Ultrasound Transient Shear Wave Elasticity Imaging for Tendon Tissue

Degeneration of tendon tissue is a common cause of tendon dysfunction with the symptoms of repeated episodes of pain and palpable increase of tendon thickness. Tendon mechanical properties are directly related to its physiological composition and the structural organization of the interior collagen fibers which could be altered by tendon degeneration due to overuse or injury. Thus, measuring mechanical properties of tendon tissue may represent a quantitative measurement of pain, reduced function, and tissue health. Ultrasound elasticity imaging has been developed in the last two decades and has proved to be a promising tool for tissue elasticity imaging. To date, however, well established protocols of tendinopathy elasticity imaging for diagnosing tendon degeneration in early stages or late stages do not exist. This thesis describes the re-creation of one dynamic ultrasound elasticity imaging method and the development of an ultrasound transient shear wave elasticity imaging platform for tendon and other musculoskeletal tissue imaging. An experimental mechanical stage with proper supporting systems and accurate translating stages was designed and made. A variety of high-quality tissue-mimicking phantoms were made to simulate homogeneous and heterogeneous soft tissues as well as tendon tissues. A series of data acquisition and data processing programs were developed to collect the displacement data from the phantom and calculate the shear modulus and Young’s modulus of the target. The imaging platform was found to be capable of conducting comparative measurements of the elastic parameters of the phantoms and quantitatively mapping elasticity onto ultrasound B-Mode images. This suggests the system has great potential for not only benefiting individuals with tendinopathy with an earlier detection, intervention and better rehabilitation, but also for providing a medical tool for quantification of musculoskeletal tissue dysfunction in other regions of the body such as the shoulder, elbow and knee.

A Rubber Band Around an Atlantic Croaker

A rubber band permanently girdled an Atlantic croaker, Micropogon undulatus, resulting in considerable malformation and pathological alterations of the fish. On 12 July 1973 at Graveline Bayou, Jackson County, Mississippi, Mrs. Buster Blades caught on hook and line a 175 mm standard length (102.1 g) croaker that she immediately separated from the rest of her catch as a suspected parasitized fish. Later upon closer examination, she realized that a rubber band encircled the fish, and so she brought the fish to us. The band had deformed the prepelvic isthmus, restricted movement of the pectoral fins, and permanently encircled the fish through a hole in the dorsum. Much of the elasticity was lost, but the band was entire and free to rotate through the perforation below the first dorsal fin. The tissue above the perforation, including the tissue of the dorsal fin, was complete and not severed, although several scales were regenerated. These observations, in addition to the malformed ventral area, suggest a lengthy association between band and fish.

A Response to Seth H. Giertz

There are two aspects of Seth Giertz's excellent chapter that I want to talk about. One is slightly technical; I want to try to provide some explanation for why estimating elasticity of taxable income (ETI) is so difficult. I think this difficulty is unappreciated by nonspecialists, who are quick to latch onto a favorite estimate without understanding the weaknesses in the estimation. The other aspect is a bit more philosophical and addresses the different functions of the partial equilibrium analysis done here and the general equilibrium work done a few years back in the macro group at the Congressional Budget Office (CBO). Perhaps surprisingly, I strongly endorse the partial equilibrium approach taken here for the comparison of tax reforms.