Effects of strontium ranelate administration on bisphosphonate-altered hydroxyapatite: Matrix incorporation of strontium is accompanied by changes in mineralization and microstructure.

Strontium ranelate (SR) is one therapeutic option for reducing risk of fracture in osteoporosis. The effects of SR treatment on hydroxyapatite (HA) previously altered by bisphosphonate (BP) administration remain to be established. Patients who have received long-term BP treatment and present with persistent high fracture risk are of particular interest. Paired iliac crest biopsies from 15 patients post-BP therapy were subjected to a baseline biopsy and a follow-up biopsy after treatment with 2g SR day⁻¹ after either 6 months (n=5) or 12 months (n=10). Dual energy X-ray absorptiometry scans, serum parameters and biochemical markers were obtained. Quantitative backscattered electron imaging and energy-dispersive X-ray analyses combined with micro-X-ray fluorescence determinations were performed to observe any mineralization changes. Static 2-D histomorphometry was carried out to evaluate cellular and structural indices. After 6 months of SR treatment, increases in osteoid surface and strontium content were observed, but no other indices showed significant change. After 12 months of SR treatment, there was a significant increase in bone volume and trabecular thickness, and further increases in strontium content and backscattered signal intensity. These structural changes were accompanied by increased numbers of osteoblasts and increased osteoid surface and volume. Additionally, low bone resorption, as measured by beta-cross-laps, and a low number of osteoclasts were observed. SR treatment led to increased strontium content within the BP-HA nanocomposites and to increased osteoid indices and bone volume, which is indicative of newly formed bone, while osteoclasts were still suppressed. These data points suggest that SR might be considered as a therapeutic option for patients following long-term BP treatment.

Allocation of nonbirefringent wear debris: darkfield illumination associated with PIXE microanalysis reveals cobalt deposition in mineralized bone matrix adjacent to CoCr implants.

Abrasive joint replacement material that accumulates in the tissue induces reciprocal effects between prosthesis material and organism. Since the limitations of brightfield and polarized light microscopy for foreign body analysis are well known, a method was applied that ensures the detailed histological assessment of nonbirefringent particles in periprosthetic soft and hard tissue. Cemented and cementless interface regions of five selected autopsy hip implant cases (2 x Endo-Modell Mark III, LINK, 1 x St. Georg Mark II, LINK, Germany; 2 x Spongiosa Metal II, ESKA, Germany) were viewed under darkfield illumination and subsequently analyzed with proton-induced X-ray emission (PIXE). Eight autopsy cases without implants served as controls. Using darkfield illumination technique, metallic particles became visible as luminous points under the microscope. The majority of particles in the samples from the cemented cases were degradation products of radiopaque bone cement. There was minimal evidence of metallic alloy particles in the soft tissues. However, a considerable quantity of heavy metal cobalt (Co) was found in the periprosthetic mineralized bone tissue, which was not observed in the controls. The periprosthetic concentration of cobalt ranged from 38 to 413 ppm. The findings demonstrate a correlation between cobalt concentration, time since implantation, and distance from the implant. Darkfield microscopy associated with PIXE enables a detailed histological assessment of metal particles in the tissue. In an effort to optimize biomechanics, implant design and implantation techniques, the contamination of soft and hard tissue with heavy metal degradation products deserves similar attention in terms of alloy assortment.

[Polyethylene abrasion: cause or consequence of an endoprosthesis loosening? Investigations of firm and loosened hip implants]. / Polyethylen-Abrieb: Ursache oder Folge einer Endoprothesenlockerung? Untersuchungen an festen und gelockerten Hüftendoprothesen.

AIM: Periprosthetic tissue was analysed by the combination of different investigation techniques without destruction. The localisation and geometry of polyethylene abrasion particles were determined quantitatively to differentiate between abrasion due to function and abrasion due to implant loosening. Non-polyethylene particles from implant components which contaminate the tissue were micro-analytically measured. The results will help us to understand loosening mechanisms and thus lead to implant optimisations. METHOD: A non-destructive particle analysis using highly sensitive proton-induced X-ray emission (PIXE) was developed to achieve a better histological allocation. Five autopsy cases with firmly fitting hip endoprosthesis (2 x Endo-Modell Mark III, 1 x St. Georg Mark II, LINK, Germany; 2 x Spongiosa Metal II, ESKA, Germany) were prepared as ground tissue specimens. Wear investigations were accomplished with a combined application of different microscopic techniques and microanalysis. The abrasion due to implant loosening was histologically evaluated on 293 loosened cup implants (St. Georg Mark II, LINK, Germany). RESULTS: Wear particles are heterogeneously distributed in the soft tissue. In cases of cemented prostheses, cement particles are dominating whereas metal particles could rarely be detected. The concentration of the alloy constituent cobalt (Co) is increased in the mineralised bone tissue. The measured co-depositions depend on the localisation and/or lifetime of an implant. Functional polyethylene (PE) abrasion needs to be differentiated from PE abrasion of another genesis (loosening, impingement) morphologically and by different tissue reactions. CONCLUSION: In the past a reduction of abrasion was targeted primarily by the optimisation of the bearing surfaces and tribology. The interpretation of our findings indicates that different mechanisms of origin in terms of tissue contamination with wear debris and the alloy should be included in the improvement of implants or implantation techniques.

Penetration by Artificial Electron Acceptors of the Plasma Membrane-Bound Redox System into Intact Zea mays L. Roots Investigated by Proton-Induced X-Ray Emission.

Proton-induced x-ray emission was used to investigate the penetration of compounds of the membrane-impermeant electron acceptors hexabromoiridate IV, hexachloroiridate IV, and hexacyanoferrate III into corn (Zea mays L.) roots. Maps of the heavy element distribution in cross-sections of fixed, epoxy-embedded roots showed for hexabromoiridate IV small amounts of Br in samples treated for 24 h with concentrations normally used in physiological experiments (0.02 mM). After treatment with high concentrations (0.8 mM) of these complexes, Fe and Ir as well as Br were found in root cross-sections. In samples taken at a distance of 5 mm behind the root tip, we found an even distribution of Fe, Ir, and Br over the whole cross-section. In samples taken 15 mm behind the root tip, about 99% of both Br and Ir was confined to the rhizodermal cell layer. The distribution did not change with the complex used. These data are consistent with the view that apoplastic diffusion of the electron acceptors was blocked by the hypodermal Casparian band.

[Histologic reactions of the bone-implant zone and cortical bone area after long-term hip replacement]. / Histologische Reaktionen an der Knochen-Implantat-Grenze und der Corticalis nach mehrjährigem Hüftgelenkersatz.

29 femora with cemented hip endoprostheses and 17 age related controls were analyzed regarding different histological criteria. All specimens were processed to undecalcified ultra thin grindings and in addition a few to surface stained block-grindings. The reactions at the bone implant interface in cases without loosening of the implant are: accumulation of macrophages and multinucleated giant cells, fibrous tissue membranes with a mean thickness of 103 microns and mineralization defects near the cement. The mean rate of direct bone/bone-cement contact is 2.7% of the whole cement surface. The phenomenons at the interface were explained as being the result of micromovement and resulting from wear and tear. The cortical bone demonstrates a remarkable loss of bone (up to 60% after 12 years) following an increase of osteoclastic resorption with no change of osteoblast activity. The localization of the bone loss indicates a relation to the new load situation after implantation.

Sulfide silver amplification of ferritin iron cores in blood and bone marrow cells. Methods, adaptations to microphysical analyses, and the impact of advanced iron overload.

A short exposure of cell suspensions to gaseous hydrogen sulfide, appropriate fixations, and subsequent physical development of silver shells around sulfidated insoluble metals were used to amplify ferritin iron cores in blood and bone marrow cells. The methods described are suitable for both light microscopy and transmission electron microscopy. These techniques made it possible to visualize Prussian Blue stainable ferritin and haemosiderin, as well as a large variety of isoferritin iron and other smaller particles beyond the sensitivity of Prussian Blue staining. Admixtures of sulfidatible zinc and traces of other heavy metals had to be taken into consideration. For further research, adaptations of sulfide silver staining to microphysical analyses were developed. However, conventional energy dispersive X-ray analysis was not sensitive enough to signalize the presence of Fe in sulfide silver amplified iron cores of a single or a few ferritin molecule(s). Proton-induced X-ray emission was used to measure Fe and Zn down to 1 fg/single cell in unstained or sulfide silver stained smears on thin foils. However, multielement analysis of homogeneous cell concentrates was much easier to perform and far more sensitive. In advanced iron overload, highly increased sulfide silver staining was found in peripheral blood cells including lymphocytes, monocytes, eosinophils, basophils, and--in extreme cases--also in neutrophils and platelets.