7.4). In addition, addition of m-MS facilitated the apatite-mineralization of m-MSC in simulated body fluid (SBF), indicating good bioactivity. For cell cultural experiments, the results revealed that the m-MSC promoted the cells adhesion and proliferation, and improved the alkaline phosphatase (ALP) activity of MC3T3-E1 cells, revealing good cytocompatibility. It could be suggested that the m-MSC might be promising cements biomaterials for bone tissue regeneration.

Combination of simvastatin, calcium silicate/gypsum, and gelatin and bone regeneration in rabbit calvarial defects.

The present study was performed to determine whether simvastatin improves bone regeneration when combined with calcium silicate/gypsum and gelatin (CS-GEL). The surface morphology was determined using field-emission scanning electron microscopy (FSEM). Degradation in vitro was evaluated by monitoring the weight change of the composites soaked in phosphate buffered saline (PBS). Drug release was evaluated using high-performance liquid chromatography (HPLC). Cytotoxicity testing was performed to assess the biocompatibility of composites. Four 5 mm-diameter bone defects were created in rabbit calvaria. Three sites were filled with CS-GEL, 0.5 mg simvastatin-loaded CS-GEL (SIM-0.5) and 1.0 mg simvastatin-loaded CS-GEL (SIM-1.0), respectively, and the fourth was left empty as the control group. Micro-computed tomography (micro-CT) and histological analysis were carried out at 4 and 12 weeks postoperatively. The composites all exhibited three-dimensional structures and showed the residue with nearly 80% after 4 weeks of immersion. Drug release was explosive on the first day and then the release rate remained stable. The composites did not induce any cytotoxicity. The results in vivo demonstrated that the new bone formation and the expressions of BMP-2, OC and type I collagen were improved in the simvastatin-loaded CS-GEL group. It was concluded that the simvastatin-loaded CS-GEL may improve bone regeneration.

[Changes in plasma pharmacokinetics and urinary excretion characteristics before and after combined administration of Ephedrae Herba-Gypsum Fibrosum].

In this study, UPLC-MS/MS was adopted to determine the contents of five ephedrine alkaloids (Norephedrine, Norpseudoephedrine, Ephedrine, Pseudoephedrine, Methylephedrine) in plasma and urine in rats after the combined administration of Ephedrae Herba-Gypsum Fibrosum and calculate relevant pharmacokinetic parameters, in order to discuss the effect of the combined administration of Ephedrae Herba-Gypsum Fibrosum on plasma pharmacokinetics and urinary excretion characteristics. According to the results, after being combined with Gypsum, the five ephedrine alkaloids showed similar pharmacokinetic changes, such as shortened t(max), accelerated absorption rate, but reduced AUC(0-t) and V(z)/F, which may be related to the increase in urine excretion. Besides, Gypsum was added to enhance C(max) of Pseudoephedrine and prolong MRT(0-t) of Methylephedrine, so as to enhance the anti-asthmatic effect of Ephedrae Herba and resist the toxic effect of Norephedrine and Ephedrine. This study proved the scientific compatibility of Ephedrae Herba-Gypsum Fibrosum and provided a reference for studies on the prescription compatibility regularity and relevant practices.

Bone regeneration in sinus augmentation procedures with calcium sulphate. Microstructure and microanalytical investigations.

BACKGROUND: The aim of this study was a histological and ultrastructural evaluation of the bone formed in human sinus augmentation procedures with calcium sulphate (CaS). METHODS: Scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDS) were used to evaluate the relationship between CaS and newly-formed bone, while birefringence was used to evaluate the bone structure around the CaS particles by polarized light microscopy. Unstained sections were studied with an Axiovert 200 M using the fluorescence in reflected UV light to evaluate the interface between CaS and newly-formed bone. Twenty specimens retrieved from the sinus after a healing period of six months were studied. RESULTS: EDS analysis of six specimens showed that little sulphur remained and residual particles appeared to have transformed to calcium phosphate. Under polarized light a few biomaterial remnants were present in some areas and covered by mature bone. The relationship between residual particles and bone due to the different photon emission under UV light stimulation was observed under fluorescence microscopy. CONCLUSIONS: The present results confirm the high biocompatibility and rapid resorption rate of CaS. The mechanism of transformation of CaS to calcium phosphate, already demonstrated in animal studies, has been confirmed in the present human study.

In vitro and in vivo evaluation of the effects of demineralized bone matrix or calcium sulfate addition to polycaprolactone-bioglass composites.

The objective of this study was to improve the efficacy of polycaprolactone/bioglass (PCL/BG) bone substitute using demineralized bone matrix (DBM) or calcium sulfate (CS) as a third component. Composite discs involving either DBM or CS were prepared by compression moulding. Bioactivity of discs was evaluated by energy dispersive X-ray spectroscopy (ESCA) and scanning electron microscopy (SEM) following simulated body fluid incubation. The closest Calcium/Phosphate ratio to that of hydroxyl carbonate apatite crystals was observed for PCL/ BG/DBM group (1.53) after 15 day incubation. Addition of fillers increased microhardness and compressive modulus of discs. However, after 4 and 6-week PBS incubations, PCL/BG/DBM discs showed significant decrease in modulus (from 266.23 to 54.04 and 33.45 MPa, respectively) in parallel with its highest water uptakes (36.3 and 34.7%). Discs preserved their integrity with only considerable weight loss (7.5-14.5%) in PCL/BG/DBM group. In vitro cytotoxicity tests showed that all discs were biocompatible.

Calcium sulfate and PTFE nonporous barrier for regeneration of experimental bone defects

No disponible

The aim of the study was to evaluate the possibility to obtain guided bone regeneration with two types of physical barriers (calcium sulfate and PTFE nonporous barrier) in surgical defects created in rat parietal bones. In the right parietal bone the calcium sulfate barrier filled out the whole defect and in the left parietal bone the barrier of PTFE was positioned in the floor and externally to the surgical defect. After 7, 14, 30 and 45 days four animals were sacrificedin each period and the bone containing the defects were submitted to the microscopic analysis. The results ofthe study revealed that the PTFE barrier was more effective for bone regeneration in shallow transcortical defects compared to the calcium sulfate. However, additional experiments are necessary to determine if calcium sulfate would be successful in other bone defects types or the use of the material under another consistence could complement the results obtained in this work

Daptomycin eluted from calcium sulfate appears effective against Staphylococcus.

The emergence of resistant strains of Gram-positive organisms in osteomyelitis creates treatment challenges. Daptomycin is an antibiotic that shows promise for treating some resistant strains of Gram-positive infections; however, it has not been widely used clinically for the treatment of osteomyelitis. We determined whether daptomycin eluted from calcium sulfate-a local delivery vehicle used for the treatment of osteomyelitis-retained activity against Gram-positive bacteria. Daptomycin was mixed with calcium sulfate hemihydrate, with both laboratory powder and a commercial kit, to form a hardened pellet. Daptomycin was eluted from calcium sulfate and retained its ability to inhibit bacterial growth of Staphylococcus aureus and Staphylococcus epidermidis for eluates gathered up to 28 days. Our preliminary data demonstrates sterilized pellets with daptomycin retained their ability to inhibit bacterial growth of certain strains of Gram-positive organisms.

Comparative performance of three ceramic bone graft substitutes.

BACKGROUND CONTEXT: A number of different synthetic calcium-based bone graft substitutes (BGS) are currently available for clinical use. There is, however, a lack of comparative performance data regarding the relative efficacy of these materials when placed in an osseous defect site. PURPOSE: To compare the rate, quality, and extent of osseous healing in a standard rabbit defect model for three commercially available BGS materials by measuring early bone formation and completion of defect healing and to identify whether rapid scaffold resorption stimulated or impaired bone healing. STUDY DESIGN: Osteochondral defects, 4.8 mm in diameter and 6 to 7 mm deep, were made through the articular surface into the subchondral bone of the femoral condyle of New Zealand White rabbits and filled with cylindrical pellets of one of three commercially available BGS materials: dense calcium sulfate (DCaS), ultraporous tricalcium phosphate (beta-TCP), and porous silicated calcium phosphate (Si-CaP). The repair response was examined at 1, 3, 6, and 12 weeks after surgery (n=4 per BGS per time point). METHOD: Qualitative histological and quantitative histomorphometric (% new bone, % bone graft substitute, capillary index, and mineral apposition rates) analysis. RESULTS: Rapid resorption of D-CaS, primarily through dissolution, elicited a mild inflammatory response that left the defect site empty before significant quantities of new bone were formed. Both beta-TCP and Si-CaP scaffolds supported early bone apposition (<1 week). However, beta-TCP degradation products subsequently provoked an inflammatory response that impaired and reversed bone apposition within the defect site. The Si-CaP scaffolds appeared to be more stable and supported further bone apposition, with the development of an adaptive bone-scaffold composite; cell-mediated resorption of scaffold and new bone were observed in response to local load and contributed to the production of a functional repair within the defect site. CONCLUSIONS: Rapid BGS resorption impaired the regenerative ability of local bone via three pathways: 1) insufficient persistence of an osteoconductive scaffold to encourage bone apposition, 2) destabilization of early bony apposition through scaffold disintegration, and 3) stimulation of an inflammatory response by elevated levels of particulate degradation products. This had a significant impact on the ultimate rate of healing. D-CaS did not stimulate early bone apposition, but bone repair was more advanced in D-CaS-treated defects at 12 weeks as compared with those treated with beta-TCP, despite the beta-TCP supporting direct bone apposition at 1 week. Si-CaP appeared to provide a more stable osteoconductive scaffold, which supported faster angiogenesis and bone apposition throughout the defect site, with the development of a functionally adaptive trabecular structure through resorption/remodelling of both scaffold and new bone. There was rapid formation of mineralized tissue at week 1 within the center of the defect and complete infiltration with dense, predominantly mature bone by weeks 3 to 6. The progressive remodeling of bone ingrowth and scaffold to reflect the distribution of local host tissue, combined with histological evidence of targeted osteoclastic resorption of both scaffold and bone, suggest that bone adaptation within the scaffold could be in response to Wolff's law. Although this model may not directly translate to a spinal fusion model and the products may vary according to the environment, these results suggest that, in patients in whom bone regeneration may be compromised, the degradation observed with some resorbable bone grafts may contribute to the decoupling of bone regeneration and resorbtion within the graft site, which may ultimately lead to incomplete bone repair.

A rat osteoporotic spine model for the evaluation of bioresorbable bone cements.

BACKGROUND CONTEXT: As the aging population increases, the rising prevalence of osteoporosis-related spine fractures will have a dramatic impact on health care. At present, mainstay treatment relies on systemic medications intended to prevent diminishing bone mineral density (BMD) and bone mass. However, an adjunctive treatment strategy is to target specific areas of the skeletal system that are prone to clinically significant osteoporotic fractures. We term this strategy the "local treatment of osteoporosis" or osteoplasty. Potential use of osteoplasty involves the percutaneous injection of bioresorbable and bioactive bone cements into bones at risk of sustaining osteoporotic fractures. Calcium sulfate (CaSO(4)) is among the candidate bioresorbable bone cements with the material attributes desirable for potential application with osteoplasty, yet previous studies on the osteoconductive properties of CaSO(4) have been limited to animal models exhibiting normal bone biology and architecture. However, osteoporotic bone physiology may potentially interfere with the material properties of common osteoconductive biomaterials, such as that of CaSO(4). To further test this hypothesis, a suitable animal model is needed to evaluate the in vivo behavior of potential biomaterials in osteoporotic bone. PURPOSE: The purpose of this study is to evaluate the caudal (proximal tail) rat vertebral body as an appropriate system for the in vivo evaluation of bone cement performance in the osteoporotic spine. STUDY DESIGN: (1) Micro-computed tomography radiomorphometry study and (2) biomechanical vertebral compression analysis. METHODS: Female Sprague Dawley rats were ovarectomized (OVX) at age 8 weeks and subsequently maintained on a low-calcium diet for 3 months. Normal nonovarectomized female rats (NL) of similar age and size were maintained on regular rodent feed. Micro-CT analysis was performed on both the lumbar and caudal vertebrae (levels 5-7) of both groups. The following bone radiomorphometric parameters were determined: bone mineral density (BMD), average cortical thickness (ACT), average trabecular thickness (TbTh), and average trabecular spacing (TbSp). Strength and stiffness of both NL and OVX vertebral bodies were assessed under axial compression at 0.1 mm/s, whereas displacement (mm) and force (N) were measured at 10 Hz until completion to failure. After the implantation of an injectable form of CaSO(4) bone cement into caudal vertebrae, radiomorphometric analysis of cement volume, based on its unique CT absorption profile, was performed over the 8-week time period, as well as the subsequent bone response of both NL and OVX caudal vertebrae to CaSO4. RESULTS: OVX caudal vertebrae showed an 18% decrease in BMD, a 28% decrease in diaphyseal ACT, a 55% decrease in TbTh, and a 2.4-fold increase in TbSp compared with NL (p<.05). Additionally, lumbar vertebrae exhibited a 21% decrease in BMD, a 24% decrease in anterior body ACT, a 48% decrease in TbTh, and a 4.7-fold increase in TbSp (p<.05). Failure testing of OVX caudal vertebral bodies revealed a 29% decrease in strength and a 60% decrease in stiffness compared with NL (p<.01). After implantation into OVX caudal vertebrae, CaSO(4) cement exhibited a 50% decrease in initial cement volume at 2 weeks and complete resorption by 4 weeks, whereas CaSO(4) injected into NL vertebrae exhibited a 79% decrease in initial cement volume at 4 weeks, trace amounts at 6 weeks, and complete resorption by 8 weeks. At 8 weeks, NL vertebrae implanted with CaSO(4) cement exhibited increased cortical bone thickness compared with NL sham vertebrae. This CaSO(4) cement-mediated bone augmentation was altered in osteoporotic vertebrae that exhibited porous irregular cortical bone not noted in cement-treated NL vertebrae or OVX sham vertebrae. CONCLUSIONS: Future investigation of potential biomaterials intended for the local treatment of osteoporosis will require their study within an appropriate osteoporosis animal model. The OVX rat caudal spine exhibits pathologic bone changes consistent with the osteoporosis phenotype, including decreased BMD, diminished trabecular network density, cortical thinning, and decreased mechanical strength. These derangements in bone microarchitecture and physiology may contribute toward the accelerated cement resorption and altered bone response to CaSO4 observed in this study. Important advantages of the OVX rat caudal spine are the rapid and minimally invasive surgical exposure of the vertebral body and the ease of cement injection. We propose that the OVX rat caudal spine represents a valuable and cost-effective tool in the armamentarium of investigators evaluating biomaterials designed for implantation into the osteoporotic spine.

Increased bone formation using calcium sulfate-calcium phosphate composite graft.

Calcium phosphates (CaPO4) and faster-resorbing calcium sulfate (CaSO4) are successfully employed as synthetic bone grafts for treatment of contained defects. We used a canine critical-sized bone defect model to study an injectable CaSO4/CaPO4 composite graft that incorporated a matrix of CaSO4 and dicalcium phosphate dihydrate into which beta-tricalcium phosphate granules were distributed. The area fraction, ultimate compressive stress, and elastic modulus of restored bone and the relative rates of material resorption were compared between the CaSO4/CaPO4 composite graft and pure CaSO4 pellets and to normal canine bone. The area fraction of bone in stained sections and the ultimate compressive stress of the regenerated bone were greater using the CaSO4/CaPO4 composite graft compared to pure CaSO4 pellets after 13 and 26 weeks and were greater than normal bone. The elastic modulus of restored bone in defects treated with CaSO4/CaPO4 composite graft was greater than in defects treated with CaSO4 pellets after 26 weeks, but similar to specimens of normal bone. A small amount of CaSO4/CaPO4 composite graft and no CaSO4 pellets remained after 13 or 26 weeks. This novel CaSO4/CaPO4 composite holds promise for clinical applications where a strong, injectable, slower-resorbing, and biocompatible bone graft substitute would be advantageous.

Small bowel absorption of magnesium and calcium sulphate from a natural mineral water in subjects with ileostomy.

BACKGROUND: In many developed countries, magnesium and calcium intakes do not reach recommendations for a large part of the population. Mineral water may be a useful alternative source of dietary minerals, especially in groups of people at risk for developing deficiency due to low intakes. AIM: To assess if the addition of a natural and mineral-rich water increased small bowel mineral absorption in people with ileostomy. METHODS: A controlled randomised crossover study with two periods of two days each and a minimum 5 days of washout was performed in six ileostomy subjects. Apparent mineral absorption from 0.5 L of natural mineral water with either a high or a low mineral content consumed in the fasting state was compared. The daily addition of minerals corresponded to 2.3mmol magnesium, 6.9 mmol calcium and 7.7mmol sulphate. Ileostomy effluents were sampled and analysed for magnesium, calcium and total sulphate. RESULTS: When compared with the control, the median absorbed amount of magnesium increased from 0.8 (0-1.34) mmol/d to 1.2 (0.8-1.9) mmol/d,which corresponded to a 30% increase (P = 0.028). Median amount of calcium absorbed increased from 8.3 (6.7-13.6) mmol/d to 14.8 (8.3-20.4) mmol/d, i. e. a 45% increase (P = 0.027). The sulphate absorption increased from 1.9 (1.3-2.2) mmol/d to 5.1 (4.2-6.8) mmol/d,which corresponded to 197 % increase (P = 0.028). CONCLUSIONS: The mineral-rich water increased absorption of both magnesium and calcium and can therefore be used as an additional source of minerals. However, consumption with meals may be preferred.

Uptake of iron by a vegetable; kaiware daikon (Japanese radish sprout).

Uptake of iron and several other minerals into kaiware daikon (Japanese radish sprout) was investigated by changing their supplementary conditions. The supplementation of calcium sulfate (0.1% (w/v), 230 ppm as calcium ion) and iron (III) chloride (0.1% (w/v), 200 ppm as iron ion) in hydroponics promoted the growth of kaiware daikon ca. 1.0-1.5 cm longer than the control group of no additions, while magnesium sulfate (0.1% (w/ v), 100 ppm as magnesium ion) did not affect the length of sprouts so much, but caused their leaves to grow a little wider. Mineral contents in the sprout were maximal when it was added, at ca. 0.1% (w/v), to the hydroponic solution. In tests regarding iron (II) ion supplementation, the color of the kaiware daikon seeds changed from brownish to black and the sprout did not grow well. In contrast, the iron (III) ion did not affect their color and promoted growth of the sprout. When the seeds were soaked in an iron (II) sulfate (75 ppm) or an ammonium iron (III) citrate (180 ppm) solution for 24 h prior to germination, the resulting kaiware daikon contained a few times higher the amount of iron than commercially available ones.

The effect of sampling method on the elution of tobramycin from calcium sulfate.

Release rate is a critical property of all drug delivery vehicles, including antibiotic-laden bioerodibles. In vitro elution studies, used to evaluate release rates, use different sampling methods, including changing the entire amount of buffer and partial exchanges each day. Two groups of 10% calcium sulfate-tobramycin pellets were eluted in 20 mL of buffer for 30 days. Group I had 5 mL of buffer withdrawn and replaced daily whereas Group II had the entire 20 mL of buffer changed daily. The results show that the complete exchange method caused a significantly faster release of antibiotic than the partial exchange method. In the complete exchange group, greater than 50% of the tobramycin was released by 24 hours, whereas in the partial exchange group, 50% of the antibiotic was not released until Day 6. The two methods of sampling used to evaluate this bioerodible material provide data that allow the user to anticipate how the material will function in relatively inert and volatile environments. The method used to sample the elution of antibiotics from bioerodible materials affects the amount of antibiotic eluted. It therefore is important to know the method of sampling when making a decision to use a bioerodible material to deliver antibiotics locally.

Efeito da expansäo do gesso na montagem dos modelos no articulador / Effect of gypsum expansion on the setting-up of the models in the articulador

Os autores estudaram as alteraçöes da posiçäo do pino incisal, esferas condilares e espaço inter-rebordos, por força da expansäo de presa do gesso utilizado na moldagem dos modelos no articulador T. T. Nesta pesquisa, foram realizados oito experimentos diferentes, sendo que as variáveis submetidas ao estudo foram: montagem alternada e simultânea; modelo seco e úmido; corpo de fixaçäo em forma de taça e de cilindro. Com base nos resultados encontrados, concluiu-se que: houve afastamento do pino incisal em todos os experimentos; verificou-se o afastamento das esferas condilares apenas em alguns dos experimentos; näo houve alteraçäo no espaço inter-rebordos; os modelos hidratados provocaram maiores alteraçöes do que os modelos secos; as formas do corpo de fixaçäo influíram pouco na magnitude das alteraçöes

Stimulation of bone healing by transforming growth factor-beta 1 released from polymeric or ceramic implants.

The ability to transforming growth factor-beta 1 (TGF-beta 1), to stimulate bone healing was evaluated in a rat critical calvarial defect model. Both a low dose and a high dose of TGF-beta 1 were incorporated into two different types of implants: one made from a composite of poly(lactic-co-glycolic acid) (PLPG) (50:50) and demineralized bone matrix (DBM), and the other from calcium sulfate (CaSO 4). Scanning electron microscopy showed that the CaSO 4 implants were more porous than the PLPG/DBM samples. Both types of implants released biologically active TGF-beta 1 for over 300 h in vitro. The samples were implanted in a 9-mm diameter rat calvarial defect for 6 weeks along with contralateral control implants containing no TGF-beta 1. Microradiography and histological analysis were used to assess the bone healing in the defects. Microradiography revealed that the greatest amount of calcified bone (67.5%) was present in in the CaSO 4 implants containing a high dose of TGF-beta 1 while minimal new bone formation occurred in the PLPG/DBM implants. Histologically, the PLPG/DBM implants exhibited an inflammatory response with little mineralization or bone formation. The defects containing the PLPG/DBM implants consisted of a connective tissue stroma with large void spaces. Giant cells and numerous polymorphonuclear leukocytes were present throughout the implants. In contrast, the CaSO 4 implants had only a few inflammatory cells and the presence of mineralization and true bone was a more consistent feature. These preliminary studies show that TGF-beta 1 is capable of inducing new bone formation. Furthermore, the materials used to deliver the growth factor can play a significant role in the bone healing process.

Antibiotic release from impregnated pellets and beads.

Antibiotic impregnated beads are being used increasingly in the initial treatment of open fracture wounds, producing high antibiotic levels locally, over the first few days. Pellets were prepared to assess the release of the following antibiotics: benzylpenicillin, flucloxacillin, amoxycillin, amoxycillin-clavulanate (Co-Amoxiclav), ciprofloxacin, imipenem, or gentamicin; the carrier material was either polymethylmethacrylate (PMMA) or plaster of Paris (PoP). Elution of antibiotic over 72 hours from the pellets in vitro was determined using an agar-diffusion microbiologic assay. The initial rapid release of antibiotic lasted 12-24 hours, with release from PoP pellets at least four-fold greater than that from corresponding PMMA pellets. A second phase consisted of a sustained but gradually diminishing elution. The release of antibiotics from PoP pellets compared favorably with that from the PMMA beads currently used. We conclude that PoP pellets may be particularly suitable for short-term applications such as infection prophylaxis in open fractures.

Diffusion of fibroblast growth factor from a plaster of Paris carrier.

Fibroblast growth factor (FGF) is a polypeptide that has been shown to have a stimulatory effect on osseous tissues in vitro. This study characterized the release of FGF from plaster of Paris (PLP) and measured the dissolution of PLP in various solutions with the aim of developing a reliable carrier system for the release of FGF in vivo. The study consisted of five experiments: (I) FGF diffusion from PLP pellets, (II) FGF diffusion from PLP discs, (III) PLP dissolution in saline, (IV) PLP dissolution in serum, and (V) FGF adsorption by commercially pure titanium. FGF was observed to be released at a rate directly proportional to the rate of dissolution of the PLP carrier, suggesting that either the FGF binds to the PLP; or, alternatively, the FGF may be entrapped by the PLP. Dissolution rate, and thus release rate, could be varied by varying the mass of the carrier. Greater diffusion of FGF was observed in larger, more slowly dissolving PLP carriers. Dissolution of PLP was observed to be slower in serum than in saline, apparently due to stabilization by factors in the serum but not due to a concentration gradient effect. Titanium coupons did not adsorb significant amounts of FGF. These results indicate that PLP, which has been shown in the past neither to aggravate inflammatory response nor to interfere with bone ingrowth, may serve as delivery vehicle for FGF to osseous tissues in vivo.

Distribution of selenium-binding proteins in different tissues of the mouse and rat.

The distribution of selenium-binding proteins in specific tissues of mice and rats was examined by electrophoretic and immunologic techniques. Major selenium-binding proteins of 58K and 26K daltons were present in whole blood, erythrocytes, liver, duodenum, mammary tumors, kidney, testis, ovary and pancreas by electrophoretic analysis. By Western immunoblot it was evident that the 58K protein in plasma did not cross-react with the cellular 58 K protein. Furthermore, muscle did not exhibit any immunologically recognizable 58K protein. The antibody raised against mouse liver 58K recognized a similar protein in rat liver, kidney and testis. The 58K selenium-binding protein appeared to be concentrated in tissues enriched in G1 and the effect of hydroxyurea on selenium-binding protein levels suggested the 58K selenium-binding protein appeared to be made predominantly during the G1 phase of the cell cycle. Evidence is also presented that whole blood contains selenium bound to hemoglobin which supports prior evidence by other investigators. These results further support the evidence for tissue selenium-binding proteins other than glutathione peroxidase and document the immunological specificity and reactivity of a new antibody against a selenium-binding protein.