In this dissertation, small and large NaCl particle-derived surfaces (Ra > 40 microns) were generated on 2D Zn materials, and the surfaces were carefully studied concerning topography, corrosion behavior, and bone cell compatibility. Increases in surface roughness accelerated the corrosion rate, and cell viability was maintained. This method was then extended to 3D porous scaffolds prepared by a hybrid AM/casting technique. The scaffolds displayed a near-net shape, an interconnected pore structure, increasing porosity paralleled to an increased corrosion rate, an ability to support cell growth, and powerful antibacterial properties. Lastly, nano/micro (Rz 0.02–1 microns) topographies were generated on 2D Zn materials, and the materials were comprehensively studied with special attention devoted to corrosion behavior, biocompatibility, osteogenic differentiation, immune cell response, hemocompatibility, and antibacterial performance. For the first time, the textured nonhemolytic surfaces on Zn were shown to direct cell fate, and the micro-textures promoted bone cell differentiation and directed immune cells away from an inflammatory phenotype.

Angioplasty, or the use of rapidly deploying stents, is a common treatment for reopening narrowed vasculature often caused by atherosclerotic plaque. However, in-stent restenosis (ISR) induced by intimal hyperplasia is a common challenge to angioplasty. High impact stresses from current stent deployment processes have been linked to intimal hyperplasia; thus a stent that is gradually deployed over a longer period of time holds potential to mitigate these stresses. This work hypothesizes that resorbable polymeric links can be used as a triggering mechanism to enable repeatably controlled deployment of a compliant nitinol stent design with the eventual goal of reducing intimal hyperplasia. The aims of this work include the structured design process and design validation of a stent intended to meet this challenge. A structured design process was used to develop a multi-stage, gradually deploying nitinol stent in which PDLG (DL-lactide/Glycolide copolymer) bioresorbable links constrained specific mechanical cells within the stent geometry, thus limiting initial deployment to an intermediate diameter and allowing for secondary gradual deployment as the PDLG degraded via a combination of bioresorption and creep. A finite element analysis was carried out to design the link geometry to hold the stent at an intermediate stage (90% of final diameter) upon initial deployment, and enable a gradual secondary deployment phase lasting several minutes. Prototypes were then manufactured and the design was validated in a flow chamber mimicking the conditions of human blood flow and temperature. Using a camera and image processing methods, the diameter increase of the stents was tracked over time to characterize the secondary gradual deployment process of the stents. Results showed the links constrained the stents to an initial ~90% diameter upon initial deployment, followed by a gradual, secondary deployment with an average 63.2% rise time of 16.2 minutes. Creep was observed to be the primary driver of the gradual deployment, followed by subsequent bioresorption of the material. All prototypes exhibited gradual secondary deployment without any visible delamination of the bioresorbable links from the stent struts. Based on these findings it can be concluded our hypothesis has been demonstrated, and that a feasible gradually deploying stent design has been mechanically validated, preparatory to pre-clinical studies of its efficacy. Prior to clinical application, future in vivo work is needed to compare actual ISR rates with this stent design to other commonly used stent designs in preclinical trials. In addition, further preclinical work is needed to compare ISR rates through several stent design parameters such as initial deployment diameter, gradual deployment rate, final deployment diameter, and stent sizes to give insights into the optimal stent design. We anticipate that this gradually expanding stent design could reduce in-stent restenosis and improve clinical outcomes.

While there is continuing interest in bioresorbable materials for orthopedic fixation devices, the major challenge in utilizing these materials in load-bearing applications is creating materials sufficiently stiff and strong to sustain loads throughout healing while maintaining fracture stability. The primary aim of this study is to quantify the degradation rate of a bioresorbable material system, then use this degradation rate to determine the material response of an orthopedic device made of the same material as healing progresses. The present research focuses on the development and characterization of a material system consisting of carbon foam infiltrated with hydroxyapatite (HA) reinforced poly(D,L-lactide)-co-poly(glycolide) (PDLGA). A processing technique is developed to infiltrate carbon foam with HA/PDLGA and material morphology is investigated. Additionally, short-term rat osteoblast cell studies are undertaken to establish a starting point for material biocompatibility. Degradation experiments are conducted to elicit the time-dependent properties of the material system at the material scale. These properties are then incorporated into computational models of an internal plate attached to a fractured human femur to design and predict the material response to applied physiological loads. Results from this work demonstrate the importance of material dissolution rate as well as material strength when designing internal fixation plates.

While there is continuing interest in bioresorbable materials for orthopedic fixation devices, the major challenge in utilizing these materials in load-bearing applications is creating materials sufficiently stiff and strong to sustain loads throughout healing while maintaining fracture stability. The primary aim of this study is to quantify the degradation rate of a bioresorbable material system, then use this degradation rate to determine the material response of an orthopedic device made of the same material as healing progresses. The present research focuses on the development and characterization of a material system consisting of carbon foam infiltrated with hydroxyapatite (HA) reinforced poly(D,L-lactide)-co-poly(glycolide) (PDLGA). A processing technique is developed to infiltrate carbon foam with HA/PDLGA and material morphology is investigated. Additionally, short-term rat osteoblast cell studies are undertaken to establish a starting point for material biocompatibility. Degradation experiments are conducted to elicit the time-dependent properties of the material system at the material scale. These properties are then incorporated into computational models of an internal plate attached to a fractured human femur to design and predict the material response to applied physiological loads. Results from this work demonstrate the importance of material dissolution rate as well as material strength when designing internal fixation plates.

No description available.

京都大学 / 新制・課程博士 / 博士(医学) / 甲第24966号 / 医博第5020号 / 新制||医||1069(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 江木 盛時, 教授 浅野 雅秀, 教授 湊谷 謙司 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

A Organização Mundial da Saúde (OMS) relata o câncer como uma das principais causas de morte no mundo. O câncer de próstata é o segundo tipo de câncer mais prevalente em homens, com cerca de 1,1 milhão de casos diagnosticados em 2012. Braquiterapia com iodo-125 é uma método de radioterapia que consiste na introdução de sementes com material radioativo no interior do órgão a ser tratado. As sementes de iodo-125 podem ser inseridas soltas ou em cordas poliméricas bioabsorvíveis, mais comumente o poli(ácido lático-co-ácido glicólico) (PLGA). A função do polímero é reduzir a possibilidade de migração das sementes, o que poderia ser prejudicial para órgãos e tecidos saudáveis. De modo a reduzir os custos do tratamento, a síntese dos dímeros L-lactídeo e glicolídeo, para posterior utilização para preparação do PLGA, por meio da polimerização por abertura de anel, é proposta neste trabalho. Adicionalmente, propõe-se a utilização do amino-alcóxido tris(fenolato) de zircônio (IV) como alternativa ao usual octanoato de estanho (SnOct2), uma vez que a toxicidade do estanho permanece como obstáculo na produção do PLGA para aplicações biomédicas. Embora o iniciador de zircônio seja mais lento do que o SnOct2, massas molares relativamente elevadas foram obtidas quando razões monômero/iniciador (M/I) de 1000/1 (24 h), e 5000/1 (48 h) foram utilizadas. Considerando que as unidades glicolila (GA) são mais reativas do que as unidades lactila (LA), tempos longos de reação são necessários para atingir uma razão LA/GA próxima do objetivo do trabalho (85/15). O grau de racemização também depende do iniciador utilizado. As reações de polimerização realizadas com o iniciador de zircônio mostraram um maior grau de racemização, quando comparadas com aquelas realizadas com o SnOct2. Também foi observado um ligeiro aumento na racemização com o tempo. Considerando os resultados obtidos na síntese e purificação dos dímeros, e na síntese do PLGA em condições semelhantes às industriais, foi possível preparar o polímero de alta massa molar com um custo dezenas de vezes inferior ao custo do PLGA no mercado internacional. Os efeitos da radiação gama no PLGA também foram estudados. Doses normalmente aplicadas para esterilizar materiais para aplicações biomédicas foram empregadas: 10, 18, 25 e 50 kGy. A massa molar de todas as amostras irradiadas diminuiu de uma forma proporcional à dose até 56% de perda para 10 kGy e 72% para 50 kGy porém, são menos pronunciadas para doses mais elevadas. Alterações nas propriedades térmicas, tais como temperatura de fusão, temperatura de transição vítrea e a entalpia de cristalização e fusão foram também observadas após a irradiação. / The World Health Organization (WHO), reports cancer a leading cause of death worldwide. Prostate cancer is the second most common cancer in men, with 1.1 million diagnoses in 2012. Brachytherapy is a method of radiotherapy where encapsulated radioactive sources (seeds) are placed inside or very close to the area requiring treatment. Iodine-125 seeds can be inserted loose or stranded in bioresorbable materials most commonly poly(lactic-co-glycolic) acid (PLGA). The main function of the polymer is to reduce the possibility of seeds migration, which could potentially harm healthy organs and tissues. In order to reduce the cost of the treatment, we propose in this work the synthesis of L-lactide and glycolide dimers, for the production of PLGA using the ring-opening polimerisation route. Additionally, we also propose the use of a Zr (IV) amine tris(phenolate) alkoxide initiator as an alternative to the usual SnOct2, which is still considered an unsolved problem for biomedical applications due to its toxicity. Although the zirconium alkoxide initiator is less active and slower than SnOct2, relatively high molecular weights were obtained at a temperature of 130°C, for a monomer to initiator ratio of 1000/1 (24 h), and 5000/1, in 48 h. Since glycolyl units are more reactive than lactyl counterpart, longer reaction times are needed to achieve a LA/GA ratio closer to the initial (85/15). The degree of racemisation of the polymer depended upon the initiator used. The reactions carried out with the zirconium initiator showed a higher degree of racemisation when compared to those carried out with SnOct2. A modest increase in the degree of racemisation with time was also observed. Considering the results obtained for the synthesis and purification of the dimers, and for the synthesis of PLGA under industrial-like conditions, we concluded that it was possible to produce a high molecular weight polymer that costs far less than the usual price of PLGA on the market. The effects of gamma radiation on PLGA were also studied. We used doses commonly applied to sterilise materials for biomedical applications: 10, 18, 25 and 50 kGy. All irradiated samples showed a reduction in the molecular weight in a dose dependent fashion - up to 56% loss for 10 kGy and 72% for 50 kGy - but these reductions were less pronounced for higher doses. Changes in thermal properties, such as melting point, glass transition temperature and enthalpy of crystallisation and fusion were also observed after irradiation.

Understanding, and ultimately, predicting the degradation of bioresorbable composites made of biodegradable polyesters and calcium-based ceramics is paramount in order to fully unlock the potential of these materials, which are heavily used in orthopaedic applications and also being considered for stents. A modelling framework which characterises the degradation of bioresorbable composites was generated by generalising a computational model previously reported in literature. The framework uses mathematical expressions to represent the interwoven phenomena present during degradation. Three ceramic-specific models were then created by particularising the framework for three common calcium-based fillers, namely tricalcium phosphate (TCP), hydroxyapatite (HA) and calcium carbonate (CC). In these models, the degradation of a bioresorbable composite is described with four parameters: the non-catalytic and auto-catalytic polymer degradation rates, $k_1$ and $k_2'$ respectively and the ceramic dissolution rate and exponent, $A_\text{d}$ and $\theta$ respectively. A comprehensive data mining exercise was carried out by surveying the existing literature in order to obtain quantitative degradation data for bioresorbable composites containing TCP, HA and CC. This resulted in a database with a variety of case studies. Subsequently, each case study was analysed using the corresponding ceramic-specific model returning a set of values for the four degradation constants. Both cases with agreement and disagreement between model prediction and experimental data were studied. 76% of the 107 analysed case studies displayed the expected behaviour. In general terms, the analysis of the harvested data with the models showed that a wide range of degradation behaviours can be attained using different polymeric matrix - ceramic filler combinations. Furthermore, the existence of discrepancies in degradation behaviour between a priori similar bioresorbable composites became apparent, highlighting the high number of hidden factors affecting composite degradation such as polymer tacticity or ceramic impurities. The analysis of the case studies also highlighted that the ceramic dissolution rate needed to depict the portrayed degradation behaviours is significantly higher than that reported for ceramics alone in dissolution studies under physiological conditions, indicating that studies of the filler elements alone do not provide a complete picture. Lastly, the computational analysis provided insight into the complex influence of factors such as sample porosity and degradation protocol in the degradation behaviour. In addition to the computational analysis of literature data, an experimental degradation study was carried out with nanocomposites made of calcium carbonate and poly(D,L-lactide-co-glycolide). This study showed the existence of a clear buering effect with the addition of the ceramic filler and confirmed the assumptions employed in the modelling framework in this particular bioresorbable composite. The detailed nature and modest size of these data enabled a more precise and thorough analysis using the CC composites degradation model. In summary, the modelling framework is able to capture the main degradation behaviour of bioresorbable composites and also point to factors responsible for dissimilar behaviours. The degradation maps generated with the values of $k_1$, $k_2'$, $A_\text{d}$ and $\theta$ output by the models appear to be a good tool to summarise, classify and facilitate the analysis and search of specific bioresorbable composites.

A Organização Mundial da Saúde (OMS) relata o câncer como uma das principais causas de morte no mundo. O câncer de próstata é o segundo tipo de câncer mais prevalente em homens, com cerca de 1,1 milhão de casos diagnosticados em 2012. Braquiterapia com iodo-125 é uma método de radioterapia que consiste na introdução de sementes com material radioativo no interior do órgão a ser tratado. As sementes de iodo-125 podem ser inseridas soltas ou em cordas poliméricas bioabsorvíveis, mais comumente o poli(ácido lático-co-ácido glicólico) (PLGA). A função do polímero é reduzir a possibilidade de migração das sementes, o que poderia ser prejudicial para órgãos e tecidos saudáveis. De modo a reduzir os custos do tratamento, a síntese dos dímeros L-lactídeo e glicolídeo, para posterior utilização para preparação do PLGA, por meio da polimerização por abertura de anel, é proposta neste trabalho. Adicionalmente, propõe-se a utilização do amino-alcóxido tris(fenolato) de zircônio (IV) como alternativa ao usual octanoato de estanho (SnOct2), uma vez que a toxicidade do estanho permanece como obstáculo na produção do PLGA para aplicações biomédicas. Embora o iniciador de zircônio seja mais lento do que o SnOct2, massas molares relativamente elevadas foram obtidas quando razões monômero/iniciador (M/I) de 1000/1 (24 h), e 5000/1 (48 h) foram utilizadas. Considerando que as unidades glicolila (GA) são mais reativas do que as unidades lactila (LA), tempos longos de reação são necessários para atingir uma razão LA/GA próxima do objetivo do trabalho (85/15). O grau de racemização também depende do iniciador utilizado. As reações de polimerização realizadas com o iniciador de zircônio mostraram um maior grau de racemização, quando comparadas com aquelas realizadas com o SnOct2. Também foi observado um ligeiro aumento na racemização com o tempo. Considerando os resultados obtidos na síntese e purificação dos dímeros, e na síntese do PLGA em condições semelhantes às industriais, foi possível preparar o polímero de alta massa molar com um custo dezenas de vezes inferior ao custo do PLGA no mercado internacional. Os efeitos da radiação gama no PLGA também foram estudados. Doses normalmente aplicadas para esterilizar materiais para aplicações biomédicas foram empregadas: 10, 18, 25 e 50 kGy. A massa molar de todas as amostras irradiadas diminuiu de uma forma proporcional à dose até 56% de perda para 10 kGy e 72% para 50 kGy porém, são menos pronunciadas para doses mais elevadas. Alterações nas propriedades térmicas, tais como temperatura de fusão, temperatura de transição vítrea e a entalpia de cristalização e fusão foram também observadas após a irradiação. / The World Health Organization (WHO), reports cancer a leading cause of death worldwide. Prostate cancer is the second most common cancer in men, with 1.1 million diagnoses in 2012. Brachytherapy is a method of radiotherapy where encapsulated radioactive sources (seeds) are placed inside or very close to the area requiring treatment. Iodine-125 seeds can be inserted loose or stranded in bioresorbable materials most commonly poly(lactic-co-glycolic) acid (PLGA). The main function of the polymer is to reduce the possibility of seeds migration, which could potentially harm healthy organs and tissues. In order to reduce the cost of the treatment, we propose in this work the synthesis of L-lactide and glycolide dimers, for the production of PLGA using the ring-opening polimerisation route. Additionally, we also propose the use of a Zr (IV) amine tris(phenolate) alkoxide initiator as an alternative to the usual SnOct2, which is still considered an unsolved problem for biomedical applications due to its toxicity. Although the zirconium alkoxide initiator is less active and slower than SnOct2, relatively high molecular weights were obtained at a temperature of 130°C, for a monomer to initiator ratio of 1000/1 (24 h), and 5000/1, in 48 h. Since glycolyl units are more reactive than lactyl counterpart, longer reaction times are needed to achieve a LA/GA ratio closer to the initial (85/15). The degree of racemisation of the polymer depended upon the initiator used. The reactions carried out with the zirconium initiator showed a higher degree of racemisation when compared to those carried out with SnOct2. A modest increase in the degree of racemisation with time was also observed. Considering the results obtained for the synthesis and purification of the dimers, and for the synthesis of PLGA under industrial-like conditions, we concluded that it was possible to produce a high molecular weight polymer that costs far less than the usual price of PLGA on the market. The effects of gamma radiation on PLGA were also studied. We used doses commonly applied to sterilise materials for biomedical applications: 10, 18, 25 and 50 kGy. All irradiated samples showed a reduction in the molecular weight in a dose dependent fashion - up to 56% loss for 10 kGy and 72% for 50 kGy - but these reductions were less pronounced for higher doses. Changes in thermal properties, such as melting point, glass transition temperature and enthalpy of crystallisation and fusion were also observed after irradiation.

京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第21682号 / 医博第4488号 / 新制||医||1036(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 妻木 範行, 教授 大森 孝一, 教授 別所 和久 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM