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Elasticity of crystalline beta-sheet monolayers.

Designed amphiphilic beta-sheet peptides with the sequence Pro-Glu-(Phe-Glu)(n)-Pro (n = 2-7) were previously shown by grazing incidence X-ray diffraction (GIXD), to form ordered two-dimensional (2-D) monolayer structures at interfaces induced by the proline residues at peptide termini. The GIXD diffraction pattern was modeled with two coexisting lattice arrangements, suggesting structural flexibility exhibited in the multiple ways by which beta-strands and their amino acid side chains pack into ordered 2-D structures. Here, we find by in-situ GIXD measurements that the ordered beta-sheet assemblies may undergo a quasi-reversible compression and expansion cycle at the air-water interface. The diffraction measurements indicate that on compression the repeat distance that corresponds to the long axes of the peptide strands may decrease by up to 37% in length. Upon expansion the compressed beta-sheet assemblies revert elastically to their original conformation. The interstrand repeat distance along the peptide hydrogen bonds apparently does not change along the film compression and expansion. Based on the GIXD data, at surface pressures higher than approximately 3 mN/m, beyond the peptide limiting area per molecule, the compressibility is 7.4 +/- 0.6 m/N. The out-of-plane Bragg rod diffraction patterns imply that in the compressed state the beta-strands buckle up in reaction to the increase in surface pressure. At low surface pressure, the 2-D compressibility of the crystalline beta-sheet was estimated at approximately 32 m/N attributed to interdomain rearrangements.

Crystallization↗

Can we distinguish between benign versus malignant compression fractures of the spine by magnetic resonance imaging?

STUDY DESIGN: The authors investigate the usefulness of magnetic resonance imaging in differentiating benign versus malignant compression fractures by reviewing patients and a fracture model in a canine model. OBJECTIVES: To determine the sensitivity and specificity of magnetic resonance imaging in differentiating benign versus malignant compression fractures of the spine and to obtain distinguishing features in magnetic resonance imaging. SUMMARY OF BACKGROUND DATA: The differentiation between benign and abnormal compression fractures of the thoracolumbar spine has important implications regarding patient treatment and prognosis. Plain radiographs, bone scans, and computed tomography are not accurate imaging modalities for this purpose. METHODS: Magnetic resonance imaging scans of 22 patients with confirmed lesions of the thoracolumbar spine were studied. There were 11 malignant and 11 benign lesions. Two experienced neuroradiologists blindly reviewed the magnetic resonance imaging scans and determined benign or malignant lesions. A canine study was performed to simulate a compression fracture model with a vertebral osteotomy in two dogs, and serial contrast-enhanced magnetic resonance imaging scans were performed 15, 30, 60 and 90 days after surgery. RESULTS: The correct interpretation between two neuroradiologists was 77% and 95%. The combined sensitivity rate was 88.5%, and the specificity rate was 89.5%. Magnetic resonance imaging reliably distinguished benign versus malignant lesions based on the anatomic distribution and intensity of signal changes of bone and adjacent tissues, contrast enhancement characteristics, and changes over time. Only one malignant lesion was misinterpreted by both neuroradiologists as benign, whereas there was one additional missed malignant lesion and three misinterpreted benign lesions by one radiologist. In the canine study, signal changes and enhancement were found 60 days after surgery, but no signal changes or enhancement were noted on the scan 90 days after surgery. CONCLUSIONS: Magnetic resonance imaging scans can detect malignant vertebral lesions early, but acute healing compression fractures may mimic the findings of metastatic lesions. The use of contrast-enhanced magnetic resonance imaging scans and serial magnetic resonance imagings are helpful for additional differentiation between benign and malignant compression fractures. In addition to magnetic resonance imaging scans, other diagnostic tests and clinical findings should be correlated before biopsy or surgery of the suspected lesion.

Adult↗

[The effect of the group and individual characteristics of the vertebrae on their strength in experimental compression fractures].

The authors give an account of their investigation into the strength characteristics of the vertebrae preparations depending on a number of geometric characteristics of the vertebral bodies, the biological state of the bone tissue (osteoporosis, degenerative and dystrophic changes) and their group belonging. A number of factors has been revealed in some parameters of which it is possible to determine the dynamics of the state of the support function of the injured segment in the modelling of compressive fractures of the vertebral bodies. The results obtained by the authors allow to specify the literature data concerning the strength properties of the compressed vertebral body.

Biomechanical Phenomena↗

Meta-analysis of effectiveness of intermittent pneumatic compression devices with a comparison of thigh-high to knee-high sleeves.

This meta-analysis used all original articles from 1966 to June 1996 that fit the preset inclusion criteria to examine the clinical effectiveness of intermittent pneumatic compression (IPC) devices in preventing deep vein thrombosis (DVT) and pulmonary embolism and to compare the results of knee-high sleeves to thigh-high sleeves. IPC devices decreased the relative risk of DVT by 62 per cent when compared with placebo, 47 per cent compared with graduated compression stockings, and 48 per cent compared with mini-dose heparin. IPC devices significantly decreased the relative risk of DVT compared with placebo in high-risk patients such as neurosurgery and major orthopedic surgery patients and in modest risk patients such as general surgery patients. In major orthopedic surgery patients, the incidence of DVT was similar for IPC- and warfarin-treated patients; however, IPC was significantly better than warfarin at decreasing the incidence of calf only DVT, whereas warfarin seemed to be better at decreasing proximal DVT. IPC devices are effective in decreasing the incidence of DVT in patients at moderate to high risk and are probably more efficacious than graduated compression stockings or mini-dose heparin; however, IPC devices are not protective against pulmonary embolism. The data directly comparing the various methods of compression (knee-high versus thigh-high sleeves and graded-sequential versus uniform compression) are sparse and conflicting.

Bandages↗

Effects of MPEG compression on the quality and diagnostic accuracy of digital echocardiography studies.

The advantages of digital echocardiography studies include ease of retrieval, review, comparison, duplication, and quantitation as well as the potential for moving studies over networks. However, the large amounts of data associated with digital echocardiography studies have posed new problems. Reduction of the amount of data can be accomplished with image compression, in particular MPEG-1 (Moving Pictures Expert Group), which is designed for dynamic image sequences. However the effects of different levels of compression on the quality and diagnostic content of echocardiographic images need to be established. Digital sequences of single cardiac cycles were acquired in 40 consecutive patients, MPEG-1-compressed at different effective ratios (60:1, 80:1, 120:1, 200:1, 300:1, 370:1, 500:1), reviewed, and scored for endocardial visualization. The overall visualization scores and percentages of nonvisualized segments in the compressed images were not different from the uncompressed images up to a compression ratio of 200:1. Differential effects of compression were noted on a segmental basis and also varied with baseline image quality. The ability to correctly identify regional wall motion abnormalities did not decrease until compression ratios of 1:200 or higher were used. Digital echocardiography loops, MPEG-1-compressed at an effective ratio of 200:1, demonstrate no degradation in endocardial visualization quality or diagnostic content. Compression at this ratio has the potential to reduce the storage size of digital echocardiography studies to less than 1% of their current size.

Echocardiography↗

Wheelchair integrated occupant restraints: feasibility in frontal impact.

Individuals often use their wheelchair as a motor vehicle seat when traveling in motor vehicles. The current use of fixed vehicle-mounted wheelchair occupant restraint systems (FWORSs) often results in poor belt fit and discomfort. Additionally, satisfaction, usability and usage rate of FWORSs during transit use are often low. The automotive industry has shown improved occupant restraint usage, belt fit and injury protection when integrating the upper torso and pelvic restraint in a motor vehicle seat. This study compared occupant injury measures of a FWORS to a concept wheelchair integrated restraint system (WIRS) using a 20g frontal sled impact test with a 30 mph change in velocity. Neck loads, neck moments, head, pelvis and chest acceleration, sternum compression and knee and head excursion data were recorded from the wheelchair seated 50th percentile male hybrid III anthropomorphic test dummy (ATD). The WIRS resulted in a lower head injury criteria (HIC) value, lower sternum compression and a lower upper-torso restraint load than the FWORS. Compared with the FWORS, increased head, knee and wheelchair excursions and higher neck loads and moments were measured in the WIRS test. Both restraint scenario injury parameters were complied with occupant injury criteria based on General Motors Injury Assessment Reference Values (GM-IARVs) and occupant kinematic requirements defined by the Society of Automotive Engineers (SAE) voluntary standard, J2249. A higher motion criteria index was calculated for the WIRS scenario and a comparable combined injury criteria index was calculated for both restraint scenarios. The sled impact test showed WIRS concept feasibility, facilitating further development by industrial manufacturers who might further want to pursue this restraint principle to increase wheelchair occupant safety and comfort during transport in motor vehicles.

Accidents, Traffic↗

Anterior-posterior and medial compression of the supraglottis: signs of nonorganic dysphonia or normal postures?

Two vocal tract postures commonly identified as hallmarks of nonorganic dysphonia are anterior-posterior and medial compression of the supraglottis. However, insufficient data exist to support their diagnostic utility. The purpose of this study was to compare these two postures in patients with nonorganic dysphonia and normal controls using interval data derived from quantitative measures of videostroboscopic images obtained with an oral endoscope. Retrospectively, 40 patients with nonorganic dysphonia and 40 normal controls were selected. Relative anterior-posterior compression (LO(AP)) was calculated as the laryngeal outlet (LO) (the view of the true vocal folds during phonation) normalized to the anterior-posterior dimension in pixels. Relative ventricular fold medial compression (LO(w)) was calculated as the laryngeal outlet normalized to the medial dimension in pixels. Results were as follows: (1) LO(AP) was significantly greater for the dysphonic group, (2) the range of LO(AP) values between the two groups overlapped considerably, (3) no significant difference was found between groups for LO(w), (4) the correlation between LO(AP) and LO(w) within each subject yielded r values of 0.71 and 0.67 for the nonorganic dysphonia and normal control groups, respectively. It is concluded that medial compression of the ventricular folds can be a normal laryngeal posture, and that although anterior-posterior compression is present in greater degree in dysphonics, it is sufficiently common in normals to question its utility as a diagnostic sign of phonatory dysfunction.

Adult↗

Hadronic matter is soft.

The stiffness of the hadronic equation of state has been extracted from the production rate of K+ mesons in heavy-ion collisions around 1 AGeV incident energy. The data are best described with a compression modulus K around 200 MeV, a value which is usually called "soft." This is concluded from a detailed comparison of the results of transport theories with the experimental data using two different procedures: (i) the energy dependence of the ratio of K+ from Au+Au and C+C collisions and (ii) the centrality dependence of the K+ multiplicities. It is demonstrated that input quantities of these transport theories which are not precisely known, such as the kaon-nucleon potential, the deltaN --> NK+lambda cross section, or the lifetime of the delta in matter, do not modify this conclusion.

Journal Article↗

Differences between eccentric and rotary tablet machines in the evaluation of powder densification behaviour.

Differences in the dynamics of powder densification between eccentric and rotary machine were pointed out by compressing at different compression pressures microcrystalline cellulose, lactose monohydrate and dicalcium phosphate dihydrate and recovering the corresponding stress/strain data in both machines equipped to monitor punches displacement and compression forces. Heckel plots were then obtained from these stress/strain data. Curves obtained in the rotary machine possess a narrower zone of linearity for the calculation of P(Y) and D(A). The effect of the different compression mechanism of the rotary machine on the shape of the Heckel plot is more noticeable in a non-deforming material such as dicalcium phosphate. The effect of the longer dwell time of the rotary machine on the porosity reduction occurring after the maximum pressure has been reached, is more noticeable in a ductile material such as microcrystalline cellulose. Heckel parameters obtained in the rotary press are in some cases different from those recovered in the eccentric machine because of the longer dwell time, machine deflection and punch tilting occurring in the rotary machine, although theoretically they could better describe the material densification in a high speed production rotary machine.

Powders↗

Periosteal bone formation stimulated by externally induced bending strains.

The rat tibia four-point bending model is a new mechanical loading model in which force is applied through external pads to the rat lower limb. The advantages of the model are controlled force application to a well-defined bone, noninvasive external loading, and the addition of loads to normal daily activity. A disadvantage of the model is that the pads create local pressure on the leg at the contact sites. This study examined the differences in tibial response to bending strains and to local pressure under the pads. A total of 30 adult Sprague-Dawley rats were randomized into three external loading groups: bending, cyclic pressure, and static pressure. The right leg of each rat was externally loaded to create either bending or local pressure without bending; the left leg served as a control. Strains on the lateral surface averaged 1200 mu epsilon in compression during bending load application and < 200 mu epsilon in compression during pressure loading. Histomorphometric data were collected from three regions: the maximal bending region, under the loading pads, and outside the maximal bending region. In the maximal bending region, bending loads created greater mineral apposition rate (MAR) on the lateral surface and greater MAR and formation surface on the medial surface of loaded than control tibiae. The region under the bending pad was exposed to similar bending strains and showed the same pattern of increased MAR as sections from the maximal bending region. Cyclic pressure had no effect on periosteal MAR or formation surface. Static pressure increased MAR only on the lateral tibial surface. Bending stimulates bone formation in regions with the highest bending strains. Similar forces applied only in the form of pressure loading do not stimulate tibial formation either at the contact site or between loading pads. These results suggest that externally applied forces of moderate magnitude stimulate bone formation primarily as a result of increased bending strains, not local pressure at the contact site.

Animals↗

Three-dimensional geometric and structural symmetry of the turkey ulna.

Structural models of long-bone preparations usually assume left-right symmetry of contralateral bones under normal (baseline) conditions. To obtain insight on how this assumption affects the detection of subtle changes (as from functional adaptation), we formally examined the three-dimensional geometric and structural symmetry of paired long bones, using contemporary image reconstruction and stress analysis techniques. Nine pairs of ulnae from normal male turkeys were reconstructed computationally from serial transverse images obtained by either (a) mechanical sectioning and digital photographic imaging or (b) computed tomography. Computed tomography scans allowed greater precision in reconstruction than did digitally imaged photographs. Left-right comparisons of parameters of geometric symmetry (from computed tomography reconstructions) revealed average differences in whole bone volume and whole bone principal moments of inertia of 3.6 and 3.0%, respectively. Differences in bone curvature were indexed as noncolinearity of left compared with (mirrored) right centroidal axes, giving a disparity of 0.7 +/- 0.3 mm. Within the longitudinal central 20% of the diaphysis (the customary region for histomorphometry), average left-right differences in cross-sectional area and area principal moments of inertia for computed tomography images were 4.7 and 5.0%, respectively. The overlap of longitudinally paired cross sections of the mid-diaphysis, aligned at common centroids and oriented in the respective principal inertial directions, was greatest (as much as 95%) in the central 20% of the diaphysis. Paired three-dimensional finite element models demonstrated nearly identical left and right stress/strain fields throughout the ulnar diaphyses for both compressive and torsional loading. Our data suggest that the assumption of contralateral geometric symmetry in long bones should be judged in the context of the specific attribute of symmetry under consideration; however, we conclude that for purposes of finite element modeling the assumption of symmetry is reasonable.

Adaptation, Physiological↗

VER analysis of the chiasmal syndrome.

In the evaluation of chiasmal syndromes the efficiency of VER analysis could be enhanced by separate stimulation of the temporal and nasal half of the visual field. The report is based on data of 27 patients with compressive chiasmal lesions. VER findings have been correlated with the visual fields meticulously plotted with a Tuebingen perimeter and/or an Octopus computer perimeter. Alterations in both parameters have been graded in three groups. The degree of alteration correlated fairly well for both test procedures. Not only was a reduction of VER amplitude observed for the affected hemifield, but a latency delay as well. A discrete damage in the nasal hemifield may be detected even earlier by means of VER half field analysis than by conventional subjective perimetry.

Adenoma↗

Computer assisted detection of REM and non-REM sleep for analysis of nocturnal hypoxaemia in patients with ventilatory impairment.

A computer-assisted method for the evaluation of sleep and breathing in patients showing chronic ventilatory impairment is described and validated. Signals of body and respiratory movements (static charge sensitive bed), air-flow (thermistors), oxygen saturation (SaO2), electro-oculography (EOG), and electromyography (EMG) were recorded overnight and analysed. Using the compressed output graphs of the data and a rapid scoring procedure, stages of wakefulness, non-REM (stages S1-S4) and REM sleep were identified. The procedure allowed analysis of oxygen saturation data separately for each sleep stage. For validation of the method, the sleep stages identified were compared with traditional sleep staging based on a simultaneous recording of EEG, EMG and EOG in 10 patients with chronic obstructive pulmonary disease (COPD) and in 15 patients treated by thoracoplasty (TPL) for pulmonary tuberculosis. The recordings were performed in a patient ward. In total, 32 night recordings were analysed. In the COPD patients, the sensitivity and specificity of the new method were 87% and 84% in detecting non-REM sleep, and 72% and 87% in detecting REM sleep, respectively. In the TPL patients, the sensitivity and specificity were 93% and 89% with respect to non-REM sleep, and 92% and 94% in regard to REM sleep. The new method and traditional sleep staging provided closely similar quantitative estimates of the degree of sleep stage-(REM and non-REM) dependent arterial oxygen desaturation. It is concluded that the computer-assisted method, which is considerably less time consuming than traditional polysomnography, is reliable in studying sleep-related oxygenation in patients with chronic lung diseases.

Aged↗

Outcomes analysis in cranial base surgery - preliminary results.

A system of analysis addressing predictors of management outcomes in Cranial Base Surgery has yet to be published. We therefore report data on seventy-nine consecutive patients undergoing surgery for tumors involving the cranial base, excluding patients with the diagnosis of pituitary microadenoma. Outcomes were defined prospectively in terms of completeness of tumor resection, complications of treatment with emphasis on neurological morbidity, and return to work or independent living. Also, preoperative features are analyzed as influencing cost of treatment, estimated in terms of the number of surgical procedures required, duration of hospital and Intensive Care Unit stay, and time taken to return to work. Preliminary analysis of data reveals that severe brainstem compression, large tumor size (average diameter > 3 cm), high cavernous sinus grade, and tumor encasement of major cerebral arteries are associated with incomplete tumor resection (p < 0.05). Patient age greater than 65, preoperative Karnofsky Performance Score (KPS) less than 80, and severe brainstem compression are associated with increased risk of stroke (p < 0.05). Age greater than 65 and preoperative KPS less than 80 are associated with an increased length of stay (p < 0.05). Other untoward events did not occur with sufficient frequency to reach statistical significance. A model of outcomes analysis in Cranial Base Surgery is proposed utilizing a database to incorporate a group of non-operated patients and include quality of life measurements in long-term patient follow-up.

Brain Neoplasms↗

Tensile strength of bovine trabecular bone.

Data on the tensile and compressive properties of trabecular bone are needed to define input parameters and failure criteria for modeling total joint replacements. To help resolve differences in reports comparing tensile and compressive properties of trabecular bone, we have developed new methods, based on porous foam technology, for tensile testing of fresh/frozen trabecular bone specimens. Using bovine trabecular bone from an isotropic region from the proximal humerus as a model material, we measured ultimate strengths in tension and compression for two groups of 24 specimens each. The average ultimate strength in tension was 7.6 +/- 2.2 (95% C.I.) MPa and in compression was 12.4 +/- 3.2 MPa. This difference was statistically significant (p = 0.013) and was not related to density differences between the test groups (p = 0.28). Strength was related by a power-law function of the local apparent density, but, even accounting for density influences, isotropic bovine trabecular bone exhibits significantly lower strengths in tension than in compression.

Animals↗

Comparison of models for flow induced deformation of soft biological tissue.

The behaviour of a deformable porous medium during the flow of fluid under a pressure difference is examined for both infinitesimal and finite deformations. Models for both cases are solved for the problem of steady one-dimensional compression and compared with experimental data from Parker et al. (J. appl. Mech. 54, 794-800, 1987) for a polyurethane sponge. The purpose of this study is to identify a simple model which agrees qualitatively with these published results. To relate the stress relations for biological tissues to the data for polymer sponges (Parker et al., 1987) a translation of 1.1 kPa was introduced. This allows for some structural differences between the two media. It was found that the infinitesimal models were adequate up to 20% strain, but significant divergence occurred for higher strains. A finite deformation model with the permeability depending exponentially on the strain gave the most consistent results and required the fitting of only two parameters.

Connective Tissue↗

How do axons control myelin formation? The model of 6-aminonicotinamide neuropathy.

Injection of 6-aminonicotinamide into young rats produces a peculiar neuropathy characterized by selective swelling and disruption of the layer of Schwann cell cytoplasm lining the inner surface of the myelin sheath. This layer increases greatly in volume, compressing the axon and distending the myelin sheath. Morphometry of such swollen fibers discloses that the amount of myelin in the distended sheaths is considerably greater than would correspond to the size of the axons, even if axonal compression is accounted for. The data favor the concept that sheath growth is stimulated by non-specific distension of the myelin sheath from inside.

6-Aminonicotinamide↗

Influence of attenuation on measurements of ultrasonic myocardial integrated backscatter during cardiac cycle (an in vitro study).

The purpose of this study was to investigate the dependence of ultrasonic integrated backscatter (IB) and attenuation in myocardium on wall thickness in a state of acute ischemia. Therefore, an in vitro experiment was set up in which attenuation, IB and wall thickness of a piece of freshly excised myocardium could be measured almost simultaneously. The myocardium was taken from 11 Yorkshire pigs (25-30 kg) that were killed less than 45 min before the experiment. The myocardium was placed in the far field of an ultrasound transducer (3.2-7.2 MHz) and then compressed by a stainless steel sphere. Data were processed off-line. Backscatter and attenuation were also measured as a function of frequency at 100% and 75% wall thickness, respectively. Both attenuation and IB varied during compression. Attenuation had an initial value of 2.19 +/- 0.76 dB/cm and a slope of 0.015 +/- 0.017 dB/cm% wall thickness. IB had an initial value of -76.9 +/- 2.7 dB and a slope of -0.12 +/- 0.07 dB/% wall thickness. After subtracting the influence of the attenuation from the IB the initial value of IB was -74.0 +/- 2.7 dB and the slope -0.08 +/- 0.07 dB/% wall thickness. Attenuation appeared to have a linear dependency on frequency. Backscatter appeared not to increase with increasing frequency without correction of the spectrum for the frequency dependent insonified volume.

Animals↗