Biomedical subjects

David M Rempel

Publications and source records attributed to David M Rempel.

8 recordsLinked to original sources

PubMed2006

VEGF, VEGFR-1, and CTGF cell densities in tendon are increased with cyclical loading: An in vivo tendinopathy model.

Tendon injuries can occur in athletes and workers whose tasks involve repetitive, high-force hand activities, but the early pathophysiologic processes of tendinopathy are not well known. The purpose of this animal study was to evaluate the effects of cyclical tendon loading on the densities of cells producing growth factors such as vascular endothelial growth factor (VEGF), its receptor, vascular endothelial growth factor receptor 1 (VEGFR-1), and connective tissue growth factor (CTGF) in the Flexor Digitorum Profundus (FDP) tendon at the epicondyle. The FDP muscles of nine New Zealand rabbits were electrically stimulated to contract repetitively for 80 h of cumulative loading over 14 weeks. The contralateral limbs served as controls. The tendons at the medial epicondyle insertion sites were harvested, and sections were immunostained with antibodies directed against VEGF, VEGFR-1, or CTGF. Positive-staining cells were counted in six regions of interest: three along the enthesis, and three corresponding regions 1500 microns distal to the enthesis. VEGF (p = 0.0001), VEGFR-1 (p = 0.046), and CTGF (p = 0.0001) cell densities were increased in the tendon of the loaded limb compared to the nonloaded limb. In addition, regional differences in VEGF, VEGFR-1, and CTGF cell densities were found. VEGF, VEGFR-1, and CTGF are increased in tendon experiencing cyclical loading and may play a role in the early vascular changes in the progression to tendinosis.

Animals↗

PubMed2006

Long-term cyclical in vivo loading increases cartilage proteoglycan content in a spatially specific manner: an infrared microspectroscopic imaging and polarized light microscopy study.

Understanding the changes in collagen and proteoglycan content of cartilage due to physical forces is necessary for progress in treating joint disorders, including those due to overuse. Physical forces in the chondrocyte environment can affect the cellular processes involved in the biosynthesis of extracellular matrix. In turn, the biomechanical properties of cartilage depend on its collagen and proteoglycan content. To understand changes due to physical forces, this study examined the effect of 80 cumulative hours of in vivo cyclical joint loading on the cartilage content of proteoglycan and collagen in the rabbit metacarpophalangeal joint. The forepaw digits of six anesthetized New Zealand White adult female rabbits were repetitively flexed at 1 Hz with an estimated joint contact pressure of 1 to 2 MPa. Joints were collected from loaded and contralateral control specimens, fixed, decalcified, embedded, and thin-sectioned. Sections were examined under polarized light microscopy to identify and measure superficial and mid zone thicknesses of cartilage. Fourier Transform Infrared microspectroscopy was used to measure proteoglycan and collagen contents in the superficial, mid, and deep zones. Loading led to an increase in proteoglycan in the cartilage of all six rabbits. Specifically, there was a 46% increase in the cartilage deep zone (p = 0.003). The collagen content did not change with loading. Joint loading did not change the superficial and mid zone mean thicknesses. We conclude that long-term (80 cumulative hours) cyclical in vivo joint loading stimulates proteoglycan synthesis. Furthermore, stimulation is localized to cartilage regions of high hydrostatic pressure. These data may be useful in developing interventions to prevent overuse injuries or in developing therapies to improve joint function.

Animals↗

PubMed2005

Evidence of tendon microtears due to cyclical loading in an in vivo tendinopathy model.

Tendon injuries at the epicondyle can occur in athletes and workers whose job functions involve repetitive, high force hand activities, but the early pathophysiologic changes of tendon are not well known. The purpose of this study was to evaluate early tendon structural changes, specifically the formation of microtears, caused by cyclical loading. The Flexor Digitorum Profundus (FDP) muscle of nine New Zealand White rabbits was stimulated to contract repetitively for 80 h of cumulative loading over 14 weeks. The contralateral limb served as a control. The tendon at the medial epicondyle insertion site was harvested, sectioned, and stained. Microtears were quantified, using image analysis software, in four regions of the tendon, two regions along the enthesis and two distal to the enthesis. The tear density (loaded: 1329+/-546 tears/mm(2); unloaded: 932+/-474 tears/mm(2)) and mean tear size (loaded: 18.3+/-6.1 microm(2); unloaded: 14.0+/-4.8 microm(2)) were significantly greater in the loaded limb (p<0.0001) across all regions compared to the unloaded contralateral limb. These early microstructural changes in a repetitively loaded tendon may initiate a degenerative process that leads to tendinosis.

Animals↗

PubMed2005

Upper extremity mononeuropathy among engineers.

OBJECTIVES: The objectives of this study were to estimate the prevalence of mononeuropathy at the wrist among engineers who use computers and to identify associated risk factors. METHODS: This is a cross-sectional study of 202 engineers using questionnaires and electrophysiological nerve testing. The definition for median or ulnar mononeuropathy required the combination of distal upper extremity discomfort and abnormal distal motor latency. RESULTS: The prevalence of neuropathy at the wrist among engineers was 10.3% (right median), 3.4% (left median), 1.8% (right ulnar), and 2.9% (left ulnar). Logistic regression analysis identified three variables with positive associations (body mass index, hours of computer use, and antihypertensive medication) and three variables with negative associations (typing speed, driving hours, total break time). CONCLUSIONS: Mononeuropathies at the wrist occur among computer-using engineers and are related to a number of factors, including hours of computer use.

Adult↗

PubMed2005

Thumb force and muscle loads are influenced by the design of a mechanical pipette and by pipetting tasks.

Work involving pipetting is associated with elevated rates of musculoskeletal disorders of the hand and wrist. The purpose of this study was to quantify thumb loading and muscle activity and determine if they varied among pipetting tasks. Fourteen experienced participants performed nine pipetting tasks while surface electromyography was measured for the extensor pollicis brevis, abductor pollicis longus, flexor pollicis longus, and abductor pollicis brevis muscles. For five tasks, participants used a pipette instrumented to measure the thumb force applied to the plunger. High-precision tasks significantly increased static muscle activity but reduced peak thumb force on average 5% as compared with low-precision tasks. Pipetting high-viscosity fluids increased peak thumb forces on average 11% as compared with pipetting low-viscosity fluids. Use of a latch pipette increased muscle activity of three muscles. We conclude that pipette design and pipetting tasks can influence applied thumb force and muscle activity. We recommend that pipettes be designed to limit applied peak forces and that pipette users be instructed in use patterns that will reduce applied forces. Actual or potential applications of this research include modifications to pipette designs and worker training in order to reduce hand pain associated with pipetting.

Adult↗

PubMed2004

Upper extremity pain and computer use among engineering graduate students.

BACKGROUND: The objective of this study was to investigate risk factors associated with persistent or recurrent upper extremity and neck pain among engineering graduate students. METHODS: A random sample of 206 Electrical Engineering and Computer Science (EECS) graduate students at a large public university completed an online questionnaire. RESULTS: Approximately 60% of respondents reported upper extremity or neck pain attributed to computer use and reported a mean pain severity score of 4.5 (+/-2.2; scale 0-10). In a final logistic regression model, female gender, years of computer use, and hours of computer use per week were significantly associated with pain. CONCLUSIONS: The high prevalence of upper extremity pain reported by graduate students suggests a public health need to identify interventions that will reduce symptom severity and prevent impairment.

Adult↗

PubMed2004

Entrapment neuropathies: pathophysiology and pathogenesis.

A number of theories of pathogenesis of entrapment neuropathy, due to repeated loading, have been proposed and these theories are being actively explored with animal models. Tubes placed loosely around peripheral nerves cause delayed onset, chronic pain and changes in nerve morphology including nerve sprouting. Balloons placed around or adjacent to the nerve and inflated to low pressures, rapidly produce endoneurial edema and a persistent increase in intraneural pressure. The same models demonstrate long-term changes such as demyelination and fibrosis. The applied pressure causes a decrement in nerve function and abnormal morphology in a dose-dependent manner that appears to be linked to the amount of endoneurial edema. A new model involving involuntary, repetitive fingertip loading for 6 h per week for 4 weeks has caused slowing of nerve function at the wrist similar to that seen in patients with carpal tunnel syndrome. These models have the potential to reveal the mechanisms of injury at the cellular and biochemical level and address questions about the relative importance of various biomechanical factors (e.g. peak force, mean force, force rate, duty cycle, etc.). In addition, these models will allow us to evaluate various prevention, treatment and rehabilitation protocols.

Animals↗

PubMedDate not supplied

Pathomechanics of peripheral nerve loading. Evidence in carpal tunnel syndrome.

Peripheral nerve injury is a common occurrence, with carpal tunnel syndrome (CTS) receiving the most attention. Nerve dysfunction associated with compression syndromes results from an interruption or localized interference of microvascular function due to structural changes in the nerves or surrounding tissues. This article reviews the physiologic, pathophysiologic, and histologic effects of compressing peripheral nerves in animal models, and then examines the evidence for similar processes in humans using CTS as a model.

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