Biomedical subjects

Michael S Sacks

Publications and source records attributed to Michael S Sacks.

52 records · Page 3Linked to original sources

PubMed2004

Changes in the biaxial viscoelastic response of the urinary bladder following spinal cord injury.

In order to gain a deeper understanding of bladder function, it is necessary to study the time-dependent response of the bladder wall. The present study evaluated and compared the viscoelastic behaviors of normal and spinal cord injured (SCI) rat bladder wall tissue using an established rat model and planar biaxial stress relaxation tests. Bladders from normal and spinalized (3 weeks) rats were subjected to biaxial stress (either 25 or 100 kPa in each loading direction) rapidly (in 50 ms) and subsequently allowed to relax at the constant stretch levels in modified Kreb's solution (in the absence of calcium; with no smooth muscle tone) for 10,000 s. We observed slower and therefore less stress relaxation in the SCI group compared to the normal group, which varied with the stress-level. These experimental results were fitted (r2 > 0.98) to a reduced relaxation function. Furthermore, biochemical assays revealed that the collagen content of SCI rat bladders was significantly (p < 0.05) lower by 43%, while the elastin content was significantly (p < 0.001) higher by 260% than that of normal bladders. These results suggest that SCI and the associated urologic functional changes induce profound tissue remodeling, which, in turn, provided the structural basis for the alterations in the complex, time-dependent mechanical behavior of the urinary bladder wall observed in the present study.

Adaptation, Physiological↗

PubMed2004

Age dependency of the biaxial biomechanical behavior of human abdominal aorta.

BACKGROUND: The biomechanical behavior of the human abdominal aorta has been studied with great interest primarily due to its propensity to develop such maladies as atherosclerotic occlusive disease, dissections, and aneurysms. The purpose of this study was to investigate the age-related biaxial biomechanical behavior of human infrarenal aortic tissue. METHODS OF APPROACH: A total of 18 samples (13 autopsy, 5 organ donor) were harvested from patients in each of three age groups: Group 1 (<30 years old, n=5), Group 2 (between 30 and 60 years old, n=7), and Group 3 (>60 years old, n=6). Each specimen was tested biaxially using a tension-controlled protocol which spanned a large portion of the strain plane. Response functions fit to experimental data were used as a tool to guide the appropriate choice of the strain energy function W. RESULTS: Under an equibiaxial tension of 120 N/m, the average peak stretch values in the circumferential direction for Groups 1, 2, and 3 were (mean +/-SD) 1.46 +/- 0.07, 1.15 +/- 0.07, and 1.11 +/- 0.06, respectively, while the peak stretch values in the longitudinal direction were 1.41 +/- 0.03, 1.19 +/- 0.11, and 1.10 +/- 0.04, respectively. There were no significant differences between the average longitudinal and circumferential peak stretch within each group (p > 0.1), but both of these values were significantly less (p < 0.001) for Groups 2 and 3 when compared to Group 1. Patients in Group 1 were modeled using a polynomial strain energy function W, while patients in Groups 2 and 3 were modeled using an exponential form of W, suggesting an age-dependent shift in the mechanical response of this tissue. CONCLUSION: The biaxial tensile testing results reported here are, to our knowledge, the first given for the human infrarenal aorta and reinforce the importance of determining the functional form of W from experimental data. Such information may be useful for the clinician or researcher in identifying key changes in the biomechanical response of abdominal aorta in the presence of an aneurysm.

Adult↗

PubMed2003

Prevention of polyurethane valve cusp calcification with covalently attached bisphosphonate diethylamino moieties.

OBJECTIVE: Calcification of polyurethane prosthetic valve leaflets causes a major functional impairment. Previously we showed that polyurethane heart valves modified with covalently linked bisphosphonate groups were resistant to calcification in vivo. However, we also found that the highly polar anionic bisphosphonate groups on the polyurethane surface attracted sodium counter ion adsorption, and thereby increased the elastomer's water absorption to 20% of total weight. In this study we address the increased water absorption by investigating the hypothesis that covalently attaching cationic diethylamino groups to the bisphosphonate-modified polyurethane will reduce water absorption. Thus we evaluated the mechanical and in vivo anticalcification properties of heart-valve leaflets composed of this modified polymer. METHODS: Diethylamino and bisphosphonate groups (DBP) were appended to the polyurethane Biospan's hard segment using previously published bromoalkylation methodology. Water absorption and biaxial mechanical and uniaxial failure testing were used to determine the mechanical properties of the DBP-modified polymer. Rat subdermal implants (60 days) and extended (150 days) single pulmonary leaflet replacements in juvenile sheep provided in vivo assessments of the bisphosphonate-modified polyurethane. RESULTS: The water absorption properties of the DBP-modified polymers and unmodified polyurethanes were 1.86 and 2.3 %, respectively. Biaxial mechanical tests showed the DBP-modified polymer was more compliant than the unmodified control material, but all polymeric material had similar uniaxial failure properties. In both rat subdermal and sheep circulatory implants, the DBP-modified polyurethane resisted calcification, as assessed by scanning electron microscopy, with complete calcification inhibition in prosthetic sheep valve leaflet replacements. CONCLUSION: DBP polyurethane possesses physical (water absorption) and biomechanical properties comparable to unmodified polyurethane and can resist intrinsic heart-valve leaflet calcification in blood-stream implants.

Animals↗

PubMed2003

Multiaxial mechanical behavior of biological materials.

For native and engineered biological tissues, there exist many physiological, surgical, and medical device applications where multiaxial material characterization and modeling is required. Because biological tissues and many biocompatible elastomers are incompressible, planar biaxial testing allows for a two-dimensional (2-D) stress-state that can be used to fully characterize their three-dimensional (3-D) mechanical properties. Biological tissues exhibit complex mechanical behaviors not easily accounted for in classic elastomeric constitutive models. Accounting for these behaviors by careful experimental evaluation and formulation of constitutive models continues to be a challenging area in biomechanical modeling and simulation. The focus of this review is to describe the application of multiaxial testing techniques to soft tissues and their relation to modern biomechanical constitutive theories.

Anisotropy↗

PubMed2003

A novel bioreactor for the dynamic flexural stimulation of tissue engineered heart valve biomaterials.

Dynamic flexure is a major mode of deformation in the native heart valve cusp, and may effect the mechanical and biological development of tissue engineered heart valves (TEHV). To explore this hypothesis, a novel bioreactor was developed to study the effect of dynamic flexural stimulation on TEHV biomaterials. It was implemented in a study to compare the effect of uni-directional cyclic flexure on the effective stiffness of two candidate TEHV scaffolds: a non-woven mesh of polyglycolic acid (PGA) fibers, and a non-woven mesh of PGA and poly L-lactic acid (PLLA) fibers, both coated with poly 4-hydroxybutyrate (P4HB). The bioreactor has the capacity to dynamically flex 12 rectangular samples (25 x 7.5 x 2mm) under sterile conditions in a cell culture incubator. Sterility was maintained in the bioreactor for at least 5 weeks of incubation. Flexure tests to measure the effective stiffness in the "with-flexure" (WF) and opposing "against-flexure" (AF) directions indicated that dynamically flexed PGA/PLLA/P4HB scaffolds were approximately 72% (3 weeks) and 76% (5 weeks) less stiff than static controls (p<0.01), and that they developed directional anisotropy by 3 weeks of incubation (stiffer AF, p<0.01). In contrast, both dynamically flexed and static PGA/P4HB scaffolds exhibited a trend of decreased stiffness with incubation, with no development of directional anisotropy. Dynamically flexed PGA/P4HB scaffolds were significantly less stiff than static controls at 3 weeks (p<0.05). Scanning electron microscopy revealed signs of heterogeneous P4HB coating and fiber disruption, suggesting possible explanations for the observed mechanical properties. These results indicate that dynamic flexure can produce quantitative and qualitative changes in the mechanical properties of TEHV scaffolds, and suggest that these differences need to be accounted for when comparing the effects of mechanical stimulation on the development of cell-seeded TEHV constructs.

Absorbable Implants↗

PubMed2003

Experimentally tractable, pseudo-elastic constitutive law for biomembranes: I. Theory.

Although visco-elastic in general, the stress-strain relation of biomembranes is one-to-one or pseudo-elastic when being loaded after preconditioning. This pseudo-elastic relation is hypoelastic (i.e., it is not hyperelastic), yet much of the stress response can be characterized by a scalar function omega that represents the work done (per unit reference volume) on the specimen during loading. (Since a pseudo-strain-energy function W is optimized to fit the test data and not the work done, omega is not equal to W in general.) The remaining part tR of the stress response does no work during loading. With biaxial testing, omega can be definitively determined from data. Moreover, for tests with the stretch directions coaxial to the axes of anisotropy, tR can be accurately characterized by a scalar function omega that depends on the strain. This paper is part 1 of 2 with "I. Theory" and "II. Application."

Animals↗

PubMed2003

Experimentally tractable, pseudo-elastic constitutive law for biomembranes: II. Application.

This is the second paper of a 2 part series. In the first, a theoretical framework is developed that provides 3 enhancements for the constitutive theory of biomembranes. 1) Covariance amongst response terms is minimized, 2) the pseudo-strain-energy potential is redefined so as to be measurable, and 3) the stress response is decomposed into 2 parts--a hyperelastic part plus a hypoelastic-stress-residual. This paper illustrates the experimental advantages of this novel constitutive theory via analysis of biaxial test data obtained from chemically treated bovine pericardium.

Animals↗

PubMed2003

Incorporation of experimentally-derived fiber orientation into a structural constitutive model for planar collagenous tissues.

Structural constitutive models integrate information on tissue composition and structure, avoiding ambiguities in material characterization. However, critical structural information (such as fiber orientation) must be modeled using assumed statistical distributions, with the distribution parameters estimated from fits to the mechanical test data. Thus, full realization of structural approaches continues to be limited without direct quantitative structural information for direct implementation or to validate model predictions. In the present study, fiber orientation information obtained using small angle light scattering (SALS) was directly incorporated into a structural constitutive model based on work by Lanir (J. Biomech., v. 16, pp. 1-12, 1983). Demonstration of the model was performed using existing biaxial mechanical and fiber orientation data for native bovine pericardium (Sacks and Chuong, ABME, v.26, pp. 892-902, 1998). The structural constitutive model accurately predicted the complete measured biaxial mechanical response. An important aspect of this approach is that only a single equibiaxial test to determine the effective fiber stress-strain response and the SALS-derived fiber orientation distribution were required to determine the complete planar biaxial mechanical response. Changes in collagen fiber crimp under equibiaxial strain suggest that, at the meso-scale, fiber deformations follow the global tissue strains. This result supports the assumption of affine strain to estimate the fiber strains. However, future evaluations will have to be performed for tissue subjected to a wider range of strain to more fully validate the current approach.

Animals↗

PubMed2003

Biaxial mechanical response of bioprosthetic heart valve biomaterials to high in-plane shear.

Utilization of novel biologically-derived biomaterials in bioprosthetic heart valves (BHV) requires robust constitutive models to predict the mechanical behavior under generalized loading states. Thus, it is necessary to perform rigorous experimentation involving all functional deformations to obtain both the form and material constants of a strain-energy density function. In this study, we generated a comprehensive experimental biaxial mechanical dataset that included high in-plane shear stresses using glutaraldehyde treated bovine pericardium (GLBP) as the representative BHV biomaterial. Compared to our previous study (Sacks, JBME, v.121, pp. 551-555, 1999), GLBP demonstrated a substantially different response under high shear strains. This finding was underscored by the inability of the standard Fung model, applied successfully in our previous GLBP study, to fit the high-shear data. To develop an appropriate constitutive model, we utilized an interpolation technique for the pseudo-elastic response to guide modification of the final model form. An eight parameter modified Fung model utilizing additional quartic terms was developed, which fitted the complete dataset well. Model parameters were also constrained to satisfy physical plausibility of the strain energy function. The results of this study underscore the limited predictive ability of current soft tissue models, and the need to collect experimental data for soft tissue simulations over the complete functional range.

Animals↗

PubMed2003

Effects of papillary muscle position on in-vitro dynamic strain on the porcine mitral valve.

BACKGROUND AND AIM OF THE STUDY: Improved knowledge of mitral valve (MV) mechanics is essential to understand normal MV function and design and evaluate new surgical repair procedures. Initially, the dynamic deformation of the central region of the porcine MV anterior leaflet was quantified under simulated physiological conditions to explore the effects of varying papillary muscle (PM) position. METHODS: Fresh porcine MVs were mounted in an in-vitro physiological flow loop. The PM positions were set to normal, taut, and slack states to simulate physiological and pathological PM positions. Leaflet deformation was measured by tracking the displacement of 16 markers (approximately 250 microm diameter) placed in a 5 x 5 mm section of the central region of the anterior leaflet, approximately 5 mm from the annulus and coaptation line. Local leaflet tissue strain and strain rates were calculated from measured displacements under dynamic loading conditions. A total of 11 mitral valves was studied. RESULTS: Under the normal PM positional state, the average areal strain rate during valve closure was typically approximately 620% per second. While not measurably altering the maximal areal strain rate, the slack PM position led to a delay in complete valve closure and more rapid leaflet loading (defined as delta transvalvular pressure/delta areal strain) in late systole compared to the other two PM positions. CONCLUSION: It was shown that PM position influenced the MV loading process in the central area of the anterior leaflet. The slack PM position led to a delay in complete valve closure and more rapid leaflet loading in late systole. This increase in loading rate may have long-term consequences in MV function.

Animals↗

PubMed2002

Collagen fiber disruption occurs independent of calcification in clinically explanted bioprosthetic heart valves.

The durability of bioprosthetic heart valves (BHV) is severely limited by tissue deterioration, manifested as calcification and mechanical damage to the extracellular matrix. Extensive research on mineralization mechanisms has led to prevention strategies, but little work has been done on understanding the mechanisms of noncalcific matrix damage. The present study tested the hypothesis that calcification-independent damage to the valvular structural matrix mediated by mechanical factors occurs in clinical implants and could contribute to porcine aortic BHV structural failure. We correlated quantitative assessment of collagen fiber orientation and structural integrity by small angle light scattering (SALS) with morphologic analysis in 14 porcine aortic valve bioprostheses removed from patients for structural deterioration following 5-20 years of function. Calcification of the explants varied from 0 (none) to 1+ (minimal) to 4+ (extensive), as assessed radiographically. SALS tests were performed over entire excised cusps using a 0.254-mm spaced grid, and the resultant structural information used to generate maps of the local collagen fiber damage that were compared with sites of calcific deposits. All 42 cusps showed clear evidence of substantial noncalcific structural damage. In 29 cusps that were calcified, structural damage was consistently spatially distinct from the calcification deposits, generally in a distribution similar to that noted in porcine BHV subjected to in vitro durability testing. Our results suggest a mechanism of noncalcific degradation dependent on cuspal mechanics that could contribute to porcine aortic BHV failure.

Animals↗

PubMed2002

Synthesis, characterization, and cytocompatibility of elastomeric, biodegradable poly(ester-urethane)ureas based on poly(caprolactone) and putrescine.

The engineering of tissue for mechanically demanding applications in the cardiovascular system is likely to require mechanical conditioning of cell-scaffold constructs prior to their implantation. Scaffold properties amenable to such an application include high elasticity and strength coupled with controllable biodegradative and cell-adhesive properties. To fulfill such design criteria, we have synthesized a family of poly(ester-urethane)ureas (PEUUs) from polycaprolactone and 1,4-diisocyanatobutane. Lysine ethyl ester (Lys) or putrescine was used as chain extenders. To encourage cell adhesion, PEUUs were surface modified with radio-frequency glow discharge followed by coupling of Arg-Gly-Asp-Ser (RGDS). The synthesized PEUUs were highly flexible, with breaking strains of 660-895% and tensile strengths from 9.2-29 MPa. Incubation in aqueous buffer for 8 weeks resulted in mass loss, from >50% (Lys chain extender) to 10% (putrescine chain extender). Human endothelial cells cultured for 4 days with medium containing the degradation products from PEUUs with either the Lys or putrescine chain extender showed no toxic effects. Cell adhesion was 85% of that measured on tissue-culture polystyrene for unmodified PEUU surfaces (p < 0.01) and >160% (p < 0.001) of polystyrene on RGDS-modified PEUUs. These biodegradable PEUUs demonstrate potential for future application as cell scaffolds in cardiovascular tissue-engineering or other soft-tissue applications.

Absorbable Implants↗

PubMed2002

Effects of fixation pressure on the biaxial mechanical behavior of porcine bioprosthetic heart valves with long-term cyclic loading.

Zero transvalvular pressure fixation is thought to improve porcine bioprosthetic heart valve (BHV) durability by preserving the collagen fiber architecture of the native tissue, and thereby native mechanical properties. However, it is not known if the native mechanical properties are stable during long-term valve operation and thus provide additional durability. To address this question, we examined the biaxial mechanical properties of porcine BHV fixed at 0 and 4mmHg transvalvular pressure following 0, 1 x 10(6), 50 x 10(6), and 200 x 10(6) in vitro accelerated test cycles. At 0 cycles, the extensibility and degree of axial cross-coupling of the zero-pressure-fixed cusps were higher than those of the low-pressure-fixed cusps. Furthermore, extensibility of the zero-pressure-fixed tissue decreased between 1 x 10(6) and 50 x 10(6) cycles, approaching that of the low-pressure-fixed tissue, whose extensibility was unchanged over 0-200 x 10(6) cycles. The decrease in extensibility of the zero-pressure-fixed tissue between 1 x 10(6) and 50 x 10(6) cycles may be attributable to the ability of its collagen fibers to undergo larger changes in orientation and crimp with cyclic loading. These observations suggest that the collagen fiber architecture of the 0-mmHg-fixed porcine BHV, although locked in place by chemical fixation, may not be maintained over a sufficient number of cycles to be clinically beneficial. This study further underscores that chemically treated collagen fibers can undergo conformational changes under long-term cyclic loading not associated with damage.

Animals↗

PubMed2002

Passive biaxial mechanical properties of the rat bladder wall after spinal cord injury.

PURPOSE: Changes in the mechanical properties of the bladder wall after spinal cord injury can alter bladder compliance and wall tension, leading to changes in afferent nerve activity and to abnormal reflex mechanisms. To our knowledge we report the first application of biaxial mechanical testing to the normal bladder wall and demonstrate how these properties change after spinal cord injury. MATERIALS AND METHODS: Whole bladders were harvested from mature female Sprague-Dawley rats weighing 250 to 300 gm. Test group animals underwent complete spinal cord transection at the T9 to T10 level and normal animals comprised the control group. The bladders were cut open longitudinally, the trigone and apex were removed and the remaining tissue was trimmed to a square of 9 to 13 mm. per side. Mechanical properties of the tissue sample were tested using planar biaxial testing, in which a stress was applied in the circumferential and longitudinal (base-apex) directions, and resulting axial strains were measured. RESULTS: In normal and spinal cord injured rats bladder wall tissue demonstrated isotropic mechanical behavior when equal stress levels were applied in anatomical directions. However, under nonequi-biaxial loading bladder specimens were not truly isotropic but displayed anisotropic-like behavior. Spinal cord injured tissues were consistently more compliant than normal controls. CONCLUSIONS: Biaxial mechanical testing can detect differences in normal control and hypertrophied rat bladders 10 and 14 days after spinal cord injury. These changes represent an important component of the bladder response to spinal cord injury.

Animals↗

PubMed2002

The future of bladder control-intravesical drug delivery, a pinch of pepper, and gene therapy.

The incidence of urinary incontinence and overactive bladder problems will continue to grow as the population ages. Future treatments are likely to include an implantable drug delivery system, gene therapy, and the intravesical use of the vallinoids capsaicin and resiniferatoxin (RTX). An understanding of the urothelium is essential for effective design of these therapies. Intravesical anticholinergic drug treatment is currently not widely used, but intravesical pumps are under development to provide less cumbersome treatment methods and will provide nonsurgical options for patients who cannot tolerate oral anticholinergic agents. Research on the use of capsaicin as an intravesicular drug has had limited success, but trials have confirmed the efficacy of intravesical capsaicin for detrusor hyperreflexia. RTX is as effective as capsaicin but without side effects, such as pain and inflammatory neuropeptide release. RTX treatment may eliminate the need for surgical and other drug treatments of lower urinary tract dysfunction in patients with spinal cord injuries. Gene therapy will change the practice of urology by addressing the deficiencies that cause symptoms rather than attacking the symptoms themselves.

Journal Article↗

PubMedDate not supplied

The collagen fibers of the anteroinferior capsulolabrum have multiaxial orientation to resist shoulder dislocation.

Instability of the glenohumeral joint can be associated with anteroinferior capsulolabral rupture. To understand its static stabilizing effect better, the collagen fiber orientation of the inferior glenohumeral ligament (IGHL), a component of the anteroinferior capsulolabrum, was studied with a small angle light scattering technique. Three rectangular samples (approximately 11 x 6 mm) were excised from the axillary pouch, one from the anterior band (AB) of the IGHL and one control sample from the long head of the biceps tendon of 7 cadaveric shoulders. The small angle light scattering technique scans the tissue with a helium-neon laser beam and quantifies the fiber alignment based on the resultant scattering pattern. The fiber orientation was quantified by an orientation index, defined as the angle within which 50% of the fibers lie. The axillary pouch had a random orientation, whereas the AB-IGHL was random with some regions of localized alignment. The percentage of tissue with an orientation index range of 25 degrees to 45 degrees was 23.2% +/- 8.5% and 29.0% +/- 13.1% for the axillary pouch and the AB-IGHL, respectively, whereas that for the long head of the biceps tendon was 61.6% +/- 15.2%. This suggests that the collagen fibers in the IGHL are not highly aligned and the anteroinferior capsulolabrum can be modeled as a continuous sheet. Moreover, a biomechanical evaluation of the anteroinferior capsulolabrum that investigates the possibility that the mechanical properties may be directionally independent should be conducted.

Adult↗