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Herger S, Vach W, Nüesch C, Liphardt AM, Egloff C, Mündermann A. Dose-response relationship of in vivo ambulatory load and mechanosensitive cartilage biomarkers-The role of age, tissue health and inflammation: A study protocol. PLoS One 2022; 17:e0272694. [PMID: 35984848 PMCID: PMC9390933 DOI: 10.1371/journal.pone.0272694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 07/19/2022] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To describe a study protocol for investigating the in vivo dose-response relationship between ambulatory load magnitude and mechanosensitive blood markers of articular cartilage, the influence of age, cartilage tissue health and presence of inflammation on this relationship, and its ability to predict changes in articular cartilage quality and morphology within 2 years. DESIGN Prospective experimental multimodal (clinical, biomechanical, biological) data collection under walking stress and three different load conditions varied in a randomized crossover design. EXPERIMENTAL PROTOCOL At baseline, equal numbers of healthy and anterior cruciate ligament injured participants aged 20-30 or 40-60 years will be assessed clinically and complete questionnaires regarding their knee health. Biomechanical parameters (joint kinetics, joint kinematics, and surface electromyography) will be recorded while performing different tasks including overground and treadmill walking, single leg balance and hopping tasks. Magnetic resonance images (MRI) of both of knees will be obtained. On separate stress test days, participants will perform a 30-minute walking stress with either reduced (80% body weight (BW)), normal (100%BW) or increased (120%BW) load. Serum blood samples will be taken immediately before, immediately after, 30, 120 and 210 minutes after the walking stress. Concentration of articular cartilage blood biomarkers will be assessed using enzyme linked immunosorbent assays. At 24-month follow-up, participants will be again assessed clinically, undergo an MRI, complete questionnaires, and have a blood sample taken. CONCLUSION The study design provides a standardized set up that allows to better understand the influence of ambulatory load on articular cartilage biomarkers and thereby extend current knowledge on in vivo cartilage metabolism and mechanosensitivity. Further, this study will help to elucidate the prognostic value of the load-induced cartilage biomarker response for early articular cartilage degeneration. TRIAL REGISTRATION The protocol was approved by the regional ethics committee and has been registered at clinicaltrials.gov (NCT04128566).
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Affiliation(s)
- Simon Herger
- Department of Orthopaedics and Traumatology, University Hospital Basel, Basel, Switzerland
- Department of Spine Surgery, University Hospital Basel, Basel, Switzerland
- Department of Biomedical Engineering, University of Basel, Basel, Switzerland
- Department of Clinical Research, University of Basel, Basel, Switzerland
| | - Werner Vach
- Basel Academy for Quality and Research in Medicine, Basel, Switzerland
| | - Corina Nüesch
- Department of Orthopaedics and Traumatology, University Hospital Basel, Basel, Switzerland
- Department of Spine Surgery, University Hospital Basel, Basel, Switzerland
- Department of Biomedical Engineering, University of Basel, Basel, Switzerland
- Department of Clinical Research, University of Basel, Basel, Switzerland
| | - Anna-Maria Liphardt
- Department of Internal Medicine 3 –Rheumatology and Immunology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum für Immuntherapie (DZI), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Universitätsklinikum Erlangen, Erlangen, Germany
| | - Christian Egloff
- Department of Orthopaedics and Traumatology, University Hospital Basel, Basel, Switzerland
- Department of Clinical Research, University of Basel, Basel, Switzerland
| | - Annegret Mündermann
- Department of Orthopaedics and Traumatology, University Hospital Basel, Basel, Switzerland
- Department of Spine Surgery, University Hospital Basel, Basel, Switzerland
- Department of Biomedical Engineering, University of Basel, Basel, Switzerland
- Department of Clinical Research, University of Basel, Basel, Switzerland
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Shoga JS, Graham BT, Wang L, Price C. Direct Quantification of Solute Diffusivity in Agarose and Articular Cartilage Using Correlation Spectroscopy. Ann Biomed Eng 2017; 45:2461-2474. [PMID: 28612188 PMCID: PMC5693644 DOI: 10.1007/s10439-017-1869-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Accepted: 06/07/2017] [Indexed: 11/26/2022]
Abstract
Articular cartilage is an avascular tissue; diffusive transport is critical for its homeostasis. While numerous techniques have been used to quantify diffusivity within porous, hydrated tissues and tissue engineered constructs, these techniques have suffered from issues regarding invasiveness and spatial resolution. In the present study, we implemented and compared two separate correlation spectroscopy techniques, fluorescence correlation spectroscopy (FCS) and raster image correlation spectroscopy (RICS), for the direct, and minimally-invasive quantification of fluorescent solute diffusion in agarose and articular cartilage. Specifically, we quantified the diffusional properties of fluorescein and Alexa Fluor 488-conjugated dextrans (3k and 10k) in aqueous solutions, agarose gels of varying concentration (i.e. 1, 3, 5%), and in different zones of juvenile bovine articular cartilage explants (i.e. superficial, middle, and deep). In agarose, properties of solute diffusion obtained via FCS and RICS were inversely related to molecule size, gel concentration, and applied strain. In cartilage, the diffusional properties of solutes were similarly dependent upon solute size, cartilage zone, and compressive strain; findings that agree with work utilizing other quantification techniques. In conclusion, this study established the utility of FCS and RICS as simple and minimally invasive techniques for quantifying microscale solute diffusivity within agarose constructs and articular cartilage explants.
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Affiliation(s)
- Janty S Shoga
- Biomechanics & Movement Science, University of Delaware, Newark, DE, USA
| | - Brian T Graham
- Department of Mechanical Engineering, University of Delaware, Newark, DE, USA
| | - Liyun Wang
- Department of Mechanical Engineering, University of Delaware, Newark, DE, USA
| | - Christopher Price
- Biomechanics & Movement Science, University of Delaware, Newark, DE, USA.
- Department of Mechanical Engineering, University of Delaware, Newark, DE, USA.
- Department of Biomedical Engineering, University of Delaware, 161 Colburn Lab, Newark, DE, 19716, USA.
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3
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Shi C, Kuo J, Bell PD, Yao H. Anisotropic solute diffusion tensor in porcine TMJ discs measured by FRAP with spatial Fourier analysis. Ann Biomed Eng 2010; 38:3398-408. [PMID: 20582475 DOI: 10.1007/s10439-010-0099-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2010] [Accepted: 06/08/2010] [Indexed: 10/19/2022]
Abstract
A new method solely based on spatial Fourier analysis (SFA) was developed to completely determine a two-dimensional (2D) anisotropic diffusion tensor in fibrous tissues using fluorescence recovery after photobleaching (FRAP). The accuracy and robustness of this method was validated using computer-simulated FRAP experiments. This method was applied to determine the region-dependent anisotropic diffusion tensor in porcine temporomandibular joint (TMJ) discs. The average characteristic diffusivity of 4 kDa FITC-Dextran across the disc was 26.05 ± 4.32 μm²/s which is about 16% of its diffusivity in water. In the anteroposterior direction, the anterior region (30.99 ± 5.93 μm²/s) had significantly higher characteristic diffusivity than the intermediate region (20.49 ± 5.38 μm²/s) and posterior region (20.97 ± 2.46 μm²/s). The ratio of the two principal diffusivities represents the anisotropy of the diffusion and ranged between 0.45 and 0.51 (1.0 = isotropic). Our results indicated that the solute diffusion in TMJ discs is inhomogeneous and anisotropic. These findings suggested that diffusive transport in the TMJ disc is dependent on tissue composition (e.g., water content) and structure (e.g., collagen orientation). This study provides a new method to quantitatively investigate the relationship between solute transport properties and tissue composition and structure.
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Affiliation(s)
- Changcheng Shi
- Department of Bioengineering, Clemson University, CU-MUSC Bioengineering Program, 173 Ashley Avenue, P.O. Box 250508, Charleston, SC 29425, USA
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Wilcox CS, Pearlman A. Chemistry and antihypertensive effects of tempol and other nitroxides. Pharmacol Rev 2009; 60:418-69. [PMID: 19112152 DOI: 10.1124/pr.108.000240] [Citation(s) in RCA: 290] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Nitroxides can undergo one- or two-electron reduction reactions to hydroxylamines or oxammonium cations, respectively, which themselves are interconvertible, thereby providing redox metabolic actions. 4-Hydroxy-2,2,6,6-tetramethylpiperidine-N-oxyl (tempol) is the most extensively studied nitroxide. It is a cell membrane-permeable amphilite that dismutates superoxide catalytically, facilitates hydrogen peroxide metabolism by catalase-like actions, and limits formation of toxic hydroxyl radicals produced by Fenton reactions. It is broadly effective in detoxifying these reactive oxygen species in cell and animal studies. When administered intravenously to hypertensive rodent models, tempol caused rapid and reversible dose-dependent reductions in blood pressure in 22 of 26 studies. This was accompanied by vasodilation, increased nitric oxide activity, reduced sympathetic nervous system activity at central and peripheral sites, and enhanced potassium channel conductance in blood vessels and neurons. When administered orally or by infusion over days or weeks to hypertensive rodent models, it reduced blood pressure in 59 of 68 studies. This was accompanied by correction of salt sensitivity and endothelial dysfunction and reduced agonist-evoked oxidative stress and contractility of blood vessels, reduced renal vascular resistance, and increased renal tissue oxygen tension. Thus, tempol is broadly effective in reducing blood pressure, whether given by acute intravenous injection or by prolonged administration, in a wide range of rodent models of hypertension.
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Affiliation(s)
- Christopher S Wilcox
- Division of Nephrology and Hypertension, Kidney and Vascular Disorder Center, Georgetown University, Washington, DC 20007, USA.
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Abstract
Cartilaginous tissues, such as articular cartilage and intervertebral disc, are avascular tissues which rely on transport for cellular nutrition. Comprehensive knowledge of transport properties in such tissues is therefore necessary in the understanding of nutritional supply to cells. Furthermore, poor cellular nutrition in cartilaginous tissues is believed to be a primary source of tissue degeneration, which may result in osteoarthritis (OA) or disc degeneration. In this mini-review, we present an overview of the current status of the study of transport properties and behavior in cartilaginous tissues. The mechanisms of transport in these tissues, as well as experimental approaches to measuring transport properties and results obtained are discussed. The current status of bioreactors used in cartilage tissue engineering is also presented.
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Affiliation(s)
- Ar Jackson
- Tissue Biomechanics Lab, Dept of Biomedical Engineering, University of Miami, Coral Gables, FL
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7
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Evans S, Hall L. Evaluation of a range of MRI-active pH indicators using a multiple-sample method. AIChE J 2005. [DOI: 10.1002/aic.10387] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Abstract
Thermal chondroplasty provides a visually enticing effect on articular cartilage, but the long-term effects of thermal modification and injury to articular cartilage must be understood before the technology is applied to cartilage and chondrocytes in a clinical setting.
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Affiliation(s)
- Ryland B Edwards
- Department of Surgical Sciences, Comparative Orthopaedic Research Laboratory, School of Veterinary Medicine, University of Wisconsin at Madison, 2015 Linden Drive, Madison, WI 53706-1102, USA
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Paterson-Beedle M, Nott KP, Macaskie LE, Hall LD. Study of biofilm within a packed-bed reactor by three-dimensional magnetic resonance imaging. Methods Enzymol 2001; 337:285-305. [PMID: 11398437 DOI: 10.1016/s0076-6879(01)37022-2] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Affiliation(s)
- M Paterson-Beedle
- School of Biosciences, University of Birmingham, Birmingham B15 2TT, United Kingdom
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11
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Winalski CS, Minas T. Evaluation of chondral injuriesby magnetic resonance imaging: Repair assessments. OPER TECHN SPORT MED 2000. [DOI: 10.1053/otsm.2000.6577] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Gonsalves M, Barker AL, Macpherson JV, Unwin PR, O'Hare D, Winlove CP. Scanning electrochemical microscopy as a local probe of oxygen permeability in cartilage. Biophys J 2000; 78:1578-88. [PMID: 10692342 PMCID: PMC1300755 DOI: 10.1016/s0006-3495(00)76710-5] [Citation(s) in RCA: 64] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
The use of scanning electrochemical microscopy, a high-resolution chemical imaging technique, to probe the distribution and mobility of solutes in articular cartilage is described. In this application, a mobile ultramicroelectrode is positioned close ( approximately 1 microm) to the cartilage sample surface, which has been equilibrated in a bathing solution containing the solute of interest. The solute is electrolyzed at a diffusion-limited rate, and the current response measured as the ultramicroelectrode is scanned across the sample surface. The topography of the samples was determined using Ru(CN)(6)(4-), a solute to which the cartilage matrix was impermeable. This revealed a number of pit-like depressions corresponding to the distribution of chondrocytes, which were also observed by atomic force and light microscopy. Subsequent imaging of the same area of the cartilage sample for the diffusion-limited reduction of oxygen indicated enhanced, but heterogeneous, permeability of oxygen across the cartilage surface. In particular, areas of high permeability were observed in the cellular and pericellular regions. This is the first time that inhomogeneities in the permeability of cartilage toward simple solutes, such as oxygen, have been observed on a micrometer scale.
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MESH Headings
- Animals
- Cartilage, Articular/cytology
- Cartilage, Articular/physiology
- Cartilage, Articular/ultrastructure
- Cattle
- Electrochemistry/instrumentation
- Electrochemistry/methods
- Indicators and Reagents
- Metacarpophalangeal Joint
- Microscopy, Atomic Force
- Microscopy, Electron, Scanning/instrumentation
- Microscopy, Electron, Scanning/methods
- Models, Biological
- Models, Theoretical
- Oxygen/metabolism
- Permeability
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Affiliation(s)
- M Gonsalves
- Department of Chemistry, University of Warwick, Coventry CV4 7AL, United Kingdom
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Gordon MJ, Chu KC, Margaritis A, Martin AJ, Ethier CR, Rutt BK. Measurement of Gd-DTPA diffusion through PVA hydrogel using a novel magnetic resonance imaging method. Biotechnol Bioeng 1999; 65:459-67. [PMID: 10506421 DOI: 10.1002/(sici)1097-0290(19991120)65:4<459::aid-bit10>3.0.co;2-o] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Polyvinyl alcohol-cryogel (PVA-C) is a hydrogel that is an excellent tissue mimic. In order to characterize mass transfer in this material, as well as to demonstrate in principle the ability to noninvasively measure solute diffusion in tissue, we measured the diffusion coefficient of the magnetic resonance (MR) contrast agent gadolinium diethylene triaminopentaacetic acid (Gd-DTPA) through PVA-C using a clinical MR imager. The method involved filling thick-walled rectangular PVA-C "cups" with known concentrations of Gd-DTPA solutions. Then by using a fast inversion recovery spin echo MR imaging protocol, a signal "null" contour was created in the MR image that corresponded to a second, known concentration of Gd-DTPA. By collecting a series of MR images through the PVA-C wall as a function of time, the displacement of this second known isoconcentration contour could be tracked. Application of Fick's second law of diffusion yielded the diffusion coefficient. Seven separate experiments were performed using various combinations of initial concentrations of Gd-DTPA within the PVA-C cups (3.2, 25.6, or 125 mM) and tracked isoconcentrations contours (0.096, 0.182, or 0.435 mM Gd-DTPA). The experimental results and the predictions of Fick's law were in excellent agreement. The diffusivity of Gd-DTPA through 10% PVA hydrogel was found to be (2.6 +/- 0.04) x 10(-10) m(2)/s (mean +/- s.e.m.). Separate permeability studies showed that the diffusion coefficient of Gd-DTPA through this hydrogel did not change with an applied pressure of up to 7.1 kPa. Accurate measurements could be made within 30 min if suitable Gd-DTPA concentrations were selected. Due to the excellent repeatability and fast data acquisition time, this technique is very promising for future in vivo studies of species transport in tissue.
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Affiliation(s)
- M J Gordon
- Department of Chemical and Biochemical Engineering, University of Western Ontario, London, Ontario, N6A 5B9, Canada
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14
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Knauss R, Schiller J, Fleischer G, Kärger J, Arnold K. Self-diffusion of water in cartilage and cartilage components as studied by pulsed field gradient NMR. Magn Reson Med 1999; 41:285-92. [PMID: 10080275 DOI: 10.1002/(sici)1522-2594(199902)41:2<285::aid-mrm11>3.0.co;2-3] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Pulsed field gradient (PFG) nuclear magnetic resonance (NMR) was used to investigate the self-diffusion behavior of water molecules in cartilage, polymeric cartilage components, and different model polymers. The short-time self-diffusion coefficients (diffusion time delta approximately/= 13 msec) are found to decrease steadily with decreasing water content. This holds equally well for cartilage and cartilage components. The short-time diffusion coefficients are subjected to a rather nonspecific obstruction effect and mainly depend on the water content of the sample. The long-time diffusion coefficients in cartilage (delta approximately/= 500 msec), however, reflect structural properties of this tissue. Measurements with varying observation times as well as experiments involving enzymatic treatment of articular cartilage suggest that the collagenous network in cartilage is likely to be responsible for the observed restricted diffusion.
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Affiliation(s)
- R Knauss
- Institute of Medical Physics and Biophysics, Medical Faculty, University of Leipzig, Germany
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15
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Macpherson JV, O'Hare D, Unwin PR, Winlove CP. Quantitative spatially resolved measurements of mass transfer through laryngeal cartilage. Biophys J 1997; 73:2771-81. [PMID: 9370471 PMCID: PMC1181179 DOI: 10.1016/s0006-3495(97)78306-1] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
The scanning electrochemical microscope (SECM) is a scanned probe microscope that uses the response of a mobile ultramicroelectrode (UME) tip to determine the reactivity, topography, and mass transport characteristics of interfaces with high spatial resolution. SECM strategies for measuring the rates of solute diffusion and convection through samples of cartilage, using amperometric UMEs, are outlined. The methods are used to determine the diffusion coefficients of oxygen and ruthenium(III) hexamine [Ru(NH3)6(3+)] in laryngeal cartilage. The diffusion coefficient of oxygen in cartilage is found to be approximately 50% of that in aqueous electrolyte solution, assuming a partition coefficient of unity for oxygen between cartilage and aqueous solution. In contrast, diffusion of Ru(NH3)6(3+) within the cartilage sample cannot be detected on the SECM timescale, suggesting a diffusion coefficient at least two orders of magnitude lower than that in solution, given a measured partition coefficient for Ru(NH3)6(3+) between cartilage and aqueous solution, Kp = [Ru(NH3)6(3+)]cartilage/[RU(NH3)6(3+)]solution = 3.4 +/- 0.1. Rates of Ru(NH3)6(3+) osmotically driven convective transport across cartilage samples are imaged at high spatial resolution by monitoring the current response of a scanning UME, with an osmotic pressure of approximately 0.75 atm across the slice. A model is outlined that enables the current response to be related to the local flux. By determining the topography of the sample from the current response with no applied osmotic pressure, local transport rates can be correlated with topographical features of the sample surface, at much higher spatial resolution than has previously been achieved.
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Affiliation(s)
- J V Macpherson
- Department of Chemistry, University of Warwick, Coventry, United Kingdom
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BUCKWALTER JA, MANKIN HJ. Instructional Course Lectures, The American Academy of Orthopaedic Surgeons - Articular Cartilage. Part I. J Bone Joint Surg Am 1997. [DOI: 10.2106/00004623-199704000-00021] [Citation(s) in RCA: 343] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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Potter K, Spencer RG, McFarland EW. Magnetic resonance microscopy studies of cation diffusion in cartilage. BIOCHIMICA ET BIOPHYSICA ACTA 1997; 1334:129-39. [PMID: 9101706 DOI: 10.1016/s0304-4165(96)00083-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The diffusion of copper ions in bovine nasal cartilage (BNC), a dense connective tissue, was investigated to further the understanding of ion transport in charged biopolymer systems. Using an inversion-recovery null-point imaging technique, it was found that the diffusion rate of divalent copper ions into cartilage was significantly lower in normal BNC than in BNC in which the matrix fixed charges had been reduced by enzymatic digestion or acid neutralization. In normal cartilage, counterion diffusion was not well described by a simple Fickian process, likely owing to the high charge density of the constituent molecules. In contrast, in both digested and acid neutralized BNC, counterion diffusion appeared Fickian. Features of the ion transport process were modeled using a diffusion equation which included a linear sorption term to account for cation binding. The diffusion coefficient of copper in cartilage increased with decreasing matrix fixed charge and was constant for reservoir concentrations up to 30 mM. The activation energy for the diffusion of copper into BNC was determined to be 34.5 kJ/mol.
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Affiliation(s)
- K Potter
- Department of Chemical Engineering, University of California, Santa Barbara 93106-5080, USA
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Fischer AE, Hall LD. Visualization of the diffusion of metal ions and organic molecules by magnetic resonance imaging of water. Magn Reson Imaging 1996; 14:779-83. [PMID: 8970081 DOI: 10.1016/s0730-725x(96)00163-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Null point magnetic resonance imaging (MRI) of water has been used to map the location in space and time of small concentrations of paramagnetic metals and nitroxide free radicals. Any paramagnetic species whose effective magnetisation is dependent on the chemical potential of the surrounding medium, can be used either as a "molecular amplifier" or as an "MRI-active indicator"-This approach has been used to study the diffusion of acid (via (Cu EDTA)), and of oxidising and reducing agents (via Fe(II), Fe(III), ions) in a range of hydrogels and in hen-knee cartilage.
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Affiliation(s)
- A E Fischer
- Herchel Smith Laboratory for Medicinal Chemistry, University of Cambridge School of Clinical Medicine, UK
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