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Standards and guidelines for biopolymers in tissue-engineered medical products: ASTM alginate and chitosan standard guides. American Society for Testing and Materials.

The American Society for Testing and Materials (ASTM) is making a concerted effort to establish standards and guidelines for the entire field of tissue-engineered medical products (TEMPS). Safety, consistency, and functionality of biomaterials used as matrices, scaffolds, and immobilizing agents in TEMPS are a concern. Therefore, the ASTM has established a number of task groups to produce standards and guidelines for such biomaterials. Alginate is a naturally occurring biomaterial used for immobilizing living cells to form an artificial organ, such as encapsulated pancreatic islets. In order to aid in successful clinical applications and to help expedite regulatory approval, the alginate used must be fully documented. The ASTM alginate guide gives information on selection of testing methodologies and safety criteria. Critical parameters such as monomer content, molecular weight, and viscosity, in addition to more general parameters, such as dry matter content, heavy metal content, bioburden, and endotoxin content are described in the ASTM document. In a like manner, the characterization parameters for chitosan, a bioadhesive polycationic polysaccharide, are described in a separate guide. For chitosan, the degree of deacetylation is of critical importance. Control of protein content and, hence, potential for hypersensitivity, endotoxin content, and total bioburden are important in chitosan preparations for TEMPS. Together these two guides represent part of the effort on behalf of the ASTM and other interested parties to ensure quality and standardization in TEMPS.

Alginates↗

Experimental examination of factors that affect dust generation by using Heubach and MRI testers.

Four factors that affect dust generation were investigated--type of test material, particle size distribution of the test material, moisture content of the test material, and apparatus used to generate dust. Dust generated from silicon carbide and aluminum oxide was measured by using MRI and Heubach dustiness testers modified to allow the measurement of dust particle size distribution with an Andersen impactor. The two materials investigated generated similar dusts. The size distribution of the test material slightly influenced the amount but strongly influenced the size distribution of the dust generated. Increased moisture content decreased the amount of dust generated; moisture content had little influence on dust size distribution. The two testers generated different amounts of dust; however, the dust particle size distributions generated were similar. These results help explain factors that affect dust generation and the relative importance of alternative methods for dust control.

Aluminum Oxide↗

Color stability of heat-polymerized and autopolymerized soft denture liners.

STATEMENT OF PROBLEM: The physical and mechanical properties of soft denture liners are influenced by a number of factors. Aging is one factor that has an effect on the characteristics of polymers. The resistance of denture liners to aging can potentially influence the color stability of these liners. PURPOSE: This study attempted to determine the color stability of soft liners by subjecting them to an in vitro accelerated aging test. MATERIAL AND METHODS: Two autopolymerizing and 3 heat polymerizing commercially available soft denture lining materials were tested. Seven sample disks were made of each material according to manufacturers' instructions. Color measurements were recorded before and after the accelerated aging process. Color changes (DeltaE) were calculated by measuring tristimulus values at several wavelengths in the visual spectrum with the use of Commission International de l'Eclairge Lab (CIE-LAB) uniform color scale. RESULTS: Kruskall-Wallis variance analysis and Mann-Whitney U-Wilcoxon rank sum W tests were performed for statistical comparison of the DeltaE values. Ufigel P and Simpa liner materials showed significantly greater color changes than the other tested materials. There were no significant differences in color change among Ufigel L-Molloplast B, Ufigel L-Flexor, and Molloplast B-Flexor liner materials. However, a significant difference in color change was found between Ufigel P and Simpa liners. CONCLUSION: Heat-polymerized soft liners were more color stable than autopolymerized soft liners. No significant differences were found among heat polymerized materials; however, significant differences in color change were found between the 2 autopolymerized liners.

Analysis of Variance↗

Determination of strength and deformation behavior of human cartilage for the definition of significant parameters.

In reconstructive surgery, an artificial supporting scaffold made from autogenous cartilage from the rib, the ear concha, or the nasal septum is used as a substitute for the destroyed endogenous tissue in the ear concha, the nose, the trachea, and in parts of the facial skeleton. For the successful use of polymer materials in reconstructive surgery, an exact knowledge of the material properties of the natural tissues is required. The applicability of conventional material test methods was examined with regard to the suitability of the test methodology. Materials properties are to be assessed for different specimen sizes and geometries. Human cartilage specimens from the septum, rib, and ear were subsected to the following test methods: (1) tension, (2) bending, (3) compression, and (4) micro-hardness measuring. Specimen geometry was evaluated for each experimental method by taking into account the dimensions of samples used in plastics testing as well as the appropriate model of miniaturization. Elastic properties determined using test methods (1), (2), and (3) are Et-sep=(7.2+/-3.4) MPa, Ef-rib=(8.8+/-2.9) MPa, and Ec-rib=(103+/-30) MPa. The micro-hardness values hpl fluctuate for septum from 1 to 4 N/mm2 and for the rib from 0.5 to 1.3 N/mm2. The experiments have shown that, beside the sex- and age-specific values recorded, the standard values and their variation are particularly influenced by preparation technique and by the conditions of storage. As a result of these first investigations, characteristic values for strength and deformation were determined under quasistatic and dynamic load conditions. The aim of this study was not the determination of statistically firmed properties, but the examination of the applicability of mechanical test methods of the polymer testing for these materials.

Cartilage↗

Adsorption kinetics of fluoride on low cost materials.

Adsorption is one important technique in fluoride removal from aqueous solutions. The viability of adsorption techniques is greatly dependent on the development of adsorptive materials. A large number of materials have been tested at a fluoride concentration greater than 2 mg/l, and the lowest limit for fluoride reduction by them is about 2 mg/l. Decreasing the fluoride concentration to less than 2 mg/l, most of the tested materials displayed a very low capacity of fluoride removal. This paper has concentrated on investigating the adsorption kinetics and adsorption capacity of low cost materials at a low initial fluoride concentration. The experiments were carried out at a natural pH, and radioisotope 18F rather than 19F was used since 18F can be rapidly measured by measuring the radioactivity with a resolution of 1 x 10(-13)mg or 0.01 microCi. The tested materials are hydroxyapatite, fluorspar, calcite, quartz and quartz activated by ferric ions. Their adsorption capacities follow the order: Hydroxyapatite>Fluorspar>Quartz activated using ferric ions>Calcite>Quartz. The uptake of fluoride on hydroxyapatite is an ion-exchange procedure and follows the pseudo-first- and second-order equations, while the uptake of fluoride on the others is a surface adsorption and follows the pseudo-second-order equation. Calcite has been seen as a good adsorbent in fluoride removal and has been patented. However, our data suggested that its adsorption capacity is only better than quartz. The external mass transfer is a very slow and rate-determining step during fluoride removal from the aqueous solution. Under static conditions, there was no relative movement between adsorbents and solutions, the fluoride uptake was at a very slow rate and the adsorbent properties did not significantly affect the fluoride uptake. Under shaken conditions, the adsorption of fluoride was controlled by the adsorbent structure and chemical properties.

Adsorption↗

Effects of end boundary conditions and specimen geometry on the viscoelastic properties of cancellous bone measured by dynamic mechanical analysis.

The viscoelastic properties of cancellous bone can be measured nondestructively in compression testing using a dynamic mechanical analyzer. In this study, we examined the effects of end boundary conditions and specimen geometry on the viscoelastic properties of cancellous bone measured by dynamic mechanical analysis. During dynamic compression testing, the cancellous bone specimens may be mechanically fixed (e.g., glued) to the loading platens or they may be free to expand across the platen surface. When specimens of cancellous bone were tested between platens with gluing, the dependence of loss tangent on frequency was not consistent with previously observed strain-rate-dependent mechanical behavior of cancellous bone. When long specimens of cancellous bone (length = 10 mm, diameter = 8 mm) were tested without gluing, the relationship between loss tangent and frequency depended on the level of load applied. For short specimens (length = 5 mm, diameter = 8 mm) tested without gluing, however, the frequency dependence of loss tangent agreed with existing data reported for the strain-rate-dependent behavior of cancellous bone and also with the frequency dependence of cortical bone viscoelasticity. Therefore, we recommend that short cancellous bone cylinders with a length of 5 mm and a diameter of 8 mm should be used without gluing in the dynamic mechanical analysis of cancellous bone. This is consistent with the American Society for Testing and Materials testing recommendations for plastics, but different from current practice for unimodal mechanical testing of cancellous bone.

Animals↗

Pullout properties of 3.5-mm AO/ASIF self-tapping and cortex screws in a uniform synthetic material and in canine bone.

OBJECTIVES--To compare the pullout properties of 3.5-mm AO/ASIF self-tapping screws (STS) to corresponding standard cortex screws (CS) in a uniform synthetic test material and in canine femoral bone. The influence of screw-insertion technique, test material, and test-material thickness were also assessed. STUDY DESIGN--In vitro experimental study. SAMPLE POPULATION--Two independent studies: a uniform synthetic test material and paired femurs from mature dogs. METHODS-Mechanical testing was performed in accordance with standards established by the American Society for Testing and Materials for determination of axial pullout strength of medical bone screws. Completely inserted STS, completely inserted CS, and incompletely inserted STS were tested in 3 groups of 10 test specimens each in 4.96-mm and 6.8-mm thick sheets of synthetic material. In the bone study, group 1 consisted of 24 completely inserted STS compared with 24 completely inserted CS, and group 2 consisted of 24 incompletely inserted STS versus 24 completely inserted CS. Comparisons were made between paired femurs at corresponding insertion sites. Pullout data were normalized, thereby eliminating the effect of test-material thickness on pullout properties. Mean values were compared using 2-way ANOVA. Statistical significance was set at P <.05. RESULTS--In both the 4.96-mm and 6.8-mm synthetic material, pullout testing of the completely inserted STS demonstrated significantly greater yield strength and ultimate strength than completely inserted CS. There was no significant difference between incompletely inserted STS and completely inserted STS. The 6.8-mm test material significantly increased yield strength and ultimate strength for all test groups compared with the 4.96-mm test material. In canine bone, there was no significant difference in yield strength of completely inserted STS and completely inserted CS. Yield strength of completely inserted STS and completely inserted CS were significantly greater than incompletely inserted STS. CONCLUSIONS--Pullout properties of completely inserted STS were significantly greater than corresponding CS in a uniform test material. In canine bone, the pullout strength of STS and CS were not different. Incomplete STS insertion resulted in an 18% reduction in holding power as compared with completely inserted CS and STS in canine bone. CLINICAL RELEVANCE--The length of STS used in canine bone should be such that the cutting flutes extend beyond the trans cortex to maximize pullout strength.

Animals↗

Reduced adherence of Candida to silane-treated silicone rubber.

Silicone rubber is widely used in the construction of medical devices that can provide an essential role in the treatment of human illness. However, subsequent microbial colonization of silicone rubber can result in clinical infection or device failure. The objective of this study was to determine the effectiveness of a novel silane-treated silicone rubber in inhibiting microbial adherence and material penetration. Test material was prepared by a combination of argon plasma discharge treatment and fluorinated silane coupling. Chemicophysical changes were then confirmed by X-ray photoelectron spectroscopy, contact-angle measurement, and atomic force microscopy. Two separate adherence assays and a material penetration assay assessed the performance of the new material against four strains of Candida species. Results showed a significant reduction (p < 0.01) of Candida albicans GDH 2346 adherence to silane-treated silicone compared with untreated controls. This reduction was still evident after the incorporation of saliva into the assay. Adherence inhibition also occurred with Candida tropicalis MMU and Candida krusei NCYC, although this was assay dependent. Reduced penetration of silane-treated silicone by Candida was evident when compared to untreated controls, plaster-processed silicone, and acrylic-processed silicone. To summarize, a novel silicone rubber material is described that inhibits both candidal adherence and material penetration. The clinical benefit and performance of this material remains to be determined.

Argon↗

Biocompatibility testing of an experimental fluoride releasing resin using human gingival epithelial cells in vitro.

Cell culture is a valuable method of evaluating the biocompatibility of new dental materials. The purpose of this study was to compare the in vitro biocompatibility of an experimental fluoride composite resin with fluoride and non-fluoride-releasing materials currently available. The dental materials tested were: MQ Silicate (silicate cement), KETAC-CEM and FUJI (type II glass ionomer cements), VISIO DISPERS (a light-cured, nonfluoridated, microfilled composite resin), and FR-17 (an experimental fluoride-releasing composite resin). The Smulow-Glickman (S-G) human gingival epithelial cell line, which exhibits semidifferentiated characteristics, was used in the study as a test system. Biocompatibility was quantified by counting the viable cells per unit area remaining after 24 and 48 h at two radial distances from cured specimens immersed in the cell culture medium. The test materials were observed to be most toxic to cells nearest the materials. A Time-Distance Cytotoxicity Index (TDCI) was calculated to relate the percentage of dead cells to viable cells at each diffusion distance for each exposure time compared to a nontoxic control. The relative toxicity ranking of the materials tested based on the TDCI was VISIO DISPERS (91%), FUJI (82%), FR-17 (30%), MQ Silicate (23%), and KETAC-CEM (10%), which exhibited the least toxicity. The cytotoxicity of the experimental resin FR-17 was within the range of cytotoxicity of currently accepted restorative materials.

Cell Survival↗

Training program on microbiological test collection material methods at a teaching hospital: investment and result assessment.

This study aimed at evaluating the results, direct costs and investment of a training program on microbiological test material collection at a teaching hospital. Test collections that did not follow the established criteria (failure) were considered as the result measure. Variable and absorption costing were used to calculate direct costs and investments, respectively. Of the 11,893 collected materials, failures were evidenced in 59 (0.5%). Direct cost corresponded to R$ 154.10 and R$ 2,431.29 was invested in training. These findings revealed that the evidenced number of anomalies (failures) represented a low percentage in relation to the total collected material for microbiological exams. Therefore, this should not be considered a critical point that justifies the continuity of the training and, consequently, the investment.

Bacteriological Techniques↗

Matrix effects in blood gas proficiency testing.

Materials currently used for blood gas proficiency testing are unlike whole blood in several obvious respects, which by definition introduces matrix effects as possible sources of error that can affect proficiency testing results. Data from recent College of American Pathologists surveys are reviewed and aqueous and fluorocarbon matrices for PO2 and PCO2 testing are compared. Closely related to matrix effects are other sources of error unique to proficiency testing samples, such as sample temperature and sample packaging. Proficiency testing programs are seriously hampered by not being able to use either whole blood or a better surrogate than is currently available. In particular, the use of aqueous materials has the potential to penalize participant laboratories unfairly in some cases and to turn proficiency testing into a meaningless exercise in others.

Bias↗

Biological implications of dental materials.

Testing of the biologic effects of dental materials has lagged far behind the characterization of their mechanical and physical properties. Various biologic-type tests, whether in vitro or in vivo, have often produced conflicting or confusing data. The objective of this article was to bring together the results of various investigations to form guidelines for the safest use of dental materials. Since many interactions between dental materials and living tissue have not been definitively established, a conservative approach was taken. The clinician who heeds the data summarized for the dental materials presented here will have the greatest probability of obtaining a benign chemical response of soft and hard tissues.

Biocompatible Materials↗

High throughput screening (HTS) for phototoxicity hazard using the in vitro 3T3 neutral red uptake assay.

Testing for phototoxic hazard is usually carried out for product ingredients intended for use on skin, which may be exposed to sunlight. Unilever currently uses the validated in vitro 3T3 Neutral Red Uptake phototoxicity test (NRU PT). This protocol involves 2-3 experiments, each taking 3 days to perform. One person can test up to seven test materials plus positive control at any one time, requiring approximately 0.5 g test material. Higher throughput is required where libraries of potential actives are being generated and screening for potential phototoxicants is required. A proposed HTS protocol would use the NRU PT, but only one concentration (10 microg/ml) in a single experiment. The validity of the HTS protocol was investigated by a retrospective examination of data from 86 materials previously tested. Phototoxic hazard predictions made using the conventional NRU PT were compared with those obtained if only data at 10 microg/ml were considered. A majority of 73 materials (84.9%) gave agreement in predictions between the two protocols; for 13 materials (15.1%) the assessments did not agree. There were no false positives; however, there were some false negatives, i.e., predicted as phototoxic from the conventional assay, but non-phototoxic at 10 microg/ml. As this protocol is intended for screening purposes only it is considered that this would be acceptable at this stage in material selection. One person could screen 128 test materials in 3 days, requiring <1 mg test material, giving a substantial increase in productivity. Any material selected for further development and inclusion in a formulation may require further confirmatory testing, e.g. using a human skin model assay for phototoxicity.

Animal Testing Alternatives↗

Impact absorption of four processed soft denture liners as influenced by accelerated aging.

The cushioning effect of soft denture liners was evaluated by using a free drop test with an accelerometer. Materials tested included SuperSoft (Coe Laboratories, Chicago, IL), Kurepeet-Dough (Kreha Chemical, Tokyo), Molteno Soft (Molten, Hiroshima, Japan), and Molloplast-B (Molloplast Regneri, Karlsruhe, Germany). All materials were found to reduce the impact force when compared to acrylic denture base resin. A 2.4-mm layer of soft denture material demonstrated good impact absorption, and Molloplast-B and Molteno had excellent impact absorption. When the soft denture liner was kept in an accelerated aging chamber for 900 hours, the damping effect recorded increased for all materials tested. Aging of all materials also affected the cushioning effect.

Acrylic Resins↗

Safety assessment of DHA-rich microalgae from Schizochytrium sp.

The purpose of this series of studies was to assess the genotoxic potential of docosahexaenoic acid-rich microalgae from Schizochytrium sp. (DRM). DRM contains oil rich in highly unsaturated fatty acids (PUFAs). Docosahexaenoic acid (DHA n-3) is the most abundant PUFA component of the oil ( approximately 29% w/w of total fatty acid content). DHA-rich extracted oil from Schizochytrium sp. is intended for use as a nutritional ingredient in foods. All in vitro assays were conducted with and without mammalian metabolic activation. DRM was not mutagenic in the Ames reverse mutation assay using five different Salmonella histidine auxotroph tester strains. Mouse lymphoma suspension assay methodology was found to be inappropriate for this test material because precipitating test material could not be removed by washing after the intended exposure period and the precipitate interfered with cell counting. The AS52/XPRT assay methodology was not subject to these problems and DRM was tested and found not to be mutagenic in the CHO AS52/XPRT gene mutation assay. DRM was not clastogenic to human peripheral blood lymphocytes in culture. Additionally, DRM did not induce micronucleus formation in mouse bone marrow in vivo further supporting its lack of any chromosomal effects. Overall, the results of this series of mutagenicity assays support the conclusion that DRM does not have any genotoxic potential.

Animals↗

A manufacturer's approach to development of matrix robust methods.

Use of matrix robust methods (MRM) to solve the problem of matrix-induced analytic errors appears to be a sound strategy. The development of MRM, however, is in an infancy stage. The principal barrier is the complexity of the matrix effect that involves interactions of the matrix, the analyte, and the technology base of the test method. Each of these three components has its own set of variables. The present article focuses on concepts and tactics to develop the MRM that appear promising on a path-forward basis. The author believes that the current environment favors probability of successful development of MRM. The quality awareness at all functional levels is high, technically feasible models for the design and development of MRM exist, and commercialization of such a method promises the developer a competitive advantage in the marketplace. The optimum strategy for MRM development appears to be evolutionary, ie, starting with a few critical methods and the samples representing the prevalent matrix types. Success in developing MRM also depends on close cooperation between the developers of the MRM, proficiency testing material, the proficiency testing providers, and the regulatory bodies. The research and development program may also include approaches that detect and/or correct the matrix-caused error(s) both in place of, or as an adjunct to, MRM. With respect to the development of genuine MRM, the author has given a typical development scenario comprising the design specifications, specific experimental approaches, evaluation, market introduction, and postintroduction monitoring of its robustness. The crux of the experimental approach is the response surface co-optimization of reaction conditions for the samples of prevalent matrix types such as the proficiency testing materials. The recommended approach is supported by examples of existing methods that exhibit robustness against certain types of matrices. The author believes that addition of MRM to the clinical chemistry methods repertoire is likely to improve the test result quality. It will also improve proficiency testing performance and patient care while boosting the morale of laboratory personnel.

Bias↗

Altered developmental toxicity caused by three carrier solvents.

Many aquatic bioassays rely on chemical solvents to solubilize water-insoluble test materials. Interactions between solvents and test materials can lead to false positive or negative results. For this reason, tests for interactions between solvents and test materials were performed. The Frog Embryo Teratogenesis Assay--Xenopus (FETAX) was chosen because of its capacity to assess three different endpoints; mortality, malformation and embryo growth. Three solvents--dimethylsulfoxide (DMSO), acetone and triethylene glycol (TG)--were tested with two teratogens--methylmercury chloride (MMC) and trichloroethylene (TCE). DMSO potentiated the lethal effect of both teratogens but did not alter significantly the rate of malformation. Acetone increased the mortality for both teratogens, but only increased the MMC malformation greater than the additive effects. TG only increased the mortality and malformation with TCE. There were additive effects for growth for all solvents with the teratogens. The carrier solvents caused interactions even at their no-observable-effect concentration (NOEC). Therefore, the choice of carrier solvent should be made with caution. This study shows that different results can occur depending on the solvent used, and that a difference in one endpoint does not necessarily change the other endpoints.

Acetone↗

Use of a lyophilized reference plasma to compare coagulation test procedures: Normotest, Simplastin-A and Thrombotest.

In 4 collaborative trials, involving a varying number of hospital laboratories in the Stockholm area, the coagulation activity of different test materials was estimated with the one-stage prothrombin tests routinely used in the laboratories, viz. Normotest, Simplastin-A and Thrombotest. The test materials included different batches of a lyophilized reference plasma, deep-frozen specimens of diluted and undiluted normal plasmas, and fresh and deep-frozen specimens from patients on long-term oral anticoagulant therapy. Although a close relationship was found between different methods, Simplastin-A gave consistently lower values than Normotest, the difference being proportional to the estimated activity. The discrepancy was of about the same magnitude on all the test materials, and was probably due to a divergence between the manufacturers' procedures used to set "normal percentage activity", as well as to a varying ratio of measured activity to plasma concentration. The extent of discrepancy may vary with the batch-to-batch variation of thromboplastin reagents. The close agreement between results obtained on different test materials suggests that the investigated reference plasma could be used to calibrate the examined thromboplastin reagents, and to compare the degree of hypocoagulability estimated by the examined PIVKA-insensitive thromboplastin reagents. The assigned coagulation activity of batches of the reference plasma agreed closely with experimentally obtained values. The stability of supplied batches was satisfactory as judged from the reproducibility of repeated measurements. The variability of test procedures was approximately the same on different test materials.

Anticoagulants↗