The objectives of this prospective, observational study were (1) to determine whether a transplanted liver graft releases proinflammatory cytokines into the systemic circulation upon reperfusion and (2) to determine whether they contribute to any subsequent hemodynamic instability observed after graft reperfusion (if this release occurs). Blood samples from 17 consecutive patients undergoing liver transplantation were analyzed for cytokines, including tumor necrosis factor a (TNFa), interleukin-1b (IL-1b), IL-2, IL-6, and IL-8. Blood samples were obtained from the radial artery, portal vein, and flush blood (a sample taken from a catheter placed above the infrahepatic inferior vena cava clamp). The amount of catecholamines necessary to maintain a mean arterial pressure between 65 and 75 mm Hg during graft reperfusion was compared with the level of cytokines. A statistical analysis was performed with the least squares method, Kendall's tau-b test, and regression analysis. We demonstrated that flush blood from the liver grafts contained a significant amount and variety of cytokines. Most of these were removed by graft irrigation. The concentration of TNF-a in samples obtained from flush blood at the end of liver irrigation was significantly higher than the concentration in samples obtained from the radial artery (P ¼ 0.0067) or portal vein (P ¼ 0.0003) before reperfusion. This correlated directly with the amount of catecholamines used to treat hemodynamic instability. Although there were increased levels of IL-1b, IL-2, and IL-8 in the flush blood, there was no statistically significant correlation between the levels of these cytokines and the amount of catecholamines used. Liver

The fatigue life of mini or small-diameter dental implants is of particular interest because these implants are used to retain and support fixed and removable dental prostheses. The fatigue life of an implant depends on both the implant itself as well as on the physical properties of the bone. However, the capability to predict the fatigue life of a newly placed implant is currently inexistent. This pilot study represents the first step in developing such a methodology and focuses on the design of a cost-effective device to measure the fatigue life of a dental implant. In our measurements, the implant has been mounted in an essentially rigid support, but test specimens can also be bone mounted in vitro. Furthermore, we developed a finite element-based computer model capable of predicting the corresponding fatigue life. The finite element analysis was performed in ABAQUS, and the results predicted by the model correlated fairly well with our initial experimental results. Most of the 2-mm diameter implants fractured after more than a million cycles.

No abstract

Dental implants are used to retain and support fixed and removable dental prostheses. In many clinical situations, local bone morphology requires dental implants that have a diameter that is significantly smaller than the typical implant diameters. In these cases, the fatigue life of the smaller diameter implants becomes a critical therapeutic parameter. However, this fatigue life depends on the implant itself, on the physical properties of the bone, as well as on other morphological characteristics that are patient dependent. In other words, this fatigue life varies greatly with each newly placed implant, but the capability to predict the fatigue life of dental implants does not exist today. In this paper, we present the first steps towards establishing such a methodology. We develop a finite element based fatigue model for rigidly mounted dental implants, and correlate its results with both analytical predictions as well as physical measurements. This implies that such a model can be used as a valid predictor of fatigue life of dental implants themselves, and can be used as a valuable implant design tool. Furthermore, we present the design of a cost effective device to measure the fatigue life of dental implants that can be either rigidly or bone mounted (in vitro). This device was used to measure the fatigue life of an initial sample of nine dental implants, and we show that the results predicted by the finite element model correlated well with our initial experimental results.

No abstract