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PubMed1975

Characterization of hydrogen bonding between selected barbiturates and polyethylene glycol 4000 by IR spectral analysis.

Several barbiturates and primidone were equilibrated with polyethylene glycol 4000 in pyridine. IR spectral properties of these samples indicate that seven disubstituted barbiturates complex with polyethylene glycol 4000 while five disubstituted barbiturates and two trisubstituted barbiturates as well as primidone do not. Forces responsible for complexation of barbiturates with polyethylene glycol 4000, as inferred from spectral data, consist of hydrogen bonds formed between N1 and N3 hydrogens of the barbiturate ring and two oxygen atoms of the --O--CH2CH2--O--moiety. Also, there appear to be three configurations of intermolecular hydrogen bonding sites between disubstituted barbiturates. Several factors affect the barbiturate-polyethylene glycol 4000 interaction, including the nature of the solvent, C5 substituents, the number of hydrogen bonds formed between reactants, and the 2-carbonyl group of the barbiturate ring. Complexes of polyethylene glycol 4000 with phenobarbital, butabarbital, and cyclobarbital are stable in water at 26 degrees or below, but complexes of polyethylene glycol 4000 with butethal, cyclopentenyl allylbarbituric acid, pentobarbital, and probarbital are not.

Barbiturates↗

PubMed1989

Polyethylene glycol effect on the oxygenated and hypoxic isolated perfused rat kidney.

Polyethylene glycol protects against O2 deprivation after clamping of the renal artery or norepinephrine infusion and in hypoxic primary cell culture. Isolated perfused kidneys under hypoxic conditions develop morphological alterations in all segments of the proximal tubule and medullary thick ascending limb. In an attempt to ameliorate the effect of hypoxia, rat kidneys were perfused for 90 min with regularly oxygenated (95% O2 + 5% CO2) or hypoxic perfusate (95% N2 + CO2) supplemented with 8-12% polyethylene glycol (MW approximately 8000). In oxygenated and hypoxic kidneys, polyethylene glycol produced similar changes in S1-S2 segments consisting of reduction of cell thickness and organelle compaction with internalization of brush border into the tubulo-vesicular system. In the S3 segment, the cellular volume loss was more limited; the brush border was transformed to membranous whorls and the cytoplasm contained large, irregular, clear zones. Mitochondrial swelling was pronounced in the hypoxic proximal tubules. Polyethylene glycol quantitatively increased and emphasized the damage in the medullary thick ascending limb. Inclusion of 10(-2) M ouabain preserved the medullary thick ascending limb from hypoxic injury and polyethylene glycol had no effect on this undamaged epithelium. Thus, polyethylene glycol affects renal tubules on the basis of their known water permeability and does not protect against but rather worsens hypoxic injury in the medullary thick ascending limb.

Animals↗

PubMed1984

Small intestinal permeability to mannitol, lactulose, and polyethylene glycol 400 in celiac disease.

Mannitol (molecular weight 182), lactulose (342), and polyethylene glycol 400 (range 242-550) absorption was studied in 25 controls, 22 untreated celiacs, and 13 treated celiacs. Untreated celiacs absorbed less mannitol and more lactulose than controls. Absorption of higher as well as lower molecular-weight polyethylene glycols was reduced in untreated celiac disease. Absorption returned towards normal on treatment. Polyethylene glycol and lactulose absorption was enhanced by administering them in a hypertonic solution. Polyethylene glycol 400 but not lactulose or mannitol was lipid soluble in vitro. It was concluded that the mucosa in untreated celiac disease was more "leaky" than normal. Polyethylene glycol 400 absorption data suggested that its absorption may largely be determined by its lipid solubility and was decreased in celiac disease because of the reduced surface area of the small intestine. Polyethylene glycol 400 cannot be recommended as a suitable marker for permeability studies of the small intestine.

Adult↗

PubMed2003

[Polyethylene as an implant material].

Since the early 1960s, ultrahigh-molecular weight polyethylene (UHMWPE) has been one of the most frequently and successfully used materials in total joint replacement. However, in the course of clinical usage, various weaknesses of the material became apparent including wear and aging properties. As a result of research on this polymer, several improvements in the quality of the raw material, the processing, and the sterilization have been introduced. These changes paired with an improved knowledge of the viscoelastic behavior of UHMWPE have led to an improved design of the components to meet the requirements of the given material characteristics and in turn to better clinical results. In the 1990s, investigations focused on the influence of radiation on the molecular structures of polyethylene. Gamma radiation treatment in air leads to an important decrease in the molecular weight with reduced tribological behavior and accelerated aging. In contrast, a nitrogen atmosphere during irradiation and storage can improve the linkage of the polyethylene and promote the positive effects of radiation treatment. This effect can be further intensified by increased radiation levels. Such highly cross-linked polyethylenes demonstrate extremely low wear rates in vitro;however, other material properties are also changed. First reports on fissures in highly cross-linked polyethylene explants demonstrate that only long-term clinical trials can allow a final verdict on the clinical potential of highly cross-linked polyethylenes.

Elasticity↗

PubMed1998

Effect of polyethylene on osteocalcin, alkaline phosphatase and procollagen secretion by human osteoblastic cells.

We have studied the direct effects of polyethylene particles on osteoblastic function in primary human bone cell cultures. The cells were obtained from trabecular bone fragments of patients undergoing knee reconstructive surgery. When the cells reached confluency, they were subcultured into two flasks, one untreated (control culture) and the other treated with polyethylene particles, and incubated until confluency. Osteoblastic function was evaluated by assaying osteocalcin, alkaline phosphatase, and C-terminal procollagen type I, with and without 1,25(OH)2D stimulation, in the cell-conditioned medium. We found that addition of polyethylene to these osteoblastic cell cultures induced higher levels of secreted osteocalcin after 1, 25(OH)2D stimulation. Alkaline phosphatase levels increased whereas C-terminal procollagen type I levels decreased in the cell conditioned medium after polyethylene was added to the cultures. Treatment of the control cultures with 1,25(OH)2D stimulated alkaline phosphatase levels and decreased C-terminal procollagen type I. However, these osteoblastic markers in 1,25(OH)2D-treated cells did not change in cultures with polyethylene. This study demonstrates that polyethylene particles have a direct effect on osteoblastic markers in human bone cells in culture.

Aged↗

PubMedDate not supplied

Randomised trial of self-expanding metal stents versus polyethylene stents for distal malignant biliary obstruction.

Self-expanding metal stents are claimed to prolong biliary-stent patency, although no formal comparative trial between plastic and expandable stents has been done. In a prospective randomised trial, we assigned 105 patients with irresectable distal bile-duct malignancy to receive either a metal stent (49) or a straight polyethylene stent (56). Median patency of the first stent was significantly prolonged in patients with a metal stent compared with those with a polyethylene stent (273 vs 126 days; p = 0.006). The major cause of stent dysfunction was tumour ingrowth in the metal-stent group and sludge deposition in the polyethylene-stent group. Treatment after any occlusion included placement of a polyethylene stent. In the metal-stent group none of 14 second stents occluded, whereas 11 of 23 (48%) second stents clogged in the polyethylene-stent group (p = 0.002). Overall median survival was 149 days and did not differ significantly between treatment groups. Incremental cost-effectiveness analysis showed that initial placement of a metal stent results in a 28% decrease of endoscopic procedures. Self-expanding metal stents have a longer patency than polyethylene stents and offer adequate palliation in patients with irresectable malignant distal bile-duct obstruction.

Aged↗

PubMed1997

Beneficial effects of fluosol-polyethylene glycol cardioplegia on cold, preserved rabbit heart.

BACKGROUND: Because of its high oxygen-carrying capacity, especially at low temperatures, fluosol may enhance heart preservation. METHODS: Hearts of male New Zealand white rabbits (1.5-2.0 kg) were excised and flushed through the aorta with 0 degree C St. Thomas' Hospital solution, fluosol, or polyethylene glycol or fluosol-polyethylene glycol cardioplegic solution. Hearts were then stored for 12 hours at 0 degree C and reperfused with Krebs-Henseleit buffer at 36.5 degrees C for 60 minutes using a Langendorff system. RESULTS: Myocardial contractile function was significantly greater in the fluosol-polyethylene glycol cardioplegia-preserved group (p < 0.01) and polyethylene glycol-cardioplegia preserved group (p < 0.05) than in the St. Thomas' Hospital solution-preserved group. The myocardial high-energy phosphate content was significantly higher in the fluosol-polyethylene glycol-cardioplegia-preserved group (p < 0.01), with reduced release of lactate dehydrogenase (p < 0.01) in comparison with the St. Thomas' Hospital solution-preserved group. CONCLUSIONS: The addition of fluosol and polyethylene glycol to the cardioplegic solution may enhance long-term cold heart preservation.

Animals↗

PubMed2001

Transmission electron microscopy of intracellular particles of polyethylene from joint replacement prostheses: size distribution and cellular response.

The objectives of this transmission electron microscopy study of peri-implant tissues retrieved at revision arthroplasty were to (1) determine the size distribution of intracellular polyethylene particles, and (2) assess the cellular response to phagocytosed polyethylene particles as revealed by the condition of the cellular organelles. The frequency distributions of intracellular polyethylene particle sizes for 15 cases of total hip replacement showed that more than 75% of the particles had lengths of less than 0.5 microm. More than 90% of the particles were less than 1.0 microm in size. In comparison, the frequency distribution for the particles in cellscomprising tissue retrieved from three total knee replacement prostheses showed that only 43% of the particles were less than 0.5 microm in length and 72% were less than 1 microm in size. There was no statistically significant difference in the mean particle length between the specimens from the hip and knee patients. The majority of the cells containing polyethylene were without signs of degeneration. The cytoplasmic and nuclear membranes were intact. Several electron lucent voids which once contained polyethylene particles were seen surrounded by several healthy appearing mitochondria, which displayed sharp membranes and intact cristae. There were no signs of a cytotoxic response to polyethylene at the ultrastructural level.

Adult↗

PubMed1999

Radiation and chemical crosslinking promote strain hardening behavior and molecular alignment in ultra high molecular weight polyethylene during multi-axial loading conditions.

The mechanical behavior and evolution of crystalline morphology during large deformation of eight types of virgin and crosslinked ultra high molecular weight polyethylene (UHMWPE) were studied using the small punch test and transmission electron microscopy (TEM). We investigated the hypothesis that both radiation and chemical crosslinking hinder molecular mobility at large deformations, and hence promote strain hardening and molecular alignment during the multiaxial loading of the small punch test. Chemical crosslinking of UHMWPE was performed using 0.25% dicumyl peroxide (GHR 8110, GUR 1020 and 1050), and radiation crosslinking was performed using 150 kGy of electron beam radiation (GUR 1150). Crosslinking increased the ultimate load at failure and decreased the ultimate displacement of the polyethylenes during the small punch test. Crosslinking also increased the near-ultimate hardening behavior of the polyethylenes. Transmission electron microscopy was used to characterize the crystalline morphology of the bulk material, undeformed regions of the small punch test specimens, and deformed regions of the specimens oriented perpendicular and parallel to the punch direction. In contrast with the virgin polyethylenes, which showed only subtle evidence of lamellar alignment, the crosslinked polyethylenes exhibited enhanced crystalline lamellae orientation after the small punch test, predominantly in the direction parallel to the punch direction or deformation axis. Thus, the results of this study support the hypothesis that crosslinking promotes strain hardening during multiaxial loading because of increased resistance to molecular mobility at large deformations effected by molecular alignment. The data also illustrate the sensitivity of large deformation mechanical behavior and crystalline morphology to the method of crosslinking and resin of polyethylene.

Biocompatible Materials↗

PubMed1995

Tibial polyethylene failure after primary porous-coated anatomic total knee arthroplasty. Aids to diagnosis and revision.

Recognizing and providing effective treatment for polyethylene failure after total knee arthroplasty (TKA) are challenging problems. The range of presenting symptoms and the usefulness of diagnostic tests are examined, and the outcome of surgical treatment of patients with tibial polyethylene failure is reported. From a consecutive series of 209 Primary Porous-Coated Anatomic (Howmedica, Rutherford, NJ) TKAs performed between 1984 and 1987, 18 cases (9%) required revision surgery. No patient experienced polyethylene failure prior to 48 months, and the average time to revision was 81 months after index TKA. The follow-up period after revision surgery averaged 24 months. Symptoms began after a period of good function, and preceded revision by an average of 8 months. The most common presenting symptom was swelling (89%), followed by stiffness (72%), pain (67%), and clicking (38%) or instability (22%). Single leg standing anteroposterior radiographs were most effective, demonstrating polyethylene failure by a change to increasing varus and narrowing of the polyethylene space in 16 of 18 cases. Arthroscopic evaluation confirmed the diagnosis in two cases. Five cases required tibial tubercle osteotomy for exposure, and 15 required complete synovectomy. Exchange of the damaged heat-pressed polyethylene insert with a machined insert was performed in 14 cases, exchange plus tibial tray revision in 3 cases, and complete knee revision in 1 case. Revision surgery successfully restored pain-free function and improved range of motion in 16 of 18 cases. Survivorship analysis showed an 11% failure rate at 8 years after index procedure. Regular follow-up evaluation for the Primary Porous-Coated Anatomic TKA is suggested.

Aged↗

PubMed1999

Deformation of the acetabular polyethylene liner and the backside gap.

Polyethylene wear of acetabular components may cause osteolysis and aseptic loosening in total hip arthroplasty. Case reports of wear between the polyethylene liner and acetabular metal backing (backside wear) have promoted speculation on the clinical importance of debris generation at this site and the potential importance of insert conformity. We examined 90 retrieved nonconforming acetabular components from a single manufacturer. Twenty-four liners (27%) showed polyethylene deformation corresponding to screw holes on the backside surface. The location of screw-hole deformations corresponded to the direction of polyethylene deformation (wear) on the articular surface in all cases. The polyethylene liners with backside deformations were significantly thinner than the liners without deformation (P = .02). The presence of acetabular osteolysis did not significantly correlate with backside deformation, but there was a significant association between osteolysis and wear of the articular surface (P = .0004). In this implant design, backside deformation (wear) may not be due to micromotion at the interface but to the viscoelastic nature of ultra-high-molecular weight polyethylene.

Acetabulum↗

PubMed1999

Effect of polyethylene wear on osteolysis in cementless primary total hip arthroplasty: minimal 5-year follow-up study.

We measured polyethylene wear radiographically in 85 cementless primary total hip arthroplasties. All patients were followed up for at least 5 years (mean, 6.3 years). The mean extent of linear wear was 0.88 mm, and the mean rate of linear wear was 0.14 mm/y. The mean volumetric wear was 539.42 mm3, and the mean rate of volumetric wear was 87.69 mm3/y. Polyethylene wear was correlated inversely with the patients' age only and was not influenced by other clinical factors. Osteolysis developed in 34 femurs and in 11 acetabula. Radiographic loosening was found in 2 cases in the femur and none in the acetabulum. Polyethylene wear was significantly correlated with frequency and size of osteolytic lesions. Therefore, polyethylene wear was considered one of the major causes of osteolysis, but it was not directly associated with prosthesis loosening. To reduce the extent of polyethylene wear, the material characteristics of polyethylene should be improved, or more durable articulating materials should be developed.

Adult↗

PubMed2001

Laser desorption ionization and MALDI time-of-flight mass spectrometry for low molecular mass polyethylene analysis.

Polyethylene's inert nature and difficulty to dissolve in conventional solvents at room temperature present special problems for sample preparation and ionization in mass spectrometric analysis. We present a study of ionization behavior of several polyethylene samples with molecular masses up to 4000 Da in laser desorption ionization (LDI) time-of-flight mass spectrometers equipped with a 337 nm laser beam. We demonstrate unequivocally that silver or copper ion attachment to saturated polyethylene can occur in the gas phase during the UV LDI process. In LDI spectra of polyethylene with molecular masses above approximately 1000 Da, low mass ions corresponding to metal-alkene structures are observed in addition to the principal distribution. By interrogating a well-characterized polyethylene sample and a long chain alkane, C94H190, these low mass ions are determined to be the fragmentation products of the intact metal-polyethylene adduct ions. It is further illustrated that fragmentation can be reduced by adding matrix molecules to the sample preparation.

Indicators and Reagents↗

PubMed1992

Effects of spermine on water absorption, polyethylene glycol 4000 permeability and collagenase activity in rat descending colon in vivo.

1. The effects of spermine in the concentration range 0-10 mmol/l on (a) the fluid absorption, (b) the polyethylene glycol permeability, (c) the release of collagenase activity activity into the lumen and (d) the histological appearance of rat descending colon were examined. 2. Spermine (5 mmol/l) decreased fluid absorption from 48.83 +/- 2.98 (n = 7) to 23.98 +/- 2.32 (n = 6) microliters h-1 cm-2 (P < 0.01); polyethylene glycol 4000 permeability was increased from 0.030 +/- 0.001 (n = 7) to 0.047 +/- 0.003 (n = 6) cm/h (P < 0.01) and luminal collagenase activity increased from a negligible control value to 250 +/- 39 (n = 6) units/ml (P < 0.001). Spermine also caused oedema formation within the mucosal interstitial fluid, without inducing an overt breakdown of the mucosa at the luminal surface. 3. Polyamine-free dialysed seminal plasma had no effect on polyethylene glycol 4000 permeability, although it still caused a significant decrease in colonic fluid absorption from 48.83 +/- 2.98 (n = 7) (control) to 31.41 +/- 2.08 (n = 5) microliters h-1 cm-2 (P < 0.01). 4. Low-molecular-mass heparin (600 units/ml) prevented the spermine (5 mmol/l)- and whole-semen-induced increase in colonic polyethylene glycol 4000 permeability and reduced the effect of semen on fluid absorption by 63% (P < 0.001) and that of spermine by 56% (P < 0.01). 5. The Zn2+ chelator and collagenase inhibitor o-phenanthroline reduced the effect of spermine on fluid absorption and polyethylene glycol 4000 permeability by 100% (P < 0.001) and on interstitial oedema formation. o-Phenanthroline also reduced the effects of whole semen on fluid absorption (by 70%, P < 0.01) and on polyethylene glycol 4000 permeability by 95%, P < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed1993

Diffusion of polyethylene glycol-400 across lipid barriers in vitro.

1. Polyethylene glycol has been used extensively as a probe to measure passive small-intestinal permeability in vivo. However, there has been some uncertainty as to its suitability for use as an indicator of the permeation of water-soluble molecules across the intestinal wall because it seems to traverse the mucosa in much greater quantities than sugar molecules of equivalent M(r). 2. We have measured the permeation of polyethylene glycol-400 and lactulose from aqueous solution across pure lipid solvents in vitro. We found considerable transport of polyethylene glycol-400 across chloroform (1.03 g h-1 m-2) but no movement across petroleum ether. 3. However, in a separate experiment in which phospholipid (egg lecithin) was dissolved in the petroleum ether, permeation of polyethylene glycol-400 did occur (0.13 g h-1 m2), implying interaction of polyethylene glycol-400 with the phospholipid. No permeation of lactulose was seen in any of the experiments. 4. Our results suggest that, because of its interaction with lipid solvents, polyethylene glycol-400 is unsuitable as a probe to measure passive intestinal permeability in vivo.

Diffusion↗

PubMed2000

Low-conforming all-polyethylene tibial component not inferior to metal-backed component in cemented total knee arthroplasty: prospective, randomized radiostereometric analysis study of the AGC total knee prosthesis.

In a prospective, randomized study of 40 patients, the quality of fixation of cemented metal-backed versus all-polyethylene tibial components of the unconstrained anatomic graduated component total knee arthroplasty design was studied during 2 years using radiostereometric analysis (RSA). The shape, as well as the articulating geometry, of the implants was identical, as was the operative technique and the postoperative regimen. In this study, no negative consequences regarding the quality of fixation using an all-polyethylene tibial component with unconstrained articulating surfaces could be identified. In all aspects, the all-polyethylene tibial components displayed migration on par with, or sometimes lower than, their metal-backed counterparts. The rotations of the all-polyethylene components were equally low as for the metal-backed components, and maximum lift-off was significantly lower than for the metal-backed implants. We could not identify any collapse of the bone at the medial condyle or increased subsidence at the medial part of the tibia or increased rates of radiolucent lines in the knees with all-polyethylene components. All all-polyethylene implants seemed to be stable within the resolution of RSA between 1 and 2 years, a finding known to be of positive prognostic significance regarding future aseptic loosening.

Aged↗

PubMedDate not supplied

[Migration analysis of cemented Müller polyethylene acetabular cups versus cement-free Zweymüller screw-attached acetabular cups].

OBJECTIVE: Is the cementless Zweymüller hip cup superior to the cemented Müller cup? METHOD: This article presents a radiographic analysis of 25 cemented Müller acetabular cups versus 22 cementless Zweymüller cups using the Einbildröntgenanalyse (EBRA), a software tool for radiographic measurement of acetabular cup migration. In addition, we determined the effects of the cup anteversion and inclination, the polyethylene wear, the lateral bone coverage of the acetabular cup, the position of the center of rotation, and individual factors on the incidence of cup migration. RESULTS: The incidence of cup migration was 64% in the cementless group and 48% in the cemented group after a mean follow-up of 6 years. The average migration rate was 0.33 mm/a for cementless Zweymüller cups and 0.38 mm/a for cemented Müller cups. Cup anteversion and inclination showed no effect on the incidence of cup migration. The combination metal-polyethylene (0.17 mm per year) demonstrated a significantly higher wear rate in comparison to the ceramic-polyethylene combination (0.11 mm per year). Incompletely lateral covered cups demonstrated a significantly higher incidence of cup migration. Cranial or medial deviations of the center of rotation up to 5 mm are tolerable, in contrast to caudal or lateral deviations that lead to a significantly higher incidence of cup migration. CONCLUSION: The superiority of the cementless Zweymüller cup was not observed. We recommend a complete lateral bone coverage of the hip cup. Cranial and medial deviations of the center of rotation up to 5 mm are tolerable. In the present study the polyethylene wear of the ceramic-polyethylene combination was significantly less as compared with the metal-polyethylene combination.

Acetabulum↗

PubMed2000

Primary placement of a titanium motility post in a porous polyethylene orbital implant: animal model with quantitative assessment of fibrovascular ingrowth and vascular density.

PURPOSE: To determine whether a Medpor porous polyethylene orbital implant, at the time of initial orbital implant surgery, will tolerate the insertion of a titanium screw on the anterior surface of the implant. METHODS: Twelve New Zealand white rabbits were enucleated and implanted with a porous polyethylene orbital implant. At the time of enucleation, the porous polyethylene orbital implants were drilled, and titanium motility coupling posts were inserted. The motility coupling posts were inserted at two projection heights (2 or 4 mm) and either covered within Tenon capsule/conjunctiva (eight implants) or left exposed (four implants). Rabbits were killed at 6 or 12 weeks. Clinical tissue tolerance, histologic response to the motility coupling post, and vascular density of the porous polyethylene orbital implant were evaluated. RESULTS: The motility coupling posts were well tolerated, and extrusion or migration of the motility coupling post did not occur. The average percentage cross-sectional area of the implant occupied by fibrovascular tissue at 6 and 12 weeks was 76.3% and 97.5%, respectively. In comparing the vascular density (number of vessels per square millimeter) in the porous polyethylene orbital implant within a 1-mm zone immediately surrounding the motility coupling post, no significant difference between this zone and the vascular density found within its entire corresponding annulus was found at either 6 or 12 weeks. CONCLUSIONS: During the 6- and 12-week observation periods, all implanted motility coupling posts demonstrated favorable tissue tolerance and stable interfaces with surrounding tissues. The extent of fibrovascular tissue ingrowth and vascular density verify that initial screw insertion does not adversely affect the healing process after porous polyethylene orbital implant implantation. Thus, primary placement of the motility coupling post may obviate the need for a secondary surgical procedure.

Animals↗