This study describes the comparative performance of four commercially available microspherical embolisation products: Embosphere, Embogold, Contour SE and Bead Block. A series of in vitro evaluations were designed to assess the mechanical and biological characteristics of these biomaterials. Size distribution analysis revealed sieving techniques used to fractionate the embolics produced similar size distributions. The forces required to compress Embosphere, Embogold and Bead Block were in the range 21-27.5 kPa. Contour SE was significantly more compressible at approximately 5 kPa. However, recoverability of Contour SE required several minutes in contrast to the other products, a phenomenon attributed to its macroporous structure. When time taken to reach and remain in suspension was studied, results showed that the products quickly reached equilibrium with contrast agent. Bead Block was maintained in suspension for twice as long as the other products. Catheter deliverability was assessed and found to be dependent upon both microsphere and catheter, the best combination being Bead Block delivered via the Progreat catheter. Both the blood contacting SEM and plasma coagulation time showed none of the products were pro-thrombic or pro-coagulatory, each producing comparable results. Small differences in physical properties such as compressibility, could play an important role in delivery and effectiveness of vessel blockage. Currently all products are used routinely in clinical practice.

The aim of the present study was to determine the effect of the antibiotic cefpodoxime on the gram-negative periodontopathic microorganism Actinobacillus actinomycetemcomitans and its interaction with elements of the host immune system. Growth of A. actinomycetemcomitans in subinhibitory concentrations of cefpodoxime induced morphological changes in the bacteria, causing the organisms to grow as filaments rather than coccobacilli. Growth in cefpodoxime did not render these bacteria susceptible to killing by serum, nor did it abrogate the requirement for serum opsonins to support the bactericidal activity of neutrophils. Cefpodoxime enhanced the susceptibility of A. actinomycetemcomitans to the bactericidal activity of neutrophils. In the presence of suitable opsonins, neutrophils were able to kill four times as many cefpodoxime-induced A. actinomycetemcomitans filaments as untreated A. actinomycetemcomitans CFU. This effect was due to antibiotic actions on the bacterium and not on the neutrophil. At inhibitory concentrations, the bactericidal activities of cefpodoxime and neutrophils were additive, and cefpodoxime did not interfere with the normal functioning of the neutrophils. Concomitant with these morphological and functional changes, the expression of two outer membrane proteins (66 and 29 kDa) and one inner membrane protein (57 kDa) was decreased in A. actinomycetemcomitans grown in cefpodoxime. The concentration range over which cefpodoxime is effective against A. actinomycetemcomitans in vivo may be extended by the ability of subinhibitory concentrations to enhance the susceptibility of this organism to host immune defenses.