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Biomedical subjects

L C Chow

Publications and source records attributed to L C Chow.

At least 37 records · Page 2Linked to original sources

Reaction of calcium phosphate cements with different amounts of tetracalcium phosphate and dicalcium phosphate anhydrous.

Calcium phosphate cements (CPCs) with different amounts of tetracalcium phosphate (TTCP) and dicalcium phosphate anhydrous (DCPA) (TTCP/DCPA molar ratio from 0.25 to 2.00) were prepared to further understand the setting reaction and the factors that could influence the properties of CPCs. Quantitative X-ray diffraction patterns, Fourier transform IR spectra, and diametral tensile strength of the set mass were measured along with pH measurements of the CPC suspension. Calcium-deficient hydroxyapatite (d-HAP) with a calcium to phosphate molar ratio of approximately 1.5 was formed initially in the CPC setting consisting of an equimolar mixture of TTCP and DCPA. This gradually transformed into stoichiometric HA (s-HA) with increasing incubation time. The s-HA was formed in the initial stage when the CPC contained an excess amount of TTCP. In contrast, maturation to s-HAP was slow when the CPC contained excess amounts of DCPA. The highest mechanical strength of set CPC was associated with an equimolar mixture of TTCP and DCPA, and the mechanical strength decreased as the TTCP/DCPA molar ratio deviated from 1.00. We concluded, therefore, that the setting reaction and the nature of the resulting set mass are dependent on the molar ratios of TTCP and DCPA.

Bone Cements↗

Effect of powder grinding on hydroxyapatite formation in a polymeric calcium phosphate cement prepared from tetracalcium phosphate and poly(methyl vinyl ether-maleic acid).

The primary aim of this study was to determine if cements based on poly(methyl vinyl ether-maleic acid) (PMVE-Ma) and tetracalcium phosphate resulted in hydroxyapatite formation. In addition, the mechanical strength of this type of polymeric calcium phosphate cement was evaluated. Cements were prepared by mixing, in a powder/liquid mass ratio of 3.0, an aqueous solution of PMVE-Ma (mass fraction = 25%) and tetracalcium phosphate powders ground for various periods of time. The tetracalcium phosphate powders and set cements were characterized by means of X-ray powder diffraction and scanning electron microscopy. Mechanical strengths of the cements were tested 24 h after mixing. Prolonged grinding of tetracalcium phosphate powder decreased particle size and/or crystallite size and increased lattice distortion. This enhanced the reactivity of the tetracalcium phosphate powder and elevated the extent of crosslinking between PMVE-Ma molecules, resulting in improved mechanical strength. Hydroxyapatite formation was detected in the cement prepared with the most finely ground tetracalcium phosphate powder. The conversion of residual tetracalcium phosphate particles to more thermodynamically stable hydroxyapatite crystals will reduce the solubility of the polymeric cement and increase its biocompatibility.

Calcium Phosphates↗

BoneSource hydroxyapatite cement: a novel biomaterial for craniofacial skeletal tissue engineering and reconstruction.

BoneSource-hydroxyapatite cement is a new self-setting calcium phosphate cement biomaterial. Its unique and innovative physical chemistry coupled with enhanced biocompatibility make it useful for craniofacial skeletal reconstruction. The general properties and clinical use guidelines are reviewed. The biomaterial and surgical applications offer insight into improved outcomes and potential new uses for hydroxyapatite cement systems.

Animals↗

Formation of hydroxyapatite in new calcium phosphate cements.

Tetracalcium phosphate (TTCP) has been shown previously to be an essential component of self-setting calcium phosphate cements that form hydroxyapatite (HA) as the only end-product. We report herein on a new self-setting calcium phosphate cement that does not contain TTCP. These cements consist of dicalcium phosphate anhydrous (DCPA), dicalcium phosphate dihydrate (DCPD), alpha-tricalcium phosphate, or amorphous calcium phosphate and, as an additional source of calcium, calcium hydroxide or calcium carbonate. These cements require the use of a phosphate (0.2 moll(-1) or higher) solution or a high pH solution as the cement liquid. The cements harden in relatively short time (5-30 min) and form HA as the dominant end-product in 24 h. The diametral tensile strengths of the 24-h samples are in the range of 0.2 to 7.5 MPa. Results from X-ray diffraction studies suggest that the cement setting is caused by rapid HA formation induced by the high phosphate concentration of the cement liquid. Because DCPA and DCPD are highly soluble at pH values above 12.7, which is the pK3 of phosphoric acid, high phosphate concentration in the slurry solution was also attainable by using a highly alkaline solution as the cement liquid. The physicochemical properties of these cements are comparable to those of TTCP-containing cements, and the new cements may be expected to have in vivo characteristics similar to those of TTCP-containing cements as well.

Biocompatible Materials↗

Effect of fluoride on apatite formation from Ca4(PO4)2O in 0.1 mol L(-1) KH2PO4.

The effect of fluoride on the hydrolysis of tetracalcium phosphate (TTCP; Ca4(PO4)2O) was investigated in 0.1 mol l(-1)KH2PO4 containing 0-83 mol l(-1) KF. Characterization of the final apatite phase formed by the hydrolysis was made with X-ray diffraction and SEM. The initial pH was between 4.5 and 5.4, depending on the solutions, and the pH rapidly increased and was kept constant between 7.3 and 6.5. An increase in KF concentration tended to lower the pH in the final stage of hydrolysis. The calcium concentration was considerably lower than the phosphorus concentration throughout the reaction. The fluoride concentration decreased shortly after the start of hydrolysis. The hydrolysis of TTCP in 0.1 mol l(-1) KH2PO4 proceeded to form hydroxyapatite via DCPD when the KF concentration was low. The hydrolysis product was a calcium-deficient non-stoichiometric hydroxyapatite with a Ca/P ratio of about 1.5. With an increase in the KF concentration in the 0.1 mol l(-1) KH2PO4 solution, TTCP directly transformed into hydroxyapatite containing F- ions or fluorapatite and with improved crystallinity. The addition of fluoride in the solution initially accelerated the formation of apatite. However, the layer of newly formed apatite adhering to the TTCP particles retarded TTCP dissolution; as a result, hydrolysis was delayed. IR analysis showed that the apatite phase contained HPO2-4 ions in the structure. The formula for the hydrolysis product of TTCP in the presence of fluoride can be expressed as follows: Ca10-x(HPO4)x(PO4)10-x(OH)2-x-yFy.

Journal Article↗

Composition of plaque and saliva following a sucrose challenge and use of an alpha-tricalcium-phosphate-containing chewing gum.

Calcium phosphate concentrations in plaque, plaque fluid, and saliva play an important role in caries prevention. In this study, we used a microanalytical technique to examine the anticaries potential of a 2.5% (mass fraction) alpha-tricalcium-phosphate-fortified experimental gum by measuring the pH, free and total calcium, and total phosphate in plaque fluid, whole plaque, and saliva, and centrifuged saliva from 14 subjects who (1) accumulated plaque for 48 hours, (2) fasted overnight, (3) rinsed for 1 min with sucrose, and (4) chewed a control or experimental gum for 15 min. From these data, the hydroxyapatite (HAp) ion activity products (IAP[HAp]) of saliva and plaque fluid were calculated as a measure of tooth mineral saturation. Results, compared with those of the control gum, show significant increases in pH and in free calcium and phosphate concentrations in plaque fluid and saliva when the experimental gum was chewed following sucrose ingestion. These increases result in a rise in fluid saturation with respect to tooth mineral that, for plaque fluid, nearly cancels the decrease seen with the control gum after the sucrose rinse. This suggests that the experimental gum may be more effective than a conventional gum in ameliorating the cariogenic effects of sucrose. Similar statistically significant increases were also seen in the total calcium content of the plaque fluid, centrifuged saliva, whole saliva, and whole plaque, and in the total phosphate of whole plaque and whole saliva. These results suggest that the deposition of a mineral reservoir in plaque and saliva by the experimental gum may help resist future cariogenic challenges.

Adult↗

Effects of hydroxypropyl methylcellulose and other gelling agents on the handling properties of calcium phosphate cement.

The calcium phosphate cement (CPC) used in this study was formed by combining equimolar amounts of tetracalcium phosphate (TTCP) and dicalcium phosphate anhydrous (DCPA). This powder, when mixed with water, sets to a hard cement in about 30 min. However, the water-based CPC paste is not highly cohesive and is vulnerable to washout until hardening occurs. The objectives of this study were to investigate the effects on handling properties, washout resistance, cement hardening behavior, and mechanical properties of adding several gelling agents to CPC paste. Aqueous solutions that contained a mass fraction of 2-4% of hydroxypropyl methylcellulose (HPMC), carboxyl methylcellulose (CMC), chitosan acetate, and chitosan lactate were used as cement liquids. Hardening time was measured by the Gilmore needle test; resistance to washout was evaluated by the disintegration of the cement specimen in water with agitation; and mechanical strength was evaluated by the measurement of diametral tensile strength and compressive strength. Handling properties were greatly improved by the addition of HPMC, CMC, chitosan acetate, and chitosan lactate. Hardening time was retarded by the additions of HPMC and CMC, and mechanical strength was weakened by the addition of either the chitosan lactate or the chitosan acetate.

Biocompatible Materials↗

An in vitro diffusion model for the study of calcification of bovine pericardium tissue.

Bovine pericardium (BP) is extensively used for the production of heart valve bioprostheses. BP has excellent mechanical properties but a limited lifespan because of intrinsic subsurface calcification in vivo. In this study, the in vitro mineralization of BP was investigated by a novel diffusion cell model. In two sets of experiments, glutaraldehyde-treated BP membranes were placed between two compartments, both of which contained calcium phosphate solutions made by equilibration of octacalcium phosphate (Exp I) or dicalcium phosphate dihydrate (Exp II) in phosphoric acid. The movement of calcium (Ca), phosphate (P), and protons through the BP membrane was followed throughout the diffusion process. Histology, scanning electron microscopy, wet chemical analysis, and energy dispersive X-ray analyses provided good evidence of subsurface mineralization of BP that resembled in vivo mineral deposition. Energy dispersive x-ray microanalyses found a Ca/P heterogeneity of the early subsurface mineral that formed in the membrane. The use of a diffusion cell to model BP calcification under well-characterized conditions has led to in vitro mineralization that more closely matches that observed in vivo. The results suggest that this in vitro diffusion model can be used to study the mechanism of pathological mineralization. This model has the potential to provide rapid, inexpensive, basic information about the mineralization process.

Animals↗

Effect of a two-solution fluoride mouth rinse on deposition of loosely bound fluoride on sound root tissue and remineralization of root lesions in vitro.

A constant-composition fluoride (F) titration method was used to measure the amount of leachable F deposited on root surfaces in vitro by a 1-min rinse with a 12 mmol/l sodium fluoride (228 micrograms/g F) solution or a two-solution rinse that contained 2 mmol/l sodium fluorosilicate (228 micrograms/g total F ) and 10 mmol/l calcium chloride. The mean +/- standard deviations (n = 3) F uptake from the two rinse treatments were 0.70 +/- 0.24 micrograms/cm2 and 3.25 +/- 0.74 micrograms/cm2, respectively. In a separate experiment, the effects of sodium fluoride and the two-solution rinses on remineralization of root lesions were evaluated in an in vitro pH cycling model. The results showed that the average decrease in mineral loss (delta Z) in the two-solution rinse group (60%) was significantly greater than that obtained in the NaF rinse (41%) or the control (9%) group.

Aluminum Compounds↗

Changes in the permselectivity of human teeth during caries attack.

Previous studies have shown that enamel permselectivity can influence fluid composition within caries lesions during de- and remineralization. The permselectivity of human enamel, cementum, and dentin sections was examined, in a microwell model, by measurement of the membrane potential developed by KCl diffusion while the sections were immersed in solutions simulating resting (pH = 5.6) and cariogenic plaque fluid (pH = 4.8). In a second experiment, the effects of charged compounds (phytate and Zonyl-FSC) on the tooth permselectivity were examined. The average membrane potentials (+/- SD) in "resting plaque" solution were: sound enamel, 18.9 +/- 3.2 mV, n = 66; dentin, 0.9 +/- 9.2 mV, n = 59; and cementum, -0.8 +/- 8.2 mV, n = 42, with a positive sing indicating cation selectivity. The average membrane potentials became more negative in "cariogenic plaque" solution for all types of sections: sound enamel, 5.2 +/- 2.1 mV, n = 46; dentin, -8.1 +/- 7.4 mV, n = 45; and cementum, -14.3 +/- 8.0 mV, n = 34. In lesion enamel sections, the membrane potential was reduced from the non-lesion wells in both types of test solutions, while phytate treatment caused an increase of approximately 10 mV in potential (increased cation selectivity) in every enamel well in either "resting" or "cariogenic" solution. Treatment of enamel sections with Zonyl-FSC caused the membrane potential to become more negative in both test solutions, with many of the wells showing anion selectivity in the cariogenic "plaque-like" solution. However, the changes in enamel membrane potentials induced by Zonyl-FSC slowly increased toward the initial values after treatment, while the effects of the phytate pre-treatment persisted. Most dentin sections treated with phytate also showed an increase in potential after phytate treatment; however, Zonyl-FSC seemed to have little effect on the membrane potential of dentin. The results of this study suggest that modification of tooth permselectivity by surface-active agents may be a viable method of decreasing the rate of caries progression.

Dental Caries↗

Increased overnight fluoride concentrations in saliva, plaque, and plaque fluid after a novel two-solution rinse.

Recent studies showed that salivary, plaque-fluid, and whole-plaque fluoride were significantly higher 120 min after subjects rinsed with a novel two-solution rinse than after they rinsed with a NaF rinse of the same fluoride concentration. In this study, the persistence of these increases was investigated overnight, a period of time that is more clinically relevant. Improved analytical techniques for the ultramicro determination of whole-plaque and plaque-fluid fluoride from the same sample are also described. Thirteen subjects abstained from toothbrushing for 48 hrs and rinsed for 1 min with a 12 mmol/L (228 ppm) NaF or the two-solution rinse before bedtime. Samples were then collected the following morning before breakfast: (1) Saliva samples were either clarified by centrifugation or acid-extracted with 1 mol/L HClO4; and (2) single-site molar plaque samples were centrifuged to obtain plaque fluid and/or extracted with 1 mol/L HClO4. Results showed that, compared with NaF, the two-solution rinse produced significantly higher fluoride concentrations in all samples: The concentration of fluoride in whole plaque and whole saliva following the new rinse exceeded concentrations found after the NaF rinse by factors of three and four, respectively, while in plaque fluid, the two-solution rinse produced about a two-fold increase over NaF values, which were near baseline levels. This increase, however, was only about 20% in centrifuged saliva. The increases in saliva and especially in plaque-fluid fluoride after the two-solution rinse indicate a greater remineralization potential, while the enhanced fluoride reservoirs found in plaque overnight after this rinse constitute a reserve that may release fluoride into the plaque fluid over an extended period of time.

Adult↗

Effects of dietary carbohydrates on glucose and lipid metabolism in golden Syrian hamsters.

Frequent coexistence of insulin resistance, central obesity, and hypertriglyceridemia in the same individual suggests an underlying common pathogenesis. Insulin resistance and hypertriglyceridemia can be induced by carbohydrate feeding in rats. Golden Syrian hamsters are believed to be resistant to the metabolic effects of dietary carbohydrates. We investigated the effects of diets containing 60% fructose or sucrose on glucose and lipid metabolism in hamsters, both in the fasting state and during an intravenous glucose tolerance test. Fructose caused obesity (weight after treatment: 131 +/- 7 gm in the control group, 155 +/- 5 gm in the fructose group, 136 +/- 7 gm in sucrose group, p < 0.04). Fructose also reduced glucose disappearance rate (KG: 2.69% +/- 0.39% in the control group, 1.45% +/- 0.18% in the fructose group, p < 0.02). Sucrose caused a marginal decrease in glucose disappearance (KG: 1.93% +/- 0.21%, p = 0.08 vs the control group). Only fructose feeding increased fasting plasma nonesterified fatty acids (0.645 +/- 0.087 mEq/L in the control group, 1.035 +/- 0.083 mEq/L in the fructose group, 0.606 +/- 0.061 mEq/L in the sucrose group, p < 0.002), plasma triglycerides (84 +/- 6 mg/dl in the control group, 270 +/- 65 mg/dl in the fructose group, 94 +/- 16 mg/dl in the sucrose group, p < 0.0002), and liver triglycerides (1.88 +/- 0.38 mg/gm liver weight in the control group, 2.35 =/- 0.24 mg/gm in the fructose group, 1.41 +/- 0.13 mg/gm in the sucrose group, p < 0.04). Previous studies in the rat have suggested that dietary carbohydrates induce insulin resistance by increasing plasma nonesterified fatty acids and triglycerides, which are preferentially used by the muscles. The present report shows that sucrose also can cause some decrease in glucose disappearance in the hamster without causing hypertriglyceridemia or increasing plasma nonesterified fatty acids. Thus other mechanisms may also contribute to the insulin resistance in the hamster. These findings suggest that hamsters provide a good model for investigation of hormonal and nutritional regulation of glucose and lipid metabolism.

Animals↗

Polymeric calcium phosphate cements derived from poly(methyl vinyl ether-maleic acid).

OBJECTIVES: The purpose of this study was to assess the feasibility of forming polymeric calcium phosphate cements from a mixed powder of dicalcium phosphate/tetracalcium phosphate or only tetracalcium phosphate and poly(methyl vinyl ether-maleic acid) (PMVE-Ma), and to study their setting reaction. METHODS: The setting reaction process of the polymeric cements was evaluated by mechanical strength tests, infrared spectroscopy and x-ray diffraction analysis and compared with that of a water-setting calcium phosphate cement. The mechanical strength data were analyzed using ANOVA and Scheffé's multiple comparisons test. RESULTS: Cements prepared from the mixed powder and 25-30 wt% aqueous solutions of PMVE-Ma had high mechanical strength after 24 h storage in distilled water at 37 degrees C. The hardening mechanism depended on an acid-base reaction between the carboxyl groups of PMVE-Ma and the mixed powder, especially its tetracalcium phosphate component. The formation of hydroxyapatite in the polymeric calcium phosphate cement was not detected and is apparently inhibited as a result of the competing reaction of PMVE-Ma with the mixed powder. SIGNIFICANCE: The cement-forming reaction was significantly faster than that of a water-setting calcium phosphate cement and slower than that observed with the mixed powder and polyacids such as poly(acrylic acid). The characteristics of the polymeric cements suggest that the materials may be useful in cavity lining or endodontic sealing.

Analysis of Variance↗

The reinforcement of cancellous bone screws with calcium phosphate cement.

The ability of calcium phosphate cement (CPC) to reinforce cancellous screws placed in previously stripped holes was studied in vitro. The distal end of canine femurs were harvested. A total of 15 screws were placed in six femurs. The pullout strength (failure force), failure displacement, stiffness, and energy absorbed were determined for the screws in the intact cancellous bone. Next, these stripped screw holes were packed with CPC. The pullout test was repeated, and the results were compared using a paired, Student's t test. We found that the CPC was able to reinforce the previously stripped holes and significantly increase the pullout strength (1,159 +/- 278 N versus 678 +/- 297 N) and the stiffness (1,990 +/- 569 N/mm versus 1,519 +/- 609 N/mm) of the constructs, as well as the energy absorbed by the constructs until failure (467 +/- 180 N.mm versus 278 +/- 140 N.mm). There was no difference in the failure displacement (0.94 +/- 0.23 versus 0.85 +/- 0.51 mm). This study documents the ability of CPC to acutely reinforce cancellous bone screws in a region with no or poor-quality cancellous bone.

Animals↗

Preoperative examination of lung transplant candidates: value of chest CT compared with chest radiography.

OBJECTIVE: The purpose of our study was to determine the usefulness of CT in examining candidates for lung transplantation to detect cancer not visible on plain chest radiographs (a finding that would exclude a patient from transplantation) and to determine which lung is more severely diseased to aid in the decision of which side to transplant. MATERIALS AND METHODS: We reviewed the chest radiographs and CT scans of 190 transplant candidates during a 3-year period for findings suggestive of neoplasm, including lung nodules and atelectasis; we also reviewed the symmetry of disease. In the latter category, patients with primary pulmonary hypertension, Eisenmenger's complex (pulmonary vascular, not parenchymal, disease), and cystic fibrosis (for which bilateral transplantation is performed) were excluded. A total of 190 plain chest radiographs, 180 thin-section CT scans, and 31 standard CT scans were reviewed retrospectively. RESULTS: Plain chest radiographs revealed 20 noncalcified nodules; 13 were 8 mm or more in diameter, and 7 were less than 8 mm. CT scans revealed 66 noncalcified nodules; 37 were 8 mm or more in diameter, and 29 were less than 8 mm. Eight non-calcified nodules seen on plain chest radiographs were either absent on CT scans (and follow-up plain chest radiographs) or appeared calcified on CT scans. Solitary nodules in three patients proved to be bronchogenic carcinomas; two of these lesions were identified only on CT scans. CT prompted a change in the determination of which lung was more severely diseased from that made on the basis of plain radiography for 27 of 169 patients (16%) evaluated. Of the 45 patients who subsequently underwent transplantation, CT prompted a change in the determination of which side to transplant from that made on the basis of plain radiography for 4 patients (9%). CONCLUSION: CT provides additional information to supplement plain radiography in the examination of lung transplant candidates. This information can alter patient management, particularly when bronchogenic carcinoma is detected, and enable a better determination of which lung is more severely diseased to aid in the decision of which lung to transplant for single-lung transplantation.

Adolescent↗

Remineralization of root lesions with concentrated calcium and phosphate solutions.

Remineralization of enamel lesions in vitro by use of sequential treatments with an alkaline (pH 9) phosphate (1 mol/L) solution and slightly acidic (pH 6) calcium (1 mol/L) solution was reported to be relatively ineffective. An analysis of the diffusion processes that may occur during the remineralization treatments suggested that the driving force for diffusion of Ca into the lesion can be increased by making the calcium solution more alkaline than the phosphate solution. In the present study this modified treatment procedure was evaluated for remineralizing root lesions in vitro. Results show that (1) in the control group there was a slight increase in mineral density in the surface region of the lesion, (2) in the experimental group there were significant (p < 0.05) increase in mineral content in the outer 40 microns of the lesion, and (3) in contrast to the finding reported previously, thick mineral deposits on the surface of the root were not observed.

Calcium↗