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Biomedical subjects

A S Landsman

Publications and source records attributed to A S Landsman.

17 recordsLinked to original sources

Onset and saturation of ion heating by odd-parity rotating magnetic fields in a field-reversed configuration.

Heating of figure-8 orbit ions by odd-parity rotating magnetic fields (RMF(O)) applied to an elongated field-reversed configuration (FRC) is investigated. The largest energy gain occurs at resonances (s congruent to omega(R)/omega) of the RMF(O) frequency, omega(R), with the figure-8 orbital frequency, omega, and is proportional to s2 for s-even resonances and to s for s-odd resonances. The threshold for the transition from regular to stochastic orbits explains both the onset and saturation of heating. The FRC magnetic geometry lowers the threshold for heating below that in the tokamak by an order of magnitude.

Journal Article↗

Off-loading neuropathic wounds associated with diabetes using an ankle-foot orthosis.

Patients with chronic diabetes have a broad spectrum of associated peripheral neurologic deficits that culminate in an increased susceptibility to ulcer formation. The authors focus on the use of the ankle-foot orthosis as both a treatment and a definitive solution for achieving ulcer closure and for minimizing the chance of ulcer recurrence in the ambulatory patient. An analysis of the pathologic forces encountered, and the solution achieved with the ankle-foot orthosis is presented. In addition, the results from a clinical pilot study in subjects with recalcitrant ulcers secondary to Charcot's neuroarthropathy are presented.

Ankle↗

The biochemical pathway mediating the proliferative response of bone cells to a mechanical stimulus.

Calvarial bone cells of rats were subjected to either a cyclic biaxial strain of 0.17 per cent (1700 microstrain) or a hydrostatic pressure of 2.5, five, or ten pounds per square inch (17.2, 34.5, or sixty-nine kilopascals). The frequency was held constant at one hertz for both types of mechanical stimulation. When cultured bone cells that had been subjected to a cyclic biaxial strain for two hours were harvested twenty-two hours later, it was found that the level of prostaglandin E2 had increased significantly (p < 0.01) as had cellular proliferation (p < 0.01), as indicated by the incorporation of [3H]-thymidine. The addition to the medium of indomethacin, an inhibitor of prostaglandin synthesis, at a ten-micromolar concentration significantly inhibited (p < 0.01) the increase in prostaglandin E2 synthesis but had no effect on the strain-induced increase in cellular proliferation, as indicated by the incorporation of [3H]-thymidine. Twenty-four hours after exposure to the same cyclic biaxial strain for thirty seconds, other cultured bone cells showed a significant increase in the level of cytoskeletal calmodulin (p < 0.05) and in the DNA content (p < 0.05). N-(6-aminohexyl)-5-chloro-1-naphthalene-sulfonamide (W-7), a calmodulin antagonist, was added to the medium at a one-micromolar concentration, which had been shown to have no effect on the increase in the DNA content of control cells; W-7 completely blocked the increase in the level of cytoskeletal calmodulin and in the DNA content in the cells that were subjected to a cyclic biaxial strain. The bone cells subjected to a hydrostatic pressure showed a dose-dependent increase in the concentration of cytosolic Ca2+, as measured with Fura 2-AM, a fluorescent indicator of intracellular calcium. With a pressure of ten pounds per square inch (sixty-nine kilopascals), the increase in the concentration of cytosolic Ca2+ was nearly eight times greater than that at 2.5 pounds per square inch (17.2 kilopascals) (126 +/- 15.2 compared with 16 +/- 8.0 nanomolar, mean and standard deviation). The addition to the medium of neomycin, an inhibitor of the inositol phosphate cascade, at a ten-millimolar concentration completely blocked the increase in the concentration of cytosolic Ca2+ in these cells; this concentration of neomycin had been shown to have no effect on proliferation in control bone cells. There was also a dose-dependent relationship between the duration of the stimulus and the cellular proliferation. Remarkably, one cycle of pressure at ten pounds per square inch (sixty-nine kilopascals) and a frequency of approximately one hertz produced a 57 per cent increase in the incorporation of [3H]-thymidine at twenty-four hours (p < 0.001). From these findings, we hypothesized that the inositol phosphate cascade-cytosolic Ca(2+)-cytoskeletal calmodulin system plays a dominant role in the signal transduction of a mechanical stimulus into increased proliferation of bone cells, at least under the conditions reported here.

Animals↗

Research perspectives in first metatarsal osteotomy and fixation stability.

Well-designated research is required to provide clinical guidance by validation of old and new methods. Variables, including technologic advancement in surgical techniques, diagnosis, shoe design, and immobilization all contribute to the challenge of investigating surgical procedures of the foot. This article highlights some of the relevant research pertaining to first metatarsal osteotomies and internal fixation and provides direction for potential, future research. Numerous aspects about the research techniques involved are discussed.

Biomechanical Phenomena↗

1995 William J. Stickel Gold Award. High strain rate tissue deformation. A theory on the mechanical etiology of diabetic foot ulcerations.

Foot ulcerations are one of the most common and dangerous complications associated with chronic diabetes mellitus. Many studies have focused on neuropathy, in conjunction with elevated ground reactive forces, as the principal cause of these ulcerations. The authors discuss the mechanical cause of diabetic ulcerations at the cellular level. It is hypothesized that increased rate of tissue deformation associated with foot slap secondary to progressive motor neuropathy is the actual culprit, and not the magnitude of local pressure applied. The authors present a cellular model that shows that high rates of tissue deformation may result in elevated intracellular calcium concentrations, which may lead to cellular death, while comparable loads gradually applied do not. Furthermore, there is no significant difference in the response observed at 5 psi and 10 psi. Based on these findings, it is hypothesized that techniques such as ankle foot orthoses, which control the velocity of foot strike, may be useful in treating diabetic foot ulcerations.

Awards and Prizes↗

Mechanical testing of materials and the material-tissue interface.

This article discusses various aspects of mechanical testing for podiatric applications. Included is a brief overview of the terminology used to describe a variety of mechanical tests, suggestions for the preparation and storage of specimens, and an overview of various mechanical testing techniques that have been used to collect data on internal fixation and osteotomy stability.

Biomechanical Phenomena↗

Economic implications of implant selection.

Numerous types of implantable biomaterials are available for a variety of applications. Although much has been written about the physical properties or biocompatibility issues, very few papers have focused on the economic feasibility of these materials. This article assesses financial factors associated with first metatarsophalangeal total joint prostheses.

Adult↗

Applications of biodegradable lactides and glycolides in podiatry.

A comprehensive review of the clinical applications and the properties of biodegradable lactide and glycolides is presented. Specific podiatric and other orthopaedic applications of polylactic acid, polyglycolic acid, and their copolymers are reviewed also. The authors then discuss numerous biocompatibility studies, basic manufacturing techniques, sterilizations/storage of the polymers, and the development of biodegradable polymers.

Animals↗

Peripheral skeletal tuberculosis of the foot. Etiologic review and case study.

Mycobacterium tuberculosis is a disease that is being reported much more frequently in the literature, primarily because of the rapid increase in severely immunocompromised patients, but also because of the development of multiple drug-resistant tuberculosis strains. Extrapulmonary M. tuberculosis is also reportedly on the rise, and may manifest itself at a number of sites in the body, including the peripheral skeleton. It is important to recognize peripheral tuberculosis osteomyelitis early because early treatment can effectively eliminate long-term morbidity. The authors present a review of the diagnosis and treatment of extrapulmonary M. tuberculosis, with special emphasis on peripheral skeletal tuberculous osteomyelitis. A case study involving peripheral skeletal tuberculous osteomyelitis in the foot is presented.

Adult↗

Arthroscopic lateral ankle stabilization.

The indications for arthroscopic stabilization include those patients with isolated ruptures or strains of the ATF. The procedure is particularly convenient for patients with ankle joint pathology that is already most commonly treated arthroscopically, such as chronic instability, in which inflamed synovium or meniscoid bodies are to be excised. Although significant stability can be gained with this technique, injuries that result in damage to the calcaneofibular ligament may require additional open surgery, since this ligament cannot be visualized arthroscopically. However, the anchoring techniques described in this article can still be used when performing open surgery.

Ankle Injuries↗

Austin bunionectomy with 3M Staplizer fixation. An assessment of 20 cases.

The authors describe a new approach to Austin bunionectomy fixation using the 3M Staplizer. Twenty cases are examined retrospectively for various postoperative results. The Staplizer technique is compared and contrasted to other modes of fixation that are described in the literature. The authors suggest that internal fixation with the Staplizer provides decreased risk of infection, early ambulation, high patient acceptance, and fewer complications. A detailed description of the technique used to insert the staples is presented, and mechanical analysis of the osteotomy and optimal staple position are discussed.

Hallux Valgus↗

Myxoid liposarcoma of the ankle.

Liposarcomas are among the most common soft tissue sarcomas, but are rarely found in the foot or ankle. Certain types of liposarcomas, which range from well-localized low-grade entities to highly aggressive neoplastic lesions, may resemble common benign soft tissue lesions. Myxoid liposarcoma is the most common type of liposarcoma and is important to recognize and differentiate from a benign soft tissue lesion because it may be a limb-threatening and/or life-threatening tumor. A thorough literature review and perplexing case study of myxoid liposarcoma of the ankle is presented.

Adult↗

Can synthetic bone models approximate the mechanical properties of cadaveric first metatarsal bone?

The authors evaluated the value of plastic foam models for approximating the mechanical properties of cadaveric bone. Three mechanical tests (3-point bending, cantilevered load to failure, screw push-out) were performed to evaluate the performance of fresh (nonpreserved) human metatarsals, plastic solid foam anatomic models, and modified anatomic models. The test results indicate that plastic models may simulate the mechanical properties of natural bone in tests in which only elastic deformation is achieved. However, under circumstances where load is applied until material failure, the mechanical properties vary dramatically. These tests indicate that specific goals should be established with these results in mind, when planning mechanical testing studies with either plastic or cadaveric models.

Biomechanical Phenomena↗

The effects of a moderate and high dose of vitamin C on wound healing in a controlled guinea pig model.

The purpose of this pilot study was to investigate the effect of vitamin C on wound healing in a controlled animal study. Twenty male guinea pigs were divided into two groups and were maintained on one of two commercially prepared diets: 1) supplemented with a moderate dose of vitamin C, or 2) supplemented with a high dose of vitamin C. After 6 weeks, a dorsal incision was made on the back of each of the animals. The incision was closed by primary intention as the animals continued on their respective diets until they were sacrificed. At the time of testing, either 10 days or 21 days postoperatively, the animals' skin was excised around the original incision using a metal template. A second skin sample was excised from each animal from an area adjacent to the original skin incision. This was done in order to determine the breaking force of the intact unaffected skin. Tension studies were performed to measure and compare the integrity and strength of the healing incisions. Biopsies were also sent for histopathologic analysis. The study presented here focused on whether or not increases in dietary vitamin C may improve the strength of a skin wound postoperatively. Although the sample size was small, the data suggest that a trend may exist in which increased vitamin C intake prior to and after surgery may result in faster recovery of skin integrity and strength across the wound. Although the difference between the groups is not statistically significant, the data clearly indicate that the animals receiving the higher dose of vitamin C demonstrated greater wound integrity than those receiving the moderate dose of the vitamin.

Animals↗

An assessment of oblique base wedge osteotomy stability in the first metatarsal using different modes of internal fixation.

The modified Juvara osteotomy is a classic oblique base wedge osteotomy of the first metatarsal and is often used to reduce hallux valgus deformity. However, complications attributed to osteotomy instability and currently available modes of osteosynthesis are common. The authors have developed a technique that enables them to quantitatively and objectively evaluate the stability of this osteotomy when various modes of internal fixation are used. Stability testing was performed on fresh, previously frozen human cadaveric specimens using engineering principles. Results indicate that there is no statistically significant difference in stability between crossed 0.062-inch Kirschner wire fixation and internal fixation using a single 3.5-mm. cancellous screw. The tests also indicate that both of these techniques are superior to two 2.7-mm. cortical screws for stability.

Biophysical Phenomena↗

A new radiographic classification for hallux limitus.

A new classification system for hallux limitus that is based on objective radiographic changes around the first metatarsophalangeal joint is introduced. The new system is demonstrated in a 3-year, 110-patient retrospective study. From the information gathered, a surgical algorithm has been developed. Statistical analysis demonstrates an 87% satisfaction rate with the recommended surgical algorithm.

Adolescent↗