An in vitro comparison of bone deformation measured with surface and staple mounted strain gauges

Chicken tibiae were chosen as a model for human second metatarsals. Local surface bone deformation in a 4-point bending configuration was measured in vitro by both strain gauge instrumented staples and strain gauges bonded to the bone's cortical surface. A series of staple bridge dimensions (0.5, 0.6, 0.8 and 1.0 mm) was compared to test for staple influence on bone characteristics and greatest measurement validity and reliability. Thicker staple inhibition of bone deformation was the greatest but differences to thinner staples were not statistically significant (p>0.05). All staples except 0.5 mm had maximum deviations from linearity less than 1%. The 1.0 mm staple had an R² value of 0.992±0.006 plotted against the 4-point bending input force and 0.994±0.002 plotted against the surface strain gauge signal. The mean intraclass correlation coefficients (ICC) calculated with four input forces (30, 60, 90 and 120 N) and for loading and unloading conditions for the 0.5, 0.6, 0.8 and 1.0 mm staples were 0.75, 0.83, 0.87 and 0.92, respectively. Finally, the differences in slope of the staple strain gauge signal plotted against surface strain gauge signal between input force loading and unloading conditions (0.32), and between input compression and tension conditions (0.79) was least for the 1.0 mm staple which also resulted in the lowest standard deviations. These results suggested the appropriateness of the 1.0 mm staple for in vivo application.     

Soft-tissue expansion in the lower extremities

Soft-tissue expansion enjoys ever-wider use, but to date an experience using this technique in the lower extremity has never been presented. We reviewed our first 16 patients to describe the indications and contraindications for the use of tissue expansion in the lower extremity. Guidelines evolved from study of the data. Soft-tissue expansion merits consideration for coverage of problem wounds, in preparation for removal of large benign lesions, and for the repair of contour defects. The operator should know that an open wound below the knee predicts a complication if soft-tissue expansion is attempted in that location. In the thigh, incisions can be confidently placed at the edge of the defect. In every location, large expanders should be chosen so that they are as long as or longer than the adjacent defect. The increase in circumference of the limb should be followed. Simple designs for advancement flaps usually work well. As our experience has grown, reconstruction using soft-tissue expansion in the lower extremity has become safer and the results more predictable through better patient selection and diligent monitoring of intraluminal pressures, even if only by ensuring that the patient is always comfortable. Soft-tissue expansion has a role in reconstruction of the lower extremity.     

Tachykinin-induced vasodilatation in rat skin measured with a laser-Doppler flowmeter: evidence for receptor-mediated effects

Vasodilatation was induced by perfusion of the tachykinins substance P (SP), neurokinin A and neurokinin B and the analogues [Glp6, D-Pro9]SP-(6-11) and [Glp6, L-Pro9]SP-(6-11) over the base of vacuum-induced blisters on the rat footpad. Vasodilatation was measured as change in blood flow using a laser-Doppler flowmeter. The tachykinins induced vasodilatation in a dose-response manner with a threshold of approximately 3 pmol and pD2's of 6.48, 6.13 and 6.21 for SP, neurokinin A and neurokinin B respectively. The D- and L-Pro analogues of [Glp6, Pro9]SP-(6-11) also induced vasodilatation in a dose-dependent manner. The L-Pro analogue was more potent than the D-Pro analogue (D/L ratio of the EC50's = 21) which suggests the involvement of an NK-1 type receptor in the mediation of small vessel vasodilatation. The vasodilatation to SP was reduced by 64% and 59% in capsaicin- and antihistamine-pretreated animals respectively, demonstrating the involvement of capsaicin-sensitive primary afferent nerves and mast cells in the vasodilatation component of the neurogenic inflammatory response.     

Neurogenic vasodilation in the rat hairy skin measured using a laser Doppler flowmeter

Intradermal stimulation of the saphenous nerve of anesthetized rats at C-fiber strength elicited stimulus-dependent vasodilator responses in saphenous-innervated hairy skin. A laser Doppler flowmeter (Periflux, Pf1d) was used to measure these neurovascular responses non-invasively. Capsaicin pretreatment significantly attenuated the vasodilator response. Furthermore, intraperitoneal administration of atropine or mepyramine significantly reduced the skin vascular responses. The responses of halothane-anesthetized rats were significantly attenuated when compared with rats anesthetized with pentobarbitone. Results of this study suggest the presence of endothelium-dependent vasodilator peptidergic, cholinergic and histaminergic contributions to electrically-evoked axon reflex vasodilation in the rat hairy skin.     

Muscle-specific atrophy of the quadriceps femoris with aging.

We examined the size of the four muscles of the quadriceps femoris in young and old men and women to assess whether the vastus lateralis is an appropriate surrogate for the quadriceps femoris in human studies of aging skeletal muscle. Ten young (24 +/- 2 yr) and ten old (79 +/- 7 yr) sedentary individuals underwent magnetic resonance imaging of the quadriceps femoris after 60 min of supine rest. Volume (cm3) and average cross-sectional area (CSA, cm2) of the rectus femoris (RF), vastus lateralis (VL), vastus intermedius (VI), vastus medialis (VM), and the total quadriceps femoris were decreased (P < 0.05) in older compared with younger women and men. However, percentage of the total quadriceps femoris taken up by each muscle was similar (P > 0.05) between young and old (RF: 10 +/- 0.3 vs. 11 +/- 0.4; VL: 33 +/- 1 vs. 33 +/- 1; VI: 31 +/- 1 vs. 31 +/- 0.4; VM: 26 +/- 1 vs. 25 +/- 1%). These results suggest that each of the four muscles of the quadriceps femoris atrophy similarly in aging men and women. Our data support the use of vastus lateralis tissue to represent the quadriceps femoris muscle in aging research.     

下肢间歇负压疗法对男子赛艇运动员股四头肌皮肤微循环血流灌注量的影响*

目的: 观察下肢间歇负压疗法对男子赛艇运动员股四头肌皮肤微循环血流灌注量的影响,为该方法的实际应用提供理论依据。方法: 选取国家赛艇集训队的14名男子运动员,随机分为试验组和对照组,两组队员每日的训练计划相同,采用德国生产的VACUSPORT间歇负压体能恢复舱对试验组队员实行恢复干预,每次干预20 min,每周干预5次,共持续4周。在4周干预前后利用PeriFlux System 5000激光多普勒血流监测仪采集两组运动员股四头肌皮肤微循环血流灌注量(MBP)、血细胞运动速度(AVBC)及血细胞浓度(CMBC)等数据,测试值包括基础值与加热后值(44℃),并以加热前后的差值作为该指标的储备能力。结果: 干预前两组的微循环相关指标无统计学差异(P＞0.05),4周干预后的测试结果如下①MBP:试验组MBP的加热后值和前后差值均显著高于对照组(P＜0.05);组内比较无统计学差异。②AVBC:试验组AVBC的加热后值和前后差值均显著低于对照组(P＜0.05);组内比较发现,干预后试验组AVBC的加热后值相比干预前显著降低(P＜0.01),其加热前后差值相比干预前显著降低(P＜0.05)。③CMBC:试验组CMBC的加热后值和前后差值均非常显著高于对照组(P＜0.01);组内比较无统计学差异。结论: 下肢间歇负压疗法可改善男子赛艇运动员股四头肌皮肤微循环血流状态,对促进体能的快速恢复有着积极作用。     

The biomechanical properties of canine skin measured in situ by uniaxial extension

Introduction

A uniaxial extension system was setup to analyze the mechanical properties of dog skin.

Material and methods

Pads were glued onto dog skin with constant reproducible geometrical parameters and the extension force was measured as a function of the extension values. Forty-one sites (82 cycling tests) were investigated in situ on 11 canine cadavers, half of them after surgically isolating the test area from the surrounding skin. Series of loading-unloading cycles of up to 5 N or 10 N or both loads were performed on each site. The elastic properties and the dissipative effects were characterized respectively by evaluating the secant Rigidity at maximum loads and the Fraction of dissipated energy.

Results

A hysteresis phenomenon, implying the need for preconditioning to attain equilibrium cycles, was apparent during mechanical characterization. Polynomial expressions were used to relate the measured Rigidities and the Fractions of dissipated energy with or without sample isolation. The latter were less affected by isolation. The ratios between the Rigidities at 5 N to those at 10 N displayed non-linearity in the investigated extension range in contrary to the Fractions of dissipated energy.

Discussion/conclusion

The parameters confirming the dissipative non-linear elastic behavior of dog skin were identified and the correlation between Rigidity and Fraction of dissipated energy on isolated and non-isolated skin samples was quantitatively determined. This extension setup can now be used as a “true in vivo” mapping tool to determine the mechanical characteristics of the skin during healing processes or during the study of Human skin disease with the dog as an animal model.     

MAPK signaling in the quadriceps of patients with chronic obstructive pulmonary disease

Muscle atrophy in chronic obstructive pulmonary disease (COPD) is associated with reduced exercise tolerance, muscle strength, and survival. The molecular mechanisms leading to muscle atrophy in COPD remain elusive. The mitogen-activated protein kinases (MAPKs) such as p38 MAPK and ERK 1/2 can increase levels of MAFbx/Atrogin and MuRF1, which are specifically involved in muscle protein degradation and atrophy. Our aim was to investigate the level of activation of p38 MAPK, ERK 1/2, and JNK in the quadriceps of patients with COPD. A biopsy of the quadriceps was obtained in 18 patients with COPD as well as in 9 healthy controls. We evaluated the phosphorylated as well as total protein levels of p38 MAPK, ERK 1/2, and JNK as well as MAFbx/Atrogin and MuRF1 in these muscle samples. The corresponding mRNA expression was also assessed by RT-PCR. Ratios of phosphorylated to total level of p38 MAPK (P = 0.02) and ERK 1/2 (P = 0.01) were significantly elevated in patients with COPD compared with controls. Moreover, protein levels of MAFbx/Atrogin showed a tendency to be greater in patients with COPD (P = 0.08). mRNA expression of p38 MAPK (P = 0.03), ERK 1/2 (P = 0.02), and MAFbx/Atrogin (P = 0.04) were significantly elevated in patients with COPD. In addition, phosphorylated-to-total p38 MAPK ratio (Pearson's r = -0.45; P < 0.05) and phosphorylated-to-total ERK 1/2 ratio (Pearson's r = -0.47; P < 0.05) were negatively associated with the mid-thigh muscle cross-sectional area. These data support the hypothesis that the MAPKs might play a role in the development of muscle atrophy in COPD.     

419名汶川地震颌面部伤员软组织伤伤情特点分析

目的:回顾性分析研究419名在汶川地震中颌面部软组织受伤的伤员的伤情特点,从而为颌面部创伤医学以及救治规范的完善提供依据和参考.方法:调查分析在汶川地震中受伤的2944名伤员,其中颌面伤员有419名,伴有软组织伤的伤员有381人,分析5.12汶川地震后419名口腔领面伤员的伤情特点,调查结果采用自主研发设计的数据库进行统计.结果:在调查的419名颌面伤员中,伴有软组织伤的伤员有381人(91%),男女无明显差别.受伤原因以挤压掩埋伤最多,受伤部位以额部和颧面部最多.擦伤和裂伤是最为常见的受伤类型.伤口局部感染比例较高(22%),但全身感染者很少.结论:地震导致的颌面部软组织伤有其自身特点,主要体现在其受伤机制上,而其他特点和其他颌面部软组织伤无明显差别.     

Redox balance following magnetic stimulation training in the quadriceps of patients with severe COPD

In severe COPD patients, oxidative stress, which is involved in their peripheral muscle dysfunction, increases in response to exercise. In this study, muscle oxidative stress was explored after quadriceps magnetic stimulation training. A randomized controlled study was conducted on very severe COPD patients, who underwent quadriceps magnetic stimulation training for 8 weeks. A control group was also studied. In both groups, vastus lateralis specimens were obtained before and after the 8-week period. Muscle protein carbonylation and nitration and antioxidant enzymes were determined using immunoblotting and proportions and sizes of type I and II fibres using immunohistochemistry. Compared to controls, magnetic stimulation muscle training did not modify redox balance, whilst inducing a significant increase in type I fibre sizes. In severe COPD patients, it is concluded that quadriceps magnetic stimulation training was a well-tolerated therapeutic intervention, which did not enhance muscle oxidative stress, while increasing the size of slow-twitch fibres.     

Soft-tissue refinements in the treatment of unicoronal craniosynostosis: the rotational forehead flap

Unicoronal craniosynostosis is characterized by ipsilateral superior and posterior displacement of the supraorbital rim and frontal bone, ipsilateral widening of the palpebral fissure, ipsilateral superior displacement of the brow, and contralateral brow depression. In the literature, surgical treatment has focused on bony anatomy, with little written about soft-tissue correction. Over the last 25 years, the senior author (L.A.W.) has incorporated soft-tissue refinements, including a rotational flap of the forehead, elevating the contralateral brow, depressing the ipsilateral brow, and equilibrating the supratarsal sulci in unicoronal craniosynostosis. This rotational forehead repositioning is a simple innovation that has provided for improved orbital and brow symmetry on long-term follow-up.     

Preferential quadriceps activation in female athletes with incremental increases in landing intensity

The purpose of this study was to identify alterations in preparatory muscle activation patterns across different drop heights in female athletes. Sixteen female high school volleyball players performed the drop vertical jump from three different drop heights. Surface electromyography of the quadriceps and hamstrings were collected during the movement trials. As the drop height increased, muscle activation of the quadriceps during preparatory phase also increased (p < .05). However, the hamstrings activation showed no similar increases relative to drop height. Female athletes appear to preferentially rely on increased quadriceps activation, without an increase in hamstrings activation, with increased plyometric intensity. The resultant decreased activation ratio of the hamstrings relative to quadriceps before landing may represent altered dynamic knee stability and may contribute to the increased risk of ACL injury in female athletes.     

Characteristics of the muscle mechanoreflex during quadriceps contractions in humans

We examined muscle sympathetic nerve activity (MSNA) in thenonexercising lower limb during repetitive static quadricepscontraction paradigm at 25% maximal voluntary contraction in eightmen. Subjects performed 20-s contractions with 5-s rest periods for upto 12 contractions. Although the workload was constant, we found that MSNA amplitude rose as a function of contraction number [0.6 ln (amplitude/min)/contraction]; this suggests chemicalsensitization of the muscle reflex response. We employedsignal-averaging techniques and then integrated the data to examine theonset latency of the MSNA response as a function of the 25-scontraction-rest period. We observed an onset latency of ~4-6 s.Moreover, although the onset latency did not appear to vary as afunction of contraction number, the rate of MSNA increase tookapproximately four contractions to reach a steady-state rate of rise;this suggests contraction-induced sensitization. The onset latencyreported here is similar to findings in recent animal studies, but itis at odds with latencies determined in prior human handgripcontraction studies. We believe our data suggest that1) mechanically sensitive afferentscontribute importantly to the MSNA response to the paradigm employedand 2) these afferents may besensitized by the chemical products of muscle contraction.     

Alterations in quadriceps and hamstrings coordination in persons with medial compartment knee osteoarthritis

Altered muscle coordination strategies in persons with knee osteoarthritis (OA) result in an increase in co-contraction of the quadriceps and hamstrings during walking. While this may increase intersegmental joint contact force and expedite disease progression, it is not currently known whether the magnitude of co-contraction increases with a progressive loss of joint space or whether the level of co-contraction is dependent on walking speed. The purposes of this study were to (1) determine if co-contraction increased with OA severity and (2) discern whether differences in co-contraction were a result of altered freely chosen walking speeds or rather an inherent change associated with disease progression. Forty-two subjects with and without knee osteoarthritis were included in the study. Subjects were divided into groups based on disease severity. When walking at a controlled speed of 1.0 m/s, subjects with moderate and severe knee OA showed significantly higher co-contraction when compared to a healthy control group. At freely chosen walking speeds only the moderate OA group had significantly higher co-contraction values. Increased walking speed also resulted in a significant increase in co-contraction, regardless of group. The results of this study demonstrate that persons with knee OA develop higher antagonistic muscle activity. This occurs despite differences in freely chosen walking speed. Although subjects with OA had higher co-contraction than the control group, co-contraction may not increase with disease severity.     

Mobility of integrin alpha5beta1 measured on the isolated ventral membranes of human skin fibroblasts

We have measured the lateral mobility of individual alpha5 integrin molecules in ventral plasma membranes of fibroblasts, which were prepared by removal of apical surfaces and nuclei followed by elimination of actin filaments with gelsolin, an actin-severing protein. The cytoplasmic domain of individual integrin molecules was tagged with 100 nm fluorescent polystyrene bead, and motion of the bead was observed and video-recorded. Position of the bead in each frame was determined from the centroid of the fluorescence image, from which plots of the mean-square displacement against time intervals were derived. Within short intervals of time (<100 ms) the mean-square displacement was proportional to the time interval, and the averaged translational diffusion coefficient of (5.3+/-4.4) x 10(-10) cm2/s was obtained with a broad distribution of (1.3-20) x 10(-10) cm2/s. The broad distribution might reflect the oligomerized state of integrin. The largest diffusion coefficient was comparable to that of lipid molecules previously measured in cells and probably represented the diffusion of a single integrin molecule in the presence of little interference of actin cytoskeleton or extracellular matrix. In longer time intervals (>100 ms) the motion of the bead was confined in an area, the average diameter of which was 410+/-160 nm. This was similar to the values described in previous reports, in which the motion of other membrane receptors labeled on their extracellular domain was measured in living cells.     

The duration of the inhibitory effects with static stretching on quadriceps peak torque production

Although several studies have investigated the acute effect of static stretching exercises, the duration of exercises that negatively affects performance has not been ascertained. This study was conducted to determine the acute effect of different static stretching durations on quadriceps isometric and isokinetic peak torque production. The 50 participants were randomly allocated into five equivalent sized groups and were asked to perform a stretching exercise of different duration (no stretch, 10-second stretch, 20-second stretch, 30-second stretch, and 60-second stretch). The knee flexion range of motion and the isometric and concentric isokinetic peak torques of the quadriceps were measured before and after a static stretching exercise in the four experimental groups. The same parameters were examined in the control group (no stretch) without stretching, before and after a 5-minute passive rest. There were no significant differences among groups before the experimentation regarding their physical characteristics and performances (P > 0.05). These results reflect the different groups' homogeneity. Significant knee joint flexibility increases (P < 0.001) and significant isometric and isokinetic peak torque reductions (P < 0.05-0.001) have been shown to occur only after 30 and 60 seconds of quadriceps static stretching. Stretching reduced isometric peak torque by 8.5% and 16.0%, respectively. Concerning isokinetic peak torque after 30 and 60 seconds of stretching, it was reduced by 5.5% vs. 11.6% at 60 degrees/s and by 5.8% vs. 10.0% at 180 degrees/s. We suggest that torque decrements are related to changes of muscle neuromechanical properties. It is recommended that static stretching exercises of a muscle group for more than 30 seconds of duration be avoided before performances requiring maximal strength.