Search

A cellulose membrane was exposed to the static magnetic field (SMF) in the presence of KCl solution and ion transport through the membrane was measured before and after the SMF exposure. SMF at 0.24 T significantly enhanced the rate of ion transport, especially after the first exposure (p

Previously we found that laser perforation of a collagen membrane (35 microm thickness, Koken Co., Tokyo) produced an effective bone morphogenetic protein (BMP) carrier, if the created pore sizes were larger than 0.5 mm. In this study we applied the same technique to create pores of 0.2 and 1.0 mm in a thicker (1.2 mm thickness) porous biodegradable membrane made of polylactic acid and an epsilon-caprolactone copolymer (PLA-CL) to obtain an effective membranous BMP carrier with higher mechanical strength. Pieces of PLA-CL (0.5 x 1.0 x 0.12 cm) combined with rhBMP-2 (5 microg) were implanted subcutaneously into rats and processed for analyses at 1-3 weeks. The laser-perforated PLA-CL membranes equipped with 1.0 mm pores induced mineralization beginning from the margins of the pores judging from the X-ray patterns, but bone formation seemed to proceed irregularly inside the pores. In the perforated PLA-CL membrane with 1.0-mm pores bone formation did not significantly increase compared with the nonperforated one. This was due to the fact that the PLA-CL membrane was already a porous structure (85% porosity). In contrast with laser-perforated PLA-CL 0.2 mm pores, bone was induced on the collagen fibers and fiber bundles inside the pores. The different patterns of bone formation between the PLA-CL membranes with 1.0 and 0.2 mm pores seemed to be related to the active formation of perpendicular collagen fibers through the 0.2 mm pores.

We developed a novel artificial skin substitute consisting of two collagen sponge layers with different pore sizes and cross-link densities. Fibroblasts suspended in 0.5 ml Dulbecco-modified Eagle's medium (DMEM) + 10% fetal bovine serum (FBS) were seeded on the lower dermal sponge layer, then epidermal collagen sponge and 0.1 ml suspension of keratinocytes in KGM were layered in this order. After a few hours, the medium was changed to DMEM + 5% FBS. These processes were carried out in one day, and the composite layers were then cultured by the air-liquid interface culture method. Three to five days after seeding, keratinocytes had grown to about ten layers, and fibroblasts had grown three-dimensionally into the lower dermal sponge layer. This novel cellular artificial skin substitute was grafted onto nude mice and took in 4 weeks. This skin substitute has the advantage of a shorter culturing period than previously cultured skins, and may be clinically useful for grafting that is urgently required in patients with severe generalised burns.

The effects of remaining monomer on hydrolysis of poly(DL-lactide) were examined by adding different amounts of monomer to purified polymer samples. The existence of monomer in the polymerization products was found to enhance hydrolytic degradation of the polymer. A porous texture was observed on the SEM photographs of degraded materials, which led to the conclusion that the remaining monomer enabled water molecules to gain better access to the polymer matrix through this porous structure. The effects of molecular weight and chemical composition of polylactides on the hydrolytic degradation were also studied. Poly(DL-lactic acid) with higher molecular weights showed longer retention of the initial properties such as molecular weight and tensile strength. Copolymerization of DL-lactide with glycolide enhanced the hydrolysis, probably because of increased hydrophilicity of the polymers. © 1998 SCI.

Resorbable (poly-L-lactide) and non-resorbable (polyethylene terephathalate) tendon augmentation devices (TAD) in conjunction with a pericardial adhesion barrier, were designed to strengthen tenorrhaphies and were evaluated in an ovine extensor tendon deficit model in a short term study. Fifteen centimetres of tendon were resected and replaced with kangaroo tail tendon xenografts that had been cross-linked with 0.075% glutaraldehyde (GA) at 4 degrees C for one or seven days. Compared with tenorrhaphies performed with Kessler sutures alone, both types of TAD were more effective at preventing tenorrhaphy dehiscence, and thus maintaining tendon function. Furthermore, tensile strength of TAD tenorrhaphies increased significantly between zero and twelve weeks. For xenografts cross-linked in GA for one day, the tensile strength of tenorrhaphies with the resorbable TAD rose from 38 +/- 9 N at time zero, to 116 +/- 46 N at twelve weeks, while non-resorbable TAD tenorrhaphy strength at time zero was 42 +/- 16 N and 99 +/- 27 N at twelve weeks. For xenografts cross-linked with GA for seven days, similar increases in tensile strength of tenorrhaphies, with the two types of TAD were found. As there was no significant difference in mechanical performance or tissue response between the two TAD types in the first 12 weeks, use of the resorbable poly-L-lactide device may be advantageous clinically. Tensile strengths of midsections of the tendon xenograft cross-linked for 7 days was not significantly diminished 12 weeks after implantation and these xenografts were partially remodelled around the periphery. However, the tensile strength of xenografts cross-linked for one day declined significantly between time zero (319 +/- 80 N) and twelve weeks (239 +/- 92 N), suggesting that this degree of cross-linking was inadequate for maintenance of mechanical strength. Evaluation of the performance of tenorrhaphy augmentation devices with xenografts, over a longer implantation period, is required to further understand their usefulness for reconstruction of traumatic tendon injuries.

The reaction of C60 with poly(ethylene glycol) having a terminal primary amino group or a mixture of ethylene diamine and poly(ethylene glycol) having terminal carboxyl groups resulted in formation of water-soluble C60 conjugates. These conjugates showed strong cytotoxicity to L929 cells upon visible light irradiation as a result of superoxide production.

Tartaric acid, malic acid, and glyceric acid were copolycondensed with glycolic acid at various molar ratios in feed to quickly synthesize biodegradable oligoesters. They were likely to have a moderately cross-linked structure with relatively low molecular weights and hydrophilic groups on the chains. In addition to macroscopic gels which were insoluble in any solvents, we could obtain the oligoesters which were insoluble in water but soluble in N,N-dimethylformamide. The degradation rate of the oligoesters was higher than that of lactic acid (LA) oligomers having molecular weights of a few thousands. On the contrary, their glass transition and flow temperatures were much higher than those of LA oligomers, indicating that their handling during the preparation of drug delivery dosage forms was much improved. The formulation of microspheres containing drugs from the oligoesters revealed that they were useful as biodegradable matrices having high degradation rates.

A "bilayer artificial skin", composed of an inner layer of collagen sponge and an outer silicone layer, was developed by modifying the material reported by Yannas and Burke. Since our early results from experimental and clinical use of the original version of the "bilayer artificial skin" were reported, several improvements have been made in stages to eliminate some drawbacks related to disinfection and preservation and to reduce the primary cost of manufacture. The latest version of the material was successfully used in 27 sites on 23 patients. In this paper, the improvements in the material and the clinical results are described.

Poly-L-lactide, a polymer of lactic acid, shows slow degradation in living tissue. Poly-L-lactide plate of high molecular weight maintains more than 90% of its initial mechanical properties for more than 3 months after implantation. Using struts made from poly-L-lactide plate, we performed chest wall reconstruction in 56 patients: for postoperative chronic sternal dehiscence in 23 and sternal elevation for pectus excavatum in 33 cases. The postoperative external appearances of the anterior chest were improved in comparison with the preoperative state in all cases. The internal features were evaluated by computed tomographic scan. Neither postoperative wound infection nor respiratory complication was observed, and no tendency for regression of the anterior chest occurred in any of the patients. In 3 of 56 cases (5.4%; one in the sternal dehiscence group and two in the pectus excavatum group), it was necessary to remove part of the strut because of overgrowth of granulation tissue around the implanted material after 4, 12, and 13 postoperative months, respectively. In the pectus excavatum group, the computed tomographic evaluations showed that poly-L-lactide strut maintained sufficient strength to support the thoracic wall 5 months after implantation. These findings suggest that the bioabsorbable poly-L-lactide strut is a promising material for surgical treatment of chest deformity.

Thin layers made from three kinds of hydrophilic polymer were coated onto poly(ethylene terephthalate)(PET) fibers to study the interaction of an anionic surfactant, sodiumn-dodecyl benzenesulfonate, with the polymer layers. The coated layers include a) poly(vinyl alcohol) (PVA) crosslinked with glutaraldehyde [nonionic], b) crosslinked, sulfated PVA [anionic], and c) polyethyleneimine crosslinked with poly(ethyleneglycol diglycidylether) [cationic]. All of these coatings were found to reduce the electrostatic charging of the PET cloths, indicating that they were effectively coated with the hydrophilic polymers. The PET cloth coated with the thin layers was immersed in the aqueous solution of surfactant at 40°C for different durations and the electrostatic voltage as well as the weight change were determined after drying. When the cloth coated with the nonionic or the anionic layer was brought into contact with the surfactant, neither the electrostatic voltage nor the weight of PET changed. On the contrary, immersion in the surfactant solution brought about an increase in both the electrostatic voltage and the weight for the PET coated with the cationic layer. This suggested that the surfactant molecules were bound to the cationic layer, in contrast to the nonionic and the anionic layer. It was concluded that the binding was due to ion complexing between the cationic groups in the polymeric layer and the sulfate groups in the surfactant molecules.

Background. A new drug-delivery formulation of cisplatin, whereby cisplatin was incorporated in lactic acid oligomer microspheres (CDDP-MS), has been developed in dosage form for peritoneal carcinomatosis and has been designed to release 70% of the incorporated cisplatin slowly during a period of 3 weeks. In this study, its pharmacologic effects were examined in rodents. Methods. CDDP-MS was tested to determine (1) tissue distribution of cisplatin after intraperitoneal administration of cisplatin at 3.0 mg/kg body weight to rats, (2) acute toxicity in mice when injected intraperitoneally, and (3) therapeutic effects on peritoneal carcinomatosis induced by transplantable M5076 tumors in mice. Results. These experiments revealed the following: (1) CDDP-MS resulted in a higher cisplatin concentration in tissues adjacent to the peritoneum for a longer period, and the concentration of cisplatin measured in the rest of the body was lower than that delivered by the cisplatin aqueous solution; (2) the 50% lethal dose value, determined by the Litchfield-Wilcoxon method, was 23.8 mg/kg body weight in CDDP-MS in terms of cisplatin, whereas in the cisplatin aqueous solution it was 13.5 mg/kg body weight; (3) CDDP-MS enhanced therapeutic effects when compared with the same toxicity dosage of cisplatin aqueous solution. Conclusions. Intraperitoneal CDDP-MS releases cisplatin into the peritoneal cavity for a long time, and it results in less systemic toxicity and greater therapeutic effects on peritoneal carcinomatosis than does cisplatin aqueous solution.

In this study, we first examined in vitro a polyvinyl alcohol membrane to be used to contain hybrid islet cells, and second we tested a bioartificial pancreas with entrapment of pancreatic islets in polyvinyl alcohol membrane in rats with experimentally induced diabetes. The permeability of the polyvinyl alcohol membrane to different substances was studied in a two-cell chamber system. Glucose, insulin, and nutrients passed through the membrane easily, whereas the passage of immunoglobulin G was completely prevented, indicating that this membrane could be effective in protecting the bioartificial pancreas from immunorejection. Approximately 2,000 islets collected from three Sprague-Dawley rats were enclosed in a mesh-reinforced polyvinyl alcohol tube and transplanted into the peritoneal cavity of six Wistar rats with streptozotocin-induced diabetes. Their nonfasting serum glucose levels were significantly decreased for at least 12 days. Six diabetic rats receiving intraperitoneal transplantation of free islets without the tube showed a slight but significant decrease in nonfasting serum glucose levels for only 3 days. One diabetic rat with transplantation of the bioartificial pancreas had a significant and sustained decrease in nonfasting glucose levels from pretransplanted levels of 440-500 mg/dl to a mean value of 162 +/- 13 mg/dl for over 3 months without immunosuppression. The bioartificial pancreas was then removed, and glucose levels gradually increased to over 500 mg/dl. The results of the present study suggest that a bioartificial pancreas with entrapment of islets in a polyvinyl alcohol membrane could be a promising therapeutic approach to diabetes mellitus.

Human thrombomodulin (hTM) is an endothelial cell-surface glycoprotein and has effective anticoagulant properties. This protein was immobilized onto polytetrafluorethylene (PTFE) surfaces to create biomaterials with enhanced haemocompatibility. The PTFE surface was functionalized by CO2 plasma activation and subsequent vapour-phase graft polymerization of acrylic acid. Surface characterization after plasma treatment, grafting and hTM immobilization was achieved by attenuated total reflection-Fourier transform-infrared spectroscopy, X-ray photoelectron spectroscopy, zeta potential and wetting measurements. The activity of immobilized hTM was estimated using the protein C activation test.

Fibrovascular tissue ingrowth into poly(vinyl alcohol) (PVA) sponges of different pore sizes was investigated by incorporating basic fibroblast growth factor (bFGF) into the sponges. The average pore size of PVA sponges used in this study was 30, 60, 110, 250, 350, and 700 microm and gelatin microspheres were employed as release carrier of bFGF. The sponges were subcutaneously implanted into the back of mice after incorporating free bFGF or gelatin microspheres containing bFGF into the sponges. Fibrovascular tissue infiltrated with time into the sponge pores and the extent of fibrous tissue ingrowth showed a maximum at a pore size around 250 microm 1 and 6 weeks after implantation. Significant promotion of the growth of fibrous tissue by bFGF was observed only at 3 weeks post-implantation (p0.05). New capillaries were formed in the tissue at any time, as long as bFGF was given to the sponges. Both empty gelatin microspheres and phosphate buffered solution neither promoted tissue ingrowth nor induced capillary formation in the sponges. It was concluded that bFGF was essential to induce the fibrovascular tissue ingrowth into the pores of PVA sponges.

The release rate of insulin, as a model peptide, from gelatin microspheres (GM) prepared with gelatin having various cross-linking densities in vitro was examined. The release of insulin from GM showed the burst effect, followed by a slow release phase regardless of the cross-linking density of gelatin. The total amount of insulin released in 2 weeks decreased with increasing cross-linking density of gelatin. The release rate of insulin within 6 h was well correlated with the cross-linking density of gelatin. The remaining amounts of both insulin and GM after injection of insulin incorporated in GM to mice femoral muscle tissue were also examined in vivo. Both insulin and GM rapidly disappeared from the injection site within 1 day, and thereafter slowly disappeared over 14 days. The time courses of the remaining amounts were fairly similar to each other. Furthermore, the remaining amount of insulin 1 day after administration was well correlated with the cross-linking density of gelatin. These data suggest that insulin was released from GM with the degradation of GM in mice muscular tissue and that the release rate of insulin can be controlled by modifying the cross-linking density of gelatin. In conclusion, the control of the release rate of insulin from GM can be achieved under both in vitro and in vivo conditions by gelatin through the alteration of cross-linking conditions.

Previously we found that laser perforation of a collagen membrane (35 microm thickness, Koken Co., Tokyo) produced an effective bone morphogenetic protein (BMP) carrier, if the created pore sizes were larger than 0.5 mm. In this study we applied the same technique to create pores of 0.2 and 1.0 mm in a thicker (1.2 mm thickness) porous biodegradable membrane made of polylactic acid and an epsilon-caprolactone copolymer (PLA-CL) to obtain an effective membranous BMP carrier with higher mechanical strength. Pieces of PLA-CL (0.5 x 1.0 x 0.12 cm) combined with rhBMP-2 (5 microg) were implanted subcutaneously into rats and processed for analyses at 1-3 weeks. The laser-perforated PLA-CL membranes equipped with 1.0 mm pores induced mineralization beginning from the margins of the pores judging from the X-ray patterns, but bone formation seemed to proceed irregularly inside the pores. In the perforated PLA-CL membrane with 1.0-mm pores bone formation did not significantly increase compared with the nonperforated one. This was due to the fact that the PLA-CL membrane was already a porous structure (85% porosity). In contrast with laser-perforated PLA-CL 0.2 mm pores, bone was induced on the collagen fibers and fiber bundles inside the pores. The different patterns of bone formation between the PLA-CL membranes with 1.0 and 0.2 mm pores seemed to be related to the active formation of perpendicular collagen fibers through the 0.2 mm pores.

Summary form only received. The author presents some results by obtained by collaborative work with medical people on tissue engineering using resorbable polymers such as polylactides and collagen. The tissues studied for regeneration include bones, skin, ligaments, and fibrous cartilage. The fixation of fractured bones in joints, jaw, and the face was performed using screws, pins, and mini-plates prepared from a high-strength poly(L-lactide). Regeneration of lost mandibula with the help of a poly(L-lactide) tray containing the patient's cancellous bone is currently undergoing clinical trials. A bilayered artificial skin was fabricated from a thin silicone sheet and a thick porous collagen sheet without glycosaminoglycans. The artificial skin functioned very effectively as the scaffold for the regeneration of the dermis tissue of full skin-deficient patients. The epidermis graft of patient origin was covered on the regenerated dermis to enable regeneration of the whole skin. Regeneration of broken anterior cruciate ligaments was attempted with the use of poly(L-lactide) fibers. The results with goats and sheep were as good as those of a non-resorbable ligament assist device. The periodontic ligament also could be regenerated with the use of a glycolide-lactide copolymer membrane.

Synthetic materials made from polymers, glass ceramics, and metals, as well as materials of biological origin, have been used as biomaterials which can be defined as materials to be used in contact with human living cells. Advantages of polymeric materials over the others are their wide flexibility in physical properties varying from viscous fluid to tough solid. A serious drawback of polymers is their insufficient mechanical strength when used as medical devices in orthopaedic and oral surgeries. In such cases, ceramics and metals are the first choice for the biomaterials, although their modulus is too high in comparison with that of bone and tooth tissues, occasionally resulting in stress shielding to the tissues in contact.

The most powerful treatment to cure diseases may be medication, that is, drug administration to the patients. However, drugs are no more effective when large part of a tissue has been severely damaged or an organ has irreversibly lost its function. In these cases, either artificial organ or organ transplantation is at present the first choice for reconstruction of the defective or lost organ. Unfortunately, these therapeutic methods are not always effective, but have several problems that are difficult to solve. For instance, the number of organ donors is quite smaller than that of the patients waiting for the organ to be transplanted. Complications of immuno-suppresive agents are also trouble for the organ recipients. Also, current artificial organs are required to improve the poor biocompatibility and the insufficient ability to replace defective organs.

Effects of a static magnetic field were studied on bone formation using an ischemic rat femur model. Metal rods were prepared from magnetized and unmagnetized samariun cobalt to have tapered structure, both with the same geometrical dimension, and were implanted transcortically into the middle diaphysis of 88 rat femurs. Both sides of the rat femoral artery were ligated to create an ischemic bone model, followed by implantation of the tapered rod to the femur. The bone mineral density (BMD) and weight of the femurs were measured at 1st and 3rd week after implantation. The result at the 3rd week post-implantation revealed that the BMD and weight of the ischemic bone model rats were significantly reduced, compared with that of non-operated femur. It was also found that the magnetized group had significantly higher bone weights than the unmagnetized (p0.05). The BMD of the rats implanted with the magnetized rods were similar to those of the non-operated (p0.05). This enhancement of the femoral bone formation of the ischemic rat model by the static magnetic field seems to be due to the improved blood circulation of the femur.

Frequent and high-dose i.v. injections of interferon-beta (IFN-beta) have been used clinically to treat patients with viral hepatitis despite various side effects. Because side effects are caused by the systemic effects of IFN-beta, the purpose of this study was to target the drug specifically to the liver, thus reducing the adverse events. A chelating residue, diethylenetriaminepentaacetic acid (DTPA), was introduced to pullulan, a water-soluble polysaccharide with a high affinity for the liver. Murine IFN-beta could be coordinately conjugated with the DTPA-pullulan by simple mixing in an aqueous solution containing zinc ion (Zn2+). Intravenous injection of the IFN-beta-DTPA-pullulan conjugate with Zn2+ coordination enhanced liver induction of an antiviral enzyme, 2',5'-oligoadenylate synthetase (2-5AS), to a greater extent than that by free IFN-beta, although the 2-5AS levels in the liver depended on the mixing ratio of the IFN-beta/DTPA residue of DTPA-pullulan/Zn2+. In addition, the duration of the liver 2-5AS induction by the IFN-beta-DTPA-pullulan conjugate with Zn2+ coordination was longer than that by free IFN-beta. The liver targeting of IFN-beta by DTPA-pullulan with Zn2+ coordination may be a promising IFN therapy.

The surface modification is achieved by two methods: the graft coupling and the graft polymerization method. In the former, an existing water-soluble polymer is covalently fixed on a substrate polymer through a polymer-polymer coupling reaction like condensation. On the other hand, a water-soluble monomer is graft-polymerized onto the surface of the substrate in the graft polymerization method. To effect the graft polymerization, initiation species for polymerization have to be generated on the substrate surface. For this purpose we create peroxides on the substrate polymer by plasma treatments (glow and corona), ultraviolet irradiation, and ozonization. In addition, high-energy radiation like gamma rays and electron beam can be employed. A water-soluble monomer is readily graft-polymerized onto the peroxide-introduced substrate if the inhibitor and oxygen are completely removed from the monomer solution.

Artificial tracheas were fabricated from poly(L-lactic acid) mesh or unwoven cloth coated with collagen in order to reconstruct the respiratory airway by self regeneration without retaining the prosthesis at the replacement site, thus preventing infection, air leakage, granulation tissue formation, and displacement of the prosthesis. Nine weeks after placing a periosteal autologous graft from the tibia around the cervical trachea of a rabbit, bone rings formed without infection. Two weeks after replacement of an 8 X 8 mm window-shaped section of the cervical trachea with autologous periosteum, the internal surface of the trachea was well epithelialized without local complications, but ossification was not seen. One week after cervical substitution with our 2 cm long artificial trachea combined with the periosteal graft, cartilage was produced around the mesh material but neither ossification nor epithelization was observed thereafter, probably due to local infection. On the other hand, cartilage, bone, and epithelium did not form around the unwoven cloth artificial trachea after the substitution, probably because of severe infection due to collapse of the tracheal lumen. However, the formation of bone rings around the trachea suggests preservation of the neotracheal lumen, which may have potential for the treatment of tracheomalacia and/or bronchomalacia.

The conjugation of drugs with water-soluble polymers such as poly(vinyl alcohol) (PVA) tends to prolong the half-life of drugs and facilitate the accumulation of drugs in tissues involving neovascularization. The purpose of this study was to evaluate the effect of TNP-470-PVA conjugate on the proliferation of endothelial cells in vitro and on experimental choroidal neovascularization (CNV) in vivo.TNP-470 was conjugated in PVA by a dimethylaminopyridine-catalyzed reaction. The effects of TNP-470-PVA and free TNP-470 on the proliferation of human umbilical vein endothelial cells (HUVECs) and bovine retinal pigment epithelial cells (BRPECs) were evaluated by the tetrazolium-based colorimetric assay (XTT assay). Experimental CNV was induced by subretinal injection of gelatin microspheres containing basic fibroblast growth factor, into rabbits. Thirty rabbits were intravenously treated either with TNP-470-PVA (n = 8), free TNP470 (n = 5), free PVA (n = 5), or saline (n = 12) daily for 3 days, 2 weeks after implantation of gelatin microspheres. Fluorescein angiography was performed to detect the area with CNV, and the evaluation was made by computerized measurement of digital images. These eyes were also examined histologically. To observe the accumulation of conjugate, 3 rabbits with CNV received rhodamine B isothiocyanate-binding PVA (RITC-PVA), and the lesion was studied 24 hours later by fluorescein microscopy.The TNP-470-PVA inhibited the growth of HUVECs, similar to that of free TNP-470. The BRPECs were less sensitive to TNP-470-PVA than were the HUVECs. TNP-470-PVA significantly inhibited the progression of CNV in rabbits (P = 0.001). Histologic studies at 4 weeks after treatment demonstrated that the degree of vascular formation and the number of vascular endothelial cells in the subretinal membrane of the eyes treated with TNP-470-PVA were less than those of the control eyes. RITC-PVA remained in the area with CNV 24 hours after administration.These results suggest that TNP-470-PVA inhibited the proliferation of HUVECs more sensitively than that of BRPECs, and the targeted delivery of TNP-470-PVA may have potential as a treatment modality for CNV.

This article describes preliminary in vitro and in vivo studies comparing bulk and surface hydrolysis in absorbable polymer scaffolds proposed for tissue engineering of bone. The two polymers systems used were a bulk hydrolyzing 50:50 poly(DL-lactide-co-glycolide) (PLGA) and a surface hydrolyzing self-catalytic poly(ortho ester) (POE). Polymer scaffolds were exposed to physiological saline at body temperature and changes in polymer mass loss and inherent viscosity were monitored over time. New bone formation and local tissue response were evaluated by implanting scaffold disks of both polymer systems into non-critical-size calvarial defects in rabbits. New bone formation was determined by bone mineral density measurements, and local tissue response was determined by qualitative histology. Preliminary results confirmed that one of the main design characteristics for absorbable polymers in tissue engineering of bone, coordination of controlled polymer mass loss with new tissue formation, appeared to be achieved better using a surface hydrolyzing POE, rather than with a bulk hydrolyzing 50:50 PLGA. Bone mineral density at 6 and 12 weeks was an average 25% higher in the surface hydrolyzing scaffold. Unfortunately, the amount of bone formed was so inconsequential that this observation is of little relevance. Use of a water-soluble signaling factor such as basic fibroblast growth factor (bFGF) failed to increase bone formation. The histological response of these two polymer systems was similar and unaffected by the presence or absence of bFGF. The persistence of structural integrity for self-catalytic POE scaffolds after 6 and 12 weeks implantation, while 50:50 PLGA scaffolds had partially collapsed after 6 weeks, suggests surface hydrolyzing scaffolds may have some advantage over bulk hydrolyzing scaffolds in resisting normal in vivo stresses when used in a calvarial defect.

Radiation therapy has been used to treat choroidal neovascularization (CNV) in patients with age-related macular degeneration. The in vivo effect of applying focal x-ray irradiation to the eye of rabbits with experimental CNV was investigated.CNV was induced in the rabbit eyes by subretinal implantation of gelatin hydrogel microspheres impregnated with basic fibroblast growth factor. Three weeks after implantation, 17 of 34 eyes with CNV lesions accompanied by fluorescein leakage were irradiated with a single dose of 20 Gy; the other 17 eyes were not irradiated and served as the controls. The eyes were examined before irradiation and 1, 2, and 4 weeks after irradiation, by indirect ophthalmoscopy and fluorescein angiography. The degree of a decreasing amount of fluorescein leakage from the CNV lesions after irradiation was graded using a computerized image analysis system and was compared in the irradiated and nonirradiated eyes. These eyes were also examined histologically and immunohistochemically.Fluorescein leakage from the CNV lesions had significantly decreased in the eyes irradiated with 20 Gy compared with the control eyes, throughout the study period (P0.05). Histologic and immunohistochemical studies at 4 weeks after irradiation demonstrated that the degree of vascular formation and the number of vascular endothelial cells in the subretinal membrane of the irradiated eyes were less than those of the control eyes.Focal x-ray irradiation at the ocular region effectively reduced experimental CNV activity. These results support the possibility that radiation therapy may be beneficial in treating CNV.

Non-suture end-to-end anastomoses between polytetrafluoroethylene grafts and blood vessels were achieved using absorbable cuff material in experimental and clinical studies. The cuff was made of a synthetic biodegradable material, a lactic-glycolic acid copolymer, similar in composition to conventional absorbable surgical sutures.In the experimental study, vascular anastomoses for prosthetic interposition of the infrarenal aorta in rabbits were created using the cuff method. Six months after surgery, the cuff anastomoses sites were examined angiographically and microscopically and found to be patent and smooth without neointimal hyperplasia.The cuff layer had been completely absorbed. The clinical application used a similar technique and involved the creation of forearm bridge graft fistula in twelve patients for hemodialysis. In eight patients, Doppler fistula flow rate ranged from 167 ml/min to 392 ml/min. Ten of the twelve patients continued dialysis uneventfully. The one-year patency rate was 78% (7/9). The longest patency period was 920 days and the graft access continued to maintain sufficient blood flow for hemodialysis.This absorbable cuff material is therefore well suited for the construction of prosthetic vascular end-to-end anastomoses.

To determine the sequence of cellular changes associated with a new rabbit model of subretinal neovascularization (SRN) induced by subretinal injection of basic fibroblast growth factor (bFGF)-impregnated microspheres.bFGF-impregnated gelatin microspheres, prepared by forming a polyion complex between gelatin and bFGF, were subretinally implanted into rabbit eyes. The eyes were studied by immunochemistry at 3 days to 8 weeks after implantation. Antibodies to CD4, CD8, cytokeratin, CD31, glial fibrillary acidic protein (GFAP), and RAM11 were used.Cytokeratin-positive retinal pigment epithelial (RPE) cells appeared on day 3 and continued to increase in number in the subretinal space throughout the growth of the SRN membrane, becoming the predominant cell type. Macrophages (RAM11-positive) appeared early, but most disappeared within 7 days. GFAP-positive Müller cells were evident early in the retina but migrated into the subretinal space after 7 days; the gliotic adhesion they formed between the retina and the SRN membrane was prominent at 8 weeks. CD31-positive endothelial cells were first evident at 14 days and formed neovascular channels that were still present for up to 8 weeks. CD4- and CD8-positive lymphocytes appeared in the early stages but were few in number.SRN membranes are primarily composed of RPE cells and vascular endothelial cells. The membrane adheres to the retina by a gliotic band. The cellular components involved in the membrane of this model resemble those found in SRN membranes removed from patients with age-related macular degeneration.

Although fibrin glue has been widely used as a surgical adhesive, its components, fibrinogen and thrombin, obtained from human blood are not completely free from the risk of virus infection due to acquired immune deficiency and hepatitis. Recently, we have reported that a polymer pair composed of gelatin and poly(L-glutamic acid) (PLGA) promptly forms a gel and can firmly bond to soft tissues when crosslinked with the aid of water-soluble carbodiimide (WSC). The present study was undertaken to design a new PLGA-gelatin glue without using WSC. Two kinds of PLGA with molecular weights of 71 and 22 kDa were employed to prepare N-hydroxysuccinimide (NHS) activated derivatives. The NHS-activated PLGA could be synthesized at high yields and was found to be stable for an extended time without losing the ability to crosslink with gelatin when stored under a dry-cold condition. This NHS-activated PLGA could spontaneously form a gel with gelatin in an aqueous solution within a short time, comparable to a commercial fibrin glue, when gelation was allowed to proceed at pH 8.3. The NHS-activated PLGA prepared from PLGA with the molecular weight of 22 kDa could be readily dissolved at high concentrations and its ability to form a gel was maintained for more than 10 min when an acidic 8% NHS-activated PLGA solution was used. The bonding strength of PLGA gelatin glues with natural tissue was higher than that of fibrin glue. These findings strongly suggest that this combination of gelatin and NHS-PLGA is very promising as a surgical adhesive and may possibly replace fibrin glues prepared from human blood components.

Flat plates made from a copolymer of epsilon-caprolactone and L-lactide (P-CL-LA) [50:50 (w/w), molecular weight 1.62 x 10(5); 20 x 10 x 1 mm size] were subcutaneously implanted into 50 young, male Wistar rats (P-CL-LA group). After 24 months the plates had become a mass of small pieces, which were concentrated in an area of 3 x 2 x 1 mm. For comparison, 50 rats were implanted with medical-grade polyethylene plates (PE group) while another set of 50 rats was subjected to the same operation but without an implant (Sham Op group). Tumors arose in 25 rats from the P-CL-LA group: 24 were malignant mesenchymal tumors at the implant sites. In the PE group, tumors appeared in 16 rats (14 at the implant sites and two ectopically). The average tumor latency was 578+/-84 days in the P-CL-LA group and 452+/-102 days in the PE group. There was no difference in tumor incidence between the P-CL-LA and PE groups (p0.05). In the Sham Op group, two malignant tumors appeared over 2 years. Pathologically, these induced tumors arose from the inflammatory cells surrounding the degrading fragments of P-CL-LA within the tissue capsule. This indicates that relatively slowly degrading material can induce malignant tumors at a similarly high rate to nonabsorbable medical grade PE, at least in this animal model.

We aimed to evaluate the in vitro and in vivo effects of poly [L-lactic acid] microsphere containing cisplatin (CDDP-MS) for intraperitoneal (i.p.) chemotherapy for ovarian cancer.We initially examined the in vitro and in vivo profile of cisplatin release from the CDDP-MS, then this drug delivery system was evaluated in 15 patients.The in vitro study showed that cisplatin was released constantly over a 3-week period. Rats in the CDDP-MS group had a significantly lower peak serum concentration of platinum compared with rats in the aqueous cisplatin solution (CDDP-S) group; the serum concentration of platinum showed a gradual decline. The ascitic fluid concentration of platinum also gradually decreased in the CDDP-MS group. We treated 15 patients with recurrent ovarian cancer with CDDP-MS containing 200 mg of cisplatin (n = 5) or CDDP-S containing 100 mg of cisplatin (n = 10) administered i.p. The peak serum and ascites concentrations of platinum were lower immediately after administration of CDDP-MS than after administration of CDDP-S, but increased over time in the CDDP-MS group, reflecting the slow-release effect of CDDP-MS. Grade 1 to 2 leukopenia and/or neutropenia occurred in 2 of 5 patients. No thrombocytopenia or renal or neurologic toxicity was observed;These findings indicate that the i.p. administration of CDDP-MS increased the dose intensity of cisplatin and appeared to be safe and effective for the treatment of ovarian cancer.

To provide a substitute for the dura mater a new bioabsorbable composite sheet was developed. This composite was composed of two L-lactic acid-epsilon-caprolactone (50:50) copolymer films and a poly (glycolic acid) nonwoven fabric. They displayed good mechanical properties and were completely absorbed 24 weeks after implantation in the back of rats. Histological evaluation of the composite sheet was undertaken by implanting it in 31 rabbits with dural defects and examining the sites of implantation 2 weeks to 26 months later. Any infection, cerebrospinal fluid leakage, evidence of convulsive disorders, significant adhesion to underlying cortex, and calcification was not noticed in any cases. In addition, the regenerated duralike tissue had a high pressure-resistant strength 2 weeks after implantation.

The cell occlusive effects on human gingival fibroblasts of degradable lactic acid-glycolic acid copolymer membranes (noncoated membranes) and membranes coated with a sucrose ester of fatty acid (coated membranes) were studied and compared with those of expanded polytetrafluoroethylene (e-PTFE) membranes. The membranes were immersed in a culture medium periodically for 21 days and interposed into a chemotaxis chamber, and the fibroblasts then were cultured in the chamber for another 7 days. The passage rate of cells through the membranes was calculated and the change in surface structure of each membrane after immersion for 28 days was observed by an environmental scanning electron microscope. The passage rate of coated membranes (3.4+/-2.2%) was significantly lower than that of noncoated (25.7+/-5.1%) at the 28th day whereas the passage rate of e-PTFE membranes was 0.8-1.5%. Many pores were observed on the noncoated membranes before immersion while the coating material covered most of the pores on the coated membranes. The average pore size of the noncoated membranes was larger than that of the coated membranes at day 28. The structure of the e-PTFE membranes underwent no change. The passage rate of the coated membranes was not different from the e-PTFE membranes, suggesting an effect that might be useful for a guided tissue regeneration procedure.

Catheter model tubes were prepared from a medical-grade polyetherurethane and their outer surfaces modified by surface-graft polymerization of acrylamide and dimethyl acrylamide (DMAA). The surface-graft layer was characterized by means of dry staining, scanning electron microscopy (SEM), X-ray photoelectron spectroscopy, and protein adsorption. Ex vivo evaluation for the blood compatibility of the surface-modified polyurethane was carried out using the polyurethane tube as an arterio-venous shunt between the carotid artery and the jugular vein of rabbits. When the surface density of grafted polymer was in the range of 10-30 microg/cm2, the in vitro adsorption of IgG exhibited a minimum value and platelet adhesion to the grafted polyurethane surface was insignificant, in marked contrast with that to the virgin (nonmodified) surface. The in vivo blood compatibility of polyurethane was evaluated by implanting the catheter tube in the inferior vena cava of rabbits from the femoral vein after ligation of a distal site of the exposed femoral vein. After remaining there for predetermined periods of time, the implanted catheters were taken out together with the veins of the rabbits that had been heparinized and sacrificed just prior to excision of the veins. After exchange of the blood in the veins for saline, the excised veins were opened by cutting longitudinally to inspect for clot formations on the surfaces of the implanted catheters. Occlusion of the inferior vena cava was not observed for any of the catheters, nor was there any apparent damage or microembolizations in the lungs and kidneys. Many small-sized clots were observed on the surfaces of the nonmodified polyurethane tubes after a 2-week implantation whereas the catheter surfaces grafted with DMAA polymer chains had a much smaller number of clots. When the blood compatibility of polyurethane surfaces was graded for relative evaluation from one (marked clotting) to five (no clotting) based on the size and number of the clots, the evaluation results were as follows: 3.1 (virgin, 2 weeks), 4.0 (grafted, 1 week), 4.1 (grafted, 2 weeks), and 3.5 (grafted, 1 month).

The bioartificial pancreas was designed to incorporate islet tissues and a selectively permiable membrane that isolates islets from the immune system of the recipient. The efficacy of agarose, a nontoxic polysaccharide, has been evaluated as a material of microcapsules to prevent allo- and xenograft rejection in rodents. The aim of this study is to demonstrate the possibility of the agarose microcapsule containing allo-islets as a bioartificial pancreas in canine model. In vitro viability of islets was determined by glucose challenge during perifusion experiments (n = 4). Insulin secretion from both encapsulated (enc.) and non-encapsulated (non-enc.) canine islets rose from initial basal levels of 0.09 (encap.), 0.07 (non-encap.) to the peak of 0.2 (encap.), 0.1 (non-encap.) in microU/islet/min after 5 minutes, then decreased to the basal level when the glucose challenge was discontinued. Auto-transplantation was performed in two dogs to evaluated in vivo viability and biocompatibility of encapsulated islets implanted into the splenic sinus by venouse reflux. Two weeks after auto-transplantation, the plasma insulin levels in the splenic vein and artery of two dogs were assayed. In the first dog, serum insulin level was 1 microU/ml both in the vein and the artery and increased, after glucagon (1.0 mg) injection, to levels of 9 microU/ml in the vein, but still kept 1 microU/ml in artery, as well as in the second one. Histological and electron-microscopical examination of the spleen revealed that encapsulated islets remained morphologically intact and the surface of agarose capsules showed no significant adherence of fibroblasts and inflammatory cells. Functional efficacy of the microencapsulated islets was determined using five totally-pancreatectomized diabetic dogs as recipients without immunosuppression. Defined quantity of microencapsulated islets from outbred mongrel donors were grafted through the catheter into omental tissue of the pancreatectomized recipients. All dogs had various degrees of reduced insulin requirements. In three of five recipients, the average fasting glucose values were controlled under 120 mg/dl for 28, 42, 49 days without exogenous insulin, which received totally 4.3 x 10(3), 7.3 x 10(3) and 1.0 x 10(4) (IE/kg) of microencapsulated islets, respectively. In conclusion, the present study indicates that the agarose-based microencapsulated islets can function in large diabetic animals, resulting in the independence of exogenous insulin therapy for prolonged periods without the need for immunosuppression.