Polyetheretherketone (PEEK) has been widely applied in orthopedics because of its excellent mechanical properties, radiolucency, and biocompatibility. However, the bioinertness and poor osteointegration of PEEK have greatly limited its further application. Growing evidence proves that physical factors of implants, including their architecture, surface morphology, stiffness, and mechanical stimulation, matter as much as the composition of their surface chemistry. This review focuses on the multiple strategies for the physical modification of PEEK implants through adjusting their architecture, surface morphology, and stiffness. Many research findings show that transforming the architecture and incorporating reinforcing fillers into PEEK can affect both its mechanical strength and cellular responses. Modified PEEK surfaces at the macro scale and micro/nano scale have positive effects on cell-substrate interactions. More investigations are necessary to reach consensus on the optimal design of PEEK implants and to explore the efficiency of various functional implant surfaces. Soft-tissue integration has been ignored, though evidence shows that physical modifications also improve the adhesion of soft tissue. In the future, ideal PEEK implants should have a desirable topological structure with better surface hydrophilicity and optimum surface chemistry.
Benzophenones ; Ketones/chemistry* ; Polyethylene Glycols/chemistry* ; Polymers/chemistry* ; Surface Properties

OBJECTIVE: To explore a novel method for fabricating removable partial dentures (RPDs) using polyetheretherketone (PEEK) by computer-aided design and computer-aided manufacturing (CAD/CAM) technologies and to evaluate their fits for different assemblies in vitro. METHODS: A standard stone cast of mandibular partial edentulous jaw was scanned using a lab scanner. Based on the digital cast, thirteen complete RPDs were designed combing dental CAD software and reverse engineering software, and then fabricated using PEEK by milling machine. Fits of assemblies were evaluated quantitatively by measuring the spaces between RPDs and casts. The gaps between RPDs and stone casts in different assemblies were duplicated using light-body silicone impression material and then measured using three-dimensional (3D) digital analysis methods in virtue of a dedicated software. Statistically, one-way analysis of variance (ANOVA) was used to compare the difference of gaps among assemblies in different shapes such as occlusal rest, denture base, and major connector. Paired-samples t test was used to compare the gaps difference for the similar shape assemblies in different areas. RESULTS: One-piece PEEK RPDs were successfully designed and fabricated by CAD/CAM, and all the RPDs were well-seated on stone casts. The gaps between occlusal rests and casts [(84.3±23.6) μm] were significantly larger than those of denture bases [(32.5±27.8) μm] and major connectors [(49.9±47.0) μm], which meant that the fits of denture bases and major connectors were better than that of occlusal rests. However, the fits of all assemblies could be accepted clinically. For the similar shape assemblies in different areas, there were no significantly differences for gaps between distal extension denture bases [(25.1±55.3) μm] and non-extensive denture bases [(41.5±17.7) μm]. The gaps of occlusal rests adjacent and nonadjacent to the edentulous space were (86.1±29.8) μm and (80.8±42.1) μm respectively and there were no significantly difference between them either. These results implied that different locations had no apparent effect on the fits of assemblies. CONCLUSION With the computer-aided design and computer-aided manufacturing technology, PEEK can be used to fabricate one-piece removable partial dentures. And all assemblies of the one-piece PEEK RPDs showed satisfying fits in vitro, indicating a promising clinical application in the future.
Benzophenones ; Computer-Aided Design ; Denture, Partial, Removable ; Ketones ; Polyethylene Glycols ; Polymers

OBJECTIVE: To develop dexamethasone plus minocycline-loaded liposomes (Dex/Mino liposomes) and apply them to improve bioinert polyetheretherketone (PEEK) surface, which could prevent post-operative bacterial contamination, enhance ossification for physiologic osseointegration, and finally reduce implant failure rates. METHODS: Dex/Mino liposomes were covalently grafted onto the PEEK surface using polydopamine (pDA) coating as a medium. Confocal laser scanning microscopy was used to confirm the binding of fluorescently labeled liposomes onto the PEEK substrate, and a microplate reader was used to semiquantitatively measure the average fluorescence intensity of fluorescently labeled liposome-decorated PEEK surfaces. Moreover, the mouse subcutaneous infection model and the beagle femur implantation model were respectively conducted to verify the bioactivity of Dex/Mino liposome-modified PEEK in vivo, by means of micro computed tomography (micro-CT) and hematoxylin and eosin (HE) staining analysis. RESULTS: The qualitative and quantitative results of fluorescently labeled liposomes showed that, the red fluorescence intensity of the PEEK-pDA-lipo group was stronger than that of the PEEK-NF-lipo group (P < 0.05); the liposomes were successfully and uniformly decorated on the PEEK surfaces due to the pDA coating. After mouse subcutaneous implantation of PEEKs for 24 hours, HE staining results showed that the number of inflammatory cells in the PEEK-Dex/Mino lipo group were lower than that in the inert PEEK group (P < 0.05), indicating a lower degree of infection in the test group. These results suggested that the Mino released from the liposome-functionalized surface provided an effective bacteriostasis in vivo. After beagle femoral implantation of PEEK for 8 weeks, micro-CT results showed that the PEEK-Dex/Mino lipo group newly formed more continuous bone when compared with the inert PEEK group; HE staining results showed that more new bones were formed in the PEEK-Dex/Mino lipo group than in the inert PEEK group, which were firmly bonded to the functionalized PEEK surface and extended along the PEEK interface. These results suggested that the Dex released from the liposome-functionalized surface induced effective bone regeneration in vivo. CONCLUSION Dex/Mino liposome modification enhanced the bioactivity of inert PEEK, the functionalized PEEK with enhanced antibacterial and osseointegrative capacity has great potential as an orthopedic/dental implant material for clinical application.
Animals ; Benzophenones ; Dogs ; Ketones ; Liposomes ; Mice ; Osseointegration ; Polyethylene Glycols ; Polymers ; Surface Properties ; X-Ray Microtomography

PURPOSE: The ketogenic diet (KD) remains a therapy in search of explanation although it is an established treatment for patients with intractable seizures. It was designed to mimic the biochemical changes seen upon fasting, specifically the formation of ketone bodies: acetoacetate (ACA), beta-hydroxybutyrate (BHB), and to a lesser extent, acetone. The present study was designed to investigate the protective effect of BHB on flurothyl-induced seizures in rats. METHODS: Thirty-four male Sprague-Dawley rats were divided into two equal groups. Experimental rats (n=17) were injected intraperitoneally with BHB (20 mmol/kg), while control animals (n=17) with normal saline. Fifteen minutes later, seizures were chemically induced by flurothyl infusion (40 mL/min). Seizure susceptibility was defined as the latency from the start of flurothyl infusion to the onset of a generalized seizure. Shorter latencies reflected greater seizure susceptibility. RESULTS: The mean (+/- SEM) latency to the onset of a generalized seizure in the experimental animals treated with BHB was 476.5 +/- 13.9 seconds, which was significantly longer (P < 0.05) than the control (438.0 +/- 10.5 seconds). CONCLUSION: This study demonstrated the significant decrease in flurothyl-induced seizure susceptibility in rats treated with BHB. Our results suggest that BHB may be directly anticonvulsant.
3-Hydroxybutyric Acid ; Acetoacetates ; Acetone ; Animals ; Fasting ; Flurothyl ; Humans ; Hydrazines ; Ketogenic Diet ; Male ; Rats ; Rats, Sprague-Dawley ; Seizures

OBJECTIVE: This study aims to assess the effects of the different thicknesses of body-shade resin layers on the color of polyetheretherketone (PEEK)-Crea.lign restorations. METHODS: Five PEEK specimens with the thickness of 0.6 mm were prepared. The color values of PEEK specimens were measured. Afterward, opaque-shade resin layers (0.1 mm) and body-shade resin layers (1.5 mm) were stacked with mold. The five specimens were evenly ground to a thickness of 1.4, 1.2, 1.0, 0.8, 0.6, 0.4, 0.2, and 0.0 mm in sequence. After grinding and ultrasonic cleaning, the color value was measured. RESULTS: With the constant thickness of PEEK and 0.1 mm thickness of opaque-shade resin layer, the L*, a*, and b* values all showed downward trend with the increased thickness of the body-shade resin layer (1.0-1.4 mm). With the constant thickness of PEEK and 0.1 mm thickness of opaque-shade resin layer, the color difference between the adjacent groups was less than 1.5 NBS. This difference between nonadjacent groups was more than 1.5 NBS when the thickness of the body-shade resin layer reached 0.6 mm. Color difference between PEEK-Crea.lign restoration and PEEK was more than 1.5 NBS. CONCLUSIONS The thickness change in the body-shade resin layers influence the color of the PEEK-Crea.lign restorations. Using A2 shade Crea.lign, opaque-shade resin layer thickness is 0.1 and 0.6 mm thickness of body-shade resin layer can produce color which clinically acceptable.
Color ; Composite Resins ; Ketones ; Polyethylene Glycols

Objective: To establish a method for the determination of methyl isobutyl ketone (MIBK) in urine samples by headspace-gas chromatography-mass spectrometry. Methods: Automatic headspace sampling technique was adopted to optimize the headspace conditions (headspace bottle heating temperature and equilibration time) and gas chromatographic conditions. A total of 5 ml samples were taken and added with 3.0 g ammonium sulfate into a 20 ml headspace bottle. After heated at 60 ℃ for 30 mins, gas from the upper part of headspace bottle was injected into gas chromatography with an injection volume of 100 μl. The target was separated by HP-5MS UI (30 m×0.25 mm×0.25 μm) capillary column and then detected by mass spectrometry detector. The retention time and external standard method were used for qualitative and quantitative analysis of MIBK in samples, respectively. Results: The standard curve of MIBK showed significant linearity between 20.0-1 000.0 μg/L. The standard curve was y=62.9x-652.5, and the correlation coefficient r=0.9998. The detection limit of MIBK was 5.0 μg/L and the quantification limit of MIBK was 16.0 μg/L. The average recovery rate was 95.3%~100.2% at three spiked concentrations of low (50.0 μg/L) , medium (200.0 μg/L) and high (500.0 μg/L) . The intra-day and inter-day precisions were 1.7%~3.8% (n=6) and 1.2%~4.0% (n=6) respectively. This method was stable for the determination of MIBK, and the urine could be kept 14 d at -20 ℃ without significantly loss. Conclusion: This method is proved to be simple, practical and highly sensitive. It can satisfy the request for the determination of urine samples of workers exposed to MIBK.
Gas Chromatography-Mass Spectrometry ; Humans ; Methyl n-Butyl Ketone

Lignin degradation products are toxic to microorganisms, which is one of the bottlenecks for fuel ethanol production. We studied the effects of phenolic ketones (4-hydroxyacetophenone, 4-hydroxy-3-methoxy-acetophenone and 4-hydroxy-3,5-dimethoxy-acetophenone) derived from lignin degradation on ethanol fermentation of xylose and cellular lipid composition of Pichia stipitis NLP31. Ethanol and the cellular fatty acid of yeast were analyzed by high performance liquid chromatography (HPLC) and gas chromatography/mass spectrometry (GC/MS). Results indicate that phenolic ketones negatively affected ethanol fermentation of yeast and the lower molecular weight phenolic ketone compound was more toxic. When the concentration of 4-hydroxyacetophenone was 1.5 g/L, at fermentation of 24 h, the xylose utilization ratio, ethanol yield and ethanol concentration decreased by 42.47%, 5.30% and 9.76 g/L, respectively, compared to the control. When phenolic ketones were in the medium, the ratio of unsaturated fatty acids to saturated fatty acids (UFA/SFA) of yeast cells was improved. When 1.5 g/L of three aforementioned phenolic ketones was added to the fermentation medium, the UFA/SFA ratio of yeast cells increased to 3.03, 3.06 and 3.61, respectively, compared to 2.58 of the control, which increased cell membrane fluidity and instability. Therefore, phenolic ketones can reduce the yeast growth, increase the UFA/SFA ratio of yeast and lower ethanol productivity. Effectively reduce or remove the content of lignin degradation products is the key to improve lignocellulose biorefinery.
Acetophenones ; chemistry ; Ethanol ; chemistry ; Fermentation ; Industrial Microbiology ; Ketones ; chemistry ; Lignin ; chemistry ; Lipids ; chemistry ; Phenols ; chemistry ; Pichia ; chemistry ; Xylose ; chemistry

The ketoreductase (KR) domain in the first extending module of the polyketide synthase (PKS) catalyzes the reductions of both an α-keto group and a β-keto group in the biosynthesis of bacillaene, suggesting the intrinsic substrate promiscuity. In order to further investigate the substrate specificity, the KR domain (BacKR1) was heterologously overexpressed in Escherichia coli. In vitro enzymatic analysis showed that only one of the four diastereomers was formed in the reduction of the racemic (±)-2-methyl-3-oxopentanoyl-N-acetylcysteamine thioester catalyzed by BacKR1. In addition, BacKR1 was revealed to catalyze the reductions of cyclohexanone and p-chloroacetophenone, indicating the potential of KR domians of PKSs as biocatalysts.
Bacterial Proteins ; genetics ; metabolism ; Catalysis ; Cyclohexanones ; metabolism ; Escherichia coli ; enzymology ; Polyketide Synthases ; genetics ; metabolism ; Protein Structure, Tertiary ; Substrate Specificity ; omega-Chloroacetophenone ; metabolism

OBJECTIVE: Aim of study was to find a proper method for assessing subsidence using a radiologic measurement following anterior cervical discectomy and fusion (ACDF) with stand-alone polyetheretherketone (PEEK), Solis(TM) cage. METHODS: Forty-two patients who underwent ACDF with Solis(TM) cage were selected. With a minimum follow-up of 6 months, the retrospective investigation was conducted for 37 levels in 32 patients. Mean follow-up period was 18.9 months. Total intervertebral height (TIH) of two fused vertebral bodies was measured on digital radiographs with built-in software. Degree of subsidence (DeltaTIH) was reflected by the difference between the immediate postoperative and follow-up TIH. Change of postoperative disc space height (CT-MR DeltaTIH) was reflected by the difference between TIH of the preoperative mid-sagittal 2D CT and that of the preoperative mid-sagittal T1-weighted MRI. RESULTS: Compared to preoperative findings, postoperative disc height was increased in all cases and subsidence was observed only in 3 cases. For comparison of subsidence and non-subsidence group, TIH and CT-MRDeltaTIH of each group were analyzed. There was no statistically significant difference in TIH and CT-MR DeltaTIH between each group at 4 and 8 weeks, but a difference was observed at the last follow-up TIH (p=0.0497). CONCLUSION: ACDF with Solistrade mark cage was associated with relatively good radiologic long-term results. Fusion was achieved in 94.5% and subsidence occurred in 8.1% by the radiologic assessment. Statistical analysis reveals that the subsidence seen later than 8 weeks after surgery and the development of subsidence does not correlate statistically with the change of the postoperative disc space height.
Diskectomy ; Follow-Up Studies ; Humans ; Ketones ; Polyethylene Glycols ; Retrospective Studies

When anterior reduction fail in the surgical treatment of cervical bilateral facet fracture-dislocation with concomitant disc extrusion, it is necessary to perform a reduction using a posterior approach and then a third anterior procedure is often necessary to accomplish the anterior reconstruction. This presents difficulties for both patients and surgeons because of the need for frequent position changes (supine-prone-supine). The purpose of this study is to illustrate a modified surgical technique, which is anterior reduction and fixation with a prefixed polyetheretherketone (PEEK) cage to a buttress plate for the treatment of irreducible bilateral cervical facet fracture-dislocation with a prolapsed disc is an enhancing technique for the stability of the interbody graft than a buttress plate alone because the PEEK cage has more fixation power and reduces both the number of position changes and the length of the operation.
Humans ; Intervertebral Disc Displacement ; Ketones ; Polyethylene Glycols ; Transplants