Torsional stability of interference screws derived from bovine bone - a biomechanical study

Introduction: It has been proposed that individual genetic variation contributes to the course of severe infections and sepsis. Recent studies of single nucleotide polymorphisms (SNPs) within the endotoxin receptor and its signaling system showed an association with the risk of disease development. This study aims to examine the response associated with genetic variations of TLR4, the receptor for bacterial LPS, and a central intracellular signal transducer (TIRAP/Mal) on cytokine release and for susceptibility and course of severe hospital acquired infections in distinct patient populations. Methods: Three intensive care units in tertiary care university hospitals in Greece and Germany participated. 375 and 415 postoperative patients and 159 patients with ventilator associated pneumonia (VAP) were included. TLR4 and TIRAP/Mal polymorphisms in 375 general surgical patients were associated with risk of infection, clinical course and outcome. In two prospective studies, 415 patients following cardiac surgery and 159 patients with newly diagnosed VAP predominantly caused by Gram-negative bacteria were studied for cytokine levels in-vivo and after ex-vivo monocyte stimulation and clinical course. Results: Patients simultaneously carrying polymorphisms in TIRAP/Mal and TLR4 and patients homozygous for the TIRAP/Mal SNP had a significantly higher risk of severe infections after surgery (odds ratio (OR) 5.5; confidence interval (CI): 1.34 - 22.64; P = 0.02 and OR: 7.3; CI: 1.89 - 28.50; P < 0.01 respectively). Additionally we found significantly lower circulating cytokine levels in double-mutant individuals with ventilator associated pneumonia and reduced cytokine production in an ex-vivo monocyte stimulation assay, but this difference was not apparent in TIRAP/Mal-homozygous patients. In cardiac surgery patients without infection, the cytokine release profiles were not changed when comparing different genotypes. Conclusions: Carriers of mutations in sequential components of the TLR signaling system may have an increased risk for severe infections. Patients with this genotype showed a decrease in cytokine release when infected which was not apparent in patients with sterile inflammation following cardiac surgery

Surface modification of synthetic clay aimed at biomolecule adsorption: synthesis and characterization

This work describes the process for functionalization of laponite through the grafting of 3-mercaptopropyltrimethoxysilane (MPTS). Laponite is synthetic smectite clay with surface area of 350 m²/g. The samples, prior to and after functionalization, were characterized by chemical analyses, thermogravimetric analysis (TGA), x ray diffraction (XRD), diffuse reflectance infrared Fourier transform spectroscopy (DRIFT), scanning electron microscopy and energy dispersive spectrometry (MEV/EDS). Infrared spectroscopy and elemental analyses confirmed the presence of organic chains and thiol groups in the modified clay. The immobilized and available thiol group, measured according to the Volhard method, totaled 1.4 meq/g of clay, with approximately 90% accessible for Ag+ trapping. These results represent an improvement as compared to other works concerning the functionalization of smectite-type clays in which the effect produced by functional group blockage limits the access of species to less than 10% of the complexing sites