Biomedical Ti-Nb-Zr Foams Prepared by Means of Thermal Dealloying Process and Electrochemical Modification.

The paper presents results of preparation and modification of Ti20Nb5Zr foams by a thermal dealloying method followed by electrochemical modification. The first step of this study was the preparation of Ti20Nb5Zr30Mg nanopowder using mechanical alloying (MA). The second was forming green compacts by cold pressing and then sintering with magnesium dealloyed from the structure, which resulted in pores formation. The next step was surface modification by electrochemical etching and silver nanoparticle deposition. Porosity, morphology, mechanical properties as well as biocompatibility and antibacterial behavior were investigated. Titanium foam porosity up to approximately 60% and wide pore size distribution were successfully prepared. The new materials have shown positive behavior in the MTT assay as well as antibacterial properties. These results confirmed great potential for thermal dealloying in preparation of porous structures.

Ultrafine-Grained Ti-31Mo-Type Composites with HA and Ag, Ta2O5 or CeO2 Addition for Implant Applications.

Ultrafine-grained Ti31Mo alloy and Ti31Mo5HA, Ti31Mo5HA-Ag (or Ta2O5, CeO2) composites with a grain size of approximately 2 µm were produced by the application of mechanical alloying and powder metallurgy. Additionally, the surface of the Ti31Mo alloy was modified. In the first stage, the specimens were immersed in 5M NaOH for 24 h at 60 °C. In the second stage, hydroxyapatite (HA) was deposited on the sample surface. The cathodic deposition at -5 V vs. open circuit potential (OCP) in the electrolyte containing 0.25M CaNa2-EDTA (di-calcium ethylenediaminetetraacetic acid), 0.25M K2HPO4 in 1M NaOH at 120 °C for 2 h was applied. The bulk Ti31Mo alloy is a single ß-type phase. In the alkali-modified surface titanium oxide, Ti3O is formed. After hydrothermal treatment, the surface layer mostly consists of the Ca10(PO4)6(OH)2 (81.23%) with about 19% content of CaHPO4·2H2O. Using optical profiler, roughness 2D surface topography parameters were estimated. The in vitro cytocompatibility of synthesized materials was studied. The cell lines of normal human osteoblasts (NHost) and human periodontal ligament fibroblasts (HPdLF) was conducted in the presence of tested biomaterials. Ultrafine-grained Ti-based composites altered with HA and Ag, Ta2O5 or CeO2 have superior biocompatibility than the microcrystalline Ti metal. NHost and HPdLF cells in the contact with the synthesized biomaterial showed stable proliferation activity. Biocompatibility tests carried out indicate that the ultrafine-grained Ti31Mo5HA composites with Ag, Ta2O5, or CeO2 could be a good candidate for implant applications.

Composite and Surface Functionalization of Ultrafine-Grained Ti23Zr25Nb Alloy for Medical Applications.

In this study, the ultrafine-grained Ti23Zr25Nb-based composites with 45S5 Bioglass and Ag, Cu, or Zn additions were produced by application of the mechanical alloying technique. Additionally, the base Ti23Zr25Nb alloy was electrochemically modified in the two stages of processing: electrochemical etching in the solution of H3PO4 and HF followed by electrochemical deposition in Ca(NO3)2, (NH4)2HPO4, and HCl. The in vitro cytocompatibility studies were also done with comparison to the commercially pure titanium. The established cell lines of Normal Human Osteoblasts (NHost, CC-2538) and Human Periodontal Ligament Fibroblasts (HPdLF, CC-7049) were used. The culture was conducted among the tested materials. Ultrafine-grained titanium-based composites modified with 45S5 Bioglass and Ag, Cu, or Zn metals have higher biocompatibility than the reference material in the form of a microcrystalline Ti. Proliferation activity was at a stable level with contact with studied materials. In vitro evaluation research showed that the ultrafine-grained Ti23Zr25Nb-based composites with 45S5 Bioglass and Ag, Cu, or Zn additions, with a Young modulus below 50 GPa, can be further used in the biomedical field.

Skeletal system evaluation using RTG absorptiometry in women with bone mineral density disorders.

INTRODUCTION: Osteoporosis is a metabolic disease of the skeleton, characterized by decreased bone mass and abnormal microarchitecture, which contribute to an increased risk of fractures. Currently, over 200 million people are struggling with it worldwide, and therefore it is considered a social disease. Many of the affected require constant help from others, which is often associated with an increase in the cost of health care. AIM OF THE STUDY: To analyze the role of prophylaxis in the improvement of bone mass density and the evaluation of various methods of treating bone mineral density (BMD) disorders in women. MATERIAL AND METHODS: The cohort study includes retrospective analysis of 105 patients documentation which were examined using the DXA densitometric method (Dual Energy X-Ray Absorptiometry) using LUNAR DPX equipment. The test results were given in g/cm2 and presented using a T-score (SD average result for peak bone mass in young healthy women) and Z-score (SD mean score for the same group of women). The study included only women with BMD disorders. The analysis, the evaluation and statistical analysis are presented in Microsoft Excel, 2010. The bioethical commission agreement was not needed in this case. RESULTS: The largest group (55 surveyed patients) - 52.4%, were women suffering from osteoporosis. Decreased BMD was less common in patients living in urban areas. Among patients who suffered from osteoporosis, severe bone pain in the whole body occurred most often. CONCLUSIONS: In Polish society, the incidence of osteoporosis is increasing. The main reason is the aging of the population. The number of fractures associated with this ailment increases after the age of 60. Analyzing the methods of treatment and assessing their effects on the reduced density of bone mass shows that the process of bone tissue disorders has deepened in non-treated patients.

Response of inflammatory cells to biodegradable ultra-fine grained Mg-based composites.

Ultra-fine grained biodegradable Mg-based Mg1Zn1Mn0.3 Zr - HA and Mg4Y5.5Dy0.5 Zr - 45S5 Bioglass composites have shown great medical potential. Two types of these Mg-based biomaterials subjected to different treatments were tested and as shown earlier they are biocompatible. The aim of the study is to determine how much culture media incubated with these ultra-fine trained Mg-based composites can cause inflammatory reactions and /or periodontal cell death. The incubation of composites in the medium releases metal ions into the solution. It can be assumed that this process is permanent and also occurs in the human body. The results have shown that the effect of proinflammatory IL-6 and TNF- cytokines results in the strongest production of the acute phase proteins in the first day on the Mg1Zn1Mn0.3 Zr-5 wt.% HA-1 wt. % Ag HF-treated biocomposite after immersion for 2 h in 40 % HF and then the fastest decrease in these processes on the third day. In turn, the inflammatory process induced on the Mg1Zn1Mn0.3 Zr-5 wt.% HA-1 wt. % Ag biomaterial, in BAX / BCL ratio assessment, is the strongest on the third day and maintains a significantly high level on the following day, which, at the same time, confirms its persistence and development. In addition, these results confirm the successively generated necrotic processes. Ions can induce inflammatory reactions, which in the case of the implant may take a long time, which results in the loss of the implant. Even if the material is biocompatible in rapid in-vitro tests, it can induce inflammation in the body after some time due to the release of ions. Not every treatment improves the material's properties in terms of subsequent safety.

Formation and Properties of Biomedical Ti-Ta Foams Prepared from Nanoprecursors by Thermal Dealloying Process.

The paper presents a promising method of preparation of titanium-based foams by the thermal dealloying method. The first step of this study was the Ti-Ta-Mg based nanopowder preparation using the mechanical alloying (MA) process performed at room temperature. The next step was forming the green compacts by cold pressing and then sintering with magnesium dealloying from the titanium-based alloy structure. The mechanism of the porous structure formation was based on the removal of magnesium from the titanium alloy at a temperature higher than the boiling point of magnesium (1090 °C). The influence of the Mg content on the formation of the porous Ti-30Ta foam has been investigated. The sintering stage was performed in vacuum. During the dealloying process, the magnesium atoms diffuse from the middle to the surface of the sample and combine to form vapors and then evaporate leaving pores surrounded by the metallic scaffold. The porosity, the mechanical properties as well as biocompatibility have been investigated. The titanium-based foam of high porosity (up to 76%) and the pore size distribution from nano- to micro-scale have been successfully prepared. For the medical applications, the Ti-Ta metallic foams have shown a positive behavior in the MTT test. The as-shown results clearly exhibit a great potential for thermal dealloying in the preparation of porous structures.

Molecular analysis of biocompatibility of anodized titanium with deposited silver nanodendrites.

Titanium (>99.6% purity) and its anodically oxidized modifications, with and without deposited silver nanodendrites regarding its biocompatibility were evaluated. In human gingival fibroblasts and osteoblast cell lines grown on tested samples, the level of expression of genes encoding αV (ITGAV) and ß1 (ITGB1) integrin subunits also genes encoding focal adhesion (FAK) and extracellular-signal regulated (ERK) kinases was assessed. For this purpose, the qualitative and quantitative PCR technique was used. The expression of studied genes was dependent on the origin of cell lines and the type of evaluated material. The high expression of PBGD and ITGAV genes in fibroblasts grown on the surface of anodically modified titanium with deposited silver nanodendrites indicates potentially high biocompatibility of these samples for soft tissue cells. The high expression of the ITGB1 and ERK1 genes and the enhanced expression of the FAK gene in osteoblasts cells grown on the tested material was also observed. Summarizing, the nanocrystalline Ti modified with silver deposits showed higher biocompatibility in comparison with the conventional pure Ti samples.

Diagnostic methods for detection of bone metastases.

Skeletal metastases are severe complications in the course of cancer, and they indicate a worse prognosis. The use of modern imaging techniques allows rapid diagnosis of bone metastases. Properly selected diagnostic imaging (scintigraphy, positron emission tomography, whole body MRI) allows us to evaluate the number of metastatic foci in the skeletal system. Complementary imaging examinations (X-ray, computed tomography, magnetic resonance imaging) determine the extent of metastasis and its character: osteolytic, osteoblast, mixed). Hypercalcaemia is a symptom of low specificity for metastatic bone disease (a result of osteolysis); nevertheless, it is a significant complication in oncological treatment and worsens the prognosis of the patient. A biopsy is the final stage of the diagnostic process, which allows us to assess cell and tissue changes. Guided biopsies are performed under the control of musculoskeletal imaging methods (CT, MRI) and they are the most promising tools in bone metastases diagnosis. The development of guided biopsy techniques has led to the conclusion that they should be standard in diagnosing bone metastases. Liquid biopsy (LB) seems to be the most promising diagnostic method for detection of bone metastases. LB based on tumour-specific DNA mutation gives an opportunity for early detection and assessment of the molecular heterogeneity of the overall disease.

Nanoscale size effect in in situ titanium based composites with cell viability and cytocompatibility studies.

Novel in situ Metal Matrix Nanocomposite (MMNC) materials based on titanium and boron, revealed their new properties in the nanoscale range. In situ nanocomposites, obtained through mechanical alloying and traditional powder metallurgy compaction and sintering, show obvious differences to their microstructural analogue. A unique microstructure connected with good mechanical properties reliant on the processing conditions favour the nanoscale range of results of the Ti-TiB in situ MMNC example. The data summarised in this work, support and extend the knowledge boundaries of the nanoscale size effect that influence not only the mechanical properties but also the studies on the cell viability and cytocompatibility. Prepared in the same bulk, in situ MMNC, based on titanium and boron, could be considered as a possible candidate for dental implants and other medical applications. The observed relations and research conclusions are transferable to the in situ MMNC material group. Aside from all the discussed relations, the increasing share of these composites in the ever-growing material markets, heavily depends on the attractiveness and a possible wider application of these composites as well as their operational simplicity presented in this work.

In vitro biocompatibility of titanium after plasma surface alloying with boron.

Recently, the effect of different sizes of precursor powders during surface plasma alloying modification on the properties of titanium surface was studied. In this work we show in vitro test results of the titanium (α-Ti) after plasma surface alloying with boron (B). Ti-B nanopowders with 2 and 10wt% B were deposited onto microcrystalline Ti substrate. The in vitro cytocompatibility of these biomaterials was evaluated and compared with a conventional microcrystalline Ti. During the studies, established cell line of human gingival fibroblasts and osteoblasts were cultured in the presence of tested materials, and its survival rate and proliferation activity were examined. For this purpose, MTT assay, flow cytometric and fluorescent microscopic evaluation were made. Biocompatibility tests carried out indicate that the Ti after plasma surface alloying with B could be a possible candidate for dental implants and other medicinal applications. Plasma alloying is a promising method for improving the properties of titanium, thus increasing the field of its applications.

Knowledge assessment of women living in the Wielkopolska region concerning risk factors for cervical cancer.

INTRODUCTION: Cervical cancer (CC) is a malignant tumor which for many years has been a serious epidemiological problem in Poland. This issue is important because CC is the second most common type of malignant tumor, after breast cancer, and the second most common cause of death among women. The aim of this study was to assess the knowledge and awareness of women living in the Wielkopolska region (Gniezno district) of risk factors for cervical cancer. MATERIAL AND METHODS: The study used the diagnostic poll method, based on a previously developed survey questionnaire. The study was carried out between March and April 2013. The study group consisted of 100 women, involving schoolgirls from the secondary school in Gniezno (Group I), workers (doctors, nurses and midwives) of two outpatient clinics in the Gniezno district (Group II) and patients of the same clinics (Group III). RESULTS: According to the respondents, the main cause of CC is human papillomavirus (Group II - 36%) and genetic predisposition (Group III - 35%). It is alarming that 26% of women did not know the risk factors for CC. CONCLUSIONS: It is necessary to improve health education, especially concerning the main factors affecting the development of CC, in order to reduce the morbidity and mortality rates related to this cancer.

Development of ß Type Ti23Mo-45S5 Bioglass Nanocomposites for Dental Applications.

Titanium ß-type alloys attract attention as biomaterials for dental applications. The aim of this work was the synthesis of nanostructured ß type Ti23Mo-x wt % 45S5 Bioglass (x = 0, 3 and 10) composites by mechanical alloying and powder metallurgy methods and their characterization. The crystallization of the amorphous material upon annealing led to the formation of a nanostructured ß type Ti23Mo alloy with a grain size of approximately 40 nm. With the increase of the 45S5 Bioglass contents in Ti23Mo, nanocomposite increase of the α-phase is noticeable. The electrochemical treatment in phosphoric acid electrolyte resulted in a porous surface, followed by bioactive ceramic Ca-P deposition. Corrosion resistance potentiodynamic testing in Ringer solution at 37 °C showed a positive effect of porosity and Ca-P deposition on nanostructured Ti23Mo 3 wt % 45S5 Bioglass nanocomposite. The contact angles of glycerol on the nanostructured Ti23Mo alloy were determined and show visible decrease for bulk Ti23Mo 3 wt % 45S5 Bioglass and etched Ti23Mo 3 wt % 45S5 Bioglass nanocomposites. In vitro tests culture of normal human osteoblast cells showed very good cell proliferation, colonization, and multilayering. The present study demonstrated that porous Ti23Mo 3 wt % 45S5 Bioglass nanocomposite is a promising biomaterial for bone tissue engineering.

Effect of demographic factors on brachytherapy treatment results in patients with endometrial cancer 1995-2010.

INTRODUCTION: Approximately 1 in 20 female cancers in Europe is of the endometrium. Endometrial carcinoma is the most common gynaecologic cancer. Considering the fact that an upward tendency has recently been observed in morbidity due to this type of cancer, this is a serious medical problem. OBJECTIVE: The presented report describes the results of the analysis of selected demographic factors and their effect on the incidence of endometrial cancer. Analysis of the results of treatment of endometrial cancer during 1995-2010 was also an objective of the study. MATERIALS AND METHODS: Based on medical records obtained from the HDR Laboratory of Brachytherapy at the Gynaecological & Obstetrics Clinical Hospital, University of Medical Sciences in Poznan, the results of treatment of patients with endometrial cancer by brachytherapy were analyzed. The analysis covered a group of 400 patients. RESULTS: More than a half of the patients completed their education on the level of elementary or secondary school. Taking into consideration the weight of the patients, it appeared that most women had excessive body weight. Most frequently, concomitant hypertension was observed. Moreover, the age at menarche was 12 and 13. CONCLUSIONS: Demographic factors exert a significant effect on the incidence of endometrial cancer. 1. Overweight and obesity are important risk factors of endometrial cancer. 2. A strong relationship is observed between the occurrence of hypertension or diabetes, and the development of endometrial cancer. 3. Women who come from the rural environment and continue to live in this environment are more likely to contract endometrial cancer.