Axial vs. angular dynamization of anterior cervical fusion implants

Aim of our study was to compare anterior cervical fusion with fusion augmented with dynamic implants and with the first generation-plate. Methods. Patients with radiculopathy and/or myelopathy were included in a prospective cohort study. Clinical outcome was assessed according to the Nurick, Odom, and SF 36 scales. Rotation and translation of screws, and quality of fusion (Tribus) were assessed at the 6-week and 4-year follow-up examinations. Neurodecompression was performed in 81 patients (one-level N = 45, two-level N = 26 and multi-level N = 10) in the period from January 2001 to September 2003. 50 male and 31 female patients were divided into three groups, depending upon type of fusion: 1. Augmented with dynamic implants (N = 33), 2. Augmented with H-plate (N = 33), and 3. Non-augmented (N = 15), one-level. There were no significant differences in clinical outcomes between the groups. Dynamization was detected in both augmented groups: axial in the dynamic implant group (mean translation +/- SD = 2.67 +/- 0.79 mm), and angular in the H-plate group (angle of rotation 7.2 degrees +/- 3.04 degrees). Six-week fusion was significantly better in the dynamic implants and non-augmented groups, as compared with the H-plate group. Two patients in the H-plate group developed pseudoarthrosis, 7 patients in the dynamic implant group had supradjacent segment heterotopic ossification and two of these additional ankylosis. Three patients in the non-augmented group had dislodgement of the bone graft with transient dysphagia in one of them. Our results suggest that selection of implants is not crucial for clinical outcome. Subsidence is allowed with both fixation systems. Fusion is faster and more effective in the axially dynamized group.     

A new acceleration apparatus for the study of whiplash with human cadaveric cervical spine specimens

The biomechanics of whiplash is often studied using cadaveric cervical spine specimens. One of the most important points in this kind of study is to create realistic loading conditions. The aim of the present project therefore was to develop an acceleration apparatus, which allows the study of whiplash with human cadaveric cervical spine specimens under as realistic loading conditions as possible. The new acceleration apparatus mainly consisted of a sled, a pneumatic acceleration unit and a railtrack and offered several unique features to create more realistic loading conditions. Among these features, the possibility to simulate the passive movements of the trunk is of capital importance. In this new apparatus, first, the general feasibility of whiplash experiments was studied, second, the reproducibility of the impacts was quantified and third, the effect of simulated movements of the trunk on accelerations and loads was examined. In the new acceleration apparatus various types of collisions could reproducibly be simulated. Simulated passive movements of the trunk strongly influenced the loading pattern of the neck. Without pivoting a steep increase of all loading parameters could be observed. This increase was less pronounced if pivoting was allowed. In conclusion, biomechanical aspects of whiplash could reproducibly be examined in the new acceleration apparatus. Due to its significant effects on the loading of the neck, pivoting of the trunk should always be taken into account in future experiments on the biomechanics of whiplash in which isolated cervical spine specimens are used.     

Membrane fusion in the rod outer segment disk membrane

The rod outer segment disk membrane of bovine retina has been isolated in a predominantly fused state. The physical and chemical properties of the membrane in the fused state are profoundly different from the corresponding properties of the same membrane in the unfused state. Exposure to light induces the transition of the disk membrane from the fused to the unfused state. Evidence is presented which suggests that the fusion-defusion cycle of the disk membrane is a primary event of photoexcitation and nerve stimulation.     

Comparison of electrophysiological models for human ventricular cells and tissues

In this paper we briefly review currently published models for human ventricular cells and tissues. We discuss the Priebe–Beuckelmann (PB) model and the reduced version of this model constructed by Bernus et al. (redPB), the Ten Tusscher–Noble–Noble–Panfilov (TNNP) model and the Iyer–Mazhari–Winslow (IMW) model. We compare several characteristics of these models such as: sources of experimental data the models are based on, action potential morphology, action potential duration (APD) and conduction velocity (CV) restitution and computational efficiency. Finally, we discuss the application of a subset of these models—the redPB and the TNNP model—to study simulated spiral wave dynamics in 2D tissue sheets and in the human ventricles. We discuss the suitability of the different models for particular research questions and their limitations.     

Comparison of linear and nonlinear models for human population dynamics

In standard demographic practice, population projections are commonly based on one-sex linear models of the Lotka-Leslie type. We demonstrate here that such projections based solely on time-invariant, age-specific male fertilities and mortalities are incompatible with those based solely on female fertilities and mortalities. This incompatibility obtains even in the singular case where effective male and female fertility functions are equal, and generate equal ultimate rates of growth. In standard demographic practice, the incompatibility is initially masked, since one-sex fertility functions are generally calculated from the same initial-time data and thereby tautologically forced to initially concur; however, with the passage of any finite time, the incompatibility reasserts itself—the only exception being the uninteresting case where the system is already in the stationary age and sex distribution of balanced exponential growth.An example is adduced of a nonlinear (age-free) system whose true rate of ultimate growth is correctly bracketed by the male and female one-sex rates of ultimate growth. Analysis of more general two-sex models shows that the two one-sex growth rates, calculated for arbitrary male and female initial age distributions, need not bracket the true rate. We show, however, that models exist such that with appropriate choices of initial conditions, this bracketing will occur.     

Cryopreservation of human cadaveric bone marrow cells

The viability of cryopreserved human cadaveric bone marrow cells was studied using methylcellulose clonal cell culture assays. This is the first study done to reveal the persistence of hemopoietic proliferative and differentiative functions using the methylcellulose clonal cell assay in cryopreserved human cadaveric bone marrow cells which are several hours postmortem. Studies of cryopreserved human cadaveric bone marrows corresponded with those of murine bone marrows. These results strongly suggest that several hours postmortem human cadaveric bone marrow cells can be cryopreserved and may be useful for transplantation.     

Biomechanical measurements of torsion-tension coupling in human cadaveric femurs

The mechanical behavior of human femurs has been described in the literature with regard to torsion and tension but only as independent measurements. However, in this study, human femurs were subjected to torsion to determine if a simultaneous axial tensile load was generated. Fresh frozen human femurs (n=25) were harvested and stripped of soft tissue. Each femur was mounted rigidly in a specially designed test jig and remained at a fixed axial length during all experiments. Femurs were subjected to external and internal rotation applied at a constant angulation rate of 0.1 deg/s to a maximum torque of 12?N?m. Applied torque and generated axial tension were monitored simultaneously. Outcome measurements were extracted from torsion-versus-tension graphs. There was a strong relationship between applied torsion and the resulting tension for external rotation tests (torsion/tension ratio=551.7±283.8?mm, R(2)=0.83±0.20, n=25), internal rotation tests (torsion/tension ratio=495.3±233.1?mm, R(2)=0.87±0.17, n=24), left femurs (torsion/tension ratio=542.2±262.4?mm, R(2)=0.88±0.13, n=24), and right femurs (torsion/tension ratio=506.7±260.0?mm, R(2)=0.82±0.22, n=25). No statistically significant differences were found for external versus internal rotation groups or for left versus right femurs when comparing torsion/tension ratios (p=0.85) or R(2) values (p=0.54). A strongly coupled linear relationship between torsion and tension for human femurs was exhibited. This suggests an interplay between these two factors during activities of daily living and injury processes.     

Biomechanical analysis of the anterior cervical fusion

This paper presents a biomechanical analysis of the cervical C5-C6 functional spine unit before and after the anterior cervical discectomy and fusion. The aim of this work is to study the influence of the medical procedure and its instrumentation on range of motion and stress distribution. First, a three-dimensional finite element model of the lower cervical spine is obtained from computed tomography images using a pipeline of image processing, geometric modelling and mesh generation software. Then, a finite element study of parameters' influence on motion and a stress analysis at physiological and different post-operative scenarios were made for the basic movements of the cervical spine. It was confirmed that the results were very sensitive to intervertebral disc properties. The insertion of an anterior cervical plate influenced the stress distribution at the vertebral level as well as in the bone graft. Additionally, stress values in the graft decreased when it is used together with a cage.     

Biomechanical analysis of the anterior cervical fusion

This paper presents a biomechanical analysis of the cervical C5–C6 functional spine unit before and after the anterior cervical discectomy and fusion. The aim of this work is to study the influence of the medical procedure and its instrumentation on range of motion and stress distribution. First, a three-dimensional finite element model of the lower cervical spine is obtained from computed tomography images using a pipeline of image processing, geometric modelling and mesh generation software. Then, a finite element study of parameters' influence on motion and a stress analysis at physiological and different post-operative scenarios were made for the basic movements of the cervical spine. It was confirmed that the results were very sensitive to intervertebral disc properties. The insertion of an anterior cervical plate influenced the stress distribution at the vertebral level as well as in the bone graft. Additionally, stress values in the graft decreased when it is used together with a cage.     

Contact pressure in the facet joint during sagittal bending of the cadaveric cervical spine

The facet joint contributes to the normal biomechanical function of the spine by transmitting loads and limiting motions via articular contact. However, little is known about the contact pressure response for this joint. Such information can provide a quantitative measure of the facet joint's local environment. The objective of this study was to measure facet pressure during physiologic bending in the cervical spine, using a joint capsule-sparing technique. Flexion and extension bending moments were applied to six human cadaveric cervical spines. Global motions (C2-T1) were defined using infra-red cameras to track markers on each vertebra. Contact pressure in the C5-C6 facet was also measured using a tip-mounted pressure transducer inserted into the joint space through a hole in the postero-inferior region of the C5 lateral mass. Facet contact pressure increased by 67.6 ± 26.9 kPa under a 2.4 Nm extension moment and decreased by 10.3 ± 9.7 kPa under a 2.7 Nm flexion moment. The mean rotation of the overall cervical specimen motion segments was 9.6 ± 0.8° and was 1.6 ± 0.7° for the C5-C6 joint, respectively, for extension. The change in pressure during extension was linearly related to both the change in moment (51.4 ± 42.6 kPa/Nm) and the change in C5-C6 angle (18.0 ± 108.9 kPa/deg). Contact pressure in the inferior region of the cervical facet joint increases during extension as the articular surfaces come in contact, and decreases in flexion as the joint opens, similar to reports in the lumbar spine despite the difference in facet orientation in those spinal regions. Joint contact pressure is linearly related to both sagittal moment and spinal rotation. Cartilage degeneration and the presence of meniscoids may account for the variation in the pressure profiles measured during physiologic sagittal bending. This study shows that cervical facet contact pressure can be directly measured with minimal disruption to the joint and is the first to provide local pressure values for the cervical joint in a cadaveric model.     

Comparison of selenium treatments of crops in the field

Field experiments with spring and winter barley and ryegrass were carried out to compare the effect of fertilizers enriched with selenate or selenite with foliar application on the selenium (Se) concentrations in the crops. Application of about 20 g Se/ha given as selenate or about 100 g as selenite in a PK fertilizer and about 5 g Se/ha sprayed on the plants increased the Se-concentrations from insufficient levels to levels that met the animal nutritional requirement. Ryegrass obtained sufficient Se concentrations at lower levels of added Se than did the barley. Toxic concentrations did not occur. The choice of method thus depends on the farming practice in the individual cases.     

Comparison of verapamil and nifedipine in thrombosis models

Calcium blockers and calmodulin antagonists have been reported to inhibit the aggregation of blood platelets in vitro. In the present study, the effects of two calcium blockers, verapamil and nifedipine, were compared in several rodent thrombosis models. In rat and mouse platelet-rich plasma, preincubation with either verapamil or nifedipine had a dose-dependent inhibitory effect on collagen-induced aggregation (P less than 0.01). The concentration required for 50% inhibition of rat platelet aggregation was 0.91 X 10(-4) M for verapamil and 1.77 X 10(-4) M for nifedipine. In in vivo thrombosis models in mice, acute pretreatment with nifedipine had a significant, dose-dependent protective effect (P less than 0.05). At a dose of 500 micrograms/kg, nifedipine inhibited thrombotic sudden death provoked by arachidonic acid, a thromboxane agonist (U46619), or a combination of collagen and epinephrine. In vivo platelet depletion induced by U46619 was also inhibited by this calcium blocker. Thus, nifedipine is protective against a variety of thrombotic stimuli, and its antiplatelet aggregatory effect apparently extends to the in vivo situation. In contrast, no in vivo antithrombotic activity was observed for verapamil. Two additional calcium blockers, perhexilene and diltiazem, and three calmodulin antagonists, W-7, chlorpromazine, and trifluoperazine, were also tested in the U46619-induced thrombotic sudden death model. Of these, only diltiazem (5 and 10 mg/kg) had an acute protective effect.     

Handling modular hip implants in model-based RSA: combined stem-head models

Migration measurements of hip prostheses using marker-based Roentgen stereophotogrammetric analysis (RSA) require the attachment of markers to the prostheses. The model-based approach, which does not require these markers, is, however, less precise. One of the reasons may be the fact that the spherical head has not been modelled. Therefore, we added a 3D surface model of the spherical head and estimated the position and orientation of the combined stem-head model. The new method using a combined stem-head model was compared in a phantom study on five prostheses (of different types) and in a clinical study using double examinations of implanted hip prostheses, with two existing methods: a standard model-based approach and one using elementary geometrical shapes. The combined model showed the highest precision for the rotation about the longitudinal axis in the phantom experiments. With a standard deviation of 0.69 degrees it showed a significant improvement (p=0.02) over the model-based approach (0.96 degrees ) on the phantom data, but no improvement on the clinical data. Overall, the use of elementary geometrical shapes was worse with respect to the model-based approach, with a standard deviation of 1.02 degrees on the phantom data and 0.79 degrees on the clinical data. This decrease in precision was significant (p<0.01) on the clinical data. With relatively small differences in the other migration directions, these results demonstrate that the new method with a combined stem-head model can be a useful alternative to the standard model-based approach.