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Nothing but skin and bone.

Skin and bone - what comes to mind at hearing this phrase? While certainly a metaphor for disease, it also defines two very different tissues, one a flexible and contiguous outer covering, the other a morphologically diverse hard tissue distributed at over 200 sites in the body. As the accompanying series of Reviews highlights, these tissues are indeed diverse, but there are also surprising similarities. Skin is the interface between the internal organs and the environment, and as such plays a crucial role in the body's defense mechanism. The skin and its many appendages are responsible for functions as diverse as epidermal barrier and defense, immune surveillance, UV protection, thermoregulation, sweating, lubrication, pigmentation, the sensations of pain and touch, and, importantly, the protection of various stem cell niches in the skin. Bone serves a number of purposes: it provides protection for vital organs, a lever for locomotion, a reservoir for calcium, and the site of adult hematopoiesis. The tissue is composed of osteoblasts, osteoclasts, and their individual precursors plus a complex mixture of mesenchymal, myeloid, and lymphoid cells in the marrow space. Finally, the endothelial microenvironment provides nutrition and is a conduit for the influx and emigration of cells that impact bone biology in several important ways. This Review series guides the reader through these various facets of 2 diverse, yet interdependent, tissues.

Animals↗

Predicting the risk of rupture of abdominal aortic aneurysms by utilizing various geometrical parameters: revisiting the diameter criterion.

The authors estimated noninvasively the wall stress distribution for actual abdominal aortic aneurysms (AAAs) in vivo on a patient-to-patient basis and correlated the peak wall stress (PWS) with various geometrical parameters. They studied 39 patients (37 men, mean age 73.7 +/- 8.2 years) with an intact AAA (mean diameter 6.3 +/- 1.7 cm) undergoing preoperative evaluation with spiral computed tomography (CT). Real 3-dimensional AAA geometry was obtained from image processing. Wall stress was determined by using a finite-element analysis. The aorta was considered isotropic with linear material properties and was loaded with a static pressure of 120.0 mm Hg. Various geometrical parameters were used to characterize the AAAs. PWS and each of the geometrical characteristics were correlated by use of Pearson's rank correlation coefficients. PWS varied from 10.2 to 65.8 N/cm2 (mean value 37.1 +/- 9.9 N/cm2). Among the geometrical parameters, the PWS was well correlated with the mean centerline curvature, the maximum centerline curvature, and the maximum centerline torsion of the AAAs. The correlation of PWS with maximum diameter was nonsignificant. Multiple regression analysis revealed that the mean centerline curvature of the AAA was the only significant predictor of PWS and subsequent rupture risk. This noninvasive computational approach showed that geometrical parameters other than the maximum diameter are better indicators of AAA rupture.

Aged↗

The principal stress distribution in a root with a loaded post in model experiments.

The principal stress distribution in a root with a loaded post was analyzed in model experiments, in which emphasis was directed to the cervical boundary of the root where the stresses are greatest. Maximum stresses were found in the inner proximal sides, and were stronger when the prepared root canal walls were parallel. When contact between post and root was reduced, stresses decreased. These findings point to the importance of sparing tooth substance in the proximal parts of the canal in order to reduce the risk of breaking the cement layer and loosening the post.

Crowns↗

Determination of arbitrary tooth displacements.

The noninvasive, modern technique based on the method of double-exposure hologram interferometry was used to measure arbitrary displacements of teeth in the three dimensional space. The experimental studies were carried out on an idealized model of the maxillary central incisor. The results show that the experimental data, based on component loading, are inadequate to accurately predict tooth displacement from an arbitrary force acting in the three dimensional space.

Alveolar Process↗

A three-dimensional model of dentin apposition.

Since we have found that conventional methods of dentin apposition measurements are inaccurate, we have devised a three dimensional model. This model allows the investigator to measure dentin apposition volumetrically, and simultaneously consider odontoblast activity and the geometric relationships which influence the configuration of the dentin.

Animals↗

Verification of theoretical modeling of heat transmission in teeth by in vivo experiments.

A theoretical axisymmetric tooth model, simulating the conditions involved in the drinking of a liquid of a certain temperature, was compared with results of a similar in vivo experiment. The temperature changes as a result of one draught of a hot/cold liquid were recorded within the model as well as in the surrounding environment. The experimental data obtained were compared with the calculated results for the theoretical model as determined by the Finite Element Analysis. The temperatures recorded experimentally agreed reasonably with the calculated results. It can be concluded that the assumptions which have been made concerning the described thermal loading conditions lead to a good approximation of the physical reality.

Cold Temperature↗

A technique to model the nasal airway for aerodynamic study.

This article presents a new technique for creation of a model that can be used to study the aerodynamics of the nasal airway. The model is employed to determine parameters used to calculate nasal resistance and modified to compare various types of nasal obstruction. It quantitatively compares the importance of septal deviation, turbinate size, and nasopharyngeal port size to airflow. A new parameter of nasal resistance is introduced.

Acrylates↗

Repair of severed peripheral nerve: a superior anatomic and functional recovery with a new "reconnection" technique.

The objective of this study was to use a quantitative functional and anatomic model to compare surgical repair of the rat sciatic nerve according to two techniques; standard epineurial repair and the recently reported "nerve reconnection technique" ("freeze-trim technique"). Functional recovery was evaluated using a functional index based on the measurements of the rats' footprints. Neuroanatomic experiments were conducted on the same animals to correlate functional recovery with regeneration of known motoneuron populations. The results of surgical repairs were also compared to those obtained from untreated sciatic nerve crush injuries. Functional recovery after epineurial repairs typically averaged 18%, whereas the mean recovery from the "nerve reconnection technique" was 71%. Crush injuries recovered to normal and reached a plateau much earlier than the surgical repairs. Retrograde horseradish peroxidase (HRP) labeling of motoneurons of the common peroneal nerve, a branch of the sciatic, revealed that there was a complex relationship between functional recovery and the number and distribution of motoneurons that regenerated axons distal to the repair site. The "nerve reconnection technique" greatly reduced the probability of axonal misdirection into the wrong distal branches at the repair site and brought an improvement of 300% to 400% in functional recovery over that found with epineurial repair. This technique of nerve repair may prove to be a valuable tool in reconstructive surgery.

Animals↗

Teaching indirect mirror laryngoscopy.

Indirect mirror laryngoscopy is difficult to learn. An anatomic model of the oropharynx and larynx is described here. This model is used to familiarize medical students with the component skills of mirror laryngoscopy. The students progress to competency at mirror laryngoscopy on patients more quickly after initial use of this model.

Laryngoscopy↗

Numerical simulation of a realistic total cavo-pulmonary connection: effect of unbalanced pulmonary resistances on hydrodynamic performance.

Total cavo pulmonary connection (TCPC) is one of the surgical techniques adopted to compensate the failure of the right heart in pediatric patients. The main goal of this procedure is the realization of a configuration for the caval veins and for the pulmonary arteries that can guarantee as low as possible pressure losses and appropriate lung perfusion. Starting from this point of view, a realistic TCPC with extracardiac conduit (TECPC) is investigated by means of Computational Fluid Dynamics (CFD) to evaluate the pressure loss under different pressure conditions, simulating different vessel resistances, on the pulmonary arteries. A total flow of 3 L/min, with a distribution between the inferior vena cava (IVC) and the superior vena cava (SVC) equal to 6/4, was investigated; three different boundary conditions for the pressure were imposed, resulting in three simulations in steady-state conditions, to the right pulmonary artery (RPA) and to the left pulmonary artery (LPA), simulating a balanced (deltaP(LPA-RPA) = 0 mmHg) and two unbalanced pulmonary resistances to blood flow (a pressure difference deltaP(LPA-RPA) = +/- 2 mmHg, respectively). The geometry for the TECPC was realized according to MRI derived physiological values for the vessels and for the configuration adopted for the anastomosis (the extra-cardiac conduit was inclined 22 degrees towards the left pulmonary artery with respect to the IVC axis). The computed power losses agree with previous in vitro Particle Image Velocimetry investigations. The results show that a higher resistance on the LPA causes the greater pressure loss for the TECPC under study, while the minimum pressure loss can be achieved balancing the pulmonary resistances, subsequently obtaining a balanced flow repartition towards the lungs.

Child↗

Immunoreactivities to three circadian clock proteins in two ground crickets suggest interspecific diversity of the circadian clock structure.

The closely related crickets Dianemobius nigrofasciatus and Allonemobius allardi exhibit similar circadian rhythms and photoperiodic responses, suggesting that they possess similar circadian and seasonal clocks. To verify this assumption, antisera to Period (PER), Doubletime (DBT), and Cryptochrome (CRY) were used to visualize circadian clock neurons in the cephalic ganglia. Immunoreactivities referred to as PER-ir, DBT-ir, and CRY-ir were distributed mainly in the optic lobes (OL), pars intercerebralis (PI), dorsolateral protocerebrum, and the subesophageal ganglion (SOG). A system of immunoreactive cells in the OL dominates in D. nigrofasciatus, while immunoreactivities in the PI and SOG prevail in A. allardi. Each OL of D. nigrofasciatus contains 3 groups of cells that coexpress PER-ir and DBT-ir and send processes over the frontal medulla face to the inner lamina surface, suggesting functional linkage to the compound eye. Only 2 pairs of PER-ir cells (no DBT-ir) were found in the OL of A. allardi. Several groups of PER-ir cells occur in the brain of both species. The PI also contains DBT-ir and CRY-ir cells, but in A. allardi, most of the DBT-ir is confined to the SOG. Most immunoreactive cells in the PI and in the dorsolateral brain send their fibers to the contralateral corpora cardiaca and corpora allata. The proximity and, in some cases, proven identity of the PER-ir, DBT-ir, and CRY-ir perikarya are consistent with presumed interactions between the examined clock components. The antigens were always found in the cytoplasm, and no diurnal oscillations in their amounts were detected. The photoperiod, which controls embryonic diapause, the rate of larval development, and the wing length of crickets, had no discernible effect on either distribution or the intensity of the immunostaining.

Animals↗

Analysis of contact mechanics in McKee-farrar metal-on-metal hip implants.

Contact mechanics analysis for a typical McKee-Farrar metal-on-metal hip implant was carried out in this study. The finite element method was used to predict the contact area and the contact pressure distribution at the bearing surfaces. The study investigated the effects of the cement and underlying bone, the geometrical parameters such as the radial clearance between the acetabular cup and the femoral head, and the acetabular cup thickness, as well as other geometrical features on the acetabular cup such as lip and studs. For all the cases considered, the predicted contact pressure distribution was found to be significantly different from that based upon the classical Hertz contact theory, with the maximum value being away from the centre of the contact region. The lip on the cup was found to have a negligible effect on the predicted contact pressure distribution. The presence of the studs on the outside of the cup caused a significant increase in the local contact pressure distribution, and a slight decrease in the contact region. Reasonably good agreement of the predicted contact pressure distribution was found between a three-dimensional anatomical model and a simple two-dimensional axisymmetric model. The interfacial boundary condition between the acetabular cup and the underlying cement, modelled as perfectly fixed or perfectly unbonded, had a negligible effect on the predicted contact parameters. For a given radial clearance of 0.079 mm, the decrease in the thickness of the acetabular cup from 4.5 to 1.5 mm resulted in an increase in the contact half angle from 15 degrees to 26 degrees, and a decrease in the maximum contact pressure from 55 to 20 MPa. For a given acetabular cup thickness of 1.5 mm, a decrease in the radial clearance from 0.158 to 0.0395 mm led to an increase in the contact half-angle from 20 degrees to 30 degrees, and a decrease in the maximum contact pressure from 30 to 10 MPa. For zero clearance, although the contact pressure was significantly reduced over most of the contact area, the whole acetabular cup came into contact with the femoral head, leading to stress concentration at the edge of the cup. Design optimization of the geometrical parameters, in terms of the acetabular cup thickness and the radial clearance, is important, not only to minimize the contact stress at the bearing surfaces, but also to avoid equatorial and edge contact.

Acetabulum↗

Modeling the mechanical behavior of the jaws and their related structures by finite element (FE) analysis.

In this paper, we provide a review of mechanical finite element analyses applied to the maxillary and/or mandibular bone with their associated natural and restored structures. It includes a description of the principles and the relevant variables involved, and their critical application to published finite element models ranging from three-dimensional reconstructions of the jaws to detailed investigations on the behavior of natural and restored teeth, as well as basic materials science. The survey revealed that many outstanding FE approaches related to natural and restored dental structures had already been done 10-20 years ago. Several three-dimensional mandibular models are currently available, but a more realistic correlation with physiological chewing and biting tasks is needed. Many FE models lack experimentally derived material properties, sensitivity analyses, or validation attempts, and yield too much significance to their predictive, quantitative outcome. A combination of direct validation and, most importantly, the complete assessment of methodical changes in all relevant variables involved in the modeled system probably indicates a good FE modeling approach. A numerical method for addressing mechanical problems is a powerful contemporary research tool. FE analyses can provide precise insight into the complex mechanical behavior of natural and restored craniofacial structures affected by three-dimensional stress fields which are still very difficult to assess otherwise.

Anatomy, Cross-Sectional↗