Design and Mechanics Simulation of Bionic Lubrication System of Artificial Joints

We propose a new structure for artificial joints with a joint capsule which is designed to overcome the drawback of current prostheses that omit many functions of the lubricant and the joint capsule. The new structure is composed of three components： lubricant, artificial joint and artificial joint capsule. The lubricant sealed in the capsule can not only reduce the wear of the artificial joint but also prevents the wear particles leaking into the body. So unexpected reactions between the wear particles and body can be avoided completely. A three-dimensional （3-D） finite element analysis （FEA） model was created for a bionic knee joint with capsule. The stresses and their distribution in the artificial capsule were simulated with different thickness, loadings, and flexion angles. The results show that the maximum stress occurs in the area between the artificial joint and the capsule. The effects of capsule thickness and the angles of flexion on stress are discussed in detail.     

Individual variability of the projection line of the common carotid artery

The investigation has been performed on 87 corpses of persons of both sex, that died after 60 years of age from the pathology not connected with any diseases in the neck organs. Individual variability in the common carotid artery projection line has been revealed; it conforms, to a certain extent, with the value of the neck index. When the neck is short and thick, the artery position corresponds to the line that runs across the following points: the superior--0.5 cm forward from the mandibular angle, the inferior--0.5 cm medially from the sternoclavicular joint. When the neck index is within the limits 1.71-1.88, it is expedient to draw the classical projection line. When the neck index is within the limits 1.57-1.69, it is possible to determine the projection zone as an elongated rectangle. At the bottom of every side the border of this zone is a straight line drawn between the sternoclavicular joint and the point situating 0.6 cm laterally from the joint, and at the top--the line connecting the top of the mastoid process with the point 1.0 cm behind the mandibular angle.     

Electromyographic study of the subclavius muscle

The electromyographic study of the subclavius muscle (SM) was performed in 31 different movements, in 12 subjects (10 male and 2 female) aged from 17 to 28 years. The action potentials were obtained with an electromyograph Teca TE 4. Our findings suggest that the SM acts mainly on the stability of the sternoclavicular joint; with more or less intensity according to the degree of the clavicular interaction with the movements of the peripheral parts of the superior limb. The SM seems to act as a substitute for the ligaments of the sternoclavicular joint.     

The dormant buds of Rhabdopleura compacta (Hemichordata)

Rhabdopleura has an overwintering stage that consists of two layers of cells surrounding a central yolk mass. This cellular part is surrounded by a thick electron dense capsule which is secreted by the bud itself. The capsule is probably impervious and protective to its contents. Blood vessels join the buds to the zooids of the colony. They form the probable route of transfer of yolk from the zooids to the dormant bud. The capsule of the dormant bud has some structural features in common with the black stolon of the adult zooids. The black stolon is probably formed in a manner similar to that which made the fusellar fabric of the periderm of fossil graptolities.     

Computational hip joint simulator for wear and heat generation

This paper presents a computational simulator for the hip to compute the wear and heat generation on artificial joints. The friction produced on artificial hip joints originates wear rates that can lead to failure of the implant. Furthermore, the frictional heating can increase the wear. The developed computational model calculates the wear in the joint and the temperature in the surrounding zone, allowing the use of different combinations of joint materials, daily activities and different individuals. The pressure distribution on the joint bearing surfaces is obtained with the solution of a contact model. The heat generation by friction and the volumetric wear is computed from the pressure distribution and the sliding distance. The temperature is obtained from the solution of a transient heat conduction problem that includes the time-dependent heat generated by friction. The contact and heat conduction problems are solved numerically with the Finite Element Method. The developed computational model performs a full simulation of the acetabular bearing surface behaviour, which is useful for acetabular cup design and material selection. The results obtained by the present model agree with experimental and clinical data, as well as other numerical studies.     

Studies on cartilage formation XXL Activity of enzymes belonging to the pentose-phosphate cycle in the regenerating articular surface

The distal articular surface of the femur was removed operatively in 36 dogs. In the regenerating chondrifying articular surface and in the granulation tissue adhering to the capsule glucose-6-phosphate dehydrogenase and 6-phosphogluconate dehydrogenase activities were determined 7, 33 and 70 days after operation. In both tissues the activity of these enzymes characteristic of the pentose phosphate cycle ws the highest in the early postoperative stage. This initial increase in activity was followed by a marked reduction in the regenerating articular surface and by a moderate decrease in the tissue adhering to the capsule. For the loss in activity occurring in the chondrifying articular surface, the connective tissue cells (fibroblasts) are responsible. Cartilage precursors and young chondrocytes show a high glucose-6-phosphate dehydrogenase and 6-phosphogluconate activity. Presumably, in the given case of the functions of the pentose-phosphate cycle the NADPH generation and supply of building stones prevail. The activity of these enzymes ws determined in the articular cartilage and in the synovial membrane of the knee joint in further 18 dogs. The activity in the articular cartilage was very slight as compared to that in the synovial membrane.     

Enhanced healing of cartilaginous injuries by glucosamine hydrochloride

We investigated the restorative effect of orally administered glucosamine hydrochloride (GlcN) on the experimentally produced cartilaginous injuries in rabbits. A total of three holes in the left stifle joint including one in the medial trochlear ridge and two in the trochlear sulcus (proximal and distal) of articular cartilage were made surgically using a drill. For the control group, only tap water and for the glucosamine group, a water based solution of GlcN (1 g/head) was administered daily, respectively. We observed the clinical symptoms daily and the condition of the injured part was observed visually and histologically at 3 weeks after the operation. There was no difference in body weight or general conditions between the two groups. However, in the control group, the muscle weight of the biceps of the left femur was significantly reduced (p<0.05). With respect to the medial trochlear injury, four out of six cases in the control group and five out of six cases in the glucosamine group were cured, respectively. With respect to the proximal and the distal holes in sulcus, only two out of six cases in the control group and five expansive out of six cases in the glucosamine group were cured. There was significant difference between the glucosamine group and the control with respect to healing of the proximal hole (p<0.05) and the total points (p<0.05), indicating that the artificial cartilage injuries were facilitated by GlcN. On histological examination, the injured parts were covered by fibrous connective tissues in the control, whereas in the glucosamine group, the massive proliferation of matured cartilaginous tissues was observed, and the regenerated cartilaginous tissues were surrounded by the proliferation of chondroblast cells. In the regenerated tissue, matured cartilage substrate was about to be formed. Safranin O and alcian blue stains marked significantly dense in the glucosamine group than in the control (p<0.01) in injured parts as well as in non-injured joint cartilage.     

仙灵骨葆胶囊联合改良髓芯减压人工骨植入术对股骨头坏死患者血液流变学和生活质量的影响

摘要 目的：探讨仙灵骨葆胶囊联合改良髓芯减压人工骨植入术治疗股骨头坏死的疗效及对血液流变学和生活质量的影响。方法：选取2015年3月~2018年12月期间我院收治的股骨头坏死患者60例,上述患者根据随机数字表法分为对照组（n=30）和研究组（n=30）,对照组患者予以改良髓芯减压人工骨植入术治疗,研究组在对照组基础上联合仙灵骨葆胶囊治疗,对两组患者疗效、血液流变学、生活质量、髋关节功能及并发症情况进行比较。结果：研究组治疗后12个月的临床总有效率93.33%（28/30）高于对照组70.00%（21/30）（P<0.05）。两组患者治疗后Harris髋关节功能评分均升高,且研究组高于对照组（P<0.05）。两组患者治疗后12个月生活质量测定量表(SF-36)各维度评分均升高,且研究组高于对照组（P<0.05）。两组患者治疗后12个月全血黏度、红细胞压积、纤维蛋白原均降低,且研究组低于对照组（P<0.05）。两组并发症发生率比较无明显差异(P>0.05)。结论：仙灵骨葆胶囊联合改良髓芯减压人工骨植入术治疗股骨头坏死,疗效显著,可有效改善患者髋关节功能、血液流变学及提高生活质量,且安全性较好。     

Encapsulation of the metacercariae of two species of trematodes in the skin and musculature of the stone cockscomb <Emphasis Type="Italic">Alectrias alectrolophus</Emphasis> (Pallas, 1814)

The structure of the coating surrounding the metacercaria of Cryptocotyle lingua in the skin and the metacercaria of Liliatrema skrjabini in the muscles of the stone cockscomb was studied. Metacercariae of these trematodes were surrounded by a cyst adjacent to the helminth and by a capsule. In both species, the cyst consisted of electron- dense homogeneous material, which was probably synthesized by the parasite. The capsules were formed from host tissues; in C. lingua, they mostly consisted of ordered layers of collagen fibers and in L. skrjabini they were formed from fibroblasts and, presumably, phagocytes. The differences in capsule structure of the studied metacercariae may be related to the physiological features of surrounding tissues or to the taxonomic attribution of the trematodes.     

Passive and active components of the internal moment developed about the ankle joint during human ambulation

The internal moment developed about a joint during a functional activity is the result of contraction of muscles and the visco-elastic properties of the joint and its surrounding soft tissues. In this study, the contribution of each one of these mechanisms to the total internal moment developed about the ankle joint during human level walking was assessed. The results indicate that during normal level walking the internal moment about the ankle is mainly due to contraction of muscles surrounding the joint. The contribution of the passive component was found to be negligible. These results, however, were found to be different for the pathological case tested. The results indicated that in a subject with a mild equinus ankle deformity, a substantial portion (21%) of the total internal moment was contributed by the passive resistance of the joint and its surrounding structures.     

Zinc supplementation during pregnancy: a double blind randomised controlled trial.

OBJECTIVE--To see whether zinc supplementation during pregnancy improves maternal and fetal outcome. DESIGN--Prospective study started at booking and continued till discharge of mother and baby from the maternity hospital. Mothers were randomly assigned to receive zinc supplementation or placebo in a double blind trial. SETTING--Mothers booking at one hospital. PATIENTS--Women booking before 20 weeks of gestation who agreed to take part in the study. 494 Mothers were followed up till the end of pregnancy. There was no difference between the groups given zinc and placebo in their social or medical backgrounds. INTERVENTIONS--Mothers in the active treatment group received one capsule of 20 mg elemental zinc daily and those in the placebo treated group a capsule identical in appearance and taste with the active capsule but which contained inert substances. MAIN OUTCOME MEASURE--Various adverse outcomes were tested, including maternal bleeding, hypertension, complications of labour and delivery, gestational age, Apgar scores, and neonatal abnormalities. The main outcome measure was birth weight. RESULTS--There were no differences whatsoever between mothers given a zinc supplement and those given a placebo. CONCLUSION--Zinc supplementation in pregnancy in the United Kingdom does not seem to offer any benefits to the mother or her fetus.     

In vivo and in vitro studies in a patient with cyclical Cushing's disease showing some responsiveness to bromocriptine.

In vivo and in vitro studies were carried out in a 37-year old female with cyclical Cushing's disease. Preoperative studies revealed periodic secretions of urinary corticosteroids occurring with a cyclicity of 2-3 weeks. On transsphenoidal surgery, a microadenoma was visualized in the anteroinferior portion of the anterior pituitary. Gel filtration analyses of the adenoma and surrounding tissues revealed increased concentrations of beta-endorphin and an activated conversion of beta-lipotropin to beta-endorphin in the adenoma compared with the surrounding tissues. These findings were in agreement with the characteristics previously reported for corticotroph adenomas. However, unexpectedly, concentrations of ACTH and beta-lipotropin in the adenoma were only slightly higher than those in the surrounding tissues. Precise mechanisms underlying this unusual finding were elusive, but it may have been due to the periodic nature of her hypercortisolism. In addition, this patient was reproducibly responsive to bromocriptine (2.5 mg, per os) with a reduction of the plasma cortisol level. Although this may suggest an intermediate lobe subtype of Cushing's disease as proposed by Lamberts' group, our case did not have any other characteristic suggestive of this proposed variant. However, it is tempting to speculate that cyclical changes in the central dopaminergic tone may have been at least a partial trigger for the periodic hormonogenesis in this patient.     

膝关节人工单髁置换的近期疗效分析

目的:探讨膝关节人工单髁置换治疗晚期膝关节单间室骨性关节炎的近期疗效。方法:选择2007年3月至2011年9月我院采用膝关节人工单髁置换且随访超过2年的单间室病变的骨性关节炎的患者37例,采用膝关节人工单髁置换治疗,随访时行膝关节X线摄片检查,观察有无松动、下沉及另外一侧间室有无退变或是否加重,末次随访时评估HSS评分,比较与术前的疼痛及功能的差异。结果:37例患者均获得随访,随访时间22~38个月,平均29.8个月,所有患者均无松动、下沉及另外一侧间室退变或退变加重,末次随访时HSS评分(95.5±1.7)分,显著高于术前(68.5±2.1)分,差异有统计学意义(P=0.016)。结论:膝关节人工单髁置换手术治疗晚期膝关节单间室骨性关节炎创伤小,患者并发症少,术后功能恢复良好,近期疗效好。     

The effect of tactile and verbal guidance during scapulothoracic exercises: An EMG and kinematic investigation

BackgroundClinician-led training through tactile and verbal guidance to improve muscle activity and joint motion are a common but understudied focus of therapeutic interventions for shoulder pain. The purpose of this study was to determine if clinician guidance changes scapulothoracic muscle activity and kinematics compared to unguided shoulder exercises.MethodsEleven participants with shoulder pain were studied. Electromyographic (EMG) sensors were placed on the serratus anterior and upper and lower trapezii. Scapulothoracic and sternoclavicular kinematics were collected using electromagnetic sensors. Five common resisted shoulder exercises were performed with the following guidance: unguided, combined (verbal and tactile cues), and verbal guidance only. One-way repeated measures ANOVAs determined the effect of guidance versus unguided conditions for each exercise.ResultsNine of ten combinations of exercise and guidance techniques demonstrated a significant effect of guidance for either muscle activity or joint kinematics. The guidance condition with the most frequent significant improvements across all variables was the combined condition. The exercises with the most frequent significant improvements across all variables were the external rotation exercises. Variables improved most frequently were: upper:lower trapezius EMG ratio (up to 11%), sternoclavicular elevation (up to 6°) and scapulothoracic internal rotation positioning (up to 8°), and sternoclavicular retraction displacement (up to 5°).ConclusionShoulder muscle activity and kinematics during exercises can be modified by tactile and verbal guidance. Most improvements in muscle activity occurred with verbal guidance during external rotation exercises. Most improvements in joint positioning and movement occurred with combined guidance during external rotation exercises.     

Sonic hedgehog regulates otic capsule chondrogenesis and inner ear development in the mouse embryo

Development of the cartilaginous capsule of the inner ear is dependent on interactions between otic epithelium and its surrounding periotic mesenchyme. During these tissue interactions, factors endogenous to the otic epithelium influence the differentiation of the underlying periotic mesenchyme to form a chondrified otic capsule. We report the localization of Sonic hedgehog (Shh) protein and expression of the Shh gene in the tissues of the developing mouse inner ear. We demonstrate in cultures of periotic mesenchyme that Shh alone cannot initiate otic capsule chondrogenesis. However, when Shh is added to cultured periotic mesenchyme either in combination with otic epithelium or otic epithelial-derived fibroblast growth factor (FGF2), a significant enhancement of chondrogenesis occurs. Addition of Shh antisense oligonucleotide (AS) to cultured periotic mesenchyme with added otic epithelium decreases levels of endogenous Shh and suppresses the chondrogenic response of the mesenchyme cells, while supplementation of Shh AS-treated cultures with Shh rescues cultures from chondrogenic inhibition. We demonstrate that inactivation of Shh by targeted mutation produces anomalies in the developing inner ear and its surrounding capsule. Our results support a role for Shh as a regulator of otic capsule formation and inner ear development during mammalian embryogenesis.     

Mechanisms of synovial joint and articular cartilage formation: recent advances, but many lingering mysteries

Synovial joints are elegant, critically important, and deceptively simple biomechanical structures. They are comprised of articular cartilage that covers each end of the opposing skeletal elements, synovial fluid that lubricates and nourishes the tissues, ligaments that hold the skeletal elements in check, and a fibrous capsule that insulates the joints from surrounding tissues. Joints also exhibit an exquisite arrays of shapes and sizes, best exemplified by the nearly spherical convex femoral head articulating into a nearly spherical concave hip acetabulum, or a phalangeal joint with two condyles on the distal side articulating in reciprocally-shaped sockets on the opposing proximal side. Though few in number, joint tissues are highly specialized in structure and function. This is illustrated by articular cartilage with its unique extracellular matrix, unique biomechanical resilience, its largely avascular nature, and its ability to persist through life with minimal turnover of its cells and components. The fact that interest in synovial joints has remained unabated for decades is a reflection of their fundamental importance for organism function and quality of life, and for their susceptibility to a variety of acquired and congenital conditions, most importantly arthritis. This has led to many advances in this field that encompass molecular genetics to biomechanics to medicine. Regrettably, what continues to be poorly understood are the mechanisms by which synovial joints actually form in the developing embryo. If available, this information would be not only of indisputable biological interest, but would also have significant biomedical ramifications, particularly in terms of designing novel tissue regeneration or reconstruction therapies. This review focuses on recent advances in understanding the mechanisms of synovial joint formation in the limbs, and places and discusses the information within the context of classic studies and the many mysteries and questions that remain unanswered.     

Bovine joint capsule and fibroblasts derived from joint capsule express aggrecanase activity.

Bovine joint capsule was maintained in explant culture in the presence of bovine aggrecan monomer and it was shown that the aggrecan monomer was degraded. Amino-terminal sequence analysis of the resulting aggrecan core protein fragments revealed that the core protein was cleaved at five specific sites attributed to glutamyl endopeptidases referred to as aggrecanase activity. Fibroblast cultures were established from explant cultures of joint capsule and when these cells were exposed to aggrecan, cleavage of the core protein of aggrecan at the aggrecanase sites was observed. Inclusion of either retinoic acid or interleukin-1alpha in medium of either joint capsule explant cultures or fibroblast cultures did not increase the rate of cleavage of exogenous aggrecan present in the culture medium. When aggrecan monomer was incubated with conditioned medium from explant cultures of joint capsule maintained in medium, degradation could be detected after 10 min. After a 6-h incubation period the same fragments of aggrecan core protein were observed as those for tissue or cells incubated directly with aggrecan monomer. RT-PCR analysis of mRNA extracted from joint capsule fibroblasts showed that these cells express both aggrecanase-1 and -2 [ADAMTS-2 (Tang) and ADAMTS-5].     

Purinergic signaling microenvironments: An introduction

The common theme of this introductory article and the minireviews that follow in this special issue is the concept of microenvironments within tissues and surrounding cells that would be ideal signaling venues for a biologically active purinergic ligand. Collectively, the editors/authors and the other contributing authors agree that nucleotides and nucleosides would be most potent within a confined system. A talented cadre of purinergics has been solicited to discuss purinergic signaling in his or her favorite microenvironment within a given organ or tissue. We are gratified by the large number of original articles that also have successfully navigated the peer review process and are part of this special issue. These concepts are not simply purinergic, but the idea of maximal potency in a tissue microenvironment and surrounding specialized cells within a tissue pertains to any autacoid or paracrine agonist.     

Finding consistent strain distributions in the glenohumeral capsule between two subjects: implications for development of physical examinations

The anterior-inferior glenohumeral capsule is the primary passive stabilizer to the glenohumeral joint during anterior dislocation. Physical examinations following dislocation are crucial for proper diagnosis of capsule pathology; however, they are not standardized for joint position which may lead to misdiagnoses and poor outcomes. To suggest joint positions for physical examinations where the stability provided by the capsule may be consistent among patients, the objective of this study was to evaluate the distribution of maximum principal strain on the anterior-inferior capsule using two validated subject-specific finite element models of the glenohumeral joint at clinically relevant joint positions. The joint positions with 25 N anterior load applied at 60° of glenohumeral abduction and 10°, 20°, 30° and 40° of external rotation resulted in distributions of strain that were similar between shoulders (r2 ≥ 0.7). Furthermore, those positions with 20-40° of external rotation resulted in capsule strains on the glenoid side of the anterior band of the inferior glenohumeral ligament that were significantly greater than in all other capsule regions. These findings suggest that anterior stability provided by the anterior-inferior capsule may be consistent among subjects at joint positions with 60° of glenohumeral abduction and a mid-range (20-40°) of external rotation, and that the glenoid side has the greatest contribution to stability at these joint positions. Therefore, it may be possible to establish standard joint positions for physical examinations that clinicians can use to effectively diagnose pathology in the anterior-inferior capsule following dislocation and lead to improved outcomes.