Surface analysis of long-term hemodialysis catheters made of carbothane (poly(carbonate)urethane) before and after implantation in the patients' bodies.

PURPOSE: The vascular cannulation is associated with a number of complications. The aim of this work was to study the composition and distribution of the film covering the surfaces of Mahurkar Maxid and Palindrome catheters, which were removed from the body of long-term hemodialysis patients. Moreover, the roughness and contact angle of the catheters were evaluated. METHODS: Two brand new (as a reference) and thirty used catheters were the subject of the study. Their implantation period lasted from 4 months to a year and the reason for removal was the production of another vascular access or obstruction. Surfaces were analyzed by scanning electron microscope, atomic force microscope and goniometer. RESULTS: The inner surfaces of the used catheters were covered with a film of various complexity which includes a plurality of protein, blood cell counts and the crystals. The closer to the distal part the film becomes more complex and multi-layered. Even the surfaces of brand new catheter were not completely smooth. The only significant difference between analyzed models was the presence of thrombus in the distal part of Mahurkar Maxid catheters, not in the Palindrome. CONCLUSIONS: The distal part of the catheters is the place most exposed to obstruction and infection, which may be due to not reaching the anticoagulant agent into this part. Not only the occurrence of side holes affects the formation of thrombus, but also their quantity, geometry and distribution which effect on fluid mechanics. The surface of the catheters needs to improvement to minimize the occurrence of defects and cracks.

Effects of titanium-based nanotube films on osteoblast behavior in vitro.

One of the major research interests of nanomedicine is the designing of harmless and biocompatible medical devices. To improve the features of Ti surface, TiO2 based nanotube (TNT) films (50 nm diameter) achieved by anodic oxidation and thermal treatment were grown on titanium and on Ti6Al4V and Ti6Al7Nb alloys. Their in vitro toxicity and biocompatibility were investigated using G292 osteoblast cell line. The LDH release after 24 and 48 h of exposure demonstrated that TNT layers were not cytotoxic. The cell growth on TNT films deposited on titanium and Ti6Al4V was significantly increased compared with Ti6Al7Nb. F-actin staining showed a better organized actin cytoskeleton in osteoblasts grown on these two samples, which provide the best conditions for osteoblast attachment and spreading. Analysis of GSH distribution revealed a higher nuclear level in the samples with TNTs compared with Ti plate without nanotubes, indicating an active proliferation. Thus, nuclear glutathione levels can be used as a useful biomarker for biocompatibility assessment. Our results suggest that the substrate for TNTs can have a significant impact on cell morphology and fate. In conclusion, the TNT/Ti and TNT/Ti6Al4V were toxicity-free and can provide a proper nanostructure for a positive cell response.

Titanium dioxide nanotube films: Preparation, characterization and electrochemical biosensitivity towards alkaline phosphatase.

Titania nanotubes (TNTs) were prepared by anodization on different substrates (titanium, Ti6Al4V and Ti6Al7Nb alloys) in ethylene glycol and glycerol. The influence of the applied potential and processing time on the nanotube diameter and length is analyzed. The as-formed nanotube layers are amorphous but they become crystalline when subjected to subsequent thermal treatment in air at 550°C; TNT layers grown on titanium and Ti6Al4V alloy substrates consist of anatase and rutile, while those grown on Ti6Al7Nb alloy consist only of anatase. The nanotube layers grown on Ti6Al7Nb alloy are less homogeneous, with supplementary islands of smaller diameter nanotubes, spread across the surface. Better adhesion and proliferation of osteoblasts was found for the nanotubes grown on all three substrates by comparison to an unprocessed titanium plate. The sensitivity towards bovine alkaline phosphatase was investigated mainly by electrochemical impedance spectroscopy in relation to the crystallinity, the diameter and the nature of the anodization electrolyte of the TNT/Ti samples. The measuring capacity of the annealed nanotubes of 50nm diameter grown in glycerol was demonstrated and the corresponding calibration curve was built for the concentration range of 0.005-0.1mg/mL.