Determination of antibacterial properties and cytocompatibility of silver-loaded coral hydroxyapatite.

In this study, silver-loaded coral hydroxyapatites (SLCHAs) were used as scaffolds for bone tissue engineering. The SLCHAs were prepared by surface adsorption process and ion-exchange reaction between Ca(2+) of coral hydroxyapatite (CHA) and Ag(+) of silver nitrate with different concentrations at room temperature. The properties of the composite SLCHAs were investigated by inductively coupled plasma-atomic emission spectrometry (ICP-AES), scanning electron microscropy (SEM) equipped with backscattered electron detector (BSE), and energy-dispersive X-ray spectrometer (EDS). The SEM images showed that the morphology of the SLCHAs depended on the content of Ag(+), and the silver ions were uniformly distributed on the surface of SLCHAs. The ICP-AES results demonstrated that the silver content of the SLCHAs decreased along with the decrease of the concentration of silver nitrate. The SLCHAs were found effective against Escherichia coli and Staphylococcus aureus by antibacterial test. Mouse embryonic pre-osteoblast cells (MC3T3-E1) were used to test the cytocompatibility of SLCHAs, CHA, and pure coral. Cell morphology and cell proliferation were studied with SEM, laser scanning confocal microscope (LSCM), and MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide) assay after 1, 3, and 5 days of culture. The results indicated the cell morphology and proliferation on the scaffolds of Ag(+) (13.6 microg/ml)/CHA and Ag(+) (1.7 microg/ml)/CHA were better than that on Ag(+) (170 microg/ml)/CHA. In addition, adhesion of MC3T3-E1 on the scaffolds showed that the confluent cells showed fusiform shape and arranged tightly on the scaffolds. All the results showed that the antibacterial SLCHAs would have potential clinical application as the scaffolds for bone tissue engineering.

[Diagnosis and treatment for complicated atlantoaxial dislocation].

OBJECTIVE: To explore the clinical characteristics and treatment methods for complicated atlantoaxial dislocation. METHODS: A retrospective evaluation was done to summarize and analyze the clinical characteristics and complicated factors of 54 patients with complicated atlantoaxial dislocation who could not to be treated effectively by using conventional therapy in our hospital from February 2005 to October 2008. According to different complicated factors, different treatment methods mainly including transoral atlantoaxial reduction plate-III (TARP-III) operation, decompression procedure with deep grinding guided by computer aided design-rapid prototyping (CAD-RP), screw placement technique with CAD-RP guide plate and extensile approach surgery were performed. RESULTS: The average follow-up period was 24 months. Among 54 cases, 48 cases achieved immediate anatomic reduction completely and 6 cases almost achieved anatomical reduction. All the compressed spinal cords were decompressed sufficiently. The decompression rate was 86.0% and the improvement rate of nerve function was 77.8%. Two cases suffered postoperative intracranial infection. CONCLUSION: Some cases of complicated atlantoaxial dislocation can be effectively treated by using TARP-III operation, decompression procedure with deep grinding guided by CAD-RP, individualized screw placement technique with CAD-RP guide plate and extensile approach surgery.

[Determination of silver content in silver-loaded coral hydroxyapatite in relation to the biocompatibility].

OBJECTIVE: To determine the amount of silver in silver-loaded coral hydroxyapatite (Ag(+)-CHA) bone substitute and its impact on the biocompatibility of this material with mouse embryonic osteoblast cells. METHODS: Ag(+)-CHA was prepared by immersing coral hydroxyapatite in a serial concentration of silver nitrate solutions. The amount of silver in the prepared Ag(+)-CHA was measured by inductively coupled plasma atomic emission spectrometry (ICP-AES). The viability of MC3T3-E1 cells incubated with Ag(+)-CHA was measured by MTT colorimetric assay, and the cell growth and morphological changes were observed by inverted phase-contrast microscope and confocal laser scanning microscope. RESULTS: The amount of silver loading in the bone substitutes prepared by immersion in 1×10(-2), 1×10(-3), 5×10(-4), 10(-4), 8×10(-5), and 5×10(-5) mol/L silver nitrate solutions were 4127.67∓47.35, 167.90∓11.00, 83.42∓4.51, 30.20∓2.32, 22.39∓4.09, and 15.11∓0.55 µg/g, respectively. A low silver content in the material (prepared with silver nitrate solution of less than 8×10(-5) mol/L) showed no significant inhibitory effect on the growth of MC3T3-E1 cells or produced noticeable cytotoxic effect. On the materials prepared with 8×10(-5) and 10(-5) mol/L silver nitrate solution, the osteoblasts displayed active proliferation similar to those incubated on materials without silver loading. The confluent cells showed a normal fusiform morphology with tight arrangement. CONCLUSION: Ag(+)-CHA with low silver content has a good biocompability and can promote the proliferation and growth of MC3T3-E1 cells in vitro, suggesting the clinical potential of this material as a anti-infection bone substitute.