Determination of Insecticidal Effect (LC50 and LC90) of Organic Fatty Acids Mixture (C8910+Silicone) Against Aedes aegypti and Aedes albopictus (Diptera: Culicidae)

Emerging and re-emerging vector-borne diseases such as chikungunya and dengue and associated Aedes vectors are expanding their historical ranges; thus, there is a need for the development of novel insecticides for use in vector control programs. The mosquito toxicity of a novel insecticide and repellent consisting of medium-chain carbon fatty acids (C8910) was examined. Determination of LC₅₀ and LC₉₀ was made against colony-reared Aedes aegypti (L.) and Aedes albopictus (Skuse) using probit analysis on mortality data generated by Centers for Disease Control and Prevention bottle bioassays. Six different concentrations of C8910 + silicone oil yielded an LC₅₀ of 160.3 µg a.i/bottle (147.6-182.7) and LC₉₀ of 282.8 (233.2-394.2) in Ae. aegypti; five concentrations yielded an LC₅₀ of 125.4 (116.1-137.6) and LC₉₀ of 192.5 (165.0-278.9) in Ae. albopictus. Further development of C8910 and similar compounds could provide vector control specialists novel insecticides for controlling insect disease vectors.

Design and Characterization of Silicone and Surfactant Based Systems for Topical Drug Delivery

Nanotechnology offers advantages for new drug delivery design by providing drug targeting while minimizing the side effects. Polyoxyethylene 20 cetyl alcohol (CETETH-20) is a surfactant that may form nanostructured systems, such as liquid crystals, when in contact with water/oil, which are structurally similar to biological membranes and may improve skin interaction. The aim of this study was to develop and characterize CETETH 20-based nanostructured systems by combining CETETH-20 with water and different oily phases, including PEG-12-dimethicone for topical drug administration. The systems were characterized by polarized light microscopy (PLM), small-angle X-ray scattering (SAXS), rheology, texture profile analyses (TPA), in vitro cytotoxicity and histopathological analyses of rabbits' skin. Lamellar, hexagonal and cubic phases were identified and their viscoelastic moduli varied according to each phase. The stiffness of the cubic phase was 3-fold higher and twice more adhesive than the hexagonal phase. The formulations did not affect the normal macrophages cells, neither promoted skin irritation. They were spontaneously obtained by simply mixing the components, which corroborates for an ease scaled-up. These results suggest that systems composed of CETETH 20, PEG-12-dimethicone and water are a promising new approach for designing nanostructured topical drug delivery systems.

Surface modification of silicone for biomedical applications requiring long-term antibacterial, antifouling, and hemocompatible properties

Silicone has been used for peritoneal dialysis (PD) catheters for several decades. However, bacteria, platelets, proteins, and other biomolecules tend to adhere to its hydrophobic surface, which may lead to PD outflow failure, serious infection, or even death. In this work, a cross-linked poly(poly(ethylene glycol) dimethacrylate) (P(PEGDMA)) polymer layer was covalently grafted on medical-grade silicone surface to improve its antibacterial and antifouling properties. The P(PEGDMA)-grafted silicone (Silicone-g-P(PEGDMA)) substrate reduced the adhesion of Staphylococcus aureus , Escherichia coli , and Staphylococcus epidermidis , as well as 3T3 fibroblast cells by ≥90%. The antibacterial and antifouling properties were preserved after the modified substrate was aged for 30 days in phosphate buffer saline. Further immobilization of a polysulfobetaine polymer, poly((2-(methacryloyloxy)ethyl)dimethyl-(3-sulfopropyl)ammonium hydroxide) (P(DMAPS)), on the Silicone-g-P(PEGDMA) substrate via thiol-ene click reaction leads to enhanced antifouling efficacy and improved hemocompatibility with the preservation of the antibacterial property. Compared to pristine silicone, the so-obtained Silicone-g-P(PEGDMA)-P(DMAPS) substrate reduced the absorption of bovine serum albumin and bovine plasma fibrinogen by ≥80%. It also reduced the number of adherent platelets by ≥90% and significantly prolonged plasma recalcification time. The results indicate that surface grafting with P(PEGDMA) and P(DMAPS) can be potentially useful for the modification of silicone-based PD catheters for long-term applications.

The effects of model polysiloxane and fouling-release coatings on embryonic development of a sea urchin (Arbacia punctulata) and a fish (Oryzias latipes)

In recent decades attention has focused on the development of non-toxic fouling-release coatings based on silicone polymers as an alternative to toxic antifouling coatings. As fouling-release coatings gain market share, they will contribute to environmental contamination by silicones. We report effects of eight model polysiloxane and three commercial foul-release coatings on embryonic development of sea urchins and fish, Japanese medaka. We used model coatings because they have known composition and commercially available components and molecules leaching from these coatings have been partially characterized. The commercial fouling-release coatings are purported to be non-toxic and components are proprietary. Our goal was to expose embryos of well studied model animals to the coatings to determine if the complex mixtures leaching from the coatings impact development. Urchins were chosen because development is rapid and embryos can enter the non-slip layer over surfaces. Medaka was chosen because the female deposits the sticky eggs onto the anal fin and then scrapes them off onto surfaces. Embryos were confined in water over coatings in 24 well plates. Fresh model coatings had no effect on urchin development while commercial fouling-release coatings inhibited development. Fish embryos had delayed hatching, increased mortality of hatchlings and dramatically decreased ability of hatchlings to inflate the swim bladder and reduced hatching success on all coatings. After one-month immersion of coatings in running seawater to simulate initial application in the marine environment, sea urchin embryos died when placed over model silicones. Effects of the commercial coatings were reduced but included retarded development. Effects on fish embryos over leached coating were reduced compared to those of fresh coating and included decreased hatching success, decreased hatchling survival and inability to inflate the swim bladder for commercial coatings. These findings suggest, similar to medical conclusions, compounds leaching from silicone coatings can impact development and the topic deserves study.

Liquid silicone to mitigate plantar pedal pressure: a literature review

Disruption of the body's plantar fat pad can occur as a result of one of three mechanisms: simple fat pad atrophy associated with age-related degeneration, steroid use, or collagen vascular disease. Actual or relative displacement in to the underlying osseous prominences may be seen in association with structural deformity of the foot. Disease states such as diabetes may alter the normal structural integrity of soft tissues through nonenzymatic glycation leading to increased stiffness and thus reduced attenuating capacity. Fat pad atrophy, regardless of the cause, is often associated with substantial emotional, physical, productivity, and financial losses. In situations where the patient is sensate, the resultant skin on bone situation is extremely painful, especially when walking.

[Preliminary study on immunosuppressive effects evaluation of biomaterial]

In this paper, an immunosuppression model of immunotoxicity built through applying immunosuppressive agent-cyclophosphamide. Subsequently the changes of some assessment indexes including total amount of lymphocytes and concentration of cytokine TNF-alpha in peripheral blood were observed and were used to evaluate immunotoxicity induced by Medical Heat Vulcanizing Silicone Rubber. The final results showed no immunosuppressive effect caused by this material. The study provide effective and sensitive detection technique for evaluation of medical devices and biomaterials' immunotoxicity.

Production of silicon alloys is associated with respiratory symptoms among employees in Norwegian smelters

OBJECTIVES

To develop a qualitative exposure classification of employees in Norwegian smelters and to investigate the relationship between respiratory symptoms and occupational exposure using this classification.

METHODS

The 3,924 participants completed a standardised questionnaire including questions of respiratory symptoms, familial asthma, allergy, doctor-diagnosed asthma, smoking habits, previous exposure and occupation. The employees were classified according to their current job function: (1) line operators were employed full time on the production line, (2) non-exposed employees did not work in production, (3) the remaining employees were classified as non-line operators. The association between the prevalence of respiratory symptoms and job category was examined using multivariate logistic regression.

RESULTS

The mean age of the participants was 38.6 years (standard deviation 9.2 years), 88.5% were males. The odds ratios (OR) (95% confidence intervals in parenthesis) for dyspnoea, cough and phlegm regarding previous exposure compared with no previous exposure were 1.4 (1.1-1.7), 1.4 (1.2-1.8) and 1.3 (1.0-1.7), respectively. The OR in line operators compared with non-exposed employees was 1.2 (0.9-1.7) for dyspnoea, 1.3 (1.0-1.8) for cough and 1.9 (1.4-2.7) for phlegm. The OR for respiratory symptoms was higher in relation to previous exposure than current job function except for phlegm.

CONCLUSION

In Norwegian smelters respiratory symptoms appear to be positively related to both current job function and previous exposure. Previous exposure appears to be more important than current job function.

Categorizing mistaken false positives in regulation of human and environmental health

One of the concerns often voiced by critics of the precautionary principle is that a widespread regulatory application of the principle will lead to a large number of false positives (i.e., over-regulation of minor risks and regulation of nonexisting risks). The present article proposes a general definition of a regulatory false positive, and seeks to identify case studies that can be considered authentic regulatory false positives. Through a comprehensive review of the science policy literature for proclaimed false positives and interviews with authorities on regulation and the precautionary principle we identified 88 cases. Following a detailed analysis of these cases, we found that few of the cases mentioned in the literature can be considered to be authentic false positives. As a result, we have developed a number of different categories for these cases of "mistaken false positives," including: real risks, "The jury is still out," nonregulated proclaimed risks, "Too narrow a definition of risk," and risk-risk tradeoffs. These categories are defined and examples are presented in order to illustrate their key characteristics. On the basis of our analysis, we were able to identify only four cases that could be defined as regulatory false positives in the light of today's knowledge and recognized uncertainty: the Southern Corn Leaf Blight, the Swine Flu, Saccharin, and Food Irradiation in relation to consumer health. We conclude that concerns about false positives do not represent a reasonable argument against future application of the precautionary principle.

A new, heavier-than-water silicone oil: a solution of perfluorohexyloctane in polydimethylsiloxane

PURPOSE

To pre p a re and explore new solutions of semifluorinated alkane in silicone oil, which have a specific gravity slightly higher than silicone oil and vitreous fluid (referred to in the following as heavier-than-water silicone oils (HWSs), and to investigate, in vitro, whether HWSs can be used to plug retina holes, while allowing dehydration of the subretinal space.

METHODS

HWS solutions were pre p a red with silicone oil 5000 and perfluorohexyloctane (F6H8). The stability was investigated under different conditions. The viscosity was determined by means of a capillary viscometer. The surface and interface tension were measured using the ring method.

RESULTS

HWSs are insoluble in an aqueous medium. Densiron(R)68 (HWS 1.06) is a transparent homogeneous liquid which is slightly heavier (1.06 g/cm3) than water and has a refractive index close to that of vitreous liquid. Densiron68 (HWS 1.06) has a low viscosity (1480 mPas) and interface tension (40.82 mN/m), making it an effective tamponade in the surgical treatment of an inferior detached retina. In addition, the interfaces between Densiron68 and other perfluorocarbon liquids are clearly visible. However, the interface layer between Densiron68 and water is not clear. Finally, all HWSs are stable over the long term at ambient temperatures, as well as physically and thermally resistant. CONCLUSIONS. Due to its physiochemical properties, Densiron68 could meet the requirements for a heavier-than-water tamponade.

[Silicone and latex urinary catheters cytotoxicity on primary cultured rabbit urothelial cells]

In everyday urological practice, the use of urinary catheters creates problems such as epithelial hyperplasia, edema or erosion.

THE AIM

of this study is estimation of the toxicity of latex and silicone urinary catheters on primary cultured rabbit urothelial cells (PRUCC) was compared.

MATERIALS AND METHODS

Primary cultured rabbit urothelial cells (PRUC) were characterized for their proliferation, qualitative evaluation and quantitative measurement of cytokeratins. In the first kind of cytotoxic assay included exposition of the PRUC cells on liquid extracts of latex and silicone. Cytotoxicity of 1, 5, 10, 20, 50% dilution and pure extract was evaluated after 24 h. Additionally for 1% solution observation was extended up to 3 days. The second cytotoxic assay was based on the close contact between the catheter surface and cells. In direct contact test, latex and silicon catheters samples covered cultured cells. Trypan blue exclusion assay was used to measure cell viability. Cells were counted using inverted microscope with camera.

RESULTS

1, 5, 10 and 20% of silicon extracts did not affect cell viability while 5% of latex catheter extracts did. There was no difference in cytotoxicity when PRUC cells had been exposed to 1% dilutions of both silicone and latex catheters extracts after 3-days observation. 50% dilution and pure latex and silicone urinary catheters extracts appears to be highly toxic on PRUC. Direct contact test confirmed high toxicity of latex and silicone catheters on PRUC.

CONCLUSIONS

We confirmed latex and silicone on PRUC to be very toxic with direct contact. Using extract test the properties of silicone seemed to be slightly better. Authors postulate using catheters covered with hydrogenic gel in every day urological practice.

A comparison of the in vitro cytotoxicity of two root canal sealers

The purpose of this study was to compare the cytotoxicity of an epoxy resin-based sealer (AH Plus) and a silicone-based sealer (Roeko Seal Automix, RSA). Cytotoxicity was assessed using the MTT assay for mitochondrial enzyme activity and haemocytometer viable cell counting after 24, 48 and 72-h exposure to L929 cells. AH Plus and RSA showed no statistically significant difference in the degree of toxicity. Both sealers had a low toxic influence on the cells during the experimental period. This study indicates that epoxy resin-based sealer AH Plus and the silicone-based sealer RSA have similar levels of cytotoxicity to mouse fibroblasts.

Soft tissue response to microtextured silicone and poly-L-lactic acid implants: fibronectin pre-coating vs. radio-frequency glow discharge treatment

From in vitro studies it is known that a plasma-treatment can enhance cell spreading. Similar effects can be observed after pretreatment of the surface with a protein coating, to mediate cell adhesion. The aim of the current study was to evaluate the in vivo effects of these surface modifications, in a three-month experiment in a goat model. We made silicone and poly-L-lactic acid implants with double-sided parallel micro-grooves (depth 1.0 microm, width 10.0 microm), a random surface roughness, or a smooth surface. Implants either received a radio-frequency glow discharge (RFGD) treatment, a fibronectin (Fn) pre-coating, or no pre-treatment. Subsequently, they were inserted into subcutaneous pockets created on the flanks of goats for 1, 3 or 12 weeks. Histological analysis showed that a fibrous tissue capsule had formed around all implants. Histomorphometrical analysis was performed on capsule thickness, capsule quality and the implant-tissue interface quality. Fn-treated surfaces showed a considerable early inflammatory reaction. Besides this, RFGD treatment or Fn pre-coating did not further influence any of the measured parameters. In conclusion, pre-treatment of polymer implant surfaces with Fn or RFGD treatment did not significantly influence tissue reaction around implants with micro-grooved, roughened or smooth surfaces.

Toxicology of polymers for implant contraceptives for women

This article reviews the toxicology of polymers that are used in contraceptive implants. The two main classes of synthetic, nondegradable polymers used in the delivery of female contraceptives are silicone elastomers (e.g., Silastic) and ethylene co-vinyl acetate (EVA; ELVAX). The controversies surrounding the silicone breast implants have prompted several studies to evaluate the toxicity of silicones. The epidemiologic data obtained thus far have overwhelmingly concluded that no correlation exists between certain chronic symptoms, such as arthritis, in patients and silicone prosthesis. This conclusion has been echoed by the expert panel report by the Institutes of Medicine. Although the IOM report focused on the safety of silicone breast prosthesis, data emerging from the joint reconstruction area also suggests that Silastic is safe for in vivo use. The toxicological studies on EVA are few, and the conclusion thus far is that they elicit no adverse local or systemic response over extended periods in vivo. In conclusion, the prognosis for Silastic and ELVAX as of now is excellent. However, any future implant development using these polymers should place an emphasis on processing parameters to minimize potential small molecule leachants and establish safety as a function of both site and duration of implantation.

Laboratory analyses of the potential toxicity of sediment-associated polydimethylsiloxane to benthic macroinvertebrates

Polydimethylsiloxane (PDMS) is widely used in a number of industrial processes and consumer products that result in down-the-drain disposal. The log p value for the PDMS used in the present study was 10, and the vapor pressure and water solubility values were below detection limits. These physicochemical characteristics and a measured degradation rate of 3% after six months in moist soils suggest that PDMS may accumulate in aquatic sediments. Sediment toxicity tests with the amphipod Hyalella azteca and with larvae of the midge Chironomus tentans were used to assess the potential for toxicity of PDMS-amended sediments to benthic invertebrates in short-term (10-d) and whole-life-cycle (28 d for H. azteca, 50-65 d for C. tentans) exposures. Endpoints for short-term tests included survival and growth, while life-cycle assays considered survival, growth, reproduction, and, for C. tentans only, emergence. Short-term and life-cycle exposures to concentrations of > or = 1,000 mg PDMS/kg sediment (dry wt) indicated that PDMS will not reduce survival, growth, or reproduction in H. azteca or C. tentans.

A comparison of the inflammatory response to a polydimethylsiloxane implant in male and female Balb/c mice

The implantation of biomaterials elicits a host response that influences the long-term behavior of implanted medical devices. This foreign body response is governed by cells of the immune system. Because sexual dimorphism in the immune system is well-established, a comparative study of the foreign body response in male and female mice was initiated. Eight-week-old male and female Balb/c mice received two subcutaneous implants in the interscapular region of a smooth peroxide-catalyzed polydimethylsiloxane (PDMS) and were sacrificed at 2, 14, 42, 70, and 105 days after implantation (n = 6 per sex per time point). Controls for each time point underwent the surgical procedure but received no implant. Tissue from the implant or surgical site was fixed, processed, and paraffin-embedded for histopathological evaluation and immunohistochemical (IHC) staining for tumor necrosis factor-alpha TNF-alpha) and interleukin-1 beta (IL-1beta). In control animals, an inflammatory response was observed at 2 days that was decreased by 14 days and absent after 42 days. At 2 and 14 days after PDMS implantation, a mild to moderate inflammatory reaction was observed around implants. The peak response was seen at 14 days, and granulation tissue, composed primarily of fibroblasts, macrophages, and neutrophils, was first observed at this time. After 105 days, the implantation site was surrounded by mature connective tissue, which had minimal numbers of macrophages and neutrophils, with severity scores that did not differ significantly in males and females. The immunostaining for TNF-alpha and IL-1beta followed similar temporal patterns, with both reaching a peak at the two week time point and remaining elevated, compared to level of expression in the controls, throughout the 105 day observation period. Staining for both cytokines in the implanted animals was generally higher in females than in males, although this difference was significant only for IL-1beta. These results suggest subtle differences between males and females in the activity of peri-implant inflammatory cells.

Surface modification with PEO-containing triblock copolymer for improved biocompatibility: in vitro and ex vivo studies

Poly(ethylene oxide) (PEO) has been frequently used to modify biomaterial surfaces for improved biocompatibility. We have used PEO-polybutadiene-PEO triblock copolymer to graft PEO to biomaterials by gamma-irradiation for a total radiation dose of 1 Mrad. The molecular weight of PEO in the block copolymer was 5000. In vitro study showed that fibrinogen adsorption to Silastic, polyethylene, and glass was reduced by 70 to approximately 95% by PEO grafting. On the other hand, the reduction of fibrinogen adsorption was only 30% on expanded polytetrafluoroethylene (e-PTFE). In vitro platelet adhesion study showed that almost no platelets could adhere to PEO-coated Silastic, polyethylene, and glass, while numerous platelet aggregates were found on the ePTFE. The platelet adhesion in vitro corresponded to the fibrinogen adsorption. When the PEO-grafted surfaces were tested ex vivo using a series shunt in a canine model, the effect of the grafted PEO was not noticeable. Platelet deposition on ePTFE was reduced by PEO grafting from 8170 +/- 1030 to 5100 +/- 460 platelets 10(-3) microm2, but numerous thrombi were still present on the PEO-grafted surface. The numbers of platelets cumulated on Silastic, polyethylene, and glass were 100 +/- 80, 169 +/- 35, and 24 +/- 22 platelets 10(-3) microm2, respectively. This is about 35% reduction in platelet deposition by PEO grafting. While the numbers of deposited platelets were small, the decreases were not as large as those expected from the in vitro study. This may be due to a number of reasons which have to be clarified in future studies, but it appears that in vitro platelet adhesion and fibrinogen adsorption studies may not be a valuable predictor for the in vivo or ex vivo behavior of the PEO-grafted surfaces.

Influence of long term silicone implantation on type II collagen induced arthritis in mice

OBJECTIVES

The use of silicone implants in cosmetic and reconstructive surgery has been implicated in the development of autoimmune connective tissue diseases. Previous investigation of the influence of short-term silicone implantation using an experimental model of rheumatoid arthritis revealed no adverse influence upon disease despite the generation of autoantibodies against silicone bound proteins. This study was designed to examine the influence of long term implantation of different forms of silicone in collagen induced arthritis.

METHODS

DBA/1 mice were surgically implanted with silicone elastomers, gel or oil nine months before immunisation with type II collagen emulsified in Freund's incomplete adjuvant. The incidence and severity of arthritis, antibodies to type II collagen, and serum cytokines were assessed and compared with sham implanted mice. Silicone implants were recovered, and autoantibodies to silicone bound proteins evaluated in arthritic and non-arthritic mice.

RESULTS

Immunisation with CII/FIA resulted in a 30% arthritis incidence in sham implanted DBA/1 mice. Long term silicone implantation resulted in an increased incidence of arthritis, with a significant increase of 90% arthritis in animals implanted with silicone elastomers. Animals implanted with silicone elastomer also developed foreign body sarcomas during the study. Serum concentrations of interleukin 10 were increased in mice implanted with elastomers and immunised with CII/FIA, while interleukin 5 concentrations were significantly diminished in these mice. The production of autoantibodies to autologous silicone bound proteins, including anti-type I collagen antibody, was also attributed to the implantation of either silicone gel or silicone elastomer in type II collagen immunised animals.

CONCLUSIONS

These data suggest that long term silicone implantation results in both the production of autoantibodies to connective tissue antigens and increased susceptibility to an experimental model of autoimmune disease.

Contrast medium-induced pulmonary edema is aggravated by silicone contamination in rats

PURPOSE

To examine the effect of silicone contamination, which occurs in clinical settings during vial preparation with disposable syringes, on contrast medium-induced pulmonary edema in rats.

MATERIALS AND METHODS

Ioxaglate, ioversol, and iohexol, silicone-containing physiologic saline solutions, and three silicone-containing contrast media were separately, intravenously injected at 1.5 mL/min in rats. Pulmonary edema was evaluated as changes in the relative lung weight and in the water, sodium, and potassium contents of the lung.

RESULTS

Intravenous injection of ioxaglate induced marked pulmonary edema, even with a dose of only 4 g of iodine per kilogram of body weight. In contrast, ioversol and iohexol induced significant pulmonary edema only after the injection of large doses (6 g of iodine per kilogram; P < .05). The injection of 4 microL/mL silicone-containing physiologic saline at a dose of 18.75 mL/kg also produced marked pulmonary edema, whereas doses of 6.25 and 12.5 mL/kg showed no significant influence. The addition of an ineffective dose (12.5 mL of physiologic saline per kilogram of body weight) of silicone in contrast medium substantially aggravated the pulmonary edema induced by the contrast medium alone; this phenomenon was also confirmed with morphologic observation.

CONCLUSION

Ionic contrast media are more toxic to the endothelial cells than are nonionic contrast media. Silicone contamination might be one of the causes of pulmonary edema after intravenous injection. However, caution must be exercised in extrapolating these results to humans.

Flow cytometric study of in vitro neutrophil activation by biomaterials

Neutrophil activation for adherent and nonadherent cells, as measured by flow cytometry, was not strongly dependent on material surface chemistry. We had hypothesized that material-induced neutrophil activation was an important parameter associated with material failure. All materials tested [cellophane, an acrylonitrile copolymer (AN69), Pellethane, nylon, polyethylene terephthalate, low density polyethylene, and polydimethylsiloxane] activated isolated human neutrophils, which were resuspended in plasma or serum, to similar extents based on L-selectin shedding, CD11b upregulation, and stimulation of the oxidative burst after 30-min exposure. Inhibition of complement activation by sCR1 unexpectedly had little effect if any on nonadherent neutrophils. However, neutrophil adhesion, but not the level of activation of the adherent cells, was strongly dependent on complement activation. Pretreatment with albumin did not inhibit adhesion or reduce neutrophil activation, but plasma pretreatment resulted in increased activation for nonadherent and adherent cells. More adhesion and a higher level of activation of adherent cells was observed following pretreatment with fibrinogen, a ligand of CD11b. Taken together these results suggest that upon contact with a material, neutrophil activation may occur though mechanisms that are not mediated by complement. For example, the presence of plasma proteins such as fibrinogen at the interface may trigger activation and the release of other activating agents. Although the material differences are small, the extent of activation may be significant and warrant further study of the mechanism and consequences of that activation.

Cytotoxicity testing of materials with limited in vivo exposure is affected by the duration of cell-material contact

Silicones for dental impression largely are used to record the geometry of hard and soft dental tissues. They are considered to be medical devices, and the assessment of cytotoxicity is a necessary step in the evaluation of their biocompatibility. Extracts of six addition-type and six condensation-type silicones have been tested with L929 cells according to the ISO 10993-Part 5 standard. The cytotoxicity was evaluated by three different methods: neutral red uptake, propidium iodide (PI) staining, and amido black staining. According to the selected specific assay, contact between cells and material extracts was maintained for 24 h in the first series of experiments; then, considering that in vivo application of these materials is restricted to a few minutes, additional experiments were performed after 1 h of cell/extract contact. Analysis of the results showed that the addition-type silicones are nontoxic even when tested after prolonged exposure of the cells to the materials while the condensation-type silicones were cytotoxic at 24 h of incubation. Nevertheless, harm to the patient actually could be negligible, considering its very short time of exposure in vivo. This is supported by our finding that most are not toxic after 1 h. We suggest that the experimental conditions of cytotoxicity testing have to be relevant to the in vivo situation; accordingly, the time of exposure should be designed carefully.

Silicone gel enhances the development of autoimmune disease in New Zealand black mice but fails to induce it in BALB/cAnPt mice

Anecdotal evidence links silicone gel breast implants with the development of autoimmune connective tissue disease in women. To investigate whether silicone gel is capable of directly inducing and/or enhancing the development of autoimmune disease, female BALB/cAnPt (BALB/c) and New Zealand Black (NZB) mice were injected subcutaneously with silicone gel, pristane, a nonmetabolizable substance that can cause plasmacytomas in BALB/c and NZB mice, or saline and monitored for the development of glomerulonephritis and autoantibody production. NZB, but not BALB/c, mice spontaneously develop autoantibodies and an autoimmune hemolytic anemia by 12 months of age. Over a period of 10 months, biweekly screening for proteinuria revealed increases in urinary protein in NZB mice that received multiple injections of either silicone gel or pristane. In contrast, urinary protein was unaffected in identically treated BALB/c mice. Although, silicone gel had no effect on serum titers of antierythrocyte antibodies in NZB mice, the hematocrits were significantly decreased. Moreover, silicone gel both increased the concentration of IgM anti-type I collagen antibodies and skewed the immunofluorescent staining pattern of serum autoantibodies on HEp-2 cells. In contrast, silicone gel failed to induce the production of anti-erythrocyte or antinuclear antibodies in BALB/c mice and induced only slight increases in IgG anti-type I collagen antibodies. These results suggest that silicone gel can exacerbate the development of autoimmune disease in autoimmune NZB mice, but fails to induce disease in normal BALB/c mice. This is consistent with several epidemiological studies failing to demonstrate an increase in the incidence of autoimmune disease in women with breast implants. However, because silicone gel was able to exacerbate autoimmune disease in NZB mice, it may play a similar role in the development of autoimmune disease in a small percentage of women who are genetically susceptible to such diseases.

The effect of a subcutaneous silicone rubber implant with shallow surface microgrooves on the surrounding tissues in rabbits

It has been suggested that during wound healing microtextured surfaces can alter events at the interface between implant surface surface and surrounding tissues. To investigate this phenomenon, smooth and microtextured silicone rubber implants were implanted subcutaneously in rabbits for 3, 7, 42, and 84 days. The textured implants possessed parallel surface microgrooves and ridges with a width of 2.0, 5.0, and 10.0 microns. All grooves had a depth of approximately 0.5 microns. SEM observation showed fibroblasts, erythrocytes, lymphocytes, macrophages, fibrin, and collagen on all implant surfaces after 3 and 7 days. After 42 and 84 days only little collagen, a small number of fibroblasts, but no inflammatory cells were seen on the implant surfaces. The fibroblasts were not oriented along the surface grooves on all textured surfaces. Three-dimensional reconstruction of CLSM images and LM images showed no significant differences between the thickness of the capsules surrounding the smooth and those surrounding the microgrooved implants. In contrast LM did show a significantly lower number of inflammatory cells and a significantly higher number of blood vessels in the capsules surrounding the microgrooved implants. Differences between the 2.0, 5.0, and 10.0 microns grooved implants were not detected. Our results concerning the capsule thickness suggest that the depth of our grooves was not sufficient to facilitate mechanical interlocking, but the cause for the observed differences in inflammatory response and number of blood vessels remains unclear.

Adjuvancy effect of different types of silicone gel

Women with silicone gel-filled breast implants (SBIs) are likely to be at a slightly higher risk of developing an autoimmune-like syndrome. This risk, although small, may be associated with the immunological adjuvancy property of the silicone gel. However, not all silicone gels are chemically formulated exactly the same and their adjuvancy behavior may vary. This study compared, in rats, the adjuvant effect of three different lots of silicone gel using ovalbumin (OVA) as the test antigen. Test bleeds were taken at 21, 48, 62, and 84 days post immunization and the rat sera were analyzed for anti-OVA antibodies by enzyme linked immunosorbent assay (ELISA). A delayed type hypersensitivity (DTH) test was performed on all the treated rats beginning at 14 post-immunization days. The results showed that silicone gel #3 (McGhan lot #S0400488) produced the highest mean anti-OVA antibody titer followed by silicone gel #1 (DC lot #HH019581) and silicone gel #2 (McGhan lot #DP9339). The DTH results showed that rats treated with silicone gel #1 and #3 had a clear positive response, whereas silicone gel #2 caused only a minimal response. These results demonstrate the immunological adjuvancy difference among three types of silicone gel. The chemical composition of each of these silicone gels, that would help explain these results, is yet to be determined.

Characterization of cellular response to silicone implants in rats: implications for foreign-body carcinogenesis

Foreign-body (FB) carcinogenesis is a classic model of multistage tumour development in rodents. Previous studies have demonstrated that the physical characteristics of the implant, and not the chemical composition, are the critical determinants of tumour development. The recent controversy over silicone breast implants has raised questions regarding the potential carcinogenicity of lifetime tissue exposure to silicone products. The present study was designed to determine whether the inflammatory and fibrotic reactions associated with silicone implants are due to a non-specific foreign-body reaction or whether these responses reflect the unique chemical composition of silicone. F344 rats were implanted subcutaneously with one of three biomaterials: silicone elastomer (Group 1); impermeable cellulose acetate filters (Group 2, positive control); or porous cellulose acetate filters (Group 3, negative control). The silicone and cellulose implants of Groups 1 and 2 have been previously shown to induce fibrosarcomas in rodents, whereas the porous cellulose acetate implants of Group 3 have been shown to be non-carcinogenic. One week and two months after implantation, the pericapsular tissues were evaluated using histopathological and in situ immunohistochemical analyses. Endpoints included expression of leucocyte antigens CD4 (T helper/inducer), CD8 (T suppressor/cytotoxic) and CD11 b/c (macrophage), proliferating cell nuclear antigen (PCNA) as an indicator of proliferation, and in situ end-labelling (ISEL) of 3'OH DNA strand breaks as an indicator of DNA damage and apoptosis. The results indicated that the acute and chronic cellular responses to silicone (Group 1) were not different from impermeable cellulose filters (Group 2) of identical size and shape, suggesting that these responses were not unique to silicone. The inflammatory response to the carcinogenic cellulose and silicone implants (Groups 1 and 2) was attenuated and associated with the formation of a thick fibrotic capsule. In contrast, the porous cellulose filters (Group 3) induced a markedly different cellular response in which the inflammatory reaction was more extensive, prolonged and associated with minimal fibrosis. Within the fibrotic capsule surrounding the tumorigenic implants, but not the non-tumorigenic implants, cell proliferation and apoptotic cell death were increased and associated with persistent DNA strand breaks. Taken together, the results suggest that the micrometre-scale surface morphology of the implant determines the nature of the subsequent cellular response which may predispose to tumour development. Further, these studies serve to emphasize the critical importance of appropriate physical controls in studies designed to evaluate carcinogenic or autoimmune manifestations associated with silicone implants in order to rule out the contribution of the chronic foreign-body reaction.

Testicular implants

Testicular implants have been in use for more than 50 years with an excellent record of safety and efficacy. The controversy concerning the use of silicone prosthetics in breast implants also affected testicular implants. There is no conclusive evidence associating connective tissue disorders, autoimmunity, or malignancy with silicone implants. Studies show silicone leakage from these implants, but long-term follow-up is required to identify the significance of this finding. Saline-filled silastic shell testicular prostheses will be implanted as part of an ongoing study to monitor various safety parameters, as required by the Food and Drug Administration.

Biocompatibility of latex and silicone T tubes in the porcine common bile duct: an experimental study

Toxicity of materials used in indwelling drains or catheters has the potential to damage surrounding tissues. The biocompatibility of biliary T-tubes was investigated using in groups of piglets (total 30 animals). In group 1 (n=16) a choledochotomy was performed with insertion of a latex T-tube (n=6) or a silicone T-tube (n=8), or without a T-tube (n=2). In group 2 (n=14) the common bile duct (CBD) was 3/4-transected, and the lesion was sutured over a latex T-tube (n=4) or a silicone T-tube (n=5), or without a T-tube (n=5). The groups were reoperated upon after 2 and 6 weeks respectively, and the CBD was harvested for scanning electron microscopy and light microscopy. The T-tubes were examined for cell culture toxicity with a DNA synthesis inhibition test. According to the cell culture tests, latex T-tubes were toxic and silicone T-tubes nontoxic. T-tubes induced moderate to pronounced fibrosis and epithelial damage in the CBD wall, but did not induce excessive fibrosis or scarring at the site of CBD suture. In the 6-week study period, however, the grade of tissue reactions in the CBD did not correlate with the toxicity of the T-tube materials, but rather reflected a foreign body reaction and mechanical pressure. Although gross anatomical changes did not occur, neither material seemed to be completely harmless for porcine CBD wall.

Tissue response to commercial silicone and polyurethane elastomers after different sterilization procedures

Two different commercial polymeric materials, a silicone and a polyurethane (PUR), were studied with regard to correlations between the chemical and physical compositions of the polymer surfaces and the biological response on implantation. Test specimens of the materials were manufactured according to standard procedures. The specimens were implanted in rats for 10 and 90 days. Before implantation the polymers were sterilized in three different ways, namely, beta irradiation, ethylene oxide sterilization and steam sterilization. The polymers were characterized before and after the implantation with respect to the chemical composition and the morphology of the surfaces. After implantation the biological response was evaluated by counting numbers of macrophages, giant cells, fibroblasts and other cells present at the surfaces. The thickness of the fibrous capsule surrounding the test specimens was measured at the thickest and thinnest parts. PUR surfaces showed signs of degradation already after sterilization and after 10 to 90 days of implantation, pits and cracks appeared, especially in the ethylene oxide sterilized samples. However, differences in the biological responses were small and independent of the sterilization method. After 10 days of implantation the capsule thickness and the amounts of cell material adhering at the surfaces were different, and it appears that the silicone rubber induces more tissue response than PUR. The differences in the early tissue response evened out after 90 days implantation time and a steady state situation evolved, which was similar for the silicone and the polyurethane.

Development of scleroderma-like syndrome in Tsk/+ mice is not enhanced by silicone administration

The possible role of silicone in the pathogenesis of a scleroderma-like syndrome is still unresolved. It has been proposed that silicone escaping from breast implants potentiates the progression of the disease. To clarify whether silicone enhances development of fibrotic skin lesions and autoantibodies, we tested its effect on tight skin (TSK/+) mice. TSK/+ mice spontaneously develop skin fibrosis and characteristic autoantibodies which resemble human scleroderma. The results of the present study indicate that silicone administration does not enhance development of skin fibrosis nor synthesis of autoantibodies to RNA polymerase and topoisomerase in TSK/+ mice.

Plasmacytoma development in mice injected with silicone gels

Silicone gels derived from commercially obtained implants induce plasmacytomas in 60-70% of highly susceptible BALB/cAn.DBA/2-Idh1-Pep3 congenic mice. In contrast, dimethylpolysiloxane (DMPS) silicone oils with viscosities of 5, 1000 and 12,500 cs fail to elicit these tumors. 1000 cs vinylmethylpolysiloxane is also inactive. Silicone gels, in contrast to the oils, induce a highly inflammatory silicone granuloma. Silicone gels contain chemical components not found in the oils. The chemical component responsible for inducing the permissive environment for plasmacytoma formation has not yet been identified. Silicone gels are well tolerated for long periods of time in mice without adverse effects other than plasmacytoma formation. The response to different gel preparations varies; some are associated with relatively rapid formation of plasmacytomas resembling that seen with pristane, while in others the plasmacytoma formation is extended nearly over a two year period.

Biomaterial-induced dysfunction in the capacity of rabbit alveolar macrophages to kill Staphylococcus epidermidis RP12

The effect of poly(methyl methacrylate) (PMMA), titanium alloy, and silicone discs on the capacity of rabbit alveolar macrophages (AM) to kill RP12 strain of Staphylococcus epidermidis (RP12) was studied in vitro. When freshly harvested AM were preincubated with PMMA discs for 3 h and subsequently assayed for RP12 killing, there was no change in the RP12 killing capacity of AM. However, when AM were incubated with PMMA discs for 6 or 18 h at 37 degrees C in 5% CO2, the RP12 killing capacity of AM was reduced to 15% and 4%, respectively. Preincubation of AM with titanium alloy for 6 h reduced RP12 killing capacity of AM to 30%, and to 21% in 18-h incubation. Silicone discs did not affect the RP12 killing by AM at 6 h of preincubation, but reduced RP12 killing (35%) by AM when preincubated for 18 h. Preincubation of AM with PMMA discs for 3 or 6 h did not affect the level of PMA-elicited oxidative burst of AM as measured by a luminol-enhanced chemiluminescent assay. Superoxide dismutase, which eliminated the oxidative burst of AM by 90%, did not affect the RP12 killing by AM.

Histopathology of rabbit eyes with silicone-fluorosilicone copolymer oil as six months internal retinal tamponade

Silicone-fluorosilicone copolymer oil has low viscosity (175-185 cSt) and is heavier than water (density, 1.16 g cm-3). Short term retinal tolerance (within 2 months) of the silicone-fluorosilicone copolymer oil has been reported to be the same as that of currently used intraocular silicone oil. Ocular response of the purified silicone-fluorosilicone copolymer oil were examined clinically and histopathologically from 2.5 months to 6 months after vitreous cavity injection in rabbit phakic eyes, and compared the oil tolerance with that of purified silicone oil (0.97 g cm-3, 5000 cSt). The effects in anterior chamber also were examined within 4 weeks of the silicone-fluorosilicone copolymer oil injection in different rabbits. Silicone-fluorosilicone copolymer oil recovered from the vitreous cavity at 6 months was analysed for cholesterol and retinol content by high performance liquid chromatography. Because of its low viscosity, silicone-fluorosilicone copolymer oil was easy to inject and remove from the vitreous cavity with a 20-G needle. After the vitreous injection, discrete droplet formation by the silicone-fluorosilicone copolymer oil occurred more easily than by silicone oil. Medullary ray detachment was seen in a silicone oil-, and some silicone-fluorosilicone copolymer oil-injected eyes at 4-6 months. Histopathologically, after 3-6 months disappearance of outer plexiform layer and disorganization of the photoreceptor layer of silicone oil-, and silicone-fluorosilicone copolymer oil-injected eyes were seen in the superior and the inferior retina, respectively. Migration of the photoreceptor cell nuclei to the photoreceptor layer was found in the inferior retina of silicone-fluorosilicone copolymer oil-injected eyes at 5-6 months. Small droplets ingested by mononuclear cells were found in the vitreous cavity or preretina at 4-6 months in silicone-fluorosilicone copolymer oil-injected eyes. After the anterior chamber injection, silicone-fluorosilicone copolymer oil induced endothelial cell damage in the area where the oil contacted continuously. Retinol and cholesterol were identified in silicone-fluorosilicone copolymer oil removed from the vitreous cavity. Silicone-fluorosilicone copolymer oil may be useful as an intraoperative device in retinal detachment surgery and as a short term (up to about 2 months) retinal tamponade but we do not recommend it for long term retinal tamponade.

The effect of molecular weight and gel preparation on humoral adjuvancy of silicone oils and silicone gels

Silicone gels from commercial breast implants have been shown previously by our laboratory to be potent humoral adjuvants, while the low molecular size 20 centistoke (cs) silicone oil (M.W. 1900) possesses no measurable adjuvant properties. It became necessary to shear the silicone gel during our previous experiments in order to facilitate injection through a syringe and needle, it is conceivable that shearing may reduce the molecular weight of the silicone gel used. This investigation was undertaken to determine whether humoral adjuvancy of silicone oils is dependent on molecular weight and whether the method of shearing the silicone gel affects its adjuvancy. Four Dow Corning 360 Medical silicone oils (100 cs, M.W. approximately 5,000; 350 cs, M.W. approximately 10,000; 1000 cs, M.W. approximately 16,500 and 12,500 cs, M.W. approximately 60,000) and Dow Corning octamethylcyclotetrasiloxane (D4, M.W. 296) were tested for their humoral adjuvancy by immunizing 64 Sprague Dawley rats with 50 micrograms of bovine serum albumin (BSA) mixed with each oil. The rats were periodically bled and the sera were analyzed for anti-BSA antibodies by ELISA. In a separate experiment, three silicone gel preparations with reproducible characteristics were prepared by using a tissue homogenizer and varying the applied shear force. Each of these preparations was tested for its humoral adjuvancy as previously described for silicone oils. Rats immunized with BSA mixed with the highest molecular size silicone oil tested (M.W. approximately 60,000) showed a significant increase in anti-BSA antibodies as compared to the lower molecular size oils. The three silicone gel preparations showed no difference in their adjuvancy effect. Thus, the humoral adjuvancy of silicone oil appears to be dependent on molecular weight. Differential shearing of the silicone gel does not alter its humoral adjuvancy.

Induction of plasmacytomas in genetically susceptible mice with silicone gels

Silicone gels injected intraperitoneally into strains of mice related to BALB/c develop plasmacytomas in approximately the same numbers and with similar phenotypes as previously obtained with pristane. Silicone gels produce few side effects and are well tolerated for long periods. Silicone gels contain several components that are potentially biologically active: residual vinyl groups and platinum. Microscopic and histological evidence suggests the silicone gel is degraded over a long period of time. Preliminary studies with long chain liquid dimethylpolysiloxanes with viscosities of 1000 cSt and 12,500 cSt have not produced plasmacytomas as yet. The plasmacytomagenic action of the gel appears to be due to the release of liquids from the gel matrix.

Studies on the tumor-promoting activity of biomaterials: inhibition of metabolic cooperation by polyetherurethane and silicone

When V79 metabolic cooperation (MC) assay was performed to detect tumor-promoting activities, inhibitory activities on the gap-junctional intercellular communication were first detected in both extracts prepared from polyetherurethane (PEU) and silicone. The former inhibited more strongly than the latter. Furthermore, the lowest effective concentrations in MC assay correlated well with the values of the total active incidences obtained by histologic evaluation of the 2-year implantation test in rats. Poly(tetramethylene oxide) (PTMO) showed the highest inhibitory activities among the constituents of PU. Thus, the shorter the chain length of PTMO, the stronger the inhibitory activities of PTMO in MC assay. PTMO moiety may play an important role in the tumor-promotion stage during tumorigenesis induced by PU.

Current issues in lactation: advantages, environment, silicone

The physiological process of breast-feeding should be encouraged under most circumstances despite the presence of trace amounts of environmental toxins. The decision for the initiation and continuation of lactation must involve the expectant father, especially in the provision of knowledge by clinicians of the beneficial effects to infant and mother. Awareness that growth patterns of breast-fed infants differ from formula-feeding is essential in the interpretation of toxicity and not an indicator to terminate lactation. Numerous studies demonstrate the importance of breast-feeding in providing protection against various diseases and decreasing the incidence of infant morbidity and mortality. Inert material such as silicone or environmental toxins including organophosphate pesticides, chlorinated hydrocarbons, solvents, and heavy metals have been identified in human milk. Toxic manifestations were reported in suckling infants exposed to mammary chemicals. The observed adverse reactions were suggested to be due to either (1) a direct action of the chemical without any maternal dietary deficiency, (2) a combination of essential mother nutrient deficiency and excess toxicant in breast milk; or (3) the presence of several toxicants in human milk acting in conjunction as bioactivators or promoters of toxicity. In weighing the risks vs benefits of lactation there is a clear consensus that even in the presence of mammary toxicants, breast-feeding should be promoted and maintained.

Silicone-induced arthritis in rats and possible role for T cells

Intra-articular injection of silicone into the ankle joint of the rat induced persistent arthritis. Histologically, at 24 h after silicone injection, there was marked edema of the synovial tissue containing many inflammatory cells including polymorphs, monocytes and macrophages. This was followed by marked proliferation of synovium with dense infiltration of mononuclear cells and destruction of cartilage. Immunohistological studies showed that a large number of CD5+ and alpha beta+ T cells infiltrated in synovial tissues in the chronic phase of joint inflammation. Treatment of rats with a monoclonal antibody against TCR alpha beta significantly suppressed the development of chronic, but not acute arthritis. Thus, T cells may play a role in silicone-induced chronic arthritis.

Reproductive and developmental toxicity studies of silicone gel Q7-2159A in rats and rabbits

Studies reported here assessed the potential adverse effects of silicone gel, Dow Corning Q7-2159A, on general reproduction and fetal development in male and female Charles River CD rats and New Zealand white rabbits. Two control and three treatment groups of 30 male and 30 female rats and 25 female rabbits per group were used in the one-generation reproduction and developmental toxicity studies, respectively. The silicone gel was implanted subcutaneously in two flank sites at dosage levels of 3, 10, and 30 ml/kg. The highest dose was selected on the basis of likely human body burden. Control groups received either sterile saline or carboxymethylcellulose solution in two flank implantation sites. The control and test articles were implanted in male and female rats 61 and 47 days, respectively, prior to mating (in the rat reproduction study) and approximately 42 days prior to insemination of female rabbits (in the rabbit developmental toxicity study). There were no treatment-related effects on F0 parental general conditions and reproductive performance, F1 neonatal viability, or growth in the rat reproduction study. No maternal nor developmental effects, including teratogenicity, were observed in rabbits in the groups implanted with Q7-2159A gel in the developmental toxicity study.

Induction of plasmacytomas with silicone gel in genetically susceptible strains of mice

BACKGROUND

Plasmacytomas can be induced in high frequency in susceptible strains of mice by the intraperitoneal introduction of plastics or paraffin oils, including the chemically defined oil pristane (2,6,10,14-tetramethylpentadecane). These materials persist in the peritoneal cavity, where they induce chronic inflammation during the long periods before plasmacytomas develop. Such plasmacytomas appear to arise from B cells carrying chromosomal translocations that affect c-myc transcription.

PURPOSE

Because silicone gels are in widespread medical use and share many of the characteristics of other materials known to be inducers of plasmacytomas, we wished to determine their capacity to induce plasmacytomas in mice.

METHODS

In a series of parallel experiments, corn oil, pristane, silicone oil (dimethylpolysiloxane), or silicone gel from commercially obtained mammary implants was injected intraperitoneally into plasmacytoma-susceptible BALB/cAnPt-A and congenic BALB/cAnPt.DBA/2-Idh1-Pep3 mice, as well as into plasmacytoma-resistant C57BL/6N, C3H/HeJ, DBA/2N, and (BALB/c x DBA/2)F1 mice. Mice were examined at least once every 2 weeks for signs of abdominal tumor or weight loss and screened every 4-6 weeks for peritoneal plasmacytoma cells by peritoneal lavage. Tissues were examined by histologic and immunohistochemical techniques. Metaphase chromosome spreads were made from ascitic plasmacytomas without Colcemid treatment, and metaphase plates were G-banded according to standard techniques. The t(12;15) or t(6;15) translocation chromosomes were identified under the microscope in at least five metaphase plates of high banding quality. Mice were autopsied 125-400 days after the injection of test material. Gas chromatography and mass spectrometry were utilized to determine the composition of the silicone oil and silicone gel used in the injections.

RESULTS

The silicone gels tested induced plasmacytomas in BALB/cAnPt-A and BALB/cAnPt.DBA/2-Idh1-Pep3 mice. Neither corn oil used as a control nor 1000-centistoke or 12,500-centistoke dimethylpolysiloxane induced plasmacytomas in these mice. The plasmacytomas were transplantable in syngeneic hosts. Cytogenetic studies of 41 silicone-induced plasmacytomas showed that 30 had t(12;15) translocations, eight had t(6;15) translocations, and three had no translocations.

CONCLUSIONS

The silicone gels used in mammary implants, which contain a complex mixture of different siloxanes, induced peritoneal plasmacytomas in genetically susceptible mice. Silicone gels provide new chemically defined materials that are effective inducers of plasmacytomas in BALB/cAnPt-A and BALB/cAnPt.DBA/2-Idh1-Pep3 mice. Further studies will be required to determine which of the components of these gels are the active materials.

Health risks for women with breast implants

Women who have undergone implantation of a breast prosthesis have been exposed to a variety of health risks, many of which were unknown to them at the time of surgery. Recognition of health hazards has prompted the Food and Drug Administration to restrict implantation of these devices while study of safety and efficacy are undertaken. Capsule contracture, or the contraction of the fibrous tissue surrounding the prosthesis, is the most frequently occurring complication. Exposure to an implant does not appear to heighten the risk for breast cancer, but the opacity of a prosthesis substantially reduces the diagnostic capability of mammography. Silicone, used in the manufacture of implants, is linked to immunologic changes that result in connective tissue disorders. Most often this condition is scleroderma. Damaging effects from toluenediamine, a disintegration product of the polyurethane coating, have been reported. Whether the concentration of this chemical reaches toxic levels in women with prostheses remains to be clarified by current investigations.

Nailing and occlusion of the medullary cavity. Flow and mechanical changes in rat femora

25 rats were bilaterally operated on and the femoral canal nailed, nailed and plugged with silicone or only plugged with silicone after intramedullary nailing. A fourth group was intramedullary reamed without any other intervention. The bones were evaluated after 12 weeks, including flow measurements, mechanical properties and bone dimensions. There were no differences between the groups in total bone or cortical bone blood flow. There were only marginal changes in outer and inner anteroposterior diameters and the area moment of inertia. The maximum bending stress in bones that had been both nailed and silicone-plugged was decreased compared to the other groups, except the nailed bones. In the silicone/nail group, energy absorption was less than in the other groups, except the nailed group. We conclude that modest intramedullary reaming, nailing or plugging of the femoral canal do not change the mechanical properties of the bone, nor do they induce chronic vascular changes in bone. However, when the medullary cavity is filled with both a nail and silicone, mechanical as well as structural changes may ensue.

Immunotoxicity of 180 day exposure to polydimethylsiloxane (silicone) fluid, gel and elastomer and polyurethane disks in female B6C3F1 mice

Millions of people have been exposed to silicones which are present in consumer goods such as cosmetics and toiletries, processed foods and household products. In addition, silicones have been used extensively in medical practice as a lubricant in tubing and syringes, and as implantable devices. A silicone widely used in medical practice is polydimethylsiloxane. This study was undertaken to determine the immunotoxicologic potential of long term exposure to the principal constituents of breast implants: silicone fluid, silicone gel and silicone elastomer. An alternative covering for devices containing silicone gels, polyurethane, was also included in the study. Silicone fluid and gel were injected subcutaneously into female B6C3F1 mice (1 ml/mouse) and 6 mm disks of silicone elastomer or polyurethane were implanted subcutaneously. There were no treatment-related deaths or overt signs of toxicity during the 180 day exposure. None of the tested materials had notable effects on body or organ weights, erythrocytes or leukocytes in the blood, blood chemistries such as alanine aminotransferase, urea nitrogen, glucose, albumin or total protein, or serum CH 50 or C3 levels. The cellularity of the bone marrow and responses to CSF-GM and CSF-M were normal. The tested silicones and polyurethane marginally reduced the level of Ig+ cells in the spleen but did not consistently alter the distribution of T cell surface markers. The antibody response to sheep erythrocytes was not markedly altered, nor were proliferative responses to concanavalin A, phytohemagglutinin, lipopolysaccharide or allogeneic cells. Reticuloendothelial function was normal, as was phagocytosis of chicken erythrocytes and Covaspheres by adherent peritoneal cells. Natural killer cell activity was depressed in all silicone treatment groups and in mice implanted with polyurethane. No silicone or polyurethane treatment group displayed altered susceptibility to a challenge with Listeria monocytogenes, Streptococcus pneumoniae or the B16F10 tumor. The only consistent effect of 180 day exposure to silicone materials or polyurethane was a modest depression of natural killer cell activity.

Subchronic 10 day immunotoxicity of polydimethylsiloxane (silicone) fluid, gel and elastomer and polyurethane disks in female B6C3F1 mice

Millions of people have been exposed to silicones because of the widespread use in consumer products such as cosmetics and toiletries, food products, household products and paints. Silicones have wide use in medical practice, including lubricants in tubing and syringes, and as implantable devices. The most prevalent silicone in medical use is polydimethylsiloxane. This study was undertaken to determine the subchronic immunotoxicologic potential of the principal constituents of breast implants: silicone fluid, silicone gel and silicone elastomer. An alternative covering for devices containing silicone gels, polyurethane, was also included in the study. Silicone fluid and gel were injected subcutaneously into female B6C3F1 mice (1 ml/mouse) and 6 mm disks of silicone elastomer or polyurethane were implanted subcutaneously. There were no treatment-related deaths or overt signs of toxicity. None of the tested materials had notable effects on body or organ weights, erythrocytes or leukocytes in the blood, blood chemistries such as alanine aminotransferase, urea nitrogen, glucose, albumin or total protein. The cellularity of the bone marrow and responses to CSF-GM and CSF-M were normal. The tested silicones did not alter the distribution of B cells and T cells in the spleen, but polyurethane perturbed the distribution of CD4+CD8+ and CD4-CD8- T cells. The antibody response to sheep erythrocytes was not markedly altered, nor were proliferative responses to concanavalin A, phytohemagglutinin, lipopolysaccharide or allogeneic cells. Reticuloendothelial function was normal, but polyurethane evoked an enhanced phagocytosis of Covaspheres by adherent peritoneal cells. Natural killer cell activity and serum complement were not altered. All silicone materials afforded modest protection to a challenge with Listeria monocytogenes that killed 40 to 58% of control mice. Host resistance to Streptococcus pneumoniae or the B16F10 tumor was not affected by any of the treatments. There is a pattern indicative of some perturbation of T cell differentiation in mice implanted with a polyurethane disk.