Loosening and revision rates after total shoulder arthroplasty: a systematic review of cemented all-polyethylene glenoid and three modern designs of metal-backed glenoid.

BACKGROUND: Several modern designs of metal-backed glenoids (MBG) have been devised to overcome flaws such as loosening and a high failure rate. This review aimed to compare rates of complications and revision surgeries between cemented polyethylene glenoid (PEG) and three examples of modern MBG designs. METHODS: Literature search was carried out using PubMed, Cochrane Library, EMBASE, and Google Scholar using MeSH terms and natural keywords. A total of 1186 articles were screened. We descriptively analyzed numerical data between the groups and statistically analyzed the categorical data, such as the presence of radiolucent line, loosening, and revision surgery (failure). Articles were divided into three groups based on follow-up duration: < 36-month, 36-72-month, and > 72-month subgroups. RESULTS: This study included 35 articles (3769 shoulders); 25 on cemented PEG and ten on the modern MBG. Mean age was 66.4 (21-93) and 66.5 years (31-88). The mean duration of follow-up was 73.1 (12-211) and 56.1 months (24-100). Overall, the rate of the radiolucent line was 354/1302 (27%) and 47/282 (17%), the loosening rate was 465/3185 (15%) and 22/449 (5%), and the failure rate was 189/3316 (6%) and 11/457 (2%), for PEG and MBG, respectively. The results of < 36-month and 36-72-month subgroups showed lower rates of radiolucency and loosening in the cemented PEG group, but there was no significant difference in failure rate (P = 0.754 and 0.829, respectively). In the > 72-month subgroup, MBG was better in terms of loosening (P < 0.001) and failure rates (P = 0.006). CONCLUSIONS: The modern MBG component, especially TM glenoid, seems to be a promising alternative to cemented PEGs, based on subgroup revision rates according to the follow-up duration and overall results of ROM and clinical scores. All polyethylene glenoids tend to increase loosening and failure over time. Three modern MBG designs seem to have no difference in failure, at least in the < 36-month and 36-72-month subgroups compared to the cemented PEG. More long-term follow-up studies on modern MBG should be ultimately conducted. LEVEL OF EVIDENCE: Level IV, systematic review.

Congenital anomalies in the offspring of occupationally exposed mothers: a systematic review and meta-analysis of studies using expert assessment for occupational exposures.

STUDY QUESTION: Is there an association between maternal occupational exposure to solvents, pesticides and metals as assessed by expert-based assessment and congenital anomalies in the offspring? SUMMARY ANSWER: There is an association between maternal occupational exposure to solvents and congenital anomalies in the offspring, including neural tube defects, congenital heart defects and orofacial clefts. WHAT IS KNOWN ALREADY: One important environmental risk factor for development of congenital anomalies is maternal occupational exposure to chemicals in the workplace prior to and during pregnancy. A number of studies have assessed the association with often conflicting results, possibly due to different occupational exposure assessing methods. STUDY DESIGN, SIZE, DURATION: For this systematic review with meta-analysis, the search terms included maternal occupation, exposure, congenital anomalies and offspring. Electronic databases MEDLINE and EMBASE were searched for English studies up to October 2017. PARTICIPANTS/MATERIALS, SETTING, METHODS: Two reviewers independently screened all citations identified by the search. Case-control studies and cohort studies were included if (I) they reported on the association between maternal occupational exposure to solvents, pesticides or metals and congenital anomalies, and (II) assessment of occupational exposure was performed by experts. Data on study characteristics, confounders and odds ratios (ORs) were extracted from the included studies for four subgroups of congenital anomalies. Methodological quality was assessed using the Newcastle-Ottawa Scale. In the meta-analysis, random effects models were used to pool estimates. MAIN RESULTS AND THE ROLE OF CHANCE: In total, 2806 titles and abstracts and 176 full text papers were screened. Finally, 28 studies met the selection criteria, and 27 studies could be included in the meta-analysis. Our meta-analysis showed that maternal occupational exposure to solvents was associated with neural tube defects (OR: 1.51, 95%CI: 1.09-2.09) and congenital heart defects (OR: 1.31, 95%CI:1.06-1.63) in the offspring. Also maternal occupational exposure to glycol ethers, a subgroup of solvents, was associated with neural tube defects (OR: 1.93, 95%CI: 1.17-3.18) and orofacial clefts (OR: 1.95, 95%CI: 1.38-2.75) in the offspring. Only one study investigated the association between maternal occupational exposure to solvents and hypospadias and found an association (OR: 3.63, 95%CI: 1.94-7.17). Results of the included studies were consistent. In our meta-analysis, we found no associations between occupational exposure to pesticides or metals and congenital anomalies in the offspring. LIMITATIONS, REASONS FOR CAUTION: A limited number of studies was included, which made it impossible to calculate pooled estimates for all congenital anomalies, analyse individual chemicals or calculate exposure-response relations. Bias could have been introduced because not all included studies corrected for potentially confounding factors. WIDER IMPLICATIONS OF THE FINDINGS: Employers and female employees should be aware of the possible teratogenic effects of solvent exposure at the workplace. Therefore, is it important that clinicians and occupational health specialist provide women with preconception advice on occupational solvent exposure, to reduce the congenital anomaly risk. STUDY FUNDING/COMPETING INTEREST(S): NSp was paid by the Graduate School of Medical Sciences (MD/PhD program), UMCG, Groningen, the Netherlands. EUROCAT Northern Netherlands is funded by the Dutch Ministry of Health, Welfare and Sports. There are no competing interests. REGISTRATION NUMBER: CRD42017053943.

Certification of a reference material of metal content in atmospheric particles deposited on filters.

Air quality is one of the areas in Europe where a series of EU Directives have been published with the aim of achieving improved long-term and harmonised air quality objectives across the European Union. This paper describes the production of a certified reference material, aiming to support QA/QC programmes of analytical laboratories in the framework of the air quality monitoring activities. The certified values are the As, Cd, Ni and Pb masses in PM10 particles deposited on quartz filters (CRM SL-MR-2-PSF-01). All the steps of the certification, i.e. the material characterisation, homogeneity and stability evaluation and uncertainty calculation, were performed according to the ISO guide 35 guidelines. The certification was conducted using the characterisation by a single method approach based on isotope dilution for cadmium, nickel, and lead and gravimetric standard addition calibration for arsenic associated with inductively coupled mass spectrometry (ICP-MS). The amounts of the four elements are in the range of the target values regulated by EU Directives.

Soil criteria to protect terrestrial wildlife and open-range livestock from metal toxicity at mining sites.

Thousands of hard rock mines exist in the western USA and in other parts of the world as a result of historic and current gold, silver, lead, and mercury mining. Many of these sites in the USA are on public lands. Typical mine waste associated with these sites are tailings and waste rock dumps that may be used by wildlife and open-range livestock. This report provides wildlife screening criteria levels for metals in soil and mine waste to evaluate risk and to determine the need for site-specific risk assessment, remediation, or a change in management practices. The screening levels are calculated from toxicity reference values based on maximum tolerable levels of metals in feed, on soil and plant ingestion rates, and on soil to plant uptake factors for a variety of receptors. The metals chosen for this report are common toxic metals found at mining sites: arsenic, cadmium, copper, lead, mercury, and zinc. The resulting soil screening values are well above those developed by the US Environmental Protection Agency. The difference in values was mainly a result of using toxicity reference values that were more specific to the receptors addressed rather than the most sensitive receptor.

Candidate reference measurement procedures for chloride, potassium, sodium, calcium, magnesium, and lithium by inductively coupled plasma (isotope dilution) sector field mass spectrometry (ICP-(ID) SFMS) in serum.

BACKGROUND: Standardization of the measurement of electrolyte concentrations in serum is of considerable interest for quality assurance in patient care. To promote the ongoing process of standardization we developed candidate reference measurement procedures of highest metrological order for Cl, K, Na, Ca, Mg, and Li using ICP-(ID) SFMS. METHODS: Serum samples were diluted with 4 mmol/L nitric acid and were spiked with the internal standard for quantification, separately for each analyte. The samples were introduced in the ICP-SFMS device by continuous infusion using a peristaltic pump. The measurement results were compared with reference measurement procedure values obtained by atom absorption spectroscopy, flame emission spectroscopy, and coulometry. The measurement accuracy and precision was calculated by analyzing certified reference materials and EQAS samples. RESULTS: The mean coefficient of variation (CV) of the ICP-MS procedures for the serum samples was 0.65% for Cl, 0.46% for K, 0.51% for Na, 0.77% for Ca, 0.78% for Mg, and 0.58% for Li. The mean bias from target values of NIST certified reference materials was +0.85% for Cl, -0.46% for K, +0.68% for Na, -0.21% for Ca, +0.27% for Mg, and -0.39% for Li. CONCLUSIONS: Candidate reference measurement procedures for 6 electrolytes were developed by high performance magnetic sector field ICP-MS fulfilling the requirements of ISO 15193:2009 for reference measurement procedures with traceability to SI according to ISO 17511:2003 and can be used for setting target values in EQAS and for certification of reference materials.

A Comprehensive dataset for Australian mine production 1799 to 2021.

Given that metals, minerals and energy resources extracted through mining are fundamental to human society, it follows that accurate data describing mine production are equally important. Although there are often national statistical sources, this typically includes data for metals (e.g., gold), minerals (e.g., iron ore) or energy resources (e.g., coal). No such study has ever compiled a national mine production data set which includes basic mining data such as ore processed, grades, extracted products (e.g., metals, concentrates, saleable ore) and waste rock. These data are crucial for geological assessments of mineable resources, environmental impacts, material flows (including losses during mining, smelting-refining, use and disposal or recycling) as well as facilitating more quantitative assessments of critical mineral potential (including possible extraction from tailings and/or waste rock left by mining). This data set achieves these needs for Australia, providing a world-first and comprehensive review of a national mining industry and an exemplar of what can be achieved for other countries with mining industry sectors.

Characterization and validation of a Portuguese natural reference soil to be used as substrate for ecotoxicological purposes.

This study describes the first attempt to validate a Portuguese natural soil (PTRS1) to be used as reference soil for ecotoxicological purposes, aimed to both: (i) obtain ecotoxicological data for the derivation of Soil Screening Values (SSVs) with regional relevance, acting as a substrate to be spiked with ranges of concentrations of the chemicals under evaluation and (ii) act as control and as substrate for the dilution of contaminated soils in ecotoxicological assays performed to evaluate the ecotoxicity of contaminated soils, in tier 2 of risk assessment frameworks, applied to contaminated lands. The PTRS1 is a cambisol from a granitic area integrated in the Central Iberian Zone. After chemical characterization of the soil in terms of pseudo-total metals, PAHs, PCBs and pesticide contents, it was possible to perceive that some metals (Ba, Be, Co, Cr and V) surpass the Dutch Target Values (Dtvs) corrected for the percentage of organic matter and clay of the PTRS1. Nevertheless, these metals displayed total concentrations below the background total concentrations described for Portuguese soils in general. The same was observed for aldrin, endosulfan I, endosulfan II, heptachlor epoxide, and heptachlor; however the Dtvs corrected become negligible. The performance of invertebrate and plant species, commonly used in standard ecotoxicological assays, was not compromised by both soil properties and soil metal contents. The results obtained suggest that the PTRS1 can be used as a natural reference soil in ecotoxicological assays carried out under the scope of ecological risk assessment.

Baseline values for metals in soils on Fildes Peninsula, King George Island, Antarctica: the extent of anthropogenic pollution.

Metal contents (Al, Ca, Cd, Cr, Cu, Fe, Hg, Mg, Mn, Ni, Pb, Ti, and Zn) have been measured in 30 surface soils on Fildes Peninsula, King George Island, Antarctica, yielding values (in milligrams kilogram(-1)) of 41.57-80.65 (Zn), 2.76-60.52 (Pb), 0.04-0.34 (Cd), 7.18-25.03 (Ni), 43,255-70,534 (Fe), 449-1,401 (Mn), 17.10-64.90 (Cr), 1,440-25,684 (Mg), 10,941-49,354 (Ca), 51.10-176.50 (Cu), 4,388-12,707 (Ti), 28,038-83,849 (Al), and for Hg (in nanograms gram(-1)) 0.01-0.06. Relative cumulative frequency analysis was used to determine the baseline values for the 13 metals. Compared with adjacent areas in Antarctica, Mg and Ni are significantly lower, but Cu is significantly higher than that of McMurdo Station. Enrichment factor analysis and the geo-accumulation index method were applied in order to determine the extent of anthropogenic contamination, and both show that Pb, Cd, and Hg have been significantly increased by human activities. Principal component analysis was used to identify the sources of metals in these soil samples.

Baseline of the spatial and temporal metal contamination in Dilek National Park, Turkey.

Dilek National Park in Western Turkey is a protected habitat for several endangered and threatened species. In an attempt to protect the endangered species, the park was classified as a World Heritage Preserve. Even with this change, the animal and flora variety are still at risk from previous metal contamination. Water samples were collected 10 cm below the water surface and sediment from 0-30 and 30-60 cm depth. Inorganic elements were found in all sediment samples. Sodium had the highest aqueous concentration (10,312 mg/L), while Cu, Fe, Mn, and Zn were present at levels significantly lower than the chronic exposure criteria. Zn was the least prevalent (0.4 mg/kg) compound found in the sediment. The highest toxic contaminant concentration was Mg at an average of 1,100 mg/kg. The main contamination source of that seems to be Great Meandrous River. More studies are needed to develop a protection and remediation strategy for Dilek National Park.

Tissue reaction to implants of different metals: a study using guide wires in cannulated screws.

Cannulated screws, along with guide wires, are typically used for surgical fracture treatment in cancellous bone. Breakage or bending deformation of the guide wire is a clinical concern. Mechanically superior guide wires made of Co-Cr alloys such as MP35N and L605 may reduce the occurrence of mechanical failures when used in combination with conventional (316L stainless steel) cannulated screws. However the possibility of galvanic or crevice corrosion and adverse tissue reaction, exists when using dissimilar materials, particularly in the event that a guide wire breaks, and remains in situ. Therefore, we designed an experiment to determine the tissue reaction to such an in vivo environment. Implant devices were designed to replicate a clinical situation where dissimilar metals can form a galvanic couple. Histological and SEM analyses were used to evaluate tissue response and corrosion of the implants. In this experiment, no adverse in vivo effects were detected from the use of dissimilar materials in a model of a broken guide wire in a cannulated screw.

Update on metal-induced occupational lung disease.

PURPOSE OF REVIEW: Occupational and environmental exposures to metals can result in multiple pulmonary conditions. This article will review recent epidemiologic and mechanistic studies that have enhanced our understanding of the association between particular lung diseases and exposure to specific metals. RECENT FINDINGS: Recent studies have broadened our understanding of the mechanisms of lung diseases such as CBD in established industries and drawn attention to conditions that may arise from exposure to metals such as indium in developing technologies. New diagnostic techniques such as elemental tissue analysis may help establish a diagnosis of metal-induced occupational lung disease. Electronic cigarette devices, environmental pollutants, and the growing use of nanoparticle-sized metals pose additional risks to workers and consumers. SUMMARY: Recognizing the risks of pulmonary disease in workers exposed to metals and performing a thorough occupational history and diagnostic work-up in patients with unexplained respiratory findings is necessary to promote understanding and prevention of metal-induced lung disease.

Spatial distribution of heavy metals in Hong Kong's marine sediments and their human impacts: a GIS-based chemometric approach.

A geographic information system (GIS)-based chemometric approach was applied to investigate the spatial distribution patterns of heavy metals in marine sediments and to identify spatial human impacts on global and local scales. Twelve metals (Zn, V, Ni, Mn, Pb, Cu, Cd, Ba, Hg, Fe, Cr and Al) were surveyed twice annually at 59 sites in Hong Kong from 1998 to 2004. Cluster analysis classified the entire coastal area into three areas on a global scale, representing different pollution levels. Backward discriminant analysis, with 84.5% correct assignments, identified Zn, Pb, Cu, Cd, V, and Fe as significant variables affecting spatial variation on a local scale. Enrichment factors indicated that Cu, Cr, and Zn were derived from human impacts while Al, Ba, Mn, V and Fe originated from rock weathering. Principal component analysis further subdivided human impacts and their affected areas in each area, explaining 87%, 84% and 87% of the total variances, respectively. The primary anthropogenic sources in the three areas were (i) anti-fouling paint and domestic sewage; (ii) surface runoff, wastewater, vehicle emissions and marine transportation; and (iii) ship repainting, dental clinics, electronic/chemical industries and leaded fuel, respectively. Moreover, GIS-based spatial analysis facilitated chemometric methods.

Derivation of soil values for the path 'soil-soil organisms' for metals and selected organic compounds using species sensitivity distributions.

BACKGROUND, AIMS AND SCOPE: According to the German Federal Soil Protection Act, the natural function of soil as a habitat for human beings, animals, plants and soil organisms is, among other things, to be protected by deriving soil values for important chemicals regarding their amounts in the environment, their persistence and/or their toxicity. This contribution presents the results of the mathematical derivation of such values for nine metals and ten organic substances from soil ecotoxicological effect values available in the literature for microbial processes, plants and soil invertebrates. MATERIAL AND METHODS: Ecotoxicological data were mostly extracted from published papers and reports and had to originate from valid studies that were performed according to internationally standardised guidelines (e.g. ISO) or were otherwise well documented, plausible and performed according to accepted laboratory practice. As test results, both structural (i.e., effects on mortality, growth or reproduction) and functional (i.e., effects on microbial activity or organic matter breakdown) parameters were included. The derivation of soil values was performed using the distribution based extrapolation model (DIBAEX) and EC(50)s (Effective Concentration) as input data. RESULTS: For 19 compounds, soil values could be calculated. In 18 of these 19 cases clear laboratory ecotoxicological effects (i.e., EC50 values) below the calculated soil value have been found in the literature. DISCUSSION: In those few cases where a comparison with field studies is possible, effects have been observed in the same order of magnitude as the calculated soil values. A comparison with other similar approaches confirmed the plausibility of the calculated values. CONCLUSIONS: The DIBAEX-method is a feasible and widely accepted method for deriving soil values from ecotoxicological input data. Data availability was already satisfactory for some substances, but other substances, especially organics, were only poorly covered. The soil values presented here were based on EC50 input data. However, depending on the protection level aimed at by using soil values in legislation, it might be appropriate to use other input data such as NOECs in the derivation process. RECOMMENDATIONS AND PERSPECTIVES: It is recommended to generate an appropriate number of data for further relevant substances by means of a test battery or multi-species approaches such as terrestrial model ecosystems. These tests should also consider the influence of the bioavailability of substances. A final recommendation for legally binding soil values demands a plausibility check of the mathematically derived values. This should include a comparison with natural background concentrations, soil values for other pathways and soil values used in legislation of other countries. Finally, expert judgement always has to be considered.

Potable groundwater quality in some villages of Haryana, India: focus on fluoride.

The fluoride concentration in ground water was determined in ten villages of Rohtak district of Haryana state (India). The fluoride concentration in the underground water of these villages varied from 0.034-2.09 mg/l. Various other water quality parameters, viz., pH, electrical conductivity, total dissolved salts, total hardness, total alkalinity sodium, potassium, calcium, magnesium, carbonate, bicarbonate, chloride and sulfate were also measured. A systematic calculation of correlation coefficients among different physicochemical parameters indicated considerable variations among the analyzed samples with respect to their chemical composition. Majority of the samples do not comply with Indian as well as WHO standards for most of the water quality parameters measured. Overall water quality was found unsatisfactory for drinking purposes. Fluoride content was higher than permissible limit in 50% samples.

Distribution, enrichment, and potential toxicity of trace metals in the surface sediments of Sundarban mangrove ecosystem, Bangladesh: a baseline study before Sundarban oil spill of December, 2014.

The distribution, enrichment, and ecotoxicity potential of Bangladesh part of Sundarban mangrove was investigated for eight trace metals (As, Cd, Cr, Cu, Fe, Mn, Pb, and Zn) using sediment quality assessment indices. The average concentration of trace metals in the sediments exceeded the crustal abundance suggesting sources other than natural in origin. Additionally, the trace metals profile may be a reflection of socio-economic development in the vicinity of Sundarban which further attributes trace metals abundance to the anthropogenic inputs. A total of eleven surficial sediment samples were collected along a vertical transect along the freshwater-saline water gradient. The sediment samples were digested using EPA 3051 method and were analyzed on ICP-MS. Geo-accumulation index suggests moderately polluted sediment quality with respect to Ni and As and background concentrations for Al, Fe, Mn, Cu, Zn, Pb, Co, As, and Cd. Contamination factor analysis suggested low contamination by Zn, Cr, Co, and Cd, moderate by Fe, Mn, Cu, and Pb while Ni and As show considerable and high contamination, respectively. Enrichment factors for Ni, Pb, and As suggests high contamination from either biota or anthropogenic inputs besides natural enrichment. As per the three sediment quality guidelines, Fe, Mn, Cu, Ni, Co, and As would be more of a concern with respect to ecotoxicological risk in the Sundarban mangroves. The correlation between various physiochemical variables and trace metals suggested significant role of fine grained particles (clay) in trace metal distribution whereas owing to low organic carbon content in the region the organic complexation may not be playing significant role in trace metal distribution in the Sundarban mangroves.

Metrology test object for dimensional verification in additive manufacturing of metals for biomedical applications.

Additive manufacturing continues to increase in popularity and is being used in applications such as biomaterial ingrowth that requires sub-millimeter dimensional accuracy. The purpose of this study was to design a metrology test object for determining the capabilities of additive manufacturing systems to produce common objects, with a focus on those relevant to medical applications. The test object was designed with a variety of features of varying dimensions, including holes, cylinders, rectangles, gaps, and lattices. The object was built using selective laser melting, and the produced dimensions were compared to the target dimensions. Location of the test objects on the build plate did not affect dimensions. Features with dimensions less than 0.300 mm did not build or were overbuilt to a minimum of 0.300 mm. The mean difference between target and measured dimensions was less than 0.100 mm in all cases. The test object is applicable to multiple systems and materials, tests the effect of location on the build, uses a minimum of material, and can be measured with a variety of efficient metrology tools (including measuring microscopes and micro-CT). Investigators can use this test object to determine the limits of systems and adjust build parameters to achieve maximum accuracy.

Bioresorbable Vascular Scaffolds Versus Metallic Stents in Patients With Coronary Artery Disease: ABSORB China Trial.

BACKGROUND: The everolimus-eluting bioresorbable vascular scaffold (BVS) is designed to achieve results comparable to metallic drug-eluting stents at 1 year, with improved long-term outcomes. Whether the 1-year clinical and angiographic results of BVS are noninferior to current-generation drug-eluting stents has not been established. OBJECTIVES: This study sought to evaluate the angiographic efficacy and clinical safety and effectiveness of BVS in a randomized trial designed to enable approval of the BVS in China. METHODS: Eligible patients with 1 or 2 de novo native coronary artery lesions were randomized to BVS or cobalt-chromium everolimus-eluting stents (CoCr-EES) in a 1:1 ratio stratified by diabetes and the number of lesions treated. Angiographic and clinical follow-up were planned at 1 year in all patients. The primary endpoint was angiographic in-segment late loss (LL), powered for noninferiority with a margin of 0.15 mm. RESULTS: A total of 480 patients were randomized (241 BVS vs. 239 CoCr-EES) at 24 sites. Acute clinical device success (98.0% vs. 99.6%; p = 0.22) and procedural success (97.0% and 98.3%; p = 0.37) were comparable in BVS- and CoCr-EES-treated patients, respectively. The primary endpoint of in-segment LL at 1 year was 0.19 ± 0.38 mm for BVS versus 0.13 ± 0.38 mm for CoCr-EES; the 1-sided 97.5% upper confidence limit of the difference was 0.14 mm, achieving noninferiority of BVS compared with CoCr-EES (pnoninferiority = 0.01). BVS and CoCr-EES also had similar 1-year rates of target lesion failure (cardiac death, target vessel myocardial infarction, or ischemia-driven target lesion revascularization; 3.4% vs. 4.2%, respectively; p = 0.62) and definite/probable scaffold/stent thrombosis (0.4% vs. 0.0%, respectively; p = 1.00). CONCLUSIONS: In the present multicenter randomized trial, BVS was noninferior to CoCr-EES for the primary endpoint of in-segment LL at 1 year. (A Clinical Evaluation of Absorb Bioresorbable Vascular Scaffold [Absorb BVS] System in Chinese Population-ABSORB CHINA Randomized Controlled Trial [RCT]; NCT01923740).

Characteristics of metals used in implants.

The performance of any material in the human body is controlled by two sets of characteristics: biofunctionality and biocompatibility. With the wide range of materials available in the mid-1990s, it is relatively easy to satisfy the requirements for mechanical and physical functionality of implantable devices. Therefore, the selection of materials for medical applications is usually based on considerations of biocompatibility. When metals and alloys are considered, the susceptibility of the material to corrosion and the effect the corrosion has on the tissue are the central aspects of biocompatibility. Corrosion resistance of the currently used 316L stainless steel, cobalt-chromium, and titanium-based implant alloys relies on their passivation by a thin surface layer of oxide. Stainless steel is the least corrosion resistant, and it is used for temporary implants only. The titanium and Co-Cr alloys do not corrode in the body; however, metal ions slowly diffuse through the oxide layer and accumulate in the tissue. When a metal implant is placed in the human body, it becomes surrounded by a layer of fibrous tissue of a thickness that is proportional to the amount and toxicity of the dissolution products and to the amount of motion between the implant and the adjacent tissues. Pure titanium may elicit a minimal fibrous encapsulation under some conditions, whereas the proliferation of a fibrous layer as much as 2 mm thick is encountered with the use of stainless steel implants. Superior fracture and fatigue resistance have made metals the materials of choice for traditional load-bearing applications. In this review, the functionality of currently used metals and alloys is discussed with respect to stenting applications. In addition, the "shape memory" and "pseudo-elasticity" properties of Nitinol-an alloy that is being considered for the manufacturing of urologic stents-are described.

Determination of total metals in cultivated oysters (Crassostrea gigas) from the northwest coast of Mexico by microwave digestion and atomic absorption spectrometry.

Bivalves such as oysters often accumulate heavy metals, and therefore can be used to monitor changes of pollutant concentrations in the environment. Cultivated oysters from the northwest coast of Mexico are widely used for human consumption and thus have an important commercial value. Information was gathered on the concentration of these elements in oysters (Crassostrea gigas) cultivated on the coast of Sonora. Oysters were randomly collected from April to October 1997, from 6 different locations (65 individuals per site) in 4 different months. Metals were determined by microwave digestion followed by atomic absorption spectroscopy. The mean values (microg/g fresh weight) for each metal were: Cd, 0.76; Cu, 3.64; Zn, 17.71; Pb, 0.50; As, 0.05; Hg, 0.03; and Se, 0.21. The results show that, except for Cd, concentrations of regulated metals were under the maximum permitted values specified by regulatory agencies of Mexico and were comparable to those reported from other areas.