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Biomedical subjects

C K Cheng

Publications and source records attributed to C K Cheng.

At least 19 recordsLinked to original sources

Geometric parameters of the in vivo tissues at the lumbosacral joint of young Asian adults.

STUDY DESIGN: Magnetic resonance images (MRIs) were used to determine the geometry of the tissues studied. OBJECTIVE: To investigate the geometric parameters of tissues around the lumbosacral joint. SUMMARY OF BACKGROUND DATA: Cross-sectional area (CSA), moment arms, and line of action of the tissues located at lumbosacral joint (L5-S1), which are important in the study of spinal mechanics and models for the investigation of low back pain. It was insufficient information to describe the relative dimension of spinal tissues except muscles around the lumbar spine. METHODS: MRIs from eight asymptomatic young Taiwanese male adults were collected to present CSA, moment arms, and line of action of the tissues located at lumbosacral joint (L5-S1). Four pairs of trunk muscles, erector spinae, rectus abdominis, abdominal oblique externus, and psoas muscles, ligamentum flavum, and facet joints at the bilateral sides were studied. RESULTS: Spinal tissues at the level of lumbosacral joint were determined. The CSAs of the spinal elements at the L5-S1 normalized by the CSA of trunk ranged from 5.42% (the erector spinae) to 0.14% (the ligamentum flavum). The moment arm of the spinal elements relative to the trunk width and depth ranged from 40.91% (rectus abdominis at the y direction) to 0.38% (ligamentum flavum at the x direction). The profile of geometric elements of lumbosacral joint in the Asian male subjects was similar to the data collected from the white population. The data also showed that right-left symmetry in the aforementioned dimension. CONCLUSION: Normalized data of the CSA, moment arm, and line of action of the spinal tissues at the L5-S1 joint were reported in vivo through the MRI techniques. The profile of geometric elements of lumbosacral joint in the Asian male subjects did not differ from the white population. In addition to muscles, the geometry of facet joint and ligament was determined, which would be important to the calculation of force distribution on the lumbosacral joint.

Adult↗

The influence of inserting a Fuji pressure sensitive film between the tibiofemoral joint of knee prosthesis on actual contact characteristics.

OBJECTIVE: To investigate the influence of inserting a Fuji pressure sensitive film between the tibiofemoral joint of knee prosthesis on actual contact characteristics. DESIGN: A finite element analysis was used to investigate the alteration of contact characteristics of the tibiofemoral joint due to inserting a pressure sensitive film between the contacting surfaces. BACKGROUND: The discrepancy between actual contact behaviors of tibiofemoral joint of knee prosthesis and the measurement using Fuji pressure sensitive film was not discussed extensively. The change of direct contact circumstance of the tibiofemoral joint due to inserting a pressure sensitive film was not well reported. METHOD: A two-dimensional finite element model of the tibiofemoral joint of knee prosthesis in the sagittal plane was constructed. Four different radii of the femoral component were used to investigate the conformity effect. Two-layers of plane strain element were used to model the pressure sensitive film. The influence of inserting a pressure sensitive film on the actual contact characteristics was analyzed by comparing the results of the change in contact radius. RESULTS: Inserting a pressure sensitive film between contacting surfaces would disturb the original contact behaviors, especially in the lowest conformity design. The maximum difference of contact radius between the model simulating actual contact circumstance and the model with inserting a pressure sensitive film between contacting surface was 77% in the lowest conformity condition at the smallest load. CONCLUSIONS: This study proposes a quantitative analysis of contact characteristics in the tibiofemoral joint of knee prosthesis between the models with and without inserting a pressure sensitive film into the contact surface. The measurement of contact area in artificial tibiofemoral joints by using Fuji pressure sensitive film is always overestimated its true contact area by 14-77%. RELEVANCE: This study revealed the measurement of contact characteristics of artificial tibiofemoral joints by using Fuji pressure sensitive film which depends on not only the applied load, but also the conformity and material properties of the contact surface. Therefore, the information of the conformity and material properties of the contact surface should be provided as well as the applied load wherever a measurement of contact characteristics using Fuji pressure sensitive film is analyzed and interpreted.

Biomechanical Phenomena↗

Stress analysis of the disc adjacent to interbody fusion in lumbar spine.

After anterior interbody fusion in the lumbar spine, the accelerated degeneration of the disc adjacent to the fusion levels was clinically observed. To understand the stress distribution of the adjacent disc, this study created a finite element model of the lumbar spine from L1-L5 vertebral body. The fusion model modified from the intact model was used to simulate the anterior interbody fusion. Various loading conditions, which included flexion, extension, lateral bending, and torsion, were applied to the finite element model to study the corresponding stress distribution. From the finite element model calculation, at a lower fusion site or more fusion levels, the stress of the disc adjacent to interbody fusion increased more than upper fusion site or single fusion level under flexion, torsion and lateral bending. Larger stress increase was estimated at the upper disc adjacent to interbody fusion than the lower disc adjacent to interbody fusion. In stress distribution, the upper disc adjacent to interbody fusion had a little alteration under torsion.

Finite Element Analysis↗

PEG adsorption of autoantibodies and detection of alloantibodies in warm autoimmune hemolytic anemia.

BACKGROUND: The purpose of this study was to evaluate the effectiveness of PEG in the adsorption of autoantibodies and the detection of alloantibodies in patients with warm autoimmune hemolytic anemia (WAIHA). STUDY DESIGN AND METHODS: The study was divided into three parts. First, the effectiveness of antibody removal by a conventional adsorption procedure and that by the PEG adsorption method were compared by using commercial antisera adsorbed with antigen-positive RBCs. Second, patients' sera with known weak alloanti-E were used to test against screening cells after allogeneic adsorption to show nonspecific coating of antibodies and the dilution effect on the PEG adsorption procedure. Third, conventional and PEG one-cell sample allogeneic adsorptions of WAIHA patients' sera with and without alloantibodies were performed and compared. RESULTS: In the first part, seven of the eight polyclonal antisera gave a lower titer and score when tested against antigen-positive RBCs in the indirect antiglobulin test; this indicated that PEG is more efficient in removing antibodies. In the second part, similar reaction patterns were observed in antibody screening tests on unadsorbed sera and on sera after the first, second, and third adsorptions, which indicated that there was no alloantibody loss, nonspecific antibody coating, or dilution effect when PEG was added in the allogeneic adsorption procedures. In the third part, a 40-percent increase in efficiency in reducing the number of adsorptions and an 85-percent decrease in completion time of the adsorption procedures were obtained when PEG was used for adsorbing sera from 16 patients with WAIHA. Both conventional and PEG procedures were capable of removing autoantibodies to identify the specificities of alloantibodies. CONCLUSION: The PEG adsorption method is an effective, sensitive, and efficient method of enhancing auto- antibody adsorption and alloantibody detection. It can reduce the processing time and minimize the delay of urgent transfusions to patients with WAIHA and can indirectly enhance cost-effectiveness and decrease the labor-intensive testing required by these cases.

Anemia, Hemolytic↗

Tracheal intubation using suspension laryngoscopy in an infant with Goldenhar's syndrome.

We present a case of a ten-month-old boy with Goldenhar's syndrome and significant retrognathia in whom a tracheostomy was performed to relieve upper airway obstruction. Tracheal intubation was facilitated by direct suspension laryngoscopy using a slotted rigid laryngoscope. We propose this technique as an alternative method for tracheal intubation in infants and young children with a difficult airway. The management of the difficult airway in children with Goldenhar's syndrome is discussed.

Goldenhar Syndrome↗

Differential role of PR-A and -B isoforms in transcription regulation of human GnRH receptor gene.

The presence of progesterone response element (PRE) in the 5'-flanking region of the human GnRH receptor (GnRHR) suggests the possible regulation of this gene by progesterone (P). In the present study, we examined the effects of P in transcriptional regulation of human GnRHR gene expression at the pituitary and placenta levels since the GnRHR has been detected in both tissues. By the use of transient transfection assays, a differential regulation of human GnRHR promoter activity by P was observed. P treatment resulted in a decrease in promoter activity in the pituitary alphaT3-1 cells, suggesting a P-mediated inhibitory action. Interestingly, P is found to have a stimulatory role at the placental expression of this gene. Addition of RU486 to, or inhibition of endogenous P production by, the placental JEG-3 cells leads to a decrease in promoter activity, which is reversed by the replacement of P. Further studies have identified a putative PRE, namely human GR-PRE (located between -535 and -521, related to translation start site), that may be responsible for the P action since the mutation of these motifs reversed the P-mediated effects. The binding of PR to this element is confirmed by antibody supershift assays. The physiological effects of P are mediated through two PR isoforms, namely PR-A and PR-B. In the present study, overexpression of human PR-A resulted in a decrease in human promoter activity in both pituitary and placental cells. Interestingly, overexpression of PR-B exhibits a cell-dependent transcriptional activity, whereby it functions as a transcription activator in the placenta but as a transcription repressor in the pituitary. In summary, our results demonstrated a differential usage of PR-A and PR-B in transcriptional regulation of human GnRHR gene expression by P at the pituitary and placenta levels.

Aminoglutethimide↗

A cellular automata model of chromatography.

Dynamic models of the behavior of solvent and solute molecules can be made using cellular automata. A chromatographic column was represented by use of a cellular automata grid of 43 x 200 spaces. Solvent (mobile phase), solute and stationary phase cells were designated to simulate the chromatographic situation. The movements of solute and solvent cells down the grid were monitored for different numbers of iterations, different flow rates and different affinities of the solutes for the stationary phase and the solvent for itself. The cellular automata dynamics were successfully able to model expected chromatographic behavior except in a few cases where the number of cells was not large enough to provide an average value reflective of the molecular situation.

Cell Separation↗

Segment inertial properties of Chinese adults determined from magnetic resonance imaging.

OBJECTIVE: To improve the simulation of the task of manual materials handling for Chinese laborers, this study estimated the inertial properties of Chinese adults by using magnetic resonance imaging. DESIGN: Magnetic resonance imaging was used as a means of estimating inertial property. Following the estimation of inertial properties for the Chinese subjects, comparison between estimates for Chinese and Caucasian populations was made. BACKGROUND: Estimates of segment inertial properties are frequently based on data and procedures developed from human cadaver studies in which inertial properties have been measured directly. The errors might be derived from the utilization of the Caucasian data were questioned in our previous study on the spinal force prediction of the Chinese subjects during manual lifting. METHODS: Magnetic resonance images were scanned at a 20 mm interval from eight males aged 26 (S.D., 4) years. Tissues were differentiated and verified using adequate intensity thresholds on each slice, and the segmental volume and mass were integrated by slices. The moments of inertia for each segment were then determined about the anatomical axes using the parallel axis theorem.Results. Results showed that our estimates were close to the data derived by Dempster with a slight deviation. Larger percentages of mass were found in the upper arm (4.0%) and thigh (13.6%) than in previous studies. On the other hand, smaller moments of inertia about three axes were noted in the shank. CONCLUSION: Biomechanical modeling of the human body requires accurate prediction of body segment parameters that include measures of volume, mass, center of mass, and moments of inertia. This study suggests the need to estimate the inertial properties of segments from the Chinese population. Application of the data may improve the simulation of the task of manual materials handling for Chinese laborers in the future studies. RELEVANCE: Biomechanical modeling of the human body requires accurate prediction of body segment parameters that include measures of volume, mass, center of mass, and moments of inertia. To obtain the basic data of segment parameters for the Chinese adults, this study was proceeded with the magnetic resonance imaging technique.

Adult↗

A cellular automata model of an anticipatory system.

An anticipatory system has been modeled using the dynamic characteristics of cellular automata. Rules governing the steps in an enzymatic conversion of substrates to products are operative in the system. A concentration of an intermediate product influences the creation of a supplemental enzyme that enhances the competence of an enzyme down stream. This anticipation of the future event creates a condition in which the concentration of a later substrate is suppressed, a property characteristic of the system. The model presents a useful opportunity to study a variety of aspects of this fascinating phenomena.

Computer Simulation↗

Cellular automata models of chemical systems.

This paper describes the use of kinematic, asynchronous, stochastic cellular automata to model liquid properties, solution phenomena and kinetic phenomena encountered in complex biological systems. Cellular automata models of dynamic phenomena represent in silico experiments designed to assess the effects of competing factors on the physical and chemical properties of solutions and other complex systems. Specific applications include solution behavior, separation of immiscible liquids, micelle formation, diffusion, membrane passage, first- and second-order chemical kinetics, enzyme activity and acid dissociation. Cellular automata is thus considered as providing an exploratory method for the analysis of dynamic phenomena and the discovery and understanding of new, unexpected phenomena.

Animals↗

Analysis of ultrahigh molecular weight polyethylene failure in artificial knee joints: thermal effect on long-term performance.

The mechanism resulting in damage to and failure of ultrahigh molecular weight polyethylene (UHMWPE) tibial inserts was investigated on clinically retrieved components. The severity of the subsurface damage increased with the length of time that the component had been implanted. A theoretical analysis was developed to account for the generation of subsurface damage based on a heat transfer model. Friction generates surface heat during articulation of total knee systems. Due to the cooling effect of body fluid on the surface, the rise in temperature on the UHMWPE surface is lower than that below the surface. The peak temperature was estimated to occur on a plane positioned about 1 to 2 mm below the surface. This result was similar to the bulk temperature variation observed during in vivo and in vitro studies by other investigators. Although the difference in temperature on and below the surface is only a few degrees, the thermal effect becomes apparent after a long time and may be explained by the viscoelastic behavior of polymers: the temperature-time equivalence. It is therefore suggested that this thermal effect is another contributory factor to material damage, in addition to high stress and oxidative degradation (in appropriate cases). Therefore, any technological efforts aimed at improving the performance of artificial joint prostheses should minimize the thermal effects at the subsurface of the articular components.

Aged↗

A new approach of designing the tibial baseplate of total knee prostheses.

OBJECTIVE: To improve the design of the knee prosthesis, a new technique to design the tibial baseplate of total knee prostheses was developed. METHODS: One senior surgeon operated on 79 osteoarthrosis patients by using PCA total knee prostheses for total knee replacement. Four dimensions were measured intraoperatively and compared, including the anterioposterior length and the mediolateral width of the resected tibia plateau and implant. The data of anterioposterior length and the mediolateral width of resected surfaces of the tibial plateau of the 79 patients were plotted in a coordinate system. This coordinate system was formed with the mediolateral width as the x-axis and anterioposterior length as the y-axis. A circle, 5 mm in diameter, was used as the maximum coverage criterion. Five contemporary products and a new design product were used to screen the data to see how many patients would fall within the criteria. From the results of the screened data, we calculated the coverage percentage of the patients. RESULTS: The ratio of the anterioposterior length to the mediolateral width of the resected surfaces of the tibial plateau was greater than that of the ratio of the PCA prostheses (P < 0.05). The results showed that no single product on the market had the patients meet over 70% of the criterion. A different ratio of the anterioposterior length to the mediolateral width was designed to achieve 90% coverage of the patients that met the criterion. DISCUSSION: One possible explanation for the discrepancy between resected surfaces and implants is that the osteoarthrosis patients developed knee deformities that changed the surface of the tibial plateau and thus altered the knee dimensions. Since the total knee prostheses were used on osteoarthrosis patients, the dimensions of the resected tibial surfaces of osteoarthrosis patients should be considered in the design of the tibial baseplate of total knee prostheses.

Aged↗

The influence of contact alignment of the tibiofemoral joint of the prostheses in in vitro biomechanical testing.

OBJECTIVE: To investigate the influence of contact alignment of the tibiofemoral joint of the prostheses in in vitro biomechanical testing. DESIGN: An experimental set-up was used to measure the total contact areas of the tibiofemoral joint of the prostheses subjected to a compressive load, and the malalignment situations were simulated. BACKGROUND: The contact alignment of the femoral component related to the tibial component in the literature was not described clearly and the effect of malalignment on the testing method has not been reported well. METHODS: Three commercial knee prostheses (Omnifit, Genesis, and AMK) were used for testing under a compression load (3000 N) at flexion 0 degrees and 10 degrees. After aligning the normal contact alignment, the simulated malalignment was done to evaluate the influence on the total contact areas in these conditions relative to the normal contact alignment. The simulated malalignment includes the medial-lateral translation (0.5 and 1 mm), anterior-posterior translation (2 and 4 mm) and internal-external rotation (1 degrees, 3 degrees and 5 degrees ) of the femoral component relative to the tibial component. RESULTS: The ratios of total contact areas of malalignment relative to normal contact alignment ranged from 1.06 to 0.93 in medial-lateral malalignment in these three prostheses. In anterior-posterior malalignment, the ratios ranged from 0.69 to 0.79 in Omnifit, 0.93-0. 96 in Genesis and 0.96-1.04 in AMK. In internal-external malrotation, the ratios ranged from 0.90 to 1.03 in these prostheses. CONCLUSIONS: This study proposes that contact alignment would affect the contact characteristics, especially in anterior-posterior alignment when high conformity knee prosthesis is tested. The contact alignment must be standardized in the procedure in in vitro biomechanical testing, which will be more objective to evaluate the contact characteristics of different knee prostheses. RELEVANCE: This study revealed the importance of contact alignment of the tibiofemoral joint of the prosthesis in in vitro biomechanical testing. Many published reports of the biomechanical evaluations on different designs of knee prostheses would show different results due to contact alignment. Furthermore, this study indicates that the ideal contact characteristics of the tibiofemoral joint in original design will be changed when the prosthesis under the malalignment condition which was caused by surgery technique or soft tissues imbalance.

Biomechanical Phenomena↗

Failure of the all-polyethylene patellar component after total knee arthroplasty.

From 1991 to 1996, 953 cases of porous-coated anatomic modular knee prostheses with all-polyethylene patellar components were implanted. Among them, 4 cases had breakage of the patellar component at the peg-button interfaces. One had loosening of the patellar component by cutting out the patellar bony bed. Heavy body weight, weakness of the pegs of the all-polyethylene patellar component, and osteonecrosis of the patella were conceived as the causes of failure.

Aged↗

An in vitro comparison of the motion behavior of different bipolar endoprostheses.

The relative motion of 3 different bipolar endoprostheses was evaluated in vitro. A paired fresh acetabulum was frozen at 0 degrees C and defrosted 12 hours before the experiment. Three bipolar endoprostheses were evaluated: UNIQHIP system (United Orthopedics), UHR system (Osteonics), and AML system (Depuy). The surface roughness and spherical roundness of outer shells and inner heads of the bipolar prostheses were measured before the experiments. The acetabulum and outer shell of the bipolar prostheses were fixed on a Bionix 858 material testing system axially by separate fixation tools. The axial load of 1,400 N and 2,800 N was than applied on the specimen. The axis was rotated from 0 degrees to 90 degrees at the speed of 1 degree/s. All 3 outer shells were tested to this paired acetabulum randomly and separately. The frictional torque on the outer bearing surface of the different prostheses was recorded by the material testing system. The frictional torque on the inner bearing surface was also measured by the same procedure as was done for the outer bearing. The final results were statistically compared by the 1-way analysis of variance test method. Bipolar prostheses of the UHR system showed the largest frictional torque on outer bearing when it was loaded with 1,400 N and 2,800 N. The final results showed that all the bipolar prostheses had ideal motion behavior when functioning under the loading of 1,400 N. The frictional torque on the inner bearing was found to be larger than the frictional torque on the outer bearing in some prostheses when the loading was increased to 2,800 N. Thus, the bipolar endoprostheses functioned as unipolar prostheses. The only relative motion remained between the outer bearing surface and the acetabulum. This effect causes complications, such as implant protrusion in the acetabulum.

Hip Prosthesis↗

Fracture of the femoral component associated with polyethylene wear and osteolysis after total knee arthroplasty.

Fracture of the femoral component associated with polyethylene wear and osteolysis after total knee arthroplasty (TKA) has not been well reported before. A 63-year-old man with osteoarthritis of the right knee underwent TKA with a New Jersey LCS Knee, with cementing on the tibia and patella but not on the femoral component. After 42 months, in addition to wearing of polyethylene of the tibia and patella, severe osteonecrosis of the medial femoral condyle was noted. Osteonecrosis caused loss of osseous support of the medial flange of the femoral component, and the bone ingrowth of the central and lateral flange to the distal femur was so good that it overcame the yield stress of the metal of the femoral component and caused fracture of the femoral component. The osteolytic area was filled with autogenous iliac bone, and a new femoral component was inserted and cemented. The patient's condition became satisfactory with relief of pain. Although uncommon, fracture of the femoral component does occur associated with polyethylene wear and osteolysis.

Arthroplasty, Replacement, Knee↗

Isokinetic elbow joint torques estimation from surface EMG and joint kinematic data: using an artificial neural network model.

Because the relations between electromyographic signal (EMG) and anisometric joint torque remain unpredictable, the aim of this study was to determine the relations between the EMG activity and the isokinetic elbow joint torque via an artificial neural network (ANN) model. This 3-layer feed-forward network was constructed using an error back-propagation algorithm with an adaptive learning rate. The experimental validation was achieved by rectified, low-pass filtered EMG signals from the representative muscles, joint angle and joint angular velocity and measured torque. Learning with a limited set of examples allowed accurate prediction of isokinetic joint torque from novel EMG activities, joint position, joint angular velocity. Sensitivity analysis of the hidden node numbers during the learning and testing phases demonstrated that the choice of numbers of hidden node was not critical except at extreme values of those parameters. Model predictions were well correlated with the experimental data (the mean root-mean-square-difference and correlation coefficient gamma in learning were 0.0290 and 0.998, respectively, and in three different speed testings were 0.1413 and 0.900, respectively). These results suggested that an ANN model can represent the relations between EMG and joint torque/moment in human isokinetic movements. The effect of different adjacent electrode sites was also evaluated and showed the location of electrodes was very important to produce errors in the ANN model.

Adult↗

Polyethylene failure in New Jersey low-contact stress total knee arthroplasty.

From January 1985 to December 1990, 598 consecutive New Jersey low-contact stress (LCS) total knee arthroplasties (TKAs) were performed for gonarthrosis. Among these 598 operations, 322 were with rotating platform elements and 276 were with meniscal bearing elements. During 5 to 8 years of follow-up, eight knees had severe symptomatic polyethylene failure that required revision surgery; all eight cases were meniscal bearing types. The failed polyethylene inserts were retrieved and studied. It was observed that there were four probable failure mechanisms associated with the catastrophic polyethylene wear. First, insufficient thickness of the meniscal bearing was the major reason for wear. Second, the malpositioning of the metal tibial tray in the transverse plane resulted in the breaking of the meniscal bearing. Third, the inability of the patellar to rotate due to tissue ingrowth made the polyethylene break. Last, yellowing of the subsurface of the meniscal bearing was a sign of polyethylene failure. These four possible failure mechanisms are all associated with the design of the meniscal bearing type of LCS knee prostheses. Therefore, it is suggested that the design of the LCS knee prosthesis should be modified.

Aged↗