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Biomedical subjects

W W Lu

Publications and source records attributed to W W Lu.

52 records · Page 3Linked to original sources

Prevention of spinal cord injury with time-frequency analysis of evoked potentials: an experimental study.

OBJECTIVES: To verify the applicability and validity of time-frequency analysis (TFA) of evoked potential (EP) signals in detecting the integrity of spinal cord function and preventing spinal cord injury. METHODS: The spinal cord was simulated during surgery in 20 mature rats by mechanically damaging the spinal cord. Cortical somatosensory evoked potential (CSEP), spinal somatosensory evoked potential (SSEP), cortical motor evoked potential (CMEP), and spinal cord evoked potential (SCEP) were used to monitor spinal cord function. Short time Fourier transform (STFT) was applied to the CSEP signal, and cone shaped distribution (CSD) was used as the TFA algorithm for SSEP, CMEP, and SCEP signals. The changes in the latency and amplitude of EP signals were measured in the time domain, and peak time, peak frequency, and peak power were measured in the time-frequency distribution (TFD). RESULTS: The TFDs of EPs were found to concentrate in a certain location under normal conditions. When injury occurred, the energy decreased in peak power, and there was a greater dispersion of energy across the time-frequency range. Strong relations were found between latency and peak time, and amplitude and peak power. However, the change in peak power after injury was significantly larger than the corresponding change in amplitude (p<0.001 by ANOVA). CONCLUSIONS: It was found that TFA of EPs provided an earlier and more sensitive indication of injury than time domain monitoring alone. It is suggested that TFA of EP signals should therefore be useful in preventing spinal cord injury during surgery.

Algorithms↗

[Effect of Rg2 on hemodynamics of hemorrhagic shock and its antioxidation in dogs].

OBJECTIVE: To investigate the protective effect of Rg2 on hemodynamics of hemorrhagic shock and its antioxidant properties. METHOD: Twenty mongrel dogs were randomly divided into Rg2 group, Shen Mai group and control group. The hemorrhagic shock model was built in all dogs by artery bleeding and mean arterial blood pressure was kept < 5.33 kPa for 4.5 hours. Rg2 0.5-1.0 mg.kg-1 and Shen Mai 100 mg.kg-1 were intravenously administered after hemorrhagic shock appeared. RESULT: Rg2 significantly enhanced blood pressure, LVSP and +/- dp/dtmax on hemorrhagic shock dogs who had lost compensation ability. Rg2 0.5-1.0 mg.kg-1 could reduce serum MDA, increase superoxide dismutase activity and prolong survival rate of dogs after shock. All these data have statistically significant when compared to control group (P < 0.05, P < 0.01, P < 0.001). CONCLUSION: These results suggest that Rg2 is more potent and effective than Shen Mai in improving hemodynamic state and activiting SOD on hemorrhagic shock dogs.

Animals↗

The effects of cyclic loading on pull-out strength of sacral screw fixation: an in vitro biomechanical study.

STUDY DESIGN: The pull-out strength of sacral screw fixation after cyclic loading was tested using young human cadaveric specimens. OBJECTIVES: To evaluate the effects of fatigue loading on the pull-out strength of medial and lateral unicortical and bicortical sacral screws and to correlate the pull-out strength with sacral bone density and the screw insertion torque. SUMMARY OF BACKGROUND DATA: The immediate biomechanical effects of depth of penetration, screw orientation, and bone density on sacral screw fixation have been studied in aged cadaveric specimens. The effect of cyclic loading on the pull-out strength of sacral screw fixation is unknown, however, and data from young specimens is rare. METHODS: Eleven fresh specimens of human sacrum were used in this study. Bone mineral density at the vertebral body and the ala were determined by peripheral quantitative computed tomography. Seven-millimeter compact Cotrel-Dubousset sacral screws were inserted into the sacrum anteromedially and anterolaterally, both unicortically and bicortically, and the insertion torque for each screw was measured. Cyclic loading from 40 to 400 N was applied to each screw at a frequency of 2 Hz up to 20,000 cycles. Pull-out tests were conducted after completion of the fatigue tests. RESULTS: The average bone density was 0.38 +/- 0.08 g/mL at the S1 body and 0.24 +/- 0.05 g/mL at the S1 ala. The insertion torque and average pull-out force after cyclic loading were significantly higher for bicortical fixation than for unicortical fixation for a particular screw alignment. The pull-out strength and insertion torque of medially oriented fixation was always higher than that for lateral fixation, however, regardless of whether the insertion was unicortical or bicortical. The pull-out force of unicortical and bicortical medial screw fixations after cyclic loading showed significant linear correlations with both the insertion torque and the bone mineral density of the S1 body. CONCLUSIONS: In a young population, screw orientation (anterolateral or anteromedial) was more important in determining pull-out strength than screw depth (unicortical or bicortical) after fatigue loading, anteromedially directed screws being significantly stronger than laterallyplaced screws. Bone mineral density of the S1 body andinsertion torque were good preoperative and intraoperative indicators of screw pull-out strength.

Adult↗

Variation in bone mineral density of the sacrum in young adults and its significance for sacral fixation.

STUDY DESIGN: Bone mineral density variations throughout the sacrum were measured and correlated with sacral screw insertion torque. OBJECTIVE: To quantify bone mineral density variations within the S1 body and ala of young human specimens, especially along the pathways of sacral screws, and to examine the relation between sacral screw fixation and bone mineral density. SUMMARY OF BACKGROUND DATA: Vertebral bone quality is an essential factor in anterior or posterior screw fixation of the spine. Several studies have been conducted regarding bone mineral density variations in the cervical and thoracolumbar spine. However, such variations in bone mineral density in the sacrum have not been well documented. METHODS: The bone mineral density of 13 sacral specimens from young male cadavers (mean age, 31 years) was measured using highly accurate quantitative computed tomography. Variations in bone mineral density were measured in five transverse layers and seven vertical columns within the S1 body, and in four transverse layers and six vertical columns within the ala. The sacral screw insertion torque was measured (unicortical and bicortical), and the correlation with bone mineral density was calculated. RESULTS: The mean bone mineral density of the S1 body was 381.9 +/- 59 mg/cm3, which was 31.9% higher than that of the sacral ala (mean, 296.9 +/- 86 mg/cm3) (P < 0.05). Bone mineral density of the superior sacral endplate was higher than that of any other transverse layer. Columns near the lateral posterior and lateral anterior of the S1 body had the highest bone mineral density. In the ala, bone mineral density values of the internal columns (pedicle) were the highest. Screw insertion torque for bicortical purchase along the S1 pedicle correlated well with the bone mineral density of the S1 body (r = 0.67, P < 0.05). CONCLUSION: This study quantified the volumetric bone mineral density variations within the S1 body and ala, and a significant linear correlation between the screw insertion torque and bone mineral density was found. Optimal sacral screw insertion pathways were also outlined based on bone mineral density values.

Adult↗

A novel injectable bioactive bone cement for spinal surgery: a developmental and preclinical study.

The injection of bone cement by minimally invasive techniques for the treatment of vertebral body fractures or for stabilization of an osteoporotic vertebral body is regarded as promising in spinal surgery. The purpose of this study was to develop a novel injectable bioactive bone cement to address such concerns. The cement was composed mainly of strontium-containing hydroxyapatite (Sr-HA) filler and Bisphenol A Diglycidylether Dimethacrylate (D-GMA) resin. The Sr-HA filler was prepared by precipitation and calcination, then analyzed with Fourier transform infrared (FTIR) spectra and X-ray diffraction (XRD) patterns. Samples of strontium-containing hydroxyapatite cement (SrHAC) were formed by a combination of powder filler and resin matrix, with the setting time and peak temperature recorded. Cell relative growth rate (RGR), Tetrazolium bromide (MTT), and haemolysis tests were used to detect initial in vitro biocompatibility of the new cement. In vitro spinal biomechanical testing and morphological observation after bone cement injection were performed on pig spines. Results indicate that the setting time and peak temperature of the cement was 15 min and 55 degrees C, respectively. Cytotoxicity of the cement was class 1 (no cytotoxicity) and haemolysis was 1% (no haemolysis). Stiffness after cement injection and fatigue loading were 112% and 95% of the intact bone, respectively, which is similar to that of natural bone. Radiopacity of SrHAC allowed easy radiographic imaging. The use of SrHAC cement is, thus, promising in spinal surgery.

Animals↗

Loosening of sacral screw fixation under in vitro fatigue loading.

Sacral screw fixation is frequently used for fusion of the lower lumbar spine, but sacral screws appear to offer less secure fixation than lumbar pedicle screws, and failure due to loosening under fatigue loading is common. The aim of this study was to examine in vitro the stability of medial and lateral bicortical and unicortical sacral screw fixation under a physiologically relevant fatigue-loading pattern. Bone mineral density, screw insertion torque, and screw-fixation stiffness were measured prior to cyclic loading between 40 and 400 N compression at 2 Hz for 20,000 cycles. The screw-fixation stiffness was measured every 500 cycles, and the axial pullout strength of the screws was recorded following loading. All of the lateral insertions loosened under the applied loading, but some of the medial insertions remained stable. Medial insertions proved stiffer and stronger than lateral insertions, and bicortical fixations were stronger than unicortical fixations. Bone mineral density and insertion torque were correlated with screw stiffness and pullout strength, although better correlation was found for insertion torque than bone mineral density. Bone mineral density is a good preoperative indicator of sacral screw-fixation strength, and insertion torque is a good intraoperative indicator. An insertion torque greater than 1.5 Nm is suggested as an indicative value for a stable medial unicortical insertion, whereas an insertion torque greater than 2 Nm suggests a stable medial bicortical insertion. It appears that, apart from the choice of technique (screw orientation and depth), minimizing the load on the screws during the initial part of the fusion process is also critical to maintain stability of the fused section and to obtain a solid fusion mass.

Adult↗

Biomechanical properties of thin skin flap after basic fibroblast growth factor (bFGF) administration.

This study is designed to examine the effects of basic fibroblast growth factor (bFGF) administration on the biomechanical properties of thin skin flap healing. A total of 42 rats were used in this study, and skin flaps 10 cm long by 3 cm wide were raised in 28 rats. One injection of bFGF was applied at three different times (immediately postoperatively, and 24 h and 48 h postoperatively) between the flap and wound bed of 14 rats (the bFGF treated group), while the other 14 rats with flaps had the same tissue culture medium treatment but without bFGF (the untreated group). The remaining 14 rats without flaps constituted the control group (normal group). The rats were killed 10 days postoperatively, and 1. 0 cm x 6.0 cm sections of the skin flap taken for mechanical and histological testing. The load, deformation and tensile strength at failure were recorded. The average flap survival area in the bFGF treated group was 27 cm(2), significantly higher (P< 0.001) than that seen in the untreated group. The average elastic stiffness of the skin flap in the bFGF treated group was also observed to be higher than in the untreated group although this difference was not significant. The mean tensile strength of the bFGF treated group (61 N) was significantly higher than the untreated group (38 N, P< 0.01) however. Despite this, the tensile strengths at failure of both of these groups were found to be significantly lower than that of normal skin (101 N, P< 0.01). A relaxation in load of about 8% was seen in specimens from the normal group and the bFGF treated group, while the untreated group showed a relaxation of about 15%.

Animals↗

Bone mineral density variations along the lumbosacral spine.

Vertebral bone quality is essential in vertebral strength and the stability of spinal screw fixation. A major factor of bone quality is the density of bone mineral and its distribution throughout the bone. There have been studies regarding bone mineral density variations in the cervical and thoracolumbar spine, but bone mineral density variations in the lumbosacral spine have not been documented. The purpose of the current study was to quantify bone mineral density variations at different lumbosacral levels and within vertebra, especially along the pathways of lumbar pedicle screws. Bone mineral density variations within the vertebrae along the lumbosacral spine were measured in 13 specimens from young male cadavers using peripheral quantitative computed tomography. Measurements included bone mineral density variations at different lumbosacral levels and in transverse layers and vertical columns within each vertebral body. These original data showed that the bone mineral density increased gradually from lumbar to S1 vertebrae, possibly reflecting a caudally increasing load on different lumbosacral levels. The highest bone mineral density in the lumbosacral spine is found at the pedicles and regions closest to pedicle bases, supporting the use of pedicle screw fixation.

Adult↗

Age-related alteration of gap junction distribution and connexin expression in rat aortic endothelium.

We investigated endothelial gap junctions and their three component connexins, connexin37 (Cx37), Cx40, and Cx43, during growth and senescence in rat aorta by en face immunoconfocal microscopy and electron microscopy. Gap junction spots labeled by specific antisera against Cx37, Cx40, and Cx43 were quantified at 1 day, 7 days, 28 days, 16 months, and > or =20 months of age, and the relationship between the connexins was examined by co-localization analysis. At birth, all three connexins were abundantly expressed; the number and total area of connexin spots then declined within 1 week (p<0.05 for each connexin). From 1 week, each connexin showed a distinct temporal expression pattern. Whereas Cx43 signal decreased progressively, Cx37 signal fluctuated in a downward trend. By contrast, Cx40 maintained an abundant level until > or =20 months of age (> or =20 months vs. 28 days, p<0.05 for number and total connexin signal area). These patterns were associated with changes in endothelial cell morphology. Double-label analysis showed that the extent of co-localization of connexins to the same gap junctional spot was age-dependent [>70% at birth and 28 days old; <70% at later stages (p<0.05)]. We conclude that expression of the three connexins in aortic endothelium is age-related, implying specific intercellular communication requirements during different stages after birth.

Aging↗

Stability of the whole lumbar spine after multilevel fenestration and discectomy.

STUDY DESIGN: An investigation of the in vitro biomechanical effects of multilevel fenestrations and discectomies on the behavior of whole lumbar spine motion, using a material testing system (Instron 1341, Instron Limited, High Wycombe, England) and Elite three-dimensional motion analysis system (BTS, Milano, Italy). OBJECTIVES: To investigate the effects of multilevel fenestrations and discectomies on the stability of the whole lumbar spine, including segmental stiffness and sagittal (horizontal and vertical) translation. SUMMARY OF BACKGROUND DATA: In the management of lumbar spinal stenosis, wide decompressive laminectomy with partial or total facetectomy has been the standard procedure for multilevel nerve decompression. Main complications with these procedures have been instability and chronic pain syndrome. Multilevel fenestration with undermining enlargement of the spinal canal has been selected for multilevel nerve decompression in recent years. However, the biomechanical effects of multilevel fenestration and discectomy have been controversial and difficult to validate. This study investigated the in vitro biomechanical effects of multilevel fenestrations and discectomies on motion behavior of the whole lumbar spine. METHODS: Seven fresh human specimens from L1 to sacrum were used in this study. The fenestrations and discectomies consisted of L3-L4 bilateral fenestration, L4-L5 bilateral fenestration, L5-S1 bilateral fenestration, L4-L5 discectomy, and L5-S1 discectomy. Flexion, lateral bending, and axial rotation (torsion) loading were applied. Ranges of motion were determined two-dimensionally by the Elite system with an infrared camera. The postoperation results were compared with the intact conditions. RESULTS: After multiple fenestrations, the sagittal ranges of motion at L4-L5 increased by 18% anteroposteriorly and 16% vertically under the flexion loads. At L5-S1, the motions increased by 19% and 45%, respectively. After fenestrations and discectomies, the ranges of motion in the sagittal plane increased by 28% horizontally and 71% vertically at L4-L5, and 14% and 166% at L5-S1. Motion increases were statistically significant (P < 0.05) in vertical translations. However, after the multilevel surgeries, no significant motions were found in each of the lumbar segments during lateral bending and axial rotation. CONCLUSIONS: The results demonstrate that multilevel fenestrations and discectomies affect lumbar spinal stability in flexion, but have no effect on the stability of the lumbar spine in lateral bending or axial rotation.

Adult↗

Kinematics of the chest cage and spine during breathing in healthy individuals and in patients with adolescent idiopathic scoliosis.

STUDY DESIGN: The lung function test by a Plethysmograph enabled calculations to be made of the total lung capacity and vital capacity. A Motion Analysis System (Elite, BTS Inc., Milano, Italy) was used to observe and record chest cage and spinal movements and as to correlate lung function with the chest cage and spine kinematics. OBJECTIVES: To determine the three-dimensional kinematics and the shape and size changes of the chest cage and thoracic spine motion during deep breathing in healthy and scoliotic individuals. SUMMARY OF BACKGROUND DATA: Lateral flexion plus rotation of the involved vertebrae around a vertical axis causing a decrease in lung function is the main disfigurement of scoliosis. Reports show that even after spinal fusion, reduced vital capacity associated with an increased residual volume are detected. Factors such as angle of scoliosis, length of the spinal column involved, and duration of the deformity influence pulmonary function but do not significantly affect its reduction. Mechanical inefficiency during breathing has not been studied. METHODS: Three-dimensional kinematics of the chest cage and spine during breathing were studied in 41 scoliotic patients and in 20 healthy individuals. Three-dimensional chest cage motions relative to the spine and thoracic spine motions relative to T12 were calculated. To examine stiffness of the spine, lateral bending angles were calculated. The lung function test, which including spirometry and lung subdivision, also was performed for the scoliotic patients. RESULTS: Significant differences (P < 0.05) were found in the movements of the upper level of the chest cage in anteroposterior and vertical directions, ranging from 16.7 to 28.6 mm in healthy individuals and from 12.1 to 24.2 mm in scoliotic patients. The thoracic spine displayed two-dimensional movements posteriorly and vertically during breathing, whereas less movement was seen in scoliotic patients. In addition, overall the scoliotic spine showed signs of stiffness in lateral bending. CONCLUSIONS: The range of movement of the chest cage and spine is more limited in the scoliotic cases. This overall stiffness of the chest cage and the spine may contribute to the mechanical inefficiency and impairment of pulmonary function found in scoliotic patients.

Adolescent↗

Comparison of the strengths of lumbosacral fixation achieved with techniques using one and two triangulated sacral screws.

STUDY DESIGN: The strength of sacral screw fixation achieved with techniques using one sacral screw and two triangulated sacral screws with Chopin block was tested on 10 fresh human sacrum specimens. OBJECTIVES: To compare the stiffness and the failure strength of single sacral screw fixation and those of two divergent triangulated sacral screw fixation under different loading conditions. SUMMARY OF BACKGROUND DATA: Weak sacral screw fixation is the major cause of failure in instrumented lumbosacral fusion. Although previous studies have evaluated the strength of anteromedially and anterolaterally inserted sacral screws, the strength of two divergent triangulated sacral screws has not been evaluated biomechanically. It is assumed that increasing the number of sacral screws and using a triangulated insertion technique may increase the strength of purchase for lumbosacral fixation. METHODS: Ten fresh human sacrum specimens were used in this study. Six specimens were from donors less than 30 years of age (younger group), and the other four were from donors more than 60 years of age (aged group). The specimens were assigned randomly to either one side one S1 pedicle screw inserted anteromedially or to the other side with two screws directed anteromedially and anterolaterally. All specimens were tested with an Instron material testing machine (Instron Limited, High Wycombe, England). The average stiffness under compression, tension, and torsion were calculated from the average slopes of the load deformation curves. The failure load was applied for the final testing. RESULTS: The results showed significant differences in stiffness between fixation with one screw and fixation with two divergent triangulated screws. With one S1 pedicle screw fixation, the average stiffness was 203 N/mm for compression, 147 N/mm for tension, and 2 Nm/degree for torsion. With two-screw fixation the average stiffness increased to 255 N/mm (126%), 185 N/mm (126%) and 2.4 Nm/degree (120%), respectively. The average failure strength under tension loads was found to be 1450 N in the younger specimens and was reduced to 980 N in the aged specimens. CONCLUSION: This study showed that fixation with two divergent triangulated screws to the sacrum was significantly stronger than one-screw fixation for lumbosacral fusion. The strength of fixation seems to have a negative correlation with aging.

Adult↗

Electromyographic activity of the cervical musculature during dynamic lateral bending.

STUDY DESIGN: Electromyographic profiles from the neck muscles of five young, healthy men were obtained to study the muscular, activation patterns during dynamic external loading. OBJECTIVES: To examine the myoelectric activity of selected cervical muscles during dynamic loading, and to explore the reaction of the cervical muscles to different loading conditions. SUMMARY OF BACKGROUND DATA: The response of cervical muscles throughout dynamic external loading is not well understood. Electromyography provides information, within certain limitations, about the neural drive to various components of the musculature. Such information on activation, combined with geometric parameters of the musculoskeletal tissues, constitutes a tool for helping to understand the mechanism of head and neck impact-related injury. METHODS: Subjects were tested with the head and neck in the neutral and prebent positions. Dynamic loads were applied laterally to each subject by free-falling masses to create peak dynamic loads ranging from about 40 to 100 N. Force and electromyographic data were recorded, and cross-correlations from linear envelope electromyography were calculated. RESULTS: The peak electromyogram showed large differences between the two applied loads and between subjects. There were time delays (75-165 msec) between the peak applied force and the peak electromyogram. The muscles on the contralateral side demonstrated different electromyographic profiles between subjects. Within subjects, the electromyographic profiles from each muscle were consistent for the same trial conditions. CONCLUSIONS: Electromyographic profiles and the cross-correlator coefficients for cervical muscles have shown reproducible intrasubject muscle synergies, which were not sensitive to the magnitude of applied load and the posture of the head. Intersubject muscle activity patterns varied.

Adult↗

Fixation for comminuted phalangeal fractures. A biomechanical study of five methods.

The rigidities of five fixation methods have been studied with a comminuted phalangeal fracture model. Mechanical testing of compression, bending and torsion were performed for each fixation. Lateral plating with six screws seems to provide the most rigid fixation. If such lateral plating is not practicable, the four-Kirschner wire method would be a satisfactory alternative.

Biomechanical Phenomena↗

Colorimetric assay for lysine decarboxylase in Escherichia coli.

A new assay is described for lysine decarboxylase. It is rapid and reproducible in assaying large numbers of samples, a situation in which earlier methods were less convenient. The new method is valuable in the study of peptide fractions and amino acid mixtures which stimulate induction of lysine decarboxylase. It may be useful for work on enzyme structure and modification, genetics, and kinetics.

Amino Acids↗