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Principal-component amplitude compression for the hearing impaired.

Principal-component amplitude compression, a means for matching speech to the reduced dynamic range in sensorineural hearing impairments, is a multiband approach aimed at preserving details of spectral shape while reducing overall level variation. The effect of compression has been studied for the first and second principal components (PC1 an PC2) of the short-term speech spectrum, which are roughly representative of overall level and spectral tilt, respectively. Compression of PC1 roughly equalizes consonant and vowel levels while compression of PC2 provides time-varying high-frequency emphasis. The effect on speech intelligibility of sensorineural hearing-impaired listeners of two principal-component compression system implementations, compression of PC1 and compression of both PC1 and PC2, was compared to that of linear amplification (LA), independent compression of multiple bands (MBC), and wideband compression (WC). Results indicate that compression of overall level as provided by compression of PC1 and WC improved intelligibility relative to LA over a 10- to 15-dB range of input levels. While MBC was beneficial in some cases, it did not provide higher intelligibility than WC. Compression of PC2 did not benefit but rather degraded performance relative to LA. Error analyses and band-level measurements indicate that the highest intelligibility is obtained when audibility is improved and the relative spectral shapes of different speech sounds are preserved.

Auditory Threshold↗

Prophylaxis against deep venous thrombosis after total knee arthroplasty. Pneumatic plantar compression and aspirin compared with aspirin alone.

A prospective, randomized study was conducted to assess the efficacy of pulsatile pneumatic plantar compression for prophylaxis against deep venous thrombosis after total knee arthroplasty performed with use of regional anesthesia. One hundred and twenty-two patients (164 knees) who were scheduled to have a unilateral or a one-stage bilateral total knee arthroplasty were separately randomized to be managed with either aspirin alone or the pulsatile pneumatic plantar-compression device and aspirin. The prevalence of deep venous thrombosis was 27 per cent (twenty-two of eighty-one knees) in the group treated with pneumatic plantar compression compared with 59 per cent (forty-nine of eighty-three knees) in the patients managed with aspirin alone (the control group) (p < 0.001). A significant difference was also noted in the group that had had a unilateral arthroplasty (a prevalence of 27 per cent [eleven of forty-one knees] in the group treated with pneumatic plantar compression, compared with 67 per cent [twenty-six of thirty-nine knees] in that treated with aspirin alone; p < 0.006) and in the group that had had a one-stage bilateral procedure (a prevalence of 28 per cent [eleven of forty knees] in the group treated with pneumatic plantar compression, compared with 52 per cent [twenty-three of forty-four knees] in that treated with aspirin alone; p < 0.03). No proximal thrombi were noted in any patient who used the pulsatile pneumatic plantar-compression device, while the prevalence of proximal thrombosis in the popliteal or femoral veins was 14 per cent (twelve of eighty-three knees) in the group treated with aspirin alone (p < 0.0003). In the group treated with a unilateral procedure and aspirin alone the prevalence of proximal thrombosis was 13 per cent (five of thirty-nine knees; p < 0.02), while in the group treated with a bilateral procedure and aspirin alone it was 16 per cent (seven of forty-four knees; p < 0.01). Only in the patients who had had a unilateral procedure was use of the compression device associated with significantly less edema postoperatively than was use of aspirin alone. The change between the preoperative and postoperative circumferences of the thigh and leg was significantly less (9 +/- 4.1 millimeters [mean and standard deviation] less for the thigh [p < 0.01] and 6 +/- 3.9 millimeters less for the leg [p < 0.049]) with the compression device than with aspirin alone. In addition, there was significantly less mean drainage (98 +/- 61.1 milliliters) in the group treated with a unilateral procedure and pneumatic compression, compared with that treated with a unilateral procedure and aspirin alone (p < 0.041). An internal timer of the compression device was used to assess the compliance of the patient with use of the device, and a relationship between deep venous thrombosis and the total duration of treatment with the device was found. The patients in whom deep venous thrombosis did not develop used the device for a mean of 96 +/- 23.4 hours (range, sixty to 164 hours) postoperatively, or 19.2 +/- 5.1 hours a day, while those in whom thrombosis developed used it for a mean of 67 +/- 21.1 hours (range, twenty-six to 101 hours), or 13.4 +/- 4.3 hours a day (p < 0.001). No untoward effects were noted in any patient who used the device. This study confirms the safety and efficacy of pulsatile pneumatic plantar compression and aspirin compared with aspirin alone and supports the use of mechanical compression for prophylaxis against deep venous thrombosis and for reduction of edema in patients who have had a total knee arthroplasty. In addition, we found a direct relationship between compliance with the use of this device and its efficacy in reducing deep venous thrombosis.

Arthritis, Rheumatoid↗

Effects of fast-acting high-frequency compression on the intelligibility of speech in steady and fluctuating background sounds.

This study examines whether speech intelligibility in background sounds can be improved for persons with loudness recruitment by the use of fast-acting compression applied at high frequencies, when the overall level of the sounds is held constant by means of a slow-acting automatic gain control (AGC) system and when appropriate frequency-response shaping is applied. Two types of fast-acting compression were used in the high-frequency channel of a two-channel system: a compression limiter with a 10:1 compression ratio and with a compression threshold about 9 dB below the peak level of the signal in the high-frequency channel; and a wide dynamic range compressor with a 2:1 compression ratio and with the compression threshold about 24 dB below the peak level of the signal in the high-frequency channel. A condition with linear processing in the high-frequency channel was also used. Speech reception thresholds (SRTs) were measured for two background sounds: a steady speech-shaped noise and a single male talker. All subjects had moderate-to-severe sensorineural hearing loss. Three different types of speech material were used: the adaptive sentence lists (ASL), the Bamford-Kowal-Bench (BKB) sentence lists and the Boothroyd word lists. For the steady background noise, the compression generally led to poorer performance than for the linear condition, although the deleterious effect was only significant for the 10:1 compression ratio. For the background of a single talker, the compression had no significant effect except for the ASL sentences, where the 10:1 compression gave significantly better performance than the linear condition. Overall, the results did not show any clear benefits of the fast-acting compression, possibly because the slow-acting AGC allowed the use of gains in the linear condition that were markedly higher than would normally be used with linear hearing aids.

Adult↗

Compression volume in adult ventilator circuits: a comparison of five disposable circuits and a nondisposable circuit.

UNLABELLED: Although the concept of ventilator circuit compression is well known, it is not fully appreciated clinically. We compared the compression volume of five adult disposable ventilator circuits and a nondisposable circuit. METHODS: Five brands of disposable circuits (Inspiron, Intertech, Marquest, Seamless, and U-Mid) and one nondisposable brand (Bennett) were used. The circuits were attached to the outlet of a Bennett MA-1 ventilator in the standard manner, and the filter and humidifier were bypassed to eliminate their contribution to compression volume. The ventilator delivered 1 L of gas to a Michigan Instruments Test Training Lung at a flow of 60 L/min and a rate of 12/min. A valve system was placed between the Y-connector and the TTL to partition circuit compression volume from the volume delivered to the test lung. The compression factor was calculated by dividing the compression volume by the ventilating pressure. Five compliance settings were used on the TTL (0.1, 0.05, 0.03, 0.02, and 0.015 L/cm) to simulate different ventilating pressures. Pressure at the Y-connector, compressible volume, and volume delivered to the TTL were measured using a calibrated Timeter RT200 volume-pressure analyzer. Five measurements were made with each brand. A new circuit was used for each run with a disposable circuit, and a different circuit from the respiratory care department stock was used for each run with a nondisposable circuit. RESULTS: There were significant differences between the compression factors at different TTL compliance settings (p less than 0.001), and brands of circuits evaluated (p less than 0.001). There was a significant interaction effect for compression factors between TTL compliance setting and circuit brands (p less than 0.001). The compression factors for all disposable circuits were greater than the compression factors for the nondisposable circuits (p less than 0.05). CONCLUSIONS: There were differences in circuit compression factors as a function of the ventilating pressure and the brand of circuit. Although these differences are too small to be clinically important in many cases, they may be important during ventilation with low tidal volumes and high pressures.

Adult↗

Endoscopic ultrasonography to study the causes of extragastric compression mimicking gastric submucosal tumor.

BACKGROUND AND PURPOSE: Many reports have confirmed that endoscopic ultrasonography (EUS) can differentiate gastric submucosal tumor from extragastric compression, but only a few specifically concentrated on EUS in identifying the causes of external compression. MATERIALS AND METHODS: From May 1993 to May 2001, we used EUS in 238 patients to diagnose gastric submucosal tumor or external compression. We excluded 183 patients who had submucosal tumors and analyzed the remaining 55 patients with extragastric compression. Malignant causes of external compression were proved by surgery or biopsy. Benign causes of external compression were proved by other imaging examinations (abdominal ultrasound, computerized tomography, angiography) or surgery. Patients with external compression caused by normal organs were followed up with repeated upper gastrointestinal endoscopy or EUS. RESULTS: The stomach was compressed by normal extragastric organs in 32 patients (spleen 10, splenic vessel 6, gall bladder 9, liver 3, pancreas 3, and intestine 1), by benign pathologic lesions in 12 patients (liver cyst 7, liver hemagioma 2, splenic cyst 1, pancreatic cyst 1, pancreatic cystadenoma 1) and by malignant tumors in 5 patients (hepatoma 1, liver metastasis from colon cancer 2, pancreatic cystadenocarcinoma 1 and lymphoma of spleen 1). In the remaining six patients, neither submucosal tumor nor external compression was found during EUS examination and the external compression was considered transient. CONCLUSION: When an extragastric compression mimicking submucosal tumor is detected by upper gastrointestinal endoscopy, EUS is indicated to identify the cause of extragastric compression.

Adolescent↗

Double-level cauda equina compression: an experimental study with continuous monitoring of intraneural blood flow in the porcine cauda equina.

Compression of the spinal nerve roots may occur clinically at multiple levels at the same time; however, the basic pathophysiology of multi-level compression is largely unknown. In this study, the intraneural blood flow was analyzed continuously in the uncompressed segment between two compression balloons, with a pig used as an experimental model and a thermal diffusion method. At 10 mm Hg compression, there was a 64% reduction of total blood flow in the uncompressed segment compared with pre-compression values. Total ischemia occurred at pressures 10-20 mm Hg below the mean arterial blood pressure. After two-level compression at 200 mm Hg for 10 min, there was a gradual recovery of the intraneural blood flow towards the baseline. Recovery was less rapid and less complete after 2 h of compression. Double-level compression of the cauda equina can thus induce impairment of blood flow, not only at the compression sites, but also in the intermediate nerve segments located between two compression sites, even at very low pressures. These findings may have clinical importance in the understanding of the pathophysiology of multiple-level cauda equina compression.

Animals↗

Anisotropic strain-dependent material properties of bovine articular cartilage in the transitional range from tension to compression.

Articular cartilage exhibits complex mechanical properties such as anisotropy, inhomogeneity and tension-compression nonlinearity. This study proposes and demonstrates that the application of compressive loading in the presence of osmotic swelling can be used to acquire a spectrum of incremental cartilage moduli (EYi) and Poisson's ratios (upsilon ij) from tension to compression. Furthermore, the anisotropy of the tissue can be characterized in both tension and compression by conducting these experiments along three mutually perpendicular loading directions: parallel to split-line (1-direction), perpendicular to split-line (2-direction) and along the depth direction (3-direction, perpendicular to articular surface), accounting for tissue inhomogeneity between the surface and deep layers in the latter direction. Tensile moduli were found to be strain-dependent while compressive moduli were nearly constant. The peak tensile (+) Young's moduli in 0.15M NaCl were E+Y1=3.1+/-2.3, E+Y2=1.3+/-0.3, E+Y3(Surface)=0.65+/-0.29 and E+Y3(Deep)=2.1+/-1.2 MPa. The corresponding compressive (-) Young's moduli were E-Y1=0.23+/-0.07, E-Y2=0.22+/-0.07, E-Y3(Surface)=0.18+/-0.07 and E-Y3(Deep)=0.35+/-0.11 MPa. Peak tensile Poisson's ratios were upsilon+12=0.22+/-0.06, upsilon+21=0.13+/-0.07, upsilon+31(Surface)=0.10+/-0.03 and upsilon+31(Deep)=0.20+/-0.05 while compressive Poisson's ratios were upsilon-12=0.027+/-0.012, upsilon-21=0.017+/-0.07, upsilon-31(Surface)=0.034+/-0.009 and upsilon-31(Deep)=0.065+/-0.024. Similar measurements were also performed at 0.015 M and 2 M NaCl, showing strong variations with ionic strength. Results indicate that (a) a smooth transition occurs in the stress-strain and modulus-strain responses between the tensile and compressive regimes, and (b) cartilage exhibits orthotropic symmetry within the framework of tension-compression nonlinearity. The strain-softening behavior of cartilage (the initial decrease in EYi with increasing compressive strain) can be interpreted in the context of osmotic swelling and tension-compression nonlinearity.

Animals↗

JPEG compression of stereoscopic digital images for the diagnosis of diabetic retinopathy via teleophthalmology.

BACKGROUND: Canada's vast size and remote rural communities represent a significant hurdle for successful monitoring and evaluation of diabetic retinopathy. Teleophthalmology may provide a solution to overcome this problem. We investigated the application of Joint Photographic Experts Group (PEG) compression to digital retinal images to determine whether JPEG compression could reduce file sizes while maintaining sufficient quality and detail to accurately diagnose diabetic retinopathy. METHODS: All 20 patients with type 2 diabetes mellitus assessed at a 1-day teleophthalmology clinic in northern Alberta were enrolled in the study. Following pupil dilation, seven 30 degrees fields of each fundus were digitally photographed at a resolution of 2008 x 3040 pixels and saved in uncompressed tagged image file format (TIFF). The files were compressed approximately 55x and 113x their original size using JPEG compression. A reviewer in Edmonton randomly viewed all original TIFF images along with the compressed JPEG images in a masked fashion for image quality and for specific diabetic retinal pathology in accordance with Early Treatment Diabetic Retinopathy Study standards. The level of diabetic retinopathy and recommendations for clinical follow-up were also recorded. Exact agreement and weighted kappa statistics, a measure of reproducibility, were calculated. RESULTS: Exact agreement between the compressed JPEG images and the TIFF images was high (75% to 100%) for all measured variables at both compression levels. Reproducibility was good to excellent at both compression levels for the identification of diabetic retinal abnormalities (K = 0.45-1), diagnosis of level of retinopathy (kappa = 0.73-1) and recommended follow-up (kappa = 0.64-1). INTERPRETATION: The application of JPEG compression at ratios of 55:1 and 113:1 did not significantly interfere with the identification of specific diabetic retinal pathology, diagnosis of level of retinopathy or recommended follow-up. These results indicate that JPEG compression at ratios as high as 113:1 has the potential to reduce storage requirements without interfering with the accurate and reproducible teleophthalmologic diagnosis of diabetic retinopathy. This pilot project demonstrates the potential for JPEG compression within a digital teleophthalmology viewing system.

Adult↗

Decreased choline acetyltransferase activity in the murine spinal cord motoneurons under chronic mechanical compression.

The tiptoe-walking Yoshimura (twy) mouse is a model of chronic spinal cord compression caused by ossification of intraspinal ligaments. Choline acetyltransferase (CAT), which is known to be a specific marker of cholinergic neurons, best reflects spinal motoneuron function. Changes in CAT immunoreactivity following chronic spinal cord compression in twy mice were investigated quantitatively in order to elucidate spinal motoneuron functional changes according to the degree and direction of compression. Thirty 24-week-old twy mice were used in this study. They were divided into three groups according to the direction of spinal cord compression (anterior, posterior, and lateral) and the CAT immunoreactivities in whole sections of their upper cervical spinal cords were investigated quantitatively using a fluorescence microphotometry system. The lateral compression group showed histological spinal motoneuron atrophy and loss on the compressed, but not the non-compressed, side. Spinal motoneuron atrophy and loss were observed when the severity of spinal canal stenosis due to the ossified lesion, expressed as the occupation rate, was 30% or more, but the spinal motoneurons appeared normal when it was below 30%. The CAT immunofluorescence intensity of the anterior horn showed a linear negative correlation with the degree of canal stenosis. When the occupation rate was below 20%, the CAT immunofluorescence intensities in the anterior horns of the compression and control groups did not differ significantly. The CAT immunofluorescence intensity of twy mice with occupation rates of 20% or more were significantly lower than that of those with occupation rates below 20%. Furthermore, the CAT immunofluorescence intensity was significantly lower on the compressed than the non-compressed side of the lateral compression group. Thus, our findings indicate that an occupation rate of about 20% may be the critical level for functional changes in the spinal motoneurons.

Animals↗

Sympathetic activation and contribution of genetic factors in hypertension with neurovascular compression of the rostral ventrolateral medulla.

OBJECTIVE: The rostral ventrolateral medulla is an important center for the regulation of sympathetic and cardiovascular activities. Reportedly, neurovascular compression of the rostral ventrolateral medulla may be causally related to essential hypertension. We aimed to determine the mechanism behind elevated blood pressure in hypertensive patients with compression of the rostral ventrolateral medulla and to investigate whether genetic factors contribute to the etiology of hypertension with compression. DESIGN AND METHODS: The study included 56 patients with essential hypertension and 25 normotensive individuals. With the use of magnetic resonance imaging, the essential hypertension group was subdivided into hypertension with compression and without compression groups. We compared plasma levels of hormones that raise blood pressure and family histories of hypertension between the two hypertension groups and the normotension group. RESULTS: Plasma norepinephrine levels, but not plasma renin activity, aldosterone, epinephrine, or vasopressin levels, were significantly higher in the hypertension with compression group (389+/-53 pg/ml) than in the hypertension without compression group (217+/-38, P<0.05) or in the normotension group (225+/-30, P<0.05). The percentage of individuals who had two hypertensive parents was significantly higher in the hypertension with compression group (39.4%) than in the hypertension without compression group (13.0%, P<0.05) or in the normotension group (8.0%, P<0.01). CONCLUSIONS: These results indicate that neurovascular compression of the rostral ventrolateral medulla might be, at least in part, causally related to essential hypertension by increasing sympathetic nerve activity. They also suggest that genetic factors might contribute to the etiology of hypertension with neurovascular compression.

Alleles↗

Is the root entry/exit zone important in microvascular compression syndromes?

OBJECTIVE: Microvascular compression syndromes such as trigeminal neuralgia, hemifacial spasm, and disabling positional vertigo involve an artery or vein compressing a cranial nerve. A cranial nerve is composed of a central nervous system (CNS) segment and a peripheral nervous system (PNS) segment separated by the root entry/exit zone (REZ). Although vascular compression can occur at any point along the cranial nerve, it has been generally assumed that only vascular contact at the REZ of the affected cranial nerve can cause symptoms. On the basis of personal surgical experience, we propose that vascular compression of the CNS segment alone causes symptoms. This has important repercussions for the future diagnosis and treatment of microvascular compression syndromes, especially the cochleovestibular compression syndrome. METHODS: For the anatomic study, four autopsy specimens and one surgical biopsy specimen of the vestibulocochlear nerve were microscopically and ultramicroscopically analyzed for structural differences between the CNS and PNS segments. For the clinical study, five patients with the clinical picture of cochleovestibular compression syndrome were treated by microsurgical decompression at the level of the CNS segment and not the REZ. One patient underwent reoperation for recurrent symptoms 4 years later, and a 4-mm vestibular neurectomy was performed at that stage. We performed an epidemiological analysis to demonstrate that the known incidences of trigeminal neuralgia, hemifacial spasm, and glossopharyngeal neuralgia are related to the length of their respective CNS segments. RESULTS: Histological differences between the PNS and CNS segments suggest that the PNS segment is more resistant to compression. This was confirmed by neurophysiological data from intraoperative monitoring in posterior fossa surgery and experimental studies. We found a clear epidemiological correlation between the length of the CNS segment, which differed among cranial nerves, and the incidence of the microvascular compression syndrome. Successful decompression of the CNS segment in patients without compression at the REZ of the vestibulocochlear nerve for disabling positional vertigo provides clinical support for this hypothesis. CONCLUSION: The evidence we present supports the hypothesis that vascular compression syndromes arise from vascular contact along the CNS segment of the cranial nerves.

Blood Vessels↗

Effects of magnitude and duration of compression on spinal nerve root conduction.

Spinal nerve root compression occurs commonly in conditions such as herniated nucleus pulposus, spinal stenosis, and trauma. However, the pathophysiology of the symptoms and signs related to spinal nerve root compression is poorly understood. The purpose of the present study was to assess and compare effects of various pressures and durations of acute compression on spinal nerve root conduction in the pig cauda equina. Efferent conduction (compound motor action potentials) and afferent conduction (compound nerve action potentials) were monitored during compression for 2 or 4 hours with compression pressures of 0 (sham), 50, 100, or 200 mm Hg. Recovery from compression was monitored for 1.5 hours. No significant deficits in spinal nerve root conduction were observed with 0 or 50 mm Hg compression, compared to significant conduction deficits induced by 100 and 200 mm Hg compression. Three-way analysis of variance demonstrated significant effects of compression pressure and duration on conduction at the end of compression and recovery, with a significant difference between efferent and afferent conduction at the end of the recovery period. These observations suggest an interaction between biomechanical and microvascular mechanisms in the production of nerve root conduction deficits. Such information may relate to the motor and sensory dysfunction in clinical conditions associated with spinal nerve root compression.

Action Potentials↗

Chronic double-level cauda equina compression. An experimental study on the dog cauda equina with analyses of nerve conduction velocity.

STUDY DESIGN: Nerve conduction velocity was studied in the dog cauda equina subjected to chronic double-level compression. OBJECTIVES: To analyze the effects of chronic double-level cauda equina compression. SUMMARY OF BACKGROUND DATA: Double-level cauda equina compression produces more symptoms in patients and more changes in acute experimental set-ups than does single-level compression. However, there have been no controlled, experimental studies on chronic double-level compression. METHODS: A total of 20 dogs were anesthetized. Two balloons were placed under the lamina of the seventh lumbar vertebra and the first sacral vertebra, respectively. One week (10 mm Hg, n = 5; 0 mm Hg, n = 5) and 1 month (10 mm Hg, n = 5; 0 mm Hg, n = 5) after inflation with a viscous substance, nerve conduction velocity was studied by local electrical stimulation and recording of muscle action potentials in the tail muscles. RESULTS: Nerve conduction velocity was determined over the cranial balloon, the caudal balloon, and both balloons. The data were similar for all three recordings. After 1 week there was a significant reduction in nerve conduction velocity induced by 10 mm Hg, compared with that induced by 0 mm Hg, which showed normal conditions. However, after 1 month this initial reduction in nerve conduction velocity had recovered partially. The reduction was similar to that described for single-level compression in a previous study in which the same compression model was used. CONCLUSIONS: Unlike the acute situation, chronic double-level compression does not induce more changes than single-level compression after 1 week, although the recovery after 1 month of compression is less complete after double-level compression. This less complete recovery may be a result of an adaptation of the nerve tissue and the vascularization of the cauda equina nerve roots to the applied pressure.

Action Potentials↗

Experimental verification of the roles of intrinsic matrix viscoelasticity and tension-compression nonlinearity in the biphasic response of cartilage.

A biphasic-CLE-QLV model proposed in our recent study [2001, J. Biomech. Eng., 123, pp. 410-417] extended the biphasic theory of Mow et al. [1980, J. Biomech. Eng., 102, pp. 73-84] to include both tension-compression nonlinearity and intrinsic viscoelasticity of the cartilage solid matrix by incorporating it with the conewise linear elasticity (CLE) model [1995, J. Elasticity, 37, pp. 1-38] and the quasi-linear viscoelasticity (QLV) model [Biomechanics: Its foundations and objectives, Prentice Hall, Englewood Cliffs, 1972]. This model demonstrates that a simultaneous prediction of compression and tension experiments of articular cartilage, under stress-relaxation and dynamic loading, can be achieved when properly taking into account both flow-dependent and flow-independent viscoelastic effects, as well as tension-compression nonlinearity. The objective of this study is to directly test this biphasic-CLE-QLV model against experimental data from unconfined compression stress-relaxation tests at slow and fast strain rates as well as dynamic loading. Twelve full-thickness cartilage cylindrical plugs were harvested from six bovine glenohumeral joints and multiple confined and unconfined compression stress-relaxation tests were performed on each specimen. The material properties of specimens were determined by curve-fitting the experimental results from the confined and unconfined compression stress relaxation tests. The findings of this study demonstrate that the biphasic-CLE-QLV model is able to describe the strain-rate-dependent mechanical behaviors of articular cartilage in unconfined compression as attested by good agreements between experimental and theoretical curvefits (r2 = 0.966 +/- 0.032 for testing at slow strain rate; r2 = 0.998 +/- 0.002 for testing at fast strain rate) and predictions of the dynamic response (r2 = 0.91 +/- 0.06). This experimental study also provides supporting evidence for the hypothesis that both tension-compression nonlinearity and intrinsic viscoelasticity of the solid matrix of cartilage are necessary for modeling the transient and equilibrium responses of this tissue in tension and compression. Furthermore, the biphasic-CLE-QLV model can produce better predictions of the dynamic modulus of cartilage in unconfined dynamic compression than the biphasic-CLE and biphasic poroviscoelastic models, indicating that intrinsic viscoelasticity and tension-compression nonlinearity of articular cartilage may play important roles in the load-support mechanism of cartilage under physiologic loading.

Animals↗

Effects of expiratory rib cage compression and/or prone position on oxygenation and ventilation in mechanically ventilated rabbits with induced atelectasis.

INTRODUCTION: Expiratory rib cage compression is a chest physiotherapy technique known as "squeezing" technique in Japan. It has been claimed that rib cage compression effectively treats and/or prevents lung collapse, but no studies have been reported on rib cage compression focused on improving ventilation and/or oxygenation in subjects with collapsed lung. Therefore, we studied whether rib cage compression, with and without prone positioning, improves the ratio of P(aO)(2) to fraction of inspired oxygen (P(aO)(2)/F(IO)(2)), P(aCO)(2), or dynamic compliance of the respiratory system. METHODS: We used anesthetized adult rabbits with induced atelectasis. An endotracheal tube and an 18-gauge catheter were placed into the airway via a tracheostoma, and pressure-controlled mechanical ventilation was used. To create atelectasis, artificial mucus was infused into the airway via the catheter. The rabbits were randomly assigned to one of 4 groups ( = 10 in each group): (1) supine without rib cage compression, (2) supine with rib cage compression, (3) prone without rib cage compression, and (4) prone with rib cage compression. Each rib cage compression session lasted for 5 min and was repeated 5 times every 30 min. After these interventions for 180 min all animals were placed in the supine position for 120 min. RESULTS: The prone-position groups had significantly higher P(aO)(2)/F(IO)(2) than the supine-position groups at 60 min after the beginning of the intervention, and at 60, 90, and 120 min after the end of the intervention (p < 0.05). Rib cage compression did not significantly affect P(aO)(2)/F(IO)(2), P(aO)(2), or dynamic compliance. CONCLUSIONS: It is unlikely that rib cage compression re-expands collapsed lung. Prone positioning improved oxygenation in rabbits with induced atelectasis.

Animals↗

Compression of rat spinal cord in vitro: effects of ethanol on recovery of axonal conduction.

The effect of ethanol on recovery of neural conduction after spinal cord compression was evaluated in an isolated rat spinal cord preparation. Controlled compression of 50 to 75 percent of the cord cross-section was delivered using a piezoelectric translator. Postcompression compound action potential (CAP) amplitude, latency, and refractory periods were measured relative to pre-compression values. Recovery of CAP's was compared for spinal cords exposed to ethanol in vitro (100 mg/dl bath concentration, started one hour prior to compression) versus those maintained in normal artificial CSF. The in vitro effects of ethanol were evaluated on spinal cords from rats maintained on a normal diet and from those repeatedly intoxicated with ethanol for 15 days prior to the acute experiment. Compression of the cord resulted in an immediate 68% decrease in CAP peak amplitude and an increase in latency (171%) and refractory period (256%). In normal bathing medium, CAP amplitude recovered to 83% of pre-compression values 180 minutes after compression. The addition of ethanol to the artificial CSF did not directly affect CAP parameters, but combined with compression, CAP amplitude recovered to only 42% of pre-compression values 180 minutes after impact (p less than .01). Recovery was less affected by acute ethanol exposure in cords from ethanol pretreated animals. CAP amplitude recovered to 83% of pre-compression levels and was not different from compression-only recovery (p less than 0.10). The data suggest that direct effects of ethanol on axonal membranes may affect the sensitivity of axons to mechanical trauma or their capacity to recover normal function. Since spinal cords from repeatedly exposed animals are less sensitive to the acute effects of ethanol, ethanol may be acting to "fluidize" the axonal membrane.

Alcoholic Intoxication↗

Effect of data compression on quantitative coronary measurements.

Digital coronary and left ventricular angiography demand high transfer rates and very large data storage if all the clinical data are to be achieved. If appropriate compression schemes were available without compromising the quality and resolution of the image data, such demands could be lessened. In this study we compared the influence of different compression factors of the Adaptive Real Time Image Compression (ARTIC) scheme used on the Philips DCI-SX systems on coronary measurements assessed with the Automated Coronary Analysis (ACA) package. Loss-free acquired images of size 512(2) x 8 bits, which had been stored digitally on tape, were reloaded into the DCI with compression factors of 2, 3, and 4; only the factor 2 is loss free. To evaluate the effect of the different data compressions on the accuracy of the measurements, the diameters of a vessel phantom (tube sizes ranging from 0.687 to 5.062 mm) were determined. To evaluate the reproducibility of the results, the intraobserver variability was determined for the different compression factors from 40 coronary obstructions. The differences in the reference diameter measurements of the vessel phantom were -0.03 +/- 0.06 mm, 0.01 +/- 0.07 mm, and 0.04 +/- 0.08 mm for the compression factors 2 (loss free), 3, and 4, respectively. The results were not statistically significantly different. The intraobserver variabilities in the obstruction diameter measurements of the coronary obstructions were -0.04 +/- 0.13 mm, 0.00 +/- 0.14 mm, and 0.02 +/- 0.13 mm for the compression factors 2, 3 and 4, respectively. The intraobserver variabilities in the reference diameter measurements were -0.02 +/- 0.12 mm, 0.01 +/- 0.09 mm, and 0.03 +/- 0.09 mm for the compression factors 2, 3, and 4, respectively. The intraobserver variabilities of the percent diameter stenosis were 0.96 +/- 4.19%, -0.01 +/- 4.88% and -0.04 +/- 4.68% for the compression factors 2, 3, and 4, respectively. None of these differences were statistically significant. Both from a qualitative and quantitative point of view, data compression factors 3 and 4 are acceptable in digital coronary arteriography.

Coronary Angiography↗

Biosynthetic response of cartilage explants to dynamic compression.

The biosynthetic response of calf articular cartilage explants to dynamic compression was examined over a wide range of amplitudes, waveforms, and frequencies. Glycosaminoglycan synthesis was assessed by 35S-sulfate incorporation, and amino acid uptake and protein synthesis were assessed by 3H-proline incorporation. Two culture chambers were designed to allow uniaxial radially unconfined compression and mechanical testing of cartilage disks: one chamber was used inside a standard incubator; the other was used with a mechanical spectrometer and allowed load and displacement to be monitored during compression. Dynamic stiffness measurements of 3-mm diameter disks identified a characteristic frequency [0.001 Hz (cycles/sec)] that separated low- and high-frequency regimes in which different flow and deformation phenomena predominated; e.g., at 0.0001-0.0001 Hz, significant fluid was exuded from cartilage disks, whereas at 0.01-1 Hz, hydrostratic pressure increased within disks. At the higher frequencies, oscillatory strains of only approximately 1-5% stimulated 3H-proline and 35S-sulfate incorporation by approximately 20-40%. In contrast, at the lower frequencies (a) compressions of less than 5% had no effect, consistent with the dosimetry of biosynthetic inhibition by static compression (approximately 25% compression caused a approximately 20% inhibition of radiolabel incorporation), and (b) higher amplitudes (cycling between disk thicknesses of 1.25 and 0.88-1.00 mm) stimulated 3S-sulfate incorporation by approximately 20-40%, consistent with the kinetics of response to a single 2-h compression and release. None of the compression protocols was associated with detectable alterations in (e.g., compression-induced depletion of) total glycosaminoglycan content. This study provides a framework for identifying both the physical and biological mechanisms by which dynamic compression can modulate chondrocyte biosynthesis. In addition, the culture and compression methodology potentially allows in vitro evaluation of clinical strategies of continuous passive motion therapy to stimulate cartilage remodeling.

Animals↗