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Biomedical subjects

D L Butler

Publications and source records attributed to D L Butler.

At least 19 recordsLinked to original sources
PubMed1992

The use of wide area computer networks in disaster management and the implications for hospital/medical networks.

Computer-mediated communication in various forms is already being used in all phases of disaster management--preparation, response, recovery, and long-term mitigation. However, to date wide area computer networks--particularly the Internet (the supernetwork of networks)--have been used only to a limited extent in disaster management and prevention. Some of these applications are described in this paper. Nevertheless, the high speed and ease of information transfer by computer network and the vast resources becoming available on the Internet make it inevitable that the use of computer networks to temper disasters will increase enormously in the next decade. The Internet will provide a key means through which networks initially dedicated to solely medical purposes and the individuals who use them will become involved not only in disaster response and mitigation worldwide, but in the global community and consciousness that is the Internet.

Australia↗
PubMed1992

Primary and coupled motions in the intact and the ACL-deficient knee: an in vitro study in the goat model.

Quadrupeds are commonly used as animal models to study healing of anterior cruciate ligament (ACL) reconstructions. While rabbits, dogs, goats, and sheep have been used, goats and sheep are increasingly being employed because of the larger joint size that facilitates surgery, ease of availability, and lower expense to maintain in the farm environment. In spite of this, little is known about the function of the ACL in controlling primary and coupled motions in the quadruped. We report here on the measurements of these motions in goats, with the application of anterior-posterior forces, varus-valgus moments, and internal-external moments in the intact and ACL-deficient knee. Sectioning the ACL caused significant increases in primary anterior translation, and in varus-valgus and internal rotations. The increases in anterior translation were similar in amount and dependence on flexion angle to those seen in human knees. The increase in varus averaged 7 degrees and did not depend on flexion angle, whereas the increase in valgus was significant only in the flexed knee. The increases in internal tibial rotation were greatest in extension, whereas the increases in external rotation were small and independent of flexion angle. When the ACL was cut, coupled internal rotation increased with an anterior force as well as a valgus moment. Large increases were seen in coupled anterior translation with the application of varus and valgus moments, whereas smaller increases were seen with internal and external moments. These findings demonstrate that the ACL restrains multiple motions in the goat knee. This study also provides baseline data for future studies of ACL reconstruction.

Animals↗
PubMed1992

The correlation between anterior-posterior translation and cross-sectional area of anterior cruciate ligament reconstructions.

Total anterior-posterior translation is commonly used to assess the integrity of the cruciate ligaments and the success of reconstructive surgery. The purpose of this study was to determine, after surgical reconstruction of the anterior cruciate ligament with a biological graft, if total anterior-posterior translation correlated with graft length, cross-sectional area, or mechanical properties. These factors were investigated by analyzing data from three previous studies. These studies involved replacement of the anterior cruciate ligament in cynomolgus monkeys and goats, with free and vascularized patellar tendon autografts and both patellar tendon and anterior cruciate ligament allografts. Data were available at time periods of 6 and 12 months after surgery. We found statistically significant inverse correlations between the amount of anterior-posterior translation and cross-sectional area of a graft at the time of sacrifice. The Pearson correlation coefficients ranged from -0.966 (p < 0.002) to -0.830 (p < 0.05). We hypothesize that these correlations result from the following mechanism: the increased anterior translation reflects a slack graft; a slack graft is stress shielded by other structures about the knee; the reduced in vivo stresses on the graft modulate cellular metabolism in a way that over time produces a small cross-sectional area.

Analysis of Variance↗
PubMed1992

Location-dependent variations in the material properties of the anterior cruciate ligament.

Our recent anterior drawer studies in human cadaveric knees [Guan and Butler, Adv. Bioengng 17, 5 (1990); Guan et al., Trans. orthop. Res. Soc. 16, 589 (1991)] have suggested that anterior bundles of the anterior cruciate ligament (ACL) develop higher load-related material properties than posterior bundles. This was confirmed when we reevaluated the axial failure data for these bundle-bone specimens from an earlier study [Butler et al., J. Biomechanics 19, 425-432 (1986)]. The purpose of this study was to determine, in a larger data set, if anteromedial and anterolateral bundles of the anterior cruciate ligament exhibit significantly larger load-related material properties than the posterior ligament bundles. Seven ACL-bone units from seven donors (the three tissues from the original study plus four new ones) were subdivided into three subunits, preserving the bone insertions. The subunits were failed in tension at a constant strain rate (100% s-1) and four material properties were compared within and between donors. The anterior bundles developed significantly larger moduli, maximum stresses, and strain energy densities to maximum stress than the posterior subunits. Moduli for the anterior vs posterior subunits averaged 284 MPa vs 155 MPa, maximum stresses averaged 38 MPa vs 15 MPa, and strain energy densities averaged 2.7 N m cc-1 vs 1.1 N m cc-1, respectively. No significant differences were found, however, among strains to maximum stress or between any of the other properties for the two anterior subunits. These results are important to the design of ligament replacements and suggest new experiments designed to distinguish in vivo force levels in these ACL bands, a possible reason for the material differences.

Adult↗
PubMed1992

Theoretical analysis of an implantable force transducer for tendon and ligament structures.

A mathematical model was developed for an implantable force transducer to be inserted within the midsubstance of a ligament or tendon. The model was generated by performing both equilibrium and strain-displacement analyses on a metallic, curved beam structure placed within a parallel-fibered tissue. The analysis permitted the transverse pressure acting between the device and fibers to be calculated along with peak device strain and sensitivity (ratio of strain output to axial tissue force). Transducer pressure and transducer strain were expressed in terms of nondimensionalized design factors. A parametric analysis of the key design factors was then performed. The transverse pressure was shown to vary little for large changes in these factors whereas device strain changed markedly. The analysis was verified by a bench test on an example device. Such a model permits a proposed design to be evaluated without having to conduct costly experiments.

Animals↗
PubMed1992

Induced release of acetylcholine from guinea pig ileum longitudinal muscle-myenteric plexus by anatoxin-a.

Anatoxin-a (ANTX), a nicotinic agonist, has been shown to induce contraction of guinea pig ileum, which was abrogated by the muscarinic antagonist atropine and the nicotinic antagonists tubocurarine and hexamethonium. We showed here that the ganglionic nicotinic antagonist mecamylamine was a better inhibitor of the contraction of ileum induced by ANTX. The sodium channel blocker tetrodotoxin also abolished ANTX-induced contraction. In contrast, alpha-bungarotoxin, the muscle type nicotinic receptor blocker, had no effect on ANTX-induced contraction of guinea pig ileum. Longitudinal muscle-myenteric plexus prepared from guinea pig ileum, labeled with [3H]choline and then incubated with ANTX was shown for the first time to release [3H]acetylcholine (ACh) in a dose-dependent manner. Pretreatment of longitudinal muscle-myenteric plexus with tubocurarine, hexamethonium or mecamylamine blocked ANTX-induced release of [3H]ACh. In contrast, atropine was without effect. Mecamylamine was the most potent antagonist. As observed in ileum contraction, tetrodotoxin completely and potently blocked the release of [3H]ACh induced by ANTX. Neither alpha-bungarotoxin nor the neuromuscular junction blockers conotoxin G1 or M1 could inhibit the [3H]ACh release. Taken together, these results suggested that ANTX activated nicotinic receptors on ganglionic interneurons to trigger a release of ACh, which next stimulated muscarinic receptors and induced ileum contraction.

Acetylcholine↗
PubMed1991

Effects of gamma irradiation on the initial mechanical and material properties of goat bone-patellar tendon-bone allografts.

The effects of 60Co gamma irradiation on the initial mechanical properties of the composite bone-patellar tendon-bone unit (CU) and the tendon midsubstance (TM) were studied. Frozen specimens were exposed to either 2 or 3 Mrad of gamma irradiation. Paired frozen specimens served as intraanimal controls. Treatment effects on the CU were assessed using four mechanical parameters. Effects on the TM were assessed using four material parameters measured using an optical surface-strain analysis system. The maximum force and strain energy to maximum force of the composite unit were significantly reduced 27% and 40%, respectively, after 3 Mrad of irradiation (p less than .05). Mechanical properties of the CU were not significantly altered, however, following 2 Mrad of irradiation. Based on individual paired contrasts between treatment and control, significant differences were also found in the material properties of the tendon midsubstance. The maximum stress, maximum strain, and strain energy density to maximum stress were significantly reduced following 3 Mrad, but not 2 Mrad, of irradiation. The results provide important "time zero" material property data, which will be useful for later anterior cruciate ligament reconstruction studies using irradiated allograft patellar tendons in the goat model and other animal models as well.

Analysis of Variance↗
PubMed1991

Nicotinic action of anatoxin-a on guinea pig ileum antagonized by thymopentin.

(+)-Anatoxin-a (ANTX) stimulated guinea pig ileum contraction with a potency similar to that of acetylcholine (ACh); the stimulation was blocked by tubocurarine, hexamethonium, or atropine. Although the contraction stimulated by ANTX was blocked by atropine, no specific inhibition of the binding of [3H]N-methylscopolamine to ileum membranes was observed in the presence of ANTX. Furthermore, ANTX failed to stimulate the secretion of alpha-amylase from pancreatic acinar cells, a process that is activated by cholinergic agonists at the muscarinic receptors. When the ileum itself was stimulated by ACh, the contraction was not blocked by either hexamethonium or tubocurarine. Preincubation of the ileum with hemicholinium caused a 50% reduction in the ability of ANTX to stimulate contraction. Based upon these data, it was inferred that ANTX binds to postganglionic synaptic nicotinic receptors in the ileum, thus releasing endogenous ACh, which in turn causes ileum contraction by interacting with the postsynaptic muscarinic receptors. It was also observed that thymopentin (TP-5), a pentapeptide corresponding to positions 32-36 of thymopoietin, blocked the stimulation of ileum contraction by ANTX.

Amino Acid Sequence↗
PubMed1991

Mammography and early breast cancer detection.

Screening mammography has been shown to reduce breast cancer mortality. Both film-screen mammography and xeromammography are highly sensitive and specific. Mammography accreditation programs assure physicians and patients that a facility provides mammography of the highest quality, using the lowest possible radiation dose. Mammographic signs of early cancer include a small mass, calcifications, architectural distortion and a neodensity. Dense tissue may result in a false-negative examination even when a cancer is palpable, with adverse effects if biopsy is delayed.

Adult↗
PubMed1990

Anterior cruciate ligament replacements: a mechanical study of femoral attachment location, flexion angle at tensioning, and initial tension.

We examined three surgical variables that affect the ability of an anterior cruciate ligament replacement to restore the limit of anterior tibial translation. These were the placement site of the substitute on the femur, the initial tension applied to the replacement, and the flexion angle of the knee at the time of tensioning. An anterior load of 100 N was applied to the tibia. As the knee was flexed, we measured the tensile force in the substitute and the anteroposterior position of the femur relative to the tibia. Placement largely determined whether the force in the replacement increased or decreased with flexion. Placement also largely determined whether the tibia moved anteriorly or posteriorly with flexion compared to its position in the intact knee. The initial tension and the flexion angle at tensioning affected the magnitude of force in the substitute and the magnitude of the change in AP position. They did not affect how force and AP position changed with flexion. Greater increases in force and greater posterior shifts in tibial position were produced by changing the flexion angle at tensioning from 0 degrees to 30 degrees than by increasing the initial tension from 22 to 44 N.

Adult↗
PubMed1990

Tumoral calcinosis-like lesion of the proximal linea aspera.

Tumoral calcinosis is presently a poorly defined disease. In its classic form, it consists of multiple large foci of benign mineralization in the soft tissue adjacent to bone near large joints. Patients are generally of African descent and are adolescents or young adults at presentation. Both metabolic and traumatic etiologies have been proposed. We report six adult Caucasian patients with lesions that pathologically resembled tumoral calcinosis. All lesions were small (less than 3 x 3 cm) and were located along the proximal linea aspera of the femur. All patients presented with pain. Because of the atypical patient population and the unusual size and location of the lesions, we refer to this process as a "tumoral calcinosis-like lesion." A typical radiographic appearance and location, together with appropriate clinical history, can strongly suggest this diagnosis.

Aged↗
PubMed1990

Surface strain variation in human patellar tendon and knee cruciate ligaments.

Local surface strains in bone-fascicle-bone subunits from human patellar tendon and anterior and posterior cruciate ligaments were measured between markers using low-speed photography during low rate subfailure testing. A simple stress-strain relationship of the power form was found to describe the bone-to-bone responses up to four percent strain for all three tissue types examined. The regional material behavior were best fit using an inverted strain-stress relationship, however. The power model, fitted to the experimental data, conformed to the expected stress-strain relationship better than either the quadratic or cubic models. With few exceptions, for a given stress, the strains near the proximal and distal bone ends were not significantly different from each other, but were significantly higher than the strains in the tissue midregions. Local strain patterns generally varied among subunits from the same tissue.

Adult↗
PubMed1989

Mechanical properties of primate vascularized vs. nonvascularized patellar tendon grafts; changes over time.

Mechanical properties of patellar tendon autografts used to replace the anterior cruciate ligament (ACL) in the cynomolgus monkey were measured at four time periods up to 1 year. The ACL was replaced in each knee with the medial half of the patellar tendon: as a vascularized graft (VG) on one side and as a nonvascularized or free graft (FG) on the other. Postoperative care consisted of 4 weeks of cast immobilization at 30 degrees flexion followed by unrestricted activity in a large cage. Both grafts showed low stiffness and maximum force at 7 weeks (24% and 16% of ACL control values, respectively), increasing to 57% of control ACL stiffness and 39% of control maximum force by 1 year. Corresponding material properties, modulus and maximum stress, also increased over time, but at 1 year were only 34% and 26% of ACL values, respectively. The results indicate that retaining vascularity does not prevent significant reduction in graft properties that occur postoperatively, nor does it accelerate the return in strength and stiffness. Tissue stiffness, which returns earlier than maximum force and joint anteroposterior (AP) force displacement data, should be routinely reported in any healing study. Finally, in studies of this kind, the large variation in the results makes sampling only one or two animals from each time period unreliable.

Animals↗
PubMed1989

Kappa Delta Award paper. Anterior cruciate ligament: its normal response and replacement.

This article reviews our research studies on the anterior cruciate ligament (ACL). The human ACL was found to be a primary restraint to anterior tibial displacement at both 90 degrees and 30 degrees of flexion. Geometric measurements of the ligament showed it to have a complex macrostructure, consisting of bundles of different lengths, curvatures, and orientations. Similar material properties were measured for subunits from the human anterior and posterior cruciate and lateral collateral ligaments. However, the linear modulus, maximum stress, and strain energy density to maximum stress of the ACL were significantly less than similar properties for patellar tendons. These tissue subunits exhibited nonuniform axial strain during tensile loading, which was partially attributed to differences in bundle crimp period and crimp angle. The structural mechanical properties (stiffness, strength, and energies and elongations to maximum force and failure) of nine commonly used human ACL substitutes were also compared. Only the bone-patellar tendon-bone unit had maximum force and stiffness greater than that of the ACL. The patellar tendon, when used as an ACL replacement in the dog and primate, exhibited significant loss in structural mechanical and material properties early after implantation. These properties showed only a gradual improvement up to 1 year after surgery. Maintaining a vascular supply to these grafts or using intermittent passive motion immediately after surgery produced no significant improvement in graft properties in the primate model.

Animals↗
PubMed1988

Biomechanics of fascia lata ligament replacements: early postoperative changes in the goat.

Mechanical properties of fascia lata autografts used to replace the anterior cruciate ligament (ACL) in the goat were measured at 0, 2, 4, and 8 weeks after surgery. The ACL was replaced in the right knee of 50 animals divided equally into two groups according to graft fixation technique: (a) two smooth staples at each end, with the tissue pulled back toward the joint over the first staple and (b) reinforced fixation with a spiked bushing placed through the tissue and a 3-cm-long flat polypropylene braid sutured to each end of the graft. Eleven unoperated contralateral knees were tested as controls. All statistically significant effects of the reinforced versus staple fixation were observed at 0 weeks, with the reinforced group showing less anteroposterior (AP) translation of the joint and greater maximum force and stiffness of the femur-graft-tibia units. The reinforced group had increased AP translation and decreased strength and stiffness by 2 weeks after surgery. Increased AP translation resulted primarily from increases in the low-stiffness region of the force-displacement curve (primary AP translation) and to a lesser extent from increased translation in the high-stiffness region (secondary anterior translation). Failures at 0 weeks with the reinforced fixation occurred at the bushing or end of the reinforcing braid, while all but one of the later failures occurred in the tissue mid-substance. In the staple group, maximum force was greater at 8 weeks than at 0 weeks, as the failure locations changed from the fixation to the tissue mid-substance.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗