No description available.

<p>Inflammation and the formation of an avascular fibrous capsule have been identified as the key factors controlling the wound healing associated failure of implantable glucose sensors. Our aim is to guide advantageous tissue remodeling around implanted sensor leads by the temporal release of dexamethasone (Dex), a potent anti-inflammatory agent, in combination with the presentation of a stable textured surface. </p><p>First, Dex-releasing polyurethane porous coatings of controlled pore size and thickness were fabricated using salt-leaching/gas-foaming technique. Porosity, pore size, thickness, drug release kinetics, drug loading amount, and drug bioactivity were evaluated. In vitro sensor functionality test were performed to determine if Dex-releasing porous coatings interfered with sensor performance (increased signal attenuation and/or response times) compared to bare sensors. Drug release from coatings monitored over two weeks presented an initial fast release followed by a slower release. Total release from coatings was highly dependent on initial drug loading amount. Functional in vitro testing of glucose sensors deployed with porous coatings against glucose standards demonstrated that highly porous coatings minimally affected signal strength and response rate. Bioactivity of the released drug was determined by monitoring Dex-mediated, dose-dependent apoptosis of human peripheral blood derived monocytes in culture. </p><p>The tissue modifying effects of Dex-releasing porous coatings were accessed by fully implanting Tygon® tubing in the subcutaneous space of healthy and diabetic rats. Based on encouraging results from these studies, we deployed Dex-releasing porous coatings from the tips of functional sensors in both diabetic and healthy rats. We evaluated if the tissue modifying effects translated into accurate, maintainable and reliable sensor signals in the long-term. Sensor functionality was accessed by continuously monitoring glucose levels and performing acute glucose challenges at specified time points. </p><p>Sensors treated with porous Dex-releasing coatings showed diminished inflammation and enhanced vascularization of the tissue surrounding the implants in healthy rats. Functional sensors with Dex-releasing porous coatings showed enhanced sensor sensitivity over a 21-day period when compared to controls. Enhanced sensor sensitivity was accompanied with an increase in sensor signal lag and MARD score. These results indicated that Dex-loaded porous coatings were able to elicit a favorable tissue response, and that such tissue microenvironment could be conducive towards extending the performance window of glucose sensors in vivo.</p><p>The diabetic pilot animal study showed differences in wound healing patters between healthy and diabetic subjects. Diabetic rats showed lower levels of inflammation and vascularization of the tissue surrounding implants when compared to their healthy counterparts. Also, functional sensors treated with Dex-releasing porous coatings did not show enhanced sensor sensitivity over a 21-day period. Moreover, increased in sensor signal lag and MARD scores were present in porous coated sensors regardless of Dex-loading when compared to bare implants. These results suggest that the altered wound healing patterns presented in diabetic tissues may lead to premature sensor failure when compared to sensors implanted in healthy rats.</p> / Dissertation

Les biopiles enzymatiques miniatures représentent un potentiel important pour la future génération de dispositifs médicaux implantables, utilisés pour le diagnostic, le pronostic et le traitement. Ces derniers fonctionnent actuellement avec des sources d'énergie externes. Ces biopiles utilisant les molécules présentes dans les fluides biologiques sont des dispositifs médicaux prometteurs. Le glucose, qui est abondamment disponible dans le corps, est à l’étude comme biocarburant permettant de produire de l’énergie. Les enzymes utilisées pour produire l'énergie à partir des produits biochimiques sont immobilisées sur des électrodes en or par des médiateurs redox. Cependant, la faible puissance actuellement disponible et la sensibilité des enzymes à l'environnement limitent leur application in vivo. Malgré des recherches intensives, de nombreux problèmes restent à résoudre, notamment l'amélioration de la puissance, de la stabilité et de la biocompatibilité des biopiles.La réaction à corps étranger et l'isolement du dispositif médical par la formation d'une capsule fibreuse peuvent d'une part dénaturer les enzymes et, d'autre part, entraver la diffusion des analytes et de l'oxygène. Le travail décrit dans cette thèse vise à protéger les biopiles fonctionnant à base de glucose. Afin de résoudre les problèmes mentionnés ci-dessus, les hydrogels, actuellement développés pour diverses applications telles que l'administration de médicaments, l'ingénierie tissulaire et les dispositifs médicaux, offrent des propriétés prometteuses en tant que matériaux de revêtement.La première partie de la thèse est centrée sur l'évaluation de différents hydrogels injectables de faible poids moléculaire, en analysant à la fois la gélification in vitro et in vivo, la cinétique de dégradation, la réaction à corps étranger et l'angiogenèse. Les hydrogels présentent une dégradation lente et une intégration tissulaire optimale. Une angiogenèse accrue a été observée en raison de la libération d'une molécule pro-angiogénique pendant la dégradation de l'hydrogel.Dans la seconde partie de la thèse, l'un des hydrogels étudiés a été utilisé pour recouvrir l'électrode en or : le choix de l'enzyme a été basé sur des études de stabilité in vitro. En parallèle, le processus de revêtement a été optimisé, à la fois pour son uniformité et son épaisseur. Même si un revêtement plus épais présente l’avantage de protéger l’électrode contre la réaction à corps étranger, il est nécessaire de limiter l’épaisseur afin de maintenir une diffusion efficace des analytes et de l’oxygène.Les expériences en cours décrites dans la dernière partie de la thèse sont axées sur l'optimisation de l'implantation chez le rat et la mesure de l'activité des biopiles. De plus, les électrodes ont été connectées à une antenne pour établir une communication sans fil ; en effet, cela permettrait une mesure non invasive de l'activité enzymatique.En conclusion, ces travaux ont permis d'identifier un hydrogel pouvant être utilisé pour revêtir les électrodes de biopiles. Le sous-produit libéré lors de la biodégradation favorise l'angiogenèse au voisinage du matériau. Grâce à ce revêtement, on peut donc s'attendre à un échange accru d'analytes et d'oxygène, préalable indispensable à l'activité enzymatique. / Miniature enzymatic biofuel cells hold great potential to power the future generation of implantable medical devices, which are currently working on external power sources used for diagnosis, prognosis and treatment. Enzymatic biofuel cells appear to be promising in harvesting the energy from biochemicals present in physiological body fluids. Glucose, which is abundantly available in the body, is being explored as a biofuel to harvest energy. The enzymes employed to harvest the energy from the biochemicals are electrically wired on gold electrodes by redox mediators. However, the limitation of insufficient power, and the sensitivity of the enzymes towards host environment restrict their in vivo application. Despite several attempts, numerous challenges remain to be addressed such as improved current density, increased stability, and biocompatibility of enzymatic biofuel cells.Foreign body reaction and isolation of the medical device by formation of a fibrous capsule may firstly denature the enzymes, and secondly hinder the diffusion of analytes and oxygen. The work described in this thesis aims at protecting glucose based biofuel cells. As a strategy for combatting the bottlenecks mentioned above, hydrogels, currently developed for various applications such as drug delivery, tissue engineering, and medical device, offer promising properties as coating materials.The first part of the thesis is focused on evaluating different low molecular weight injectable hydrogels by analysing both in vitro and in vivo gel formation, degradation kinetics, foreign body reaction and angiogenesis. The hydrogels exhibit slow degradation, and optimal tissue integration. Enhanced angiogenesis was observed due to a pro-angiogenic molecule released during hydrogel degradation.In the second part of the thesis, one of the studied hydrogels was used to coat the gold electrode functionalised with enzyme: the selection of the enzyme was based on in vitro stability studies. In parallel, the process of coating was optimised, both for uniformity and thickness. Although a thicker coating should protect the electrode against foreign body reaction, it was necessary to limit the thickness in order to maintain an efficient analyte and oxygen diffusion.Ongoing experiments described in the last part of the thesis are focused on the optimisation of implantation in rat and measurement of the biofuel cell activity. In addition, the electrodes were connected to an antenna for wireless communication; indeed, such a device would allow for a non-invasive measurement of enzyme activity.To conclude, this work allowed for the identification of a hydrogel that can be used to coat the electrodes of biofuel cells. The byproduct released during the biodegradation favours angiogenesis in the vicinity of the material. Thanks to this coating, we can therefore expect an enhanced exchange of analytes and oxygen, which is a prerequisite for enzyme activity.

<p>Many implanted devices fail due to the formation of an avascular capsule. Fat is known to promote healing and vascularization. It is possible that isolating and attaching ASCs (adipose stem cells) to an implanted device improves the healing in the adjacent tissue. </p><p> Various attachment methods were studied, and the fibronectin treatment was found comparable to or better than other treatments. Next, bare and ASC coated polyurethane were implanted into rats. The fibrous capsule surrounding the bare polyurethane was thicker and contained more collagen at 8 weeks. Additionally, the microvessel density in the tissue surrounding the ASC coated polyurethane was significantly higher at 4 and 8 weeks. Quantification of glucose sensor response following ASC attachment for 1 week found no measurable significant differences in function.</p><p> The bioluminescence technique, which quantifies the tissue glucose concentration around the implant at the moment of freezing, was used to determine if ASC attachment to biomaterials impacts the tissue glucose concentration profile. ASC attachment to polyurethane and to glucose sensors did not significantly change the glucose profiles in the tissue. However, a quantifiable glucose concentration profile was observed around all glucose sensors.</p><p> The final experiments were performed to identify a possible mechanism that adipose tissue uses to alter the foreign body response. In vitro experiments showed that VEGF (VEGF-A specifically) secretion following ASC attachment to polyurethane was 10-20 times higher than with fibroblast attachment after three days and 40-70 times higher after six days. This high secretion of VEGF would likely have in vivo physiological affects on microvasculature.</p><p> In conclusion, the attachment of ASCs to polyurethane reduced the thickness and collagen content of the fibrous capsule surrounding ASC coated implants and increased the microvessel density in adjacent tissue. In addition, ASC attachment did not enhance glucose sensor function, nor did it decrease the glucose concentration in the adjacent tissue. Finally, ASCs were found to secrete high amounts of pro-vascular cytokines, which likely plays a key role in the observed improvement of the foreign body response.</p> / Dissertation

Cholesterol crystals have been linked to activation of the NLRP3 inflammasome and the formation of foreign body giant cells (FBGCs). It has been hypothesized that FBGCs have a role in advanced atherosclerotic plaque formation. This thesis examined the feasibility of producing stable cultures of FBGCs starting with human monocytes with the goal to examine pterin production by these cells in comparison to human monocyte derived macrophages (HMDMs). The study also investigated the effect of cholesterol crystals on 7,8-dihydroneopterin (7,8-NP) production and modulation of IL-1β levels in macrophages. 7,8-Dihydroneopterin is a potent antioxidant generated by macrophages which also down regulates the expression of macrophage scavenger receptor CD36. The use of alpha-tocopherol and IL-4 as FBGC fusion mediators was explored. Using these mediators, large numbers of FBGC were successfully cultured. The rates of fusion achieved in the cultures were low, and the cells had poor adhesion, which prevented pterin measurement. FBGC, which are thought to remove crystallized cholesterol from the plaque, cleared 21% of cholesterol crystal compared to 50% cleared by HMDM cells. Due to this result, the effect of cholesterol crystals on pterin production in monocytes and macrophages was explored. Cholesterol crystals cause inflammation through the activation of the NLRP3 inflammasome, however, it was unknown whether they could modulate 7,8-NP production. Cholesterol crystals caused an intracellular dose-dependent loss of 7,8-NP to its oxidized form, neopterin, in HMDM cells. Cholesterol crystals induced intracellular synthesis of 7,8-NP in HMDMs. 7,8-NP was released into the supernatant and oxidized to neopterin in media. Monocytes treated with cholesterol crystals released up to 100 nM of neopterin and 120 nM of 7,8-NP in the media after 48 hours. The combination of IFN- and cholesterol crystals appeared to inhibit the release of 7,8-NP into the media for the first 48 hours, after this time 7,8-NP release rapidly increased. The addition of exogenous 200 μM 7,8-NP showed that in the presence of monocytes, cholesterol crystals did not cause the oxidation of 7,8-NP to neopterin, as seen in HMDMs but possibly to 7,8-dihydroxanthopterin or xanthopterin. The presence of 7,8-NP increased IL-1β expression in the presence of cholesterol crystals after 24 hours incubation. FBGCs and the removal of cholesterol crystals may be a key process in the resolution of atherosclerotic plaques. It appears that cholesterol crystals are able to modulate inflammatory processes including activation of the inflammasome and balance of 7,8-dihydroneopterin to the oxidized neopterin. The infiltrating monocytes may provide antioxidant protection against the inflammation induced by cholesterol crystals and the activity of the infammasome.

This MEng (Master of Engineering) research thesis evaluates the capabilities and limitations of line-scan thermography for the non-destructive evaluation of composite structures containing hidden defects. In simple terms, line-scan thermography is a state-of-the-art technique in which a focused line of thermal energy is transmitted into a material. Line-scan thermography has great potential for the rapid and low cost non-destructive inspection of composite structures for aircraft, automobiles and ships. In this project, theoretical research exploring the heat transfer physics was undertaken in conjunction with experimental studies to develop an optimum inspection regime for line-scan thermography. The capability of line-scan thermography to detect impact damage in carbon/epoxy laminates was experimentally investigated in Chapter 3. From the impact side, in all materials, line-scan thermography overestimated the size of the impact damage whereas flash thermography underestimated the size. There was a close relationship between the ultrasonic profile and the line-scan thermographic thermal response curve. New experimental data has been produced and analysed for the ability of line-scan thermography to determine the defect as well as the defect size. It was found that line-scan thermography was able to distinguish back drilled holes, but it was not possible to determine accurate defect sizing due to the depth of the holes from the inspected surface and the limitations associated with the line-scan thermographic apparatus itself. There was excellent correlation between the C-scan ultrasonics intensity curves and the line-scan thermographs as well as excellent correlation with the theoretical results. The relationship between line-scan thermography and foreign body objects were experimentally investigated for carbon/epoxy composites. A major limitation found with line-scan thermography is its limited depth penetration, which is highlighted in the foreign object study using 6 mm and 13 mm diameter Teflon® discs and 13 mm Teflon® strips embedded in carbon/epoxy laminates. Depth penetration allowed only 2 mm resolution for the 13 mm diameter discs and 1.5 mm resolution for the 6 mm discs in a composite panel. The results of the investigation of stainless steel shim objects in carbon/epoxy laminates reveal that line-scan thermography is capable of determining their presence and size close to the surface. There was also excellent correlation between the ultrasonic response curve and the line-scan thermographic intensity curve. The results of the investigation of thermoplastic film foreign body objects in carbon/epoxy laminates show that at present line-scan thermography does not have the capability to determin e such defects. Experimental results show that line-scan thermography is capable of detecting large voids, back drilled holes, some foreign body objects, and impact damage. However, the ability of line-scan thermography to measure the defect dimensions is dependent on the size and type of damage, the distance from the line source, the depth of the defect, and the type of composite material.

Thesis (Ph. D.)--University of Washington, 2004. / Vita. Includes bibliographical references (leaves 113-116).

Coins occasionally cause health problems. These have a wide range of presentations and can affect multiple organ systems. This article presents a review of the medical literature addressing health problems caused by coins. These problems can be categorized as follows: (1) respiratory manifestations of ingested coins, (2) gastrointestinal manifestations of swallowed coins, (3) systemic effects of swallowed coins, (4) clinical management of swallowed coins, (5) allergic manifestations of coin exposure, and (6) miscellaneous health issues related to swallowed coins.

No description available.

The dermal filler Sculptra® has been employed to treat facial volume loss and age-related wrinkles in Europe since 1999. Sculptra® injections were administered 87,946 times (increase of 25.7% to 2012) in the USA in 2013. Except for histological analysis and clinical reports, data based on molecular biology or biochemistry, enlightening the mechanisms of action, do not exist to date. In contrast, such data are available for cross-linked hyaluronic acid, which is also administered for facial augmentation. To overcome this gap of knowledge, a comprehensive study about macroscopic to microscopic events occurring after Sculptra® injections was conducted. The augmentation of facial tissue with Sculptra® is approved; however, as the required repetitive biopsies could not be taken from the face, Sculptra® was injected to the inner side of the upper arms of 21 volunteers. Furthermore, this “off label use” was documented: The effect of the injections on the volunteer’s subjective quality of life was investigated using a questionnaire. For objective evaluation, the upper arms were photographed and sonographic measurements were applied. Photos of the treated upper arms revealed no changes in their shape during the study course. The amount of Sculptra® administered was not sufficient to augment the upper arms of postmenopausal women. Furthermore, these applied Sculptra® treatments of the upper arm did not improve the volunteers’ quality of life significantly. Upon sonographic measurement, however, a highly significant decrease in echogenicity was retrieved by comparing baseline subepidermal tissue values (t0) with 20 month (t2) values from either arm. Upon comparison of both treated sides, echogenicity was comparable; therefore 22 MHz sonography is an objective non-invasive measure to document the subcutaneous effect of Sculptra®. Immunofluorescence staining of sections from biopsies characterised the cell infiltrate and collagen type. CD68+ macrophages were found in direct proximity to PLLA, CD90+ fibroblasts aligned adjacently, while αSMA positive structures indicated myofibroblasts and neovascularisation. Substantial collagen type III deposition was detected right next to PLLA particles and collagen type I in the periphery of a given PLLA encapsulation. mRNA expression was strongly up-regulated for collagen type I and III transcripts, as well as for TGFß1 and TIMP1. PLLA particles were still retrievable 28 months after subcutaneous application. The augmenting effect of Sculptra® is generated by a complex reaction, comprised of various cells, chemokines and cytokines, leading to the proliferation of fibroblasts and their differentiation into myofibroblasts, synthesising a substantial amount of collagen in order to restore subcutaneous volume deficiencies. Degradation of facial and extra facial PLLA particles is considerably slower than described previously. The augmenting effect of Sculptra® diminishes over a period of 18-20 months in the face, but the degradation of PLLA particles seems to be much slower. Whether Sculptra® stimulates the synthesis of other ECM components, such as HA, or rationalises a continuous stimulus for collagen production, at least as long as it is not synthesised, should be analysed in further studies.