Reduction of cement leakage by sequential PMMA application in a vertebroplasty model

PURPOSE Leakage is the most common complication of percutaneous cement augmentation of the spine. The viscosity of the polymethylmethacrylate (PMMA) cement is strongly correlated with the likelihood of cement leakage. We hypothesized that cement leakage can be reduced by sequential cement injection in a vertebroplasty model. METHODS A standardized vertebral body substitute model, consisting of aluminum oxide foams coated by acrylic cement with a preformed leakage path, simulating a ventral vein, was developed. Three injection techniques of 6 ml PMMA were assessed: injection in one single step (all-in-one), injection of 1 ml at the first and 5 ml at the second step with 1 min latency in-between (two-step), and sequential injection of 0.5 ml with 1-min latency between the sequences (sequential). Standard PMMA vertebroplasty cement was used; each injection type was tested on ten vertebral body substitute models with two possible leakage paths per model. Leakage was assessed by radiographs using a zonal graduation: intraspongious = no leakage and extracortical = leakage. RESULTS The leakage rate was significantly lower in the "sequential" technique (2/20 leakages) followed by "two-step" (15/20) and "all-in-one" (20/20) techniques (p < 0.001). The RR for a cement leakage was 10.0 times higher in the "all-in-one" compared to the "sequential" group (95 % confidence intervals 2.7-37.2; p < 0.001). CONCLUSIONS The sequential cement injection is a simple approach to minimize the risk for leakage. Taking advantage of the temperature gradient between body and room temperature, it is possible to increase the cement viscosity inside the vertebra while keeping it low in the syringe. Using sequential injection of small cement volumes, further leakage paths are blocked before further injection of the low-viscosity cement.

Surface roughness after excimer laser ablation using a PMMA model:profilometry and effects on vision

PURPOSE: To show that the limited quality of surfaces produced by one model of excimer laser systems can degrade visual performance with a polymethylmethacrylate (PMMA) model. METHODS: A range of lenses of different powers was ablated in PMMA sheets using five DOS-based Nidek EC-5000 laser systems (Nidek Technologies, Gamagori, Japan) from different clinics. Surface quality was objectively assessed using profilometry. Contrast sensitivity and visual acuity were measured through the lenses when their powers were neutralized with suitable spectacle trial lenses. RESULTS: Average surface roughness was found to increase with lens power, roughness values being higher for negative lenses than for positive lenses. Losses in visual contrast sensitivity and acuity measured in two subjects were found to follow a similar pattern. Findings are similar to those previously published with other excimer laser systems. CONCLUSIONS: Levels of surface roughness produced by some laser systems may be sufficient to degrade visual performance under some circumstances.

Disinfection of clinical materials using photo-activated tolonium chloride solution

Photo-activated disinfection is beginning to be used in dental surgery to treat deep seated bacterial infection. It works by combining a photosensitiser and light of a specific frequency to generate singlet oxygen which is toxic to many types of bacteria. It is suggested that this technique could be used as a means to help treat infection more generally. To do so, it needs to work with materials and geometries exhibiting different physical and optical characteristics to teeth. In these trials, samples of stainless steel and polymethylmethacrylate were exposed to bacterial solutions of Staphylococcus aureus and Staphylococcus epidermis. These were treated with tolonium chloride-based photo-activated disinfection regimes showing positive results with typically 4 log10 reductions in colony forming units. Tests were also carried out using slotted samples to represent geometric features which might be found on implants. These tests, showed disinfectant effect however to a much lesser degree. © 2011 Inderscience Enterprises Ltd.

The morphology of ordered block copolymer patterns as probed by high resolution imaging

The microphase separation of block copolymer (BCP) thin films can afford a simple and cost-effective means to studying nanopattern surfaces, and especially the fabrication of nanocircuitry. However, because of complex interface effects and other complications, their 3D morphology, which is often critical for application, can be more complex than first thought. Here, we describe how emerging microscopic methods may be used to study complex BCP patterns and reveal their rich detail. These methods include helium ion microscopy (HIM) and high resolution x-section transmission electron microscopy (XTEM), and complement conventional secondary electron and atomic force microscopies (SEM and TEM). These techniques reveal that these structures are quite different to what might be expected. We illustrate the advances in the understanding of BCP thin film morphology in several systems, which result from this characterization. The systems described include symmetric, lamellar forming polystyrene-b-polymethylmethacrylate (PS-b-PMMA), cylinder forming polystyrene-b-polydimethylsiloxane (PS-b-PDMS), as well as lamellar and cylinder forming patterns of polystyrene-b-polyethylene oxide (PS-b-PEO) and polystyrene-b-poly-4-vinylpyridine (PS-b-P4VP). Each of these systems exhibits more complex arrangements than might be first thought. Finding and developing techniques whereby complex morphologies, particularly at very small dimensions, can be determined is critical to the practical use of these materials in many applications. The importance of quantifying these complex morphologies has implications for their use in integrated circuit manufacture, where they are being explored as alternative pattern forming methods to conventional UV lithography.

Alteration of the bone tissue material properties in type 1 diabetes mellitus: A Fourier transform infrared microspectroscopy study

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