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Biomedical subjects

T Gilchrist

Publications and source records attributed to T Gilchrist.

At least 19 recordsLinked to original sources

Early dissolution of a morsellised impacted silicate-free bioactive glass in metaphyseal defects.

The purpose of this study was to evaluate the biological properties of idealized, morsellised impacted Corglaes, a soluble silicate-free glass. Twenty-two sheep underwent implantation of pellets in six metaphyseal defects in both rear limbs. Particle size distribution of all aggregates (except the autograft) approached the ideal logarithmic grading line and all implants were impacted to a standard compactive effort. Treatment groups consisted of (1) empty defect (negative control), (2) autograft (positive control), (3) allograft (clinical control), (4) allograft idealized with Corglaes, (5) 50/50 allograft/Corglaes and (6) Corglaes. Defects were sealed with polymethylmethacrylate. Healing of the defects was evaluated at 7 weeks (n=6) and 14 weeks (n=16) with computed tomography, histology, and histomorphometry. Remnants of Corglaes were found within one of the defects 7 weeks after implantation. Defects filled with mixtures containing 50% or 100% Corglaes were less dense, contained less bone and more fibrous tissue than defects with allograft, autograft, or allograft idealized with Corglaes. Allograft idealized with Corglaes may be considered for impaction grafting in revision hip arthroplasty, as well as local delivery of antibiotics. However, further studies and potential revision of the agent are required before mixtures containing concentrations of Corglaes equal to or higher than 50% can be recommended.

Animals↗

Biodegradable controlled release glass in the repair of peripheral nerve injuries.

The experiments in this paper were concerned with the recovery of function and ease of application of an entubulation technique using a biodegradable, controlled release glass tube (CRG) for the repair of a transected peripheral nerve. The peroneal nerves of 15 New Zealand White rabbits were repaired with either a CRG tube filled with freeze-thawed muscle, or a conventional freeze thawed muscle graft (FTMG). These were compared with controls in which a CRG was used to enclose the cut ends of a nerve separated by a 1 cm gap. Electrophysiological and morphometric assessment was carried out 6 months after repair. No statistical difference was found in any test between the FTMG and the CRG tube filled with freeze thawed muscle. The CRG tube and 1 cm gap produced inferior levels of recovery of function when compared with the other two repair groups.

Action Potentials↗

Haemocompatiblity of controlled release glass.

There are many medical applications which benefit from the use of soluble biomaterials, including the sustained release of drugs over a precise period of time, or temporary conduits for controlling nerve regrowth. We have manufactured a series of phosphate-based controlled release glasses (CRGs) in which the solubility could be controlled by varying the concentration of CaO and Na2O. Fibres of the CRG containing iron and cerium were placed into direct contact with human neutrophils and macrophages in tissue culture for 2.5 and 24 h respectively and the responses analysed by scanning electron microscopy (SEM) and confocal microscopy. The supernatants were analysed for the cytokine IL-1beta by enzyme-linked immunosorbent assay (ELISA). Disks of CRG of various compositions were placed in contact with whole blood for 30 min and platelet adhesion assessed by SEM. Activation of platelets, granulocytes and complement were quantified by ELISA for beta-thromboglobulin, elastase and iC3b. Intrinsic coagulation activation was measured by timing the clotting of recalcified plasma. Only the cerium fibre inhibited IL-1beta release from macrophages. No platelet adhesion was observed to any disk composition. Three compositions containing MgO inhibited plasma clotting and showed an insignificant level of complement activation. This study has demonstrated the development of a number of compositions of CRG, which have great potential in a wide variety of biomedical applications.

Journal Article↗

Soft tissue response to glycerol-suspended controlled-release glass particulate.

Vesicoureteral reflux and urinary incontinence have previously been treated by various means including the endoscopic delivery of injectable bulking materials such as silicone micro-implants, PTFE implants, glass particles, fat and bovine collagen. These first three materials do not degrade and collagen requires frequently repeated injections in order to sustain the restored continence provided. Vesicoureteric reflux in children usually resolves independently before the age of five. Correction is required before this, because treatment by prophylactic antibiotics is frequently unsuccessful in preventing breakthrough infection. The ideal material for injection should have large particles to avoid migration, inject easily and controllably, be non-toxic and dissolve over the period of time by which time the kidney will be mature. Three different controlled-release glass (CRG) granule compositions have been prepared by Giltech Ltd, and suspended in a suitable carrier medium (in this case glycerol). The degradable glasses, which have two different size ranges of 200-300 and <53 microm, and three different solution rates, were injected intramuscularly into the dorso-lumbar region of rats. Histological analysis of cryostat cut section after time periods of 2 d, 4 and 9 wk, and 6 mon has been performed. Histology sections were stained for neutrophils and macrophages using enzyme histochemistry. ED1 (monocytes and immature macrophages), ED2 (mature tissue macrophages), CD4 (helper/inducer T-lymphocytes and macrophages), CD8 (suppressor/cytotoxic T-lymphocytes), Interleukin-1beta, IL-2 (activated T-lymphocytes), Major Histocompatibility Complex (MHC) class II (activated macrophages and activated B-lymphocytes), alpha-beta (T-lymphocytes) and CD45RA (B lymphocytes) antibodies have been used to stain immunohistochemically each sample. This study demonstrates that particulate, degrading glass is stimulating an inflammatory response in soft tissue at time periods up to 6 mon. It should be noted that very small particulate, fast degrading glass is leading to tissue necrosis and should not be considered further for these applications. However, larger particulate, slower degrading materials are demonstrating effective potential for stress incontinence applications.

Journal Article↗

In vitro nerve repair--in vivo. The reconstruction of peripheral nerves by entubulation with biodegradeable glass tubes--a preliminary report.

Biodegradeable "controlled release" inorganic polymer glass tubes can be manufactured to fit the dimensions of any nerve and their rate of solubility can be adjusted to encompass the time taken for nerve regeneration. They have been used in a number of biological applications. The facial nerve was repaired in a group of five sheep by entubulation with biodegradeable glass tubes. The sheep were assessed 10 months after repair and compared with a similar sized group of normal sheep. It was found that while there was a reduction in the peak velocity of conduction in the repaired nerves and in the range of conduction velocities, the minimum conduction velocity was within normal limits. There was a diminution in all of the measured variables of nerve morphometry but in no case did this reach statistical significance. These findings are consistent with the view that regeneration of the nerves had taken place to a degree at least as effective as that seen in nerves of a similar size repaired by conventional means.

Animals↗

Sorbsan calcium alginate fibre dressings in footcare.

This report outlines the successful application of Sorbsan-calcium alginate fibre dressings in footcare. This biomaterial has been found in clinical trials to have quite outstanding merit and can be used for sinus drainage and in the treatment of fissures, hypergranulation tissue, interdigital maceration, heloma molle and other lesions. Sorbsan bonds with and aids natural healing scabs and effects drainage of moist sites thus assisting in creating an environment conducive to the healing process. Similar promise has been demonstrated for this material in ongoing trials in hospitals in Sunderland where Sorbsan has been used effectively in the treatment of diabetic and trophic ulcers.

Adolescent↗

Wound treatment with Sorbsan--an alginate fibre dressing.

This highly absorbent, biodegradable dressing derived from seaweed can be successfully applied to cleanse a wide variety of secreting lesions. The high absorption of exudate is achieved via strong hydrophilic gel formation and this serves to control wound secretion levels and to minimize bacterial contamination. Alginate fibres trapped in a wound are readily biodegraded and do not have to be removed thus avoiding disturbance of granulation tissue formation. Additional features are odour remission, conformability and ready removal of tissue adherent material.

Alginates↗

Reflections on the role of carbon haemoadsorption in therapeutic medicine.

The selection of Norit RBX-1-activated carbon granules for blood detoxification by haemoadsorption is outlined. Synthetic polymer membranes have been coated on to this carbon by a specially developed process and perfusion devices prepared from these materials have been evaluated in animal models of acute poisoning and liver failure. Clinical application of carbon haemoadsorption has been explored in acute poisoning, liver failure and uraemia. The experience to date would suggest that carbon will have to be augmented by other adsorbent species before life support systems based principally on haemoadsorption become a reality especially in the treatment of uraemia and in liver failure. A secondary role as a temporary adjunct to dialysis has been established for carbon haemoperfusion in the treatment of uraemic pericarditis and is under further investigation in the treatment of pruritus, pigmentation and neuropathy.

Animals↗

Activated carbon for haemoperfusion.

Some features of activated carbon are consisted and the grades of the adsorbent used in haemoperfusion are examined. Aspects of the activation process and the properties of the resultant carbons are discussed.

Adsorption↗

The role of heparin on platelet retention by acrylonitrile co-polymer dialysis membranes.

The role of heparin on platelet--foreign surface interactions was examined by platelet retention studies on acrylonitrile--dimethylaminoethyl methacrylate (AN-DMAEMA) dialysis membranes both with and without the bonding of heparin onto their surfaces. Heparin bonding significantly reduced platelet retention. Heparin in solution (4 units/ml.) increased platelet retention when the surface of the membranes was modified by ethylene oxide but had no significant effect on the platelet-retaining properties of unmodified membranes. Studies using heparin 99mTc demonstrated that unmodified membranes took up heparin from solution whereas ethylene oxide-modified membranes had little such affinity. The heparin bonding process greatly increased the heparin uptake achieved by simple soaking in heparin solution, and the leaching rate was less than 1% at 70 hours. The results indicate that heparin has two antagonistic effects in this platelet-foreign surface interaction: it acts directly on platelets to increase adhesiveness while acting on the foreign surface to reduce platelet retention.

Acrylates↗

Banked blood microfiltration. II. Dacron-wool microfilter.

It is well established that debris tends to accumulate in banked blood, the amount of debris increasing with storage time. If such a blood is transfused to a patient, it will be filtered by the capillary network of the lungs and could cause various intensities of microemboli. These can be prevented by microfiltration--the Swank IL200 transfusion filter made of Dacron wool is perfectly suitable. It removes more than 70% of the debris 29-100 mum size from four blood units and its efficiency for particle removal is greatly increased by lactate priming.

Animals↗

Platelets, foreign surfaces, and heparin.

These studies clearly indicate that heparin has 2 antagonistic effects in this platelet-foreign surface interaction; it acts directly on platelets to increase retention, while acting on the foreign surface to reduce platelet retention, perhaps by competing for cationic sites. This study also suggests that it is unlikely that heparin bonding confers reduced surface thrombogenicity by virtue of the ability to leach off that surface and that further studies in heparin bonding or other surface modification should consider the antiplatelet effect which can easily be studied in vitro.

Blood Platelets↗