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Biomedical subjects

P W Brown

Publications and source records attributed to P W Brown.

At least 19 recordsLinked to original sources
PubMed2006

Formation of hydroxyapatite-polyphosphazene polymer composites at physiologic temperature.

Aspects of the formation of bone analog composites at 37 degrees C are described. The composites are composed of hydroxyapatite (HAp) and the calcium salt of a biocompatible polymer and are capable of forming under in vivo conditions. Composite formation involves the formation of monolithic HAp from particulate calcium phosphate precursors while Ca ions liberated to the aqueous medium in which this reaction is occurring form crosslinks with the acidic polymer. The reactants are poly[bis(carboxylatophenoxy)phosphazene] (acid-PCPP), tetracalcium phosphate [Ca4(PO4)2O, TetCP], and anhydrous dicalcium phosphate (CaHPO4, DCPA). The effects of the proportion of polymer (5, 10, or 15 wt %) on the kinetics of HAp formation were studied. Compositional evolution of the solid calcium phosphates present was followed by X-ray diffraction and infrared spectroscopy analyses. HAp formation through a dissolution-precipitation process provided a mildly alkaline medium suitable for deprotonation of the acid-PCPP and for the formation of the calcium crosslinks, as monitored by infrared spectroscopy. Concurrence of crosslinking of the polymer and HAp formation was established, indicating true composite formation can be realized at physiologic temperature.

Biocompatible Materials↗
PubMed2005

Composite formation from hydroxyapatite with sodium and potassium salts of polyphosphazene.

The low temperature synthesis of composites potentially suitable as bone substitutes which form in vivo, was investigated. The composites were comprised of stoichiometric hydroxyapatite (SHAp) and water-soluble poly phosphazenes. These constituents were selected because of their biocompatibility, and were mixed as powders with a phosphate buffer solution (PBS) to form the composites. The effects of poly[bis(sodium carboxylatophenoxy)phosphazene] (Na-PCPP) or poly[bis(potassium carboxylatophenoxy) phosphazene] (K-PCPP) on stoichiometric hydroxyapatite (SHAp) formation from tetracalcium phosphate and anhydrous dicalcium phosphate were assessed. The kinetics and reaction chemistries of composite formation were followed by isothermal calorimetry, X-ray diffraction, infrared spectroscopy and scanning electron microscopy. In the presence of 1% by weight of polyphosphazenes, composites comprised of SHAp and calcium cross-linked polymer salts were formed. Thus a mechanism for binding between polymer chains was established. Elevated proportions (5 and 10% by weight) of polyphosphazene, however, resulted in the inhibition of SHAp formation. This is attributed to the formation of viscous polymer solution coatings on the calcium phosphate precursors, retarding their reaction, and consequently inhibiting SHAp formation.

Biocompatible Materials↗
PubMed2005

Low temperature formation of hydroxyapatite-poly(alkyl oxybenzoate)phosphazene composites for biomedical applications.

The formation of biodegradable composites which may be suitable as bone analogs is described. Polyphosphazene-hydroxyapatite (HAp) composites were produced via an acid-base reaction of tetracalcium phosphate and anhydrous dicalcium phosphate in the presence of polyphosphazenes bearing alkyl ester containing side-groups. The polyphosphazenes used were poly(ethyl oxybenzoate)phosphazene (PN-EOB) and poly(propyl oxybenzoate) phosphazene (PN-POB). The effects of temperature and the proportions of polymers, PN-EOB and PN-POB on the kinetics, reaction chemistry and phase evolution during the formation of stoichiometric HAp were studied. Kinetics, phase evolution and microstructural development were evaluated using isothermal calorimetry, X-ray diffraction and scanning electron microscopy, respectively. Analysis of solution chemistry revealed that the increases in the pH during the formation of SHAp, resulted in partial hydrolysis of the polymer surfaces, which led in turn to the formation of a calcium cross-linked polymer surface. The calcium cross-linked polymer surface appeared to facilitate the nucleation and growth of apatite deposits on the polymer. The current study illustrates the in situ formation of HAp in the presence of polyphosphazenes, where HAp is chemically bonded to the polymer.

Absorbable Implants↗
PubMed2001

Characterization of wollastonite-reinforced HAp--Ca polycarboxylate composites.

The effects of wollastonite on the mechanical properties and in vitro behavior of hydroxyapatite-Ca polyacrylate composites were studied. Powder mixtures of tetracalcium phosphate, poly(acrylic-co-itaconic), and wollastonite fibers (< or =75% by weight) were hot-pressed for 30 min at 300 degrees C and 60 kpsi. Tensile strengths, elastic moduli, and microstructures of the composites were investigated. The tensile strengths of these composites were improved by the addition of wollastonite fibers, whereas the elastic moduli decreased. The highest value of tensile strength (approximately 155 MPa) was achieved by the addition of 40% wollastonite. Composites were immersed in simulated body fluid (SBF) for up to 14 days and then in 1.5 SBF for a week. The changes in the concentrations of Ca, Si, and P ions and the pH of these solutions indicate bioactivity. An evaluation of the microstructures of the composites after SBF immersion indicated that apatite layers had formed on the surfaces of the composites.

Acrylates↗
PubMed2001

Chemically formed HAp-Ca poly(vinyl phosphonate) composites.

The formation of biocompatible organic-inorganic composites by reactions between tetracalcium phosphate (Ca4(PO4)2O, TetCP) and the biomedical polymer poly(vinyl phosphonic acid) (PVPA) is described. Composites were prepared by hot pressing mixtures of these powders at 80 kpsi and 300 degrees C for 30 min. Composite formation was investigated depending on the proportions of reactants and the processing route used. Two inorganic phases were produced as a result of the acid-base reaction between TetCP and PVPA: hydroxyapatite (Ca10(PO4)6(OH)2, HAp) and anhydrous dicalcium phosphate (CaHPO4, DCPA). The later phase preferentially formed at lower TetCP/PVPA ratios while the amount of HAp increased with increasing TetCP/PVPA ratio. The reactions appear to start with the softening of the polymer when heated to T > Tg. The flowing polymer surrounds the TetCP grains permitting the TetCP to initially form DCPA crystallites in a matrix of the Ca salt of the polymer. When H2O is added prior to pressing, the DCPA produced reacts with the remaining TetCP forming HAp.

Biocompatible Materials↗
PubMed2001

Preparation and characterization of calcium phosphate-poly(vinyl phosphonic acid) composites.

Composites of calcium phosphates and the calcium salt of a biomedical polymer were prepared in situ by hot-pressing particulate mixtures of poly (vinyl phosphonic acid) (PVPA) and tetracalcium phosphate Ca4(PO4)2O, or TetCP) at different temperatures, pressures, and time periods. The objective was to establish whether PVPA could react with TetCP (Ca/P ratio of 2.0) to form a calcium salt, and thereby decrease the available Ca/P ratio 1.67 to facilitate hydroxyapatite (Ca10(PO4)6(OH)2 or HAp) formation. The effects of varying the bulk composition, temperature (to 300 degrees C), pressure (to 690 MPa) and time (to 60 min) on the reaction between TetCP and PVPA were studied using X-ray diffraction, infra-red spectroscopy and scanning electron microscopy techniques. Results showed that the conversion of TetCP into HAp increased with compaction time as temperature and/or pressure were increased. Formation of anhydrous dicalcium phosphate (CaHPO4, or DCPA) was also observed. Complete conversion of TetCP to HAp was achieved in composites pressed at 250 degrees C and 415 MPa for 30 min.

Journal Article↗
PubMed2001

Herniography: a prospective, randomized study between midline and left iliac fossa puncture techniques.

AIM: To determine whether an optimal site of injection exists for herniography. MATERIALS AND METHODS: This was a prospective, randomized study of 93 consecutive patients who were referred for herniography over a period of 9 months. Patients underwent either a left iliac fossa (LIF) or midline puncture. Parameters assessed included initial adequate needle placement, complications, pain scores and body mass index (BMI). The groups were compared using Chi-squared test for categorical data, Student's t-test for continuous data and the Mann-WhitneyU-test for skewed data, withP < 0.05 considered statistically significant RESULTS: Four complications were encountered (4%), and these were equally distributed between the two groups. Adequate initial positioning of the needle was similar in both groups. The volume of local anaesthetic used was correlated with discomfort using a pain scale: a volume of >6 ml resulted in significantly more pain. More frequent initial adequate needle placement was observed in thin patients (BMI < 45 kg/m(2)) with experienced operators. Conversely, increased body mass index resulted in more difficult needle placement. CONCLUSION: Herniography is a safe procedure with few complications. There was no significant difference comparing the midline and LIF approaches.Nadkarni, S.et al. (2001). Clinical Radiology56, 389-392.

Anesthetics, Local↗
PubMed2001

Sclerosing encapsulating peritonitis: a case series from a single U.K. center during a 10-year period.

Sclerosing encapsulating peritonitis (SEP) is a serious complication of peritoneal dialysis (PD). Previous reports place the prevalence of SEP at 0.54%-7.3%. We estimated the prevalence of SEP in our unit to be 1.4% over the period 1989-1999. We here present the 6 identified cases. All of the patients presented with small-bowel obstruction; hemorrhagic ascites was identified in 3 cases. All 6 patients experienced ultrafiltration inadequacy, and 5 were treated with glucose polymer (icodextrin; duration of treatment: 1 month-2.5 years). Peritoneal dialysis was stopped at the time of diagnosis in 2 cases. In the other 4 cases, PD had been withdrawn some time prior to the SEP being diagnosed (2 weeks-5 years). Five of the patients have died; the 6th currently uses hemodialysis.

Adult↗
PubMed2000

Characterization of bioactive glass-reinforced HAP-polymer composites.

The effect of bioactive glass on the mechanical properties of hydroxyapatite-Ca polyacrylate composites was studied. Powder mixtures of tetracalcium phosphate (TetCP), poly(acrylic-co-itaconic) and bioactive glass (up to 50% by weight) were hot pressed for 30 min at 300 degrees C and 40 kpsi. Tensile strengths, elastic moduli, and microstructures of the composites produced were investigated. Results showed the mechanical properties of these composites were enhanced by the addition of bioactive glass. The highest values of tensile strength and elastic modulus were achieved with the addition of 10% bioactive glass. Composites were immersed in SBF for up to 10 days, then in 1.5 simulated body fluid (SBF) for a week. The changes in the concentrations of Ca, P, and Si ions of these solutions were measured. The microstructures of these composites after SBF immersion were also evaluated. Concentrations of Ca, P, and Si increased with the time of immersion in SBF owing to the formation of an apatite layer on their surfaces as found by SEM with energy-dispersive spectroscopy attachment.

Biocompatible Materials↗
PubMed2000

Low temperature formation of calcium-deficient hydroxyapatite-PLA/PLGA composites.

Hydroxyapatite-biodegradable polymer composites have been formed by a low temperature chemical route. Precomposite structures were prepared by combining alpha-Ca(3)(PO(4))(2) (alpha-tricalcium phosphate or alpha-TCP) with poly(L-lactic) acid and poly(DL-lactide-co-glycolide) copolymers. The final composite structure was achieved by in situ hydrolysis of alpha-TCP to Ca(9)(HPO(4))(PO(4))(5)OH (calcium deficient hydroxyapatite or CDHAp) either in solvent cast or pressed precomposites. Hydrolysis was performed at 56 degrees C-a temperature slightly above the glass transition of the polymers. The effects of polymer chemistry, composite formation technique, and porosity on hydrolysis kinetics and degree of transformation were examined with isothermal calorimetry, X-ray diffraction (XRD), Fourier transform infrared spectroscopy, and scanning electron microscopy. Calorimetric data and XRD analyses revealed that hydrolysis reactions were inhibited in the presence of the polymers. Isothermal calorimetry indicated the extent of the alpha-TCP to CDHAp transformation in 24 h to be 85% in the solvent cast composites containing PLGA (85:15) copolymer; however, XRD analyses suggested almost complete reaction. The CDHAp formation extent was 26% for the pressed composites containing the same polymer. In the presence of NaCl as a pore generator, 81% transformation was observed for the pressed composites. This transformation occurred without any chemical reaction between the polymer-inorganic components, as determined by Fourier transform infrared spectroscopy. Minimal transformation to CDHAp occurred in composites containing poly(L-lactic) acid.

Biocompatible Materials↗
PubMed2000

Calcium-deficient hydroxyapatite-PLGA composites: mechanical and microstructural investigation.

The microstructural and mechanical properties of composites composed of calcium deficient hydroxyapatite (CDHAp) and poly(lactide-co-glycolide) (PLGA) have been investigated. The composites were formed by hydrolysis of alpha-tricalcium phosphate (alpha-TCP) to CDHAp in pressed precomposite compacts of alpha-TCP-PLGA-NaCl. The differences in hydrolysis of alpha-TCP-PLGA-NaCl for two compositions of 80:10:10 wt % and 60:20:20 wt %. were monitored by isothermal calorimetry and X-ray diffraction. The microstructural evolution and variance in final composite microstructure after hydrolysis at 37 degrees C, 45 degrees C, and 56 degrees C were examined by scanning electron microscopy. HAp-PLGA composite formed from the alpha-TCP-PLGA-NaCl (80:10:10) precomposites at 37 degrees C developed a tensile strength of 13.3 +/- 0.9 MPa, a flexural strength of 24.8 +/- 1.7 MPa, and Young's modulus of 2.8 +/- 0.3 GPa. These values were 12.00 +/- 0.2 MPa, 36.1 +/- 2.1 MPa, and 5.5 +/- 0.8 GPa for the precomposite composition 60:20:20. All these mechanical properties showed a variation with hydrolysis temperature and composition. The differences in mechanical properties were related to the final microstructures of the composites, which are governed by the morphological changes in the polymer structure at its glass transition temperature and the extent of cement-type formation of CDHAp by hydrolysis of alpha-TCP.

Biomechanical Phenomena↗
PubMed2000

An evaluation of mechanical property and microstructural development in HAP-Ca polycarboxylate biocomposites prepared by hot pressing.

A hot-pressing technique was used to prepare composites anticipated to be biocompatible. Ca(4)(PO(4))(2)O (TetCP) was reacted with an acrylic-itaconic copolymer (CoP) in the absence of a solvent to form composites comprised of Ca(10)(PO(4))(6)(OH)(2') (hydroxyapatite, or HAp) and the Ca polyalkenoate salt. The effect of temperature, pressure, and hot-pressing time on the mechanical properties and microstructure of the composites were studied. Results showed that both tensile strength and elastic modulus increased when temperature and time were increased. When the compaction pressure was increased, these properties initially increased but decreased at high pressures. These variations in the mechanical properties were correlated with the microstructure of these composites. The mechanism of the reaction was also studied. Reaction starts when the copolymer is heated to above its T(g) permitting it to flow and react with the TetCP grains. The COOH groups on the polymer are neutralized by Ca(2+) ions liberated from the TetCP. At the end of reaction, a network of the Ca polyalkenoate salt is formed in which HAp crystals are embedded.

Biocompatible Materials↗
PubMed2000

alpha-Tricalcium phosphate hydrolysis to hydroxyapatite at and near physiological temperature.

The kinetics of hydroxyapatite (HAp) formation by direct hydrolysis of alpha-tricalcium phosphate (alpha-TCP) [alpha-Ca(3)(PO(4))(2)] have been investigated. Transformation kinetics were examined for reactions at 37 degrees C, 45 degrees C and 56 degrees C by isothermal calorimetric analysis. Setting times and morphologies of the resultant HAp were found to be strongly dependent on reaction temperature. XRD analysis accompanied by FTIR confirmed that phase pure calcium-deficient hydroxyapatite (CDHAp) [Ca(10-x)(HPO(4))(x)(PO(4))(6-x)(OH)(2-x)] was formed. Complete reaction occurs within 18, 11, 6.5 h at 37, 45 and 56 degrees C, respectively. The extent of HAp formation differs for particulate slurries and pre-shaped forms of reactant alpha-TCP. Formation of hydroxyapatite in pre-formed pellets was hindered due to limited water penetration, but enhanced with the presence of NaCl as a pore generator. Regardless of the precursor characteristics and temperature, HAp formation is characterized by an initial period of wetting of the alpha-TCP precursor, an induction period and a growth period during which the bulk transformation to HAp occurs. The microstructures of the resultant HAp at all temperatures were generally similar and are characterized by the formation porous flake-like morphology. Microstructural coarsening was observed for the CDHAp formed above the physiological temperature. The hardening generated by the hydrolysis reaction was demonstrated using diametrical compression tests. The original tensile strength of 56% dense alpha-TCP increased from 0.70+/-0.1 MPa to 9.36+/-0.4 MPa after hydrolysis to CDHAp at 37 degrees C, corresponding to a density of 70%.

Journal Article↗
PubMed2000

Designing an ambulatory clinical practice for outcomes improvement: from vision to reality--the Spine Center at Dartmouth-Hitchcock, year one.

Development of a new program for diagnosis and treatment of spine-related problems provided a unique opportunity to design and implement a new model for delivery of health care incorporating outcomes measurement and improvement. Key features include: application of microsystem thinking and interdisciplinary practice; integration of a uniform outcomes measurement tool, the Dartmouth Clinical Value Compass; and touch pad technology for data collection. This, for the first time, provided clinically meaningful point-of-service data and aggregated information for improvement. A further advantage was the ability to integrate a clinical research program within this microsystem. A multisite clinical research trial, the Spine Patient Outcomes Research Trial (SPORT), modeled on the Spine Center microsystem and funded by The National Institute of Arthritis, Musculoskeletal and Skin Diseases and the Office of Research on Woman's Health, the National Institutes of Health, and the National Institute of Occupational Safety and Health, the Centers for Disease Control and Prevention, is currently underway. The significant problems we face today cannot be solved by the same level of thinking that created them.

Ambulatory Care↗
PubMed2000

Influence of diet on the hematology and serum biochemistry of zinc-intoxicated mallards.

Changes in hematological and serum biochemistry parameters in female zinc (Zn)-dosed farm-raised mallards (Anas platyrhynchos) fed four different diets were examined. Sixty ducks received an average dose of 0.97 g of Zn in the form of eight, 3.30-mm diameter shot pellets containing 98% Zn and 2% tin, and another 60 ducks were sham-dosed as controls. Fifteen ducks from each of the two dosing groups were assigned to one of four dietary treatments: corn only, corn with soil, commercial duck ration only, or commercial duck ration with soil. Shot-pellet dissolution rates ranged from 7 mg/Zn/day to 27 mg/Zn/day. Regardless of diet, the Zn dose resulted in mortality; incoordination; paralysis and anorexia; decreased body, liver, pancreas, gonad, and gizzard weight; increased kidney weight; and macroscopic lesions. Zn-dosed ducks had a lower mean erythrocyte packed cell volume (PCV), higher mean reticulocyte count, and a greater number of individuals with immature and/or abnormal erythrocytes, than did control mallards. Mean total leucocyte counts were higher in Zn-dosed ducks than in controls. Zn-dosed ducks that had soil available had higher leucocyte counts than those without soil. Zn-dosed ducks were characterized by a marked heterophilia and relative lymphopenia. In Zn-dosed ducks, the mean lymphocyte count was highest in those provided a commercial duck ration, and lowest in those fed corn. In control ducks, the mean lymphocyte count was highest in ducks fed corn, and lowest in those provided soil along with a commercial duck ration. Zn-dosed mallards had higher serum aspartate aminotransferase and amylase levels, and lower alkaline phosphatase activities than control ducks. Serum phosphorus and uric acid concentrations were higher, and calcium, glucose, and total protein levels lower, in Zn-dosed ducks than in control ducks. Diet did affect serum calcium, phosphorus, total protein, and uric acid concentrations. Differences in erythrocyte and leucocyte parameters, serum enzyme activities, and metabolite concentrations were associated with dose and diet effects. Diets high in protein and other organic matter and calcium and phosphorus did not prevent or substantially alleviate Zn toxicosis in farm-raised mallard ducks.

Animal Feed↗
PubMed1999

Hydrolysis of alpha-tricalcium phosphate in NaF solutions.

Controlling the incorporation of Na and fluoride in apatite-based dental restoratives and analogs of bone formed under physiologic conditions may be desirable in controlling their long-term in vivo responses. Formation of these analogs was investigated. Hydrolysis of alpha-tricalcium phosphate (alpha-TCP) was carried out at physiologic temperature in NaF solutions and the solids product(s) were analyzed. alpha-TCP hydrolysis was complete within 48 h and the only solid products identified were apatites. Changes in solution chemistry were determined at 48 h and 4 weeks. Na and Ca concentrations were determined by spectrometric methods, P and F concentrations were determined by ion chromatography; pH values were obtained. The extent of fluoride and sodium incorporation in the apatites formed varied depending on the NaF concentration of the solution. Both increased with increasing NaF concentration. Apatite compositions ranged from Ca9.06(HPO4)0.94(PO4)5.06OH1.06 for hydrolysis in water to Ca9.28Na0.56(HPO4)(x)(PO4)(6-x)F0.920Hy for hydrolysis in 0.1 M NaF solution. The proportions of PO4, HPO4 and OH in Na- and F-containing apatites are indeterminate but obey the equation (y = constant+x). The (Ca+Na)/P ratio of the apatite formed by alpha-TCP hydrolysis in 0.1M NaF approaches 1.67 indicating the vacant Ca sites become almost completely filled by the Na ions. The surface areas of these apatites initially remain constant with increasing NaF concentrations; at elevated concentrations apatite surface areas decrease with increasing NaF concentration. This is consistent with the removal of Na from solution by its incorporation in the apatites, not by its adsorption onto their surfaces.

Adsorption↗
PubMed1999

The formation of hydroxyapatite-calcium polyacrylate composites.

Tetracalcium phosphate (TetCP, Ca4(PO4)2O) reacts rapidly with polyacrylic acid (PAA). Complete reaction results in the formation of hydroxyapatite (HAp) and calcium polyacrylate. Consequently, this combination of reactants can react to form a dental cement. However, reaction occurs so rapidly that it would be difficult to achieve a homogeneous mixture of reactants suitable for use in restorations. In order to explore extending the working time, the effects of prehydrating the TetCP to form surface layers of HAp on the TetCP particles was explored. Prehydration was found to be an effective means of allowing workability. Therefore, the effects of the proportions of TetCP and PAA, with and without HAp filler, on cement properties were investigated. The extents of the reactions were investigated by X-ray diffraction analysis; the extents of PAA neutralization were studied by Fourier transform infra-red spectroscopy (FTIR); pore structures were determined by mercury intrusion porosimetry; microstructures were observed by scanning microscopy, and compressive strengths were determined. After curing for 17 days at room temperature PAA neutralization was almost complete; however, residual TetCP could be detected by X-ray diffraction and PAA by FTIR. As expected, the compressive strengths of the cements showed a dependence on the liquid (water+polymer)-to-solid (TetCP+HAp filler) used. The presence of HAp filler caused a significant decrease in compressive strength and increasing the proportion of HAp filler resulted in a decrease in the compressive strength. The characteristics of the load-deflection curves showed a dependence on the presence of HAp filler. In the absence of filler, two slopes were observed in the curves whereas a linear curve, typical of a ceramic, was observed when HAp filler was present. Mercury intrusion porosimetry (MIP) indicated the majority of the porosity was present in pores larger than 0.1 microm. Porosity increased with increasing liquid-to-solids ratio and with an increasing proportion of HAp filler at a constant liquid-to-solids ratio. Microstructural observations indicated the effect of HAp filler on increasing porosity was the result of porosity present in the filler itself. Thus, poorly consolidated HAp filler contributed to increased porosity and reduced compressive strength.

Journal Article↗