Cross-Sectional Morphology of the Femoral Neck of Wild Chimpanzees

To understand the mechanical effects of different modes of locomotion on the femoral neck of chimpanzees, we investigated the cross-sectional morphology of the femoral neck of 4 chimpanzees (Pan troglodytes schweinfurthii) collected from the Mahale Mountains, Tanzania. We performed serial computed tomography (CT) scans of the neck from the femoral head to the base of the neck perpendicular to the long axis of the neck. We measured the cortical thickness of the serial 5 cross sections of the neck region every 45° around the circumference, i.e., 8 points per section, and examined the cross-sectional properties of the mid-section. When we compared the superior and inferior parts of the cortical thickness of the femoral neck, the inferior part exhibited the greatest cortical thickness whereas the superior part had the smallest values in every specimen. Researchers have also observed such regional differences between superior and inferior cortical thicknesses in bipedal humans and other primates, although these differences are not as large in the chimpanzee as in bipedal hominini. The present study differed from the past study on hominini and chimpanzees in that the superior anterior (SA) part exhibited greater cortical thickness in chimpanzees. We believe these observations reflect the structural strengthening of parts of the chimpanzee femoral neck that is needed to accommodate the mechanical loads imposed by arboreal vertical climbing and terrestrial quadrupedal and bipedal locomotion.     

CT based conformal brachytherapy treatment planning

PURPOSE: To introduce the CT based three dimensional (3D) conformal brachytherapy treatment planning for interstitial implants, to compare the conventional X-ray film based planning with the 3D planning from the point of view of reconstruction and dosimetry, to discuss the differences and highlight the advantages. MATERIAL AND METHODS: On 10 patients with breast and 5 with head and neck tumor treated with HDR interstitial implants, following the catheter implantations, CT scans were taken at 5 mm spacing. The images were loaded into the PLATO BPS v14.0 3D planning system for brachytherapy. The contours of the target volume and critical structures were outlined on each slice, the catheter describing points were identified and the anatomical structures and catheter positions were reconstructed in 3D. Having taken into account the target volume, the active lengths were determined in each catheter, and dose optimization on dose points on target was performed. RESULTS: The 3D treatment planning was applied at interstitial breast treatments and head and neck implants. We investigated the dose distribution on axial, reconstructed coronal / sagittal planes and in 3D view with respect to anatomical structures. Dose volume histograms related to the target volume and critical structures were used for quantitative assessment of the plans. We found that the conformal dose distribution might result in increase of dose inhomogeneity within the target volume. CONCLUSIONS: The three dimensional brachytherapy treatment planning can be introduced into the clinical practice under proper technical conditions. A tradeoff between conformality and dose homogeneity results in an acceptable dose plan. The dose inhomogeneity can be decreased with the use of CT scans taken before the implantation. The guidelines and quantitative parameters describing the dose distribution, which can be used for determining the optimal dose distribution in clinical point of view, are still waiting to be established.     

Body segment mass, radius and radius of gyration proportions of children

The segment inertial parameters of children are fundamental to the analysis and simulation of their movements. Generally it has been recognized that adult parameters cannot be extrapolated and most of the anthropometric data on children are of little or no use for determining inertias. Consequently, there have been few studies of children's kinetics. In response to this problem a longitudinal investigation, the Laurentian Study of Biomechanical Development, was launched and in this paper the effects of growth on selected segmental size and inertial parameters are reported for boys between the ages of 4 and 15 yr. The twelve subjects, representing heterogeneous body types were followed over 3 yr for a total of 36 observations. Elliptical zones 2 cm wide were used to model the body and segment inertias calculated using segment densities from the literature. These inertias were the mass, moment of inertia and mass centroid location for a fourteen segment planar representation of the body. The general accuracy mean error based on body mass was 0.203% which is consistent with reports from similar studies and techniques. Plots of segment mass proportions with respect to age showed a decrease in the head proportion balanced by increases in the thigh, shank, foot and upper arm proportions in particular. The trends for each segment were consistent with the trends for linear measures reported in the anthropometry literature. Radius proportions to the mass centroid and radius of gyration proportions were also plotted and showed smaller but consistent changes with respect to age. Linear regressions were then fitted to the distributions and standard errors calculated. The magnitude and slope of the regressions were for the most part consistent with a reported cross-sectional study of Japanese children. Where data were available, predicted parameters were compared with the reported parameters for a 12 yr old analyzed using a different mathematical model. Comparisons were also made between the predicted parameters at 15 yr and the reported parameters for healthy young adults who had been scanned using a gamma-radiation technique. For most parameters there was either good agreement or differences could be explained logically. The traditionally used parameters from older cadavers were quite inconsistent with the above. The variances of the 36 observations about the regression lines as indicated by the standard errors were small. As an illustration of the effect of these variances, the trunk parameters for a 10 yr old performing a standing jump for distance were decreased by 1 S.E. and this matched by increases for the thigh, shank and head.(ABSTRACT TRUNCATED AT 400 WORDS)     

A statistical human rib cage geometry model accounting for variations by age,sex, stature and body mass index

In this study, we developed a statistical rib cage geometry model accounting for variations by age, sex, stature and body mass index (BMI). Thorax CT scans were obtained from 89 subjects approximately evenly distributed among 8 age groups and both sexes. Threshold-based CT image segmentation was performed to extract the rib geometries, and a total of 464 landmarks on the left side of each subject?s ribcage were collected to describe the size and shape of the rib cage as well as the cross-sectional geometry of each rib. Principal component analysis and multivariate regression analysis were conducted to predict rib cage geometry as a function of age, sex, stature, and BMI, all of which showed strong effects on rib cage geometry. Except for BMI, all parameters also showed significant effects on rib cross-sectional area using a linear mixed model. This statistical rib cage geometry model can serve as a geometric basis for developing a parametric human thorax finite element model for quantifying effects from different human attributes on thoracic injury risks.     

Changes in segment inertia proportions between 4 and 20 years

Growth between 4 and 20 yr produces an increase in body mass and a redistribution of that mass throughout the body. It is the purpose of this investigation to describe changes in the segment mass, radius to the mass centre and radius of gyration for a sample of males, 4-20 yr and the potential effects of these changes on joint reaction forces and moments. The data were collected annually over 9 yr in a mixed longitudinal study completed in 1985. Elliptical zones 2 cm wide were used to model the 16 segments of the body. From these and reported segment densities, mass, the coordinates of the mass centre and the principal moments of inertia were determined for the segments and the body. The parameters reported are the inertia parameters suitable for a sagittal planar analysis with the head and neck considered one segment and values given for other fused segments. The accuracy of the method was judged against the total body mass, and other accuracy estimates from the literature were examined. The parameters are presented as proportions of total mass or segment length. It is clear from the polynomial regressions that there is a substantial redistribution of the mass between segments and this is consistent with the principles of cephalo-caudal and distal-to-proximal development. The proportions for radius and radius of gyration indicate that mass redistribution within segments is comparatively small. The parameters for a 6 yr-old were compared to the parameters expected at 18, 24 and 54 yr and substantial differences noted.(ABSTRACT TRUNCATED AT 250 WORDS)     

The use of magnetic resonance imaging for measuring segment inertial properties

The purpose of the study was to determine whether valid measures of segment inertial properties can be generated from a series of cross-sectional tissue scans using magnetic resonance imaging (MRI). The cross-sectional images for eight baboon cadaver segments (four forearms, two upper arms, and two lower legs) were digitized to yield areas of muscle, bone, and fat tissues. These data, along with tissue density values, were used for calculations of segment volume (V), density (D), mass (M), center of mass location (CM), and moment of inertia (Icm) about a transverse axis through the segment center of mass. Criterion measures of these properties were obtained using standard experimental techniques. Close agreement was found between criterion and MRI values for mean segment CM (44.67 vs. 43.36% from proximal end, respectively) while mean segment D was the same (1.124 g.cm-3) for both methods. MRI procedures tended to overestimate segment V(595.3 vs. 633.4 cm3), M(720.0 vs. 769.9 g), and Icm (3.208 vs. 3.332 x 10(-3) kg.m2). It was concluded that MRI represents a promising technique for generating valid measures of segment inertial characteristics as well as other anatomical features.     

The relation between external dimensions of the human mandible and cortical bone morphology as determined with the aid of CT scans

Computerized tomographs were taken of 22 mandibles, selected from an early Arab population and aged between 17 and 60 years. A specially designed holder was used to define specific locations along the mandible, namely symphysis, mid sagittal section through the corpus, midpoint of the first molar (M1), gonion and ramus. Cortical cross sectional area and principal moments of inertia were then calculated for the locations specified, to obtain estimates of the resistance of the bone to deformation. They were analyzed in relation to age, sex, side and external dimensions of the mandible. The error of measurement calculated from (i) repeated CT scans (ii) repeated measurements (iii) from comparison of CT scans with a sectioned mandible, were of the same order of magnitude. All values were greater in males than in females; they were only slightly affected by age and were unaffected by side. Mandibular length and ramus height accounted for most of the variation observed in moments of inertia. We consider that these results can best be interpreted in accordance with the hypotheses put forward by Hylander (1975, 1985) according to which the mandible acts as a third degree lever, with “wishboning” forces acting at the symphysis and parasagittal bending at the first molar. We now plan to apply this method to study the “strength” of the mandibles of past populations with different dietary adaptations.     

The mechanical properties of cranial bone: The effect of loading rate and cranial sampling position

Linear and depressed skull fractures are frequent mechanisms of head injury and are often associated with traumatic brain injury. Accurate knowledge of the fracture of cranial bone can provide insight into the prevention of skull fracture injuries and help aid the design of energy absorbing head protection systems and safety helmets. Cranial bone is a complex material comprising of a three-layered structure: external layers consist of compact, high-density cortical bone and the central layer consists of a low-density, irregularly porous bone structure.In this study, cranial bone specimens were extracted from 8 fresh-frozen cadavers (F=4, M=4; 81±11 years old). 63 specimens were obtained from the parietal and frontal cranial bones. Prior to testing, all specimens were scanned using a μCT scanner at a resolution of 56.9 μm. The specimens were tested in a three-point bend set-up at different dynamic speeds (0.5, 1 and 2.5 m/s). The associated mechanical properties that were calculated for each specimen include the 2nd moment of inertia, the sectional elastic modulus, the maximum force at failure, the energy absorbed until failure and the maximum bending stress. Additionally, the morphological parameters of each specimen and their correlation with the resulting mechanical parameters were examined.It was found that testing speed, strain rate, cranial sampling position and intercranial variation all have a significant effect on some or all of the computed mechanical parameters. A modest correlation was also found between percent bone volume and both the elastic modulus and the maximum bending stress.     

On the non-linear dynamic response of the rhesus to impact

A non-linear discrete parameter mathematical model describing the dynamic behavior of a primate (Macaca mulatta) has been developed and programmed for solution on the IBM model 360/91 computer using the Continuous Systems Modeling Program (CSMP). The primate is described by a system of discrete anatomical segments connected by translational and rotational springs representing the inter-segment stiffnesses. For example, the neck is represented by three discrete masses, one translational and four rotational springs. The masses, mass moments of inertia, centers of gravity and the neck axial stiffness, were obtained experimentally. The predicted dynamic behavior of the rhesus monkey to blunt head inpact compares favorably with the observations taken from high-speed films of a cerebral concussion experiment. A study of the effect of the point of application and angle of inclination of the forcing function was conducted. The results show that the important response parameters display the expected sensitivity to the location of the blow but are particularly sensitive to its angle of inclination with respect to the plane containing the foramen magnum.     

Senile changes in human lymph nodes

BACKGROUND: The degenerative process of lymph nodes is poorly documented. METHODS: 161 lymph nodes of seven fresh and one embalmed human cadavers in the head and neck were studied. We used 6% hydrogen peroxide, lead oxide injectant, and radiographs to demonstrate lymphatic vessels, and found both solidified and transparent lymph nodes. They were removed, fixed in 10% formalin and sent for histopathology cross section. RESULTS: Thirty-eight solidified and 123 transparent lymph nodes were found. A series of histopathological sections show the degenerative process is variable and continuous. Senile involution affects all elements of the lymph node including the cortex, the medulla, and the architecture. CONCLUSION: This study provides actual anatomical and histopathological images of lymph nodes in different degenerative stages in the head and neck region. It may help explain some clinical conditions in the elderly, especially their diminished immunological response to infection and cancer metastasis.     

Measurement of canal occlusion during the thoracolumbar burst fracture process

Post-injury CT scans are often used following burst fracture trauma as an indication for decompressive surgery. Literature suggests, however, that there is little correlation between the observed fragment position and the level of neurological injury or recovery. Several studies have aimed to establish the processes that occur during the fracture using indirect methods such as pressure measurements and pre/post impact CT scans. The purpose of this study was to develop a direct method of measuring spinal canal occlusion during a simulated burst fracture by using a high-speed video technique. The fractures were produced by dropping a mass from a measured height onto three-vertebra bovine specimens in a custom-built rig. The specimens were constrained to deform only in the impact direction such that pure compression fractures were generated. The spinal cord was removed prior to testing and the video system set up to film the inside of the spinal canal during the impact. A second camera was used to film the outside of the specimen to observe possible buckling during impact. The video images were analysed to determine how the cross-sectional area of the spinal canal changed during the event. The images clearly showed a fragment of bone being projected from the vertebral body into the spinal canal and recoiling to the final resting position. To validate the results, CT scans were taken pre- and post-impact and the percentage canal occlusion was calculated. There was good agreement between the final canal occlusion measured from the video images and the CT scans.     

Risk of Maltreatment-Related Injury: A Cross-Sectional Study of Children under Five Years Old Admitted to Hospital with a Head or Neck Injury or Fracture

Objectives

To determine the predictive value and sensitivity of demographic features and injuries (indicators) for maltreatment-related codes in hospital discharge records of children admitted with a head or neck injury or fracture.

Methods

Study design: Population-based, cross sectional study. Setting: NHS hospitals in England. Subjects: Children under five years old admitted acutely to hospital with head or neck injury or fracture. Data source: Hospital Episodes Statistics, 1997 to 2009. Main outcome measure: Maltreatment-related injury admissions, defined by ICD10 codes, were used to calculate for each indicator (demographic feature and/or type of injury): i) the predictive value (proportion of injury admissions that were maltreatment-related); ii) sensitivity (proportion of all maltreatment-related injury admissions with the indicator).

Results

Of 260,294 childhood admissions for fracture or head or neck injury, 3.2% (8,337) were maltreatment-related. With increasing age of the child, the predictive value for maltreatment-related injury declined but sensitivity increased. Half of the maltreatment-related admissions occurred in children older than one year, and 63% occurred in children with head injuries without fractures or intracranial injury.

Conclusions

Highly predictive injuries accounted for very few maltreatment-related admissions. Protocols that focus on high-risk injuries may miss the majority of maltreated children.     

Pipette aspiration technique for the measurement of nonlinear and anisotropic mechanical properties of blood vessel walls under biaxial stretch

A pipette aspiration technique was proposed for the measurement of nonlinear mechanical properties of arteries under biaxial stretching. A cross-shaped specimen of porcine thoracic aorta whose principal axes corresponded with the axial and circumferential directions of the aortic walls was excised. The intraluminal surface of the specimen was aspirated with a circular cross-sectioned glass pipette while the specimen was stretching in the axial and circumferential directions in 10% increments. The elastic modulus agreed with the incremental elastic modulus obtained through a conventional pressure-diameter test of the same specimen to within an error of 30% at a circumferential stretch ratio below 1.3 and an axial stretch ratio of 1.0, 1.1 or 1.2, which represent lower range of physiological stretch ratios for the porcine aorta. A rectangular cross-sectioned pipette was utilized to measure anisotropic properties of the specimen under biaxial stretching. When aspirated with such a pipette, the specimens' elastic properties along the length of the rectangular pipette cross section can be neglected. The elastic modulus was found to increase rapidly when the specimen was stretched in the direction of the pipette's width. Thus, pipette aspiration should have many advantages such as well measurement of the local nonlinear and anisotropic mechanical properties of blood vessel walls.     

2D calculation method based on composite beam theory for the determination of local homogenised stiffnesses of long bones

A calculation method using the finite element technique is presented. Its main objective was to determine strains, stresses and more particularly stiffnesses in any cross section of a tibia, thus enabling the localisation of tibial torsion in vivo. Each tibial cross section was considered to be a non-uniform cross section of a composite beam with arbitrary orientation of fibres. The determination of stresses, strains and stiffnesses within a composite beam cross section has been defined by solving a variational problem. The validation of this method was performed on a tibial diaphysis of which each cross section was assumed to be the cross section of a composite beam made of orthotropic materials with orthotropic axes of any orientation with respect to the principal axis of the bone. The comparison of the results, from our model and that of a three-dimensional one, was performed on each nodal value (strains, stresses) of the meshed cross section as it was impossible to obtain local stiffnesses by experimentation. The good agreement between the results has validated our finite element program. Actually, this method has enabled to treat directly 2D geometric reconstructions from CT scan images with a good accuracy to determine locally the homogenised mechanical characteristics of human tibia in vivo, and particularly to quantify torsional tibial abnormalities of children without approximation of the shape of the cross section and by calculating the real moment of inertia J. The importance of the fibre orientation with regards to the stiffness values has been emphasised. This 2D method has also allowed to reduce CPU time of the 3D modelling and calculation.     

A new cortical thickness mapping method with application to an in vivo finite element model

Finite element modelling of musculoskeletal systems, with geometrical structures constructed from computed tomography (CT) scans, is a useful and powerful tool for biomechanical studies. The use of CT scans from living human subjects, however, is still limited. Accurate reconstruction of thin cortical bone structures from CT scans of living human subjects is especially problematic, due to low CT resolution that results from mandatory low radiation doses and/or involuntary movements of the subject. In this study, a new method for mapping cortical thickness is described. Using the method, cortical thickness measurements of a coxal (pelvis) bone obtained from CT scans of a cadaver were mapped to the coxal geometry as obtained through CT scans of a live human subject, resulting in accurate cortical thickness while maintaining geometric fidelity of the live subject. The mapping procedure includes shape-preserving parameterisation, mesh movement and interpolation of thickness using a search algorithm. The methodology is applicable to modelling of other bones where accurate cortical thickness is needed and for which such data exist.     

Anatomical atlas in the context of head and neck radiotherapy and its use to automatic segmentation

In this paper we present a methodology to form an anatomical atlas based on the analysis of dense deformation fields recovered by the Morphons non-rigid registration algorithm. The methodology is based on measuring the bending energy required to register the whole database to a reference, and the atlas is the one image in the database which yields the smallest bending energy when taken as reference. The suitability of our atlas is demonstrated in the context of head and neck radiotherapy through its application to a database with thirty-one computed tomography (CT) images of the head and neck region. In head and neck radiotherapy, CT is the most frequently used modality for the segmentation of organs at risk and clinical target volumes. One challenge brought by the use of CT images is the presence of important artifacts caused by dental implants. The presence of such artifacts hinders the use of intensity averages, thus severely limiting the application of most atlas building techniques described in the literature in this context. The results presented in the paper show that our bending energy model faithfully represents the shape variability of patients in the head and neck region; they also show its good performance in segmentation of volumes of interest in radiotherapy. Moreover, when compared to other atlases of similar performance in automatic segmentation, our atlas presents the desirable feature of not being blurred after intensity averaging.     

不同种源鹅掌楸苗木叶解剖性状的遗传多样性

以5个鹅掌楸种源的1年生苗木成熟叶片为材料,对叶表皮、叶片横切面及主脉横切面的16个解剖性状进行观察和变异性分析。结果表明:鹅掌楸叶解剖性状在种源间及种源内存在极丰富的变异,除下表皮密度在种源间差异不显著外,其余性状在种源间及种源内(包括下表皮密度)均存在极显著差异。种源间的平均表型分化系数为27.5%,说明鹅掌楸叶片结构的主要性状存在于种源内的变异(72.5%)远大于种源间的变异。鹅掌楸叶的解剖性状与地理生态因子的相关分析表明,其种源间的变异呈现梯度规律性,表皮各性状与经度、年均温呈负相关关系,叶片和主脉横切面各性状与经度、纬度大部分呈正相关关系,而与年降水量、年均温大都呈负相关关系。用种源间欧式距离进行UPGMA聚类,可将5个种源的鹅掌楸划分为3个类群。     

Occurrence of Cryptosporidium in home daycare centers in west-central Colorado

Thirty white middle-class 5 yr olds from home daycare centers were examined for Cryptosporidium. Five fecal samples were collected from each child, over a 3-wk period, concentrated by sedimentation, and stained by a modified acid-fast technique. Nine children were positive (30%), 6 of these were asymptomatic (5 of these were under 2 yr old). Two girls and 1 boy, under 2 yr old, had mild diarrhea within 3 wk prior to fecal collection.     

Medical diagnostic radiation exposures and risk of gliomas

High-dose ionizing radiation is an established risk factor for glioma, but it remains unknown whether moderate- and low-dose radiation increase glioma risk. In this analysis, we assessed the evidence that self-reported exposures to diagnostic ionizing radiation, including computerized tomography (CT) scans, is associated with increased risk of adult glioma. While no independent association was observed for CT scans alone (3+ scans compared to none P = 0.08 and 1-2 scans compared to none P = 0.68), our findings suggest an increased risk of adult gliomas with cumulative exposure to three or more CT scans to the head and neck region (OR = 1.97, 95% CI: 0.92-4.23) limited to those who reported a family history of cancer: the P value for the interaction between having three or more CT scans and family history of cancer was 0.08. The stratum-specific adjusted OR for those with family history of cancer was more than three times that for the sub-group without family history of cancer. While there is some potential for symptom-related bias, one might expect this to be present for all diagnostic procedures rather than specific to one procedure. The interaction between CT scans and glioma with family history of cancer supports the biological plausibility of our findings, because similar results have been found for breast cancer and radiation. This observational data will increase awareness about potential risks associated with CT scans and the need to minimize the use of unnecessary examinations.     

The influence of material property and morphological parameters on specimen-specific finite element models of porcine vertebral bodies

The use of finite element (FE) methods in spinal research is increasing, but there is only limited information available on the influence of different input parameters on the model predictions. The aim of this study was to investigate the role of these parameters in FE models of the vertebral body. Experimental tests were undertaken on porcine lumbar vertebral bodies and scans of the specimens were used to create specimen-specific FE models. Three models were created for each specimen with combinations of generic and specimen-specific parameters. Stiffness and strength predictions were also made directly from the specimen trabecular bone volume fraction (BVF) and cross-sectional area (CSA). The agreement between the experimental results and the FE models with generic morphology was poorer (concordance coefficients = 0.058, 0.125 for stiffness, strength) than those made from the BVF and CSA (concordance coefficients = 0.638, 0.609). The greatest levels of agreement were found with the morphologically specific models including element-specific material properties (concordance coefficients = 0.881, 0.752). This indicates that highly specific models, both in terms of morphology and bone quality, are necessary if the FE tool is to be used effectively for spinal research and clinical practice.