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  1. Sahapaibounkit P, Prasertsung I, Mongkolnavin R, Wong CS, Damrongsakkul S
    J Biomed Mater Res B Appl Biomater, 2017 08;105(6):1658-1666.
    PMID: 27177842 DOI: 10.1002/jbm.b.33708
    In this study, polycaprolactone (PCL) film, a high potential material used in biomedical applications, was treated by air plasma prior to a conjugation by carbodiimide cross-linking with various types of proteins, including type A gelatin, type B gelatin, and collagen hydrolysate. The properties of modified PCL films were characterized by X-ray photoelectron spectroscopy (XPS), contact angle measurement, and atomic force microscopy. The XPS results showed that oxygen and nitrogen atoms were successfully introduced on the air plasma-treated PCL surface. Primary amine was found on the air plasma-treated PCL films. All proteins were shown to be successfully cross-linked on air plasma-treated PCL films. The wettability and roughness of protein-conjugated PCL films were significantly increased compared to those of neat PCL film. In vitro biocompatibility test using L929 mouse fibroblast showed that the attachment percentage and spreading area of attached cells on all protein-conjugated PCL films were markedly increased. Comparing among modified PCL films, no significant difference on the attachment of L929 on modified PCL films was noticed. However, the spreading areas of cells after 24 hours of culture on type A gelatin- and type B gelatin-modified PCL surfaces were higher than that on collagen hydrolysate-modified surface, possibly related to the lower percentage of amide bond on collagen hydrolysate-conjugated surface compared to those on both gelatin-conjugated PCL ones. This indicated that the two-step modification of PCL film via air plasma and carbodiimide cross-linking with collagen-derived proteins could enhance the biocompatibility of PCL films. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 1658-1666, 2017.
  2. Ballouze R, Marahat MH, Mohamad S, Saidin NA, Kasim SR, Ooi JP
    J Biomed Mater Res B Appl Biomater, 2021 Oct;109(10):1426-1435.
    PMID: 33484103 DOI: 10.1002/jbm.b.34802
    Autologous bone grafting remains the gold standard for almost all bone void-filling orthopedic surgery. However, autologous bone grafting has several limitations, thus scientists are trying to identify an ideal synthetic material as an alternative bone graft substitute. Magnesium-doped biphasic calcium phosphate (Mg-BCP) has recently been in the spotlight and is considered to be a potential bone substitute. The Mg-BCP is a mixture of two bioceramics, that is, hydroxyapatite (HA) and β-tricalcium phosphate (β-TCP), doped with Mg2+ , and can be synthesized through chemical wet-precipitation, sol-gel, single diffusion gel, and solid state reactions. Regardless of the synthesis routes, it is found that the Mg2+ preferentially accommodates in β-TCP lattice instead of the HA lattice. The addition of Mg2+ to BCP leads to desirable physicochemical properties and is found to enhance the apatite-forming ability as compared to pristine BCP. In vitro results suggest that the Mg-BCP is bioactive and not toxic to cells. Implantation of Mg-BCP in in vivo models further affirmed its biocompatibility and efficacy as a bone substitute. However, like the other bioceramics, the optimum physicochemical properties of the Mg-BCP scaffold have yet to be determined. Further investigations are required regarding Mg-BCP applications in bone tissue engineering.
  3. Low KL, Tan SH, Zein SH, Roether JA, Mouriño V, Boccaccini AR
    J Biomed Mater Res B Appl Biomater, 2010 Jul;94(1):273-86.
    PMID: 20336722 DOI: 10.1002/jbm.b.31619
    A major weakness of current orthopedic implant materials, for instance sintered hydroxyapatite (HA), is that they exist as a hardened form, requiring the surgeon to fit the surgical site around an implant to the desired shape. This can cause an increase in bone loss, trauma to the surrounding tissue, and longer surgical time. A convenient alternative to harden bone filling materials are injectable bone substitutes (IBS). In this article, recent progress in the development and application of calcium phosphate (CP)-based composites use as IBS is reviewed. CP materials have been used widely for bone replacement because of their similarity to the mineral component of bone. The main limitation of bulk CP materials is their brittle nature and poor mechanical properties. There is significant effort to reinforce or improve the mechanical properties and injectability of calcium phosphate cement (CPC) and this review resumes different alternatives presented in this specialized literature.
  4. Mohamad N, Buang F, Mat Lazim A, Ahmad N, Martin C, Mohd Amin MCI
    J Biomed Mater Res B Appl Biomater, 2017 Nov;105(8):2553-2564.
    PMID: 27690276 DOI: 10.1002/jbm.b.33776
    The use of bacterial cellulose (BC)-based hydrogel has been gaining attention owing to its biocompatibility and biodegradability. This study was designed to investigate the effect of radiation doses and acrylic acid (AA) composition on in vitro and in vivo biocompatibility of BC/AA as wound dressing materials. Physical properties of the hydrogel, that is, thickness, adhesiveness, rate of water vapor transmission, and swelling were measured. Moreover, the effect of these parameters on skin irritation and sensitization, blood compatibility, and cytotoxicity was studied. Increased AA content and irradiation doses increased the thickness, crosslinking density, and improved the mechanical properties of the hydrogel, but reduced its adhesiveness. The swelling capacity of the hydrogel increased significantly with a decrease in the AA composition in simulated wound fluid. The water vapor permeability of polymeric hydrogels was in the range of 2035-2666 [g/(m-2  day-1 )]. Dermal irritation and sensitization test demonstrated that the hydrogel was nonirritant and nonallergic. The BC/AA hydrogel was found to be nontoxic to primary human dermal fibroblast skin cells with viability >88% and was found to be biocompatible with blood with a low hemolytic index (0.80-1.30%). Collectively, these results indicate that these hydrogels have the potential to be used as wound dressings. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 2553-2564, 2017.
  5. Sing NB, Mostavan A, Hamzah E, Mantovani D, Hermawan H
    J Biomed Mater Res B Appl Biomater, 2015 Apr;103(3):572-7.
    PMID: 24954069 DOI: 10.1002/jbm.b.33242
    This article reports a degradation study that was done on stent prototypes made of biodegradable Fe35Mn alloy in a simulated human coronary arterial condition. The stent degradation was observed for a short-term period from 0.5 to 168 h, which simulates the early period of stenting procedure. Potentiodynamic polarization and electrochemical impedance spectroscopy were used to quantify degradation rate and surface property of the stents. Results showed that signs of degradation were visible on both crimped and expanded stents after 1 h of test, mostly located on the stent's curvatures. The degradation rate of stent was higher compared to that of the original alloy, indicating the surface altering effect of stent fabrication processing to degradation. A single oxide layer was formed and detected as a porous structure with capacitive behavior. Expanded stents exhibited lower polarization resistance compared to the nonexpanded ones, indicating the cold work effect of expansion procedure to degradation.
  6. Md Yusop AH, Alsakkaf A, Noordin MA, Idris H, Nur H, Szali Januddi F
    J Biomed Mater Res B Appl Biomater, 2021 Dec;109(12):2184-2198.
    PMID: 33983686 DOI: 10.1002/jbm.b.34866
    This work is dedicated to the investigation of drug-release control by a direct effect of degradation from biodegradable metallic surfaces. Degradation behaviors characterized by surface morphology, immersion, and electrochemical techniques demonstrated that curcumin-coated zinc (c-Zn) had a higher degradation rate compared to curcumin-coated Fe (c-Fe). High anodic dissolution rate due to the higher degradation rate and widely extended groove-like degradation structure of c-Zn propelled a higher curcumin release. On the other hand, a slower curcumin release rate shown by c-Fe scaffolds is ascribed to its lower anodic dissolution and to its pitting degradation regime with relatively smaller pits. These findings illuminate the remarkable advantage of different degradation behaviors of degradable metallic surfaces in directly controlling the drug release without the need for external electrical stimulus.
  7. Thilagar S, Jothi NA, Omar AR, Kamaruddin MY, Ganabadi S
    PMID: 18161832
    Skin grafts are indicated when there is a major loss of skin. Full-thickness skin graft is an ideal choice to reconstruct defect of irregular surface that is difficult to immobilize. Full-thickness mesh grafts can be applied to patch large skin defect when there is less donor site in extensively traumatized and burned surgical patients. The concept of using natural biomaterials such as keratin, basic fibroblast growth factor is slowly gaining popularity in the field of medical research to achieve early healing. The main objective of this study is to evaluate the efficacy of gelatin conjoined with keratin processed from the poultry feather and commercially available basic fibroblast growth factor (bFGF) as a sandwich layer in promoting the viability of full-thickness skin mesh grafts. The efficacy was assessed from the observation of clinical, bacteriological, and histopathological findings in three groups of experimental dogs. The clinical observations such as color, appearance and discharge, and hair growth were selected as criteria which indicated good and early acceptance of graft in keratin-gelatin (group II). On bacteriological examination, Staphylococcus aureus and Proteus was identified in few animals. Histopathological study of the patched graft revealed early presences of hair follicles; sebaceous gland, and normal thickness of the epidermis in keratin-gelatin in group II treated animals compared with other group (group I-control, group III-bFGF-gelatin).
  8. Ulum MF, Nasution AK, Yusop AH, Arafat A, Kadir MR, Juniantito V, et al.
    J Biomed Mater Res B Appl Biomater, 2015 Oct;103(7):1354-65.
    PMID: 25385691 DOI: 10.1002/jbm.b.33315
    Iron-bioceramic composites have been developed as biodegradable implant materials with tailored degradation behavior and bioactive features. In the current work, in vivo bioactivity of the composites was comprehensively studied by using sheep animal model. Five groups of specimens (Fe-HA, Fe-TCP, Fe-BCP composites, and pure-Fe and SS316L as controls) were surgically implanted into medio proximal region of the radial bones. Real-time ultrasound analysis showed a decreased echo pattern at the peri-implant biodegradation site of the composites indicating minimal tissue response during the wound healing process. Peripheral whole blood biomarkers monitoring showed a normal dynamic change of blood cellular responses and no stress effect was observed. Meanwhile, the released Fe ion concentration was increasing along the implantation period. Histological analysis showed that the composites corresponded with a lower inflammatory giant cell count than that of SS316L. Analysis of the retrieved implants showed a thicker degradation layer on the composites compared with pure-Fe. It can be concluded that the iron-bioceramic composites are bioactive and induce a preferable wound healing process.
  9. Choudhury D, Ay Ching H, Mamat AB, Cizek J, Abu Osman NA, Vrbka M, et al.
    J Biomed Mater Res B Appl Biomater, 2015 Jul;103(5):1002-12.
    PMID: 25220737 DOI: 10.1002/jbm.b.33274
    Diamond like carbon (DLC) is applied as a thin film onto substrates to obtain desired surface properties such as increased hardness and corrosion resistance, and decreased friction and wear rate. Microdimple is an advanced surface modification technique enhancing the tribological performance. In this study, DLC coated microdimples were fabricated on hip prosthesis heads and their mechanical, material and surface properties were characterized. An Electro discharge machining (EDM) oriented microdrilling was utilized to fabricate a defined microdimple array (diameter of 300 µm, depth of 70 µm, and pitch of 900 µm) on stainless steel (SS) hip prosthesis heads. The dimpled surfaces were then coated by hydrogenated amorphous carbon (a-C:H) and tetrahedral amorphous carbon (Ta-C) layers by using a magnetron sputtering technology. A preliminary tribology test was conducted on these fabricated surfaces against a ceramic ball in simulated hip joint conditions. It was found that the fabricated dimples were perpendicular to the spherical surfaces and no cutting-tools wear debris was detected inside the individual dimples. The a-C:H and Ta-C coatings increased the hardness at both the dimple edges and the nondimpled region. The tribology test showed a significant reduction in friction coefficient for coated surfaces regardless of microdimple arrays: the lowest friction coefficient was found for the a-C:H samples (µ = 0.084), followed by Ta-C (µ = 0.119), as compared to the SS surface (µ = 0.248).
  10. Chen XY, Low HR, Loi XY, Merel L, Mohd Cairul Iqbal MA
    J Biomed Mater Res B Appl Biomater, 2019 08;107(6):2140-2151.
    PMID: 30758129 DOI: 10.1002/jbm.b.34309
    Graphene oxide (GO) is a potential material for wound dressing due to its excellent biocompatibility and mechanical properties. This study evaluated the effects of GO concentration on the synthesis of bacterial nanocellulose (BNC)-grafted poly(acrylic acid) (AA)-graphene oxide (BNC/P(AA)/GO) composite hydrogel and its potential as wound dressing. Hydrogels were successfully synthesized via electron-beam irradiation. The hydrogels were characterized by their mechanical properties, bioadhesiveness, water vapor transmission rates (WVTRs), water retention abilities, water absorptivity, and biocompatibility. Fourier transform infrared analysis showed the successful incorporation of GO into hydrogel. Thickness, gel fraction determination and morphological study revealed that increased GO concentration in hydrogels leads to reduced crosslink density and larger pore size, resulting in increased WVTR. Thus, highest swelling ratio was found in hydrogel with higher amount of GO (0.09 wt %). The mechanical properties of the composite hydrogel were maintained, while its hardness and bioadhesion were reduced with higher GO concentration in the hydrogel, affirming the durable and easy removable properties of a wound dressing. Human dermal fibroblast cell attachment and proliferation studies showed that biocompatibility of hydrogel was improved with the inclusion of GO in the hydrogel. Therefore, BNC/P(AA)/GO composite hydrogel has a potential application as perdurable wound dressing. © 2019 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B: 2140-2151, 2019.
  11. Wenliang F, Rameli MABP, Ibrahim TAT, Noor MHM, Yusof LM, Zakaria MZAB
    J Biomed Mater Res B Appl Biomater, 2019 Aug;107(6):1898-1907.
    PMID: 30597760 DOI: 10.1002/jbm.b.34282
    Doxorubicin (DOX) is an effective and commonly used anthracycline anticancer drug for the treatment of osteosarcoma (OS). However, its antitumor effect is hampered by the nonspecific distribution and significant adverse effects. Nanoparticles based drug delivery systems are promising approaches to maximize the anticancer efficacy while decrease the side effects. In this study, biogenic aragonite nanoparticles (ANPs) were developed from cockle shells and loaded with DOX. An orthotopic rat OS model was induced by UMR-106 cells tibia cavity injection. The anticancer efficacy study included five groups: normal control group, OS model group, free DOX group (2 mg/kg), DOX-ANPs 1 group (2 mg of equivalent DOX/kg) and DOX-ANPs 2 group (1.5 mg of equivalent DOX/kg). This study demonstrates that the DOX-ANPs treatment groups can significantly reduce the tumor volume and increase the surviving ratio as compared to the OS model group. In addition, these two DOX-ANPs groups showed less toxicity to the normal organs compared to the free DOX group. Furthermore, DOX-ANPs 2 group showed the similar anticancer efficacy as DOX-ANPs 1 group, which suggested that DOX loaded onto the ANPs may allow the reduction of chemotherapy doses. These results highlight the promising application of ANPs derived from cockle shells as an effective drug delivery system for a successful chemotherapy against OS. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B: 1898-1907, 2019.
  12. Cheah WK, Ishikawa K, Othman R, Yeoh FY
    J Biomed Mater Res B Appl Biomater, 2017 07;105(5):1232-1240.
    PMID: 26913694 DOI: 10.1002/jbm.b.33475
    Hemodialysis, one of the earliest artificial kidney systems, removes uremic toxins via diffusion through a semipermeable porous membrane into the dialysate fluid. Miniaturization of the present hemodialysis system into a portable and wearable device to maintain continuous removal of uremic toxins would require that the amount of dialysate used within a closed-system is greatly reduced. Diffused uremic toxins within a closed-system dialysate need to be removed to maintain the optimum concentration gradient for continuous uremic toxin removal by the dialyzer. In this dialysate regenerative system, adsorption of uremic toxins by nanoporous biomaterials is essential. Throughout the years of artificial kidney development, activated carbon has been identified as a potential adsorbent for uremic toxins. Adsorption of uremic toxins necessitates nanoporous biomaterials, especially activated carbon. Nanoporous biomaterials are also utilized in hemoperfusion for uremic toxin removal. Further miniaturization of artificial kidney system and improvements on uremic toxin adsorption capacity would require high performance nanoporous biomaterials which possess not only higher surface area, controlled pore size, but also designed architecture or structure and surface functional groups. This article reviews on various nanoporous biomaterials used in current artificial kidney systems and several emerging nanoporous biomaterials. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 1232-1240, 2017.
  13. Nasution AK, Murni NS, Sing NB, Idris MH, Hermawan H
    J Biomed Mater Res B Appl Biomater, 2015 Jan;103(1):31-8.
    PMID: 24757071 DOI: 10.1002/jbm.b.33174
    This article describes the development of a partially degradable metal bone pin, proposed to minimize the occurrence of bone refracture by avoiding the creation of holes in the bone after pin removal procedure. The pin was made by friction welding and composed of two parts: the degradable part that remains in the bone and the nondegradable part that will be removed as usual. Rods of stainless steel 316L (nondegradable) and pure iron (degradable) were friction welded at the optimum parameters: forging pressure = 33.2 kPa, friction time = 25 s, burn-off length = 15 mm, and heat input = 4.58 J/s. The optimum tensile strength and elongation was registered at 666 MPa and 13%, respectively. A spiral defect formation was identified as the cause for the ductile fracture of the weld joint. A 40-µm wide intermetallic zone was identified along the fusion line having a distinct composition of Cr, Ni, and Mo. The corrosion rate of the pin gradually decreased from the undeformed zone of pure iron to the undeformed zone of stainless steel 316L. All metallurgical zones of the pin showed no toxic effect toward normal human osteoblast cells, confirming the ppb level of released Cr and Ni detected in the cell media were tolerable.
  14. Zohdi RM, Zakaria ZA, Yusof N, Mustapha NM, Abdullah MN
    PMID: 21504052 DOI: 10.1002/jbm.b.31828
    Malaysian sea cucumber was incorporated into hydrogel formulation by using electron beam irradiation technique and was introduced as novel cross-linked Gamat Hydrogel dressing. This study investigated whether Gamat Hydrogel enhanced repair of deep partial skin thickness burn wound in rats and its possible mechanism. Wounds were treated with either Gamat Hydrogel, control hydrogel, OpSite® film dressing or left untreated. Skin samples were taken at 7, 14, 21, and 28 days post burn for histological and molecular evaluations. Gamat Hydrogel markedly enhanced wound contraction and improved histological reorganization of the regenerating tissue. Furthermore, the dressing modulated the inflammatory responses, stimulated the activation and proliferation of fibroblasts, and enhanced rapid production of collagen fiber network with a consequently shorter healing time. The level of proinflammatory cytokines; IL-1α, IL-1β, and IL-6, were significantly reduced in Gamat Hydrogel treated wounds compared with other groups as assessed by reverse transcription-polymerase chain reaction (RT-PCR). In summary, our results showed that Gamat Hydrogel promoted burn wound repair via a complex mechanism involving stimulation of tissue regeneration and regulation of pro-inflammatory cytokines. The resultant wound healing effects were attributed to the synergistic effect of the hydrogel matrix and incorporated sea cucumber.
  15. Rahimnejad Yazdi A, Torkan L, Stone W, Towler MR
    J Biomed Mater Res B Appl Biomater, 2018 Jan;106(1):367-376.
    PMID: 28152268 DOI: 10.1002/jbm.b.33856
    Zinc borate glasses with increasing gallium content (0, 2.5, 5, 10, and 15 Wt % Ga) were synthesized and their degradation, bioactivity in simulated body fluid (SBF), and antibacterial properties were investigated. ICP measurements showed that increased gallium content in the glass resulted in increased gallium ion release and decreased release of other ions. Degradability declined with the addition of gallium, indicating the formation of more symmetric BO3 units with three bridging oxygens and asymmetric BO3 units with two bridging oxygens in the glass network as the gallium content in the series increased. The formation of amorphous CaP on the glass surface after 24 h of incubation in SBF was confirmed by SEM, XRD, and FTIR analyses. Finally, antibacterial evaluation of the glasses using the agar disc-diffusion method demonstrated that the addition of gallium increased the antibacterial potency of the glasses against P. aeruginosa (Gram-negative) while decreasing it against S. epidermidis (Gram-positive); considering the ion release trends, this indicates that the gallium ion is responsible for the glasses' antibacterial behavior against P. aeruginosa while the zinc ion controls the antibacterial activity against S. epidermidis. The statistical significance of the observed trends in the measurements were confirmed by applying the Kruskal-Wallis H Test. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 367-376, 2018.
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