PBF-LB/M of Low-Alloyed Steels: Bainite-like Microstructures despite High Cooling Rates.

Laser-based powder bed fusion of metals (PBF-LB/M) is an emerging technology with enormous potential for the fabrication of highly complex products due to the layer-wise fabrication process. Low-alloyed steels have recently gained interest due to their wide potential range of applications. However, the correlation between the processing strategy and the material properties remains mostly unclear. The process-inherent high cooling rates support the assumption that a very fine martensitic microstructure is formed. Therefore, the microstructure formation was studied by means of scanning electron microscopy, hardness measurements, and an analysis of the tempering stability. It could be shown that additively manufactured Bainidur AM samples possess a bainitic microstructure despite the high process-specific cooling rates in PBF-LB/M. This bainitic microstructure is characterized by an excellent tempering stability up to temperatures as high as 600 °C. In contrast to this, additively manufactured and martensitic-hardened specimens are characterized by a higher initial hardness but a significantly reduced tempering stability. This shows the potential of manufacturing products from Bainidur AM for high-temperature applications without the necessity of a post-process heat treatment for achieving the desired bainitic microstructure.

New dual dye for vitreoretinal surgery with increased transparency.

OBJECTIVES: To develop a new dye formulation for vitreoretinal surgery, which shows increased transparency for better intraoperative handling with better parameters important for use. METHODS AND ANALYSIS: A new blue dye, DDG, was synthesised and tested for toxicity and staining. Diglycerol as new density-increasing additive was identified, and its toxicity and lack of influence of the staining with trypan blue (TB) on a collagen membrane as model for the epiretinal membrane was determined. Transparency of the dye solution was evaluated. RESULTS: DDG is as alternative to Brilliant Blue G (BBG), with good staining properties for interna limitans models, and a good safety profile. Diglycerol is a new non-toxic additive replacing PEG3350, with reduced viscosity and no reduction in staining, allowing the reduction of TB to achieve the same staining level of the collagen membrane by 40%, with greater transparency of the dye solution and reduced viscosity. Both factors should facilitate a safe removal during surgery. CONCLUSION: A new dye preparation with improved performance in comparison to marketed combinations of BBG and TB was developed. Its reduced TB concentration and viscosity with maintained density allow better tolerance and handling.

New stains for anterior capsule surgery.

PURPOSE: To investigate whether new dyes and dye combinations can give equivalent or better staining in anterior capsule surgery than existing dyes with a low degree of toxicity on relevant cells. SETTING: University laboratory of Jacobs University Bremen, Germany. DESIGN: Laboratory experimental study. METHODS: Pig eyes were collected post mortem. Cataract was induced by microwave irradiation. Access to the lens capsule was through open-sky surgery. Staining was performed and results were documented by photography. The toxicity of the dyes was evaluated in 3 different cell lines immediately after exposure and with a delay of 24 hours, with exposure in the dark or subsequent strong illumination. RESULTS: A new cyanine dye, BIP (2-[5-[3,3-dimethyl-1-(4-sulfobutyl)-1,3-dihydro-indol-2-ylidene]-penta-1,3-dienyl]-3,3-dimethyl-1-(4-sulfobutyl)-3H-indolium sodium), was found to lead to green staining, with reduced toxicity on corneal endothelial cells. Staining could be further enhanced by combining it with trypan blue. Methylene blue was very toxic, whereas its combination with trypan blue was much less toxic. CONCLUSIONS: With BIP alone or in combination with trypan blue, safe staining of the capsule can be achieved, resulting in a green color.

[Cold Plasma to Treat Therapy-Refractive Corneal Ulcers]. / Kaltplasma zur Behandlung therapierefraktärer Hornhautulzera.

BACKGROUND: The integrity of the ocular surface and the transparency of the cornea is crucial to obtain a good visual acuity - a requirement to actively participate in both social and professional environments. The homeostasis of the ocular surface is constantly endangered by microbes and by intrinsic factors with negative influence on wound healing. Furthermore, widespread use of contact lenses obtain a risk of corneal infection even resulting in corneal perforation and loss of the eye. Current therapies include topical and systemic antibiotics and antimycotics, often applied in an in-ward setting. PATIENTS/MATERIALS AND METHODS: Some microbes can be therapy-resistent or -refractory and therefore cause a deterioration of the clinical aspect. In this study, the effects of cold plasma treatment of corneal ulcers on reduction of microbial load in vitro, in tissue ex vivo and in a therapy-refractory ulcer. RESULTS: In vitro, ex vivo and in the patient microbial load could be reduced or the clinical findings improved. CONCLUSIONS: Plasma medicine and its disinfective properties could open a novel approach to treat microbial infections of the cornea. The can result in reduced treatment times, a faster demission of the patients and overall in a reduction of health care costs.

Toxicity and phototoxicity in human ARPE-19 retinal pigment epithelium cells of dyes commonly used in retinal surgery.

PURPOSE: To compare, for the first time, systematically the toxicity and phototoxicity of dyes and dye combinations used in vitreoretinal surgery. The dyes were trypan blue, brilliant blue G, trypan blue + brilliant blue G, indocyanine green, bromophenol blue, bromophenol blue + brilliant blue G, and acid violet 17, in clinically used concentrations. METHODS: Human ARPE retinal pigment epithelium cells were exposed to the dyes for 30 min. For phototoxicity, the cells were exposed for 15 min to high-intensity light from a light emitting diode source with an intensity similar to surgical conditions. Toxicity was assayed either directly after exposure to either dye alone or dye and light, or with a delay of 24 h. RESULTS: None of the dyes or their combinations was toxic when cells were exposed to them at ambient light. Acid violet led to a reduction viability by 90% already immediately after light exposure. Bromophenol blue and its combination with brilliant blue G showed strong phototoxicity (reduction of viability by 83%) when assayed with delay. Indocyanine green with different agents to adjust osmolarity (balanced salt solution, glucose, and mannitol) was not found to be toxic. CONCLUSION: The strong immediate phototoxicity of acid violet reflects its clinical toxicity. Bromophenol blue might also be disadvantageous for patient outcome because of its delayed phototoxicity. The other dyes (trypan blue, brilliant blue g, and indocyanine green) were not found to be toxic neither with exposure to ambient light nor after exposure to light of intensities used in surgery.

Argon Cold Plasma-A Novel Tool to Treat Therapy-resistant Corneal Infections.

PURPOSE: To test whether therapy-resistant corneal infections can be successfully treated with argon cold plasma to reduce or eliminate pathogen microorganisms without affecting corneal cell viability. DESIGN: First-in-human case series and experimental study. METHODS: Cold plasma effects on viability of primary human corneal limbal epithelial cells were studied using exposure times from 0.5 to 10 minutes (metabolic activity, oxidative stress, apoptosis). Disinfective potential of cold plasma was tested against common pathogens (Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli, Pseudomonas aeruginosa, and Candida albicans) on culture medium and evaluated by counting colony-forming units and optical density measurements, as well as against S aureus in a human cornea infection model. Additionally, in a first-in-human trial 4 patients with therapy-resistant corneal ulcers were treated to evaluate the clinical potential of cold plasma. RESULTS: Cells treated for 0.5-5 minutes completely recovered within 24 hours without changes in morphology; only 10-minute treatment impaired the cells permanently. No evident oxidative stress, apoptosis, or damage to the corneal structure could be found. All pathogens were susceptible to cold plasma treatments, with different levels of sensitivity. The condition of all 4 patients significantly improved after cold plasma treatment combined with antibiotic therapy. CONCLUSIONS: Our results indicate that argon cold plasma treatment reduces or eliminates common pathogens without impairing corneal epithelial cells in vitro, ex vivo, and in direct application on patients' eyes. We conclude that argon cold plasma therapy offers a potential supplement or alternative therapy for therapy-resistant corneal infections. A larger, comparative study is necessary to further confirm these findings.

Surveillance study on the tolerability and safety of Flebogamma® DIF (10% and 5% intravenous immunoglobulin) in adult and pediatric patients.

Direct comparisons of tolerability and safety of concentrated intravenous immunoglobulin (IVIG) versus less concentrated products are scarce. In this postauthorization, prospective, observational, multicenter study, a systematic comparison of 10% and 5% concentrations of Flebogamma® DIF IVIG was performed in both adult and pediatric patients treated with the studied IVIG products according to the approved indications under routine conditions. Dose of product administered, adverse events (AEs), physical assessments, laboratory tests, and concomitant therapy were analyzed. Patient recruitment in the 10% and 5% product groups was, respectively, 34 (32 analyzed, 13 of them children, receiving 130 IVIG infusions) and 35 (34 analyzed, receiving 135 IVIG infusions). Twenty-four infusions (18.5%; 95% CI: 11.8, 25.1) with the 10% product and 3 (2.2%; 95% CI: -0.3, 4.7) with the 5% product were associated with potentially treatment-related AEs (P < 0.0001). Nine patients (28.1%) infused with the 10% product and 3 (8.8%) infused with the 5% product presented, respectively, 33 and 8 treatment-related AEs (of which 7 and 6, respectively, were serious AEs, experienced by only three hypersensitive patients). The profile of AEs occurring with the infusion of 10% and 5% products were comparable. The most frequent treatment-related AEs were headache (n = 17, 3 patients; 15 episodes, 1 patient) and pyrexia (n = 6, 4 patients). In conclusion, no unpredictable risk was detected for both Flebogamma DIF 10% and 5% concentrations, which were therefore deemed as safe and well-tolerated IVIG in the studied population. The frequency of infusions associated with treatment-related AEs was lower with the 5% concentration.

Dexamethasone intravitreal implant in retinal vein occlusion: real-life data from a prospective, multicenter clinical trial.

PURPOSE: To evaluate the relationship between duration of macular edema associated with retinal vein occlusion (RVO) and the achievement of vision gain in patients receiving dexamethasone intravitreal implant (DEX implant) in real-world clinical practice, and to define patterns of use of DEX implant and its efficacy and safety in the treatment of patients with RVO in clinical practice. METHODS: This prospective, open-label, multicenter, 6-month observational phase IV study conducted at 70 sites in Germany enrolled patients diagnosed with macular edema following branch or central RVO (BRVO, CRVO) who were given DEX implant. Follow-up visits and evaluations occurred in accordance with normal clinical practice. Re-treatment with DEX implant and use of other RVO therapies was at the discretion of the treating physician. The primary endpoint was mean change in best-corrected visual acuity (BCVA) from baseline at week 12. RESULTS: The analysis population consisted of 573 patients (64 % BRVO, 36 % CRVO). Patients received a mean of 1.17 DEX implant treatments during the study period; 84.3 % of patients received a single DEX implant and 19.9 % received adjunctive other RVO treatment. Among patients with analyzable BCVA data at baseline and week 12 (n = 351), mean change from baseline BCVA at week 12 was -0.16 (standard deviation, 0.30) logMAR (+7.8 approximate Early Treatment Diabetic Retinopathy Study [ETDRS] letters) (p < 0.001), and 33.9 % of patients had gained at least 3 lines in BCVA from baseline. Mean change from baseline BCVA at week 12 was +9.5, +7.3, and +5.4 approximate ETDRS letters in patients with macular edema duration < 90 days, from 90 to 180 days, and >180 days respectively. Improvement in BCVA through week 24 and decreases in central retinal thickness were seen in both BRVO and CRVO. The most common adverse drug reaction was increased intraocular pressure. No glaucoma incisional surgeries were required. CONCLUSIONS: DEX implant was effective in improving BCVA and central retinal thickness in patients with BRVO and CRVO in real-world clinical practice. The largest gains in BCVA over 6 months occurred in patients with recent onset macular edema, confirming the benefit of early treatment. DEX implant was well tolerated and had an acceptable safety profile.

A parallel panning scheme used for selection of a GluA4-specific Fab targeting the ligand-binding domain.

A method for development of murine Fab fragments towards extracellular domains of a surface receptor is presented. The GluA4 ionotropic glutamate receptor is used as a model system. Recombinant GluA4 ectodomain comprising both the N-terminal domain (NTD) and the ligand-binding domain (LBD) in one molecule was used for immunization. A Fab-phage library was constructed and a parallel panning approach enabled selection of murine Fab fragments towards either intact ectodomain or the isolated LBD of the GluA4 receptor. One LBD-Fab (FabL9) showed exclusive selectivity for the GluA4 LBD, over a panel of LBDs from GluA2, GluK1, GluK2 and GluD2. Soluble FabL9 was produced in amounts suitable for characterization. Competitive ELISA and rat-brain immunoprecipitation experiments confirmed that the FabL9 epitope is conserved in the LBD and in the intact native receptor. By an alignment of GluA2 and GluA4, the likely binding epitope for FabL9 was predicted. This study demonstrates a simple approach for development of antibody fragments towards specific sub-domains of a large ligand-gated ion channel, and this method could be utilized for all multi-domain surface receptors where antibody domain-selectivity may be desirable. Furthermore, we present for the first time a GluA4 subtype-specific murine Fab fragment targeting the LBD of the receptor.

Nile red dye in aqueous surfactant and micellar solution.

The solubilization behavior of nile red dye in aqueous surfactant and micellar solutions was studied by optical spectroscopic techniques, dynamic light scattering, and atomic force microscopy. Nile red exhibits considerable absorption in the submicellar concentration region. When dispersed in aqueous surfactant and/or micellar solution, nile red molecules tend to form nonemissive dimers and/or H-type aggregates through π-π stacking interactions. This phenomenon may limit the use of nile red in solubilization studies. In the presence of ionic SDS and CTAB micelles, the solubilization of nile red appears to take place primarily at the charged micellar surface within the interfacial region. Similarly, spectra in micellar solution of nonionic Triton X-100 revealed that nile red dye penetrates the hydrophilic, interfacial poly(oxyethylene) region of the micelles but cannot reach the hydrophobic, innermost core. Our results therefore suggest that nile red dye must be chosen carefully when probing (micellar) hydrophobic environments and (micro)domains.

Novel 'heavy' dyes for retinal membrane staining during macular surgery: multicenter clinical assessment.

PURPOSE: To evaluate the feasibility of two novel 'heavy' dye solutions for staining the internal limiting membrane (ILM) and epiretinal membranes (ERMs), without the need for a prior fluid-air exchange, during macular surgery. METHODS: In this prospective nonrandomized multicenter cohort study, the high molecular weight dyes ILM-Blue™ [0.025% brilliant blue G, 4% polyethylene glycol (PEG)] and MembraneBlue-Dual™ (0.15% trypan blue, 0.025% brilliant blue G, 4% PEG) were randomly used in vitrectomy surgeries for macular disease in 127 eyes of 127 patients. Dye enhanced membrane visualization of the ILM and ERMs, 'ease of membrane peeling', visually detectable perioperative retinal damage, postoperative best-corrected visual acuity (BCVA), dye remnants and other unexpected clinical events were documented by 21 surgeons. RESULTS: All surgeries were uneventful, and a clear bluish staining, facilitating the identification, delineation and removal of the ILM and ERMs, was reported in all but five cases. None of the surgeries required a fluid-air exchange to assist the dye application. BCVA at 1 month after surgery improved in 83% of the eyes in the MembraneBlue-Dual™ group and in 88% in the ILM-Blue™ group. No dye remnants were detected by ophthalmoscopy, and no retinal adverse effects related to the surgery or use of the dyes were observed. CONCLUSION: The 'heavy' dye solutions ILM-Blue™ and MembraneBlue-Dual™ can be injected into a fluid-filled vitreous cavity and may facilitate staining and removal of the ILM and/or ERMs in macular surgery without an additional fluid-air exchange.

Dyes for Eyes™: hydrodynamics, biocompatibility and efficacy of 'heavy' (dual) dyes for chromovitrectomy.

As epiretinal membranes (ERMs), the internal limiting membrane (ILM) and the vitreous cortex are essentially transparent tissues, or translucent structures, nontraumatic removal may be challenging in various types of macular surgery. Vital dyes stain these thin tissues, thus allowing for better visualization of these structures during vitrectomy and selective 'membrane peeling' from the underlying retina. To avoid swirling of the dye within the fluid-filled vitreous cavity, and to better target the dye onto the macula, a fluid-air exchange is commonly performed. However, this may jeopardize visualization of the macula during peeling due to clouding of the posterior lens capsule, and may lead to postoperative visual field defects. Recently, a new dye solution for staining the ERM and ILM simultaneously has been developed that circumvents the need for fluid-air exchange, i.e. MembraneBlue-Dual™. This paper will focus on the hydrodynamics and biocompatibility of this 'heavy' dual dye and its efficacy for staining of the ILM and/or ERMs during posterior segment surgery in a multicenter clinical setting.

Brilliant Blue G as protective agent against trypan blue toxicity in human retinal pigment epithelial cells in vitro.

BACKGROUND: Combinations of trypan blue (TB), Brilliant Blue G (BBG) and polyethyleneglycol had been shown before to be less toxic to ARPE retinal pigment epithelial cells than TB alone. We studied systematically the influence of combinations of dyes on cell damage. METHODS: ARPE cells were exposed to TB (concentration range 0.025 to 1 %), BBG (0.0025 to 0.5 %), and combinations of the two dyes, dissolved in phosphate buffered saline (PBS), for periods between 5 and 60 min. Cell damage was monitored with the WST-1 assay. The effect of different salt concentration was measured in the same way. RESULTS: TB in concentrations of 0.075 % and higher was toxic to the cells already after 30 min incubation. BBG was toxic after 30 min in concentration of 0.1 % and higher, but had a protective effect on cells with incubation time of 5 min and concentrations up to 0.1 %. BBG at concentrations of 0.025 % protected against TB-induced damage at 5 min and 30 min incubation. Salt concentrations between 113 and 225 mM did not influence cell survival even after 30 min. In the presence of TB, propidium iodide bound strongly to the cells. CONCLUSIONS: BBG acts as a protecting agent against TB toxicity.

A bifunctional nanocarrier based on amphiphilic hyperbranched polyglycerol derivatives.

We here report on the synthesis of a bifunctional nanocarrier system based on amphiphilic hyperbranched polyglycerol (hPG), which is modified by introducing hydrophobic aromatic groups to the core and retaining hydrophilic groups in the shell. "Selective chemical differentiation" and chemo-enzymatic reaction strategies were used to synthesize this new core-shell type nanocarrier. The system shows an innovative bifunctional carrier capacity with both polymeric and unimolecular micelle-like transport properties. Hydrophobic guest molecules such as pyrene were encapsulated into the hydrophobic core of modified hPG via hydrophobic interactions as well as π-π stacking, analogous to a unimolecular micelle system. A second guest molecule, which has a high affinity to the shell like nile red, was solubilized in the outer shell of the host molecule, thus connecting the nanocarrier molecules to form aggregates. This model is confirmed by UV-Vis, fluorescence, atomic force microscopy, and dynamic light scattering, as well as release studies triggered by pH-changes and enzymes. Encapsulated guest molecules, respectively in the core and in the shell, present different controlled release profiles. The bifunctional nanocarrier system is a promising candidate for simultaneous delivery of different hydrophobic drugs for a combination therapy, e.g., in tumor treatment.

Glycine-terminated dendritic amphiphiles for nonviral gene delivery.

Development of nonviral vectors for the successful application of gene therapy through siRNA/DNA transfection of cells is still a great challenge in current research. (1, 2) In the present study, we have developed multivalent polyglycerol dendron based amphiphiles with well-defined molecular structures that express controlled glycine arrays on their surfaces. The structure-activity relationships with respect to the siRNA complexation, toxicity, and transfection profiles were studied with synthesized amphiphilic polycations. Our findings revealed that a second-generation amphiphilic dendrimer (G2-octaamine, 4) that has eight amine groups on its surface and a hydrophobic C-18 alkyl chain at the core of the dendron, acts as an efficient vector to deliver siRNA and achieve potent gene silencing by investigating the knockdown of luciferase and GAPDH gene activity in HeLa cells. Interestingly, the amphiphilic vector is nontoxic even at higher ratio of N/P 100. To the best of our knowledge this is the first example of successful in vitro siRNA transfection using dendritic amphiphiles. We believe that this supramolecular complex may serve as a new promising alternative for nonviral siRNA delivery systems and will be investigated for in vivo siRNA delivery in the future.

Mixtures of cationic copolymers and oppositely charged surfactants: effect of polymer charge density and ionic strength on the adsorption behavior at the silica-aqueous interface.

This study addresses polymer-surfactant interactions at solid-liquid interfaces and how these can be manipulated by modulating the association between ionic surfactant and oppositely charged polymer, with a particular focus on electrostatic interactions. For this purpose, the interaction of a series of cationic copolymers of vinylpyrrolidone and quaternized vinylimidazol with sodium dodecyl sulfate (SDS) at the silica-aqueous interface was followed by in situ ellipsometry. To reveal the nature of the interaction, we performed measurements for different copolyion charge densities, in the absence and presence of added salt. The path-dependence of the interaction was studied by comparing the adsorption under two different conditions, adsorption from premixed solutions and sequential addition of surfactant to the polymer solution, but the same end state. The reversibility of the adsorption process was studied by following the effect of dilution on the adsorbed layer. All copolyions adsorbed to both silica and hydrophobized silica, revealing the importance of both hydrophobic and electrostatic attractive interactions. On both types of surface, an increase in adsorbed amount was found on lowering the fraction of charged units. An increased ionic strength gave an increased adsorbed amount in all cases, but especially on hydrophobic surfaces. The adsorbed amount on silica from mixtures of the copolyions with SDS peaked at an SDS concentration corresponding closely to the concentration of cationic charges of the different polyions. Around the region of charge equivalence, there was also a phase separation in the bulk. At higher concentrations of SDS, a redissolution in the bulk, and a decrease in adsorbed amount, occurred as a result of excess SDS binding to the complexes. For the most highly charged polyions, we observed a decrease in adsorbed amount, and a shift in the adsorption maxima to lower SDS concentrations, with increasing ionic strength.

Advances in switchable supramolecular nanoassemblies.

Supramolecular nanoassemblies are gaining increasing importance as promising new materials with considerable potential for novel and promising applications. Within supramolecular nanoassemblies the connectivity of the monomeric units is based on reversible noncovalent interactions, like van der Waals interactions, hydrogen bonding, or ionic interactions. As the strength of these interactions depends on the molecular surrounding, the formation of nanoassemblies in principle can be controlled externally by changing the environment and/or the molecular shape of the underlying monomer. This way it is not only possible to switch the self-assembly on or off, but also to change between different aggregation states. In this minireview we present some recent selected approaches to supramolecular stimuli-responsive nanoassemblies.

Prevalence of magnetic resonance imaging-defined atrophic and hypertrophic phenotypes of knee osteoarthritis in a population-based cohort.

OBJECTIVE: To describe the association of osteophytes with concomitant cartilage damage, assessed using semiquantitative magnetic resonance imaging (MRI), and to describe the prevalence of atrophic and hypertrophic phenotypes of tibiofemoral knee osteoarthritis (OA) in a population-based cohort. METHODS: Participants of the Framingham Knee Osteoarthritis Study were examined with a 1.5T MRI system using triplanar intermediate-weighted fat-suppressed sequences. Cartilage and osteophytes were assessed using the Whole-Organ Magnetic Resonance Imaging Score (WORMS). Overall prevalence of knees with severe cartilage damage and concomitant osteophyte status were described. Odds ratios for the likelihood of having severe cartilage damage according to osteophyte size were estimated using a logistic regression model. An additional analysis assessed knees according to phenotype in relation to radiographic OA status, with the atrophic phenotype being defined as knees with absent or only tiny osteophytes (WORMS grade ≤2 on a 0-7 scale) in all 10 tibiofemoral subregions but exhibiting severe cartilage damage, and the hypertrophic phenotype being defined as knees with large osteophytes (WORMS grade ≥5 on a 0-7 scale) but lacking substantial cartilage damage. RESULTS: In this study, 1,597 knees of 1,248 subjects were included. Of the 67 knees with large osteophytes, 54 (80.6%) exhibited severe cartilage damage. The risk of severe cartilage damage increased markedly with increasing osteophyte size. Twenty-one knees (1.3%) showed an atrophic phenotype. Only 3 knees (0.2%) exhibited a hypertrophic phenotype. CONCLUSION: The majority of knees with severe tibiofemoral cartilage damage exhibited moderate to large osteophytes. The larger the osteophyte, the more likely was the presence of severe cartilage damage. A minority of knees exhibited the atrophic phenotype, which also included knees without radiographic OA. The hypertrophic phenotype was extremely rare.