Influence of surface morphology and chemistry on the enzyme catalyzed biodegradation of polycarbonate-urethanes

Polycarbonate based polyurethanes were synthesized with varying hard segment content as well as hard segment chemistry based on three different diisocyanates,1,6-hexane diisocyanate (HDI), 4.4'-methylene bisphenyl diisocyanate (MDI) and 4,4-methylene biscyclohexyl diisocyanate (HMDI). The surface chemistry and morphology were characterized using X-ray photoelectron spectroscopy (XPS) and atomic force microscopy (AFM). The polymers were incubated with cholesterol esterase (CE) in a phosphate buffer solution at 37 degrees C over 10 weeks. XPS results showed that the surface chemistry changed as the size and chemistry of the hard segment varied within the materials. AFM images exhibited distinctive surface morphologies for all polymers, and this was particularly apparent with changes in the hard segment chemistry. The results showed that the surface of HDI polymers consisted of relatively stiff rod-like structures, which corresponded to the soft segment domains. Polymers with a higher HDI content exhibited a dense top layer containing a relatively higher hard segment component, covering the sub-surface matrix of rod like structures. The MDI based polyurethane had large aggregates on its top surface, which corresponded to the aggregation of harder components. The HMDI based polycarbonate-urethane presented a relatively homogeneous surface where no phase separation could be detected. The relative differences in hard and soft segment content in their surface structure was supported by XPS findings. The analysis of the biodegradation results, concluded that enzyme catalyzed biodegradation within these materials was initiated in amorphous soft segment regions located in the region of the interface between hard and soft segments. A higher hard segment content at the surface contributed significantly to an increase in biostability. The findings provided an enhanced understanding for the role of surface molecular structure in the enzyme catalyzed biodegradation of polyurethanes.     

Differential response to chemically altered polyethylene by activated mature human monocyte-derived macrophages

Macrophages and polyethylene (PE) particulate are currently recognized as being the two common denominators in the development of chronic inflammation, periprosthetic osteolysis, and subsequent implant failure. In this study, the effect of PE particulate surface chemistry on mature human monocyte-derived macrophage (MDM) function was investigated. Virgin high-density PE (HDPE: 4-10 microm) and HDPE oxidized by irradiation, thermal and chemical treatment were characterized by FT-IR and suspended in soluble type I collagen, which was subsequently solidified on glass coverslips. Human MDMs, derived from differentiating monocytes on polystyrene for 14 days, were trypsinized and cultured on collagen-particle substrata and collagen controls for 31 days. Analysis of conditioned media collected at 24h incubation showed a significantly higher level of IL-1beta secretion in virgin HDPE over oxidized HDPE or collagen controls, and a significant inhibition of IL-6 secretion in both virgin and oxidized samples. Esterase activity was increased in the medium at a significantly higher level in the virgin HDPE versus controls with the highest activity observed in oxidized HDPE at 31 days. These results illustrate the effect of PE particle surface chemistry (oxidation) on MDM cytokine secretion and esterase activity, and highlight the need to further investigate the potential of PE surface chemistry on modulating MDM function.     

Biological characterization of a novel biodegradable antimicrobial polymer synthesized with fluoroquinolones.

Biomaterial-related infections continue to represent a significant challenge to the medical community. Several approaches have been utilized to incorporate antimicrobial agents at the surface of implant devices in attempts to delay or eliminate the formation of biofilms. To date, most of these strategies have focused on drug conjugation or diffusion-limited systems for the delivery of such pharmaceutical agents. More recently, work has been presented on the feasibility of incorporating drugs into the backbone of polymers as a main-chain monomer. When sequenced into the backbone of the polymer with other monomers that are hydrolytically sensitive to enzyme-catalyzed breakdown, it is thought that drugs may be able to be selectively released. Specifically, degradable polyurethanes have been synthesized with fluoroquinolone antibiotics and have shown an ability to kill bacteria when released following degradation of the polymer chains by the macrophage-derived enzyme cholesterol esterase. However, specificity of the cleavage sites in the polymer was difficult to control. Since cholesterol esterase has specificity for hydrophobic moieties, it is desirable to alter the formulation of the polyurethanes to incorporate long hydrophobic monomers immediately adjacent to the ciprofloxacin molecule. Hence, the current study focuses on evaluating the enzyme-catalyzed degradation of a degradable polyurethane synthesized with 1,12 diisocyanatododecane as a substitute for 1,6 diisocyanatohexane, which was used in previous work. Validation of specific ciprofloxacin release and the generation of antimicrobial are shown. A preliminary cell study to assess the cytotoxicity of this biodegradable antibiotic polymer shows that the material has no observable effects on cell proliferation or cell membrane structure.     

Insulin synthesis in a clonal cell line of simian virus 40-transformed hamster pancreatic beta cells.

A clonal hamster beta cell line (HIT) was established by simian virus 40 transformation of Syrian hamster pancreatic islet cells. Cytoplasmic insulin was detected in all cells by indirect fluorescent antibody staining, and membrane-bound secretory granules were observed ultrastructurally. Acidified-ethanol extracts of HIT cell cultures contained hamster insulin as determined by radioimmunoassay, radioreceptor assay, and bioassay. One subclone at passage 39 contained 2.6 micrograms of insulin per mg of cell protein. [3H]Leucine-labeled HIT insulin and proinsulin were identical to islet-derived proteins when compared by NaDodSO4/polyacrylamide gel electrophoresis of immunoprecipitates. HIT cell insulin secretion was stimulated by glucose, glucagon, and 3-isobutyl-1-methylxanthine. Insulin secretion at optimal glucose concentration (7.5 mM) was 2.4 milliunits per 10(6) cells per hr. Somatostatin and dexamethasone markedly inhibited HIT insulin secretion. The HIT cell line represents a unique in vitro system for studying beta cell metabolism and insulin biosynthesis.     

Establishing a gingival fibroblast phenotype in a perfused degradable polyurethane scaffold: Mediation by TGF-β1, FGF-2, β1-integrin,and focal adhesion kinase

Medium perfusion has been shown to enhance cell proliferation and matrix protein production. In more recent work, under perfusion, a degradable/polar/hydrophobic/ionic polyurethane (D-PHI) scaffold was shown to enhance growth and production of collagen by human gingival fibroblasts (HGFs). However, the nature of the HGFs cultured in the perfused D-PHI scaffolds, and the mechanisms by which medium perfusion activates these cells to facilitate proliferation and collagen production are not defined. The current study sought to investigate HGF interaction within the D-PHI scaffolds under perfusion by examining the production and the spatial distribution of α-smooth muscle actin (α-SMA) and type I collagen (Col I), the secretion of transforming growth factor (TGF)-β1 and basic fibroblast growth factor (FGF-2) in the conditioned medium, with a goal of defining the mechanistic pathways affecting the production of these markers in the dynamic culture. It was found that the perfused D-PHI scaffold shifted the HGF phenotype from myofibroblast-like (upregulation of α-SMA) to fibroblast-like (downregulation of α-SMA) over the course of 28 days. Both TGF-β1 and FGF-2 were significantly greater in the dynamic vs. static culture at day 1. Although TGF-β1 has been often reported to increase α-SMA and collagen expression, the D-PHI material and significant high level of FGF-2 at day 1 of dynamic culture appear to play a role in regulating α-SMA production while allowing HGFs to increase Col I production. β1-integrin production was increased and focal adhesion kinase (FAK) were activated 2 h after HGFs were exposed to medium perfusion, which may have in part promoted cell growth, α-SMA and Col I production in the early dynamic culture. Consequently, the D-PHI material and medium perfusion has modulated fibroblast phenotype, and enhanced cell growth and Col I production through the coordinated actions of TGF-β1, FGF-2, β1-integrin and FAK.     

Hallmarks of Metabolic Reprogramming and Their Role in Viral Pathogenesis

Metabolic reprogramming is a hallmark of cancer and has proven to be critical in viral infections. Metabolic reprogramming provides the cell with energy and biomass for large-scale biosynthesis. Based on studies of the cellular changes that contribute to metabolic reprogramming, seven main hallmarks can be identified: (1) increased glycolysis and lactic acid, (2) increased glutaminolysis, (3) increased pentose phosphate pathway, (4) mitochondrial changes, (5) increased lipid metabolism, (6) changes in amino acid metabolism, and (7) changes in other biosynthetic and bioenergetic pathways. Viruses depend on metabolic reprogramming to increase biomass to fuel viral genome replication and production of new virions. Viruses take advantage of the non-metabolic effects of metabolic reprogramming, creating an anti-apoptotic environment and evading the immune system. Other non-metabolic effects can negatively affect cellular function. Understanding the role metabolic reprogramming plays in viral pathogenesis may provide better therapeutic targets for antivirals.     

The inequity of Medicaid reimbursement in the United States

The United States Medicaid programme aims to provide public health insurance to certain categories of the low-income population. Considerable non-uniformity exists within the programme because each of the 50 states, Washington, DC and 5 territories are individually responsible, within broad federal guidelines, for its administration. The non-uniformity shows up in different eligibility requirements, benefits and health care provider reimbursement rates. This paper examines reimbursement rate variations across individual programmes and discusses how these variations affect health care provider participation. Dual market theory suggests, and empirical results conclude that low reimbursement rates cause health care providers to participate less fully in the programme. Variations in access to medical care because of differences in reimbursement rates thereby create severe horizontal and vertical inequities across programmes. To reduce these inequities, the federal government might offer earmarked grants for the mandated purpose of raising reimbursement rates to a uniform percentage of private rates in all programmes.     

The hemolytic and cytotoxic properties of a zeolite-containing root filling material in vitro

OBJECTIVE: This in vitro study characterized the hemolysis and cytotoxicity of ZUT, an experimental glass ionomer cement (GIC) sealer with an added antimicrobial-containing zeolite (0.2% Zeomic w/w). STUDY DESIGN: ZUT, Ketac-Cem (GIC component of ZUT), Ketac-Endo, and two AH 26 sealer formulations were tested at various times after mixing. Hemolysis produced by standardized specimens was determined spectrophotometrically (n = 6/material). Cytotoxicity was assessed by using a Millipore Filter test with a HeLa cell monolayer (n = 10/material). Tests were repeated, and results were analyzed with a one-way analysis of variance (alpha = .05). RESULTS: Disks of AH 26 containing silver produced the most hemolysis of all test groups (P < .0001). Compared to controls, GICs and AH 26 formulations were noncytotoxic at 1 and 6 hours after mixing, respectively (P > .05). Addition of Zeomic did not increase the cytotoxic and hemolytic activity of Ketac-Cem (P > .05). CONCLUSION: Overall results suggest ZUT is less cytotoxic than AH 26 and possesses characteristics similar to the other GIC formulations tested.     

The welfare loss from hospital cost-shifting behavior: a partial equilibrium analysis

Cost shifting occurs when changes in administered prices of one payer lead to compensating changes in prices charged to other payers. Microeconomic theory suggests that cost shifting can take place under limited conditions and some empirical studies indicate that that hospital cost shifting may have actually occurred at various times. This study designs a model to conceptualize and quantify the potential welfare loss caused by hospital cost shifting under idealized yet fairly plausible conditions. The resulting estimate yields only a small efficiency loss of at most, 0.84% of private hospital expenditures in the US for 1992.