ABSTRACT
BACKGROUND: Bioactive glass-ceramics have the ability to directly bind to bones and have been widely used as bone graft substitutes due to their high osteoconductivity and biocompatibility. CaO-SiO2-P2O5-B2O3 glass-ceramics are known to have good osteoconductivity and are used as bone graft extenders. METHODS: This study aimed to evaluate the effects of the resorbing properties of glass-ceramics in bone fusion after producing and analyzing three types of CaO-SiO2-P2O5-B2O3 glass-ceramics with high osteoconductivity that had enhanced resorption by having an increased B2O3 content. The three types of CaO-SiO2-P2O5-B2O3 glass-ceramics with B2O3 contents of 8.0, 9.0, and 9.5 weight % were designated and grouped as P20B80, P10B90, and P5B95, respectively. Glass-ceramic types were tested for fusion rates and bone formation by employing the lumbar 5-6 intertransverse process fusion model in 51 New Zealand male rabbits. Bioactivity was assessed by soaking in simulated body fluid (SBF). RESULTS: In vitro study results showed sufficient hydroxycarbonate apatite layer formation occurred for P20B80 in1 day, for P10B90 in 3 days, and for P5B95 in 5 days after soaking in SBF. For the rabbit lumbar spine posterolateral fusion model, the autograft group recorded a 100% fusion rate with levels significantly higher than those of P20B80 (29.4%), P10B90 (0%), and P5B95 (14.3%), with high resorbing properties. Resorbing property differences among the three glass-ceramic groups were not significant. Histological results showed new bone formation confirming osteoconductivity in all three types of glass-ceramics. Radiomorphometric results also confirmed the resorbing properties of the three glass-ceramic types. CONCLUSIONS: The high resorbing properties and osteoconductivity of porous glass-ceramics can be advantageous as no glass-ceramics remain in the body. However, their relatively fast rate of resorption in the body negatively affects their role as an osteoconductive scaffold as glass-ceramics are resorbed before bony fusion.
Subject(s)
Animals , Male , Rabbits , Bone Resorption , Bone Substitutes/adverse effects , Ceramics/adverse effects , Electric Conductivity , Lumbosacral Region/surgery , Spinal Fusion/methodsABSTRACT
Behcet's disease is a chronic disease characterized by recurrent systemic vasculitis. The pathogenesis remains unclear. This disease involves various organs of the body and it can have a variety of symptoms with an unpredictable course. The diagnosis of Behcet's disease is made in patients with oral and genital ulcers and uveitis. In addition, gastrointestinal symptoms are frequently present; however, intestinal ulcers are infrequent. The most common extra-oral sites of gastrointestinal involvement are ileocecal and colon lesions. The lesions are typically resistant to medical treatment and frequently recur after surgical treatment. Here we present two cases treated with the monoclonal antibody anti-tumor necrosis factor (TNF) and regression of all symptoms.
Subject(s)
Humans , Antibodies, Monoclonal , Chronic Disease , Colon , Necrosis , Systemic Vasculitis , Ulcer , Uveitis , InfliximabABSTRACT
Pyoderma gangrenosum (PG) is a vasculitic process, often associated with systemic diseases, including Takayasu's arteritis (TA), rheumatoid arthritis, and inflammatory bowel disease. Most cases of PG associated with TA have been observed in Japan. However, this association is not commonly observed in North American and European patients. PG is often refractory to therapy, requiring high dosages of glucocorticoids. Here, we describe a case of recalcitrant PG that was associated with TA and successfully treated with methotrexate.
Subject(s)
Humans , Arthritis, Rheumatoid , Glucocorticoids , Inflammatory Bowel Diseases , Japan , Methotrexate , Pyoderma Gangrenosum , Pyoderma , Takayasu ArteritisABSTRACT
Juvenile onset ankylosing spondylitis is a chronic inflammatory arthritis showing oligoarthritis and enthesopathy of the peripheral and axial skeleton. This have been shown to have different clinical presentation and outcome from adult onset ankylosing spondylitis. Takayasu arteritis is a uncommon, chronic inflammatory disease of elastic arteries such as the aorta, its larger branches and the pulmonary artery trunk. Although, it has rare report about association between ankylosing spondylitis and Takayasu arteritis, there was no report of juvenile onset ankylosing spondylitis with Takayasu arteritis. Thereby, we report a patient with Takayasu arteritis who had juvenile onset ankylosing spondylitis in the course of his disease.
Subject(s)
Adult , Humans , Aorta , Arteries , Arthritis , Pulmonary Artery , Rheumatic Diseases , Skeleton , Spondylitis, Ankylosing , Takayasu ArteritisABSTRACT
STUDY DESIGN: A comparative in vivo study between ceramics with different compositions. OBJECTIVES: To compare the biodegradation and osteoconduction properties of CaO-SiO2- P2O5- B2O3 glass-ceramics and Cerabone(R)-AW. Summary of Literature Review: Bioglass ceramics can be used as bone graft substitutes. However, no study has been undertaken to investigate the possibility of CaO-S i O2-P2O5-B2O3 glass-ceramics as a bone graft substitute. MATERIALS AND METHODS: Porous CSPB2 implants (44.07% CaO, 40.28% SiO2, 8.1% P2O5 and 5.0% B2O3), porous CSPB3 implants (43.76% CaO, 43.41% SiO2, 4.05% P2O5 and 7.5% B2O3) and porous Cerabone(R)-AW were prepared by the polymer sponge method. Single-level posterolateral spinal fusions were performed on sixty New Zealand white male rabbits. The animals were divided into four groups (9 of autograft, 17 per 3 kind of porous implant group) according to the implant material used: autograft, CSPB2, CSPB3 and Cerabone(R)-AW. Radiographs were performed every two weeks. All animals were sacrificed 12 weeks after surgery. Manual palpation and uniaxial tensile strength were determined. The proportion of the area occupied by the ceramics in the final compared to the initial radiographs was calculated. Decalcified and undecalcified histological sections were evaluated by light microscopy. RESULTS: Fifty one rabbits were evaluated. The union rates were 100 (9 out of 9), 80 (8 out of 8), 81.1 (9 out of 11) and 90.9% (10 out of 11) in the autograft, Cerabone(R)-AW, CSPB2 and CSPB3 groups, respectively. The proportion of the area occupied by Cerabone(R)-AW (90.8 % +/- 14.0) was significantly higher than for CSPB2 (73.1% +/- 11.5) and CSPB3 (73.5% +/- 10.0)(p=0.0011). The mean values of the tensile strengths of Cerabone(R)-AW (214. +/- 57.3N), CSPB2 (214. +/- 57.3 N) and CSPB3 (217 +/- 70.1 N) were not significantly different (p>0.05). CONCLUSION: CSPB2 and CSPB3 had similar tensile strengths and fusion rates of the fusion masses as those of Cerabone(R)-AW; however, they degraded more rapidly than Cerabone(R)-AW. These findings suggest that CSPB2 and CSPB3 grafts can be used as a more ideal new bone graft substitutes than Cerabone(R)-AW.
Subject(s)
Animals , Humans , Male , Rabbits , Autografts , Bone Regeneration , Ceramics , Lumbar Vertebrae , Microscopy , New Zealand , Palpation , Polymers , Porifera , Spinal Fusion , Tensile Strength , TransplantsABSTRACT
PURPOSE: To compare the biodegradation and osteoconduction properties of CaO-SiO2-B2O3 glass-ceramics (CS10B), hydroxyapatite(HA), and tricalcium phosphate (TCP). MATERIALS AND METHODS: Porous CS10B implants were prepared by the polymer sponge method. Single-level posterolateral spinal fusions were performed on thirty rabbits. The animals were divided into three groups by implant material: HA, TCP and CS10B. Radiographs were performed every two weeks. All animals were sacrificed 12 weeks after surgery. The proportion of the area occupied by the ceramicsin the final over the initial radiographs was calculated. Uniaxial tensile strength was determined from 7 cases in each group. RESULTS: The proportion of the area occupied by HA (88.7+/-16.1%) was significantly higher than the others (p<0.05), and the proportion of the area occupied by CS10B (28.2+/-9.3%) was significantly lower than those of HA and TCP (37+/-9.6%) (p<0.05). The mean values of the tensile strengths of HA (191.4+/-33.5 N) and CS10B (182.7+/-19.9 N) were significantly higher (p<0.05) than those of TCP (141.1+/-28.2 N). CONCLUSION: CS10B had similar tensile strengths of the fusion masses as HA, however, it degraded more rapidly than HA or TCP. These findings suggest CS10B grafts as possible bone replacement materials.
Subject(s)
Animals , Rabbits , Bone Regeneration , Bone Substitutes , Durapatite , Lumbar Vertebrae , Polymers , Porifera , Spinal Fusion , Tensile Strength , TransplantsABSTRACT
PURPOSE: To evaluate the osseointegration of different dense ceramics. MATERIALS AND METHODS: Twenty-eight New Zealand white male rabbits were divided into 4 groups by implant materials: Cerabone(R)-AW, CaO-SiO2- B2O3 glass ceramics (CS10B), CaO-SiO2- B2O3 glass (CS5B glass) and Cerabone(R)- A W + A l2O3 glass ceramics. We implanted the dense ceramics into the tibia of rabbits with external fixator and checked the radiographs every 4 weeks. The union rate, histology and SEM were evaluated 8 weeks after surgery. RESULTS: The union rates were 85.7% (6 of 7) in Cerabone(R)-AW, 85.7% (6 of 7) in CS10B, 71.4% (5 of 7) in CS5B glass and 28.6% (2 of 7) in Cerabone(R)-AW+Al2O3 by simple radiographs. The union rates of Cerabone (R)-AW and CS10B were statistically higher than that of Cerabone(R)-AW+Al2O3 (p=0.031). Histologically, the Cerabone(R)-AW had fused with tibia without biodegradation, CS10B, CS5B glass had fused with tibia in some portion but resorbed in others. Cerabone(R)-AW+Al2O3 had not fused with bony tissue. CONCLUSION: We confirmed the osseointegration and insolubility of Cerabone(R)-AW. We also confirmed the osseointegration and partial solubility of CaO-SiO2-B2O3 glass ceramics. These findings suggest that Cerabone (R)-AW can be used as an insoluble artificial bone and CaO-SiO2-B2O3 glass ceramics as biodegradable bone replacement materials.