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Biomedical subjects

A Simkin

Publications and source records attributed to A Simkin.

At least 19 recordsLinked to original sources

Intra-articular pressure measurements in patients with suddenly developing, severely limited mouth opening.

A condition of sudden, severe, and persistent limited mouth opening, which readily responds to arthrocentesis, is postulated to be the effect of a vacuum between disc and fossa in the upper compartment of the temporomandibular joint. In 16 patients with this condition, the negative intra-articular pressure was found to be significantly lower (mean, -82.6 +/- 25.4 mm Hg) than in the control group (mean, -7.7 +/- 2.5 mm Hg) (P less than .0001). It is suggested that the process underlying the vacuum effect starts with persistent pressure (eg, clenching) resulting in the viscoelastic disc being pressed flat against the fossa. Immediately on cessation of the pressure, the disc resumes its natural biconcave shape, but its rims remain fastened to the fossa. The consequent increased negative pressure in the closed space created firmly anchors the disc to the fossa and any attempt to elicit condyle and disc sliding will only stretch the joint capsule and cause pain. This, in turn, will reflexly prevent the pterygoid muscle from exerting sufficient force to pull the disc and thus release the vacuum. This chain of events may account for the severe and persistent limitation in jaw movement and for the easy reversal of the condition by simple nonsurgical treatment.

Adolescent

Risk factors for lateral ankle sprain: a prospective study among military recruits.

In a prospective study of risk factors for lateral ankle sprain among 390 male Israeli infantry recruits, a 18% incidence of lateral ankle sprains was found in basic training. There was no statistically significant difference in the incidence of lateral ankle sprains between recruits who trained in modified basketball shoes or standard lightweight infantry boots. By multivariate stepwise logistic regression a statistically significant relationship was found between body weight x height (a magnitude which is proportional to the mass moment of inertia of the body around a horizontal axis through the ankle), a previous history of ankle sprain, and the incidence of lateral ankle sprains. Recruits who were taller and heavier and thus had larger mass moments of inertia (P = 0.004), and those with a prior history of ankle sprain (P = 0.01) had higher lateral ankle sprain morbidity in basic training.

Analysis of Variance

Role of the calcaneal inclination in the energy storage capacity of the human foot--a biomechanical model.

The energy storage capacity of the human foot as a passive structure depends on both its geometry and elastic properties. The present study examines theoretically the relationship between the energy stored in the longitudinal arch and the inclination of the calcaneus, when a vertical load is applied. A simple two-dimensional model was used, consisting of two inclined rigid elements, hinged at the apex of the arch and connected by a horizontal tension spring at the bottom of the arch. The spring serves as the energy-storing element of the model, representing the foot plantar ligaments. The behaviour of the model was examined using both a linear and an exponential spring. It demonstrated that the stored energy depends strongly on the calcaneal inclination. For a given vertical load, the energy storage capacity is low at both large and small inclinations and rises markedly at an intermediate value. Assuming that the incidence of stress fractures during locomotion is affected by insufficient energy attenuation of the foot, this model provides an explanation for the higher prevalence of tibial and femoral stress fractures in subjects with high or low arches.

Biomechanical Phenomena

Acoustic emission from trabecular bone during mechanical testing: the effect of osteoporosis and osteoarthritis.

This study examines the relation between the nature of acoustic emission signals emitted from cancellous bone under compression and the mechanical properties of the tissue. The examined bone specimens were taken from 12 normal, 31 osteoporotic and six osteoarthritic femoral heads. The mechanical behaviour of the osteoporotic bone specimens was found to be significantly different from that of the normal specimens both in the pre-yield and post-yield ranges. In the osteoarthritic bones only the elastic behaviour was significantly different. The rates of acoustic events before yield and beyond it were found to be significantly higher both in the osteoporotic and osteoarthritic bone specimens. The average peak amplitude of the signals was also significantly higher in the diseased bones. Stepwise regression analysis showed that a combination of the acoustic emission parameters could significantly predict some mechanical properties of the bone. The energy absorbed during compression and the ultimate compressive stress of the specimens could be estimated from the rate of pre-yield acoustic events, the average amplitude of the signals and the rate of post-yield events. However, the explanation power of the acoustic emission parameters was only moderate. The nature of acoustic emission signals was thus demonstrated to be a potential tool for assessing bone quality.

Acoustics

Gain in mass density of bone following strenuous physical activity.

A group of 223 military recruits aged 18-21 years underwent strenuous physical training for a period of 14 weeks. The absolute bone density of the distal tibia in both lower limbs was measured before the training period and at its end. The density was determined by the Compton scattering technique, which has been developed in our laboratory; this method provides the bone mass of all bone constituents per unit volume. The distribution curve of the bone density in both tibiae shifted to higher values at the end of the training period. The mean bone density in the right and left tibia increased significantly by 7.5%. This study indicates that following an intensive physical exercise regime, a significant increase in the mass density of bone can be obtained in young adults within a short period.

Adolescent

The effect of swimming activity on bone architecture in growing rats.

The effect of non-habitual physical activity on bone architecture in the rat humeral shaft was examined. Two groups of rats were trained to swim for 1 h a day, for 20 weeks, at two training levels. The control group consisted of sedentary rats. Parameters of cross-sectional bone morphology (cross-section areas, principal area moments of inertia and their ratio) were used to evaluate the response of bone architecture to mechanical loading. The strength of bone was assessed by measuring the ultimate compressive force and stress. The cortical cross-section area and principal moments of inertia were found to be significantly higher in the swimming groups than in the controls. Examination of the ratio between the major and minor moments of inertia revealed a pronounced change in the shape of the bone cross-section which became more rounded following swimming training. The ultimate compressive force was significantly higher in the swimming rats while the changes in ultimate stress were not significant. Our results indicate a gain of bone strength due to increased periosteal apposition and modified bone tissue distribution. The marked changes in bone morphology are attributed to the different nature of the forces and moments exerted on the humerus during swimming compared to those prevailing during normal locomotion.

Adaptation, Physiological

The area moment of inertia of the tibia: a risk factor for stress fractures.

In a prospective study of stress fractures among Israeli infantry recruits, the area moment of inertia of the tibia was found to have a statistically significant correlation with the incidence of tibial, femoral and total stress fractures. Recruits with "low" area moments of inertia of the tibia were found to have higher stress fracture morbidity than those with "high" area moments of inertia. The best correlation was obtained when the area moment of inertia was calculated about the AP axis of bending at a cross-sectional level corresponding to the narrowest tibial width on lateral X-rays, a point which is at the distal quarter of the tibia. This finding indicates that bending forces about the approximate AP axis are an important causal factor for tibial and many other stress fractures. The bone's bending strength, or ability to resist bending moments, as measured by the area moment of inertia, helps determine risk to stress fracture.

Biomechanical Phenomena

Effect of swimming on bone growth and development in young rats.

The effect of chronic swimming on bone modelling was studied. Forty female Sabra rats (5 weeks old) were randomly assigned to the following experimental groups: 30 rats were trained to swim (water bath 35 +/- 1 degree C, one h daily, five times a week) for 20 weeks--20 of them loaded with lead weights (1% body weight) while the rest (10 animals) swam load free. Ten sedentary rats matched for age and weight served as controls. At the end of the twenty-week swimming period, all rats were sacrificed, both humeri bones were dissected and prepared for the following examinations: morphometric, bone density (BD), bone mineral content (BMC), compression tests and cross-sectional geometrical parameters, histomorphometry and biochemical analysis of minerals (Ca, Pi, Mg, Zn). All measured parameters were found to be significantly higher (P less than 0.05) in the swimming rats irrespective of load, as compared with the controls. Bone weight was higher by 19%, bone volume by 11%, bone length by 2.8%, cortical area by 16%, BD by 7% and BMC by 15%. The compression breaking force at the distal shaft of the humerus was higher by 24% in the trained group, while the ultimate compressive stress was not significantly different. Maximal and minimal moment of inertia at the distal diaphysis were 33.4 and 40% higher, respectively, for the swimming groups than the controls. Ca, Pi, Mg and Zn levels per total humeral bone were significantly higher in the exercising rats. The histomorphometry and cross-sectional data emphasize longitudinal and transversal growth. These data indicate that swimming exercise exerts a positive effect on bone growth and development in young rats.

Animals

Combined effect of foot arch structure and an orthotic device on stress fractures.

In a prospective study, quantitative measures of the structure of the longitudinal arch of the foot were established and related to the incidence of stress fractures in the bones of the lower limbs of military recruits. In addition, the role of a semirigid orthotic device (Langer military stress orthotic) in preventing stress fractures was evaluated as a function of the structure of the longitudinal arch. Femoral and tibial stress fractures were found to be more prevalent in the presence of feet with high arches, whereas the incidence of metatarsal fractures was higher in feet with low arches. The use of an orthotic device reduced the incidence of femoral stress fractures only in the presence of feet with high arches and the incidence of metatarsal fractures only among feet with low arches. The findings suggest that the normal foot with a low arch acts as a better shock absorber than the normal foot with a high arch, and that an orthotic device may improve the shock absorbing capacity of the arch.

Adult

An analysis of the biomechanical mechanism of tibial stress fractures among Israeli infantry recruits. A prospective study.

The biomechanical mechanism of tibial diaphyseal stress fractures was studied prospectively in a group of 286 Israeli recruits. Before training each recruit had roentgenograms taken of his tibiae. Measurements of total tibial and cortical widths in the anteroposterior (AP) and mediolateral planes were made on these roentgenograms at two levels: at the point of the narrowest tibial width on AP roentgenograms (Level 1) and at the point of the narrowest width on lateral roentgenograms (Level 2). The tibial cross section was idealized as an eccentric ellipse within an ellipse, and on the basis of measurements taken from the roentgenograms, the cross-sectional area (compression strength), area moments of inertia about AP and mediolateral axes of bending (bending strength), and the area polar moment of inertia (torsional strength) were calculated for each cross section. During the course of 14 weeks of training, 20% of the recruits sustained tibial diaphyseal stress fractures, all of which were along the medial cortex. Using stepwise logistic regression analysis the tibia's bending strength along an AP axis of bedding at Level 2 was found to be the most significant factor determining whether or not a recruit would develop a tibial stress fracture.

Adult

Increased trabecular bone density due to bone-loading exercises in postmenopausal osteoporotic women.

A program of diverse and dynamic loading exercises of the distal forearm, a common site of osteoporotic fractures, was applied three times a week for 5 months to 14 postmenopausal osteoporotic women. Two parameters were used to assess the effect of the exercises on bone mass. The mass density of bone (g/cm3) was measured by the Compton scattering technique. The bone mineral content (g/cm2) was measured by single photon absorptiometry. Both measurements were taken at the same location in the distal radius 1 year prior to the exercise period, at its beginning, and at its end, in both the exercised group and a matched control group of 26 osteoporotic women. During the exercise period the mean bone density decreased by 1.9% in the control group whereas it increased by 3.8% in the exercise group. The bone mineral content results did not demonstrate any significant trend over the whole period of the study. It is concluded that the trabecular bone tissue in the distal radius of postmenopausal osteoporotic women responds favorably to dynamic and diverse bone stressing exercises even in the seventh decade of life.

Adipose Tissue

Stress fractures and tibial bone width. A risk factor.

A prospective study of 295 infantry recruits has shown that the mediolateral width of the tibia measured radiographically at each of three different levels in the bone had a statistically significant correlation with the total incidence of stress fractures as well as with those in the tibia alone or the femur alone. A narrow tibial width was shown to be a risk factor, but cortical thickness was not found to be significant.

Femoral Fractures

Dynamic bone loading exercises for postmenopausal women: effect on the density of the distal radius.

A set of dynamic bone loading exercises for the distal forearm, designed for high rates of loading, within physiologic range, and diversity of strain regime, was applied to a group of postmenopausal osteoporotic women. The effect of five months of three weekly sessions, 50 minutes each, on the bone status was studied by measuring the bone density at the distal radius by the Compton scattering technique. A group of 14 women who participated in the program and an inactive group of 26 women were examined one year prior to the study, at its beginning and at its end. During the year preceding the exercise program the mean bone density in both groups decreased significantly. During the exercise period the bone density of the exercise group increased by 3.8% while that of the control group continued to decline. This study demonstrates that an appropriate physical activity regime may be effective as a prophylactic treatment for postmenopausal bone loss.

Absorptiometry, Photon

External rotation of the hip. A predictor of risk for stress fractures.

External rotation of the hip was found to have a statistically significant correlation with the incidence of stress fractures, in a prospective study among Israeli infantry recruits of possible anthropomorphic predictors of risk for stress fractures. Soldiers in whom hip external rotation was greater than 65 degrees were at a higher risk for tibial and total stress fractures than those with external rotations of less than 65 degrees. The mean hip external rotation in this study of 57 degrees +/- 9.3 degrees was higher than in statistics reported in the American literature. The existence of a larger subpopulation with hip external rotation greater than 65 degrees may partially explain why the reported incidence of stress fractures in the Israeli army is higher than that of the American army.

Adolescent

Effect of intense physical activity on the bone-mineral content in the lower limbs of young adults.

The effect of intense physical training on the bone-mineral content of young adults who are unaccustomed to physical activity has not yet been established. In this study, 268 male recruits, eighteen to twenty-one years old, were evaluated before and after fourteen weeks of strenuous physical training. The bone-mineral content of both legs at the level of the distal third of the tibia in each individual was measured using single-beam photon absorptiometry. The subjects started their training with equal values for bone-mineral content in both legs. During the training period, the average bone-mineral content of the left leg increased by 11.1 per cent and that of the right leg, by 5.2 per cent. In the group of subjects who did not complete the training course, mainly because they incurred stress fractures, the increase in bone-mineral content was significantly less than the increase in those who completed the program. This study indicated that in young adults a high level of loading of bone results in either a stress fracture or a rapid increase in bone-mineral content.

Adolescent