Review of in vitro mechanical testing for intervertebral disc injectable biomaterials.

Many early stage interventions for intervertebral disc degeneration are under development involving injection of a biomaterial into the affected tissue. Due to the complex mechanical behaviour of the intervertebral disc, there are challenges in comprehensively evaluating the performance of these injectable biomaterials in vitro. The aim of this review was to examine the different methods that have been developed to mechanically test injectable intervertebral disc biomaterials in an in vitro disc model. Testing methods were examined with emphasis on overall protocol, artificial degeneration method, mechanical testing regimes and injection delivery. Specifically, the effects of these factors on the evaluation of different aspects of device performance was assessed. Broad testing protocols varied between studies and enabled evaluation of different aspects of an injectable treatment. Studies employed artificial degeneration methodologies which were either on a macro scale through mechanical means or on a microscale with biochemical means. Mechanical loading regimes differed greatly across studies, with load being either held constant, ramped to failure, or applied cyclically, with large variability on all loading parameters. Evaluation of the risk of herniation was possible by utilising ramped loading, whereas cyclic loading enabled the examination of the restoration of mechanical behaviour for initial screening of biomaterials and surgical technique optimisation studies. However, there are large variations in the duration or tests, and further work is needed to define an appropriate number of cycles to standardise this type of testing. Biomaterial delivery was controlled by set volume or haptic feedback, and future investigations should generate evidence applying physiological loading during injection and normalisation of injection parameters based on disc size. Based on the reviewed articles and considering clinical risks, a series of recommendations have been made for future intervertebral disc mechanical testing.

[Photocarcinogenesis-molecular mechanisms and practical relevance]. / Photokarzinogenese ­ Molekulare Mechanismen und praktische Relevanz.

Ultraviolet (UV) radiation is the main risk factor for the development of melanocytic and nonmelanocytic skin cancer. UVA and UVB radiation are of particular importance in photocarcinogenesis. Depending on the wavelength, mechanisms of tumor initiation and promotion include direct DNA damage and proinflammatory processes. In recent years, the number of skin cancer cases in Germany has continuously increased. In addition to regular skin check-ups, use of suitable textile protection and sunscreens play a central role in the prevention of cancer development. As dermatologists, it is our task to regularly inform our patients about the consequences of excessive sun exposure and to adequately inform them about necessary protective devices.

Mesh management methods in finite element simulations of orthodontic tooth movement.

In finite element simulations of orthodontic tooth movement, one of the challenges is to represent long term tooth movement. Large deformation of the periodontal ligament and large tooth displacement due to bone remodelling lead to large distortions of the finite element mesh when a Lagrangian formalism is used. We propose in this work to use an Arbitrary Lagrangian Eulerian (ALE) formalism to delay remeshing operations. A large tooth displacement is obtained including effect of remodelling without the need of remeshing steps but keeping a good-quality mesh. Very large deformations in soft tissues such as the periodontal ligament is obtained using a combination of the ALE formalism used continuously and a remeshing algorithm used when needed. This work demonstrates that the ALE formalism is a very efficient way to delay remeshing operations.

An enhanced version of a bone-remodelling model based on the continuum damage mechanics theory.

The purpose of this work was to propose an enhancement of Doblaré and García's internal bone remodelling model based on the continuum damage mechanics (CDM) theory. In their paper, they stated that the evolution of the internal variables of the bone microstructure, and its incidence on the modification of the elastic constitutive parameters, may be formulated following the principles of CDM, although no actual damage was considered. The resorption and apposition criteria (similar to the damage criterion) were expressed in terms of a mechanical stimulus. However, the resorption criterion is lacking a dimensional consistency with the remodelling rate. We propose here an enhancement to this resorption criterion, insuring the dimensional consistency while retaining the physical properties of the original remodelling model. We then analyse the change in the resorption criterion hypersurface in the stress space for a two-dimensional (2D) analysis. We finally apply the new formulation to analyse the structural evolution of a 2D femur. This analysis gives results consistent with the original model but with a faster and more stable convergence rate.

A non-linear homogeneous model for bone-like materials under compressive load.

Finite element (FE) models accurately compute the mechanical response of bone and bone-like materials when the models include their detailed microstructure. In order to simulate non-linear behavior, which currently is only feasible at the expense of extremely high computational costs, coarser models can be used if the local morphology has been linked to the apparent mechanical behavior. The aim of this paper is to implement and validate such a constitutive law. This law is able to capture the non-linear structural behavior of bone-like materials through the use of fabric tensors. It also allows for irreversible strains using an elastoplastic material model incorporating hardening. These features are expressed in a constitutive law based on the anisotropic continuum damage theory coupled with isotropic elastoplasticity in a finite strain framework. This material model was implemented into metafor (LTAS-MNNL, University of Liège, Belgium), a non-linear FE software. The implementation was validated against experimental data of cylindrical samples subjected to compression. Three materials with bone-like microstructure were tested: aluminum foams of variable density (ERG, Oakland, CA, USA), polylactic acid foam (CERM, University of Liège, Liège, Belgium), and cancellous bone tissue of a deer antler (Faculty of Veterinary Medicine, University of Liège, Liège, Belgium).

Differential stability of E. coli ribosomal particles and free RNA towards thermal degradation studied by microcalorimetry.

We investigated the thermal degradation of E. coli ribosomes by differential scanning microcalorimetry. The 70S particles show two distinctive and irreversible peaks upon thermal degradation. Free rRNA in solution produces, on the contrary, an unstructured denaturation profile. The thermal analysis of 50S particles shows a profile substantially identical to that observed in 70S, while 30S particles produce an unstructured denaturation pattern. Therefore the thermal behavior of the 70S particle is essentially attributable to the denaturation of the 50S subunit. Our data validate previous observations that the 50S has a more rigid structure as compared to 30S, which behaves as a 'floppy' particle. In addition our data suggest that protein/RNA interactions play a significant role to stabilize three-dimensional structures of the ribosome.

A study of the dielectric properties of E. coli ribosomal RNA and proteins in solution.

The permittivity of ribosomal proteins and ribosomal RNA (rRNA) in solution was measured in the range 100 kHz to 1 GHz at four different temperatures (5, 15, 25 and 35 degrees C). The experimental dielectric relaxation was analysed by the Cole-Cole equation and, from the best-fit parameters, the average values of the dipole moment and molecular radius of the proteins were obtained. The activation enthalpy was calculated from an Arrhenius plot of the relaxation time. The energy involved in the dielectric polarization of free proteins has a magnitude of about one hydrogen bond. The data on RNA were analysed according to the Mandel model. This analysis allowed the calculation of the "subunit b" as defined by Mandel. This parameter is dependent on the temperature and therefore the relaxation time does not follow the Arrhenius law. Our data thus show that, in solution, the rRNA structure is thermally rather unstable and highly flexible.

Effects of magnesium and temperature on the conformation and reassociation of Escherichia coli and Sulfolobus solfataricus ribosomes.

The structural response of the ribosomes of the extremely thermophilic archaeon Sulfolobus solfataricus was analysed and compared to that of the mesophilic (E. coli) ribosomes by assaying ethidium bromide (EB) binding to the native 70S particles as a function of magnesium concentration. We found that the thermophilic ribosomes bound more EB than their mesophilic counterparts; on the other hand, inhibition of EB binding by Mg2+ ions was more effective in the E. coli 70S particle. In Sulfolobus, the separated 30S and 50S subunits and the 70S particle bound the drug in a similar fashion, whereas the E. coli 70S had a reduced number of binding sites with respect to the subunits. Light scattering measurements as a function of Mg2+ concentration were carried out at various temperatures to study the interaction between the ribosomal subunits from the thermophilic and the mesophilic bacteria. As expected, the association of ribosomal subunits in E. coli was magnesium dependent and could be observed also at low temperature. By contrast, the interaction between Sulfolobus ribosomal subunits was obligatorily dependent upon both magnesium ions and a temperature of at least 80 degrees C, close to the physiological optimum for cell growth (87 degrees C).

Hypothalamic-pituitary-adrenal function in children with atopic dermatitis treated with clobetasone butyrate and its clinical evaluation.

Twenty-nine patients with symmetrical eczematous lesions were treated with 0.05% clobetasone butyrate cream. Clinical conditions and cortisol and ACTH concentrations were evaluated at the beginning and after 1 week in 12 children and after 2 weeks of treatment in 17 patients respectively. The lesions and symptoms improved steadily and no significant change in cortisol and ACTH plasma levels was observed throughout the study in all children. This steroid offers clinically effective topical antiinflammatory activity with a wide margin of safety.

A combination of cefuroxime plus acetylcysteine in the intensive care of patients with respiratory insufficiency.

Thirty patients admitted to our Intensive Care Unit for respiratory insufficiency attributable to a variety of disease conditions were treated with a combination of cefuroxime plus acetylcysteine. Clinical and laboratory variables were evaluated, and bacteriological tests were performed on tracheal aspirate. At the end of treatment, 12 patients were judged to be recovered, 14 improved and 4 unchanged. No side effects were observed.

Adrenocortical function during prolonged treatment with clobetasone butyrate in children with chronic atopic dermatitis and elevated IgE levels.

Twelve children with chronic atopic dermatitis and elevated IgE levels (age range: 2-13 years; mean age = 8.2 +/- 3.5 years) were selected for the study and treated with clobetasone butyrate (0.05% cream) thrice daily during the first week, then twice daily for three weeks. Adrenocortical function was evaluated at the beginning and the end of treatment period. The results show that there was no statistically significant change in adrenal function during the study period (tetracosactrin test). The results of the immunological studies, namely total IgE using the paper disc radioimmunoassay technique, specific IgE using the radioallergosorbent test and immunoglobulin levels are given.