Utilizzo di dispositivi magnetici nel trattamento della patologia artrosica del ginocchio

The use of scaffolds for Tissue Engineering (TE) is increasing due to their efficacy in helping the body rebuild damaged or diseased tissue. Hydroxyapatite (HA) is the most suitable bioactive ceramic to be used in orthopaedic reconstruction since it replicates the mineral component of the hard tissues, and it has therefore excellent biocompatibility properties. The temporal and spatial control of the tissue regeneration process is the limit to be overcome in order to treat large bone and osteochondral defects. In this thesis we describe the realization of a magnetic scaffolds able to attract and take up growth factors or other bio-agents in vivo via a driving magnetic force. This concept involves the use of magnetic nanoparticles (MNP) functionalized with selected growth factors or stem cells. These functionalized MNP act as shuttles transporting the bio-agents towards and inside the scaffold under the effect of the magnetic field, enhancing the control of tissue regeneration processes. This scaffold can be imagined as a fixed “station” that provides a unique possibility to adjust the scaffold activity to the specific needs of the healing tissue. Synthetic bone graft substitutes, made of collagen or biomineralized collagen (i.e. biomimetic Hydroxyapatite/collagen composites) were used as starting materials for the fabrication of magnetic scaffolds. These materials are routinely used clinically to replace damaged or diseased cartilaginous or bone tissue. Our magnetization technique is based on a dip-coating process consisting in the infilling of biologically inspired porous scaffolds with aqueous biocompatible ferrofluids’ suspensions. In this technique, the specific interconnected porosity of the scaffolds allows the ferrofluids to be drawn inside the structure by capillarity. A subsequent freeze-drying process allows the solvent elimination while keeping very nearly the original shape and porosity of the scaffolds. The remaining magnetic nanoparticles, which are trapped in the structure, lead to the magnetization of the HA/Collagen scaffold. We demonstrate here the possibility to magnetize commercially available scaffolds up to magnetization values that are used in drug delivery processes. The preliminary biocompatibility test showed that the investigated scaffolds provide a suitable micro-environment for cells. The biocompatibility of scaffold facilitates the growth and proliferation of osteogenic cells.

Perfluorinated compounds in environmental matrices of Lake Victoria Gulf

ABSTRACT One of the major ecological challenges on Lake Victoria resources is the existence of “hot spots”, caused by human waste, urban runoff, and industrial effluents. The lake is tending towards eutrophication which is attributed to the increasing human population in its watershed. A report of the levels of perfluorooctane sulfonate and perfluorooctanoic acid in environmental matrices of Lake Victoria is presented, and the management implication of perfluorinated compounds and similar potential organic pollutants examined. Two widely consumed and economically important fish species namely Lates niloticus (Nile perch) and Oreochromis niloticus (Nile tilapia) were obtained from Winam gulf of Lake Victoria, Kenya, and analysed for perfluorooctane sulfonate and perfluorooctanoic acid in muscles and liver using liquid chromatography coupled with mass spectroscopy. Variability in the concentrations of perfluorooctanoic acid or perfluorooctane sulfonate in river waters (range perfluorooctanoic acid 0.4 – 96.4 ng/L and perfluorooctane sulfonate < 0.4 – 13.2 ng/L) was higher than for Lake waters (range perfluorooctanoic acid 0.4 – 11.7 ng/L and perfluorooctane sulfonate < 0.4 – 2.5 ng/L respectively). Significant correlations were tested between perfluorinated compounds levels in sediments, fish and water. Wastewater treatment plants and other anthropogenic sources have been identified as significant sources or pathways for the introduction of perfluoroalkyl compounds into Lake Victoria ecosystem. In this study, elevated concentrations of perfluorooctanoic acid and perfluorooctane sulfonate was found in two wastewater treatment plants (WWTPs) in Kisumu, City of Kenya. An alternative analytical method to liquid chromatography/ mass spectroscopy for analysis of perfluorocarboxylic acids in abiotic and biotic matrices where high concentrations are expected is also presented. Derivatisation of the acid group to form a suitable alkyl ester provided a suitable compound for mass spectroscopy detection coupled to gas chromatography instrumental analysis. The acid is esterified by an alkyl halide i.e benzyl bromide as the alkylating agent for Perfluorocarboxylic acids quantification. The study also involved degradability measurements of emerging perfluorinated surfactants substitutes. The stability of the substitutes of perfluorinated surfactants was tested by employing advanced oxidation processes, followed by conventional tests, among them an automated method based on the manometric respirometry test and standardized fix bed bioreactor [FBBR] on perfluorobutane sulfonate (PFBS), a fluoroethylene polymer, fluorosurfactant (Zonyl), two fluoraliphaticesters (NOVEC ™ FC4430 and NOVEC ™ FC4432) and 10-(trifluoromethoxy) decane-sulfonate. Most of these emmerging surfactants are well-established in the market and have been used in several applications as alternatives to PFOS and PFOA based surfactants. The results of this study can be used as pioneer information for further studies on the sources, behaviour and fate of PFOA and PFOS and other related compounds in both abiotic and biota compartments of Lake Victoria and other lakes. Further an overview in degradation of emerging perfluorinated compounds substitutes is presented. Contribution in method development especially for acid group based fluorosurfactants is presented. The data obtained in this study can particularly be considered when formulating policies and management measures for preservation and sustainability of Lake Victoria resources.

Aging of nuclear power plant cables: in search of non-destructive diagnostic quantities

The safety systems of nuclear power plants rely on low-voltage power, instrumentation and control cables. Inside the containment area, cables operate in harsh environments, characterized by relatively high temperature and gamma-irradiation. As these cables are related to fundamental safety systems, they must be able to withstand unexpected accident conditions and, therefore, their condition assessment is of utmost importance as plants age and lifetime extensions are required. Nowadays, the integrity and functionality of these cables are monitored mainly through destructive test which requires specific laboratory. The investigation of electrical aging markers which can provide information about the state of the cable by non-destructive testing methods would improve significantly the present diagnostic techniques. This work has been made within the framework of the ADVANCE (Aging Diagnostic and Prognostics of Low-Voltage I\&C Cables) project, a FP7 European program. This Ph.D. thesis aims at studying the impact of aging on cable electrical parameters, in order to understand the evolution of the electrical properties associated with cable degradation. The identification of suitable aging markers requires the comparison of the electrical property variation with the physical/chemical degradation mechanisms of polymers for different insulating materials and compositions. The feasibility of non-destructive electrical condition monitoring techniques as potential substitutes for destructive methods will be finally discussed studying the correlation between electrical and mechanical properties. In this work, the electrical properties of cable insulators are monitored and characterized mainly by dielectric spectroscopy, polarization/depolarization current analysis and space charge distribution. Among these techniques, dielectric spectroscopy showed the most promising results; by means of dielectric spectroscopy it is possible to identify the frequency range where the properties are more sensitive to aging. In particular, the imaginary part of permittivity at high frequency, which is related to oxidation, has been identified as the most suitable aging marker based on electrical quantities.

Skin tissue engineering: medical problems and technological solutions.

In questo elaborato si affrontano problematiche cliniche legate ai traumi gravi della cute in cui è necessario intervenire chirurgicamente per ripristinare una situazione normale: si approfondisce lo studio della fisiologia del tessuto, la classificazione dei gradi delle ustioni della pelle, la guarigione delle ferite e la meccanica della cute. Il trapianto di tessuto autologo costituisce la soluzione più efficace e con minori complicazioni. Tuttavia il paziente potrebbe non presentare una superficie di cute disponibile sufficientemente estesa, per cui si ricorre ad altri metodi. In primo luogo, si effettuano degli allotrapianti di tessuto di donatore cadavere prelevati secondo le normative vigenti e conservati attraverso le varie tecniche, il cui sviluppo ha consentito una durata di conservazione maggiore; mentre la glicerolizzazione abbatte al 100% il rischio di trasmissione di patologie e lo sviluppo di microorganismi, la crioconservazione preserva la vitalità del tessuto. La chirurgia utilizzata per queste operazioni si avvale di tecnologie innovative come la Tecnologia a Pressione Negativa. Un'alternativa necessaria per sopperire all'ingente richiesta di tessuto di donatore sono i sostituti cutanei, che presentano un grande potenziale per il futuro. Per eliminare totalmente il rischio di rigetto sarebbe necessario personalizzare il costrutto utilizzando cellule autologhe, ma la ricerca è stata rallentata da minori investimenti da parte dell'industria biomedica, che si è maggiormente focalizzata sulla realizzazione di prodotti utilizzabili da un più ampio raggio di pazienti. Per queste ragioni, l'ingegneria tissutale della cute ha trovato più ampio campo di applicazione nel sistema dei test in vitro. A tale scopo sono stati creati dei protocolli certificati per testare la corrosività, la irritabilità e la vitalità del tessuto cutaneo, quali EpiDerm, EpiSkin e SkinEthic che si avvalgono dell'uso del metodo MMT e della spettrofotometria, che è diventata un supporto fondamentale per le scienze biologiche.

Use of essential oils and biocontrol cultures for the improvement of shelf-life of fresh cut products

The demand of minimally processed fruits and vegetables has increased in the last years. However, their intrinsic characteristics may favor the growth of pathogens and spoilage microbiota. The negative effects on human health reported for some traditional chemical sanitizers have justified the search for substitutes to guarantee food safety and quality. In this work we have evaluate the potential of some essential oils and their components to improve the safety and the shelf life of Lamb’s lettuce (Valerianella locusta) and apples (Golden delicious). Moreover, the effects of selected lactic acid bacteria alone or in combination with essential oils or their components, on the shelf-life and safety as well as organoleptic properties of minimally processed products, were evaluated. Since the lack of knowledge of microbial cell targets of essential oils represent one of the most important limit to the use of these molecules at industrial level, another aim of this thesis was the study of the action mechanisms of essential oils and their components. The results obtained showed the beneficial effects of the natural antimicrobials as well as the selected lactic acid bacteria on minimally processed fruit and vegetable safety and shelf-life, without detrimental effects on the quality parameters. The beneficial effects obtained by the use of the selected biocontrol agents were further increased combining them with selected natural antimicrobials. The natural antimicrobial employed induced noticeable modifications of membrane fatty acid profiles and volatile compounds produced by microbial cells during the growth. The modification of the expression in genes involved in fatty acid biosynthesis suggesting that the cytoplasmic membrane of microbial cells is one of the major cellular target of essential oils and their components. The comprehension of microbial stress response mechanisms can contribute to the scaling up of natural antimicrobials and bio-control agents at industrial level.

Computer aided design and finite element modeling to predict bulk mechanical properties of bone scaffolds using triply periodic minimal surfaces (progettazione assistita al calcolatore ed analisi con il metodo degli elementi finiti per predire il comportamento meccanico di scaffolds ossei creati con l'uso di superfici minime periodiche in tre direzioni)

The aim of Tissue Engineering is to develop biological substitutes that will restore lost morphological and functional features of diseased or damaged portions of organs. Recently computer-aided technology has received considerable attention in the area of tissue engineering and the advance of additive manufacture (AM) techniques has significantly improved control over the pore network architecture of tissue engineering scaffolds. To regenerate tissues more efficiently, an ideal scaffold should have appropriate porosity and pore structure. More sophisticated porous configurations with higher architectures of the pore network and scaffolding structures that mimic the intricate architecture and complexity of native organs and tissues are then required. This study adopts a macro-structural shape design approach to the production of open porous materials (Titanium foams), which utilizes spatial periodicity as a simple way to generate the models. From among various pore architectures which have been studied, this work simulated pore structure by triply-periodic minimal surfaces (TPMS) for the construction of tissue engineering scaffolds. TPMS are shown to be a versatile source of biomorphic scaffold design. A set of tissue scaffolds using the TPMS-based unit cell libraries was designed. TPMS-based Titanium foams were meant to be printed three dimensional with the relative predicted geometry, microstructure and consequently mechanical properties. Trough a finite element analysis (FEA) the mechanical properties of the designed scaffolds were determined in compression and analyzed in terms of their porosity and assemblies of unit cells. The purpose of this work was to investigate the mechanical performance of TPMS models trying to understand the best compromise between mechanical and geometrical requirements of the scaffolds. The intention was to predict the structural modulus in open porous materials via structural design of interconnected three-dimensional lattices, hence optimising geometrical properties. With the aid of FEA results, it is expected that the effective mechanical properties for the TPMS-based scaffold units can be used to design optimized scaffolds for tissue engineering applications. Regardless of the influence of fabrication method, it is desirable to calculate scaffold properties so that the effect of these properties on tissue regeneration may be better understood.

Ricostruzione della colonna anteriore dopo resezione tumorale: Utilizzo di gabbia in titanio/carbonio o innesto osseo allogenico armato in titanio?

Il rachide è stato suddiviso in tre colonne da Denis: anteriore e centrale comprendono la metà anteriore del corpo vertebrale, la metà posteriore e l’inizio dei peduncoli, mentre la colonna posteriore comprende l’arco e i peduncoli stessi. In caso di resezione o lesione della colonna anteriore e media è indicata la ricostruzione. Diverse tecniche e materiali possono essere usati per ricostruire il corpo vertebrale. Innesti vascolarizzati, autograft, allograft sono stati usati, così come impianti sintetici di titanio o materiale plastico come il PEEK (Poly etere etere ketone). Tutti questi materiali hanno vantaggi e svantaggi in termini di proprietà intrinseche, resistenza meccanica, modulo di elasticità, possibilità di trasmissione malattie, capacità di fondersi con l’osso ospite o meno. Le soluzioni più usate sono le cage in titanio o carbonio, il PMMA ( Poli methil metacrilato), gli innesti ossei massivi. Si è effettuato uno studio di coorte retrospettivo paragonando due gruppi di pazienti oncologici spinali trattati da due chirurghi esperti in un centro di riferimento, con vertebrectomia e ricostruzione della colonna anteriore: un gruppo con cage in carbonio o titanio, l’altro gruppo con allograft massivo armato di innesto autoplastico o mesh in titanio. Si sono confrontati i risultati in termini di cifosi segmenterai evolutiva, fusione ossea e qualità di vita del paziente. Il gruppo delle cage in carbonio / titanio ha avuto risultati leggermente migliori dal punto di vista biomeccanico ma non statisticamente significativo, mentre dal punto di vista della qualità di vita i risultati sono stati migliori nel gruppo allograft. Non ci sono stati fallimenti meccanici della colonna anteriore in entrambi i gruppi, con un Fu tra 12 e 60 mesi. Si sono paragonati anche i costi delle due tecniche. In conclusione l’allogar è una tecnica sicura ed efficace, con proprietà meccaniche solide, soprattutto se armato con autograft o mesi in titanio.

Liquid crystalline cellulose derivatives for mirrorless lasing

In this thesis cholesteric films made of liquid crystalline cellulose derivatives with improved optical properties were prepared. The choice of the solvent, hydrogen bond influencing additives, the synthetic realization of a very high degree of substitution on the cellulosic polymer and the use of mechanical stirring at the upper concentration limit of the liquid crystalline range were the basis for an improved alignment of the applied cellulose tricarbamates. In combination with a tuned substrate treatment and film preparation method, cholesteric films were obtained, with optical properties that were theoretically predicted and only known from low molecular weight liquid crystals so far. Subsequent polymerization allowed a permanent fixing of the alignment and the fabrication of free standing and insensitive films.rnThe incorporation of inorganic nanorods into the cholesteric host material was mediated with tailored block copolymers, available via controlled radical polymerization methods. In addition to the shape match between the rodlike mesogens of the host and the nanorods it was possible to increase the miscibility of both materials. Nevertheless, the size of the nanorods, in comparison to the mesogens, in these densely packed liquid crystalline phases as well as their long equilibration times were the reasons for phase separation. Nanorods are, in principle, valuable substitutes for organics, but their utilization in cellulosic CLC was not to be combined with a high quality alignment of the cholesteric structure.rnA swelling process of polymerized films in a dye solution or dissolving dyes in non-polymerized CLC was used for incorporation of the organic chromophores. With the first method the CLC could be aligned and polymerized without any disturbance due to dye molecules. The optical properties of dye and CLC were matched, with regard to mirrorless lasing devices. The dye was optically excited and laser emission supported by the cholesteric cavity was obtained. The polarization and wavelength of the emitted radiation as well as its bandwidth, the obtained interference pattern and threshold behavior of the emission proofed the feedback mechanism that was not believed to be realizable in liquid crystalline polymers. rnUtilization of a microfluidic co-flow injection device enabled us to transfer the properties of cellulosic CLC from the planar film shape to spherical micrometer sized particles. The pure material yielded particles with distorted mesogen alignment similar to films prepared by capillary flow. Dilution of the CLC with a solvent that migrated into the carrier phase during particle preparation provided the basis for particles with well ordered areas. rnAlthough cellulose derivatives were known for their liquid crystalline behavior for decades and synthesized in mass production, their application as feedback material was affected by bad optical properties. In comparison to low molar mass compounds, the low degree of order in the CLC phase was the cause. With the improved material, defined lasing emission was shown and characterized. Derivatives of cellulose are desirable materials, because, as a renewable resource, they are available in large amounts for a low price and need only simple derivatization reactions. The fabrication of CLC films with tunable lasing emission, for which this thesis can provide a starting point, is in good agreement with today's requirements of modern technology and its miniaturization.rn

Identity Changes and Consumer Behavior. How Becoming Parents Changes Our Consumption Choices

This research aims at investigating the impact of the identity change on consumption. An identity change is defined as the acquisition of a new identity after a life change event. For instance after the birth of the first child the new identity as parent is acquired and a woman can define herself as a mother. Despite marketing research recognizes that individuals’ identity is unstable and susceptible to change, the investigation of the identity change is still in its infancy. Furthermore, marketing research did not investigate the contextual effect of the new as well as the old identity on individuals’ reaction toward identity-marketing. In order words, whether people show a more favorable reaction toward product related to their new or their old identities after an identity change is still unclear. In order to answer this question, five studies are conducted. Results show that when the new identity substitutes the old one, people show a more positive reaction toward new-identity related products, while when the new identity is added to the old ones, people show a more positive reaction toward old-identity related products. This is the case also when the new identity accounts for high levels of identification (study three) and when the old identity is squeezed by the new one (studies four and five). A new concept, the identity strain, is then introduced and discussed.

Coating of surfaces of composite materials with enzymatically formed biosilica

Die Bildung kieselsäurehaltiger Spicula in marinen Schwämmen ist nur möglich durch die enzymatische Aktivität des Silicatein- in Verbindung mit der stöchiometrischen Selbstassemblierung des Enzyms mit anderen Schwammproteinen. Die vorliegende Arbeit basiert auf einem biomimetischen Ansatz mit dem Ziel, unterschiedliche Oberflächen für biotechnologische und biomedizinische Anwendungen mit Biosilica und Biotitania zu beschichten und zu funktionalisieren. Für biotechnologische Anwendungen ist dabei das Drucken von Cystein-getaggtem Silicatein auf Gold-Oberflächen von Bedeutung, denn es ermöglichte die Bildung definierter Biotitania-Strukturen (Anatas), welche als Photokatalysator den Abbau eines organischen Farbstoffs bewirkten. Des Weiteren zeigte sich die bio-inspirierte Modifikation von Tyrosin-Resten an rekombinantem Silicatein-(via Tyrosinase) als vielversprechendes Werkzeug zur Beschleunigung der Selbstassemblierung des Enzyms zu mesoskaligen Filamenten. Durch eine solche Modifikation konnte Silicatein auch auf der Oberfläche von anorganischen Partikeln immobilisiert werden, welches die Assemblierung von anorganisch-organischen Verbundwerkstoffen in wäßriger Umgebung förderte. Die resultierenden supramolekularen Strukturen könnten dabei in bio-inspirierten und biotechnologischen Anwendungen genutzt werden. Weiterhin wurde in der vorliegenden Arbeit die Sekundärstruktur von rekombinantem Silicatein- (Monomer und Oligomer) durch Raman Spektroskopie analysiert, nachdem das Protein gemäß einer neu etablierten Methode rückgefaltet worden war. Diese Spektraldaten zeigten insbesondere Änderungen der Proteinkonformation durch Solubilisierung und Oligomerisierung des Enzyms. Außerdem wurden die osteoinduzierenden und osteogenen Eigenschaften unterschiedlicher organischer Polymere, die herkömmlich als Knochenersatzmaterial genutzt werden, durch Oberflächenmodifikation mit Silicatein/Biosilica verbessert: Die bei der Kultivierung knochenbildender Zellen auf derart oberflächenbehandelten Materialien beobachtete verstärkte Biomineralisierung, Aktivierung der Alkalischen Phosphatase, und Ausbildung eines typischen zellulären Phänotyps verdeutlichen das Potential von Silicatein/Biosilica für der Herstellung neuartiger Implantat- und Knochenersatzmaterialien.

EpiDex® Swiss field trial 2004-2008

Approximately 20% of leg ulcers remain unresponsive to the best conservative standard of care. So far, these patients could either receive conventional skin grafts or had to accept their intractable wound. Skin substitutes from cell culture may represent a promising alternative to heal a major part of these patients on a non-surgical, potentially more cost-effective basis.

Tissue response and wound healing after placement of two types of bioengineered grafts containing vital cells in submucosal maxillary pouches: an experimental pilot study in rabbits

PURPOSE: This pilot study evaluated the wound healing and tissue response after placement of two different skin substitutes in subgingival mucosal pouches in rabbits. MATERIALS AND METHODS: Four rabbits were selected to receive a commercially available skin substitute consisting of a collagen matrix with fibroblasts and an epithelial layer (test membrane 1) and a prototype device consisting of a collagen matrix with fibroblasts only (test membrane 2). In each rabbit, two horizontal incisions were made in the buccal alveolar mucosa of the maxilla bilaterally to create submucosal pouches. Three pouches in each animal were filled with either the test 1 or test 2 membranes, and one pouch was left without a membrane (sham-operated control). All rabbits were sacrificed after a healing period of 4 weeks, and histologic samples were prepared and examined. RESULTS: After a healing period of 1 month, both tested membranes were still visible in the sections. Test membrane 1 was still bilayered, contained inflammatory cells in its center, and was encapsulated by a thick fibrous tissue. Numerous ectopic calcifications were evident in the collagenous part of the membrane and in association with some basal epithelial cells. Test membrane 2 was also encapsulated in fibrous tissue, with inflammatory cells present only between the fibrous encapsulation and the remnants of the membrane. For test membrane 2, no calcifications were visible. CONCLUSIONS: Test membrane 1 seemed to be more resistant to degradation, but there was also a more pronounced inflammatory reaction in comparison to test membrane 2, especially in the vicinity of the keratinocytes. The significance of the ectopic calcifications, along with that of the resorption or degradation processes of both tested membranes, must be evaluated in future experimental studies, with different time points after implantation examine

Impact of measurement errors on the determination of the linear modulus of human meniscal attachments

For the development of meniscal substitutes and related finite element models it is necessary to know the mechanical properties of the meniscus and its attachments. Measurement errors can falsify the determination of material properties. Therefore the impact of metrological and geometrical measurement errors on the determination of the linear modulus of human meniscal attachments was investigated. After total differentiation the error of the force (+0.10%), attachment deformation (−0.16%), and fibre length (+0.11%) measurements almost annulled each other. The error of the cross-sectional area determination ranged from 0.00%, gathered from histological slides, up to 14.22%, obtained from digital calliper measurements. Hence, total measurement error ranged from +0.05% to −14.17%, predominantly affected by the cross-sectional area determination error. Further investigations revealed that the entire cross-section was significantly larger compared to the load-carrying collagen fibre area. This overestimation of the cross-section area led to an underestimation of the linear modulus of up to −36.7%. Additionally, the cross-sections of the collagen-fibre area of the attachments significantly varied up to +90% along their longitudinal axis. The resultant ratio between the collagen fibre area and the histologically determined cross-sectional area ranged between 0.61 for the posterolateral and 0.69 for the posteromedial ligament. The linear modulus of human meniscal attachments can be significantly underestimated due to the use of different methods and locations of cross-sectional area determination. Hence, it is suggested to assess the load carrying collagen fibre area histologically, or, alternatively, to use the correction factors proposed in this study.

Guidance for the preparation of neurological management guidelines by EFNS scientific task forces - revised recommendations 2012

This paper is meant to provide guidance to anyone wishing to write a neurological guideline for diagnosis or treatment, and is directed at the Scientist Panels and task forces of the European Federation of Neurological Societies (EFNS). It substitutes the previous guidance paper from 2004. It contains several new aspects: the guidance is now based on a change of the grading system for evidence and for the resulting recommendations, and has adopted The Grading of Recommendations, Assessment, Development and Evaluation system (GRADE). The process of grading the quality of evidence and strength of recommendations can now be improved and made more transparent. The task forces embarking on the development of a guideline must now make clearer and more transparent choices about outcomes considered most relevant when searching the literature and evaluating their findings. Thus, the outcomes chosen will be more critical, more patient-oriented and easier to translate into simple recommendations. This paper also provides updated practical recommendations for planning a guideline task force within the framework of the EFNS. Finally, this paper hopes to find the approval also by the relevant bodies of our future organization, the European Academy of Neurology.

Bone healing and graft resorption of autograft, anorganic bovine bone and beta-tricalcium phosphate. A histologic and histomorphometric study in the mandibles of minipigs

OBJECTIVE: The purpose was to qualitatively and quantitatively compare the bone formation and graft resorption of two different bone substitutes used in both orthopedic and oral surgery, with autogenous bone as a positive control. MATERIALS AND METHODS: Three standardized bone defects were prepared in both mandibular angles of 12 adult minipigs. The defects were grafted with either autograft, anorganic bovine bone (ABB), or synthetic beta-tricalcium phosphate (beta-TCP). Sacrifice was performed after 1, 2, 4, and 8 weeks for histologic and histomorphometric analysis. RESULTS: At 2 weeks, more new bone formation was seen in defects filled with autograft than with ABB (P approximately 0.0005) and beta-TCP (P approximately 0.002). After 4 weeks, there was no significant difference between beta-TCP and the two other materials. Defects grafted with ABB still exhibited less bone formation as compared with autograft (P approximately 0.004). At 8 weeks, more bone formation was observed in defects grafted with autograft (P approximately 0.003) and beta-TCP (P approximately 0.00004) than with ABB. No difference could be demonstrated between beta-TCP and autograft. beta-TCP resorbed almost completely over 8 weeks, whereas ABB remained stable. CONCLUSION: Both bone substitutes seemed to decelerate bone regeneration in the early healing phase as compared with autograft. All defects ultimately regenerated with newly formed bone and a developing bone marrow. The grafting materials showed complete osseous integration. Both bone substitutes may have a place in reconstructive surgery where different clinical indications require differences in biodegradability.