Experimental evaluation of local wave speed in the presence of reflected waves

Wave speed (also called pulse wave velocity) is the speed by which disturbance travels along the medium and it depends on the mechanical and geometrical properties of the vessel and on the density of the blood. Wave speed is a parameter of clinical relevance because it is an indicator of arterial stiffness and cardiovascular diseases.     

Analysis of a femoral hip prosthesis designed to reduce stress shielding

The natural stress distribution in the femur is significantly altered after total hip arthroplasty (THA). When an implant is introduced, it will carry a portion of the load, causing a reduction of stress in some regions of the remaining bone. This phenomenon is commonly known as stress shielding. In response to the changed mechanical environment the shielded bone will remodel according to Wolff's law, resulting in a loss of bone mass through the biological process called resorption. Resorption can, in turn, cause or contribute to loosening of the prosthesis. The problem is particularly common among younger THA recipients. This study explores the hypothesis that through redesign, a total hip prosthesis can be developed to substantially reduce stress shielding. First, we describe the development of a new femoral hip prosthesis designed to alleviate this problem through a new geometry and system of proximal fixation. A numerical comparison with a conventional intramedullary prosthesis as well as another proximally fixed prosthesis, recently developed by Munting and Verhelpen (1995. Journal of Biomechanics 28(8), 949–961) is presented. The results show that the new design produces a more physiological stress state in the proximal femur.     

The elastic properties of a polyurethane arterial prosthesis

The relationship between the mechanical properties of a fibrous polyurethane arterial prosthesis and the graft manufacturing process variables was studied from uniaxial tensile tests. A non-linear model was used to characterize the cylindrical elastic properties. Experiments on cylindrical segments were carried out to determine the constitutive constants and to assess the applicability of the model to the polyurethane graft. The compliance of 4 mm internal diameter grafts with various wall-thicknesses was predicted. The results were used to produce grafts with compliance matched to that of the carotid and femoral arteries.     

Determination of metallic ion transfer from an implanted prosthesis by the PIXE method

Prostheses can release some metallic elements to the surrounding tissues, particularly when they are not covered with a biomaterial layer and when an unsealing process happens. We try to measure major and trace elements in these tissues with an experimentally sensitive method. Proton-induced X-ray emission is used to detect about 10 elements in tissue. Tissues are calcinated and deposited in a thin layer before irradiation. Results are obtained in a standard and samples from three patients. We observe contamination by Ti, Cr, Ni, and Zn in the tissues. Correlations are to be studied between these atomic transfers and prosthesis in the patient.     

Feasibility of using combined EMG and kinematic signals for prosthesis control: A simulation study using a virtual reality environment

Transhumeral amputation has a significant effect on a person’s independence and quality of life. Myoelectric prostheses have the potential to restore upper limb function, however their use is currently limited due to lack of intuitive and natural control of multiple degrees of freedom. The goal of this study was to evaluate a novel transhumeral prosthesis controller that uses a combination of kinematic and electromyographic (EMG) signals recorded from the person’s proximal humerus. Specifically, we trained a time-delayed artificial neural network to predict elbow flexion/extension and forearm pronation/supination from six proximal EMG signals, and humeral angular velocity and linear acceleration. We evaluated this scheme with ten able-bodied subjects offline, as well as in a target-reaching task presented in an immersive virtual reality environment. The offline training had a target of 4° for flexion/extension and 8° for pronation/supination, which it easily exceeded (2.7° and 5.5° respectively). During online testing, all subjects completed the target-reaching task with path efficiency of 78% and minimal overshoot (1.5%). Thus, combining kinematic and muscle activity signals from the proximal humerus can provide adequate prosthesis control, and testing in a virtual reality environment can provide meaningful data on controller performance.     

Wave intensity amplification and attenuation in non-linear flow: Implications for the calculation of local reflection coefficients

Local reflection coefficients (R) provide important insights into the influence of wave reflection on vascular haemodynamics. Using the relatively new time-domain method of wave intensity analysis, R has been calculated as the ratio of the peak intensities (R_PI) or areas (R_CI) of incident and reflected waves, or as the ratio of the changes in pressure caused by these waves (R_ΔP). While these methods have not yet been compared, it is likely that elastic non-linearities present in large arteries will lead to changes in the size of waves as they propagate and thus errors in the calculation of R_PI and R_CI. To test this proposition, R_PI, R_CI and R_ΔP were calculated in a non-linear computer model of a single vessel with various degrees of elastic non-linearity, determined by wave speed and pulse amplitude (ΔP₊), and a terminal admittance to produce reflections. Results obtained from this model demonstrated that under linear flow conditions (i.e. as ΔP₊→0), R_ΔP is equivalent to the square-root of R_PI and R_CI (denoted by R_PI^p and R_CI^p). However for non-linear flow, pressure-increasing (compression) waves undergo amplification while pressure-reducing (expansion) waves undergo attenuation as they propagate. Consequently, significant errors related to the degree of elastic non-linearity arise in R_PI and R_CI, and also R_PI^p and R_CI^p, with greater errors associated with larger reflections. Conversely, R_ΔP is unaffected by the degree of non-linearity and is thus more accurate than R_PI and R_CI.     

Soliton-Like Regimes and Excitation Pulse Reflection (Echo) in Homogeneous Cardiac Purkinje Fibers: Results of Numerical Simulations

On the basis of numerical simulations of the partial McAllister-Noble-Tsien equations quantitatively describing the dynamics of electrical processes in conductive cardiac Purkinje fibers we reveal unusual – soliton-like – regimes of interaction of nonlinear excitation pulses governing the heart contraction rhythm: reflection of colliding pulses instead of their annihilation. The phenomenological mechanism of the reflection effects is that in a narrow (but finite) range of the system parameters the traveling pulse presents a doublet consisting of a high-amplitude leader followed by a low-amplitude subthreshold wave. Upon collisions of pulses the leaders are annihilated, but subthreshold waves summarize becoming superthreshold and initiating two novel echo-pulses traveling in opposite directions. The phenomenon revealed presents an analogy to the effect of reflection of colliding nerve pulses, predicted recently, and can be of use in getting insight into the mechanisms of heart rhythm disturbances.     

Origins of blood volume change due to glutamatergic synaptic activity at astrocytes abutting on arteriolar smooth muscle cells

The cellular mechanisms that couple activity of glutamatergic synapses with changes in blood flow, measured by a variety of techniques including the BOLD signal, have not previously been modelled. Here we provide such a model, that successfully accounts for the main observed changes in blood flow in both visual cortex and somatosensory cortex following their stimulation by high-contrast drifting grating or by single whisker stimulation, respectively. Coupling from glutamatergic synapses to smooth muscle cells of arterioles is effected by astrocytes releasing epoxyeicosatrienoic acids (EETs) onto them, following glutamate stimulation of the astrocyte. Coupling of EETs to the smooth muscle of arterioles is by means of potassium channels in their membranes, leading to hyperpolarization, relaxation and hence an increase in blood flow. This model predicts a linear increase in blood flow with increasing numbers of activated astrocytes, but a non-linear increase with increasing glutamate release.     

The impact of network clustering and assortativity on epidemic behaviour

Epidemic models have successfully included many aspects of the complex contact structure apparent in real-world populations. However, it is difficult to accommodate variations in the number of contacts, clustering coefficient and assortativity. Investigations of the relationship between these properties and epidemic behaviour have led to inconsistent conclusions and have not accounted for their interrelationship. In this study, simulation is used to estimate the impact of social network structure on the probability of an SIR (susceptible-infective-removed) epidemic occurring and, if it does, the final size. Increases in assortativity and clustering coefficient are associated with smaller epidemics and the impact is cumulative. Derived values of the basic reproduction ratio (R₀) over networks with the highest property values are more than 20% lower than those derived from simulations with zero values of these network properties.     

The design and preparation of a flexible bio-chip for use as a visual prosthesis, and evaluation of its biological features

We aimed to design and manufacture a novel low-cost polyimide microelectrode array (MEA) chip for visual prosthesis research and to evaluate its biological features. A microelectrode array was developed, based on Flexible Printed Circuit Board (FPC) technology which enables electrical stimulation of the cortex. In an in vitro experiment, rat visual cortex cells were co-cultured with the chip and examined using scanning electron microscopy. Trypan blue exclusion and methyl blue tetrazolium tests showed that cell viability and survival rates (90–98%) did not significantly differ between the co-cultured chip group and the control group. In an in vivo experiment HE/Nissl staining performed to investigate the possibility of brain tissue degeneration around implanted MEAs showed no negative effects of the chip on visual cortical cells after 1 month in situ. The good functional characteristics and biocomptability suggest that such a low-cost device could have widespread application, particularly in countries with a large blind population and limited financial resources     

The design of a model for a three dimensional stress analysis of the cement layer beneath the medial plateau of a knee prosthesis

Factors which have influenced the design of a large scale model for an analysis of the strain in three dimensions of the cement layer beneath the medial plateau of a knee prosthesis are discussed. Materials were selected to model the medial tibial plateau, underlying cement and bone for a typical prosthesis and a two dimensional finite element analysis was used to indicate where the strain gauges should be embedded in the model.     

Modeling of intraorgan arterial vasculature. II. Propagation of pressure waves

The dependence of the wave conductance in self-similar dichotomous models of intraorgan arterial vasculatures on the model parameters was studied. It was found that, with different sets of parameters, it is possible to simulate the suction effect induced by negative reflections of waves from arterial branchings and to model the resonance properties of arterial beds. It was shown that the choice of an adequate model for a given intraorgan arterial vasculature should be based on agreement between the biophysical characteristics of the model and the bed that characterize the propagation and reflection of pulse waves.     

The subscapular arterial tree as a source of microvascular arterial grafts

The subscapular arterial tree may be used as a source of microvascular grafts to replace damaged or diseased portions of arteries, particularly in the hand and forearm. By studying cadaver dissections, it is possible to estimate the number of branches that may be found at different arterial segment lengths from the origin of the subscapular artery. Fifty-five preserved cadaver subscapular arterial trees were dissected, and the branching patterns were documented. Three major arterial branching patterns of the subscapular artery were observed with one, two, and three major branches to the serratus anterior in 60 percent, 29 percent, and 9 percent of the cases, respectively. The authors determined the number of 1-mm-diameter, 1-cm-long branches arising from each of six 3-cm regions of the arterial tree measured from the origin of the subscapular artery to the end of the longest terminal branch. The probability of finding at least one usable terminal branch that is at least 12.0 cm in length was found to be 98 percent. Typically, there are two to five useful branches at this distance. Such information may help surgeons fine tune their process of selecting an appropriate arterial donor site for a particular arterial defect and supports the use of the subscapular arterial tree as a donor site for microvascular arterial grafts.     

Structure-based design of aliskiren,a novel orally effective renin inhibitor

Hypertension is a major risk factor for cardiovascular diseases such as stroke, myocardial infarction, and heart failure, the leading causes of death in the Western world. Inhibitors of the renin-angiotensin system (RAS) have proven to be successful treatments for hypertension. As renin specifically catalyses the rate-limiting step of the RAS, it represents the optimal target for RAS inhibition. Several peptide-like renin inhibitors have been synthesized previously, but poor pharmacokinetic properties meant that these compounds were not clinically useful. We employed a combination of molecular modelling and crystallographic structure analysis to design renin inhibitors lacking the extended peptide-like backbone of earlier inhibitors, for improved pharmacokinetic properties. This led to the discovery of aliskiren, a highly potent and selective inhibitor of human renin in vitro, and in vivo; once-daily oral doses of aliskiren inhibit renin and lower blood pressure in sodium-depleted marmosets and hypertensive human patients. Aliskiren represents the first in a novel class of renin inhibitors with the potential for treatment of hypertension and related cardiovascular diseases.     

The prostacyclin analogue beraprost sodium prevents development of arterial stiffness in elderly patients with cerebral infarction

Prostacyclin (PGI(2)) inhibits platelet aggregation, smooth muscle cell proliferation, and vasoconstriction. Arterial stiffness assessed by pulse wave velocity (PWV) predicts mortality in various cardiovascular diseases. To study the preventive effects of a prostacyclin analogue, beraprost sodium, on arterial PWV values in elderly patients with cerebral infarction. Forty-four patients with a history of cerebral infarction received beraprost sodium (120 microg/day p.o.) or no beraprost sodium (control) for 3 months. Arterial PWV and ankle brachial indices (ABI) were determined prior to starting the medication and after 3 months of medication. Initially, there were no differences in age, blood pressure, and body mass index. Further, PWV or ABI did not differ between the beraprost sodium group (n = 22) and the control group (n = 22). After 3 months, PWV in beraprost sodium group was significantly reduced (-123 +/- 282) when compared with the control group (147 +/- 274)(P = 0.006). ABI was not significantly different when comparing the two groups at 3 months. Long-term administration of beraprost sodium prevents the decline in arterial biomechanics in elderly patients with cerebral infarction.     

Propagation of fast and slow intercellular Ca(2+) waves in primary cultured arterial smooth muscle cells

Smooth muscle contraction is regulated by changes in cytosolic Ca²⁺ concentration ([Ca²⁺]_i). In response to stimulation, Ca²⁺ increase in a single cell can propagate to neighbouring cells through gap junctions, as intercellular Ca²⁺ waves. To investigate the mechanisms underlying Ca²⁺ wave propagation between smooth muscle cells, we used primary cultured rat mesenteric smooth muscle cells (pSMCs). Cells were aligned with the microcontact printing technique and a single pSMC was locally stimulated by mechanical stimulation or by microejection of KCl. Mechanical stimulation evoked two distinct Ca²⁺ waves: (1) a fast wave (2 mm/s) that propagated to all neighbouring cells, and (2) a slow wave (20 μm/s) that was spatially limited in propagation. KCl induced only fast Ca²⁺ waves of the same velocity as the mechanically induced fast waves. Inhibition of gap junctions, voltage-operated calcium channels, inositol 1,4,5-trisphosphate (IP₃) and ryanodine receptors, shows that the fast wave was due to gap junction mediated membrane depolarization and subsequent Ca²⁺ influx through voltage-operated Ca²⁺ channels, whereas, the slow wave was due to Ca²⁺ release primarily through IP₃ receptors. Altogether, these results indicate that temporally and spatially distinct mechanisms allow intercellular communication between SMCs. In intact arteries this may allow fine tuning of vessel tone.     

腹部手术前后血气分析及肠道菌群变化

目的:探讨围手术期腹部外科病人血气和酸碱平衡、肠道菌群变化及临床意义.方法:随机检测100例腹部外科择期手术患者术前和术后血气分析.同时对术后发生腹泻的13例患者行粪便菌群分析.结果:手术后低血氧27例,而胃癌根治、直肠癌根治、肝叶切除等大手术者均有不同程度酸碱失衡,且发生酸碱失衡者中9例合并菌群失调.结论:具有高危因素的腹部手术患者,术前及术后检测血气,监测肺功能及酸碱平衡,并积极诊治肠道菌群失调.     

GF昆明小鼠主要重量系数及血液生理指标的测定

目的测定无菌KM小鼠体重、体长、尾长、脏器系数、血常规值。方法选取8只全雄无菌KM小鼠,8只SPF级测量体重、体长、尾长;检测红细胞总数(RBC),血红蛋白(HGB),红细胞压积(HCT),平均红细胞体积(MCV),血小板总数(PLT),白细胞总数(WBC),白细胞分类(DLC),平均血红蛋白含量(MCH),平均血红蛋白浓度(MCHC)等血液生理指标;解剖采集小鼠心脏、肝脏、脾脏、肺、肾、睾丸、盲肠,称重,计算脏器系数(脏器系数=脏器湿重/体重×100)。结果体长、尾长、心脏、脾脏、肺、肾脏、脑、睾丸、及血液生理指标等项目差异无统计学意义(P>0.05),体重、肝脏、盲肠项目差异有统计学意义(P<0.05)。结论所测数值为研究者提供基础数据,建立国内无菌KM小鼠背景资料。     

Effect of nitrendipine on cardiac and renal lesions and arterial hypertrophy

A low dose of nitrendipine (1 mg/kg twice daily) ameliorated the percent incidence and severity of vascular lesions in the kidney and heart induced by deoxycorticosterone (DOC). Less protection was offered by administration of 1 mg/kg of the calcium antagonist once daily. A lower dose of the antagonist (0.5 mg/kg) administered twice daily produced almost no protection against myocardial scars, but the percent incidence and severity of renal tubular casts and glomerular changes were similar to those following injection of 1 mg/kg of the antagonist twice daily. DOC induced hypertrophy of the media in aorta, coronary artery and renal interlobular artery and renal arteriole. Neither 1 mg/kg once or twice daily nor 0.5 mg twice daily of calcium antagonist modified the hypertrophy of the arterial vasculature in the hypertensive DOC group. We conclude that a low dose of the calcium antagonist dissociates at least in part lesions but not hypertrophy from the increased systolic blood pressure, because the antagonist protects against vascular lesions induced by the hypertension. The antagonist likely acts on the endothelial cell of the vessels alone or combined with an effect on the vascular smooth muscle cells.