Biomedical subjects

M J Silva

Publications and source records attributed to M J Silva.

At least 55 records · Page 3Linked to original sources

PubMed1998

Flexor digitorum profundus tendon-to-bone repair: an ex vivo biomechanical analysis of 3 pullout suture techniques.

Avulsions or distal transsections of the flexor digitorum profundus tendon are typically repaired by direct suture of tendon to the distal phalanx. The tensile properties of tendon-tobone repairs performed in cadaver fingers using 3 common suture patterns, the Bunnell, the Kessler, and the Kleinert techniques, were compared; 3-0 Prolene (monofilament) suture was used. Repairs done using the Kessler pattern had an average yield force of 30 N, compared to 39 N for the Bunnell and Kleinert patterns. Although these average yield forces were greater than that required for active digital flexion, considerable elongation (average, 8 mm) was measured at a force of 20 N. Data indicated that the safety factor achieved with these repair methods is lower than that achieved with modern tendon-to-tendon repair methods. The authors conclude that the common tendon-to-bone repair techniques are insufficient to withstand the higher forces associated with controlled passive and active motion rehabilitation methods that are currently advocated.

Aged↗

PubMed1998

Karyotype and chromosomal polymorphism of an undescribed Akodon from Central Brazil, a species with the lowest known diploid chromosome number in rodents.

The diploid chromosome number of 2n = 10 found in a new species of Akodon (Cricetidae, Rodentia) from two localities of the state of Mato Grosso, Central Brazil, represents the lowest chromosome number known for rodents. One female with nine chromosomes due to sex chromosome monosomy (2n = 9,XO) was also found. The karyotype comprises two large metacentric pairs (1 and 2); one large polymorphic pair (3), which could be acrocentric, submetacentric, or heterozygous as a result of a pericentric inversion; and one minute metacentric pair (4). The sex determination is of the XX/XY type. CBG, GTG, and RBG banding patterns, Ag-NORs, and meiotic data are presented. Fluorescence in situ hybridization with a (TTAGGG)7 repeat as a probe revealed interstitial telomeric bands (ITBs) in two of the large pairs.

Animals↗

PubMed1998

Changes in interstitial pressure and cross-sectional area of the cubital tunnel and of the ulnar nerve with flexion of the elbow. An experimental study in human cadavera.

The purpose of this study was to determine the relationship between the ulnar nerve and the cubital tunnel during flexion of the elbow with use of magnetic resonance imaging and measurements of intraneural and extraneural interstitial pressure. Twenty specimens from human cadavera were studied with the elbow in positions of incremental flexion. With use of magnetic resonance imaging, cross-sectional images were made at each of three anatomical regions of the cubital tunnel: the medial epicondyle, deep to the cubital tunnel aponeurosis, and deep to the flexor carpi ulnaris muscle. The cross-sectional areas of the cubital tunnel and the ulnar nerve were calculated and compared for different positions of elbow flexion. Interstitial pressures were measured with use of ultrasonographic imaging to allow a minimally invasive method of placement of the pressure catheter, both within the cubital tunnel and four centimeters proximal to it, at 10-degree increments from 0 to 130 degrees of elbow flexion. As the elbow was moved from full extension to 135 degrees of flexion, the mean cross-sectional area of the three regions of the cubital tunnel decreased by 30, 39, and 41 per cent and the mean area of the ulnar nerve decreased by 33, 50, and 34 per cent. These changes were significant in all three regions of the cubital tunnel (p < 0.05). The greatest changes occurred in the region beneath the aponeurosis of the cubital tunnel with the elbow at 135 degrees of flexion. The mean intraneural pressure within the cubital tunnel was significantly higher than the mean extraneural pressure when the elbow was flexed 90, 100, 110, and 130 degrees (p < 0.05). With the elbow flexed 130 degrees, the mean intraneural pressure was 45 per cent higher than the mean extraneural pressure (p < 0.001). Similarly, with the elbow flexed 120 degrees or more, the mean intraneural pressure four centimeters proximal to the cubital tunnel was significantly higher than the mean extraneural pressure (p < 0.01). Relative to their lowest values, intraneural pressure increased at smaller angles of flexion than did extraneural pressure, both within the cubital tunnel and proximal to it. With the numbers available, we could not detect any significant difference in intraneural pressure measured, either at the level of the cubital tunnel or four centimeters proximal to it, after release of the aponeurotic roof of the cubital tunnel.

Aged↗

PubMed1998

The effects of multiple-strand suture techniques on the tensile properties of repair of the flexor digitorum profundus tendon to bone.

We examined the effects of multiple-strand suture techniques on the tensile properties of flexor digitorum profundus tendon-to-bone repairs in a human cadaver finger model. Forty-four fingers were obtained from the cadavera of fifteen donors who had been an average of seventy-four years old (range, fifty-four to eighty-nine years old) at the time of death. Four or eight-strand proximal grasping sutures were secured to the distal phalanx of each finger with use of either a suture anchor or a dorsally placed button. There were four subgroups of eleven fingers each. We found that repairs performed with use of a dorsally placed button had greater yield force, ultimate force, and rigidity than those performed with use of an anchor and that repairs performed with eight strands had greater ultimate force than those performed with four strands. These differences were significant (p < 0.05). We could detect no differences among the four types of repairs with regard to the amount of relative tendon-bone elongation at twenty newtons of force. The repairs performed with eight strands and a dorsally placed button had an average yield force (and 95 per cent confidence interval) of 50.0 +/- 14.1 newtons, an average ultimate force of 68.5 +/- 14.6 newtons, an average rigidity of 744 +/- 327 newton/(millimeter/millimeter), and an average tendon-bone elongation of 3.4 +/- 0.7 millimeters at twenty newtons of force. Multiple-comparison testing showed that the eight-strand repairs performed with a dorsally placed button had greater ultimate force than the other three types of repairs as well as greater yield force and rigidity than the four and eight-strand repairs performed with a suture anchor.

Aged↗

PubMed1998

Integrin expression is upregulated during early healing in a canine intrasynovial flexor tendon repair and controlled passive motion model.

To explore crucial early molecular events involved in contact healing of the intrasynovial flexor tendon, integrin expression was evaluated at the transcriptional and post-transcriptional levels during the first two weeks following injury, repair and controlled passive motion in a canine model. Specifically, immunohistochemical and reverse transcription polymerase chain reaction (RT-PCR) techniques were employed to evaluate expression of the fibronectin, vitronectin and endothelial cell binding integrin receptor subunits alpha5, alphav and alpha6, along with the common beta1 subunit. The two techniques revealed increasing expression of the four subunits over the two week post-repair period. Immunohistochemistry revealed that beta1 and alpha5 expression was concentrated in the epitenon layer near the repair site and interiorly within the wound area, while alpha6 was associated with capillary-forming endothelial cells near the wound. RT-PCR and quantitation by NIH image analysis demonstrated peak messenger RNA expression of beta1 and alpha5 at ten days post-repair and peak expression of alpha6 and alphav at 15 days. The results in this study correlate well with previous results demonstrating increased fibronectin deposition and angiogenesis during the same time period in a similar injury/repair model.

Animals↗

PubMed1997

Load sharing between the shell and centrum in the lumbar vertebral body.

STUDY DESIGN: A finite element parametric analysis to investigate the relative load carrying roles of the shell and centrum in the lumbar vertebral body. OBJECTIVE: To address the issue of the structural role of the vertebral shell and clarify some of the contradictions raised by previous studies. SUMMARY OF BACKGROUND DATA: A number of experimental and finite element studies have attempted to quantify the relative structural roles of the shell and centrum, but these studies support no consensus on the relative contribution of the shell to vertebral body strength. METHODS: The authors developed finite element models to predict the fraction of the total compressive force acting on the lumbar vertebral body that is carried by the shell. Parametric variations were investigated to determine how the fraction of shell force was affected by changes in shell thickness, shell and centrum modulus, centrum anistropy, and loading conditions. RESULTS: The fraction of compressive force carried by the shell increased from approximately 0 at the endplate to approximately 0.2 at the mid-transverse plane for a typical case. The shell force was highly sensitive to the degree of anisotropy of the trabecular centrum but was relatively insensitive to changes in shell thickness and the ratio of shell-to-centrum elastic modulus. CONCLUSIONS: The conflicting conclusions of previous studies about the structural roles of the vertebral shell and centrum can be explained by differences in their methods. Our findings support the claims that the shell accounts for only approximately 10% of vertebral strength in vivo and that the trabecular centrum is the dominant structural component of the vertebral body.

Biomechanical Phenomena↗

PubMed1997

Modeling the mechanical behavior of vertebral trabecular bone: effects of age-related changes in microstructure.

Age-related reductions in the thickness and number of trabeculae in vertebral trabecular bone have been documented by several workers, yet the relative effects of these changes on mechanical properties are not known. We developed a two-dimensional model of human vertebral trabecular bone and investigated its mechanical behavior using finite element analysis. The stress-strain behavior, failure mode, and strain distributions predicted using the model were consistent with those observed for vertebral trabecular bone under compressive loading. Random reductions in the number of trabeculae reduced the modulus and strength of the models two to five times more than uniform reductions in the thickness of trabeculae that caused the same loss of bone volume. For example, randomly removing longitudinal trabeculae to achieve a reduction in density of 10% reduced the strength by approximately 70%, whereas removing the same amount of bone by uniformly reducing the thickness of the longitudinal trabeculae only reduced the strength by approximately 20%. For a simulation of aged bone, in which the thickness and number of trabeculae were reduced concurrently, the strength was 23% of its intact ("young") value. When the bone mass of the aged model was restored to its intact level by increasing the thickness but not the number of trabeculae, the strength increased by 60%, but was still only 37% of its intact value. These combined findings, based on a two-dimensional, idealized model of vertebral trabecular bone, illustrate the importance of maintaining trabecular number and suggest that it may not be possible to restore bone strength following a period of advanced bone loss if a substantial number of trabeculae have been resorbed. Thus, until treatments exist that can increase trabecular number, the most effective treatment strategy is to prevent the degradation of bone strength by maintaining the number of trabeculae at a healthy level.

Aged↗

PubMed1997

New karyotypes of two related species of Oligoryzomys genus (Cricetidae, Rodentia) involving centric fusion with loss of NORs and distribution of telomeric (TTAGGG)n sequences.

Comparative cytogenetics studies based on conventional staining, CBG, GTG, RBG-banding, Ag-NOR staining, fluorescence in situ hybridization (FISH) using telomere probes, length measurements, and meiotic data were performed on two related but previously undescribed cricetid species referred to as Oligoryzomys sp. 1 and Oligoryzomys sp. 2, respectively, from Pico das Almas (Bahia: Brazil) and Serra do Cipó (Minas Gerais: Brazil). Oligoryzomys sp. 1 had 2n = 46 and Oligoryzomys sp. 2 had 2n = 44, 44/45. Our banding data and measurements as well as FISH results support the hypothesis that the difference between the diploid numbers occurred by centric fusion events. The karyotypes had conspicuous and distinguishable macro- and micro-chromosomes, and we suppose that the largest pairs (1, 2, and 3) have evolved from a higher diploid number because of successive tandem fusion mechanisms.

Animals↗

PubMed1997

Predicting failure of thoracic vertebrae with simulated and actual metastatic defects.

Indications for operative treatment in spinal metastatic disease depend on estimates of vertebral loadbearing capacity. There are no noninvasive diagnostic tools for estimating vertebral loadbearing capacity in the presence of a metastatic lesion. Thus, relationships between vertebral failure load and measurements from computed tomography data were investigated to determine if measurements that account for defect size and bone density can predict loadbearing capacity better than can defect size alone. Cylindrical defects were created in thoracic vertebrae of 20 anatomic specimen spinal segments, with 10 other segments serving as controls. Five vertebrae with actual metastatic defects also were tested. Vertebrae were scanned using quantitative computed tomography, and the defect size and the axial rigidity of the midvertebral cross section were calculated using an image analysis program. The spinal segments were tested to failure using a combination of axial compression and anterior flexion. Linear regressions between axial rigidity and absolute failure load showed a high positive correlation, but there was no correlation between defect size and failure load. Axial rigidity may prove useful as a noninvasive assessment of vertebral loadbearing capacity in patients with spinal metastatic disease.

Aged↗

PubMed1996

Sister chromatid exchange analysis in workers exposed to noise and vibration.

Workers chronically exposed to whole-body vibration and noise are known to develop pathophysiological and psychological disturbances. The frequencies of sister chromatid exchanges (SCEs) and of cells with high frequencies of SCEs (HFCs) were analyzed in lymphocytes of 50 workers occupationally exposed to vibration and noise and of 34 controls. The exposed group included: individuals operating hand-vibrating tools (group 1), 'test-cell operators' (group 2) and 'run-up' operators (group 3) from an air base and helicopter pilots (group 4). The statistical analysis of the mean SCE count per cell was carried out by multiple regression analysis, comparing various predictor variables: exposure group, duration of exposure, age and cigarette consumption. Only cigarette consumption and exposure group were found to be significantly correlated with the mean SCE frequency. After allowing for the effects of smoking, the analysis indicates that: (1) there was no significant difference between group 1 and controls (p > 0.05); (2) the differences between group 2 and group 0, group 3 and group 0 and group 4 and group 0 were all highly significant (p < 0.001); (3) there was no significant difference between groups 2 and 3 (p > 0.05), nor between groups 2 and 3 combined and group 4 (p > 0.05); (4) exposure groups 2, 3 and 4 combined, had a significantly elevated mean SCE frequency compared to the control group (p < 0.0001). Statistical analysis of the proportion of HFCs was consistent with these results. Our data suggest that chronic exposure to whole-body vibration and noise may lead to an increase in the level of SCEs in man. The observed effects may not reflect a direct action of these physical agents on DNA. Alternative explanations may include some of the whole-body vibration and noise-induced or stress-induced pathophysiological alterations which may indirectly induce SCE formation.

Adult↗

PubMed1996

[Psychosocial approach in the care of hospitalized adults].

This article shows aspects of the hospitalized patient's psychosocial needs, pointing out how the knowledge of the patient's mental functions aids the nurse to identify disfunctions in this area. In the current structure of the Brazilian health system, which does not value the holistic vision of man, it is difficult for the nurse to give assistance to these aspects. This phenomenon is more subtle than biological aspects and, among other things, demands a lot of time and dedication from the nurse. To be attentive to the patient's psychosocial needs, represents an ethical aspect and the humanization in nursing assistance.

Ethics, Nursing↗

PubMed1994

Dose dependence of radiation-induced micronuclei in cytokinesis-blocked human lymphocytes.

Following selection of appropriate culture conditions, various experiments were conducted to evaluate the suitability of the micronucleus assay in cytokinesis-blocked lymphocytes for biological dosimetry purposes. A dose-effect relationship was determined, based on the frequency of micronuclei induced by various doses of 60Co gamma-rays. The data were best fitted to a linear-quadratic model. To validate the system, an attempt was made to estimate unknown dose levels from the yield of micronuclei, by inverting the derived dose-response function. It was concluded that the assay provides a valid approach for dose assessment. The size of radiation-induced micronuclei was measured in relation to the dose. A significant difference in the proportion of large micronuclei between high and low doses was observed. The chromosomal composition of micronuclei, detected by immunofluorescent staining of kinetochores, showed that only a small proportion of micronuclei contains kinetochore. The possible contribution of various mechanisms for the formation of large radiation-induced micronuclei is discussed.

Adult↗

PubMed1994

[Ebstein's anomaly of the tricuspid valve. Clinical tolerance up to 38 years of age and pregnancy].

Ebstein's Anomaly of the tricuspid valve has a variable degree of abnormality with a continuous change between mild and severe forms and, consequently, a variable clinical course. Pregnancy can also be well tolerated with a good fetal outcome. The authors present a case of a 44 year old woman with Ebstein's Anomaly of the tricuspid valve. Clinical evolution to the age of 38 and two term pregnancies in the third decade of life were well tolerated. The infants were normal and had an adequate development.

Adult↗

PubMed1993

Finite-element stress analysis of the normal and osteoporotic lumbar vertebral body.

A finite-element model of an isolated elderly human L3 vertebral body was developed to study how material properties and loading conditions influence end-plate and cortical-shell displacements and stresses. The model consisted of an idealized geometric representation of an isolated vertebral body, with a 1-mm-thick end plate and cortical shell. For uniform compression, large tensile stresses occurred all around the cortical shell just below the end plate as a result of bending of the cortical shell as it supported the end plate. Large tensile bending stresses also developed in the inferior surface of the end plate. Equal reductions in both trabecular and cortical bone moduli increased displacements but did not affect peak stresses. A 50% reduction in trabecular bone modulus alone increased peak stresses in the end plate by 74%. Elimination of the cortical shell reduced peak stresses in the end plate by approximately 20%. For nonuniform, anteriorly eccentric compression, peak stresses everywhere changed by less than 11% but moved to the anterior aspect. When material properties were adjusted to represent osteoporosis with disproportionate reductions in trabecular (50% decrease) and cortical (25% decrease) bone moduli, anterior compression increased peak stresses by up to 250% compared to uniform compression. If fractures are initiated in regions of large tensile stresses, the results from this relatively simple model may explain how central end-plate and transverse fractures initiate from uniform compression of the end plate. Furthermore, for anterior compression, disproportionate modulus reductions in trabecular and cortical bone may substantially increase end plate and cortical shell stresses, suggesting a cause of age-related spine fractures.

Aged↗

PubMed1993

[Involvement of the nervous system in leptospirosis. I. Evaluation of neurologic aspects].

From January 1st up to September 30th 1990, 77 patients with leptospirosis confirmed by laboratory studies were admitted at the Infectious and Parasitic Diseases Service of the Hospital das Clínicas of the Universidade Federal de Pernambuco. Clinical manifestations had sudden onset with presence of fever, headache, chills and muscle pains. Plurisystemic involvement was observed both in the icteric and in the non-icteric patients. The neurological exam was abnormal in 70 of the patients (90.91%). Neurological findings were essentially variable. Though in a transitory form, they allowed the observation of the following clinical forms: meningoencephalitis and polyneuritis in association, meningoencephalitis, polyneuritis, and subarachnoid hemorrhage.

Central Nervous System Diseases↗

PubMed1993

[Involvement of the nervous system in leptospirosis. II. Cerebrospinal fluid evaluation].

From January 1st up to September 30th 1990, 77 patients with leptospirosis diagnosis confirmed by laboratory studies were admitted at the Infectious and Parasitic Disease Service of the Hospital das Clínicas of the Universidade Federal de Pernambuco. The neurological exam was abnormal in 70 of the patients (90.91%). The cerebrospinal fluid (CSF) examination was carried out on 67 (87%) of the patients; it was abnormal in 64 (95.52%) yielding hypercytosis in the majority of cases. There was no difference in the CSF behavior in report to the several neurological forms nor in relation to the icteric or non-icteric forms of the disease. Significant were the results for the microscopic agglutination tests for leptospirosis in the CSF.

Central Nervous System Diseases↗

PubMed1993

[Involvement of the nervous system in leptospirosis. III. Immunologic reactions in the blood and cerebrospinal fluid].

From January 1st up to September 30th 1990, 77 patients with leptospirosis were admitted at the Infectious and Parasitic Diseases Service of the Hospital das Clínicas of the Universidade Federal de Pernambuco. The majority (64) were male patients, and average age was 28 years old. Serovars icterohaemorrhagic and canicola were the most frequent. CSF examination was performed in 67 (87.0%) patients and it was abnormal in 64 (95.52%). Micro-agglutination test for leptospirosis with live antigens was performed in CSF, as well as immunological tests for syphilis, cysticercosis and schistosomiasis for differential diagnosis. Concerning the serovar identification, results of microagglutination test for leptospirosis in CSF were significant considering the similitude of responses when compared to those found for blood samples.

Adolescent↗

PubMed1992

Finite element stress analysis of simulated metastatic lesions in the lumbar vertebral body.

A three-dimensional finite element model of a lumbar vertebral body was developed to study the effects of geometry, material properties and loading conditions on stresses in the presence of metastatic lesions. Parameters studied included location and size of the lesion, modulus of the cortical and trabecular bone within and near the lesion, generalized osteoporosis and load distribution. The results, expressed as ratios of peak values of displacement and stress, relative to a normal baseline case, indicated that the location of a defect which did not penetrate the cortex had a minor influence on the peak displacement and stresses, as did the presence of lesions occupying less than 40% of the volume of the vertebral centrum. A lesion occupying 40% of the centrum volume increased the endplate displacement by 2.9 times, the peak tensile stress in the cortical shell by 2.2 times, and the peak von Mises stress in the endplate by 2.8 times. When this lesion penetrated the cortex, these values increased to 3.8, 3.3 and 4.4 times, respectively. The most severe case involved a defect penetrating the anterior cortex, osteoporotic bone properties and anteriorly eccentric loading. In this case, the peak values increased to 8.4, 3.4 and 5.9 times their baseline values, respectively. The results are consistent with a model of the vertebral body as a stiff frame of cortical bone surrounding a relatively compliant core of trabecular bone. Only variations in geometry and properties large enough to lessen significantly the structural stiffness affect the peak stresses and displacements.(ABSTRACT TRUNCATED AT 250 WORDS)

Humans↗