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Wu Y, Wang F, Huang Y, Zheng F, Zeng Y, Lu Z, Wang S, Sun B, Sun Y. A tantalum-containing zirconium-based metallic glass with superior endosseous implant relevant properties. Bioact Mater 2024; 39:25-40. [PMID: 38800719 PMCID: PMC11126771 DOI: 10.1016/j.bioactmat.2024.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 03/28/2024] [Accepted: 04/14/2024] [Indexed: 05/29/2024] Open
Abstract
Zirconium-based metallic glasses (Zr-MGs) are demonstrated to exhibit high mechanical strength, low elastic modulus and excellent biocompatibility, making them promising materials for endosseous implants. Meanwhile, tantalum (Ta) is also well known for its ideal corrosion resistance and biological effects. However, the metal has an elastic modulus as high as 186 GPa which is not comparable to the natural bone (10-30 GPa), and it also has a relative high cost. Here, to fully exploit the advantages of Ta as endosseous implants, a small amount of Ta (as low as 3 at. %) was successfully added into a Zr-MG to generate an advanced functional endosseous implant, Zr58Cu25Al14Ta3 MG, with superior comprehensive properties. Upon carefully dissecting the atomic structure and surface chemistry, the results show that amorphization of Ta enables the uniform distribution in material surface, leading to a significantly improved chemical stability and extensive material-cell contact regulation. Systematical analyses on the immunological, angiogenesis and osteogenesis capability of the material are carried out utilizing the next-generation sequencing, revealing that Zr58Cu25Al14Ta3 MG can regulate angiogenesis through VEGF signaling pathway and osteogenesis via BMP signaling pathway. Animal experiment further confirms a sound osseointegration of Zr58Cu25Al14Ta3 MG in achieving better bone-implant-contact and inducing faster peri-implant bone formation.
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Affiliation(s)
- Yunshu Wu
- Center of Digital Dentistry, Peking University School and Hospital of Stomatology, Beijing, 100081, China
- National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, 100081, China
- Beijing Key Laboratory of Digital Stomatology, Beijing, 100081, China
- Beijing Laboratory of Oral Health, Capital Medical University, Beijing, 100069, China
| | - Feifei Wang
- Center of Digital Dentistry, Peking University School and Hospital of Stomatology, Beijing, 100081, China
- National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, 100081, China
- Beijing Key Laboratory of Digital Stomatology, Beijing, 100081, China
| | - Yao Huang
- Institute of Physics, Chinese Academy of Sciences, Beijing, 100190, China
| | - Fu Zheng
- National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, 100081, China
- Beijing Key Laboratory of Digital Stomatology, Beijing, 100081, China
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, 100081, China
| | - Yuhao Zeng
- Center of Digital Dentistry, Peking University School and Hospital of Stomatology, Beijing, 100081, China
- National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, 100081, China
- Beijing Key Laboratory of Digital Stomatology, Beijing, 100081, China
| | - Zhen Lu
- Institute of Physics, Chinese Academy of Sciences, Beijing, 100190, China
| | - Songlin Wang
- Beijing Laboratory of Oral Health, Capital Medical University, Beijing, 100069, China
- Laboratory of Homeostatic Medicine, School of Medicine, Southern University of Science and Technology, Shenzhen, 518055, China
| | - Baoan Sun
- Institute of Physics, Chinese Academy of Sciences, Beijing, 100190, China
| | - Yuchun Sun
- Center of Digital Dentistry, Peking University School and Hospital of Stomatology, Beijing, 100081, China
- National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, 100081, China
- Beijing Key Laboratory of Digital Stomatology, Beijing, 100081, China
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Thomas P, Arenberger P, Bader R, Bircher AJ, Bruze M, de Graaf N, Hartmann D, Johansen JD, Jowitz-Heinke A, Krenn V, Kurek M, Odgaard A, Rustemeyer T, Summer B, Thyssen JP. A literature review and expert consensus statement on diagnostics in suspected metal implant allergy. J Eur Acad Dermatol Venereol 2024; 38:1471-1477. [PMID: 38606660 DOI: 10.1111/jdv.20026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 03/11/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND Although rare, allergic reactions to metal implants represent a diagnostic challenge in view of missing guidelines. OBJECTIVES To develop an European expert consensus on characteristics of metal allergy reactions and the utility of various diagnostic tools in suspected metal implant allergy. METHODS A nominal group technique (NGT) was applied to develop consensus statements. Initially an online literature database was created on a secure server to enable a comprehensive information. Twenty-three statements were formulated on potential aspects of metal implant allergy with a focus on diagnostics and grouped into five domains. For the consensus development, the panel of 12 experts initially did refine and reformulate those statements that were ambiguous or had unclear wording. By face-to-face (9/12) or virtual participation (3/12), an anonymous online voting was performed. RESULTS Consensus (≥80% of agreement) was reached in 20/23 statements. The panel agreed that implant allergy despite being rare should be considered in case of persistent unexplained symptoms. It was, however, recommended to allow adequate time for resolution of symptoms associated with healing and integration of an implant. Obtaining questionnaire-aided standardized medical history and standardized scoring of patient outcomes was also considered an important step by all experts There was broad consensus regarding the utility/performance of patch testing with additional late reading. It was recognized that the lymphocyte transformation test (LTT) has to many limitations to be generally recommended. Prior to orthopaedic implant, allergy screening of patients without a history of potential allergy to implant components was not recommended. CONCLUSIONS Using an expert consensus process, statements concerning allergy diagnostics in suspected metal implant allergy were created. Areas of nonconsensus were identified, stressing uncertainty among the experts around topics such as preoperative testing in assumed allergy, histological correlate of periimplant allergy and in vitro testing, which underscores the need for further research.
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Affiliation(s)
- P Thomas
- Department of Dermatology and Allergology, University Hospital, Munich, Germany
| | - P Arenberger
- Department of Dermatovenereology, Third Faculty of Medicine, Charles University and University Hospital of Kralovske Vinohrady, Prague, Czech Republic
| | - R Bader
- Department of Orthopaedics, Rostock University Medical Center, Rostock, Germany
| | - A J Bircher
- Department of Dermatology and Allergology, University Hospital and University of Basel, Basel, Switzerland
| | - M Bruze
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - N de Graaf
- Department of Dermatology, VU University Medical Center, Amsterdam, The Netherlands
| | - D Hartmann
- Department of Dermatology and Allergology, University Hospital, Munich, Germany
- München Klinik gGmbH, Munich, Germany
| | - J D Johansen
- Department of Dermatology and Allergy, National Allergy Research Centre, University of Copenhagen, Herlev and Gentofte Hospital, Hellerup, Denmark
| | - A Jowitz-Heinke
- Department of Orthopaedics, Rostock University Medical Center, Rostock, Germany
| | - V Krenn
- MVZHZMD Trier GmbH, Trier, Germany
| | - M Kurek
- Hospital MEDICAM, Gryfice, Poland
| | - A Odgaard
- Department of Orthopaedic Surgery, Rigshospitalet - Copenhagen University Hospital, Copenhagen, Denmark
- Institute of Clinical Medicine, Copenhagen University, Copenhagen, Denmark
| | - T Rustemeyer
- Department of Dermatology, VU University Medical Center, Amsterdam, The Netherlands
| | - B Summer
- Department of Dermatology and Allergology, University Hospital, Munich, Germany
| | - J P Thyssen
- Department of Dermatology and Allergy, University of Copenhagen, Herlev and Gentofte Hospital, Hellerup, Denmark
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Rivkin B, Akbar F, Otto M, Beyer L, Paul B, Kosiba K, Gustmann T, Hufenbach J, Medina-Sánchez M. Remotely Controlled Electrochemical Degradation of Metallic Implants. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2024; 20:e2307742. [PMID: 38326101 DOI: 10.1002/smll.202307742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 01/22/2024] [Indexed: 02/09/2024]
Abstract
Biodegradable medical implants promise to benefit patients by eliminating risks and discomfort associated with permanent implantation or surgical removal. The time until full resorption is largely determined by the implant's material composition, geometric design, and surface properties. Implants with a fixed residence time, however, cannot account for the needs of individual patients, thereby imposing limits on personalization. Here, an active Fe-based implant system is reported whose biodegradation is controlled remotely and in situ. This is achieved by incorporating a galvanic cell within the implant. An external and wireless signal is used to activate the on-board electronic circuit that controls the corrosion current between the implant body and an integrated counter electrode. This configuration leads to the accelerated degradation of the implant and allows to harvest electrochemical energy that is naturally released by corrosion. In this study, the electrochemical properties of the Fe-30Mn-1C/Pt galvanic cell model system is first investigated and high-resolution X-ray microcomputed tomography is used to evaluate the galvanic degradation of stent structures. Subsequently, a centimeter-sized active implant prototype is assembled with conventional electronic components and the remotely controlled corrosion is tested in vitro. Furthermore, strategies toward the miniaturization and full biodegradability of this system are presented.
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Affiliation(s)
- Boris Rivkin
- Leibniz Institute for Solid State and Materials Research (IFW), 01069, Dresden, Germany
| | - Farzin Akbar
- Leibniz Institute for Solid State and Materials Research (IFW), 01069, Dresden, Germany
| | - Martin Otto
- Leibniz Institute for Solid State and Materials Research (IFW), 01069, Dresden, Germany
- Institute of Materials Science, Technische Universität Bergakademie Freiberg, 09599, Freiberg, Germany
| | - Lukas Beyer
- Leibniz Institute for Solid State and Materials Research (IFW), 01069, Dresden, Germany
- Institute of Materials Science, Technische Universität Bergakademie Freiberg, 09599, Freiberg, Germany
| | - Birgit Paul
- Leibniz Institute for Solid State and Materials Research (IFW), 01069, Dresden, Germany
| | - Konrad Kosiba
- Leibniz Institute for Solid State and Materials Research (IFW), 01069, Dresden, Germany
| | - Tobias Gustmann
- Leibniz Institute for Solid State and Materials Research (IFW), 01069, Dresden, Germany
| | - Julia Hufenbach
- Leibniz Institute for Solid State and Materials Research (IFW), 01069, Dresden, Germany
- Institute of Materials Science, Technische Universität Bergakademie Freiberg, 09599, Freiberg, Germany
| | - Mariana Medina-Sánchez
- Leibniz Institute for Solid State and Materials Research (IFW), 01069, Dresden, Germany
- Center for Molecular Bioengineering (B CUBE), Chair of Micro- and Nano Systems, Technische Universität Dresden, 01307, Dresden, Germany
- CIC nanoGUNE-BRTA, Donostia-San Sebastián, 20018, Spain
- Ikerbasque, Basque Foundation for Science, Bilbao, 48013, Spain
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Jaenisch M, Wirtz DC. Titanium - a Cementable Material for Endoarthroplasty. ZEITSCHRIFT FUR ORTHOPADIE UND UNFALLCHIRURGIE 2024; 162:296-302. [PMID: 36720242 DOI: 10.1055/a-1975-0687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
As materials for arthroplasty, titanium alloys exhibit the following advantages over conventional steel, cobalt chromium or chromium nickel alloys - good fatigue strength, excellent biocompatibility, low modulus of elasticity, and high corrosion resistance. The previous worse clinical outcome was most likely caused by crevice corrosion and led to reduced use. To warrant safe use, the design should be optimised (sufficient proximal diameter, proximal collar), in order to reduce unwanted deformation in the proximal part of the prosthesis. Additionally, a rough surface (Ra > 2.5 µm) should not be used. Further research in surface treatments (e. g. silicate-silane) could facilitate additional improvement.
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Affiliation(s)
- Max Jaenisch
- Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Bonn, Bonn, Deutschland
| | - Dieter Christian Wirtz
- Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Bonn, Bonn, Deutschland
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5
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Taliercio MJ, Alnabulsi RK, Uppal PA, Shaw IM, Semenza KM, Pasha MA. Metal implant allergy: A retrospective cohort analysis at a university allergy practice. Allergy Asthma Proc 2024; 45:186-194. [PMID: 38755777 DOI: 10.2500/aap.2024.45.240005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
Background: Concern of metal sensitization in pre- and postsurgical evaluation is growing, with the recent guidelines remaining the criterion standard for consideration of patch testing. Information remains scarce on surgical screening in the groups of patients who reported a history of metal sensitivity versus those with no reported history. Objective: The objective of this study was to assess the utility of patch testing in surgical candidates based on reported metal allergy history. The secondary objective was to evaluate the utility and outcomes in postsurgical patch testing. Methods: Nine hundred and thirty-one patient charts of patients with the diagnosis of "contact dermatitis" who underwent an evaluation at a single allergy clinic site between January 2013 and December 2022 were identified and reviewed as part of a retrospective chart review study. Patients were included in subgroups based on the time of patch testing and history of reported metal allergy. Results: In all, 67 patients underwent patch testing, 10 (14.9%) of whom were surgical candidates without a history of metal sensitivity, 31 (46.2%) of whom were surgical candidates with a history of metal sensitivity, and 26 (38.8%) of whom were postsurgical patients. Twenty-nine (43.3%) of patients had positive patch testing results, with only one (10%) in the presurgical group, 17 (54.8%) in the presurgical with a history of metal sensitivity, and 11 (42.3%) in the postsurgical group. Zero patients in our cohort without metal sensitivity who were undergoing the Nuss procedure had positive reactions on patch testing, whereas two of four (50%) with reported metal sensitivity who were undergoing the Nuss procedure had positive relevant metal reactions. Conclusion: Ambiguity in the utility of patch testing for surgical decision making remains, despite common utilization. Recent guidelines along with coordination of care among the surgeon, allergist, and patient remains the criterion standard of care.
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Affiliation(s)
- Mark J Taliercio
- From the Department of Internal Medicine, Albany Medical Center, Albany, New York
| | - Rawaa K Alnabulsi
- Division of Allergy and Immunology, Department of Internal Medicine, Albany Medical Center, Albany, New York
| | | | - Ian M Shaw
- Department of Pediatrics, Albany Medical Collage, Albany, New York, and
| | - Kristy M Semenza
- Department of Allergy and Immunology, Bassett Medical Center, Cooperstown, New York
| | - Muhammad A Pasha
- Division of Allergy and Immunology, Department of Internal Medicine, Albany Medical Center, Albany, New York
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Fischer A, Telouk P, Beckmann C, Heermant S, Wittrock A, Debus J, Wimmer MA. Performance of Austenitic High-Nitrogen Steels under Gross Slip Fretting Corrosion in Bovine Serum. J Funct Biomater 2024; 15:110. [PMID: 38667567 PMCID: PMC11051106 DOI: 10.3390/jfb15040110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 04/08/2024] [Accepted: 04/09/2024] [Indexed: 04/28/2024] Open
Abstract
Modular artificial hip joints are a clinical standard today. However, the release of wear products from the head-taper interface, which includes wear particles in the nm size range, as well as metal ions, have raised concerns. Depending on the loading of such taper joints, a wide variety of different mechanisms have been found by retrieval analyses. From these, this paper concentrates on analyzing the contribution of gross slip fretting corrosion at ultra-mild wear rates using a bovine calf serum solution (BCS) as the lubricant. The parameters were chosen based on biomechanical considerations, producing wear rates of some ng/m wear path. In parallel, the evolution of tribomaterial (third bodies) was analyzed as to its constituents and generation rates. It has already been shown earlier that, by an advantageous combination of wear mechanisms and submechanisms, certain constituents of the tribomaterial remain inside the contact area and act like extreme-pressure lubricant additives. For the known wear and corrosion resistance of austenitic high-nitrogen steels (AHNSs), which outperform CoCrMo alloys even under inflammatory conditions, we hypothesized that such steels will generate ultra-mild wear rates under gross slip fretting. While testing AHNSs against commercially available biomedical-grade materials of CoCrMo and TiAlV alloys, as well as zirconia-toughened alumina (ZTA) and against itself, it was found that AHNSs in combination with a Ti6Al4V alloy generated the smallest wear rate under gross slip fretting corrosion. This paper then discusses the wear behavior on the basis of ex situ analyses of the worn surfaces as to the acting wear mechanisms and submechanisms, as well as to the tribological reaction products.
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Affiliation(s)
- Alfons Fischer
- Max Planck Institute for Sustainable Materials, Microstructure Physics and Alloy Design, 40237 Duesseldorf, Germany
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL 60612, USA;
| | - Philipe Telouk
- Laboratoire de Géologie, Université de Lyon, 69342 Lyon, France;
| | - Christian Beckmann
- Department of Physics, TU Dortmund University, 44227 Dortmund, Germany; (C.B.); (S.H.); (A.W.); (J.D.)
| | - Saskia Heermant
- Department of Physics, TU Dortmund University, 44227 Dortmund, Germany; (C.B.); (S.H.); (A.W.); (J.D.)
| | - Adrian Wittrock
- Department of Physics, TU Dortmund University, 44227 Dortmund, Germany; (C.B.); (S.H.); (A.W.); (J.D.)
| | - Jörg Debus
- Department of Physics, TU Dortmund University, 44227 Dortmund, Germany; (C.B.); (S.H.); (A.W.); (J.D.)
| | - Markus A. Wimmer
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL 60612, USA;
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Ali KA, He L, Li W, Zhang W, Huang H. Sleep quality and psychological health in patients with pelvic and acetabulum fractures: a cross-sectional study. BMC Geriatr 2024; 24:314. [PMID: 38575871 PMCID: PMC10993547 DOI: 10.1186/s12877-024-04929-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 03/29/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND AND OBJECTIVES It is known that difficulty sleeping after a fracture can have negative effects on both mental and physical health and may prolong the recovery process. The objective of this study is to explore how sleep quality and psychological health are linked in patients with pelvic and acetabulum fractures. METHODS A study was conducted on 265 patients between 2018 and 2022 who had suffered pelvic and acetabulum fractures. The study examined various factors, including age, gender, cause of injury, post-operative complications, and injury severity. The study employed ordinal logistic regression to examine the relationship between various pelvic fractures and seven subscales of the Majeed Pelvic Score (MPS), as well as the Sleep Disorder Questionnaire (SDQ) and Beck Depression Inventory (BDI). The study focused on the postoperative outcome one year after surgery, and each patient was assessed at the one-year mark after surgical intervention. Additionally, the study evaluated the functional outcome, sleep quality, and psychological disorders of the patients. RESULTS From 2018 to 2022, a total of 216 patients suffered from pelvic and acetabulum fractures. Among them, 6.6% experienced borderline clinical depression, and 45.2% reported mild mood disturbances. Anxiety was found to be mild to moderate in 46% of Tile C and posterior acetabulum wall fracture patients. About 24.8% of patients reported insomnia, while 23.1% reported sleep movement disorders. However, no significant correlation was found between fracture types and sleep disorders. The mean Majeed pelvic score (MPS) was 89.68. CONCLUSIONS Patients with pelvic and acetabular fractures typically experience functional improvement, but may also be at increased risk for insomnia and sleep movement disorders, particularly for certain types of fractures. Psychological well-being varies between fracture groups, with signs of borderline clinical depression observed in some cases. However, anxiety levels do not appear to be significantly correlated with pelvic and acetabular fractures.
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Affiliation(s)
- Khan Akhtar Ali
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue, Qiaokou District, Wuhan, Hubei, 430030, China
| | - LingXiao He
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue, Qiaokou District, Wuhan, Hubei, 430030, China
| | - Wenkai Li
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue, Qiaokou District, Wuhan, Hubei, 430030, China
| | - Weikai Zhang
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue, Qiaokou District, Wuhan, Hubei, 430030, China
| | - Hui Huang
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue, Qiaokou District, Wuhan, Hubei, 430030, China.
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Eraqi M, Diab AH, Matschke K, Alexiou K. Confirmation of Safety of Titanium Wire in Sternotomy Closure, A Randomized Prospective Study. Thorac Cardiovasc Surg 2024; 72:70-76. [PMID: 36918153 PMCID: PMC10786665 DOI: 10.1055/s-0043-1764315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 01/26/2023] [Indexed: 03/15/2023]
Abstract
BACKGROUND There are many factors that are known to increase the risk of sternal wound infection (SWI); some studies have reported that nickel is a risk factor for SWI. Titanium wires have only been used as an alternative to steel wires in patients with known allergy to nickel. However, there is a paucity of literature regarding the safety of using titanium wires compared to that on the safety of steel wires for sternum closure after cardiac surgery. Therefore, this study aimed to demonstrate the noninferiority of titanium wires, even in patients without a known allergy. METHODS A total of 322 patients who underwent elective full median sternotomy were randomly assigned to sternal closure either by titanium wires (n = 161) or by stainless steel wires. RESULTS Fourteen patients had sternal instability, six (3.7%) patients in the titanium group and eight (5%) patients in the stainless steel group (p = 0.585). There was no statistically significant difference between both groups in terms of postoperative wound infection (p = 0.147). Patients in the titanium group experienced statistically significant lower postoperative pain than those in the stainless steel group (p = 0.024). The wire type was not an independent risk factor for SI, as shown by univariate and logistic regression analyses. CONCLUSION Titanium wires are a good alternative and have been proven to be safe and effective for sternal closure. The surgeon should be aware of the possibility of developing an allergic reaction to the wires, especially in patients with previous multiple allergic histories.
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Affiliation(s)
- Mohamed Eraqi
- Klinikum Bayreuth GmbH, Bayreuth, Germany
- Department of Cardiac Surgery, Heart Center Dresden at the University Hospital Carl Gustav Carus, Dresden, Germany
| | - Abdel Hannan Diab
- Department of Cardiac Surgery, Heart Center Dresden at the University Hospital Carl Gustav Carus, Dresden, Germany
| | - Klaus Matschke
- Department of Cardiac Surgery, Heart Center Dresden at the University Hospital Carl Gustav Carus, Dresden, Germany
| | - Konstantin Alexiou
- Department of Cardiac Surgery, Heart Center Dresden at the University Hospital Carl Gustav Carus, Dresden, Germany
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Tidd JL, Gudapati LS, Simmons HL, Klika AK, Pasqualini I, Piuzzi NS. Do Patients With Hypoallergenic Total Knee Arthroplasty Implants for Metal Allergy Do Worse? An Analysis of Health Care Utilizations and Patient-Reported Outcome Measures. J Arthroplasty 2024; 39:103-110. [PMID: 37454947 DOI: 10.1016/j.arth.2023.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 07/02/2023] [Accepted: 07/10/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND Metal allergy is a rare and controversial cause of implant failure and poor outcomes following total knee arthroplasty (TKA). Few studies have investigated clinical and patient-reported outcome measures (PROMs) in patients treated with hypoallergenic implants. This investigation aimed to compare: (1) health care utilizations (eg, hospital length of stay, 90-day readmission rate, and incidence of nonhome discharge) and (2) 1-year PROMs between patients who received hypoallergenic and standard TKA implants. METHODS This was a retrospective review of prospectively collected data from patients who underwent primary TKA between 2018 and 2019. Propensity score matching (3:1) was used to compare standard TKA patients with those who received hypoallergenic TKA implants, respectively. Knee injury and Osteoarthritis Outcome Score (KOOS) pain, KOOS Physical function Shortform (PS), and Veterans RAND 12-Item Health Survey Mental Component Score were collected preoperatively and at 1-year. After matching, 190 hypoallergenic and 570 standard TKAs were analyzed. RESULTS No differences were observed in length of stay (P = .98), 90-day readmission (P = .89), and nonhome discharge (P = .82). Additionally, there was no significant difference in change from preoperative to 1-year PROMs (KOOS pain, P = .97; KOOS PS, P = .88; Veterans RAND 12-Item Health Survey Mental Component Score, P = .28). Patient-reported satisfaction was similar at 1-year (P = .23). Patients achieved similar rates of Patient Acceptable Symptom State (PASS) and minimal clinically important difference (MCID) for KOOS pain (PASS, P = .77; MCID, P = .33) and KOOS PS (PASS, P = .44; MCID, P = .65). CONCLUSION Patients treated with hypoallergenic TKA implants for suspected metal allergy had similar outcomes compared to patients who had standard implants and no metal allergy.
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Affiliation(s)
- Joshua L Tidd
- Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio; College of Medicine, Northeast Ohio Medical University, Rootstown, Ohio
| | | | - Hannah L Simmons
- Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio
| | - Alison K Klika
- Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio
| | | | - Nicolas S Piuzzi
- Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio; Department of Biomedical Engineering, Cleveland Clinic, Cleveland, Ohio
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10
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Tao H, Li X, Chu M, Wang Q, Li P, Han Q, Chen K, Zhu P, Hao Y, Yang X, Geng D, Gu Y. CB2 regulates oxidative stress and osteoclastogenesis through NOX1-dependent signaling pathway in titanium particle-induced osteolysis. Cell Death Discov 2023; 9:461. [PMID: 38104087 PMCID: PMC10725463 DOI: 10.1038/s41420-023-01761-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 11/29/2023] [Accepted: 12/06/2023] [Indexed: 12/19/2023] Open
Abstract
Periprosthetic osteolysis (PPO) induced by wear particles at the interface between the prosthesis and bone is a crucial issue of periprosthetic bone loss and implant failure. After wear and tear, granular material accumulates around the joint prosthesis, causing a chronic inflammatory response, progressive osteoclast activation and eventual loosening of the prosthesis. Although many studies have been conducted to address bone loss after joint replacement surgeries, they have not fully addressed these issues. Focusing on osteoclast activation induced by particles has important theoretical implications. Cannabinoid type II receptor (CB2) is a seven-transmembrane receptor that is predominantly distributed in the human immune system and has been revealed to be highly expressed in bone-associated cells. Previous studies have shown that modulation of CB2 has a positive effect on bone metabolism. However, the exact mechanism has not yet been elucidated. In our experiments, we found that NOX1-mediated ROS accumulation was involved in titanium particle-stimulated osteoclast differentiation. Furthermore, we confirmed that CB2 blockade alleviated titanium particle-stimulated osteoclast activation by inhibiting the NOX1-mediated oxidative stress pathway. In animal experiments, downregulation of CB2 alleviated the occurrence of titanium particle-induced cranial osteolysis by inhibiting osteoclasts and scavenging intracellular ROS. Collectively, our results suggest that CB2 blockade may be an attractive and promising therapeutic scheme for particle-stimulated osteoclast differentiation and preventing PPO.
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Affiliation(s)
- Huaqiang Tao
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, No. 188 Shizi Street, Suzhou, Jiangsu, China
| | - Xueyan Li
- Anesthesiology department, Suzhou Municipal Hospital, Nanjing Medical University Affiliated Suzhou Hospital, 242, Guangji Road, Suzhou, Jiangsu, China
| | - Miao Chu
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, No. 188 Shizi Street, Suzhou, Jiangsu, China
| | - Qiufei Wang
- Department of Orthopedics, Changshu Hospital Affiliated to Soochow University, First People's Hospital of Changshu City, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Ping Li
- Department of Central Laboratory, Nanjing Medical University Affiliated Suzhou Hospital, Gusu School, Suzhou, Jiangsu, China
| | - Qibin Han
- Orthopedics and Sports Medicine Center, Suzhou Municipal Hospital, Nanjing Medical University Affiliated Suzhou Hospital, 242, Guangji Road, Suzhou, Jiangsu, China
| | - Kai Chen
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, No. 188 Shizi Street, Suzhou, Jiangsu, China
| | - Pengfei Zhu
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, No. 188 Shizi Street, Suzhou, Jiangsu, China
| | - Yuefeng Hao
- Orthopedics and Sports Medicine Center, Suzhou Municipal Hospital, Nanjing Medical University Affiliated Suzhou Hospital, 242, Guangji Road, Suzhou, Jiangsu, China
| | - Xing Yang
- Orthopedics and Sports Medicine Center, Suzhou Municipal Hospital, Nanjing Medical University Affiliated Suzhou Hospital, 242, Guangji Road, Suzhou, Jiangsu, China.
| | - Dechun Geng
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, No. 188 Shizi Street, Suzhou, Jiangsu, China.
| | - Ye Gu
- Department of Orthopedics, Changshu Hospital Affiliated to Soochow University, First People's Hospital of Changshu City, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
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11
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Watanabe M, Liu L, Ichikawa T. Are Allergy-Induced Implant Failures Actually Hypersensitivity Reactions to Titanium? A Literature Review. Dent J (Basel) 2023; 11:263. [PMID: 37999027 PMCID: PMC10670842 DOI: 10.3390/dj11110263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 11/02/2023] [Accepted: 11/08/2023] [Indexed: 11/25/2023] Open
Abstract
PURPOSE This literature review was performed to assess whether implant failures are associated with titanium allergy. MATERIALS AND METHODS An electronic search of the MEDLINE/PubMed, Cochrane Library, and Scopus databases up to April 2021 was conducted, and the obtained articles were independently assessed by two reviewers. Articles describing cases of implant failure in which the cause of implant failure was only identified as allergy were included. RESULTS Twelve studies were included. Eight studies identified Ti allergy by clinical examinations, of which four used patch tests, three used the lymphocyte transformation test (LTT)/memory lymphocyte immunostimulation assay (MELISA), and one used both tests. Nine studies reported cases of titanium hypersensitivity in combination with other systemic allergy-related disorders, with eight cases also showing positive results for Ni, Hg, Cr, and Co hypersensitivity. Ten papers reported the improvement of symptoms after the removal of the Ti implants and their replacement with zirconia implants, and two of these papers showed good results. CONCLUSION Cases of probable titanium allergy included those with true titanium allergies and those with a potentially different cause. However, the differentiation of these cases is difficult. Since no definitive method has been established for diagnosing titanium allergy, a comprehensive diagnosis based on the clinical course and clinical examination using a patch test/LTT/MELISA is necessary. Implant treatment should be performed with caution in patients with any preoperative allergies.
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Affiliation(s)
- Megumi Watanabe
- Department of Prosthodontics & Oral Rehabilitation, Tokushima University, Graduate School of Biomedical Sciences, 3-18-15, Kuramoto, Tokushima 770-8504, Japan; (L.L.); (T.I.)
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12
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Dong W, Yang Z. Association of nickel exposure with body mass index, waist circumference and incidence of obesity in US adults. CHEMOSPHERE 2023; 338:139599. [PMID: 37480956 DOI: 10.1016/j.chemosphere.2023.139599] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 06/25/2023] [Accepted: 07/19/2023] [Indexed: 07/24/2023]
Abstract
This study aimed to detect the relationship between nickel exposure and body mass index (BMI), waist circumference and incidence of obesity in the general population of the United States. The National Health and Nutrition Examination Survey (NHANES) 2017-2018 database was utilized, and the sample comprised 1702 participants aged 18 years and above with complete urinary nickel, body mass index, and waist circumference data. Obesity was determined using BMI and waist circumference data. The multivariate linear regression and logistic regression models were utilized to detect the association between urinary nickel concentration and BMI, waist circumference, and incidence of obesity. After multivariable adjustment, the log-transformed urinary nickel concentration was inversely associated with BMI [β = -0.87; 95% confidence interval (CI): (-1.36, -0.38)] and waist circumference [β = -1.51; 95% CI: (-2.93, -0.08)]. Compared with the lowest tertile of urinary nickel, the β value and 95% CI of BMI and waist circumference for the highest tertile were β = -1.65.95% CI: (-2.85, -0.45) and β = -2.78, 95% CI: (-6.17, 0.62), respectively. The log-transformed urinary nickel concentration was also negatively associated with obesity status [adjusted odds ratio (OR) = 0.81, 95% CI: (0.64, 1.01)]. Compared with the lowest tertile of urinary nickel, the adjusted OR and 95% CI of obesity status for the highest tertile were OR = 0.64 and 95% CI: (0.37, 1.12). Smooth curve fitting and the generalized additive model indicated that elevated urinary nickel concentration was associated with decreased BMI, waist circumference, and incidence of obesity. The negative association was consistent and robust in different subgroups, according to stratified analysis. This study found that nickel exposure may be negatively associated with BMI, waist circumference and incidence of obesity in US Adults.
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Affiliation(s)
- Weiwei Dong
- Department of Neurosurgery, Shengjing Hospital of China Medical University, Shenyang, China
| | - Zhiyong Yang
- Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, China.
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13
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Miller AC, Ratushny V, Cognetta AB. Rash and Poor Wound Healing After Mastectomy. JAMA 2023; 330:1092-1093. [PMID: 37642971 DOI: 10.1001/jama.2023.16367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
A patient who had recently undergone bilateral mastectomy had erythema, edema, pain, pruritus, serous fluid drainage at the incision sites, and an erythematous papulovesicular rash on the trunk and extremities. A skin swab bacterial culture result was negative, and the skin findings did not improve with antibiotics. What is the diagnosis and what would you do next?
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Affiliation(s)
- Austinn C Miller
- Dermatology Associates of Tallahassee, Tallahassee, Florida
- University of Central Florida/HCA Consortium, Tallahassee
| | - Vladimir Ratushny
- Dermatology Associates of Tallahassee, Tallahassee, Florida
- Mohs Micrographic Surgery Unit, Division of Dermatology, Florida State University College of Medicine, Tallahassee
| | - Armand B Cognetta
- Dermatology Associates of Tallahassee, Tallahassee, Florida
- University of Central Florida/HCA Consortium, Tallahassee
- Mohs Micrographic Surgery Unit, Division of Dermatology, Florida State University College of Medicine, Tallahassee
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14
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Meng M, Wang J, Huang H, Liu X, Zhang J, Li Z. 3D printing metal implants in orthopedic surgery: Methods, applications and future prospects. J Orthop Translat 2023; 42:94-112. [PMID: 37675040 PMCID: PMC10480061 DOI: 10.1016/j.jot.2023.08.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 07/28/2023] [Accepted: 08/02/2023] [Indexed: 09/08/2023] Open
Abstract
Background Currently, metal implants are widely used in orthopedic surgeries, including fracture fixation, spinal fusion, joint replacement, and bone tumor defect repair. However, conventional implants are difficult to be customized according to the recipient's skeletal anatomy and defect characteristics, leading to difficulties in meeting the individual needs of patients. Additive manufacturing (AM) or three-dimensional (3D) printing technology, an advanced digital fabrication technique capable of producing components with complex and precise structures, offers opportunities for personalization. Methods We systematically reviewed the literature on 3D printing orthopedic metal implants over the past 10 years. Relevant animal, cellular, and clinical studies were searched in PubMed and Web of Science. In this paper, we introduce the 3D printing method and the characteristics of biometals and summarize the properties of 3D printing metal implants and their clinical applications in orthopedic surgery. On this basis, we discuss potential possibilities for further generalization and improvement. Results 3D printing technology has facilitated the use of metal implants in different orthopedic procedures. By combining medical images from techniques such as CT and MRI, 3D printing technology allows the precise fabrication of complex metal implants based on the anatomy of the injured tissue. Such patient-specific implants not only reduce excessive mechanical strength and eliminate stress-shielding effects, but also improve biocompatibility and functionality, increase cell and nutrient permeability, and promote angiogenesis and bone growth. In addition, 3D printing technology has the advantages of low cost, fast manufacturing cycles, and high reproducibility, which can shorten patients' surgery and hospitalization time. Many clinical trials have been conducted using customized implants. However, the use of modeling software, the operation of printing equipment, the high demand for metal implant materials, and the lack of guidance from relevant laws and regulations have limited its further application. Conclusions There are advantages of 3D printing metal implants in orthopedic applications such as personalization, promotion of osseointegration, short production cycle, and high material utilization. With the continuous learning of modeling software by surgeons, the improvement of 3D printing technology, the development of metal materials that better meet clinical needs, and the improvement of laws and regulations, 3D printing metal implants can be applied to more orthopedic surgeries. The translational potential of this paper Precision, intelligence, and personalization are the future direction of orthopedics. It is reasonable to believe that 3D printing technology will be more deeply integrated with artificial intelligence, 4D printing, and big data to play a greater role in orthopedic metal implants and eventually become an important part of the digital economy. We aim to summarize the latest developments in 3D printing metal implants for engineers and surgeons to design implants that more closely mimic the morphology and function of native bone.
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Affiliation(s)
- Meng Meng
- Department of Orthopedics, First Affiliated Hospital of Dalian Medical University, Dalian, PR China
- Key Laboratory of Molecular Mechanism for Repair and Remodeling of Orthopedic Diseases, Liaoning Province, PR China
| | - Jinzuo Wang
- Department of Orthopedics, First Affiliated Hospital of Dalian Medical University, Dalian, PR China
- Key Laboratory of Molecular Mechanism for Repair and Remodeling of Orthopedic Diseases, Liaoning Province, PR China
| | - Huagui Huang
- Department of Orthopedics, First Affiliated Hospital of Dalian Medical University, Dalian, PR China
- Key Laboratory of Molecular Mechanism for Repair and Remodeling of Orthopedic Diseases, Liaoning Province, PR China
| | - Xin Liu
- Department of Orthopedics, First Affiliated Hospital of Dalian Medical University, Dalian, PR China
- Key Laboratory of Molecular Mechanism for Repair and Remodeling of Orthopedic Diseases, Liaoning Province, PR China
| | - Jing Zhang
- Department of Orthopedics, First Affiliated Hospital of Dalian Medical University, Dalian, PR China
- Key Laboratory of Molecular Mechanism for Repair and Remodeling of Orthopedic Diseases, Liaoning Province, PR China
| | - Zhonghai Li
- Department of Orthopedics, First Affiliated Hospital of Dalian Medical University, Dalian, PR China
- Key Laboratory of Molecular Mechanism for Repair and Remodeling of Orthopedic Diseases, Liaoning Province, PR China
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15
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Deng H, Li M, Fang X, Zhang J, Wang J, Tang K, Tang R, Jia R, Han Y, Shi Y, Dong Y. Evaluation of the mechanical properties and clinical application of nickel-titanium shape memory alloy anal fistula clip. Front Surg 2023; 10:1235666. [PMID: 37680263 PMCID: PMC10481869 DOI: 10.3389/fsurg.2023.1235666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 08/03/2023] [Indexed: 09/09/2023] Open
Abstract
Objective The study investigates the mechanical properties of a nickel-titanium shape memory alloy anal fistula clip (NiTi-AFC), studies the surgical method of treating anal fistula, and evaluates its clinical efficacy. Methods The anal fistula clip was formed in nickel-titanium alloy with a titanium content of 50.0%-51.8%. The mechanical properties and chemical properties were tested. A total of 31 patients with anal fistula were enrolled between 1 January 2020 and 1 January 2023. All patients underwent internal orifice closure surgery using NiTi-AFC, and anorectal magnetic resonance or ultrasound was performed before surgery and 6 months after surgery for diagnosis and evaluation. Fistula cure rates, length of stay, perianal pain, and Wexner incontinence scores were retrospectively compared between patients treated with NiTi-AFC and patients treated with other surgical methods. Result NiTi-AFC has a density of 6.44-6.50 g·cm-3, with a shape-restoring force of 63.8 N. The corrosion rate of NiTi-AFC in 0.05% hydrochloric acid solution at atmospheric pressure and 20°C is approximately 6.8 × 10-5 g·(m·h)-1. A total of 31 patients (male/female: 19/12, age: 43.7 ± 17.8 years) were included. Among them, 22.6% (7) had multiple anal fistula, 16.1% (5) had high anal fistula, and 48.3% (15) had perianal fistula Crohn's disease. In total, 12.9% (4/31) did not achieve primary healing, underwent fistula resection, and eventually recovered. A retrospective analysis showed that the fistula healing rate, length of stay, and anal pain of NiTi-AFC treatment were similar to those of other traditional surgeries, but the Wexner incontinence score was significantly lower. Conclusion NiTi-AFC has shape memory properties, corrosion resistance, superelastic effect, and surface cell adhesion. It is applied to internal orifice closure surgery of anal fistula, with good therapeutic effect, and can protect the anal function.
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Affiliation(s)
- Heng Deng
- Department of Anorectal Surgery, Second Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, China
| | - Ming Li
- Department of Anorectal Surgery, First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Hefei, China
| | - Xiaoli Fang
- Department of Anorectal Surgery, First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Hefei, China
| | - Jun Zhang
- College of Traditional Chinese Medicine, Anhui University of Chinese Medicine, Hefei, China
| | - Jianmin Wang
- Department of Anorectal Surgery, First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Hefei, China
| | - Kun Tang
- Department of Anorectal Surgery, First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Hefei, China
| | - Ran Tang
- Department of Anorectal Surgery, First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Hefei, China
| | - Ru Jia
- Department of Anorectal Surgery, Second Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, China
| | - Ying Han
- Department of Anorectal Surgery, First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Hefei, China
| | - Yang Shi
- Department of Anorectal Surgery, First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Hefei, China
| | - Yu'ang Dong
- College of Traditional Chinese Medicine, Anhui University of Chinese Medicine, Hefei, China
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16
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De Ruvo E, Petrungaro M, De Luca L, Bressi E, Bruni G, Fagagnini A, Grieco D, Martino AM, Panuccio M, Politano A, Rebecchi M, Calò L. Cardiac implantable electronic devices (CIEDs) and allergy. J Arrhythm 2023; 39:310-314. [PMID: 37324770 PMCID: PMC10264757 DOI: 10.1002/joa3.12852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 03/09/2023] [Accepted: 03/27/2023] [Indexed: 06/17/2023] Open
Abstract
Advances in cardiac implantable electronic devices (CIEDs) have prolonged life expectancy in various medical settings. However, the issue of hypersensitivity to components of CIEDs is still a concern. Since 1970, allergic reactions to metallic and nonmetallic components of CIEDs have been reported. Hypersensitivity reactions to medical devices are rare and not fully understood. In some cases, diagnosis and treatment are difficult. Cardiologists should always keep in mind pacemaker allergy when a patient appears with wound complications and no signs of infection. Patch testing should be tailored toward the specific biomaterials used in a device, in addition to testing with standard screening allergens in select cases.
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Affiliation(s)
| | - Mattia Petrungaro
- Cardiology Department, Faculty of Medicine and Psychology, Sant'Andrea HospitalUniversity of Rome SapienzaRomeItaly
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17
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Mortada WI, El-Naggar A, Mosa A, Palansooriya KN, Yousaf B, Tang R, Wang S, Cai Y, Chang SX. Biogeochemical behaviour and toxicology of chromium in the soil-water-human nexus: A review. CHEMOSPHERE 2023; 331:138804. [PMID: 37137390 DOI: 10.1016/j.chemosphere.2023.138804] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 04/25/2023] [Accepted: 04/27/2023] [Indexed: 05/05/2023]
Abstract
Chromium (Cr) affects human health if it accumulates in organs to elevated concentrations. The toxicity risk of Cr in the ecosphere depends upon the dominant Cr species and their bioavailability in the lithosphere, hydrosphere, and biosphere. However, the soil-water-human nexus that controls the biogeochemical behaviour of Cr and its potential toxicity is not fully understood. This paper synthesizes information on different dimensions of Cr ecotoxicological hazards in the soil and water and their subsequent effects on human health. The various routes of environmental exposure of Cr to humans and other organisms are also discussed. Human exposure to Cr(VI) causes both carcinogenic and non-carcinogenic health effects via complicated reactions that include oxidative stress, chromosomal and DNA damage, and mutagenesis. Chromium (VI) inhalation can cause lung cancer; however, incidences of other types of cancer following Cr(VI) exposure are low but probable. The non-carcinogenic health consequences of Cr(VI) exposure are primarily respiratory and cutaneous. Research on the biogeochemical behaviour of Cr and its toxicological hazards on human and other biological routes is therefore urgently needed to develop a holistic approach to understanding the soil-water-human nexus that controls the toxicological hazards of Cr and its detoxification.
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Affiliation(s)
- Wael I Mortada
- Urology and Nephrology Center, Mansoura University, Mansoura, 35516, Egypt
| | - Ali El-Naggar
- State Key Laboratory of Subtropical Silviculture, Zhejiang A&F University, Lin'an, 311300, China; Department of Soil Sciences, Faculty of Agriculture, Ain Shams University, Cairo, 11241, Egypt; Department of Renewable Resources, University of Alberta, Edmonton, Alberta, T6G 2H1, Canada
| | - Ahmed Mosa
- Soils Department, Faculty of Agriculture, Mansoura University, Mansoura, 35516, Egypt.
| | | | - Balal Yousaf
- CAS-Key Laboratory of Crust-Mantle Materials and the Environments, School of Earth and Space Sciences, University of Science and Technology of China, Hefei, 230026, China; Department of Environmental Engineering, Middle East Technical University, Ankara, 06800, Turkey
| | - Ronggui Tang
- State Key Laboratory of Subtropical Silviculture, Zhejiang A&F University, Lin'an, 311300, China
| | - Shengsen Wang
- College of Environmental Science and Engineering, Yangzhou University, 196 W Huayang Rd, Yangzhou, Jiangsu, PR China
| | - Yanjiang Cai
- State Key Laboratory of Subtropical Silviculture, Zhejiang A&F University, Lin'an, 311300, China
| | - Scott X Chang
- State Key Laboratory of Subtropical Silviculture, Zhejiang A&F University, Lin'an, 311300, China; Department of Renewable Resources, University of Alberta, Edmonton, Alberta, T6G 2H1, Canada.
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18
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Johanes M, Gupta M. An Investigation into the Potential of Turning Induced Deformation Technique for Developing Porous Magnesium and Mg-SiO 2 Nanocomposite. MATERIALS (BASEL, SWITZERLAND) 2023; 16:2463. [PMID: 36984345 PMCID: PMC10051495 DOI: 10.3390/ma16062463] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 03/17/2023] [Accepted: 03/18/2023] [Indexed: 06/18/2023]
Abstract
A new and novel method of synthesising porous Mg materials has been explored utilising a variant of a processing method previously used for the synthesis of dense Mg materials, namely the turning-induced deformation (TID) method combined with sintering. It was found that the Mg materials synthesised possessed comparable properties to previously-synthesised porous Mg materials in the literature while subsequent sintering resulted in a more consistent mechanical response, with microwave sintering showing the most promise. The materials were also found to possess mechanical response within the range of the human cancellous bone, and when reinforced with biocompatible silica nanoparticles, presented the most optimal combination of mechanical properties for potential use as biodegradable implants due to most similarity with cancellous bone properties.
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19
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Clinical Benefit and Safety of Microneedle Patches Composed of Magnesium: A Pilot Study in Acne Patients. Dermatol Ther 2023. [DOI: 10.1155/2023/7667296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023]
Abstract
Magnesium (Mg) is a newly investigated biomaterial that corrodes physiologically in water, resulting in evolved hydrogen with beneficial effects of anti-inflammation and acceleration of the wound healing process. In addition, Mg itself has antimicrobial activity against Cutibacterium acnes, which play a pathogenic role in developing inflammatory acne. This study aimed to evaluate efficacy and safety of a newly developed magnesium microneedle (Mg MN) patch, with a needle length of 0.25 mm, on acne and widened pores. A total of 19 patients with mild to moderate acne and receiving no topical or oral treatment was enrolled in the study. Mg MN patches were applied to inflammatory acne lesions and widened pores on both cheeks and nose. Researchers evaluated efficacy by counting acne lesions and measuring pore sizes, porphyrin level, and sebum secretion. Any objective or subjective adverse events were recorded during the study. The number of acne lesions and scores improved significantly within seven days (
). The porphyrin level tended to decrease over 12 weeks, although pore size and sebum secretion showed unsatisfactory results. No adverse reactions were noted during the study period. Mg MN patches can be useful in treating inflammatory acne lesions, and they are safe to use. For the improvement of widened pores, modification of needle length or a combination of topical agents may be required.
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20
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Dadkhahfar S, Chehrassan M, Faldini C. Hypersensitivity reactions to metals in spine surgery. Musculoskelet Surg 2023; 107:29-35. [PMID: 36344900 DOI: 10.1007/s12306-022-00765-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 10/05/2022] [Indexed: 11/09/2022]
Abstract
Hypersensitivity to orthopedic devices is a rare condition with an underestimated incidence due to the lack of diagnostic guideline and ambiguous clinical manifestations. Although hypersensitivity to metal is common, a few cases of hypersensitivity reactions have been reported after spinal instrumentation. Spinal fusion and stabilization require a wide range of devices such as screws, wires, bands, and artificial disk replacement devices. Spinal instrumented surgeries are different from total joint arthroplasty in several aspects such as degree and pattern of motion, loading environment, and adjacent tissues with distinct characteristics. The interval for hypersensitivity reactions to occur after spinal metallic implantation is usually weeks to months. The present review covers the topic of hypersensitivity reactions that have been reported after spinal surgeries with the focus on cutaneous presentations.
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Affiliation(s)
- S Dadkhahfar
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - M Chehrassan
- Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran.
| | - C Faldini
- Istituto Orthopedico Rizzoli, Bologna, Italy
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21
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Koizumi H, Yamamoto D, Handa H, Saruta W, Shimizu S, Hide T, Kumabe T. Frontotemporal Craniotomy for Clipping of Unruptured Aneurysm Using a Diamond-Coated Thread Wire Saw and Reconstruction Using Calcium Phosphate Cement without Metal Fixation. Arch Plast Surg 2023; 50:248-253. [DOI: 10.1055/s-0042-1758543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 07/23/2022] [Indexed: 02/12/2023] Open
Abstract
AbstractMetal fixation systems for cranial bone flaps cut by a drill are convenient devices for cranioplasty, but cause several complications. We use modified craniotomy using a fine diamond-coated threadwire saw (diamond T-saw) to reduce the bone defect, and osteoplasty calcium phosphate cement without metal fixation. We report our outcomes and tips of this method. A total of 78 consecutive patients underwent elective frontotemporal craniotomy for clipping of unruptured intracranial aneurysms between 2015 and 2019. The follow-up periods ranged from 13 to 66 months. The bone fixation state was evaluated by bone computed tomography (CT) and three-dimensional CT (3D-CT). The diamond T-saw could minimize the bone defect. Only one wound infection occurred within 1 week postoperatively, and no late infection. No pain, palpable/cosmetically noticeable displacement of the bone flap, fluid accumulations, or other complications were observed. The condition of bone fixation and the cosmetic efficacy were thoroughly satisfactory for all patients, and bone CT and 3D-CT demonstrated that good bone fusion. No complication typical of metal fixation occurred. Our method is technically easy and safety, and achieved good mid-term bone flap fixation in the mid-term course, so has potential for bone fixation without the use of metal plates.
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Affiliation(s)
- Hiroyuki Koizumi
- Department of Neurosurgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
| | - Daisuke Yamamoto
- Department of Neurosurgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
| | - Hajime Handa
- Department of Neurosurgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
| | - Wakiko Saruta
- Department of Neurosurgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
| | - Satoru Shimizu
- Department of Neurosurgery, Yokohama Brain and Spine Center, Yokohama, Kanagawa, Japan
| | - Takuichiro Hide
- Department of Neurosurgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
| | - Toshihiro Kumabe
- Department of Neurosurgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
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22
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Mizukoshi K, Okazawa Y, Amemiya K, Tsuchiya Y, Motegi S, Tsukamoto R, Honjo K, Takahashi R, Yoshihara N, Kawano S, Kawai M, Munakata S, Ishiyama S, Sugimoto K, Takahashi M, Kojima Y, Ikeda S, Sakamoto K. Examination of colorectal cancer cases with metal allergy. Surg Today 2023:10.1007/s00595-023-02643-7. [PMID: 36757618 DOI: 10.1007/s00595-023-02643-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 09/30/2022] [Indexed: 02/10/2023]
Abstract
PURPOSE To report our initiatives and treatment results for patients with colorectal cancer with metal allergy. METHODS A total of 27 patients (2.6%) with a history of metal contact dermatitis were identified among 1027 patients who underwent curative resection of colorectal cancer from 2014 to 2020. The results of the patch test, perioperative results, and postoperative colonoscopy findings were also investigated. RESULTS The patch test for metal allergens and staples was performed in 21 patients (77.8%), and 13 of them (61.9%) tested positive for at least one metal allergen. Ni (38.1%), Co (28.6%), and Pd (19.0%) showed higher positive rates than other metals, and 1 patient (4.8%) tested positive for staples. Stapled anastomosis/suturing was performed as planned in 15 of 27 patients. In 10 patients, the anastomosis method was changed from stapled to hand-sewn according to the no-patch test results (60%), positivity for multiple metals (20%), positivity for staples (10%), and surgeon's judgment (10%). No complications and abnormal colonoscopy findings were found to be associated with stapled anastomosis/suturing. CONCLUSION The patch test is useful for selecting an optimal anastomosis method for patients with suspected metal allergy.
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Affiliation(s)
- Kosuke Mizukoshi
- Department of Coloproctological Surgery, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan. .,Department of Surgery, Kuwana City Medical Center, 3-11 Kotobuki-cho, Kuwana-shi, Mie, 511-0061, Japan.
| | - Yu Okazawa
- Department of Coloproctological Surgery, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan
| | - Kota Amemiya
- Department of Coloproctological Surgery, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan
| | - Yuki Tsuchiya
- Department of Coloproctological Surgery, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan
| | - Shunsuke Motegi
- Department of Coloproctological Surgery, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan
| | - Ryoichi Tsukamoto
- Department of Coloproctological Surgery, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan
| | - Kumpei Honjo
- Department of Coloproctological Surgery, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan
| | - Rina Takahashi
- Department of Coloproctological Surgery, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan
| | - Nagisa Yoshihara
- Department of Dermatology and Allergology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan
| | - Shingo Kawano
- Department of Coloproctological Surgery, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan
| | - Masaya Kawai
- Department of Coloproctological Surgery, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan
| | - Shinya Munakata
- Department of Coloproctological Surgery, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan
| | - Shun Ishiyama
- Department of Coloproctological Surgery, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan
| | - Kiichi Sugimoto
- Department of Coloproctological Surgery, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan
| | - Makoto Takahashi
- Department of Coloproctological Surgery, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan
| | - Yutaka Kojima
- Department of Coloproctological Surgery, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan
| | - Shigaku Ikeda
- Department of Dermatology and Allergology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan
| | - Kazuhiro Sakamoto
- Department of Coloproctological Surgery, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan
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23
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Liu Z, Zhu J, Li Z, Liu H, Fu C. Biomaterial scaffolds regulate macrophage activity to accelerate bone regeneration. Front Bioeng Biotechnol 2023; 11:1140393. [PMID: 36815893 PMCID: PMC9932600 DOI: 10.3389/fbioe.2023.1140393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 01/26/2023] [Indexed: 02/05/2023] Open
Abstract
Bones are important for maintaining motor function and providing support for internal organs. Bone diseases can impose a heavy burden on individuals and society. Although bone has a certain ability to repair itself, it is often difficult to repair itself alone when faced with critical-sized defects, such as severe trauma, surgery, or tumors. There is still a heavy reliance on metal implants and autologous or allogeneic bone grafts for bone defects that are difficult to self-heal. However, these grafts still have problems that are difficult to circumvent, such as metal implants that may require secondary surgical removal, lack of bone graft donors, and immune rejection. The rapid advance in tissue engineering and a better comprehension of the physiological mechanisms of bone regeneration have led to a new focus on promoting endogenous bone self-regeneration through the use of biomaterials as the medium. Although bone regeneration involves a variety of cells and signaling factors, and these complex signaling pathways and mechanisms of interaction have not been fully understood, macrophages undoubtedly play an essential role in bone regeneration. This review summarizes the design strategies that need to be considered for biomaterials to regulate macrophage function in bone regeneration. Subsequently, this review provides an overview of therapeutic strategies for biomaterials to intervene in all stages of bone regeneration by regulating macrophages.
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Affiliation(s)
- Zongtai Liu
- Department of Spine Surgery, First Hospital of Jilin University, Changchun, China,Department of Orthopedics, Affiliated Hospital of Beihua University, Jilin, China
| | - Jiabo Zhu
- Department of Orthopedics, Affiliated Hospital of Beihua University, Jilin, China
| | - Zhuohan Li
- Department of Gynecology, Affiliated Hospital of Beihua University, Jilin, China
| | - Hanyan Liu
- Department of Orthopedics, Baicheng Central Hospital, Baicheng, China
| | - Changfeng Fu
- Department of Spine Surgery, First Hospital of Jilin University, Changchun, China,*Correspondence: Changfeng Fu,
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24
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Sun L, Chen X, Ma K, Chen R, Mao Y, Chao R, Wang H, Yu B, Wang J, Zhang S. Novel Titanium Implant: A 3D Multifunction Architecture with Charge-Trapping and Piezoelectric Self-Stimulation. Adv Healthc Mater 2023; 12:e2202620. [PMID: 36622654 DOI: 10.1002/adhm.202202620] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 12/28/2022] [Indexed: 01/10/2023]
Abstract
Implant-associated infection and inflammation are the main causes of implant failure, causing irreversible damage and significantly increasing clinical risks and economic losses. In this study, a 3D multifunctional architecture is constructed that consisted of hierarchical TiO2 nanotubes (NTs) and electrospun polyvinylidene fluoride nanofiber layers on the surface of a titanium implant. The movement of bacteria through the nanofiber layer is facilitated by its appropriate pore sizes and electrostatic interactions to reach the NT layer where the bacteria are killed by positive charge traps. In contrast, the macrophages tend to adhere to the nanofiber layer. The mechanical interactions between the macrophages and piezoelectric nanofibers generate a self-stimulated electric field that regulated an anti-inflammatory phenotype. This study provides a new method for multifunctional implant materials with antibacterial, piezoelectrically self-stimulated anti-inflammatory, and osteointegration properties that are driven by electrical stimulation.
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Affiliation(s)
- Lei Sun
- Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, National Clinical Research Center of Stomatology, Shanghai, 200011, China.,Department of Stomatology, the Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230601, China
| | - Xuzhuo Chen
- Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, National Clinical Research Center of Stomatology, Shanghai, 200011, China
| | - Kun Ma
- High Magnetic Field Laboratory, CAS Key Laboratory of High Magnetic Field and Ion Beam Physical Biology, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, Anhui, 230031, China
| | - Ruiguo Chen
- High Magnetic Field Laboratory, CAS Key Laboratory of High Magnetic Field and Ion Beam Physical Biology, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, Anhui, 230031, China
| | - Yi Mao
- Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, National Clinical Research Center of Stomatology, Shanghai, 200011, China
| | - Rui Chao
- Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, National Clinical Research Center of Stomatology, Shanghai, 200011, China
| | - Hui Wang
- High Magnetic Field Laboratory, CAS Key Laboratory of High Magnetic Field and Ion Beam Physical Biology, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, Anhui, 230031, China
| | - Bin Yu
- State Key Laboratory for Modification of Chemical Fibers & Polymer Materials, College of Materials Science & Engineering, Donghua University, Shanghai, 201620, China
| | - Junfeng Wang
- High Magnetic Field Laboratory, CAS Key Laboratory of High Magnetic Field and Ion Beam Physical Biology, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, Anhui, 230031, China
| | - Shanyong Zhang
- Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, National Clinical Research Center of Stomatology, Shanghai, 200011, China
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25
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Riedel F, Aparicio-Soto M, Curato C, Münch L, Abbas A, Thierse HJ, Peitsch WK, Luch A, Siewert K. Unique and common TCR repertoire features of Ni 2+ -, Co 2+ -, and Pd 2+ -specific human CD154 + CD4+ T cells. Allergy 2023; 78:270-282. [PMID: 36005389 DOI: 10.1111/all.15494] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 07/21/2022] [Accepted: 08/08/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND Apart from Ni2+ , Co2+ , and Pd2+ ions commonly trigger T cell-mediated allergic contact dermatitis. However, in vitro frequencies of metal-specific T cells and the mechanisms of antigen recognition remain unclear. METHODS Here, we utilized a CD154 upregulation assay to quantify Ni2+ -, Co2+ -, and Pd2+ -specific CD4+ T cells in peripheral blood mononuclear cells (PBMC). Involved αβ T cell receptor (TCR) repertoires were analyzed by high-throughput sequencing. RESULTS Peripheral blood mononuclear cells incubation with NiSO4 , CoCl2 , and PdCl2 increased frequencies of CD154 + CD4+ memory T cells that peaked at ~400 μM. Activation was TCR-mediated as shown by the metal-specific restimulation of T cell clones. Most abundant were Pd2+ -specific T cells (mean 3.5%, n = 19), followed by Co2+ - and Ni2+ -specific cells (0.6%, n = 18 and 0.3%, n = 20) in both allergic and non-allergic individuals. A strong overrepresentation of the gene segment TRAV9-2 was unique for Ni2+ -specific TCR (28% of TCR) while Co2+ and Pd2+ -specific TCR favorably expressed TRAV2 (8%) and the TRBV4 gene segment family (21%), respectively. As a second, independent mechanism of metal ion recognition, all analyzed metal-specific TCR showed a common overrepresentation of a histidine in the complementarity determining region 3 (CDR3; 15% of α-chains, 34% of β-chains). The positions of the CDR3 histidine among metal-specific TCR mirrored those in random repertoires and were conserved among cross-reactive clonotypes. CONCLUSIONS Induced CD154 expression allows a fast and comprehensive detection of Ni2+ -, Co2+ -, and Pd2+ -specific CD4+ T cells. Distinct TCR repertoire features underlie the frequent activation and cross-reactivity of human metal-specific T cells.
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Affiliation(s)
- Franziska Riedel
- Dermatotoxicology Study Centre, German Federal Institute for Risk Assessment, Berlin, Germany.,Department of Chemical and Product Safety, German Federal Institute for Risk Assessment, Berlin, Germany.,Institute of Pharmacy, Freie Universität Berlin, Berlin, Germany
| | - Marina Aparicio-Soto
- Dermatotoxicology Study Centre, German Federal Institute for Risk Assessment, Berlin, Germany.,Department of Chemical and Product Safety, German Federal Institute for Risk Assessment, Berlin, Germany
| | - Caterina Curato
- Dermatotoxicology Study Centre, German Federal Institute for Risk Assessment, Berlin, Germany.,Department of Chemical and Product Safety, German Federal Institute for Risk Assessment, Berlin, Germany
| | - Lucas Münch
- Dermatotoxicology Study Centre, German Federal Institute for Risk Assessment, Berlin, Germany
| | - Amro Abbas
- Dermatotoxicology Study Centre, German Federal Institute for Risk Assessment, Berlin, Germany.,German Rheumatism Research Center (DRFZ), Berlin, Germany
| | - Hermann-Josef Thierse
- Department of Chemical and Product Safety, German Federal Institute for Risk Assessment, Berlin, Germany
| | - Wiebke K Peitsch
- Department of Dermatology and Phlebology, Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Andreas Luch
- Department of Chemical and Product Safety, German Federal Institute for Risk Assessment, Berlin, Germany.,Institute of Pharmacy, Freie Universität Berlin, Berlin, Germany
| | - Katherina Siewert
- Dermatotoxicology Study Centre, German Federal Institute for Risk Assessment, Berlin, Germany.,Department of Chemical and Product Safety, German Federal Institute for Risk Assessment, Berlin, Germany
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26
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Anastasio AT, Johnson LG, Willhite JP, Mousallem T, Hendershot EF, Parekh SG. Team Approach: Metal Hypersensitivity in Total Joint Arthroplasty. JBJS Rev 2023; 11:01874474-202301000-00002. [PMID: 36722837 DOI: 10.2106/jbjs.rvw.22.00157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
» As total joint arthroplasty volume continues to grow nationwide, more uncommon complications such as metal implant hypersensitivity are reported with greater frequency in the literature. » Metal hypersensitivity is a challenging diagnosis given the potentially vague symptomology. It should be considered a diagnosis of exclusion, necessitating careful consideration of other potential etiologies of a failing implant before arriving at the final diagnosis of metal hypersensitivity. » Patients can experience substantial morbidity from implant rejection and in severe, refractory cases may even require revision arthroplasty and conversion to a hypoallergenic implant. » Given the complex nature of the condition, successful treatment of metal hypersensitivity to orthopaedic implants is best achieved through the use of a multidisciplinary, team-based approach. Immunologists, radiologists, and infectious disease physicians as well as orthopaedic surgeons and mechanical engineers are all vital in appropriate diagnosis and treatment of the condition.
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Affiliation(s)
| | - Lindsey G Johnson
- Campbell University School of Osteopathic Medicine, Lillington, North Carolina
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27
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Khodaei T, Schmitzer E, Suresh AP, Acharya AP. Immune response differences in degradable and non-degradable alloy implants. Bioact Mater 2022; 24:153-170. [PMID: 36606252 PMCID: PMC9793227 DOI: 10.1016/j.bioactmat.2022.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 12/13/2022] [Accepted: 12/15/2022] [Indexed: 12/23/2022] Open
Abstract
Alloy based implants have made a great impact in the clinic and in preclinical research. Immune responses are one of the major causes of failure of these implants in the clinic. Although the immune responses toward non-degradable alloy implants are well documented, there is a poor understanding of the immune responses against degradable alloy implants. Recently, there have been several reports suggesting that degradable implants may develop substantial immune responses. This phenomenon needs to be further studied in detail to make the case for the degradable implants to be utilized in clinics. Herein, we review these new recent reports suggesting the role of innate and potentially adaptive immune cells in inducing immune responses against degradable implants. First, we discussed immune responses to allergen components of non-degradable implants to give a better overview on differences in the immune response between non-degradable and degradable implants. Furthermore, we also provide potential areas of research that can be undertaken that may shed light on the local and global immune responses that are generated in response to degradable implants.
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Affiliation(s)
- Taravat Khodaei
- Biomedical Engineering, School of Biological and Health System Engineering, Arizona State, University, Tempe, AZ, 85281, USA
| | - Elizabeth Schmitzer
- Biomedical Engineering, School of Biological and Health System Engineering, Arizona State, University, Tempe, AZ, 85281, USA
| | | | - Abhinav P. Acharya
- Biomedical Engineering, School of Biological and Health System Engineering, Arizona State, University, Tempe, AZ, 85281, USA,Biological Design, Arizona State University, Tempe, AZ, 85281, USA,Chemical Engineering, School for the Engineering of Matter, Transport, and Energy, Arizona State, University, Tempe, AZ, 85281, USA,Materials Science and Engineering, School for the Engineering of Matter, Transport, and Energy, Arizona State University, Tempe, AZ, 85281, USA,Center for Immunotherapy, Vaccines and Virotherapy, Arizona State University, Tempe, AZ, 85281, USA,Corresponding author. Biomedical Engineering, School of Biological and Health System Engineering, Arizona State, University, Tempe, AZ, 85281, USA.
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28
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Summer B, Lill D, Remmel K, Schraml A, Schopf C, Banke IJ, Kuechenhoff H, Maierhofer T, Endres S, Thomas P. An interleukin-1 polymorphism additionally intensified by atopy as prognostic factor for aseptic non-mechanical complications in metal knee and hip arthroplasty. Front Immunol 2022; 13:1050315. [PMID: 36518750 PMCID: PMC9742593 DOI: 10.3389/fimmu.2022.1050315] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 11/15/2022] [Indexed: 11/29/2022] Open
Abstract
Background In contrast to infection or mechanical issues joint replacement failure following inflammatory adverse reactions is poorly understood. Objective To assess the association of IL-1β polymorphisms and history of allergy with aseptic non-mechanical complications following arthroplasty. Methods In 102 patients with aseptic non-mechanically caused symptomatic knee or hip arthroplasty (SA) and 93 patients with asymptomatic arthroplasty (AA) questionnaire-based history, patch test with at least standard series, lymphocyte transformation test (LTT) with nickel, cobalt and chromium and interleukin-1 polymorphism analysis were done. Three polymorphisms of the IL1B gene [IL-1b -3954 (rs1143634), IL-1b -511 (rs16944) and IL-1b -31 (rs1143627)] and one polymorphism of the IL1RN gene [IL1RN intron 2, variable number of tandem repeats, VNTR (rs2234663)] were assessed by PCR and gel electrophoresis. Results We found no significant difference in smoking history and atopy but 25% versus 10% of self-reported metal allergy in SA versus AA; the patch test (respective, LTT) for metal sensitivity was more often positive in SA patients. The allele 498 bp of the IL1RN polymorphism occurred significantly more often in the SA group (37% versus 11%; p < 0.0001). Upon additional presence of atopy, the difference was even greater (60% vs 10%) (p < 0.000001). There was no association of IL-1 polymorphisms with metal allergy. Conclusion The IL1RN VNTR allele 498 bp was strongly associated with SA. In patients with a history of atopy, presence of the IL1RN VNTR allele 498 bp led to a four-fold higher SA prevalence compared to patients without this allele.
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Affiliation(s)
- B. Summer
- Department of Dermatology and Allergology, University Hospital, Munich, Germany,*Correspondence: B. Summer,
| | - D. Lill
- Department of Dermatology and Allergology, University Hospital, Munich, Germany
| | - K. Remmel
- Department of Orthopedic Surgery, Clinic Rummelsberg and Nürnberg, Rummelsberg, Germany
| | - A. Schraml
- Department of Orthopedic Surgery, Clinic Rummelsberg and Nürnberg, Rummelsberg, Germany
| | - C. Schopf
- Department of Orthopaedics, Physical Medicine and Rehabiliation University Hospital, Munich, Germany
| | - I. J. Banke
- Clinic of Orthopedics and Sports Orthopedics, Klinikum rechts der Isar, Technical University of Munich (TUM), Munich, Germany
| | - H. Kuechenhoff
- Statistical Consulting Unit StaBLab, Department of Statistics, LMU, Munich, Germany
| | - T. Maierhofer
- Department of Statistics, University of California, Los Angeles (UCLA), Los Angeles, CA, United States
| | - S. Endres
- Division of Clinical Pharmacology, University Hospital, Munich, Germany
| | - P. Thomas
- Department of Dermatology and Allergology, University Hospital, Munich, Germany
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29
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Su Z, Zhang J, Tan P, Zhu S, Jiang N. Selective Polyetheretherketone Implants Combined with Graphene Cause Definitive Cell Adhesion and Osteogenic Differentiation. Int J Nanomedicine 2022; 17:5327-5338. [PMID: 36411765 PMCID: PMC9675333 DOI: 10.2147/ijn.s380345] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 10/30/2022] [Indexed: 09/07/2023] Open
Abstract
INTRODUCTION Polyetheretherketone (PEEK) has good biosafety and chemical stability for bone repair. However, PEEK is biologically inert and cannot promote bone apposition. This study investigated whether graphene-modified PEEK (G-PEEK) could improve cell adhesion and osteogenic differentiation. METHODS G-PEEK was prepared by melted blending and was characterized. In vitro, the biocompatibility of G-PPEK and the ability to promote cell adhesion and osteogenic differentiation in rabbit bone marrow mesenchymal stem cells (rBMSCs) were examined using live and dead cell double staining, the cell counting kit-8 (CCK-8) assay, immunofluorescence and quantitative real-time PCR (qRT‒PCR). An in vivo rabbit extra-articular graft-to-bone healing model was established. At 4 and 12 weeks after surgery, CT analysis and histological evaluation were performed. RESULTS In vitro, G-PEEK significantly improved the adhesion and proliferation of rBMSCs, with good biocompatibility. In vivo, G-PEEK promoted new bone formation at the site of the bone defect. CONCLUSION G-PEEK showed excellent osteogenesis performance, which promises new applications in implant materials.
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Affiliation(s)
- Zhan Su
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral & Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, People’s Republic of China
| | - Jie Zhang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral & Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, People’s Republic of China
| | - Peijie Tan
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral & Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, People’s Republic of China
| | - Songsong Zhu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral & Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, People’s Republic of China
| | - Nan Jiang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral & Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, People’s Republic of China
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30
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Abi El Cheikh T, Vargas IM, Alili E, Tiesenga F. The Improvement of Nonspecific Chronic Symptoms Post-Gallbladder Clip Removal. Cureus 2022; 14:e30625. [DOI: 10.7759/cureus.30625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2022] [Indexed: 11/05/2022] Open
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31
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Ishihara K. Biomimetic materials based on zwitterionic polymers toward human-friendly medical devices. SCIENCE AND TECHNOLOGY OF ADVANCED MATERIALS 2022; 23:498-524. [PMID: 36117516 PMCID: PMC9481090 DOI: 10.1080/14686996.2022.2119883] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 08/26/2022] [Accepted: 08/28/2022] [Indexed: 06/01/2023]
Abstract
This review summarizes recent research on the design of polymer material systems based on biomimetic concepts and reports on the medical devices that implement these systems. Biomolecules such as proteins, nucleic acids, and phospholipids, present in living organisms, play important roles in biological activities. These molecules are characterized by heterogenic nature with hydrophilicity and hydrophobicity, and a balance of positive and negative charges, which provide unique reaction fields, interfaces, and functionality. Incorporating these molecules into artificial systems is expected to advance material science considerably. This approach to material design is exceptionally practical for medical devices that are in contact with living organisms. Here, it is focused on zwitterionic polymers with intramolecularly balanced charges and introduce examples of their applications in medical devices. Their unique properties make these polymers potential surface modification materials to enhance the performance and safety of conventional medical devices. This review discusses these devices; moreover, new surface technologies have been summarized for developing human-friendly medical devices using zwitterionic polymers in the cardiovascular, cerebrovascular, orthopedic, and ophthalmology fields.
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Affiliation(s)
- Kazuhiko Ishihara
- Division of Materials and Manufacturing Science, Graduate School of Engineering, Osaka University, Osaka, Japan
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32
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Clermidy H, Fadel G, De Lemos A, Pradere P, Mitilian D, Girault A, Menager JB, Fabre D, Mussot S, Leymarie N, Fadel E, Mercier O. Long-term outcomes after chest wall resection and repair with titanium bars and sternal plates. Front Surg 2022; 9:950177. [PMID: 36157422 PMCID: PMC9489911 DOI: 10.3389/fsurg.2022.950177] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Accepted: 07/26/2022] [Indexed: 11/27/2022] Open
Abstract
Objectives En-bloc complete resection remains the treatment of choice for localized chest wall (CW) tumors. Titanium bars reconstruction demonstrated encouraging results with satisfactory early outcomes. However, long-term outcomes remain under-reported. The purpose of this study is to evaluate long-term outcomes after CW resection and repair with titanium devices. Methods From June 2012 to December 2018, we retrospectively reviewed all patients with CW tumors who underwent surgical resection and repair using titanium. Long-term outcomes were assessed. Results We identified 87 patients who underwent CW tumor resections and titanium reconstruction. Sixty-eight patients were included in the study (excluding benign tumors, Pancoast tumors, palliative surgeries, or clavicle reconstruction). There were 29 sarcomas, 20 isolated CW metastases, eight lung cancers, four breast cancers, three thymic malignancies, two sarcomatoid mesothelioma, and one desmoid tumor. Complete resection was achieved in 64 patients (94%), while R1 resection in four patients (6%). Resection involved one rib in two patients, two ribs in thirteen, three ribs in eighteen, four ribs in nine, five ribs in two, seven ribs in one, partial sternum in fifteen, and full sternum in sixteen patients. No patient experienced flail chest. The 1-year, 3-year, and 5-year overall survival rates and disease-free survivals were 82.3%, 61.4%,57.3%, and 67.6%,57.3%,52.6%, respectively. Surgical site infection occurred in 18% (n = 12) of cases. Eleven of twelve patients had an early infection (<1 year), which required material removal in six patients. Asymptomatic connector unsealing occurred in 6% (n = 4), with only one re-intervention. Titanium allergy has never been reported. Chronic chest pain (lasting more than 3 months after surgery, with daily use of pain killer) was reported in 24% of patients.
Conclusion CW resections with titanium reconstruction are associated with long-term survivors. Titanium devices were safe, reliable, and achieved satisfactory oncological results with low morbidity and implant-related complication rates.
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Affiliation(s)
- Hugo Clermidy
- Department of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Université Paris-Saclay, International Center for Thoracic Cancers, Marie-Lannelongue Hospital, GHPSJ, Le Plessis Robinson, France
| | - Guillaume Fadel
- Department of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Université Paris-Saclay, International Center for Thoracic Cancers, Marie-Lannelongue Hospital, GHPSJ, Le Plessis Robinson, France
| | - Alexandra De Lemos
- Department of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Université Paris-Saclay, International Center for Thoracic Cancers, Marie-Lannelongue Hospital, GHPSJ, Le Plessis Robinson, France
| | - Pauline Pradere
- Department of Pneumology, Marie-Lannelongue Hospital, Groupe Hospitalier Paris Saint-Joseph, Le Plessis Robinson, France
| | - Delphine Mitilian
- Department of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Université Paris-Saclay, International Center for Thoracic Cancers, Marie-Lannelongue Hospital, GHPSJ, Le Plessis Robinson, France
| | - Antoine Girault
- Department of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Université Paris-Saclay, International Center for Thoracic Cancers, Marie-Lannelongue Hospital, GHPSJ, Le Plessis Robinson, France
| | - Jean-Baptiste Menager
- Department of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Université Paris-Saclay, International Center for Thoracic Cancers, Marie-Lannelongue Hospital, GHPSJ, Le Plessis Robinson, France
| | - Dominique Fabre
- Department of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Université Paris-Saclay, International Center for Thoracic Cancers, Marie-Lannelongue Hospital, GHPSJ, Le Plessis Robinson, France
| | - Sacha Mussot
- Department of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Université Paris-Saclay, International Center for Thoracic Cancers, Marie-Lannelongue Hospital, GHPSJ, Le Plessis Robinson, France
| | - Nicolas Leymarie
- Department of Plastic and Reconstructive Surgery, Gustave Roussy, Villejuif, France
| | - Elie Fadel
- Department of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Université Paris-Saclay, International Center for Thoracic Cancers, Marie-Lannelongue Hospital, GHPSJ, Le Plessis Robinson, France
| | - Olaf Mercier
- Department of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Université Paris-Saclay, International Center for Thoracic Cancers, Marie-Lannelongue Hospital, GHPSJ, Le Plessis Robinson, France
- Correspondence: Olaf Mercier
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Ma S, Li X, Hu H, Ma X, Zhao Z, Deng S, Wang J, Zhang L, Wu C, Liu Z, Wang Y. Synergetic osteogenesis of extracellular vesicles and loading RGD colonized on 3D-printed titanium implants. Biomater Sci 2022; 10:4773-4784. [PMID: 35849688 DOI: 10.1039/d2bm00725h] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Titanium (Ti) and its alloys have been universally used as surgical implants, and the clinical need for modifying titanium surfaces to accelerate early stage osseointegration and prevent implant loosening is in huge demand. 3D printing technology is an accurate and controllable method to create titanium implants with complex nanostructures, which provide enough space to react and fit in the microenvironment of cells. Recently, extracellular vesicles (EVs) have attracted attention in promoting osteogenesis. The vesicles derived from bone marrow mesenchymal stem cells (BMSC-EVs) have been proved to pack osteogenic-relative RNAs thereby regulating the osteogenic differentiation and mineralization of the target BMSCs. Arg-Gly-Asp (RGD)-derived peptides are typical peptides used to improve cell attachment and proliferation in bone tissue engineering. A novel strategy is proposed to load RGD-derived peptides on EVs with a fusion peptide (EVsRGD) and colonize EVsRGD on the titanium surface via a specific bonding peptide. In this study, we verify that the presence of EVsRGD enables the realization of the synergetic effect of EVs and RGD, enhancing the osteogenic differentiation and mineralization of BMSCs in vitro, resulting in satisfactory osseointegration around implants in vivo.
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Affiliation(s)
- Shiqing Ma
- Department of Stomotology, Tianjin Medical University Second Hospital, 23 Pingjiang Road, Hexi District, Tianjin, 300211, China
| | - Xuewen Li
- School and Hospital of Stomatology, Tianjin Medical University, 12 Observatory Road, Tianjin, 030070, China.
| | - Han Hu
- School and Hospital of Stomatology, Tianjin Medical University, 12 Observatory Road, Tianjin, 030070, China.
| | - Xinying Ma
- School and Hospital of Stomatology, Tianjin Medical University, 12 Observatory Road, Tianjin, 030070, China.
| | - Zhezhe Zhao
- School and Hospital of Stomatology, Tianjin Medical University, 12 Observatory Road, Tianjin, 030070, China.
| | - Shu Deng
- Department of Stomotology, Tianjin Medical University Second Hospital, 23 Pingjiang Road, Hexi District, Tianjin, 300211, China
| | - Jie Wang
- School and Hospital of Stomatology, Tianjin Medical University, 12 Observatory Road, Tianjin, 030070, China.
| | - Leyu Zhang
- School and Hospital of Stomatology, Tianjin Medical University, 12 Observatory Road, Tianjin, 030070, China.
| | - Chenxuan Wu
- School and Hospital of Stomatology, Tianjin Medical University, 12 Observatory Road, Tianjin, 030070, China.
| | - Zihao Liu
- School and Hospital of Stomatology, Tianjin Medical University, 12 Observatory Road, Tianjin, 030070, China.
| | - Yonglan Wang
- School and Hospital of Stomatology, Tianjin Medical University, 12 Observatory Road, Tianjin, 030070, China.
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Contact Dermatitis in the Inpatient Hospital Setting–an Updated Review of the Literature. CURRENT DERMATOLOGY REPORTS 2022. [DOI: 10.1007/s13671-022-00366-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Fonacier L, Frankel D, Mawhirt S. Contact allergens for the allergist. Ann Allergy Asthma Immunol 2022; 128:629-644. [PMID: 35346877 DOI: 10.1016/j.anai.2022.03.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/18/2022] [Accepted: 03/21/2022] [Indexed: 12/20/2022]
Abstract
OBJECTIVE The objective of this article is to provide an overview and describe typically encountered skin contact allergens implicated in allergic contact dermatitis (ACD). DATA SOURCES Published literature obtained through textbooks, online PubMed, and Google Scholar database searches, author photography, and adapted figures were used. STUDY SELECTIONS Studies on the evaluation of ACD and specific skin contact allergens were selected, with a focus on original research articles and clinical reviews. RESULTS Major classifications of common contact allergens include the following: (1) fragrances, (2) preservatives, (3) excipients, (4) rubber chemicals, (5) textile dyes, (6) topical medications, and (6) metals and other biomedical device components. The dermatitis distribution can aid in identifying the suspected contact allergen culprit. Certain contact allergens have features that are important to consider in the patch testing (PT) interpretation; these include possible irritant reactions, false-negative reactions or missed detection, and delayed reactions. Fragrances, preservatives, and excipients are culprits in personal products and facial or neck dermatitis. Patch testing with fragrances, preservatives, and patient-supplied products requires careful interpretation. Hand or foot dermatitis may be attributed to rubber chemicals or textile dyes. The management of topical corticosteroid contact allergy is guided on the basis of structural group classifications. Metal sensitization has been associated with dermatitis or biomedical device complications. CONCLUSION Each skin contact allergen has unique characteristics with regard to the dermatitis clinical presentation and potential PT nuances. These features are critical to recognize in the evaluation of ACD and PT interpretation and clinical relevance, leading to an accurate diagnosis.
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Affiliation(s)
- Luz Fonacier
- Division of Rheumatology, Allergy, and Immunology, Department of Medicine, New York University Langone Hospital-Long Island, Mineola, New York; New York University Long Island School of Medicine, Mineola, New York.
| | - David Frankel
- Division of Rheumatology, Allergy, and Immunology, Department of Medicine, New York University Langone Hospital-Long Island, Mineola, New York
| | - Stephanie Mawhirt
- Division of Rheumatology, Allergy, and Immunology, Department of Medicine, New York University Langone Hospital-Long Island, Mineola, New York; New York University Long Island School of Medicine, Mineola, New York
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Metallic Implants Used in Lumbar Interbody Fusion. MATERIALS 2022; 15:ma15103650. [PMID: 35629676 PMCID: PMC9146470 DOI: 10.3390/ma15103650] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/12/2022] [Accepted: 05/13/2022] [Indexed: 02/07/2023]
Abstract
Over the last decade, pedicle fixation systems have evolved and modifications in spinal fusion techniques have been developed to increase fusion rates and improve clinical outcomes after lumbar interbody fusion (LIF). Regarding materials used for screw and rod manufacturing, metals, especially titanium alloys, are the most popular resources. In the case of pedicle screws, that biomaterial can be also doped with hydroxyapatite, CaP, ECM, or tantalum. Other materials used for rod fabrication include cobalt-chromium alloys and nitinol (nickel-titanium alloy). In terms of mechanical properties, the ideal implant used in LIF should have high tensile and fatigue strength, Young's modulus similar to that of the bone, and should be 100% resistant to corrosion to avoid mechanical failures. On the other hand, a comprehensive understanding of cellular and molecular pathways is essential to identify preferable characteristics of implanted biomaterial to obtain fusion and avoid implant loosening. Implanted material elicits a biological response driven by immune cells at the site of insertion. These reactions are subdivided into innate (primary cellular response with no previous exposure) and adaptive (a specific type of reaction induced after earlier exposure to the antigen) and are responsible for wound healing, fusion, and also adverse reactions, i.e., hypersensitivity. The main purposes of this literature review are to summarize the physical and mechanical properties of metal alloys used for spinal instrumentation in LIF which include fatigue strength, Young's modulus, and corrosion resistance. Moreover, we also focused on describing biological response after their implantation into the human body. Our review paper is mainly focused on titanium, cobalt-chromium, nickel-titanium (nitinol), and stainless steel alloys.
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Migliorini F, Schenker H, Maffulli N, Hildebrand F, Eschweiler J. Histomorphometry of Ossification in Functionalised Ceramics with Tripeptide Arg-Gly-Asp (RGD): An In Vivo Study. Life (Basel) 2022; 12:life12050761. [PMID: 35629427 PMCID: PMC9146276 DOI: 10.3390/life12050761] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 05/16/2022] [Accepted: 05/16/2022] [Indexed: 12/31/2022] Open
Abstract
The present study investigated the osseointegration promoted by functionalised ceramics with peptide Arg-Gly-Asp (RGD) in a rabbit model in vivo. Histomorphometry of the RGD functionalised ceramic implants was conducted by a trained pathologist to quantify the amount of mature and immature ossification at the bone interface, and then compared to titanium alloy implants. The region of interest was the area surrounding the implant. The percentage of ROI covered by osteoid implant contact and mature bone implant contact were assessed. The presence of bone resorption, necrosis, and/or inflammation in the areas around the implant were quantitatively investigated. All 36 rabbits survived the experimental period of 6 and 12 weeks. All implants remained in situ. No necrosis, bone resorption, or inflammation were identified. At 12 weeks follow-up, the overall mean bone implant contact (p = 0.003) and immature osteoid contact (p = 0.03) were improved compared to the mean values evidenced at 6 weeks. At 6 weeks follow-up, the overall osteoid implant contact was greater in the RGD enhanced group compared to the titanium implant (p = 0.01). The other endpoints of interest were similar between the two implants at all follow-up points (p ≥ 0.05). Functionalised ceramics with peptide RGD promoted ossification in vivo. The overall osteoid and bone implant contact improved significantly from 6 to 12 weeks. Finally, RGD enhanced ceramic promoted faster osteoid implant contact in vivo than titanium implants. Overall, the amount of ossification at 12 weeks is comparable with the titanium implants. No necrosis, bone resorption, or inflammation were observed in any sample.
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Affiliation(s)
- Filippo Migliorini
- Department of Orthopaedic, Trauma and Reconstructive Surgery, RWTH University Hospital, 52074 Aachen, Germany; (F.M.); (H.S.); (F.H.); (J.E.)
| | - Hanno Schenker
- Department of Orthopaedic, Trauma and Reconstructive Surgery, RWTH University Hospital, 52074 Aachen, Germany; (F.M.); (H.S.); (F.H.); (J.E.)
| | - Nicola Maffulli
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Baronissi, Italy
- School of Pharmacy and Bioengineering, Keele University Faculty of Medicine, Stoke on Trent ST4 7QB, UK
- Barts and The London School of Medicine and Dentistry, Centre for Sports and Exercise Medicine, Mile End Hospital, Queen Mary University of London, London E1 4DG, UK
- Correspondence:
| | - Frank Hildebrand
- Department of Orthopaedic, Trauma and Reconstructive Surgery, RWTH University Hospital, 52074 Aachen, Germany; (F.M.); (H.S.); (F.H.); (J.E.)
| | - Jörg Eschweiler
- Department of Orthopaedic, Trauma and Reconstructive Surgery, RWTH University Hospital, 52074 Aachen, Germany; (F.M.); (H.S.); (F.H.); (J.E.)
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Bueno BT, Henry M, Cho SK. Hypersensitivity Reaction to Carbon Fiber-Polyetheretherketone Composite Spinal Implant: A Case Report. JBJS Case Connect 2022; 12:01709767-202206000-00053. [PMID: 35703153 DOI: 10.2106/jbjs.cc.21.00731] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
CASE A 52-year-old woman presented with localized hypersensitivity symptoms immediately after insertion of a carbon fiber-polyetheretherketone (CF-PEEK) vertebral fusion device. After a modified cutaneous patch test confirmed an allergic reaction to the implant, the device was surgically removed. The patient's symptoms were largely resolved 1 month after the removal of the device. CONCLUSION CF-PEEK is a commonly used biomaterial in surgical implants. As far as we know, this is the first reported case of a hypersensitivity reaction to CF-PEEK.
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Affiliation(s)
- Brian T Bueno
- Department of Orthopedics, Icahn School of Medicine at Mount Sinai, New York, New York
- Department of Orthopaedics, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
| | - Mark Henry
- Department of Orthopedics, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Samuel K Cho
- Department of Orthopedics, Icahn School of Medicine at Mount Sinai, New York, New York
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Battaglia AG, Ali-Zade C, Monti L, Al Khawashki H, Winkler H, Del Sel H, Mavrogenis AF, Benzakour T, Drago L, Romanò CL. Metal Hypersensitivity or Missed Periprosthetic Joint Infection? A Critical Review. Orthopedics 2022; 45:e73-e78. [PMID: 34978510 DOI: 10.3928/01477447-20211227-04] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The World Association Against Infection in Orthopedics And Trauma (W.A.I.O.T.) Study Group on Bone And Joint Infection Definitions Metal hypersensitivity (MHS) has been investigated by several authors as a possible reason for painful total joint arthroplasty, with controversial results. Periprosthetic joint infection (PJI) is another possible source of unexplained pain and implant failure that may be difficult to diagnose if not properly investigated. We performed this critical review to assess whether the current literature on MHS includes an adequate diagnostic workup to discern metal allergy from PJI. The results of this review highlight the importance of assessing patients for PJI before making a diagnosis of MHS and emphasize that the methods currently used to exclude PJI are substantially inadequate. Therefore, well-designed clinical trials with adequate diagnostic protocols and definitions of PJI that can differentiate MHS from low-grade PJI are needed. [Orthopedics. 2022;45(2):e73-e78.].
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Finding the Perfect Membrane: Current Knowledge on Barrier Membranes in Regenerative Procedures: A Descriptive Review. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12031042] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Guided tissue regeneration (GTR) and guided bone regeneration (GBR) became common procedures in the corrective phase of periodontal treatment. In order to obtain good quality tissue neo-formation, most techniques require the use of a membrane that will act as a barrier, having as a main purpose the blocking of cell invasion from the gingival epithelium and connective tissue into the newly formed bone structure. Different techniques and materials have been developed, aiming to obtain the perfect barrier membrane. The membranes can be divided according to the biodegradability of the base material into absorbable membranes and non-absorbable membranes. The use of absorbable membranes is extremely widespread due to their advantages, but in clinical situations of significant tissue loss, the use of non-absorbable membranes is often still preferred. This descriptive review presents a synthesis of the types of barrier membranes available and their characteristics, as well as future trends in the development of barrier membranes along with some allergological aspects of membrane use.
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Solomon SM, Sufaru IG, Teslaru S, Ghiciuc CM, Stafie CS. Finding the Perfect Membrane: Current Knowledge on Barrier Membranes in Regenerative Procedures: A Descriptive Review. APPLIED SCIENCES-BASEL 2022. [DOI: https://doi.org/10.3390/app12031042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Guided tissue regeneration (GTR) and guided bone regeneration (GBR) became common procedures in the corrective phase of periodontal treatment. In order to obtain good quality tissue neo-formation, most techniques require the use of a membrane that will act as a barrier, having as a main purpose the blocking of cell invasion from the gingival epithelium and connective tissue into the newly formed bone structure. Different techniques and materials have been developed, aiming to obtain the perfect barrier membrane. The membranes can be divided according to the biodegradability of the base material into absorbable membranes and non-absorbable membranes. The use of absorbable membranes is extremely widespread due to their advantages, but in clinical situations of significant tissue loss, the use of non-absorbable membranes is often still preferred. This descriptive review presents a synthesis of the types of barrier membranes available and their characteristics, as well as future trends in the development of barrier membranes along with some allergological aspects of membrane use.
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42
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Shields LB, Vessell M, Mutchnick IS. Epidural Effusion as Allergic Reaction Following Polyetheretherketone Cranioplasty: An Illustrative Case and Review of the Literature. Cureus 2022; 14:e21390. [PMID: 35198299 PMCID: PMC8853833 DOI: 10.7759/cureus.21390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2022] [Indexed: 11/05/2022] Open
Abstract
Well-described complications of polyetheretherketone (PEEK) cranioplasty in pediatric patients include surgical site infection, post-operative hematoma, cerebral edema, and implant fracture. We present a rare case of hypersensitivity to PEEK presenting as an epidural effusion in a 7-year-old male receiving a PEEK cranioplasty following a decompressive craniectomy. Within three weeks, the patient experienced fever and emesis. Erythrocyte sedimentation rate (ESR) was high (>130 mm/Hr) as well as C-reactive protein (CRP) (6.4 mg/dL). A brain MRI with contrast demonstrated both subgaleal and epidural fluid collections with T2 isointense columns projecting from the galeal surface, through the holes in the implant to the dural surface. The patient appeared clinically well. A sterile tap of the pericranial fluid showed no growth, b2-transferrin was negative, but the IgG level was high (>129.2 mg/dL) in the tap fluid. High-dose steroids reduced the epidural collection, but then the collection returned with steroid wean. A second cranioplasty operation replaced the PEEK flap with autologous bone. Postoperative imaging demonstrated markedly reduced fluid collections and a decreased midline shift. The patient remained clinically intact throughout the experience. PEEK allergy following cranioplasty is a rare entity and must be distinguished from infection or hematoma. Medical treatment with steroids can be attempted, but, if refractory, then appropriate treatment may necessitate removal of the offending PEEK implant.
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Bui R, Boven L, Kaufman D, Weinberger P. Metal Allergy in Tracheostomy Tube Placement Resulting in Complete Subglottic Stenosis: A Case Report. Ann Otol Rhinol Laryngol 2022; 131:1394-1397. [PMID: 34991357 DOI: 10.1177/00034894211070135] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Metal hypersensitivity reaction to surgical implants is a well- known phenomenon that is associated with pain, swelling, inflammation, and decreased efficacy of the implant. We present a unique case of a patient with placement a metal Jackson tracheostomy tube that led to expeditious total subglottic stenosis. METHODS The patient was a 33-year old, severely atopic woman with history of asthma exacerbations requiring several intubations for acute respiratory failure with several subsequent tracheal dilations with steroid injections, and eventual tracheostomy placement with a metal Jackson tracheostomy tube that led to expeditious total subglottic stenosis. RESULTS Initial intervention included performing an airway evaluation, CO2 laser, and steroid injection of the area of complete subglottic stenosis. Follow up several months later revealed little improvement in level of tracheal narrowing proximal to the tracheostomy tube. Patient did not have shortness of breath but continued to be aphonic. Cricotracheal versus tracheal resection have been proposed but surgical morbidity was deemed too high due to patient's obesity. CONCLUSIONS Metal hypersensitivity reactions are well known phenomena as it relates to surgical implants in other surgical specialties but are seldom reported within the ear, nose and throat literature. Oftentimes, it takes astute observation to diagnose and establish a connection. Prompt recognition and treatment can be acquired from interdisciplinary collaboration with allergy.
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Affiliation(s)
- Roger Bui
- Department of Otolaryngology- Head and Neck Surgery, LSU Health Shreveport, Shreveport, LA, USA
| | - Lindsay Boven
- Department of Otolaryngology- Head and Neck Surgery, LSU Health Shreveport, Shreveport, LA, USA
| | - David Kaufman
- Department of Allergy and Immunology, LSU Health Shreveport, Shreveport, LA, USA
| | - Paul Weinberger
- Department of Otolaryngology- Head and Neck Surgery, LSU Health Shreveport, Shreveport, LA, USA
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Park E, Jung J, Son M, Jeong S, Kim K, Kim K. Relationship between dermatitis and joint replacement: A nationwide population-based cohort study. Indian J Dermatol 2022; 67:312. [DOI: 10.4103/ijd.ijd_1012_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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45
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Antmen E, Vrana NE, Hasirci V. The role of biomaterials and scaffolds in immune responses in regenerative medicine: macrophage phenotype modulation by biomaterial properties and scaffold architectures. Biomater Sci 2021; 9:8090-8110. [PMID: 34762077 DOI: 10.1039/d1bm00840d] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Scaffolds are an integral part of the regenerative medicine field. The contact of biomaterials with tissue, as was clearly observed over the years, induces immune reactions in a material and patient specific manner, where both surface and bulk properties of scaffolds, together with their 3D architecture, have a significant influence on the outcome. This review presents an overview of the reactions to the biomaterials with a specific focus on clinical complications with the implants in the context of immune reactions and an overview of the studies involving biomaterial properties and interactions with innate immune system cells. We emphasize the impact of these studies on scaffold selection and upscaling of microenvironments created by biomaterials from 2D to 3D using immune cell encapsulation, seeding in a 3D scaffold and co-culture with relevant tissue cells. 3D microenvironments are covered with a specific focus on innate cells since a large proportion of these studies used innate immune cells. Finally, the recent studies on the incorporation of adaptive immune cells in immunomodulatory systems are covered in this review. Biomaterial-immune cell interactions are a critical part of regenerative medicine applications. Current efforts in establishing the ground rules for such interactions following implantation can control immune response during all phases of inflammation. Thus, in the near future for complete functional recovery, tissue engineering and control over biomaterials must be considered at the first step of immune modulation and this review covers these interactions, which have remained elusive up to now.
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Affiliation(s)
- Ezgi Antmen
- BIOMATEN, Middle East Technical University, Center of Excellence in Biomaterials and Tissue Engineering, Ankara, Turkey.
| | - Nihal Engin Vrana
- SPARTHA Medical, 14B Rue de la Canardiere, Strasbourg Cedex 67100, France. .,INSERM Unité 1121 Biomaterials and Bioengineering, CRBS, 1 Rue Eugène Boeckel, Strasbourg Cedex 67000, France
| | - Vasif Hasirci
- BIOMATEN, Middle East Technical University, Center of Excellence in Biomaterials and Tissue Engineering, Ankara, Turkey. .,Biomaterials A&R Center, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey.,Department of Medical Engineering, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
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Bouchard ME, Petrosyan M, Kane TD. Case series of metal allergy following Nuss procedure: Not only for stainless steel bars. J Pediatr Surg 2021; 56:1976-1981. [PMID: 33487461 DOI: 10.1016/j.jpedsurg.2021.01.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 01/04/2021] [Accepted: 01/08/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Pectus excavatum is often managed with the Nuss procedure. Metal allergies to pectus bars occur in 5% of patients, though pre-operative testing is not generally routine. OBJECTIVES This study describes our experience with pre-operative metal allergy testing and post-operative allergic reactions to pectus bars. METHODS A retrospective study of patients who underwent a Nuss procedure at our institution from 2010-2020 was performed. Patients with documented "metal" allergy, defined by the need for and positive response to steroid treatment and the absence of infection, were included. Data on patient characteristics and clinical course were analyzed. RESULTS Five of 204 patients (2.5%) identified developed allergic metal reactions. Three of five patients developed allergic reactions to titanium bars, with two requiring early removal of the bar (< 2-3 years). Four patients required more than one course of steroids, and three required debridements for skin breakdown. All patients have maintained good surgical correction at one- and three-years post removal. CONCLUSIONS Pectus bar metal allergies occur with both stainless steel and titanium bars. Properly selected patients for pre-operative FinnⓇ Chamber testing may reduce the overall incidence of stainless-steel allergies but may miss titanium bar allergies. Early recognition and treatment of bar allergies may salvage the bar and avoid premature removal.
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Affiliation(s)
- Megan E Bouchard
- Department of Surgery, Medstar Georgetown University Hospital, Washington, DC, United States
| | - Mikael Petrosyan
- Department of General & Thoracic Surgery, Children's National Medical Center, Washington, DC, United States
| | - Timothy D Kane
- Department of General & Thoracic Surgery, Children's National Medical Center, Washington, DC, United States.
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Moseley T, Birgersdotter-Green U, Feld G, Pollema T. Malignancies masquerading as device pocket infections. HeartRhythm Case Rep 2021; 7:694-697. [PMID: 34712568 PMCID: PMC8530908 DOI: 10.1016/j.hrcr.2021.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Affiliation(s)
- Toni Moseley
- Division of Cardiothoracic Surgery, University of California San Diego, La Jolla, California
| | | | - Gregory Feld
- Division of Cardiology, University of California San Diego, La Jolla, California
| | - Travis Pollema
- Division of Cardiothoracic Surgery, University of California San Diego, La Jolla, California
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Riedel F, Aparicio-Soto M, Curato C, Thierse HJ, Siewert K, Luch A. Immunological Mechanisms of Metal Allergies and the Nickel-Specific TCR-pMHC Interface. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10867. [PMID: 34682608 PMCID: PMC8535423 DOI: 10.3390/ijerph182010867] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 10/03/2021] [Accepted: 10/11/2021] [Indexed: 12/19/2022]
Abstract
Besides having physiological functions and general toxic effects, many metal ions can cause allergic reactions in humans. We here review the immune events involved in the mediation of metal allergies. We focus on nickel (Ni), cobalt (Co) and palladium (Pd), because these allergens are among the most prevalent sensitizers (Ni, Co) and immediate neighbors in the periodic table of the chemical elements. Co-sensitization between Ni and the other two metals is frequent while the knowledge on a possible immunological cross-reactivity using in vivo and in vitro approaches remains limited. At the center of an allergic reaction lies the capability of a metal allergen to form T cell epitopes that are recognized by specific T cell receptors (TCR). Technological advances such as activation-induced marker assays and TCR high-throughput sequencing recently provided new insights into the interaction of Ni2+ with the αβ TCR-peptide-major histocompatibility complex (pMHC) interface. Ni2+ functionally binds to the TCR gene segment TRAV9-2 or a histidine in the complementarity determining region 3 (CDR3), the main antigen binding region. Thus, we overview known, newly identified and hypothesized mechanisms of metal-specific T cell activation and discuss current knowledge on cross-reactivity.
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Affiliation(s)
- Franziska Riedel
- Department for Chemicals and Product Safety, Federal Institute for Risk Assessment, Max-Dohrn-Straße 8-10, 10589 Berlin, Germany; (M.A.-S.); (C.C.); (H.-J.T.); (K.S.); (A.L.)
- Institute of Pharmacy, Freie Universität Berlin, Königin-Luise-Straße 2, 14195 Berlin, Germany
| | - Marina Aparicio-Soto
- Department for Chemicals and Product Safety, Federal Institute for Risk Assessment, Max-Dohrn-Straße 8-10, 10589 Berlin, Germany; (M.A.-S.); (C.C.); (H.-J.T.); (K.S.); (A.L.)
| | - Caterina Curato
- Department for Chemicals and Product Safety, Federal Institute for Risk Assessment, Max-Dohrn-Straße 8-10, 10589 Berlin, Germany; (M.A.-S.); (C.C.); (H.-J.T.); (K.S.); (A.L.)
| | - Hermann-Josef Thierse
- Department for Chemicals and Product Safety, Federal Institute for Risk Assessment, Max-Dohrn-Straße 8-10, 10589 Berlin, Germany; (M.A.-S.); (C.C.); (H.-J.T.); (K.S.); (A.L.)
| | - Katherina Siewert
- Department for Chemicals and Product Safety, Federal Institute for Risk Assessment, Max-Dohrn-Straße 8-10, 10589 Berlin, Germany; (M.A.-S.); (C.C.); (H.-J.T.); (K.S.); (A.L.)
| | - Andreas Luch
- Department for Chemicals and Product Safety, Federal Institute for Risk Assessment, Max-Dohrn-Straße 8-10, 10589 Berlin, Germany; (M.A.-S.); (C.C.); (H.-J.T.); (K.S.); (A.L.)
- Institute of Pharmacy, Freie Universität Berlin, Königin-Luise-Straße 2, 14195 Berlin, Germany
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Poli PP, de Miranda FV, Polo TOB, Santiago Júnior JF, Lima Neto TJ, Rios BR, Assunção WG, Ervolino E, Maiorana C, Faverani LP. Titanium Allergy Caused by Dental Implants: A Systematic Literature Review and Case Report. MATERIALS 2021; 14:ma14185239. [PMID: 34576463 PMCID: PMC8465040 DOI: 10.3390/ma14185239] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 08/25/2021] [Accepted: 09/08/2021] [Indexed: 12/29/2022]
Abstract
(1) Background: Hypersensitivity reactions to metals may arise in predisposed patients chronically exposed to metallic materials, including dental implants made of titanium alloys. The purpose of this article was to systematically review titanium allergy manifestations in patients treated with dental implants and report a clinical case; (2) Methods: A systematic electronic search was performed for articles published in the English language until July 2021. The following eligibility criteria were adopted: (1) Population: individuals undergoing titanium and/or titanium alloy implant-supported rehabilitations; (2) Exposure: peri-implant soft tissue reactions attributable to implant insertion; (3) Outcome: evidence of titanium allergy, diagnostic methods, and forms of resolution; (3) Results: The included studies, in summary, presented evidence that titanium should not be considered an inert material, being able to trigger allergic reactions, and may be responsible for implant failure. A 55-year-old male patient received 3 implants in the posterior region of the left mandible and presented an epulis-like lesion developed from the peri-implant mucosa. The immunohistochemical analysis of the biopsy specimen confirmed the initial diagnosis of allergic reaction to titanium; (4) Conclusions: Although the evidence is weak, and titanium allergy has a low incidence, hypersensitivity reactions should not be underestimated. A rapid and conclusive diagnosis is mandatory to prevent further complications.
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Affiliation(s)
- Pier Paolo Poli
- Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Odontostomatology Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, University of Milan, 20122 Milan, Italy
| | - Fábio Vieira de Miranda
- Department of Diagnosis and Surgery, Division of Oral and Maxillofacial Surgery and Implantology, School of Dentistry, São Paulo State University-UNESP, Araçatuba 16015-050, SP, Brazil
| | - Tárik Ocon Braga Polo
- Department of Diagnosis and Surgery, Division of Oral and Maxillofacial Surgery and Implantology, School of Dentistry, São Paulo State University-UNESP, Araçatuba 16015-050, SP, Brazil
| | | | - Tiburtino José Lima Neto
- Department of Diagnosis and Surgery, Division of Oral and Maxillofacial Surgery and Implantology, School of Dentistry, São Paulo State University-UNESP, Araçatuba 16015-050, SP, Brazil
| | - Bárbara Ribeiro Rios
- Department of Diagnosis and Surgery, Division of Oral and Maxillofacial Surgery and Implantology, School of Dentistry, São Paulo State University-UNESP, Araçatuba 16015-050, SP, Brazil
| | - Wirley Gonçalves Assunção
- Department of Dental Materials and Prosthodontics, School of Dentistry, São Paulo State University-UNESP, Araçatuba 16015-050, SP, Brazil
| | - Edilson Ervolino
- Department of Basic Sciences, School of Dentistry, São Paulo State University-UNESP, Araçatuba 16015-050, SP, Brazil
| | - Carlo Maiorana
- Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Odontostomatology Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, University of Milan, 20122 Milan, Italy
| | - Leonardo Perez Faverani
- Department of Diagnosis and Surgery, Division of Oral and Maxillofacial Surgery and Implantology, School of Dentistry, São Paulo State University-UNESP, Araçatuba 16015-050, SP, Brazil
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50
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Manivasagam VK, Popat KC. Hydrothermally treated titanium surfaces for enhanced osteogenic differentiation of adipose derived stem cells. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2021; 128:112315. [PMID: 34474866 DOI: 10.1016/j.msec.2021.112315] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 06/20/2021] [Accepted: 07/07/2021] [Indexed: 02/07/2023]
Abstract
Implant surface plays a crucial role in improving osseointegration and long-term implant life. When the implant comes in contact with the bone tissue, the bone marrow mesenchymal cells interact with the implant surface and the surface properties such as morphology, wettability, mechanical properties and chemistry influences cell migration, proliferation and differentiation. Different surface modification strategies such as ceramic coatings, surface dealloying, and surface topography modifications for improving osteointegration have been investigated. However, studies have not yet established which of the surface property is more influential. In this study, titanium surfaces were treated hydrothermally with sodium hydroxide and sulfuric acid separately. This treatment led to the development of two unique surface topography at nanoscale. These modified surfaces were characterized for surface morphology, wettability, chemistry, and crystallinity. Cytotoxicity, cell adhesion, proliferation, morphology, and differentiation of adipose derived stem cells on modified surfaces was investigated. The results indicate that wettability does influence initial cell adhesion. However, the surface morphology can play major role in cell spreading, proliferation and differentiation. The results indicate that titanium surfaces treated hydrothermally with sodium hydroxide led to a nanoporous architecture that promoted appropriate cell interaction with the surface promoting osteoblastic lineage.
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Affiliation(s)
- Vignesh K Manivasagam
- Department of Mechanical Engineering, Colorado State University, Fort Collins, CO 80523, USA
| | - Ketul C Popat
- Department of Mechanical Engineering, Colorado State University, Fort Collins, CO 80523, USA; School of Biomedical Engineering, Colorado State University, Fort Collins, CO 80523, USA; School of Advanced Materials Discovery, Colorado State University, Fort Collins, CO 80523, USA.
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