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Immunization by subcutaneous implants of polyester-polyurethane sponges coupled with antigen.

A new protocol is described for immunization of outbred Swiss mice. The procedure is based on subcutaneous implantation of antigen-coupled polyester-polyurethane sponges cut into disks of 10 mm in diameter vs 2 mm in thickness. Antigen coupling was performed by overnight incubation of the sponge with a solution of ovalbumin (Ova) (2 mg/ml) diluted in sodium carbonate buffer, pH 9.6. The amount of ovalbumin that was taken up by the sponge was between 71.4 to 82.5 micrograms. This was estimated by comparing the Ova absorbance at 280 nm in coating buffer solutions before and after incubation. To compare the efficiency of the proposed method, experimental groups immunized with the antigen in the presence of adjuvants (10 micrograms in Al(OH)3 or 100 micrograms in complete Freund's adjuvant (CFA)) were run in parallel. The data obtained after the 3rd week of immunization indicate that both cellular and humoral immune responses were achieved. These were assayed by antigen-induced footpad swelling and ELISA (specific antibodies), respectively. The levels of both immune responses elicited were similar to the responses observed in mice immunized with ovalbumin in the presence of Al(OH)3. The method might represent an advantage when immunizing with pathogenic antigens. Preliminary experiments have suggested that the antigen remains immobilized or bound to the sponge for a long period of time, since there is an increment on the cell population inside the sponges after boosting the animals. If so, the undesirable effects of immunization would be reduced.

Animals↗

Percutaneously inserted polyurethane central catheters in the NICU: one unit's experience.

This article describes the authors' experiences with using polyurethane percutaneously inserted central catheters from June 1993, when these catheters were introduced in the NICU at Children's Hospital, Omaha, Nebraska, through September 1997. Indications for line placement and anatomy are reviewed. Patient demographics, success rates, and complications are analyzed. Line cares, including dressing changes, management of infusions, and troubleshooting, are also discussed.

Catheterization, Central Venous↗

Creation and use of a composite polyurethane-expanded polytetrafluoroethylene graft for hemodialysis access.

The Thoratec (Vectra) polyurethane vascular access graft (TPVA) is among the most recent additions to the list of materials used to construct prosthetic grafts for vascular access during hemodialysis. We give the TPVA very high marks, and recognize the utility of such a graft for use in hemodialysis. However, the strong elasticity of this graft can lead to unexpected complications after suturing. We devised a new surgical method using a TPVA-ePTFE (expanded polytetrafluoroethylene) composite graft, substituting the anastomosis section of the TPVA with a portion of ePTFE graft material, and have been able to overcome most of the TPVA's potential problems. We herein describe the technique.

Aged↗

Platelet adhesion studies on dipyridamole coated polyurethane surfaces.

Surface modification of polyurethanes (PUs) by covalent attachment of dipyridamole (Persantin) is known to reduce adherence of blood platelets upon exposure to human platelet rich plasma (PRP). This effect was investigated in further detail. First platelet adhesion under static conditions was studied with four different biomaterial surfaces: untreated PU, PU immobilised with conjugate molecule 1, PU immobilised with conjugate molecule 2, and PU immobilised with conjugate molecule 3. In PU immobilised with 1 dipyridamole is directly linked to the surface, in PU immobilised with 2 there is a short hydrophilic spacer chain in between the surface and the dipyridamole, while conjugate molecule 3 is merely the spacer chain. Scanning electron microscopy (SEM) was used to characterise platelet adhesion from human PRP under static conditions, and fluorescence imaging microscopy was used to study platelet adhesion from whole blood under flow. SEM experiments encompassed both density measurements and analysis of the morphology of adherent platelets. In the static experiments the surface immobilised with 2 showed the lowest platelet adherence. No difference between the three modified surfaces emerged from the flow experiments. The surfaces were also incubated with washed blood platelets and labeled with Oregon-Green Annexin V. No capture of Oregon-Green Annexin V was seen, implying that the adhered platelets did not expose any phosphatidyl serine at their exterior surface.

Adult↗

Mechanical assessment of polyurethane impregnated fibreglass bandages for splinting.

The introduction of polyurethane (PU) resin impregnated fibreglass bandages is likely to have a significant effect on modern orthopaedic practice. The manufacturers of these products claim many improved properties compared to plaster of Paris bandages, such as , high strength to weight ratio, rapid setting time and high radiolucency. This paper reports on a series of mechanical tests designed to assess the strength, flexibility, working time and wear properties of the current range of fibreglass bandages and to compare them with plaster of Paris bandages. The results have clearly demonstrated that the fibreglass bandages are mechanically superior and offer numerous advantages over plaster of Paris for use as the definitive casting material for both weight-bearing and non-weight-bearing casts.

Bandages↗

Preliminary results with an apico-aortic valved conduit (AAVC) using polyurethane and aortic allograft valves.

Stenosis of the left ventricular outflow tract is one of the most frequent congenital cardiac anomalies in dogs. The subvalvular stenosis is described as a ring of fibrous tissue located in the left ventricular outflow tract immediately below the aortic valve. The best method of surgical treatment in dogs seems to be relief of the aortic obstruction with a ventricular aortic prosthesis. A new trileaflet valve manufactured out of polyurethane has been developed. For the conduit a woven Dacron graft has been used. In 5 male dogs a valved conduit was implanted between the apex of the left ventricle and the aorta thoracica without using hypothermia and/or cardiopulmonary bypass. Four dogs survived the surgical procedure and showed no clinical symptoms postoperatively. Blood flow through the conduit was demonstrated postoperatively by angiocardiography for a maximum of 22 days, the longest surviving time being 8 weeks. Trials for the replacement of the artificial valve in the conduit by a canine aortic allograft valve are in progress. Studies were done with the cryopreservation of fresh aortic valves. Sterilization, cryoconservation, and storage methods for the allograft are described.

Animals↗

Release of chemicals from polyurethane foam in the Même breast implant.

Samples of polyurethane (PU) foam from the Même breast implant were incubated at 37 degrees C in either 0.3-3.0 N sodium hydroxide (NaOH) solutions, normal saline, or methanol. The chemicals released were analyzed by gas chromatography (GC), gas chromatography/mass spectrometry (GC/MS), and Fourier-transform infra-red (FT-IR) spectroscopy. The surfaces of the treated and untreated foam samples were studied by scanning electron microscopy (SEM). The NaOH solutions hydrolysed the foam, releasing toluene diamine (TDA). Incubating the foam in methanol washed out trace quantities of anti-oxidant, 2,4-dimethyl-6-t-butylphenol (DBP). When the foam was incubated in normal saline at 37 degrees C no TDA was detectable but another compound with a mass ion of 173 was detected. Further GC/MS studies confirmed that this compound was polyol, one of the reagents used to manufacture the PU foam. Repeatedly incubating or washing the foam in normal saline or methanol eliminated the release of polyol. SEM studies of the foam samples before and after incubation experiments, showed no evidence of polymer degradation. These findings indicated that polyol was present in the PU foam only as an impurity or residue and did not originate from the breakdown of the foam itself.

Breast↗

Biodegradable guide for bone regeneration. Polyurethane membranes tested in rabbit radius defects.

Segmental, 1-cm osteoperiosteal defects were produced in both radii of 10 rabbits. One defect was covered with a biodegradable polyurethane membrane formed as a tube. The contralateral defect served as an untreated control. Healing was analyzed by radiographic and histologic studies after 5 weeks. Nine out of 10 control defects displayed nonunion, whereas membrane-treated defects consistently healed by forming callus external to the membrane fusing the bone fragments. Loose connective tissue was predominant in the bone gap underneath the membrane. Presumably, the membrane has served as a scaffold for regenerating periosteum.

Animals↗

Efficacy of a larger version of the hybrid artificial liver support system using a polyurethane foam/spheroid packed-bed module in a warm ischemic liver failure pig model for preclinical experiments.

We have reported the usefulness of a polyurethane foam packed-bed culture system of hepatocyte spheroids as a hybrid artificial liver support system (PUF-HALSS). The aim of this study was to evaluate in detail the efficacy in serum parameters regarding the liver function of a larger version of the PUF-HALSS containing 2 x 10(10) porcine hepatocytes for clinical use in warm ischemic liver failure pigs. Warm ischemic liver failure pigs weighing 25 kg were divided into two groups: (1) a control group (n = 3), in which each pig was attached to a PUF-HALSS without hepatocytes, and (2) a HALSS group (n = 3), in which each pig was attached to a PUF-HALSS. In the HALSS group, the increase of blood ammonia was completely suppressed and blood lactate levels were significantly suppressed. The Fisher's ratio was better maintained, and the increase of total bile acid, glycochenodeoxycholic acid, and taurochenodeoxycholic acid was significantly suppressed in the HALSS group. Serum creatinine levels were significantly lower, and blood glucose levels were significantly higher in the HALSS group. Serum levels of tumor necrosis factor- a were not elevated in either group. In conclusion, the larger version of the PUF-HALSS demonstrated many advantages as a liver support system in warm ischemic liver failure pigs.

Amino Acids↗

Efficacy of a polyurethane foam/spheroid artificial liver by using human hepatoblastoma cell line (Hep G2).

We invesigated the availability of human hepatoblastoma cell line (Hep G2), compared with human primary hepatocytes (HH) and porcine primary hepatocytes (PH), as a cell source for the hybrid artificial liver support system (HALSS) by using polyurethane foam (PUF). All three kinds of hepatocytes spontaneously formed spherical multicellular aggregates (spheroids) of 100-200 microm diameter in the pores of PUF within 3 days of culture. In a PUF stationary culture, Hep G2 spheroids recovered the ammonia removal activity that was lost in monolayer culture, although the removal for each unit cell number was about one tenth that of HH spheroids and about one eighth of PH spheroids. The synthesis activities of albumin and fibrinogen of each unit cell number of Hep G2 were also upregulated by PUF spheroid culture, and were about twice as high as in monolayer culture. The albumin secretion activity of Hep G2 spheroids was almost the same as that of PH spheroids. HH scarcely secreted these proteins in this experiment, probably because they were cultured in a serum-free medium. In the PUF module in a circulation culture, HH had high ammonia removal and low synthesis activities similar to stationary culture. Hep G2 proliferated to a high cell density, such as about 4.8 x 10(7) cells/cm3-module at 10 days of culture. Although Hep G2 spheroids had low ammonia removal activity in each cell, the removal rate in the PUF module was almost the same as for PH at 7 days of culture because of the high cell density culture by cell proliferation. The albumin secretion rate by Hep G2 in the PUF module also increased with cell proliferation and was about 10 times higher than the initial for the rate for PH at 7 days of culture. These results suggest that Hep G2 is a potential cell source PUF-HALSS.

Albumins↗

Effects of betamethasone, sulindac and quinacrine drugs on the inflammatory neoangiogenesis response induced by polyurethane sponge implanted in mouse.

In this study, we showed the effect of the betamethasone, sulindac and quinacrine alone or combined, on the inflammatory angiogenesis promoted by polyurethane sponge on mice. The main finding reported here is that the formation of new blood vessels was strongly inhibited by low concentration of betamethasone, sulindac or quinacrine, whether alone or in combination. It is known that steroidal anti-inflammatory drugs inhibit the enzymes required for the production of prostaglandins through a nuclear glucocorticoid receptor (GR) mediated mechanism. This mechanism may occur in endothelial cells as well. Considering that activity of cyclo-oxigenases 1 and 2 is inhibited by sulindac, and that these enzymes are located in the stromal tissue, we propose that the anti-angiogenic effect of these agents may occur via inhibition of both COX isoforms. On the other hand, quinacrine inhibited PLA2 activity, and we propose here that the anti-angiogenic effect occurs via inhibition of the enzyme PLA2. The potentiated effect of the association of betamethasone, sulindac and quinacrine may have some therapeutic benefit in the control of pathological angiogenesis. Further studies are required to validate these propositions.

Animals↗

Acute respiratory disorder, rhinoconjunctivitis and fever associated with the pyrolysis of polyurethane derived from diphenylmethane diisocyanate.

OBJECTIVES: A case is described of complex reactions associated with exposure to diphenylmethane diisocyanate (MDI), with some immunologic observations. METHODS: Medical history, clinical examinations, and analyses of immunologic parameters and the 4,4'-MDI-related amine 4,4'-diaminodiphenylmethane (MDA) in hydrolyzed serum and urine were used. RESULTS: The patient, a mechanic whose medical history suggested repeated attacks of a work-related pulmonary or systemic disease, was examined because of acute respiratory disorder, rhinoconjunctivitis, and a late systemic reaction after exposure to polyurethane pyrolysis products, including 4,4'-MDI (air level 15 micrograms.m3). Spirometry showed a partly reversible obstructive dysfunction, and a skin-prick test was positive versus isocyanates conjugated with human serum albumin (HSA). MDA was detected in hydrolyzed serum (5.6 ng.ml) and urine (1.6 micrograms.g creatinine-1). In serum, there were specific immunoglobulin (Ig) G (IgG1 and IgG4) and IgE antibodies to 4,4'-MDI-HSA and other isocyanates (phenylisocyanate, toluene diisocyanate, p-toluene monoisocyanate, hexamethylene diisocyanate) conjugated with HSA, a very high total IgE, a raised total IgG, and moderate neutrophilia and eosinophilia. The specific antibodies declined, but were still increased five years later. Furthermore, the values of circulating immune complexes were high. In vitro, the circulating immune complexes in serum increased after the addition of 4,4'-MDI-HSA. The patient had anti-Clq antibodies, which probably accounted for part of the circulating immune complexes. CONCLUSIONS: The reactions associated with MDI exposure (in combination with exposure to pyrolysis products) had features compatible with immediate hypersensitivity and with a complement-mediated immune-complex reaction.

Allergens↗

Determination of N-methylmorpholine in air samples from a polyurethane foam factory. Comparison between two methods using gas chromatography and isotachophoresis for analysis.

The N-methylmorpholine levels in workroom air in a polyurethane foam factory were determined by two methods in which midget impinger flasks were used for sampling. The analyses were performed by gas chromatography and isotachophoresis. The values obtained by the gas chromatographic method were 19% higher than those of the isotachophoretic method. Determinations of the amine in samples generated in laboratory experiments showed no statistical difference between the two methods. The mean air concentrations of N-methylmorpholine in different work areas of the factory ranged from 7 to 22 mg/m3. Urine was collected from seven workers and analyzed for N-methylmorpholine by gas chromatography. The amine concentrations and the excretion rates increased considerably during the workday.

Air Pollutants, Occupational↗

Charcoal sampling and gas chromatographic determination of N,N-dimethylformamide in air samples from a polyurethane plant.

A charcoal sampling method and a gas chromatographic determination of N,N-dimethylformamide in the air of a plant producing polyurethane lumps is described. The collection efficiency was checked by drawing standard N,N-dimethylformamide air mixtures through the sampling tube at 0.1 1/min and detecting the organic vapors spectrophotometrically at 215.4 nm. At 1,000 mg/m3, samplings could be carried out for 190 min with negligible N,N-dimethylformamide losses (lower than 1%). The analysis of N,N-dimethylformamide was performed by gas chromatography on Porapack Q and Tenax GC after extraction with 2 ml of acetone/100 mg of charcoal, with a mean recovery of 90 (SD 2) %, in the range of 0.05-0.5 mg of N,N-dimethylformamide/100 mg of charcoal. The relative standard deviation of the entire procedure was 3.5%. Because of the good adsorbing efficiency of the charcoal, short-term sampling could be carried out at a relatively high N,N-dimethylformamide concentration. Stationary and personal sampling resulted in mean values ranging between 1.26 and 1.60 mg/m3. The method is particularly suitable in instances where other pollutants are present, and therefore it can be used also for other work areas as well.

Adsorption↗

Augmentation mammaplasty--a further review of 20 years using the polyurethane-covered prosthesis.

Augmentation mammaplasty continues to attract much attention. So far, it seems to be an operation with an indefinite endpoint regarding the longevity of results. It is also a procedure that has wide monetary implications and would often seem to be inappropriately used. With the advent of the latest polyurethane-covered prostheses, marketed under various trade names such as Meme, Replicon, and Optimam, a more predictable result can be obtained, at least for the first 6 years. Much controversy still exists, and in view of this, the authors have revised their long-term results and comments on important current aspects.

Breast↗

In vitro evaluation of the calcification behavior of polyurethane biomaterials for cardiovascular applications.

Scope of the study is the calcification behavior of medical grade polyurethanes for cardiovascular devices. Within these applications, implant material calcification is a serious complication. The calcification behavior of these materials is investigated with a dynamic in vitro testing method for evaluating the influence of dynamic mechanical strain and parameters of the solubility of calcium salts.

Calcification, Physiologic↗

[Occupational sensitization to methylene diphenyl diisocyanate during the manufacture of polyurethane products].

A complex occupational hygienic and clinical allergologic investigation in a methylene-diphenyl diizocyanate (MDI)-based polyurethane products manufacture was carried out for the first time in this country. The average MDI concentrations for a shift are within the limits of TWA, but during short operations exceed STEL and reach 0.072-0.181 mg/m3. By clinical and immuno-allergologic methods, applied on 46 MDI-exposed workers and 42 controls, the sensibilizing effect on the respiratory system, skin and eyes was detected. The allergic reactions take the course of bronchial asthma (6.5%), rhinitis and rhinopharyngitis (37%), rhinosinusitis (13%), conjunctivitis (13%), and urticaria and dermatitis (17.4%), as in 12 cases (12%) the allergic illnesses are combined. The specific occupational sensibilization, proved by positive dermal allergy tests with MDI in 24 (52%) exposed workers, and increased MDI-IgE antibodies in 4 workers, is of high statistical reliability in comparison with the control group and supposes immune reactions of quick type (IgE) and mainly retarded type--cell mediated. Various prophylactic measures against the proven occupational sensibilization risk are proposed.

Adult↗

Polyurethane blended with polylactides for improved cell adhesion and reduced platelet activation.

Poly(L-lactide) (PLLA) or 50:50 poly(lactide-co-glycolide) (PLGA) was blended with a commercial polyurethane (PU), Pellethane 2103-80A, using a mutual solvent technique. After preparation by salt casting, the mechanical properties of the porous matrices were measured, and the surface element was characterized by electron spectroscopy for chemical analysis. The attachment and growth of fibroblasts as well as human umbilical vein endothelial cells on the substrates were investigated by the cell culture test. Platelet activation on different substrates was also studied. It was found that blending with these biodegradable polymers, especially PLGA. enhanced the cellular attachment and growth. This enhancement may be correlated with the higher oxygen/carbon (0/C) atomic ratio on the surface of the blends. Blending with either PLLA or PLGA was also found to decrease platelet adhesion and activation in vitro. These characteristics make PU/polylactide blends potential substrates for cardiovascular applications.

Absorbable Implants↗