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Biomedical subjects

A Moroni

Publications and source records attributed to A Moroni.

At least 55 records · Page 3Linked to original sources

Biomechanical, scanning electron microscopy, and microhardness analyses of the bone-pin interface in hydroxyapatite coated versus uncoated pins.

OBJECTIVE: To evaluate the bone-pin interface in hydroxyapatite coated versus uncoated pins. DESIGN: Eighty-four bicylindrical stainless steel external fixation pins were implanted in a test group of 14 sheep. One-half of the pins were coated with hydroxyapatite and the rest remained uncoated. INTERVENTION: Six coated pins were implanted in the left tibia of seven sheep, and six uncoated pins were implanted in the left tibia of the other seven sheep. In all sheep, the right tibia was left intact. During pin implantation, the final insertion torque was measured, and a linear external fixator was mounted on the pins. Then the medial tibial mid-diaphysis was exposed and a 5-mm resection osteotomy was performed. The sheep were killed six weeks after surgery. MAIN OUTCOME MEASURES: The extraction torque was measured on four pins removed from each sheep. Radiographic pin tract rarefaction was measured on all the pins. Two pins from each sheep were used for histologic, scanning electron microscopy (SEM), and microhardness analysis. Histomorphometric analysis was carried out on the SEM specimens at x 36 magnification. RESULTS: Radiographic pin tract rarefaction was significantly lower in the hydroxyapatite coated pins than in the uncoated pins (P < 0.001). Group average insertion torque was 960 +/- 959 N/mm in the hydroxyapatite coated pins, and 709 +/- 585 N/mm in the uncoated pins (p = not significant). Group average extraction torque was 1485 +/- 1308 N/mm and 298 +/- 373 N/mm, respectively (p = 0.0001). Histomorphometric analysis showed that the group average bone-pin contact was 50.7 +/- 16.9% in the hydroxyapatite coated pins and 27.6 +/- 7.1% in the uncoated pins (p < 0.01). Microhardness analysis showed that bone tissue close to the pins was softer than bone tissue far from them. CONCLUSION: Hydroxyapatite coating is an effective method of refining the bone-pin interface and may improve the clinical results of the external fixation technique.

Animals↗

Hydroxyapatite coating of threaded pins enhances fixation.

We measured the insertion and extraction torque forces in a randomised study of 76 external fixation screws in 19 patients treated by hemicallotasis for osteoarthritis of the medial side of the knee. The patients were randomised to have either standard tapered screws (Orthofix 6/5 mm) or the same screws with hydroxyapatite (HA) coating. One patient had two standard and two HA-coated screws. All patients had an anterior external fixator (Orthofix T-garche), with two screws in the proximal tibial metaphysis parallel to and about 2 cm below the joint surface and two in the tibial diaphysis. The mean torque forces for insertion of the standard screws were 260 Ncm for the proximal to medial screw, 208 for the proximal to lateral screw and 498 and 546 Ncm for the diaphyseal pins. The corresponding forces for the HA-coated pins were not significantly different. The torque forces for the extraction of the standard pins were 2 Ncm for the proximal pins, 277 and 249 Ncm for the distal pins and 482, 478, 585 and 620 Ncm, respectively (p < 0.005) for the HA-coated pins. All 18 of the metaphyseal standard screws were loose at extraction (extraction force < 20 Ncm), but only one of the HA screws in the metaphysis was loose. In the diaphysis the standard screws lost about 40% of their fixation in contrast to the HA-coated screws which retained full fixation strength.

Adult↗

Differences in the envelope proteins of Chlamydia pneumoniae, Chlamydia trachomatis, and Chlamydia psittaci shown by two-dimensional gel electrophoresis.

Analysis by two-dimensional gel electrophoresis of the N-laurylsarkosinate(Sarkosyl)-insoluble envelope complexes of L-[35]S-cysteine-labeled elementary bodies of Chlamydia pneumoniae strain IOL-207, Chlamydia trachomatis serovar LGV2, D, and F, and Chlamydia psittaci strain 6BC showed differences in the molecular charges of chlamydial outer membrane proteins. The apparent isoelectric point (pI) of the major outer membrane protein of C. pneumoniae strain IOL-207 was 6.4, whereas the pI of the major outer membrane protein of the C. trachomatis and C. psittaci strains differed little from one another, ranging from 5.3 to 5.5. The 60-kDa cysteine-rich protein of C. pneumoniae was the only 60-kDa chlamydial protein with a pI value (5.9) more acidic than that of the corresponding major outer membrane protein. As a general rule, the charges of both the 60-kDa and the low-molecular-mass (12-15 kDa) cysteine-rich proteins were widely variable, depending on the strain. However, in each individual strain, the variation of the charge of the 60-kDa protein had a compensatory change in the low-molecular-mass cysteine-rich protein.

Bacterial Outer Membrane Proteins↗

Schizencephaly: surgical features and new molecular genetic results.

Schizencephaly is a rare developmental disorder characterized by a full thickness cleft within the cerebral hemispheres. Large portions of the cerebral hemispheres may be missing and are replaced by cerebrospinal fluid (CSF). The walls of the clefts are lined by polymicrogyric grey matter and are covered by the so-called "pialependymal seam". The cleft may be unilateral or bilateral, and if bilateral are fairly symmetrical. Their dimensions can be small or large. The clinical features may vary from a normal to a severe development delay. 13 patients with this anomaly have been evaluated. Using SSCP (single strand conformation polymorphism) analysis, as previously described (2), they were found to have a mutant homeobox gene, Emx2.

Abnormalities, Multiple↗

Hydroxyapatite coated external fixation pins: an experimental study.

A sheep model was developed for the implantation of 84 bicylindrical stainless steel external fixation pins. One-half of the pins were coated with hydroxyapatite, and the rest remained uncoated. A set of 6 pins with the same coating was implanted in the lateral side of the left tibias of 14 sheep, the final insertion torque was measured, and a monolateral external fixator was assembled on the pins. The medial tibial middiaphysis then was exposed and a 5-mm resection osteotomy was done. Sheep were euthanized 6 weeks after surgery, radiographs were taken, and the initial extraction torque was measured on 4 pins from each sheep. Undecalcified sectioning and histologic and histomorphometric analyses were done on the remaining 2 pins. Radiographic pin tract rarefaction was significantly lower in the hydroxyapatite coated pins compared with the uncoated pins. Group average insertion torque was 960 +/- 959 Nmm in the hydroxyapatite coated pins and 709 +/- 585 Nmm in the uncoated pins. Group average initial extraction torque was 1485 +/- 1308 Nmm and 298 +/- 373 Nmm, respectively. Bone pin contact was 85.7% +/- 8.9% and 50.3% +/- 20.4%, respectively, in hydroxyapatite coated and uncoated pins. Bone between the threads was 95.6% +/- 5.7% and 80% +/- 8.7%, respectively, in hydroxyapatite coated and uncoated pins. Hydroxyapatite coating was effective for improving the bone-to-pin interface.

Animals↗

Improvement of the bone-pin interface with hydroxyapatite coating: an in vivo long-term experimental study.

The present study was designed to comparatively evaluate the bone-pin interface in a long-term unloaded experimental study in two groups of pins, uncoated and coated with hydroxyapatite. Forty pins made of stainless steel were used. Half of the pins were plasma-sprayed with hydroxyapatite, and the other half remained uncoated. Four adult sheep were selected. Each sheep tibia was implanted with five pins. Two sheep were euthanized 4 months after surgery and the remaining two 12 months after surgery. Extraction torque was higher in the hydroxyapatite-coated pins compared with the uncoated ones at both 4 (p < or = 0.0005) and 12 months (p < or = 0.0005) after implantation. The histological patterns observed in the sheep euthanized 4 and 12 months after implantation were very similar. An extensive bony coverage of the hydroxyapatite-coated pins without any coating resorption and delamination from the metallic substrate was observed. Fibrous tissue encapsulation was found in the uncoated pins. These results demonstrate that the hydroxyapatite coating significantly improved the bone-pin interface. A similar improvement of bone-pin interface rigidity in many clinical situations is likewise possible.

Animals↗

Microhardness of bone at the interface with ceramic-coated metal implants.

We evaluated bone microhardness at the interface with hydroxyapatite-coated stainless-steel pins used in an external fracture fixation system. Pins were transversally inserted into the diaphyses of sheep tibiae and were loaded in for 6 weeks. Uncoated pins were implanted as controls. Microhardness analysis, based on the measure of the resistance of the bone to the penetration of a small diamond pyramid, yielded an accurate and reproducible measure of the mineralization degree and of the orientation of collagen fibers. Bone tissue close to the pin is less hard than bone tissue far from it. Moreover, the presence of hydroxyapatite coating on the pins did not significantly affect bone hardness; actually, the mean hardness at the interface with the pins was 56.9 Vickers degrees, whereas at the interface with the uncoated pins it was 62.2. It can be concluded that, 6 weeks postsurgery, the bone growing into the threadings of a loaded screwed implant reached maturity at a degree lower than that of the host bone in both uncoated and coated implants.

Animals↗

Surgical treatment of both-column fractures by staged combined ilioinguinal and Kocher-Langenbeck approaches.

Between 1981 and 1989, 18 patients affected by both-column acetabular fractures were operated on by staged combined ilioinguinal and Kocher-Langenbeck approaches. Postoperative reduction quality and long-term radiographic results were evaluated according to the Matta radiological systems. The Harris hip scoring system was used for the functional results. Average follow-up was 53.2 months, ranging from 24 to 132 months. Reduction was anatomical in five cases (27.8 per cent), satisfactory in 11 (67.1 per cent), and non-anatomical in two cases (11.1 per cent). Radiographic long-term results were excellent in nine cases (50 per cent), good in five (27.8 per cent), fair in two (11.1 per cent) and poor in two (11.1 per cent). The Harris score was more than 90 in eight patients (44.4 per cent), between 80 and 90 in seven (38.8 per cent), between 80 and 70 in one (5.5 per cent), and less than 70 in two (11.1 per cent).

Acetabulum↗

Composite bone grafting and plate fixation for the treatment of nonunions of the forearm with segmental bone loss: a report of eight cases.

Between June 1986 and December 1991, eight aseptic isolated severe forearm segmental bone losses were treated. The average age of the patients was 26 years. Three cases involved the radius and five the ulna. The average time between the onset of trauma and the final surgical intervention was 9 months. The surgical technique consisted of complete removal of necrotic bone, filling of the bone defect with an intercalary autogenous bone graft, and stable internal fixation, which required combining a plate and an opposite cortical bone allograft. The average bone loss length after freshening the bone ends was 7 cm (range 4-11). The average follow-up was 48 months (range 24-80). In all eight cases union and recovery of forearm function was achieved. The proposed surgical technique proved to be effective in obtaining results with no major complications.

Adolescent↗