Changes in hemodynamics of the long bone due to tunnelization under pulsing and non-pulsing pressure in a shaft cavity

In 25 dogs, it was revealed that the pressure in a long bone shaft cavity (IBP) pulsed at relatively high values. According to rheovasography data, the pulse changes of the vascular blood filling of a shaft cavity caused the IBP. The blood filling changes at pulsing IBP produced pulse changes in interstitial fluid amount, at non-pulsing IBP they provided for fluid coming into the interstitial space of the shaft cavity without pulsations. Tunnelization led to appearance of compact substance defect, at the size of which, coming to 2.4% of shaft area, IBP always decreased, remained decreased during 2 months and restored during the third month. The IBP decrease changed the bone hemodynamics.     

Circulation changes depending on manifestations in soft tissue tensioning in the leg lengthening process

Surgical intervention was found to intensify circulation in the limb and redistribute the blood flow. Leg lengthening led to arterial inflow limitation due to the magisterial artery strain. The changes were accompanied both by increase of functioning capillaries in number and increase of venous outflow dependence on blood inflow. The decreased after surgery oxygen tension in m. gastrocnemius did not change throughout distraction. The increase of functioning capillaries in number in resting contributed to maintenance of tissue oxygenation in the initial period of distraction, and in case of maximal tissue tensioning hydrostatic pressure increased in the capillaries due to arterial pressure rise. Restoration of the circulation parameters in the fixation period started with an increase of circulation volumetric rate in vessels with preservation of the rest mechanisms of the tissue oxygenation maintenance.     

Flow-induced deformation from pressurized cavities in absorbing porous tissues

The behaviour of a cavity during an injection of fluid into biological tissue is considered. High cavity pressure drives fluid into the neighbouring tissue where it is absorbed by capillaries and lymphatics. The tissue is modelled as a nonlinear deformable porous medium with the injected fluid absorbed by the tissue at a rate proportional to the local pressure. A model with a spherical cavity in an infinite medium is used to find the pressure and displacement of the tissue as a function of time and radial distance. Analytical and numerical solutions for a step change in cavity pressure show that the flow induces a radial compression in the medium together with an annular expansion, the net result being an overall expansion of the medium. Thus any flow induced deformation of the material will aid in the absorption of fluid.     

Non-Newtonian flow-induced deformation from pressurized cavities in absorbing porous tissues

We investigate the behavior of a spherical cavity in a soft biological tissue modeled as a deformable porous material during an injection of non-Newtonian fluid that follows a power law model. Fluid flows into the neighboring tissue due to high cavity pressure where it is absorbed by capillaries and lymphatics at a rate proportional to the local pressure. Power law fluid pressure and displacement of a solid in the tissue are computed as function of radial distance and time. Numerical solutions indicate that shear thickening fluids exhibit less fluid pressure and induce small solid deformation as compared to shear thinning fluids. Absorption in the biological tissue increases as a consequence of flow-induced deformation for power law fluids. In most cases non-Newtonian results are compared with the viscous fluid case to magnify the differences.     

Effect of left atrial ligation-driven altered inflow hemodynamics on embryonic heart development: clues for prenatal progression of hypoplastic left heart syndrome

Congenital heart defects (CHDs) are abnormalities in the heart structure present at birth. One important condition is hypoplastic left heart syndrome (HLHS) where severely underdeveloped left ventricle (LV) cannot support systemic circulation. HLHS usually initiates as localized tissue malformations with no underlying genetic cause, suggesting that disturbed hemodynamics contribute to the embryonic development of these defects. Left atrial ligation (LAL) is a surgical procedure on embryonic chick resulting in a phenotype resembling clinical HLHS. In this study, we investigated disturbed hemodynamics and deteriorated cardiac growth following LAL to investigate possible mechanobiological mechanisms for the embryonic development of HLHS. We integrated techniques such as echocardiography, micro-CT and computational fluid dynamics (CFD) for these analyses. Specifically, LAL procedure causes an immediate flow disturbance over atrioventricular (AV) cushions. At later stages after the heart septation, it causes hemodynamic disturbances in LV. As a consequence of the LAL procedure, the left-AV canal and LV volume decrease in size, and in the opposite way, the right-AV canal and right ventricle volume increase. According to our CFD analysis, LAL results in an immediate decrease in the left AV canal WSS levels for 3.5-day (HH21) pre-septated hearts. For 7-day post-septated hearts (HH30), LAL leads to further reduction in WSS levels in the left AV canal, and relatively increased WSS levels in the right AV canal. This study demonstrates the critical importance of the disturbed hemodynamics during the heart valve and ventricle development.

     

Light microscopic and ultrastructural observations in advanced stages of induced exencephaly and spinal bifida.

This investigation was performed to demonstrate the morphologic basis of the elevation of fetal proteins in the amniotic fluid of fetuses with neural tube defects. Pregnant rats were treated with hypervitaminosis. A to induce exencephaly or with trypan blue to produce spina bifida aperta. The malformations were studied on days 15-20. On day 15 of gestation, edema developed in the primitive nervous tissue. This was followed by the appearance of quickly expanding hemorrhages throughout the ventricular and intermediate zones. Some capillaries did not rupture but collapsed and showed degenerative changes of the endothelium, probably due to lack of blood perfusion. The ventricular layer in exencephaly and spina bifida aperta was exposed to the amniotic cavity due to non closure of the neural tube. On day 17, this superficial lining of the primitive nervous tissue was disrupted by the expanding hemorrhages and subsequent necrosis. As a result vast amounts of fetal blood and cell debris were extruded into the amniotic fluid. During days 18 to 20, the degeneration of the nervous tissue proceeded rapidly. This process showed the same features in the ventricular cells, the primitive neurons and the neurons. Initially it was characterized by condensation of the nuclear chromatin and the cytoplasm, irregular outlines and breakdown of the plasma membrane. Only part of the cell debris was phagocytozed by macrophages. It is concluded that the leakage of fetal serum and cell debris causes the elevation of fetal protein levels in the amniotic fluid of fetuses with open neural tube defects.     

Studies on cartilage formation XIX. Oxygen and glucose supply of the regenerating articular surface.

Complete removal of the articular cartilage in dogs is followed by regeneration of the articular surface. At the site of the bone wound, granulation tissue develops, which later differentiates into cartilage. The O2 and glucose supply of the regenerating articular surface is ensured by the synovial fluid, by the large exposed surface of the medullary cavity, and by the capillary network of the granulation tissue. Oxygen and glucose supply of the articular surface in different stages of differentiation has been statistically analyzed. It is suggested that in the early stage of regeneration O2 supply comes predominantly from the capillaries of the granulation tissue. Later on, as capillarization regresses, the oxygen supply, originating from the synovia and medullary cavity, assumes a more important role. In the stage of cartilage regeneration an oxygen-deficient state can be supposed in the entire articular surface, but areas differing in oxygen supply may be formed owing to local differences (due mainly to the extent of vascularization and degree of generation of the subchondral bone layer). At the site of chondrogenesis, conditions allowing aerobic metabolism of cells with reduced O2 requirements seem to be ensured. Glucose supply deriving from the above-mentioned sources satisfies the highest glucose requirements of the cells in the regenerating articular surface.     

Slow Rhythmic Oscillations within the Human Cranium: Phenomenology, Origin, and Informational Significance

Slow rhythmic oscillations in the human cranial cavity were studied using two noninvasive methods: the bioimpedance method (volume ratios between liquid media in the cranial cavity) and transcranial ultrasound Doppler echography (variation in the blood flow in the middle cerebral artery). The combination of these methods made it possible to estimate the intracranial hemodynamics. Simultaneous recording of these parameters and their spectral analysis were carried out in healthy subjects and patients with intracranial hypertension syndrome and disturbed cerebrospinal fluid (CSF) flow. The parameters were recorded at rest and immediately after manual (osteopathic) correction. The recording and analysis were performed using a Macintosh-IIsi PC and the Chart-3.52, Cricket Graph-3.32, and Canvas-3.5 software. It was found that slow oscillations of the bioimpedance (BIM) in the frequency range 0.08–0.2 Hz were of intracranial origin and were related to the mechanisms of regulation of the blood supply to and oxygen consumption by cerebral tissue, as well as with the dynamics of the CSF circulation.     

Newtonian and non-Newtonian blood flow in coiled cerebral aneurysms

Endovascular coiling aims to isolate the aneurysm from blood circulation by altering hemodynamics inside the aneurysm and triggering blood coagulation. Computational fluid dynamics (CFD) techniques have the potential to predict the post-operative hemodynamics and to investigate the complex interaction between blood flow and coils. The purpose of this work is to study the influence of blood viscosity on hemodynamics in coiled aneurysms. Three image-based aneurysm models were used. Each case was virtually coiled with a packing density of around 30%. CFD simulations were performed in coiled and untreated aneurysm geometries using a Newtonian and a Non-Newtonian fluid models. Newtonian fluid slightly overestimates the intra-aneurysmal velocity inside the aneurysm before and after coiling. There were numerical differences between fluid models on velocity magnitudes in coiled simulations. Moreover, the non-Newtonian fluid model produces high viscosity (>0.007$>0.007$ [Pa s]) at aneurysm fundus after coiling. Nonetheless, these local differences and high-viscous regions were not sufficient to alter the main flow patterns and velocity magnitudes before and after coiling. To evaluate the influence of coiling on intra-aneurysmal hemodynamics, the assumption of a Newtonian fluid can be used.     

Fluid pressure gradients, arising from oscillations in intramedullary pressure, is correlated with the formation of bone and inhibition of intracortical porosity

Fluid flow that arises from the functional loading of bone tissue has been proposed to be a critical regulator of skeletal mass and morphology. To test this hypothesis, the bone adaptive response to a physiological fluid stimulus, driven by low magnitude, high frequency oscillations of intramedullary pressure (ImP), were examined, in which fluid pressures were achieved without deforming the bone tissue. The ulnae of adult turkeys were functionally isolated via transverse epiphyseal osteotomies, and the adaptive response to four weeks of disuse (n=5) was compared to disuse plus 10 min per day of a physiological sinusoidal fluid pressure signal (60 mmHg, 20Hz). Disuse alone resulted in significant bone loss (5.7+/-1.9%, p< or =0.05), achieved by thinning the cortex via endosteal resorption and an increase in intracortical porosity. By also subjecting bone to oscillatory fluid flow, a significant increase in bone mass at the mid-diaphysis (18.3+/-7.6%, p<0.05), was achieved by both periosteal and endosteal new bone formation. The spatial distribution of the transcortical fluid pressure gradients (inverted Delta P(r)), a parameter closely related to fluid velocity and fluid shear stress, was quantified in 12 equal sectors across a section at the mid-diaphyses. A strong correlation was found between the inverted Delta P(r) and total new bone formation (r=0.75, p=0.01); and an inverse correlation (r=-0.75, p=0.01) observed between inverted Delta P(r) and the area of increased intracortical porosity, indicating that fluid flow signals were necessary to maintain bone mass and/or inhibit bone loss against the challenge of disuse. By generating this fluid flow in the absence of matrix strain, these data suggest that anabolic fluid movement plays a regulatory role in the modeling and remodeling process. While ImP increases uniformly in the marrow cavity, the distinct parameters of fluid flow vary substantially due to the geometry and ultrastructure of bone, which ultimately defines the spatial non-uniformity of the adaptive process.     

Changes in hemodynamics of tibial diaphysis in case of blood flow disorder in superficial femoral artery

Changes in tibial hemodynamics have been studied experimentally after applying a clamp (n=41) and resection of superficial femoral artery (n=22) in 63 adult dogs. It has been revealed with the help ofrheovasography that, in case of blood flow disorders in the superficial femoral artery, anastomoses with deep femoral artery branches contribute to maintenance of blood circulation in tibia, and in this connection the parameters of tibial blood flow may significantly differe from those of circulation in the leg soft tissues. Preservation of intraosseous pressure all along tibial diaphyseal cavity demonstrates a possibility of using its driving force to compensate for the circulatory insufficiency in the leg soft tissues and, moreover, in that part of the bone the environment of which in ischemia is involved.     

骨陷窝—骨小管系统内液体的流动

基于骨陷窝和骨小管的生理结构特性,并考虑到它们内部骨细胞的存在,研究了它们内部组织液的流动。得到了它们内部压力与流量的关系式,为进一步研究密质骨内力敏（mechanosensory)问题提供了依据。     

Analysis of coupled intra- and extraluminal flows for single and multiple capillaries

Matched asymptotic expansions are used to study a model of the coupled fluid flow in the capillaries and tissue of the microcirculation. These capillaries are long, narrow cylindrical tubes embedded in a uniform tissue space. The capillary, or intraluminal, flow is assumed to be that of an incompressible Navier-Stokes fluid wherein colloids are represented as dilute solute; the extraluminal flow in the tissue is according to Darcy's law. Central to this fluid exchange is the boundary condition on the fluid radial velocity at the semipermeable wall of the capillary. This boundary condition, involving the local hydrostatic and colloidal osmotic pressures in both the capillary and the tissue, together with the radial gradient of the tissue hydrostatic pressure, couples the intra- and extraluminal flow fields. With this model we investigate the relationship between transport properties, hydrostatic pressures, and flow exchange for a single capillary, and describe the fluid transport in the tissue space produced by an array of such capillaries.     

Self-fitting shape memory polymer foam inducing bone regeneration: A rabbit femoral defect study

Although tissue engineering has been attracted greatly for healing of critical-sized bone defects, great efforts for improvement are still being made in scaffold design. In particular, bone regeneration would be enhanced if a scaffold precisely matches the contour of bone defects, especially if it could be implanted into the human body conveniently and safely. In this study, polyurethane/hydroxyapatite-based shape memory polymer (SMP) foam was fabricated as a scaffold substrate to facilitate bone regeneration. The minimally invasive delivery and the self-fitting behavior of the SMP foam were systematically evaluated to demonstrate its feasibility in the treatment of bone defects in vivo. Results showed that the SMP foam could be conveniently implanted into bone defects with a compact shape. Subsequently, it self-matched the boundary of bone defects upon shape-recovery activation in vivo. Micro-computed tomography determined that bone ingrowth initiated at the periphery of the SMP foam with a constant decrease towards the inside. Successful vascularization and bone remodeling were also demonstrated by histological analysis. Thus, our results indicate that the SMP foam demonstrated great potential for bone regeneration.     

Osteogenic ability of free perichondreal autografts in canine tibial defects: An experimental study

This study set out to establish the effect of transplanting perichondreum on bone healing at sites of tibial bone defects in an experimental dog model. Transplantation of free, autologous, non-vascularised, perichondreal grafts to the distal of right anteromedial plane side of the tibia was compared with non-transplantation on the proximal side of the same bone.

In experimental dogs (n = 7), a 5 cm piece segment of perichondreum, that has been excised from the thirteenth rib of the same animal, was transplanted to the middle defect fracture site of bone, but not to the control proximal defect fracture site.

The dogs were allowed to recover from the operation and were kept 21 days in cages, with free-range. On days 30 (Group I) and 45 (Group II) after operations, the dogs were euthanatized. Histopathologically, defects in 30 days treated perichondreum group were filled by new ossified tissue while control defects in the same period were not fully resurfaced. The new ossified tissue consisted of a thin and inadequate trabeculae. In 45 days treated groups, defects with transplanting perichondreum were filled by thick trabeculae converting into a compact bone tissue. The control defects of this group, however, were filled by an extreme callus overflowing to medulla and bone surface.

This study has provided evidence to show that autologous, non-vascularized perichondreum retains an osteogenic ability when transplanted to tibial bone defect sites. It appears that callus formation occurred within the perichondreum grafting which resembles that of enchondral and intramembranous ossification.     

The effect of craniotomy on the intracranial hemodynamics and cerebrospinal fluid dynamics in humans

The goal of the research was to study the effect of the trephination of the human cranial cavity on the intracranial hemodynamics and cerebrospinal fluid (CSF) dynamics. The sample comprised 15 patients of a neurosurgical clinic in whom a trephine opening in the cranial bones was made for medical indications. In these patients, at rest and during an appropriate functional load, we recorded pulse changes in blood circulation (by transcranial Doppler sonography) and in the ratio between the pulse fluctuations in the blood and CSF volumes (by rheoencephalography) before and after surgery. Simultaneous recording of these parameters followed by computer pattern and phase analyses allowed evaluation of the complex biomedical compliance of the cranium during successive phases of the cardiac rhythm: the inflow of arterial blood, the redistribution of blood/CSF volumes, and the outflow of venous blood. Analysis of the results showed a beneficial influence of craniotomy on the intracranial hemodynamics and CSF dynamics. This was reflected in an increase in the cranial compliance, which increased the pulse increment in the volume of the arterial blood in the skull almost twofold. After craniotomy, the cross-flow of CSF between the cranial and spinal cavities decreased significantly, giving way to volumetric compensatory translocations of blood and CSF within the cranial cavity per se during the cardiac cycle, which increased the intracranial utilization of the energy of the cardiac output and contributed to the outflow of venous blood from the cranium. The results suggest a beneficial effect of craniotomy on the physiological mechanisms of the circulatory and metabolic maintenance of the brain activity.     

Current views on oxygen transport from blood to tissues]

During the recent 25-30 years, sophisticated experiments and mathematical simulation significantly changed the generally accepted theory of oxygen transport in tissue, which was based on two major postulates, namely: 1) Blood flows in capillaries continuously at uniform velocity, 2) Gas circulation between blood and tissue takes place exclusively in capillaries. As was shown by modern research techniques, blood flow in microvessels has irregular sharp velocity fluctuations in very short time intervals (seconds). In addition, mean velocity of blood flow in microvessels of the same caliber and the same micro-region of tissue may differ several times. Therefore, efficiency of microcirculation reactions may be assessed exclusively witH mean blood velocity in capillaries of the whole micro-region, and with complicated changes of the histogram of mean velocity distribution in capillaries. It was shown that arteriolas and venulas of inactive muscles and brain account for 30 to 50% of gas circulation between blood and tissue. This resulted in fundamental change of the previous postulates in the area of tissue gas circulation physiology, and, in effect, in replacement of oxygen transport paradigm created by A. Krog. This study is an attempt to present a new modern concept of oxygen transport in tissue, to show its research significance, and possible applications.     

The total cavopulmonary connection resistance: a significant impact on single ventricle hemodynamics at rest and exercise

Little is known about the impact of the total cavopulmonary connection (TCPC) on resting and exercise hemodynamics in a single ventricle (SV) circulation. The aim of this study was to elucidate this mechanism using a lumped parameter model of the SV circulation. Pulmonary vascular resistance (1.96+/-0.80 WU) and systemic vascular resistances (18.4+/-7.2 WU) were obtained from catheterization data on 40 patients with a TCPC. TCPC resistances (0.39+/-0.26 WU) were established using computational fluid dynamic simulations conducted on anatomically accurate three-dimensional models reconstructed from MRI (n=16). These parameters were used in a lumped parameter model of the SV circulation to investigate the impact of TCPC resistance on SV hemodynamics under resting and exercise conditions. A biventricular model was used for comparison. For a biventricular circulation, the cardiac output (CO) dependence on TCPC resistance was negligible (sensitivity=-0.064 l.min(-1).WU(-1)) but not for the SV circulation (sensitivity=-0.88 l.min(-1).WU(-1)). The capacity to increase CO with heart rate was also severely reduced for the SV. At a simulated heart rate of 150 beats/min, the SV patient with the highest resistance (1.08 WU) had a significantly lower increase in CO (20.5%) compared with the SV patient with the lowest resistance (50%) and normal circulation (119%). This was due to the increased afterload (+35%) and decreased preload (-12%) associated with the SV circulation. In conclusion, TCPC resistance has a significant impact on resting hemodynamics and the exercise capacity of patients with a SV physiology.     

O2 transport in cerebral microregions (mathematical simulation)

The effects of the circulation rate in capillaries, the intensity of O2 consumption by nerve cells and the capillary network density on the O2 tension distribution in the cerebral cortex have been studied, utilizing a mathematical model simulating actual neuron-capillary relationships. The model has been written as a system of equations in partial derivatives, its solution obtained by the net-point method. Regulatory variations of the capillary circulation rate in certain cerebral microregions have been shown to ensure similar changes in oxygen supply throughout the region. A drop of the pO2 level in a cerebral microregion with a rising O2 consumption by nerve cells is shown to be due, by 75 percent, to the increase of O2 consumption and by 25 percent, to the lower pO2 in the capillaries. Conversely, an increase in pO2 in microregions resulting from a lower O2 consumption by neurons is due by 75 percent, to a pO2 rise in capillaries and by 25 percent, at the expense of an O2 consumption decrease. In cerebral regions differing in capillary network density by 20 percent, changes in the conditions for oxygen supply to tissue are due by 1/3 to pO2 variations in the capillaries and by 2/3 to alterations in the diffusion distances.