Free-flap coverage of the exposed Achilles tendon

Posterior skin loss of the distal lower leg enhances the risk of exposure of the Achilles tendon. Most commonly, these wounds are a sequela to peripheral vascular insufficiency or else posttraumatic in origin. As a consequence, local flaps or skin grafts frequently are inadequate options for achieving coverage. Free-tissue transfers have proven to be a reasonable alternative in these situations for preservation of tendon function or even limb salvage. In this series of 12 patients, small defects were best covered with fasciocutaneous flaps, whereas the larger and usually chronic, concomitantly suppurating wounds required muscle flaps. Eighty-three percent (10 of 12) of patients remained ambulatory with healed wounds, obviating the need for extremity amputation.     

Nonlinear model for viscoelastic behavior of Achilles tendon

Although the mechanical properties of ligament and tendon are well documented in research literature, very few unified mechanical formulations can describe a wide range of different loadings. The aim of this study was to propose a new model, which can describe tendon responses to various solicitations such as cycles of loading, unloading, and reloading or successive relaxations at different strain levels. In this work, experiments with cycles of loading and reloading at increasing strain level and sequences of relaxation were performed on white New Zealand rabbit Achilles tendons. We presented a local formulation of thermodynamic evolution outside equilibrium at a representative element volume scale to describe the tendon's macroscopic behavior based on the notion of relaxed stress. It was shown that the model corresponds quite well to the experimental data. This work concludes with the complexity of tendons' mechanical properties due to various microphysical mechanisms of deformation involved in loading such as the recruitment of collagen fibers, the rearrangement of the microstructure (i.e., collagens type I and III, proteoglycans, and water), and the evolution of relaxed stress linked to these mechanisms.     

Measuring Achilles tendon mechanical properties: a reliable, noninvasive method

The purpose of this technical report is to describe a cost-effective and highly reliable methodology to measure mechanical and material properties of the Achilles tendon. Subjects are positioned on an isokinetic dynamometer time synchronized to a diagnostic ultrasound device. A tendon fascicle distal to the soleus is visualized during a ramped isometric maximal plantarflexion contraction. Excursion of the fascicle and tendon torque output yield a force-elongation curve in which mechanical characteristics and material properties are derived. Excellent intrasession and intersession reliabilities were observed for both the dynamometer (intraclass correlation coefficient [ICC] 0.99, 0.95) and excursion (ICC 0.99, 0.93) measures. Practical applications for this methodology include examination of training regimes for optimal tendon adaptation and rehabilitation in the presence of tendinopathy.     

An improved method for the extraction of prostaglandins

Present methods of extracting prostagalndins (PGs) give poor recoveries from synovial fluid, probably because the PGs bind to protein and are lost in the precipitation stage of extraction. Addition of the nonpolar detergent sodium lauryl sulphate prior to extraction improves recovery of PGs. It is suggested that sodium lauryl sulphate competes with PGs for the binding sites.     

An improved method for the assay of hydroxylysine

An improved method for specific detection of hydroxylysine is presented. The procedure is based on the capability of 0.0015 m periodic acid and periodates to oxidize hydroxylysine without interference of proline. Glycosylated hydroxylysine can be detected in collagen by oxidation of unglycosylated residues before hydrolysis.     

An improved method for the synthesis of flavanones

An isomerization of 2'-hydroxychalcones into the corresponding flavanones in ethanol in the presence of triethylamine is described.     

An improved method for butyrylcholinesterase phenotyping

An improved method for the identification of butyrylcholinesterase phenotypes is proposed. It is based on modifications of a method that uses -naphthyl acetate as substrate anddl-propranolol and Ro2-0683 as inhibitors. The proposed modifications make the method more rapid and increase the accuracy of the determinations of the phenotypes tested (BCHE U, BCHE UF, BCHE UA, BCHE AK, BCHE AF, and BCHE A). These modifications make the method even more adequate for population studies and clinical routine.We are grateful to the CNPq for research grants and scholarships.A preliminary report was presented at the Third International Meeting on Cholinesterases, France, May 12–16, 1990.     

An improved method for chemical alpha-oxidation

A nonisotopic assay for acetylserotonin methyltransferase (ASMT) was devised. Melatonin, the product of the enzyme reaction, is measured fluorometrically after its reaction with o-phthaldialdehyde (OPT). The reaction of melatonin with OPT is carried out in 1 n HCl to suppress the reaction of N-acetylserotonin, the substrate of ASMT, with OPT. The mixture is gassed with nitrogen just before incubation at 60°C for 60 min in order to secure the linear relationship between the concentration of melatonin and the fluorescence intensity. This method is much simpler than the isotopic assay and also has as much high sensitivity. Moreover, in this assay the enzyme can be well saturated with S-adenosylmethionine, whereas in the isotopic assay it cannot.     

Dynamic creep and pre-conditioning of the Achilles tendon in-vivo

Warm-up exercises are often advocated prior to strenuous exercise, but the warm-up duration and effect on muscle–tendon behavior are not well defined. The gastrocnemius–Achilles tendon complexes of 18 subjects were studied to quantify the dynamic creep response of the Achilles tendon in-vivo and the warm-up dose required for the Achilles tendon to achieve steady-state behavior. A custom testing chamber was used to determine each subject's maximum voluntary contraction (MVC) during an isometric ankle plantar flexion effort. The subject's right knee and ankle were immobilized for one hour. Subjects then performed over seven minutes of cyclic isometric ankle plantar flexion efforts equal to 25–35% of their MVC at a frequency of 0.75 Hz. Ankle plantar flexion effort and images from dual ultrasound probes located over the gastrocnemius muscle–Achilles tendon and the calcaneus–Achilles tendon junction were acquired for eight seconds at the start of each sequential minute of the activity. Ultrasound images were analyzed to quantify the average relative Achilles tendon strain at 25% MVC force (ε_25%MVC) for each minute. The ε_25%MVC increased from 0.3% at the start of activity to 3.3% after seven minutes, giving a total dynamic creep of ~3.0%. The ε_25%MVC increased by more than 0.56% per minute for the first five minutes and increased by less than 0.13% per minute thereafter. Therefore, following a period of inactivity, a low intensity warm-up lasting at least six minutes or producing 270 loading cycles is required for an Achilles tendon to reach a relatively steady-state behavior.     

A numerical framework for mechano-regulated tendon healing—Simulation of early regeneration of the Achilles tendon

Mechano-regulation during tendon healing, i.e. the relationship between mechanical stimuli and cellular response, has received more attention recently. However, the basic mechanobiological mechanisms governing tendon healing after a rupture are still not well-understood. Literature has reported spatial and temporal variations in the healing of ruptured tendon tissue. In this study, we explored a computational modeling approach to describe tendon healing. In particular, a novel 3D mechano-regulatory framework was developed to investigate spatio-temporal evolution of collagen content and orientation, and temporal evolution of tendon stiffness during early tendon healing. Based on an extensive literature search, two possible relationships were proposed to connect levels of mechanical stimuli to collagen production. Since literature remains unclear on strain-dependent collagen production at high levels of strain, the two investigated production laws explored the presence or absence of collagen production upon non-physiologically high levels of strain (>15%). Implementation in a finite element framework, pointed to large spatial variations in strain magnitudes within the callus tissue, which resulted in predictions of distinct spatial distributions of collagen over time. The simulations showed that the magnitude of strain was highest in the tendon core along the central axis, and decreased towards the outer periphery. Consequently, decreased levels of collagen production for high levels of tensile strain were shown to accurately predict the experimentally observed delayed collagen production in the tendon core. In addition, our healing framework predicted evolution of collagen orientation towards alignment with the tendon axis and the overall predicted tendon stiffness agreed well with experimental data. In this study, we explored the capability of a numerical model to describe spatial and temporal variations in tendon healing and we identified that understanding mechano-regulated collagen production can play a key role in explaining heterogeneities observed during tendon healing.     

An improved method for the single-step purification of streptavidin

A new method for the preparation of a more efficient, stable iminobiotin-containing resin for the isolation of streptavidin was developed. CL-Sepharose was activated with p-nitrophenyl chloroformate, and the resultant carbonate derivative was reacted with diaminohexane. Subsequent reaction of the amino-containing resin with iminobiotin-N-hydroxysuccinimide ester (in an organic solvent) yielded the stable affinity resin. The capacity of this resin for either avidin or streptavidin was 12 mg per ml resin, and streptavidin could be purified in one step directly from the culture broth of Streptomyces avidinii. The biotin-binding protein isolated in this manner exhibited a major band at about 75 kDa and a minor band at about 150 kDa. Under denaturing conditions, a spectrum of subunit molecular weights ranging between 15 and 19 kDa was detected, the distribution of which depended upon the specific preparation.     

An improved method for the preparation of 3-ketoglycosides

Summary Improved conditions were described to increase the yield of 3-ketoglycosides, which are formed during the oxidation of several disaccharides and bionates by a strain of aerobic bacteria. These end-products were formed fastest when a heavy inoculum (10¹⁴–10¹⁵ cells/ml) of non-adapted organisms was used. The aeration rate was found to be very important. An oxygen absorption rate (O.A.R.) of 6 was currently used. In these conditions a 4% solution of lactose, lacto- and maltobionate was nearly quantitatively converted into the corresponding 3-keto-compounds. Maltose and saccharose gave a yield of 12 and 20% respectively. An analytical method to determine 3-ketoglycosides with semicarbazide was described. 3-Ketolactose has been obtained in the crystalline state. Geassocieerde Nationaal Fonds voor Wetenschappelijk Onderzoek.